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The nurse role on an Assertive Community Treatment (ACT) team requires a specialized set of skills in psychiatric community-based care. While the ACT model has existed for fifty years, no nationally recognized standard curriculum to train ACT nurses has been developed. The ACT Nursing Project described in this paper aimed to create a competency-based on-board training program using the Developing a Curriculum (DACUM) method. Eight ACT nurses from three states served as the expert panel to create a DACUM chart detailing the full set of nine duties and 127 tasks required of ACT nurses. To verify the DACUM results, 57 ACT nurses from four states completed a survey and confirmed that 80% of the tasks identified by the expert panel were also performed by the validation sample of ACT nurses. This paper describes how the DACUM duties and tasks provided the framework to develop onboard training curriculum for ACT program nurses. The next step is to pilot the onboard training curriculum to newly hired ACT nurses to ensure they are equipped to meet the complex needs of people living with serious mental illness, and to increase their competency, job satisfaction and decrease the high annual turnover rate among ACT nurses. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to explore and understand the organizational culture of a workplace in terms of support and well‐being for staff experiencing perimenopausal and menopausal symptoms at work. Design: It is widely acknowledged that perimenopause and menopause symptoms are experienced by a large percentage of the female workforce. There is a lack of research into how nurses are supported through menopause (Cronin et al. Issues in Mental Health Nursing, 42, 2021, 541–548). The perimenopause and menopause transition can be a challenging time where many may require symptom management and support (RCN, The Menopause and Work: Guidance for RCN Representatives, 2020). This paper presents a case study research (CSR) approach to examine one healthcare organization. Methods: CSR design was used: A survey distributed to all staff employed, a review of the available documentation on menopause and interviews with managers from different levels of the organization. The COREQ consolidated criteria was used for reporting the qualitative research reported this study. Results: The case study generated both quantitative and qualitative data using surveys, interviews and documentation. Data from the organization (n = 6905) showed a majority female workforce of 81.9% with 40.6% aged between 41 and 55 years old, meaning a third of the organization working through perimenopause and menopause. Survey responses (n = 167) collected biographical and psychometric data on the prevalence of perimenopausal and menopausal symptoms. Seven managers were interviewed highlighting two themes: Access to support and culture of menopause and 13 documents from the organization on menopause were analysed for content. The study design permitted an iterative approach to data collection and providing an in‐depth understanding of the needs and support for those experiencing perimenopause and menopause. The findings help healthcare organizations to understand their workforce and take in to account the larger numbers of female employees particularly nurses with the need to provide person‐centred support mechanisms and an organizational approach for all employees. [ABSTRACT FROM AUTHOR]

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Aim: To describe activities and professional characteristics of nurses in expanded roles in acute care in Germany and achieve a greater understanding of the current situation of advanced practice nursing. Background: Advanced practice nursing plays an important role in meeting increased demands in healthcare and promoting high‐quality care. Introduction: In Germany, advanced practice nursing is still at an early stage with a lack of studies describing the scope of practice of nurses in expanded roles. Methods: We conducted a cross‐sectional‐study using a paper‐and‐pencil questionnaire. In a nationwide convenience sample, we surveyed nurses with an academic degree, who work in an acute care hospital and take over expanded roles in direct patient care. Reporting followed the STROBE checklist. Results: Of 108 eligible nurses, 84 (77%) completed the survey. The majority had a Master's degree (63.1%) and the average work experience was 18.2 years. Participants carried out activities in all the domains that were queried (direct clinical practice, guidance and coaching, consultation, leadership and research) with differences within and between domains. Foci were on direct clinical practice and coaching and guidance. Discussion: In Germany, qualifications are nearing the international standard of advanced practice nursing. Results suggest that participants partly undertake activities within the scope of registered nurses' practice that do not correspond fully to their formal qualifications. Conclusion and implications for nursing and/or health policy: In order to foster the role development of expanded practice nurses in Germany, political efforts are needed in terms of training (e.g. specific Master's programmes), funding of corresponding positions in practice and control mechanisms (e.g. professional registration). [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on this subject?: The physical health of people with serious mental illness (SMI) is an issue of growing concern in New Zealand and internationally.Metabolic syndrome is prevalent among people with severe mental illness and increases the likelihood of developing cardiovascular disease and diabetes.No previous international research has investigated rates of metabolic monitoring in specialist mental health services and in primary care. What this paper adds to existing knowledge?: Rates of metabolic monitoring are low in this specialist mental health service and in primary care.Primary care nurses are positive in their views of their role in providing care for people with mental illness, and would value further education in this area. What are the implications for practice?: Services need to consider ways in which nurses can be supported to improve rates of metabolic monitoring.Guidelines may have a role to play in improved monitoring but need service‐level support in order to be effective. Introduction: People with serious mental illness experience significant disparities in their physical health compared with the general population. One indicator of health impairment is metabolic syndrome, which increases the likelihood of developing cardiovascular disease and diabetes. No international studies have reported both primary care and mental health nurses' rates of metabolic monitoring among people with serious mental illness, and no New Zealand studies have investigated rates of metabolic monitoring. Aim: To evaluate metabolic monitoring practices within one of New Zealand's 20 district health board regions. Method: An audit of clinical records in primary care (n = 46) and secondary care (n = 47) settings and a survey of practice nurses were conducted. A survey was sent to 127 practice nurses with a response rate of 19% (n = 24). Data were analysed using descriptive statistics. Results: Rates of metabolic monitoring were low in both services. Survey participants expressed positive views towards physical health monitoring and confidence in relating to mental health consumers. Rates of treatment of metabolic abnormalities were low, and communication between primary and secondary services was limited. Conclusion: Despite existence of guidelines and protocols, metabolic monitoring rates in both primary and secondary health services are low. Incorporating metabolic monitoring systems into service delivery, supported by appropriate tools and resourcing, is essential to achieve better clinical outcomes for people experiencing mental illness. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this paper was to investigate the relationship between high‐involvement human resource management, autonomy, affective organisational commitment and innovative behaviours of nursing staff who care for elderly clients. Background: Nursing teams are increasingly required to demonstrate innovative behaviours that enhance care quality. Nursing leaders need to create environments where nursing staff have sufficient autonomy and feel a sense of commitment to support these behaviours. The appropriate implementation of these processes and practices may lead to greater involvement. Methods: A cross‐sectional survey‐based research design was employed to explore the experiences of involvement practices, autonomy, affective organisational commitment and innovative behaviours of 567 nursing staff workers from four elderly care organisations in the Netherlands. Results: The results demonstrate that a bundle of high‐involvement practices positively influences innovative behaviour and that affective commitment and autonomy fully mediate this relationship. Conclusions: The study highlights the role of autonomy and commitment as routes towards translating involvement practices into nurses' innovativeness. Implications for Nursing Management: To create an innovative environment, leaders need to create a positive climate by providing nurses with opportunities to enhance their competence, relatedness and autonomy through active involvement. Leaders should, therefore, encourage involvement as a mechanism to promote innovation. [ABSTRACT FROM AUTHOR]

Aims Cardiovascular disease burden is increasing globally, pressuring nursing staff to deliver high-quality care across a diverse range of treatment areas. As such, an evaluation of the educational preparation of nurses is needed. To determine the current role, scope of practice, education level, and needs of cardiovascular nurses working across the European Society of Cardiology (ESC)-affiliated countries. Methods and results A short survey was distributed in paper (EuroHeartCare 2018) or electronic format to nurses delivering cardiovascular care. A total of 876 cardiovascular nurses from 26 ESC-affiliated countries completed the survey. Most respondents (79%), were educated to at least bachelor level, with 46% having a masters or doctorate, and were highly motivated to continue their educational development. Despite this, a large number (44.3%) of respondents believed they were not fully prepared for their job. The main areas where further education was requested included acute care in cardiovascular disease (CVD) and CVD risk factor management. Face-to-face courses/training were the most requested delivery mode, followed by E-learning--which appears to be underutilized in this population. Awareness of the existing curricula for cardiovascular nurse education was minimal, and therefore these resources require further promotion and implementation. Conclusions This international sample of cardiovascular nurses was generally educated to degree level and motivated to improve their cardiovascular knowledge. Many believed they were underprepared for their role, highlighting the need for increased investment in education. This should be focused on specific needs and delivered using a face-to-face, E-learning, or blended-learning format. Furthermore, increased signposting of existing resources is required. [ABSTRACT FROM AUTHOR]

