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Background and study aim: Adolescent substance abuse significantly impacts on the lives of mothers. This paper explores the coping responses of mothers whose adolescents have been admitted to treatment for substance abuse. Design and method: A multiple case study design was adopted and the data were collected through one-on-one interviews facilitated by the Lifegrid. Interpretative phenomenological analysis was used to interrogate the data. Results: Coping emerged as a complex construct in our analysis. The mother's used problem-focused and emotion-focused coping in different combinations of withdrawing, tolerating and engaged coping responses. The mother's coping responses were also influenced by individual and relational factors like subjective distress and the mother-adolescent relationship. Conclusions: We argue that research and practice initiatives should consider using a multidimensional perspective of parental coping that recognises the heterogeneity of mother's coping responses. Impact statement: The current paper offers new insights into the complexities of mother's coping responses to adolescent substance abuse. [ABSTRACT FROM AUTHOR]

Background: This paper reports on a qualitative study utilising in-depth interviews of sixteen Australian mental health nurses (MHNs) working in general practice. On 1st July 2015, the commonwealth government of Australia established 31 primary health networks (PHN) to increase the efficiency and effectiveness of medical services for people, particularly those at risk of poor health outcomes, and to improve coordination of care. Aim: This study explores the experiences of Australian MHNs working in general practice. Design: Data were analysed using thematic analysis. Four themes emerged through the data analysis: (1) autonomy and flexibility, (2) opportunity for more clinically focused work, (3) health promotion and preventative health and (4) excited to work in general practice. Findings: Study Participants identified many clinical opportunities working in primary practice and noted that the autonomy and flexibility of their role was quite different from other areas they had previously worked. They reported having more time to spend with the patients and being able to engage in health promotion. Conclusions: In order to make mental health care more accessible it is important to have a well-qualified workforce within primary health care (PHC) settings such as general practice. The participants of this study have identified ways they have been best utilised in the Primary Care workforce. They embrace the autonomy of the role and the ability to engage with consumers by providing clinical interventions that can assess and intervene with people experiencing mental illness. [ABSTRACT FROM AUTHOR]

Background: Communication with indigenous patients is often a problem for health staff in Australia. Aim: This paper examines the barriers and enablers in communication between health staff and Indigenous carers of paediatric patients in a hospital, about advice to help reduce exposure of children to second-hand smoke (SHS). Methods: Non-indigenous health staff and Indigenous carers, were recruited from a paediatric ward of a regional hospital in the Northern Territory. A constructivist grounded theory with multiphase case study design and semi-structured interviews was used. Results: Health staff and carers had different perceptions about raising the issue of smoking. Health staff lacked confidence to talk about smoking and questioned the cultural appropriateness of doing so. In contrast, carers expected to talk about smoking while in the hospital., and perceived it as part of a caring and protective relationship by health staff. English being a second language for carers was considered a significant communication barrier by staff; carers, however, felt that health staff needed to modify their communication styles. The possible misperceptions about carers' lack of response to messages, led to health staff dropping the subject, when, in fact, carers were struggling with health workers communication styles. Conclusions: Health staff and carers perceive discussion around smoking differently. Cross-cultural communication education may empower staff to provide effective smoking cessation interventions in this setting. Impact statement: Improving communication between health staff will help ensure the optimal provision of smoking cessation support to carers. [ABSTRACT FROM AUTHOR]

Aims and Objectives: The aim of this paper was to evaluate the impact of phone support on sick day management of young people with type 1 diabetes. Method: Qualitative exploratory study to understand the usage of a phone support service available, 8am to 8.30pm, seven days a week. Inclusion criteria were: (a) young people with type 1 diabetes who attend an age-specific service; (b) experienced acute diabetes crisis. Interviews were coded for themes using QSR NVivo™ Version 11 software. Findings were examined through the theoretical lens of the Health Belief Model. Results: Of 20 eligible individuals, 8 participated in the study. Five avoided emergency presentation by accessing the phone support service; three who did not were admitted for diabetic ketoacidosis. The interviews generated 3 major themes: (a) self-efficacy, (b) cues to action, (c) susceptibility. Conclusion: Enhancing self-efficacy and promoting confidence to seek help early during an acute health crisis enables young people to effectively self-manage and avoid hospitalization. [ABSTRACT FROM AUTHOR]

Background: Undergraduate preparation is important in ensuring health care professionals are prepared to identify and respond to intimate partner violence (IPV). Previous studies confirm this education is highly variable and IPV-related content remains marginalised in undergraduate nursing, midwifery and paramedicine curricula. Aim: To investigate frontline academics' attitudes and beliefs in relation to the inclusion of IPV-related content in the aforementioned degrees. Design: A large multi-phase mixed methods Australian case study of Australian undergraduate nursing, midwifery and paramedicine degrees. In this paper, components of the survey and interviews from this study will be reported on. Methods: Quantitative comparative analysis of a 51-item on-line survey and qualitative thematic analysis of guided conversational interviews. Results: Across Australian universities IPV remains poorly embedded in nursing, midwifery and paramedicine programmes. Academics report a range of barriers to such inclusion, including an already overcrowded curriculum, a lack of confident and competent academics to teach this content area and a lack of support for this content inclusion. One factor statistically significant in its association with non-inclusion of IPV-related content was academic attitudes of professional role resistance. Gender was also identified as a significant factor associated with non-inclusion and resistant professional attitudes. Qualitative interviews revealed that only six of the 18 participants identified IPV-related care as within their scope of practice, with professional role resistance a common theme identified. Conclusion: Though professional organisation and policy makers now advocate for the inclusion of IPV-related content in the undergraduate preparation of nurses and midwives, work remains to address gendered and resistant attitudes amongst academics. [ABSTRACT FROM AUTHOR]

