The 50 most-cited articles in Journal of Advanced Nursing, 2016

AIM: To produce a framework for the development of a qualitative semi-structured interview guide. BACKGROUND: Rigorous data collection procedures fundamentally influence the results of studies. The semi-structured interview is a common data collection method, but methodological research on the development of a semi-structured interview guide is sparse. DESIGN: Systematic methodological review. DATA SOURCES: We searched PubMed, CINAHL, Scopus and Web of Science for methodological papers on semi-structured interview guides from October 2004-September 2014. Having examined 2,703 titles and abstracts and 21 full texts, we finally selected 10 papers. REVIEW METHODS: We analysed the data using the qualitative content analysis method. RESULTS: Our analysis resulted in new synthesized knowledge on the development of a semi-structured interview guide, including five phases: (1) identifying the prerequisites for using semi-structured interviews; (2) retrieving and using previous knowledge; (3) formulating the preliminary semi-structured interview guide; (4) pilot testing the guide; and (5)…

AIM: To use systematic methods to examine how resilience is defined in empirical research. BACKGROUND: Resilience is a term that is increasingly being used to describe and explain the complexities of individual and group responses to traumatic and challenging situations. It is now frequently mentioned in relation to many areas of nursing practice, including research. Given the increasing use of the term, it is timely to examine how resilience has been defined in empirical research. DESIGN: An integrative review of the empirical literature (2000-2015). DATA SOURCES: Three health-related databases were searched: Medline, PsycINFO and the Cumulative Index for Nursing and Allied Health (CINAHL). Reference and citation tracking was performed on all articles included in the review. REVIEW METHODS: The methods described by Whittemore and Knafl were used to guide this review. Two reviewers were involved in screening articles for inclusion and in the data extraction process. Data were synthesized using the constant comparative method of analysis. RESULTS: One hundred articles were included…

AIM: To identify factors that may serve as facilitators and barriers to self-management described by adults living with chronic illness by conducting a qualitative metasynthesis. BACKGROUND: Self-management is an individuals' active management of a chronic illness in collaboration with their family members and clinicians. DESIGN: Qualitative metasynthesis. DATA SOURCES: We analysed studies (N = 53) published between January 2000-May 2013 that described factors affecting self-management in chronic illness as reported by adults aged over 18 years with chronic illness. REVIEW METHODS: Sandelowsi and Barroso approach to qualitative metasynthesis: literature search; quality appraisal; analysis and synthesis of findings. RESULTS: Collectively, article authors reported on sixteen chronic illnesses, most commonly diabetes (N = 28) and cardiovascular disease (N = 20). Participants included men and women (mean age = 57, range 18-94) from 20 countries representing diverse races and ethnicities. We identified five categories of factors affecting self-management: Personal/Lifestyle…

AIM: To test a hypothesized model linking new graduate nurses' perceptions of their manager's authentic leadership behaviours to structural empowerment, short-staffing and work-life interference and subsequent burnout, job satisfaction and patient care quality. BACKGROUND: Authentic leadership and structural empowerment have been shown to reduce early career burnout among nurses. Short-staffing and work-life interference are also linked to burnout and may help explain the impact of positive, empowering leadership on burnout, which in turn influences job satisfaction and patient care quality. DESIGN: A time-lagged study of Canadian new graduate nurses was conducted. METHODS: At Time 1, surveys were sent to 3,743 nurses (November 2012-March 2013) and 1,020 were returned (27·3% response rate). At Time 2 (May-July 2014), 406 nurses who responded at Time 1 completed surveys (39·8% response rate). Descriptive analysis was conducted in SPSS. Structural equation modelling in Mplus was used to test the hypothesized model. RESULTS: The hypothesized model was supported. Authentic leadership…

AIM: This study examines the factors that mediate and moderate the relationships of perceived organizational support with work engagement and organization citizenship behaviour. Specifically, affective commitment is posited to mediate and psychological contract breach to moderate the above relationships. BACKGROUND: Nurses play a critical role in delivering exemplary health care. For nurses to perform at their best, they need to experience high engagement, which can be achieved by providing them necessary organizational support and proper working environment. DESIGN: Data were collected via a self-reported survey instrument. METHODS: A questionnaire was administered to a random sample of 750 nurses in nine large hospitals in India during 2013-2014. Four hundred and seventy-five nurses (63%) responded to the survey. Hierarchical multiple regression was used for statistical analysis of the moderated-mediation model. RESULTS: Affective commitment was found to mediate the positive relationships between perceived organizational support and work outcomes (work engagement, organizational…

AIM: The aim of this study was to report a systematic and psychometric review. BACKGROUND: The Nurse Competence Scale is currently the most widely used generic instrument to measure Registered Nurses' competence in different phases of their careers. Based on a decade of research, this review provides a summary of the existing evidence. DESIGN: A systematic literature review of research evidence and psychometric properties. DATA SOURCES: Nine databases from 2004 - October 2015. REVIEW METHODS: We retrieved scientific publications in English and Finnish. Two researchers performed data selection and appraised the methodological quality using the COnsensus-based Standards for the selection of health status Measurement INstruments checklist. RESULTS: A total of 30 studies reported in 43 publications were included. These consisted of over 11,000 competence assessments. Twenty studies were from Europe and 10 from outside Europe. In addition to experienced nurses, the Nurse Competence Scale has been used for the competence assessment of newly graduated nurses and nursing students, mainly in…

