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Background: Professional caregiving relationships are central to quality healthcare but are not always developed to a consistently high standard in clinical practice. Existing literature on what constitutes high‐quality relationships and how they should be developed is plagued by dyadic conceptualisations; discipline, context and condition‐specific research; and the absence of healthcare recipient and informal carer voices. This study aimed to address these issues by exploring how healthcare recipients and carers conceptualise good professional caregiving relationships regardless of discipline, care setting and clinical condition. Design: A qualitative story completion approach was used. Participants completed a story in response to a hypothetical stem that described a healthcare recipient (and, in some instances, carer) developing a good relationship with a new healthcare provider. Stories were analysed using reflexive thematic analysis. Participants: Participants were 35 healthcare recipients and 37 carers (n = 72 total). Results: Participants' stories were shaped by an overarching discourse that seeking help from new providers can elicit a range of unwanted emotions for both recipients and carers (e.g., anxiety, fear, dread). These unwanted emotions were experienced in relation to recipients' presenting health problems as well as their anticipated interactions with providers. Specifically, recipient and carer characters were fearful that providers would dismiss their concerns and judge them for deciding to seek help. Good relationships were seen to develop when healthcare providers worked to relieve or minimise these unwanted emotions, ensuring healthcare recipients and carers felt comfortable and at ease with the provider and the encounter. Participants positioned healthcare providers as primarily responsible for relieving recipients' and carers' unwanted emotions, which was achieved via four approaches: (1) easing into the encounter, (2) demonstrating interest in and understanding of recipients' presenting problems, (3) validating recipients' presenting problems and (4) enabling and respecting recipient choice. Participants' stories also routinely oriented to temporality, positioning relationships within recipients' and carers' wider care networks and biographical and temporal contexts. Conclusion: The findings expand our understanding of professional caregiving relationships beyond dyadic, static conceptualisations. Specifically, the findings suggest that high‐quality relationships might be achieved via a set of core healthcare provider behaviours that can be employed across disciplinary, context and condition‐specific boundaries. In turn, this provides a basis to support interprofessional education and multidisciplinary healthcare delivery, enabling different healthcare disciplines, specialties, and teams to work from the same understanding of what is required to develop high‐quality relationships. Patient or Public Contribution: The findings are based on stories from 72 healthcare recipient and carer participants, providing rich insight into their conceptualisations of high‐quality professional caregiving relationships. [ABSTRACT FROM AUTHOR]

Aim: To explore factors influencing newly graduated nurses' delivery of direct care in acute care hospital settings. Design: Qualitative study using focused ethnography. Methods: During the period from March to June 2022, a total of ten newly graduated nurses were purposively sampled, and data were collected through 96 h of participant observation as well as ten semi‐structured interviews. This research took place in a large hospital located in Denmark. Data were analysed using LeCompte and Schensul's ethnographic content analysis. Results: Three main structures were developed from the data: 'Contrasting Intentions and Actions for care delivery', 'Organizational Constraints Block Interpersonal Aspects of Nursing Care' and 'Newly Graduated Nurses' Suppressed Need for Support Constitutes Delay in Care Actions'. Conclusion: Newly graduated nurses were committed to delivering high‐quality care but were aware they sometimes provided compromised care. The paradox between a commitment to care and compromised care delivery was borne out of tensions between newly graduated nurses' professional beliefs and nursing values, a desire to integrate patients' needs and preferences, and organizational constraints on everyday practices where newly graduated nurses often worked alone without the support of a more experienced nurse. Critical reflection on cultural, social and political forces that influence direct care delivery might support newly graduated nurses to deliver direct patient care more intentionally. Relevance to Clinical Practice: Establishment of onboarding programs and other support activities for newly graduated nurses to cope with contrasting intentions and actions that must address organizational constraints is essential. These development programs should include how critical reflection competency is supported to address value inconsistencies and emotional distress to ensure high‐quality patient care. Reporting Method: The reporting adhered to the COREQ guidelines. Patient or Public Contribution: 'No Patient or Public Contribution'. [ABSTRACT FROM AUTHOR]

Aim. The aim of this article is to report the process and outcomes of codesigning a nursing leadership program for fundamental care. The leadership program is designed to empower nursing leaders, across research, education, clinical practice, and policy, to challenge and change how fundamental care is valued, prioritised, and actioned within health and care systems. Background. Deficits in fundamental care represent an intractable problem adversely impacting care recipients, care providers, and health and care systems globally. These deficits stem from the minimal value placed on fundamental care and its subsequent invisibility across research, education, clinical practice, and policy. Sustainable systems change requires effective nursing leadership; however, existing nursing leadership programs tend to address only one area of health and care systems, typically clinical practice, and do not focus specifically on fundamental care. Methods. The Fundamentals of Care Leadership Program was codesigned with current and emerging nursing leaders using a participatory action research approach. The collaborative codesign process involved two stages: (1) idea generation and preliminary program development via Nominal Group Technique (n = 60 participants from 11 countries) and (2) refinement and trialling of program content and process via a three-day workshop (n = 19 participants from 9 countries). Results. Participants prioritised a program that provided clear understanding of the concept of fundamental care, enabled the development of influencing and negotiating skills to advocate for this care, and offered resources on knowledge translation, implementation, and measurement strategies. Participants also wanted allotted time to design research and quality improvement projects that would allow them to transfer the skills learned to the real-world issues occurring within their respective organisations. Conclusions. The codesign process, embedded within a participatory action approach, enabled the development of a Fundamentals of Care Leadership Program that is shaped by, and meets the needs of, current and emerging nursing leaders. The leadership program will enable nursing leaders to challenge value systems on fundamental care and to champion this care across research, education, clinical practice, and policy, working towards enhanced fundamental care outcomes and experiences. [ABSTRACT FROM AUTHOR]

Aim: To investigate the strategies used by nurse leaders to facilitate fundamental care delivery in their clinical area. Design: An interpretative qualitative design study reported in line with the Consolidated Criteria for Reporting Qualitative Research (COREQ). Methods: Twenty‐four self‐identified nurse leaders from across Australia were interviewed between November 2020 and April 2021 to discuss their strategies for facilitating fundamental care. Data was analysed using inductive thematic analysis. Results: Nurse leaders' experience of facilitating fundamental care produced two major themes, delivery of fundamental care (comprising three sub‐themes: valuing fundamental care, understanding and developing staff capacity and supportive relationships), and monitoring of fundamental care (including three sub‐themes: visibility in the clinical area, embedding fundamental care in the practice setting and specific direct actions). Conclusion: Facilitating fundamental care delivery is complex. This study highlighted the importance of nurse leaders' individual characteristics, and nurse leaders' ability to establish and maintain relationships alongside the role of informal and formal monitoring of fundamental care delivery. Impact Findings from this study build on existing research into fundamental care and contribute to our understanding of the role, characteristics and actions of nurse leaders to facilitate fundamental care. The results demonstrate the complexity and intricacy of nursing leadership to facilitate fundamental care, and that a dynamic 'thinking and linking' approach is required. The results show individualized practice which may create challenges for new nurse leaders seeking guidance, and for monitoring nurse leader activity. Further research is advocated to explore insights and tools to optimize nurse leaders' endeavours in facilitating fundamental care. Patient or Public Contribution: This study was designed using insights generated from patient and public involvement in nursing leadership and fundamental care. [ABSTRACT FROM AUTHOR]

