Phenomenology is one of the most popular qualitative research methodologies used in nursing research. Although interpretive phenomenology is often a logical choice to address the concerns of nursing, the vast number of methods of phenomenology means choosing an appropriate method can be daunting, especially for novice researchers. It is critical that nurse researchers select a phenomenological method that fits the research problem and the skill and world view of the researcher; doing so will result in a research experience that resonates with and excites the researcher. The interpretive phenomenological methodologies of Benner, Munhall, and Conroy each offer unique methods of phenomenological inquiry. However, to date, we are not aware of any literature that explores and compares the methodological approaches of these nurses. In this paper, the origins and influence of phenomenology as both a philosophy and methodology on nurse researchers will be explored, followed by a critical analysis and comparison of these three nurses. By highlighting the distinctive differences and attributes of each method, this paper provides an analysis and comparison of the approaches of these prominent nurses. In doing so, we aim to aid the researcher in their methodological selection, thereby resulting in a successful and rewarding research endeavor.

Aims and Objectives: The aim of this article is to provide an integrative review of rural family members' experiences of a relative's inter-facility transfer to an urban tertiary care centre for advanced critical care services.Background: Although there is an increasing awareness of the negative consequences of a relative's critical illness for family members, there has been limited research conducted on the impacts of this experience for families of patients in rural settings who require an inter-facility transfer for advanced services.Search strategy: The search strategy for this review was framed by the study purpose, research question, and a conceptual structure of key constructs. Databases and reference lists were electronically and manually searched.Inclusion and exclusion criteria: Articles were included if they were research articles, available in English, and focused on family members' experiences of inter-facility transfer during critical illness. Articles focusing on critical care transfers within a single urban setting, elective transfers undertaken for patient or family preference, transfers not associated with critical illness, and systematic or scoping reviews were excluded.Conclusion: Stress and anxiety are central to the rural family members' experience of this phenomenon. These constructs are influenced by modifiable factors, including the actions of health care providers, the financial burden associated with the transfer, the family members' physical proximity to the patient, and their access to information and support networks. Further research is required to explore potential short-and long-term consequences of this experience and the experience of family members who are left behind and to develop and test interventions to support families.Relevance to clinical practice: This review highlights the concern that health care providers frequently misunderstand the needs of family members who are experiencing this phenomenon. Through a better understanding of this phenomenon, health care providers will be better positioned to effectively support these individuals during this unique experience. K E Y W O R D Scritical illness, family, integrative review, interfacility transfer, rural

Constructivist research methodologies are useful in discerning meanings of experience to subsequently inform and improve healthcare practice. For researchers who philosophically align with the constructivist paradigm, numerous methodologies are available from which to choose to address research questions. However, it can be challenging for researchers, especially novice ones, to choose the most appropriate methodology that aligns with the current state of knowledge of the identified topic, proposed research question, and the study purpose. To reduce the confusion faced by health researchers when choosing an appropriate methodology for a specific study, this paper compares two popular qualitative health research approaches: constructivist grounded theory and interpretive phenomenology. Philosophical underpinnings and the epistemological and ontological evolution of each methodology are explored with similarities and differences highlighted. Manifestation of the philosophical foundations of constructivist grounded theory and interpretive phenomenology are described in relation to data collection, analysis, and the research findings. To illustrate distinctions of each approach and support researchers in the navigation of methodological decision-making, a specific healthcare study context is presented: the rural family members’ experiences of a relative’s interhospital transfer for advanced critical care services. This study context is increasingly being recognized as an important area of healthcare research and practice. However, gaps in knowledge persist, specifically in relation to the experiences of rural family members when a critically ill relative requires an interhospital transfer to a distant urban center for advanced critical care services. Improved understanding of such experiences is necessary to inform the care provided to rural family members, potentially mitigating short and long-term negative consequences for these individuals. Within this example, the importance of the research purpose and research question within a specific study context is underscored as central to appropriate methodological decision-making.

Assuming the role of caregiver for a life partner after critical illness can be both a rewarding and challenging experience for spouses. Using a grounded theory approach, Ågård, Egerod, Tønnesen, and Lomborg developed a theoretical model describing the experience from spouse to caregiver and back. To further develop this theoretical model, a literature review was completed and nursing interventions were identified and included in the model. Testing of this theoretical model is recommended to determine its empirical adequacy.

