Exploring the Implications of Patient Advocacy Outcomes among Practicing Nurses within the Hospital Context: A Qualitative Research

Background: Nurses are expected by their international code of ethics to advocate for patients to enhance safety and quality care. However, there is a limited understanding regarding the implications of specific patient advocacy outcomes experienced by nurses who advocate for patients in the hospital context. Purpose: This study explored the implications of patient advocacy outcomes experienced among practicing nurses in the hospital context. Methods: A qualitative, descriptive study design was utilized. Data was collected through purposive sampling and an in-depth semi-structured interview of 25 Registered Nurses in an acute care hospital. An inductive qualitative content analysis method was used, and the SRQR guidelines for reporting qualitative studies were followed. Results: This study revealed that nurses who succeeded in advocating for patients experienced feelings of happiness, increased confidence levels, increased work output, and job satisfaction. However, nurses who failed to succeed in advocating for patients experienced physical, emotional, and psychological consequences, which contributed negatively to the quality of patient care. Therapeutic communication and nurses’ commitment to intervene for patients emerged as vital qualities and skills required to succeed in the patient advocacy process. Conclusions: This study showed that patient advocacy has advantages. However, when nurses fail to succeed in their attempt to advocate for patients in clinical practice, the outcomes can negatively affect their own well-being and the quality of patient care delivery. These study results could promote awareness and help nurses to develop strategies for improving patient advocacy activities based on their experiences. Additionally, nurses can seek help, including psychological counseling, when necessary to enhance their optimal well-being as they care for their patients. Nursing educational institutions and hospital managers can support, train, and equip nurses with the required skills for enhancing positive advocacy outcomes. .

Nursing undergraduates’experiences of a simulation-centred educational program in hospice care in Macao:A qualitative research

Objectives:The study aimed to explore the experiences of nursing undergraduates participating in a simulation-centred educational program in hospice care in Macao,China.Methods:This descriptive qualitative study was based on the data collected through semi-structured individual interviews.Seventeen nursing undergraduates in Macao,China who attended the simulation-centred program in hospice care participated in this qualitative from November to December 2020.This program included three parts:introduction to hospice care(2 h),management of terminal symptoms(10 h),and hospice situation simulations(6 h).The interview data were analyzed using qualitative content analysis.Results:This study revealed two themes and six sub-themes.Theme 1 was developing competencies in caring for dying patients and their families,which included four subcategories of sensitivity to patients’needs,knowledge of hospice care,skills of symptom control and comfort supply,and communication skills.Theme 2 was improving the ability to self-care and support colleagues,which included two subcategories of reflection on life and death and sharing and supporting among colleagues.Conclusion:This program improved the competency of nursing undergraduates in hospice care and participants’learning experience was good.

Self-experience of buried seeds at auricular points in depressive patients with sleep disorder: a qualitative research

Objective To explore the self-experience of burying seeds at auricular points in depressive patients with sleep disorder,so as to seek possible approaches to improve the quality of care.Methods Eleven patients involved in a three-week randomized controlled clinical trial were purposefully interviewed by the experienced,qualified counselor.The process of thematic analysis was applied in this study,the self-experience was discussed and recorded,transcribed,and analyzed accordingly.Results Four themes related to self-experience were extracted,these included the deficiency in relevant support,passive acceptance,distrust,expectation and further advice.Conclusion There was an urgent demand of humane care and emotional support,which might improve compliance of the treatment to some extent in terms of health education.Additionally,medical practitioners should provide the patient with comprehensive support,professional health education,as well as standardize training program for TCM operator and control the operation’s quality.

Factors influencing the degree of participation in surgical decision-making among Chinese patients with prostate cancer:A qualitative research