Aims: To investigate nursing and allied health professional perceptions of the interrelationship between avoidable hospital readmissions and fundamental care delivery. Design: A qualitative, exploratory study using a critical realist approach. Method: One‐to‐one semi‐structured interviews with 14 nursing and allied health professionals conducted between May and September 2019. Results: Several tensions and contradictions were identified in the data, which demonstrated clinicians' perceptions about the priority of both fundamental care and two avoidable readmission conditions (aspiration pneumonia and constipation). These tensions are illustrated in two major themes: Avoidable versus inevitable; and everyone versus no one. The first theme demonstrates clinicians' perceptions that readmissions for aspiration pneumonia and constipation are not common, despite acknowledging that they generally lacked knowledge on readmission rates; and that these conditions may not be preventable in acute settings. The second theme demonstrates clinicians' perception that preventing readmissions is everyone's responsibility, however, this was coupled with a lack of articulation around how this multidisciplinary approach could be achieved, leading to a distinct lack of agency for care delivery. Conclusion: Articulating the tensions described in the results provides vital knowledge for understanding how clinicians may respond to initiatives designed to reduce avoidable readmissions. Avoidable hospital readmissions may be usefully understood as a wicked problem: one that is complex and requires adaptive, not linear, solutions. Wicked problems pose a challenge for leaders and managers in healthcare because top‐down, hierarchical strategies are unlikely to be successful. Effective prevention of avoidable readmissions requires leaders to enable facilitator‐led change through relational leadership strategies. Impact Avoidable hospital readmissions are a global problem increasingly addressed via funding changes and the introduction of penalties to hospitals. This study provides insights on clinicians' perspectives of avoidable hospital readmissions and their prevention, demonstrating the complexity of this challenge and the need for healthcare leaders to enable individual and organizational readiness for change. [ABSTRACT FROM AUTHOR]

Aims: To explore the role of ward‐based nurse managers in supporting nurses to undertake high‐quality fundamental care. Design: A qualitative study guided by the principles of interpretive description. Reported in accordance with Consolidated Criteria for Reporting Qualitative Research (COREQ). Methods: Nurse managers in three urban, publicly funded hospitals in Australia, Denmark and New Zealand, were invited to participate in group interviews to discuss how they support fundamental care in their clinical areas. Six group interviews were conducted between February 2017 and March 2020 involving 31 participants. Results: Six interrelated themes were identified: Difficulty expressing how to support the nurse—patient relationship;Establishing expectations for care delivery without clear strategies for how this can be achieved;Role modelling desired behaviours;Significance of being present to support care quality;The importance of engaging and supporting staff in their work; andRecognizing the challenges of prioritizing care needs. Conclusion: This study indicates that nurse managers are not universally clear in explaining how they support their staff to provide fundamental care. If fundamental care is not clearly understood and communicated in the nursing team, then there are risks that fundamental care will not be prioritized, with potential negative consequences for patient care. Nurse managers may benefit from additional resources and guidance to help them to support fundamental care delivery in their clinical areas. Impact: Previous research exploring fundamental care and missed care highlights the importance of the role of the nurse manager in influencing nursing care. This study demonstrates that though nurse managers have a passion for supporting their staff to deliver fundamental care, clear strategies to achieve this are not always evident. This study suggests that scholarship around leadership to promote and facilitate fundamental care is crucial to improving nursing practice and patient outcomes. [ABSTRACT FROM AUTHOR]

Background: Infectious disease outbreaks disrupt inpatient clinical care and have an impact on staff and patients' ability to communicate with each other and with the wider community. Digital technology may offer opportunities for communication in the inpatient setting during infectious disease outbreaks. Aim: This scoping review aimed to investigate the use of digital technology in the inpatient setting to promote communication in the early stages of an infectious disease outbreak. Methods: There were three aspects to this scoping review: (1) a database search of Ovid MEDLINE (MEDLINE), Cumulative Index of Nursing and Allied Health Literature (CINAHL), Association for Computing Machinery Digital Library (ACM) and IEEE Xplore (IEEE) exploring peer-reviewed articles, (2) a gray literature search, and (3) a media search. Results: Results focused on the early stages of the COVID-19 pandemic. Thirty-eight peer-reviewed articles were extracted from the database search. There were three main areas of investigation: study characteristics, technology features, and benefits and barriers. Forty-four websites were searched for the gray literature search focusing on policy and guidance. Eighteen media articles were retrieved focusing on patients' use of technology and community involvement. Conclusion: Results demonstrate the diverse use of digital technology in the inpatient setting to facilitate communication during the early stages of the COVID-19 pandemic. However, the articles provide limited data to allow readers to fully understand and reproduce described actions. Furthermore, there was limited guidance to support clinicians to communicate using digital technology to create trusting therapeutic relationships. Areas for future development include standard reporting process for technology hardware, software, and content; and structured reporting and evaluation of the implementation of technologies. [ABSTRACT FROM AUTHOR]

The Fundamentals of Care Framework is an evidence‐based, theory‐informed framework that conceptualises high‐quality fundamental care. The Framework places the nurse–patient relationship at the centre of care provision and outlines the nurse behaviours required for relationship development. Numerous instruments exist to measure behavioural aspects of the nurse–patient relationship; however, the literature offers little guidance on which instruments are psychometrically sound and best measure the core relationship elements of the Fundamentals of Care Framework. This study evaluated the quality of nurse–patient relationship instruments by (1) assessing their content development and measurement properties (e.g. dimensionality, targeting, reliability, validity) and (2) mapping instrument content to the Framework's core relationship elements: trust, focus, anticipate, know, and evaluate. Twenty‐seven instruments were evaluated. Findings demonstrated that patients and nurses were rarely involved in item development. Most instruments exhibited poor measurement properties, with only one instrument having complete information on all quality indicators. Instrument content focused primarily on nurses getting to know patients and earning their trust, with only 54, 18, and 1 item(s), respectively, measuring 'focus', 'anticipate' and 'evaluate'. Hence, there does not appear to be a robust instrument measuring behavioural aspects of nurse–patient relationships, nor one capturing the relationship elements of the Fundamentals of Care Framework. [ABSTRACT FROM AUTHOR]

