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Aim: To describe the activities nurses perceived to be delegable to other staff (delegable activities) in order to estimate the time nurses spend on delegable activities and explore nurses' reasons for not delegating these activities. Design: Mixed‐methods explanatory sequential. Methods: In total, 236 nurses from 27 medical and surgical wards of five hospitals in northern Italy completed a web‐based survey during a single shift between June and July 2022. Minutes spent on delegable activities, staff member to whom participants could have delegated and reason(s) for not delegating were reported. Chief nurses provided specific wards' characteristics using a paper‐and‐pencil questionnaire. Twenty semi‐structured interviews were conducted to explore delegable activities and reasons for not delegating. Quantitative and qualitative results were merged using joint displays. Results: Participants spent approximately one‐quarter of their time performing delegable activities, mainly delegable to nurse aides or nurse clerks, and performed due to a lack/shortage of staff or their concurrent participation in other activities. Participants recognized that activities requiring clinical assessment and decision‐making skills cannot be delegated, whereas technical activities and indirect care should be delegated. Organizational, structural and cultural factors, as well as patient characteristics, available staff and experience affected delegation, leading nurses to perform delegable activities to ensure patient care. Conclusion: Nurses spend a considerable part of their time on delegable activities due to a lack of staff or support services and suboptimal organization, which could be addressed by optimal staff management, but also to the complexity of the contexts, including individual and cultural factors that should be addressed through policy interventions. Impact: This study estimates the time nurses spend on delegable activities in acute care settings. Our findings highlighted the reasons that sustain the decision not to delegate that policymakers, healthcare managers, and nurse educators should consider to promote nurses' delegation skills. Reporting Methods: MMR checklist. Patient/Public Contribution: None. [ABSTRACT FROM AUTHOR]

Aim(s): The aim of this study is to understand factors that challenge retention and support nurses to stay in general practice. Background: One in four general practice nurse positions in England expected to be left unfilled within the next 10 years. Cultural and structural issues associated with working in general practice have been linked with nurses leaving general practice, re‐evaluating their professional futures, adjusting work‐life balance and bringing forward retirement. This has implications for the future of the general practice nursing workforce and patient care more broadly. Design: Exploratory qualitative interview study funded by the General Nursing Council Trust for England and Wales. University of York ethics approval (Ref: HSRGC/2023/586/A) was gained in September 2023. The study will be conducted between September 2023 and August 2024. Methods: Qualitative interviews will be conducted with a range of nurses working in, or who have worked in, general practice as well as nurse leaders associated with general practice across England and Wales. Recruitment will be via professional and social media networks and snowballing techniques. We aim to purposively recruit 30–40 participants for maximum variation. Cultural and structural influences which may contribute to retention decisions will be explored. Data will be analysed following framework analysis. Discussion/Conclusion: This study will explore how underpinning cultural and structural issues may impact on retention of this highly skilled professional group and identify factors to support retention. Implications for the Profession and/or Patient Care: By exploring factors that support or discourage nurses to remain in general practice, retention strategies can be better planned on order to address the general practice nursing workforce crisis. Impact: What problem did the study address? This study will address the retention crisis in nursing in general practice by exploring how cultural and structural issues may impact on retention of this highly skilled professional group and identify factors to support retention. Where and on whom will the research have an impact? From the study findings, recommendations will be developed to inform future policy and practice. Key factors to address attrition will be generated to support employers and policy makers in future primary care workforce planning, as well as supporting nurses, at an individual level, in negotiating their roles in practice. Reporting Method: Standards for Reporting Qualitative Research (O'Brien et al., 2014). Patient or Public Contribution: As this is a workforce study protocol, there is no patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim(s): To describe advanced practice nursing (APN) in the French healthcare landscape and to provide insights on how the role is defined and implemented and how the role is perceived by physicians. Design: A mixed‐method approach incorporating qualitative and quantitative data to offer a global understanding of APN implementation in France was used. Methods: Data were collected through questionnaires and interviews with APNs and physicians in diverse healthcare settings in France. The questionnaire assessed the roles, relationships with physicians and patients and the perceived implementation success of APNs. In‐depth interviews explored experiences, definitions, challenges and perspectives of APNs. A thematic analysis was applied to the qualitative data to complete the quantitative exploration. Descriptive analyses were performed for quantitative data. Results: A total of 41 APNs and 12 physicians were involved in this study between December 2022 and March 2023. The findings underscore APN as a pivotal, independent profession integrating advanced clinical expertise and interprofessional skills. The challenges encountered by APNs include role ambiguity, ongoing resistance and the need to address institutional barriers. Despite the fact that 73.2% of APNs reported that their role was well implemented, only 17.1% had clearly defined roles at the outset. Conclusion: This study revealed the dynamic and evolving nature of APN in France, highlighting its challenges and opportunities. Despite facing role ambiguity and resistance, APNs play a crucial role in the healthcare system. Implications for the Profession and/or Patient Care: The results highlight the need for specific interventions to tackle challenges and facilitate successful integration of APN. These insights lay a foundation for future research and interventions aimed at boosting the impact and acceptance of APN in France, potentially influencing policy modifications and professional development. Impact: Problem Addressed: The study aimed to enhance comprehension of the implementation and role of advanced practice nursing (APN) in France. It focused on defining APN in the French context, identifying barriers and facilitators to its implementation and evaluating its impact. Main Findings: The study revealed that APN in France is evolving with expanded competencies and clinical autonomy, but faces challenges like role ambiguity and professional resistance. Key findings include the successful integration of APNs in healthcare settings, positive relationships with medical doctors and patient satisfaction. However, the study also highlighted the necessity to resolve role ambiguity and to improve the understanding and acceptance of APN roles among healthcare professionals for successful APN integration. Impact of the research: This research will primarily impact healthcare systems and policy‐making in France, guiding the future development and integration of APN roles. It is also relevant for healthcare professionals, particularly nurses and physicians, by providing information about the evolving nature of APN and its benefits in patient care. Globally, the study contributes to the broader discourse on APN, offering insights that could inform APN implementation strategies in other countries facing similar healthcare challenges. Reporting Method: COREQ—STROBE. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: Master's degrees for nurses have various foci including clinical practice, leadership and education, with some programs consisting of coursework, while others offer hybrid study that combines coursework and research. Multiple formats are associated with offering the research component. The research component is often termed the minor thesis. Limited knowledge exists regarding the supervision of the research component. Aim(s): To capture the practices and perspectives of experienced nurse academics regarding effective supervision of the masters‐level minor thesis in nursing coursework master degrees. The Study: Design: Qualitative descriptive. Methods: Semi‐structured interviews with 28 experienced nurse academics recruited from 15 Australian and three New Zealand universities linked to the Council of Deans in Australia and New Zealand. Inclusion criteria were having experience of supervising masters‐level minor theses and higher degrees. Interviews were face‐to‐face using the internet platform Zoom©. Thematic analysis was undertaken. Findings: The analysis revealed three themes and associated sub‐themes: (i) establishing the framework (setting up the student's research; building the student–supervisor relationship; setting clear expectations), (ii) supervisors' knowledge and actions: driving for success (supervisors' knowledge for a satisfactory and timely outcome; supervisors' actions to develop students' capabilities; supervisors' actions of drawing in other expertise) and (iii) supervisor savviness: Attending to the finer points of supervision for student success (using your attributes as a supervisor; being savvy to teach and engage students; creatively seeking a smooth process for student success). Conclusion: The findings highlight three themes crucial to effective supervision of masters‐level minor theses in nursing: Establishing a strong research framework, emphasizing supervisors' knowledge and proactive engagement and attending to nuanced aspects of supervision for student success. These insights contribute to deeper understanding of the multifaceted nature of supervising minor theses, providing a valuable foundation for refining supervisory practices and enhancing the educational experience within coursework nursing master degree programs. Implications for the Profession and/or Patient Care: The findings highlight the supervisors' pivotal practices in guiding students through the minor thesis. These insights will be useful for inexperienced and experienced supervisors and for degree program directors. The findings should inform supervision training and supervision practices in the future. Impact: The study addressed a gap in knowledge about what experienced supervisors do to be effective and achieve success in the research component in a hybrid master degree for registered nurses.Effective supervision for student success in the minor thesis requires supervisors to establish and maintain a project and supervisory framework with appropriate boundaries and that is attuned to both the supervisor and student capabilities and preferences.Supervisors have an active role in directing the focus, scale and scope of a minor theses in keeping with university requirements and the short timeframe.Supervisors pay attention to the development of multiple student literacies (research, academic, professional, feedback and cultural) as core aspects of the masters research journey.Supervisors use their savviness and customize supervision to student contexts and capabilities as they guide development to achieve student success.The research findings have implications for targeted supervisor training and enhancing educational strategies for research supervision of minor thesis students. Reporting Method: COREQ reporting was adhered to as the relevant EQUATOR guideline. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To discover what long‐term care (LTC) staff working in self‐managing teams consider necessary to remain sustainably employable. Design: Qualitative study with semi‐structured interviews. Methods: In 2020, semi‐structured interviews were conducted one‐on‐one with 25 LTC workers from a medium‐large Dutch organization providing long‐term care. All interviews were audio‐recorded, anonymously transcribed verbatim and analysed with thematic content analysis in the software program Atlas.ti. Results: LTC workers indicated a need for autonomy. They wanted their control and involvement in decisions to be strengthened. Furthermore, LTC workers indicated a need for relatedness, by experiencing support, a feeling of togetherness and more time to have attention for the residents. Lastly, LTC workers expressed a need for (assistance in) further developing their competence. Conclusion: In order to remain willing and able to work, LTC workers in self‐managing teams want their needs for autonomy, relatedness and competence to be addressed. Working conditions are important to these LTC workers' sustainable employability since they can hinder or promote the satisfaction of their needs. Implications: It is important that management in LTC is aware of the importance of LTC workers' needs for sustainable employability. We recommend that management critically reflect on and invest in addressing these needs by enhancing indicators and limiting inhibitors of the needs. Impact: A robust LTC workforce is necessary to provide care to the aging population. In the context of the increasing implementation of self‐managing teams in LTC organizations, understanding what workers in self‐managing teams need in order to remain sustainably employable is crucial.For sustainable employability (i.e. to remain willing and able to work), interviewees indicated a need for autonomy, relatedness, and competence. Nearly all participants stressed the importance of belonging and feeling connected. Working conditions seemed to relate not only directly to the sustainable employability of LTC staff but also indirectly through their lack of contribution to the satisfaction of workers' psychological needs.The outcomes of this study primarily impact workers and management within LTC organizations with self‐managing teams. They benefit from recognizing the significance of addressing workers' needs to ensure their essential and sustainable employability in the sector. Reporting Method: The Standards for Reporting Qualitative Research and the Consolidated Criteria for Reporting Qualitative (COREQ) research were used. Patient or Public Contribution: Two LTC workers provided advice and feedback regarding the materials and set up of the interviews. These two ambassadors additionally helped in reaching our population, by disseminating information about the study. [ABSTRACT FROM AUTHOR]

