Global Qualitative Nursing Research最新文献

Nurses are in the front line in caring for refugee youth in relation to their sexual and reproductive health. Culturally competent nursing care requires an understanding of different health values, beliefs, and practices and to be aware of the perceptions refugee youth have regarding sexual health. Therefor the aim of this meta-ethnography was to synthesize knowledge of refugee youth, and their perceptions related to sexual and reproductive health, before and after resettlement to a new country. Nine qualitative studies were included, describing the experiences of 297 refugee youth, originating from 13 countries, resettled in respectively Australia, USA and in temporary resettlements in Lebanon. Secret voices are breaking the silence was established as an overarching metaphor in a lines-of-argument synthesis. This metaphor was accompanied by three main themes: (1) The sounds of silence; (2) We have no words for it; and (3) Longing to learn. Findings indicate that cultural values and beliefs represent a barrier for refugee youth in accessing sexual and reproductive health information, services, and care. In a resettlement context language is a barrier to access sexual health information, and fear of judgment from family, friends, and community holds young refugees back from seeking services and care. Young refugees are longing for more knowledge, for themselves and their parents. This meta-ethnography can contribute to a heightened awareness amongst nurses in providing sensitive and culturally competent care for a diverse population of refugee youth.

Long-term care managers are essential in creating high-quality services. Previous research has a limited focus on managers' practices and approaches to quality improvement work. This study aims to explore how Norwegian long-term care managers approach systematic and ad hoc quality improvement work in the context of service planning and provision. In-depth interviews were conducted with twelve long-term care managers from three municipalities and analysed using inductive thematic analysis. Three themes were identified: delegating responsibility to ensure care quality, the creation of comparable services is a goal and using quality indicators in quality improvement work. The results indicate that using key nurses' expertise and resources were crucial approaches in the long-term care managers' quality improvement work. Quality indicators, delegation of responsibility to other care staff and collaboration within and across municipalities were used to varying degrees. Increased collaboration with other managers, involvement of care staff and awareness and use of quality indicators are approaches that may strengthen long-term care managers' quality improvement work.

Family caregivers often face challenges in navigating care decisions and maintaining involvement after their relatives transition to long-term care facilities. This study explores family caregivers' perspectives on the benefits of engaging in conversations with professional caregivers in long-term dementia care. Semi-structured interviews were conducted with 17 family caregivers in Denmark. Using thematic and template analysis, five core themes were constructed, highlighting both emotional and practical motivations for communicating with healthcare professionals: (1) feeling disconnected and uninformed about their loved one's care, (2) managing emotional challenges while seeking reassurance, (3) leveraging professional expertise for guidance, (4) fostering collaboration through openness, and (5) achieving mutual understanding and perspective shifts. The findings underscore the critical role of open and ongoing communication among family and professional caregivers in building trust, addressing family caregivers' emotional and informational needs, and supporting them in navigating the shared caregiving roles of long-term dementia care. In addition, the findings point to the potential benefits of structured dialogues to promote family involvement and person-centered care in long-term dementia settings.

The vast amount of online health resources accessible to the public and the pregnant population shows their high interest in using online health resources for their pregnancies. In this study, we specifically aimed to understand the experience and use of online pregnancy health information among Hispanic individuals, who are at higher risk of gaining outside of the recommended guideline of gestational weight gain (GWG) than the overall U.S. childbearing population. We conducted face-to-face semi-structured interviews with 20 childbearing-age Hispanic individuals (who were either pregnant or non-pregnant) in the Austin area to explore seeking, understanding, and using online information about recommendations for GWG, diet, and physical activity during pregnancy. Using reflexive thematic analysis, we identified both user perspectives and website features that affected the participants' engagement with and application of online pregnancy information. We conclude that the benefits of online resources fill gaps left by healthcare providers. Nurses as care providers and content creators of health information can help translate guidelines into behaviors that Hispanic people could apply in their everyday lives.