Aim: To present the first iteration of the caring life‐course theory. Background: Despite requiring care from birth to death, a person's universal or fundamental care needs and the subsequent care provision, either by self or others, has yet to be presented within a life‐course perspective. Accurately describing the care people require across their lifespan enables us to identify who, what type, how and where this care should be provided. This novel perspective can help to legitimise a person's care needs and the support they require from wider care systems and contexts. Design: Discussion paper outlines theory development. We adopted an inductive approach to theory development, drawing upon existing literature and the team's diverse experiences. Our theoretical insights were refined through a series of collaborative meetings to define the theory's constructs, until theoretical saturation was reached. Discussion: Fourteen constructs are identified as essential to the theory. We propose it is possible, using these constructs, to generate caring life‐course trajectories and predict divergences in these trajectories. The novel contribution of the theory is the interplay between understanding a person's care needs and provision within the context of their lifespan and personal histories, termed their care biography, and understanding a person's care needs and provision at specific points in time within a given care network and socio‐political context. Impact for Nursing: The caring life‐course theory can provide a roadmap to inform nursing and other care industry sectors, providing opportunities to integrate and deliver care from the perspective of the person and their care history, trajectories and networks, with those of professional care teams. It can help to shape health, social and economic policy and involve individuals, families and communities in more constructive ways of talking about the importance of care for improved quality of life and healthy societies. [ABSTRACT FROM AUTHOR]

Aims and objectives: To elucidate the synergies between fundamental care and seminal nursing theories. Background: Nursing theories are often criticised for their limited clinical relevance, with the existence of a theory‐to‐practice gap widely acknowledged. Pervasive examples of poor‐quality care, particularly for people's most fundamental needs, raise questions as to whether nursing theories sufficiently prioritise fundamental care. The Fundamentals of Care Framework (hereinafter "the Framework") represents a valid, comprehensive and evidence‐based description of fundamental care. The Framework captures the complexity and multidimensionality of fundamental care delivery, predicated on the nurse–patient relationship; integration of physical, psychosocial and relational needs; and a supportive context. Despite strong face validity, the Framework's alignment with seminal nursing theories remains unexplored. Design: Narrative review. Method: Twenty‐nine seminal nursing theories were included. Categories for analysis were developed inductively and deductively, focusing on the themes of relationship, integration of care, context and the theories' ease of use. Results are reported in accordance with PRISMA‐ScR guidelines. Results: Though relationship, integration of care and context and were features shared across a number of nursing theories, no single theory depicts these collectively to the same extent as the Framework. In particular, integration of physical, psychosocial and relational aspects of care was found to be poorly described in the theories. Conclusion: Failure to account for integration of care means that nursing theories continue to conceptualise fundamental care as a series of discrete tasks. To ensure relevance at the point of care, future nursing theories must accurately reflect the complexities of fundamental care delivery, specifically the need to integrate multiple care needs simultaneously, alongside being straightforward to apply in practice. Relevance to clinical practice: Bridging the theory‐to‐practice gap requires a nursing discourse that is relevant at the point of care. We provide suggestions for how future nursing theories can bridge this gap. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify and map tools measuring behavioural aspects of the nurse–patient relationship. Background: The behaviours nurses employ to develop relationships with patients form a key part of nursing practice. Systematically measuring these behaviours provides an objective means of assessing and evaluating how nurses establish and maintain relationships with patients in a variety of settings. Whilst tools exist to measure these behaviours, little is known about their aims/scope, structure, method of development and contexts of use. Such knowledge is crucial for understanding the nature of the literature, including in which contexts and for which patient groups existing tools are suited. Design: Scoping review informed by Joanna Briggs Institute methodology. Methods: A database search was undertaken using CINAHL, PsycINFO, Pubmed and Embase. Primary research articles, theses and methodological papers that developed, refined and/or administered tools measuring behavioural aspects of the nurse–patient relationship, in any setting and for any patient group, were included. Tools had to measure actual not hypothetical behaviour (e.g., perceptions regarding importance). Data from included studies and tools were mapped. Results are reported in accordance with PRISMA‐ScR guidelines. Results: One hundred and twenty‐seven studies, containing 35 tools, were included. The literature was characterised by substantial variability, stemming from the continued refinement of tools (e.g., reduction to short forms) but also the development of new tools that appeared to duplicate existing work and the inconsistent use of tools across studies. Conclusions: The volume of tools available demonstrates the importance of measuring the nurse–patient relationship. However, the existing duplication and variability create challenges in choosing amongst the tools available and show that, as a concept, the nurse–patient relationship remains poorly understood. Relevance to clinical practice: Research is required to synthesise, and assess the quality of, existing tools, enabling clinicians, leaders/managers, educators and researchers to administer appropriate tools to evaluate the nurse–patient relationship. [ABSTRACT FROM AUTHOR]

Aim Design Methods Results Conclusion Implications for the Profession and/or Patient Care Impact Patient or Public Contribution What Does this Paper Contribute to the Wider Global Clinical Community? The aim of this study was to present the third position statement from the International Learning Collaborative (ILC). The ILC is the foremost global organization dedicated to transforming fundamental care. Internationally, fundamental care is reported to be poorly delivered, delayed or missed, negatively impacting patients, their families/carers and healthcare staff and systems. Overcoming this global challenge requires profound transformation in how our healthcare systems value, deliver and evaluate fundamental care. This transformation will take both evolutionary and revolutionary guises. In this position statement, we argue how this [r]evolutionary transformation for fundamental care can and must be created within clinical practice.Position paper.This position statement stems from the ILC's annual conference and Leadership Program held in Portland, Maine, USA, in June 2023. The statement draws on the discussions between participants and the authors' subsequent reflections and synthesis of these discussions and ideas. The conference and Leadership Program involved participants (n = 209) from 13 countries working primarily within clinical practice.The statement focuses on what must occur to transform how fundamental care is valued, prioritized and delivered within clinical practice settings globally. To ensure demonstrable change, the statement comprises four action‐oriented strategies that must be systematically owned by healthcare staff and leaders and embedded in our healthcare organizations and systems: Address non‐nursing tasks: reclaim and protect time to provide high‐value fundamental care. Accentuate the positive: change from deficit‐based to affirmative language when describing fundamental care. Access evidence and assess impact: demonstrate transformation in fundamental care by generating relevant indicators and impact measures and rigorously synthesizing existing research. Advocate for interprofessional collaboration: support high‐quality, transdisciplinary fundamental care delivery via strong nursing leadership. The ILC Maine Statement calls for ongoing action – [r]evolution – from healthcare leaders and staff within clinical practice to prioritize fundamental care throughout healthcare systems globally. We outline four action‐oriented strategies that can be embedded within clinical practice to substantially transform how fundamental care is delivered. Specific actions to support these strategies are outlined, providing healthcare leaders and staff a road map to continue the transformation of fundamental care within our healthcare systems. Fundamental care affects everyone across their life course, regardless of care context, clinical condition, age and/or the presence of disability. This position statement represents a call to action to healthcare leaders and staff working specifically in clinical practice, urging them to take up the leadership challenge of transforming how fundamental care is delivered and experience globally. Patients, service users and caregivers were involved in the ILC annual conference, thus contributing to the discussions that shaped this position statement. The strategies and actions outlined in this position statement are relevant to all clinical settings globally, providing practical strategies and actions that can be employed to enhance fundamental care for all patients and their families/carers. By outlining the importance of both evolutionary and revolutionary change, we identify ways in which healthcare systems globally can begin making the necessary steps towards radical fundamental care transformation, regardless of where they are in the change journey. [ABSTRACT FROM AUTHOR]