ObjectiveTo identify, characterise and map the existing knowledge about (1) immunisation programmes that provide evidence-based support about vaccines to Canadians and reduce barriers to vaccination; and (2) barriers and facilitators to the delivery of immunisation support programmes.IntroductionVaccine hesitancy is a complex issue that has significant repercussions for the health and safety of Canadians. Engaging in evidence-based communication about vaccines can reduce vaccine hesitancy and increase participation in immunisation programmes.MethodsThe Joanna Briggs Institute methodology for scoping reviews will be used for this scoping review. A comprehensive keyword search strategy was developed and translated for six electronic databases on 19 November 2021: CINAHL via EBSCOhost, APA PsycINFO via EBSCOhost, Academic Search Complete via EBSCOhost, Scopus, Medline via EBSCOhost and EmCare via Ovid. We will identify unpublished literature by searching websites listed in CADTH’s Grey Matters checklist and other relevant sources in January 2022. Two independent raters will screen and extract data from identified material. Data will be presented in a tabular form.Inclusion criteriaWe will consider Canadian programmes that target the general public and exclude papers targeting health professionals. Our review will not limit by vaccine type and will consider any intervention that aims to inform individuals about immunisation. Our primary concept involves mapping the characteristics of programmes (eg, programme description, delivery format) and our secondary concept will examine barriers and facilitators to programme delivery.Ethics and disseminationEthical approval is not required as this study is a review of the published and publicly reported literature. Findings from this review will be disseminated to academic and health system stakeholders to inform immunisation programmes across a wide range of vaccine types and settings. We intend to use the results of this review to develop an immunisation support programme in Prince Edward Island, Canada.

A critical illness event is intensely stressful for family members and can lead to negative psychological, emotional, social and financial consequences. In geographically rural areas, critically ill patients may require an interfacility transfer to an urban centre for advanced critical care services. In this context, research suggests that these family members from rural areas experience additional burdens, yet little is known about these experiences. An interpretive phenomenological approach was used to explore lived experiences of family members from rural areas whose critically ill relative undergoes an interfacility transfer to an urban centre for advanced critical care services. Participants described feelings of vulnerability in the urban centre, the need to protect the critically ill patient and other relatives, maintaining responsibilities at home, navigating family relationships, and a loss of connection during the transfer window. These findings may better position nurses to address family members’ stress and anxiety during this experience.

Nursing knowledge development and application are influenced by numerous factors within the context of science and practice. The prevailing culture of science along with an evolving context of increasingly technological environments and rationalization within health care impacts both the generation of nursing knowledge and the practice of nursing. The effects of the culture of science and the context of nursing practice may negatively impact the structure and application of nursing knowledge, how nurses practice, and how nurses understand the patients and families for whom they care. Specifically, the nature of critical care and its highly technical environment make critical care nursing especially vulnerable to these potentially negative influences. The influences of the culture of science and the increasingly technical practice context may result in an overreliance on the natural sciences to guide critical care nursing actions and an associated marginalization of the caring relationship in critical care nursing practice. Within this environment, nursing philosophy may not be foundational to nursing actions; rather, the dominant culture of science and the rationalization of health care may be informing nursing practice. As such, the ideology and goals of nursing may not be central to the practice of critical care nursing. The purpose of this paper is to explore the influence of the culture of science on the development of nursing knowledge and theory. Further, we aim to describe the value of using conceptual frameworks, such as Roy's Adaptation Model, as a nursing philosophy to influence the development of person-centred nursing knowledge and theory to inform critical care nursing practice as it related to the care of patients and families. In doing so, nursing philosophy is situated as foundational for nursing actions. K E Y W O R D S conceptual framework, critical care nursing, nursing knowledge development, nursing philosophy, rationalization How to cite this article: Burns M, Bally J, Burles M, Holtslander L, Peacock S. Influences of the culture of science on nursing knowledge development: Using conceptual frameworks as nursing philosophy in critical care nursing.

ObjectiveTo identify, characterise and map the existing knowledge about programmes that provide immunisation support to Canadians and barriers and facilitators to their delivery.DesignScoping review and environmental scan.IntroductionVaccine hesitancy may be associated with unmet support needs of individuals. Immunisation support programmes that provide multicomponent approaches can improve vaccine confidence and equitable access.Inclusion criteriaCanadian programmes that focus on providing information about immunisation for the general public, but excluding articles targeting health professionals. The primary concept involves mapping the characteristics of programmes and our secondary concept examines barriers and facilitators to programme delivery.MethodsThe Joanna Briggs Institute (JBI) methodology guided this review, reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. A search strategy was developed and translated for six databases in November 2021 (updated October 2022). Unpublished literature was identified through the Canadian Agency for Drugs and Technologies in Health Grey Matters checklist and other relevant sources. Stakeholders (n=124) from Canadian regional health authorities were also contacted by email for publicly accessible information. Two independent raters screened and extracted data from identified material. Results are presented in tabular form.ResultsThe search strategy and environmental scan resulted in 15 287 sources. A total of 161 full-text sources were reviewed after applying eligibility criteria, resulting in 50 articles. Programmes were delivered in multiple Canadian provinces, focusing on various vaccine types. All programmes aimed to increase vaccine uptake and were mostly provided in person. Multidisciplinary delivery teams based on collaborations among multiple entities were credited as a facilitator to programme delivery across settings. Limitations on programme resources, attitudes of programme staff and participants, and systems organisation were identified as barriers to delivery.ConclusionsThis review highlighted characteristics of immunisation support programmes across various settings and described multiple facilitators and barriers. These findings can inform future interventions that aim to support Canadians in making decisions about immunisation.