The human factor.

Background:Rheumatoid Arthritis (RA) is a chronic inflammatory disease that affects various systems of the body. The present study was conducted with the aim to explain the lived experiences of Iranian patients with RA.Materials and Methods:According to the research question, the phenomenological research approach was used. The participants were selected through purposive sampling, and sampling was continued until data saturation was achieved. The data was collected by conducting unstructured interviews and using an audio recorder. To interpret the data, an interpretive/hermeneutic approach was implemented using Van Manen's method. In addition, Lincoln and Guba's criteria were used to evaluate data robustness.Results:A total of 24 participants participated in the study. Overall, 145 basic concept codes were extracted which were classified into the four main themes of self-management with the participation of the family, spiritual resilience in the face of existing problems, the tendency to hide the disease, and the fear of an uncertain future.Conclusions:It is recommended that care providers use the findings of this study to develop care plans in the various aspects of the physical, mental, social, and spiritual needs of patients with RA based on their concerns and deep experiences. It is also suggested that other qualitative research approach methodologies such as grounded theory for explaining the process of patient care and providing an appropriate model, or action research for solving the problems of hospitalized patients through suitable care at home be implemented.

Job satisfaction among nurses is a critical determinant of healthcare quality and workforce stability. Extended work shifts, particularly the 12-hour model, are increasingly adopted worldwide but remain controversial in their impact on nurse well-being and patient care. This study examined the job satisfaction of Filipino nurses employed locally in the Philippines and overseas Filipino worker (OFW) nurses in Saudi Arabia, both working on 12-hour shifts. A phenomenological research approach was employed, guided by Herzberg’s Two-Factor Theory. The study used a purposive sampling technique, selecting 20 registered nurses. The findings revealed that while nurses in both countries generally favored 12-hour shifts over traditional 8-hour shifts due to fewer workdays, greater continuity of care, and cost savings, Saudi-based nurses expressed higher satisfaction overall. The primary differentiator was compensation and institutional support, with Philippine nurses indicating dissatisfaction related to low salaries and limited organizational recognition. The results of the study highlighted the importance of intrinsic and extrinsic motivators in shaping satisfaction, recommending strengthening policies on standardized shift systems, competitive remuneration, and retention-focused management strategies in the Philippines.

The authors report the latest findings from a 32-year longitudinal study of 269 back-ward patients from Vermont State Hospital. This intact cohort participated in a comprehensive rehabilitation program and was released to the community in a planned deinstitutionalization effort during the mid-1950s. At their 10-year follow-up mark, 70% of these patients remained out of the hospital but many were socially isolated and many were recidivists. Twenty to 25 years after their index release, 262 of these subjects were blindly assessed with structured and reliable protocols. One-half to two-thirds of them had achieved considerable improvement or recovery, which corroborates recent findings from Europe and elsewhere.

Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors. Mental health nurses often describe role confusion in relation to other health professionals. Opportunities for interdisciplinary communication with other professionals may benefit health care. The current large-scale study is the first to investigate whether mental health and SUD nurses' perceptions of their opportunities to accommodate patients' needs are related to interdisciplinarity in the treatment unit and a nursing role with clearly defined responsibilities. Strong interdisciplinarity was associated with greater perceived opportunities to accommodate patients' psychosocial, somatic, and economic and legal needs, while strictly defined nursing roles/responsibilities were related to weaker opportunities to do so. The findings highlight the need to address how mental health and SUD nurses organize practice to meet patients' diverse needs Interdisciplinary teamwork could strengthen nurses' ability to address patient needs Finding the best possible balance of providing service in teams or individually could improve resource utilization at the same time as strengthening patient care, and making sure that the patients' various needs are met. INTRODUCTION: Nurses' roles in specialist mental health and substance use disorder (SUD) treatment services are multidimensional and complex. Their responsibility, autonomy and interdisciplinary collaboration may be of importance for their perceived opportunities to accommodate patients' health needs. Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors, and included relatively small samples. The studies have also mainly been conducted in other sectors than the mental health and SUD nursing sectors. The aim of this study is to examine the associations between nurses' roles, interdisciplinarity and their perceived opportunities to accommodate patients' psychosocial, somatic and economic/legal needs. A cross-sectional web-based questionnaire survey was conducted in a nationwide sample of Norwegian nurses in the mental health, SUD treatment and combined mental health and SUD treatment sectors. Of 5,501 contactable nurses (74% of the population), 1918 (35%) responded. The results revealed that interdisciplinarity was significantly associated with greater perceived opportunity to accommodate patient needs, whereas strictly defined nursing roles/responsibilities were associated with less opportunity to accommodate these needs. Facilitation of interdisciplinary collaboration may improve quality of care for patients in mental health and SUD treatment services.

