A qualitative systematic review on the experiences of homelessness among older adults

Adults who experience homelessness for an extended period of time also experience accelerated ageing and other negative impacts on their general health and wellbeing. Homelessness amongst older adults is on the rise, yet there are few systematic reviews investigating their experiences. Thus, this review classifies and synthesises qualitative research findings of studies published between 1990 to 2020 that have examined the needs and challenges of homeless older adults to elucidate their journey of homelessness. Seven papers met the requirements for inclusion. Three main themes were identified in the review: - (1) Pathways to homelessness, (2) Impact of homelessness, and (3) Outcomes and resolutions. This review collates current evidence on what is known about the experience of homelessness among older adults. In this study, homeless older adults identified a wide range of challenges associated with the experience of homelessness

A bibliometric analysis of missed nursing care research: Current themes and way forward

Background. Missed nursing care adversely affects nurse and patient outcomes in healthcare settings. Comprehensive bibliometric overview of research output in this field is limited, which restricts knowledge of this complex phenomenon in terms of research trends, author’s productivity, and thematic focus of scientific publications. This study aims to examine publications on missed nursing care by conducting a comprehensive bibliometric analysis. Methods. A search was performed in the Scopus database to identify 276 published studies on missed nursing care from inception to 20th February 2022. A bibliometric approach was used to comprehensively analyse retrieved publications based on trend, thematic focus, and scientific production. The R based software was used for data analysis. Results. The result from this bibliometric analysis indicates that the first study performed on the concept of missed nursing care was published in 2006. The United States of America (USA) ranked first in number of publications, and the study by Ball et al. published in 2014 was the most cited paper among the documents analysed. The results also identified names of prolific authors such as Kalisch B.J., Ausserhofer D., Willis E., Papastavrou E., Schubert M., Palese A., Simon M., and Aiken L. H. and relevant institutions in this field. Trending keywords identified included “missed nursing care,” “unfinished nursing care,” “patient safety,” and “care left undone.” In addition, thematic analysis showed emerging themes such as “neonatal intensive care unit,” “patient satisfaction,” “health resources,” “failure to maintain,” and “adverse events.” Conclusion. Findings from this study reveal a lack of bibliometric analysis in missed nursing care research. This study provides significant contribution by presenting a comprehensive overview on thematic focus, hotspots studies, and directions for future research in this field. Findings from this study can guide scholars in defining research focus and aspects of research on missed nursing care for future exploration

The nursing care of people with class III obesity in an acute care setting: A scoping review

Background Patients with Class III obesity pose unique challenges to health care staff and organisations. Care requirements of this population are unique and require specialised equipment and knowledge to meet these needs, maintain the quality of care, as well as the safety of patients and staff. Aim To synthesise the evidence on the nursing care of Class III obese patients in acute care settings. Methods A scoping review informed by JBI. CINAHL Plus, Medline, Scopus, Proquest Central, Web of Science and Embase were searched for primary research articles about the nursing management of people classified as Class III obese in acute care. Methodological quality of included studies was assessed; data extracted and synthesised into themes. Results Fourteen studies were included in the review. The synthesis generated three themes: Access to equipment, knowledge and training, patient care, and opportunities to improve care. Conclusions A paucity of high-quality evidence informs the nursing care of people with Class III obesity in acute care. Access to appropriate equipment dominated the findings of this review. Adequate provision of equipment and education on its use are required. Education to promote engagement with patients, adapting clinical practice and promotion of self-care could improve care and outcomes

Barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth worldwide: A systematic review

