Autonomy has been recognised as a key principle in healthcare, but we still need to develop a consistent understanding of older people’s perceived autonomy in residential care. This study aimed to identify, describe and synthesise previous studies on the perceived autonomy of older people in residential care. Ethical approval was not required, as this was a review of published literature. We carried out an integrative review to synthesise previous knowledge published in peer-review journals in English up to September 2019. Electronic and manual searches were conducted using the CINAHL, Philosopher’s Index, PubMed, SocINDEX, Scopus and Web of Science databases. The data were analysed using the constant comparison method. The review identified 46 studies. Perceived autonomy referred to the opportunities that older people had to make their own choices about their daily life in residential care, and achieving autonomy promoted both health and quality of life. Autonomy was linked to older people’s individual capacities, including their level of independence, physical and mental competence, personal characteristics, and whether relatives shared and supported their perceived autonomy. Professionals could facilitate or hinder older peoples’ autonomy in a number of ways, including providing opportunities for autonomy, how daily care needs and activities were managed, and controlling older people’s choices. Professionals’ characteristics, such as education and attitudes, and the older people’s living environments were also associated with their perceived autonomy and included organisational characteristics and physical and social care facilitators. Older people’s perceived autonomy promoted health and quality of life in residential care. However, their autonomy was associated with a number of protective and restrictive individual and environmental factors, which influenced whether autonomy was achieved.

Aim: To explore how nurses perceived having a calling to nursing.Design: A mixed‐method study.Methods: Survey data collected in autumn 2020 and semi‐structured individual interview data collected in spring 2021. The 7925 survey respondents were care professionals and 414 of them were registered nurses. The 23 interview participants were registered nurses who responded to the survey. We examined the survey results using analysis of variance and t‐tests and the interview data with qualitative thematic analysis.Results: Registered nurses had a lower calling than other care professionals. Based on the interviews, having a calling to nursing produce four key findings. Nurses with a calling experienced their work as meaningful. They also adopted a humane and holistic approach to their work. However, their calling could change during their professional career. Due to its historical roots, having a calling was seen as a risk for the nursing profession, as it meant nurses had an oppressed position in society and nurses associated it with poor working conditions and low pay.Conclusion: Our study showed that having a calling to nursing had multidimensional benefits for the individual nurse, their patient, colleagues, organization and society, but showed strong association between calling and nurses' poor working conditions and low pay.Impact: We found that nurses had a lower calling than other care professionals. Calling still exists, but it can produce tension in modern nursing. Organizations and society need to focus on how calling can be seen as a more positive attribute of nursing and improve nurses' working conditions and pay.

Healthcare provides a rich, and constantly increasing, number of written documents, which are underutilized in research data for health and nursing sciences, but previous literature has only provided limited guidance on the process of document analysis. The aim of this paper is to provide a methodological framework for analyzing health care documents as written data, based on a systematic methodological review and the research team’s experience of the method. Based on the results, the methods consist of seven phases: (i) identify the purpose, (ii) determine the document selection strategy, (iii) select or design an extraction matrix, (iv) carry out pilot testing, (v) collect and analyze the data, (vi) consider the credibility, and (vii) ethics of the study. The framework that has been developed can be used to carry out document analysis studies that are both feasible and credible.

Orientation. Trust is the central part of leadership and organizational culture and can often go unnoticed until it decreases. There is a lack of a comprehensive concept analysis of trust in the healthcare setting. Research Purpose. The research aim was to gather, assess, and synthesize previous empirical evidence from the field of healthcare about the concepts of trust in the leader and trust in the organization. Motivation for the Study. To create a comprehensive and generic concept analysis of trust in the leader and organization for the healthcare sector based on recent empirical studies. Research Design and Method. A concept analysis, which followed the method presented by Walker and Avant, was conducted as a systematic review that adhered to the PRISMA guidelines. A total of eight databases were searched for relevant literature and 42 articles were included. Main Findings. The definitions of trust in the leader and the organization were based on emotion and cognition. Trust in the leader emerged as a core feature of collaborative leader-employee relationships, whereas trust in the organization was a key construct of organizational functioning. Trust in the leader and the organization contributed to commitment, increased work production, enhanced collaboration, and improved workplace well-being. Defense mechanisms were identified as a new contrary concept, while justice was found to be a related concept. Contribution. Both trust in the leader and trust in the organization positively impact an organization, nurse leaders, and employees. Deeper knowledge of trust and its attributes will be critical to the operationalization and estimation of levels of trust in healthcare organizations. Managerial Implications. Trust in the leader and the organization can significantly influence the attractiveness of an organization, retention of personnel, productivity, and work-related well-being. Thus, this aspect should be measured and developed systematically while acknowledging the antecedents of trust building.