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Aim: To develop and test the psychometric properties of an expanded catheter self‐management scale for patients with in‐dwelling urinary catheters. Design: A cross‐sectional validation study. Despite the utility of the original 13‐item catheter self‐management scale, this instrument did not include bowel management, general hygiene and drainage bag care, which are fundamental skills in urinary catheter self‐management to prevent common problems resulting in unnecessary hospital presentations. The expanded catheter self‐management scale was developed with 10 additional items to comprehensively assess all five essential aspects of urinary catheter self‐management. Methods: A total of 101 adult community‐dwelling patients living with indwelling urinary catheters were recruited from Western Sydney, Australia. Using exploratory factor analysis with Varimax rotation, the number of factors to be extracted from the expanded 23‐item expanded catheter self‐management scale was determined using a scree plot. The reliability of the overall scale and subscales was measured using Cronbach's alpha. Convergent validity was assessed using Spearman's correlations between clinical characteristics, overall scale and subscales. Results: The 23‐item expanded catheter self‐management scale yielded a 5‐factor solution, labelled as: (i) self‐monitoring of catheter function, (ii) proactive, help‐seeking behaviour function, (iii) bowel self‐care function, (iv) hygiene‐related catheter site function and (v) drainage bag care function. Cronbach's alpha of the expanded catheter self‐management scale indicating all 23 items contributed to the overall alpha value. Convergent validity results showed a negative correlation between the overall expanded catheter self‐management scale and catheter‐related problems. Conclusion: The 5‐factor structure provided a comprehensive assessment of key aspects of urinary catheter self‐management essential to reduce the likelihood of catheter‐related hospital presentations. Implications: The expanded catheter self‐management scale can be used to assess and monitor effective patient‐centred interventions for optimal self‐management to prevent catheter‐related problems and improve the quality of life of patients. Impact: Many patients start their journey of living with a urinary catheter unexpectedly and are not supported with quality information to care for their catheter.The findings of this study show the correlation between catheter self‐management skills and catheter‐related problems.The expanded catheter self‐management scale (E‐CSM) assists with analysing the self‐management skills of patients living with a catheter and developing tailored interventions to prevent problems and improve their quality of life. In addition, this screening tool can be included in policies, guidelines, and care plans as a standard for improving catheter management and developing educational resources for patients. Reporting Method: STROBE checklist was used to report all aspects of this study comprehensively and accurately. Patient or Public Contribution: Patients living with indwelling urinary catheter and their carers have participated in surveys, interviews and co‐designing interventions. This paper reports the psychometric analysis of the expanded catheter self‐management scale (E‐CSM) used in the patient survey as part of the main study 'Improving Quality of Life of Patients Living with Indwelling Urinary Catheters: IQ‐IDC Study' (Alex et al. in Collegian, 29:405–413, 2021). We greatly value our consumers' contributions and continue to communicate the progress of the study to them. Their contributions will be acknowledged in all publications and presentations. In addition, all participants will be provided the option of receiving the interventions and publications generated from this study. [ABSTRACT FROM AUTHOR]

This paper investigated a 60-item version of the Multidimensional Inventory of Dissociation (MID) with the potential to capture the full range of dissociative symptoms that characterize each of the dissociative disorders (DD). The 28-item Dissociative Experiences Scale (DES) was designed to capture a wide range of dissociative phenomena, but college population studies indicate it may not be adept at identifying the full range of dissociative symptoms and disorders. The 218-item MID has the advantage of capturing the full range of dissociative symptoms and has diagnostic capabilities for all DSM-5 DD, but the disadvantage of taking considerably longer than the DES to complete. Using university students and staff (N = 313), this paper investigated a 60-item version of the MID with the potential to capture the full range of dissociative symptoms that characterize each of the DD. Results indicate the MID-60 has a nearly identical factor structure to the full MID, excellent internal reliability, and content and convergent validity. Using the MID-60, at least 8% of participants at an Australian university were positive for a DD and, on average, participants self-reported having dissociative experiences 13% of the time. The present study's findings suggest the MID-60 is a promising alternative to the DES, with results about the prevalence of DDs and dissociative experiences consistent with those found using clinical interviews and the DES. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to evaluate the validity and reliability of the modified Chronic Kidney Disease Self‐Management instrument in an English‐speaking population. Background: There is growing evidence that self‐management behaviours can improve outcomes for people with chronic kidney disease. However, there are few suitable instruments available. Design The study was cross sectional, with a test–retest protocol. Method: Adults with chronic kidney disease attending a primary health care between June and December 2015 completed the Chronic Kidney Disease Self‐Management instrument. Construct validity was determined using exploratory factor analysis, internal consistency and test–retest reliability using Cronbach's α and intraclass correlation. For convergent validity, the relationships between knowledge, self‐efficacy and self‐management were investigated. Results: The Australian version of the Chronic Kidney Disease Self‐Management instrument has 17 items grouped into four factors: self‐integration, seeking social support, adherence to lifestyle modification and problem solving. The instrument demonstrated good reliability. Self‐efficacy was positively correlated with self‐management scores, although there was no correlation between chronic kidney disease knowledge and self‐management. Conclusions: The Australian version of the Chronic Kidney Disease Self‐Management instrument was found to be a valid and reliable patient‐reported outcome measure. It can be used in clinical practice to support self‐management, as well as future research. SUMMARY STATEMENT: What is already known about this topic? The burden of chronic kidney disease is rising mostly due to the increasing prevalence of diabetes and hypertension.Chronic kidney disease progression can be slowed with effective self‐management behaviours.Patient‐reported outcome measures need testing in target populations prior to implementation in clinical settings and research. What this paper adds? The Australian version of the Chronic Kidney Disease Self‐Management instrument demonstrated good validity and reliability in the target population.The instrument is suitable to use in research testing interventions to improve self‐management of chronic kidney disease. The implications of this paper: Clinicians can use this patient‐reported outcome measure to assess for changes in CKD self‐management behaviours following patient education.The instrument can be used to identify individuals in need of support for self‐management skills. [ABSTRACT FROM AUTHOR]

The term Non-Medical Surgical Assistant (NMSA) encompasses all roles where healthcare clinicians without a medical degree provide clinical services during the perioperative cycle. The role of NMSA is gaining momentum within Australia. It is timely to ascertain who is preforming the role and quantify the practice setting and scope of practice to enable a nationally recognised platform for role evolution. For two months in 2015 a NMSA Practice Audit was available online. Sampling was initially of a convenience modality. A total of 83 clinicians responded. The majority of NMSAs were experienced RNs [>11yrs]; held post-graduate qualifications [80%], practiced predominantly in metropolitan areas [65%] and had been performing the role for 8 years or less. The specialty with the highest uptake of the NMSAs is orthopaedic surgery. This paper provides an overview of NMSAs practicing in Australia and provides cost effective evidence of the need for this service in Australian healthcare. [ABSTRACT FROM AUTHOR]

Loneliness research has tended to focus on mainstream and older populations despite evidence that non‐mainstream groups, like those experiencing homelessness, may experience loneliness differently. Limited existing research indicates that (a) people who have been homeless experience loneliness as multidimensional (as a pluralistic, non‐unidimensional emotion, experienced specific to lacked relationships) and (b) mainstream loneliness scales may be inappropriate for this group. The current study piloted and appraised the feasibility the short version of the Social and Emotional Loneliness Scale for Adults (SELSA‐S) among 129 Australian adults with a lived experience of homelessness. Exploratory Factor Analysis and an observational questionnaire appraisal were used to assess factorial and content validity and showed the measure did not fit this sample as well as in mainstream samples. Removal of items that participants found difficult to comprehend/answer improved the factorial fit of the scale. In conclusion, the SELSA‐S may be inappropriate for measuring loneliness among people who have experienced homelessness. Further research needs to explore the potentially different structure of loneliness among marginalised groups so that a better understanding of loneliness can be reached. [ABSTRACT FROM AUTHOR]

Purpose: Emotional distress, which includes stress, anxiety and depression, is considered a substantial mental health problem among university students because of its effects on academic achievement and well-being. The purpose of this paper is to examine levels of emotional distress, self-esteem, social support and coping methods and predicted emotional distress in undergraduate students across year levels in two semesters. Design/methodology/approach: A cross-sectional study was conducted in a regional university with 117 and 118 students, respectively, the majority of whom were from the Faculty of Science. Announcements posted on the university website in two semesters were used to recruit convenience samples of participants who completed a battery of four self-administered questionnaires online. Findings: Findings showed significant differences across year levels for emotional distress total (F(2, 107)=3.90, p=0.02), and social support total (F(2, 107)=3.57, p=0.03), especially in semester 1. Almost all maladaptive coping approaches led to risk of heightened emotional distress in both semester cohorts, ranging from using self-distraction (adjusted OR=4.54) to denial (adjusted OR=32.05). Interestingly, the use of active coping and high self-esteem appeared as risk factors rather than protective factors for mental distress, adjusted ORs=11.27 and 8.46, respectively. Originality/value: Although adaptive coping skills did not alleviate students' mental distress, encouraging students to use adaptive coping and social support may help students face the challenges of university life. [ABSTRACT FROM AUTHOR]

