"When I hold my daughter, she quiets, no need [for]any verbal conversation": A qualitative understanding of responsive caregiving in rural, Sindh Pakistan.

Responsive caregiving is associated with secure attachment and positive child developmental outcomes. However, there is some debate on whether responsive caregiving is a universal construct. Few studies have researched responsive caregiving in diverse cultural settings, particularly in low- and middle-income countries. In this study, we explore if and how responsive caregiving is conceptualized among mothers of children under 3-years-old in rural, Sindh Pakistan. A phenomenological qualitative study was implemented in Naushahro Feroze through in-depth interviews with twenty mothers. Mothers were asked about their aspirations for their children and how they would respond in a variety of different scenarios. Data were analyzed using thematic content analysis with an inductive-deductive coding scheme. There was substantial variation in mothers' described responsive behaviors and beliefs. Almost all mothers described using some form of responsive parenting. Responding to children's demands while the mother was preoccupied, using verbal responses to console children, and if mothers believed that children should be praised, lacked consensus. Most mothers described using breastfeeding for consolation and highlighted the importance of immediately consoling their crying child. The results suggest that there is a need for a more nuanced approach to understand caregiver behaviors across contexts.

Una sensible prestación de cuidado se asocia con una afectividad segura y con resultados positivos en el desarrollo del niño. Sin embargo, se da un debate sobre si la sensible prestación de cuidado es una estructura universal. Pocos estudios han investigado la sensible prestación de cuidado en diversos escenarios culturales, particularmente en países de bajas y medias entradas económicas. En este estudio, exploramos si la sensible prestación de cuidado está conceptualizada entre las madres de niños menores de 3 años en el área rural de Sindh en Pakistán y cómo lo está. Un estudio fenomenológico cualitativo se implementó usando datos de Naushahro Feroze (ciudad en la provincia de Sindh), por medio de entrevistas profundas con veinte madres. A las madres se les preguntó acerca de sus aspiraciones con respecto a sus niños y cómo ellas responderían en una variedad de diferentes escenarios. Se analizaron los datos usando un análisis de contenido temático con un esquema de codificación inductivo­deductivo. Hubo variación sustancial en las descripciones de las madres acerca de sus conductas y creencias sensibles. Casi todas las madres hicieron las descripciones usando alguna forma de crianza sensible. Faltó el consenso en el caso de responder a las peticiones de los niños mientras la madre estaba preocupada, en el uso de respuestas verbales para consolar a los niños, así como en el caso de si las madres creían que los niños debían ser elogiados. La mayoría de las madres hizo sus descripciones usando el amamantar como manera de consolar y subrayó la importancia de consolar inmediatamente al niño que llora. Los resultados sugieren que hay una necesidad de un acercamiento más matizado para comprender las conductas de prestación de cuidado a través de los contextos.

Development of Fear of Falling after proximal femoral fracture.

Background: Proximal femoral fracture is common in older people. Beyond a long recovery process and significant permanent functional limitations, older people often experience subsequent Fear of Falling. The phenomenon of Fear of Falling is not fully understood; qualitative research is underrepresented but can provide insights into the experience of those affected. Objectives: We aimed to explore the experiences of Fear of Falling development and to what extent it affects peoples' life after proximal femoral fracture. Methods: We conducted semi-structured, in-depth interviews with nine older people, aged between 61 and 88, who participated in a prospective observational study. Interview data were analysed through inductive content analysis. Results: Six major themes emerged: The development of Fear of Falling; the effect of FoF and hope for recovery; alternating between moments of fear and security; fear of helplessness and of losing independence; strategies for dealing with Fear of Falling and maintaining independence; need of support by health care professionals. Conclusion: To identify and support older people in coping with Fear of Falling (after proximal femoral fracture), strategies for dealing with Fear of Falling across occupational groups and all healthcare settings should be implemented. Nurses have a key role in this process.

[Advance care planning in the acute hospital: A qualitative analysis of terms and conditions]. / Advance Care Planning im Akutkrankenhaus.