Aim: To understand the perceived helpfulness and acceptability of a bespoke psychological therapy service for registered nurses. The service provided a free and confidential specialist mental health service to all healthcare professionals, including nurses and nursing students. Design: An exploratory study using a descriptive qualitative approach. Methods: A purposive sample of 20 registered nurses accessing a bespoke psychological therapy service in Wales participated in audio‐recorded semi‐structured interviews in January 2022. Transcribed data were analysed using reflexive thematic analysis. Results: Four interrelated themes were identified from the data analysis: COVID [SARS‐CoV‐2] changed things; You're a nurse, you're human; I've got 'me' back; and pretty close to miracle workers. Conclusion: Participants attempted to live up to an idealized image of a nurse, generating self‐stigmatizing beliefs that negatively affected their mental health. The psychological therapy service enabled participants to put their roles into perspective, that is, separate themselves from their role, be vulnerable, and develop confidence and adaptive coping strategies. Participants valued the minimal barriers and ease of access to support. Implications for the Profession and/or Patient Care: The complex relationship between nurse identity and the challenges of the workplace needs to be central to nurse education. Nurses can benefit from rapid access to a timely, confidential, and independent self‐referring psychological therapy service. Impact: This qualitative study explored the helpfulness and accessibility of psychological support for nurses. The main themes were that COVID changed things; You're a nurse, you're human; I've got 'me' back; and pretty close to miracle workers. The findings will impact how nurses are supported in the United Kingdom and worldwide. Reporting Method: This report adheres to the standards for reporting qualitative research (SRQR). Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To deepen our understanding of why nurses decide to leave their occupation instead of changing jobs, we examined the antecedents that led to this decision through the theoretical lens of psychological contract breach. Design: A qualitative design with semi‐structured interviews. Methods: We collected 28 interviewees from our social networks and a social media platform. We included professional nurses who had decided to leave or had left the occupation. We analysed our data with reflexive thematic analysis, thereby giving space for the interviewee voices to rise. Results: We identified various experiences of dissonance between interviewee expectations and reality. The interviewees expressed unfulfilled expectations or psychological contract breaches in relation to their occupation on different levels and over extended time periods. The psychological contract breaches and decisions to leave the occupation were built up over time because of continuous disappointment and dissonance between expectations and reality. The frustration, dissonance and unfulfilled expectations were expressed towards the institution of nursing rather than a specific employer or organization. Conclusion: Unfulfilled expectations over a longer period might cause psychological contract breach, leading to turnover intentions. Our research brings novel insights into the psychological contract, as our findings indicate that the psychological contract can be formed and breached, also between the employee and the occupation. This means that turnover intentions might result in nurses leaving the profession rather than seeking work in new organizations. Impact: The study addresses the problem of nurse shortage by showing the root reasons for deciding to leave the occupation. Our findings show how psychological contract breaches over time erupt as turnover intentions regarding the occupation rather than a job. The results guide healthcare managers and decision‐makers to recognize factors leading to a psychological contract breach, thereby enabling the retention of nurses. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To describe intensive care unit nurses' experiences of moral distress during the COVID‐19 pandemic, and their recommendations for mitigative interventions. Design: Interpretive description. Methods: Data were collected with a purposeful sample of 40 Canadian intensive care unit nurses between May and September 2021. Nurses completed a demographic questionnaire, the Measure of Moral Distress—Healthcare Professionals survey and in‐depth interviews. Quantitative data were analysed using descriptive statistics. Qualitative data were categorized and synthesized using reflexive thematic analysis and rapid qualitative analysis. Results: Half of the nurses in this sample reported moderate levels of moral distress. In response to moral distress, nurses experienced immediate and long‐term effects across multiple health domains. To cope, nurses discussed varied reactions, including action, avoidance and acquiescence. Nurses provided recommendations for interventions across multiple organizations to mitigate moral distress and negative health outcomes. Conclusion: Nurses reported that moral distress drove negative health outcomes and attrition in response to moral events in practice. To change these conditions of moral distress, nurses require organizational investments in interventions and cultures that prioritize the inclusion of nursing perspectives and voices. Implications for the Profession: Nurses engage in a variety of responses to cope with moral distress. They possess valuable insights into the practice issues central to moral distress that have significant implications for all members of the healthcare teams, patients and systems. It is essential that nurses' voices be included in the development of future interventions central to the responses to moral distress. Reporting Method: This study adheres to COREQ guidelines. Impact: What Problem did the Study Address?: Given the known structural, systemic and environmental factors that contribute to intensive care unit nurses' experiences of moral distress, and ultimately burnout and attrition, it was important to learn about their experiences of moral distress and their recommendations for organizational mitigative interventions. Documentation of these experiences and recommendations took on a greater urgency during the context of a global health emergency, the COVID‐19 pandemic, where such contextual influences on moral distress were less understood. What Were the Main Findings?: Over half of the nurses reported a moderate level of moral distress. Nurses who were considering leaving nursing practice reported higher moral distress scores than those who were not considering leaving. In response to moral distress, nurses experienced a variety of outcomes across several health domains. To cope with moral distress, nurses engaged in patterns of action, avoidance and acquiescence. To change the conditions of moral distress, nurses desire organizational interventions, practices and culture changes situated in the amplification of their voices. Where and on Whom Will the Research Have an Impact on?: These findings will be of interest to: (1) researchers developing and evaluating interventions that address the complex phenomenon of moral distress, (2) leaders and administrators in hospitals, and relevant healthcare and nursing organizations, and (3) nurses interested in leveraging evidence‐informed recommendations to advocate for interventions to address moral distress. What Does this Paper Contribute to the Wider Global Community?: This paper advances the body of scientific work on nurses' experiences of moral distress, capturing this phenomenon within the unique context of a global health emergency.Nurses' levels of moral distress using Measure of Moral Distress—Healthcare Professional survey were reported, serving as a comparator for future studies seeking to measure and evaluate intensive care unit nurses' levels of moral distress.Nurses' recommendations for mitigative interventions for moral distress have been reported, which can help inform future interventional studies. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: This study aims to determine the prevalence of workplace violence against healthcare professionals and its effects on work engagement and meaningful work in healthcare settings. Design: This study is designed as an analytical cross‐sectional study. Methods: This study surveyed 676 healthcare professionals in Turkiye between June and December 2022, using face‐to‐face and online methods. Scales measured exposure to and witnessing violence, work engagement, and meaningful work. The study has adhered to STROBE guidelines. Statistical analyses included descriptive, correlation, and linear regression. Results: According to the results, shouting and cursing by patients and their companions were determined as the most common type of violence encountered by healthcare professionals. The effect of healthcare professionals' exposure to violence from patients' companion on work engagement and witnessing to violence from colleagues on meaningful work were found to be negative and significant. Discussion: The findings emphasise the urgent need for interventions addressing workplace violence against healthcare professionals. Since workplace violence significantly reduces work engagement and the sense of meaningful work in healthcare setting. Impact: By highlighting the prevalence of workplace violence and its negative impact on both work engagement and meaningful work in healthcare setting, this study provides critical evidence for policymakers and healthcare administrators. Patient or Public Contribution: The participants in this study were healthcare professionals who had direct contact with patients and their relatives. [ABSTRACT FROM AUTHOR]

Aim: To develop and psychometrically test the triage decision‐making instrument, a tool to measure Emergency Department Registered Nurses decision‐making. Design: Five phases: (1) defining the concept, (2) item generation, (3) face validity, (4) content validity and (5) pilot testing. Methods: Concept definition informed by a grounded theory study from which four domains emerged. Items relevant to the four domains were generated and revised. Face validity was established using three focus groups. The target population upon which the reliability and validity of the triage decision‐making instrument was explored were triage registered nurses in emergency departments. Three expert judges assessed 89 items for content and domain designation using a 4‐point scale. Psychometric properties were assessed by exploratory factor analysis, following which the names of the four domains were modified. Results: The triage decision‐making instrument is a 22‐item tool with four factors: clinical judgement, managing acuity, professional collaboration and creating space. Focus group data indicated support for the domains. Expert review resulted in 46 items with 100% agreement and 13 with 66% agreement. Fifty‐nine items were distributed to a convenience sample of 204 triage nurses from six hospitals in 2019. The Kaiser–Meyer–Olkin measures indicated that the data were sufficient for exploratory factor analysis. Bartlett's test indicated patterned relationships among the items (X2 (231) = 1156.69). An eigenvalue of >1.0 was used and four factors explained 48.64% of the variance. All factor loadings were ≥0.40. Internal consistency was demonstrated by Cronbach's alphas of.596 factor 1,.690 factor 2,.749 factor 3 and.822 for factor 4. Conclusion: The triage decision‐making instrument meets the criteria for face validity, content validity and internal consistency. It is suitable for further testing and refinement. Impact: The instrument is a first step in quantifying triage decision‐making in real‐world clinical environments. The triage decision‐making instrument can be used for targeted triage interventions aimed at improving throughput and staff education. Statistical Support: Dr. Tak Fung who is a member of the research team is a statistician. Statistical Methods: Development, validation and assessment of instruments/scales. Descriptive statistics. Reporting Method: STROBE cross‐sectional checklist. Implications for the Profession and/or Patient Care: The TDI makes the complexity of triage decision‐making visible. Identifying the influence of decision‐making factors in addition to acuity that affect triage decisions will enable nurse managers and educators to develop targeted interventions and staff development initiatives. By extension, this will enhance patient care and safety. [ABSTRACT FROM AUTHOR]