Objective:There was increasingly demand of participation in surgical decision-making among Chinese patients with prostate cancer.However,due to the complex healthcare system and advanced care settings,it is quite challenging for the patients to gain sufficient support from the institute and the government.This research aimed to investigate the factors that impact the degree of participation in surgical decision-making among Chinese prostate cancer patients.Methods:A phenomenological approach of qualitative research based on the results of semi-structured interviews was adopted,to explore the influencing factors which hinder the participation in surgical decision-making.Consolidated Criteria for Reporting Qualitative Research were utilized.Up to 160 post-operative patients who had undergone radical prostatectomy along with 68 medical and nursing staffs,were purposively recruited in this research.This retrospective study was carried out from September 2018 to August 2019.After recording and transcribing the interviews,the interview materials were evaluated via the Colaizzi's seven step approach and the NVivo Version 10 software to analyze the interview content.Results:According to the analysis and summary of the interviews,there were three factors affecting the degree of participation in surgical decision-making.Firstly,insufficient information was provided by medical and nursing staffs because of their lack of time,proper communication skills,and career experience,as well as difficulties in the development of patient decision aid and inconsistent resource availability.Secondly,the cognitive level of decision-making among patients was relatively low due to poor psychological endurance,insufficient amount of education,senility,and less knowledge and information demand.Ultimately,decisions were constantly made by family members with/without patients.Conclusions:The degree of participation of Chinese prostate cancer patients in the surgical decision-making had much space for improvement.

Qualitative Research Methods in Spatial Urban Development： A Methodological Investigation of Approaches into Urban Development Based on Centralities in the Context of a Medium-Sized European City

Dispersed and peripheral spaces in the urban core are influenced both by the trend towards constant growth as well as social ways of life which are constantly evolving. Following a connotation, these two factors therefore play a crucial role in defining the alternation of urban space--in particular, that of the centers. The main focus of this research article is on the methodology used in the survey and evaluation of ＂centralities＂ as well as their developments over the past four decades （1974-2014） in approaches to urban development that has been developed in Graz.~ The analysis has drawn on the four editions （＂evolution＂） of approaches to urban development as conceived by the city of Graz in order to examine their verbal characteristics in regard to centralities. At the same time, the analysis does not examine presentations of plans which exist in supplementary forms （e.g., explanatory reports and supplemented plans）--it restricts itself solely to the various plans set out in the STEKs.2 The highest degree of accuracy has been applied to the notion of ＂centralis＂ in approaches to urban development. The goal of the research project was to depict the modulation of the notion of ＂centrality＂ in the urban context as a space-forming dimension. Furthermore, it clearly shows the extent to which the notion of the ＂centre＂ （in the widest sense of the word） has become distanced from qualitative, spatial development and at the current time of urban development is experiencing a sort of Renaissance. In the field of ＂urban development＂, architectural references in the context of＂centrality＂ have scarcely been researched. This has led to the opening-up of a complex interdisciplinary research field. In order to make the complex architectural determinants of ＂centrality＂ more accessible to the participating disciplines, approaches to urban development have been explored in the form of a social and spatial analysis.

A qualitative research of idiopathic granulomatous mastitis patients

Objective To thoroughly investigate the genuine emotional experience of patients with idiopathic granulomatous mastitis(IGM)pre-and post-treatment.Methods A purposive sampling method was adopted to select 13 patients with idiopathic granulomatous mastitis(IGM)as study objects during Feb to Dec 2016 who were all from the Department of Breast Surgery,the first affiliated hospital of Xiamen University.In addition,hermeneutic phenomenological method was performed in different ways including face-to-face interview,semi-structured interview,indepth interview,live recording and subject analysis of these collected data in hermeneutics rota⁃tion principle.Results The genuine emotional experience of patients with idiopathic granuloma⁃tous mastitis(IGM)pre-and post-treatment could be summarized into six subjects,through the thoroughly analysis of interview data,including change of sleep state,fatigue,lack of knowledge of disease,difficult to adapt to treatment state,worries and fears,and positive views of prosthesis implantation.Conclusion Lifestyle change among patient was prevalent pre-idiopathic granulo⁃matous mastitis,and patient always suffered from negative emotions and lack of disease knowl⁃edge once developed it.Therefore,it would demand medical staff to be committed to health edu⁃cation,communication with patients,and discovery problems in the first time.Moreover,posi⁃tive pertinent measures were appealed to improve confidence to overcome the suffering,and to ease or eliminate the negative emotion for recovery promotion.