Advance care planning in the acute hospital: A qualitative analysis of terms and conditions Abstract: Background: Advance Care Planning (ACP) is an internationally established concept aimed to facilitate anticipatory care planning in the event of future inability to consent. In Germany, ACP is currently not regularly offered to patients in acute care hospitals. Aim: We aimed to identify preconditions for implementation of ACP in acute care hospitals in Germany through review of the international literature and expert interviews. Methods: A systematic literature search was carried out in the databases MEDLINE and CINAHL for internationally used strategies for implementing ACP in acute care hospitals. Consecutively, a guide for interviews with experts to evaluate the strategies was developed. Interviews were analyzed by qualitative content analysis according to Mayring. Results: Out of 13 included publications, 17 preconditions were identified and assigned to 16 categories after evaluation by experts. In international ACP programs, it was described how to proceed and organize the ACP conversation. German experts emphasized that appropriate preconditions, such as sufficient time resources and training, must be granted, whereas the literature search revealed the conversation process and organization as important determinants. Conclusions: The implementation of ACP programs is conceivable, but requires specific conditions as legal regulation and defining and structuring of the processes.

Using the candidacy framework to conceptualize systems and gaps when developing infant mental health (IMH) services: A qualitative study.

The development of infant mental health (IMH) services globally is still in its early stages. This qualitative study aims to understand the challenges of setting up IMH services and explores the views and experiences of 14 multi-disciplinary stakeholders who are part of the IMH implementation group in a large Scottish health board. Six major themes were identified through thematic analysis. This paper examines the most prominent theme "Systems" alongside the theme "Gaps in Current Service". The theoretical framework of "candidacy" is found to be a valuable way to conceptualize the complex systemic layers of micro, meso, and macro factors that contribute to the challenges of setting up services. At the micro level, key themes included the view that services must be accessible, individualized, and involve families. At the meso level, in line with the aims of the service, multiagency integration, aspects of early intervention, and clear operating conditions were all seen as important. Finally, at the macro level, perhaps the biggest challenge perceived by stakeholders is delivering a service that is entirely infant-focused. These findings will help inform policy makers about factors considered by professionals to be vital in the establishment of IMH services in Scotland and across the globe.

El desarrollo de los servicios de salud mental infantil (IMH) globalmente está aún en sus niveles básicos. Este estudio cualitativo se propone comprender los retos de establecer los servicios IMH y explora los puntos de vista y experiencias de 14 personas interesadas de múltiples disciplinas que son parte de un grupo de implementación de IMH dentro de una extensa junta de salud escocesa. A través de análisis temáticos se identificaron seis temas de mayor importancia. Este estudio examina el tema más prominente según la mayor percepción, "Sistemas," junto con el tema "Vacíos en la Actual Prestación de Servicio." Se estima que el marco teorético de trabajo de "candidatura," es una manera valiosa de conceptualizar los complejos niveles sistémicos de micro, medio y macro factores que contribuyen a los retos de establecer los servicios. Al nivel micro, los temas claves incluyen el punto de vista de que los servicios deben ser accesibles, individualizados y deben involucrar a las familias. Al nivel medio, alineados con las metas del servicio, la integración de agencias múltiples, aspectos de temprana intervención y claras condiciones operativas fueron todas estimadas como importantes. Finalmente, al nivel macro, quizás el mayor reto percibido por las personas interesadas es cumplir con el ofrecimiento de un servicio que esté enteramente enfocado en el infante. Estos resultados ayudarán a informar a quienes determinan las políticas a seguir acerca de los factores que los profesionales consideran vitales en el establecimiento de servicios IMH en Escocia y alrededor del globo.

Au niveau global, le développement de service de santé mentale du nourrisson et de la petite enfance en est encore à ses débuts. Cette étude qualitative s'est donnée pour but de comprendre les défis que pose l'installation de services IMH. Elle explore les vues et les perspectives de 14 parties prenantes de diverses disciplines qui font partie d'un groupe de mise en place IMH dans un grand conseil de santé en Ecosse. Six thèmes principaux ont été identifiés au travers une analyse thématique. Cet article examine le thème ayant été perçu comme le plus grand et proéminent, Systèmes, ainsi que le thème « Brèches dans les services actuels ¼. La structure théorique de la 'candidature' a été utilisée pour trouver une manière utile de conceptualiser les couches systémiques complexes de facteurs micro, méso, et macro qui contribuent aux défis qu'il y a dans l'installation de services. Au niveau micro, les thèmes clés ont inclus l'idée que les services doivent être accessibles, individualisés et engager les familles. Au niveau méso, s'alignant avec les buts du service, l'intégration de plusieurs agences, les aspects d'une intervention précoce et des conditions d'opération claires ont tous été estimé être importants. Enfin, au niveau macro, le défi étant peut-être le plus grand selon les parties prenantes est d'offrir un service qui est entièrement focalisé sur le nourrisson. Ces résultats aideront les décideurs pour ce qui s'agit des facteurs considérés comme étant vitaux par les professionnels pour ce qui concerne l'établissement de services IMH en Ecosse et au travers du globe.

