Search

Aims and Objectives: To explore the shared experiences of people with stroke and caregivers in preparedness to manage post-discharge care., Background: People with stroke and caregivers show dyadic effects in dealing with post-discharge care challenges. However, few studies have explored their shared experiences and unique challenges for each dyadic member in preparedness to manage post-discharge care. This study addresses this research gap., Design: An interpretive approach underpinned by Gadamer's philosophical hermeneutics., Methods: Semi-structured interviews were conducted with people with stroke and caregivers in 5 days before hospital discharge (n = 26) or 2 weeks after discharge (n = 4) between July and December 2019. The study followed a five-step data analysis method aligning with Gadamerian hermeneutics. The study reporting followed the COREQ checklist., Results: Three themes and six subthemes were identified. First, both people with stroke and caregivers experienced psychological stress, although the sources differed. Second, stroke dyads demonstrated resilience built on positive thoughts, confidence, and support from family and health professionals. Third, stroke dyads exhibited different levels of certainty about post-discharge care. They desired to be equal partners in co-developing and co-implementing discharge plans., Conclusions: Similarities and differences in perceived preparedness to manage post-discharge care existed between stroke dyadic members. A co-design approach to developing and implementing discharge plans would enhance planned post-discharge care., Impact: Hospital-to-home transition is a challenging time for people with stroke and their caregivers. Understanding the shared experiences of stroke dyads in preparedness for post-discharge care enables nurses to take proactive actions to enhance managing post-discharge care. Early identification of those at risk of developing psychological stress will enable nurses to co-develop stress-coping strategies. These will have a positive influence on the dyad when facing setbacks due to stroke-related complications., (© 2022 John Wiley & Sons Ltd.)

Aim: We aim to investigate nurses' perceptions of support after incidences of Workplace Violence., Background: Nurses experience workplace violence daily. Adequate support following incidents of violence can reduce adverse impacts. Current support systems for coping with workplace violence are lacking., Methods: Focus group interviews were conducted with 23 nurses working in a regional Queensland Hospital. Qualitative data was transcribed and thematically analyzed to determine themes. The consolidated criteria for reporting qualitative research checklist was followed., Results: The primary source of support after a violent incident was from other nurses. Support was needed immediately to empower nurses to be able to continue their caring role. Often the support was not provided nor were nurses aware of the support services available. Although personal family and friends were a valuable support, most nurses were reluctant to disclose their experiences to protect them., Conclusions: This paper discusses nurses' experience of support following violence incidents at work as part of findings from a more extensive study that explored the perceptions of nurses regarding violence, strategies and support in a regional Queensland Hospital. Hospital support following a violent incident was perceived as inadequate and nurses felt unsupported immediately following an incident., Implications for Nursing Management: After an incidence of workplace violence, appropriate effective support may mitigate the enduring impacts of experiencing violence. There is the need for hospital management to provide effective support services and improve staff awareness of available support services., (© 2022 John Wiley & Sons Ltd.)

Aims and Objectives: To synthesise qualitative research evidence on the experience of stroke survivors and informal caregivers in hospital-to-home transitional care., Background: Due to a shortened hospital stay, stroke survivors/caregivers must take over complex care on discharge from hospital to home. Gaps in the literature warrant a meta-synthesis of qualitative studies on perceived enablers and barriers during this crucial period., Design: A systematic review and meta-synthesis., Methods: A review was guided by Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) checklist where six databases were searched from April to June 2020 including CINAHL Plus, MEDLINE, PsycINFO, Scopus, Web of Science and ProQuest and ProQuest Dissertations and Theses. There was no date limit to the search. Selected studies were critically appraised. A thematic synthesis approach was applied., Results: The synthesis of 29 studies identified three major findings. First, partnerships with stroke survivors/caregivers empower discharge preparation, foster competence to navigate health and social care systems and activate self-management capabilities. Second, gaps in discharge planning and the lack of timely postdischarge support contribute to unmet care needs for stroke survivors/caregivers and affect their ability to cope with poststroke changes. Third, stroke survivors/caregivers expect integrated transitional care that promotes shared decision-making and enables long-term self-management at home., Conclusions: Hospital-to-home transition is a challenging period in the trajectory of poststroke rehabilitation and recovery. Further research is required to deepen understandings of all stakeholders' views and address unmet needs during transitional care., Relevance to Clinical Practice: Protocols and clinical guidelines relating to discharge planning and transitional care need to be reviewed to ensure partnership approach with survivors/caregivers in the design and delivery of individualised transitional care. Stroke nurses are in a unique position to lead timely support for survivors/caregivers and to bridge service gaps in hospital-to-home transitional care., (© 2021 John Wiley & Sons Ltd.)