AIM: To review empirical studies examining antecedents (sources, causes, predictors) in the management and mitigation of interpersonal conflict. BACKGROUND: Providing quality care requires positive, collaborative working relationships among healthcare team members. In today's increasingly stress-laden work environments, such relationships can be threatened by interpersonal conflict. Identifying the underlying causes of conflict and choice of conflict management style will help practitioners, leaders and managers build an organizational culture that fosters collegiality and create the best possible environment to engage in effective conflict management. DESIGN: Integrative literature review. DATA SOURCES: CINAHL, MEDLINE, PsycINFO, Proquest ABI/Inform, Cochrane Library and Joanne Briggs Institute Library were searched for empirical studies published between 2002-May 2014. REVIEW METHODS: The review was informed by the approach of Whittemore and Knafl. Findings were extracted, critically examined and grouped into themes. RESULTS: Forty-four papers met the inclusion criteria. Several…

AIMS: To investigate physical activity levels of nursing and medicine students, examine predictors of physical activity level and examine the most influential benefits and barriers to exercise. BACKGROUND: Healthcare professionals have low levels of physical activity, which increases their health risk and may influence their health promotion practices with patients. DESIGN: We surveyed 361 nursing (n = 193) and medicine (n = 168) students studying at a UK medical school. METHODS: Questionnaire survey, active over 12 months in 2014-2015. Measures included physical activity level, benefits and barriers to exercise, social support, perceived stress and self-efficacy for exercise. RESULTS: Many nursing and medicine students did not achieve recommended levels of physical activity (nursing 48%; medicine 38%). Perceived benefits of exercise were health related, with medicine students identifying additional benefits for stress relief. Most notable barriers to exercise were as follows: lack of time, facilities having inconvenient schedules and exercise not fitting around study or placement…

AIM: To review the effects of mindfulness-based interventions on Registered Nurses and nursing students. BACKGROUND: Work-related stress among nurses is estimated to be the biggest occupational health problem after musculoskeletal disorders. DESIGN: A mixed-method systematic review incorporating quantitative and qualitative data was conducted. DATA SOURCES: Studies on the effects of mindfulness-based interventions for nurses and nursing students published between 1980 and 2014 were identified through a systematic search in electronic databases: Medline, Embase, PsycINFO, Cochrane Library and Cinahl. REVIEW METHODS: Data analysis was conducted based on the framework of Thomas and Harden (2004). RESULTS: A total of 32 studies, including 17 controlled designs, 11 pre-post designs and four qualitative designs were reviewed. Meta-analysis suggests that mindfulness-based interventions may be effective in significantly reducing state anxiety and depression at posttreatment and state anxiety and trait anxiety at follow-up. Qualitative studies and uncontrolled studies shed light on benefits…

AIMS: To explore the extent to which patient ratings of perceived caring and person-centredness are associated with perceived nursing care quality in an acute hospital sample of inpatients. BACKGROUND: Self-reported patient experiences have had limited attention in conceptualizations of healthcare quality as described in policy and national standards, as well as in health and nursing care practice. The impact of central nursing concepts such as caring and person-centredness on patient ratings of nursing care quality is largely unknown. DESIGN: A descriptive non-experimental correlational design was used to collect and analyse data from a sample of Australian acute hospital inpatients (n = 210) in December 2012. METHODS: The study collected self-report patient data through a study survey including demographic data and the Caring Behaviours Inventory, the Person-centred Climate Questionnaire, the SF-36 and the Distress thermometer. Descriptive statistics together with Pearson correlation and hierarchical linear regression were used. FINDINGS: Perceived caring behaviours of staff and…

AIM: To analyse the concept of transformational leadership in the nursing context. BACKGROUND: Tasked with improving patient outcomes while decreasing the cost of care provision, nurses need strategies for implementing reform in health care and one promising strategy is transformational leadership. Exploration and greater understanding of transformational leadership and the potential it holds is integral to performance improvement and patient safety. DESIGN: Concept analysis using Walker and Avant's (2005) concept analysis method. DATA SOURCES: PubMed, CINAHL and PsychINFO. METHODS: This report draws on extant literature on transformational leadership, management, and nursing to effectively analyze the concept of transformational leadership in the nursing context. IMPLICATIONS FOR NURSING: This report proposes a new operational definition for transformational leadership and identifies model cases and defining attributes that are specific to the nursing context. The influence of transformational leadership on organizational culture and patient outcomes is evident. Of particular…

AIMS: To determine factors associated with variation in 'care left undone' (also referred to as 'missed care') by Registered Nurses (RNs) in acute hospital wards in Sweden. BACKGROUND: 'Care left undone' has been examined as a factor mediating the relationship between nurse staffing and patient outcomes. The context has not previously been explored to determine what other factors are associated with variation in 'care left undone' by RNs. DESIGN: Cross-sectional survey to explore the association of RN staffing and contextual factors such as time of shift, nursing role and patient acuity/dependency on 'care left undone' was examined using multi-level logistic regression. METHODS: A survey of 10,174 RNs working on general medical and surgical wards in 79 acute care hospitals in Sweden (January-March 2010). RESULTS: Seventy-four per cent of nurses reported some care was left undone on their last shift. The time of shift, patient mix, nurses' role, practice environment and staffing have a significant relationship with care left undone. The odds of care being left undone is halved on…