[How can resilience be described in a process-oriented view and does this have significance for psychotherapy? A qualitative study]. / Wie kann Resilienz prozessorientiert beschrieben werden und hat das Bedeutung für die Psychotherapie? Ein qualitativer Beitrag.

Objectives: Despite its high appeal, the concept of resilience remains unclear. Current definitions include a process approach, but most resilience scales remain trait-based. This study assessed implicit concepts of researchers in an interdisciplinary research group in order to develop a process-based model of resilience. Methods: Expert interviews were conducted with nine experienced researchers from the fields of theology, medicine, and philosophy and analyzed using qualitative content analysis. Results: Categories are classified as predictive, process-related or outcome-related. Central elements in the process are the articulation and acceptance of negative experiences as well as a narrativization and meaningful integration of experiences. Conclusions: Based on the categories, a working definition for a process-oriented resilience model is created.The categories show proximity to known elements and goals of psychotherapy. The reinterpretation of resilience as a process of conscious "moving forward" (Yahuda) instead of an unattainable "hero ideal" can be helpful for psychotherapy patients.

[Toward a safe home: Experiencing the transition to an outpatient setting with home mechanical ventilation. A thematic analysis]. / Auf dem Weg in ein sicheres Daheim: Erleben des Übergangs in ein ambulantes Setting mit Heimbeatmung.

Toward a safe home: Experiencing the transition to an outpatient setting with home mechanical ventilation. A thematic analysis Abstract. Background: With the progress in medical options, the need for home mechanical ventilation increases. The transition from long-term ventilation in an institution to home mechanical ventilation in an outpatient setting is a difficult phase in terms of setting up the network of care, coordination of care for those with the ventilatory insufficiency and the financing. Aim: The study describes how patients with ventilatory insufficiency and family caregivers experience the transition from an institution to an ambulatory setting with invasive or non-invasive home mechanical ventilation. Methods: A qualitative research design with a social-constructivist approach was adopted using thematic analysis according to Braun and Clarke. We included seven German-speaking patients (≥ 18 years old) with ventilatory insufficiency and home mechanical ventilation (> 6 h/day) from the German part of Switzerland, with discharge from an institution to home, and five family caregivers who care for patients with the described criteria. Results: The institution was seen as a safe place. Affected persons and their family caregivers had to create a safe environment at home. Three themes were formed inductively: To gradually build trust with each other, to become experts as family caregivers, to align their own network with the new care needs.Conclusions: The transition home succeeds in the interplay of gaining trust, building expertise, and creating sustainable networks. Professionals can use this knowledge to provide targeted support to patients with home mechanical ventilation and their family caregivers.

[Stress experience of teachers in nursing education: A qualitative survey]. / Belastungserleben von Lehrenden in der Gesundheits- und Krankenpflege.

Stress experience of teachers in nursing education: A qualitative survey Abstract: Background: Teachers in nursing operate in a special area of tension. In addition to the demands of teaching, stress factors arise out of the nature of nursing. Aims: The main question is how teachers in health care and nursing describe their professional stress experience. Supportive and stressful factors as well as coping strategies of the teachers should be identified and described. Methods: This is descriptive qualitative research. Twenty-six guideline-based telephone interviews were conducted with nursing teachers in northern Germany. After transcription these were subjected to qualitative content analysis according to 21-2Mayring (2015). Results: The teachers in nursing indicate varying degrees of professional stress. Main aspects are general conditions, high workload, misconduct and problems of students and cooperation with the collegial team and school management. The proximity to the professional field of nursing has both mitigating and reinforcing factors on the experience of stress. Conclusions: Stress experience is described by the teachers in the context of a lack of support and appreciation of professional performance. In order to maintain the high level of motivation and identification with nursing and the professionalization of nursing, and to ensure high-quality education, teachers need support in the form of solid personnel, material and space resources, as well as more visible recognition of their work.

Specifics of and training needs in the inter-professional home care ofpeople with dementia.

