Usefulness of pedagogical design features of a digital educational resource into nursing home placement: a qualitative study of nurse educators' experiences.

BACKGROUND: The rapid advancement of technology-enhanced learning opportunities has resulted in requests of applying improved pedagogical design features of digital educational resources into nursing education. Digital educational resources refers to technology-mediated learning approaches. Efficient integration of digital educational resources into nursing education, and particularly into clinical placement, creates considerable challenges. The successful use of digital educational resources requires thoughtful integration of technological and pedagogical design features. Thus, we have designed and developed a digital educational resource, digiQUALinPRAX, by emphasizing pedagogical design features. The nurse educators' experiences of the usefulness of this digital educational resource is vital for securing improved quality in placement studies. AIM: To obtain an in-depth understanding of the usefulness of the pedagogical design features of a digital educational resource, digiQUALinPRAX, in supporting nurse educators' educational role in nursing home placements in the first year of nursing education. METHODS: An explorative and descriptive qualitative research design was used. Individual semi-structured interviews were conducted with six nurse educators working in first year of a Bachelor's of Nursing programme after using the digital educational resource, digiQUALinPRAX, during an eight-week clinical placement period in nursing homes in April 2022. RESULTS: Two main categories were identified: (1) supporting supervision and assessment of student nurses and (2) supporting interactions and partnerships between stakeholders. CONCLUSION: The pedagogical design features of the digiQUALinPRAX resource provided nurse educators with valuable pedagogical knowledge in terms of supervision and assessment of student nurses, as well as simplified and supported interaction and partnership between stakeholders.

Co-creating digital educational resources to enhance quality in student nurses' clinical education in nursing homes: Report of a co-creative process.

AIM: To report a methodological, co-creative approach for developing an interactive digital educational resource to enhance the quality of student nurses' clinical education in nursing homes and to elucidate the lessons learned from this approach. DESIGN: This study applied a co-design methodology that builds on participatory design principles. METHODS: Co-creating the digital educational resource included multiple sequential and interactive phases inspired by the design thinking framework. Workshops were employed as the primary co-creative activity. RESULTS: Seven separate homogenous or joint heterogeneous workshops were conducted with student nurses, nurse educators, registered nurse mentors and e-learning designers (n = 36) during the active stakeholder engagement phases to inform the educational content, design and functionality of the digital educational resource. These were informed by, and grounded in, learning theory and principles. CONCLUSION: Co-creative approaches in nursing education are an essential avenue for further research. We still lack systematic knowledge about the impact and benefits of co-created initiatives, stakeholders' motivations, barriers, facilitators to participation and the role of context in supporting effective co-creative processes to increase the quality of nursing education. IMPACT: This paper demonstrates how digital educational initiatives to enhance quality in clinical nursing education can be co-created with key stakeholders through a novel methodological approach inspired by design thinking. To date, the methodological development process of co-created educational interventions has received limited attention and compared with the content and theoretical underpinnings of such interventions, has rarely been addressed. Therefore, this paper facilitates knowledge exchange and documents vital aspects to consider when co-creating digital educational initiatives incorporating multistakeholder perspectives. This promotes a stronger academic-practice partnership to impact and enhance the quality of clinical nursing education in nursing homes. PUBLIC CONTRIBUTIONS: Student nurses, nurse educators, and registered nurse mentors worked alongside researchers and e-learning designers in the co-creative process.

Registered nurse mentors' experiences from co-creation in higher education targeting enhancement of mentorship practices in nursing homes: A qualitative study.

AIM: To explore registered nurse (RN) mentors' experiences of participating in the co-creation of a digital educational resource intended to enhance mentorship practices of first-year nursing students in clinical placement in nursing homes. DESIGN: An interpretive, descriptive qualitative study design. METHODS: Data were collected through two focus group interviews with 15 RN mentors (n = 15) participating in co-creative workshops. The co-creative process entailed four co-creative workshops conducted over a 17-month period (June 2019 to end of Oct 2020). Focus group interviews were conducted following the second and third workshops (i.e., in Dec 2019 and in Oct 2020) and data were analysed using thematic analysis. The consolidated criteria for reporting qualitative research (COREQ) checklist was used to report the findings. RESULTS: The analysis identified three themes: (1) co-creative reflective dialogues contributed to knowledge development and increased motivation among mentors; (2) the co-creative approach facilitated and validated the nursing academic-practice tripartite partnership; and (3) effectiveness of workshop structure in facilitating collaboration and mitigating power inequities. CONCLUSION: A co-creative process provides notable opportunities to advocate for mentorship needs and to enhance mentorship practices in nursing homes. IMPACT: Our study adds to the evidence on co-creation in nursing education, providing insights on the co-creative process and methodology. Higher Education Institutions are uniquely positioned to act as a co-creative arena for the academic-practice collaboration and for the development of educational resources within nursing education. Co-creation may facilitate stronger academic-practice partnership that may more effectively impact mentorship practices in nursing homes and health care system effectiveness. PUBLIC CONTRIBUTIONS: The RNs included in the study were involved in the co-creative process as active contributors informing the digital educational resource content and design.

