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Anteayer Journal of Advanced Nursing

Expanding and Accumulating Transformative Potential: The Leadership Trajectories of Graduates of a Doctor of Philosophy in Nursing Education Programme

ABSTRACT

Aims

To describe the leadership trajectories of graduates of a Doctor of Philosophy in Nursing Education programme in a single university in the Philippines and examine how the doctoral programme influenced these trajectories.

Design

Qualitative design, specifically thematic narrative analysis.

Methods

A total of 10 purposively selected graduates of the programme were interviewed with the aid of videoconferencing and life-calendaring methods.

Results

The emerging central narrative theme is transformative potential. Leadership trajectories are characterised by expanding fields of transformative potential from within to beyond their organisations. Doctoral education shapes these trajectories through curriculum-driven capacity building, beyond-curriculum capacity building and character building.

Conclusion

The evolving leadership trajectories of graduates of the Doctor of Philosophy in Nursing Education programme are characterised by expanding and accumulating transformative potential.

Implications for the Profession

The findings can help nursing academic institutions design and improve postgraduate degrees, which will develop transformational leaders in the profession.

Impact

What problem did the study address?

This study aims to map and describe the leadership trajectories of graduates of a Doctor of Philosophy in Nursing Education programme.

What were the main findings?

The leadership trajectories of graduates are characterised by expanding and accumulating transformative potential.

Where and on whom will the research have an impact?

The findings can inform the planning, design and evaluation of doctoral nursing degree programmes in higher education institutions, as well as continuing educational programmes for nursing leaders in academic and clinical settings.

Patient or Public Contribution

Initial findings were sent to the graduates of Doctor of Philosophy in Nursing Education programme to validate the qualitative insights as part of member checking.

Uniforms, Identity and Digital Visibility in Nursing

Journal of Advanced Nursing, Volume 82, Issue 5, Page 5570-5571, May 2026.

Quality of Dying Among Institutionalised Nursing Home Residents From the Caregivers' Perspective: A Mixed‐Methods Study

ABSTRACT

Aims

To examine how family caregivers of deceased nursing home residents scored and justified their ratings for each item on the Quality of Dying in Long-Term Care scale and to identify the consistencies and discrepancies between their perceptions and the scores assigned when assessing the residents' end-of-life experience.

Design

A convergent mixed-methods design, comprising a cross-sectional study and a thematic analysis for quantitative and qualitative phases, respectively.

Methods

Quantitative and qualitative data were collected simultaneously between May 2018 and February 2019. The two sets of data were analysed separately. For the quantitative component, family caregivers completed the quality of dying in long-term care scale and a single-item question assessing the final month of the residents' life. Descriptive statistics, Mann–Whitney U-tests for comparative analyses and Spearman's correlations were applied to the quantitative data, while deductive thematic analysis was conducted for the qualitative data obtained through semi-structured interviews.

Results

Sixty-nine family caregivers completed the QoD-LTC, and 11 participated in qualitative interviews. The mean overall QoD-LTC score was 39.29 (SD = 7.58). The highest-rated domain was ‘Personhood’ (M = 4.32; SD = 0.68), while the lowest was ‘Preparatory Tasks’ (M = 2.66; SD = 1.26). Interviewed family caregivers reported effective management of pain and other symptoms, satisfaction with the care provided and respectful and appropriate treatment. However, they identified significant shortcomings in communication concerning end-of-life issues, coping with death and advance care planning. Residents with cognitive impairment had significantly lower scores on the ‘closure’ (p < 0.01) and ‘preparatory tasks’ (p = 0.03) domains as well as on the overall QoD-LTC score (p = 0.01).

Conclusions and Implications

The findings demonstrate consistency between the quantitative and qualitative data, with high scores reported across most domains of the QoD-LTC scale, with the exception of the ‘Preparatory Tasks’ domain. Cognitive impairment among residents was associated with lower perceived quality of the dying process from the perspective of family members.

Clinical Relevance

Aspects related to closure and preparatory tasks were often overlooked. Strategies to enhance end-of-life communication and advance care planning are needed.

Reporting Method

The study adhered to the EQUATOR guidelines. The Mixed Methods Reporting in Rehabilitation & Health Sciences (MMR-RHS) checklist for mixed-methods studies, the STROBE checklist for cross-sectional studies, and the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines for qualitative studies were used for reporting.

Patient or Public Contribution

No funding was received for the completion of this study.

Association Between Nursing Workload and Intensive Care Unit Readmissions: A Prospective Cohort Study

ABSTRACT

Aim

The aim of this study was to assess the relationship between nursing workload at the time of intensive care unit discharge and the likelihood of intensive care unit readmission.

Design

This single-center prospective cohort study was conducted at a Belgian academic hospital and included all intensive care unit admissions from June 1, 2021 to May 31, 2022.