Background: Interventions aimed at reducing risky sexual behavior are considered an important strategy for averting Human Immunodeficiency Virus (HIV) infection among youth (15-24 years) who continue to be at risk of the disease. Enhancing intervention success requires a comprehensive understanding of the barriers and facilitators to interventions targeting youth. However, there is lack of a systematic review of both quantitative and qualitative studies to comprehensively identify and synthesize barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth worldwide. This review aimed to identify and synthesize barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth globally based on original peer-reviewed studies published in the last decade. Methods: The Joanna Briggs Institute approach for mixed methods systematic reviews and Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were used to guide this review. Nine electronic databases, Joint United Nations Programme on HIV/AIDS and World Health Organization websites, and reference lists of included studies and systematic reviews on barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth were searched for eligible articles. Studies that met the inclusion criteria underwent quality appraisal and data extraction. Findings were analyzed using thematic synthesis and underpinned by Nilsen, 2015\u27s Determinant Framework. Results: Overall 13 studies comprising of eight qualitative studies, four quantitative studies and one mixed methods study were included in the review. Several barriers and facilitators across the five Determinant Framework domains were identified. Most of the barriers fell under the characteristics of the context domain (e.g., gender-biased norms). The next important group of barriers emerged within the characteristics of the end users domain (e.g., fear of relationship breakdown). In terms of facilitators, the majority fell under the characteristics of the strategy of facilitating implementation domain (e.g., implementation of intervention with fidelity) and characteristics of the end users domain (e.g., fear of pregnancy or sexually transmitted infections). The next common set of facilitators appeared within the characteristics of the context domain (e.g., family support). Conclusion: This review identified several multi-level barriers and facilitators to HIV prevention interventions for reducing risky sexual behavior among youth. Multi-level and combination approaches are needed to address these factors and enhance intervention success

The validity and utility of violence risk assessment tools to predict patient violence in acute care settings: An integrative literature review

To examine risk assessment tools to predict patient violence in acute care settings. An integrative review of the literature. Five electronic databases – CINAHL Plus, MEDLINE, OVID, PsycINFO, and Web of Science were searched between 2000 and 2018. The reference list of articles was also inspected manually. The PICOS framework was used to refine the inclusion and exclusion of the literature, and the PRISMA statement guided the search strategy to systematically present findings. Forty-one studies were retained for review. Three studies developed or tested tools to measure patient violence in general acute care settings, and two described the primary and secondary development of tools in emergency departments. The remaining studies reported on risk assessment tools that were developed or tested in psychiatric inpatient settings. In total, 16 violence risk assessment tools were identified. Thirteen of them were developed to assess the risk of violence in psychiatric patients. Two of them were found to be accurate and reliable to predict violence in acute psychiatric facilities and have practical utility for general acute care settings. Two assessment tools were developed and administered in general acute care, and one was developed to predict patient violence in emergency departments. There is no single, user-friendly, standardized evidence-based tool available for predicting violence in general acute care hospitals. Some were found to be accurate in assessing violence in psychiatric inpatients and have potential for use in general acute care, require further testing to assess their validity and reliability

Impact of You Only Live Once: A resilience-based HIV prevention intervention to reduce risky sexual behaviour among youth in South Africa

Purpose: Interventions focused on promoting resilience or protective factors of youth have been proposed as a strategy for reducing risky behaviours associated with HIV infection among youth; however few studies have explored their effectiveness. This study assessed the impact of a resilience-based HIV prevention intervention (You Only Live Once) on risky sexual behaviours, resilience and protective factors of youth. Methods: A one-group pretest-posttest design was used. One hundred and ninety-seven youth aged 15 – 24 years were conveniently recruited from a non-profit organisation in Maluti-a-Phofung Local Municipality, South Africa and participated in a 12-session, resilience-based HIV intervention delivered over a 1-week period by trained adult facilitators. Outcomes of interest were assessed at baseline and 3-month follow-up using validated risky sexual behaviour measures, and Child and Youth Resilience Measure. Mixed effect logistic and linear regression models were formulated to assess the impact of the intervention on risky sexual behaviours; resilience and protective factors respectively. Results: Compared to baseline, participants at 3-month follow-up were 68 % less likely to have unprotected sex, 22 % less likely to regret their decision to engage in sexual activity and 0.4 % less likely to be pregnant or made someone pregnant. Conversely, participants at the 3-month follow-up had a higher propensity to engage in multiple sexual partnerships, transactional sex and intergenerational sex than baseline. Participants at 3-month follow-up had significant improvements in their scores of resilience, individual capacities and contextual factors that facilitate a sense of belonging (p \u3c 0.05). Conclusion: You Only Live Once intervention appeared to have mitigated some risky sexual behaviours, and improved resilience and protective factors over a 3-month period. These findings suggest that the intervention has ability to reduce risky sexual behaviours associated with HIV, and improve resilience and protective factors among youth in South Africa. Further evaluation of the intervention with a rigorous study design, larger sample size and longer period for follow-up is warranted