A digital educational resource to support and enhance effective mentorship practices of nursing students in nursing homes: a qualitative study.

BACKGROUND: There is a grooving body of evidence emphasising the need to support and enhance effective mentorship practices for nursing students in nursing home placements, including strengthening of the pedagogical competence of registered nurse mentors. Owing to the necessity for multifaceted mentoring competence and the challenges of workload registered nurses are facing, the use of flexible digital educational resources has been suggested. However, current knowledge on the effectiveness of digital educational resources in enhancing mentorship practices in nursing homes is scarce. This study aimed to explore the perception of registered nurse mentors regarding the effectiveness of a digital educational resource, particular its usability and value-in-use in supporting and enhancing mentorship practices in nursing homes. METHODS: The study applied an exploratory descriptive qualitative design. Pre- and post-mentoring semi-structured focus group interviews were conducted among a total of 23 registered nurse mentors across three Norwegian nursing homes. The transcribed interviews were thematically analysed. Standards for reporting qualitative research were followed. RESULTS: The analysis yielded one pre-mentoring theme: (1) predominant enthusiasm and satisfaction and three post-mentoring themes: (2) enhanced confidence and motivation, (3) enhanced mentoring competence in supporting the nursing students' learning process, and (4) factors influencing the value-in-use of the digital educational resource. CONCLUSIONS: Digital educational resources support effective mentorship practices by enhancing the confidence and motivation in the mentor role and by enabling more goal-oriented supervision and assessment tailored to the learning goals of students. The implementation of digital educational resources to support and enhance effective mentorship practices is an important avenue for further research towards achieving high-quality learning environments in clinical nursing education in general and nursing homes. Based on the study findings, nursing educational institutions should consider offering digital educational resources to develop, support, and advance mentorship training, which may more effectively impact and improve the quality of clinical nursing education.

Exploring stakeholders' experiences in co-creation initiatives for clinical nursing education: a qualitative study.

BACKGROUND: Co-creation is an emerging approach in nursing education, wherein academics engage in multi-stakeholder collaborations to generate knowledge, ideate solutions, promote sustainability, and enhance educational quality. However, knowledge on stakeholders' experiences in participation in co-creation initiatives for nursing education is scarce. This study aimed to explore the experiences of student nurses, nurse educators, and e-learning designers in co-creation initiatives to design and develop a digital educational resource for clinical nursing education. METHODS: The study adopted an exploratory qualitative design. Data were collected via three separate semi-structured focus group interviews with student nurses (n = 7), nurse educators (n = 8), and e-learning designers (n = 3) who participated in co-creation workshops. Collected data were then thematically analyzed. RESULTS: Three themes related to the participants' experiences emerged: (1) The co-creation workshops were enjoyable, useful, and instructive; (2) power imbalances influenced the students' engagement; and (3) contextual factors influenced the participants' overall engagement. CONCLUSIONS: This study shows that co-creation through workshops is a novel, enjoyable, and instructive approach that facilitates knowledge exchange. It also highlights the needs and experiences of stakeholders, especially student nurses. However, the use of co-creation in nursing education presents some challenges. Recognizing and managing power differentials are essential for successful co-creation in clinical nursing education, alongside a mindset of collaboration and mutuality. Future research is required to systematize knowledge about the benefits and impacts of the processes and outcomes of co-creation initiatives, including stakeholders' motivation, barriers, and facilitators to participation in co-creation, to improve the quality of clinical nursing education.

Supporting the nurse educator in clinical education - a qualitative evaluation of a digital educational resource DigiVIS.

