BACKGROUND: The aim of the study was to explore patients\' perspectives on diagnosis and treatment options for complicated monochorionic multiple gestations, and experiences with fetoscopic laser photocoagulation.
METHODS: This is a prospective cohort study of patients undergoing laser photocoagulation. Participants were interviewed during pregnancy and the postpartum period. Qualitative analysis was performed.
RESULTS: Twenty-seven patients who were candidates for laser photocoagulation were included. All elected to have laser photocoagulation. Patients chose surgery with goals of improving survival, decreasing the risk of preterm delivery, and improving the long-term health of their fetuses. They demonstrated accurate knowledge of the risks and benefits of treatment. Most (74%) felt that laser photocoagulation represented their only viable clinical option. Few seriously considered pregnancy termination or selective reduction (7% and 11% respectively). Postpartum, patients expressed no regrets about their decisions for surgery, but many felt unprepared for the challenges of preterm delivery.
CONCLUSIONS: Participants weighed treatment options similarly to fetal specialists. They acknowledged but did not seriously consider treatments other than fetoscopic laser photocoagulation and were highly motivated to do whatever they could to improve outcomes for their fetuses.

BACKGROUND: Leadership acumen, interprofessional relationships, and knowledge of healthcare operations are essential proficiencies for nurses to navigate the dynamic and complex healthcare landscape. The American Association of Colleges of Nursing (AACN) re-envisioned the academic nursing standards, The Essentials: Core Competencies for Professional Nursing Education (Essentials), to guide curricular development in preparing nurses with the aptitude to meet these challenges.
OBJECTIVE: The purpose of this project was to develop an innovative Master of Science nursing program to address the challenges facing the RN workforce.
METHODS: A relationship-based framework and the Analysis, Design, Development, Implementation and Evaluation (ADDIE) model were used to guide the development of the program using the Essentials to inform curricular design.
RESULTS: A Nursing and Interprofessional Leadership Master of Science program was designed comprising seven core courses with two tracks, Bachelor of Nursing and Post Graduate Option.
CONCLUSIONS: The program was created during the COVID-19 pandemic, which may have influenced the data used for the program\'s design.
CONCLUSIONS: Healthcare complexities are requiring nursing education to evaluate curricula for advanced knowledge and skills. A Nursing and Interprofessional Leadership Master of Science degree program guided by the Essentials was developed to meet this challenge.

OBJECTIVE: The aim of this article is to present the Nursing Educational Framework (NEF) as an opportunity to integrate core elements of a humanistic person/family-centered view and as guidance in structuring a relationship-based curriculum.
METHODS: Empirical and theoretical literature studies were reviewed to define the framework rationale and its components.
RESULTS: A deductive/inductive collaborative expert-informed approach was undertaken to develop this evidence-based codesigned framework. Its mission, along with unique components, implementation strategies, and outcomes, were successively integrated into the framework to guide nursing knowledge, learning, and curriculum development. A hermeneutic collaborative process of circular reflection was used in the development process.
CONCLUSIONS: The NEF contains central guiding principles and concepts that are intended to provide structural consistency across its included programs from a humanistic person/family-centered approach.
CONCLUSIONS: This comprehensive theory-guided framework allows educators to suggest specific directions for nursing practice within the nursing discipline and articulate nursing\'s unique and specialized approach to promoting excellent patient care outcomes. It can assist students to develop critical lens from a person/family-centered relationship-based practice approach.
PROPÓSITO: El objetivo de este artículo es presentar el Modelo Formativo de Enfermería como una oportunidad para integrar los elementos principales de una visión humanística centrada en la persona/familia y como una guía para estructurar un currículo basado en la relación enfermera/paciente. FUENTES DE DATOS: Se revisó literatura teórica y empírica con el fin de definir las bases fundamentales del modelo y sus componentes. SÍNTESIS DE LOS DATOS: Con el fin de desarrollar el modelo, se planteó una aproximación deductiva/inductiva con enfoque colaborativo y basado en expertos. Su misión, junto con los componentes conceptuales más específicos, estrategias de implementación y resultados, fueron progresivamente integrados en él, para guiar el desarrollo del conocimiento, el aprendizaje y la conformación curricular. Se empleó un proceso hermenéutico colaborativo de reflexión circular. CONCLUSIONES: El modelo contiene los principios guía y conceptos que dan consistencia estructural a todos los programas incluidos, desde un punto de vista humanístico y centrado en la persona/familia. IMPLICACIONES PARA LA PRÁCTICA DE ENFERMERÍA: Este amplio marco teórico permite a los educadores sugerir direcciones específicas para la práctica de la enfermería dentro de la disciplina y articular su enfoque único y especializado para promover excelentes resultados en el cuidado del paciente. Puede ayudar a los estudiantes a desarrollar una lente crítica desde un enfoque de la práctica basada en la relación enfermera/paciente ycentrado en la persona y la familia.

