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BACKGROUND: A concern before 2020, physician burnout worsened during the COVID-19 pandemic. Little empirical data are available on pandemic workplace support interventions or their influence on burnout. We surveyed a national sample of frontline physicians on burnout and workplace support during the pandemic. METHODS: We surveyed a stratified random sample of 12,833 US physicians most likely to care for adult COVID-19 patients from the comprehensive AMA Physician Professional Data ™ file. The sample included 6722 primary care physicians (3331 family physicians, 3391 internists), 880 hospitalists, 1783 critical care physicians (894 critical care physicians, 889 pulmonary intensivists), 2548 emergency medicine physicians, and 900 infectious disease physicians. The emailed survey elicited physicians perceptions of organizational interventions to provide workplace support and/or to address burnout. Burnout was assessed with the Professional Fulfillment Index Burnout Composite scale (PFI-BC). Proportional specialty representation and response bias were addressed by survey weighting. Logistic regression assessed the association of physician characteristics and workplace interventions with burnout. RESULTS: After weighting, respondents were representative of the total sample. Overall physician burnout was 45.4%, significantly higher than in our previous survey. Open-ended responses mentioned that staffing shortages (physician, nursing, and other staff) combined with the increased volume, complexity, and acuity of patients during the pandemic increased job demands. The most frequent workplace support interventions were direct pandemic control measures (increased access to personal protective equipment, 70.0%); improved telehealth functionality (43.4%); and individual resiliency tools (yoga, meditation, 30.7%). Respondents placed highest priority on workplace interventions to increase financial support and increase nursing and clinician staffing. Factors significantly associated with lower odds of burnout were practicing critical care (compared with emergency medicine) OR 0.33 (95% CI 0.12 - 0.93), improved telehealth functionality OR 0.47 (95% CI 0.23 - 0.97) and being in practice for 11 years or longer OR 0.44 (95% CI 0.19-0.99). CONCLUSIONS: Burnout across frontline specialties increased during the pandemic. Physician respondents focused on inadequate staffing in the context of caring for more and sicker patients, combined with the lack of administrative efforts to mitigate problems. Burnout mitigation requires system-level interventions beyond individual-focused stress reduction programs to improve staffing, increase compensation, and build effective teams.

BACKGROUND: Coaching has been demonstrated to be an effective physician wellness intervention. However, this evidence-based intervention has not yet been widely adopted in the physician community. Documentation and implementation research of interventions to address physician burnout in real world settings is much needed. OBJECTIVE: Assess the impact of a virtual physician coaching program in women physicians. DESIGN: Pre- and post-intervention surveys administered to participants enrolled in the program (N = 329). Effect size was calculated comparing pre- and post-intervention paired data (N = 201). PARTICIPANTS: 201 women physicians from 40 states in the United States of America and 3 international participants. INTERVENTIONS: Participants were given access to an 8 week virtual coaching program including eight individual, six small group, and 24 large group sessions. MAIN MEASURES: Stanford Professional Fulfillment Inventory (PFI) containing categories for assessing professional fulfillment, burnout, and the Clinician Self-Valuation (SV) Scale (a measure of self-compassion). KEY RESULTS: Burnout was found in 77.1% (N = 155) of participants at baseline, which reduced to 33.3% (N = 67) at completion with large effect size (Cohens d 1.11). The percentage of participants who endorsed significant professional fulfillment started at 27.4% (N = 55) and improved to 68.2% (N = 137) with a large effect size (Cohens d 0.95). Self-valuation improved from 17.9% (N = 36) of the participants endorsing a compassionate self-improvement perspective to 64% of the same participants eight weeks later. The self-valuation metric showed a very large effect size (Cohens d 1.28). CONCLUSIONS: Virtual physician coaching programs led by physician coaches can decrease burnout, improve professional fulfillment, and increase self-compassion. Non-institution-based opportunities for coaching available to any physician across the United States and internationally can facilitate access to effective physician well-being interventions.