Introduction: Successful home care for people living with dementia (PLwD) allows them to live in their own home environment for as long as possible. Current findings indicate a need for further development of medical and nursing knowledge and skills in evidence-based collaborative care for these patients. Aim: To identify specifics of inter-professional care for PLwD and training needs of home care nurses and general practitioners involved in care. Method: A multi-perspective qualitative study was conducted, comprising focus groups as well as individual interviews. Focus groups and interviews followed a semi-structured topic guide. Interview data was digitally recorded and transcribed verbatim, followed by a thematic framework analysis. Results: The sample consisted of nine nurses, one medical assistant, three general practitioners and nine family caregivers of PLwD. Five themes related to inter-professional home care were inductively developed: challenges in outpatient dementia care, challenges in collaboration, insufficient healthcare infrastructure, competencies needed in dementia care, and training requirements. Challenges were a lacking flow of information as well as continuity and organization of care. Home care nurses and family caregivers complained about missing communication skills in health professionals involved in the care of PLwD. Conclusions: The interviews revealed heterogeneous training needs of home care nursing staff and general practitioners that can be addressed by an inter-professional training course.

[Registered nurses' experience of necessary performed and missed nursing care: a qualitative study]. / Erleben von Pflegefachpersonen in Bezug auf durchgeführte und versäumte Pflege.

Registered nurses' experience of necessary performed and missed nursing care: a qualitative study Abstract: Background: Providing high quality care based on their caring attitude is essential for nurses. Missed Care can cause feelings of guilt and dissatisfaction among them. Studies on their experiential transition between fully performed and missed care are lacking. They may contribute to a more comprehensive understanding of influencing factors and the impact on nurses' experience. Aim: The aim was to explore how nurses at a centre hospital in German-speaking Switzerland describe performance of nursing interventions in terms of the different expressions between performed and missed care. Methods: Between September 2020 and March 2021 the first author conducted eleven qualitative guide-based individual interviews with registered nurses which were analysed using Mayring's qualitative content analysis and knowledge maps. Results: The analysis resulted in five main categories: Optimal care, satisfaction in mediocrity, a huge lack, patients' reactions and influencing factors. Nurses described, in addition to personal experience and expertise, different coping strategies to prevent missed care and maintain patients' and their own satisfaction. Conclusions: In addition to interventions that can prevent missed care, nurses' experience of performed care should be explored further. This can deepen the understanding of its relationship with professional caring attitudes as well as with patient-related and professional satisfaction.

[Care provided by an advanced practice nurse: Experiences of patients with sarcoma and family members. A qualitative study]. / Betreuung durch eine Advanced Practice Nurse: Erfahrungen von Patient_innen mit Sarkom und Angehörigen.

Care provided by an advanced practice nurse: Experiences of patients with sarcoma and family members. A qualitative study Abstract. Background: Sarcomas are a rare, heterogeneous group of malignant tumors with different trajectories, which cause significant burden to patients and families. Due to the complex nature of treatment, an interprofessional team at the sarcoma center of a Swiss university hospital provides care to affected individuals. This interprofessional team includes an advanced practice nurse (APN) who cares for patients and family members throughout the trajectory of the disease. To date, there are limited descriptions within literature of APN care from the perspective of patients with sarcoma and their family members. Aim: To investigate how patients with sarcoma and their family members experienced APN care. Methods: The study was guided by the qualitative research methodology "Interpretive Description". Individual interviews with seven patients and five family members were conducted and analyzed in an iterative process. Results: For patients and family members, the time from diagnosis to therapy and follow-up was very stressful. They experienced the APN's care during this time as a great support and described her as a compassionate, trustworthy and continuous contact person who expertly provided information and advice while acting as a coordinator. Conclusions: Patients with sarcoma and their family members require continuous contact with a person who is compassionate, while also professional, confident and competent. Providing APN care can meet all of these essential requirements.

[Justification of nurses' interventions for skin cleansing and skincare: Qualitative results of the SKINCARE-Pilot study]. / Begründung pflegerischer Maßnahmen zur Hautreinigung und Hautpflege.