There are few short, validated tools to assess young children's obesity‐related dietary behaviours, limiting the rapid screening of dietary behaviours in research and practice‐based early obesity prevention. This study aimed to develop and assess the reliability and validity of a caregiver‐reported short dietary questionnaire to rapidly assess obesity‐related dietary behaviours in children aged 6 months to 5 years. The Early Prevention of Obesity in Childhood Dietary Questionnaire (EPOCH‐DQ) was developed using a rigorous process to determine content and structural validity. Three age‐appropriate versions were developed for (1) infants, aged 6–12 months, (2) toddlers, aged 1–2.9 years and (3) pre‐schoolers, aged 3–5 years. The questionnaire (7–15 items) measures dietary behaviours, including diet risk from non‐core food and beverage intake, diet quality from vegetable frequency, bread type and infant feeding practices. Test–retest reliability was assessed from repeated administrations 1 week apart (n = 126). Internal consistency, concurrent validity (against a comparison questionnaire, the InFANT Food Frequency Questionnaire), construct validity and interpretability were assessed (n = 209). Most scores were highly correlated and significantly associated (p < 0.05) for validity (rs: 0.45–0.89, percentage agreement 68%–100%) and reliability (intraclass correlation coefficient: 0.61–0.99) for diet risk, diet quality and feeding practice items. The EPOCH‐DQ shows acceptable validity and reliability for screening of obesity‐related behaviours of children under 5 years of age. The short length and, thus, low participant burden of the EPOCH‐DQ allows for potential applications in various settings. Future testing of the EPOCH‐DQ should evaluate culturally and socio‐economically diverse populations and establish the predictive validity and sensitivity to detect change. Key messages: Accurate measurement of obesity‐related dietary behaviours is essential for the evaluation of early obesity prevention programmes and monitoring population trends.The 7–15 item Early Prevention of Obesity in Childhood Dietary Questionnaire (EPOCH‐DQ) was shown to have acceptable validity and reliability for assessing obesity‐related behaviours of children aged 6 months to 5 years of age.The short length and thus low participant burden of the EPOCH‐DQ allows for potential applications in various settings, including research, population health monitoring and use by health professionals.Future testing of the EPOCH‐DQ should include evaluation across culturally and socio‐economically diverse populations and determine the predictive validity and sensitivity to detect change of the EPOCH‐DQ. [ABSTRACT FROM AUTHOR]

Background Short food questions are appealing to measure dietary intakes. Methods A review of studies published between 2004 and 2016 was undertaken and these were included in the present study if they reported on a question or short item questionnaire (≤50 items, data presented as ≤30 food groups) measuring food intake or food-related habits, in children (aged 6 months to 18 years), and reported question validity or reliability. Thirty studies met the inclusion criteria. Results Most questions assessed foods or food groups ( n = 29), with the most commonly assessed being fruit ( n = 22) or vegetable intake ( n = 23), dairy foods and discretionary foods ( n = 20 studies each). Four studies assessed food habits, with the most common being breakfast and meal frequency ( n = 4 studies). Twenty studies assessed reliability, and 25 studies determined accuracy and were most commonly compared against food records. Evaluation of question performance relied on statistical tests such as correlation. Conclusions The present study has identified valid and reliable questions for the range of key food groups of interest to public health nutrition. Questions were more likely to be reliable than accurate, and relatively few questions were both reliable and accurate. Gaps in repeatable and valid short food questions have been identified that will provide direction for future tool development. [ABSTRACT FROM AUTHOR]

Background: Quality of life is an important quality indicator for health and aged care sectors. However, self-reporting of quality of life is not always possible given the relatively high prevalence of cognitive impairment amongst older people, hence proxy reporting is often utilised as the default option. Internationally, there is little evidence on the impact of proxy perspective on interrater agreement between self and proxy report. Objectives: To assess the impacts of (i) cognition level and (ii) proxy perspective on interrater agreement using a utility instrument, the Quality of Life-Aged Care Consumers (QOL-ACC). Methods: A cross-sectional study was undertaken with aged care residents and family member proxies. Residents completed the self-report QOL-ACC, while proxies completed two proxy versions: proxy-proxy perspective (their own opinion), and proxy-person perspective (how they believe the resident would respond). Interrater agreement was assessed using quadratic weighted kappas for dimension-level data and concordance correlation coefficients and Bland-Altman plots for utility scores. Results: Sixty-three residents (22, no cognitive impairment; 41, mild-to-moderate cognitive impairment) and proxies participated. In the full sample and in the mild-to-moderate impairment group, the mean self-reported QOL-ACC utility score was significantly higher than the means reported by proxies, regardless of perspective (p < 0.01). Agreement with self-reported QOL-ACC utility scores was higher when proxies adopted a proxy-person perspective. Conclusion: Regardless of cognition level and proxy perspective, proxies tend to rate quality of life lower than residents. Further research is needed to explore the impact of such divergences for quality assessment and economic evaluation in aged care. [ABSTRACT FROM AUTHOR]

Objectives: Chinese medicine is a complex domain of theoretical and practical approaches that is being increasingly put under the research spotlight. The "Chinese Medicine in Australia"research project attempted to capture the clinical features of practitioners of Chinese medicine. Participants and Interventions: The project involved a national survey of Chinese medicine professional association members and registered practitioners in the state of Victoria, Australia (n = 655; response rate, 42%-55%) completed in 2012-2013. Design: The content and face validated survey was developed using new and previous workforce survey questions. Results: This paper reports on the workforce and practice characteristics of the survey respondents. Chinese medicine practitioners are highly educated, come from diverse backgrounds, and have chosen to practice predominantly in sole or multipractitioner private practice settings. An interest in the philosophy of Chinese medicine and previous experiences contributed to practitioners' decisions to study and practice Chinese medicine. Incorporating a variety of techniques, practitioners describe themselves as practicing predominantly Chinese acupuncture and herbal medicine. Conclusions: The results from this survey contribute to the understanding of the nature and description of Chinese medicine practice in Australia. [ABSTRACT FROM AUTHOR]

Eliciting clinicians' views about antipsychotic medication side-effects may assist in understanding strategies that could enhance the identification and management of these side-effects. The present paper details the development and psychometric evaluation of a questionnaire that captures clinicians' perceptions about these issues. An initial item set was derived from a literature review, and then refined by an expert content validity panel that assessed the relevance of the items. The online questionnaire was distributed to Australian mental health nurses and 140 fully completed questionnaires were returned. Principal components analysis yielded two robust scales that conceptually tapped 'system responsibility' and 'personal confidence'. These scales may be used to advance knowledge about how mental health nurses' attitudes towards the assessment and management of antipsychotic medication side-effects influences their clinical behaviour. [ABSTRACT FROM AUTHOR]

The relationship between general practice (GP) registrars and their supervisors underpins the training experience for the next generation of medical practitioners. Building on recent research into the development and validation of a measure of the relationship between registrars and supervisors from the perspective of the supervisor, the current study focuses on the educational alliance from the perspective of the registrar. This paper presents an adaptation and initial validation of the clinical psychology supervisory relationship measure for GP registrars in an Australian context. Following an Expert Group review and adaptation of the items, 238 GP registrars completed the adapted tool. Using exploratory factor analysis and Procrustes confirmatory rotation, an optimal four factor model of the supervisory relationship was identified, reflecting measures of Safe base (α =.93), Supervisor investment (α =.96), Registrar professionalism (α =.90), and Emotional intelligence (α =.87). The general practice supervisory relationship measure for registrars (GP-SRMR) demonstrated excellent model fit, high internal consistency, and was theoretically consistent with the original tool. Implications for clinical education and future research are presented. [ABSTRACT FROM AUTHOR]

