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Nurses confront substantial daily workloads. Coping mechanisms, including resilient behaviours at both individual and team levels, are pivotal in managing these challenges. Factors like work experience can significantly influence individual resilience. Yet, team resilience among nurses remains relatively unexplored.
Our study examined perceptions of both individual and team resilience among Dutch hospital nurses. Furthermore, we investigated the impacts of hospital type, ward type and work experience.
The Employee Resilience Scale was used to evaluate individual resilience and adapted for team contexts to assess team resilience. This study was one of three conducted under a governmental research program aimed at improving patient safety in the Netherlands. A paired t-test and correlation analysis were conducted to compare individual resilience with team resilience. A separate t-test assessed the impact of ward type on perceived individual and team resilience. Finally, post hoc analyses were used to examine the effects of hospital type and work experience.
In total, 344 nurses from 25 different wards of 17 Dutch hospitals completed the survey. In general, nurses indicated to act more resilient on the individual level (mean = 3.77, SD = 0.61) compared to the team level (mean = 3.53, SD = 0.65; t = 7.25, p = 0.00). A correlation was found between perceived individual and team resilience (r = 0.53, p = 0.00). No effects of hospital- and ward type were found on both individual or team resilience. Years of work experience did not affect individual resilience but showed a significant effect on team resilience.
Dutch hospital nurses indicated they often act resilient on both individual and team levels. However, with increasing workloads in healthcare, being able to remain resilient will become increasingly challenging and important. Organisations should therefore support employees to maintain resilience by adapting their work environment to meet more employees' needs.
Investigate the perception of male accessibility to the fields of nursing practice by those studying or teaching nursing in England.
Cross-sectional survey.
Online questionnaire with three closed-scale questions and two open-text questions designed to elicit perceptions on the accessibility of men to the fields of nursing practice. The questionnaire was distributed to the staff and students at 61 nursing schools in England. Inferential and descriptive statistics were used to analyse the closed questions data and inductive content analysis was used to analyse open-text questions data.
Students (n = 52) and staff (n = 51) responded to the survey. Adult (Mdn = 6, IQR = 2) and mental health (Mdn = 6, IQR = 2) were perceived as the most accessible fields of nursing practice to men, and child (Mdn = 4, IQR = 2) the least. Specialised practice areas in acute and emergency (Mdn = 6, IQR = 2), education (Mdn = 6, IQR = 2), leadership (Mdn = 7, IQR = 1), prison services (Mdn = 7, IQR = 1), and research (Mdn = 7, IQR = 2) were rated the most accessible to men and neonatal care (Mdn = 3, IQR = 3) the least. Societal stereotyping and stigma were seen as barriers to men entering the nursing profession. The perception that nursing is a feminised profession persists and a distrust of men is associated with child nursing. Men were viewed as progressing to leadership roles with greater ease than women.
Societal level stereotyping and stigma are perceived as prevalent in nursing practice areas considered less accessible to men entering the nursing profession.
This study adds insight into the gendered nature of nursing and highlights the barriers to men entering a profession with a workforce crisis.
STROBE cross-sectional studies guidelines. COREQ guidelines for content analysis.
No patient or public contribution.
To understand the social representations of bedside milk expression (BME) among mothers of preterm newborns in neonatal intensive care units (NICUs).
Qualitative descriptive study.
The study was conducted from July to August 2024 in two NICUs of a referral maternity hospital in Fortaleza, Brazil. Nineteen mothers of hospitalised premature newborns participated. Semi-structured interviews were conducted and subjected to thematic content analysis.
Mothers perceived BME as a meaningful act of protection and bonding, though some were unfamiliar with the practice. Emotional ambivalence was common, shaped by prior breastfeeding experiences and the context of prematurity. Discomfort related to privacy and shared spaces was noted. Support from healthcare professionals was essential to promote understanding and adherence.
Social representations of BME are shaped by emotional, social and institutional experiences. Anchored in prior breastfeeding experiences and cultural meanings of maternal care, the practice is objectified through both gestures of affection and tangible barriers.
Healthcare professionals, particularly nurses, should receive training to support mothers in BME. Structural improvements, privacy and emotional support are essential for fostering maternal autonomy and confidence.
This study highlights the barriers to BME, emphasising the role of healthcare support and the need for better infrastructure, privacy and training to enhance maternal confidence and breastfeeding.
The study followed the Consolidated Criteria for Reporting Qualitative Research checklist.
None.
This paper highlights the pivotal role of healthcare professional support in overcoming barriers to BME and promoting breastfeeding practices.