AIM: The aim of this study was to investigate effects of robot-assisted group activity with Paro on quality of life in older people with dementia. BACKGROUND: Nursing home residents with severe dementia often experience social withdrawal and lower quality of life, which are suggested to be enhanced by non-pharmacological interventions. DESIGN: A cluster-randomized controlled trial. Ten nursing home units were randomized to robot-assisted intervention or control group (treatment as usual). METHODS: Data were collected between March 2013-September 2014. 27 participants participated in group activity for 30 minutes twice a week over 12 weeks, 26 participated in the control group. Change in quality of life was assessed by local nurses through the Quality of Life in Late-Stage Dementia scale at baseline, after end of intervention and at 3 months follow-up. The scale and regular psychotropic medication were analysed stratified by dementia severity. Analysis using mixed model, one-way anova and linear regression were performed. RESULTS: An effect was found among participants with severe…

AIM: The aim was to conduct an integrative systematic review to identify barriers and facilitators to healthy eating for working nurses. BACKGROUND: There is growing recognition of the influence of the workplace environment on the eating habits of the workforce, which in turn may contribute to increased overweight and obesity. Overweight and obesity exact enormous costs in terms of reduced well-being, worker productivity and increased risk of non-communicable diseases. The workplace is an ideal place to intervene and support healthy behaviours. This review aimed to identify barriers and facilitators to nurses' healthy eating in the workplace. DESIGN: Integrative mixed method review. DATA SOURCES: Five electronic databases were searched: CINAHL, MEDLINE, PROQUEST Health and Medicine, ScienceDirect and PsycINFO. Reference lists were searched. Included papers were published in English between 2000-2016. Of 26 included papers, 21 were qualitative and five quantitative. REVIEW METHODS: An integrative literature review was undertaken. Quality appraisal of included studies used…

AIMS: To investigate the moderating effects of work overload and supervisor support on the emotional exhaustion-depressive state relationship. BACKGROUND: Burnout and depression are prevalent in human service professionals and have a detrimental impact on clients. Work overload and supervisor support are two key job demands and job resources, whose role and interplay for the development and maintenance of burnout and depression are not fully understood yet. DESIGN: Two consecutive cross-sectional surveys: survey 1 investigated 111 hospital nursing professionals and survey 2 examined 202 day care professionals. Data collection was completed in 2010. RESULTS: After controlling for general well-being and sociodemographic characteristics, nurses' emotional exhaustion was associated with increased depressive state in both samples. We found a meaningful three-way interaction: our results show consistently that the relationship between emotional exhaustion and depressive state was strongest for nurses with high work overload and low supervisor support. Additionally, nurses with low work…

AIMS: To propose definitions of global health and global nursing that reflect the new paradigm that integrates domestic and international health. BACKGROUND: Increased globalization has led to expanded awareness of the importance of global health and global nursing among students and faculty in the health professions and among policymakers and practitioners. DESIGN: Discussion paper that includes a discussion and review of the literature related to global health and global nursing. DATA SOURCES: A task force searched for and reviewed articles published in English, Spanish or Portuguese between 2005-2015, developed summaries, listed key elements, identified prevalent themes and developed consensus definitions. IMPLICATIONS FOR NURSING: The definitions will be used by the Global Advisory Panel on the Future of Nursing to guide promoting a voice and vision for nursing that will contribute to the advancement of the profession's contribution to global health. CONCLUSIONS: Definitions of global health and global nursing were developed based on main themes and concepts identified in the…

AIM: To investigate the prevalence of secondary traumatic stress among Emergency nurses in the West of Scotland and explore their experiences of this. BACKGROUND: Unexpected death, trauma and violence are regular occurrences that contribute to the stressful environment nurses working in the Emergency department experience. A potential consequence of repeated exposure to such stressors can be referred to as secondary traumatic stress. DESIGN: Triangulation of methods of data collection, using two distinct phases: Phase 1 - quantitative Phase 2 - qualitative METHODS: Quantitative data were collated via postal questionnaire, from a convenience sample of Emergency nurses. Qualitative data were subsequently collated from a focus group constituting of a random sample of these Emergency nurses. Descriptive statistics were computed and thematic analysis conducted. All data were collated during February 2013. RESULTS/FINDINGS: 75% of the sampled Emergency nurses reported at least one secondary traumatic stress symptom in the last week. Participants said that acute occupational stressors such…

AIM: The study examined whether three resources, that is, compassion, transformational leadership and work ethic feasibility, buffer against the negative effects of emotional labour on work engagement. BACKGROUND: Emotional labour is a common job stressor among nurses, but little is known about whether certain personal and work resources buffer against it in relation to work engagement. Revealing buffers of emotional labour would help organizations to design tailored interventions. DESIGN: Cross-sectional online survey conducted in 2014. METHODS: Participants were 3466 Finnish nurses. Hypotheses were tested via hierarchical moderated regression analyses. RESULTS: Higher emotional labour related to lower engagement. Two interaction effects were found. First, work ethic feasibility buffered against emotional labour: the nurses who perceived work ethic feasibility as high in a situation of high emotional labour, scored higher on engagement compared with those nurses who in this stress situation perceived work ethic feasibility to be low. Second, high compassion was detrimental to…

AIM: To synthesize the effects of theory-based self-management educational interventions on patients with type 2 diabetes (T2DM) in randomized controlled trials. BACKGROUND: Type 2 diabetes is a common chronic disease causing complications that put a heavy burden on society and reduce the quality of life of patients. Good self-management of diabetes can prevent complications and improve the quality of life of T2DM patients. DESIGN: Systematic review with meta-analysis of randomized controlled trials following Cochrane methods. DATA RESOURCES: A literature search was carried out in the MEDLINE, EMBASE, CINAHL, PSYCINFO, and Web of Science databases (1980-April 2015). REVIEW METHODS: The risk of bias of these eligible studies was assessed independently by two authors using the Cochrane Collaboration's tool. The Publication bias of the main outcomes was examined. Statistical heterogeneity and random-effects model were used for meta-analysis. RESULTS: Twenty studies with 5802 participants met the inclusion criteria. The interventions in the studies were based on one or more theories…