Aims: To explore the co‐occurrence of urinary incontinence and frailty by testing the roles of depression and activity engagement guided by the mechanisms of common cause and interaction pathways. Design: A secondary analysis of a 1‐year three‐wave panel data collected from older nursing home residents in China. Methods: Changes in depression and activity engagement were regressed on urinary incontinence and frailty incidence underpinned by the common cause mechanism of chronic conditions co‐occurrence, and these changes were also taken as mediators linking from frailty to urinary incontinence incidence supported by the interaction pathways' mechanism. Results: A total of 348 older adults were included in this study, and 55.7% were women. The co‐occurrence of urinary incontinence and frailty was found in 16.7% of the participants at baseline. Older adults with sole frailty at baseline had almost twice the rate of incident urinary incontinence (32.7%) compared with those without (16.7%) over a 1‐year period. The subsample analyses showed that changes in depression and activity engagement failed to significantly predict the incidence of urinary incontinence and frailty. The mediating roles of these changes linking frailty to urinary incontinence incidence were also not statistically significant. Conclusion: The co‐occurrence of urinary incontinence and frailty is prevalent in older nursing home residents. Older adults with frailty at baseline are more likely to develop urinary incontinence a year later. The common cause and interaction pathways mechanisms for the co‐occurrence of urinary incontinence and frailty were not verified with changes in depression and activity engagement. Implications for the Profession and/or Patient Care: The phenomenon of urinary incontinence and frailty co‐occurrence should be given extreme emphasis. Although statistically significant findings on the roles of depression and activity engagement were not inferred, this study provides multiple possibilities for future studies to test and depict a clear picture of this co‐occurrence. Impact: What problem did the study address? This study was designed to test the roles of depression and activity engagement in predicting the incidence of urinary incontinence and frailty, and the mediating roles in linking frailty to urinary incontinence incidence.What were the main findings? Despite the methodological pitfalls in literature have been addressed, neither depression nor activity engagement would significantly predict the incidence of urinary incontinence and frailty in older adults. Their mediating roles in linking frailty to urinary incontinence incidence were also not significant.Where and on whom will the research have an impact? Our findings add important pieces of evidence to promote researchers' understanding and provide an important basis for untangling the puzzle of urinary incontinence and frailty co‐occurrence. Reporting Method: The report of this study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement guidelines. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to establish the feasibility of delivering a structured post‐diagnosis information and support program to dyads (persons living with dementia or mild cognitive impairment and family carers) in two primary care settings. Design: A two‐phase explanatory mixed‐method approach guided by the Bowen Feasibility Framework focused on acceptability, implementation, adaptation, integration and efficacy of a five‐part programme. In phase 1, the quantitative impact of the programme on the dyadic programme recipients' self‐efficacy, quality of life, dyadic relationship and volume of care was measured. In phase 2, inductive content analysis focused on nurse and dyad participant experiences of the programme. Quantitative and qualitative data were reviewed to conclude each element of feasibility. Methods: Four registered nurses working within the participating sites were recruited, trained as programme facilitators and supported to deliver the programme. Eligible dyads attending the respective primary health clinics were invited to participate in the programme and complete surveys at three time points: recruitment, post‐programme and 3‐month follow‐up. Post‐programme semi‐structured interviews were conducted with dyads and programme facilitators. Results: Twenty‐nine dyads completed the program; the majority were spousal dyads. The programme proved acceptable to the dyads with high retention and completion rates. Implementation and integration of the programme into usual practice were attributed to the motivation and capacity of the nurses as programme facilitators. Regarding programme efficacy, most dyads reported they were better prepared for the future and shared the plans they developed during the programme with family members. Conclusion: Implementing a structured information and support programme is feasible, but sustainability requires further adaptation or increased staff resources to maintain programme fidelity. Future research should consider selecting efficacy measures sensitive to the unique needs of people living with dementia and increasing follow‐up time to 6 months. Impact: This study established the feasibility of registered nurses delivering a post‐diagnosis information and support programme for people living with early‐stage dementia or mild cognitive impairment and their informal carers in primary care settings.The motivation and capacity of nurses working as programme facilitators ensured the integration of the programme into usual work, but this was not considered sustainable over time.Family carer dyads reported tangible outcomes and gained confidence in sharing their diagnosis with family and friends and asking for assistance.Findings from this study can be used to provide direction for a clinical trial investigating the effectiveness of the structured information and support programme in the primary care setting. Reporting Method: The authors have adhered to the EQUATOR STROBE Statement. Patient or Public Contribution: A public hospital memory clinic and general medical practice participated in project design, study protocol development and supported implementation. [ABSTRACT FROM AUTHOR]

Aim: To explore experiences of patients affiliated to a cross‐sectorial outgoing lung team. Background: The outgoing lung team consisted of respiratory nurses from the hospital and community nurses. The lung team offered 24/7 help to patients with advanced chronic obstructive pulmonary disease (COPD) through visits and/or treatment in the patients' home. Affiliation to the lung team reduced both hospitalizations and length of hospital stay due to acute exacerbation of COPD. However, based on questionnaires on health‐related quality of life, no significant differences were found between patients affiliated to the lung team and patients receiving usual care. Design: A qualitative interview study. Methods: In total, 16 patients, aged 61–88 years were interviewed between February 2019 and July 2021. They had been affiliated to the outgoing lung team for 1–3 years. Semi‐structured interviews were conducted in the patients' home and audio‐recorded after informed consent was obtained. The interviews were transcribed verbatim and analysed, inspired by systematic text condensation by Malterud. Findings: Four themes emerged from the analysis: (1) feeling safe, (2) improvements in living with COPD, (3) avoiding hospitalization and (4) satisfied with staying at home. Conclusion: Affiliation to the cross‐sectorial outgoing lung team gave the patients peace of mind and improved their ability to live with advanced COPD. The patients preferred contacting the lung team because they could stay at home and receive treatment, and thus avoid hospitalization. Impact: The findings from this study support that municipalities should consider implementing an outgoing lung team, as it has the potential to bring several benefits, including improving patient self‐management. Reporting Method: The manuscript adhered to Consolidated criteria for reporting qualitative research (COREQ) guideline. Patient or Public Contribution: Patients were interviewed. Additionally, no patient or public contributed to the design or conduction of the study, analysis, or interpretation of the data. [ABSTRACT FROM AUTHOR]

Aims: To assess visitors' perceptions of the benefits and challenges related to engaging in a remote visit intervention, which was designed to address the loneliness of people living with moderate to severe dementia in care homes. Design: A qualitative descriptive study. Methods: Twenty‐four people living with dementia in care homes in Canada and their family and friends (i.e., remote visitors) took part in facilitated remote visits in 2021. Each person living with dementia received scheduled visits for 30–60 min per week for 6 weeks. Participants chose to complete one longer visit, or multiple shorter visits, per week. Twenty remote visitors participated in semi‐structured interviews after six weeks to discuss their perspectives on the effectiveness, benefits and challenges of the program in relation to addressing experiences of loneliness of the person living with dementia. Conventional content analysis was used to analyze the data. Results: We describe three themes and several sub‐themes. Themes support the use of remote visits to enhance, rather than replace, in‐person visits; the benefits of remote visits for the person living with dementia and their remote visitors; and the conditions that lead to a successful remote visit. Conclusion: Remote visitors reported that facilitated visits had positive effects for both visitors and people living with dementia with respect to loneliness, communication, relationships, and social connection. Implications for Patient Care: Clinicians can consider the factors that contributed to positive experiences of remote visits. The factors include individualized, facilitated visits that were flexible, and the use of reliable technology in a supportive, distraction‐free environment. Impact: Loneliness and social isolation are growing health concerns. When experienced by people living with dementia residing in long‐term care homes, loneliness and social isolation can result in lower levels of quality of life and well‐being, and higher levels of anxiety and responsive behaviours.Remote visitors perceived that facilitated remote visits have the potential to address loneliness and improve quality of life for people living with dementia and also offer social support to remote visitors.The findings can impact clinician practice by guiding the use of remote visits in care homes, and inform future intervention research to evaluate the effectiveness of remote visits for people living with dementia and their remote visitors. Reporting Method: This manuscript adheres to the relevant EQUATOR guidelines (the Consolidated criteria for reporting qualitative research or COREQ). Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To explore the lived experiences of patients with severe obesity during hospital admissions. Design: Qualitative study design. Methods: Semi‐structured individual interviews with 14 participants with severe obesity from Norway were conducted between May and October 2021. A qualitative phenomenological hermeneutical approach inspired by Paul Riceour was used to analyse the data. Results: The following three themes were identified through the analysis of the lived experiences of patients with severe obesity during hospital admissions: blaming my weight, being prejudged and feeling different. The participants shared various emotional experiences of encounters with healthcare professionals at hospitals. They struggled to be recognized and welcomed like everyone else and found it difficult to be judged by someone who did not know them. The various experiences resulted in a vicious circle, ultimately leading to a fear of future hospitalization. Conclusion: Being a patient with obesity in a hospital setting can present various challenges, leading to feelings of shame and guilt. Experiences of stigma may not necessarily be related to the overall hospital context but rather to encounters with healthcare professionals who may be unfamiliar with the patient's history, which can lead to stigmatizing behaviours. Impact: Understanding how patients with severe obesity experience their hospital admissions and the importance of familiarizing themselves with the individual patients to avoid stigmatizing behaviours is important for healthcare professionals caring for obese patients. Reporting Method: Consolidated Criteria for Reporting Qualitative Research. Patient or Public Contribution: No patient or public contribution. Impact Statement: Patients with obesity often encounter stigmatization and negative attitudes from healthcare professionals, particularly in primary care settings.Patients with severe obesity experienced various challenging encounters with healthcare professionals during hospital admissions, resulting in a vicious circle, ultimately leading to a fear of future hospitalization.It is crucial for healthcare professionals involved in the care of patients with obesity to acquaint themselves with individual patients to prevent stigmatizing behaviours. [ABSTRACT FROM AUTHOR]

Aim: To explore general nurses' experiences of modifying and implementing contextually suitable Safewards interventions into medical and surgical hospital wards. Design: Qualitative action research was used working with nurses as co‐researchers. Methods: Pre‐implementation focus groups were conducted in April 2022 to understand and explore the current strategies nurses utilized to avert, respond to or decrease violence. Following this, two Safewards interventions were modified by the nurses on the wards. Post‐implementation focus groups were conducted in October 2022, to explore the nurses' experience of implementing Safewards interventions and the effect on their nursing practice. Data were analysed using Braun and Clarke's framework for thematic analysis. Results: Three themes emerged from the analysis of the pre‐implementation focus groups that reflected the type of violence experienced by these nurses and the context within which they occurred: 'the space is hectic'; 'it can feel like a battlefield'; and 'the aftermath'. These themes encompass the nurses' experience of violence from patients and their visitors. Following the implementation of two modified Safewards interventions, the analysis of the focus groups reflected a change in nursing skills to avert or respond to violence: 'Safewards in action'; 'empathy and self‐reflection'; and 'moving forward'. Conclusion: Safewards interventions can be successfully modified and used in general hospital wards and influence nursing practice to manage patient and visitor violence. Implications for the Profession: In the interests of safety, successful interventions to reduce violence towards general hospital nurses should be a priority for managers and healthcare organizations. Averting, mitigating and managing violence can decrease the negative professional and personal effect on nurses and ultimately improve well‐being, job satisfaction and retention rates. Furthermore, decreasing violence or aggressive incidents leads to a safer patient experience and decreased number of nursing errors ultimately improving patient experiences and outcomes. Understanding nurses' experiences of violence and working with them to explore and develop contextually relevant solutions increases their capacity to respond to and avert violent incidents. Contextually modified Safewards interventions offer one such solution and potentially has wider implications for healthcare settings beyond the specific wards studied. Impact: This study addressed the implementation of modified Safewards strategies in medical and surgical wards to prevent violence.Three themes emerged from the analysis of the pre‐implementation focus groups that reflected the type of violence experienced by these nurses and the context within which they occurred.Following the implementation of two modified Safewards interventions, the post‐implementation focus groups reported positive changes to their practices using the modified resources to prevent violence from patients and their visitors.Mental health interventions, such as those used in the Safewards model can be modified and provide a tool kit of interventions that can be used by medical and surgical nurses. Reporting Method: This paper has adhered to the COREQ guidelines. Patient or Public Contribution: No patient or public contribution. What Does this Paper Contribute to the wider Global Clinical Community?: This paper outlines and discusses the action research approach undertaken to work with general hospital nurses to modify mental health nurses' Safewards interventions into their clinical practice.This paper provides evidence of the 'real world' application of Safewards interventions by medical and surgical nurses in general hospital wards.This paper presents qualitative findings based on focus group methods to highlight the narratives of general nurses and their experiences of violence. [ABSTRACT FROM AUTHOR]