BACKGROUND: Despite the increased use of technology for teaching and learning in clinical nursing education, relatively little attention seems to be directed toward the usefulness of digital educational resources (DERs) to support nurse educators' educational role in clinical nursing education. METHODS: An interpretive descriptive qualitative study design was conducted to evaluate the usefulness of a DER to support nurse educators in clinical nursing education. Data were collected through two focus group interviews with part-time and novice educators (n = 5) and full-time, more experienced educators (n = 5), after they had overseen student nurses in nursing home placements. Data were analyzed using thematic analysis and Standards for Reporting Qualitative Research guidelines were used for this study. FINDINGS: The analysis identified three themes related to nurse educators' experiences of the usefulness of a DER to support their educational role while overseeing first-year students on clinical placements in nursing homes: (1) Provides academic support and a sense of security (2) promotes pedagogical efficacy, and (3) represents a flexible resource for educational planning. CONCLUSION: This study shows that a digital educational resource can be an efficient and useful supplementary strategy to support the nurse educator's role in clinical nursing education. Future research is required to systematize knowledge about the impact of DERs on orientation and training, as well as motivation and facilitators for, and barriers to, their use to enhance quality and strengthen the nurse educator's role in clinical nursing education.

Exploring mentorship practices in clinical education in nursing homes: A qualitative mixed-methods study.

AIMS AND OBJECTIVES: To explore registered nurses' mentorship practices of first-year nursing students in nursing home placements. BACKGROUND: Enabling nursing students to develop professional competence through clinical placements relies heavily on registered nurses' mentorship practices. Despite renewed interest in nursing homes as an important clinical placement setting, studies are scarce on registered nurses' mentorship practices in this context. DESIGN: An exploratory, qualitative mixed-methods design. METHODS: The data consisted of 126 h' observation of two registered nurse mentor-student dyads, supplemented by in-depth interviews (n = 12) with registered nurse mentors. The data were collected in three Norwegian nursing homes and analysed using content analysis. The consolidated criteria for reporting qualitative research (COREQ) checklist were used to report the findings. RESULTS: The registered nurses' mentorship practices of first-year nursing students in nursing home clinical placement were characterised by (1) variability and uncertainty in pedagogical supervisory approaches, (2) lack of management support and engagement of staff members in supervision, (3) lack of supervisory continuity and (4) a peripheral role in formal assessment discussions. CONCLUSIONS: A marginal nursing home context, alongside a mismatch between registered nurses' roles and first-year students' learning objectives, introduces considerable vulnerability that impedes effective mentorship practices. Targeted efforts to enhance mentorship practices in nursing homes are warranted to promote full use of the learning potential in this context. Developing and testing educational interventions is necessary to effectively enhance registered nurses' pedagogical competence, alongside engagement and support from nurse managers and nurse educators. RELEVANCE TO CLINICAL PRACTICE: This study provides insight into barriers to effective mentorship practices of first-year nursing students in nursing home placements. These barriers warrant attention from nursing home managers and nurse education institutions towards improvements that enhance effective mentorship practices vital for students' learning, professional growth and future recruitment to care for older people.

Exploring the formal assessment discussions in clinical nursing education: An observational study.

INTRODUCTION: According to EU standards, 50% of the bachelor education program in nursing should take place in clinical learning environments. Consequently, this calls for high quality supervision, where appropriate assessment strategies are vital to optimize students' learning, growth, and professional development. Despite this, little is known about the formal assessment discussions taking place in clinical nursing education. OBJECTIVE: The aim of this study was to explore the characteristics of the formal assessment discussions taking place during first-year students' clinical education in nursing homes. METHOD: An exploratory qualitative study was performed. The data consist of passive participant observations of 24 assessment discussions (12 mid-term and 12 final assessments) with first-year nursing students (n=12), their assigned registered nurse mentors (n=12) and nurse educators (n=5). The study was conducted in three public nursing homes in a single Norwegian municipality. Data were subjected to thematic analysis. The findings were reported using the Standards for Reporting of Qualitative Research. RESULTS: Three themes were identified regarding the characteristics of the formal assessment discussions: (1) adverse variability in structuring, weighting of theoretical content and pedagogical approach; (2) limited three-part dialogue constrains feedback and reflection; and (3) restricted grounds for assessment leave the nurse educators with a dominant role. CONCLUSION: These characteristic signal key areas of attention to improve formal assessment discussions to capitalize on unexploited learning opportunities.