AIM: To report a concept analysis of interprofessional collaboration in the context of chronic disease management, for older adults living in communities. BACKGROUND: Increasing prevalence of chronic disease among older adults is creating significant burden for patients, families and healthcare systems. Managing chronic disease for older adults living in the community requires interprofessional collaboration across different health and other care providers, organizations and sectors. However, there is a lack of consensus about the definition and use of interprofessional collaboration for community-based chronic disease management. DESIGN: Concept analysis. DATA SOURCES: Electronic databases CINAHL, Medline, HealthStar, EMBASE, PsychINFO, Ageline and Cochrane Database were searched from 2000 - 2013. METHODS: Rodgers' evolutionary method for concept analysis. RESULTS: The most common surrogate term was interdisciplinary collaboration. Related terms were interprofessional team, multidisciplinary team and teamwork. Attributes included: an evolving interpersonal process; shared goals,…

BACKGROUND: Increasingly there is a focus on self-care strategies for both malignant and non-malignant conditions. Models of self-care interventions have focussed on the individual and less on the broader context of family and society. In many societies, decision-making and health seeking behaviours, involve family members. OBJECTIVE: To identify elements of effective family-centred self-care interventions that are likely to improve outcomes of adults living with chronic conditions. DESIGN: Review paper. DATA SOURCES: MEDLINE (Ovid), CINAHL, Academic Search Complete, PsychInfo and Scopus between 2000-2014. REVIEW METHODS: Quantitative studies targeting patient outcomes through family-centred interventions in adults were retrieved using systematic methods in January, 2015. Search terms used were: 'family', 'spouse', 'carer', 'caregiver', 'chronic', 'chronic disease', 'self-care', 'self-management' and 'self-efficacy'. Reference lists were reviewed. Risk of bias assessment was performed using the Cochrane Collaboration's tool. Data were reported using a narrative summary approach.…

AIMS: The aim of this study was to examine the direct and indirect effect, through organizational identification, of workplace ostracism on nurses' silence towards patient safety. BACKGROUND: Employee silence in nursing has recently received attention in relation to its antecedents. Yet, very little is known about the role of workplace ostracism in generating nurses' silence. DESIGN: A cross-sectional survey was conducted in a public hospital in Cyprus. METHOD: Data were collected from 157 nurses employed in a public hospital of Cyprus between November 2014-January 2015. To examine the present hypotheses bootstrapping analysis and Sobel test were conducted. RESULTS: Results demonstrated that workplace ostracism has an effect on nurses' silence towards patient safety. Moreover, this effect was partially mediated through organizational identification. CONCLUSIONS: Workplace ostracism among nurses significantly affects both nurses' attitude and behaviour namely organizational identification and employee silence.

AIM: To establish a profile of men in nursing in Western Australia and explore the perception of men in nursing from the perspective of male and female nurses. BACKGROUND: A project team, including some of the current authors, produced a YouTube video and DVD about men in nursing which led to further enquiry on this topic. DESIGN: The study employed a non-experimental, comparative, descriptive research design focused on a quantitative methodology, using an online survey in early 2014. METHOD: A convenience sample incorporated registered and enrolled nurses and midwives in Western Australia. FINDINGS: The range of data included demographic information and the respondents' perceptions of men in nursing were collected. Findings indicated that the main reasons for choosing a career in nursing or midwifery were similar for both genders. Common mis-perceptions of men in nursing included: most male nurses are gay; men are not suited to nursing and men are less caring and compassionate than women. Suggestions to promote nursing to men included: nurses are highly skilled professionals; there…

AIMS: To test the relationship between greenery in gardens at residential facilities for older people and the self-perceived health of residents, mediated by experiences of being away and fascination when in the garden and the frequency of visitation there. To examine how these indirect effects vary with the number of physical barriers to visiting the garden. BACKGROUND: Many older people in residential facilities suffer from complex health problems. Access to a green outdoor environment may enable psychological distance, engage effortless attention, encourage more frequent visitation and promote resident health. DESIGN: A multi-level, cross-sectional, correlational design. METHODS: Questionnaires were administered June-August, 2011 to convenience samples of residents at 72 facilities for older people with complex healthcare needs. One to 10 eligible residents were sampled during self-motivated garden visits at each facility (n = 290). They reported on their garden experiences and health. Facility staff reported on objective garden characteristics and barriers to access. A serial…

AIM: The aim of this study was to determine the diagnostic accuracy of the water swallow test for screening aspirations in stroke patients. BACKGROUND: The water swallow test is a simple bedside screening tool for aspiration among stroke patients in nursing practice, but results from different studies have not been combined before. DESIGN: A systematic review and meta-analysis was conducted to provide a synthetic and critical appraisal of the included studies. DATA SOURCES: Electronic literature in MEDLINE, EMBASE, CINAHL and other sources were searched systemically in this study. Databases and registers were searched from inception up to 30 April 2015. REVIEW METHODS: This systematic review was conducted using the recommendations from Cochrane Collaboration for Systematic Reviews of Diagnostic Test Accuracy. Bivariate random-effects models were used to estimate the diagnostic accuracy across those studies. The tool named Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) was used to evaluate the quality of the studies. RESULTS: There were 770 stroke patients in the 11…

