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Aim: To synthesise nurses' and physicians' experiences with withdrawing life‐sustaining treatment in an intensive care unit. Design: The chosen methodology is thematic synthesis. The Preferred Reporting Items for Systematic Review and Meta‐Analyses and Enhancing Transparency are used in Reporting the Synthesis of Qualitative Research Statement. Methods and Data Sources: A systematic search is conducted in APA PsycINFO, CINAHL Plus, EMBASE, PubMed and Web of Science following the inclusion and exclusion criteria in April 2023. Two reviewers independently screened and extracted the qualitative data. Subsequently, data analysis was conducted using thematic analysis of qualitative research. This study was not registered with any review registry due to the irrelevance of the data to health‐related outcomes. Results: From the 16 articles, 267 quotes were extracted and analysed. The findings of the study revealed five analytical themes: (1) tensions between interdependent collaboration and hierarchical roles; (2) tensions between dignified dying or therapeutic perspectives; (3) family members' reflections of patient's wishes; (4) tensions in family members' positions; and (5) double‐sidedness of distress. Conclusion: This study contributes to nursing knowledge by providing a more nuanced understanding of this complex phenomenon of withdrawing life‐sustaining treatment. The findings of this study have revealed significant variations globally in the practices surrounding the withdrawal of life‐sustaining treatment in intensive care units, emphasising the need for further research to inform clinical practices that cater to diverse contexts. Reporting Method: Enhancing Transparency are used in Reporting the Synthesis of Qualitative Research Statement (ENTREQ statement). Patient or Public Contribution: Since this study reported a potential collision between the patient's dignified dying and the family member's perceptions and interests, the family member's wishes should be carefully distinguished from the patient's quality of end of life in practice. [ABSTRACT FROM AUTHOR]

Aim and Objectives: To assess (1) the experience, knowledge and preferences of end‐of‐life care among frail nursing home residents and (2) the preferences of residents' family caregivers. Background: Globally, nursing homes are becoming an important place where many older people will receive their end‐of‐life care. Thus, assessing the end‐of‐life care preferences among nursing home residents is crucial. Design: Cross‐sectional survey. Methods: Residents aged ≥65 years, with frail or pre‐frail status (n = 286) in 34 nursing homes were interviewed using a structured questionnaire. Descriptive statistics were used to describe the outcomes and regression analyses were used to evaluate factors related to the outcomes. Kappa statistics were used to examine the agreement between the preferences among 21 residents and their family caregivers. The manuscript was guided by the STROBE checklist. Results: 5.9% and 10.5% of the participants had heard of advance care planning and advance directive respectively. After explanations of the terms by the research team, 42.3% of the participants preferred advance care planning, whereas 22.0% preferred advance directive. The top reason for not preferring advance care planning/advance directive is perceiving them as 'not necessary'. Nursing homes were the most preferred place to receive end‐of‐life care (41.6%). Whereas hospitals were the most preferred place for death (36.0%). The agreement among resident and family caregiver dyads ranged from none to minimal in most outcomes. Conclusions: This study revealed the lack of awareness around advance care planning and advance directive among frail nursing home residents. Future research should focus on developing effective educational interventions to enhance the residents' awareness of these topics. Relevance to clinical practice: To increase awareness among nursing home residents, more educational programs should be implemented. Frail older residents might not see the relevance of advance care planning; interventions need to include both current and future care to increase its relevance. [ABSTRACT FROM AUTHOR]

Aim Design Method Results Conclusion Implications for the profession and/or patient care Impact Reporting Method Patient or Public Contribution What Does This Paper Contribute to the Wider Global Clinical Community? Trial and Protocol Registration The aim of the study was to investigate the impact of the use of baby‐friendly community initiative (BFCI) model on various stakeholders in the community.Quasi‐experimental research design.The study was conducted in public premises and online workshops from April 2019 to September 2022. Participants were followed up for a period of 1 month, except for those employed at public premises. The program involved training based on an accredited BFCI framework to cultivate a breastfeeding‐friendly attitude and knowledge. A paired sample t‐test was used to examine breastfeeding attitude and knowledge scores before and after BFCI training among staff employed from public premises. An analysis of variance was conducted to examine the breastfeeding self‐efficacy and attitude scores, measured repeatedly at different timepoints over 1‐month timepoint (T0, T1 and T2) among pregnant and postpartum women.A total of 2340 perinatal women and 1339 staff from public premises were recruited. For staff, there was an increase in the mean score of breastfeeding knowledge and attitude by 5.8 and 6.1, respectively, at T1. Similarly, for perinatal women, there was an increase in the mean score of breastfeeding self‐efficacy and attitude by 6.6 and 3.3, respectively, at T1.In summary, a BFCI model, with active community participation, accreditation and an award system, has been effective in promoting breastfeeding. Adapting the baby‐friendly hospital initiative to local contexts and employing a social theory model can enhance breastfeeding promotion and improve infant health outcomes. Prioritizing culturally sensitive breastfeeding education is crucial for successful BFCI implementation.Healthcare professionals should consider clients' culture and socio‐economic backgrounds when providing breastfeeding education to maximize effectiveness. The target audience for breastfeeding education should be expanded to include various community stakeholders beyond families.What problem did the study address? This study addressed the problem of knowledge gaps among stakeholders in building a breastfeeding‐friendly community, particularly in implementing a baby‐friendly community initiative (BFCI) as part of a baby‐friendly hospital initiative (BFHI). The research filled a service gap by providing effective interventions targeting community stakeholders and assessing the impact of a BFCI program on their knowledge and attitudes towards breastfeeding.What were the main findings? The findings highlighted the effectiveness of a BFCI program in enhancing breastfeeding knowledge and attitudes among frontline staff and increasing breastfeeding confidence among mothers. These findings contribute to the understanding of the program's impact on different stakeholders in the community.Where and on whom will the research have an impact? It impacts on global policymakers by providing insights for developing comprehensive guidelines for future BFCI implementations. It also contributes to the creation of a more baby‐friendly community, benefiting breastfeeding families and their infants by promoting and supporting breastfeeding families.This study has adhered to relevant EQUATOR guidelines using the TREND reporting guideline.No patient or public contribution.This study provides an overview of the establishment of a localized BFCI program. It also opens up a new direction for the community to investigate BFCI strategies for community stakeholders. It also provides evidence to support other countries in following a similar process, as each country approaches becoming breastfeeding‐friendly in its own unique way.No protocol. [ABSTRACT FROM AUTHOR]