FreshRSS

🔒
❌ Acerca de FreshRSS
Hay nuevos artículos disponibles. Pincha para refrescar la página.
Anteayer Journal of Advanced Nursing

Antecedents and outcomes of work engagement among nursing staff in long‐term care facilities—A systematic review

Abstract

Aim

To determine antecedents and outcomes of work engagement (WE) among nursing staff in long-term care (LTC) using the Job Demand-Resources model.

Design

A systematic review following the Preferred Reporting Items for Systematic Review and Meta-Analysis statement and Synthesis Without Meta-analysis in systematic reviews guideline. A study protocol was registered in PROSPERO (registration number CRD42022336736).

Data Sources

The initial searches were performed in PsycInfo, Medline, Academic Search Premier, CINAHL and Scopus and yielded 3050 unique publications. Updated searches identified another 335 publications. Sixteen studies published from 2010 to 2022 were included.

Review Methods

The screening of titles and abstracts, and subsequently full-text publications, was performed blinded by two author teams using the inclusion/exclusion criteria. When needed, a mutual consensus was obtained through discussion within and across the teams. A descriptive and narrative synthesis without a meta-analysis of the included studies was performed.

Results

The extent of research on WE in LTC facilities is limited and the factors examined are heterogeneous. Of forty-two unique antecedents and outcomes, only three factors were assessed in three or more studies. Antecedents—in particular job resources—are more commonly examined than outcomes.

Conclusion

Existing literature offers scant evidence on antecedents and outcomes of WE among nursing staff in LTC facilities. Social support, learning and development opportunities and person-centred processes are the most examined factors, yet with ambiguous results.

Impact

Antecedents and outcomes of engagement among nursing staff in LTC facilities have not previously been reviewed systematically. Engagement has been correlated with both more efficient and higher-quality service delivery. Our findings suggest opportunities to improve health and care services by enhancing engagement, whilst at the same time better caring for employees. This study lays the groundwork for more detailed research into the contributing factors and potential results of increasing caregivers' engagement.

No patient or public contribution.

Barriers and enablers to screening, management and referral of sleep disorders in patients attending cardiac rehabilitation: A qualitative descriptive study

Abstract

Aims

To examine healthcare professional's knowledge about assessment and management of sleep disorders for cardiac patients and to describe the barriers to screening and management in cardiac rehabilitation settings.

Design

A qualitative descriptive study. Data were collected via semi-structured interviews.

Methods

In March 2022, a total of seven focus groups and two interviews were conducted with healthcare professionals who currently work in cardiac rehabilitation settings. Participants included 17 healthcare professionals who had undertaken cardiac rehabilitation training within the past 5 years. The study adheres to the consolidated criteria for reporting qualitative research guidelines. An inductive thematic analysis approach was utilized.

Results

Six themes and 20 sub-themes were identified. Non-validated approaches to identify sleep disorders (such as asking questions) were often used in preference to validated instruments. However, participants reported positive attitudes regarding screening tools provided they did not adversely affect the therapeutic relationship with patients and benefit to patients could be demonstrated. Participants indicated minimal training in sleep issues, and limited knowledge of professional guidelines and recommended that more patient educational materials are needed.

Conclusion

Introduction of screening for sleep disorders in cardiac rehabilitation settings requires consideration of resources, the therapeutic relationship with patients and the demonstrated clinical benefit of extra screening. Awareness and familiarity of professional guidelines may improve confidence for nurses in the management of sleep disorders for patients with cardiac illness.

Impacts

The findings from this study address healthcare professionals' concerns regarding introduction of screening for sleep disorders for patients with cardiovascular disease. The results indicate concern for therapeutic relationships and patient management and have implications for nursing in settings such as cardiac rehabilitation and post-cardiac event counselling.

Reporting Method

Adherence to COREQ guidelines was maintained.

Patient or Public Contribution

No Patient or Public Contribution as this study explored health professionals' experiences only.

Long‐term care facilities' response to the COVID‐19 pandemic: An international, cross‐sectional survey

Abstract

Aims

To (i) assess the adherence of long-term care (LTC) facilities to the COVID-19 prevention and control recommendations, (ii) identify predictors of this adherence and (iii) examine the association between the adherence level and the impact of the pandemic on selected unfavourable conditions.

Design

Cross-sectional survey.

