Search

Aim: The aim of this paper is to explore the perceptions, attitudes and beliefs of middle‐aged Australians around their health, lifestyle risks and chronic disease. Background: Health promotion and risk reduction are important to stem the rising prevalence of chronic disease. While there has been much emphasis on supporting these strategies in older Australians, there has been less attention on those in middle age. However, as this group age, their health will inevitably be impacted by lifestyle risk. Design: A qualitative descriptive study using semi‐structured interviews. Reporting was guided by the COREQ checklist. Methods: Thirty‐four participants aged 40–65 years were recruited across South Eastern New South Wales, Australia, using convenience sampling. Semi‐structured interviews were conducted by four registered nurses with qualitative research experience. Verbatim transcripts were analysed using thematic analysis. Results: Sixteen women and 18 men participated in the interviews. Four themes emerged, namely: adopting healthy lifestyles; denial; an impetus for change; and sustaining change. Perceptions about what constituted good health varied, with male participants being more ambivalent about their health. Impetus for change was mostly influenced by family history, awareness of health risks and identification of risks by health professionals. Participants found sustaining change challenging, particularly with regard to smoking cessation and dietary modifications. Conclusions: Understanding the perceptions of health of middle‐aged people is important and enables health professionals to engage in early behavioural change conversations that consider perceived barriers to lifestyle modification. Findings from this study emphasise the importance of discussions about lifestyle risk to reduce the future burden of chronic disease. Relevance to Clinical Practice: These findings illustrate the importance of understanding perceptions of health to guide primary health care nurses to develop person‐centred health promotion and chronic disease prevention strategies in this age group. [ABSTRACT FROM AUTHOR]

Aims and objective: To capture the experiences of nurses in relation to the acutely physiologically deteriorating consumer. Background: Improving the physical health care of consumers with mental illness has been widely adopted as a priority for mental health nursing. Much of the effort thus far has focused on routine screening, prevention and treatment of common comorbidities including cardiovascular disease, diabetes mellitus and cancer. There has been less focus on the acutely physiologically deteriorating consumer in the mental health setting. Further study is warranted since this issue poses a set of highly complex challenges for nurses within the inpatient setting. Method: An exploratory, descriptive study was employed using focus groups to gather narrative data, which was then subject to qualitative analysis. Eleven mental health inpatient wards within a local health district in Sydney, Australia, were studied, comprising ward‐based nurses (n = 64) and nurse unit managers (n = 8). This paper follows the COREQ guidelines for reporting qualitative health research. Results: Qualitative data analysis revealed three themes central to the nurses' experience: (a) lack of clarity (subthemes: procedures and leadership accountability); (b) confidence in the workforce (subthemes: knowledge and skills, training needs, relevant experience, collaboration with emergency and medical teams, stigmatising attitudes); and (c) complexity (subthemes: complexity as the new norm and suitability of the mental health environment). Conclusion: The themes found in this study can be used to guide and inform healthcare policy, protocols, education and processes around building a more confident nurse workforce for the acutely physiologically deteriorating consumer. Relevance to clinical practice: Findings provide a rich data set for the generation of measurement tools and protocols to guide physical health care and evaluate performance. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Advanced Nursing (John Wiley & Sons, Inc.) is the property of John Wiley & Sons, Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aims and Objectives: The aim of this study was to explore healthcare managers' perceptions about older nurses' and midwives' and their contribution to the workplace. Design: A qualitative descriptive methodology. Method: Twenty healthcare managers working in Australia participated in semi‐structured interviews. Data were collected between April 2019 and April 2021. Interviews were recorded, transcribed and then analysed using thematic analysis. Results: All healthcare managers said older nurses and midwives contributed to the workplace through their experience and knowledge. Managers viewed them as a different type of worker and while there were some positive aspects to this, it was mostly negative. Although managers identified a broad age range for the older nurses or midwives, there was a common perception that if they were no longer able to perform their duties, they should leave the workforce. Conclusion: Healthcare managers' perceptions towards older nurses and midwives are mostly negative, and their understanding of older workers' contribution is contradictory and poor. These negative views co‐exist with the lack of agreement on who is the older worker, which explain the reluctance of healthcare organizations to invest in their older workforce. Future research is needed to better understand the unique contribution of older nurses and midwives in healthcare and how they can be supported at work. Impact The global ageing population will result in a rise in complex age‐related health issues and will require an experienced and knowledgeable workforce. Given the greater experience of older nurses and midwives they are an important part of the health workforce. Yet managers' perception of the contribution by older nurses and midwives were often negative. The findings of this study highlight the need for organizational change so that the contribution of older nurses and midwives is recognized and supported by managers. [ABSTRACT FROM AUTHOR]

