Global Qualitative Nursing Research最新文献

With the growing population in South Africa, there is a need for long-term care facilities. Using institutional ethnography, this study investigates the quality of life for older adults in South African long-term care facilities. Twenty key informants and 10 staff members were purposively sampled across 5 long-term care facilities in Gauteng, South Africa, for participation in in-depth interviews and observations. An analysis of institutional texts was conducted, focusing on legislative frameworks and practices. The findings include three analytic threads, namely: (a) Healthcare Access and Physical Well-Being, (b) Institutional Constraints on Meaningful Engagement, and (c) Efficiency Overriding Privacy and Autonomy. A significant gap exists between legislative policies and actual practices, with older adults seeking more autonomy and decision-making involvement. This institutional ethnography, rooted in the perspectives of older residents and care workers, highlights how long-term care facilities are shaped by regulatory frameworks and institutional ideologies. These frameworks often restrict care workers in fully leveraging their intimate knowledge of residents to address individual needs, as their care work interventions are bound to compliance with the textual and accountability demands of the Older Persons Act 13 of 2006.

Workplace bullying impacts at least half of the nurses worldwide. Despite the link to increased nurse turnover, few intervention studies have addressed bullying in the workplace. Since most studies report cross-sectional designs that provide little insight into the complexities of this phenomenon, the purpose of this descriptive phenomenology was to describe the lived experiences of nurses as they were actively being bullied in the workplace. Semi-structured interviews were conducted through Skype until data adequacy was realized with 12 participant interviews. Giorgi's six-step method was used to analyze the data in Atlas.ti. A central theme, "The whole culture of nursing needs to change" described an organizational culture where managers were unable to identify or unwilling to respond to workplace bullying. The four themes identified from the data included "going to work can be really hard," "not good for patient care," "learning to live with bullying," and "changing the culture." Leaders of organizations should implement comprehensive anti-bullying programs to assess bullying in their workplace and to provide bullied nurses with reporting options. Nurse managers need to prevent workplace bullying by intervening when aware of bullying and cultivating a culture of mutual respect.

In 2020, the UK's National Health Service (NHS) braced itself for the challenge of the COVID pandemic. Older, frail adults were among those at highest risk for morbidity and mortality. This study aimed to capture the lived experiences of patients, families/carers and staff on a COVID ward. Thirty participants were included, and data collected through in-depth unstructured interviews. The data were analyzed using interpretive phenomenology. Four main themes were constructed, capturing the collective experiences of the participants. The first theme, the changing and uncertain period of time, describes the shared sense of immersion in the chaotic situation, lack of control and resulting fears related to the contagion. Secondly, challenges of care, focuses on shared anxieties and guilt related to shortcomings in care delivery, and efforts to adapt to the new situation. The third theme, communication and keeping in touch, details the effect restrictions had on efforts to maintain contact and its toll on mental health. The last theme of challenging situations in end-of-life care, reflects experiences of grief and loss shared by all three participant groups. This study adds to the growing evidence base around experiences of the COVID pandemic through exploration of the profound triangulated experience of all participants.

Underutilization of sexual and reproductive health services among young people is associated with many adverse sexual and reproductive health-related outcomes and morbidity. Guided by the socioecological model, this study undertook a qualitative exploration of the barriers limiting young peoples' uptake of sexual and reproductive health services in Osun State, Nigeria. Fifty-eight young people (aged 15-24 years) from two universities and one community in Osun State were selected and involved in six focus group discussions. A thematic analysis was performed using NVivo software version 12. Intrapersonal, interpersonal, institutional, and community-level barriers were identified from the focus group discussions, aligning with the socioecological model framework. The study identified various interwoven barriers to the utilization of sexual and reproductive health information and services. The interrelatedness of the factors at different levels underscores the need to design and implement multifaceted policies and interventions aimed at improving young people's access to and utilization of sexual and reproductive health services.

The aim of this study was to describe the childhood experiences of polio patients after the isolation phase of the disease in post-war Finland in the 1950s and 1960s. Qualitative empirical research was conducted. Interview material was gathered through theme-based written interviews, and the data were analyzed using reflective thematic analysis. The analysis resulted in the overarching main theme of "constructing psychological safety," which reflected the themes "emotionally inadequate care," "reclaiming physical identity," and "the need to construct a child's world." These themes and their subthemes highlighted children's experiences of the rules set by adults as well as their subordinate relationships with adults. Polio survivors' experiences following the isolation phase of the disease were traumatic and demonstrated children's inferior position in nursing in Finland in the 1950s and 1960s. Specifically, children recovering from polio experienced traumatic treatment and care and loneliness even beyond the isolation phase of the disease.