Enhancing student nurses' clinical education in aged care homes: a qualitative study of challenges perceived by faculty staff.

BACKGROUND: Ageing populations are increasing the demand for geriatric care services. As nursing schools respond to this demand, more high-quality clinical placements are required, and aged care homes offer suitable placement sites. Although an aged care experience for students is beneficial, the basis for effective implementation of these placements is yet to be fully established. The aim of this study was to explore faculty staff perspectives on the challenges associated with providing effective clinical education in aged care homes for first-year student nurses. METHODS: An exploratory qualitative study was performed. Fifteen in-depth interviews were conducted with program leaders of nursing degree programs (n = 4), course leaders (n = 6) and practice coordinators (n = 5) in three Norwegian universities. Data were analysed using thematic analysis. The findings were reported using the Standards for Reporting Qualitative Research (SRQR). RESULTS: Five themes were identified regarding the perceived challenges to implementing effective clinical education in aged care homes: (1) low staffing levels of registered nurses limit the capacity to effectively host students; (2) prevalence of part-time teachers can compromise the quality of students' learning experiences; (3) tensions about the required qualifications and competencies of nurse teachers; (4) variation in learning assessments; and (5) lack of quality assurance. CONCLUSIONS: These challenges signal key areas to be addressed in quality assurance for effective aged care placements. Further research into the minimum staffing levels required to support student learning in the aged care setting is required. Methods for developing shared practices to facilitate learning in aged care homes need to address the prevalence of part-time teaching appointments. Further research into the levels of qualification and competence required to support student learning in aged care facilities can assist with setting standards for this sector. Finally, academic-practice institutions must engage with government officials and national nursing bodies to develop national standards for clinical education in aged care homes.

Nursing students' experience with clinical placement in nursing homes: a focus group study.

BACKGROUND: A renewed interest in nursing homes as clinical placement settings for nursing students has been prompted by the growing healthcare needs of an ageing population. However, if future nurses are to be enthusiastic about working in this healthcare context, it is essential that higher education institutions that educate nurses and nursing homes that provide placement experiences to students do so with a supportive, positive, and enriched approach. METHODS: To explore first-year nursing students' placement experience in nursing homes, we conducted an exploratory qualitative study in three city-based nursing homes in western Norway. Thirteen first-year nursing students participated in the study. Three focus group interviews were conducted to explore the students' placement experiences. Data were analysed using thematic analysis. The findings were reported using the Standards for Reporting Qualitative Research (SRQR). RESULTS: The analysis describes five themes relating to first-year students' placement experience in nursing homes; (1) variations in utility of pre-placement orientation and welcome at placement site; (2) a challenging learning environment; (3) spending considerable placement time with non-registered nurses; (4) considerable variability in supervision practices; and (5) a vulnerable and demanding student role. CONCLUSIONS: The research provides insight into the contextual characteristics encountered by first-year students that influence the quality of their placement experiences. Consequently, these characteristics impede access to important role models who lend support to a student's growth and professional development, preventing full utilisation of the learning potential offered in nursing homes. Hence, we propose that targeted efforts are warranted to foster positive placement experiences and enhance students' clinical education in nursing homes.

Health professionals' involvement of parents in decision-making in interprofessional practice at the hospital.

Health professionals have the responsibility of involving parents in decision-making regarding children's healthcare. This is to ensure that healthcare is customised to meet children's and families' needs and preferences. There is inadequate knowledge about health professionals' role in involving parents in these decisions in interprofessional practice in hospital settings. The aim of this study was to explore health professionals' construction of the phenomenon of parental involvement in decision-making about children's healthcare at the hospital and to identify how parental involvement can be improved. This explorative, descriptive qualitative study within a constructivist research paradigm selected a purposive sample of 12 health professionals who participated in individual semi-structured interviews. This qualitative data was used to construct a description of this phenomenon. The health professionals described ethical dilemmas and challenges related to parental involvement in decision-making while also providing technically safe, justifiable healthcare. Individual health professionals' involvement of parents in decision-making and the intra- and interprofessional collaboration between health professionals seemed to be of great importance to increase parents' active involvement in the co-production of children's healthcare. Further research is required to confirm the findings for generalisation.