Fresh breast milk is considered the gold standard for reducing complications and improving survival in preterm infants. BME is recommended as an effective strategy to ensure the availability of fresh breast milk. Mothers' social representations of this practice remain underexplored within the neonatal intensive care context.
Explores mothers' social representations of BME in NICUs, addressing a significant gap in qualitative research. Reveals how emotional, social and institutional factors shape mothers' perceptions, motivations and challenges related to BME. Highlights the need for targeted professional support, improved infrastructure and privacy to enhance maternal autonomy and adherence to milk expression practices.
Healthcare professionals, particularly nurses, should receive specialised training to provide technical guidance and emotional support, enhancing mothers' confidence and autonomy in BME. Improving infrastructure and ensuring privacy in NICUs are crucial to creating supportive environments that facilitate milk expression and strengthen maternal–infant bonding. Institutional policies should integrate maternal-centred strategies to support breastfeeding continuity and promote humanised neonatal care.
Postpartum psychosis is a psychiatric emergency that occurs following childbirth. Women are often cared for in general psychiatric units or in psychiatric Mother and Baby units. Postpartum psychosis is associated with a significant risk of relapse. There is a need to explore how women perceive care to understand what works well or needs further improvement.
This review aimed to explore women's experiences of care and support for postpartum psychosis.
A systematic review using meta-ethnographic methods was conducted.
Comprehensive searches were conducted between 4 March 2024 and 4 March 2025 on five databases (CINAHL, EMBASE, MEDLINE, PsycINFO and Web of Science). Backward and forward chain searching was also undertaken.
Critical appraisal was conducted following screening. Reciprocal and refutational translation were used to form the synthesis, and a line of argument was developed. The eMERGe reporting guidelines were used.
Fifteen studies were included within this synthesis. All the studies were conducted in high income countries and included 235 women. Three main themes were developed. ‘Navigating the unknown’ explored women's perceptions of postpartum psychosis as a less well-known condition, and their informational needs. ‘The double-edged sword of care’ found that there were helpful elements of formal mental health care, but that accessing care was sometimes traumatic, stigmatising and conflicting to women's identities. ‘Seeking consolation and recovery’ explored women's need for psychological support and experiences of peer support.
The findings of this review highlighted women's needs in respect to informational support, medication support, psychological support and in-patient care settings. Mother and baby units were strongly preferred by women.
The findings highlighted a need for specialised care for postpartum psychosis.
There were no patient or public contributions.
Prospero (CRD42024515712)
To provide a structured analysis of the acceptability of transcatheter aortic valve implantation to support clinical conversations, decision making and recovery for older adults with aortic stenosis and their carers.
While transcatheter aortic valve implantation is an effective treatment for heart valve disease, its acceptability to patients and caregivers remains unclear. Understanding the acceptability of clinical procedures is key for influencing patient engagement in self-care and guiding the information and support patients and carers need.
A descriptive, qualitative study used deductive content analysis, guided by Sekhon's Theoretical Framework of Acceptability.
Participants included 18 aortic stenosis patients (mean age 84.2 ± 4.1 years) and 8 carers from three Australian metropolitan hospitals (2018–2020). Semi-structured interviews were conducted 4–6 months post–TAVI and transcribed verbatim. Analysis used Sekhon's Theoretical Framework of Acceptability across three temporal zones, with deductive coding examining affective attitude, burden, ethicality, intervention coherence, opportunity costs, perceived effectiveness and self-efficacy.
Participants described high prospective, concurrent and retrospective acceptability of transcatheter aortic valve implantation. Perceived prospective acceptability framed the procedure as lifesaving. Peri-operatively, participants found the procedure simple, low-risk and minimally disruptive, ensuring high concurrent acceptability. Post-procedure, patient participants described a slow but gradual return to normal, growing confidence and a reengagement with their valued pastimes. The absence of structured rehabilitation advice led to self-designed recoveries and uncertainty about safe limits.
Transcatheter aortic valve implantation was perceived as a highly acceptable intervention that helped this group of mostly older adults achieve their personal goals.
Despite the minimally invasive nature of transcatheter aortic valve replacement, optimising recovery and rehabilitation requires a holistic approach that addresses both clinical needs and patient goals.
None in the conceptualisation or design.
To explore nursing professionals' perceptions of the intersectional positioning of their profession within healthcare and society, examining how axes of oppression shape healthcare responses and resource management.
A qualitative study framed in critical theory paradigm employing constructivist grounded theory, as outlined by Charmaz.