Most direct residential aged care is provided by personal care assistants (PCAs), with western societies increasingly relying on culturally diverse aged care workers. In Australia and internationally, studies have reported that the level of training in both instrumental and relational care for PCAs is insufficient and inconsistent. This study evaluated the impact of The Little Things training program, designed for culturally diverse PCAs and students training to become PCAs. A modified Most Significant Change process, comprising a group-based qualitative analysis of narratives, was used to gain a rich understanding of the impacts and outcomes of the training. Narratives supplied by 29 PCAs and students were reviewed with aged care and training organization managers, who identified six themes: Increased confidence; Taking time; Building rapport and collaboration; Awareness of new skills; Seeing the whole person; and Positive impact on the resident. These themes reflected two key aims of The Little Things training: improving PCAs' communication with residents and increasing PCAs' confidence in communicating with residents. The study findings showed that The Little Things training program can improve the confidence of PCAs to communicate with aged care residents and may improve their capacity to form relationships.

Caring for technology-dependent children significantly impacts the family unit, a topic that has not been researched in Portugal. Understanding this impact can help nurses to improve their interventions. This study aimed to describe the lived experiences of parents with technology-dependent children using a qualitative descriptive design. We applied Giorgi's approach to analyze 10 individual semi-structured interviews with parents recruited through a children's hospital in Portugal. Our analysis identified two major themes: (1) Discovering a new parenthood: parent and caregiver, comprising two subthemes: Family reorganization and Learning to use a medical device; (2) Reconciling daily life with the needs of the technology-dependent children, comprising two subthemes: Importance of support systems and Experiencing difficulties. These results indicate that parents experience a wide range of concerns and challenges in managing medical devices, starting from the moment the need for a device is communicated and continuing through the process of learning and providing care. This journey involves significant changes in family dynamics and is marked by sacrifice and adaptation, supported by family, formal support systems, and healthcare professionals. Our findings provide valuable insights into the vulnerabilities faced by these parents and highlight how nursing care can enhance the quality of care for these families.

Emergency department (ED) HIV screening is a key component of the strategy to end the HIV epidemic, reaching populations with limited access to care for screening and early diagnosis. Many screening programs rely primarily on participation from ED nurses; however, little is known about the factors affecting nurse participation in screening. Guided by the Consolidated Framework for Implementation Research, 20 semi-structured interviews were conducted with ED nurses to explore perceptions of HIV screening, barriers and facilitators to participation, and implementation insights. Nurses were categorized as either high adopters or low adopters based on the number of HIV tests ordered 3 months prior to interviews. The Stanford Lightning Report Method, a rapid qualitative analysis approach, was used to analyze field notes. All participants generally agreed that the ED was an appropriate location for screening and that frequent, multimodal education about screening was needed. Integration of screening into standard workflows, education about the public health impact of screening, and the use of peer champions and mentors were identified as important strategies to increase participation. By incorporating these findings into implementation strategies, EDs may be able to increase nurse participation in screening, addressing important health equity issues in HIV diagnosis.

Men who have sex with men (MSM) bear a disproportionate burden of HIV in China and are particularly vulnerable to mental health challenges. This study is phase one of a multi-phase project that aimed to identify unmet needs of MSM living with HIV to inform the development of a multi-level intervention. We interviewed 24 stakeholders through videoconferencing, including 15 MSM living with HIV, five staff from a community-based organization serving gender and sexual minority individuals, and four staff from the Centers for Disease Control and Prevention in Shanghai, China. We conducted content analysis using inductive and deductive coding and identified the following themes: 1) Navigating Turbulent Waters: multi-level stress currents; 2) Mapping Anchors: multifaceted support network; 3) Staying Afloat: Daily strategies and functioning; and 4) Charting New Courses: paths for intervention. Examining the stress and coping process among MSM living with HIV from a socio-ecological lens is especially important in the collective cultural context. The interactive nature of the stress from multiple socio-ecological levels, lack of individual coping skills, and scarcity of psychosocial services highlighted the importance of community-based, multi-level interventions to meet the needs of MSM living with HIV in China.

Undignified care of women during labor has been associated with increased preventable maternal morbidity and mortality. The purpose of this study was to explore midwives' perspectives on undignified care of women in a midwife's obstetric unit within a rural community healthcare center in South Africa. Using ethnographic methods, seven midwives were recruited to participate in individual interviews and participant observations were conducted in the unit. Three main themes describing undignified care were identified based on an inductive analysis of observations and interview data. These included a lack of respect for women's bodily autonomy during labor, structural challenges in the provision of quality maternity care, and the lack of confidential care for women in labor and delivery. The study findings show that obstetric violence remains a serious crisis in the well-being of women during childbirth. Policy development by stakeholders in maternity care, including operational healthcare practitioners, should prioritize training, monitoring, and peer support on dignified care and curbing disrespect and abuse of women during childbirth, which seemed to be deeply rooted in the routine unorthodox treatment of childbirth.