Recovery‐oriented principles have progressively been accepted as a standard of mental health practice in many countries, including Australia. A private mental health Clinic in Melbourne, Australia, is dedicated to embedding the principles of recovery‐oriented practice into care by (i) providing recovery education and training for their staff and (ii) co‐designing resources with consumers to promote active consumer engagement and participation. The purpose of this study was to evaluate the impact of these initiatives on staff knowledge and provision of recovery‐oriented care in acute care. Two groups of study participants were recruited: the first group completed the staff training programme introducing the concept of recovery‐oriented practice, and the second group was a convenience sample of nurses recruited 12 months later working on the acute inpatient wards at the study site. Nurses completed Recovery Knowledge Inventory (RKI) and Recovery Self‐Assessment (RSA‐Provider) surveys and participated in a focus group discussion. The three major themes identified from the focus group discussion were as follows: (i) nurses' understanding of personal recovery‐orientated practice, (ii) how to embed personal recovery‐oriented care into practice, and (iii) barriers to consumer participation in recovery‐oriented activities in acute care. There were significant differences between the two groups on the RKI subscale scores of 'Expectations regarding recovery' and the 'Roles of self‐definition and peers in recovery' and 'Life goals' and 'Choice' factors on the RSA subscale scores. There were some gaps in the nurses' knowledge and implementation of personal recovery‐oriented concepts, highlighting the need for further training and cultural change. [ABSTRACT FROM AUTHOR]