Chronic pain disproportionately affects women yet is often underestimated by medical professionals. In Canada, chronic pain rates have risen significantly, particularly among those aged 20 to 29 without other health conditions. However, limited qualitative research focuses on chronic pain exclusively in women under 30. By focusing on gender, this narrative inquiry study examined how societal narratives and stereotypes uniquely affect emerging adult women's experiences of chronic pain, contributing to their dismissal and invisibility in both personal and institutional contexts. Two key narrative threads were co-created with participants through analysis of their stories: silenced, invisible, and locating self with pain, and resisting singular stories of people living with chronic pain. Participants' shared family narratives of dismissal, stories of being silenced in health care, and dominant narratives in the context of age and gender that shaped the participants' stories to live by. This study demonstrates the importance of recognizing people in the midst of living with chronic pain. Understanding unique pain experiences during emerging adulthood can improve treatment options and long-term outcomes for this demographic.

Obstetric nurses are at increased risk of work-related musculoskeletal disorders associated with equipment and materials, the parturient and the specific nature of their work. We used the photovoice method to identify obstetric nurses' perceptions of work-related musculoskeletal injuries involving 20 participants who worked in the delivery room. A total of 100 photographs were captured by participants and their narratives were obtained through 20 interviews. Analysis of the photographs, the nurses' descriptions of the photos, the researcher's field notes and the interviews, resulted in three semantic categories: perception of risk, perception of preventive measures and musculoskeletal symptoms, and one expressive category related to decision-making. Perceived risks for musculoskeletal injury were associated with workspaces, the precariousness of the equipment and materials, and the organization and nature of obstetrical nurses' work. The importance of preventive measures was recognized and reinforced by reports of transitory work-related musculoskeletal symptoms by 18 of 20 obstetric nurses participating in the study. The strategies perceived by the obstetric nurses as potentially effective for preventing musculoskeletal injury included improvements to the physical work environment and equipment, sensitization of the team to the problem, and developing biomechanical skills in situ through simulated exercises and peer support.

Healthcare is undergoing an unprecedented technological transition to structured documentation in electronic health records (EHR), which has the potential to increase the quality of documentation. However, given the rising demand for direct transfer of data, there is a risk that requirements for more documentation will follow. This study seeks to investigate primary care nurses' experiences of structured documentation with direct transfer to a national quality registry. Nine primary care nurses using structured documentation in their management of chronic obstructive pulmonary disease (COPD) patients were recruited from different Swedish regions. The semi-structured interviews addressed experiences and work procedures when using a structured documentation template with direct data transfer to a quality register. Interviews were transcribed verbatim and analyzed using qualitative content analysis. Data were framed according to five key concepts; patient safety, time-saving work methods, quality of care, equitable care, and professional autonomy. The nurses experienced some barriers in relation to structured documentation but mainly observed benefits, raising the potential to enhance equitable care and safety for patients with COPD in primary care. Professional experience and autonomy were described as important prerequisites in achieving these benefits. The findings from this study can contribute to strengthening the documentation work procedures of nurses.

To develop effective and implementable complex health interventions, we need to understand the mechanisms through which an intervention contributes to desired outcomes. This article provides a practical example of how nursing and other health researchers can qualitatively explore change mechanisms of complex interventions with a longitudinal constructivist grounded theory approach. It shares and discusses lessons learned when applying this approach to explore change mechanisms in the context of a psychoeducational intervention for family dementia caregivers. Important lessons learned included: (1) By comparing data from different time points, changes could be identified even when not explicitly mentioned by participants. (2) Participants exhibited more awareness of changes and related mechanisms in interviews conducted during the intervention compared to those executed after, where they had already integrated the new strategies into their daily lives. (3) Analyses conducted within and across participants for each time point and across all time points revealed time-specific mechanisms, shared patterns and journeys substantially differing from others. (4) Including participants' quantitative intervention outcomes as additional data in the qualitative analysis helped identify facilitators and barriers to change. In conclusion, our approach produced in-depth knowledge about the intervention's change mechanisms by considering the complexity and temporal dimensions of participants' experiences.

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.