BACKGROUND: Hypertension remains a critical health disparity among Black older adults, driven by factors such as socioeconomic inequities, chronic stress and barriers to healthcare access. Within this population, family...BACKGROUND: Hypertension remains a critical health disparity among Black older adults, driven by factors such as socioeconomic inequities, chronic stress and barriers to healthcare access. Within this population, family relationships, particularly intergenerational interactions, significantly influence health behaviours and the management of hypertension remain understudied. AIM: To explore intergenerational factors influencing hypertension prevention and management among Black older adults, focusing on how family relationships impact health behaviours, knowledge transfer and treatment adherence. METHODS: A discursive paper applying the Transtheoretical Model of Change and Self-Determination Theory as guiding frameworks to examine the role of family dynamics in hypertension management. PubMed, Scopus and Google Scholar were searched for peer-reviewed papers published from 2015 to 2025. DISCUSSION: The role of family in health behaviours is examined, including the transmission of health knowledge, caregiving dynamics and emotional support. Both barriers and facilitators to effective hypertension management are identified, including cultural beliefs, community resources and the impact of intergenerational role modelling. IMPLICATIONS FOR PRACTICE: The discussion underscores the need for nurses to adopt family-centred approaches in hypertension management, considering the intergenerational influences on health outcomes. Recommendations for integrating these insights into clinical practice and nursing education are provided. CONCLUSION: Understanding the intergenerational context of hypertension management can enhance patient care by improving adherence and prevention strategies. Future research should further explore the role of family in managing hypertension among Black older adults.
AIMS: This article investigates school vaccination for adolescents with intellectual and developmental disability through the lens of person-centred care principles. DESIGN: This is a theoretical framework analysis in wh...AIMS: This article investigates school vaccination for adolescents with intellectual and developmental disability through the lens of person-centred care principles. DESIGN: This is a theoretical framework analysis in which qualitative interview data were mapped to the principles of a Person-Centred Practice Framework. DATA SOURCES: Data were drawn from Vax4Health, an empirical study that aims to improve vaccination uptake and experiences for adolescents with disabilities. METHODS: Our four-step process included: identifying elements of the school vaccination programme that relate to the Framework domains; mapping programme capacities and challenges by each domain; identifying key factors influencing person-centredness; and synthesising these key influencing factors into three themes. RESULTS: We extrapolated three themes: (1) Parents and students expressed strong support for the programme, but there is potential to enhance their participation in vaccination decision-making processes. (2) Nurses bring high levels of motivation, clinical experience, empathy and creativity to vaccinate students, but opportunities remain to enhance disability-specific training and knowledge of individual students' needs. (3) Special schools are committed to supporting families and facilitating the programme, but limited resourcing and unclear responsibilities present challenges that need addressing. We discuss how these themes relate to the five domains of the Framework. Key considerations for vaccination programme improvement towards a more person-centred approach are highlighted. CONCLUSION: Applying the Framework to the findings of the Vax4Health study identified a range of opportunities to improve person-centred school-based vaccination for adolescents with IDD. Future research could involve engagement with all stakeholders to co-design interventions aimed at applying person-centred care principles to vaccinating students with IDD. IMPACT: The findings from this analysis could be used to inform future implementation research into person-centred approaches to school vaccination aiming for positive outcomes for adolescents with IDD, their families and schools and health professionals.
AIM: To explore survivors' perspectives and experiences of psychological detachment while living with a stoma. DESIGN: A qualitative descriptive study was conducted. This study followed the Consolidated Criteria for Repo...AIM: To explore survivors' perspectives and experiences of psychological detachment while living with a stoma. DESIGN: A qualitative descriptive study was conducted. This study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. METHODS: A total of 15 semi-structured interviews were conducted between February 2024 and May 2024. The phenomenological method proposed by Colaizzi was used to analyze the data. RESULTS: Four major themes emerged from the analysis: (1) Trapped in the Persistent Impact of Dual Traumas: Struggles with Adaptation; (2) Trapped by the Unrelenting Burden of Stoma Care: A Cycle of Powerlessness; (3) Trapped by the Shackles of a Stigmatised Identity: The Dilemma of Social Reintegration; and (4) Divergent Pathways of Detachment: Navigating Between Immersion and Transcendence. Within the main themes, eight subthemes were formulated. CONCLUSION: This study thoroughly explored and elucidated the psychological detachment experiences of colorectal cancer survivors with a stoma, revealing its key role in mental health recovery and psychosocial rehabilitation and informing clinical interventions. IMPLICATIONS FOR PRACTICE: The study suggests that healthcare staff should guide survivors in drawing a clear boundary between stoma care and their personal life, encourage any correction of erroneous social cognition, and promote the positive development of psychological detachment among survivors. IMPACT: This study explored the challenges of psychological detachment in stoma survivors, identifying key barriers like trauma, care burden, role misconceptions, and varying detachment levels. The findings can guide healthcare providers in supporting survivors' mental well-being and inform better survivorship care strategies. PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public contribution.