The study was conducted in Catalonia, Spain, between 2022 and 2023. A total of 26 nursing professionals participated, representing a range of professional roles and settings. Theoretical sampling guided participant recruitment and was saturated after 17 in-depth interviews and 2 thematic focus groups. Interviews and focus groups were transcribed verbatim. Thematic analysis, informed by Charmaz's approach, was applied to identify key dimensions and themes. Intersectionality theory was used as a critical analysis framework.
A predominant theme emerged from data identified as ‘intersectional disempowerment of nursing profession’. Four categories shape this positioning: (1) symbolic and historical undervaluation of care, rooted in nursing's feminization and patriarchal norms; (2) patriarchal influence on professional leadership, manifested by men disproportionately occupy leadership roles, reinforcing vertical segregation; (3) intra-professional hierarchies and technocratic influence, forcing prestige disparities within nursing and promoting horizontal segregation; and (4) internalised barriers among nurses regarding professional prestige, authority and recognition which combined undermine nursing's visibility, legitimacy and influence within healthcare.
Nursing cannot be understood as a neutral profession. Its societal positioning is deeply shaped by structural inequities, gendered assumptions and entrenched hierarchies, which collectively undermine its potential for autonomy and recognition.
This study highlights the need to challenge intersectional hierarchies in nursing, promoting equitable recognition, policy reforms and leadership opportunities to enhance nurses' authority, visibility and professional empowerment within healthcare systems. Addressing these challenges requires systemic policy reforms and a critical re-evaluation of societal perceptions. What problem did the study address? Nursing's social image is strongly shaped by biomedical, technocratic and social views. The gap between nursing's public image and identity limits professional growth and recognition. Analysing how power relations intersect in nursing's social position is essential. What were the main findings? Nursing's role is shaped by the intersection of gender, prestige, socioeconomic status and social recognition. Nurses' empowerment must be tied to transforming unjust institutions and systemic structures. Where and on whom will the research have an impact? This study provides a critical analysis of the intersectional positioning of the nursing profession. The findings have implications at multiple levels: micro, by offering nurses a critical perspective on their professional positionality; meso, by providing healthcare managers with insights into the underlying factors contributing to nursing's undervaluation; and macro, by fostering reflection within the broader healthcare community on the power dynamics shaping interprofessional relationships.
This study did not include patient or public involvement in its design, conduct, or reporting.
The manuscript is based on the Consolidated Criteria for Reporting Qualitative Research (COREQ).
To investigate what works when using Patient-Reported Outcome Measures (PROMs), for whom, in what contexts, and why in four Value-Based Healthcare (VBHC) programmes.
Realist evaluation.
Evaluation of Heart Failure, Parkinson's Disease, Epilepsy and Cataract surgery programmes using data from a scoping review, documentary analysis, questionnaires, quantitative routinely collected data and semi-structured interviews with staff, patients and carers (July 2022–August 2023). Programme theories and logic models were developed, tested and refined.
We conducted 105 interviews (67 patients, 21 carers and 17 staff) and collected data from 230 patients (66 Epilepsy, 140 Heart Failure and 24 Parkinson's Disease) and 14 staff via questionnaires. Clinicians used PROMs data to regularly monitor patients with Heart Failure and Epilepsy, which resulted in better triage and tailoring treatment, prioritisation of access based on the urgency of need, and facilitation of referral to relevant professionals. In Heart Failure, this further resulted in a more efficient provision of care and better use of resources, care closer to home, improved health outcomes (e.g., better symptom management) and service redesign. The same was not observed in Epilepsy, as patients who required mental health treatment had to be referred, but they were not always able to access specialist services. PROMs were discontinued in Cataract surgery services mainly due to the lack of integrated IT systems, which caused an increased workload and staff resistance. In Parkinson's Disease, patients were asked to complete PROMs even though the information was not consistently being used.
Findings challenge the orthodoxy that implementing PROMs is universally good and brings about real improvements in patient outcomes in a VBHC context. PROMs are generally ill-suited for long-term use with patients in routine care without further adaptation. Greater staff and patient involvement are imperative to enhance the acceptability and relevance of the programmes.
Patient-Reported Outcome Measures can improve care when embedded in well-supported systems. Implementation must be realistic, involve staff and patients, and be underpinned by clear leadership and robust digital infrastructure. Co-designed patient-facing tools can improve accessibility and engagement.
What problem did the study address? There is limited evidence on how Patient-Reported Outcome Measures function across different routine healthcare contexts. What were the main findings? Patient-Reported Outcome Measures improved care in Heart Failure but not in other services, largely due to contextual barriers. Where and on whom will the research have an impact? Findings are relevant for clinicians, service designers, and policymakers seeking to implement meaningful person-centred outcome measurement in long-term conditions.