Bibliometric analysis of qualitative researches in nursing in China from 2013 to 2019

Aims:To analyze the research status and development trend of nursing qualitative research in China from 2013 to 2019.Method:China national knowledge infrastructure(CNKI),Wanfang Data and VIP database were researched to include all related articles which were published from 2013 to 2019 about nursing qualitative research literature.NoteExpress literature management software and Excel were used to organize literature from annual distribution region,organization,core periodical,as well as the research object,research methods,data collection method and sampling method for metrology analysis.Results:2194 articles met the inclusion criteria,the number of articles is increasing year by year.Most of them come from Shanghai,Beijing,zhejiang and other developed areas.The top three institutions were the Huazhong University of Science and Technology,Tongji Medical College,Affiliated Union Hospital,Fudan university and Shanghai jiao tong university.And 835 of them were published in core journals.Research object are mainly divided into patient,nurses,nursing managers,etc.The included literature mainly adopts phenomenological research methods.Interview is the mainly data collection methods,and Colaizzi method is the mainly data analysis methods.Most articles use the method of purpose sampling.Conclusion:The qualitative research is becoming more and more attention by researchers in China.Qualitative research has covered clinical nursing,nursing education,nursing management,nursing psychology and other different nursing field.However,the selection of qualitative research methods,data analysis methods and related reports need to be further improved and standardized.

Perceptions and factors influencing exercise interventions in elderly patients with debilitating spinal surgery and healthcare professionals:A qualitative study

BACKGROUND Older spine surgery patients have a high incidence of debilitation,which can be managed with certain exercises.AIM To investigate the current status and influencing factors related to the knowledge of exercise intervention among patients and professionals.METHODS Descriptive research methods were used to classify and summarize patients and professionals’perceptions and factors affecting exercise interventions.Data were analysed using the Colaizzi seven-step analysis method to distill and refine themes.RESULTS A total of 7 themes were identified:(1)The current status of patients'exercise is unsatisfactory;(2)patients'health literacy is low,coupled with a lack of social and family support;(3)there are numerous challenges with systematic exercise interventions;(4)healthcare professionals acknowledge the importance and need for exercise interventions;(5)there's a pronounced willingness among patients to participate in exercise intervention programs;(6)healthcare professionals believe that exercise interventions are beneficial;and(7)participants offered invaluable insights and suggestions on perioperative exercise during spinal surgery.CONCLUSION To investigate the current status and influencing factors related to the knowledge of exercise intervention among patients and the related healthcare professionals to provide a reference for the construction of exercise management programs for these patients.

Bowel preparation experiences and needs before follow-up colonoscopy in older adult postoperative colorectal cancer patients: A qualitative study

BACKGROUND The bowel preparation process prior to colonoscopy determines the quality of the bowel preparation,which in turn affects the quality of the colonoscopy.Colono-scopy is an essential procedure for postoperative follow-up monitoring of colorec-tal cancer(CRC)patients.Previous studies have shown that advanced age and a history of colorectal resection are both risk factors for inadequate bowel prepara-tion.However,little attention has been paid to the bowel preparation experiences and needs of predominantly older adult postoperative CRC patients.AIM To explore the experiences and needs of older adult postoperative CRC patients during bowel preparation for follow-up colonoscopy.METHODS Fifteen older adult postoperative CRC patients who underwent follow-up colonoscopy at a tertiary hospital in Shanghai were selected using purposive sampling from August 2023 to November 2023.The phenomenological method in qualitative research was employed to construct an interview outline and conduct semi-structured interviews with the patients.Colaizzi's seven-step analysis was utilized to organize,code,categorize,summarize,and verify the interview data.RESULTS The results of this study were summarized into four themes and eight sub-themes:(1)Inadequate knowledge about bowel preparation;(2)Decreased physiological comfort during bowel preparation(gastrointestinal discomfort and sleep deprivation caused by bowel cleansing agents,and hunger caused by dietary restrictions);(3)Psychological changes during different stages of bowel preparation(pre-preparation:Fear and resistance due to previous experiences;during preparation:Irritation and helplessness caused by taking bowel cleansing agents,and post-preparation:Anxiety and worry while waiting for the colonoscopy);and(4)Needs related to bowel preparation(detailed instructions from healthcare professionals;more ideal bowel cleansing agents;and shortened waiting times for colonoscopy).CONCLUSION Older adult postoperative CRC patients'knowledge of bowel preparation is not adequate,and they may encounter numerous difficulties and challenges during the process.Healthcare professionals should place great emphasis on providing instruction for their bowel preparation.