AIM: To explore the experiences of healthcare staff in organisations undergoing regulatory scrutiny and to identify the professional and organisational impact. DESIGN: Integrative review. DATA SOURCES: Medline, CINAHL, S...AIM: To explore the experiences of healthcare staff in organisations undergoing regulatory scrutiny and to identify the professional and organisational impact. DESIGN: Integrative review. DATA SOURCES: Medline, CINAHL, Scopus, and Google Scholar. REVIEW METHODS: This review followed Whittemore and Knafl's framework, adhering to PRISMA guidelines. Searches identified peer-reviewed studies from 2010 to 2025 examining healthcare staff under regulatory scrutiny. Studies employing diverse methodologies were included and synthesised using the constant comparison method to identify and refine key themes. RESULTS: Eight studies were included. Four interrelated themes were identified: (1) workforce wellbeing, autonomy, and professional identity; (2) regulatory culture, organisational adaptation, and quality improvement; (3) communication and relationships; and (4) impact on patient care and contextual variation. CONCLUSION: Regulatory scrutiny profoundly shapes healthcare quality and professional culture but can unintentionally undermine workforce adaptability and innovation essential for effective care. These findings highlight the need for nursing-sensitive regulatory approaches that support professional autonomy, reduce burden, and enhance patient-centred care. IMPACT: This evidence will inform nursing and midwifery policy and practice globally by providing support to inform nuanced, context-sensitive regulatory approaches that safeguard professional autonomy, reduce administrative burden, and promote safe, person-centred care across diverse healthcare settings. It will assist policymakers, healthcare leaders, and educators worldwide in enhancing workforce sustainability, patient safety, and care quality, facilitating the transfer of learning to varied healthcare environments and systems. PATIENT OR PUBLIC CONTRIBUTION: Not applicable.
AIM: To synthesise the literature around the roles of general practice nurses (GPNs) and the barriers and facilitators of their role. DESIGN: Integrative literature review using Whittemore and Knafls framework. METHODS:...AIM: To synthesise the literature around the roles of general practice nurses (GPNs) and the barriers and facilitators of their role. DESIGN: Integrative literature review using Whittemore and Knafls framework. METHODS: Papers were exported into Covidence for screening. Quality was appraised using the Mixed Method Appraisal Tool. Data were extracted into a summary table and analysed using thematic analysis. DATA SOURCES: CINAHL, Medline, and Google Scholar were used to identify papers published between January 2000 and February 2025 in English that reported primary research about GPN roles. RESULTS: Twelve papers were included in the review. The four overarching themes were role characteristics, the clinical role, the non-clinical role, and barriers and enablers. Findings suggest ambiguity surrounding the GPN role, with inconsistent perspectives and overlapping responsibilities contributing to underutilisation. GPNs played an important role in continuity of care and reported a desire to spend more time on health promotion, health education and assessment. GPNs were leaders in collaboration as they functioned as agents of connectivity for patients and staff. The GPN role faces both barriers and enablers, with the organisational structure, interprofessional relationships, and professional development. CONCLUSION: The GPN role offers an opportunity to enhance access to general practice care. However, there is limited and mixed literature describing the roles of GPNs. Future research should more closely explore the current practice of GPNs to inform policy and optimal utilisation of the workforce to the full extent of their practice scope. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Understanding the complex roles of GPNs requires more robust data on clinical activity. These data would have the potential to inform ways to optimise the GPN role within the multidisciplinary team. REPORTING METHOD: This study adhered to the PRISMA reporting guideline. PATIENT OR PUBLIC CONTRIBUTION: This review did not include patient or public involvement.
