Caring for someone with stroke is challenging as caregivers navigate complex care demands. These demands are often compounded by limited resources, inadequate support, and overwhelming responsibilities. While much of the existing literature focuses on moral distress among healthcare professionals, this concept is relevant for stroke family caregivers. The aim of this study was to identify the attributes of moral distress among family caregivers of stroke survivors. A descriptive qualitative secondary analysis was conducted using data from telephone calls from 23 purposively sampled family caregivers, analyzed using Braun and Clarke’s thematic analysis framework. Three interrelated themes captured attributes of moral distress in family caregiving: making decisions under uncertainty and competing values, feeling powerless over the future, and turning negative emotions inward. These themes reflected caregivers’ struggles with making difficult decisions under uncertainty and competing moral values, coping with limited control over recovery outcomes, and directing negative emotions inward. These findings extended the concept of moral distress to stroke family caregivers. Nurses, who are often the first point of contact for family caregivers, are well positioned to recognize these attributes of moral distress. Understanding them may inform nurse-led interventions and support strategies aimed at reducing caregiver moral distress and improving caregiver well-being.
This study investigates healthcare supervisors’ perspectives on environmental responsibility in healthcare settings and aims to outline strategies for environmentally responsible healthcare. While previous studies have examined nurses’ views on environmental responsibility, healthcare supervisors’ observations on this issue remain underexplored. The aim of this study was to examine healthcare supervisors’ perspectives on environmental responsibility in healthcare and strategies for supporting it. A qualitative descriptive research design was selected, and interviews were conducted with 10 healthcare supervisors in Finland. Data were analyzed using inductive content analysis. Participants described strategies for environmental responsibility in healthcare at the micro-, meso-, and macro-levels. These findings highlight the need for organizational structures that support healthcare supervisors’ coordination responsibilities and acknowledge the influence of broader system-level factors on managerial work.
Family caregivers are central to lung transplantation, yet their experiences are often framed through the language of burden, needs, or support. While important, these framings may obscure how caregiving reorganises everyday life, embodied wellbeing, social recognition, and selfhood. This interpretive phenomenological study explored the lived meanings of family caregiving in lung transplantation through in-depth interviews with 31 adult family caregivers of lung transplant recipients in Spain. Analysis followed a phenomenological-hermeneutic movement from naïve understanding to structural analysis and comprehensive interpretation. Parse’s Human Becoming informed the interpretive orientation. The myth of Inanna’s descent was introduced only in the final interpretive phase as a heuristic device to communicate patterns already grounded in participants’ accounts. The findings show caregiving as a liminal descent across seven interrelated domains of progressive relinquishment: time, body, paid work, social life, recognition, autonomy, and identity. The “return” was not a restoration of the pre-transplant self, but a quiet reconfiguration made possible through relational support, recognition, and professional responsiveness. The study contributes to nursing knowledge by offering an interpretive language for recognising forms of caregiver suffering and endurance that remain difficult to see within conventional burden-based accounts.
Qualitative nursing researchers require flexible, secure and responsive data collection methods. Encrypted asynchronous email interviewing offers a secure approach for engaging geographically dispersed participants, individuals with demanding schedules, and those discussing sensitive experiences in rural communities where anonymity may be difficult to maintain. This paper describes the implementation of an encrypted email interviewing protocol across three undergraduate nursing honours studies conducted at a rural Canadian university. Recruitment was through purposive sampling and used semi-structured, asynchronous interviews via encrypted institution-affiliated email systems. Data security measures included encryption procedures, de-identification strategies, multi-factor authentication, and secure data storage. Data were analyzed using reflexive thematic analysis. Encrypted email interviewing generated rich qualitative data while enhancing participant agency, confidentiality, and privacy. The method reduced power imbalances associated with face-to-face interviewing, eliminated transcription requirements, and supported rigorous qualitative analysis. It was adaptable for both text-based and visual data collection. Challenges included the absence of nonverbal cues, reliance on participants’ literacy and access to technology, and potentially extended data collection timelines. Encrypted asynchronous email interviewing is a rigorous, adaptable, and ethically responsive qualitative data collection method that supports trustworthy qualitative inquiry on sensitive topics and with vulnerable populations in rural settings.
Providing end-of-life support for a family member with advanced cancer is often accompanied by significant burden and uncertainty, yet this experience remains underexplored in rural contexts. This study aimed to explore and interpret the meaning of uncertainty among rural family caregivers providing end-of-life care for a person with advanced cancer. A Gadamerian hermeneutic approach guided the study. Qualitative interview data were analyzed using reflexive thematic analysis. Findings are conceptualized through the metaphor “Walking a foggy path,” comprising four themes: (1) Navigating the unknown – uncertainty due to lack of information; (2) When and where – uncertainty about the timing and place of death; (3) Letting go or holding on – the caregiving dilemma; and (4) Am I enough? – the lonely landscape of caregiving. Caregivers reported feeling unprepared and isolated, unsure when or where death would occur, while managing emotional and practical challenges. Rural isolation and limited services intensified loneliness and complexity in home-based palliative care. Specialist nurses play a key role in reducing uncertainty through guidance and support. To improve rural healthcare, policies should prioritize telehealth, specialized teams, and community-based services. Future research should develop interventions that reduce uncertainty, strengthen preparedness, and enhance the quality of rural palliative care.
