Global Qualitative Nursing Research最新文献

Integrating research and evidence into teaching promotes critical thinking, problem solving and innovation, but challenges remain in identifying the most effective methods. The Research Inspired Online/Offline Teaching (RIOT) framework presents a solution for midwifery and nursing education, but its applicability and feasibility must first be tested. This study investigated factors influencing the implementation of the RIOT framework and proposed solutions for overcoming barriers. Semi-structured interviews and qualitative surveys were conducted with academic staff, and educational managers and leaders in a university in the United Kingdom between February and June 2024. Twenty-four interviews and six qualitative survey responses were analysed using framework and thematic analysis. Framework analysis identified barriers and solutions at five levels: individual, interpersonal, organisational, institutional and societal. Thematic analysis formed four overarching themes: (1) understanding the relevance of research, (2) knowledge, skills, tools and confidence to apply research into teaching, (3) establishing a collaborative research culture and (4) overcoming challenges impacting the ability to maintain teaching excellence. The 4M Model for Promoting Research Inspired Teaching in Midwifery and Nursing Education was developed from the findings to provide a foundation for facilitating research integration via the RIOT framework. The 4M model emphasises the necessity for collaboration, optimisation of research impact, cultivation of a collaborative research culture, and maintenance of teaching excellence.

In passing legislation in 2016 to allow medical assistance in dying (MAID), Canada became the world's first jurisdiction to allow nurse practitioners (NPs) to act as MAID assessors and providers. Health Canada's annual report shows that the demand for MAID in Canada increases each year, as does the proportion of MAID cases that NPs provide. The purpose of this study was to better understand factors that motivate or deter nurse practitioners from becoming MAID assessors and providers. The study design was a secondary analysis of a large qualitative dataset guided by interpretive description methodology. Primary data collection took place from 2018 to 2023 via semi-structured interviews with nurses and NPs. Secondary analysis of transcripts of all of the NPs interviewed for the primary study allowed for identifying significant motivational and deterring themes in their accounts. The analysis yielded two categories of motivating factors (philosophical perspectives; experiences with death and dying) and three deterring factors (moral complexity; health system barriers; professional and social considerations), and further generated insights around supports and practices that make NP MAID work viable. As the first study that explicitly sought to understand what explains Canadian NPs' willingness to participate in MAID, these findings fill a gap in the available knowledge.

This study aimed to explore the interests and expectations of people living with Parkinson's disease (PD), family carers, health and social care professionals, and key stakeholders regarding relevant systems of support and community resources for PD management. As part of the OPTIM-PARK project (Optimisation of Community Resources and Systems of Support to Enhance the Process of Living with PD), an exploratory qualitative study was conducted in Spain. Forty-one participants completed a GENIE concentric circles mapping exercise to identify existing support systems and community resources. These maps informed subsequent semi-structured interviews. All interviews were digitally recorded and transcribed verbatim for thematic analysis. Participants identified several barriers to effective collaboration across healthcare and social care systems, including poor understanding of PD, limited financial resources, and insufficient communication among professionals and sectors. Facilitators for improved community-based PD management included personalised care pathways, shared decision-making, improved access to professional services and local resources, and the strategic use of Information and Communication Technologies (ICTs). Participants emphasised the need for long-term investment and strong institutional commitment to reinforce community-based support networks for individuals living with PD.

Older persons often stay in conflict zones, abandoned by younger generations and neglected by the government, putting them at risk of becoming victims of violence. This meta-ethnographic study aims to review and synthesise qualitative research on violence in contexts of war and armed conflicts as experienced by older persons and explore how violence in war and armed conflicts affects the health and well-being. Databases (CINAHL, PsychINFO, Web of Science, and Scopus) were searched for studies with a qualitative approach and participants aged ≥ 55 years. Twenty qualitative studies were included, describing experiences of persons from seven countries. Guarding the past and ensuring a future was established as an overarching metaphor in a lines-of-argument synthesis, accompanied by five themes: To endure a violent situation; Home - the heart of existence; To witness a fragile family line; Alienated and abandoned by society- adding insult to injury and Maintaining normality in an abnormal situation. Through interpretation, an understanding emerges of how separation from loved ones, the breakdown of healthcare services, and remaining in conflict areas can significantly increase vulnerability, while simultaneously demonstrating the resilience of older persons and their willingness to serve as resources within their communities.

In Italy, the Family and Community Nurse (FCN) was officially recognized with Legislative Decree 34/2020 and redefined by Ministerial Decree 77/2022. The introduction of the FCN has been inconsistent across the nation, leading to fragmented experiences and challenges in fully integrating the role into the healthcare system. Based on Cohen's hermeneutic approach, this phenomenological study explores the lived experiences and meaning of being an FCN in Italy. Semi-structured interviews were conducted from December 2023 to June 2024. Interviews were transcribed, read in-depth and analyzed. Thirty-seven FCNs from four Italian regions were interviewed. Four main themes were identified: (a) Navigating elderly care complexity; (b) Education as a core function; (c) Being a node in the healthcare network; (d) Establishing the FCN identity through role differentiation. Being a FCN means managing complex needs, ensuring continuity of care, and collaborating effectively with the other primary care providers. FCNs distinguish themselves from task-oriented home care nurses by embracing a proactive approach, gaining greater organizational autonomy and actively shaping their professional identity. The implications for practice suggest the need to support FCNs in this consolidation phase through health policies that enhance their contribution to community care.

