BACKGROUND: Patient safety is a global health issue that affects patients worldwide. Providing safe care in the intensive care units (ICUs) is one of the most crucial tasks for nurses. Numerous factors can impact the capacity of nurses to deliver safe care within ICUs. Consequently, this study was undertaken with the aim of identifying the components of safe nursing care in ICUs.
METHODS: The current research constitutes a qualitative conventional content analysis study conducted from January 2022 to June 2022. The study participants comprised nurses, intensivists, nurse responsible for patient safety, paramedic, patients, and patients\' family member, totaling 21 individuals selected through purposive sampling. Data collection involved individual, in-depth, and semi-structured interviews. Subsequently, data analysis was performed utilizing the approach outlined by Graneheim and Lundman (Nurse Educ Today 24(2):105-12, 2004), leading to the identification of participants\' perspectives.
RESULTS: Three themes were identified as components of safe nursing care in ICUs. These themes include professional behavior (with categories: Implementation of policies, organizing communication, professional ethics), holistic care (with categories: systematic care, comprehensive care of all systems), and safety-oriented organization (with categories: human resource management and safe environment).
CONCLUSIONS: The findings of this study underscore the significance of advocating for safe nursing practices in ICUs by emphasizing professional conduct, holistic care, and safety-focused organizational structures. These results align with existing research, suggesting that by introducing tailored interventions and tactics informed by these elements, a safer environment for nursing care can be established for ICUs patients.

Background: Patient-centered care (PCC) improves HIV adherence and retention, though lack of consensus on its conceptualization and understanding how it is interpreted has hindered implementation. Methods: We recruited 20 HIV providers at Ryan White Programs in FL for in-depth interviews. Thematic analysis identified core consistencies pertaining to: 1) provider perceptions, 2) current practices promoting PCC. Results: Provider perceptions of PCC emerged under four domains: 1) holistic, 2) individualized care, 3) respect for comfort and security, and 4) patient engagement and partnership. PCC practices occurred at multiple levels: 1) individual psychosocial and logistical support, 2) interpersonal support within patient-provider relationships through respectful communication and active engagement, and 3) institutional practices including feedback mechanisms, service integration, patient convenience, and diverse staffing. Conclusions: Our findings highlight the central tenets of PCC as respectful, holistic, individualized, and engaging care. We offer an HIV-adapted framework of PCC as a multilevel construct to guide future intervention.
Patient-centered care perspectives among HIV care providersThis study explores HIV care provider perceptions of patient-centered care (PCC) by analyzing common themes that arose in interviews. We found that providers perceived PCC to be holistic, individualized care focused on respecting patient comfort and security and actively engaging them as partners in care. Providers discussed a variety of ways in which they practiced PCC at the individual service level through psychosocial and logistical support, through their interpersonal relationships with respectful communication and trust, and through more structured facility level policies and activities such as greater service integration and employing a diverse staff. PCC is rapidly becoming the new standard of care and this study hopes to offer insight into provider perceptions of PCC and examples of practice in the HIV care field.

