AimTo describe the variations of family members' conceptions of their supportive care needs (SCN) across the colorectal cancer (CRC) trajectory.DesignA descriptive qualitative study with a phenomenographic approach.MethodIndividual semi-structured interviews were conducted from May 2022 to October 2022 with 23 family members of persons diagnosed with colorectal cancer. The interviews were analysed using phenomenographic analysis following the Consolidated criteria for reporting qualitative research (COREQ) checklist.ResultsThe phenomenographic analysis resulted in five categories. Not of importance describes family members' needs as unimportant due to the good prognosis and the organization of care and in relation to the needs of others. Only satisfiable by professionals describes information possessed by the healthcare professionals as key, as well as the need for professional counselling for the family members to process their emotions. Managed by themselves describes family members preferring to manage their SCN themselves by turning to the appropriate social support and/or by using coping skills. Understood retrospectively describes SCN as only understandable when things have calmed down and as requiring one's own experience to understand. Left unmet describes SCN as unnoticed by the healthcare professionals or not brought to light by the family members, or family members not knowing where to turn for support.ConclusionSupportive care should involve individualized information, proactive and repeated assessments of needs across the trajectory, as well as encouragement of family members to reflect on their needs and to accept support when needed.ImpactThere is a gap in the literature regarding family members' SCN across the CRC trajectory which this study addresses. Findings show five categories of family members' conceptions of their SCN. Those findings could serve as a basis for the development of clinical colorectal supportive care across the cancer trajectory.Implications for the Profession and/or Patient CareFindings show that to offer family members of persons diagnosed with colorectal cancer support only at the time of diagnosis is insufficient. Instead, the healthcare team is recommended to proactively and repeatedly try to identify those in need and the characteristics of their needs. In addition, it is important to offer individualized information and strive to encourage family members to reflect on their situation and to not suppress their own needs if emerging.Reporting MethodReporting adheres to the consolidated criteria for reporting qualitative research (COREQ) checklist.Patient or Public ContributionNo patient or public contribution.

Collaboration for nursing is a core competence and therefore educational interventions are essentials for collaborative skills. To identify such interventions, we carried out a study to understand nursing students' collaborative process. A narrative inquiry method was used to explore the collaborative process of first-year undergraduate nursing students. The analysis was conducted on field notes from 70 h of observation of 87 nursing students' collaboration during skills lab activities. It also included transcriptions of four focus group discussions with 11 students. The results are presented as a sequential process of (1) navigating in unfamiliar territory, (2) navigating together to cope, and (3) navigating together towards independency and the future nursing profession. We identified a transition from teacher-led assistance and guidance to student interdependency and reciprocal learning, ending with student-led assistance supporting independency. In line with Vygotsky's theory of zone of proximal development, different scaffolding interventions are needed depending on where the students are in the collaborative process. 

Aim: To describe how Swedish emergency nurses experience the preconditions of providing safe care during the COVID-19 pandemic when collecting blood culture in the emergency department. Design: A qualitative exploratory design using content analysis with a manifest approach. Method: Semi-structured interviews were conducted with 13 emergency nurses working in the emergency department. Results: The analysis resulted in one main category: unprecedented preconditions create extraordinary stress and jeopardize safe care when collecting blood culture. This main category includes four additional categories: organizational changes, challenges in the isolation room, heavy workload creates great stress, and continuous learning. Conclusion: The COVID-19 outbreak has made the emergency department a workplace where constant changes of routines combined with new information and reorganization risk jeopardize safe care during blood culture sampling. Accordingly, high workload and stress have been identified as a reason for emergency nurses not following guidelines. It is therefore necessary to optimize the preconditions during blood culture sampling and identify situations where there are shortcomings.

Background: Colorectal cancer is the third most common cancer diagnosis globally and is increasing in both incidence and prevalence. Despite evidence showing that family members of persons diagnosed with cancer have supportive care needs, no validated questionnaire measuring the needs of family members of persons diagnosed with CRC exists in Swedish. Thus, the objective of the present study was to translate, culturally adapt, and evaluate the psychometric properties the Supportive Care Needs Survey - Partners and Caregivers 45.