Nurse anesthetists’perceptions and experiences of managing emergence delirium:A qualitative study

BACKGROUND This study employs a descriptive phenomenological approach to investigate the challenges anesthesia nurses face in managing emergence delirium(ED),a common and complex postoperative complication in the post-anesthesia care unit.The role of nurses in managing ED is critical,yet research on their understanding and management strategies for ED is lacking.AIM To investigate anesthetic nurses’cognition and management experiences of ED in hopes of developing a standardized management protocol.METHODS This study employed a descriptive phenomenological approach from qualitative research methodologies.Purposeful sampling was utilized to select 12 anesthetic nurses from a tertiary hospital in Shanghai as research subjects.Semi-structured interviews were conducted,and the data were organized and analyzed using Colaizzi’s seven-step analysis method,from which the final themes were extracted.RESULTS After analyzing the interview content,four main themes and eight subthemes were distilled:Inefficient cognition hinders the identification of ED(conceptual ambiguity,empirical identification),managing diversity and challenges(patientcentered safe care,low level of medical-nursing collaboration),work responsibilities and pressure coexist(heavy work responsibilities,occupational risks and stress),demand for high-quality management(expecting the construction of predictive assessment tools and prevention strategies,and pursuing standardized management processes to enhance management effectiveness).CONCLUSION Nursing managers should prioritize the needs and suggestions of nurses in order to enhance their nursing capabilities and provide guidance for standardized management processes.

Value of qualitative research in polycystic ovary syndrome

Objective This article aims to introduce the benefits of qualitative research and to discuss how such research can be applied to the study of polycystic ovary syndrome （PCOS）. Data sources Relevant articles were published in English as of May 2013 from Pubmed. Terms ＂polycystic ovary syndrome/PCOS, qualitative research and methodology＂ were used for searching. Study selection Articles studying PCOS with qualitative methods were reviewed. Articles associated with the use of qualitative research in clinical research were cited. Results Six qualitative studies related to PCOS were found in the literature search. These studies addressed different aspects in PCOS women including their womanhood, lived experience, information need, and experience of treatment with acupuncture. Five of these six studies used phenomenology as guiding theory. Conclusion Quantitative research has been the dominant approach in the field so far, qualitative research is relevant to the advancement of PCOS.

Ensuring that the outcome domains proposed for use in burns research are relevant to adult burn patients:a systematic review of qualitative research evidence

Background:There have been several attempts to define core outcome domains for use in research focused on adult burns.Some have been based in expert opinion,whilst others have used primary qualitative research to understand patients’perspectives on outcomes.To date there has not been a systematic review of qualitative research in burns to identify a comprehensive list of patientcentred outcome domains.We therefore conducted a systematic review of qualitative research studies in adult burns.Methods:We searched multiple databases for English-language,peer-reviewed,qualitative research papers.We used search strategies devised using the SPIDER tool for qualitative synthesis.Our review utilized an iterative three-step approach:(1)outcome-focused coding;(2)development of descriptive accounts of outcome-relevant issues;and(3)revisiting studies and the broader theoretical literature in order to frame the review findings.Results:Forty-one articles were included.We categorized papers according to their primary focus.The category with the most papers was adaptation to life following burn injury(n=13).We defined 19 outcome domains across the 41 articles:(1)sense of self;(2)emotional and psychological morbidity;(3)sensory;(4)scarring and scar characteristics;(5)impact on relationships;(6)mobility and range of joint motion;(7)work;(8)activities of daily living and self-care;(9)treatment burden;(10)engagement in activities;(11)wound healing and infection;(12)other physical manifestations;(13)financial impact;(14)impact on spouses and family members;(15)analgesia and side effects;(16)cognitive skills;(17)length of hospital stay;(18)access to healthcare;and(19)speech and communication.We suggest that sense of self is a core concern for patients that,to date,has not been clearly conceptualized in the burns outcome domain literature.Conclusions:This outcome domain framework identifies domains that are not covered in previous attempts to outline core outcome domains for adult burn research.It does so with reference to existing theoretical perspectives from the sociology and psychology of medicine.We propose that this framework can be used as a basis to ensure that outcome assessment is patient-centred.Sense of self requires further consideration as a core outcome domain.