Aims This study aimed to compare the findings of the quality of nursing doctoral education survey across seven countries and discuss the strategic directions for improving quality. Background No comparative evaluation of global quality of nursing doctoral education has been reported to date despite the rapid increase in the number of nursing doctoral programmes. Design A descriptive, cross-country, comparative design was employed. Methods Data were collected from 2007-2010 from nursing schools in seven countries: Australia, Japan, Korea, South Africa, Thailand, UK and USA. An online questionnaire was used to evaluate quality of nursing doctoral education except for Japan, where a paper version was used. Korea and South Africa used e-mails quality of nursing doctoral education was evaluated using four domains: Programme, Faculty (referring to academic staff), Resource and Evaluation. Descriptive statistics, correlational and ordinal logistic regression were employed. Results A total of 105 deans/schools, 414 faculty and 1149 students/graduates participated. The perceptions of faculty and students/graduates about the quality of nursing doctoral education across the seven countries were mostly favourable on all four domains. The faculty domain score had the largest estimated coefficient for relative importance. As the overall quality level of doctoral education rose from fair to good, the resource domain showed an increased effect. Conclusions Both faculty and students/graduates groups rated the overall quality of nursing doctoral education favourably. The faculty domain had the greatest importance for quality, followed by the programme domain. However, the importance of the resource domain gained significance as the overall quality of nursing doctoral education increased, indicating the needs for more attention to resources if the quality of nursing doctoral education is to improve. [ABSTRACT FROM AUTHOR]

Aim: To develop a parsimonious, shortened version of the Perceived Perioperative Competence Scale‐Revised for perioperative nurses to complete as part of their specialty training while retaining good psychometric properties. Design: A longitudinal online survey was adopted. Methods: A national sample of perioperative nurses from Australia completed an online survey at two different time points 6 months apart between February and October 2021. Confirmatory factor analysis was conducted for item reduction and construct validity, while criterion, convergent validity and internal consistency were examined. Results: Usable data for psychometric assessment were obtained from 485 operating room nurses at time 1 and 164 nurses at time 2. The original 40‐item revised scale was reduced to an 18‐item measure, maintaining its six domains. Cronbach's alpha for the 18‐item scale was.92 at time 1 and.90 at time 2. Scale validation demonstrated moderate to weak positive relationships in perceived competence scores relative to general self‐efficacy, years of operating room experience, postgraduate education and recency of training. Conclusions: Results suggest the 18‐item Perceived Perioperative Competence Scale‐Revised Short Form has initial robust psychometric properties and may be implemented in clinical settings as part of perioperative transition‐to‐practice, orientation programs and yearly professional development reviews. Implications for the Profession: This short‐form scale can help prepare perioperative nurses to demonstrate clinical competence in a climate of increasing professional demands using a valid measure of competence required in clinical practice. Impact: Short and validated scales of perioperative competence are needed in clinical practice. Assessment of practising operating room nurses' perceived competence is essential in quality care provision, workforce planning and human resource management. This study provides an 18‐item measure of the previously validated 40‐item Perceived Perioperative Competence Scale‐Revised. This scale can help provide an option for future testing of perioperative nurses' competence in clinical or research settings. Patient or Public Contribution: Perioperative nurses were involved in the design of the study, particularly in the assessment of validation of the tools used in the study. [ABSTRACT FROM AUTHOR]

Measures of self-forgiveness that merely focus on the outcome of positive self-regard risk neglecting the process through which offenders restore it. They may thus tap pseudo self-forgiveness where offenders downplay their responsibility for the wrongdoing. For genuine self-forgiveness, the process should instead involve an attenuation of the negative link between responsibility acceptance and positive self-regard. In this paper, we examine how acts of value reaffirmation facilitate genuine self-forgiveness. In Study 1, a role-play experiment (N = 90), participants either confessed their wrongdoing to the victim or not. Although responsibility acceptance was strongly negatively related to reported self-forgiveness (i.e., self-regard), this relationship was tempered when participants confessed their wrongdoing to the victim and, through this, reaffirmed the violated values. In Study 2, a longitudinal study referring to self-reported transgressions (N = 74), responsibility acceptance was negatively related to self-forgiveness measures as well as self-esteem when offenders showed little value reaffirmation, but not when they more strongly reaffirmed the violated values. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

scott k., white k., johnson c. & roydhouse j.k. (2011) Knowledge and skills of cancer clinical trials nurses in Australia. Journal of Advanced Nursing 68(5), 1111-1121. Abstract Aims. This paper is a report of the development and testing of a questionnaire measuring knowledge and skills of cancer clinical trials nurse in Australia. Background. The role of cancer clinical trials nurse, widely acknowledged as an integral member of the clinical research team, has evolved in recent years. Elements of the clinical trials nurse role in cancer have previously been described. To evaluate specific cancer clinical trials nurse educational and training needs, the development of a valid and reliable tool is required. Methods. In 2009, a study was conducted in three stages. Stage I: questionnaire development and pilot testing; stage II: focus group; stage III: national survey. Internal consistency reliability testing and multi-trait analysis of item convergent/divergent validity were employed. Regression analysis was used to identify predictors of clinical trials nurse knowledge and skills. Results. The national survey was a 48-item questionnaire, measuring six clinical trial knowledge and seven skills sub-scales. Of 61 respondents, 90% were women, with mean age 43 years, 19 years as a Registered Nurse and 5 years as a cancer clinical trials nurse. Self-reported knowledge and skills were satisfactory to good. Internal consistency reliability was high (Cronbach's alpha: knowledge = 0·98; skills = 0·90). Criteria for item convergent/divergent validity were met. Number of years as cancer clinical trials nurse was positively related to self-reported knowledge and skills. Conclusion. Preliminary data suggest that the national survey is reliable and valid. Data have contributed to better understanding the knowledge and skills of cancer clinical trials nurse in Australia and development of a postgraduate course in clinical trials. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the parent‐proxy version of the pediatric Charcot Marie Tooth specific quality of life (pCMT‐QOL) outcome instrument for children aged 7 or younger with CMT. We have previously developed and validated the direct‐report pCMT‐QOL for children aged 8–18 years and a parent proxy version of the instrument for children 8–18 years old. There is currently no CMT‐QOL outcome measure for children aged 0–7 years old. Methods: Testing was conducted in parents or caregivers of children aged 0–7 years old with CMT evaluated at participating INC sites from the USA, United Kingdom, and Australia. The development of the instrument was iterative, involving identification of relevant domains, item pool generation, prospective pilot testing and clinical assessments, structured focus group interviews, and psychometric testing. The parent‐proxy instrument was validated rigorously by examining previously identified domains and undergoing psychometric tests for children aged 0–7. Results: The parent‐proxy pCMT‐QOL working versions were administered to 128 parents/caregivers of children aged 0–7 years old between 2010 and 2016. The resulting data underwent rigorous psychometric analysis, including factor analysis, internal consistency, and convergent validity, and longitudinal analysis to develop the final parent‐proxy version of the pCMT‐QOL outcome measure for children aged 0–7 years old. Conclusions: The parent‐proxy version of the pCMT‐QOL outcome measure, known as the pCMT‐QOL (0–7 years parent‐proxy) is a valid and sensitive proxy measure of health‐related QOL for children aged 0–7 years with CMT. [ABSTRACT FROM AUTHOR]

Objectives: Evaluate diagnostic accuracy and feasibility of a mail-out home oximetry kit. Design: Patients were referred for both the tertiary/quaternary-centre hospital-delivered oximetry (HDO) and for the mail-out remotely-delivered oximetry (RDO). Quantitative and qualitative data were collected. The COVID-19 pandemic began during this study; therefore, necessary methodological adjustments were implemented. Setting: Patients were first evaluated in Swan Hill, Victoria. RDO kits were sent to home addresses. For the HDO, patients travelled to the Melbourne city area, received the kit, stayed overnight, and returned the kit the following morning. Participants: All consecutive paediatric patients (aged 2–18), diagnosed by a specialist in Swan Hill with obstructive sleep apnoea (OSA) on history/examination, and booked for tonsillectomy +/− adenoidectomy, were recruited. Main outcome measures: Diagnostic accuracy (i.e., comparison of RDO to HDO results) and test delivery time (i.e., days from consent signature to oximetry delivery) were recorded. Patient travel distances for HDO collection were calculated using home/delivery address postcodes and Google® Maps data. Qualitative data were collected with two digital follow-up surveys. Results: All 32 patients that had both the HDO and RDO had identical oximetry results. The HDO mean delivery time was 87.7 days, while the RDO mean delivery time was 23.6 days (p value: <0.001). Qualitatively, 3/28 preferred the HDO, while 25/28 preferred the RDO (n = 28). Conclusions: The remote option is as accurate as the hospital option, strongly preferred by patients, more rapidly completed, and also an ideal investigation delivery method during certain emergencies, such as the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: The Questionnaire on Palliative Care for Advanced Dementia (qPAD) is increasingly being used to assess residential aged care workers' knowledge and attitudes about palliative care for people with dementia. The qPAD developers performed an exploratory factor analysis and assessed the internal consistency using a small sample. Aim: The aim of this study was to further assess the structural validity of the qPAD using a large sample of qPAD responses from staff who work in residential aged care homes in Australia. Methods: Data from 727 care staff who participated in an Australian dementia palliative care training project were used for exploratory factor analyses, assessment of internal consistency, and confirmatory factor analysis of the knowledge test and attitude scale components of the qPAD. Results: The exploratory factor analysis of the knowledge test produced a four‐factor solution. One item loaded weakly, and four items had cross‐loadings. Factor labels for the knowledge test were difficult to define. Factor analysis of the attitude scale produced a three‐factor structure with good internal consistency—Feeling valued and part of the care team (α = 0.88), Family and team engagement (α = 0.75) and Perceptions and beliefs (α = 0.83). Confirmatory factor analysis indicated improvements in model fit were needed for both the knowledge test and attitude scale. Conclusion: The findings of this factor analysis differed from the original study. The attitude scale produced a three‐factor structure, but the knowledge test requires further development due to weak and cross‐loadings of several items, inadequate internal consistency of factors and poor model fit. [ABSTRACT FROM AUTHOR]