Aims: Globally, the nursing shortage is a growing concern. Much of the research on retention of nurses focuses on the experience of those who left positions. In this study, we set out to listen to critical care nurses (CCRNs) who have chosen to remain in their positions to understand the factors retaining them in critical care. Design: This interpretive descriptive study was guided by the following research question: 'what factors influence CCRN's decision to continue to work in critical care?' Methods: Digitally recorded interviews and a focus group were conducted between July 2022 and January 2023 using a semi‐structured, strengths‐based interview guide with CCRNs from three critical care units at a tertiary hospital in a city in a central Canadian province. Transcribed interviews were analysed using open, axial and selective coding and constant comparative analysis. Results: Twenty‐two CCRNs participated in interviews and three in a focus group. The theme of Respect, demonstrated through the interconnected concepts of Working to Full Scope, Team, Rotations and Compensation was identified. Working to Full Scope was described as providing nursing care aligned with how each nurse envisions what nursing is. Being part of a Team led by strong nurse leaders that provides opportunities and supports the sharing of their perspectives was also found. Respect was also found to be demonstrated through Rotations that recognize that work is one part of these nurses' lives. Compensation that reflects the increased education, knowledge and skills required in critical care was the final concept of Respect. Conclusion: Organizations should focus their efforts across the identified concepts to demonstrate Respect for CCRNs and retain them. Implications for Practice: The findings of this study provide ways to support the retention of CCRNs. Impact: This research will have an impact on nursing leaders by providing tangible ways to retain CCRNs. Reporting Method: Reporting of this work was guided by the Standards for Reporting Qualitative Research. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: This study explores the experiences of interprofessional collaboration of Canadian midwives and obstetricians from midwives' perspective. Design: A concurrent mixed‐methods approach that combined a small validation study and qualitative thematic analysis was used to provide evidence of the nature and importance of collaboration between Registered Midwives (RMs) and obstetricians. Method: Eighteen RMs across Canada completed a demographic survey and the Midwifery‐Obstetrician Collaboration (MOC) scale in 2023. The quantitative analyses were conducted to assess the reliability of the Midwifery‐Obstetrician Collaboration (MOC) and accumulate preliminary evidence to support its validity. Semi‐structured interviews were conducted with 13 participants. After completing the interviews, themes were identified using thematic analysis. Results: The primary themes identified were knowledge of midwifery scope affects collaboration, collaboration is necessary for effective patient care, midwife‐physician collaboration is impacted by power differentials and hierarchies, and proposed methods to improve physician‐midwife collaboration. Although a small sample size did not permit extensive statistical testing, the quantitative results supported the reliability of the MOC scale. In addition, a strong correlation between the MOC and the communication subscale of the Inter‐Professional Collaboration (IPC) scale provided evidence of the MOC's concurrent validity as a measure of collaboration between midwives and physicians. Conclusion: This study provides support for the Midwifery‐Obstetrics Collaboration (MOC) Scale as an assessment tool to evaluate collaboration between midwives and OB/GYNs in obstetrics care. While the 18 RMs recruited for this study provided a fulsome analysis for the qualitative portion, a larger study is necessary to provide more extensive quantitative analysis to validate the MOC scale for continued use among RMs and OBs. Implications: The implications of this study are to foster strong interprofessional relationships between midwives and OBs and to improve the health outcomes of pregnant women and newborns. Reporting Method: The authors adhered to Consolidated criteria for reporting qualitative research (COREQ). [ABSTRACT FROM AUTHOR]

Aim: To explore self‐care and needs and preferences towards tailored self‐care support of patients with rheumatoid arthritis at the outpatient clinic. Design: A sequential explanatory mixed method design. Methods: The Self‐Care of Chronic Illness Inventory questionnaire, two focus groups and six semi‐structured interviews were conducted between November 2021 and April 2023. Questionnaires of 107 patients were descriptively analysed. Subsequently, 11 patients and 2 healthcare professionals participated in the focus groups and 6 patients in the interviews, which were thematically analysed. Results: Quantitative and qualitative data corresponded and showed that patients perform various self‐care activities at an adequate level and have strategies to exert control and reduce symptoms. One key theme emerged: 'Not only being the person with rheumatoid arthritis' (RA) as patients primarily aim to get on with their lives. Nine subthemes covered self‐care activities for maintaining health including staying physically active, finding the right medication and dose and adapting their diet. Patients differed in how they self‐monitored their symptoms. Recognizing symptoms and finding strategies to manage symptoms included the process of body listening in which patient seek and try different strategies to find what works for them and incorporate routines. Patients experienced positive effects of a warm or cold environment. Patients felt the need for practical and emotional support from others and preferred having credible information. Conclusion: Patients perform adequate self‐care including a diversity of self‐care activities to get on with their lives and have strategies to reduce and control the symptoms and impact of RA. Implications: Tailoring self‐care support to patients' individual needs and preferences is necessary to help patients cope with the erratic nature of the disease and maintain their quality of life. Healthcare providers need to provide practical and emotional support and use credible information to allow patients to make self‐care decisions to manage their lives. Reporting Methods: Quantitative finding are reported according to the STROBE guidelines and qualitative finding are reported according to the COREQ guidelines. What Does This Paper Add: Patients perform various self‐care activities at an adequate level and have strategies to exert control and reduce symptoms.Patients primarily aim to continue their lives and not being seen as the person with rheumatoid arthritis.Healthcare professionals need to provide practical and emotional support and use credible information to inform patients' self‐care decision‐making. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To explore adolescents' experiences of having a parent with heart disease. Design: This qualitative study was performed with semi‐structured individual interviews. Methods: Interviews were conducted with 33 adolescents between 13 and 19 years old, who either had a mother or father with one of these diagnoses: ischemic heart disease, arrhythmia, heart failure, cardiac arrest or heart valve disease. The parent had been ill for at least 6 months and up to 5 years. The study was carried out in Denmark, Norway and Sweden between 2019 and 2022. The analysis was inspired by Reflexive Methodology. Results: Three central themes emerged: Response to parental heart disease; Growing up ahead of time; and Strategies in a changed life situation. For the adolescents, heart disease was experienced as an acute and lethal disease that put their parents' lives in danger. New routines and roles not only changed everyday life within the family but they also enhanced maturity and appreciation of life. To maintain a balance in life, the adolescents pursued normality and sought a safe space to have a normal youthful life. Conclusion: In a period known to be significant for development, life with parental heart disease appeared as a biographical disruption because adolescents renegotiated their identity to manage their new life situation. Impact: It is important to help younger family members adapt to parental heart disease by informing them about possible reactions and supporting them in how to adapt to their new life by seeking breaks and normality. Patient or Public Contribution: No patient or public involvement. [ABSTRACT FROM AUTHOR]

Aim: To explore perceptions of annual surveillance with magnetic resonance imaging and perceptions of care during the examination among women with a hereditary risk of breast cancer. Design: Phenomenography. Methods: Fourteen face‐to‐face interviews using a semi‐structured interview guide were conducted among women undergoing surveillance in the southern region of Sweden. A seven‐step phenomenographic analysis with investigator triangulation was performed. Results: 'Considering own risk of developing breast cancer', 'Entrusting oneself to surveillance' and 'Living in a cycle' represented descriptive categories of perceptions. Family narratives introduced comprehension of own risk of breast cancer, followed by appraisal of own benefits of participating in surveillance. Entrusting oneself to surveillance included handing over management of diagnostic examinations and dealing with practical issues and diverse emotions related to surveillance. Planning life based around surveillance, struggling with fluctuating emotions, also between the examinations and questioning own identity implied the perception of living in a cycle. Conclusion: Surveillance for hereditary breast cancer implies living in a cycle of dealing with fluctuating emotions and planning life based around surveillance. Comprehension of one's own risk for breast cancer arises from awareness in the family. Women value the surveillance programme and trust the healthcare system. Implication for the Profession and Patient Care: Knowledge of women's perceptions of the surveillance programme and care is vital for supporting women in their decision‐making on attendance and providing person‐centred care during surveillance. Impact: A gap in explorative studies from the perspective of the individual woman in the context of surveillance for breast cancer and care in magnetic resonance imaging in surveillance was addressed. 'Considering own risk of developing breast cancer', 'Entrusting oneself to surveillance' and 'Living in a cycle' represented women's perceptions of surveillance and care. The study results have implications for person‐centred care among women in the surveillance programme. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To explore women's and health professionals' views on the development of a midwifery‐led mHealth app intervention in antenatal care and their demands for app functionality. Design: Descriptive qualitative research was utilized. Methods: In total, 15 pregnant or postpartum women were interviewed via in‐depth interviews and 10 health professionals including obstetricians, midwives and obstetric nurses were invited to participate in a focus group discussion (FGD). All interviews and the FGD were analysed using qualitative content analysis. Results: Four key themes emerged from the data, including (1) limitations of current maternity care services; (2) potential benefits for mHealth app‐based midwifery care; (3) possible challenges for providing midwifery care through mHealth apps and (4) suggestions and needs for developing a midwifery‐led mHealth app. Participants agreed on the potential need of developing a midwifery‐led mHealth app in antenatal care to increase access to midwifery care services and to meet women's diverse needs. Participants preferred to develop professional, reliable, full‐featured and interactive mobile applications. The main functions of midwifery‐led mHealth apps included personalized assessment and health education, self‐monitoring and feedback, data sharing and interactive functions. Women mentioned that online communication and consultation with midwives could help them receive continuous support outside facilities. Health professionals expressed it would be of great convenience and timeliness to send personalized messages to women and to inform them of healthy lifestyles during pregnancy. The challenges included a shortage of human resources, medico‐legal risks associated with mHealth and data security risks. Conclusions: This study explores the individual views and functional needs of target users and healthcare providers for developing a midwifery‐led mHealth app in antenatal care, which will serve as a reference for future application development. Impact: Our study has important and practical implications for guiding the development of future midwifery‐led mHealth app interventions. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To explore the lived experiences of mature female students undertaking a Bachelor of Nursing (Adult) programme in the UK, to gain insight into the challenges and barriers faced by students and investigate the factors that support students who have considered leaving, to stay and continue with their studies. Background: There is a global shortage of nurses and challenges exist in ensuring that enough nurses are available to provide care in the complex and rapidly changing care environments. Initiatives introduced to increase the number of Registered Nurses (RN), include increasing the number of students enrolled on pre‐registration nursing programmes. However, the success of this intervention is contingent on the number of students who go on to complete their course. Design: This qualitative study employed Interpretative Phenomenological Analysis (IPA), which provided a methodological framework and analytical approach to enable an exploration of participants' individual and shared lived experiences. Methods: Eight female, mature students at the end of their second year of a Bachelor of Nursing (Adult) programme at a Higher Education Institution in South Wales participated in semi‐structured, face‐to‐face interviews, which were analysed idiographically before group‐level analysis was undertaken. Findings: The analysis revealed three superordinate themes: 'Ambition to become a Registered Nurse'; 'Jugging Roles' and 'Particular Support Needs for a Particular Student'. Conclusion: Each student had a unique history, their past and present social and psychological experiences were multifaceted and complex. These differences resulted in varying degrees of resilience and motivations to continue their studies. These findings are important for ensuring that services develop and provide effective support to maximize retention and, ultimately, increase the number of students entering the RN workforce. Patient of Public Contribution: No patient or public contribution. Impact Statement: This research expands on current literature regarding the needs of mature female students, a growing student nurse demographic. Every student had a dynamic set of circumstances and demonstrated that the identification of 'at‐risk' students, purely based on demographics or information on a Curriculum Vitae, is problematic and potentially futile. This knowledge could be used to tailor University support systems and inform curriculum development and support systems for maximizing student retention. These findings are important for ensuring that services continue to develop and provide effective support to maximize retention and completion and, ultimately, increase the number of students entering the Nursing and Midwifery Council register. [ABSTRACT FROM AUTHOR]