BACKGROUND: Using advanced forms of medical technology such as extracorporeal organ support to take over organ function in the face of critical illness is a manifestation of the technological expertise to support and pro...BACKGROUND: Using advanced forms of medical technology such as extracorporeal organ support to take over organ function in the face of critical illness is a manifestation of the technological expertise to support and prolong life. However, clinician focus on the technical aspects of extracorporeal organ support both in research and clinical practice has the tendency to relegate to the background and disregard multiple, non-technical components such as the meanings, interactions, and experiences of nurses, families and other healthcare professionals. AIM: To understand how experiences and social interactions of critically ill children, families, and healthcare professionals are influenced by the use of extracorporeal organ support. DESIGN: Hermeneutic review of the literature. DATA SOURCES: CINAHL, PubMed and Web of Science followed by cross-citations and snowballing. RESULTS: A total of 24 studies were included in the review, representing four conceptual streams, namely (1) extracorporeal organ support as a biomedical intervention, (2) relationality concerning extracorporeal organ support, (3) performativity in using extracorporeal organ support and (4) the agential role of extracorporeal organ support. CONCLUSION: The hermeneutic framework helped foreground perspectives demonstrating that extracorporeal organ support is not merely a piece of medical technology, but is an active fulcrum upon which human and material elements revolve, interact, and integrate to form multiple assemblages that can influence how the huge volume of nurse work can be reframed beyond the perpetuation of the patient-machine connection and affect the ways by which patients and families are cared for. IMPACT: Understanding extracorporeal organ support as more than a medical device can enable nurses to develop informed plans of care and advocate for the interests of the family and that of the critically ill child who remains a passive recipient of care in an intensive care bed. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
AIM: To provide an overview of a project aimed at enhancing person-centred surgical care through teamwork and professional development. DESIGN: A discursive paper with the purpose of describing and discussing the project...AIM: To provide an overview of a project aimed at enhancing person-centred surgical care through teamwork and professional development. DESIGN: A discursive paper with the purpose of describing and discussing the project activities to strengthen person-centred care, teamwork and professional development. METHODS: This project aimed to strengthen evidence-based surgical nursing care within a Surgery Department. The overarching goal was to foster an attractive and sustainable work environment for nursing professionals while simultaneously enhancing the quality of person-centred care, thereby improving patient outcomes and safety. Ultimately, the project aimed to position the department as a leading example of excellence in surgical nursing care, where evidence-based practice and person-centred values form the foundation of everyday work. RESULTS: The activities were guided by previous nursing evidence and aligned with Magnet Hospital standards. Continuous quality improvement efforts and team dialogue were central to achieving the goals. Leadership was provided by experienced nurses and researchers. The structured activities improved patient safety and care quality. CONCLUSIONS: The project was successful as it enhanced precision in surgical nursing care by implementing structured activities focused on person-centred care, patient safety and professional development. These efforts led to improved quality of care and patient outcomes, demonstrating the effectiveness of evidence-based practices. IMPACT AND IMPLICATIONS FOR THE PROFESSION: A project with similar activities to those described in this paper can ensure that surgical patients receive high precision nursing care and serve as an example of promoting person-centred surgical nursing. REPORTING METHOD: None. PATIENT OR PUBLIC CONTRIBUTION: None.
AIM: To synthesise literature on hospital-based geriatric models of care for older adults undergoing surgery, examining structures, team composition, governance and nursing contributions. DESIGN: Scoping review. METHODS:...AIM: To synthesise literature on hospital-based geriatric models of care for older adults undergoing surgery, examining structures, team composition, governance and nursing contributions. DESIGN: Scoping review. METHODS: Following JBI methodology, two reviewers independently screened articles against eligibility criteria (Population: adults ≥ 65 years, Concept: multidisciplinary geriatric surgical care model; Context: acute hospital settings), with conflicts resolved by a third reviewer. Data were extracted and charted for descriptive synthesis. DATA SOURCES: Six databases (CINAHL, MEDLINE, Embase, Scopus, AgeLine, Cochrane Library) searched for studies published between January 2015 and February 2025. RESULTS: Of 2753 records identified, 81 studies were included. Models were commonly co-managed between surgical and geriatric teams, implemented at varying surgical pathway points. Orthopaedics represented 57% of studies. Geriatricians were involved in 90% of models; 38% included advanced practice nurses or specialist gerontological nurses. Comprehensive Geriatric Assessment was used in nearly half the studies, typically preoperatively. Considerable heterogeneity existed in model design, professional roles and care settings. CONCLUSION: Integrated geriatric perioperative care is expanding globally but remains limited outside orthopaedics. Research should shift from improvement projects to rigorous implementation for sustainable transformation, including nurse-led models. Critical examination is needed of whether current outcomes address comprehensive needs of older surgical patients or primarily optimise hospital flow. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Findings highlight opportunities to expand geriatric models beyond orthopaedics and enhance nursing roles, particularly advanced practice nurses, in delivering comprehensive perioperative care for older adults. IMPACT: Addressed the gap in understanding how geriatric models of surgical care are operationalised. Identified underutilisation of nursing expertise and limited expansion beyond orthopaedics. Will impact service design, policy development and clinical implementation for older surgical patients. REPORTING METHOD: Adhered to PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. PATIENT OR PUBLIC CONTRIBUTION: No patient or public involvement. PROTOCOL REGISTRATION: Open Science Framework Registries Network.