Introduction: When handover is conducted at the patient's bedside, active patient participation can be encouraged, which may improve the safety and quality of care. There is a need for valid and reliable tools to measure patient perceptions of participation in bedside handover, to ensure the rising number of implementation and improvement efforts are consistently and effectively evaluated. The aim of this study is to systematically develop and evaluate the psychometric properties of a self‐report survey to measure patients' perceptions of participation in bedside handover. Methods: In Phase 1, our team developed a conceptual framework and item pool (n = 130). In Phase 2, content validity was assessed with four health consumers, four nurses and four researchers. Next, 10 current hospital inpatients tested the survey for end‐user satisfaction. In Phase 3, 326 inpatients completed the survey, allowing exploratory factor analysis, reliability analyses and convergent/divergent validity analyses to occur. Results: Phase 1 and 2 resulted in a 42‐item survey. In Phase 3, 321 surveys were available for analysis. Exploratory factor analysis revealed a three‐factor solution, with 24 items, which matched our conceptual framework. The three factors were: 'Conditions for patient participation in bedside handover', 'Level of patient participation in bedside handover' and 'Evaluation of patient participation in bedside handover'. There was strong evidence for factor reliability and validity. Additionally, the correlation between factors was strong. Conclusion: This study furthers our conceptual understanding by showing that nurse facilitating behaviours are a strong precursor for patient participation and perceived handover outcomes, justifying the need for nursing training. A robust survey has been developed to measure patient perceptions of participation in bedside handover, which can effectively evaluate this approach to care. Engaging consumers and nurses as research team members was invaluable in ensuring that the survey is acceptable for end‐users. Patient or Public Contribution: A health consumer and nurse partnered as members of the research team from study inception to dissemination. [ABSTRACT FROM AUTHOR]

In search of Kipling's six honest serving men in upper limb rehabilitation after stroke, we sought to investigate clinicians' perspective of when and where to begin therapy, how much and what therapy to provide, and who and why (or not) to provide therapy. Materials & methods: Within-participant case cross-over experiments were nested within an anonymous web-based questionnaire (21 questions, three cases). Graph theory-based voting to produce ranked ordered lists and mixed-effect logistic regression were performed. In total, 225 Australian stroke clinicians responded: 53% occupational therapists, 61% working in acute/inpatient stroke setting. Most respondents indicated they did not have a protocol/expectation regarding when (62%), how much (84%) or what (60%) therapy to provide in their setting. Respondents ranked 24-h to 7-days post-stroke as the optimal time to commence therapy, and 30- to 60-min per day as the optimal dose to provide. Within-participant experiments demonstrated that greater motor recovery as time progressed increased the odds of offering therapy, while lack of motor recovery, shoulder pain, neurological decline and sole therapist reduced the odds. We need to develop an evidence base concerning Kipling's six honest serving men and equip clinicians with clinical decision-making skills aligned with this focus. Most clinicians did not have access to a protocol / clinical pathway which defines when, how much and what upper limb therapy to provide after stroke, which may be improved by providing individual clinicians with organisational support to make therapy decisions. To improve the personalisation of upper limb rehabilitation in clinical practice, we need to understand when and where after stroke to begin therapy, how much and what therapy to provide, as well as who and why (clinical decision-making) to provide therapy. Clinicians perceive clinical trials as successful if the therapy can demonstrate recovery that is greater than a minimal clinical important difference (MCID). [ABSTRACT FROM AUTHOR]

Aim: Evidence‐based guideline translation to practice can improve outcomes but is often impaired by poor implementation. This project aimed to evaluate the implementation of the Evidence‐based guidelines for the nutritional management of adult patients with head and neck cancer among Australian dietitians providing clinical care to this population. Methods: A questionnaire was developed, with face and content validity confirmed by an expert panel (n = 13), to gauge participant perceptions of the guidelines against an implementation evaluation framework. Dietitians were identified through Dietitians Australia and by contacting experts in the field. Eligibility was determined by questionnaire completion and prior guideline awareness. Responses were provided using a 5‐point Likert scale. Results were analysed using descriptive statistics; with inferential analysis to determine if demographic information could reveal trends in guideline use and perception. Results: Of the 43 initial respondents, n = 28 completed the questionnaire, with n = 24/28 (86%) meeting full eligibility criteria for analysis. Median (range) scores for all four domains were high: awareness (4.0 [3.2‐4.8]), agreement (4.4 [4.1‐4.7]), adoption (3.5 [3.1‐3.9]), and adherence (4.3 [4.1‐4.9]). However, perception of guideline awareness and use among multidisciplinary team colleagues was low (mean 3.2/5.0 and 3.1/5.0, respectively). Dietitians with <10 years' experience had significantly higher perceptions of the guidelines' ability to positively influence practice; support evidence‐based practice; and enhance dietitian credibility (P = 0.04) vs dietitians with ≥10 years' experience. Conclusion: Dietitians demonstrated high rates of guideline implementation and positive perceptions for its use in clinical practice. Future implementation strategies and evaluation should expand to engage the wider multidisciplinary team and more experienced clinicians. [ABSTRACT FROM AUTHOR]

The Autism Spectrum Quotient (AQ) has been widely used for measuring autistic traits however its factor structure has been primarily determined from nonclinic populations. This study aimed to establish an internally coherent and reliable factor structure for the AQ using a sample of 455 Australian adults of whom 141 had autism spectrum disorder (ASD) diagnoses. Principal component analysis revealed a 39-item questionnaire with five-factors: Sociability, Social Cognition, Interest in Patterns, Narrow Focus and Resistance to Change. The revised AQ-39 had sound goodness-of-fit indices, good-to-excellent internal consistency and test–retest reliability, and scores for ASD and non-ASD participants were significantly different. The AQ-39 may be useful in screening and for guiding the focus of therapy. [ABSTRACT FROM AUTHOR]

Reablement is described as a goal directed intervention with a view to maintain or improve the independence of clients through "doing with, rather than doing for". As a relatively new concept in care, lack of specific skills in reablement is not uncommon, however, intrinsic values aligned with reablement are beneficial to organisations providing care and support to clients. The aim of this study is to develop a pre‐employment questionnaire to assess readiness for a reablement approach to care as a step towards developing a reablement culture across organisations. A questionnaire based on activities of daily living (ADL), developed by the research team in consultation with a local community‐based care organisation, was completed by 166 staff members at a community‐based care organisation in Tasmania across several timepoints during and following reablement education sessions in 2018. The scores from these questionnaires were utilised to develop a questionnaire appropriate for determining readiness for reablement prior to employment within the organisation. Over a period of twelve months, a total of 407 Reablement Readiness Questionnaires were submitted by staff, indicating high levels of willingness to engage in reablement prior to and following the education sessions. Exploratory factor analyses were performed, and the construct validity and internal consistency of the emerging factors were assessed. An exploratory factor analysis indicated that ADL, in relation to reablement, consist of three dimensions—Lifestyle, My body and Connecting. The corresponding questions were subsequently built into an online questionnaire for pre‐employment use. This questionnaire also has potential benefit in recruitment of staff to other community service organisations, to ascertain their readiness for reablement prior to beginning a variety of different roles within client care and support. [ABSTRACT FROM AUTHOR]

