Exploring perceptions of what increased gender diversity might bring to the nursing profession.

AIMS: To explore university nursing students and academic staff's perceptions of what increased gender diversity might bring to the nursing profession. DESIGN: An exploratory study with students and academic staff from two university nursing schools. METHODS: Students and staff in two university nursing schools were invited to participate in an anonymous online survey (October-November 2022). The survey focused on gender diversity within nursing and patient care, asking respondents about existing barriers to gender diversity and inviting ideas on increasing gender diversity within nursing. The survey findings helped inform questions, which were used to further explore views and thoughts of gender diversity within nursing through semi-structured one-to-one interviews (January-February 2023). RESULTS: Nearly, two-thirds (64%, n = 69) of survey respondents strongly agreed/agreed that the lack of gender diversity in nursing negatively impacted delivering care to a gender-diverse society. Most (84%, n = 90) strongly agreed/agreed that increased gender diversity within the nursing workforce would positively contribute to nursing. Three-quarters (75%, n = 74) strongly agreed/agreed that working with a more gender-diverse nursing workforce would enrich their experience as a nurse. Three themes emerged from the interview data: shared stereotypes; improved care through knowledge, better relations and the presence of a gender-diverse workforce; a culture of welcome: suggested changes for the future. CONCLUSION: Most of those who participated in the study believe there are benefits to be gained from greater gender diversity within nursing. This study provides insight into the lack of gender diversity in the nursing environment, highlights how this might impact patient care and suggests actions to make nursing a more inclusive profession. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Practical solutions were suggested, including the greater visibility of trans and non-binary persons in advertisement and recruitment campaigns to ensure nursing is viewed as a career choice for "all". Including a space for considered pronouns on university application forms, hospital documentation and name badges. Gender-neutral titles and uniforms should be considered for all nursing staff, and more gender-neutral toilets should be made available for staff and patients in university and hospital settings. IMPACT: This study addressed the lack of gender diversity in nursing and explored what an increase in gender diversity might bring to the nursing profession. The main findings were: (i) Less than a tenth (9%, n = 12) of respondents described their team of colleagues as being "extremely gender diverse". (ii) Most (84%, n = 90) strongly agreed/agreed that increased gender diversity within the nursing workforce would be a positive attribute to nursing. (iii) Three-quarters 75% (n = 74) strongly agreed/agreed that working with a more gender-diverse nursing workforce would enrich their experience as a nurse. (iv) Many stereotypes still exist in nursing and tackling them is important to make the profession more inclusive. (v) A nurse's gender can impact the care they provide. (vi) A more gender-diverse workforce would better reflect the population it serves. (vii) This research will have an impact on the nursing profession globally. REPORTING METHOD: The consolidated criteria for reporting qualitative studies (COREQ) was used as a guide throughout data collection and analysis. PATIENT OR PUBLIC CONTRIBUTION: Every step of the study, including the survey and interview schedule, was co-constructed using an iterative approach with service users, students and staff who had personal experience of gender diversity and were a core part of the study team.

Using participatory research to co-produce an education and training e-resource to support care home staff to meet the sexuality, intimacy and relationship needs of care home residents with and without dementia.

Aim: To present the methodological approach and research methods chosen in a research study designed to enable the collaborative creation of an education and training e-resource designed to facilitate and support care home staff to address the sexuality, intimacy and relationship needs of older care home residents. Design: Co-production using community-based participatory approach. Methods: Four participatory workshops with care home staff, residents and their significant others. Results: Workshops 1 and 2 identified and developed real-world case scenarios related to sexuality, intimacy and relationship needs and identified care staff training needs in this area. Then workshop 3 provided valuable feedback on the prototype training e-resource, and the final workshop identified care home staff engagement with and implementation of the e-resource in practice. Conclusion: The findings provide evidence that using participatory approaches, such as co-production, to develop education and training resources in a sensitive subject area with care home residents, significant others, carers and care home staff, was a useful approach in engaging a vulnerable population group, in a sensitive area. However, this approach is not without challenges in care home communities.

Feasibility and acceptability of an education and training e-resource to support the sexuality, intimacy and relationship needs of older care home residents: a mixed methods study.

