Transforming nursing care for children with serious long-term conditions: A mixed methods exploration of the impact of Roald Dahl Specialist Nurses in the United Kingdom.

PURPOSE: A new model of paediatric nursing, funded initially by a charitable organisation working in partnership with UK healthcare providers, was implemented to support children living with serious long-term conditions. This study explored, from the perspective of multiple stakeholders, the impact of services provided by 21 'Roald Dahl Specialist Nurses' (RDSN) within 14 NHS Trust hospitals. DESIGN AND METHODS: A Mixed Methods Exploratory design commenced with interviews with RDSNs (n = 21) and their managers (n = 15), alongside a medical clinician questionnaire (n = 17). Initial themes (constructivist grounded theory) were validated through four RDSN focus groups, and informed development of an online survey of parents (n = 159) and children (n = 32). Findings related to impact were integrated using a six-step triangulation protocol. RESULTS: Zones of significant impact included: Improving quality and experience of care; Improved efficiencies and cost-effectiveness; Provision of holistic family-centred care; and Impactful leadership and innovation. The RDSNs forged networks across inter-agency boundaries to safeguard the child and enhance the family experience of care. RDSNs delivered improvements across a range of metrics, and were valued for their emotional support, care navigation and advocacy. CONCLUSIONS: Children living with serious long-term conditions have complex needs. Regardless of the specialty, location, organisation or service focus, this new model of care crosses organisational and inter-agency boundaries to ensure that the healthcare delivered has maximum impact. It has a profoundly positive impact on families. PRACTICE IMPLICATIONS: This integrated and family-centred model of care is strongly recommended for children with complex needs crossing organisational divides.

A Qualitative Exploration of Electronic Image Sharing Among Young People: Navigating the Issues of Conformity, Trust, Intention, and Reputation.

This research sought to explore the main factors affecting young people's image-sharing behaviors, particularly in the context of peer relationships and norms. Ten focus groups were held with young people aged 13 to 14 years (Grade 9) with a total of 68 participants (39 females and 29 males) across 15 Australian schools contributing to the discussions. Focus groups were divided into either all-girls (n = 4), all-boys (n = 4), or mixed gender (n = 2) participants to observe gender-specific issues. Thematic analysis of the data revealed the considerable complexities that young people encounter daily when sharing images in the online environment, including how they navigate issues of conformity, trust, intention, and reputation. Gender-specific differences in young people's perceptions of risky image sharing were also observed. These findings have important implications for the design of school-based interventions to prevent and reduce harm from image-sharing behaviors, including the appointment and training of cyber ambassadors in schools to help positively influence peer-level norms about image sharing.