Health-promoting leadership: An integrative review and future research agenda.

AIM: To provide a synthesis of the evidence of health-promoting leadership related to nursing by exploring definitions, core attributes and critical conditions. BACKGROUND: Increasing pressure in healthcare settings due to efficiency requirements, population ageing with complex illnesses and projected global shortage of nurses, is a potential threat to nurses' health and job satisfaction, and patient quality of care and safety. New ways of thinking about nursing leadership and evidence-based human resource management are required to improve nursing environments. DESIGN: Integrative literature review. DATA SOURCES: Eight databases were searched: Academic Search Premier, CINAHL, Emerald, ERIC, Web of Science, MEDLINE, Psychinfo and Science Direct. Included papers were published between 2000-2016. REVIEW METHODS: Of 339 papers, 13 were eligible for inclusion: eight qualitative and five quantitative. Studies were assessed for quality using standardized checklists. Framework-based synthesis was used, allowing for themes identified a priori to be specified as coding categories. This method also allows new themes to emerge de novo. RESULTS: Four themes were identified. There are multiple definitions of health-promoting leadership, along with description of the non-health-promoting leader. The health-promoting nurse leader engages in employees' health promotion, and takes responsibility for actions and maintains open communication, accommodating nurses' participation in change processes. Through competence development, the health-promoting organization builds capacity. CONCLUSION: Health-promoting leadership may be a promising path to optimizing nursing outcomes through holistic thinking, which emphasizes the importance of context. Accumulated research is required to build a stronger line of international research, with attention to underlying mechanisms, limiting conditions and behaviours known to health-promoting leadership.

Health-promoting leadership: A qualitative study from experienced nurses' perspective.

AIMS AND OBJECTIVES: To increase knowledge about experienced nurses' understanding of a health-promoting work environment, health-promoting leadership and its role in retention of staff in the nursing workplace. BACKGROUND: The quality of leadership is imperative in creating supportive and health-promoting work environments to ensure workforce productivity and ethically sustainable caring cultures. More knowledge on how leaders can promote health and sustainable careers among nurses is needed. At a time of current and projected nursing shortage, it is important to understand the reasons why nurses intend to remain in their jobs. DESIGN: Qualitative descriptive. METHOD: Twelve experienced registered nurses participated in an individual, digitally recorded, semi-structured interview. Data were transcribed verbatim and subjected to qualitative content analysis of manifest and latent content. RESULTS: A health-promoting work environment should provide autonomy, participation in decision-making, skills development and social support. Health-promoting leaders should be attentive and take action. CONCLUSION: Health-promoting work environments enable nurses to flourish. Having ample autonomy is therefore important to nurses so that when they face new challenges, they see them as a way of using and developing their competencies. Although most nurses claim their own leaders are not health promoting, they have a clear understanding of how a health-promoting leader should act. The health-promoting leader should not only be attentive and promote skills development, but also cater for nurses' meaningfulness. RELEVANCE TO CLINICAL PRACTICE: Nurses in primary health care understand a health-promoting work environment to be a workplace where they can develop, not only clinical skills, but also flourish as human beings. Further, nurses find it health promoting to have a meaningful job, using their competence to make a difference for patients and their families. Nurse Managers have an important role in facilitating meaningfulness in nurses' jobs to retain nurses as a valuable asset for the organisation.

Status of knowledge on student-learning environments in nursing homes: A mixed-method systematic review.

AIM AND OBJECTIVE: To give an overview of empirical studies investigating nursing homes as a learning environment during nursing students' clinical practice. BACKGROUND: A supportive clinical learning environment is crucial to students' learning and for their development into reflective and capable practitioners. Nursing students' experience with clinical practice can be decisive in future workplace choices. A competent workforce is needed for the future care of older people. Opportunities for maximum learning among nursing students during clinical practice studies in nursing homes should therefore be explored. DESIGN: Mixed-method systematic review using PRISMA guidelines, on learning environments in nursing homes, published in English between 2005-2015. METHODS: Search of CINAHL with Full Text, Academic Search Premier, MEDLINE and SocINDEX with Full Text, in combination with journal hand searches. Three hundred and thirty-six titles were identified. Twenty studies met the review inclusion criteria. Assessment of methodological quality was based on the Mixed Methods Appraisal Tool. Data were extracted and synthesised using a data analysis method for integrative reviews. RESULTS: Twenty articles were included. The majority of the studies showed moderately high methodological quality. Four main themes emerged from data synthesis: "Student characteristic and earlier experience"; "Nursing home ward environment"; "Quality of mentoring relationship and learning methods"; and "Students' achieved nursing competencies." CONCLUSION: Nursing home learning environments may be optimised by a well-prepared academic-clinical partnership, supervision by encouraging mentors and high-quality nursing care of older people. Positive learning experiences may increase students' professional development through achievement of basic nursing skills and competencies and motivate them to choose the nursing home as their future workplace. RELEVANCE TO CLINICAL PRACTICE: An optimal learning environment can be ensured by thorough preplacement preparations in academia and in nursing home wards, continuous supervision and facilitation of team learning.