BACKGROUND: sexuality, intimacy and relationship needs are often a neglected aspect of the care of older adults in residential care facilities. Improving awareness, knowledge and improving attitudes about these needs among care staff could enhance quality of care and lead to better outcomes for residents. OBJECTIVE: to evaluate the feasibility and acceptability of a co-designed education and training e-resource to help care staff support their residents' sexuality, intimacy and relationship needs. METHODS: we delivered the education and training e-resource to five UK care homes over a 6-month period in a pre-post mixed methods study using surveys, focus groups and individual interviews. RESULTS: fifty-nine members of staff from participating care homes undertook the education and training e-resource. 18/59 (31%) of participants completed all six modules and the pre-post surveys. Eleven participants participated in focus groups/interviews to explore experiences of using the e-resource. The e-resource was successfully implemented in the study homes and found to be acceptable. We found preliminary evidence of positive changes in staff attitudes. Factors that facilitated implementation included support from the care home manager. Barriers identified included IT infrastructure and technology. CONCLUSIONS: the findings provide initial evidence that a co-designed education and training e-resource raised awareness of, and improved attitudes towards, older adults' sexuality and intimacy needs. This work provides the foundation for a next phase to establish the effectiveness of the e-resource on staff practice and resident outcomes.

The value of social media use in improving nursing students' engagement: A systematic review.

AIM: This systematic review was undertaken to investigate the impact of social media use in relation to student engagement in nursing education. BACKGROUND: The availability of social media has transformed global connectivity within education systems. Social media has been used in various educational contexts. The widespread use of social media has prompted a demand for a better understanding of how it might be used in nursing education. While research has previously explored the positive effects of using social media on a range of learning outcomes in nursing education, studies have not specifically focused on how these positive features have an impact on students' engagement as a vital component of successful learning. DESIGN: This review uses the Joanna Briggs Institute approach to conducting systematic reviews and follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for reporting a systematic review. METHODS: Following predefined inclusion criteria, a search of electronic databases was performed using a three-step strategy to identify relevant studies. The following databases were searched: Cumulative Index of Nursing and Allied Health Literature (CINAHL), Education Resources Information Centre (ERIC), MEDLINE and PubMed. A further manual search was performed to identify potentially relevant articles. The included studies were assessed for methodological quality by all reviewers using the Mixed Methods Appraisal Tool. NVivo software was used for organising data and developing themes. RESULTS: Data from sixteen studies with different designs were extracted and thematically synthesised. The synthesised findings yielded five themes: 1) interaction and communication; 2) managing stress; 3) positive online community; 4) time spent; and 5) digital literacy and e-professionalism. CONCLUSIONS: This review reveals that using social media to support nursing students' learning has positive benefits in terms of promoting several aspects of their engagement, such as rapid interaction and communication. Further empirical studies, however, should aim to measure social media's effects on nursing students' engagement with their courses and their academic attainment.

A scoping review of education and training resources supporting care home staff in facilitating residents' sexuality, intimacy and relational needs.

BACKGROUND: Having positive intimate, sexual and relational experiences is an important issue for older adults in care settings, yet little is known on the extent to which nursing staff and care workers have received education or training in addressing and meeting these needs among older residents. This scoping review aimed to identify and examine what education and training resources exist to assist nursing staff and care workers to meet their residents' needs in this area. METHODS AND ANALYSIS: Using the Arksey and O'Malley framework, we systematically searched papers and grey literature to identify education interventions and resources that aimed to facilitate care home staff to meet their residents' sexuality, intimacy and relational needs. RESULTS: Eleven studies (one dissertation) and three education resources met the inclusion criteria; most were conducted in the USA and Australia. Across the studies and resources identified, the education content was mixed and the methodology, presentation, design and duration varied widely. The focus of the education interventions and resources was to increase knowledge and improve and/or change attitudes towards the: (i) sexual expression of older people living in residential aged care, (ii) sexuality and ageing and (iii) expression of sexuality in people with dementia. CONCLUSION: Few education interventions and training resources were identified. The findings suggest that education interventions can improve knowledge and/or change care staff attitudes, in the short-term, towards older people's sexuality, intimacy and relational needs in care home settings, which can lead to facilitating staff to enhance person-centred care in this area of need.

Personality disorder co-morbidity in primary care 'Improving Access to Psychological Therapy' (IAPT) services: a qualitative study exploring patient perspectives on treatment experience.

