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Frequent presentations to emergency departments contribute to increased service demands and healthcare costs. Literature suggests these adult presentations may be influenced by childhood adversity. This qualitatively driven, mixed methods study explored the self‐perceived role of childhood adversity in the health of adults who frequently attended Australian Emergency Departments and their perceptions of the healthcare they received. Data were collected using validated instruments and semi‐structured interviews with 12 purposefully sampled adults who frequently attended emergency departments. Qualitative data were analysed using interpretive phenomenological analysis. Three major themes were identified—The experience of childhood adversity: articulating challenges related to childhood trauma, and the subsequent impacts on participants' health, behaviours, relationships and sense of control; Pursuing safety: exploring action participants took to keep themselves and others safe, with this requirement extending into adulthood and influencing Emergency Department presentations; and Seeking humanising healthcare: identifying challenges participants experienced while seeking care in the Emergency Department. Participants perceived their mental health to be profoundly affected by their past experiences of trauma, leaving them feeling vulnerable at times and more likely to experience re‐traumatisation in the Emergency Department. Feelings of stigmatisation during Emergency Department encounters led participants to employ self‐protection strategies creating further barriers to recovery. Participants described Emergency Departments as often failing to comprehensively address their healthcare needs. They offered suggestions for more effective care interventions. Findings highlight the need for further research to inform policy and practice when designing and implementing interventions for these adults. Consolidated Criteria for Reporting Qualitative Research (COREQ) guided study reporting. [ABSTRACT FROM AUTHOR]

This study explores the concept of social connectedness for adults with Cystic Fibrosis (CF), generally and during the onset of the COVID-19 pandemic, to help inform contemporary CF healthcare. Social connectedness is an essential component of belonging and refers to an individual's sense of closeness with the social world. Unique disease factors make exploration of social connectedness pertinent, added to by COVID-19, with the CF population potentially facing increased risk for severe illness. Seventeen adults with CF in Western Australia undertook interviews, with findings categorized as overarching themes. In a general sense, participants described social connectedness challenges caused by CF, despite which they reported meaningful connections that benefits their mental and physical health. Within a COVID-19 specific context, participants demonstrated resilience in the face of adversity, highlighted the importance of empathy in relation to the pandemic, and described how social support is both an outcome and enhancer of social connectedness. This study contributes to limited social connectedness literature within CF and chronic illness in general, highlighting the importance of social connectedness awareness raising, assessments and interventions in CF healthcare inside and outside the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore the experiences of men and women with cystic fibrosis in becoming parents. Background: As lifespan for people with cystic fibrosis increases, and reproductive technology advances, having a child of their own becomes a possibility. Design: This study used a phenomenological framework. Methods: Seven Australian adults with cystic fibrosis were invited to describe their experiences of becoming parents in the context of a semi‐structured interview. Analysis of the data involved highlighting recurrent phrases and isolating emergent themes. Results: Two overarching themes characterised the participants’ experience: Counting the cost, as they recalled Concentric communication and Pathways to pregnancy; and Living the dream, as they cast a retrospective view over this, their major achievement, in the light of their Reaction: a dream comes true, Coping: a question of balance, Conjecture: the future redefined and Confidence: recalibrating. Conclusions: While advances in cystic fibrosis care and reproductive technology have increased the possibility of individuals with cystic fibrosis becoming parents, the passage to becoming a parent is a complex process. Relevance to clinical practice: These findings can inform health professionals to support the adaptive work necessary for families that include members with cystic fibrosis. A contemporary understanding of this phenomenon is necessary for facilitating clinically relevant communication. [ABSTRACT FROM AUTHOR]