Quantitative systematic review of multi-professional teamwork and leadership training to optimize patient outcomes in acute hospital settings.

AIM: To evaluate the impact of multi-professional teamwork (MPTW) and leadership training interventions on patient outcomes in acute hospital settings. BACKGROUND: Although investigations of teamwork and leadership training in acute hospital settings indicate that such programs can optimize patient outcomes, evidence-based recommendations on the content, duration and frequency of training programs associated with clinical evidence are still absent. DESIGN: Quantitative systematic review. DATA SOURCES: A search was conducted for relevant papers published during the period from 2000-February 2014. REVIEW METHODS: Twelve studies met the inclusion criteria and were appraised for quality and a risk-of-bias assessment was conducted. The review used a structured approach for literature search, data evaluation, analysis and presentation. A narrative summary was used to report results. RESULTS: Two MPTW and leadership interventions in stroke units have the greatest impact on patient outcomes in acute hospital settings. The interventions' impact on patient outcomes, explored in the ten remaining studies, is associated with great uncertainty due to several alternative explanations of the findings. CONCLUSION: Research designs that test such interventions must be improved before recommendations on the ultimate program can be made. This can be achieved by strengthening the design, methodology and descriptions of interventions and the use of more consistent patient outcomes. Building a safety culture adjacent to implementing teamwork and leadership training interventions is essential for improving patient outcomes.

Measuring mental well-being: A validation of the Short Warwick-Edinburgh Mental Well-Being Scale in Norwegian and Swedish.

AIMS: Mental health, currently one of the biggest challenges worldwide, requires attention and research. The aim of this study was to examine the psychometric properties of the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), and validate the scale for use in Norway and Sweden. SWEMWBS, which includes both hedonic and eudemonic principles of mental well-being, could facilitate useful future studies. METHOD: Data were collected among Norwegian and Swedish hotel managers (N=600) through self-rated online questionnaires. Tests used to examine the psychometric properties of the scale included descriptive statistics, correlations, reliability analyses, and explorative factor analyses in SPSS, as well as confirmatory factor analyses in AMOS. Robustness tests were run for gender and country subsamples. RESULTS: The scale showed adequate internal consistency and reliability. Results of the confirmatory factor analysis showed moderate fit in Norway and Sweden. In addition, the scale showed acceptable construct, criterion-related, and discriminant validity. CONCLUSION: The psychometric properties of the SWEMWBS were acceptable in both the Norwegian and the Swedish translations of the scale.

Parent participation in decision-making in health-care services for children: an integrative review.

AIM: To describe and synthesize previous research on parents' perceptions of their participation in decision making in child health-care services. BACKGROUND: Health policy in the area of user involvement emphasizes parent participation in decision-making (DM), thus ensuring that services are provided in accordance with their child's needs and enhancing parents' control over their child's health-care services. METHOD: A systematic literature search, covering the period January 2000 to February 2011, found 18 studies that met the inclusion criteria. The analysis process involved data extraction, reduction, comparison and synthesizing. FINDINGS: Three themes emerged: (1) relational factors and interdependence, (2) personal factors and attitudes and (3) organisational factors. CONCLUSIONS: Parents highlighted the importance of the parent-health professional relationship, professionals' competence and the possibility of varying the degree of participation in decision making. Challenges involved asymmetry in authority and power, professionals' attitudes and competence and organisational shortcomings in health-care services. Health professionals need to become more aware of their critical role and responsibility in involving parents in DM. IMPLICATIONS FOR NURSING MANAGEMENT: Health professionals' attitudes and competence can be improved by knowledge of user involvement and research and facilitating the inclusion of parents in decision making by influencing the culture, routines and resources in the health service.