Aims and objectives: To investigate how fundamental aspects of nursing care have been defined in the literature from 2010–2016. Background: A 2010 narrative review of nursing texts identified little consensus on what constitutes the fundamental aspects of nursing care. Since then there has been a proliferation of policies, strategic frameworks and research teams dedicated to investigating such care. It is unclear whether this increased activity has led to greater conceptual clarity. Design: Scoping review using the Joanna Briggs Institute methodology. Methods: A search of published and grey literature was undertaken using CINAHL, Scopus, PubMed and ProQuest. Documents providing a definition for fundamental aspects of nursing care were included for review. Definitions were identified and mapped. Results: Forty‐nine documents were included. Two ways of constructing the discourse around fundamental aspects of nursing care were identified: compassionate care (n = 25) and fundamentals of care (n = 24). The literature on compassionate care focused primarily on the moral attributes of nurses and their ability to establish meaningful connections with patients. The literature on fundamentals of care was split between describing such care as a list of nursing activities and describing it as a complex, multidimensional construct. Conclusions: There appears to be a lack of consensus around how fundamental aspects of nursing care are defined. Compassionate care and fundamentals of care have commonalities in terms of emphasising the nurse–patient relationship; however, only the literature on fundamentals of care addresses patients’ physical care needs. Despite their commonalities, it seems the two bodies of work are being developed largely independent of one another. Relevance to clinical practice: This scoping review identified areas of convergence and divergence around fundamental aspects of nursing care. An agreed definition for such care is needed to enable the development of a robust evidence base to underpin the coherent and consistent development of nursing practice. [ABSTRACT FROM AUTHOR]

Aims and objectives: To generate a standardised definition for fundamental care and identify the discrete elements that constitute such care. Background: There is poor conceptual clarity surrounding fundamental care. The Fundamentals of Care Framework aims to overcome this problem by outlining three core dimensions underpinning such care. Implementing the Framework requires a standardised definition for fundamental care that reflects the Framework's conceptual understanding, as well as agreement on the elements that comprise such care (i.e., patient needs, such as nutrition, and nurse actions, such as empathy). This study sought to achieve this consensus. Design: Modified Delphi study. Methods: Three phases: (i) engaging stakeholders via an interactive workshop; (ii) using workshop findings to develop a preliminary definition for, and identify the discrete elements that constitute, fundamental care; and (iii) gaining consensus on the definition and elements via a two‐round Delphi approach (Round 1 n = 38; Round 2 n = 28). Results: Delphi participants perceived both the definition and elements generated from the workshop as comprehensive, but beyond the scope of fundamental care. Participants questioned whether the definition should focus on patient needs and nurse actions, or more broadly on how fundamental care should be delivered (e.g., through a trusting nurse–patient relationship), and the outcomes of this care delivery. There were also mixed opinions whether the definition should be nursing specific. Conclusions: This study has initiated crucial dialogue around how fundamental care is conceptualised and defined. Future work should focus on further refinements of the definition and elements with a larger, international group of practising nurses and service users. Relevance to clinical practice: The definition and elements, through ongoing refinement, will contribute to a robust evidence base that will underpin policy development and the systematic and effective teaching, delivery, measurement and evaluation of fundamental care. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the perspectives of nursing students on their education concerning basic nursing care, learned either during theoretical education or clinical placement, with a specific focus on nutrition and communication. Background: Basic care activities lie at the core of nursing, but are ill‐informed by evidence and often poorly delivered. Nursing students’ education on basic care might be lacking, and the question remains how they learn to deliver basic care in clinical practice. Design: Descriptive study, using an online questionnaire. Methods: Nursing students at the vocational and bachelor level of six nursing schools in the Netherlands were invited to complete an online questionnaire regarding their perception of basic nursing care education in general (both theoretical education and clinical placement) and specifically in relation to nutrition and communication. Results: Nursing students (n = 226 bachelor students, n = 30 vocational students) completed the questionnaire. Most students reported that they learned more about basic nursing care during clinical placement than during theoretical education. Vocational students also reported learning more about basic nursing care in both theoretical education and clinical practice than bachelor students. In terms of nutrition, low numbers of students from both education levels reported learning about nutrition protocols and guidelines during theoretical education. In terms of communication, vocational students indicated that they learned more about different aspects of communication during clinical practice than theoretical education and were also more likely to learn about communication (in both theoretical education and clinical practice) than were bachelor students. Conclusion: Basic nursing care seems to be largely invisible in nursing education, especially at the bachelor level and during theoretical education. Relevance to clinical practice: Improved basic nursing care will enhance nurse‐sensitive outcomes and patient satisfaction and will contribute to lower healthcare costs. This study shows that there is scope within current nurse education in the Netherlands to focus more systematically and explicitly on basic nursing care. [ABSTRACT FROM AUTHOR]

Nursing policy and healthcare reform are focusing on two, interconnected areas: person-centred care and fundamental care. Each initiative emphasises a positive nurse-patient relationship. For these initiatives to work, nurses require guidance for how they can best develop and maintain relationships with their patients in practice. Although empirical evidence on the nurse-patient relationship is increasing, findings derived from this research are not readily or easily transferable to the complexities and diversities of nursing practice. This study describes a novel methodological approach, called holistic interpretive synthesis ( HIS), for interpreting empirical research findings to create practice-relevant recommendations for nurses. Using HIS, umbrella review findings on the nurse-patient relationship are interpreted through the lens of the Fundamentals of Care Framework. The recommendations for the nurse-patient relationship created through this approach can be used by nurses to establish, maintain and evaluate therapeutic relationships with patients to deliver person-centred fundamental care. Future research should evaluate the validity and impact of these recommendations and test the feasibility of using HIS for other areas of nursing practice and further refine the approach. [ABSTRACT FROM AUTHOR]