Methods: The translation and cultural adaptation followed a systematic yet iterative process. Firstly, the questionnaire was translated using a forward-backward approach. Secondly, face and content validity and comprehensibility were evaluated by two expert panels of colorectal cancer specialist nurses and family members, respectively. Lastly, the psychometric properties, validity, and reliability of the translated questionnaire were evaluated among 45 Swedish family members of persons diagnosed with colorectal cancer.

Results: The face, content, and construct validity of the translated questionnaire were evaluated as satisfying. Moreover, psychometric evaluations showed high data quality and satisfactory internal consistency. However, the results also revealed unsolved issues regarding relevance, targeting, and internal consistency, as well as a probable scaling failure.

Conclusion: The translated and adapted questionnaire can be used to identify family members unmet needs of support throughout the colorectal cancer trajectory. The questionnaire showed promising validity and reliability in the target population. However, it needs to be further evaluated in a larger sample, preferably involving factor analysis and stability over time.

Plain language summary: Colorectal cancer is the third most common cancer diagnose globally. At times of cancer, also the health and wellbeing of the surrounding family members is negatively affected. As a result, family members of persons diagnosed with cancer report that they too need support. Still, no validated questionnaire that enable measurement of family members needs of support throughout the colorectal cancer trajectory existed in Swedish. Thus, the present study undertook the process of translation of a questionnaire from English to Swedish. Thereto, evaluated it among Swedish family members of persons diagnosed with colorectal cancer. The evaluation showed a successful translation and the translated questionnaire appeared reliable and useful for measuring the family members´ needs of support throughout the colorectal cancer trajectory. However, it requires further evaluation.

Purpose: The purpose of the present study was to explore cancer specialist nurses' experiences of supporting family members of persons diagnosed with colorectal cancer.

Method: The study was designed as a qualitative study. Data was collected using individual semi-structured telephone interviews with 21 cancer specialist nurses. The interviews were transcribed and analysed with reflexive thematic analysis.

Results: The analysis generated one overarching theme, In the shadow of the person diagnosed with colorectal cancer, and four themes: striving for confidence, searching for ways to support, seeking individualization, and balancing between needs. Swedish colorectal cancer care is organized with the persons diagnosed with colorectal cancer as the centre of care and lacks both structure and allocated resources for supportive care for family members. Thus, support for family members has to be provided within the existing colorectal cancer care. The support provided focuses mainly on strengthening the family members' ability in the caregiving role and is offered primarily at the time of diagnosis.

Conclusion: There is an apparent need for developing supportive care plans for family members, involving repeated assessments of multidimensional needs, a tailored support, and follow-ups. Accordingly, a re-evaluation of the cancer specialist nurse's role is needed so that key nursing responsibilities are not ranked second to administrative tasks.

AIM: The aim was to explore collaboration between first year undergraduate nursing students in a three-year bachelor program during clinical skills lab practices.

BACKGROUND: The ability to collaborate is important in the nursing profession to ensure patient safety. Thus, efforts supporting nursing students with learning activities emphasizing this ability is crucial in nurse education as a preparation for the requirements of the nursing profession. Collaborative learning models are described as ways that support the students' interaction during education. However, collaboration between students has shown to have challenges such as negative competition and confrontations. This stresses the need to explore the collaboration between students to find ways to support the interaction.

DESIGN: The study was conducted with a focused ethnographic approach.

METHOD: Data were generated by participant observations during one semester, involving 70 h observation of 87 first year nursing students for 6 months and 24 training sessions in clinical skills lab practices. Two focus group discussions were used to elaborate students' views of collaboration and to provide an opportunity for follow up questions and interpretations from the observations. Field notes and focus group discussions were interpreted as one unit of analysis conducted with thematic network analysis. A global theme were synthesized from organizational and additional basic themes presenting the overall metaphor of the students' collaboration.

RESULT: The global theme, Between adaptation and non-conformity, revealed a field of tension in the nursing students' collaboration. One the one hand, the global theme involved the students' ability to adopt to new knowledge and to being a nursing student in a clinical skills lab and to others' perspective. On the other hand, non-conformity creates a collaboration with less reflection between the students and non-synchronized and time-consuming laboratory work.

CONCLUSION: Collaborative activities in nurse education fosters and challenges nursing students' collaboration required for clinical practices and later in the nursing profession. By the presented scaffolding efforts, nurse educators can arrange a learning environment that can support the collaboration between students and facilitate the transition into the profession.