Justification of nurses' interventions for skin cleansing and skincare: Qualitative results of the SKINCARE-Pilot study Abstract. Background: Skin care interventions are core tasks of nursing. Various factors influence the implementation of evidence-based care. Aims: To explore the perspectives of nursing staff on the relevance of skin care interventions in long-term care settings and the justification of clinical decisions about the application of such interventions. Methods: Qualitative part of a mixed methods study in three long-term-care facilities, consisting of short interviews with nursing staff members directly after nursing assistance with personal hygiene, focus group discussions with nursing staff members, and semi-structured interviews with nursing managers. The data were analyzed by means of content analysis. Results: The sample (N = 30) comprises 10 short interviews, 3 focus groups (n = 17), and 3 individual interviews. Nurses predominantly assigned a high relevance to nursing support in personal hygiene. As a basis for their decision-making, residents' needs and preferences, nurses' personal knowledge as well as own experiences and preferences were reported. Evidence-based sources of knowledge were hardly mentioned. The availability of skin cleansing and skin care products, staff and time resources, and nurse-physician cooperation were identified as influencing factors. Conclusions: Decisions about nursing support in personal hygiene seem poorly informed by evidence-based sources for clinical decision-making. Evidence-based decision support could facilitate the use of appropriate nursing interventions.

[Interprofessional corporation between registered community nurses and general practitioner: A qualitative study]. / Interprofessionelle Zusammenarbeit zwischen diplomierten Pflegefachpersonen der ambulanten Pflege und Hausärzt_innen.

Interprofessional corporation between registered community nurses and general practitioner: A qualitative study Abstract. Background: The quality and effectiveness of the work of certified nurses and physicians in the inpatient setting is significantly influenced by interprofessional collaboration (IPC). There is a lack of knowledge about IPC in outpatient primary care at home. Aim: In highlighting the differences between inpatient and outpatient settings, the challenges of IPC for the outpatient setting should become clear. Method: The data for this study was collected in interprofessional group discussions. The data were methodically extracted by knowledge mapping and structuring content analysis according to Kuckartz (2018). The results were compared with the meta-matrix for interprofessional collaboration in inpatient settings by Schärli et al. (2017). Results: The qualitative analysis showed that the outpatient IPC of qualified nurses and general practitioners is challenged by structural conditions, which are given in the inpatient area by the form of organization. Lack of agreements and coordination of processes complicate IPC in outpatient health care, as there is no recognized common management structure. Conclusions: In order to ensure that IPC in the outpatient setting is not dependent on the individual commitment of individuals, nurses and GPs must jointly define criteria for their IPC, define processes and communication channels, and develop a common approach and team spirit.

["Feeling secure at home" starts in the hospital: A qualitative study about the experience of patients with a APN hematology]. / "Sich zuhause sicher fühlen" beginnt im Spital.

"Feeling secure at home" starts in the hospital: A qualitative study about the experience of patients with a APN hematology Abstract. Background: High dose chemotherapy (HDC) and hematopoietic stem cell transplantation (HSCT) are complex procedures bringing about physical and mental stress for the persons affected. In preparation for the time after their stay in the hospital, patients need individual support and education already during their hospital stay. Aim: The study investigated how patients after HDC with or without HSCT experienced the preparations by a hematology Advanced Practice Nurse (APN) for the post hospitalization phase and how they experienced managing their day-to-day life back at home. Methods: The qualitative research approach "Interpretive Description" was applied by conducting and subsequently transcribing eleven individual interviews with six participants. The texts were read multiple times before being coded. They were continuously compared with each other and similar contents were assigned the same codes. Results: Patients find themselves in a "process of increasingly feeling secure". This process is supported by the preparation of the APN. This is reflected in three themes during their hospitalization: the relationship of trust with the APN, the comprehensive overview of the APN and the APN strengthening the feeling of security. The experience of finding back to daily life at home shows that the process of "increasingly feeling secure" is ongoing. Themes within this phase were: arriving at home, resuming daily routines and implementing the information received from the APN. Conclusions: The companionship provided by the APN enables patients to appropriately cope with their day-to-day life at home. The findings suggest that the preparations of the APN facilitate the transition from the hospital to day-to-day life back home.

Fathers' experiences of fetal attachment: A qualitative study.

Paternal-fetal attachment (PFA) is associated with the degree of emotional support offered by fathers during pregnancy and has implications for the safety and quality of a mother's labor and postnatal experiences. This study explored fathers' experiences of PFA including their understanding of the phenomenon and its manifestation. Data were collected through interviews with 10 fathers-to-be and analysis followed an interpretative phenomenological approach. Four themes emerged from the data: trigger moment; awareness of responsibility; transition to fatherhood; and emotional conflict. Most fathers experienced a trigger moment that made the reality of having a baby clear to them and which initiated or intensified feelings of attachment toward the fetus. Male family relatives, friends with children, and antenatal education groups provided support to expectant fathers. However, they felt quite lost in their role and some believed there was insufficient support for their mental health. Findings suggest that different situations can trigger the attachment process and that fathers longed to be included in perinatal care but experienced a lack of support. Raising awareness of the importance of PFA can help initiate the process in fathers and better equip them to contribute during the antenatal period and to future child development.