This article examines how third-party complaints were responded to by counsellors on a men's relationship-counselling helpline. Much prior conversation analytic research has shown that third-party complaints in institutional settings are embedded in other activities and treated as secondary to the main interactional business. As such, complaints are routinely responded to with a shift to a new, institutionally relevant activity (e.g. the reason for the call/visit). In the context examined here, however, the third-party complaints constituted callers' reasons for call. We show that, as in many other institutional contexts, counsellors do not, commonly, affiliate with callers' complaints in the sense of displaying a similar stance towards a described third party. However, unlike in other settings that have been examined, counsellors' responses did not result in an immediate shift away from callers' complaints. This was primarily because, following counsellors' non-affiliative responses, callers regularly engaged in work to pursue affiliation. [ABSTRACT FROM AUTHOR]

Meeting patients’ fundamental care needs is essential for optimal safety and recovery and positive experiences within any healthcare setting. There is growing international evidence, however, that these fundamentals are often poorly executed in acute care settings, resulting in patient safety threats, poorer and costly care outcomes, and dehumanising experiences for patients and families. Whilst care standards and policy initiatives are attempting to address these issues, their impact has been limited. This discussion paper explores, through a series of propositions, why fundamental care can be overlooked in sophisticated, high technology acute care settings. We argue that the central problem lies in the invisibility and subsequent devaluing of fundamental care. Such care is perceived to involve simple tasks that require little skill to execute and have minimal impact on patient outcomes. The propositions explore the potential origins of this prevailing perception, focusing upon the impact of the biomedical model, the consequences of managerial approaches that drive healthcare cultures, and the devaluing of fundamental care by nurses themselves. These multiple sources of invisibility and devaluing surrounding fundamental care have rendered the concept underdeveloped and misunderstood both conceptually and theoretically. Likewise, there remains minimal role clarification around who should be responsible for and deliver such care, and a dearth of empirical evidence and evidence-based metrics. In explicating these propositions, we argue that key to transforming the delivery of acute healthcare is a substantial shift in the conceptualisation of fundamental care. The propositions present a cogent argument that counters the prevailing perception that fundamental care is basic and does not require systematic investigation. We conclude by calling for the explicit valuing and embedding of fundamental care in healthcare education, research, practice and policy. Without this re-conceptualisation and subsequent action, poor quality, depersonalised fundamental care will prevail. [ABSTRACT FROM AUTHOR]

Aim: To summarize existing research syntheses reporting newly graduated registered nurses' experiences of providing direct care in hospital settings. Design: Umbrella review. Data Sources: An extensive search of all relevant databases was conducted for research syntheses. Initial key terms included "new* nurse", "nursing care" and "hospital setting" in combination with index terms to find relevant literature. Methods: Critical appraisal, data extraction and summary were performed independently by two reviewers according to the Joanna Briggs Institute guidelines for undertaking umbrella reviews. Results: Nine research syntheses published between 2010 and 2019 and representing 173 studies were included following critical appraisal. The evidence was summarized in narrative form with supporting tables. Twenty‐six sub‐branches and seven main‐branches were organized in a coding tree showing the structure of three overlapping themes: "Feeling a lack of competency", "Sense of emotional distress" and "In need of support". Conclusions: Evidence demonstrates that newly graduated registered nurses' experiences of a lack of competency, emotional distress and need for support emerged as essential requirements for the provision of competent and safe direct care for the patient. Impact Newly graduated registered nurses face multiple challenges in the transition from student nurse to practicing nurse. Unmet expectations of being a newly graduated nurse might lead to low levels of job satisfaction, high attrition rates or missed nursing care. Nurse educators, leaders and policy makers should be mindful that newly graduated registered nurses' perceptions of professional and personal identity and degree of support influences newly graduated registered nurses' direct care provision. [ABSTRACT FROM AUTHOR]

Qualitative story completion (QSC) is an innovative research method that offers researchers a range of unique opportunities for generating and analysing data. Participants are asked to write a 'story' in response to a hypothetical 'story stem', often in the third-person and involving fictional characters, rather than reporting on their direct experiences. QSC is being developed and increasingly taken up by researchers working across a range of fields; but it has been little used in health research, especially in the fields of nursing, health services research, medicine, and allied health. This means that health researchers have few examples to draw on when considering what QSC can offer them and how to rigorously design, conduct, and report a QSC study within health-related fields. We aim to address this gap and contribute to existing QSC literature by promoting increased use of QSC by health researchers and supporting them to produce rigorous QSC research. We outline three case examples illustrating how we have used QSC to conduct multidisciplinary health research relevant to nursing, medicine and nutrition. Drawing on these case examples, we reflect on challenges that we encountered, describe decision-making processes, and offer recommendations for conducting rigorous health research using QSC. [ABSTRACT FROM AUTHOR]

Literature on men's health help-seeking suggests that, consistent with hegemonic masculine ideals, men display a general preference for solution-focused interaction. Men's health services routinely orient to this preference, emphasising assistance in the form of practical advice. Little research, however, has examined the nature of actual interactions between men and health professionals. The present paper analyses interaction on a men's telephone relationship-counselling service, focusing on reasons for calling. We demonstrate some recurring interactional patterns relating to the helpline's institutional philosophy of solution-focused counselling. Specifically, callers routinely engaged in narrative reporting of relationship troubles rather than indicating that they were seeking advice; counsellors, however, routinely orientated to the role of advice- and information-provider, in addition to that of troubles-talk recipient. We examine the recurring interactional disfluencies around this reason-for-call talk, considering some consequences for institutional help-giving that arise from the assumption of a male preference for solution-focused healthcare. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: The importance of maintaining high frequencies of communication between players during team sports is widely recognised. This article highlights an additional feature of communication that has strategic significance for team interaction during play, and offers empirically-grounded recommendations for coaches and players. Design: A combination of descriptive statistics and Conversation Analysis was used to examine elite netballers’ communications during defensive play. Method: Play was video- and audio-recorded, and coded for frequency of different types of communication. Data were analysed for evidence of recurring patterns in players’ verbal and non-verbal conduct. Results: Descriptive statistics demonstrated that higher frequencies of communication between defenders occurred when opposition players successfully obtained shots at goal. Qualitative Conversation Analysis provided an opportunity to unpack this finding by examining the specific interactional consequences following from particular verbal and non-verbal communications. Uptake of communication was demonstrated to be crucially dependent upon speakers’ taking account, in their verbal and non-verbal conduct, of both their team-mate’s current orientation, and visual access to the defensive problem. Conclusions: In addition to advocating for the maintenance of high frequencies of communication, it is recommended that coaches and players also turn attention to the specific practices by which players communicate about problematic features of unfolding play. We suggest specific ways in which players might be encouraged to design their communications to allow team-mates increased opportunity to notice and act upon particular events in the complex, fast-paced, highly contingent environment of actual play. [Copyright &y& Elsevier]

