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To develop and psychometrically test a comprehensive Cancer Nurse Self-Assessment Tool (CaN-SAT).
Modified Delphi to assess content validity and cross-sectional survey to assess reliability and validity.
Phase 1: An expert group developed the tool structure and item content. Phase 2: Through a modified Delphi, cancer nursing experts rated the importance of each element of practice and assessed the relevance and clarity of each item. Content Validation Indexes (CVI) were calculated, and a CVI of ≥ 0.78 was required for items to be included. Phase 3: Cancer nurses participated in a survey to test internal consistency (using Cronbach's alpha coefficients) and known-group validity (through Mann–Whitney U tests). This study was reported using the Guidelines for Reporting Reliability and Agreement Studies (GRRAS) checklist.
The CaN-SAT underwent two rounds of Delphi with 24 then 15 cancer nursing experts. All elements of practice were rated as important. Only three items achieved a CVI < 0.78 after round one; however, based on open-ended comments, 26 items were revised and one new item added. After round two, all items received a CVI above 0.78. The final tool consisted of 93 items across 15 elements of practice. Cronbach's alpha coefficients were between 0.92 and 0.98 indicating good reliability. Mann–Whitney U tests demonstrated significant differences between clinical nurses and advanced practice nurses across 13 out of 15 elements of practice.
The CaN-SAT is a comprehensive, valid and reliable tool that can be used for cancer nurses to self-assess current skill levels, identify their learning needs and inform decisions about educational opportunities to optimise cancer care provision.
The research team included three patient advocates from Cancer Voices NSW, who were actively involved in all aspects of the study and are listed as authors.
Qualitative research offers unparalleled insights into complex human experiences. The rigour of qualitative data analysis is critical to ensuring credible and actionable findings.
Different qualitative methodologies offer unique lenses to explore human experiences. However, challenges such as context dependency and potential biases necessitate alignment between research aims, analytical strategies and ethical practices to preserve participant voices and ensure methodological rigour.
This narrative review synthesises foundational qualitative methodologies and recent research, offering practical strategies to address challenges in data analysis within nursing and health-related research.
Robust qualitative analysis requires clear analytical aims, reflexivity and ethical integrity. We explore common pitfalls, such as superficial analyses and a lack of transparency, while emphasising the role of rigorous methodologies in ensuring validity, reliability and meaningful findings.
Rigour in qualitative analysis transforms research into actionable insights, informing culturally sensitive care, evidence-based interventions and nursing education. High-quality analysis strengthens the discipline and improves patient outcomes.
Qualitative research demands meticulous and ethical analysis to unlock its full potential. Nurse researchers can deliver findings that drive impactful change in healthcare practice and policy by prioritising analytical rigour and transparency.
No Patient or Public Contribution.
This study validated and adapted the Multidimensional Nursing Generations Questionnaire to a Polish context and assessed its accuracy and reliability among Polish nurses.
A cross-sectional psychometric study.
The Multidimensional Nursing Generations Questionnaire was translated, culturally adapted and validated through a structured process involving expert panel reviews, pilot testing and psychometric validation using exploratory and confirmatory factor analyses. The study included 850 Polish nurses actively working in various healthcare settings for over 3 months. Reliability and construct validity were assessed using Cronbach's alpha. Data collection took place over 5 months (December 2022–April 2023).
The validated questionnaire contains six subscales and 43 items. High reliability was observed across all subscales, with consistent psychometric performance. The tool demonstrated strong cultural and conceptual alignment for assessing generational differences in Polish nursing teams.
The questionnaire is a reliable and valid instrument for evaluating generational diversity in nursing teams. Its application can facilitate targeted management strategies, foster collaboration and improve job satisfaction, particularly in multigenerational healthcare environments.
The questionnaire offers a practical tool for healthcare managers to address generational diversity, thereby enhancing team dynamics, reducing turnover and improving the quality of care delivery. It supports evidence-based management and education practices tailored to generational needs.
This study develops a culturally adapted, psychometrically robust tool for assessing generational differences in Polish nursing teams. Findings have significant implications for workforce management, education and policy-making, enabling strategies to improve team collaboration, nurse satisfaction and patient outcomes in Poland and globally.
This study adhered to the COnsensus-based Standards for the selection of health Measurement INstruments guidelines for the translation, cultural adaptation and psychometric validation of health measurement instruments, ensuring methodological rigour and transparency.
This paper discusses data errors and offers guidance on data cleaning techniques, with a particular focus on handling missing values and outliers in quantitative datasets.
Methodological discussion.