Aim: To explore parents' perceptions/experiences of help‐seeking for unsettled baby behaviours, including views and experiences of obtaining advice from primary healthcare professionals. Design: Semi‐structured qualitative interviews. Methods: Recruitment occurred via social media, general practice and health visiting teams. Remote semi‐structured interviews were conducted with parents of babies. Babies were under 12 months old at time of interview, and parents had perceived unsettled baby behaviours in their first 4 months of life. Interviews were transcribed and data analysed using reflexive thematic analysis. Results: Based on interviews with 25 mothers, four main themes were developed. 'The need for answers' highlighted parental uncertainty about what constitutes normal baby behaviour, leading to help‐seeking from multiple sources. 'The importance of health professionals' and 'Experiencing health professional support' identified perceptions about limited access, communication, mixed advice and how these influenced parental perception/management of behaviours. 'Foundations to help‐seeking' highlighted important roles of social support and online help for valued shared experiences, emotional and practical support. Conclusion: Health professional access and advice are important to parents, despite the increasing role of online help and importance of social support. More support and improved access to reliable sources of information is needed for parents. Implications for the Profession and/or Patient Care: Findings will inform future research and clinical practice to address parental uncertainties. Qualitative research with front‐line health professionals is necessary. Impact: Findings can inform the development of resources to support professionals/families managing unsettled babies. Reporting Method: Standards for Reporting Qualitative Research. Public Involvement: A public contributor was involved throughout all stages of the research. Emerging findings were discussed at a parent group. What does this paper contribute to the wider global clinical community?: Addressing parental uncertainties is important; about what is normal, non‐pharmacological approaches and when pharmacological intervention is required.A digital information/self‐management intervention may be useful for parents/clinicians. [ABSTRACT FROM AUTHOR]

Background: The use of primary healthcare and health promotion services is low among immigrants compared with native citizens. Immigrants are at risk of developing chronic diseases due to genetics, nutrition and a sedentary lifestyle. Registered nurses play an integral role in teaching, counselling for a healthy lifestyle and care coordination in primary healthcare. Aim: We aimed to explore the perceptions of registered nurses on healthy lifestyle counselling for preventing type 2 diabetes and other chronic diseases among immigrants in the primary healthcare setting. Design: We performed a qualitative descriptive study using focus group interviews. Methods: Data were collected with semi‐structured focus group interviews with a total of 23 registered nurses working in primary healthcare. We recruited the participants by using the purposive sampling method in the primary healthcare setting of four municipalities in Finland. Interviews were audio‐recorded, transcribed verbatim and analysed with qualitative inductive content analysis. Results: The participants' perceptions were related to (1) uniform counselling practice for both immigrants and native citizens, (2) challenges in counselling immigrants, (3) understanding cultural factors influencing immigrant counselling, (4) the need to improve immigrant counselling and (5) utilizing insights from practical experience to improve the counselling service. Conclusions: Developing a culturally sensitive health promotion service is suggested to support the health of immigrants. Moreover, both migrant communities and healthcare professionals should be involved in co‐designing and implementing health promotion projects through a community‐based participatory approach. Impact: Our study contributes to healthcare practice and management by underscoring the need for culturally tailored health promotion services for the at‐risk group of immigrants in primary healthcare. Cultural competence in nursing education needs to be reinforced. The provided recommendations inform researchers and policymakers about the health disparities and health needs of immigrants. Public Contribution: Healthcare professionals were consulted in the study design. [ABSTRACT FROM AUTHOR]

Aim: To explore the health beliefs and health behaviours of older Vietnam‐born people living with chronic disease in Western Australia. Design: This study was designed as a focused ethnography guided by the interpretative research paradigm and Leininger's Theory of Culture Care. Methods: Data were collected through participant observation and interviews undertaken at participants' homes in Western Australia over 7 months in 2019. Data were analysed using Wolcott's approach for transferring qualitative data, comprising three phases: description, thematic analysis and interpretation. Results: This study included 12 participants. The health perspectives and practices of older Vietnam‐born Australians significantly reflected the traditional Vietnamese values. These included the stigma towards chronic disease as an inevitable consequence of ageing; self‐blame thoughts about chronic disease causations and maintained traditional dietary practices. However, some aspects of their health behaviours such as beliefs and practices in traditional medicine, Western medicine and physical exercise reflected a blended approach combining both Vietnamese‐oriented and Westernized‐orientated practices. Individual factors were also identified as contributing to chronic disease self‐care among participants. Conclusion: This study emphasizes culture played a significant role in shaping the way that older Vietnam‐born Australians believed and behaved while living with chronic conditions. However, it also indicates that culture is not a stationary concept, it evolves gradually and is socially constructed. Implications: A better understanding of the health beliefs and practices of older Vietnam‐born Australians is expected to contribute to the delivery of culturally safe and effective support for this population. The achievement of culturally safe care requires a systemic approach and collaboration of strategies across sectors. Patient and public contribution: This study encompassed the contribution of 12 older Vietnam‐born Australians who offered the researcher the privilege to enter their world and the staff of social care organization who opened the gate for the researcher to approach participants. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to explore how immigrant women and men from India construct mental health and mental illness in the perinatal period. Design: Qualitative interpretive design. Methods: Data were collected by conducting in‐depth interviews with 19 participants. Photo elicitation, free listing and pile sorting were used during the interviews. Purposive sampling was used, and data were collected in 2018 and 2019. Data were analysed using thematic analysis. Finding/Results: One major theme and three subthemes were identified. 'We do not talk about it' was the major theme and the subthemes: (1) 'living peacefully and feeling happy' described the views on mental health; (2) 'that's the elephant in the room still' captures how participants felt when talking about mental illness; and (3) 'why don't we talk about it' offers reasons why the Indian community does not talk about mental health and illness. Conclusion: The findings of this study have highlighted the importance of understanding the impact of immigration and being culturally sensitive when assessing mental health in the perinatal period. Impact: The findings of this study identify some of the reasons for non‐disclosure of mental health issues by immigrants. Incorporating these findings during psychosocial assessment by health professionals in the perinatal period will help translate the cultural aspects into more effective communication. Patient or Public Contribution: Patient and public contribution to the study was provided by the Community Stakeholders Group; these were members of the immigrant community from India who had expertise in mental health. They contributed to the study design and the key terms and phrases for the free list used in interviews. [ABSTRACT FROM AUTHOR]

Background: Utilization of video calls on hospital wards to facilitate involvement of and communication with family members is still limited. A deeper understanding of the needs and expectations of family members regarding video calls on hospital wards is necessary, to identify potential barriers and facilitate video calls in practice. Aim: The aim of this study was to explore the views, expectations and needs of a patient's family members regarding the use of video calls between family members, patients and healthcare professionals, during the patient's hospital admission. Methods: A qualitative study was carried out. Semi‐structured interviews with family members of patients admitted to two hospitals were conducted between February and May 2022. Family members of patients admitted to the surgical, internal medicine and gynaecological wards were recruited. Results: Twelve family members of patients participated. Family members stated that they perceive video calls as a supplemental option and prefer live visits during hospital admission. They expected video calls to initiate additional moments of contact with healthcare professionals, e.g. to join in medical rounds. When deploying video calls, family members mentioned that adequate instruction and technical support by nurses should be available. Conclusion: Family members considered video calls valuable when visiting is not possible or to participate in medical rounds or other contacts with healthcare professionals outside of visiting hours. Implications: Family members need to be supported in options and use of video calls on hospital wards. Additional knowledge about actual participation in care through video calls is needed as well as the effect on patient, family and healthcare professional outcomes. Impact: Using video calls on hospital wards can provide family members with flexible alternatives for contact and promote family involvement. Reporting Method: COREQ guidelines. Patient or Public Contribution: Family members of patients admitted to hospital have contributed by sharing their perspectives in interviews. What does this paper contribute to the wider global clinical community?: Family members perceive additional value from the use of video calls on hospital wards.For family, use of video calls needs to be facilitated with clear instruction materials and support. Trial and Protocol Registration: Amsterdam UMC Medical Ethics Review Committee (ref number W21_508 # 21.560). [ABSTRACT FROM AUTHOR]

Aim(s): To understand patients' and healthcare professionals' experiences to improve care in and across different domains of the cerebrovascular disease pathway. Design: A qualitative descriptive study. Methods: Semi‐structured in‐person interviews were conducted among 22 patients diagnosed with acute cerebrovascular disease and 26 healthcare professionals taking care of them in a single tertiary‐level hospital from August 2021 to March 2022. Data were analysed using deductive and inductive content analysis. The consolidated criteria for reporting qualitative research was used to ensure reliable reporting. Results: Overall, 19 generic and 79 sub‐categories describing perceived challenges with 17 generic and 62 sub‐categories describing perceived needs were identified related to primary prevention, organization of stroke services, management of acute stroke, secondary prevention, rehabilitation, evaluation of stroke outcome and quality assessment, and life after stroke. Conclusion: Several challenges and needs were identified in and across the different domains of the cerebrovascular disease pathway. There is a requirement for adequate resources, early initiation of treatment, early diagnostics and recanalization, dedicated rehabilitation services, long‐term counselling and support, and impact evaluation of services to improve cerebrovascular disease care. Future research on caregivers', and clinical leadership experiences in and across the cerebrovascular disease pathway is needed to explore the provision of services. Implications for the Profession and/or Patient Care: The results of this study can be applied by organizations, managers and research for developing and improving services in the cerebrovascular disease pathway. Impact: This study identified several patient‐related, organizational and logistical needs and challenges, with suggestions for required actions, that can benefit the provision of effective, high‐quality cerebrovascular disease care. Reporting Method: We have adhered to relevant EQUATOR guidelines with the COREQ reporting method. Patient or Public Contribution: No patient or public involvement. [ABSTRACT FROM AUTHOR]