Background: Nursing educators play a critical role in training future nurses, and high turnover can disrupt the training quality and process. This study identified the institutional and personal factors influencing Canadian nursing educators' job satisfaction and turnover intention. Methods: This cross-sectional study used an online survey to obtain the levels of job satisfaction, turnover intention, role description, and institutional and personal/demographic characteristics of nursing faculty across Canadian institutions. Data were analysed using descriptive statistics, chi-square, bivariate linear regression, and hierarchical linear regression. Results: A total of 645 participants, with a mean ± SD age of 48.82 ± 10.11 years, returned a completed questionnaire. The average/maximum job satisfaction and turnover intention scores were 12.59/20 ± 3.96 and 6.50/15 ± 3.05, respectively. Higher job satisfaction was significantly associated with lower turnover intention (β=-0.559, p < 0.001). The multivariate analysis showed that having a partner or being married (β = 0.086, p = 0.031), working ≤ 40 h weekly (β=-0.235, p < 0.001), teaching ≤ 4 courses annually (β=-0.115, p = 0.007), and having higher than bachelor's degree qualification (β=-0.091, p = 0.042) predicted high job satisfaction, while high turnover intention was associated with faculty in the Prairie region (β = 0.135, p = 0.006) and working ≥ 41 h weekly (β = 0.151, p = 0.001). Conclusion: Having a partner, manageable workload, and advanced qualifications positively influenced job satisfaction, while high turnover intention was associated with high workloads. Institutions may benefit from ensuring proportionate faculty workloads, fostering career advancement, and providing robust support systems that can stabilise the workforce and preserve the quality of nursing education. [ABSTRACT FROM AUTHOR]

Background. Severe challenges in recruiting and retaining healthcare workers exist on a global level and are especially noticeable in elderly care services. Previous studies have not assessed how the attractiveness of a job is related to wellbeing at work among licensed practical nurses (LPNs) even though these professionals are vital in providing care to the elderly. Objective. The purpose of this study is to define factors that affect LPNs' attractiveness of work and wellbeing at work. Design. A cross‐sectional survey study. Participants. A large‐scale nationwide sample of 10 848 licensed practical nurses (LPNs) working in Finland. Methods. An online survey for LPNs working in Finland was conducted. Criteria for a good workplace (CFGW), measuring the attractiveness of work and wellbeing at work, were utilized. Descriptive and comparative analyses were performed. Cronbach's alpha values were tested to assess internal consistency (α = 0.739–0.915). An ANOVA or t‐test result which indicated a statistically significant between‐group difference (which was in line with difference ≥0.1) was considered as both statistically significant and significant in practice. Results. The core group, LPNs' wellbeing at work (m = 4.36), is extremely important factor of attractiveness of work. Regarding the subgroups high quality of care (m = 4.61), reconciling of work and private life (m = 4.59) and well‐functioning practices (m = 4.55) were most important. Well‐functioning practices associated with several background variables, e.g., with working for full‐time (p ≤ 0.001, mean = 3.10) and age (p < 0.001). LPNs over 56 years old, especially, regard well‐functioning practices important (p = 3.17). LPNs' who were 56 years old or older (m = 3.12) and those who had work experience 1 year or less (m = 3.19) stated rewarding work most important. Conclusions. The core group, wellbeing, is an exceptionally important for the LPNs attractiveness of work. The LPNs' wellbeing at work is supported by the quality of care and reconciliation of work and private life. [ABSTRACT FROM AUTHOR]

Background: Obesity (body mass index ≥ 30 kg/m2) is a major risk factor for heart failure with preserved ejection fraction (HFpEF) and affects most patients with HFpEF. Patients living with obesity may experience delays in HFpEF diagnosis and management. We aimed to understand the clinical journey of patients with obesity and HFpEF and the role of primary care providers (PCPs) in diagnosing and managing patients with both conditions. Methods: An anonymous, US population-based online survey was conducted in September 2020 among 114 patients with self-reported HFpEF and obesity and 200 healthcare providers, 61 of whom were PCPs who treat patients with HFpEF and obesity. Results: Half of patients (51%) with HFpEF reported waiting an average of 11 months to discuss their symptoms with a PCP; 11% then received their diagnosis from a PCP. PCPs initiated treatment and oversaw the management of HFpEF only 35% of the time, and 44% of PCPs discussed obesity treatment medication options with their patients. Only 20% of PCPs indicated they had received formal obesity management training, and 79% of PCPs indicated they would be interested in obesity management training and support. Conclusion: PCPs could play a valuable role in addressing obesity and referring patients with obesity and signs and symptoms of HFpEF to cardiologists. Increased awareness of HFpEF and its link to obesity may help PCPs more quickly identify and diagnose their patients with these conditions. Plain Language Summary: Heart failure with preserved ejection fraction (HFpEF) is a common form of heart failure. Many patients who have HFpEF also have obesity or excess weight. We wanted to understand the medical experience of patients with HFpEF and obesity and the role that primary care providers (PCPs) play in managing patients with these diseases. We surveyed 114 patients with HFpEF and obesity and 200 healthcare providers who treat patients with HFpEF and obesity, 61 of whom were PCPs. One-quarter of patients had a major heart-related event that led to their HFpEF diagnosis. Half of the patients said they had an initial discussion about HFpEF symptoms with a PCP, but only one in ten were diagnosed by a PCP. Few PCPs said they received obesity management training, but most were interested in receiving more obesity management training and support. PCPs play an important role in organizing care for patients with HFpEF and obesity. However, there is room to improve HFpEF awareness and access to obesity management tools and strategies among PCPs. [ABSTRACT FROM AUTHOR]

Background: Chronic conditions may limit older peoples' social engagement and wellbeing. Reduced social connections can result in loneliness and social isolation. This study aimed to explore the experience of social connection in older people living with chronic conditions, and the factors influencing their social participation. Methods: A purposive sample of 19 community-dwelling older Australians (mean age 75.5 years) with one or more chronic conditions participated in a qualitative descriptive study. Semi-structured interviews explored participants' perceptions of their social connections and the potential impact of their chronic conditions. Views about the role of general practice in supporting older persons' wellbeing were discussed. Data were analysed inductively using thematic analysis. Results: Five themes were identified: (1) the experience of loneliness, (2) managing diminishing social contacts, (3) living with chronic conditions, (4) barriers to social connection, and (5) facilitators of social connection. Participants felt that ageing with chronic conditions contributed to loss of function and independence, which limited social connections, and increased loneliness and social isolation. Barriers to social connections included issues with mobility, transport and forming new networks. Families were a primary support, with continued community engagement and general practice support crucial to staying well and socially connected. Conclusions: Understanding older peoples' experiences, and the barriers and facilitators of social connections can guide clinicians' interventions. General practice is a promising intervention point because of its high use by those with chronic conditions to stay well. General practice nurses are well-placed to collaboratively address the barriers older people face in maintaining social connections. Chronic conditions may limit older peoples' social engagement, with diminished social connections leading to loneliness, social isolation and other serious health consequences. This study explored the experience of social connection in older people living with chronic conditions and factors influencing their social participation. Older people identified the importance of family, community engagement and staying well through primary care support. Understanding the barriers and facilitators of social connections for older people can guide the general practice team in developing appropriate interventions. [ABSTRACT FROM AUTHOR]

Background: A variety of advanced practice nursing roles and titles have proliferated in response to the changing demands of a population characterized by increasing age and chronic illness. Whilst similarly identified as advanced practice roles, they do not share a common practice profile, educational requirements or legislative direction. The lack of clarity limits comparative research that can inform policy and health service planning. Aims: To identify advanced practice roles within nursing titles employed in New Zealand and practice differences between advanced practice and other roles. Method: Replicating recent Australian research, 3255 registered nurses/nurse practitioners in New Zealand completed the amended Advanced Practice Delineation survey tool. The mean domain scores of the predominant advanced practice position were compared with those of other positions. Differences between groups were explored using one‐way ANOVA and post hoc between group comparisons. Results: Four nursing position bands were identified: nurse practitioner, clinical nurse specialist, domain‐specific and registered nurse. Significant differences between the bands were found on many domain scores. The nurse practitioner and clinical nurse specialist bands had the most similar practice profiles, nurse practitioners being more involved in direct care and professional leadership. Conclusions: Similar to the position of clinical nurse consultant in Australia, those practicing as clinical nurse specialists were deemed to reflect the threshold for advanced practice nursing. The results identified different practice patterns for the identified bands and distinguish the advanced practice nursing roles. Implications for nursing policy: By replicating the Australian study of Gardener et al. (2016), this NZ paper extends the international data available to support more evidence‐based nursing workforce planning and policy development. [ABSTRACT FROM AUTHOR]

