Diversity, contradictions, and distinction - A scoping review of honours programmes in nursing.

BACKGROUND: There is a long-standing tradition of honours education in the field of nursing, dating back to the early 1960s in the United States. However, its adoption in European and particularly Scandinavian egalitarian educational contexts is relatively recent. PURPOSE: This scoping review aims to provide an analysis of the global utilisation and distribution of honours education within the field of nursing. METHOD: In this scoping review, we conducted an extensive examination of the existing literature to assess the worldwide implementation of honours education in nursing. We employed a systematic approach to identify key trends, patterns, and commonalities in the use of the honours concept across different regions. RESULTS: Our review reveals three predominant approaches to honours education, primarily concentrated in the Anglo-Saxon world: distinction programmes, add-on-year programmes, and embedded programmes. Regardless of the approach, our findings highlight a consistent lack of robust theoretical foundations, limited documentation supporting the educational impact, and a noticeable absence of standardisation. Instead, honours education appears to serve a symbolic and distinct purpose rather than a purely pedagogical one. CONCLUSION: As the prevalence of honours education continues to rise within continental education systems, it becomes imperative to prioritize further research to ensure the optimal allocation of resources. Addressing the lack of evidence, especially in terms of educational value and theoretical foundations, is crucial for refining and maximizing the potential benefits of honours education in nursing. A more strategic and cohesive approach to developing honours programmes is essential to enhance their effectiveness and alignment with global educational goals.

Life goals as a driving force in traumatic brain injury rehabilitation: a longitudinal dyadic perspective.

BACKGROUND: Traumatic brain injury significantly impacts survivors and their families. Rehabilitation following traumatic brain injury is often complex due to the physical, psychological, and socio-economic problems survivors face. Life goals are considered a motivational factor in rehabilitation. OBJECTIVE: The aim was to explore expectations, problems, and strategies for goal setting in survivors of traumatic brain injury and their family caregivers for one-year during rehabilitation. METHODS: A longitudinal qualitative study using dyadic interviews with survivors and family caregivers was carried out at three time points during the first year following traumatic brain injury. Data was analyzed according to Braun and Clarke's thematic analysis. RESULTS: Eight survivors of traumatic brain injury and their family caregivers completed 24 interviews. Three themes and one sub-theme were identified: 1) life goals as a driving force (subtheme: dyadic discrepancies and conflicts); 2) conflicts between specific, measurable, achievable, realistic, and timed (SMART) goals and life goals; and 3) changing perceptions of the impact of impairments.Life goals are important motivation in the rehabilitation process. Health care professionals must integrate life goals and rehabilitation goals (i.e. SMART goals) to decrease barriers and survivor ambivalence about rehabilitation. Involving both survivors and family caregivers in goal setting increases rehabilitation success.

Why do patients decline participation in offered pulmonary rehabilitation? A qualitative study.

OBJECTIVE: The purpose of this study is to produce insight in the explanations for declining pulmonary rehabilitation given by patients with chronic obstructive pulmonary disease. SETTING: The participants were recruited from a hospital in Denmark, among patients hospitalized due to an exacerbation of chronic obstructive pulmonary disease and among stable patients attending an outpatient clinic. PARTICIPANTS: Patients who decline participation in offered pulmonary rehabilitation, who speak Danish, who are able to give informed consent and to participate in a 1-hour interview. METHOD: The research question was answered through interviews with 19 patients. DATA ANALYSIS: The interviews were recorded and transcribed verbatim. The transcripts were analyzed using inductive content analysis. The transcripts were condensed; categories were developed providing different types of explanations for declining pulmonary rehabilitation. Each category was named using a content characteristic word. RESULTS: This study shows that some patients do not remember or recall that they have been offered pulmonary rehabilitation during hospitalization. Especially the oldest patients perceive themselves to be too frail from chronic obstructive pulmonary disease, comorbidity or multimorbidity. The male patients tend to find pulmonary rehabilitation irrelevant because they do not consider themselves ill. Furthermore, the study shows that pulmonary rehabilitation is perceived to be time-consuming and conflicting with daily activities. CONCLUSIONS: Patients decline pulmonary rehabilitation because the intervention does not fit their perception of health and because they find that participation in the program may collide with priorities and daily activities.

Why Do Patients with COPD Decline Rehabilitation.

AIM: This paper aimed to suggest possible answers to the question: Why do patients with COPD decline pulmonary rehabilitation (PR)? METHOD: The study is a metasynthesis inspired by Noblit of the existing qualitative research on the area. The data were collected during 2014. Six studies were found through a systematic literature search in relevant databases. In these six studies, 65 persons were identified as decliners of PR. Four themes were identified from these studies. RESULTS: The themes identified were as follows: the referral process, transport problems, perception of health and other obligations or priorities. The problems with the referral of patients relate to different areas: the referring health professional's conviction and commitment, and the patients' understanding of the referral. It seems that various transport problems cause decline, for example long distance to the PR centre or the expenses of getting back and forth. Perceptions of health cause decline. Decliners feel too sick to join PR or do not identify themselves as a sick person, and do not want undertake the 'patient role'. Other obligations or priorities such as work, family obligations and vacations are prioritised on behalf of PR causing decline. CONCLUSION: The studies included show patients' rational accounts and reflections on declining PR. The included studies tend to describe accounts for deselection of PR in relation to the preferences and beliefs of the patients rather than including the social and economic variables framing the behaviour and choices of the patients.