Methods

Managers (n = 212) and staff (n = 2143) of LTC facilities (n = 223) in 13 countries/regions (Brazil, Egypt, England, Hong Kong, Indonesia, Japan, Norway, Portugal, Saudi Arabia, South Korea, Spain, Thailand and Turkey) evaluated the adherence of LTC facilities to COVID-19 prevention and control recommendations and the impact of the pandemic on unfavourable conditions related to staff, residents and residents' families. The characteristics of participants and LTC facilities were also gathered. Data were collected from April to October 2021. The study was reported following the STROBE guidelines.

Results

The adherence was significantly higher among facilities with more pre-pandemic in-service education on infection control and easier access to information early in the pandemic. Residents' feelings of loneliness and feeling down were the most affected conditions by the pandemic. More psychological support to residents was associated with fewer residents' aggressive behaviours, and more psychological support to staff was associated with less work–life imbalance.

Conclusions

Pre-pandemic preparedness significantly shaped LTC facilities' response to the pandemic. Adequate psychological support to residents and staff might help mitigate the negative impacts of infection outbreaks.

Impact

This is the first study to comprehensively examine the adherence of LTC facilities to COVID-19 prevention and control recommendations. The results demonstrated that the adherence level was significantly related to pre-pandemic preparedness and that adequate psychological support to staff and residents was significantly associated with less negative impacts of the pandemic on LTC facilities' staff and residents. The results would help LTC facilities prepare for and respond to future infection outbreaks.

Patient or public contribution

No Patient or Public Contribution.

Advanced practice nursing in Europe—Results from a pan‐European survey of 35 countries

Abstract

Aim

To report the results of a mapping exercise by the European Federation of Nurses on current advanced practice nursing frameworks and developments across Europe.

Design

Online, cross-sectional, questionnaire study.

Methods

An online questionnaire was distributed among 35 national nurses' associations across Europe in March 2021. The questionnaire solicited input on 60 items concerning key features of advanced practice nursing, intending to map existing developments and better understand the current state of advanced practice nursing in Europe. Data analysis used descriptive statistics, including counts and percentages, tabulation; open-text responses were handled with thematic synthesis techniques.

Results

The definition, sense-making and operationalization of advanced practice nursing vary across Europe. Important variations were noted in the definition and requirements of advanced practice nursing, resulting in different views on the competencies and scope of practice associated with this role. Importantly, the level of education and training required to qualify and practice as an advanced practice nurse varies across European countries. Furthermore, only 11 countries reported the existence of a national legislation establishing minimum educational requirements.

Conclusion

Significant variation exists in how countries define advanced practice nursing and how it is regulated at academic and practice levels. More research is needed to clarify whether this variation results from designing models of advanced practice nursing that work in different contexts; and what impact a standardized regulatory framework could have to grow the volume of advanced practice nurses across Europe.

Impact

The current paper exposes the lack of clarity on the development and implementation of advanced practice nursing across Europe. We found significant variation in the definition, recognition, regulation and education of advanced practice nurses. Our data are essential to policymakers, professional associations and employers to ensure a coordinated and systematic effort in the consistency and ongoing development of advanced practice nurses across Europe.

Patient or Public Contribution

No patient or public contribution applied; the participants were national nurses' associations.

Development and testing of a patient‐reported experience measure for cancer: A cross‐sectional survey

Abstract

Aim

To develop and psychometrically test the Patient-reported Experience Measure-Cancer (PREM-C), reflecting patients' perceptions of cancer care experiences according to the Institute of Medicine domains.

Design

A three-phase cross-sectional survey was conducted.

Methods

Development, reliability and validity testing of the PREM-C measure was undertaken. Data collection included three phases: firstly (development) between October and November, 2015; secondly (psychometric testing), May 2016–June, 2017, and finally, (revision and psychometric testing) May 2019–March 2020.

Results

The final PREM-C structure, created using the Institute of Medicine domains, was psychometrically sound with five factors identified in the Exploratory Factor Analysis, demonstrating internal reliability ranging from 0.8 to 0.9. Confirmatory Factor Analysis indicated the hypothesized model fitted well (Root mean square error of approximation = 0.076). External convergent and divergent validity was established with the PREM-C found to be moderately correlated with the Picker Patient Experience Questionnaire but weakly correlated with the WHOQoL-BREF.

Conclusion

The development and testing of the PREM-C demonstrated good fit as a clinically relevant measure of ambulatory cancer patients' experiences of care. To make meaningful changes to nursing practice and health services, patient experience measures such as the PREM-C might support staff to identify areas for service improvement.

Impact

Few reliable measures and less validated measures collect patients' perceptions of the quality of their healthcare provision. Rigorous psychometric testing of the newly developed PREM-C demonstrated good internal consistency, test–retest reliability, and external convergent and divergent validity. The PREM-C is a potentially relevant measure of cancer patients' experiences of care. It might be used to assess patient-centred care and guide safety and quality improvements in clinical settings. PREM-C use might inform service providers of experiences of care in their institution and inform policy and practice development. This measure is sufficiently generic, allowing potential use in other chronic disease populations.