The developments in cutting-edge technologies, such as mobile systems, artificial intelligence (AI), robotics, the Internet of Things (IoT), embedded computing, 3D printing, genetic engineering, and quantum computing are the role of tacit knowledge embedded in the human brain. The rationale that necessitates this study is that tacit knowledge, hidden in the human brain/mind, has become an enabler that results in quality service delivery in organizations. To establish the role of tacit knowledge for enhanced quality service delivery in organizations in the context of Africa, three research objectives were used to guide the study, namely: examine tacit knowledge in organizations, determine cutting-edge technologies, and explore the role of tacit knowledge in organizations. In this study, a multi-stage approach that comprised qualitative content analysis and a phenomenological research approach was employed. Findings reveal that tacit knowledge is applied in all aspects of the organization especially when the organization is in a critical situation, employees come together as a team using their various expertise in ensuring the organization is viable, competitive, productive, and sustained irrespective of the context. The carriers (human beings/brain/mind) know more than they thought, especially when engaging in discussion. Cutting-edge technologies of mobile systems, AI, robotics, IoT, embedded computing, 3D printing, genetic engineering, and quantum computing serve as supporting tools in the roles that tacit knowledge plays in the organization. Findings revealed that the role of tacit knowledge in organizations is to solve certain problems, decision-making, plan, and execution of tasks. The study recommends the need to value and treat the carriers of the tacit knowledge better than the technologies itself which serve as tools only.

Staff well-being is vital to the functioning of the UK National Health Service (NHS). Mental health nurses (MHNs) with personal experience of mental illness can offer a professionally and personally informed insight into the occupational health (OH) service offered by their employer. To investigate MHNs' views of OH provision in the NHS, based on their personal experience. A qualitative interview study using a purposive sample of MHNs with personal experience of mental illness. Twenty-seven MHNs met the inclusion criteria. Thematic analysis identified three themes: comparisons of 'relative expertise' between the mental health nurse and the OH clinician; concerns about 'being treated' by a service at their work; and 'returning to work'. OH provision in mental health settings must take account of the expertise of its staff. Further research, looking at NHS OH provision from the provider perspective is warranted.

Little attention outside the therapeutic setting has been given to specifying the aspects of social relationships that might be helpful for patients recovering from psychotic episodes. The authors studied 20 patients who had been hospitalized for a psychotic episode for 1 year following discharge to examine the role their social relationships played during this period. The data show that 12 functions of social relationships were important and that there were two phases of social needs--convalescence and rebuilding--over the recovery period. The authors discuss the theoretical and clinical implications of these findings.

Introduction Research examining how adults with visual impairments experience physical activities is currently limited to specific age ranges (for example, youths or older adults) and geographic locations (such as Europe and North America). In an effort to extend the current literature base, the study presented here focuses on a cohort of young or middle-aged adults with visual impairments who live in Brazil. Thus, the purpose of this exploratory study was to examine the meaning Brazilian adults with visual impairments ascribed to their physical activity experiences. Methods This study was situated in the qualitative paradigm utilizing a phenomenological design. Three male participants (aged 22 to 47 years) were purposively recruited to participate. The main source of data for this study was a focus group interview using an open-ended, guided approach that was recorded on audiotape. A three-step, line-by-line, thematic analysis, informed by the phenomenological research approach, was utilized to extract meaning from the participants’ experiences. Several strategies were employed to reduce subjective bias, establish trustworthiness, and enhance transferability. Results Two interrelated themes emerged when participants described how they experienced physical activities and the meaning they ascribed to those experiences. The first theme, physical activity–indispensable, describes the importance the participants ascribed to physical activity engagement and the benefits that they garnered from these experiences. The second theme, perceived physical activity impediments, exposed the obstacles participants experienced when trying to engage in physical activities. Discussion This study's findings expose the meaning that a cohort of Brazilians with visual impairments ascribe to physical activity engagement. The participants explained how engagement in physical activity helped alleviate some social issues they previously experienced, but also noted barriers to engaging in these activities. Implications for practitioners Programs targeting physical activity promotion for adults with visual impairments should show the reported benefits of engaging in physical activity programs while attempting to manage potential obstacles that would discourage a physically active lifestyle.