A qualitative review of migrant women's perceptions of their needs and experiences related to pregnancy and childbirth.

AIM: A synthesis of the evidence of migrant women's perceptions of their needs and experiences in relation to pregnancy and childbirth. BACKGROUND: Despite the fact that all European Union member states have ratified human rights-based resolutions aimed at non-discrimination, there is a relationship between social inequality and access to pre-, intra-, and postpartum care. DESIGN: A qualitative systematic review of studies from European countries. DATA SOURCES: A search was made for relevant articles published between January 1996-June 2010. REVIEW METHODS: Data were analysed by means of thematic synthesis. RESULTS: Sixteen articles were selected, analysed, and synthesized. One overall theme; 'Preserving one's integrity in the new country' revealed two key aspects; 'Struggling to find meaning' and 'Caring relationships'. 'Struggling to find meaning' comprised four sub-themes; 'Communication and connection', 'Striving to cope and manage', 'Struggling to achieve a safe pregnancy and childbirth', and 'Maintaining bodily integrity'. 'Caring relationships' was based on the following three sub-themes: 'Sources of strength', 'Organizational barriers to maternity care', and 'The nature and quality of caring relationships'. CONCLUSION: The results of this review demonstrate that migrant women are in a vulnerable situation when pregnant and giving birth and that their access to health services must be improved to better meet their needs. Research is required to develop continuity of care and improve integrated maternal care.

Nurse educators' suggestions for a digital educational resource suitable for undergraduate student nurses' placement studies: Qualitative empirical research.

AIMS: To explore and describe nurse educators' suggestions regarding a digital educational resource addressing quality in placement studies for first-year student nurses in nursing homes. DESIGN: A qualitative, explorative, and descriptive research design. METHODS: Focus group interviews with eight nurse educators and individual interviews with six nurse educators. The interviews were audio-recorded and transcribed verbatim; subsequently, data were analysed in lines with content analysis as described by Graneheim and Lundman. RESULTS: The analysis revealed three main categories: 'Suggestions for a digital educational resource to strengthen and support nurse educators' role in follow-up students', 'Suggestions for a digital educational resource to complement and support interaction between stakeholders in placement', and 'Suggestions for a digital educational resource to facilitate student nurses' learning processes'. The categories were captured by the overarching theme, 'A digital educational resource facilitating interaction between stakeholders and students' learning processes. CONCLUSION: This study revealed nurse educators' suggestions regarding design elements, content, and use of a digital educational resource addressing placement studies for first-year student nurses' in nursing homes. Implications for the profession and/or patient care: Nurse educators should be involved in designing, developing, and implementing digital educational resources aiming to support student learning in nursing education placement studies. IMPACT: This study explored nurse educators' suggestions for a digital educational resource. They suggested a digital educational resource to strengthen and support their role, support interaction between stakeholders, and facilitate student nurses' learning processes. Further, they suggested a digital educational resource to be used as a supplement rather than as a replacement for nurse educators' physical presence in placements. REPORTING METHOD: The Consolidated Criteria for Reporting Qualitative Research reporting guidelines were used. No Patient or Public Contribution.

Clinical nurses' attitudes towards research, management and organisational resources in a university hospital: part 1.

AIM: The aim of this study was to determine clinical nurses' interest in and motivation for research. An additional aim was to identify management and organisational resources in order to improve nurses' research capacity in practice. BACKGROUND: Clinical nurses find conducting research challenging, which accords with observations of the continuing research-practice gap. METHODS: This descriptive cross-sectional survey sampled 364 clinical nurses from a university hospital on the west coast of Norway. RESULTS: The response rate was 61%. An increasingly positive attitude towards research emerged (40%), despite the fact that few were engaged in research-based activities. Clinical nurses emphasised that lack of designated time (60%), interest (31%) and knowledge (31%) constituted important research barriers, as did lack of research supervision and support (25%). Research supervision was one of the most significant needs to enhance clinical nurses' research skills, management and organisation of research activities (30%). CONCLUSION: Conscious efforts strategically built on clinical and academic collaborative networks are required to promote and sustain clinical nurses' research capacity. IMPLICATION FOR NURSING MANAGEMENT: The findings of this survey should be useful in the building of clinical nurses' research capacity.