The impact of caring for family members with mental illnesses on the caregiver: a scoping review.

A large number of multidisciplinary, qualitative and quantitative research suggests that providing care for family members with mental health illnesses can have both positive and negative effects on the carers' wellbeing. However, to date a comprehensive overview and synthesis of literature that compares and contrasts positive and negative effects of family-caregiving on the carer is missing. To address this gap, this scoping review examines the effects of family-caregiving on carers' wellbeing. A Boolean search generated a total of 92 relevant articles that were included in the analysis. The results suggest that, to understand the effects of family-caregiving on the carer's mental and physical wellbeing, it is necessary to take a combination of situational and sociodemographic characteristics into consideration. Elderly, female, spousal-carers and primary-carers may be a group that is at risk of suffering from a lack of positive mental and physical wellbeing as a result of caring. However, the negative effects of caregiving can be balanced by extraversion, social support and religious or spiritual beliefs. Therefore, future interventions that aim to promote family caregivers' wellbeing may need to take personality, particular circumstances as well as cultural and personal beliefs into consideration.

Being reflexive in qualitative grounded theory: discussion and application of a model of reflexivity.

AIM: A discussion of the meaning of reflexivity in research with the presentation of examples of how a model of reflexivity was used in a grounded theory research project. BACKGROUND: Reflexivity requires the researcher to make transparent the decisions they make in the research process and is therefore important in developing quality in nursing research. The importance of being reflexive is highlighted in the literature in relation to nursing research, however, practical guidance as to how to go about doing research reflexively is not always clearly articulated. DESIGN: This is a discussion paper. DATA SOURCES: The concept of reflexivity in research is explored using the Alvesson and Skoldberg model of reflexivity and practical examples of how a researcher developed reflexivity in a grounded theory project are presented. IMPLICATIONS FOR NURSING: Nurse researchers are encouraged to explore and apply the concept of reflexivity in their research practices to develop transparency in the research process and to increase robustness in their research. The Alvesson and Skoldberg model is of value in applying reflexivity in qualitative nursing research, particularly in grounded theory research. CONCLUSION: Being reflexive requires the researcher to be completely open about decisions that are made in the research process. The Alvesson and Skolberg model of reflexivity is a useful model that can enhance reflexivity in the research process. It can be a useful practical tool to develop reflexivity in grounded theory research.

Understanding grounded theory.

Grounded theory is a systematic research approach involving the discovery of theory through data collection and analysis. In particular, the focus is on uncovering patterns in social life that individuals might or might not be aware of. This article provides a practical overview of grounded theory to guide the research process in this area. The article is aimed at the nurse researcher who has some knowledge of grounded theory and/or is considering using this method of inquiry.

Does registered nurse involvement in improving healthcare services, influence registered nurse retention?

Background: Registered nurses are 'critical' to population health, international responses to emergencies, epidemics and disasters. Retention of registered nurses (RNs) is an international nursing priority. In England, RNs are encouraged to be involved in improving healthcare services. This benefits quality of care, operational and financial performance. However, RN involvement in improvement may reduce RN retention. It is important to understand this relationship when developing effective RN retention strategies. Aim: The purpose of this research is to describe possible relationships between RN involvement in improving healthcare services and RN retention, using published 2018 data for National Health Service (NHS) Trusts in England. Methods: The relationship between RN involvement in improving healthcare services and RN retention was explored using a correlational design, involving secondary data from the annual NHS Staff Survey and Model Hospital. Results: In mental health NHS Trusts in England, a statistically significant, positive correlation of 0.24 was found between RN 'ab(ility) to make suggestions for improvement' and RN retention. In mental health NHS Trusts, a statistically significant correlation of 0.278 was found between RNs 'making improvements happen' and RN retention. In acute NHS Trusts in England, a statistically significant, negative correlation of -0.15 was identified between RNs 'mak(ing) improvements happen' and RN retention. Conclusions: The findings suggest that RN retention factors in mental health and acute NHS Trusts differ from community and specialist NHS Trusts in England. This is an important consideration for national RN retention programmes as a single approach to RN retention may not be effective across all healthcare settings.