BACKGROUND: Health care provider stress and emotional distress were well documented long before the COVID-19 pandemic, and there is growing data suggesting these have increased in response to the pandemic. The goal of this study was to take advantage of the unique experiences of licensed mental health (MH) clinicians working with health care trainees and clinicians before and during the pandemic to identify how this crisis affected both ongoing as well as new sources of stress. The Healer Education, Assessment and Referral Program (HEAR) provides MH screening, support, and MH referrals to ~19 000 health care students, trainees, staff, and faculty. Since its inception in 2009, the program has been staffed by 4 licensed counseling professionals who have worked both before and since the COVID-19 pandemic. METHODS: Qualitative data obtained from semi-structured, 1-hour interviews and a follow-up 1-hour focus group with 4 HEAR counselors was analyzed using reflexive thematic analysis. RESULTS: Several preexisting stressors were amplified during the pandemic: financial concerns; long work hours; exposure to the suffering of illness, death, and dying; bullying; discordant values and moral distress; social inequities; individuals lack of adaptive coping; and individuals self-concept as a victim. New stressors included: health care demand greater than the workforce numbers and resources; caretaking for ill family/friends; homeschooling of children; social isolation; experiencing the COVID-19 crisis as a war, fire, or storm; fear of personal illness and death, especially before vaccines; and hopes of a cure with vaccines; followed by perceived opportunities for improvement in leadership response to staff concerns. CONCLUSION: Authentically responding to staff concerns/ideas, a patient and provider-centered health care culture, grief education and support, and attention to actionable stressors affecting providers well-being are indicated to meet the amplified and new stressors triggered by the COVID-19 pandemic and sequelae.

Background: Regarding the evidence-based practice (EBP) process, nurses tend to perceive that critical appraisal of research articles is challenging. Though critical appraisal in EBP has been a frequent topic in medical education, implementing and disseminating existing EBP education for nurses are challenging in countries with limited EBP educational resources. This study aimed to evaluate changes in practice, attitude, knowledge and skills of EBP before and after an EBP workshop focused on critical appraisal among advanced practice nurses. Methods: This study was a before and after educational intervention study. The workshops were provided in small groups in 2017 and 2018. The targeted nurses were certified nurse specialists (CNSs) who provide patient care and are certified as advanced practice nurses. The workshop was designed to include at least one CNS in each group. The Japanese version of the Evidence-based Practice Questionnaire, with four subscales—practice, attitude, and knowledge and skills of research and practice—was evaluated four times: baseline, immediately after the workshop, and 3 and 6 months after the workshop. At the end of the workshop, the participants wrote their learning objectives and plans for improving their critical appraisal of EBP. A self-reflection questionnaire was distributed 3 months after the workshop, and a qualitative descriptive analysis was used. Results: Eleven CNSs participated in this study. Only the score of the knowledge and skills of research showed a statistically significant change. Many participants did not perform critical appraisal of research articles after the workshop. The facilitators were to have a role in integrating research evidence into practice and the barriers to being too busy, personnel transfers, and insufficient conditions. Conclusions: Self-efficacy for critical appraisal in EBP might increase through the EBP education workshop. Even nurses interested in EBP require ongoing learning opportunities and organizational support for EBP activities. Trial Registration: This study was retrospectively registered with University hospital Medical Information Network Clinical Trial Registry (UMINCTR) on 09/14/2018 (Registration Number. UMIN000034146). [ABSTRACT FROM AUTHOR]

Background: The study aims to assess the situational judgment capability of students in various professions, including medicine, surgical nursing, anesthesia nursing, and emergency medical technology, using a validated and adapted Situational Judgment Test (SJT). Methods: The cross-sectional study was conducted at Qom University of Medical Sciences in 2023–2024. The study consisted of two steps: (1) adaptation and validity assessment of the SJT in various health professions, and (2) evaluation of students' situational judgment capability using the adapted SJT. Participants included 207 students from surgical nursing, anesthesia nursing, medicine, and emergency medical technology departments, selected through stratified random sampling. The SJT included 10 constructed-response scenarios developed by Alkhuzaee and colleagues in 2022. The validation and adaptation process utilized consensus methods, and the SJT was modified to a selected response format based on a knowledge-based approach. Scores ranged from 0 to 30. Cohen's method and norm-referencing standard deviation were used to calculate a cut-off score. Data were analyzed using descriptive statistics (frequency, mean, standard deviation) and inferential statistics (independent t-test, ANOVA, and ANCOVA). Results: The face and content validity of the adapted SJT with a selected-response format was confirmed by expert agreement. The reliability of the SJT was approved, with a Cronbach's Alpha of 0.81. The mean score of students' situational judgment in professionalism was 11.90 (SD 4.54). Students' professions significantly impacted their situational judgment scores (F (3.201) = 3.67, p = 0.01, Partial Eta Squared = 0.052). Conclusion: The adaption and validation of SJT with a selected response format were confirmed by experts who evaluated the situational judgment capabilities of students in different clinical professions. The reliability of the SJT was acceptable—Cohen's method as a standard-setting approach assisted in identifying students needing support and training. The moderate level of situational judgment capacity confirmed the development of the educational program for the improvement of non-cognitive and non-technical skills such as judgment and decision-making in the field of professionalism. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the historical context of the enrolled nurse (EN) and nursing associate (NA) roles • To consider the contribution of roles such as the NA to the overall nursing workforce • To learn about how the experiences of previous roles such as the EN can inform the development of new nursing roles. Background: The enrolled nurse (EN) role (second-level registration) was formalised in the UK in 1961 but phased out from the mid-1980s and training courses leading to second-level registration had ceased completely by 1992. The training and practice experiences of former ENs have garnered interest in recent years due to the similarities between the EN role and the nursing associate (NA) role, which was introduced in England in 2017 to help bridge the gap between healthcare assistants and registered nurses. Aim: To explore the past experiences of former ENs to provide a historical lens through which the contemporary role of the NA can be considered. Method: Semi-structured interviews were undertaken with nine former ENs in learning disability and mental health. Findings: Thematic analysis of interview transcripts generated four main themes – ‘the numbers’, ‘just an enrolled nurse’, ‘a stepping stone’ and ‘considerations for the NA’. Participants valued their EN training and role and believed it had provided them with a foundation on which they could make important contributions to nursing care throughout their careers. However, they also described having a perceived ‘lower status’ than registered nurses, but at the same time were expected to assume responsibilities beyond their scope of practice during workforce shortages. Participants welcomed the concept of the NA role and regarded it as a way of building a strong and reliable nursing workforce but were concerned that NAs could be exploited as a ‘cheaper nursing workforce’ and about the lack of role clarity among the wider nursing and healthcare workforce. Conclusion: Lessons from the historical experiences of former ENs should guide the ongoing development of new roles such as the NA, particularly in relation to ensuring the wider nursing and healthcare workforce are clear about the scope of the role. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your understanding of the stigma associated with personality disorders • To find out how the narrative around personality disorders is evolving • To recognise the need for comprehensive staff training and education about personality disorders. Individuals with a personality disorder diagnosis experience high levels of stigma within society generally and healthcare services specifically. This narrative review analyses the recent literature exploring the stigma associated with personality disorders. The findings offer insights into the ongoing contentious nature of personality disorder as a diagnosis, the issues around misdiagnosis and the prevailing attitudes of healthcare professionals. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To be aware that orofacial clefts are the most common facial congenital abnormalities in humans • To read a case study presenting an overview of the care provided for an infant born with a cleft palate • To recognise the vital role of children’s nurses in supporting family-centred care. Orofacial clefts are the most common facial congenital abnormalities in humans. Their management is complex due to a range of immediate and ongoing challenges. These include breathing, feeding, speech, hearing and dental issues. This article uses a case study approach to outline these challenges for a patient who was born with a cleft palate. The case is followed by a discussion of contemporary evidence-based care. The article focuses on family-centred care and multidisciplinary teamwork, and the author also details the central role of the children’s nurse. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the importance of recognising the specific healthcare needs of children and young people • To be aware of the concerns that have been raised in response to the potential move towards a generalist approach in nursing • To learn about some of the suggestions for protecting the field of children and young people’s nursing and optimising care for this patient group. At certain points in nursing history, it has been necessary to make a case for children and young people to be cared for by specialist nurses educated to meet their specific needs. However, in 2018 the updated Nursing and Midwifery Council (NMC) standards of proficiency for registered nurses adopted a generic rather than field-specific approach. This article reiterates that children, young people and their families have unique needs that are best met by nurses who are trained specifically to care for them. The case is made from a historical and legal perspective, concluding with a proposal that in the best interests of children, young people and their families, the NMC should embed specific competencies for children’s nurses into its standards of proficiency to future-proof this field of practice. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To learn about a project that aimed to support teams caring for children and young people to reflect on their experiences and the effects of the coronavirus disease 2019 (COVID-19) pandemic • To recognise the need to ensure staff are adequately prepared to manage any future surges in respiratory illness effectively • To be aware of the potential long-term effects of the COVID-19 pandemic on emotional health and well-being. The coronavirus disease 2019 (COVID-19) pandemic was a challenging experience for children and young people’s services, and the workforce. The Valuing All Staff Together programme was a one-year project hosted by the North West Paediatric Critical Care, Surgery in Children, Long Term Ventilation Operational Delivery Network to support teams caring for children and young people to reflect on their experiences of the COVID-19 pandemic. Using an online survey, focus groups and interviews, it gave staff the opportunity to explore and understand the effects of the pandemic and the subsequent surge in demand, including how these affected services and the emotional health and well-being of staff. This would enable better preparation for future surges in respiratory illness in terms of learning, training and development. This article describes the programme’s aim, method and findings, and the main recommendations for practice. [ABSTRACT FROM AUTHOR]

Background: Many nurses join the profession because they have altruistic intentions, but some nurses experience barriers to acting on altruistic intentions which may be a source of job dissatisfaction or burnout. Objective: The purpose of this study was to evaluate construct validity, internal consistency, and convergence reliability of the Nursing Altruistic Execution Scale (NAES), a novel instrument assessing the perceived ability to help others through work. Methods: The NAES was developed based upon a literature review examining altruistic behavior as a motivator for nursing work, with expert feedback for instrument refinement. Participants completed the NAES, Copenhagen Burnout Inventory Work-Related Burnout Scale, and Satisfaction of Employees in Health Care Survey. Exploratory factor analysis examined construct validity and factor loadings. Confirmatory factor analysis verified consistency in factor structure. Linear regression assessed for convergence reliability with burnout and job satisfaction. Results: The sample included 843 acute care hospital nurses surveyed in January-March 2023. Exploratory factor analysis revealed a two-factor solution, named altruistic engagement with work and workplace barriers to altruism. Nine instrument items were retained and demonstrated strong internal consistency (Cronbach's alpha 0.79). There was a significant relationship between both factors of the NAES and both burnout and job satisfaction, demonstrating that greater altruistic execution is associated with lower burnout and greater job satisfaction. Conclusion: Preliminary findings support the use of the NAES as a valid and reliable scale. Findings show there is correlation between altruistic intentions and burnout. Interventions aimed at enhancing altruistic execution may reduce nurse burnout and thereby improve retention. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise that overcrowded emergency departments result in ambulance handover delays causing avoidable harm to patients awaiting assessment • To identify how forward planning and anticipatory escalation processes can reduce the potential for patients to experience avoidable harm • To learn how a strategic quality improvement project improved patient safety and the working lives of front-line healthcare professionals. Ambulance handover delays arise when emergency departments become overcrowded as patients waiting prolonged periods for admission occupy clinical cubicles designed to facilitate the assessment and treatment of emergency arrivals. In response, many organisations become reliant on temporarily lodging acutely unwell patients awaiting admission in undesignated areas for care such as corridors, to provide additional space. This results in a significant risk of avoidable harm, indignity and psychological trauma for patients and has a negative effect on the well-being of healthcare professionals, since unacceptable standards of care become normalised. A two-phase strategic quality improvement project was implemented at the authors’ acute trust. Ambulance handover data from between 2 November 2020 and 26 July 2021 provided a benchmark for the project. The first phase was implemented between 2 November 2021 and 26 July 2022 and aimed to reduce 60-minute ambulance handover delays. The second phase was implemented between 2 November 2022 and 26 July 2023 and aimed to eradicate 60-minute ambulance handover delays and improve overall performance. Phase one resulted in a 32% reduction in 60-minute ambulance handover delays. Phase two resulted in a 97% reduction in 60-minute ambulance handover delays. Over the course of the project there was a 24% increase in handovers completed within 15 minutes. This project demonstrates how strategic planning and collaboration between healthcare teams can reduce the potential for avoidable patient harm, while simultaneously promoting workforce well-being and retention. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your knowledge of tools commonly used for breaking bad news to patients and families • To read about the challenges of breaking bad news to patients and families in major trauma care • To reflect on your own experiences of breaking bad news to patients and families. Breaking bad news is a challenging yet essential part of the role of healthcare professionals who care for major trauma patients and their families. This service evaluation investigated healthcare professionals’ attitudes and experiences regarding breaking bad news in the context of major trauma. Healthcare professionals were recruited from the South Wales Trauma Network and their views collected via an online survey based on the Breaking Bad News Attitudes Scale. The survey was completed by 149 healthcare professionals and the responses demonstrated a range of experiences of breaking bad news in major trauma care, with challenges such as the environment, building rapport and setting expectations. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To read the findings of a study that explored patients’ and professionals’ experiences of virtual clinics during COVID-19 • To recognise the need to assess individual patients when considering the use of virtual clinics • To acknowledge the need for appropriate training and equipment for staff to enhance their experience of virtual clinics. Background: The coronavirus disease 2019 (COVID-19) pandemic resulted in the rapid implementation of virtual clinics to conduct consultations via telephone or video to minimise contact between staff and patients. Aim: To investigate the experiences of patients with cancer and healthcare professionals of virtual clinics during COVID-19 and to explore ways to improve their experiences. Method: A qualitative study involving semi-structured interviews with 36 patients and ten healthcare professionals at a London NHS trust. Data were analysed using thematic analysis. Findings: Five themes emerged from analysis – acceptance, benefits, communication, technology and choice. Most participants were accepting of virtual clinics and supported their continuing use. The average satisfaction rating for virtual clinics was higher among patients than among healthcare professionals; many healthcare professionals suggested that support in setting up video-based virtual clinics might improve their satisfaction. Conclusion: Patients’ individual needs should be considered when deciding whether to use virtual or face-to-face clinics, while staff require appropriate training and adequate equipment to enhance their experience of virtual clinics. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your awareness of the communication and information needs of older people with cancer • To recognise that many older people with cancer want to be involved in decision-making about treatment • To acknowledge the benefits of a clinical nurse specialist acting as the main contact within the team. Older people with cancer often have a varying range of specific but fluctuating physical, psychological, emotional, social, economic and spiritual needs. To be able to participate in decision-making, they need optimal communication with healthcare professionals and accurate information from them. A systematic review of the literature explored the communication and information needs of older people with cancer. It appeared that these needs are not always addressed and that older people’s priorities are not always recognised. Barriers to addressing older people’s information and communication needs included personality traits and age-related functional decline, the effects of cancer on the person, a lack of time on the part of healthcare professionals and the absence of a main contact within the healthcare team. To meet the communication and information needs of older people with cancer it is crucial to adopt a person-centred approach. [ABSTRACT FROM AUTHOR]

Background: Together with addressing social determinants of health, culturally safe healthcare provision is essential for closing the health outcomes gap experienced by Aboriginal and Torres Strait Islander (Indigenous) Australians. Rural placements potentially provide students of the health professions with opportunities to enhance their knowledge and skills regarding cultural safety. We used rural placements data systematically collected from allied health students, including commencement- and end-of-placement questionnaire responses, to investigate the determinants of confidence in working with Indigenous people. Methods: The study comprised data from all students who provided survey data at both commencement and end of their first placement directly supervised by the administering University Department of Rural Health during the period 2019–2022. Five-point ordered responses to the question 'How confident do you feel about working with Aboriginal people?' were used to assess student and placement-related determinants of confidence (Confident/Very confident versus other) at baseline and increased confidence (≥ 1 point) during the placement using crude and adjusted multivariable robust Poisson regression. Results: Participating students (N = 489) were from diverse allied health disciplines (including pharmacy n = 94, 19.2%; chiropractic n= 66, 13.5%; physiotherapy n= 65, 13.3%; social work n = 59, 12.1%; and occupational therapy 58, 11.9%). Confidence in dealing with Aboriginal people was lower at commencement among females compared with males (adjusted relative risk [aRR] 0.65; 95% confidence interval [CI] 0.53–0.80), and higher among students of Australian rural origin compared with others (aRR 1.49; CI 1.22–1.83) and those who reported previous experience working with Indigenous people compared with those reporting none (aRR 1.40; CI 1.14–1.72). Placement attributes associated with increased confidence working with Indigenous people between placement commencement and end were interaction with Indigenous people within the placement (aRR 2.32; CI 1.24–4.34), placement model reflecting more structured academic supervision (aRR 1.18; CI 1.02–1.37), and placement length (aRR per additional day 1.002; CI 1.001–1.004). These associations were robust to modelling that accounted for a ceiling effect on increased confidence. Conclusions: While influenced by students' demographic attributes and prior experiences, confidence of allied health students in working with Indigenous people is enhanced during rural placements, particularly through direct contact with Indigenous people. [ABSTRACT FROM AUTHOR]