UNASSIGNED: Pancreatic cancer is the fourth leading cause of cancer death overall, with 1.5 years life expectancy and minimal therapeutic progress in the last decades. Despite the burden it causes, there is little research on the needs of this specific population. This study aimed to explore healthcare professionals\' views on providing care and patients\' unsatisfied needs.
UNASSIGNED: This qualitative descriptive study was carried out at a cancer hospital in Northern Greece. A total of 12 participants (6 physicians and 6 nurses), treating patients with pancreatic cancer undergoing chemotherapy, were recruited through purposive sampling and underwent face-to-face semi-structured interviews. Data were analyzed through the thematic analysis method in NVivo12 software.
UNASSIGNED: The analysis highlighted two themes: \"needs of patients with pancreatic cancer\" consisted of 6 subthemes (\"daily activities\", \"symptoms management\", \"psychological support\", \"information needs\", \"multidisciplinary care\" and \"end-of-life care\") and \"needs of healthcare professionals\" had 3 subthemes (\"psychological support\", \"education\" and \"organizational support\"). Several symptoms are identified and affect the daily activities of these patients, and psychological support is important for the majority of them, even at the time of diagnosis. The participants express dissatisfaction with the absence of palliative care structures and services and stated that an interdisciplinary approach would improve the quality of care.
UNASSIGNED: Healthcare professionals report a wide range of unsatisfied needs of patients with pancreatic cancer, with the majority expressing their concerns about the complete lack of patient support in the last stages of their lives.
UNASSIGNED: Rak trebušne slinavke je četrti najpogostejši vzrok smrti zaradi raka. Pričakovana življenjska doba bolnikov z rakom trebušne slinavke je 1,5 leta, terapevtski napredek v zadnjih desetletjih pa je skromen. Kljub bremenu, ki ga povzroča, je zelo malo raziskav o potrebah te specifične populacije. Cilj te študije je proučiti mnenja zdravstvenih delavcev o zagotavljanju oskrbe in neizpolnjenih potrebah bolnikov.
UNASSIGNED: Ta kvalitativna deskriptivna študija je bila izvedena v bolnišnici za zdravljenje raka v severni Grčiji. V njej je sodelovalo 12 zdravstvenih delavcev (6 zdravnikov in 6 medicinskih sester), ki so s kemoterapijo zdravili bolnike z rakom trebušne slinavke. Sodelujoči so bili izbrani z namenskim vzorčenjem, z njimi pa so bili opravljeni osebni polstrukturirani intervjuji. Podatki so bili analizirani z metodo tematske analize v programski opremi NVivo12.
UNASSIGNED: Pri analizi sta bili izpostavljeni dve temi: tema »potrebe bolnikov z rakom trebušne slinavke« s 6 podtemami (»vsakodnevne dejavnosti«, »simptomatsko zdravljenje«, »psihološka podpora«, »potrebe po informacijah«, »multidisciplinarna oskrba« in »oskrba ob koncu življenja«) in tema »potrebe zdravstvenih delavcev« s 3 podtemami (»psihološka podpora«, »izobraževanje« in »organizacijska podpora«). Ugotovljenih je bilo več simptomov, ki vplivajo na vsakodnevne dejavnosti teh bolnikov, za večino teh simptomov pa je pomembna psihološka podpora, celo v času diagnoze. Udeleženci so izrazili nezadovoljstvo zaradi pomanjkanja struktur in storitev paliativne oskrbe ter navedli, da bi interdisciplinarni pristop izboljšal kakovost oskrbe.
UNASSIGNED: Zdravstveni delavci navajajo številne neizpolnjene potrebe bolnikov z rakom trebušne slinavke, večina pa je zaskrbljenih zaradi tega, ker bolniki ob koncu življenja ne prejmejo nobene podpore.

OBJECTIVE: To explore adolescents\' experiences of having a parent with heart disease.
METHODS: This qualitative study was performed with semi-structured individual interviews.
METHODS: Interviews were conducted with 33 adolescents between 13 and 19 years old, who either had a mother or father with one of these diagnoses: ischemic heart disease, arrhythmia, heart failure, cardiac arrest or heart valve disease. The parent had been ill for at least 6 months and up to 5 years. The study was carried out in Denmark, Norway and Sweden between 2019 and 2022. The analysis was inspired by Reflexive Methodology.
RESULTS: Three central themes emerged: Response to parental heart disease; Growing up ahead of time; and Strategies in a changed life situation. For the adolescents, heart disease was experienced as an acute and lethal disease that put their parents\' lives in danger. New routines and roles not only changed everyday life within the family but they also enhanced maturity and appreciation of life. To maintain a balance in life, the adolescents pursued normality and sought a safe space to have a normal youthful life.
CONCLUSIONS: In a period known to be significant for development, life with parental heart disease appeared as a biographical disruption because adolescents renegotiated their identity to manage their new life situation.
CONCLUSIONS: It is important to help younger family members adapt to parental heart disease by informing them about possible reactions and supporting them in how to adapt to their new life by seeking breaks and normality.
UNASSIGNED: No patient or public involvement.