This paper presents the findings of a study that interviewed Aboriginal nurses to explore their experiences of the whiteness of nursing. Despite concerted efforts to improve the health of Aboriginal Australians, it still remains equivalent to third world countries. One strategy identified to address this is to increase the participation rates of Aboriginal registered nurses within the Australian healthcare workforce. Presently Aboriginal nurses account for only a small percentage of the nursing workforce. While there has been research into the recruitment and retention strategies dedicated to improving the numbers of Aboriginal registered nurses, this paper focus on the experiences of Aboriginal registered nurses within Australia's mainstream healthcare system, where they are exposed and subjected on a daily basis to the 'whiteness of nursing.' [ABSTRACT FROM AUTHOR]

Background: This paper draws on a 2015 study in New Zealand that examined perceptions of registered nurses (RNs) and general practitioners (GPs) regarding the role of Nurse Practitioners (NPs) in long-term aged care facilities (LTACF). Aim: To explore the attitudes of RNs and GPs regarding the role of NPs in LTACFs. Design: A descriptive, mixed methods design with a survey and invitation to interview was used. RNs and GPs who provided hospital-level care were invited to participate. Findings: The findings showed RNs and GPs are open to considering the NP role in aged care. However, there remains a lack of understanding of what NPs do. Conclusions: This study suggests a shift in attitude towards accepting the NP role by RNs and GP working in LTACFs. [ABSTRACT FROM AUTHOR]

Currently many nursing faculties and schools employ high numbers of sessional teachers to meet the demands of teaching. Sessional teachers are a source for future continuing academic staff; however, there is little exploration on the experiences of sessional teachers as they transition into the full-time nurse academic role. A qualitative study of 14 registered nurse participants used a story-telling approach to explore the experiences of sessional teachers as they transitioned into full-time and continuing academic roles. Findings revealed that participants had only a very limited understanding of the requirements of the academic role when appointed to it. Thematic analysis revealed two major themes. These were: 'Uncertainty: Dealing with role expectation' and 'Mitigating lack of confidence'. The implications of this paper contributes to and enhances knowledge of the transition experiences of sessional teachers and provides new evidence to suggest that adequate support processes are essential for sessional staff transitioning into permanent, full-time academic positions. [ABSTRACT FROM AUTHOR]

This paper arises from the analysis of data from a large Singapore-based survey and a complementary qualitative series of 17 individual interviews. Some results from both arms of the research have been previously analysed and are reported elsewhere. Answers to a series of questions within the questionnaire and the structured interviews have been drawn together under the umbrella of investigating of recent Singaporean graduates' views about the characteristics of a good nurse, a good day at work, and how they uphold ethical standards. Overall five themes emerged, these are: caring for others; respectful interpersonal interaction; rational clinical decision-making; the harsh reality of the workplace; and personal qualities (not easily influenced by formal education). Interviewees believed that potential nursing students should be made aware of the harsh realities they will face on graduation, which may seem counter-intuitive. However, graduates recalled their own struggles and perseverance and toughness to simply survive the early months as a key component of transition shock, indicating that an earlier awareness may be beneficial. [ABSTRACT FROM AUTHOR]

Health screening and early detection of cancer results in significantly better health outcomes and lower mortality. However barriers to such screening are multiple and complex. This paper specifically addresses barriers to women's health screening for socially disadvantaged women in an economically and service disadvantaged area. In this qualitative study, women's healthcare workers and consumers of women's health screening were interviewed and data related to issues for women who had special needs were analysed. Findings indicate there is a lack of access to appropriate services for socially disadvantaged women which affects their screening uptake rates. This study also highlights the difficulties socially disadvantaged women encountered when they were able to access these services which also influenced their decisions regarding subsequent health screening. Implications for nurses and other healthcare professionals are manifold and include advocating for greater access to services and more sensitive care in the delivery of health screening services for socially disadvantaged women. [ABSTRACT FROM AUTHOR]

Domestic violence is a major public health issue that influences all aspects of affected women's lives (World Health Organisation, 2010). Women who are subjected to domestic violence seek help from a wide range of professionals within health and social care sectors, and evidence suggests that their experiences tend to be negative. We argue that current approaches are based on responses that are medically informed and provide an alternate lens from which to view women's health care needs. This paper reports on the findings of the second phase of a two-phase study. The first phase of the study reported on women's emerging health needs, efforts to seek help and experiences of seeking healthcare. The second phase examined how nurses constructed the health and health issues of women affected by domestic violence when women presented for health care. This paper brings together the findings of both phases to argue there is a disconnection in women's experiences and needs and how nurses construct needs and deliver care. Biographical disruption is a new lens from which to view women's experiences and is a framework which highlights how women experience significant dislocation of their sense of self as a result of domestic violence. [ABSTRACT FROM AUTHOR]