Objective: Burnout in sonographers is a prevalent and complex professional hazard associated with poorer quality of work life, productivity, and patient outcomes. This study aimed to understand the prevalence of and work systems factors associated with burnout among a large sample of sonographers. Materials and Methods: Research study registry participants (n = 3659) were invited to complete a follow-up survey about personal and work environment factors, including work hours, break time, coworker and supervisor support, and job satisfaction, overall health, and sleep quality. The Copenhagen Burnout Inventory assessed personal, work-related, and client burnout. Simple and multiple linear regressions were used to identify work systems factors associated with burnout. Results: Of 1389 respondents, over half reported moderate-to-severe personal and work-related burnout, while one-quarter reported moderate-to-severe client burnout. Higher work-related burnout was associated with younger age, working in the Western United States, working full-time, taking fewer weekly break hours, poorer overall health and sleep quality, and lower supervisor support and job satisfaction. Client burnout was associated with poorer sleep quality and lower job satisfaction. Conclusion: Burnout was prevalent in a large sample of sonographers. Multilevel work systems factors are associated with burnout, suggesting collaboration among sonographers, administrators, and organizations is needed to address burnout. [ABSTRACT FROM AUTHOR]

Compensation is a key component of career satisfaction and professional growth. A new compensation model was developed to provide a framework for career growth and a compensation ladder for medical physicists with clinical responsibilities in an academic radiation oncology department. The goals for the new model were: (1) create a market competitive plan to support recruitment and retention of top physics talent, (2) incentivize clinical effort, innovation, citizenship/professional service, and academic achievement, (3) provide compensation growth opportunities separate from medical school promotions, and (4) create consistent, transparent, and fair metrics applicable to all clinical physicists in the department. The model includes a base salary, and credits for board certification, clinical tier, leadership, and academic level. Further, metrics were developed to inform the clinical tier. Years of experience is not explicitly included in the model. The model was successfully implemented for clinical physicists in a relatively large academic radiation oncology department. [ABSTRACT FROM AUTHOR]

Introduction Methods Results Conclusion Occupational burnout can be associated with negative feelings about the workplace and feeling that a person's efforts are of little consequence. Within a healthcare setting, occupational burnout can be attributed to a high workload or a non‐supportive work environment. Higher levels of burnout are associated with increased absenteeism and turnover, increased medical errors and decreased patient care. The aim of this study was to investigate the levels of occupational burnout within nuclear medicine technologists (NMTs) working in Australia and New Zealand.An online questionnaire was distributed via QuestionPro. The questionnaire consisted of four sections, including the Professional Quality of Life Scale (ProQOL) Version 5 (2009) measuring compassion satisfaction, burnout and secondary traumatic stress in the workplace. For this study, only the burnout component of this scale is reported.There were 162 survey responses. Of the 18 New Zealand participants, 10 (56%) reported moderate levels of burnout. Of the 144 Australian participants, 114 (79%) reported moderate levels of burnout. No NMTs reported high levels of burnout. All states of Australia were represented in the survey, with Queensland, Western Australia and Victoria having the highest number of participants reporting moderate levels of burnout.This study revealed that more than half of New Zealand participants and three quarters of Australian participants reported moderate levels of burnout. It is imperative to address the wellbeing needs of NMTs working in Australia and New Zealand at an individual and organisational level to support NMTs to be more engaged in their work and help organisations retain staff. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To refresh your knowledge of risk factors for suboptimal oral health in people with learning disabilities • To recognise the importance of education and training for healthcare professionals and carers to support oral health for people with learning disabilities • To read about interventions that can be used to support access to dental care for people with learning disabilities. People with learning disabilities have poorer oral health compared with the general population. Risk factors for suboptimal oral health in this group include diet, reliance on others for oral care and barriers to accessing dental care. This article discusses these risk factors and considers the importance of education and training for carers and healthcare professionals, including dentists and dental students, to enhance oral health in people with learning disabilities. The author uses a fictional case study to illustrate some of the challenges experienced by people with learning disabilities in accessing oral care and how the use of interventions such as desensitisation programmes, as well as reasonable adjustments, can help address these challenges. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise the importance of education, reasonable adjustments and medication reviews in supporting optimal medicines adherence in people with learning disabilities • To enhance your awareness of factors that contribute to suboptimal medicines adherence in people with learning disabilities • To acknowledge the importance of involving family or carers in supporting medicines adherence. Rationale and key points: People with learning disabilities often have long-term conditions that require the regular use of medicines. Medicines adherence can be particularly challenging in this population and support with taking medicines is often not provided in a way that meets people’s needs. Suboptimal medicines adherence can negatively affect the health outcomes of people with learning disabilities, which are already poorer than those of the general population. • Achieving optimal medicines adherence among people with learning disabilities requires a multi-component