AIMS: To estimate the sex-stratified prevalence and clustering of 14 behavioural and metabolic health risk factors in emerging adulthood. BACKGROUND: The high prevalence and the clustering of risk factors multiply health consequences and increase the threat to the future health and quality of life of young adults. DESIGN: Descriptive cross-sectional study. METHODS: During November-December 2012, we assessed 14 lifestyle characteristics of 1058 1st year university students' that were classified as: healthy (score = 0), unhealthy (score = 1) and high-risk unhealthy (score = 2). We subsequently created a Multiple Health Risk Behaviours Index by summing the score of each behaviour adjusted to 0-100. RESULTS: Only 0·3% of the students had one risk behaviour and 21·3% (male: 31·5%; female: 12·6%) had ≥10 of 14. Male students had higher risk index score. In adjusted regression analyses, female students had higher odds of reporting healthier behaviours in oral hygiene (tooth brushing), red meat and junk food consumption, binge drinking, cannabis/hashish/marijuana use and lower number of…

AIMS: To examine the effect of transformational leadership on early career nurses' intent to stay, job satisfaction and organizational commitment. BACKGROUND: Lack of leadership support is one of the top reasons staff nurses leave. Current studies reported mixed results about the impact of transformational leadership on key nurse outcomes. However, little is known whether leadership directly or indirectly affects satisfaction, organizational commitment and intent to stay. DESIGN: This study was a cross-sectional study of nurses who had been licensed for 7·5-8·5 years which was part of a 10-year longitudinal panel design. METHODS: The analytic sample was 1037 nationally representative newly licensed Registered Nurses. Data were collected from January-March 2013. We used a probit model to model the relationship between transformational leadership and intent to stay, organizational commitment and job satisfaction. RESULTS: Transformational leadership did not have a significant impact on intent to stay and job satisfaction, but significantly associated with organizational commitment.…

AIM: To report an analysis of the concept of vulnerability associated with pregnancy, birth and the postnatal period. BACKGROUND: The concept of vulnerability during childbirth is complex and the term, 'to be vulnerable' frequently attains a vague application. Analysis about vulnerability is needed to guide policy, practice, education and research. Clarity around the concept has the potential to improve outcomes for women. DESIGN: Concept analysis. DATA SOURCES: Searches were conducted in CINAHL, EMBASE, PubMed, Psychinfo, MEDLINE, MIDIRS and ASSIA and limited to between January 2000 - June 2014. Data were collected over 12 months during 2014. METHODS: This concept analysis drew on Morse's qualitative methods. RESULTS: Vulnerability during pregnancy, birth and the postnatal period can be defined by three main attributes: (a) Threat; (b) Barrier; and (c) Repair. Key attributes have the potential to influence outcome for women. Inseparable sub-attributes such as mother and baby attachment, the woman's free will and choice added a level of complexity about the concept. CONCLUSION: This…

AIM: The aim of this study was to examine how nurse-led interventions that support self-management of outpatients with chronic conditions work and in what contexts they work successfully. BACKGROUND: Self-management could be directed at goals such as quality of life, adherence or patients' empowerment. Self-management support is an increasingly important task of nurses. Many nurse-led interventions have been developed but it is not clear how these actually help improve patients' self-management capabilities. DESIGN: Realist review. DATA SOURCES: Primary research studies on self-management support interventions conducted by nurses from January 2000 until March 2015 were retrieved from all relevant databases. The studies had a before-after design and used qualitative and quantitative methods. REVIEW METHODS: For each study, we described how the intervention was supposed to improve self-management and compared this with the empirical evidence. Next, we described the context-mechanism-outcome strings for each separate study, explored patterns and integrated the findings. RESULTS:…

AIM: A discussion of the concepts of leadership and emotional intelligence in nursing and midwifery education and practice. BACKGROUND: The need for emotionally intelligent leadership in the health professions is acknowledged internationally throughout the nursing and midwifery literature. The concepts of emotional intelligence and emotional-social intelligence have emerged as important factors for effective leadership in the healthcare professions and require further exploration and discussion. This paper will explore these concepts and discuss their importance in the healthcare setting with reference to current practices in the UK, Ireland and internationally. DESIGN: Discussion paper. DATA SOURCES: A search of published evidence from 1990-2015 using key words (as outlined below) was undertaken from which relevant sources were selected to build an informed discussion. IMPLICATIONS FOR NURSING/MIDWIFERY: Fostering emotionally intelligent leadership in nursing and midwifery supports the provision of high quality and compassionate care. Globally, leadership has important implications…

AIM: The aim of this study was to examine how service user involvement can contribute to the development of interpretative phenomenological analysis methodology and enhance research quality. BACKGROUND: Interpretative phenomenological analysis is a qualitative methodology used in nursing research internationally to understand human experiences that are essential to the participants. Service user involvement is requested in nursing research. DESIGN: We share experiences from 4 years of collaboration (2012-2015) on a mental health promotion project, which involved an advisory team. METHODS: Five research advisors either with a diagnosis or related to a person with severe mental illness constituted the team. They collaborated with the research fellow throughout the entire research process and have co-authored this article. We examined the joint process of analysing the empirical data from interviews. Our analytical discussions were audiotaped, transcribed and subsequently interpreted following the guidelines for good qualitative analysis in interpretative phenomenological analysis…