Background: The ecological validity associated with usability testing of health information technologies (HITs) can affect test results and the predictability of real-world performance. It is, therefore, necessary to identify conditions with the greatest effect on validity. Method: We conducted a comparative analysis of two usability testing conditions. We tested a HIT designed for anesthesiologists to detect pain signals and compared two fidelity levels of ecological validity. We measured the difference in the number and type of use errors identified between high and low-fidelity experimental conditions. Results: We identified the same error types in both test conditions, although the number of errors varied as a function of the condition. The difference in total error counts was relatively modest and not consistent across levels of severity. Conclusions: Increasing ecological validity does not invariably increase the ability to detect use errors. Our findings suggest that low-fidelity tests are an efficient way to identify and mitigate usability issues affecting ease of use, effectiveness, and safety. We believe early low-fidelity testing is an efficient but underused way to maximize the value of usability testing. [ABSTRACT FROM AUTHOR]

Background: Research has indicated that providing women with information about menopause can improve their attitudes towards it and symptom experience. Nevertheless, information shared on the menopause is often arbitrary. Aim: To examine women's information needs about menopause, and understand if, when, and from whom they want information. Design & setting: A cross-sectional study was undertaken. A questionnaire survey was distributed to women in the waiting room of 54 general practice clinics in South-Eastern Norway in autumn 2022. Method: Medical students recruited women in the clinic waiting rooms. A 1-page study-specific questionnaire was used, focusing on need for information about menopause. A multinominal logistic regression model was used to analyse the association between the desire for information and education level, country of birth, and menopausal status. Results: A total of 625 women were included, with a mean age of 44.4 years (standard deviation [SD] 8.7). In all, 59% answered that they wanted information about menopause, and 81% of these wanted their GP to inform them, from a median age of 45 years. According to the women, only 10% of GPs had initiated a discussion on the menopause. Higher education was a predictor for wanting information. A main driver of information needs was to help oneself in the present and in the future. In all, 33% did not want information. The main reasons were that they already possessed sufficient information, would take menopause as it comes, were too young, or were already postmenopausal. The sex of the GP did not influence the results. Conclusion: Most women wanted information about menopause from their GP. The study emphasises the need for GPs to consider prioritising this discussion, and to keep up to date on recommendations and treatment options. [ABSTRACT FROM AUTHOR]

Background: In the Nordic healthcare systems, GPs regulate access to secondary health services as gatekeepers. Limited knowledge exists about the gatekeeper role of GPs during public health crises seen from the perspective of GPs. Aim: To document GPs' gatekeeper role and organisational changes during the initial COVID-19 lockdown in Norway. Design & setting: A cross-sectional online survey was addressed to all regular Norwegian GPs (n = 4858) during pandemic lockdown in spring 2020. Method: Each GP documented how patients with potential COVID-19 disease were triaged and handled during a full regular workday. The survey also covered workload, organisational changes, and views on advice given by the authorities. Results: A total of 1234 (25.4%) of Norway's GPs participated. Together, they documented nearly 18 000 consultations, of which 65% were performed digitally (video, text, and telephone). Suspected COVID-19 symptoms were reported in 11% of the consultations. Nearly all these patients were managed in primary care, either in regular GP offices (55.7%) or GP-run municipal respiratory clinics (40.7%), while 3.7% (n = 73) were admitted to hospitals. The GPs proactively contacted an average of 0.8 at-risk patients per day. While 84% were satisfied with the information provided by the medical authorities, only 20% were able to reorganise their practice in accordance with national recommendations. Conclusion: During the early stage of the COVID-19 pandemic in Norway, the vast majority of patients with COVID-19-suspected symptoms were handled in primary care. This is likely to have protected secondary health services from potentially detrimental exposure to contagion and breakdown of capacity limits. [ABSTRACT FROM AUTHOR]

This cross-sectional study aimed to explore the incidence of impostor phenomenon among 79 nurses in specialist roles in a single NHS trust in England, using an online anonymous questionnaire that included the Clance Imposter Phenomenon Scale and free-text responses. Results indicated a high prevalence of impostor phenomenon, with no specific variables predicting its occurrence. Four main themes emerged: self-doubt, role expectations, fear of exposure as an impostor, and factors leading to burnout. The study highlights the need for targeted support and training for this cohort, particularly as impostor phenomenon was found to be prevalent during career transitions and was not limited by gender. The findings have implications for nursing management and education, offering the opportunity to develop specific support mechanisms to alleviate impostor phenomenon and potentially reduce attrition rates in specialist nursing roles. [ABSTRACT FROM AUTHOR]

States are struggling to assure an adequate number of registered nurses are active in the clinical workforce to serve patients and communities. Nurse compact legislation—enacted in 39 states—facilitates interstate recognition of nurse licensure. We used a cross-sectional email survey of registered nurses in Michigan to measure their opinions on compact licensure legislation and examined differences in compact licensure opinions by nurses' personal characteristics. Primary analyses reported herein are from 7,098 Michigan nurses with complete data. Most respondents felt that the compact would make it easier to redeploy nurses in an emergency (76.6%), improve access to nursing care (66.6%), and boost their personal career options (55.1%). Most nurses disagreed that compact legislation would weaken patient protections (60.7%). The majority expressed neutral feelings on whether compact licensure would make disciplinary actions more difficult to enforce (50.9%) and a plurality that current licensure policies were satisfactory (44.0%). The majority were supportive of Michigan joining the compact (72.3%). In multivariable analysis, stronger support for joining the compact was associated with advanced degrees, male sex, and younger age. Less support was associated with membership in a collective bargaining unit. Policymakers who wish to ease acute nurse vacancies should consider enacting nurse licensure compact legislation. Careful attention to patient protections and disciplinary review would address potential safety concerns. [ABSTRACT FROM AUTHOR]

Aim: To assess the prevalence and identify the predictors of breakfast skipping among 14‐ to 16‐year‐old adolescents in Jordan, focusing on mother‐related variables. Background: Breakfast is an essential meal across one's entire lifespan and especially important during the adolescent years. The practice of skipping breakfast has become so prevalent among adolescents that it is now a well‐documented nutritional problem. Design A descriptive cross‐sectional correlational design. Methods: A proportional cluster stratified sampling protocol was used to select 1896 adolescents and their mothers (1013) during the period of March to June 2016. A self‐reported questionnaire was used to collect data on breakfast‐skipping rates, the perceived reasons for this behavior, the perceived importance of consuming breakfast, and maternal encouragement of breakfast consumption. Results: The prevalence of breakfast skipping was 34.3% among adolescents and 21.5% among their mothers. A significant association was found between breakfast skipping among adolescents and their mothers (χ2 [1, n = 998] = 37.90, P =.001). Maternal encouragement of breakfast consumption, gender, and adolescent perception of the importance of this meal were found to be significant predictors of adolescent breakfast skipping. Conclusion: The findings highlight the importance of involving mothers in developing nutritional health plans aimed at promoting regular breakfast consumption among adolescents. SUMMARY STATEMENT: What is known about the topic? Regular breakfast intake has been linked to positive benefits for adolescent health, including lower risk for obesity and fewer biomarkers of chronic illness.The practice of skipping breakfast is highly prevalent among adolescents, both in Jordan and across the globe.Parental eating habits and attitudes influence adolescent eating behaviors and attitudes. What the paper adds? Female adolescents in Jordan skipped breakfast more often than male adolescents and to a significant degree. For both groups, lack of appetite was reported as the main reason (39%) for skipping breakfast.The interrelationships found between maternal and adolescent variables related to breakfast consumption highlight the pivotal role of mothers in promoting this practice. When mothers valued eating breakfast, so did their adolescent children, a relation that translated into lower rates of breakfast skipping among the adolescents.Maternal encouragement of breakfast consumption, the adolescents' perceived value of this practice, and their gender proved significant predictors of breakfast skipping behavior. The implications of this paper: Health interventions to promote breakfast consumption among adolescents are likely to be more effective if based on a better understanding of the role of mothers in this regard.Nurses should involve mothers in developing nutritional health plans to promote regular breakfast consumptions among adolescents.Nurses should educate mothers and adolescents about the health costs for adolescents associated with skipping breakfast. [ABSTRACT FROM AUTHOR]