Increasingly, with globalization, various countries including Canada are becoming ethno-racially and culturally diverse. Health professionals face the challenge of working effectively across these ethno-racial and cultural boundaries. In acknowledgement of the need to generate knowledge that informs the development of effective health care policies, this paper discusses the findings of a qualitative study that examined the childbirth experiences of African-Canadian women. The meaning of childbirth, which is the primary focus of this paper, includes: sense of responsibility, childbirth as a positive life event, the uniqueness of childbirth as a life experience, childbirth as a bitter-sweet paradox, and childbirth as a spiritual event. The paper will conclude with a discussion of study implications including the need to provide opportunity for nurses to learn about the client's values, beliefs, and practices. This is necessary for the attainment of desired health outcomes such as having a healthy mother and the safe birth of a healthy baby. [ABSTRACT FROM AUTHOR]

Background: Health care within the home setting is a vital and growing component of pressure injury (PI) prevention and management. Objectives: To describe the use of health services and pressure-redistributing devices in community dwelling patients with PI's. Design: Mixedmethods collective case study of a defined, diverse geographic postcode area in the United Kingdom. Methods: Quantitative retrospective analysis of electronic and paper medical records of adult PI patients from 2015 district nursing reports. Qualitative semi-structured interviews of community dwelling adult patients receiving, or received, treatment for PI in 2016. Results: Mandatory reports (n = 103) revealed that 90 patients were supplied with a variety of pressure-redistributing devices but only one-third of patients used the equipment as recommended. Qualitative interviews (n = 12), reported to COREQ guidelines, revealed that patients felt reliant on community health services, and were concerned about the consistency of their care. Conclusions: Authentic patient involvement is required to provide care and interventions that are acceptable to PI patients and can be incorporated into self-care strategies and effectively monitored. [ABSTRACT FROM AUTHOR]

Aim: To explore residential aged care nurses working in interim, rehabilitation and residential aged care perceptions of resilience. Design: Qualitative Portraiture methodology. Inclusion criteria were that all participants were English speaking, registered with the Australian Health Practitioners Registration Authority and had more than five years' experience working in an aged care environment. Three participants were interviewed and employed within a metropolitan interim, rehabilitation and aged care setting. Results: Eight themes were identified: valuing social support; leadership, managing 'self'; 'paying it forward'; passion for the profession; focusing on the positive and the taking on of challenge. Conclusions: This paper focuses on the impact of aged care nursing work on nurses and in particular how the nurses remain resilient in their work environment. Resilience can be developed through education and can sustain professional longevity. Workload stress can be alleviated through the provision of resilience training. [ABSTRACT FROM AUTHOR]

Background: The transition from nursing student to graduate remains problematic internationally with issues arising concerning graduates' work readiness upon commencing employment. Aim: This exploratory study specifically investigated perceptions of graduate nurse program coordinators on the work readiness of nursing graduates, with the aims of identifying strengths, weaknesses and challenges that exist. Design: Qualitative descriptive design. Methods: Sixteen graduate nurse program coordinators were interviewed from various health-care services in the state of Victoria, Australia. Interviews were audio-recorded and transcribed verbatim and thematic analysis was used to disclose reoccurring themes and sub-themes. Findings: This paper reports on one theme, preparation readiness, and three sub-themes associated with this theme; clinical skills deficits, communication issues and transitioning as an enrolled nurse to a registered nurse. Conclusions: There are several areas of weaknesses and challenges for nursing graduates in their preparation for practice. As a poorly understood area, evidence from this study will inform curriculum development and transition programs, not only in Australia, but also internationally. [ABSTRACT FROM AUTHOR]

Background: Australian legislation supporting the nurse practitioner (NP) role was enacted in 1998. Since then, NPs have played an important advanced practice role within the interdisciplinary healthcare team. However, the literature suggests that transition to the NP role can be challenging. Aim: This paper highlights the complex transition experiences of ten recently endorsed Australian NPs. The convoluted legislative and regulatory requirements that were negotiated by the NPs are presented as narratives. Methods: Informed by an ethnographic approach, participants were interviewed several times during their first year. Interview transcripts were thematically analysed and aggregated into three narratives representative of key findings. Key Findings: The findings exemplify the complexity of navigating through a labyrinth of bureaucracy and the extensive negotiations required to appease those who yielded power over their future practice. Conclusion: This study raises awareness of the transition experiences of Australian NPs and their challenges and barriers during this time. [ABSTRACT FROM AUTHOR]