AIMS: To identify patient safety competencies, and determine the clinical learning environments that facilitate the development of patient safety competencies in nursing students. BACKGROUND: Patient safety in nursing education is of key importance for health professional environments, settings and care systems. To be effective, safe nursing practice requires a good integration between increasing knowledge and the different clinical practice settings. Nurse educators have the responsibility to develop effective learning processes and ensure patient safety. DESIGN: Rapid Evidence Assessment. DATA SOURCES: MEDLINE, CINAHL, SCOPUS and ERIC were searched, yielding 500 citations published between 1 January 2004-30 September 2014. REVIEW METHODS: Following the Rapid Evidence Assessment process, 17 studies were included in this review. Hawker's (2002) quality assessment tool was used to assess the quality of the selected studies. RESULTS: Undergraduate nursing students need to develop competencies to ensure patient safety. The quality of the pedagogical atmosphere in the clinical setting…

AIM: The aim of this study was to evaluate a heart failure education programme developed for patients and carers in Thailand. BACKGROUND: Heart failure is major health problem. This is the first trial of a family-based education programme for heart failure patients and carers residing in rural Thailand. DESIGN: Randomized controlled trial. METHODS: One hundred patient-carer dyads attending cardiac clinics in southern Thailand from April 2014 - March 2015 were randomized to usual care (n = 50) or a family-based education programme (n = 50) comprising face-to-face counselling, a heart failure manual and DVD and telephone support. Assessments of heart failure knowledge, health-related quality of life, self-care behaviours and perceived control were conducted at baseline, three and six months. RESULTS: Linear mixed-effects model revealed that patients and carers who received the education programme had higher knowledge scores at three and six months than those who received usual care. Among those who received the education programme, when compared with those who received usual care,…

AIM: To synthesize qualitative descriptions of the experience of chronic pain across conditions. BACKGROUND: Chronic pain is a transdiagnostic symptom in that while somatic pathology plays a role in activating pain pathways, psychological and social factors contribute to the experience of pain over time. The treatment of the underlying condition may require both biomedical intervention and biopsychosocial approaches. DESIGN: Qualitative meta-synthesis using Confidence in the Evidence from Reviews of Qualitative Research (CERQual) developed by Grading of Recommendations Assessment Development and Evaluation (GRADE) working group to evaluate the strength of the evidence. DATA SOURCES: PubMed and Ovid Medline from 2000-2015. REVIEW METHODS: Following a systematic search strategy all papers were assessed in relation to inclusion criteria and quality. Themes were extracted from each study and a meta-synthesis conducted before completing an evaluation of confidence in the findings. RESULTS: Forty-one papers exploring the experience of chronic pain were included in the review. Five…

AIM: To assess the quality of evidence and determine the effect of patient-related and economic outcomes of self-management support interventions in chronically ill patients with a low socio-economic status. BACKGROUND: Integrated evidence on self-management support interventions in chronically ill people with low socio-economic status is lacking. DESIGN: Systematic literature review. DATA SOURCES: Cochrane database of trials, PubMed, CINAHL, Web of Science, PsycINFO and Joanna Briggs Institute Library were searched (2000-2013). Randomized controlled trials addressing self-management support interventions for patients with cardiovascular disease, stroke, cancer, diabetes and/or chronic respiratory disease were included. REVIEW METHODS: Data extraction and quality assessment were performed by independent researchers using a data extraction form. RESULTS: Studies (n = 27) focused mainly on diabetes. Fourteen studies cited an underlying theoretical basis. Most frequently used self-management support components were lifestyle advice, information provision and symptom management.…

AIMS: To describe the nursing diagnoses, outcomes and interventions for patients admitted to intensive care units and to assess their possible relation with classical outcomes like length of stay and mortality. BACKGROUND: The analysis of nursing diagnosis frequencies may help to estimate the patients' complexity and the need for nursing interventions and can predict hospital outcomes. Nonetheless, few studies were conducted on critical patients. DESIGN: Prospective cohort observational study. METHODS: Between 15 July-31 October 2013 we collected the above-described nursing parameters of 100 subjects throughout their stay in intensive care. We classified the parameters according to established taxonomies. The independent association between the number of nursing diagnoses and length of stay/mortality was investigated with multiple regressions. RESULTS: We found an average of 19 diagnoses, 24 outcomes and 60 interventions per patient. Most frequently, the plans of care involved support for self-care deficits or interrupted family processes. They also included strategies to prevent…

AIM: The aim of this study was to evaluate the effectiveness of forced-air warming for preventing perioperative hypothermia. BACKGROUND: Perioperative hypothermia commonly occurs in patients receiving anaesthesia during surgeries. However, the effectiveness of warming systems requires verification. DESIGN: Systematic review incorporating meta-analysis. DATA SOURCES: We searched OVID, PubMed, Cochrane Library, Medline, CINAHL, CETD and CEPS databases (2001-2015) for randomized controlled trials published in English and Chinese. Outcome measures of interests were body temperature and thermal comfort. REVIEW METHODS: Cochrane methods, Quality of evidence (GRADE) assessments and Jadad Quality Score were used. RESULTS: Twenty-nine trials (1875 patients) met inclusion criteria, including seven trials (502 patients) related to thermal comfort. Results showed that: (1) forced-air warming was more effective than passive insulation and circulating-water mattresses; (2) there was no statistically significant difference among forced-air warming, resistive heating blankets, radiant warming…