Phenomenological researchers generally agree that our central concern is to return to embodied, experiential meanings aiming for fresh, complex, rich description of phenomena as concretely lived. Yet when it comes to deciding how best to carry out this research in practice debates abound. Some approaches to phenomenology emphasize description; others interpretive layers. Some insist on a rigorous, scientific method; others seek more poetic, artistic flourish. In this article, the author offers preliminary thoughts about what unites seemingly divergent phenomenological research approaches. She suggests that the essence of the phenomenological research approach encompasses five mutually dependent and dynamically iterative processes: (a) embracing the phenomenological attitude, (b) entering the lifeworld (through descriptions of experiences), (c) dwelling with horizons of implicit meanings, (d) explicating the phenomenon holistically, and (e) integrating frames of reference. The author argues that studies that focus on experience are not necessarily phenomenological. The line being contested is the extent a study goes beyond subjectivity and into the broader realm of lifeworld experience.

AimsTo develop a semi‐structured interview guide on stress and coping related to parenting pre‐teen children for a hermeneutic phenomenological research study.DesignHermeneutic phenomenological research approach which describes the development of an interview guide with semi‐structured questions.MethodsOvid MEDLINE, CIHAHL, ERIC, SCOPUS, Web of Science, JSTOR, Education Source, PsyINFO and ProQuest were searched to identify possible interview guides with questions related to stress and coping. The literature was searched in 2019 and included manuscripts from 1970–2019. An initial interview guide was constructed. Mock interviews were used to confirm the rigour of the guide.ResultsThe final outcome was a semi‐structured interview guide on stress and coping related to parenting pre‐teen children.ConclusionThe development of this semi‐structured interview guide is relevant to hermeneutic phenomenological researchers who are interested in discovering how personal background meanings and interpersonal concerns shape parents’ day‐to‐day stress appraisals and coping with parenting pre‐teen children.


 
 
 School superintendents who are African American women are understudied. In this study, researchers explored the lived experiences of African American women superintendents in the state of Texas. The purpose of the study was to identify the challenges, supports, and personal background characteristics that participants believed influenced their ascension to superintendent positions. A phenomenological research approach was used, and data were collected through individual interviews with superintendent participants. Data were analyzed and interpret- ed using Moustakas’ (1994) phenomenological reduction approach. Three major themes emerged in the results: (a) desire to impact others at various levels, (b) sources of personal strength, and (c) external support systems. Subthemes were identified and described for each larger theme. Findings suggest a need to expose aspiring African American women administrators to the challenges and rewards of superintendent positions and increase mentorship opportunities and quality preparation programs.
 
 

Review question/objective The objective of this systematic review is to provide a narrative summary synthesis of the quality of existing Husserlian phenomenological research studies in the health sciences. As a methodological systematic review, only studies that focus on adult patients’ experiences of preventive, screening, diagnosis, treatment or rehabilitation interventions/procedures will be considered to serve as a paradigm “case” of the use of the Husserlian phenomenological approach within the broad field of health. The review question is: What is the quality of existing Husserlian phenomenological research studies in the health sciences? The motivation for this systematic review is not to fault authors of existing Husserlian phenomenological research, but to explore the problems encountered in existing research literature, if any, and to provide guidance to authors for future health research guided by this specific philosophical perspective. In order to avoid repetition, the term ‘Husserlian phenomenological approach’ as used in the text refers to the approach described by Edmund Husserl in English translations of his own published work; or as described in English language commentaries by internationally recognized scholars; or from Husserlian phenomenological scholars including the structured framework presented by Spiegelberg. Each time the ‘content of Husserlian phenomenological research studies’ is used in the text it should be understood to mean ‘content of Husserlian phenomenological research studies as reflected in the stated philosophical perspective, research methodology, data collection methods, data analysis methods, presentation and interpretation of the results, and the conclusions’. Definition of terms: 1. Husserlian phenomenological research studies refers to primary qualitative research studies that are explicitly grounded in the work of Husserl reflected in explicit statements or descriptions by the authors. 2. Quality refers to the extent to which there is congruence between the Husserlian phenomenological approach and the content of Husserlian phenomenological research studies. These stipulative definitions are intended to preclude the need to cite the scientific literature as there is no need to demonstrate their ‘validity’ or ‘acceptability’ by the communities of scholars. TRUNCATED AT 350 WORDS.