Patient or Public Contribution

This conduct of this study was supported by the participating patients of the hospital Cancer Outpatients Service.

The role experience of advanced practice nurses in oncology: An interpretative phenomenological study

Abstract

Aim(s)

To understand the experiences of advanced practice nurses working in cancer care.

Design

Phenomenological qualitative study.

Methods

Three focus groups were held to collect qualitative data. Participants were recruited through theoretical non-probabilistic sampling of maximum variation, based on 12 profiles. Data saturation was achieved with a final sample of 21 oncology advanced practice nurses who were performing advanced clinical practice roles in the four centers from December 2021 to March 2022. An interpretative phenomenological analysis was performed following Guba and Lincoln's criteria of trustworthiness. The centers' ethics committee approved the study, and all participants gave written informed consent. Data analysis was undertaken with NVivo 12 software.

Results

Three broad themes emerged from the data analysis: the role performed, facilitators and barriers in the development of the role and nurses' lived experience of the role.

Conclusion

Advanced practice nurses are aware that they do not perform their role to its full potential, and they describe different facilitators and barriers. Despite the difficulties, they present a positive attitude as well as a capacity for leadership, which has allowed them to consolidate the advanced practice nursing role in unfavourable environments.

Implications for the Profession

These results will enable institutions to establish strategies at different levels in the implementation and development of advanced practice nursing roles.

Reporting Method

Reporting complied with COREQ criteria for qualitative research.

Patient or Public Contributions

No patient or public contribution.

Changes in parental anxiety and intention to demand antibiotics: A longitudinal study among parents during the COVID‐19 pandemic

Abstract

Aims

Assessing the effects of the COVID-19 pandemic on parental anxiety and preferences for antibiotic treatment can help inform antibiotic stewardship strategies. Therefore, this study aimed to examine COVID-19 pandemic-related changes in parental anxiety levels, their intentions to demand antibiotics and frequencies of practising preventative behaviours.

Design

This longitudinal quantitative study compared two groups of parents, those from Victoria and Western Australia, who experienced high and low COVID-19 risk, respectively.

Methods

Participants were recruited through an online panel to complete three waves of surveys between October 2020 and August 2021. Anxiety scores and frequency of preventative behaviours were analysed using mixed-effects tobit regression, considering time, state, and their interaction as fixed effects predictors. Intention to demand antibiotics was modelled using multinomial logistic regression, with time, state, and their interaction as the predictors.

Results

The final longitudinal sample comprised 50 participants from Victoria and 51 from Western Australia. Parental anxiety did not significantly change over time for either state. Intention to demand antibiotics was also stable over time within each state; however, participants from Victoria exhibited stronger intentions to demand antibiotics compared to those from Western Australia. Frequencies of parental preventative behaviours declined from Wave 1 to Wave 2 before increasing again in Wave 3, but only for Western Australia.

Conclusion

This longitudinal study among Australian parents found stable parental anxiety and intention to demand antibiotics within each state. However, the intention to demand antibiotics and preventative behaviours varied between states as per the COVID-19 risk. Thus, viral pandemics may not affect judicious antibiotic use, though the intention to demand antibiotics may increase in states with high COVID-19 risk.

Impact

Though parental anxiety may not impact antibiotic stewardship during viral respiratory illness outbreaks, tailored messaging to maintain appropriate antibiotic use may be necessary, especially when the disease risk is high.

The meaning of preparedness for informal caregivers of older adults: A concept analysis

Abstract

Aim

To examine the concept of preparedness over time in research with informal caregivers of older adults.

Design

Concept analysis.

Methods

Rodgers' evolutionary method of concept analysis was used to guide this theoretical paper due to the dynamic nature of preparedness, which is influenced by both context and time. Using Rodgers' inductive approach, concept elements were derived from a content analysis of included studies. In the final step, to generate hypotheses and implications regarding the concept, the conceptual structure of preparedness of informal caregivers of older adults was connected to a theoretical problem in the nursing discipline using the Caregiving Stress Process Framework.

Data Sources

Four databases (EBSCO CINAHL, Ovid MEDLINE, Ovid PsycINFO and Scopus) were searched in November 2022 and updated in September 2023. No date limits were set for searching, as the intent was to analyse possible variations of the concept over time.