Examining the effects of acquired limb loss on the family network: a grounded theory study.

BACKGROUND: Individuals with acquired limb loss are faced with various challenges. Family networks become important in facilitating coping and recovery, but the limited research into their own experiences has so far only examined spousal and parental carers. AIMS: This research aimed to: understand the experiences of acquired limb loss from the perspective of the family network; and to develop a theoretical model to explain how they experience limb loss of the other. The use of 'network' was adopted to include kin self-identified as family. METHOD: Participants (n = 14) were recruited nationally. Interviews were conducted in a process moving from unstructured, semi-structured and structured interviews, using Grounded Theory method. FINDINGS: A theoretical model was developed around the interaction of five core categories. Families witness the difficulties faced by the person with limb loss, leading to a responsibility to provide support. Families subsequently experience various challenges of limb loss; together with numerous emotional reactions. Various forms of coping are used in order to resolve these experiences. CONCLUSIONS: Families are involved in the processes and challenges of an amputation in another family member, regardless of aetiology, gender or relationship structure. The theoretical model can be understood through the integration of existing research. The issues identified indicate potential considerations for services supporting such families.IMPLICATIONS FOR REHABILITATIONThe challenges and emotions experienced by family members have potential consequences for the support offered to the person with limb loss.This could ultimately influence the physical and psychological rehabilitation of the person with limb loss.Services should support families in witnessing difficulties in the person with limb loss, adjusting to relational changes and managing health care systems.

Improving the awareness and care of veterans in healthcare services.

This article aims to raise awareness of veterans (people who have served in the UK military) who are receiving nursing care. Nurses will often provide care and treatment for veterans, so they should be aware of the potential health needs of this patient group to provide optimum care. Veterans should receive priority treatment where it relates to a condition that results from their service in the armed forces. Therefore, it is important for healthcare professionals to recognise if patients may be veterans and if their conditions are attributable to military service. Increased awareness of veterans is required in primary care services, as well as in healthcare professionals' education and training, to ensure that they gain access to appropriate care and support.

In defence of the viva voce: Eighteen candidates' voices.

BACKGROUND: The doctoral viva voce is an under-researched field, particularly from the point of view of doctoral candidates. With increasing numbers of health care professionals undertaking doctoral study, we can develop practice by listening to their 'living voices'. OBJECTIVE: To explore doctoral candidates' experiences of their viva. DESIGN AND METHODS: Using exploratory research and purposive sampling, eighteen participants who had undergone examination of their doctorate within the last five years were identified. Semi-structured interviews were used to explore these participants' experiences of their viva. RESULTS: Thematic analysis of the data demonstrated that: Candidates wanted to engage in academic argument but were not always provided the opportunity to do so; the viva voce examination was frequently an emotional experience, even for candidates who did not regard themselves as subject to such emotions, examiners were sometimes able to moderate the effect of these emotions; practical aspects of the examination were not always considered; issues of fairness were raised, both by successful candidates and by those who were required to resubmit. CONCLUSIONS: The viva voce examination, as experienced by candidates, is not always a fair one. We recommend engagement of the academic community to promote best practice in the "living voice" examination.

Ethics in the interface between multidisciplinary teams: a narrative in stages for inter-professional education.

An ethically problematic clinical case is used to illustrate the potential importance of understanding clinical ethics in an interdisciplinary context. Whilst much has been written on ethics education for multidisciplinary and interdisciplinary teams, we argue that it is important that both healthcare professions and healthcare teams are able to look outside their own disciplinary ethos and sometimes outside their formal teams when considering the ramifications of an ethical issue. A complex (fictional but based on the authors' pooled experiences) case involving the delivery of a new-born from a mother with HIV is used to illustrate this, because multiple clinical teams will be involved at different times and in parallel with one another.

Planning a research project.

The planning stage of any research project is one of the most important stages in the research process. This article offers insight into the important issues a researcher needs to consider when planning his or her research, including how to develop a research protocol, obtaining research funding, seeking academic, peer and social support, gaining research ethics and governance approval and planning a research schedule. Careful planning ensures that the research project is achievable and can be completed on time, with the funding available.