First death experiences of newly graduated nurses: A qualitative phenomenological study.

Newly graduated nurses typically face death for the first time during the transition to their professional careers. This encounter can cause nurses to experience compelling emotions and make it difficult for them to manage and cope with the process of adaptation to the profession and the death process of the patient. This study aims to retrospectively examine and reveal the first death experiences of newly graduated nurses (N = 15) using a retrospective phenomenological method. Analysis of the responses of the newly graduated nurses revealed three themes: first encounter with death, nothing is like before, and support need. Newly graduated nurses realized that their first death experiences change their perspectives on life and profession and that nursing touches human life.

'It is not a mannequin disease': A lived experience narrative of living with bulimia nervosa.

WHAT IS KNOWN ON THE SUBJECT?: Bulimia nervosa is characterized by recurrent episodes of binge eating, inappropriate compensatory behaviours to prevent weight gain and excessive mental preoccupation with body weight and shape. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: In this paper, the feelings, thoughts and experiences of an individual with bulimia nervosa are explained, and the positive and negative effects of their experiences during the treatment process are emphasized. This paper offers advice to patients, relatives and healthcare professionals in recognizing and treating bulimia nervosa. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health nurses should organize training, seminars and conferences to raise awareness of society against bulimia nervosa, which is defined as a mannequin disease and therefore creates a positive perception. Mental health nurses, an essential part of the health system, should raise awareness of individuals and families about recognizing, monitoring and supporting the early symptoms of bulimia nervosa. ABSTRACT: INTRODUCTION: Bulimia nervosa is one of the areas where mental health professionals have difficulties due to its nature and course. It is important to understand the factors related to this problem in-depth to discover the dynamics unique to the individual that causes the difficulty, identify new perspectives on these dynamics and identify alternative behaviours, stop stubborn binge-eating attacks and prevent relapse. AIM: It is aimed to provide an in-depth insight into the nature, course and treatment processes of bulimia nervosa through the narrative of the lived experience of an individual living with this problem. IMPLICATION FOR PRACTICE: The perception of beauty seriously impacts the onset and later course of bulimia nervosa and draws attention to the fact that mental health professionals and media workers have important duties to change the concept of beauty equals being skinny, created in society and the media. Quality of perceived social support is very important in preventing, treating and rehabilitating bulimia nervosa. Adopting a more objective approach, which will prevent the positive or negative stigmatization of the disease in explaining bulimia nervosa to the public, should be adopted.

"Working in the emergency department is not a job; it's like a war" A narrative inquiry and interpretive phenomenology of the violence experienced by emergency nurses in Turkey.

AIMS: This study aims to reveal the violent experiences of nurses working in the emergency department and the meanings they attribute to them. METHODS: This research was conducted as narrative inquiry and interpretive phenomenology and recruited 15 nurses. Interviews with nurses actively working in the emergency department and who had been exposed to violence by patients or their relatives were conducted with a semi-structured interview form. The consolidated criteria for reporting qualitative research (COREQ) checklist was used. RESULTS: In the study, three themes were determined (1) Unpredictable event, (2) Interminable effects of violence, and (3) Like a bottomless pit. With seven sub-themes. CONCLUSIONS: This study underlined that violence applied to nurses by patients or relatives of patients in the emergency department is an unexpected situation that causes negative emotions. Violence affects all aspects of life and limits communication with the patient. Coping with a violent situation is challenging for nurses, and they demand support from the management.

A structural equation modeling analysis of the effects of nurses' spirituality and spiritual care on professional quality of life.

Spiritual care helps nurses establish a deeper connection with patients and meet their spiritual needs. Spiritual belief is thought to enable nurses to be more effective in their profession and positively affect their quality of life. This study aimed to investigate the effects of nurses' spirituality and spiritual care on quality of life. This study was designed as a descriptive cross-sectional study using structural equation modeling. A total of 221 nurses were included. Data were collected using the Professional Quality of Life Scale, and Spirituality and Spiritual Care Scale. The data were analyzed using descriptive statistics, correlational statistics, and structural equation modeling. Spirituality and spiritual care were negative predictors of burnout and positive predictors of compassion satisfaction. Spirituality and spiritual care decreased the level of burnout in nurses and significantly increased the level of compassion satisfaction. This study suggests raising nurse awareness of spirituality and spiritual care. Supporting nurses with professional training programs, including spiritual care, may benefit their quality of life.