The experiences of overseas trained physiotherapists working in the United Kingdom National Health Service

T rapidly changing health care system requires expert clinician leaders to assure that changes in service systems enhance, or at least maintain, quality patient care. The number of graduates from master’s-degree programs specializing in psychiatric nursing has decreased significantly over recent years; annually there are fewer graduates in psychiatric nursing than in any of the other core mental health professions (1). This decline implies a future shortage of psychiatric nurses to fill leadership, teaching, and clinical positions in the health care system. Data from the National League for Nursing (NLN) show that the number of graduates with a master’s degree in psychiatric nursing decreased dramatically from 781 in 1980 to 443 in 1996, a period during which graduations from all types of master’s programs in nursing soared from 4,778 to 9,953. About 74 percent of psychiatric nursing enrollees were part-time students in 1996, compared with 51 percent in 1980, increasing the overall length of time between enrollment and graduation. As Figure 1 shows, the percentage of graduates with a specialty in psychiatric and mental health nursing dropped from 16.3 percent in 1980 to an all-time low of 4.5 percent in 1996. Decreased federal support for traineeships was suggested as a primary cause of the decline in the mid-1980s (2), but more recent declines may also reflect the increase in nurse practitioners, from 18 percent of all master’s-level graduates in 1991 to 43 percent in 1995. The increasing use of nurse practitioners in health care delivery is also reflected in changes in the graduate education of psychiatric nursing specialists. NLN data show that the number of psychiatric nurse practitioner programs increased from ten in 1991– 1992 to 33 in 1994–1995. The number of psychiatric nurse practitioner graduates increased from 47 in 1991 to 100 in 1996, while the number of graduates of master’s level psychiatric nursing clinical specialty practice programs decreased from 492 to 324. The failure to educate an adequate number of graduate-level psychiatric nurses will reduce the quality of psychiatric nursing education in basic nursing preparation programs and the quality of care in practice settings. In 1994 a total of 82,620, or 14.3 percent, of full-timeequivalent positions in mental health organizations were filled by registered nurses (1), the vast majority of whom received their education and clinical experience in psychiatric nursing in their basic nursing program. The unique combination of physical health care and psychiatric knowledge and skills possessed by advanced-practice psychiatric nurses is essential for providing high-quality, cost-effective patient care. Incentives must be available to increase the number of nurses with graduate degrees in psychiatric and mental health nursing to assure an adequate supply of these well-prepared and cost-effective providers. ♦

To explore the lived experiences of acute-care bedside nurses caring for patients and their families with limited English proficiency. Approximately 8.6% of the total US population is considered limited English proficient. In the hospital setting, registered nurses provide the most direct contact with patients and their families. Effective communication between patients and healthcare professionals is essential when providing quality health care. There are only few published studies about registered nurses' experiences caring for patients with language barriers, but studies among nurses' experiences on patients with limited English proficiency and their families in an acute-care setting have not been explored. A qualitative exploratory study was performed. The phenomenology research approach provides the most meaningful ways to describe and understand the entirety of the bedside nurses' experiences. A convenience, purposive sample of 40 registered nurses who work in bedside care in a 380-bed hospital in the western USA were interviewed. Each nurse had a minimum of three years of acute-care experience. The sample size was determined by data saturation. Four themes emerged from the data of this research including: Desire to Communicate; Desire to Connect; Desire to Provide Care; and Desire to Provide Cultural Respect and Understanding. Care of patients with limited English proficiency is a challenge to many nurses and other healthcare providers. This study reinforces the need to give acute-care nurses a voice to share their experiences and ideas for solutions to the challenges they face in the care they provide. Findings from this study have the potential to identify clinically relevant concerns, barriers to communication, resources for effective communication, and needs or concerns of the bedside nurses when providing care. A look at the process and organisational system may suggest opportunities for improvement in support of the nurses' expressed desires to provide the care needed for patients with limited English proficiency.