Results

The attributes of preparedness include self-confidence, having knowledge, skills and abilities to perform daily tasks, handling emotions and developed over time. These attributes can be compared with the stressors outlined in the Caregiving Stress Process Framework (i.e., the moment the caregiver identifies some ‘stressor’; something that prevents them from feeling confident in their preparedness).

Conclusion

The concept of preparedness of informal caregivers of older adults is defined as caregiver's self-confidence about their current competence related to the knowledge, skills and abilities to perform daily tasks, and to handle emotions over time. To link the concept to a theoretical perspective, we propose adaptations to a well-known theory, the Caregiving Stress Process Framework. Future research on caregiving preparedness needs to avoid circular definitions and work with the attributes of preparedness to support caregivers.

Implications for the Profession and/or Patient Care

This paper contributes to the development of interventions that focus on the health and preparedness of informal caregivers of older adults. Clarifying the concept of preparedness helps nurses to support caregivers since it is then known which aspects are included in the preparedness of caregivers (e.g., daily tasks and handling emotions). A more fulsome understanding of preparedness supports us to see beyond stressors of caregiving.

Impact

This study addresses informal caregivers of older adults' preparedness to provide care. We synthesized existing definitions that have been used in research with this population to propose a robust conceptualization of the concept of preparedness, which contributes to better understanding of how preparedness can be supported.

Reporting Method

We were unable to locate a reporting method related to this kind of work (concept analysis).

Patient or Public Contribution

Not applicable as no new data generated.

Research Electronic Data Capture (REDCap) in an outpatient oncology surgery setting to securely email, collect, and manage survey data

Abstract

Background

Nursing interventions in the post-operative time period including psychological and emotional support, adverse event education, and instructions for follow-up care contribute patient satisfaction, safety, and quality of life. However, the time spent in the post-anesthesia care unit (PACU) and hospital continues to shorten around the world to reduce health care spending and improve patient outcomes. Nurses conducting research during the important post-operative recovery period need to utilize unique techniques and emerging technologies to contact, recruit and collect data outside of the hospital setting including the Research Electronic Data Capture (REDCap) platform.

Aims

This paper describes the feasibility and acceptability, facilitators and barriers of the software application, REDCap, to complete a repeated-measures, descriptive correlational study in patients undergoing outpatient breast cancer surgeries.

Methods & Materials

The recruitment, data collection and storage were completed utilizing the secure REDCap Platform. The Institutional Research Board (IRB)-approved study was a repeated-measures, descriptive, correlational study with data collection at three time points. The data points aligned with important transitions and routine visits to improve data collection feasibility and increase relevance to clinical practice.

Results

The sample consisted of women diagnosed with breast cancer undergoing breast conserving surgery between August 15 and October 15, 2020. There were 123 potential participants, of which 76 started the surveys and 75 participated (61%) responded and participated in the study on Post-operative Day 1. Fifty-nine participants (78%) completed the surveys on post-operative Day 14.

Discussion

As the frequency of outpatient treatment increases, nurses conducting post-operative research will need to collect the data outside of the hospital setting.

Conclusion

Email provides a method of studying new phenomena by recruiting participants, providing information about the study, and collecting results in a non-traditional setting. REDCap provides a method to facilitate nursing research through a securely encrypted integrated process.

Parental presence, participation, and engagement in paediatric hospital care: A conceptual delineation

Abstract

Aim

To delineate between the concepts of parental presence, participation, and engagement in paediatric hospital care.

Design

The concepts' uses in the literature were analysed to determine attributes, influences, and relationships.

Methods

Delineations of each concept are established and conceptual definitions are proposed following Morses' methods.

Data Sources

MEDLINE (PubMed); CINAHL, PsycINFO, Sociology Source Ultimate (EBSCOhost); Embase, Scopus (Elsevier); Google Scholar. Search dates October 2021, February 2023.

Results

Multinational publications dated 1991–2023 revealed these concepts represent a range of parental behaviours, beliefs, and actions, which are not always perceptible to nurses, but which are important in family-integrated care delivery. Parental presence is the state of a parent being physically and/or emotionally with their child. Parental participation reflects parents' performing caregiving activities with or without nurses. Parental engagement is a parents' state of emotional involvement in their child's health and the ways they act on their child's behalf.

Conclusion

These concepts' manifestations are important to parental role attainment but may be inadequately understood and considered by healthcare providers.

Implications

Nurses have influence over parents' parental presence, participation, and engagement in their child's care but need support from healthcare institutions to ensure equitable family-integrated care delivery.