Aims and objectives. This paper is a report of a study conducted to investigate differences between nurse practitioners' perceptions of the importance of required competencies and their self-evaluated existing competencies, and the main factors influencing these differences. Background. The difference between nurse practitioners' perceptions of required competencies and their existing competencies has never been investigated. Therefore, it is still uncertain whether these two competencies differ. Design. A nationwide survey study was authorised by the Department of Health (DOH) in Taiwan. Methods. For this nationwide survey study, the Questionnaire of Competencies in the Nurse Practitioner's Role was mailed to all nurse practitioners who qualified for the first annual national NP licence exam in Taiwan. Of 582 questionnaires distributed, 374 valid questionnaires were returned for a response rate of 64·2%. Results. The scores for required competencies were all higher than existing competencies. The competencies with largest differences were (in increasing order) clinical research, direct care, and leadership and reform. The competencies with smallest differences were (in ascending order) medical assistance, communication and coordination, and ethical decision-making. Differences in the total score between required and existing competencies were significantly influenced by nurse practitioners' age, seniority as nurse practitioner, whether the nurse practitioners' institution had a nurse practitioner advancement system, and the number of patients under their care. Conclusions. Nurse practitioners' perceptions of the importance of their expected role competencies were significantly greater in most cases than their actual competencies. Relevance to clinical practice. These findings could serve as a reference to improve cultivation of the NP system in Taiwan, to strengthen professional competencies in NP training programs. [ABSTRACT FROM AUTHOR]

gilmour j.a., huntington a., broadbent r., strong a. & hawkins m. (2012) Nurses' use of online health information in medical wards. Journal of Advanced Nursing 68(6), 1349-1358. Abstract Aim. This paper is a report of a study of nurses' access, use and evaluation of online health information in medical wards. Background. Online health information is commonly used by patients with chronic illness to support their education needs. Nurses have a critical role in assisting patients to access and use this information. Method. This descriptive cross-sectional survey of a random sample of 540 nurses employed in medical wards was carried out in 2009. The response rate was 58·7% (293). The analytical approach included descriptive statistics and non-parametric tests of correlation and differences between groups. A content analysis was performed on the qualitative data. Results. Most respondents (78·6%) were satisfied with work Internet access and 58·2% believed that the use of online information improved care delivery. Nearly half the group was aware of patient misconceptions about their illness due to incorrect interpretations of online information, but only 24·4% checked if patients used online information. There was a significant association between assessing patients use and awareness of patient misconceptions. Conclusion. The findings of this study highlight that while online resources add to education opportunities, the ongoing nursing assessment required to determine online information needs is not always incorporated into nursing practice. Patient misunderstandings of online material were also identified; developing patient competency in evaluating open access health information should now be recognized as an integral aspect of illness management education. [ABSTRACT FROM AUTHOR]

meyer k., bjørk i.t. & eide h. (2012) Intensive care nurses' perceptions of their professional competence in the organ donor process. Journal of Advanced Nursing 68(1), 104-115. Abstract Aims. This paper is a report of a study that explored Norwegian intensive care nurses' perceptions of their professional competence to identify educational needs in the organ donor process. Background. Intensive care professionals are requested to consider organ donation each time they care for patients with severe cerebral lesion to ensure donor organs for transplantation. The donor process challenges intensive care nurses' professional competence. Nurses' knowledge and experience may influence their professional competence in caring for organ donors and their relatives. Methods. A cross-sectional survey was conducted in all 28 Norwegian donor hospitals between October 2008 and January 2009. Intensive care nurses ( N = 801) were invited to participate and the response rate was 71·4%. Dimensions of professional competence, learning needs and contextual and demographic variables were explored. Data were analysed using descriptive and inferential statistics. Findings. Few intensive care nurses had extensive experience of or competence and training in organ donation. Nurses working at university hospitals had more experience, but lesser training than nurses in local hospitals. Experience of donor acquisition had an impact on intensive care nurses' perceptions of their professional competence in the donor process. Discussions on the ward and educational input were seen as important for the further development of professional competence. Conclusion. Training provided by experienced colleagues and a culture that encourages discussion about aspects of the donor process can develop nurses' professional competence and communally defined professional practice. Educational input that cultivates various types of knowledge can be beneficial in organ donation. [ABSTRACT FROM AUTHOR]

This study explores the perceptions and experiences of Korean occupational therapists (OTs) about their role in managing elderly patients with orthopedic conditions. The goal is to inform policy discussions for better integration of OT services in orthopedic care settings in Korea. A survey was conducted among Korean clinical OTs to gather data on their perceptions, experiences, and challenges in providing orthopedic OT services. Snowball sampling was used, and the survey addressed general characteristics, orthopedic OT status, perceptions, and competence. The data were analyzed using frequency and percentage calculations in SPSS 22.0. Out of 171 respondents, only 18 had experience working in orthopedic departments, while 78 (45.6%) had provided occupational therapy to orthopedic patients. Rehabilitation medicine physicians were the primary prescribers of orthopedic OT. Key challenges included a lack of awareness among professionals, an absence of appropriate fees, and insufficient knowledge among OTs. The majority of respondents agreed that providing OT in orthopedic departments was appropriate and expressed a need for education and clinical guidelines. The study examines the current state of orthopedic OT in Korea, showing low levels of experience and highlighting challenges, such as a lack of professional awareness, inadequate fees, and insufficient knowledge among OTs. Respondents mostly agreed on the necessity for education and clinical guidelines to improve their capabilities in orthopedic settings. This study emphasizes the need for healthcare system improvements that allow OTs to participate more widely without being confined to specific medical disciplines, promoting a more comprehensive approach to OT, especially as the aging population continues to grow. [ABSTRACT FROM AUTHOR]

Aims: To explore the role of transfer centre nurses and how they facilitate communication between referring and accepting providers during calls about interhospital transfers, including their strategies to overcome communication challenges. Design: A qualitative interview study. Methods: We conducted semi‐structured interviews with 17 transfer centre nurses at one tertiary medical centre from March to August 2019, asking participants to describe their work. We performed content analysis, applying codes based on the Relational Coordination Framework and generating emergent codes, then organized codes in higher‐order concepts. We followed the COREQ checklist. Results: Transfer centre nurses employed multiple strategies to mitigate communication challenges. When referring providers had misconceptions about the transfer centre nurse's role and the accepting hospital's processes, the nurses informed referring providers why sharing information with them was necessary. If providers expressed frustrations or lacked understanding about their counterpart's caseload, the nurses managed providers' emotions by letting them "vent," explaining the other provider's situational context and describing the hospital's capabilities. Some nurses also mediated conflict and sought to break the tension if providers debated about the best course of action. When providers struggled to share complete and accurate information, the nurses hunted down details and 'filled in the blanks'. Conclusion: Transfer centre nurses perform invisible work throughout the lifespan of interhospital transfers. Nurses' expert knowledge of the transfer process and hospitals' capabilities can enhance provider communication. Meanwhile, providers' lack of knowledge of the nurse's role can impede respectful and efficient transfer conversations. Interventions to support and optimize the transfer centre nurses' critical work are needed. Impact This study describes how transfer centre nurses facilitate communication and overcome challenges during calls about interhospital transfers. An intervention that supports this critical work has the potential to benefit nurses, providers and patients by ensuring accurate and complete information exchange in an effective, efficient manner that respects all parties. Patient or public contribution: This study was designed to capture the perspectives and experiences of transfer centre nurses themselves through interviews. Therefore, it was not conducted using input or suggestions from the public or the patient population served by the organization. [ABSTRACT FROM AUTHOR]