Society and some healthcare professionals often marginalise pregnant women who take illicit substances. Midwives who care for these women are often viewed as working on the edge of society. This research aimed to examine the lived experiences of midwives who care for pregnant women who take illicit drugs. A phenomenological study informed by Heidegger, Gadamer and Merleau-Ponty was chosen to frame these lived experiences. Using face-to-face interviews, data were collected from 12 midwives making a difference, establishing partnerships and letting go and refining practice. Lived experiences are unique and can be difficult, intangible and couched in metaphor and difficult to grasp. This paper aims to discuss lived experience and suggests that like an onion, several layers have to be peeled away before meaning can be exposed; each cover reveals another layer beneath that is different from before and different from the next. The study provides exemplars that explain lived experiences. [ABSTRACT FROM AUTHOR]

Background: Sexually transmitted infections (STIs) are prevalent throughout the world with the rate of these infections increasing on a daily basis. STI acquisition has the ability to cause personal adversity and elicit feelings of stigma and shame. Aim: The aim of this paper is to report on the sources of support young women who acquired STIs drew on to overcome their associated adversity. Methods: This study utilised a feminist qualitative methodology. Findings: Findings revealed that the women drew on both personal and anonymous sources of support. Conclusion: Nurses and other health-care professionals need to be equipped with knowledge and strategies to promote personal wellbeing and minimise the adversity felt among people having acquired these infections. [ABSTRACT FROM AUTHOR]

Background Mental health recovery is a prominent topic of discussion in the global mental health settings. The concept of mental health recovery brought about a major shift in the traditional philosophical views of many mental health systems. Aim The purpose of this article is to outline the results of a qualitative study on mental health recovery, which involved mental health consumers, carers and mental health nurses from an Area Mental Health Service in Victoria, Australia. This paper is Part One of the results that explored the meaning of recovery. Methods The study used van Manen's hermeneutic phenomenology to analyse the data. Findings Themes suggested that the cohort had varying views on recovery that were similar and dissimilar. The similar views were categorised under two processes involving the self, an internal process and an external process. These two processes involved reclaiming various aspects of oneself, living life, cure or absence of symptoms and contribution to community. The dissimilar views involved returning to pre-illness state and recovery was impossible. Conclusion This study highlights the need for placing importance on the person's sense of self in the recovery process. [ABSTRACT FROM AUTHOR]

Background: Regular health screening provides opportunities for early detection and effective treatment of disease. There is underutilisation of health services by migrants from culturally and linguistically diverse backgrounds, particularly refugees in Australia. Aim: To explore the beliefs, understandings, and use of health and healthcare screening services among African refugee women living in Australia. Design/Method: Qualitative secondary analysis. Method: Oral narratives derived from two primary qualitative datasets of Sub-Saharan women in New South Wales, Australia, underwent secondary thematic analysis. Findings: Twenty-two of the forty-two women had refugee status on migrating to Australia. Thematic findings reflection of misinformation, low health literacy, and health screening as not a priority. Conclusions: There is an urgent need to develop innovative strategies to engage refugee migrant women in health screening by provision of culturally meaningful health information. Relevance to clinical practice: Including refugee women's suggestions for information to be provided by health services may improve attitudes towards screening and preventative health care. [ABSTRACT FROM AUTHOR]

This paper aims to elucidate the current status of nursing in Southern Jordan, and to identify strategies that would enable improvement in nursing within that region. A qualitative study using key informant focussed interviews was conducted in the south of Jordan during the first half of 2010. Purposeful sampling was used until saturation of the data occurred. This required involvement of eight informants in the study, drawn from various health institutions in the southern region. Major issues that affect the nursing profession in the region were identified through thematic analysis. Themes emerging included cultural issues, geographic isolation, sustainability and turnover of professional nurses, continuing professional development, and strategies for improvement. Future action to improve the status and position of the nursing profession is warranted in this region. Enhancing general conditions of employment may serve to attract and retain nursing staff. Incentives for them to live and practice in southern Jordan are needed. Nurses from the local community should be encouraged to pursue postgraduate study. [ABSTRACT FROM AUTHOR]

A growing body of research provides evidence of the link between nurse-to-patient ratios (NTPRs) and skill mix with adverse patient outcomes. This paper reports an investigation into nurse staffing patterns, skill mix and patient movement in critical care units in NSW, Australia. A 'snapshot' of staffing patterns and patient movement over 1 week in October 2012 was obtained by use of a cross-sectional design using retrospective survey and administrative data. A wide variation was found in NTPRs, skill mix and the number of nursing staff vacancies in coronary care and high dependency units. These variations suggest that the quality of patient care may vary between facilities in New South Wales. [ABSTRACT FROM AUTHOR]

Trust is integral to nursing; yet little is known about how nurses establish trust when working with patients. This grounded theory study explored nurses' perspectives of how to build trust with a child and family in the context of paediatric acute health care. Seven paediatric acute care nurses were asked what they did when they cared for a child admitted to an acute care ward from emergency department or intensive care unit following a severe traumatic accident. Building trust emerged as the basic social process for an effective working relationship between a nurse and family to promote the rehabilitation of the child. This paper argues that building trust is critical to nurses developing a working relationship with both child and family to promote optimal health, and enables nurses to effectively step out and handover the care of the child to the family. [ABSTRACT FROM AUTHOR]