This paper provides an overview of various techniques for identifying and addressing data anomalies, which can arise from incomplete, noisy, and inconsistent data. These anomalies can significantly affect data quality, leading to biased model parameter estimates and evidence-based decisions. Data cleaning, particularly the appropriate handling of missing values and outliers, is essential to improving data quality before analysis. Data cleaning includes screening for anomalies, diagnosing errors, and applying appropriate corrective measures.
Proper handling of missing values and the identification and correction of outliers are crucial aspects of data cleaning in ensuring data quality and the reliability of statistical analyses. Effective data cleaning enhances the validity and accuracy of research findings for evidence-based decision making that leads to optimal patient outcomes.
The quality of study results depends on how a dataset and its complexities are processed or handled before the analysis. Nursing researchers must use a framework to identify and address important data anomalies and produce reliable results.
This paper describes data cleaning, often overlooked during the data mining process, as a crucial step before conducting data analysis. By addressing missing values and outliers, identifying and fixing data anomalies, and enhancing data quality prior to analysis, data cleaning techniques can produce precise research findings for evidence-based decision making.
In this methodological paper, no new data were generated.
No patient or public contribution.
This paper explores the methodological challenges associated with cross-cultural validation of clinical assessment measures and proposes strategies to enhance the validity and reliability of these assessments.
Methodological discussion.
Three main phases require consideration in the cross-cultural validation of assessment instruments: (1) Linguistic translation of the assessment instrument and confirmation of its equivalence, which includes conceptual, item, semantic and operational equivalence; (2) Empirical validation of the translated version's accuracy; (3) Adjusting the scores to fit the cultural context.
Achieving cross-cultural equivalence of assessment instruments is a complex and challenging process that can only be achieved through methodological rigour. It requires interdisciplinary collaboration of both linguistic and subject experts with strong statistical knowledge and a willingness to explore the nuances of the target population. By enhancing methodological rigour, we can improve the validity of clinical assessment measures across cultures, ultimately leading to better health outcomes for diverse populations.
The implications of cross-cultural validation of clinical assessment measures/tools for nursing are significant and multifaceted. Overcoming challenges to cross-cultural validation contributes to the professional growth of nurses by equipping them with greater cultural awareness and confidence in the tools' reliability for patient assessment and evaluation. This not only aids in their clinical practice but also fosters a commitment to evidence-based practice, enhancing their overall effectiveness as healthcare providers. Reliable and valid assessment tools enable nurses to confidently engage in research literature that reflects the realities of diverse populations. This can inform healthcare policies and practices, ensuring they are inclusive and equitable.
While researchers endeavour to reach a consensus on the definition of cross-cultural equivalence and how it should be determined, this practical introduction discusses challenges and proposes strategies to enhance the validity and reliability of these measures/tools.
No patient or public contribution.
To discuss reflexivity for conducting hermeneutic phenomenology and to present the hermeneutic phenomenological circle.
Discussion paper.
We employed data on the lived experience of loneliness of older adults in residential care homes during the COVID-19 pandemic to demonstrate the reflexivity required for hermeneutic phenomenology. We showcased a reflective process grounded in Heidegger's notions of Being and temporality to uncover the context of meaningfulness and its temporal influence on being.
We proposed a hermeneutic phenomenological circle encompassing four relations passing between Being, the interpreter and being. The circle was successfully applied to demonstrate the reflexivity required to conduct hermeneutic phenomenology.
Engaging in reflexivity requires the researcher to develop knowledge about the philosophy of hermeneutic phenomenology. The hermeneutic phenomenological circle facilitates researchers in anchoring their reflections in Being and temporality.
The hermeneutic phenomenological circle serves as a useful tool for researchers/health professionals to learn hermeneutic phenomenology and to facilitate researchers/health professionals at all career stages to engage in reflexivity.
To provide insights into the challenges and benefits of being an insider nurse researcher in case study research. To describe strategies used to maintain rigour and trustworthiness when conducting insider research.
Case study with insider research methodology was used to evaluate a nurse-led supportive care model for patients with Chronic Obstructive Pulmonary Disease and their caregivers.
This paper reports a reflection on using insider research within a clinical context, utilising reflexive techniques such as journaling and discussions with academic supervisors to mitigate subjectivity. Informed consent and confidentiality were maintained to ensure ethical integrity.
The study found that insider research offers both challenges and benefits. The established therapeutic relationship with patients and caregivers provided a deep understanding but also posed risks of assumptions, role conflict, and bias toward positive responses.
Insider research was effective in evaluating a nurse-led model of care, providing unique insights from patients and caregivers. This discussion demonstrates the importance of reflexive practices and maintaining ethical rigour to balance roles and manage potential biases. The paper highlights both the challenges and benefits of insider research that may be helpful for other researchers.