Aims Design Methods Results Conclusion Implications for the Profession and/or Patient Care Impact Reporting Method Patient or Public Contribution To (a) seek examples of nursing caring success stories and (b) identify the common contributors to these successes. By focusing on the successes of nursing care rather than critically examining failures, this research seeks to provide examples of proven and feasible approaches and processes for improving care.This study used a narrative inquiry design.Data were collected through group interviews. Four interviews were conducted with a total of 20 nurse participants working in inpatient settings in South Australian hospitals. A thematic analysis approach was used to analyse the data.Two dominant themes concerning the contributors to caring success were identified. These contributors were (1) the provision of holistic care and (2) the influence of the caring community, which includes family members and other patients. The findings also indicated that the definition of caring success according to nurses is not aligned with organisational performance indicators but is more closely represented by caring values.Success, according to nurses, is not exclusively defined by patient outcomes but includes the approach to, and process of, care delivery.Nurses value the caring process while working in an environment that primarily values clinical and systems‐level outcomes. Nurses want patients and their families, allied health professionals and hospital executives to be involved and invested in the process of care.This study addressed a gap in the current literature to identify commonalities in nursing success stories, the contributors informing these successes and how these contributors can facilitate improved patient care. Understanding nursing definitions of caring success provides an opportunity to expand upon current accepted industry definitions and perspectives such as key performance indicators.Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.No direct patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: The commitment of nurses to their profession and workplace is closely linked to the delivery of high-quality patient care. Existing literature highlights the positive impact of commitment on care quality and patient outcomes. Conversely, a lack of commitment can lead to nurse burnout and disengagement. However, it remains unclear whether and how cultural beliefs and practices influence newly graduated nurses' commitment to the nursing profession and their workplace. Aim: To explore the cultural beliefs and practices influencing newly graduated nurses' commitment to the profession and commitment to their workplace during their first year of employment. Design: A focused ethnographic study. Methods: Data consisted of field notes from 94 h of participant observations and 10 semi-structured interviews with newly graduated nurses working in acute care settings in Denmark. Data were analysed using ethnographic content analysis. Data were collected between March and June 2022. Results: The findings reveal a major theme, termed 'A State of Transience among Newly Graduated Nurses', consisting of two themes: 'Newly Graduated Nurses' Pursuit of Professional Development and Supportive Work Environments' and 'A Lack of Formal Agreements or Conditions to Meet Expectations for Professional Development.' Conclusion: Hospitals and nurse managers need to support newly graduated nurses in their first employment after registration by providing a range of clinical experiences through job rotation opportunities within the same organization, deliver on promises for onboarding support and foster a culture of trust. These strategies will help maintain the motivation, commitment and ability of newly graduated nurses to deliver high-quality patient care, thereby reducing the likelihood of turnover. Relevance for Clinical Practice: A trusting and supportive work environment is fostered by providing diverse clinical experiences and consistent support for newly graduated nurses. To address potential high turnover associated with job rotation, hospitals need to rethink how retention is defined and measured, moving beyond hospital unit-level models and measures. Reporting Method: This study reports to the SRQR guidelines. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

This multi-method project examined how Australian caregivers navigated family life during the COVID-19 pandemic in 2020 and subsequent impact on family health behaviours. Participants were invited to complete all three phases. In phase 1, 115 caregivers completed an online survey, focussed on 2020 experiences of COVID-19. In phase 2, 96 of the participants completed a use-of-time recall and 80 completed a dietary recall examining participants' health behaviours including how they spent their time, their physical activity, and diet quality. Phase 3 involved 24 of the participants completing an online story completion task, focussed on understanding participants' sense-making of COVID-19. Through triangulating analyses of the three phases, this project identified how poor relationship quality negatively affected families' experiences of significant disruptions and transitions. This project provides a nuanced picture of how COVID-19 in 2020 impacted family life and highlights the importance of caregiver relationship quality for family health and wellbeing. [ABSTRACT FROM AUTHOR]

Women's involvement in decision-making around antenatal care is an issue of ongoing debate and discussion. Most research on the topic has used interview and focus group methods to examine women's perspectives. The present study uses a different kind of evidence. By analyzing recordings of actual antenatal consultations, this paper presents a preliminary exploration of model-of-care talk in a hospital setting where a policy of woman-centered care underpinned practice. Conversation Analysis was used to examine how model-of-care pathways were introduced by midwives and discussed with women in consultations. Drawing on interactional work on deontic (i.e., the rights and responsibilities of speakers to determine courses of action) and epistemic (i.e., speakers' claims to knowledge) orientations, this paper offers an account of how woman-centered care is accomplished in a hospital setting. The findings demonstrate how midwives routinely relied on their epistemic knowledge regarding women's health to invoke a "normal" categorization that worked to position midwifery-led care as an appropriate pathway. Examination of model-of-care talk also demonstrated how authority to choose a pathway was typically managed so as to reside with the woman. Talk that topicalized epidural forms of pain management were also examined, as institutional policy around where birth could occur in the hospital system under study restricted women's options (a planned epidural precluded woman access to midwifery-led care during delivery). The findings demonstrate the various ways in which midwives created opportunities for woman-centered care in an institutional setting in which there were logistical restrictions on women's choices. [ABSTRACT FROM AUTHOR]