BACKGROUND: Nursing students experience heightened stress and emotional burden during clinical training, but opportunities for structured resilience skill development remain limited. AIM: To explore undergraduate nursing...BACKGROUND: Nursing students experience heightened stress and emotional burden during clinical training, but opportunities for structured resilience skill development remain limited. AIM: To explore undergraduate nursing students' lived experiences of participation in a resilience-enhancement program. DESIGN: Qualitative descriptive phenomenology. METHODS: Undergraduate students participated in a resilience-enhancement pilot program adapted from Japan for American nursing students. Upon program completion, four semi-structured focus groups were conducted. Sessions were audio-recorded, transcribed and analysed inductively. FINDINGS: Three themes were identified: (1) Intrapersonal Resilience Strategies; (2) Interpersonal & Accountability Supports; and (3) Intervention Design & Delivery Factors. Students described increased emotional insight, stronger coping tools and the value of social accountability. CONCLUSION: This study demonstrates that an undergraduate resilience-enhancement program grounded in mindfulness, journaling and peer support is both feasible and meaningful for nursing students. Integrating brief, scalable resilience interventions into nursing curricula may help prepare the next generation of nurses to care effectively for patients and navigate the emotional, ethical and interpersonal demands of a rapidly evolving global healthcare landscape. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: This study addresses the global challenge of preparing nursing students for the emotional and relational demands of contemporary healthcare. The program's scalability and alignment with global workforce priorities highlight its potential relevance for nursing education internationally. REPORTING METHOD: This study adhered to the SRQR guidelines. PATIENT OR PUBLIC CONTRIBUTION: None.
AIMS: To examine published studies on nursing academics' experience with student incivility, explore their management strategies, and identify existing knowledge gaps. DESIGN: This scoping review was guided by Arksey and...AIMS: To examine published studies on nursing academics' experience with student incivility, explore their management strategies, and identify existing knowledge gaps. DESIGN: This scoping review was guided by Arksey and O'Malley's five-stage framework. DATA SOURCES: Studies published between 2009 and June 2024 in English were retrieved from PubMed, CINAHL Complete, ProQuest, and Scopus. METHODS: The review included qualitative, quantitative, and mixed-methods studies on nursing academics' experiences or perceptions of student incivility and/or interventions to manage it in higher education. Data were analysed using descriptive methods. RESULTS: Thirty-five studies met the inclusion criteria. The studies mostly explored nursing academics' experiences (n = 18) or perceptions (n = 15) of student incivility. Of the eleven studies that investigated how academic staff address student incivility, nine were interventional studies and two qualitative studies explored academics' experiences. CONCLUSION: The prevalence of reported nursing student incivility is substantial in the literature, yet there is limited evidence on sustainable, targeted management strategies to address the issue and support nursing academics. IMPLICATIONS FOR THE PROFESSIONAL: Further research is needed to evaluate the feasibility and long-term effectiveness of strategies and interventions aimed at reducing student incivility and to explore effective management strategies adopted by nursing academics across diverse cultural and online learning settings. It is critical to develop interventions that address the root causes of student nurse incivility and strengthen institutional support systems. IMPACT: This scoping review addresses gaps in the literature on managing nursing student incivility across diverse learning environments, providing evidence to inform the development of contextually appropriate strategies that support nursing academics in managing incivility effectively within evolving educational settings. REPORTING METHOD: This review followed the PRISMA Extension for Scoping Review (PRISMA-ScR) Checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public involvement.