This study highlights the value of insider research in a nursing context, demonstrating how nurses can leverage therapeutic relationships to enhance patient and caregiver voices to inform evidence-based practice. It also provides practical guidance for researchers on reflexive practices to manage the potential for bias and role conflicts, and the maintenance of ethical standards to ensure the integrity and trustworthiness of the research process.
The study addressed the challenges and benefits of being an insider nurse researcher in the context of evaluating a nurse-led supportive care model for patients with COPD and their caregivers. While insider research can provide unique insights, it also poses risks of assumptions, role conflict, and bias. This paper describes how these can be mitigated through reflexive techniques and integration of outsider perspectives. Established nurse–patient therapeutic relationships facilitated deeper understanding in a research setting; however, they require careful management to avoid bias. Ethical integrity was maintained through informed consent, confidentiality, and reflexive journaling. The research will impact patients and caregivers by improving their access to timely and comprehensive supportive and palliative care and offers valuable strategies for other nurse researchers to enhance the quality and trustworthiness of insider research.
The development of the model of care in this study is informed by ongoing evaluation from patients with COPD and their caregivers.
To reflect on ethnography as a qualitative research methodology in nursing, examining its conceptual, theoretical and practical applications. It offers insights into its effective adoption in nursing research, particularly in culturally diverse healthcare settings, emphasising the integration of ethnonursing and critical ethnography.
This methodological reflection draws on the author's research experience and extensive review of ethnography's principles and practices.
This paper examines key components of ethnography, including participant observation, semi-structured interviews and field notes. Ethical considerations, data analysis processes and strategies to ensure trustworthiness and reflexivity are discussed. Special attention is given to the application of ethnonursing in culturally specific care and the use of critical ethnography to analyse power dynamics and institutional structures.
Ethnography, particularly ethnonursing and critical ethnography, provides an invaluable framework for understanding healthcare's cultural and social dynamics. The paper presents reflections on methodological challenges encountered during an ethnographic study of neonatal intensive care units in Jordan, offering practical insights for nursing researchers.
Ethnography enables nursing researchers to explore the complexities of human experiences within cultural contexts, contributing to the advancement of culturally informed and evidence-based nursing practices. The combination of ethnonursing and critical ethnography enhances the ability to uncover both cultural influences on care and the structural factors shaping healthcare experiences.
This paper provides methodological insights that can guide nursing researchers to adopt ethnography effectively, promote culturally sensitive care that aligns with patients' social and cultural needs, and contribute to healthcare equity and improved patient outcomes.
This paper follows the COREQ (Consolidated Criteria for Reporting Qualitative Research) guidelines.
No patient or public contribution.
To investigate the current status of workplace spirituality and moral resilience among clinical nurses and to explore the relationship between these two factors, thereby providing a reference for developing strategies to enhance nurses' moral resilience.
A cross-sectional survey design.
From February to April 2025, a convenience sampling method was used to select 1680 nurses from ten hospitals in the Pingliang area of China. Data were collected using the general data questionnaire, Workplace Spirituality Scale(WSS). Furthermore, the relationship between workplace spirituality and moral resilience was analyzed.
A total of 1657 valid questionnaires were ultimately recovered, yielding an effective response rate of 98.63%. The mean score for workplace spirituality was 102.36 ± 21.65, and the mean score for moral resilience was 41.76 ± 6.31, both indicating a moderate level. A significant positive correlation was found between the two variables (r = 0.231, p < 0.05). Multivariate linear stepwise regression analysis revealed that monthly income, department, monthly night shifts, and workplace spirituality scores were significant predictors of moral resilience (p < 0.05).
The moral resilience of clinical nurses is at a moderate level. Enhancing workplace spirituality can contribute to improving their moral resilience.
The main purpose of this hypothesis-driven study was to assess levels of change fatigue, adaptive performance and organisational support among ICU nurses; to explore the effects of change fatigue and organisational support on adaptive performance; and to examine the mediating role of organisational support in the relationship between change fatigue and adaptive performance.
A multi-site, cross-sectional survey.
From February to April 2025, 621 ICU nurses from 12 public secondary and tertiary hospitals in Guizhou, Zhejiang, Anhui and Hebei Provinces were recruited via convenience sampling. A questionnaire assessed their change fatigue, perceived organisational support and adaptive performance.
The surveyed ICU nurses in this study exhibited moderate change fatigue, adaptive performance and perceived organisational support. Change fatigue was negatively correlated with both adaptive performance and perceived organisational support (both p < 0.05), while adaptive performance was positively correlated with perceived organisational support (p < 0.05). Perceived organisational support mediated between change fatigue and adaptive performance, accounting for 29.17% of the total effect.