Impact

Problem: Lack of clear definition among these concepts results in incomplete and at times inequitable family-integrated care delivery. Findings: Parental presence is an antecedent to parental participation, and parental presence and participation are elements of parental engagement. The concepts interact to influence one another. Impact: Hospitalized children, their families, nurses, and researchers will benefit through a better understanding of the concepts' attributes, interactions, and implications for enhanced family-integrated care delivery.

Perceived barriers and facilitators to preventing hospital‐acquired pressure injury in paediatrics: A qualitative analysis

Abstract

Aim

This qualitative study aimed to identify nurses' and allied health professionals' perceptions and experiences of providing hospital-acquired pressure injury (HAPI) prevention in a paediatric tertiary hospital in Australia, as well as understand the perceived barriers and facilitators to preventing HAPI.

Design

A qualitative, exploratory study of hospital professionals was undertaken using semi-structured interviews between February 2022 and January 2023.

Methods

Two frameworks, the Capability, Opportunity and Motivation Model of Behaviour (COM-B) and the Theoretical Domains Framework (TDF), were used to give both theoretical and pragmatic guidance. Participants included 19 nursing and allied health professionals and data analysis was informed by the framework approach.

Results

Analysis revealed nine core themes regarding professionals' beliefs about the barriers and facilitators to HAPI prevention practices across seven TDF domains. Themes included HAPI prevention skills and education, family-centred care, automated feedback and prompts, allocation and access to equipment, everybody's responsibility, prioritizing patients and clinical demands, organizational expectations and support, integrating theory and reality in practice and emotional influence.

Conclusion

These findings provide valuable insights into the barriers and facilitators that impact paediatric HAPI prevention and can help identify and implement strategies to enhance evidence-based prevention care and prevent HAPI in paediatric settings.

Impact

Overcoming barriers through evidence-based interventions is essential to reduce HAPI cases, improve patient outcomes, and cut healthcare costs. The findings have practical implications, informing policy and practice for improved preventive measures, education, and staffing in paediatric care, ultimately benefiting patient well-being and reducing HAPIs.

Patient or Public Contribution

No patient or public contribution. The focus of the study is on healthcare professionals and their perspectives and experiences in preventing HAPIs in paediatric patients. Therefore, the involvement of patients or the public was not deemed necessary for achieving the specific research objectives.

Compassion in health professionals: Development and validation of the Capacity for Compassion Scale

Abstract

Background

Health professionals witness pain and suffering when they care for sick people and their families. Compassion is a necessary quality in their work as it combines the will to help, alleviate suffering and promote the well-being of both the people they are attending and the professionals themselves. The aim of the study was to design and evaluate the psychometric properties of the Capacity for Compassion Scale (CCS).

Design

A quantitative, descriptive and cross-sectional study was carried out to evaluate the psychometric properties of the scale (reliability, temporal stability, content validity, criterion validity and construct validity).

Methods

The study was carried out in two phases: pilot study and final validation. The data were collected between April and May 2022. The sample was selected by convenience sampling and was made up of a total of 264 participants, 59 in the pilot phase and 205 in the final validation.

Results

The Capacity for Compassion Scale has been shown to have good psychometric properties in relation to reliability, temporal stability, and content, criterion, and construct validity. Factor analysis showed that there were four subdimensions of the scale: motivation/commitment, presence, shared humanity and self-compassion. The results also indicate that compassionate ability is significantly correlated with age and work experience.

Conclusions

The Capacity for Compassion Scale shows adequate psychometric properties. This instrument measures the compassion capacity of health professionals, which is a valuable discovery for new lines of research in this field.

Impact

Through this scale, low levels of capacity for compassion can be detected that negatively influence the quality of care provided by health professionals. The Capacity for Compassion Scale can therefore contribute to the identification of needs and promote training around compassion for health professionals.

Patient or Public Contribution

No patient or public contribution.

What Problem did the Study Address?

Compassion in health professionals has positive effects on improving the quality of care, the satisfaction of professionals and the work environment. There are compassion cultivation programmes whose validity has been proven for the development of the dimensions of compassion. There is no specific instrument that measures capacity for compassion in healthcare professionals.

What were the Main Findings?

A scale is designed to measure capacity for compassion in health professionals. This is the only such scale available up until now. The scale measures four dimensions of compassion: motivation/commitment, presence, shared humanity and self-compassion.

Where and on Whom will the Research Have an Impact?

The development of specific programmes that can increase the compassion of health professionals with all the benefits that this can bring to health care is encouraged. It will be possible to analyse the effects of training programmes on the cultivation of compassion.