OBJECTIVES: An international Nursing Leadership Collaborative covened in Japan to hold a patient safety and quality workshop for nursing students from six countries. The purpose was to measure students' self reported beliefs reflecting sensitivity and openness to cultural diversity before and after the international experience.

METHODS: A pre-post-test design was used and the Beliefs, Events, and Values Inventory was administered to international undergraduate and graduate nursing students.

RESULTS: The group aggregate data analysis indicate that prior to the start of the workshop, the group presented itself as quite introspective and after the workshop the group reported being more sophisticated in making causal explanations about why the world works in the way it does.

CONCLUSIONS: Nursing students experienced an expanded awareness of their beliefs and values that reflect a greater degree of intercultural sensitivity for acceptance of inclusivity and diversity after the experience.

Background Due to the need for students to integrate theory with practice, current research seeks the best learning and teaching models in primary healthcare settings. The aim of this study was to explore preceptors' and nursing students' experiences of using peer learning during clinical practice in primary health care. Methods A qualitative research approach was used based on semi-structured interviews with seven preceptors and ten nursing students. The interviews were transcribed and analyzed by using content analysis based on an inductive reasoning. Results Preceptors and students perceived peer learning as an educational model to be beneficial for learning in primary care settings. They found the model to be stimulating, challenging, and leading to development of professional identity and nursing skills. All informants were positive towards the peer learning experience, with students reporting they were seen as individuals, despite working in pairs. However, the physical environment was demanding with regards to telephone counseling issues, limited opportunities for using computers, and the use of small examination rooms. Conclusion This study shows that, despite the complex learning environment, peer learning as an educational model appears to work well in a primary healthcare setting. However, much improvement is needed to facilitate the students' learning process. Consequently, conditions for clinical practice and learning beneficial to both students and preceptors should be prioritized by management.

Background: Sexuality is an integral part of human beings and persons living with dementia still perceive negative attitudes from caregivers in this regard. Aim: This study aimed to explore registered nurses' experiences of caring for persons with dementia living in nursing homes and expressing their sexuality. Methods: A qualitative inductive design was adopted; data were collected through semi-structured interviews and analysed through content analysis. Results: The analysis reflected three categories. (1) Dealing with different reactions and responding to nursing staff and relatives: The registered nurses experienced discomfort, insecurity, frustration, distress and embarrassment when confronted with sexual expressions in people with dementia. (2) Caring with a focus on the person: The registered nurses expressed the importance of protecting the integrity of the person and consequently their right to sexual expressions. (3) Needing more competence development: The registered nurses expressed the need to educate and inform not only themselves but also the nursing staff and relatives.

BACKGROUND: The number of errors in medication management in nursing homes is increasing, which may lead to potentially life-threatening harm. Few studies on this subject are found in the municipal nursing home setting, and causes need to be identified. The aim of this study was to explore perceptions of errors connected to medication management in nursing homes by exploring the perspective of first-line registered nurses, registered nurses, and non-licensed staff involved in the care of older persons.

METHODS: A qualitative research approach was applied based on semi-structured interviews with 21 participants at their workplaces: Seven in each of the occupational categories of first-line registered nurses, registered nurses, and non-licensed staff. Subcategories were derived from transcribed interviews by content analysis and categorized according to the Man, Technology, and Organization concept of error causation, which is as a framework to identify errors.

RESULTS: Mistakes in medication management were commonly perceived as a result of human shortcomings and deficiencies in working conditions such as the lack of safe tools to facilitate and secure medication management. The delegation of drug administration to non-licensed staff, the abandonment of routines, carelessness, a lack of knowledge, inadequate verbal communication between colleagues, and a lack of understanding of the difficulties involved in handling the drugs were all considered as risk areas for errors. Organizational hazards were related to the ability to control the delegation, the standard of education, and safety awareness among staff members. Safety issues relating to technology involved devices for handling prescription cards and when staff were not included in the development process of new technological aids. A lack of staff and the lack of time to act safely in the care of the elderly were also perceived as safety hazards, particularly with the non-licensed staff working in nursing homes.

CONCLUSIONS: The staff working in nursing homes perceive that the risks due to medication management are mainly caused by human limitations or technical deficiencies. Organizational factors, such as working conditions, can often facilitate the occurrence of malpractice. To minimize mistakes, care managers need to have a systemwide perspective on safety issues, where organizational issues are essential.