Luke Molloy

BackgroundValues-based leadership has emerged as an important framework for supporting ethical practice, workforce sustainability, and patient-centred care within increasingly complex healthcare systems. Despite growing recognition of its importance, limited clarity exists regarding how personal and professional values interact to shape leadership behaviour in nursing and midwifery.PurposeThis paper synthesises contemporary literature relating to values-based leadership in nursing and midwifery and examines antecedents that influence the development of ethical leadership behaviours across professional contexts.MethodsA scholarly discussion paper using an integrative narrative review approach. Literature relating to authentic, servant, congruent, ethical, and transformational leadership was reviewed alongside research addressing professional identity, professional values, organisational culture, and leadership development in nursing and midwifery.FindingsValues-based leadership emerges through the interaction of personal values, professional socialisation, reflective identity formation, mentorship, and organisational culture. Authentic, servant, and congruent leadership approaches were consistently associated with improved staff wellbeing, psychological safety, professional engagement, and patient-centred care. Organisational cultures that reinforced ethical practice, reflective learning, and professional autonomy supported stronger leadership capability and workforce sustainability.DiscussionValues-based leadership provides an important framework for navigating contemporary healthcare pressures whilst preserving the relational and ethical foundations of nursing and midwifery practice. Leadership development strategies that integrate reflective practice, mentorship, professional identity formation, and values-based organisational cultures may strengthen workforce retention, leadership capability, and quality care outcomes.Implications for Nursing ManagementHealthcare organisations should embed values-based leadership principles into recruitment, leadership development, mentoring, and workplace culture strategies to support sustainable and ethically grounded nursing and midwifery leadership.

As individuals grow older, the likelihood of developing chronic health conditions rises, with many older adults managing multiple long-term illnesses (Chowdhury et al., 2023). Engagement in adequat...

Introduction: The Strengths Model offers a framework for mental health treatment, emphasising individuals' strengths over deficits. Traditional deficit‐focused practices often lead to feelings of helplessness among people with mental illness and clinicians. The Strengths Model's alignment with the principles of recovery has seen it become viewed as a synergistic approach to support recovery‐oriented practice. Aim/Question: This meta‐ethnography aims to synthesise qualitative research to understand how the Strengths Model is perceived, experienced and operationalised across different contexts. Method: The review followed Noblit and Hare's meta‐ethnography method, synthesising qualitative research studies identified through systematic searching and appraisal of the literature. Seven studies were included, focusing on the Strengths Model in mental health services. Results: Three overarching themes emerged: collaborative practice, empowering people and a mix of limitations. The Strengths Model fosters a therapeutic relationship between service users and clinicians, emphasises strengths over deficits and promotes a recovery‐oriented approach. Discussion: The Strengths Model enhances therapeutic relationships and collaborative working alliances, crucial for successful mental health outcomes. However, challenges include its suitability for all service users and potential resistance from clinicians. Implications for Practice: The model aligns with recovery‐oriented reforms and human rights‐based approaches, enhancing personal strengths and goals.

Collaboration is a foundational characteristic of ethical mental healthcare. However, inpatient mental healthcare often fails to espouse the practices and principles that would establish meaningful collaborative care, with coercion and restrictive practices an ongoing aspect of consumers' lived experience. This qualitative descriptive study aimed to understand consumers' perspectives of collaboration with clinicians in the inpatient mental health setting. One‐on‐one semi‐structured interviews were conducted with 12 people who have experienced involuntary inpatient mental healthcare; data were analysed by thematic analysis. The participants of this study valued collaborative inpatient mental healthcare. However, they reported that their own perspectives were not sufficiently sought or considered. Clinicians' default scepticism compounded participants' experiences of inconsideration. In contrast, genuinely caring interpersonal relationships with clinicians were valued, establishing a sense of safety and collaboration. The failure to establish collaboration requires systemic reform and the resolution of micro‐cultures that disenfranchise the perspectives of people receiving inpatient mental healthcare. Notably, the participants of this study reported that interpersonal relationships with clinicians facilitated meaningful collaboration. Collaboration relies on the presence of strong interpersonal care; the culture, policy and structures of inpatient mental healthcare must be oriented to be interpersonal.