Exploring home births in Catalonia (Spain): A cross‐sectional study of women's experiences and influencing factors

Abstract

Aim

The study explores the experiences of women with low-risk pregnancies and no complications who planned a home birth.

Design

A cross-sectional study was conducted using an online questionnaire.

Methods

The questionnaire included socio-demographic, obstetric and perinatal variables. Birth satisfaction was evaluated via the Spanish version of the childbirth experience questionnaire. The study group comprised home-birthing women in Catalonia, Spain. Data were collected from 1 January 2019 to 31 December 2021. Statistical analysis was performed using SPSS.

Results

A total of 236 women responded. They reported generally positive experiences, with professional support and involvement being the most highly rated dimensions. Better childbirth experiences were associated with labour lasting less than 12 h, no perineal injuries, no intrapartum transfers to hospital, euthocic delivery and the presence of a midwife.

Conclusions

Women's positive home birth experiences were linked to active participation and midwife support. Multiparous women felt safer. Medical interventions, especially transfers to hospitals, reduced satisfaction, highlighting the need for improved care during home births.

Implications for the Profession and Patient Care

Home births should be included among the birthplace options offered by public health services, given the extremely positive feedback reported by women who gave birth at home.

Impact

Home birth is not an option offered under Catalonia's public health system only as a private service. The experience of home-birthing women is unknown. This study shows a very positive birth experience due to greater participation and midwife support. The results help stakeholders assess home birth's public health inclusion and understand valued factors, supporting home-birthing women.

Reporting Method

The study followed the STROBE checklist guidelines for cross-sectional studies.

Public Contribution

Women who planned a home birth participated in the pilot test to validate the instrument, and their contributions were collected by the lead researcher. The questionnaire gathered the participants' email addresses, and a commitment was made to disseminate the study's results through this means.

Phenomenography: A useful methodology for midwifery research

Abstract

Aims

To outline the theoretical, philosophical, and major assumptions associated with phenomenography and then address the application of a phenomenographical approach within the context of midwifery research.

Background

Phenemonography is a little-known qualitative research approach amongst the main design traditions of phenomenology, grounded theory, case study, and ethnography more typically used within midwifery research. Phenomenography aims to describe the qualitatively different ways that people perceive, conceptualize, or experience a phenomenon. Phenemonography has a distinctly different approach from other qualitative methods as it places emphasis on the ‘collective’ meaning over individual experience.

Methodology

Phenomenography, as an approach, rests within the interpretivist paradigm recognizing that there are multiple interpretations of reality. Phenomenography emphasizes the various ways that people experience the same phenomenon, including both the similarities and differences. The second-order perspective embraced by phenomenography suggests that the researcher directs themselves towards people's understanding of the world; essentially the world is described as it is understood rather than as it is. It is the reporting about how these different realities appear at a collective level that is the output of phenomenographic research.

Findings

A framework for conducting phenomenographic research is illustrated by outlining the steps within the methodological approach required to undertake a research study using phenemonography.

Conclusion

Phenomenography is a qualitative research approach that can usefully be applied in many midwifery contexts where a collective understanding of a phenomena is required. Using a phenomenographic approach can provide the midwifery profession with knowledge about variations in how women and midwives think, and how aspects of different phenomena are experienced in within a midwifery setting.

Women's experiences of online antenatal education: An integrative literature review

Abstract

Aim

To identify what is currently known about how women experience online antenatal education.

Design

Integrative literature review.

Review Methods

This integrative review applied the five-stage methodological framework outlined by Whittemore and Knafl (2005), supporting rigour in problem identification, selection and critical appraisal of quality literature, data analysis and synthesis of findings.

Data Sources

A literature search was conducted in May/June 2022, utilizing databases including OVID Embase, CINAHL, Joanna Briggs Institute EBP database, Nursing and Allied Health database, Wiley Online Library, Google scholar search engine and related reference lists. The search was limited to English language and primary research articles published in the last 10-year period (2012–2022).

Results

12 articles met inclusion criteria. Three primary themes were identified: Comprehensibility: Looking back – understanding women's needs and preferences; Manageability: In the moment – flexibility versus social connection; and Meaningfulness & sustainability: Looking forward – the future of digital maternity education.

Conclusion

Findings identified a marked digital divide for women accessing online antenatal education, placing vulnerable women at risk of continuing inequity. E-health literacy frameworks need to be implemented to create genuine accessibility, comprehensibility and cultural responsiveness to best meet the needs of users.

Implications for the Profession and/or Health Care Consumer

As digital health is an emerging field, there is strong evidence that online antenatal education requires further evaluation to better meet the needs of pregnant women and their support people. Enhancing digital health literacy for health professionals will also promote a greater understanding for how to uphold and support the socio-technical dimensions of online service delivery.