AIM: The aim of this study was to explore bilingual nurses' perspective about providing language concordant care to patients with limited English proficiency (LEP) and its impact on patients and nurses. Factors affecting the provision of language concordant care to patients LEP were also explored. BACKGROUND: With an increase in migration and mobility of people across the world, the likelihood of experiencing language barriers while providing and receiving care is high. Nurses are responsible for providing care to patients regardless of their culture, religion, ethnic background or language. Language barriers, however, are hurdles that hamper development of effective communication between nurses and patients. Eliminating language barriers is a crucial step in providing culturally competent and patient-centred care. DESIGN: Qualitative descriptive study. METHODS: During January-August 2015, 59 nurses, working in acute hospitals in the UK, participated in 26 individual in-depth interviews and three focus group discussions. The data were analysed using thematic analysis. FINDINGS: Four…

AIM: To gather, assess and synthesize current research knowledge on the interventions aiming to improve nurses' well-being at work. BACKGROUND: Previous reviews describe health care professionals' well-being at work from the perspective of burnout. Research on the interventions for and their effectiveness on nurses' well-being at work is sporadic. DESIGN: A quantitative systematic review based on the procedure of the Centre for Reviews and Dissemination. METHODS: CINAHL, Cochrane, EBSCO, PubMed, PsycInfo, Scopus databases were sought from 2009-March 2015. The final data consisted of eight studies described in 10 articles. The study design was RCT in three studies, CBA in three and ITS in two studies. The studies were assessed with the Cochrane risk of bias tool. Data were summarised narratively and displayed in a harvest plot. RESULTS: Two of the six interventions were person-directed, two combined person- and organisation-directed and two organisation-directed interventions. Half of them were mainly targeted at stress management while the others aimed at improving interaction with…

AIMS: To test a hypothetical path model evaluating the influence of type D personality on job stress and job satisfaction and to identify the mediating effects of compassion fatigue, burnout, and compassion satisfaction among clinical nurses in South Korea. BACKGROUND: Personalities susceptible to stress, compassion fatigue, and burnout in clinical nurses have negative effects on the job stress and job satisfaction. DESIGN: A correlational, cross-sectional design was used. METHODS: A convenience sample of 875 clinical nurses was recruited between December 2014 - February 2015. The structured questionnaires included the Type D personality scale-14, Professional Quality of Life, job stress, job satisfaction, and general characteristics. To test the hypothetical path model, we performed a path analysis by using the AMOS 18·0 program. FINDINGS: Based on the path model, type D personality was significantly associated with compassion fatigue, burnout, and compassion satisfaction in our study subjects. Type D personality was significantly associated with job stress and job satisfaction via…

AIM: To describe and explore health game interventions that enhance the physical activity self-efficacy of children and to evaluate the effectiveness of these interventions. BACKGROUND: Physical inactivity among children has increased globally. Self-efficacy is one of the key determinants of physical activity engagement in children. There is a need to explore new and innovative interventions to enhance physical activity self-efficacy that are also acceptable for today's children. DESIGN: Quantitative systematic review. DATA SOURCES: MEDLINE (Ovid), CINAHL, PsychInfo, EMBASE and the Cochrane Library between 1996-2016. REVIEW METHODS: A review was conducted in accordance with the Cochrane Collaboration guidelines. A systematic search was done in June 2016 by two independent reviewers according to the eligibility criteria as follows: controlled trial, comparison of digital game intervention with no game intervention control condition, participants younger than 18 years of age and reported statistical analyses of a physical activity self-efficacy outcome measure. RESULTS: Altogether,…

AIMS: To explore the existence of symptom clusters in advanced chronic kidney disease. BACKGROUND: People with chronic kidney disease commonly report multiple symptoms. However, the complex relationships among these symptoms are still poorly understood. DESIGN: Cross-sectional. METHODS: A total of 436 people with stage 4 and 5 chronic kidney disease were recruited from three tertiary hospitals during 2013-2014. Participants completed the Chronic Kidney Disease-Symptom Burden Index that assesses four symptom dimensions (occurrence, distress, severity and frequency) of 32 symptoms. Exploratory factor analysis was used to identify symptom clusters across each symptom dimension. Core symptoms in each cluster were determined based on stability across dimensions and clinical plausibility. A high cutoff of 0·50 for factor loading was used for all analyses. RESULTS: Five symptom clusters were consistently identified across all symptom dimensions: fluid volume symptoms, neuromuscular symptoms, gastrointestinal symptoms, sexual symptoms and psychological symptoms. Overall, clusters ranged…

AIM: The aim of this study was to report: (1) an analysis of the concepts of coping, adaptation and self-management in the context of managing a neurological condition; and (2) the overlap between the concepts. BACKGROUND: The three concepts are often confused or used interchangeably. Understanding similarities and differences between concepts will avoid misunderstandings in care. The varied and often unpredictable symptoms and degenerative nature of neurological conditions make this an ideal population in which to examine the concepts. DESIGN: Concept analysis. DATA SOURCES: Articles were extracted from a large literature review about living with a neurological condition. The original searches were conducted using SCOPUS, EMBASE, CINAHL and Psych INFO. Seventy-seven articles met the inclusion criteria of: (1) original article concerning coping, adaptation or self-management of a neurological condition; (2) written in English; and (3) published between 1999-2011. METHODS: The concepts were examined according to Morse's concept analysis method; structural elements were then compared.…

AIM: To report an analysis of the concept of body image disturbance in adults who have been treated for cancer as a phenomenon of interest to nurses. BACKGROUND: Although the concept of body image disturbance has been clearly defined in adolescents and adults with eating disorders, adults who have been treated for cancer may also experience body image disturbance. In this context, the concept of body image disturbance has not been clearly defined. DESIGN: Concept analysis. DATA SOURCES: PubMed, Psychological Information Database and Cumulative Index of Nursing and Allied Health Literature were searched for publications from 1937 - 2015. Search terms included body image, cancer, body image disturbance, adult and concept analysis. METHODS: Walker and Avant's 8-step method of concept analysis was used. RESULTS: The defining attributes of body image disturbance in adults who have been treated for cancer are: (1) self-perception of a change in appearance and displeasure with the change or perceived change in appearance; (2) decline in an area of function; and (3) psychological distress…