Methods

The Nursing Activities Score was documented by the nurse responsible for each patient during every shift. Adult patients (≥ 18 years) with intensive care unit stay exceeding 24 h during the study period were eligible for inclusion. Those discharged to another hospital, a nursing home, or their own home were excluded due to the inability to ensure follow-up.

Results

Among the 1293 eligible admissions recorded during the study period, 133 patients (10.3%) experienced readmission. Readmitted patients exhibited a higher prevalence of medical reasons for intensive care unit admission, significantly increased mortality rates, and longer hospital length of stay compared to non-readmitted patients. The average daily Nursing Activities Score did not differ significantly between the two groups. The Nursing Activities Score at intensive care unit discharge was notably higher in readmitted patients, and those with a score above the median at discharge demonstrated an increased risk of readmission within 30 days. In multivariable analysis, a high Nursing Activities Score at intensive care unit discharge was an independent predictor of readmission.

Conclusions

An elevated nursing workload, as indicated by the Nursing Activities Score recorded at intensive care unit discharge, was significantly associated with a higher risk of readmission.

Implications for the Profession and/or Patient Care

The study examines the relationship between nursing workload at the time of ICU discharge and the likelihood of unplanned readmission. The results highlight the critical role of nursing workload assessment at ICU discharge in capturing the complexity of care requirements patients face at discharge. The results emphasise the importance of revising discharge planning processes, identifying nursing workload as a critical factor in unplanned readmissions.

Reporting Method

STROBE guidelines were used for this study.

Patient or Public Contribution

Not applicable.

Beyond Amount: Parent Perceptions of Feeding Success for Their Developmentally At‐Risk Infants in the First 2 Years

ABSTRACT

Aim

Examine the meaning of ‘successful feeding’ for parents of infants at risk for feeding difficulties and how this meaning evolved from 1 to 24 months post-term age.

Design

Secondary analysis of responses to an open-ended question from a U.S. longitudinal mixed methods study.

Methods

At 1-, 6-, 12-, 18-, and 24-months post-term, parents completed surveys which included the question: What is ‘successful feeding’ to you? Using conventional content analysis, 864 responses from parents of 254 infants were coded into the following categories: Child Behaviour, Positive Response, Intake, and Time. Themes characterizing each category were identified.

Results

Child Behaviour, Positive Response, and Intake were common at all time points. Responses related to Time (e.g., eating in a timely manner) were least frequent at 1, 6, and 12 months and were no longer mentioned thereafter. Demonstrating feeding skill/ability and satiety were common themes at all time points. Adequate quantity of food and no adverse response (e.g., emesis, choking) were common themes at 1 month; both decreased thereafter. The perception that the child was engaged in eating and eating nutritionally adequate food increased as children aged.

Conclusion

Parents' perspectives of successful feeding focused on indicators of their child's development and emotional and physical well-being. As their children aged, ate increasingly complex foods, and developed physiologic stability, the meaning of success focused less on the amount of intake and avoidance of an adverse response and more on child well-being.

Implications for the Profession and/or Patient Care

Nurses and feeding specialists can incorporate parents' views of success as they provide feeding support.

Impact

Children having a positive behavioural and affective response to eating, and adequate intake provide evidence to parents of their success in achieving feeding goals. Understanding issues of importance to parents is an essential component of family-centered care of children with feeding difficulties.

Patient or Public Contribution

No Patient or Public Contribution.

Reporting Method

The authors have adhered to the Standards for reporting qualitative research.

An Axiological (Re)Appraisal of Nursing in the Light of the 2025 ICN Definition: Implications for Research Development in Doctoral Education

ABSTRACT

Aim

To explore the potential axiological shift in nursing, drawing upon a critical reading of the new definition of ‘nursing’ published by the International Council of Nurses (ICN) in June 2025, and to articulate its implications for research and doctoral education.

Design

Critical discussion paper.

Methods

Guided by critical inquiry and emancipatory nursing knowledge development approaches, this paper deploys retroductive analysis to interrogate the axiological commitments that inform and are generated by the 2025 ICN definition and how it relates to nursing research. Consequently, it utilises the Vitae Researcher Development Framework (RDF) to map strategies for doctoral programmes responding to this axiological shift.

Results

A comprehensive axiological analysis of the 2025 ICN definition reveals a shift towards valuing human rights, relationality and care, planetary health and transformative leadership. However, an axiological analysis of prevailing nursing research definitions indicates a gap, particularly an explicit commitment to these expanded values beyond upholding scientific rigour. In response, an Axiologically-Driven Research Development Strategy Framework (ADRDSF) is proposed, integrating ICN's new axiologies across doctoral programmes in nursing.

Implications for Nursing

This axiological shift signals the reorientation of nursing research to be explicitly value-driven, ethical and focused on social justice, relationality and planetary health. Doctoral programmes must cultivate scholars and leaders who are not only competent but also axiologically aligned, capable of driving this transformative research agenda for a more just and sustainable future.

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