Teaching is a key role for nurses in contemporary clinical practice. Consequently, peer-assisted learning continues to gather momentum in nursing education in tertiary and professional education settings. In this study, we investigated the factor structure of the Peer Teaching Experience Questionnaire when completed by a group of nursing undergraduates from a large Australian university. Data from the 14-item Peer Teaching Experience Questionnaire completed by third year undergraduate nursing students were analyzed using factor analysis. A total of 257 final (third)-year undergraduate nursing students participated in the study. Factor analysis of the 14 items revealed three factors with eigenvalues above 1, accounting for 47.3% of the total variance. Items with loadings greater than ± 0.40, with the factor in question, were used to characterize the factor solutions. Findings from the exploratory factor analysis provide preliminary results that the Peer Teaching Experience Questionnaire has adequate dimensionality and reliability. [ABSTRACT FROM AUTHOR]

HALKETT G.K.B., COX J., ANDERSON C. & HEARD R. (2012) European Journal of Cancer Care 21, 31-40. Establishing research priorities for Australian radiation therapists: what patient care priorities need to be addressed? Much of the research conducted in radiotherapy focuses on technology advances; however, research may also be warranted in the area of patient care. The aims of this paper are to (1) identify patient care-related research priorities in radiation therapy and (2) describe similarities and differences in radiation therapists' responses to research priorities related to patient care by subgroups revealed through cluster analysis. A Delphi process was used, examining problems in research that radiation therapists face. Three hundred and seventy-four problems were identified. These were translated into 53 research areas which were then prioritised. Participant subgroups were identified using a hierarchical cluster procedure. Agreement and disagreement between subgroups for the subscale of 'Patient Care' were analysed with ANOVA and post hoc Scheffe multiple comparisons. The three subgroups had varying degrees of research interest in patient care. The groups agreed on the importance of research in relation to patient care in reducing and managing side effects, patient education and support, and treatment techniques. However, there was disagreement about the importance of conducting research into the role of radiation therapists, radiation therapists communicating and educating patients, and psychosocial support. Further research is warranted to determine radiotherapy patients' priorities and improve evidence-based practice. [ABSTRACT FROM AUTHOR]

The organisational, physical and social environment within residential aged care settings greatly influence its residents' sense of autonomy, choice and control and their ability to engage in meaningful occupations. Identifying to what extent these environmental contexts are supportive and well‐coordinated could assist with promoting meaningful engagement of residents. The Residential Environment Impact Scale (REIS) was developed to measure the impact of the physical and social environment on residents. This study examined the benefits and barriers to implementing the REIS in four Australian Residential Aged Care Facilities (RACFs) and factors to consider during implementation. Method: A multisite sequential mixed‐methods study was conducted. Research participants included occupational therapists conducting the REIS and leadership staff examining the REIS reports in four facilities. Data consisted of formal observations of the REIS assessment process, an online survey of all participants and two research consensus groups. Qualitative findings were generated from field notes, open‐ended survey questions and group discussions. Close‐ended survey questions provided quantitative data. Findings The REIS was considered a useful audit tool, generating a holistic overview of the RACF. It highlighted the quality of person‐centred care and the potential role of occupational therapists to promote opportunities for meaningful occupational engagement. Barriers included administration time, personal characteristics of residents and limited resources to action recommendations. Conclusion: The REIS has potential to be an audit tool for a whole‐environment approach to facility assessment of residents' sense of autonomy, occupational choice and meaningful engagement. As such, it provides occupational therapists with scope to support RACFs meeting national quality standards. [ABSTRACT FROM AUTHOR]

Objective: The longer-term impact of injury is increasingly recognized, but the early phases of recovery are less well understood. The best tools to measure early recovery of mobility and physical function following traumatic injury are unclear. The purpose of this study was to assess the clinical utility, validity, reliability, and responsiveness of 4 mobility and physical function measures in patients following traumatic injury. Methods: In this cohort, measurement-focused study (n = 100), the modified Iowa Level of Assistance Score, Acute Care Index of Function, Activity Measure for Post-Acute Care "6 Clicks" short forms, and Functional Independence Measure were completed during first and last physical therapy sessions. Clinical utility and floor and ceiling effects were documented. Known-groups validity (early vs late in admission and by discharge destination), predictive validity (using 6-month postinjury outcomes data), and responsiveness were established. Interrater reliability was assessed in 30 patients with stable mobility and function. Results: Participants had a median age of 52 years (interquartile range = 33–68 years), and 68% were male. The modified Iowa Level of Assistance Score, Acute Care Index of Function, and "6 Clicks" short forms were quick to administer (an extra median time of 30 seconds–1 minute), but the Functional Independence Measure took much longer (extra median time of 5 minutes). At the last physical therapy session, ceiling effects were present for all measures except the Functional Independence Measure (18%–33% of participants). All had strong known-groups validity (early vs late in admission and by discharge destination). All were responsive (effect sizes >1.0) and had excellent interrater reliability (intraclass correlation coefficients = 0.79–0.94). Conclusion: All 4 measures were reliable, valid, and responsive; however, their clinical utility varied, and ceiling effects were common at physical therapy discharge. Impact: This study is an important step toward evidence-based measurement in acute trauma physical therapy care. It provides critical information to guide assessment of mobility and physical function in acute trauma physical therapy, which may facilitate benchmarking across different hospitals and trauma centers and further progress the science and practice of physical therapy following traumatic injury. [ABSTRACT FROM AUTHOR]

Aims: To evaluate the nutrition knowledge of elite Australian athletes, and to obtain feedback from sports dietitians on the Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaires' (PEAKS‐NQ) suitability. Methods: Sports dietitians from the National Institute Network across Australia recruited athletes to complete the online, 50‐item PEAKS‐NQ which contained two sections (General Nutrition and Sports Nutrition). Sports dietitians provided feedback on the PEAKS‐NQ using a 14‐item questionnaire (with two open‐ended items). The main outcome measures were nutrition knowledge score and tool suitability (usefulness, acceptability and feasibility) scores. For knowledge scores, independent t‐tests, ANOVA and Chi‐square tests were used to evaluate differences between groups. Suitability was evaluated using descriptive statistics. Results: Twelve sports dietitians from the National Institute Network in Australia recruited a convenience sample of 240 athletes (21.3 ± 4.3 years, 63.5% female, 63.3% competed internationally). Athletes scored 70.7 ± 10.5%, with better general vs sports nutrition knowledge. Females had higher overall scores (P <.001) with no differences for age or sport played. University‐educated athletes scored higher than non‐tertiary educated athletes (P =.004). Knowledge gaps were identified in fats (role and food sources), recovery nutrition and managing body composition. Sports dietitians rated suitability of PEAKS‐NQ positively with complete agreement on 8 of 12 items. Conclusions: Athletes have greater understanding of general nutrition compared to sports nutrition concepts and may benefit from education on applying nutrition in sports‐specific contexts. Sports dietitians' responses showed PEAKS‐NQ was a highly acceptable, feasible and useful measure. [ABSTRACT FROM AUTHOR]

Study tools examining psychological distress, fear of COVID‐19 and coping amongst migrants and non‐migrants in Australia are very limited. The aim of this research was to assess the psychometric properties and correlation of the English version of Kessler Psychological Distress Scale (K‐10), Fear of COVID‐19 Scale (FCSV‐19S), and Brief Resilient Coping Scale (BRCS) tools during the COVID‐19 pandemic situation in Australia. Data from a cross‐sectional survey (n = 516) were utilized to examine reliability; 299 (57.9%) were migrants. High internal consistency, as evidenced by Cronbach's alpha, was found for the K‐10 (0.92), FCV‐19S (0.87) and BRCS (0.66) tools. The corresponding values for migrants and non‐migrants were (0.92, 0.87, 0.67) and (0.92, 0.86, 0.63), respectively. Item‐total correlations ranged 0.57‐0.78 for K‐10, 0.62–0.69 for FCV‐19S, and 0.39–0.50 for BRCS tools. EFA retained a single factor for each tool with adequate factor loadings. The scoring of K‐10 was significantly predicted by the scoring of FCV‐19S (r = 0.284, P < 0.001) and BRCS tool (r = 0.132, P < 0.01). Therefore, these tools can be used reliably amongst both migrant and non‐migrant population in Australia. [ABSTRACT FROM AUTHOR]

This research focuses on the adoption and acceptance of social assistive technologies (ATs) in the aged care context where carers provide care services to older adults. This research develops and validates a conceptual model adapted from existing technology acceptance and adoption models and theories. The moderating effects of perceived risk were also investigated to indicate how carers adopt and accept social ATs in aged care facilities. This research was undertaken using a mixed methods study combining a qualitative approach (Study 1: carer observations, focus groups and interviews) and a quantitative approach (Study 2: structural equation modelling). We observed 13 carers over 2 years using social ATs and carried out three focus groups and 15 interviews with carers. A quantitative survey was then distributed among 302 carers in Australia to collect quantitative data. Less attention was paid to the adoption of social ATs in aged care. This research provides empirical evidence showing how social robots as social ATs can facilitate technological innovation acceptance and adoption within aged care from the perspective of carers. [ABSTRACT FROM AUTHOR]