Aim: To explore the benefits and challenges of a recently introduced Registered Undergraduate Student of Nursing workforce from the perspective of Nurses and Registered Undergraduate Students of Nursing, in a major metropolitan hospital in Australia in 2020. Design: A qualitative descriptive study was undertaken using individual interviews and focus groups. Methods: Purposively selected employed Registered Undergraduate Students of Nursing and nurses who worked with them were interviewed, using a semi‐structured format. Recordings were transcribed and coded using NVivo software. Reflexive thematic analysis using an inductive approach was undertaken. Results: Four major themes were revealed: (i) Navigating the programme, (ii) Belonging and integration; (iii) Patient care; and (iv) Continuing Development. Initial challenges were common, often related to clarifying the scope of practice for the new role. Ongoing issues were associated with gaps in understanding the role and lack of integration into the team. Mostly, nurses and Registered Undergraduate Students of Nursing built positive, professional relationships. Nurses valued the Registered Undergraduate Student of Nursing knowledge and skill level, reporting improved workload and work experiences when the Registered Undergraduate Student of Nursing was on shift. Nurses believed that the Registered Undergraduate Students of Nursing enhanced patient care. Registered Undergraduate Students of Nursing described positive, therapeutic relationships with patients. Registered Undergraduate Student of Nursing employment provided opportunities for new learning, leading to increased efficiency and confidence on clinical placement. Conclusions: This employment model benefited the Registered Undergraduate Students of Nursing and nurses who worked with them. In the absence of adequate training and support, challenges remained unresolved and negatively impacted the experience for nurses. In addition to university‐level education and clinical placement, the employment model can create a third space for student learning via on‐the‐job training. The study supports the ongoing employment of student nurses through the Registered Undergraduate Student of Nursing model. Implications for the Profession and/or Patient Care: Impact: This study contributes to the very small body of literature investigating Registered Undergraduate Student of Nursing workforces in Australian hospitals. It is the first to explore the experiences of both nurses and students working together in a major metropolitan setting and also the first in the context of the COVID‐19 pandemic.This study reflected a mostly positive experience for Registered Undergraduate Student of Nursing and the nurses who worked with them and highlighted the importance of adequate oversight and support in the implementation and maintenance of a Registered Undergraduate Student of Nursing workforce.Employed Registered Undergraduate Students of Nursing reported improved confidence, skills, and felt like they started clinical placement at an advantage, ready to step up and learn the Registered Nurse scope of practice.In addition to university‐level education and clinical placement, this employment model creates a third space for learning via on‐the‐job training. Reporting Method: COREQ guidelines were followed in the reporting of this study. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aims: To explore how parents experienced their child with delirium and how parents viewed our delirium management bundle. Design: We conducted a qualitative exploratory descriptive study using semi‐structured individual or dyad interviews. Methods: Twelve semi‐structured interviews with 16 parents of 12 critically ill children diagnosed with delirium in a paediatric intensive care unit were conducted from October 2022 to January 2023 and analysed through a reflexive thematic analysis. Findings: We generated five themes: (1) knowing that something is very wrong, (2) observing manifest changes in the child, (3) experiencing fear of long‐term consequences, (4) adding insight to the bundle, and (5) family engagement. Conclusion: The parents in our study were able to observe subtle and manifest changes in their child with delirium. This caused fear of lasting impact. The parents regarded most of the interventions in the delirium management bundle as relevant but needed individualization in the application. The parents requested more information regarding delirium and a higher level of parent engagement in the care of their child during delirium. Impact: This paper contributes to understanding how parents might experience delirium in their critically ill child, how our delirium management bundle was received by the parents, and their suggestions for improvement. Our study deals with critically ill children with delirium, their parents, and staff working to prevent and manage paediatric delirium (PD) in the paediatric intensive care unit. Reporting Method: The consolidated criteria for reporting qualitative research guidelines were used to ensure the transparency of our reporting. Patient or Public Contribution: No patient or public contribution to the research design. What does this Paper Contribute to the Wider Global Community?: ‐ It increases awareness of the parent's perspective on PD in critically ill children.‐ It shows how PD might affect parents, causing negative emotions such as distress, frustration, and fear of permanent damage.‐ It shows that the parents in our study, in addition to the care bundle, requested more information on delirium and more involvement in the care of their delirious child. [ABSTRACT FROM AUTHOR]

Aim: To explore the prospective acceptability of an implementation leadership training programme prototype for nurse managers in China to implement evidence‐based practices, from the perspectives of potential programme participants and deliverers. Design: A qualitative descriptive study was conducted in Spring 2022 at three tertiary hospitals in Hunan, China. Methods: We conducted individual semi‐structured interviews with unit‐level nurse managers (n = 14), including 12 potential participants, and two potential deliverers that have been involved in developing the programme prototype. Interview questions and thematic analysis were guided by the Theoretical Framework of Acceptability. Results: After reviewing the programme content, potential participants and deliverers reported that unit nurse managers would benefit from engaging in the programme, acknowledging that the programme fit with professional nursing values for implementing research evidence. They expressed positive views about being involved in producing academic papers through the training process, and interactive multi‐modal training activities such as group work, experience‐sharing and coaching. Seven participants were not very confident about being fully engaged in the training, as they could not navigate the English research literature. Both participants and deliverers highlighted factors that would influence their participation, including time constraints, the impact of the COVID‐19 pandemic, and support from senior organizational leadership. Conclusions: The training programme prototype was perceived to be useful and acceptable. The multimodal training activities were considered a strength and managers expressed an interest in writing academic papers about their implementation processes. Support from senior hospital leaders and programme deliverers was identified as critical to the training programme's success. Impact: The study helps understand nurse managers' perceptions and concerns of participating in an implementation leadership training programme and could inform the development and refinement of similar programmes in various nursing contexts globally. [ABSTRACT FROM AUTHOR]

Aim: To catch a representative view of a multicultural population's needs. Design: Qualitative study. Methods: Semi‐structured interviews were conducted from July 2022 to January 2023 with the project's stakeholders, migrants, and residents. Data analysis was performed using a multimethod textual analysis technique. Findings: Territorial barriers, lack of social network, and specific professionals' training emerged as healthcare delivery obstacles. For migrants, language improvement emerged as a health priority. A deep relationship with migrants emerged as a deficiency for residents. Conclusion: A welcoming project equipped with solid leadership and the right resources can be fundamental in mediating health promotion and integration. In this process, the involvement of the resident population is essential. Implications for the Profession and/or Patient Care: Analysing the migrants' needs and the strengths and limitations of a reception system could help identify the challenges for professionals in delivering culturally competent care. In this context, the nurse's role becomes relevant, being responsible for taking charge and caring for the population and the link between professionals and the population. What Problem Did the Study Address?: The study addressed the problem of improving the overall health of migrants, refugees, and asylum seekers, mainly focusing on reception and integration into a new society process. What Were the Main Findings?: Worse health was identified with adaptation, integration, and family problems. Territorial barriers emerged, hindering good health. Where and on Whom Will the Research Have An Impact?: These research findings can be valuable for health professionals who want to improve the reception process and enhance a care model integrated with residents. Patient or Public Contribution: No patient or public contribution. Reporting Method: To describe the research report, we referred to the COREQ checklist (Tong et al., 2007). [ABSTRACT FROM AUTHOR]

Aim: To identify barriers and facilitators impacting the implementation of a comprehensive transfer program aimed at parents of adolescents with chronic illness in clinical practice. Design: A real‐time, qualitative process evaluation. Methods: Individual interviews were conducted with 10 nurses and seven physicians from paediatric and adult outpatient clinics: Nephrology, hepatology, neurology, and rheumatology. Data were analysed through the lens of normalization process theory. Results: Themes were framed within the theory's four components. (1) Coherence: Healthcare professionals' views on their core tasks and on the parents' role influenced their perception of the program. (2) Cognitive participation: A named key worker, autonomy, and collaboration impacted healthcare professionals' involvement in the program. (3) Collective action: Department prioritization and understanding of the program's aim were key factors in its successful delivery. (4) Reflective monitoring: Participants experienced that the program helped parents during transfer but questioned if the program was needed by all families. Conclusion: We identified three barriers: Healthcare professionals' lack of understanding of the parental role during transfer, top‐down decisions among nurses, and physicians' uncertainty about their role in joint consultations. Facilitators: Healthcare professionals' understanding of the program's purpose and expected effect, the nurses' significant role as named keyworkers, and good collaboration across paediatric and adult departments. Implications for the Profession and/or Patient Care: Implementation strategies should be developed before implementing a transfer program in clinical practice. Impact: Implementing a parental transfer program in clinical practice can be challenging. Therefore, for successful implementation, it is crucial to identify barriers and facilitators.Barriers and facilitators exist at the personal, professional, and organizational levels, and it is important to understand them.The results of this qualitative study could support the implementation of transfer programs in other settings. Reporting Method: Consolidated criteria for reporting qualitative studies (COREQ). Patient or Public Contribution: No patient or public contribution. What does this paper contribute to the wider global clinical community?: Nurses' and physicians' experiences of ownership of the transfer program is essential for successful implementation.Clinics should appoint a named keyworker, preferably a nurse, as the driving force during the implementation of a transfer program.Nurses and physicians should receive training about the purpose, justification, and expected effect of a transfer program before implementation. [ABSTRACT FROM AUTHOR]

Aim: To explore the views of neonatal intensive care nursing staff on the deliverability of a novel genetic point‐of‐care test detecting a genetic variant associated with antibiotic‐induced ototoxicity. Design: An interpretive, descriptive, qualitative interview study. Methods: Data were collected using semi‐structured interviews undertaken between January and November 2020. Participants were neonatal intensive care nursing staff taking part in the Pharmacogenetics to Avoid Loss of Hearing trial. Results: Thematic analysis resulted in four themes: perceived clinical utility; the golden hour; point‐of‐care device; training and support. Recommendations were made to streamline the protocol and ongoing training and support were considered key to incorporating the test into routine care. Conclusion: Exploring the views of nurses involved in the delivery of the point‐of‐care test was essential in its implementation. By the study endpoint, all participants could see the value of routine clinical introduction of the point‐of care test. Implications for the Profession and/or Patient Care: Nurses are in a key position to support the delivery of point‐of‐care genetic testing into mainstream settings. This study has implications for the successful integration of other genetic point‐of‐care tests in acute healthcare settings. Impact: The study will help to tailor the training and support required for routine deployment of the genetic point‐of‐care test. The study has relevance for nurses involved in the development and delivery of genetic point‐of‐care tests in other acute hospital settings. Reporting Method: This qualitative study adheres to the Standards for Reporting Qualitative Research EQUATOR guidelines and utilizes COREQ and SRQR checklists. Patient or Public Contribution: All staff working on the participating neonatal intensive care units were trained to use the genetic point‐of‐care test. All inpatients on the participating units were eligible to have testing via the point‐of‐care test. The Pharmacogenetics to Avoid Loss of Hearing Patient and Public Involvement and Engagement group provided valuable feedback. Trial and Protocol Registration: Registered within the University of Manchester. Ethics approval reference numbers: IRAS: 253102 REC reference: 19/NW/0400. Also registered with the ISRCTN ref: ISRCTN13704894. [ABSTRACT FROM AUTHOR]