Men's experiences with anxiety are under-researched and poorly understood. Existing research gives little indication of how men talk about anxiety in situ, and little is known about how men describe their experiences of anxiety. Online discussion forums provide an opportunity to conduct naturalistic observations of how men describe their experiences with anxiety without the influence of a researcher. Thematic analysis, informed by principles of discursive psychology, was used to examine 130 opening posts to an online anxiety discussion forum. One superordinate theme, where anxiety is constructed as a loss of control, was identified. Analysis of this overarching theme generated three themes relating to how posters described a loss of control: (a) anxiety as an immobilizing force, (b) anxiety as an independent entity, and (c) anxiety as a dualist construction of the self. Our analysis has clear implications for developing and improving interventions for men experiencing anxiety. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this umbrella review was to synthesize existing systematic review evidence on the effectiveness of in-hospital interventions to prevent or reduce avoidable hospital readmissions in older people (≥65 years old).Data Sources: A comprehensive database search was conducted in May 2019 through MEDLINE, EMBASE, CINAHL, the JBI Database of Systematic Reviews, DARE and Epistemonikos.Study Selection: Systematic reviews and other research syntheses, including meta-analyses, exploring the effectiveness of hospital-based interventions to reduce readmissions for people aged 65 and older, irrespective of gender or clinical condition, were included for review. If a review did not exclusively focus on this age group, but data for this group could be extracted, then it was considered for inclusion. Only reviews in English were included.Data Extraction: Data extracted for each review included the review objective, participant details, setting and context, type of studies, intervention type, comparator and findings.Results Of Data Synthesis: Twenty-nine reviews were included for analysis. Within these reviews, 11 intervention types were examined: in-hospital medication review, discharge planning, comprehensive geriatric assessment, early recovery after surgery, transitional care, interdisciplinary team care, in-hospital nutrition therapy, acute care geriatric units, in-hospital exercise, postfall interventions for people with dementia and emergency department-based palliative care. Except for discharge planning and transitional care, none of the interventions significantly reduced readmissions among older adults.Conclusion: There is limited evidence to support the effectiveness of existing hospital-based interventions to reduce readmissions for people aged 65 and older. [ABSTRACT FROM AUTHOR]

Increasing cultural and academic attention is being paid to fathers who assume the primary caregiving role, stemming from interest into whether contemporary masculinity is evolving away from traditional, hegemonic ideals. This study utilises a Discourse Analysis informed by Membership Categorisation Analysis to explore how this relatively new category – primary caregiving father – is discursively constructed in 193 Australian newsprint media articles. The analysis identified that the category of 'primary caregiving father' was defended and discursively managed so as to remain consistent with the activities and predicates typically associated with the category 'normative man'. This was routinely achieved in two ways. First, descriptions of traditional uninvolved fathers were contrasted unfavourably against the 'new' primary caregiving father, working to position primary caregiving fathers as the new norm. Second, accounts of men's decision to take on the primary caregiving role routinely relied on the category-tied predicates of rationality and stoicism, thereby working to position primary caregiving fathers as normatively masculine. Overall, this article concludes that, despite fathers taking on roles inconsistent with normative gendered categorisation, constructions of fatherhood in news media routinely work to align (or re-align) primary caregiving fathers within hegemonic ideals. Therefore, while masculinity is evolving and shifting, it remains within the bounds of what is considered hegemonic. [ABSTRACT FROM AUTHOR]

Background: There are limited opportunities for surgeons to engage in active learning programs once they achieve Fellowship, especially for non‐technical skills such as communication. This study aims to address this gap by evaluating a peer‐based coaching program in non‐technical skill using video‐recorded patient consultations from a routine outpatient clinic. Methods: Standard outpatient consultations between consultant surgeons and patients were video recorded. The surgeon viewed the videos with a peer‐coach (senior surgeon) who helped identify areas of strength and areas for improvement. To test the effect of the coaching session, outpatient consultations were recorded roughly 1 month later. Pre and post‐coaching videos were assessed using the Maastricht History‐Taking and Advice Scoring – Global Rating List (MAAS), a common tool for evaluating non‐technical skills in clinicians. Results: A total of 12 surgeons consented to participate. Coaching significantly improved MAAS scores (mean difference = −0.61; 95% CI (−0.88, −0.33); P < 0.0001). Surgeons were generally positive about the experience. All found the method of learning suitable, and most thought the process improved their skills. Most thought that coaching would improve patient outcomes and the majority thought they would participate in ongoing coaching as part of their employment. Conclusion: This supports the concept of surgical coaching as an effective tool to improve communication skills and the quality of surgical consultation. The next step is to expand beyond a voluntary cohort and link surgical coaching to improved patient outcomes. We sought to understand if a peer‐based coaching program can better the non‐technical skills of surgeons in the outpatient clinic environment. This interventional pilot study assessed 12 surgeons and was conducted at The Queen Elizabeth Hospital (TQEH) in Adelaide, Australia. Our results support the concept that a video‐based peer‐coaching program can act as an effective tool to improve the communication skills of consultant surgeons and improve the quality of surgical consultation. [ABSTRACT FROM AUTHOR]

Although anxiety disorders are the most prevalent mental health disorder in Australia, little is known about men's anxiety help-seeking practices. This study investigates how male users of an online discussion forum accounted for engaging in troubles-telling in an online community. Posts on an online discussion forum written by men who identify as experiencing anxiety were analysed using discursive psychology, through the identification of four interpretative repertoires: (1) orienting to troubles-telling as their purpose for posting, (2) troubles-talk as a necessary form of self-help, (3) the online community as a last resort and (4) anxiety as a hidden, secret experience. Findings demonstrate how men reproduced hegemonic masculine ideals of strength, self-reliance and emotional stoicism, while also sharing their experiences of anxiety online. This research highlights the relevance of masculine social norms in understanding anxiety help-seeking practices, and also illustrates the value of online communities in offering support to men in need. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to measure the level of missed nursing care and determine its relationship with nurse staffing and patient safety outcomes in acute care settings in Ethiopia. Background: Missed nursing care in hospitals increases the likelihood of patient adverse events, complications, disability and death. However, little is known about the level of missed nursing care and its impact on patient outcomes in low‐income countries. Methods: An observational study was conducted comprising of a survey of nurses at two time points (n = 74 and 80, respectively) and a medical record review of 517 patients in four units across two hospitals between September 2018 and March 2019. Results: The level of missed nursing care in the study units was very high. The hospital type and hours nurses worked during the last week were significantly associated with missed nursing care. A unit increase in missed nursing care score increased the incidence of adverse patient outcomes by 10%. Conclusion: There was a higher level of missed nursing care in the study units compared with similar studies from high‐income countries. Higher level of missed nursing care was significantly associated with higher incidence of adverse patient safety outcomes. Summary statement: What is already known about this topic? Literature shows nurses working in acute care miss important nursing care activities mainly due to lack of time to perform those nursing care activities. What this paper adds? The level of missed nursing care in the low‐income country acute care units of the study hospitals is very high compared with other settings.Higher levels of missed nursing care were statistically associated with increase adverse patient safety outcomes, whereas lower levels of missed nursing care were statistically associated with improved patient outcomes. The implication of this paper Hospital administrators and nurse managers should work towards reducing missed nursing care through regular monitoring of nursing practice and improved staffing levels.Mechanisms to improve staffing and resource are required to enable nurses enough time to perform all essential nursing care activities for patients. [ABSTRACT FROM AUTHOR]