AIMS: To identify: (1) current evidence and gaps of PhD program components influencing PhD students' career outcomes; and (2) methods and tools used to assess the relationships between PhD program components and career o...AIMS: To identify: (1) current evidence and gaps of PhD program components influencing PhD students' career outcomes; and (2) methods and tools used to assess the relationships between PhD program components and career outcomes. DESIGN: PRISMA scoping review. METHODS: Search terms included PhD nursing students, PhD education, PhD-prepared nurse, PhD in nursing, nursing faculty, and assistant professor. Studies empirically assessing PhD program components and career outcomes (e.g., desires, attitudes, actual employment) were included. Two researchers conducted screening, data extraction, and inductive content analysis. DATA SOURCES: PubMed, Scopus, and CINAHL in October 2025, without year and geographic location restrictions. RESULTS: The search yielded 379 studies. After title, abstract, and full-text screening, 13 studies were included. Analysis resulted in 10 factors spanning four categories: program preparation, readiness and satisfaction, impressions of the faculty role, and program support. CONCLUSION: Experiences in the PhD program likely influence students' desire to pursue academia. While this review synthesized influential factors, given significant gaps in the literature, there are likely more factors influencing student career desires. A more robust understanding of the factors during the PhD program which influence career outcomes is needed. PATIENT OR PUBLIC CONTRIBUTION: This study did not include patient/public involvement in design, conduct, or reporting.
BACKGROUND: At-risk mothers experience disproportionately higher rates of antenatal depression and anxiety, which can hinder mother-infant bonding and adversely affect infant socioemotional development. Despite growing e...BACKGROUND: At-risk mothers experience disproportionately higher rates of antenatal depression and anxiety, which can hinder mother-infant bonding and adversely affect infant socioemotional development. Despite growing evidence on postpartum mental health, antenatal risk factors among psychosocially vulnerable mothers remain underexplored, particularly in multi-ethnic Asian settings. AIM: To identify factors associated with antenatal depression, anxiety, and maternal-fetal bonding among at-risk mothers. METHODS: This cross-sectional observational study was nested within an ongoing randomised controlled trial. Two hundred at-risk mothers, defined as single, of low socioeconomic status, referred for psychosocial support, at risk of depression, with adverse childhood experiences, or with a fetus with a congenital malformation, were recruited from outpatient obstetric clinics between February and September 2024. Participants completed online self-administered questionnaires assessing antenatal depression, anxiety, perceived stress, social support, parenting self-efficacy, and maternal-fetal bonding. General Linear Models were used to analyse data and identify factors associated with depression, anxiety, and bonding. RESULTS: Higher perceived stress was associated with increased depression (β = 0.28, p < 0.001) and anxiety (β = 1.28, p < 0.001) and poorer bonding (β = 0.08, p = 0.02), while greater social support predicted lower anxiety (β = -0.31, p < 0.001). Higher parenting self-efficacy was linked to stronger bonding (β = -0.09, p = 0.06). Younger mothers (β = -2.68, p = 0.025) and Indian mothers (β = 7.46, p = 0.017) were particularly vulnerable to anxiety, whereas post-secondary education was protective against depression (β = -1.44, p = 0.02). Model fit ranged from 0.14 to 0.65. CONCLUSION: Perceived stress, social support, and parenting self-efficacy significantly influenced antenatal mental health and bonding in at-risk mothers. These findings underscore the need for culturally sensitive, nurse/midwife-led interventions that integrate early screening, stress reduction, and empowerment strategies within routine antenatal care to strengthen maternal mental health and early bonding outcomes. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: (1) Nurses and midwives play a critical role in screening for antenatal depression and anxiety in mothers with risk profiles highlighted in this study. (2) Culturally responsive nursing practice that demonstrates sensitivity towards sociocultural pressures is needed to provide individualised care. (3) Integration of digital and community-based antenatal education programs could provide more equitable access to care for at-risk mothers who may face barriers to in-person care. IMPACT: (1) Despite having a higher susceptibility for antenatal mental health conditions, risk factors for antenatal depression, anxiety, and maternal-infant bonding have been underexplored in at-risk mothers. (2) Antenatal stress and anxiety are universally associated with depression across risk groups, while maternal self-efficacy and perceived social support serve as key protective factors. (3) The findings from this study suggest the need for early screening and nurse-led interventions that support maternal parenting self-efficacy and stress management to improve maternal mental health outcomes among at-risk mothers. REPORTING METHOD: STROBE reporting checklist. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.