OBJECTIVE: To explore healthcare workers\' experiences of the changed caring reality during the COVID-19 pandemic in Sweden.
METHODS: An online fully mixed-methods design.
METHODS: A web-based self-reported questionnaire with fixed and open-ended answers collected data from March to April 2021, analysed in three steps. First, free-text questions were analysed by qualitative content analysis. Then quantitative linear regression analyses using models covering stress and coping mechanisms were conducted. Finally, a meta-inference of qualitative and quantitative data emerged a new comprehensive understanding. The COREQ guidelines were used for reporting.
RESULTS: Meta-inferenced results of quantitative and qualitative findings show the pandemic was a traumatic experience for healthcare workers. Main theme; When work became a frightening experience in a dehumanized reality, comprised four themes: Entering unprepared into a frightful, incomprehensible world; Sacrificing moral values and harbouring dilemmas in isolation; Lack of clear management; and Reorient in togetherness and find meaning in a changed reality. Qualitative results comprised four categories; Working in a dehumanized world; Living in betrayal of ones\' own conscience; Lack of structure in a chaotic time and Regaining vitality together. Subdimensions comprehensibility and meaningfulness were associated significantly with post-traumatic stress disorder in multiple regression analysis. In multiple regression analysis, sense of coherence was the most prominent coping strategy.
CONCLUSIONS: Forcing oneself to perform beyond one\'s limit, sacrificing moral values and lacking management was a traumatic experience to healthcare workers during the pandemic. Reorienting as a way of coping was possible in togetherness with colleagues. There is an urgency of interventions to meet the needs among healthcare workers who took on a frontline role during the COVID-19 pandemic and to prevent mental health illness in future crisis.
UNASSIGNED: No patient or public contribution.
CONCLUSIONS: The pandemic outbreak exposed frontline healthcare workers to unparallelled stress shown as negative for their mental health in several meta-analyses and systematic reviews. In-depth understanding on experiences and how symptoms of post-traumatic stress disorder relate to coping mechanisms have been scarcely explored. This study contributes to understanding on healthcare workers\' experiences and the relation between lower sense of coherence and increased risk of developing symptoms of post-traumatic stress disorder.
UNASSIGNED: This study might guide how to prepare for resilience in future emergencies.

Parent-carers of children and young people (CYP) with mental health problems are at greater risk of poor outcomes, such as poor physical and mental health. Peer interventions for parent-carers of CYP with disabilities may improve parent-carer outcomes. This qualitative study investigates parent-carer experiences of using Parental Minds (PM), a multi-component peer support service for parent-carers of CYP with disabilities.
Twelve current service-users and four staff/volunteers at PM participated in one-to-one semi-structured interviews. All participants were white females, except for one service-user who was male. All interviews were recorded and transcribed verbatim. Thematic analysis of results was used to explore perceived benefits and disadvantages of PM and possible behaviour change mechanisms.
Three themes and eight subthemes were identified. Participants identified that internal and external factors influence their self-concept. The identification of themselves as a priority, and empowerment by reassurance and affirmation lead to improved parent-carer self-efficacy and agency to better care for their CYP. Participants described the difficulty of speaking honestly with friends and family about what they experience because it is perceived as different to what \"normal\" parents experience. From participant accounts, PM enables the construction of a support network and links external services to help manage family circumstances rather than offer curative treatment/intervention. Proactive and immediate advice which is constantly and consistently available was valued by participants. Participants expressed the need for a flexible range of service components which provide holistic support that encompasses both health and social care.
PM was perceived to be beneficial as a multi-component peer support service which increases parenting self-efficacy and empowerment, reduces isolation, improves access to services, and is tailored to individual needs. Parent-carers reported benefits in parenting and wellbeing practices. The development of a refined logic model will inform a future study of the effectiveness of PM on parent-carer outcomes.

OBJECTIVE: To explore patient experiences of intimacy and sexuality in those living with inflammatory bowel disease.
METHODS: An interpretative phenomenological study guided by van Manen\'s framework. Thematic analysis was conducted through interpretation and reflection on four existential domains: body, relationships, time and space.
METHODS: Data were collected during 2019-2021 from 43 participants via face-to-face or telephone interviews, as well as anonymous collection of narratives submitted via Google Forms.
RESULTS: Four themes were identified: Sexuality as lived incompleteness was the overarching theme representing the essence of the experiences of intimacy and sexuality. This theme covered the four main themes: Otherness of the body, Interrupted connectedness, Missing out on life fullness and Fragmented openness and each corresponded to an existential domain. Intimacy and sexuality are negatively affected by inflammatory bowel disease, with impact on quality of life. Patients experienced grieving multiple losses, from body image and control, to choice of partners and future opportunities. The four domains were difficult to separate and a close inter-relationship between each domain was acknowledged.
CONCLUSIONS: A model was developed to draw new theoretical insights to understanding the relationship between sexual well-being and psycho-emotional distress similar to grief.
CONCLUSIONS: First qualitative study to explore intimacy and sexuality experiences of those living with inflammatory bowel disease. Illness impact on sexuality has negative psycho-emotional implications as a result of losing the old self and capacity to have the desired relationships/sex life. A theoretical model was developed in an attempt to illustrate the close relationship of intimacy, sexuality and psycho-emotional well-being.
UNASSIGNED: Patients were involved in the study design.