Aim: To use expert consensus to develop guidance for nurse leaders implementing e‐health tools to support nursing work in hospitals. Background: Nurse leaders are increasingly required to make decisions about the selection, development, implementation and optimisation of e‐health tools for nursing work in hospitals. Guidance in this rapidly evolving and complex space is limited. Design: A two‐phase modified Delphi study. Methods: Phase one involved in‐depth interviews with five nursing informatics experts. Analysis used the qualitative framework method, informed by the Theoretical Domains Framework (TDF), to develop statements for an anonymous online Delphi scoring survey. This was distributed using snowball sampling methods to Australian nurse informatics leaders and experts. Final analysis involved synthesis of qualitative and quantitative data. The study adheres to the COnsolidated criteria for REporting Qualitative research (COREQ) checklist. Results: Ten guidance statements to support nurse leaders to implement e‐health tools in hospitals were developed from the synthesis of qualitative interview data and 29 experts' responses to the 55‐item Delphi response survey. Conclusion: Implementation of e‐health tools for nursing work is complex in health settings and requires careful examination of multiple factors and interactions between clinicians, tools, service users and the health organisation. This research proposes ten statements to support nurse leaders with decisions about implementing e‐health tools to support nursing work in hospitals. Relevance to clinical practice: The ten statements developed by this research provide a resource to assist policy and practice decisions about e‐tools to ensure they are suited to supporting nursing work. Nurse leaders can use the ten statements for guidance in the selection, development, implementation and optimisation of e‐health tools to ensure suitability and adaptation for nursing work in hospitals. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore nurses' decision‐making regarding intravenous administration set replacement for vascular access device infusions in paediatric and adult clinical settings. Background: Intravenous administration sets are routinely replaced at regular intervals in clinical practice with the goal of preventing catheter‐related bloodstream infection; however, emerging evidence is challenging traditional hang‐time durations. Nurses' perceptions and contextual factors affecting decision‐making for administration set replacement have not been assessed previously. Design: Qualitative study using focus groups with contextualism methodology and inductive analysis. Method: During November–December 2016, eight semi‐structured focus groups were conducted with 38 nurses at two metropolitan hospitals in Queensland, Australia. Interviews were audio‐recorded and transcribed. Two authors independently reviewed transcripts and extracted significant statements using Braun and Clarke's 7‐step method of thematic analysis. The COREQ checklist provided a framework to report the study methods, context, findings, analysis and interpretation. Results: Five key themes emerged from the analysis: (a) infection prevention, (b) physical safety, (c) patient preference, (d) clinical knowledge and beliefs, and (e) workload. Administration set replacement can be a complex task, particularly when patients have multiple infusions and incompatible medications. Nurses drew on perceptions of patient preference, as well as previous experience, knowledge of peer experts and local policies, to aid their decisions. Conclusions: Nurses use clinical reasoning to balance patient safety and preferences with competing workplace demands when undertaking administration set replacement. Nurses rely on previous experience, hospital and medication manufacturer policies, and peer experts to guide their practice. Relevance to clinical practice: Nurses at times deviate from clinical guidelines in the interests of patient acuity, nurses' experience and workload. The findings of this study indicate nurses also balance considerations of patient preference and safety with these competing demands. [ABSTRACT FROM AUTHOR]

Aim: To explore Registered Nurses' attitudes and behaviour towards patients' use of complementary therapies. Background: Despite high rates of use of complementary therapies by the general population, little is known of how nurses respond to patients' use of these therapies. Design: A two-phase sequential exploratory mixed methods design. Methods: Nineteen Registered Nurses working in Australia participated in a semi-structured interview in 2015-2016 and emerging themes informed the development of a quantitative survey instrument administered online nationwide in 2016. Findings: Emerging key themes "Promoting safe care"; "Seeking complementary therapies knowledge";" Supporting holistic health care"; and "Integrating complementary therapies in practice" were reflected in survey results. Survey responses (N = 614) revealed >90% agreement that complementary therapies align with a holistic view of health and that patients have the right to use them. Most nurses (77.5%) discussed complementary therapies with patients and 91.8% believed nurses should have some understanding of the area. One-third did not recommend complementary therapies and there was a lack of overall consensus as to whether these therapies should be integrated into nursing practice. Nurses with training in complementary therapies held more positive views than those without. Conclusion: Nurses were generally supportive of patients' interest in complementary therapies, although their primary concern was safety of the patient. Despite broad acceptance that nurses should have a basic understanding of complementary therapies, there was a lack of consensus about recommendation, integration into nursing practice and referral. Further research should explore how nurses can maintain safe, patient-centred care in the evolving pluralistic healthcare system. [ABSTRACT FROM AUTHOR]

Aims To outline the way the culture of austerity arising from the Global Financial Crisis has been used by Australian and New Zealand governments to maintain and extend healthcare budget cuts, through new public management strategies leading to missed nursing care. Background Ten years on the cost of the Global Financial Crisis continues to be borne by tax payers and those employed by the welfare state, yet analysis shows clearly that it was caused by a failure to adequately regulate markets, particularly the banks and multinational corporations. In health care, one of the impacts is increased workload for nurses leading to missed care. Design/Methods Registered Nurses and midwives ( n = 7,302) completed the MISSCARE surveys between 2012 - 2015, in four Australian states and New Zealand providing quantitative and qualitative responses. The qualitative comments were analysed using a template analysis approach based on key features of New Public Management. Findings Sixty-two qualitative responses identified measures in place directly linked to austerity and new public management strategies that impacted on the quality of patient care and nursing work, as well as contributing to missed care. Conclusion Opportunities for resistance may lie outside public and private health organizations in civil society, in the nurse union movements and other health and nursing professional associations. [ABSTRACT FROM AUTHOR]