Background: The proportional method of acupuncture point location (APL) currently taught at Endeavor College of Natural Health and advocated by the World Health Organization Regional Office for the Western Pacific (WPRO) was found to be imprecise and/or inaccurate in previous student studies. The ruler and elastic methods of APL were identified as more accurate or precise than the proportional method of APL but were not well received by student participants. Use of an adjustable ruler may overcome barriers to uptake of the more accurate APL methods. This pilot study was the first to evaluate the comparative accuracy of the adjustable ruler and the proportional methods of APL in first-year students at a major Australian acupuncture training college. Methods: After 10 weeks of in-class instruction in both proportional and adjustable ruler methods of APL, student participants (n = 14) attempted location of three acupuncture points (LI10, SP6 and ST38) on a volunteer using both APL methods of interest. A self-administered questionnaire and lecturer field notes elucidated attitudes to implementation of both APL methods. Results: Points marked using the adjustable ruler were closer to the correct location than those marked using the proportional method across all three acupuncture points. Students and lecturers rated the adjustable ruler more highly than the proportional method for ease of learning and ease of use. Conclusion: Encouraging results with the adjustable ruler method warrant further larger scale studies. Use of the adjustable ruler method of APL should be considered for use in point location training at educational institutions teaching traditional acupuncture. [ABSTRACT FROM AUTHOR]

While the nursing profession recognizes the importance of leadership behaviors, limited evidence exists on essential clinical leadership behaviors that nursing students should exhibit upon graduation. The purpose of this study was to determine if there were common leadership behaviors exhibited by recently graduated baccalaureate clinical staff nurses in the United States and Australia. A quantitative descriptive study with a comparative design was conducted using The Clinical Leadership Survey. Similar clinical leadership behaviors were reported by nurses from the two countries though there was a statistically significant difference in the overall frequency of behaviors between the two groups. Behaviors in the 'challenging the process' domain were less commonly practiced in both countries, identifying a clinical gap and opportunity for student development. This study identifies the central behaviors that should be included in baccalaureate nursing education curriculum in order to prepare students for successful transition into practice. [ABSTRACT FROM AUTHOR]

Diversity characteristics such as culture, sexual orientation, and social situation potentially impact the participation of older individuals in healthcare. An awareness of diversity characteristics and their potential to impact on older people's access to health and aged care by professionals through training is important. This paper outlines the development and initial validation of a survey using adapted Delphi methodology and distribution to 195 health and aged care professionals pre- and post-diversity training. An initial pool of 31 items were developed with an expert reference group and reduced to 21 through exploratory factor analysis. A two-factor solution was extracted, measuring skills and attitudes of professionals relative to providing services to older people with diverse characteristics. Internal consistency of the items yielded a Cronbach alpha of 0.78. T-tests conducted on the pre- and post-survey data showed significantly higher scores on the domains of skills and attitudes following the training. Knowledge was not effectively captured using this method, with true-false or free-recall questions being a more appropriate approach. This tool fills a gap in the evaluation literature, providing an important first step to assess outcomes of diversity training in community aged care. Further validation is necessary for the tool to be used more widely in the sector. • Understanding older peoples' diversity characteristics and their impact on access to care through training is critical. • An evaluation tool has been developed and validation initiated through adapted Delphi methodology and completion of surveys. • Exploratory factor analysis showed effective measurement of skills and attitudes of health and aged care professionals. [ABSTRACT FROM AUTHOR]

Background: Studies report that increased levels of patient activation is associated with increased engagement with the health care system, better adherence to treatment protocols, and improved health outcomes. This study aims to evaluate the outcomes of a 12-month Patient-Centred Medical Home (PCMH) model called 'WellNet' on the activation levels of patients with one or more chronic diseases in general practices across Northern Sydney, Australia. Methods: A total of 636 patients aged 40 years and above with one or more chronic conditions consented to participate in the WellNet program which was delivered across six general practices in Northern Sydney, Australia. The WellNet intervention includes team-based care with general physicians and trained chronic disease management care coordinators collaborating with patients in designing a patient-tailored care plan with improved self-management support and care navigation according to the level of risk and health care needs. The level of patient activation was measured using the validated PAM 13-item scale at baseline and follow-up. A before and after case-series design was employed to determine the adjusted mean differences between baseline and 12-months using repeated measures analysis of covariance (ANCOVA). Additionally, the backward stepwise multivariable regression models were employed to identify significant predictors of activation at follow-up. Results: Of the 626 patients, 420 reported their PAM scores at follow-up. The mean (SD) baseline PAM score was 57.9 (13.0). The adjusted model showed significant mean difference in PAM scores by increase of 6.5 (95% CI 5.0–8.1; p-value< 0.001) after controlling for baseline covariates. The multivariable regression models showed that older age (B = − 0.14; 95% CI -0.28, − 0.01) and private insurance (uninsured patients) (B = − 3.41; 95% CI -6.50, − 0.32) were significantly associated with lower PAM scores at 12 months whereas higher baseline PAM score (B = 0.48; 95% CI 0.37, 0.59) was significantly associated with higher follow-up PAM score. Conclusion: The WellNet study is the first of its kind in Australia to report on changes in the patient activation levels among patients with one or more chronic diseases. PCMH has the potential to improve patient activation and engagement which can lead to long-term health benefits and sustained self-management behaviours. [ABSTRACT FROM AUTHOR]

Background: Children's play and leisure participation is often assessed by occupational therapists. As such, it is essential that therapists utilize play and leisure scales that are valid, reliable and responsive. Aim: To examine the convergent validity between the Children's Leisure Assessment Scale (CLASS) and Children's Assessment of Participation and Enjoyment and Preferences for Activities of Children (CAPE/PAC). Methods: Forty healthy Australian children (60% female; mean age 9.2 ± 2.01 years) completed the CLASS and CAPE/PAC. Spearman's rho correlations with bootstrapping were completed. Results: A number of the CLASS and CAPE/PAC subscales were significantly correlated. The CAPE's overall scale scores and CLASS's instrumental indoor activities, outdoor activities and games and sport activities subscales were significantly correlated (p > 0.05). The CAPE's Social domain showed several significant correlations with the CLASS's instrumental indoor activities, outdoor activities and self-enrichment activities domains (p < 0.05). Statistically significant relationships were found between the CLASS's outdoor activity preference and the PAC's recreational, physical, formal, informal and overall performance scores (r = 0.466–0.773, p < 0.05). Conclusions and Significance: Preliminary evidence in support of the convergent validity between the CAPE/PAC and CLASS was obtained. Limitations include a small sample size and convenience sampling. Further investigation of the psychometric properties of the CAPE/PAC and CLASS are recommended. [ABSTRACT FROM AUTHOR]

Aim: The current study aimed to assess the suitability of the Work Organisation Assessment Questionnaire (WOAQ) for use in the healthcare sector, specifically for community nurses and paramedics. Community nurses and paramedics work in complex environments and are exposed to a range of psychosocial hazards linked with the development of musculoskeletal and mental health disorders. To reduce the incidence of these disorders, assessment and then control of psychosocial hazards is required. WOAQ addresses this need through an employee survey to identify key hazards, with the responses used to underpin a participative development of solutions. Method: Using a bifactor model, the WOAQ and five nested factors were cross validated using a sample of 1255 community nurses and paramedics using data collected in 2011 and 2012. Results: The results of metric invariance testing demonstrated that the WOAQ is a valid tool across health organizations. Full invariance testing at mean constructs level also showed strong support of validity of the 'general score' of the WOAQ. However, minor mean differences were found between two nested factors (workload issues and the relationships with the coworkers). Conclusion: The WOAQ is a valid assessment tool for application within the nursing and paramedic settings. Practical implications for these findings in healthcare settings are discussed. [ABSTRACT FROM AUTHOR]