"I am in a Fight with My Brain": A Qualitative Study on Cancer-Related Ruminations of Individuals with Cancer.

OBJECTIVE: This study aimed to determine the cancer-related ruminations from the subjective perspectives of individuals with cancer. DATA SOURCES: The study adopted a qualitative design, and participants (N = 16) were individuals with cancer. The analysis and interpretation of data were carried out according to the phenomenological-hermeneutical method. CONCLUSION: The following four themes emerged as a result of the analysis of qualitative data revealing the experiences of individuals with cancer: (1) attributed meanings to cancer-related ruminations, (2) perceived ruminations toward an uncertain future, (3) losing against intrusive ruminations, and (4) fighting with ruminations. The results underline the negative impact of ruminative thoughts on the disease process and social life of individuals with cancer. Individuals with cancer struggle with intense thoughts about the cause, treatment, and future of the disease from the moment they are diagnosed with cancer. In order to stop ruminative thoughts, individuals with cancer have tried solutions such as distracting activities and avoiding thoughts. IMPLICATIONS FOR NURSING PRACTICE: Nurses have an important role in catching verbal and nonverbal cues for rumination, as they are constantly together with individuals with cancer and make observations. Therefore, nurses can raise awareness about their ruminative thoughts and teach coping skills to individuals with cancer.

"Cancer Never Goes Out of Your Mind Even for a Single Second". Cancer-Related Ruminations From the Perspectives of Cancer Survivors.

OBJECTIVE: This study aimed to explore a deeper understanding of how cancer survivors experience and manage ruminative thoughts. DATA SOURCES: A descriptive qualitative design. The study was conducted with cancer survivors (n = 21). A semistructured interview guide was used for data collection, and content analysis method was implemented to gain a better understanding from the collected data. The study procedure and reporting adhere to the guideline for reporting qualitative research COnsolidated criteria for REporting Qualitative research (COREQ) checklist. CONCLUSION: Three main themes were developed: "Struggling within cognitions", "Coping", and "Required needs". The results highlight that cancer survivors have intrusive ruminative thoughts about cancer and need support to cope with these thoughts. It was also found that over time, they experienced changes in their perspectives, gained meaning, and were able to use deliberate ruminations. IMPLICATIONS FOR NURSING PRACTICE: Nurses have an effective role in providing care and determining the needs of individuals. Nurses can easily recognize intrusive ruminations, help cancer survivors raise awareness about the effects of ruminative thoughts on them, and support them in coping with intrusive ruminations using effective interventions.

Covid-19-related ruminations: A qualitative study based on the perspectives of the cancer survivors.

Cancer survivors can develop repetitive ruminations due to the unexpected and challenging effects of Covid-19. This qualitative descriptive design study aimed to comprehend the Covid-19-related ruminations from the subjective perspective of cancer survivors (n = 33), accessed via online Facebook self-help groups of a cancer association. A semi-structured interview guide was used for data collection followed by systematic analysis. Based on the descriptive analysis of the data, three main themes emerged-"Welcome to my life," "Cancer versus Covid-19," and "Fight versus lose"-based on cancer survivors' experience and having two subthemes each. The findings suggested that cancer survivors have many ruminations about cancer and the pandemic. Their ruminations were mainly concerned with the possibility of suffering from cancer again and catching Covid-19. Nonetheless, participants also had positive cognitions that they could overcome the pandemic as they have previously beat cancer. The findings may also offer a promising resource for nurses to understand the ruminations of cancer survivors and develop novel approaches and interventions to help cancer survivors replace their intrusive ruminations with deliberate ones.

The relationship between rumination, fatigue and psychological resilience among cancer survivors.