Patient or Public Contribution

There were no patient or public contributions as part of this integrative review of the literature.

Nursing students' and educators' perspectives on sustainability and climate change: An integrative review

Abstract

Aim

To identify and synthesize research on the awareness, attitudes and action related to sustainability and climate change from the perspective of nursing students and educators globally.

Design

Integrative review.

Methods

The review was guided by Whittemore and Knafl. Included studies were appraised using the Mixed Methods Appraisal Tool. A deductive content analysis based on Elo and Kyngäs' methodology was employed.

Data Sources

CINAHL, MEDLINE, EMBASE, Web of Science, British Education Index, GreenFILE and Scopus were searched up to the 8th November 2022.

Results

Thirty-two studies were included in the review. Two studies included nursing educators in their samples, the rest focused solely on students. Findings suggest that whilst some students were aware of sustainability issues and felt that nurses have a responsibility to mitigate climate change, others showed limited awareness and believed that nurses have more important priorities. A global interest was seen among students for increased curricular content related to sustainability and climate change. Waste management and education of others were suggested actions students can take; however, barriers included lack of confidence and limited power.

Conclusion

There is a need for sustainability education within nursing curricula, accompanied by student support.

Implications for the Profession

The review acts as a starting point to make sustainable healthcare and climate change mitigation integral aspects of nursing.

Impact

Sustainability education within nursing curricula can positively impact on sustainable healthcare and climate change mitigation. More research is needed on the perspectives of nursing educators.

Reporting Method

The review is reported according to the PRISMA guidelines.

Patient or Public Contribution

No Patient or Public Contribution.

The potential of structured active play for social and personal development in preschoolers during cancer treatment: A qualitative RePlay study

Abstract

Aim

To explore the potential of a structured active play intervention to promote social and personal development in preschoolers during cancer treatment.

Design

A hermeneutic-phenomenological inspired explorative study.

Methods

Participant observations were conducted on 15 consecutively sampled children (aged 1–5 years) from April 2021 to April 2022. Observations were written as narrative scenic descriptions from field notes and were analysed inspired by hermeneutic-phenomenological analysis and using a thematic analysis structure.

Results

Observations were carried out during 67 group or individual structured active play sessions, resulting in 129 scenic descriptions. Observations of the children's emotional, verbal and bodily expressions and social interactions resulted in three main themes: (1) wanting to play, (2) gaining confidence in movement and (3) being part of a group. The findings showed how children, irrespective of age and the severity of their illness, wanted to play and expressed joy of movement. The children's daily physical state fluctuated and influenced their motivation to participate as well as their confidence in their physical abilities. Through structured active play and with support from their parents and healthcare professionals, the children had successful movement experiences and regained confidence in movement, supporting their personal development. Playing together with other children and accompanied by their parents, healthcare professionals supported the children's opportunities to practice social skills, such as turn-taking, waiting and taking charge. Familiarity, recognizability and fun were key motivational components for the children.

Conclusion

Participating in structured active play during treatment has the potential to promote personal and social development in preschoolers with cancer. Parents play a crucial role in supporting the participation of their children.

Implications for the Profession and/or Patient Care

The healthcare system and healthcare professionals should provide opportunities for preschoolers with cancer and other illnesses to participate in structured active play.

Impact

What problem did the study address? Cancer treatment affects the development of preschoolers’ gross motor-, personal and social skills—essential skills in childhood development. This study aimed to explore the potential for social and personal development through structured active play. What were the main findings? This study found that preschoolers want to play, and participating in structured active play can support their personal and social development through regained confidence in movement and becoming part of a group. Where and on whom will the research have an impact? The research impacts healthcare professionals working with preschoolers in the healthcare system. Creating opportunities for preschoolers to participate in structured active play throughout treatment can promote personal and social development.

Reporting Method

The study adheres to relevant EQUATOR guidelines and is reported according to the Standards for Reporting Qualitative Research (SRQR) checklist.

Patient or Public Contribution

Participants in this study were preschoolers with cancer and their parents. No public or patient involvement in the design of this study.

Trial and Protocol Registration

ClinicalTrials.gov: NCT04672681. Registered on December 17, 2020. https://clinicaltrials.gov/ct2/show/NCT04672681.

‘Hearing silences’: Exploring culturally safe transitional care: A qualitative study among Turkish‐speaking migrant frail older adults

Abstract

Aims

This study aimed to investigate the experiences and transitional care needs of Turkish frail older adults living in the UK and determine how this information can be utilized to improve the provision of culturally sensitive care during the transitional period.