Aims: To identify strategies used by registered nurses and non‐registered nursing care staff in overcoming barriers when providing fundamental nursing care for non‐invasively ventilated inpatients with COVID‐19. Design: Online survey with open‐ended questions to collect qualitative data. Methods: In August 2020, we asked UK‐based nursing staff to describe any strategies they employed to overcome barriers to delivering care in 15 fundamental nursing care categories when providing care to non‐invasively ventilated patients with COVID‐19. We analysed data using Framework Analysis. Results: A total of 1062 nurses consented to participate in our survey. We derived four themes. 1) Communication behaviours included adapting verbal and non‐verbal communication with patients, using information technology to enable patients' significant others to communicate with staff and patients, and establishing clear information‐sharing methods with other staff. 2) Organizing care required clustering interventions, carefully managing supplies, encouraging patient self‐care and using 'runners' and interdisciplinary input. 3) Addressing patients' well‐being and values required spending time with patients, acting in loco familiae, providing access to psychological and spiritual support, obtaining information about patients' wishes early on and providing privacy and comforting/meaningful items. 4) Management and leadership behaviours included training, timely provision of pandemic information, psychological support, team huddles and facilitating regular breaks. Conclusions: Our respondents identified multiple strategies in four main areas of clinical practice. Management and leadership are crucial to both fundamental care delivery and the well‐being of nurses during pandemics. Grouping strategies into these areas of action may assist nurses and leaders to prepare for pandemic nursing. Impact As these strategies are unlikely to be exclusive to the COVID‐19 pandemic, their global dissemination may improve patient experience and help nurses deliver fundamental care when planning pandemic nursing. However, their effectiveness is unknown. Therefore, we are currently evaluating these strategies in a cluster randomized controlled trial. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic may have resulted in front line social workers experiencing job stress, burnout and other psychological distress. Little is known about the work-related stress experienced by Chinese social workers during the pandemic. This study focused on the job stress of social workers from Mainland and Macao. The research aims of this study included: (1) testing whether there is a difference in job stress between social workers from Mainland and Macao during the pandemic and (2) identifying mediating factors that helped explain such regional differences. An online survey collected data from 292 social workers in Mainland China and 108 from Macao in 2020. Mainland participants reported significantly higher job stress than Macao participants. Regional differences in job stress amongst Mainland and Macao social workers were partially attributed to their age and professional role identity. More attention needs to be paid to social workers in Mainland China as they experience higher job stress than their counterparts from Macao. Future research is needed to examine other factors (e.g. job demand and financial compensation) that may contribute to such regional differences. [ABSTRACT FROM AUTHOR]

Background: Caregiver burden consists of disease specific and perceived stressors, respectively referred to as objective and subjective indicators of burden, and is associated with negative outcomes. Previous research has found that care partners to persons living with cognitive impairment and elevated levels of amyloid-β, as measured by a positron emission tomography (PET) scan, may experience caregiver burden. Aims: To elucidate the relationship between amyloid scan results and subjective and objective indicators of burden. Methods: A parallel mixed-methods design using survey data from 1338 care partners to persons with mild cognitive impairment (MCI) and dementia who received an amyloid scan from the CARE-IDEAS study; and semi-structured interviews with a subsample of 62 care partners. Logistic regression models were used to investigate objective factors associated with caregiver burden. A thematic analysis of semi-structured interviews was used to investigate subjective indicators by exploring care partners' perceptions of their role following an amyloid scan. Results: Elevated amyloid was not associated with burden. However, the scan result influenced participants perceptions of their caregiving role and coping strategies. Care partners to persons with elevated amyloid expected increasing responsibility, whereas partners to persons without elevated amyloid and mild cognitive impairment did not anticipate changes to their role. Care partners to persons with elevated amyloid reported using knowledge gained from the scan to develop coping strategies. All care partners described needing practical and emotional support. Conclusions: Amyloid scans can influence subjective indicators of burden and present the opportunity to identify and address care partners' support needs. [ABSTRACT FROM AUTHOR]

Background: To evaluate safety of acupuncture treatment by Korean Medicine Doctors (KMDs), a prospective, practice-based survey on adverse events (AEs) associated with acupuncture was conducted. Methods: From July 2016 to October 2017, KMDs were invited to participate in an online survey. Frequency was calculated as the number of AEs per 10,000 treatments; severity was assessed with the Common Terminology Criteria for Adverse Events Grading (Severity) Scale; and causality was evaluated using the World Health Organisation-Uppsala Monitoring Centre system for standardised case causality assessment. Associations between AE occurrence and KMDs' type of practice/clinical experience and patient age/gender/current medication(s) were analysed. Results: Data on 37,490 acupuncture treatments were collected from 222 KMDs. At least one AE was reported from 4,518 acupuncture treatments, giving a frequency rate of 1,205 per 10,000 acupuncture treatments; this increased to 4,768 treatments when administrative problems related to defective devices or medical negligence were added, for a rate of 1,272 per 10,000 acupuncture treatments. Commonly reported AEs were bleeding, needle site pain, and bruising. Approximately 72.9% of AEs/administrative problems were assessed as they certainly occurred by acupuncture treatment in causality assessment. Most AEs/administrative problems were considered mild in severity and two life-threatening AEs were resolved with no sequelae. Compared to males, female patients were more likely to experience AEs and KMDs' clinical experience was not associated with reported AE occurrence. Conclusions: Although acupuncture-associated AEs occur commonly, they are largely transient and mild. Acupuncture performed by qualified KMDs may serve as a reliable medical treatment with acceptable safety profiles. [ABSTRACT FROM AUTHOR]

Background: Preventable harms during hospitalization pose a major challenge for health systems globally. Nurse‐led strategies provide comprehensive harm prevention to keep the most vulnerable patients safe in hospital, but gaps in care are common. Nursing roles and activities to prevent harm to patients during acute hospitalization are poorly understood. Aim: The aim of this study was to identify nurses' perceived enablers and barriers to the implementation of comprehensive harm prevention for older people admitted to an acute hospital setting. Design: Anonymous, online, cross‐sectional survey. Methods: The adapted Influences on Patient Safety Behaviours Questionnaire (IPSBQ) was used to collect data from nurses working on five general medicine wards across three hospitals of a single tertiary health service in Australia in 2019. Participants also rated their perceptions of overall quality of care, missed care and awareness of strategies for an eight‐factor framework for comprehensive harm prevention. The STROBE reporting checklist was used. Results: Ward response rates between 35% and 58% resulted in 132 complete questionnaires for analyses. High mean scores for behavioural regulation (3.28), beliefs about capabilities (2.96) and environmental context and resources (2.73) indicated these domains were perceived by nurses as enablers. Low mean scores for the domains of intentions (1.65), beliefs about consequences (1.69), optimism (1.72) and professional role and identity (1.85) indicated these were barriers to comprehensive harm prevention by nurses. High perceived quality of care (scored 9–10/10) (p =.024), and awareness of strategies for the eight‐factor framework (p =.019) were significant enablers of comprehensive harm prevention. Conclusion: Targeted evidence‐based strategies that include education, persuasion, incentivization, coercion and modelling would be most useful for promoting comprehensive harm prevention by nurses. However, to be most effective the harm prevention strategy may need to be tailored for each ward. [ABSTRACT FROM AUTHOR]

The objective of this study was to explore the relationship among income and emotional/practical concerns, help‐seeking and unmet needs for cancer survivors aged 18 to 64 years one to three years after treatment. A cross‐sectional survey was mailed in 2016 to 40,790 survivors randomly selected from 10 Canadian provincial cancer registries. Thirty‐three percent responded. A trend analysis was conducted for survivors most likely to be in the workforce exploring the relationship across four income levels and emotional/practical concerns, whether help was sought for identified concerns, and whether help was received. A total of 4,264 respondents, aged 18–64, provided useable data with breast (34.4%) and colo‐rectal (15.0%) accounting for the primary cancer type and 32.0% reporting annual household incomes of <$50,000. More than 94% of respondents indicated having emotional or practical concerns. Between one‐third and one‐half of the respondents sought help for their concerns and, of those, between one‐third and one‐half experienced difficulty finding help or did not obtain assistance. Significant trends across income categories indicated greater percentages of those in lower income categories experienced emotional and practical concerns, rated their concerns as 'big', sought help, and had difficulty finding help to address their concerns. Clearly adult cancer survivors experience emotional and practical concerns. Healthcare professionals have important roles monitoring these concerns and connecting those who desire help to relevant services. Opportunities should be given to individuals, regardless of income level, to indicate if they have concerns and if they would like assistance. [ABSTRACT FROM AUTHOR]