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Congenital syphilis is preventable through early detection and treatment during pregnancy. Although global syphilis rates have declined, the prevalence of undiagnosed and untreated infections remains high in low- and middle-income countries. In Uganda, national clinical guidelines recommend syphilis screening and treatment at the first antenatal care (ANC) visit, yet coverage remains suboptimal, contributing to ongoing perinatal transmission. As part of a multiple-method research project, this qualitative study explored provider perspectives on barriers to antenatal syphilis screening and treatment. We conducted in-depth interviews with 20 ANC providers at six public health facilities in two districts serving diverse communities. Using a descriptive qualitative approach and thematic analysis, we identified four interrelated barriers to effective service delivery: (1) stockouts of test kits and benzathine penicillin that disrupt care; (2) limited access to formal training and continuing education, reducing provider confidence in diagnosis and treatment; (3) misalignment between clinical guidelines and routine practice, leading to missed screening opportunities; and (4) low male partner engagement, increasing risk of reinfection. Addressing these barriers through health systems strengthening-including improved supply chain monitoring, universal provider training, supportive supervision, and community-informed strategies for partner engagement-is critical to reducing perinatal syphilis transmission and advancing Uganda's progress toward congenital syphilis elimination.

The COVID-19 pandemic profoundly impacted nurses and other healthcare professionals, underscoring a need to capture and share their experiences, especially amid persistent negative perceptions of nursing. This research aimed to understand the experiences of those who worked during the pandemic, translate them into audio artworks, and understand how their resulting exhibition was experienced. Utilizing arts-based inquiry, nurses (n = 4) and other healthcare specialists (n = 4) were involved in an arts-based workshop fostering a deep exploration of their experiences, and revealing themes such as uncertainty, the complexities of navigating professional identity within widespread "hero narratives", human connection and the powerful sense of catharsis and community found in sharing their experiences. Inspired by these insights, an artist created the audio artwork "Boats on an ocean". Six other audio artworks were subsequently created in the same way. A survey (n = 18) and in two hybrid workshops (n = 6) were then undertaken to understand how audiences experienced the exhibited artwork. Audiences consistently described the exhibition as "profoundly moving". This research marks the first instance of using arts-based methods to both qualitatively capture and artistically disseminate healthcare professionals' COVID-19 experiences. It serves as a historic record, preserving accounts for future generations.

This study aimed to gain insight into the phenomenon of how wearable devices affect the sense of dignity of older patients (above 65 years of age) in palliative care settings using remote monitoring health services. Five interviews were carried out using reflective lifeworld research approach. A phenomenological analysis showed that the essence of older adults' sense of dignity in palliative care is vulnerable and, therefore, at stake when using wearable devices for remote monitoring. This essence is reflected in the following constituents: a simultaneous sense of regained and diminished quality of life; mixed feelings ranging from strengthened self-identity and independence to vulnerability and dependence; shifting care responsibilities within the context of life's finitude; and uncertainty about being valued, seen, and empowered while navigating relational expectations. The phenomenon was illuminated through the lens of various forms of dignity, offering insight into how it is experienced and challenged. These findings underscore the importance of recognising and addressing threats to dignity as digital health technologies continue to evolve in palliative care settings. Interprofessional collaboration among various stakeholders, including patients as active informants and participants, is necessary for designing future dignified remote care using wearable devices.

The early integration of palliative care (PC) alongside standard cancer care is associated with decreased symptom burden, better adherence to cancer treatment, and enhanced quality of life for individuals living with cancer. The purpose of this mixed methods systematic review was to answer the following research questions (1) What are the characteristics of PC access in non-hospital settings in the US for individuals living with cancer?, and (2) What factors facilitate or deter whether PC is integrated early alongside standard cancer care? The study followed the Joanna Briggs Institute methodology for mixed methods systematic review and a convergent integrated data analysis design. The Conceptual Framework of Access to Healthcare and its five dimensions of access (approachability, acceptability, availability, affordability, appropriateness) guided the categorization and organization of the review's findings. Fifty-one studies were included and findings illuminated facilitators and challenges of PC access and early integration. While findings supported the use of traditional PC approaches for early integration, embedded PC clinics, lay navigation, and telehealth were found to be promising alternatives, especially for historically minoritized and rural populations. The results of this review led to the development of the Conceptual Framework for Early PC Access and Integration for Individuals Living with Cancer.