The proportion of older adults living with long-term conditions (LTCs) is increasing. Self-care and self-management approaches are seen as valuable in helping older people with LTCs to manage their health and care, yet the theoretical overlaps and divergences are not always clear. The objectives of this review were to: (1) systematically identify and appraise studies of self-care or self-management of LTCs by community-dwelling older adults (aged ≥60 years) either informed by, applying, creating, or testing theory; (2) explore similarities or points of convergence between the identified theories; and (3) use a meta-ethnographic approach to synthesise the theories and group related concepts into core constructs. We conducted a systematic theory synthesis, searching six electronic databases. Three reviewers independently screened titles and abstracts followed by full texts and two reviewers appraised study quality. Theoretical data were synthesised within and across individual theories using meta-ethnographic line-of-argument synthesis. A total of 141 articles (138 studies) and 76 theories were included in the review. Seven core constructs were developed: (1) temporal and spatial context; (2) stressors; (3) personal resources; (4) informal social resources; (5) formal social resources; (6) behavioural adaptations; and (7) quality of life outcomes. A line of argument was developed that conceptualised older adults' self-care and self-management as a dynamic process of behavioural adaptation, enabled by personal resources and informal and formal social resources, aimed at alleviating the impacts of stressors and maintaining quality of life. This synthesis provides an overview of theories used in research on older adults' LTC self-care and self-management. Our synthesis describes the complex interplay of intrinsic and extrinsic factors influencing self-care and self-management behaviours and provides considerations for future research, intervention design, and implementation. The utility of the constructs in research and practice requires further attention and empirical validation. • Self-care and self-management are valuable in managing long-term conditions. • Older adults often face additional challenges in addressing their care needs. • We conducted a synthesis of theories of self-care and self-management. • We developed seven core theoretical constructs for further exploration. • Strategies targeting multiple societal levels and key actors are needed. [ABSTRACT FROM AUTHOR]

Despite its prevalence, men's anxiety is arguably under‐researched and poorly understood. The present study explores the reasoning provided by male posters to an online discussion forum about the source of their anxiety. Posts were collected from an Australian anxiety online discussion forum. This study utilises discursive psychology, informed by principles of membership categorisation analysis, to describe how age, occupation and family‐related identities can be invoked within common sense reasoning about the source of male anxiety. References to various identity categories were routinely employed by male forum posters in their representations of themselves, in order to describe the source of their anxiety in terms of a contrast between how they are, and how they should be. In examining accounts of anxiety and responses to those accounts, we can trace cultural knowledge about issues regarding men, masculinity and anxiety that those accounts make relevant. Findings illustrate how men's descriptions of the source of their anxiety should be understood as culturally bound and related to expectations and obligations associated with their social context and category memberships. By enhancing understandings of how men describe the source of their anxiety, this study offers insight into improving the identification and engagement of men experiencing anxiety in health services. [ABSTRACT FROM AUTHOR]

This article contributes to the sociology of relationships by exploring the moral imperatives that shaped perceptions and negotiations of family life during lockdowns in Australia during the COVID-19 pandemic. We identified dominant discourses from an online qualitative story completion task and situate these in relation to emerging literature on the impact of pandemic-related restrictions on domestic relationships, gender relations, and labour division. We argue that discourses of family connection, clean and tidy homes, and the commodity of time operated as moral imperatives. These imperatives simultaneously offered opportunities for enrichment and agency, as well as operating as unobtainable benchmarks that constrained people’s sense of wellbeing. In this analysis we explore how COVID-19 lockdown stories offer new ways of understanding the interplay between displaying and doing ‘family life’ where gender and labour relations are performed, reinforced and challenged. [ABSTRACT FROM AUTHOR]

Although anxiety disorders are the most prevalent mental health disorder among Australian men, very little is known about men's experiences of living with, and seeking help for, anxiety. This article examines how male users of an online discussion forum for "anxiety" describe their anxiety in their opening posts. Of particular interest is how such descriptions attend to issues of authenticity and the types of support that men appear to be seeking online. Data were taken from one Australian online anxiety discussion forum over a 2-year period and were analyzed using thematic analysis, informed by principles of discursive psychology. The analysis demonstrates that authenticity of posters' anxiety is attended to in four main ways: (a) orienting to a diagnosis, (b) detailing the severity of their anxiety, (c) emphasizing the longevity of their anxiety, and (d) constructing themselves as trouble resistant. The findings suggest that the forum partially functions as a site for authentically anxious identities to be tested by forum users. A fifth theme relates to how those identities appeared to serve a particular function in terms of men's support-seeking behaviors on the forum. This article has clear practical implications for better understanding men's experiences of anxiety and their anxiety-related help-seeking preferences. [ABSTRACT FROM AUTHOR]

Background: Nurse staffing models have been developed across different countries to address nursing shortages and improve quality of nursing care. However, there is no published study that describes nurse staffing models in Ethiopian hospitals. Aims: To describe the existing staffing models for nursing practice in acute care units of two hospitals (one public and one private) in Ethiopia. Methods: A cross‐sectional study was conducted from July to December 2018. A self‐administered questionnaire was used to collect data such as shift patterns, hours worked, and number of patients cared for per shift. Unit‐level data on nurse staffing were collected using a checklist developed specifically for this study. Results: Fifty‐nine percent (59.9%) of participants reported that they worked six or seven days per week. On average, they worked 50 hours per week and 12% working over 60 hours per week. The number of patients they provided care for during their last shift ranged from four to 45 with an average of 13 patients. Conclusion: This study demonstrates that nurses working in acute care settings in Ethiopia are typically working more than 40 hours per week and caring for many patients per shift, which has the potential to impact patient safety. SUMMARY STATEMENT: What is already known about this topic? Nurse staffing is a critical factor affecting patient safety and nurse workforce outcomes.There are different staffing models in which staff are assigned to give care for patients in different healthcare settings but much of the research is from high‐income countries. What this paper adds? This paper describes nurse staffing in acute care settings in Ethiopia, a low‐income country. The number of patients for whom nurses provide care per shift, and the number of hours nurses provide care per week, is very high compared with other settings.Nurses work very long hours, often more than 50 hours per week.Many nurses routinely work six or seven days per week and on average nurses care for 13 patients per shift The implication of this paper: Hospital managers should ensure that working more than 40 hours or more than five days per week should not be routine.Hospital policy that addresses the maximum number of patients who receive care by one nurse is necessary.The findings of this study support the consideration of mandated nurse‐to‐patient ratios in Ethiopia. [ABSTRACT FROM AUTHOR]