Aims and objectives: To explore experiences of family-centred care among parents of children with cystic fibrosis living far from tertiary treatment centres and to understand what such distances mean to their care. Background: Australia is a large continent. However, many families with a child with cystic fibrosis live in regional areas, often thousands of kilometres away from the primary treatment centres located in Australia’s coastal capital cities. Design: A qualitative, phenomenological design using a Van Manen (1990) approach. Methods: Individual, semi-structured interviews were conducted with parents (n = 7) of a child with cystic fibrosis who lived in regional Australia. Thematic content data analysis was used. Results: The essence of the participants’ experience was their seeking certainty and continuity in the changeable realm of cystic fibrosis while negotiating a collaborative approach to their child’s care. Five core themes and two subthemes were identified: “Daily care: a family affair,” including the subtheme “Accessing expert care”; “Family- centred care: seeking inclusion”; “Control versus collaboration: seeking mutual trust,” with the subtheme “The team who grows with you”; “Future projections”; and “The CF circle.” Conclusion: Some concerns are not unlike those of their city counterparts, but can be intensified by their sense of distance and isolation. Relevance to clinical practice: Insight into this unique milieu from the parents’ perspective is requisite so that care is appropriate to such a challenging environment and incorporates the whole family. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore Indigenous people's experiences of hospitalisation for acute cardiac care. Background Indigenous Australians suffer a higher burden of cardiovascular ill health and hospitalisation rates in comparison with other Australians, but there is little research that explores their perspectives of hospitalisation. Design Narrative inquiry. Methods Interviews were undertaken using storytelling to facilitate participants' descriptions of their hospital experience. Data were collected during 2014-2015. A purposive sample of Indigenous cardiac patients that were admitted to hospital and their relatives participated. Findings The narrative revealed three linked themes that characterised Indigenous people's hospitalisation experiences: The impact of the past; The reality of the present; and Anticipating the future. Hospitalisation was challenging for participants due to their sense of dislocation and disorientation, a lack of cultural and spiritual aspects to care practices, and the poor interpersonal relationships they experienced. Conclusions Findings revealed that there were many unmet needs during hospitalisation for Indigenous people. Past experiences and future expectations were connected in a way that impacted on participants' current hospitalisation experience. Understanding this context, with incorporation of cultural and spiritual aspects of care may help nurses and other healthcare professionals to provide more positive interactions that in turn may contribute to improved cardiac care experiences of Indigenous people during hospitalisation. Healthcare professionals need to be aware and focused on person-specific and contextualised aspects of Indigenous people's experience of hospitalisation for cardiac care in order to impact outcomes. Relevance to clinical practice Healthcare professionals need to understand Indigenous people's perspectives that contribute to improved health outcomes. Stories of participants' experiences may assist in the identification of aspects which might further the development of culturally appropriate continuity models that could effectively provide support throughout Indigenous people's hospital journeys, and beyond the hospital, and help improve associated health outcomes. [ABSTRACT FROM AUTHOR]

Emergency department overcrowding is an increasing issue impacting patients, staff and quality of care, resulting in poor patient and system outcomes. In order to facilitate better management of emergency department resources, a patient admission predictive tool was developed and implemented. Evaluation of the tool’s accuracy and efficacy was complemented with a qualitative component that explicated the experiences of users and its impact upon their management strategies, and is the focus of this article. Semi-structured interviews were conducted with 15 pertinent users, including bed managers, after-hours managers, specialty department heads, nurse unit managers and hospital executives. Analysis realised dynamics of accuracy, facilitating communication and enabling group decision-making. Users generally welcomed the enhanced potential to predict and plan following the incorporation of the patient admission predictive tool into their daily and weekly decision-making processes. They offered astute feedback with regard to their responses when faced with issues of capacity and communication. Participants reported an growing confidence in making informed decisions in a cultural context that is continually moving from reactive to proactive. This information will inform further patient admission predictive tool development specifically and implementation processes generally. [ABSTRACT FROM AUTHOR]

Background: In Australia, newly graduated registered nurses enter the workforce and a number of these have previous experience as enrolled nurses. For all newly graduated registered nurses, transitioning to the new role can be challenging. Aim: The aim of this study was to explore the experiences of enrolled nurses transitioning to the role of registered nurses to support the development of effective transition programs. Design: An exploratory qualitative design. Methods: In-depth interviews with a purposive sample from one health service in South East Queensland, Australia. Data were analysed thematically. Findings: The three main themes emerging from analysis: a new scope of practice, perceptions of capability, building on experience and knowledge. Conclusions: We recommend assessment of individual learning needs and support during the transition period which acknowledges previous experience and recognises learning required to effectively transition to the role of a registered nurse. [ABSTRACT FROM AUTHOR]