In today's healthcare system where technical instruments and test results are used to implement care it is easy to lose the human aspect of nursing. Personal interaction can get lost and nurses sometimes miss humorous attempts made by patients. Humour is a very personal concept, what one person thinks is funny does not necessarily make another person smile, or might even be hurtful. Humour is an important communication tool for patients as it humanises the nurses, creates a bond and opens communication lines. Humour has the potential to change the hospital experience for patients. The aim of this paper is to highlight the importance of humour in the therapeutic relationship between patient and nurse. Semi-structured interviews were held with four registered nurses and narrative inquiry was used to analyse and present the findings because of its ability to capture human interaction and experience. [ABSTRACT FROM AUTHOR]

Indigenous nurses have the potential to improve access to health services for Indigenous people by ensuring that services are culturally safe and respectful of Indigenous peoples' needs. Therefore, developing a well-educated Indigenous nursing workforce is one way to improve the poor health outcomes of Indigenous Australians. A mixed methods study was undertaken to determine the current rates of enrollment, progression and completion of Indigenous nursing students in Australia and to explore student and staff perceptions of barriers to completion and strategies for success. The results indicate that the national average completion rates are 36.3% for Indigenous nursing students and 64.6% for non-Indigenous nursing students - an average difference of 28.3%. Indigenous nursing students and academics identified barriers to completion, which were similar to those identified in previous research. Success strategies, however, revealed the importance of individual student characteristics; academics' knowledge, awareness, and understanding; relationships, connections, and partnerships; institutional structures, systems, and processes; and, family and community knowledge, awareness, and understanding. This paper offers an overview of the integration and interpretation process that makes up the final phase of a mixed methods study. [ABSTRACT FROM AUTHOR]

Lesbian mothers share mainstream existence with other mothers by virtue of their motherhood, but remain marginalised by their non-heterosexual identity. This paper will draw on the qualitative findings of a recent Australian study that examined the experiences of lesbian mothers. Using a story-sharing method, data were collected using three methods; a demographic data sheet, in-depth semi-structured interviews and journaling. The findings demonstrated that participants experienced various forms of homophobia when interfacing with healthcare services and providers and included exclusion, heterosexual assumption, inappropriate questioning and refusal of services. Strategies used to avoid homophobia included screening and crusading. [ABSTRACT FROM AUTHOR]

Foster carers have a significant responsibility in caring for vulnerable children. In order to support and facilitate foster carers it is important to understand how they perceive and fulfil this responsibility. A qualitative story-telling study, informed by feminist perspectives, was used to conduct in-depth, semi-structured interviews with 20 women providing long-term foster care in Australia. Thematic analysis revealed these women characterised themselves as mothers, rather than paid carers, to the long-term foster children in their care. Using this maternal self-perception as the starting point, this paper reveals some of the challenges and difficulties participants encountered when mothering within the confines of the child protection system. Implications for nursing practice are discussed. These implications focus on ways that nurses can effectively support foster carers, thus optimising the health and well-being of the vulnerable children in their care. [ABSTRACT FROM AUTHOR]

Lesbian, gay, bisexual, transgender, and queer (LGBTQ) identified patients report receiving substandard care from healthcare providers. They face the fear and disturbing reality of discrimination when accessing health care. Without culturally sensitive treatment, nursing and other health professions do not properly care for this population. Following the recent trend towards awareness and need for inclusion of LGBTQ populations in healthcare, this paper provides a summary of the current literature on the treatment and needs of LGBTQ people and describes focus groups conducted to explore perceptions regarding provider behaviors. It concludes with a list of behaviors that enhance or impede quality care that can serve as a guide for healthcare professionals. [ABSTRACT FROM AUTHOR]

This paper describes the evaluation of the Transition Care Cognitive Assessment and Management Pilot (TC CAMP) at a residential care facility in Victoria, Australia. Transition care aims to provide a goal-oriented time-limited service to older people at the conclusion of an episode of hospital care. The TC CAMP was established to specifically meet the needs of people with cognitive impairment. The purpose of this study was to evaluate the implementation and effectiveness of the TC CAMP. The evaluation sought to explore the perceptions ofstaffandfamily carers, and outcomes for the person with dementia. Methods consisted of file audits, focus groups and individual interviews with nursing staff and carers. This evaluation found that it was possible to provide appropriate transition care to people with cognitive impair-ment who exhibited behavioural and psychological symptoms of dementia. The TC CAMP achieved length of stay and readmission rates that were comparable with transition care for cognitively intact people. The role of the Clinical Nurse Consultant was highly valued by staffand families involved in TC CAMP. The findings from TC CAMP suggest a suit-able environment, availability of trained and resourced nursing and clinical staff and clear roles and expectations for all stakeholders should be considered in implementation of this model of care. [ABSTRACT FROM AUTHOR]

Early parenting residential units provide a child and family health support and education service for parents experiencing parenting difficulties. An ongoing concern of nursing staff and management is whether the parenting knowledge and skills gained are translated into sustainable parenting practices after discharge. This paper explores the response to a post discharge telephone interview about parents' experience of nursing care during their residential stay and their parenting experience since discharge. A descriptive qualitative approach identified four themes in the parents' responses: greater confidence, greater knowledge about their babies, changing expectations of parenting and their infants, and sustainability of parenting skills. [ABSTRACT FROM AUTHOR]