BACKGROUND: High numbers of people present with common mental health disorders and co-morbid personality disorder traits in primary care 'Improving Access to Psychological Therapies' (IAPT) services in England and they receive sub-optimal treatments. No previous studies have explored the treatment experiences or needs of this patient population in England. AIMS: This qualitative study explored the treatment experiences of patients (n = 22) with common mental health difficulties and co-morbid personality disorder as indicated by a score of 3 or more on the 'Standardised Assessment of Personality - Abbreviated Scale' (SAPAS) in receipt of primary care-based IAPT treatment. METHOD: A qualitative health research approach was used. Qualitative individual face-to-face semi-structured interviews were conducted. All interviews were audio recorded, data were transcribed verbatim and analysed using a framework analysis approach. RESULTS: Findings revealed a need to adapt away from prescriptive cognitive behavioural therapy (CBT) treatment models towards more flexible, personalised and individualised treatment with this patient group. Time to emotionally offload, build a therapeutic relationship and link past experiences to presenting problems were highlighted as important. CONCLUSIONS: For the first time, the needs and treatment experiences of this patient group have been explored. This paper provides a unique patient experience insight that should be considered when exploring new approaches to working with and developing effective interventions via a stepped care approach.

Rapid tranquillisation: an issue for all nurses in acute care settings.

The management of challenging behaviour, violence and aggression is not only an issue for mental health and learning disability nurses. Increasingly, nurses working in emergency departments (EDs), medical assessment units and general medical or surgical wards may encounter acts of challenging behaviour, violence and aggression on a regular basis. Restraint is sometimes used as a tool in the management of these patients; this may be in the form of physical, mechanical or chemical restraint. Rapid tranquillisation (RT) is often considered a form of chemical restraint, which may be used in an emergency situation when prescribed. If RT is given it should be done so as the least restrictive option, with intramuscular and intravenous administration as a last resort. Patient monitoring following administration is paramount. This article explores best practice in the administration of RT from a clinical perspective.

Personality disorder co-morbidity in primary care 'Improving Access to Psychological Therapy' services: A qualitative study exploring professionals' perspectives of working with this patient group.

A high prevalence of people present to 'Improving Access to Psychological Therapies' (IAPT) in England with common mental health disorders and co-morbid personality disorder. This group have suboptimal treatment outcomes in IAPT. Whilst new short-term treatment approaches are advocated, no solutions or guidance have been provided. This qualitative study explored IAPT health-care professional (N = 28) perspectives of working with people who present to IAPT with co-morbid personality disorder. Individual semi-structured interviews were digitally recorded, transcribed verbatim and analysed using a framework analysis approach. Results identified a lack of skills and confidence in working with this patient group, restrictive service constraints and a treatment gap between the interface of primary and secondary services. Insight into acceptable adaptions to practice are identified that have transferable utility to a wider international audience who can identify people outside of specialist mental health services with common mental health disorders and co-morbid personality disorder traits. © 2019 John Wiley & Sons, Ltd.

Openness, inclusion and transparency in the practice of public involvement in research: A reflective exercise to develop best practice recommendations.

CONTEXT: Reflective accounts of public involvement in research (PI) are important for helping researchers plan and deliver more effective PI activities. In particular, there is a need to address power differentials between team members that can prohibit effective and meaningful involvement. OBJECTIVE: To critically reflect on the PI practices that underpinned our research project on intimacy and sexuality in care homes, to develop a series of recommendations for improving future PI activities. SETTING: The research team comprised five academics from nursing, public health, sociology and psychology, and two members of the public with experience of sex education, and lesbian, gay, bisexual and trans issues in older populations. In order to address power differentials within the group, we developed an approach to PI practice that was grounded in values of openness, inclusion and transparency. METHOD: Reflective commentaries on the strengths and weaknesses of the team's approach to PI were gathered through interviews and open-ended questionnaires with research team members. These views were collated and discussed at a workshop comprising research team members and an additional member of the public to generate recommendations for future PI practice. RESULTS: A number of strengths and limitations of our approach to PI were identified. Clear recommendations for improving PI practice were developed for three broad areas of identified difficulty: (i) communication within and between meetings; (ii) the roles and responsibilities of team members; and (iii) PI resources and productivity. DISCUSSION AND CONCLUSION: These recommendations add to the developing body of guidance for conducting effective PI.