Information and Communication Technologies (ICTs) permeated social work practice before coronavirus disease 2019 (COVID-19). In addition to ICT-based formal services (e.g. e-counselling), social workers used ICTs informally as an adjunct to face-to-face practice. Building on our previous research, our cross-sectional online survey examined social workers' informal use of ICTs in four countries: Canada, the USA, Israel and the UK. The survey was administered through Qualtrics software among social workers across Canada (n  = 2,609), the USA (n  = 1,225), Israel (n  = 386) and the UK (n  = 134), and analysed using IBM SPSS Statistics version 26. The findings substantiate the ubiquitous use of informal ICTs in social work practice, as an adjunct to face-to-face treatment, across the four countries. Given the current, unprecedented context of COVID-19, we discuss the meaning of our findings related to access, ethical considerations (e.g. professional boundaries) and supervision in the context of restricted face-to-face practice. We discuss the implications for social work practice, education and research, and conclude that in the COVID-19 context, there is an even greater need for research, clinical discussion, supervision and policy on informal ICT use in social work practice. [ABSTRACT FROM AUTHOR]

senneseth m., alsaker k. & natvig g.k. (2012) Health-related quality of life and post-traumatic stress disorder symptoms in accident and emergency attenders suffering from psychosocial crises: a longitudinal study. Journal of Advanced Nursing 68(2), 402-413. Abstract Aims. This paper is a report of a study of health-related quality of life and post-traumatic stress disorder symptoms in patients attending an Accident and Emergency department because of psychosocial crises. Background. Psychosocial crises are commonplace globally, but there is little knowledge about patients attending Accident and Emergency departments because of psychosocial crises. Methods. Data were collected at an Accident and Emergency department in Norway from September 2008 to June 2009. A total of 99 adults participated in the baseline study and 41 of these participated at 2 months follow-up. The Short Form-36 Health Survey and the Post Traumatic Symptom Scale were used to obtain data. Findings. Participants reported significantly lower scores in all health-related quality of life domains at baseline compared with the general Norwegian population. The mental health score was two standard deviations below the norm. Health-related quality of life scores were improved and post-traumatic stress disorder symptoms were reduced after 2 months. High levels of post-traumatic stress disorder symptoms were reported by 78% of the participants at baseline and 59% at follow-up. Participants with high levels of post-traumatic stress disorder symptoms at follow-up also reported low health-related quality of life scores. Conclusion. This study suggests a need for an acute psychosocial intervention and an opportunity to receive follow-up support at Accident and Emergency departments. [ABSTRACT FROM AUTHOR]

Context: There is very little research on the impact of caring on physical health, and the evidence that exists is mixed. There is also lack of evidence on the role of other factors including both socio-economic factors and the role played by care services and unmet needs for such services. Aims: This study aims to understand the association between physical health outcomes among unpaid carers in the United Kingdom compared to individuals who have not provided unpaid care, and investigate what is the role that time, and unmet needs for care services play in this relationship. Methods: We used four waves of the UK Household Longitudinal Survey, a large representative sample, covering the period 2015 to 2020. We performed Propensity Score Matching to compare health outcomes of carers against non-carers and Latent Class Analysis to identify different typologies of unpaid carers. Results: We found that the relationship between care provision and physical health is complex, that effects on health may differ between the short and medium run, and that deprivation levels and unmet need for services play an important role. Conclusion: This research contributes original insights into our understanding of the impact of different care trajectories on the health of the carer taking into consideration the characteristics of care-recipients, the effect of unmet needs, and external factors. This is crucial both in relation to their ability to provide support and in terms of their own care needs and is therefore of direct relevance to policy and practice to support unpaid carers. [ABSTRACT FROM AUTHOR]

Community mental health services are the service of choice in the mental health field. In recent years, demand for these services has increased significantly. Nurses play a central role in community mental health services. Nevertheless, predictive factors of the use of such services are unclear, especially in Switzerland. This study aimed to examine relevant predictors of persons with mental health problems' use of community mental health nursing services in Switzerland. Swiss Health Survey 2017 data were used to compare those who use community mental health nursing services with those who do not. We found that age, number of doctor visits, problems with instrumental activities of daily life, use of informal help, use of emergency services, taking psychotropic medication, being female, and living without a partner were positive predictors, while experiencing severe physical symptoms was a negative predictor. Several of our findings confirm the similarity between the utilization of community mental health nursing services and the use of community mental health services in general. Our results suggest that community mental health nursing services deserve the same prominent place in the mental health system and its corresponding policies. This should be taken as an argument for policy development and better reimbursement. In research, health surveys should focus on nursing and need‐related questions. Additionally, it is necessary to develop community mental health nursing services from an add‐on service into independent nursing services and evaluate these services. [ABSTRACT FROM AUTHOR]

Background: Health promotion and patient education are crucial to improved population health and are also among the core principles that define naturopathy. Yet, the activities of naturopathic practitioners (NPs) with regards to health promotion and community education have not been widely studied. Methods: A cross-sectional online survey of an international convenience sample of NPs was conducted through disseminating a 15-item questionnaire prepared in five languages. Correlates of most frequently mentioned NP activities were studied. Results: The survey was completed by 813 NPs representing all world regions. Almost all participants (98%) reported at least one health promotion activity. Most reported were information sheets and handouts (92.7%) or social and professional network communications (91.8%) and information talks presented to community members (84.9%). The majority of NPs (79.5%) indicated that the 'health issues individuals in NPs' community have said they need help with' were a 'very important' consideration when they designed health promotion activities. NP characteristics associated with the likelihood of engaging in specific health promotion activities varied between activities but include gender, time since first qualification, factors considered to identify need when designing an activity, and stakeholder involvement in activity design. Conclusions: Health promotion is a key activity of the global naturopathic profession. There are a wide range of patient education tools utilized by NPs. [ABSTRACT FROM AUTHOR]

Aims and objectives: The aims of the study were to identify content categories of unreasonable and unnecessary illegitimate tasks and to investigate how unreasonable and unnecessary tasks relate to occupational wellbeing. Background: Illegitimate tasks are a common stressor among healthcare professionals, and they have been shown to have negative associations with occupational well‐being. Despite this evidence, research has not yet uncovered what kinds of tasks healthcare professionals consider illegitimate. Design and method: The data gathered by means of an online survey consisted of 1024 municipal healthcare organisation employees. A theory‐driven qualitative content analysis was used to analyse freely reported illegitimate tasks. For occupational well‐being associations, a mixed‐methods approach was used (ANCOVA and linear regression analysis). The STROBE statement—checklist for cross‐sectional studies was used. Results: Eight content categories were found for illegitimate tasks. For unreasonable tasks, these were (1) tasks outside one's occupational role (78% of all unreasonable tasks), (2) conflicting or unclear demands (9%), (3) tasks with insufficient resources (8%) and (4) tasks with difficult consequences (5%), and for unnecessary tasks, these were (1) impractical or outdated working habits (31% of all unnecessary tasks), (2) tasks related to dysfunctional technology (30%), (3) unnecessary procedures (27%) and (4) tasks related to bureaucratic demands (12%). Unreasonable and unnecessary tasks were associated with higher levels of burnout and lower work engagement and the meaningfulness of work. Conclusions: Our findings support the theory that illegitimate tasks are an occupational stressor with negative effects on burnout, work engagement and meaningfulness of work. Relevance to clinical practice: The study offers insights into the types of tasks health care employees see as illegitimate and highlights the importance of good job design in promoting occupational well‐being in health care. [ABSTRACT FROM AUTHOR]

Online abuse, facilitated via social media and mobile technologies, has recently attracted considerable academic attention. The nonconsensual sharing of intimate images—revenge pornography—can have a devastating effect on victims, is a global problem, and constitutes interpersonal violence. The national helpline in the United Kingdom has now received over 7,000 calls. In the United Kingdom, new legislation making revenge pornography a crime was introduced in 2014, yet the police do not always respond appropriately to victims. This article presents the findings of a national online survey of police understanding of revenge pornography, undertaken in the United Kingdom in March 2017. The study set out to investigate police knowledge of revenge pornography legislation, their confidence in responding to cases of revenge pornography, and what level of training they had received. A total of 783 members of the police force responded to the survey and, to the authors' knowledge, this the first study to seek to quantify the understanding of revenge pornography by police officers and staff in England and Wales. The findings suggest that the police in the United Kingdom have a limited understanding of revenge pornography legislation and lack confidence both in investigating cases and in effectively responding to victims. The implications of the study demonstrate that there is an urgent need for training across police forces to ensure that cases of revenge pornography are appropriately responded to, victims are safeguarded, and offenders brought to justice. [ABSTRACT FROM AUTHOR]