The level of change fatigue can directly affect adaptive performance and influence it indirectly through the mediating role of organisational support. Managers should establish a multidimensional organisational support system to enhance the adaptive performance of ICU nurses.
The findings of this cross-sectional study suggest administrators provide both instrumental and emotional support to ICU nurses to mitigate change fatigue, and recommend implementing resource depletion alert systems and adopting targeted interventions.
No patient or public contribution. This study did not involve patients, service users, caregivers or members of the public.
To explore the mediating effect of team job crafting on the transformational leadership–occupational well-being association in newly graduated nurses.
A multicentre cross-sectional study was conducted in three tertiary hospitals in China. Using convenience sampling, 677 newly graduated nurses were recruited between August 2024 and September 2024, and completed the transformational leadership questionnaire, team job crafting scale for nurses, and healthcare providers' occupational well-being scale. Data analysis was performed using IBM SPSS 27.0 software and the PROCESS 4.2 plugin. Hayes' mediation model (Model 4) was employed to test the indirect effect. The significance of the mediating effect was assessed using the bias-corrected bootstrap method (5000 resamples).
Ultimately, 546 valid questionnaires were collected. The participants' transformational leadership, nurse team job crafting and healthcare providers' occupational well-being scores were all above average. Linear regression analysis revealed that transformational leadership and team job crafting positively predicted occupational well-being (β = 0.549, p < 0.001; β = 0.695, p < 0.001). Mediating analysis revealed that the indirect effect of transformational leadership on occupational well-being was 0.276 (95% confidence interval: 0.174, 0.377), indicating the presence of an indirect effect. Additionally, team job crafting accounted for 33.5% of the effect of transformational leadership on occupational well-being.
Perceived transformational leadership among newly graduated nurses could positively influence their occupational well-being, with team job crafting playing a partial mediating role between the two. Therefore, it is recommended that nursing managers strengthen their transformational leadership practices to promote the accumulation and internalisation of job resources among newly graduated nurses, thereby enhancing their ability and level of team job crafting and further promoting their occupational well-being.
To highlight how Longitudinal Experiential Concepts can be used as conceptual anchors within Longitudinal Interpretative Phenomenological Analysis to gain temporal interpretative phenomenological insights, a lack of which can be a criticism levelled at novice nurse or midwife researchers utilising phenomenological research methods.
Longitudinal Experiential Concepts were utilised as a novel methodological adjunct to Longitudinal Interpretative Phenomenological Analysis in a study of the lived experience of perinatal anxiety by a midwife researcher.
Longitudinal Experiential Concepts were identified following assimilation of Group Experiential Themes and while building the interpretative narrative account across all three data collection time points, with reflexive annotations facilitating their formulation.
Within a longitudinal vertical (by time point) analysis, Longitudinal Experiential Concepts can add a horizontal view, giving a contemporaneous and dynamic perspective on the experiential threads woven throughout the temporal experience. Use of these conceptual anchors, enabled with reflexive prompts, can prevent the fragmentation that potentially occurs when examining moments in time in Longitudinal Qualitative Research, facilitate clarity in the temporal view of the whole phenomenon and enable phenomenological insights.
A novel addition to the Longitudinal Interpretative Phenomenological Analysis method, Longitudinal Experiential Concepts as conceptual anchors can encourage deeper holistic thinking about the less immediately obvious facets of experience and temporal progression and give the novice nurse or midwife researcher a means to robustly access the phenomenological attitude. These principles may be applicable more broadly within other Longitudinal Qualitative Research approaches.
The use of Longitudinal Experiential Concepts in Longitudinal Interpretative Phenomenological Analysis can enable nurses, midwives, and other clinical health researchers to produce high-quality, robust longitudinal phenomenological research. This is important due to the popular use and value of these methods aiming to generate new understanding of health conditions and improve patient care.
Patients and members of the public were involved in the design of the original research study. Their contributions included reviewing study plans, ensuring the research was in line with the priorities of women experiencing poor perinatal mental health, guiding the researchers on the acceptability of the proposed approach to recruitment and data collection and reviewing participant information and study marketing materials. We gratefully acknowledge Get Me Out the Four Walls, Norfolk, for their support enabling this.
Despite extensive research on doctoral education, reliable tools to measure how writers' development relates to participation in social interventions such as writing groups are lacking. To address this, we conducted a study to create and evaluate a measurement tool for assessing the impact of writing group interventions on writers' development.
This methodology paper reports on the design, content validity, and evaluation of a new survey tool: the Doctoral and Academic Writing in Nursing, Midwifery, and Allied Health Professional writing questionnaire (DAWNMAHP).