This paper reports on an aspect of a larger ethnographic study that sought to investigate the impact of HIV/AIDS on the practice of primary care nurses in Jordan. Nursing leadership and the style of management adopted by senior nursing and medical administrators at the Ministry of Heath were identified as factors impacting on the practice of the nurses and their capacity to raise community awareness and contribute to the prevention and control of HIV/AIDS. The study was undertaken in three rural and three urban primary health care centres (PHCC). Data collection included participant observation, key informant interviews, and document analysis. These data informed the development of descriptive ethnographic accounts that allowed for the subsequent identification of common and divergent themes reflective of factors recognized as influencing the practice of the nurse participants. [ABSTRACT FROM AUTHOR]

This paper reports on an evaluation of an educational initiative that seeks to improve the diabetes health outcomes of a vulnerable group, Indigenous Australians residing in remote and rural New South Wales. In this context seven Aboriginal Health Workers (AHWs) and ten registered nurses (RNs) undertook an accredited Australian Diabetes Educators Association (ADEA) course. The aims of this study were to identify the beliefs, attitudes and experiences of this group concerning specialist diabetes training, strategies already used by managers and those that could be used to help consolidate the diabetes expertise of AHWs and RNs. The fi ndings indicate specialist diabetes training and constructive support is required if AHWs and RNs are to develop from a novice to an expert. We concluded that the ADEA diabetes course is highly relevant to the needs of Indigenous Australians an [ABSTRACT FROM AUTHOR]

Introduction: Student nurses in Australia are regularly placed in acute clinical areas providing them with clinical experience to link theory with real patient situations. Specialist clinical areas such as day oncology and renal dialysis often exclude students on the basis that their clinical area may not be able to meet normal clinical expectations, including holistic care of four to six patients with minimal direction from the registered nurse. However, specialist clinical areas provide students with unique learning experiences. This paper reports on an evaluation of speciality clinical placements for student nurses with an aim to increase our understanding of this type of placement. Methods: Semi-structured audiotaped interviews were undertaken with 7 third year final semester students and 13 registered nurses working with the third year students. All interviews were transcribed and a thematic analysis conducted. Findings: Key themes from the students and registered nurses were knowledge and preparedness for specialist placement, team work and being included and customising learning needs. Conclusion: Speciality placements provide a valuable experience for the undergraduate nurse including opportunities to see excellence in team work, communication and assessment as well as identifying future intention to become an oncology or renal specialist nurse. [ABSTRACT FROM AUTHOR]

With the increasing burden of chronic kidney disease (CKD) in New Zealand (NZ) the number of people requiring pre-dialysis care is increasing. Pre-dialysis nurses play a central role in the delivery of this care. This paper describes and discusses what pre-dialysis nurses perceive to be key influences on effective pre-dialysis nursing care in NZ. It is based on findings from a wider qualitative study that interviewed the majority of NZ pre-dialysis nurses. Following inductive data analysis four main influences were identified. They were: having time from referral to commencement of renal replacement therapy (RRT) to provide adequate education and support; having good access to cultural and other supports and an understanding of differing cultural views of health; the importance of good inter-professional relationships; and support from nursing management and doctors to advance professionally. With the knowledge of the projected increase in patients with CKD, we argue that it is important to ensure the positive aspects of these influences are enhanced in order to ensure effective pre-dialysis nursing care, nurse satisfaction and professional advancement. [ABSTRACT FROM AUTHOR]

This paper reports on one of the key findings from a recent descriptive phenomenological study on lived experience of 10 new graduate nurses (NGNs) in an intensive care unit (ICU) in a major acute care hospital. Interpersonal relationships experienced by NGNs in ICU give rise to diverse thoughts, perceptions and feelings that may have significant impact on their professional development, job satisfaction and retention. The researcher conducted in-depth, semi-structured audiotaped interviews to collect the data. Interaction with others as key theme and related subthemes: interaction with patients; interaction with other members of the ICU team; who is approachable; and feedback emerged. The NGNs' perception of their ability to interact with others, as part of their professional development, is influenced by both (i) how they see themselves and (ii) how they perceive that others see them. [ABSTRACT FROM AUTHOR]

The transition process from student to Registered Nurse has been recognised as an important yet challenging time for newly graduated nurses. Knowledge about this experience from the nurse's perspective, particularly in a rural setting, is limited. This paper reports the findings of a qualitative study of the experiences of newly graduated nurses working in a rural acute care facility in New South Wales. The study examined, from the perspective of the new nurse, the orientation and support which can help to facilitate the transition from student to registered nurse. Four themes emerged which were being supported, being challenged, reflections on being a new graduate, and reflections on a rural new graduate program. These findings contribute to what is know about the transition of new graduates in a rural facility and have implications for program improvements, specifically within the rural acute care environment. The findings are also relevant to students considering rural employment on graduation and for the recruitment and retention of New Graduate Registered Nurses in rural areas. [ABSTRACT FROM AUTHOR]

The reporting of suspected child abuse and neglect is a mandated role of medical doctors, nurses, police and teachers in Victoria, Australia. This paper reports on a research study that sought to explicate how mandated professionals working in rural Victorian contexts identify a child/ren at risk and the decisions they make subsequently. [ABSTRACT FROM AUTHOR]

