Global Qualitative Nursing Research最新文献

The purpose of this study was to describe policies developed by English-speaking Canadian health authorities to guide multi-disciplinary healthcare practice in the context of MAID. Seventeen policies from 9 provinces and 3 territories were identified and analyzed thematically. Themes developed from these documents related to ensuring a team approach to care, supporting informed patient choice, creating region-specific guidance on eligibility criteria and safeguards, accommodating conscientious objection, and making explicit organizational responsibilities. Ethical language concerned vulnerability, non-judgmental care, dignity, non-abandonment, confidentiality, moral conscience, and diverse cultural values. Overall, these policies addressed important risk mitigation strategies, acknowledged important social contracts, and supported ethical practice. Collectively, these policies outline important considerations in the evolving Canadian context for other jurisdictions seeking to create policy around assisted death.

Mentoring is critical for career advancement in all professions. It is especially crucial for leadership development and succession planning. Studies suggest that increasing the racial minority representation in higher-level leadership will provide diverse skill sets, promote innovation, and yield positive outcomes. The study aimed to examine how Black women academic nurse leaders perceive mentoring in academic nursing using critical race theory as the guiding framework and explore the crucial role of mentorship in promoting and advancing Black women academic nurse leaders. The study used a narrative qualitative research design, purposive sampling, and unstructured interviews to collect and thematically analyze data. Findings fall under two major themes; being mentored and mentoring others. The findings highlight perceived significant differences in the allocation of resources and mentoring for career advancement in academic nursing for Black nurses compared to those classified as white. Increasing diversity in nursing requires deliberate effort from majority white leadership.

Obstetrics is a well-known area for malpractice and medical-legal claims, specifically as they relate to injuries the baby suffers during the intrapartum period. There is a direct implication for nurses' work in labor and delivery because the law recognizes that monitoring fetal well-being during labor is a nursing responsibility. Using institutional ethnography, we uncovered how two powerful ruling discourses, namely biomedical and medical-legal risk discourses, socially organize nurses' fetal surveillance work in labor and delivery through the use of an intertextual hierarchy and an ideological circle.

End-of-life (EOL) discussions for patients with cancer are a key factor of successful EOL care; however, identifying the optimal timing for these discussions in Japanese home-care settings is difficult. To identify the time at which patients with cancer and their caregivers need EOL discussions, we explored when home-visit nurses start EOL discussions. We interviewed 23 home-visit nurses and analyzed the data using qualitative content analysis. Three themes were derived from the analysis. Participants identified the timing of EOL discussions as being sensitive to patients' changing health and care needs (increases in patient's total pain), changes in the family caregiver's physical or mental condition through daily care (increases in family caregiver distress), and the EOL process that patients follow (trajectory of disease). Developing a tool or in-service educational program that will enable inexperienced or new graduate home-visit nurses to implement EOL discussions at appropriate times is necessary.

In long-term care, ethical challenges are becoming increasingly apparent as the number of older patients with complex care needs increases, in parallel with growing demands for more cost-efficient care. Scarce resources, cross-pressure and value conflicts are associated with missed care, moral stress and nurses wanting to leave the profession. Through five focus group interviews, this study aimed to explore how nurses working in nursing homes and homecare services perceive, experience and manage ethical challenges in everyday work. Content analysis revealed three main themes: striving to do good; failing and being let down and getting rid of frustrations and learning from experiences. The nurses' morality was mainly expressed through emotions that arose in specific situations. Dedicated spaces for ethical reflection and leaders who recognize that organizational conditions affect the individual nurse-patient relationship are required. Facilitating ethical reflection is an important leadership responsibility, which may also require leaders to actually participate.

Constantly facing human suffering and impending death can generate anxiety and insecurity in nursing personnel in end-of-life care. The aim of the study is to reveal nursing personnel's inner driving force in end-of-life care. A phenomenological hermeneutical method was used to search for meaning in the narrative data collected in this study. The structural analysis resulted in four themes: The appeal in the patient's vulnerability, The appeal in the patient's joy, Facing one's own existence in vulnerability, and Being at home with colleagues. Both vulnerability and joy motivated nursing personnel in caring. The care was often emotionally engaging and oscillated between grief and joy, which required a great deal from the nursing personnel both as professionals and fellow human beings. At the same time the emotionally engaging constituted an inner driving force, which gave them courage to do the best for the patients at the end of life.