Global Qualitative Nursing Research最新文献

Suicidal ideation (SI) is interpreted through a biomedical lens across health care systems, framing it as a pathology requiring treatment and leading to approaches aimed at controlling or eliminating these thoughts. Within this dominant medical model, illness treatment and death prevention are prioritized, eclipsing attention to health and well-being. Our previous research shows that women make efforts to improve their health despite living with SI. Using a feminist grounded theory approach, we sought to understand how women with SI manage their health. Data from interviews with 32 Canadian women were analyzed using the constant comparative method, elevating the data to a higher level of abstraction. We found that women with SI manage health by making room to be OK, creating space within their environments that allows them to better manage unbearable psychological pain. Making room to be OK becomes possible through acceptance, social recognition that ending unbearable psychological pain is a legitimate health need. Approaches critical to helping women make room to be OK include offering spaces within healthcare and community settings where SI can be discussed without pressure to think or feel otherwise. These trauma- and violence-informed approaches diverge from dominant medical services that seek to control women's suicidality.

Advancing our intersectionality-framed program of work, this article positions nursing's social‑justice mandate within grounded theory (GT). We argue that constructivist grounded theory (CGT), while oriented to social justice, requires further development to address inequities faced by people at intersecting social locations. We integrate intersectionality as critical social theory and analytical tool to institute sustained intersectional thinking that heightens attention to power relations, contextual variation, and researcher positionality. Operationally, intersectionality expands core GT methods: memoing becomes a site for documenting assumptions, emotions, and the (in)visibility of structural forces; theoretical sampling is deliberately oriented to heterogeneity; and constant comparison is tuned to systems of racism, sexism, and classism across data sources. Drawing on our intersectionality‑informed CGT study of public health nurses working with refugee‑mothering women, we offer a practical blueprint of insights for equity‑driven GT and outline future congruence with ecofeminism, queer theory, Indigenous gender frameworks, and transfeminism to further strengthen qualitative methodologies and promote health equity.

This qualitative study explored the decision-making process regarding continuation of systemic therapy among older adults with advanced cancer, focusing on how treatment choices are interpreted within the context of aging and remaining life. Seventeen participants aged ≥70 years with recurrent or metastatic cancer receiving systemic therapy were recruited from two cancer centers in Japan. Semi-structured interviews were conducted and analyzed using a modified grounded theory approach. The analysis identified six interrelated categories describing a dynamic decision-making process. Central to this process was discovering a moderately acceptable state, which functioned as a turning point through which participants recalibrated expectations of treatment and health in relation to aging. This turning point enabled participants to integrate cancer treatment into the aging process rather than perceiving treatment and aging as competing forces. Throughout the process, adopting more flexible views of health shaped how participants evaluated treatment burden, partial effectiveness, and acceptability over time. These findings highlight treatment continuation as an evolving interpretive process grounded in aging and uncertainty, underscoring the importance of nursing practices that support older adults in reflecting on lived experiences and making treatment decisions aligned with their values in later life.

In Europe the incidence of patients living with liver cirrhosis is growing due to increasing alcohol consumption, increased life span and higher body mass index. Patients with decompensated liver cirrhosis are a vulnerable group of patients suffering from stigma, negative stereotyping and bodily limitations, needing close follow-up care through a holistic nursing care model. This study aimed to explore patients' experiences of living with cirrhosis-related ascites, and the follow-up care they receive in nurse-led outpatient clinics. A qualitative approach was employed using semi-structured individual interviews and inductive reflexive thematic analysis. Eight interviews were conducted and our analysis generated two major themes: "Coming to terms with the impact of ascites" and "My second home-building partnership roles." The first theme comprised three sub-themes related to dignity, embodied knowledge and loss of energy. The second theme comprised two sub-themes related to continuity of care and patient involvement in their care. The study provides valuable insights on how nurse-led follow-up care, through continuity, availability, commitment, patient education and patient involvement may relieve the anxiety and distress this patient group may experience due to having a serious disease with an unpredictable trajectory.

Healthcare researchers are increasingly using ethnographic methods to understand the social dynamics and cultural contexts of specific groups, such as clinical teams in hospitals and community clinics. Critical ethnography is a subtype of ethnography that mobilizes critical social theory to expose and challenge group inequities and power dynamics shaped by broader social, economic, and political conditions. Critical ethnography is particularly useful for understanding how providers interact with one another in complex and high-acuity environments such as emergency rooms and intensive care units. Given the varied approaches to critical theory and ethnographic methods, this critical review summarizes how critical ethnography has been conceptualized and applied to study providers in acute care settings. After conducting a comprehensive cross-database search, we extracted the following information from the 27 reviewed publications: paradigm, theoretical framework, axiology, positionality, data collection and analysis methods, approach to rigor, and research ethics considerations. After synthesizing key trends in literature, we identified and critically interpreted several themes, contradictions, and tensions present across the studies. Drawing on social science commentary on theoretical and methodological coherence, axiology, and citational practices in critical theory, this article provides several conceptual, ethical, and methodological considerations for the use of critical ethnography in healthcare research.