Australia, along with other countries, has introduced New Public Management (NPM) into public sector hospitals in an effort to contain healthcare costs. NPM is associated with outsourcing of service provision, the meeting of government performance indicators, workforce flexibility and rationing of resources. This study explores the impact of rationing of staffing and other resources upon delivery of care outside of business hours. Data was collected through semistructured interviews conducted with 21 nurses working in 2 large Australian metropolitan hospitals. Participants identified four strategies associated with NPM which add to workload after‐hours and impacted on the capacity to deliver nursing care. These were functional flexibility, vertical substitution of staff, meeting externally established performance indicators and outsourcing. We conclude that cost containment alongside of the meeting of performance indicators has extended work traditionally performed during business hours beyond those hours when less staffing and material resources are available. This adds to nursing workload and potentially contributes to incomplete nursing care. [ABSTRACT FROM AUTHOR]

Aims and objectives. To describe the healthcare experiences of young adults with type 1 diabetes who access diabetes services in rural areas of New South Wales, Australia. Background. The incidence of type 1 diabetes in childhood and adolescence is increasing worldwide; internationally, difficulties are encountered in supporting young people during their transition from children to adulthood. Consumers' experiences and views will be essential to inform service redesign. Design. This was a qualitative exploratory study. Methods. Semistructured telephone interviews were conducted with 26 people aged 18-28 years living rurally, recruited through staff in four regional healthcare centres in 2008. Results. Two key themes were evident: lack of access (comprised of transfer to adult services, access to health professionals and access to up-to-date information) and age-appropriate provision. The impact of place of residence and personal motivation crossed all themes. Participants contrasted unfavourably the seamless care and support received from paediatric outreach services with the shortages in specialist and general practice-based care and information and practical problems of service fragmentation and lack of coordination experienced as adults. They identified a range of issues including need for ongoing education, age-appropriate services and support networks related to developing their ability to self-manage. They valued personal service; online and electronic support was seldom volunteered as an alternative. Conclusion. This was a first view of rural young people's experiences with adult diabetes services. Reported experiences were in line with previous reports from other settings in that they did not perceive services in this rural area of Australia as meeting their needs; suggestions for service redesign differed. Relevance to clinical practice. New models of age-appropriate service provision are required, to meet their needs for personal as well as other forms of support, whilst acknowledging the very real resource limitations of these locations. [ABSTRACT FROM AUTHOR]

Aim and objectives. To explore Australian lesbian mothers' experiences of becoming parents. Background. Lesbians are becoming parents and, since legislative changes in Australia, their numbers are increasing. Prior to legislative changes, fertility and health services for women in Australia exclusively served the needs of the heterosexual community. Although lesbian experience of seeking health services has been studied in other contexts, little has been done to understand their experience of deciding, conceiving and birthing. Design. Qualitative descriptive study. Method. Seven interviews conducted with lesbian mothers in Australia. Results. The following themes were identified: 'making the decision'; 'the search'; 'perseverance'; and 'problems of isolation'. Conclusions. Although legislation now affords lesbians access to reproductive technologies throughout most of Australia, their involvement with health professionals can result in homophobic interactions. One way to address the needs of lesbian families is to provide an environment where the disclosure of sexual identity is encouraged. Further larger scale research should identify changes to service provision required to address the inequalities between heterosexual and lesbian women and ensure health services are provided that are free from discrimination. Relevance to clinical practice. Most health services have policies and procedures in place to prevent discrimination on all grounds, including sexual orientation. It is imperative that administrators and clinicians take steps to ensure that these guidelines are applied. [ABSTRACT FROM AUTHOR]