OBJECTIVE: The aim of this study was to explore the relationship between sensory impairment and home care client\'s received care time.
METHODS: A cross-sectional multi-source study.
METHODS: Data from a self-reported staff survey on care time allocation were merged with registry data from the Resident Assessment Instrument registry (n = 1477). The data were collected during 1 week from 17 home care units in Finland in October 2021. The relationship between sensory impairment and clients received care time was examined using linear regression analyses.
RESULTS: The linear regression analyses showed that having vision impairment alone increased care time, while dual sensory impairment resulted in decreased received care time. Hearing impairment alone was not statistically significantly associated with care time.
CONCLUSIONS: The holistic care need of home care clients with dual sensory impairment may not be adequate. To ensure equality and the individually tailored care of clients, further attention must be paid to clients with sensory impairments, especially those with dual sensory impairment. Furthermore, the competence of home care workers to encounter and communicate with clients with sensory impairment must be developed to support the holistic care.
UNASSIGNED: The sensory impairments of home care clients must be identified in time and considered in care planning and encountering clients.
CONCLUSIONS: As there is a risk that clients with dual sensory impairment are not able to fully express themselves, it is imperative that further attention is paid to clients with sensory impairments, to better understand and support this vulnerable group. Increased awareness and continuous education are needed to better identify and support home care clients with sensory impairment.
UNASSIGNED: The study adheres to the STROBE reporting guidelines.
UNASSIGNED: No patient or public contribution.

UNASSIGNED: Tuberculosis (TB) has become a significant public health problem leading to a top ten morality. Directly Observed Therapy, Short-course (DOTS) is recommended as a critical element for curing and preventing TB. However, patients who have been living with TB often receive barriers and challenges, which may lead them to discontinue the DOTS treatment.
UNASSIGNED: This study aimed to understand patients\' experiences living with TB and receiving DOTS regimens.
UNASSIGNED: A qualitative descriptive study was employed. Semi-structured interviews were done among twenty tuberculosis patients selected using convenience sampling from the slum community in Bangkok, Thailand. The thematic approach was used for data analysis.
UNASSIGNED: Two main themes were developed: (1) troublesome disease and (2) emotional challenges. The first theme comprises three subthemes: confronting death, accepting lifestyle change, and DOTS challenges. The second theme consists of two subthemes: isolation from others and stigma.
UNASSIGNED: The findings could guide nurses and other healthcare professionals to develop the treatment guideline and the DOTS strategy using a holistic approach.

Patient participation is a cornerstone of the debate concerning healthcare professionals and patients of mental health centres. It constitutes an objective in government health policy in Scandinavia and other Western countries. However, little is known about the experiences of healthcare professionals in mental healthcare practices involving patients under their treatment and care.
This study aimed to explore the experiences of healthcare professionals with patient participation in the context of a mental health centre.
Four focus group interviews with healthcare professionals reflected differing experiences with unfolding patient participation in clinical practices in four wards of a mental health centre. A content analysis developed and framed themes.
Patient participation was based on structural conditions, which shows that predetermined structural methods predominantly control involvement. The structural methods are seen as promoting participation from the patient\'s perspective. At the same time, the methods also enable taking account of the individual patient\'s wishes and needs for involvement.
This study illuminates the meaning of patient participation in a mental health centre based on the social interactions among nurses and other healthcare professionals. The approach can contribute to dealing with the challenges of incorporating patient participation as an ideology for all patients in a psychiatric context, which is important knowledge for healthcare professionals.