Findings from international research emphasis the need of these young people to be identified and recognised. Therefore, a nationwide quantitative study of professionals' awareness was conducted in the Swiss context. Data were collected from professionals working in education, healthcare and social services. The study examined professionals' familiarity with the terms used to describe young people with caring responsibilities; their ability to identify the population in their professional context; their perception of the relevance of the issue; their ability to support them; and their own training needs. Potential study participants were contacted via email. Data were collected using an online survey, which was open for 14 weeks during the period of September to December 2016. Survey data from 2,311 professionals, who reported being regularly in contact with young people with caring responsibilities in their occupational context, were included for analysis. Of all terms presented in the survey, young carer (YC) was the term most familiar to all professionals. Among healthcare and education sector, the percentage of professionals familiar with this term was higher than that among professionals from social services. Professionals from social services were the most likely to consider the issue relevant to their work, those from education were the least likely. Professionals who were familiar with the terms describing YC were more likely to consider the issue relevant to their work. Study results showed that more than half of the respondents had not identified young people with caring responsibilities, and that the ability of participants to identify YC was related to their occupational sector. The perceived ability to support YC was related to their reported ability to recognise them. In order to enable professionals to support YC, raising awareness, providing training for professionals and a national network of existing organisations should be well considered. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Mass masking is emerging as a key non-pharmaceutical intervention for reducing community spread of COVID-19. However, although hand washing, social distancing and bubble living have been widely adopted by the 'team of 5 million', mass masking has not been socialised to the general population. AIM: To identify factors associated with face masking in New Zealand during COVID-19 Alert Level 4 lockdown to inform strategies to socialise and support mass masking. METHODS: A quantitative online survey conducted in New Zealand during April 2020 invited residents aged ≥18 years to complete a questionnaire. Questions about face masking were included in the survey. The sample was drawn from a commissioned research panel survey, with boosted sampling for Māori and Pacific participants. Responses were weighted to reflect the New Zealand population for all analyses. RESULTS: A total of 1015 individuals participated. Self-reported beliefs were strongly related to behaviours, with respondents viewing face masking measures as 'somewhat' or 'very' effective in preventing them from contracting COVID-19 more likely to report having worn a face mask than respondents who viewed them as 'not at all' effective. The strongest barriers to face mask use included beliefs that there was a mask shortage and that the needs of others were greater than their own. DISCUSSION: Highlighting the efficacy of and dispelling myths about the relative efficacy of mask types and socialising people to the purpose of mass masking will contribute to community protective actions of mask wearing in the New Zealand response to COVID-19. [ABSTRACT FROM AUTHOR]

Aims and objectives: In Canada, nurse practitioners (NP) were legally authorised to prescribe controlled drugs and substances (CDS) in 2012. The objective of this study was to understand current NP‐CDS prescribing in Alberta, Manitoba and Saskatchewan, Canada. This study is a component of a larger three‐phase survey of NP practice patterns in these same provinces. Background: Nurse practitioners are nurses with a graduate degree who have the legal authority to perform expanded functions in health systems, including prescribing CDS. Given the novelty of CDS prescribing for NPs in Canada, little is known about this component of their role. Design: A secondary analysis of survey data collected between March 2016 and May 2017 was used to examine NP‐CDS‐prescribing patterns and identify potential associated factors. Methods: Nurse practitioners in Alberta, Manitoba and Saskatchewan were invited to complete a professional practice pattern survey. The survey was administered through a secure electronic data collection software application (redcap). In the practice pattern survey, 42 variables from 15 distinct conceptual questions were analysed in this study as potential predictors of NP‐CDS prescribing within a purposeful selection ordinal logistic regression model. This scientific submission has been assessed for accuracy and completeness using the Equator STROBE guideline criteria (see Appendix S1). Results/Findings: Five variables were found to be associated with an increased odds of more frequent NP‐CDS prescribing in addition to three confounders/clinically relevant variables. Factors commonly associated with an increased frequency of NP‐CDS prescribing relate to location of practice, area of practice, previous nursing experience, team environments and common diagnoses. Conclusion: Little is known about NP‐CDS prescribing. Understanding this important component of the NPs emerging legal scope of professional practice can contribute to the continued refinement of this role as well as support ongoing enquiry into the causes of, and potential interventions to prevent, the present opioid overdose deaths occurring while under an active prescription. Relevance to clinical practice: Understanding factors that influence NP‐CDS prescribing has relevance to the current drug‐related prescription fatalities crisis in all countries. [ABSTRACT FROM AUTHOR]

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Background: Nurses' service behaviors have critical implications for hospitals. However, few studies had adequate ethical considerations of service behaviors and accounted for how organizational or individual antecedents can induce nurses to engage in service behaviors. In addition, they mainly focused on the one side of role-prescribed or extra-role service behavior. Objective: This study aims to explore the chained mediation effect of ethical climate and moral sensitivity on the relationship between organizational ethical leadership and nurses' service behaviors and to examine the relationship, from a comparative view, of the role-prescribed service behavior and extra-role service behavior. Methods: In all, 476 nurses from three tertiary hospitals were investigated with the Ethical Leadership Scale, Ethical Climate Scale, Moral Sensitivity Questionnaire and Service Behavior Questionnaire. Structural equation modeling was adopted to analyze the data. SPSS and Mplus statistical software was used in the data analysis. Ethical considerations: Approval was obtained from the Ethics Committee at School of Nursing, Hebei Medical University. Data privacy and confidentiality were maintained and assured by obtaining subjects' informed consent to participate in the research before data collection. Results: The effects of ethical leadership on nurses' service behaviors are mediated by two variables in turn: ethical climate and nurses' moral sensitivity. Ethical climate and moral sensitivity partially mediated the relationship between ethical leadership and nurses' role-prescribed service behavior and fully mediated the relationship between ethical leadership and nurses' extra-role service behavior. Conclusion: Organizational ethical leadership positively affected ethical climate, which positively affected nurses' moral sensitivity and affected both their role-prescribed service behavior and extra-role service behavior. [ABSTRACT FROM AUTHOR]

The treatment burden inherent in self-managing multiple chronic conditions (multimorbidity) is recognized, but there has been little examination of the care burden experienced by paid home health-care assistants (HCAs) who support older people with multimorbidity. Focus groups were conducted with HCAs in Ireland and data were coded using a thematic analysis approach. Care burden of HCAs was linked with lack of knowledge and information, poor communication, insufficient time and resources, gaps in medication support and work-related stress. Strategies are required to reduce the care burden of HCAs, who are essential stakeholders supporting growing numbers of older people with multimorbidity. [ABSTRACT FROM AUTHOR]

Objective: Medical care alone cannot adequately improve population health or eliminate inequities; social determinants of health (SDH) must be addressed. This study's purpose was to describe the research, teaching, service, and clinical practice activities implemented by RWJF Nurse Faculty Scholars to act on the SDH. Design: A cross-sectional survey design was used with a sample of RWJF Nurse Faculty Scholars, chosen because they were provided specialized mentoring, grants, and other support that allowed them to explore SDH. Results: Respondents (n = 57) addressed SDH in their research (86.0%), teaching (68.4%), service (66.7%), and clinical practice (33.3%). Leading research foci were quality of health care (56.1%), social and physical environmental stressors (54.4%), and access to health care services (49.1%). Leading SDH areas in teaching were discrimination in society against vulnerable populations (54.4%), quality of health care received by vulnerable populations (50.9%), and vulnerable populations' access to health care services (50.9%). Service activities included addressing discrimination against diverse populations. Leading SDH areas in clinical practice were quality of health care received by vulnerable populations (28.1%), vulnerable populations' access to health care services (22.8%), and discrimination in society against vulnerable populations (19.3%). Respondents also addressed SDH through personal mentoring (71.9%); efforts to recruit and/or retain underrepresented faculty (59.6%); developing a diverse pipeline of nurses (59.6%); and participation on a diversity committee (40.4%). Conclusion: The RWJF Nurse Faculty Scholars were able to leverage their awards to address SDH; however, further research is needed to assess the impact of the SDH work conducted. Knowledge from this study can be used as a road map for SDH elements and areas of professional work that nurses and other health professionals could address SDH in research, teaching, service, and practice. [ABSTRACT FROM AUTHOR]

Environmental factors including poor nutrition, obesity, smoking, exposure to toxins and drug and alcohol use at the time of conception can adversely affect the future health of the offspring. As primary health care (PHC) professionals who interact with women of reproductive age, Maternal, Child and Family Health Nurses (MCaFHNs) are ideally placed to promote preconception health to women who want another child. The aim of this study was to assess MCaFHNs attitudes towards preconception health promotion, whether and under what circumstances they talk to their families about this, and what might help them start a conversation about preconception health. Of the 192 respondents, most (65%) agreed it is part of the MCaFHNs role to promote preconception health but only one in eight (13%) felt very confident that they knew as much as they needed and less than half (46%) 'routinely' or 'sometimes' promoted preconception health in their clinical practice. Almost all agreed that more information and education on the topic would increase their confidence to discuss preconception health. The findings suggest that, with adequate educational and structural support, most MCaFHNs are willing to deliver preconception health promotion in their clinical practice. As most new mothers access MCaFHNs, the potential health benefits of this are considerable. [ABSTRACT FROM AUTHOR]