Five Success Factors in Elite Interviewing for Qualitative Research

The purpose of this paper is to describe the challenges of elite interviewing and identify key factors that ensure success for qualitative researchers. The authors draw on their own experiences of interviewing powerful and influential members of government and various professions as well as tips from experienced researchers from the fields of social sciences and health. They identify five essential steps to successful interviewing： （1） identifying the key informants; （2） negotiating access; （3） background research and preparation; （4） site selection, presentation questioning approach, and execution; and （5） follow-up. Each of them is discussed in detail. The authors argue that the most important quality for the elite interviewer is self-management which involves developing an individual style of interviewing that is responsive to setbacks and unexpected opportunities

What are Different Research Approaches?Comprehensive Review of Qualitative,Quantitative,and Mixed Method Research,Their Applications,Types,and Limitations

There are different ways to examine and explain a study and its findings based on using numbers as a measure,a descriptive style,or a mixture of both.These three research approaches are quantitative,qualitative,and mixed methods that are commonly used by researchers in various research studies.However,with many options regarding the research design,it seems challenging for researchers to select the most appropriate approach based on the study and realize differences.This study provides a comprehensive review of qualitative,quantitative,and mixed-method research methods.Each method is clearly defined and specifically discussed based on applications,types,advantages,and limitations to help researchers identify select the most relevant type based on each study and navigate accordingly.

Experiences of Counselors Who Provided Psychological Support during COVID-19 Disaster: A Qualitative Study

Background:In crisis intervention sites such as infectious disease disasters,counselors are repeatedly exposed,directly or indirectly,to the traumatic experiences of victims.Disaster counseling has a negative effect on coun-selors,which can eventually interfere with the counseling process for disaster victims.Therefore,exploring and understanding the experiences of counselors is necessary to ensure that qualitative counseling for disaster victims can be continuously and efficiently conducted.Objectives:This study investigated the experiences of counselors who participated in mental health counseling as psychological support for victims of the COVID-19 disaster in Korea.Design:This is a qualitative study.Participants:The study participants comprised 18 counselors who had mental health professional qualifications of level 2 or higher and who had provided mental health counseling for COVID-19 confirmed cases and quarantined persons.Methods:Data were collected using focus group interviews from February 21 to May 29,2021.The duration of each interview was 60–90 min,and the data were analyzed using content analysis.Results:Thefinal theme was“Continuing to walk this road anytime,anywhere.”The par-ticipants’experiences were identified in four sub-themes:“being deployed to unprepared counseling,”“encoun-tering various difficulties,”“feeling full of meaning and value,”and“hoping to become a better counselor.”Conclusions:In order to continuously provide qualitative counseling in case of an infectious disease disaster such as COVID-19,it is important to develop a qualification and competency strengthening program through educa-tion and training to secure the crisis intervention expertise of counselors according to the characteristics of the disaster.In addition,a psychological support manual for each disaster should be prepared at the national level according to the type of disaster.

A Qualitative Study on the Psychological Experience of Pregnant Women with Abnormal Induced Abortion of Fetuses under 20 Weeks of Pregnancy

Objective: This paper aims to understand the psychological experience and needs of pregnant women who need induction of labor due to fetal abnormalities at less than 20 weeks of gestation through in-depth interviews. Methods: Using the phenomenological research method in qualitative research, 12 pregnant women with fetal abnormalities less than 20 weeks of gestation in the obstetrics department of a hospital from January to April 2023 were selected as the research objects for semi-structured in-depth interviews. After information was collected to saturation, Colaizzi content analysis method was used to sort out, analyze and refine the data. Results: Through the interview results, three themes were refined from the transcript. Those are: 1) the support and assistance needed during the induction of labor;2) inner feelings after labor induction;3) The vision of future life. Conclusion: Abnormal fetal development at <20 weeks of gestation can cause anxiety, depression, guilt, loneliness and other negative emotions for pregnant women, and they need to get corresponding psychological support, especially during the period from fetal abnormality to induction of labor, pregnant women have to experience many physical and mental suffering, and need to get the care of family, relatives, friends, medical staff and society. Medical staff can help them seek multi-directional support, provide professional knowledge, and help them with self-management.