This study explored the experiences of people living with dementia and their care partners attending a nurse practitioner-led, community-based, multicomponent memory clinic in regional Australia. Guided by Nussbaum’s Central Human Capabilities, a qualitative descriptive design was used to examine how the model of post-diagnostic dementia care supported living a life of dignity. Emotional touchpoint interviews were conducted between January and May 2025 with people who had attended the clinic for six months or more. Fourteen interviews were completed with people living with dementia ( n = 8) and care partners ( n = 6), and analysed thematically. Four themes were generated: emotional safety in a predictable, respectful group; relational autonomy and everyday choice; feeling truly known, respected, and connected; and meaningful engagement through accessible challenge and play. People with dementia described the value of familiar routines, social connection, physical exercise, cognitive stimulation, creativity, humour, and supported choice. These experiences promoted feelings of safety, confidence, enjoyment, belonging, autonomy, and meaningful contribution. Care partners reinforced these experiences, highlighting the importance of predictability, emotional safety, individualised support, and being genuinely known within the group. The findings suggest that post-diagnostic dementia care can move beyond biomedical models focused on diagnosis, treatment, loss, and decline. Nurse practitioner-led, community-based models can support dignity when they create relational and emotional conditions in which people living with dementia can feel safe, make choices, express emotion, remain connected, and experience themselves as capable. This study highlights the potential of capability focused, nurse-led dementia care in promoting accessible, person-centred, and emotionally safe post-diagnostic support.

Aim(s): To conduct a systematic concept analysis of Ceiling of Care to clarify its definition and distinguish its core features within acute care settings. Method: The Walker and Avant’s concept analysis method was applied. Data Sources: A systematic search of six databases (APA PsycINFO, CINAHL, the Cochrane Library, MEDLINE, ProQuest Central and Scopus) was conducted from inception to July 2026, supplemented by manual reference list searches and AI‐assistance tools. Result: Nineteen records met the inclusion criteria. Five defining attributes were identified: (1) patient‐centred collaborative decision‐making; (2) comprehensive and structured prognostic evaluation; (3) establishment of explicit therapeutic boundaries; (4) proactive and continuous care strategy and (5) standardised documentation and communication. Antecedents included predisposing, precipitating and contextual factors, while key consequences included reduced nonbeneficial treatment and enhanced decision‐making clarity. The analysis distinguishes Ceiling of Care as a broad, anticipatory framework rather than a reactive, single‐intervention directive such as a do‐not‐resuscitate order. Conclusions: Ceiling of Care is defined as an anticipatory, documented clinical decision‐making approach that establishes the maximum appropriate level of treatment escalation for an individual patient, based on clinical assessment, anticipated benefit and patient values. Implication for Nursing Management: This conceptual clarity provides a foundation for standardised implementation in acute care settings. Nurse managers need to lead the integration of Ceiling of Care frameworks within acute care settings; this could support nursing management in standardising clinical decision‐making, reducing nonbeneficial treatment escalation, strengthening communication across multidisciplinary teams and ultimately enhancing the quality and dignity of patient care.

BACKGROUND Mental health apps are widely promoted to support assessment, self-management, and recovery. Yet their real-world value for people with lived experience depends on how apps are encountered, trusted, and sustained (or abandoned) in everyday life—contexts that quantitative trials alone rarely capture. OBJECTIVE To synthesize qualitative evidence on how individuals with lived experience of mental illness use mental health–related mobile apps and to develop a line-of-argument model explaining variability in engagement, perceived benefit, and burden across settings. METHODS We conducted a qualitative evidence synthesis using meta-ethnography (Noblit & Hare) and reported per eMERGe guidance. We searched CINAHL for English-language qualitative studies on mental health app use (2019–2024) and complemented this with backward/forward citation checking. Two reviewers independently screened records, extracted first-order (participant) and second-order (author) constructs, and appraised study quality using NICE qualitative standards. Through reciprocal translation and synthesis of translations, we generated third-order interpretations and an integrative line-of-argument. RESULTS Six studies from the United States, England, and the Netherlands were included, spanning apps targeting depression/anxiety, bipolar disorder, serious mental illness, and suicide prevention. Four cross-cutting themes emerged. (1) Apps as adjuncts, not replacements: they scaffold self-regulation between clinical contacts but are often set aside during crises. (2) Self-management and empowerment: mood/symptom tracking, prompts, and psychoeducation can strengthen insight and agency when tailored and meaningful. (3) Privacy, data governance, and trust: opaque data flows, surveillance concerns, and uncertainty about escalation pathways constrain disclosure and sustained use. (4) Design, usability, and discontinuation: low cognitive load, reliability, and personalization facilitate integration into routines; glitches, advertising, and burdensome data entry drive attrition. These dynamics shaped whether app use translated into improved day-to-day functioning and therapeutic conversations. CONCLUSIONS Mental health apps can extend person-centered care when embedded within trusted therapeutic relationships and usable ecosystems. Implementation should prioritize co-design with people with lived experience, transparent and choice-rich data governance (eg, clear data routes, consent options, and review plans), and design choices that minimize cognitive load—especially during distress. Clinicians and services should agree on what to track, how to review app data, and when to escalate, treating apps as shared tools rather than stand-alone solutions. Further work should standardize reporting of privacy practices and engagement trajectories and evaluate models that integrate app data into routine care without increasing burden for users or clinicians.