Background: Over the last decade several innovative approaches to enhance students' transition to graduate nurse year have been implemented or piloted. This paper describes a study that investigated how the social practices of clinical partnership placement model underpin workplace learning for undergraduate students as they transitioned to graduate. Methods: A mixed method approach was utilized comprising individual interviews with students, observation of clinical workplaces across six different areas of nursing practice, student surveys of the clinical learning environment and participant workshops. Results: Three themes were identified that influenced participants' preparedness for work and enhanced the transition into the workplace: 'organizational familiarity', 'continuity' and 'social participation'. Conclusion: A clinical partnership model offers a degree of work readiness for novices when commencing their professional practice role. It enables individuals to participate and engage in workplace activities which are a central component of their learning. [ABSTRACT FROM AUTHOR]

Objectives: Although Chinese-Australian women are at higher risk of developing breast cancer after migration to Australia, information on their experience is limited. This paper explores Chinese- Australian women's perceptions of the meaning and experience of a breast cancer diagnosis, treatment and coping mechanism. Methods: Three focus groups were conducted with 23 Chinese-Australian women diagnosed with breast cancer in their native language (Cantonese or Mandarin). Following transcription and translation, interview data was analysed by content analysis. Results: Culturally specific values, beliefs and language barriers played a significant role in shaping the women's breast cancer experiences and their response to the diagnosis. Of note these women found the experience isolating and distressing, factors that were compounded by the lack of culturally sensitive resources and information. Conclusions: In providing information for Chinese-Australian women with breast cancer, culture, language and migration experience need to be taken into account. [ABSTRACT FROM AUTHOR]

While midwifery practice predominantly deals with happy experiences, unexpected and unpredictable events occur. This paper reports on a study that explored undergraduate midwifery students' first experiences of stillbirth and neonatal death. It sought to better understand their encounters to ensure curricula were responsive to students' needs. Semi-structured interviews were conducted with eight Bachelor of Midwifery students. Many were found to have been exposed to perinatal death early in their courses and were ill prepared for the confrontations. Furthermore, the existence of support services was varied. Dealing with these experiences appears to occur through a developmental process and resonates with previous research around compassion, fatigue and posttraumatic stress disorder. Overall, students require specific preparation prior to undertaking placements, as well as clearly identified support strategies if such experiences are encountered. [ABSTRACT FROM AUTHOR]

Sessional teachers are taking an increasing role in classroom teaching in Schools of Nursing. However, there is a paucity of literature reporting the experiences of, and impact on, career academics working with or alongside the burgeoning numbers of sessional teachers. Therefore, the purpose of this paper is to explore the experiences of continuing academics working with sessional teachers. This qualitative study used purposive sampling to recruit nurse academics and collect narrative data related to their experiences of working with sessional teachers. Four major themes emerged from the data, namely: They have got real credibility -- perceptions of clinical currency, We've got people who are very good clinically, but don't know how to teach - lacking skills and confidence, No allegiance to the school or the students -- perceived lack of commitment and accountability, and A terrible burden -- workload implications for continuing academics. The development and implementation of standards for the recruitment and employment of sessional teachers would benefit both continuing academics and sessional teachers, and assist in the delivery of quality teaching and learning to nursing students. [ABSTRACT FROM AUTHOR]

The concept and definition of pastoral care in aged care remains ambiguous. This paper reports on the defining characteristics and meaning of pastoral care from the perspective of older recipients, their family members and pastoral care workers. Using a qualitative descriptive approach semistructured in-depth interviews were conducted with 18 pastoral care workers and 11 older people. Transcribed data were analysed using NVivo software and coded for emerging themes. The defining characteristics of pastoral care that emerged from analysis of transcribed interviews were: a trusting relationship, spiritual support, emotional support and practical support. Findings also portray the role of the pastoral care worker as spiritual guide, confidante, and emotional and practical supporter acting within a trusting relationship. Future studies should confirm these results by exploring the perceptions of experts in the field of pastoral care. [ABSTRACT FROM AUTHOR]

Chinese societies like most others are experiencing social change that impacts on models of care for older parents. There is tension between social change and traditional values of filial piety. The eldest son and his wife are expected to care for aged parents but that can be a challenge in modern industrial societies. This paper reports on research undertaken in Taiwan to explore changing values for aged care. It aimed to investigate how the roles and responsibilities of adult children of nursing home residents are changing. It involved aged care facility residents, their families and professional carers. [ABSTRACT FROM AUTHOR]