AIM: The aim of this study was to explore the concepts of 'resilience' and 'hardiness' in nursing and midwifery students in educational settings and to identify educational interventions to promote resilience. BACKGROUND: Resilience in healthcare professionals has gained increasing attention globally, yet to date resilience and resilience education in nursing and midwifery students remain largely under-researched. DESIGN: An integrative literature review was planned, however, only quantitative evidence was identified therefore, a review of quantitative studies was undertaken using a systematic approach. DATA SOURCES: A comprehensive search was undertaken using Medline, CINAHL, Embase, PsycINFO and Maternity and Infant Care databases January 1980-February 2015. REVIEW METHODS: Data were extracted using a specifically designed form and quality assessed using an appropriate checklist. A narrative summary of findings and statistical outcomes was undertaken. RESULTS: Eight quantitative studies were included. Research relating to resilience and resilience education in nursing and…

BACKGROUND: Grounded theory is a distinct method of qualitative research, where core features are theoretical sampling and constant comparative analysis. However, inconsistent application of these activities has been observed in published studies. AIM: This review assessed the use of theoretical sampling in grounded theory studies in nursing journals. DESIGN: An adapted systematic review was conducted. METHOD: Three leading nursing journals (2010-2014) were searched for studies stating grounded theory as the method. Sampling was assessed using a concise rating tool. RESULTS: A high proportion (86%) of the 134 articles described an iterative process of data collection and analysis. However, half of the studies did not demonstrate theoretical sampling, with many studies declaring or indicating a purposive sampling approach throughout. CONCLUSION: Specific reporting guidelines for grounded theory studies should be developed to ensure that study reports describe an iterative process of fieldwork and theoretical development.

AIM: To understand nurses' perceptions and experiences of work role transitions. BACKGROUND: Globally an uncertain healthcare landscape exists and when changing work roles nurses experience periods of transition when they may not cope well. A greater understanding of work role transitions may help facilitate workforce retention and successful careers. DESIGN: Mixed methods systematic review. DATA SOURCES: Six data bases were searched for peer reviewed primary empirical research, published in English language between January 1990 and December 2014, supplemented by hand and citation searching. REVIEW METHODS: Evidence for Policy and Practice Information and Co-ordinating Centre methods for systematic reviews principles were followed. Analysis and synthesis of the qualitative and quantitative papers was conducted separately using thematic analysis. A third synthesis combined the narrative findings and a narrative synthesis of results is presented. RESULTS: Twenty-six papers were included. Across nurses' work role transitions two pathways were found: Novice and Experienced. 'Novice'…

BACKGROUND: Compassion is core to nursing practice. Nurses' expression of compassion is a complex interaction informed by the nurse, the patient and the practice environment. AIM: The aim of this study was to identify personal, professional and organizational factors, intensive care nurses, in a major metropolitan facility in Australia, identified as enabling or disabling them to be compassionate. DESIGN: Intensive care nurses (n = 171) reflected on their experiences during 'compassion cafés' conducted in 2015. METHOD: Qualitative, reflexive methods were used to explore ICU nurses' perceptions of enablers and barriers. Nurses documented their perceptions, which were thematically analysed. Meanings were subsequently verified with participants. RESULTS: The findings identified multiple factors both inside and outside the workplace that constrained or enabled nurses' ability to be compassionate. Two main factors inside the workplace were culture of the team, in particular, support from colleagues and congruency in work practices and decision-making, and connections with patients and…

AIMS: The aim of this study was to identify the distinctive foundations of the care culture and how nurse leaders (NL) can manage and strengthen these in a quest for ethically sustainable caring cultures. BACKGROUND: Sustainability presupposes an ethical leadership, a management of the good care and a well-educated staff, but research on NLs as managers of ethically sustainable caring cultures is not available. DESIGN: The study has a quantitative design with elements of a qualitative research approach. METHOD: Data were collected through a web-based questionnaire sent to staff at eight selected units at a hospital in western Finland during September 2013; the reply rate was 32%. The data material was comprised of opinion questions, the ranking of values and two open-ended questions on lodestars in care and ethical principles in care work. RESULTS: NLs manage a care culture that rests on a solid foundation, where staff are co-creators of an ethically sustainable caring culture that includes good traditions for the praxis of care. NLs as managers are therefore responsible for…

AIM: The aim of this study was to explore factors affecting adaptation to the role of motherhood in mothers of preterm infants admitted to the neonatal intensive care unit. BACKGROUND: Transition to motherhood often causes significant issues in terms of adaptation to the role of motherhood. The main factors leading to parental stress, especially in the neonatal intensive care unit, have shown that the greatest source of stress is the loss of women's role as mothers. DESIGN: It was a qualitative study with content analysis approach. METHODS: Semi-structured in-depth interviews were used for data collection. Interviews were conducted with 17 mothers of preterm infants (under 36 weeks) who had been hospitalized for at least one week in the neonatal intensive care unit. Purposive sampling with maximum diversity was used to recruit mothers in Kermanshah province (west of Iran). Data was collected during 2013-2014. Interviews were recorded and transcribed verbatim. Data were analysed using conventional content analysis. FINDINGS: Explanation of the mothers' perspective towards factors…