La afectividad paterno-fetal (PFA) se asocia con el nivel de apoyo emocional que los papás ofrecen durante el embarazo y que tiene implicaciones en cuanto a la seguridad y calidad del proceso de parto de la madre y las experiencias postnatales. Este estudio exploró las experiencias de PFA de los papás, incluyendo su comprensión del fenómeno y su manifestación. Se recogió la información a través de entrevistas con 10 futuros papás y los análisis siguieron un acercamiento fenomenológico interpretativo. Surgieron cuatro temas a partir de la información: el momento de activación del proceso; el estar consciente de la responsabilidad; la transición a la paternidad; y el conflicto emocional. La mayoría de los papás experimentaron el momento en que el proceso de parto se puso en acción como el punto que les aclaró la realidad de tener un bebé y el cual inició o intensificó los sentimientos de afectividad hacia el feto. Parientes varones de la familia y amigos con niños y grupos de educación antenatal ofrecieron apoyo a los futuros papás. Sin embargo, ellos se sintieron muy perdidos en su papel y algunos creyeron que no había apoyo suficiente para su salud mental. Los resultados indican que situaciones diferentes pueden activar el proceso de afectividad y que los papás anhelaban ser incluidos en el cuidado perinatal, pero experimentaron una falta de apoyo. Crear consciencia de la importancia de PFA puede ayudar a iniciar el proceso en los papás y equiparlos mejor para contribuir durante el período antenatal y al futuro desarrollo del niño.

L'attachement paternel-foetal (abrégé ici suivant l'anglais PFA) est lié au degré de soutien émotionnel offert par les pères durant la grossesse et a des implications pour la sécurité et la qualité du travail d'une mère et de ses expériences postnatales. Cette étude a exploré les expériences du PFA des pères y compris le compréhension du phénomène et de sa manifestation. Les données ont été recueillies durant les entretiens avec 10 futurs pères et l'analyse a suivi une approche phénoménologique interprétative. Quatre thèmes ont émergé des données: le moment de déclenchement; la prise de conscience de la responsabilité; la transition à la paternité; et le conflit émotionnel. La plupart des pères ont fait l'expérience d'un moment de déclenchement qui a clarifié la réalité d'avoir un bébé et qui a initié ou intensifié des sentiments d'attachement envers le fœtus. Des membres de la famille mâles, des amis avec des enfants et les groupes de préparation à la naissance ont offert du soutien aux futurs pères. Cependant ces derniers se sentaient très perdus dans leur rôle et certains pensaient recevoir un soutien insuffisant pour leur santé mentale. Les résultats suggèrent que des situations différentes peuvent déclencher le processus d'attachement et que les pères avaient vraiment envie d'être inclus dans le soin périnatal mais faisaient l'expérience d'un manque de soutien. La sensibilisation de l'importance du PFA peut aider à entamer le processus chez les pères et mieux les équiper à contribuer durant la période prénatale ainsi qu'au développement à venir de l'enfant.

[Experiences of Biological Children in Foster Families - A Qualitative Study on a Blind Spot in Foster Child Care]. / Erfahrungen von leiblichen Kindern in Pflegefamilien ­ Eine qualitative Studie zu einem blinden Fleck in der Pflegekinderhilfe.

The biological children of foster parents have received little attention in the literature and in research. This article presents the results of an in-depth interview study on the experiences of biological children (9 to 18 years). Data analysis showed that the children and adolescents interviewed described the relationship with the foster sibling positively overall, although they also addressed problematic and unsatisfactory aspects. In the family, they assume numerous responsibilities and actively contribute to the success of the foster relationship. However, they often feel inadequately prepared for fostering and dealing with the foster child. Recommendations for practice and further studies are derived from the results.

[How nurse experts in Swiss nursing homes shape their role development: A qualitative secondary analysis]. / Wie Pflegeexpert_innen in Deutschschweizer Pflegeheimen ihre Rollenentwicklung gestalten.