The Newborn Behavioral Observations (NBO) system is an infant-focused, family-centered, relationship-based tool designed to help parents become aware of their baby\'s abilities and to promote a positive parent-child relationship from the very beginning of birth.
The aim of this scoping review was to provide an overview of the key characteristics of the research and evidence accumulated over the past 17 years on the early NBO intervention for infants and their parents to identify the existing research gaps and to inform the future direction of research on the NBO System.
A scoping review guided by Arksey and O\'Malley\'s methodological framework and the PRISMA-ScR Checklist was conducted. This review used six databases (PubMed, CINAHL, MEDLINE, Google Scholar, Ichushi-Web, and CiNii) and was limited to English and Japanese language articles from January 2006, when the NBO was developed, to September 2022. Reference lists were also hand-searched to further identify relevant articles from the NBO site.
A total of 29 articles were selected. Through the analysis of included articles, four overarching themes were identified: (1) usage pattern of the NBO; (2) participants, setting, duration, and frequency of the NBO intervention; (3) outcome measures and effects of the NBO intervention; and (4) findings from a qualitative perspective. The review suggested that early NBO intervention had a positive impact on maternal mental health and sensitivity to the infant, confidence and knowledge of practitioners, and infant development.
This scoping review shows that the early NBO intervention has been implemented in a variety of cultures and settings and by professionals of various disciplines. However, research to evaluate the long-term effects of this intervention on a wider range of subjects is needed.

Background: Holistic care interventions include support for healthcare worker grief in a relationship-based care paradigm. Few programs support oncology healthcare worker grief and renewal prior to and during the COVID-19 pandemic. Objective: Describe \"knowledge of\" and \"engagement with\" a program about grief and resilience, Remembrance & Renewal (R&R). Method: An anonymous, electronic survey was available to healthcare workers at an academic, comprehensive cancer center. Demographic questions were analyzed against \"knowledge of\" and \"engagement with.\" Results: Of 105 responding to \"awareness of,\" 81 knew about R&R and 48 had \"engaged with\" the program. Statistically significant relationships between a characteristic and awareness were found for education (p  =  .03), setting (p < .01), and the frequency of learning about a death (p  =  .04). Statistically significant relationships between a characteristic and level of participation were found for profession (p  =  .02) and length of time in job (p  =  .03). Open-ended questions asked about impact of patient death (n  =  93), barriers to participation (n  =  54), and feelings after \"engagement with\" (n  =  45). Responses to impact, barriers, and feelings were respectively: sadness (75.3%); time (77.8%); and calm (75.6%). Conclusion: This study describes \"knowledge of\" and \"engagement with\" a holistic grief and renewal program. Further study will add to healthcare worker holistic self-care.