With an ageing population and increasing chronic illness, the need for palliative care is growing. Most people prefer to be cared for at home when possible, making it essential to understand the experiences of patients and families receiving care at home to ensure it aligns with their needs. This study aims, therefore, to synthesise the literature regarding patients' and family carers' experiences of palliative care at home. This systematic review employed the 6S model as an analytical lens, with an abductive approach to the interpretive qualitative meta-synthesis. A total of 6,080 unique citations were yielded by searches conducted in PubMed, Embase, CINAHL, PsycInfo and Scopus. The synthesis included a total of 19 studies, of which 9 explored patient experiences, and 10 addressed both patients' and family carers' perspectives on palliative care at home. Three interconnected enablers were identified: accessible palliative care, trusting relationships, and maintaining everyday life at home. These demonstrate how palliative care can help patients and family carers feel safe and supported at home by ensuring accessible care through reliable professional support, promoting trusting relationships grounded in collaboration and open dialogue, and helping patients and family carers maintain everyday life through empowerment and person-centred care.

In recent years, with the increased accessibility of online resources, digital storytelling (DST) has emerged as a valuable and expanding database for qualitative nursing and health researchers to explore patients' experiences, professional narratives, and community voices. While the current methodological literature offers various approaches for analyzing digital storytelling with regard to its specific content, many frameworks overlook the multilayered nature of these narratives and lack a systematic guide for navigating the complex data-analysis phase. This phase requires careful identification of the different layers of data and a structured evaluation of their significance, enabling researchers to justify analytic decisions regarding which layers of DST they chose to analyze, a choice that can inform nursing practice, education, and policy. This article proposes a multilayered data-analysis framework. The suggested framework categorizes DST along a two-axis matrix: one ranging from individual to collective, and the other from simple to stylized. To illustrate its practical application, four short hypothetical case studies situated within health and nursing contexts are presented. The discussion situates this framework within the broader sociopolitical, cultural, and ethical dimensions of health-related digital storytelling, underscoring its relevance for advancing nursing knowledge, enhancing culturally sensitive care, and contributing to patient-centered health research.

The rising prevalence of mental health disorders among children and adolescents presents a significant and ongoing challenge for healthcare and education systems. Child and adolescent mental health nurses are central to the early identification, ongoing monitoring, and provision of emotional support to young people and their families. Despite their essential contribution, research into their professional experience remains limited, particularly in regions where specialist services and qualified nursing professionals are scarce. This descriptive phenomenological study explored the role of nurses in addressing the mental health needs of children, adolescents, and their families in Castile and León (Spain), with the aim of identifying the principal challenges, needs, and strategies for delivering high-quality care. Seventeen nurses currently employed in these resource-constrained services participated in the study. Data were analyzed using Moustakas's phenomenological method. Six themes were identified, highlighting the complexity and high level of specialization required in child and adolescent mental health nursing. Findings emphasize the need to strengthen interdisciplinary collaboration, expand workforce capacity and service infrastructure, and promote greater family involvement in therapeutic processes. This study deepens understanding of the experiences of Castilian-Leonese nurses in this field and offers valuable insights to guide future research and innovation in mental healthcare provision.

School-based weight measurements are routinely used in public health surveillance and are intended to support the early identification of health risks. However, concerns have been raised regarding unintended consequences, and research on pupils' experiences remains limited. This study explored how upper secondary school pupils retrospectively reflect on being weighed in school. Semi-structured interviews were conducted with 16 adolescents aged 16 to 19 years in Western Norway, and the data were analyzed using systematic text condensation. Participants described responses ranging from neutrality to increased body awareness, body dissatisfaction, and, in some cases, the onset of eating disorders. Weighing can prompt peer discussions, including pressure to disclose one's weight and to engage in body comparisons. Organizational factors such as limited privacy, lack of information, and unclear voluntariness shaped experiences that could undermine the intended health-promoting purpose. These findings indicate that school-based weighting poses psychosocial risks that undermine its health-promoting aims and contribute to the broader debate over whether such practices should continue. To better align with health-promoting goals, school health services should ensure privacy, provide clear communication about the purpose and voluntariness of weighing, and offer opportunities for dialogue. Public health nurses should use sensitive and stigma-free communication when weight deviations are identified.

Healthcare providers employ various strategies to ensure continuous care for patients taking pre-exposure prophylaxis (PrEP) for HIV prevention. However, sustained engagement in care remains challenging, especially among populations at a higher risk of acquiring HIV, such as individuals who engage in high-risk alcohol use or have alcohol dependence. Understanding the provider-level factors-markers of quality care-that positively influence patient engagement remains underexplored. Through a descriptive qualitative approach and thematic analysis of 38 interviews with 14 participants who use PrEP and who screened positive for hazardous or harmful alcohol consumption (AUDIT scores >7), six major themes were constructed that characterize PrEP quality care: (1) Access to Care and Continuity of Treatment, (2) Positive Patient-Provider Relationships, (3) Educational Engagement, (4) Psychosocial Support and Motivation, (5) Financial Accessibility, and (6) Peer Support. Overall, quality care in the context of PrEP is multifaceted, encompassing efficient service provision, positive patient-provider interactions, accessible and well-defined health education, psychosocial reinforcement, affordability, and peer-based support systems. These findings underscore the need for holistic approaches to PrEP care that address logistical, relational, educational, and financial factors to enhance patient experiences and outcomes.