Aim: To highlight the value of utilizing the Listening Guide methodology for nursing research and provide an exemplar applying this methodology to explore a novel concept in an underrepresented group—inner strength in persons newly diagnosed with mild cognitive impairment along with their care partners. Design: Methodology discussion paper. Methods: The exemplar study used the Listening Guide methods for data elicitation and analysis. Methods included adaptations for the study population and novice qualitative researchers. Results: The Listening Guide methodology with adaptations enabled the research team to centre the voices of persons living with mild cognitive impairment, highlight an abstract phenomenon and attend to the influences of the sociopolitical context. Further, this methodology helped address common challenges emerging qualitative researchers encounter, including understanding methods of application, engaging reflexively and immersing in the data. Conclusion: The Listening Guide is a voice‐centred qualitative methodology that is well suited to foreground the experiences of groups underrepresented in research and explore emerging phenomena. Implications for Nursing: Nurses are central to striving for health equity. The Listening Guide methodology offers a valuable and accessible research tool to understand the experiences and needs of underrepresented groups and shape healthcare in response. Impact: The Listening Guide methodology can be broadly applied to research with persons with mild cognitive impairment, and other underrepresented groups, to explore other phenomena beyond inner strength and move the science forward in representing the perspectives of groups underrepresented by research. Patient or Public Contribution: Persons living with cognitive impairment and their care partners participated in study conceptualization, interview guide development, methods development and dissemination plans. [ABSTRACT FROM AUTHOR]

Aim: To investigate the decisional needs in Denmark of people with kidney failure, relatives, and health professionals when planning end‐of‐life care. Design: A qualitative interview study. Methods: Individual semi‐structured interviews were carried out with people with kidney failure, relatives and health professionals from November 2021 to June 2022. Malterud's systematic text condensation was used to analyse transcripts. Results: A total of 13 patients, 10 relatives, and 12 health professionals were interviewed. Overall, four concepts were agreed on: (1) Talking about end of life is difficult, (2) Patients and relatives need more knowledge and information, (3) Health professionals need more tools and training, and (4) Experiencing busyness as a barrier to conversations about end of life. Conclusion: People with kidney failure, relatives, and health professionals shared certain decisional needs while also having some different decisional needs about end‐of‐life care. To meet these various needs, end‐of‐life conversations should be systematic and organized according to the patients' needs and wishes. Impact: Non‐systematic end‐of‐life care decision‐making processes limit patients' involvement. Patients and relatives need more knowledge about end‐of‐life care, and health professionals need more competences and time to discuss decisional needs. A shared decision‐making intervention for people with kidney failure when making end‐of‐life care decisions will be developed. Reporting Method: This empirical qualitative research is reported according to the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Patient or Public Contribution: Patients, relatives, and health professionals have been involved throughout the research process as part of the research team and advisory board. The patients are people with kidney failure and the relatives are relatives of a person with kidney failure. For this study, the advisory board has particularly contributed to the validation of the invitation letter for participation, the interview guides and the preparation of the manuscript. [ABSTRACT FROM AUTHOR]

Aim: To explore the career decisions and aspirations of early‐career registered nurses in New Brunswick, Canada. Design: A qualitative study using an interpretive description approach was conducted. Methods: Semi‐structured one‐on‐one interviews were conducted with a purposive sample of nurses (n = 22) currently working in New Brunswick, Canada, with up to 5 years of experience from February to April 2022. Results: Participants described diverse career paths and aspirations. Personal factors affecting these included the desire for meaningful work, career satisfaction, work‐life balance, spending time with family, working in a preferred location, and finances. Professionally, working conditions were the dominant factor influencing early‐career nurses' career decisions and aspirations. Participants described how short staffing, safety, support, and scheduling influenced their day‐to‐day work, mental and physical health, job and career satisfaction, and intent to leave. Conclusion: The findings highlighted the abundant and diverse career opportunities available to nurses early in their careers. Early‐career nurses are interested in finding nursing positions with a high degree of person‐job fit and value opportunities for ongoing professional education and growth. Impact: This study in New Brunswick, Canada, explores early‐career nurses' career decisions and aspirations during nursing shortages and the pandemic, emphasizing the importance of person‐job fit. Recommendations include improving working conditions and career pathways to enhance the sustainability of the nursing profession. Reporting Method: Standards for Reporting Qualitative Research (SRQR). Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To understand and interpret the lived experience of newly qualified midwives (NQMs) as they acquire skills to work in free‐standing birth centres (FSBCs), as well as the lived experience of experienced midwives in FSBCs in Germany who work with NQMs. Background: In many high‐, middle‐ and low‐income countries, the scope of practice of midwives includes autonomous care of labouring women in all settings, including hospitals, home and FSBCs. There has been to date no research detailing the skills acquired when midwives who have trained in hospitals offer care in out‐of‐hospital settings. Methods: This study was underpinned by hermeneutic phenomenology. Fifteen NQMs in their orientation period in a FSBC were interviewed three times in their first year. In addition to this, focus groups were conducted in 13 FSBCs. Data were collected between 2021 and 2023. Findings: Using Heidegger's theory of technology as the philosophical underpinning, the results illustrate that the NQMs were facilitated to bring forth competencies to interpret women's unique variations of physiological labour, comprehending when they could enact intervention‐free care, when the women necessitated a gentle intervention, and when acceleration of labour or transfer to hospital was necessary. Conclusion: NQMs learned to effectively integrate medical knowledge with midwifery skills and knowledge, creating a bridge between the medical and midwifery approaches to care. Implications: This paper showed the positive effects that an orientation and familiarization period with an experienced team of midwives have on the skill development of novice practitioners in FSBCs. Impact: The findings of this study will have an impact on training and orientation for nurse‐midwives and direct‐entry midwives when they begin to practice in out‐of‐hospital settings after training and working in hospital labour wards. Patient and Public Contribution: This research study has four cooperating partners: MotherHood, Network of Birth Centres, the Association for Quality at Out‐of‐Hospital Birth and the German Association of Midwifery Science. The cooperating partners met six times in a period of 2 ½ years to hear reports on the preliminary research findings and discuss these from the point of view of each organization. In addition, at each meeting, three midwives from various FSBCs were present to discuss the results and implications. The cooperating partners also helped disseminate study information that facilitated recruitment. [ABSTRACT FROM AUTHOR]

Aim: To explore the work of palliative care from the perspectives of district nurses with a focus on the strategies they use to achieve positive outcomes for patients. Design: An exploratory descriptive qualitative study. Methods: A combination of group and individual interviews using semi‐structured interviewing were used to explore district nurses' views of providing palliative care across two large urban community nursing services. Results: Sixteen district nurse participants were interviewed. Three key themes were identified: "Getting what was needed" involved finding solutions, selling a story and establishing relationships. District nurses sought ways to "Stay involved" recognizing the benefit of delaying discharge for some patients. "Completing a nursing task" was a way of managing time constraints and a form of self‐protection from having difficult conversations. Conclusion: This study highlights the importance of understanding the contextual nature of the practice setting in relation to the provision of palliative care. In doing so, it has revealed the strategies district nurses use to overcome the challenges associated with providing palliative care within a generalist workload. Implications for the Profession and/or Patient Care: District nurses experience a tension between managing high patient workloads and remaining patient centred in palliative care. Being task focused is a way of remaining safe while managing a high volume of work and is not always a negative factor in the care they provide. However, focusing on a task while at the same time addressing other unmet needs requires a set of skills that less experienced nurses may not have. Impact: Palliative care education alone will not improve the quality of palliative care provided by generalist community district nurses. The practice context is an important factor to take into consideration when supporting the integration of palliative care in district nursing. No Patient or Public Contribution: No patient or public contribution was made to this study. Reporting Method: We have adhered to the relevant EQUATOR guidelines and used the COREQ reporting method. [ABSTRACT FROM AUTHOR]

Aim: To explore Remote Area Nurses' experiences of the implementation of workplace health and safety policies and risk mitigation strategies in Australian very remote primary health clinics. Design: This qualitative study used online semi‐structured interviews, with participants purposively sampled to maximize variation in work location and service type. Data were analysed using a reflexive thematic analysis approach. Coding was carried out inductively, with NVivo 12 aiding data management. Setting: The interviews were conducted from 24 Februrary 2021 to 06 March 2021 with Remote Area Nurses from very remote primary health clinics in Australia. Participants: Fifteen Remote Area Nurses participated in the study. Results: Thematic analysis revealed varied approaches to workplace safety among the different health services and regions. While the spread of 'never alone' policies in many clinics addressed one of the significant risks faced by Remote Area Nurses, gaps remained even for hazards specifically highlighted in existing work health and safety legislation. Meaningful collaboration with staff and the community, local orientation, preparation for the role and providing quality care were protective factors for staff safety. Understaffing, unsafe infrastructure and inadequate equipment were common concerns among Remote Area Nurses. Conclusion: Health services need to prioritize workplace safety and take a continuous quality improvement approach to its implementation. This will include ensuring safety strategies are appropriate for the local context, improving infrastructure maintenance, and establishing sustainable second responder systems such as a pool of drivers with local knowledge. Implications for the Profession: Poor personal safety contributes to burnout and high turnover of staff. Nurses' insights into the barriers and enablers of current workplace safety strategies will aid policymakers and employers in future improvements. Reporting Method: COREQ reporting guidelines were followed. PIPE Statement: A panel of six Remote Area Nurses collaborated in the development of this project. [ABSTRACT FROM AUTHOR]