Aims and objectives: This paper reports a study aimed at exploring the nursing practices associated with the administration of pro re nata (PRN) postoperative analgesia to children, and at gaining a preliminary understanding of the decisions that nurses make about this important intervention. Background: Nurses are responsible for assessing and administering the appropriate medication at the appropriate time to the child in pain. There was scant published research about the administration of postoperative PRN analgesia to children, or about the decision-making processes inherent in this aspect of clinical nursing care. Design: A sequential mixed methods explanatory study with two data collection phases -- quantitative followed by qualitative -- was conducted. Results: Nurses used multiple strategies to ascertain children's need for postoperative PRN analgesia, including reference to pain assessment tools, focussing on the behavioural cues of children, involving parents and children, and drawing upon personal and professional backgrounds and experience. Evaluation of the effectiveness of PRN postoperative analgesia was poorly communicated. Conclusions: Decision-making associated with the selection and administration of appropriate analgesia to children is complex. In-service education should be developed and offered to nurses working with children postoperatively to ensure the appropriate use of PRN pain relief. Relevance to clinical practice: Documentation surrounding this task is poor and needs to be addressed as a matter of urgency to ensure quality patient outcomes. [ABSTRACT FROM AUTHOR]

This paper reports on research examining how service providers' perceptions of Aboriginal women's identities contributes to their experiences of accessing preventive care during pregnancy and parenting in an urban setting. An intersectionality paradigm was adopted to conduct a secondary analysis of purposively selected transcripts of exploratory interviews with Aboriginal women. Findings indicate that how Aboriginal women identity as mothers was perceived by service providers was the focal point at which women described positive or negative experiences of accessing care. These conclusions challenge nurses' understandings of developing therapeutic relationships with marginalised populations and highlight the necessity of examining how perceptions of identity shape issues of oppression and discrimination within therapeutic relationships. [ABSTRACT FROM AUTHOR]

Tobacco-related conditions contribute significantly to the health gap between Indigenous and non-Indigenous Australians. Smoking rates in Australia's Indigenous population has failed to decline even though smoking rates in Australia have declined in general. In some Indigenous communities, smoking rates remain very high. This paper outlines a project to investigate appropriate strategies to assist Indigenous smokers to quit and the important role nurses can play. [ABSTRACT FROM AUTHOR]

This paper reports a two-phased pilot study that explored the concept of 'specialling' older patients with challenging behaviours in acute ward situations. Previous research suggests that the nursing workforce is not equipped with the skills and resources required to provide quality care for these patients. The hospital in which this study was conducted, instigated a model where these patients were closely observed by 'specials'. Phase 1 of the study involved a retrospective analysis of de-identified 'Specials' Observation Charts' and 'Request for Patient Special' forms of patients aged 65 years and above, over 12 months in 2006. Phase 2 involved in-depth interviews with the nurses caring for these patients. Findings revealed inadequacy of the forms, gaps in service provision for this vulnerable group of patients and the need for education of specials and ward staff, with suggestions to improve care for this patient group. Findings suggest the necessity to design and structure the observation forms more efficiently. It is important to formulate clear assessment criteria for these patients and incorporate in-service education programmes for 'specials' and ward staff and adequately prepare and support them to meet the challenges of caring for older persons with behavioural disturbances in ward situations. [ABSTRACT FROM AUTHOR]

Heavy, pressured workloads are a feature of health workplaces internationally, presenting challenges to communication and contributing to tension and negative emotions. This paper explores supportive and unsupportive workplace conversations between nurses and midwives and their colleagues. The findings focus on qualitative interviews of ten nurses and midwives that were audio-taped and analysed for perceptions about the role of workplace conversations. Conversations between colleagues were significant for building and maintaining collaborative capital, but unsupportive conversations also threatened it. Findings suggest the need for considering the impact of co-worker conversations on workplace culture. Nurse managers and management may play a pivotal role in establishing and maintaining supportive conversations. Recognising the role and potential of workplace conversations for building capacities for support, conflict resolution, job satisfaction and the personal resilience of nurses and midwives can raise the collaborative capital of the workplace. [ABSTRACT FROM AUTHOR]

This paper reports a study aiming to present and describe the effects of whistleblowing episodes on nurses' workplace relationships. Eighteen participants with direct experience of whistleblowing were recruited into the study, which was informed by a qualitative narrative inquiry design. Findings were clustered into four main themes, namely: Leaving and returning to work--The staff don't like you; Spoiled collegial relationships--Barriers between me and my colleagues; Bullying and excluding--They've just closed ranks; and, Damaged inter-professional relationships--I did lose trust in doctors after that. Findings suggest a need to facilitate a climate in which it is safe for nurses (and others) to raise concerns about patient care or organisational wrongdoing, and to eliminate the existing belief that whistleblowing is a negative act fuelled by revenge or sedition. [ABSTRACT FROM AUTHOR]

Background: This study focuses on a decision support system (DSS) for home healthcare and the implementation of it. Aim: To describe home healthcare nurses’ experiences of the implementation and use of a new DSS, with a focus on how it influences decision making in everyday work practice. Design: A qualitative research design. Methods: Data was collected through three focus group interviews with six home healthcare nurses.The data analysis was drawn from Burnard’s method for content analysis. Results: The DSS was experienced as bringing support to decisions, but sometimes incompatible with home healthcare nurses’ work practice. Professional understanding and the DSS were sometimes experienced as parallel support systems not assisting work across healthcare organisations. Conclusion: When a DSS is used to transform work of healthcare organisations several aspects should be highlighted. If the organisation does not consider these aspects, nurses may adopt a role as mediator in the implementation process. [ABSTRACT FROM AUTHOR]