Design

Qualitative descriptive research with semi-structured individual interviews.

Methods

“The ‘Silences’ Framework guided the research design, from conceptualizing the research question to structuring the report of final outputs. For this study, semi-structured, in-depth interviews were conducted with sixteen older adults living with frailty and five family caregivers between January and May of 2023 in the United Kingdom.

Results

Major themes that were identified included: (i) information and communication, (ii) care and support, (iii) the role of culture and (iv) trust and satisfaction. Further analysis, through discussion and immersion in the data, revealed that care transition periods were presented alongside three phases of transitional care: pre-transition (during hospitalization), early-transition (the period between discharge and the 7th day after discharge) and late transition (the period between the 8th day and 12th month after discharge).

Conclusions

Our study revealed that the communication and informational needs of frail older individuals change during the transition period. While Turkish older adults and family caregivers expressed satisfaction with healthcare services in the UK, many struggled due to a lack of knowledge on how to access them.

Impact

The support of family caregivers is a crucial component in facilitating transitional care for frail older patients, as they help in accessing healthcare services and using technological devices or platforms. It should be noted that family caregivers often hold the same level of authority as their elderly Turkish counterparts.

Patient or Public Contribution

No patient or public contribution.

A survey of Indonesian nurses' educational experiences and self‐perceived capability to care for people with intellectual disability and/or autism spectrum disorder

Abstract

Aims

To describe Indonesian nurses' educational experience regarding care for people with intellectual disability and/or autism and to explore if these educational experiences are associated with their self-perceived confidence, comfort, knowledge and preparedness to care for these cohorts.

Design

Cross-sectional descriptive survey.

Methods

A descriptive survey tool utilized in a study of Australian registered nurses was replicated and adapted for this study. Following descriptive analysis, chi-square analyses were undertaken to explore associations between educational experiences, and self-rated measures of confidence, comfort and knowledge to work with people with intellectual disability and/or autism. Although there was no end-user involvement in the design of the study, the concepts explored have all been raised by those with lived insights of intellectual disability and/or autism as being critical to their healthcare experiences.

Results

There were 544 complete responses, and 51.7% were not exposed to any educational or clinical content relevant to caring for people with intellectual disability and/or autism. Moderate to low levels of self-perceived confidence, comfort, knowledge and preparedness to address healthcare needs of these cohorts were reported. Significant associations were identified between educational and clinical experiences during undergraduate training, and higher levels of self-perceived confidence, comfort and knowledge.

Conclusion

Mirroring international literature, the findings of this study highlight a large proportion of Indonesian nurses had little educational experience relevant to caring for people with intellectual disability and/or autism, and have relatively low levels of self-reported capability.

Impact

This study highlights gaps in the educational experiences, and self-perceived confidence, comfort, knowledge and preparedness of Indonesian nurses regarding caring for people with intellectual disability and/or autism. Given that internationally, people with intellectual disability and/or autism have disproportionately negative health outcomes and experiences, these findings have substantial implications for nursing curriculum, policy and professional development.

Care call requests and inpatient beds modernization: Is there any link? A prospective observational study in the oncological setting

Abstract

Aim

The study aims to analyse the principal causes of patients' care calls and compare differences before and after inpatient beds' technological modernization in a surgical breast oncological ward.

Design

A prospective observational study was conducted under the STROBE guidelines. Data were collected from June to September 2022.

Methods

Statistical analyses were performed to compare each reason for care calls, by shifts and pre and post-inpatient bed modernization.

Results

Two thousand five hundred and fifty-nine care request calls were analysed during the 202 observed shifts. The most frequent reason was related to the requests for positions.

Conclusion

Technological modernization of the beds has not led to effective—positive—changes; on the contrary, it seems at first glance to show an upward trend in calls above all in the short period after the changes.

Implications for the profession and/or patient care

What problem did the study address? By analysing the principal causes of care calls and comparing the differences before and after inpatient beds' technological modernization, this study evaluates if inpatient gear or device modernization can impact care call requests. What were the main findings? The results show that the most frequent reasons for care calls were position, possession and other. These findings seem not superimposable; the hypothesis supported by the international literature in which the causes relating to potty and pain were found among the main reasons. Where and on whom will the research have an impact? These results could impact the care organizational area in nursing care and could improve care quality, patient satisfaction and safety.

Reporting Method

This prospective observational study was conducted following STROBE guidelines.

Patient or Public Contribution

After adequate information (presentation, design methods and objectives), all unit healthcare staff agreed to collaborate in the study.

❌