Aim: To identify challenges and opportunities for stroke survivors and caregivers in hospital to home transition care., Background: Due to shortened hospital stays, stroke survivors and caregivers must take responsibility for complex care on discharge from hospital to home. Gaps exist in the literature that synthesizes studies on hospital to home transition care., Design: A systematic integrated review., Data Sources: Six databases were searched systematically between 18 June 2018 - 31 October 2018 including Medline, CINAHL, Web of Science, ProQuest, Scopus and Science Direct. The search did not have a date limit., Review Methods: Studies that met the selection criteria were critically reviewed. Data were extracted from the studies for analyses. A convergent qualitative synthesis approach using inductive thematic synthesis was applied to the review., Results: The analysis of 23 studies identified three major findings. First, health and social care systems influence transition care by either enabling stroke survivors and caregivers to manage transition care via well-coordinated services or preventing them from accessing services. Second, health professionals' partnership with stroke survivors and caregivers largely decides tailored support for them. Successful partnerships and engagements with stroke survivors and caregivers depend on organizational resources. Third, survivors and caregivers are at different levels of readiness to cope with challenges. Individualized support for them to develop resilience is highly regarded., Conclusion: Stroke survivors and caregivers encounter enormous challenges in self-management of hospital to home transition care. Further research is required to address their expectations of support during transition care., Impact: There is a lack of synthesis of studies on factors affecting hospital to home transition care for stroke survivors. Health and social care system designs, health professionals' commitment to individualized care and the self-management capability of stroke survivors and their caregivers have a profound influence on the transition care experiences., (© 2020 John Wiley & Sons Ltd.)

Aims and Objectives: To evaluate the impact of a nurse practitioner-led phase two cardiac rehabilitation and secondary prevention programme on attendance and compliance., Background: Despite strong evidence for the benefits of cardiac rehabilitation, attendance/completion rates remain low. Nurse practitioner-led services have been reported as more effective than physician-led services at increasing patient adherence to evidence-based recommendations. However, nurse practitioner-led programmes are uncommon and there appears to be no current evidence examining the impact of these programmes on attendance/completion rates., Methods: A retrospective audit of the Country Access to Cardiac Health (CATCH) database was undertaken to identify patients who attended a nurse practitioner-led cardiac rehabilitation programme between April 2014 and May 2016. Data from key performance indicators were exported to Stata/SE 15.0. The study utilised the Strengthening the Reporting of OBservational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies to ensure quality reporting during this study (See Data S1)., Results: Seventy-seven per cent (n = 199) of participants were men, and participants had a mean age of 67 years. Half (52.5%) of participants completed all CR sessions. Male participants (78%) were more likely to complete the CR programme as compared with women (67%). Participants with a family history of cardiovascular disease and a higher number of risk factors at baseline were more likely to commence and complete the programme. Attendance and completion had a positive impact on smoking cessation., Conclusions: The nurse practitioner-led programme evaluated in this study demonstrated high levels of attendance and completion rates compared to standard programmes. This high attendance/completion rate could in turn decrease the rate of subsequent cardiac events and improve mortality and morbidity rates. Relevance to clinical practice provides valuable insights into the effectiveness of nurse practitioner-led cardiac rehabilitation and secondary prevention on attendance/complete rates. These findings could guide future research and clinical practice development., (© 2019 John Wiley & Sons Ltd.)

Aims: This study re-examines the validity of a model of occupational resilience for use by nursing managers, which focused on an individual differences approach that explained buffering factors against negative outcomes such as burnout for nurses., Background: The International Collaboration of Workforce Resilience model (Rees et al., 2015, Frontiers in Psychology, 6, 73) provided initial evidence of its value as a parsimonious model of resilience, and resilience antecedents and outcomes (e.g., burnout). Whether this model's adequacy was largely sample dependent, or a valid explanation of occupational resilience, has been subsequently un-examined in the literature to date. To address this question, we re-examined the model with a larger and an entirely new sample of student nurses., Methods: A sample of nursing students (n = 708, Age M ( SD ) = 26.4 (7.7) years), with data examined via a rigorous latent factor structural equation model., Results: The model upheld many of its relationship predictions following further testing., Conclusions: The model was able to explain the individual differences, antecedents, and burnout-related outcomes, of resilience within a nursing context., Implications for Nursing Management: The results highlight the importance of skills training to develop mindfulness and self-efficacy among nurses as a means of fostering resilience and positive psychological adjustment., (© 2019 John Wiley & Sons Ltd.)