Purpose: To identify the face validity of the Client-Centred Rehabilitation Questionnaire (CCRQ) and to determine the internal consistency reliability and factorial validity of a modified CCRQ. Materials and methods: This study was conducted in 2 phases. Phase 1 consisted of 5 focus groups to examine the face validity of the CCRQ, resulting in the development of a modified CCRQ. Phase 2 consisted of a multi-site cross sectional survey, involving 408 rehabilitation inpatients, to examine the internal consistency reliability and factorial validity of the modified CCRQ. Chronbach's coefficient alpha, composite reliability coefficients, and single factor congeneric models with maximum likelihood confirmatory factor analysis were used. Results: Based on feedback from the focus groups the CCRQ was modified with the word 'rehabilitation' replacing 'program' throughout. The three negatively worded items had poor item-to-total correlations of <0.3. Removing these items resulted in subscale alphas of 0.74–0.86 and composite reliability coefficients of 0.66–0.87. Six of the seven sub-scales had good model fit and the other one had moderate fit following removal of the negatively worded item. Conclusions: This study supports the underlying structure and internal consistency of the modified CCRQ. Person-centredness is an important characteristic of effective rehabilitation service delivery that warrants measurement. A modified Client-Centered Rehabilitation Questionnaire has been found to have good face validity, internal consistency reliability and construct validity in an Australian sample of inpatient rehabilitation patients. Use of a modified Client-Centered Rehabilitation Questionnaire incorporating the 7 sub-scales in the original Client-Centered Rehabilitation Questionnaire is supported for use in inpatient rehabilitation. Both sub-scale and item level responses to the modified Client-Centered Rehabilitation Questionnaire provide detailed feedback to rehabilitation service providers looking for opportunities to make their services more person-centred. [ABSTRACT FROM AUTHOR]

Objectives: In the first of a series of three articles by the present authors, diagnostic agreement between Traditional Chinese Medicine (TCM) practitioners was found to be low. This was the first time that TCM diagnoses had been evaluated with an open population of patients and this result is a cause of concern. In the second article, incorrect statistics were shown to have often been used to calculate chance-removed inter-rater agreement, and appropriate statistics such as Gwet's Agreement Coefficient 2 (AC2) was recommended for future studies. In this, the third article, a novel approach to recording TCM diagnostic patterns, the Traditional Chinese Medical Diagnostic Descriptor (TCMDD), is presented that allows chance-removed agreement calculation. An example of mapping TCM diagnostic patterns to the TCMDD format is given and diagnostic agreement is evaluated. Design, Settings, Subjects: The same 35 subjects used to report agreement in our first article were also diagnosed by additional practitioners using the TCMDD format during the same experimental sessions at the University of Technology, Sydney Clinic. TCM diagnoses from the first article were also mapped to the TCMDD format. Outcome measures: Linearly weighted simple agreement and the AC2 statistic were utilized and all results compared. Results: Linearly weighted simple agreement using the TCMDD and TCM mapped to TCMDD format averaged 0.80 ± 0.02 compared with 0.19 for TCM. TCMDD and TCM mapped to TCMDD chance-removed agreement, as calculated with AC2, ranged between 0.67 and 0.73 ± 0.03. Conclusions: The TCMDD allows the essence of diagnoses expressed by TCM practitioners to be appropriately compared. This was confirmed by the TCM mapped to TCMDD results. In both cases, simple agreement was significantly greater than that obtained with the TCM format. Chance-removed statistics and error estimates can be reliably calculated with the AC2 and the TCMDD in open populations. [ABSTRACT FROM AUTHOR]

Purpose: To determine the factor structure of a clinical tool for the assessment of hearing loss self-management, and to identify predictors of the total score on the assessment and the extracted factor scores. Materials and methods: Hearing loss self-management assessments were conducted with 62 older adults. The factor structure of the assessment was determined by exploratory factor analysis. Multiple linear regression analyses identified significant contributors to the total score and to each of the extracted factors. Results: Three factors were identified, each representing a distinct domain of hearing loss self-management: Actions, Psychosocial Behaviours, and Knowledge. The most common significant predictor was hearing health care experience, which predicted self-management overall and in the Actions and Knowledge domains. Health literacy predicted hearing loss self-management overall and in the Psychosocial Behaviours domain. Actions were additionally predicted by hearing aid self-efficacy and gender, Psychosocial Behaviours by health locus of control, and Knowledge by age. Conclusions: The results of the factor analysis suggested that hearing loss self-management is a multidimensional construct. Each domain of hearing loss self-management was influenced by different contextual factors. Subsequent interventions to improve hearing loss self-management should therefore be domain-specific and tailored to relevant contextual factors. Hearing loss is a chronic health condition that requires on-going self-management of its effects on everyday life. Hearing loss self-management is multidimensional and encompasses the domains of Actions, Psychosocial Behaviours, and Knowledge. Different contextual factors influence each hearing loss self-management domain, including previous experience receiving hearing health care services, health literacy, hearing aid self-efficacy, health locus of control, age, and gender. Audiological rehabilitation programs should thus ensure that interventions to improve hearing loss self-management are domain- and context-specific. [ABSTRACT FROM AUTHOR]

Introduction: Validity is a dynamic process and as part of a continual process of evaluation of tools, this study aimed to evaluate content validity of the WorkHab functional capacity evaluation, a tool used in occupational rehabilitation. Methods: A cross sectional survey of health professionals who conduct FCEs investigated their ratings of item relevance and item difficulty across different categories of work and injuries. The survey also explored the relationship of the WorkHab FCE items with the physical demand items of the Dictionary of Occupational Titles (DOT). Results: The majority of items of the WorkHab FCE were rated as relevant for manual work and vocational retraining with over 90% agreement between the 106 respondents. Therapists identified the WorkHab items of climbing, crawling and balance as less relevant for sedentary work. Lifting items were perceived as the most difficult for those with a lower back injury, or an upper limb injury. Sixteen of the 18 WorkHab FCE items had 100% agreement with the equivalent items on the DOT. The WorkHab FCE items that had poor agreement with the DOT were mainly sensory items such as see, feel, talk and hear. Conclusions: The findings of this study support the content validity for the WorkHab FCE specifically in relation to manual work and for vocational retraining purposes. [ABSTRACT FROM AUTHOR]

University years are a period of increased morbidity and mortality, associated with negative health behaviours and corresponding poor mental health (MH) status amongst students. With this said, the aim of this research was to determine the level of influence a number of predictive factors have on Australia's university students' MH status. A cross-sectional study design, consisting of an online survey was implemented. Psychometric measurement components were based on adopting Bronfenbrenner's socio-ecological model approach to collecting descriptive statistics. This approach was concerned with investigating patterns of association between three predictive factors [social emotional wellbeing (SEWB), physical activity (PA) levels and sporting club (SC) involvement], against four domains (personal, university, home and community). This study identified that 25% (n =  571) of participants (n =  2326) indicated that they have been diagnosed with a MH disorder. Specifically, gender, age, negative health behaviours, lower levels of PA and SC involvement and poor SEWB, were found to be significantly and positively associated (p <  0.05 *, p <  0.01 **) with a MH diagnosis. Importantly, findings from this study indicate that there are significant (positive/negative) associations between the identified predictive factors and participants' MH status. Findings from this study will go towards informing current and future Student Health Service policies, practices and infrastructure allocation that address MH status amongst university students. [ABSTRACT FROM AUTHOR]

Seclusion and restraint continue to be used across psychiatric inpatient and emergency settings, despite calls for elimination and demonstrated efficacy of reduction initiatives. This study investigated nurses' perceptions regarding reducing and eliminating the use of these containment methods with psychiatric consumers. Nurses (n = 512) across Australia completed an online survey examining their views on the possibility of elimination of seclusion, physical restraint, and mechanical restraint as well as perceptions of these practices and factors influencing their use. Nurses reported working in units where physical restraint, seclusion, and, to a lesser extent, mechanical restraint were used. These were viewed as necessary last resort methods to maintain staff and consumer safety, and nurses tended to disagree that containment methods could be eliminated from practice. Seclusion was considered significantly more favourably than mechanical restraint with the elimination of mechanical restraint seen as more of a possibility than seclusion or physical restraint. Respondents accepted that use of these methods was deleterious to relationships with consumers. They also felt that containment use was a function of a lack of resources. Factors perceived to reduce the likelihood of seclusion/restraint included empathy and rapport between staff and consumers and utilizing trauma‐informed care principles. Nurses were faced with threatening situations and felt only moderately safe at work, but believed they were able to use their clinical skills to maintain safety. The study suggests that initiatives at multiple levels are needed to help nurses to maintain safety and move towards realizing directives to reduce and, where possible, eliminate restraint use. [ABSTRACT FROM AUTHOR]