Aim: To identify insights for supporting people at risk of suicide in the community based on primary healthcare workers' experiences. Design: Qualitative descriptive design. Methods: Semi‐structured interviews were conducted with fifteen primary healthcare workers employed by Japanese municipalities between August and October 2019. The data were subjected to qualitative descriptive analysis. Results: The analysis revealed eleven subthemes, clustered under the following three themes: (1) fostering 'opportunities for discovery' for people at risk of suicide by encompassing strategies such as increasing access to services and promoting a holistic understanding of the life cycle; (2) fostering 'meaningful connections' by searching for channels to reach the heart and taking approaches from different objectives; and (3) engaging in 'risk management', by understanding and coping with real‐life struggles and implementing timely crisis intervention. Conclusion: Not only direct care targeting suicide prevention but also holistic care that includes atypical perspectives such as 'approaches from different objectives' may provide important insights for supporting people with suicide risk. Implications for Practice: Beyond the limitations of existing suicide risk screening methods, this study highlights the importance of a holistic approach that sees people at risk of suicide in the context of their daily lives and aims to alleviate the difficulties in their lives that have brought them to the point of considering suicide. Impact: By describing support focused on the difficulties that people at risk of suicide face in their daily lives, this study identified insights for supporting people at risk of suicide in communities where screening and intervention are difficult. These findings will contribute to the relief of people at risk of suicide by stimulating suicide prevention measures in primary healthcare settings. Reporting Method: This study complied with the COREQ guidelines. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: People who are insecurely housed and use drugs are disproportionately affected by drug poisonings. Nurses are uniquely positioned to utilize harm reduction strategies to address the needs of the whole person. Needle debris encompasses drug paraphernalia discarded in public spaces. Studying needle debris provides a strategic opportunity to identify where drugs are being used and target public health strategies accordingly. Aim: Our aim in this article is to illustrate how spatial video geonarratives (SVG) combined GPS technology interviews, and videos of locations with needle debris, can elicit valuable data for nursing research. Methods: Using SVG required knowledge of how to collect data wearing cameras and practice sessions were necessary. A Miufly camera worn at waist height on a belt provided the stability to walk while interviewing stakeholders. We wore the cameras and conducted go‐along interviews with outreach workers, while filming the built environment. Upon completion of data collection, both the interview and GPS information were analysed using Wordmapper software. Conclusions: This methodology resulted in data presented uniquely in both a visual map and narrative. These data were richer than if a single modality had been used. These data highlighted specific contextual factors that were related to the location of needle debris, which created opportunities for nursing interventions to support people experiencing vulnerability. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to explore the experiences of care and recovery among older patients treated for physical trauma. Design: A qualitative study with a constructivist grounded theory design. Methods: Fifteen in‐depth interviews with older adults recovering from physical trauma were conducted and analysed between 2019 and 2023, in accordance with grounded theory methodology. Results: The findings show that for older patients who suffered physical trauma, the core category was the strive to recapture autonomy. This was achieved by means of Adaptation, Reflection and Interactions, which constitute the three main categories. Recovery involves facing and navigating various new life challenges, such as increased dependency on others, managing difficult symptoms and adapting in various ways to everyday life. The recovery process was influenced by fear, hope and the attitude towards new challenges. Conclusion: Older adults being cared for after a traumatic event have a difficult path to recovery ahead of them. Dealing with increased unwanted dependency on others was a main concern for the participants. Undertreated symptoms can lead to undesired isolation, delayed recovery and further increase unwanted dependency. On the other hand, hope, which was defined as having a positive approach to life and longing for the future, was a strong accelerating factor in the recovery process. Impact: As a result of this study, we have established that older patients experience the initial period after trauma as difficult and that support in the initial phase can be helpful when returning home. As healthcare services are under increasing pressure because of an ageing population, this study contributes by addressing an understudied population and clarifying their concerns. Reporting Method: Reporting adheres to the COREQ (COnsolidated criteria for REporting Qualitative research) Checklist. Patient or Public Contribution: No patient or public involvement. [ABSTRACT FROM AUTHOR]

Aim: To explore the experiences of recreational‐vehicle‐dwelling American nomads when seeking healthcare in the United States. Design: This exploratory, qualitative study employed interpretive description design to maintain a disciplinary focus in nursing. Methods: Twenty‐five participants were recruited from campgrounds in eight states. Semi‐structured interviews were conducted face‐to‐face. Thematic analysis was conducted using a phronetic iterative approach. Results: Three overarching themes described participants' experiences seeking healthcare: overwhelming logistics, don't need healthcare, and orchestrating a web of care. Conclusion: Recreational‐vehicle‐dwelling nomads in the United States face additional complexity when accessing healthcare related to seeking care in unfamiliar locations and policies that prevent the portability of healthcare across state lines. Implications: More research is needed to evaluate solutions to improve healthcare access for recreational‐vehicle‐dwelling nomads. Nurses and policymakers should consider healthcare practices through the lens of nomads' lifestyle mobility. The impact of policy decisions on people who are geographically mobile should be considered, and barriers to healthcare portability should be addressed. Impact: This was the first study focused on the healthcare experiences of recreational‐vehicle‐dwelling nomads in the United States.Nomads face additional complexity and barriers to healthcare access. Some nomads developed strategies to overcome barriers, while others disengaged from healthcare.The findings will impact researchers and nurses who study and care for nomads. Reporting Method: The SRQR reporting guidelines were followed. Patient or Public Contribution: Recreational‐vehicle‐dwelling nomads reviewed the recruitment flyer and interview guide and provided input on recruitment methods and sites. [ABSTRACT FROM AUTHOR]

Aims: To discuss the levels of structural empowerment (SE) and psychological empowerment (PE) and the factors that influence perceptions of empowerment among newly graduated nurses (NGNs). Design: Mixed methods study. Methods: The quantitative part of the study was conducted with 220 NGNs with <1 year of job experience. The study was conducted between February and May 2023. Focus group discussions were conducted with 30 NGNs. Data were collected by using the Conditions for Work Effectiveness Questionnaire (CWEQ‐II), the Psychological Empowerment Scale (PES) and a Semi‐Structured Interview Form. Quantitative data were analysed using stepwise regression analysis. Content analysis was used to analyse qualitative data. Results: CWEQ‐II and PES were moderate. The regression analysis showed that NGNs' SE scores increased in association with the following factors, including an increase in the total score on the PES, being married/having a partner, working a day shift, having career planning, increased satisfaction with the orientation programmes of the institution and increased satisfaction with the employing institution. As a result of the descriptive analysis of the focus group interviews conducted to determine the empowerment perceptions of NGNs, we identified three contexts along with the associated themes and subthemes. These three contexts were the 'concept of power', 'professional impression' and 'empowerment process'. Conclusion: The results of this study indicate that the SE and PE levels of NGNs are moderate, and their empowerment perceptions are influenced by many factors that can be individual, organizational and work environment relevant. Impact: This study's findings will guide policymakers, educators, researchers and administrators in empowering NGNs essential to the healthcare workforce. Reporting Method: The paper adheres to the COREQ checklist. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Aim: To describe the application of selected creative and participatory research methods in nursing science. Design: Research methodology paper. Methods: Researcher‐initiated role play, stimulated recall interviews, the Storycrafting method, painting and drawing. Altogether, 11 children (5–7 years old) and 12 parents participated in the research. Results: Each small group (n = 3) acted differently during the data collection. Not every child wanted to play, draw or tell stories, but they all expressed their views through some method. Although the same themes emerged from children's narratives, they could not have been verified by just one method. Conclusions: Using creative and participatory methods and the principles of studies of child perspectives are applicable ways of conducting research in nursing science. Children must be treated as individuals during the research process, and they must have opportunities to use several communication methods to express their views. Implications for the profession and patient care: Understanding different ways to interact with children and hear children's views will help nurses to encounter children. Impact: In this article, we present a valid way of conducting research with children. By following our protocol, nursing research from a child perspective can be implemented. Reporting Method: Consolidated criteria for reporting qualitative research (COREQ). Patient Contribution: The child participants were involved in choosing physical places for data collection and the usage and order of the selected methods. Both the children and the adult participants took part in interpreting the research data. [ABSTRACT FROM AUTHOR]

Aims and Design: This study reports a qualitative phenomenological investigation of resilience in nursing staff working in a high‐secure personality disorder service. Method: Interviews were carried out with six nursing staff, and these captured the richness and complexity of the lived experience of nursing staff. Results: Four superordinate themes emerged from the analysis: Management of emotions: participants showed an awareness that their job is about giving care to patients who may present with very challenging behaviours. The care that they offered was conceptualized as something that needed to be provided in a measured way, with boundaries. A clear distinction was drawn between 'caring personally' for patients, and 'providing care'. Teamwork: teamwork was cited as a major influencing factor by all participants. This was seen as directly impacting the smooth running of the ward, and therefore on the well‐being of nursing staff, but also of patients. Understanding: nursing staff were acutely aware that they were working in an environment where everyday interactions would be open to intense scrutiny and possible misinterpretation by patients. Work–life balance: All the participants spoke of making a conscious effort to have a separate work and home life, which was influenced by a number of factors. Conclusion: The article has discussed the themes of managing emotion, team understanding and work–life balance, illustrating how each contributes to the resilience of nursing staff in this challenging environment. New insights – applicable in both national and international contexts – have been produced. Impact: In secure environments, mental health nursing staff need organizational support and assistance to develop ways of managing difficult experiences with patients, systems that promote recovery, and educational and supervisory support to help understand and process the effects on them. This article provides evidence to support the work of managers and clinicians in these environments. No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Aim: To describe the childhood experiences of patients with polio from the acute phase of the disease during post‐war Finland in the 1950s and 1960s. Design: Qualitative empirical study based on self‐reported history of nursing rooted in the past, a history of experiences. Methodology: Interview materials were gathered in the form of themes (45) and written interviews (4) (29 September 2018 to 30 June 2019). Data were analysed by reflexive thematic analysis to highlight hidden and latent experiences. This approach generated the study's main theme, themes and subthemes. Results: The main theme, 'shattered childhood', generated from the study results and was then divided into two themes, both of which were influenced in part by the loss of a familiar childhood, the changed environment, the breakdown of the body and the absence of control. Through their childhood memories, polio survivors described their broken childhoods using the following themes: 'betrayal by their bodies' and 'isolation'. In the narratives, the theme 'betrayal by one's own body' was generated by the following subthemes: 'suddenness of the affliction', 'paralysis' and 'being moved to the hospital'. The 'isolation' theme developed from the subthemes 'isolation from the body and surroundings' and 'emotional and social loneliness'. Conclusion: Polio survivors' experiences during the acute stage of the disease were traumatic and demonstrated children's inferior nursing position in Finland in the 1950s and 1960s. Impact: The study increases our understanding of the history of caring for children and families who were affected and disabled by polio and the importance of their experiences in society and healthcare settings. Patient or Public Contribution: The authors collaborated with the Finnish Polio Association to recruit study participants and plan the study. Patients with polio during childhood underwent interviews, and their experiences formulated the data, which were analysed and the basis of the results. Reporting Method: Consolidated criteria for reporting qualitative research (COREQ), a 32‐item checklist for interviews and focus groups, have been used as a reporting and checklist tool. All authors have agreed on the final version and the use of the COREQ criteria, relationship with participants, theoretical framework, setting, data collection and data analysis and report. [ABSTRACT FROM AUTHOR]

Introduction: Greenspace is beneficial for improving adolescent mental health, yet healthcare professionals still do not understand the connection between the built environment and subjective mental well‐being. We also need to understand how this population uses greenspace and how they feel when in it. Aim: The aim of this qualitative study was threefold: to understand why adolescents use greenspace, to identify how they use greenspace and to explore how they feel when they are in greenspace. Design: Focused ethnography. Methods: Data were collected between June 2022 and August 2022 using participant observation, photo elicitation and semi‐structured interviews. Braun and Clarke's (2006) six phases of thematic analysis were used to guide data collection and analysis. Results: A total of 11 adolescents between ages 12 and 18 who resided in and around Newark, NJ, were recruited. Three themes were identified from the data: (1) A tranquil space in an unsafe place; (2) Park means family connection with burgeoning independence; and (3) My park: Sense of ownership and responsibility. Conclusions: This study deepens the understanding between subjective mental well‐being and urban greenspace exposure. Adolescents accepted responsibility for maintaining "my park", which strengthens community cohesion, detailing the importance of youth input during urban planning. Implications for Practice: Implications from this study suggest that environmental interventions may help ameliorate an ongoing mental health care crisis among adolescents. Healthcare providers should consider the built environment as another approach to promoting mental health. Patient or Public Contribution: None other than research participants. [ABSTRACT FROM AUTHOR]