We adhered to Realist and Meta-narrative Evidence Syntheses: Evolving Standards II guidance and to the Guidance for Reporting Involvement of Patients and the Public.
The study was developed alongside a wide range of patient and public stakeholders involved in the Aneurin Bevan University Health Board Value-Based Healthcare programme, third sector and specific individuals and groups representing the four included services (i.e., St. David's Hospice Care, British Heart Foundation, Digital Communities Wales, Epilepsy Action, Digital Communities Wales, Parkinson's UK Cymru, Race Equality First, Aneurin Bevan Community Health Council, Value- Based Healthcare Patient Reference Group and Wales Council of the Blind). A total of 10 virtual meetings were strategically planned to address gaps, assist in the interpretation of findings, and ensure that outcomes were pertinent and accessible to the specific needs and circumstances of under-represented or vulnerable groups.
To explore the learning processes and prerequisites for nursing students to develop and achieve passing clinical competence, following an initial failing grade in their clinical education.
A constructivist grounded theory study was employed.
Data were collected between January 2022 and June 2024 through individual interviews with seven undergraduate nursing students retaking their clinical education in the final semester at a university in Sweden. In addition, individual interviews were conducted with four teachers in higher education and two focus group discussions, one with four teachers in higher education and another with a clinical teacher and a supervisor. The data analysis was conducted using an iterative process of constant comparison of data in different phases.
The analysis resulted in a theoretical model of person-centred learning which illustrates nursing students' learning processes and the prerequisites for them to develop and achieve clinical competence in clinical education. The model's core learning processes involve tailoring clinical education to students' needs: acknowledging one's own learning needs, receiving supervision which addresses their specific needs and having an educational institution which meets these needs are the three main learning processes that define student development. Students' acknowledgement of their personal learning needs itself entails three learning processes: trusting one's own knowledge, reflecting on and applying the nursing process, and reflecting on one's own learning. For students to progress in the learning process, prerequisites related to supervision and an educational institution meeting the students' needs must be in place.
The study provides evidence for a person-centred model which promotes nursing students' learning and development of clinical competence during clinical practice at the end of their nursing education.
This model can provide support to coordinators and supervisors in nursing education with regard to planning and implementing clinical education.
This grounded theory study provides a theoretical model for nursing students' learning and development of clinical competence during their clinical education in their final year of nursing education. A person-centred learning approach in clinical education can provide learning prerequisites for students to successfully achieve learning objectives and develop safe competences for the profession. The findings of the study can offer valuable support and direction to nursing students, educators, and clinical practice supervisors in the planning and implementation of clinical education.
The study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist and the Guideline for Reporting and Evaluating Grounded Theory Research Studies (GUREGT).
This study did not include patient or public involvement.
To explore reasons why patients with inflammatory bowel disease (IBD) do (not) engage in fatigue-related care and their care needs.
A qualitative interview study, using a phenomenological methodological approach.
We included 16 fatigued patients with IBD in remission. Data were collected between December 2021 and March 2022, using semi-structured interviews. Template analysis was performed.
We identified six themes regarding reasons why (not) to seek care for fatigue: (1) Cognitions about fatigue and coping with fatigue, (2) perceptions of fatigue-related care and previous care experiences, (3) perceived knowledge and behaviour of healthcare professionals, (4) physical and emotional well-being, (5) social relationships and support, and (6) practical factors. Regarding their care needs, patients reported a need for a holistic and person-centred care approach, with healthcare professionals actively addressing fatigue and offering care. They suggested a range of options for what care to offer, including eliminating physical causes of fatigue, discussing medication options, providing information on fatigue management, lifestyle support, psychological support, peer support and practical support.
Both patient- and healthcare-related factors play a role in why IBD patients do (not) seek fatigue-related care. Our findings emphasise the importance of active screening and discussion of fatigue, using a holistic and person-centred approach to treat fatigue.
This study contributes to the understanding of IBD patients' facilitators and barriers for seeking care for fatigue and their care needs. Moreover, results can inform nurses and physicians about ways to optimise the offer and uptake of fatigue-related care, and the development of interventions that fit patients' needs. Results also provide implications for the treatment of fatigue in other chronic (inflammatory) conditions.
The current results can inform nurses and physicians about ways to optimise the offer and uptake of fatigue-related care, and the development of interventions that fit the needs of patients with IBD. An increase in the uptake of effective and acceptable interventions can improve patients' health and well-being.
Findings were reported following the consolidated criteria for reporting qualitative research (COREQ).
No patients, service users or members of the public were involved in this study. The study focused on patients' experiences with fatigue-related care and their needs.
FreshRSS 