How nurse experts in Swiss nursing homes shape their role development: A qualitative secondary analysis Abstract. Background: In Swiss nursing homes, often registered nurses in expanded roles are responsible for developing and maintaining quality of care. These are qualified nurses with a heterogeneous educational background and extensive professional experience. However, little is known of how they develop their roles in nursing homes. Aim: The aim of this study is to show how nurses in expanded roles in nursing homes create the development of their professional roles. Method: Using a constructivist approach, we conducted a qualitative secondary data analysis of 14 semi-structured interviews with nurses in expanded roles from nursing homes in German-speaking Switzerland. The data were analyzed inductively using reflexive thematic analysis. Results: We found the constituent theme "vision as motivation" and a three-phase cycle of role development in the reports of the fourteen nurses in expanded roles. The vision of high-quality care of residents motivates nurses in expanded roles to shape and further develop their role in three phases: 1) Shaping their roles successively; 2) Developing their roles continuously; and 3) Realign their roles. Conclusions: Nursing professionals continuously adapt their roles to the shifting context to improve the quality of nursing care. To succeed, they and their supervisors need a shared vision for quality of care.

[Staffing situation in home-care services: A qualitative study on current and future challenges]. / Die Personalsituation in der ambulanten Pflege.

Staffing situation in home-care services: A qualitative study on current and future challenges Abstract. Background: There are increasing signs of staff shortages in home-care nursing in Germany. Home care providers have an increasing number of vacancies and the provision of care for people in need of care is a challenge. There are only a few approaches to planning personnel requirements in home care and the existing ones are rather complex. Aim and research question: The objective of this study was to gain insights into how staff deployment and staff planning currently take place in German home care services and to evaluate options for the development of staffing measures in home care. Methods: Qualitative, guideline-based expert interviews (N = 33) were conducted and analyzed. Experts were representatives of home care service providers, advisors of home care service providers and experts in the field of human resources management. Data analysis was performed by using content analysis. Results: From the experts' point of view home care services cannot ensure sufficient provision of home care services as needed by care-recipients due to staff shortages. Staff planning as well as recruitment and retention of staff pose an increasing challenge. Staff planning is mainly determined by contractual requirements and the reimbursement system. It is less determined by individual care-recipients' needs. The company size of home care providers depends on staff recruitment and turnover. Conclusions: The staffing situation will be a remaining challenge in the foreseeable future. It will go along with the task to ensure an adequate home care supply. Approaches that go beyond reimbursement driven personnel planning can contribute valuable hints for the future.

[Geriatric patients in the emergency department: Development of an ANP role from the perspective of the multiprofessional team]. / Geriatrische Patient_innen in der Notfallambulanz.

Geriatric patients in the emergency department: Development of an ANP role from the perspective of the multiprofessional team Abstract. Background: Ever-increasing numbers of geriatric patients lead to challenges in emergency departments (ED). Aim: The aim of this study is to identify the need for change in emergency care and discuss the integration of an Advanced Practice Nurse (APN) based on the practical experience of nurses and physicians. The focus lies on the interdisciplinary cooperation. Methods: Within the scope of a qualitative research approach, guided interviews with five physicians and seven nurses from two Austrian emergency departments were conducted. The qualitative content analysis according to Mayring was used for data analysis. Results: Five central main categories emerged. Nurses and physicians describe growing challenges in the care of geriatric patients in emergency departments due to a high workload, time pressure and lack of resources as well as a healthcare supply that does not meet the specific needs of geriatric patients. The integration of geriatric specialised nurses was associated with an improved patient care. Based on the structure, process and outcome criteria of the Nursing Role Effectiveness Model (NREM), the core components of an ANP role are described. Conclusion: The expansion of nursing competences and the development of defined care pathways should be further accelerated. The findings integrated in the NREM form the groundwork for the role description of the Geriatric Practice Nurse (GPN) in the ED.

Parent and practitioner perspectives on Circle of Security Parenting (COS-P): A qualitative study.

Circle of Security Parenting (COS-P) is an attachment-theory-informed program for parents of infants and young children. Designed for scalability, COS-P has been widely adopted internationally. Evidence for the program's effectiveness is limited, however, restricting capacity to make informed decisions about program allocation, and threatening ongoing program funding. To help address this evidence gap, this qualitative study explored the experiences and perceptions of 20 COS-P facilitators and 14 parent recipients in Australia, where COS-P uptake has been particularly widespread. Thematic analysis of combined interview and focus group data revealed a perception that COS-P primarily changes the lens through which parents view (a) their child, (b) themselves in the parenting role, and (c) the parent-child relationship, and that this was a pathway to increased empathy, compassion, and parenting confidence. Participants identified four components that underpinned program impact: key content, skills practice, group processes, and facilitator support. Although COS-P was considered suitable for broad application, limitations were noted. Findings can guide clinical application of COS-P and inform empirical research.

