Simulations are of particular advantage in research studies where large samples are necessary to achieve statistical power and the information must be collected under uniform conditions in order to aid interpretation. In the study reported below, simulation was achieved through the use of medical photography accompanied by case studies of the same patients. All information was collected on the same day. The purpose of the study was to determine the validity of the three pressure ulcer risk assessment scales most commonly used in clinical nursing practice in the UK. Each clinical nurse assessed the same four patients using three risk assessment scales and a visual analogue scale designed to capture their own clinical judgement. External validity was assessed by a panel of tissue viability experts who provided independent ratings. Data were obtained from 236 clinical nurses, yielding 941 risk assessments. Experience with this approach to data collection suggests that it requires careful planning. This should include measures to ensure that the simulated information is valid and that all data collectors have been adequately trained and are able to motivate the nurses participating in the study. Providing consideration is given to these issues, the use of simulation can help to collect data that would be difficult to obtain by more conventional means. It is also important to recognize that clinical decisions are de-contextualized in simulations because they are reduced to verbal and visual summaries. The decision to use simulations should thus be taken only if this is acknowledged.

Prostate cancer is a uniquely problematic male health issue. Findings from a study employing an ethnographic approach are presented to describe the ways in which 14 men's lives were changed as a result of this experience. The theoretical basis of the study centered on embodiment to explore the personal impact of prostate cancer, its treatment, and its side effects. The findings suggest that cancer was experienced sequentially, beginning at the time of diagnosis with the problematizing of the normally "silent" male body. This trajectory of experience progressed to emphasize the importance placed on treatment side effects, embodied vulnerability, and the impact of the cancer on men's "embodied" lives. In this article, I focus on the final phase of the illness experience and illustrate how the men confronted existential threat alongside physical changes, and the way each change resulted in a new outlook on life and its priorities following cancer.

Uncertainty influences patients' experiences of their cancer and their coping. Whilst it might be impossible to avoid uncertainty entirely, its negative effects might be ameliorated by understanding patients' specific needs along the disease trajectory of breast, prostate, and colorectal cancer.

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Background The specific challenges experienced by the nursing and midwifery workforce in previous pandemics have exacerbated pre-existing professional and personal challenges, and triggered new issues. We aimed to determine the psychological impact of the COVID-19 pandemic on the UK nursing and midwifery workforce and identify potential factors associated with signs of post-traumatic stress disorder. Methods A United Kingdom national online survey was conducted at three time-points during the first wave of the COVID-19 pandemic between April and August 2020 (T1 and T2 during initial wave; T3 at three-months following the first wave). All members of the UK registered and unregistered nursing and midwifery workforce were eligible to participate. The survey was promoted via social media and through organisational email and newsletters. The primary outcome was an Impact of Events Scale-Revised score indicative of a post-traumatic stress disorder diagnosis (defined using the cut-off score ≥33). Multivariable logistic regression modelling was used to assess the association between explanatory variables and post-traumatic stress disorder. Results We received 7840 eligible responses (T1- 2040; T2- 3638; T3- 2162). Overall, 91.6% participants were female, 77.2% were adult registered nurses, and 28.7% were redeployed during the pandemic. An Impact of Events Scale-Revised score ≥33 (probable post-traumatic stress disorder) was observed in 44.6%, 37.1%, and 29.3% participants at T1, T2, and T3 respectively. At all three time-points, both personal and workplace factors were associated with probable post-traumatic stress disorder, although some specific associations changed over the course of the pandemic. Increased age was associated with reduced probable post-traumatic stress disorder at T1 and T2 (e.g. 41-50 years at T1 odds ratio (OR) 0.60, 95% confidence interval (CI) 0.42-0.86), but not at T3. Similarly, redeployment with inadequate/ no training was associated with increased probable post-traumatic stress disorder at T1 and T2, but not at T3 (T1 OR 1.37, 95% CI 1.06-1.77; T3 OR 1.17, 95% CI 0.89-1.55). A lack of confidence in infection prevention and control training was associated with increased probable post-traumatic stress disorder at all three time-points (e.g. T1 OR 1.48, 95% CI 1.11-1.97). Conclusion A negative psychological impact was evident 3-months following the first wave of the pandemic. Both personal and workplace are associated with adverse psychological effects linked to the COVID-19 pandemic. These findings will inform how healthcare organisations should respond to staff wellbeing needs both during the current pandemic, and in planning for future pandemics.

Background:Prostate cancer is for many men a chronic disease with a long life expectancy after treatment. The impact of prostate cancer therapy on men has been well defined, however, explanation of the consequences of cancer treatment has not been modelled against the wider variables of long-term health-care provision. The aim of this study was to explore the parameters of unmet supportive care needs in men with prostate cancer in relation to the experience of nursing care.Methods:A survey was conducted among a volunteer sample of 1001 men with prostate cancer living in seven European countries.Results:At the time of the survey, 81% of the men had some unmet supportive care needs including psychological, sexual and health system and information needs. Logistic regression indicated that lack of post-treatment nursing care significantly predicted unmet need. Critically, men's contact with nurses and/or receipt of advice and support from nurses, for several different aspects of nursing care significantly had an impact on men's outcomes.Conclusion:Unmet need is related not only to disease and treatment factors but is also associated with the supportive care men received. Imperative to improving men's treatment outcomes is to also consider the access to nursing and the components of supportive care provided, especially after therapy.

Inquiries in the UK into mistreatment of older people by healthcare employees over the last 30 years have focused on introducing or supporting employee whistle-blowing. Although whistle-blowers have made an important contribution to patient safety it remains a controversial activity. The fate of whistle-blowers is bleak, often resulting in personal and professional sacrifices. Here we draw on the views of healthcare and social care employees working with older people to explore perceptions of whistle-blowing as well as alternative strategies that may be used to raise concerns about the mistreatment of patients by co-workers. Whistle-blowing was perceived as a negative term. Managers said they promoted open cultures underpinned by regular team meetings and an open-door ethos. Others described workplace norms that were somewhat at odds with these open culture ideals. Whistle-blowing was considered risky, and this led to staff creating informal channels through which to raise concerns. Those who witnessed wrongdoing were aware that support was available from external agencies but preferred local solutions and drew upon personal ethics rather than regulatory edicts to shape their responses. We argue that the importance of workplace relationships and informal channels for raising concerns should be better understood to help prevent the mistreatment of vulnerable groups.