AIM AND OBJECTIVES: The study's purpose was to examine the association between rumination, fatigue and psychological resilience among cancer survivors. BACKGROUND: Cancer is a disease that causes difficult lives in individuals. Individuals can struggle with cancer-related fatigue (CRF) and ruminative thoughts during and after the disease process. However, it can also be seen that some individuals make sense out of their cancer experience and turn into stronger individuals. DESIGN: A cross-sectional design. METHODS: This study was conducted from February through November 2020. Data were collected from 159 cancer survivors using Event Related Rumination Inventory, Cancer Fatigue Scale and Connor-Davidson Resilience Scale. RESULTS: The findings showed that intrusive rumination significantly and negatively mediated psychological resilience but significantly and positively mediated with CRF. In contrast, deliberate rumination was significantly and positively mediated psychological resilience but significantly and negatively mediated with CRF. The effects of intrusive and deliberate rumination on fatigue were .431 (CI =0.042-0.635) and -.285 (CI = -0.163 to 0.491), respectively. In addition, the effects of intrusive and deliberate rumination on psychological resilience were -.253 (CI = -0.177 to 0.447) and .304 (CI = 0.045-0.124), respectively. CONCLUSIONS: The findings underline the mediating role of rumination on CRF and psychological resilience among cancer survivors. The findings also delineate the associations between rumination, CRF and psychological resilience, which differ based on rumination type. RELEVANCE TO CLINICAL PRACTICE: The findings are particularly important to oncology nurses, who are the main sources of psychosocial care. To support cancer survivors and mobilise their resources, oncology nurses should be made aware of the different types and effects of rumination. With the help of this awareness, oncology nurses can enhance managing intrusive rumination, replacing intrusive ruminations with deliberate ones, mobilising resources and promoting psychological resilience.

'Who would even want to talk about death?' A qualitative study on nursing students' experiences of talking about death with terminally ill patients with cancer.

OBJECTIVES: This study aimed to describe nursing students' experiences of talking about death with terminally ill patients with cancer. METHODS: The study adopted a qualitative design, and participants (n = 28) were final-year undergraduate nursing students. Data were collected by conducting in-depth semi-structured face-to-face interviews using a pilot-tested interview guide. The researchers followed a systematic data analysis procedure which is an appropriate method of analysis when aiming to create knowledge based on experiences and meanings from cross-case analysis. RESULTS: The responses of the nursing students were subsumed under the following three themes: (1) 'balance on the rope', (2) 'who would even want to talk about death' and (3) 'need to talk but …'. The findings suggest that many nursing students do not believe that they are competent enough to talk about death with terminally ill patients with cancer, even though they believe it is essential to end-of-life care. CONCLUSION: The findings underscore the importance of examining students' perspectives on death, which not only shapes their experiences of caring for terminally ill patients but also influences the quality of care. Further, students feel unprepared for talking to terminally ill patients with cancer and require support to avoid ignoring calls to speak about death.

Effects of interventions on rumination among individuals with cancer: A systematic review and meta-analysis.

AIM: This study aimed to examine the effects of interventions on rumination among individuals with cancer. DESIGN: A systematic review and meta-analysis. DATA SOURCES: Six databases (Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), PsyArticles, CINAHL, PubMed and Web of Science) were searched for relevant articles published between January 2000 and April 2020. REVIEW METHODS: The findings of experimental studies (including both experimental and control groups) related to interventions to effect rumination of individuals with cancer were included. Comprehensive meta-analysis was used to analyse the data. Hedges' g and 95% confidence intervals (CIs) were computed to estimate the effect. Additionally, funnel plots were created and heterogeneity was analysed using the I2 test. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used. RESULTS: Eight studies, which included a total sample of 856 individuals with cancer, were included. Half of the studies (n = 4) were randomised controlled trials, and six of them had conducted mindfulness-based interventions. The interventions had significant effects on rumination among individuals with cancer (z = -2.356, Q = 167.663, p < 0.001, I2  = 95.825%). The effect size was -0.894 (95% CI = [-1.638, -0.150]) and statistically significant (p < 0.001). CONCLUSION: The interventions had reduced rumination among individuals with cancer. These effects should be interpreted with caution because there was a high level of heterogeneity. However, only a few studies were included, and the findings underscore the need for further research. IMPACT: Many individuals are likely to benefit from rumination-focused interventions, especially mindfulness-based interventions. Nurses should utilise available opportunities to facilitate the optimal management of cancer-related rumination.