The bereavement experiences of families of potential organ donors:a qualitative longitudinal case study illuminating opportunities for family care

OBJECTIVES: To illuminate opportunities for care in the context of deceased organ donation by exploring pre-existing family and healthcare professional characteristics, in-hospital experiences, and ongoing adjustment through the lenses of grief theory, systems theory, meaning-making, narrative, and organ donation literature. METHOD: Qualitative longitudinal case studies explored individual and family change in five Australian families who had consented to Donation after Circulatory Determination of Death at a single centre. Participants attended semi-structured interviews at four, eight, and twelve months after the death. FINDINGS: Family values, pre-existing relationships, and in-hospital experiences influenced first responses to their changed lives, understanding of the patient’s death, and ongoing family adjustment. Novel behaviour that was conguent with family values was required at the hospital, especially if the patient had previously played a key role in family decision-making. This behaviour and emerging interactional patterns were drawn into family life over the first year of their bereavement. RECOMMENDATIONS: Training that includes lenses introduced in this study will enable healthcare professionals to confidently respond to individual and family psychosocial needs. CONCLUSION: The lenses of grief theory and systems thinking highlight opportunities for care tailored to the unique in-hospital context and needs that emerge in the months that follow

Engagement in Online Postgraduate Nursing Programs:An Integrative Review

Demand for online education has increased in recent decades. Uptake of postgraduate nursing education in this mode is on the rise, yet many students do not achieve completion. Student engagement is vital to success in online postgraduate nursing programs. Technology enables a more efficient means of monitoring engagement, yet limited literature is available on how the design of online postgraduate nursing programs impacts student engagement. This integrative review aims to identify barriers and facilitators to engaging in online postgraduate nursing programs. Four databases, including Cumulative Index to Nursing and Allied Health Literature, Education Resources Information Center, Scopus, and Medline, were systematically searched to identify relevant literature published over the period 1990 to 2022. Fifteen papers met the inclusion criteria. Thematic analysis generated three themes: design and delivery, support and connectivity, and student factors and success. The findings of this review uncover the range of indiscriminate variables and experiences that students have with online learning, making engaging instructional design a complex process. Nursing faculty require time and resources to develop skills specific to delivering “distance” education without being distant to the students. This review concludes that online postgraduate nursing programs are not a panacea, with ethical issues identified for higher education providers.</p

The Experience of Enablement Within Nurse Practitioner Care:A Conceptual Framework

Patient enablement after consultations has not yet been adequately investigated among patients of nurse practitioners (NP) in primary health care. The lens of enablement and a qualitative parallel multistrand approach were used to explore patients’ experiences and NPs’ perspectives of consultations. Metainferences made from this study suggest NPs enable patients by creating opportunities for education and knowledge transference and building on patients’ strengths and promoting self-efficacy. Three existential components of the experience of consultations (ie, relationality, temporality, and corporality) also played a role. These findings were used to develop a conceptual framework of how patient enablement is experienced within an NP consultation. © 2017 Elsevier Inc