El Círculo de Seguridad - Crianza (COS-P) es un programa basado en la teoría de la afectividad para progenitores de infantes y niños pequeños. Diseñado con un enfoque de escala, COS-P ha sido ampliamente adoptado internacionalmente. La evidencia de su eficacia es limitada, sin embargo, lo cual restringe la capacidad de tomar decisiones fundamentadas acerca de la distribución de fondos y amenaza el continuo apoyo económico del programa. Este estudio cualitativo explora las experiencias y percepciones de 20 mediadores que facilitaban el programa COS-P y 14 progenitores que lo recibían en Australia, donde la aceptación de COS-P ha sido particularmente extensa. Los análisis temáticos de entrevistas combinadas y datos de grupos de enfoques revelaron una percepción de que COS-P cambia el lente a través del cual los progenitores ven (a) a su niño, (b) a sí mismos en el papel de crianza, y (c) la relación progenitor-niño, y que este era una trayectoria para incrementar la empatía, la compasión, así como la confianza en la crianza. Los participantes identificaron cuatro componentes que respaldan el impacto del programa: contenido clave, práctica de habilidades, procesos de grupo y apoyo del mediador. Aunque COS-P se consideró apropiado para una aplicación más amplia, se indicaron las limitaciones. Los resultados pueden guiar la aplicación clínica de COS-P y sustentar la investigación empírica.

Le Parentage Cercle de Sécurité (en anglais Circle of Security Parenting, soit COS-P) est un programme basé sur la théorie de l'attachement pour les parents de nourrissons et de jeunes enfants. Conçu pour son extensibilité le COS-P a été largement adopté au niveau international. Les preuves d'efficacité sont cependant limitées, ce qui restreint la capacité à prendre des décisions informées sur les allocations au programme et menaçant le financement continu du programme. Cette étude qualitative a exploré les expériences et les perceptions de 20 facilitateurs COS-P et 14 récipiendaires parents en Australie, ou l'adoption du COS-P est particulièrement répandue. Une analyse thématique consistant en une combinaison d'entretien et de données de groupes de discussion a révélé une perception que le COS-P change principalement le prisme au travers duquel les parents voient (a) leur enfant, (b) eux-mêmes dans le rôle de parentage, et (c) la relation parent-enfant, et que cela crée un chemin d'empathie, de compassion et de confiance de parentage accrue. Les participants ont identifié quatre composantes qui étaient l'impact du programme: un contenu clé, la pratique des compétences, les processus de groupe et le soutien au facilitateur. Bien que le COS-P soit considéré comme étant adapté à une application générale des limites ont été notées. Les résultats peuvent guider l'application clinique du COS-P et éclairer la recherche empirique.

[Adolescent Drop-Out from Psychodynamic and Cognitive-Behaviour Psychotherapy from the Therapist's Perspective: A Qualitative Interview Study in Germany and Switzerland]. / Therapieabbrüche Jugendlicher in psychodynamischer und kognitiv-verhaltenstherapeutischer Psychotherapie aus Therapeutensicht: Eine qualitative Interviewstudie in Deutschland und der Schweiz.

Therapy drop-outs in adolescence remain a prevalent and complex problem with inconsistent research findings: Although a number of possible predictors have been identified, such as difficult family situations and development-related autonomy efforts, the underlying mechanisms and processes are hardly explained. In this qualitative study, 24 interviews were conducted with resident child and youth psychotherapists. The therapists reported a self-chosen drop-out case from their practice. Additionally, they were asked about their views on what they consider typical for adolescent dropouts. The content analysis yielded factors relating to three topics as reasons for dropouts from the therapist's perspective. The area of therapy included themes such as setting variables or disagreement about therapy goals. The family and environment area included reasons concerning the family, e. g., lack of parental support or parents opposing therapy. Finally, reasons such as therapy being too demanding, lack of motivation or loyalty conflicts were assigned to the adolescents. To conclude, a sensitive handling seems to be necessary when trying to balance the adolescent's striving for autonomy and their therapeutic needs as well as finding the right dosage of parental involvement with parents who are often in need of treatment themselves.