We created a pool of 39 items based on empirical articles from SCOPUS, ERIC, BEI, ZETOC, CINAHL, EBHOST, and PsycINFO, our experience, and stakeholder consultations. After a content validity assessment by writing experts, we revised the pool to 44 items in five domains. Finally, we tested it on doctoral writing workshop attendees using factor analysis, Pearson correlations, and Cronbach's Alpha evaluation.
Thirty-six participants completed the DAWNMAHP survey tool: 22 doctoral students, seven early-career researchers, and seven participants on a designated pre-doctoral pathway. Cronbach's Alpha evaluation demonstrated good reliability (α > 0.70) for all five factors. This sample was deemed moderately sufficient (KMO = 0.579), and the items were loaded onto the five factors with all items' factor loadings > 0.5 through principal component analysis.
DAWNMAHP is a novel, reliable tool that measures the impact of writing group interventions on an individual writer's development concerning time management, the writing process, identity, social domains, and relational agency.
Conducting pre- and post-writing group intervention tests and recruiting larger sample sizes is essential to further developing DAWNMAHP. It is a rigorous tool for researching the benefits of writing group interventions. Furthermore, DAWNMAHP is an effective assessment and measurement tool, making a novel contribution to research into doctoral education.
No patient or public involvement was necessary at the validation stage of the DAWNMAHP tool.
To translate, cross-culturally adapt, validate and psychometrically test the MISSCARE Survey–Patient for assessing patients' perspectives on missed nursing care (MNC) in a Danish hospital setting.
A two-phase cross-cultural adaptation and psychometric validation study.
The study was conducted in two phases. First, the MISSCARE Survey–Patient was cross-culturally adapted to ensure its relevance in a Danish hospital context. This phase involved translation and back-translation, expert committee reviews and cognitive interviews with 18 inpatients to establish content validity. Second, a convenience sample of 284 patients from surgical and medical departments completed the adapted survey. Psychometric properties were evaluated using structural equation modelling to test a second-order formative model.
The cross-cultural adaptation phase led to minor and substantial revisions, including the addition of six new items to enhance content validity. These items addressed aspects of nursing care relevant to patients in the contemporary hospital setting that were not captured by the original survey. Structural equation modelling confirmed the second-order formative model and demonstrated robust psychometric properties.
The MISSCARE Survey–Patient was successfully adapted and validated for use in Danish hospitals, ensuring strong content validity and psychometric robustness.
The Danish version of the survey provides a valuable tool for assessing MNC from patients' perspectives in hospital settings. Its use can help identify specific areas where nursing care falls short, guiding targeted initiatives to enhance care quality and patient safety. By integrating patients' experiences into quality improvement initiatives, the survey supports the development of more person-centred care practices.
The study adhered to the COnsensus-based Standards for the selection of health Measurement INstruments reporting guideline for studies on measurement properties of patient-reported outcome measures.
Patients were not involved in the study's design, conduct, or reporting.
The Danish version of the survey facilitates data collection on patients' perspectives of MNC in contemporary hospital settings, providing valuable insights into care quality. By offering a validated tool to assess MNC from patients' perspectives, the survey helps hospitals identify care gaps, prioritise improvement efforts and enhance person-centred care.
To propose the collaging integration procedure for linking literature and theory to research data in mixed methods research (MMR) and illustrate its application in two mixed methods studies.
Discussion paper/research methodology.
The collaging technique was used and developed based on two exploratory sequential nurse-led mixed-methods studies.
The collaging technique entails using multiple artefacts (data fragments, figures and textual information) within one figure. Collaging can generate relevant pre-post linkages, create meaning and refine inferences and meta-inferences.
This paper offers a novel integration technique for meaningful integration of the literature review and theoretical dimensions in the integration trilogy.
Nurse researchers can use the collaging integration procedure for effective integration for conducting rigorous mixed-methods research. Collaging is a straightforward yet effective technique for enhancing integration in the literature review and theoretical dimensions in MMR.
Linking literature review, theory and research data facilitates a more meaningful interpretation of research findings. While researchers may be able to create a more fully integrated MMR design by integrating multiple dimensions of the study, to date, most of the empirical and methodological literature on MMR has focused on integration at the design, fieldwork, analysis and interpretation dimensions, ignoring others, such as the literature review and theoretical dimensions. Collaging enables intensive analysis of the raw data and embeds the insights gained from literature and theory throughout the data analysis and presentation, thereby avoiding neglecting insights which could have been gained by back-and-forth comparison and integration of literature review and theoretical underpinnings.
No direct patient or public contribution.
FreshRSS 