A Qualitative Study of the Triage of Patients with Non-Traumatic Acute Abdomen

Objective: To explore the work experience of medical staff in the emergency department of a general hospital in the triage of patients with non-traumatic acute abdomen to formulate corresponding intervention measures and branch evaluation tools. Methods: With descriptive phenomenology as the research method, semi-structured interviews were conducted with the medical staff in a tertiary hospital in Nanjing from February 1st to 10th, 2023, and Colaizzi seven-step analysis was used to analyze the data. Results: A total of 17 emergency medical staff were interviewed in this study. Four themes were derived from the analysis of the data: the etiology of acute abdomen is complex, so it is difficult to categorize them: acute abdomen requires immediate treatment, but the treat will be delayed if the categorization is inaccurate;the high pressure of nurses and the accuracy in categorizing the patients are problems that should be addressed. Conclusion: The categorization of patients with non-traumatic acute abdomen is challenging. Therefore, it is necessary to carry out corresponding intervention and formulate appropriate departmental evaluation tools to improve the accuracy of categorization of patients with acute abdomen.

Laboratory Life:Twenty Years of Experimental Research with Locals and New Comers in Remote Rural Areas

Through the Latour concept of philosophy of science of laboratory life,the life course of a(geo)ethnographer researcher is analyzed,in order to establish the emotional or more personal dimensions that do not usually appear in research papers,but that have notable relevance in qualitative research.The text is structured in three large parts:A conceptual vision of the new experimental geography;the experimental geo-ethnography in old social,new social and place scenarios;and finally,the most personal and emotional dimension of the research.The first part establishes the geo-ethnographic experimental context and the assumptions in fieldwork,in addition to the geo-ethnographic reconciliation process.In the second part,the main qualitative research problems related to mobility,resistance and dynamics in place are established.Finally,in the third part the research perceptions,the personal experiences,and the emotional dimension of the research in remote rural areas are established.The laboratory life of a researcher,allows one to establish scalar conclusions and rigor in qualitative research.

A qualitative study on experience of nurses caring for patients with delirium in ICUs in China:Barriers,burdens and decision making dilemmas

Purpose:The purpose was to explore the experiences of nurses caring for patients with delirium in ICU in China.Methods:Semi-structured qualitative interviews were conducted with 14 ICU nurses in Beijing,China.Audio recordings of the transcripts were coded and analysed thematically.Results:The emergent themes reflected clearly similar experiences and were titled as follows:Internal and external barriers to care;Care burden:workload,psychological pressure and injury;Dilemmas in decision-making:balancing risks and benefits.Conclusions:The results of this qualitative study have provided a rich description of the perceptions of a sample of nurses caring for patients with dementia in Beijing.Clearly,the nurses suffered from their work experiences in several aspects:they lacked the knowledge and skills required assessing and managing the patients as early as possible;they were physically and psychologically stressed while looking after the patients and faced with dilemmas and compromises in their decision-making.

An exploration of the breastfeeding behaviors of women aftercesarean section: A qualitative study

Objectives:To explore the factors affecting breastfeeding behaviors in women after cesarean section.Methods:This is a qualitative study that used a phenomenological approach.This study used individual face-to-face interviews with 19 women who underwent a cesarean section in a Women and Children’s Hospital in China between July to September 2019.Information saturationwas used to determine sample size.Data were analyzed using a thematic content analysis method.Themes were developed based on the theory of planned behavior.Results:Thirteen(68.42%)had a planned cesarean section,and six(31.58%)cesarean sections were unplanned or emergent.Three major themes emerged:ambivalent attitude about breastfeeding,motivation to comply with the traditional cultural norms,and barriers and challenges.The motivating factors for breastfeeding after cesarean sections included perceived benefits of human milk,support from healthcare professionals,and responsibility for breastfeeding.The challenges for breastfeeding after cesarean sections included physical discomfort,knowledge and skills deficit of breastfeeding,lactation deficiency,and lack of knowledge and coping skills in managing their depressive mood after cesarean sections.There were a couple of neutral factors,such as the influences of family and peers.These factors could influence women either positively as facilitators or negatively as barriers.Conclusions:The findings can offer valuable information for healthcare professionals to help women breastfeed after cesarean sections.To promote women’s breastfeeding behaviors after cesarean sections,it is necessary to change women’s attitudes,belief systems,and the external environments and help them become more confident.