Context: Recent recommendations have emphasized return- to-learn (RTL) protocols to aid athletes in recovery from sport-related concussion (SRC) but have been based primarily on anecdotal evidence. Objective: To investigate the RTL practices of certified athletic trainers (ATs) after an SRC. Design: Cross-sectional study. Setting: Online survey. Patients or Other Participants: A total of 1083 individuals (27%) from a random sample of 4000 ATs in the National Athletic Trainers' Association membership database completed an electronic survey. Participants consisted of 729 self-identified secondary school ATs (SSATs; 67.3%; experience=14.0 6 9.7 years) and 354 self-identified collegiate ATs (CATs; 32.7%; experience = 13.4 ± 6 9.7 years). Main Outcome Measure(s): We used x2 analyses to assess respondent differences related to current knowledge, current practices, and available resources. Independent t tests were used to compare SSATs and CATs on years of certification and annual number of SRCs evaluated. Results: Of our total respondents, 41.2% (n=446) correctly indicated the absence of evidence-based RTL guidelines. Whereas most (73.9%, n=800) respondents had an established RTL policy, only 38.1% (n = 413) used such guidelines in their clinical practice. Most (97.1%, n = 708) SSATs and 82.2% (n = 291) of CATs had access to (a) mental health professional(s); however, minorities of SSATs (21.4%, n = 156) and CATs (37.0%, n = 131) never accessed these resources to care for concussed student-athletes. Conclusions: Our results suggested that, despite the absence of empirical evidence, most surveyed ATs incorporated some form of RTL protocol in their SRC management policy. The varying AT knowledge, clinical practices, and resources highlighted by our results should be considered when creating or refining an RTL protocol. [ABSTRACT FROM AUTHOR]

The purpose of this study was to explore current tobacco use treatment (TUT) practice patterns, and attitudes and beliefs among Village Health Workers (VHWs) about expanding their role to include delivering smoking cessation interventions and the perceived barriers. We conducted a survey of 449 VHWs from 26 communes in Thai Nguyen province, Vietnam. We assessed TUT practice patterns including asking about tobacco use, advising smokers to quit, offering assistance (3As) and attitudes, self-efficacy, and norms related to TUT. Seventy two per cent of VHWs reported asking patients if they use tobacco, 78.6% offered advice to quit, and 41.4% offered cessation assistance to few or more patients in the past month. Self-efficacy was low, with 53.2% agreeing that they did not have the skills to counsel patients about smoking cessation. The most commonly reported barriers to offering TUT were a lack of training and perceived lack of patient interest. Greater awareness of their commune health centre’s smoke-free policy and higher levels of self-efficacy were associated with screening and offering cessation assistance. VHWs support an expanded role in tobacco cessation, but require additional resources and training to increase their self-efficacy and skills to provide effective treatment. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To determine the need for care robots among nurses and to suggest how robotic care should be prioritized in integrated nursing care services. Background: Korea is expected to be a super‐aged society by 2030. To solve care issues with elderly inpatient caused by informal caregivers, the government introduced “integrated nursing care services”; these are comprehensive care systems staffed by professionally trained nurses. To assist them, a care robot development project has been launched. Design: The study applied a cross‐sectional survey. Methods: In 2016, we conducted a multicentre survey involving 302 Registered Nurses in five hospitals including three tertiary and two secondary hospitals in Korea. The questionnaire consisted of general characteristics of nurses and their views on and extents of agreement about issues associated with robotic care. Results: Trial centre nurses and those with ≥10 years of experience reported positively on the prospects for robotic care. The top‐three desired primary roles for care robots were “measuring/monitoring”, “mobility/activity” and “safety care”. “Reduction in workload”, especially in terms of “other nursing services” which were categorized as nonvalue‐added nursing activities, was the most valued feature. The nurses approved of the aid by care robots but were concerned about device malfunction and interruption of rapport with patients. Conclusion: Care robots are expected to be effective in integrated nursing care services, particularly in “measuring/monitoring”. Such robots should decrease nurses’ workload and minimize nonvalue‐added nursing activities efficiently. No matter how excellent care robots are, they must cooperate with and be controlled by nurses. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: Nurses have a pivotal role in bringing the benefits of genomics and precision medicine to everyday health care, but a concerted global effort is needed to transform nursing policy and practice to address widely acknowledged deficits in nurses’ genomic literacy. The purpose was to conduct a global country and organization review of nursing engagement with genomics, informing a landscape analysis to assess readiness for integration of genomics into nursing. Design: Global nursing leaders and nursing organizations were recruited using a purposive sampling strategy to complete an online survey that assessed the scope of genomic integration in practice and education, challenges and barriers, and priorities for action. Methods: The survey was administered online following an orientation webinar. Given the small numbers of nurse leaders globally, results were analyzed and presented descriptively. Findings: Delegates consisted of 23 nurse leaders from across the world. Genomic services were offered predominantly in specialty centers consisting mostly of newborn screening (15/18) and prenatal screening (11/18). Genomic literacy and infrastructure deficits were identified in both practice and education settings, with only one country reporting a genetic/genomic knowledge and skill requirement to practice as a general nurse. Conclusions: These data provide insights into the commitment to and capacity for nursing to integrate genomics, revealing common themes and challenges associated with adoption of genomic health services and integration into practice, education, and policy. Such insights offer valuable context and baseline information to guide the activities of a new Global Genomics Nursing Alliance (G2NA). The G2NA will use the landscaping exercise as a springboard to explore how to accelerate the integration of genomics into nursing healthcare. Clinical Relevance: Genomics is relevant to all healthcare providers across the healthcare continuum. It provides an underpinning for understanding health, risks for and manifestations of disease, therapeutic decisions, development of new therapies, and responses to interventions. Harnessing the benefits of genomics to improve health and care outcomes and reduce costs is a global nursing challenge. [ABSTRACT FROM AUTHOR]

Limited research exists regarding healthcare professionals' knowledge and practice of physical activity promotion for cancer survivors in Ireland. There is also a lack of research identifying the barriers experienced by oncology professionals when promoting physical activity, or referring patients to community‐based exercise programmes. This study aims to identify healthcare professionals' knowledge, barriers and practices in relation to physical activity promotion for cancer survivors, and to generate guidance regarding the optimisation of the referral process to community‐based exercise programmes. Oncology healthcare professionals (n = 114) were invited to participate in two rounds of an online Delphi study. The response rates in rounds one and two were 38% (43/114) and 70% (30/43). Most respondents acknowledged the value of physical activity for cancer survivors (≥86%) and agreed that discussing physical activity with cancer patients was part of their role (88%). However, the majority of recommendations provided to patients did not align with the current physical activity guidelines. Strategies related to four themes that could optimise the referral process to community‐based exercise programmes achieved consensus, including providing education to healthcare professionals and patients regarding the benefits of physical activity and the logistics and quality of programmes, and optimising the logistics of the referral process. [ABSTRACT FROM AUTHOR]

Speech-language therapists (SLTs) have direct contact with a wide variety of individuals who require augmentative and alternative communication (AAC) and they are therefore considered to have a primary role in the assessment, selection, and implementation of AAC symbols, techniques, aids, and strategies. Limited information is available with regard to SLTs’ practices in the field of AAC, and there is a particular paucity of information about developing country contexts such as South Africa. The aim of this study was to determine how South African SLTs perceive their current AAC practices. Specifically, the study aimed to investigate SLTs’ assessment and intervention practices, their choice and use of graphic symbols, and display layouts for aided AAC systems. An online survey was developed, using the Qualtrics Research Suite™ online survey software. The survey included open-ended questions (analyzed using thematic analysis) and closed questions (analyzed using descriptive statistics). The responses indicated that SLTs in South Africa currently use a limited variety of assessment and intervention approaches. The data suggest that current practices are informed by previous experience with various technologies and AAC systems and that the primary caseloads of SLTs do not appear to inform specific approaches to assessment and AAC implementation. [ABSTRACT FROM PUBLISHER]