Aim: To explore how nurse managers perceive and experience their role in supporting the well-being of intensive care nurses., Background: While it is known that nurse manager behaviours affect nurse well-being, literature indicates that intensive care nurses may not receive the support they require. Understanding how nurse managers see their role in supporting nurse well-being is crucial to offer recommendations for improvement., Methods: Qualitative multiple case study design. Twelve semi-structured, in-depth interviews were conducted with nurse managers from Australian intensive care unit settings. Data were analysed using thematic analysis., Results: Nurse manages felt unsure about what their supportive role involved, lacked training on how to support nurse well-being and called for organisational backup to carry out their role effectively. The study also provided insight into the strategies that enabled nurse managers to support nurse well-being., Conclusion: There is currently no consensus on the role of the nurse manager in supporting nurse well-being resulting in inconsistencies and wide practice variations. Furthermore, nurse managers need support and training if they are required to support nurse well-being., Implications for Nursing Management: A clear definition of the nurse manager supportive role describing the purpose and core functions involved in this role must be developed to support nurse well-being., (© 2019 John Wiley & Sons Ltd.)

Title: Psychological adjustments made by postburn injury patients: an integrative literature review., Aim: This paper is a report of a review examining the variables that predispose individuals to significant psychological maladjustment following burn injury., Background: The psychological sequelae of burn injury are well documented; however, the variables that influence individuals' adjustment following burn injury lack consideration., Data Sources: MEDLINE, Cumulative Index of Nursing and Allied Health, and Psychological Abstracts were searched using the keywords burn injury, psychological, psychosocial, rehabilitation, premorbid psychopathology, adjustment, reintegration, body image, post-traumatic stress disorder, depression, coping. Other sources were found from a manual search of nursing, medical and psychological literature and references of identified and related papers. The search strategy was limited to English-language research published between 1997 and 2008., Review Methods: An integrative review of the studies was conducted over a 6-month time period during 2007-2008., Results: Burn patients are a heterogeneous group and typically have comorbidities. While preburn personality and coping strategies can influence long-term psychological adjustment, the relationship between postburn adjustment and burn size and severity, and gender are poorly understood. Much of the literature focuses on the prevalence of psychological maladjustment rather than on identifying variables that influence psychological adjustment., Conclusion: The diversity and complexity that characterize burn patients lead to unique adjustment difficulties. Recognizing these difficulties is the first step to offering appropriate intervention and treatment for this unique patient group.

Aim: This paper reports a study describing the experience of surviving traumatic brain injury as narrated by individuals 1 year after injury., Background: The experience of surviving traumatic brain injury is an individual and invisible experience. Healing and resolution of grief is still problematic for many years after injury. This experience includes those with severe injury. There is limited literature focusing on the survivor., Methodology: Sixty people with hospital admission diagnoses of traumatic brain injury were interviewed 1 year after injury using the Extended Glasgow Outcome Score questionnaire. Survivors then described their experiences of recovery. Data were collected through unstructured in-depth interviews, transcribed from audio-tapes and analysed into references. Qualitative content analysis was used to compile their frequencies from recurring themes., Findings: Sixty survivors with a median age of 35 years were enrolled in the study, with 100% follow-up. Twelve per cent returned to full preinjury functioning, 35% had residual psychosocial and physical sequelae, 38% had significant restrictions in lifestyle and work capacity, and 15% were unable to care for themselves throughout the 24-hour period. The common narratives were classified into five categories: 'regret and grief within self'; 'insensitivity of health professionals'; 'invisibility of self'; 'stranded self'; and 'recovery in self'. These self-narratives reflected renewed ways to view the self, which were conceptualized to be intact 'in spite of' or to be worthwhile 'because of' the traumatic brain injury., Conclusions: Self-narratives could be a worthwhile focus of psychological intervention by substituting positive narratives for negative ones, demonstrating hope and a positive outlook on life in order to enhance self-reflection and improve mental health. They can assist people to minimize, avoid or overcome devaluation and, as such, provide a basis for considerable nursing rehabilitation practice, even in those with severe injury.