Revealing meaning from story: The application of narrative inquiry to explore the factors that influence decision making in relation to the withdrawal of life-sustaining treatment in the intensive care unit

This paper considers the effectiveness of narrative inquiry as a research method in collecting and analyzing stories from a purposive sample of intensive care nurses and doctors, regarding their perceptions of the factors that influence decision-making in relation to the withdrawal of life sustaining treatment. Delaying the withdrawal of treatment when it is clearly indicated, may result in unnecessary patient suffering at the end of life, distress for the family as well as moral distress for staff. In narrative inquiry participants’ first-hand accounts of their experiences are told through story; the focus of analysis is the story, with the story becoming the object of investigation. Initially, participants’ stories were restoried to produce narratives that were co-constructed between researcher and participant. Narrative analysis, employing McCormack’s lenses and the interconnected analytical lenses, facilitated vertical analysis of each narrative. Horizontal analysis through thematic analysis facilitated the derivation of themes that were consistent within or across narratives. We detail here how narrative inquiry methodology was effective in revealing the meaning participants gave to their decision-making experiences through story, offering a broader understanding of the factors that impact on decision-making regarding the withdrawal of life-sustaining treatment. The study’s findings were powerful, derived from narratives rich and thick in description, depicting a multi-dimensional interpretation of the participants’ perceptions of their decision-making experiences. Participants experienced transformative learning through the narrative process, which led to changes in ways of working in the study setting. Recommendations arose to enhance clinical practice and education in this vital area of practice as a result of this study. The application of narrative inquiry enabled the discovery of significant findings as an avenue to challenge legislation and current opinion regarding the autonomy and role of the family in decision-making

Traditional methods for managing illness in newborns and infants in an Arab society

Aim: This study explored self‐management practices in relation to traditional methods for managing illness in newborns and infants and the implications of these practices on infant health. Background: Self‐medication with folk remedies is believed to have short‐ and long‐term impacts on well‐being. Little is known about how mothers in Arab societies used their traditional beliefs and practices in self‐managing their newborns’ and infants’ health. Methods: Data were collected from five focus groups using open‐ended questions with 37 mothers. Participants were selected using snowball sampling and were recruited from four different cities in Jordan between June 2016 and August 2016. Ethical approval: All identifying information regarding the study participants has been omitted, and this study was approved by the Academic Research Committee at the University of Jordan. Findings: Mothers were more willing to try herbal remedies, traditional massage and certain foods to self‐manage their infants’ health. Folk remedies were not restricted to traditions handed down through generations, but included a representation of newly emerged trends towards ‘safety’ or ‘nature’. Conclusions: While the use of folk remedies have been handed down generations as customs, today, virtual support groups and social media provide modern resources for folk remedies’ promotion in care and self‐management. Implications for nursing and health policy: Nursing and health policymakers can use our findings for planning and developing strategies and health policies that increase public awareness about adverse health effects associated with herbal remedies. Such strategies are likely to be facilitated through partnerships between nursing and midwifery education institutions, antenatal clinics and social media in the region

Staff perceptions of the effectiveness of managerial communication during the COVID-19 pandemic: A cross-sectional study

Aims: This work aims to explore staff perceptions of (1) the effectiveness of organizational communication during the COVID-19 pandemic and (2) the impact of organizational communication on staff well-being and ability to progress their work and patient care. Background: Effective coordination and communication are essential in a pandemic management response. However, the effectiveness of communication strategies used during the COVID-19 pandemic is not well understood. Design: An exploratory cross-sectional research design was used. A 33-item survey tool was created for the study. Methods: The study was conducted at a tertiary teaching hospital in Western Australia. Convenience sampling was used to recruit participants from nursing, medical, allied health services, administrative and clerical, and personal support services (N = 325). Data were collected between December 2020 and May 2021. Results: Overall, all occupational groups found working during the COVID-19 pandemic stressful, and all groups wanted accessible and accurate communication from management and new policies, procedures, and protocols for future outbreaks. Conclusions: The use of occupational group-relevant strategies and COVID-19 protocols, as well as the on-going use of email, face-to-face meetings with debrief sessions, are needed to improve communication and support staff to fulfil their roles