Aims: The research explores (a) nurses' views of the change to mandatory bedside handovers, and (b) these nurses' perceptions of their skills in managing this new practice in an Australian hospital. Background: In Australia, nursing bedside handovers are now considered essential in many hospitals, although most nurses received minimal training at the time this policy was instituted. This research establishes a unique quantitative tool to investigate nurses' views of, and self‐reported actions related to, bedside handovers. Method: Prior to the implementation of mandatory bedside handovers in a hospital in Canberra, Australia, nurses in two wards (n = 66) were recruited to complete the new Bedside Handover Attitudes and Behaviours (BHAB) questionnaire. Results: Most nurses strongly value bedside handovers and have confidence in their ability to lead this clinical practice. Conclusions: Researchers identified a high level of alignment between the nurses' acceptance of bedside handovers and nurses' self‐reported actions in conducting this communication process. Implications for Nursing Management: Future research should explore the links between nurses' views of, and skills in, the management of bedside handovers, as well as the effects of professional training for this practice. Furthermore, the BHAB questionnaire may be employed in different nursing contexts in future research. [ABSTRACT FROM AUTHOR]

Aim: To evaluate characteristics of job‐related meaningfulness, and to assess its potential to moderate the relationship between over‐commitment and emotional exhaustion in nurses. Background: Increased demands on nurses may induce vulnerability to emotional exhaustion, decrease job satisfaction, and increase their intention to quit the job. The experience of job‐related meaningfulness through meaning‐centred logotherapy and counseling could be a resource to prevent emotional exhaustion. Method: Nurses (n = 466; 73% female) at an Austrian tertiary‐care hospital participated in a cross‐sectional survey for assessment of job‐related meaningfulness by the newly developed CERES (Concern, Enthusiasm, Relevance, Efficacy, Satisfaction) scale. CERES was tested for its moderating interaction with over‐commitment (assessed by the Effort‐Reward Imbalance Questionnaire) to prevent emotional exhaustion (as measured by the Maslach Burnout Inventory) by structural equation modelling. Results: The CERES scale consisting of five items has satisfactory internal consistency (Cronbach's alpha:.78). Over‐commitment correlated significantly (p < .001) with emotional exhaustion. A moderating interaction of CERES with over‐commitment on emotional exhaustion was found overall (p < .001), and separately for males (p = .002) and females (p < .001). Conclusions: CERES is suitable for assessing experienced job‐related meaningfulness and it moderates emotionally exhausting effects of over‐commitment in nurses. Implications for Nursing Management: Nursing managers may improve nurses' awareness of job‐related meaningfulness by focusing on meaning‐centred feed‐back and counselling and thereby strengthening perception of concern, enthusiasm, relevance, efficacy, and satisfaction regarding their caring behaviour. [ABSTRACT FROM AUTHOR]

Background/aim: Parent proxy reports are well used in occupational therapy, yet historically parent report instruments of motor skill have not required parents to report on the same motor skills that their children are assessed on. The aim was to examine how well a parent report of children's fundamental movement skill (FMS) was associated with children's actual FMS. Method: A sample of 100 children aged 7–9 years from Melbourne, Australia, were recruited. Parents/guardians completed proxy report (parent version of the 'Pictorial Scale of Perceived Movement Skill Competence' (PMSC)) and children's actual motor skills were assessed ('Test of Gross Motor Development' 3rd edition (TGMD‐3)). Data were first analysed using Pearson's correlation coefficients and then hierarchical linear stepwise regression was conducted with actual skill as the outcome variable in each model. Results: The PMSC‐Parent (r = 0.36, P < 0.001) was moderately associated with children's actual skill. After age and sex adjustment, the PMSC‐Parent explained 11.4% of variance in total skills. Parent report of their children's object control scores (PMSC object control scale) was significantly associated with children's actual object control (B = 0.36, P < 0.001) and explained 11.3% of the variance. Parent report of children's locomotion scores (PMSC locomotion scale) was associated with children's actual locomotor skills (B = 0.27, P = 0.007) and explained 6.2% of the variance. Conclusion: Parents are able to report to some degree on their children's FMS competency, in particular, their object control competence. Parent proxy report of FMS may help inform occupational therapists to identify children with low FMS competency to develop interventions targeting FMS. [ABSTRACT FROM AUTHOR]

Background/aim: Occupational therapists offer a unique perspective regarding the contribution of the environment to occupational performance. Therefore, a scale that measures the unique characteristics of the primary school classroom environment where children complete their daily schoolwork occupations is needed. The aim of this study was to develop and psychometrically evaluate a new teacher‐report questionnaire that measures a number of environmental characteristics of primary school classrooms. Methods: Participants (N = 117) completed the Classroom Environment Questionnaire (CEQ), which utilises a 4‐point Likert scale where teachers rate 51 environmental characteristics of their classroom. Teachers also rate the extent to which they believe the physical, social, temporal, institutional and cultural classroom environmental domains contribute to students' schoolwork performance using a 10‐point scale. The structural validity of the CEQ was examined using principal component analysis (PCA). Inter‐item correlations were examined using Pearson r correlations, while the internal consistency of the CEQ was assessed using Cronbach's alpha. Results: PCA revealed the CEQ to be multidimensional, with 31 items loading onto nine viable factors, representing the unique nature of classroom environments. Based on the PCA results, 20 items were removed from the CEQ. Cronbach's alpha and correlation analysis indicated that most CEQ subsections had acceptable internal consistency (alpha range 0.70–0.82), with four subsections demonstrating a lower level of internal consistency (alpha range 0.55–0.69). Conclusion: Preliminary structural validity and internal consistency analysis findings confirm that the CEQ has potential to be a useful scale for professionals wishing to examine the unique characteristics of primary school classrooms that influence the occupational performance of students. Ongoing analyses will be undertaken to further explore the CEQ's validity and reliability. [ABSTRACT FROM AUTHOR]

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

Aim and objective: To explore the accuracy with which nursing students can identify the fundamentals of care. Background: A challenge facing nursing is ensuring the fundamentals of care are provided with compassion and in a timely manner. How students perceive the importance of the fundamentals of care may be influenced by the content and delivery of their nursing curriculum. As the fundamentals of care play a vital role in ensuring patient safety and quality care, it is important to examine how nursing students identify these care needs. Design: Cross‐sectional descriptive design. Methods: A total of 398 nursing students (pre‐ and postregistration) from universities in Sweden, England, Japan, Canada and Australia participated. The Fundamentals of Care Framework guided this study. A questionnaire containing three care scenarios was developed and validated. Study participants identified the fundamentals of care for each of the scenarios. All responses were rated and analysed using ANOVA. Results: The data illustrate certain fundamentals of care were identified more frequently, including communication and education; comfort and elimination, whilst respecting choice, privacy and dignity were less frequently identified. The ability to identify all the correct care needs was low overall across the pre‐ and postregistration nursing programmes in the five universities. Significant differences in the number of correctly identified care needs between some of the groups were identified. Conclusions: Nursing students are not correctly identifying all a patient's fundamental care needs when presented with different care scenarios. Students more frequently identifying physical care needs and less frequently psychosocial and relational needs. The findings suggest educators may need to emphasise and integrate all three dimensions. Relevance to clinical practice: To promote students' ability to identify the integrated nature of the fundamentals of care, practising clinicians and nurse educators need to role model and incorporate all the fundamental care needs for their patients. [ABSTRACT FROM AUTHOR]

Background: The aims of this study were to evaluate the factor structure of the newly developed Adult Eating Behaviour Questionnaire (AEBQ) (Hunot et al., Appetite 105:356-63, 2016) in an Australian sample, and examine associations between the four food approach and four food avoidance appetitive traits with body mass index (BMI). Methods: Participants (N = 998) recruited between May and October 2016 via a university research participation scheme and online social network sites completed an online version of the AEBQ and self-reported demographic and anthropometric data. Of the sample, 84.8% were females, 29.6% had completed a university degree and the overall mean age was 24.32 years (SD = 8.32). Confirmatory factor analysis (CFA) was used to test three alternative factor structures (derived from issues raised in the original development study): the original 8 factor model, a 7 factor model with Food Responsiveness and Hunger scales combined, and a 7 factor model with the Hunger scale removed. Results: The CFA revealed that the original 8 factor model was a better fit to the data than the 7 factor model in which Food Responsiveness and Hunger scales were combined. However, while reliability estimates for 7 of the 8 scales were good (Cronbach's a between 0.70-0.86), the reliability of the Hunger scale was modest (0.67) and dropping this factor resulted in a good fitting model. All food avoidance scales (except Food Fussiness) were negatively associated with body mass index (BMI) whereas Emotional Overeating was the only food approach scale positively associated with BMI. Conclusions: The study supports the use of the AEBQ as a reliable and valid measure of food approach and avoidance appetitive traits in adults. Longitudinal studies that examine continuity and stability of appetitive traits across the lifespan will be facilitated by the addition of this measurement tool to the literature. [ABSTRACT FROM AUTHOR]