OBJECTIVE: The aims of this paper are (1) to present the results of the development, content validation and implementation study of the Relationship Competencies Guiding Tool; (2) to provide examples of how each item in the tool is reflected in clinical narratives written by nurses and justify the corresponding scores after the evaluation; (3) to present how the language and content of the narratives are interpreted with the tool and to describe an exemplar; and (4) to present barriers to and facilitators of the application of the tool.
BACKGROUND: From a person-centered care approach, the fostering of authentic relationships with patients is key to achieving therapeutic benefits. Therefore, it is essential to help nurses establish meaningful relationships with patients and help them acquire these abilities. Clinical narratives can be used as a way to promote reflective practice and professional competency development among nurses. A tool to evaluate the knowledge, skills, attitudes and values necessary for developing authentic encounters with patients through clinical narratives was developed, validated and implemented.
METHODS: An instrument-development study comprised of three steps: (1) conceptualization; (2) item generation and content validity; and (3) implementation of the tool and linguistic evaluation.
METHODS: This study was conducted in three major steps. Step one entailed conceptualization. Step two included the generation of items and content validation. In step three, the tool was used to independently evaluate 25 narratives. One of these narratives was also linguistically analysed to provide a comprehensive view of the interpretative strategies deployed by evaluators.
RESULTS: The Relationship Competencies Guiding Tool was developed, validated and implemented. It could help nurses work on nursing relationship-based professional competencies, guided the evaluators in the process of assigning scores to the corresponding items and helped the researchers identify certain barriers and facilitators before and during the narrative evaluation process.
CONCLUSIONS: The tool has been shown to be clear, relevant and conceptually and linguistically suitable for evaluating clinical narratives. The Relationship Competencies Guiding Tool could be applied to interpret how nurses reflect professional competencies in a clinical narrative as a preliminary step in the construction of a measurement tool.
CONCLUSIONS: From a person-centered relationship-based care approach, clinical narratives can be used to promote professional competencies between nurses. The Relationship Competencies Guiding Tool may help evaluate the knowledge, skills, attitudes and values necessary for developing authentic encounters with persons/families, as reflected by nurses\' clinical narratives.

The American Nurses Association\'s (ANA) recently published 4th edition of the Scope and Standards of Practice provides authoritative guidance on actions and behaviors that all registered nurses are expected to perform competently, regardless of role, population, specialty, or setting. The newly defined scope emphasizes the art and science of caring, compassionate presence, and the expectation that nurses be advocates for all, recognizing the connections of all humanity. It also makes frequent reference to whole-person care and highlights the importance of mindfulness by inviting nurses to reflect on how they can incorporate mindfulness and other integrative therapies into their self-care and professional practice. A new standard explicitly states that advanced practice registered nurses should have the competency to prescribe evidence-based traditional and integrative treatments, therapies, and procedures that are compatible with the consumer\'s cultural preferences, norms, and abilities. Integrative Nursing is aligned with the ANA Scope and Standards of Practice and provides a useful framework for practice that expands the reach of nursing across clinical and community settings and patient populations. In this article, exemplars highlight how Integrative Nursing is being implemented in clinical settings and nursing education programs.

Many professional medical and nursing organizations call for the reform and revision of formal nursing education. As nursing faculty work to prepare the next generations of nurses, the model of Relationship-Based Care is an ideal infrastructure for curriculum design. This paper responds to the call for transforming nursing education with a model that includes love, Relationship-Based Care, the I2E2 Model of Change, and an academic-practice partnership.

OBJECTIVE: Authentic client-centered practice is integral to positive health-care outcomes. This study examined facilitator perspectives of the See Me as a Person (SMAAP) relationship-based health-care curriculum.
METHODS: Qualitative phenomenological interviews were conducted with five facilitators of the SMAAP curriculum. The principal question and sub questions explored the facilitation and teaching methods, perceived impact of the curriculum, and the impact on health-care practice.
RESULTS: The concepts in the SMAAP curriculum are translatable into practice and may improve health care; organizational culture, leadership, and time constraints influence impact.
CONCLUSIONS: Relationship-based practice training can positively affect health-care delivery. Practitioners must be dedicated to the learning process; implementation should go beyond short-term training.

BACKGROUND: Low numbers of women in Queensland receive continuity of care across their maternity episode. The Office of the Chief Nursing and Midwifery Officer was tasked with strengthening maternity service delivery by reviewing and improving Maternity Models of Care and Workforce.
OBJECTIVE: Develop a decision-making framework (DMF) to increase maternity continuity of carer models.
METHODS: A literature review of models, specific to the public health maternity system, including suitability to rural areas and culturally appropriate to Aboriginal and Torres Strait Islander women was undertaken. Stakeholders informed development of the framework and toolkit. A prototype was built, tested and refined following input from rural, regional and metropolitan facilities.
RESULTS: 42 questions guide services to contextualise delivery of continuity of carer to local circumstances. Three rural sites have applied the i-DMF and toolkit. One used the tool for quality assurance of their existing midwifery continuity model, another has developed a midwifery continuity-of-carer model for Aboriginal and Torres Strait Islander women, the other is looking to establish a local rural birth service.
CONCLUSIONS: The i-DMF has potential to grow and sustain best practice maternity care, and particularly enable more women to receive relationship-based care with a known midwife.