strategy that includes education, reasonable adjustments and medication reviews. • Factors that cause and/or contribute to suboptimal medicines adherence among people with learning disabilities include burdensome medicine regimens, medicines prescribed in unsuitable forms, overmedication and overprescribing, lack of medication reviews, lack of reasonable adjustments, suboptimal communication from healthcare professionals and suboptimal care coordination. • Family and carers are often those who administer medicines, so it is crucial to involve, educate and support them about the person’s medicine regimen so that they can help ensure the medicines are taken as prescribed. Reflective activity: ‘How to’ articles can help you to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when supporting a person with a learning disability to take their medicines as prescribed. • How you could use this information to educate nursing students or colleagues on the appropriate actions to take to support a person with a learning disability to take their medicines as prescribed. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To develop your knowledge of rare epilepsy syndromes • To enhance your understanding of the association between epilepsy and learning disability • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers). Epilepsy is more prevalent in people with learning disabilities than in the general population and there are a number of rare epilepsy syndromes closely associated with learning disability. These syndromes are challenging to manage, notably because seizures are often refractory, the risk of status epilepticus is high and comorbidities are usually present. People with a rare epilepsy syndrome need high levels of specialist support throughout their lives. Such syndromes are rare, but professionals who care for people with learning disabilities are likely to encounter them at some point in their career. Improved knowledge and understanding of rare epilepsy syndromes can assist learning disability nurses to provide adequate information, care and support to service users, family members and paid carers as well as to other healthcare professionals. This article explains the association between epilepsy and learning disability, describes rare epilepsy syndromes and explores the goals of treatment, additional treatment options and challenges of management. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your understanding of civility and incivility in the workplace and the associated consequences • To read an action plan for nurse managers to assist their colleagues, team and organisation recognise and act on workplace incivility • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers). Incivility is a major concern in healthcare, and it is vital that uncivil behaviour is recognised and addressed. Manifestations of incivility are wide ranging and can take the form of microaggressions, which are difficult to pinpoint but have significant repercussions. Research has demonstrated the negative effects of incivility on staff and patients. Uncivil acts and behaviour can create conflict, reduce performance, affect morale, decrease retention and jeopardise patient safety. The role of nurse managers in reducing incivility and promoting civility includes providing leadership, fostering psychological safety, creating a shared understanding of civil behaviour and managing uncivil behaviour as soon as it occurs. The input of employers is crucial to promote a compassionate and inclusive organisational culture and to support nurse managers to acquire the knowledge, skills and confidence to prevent and reduce incivility. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise the importance of self-awareness in effective nurse leadership • To enhance your understanding of the benefits of self-awareness for nurse leaders and managers • To identify practical tools and educational methods that you can use to enhance your self-awareness. Self-awareness is a crucial component of effective leadership. Leaders who are self-aware exhibit an understanding of their strengths and limitations, as well as an ability to manage their emotions and those of their team members. Heightened self-awareness and understanding of oneself and others can have benefits in terms of increasing confidence and enhancing communication. Moreover, nurse leaders and managers need self-awareness to identify their strengths and weaknesses, navigate complexities, foster positive relationships and cultivate a culture of continuous improvement. This article defines self-awareness, discusses its importance for nurse leadership and identifies various tools and methods that nurses can use to develop their self-awareness. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To gain an understanding of nurse managers’ experiences of the COVID-19 pandemic • To appreciate that fear, related to fear of infection and information overload, was a major issue for nurse managers during the pandemic • To consider adopting already-established COVID-19 guidelines to support effective infection control procedures and communication in future pandemics. Background: Research shows that front-line nurses’ workload and stress levels increased during the coronavirus disease 2019 (COVID-19) pandemic, however, there is little research of these factors in relation to nurse managers. Previous research undertaken in Austria found that some nurse managers working in nursing homes undertook clinical as well as managerial functions during the pandemic, a double burden that could have increased their stress levels and have had adverse psychological, physical and social consequences. Aim: To investigate the effects of the COVID-19 pandemic on nurse managers’ workload, perceptions of teamwork and stress levels, and the physical, psychological and social consequences of working during the pandemic. Method: A cross-sectional design was used. Respondents (n=238) were sent an online questionnaire during the second wave of the pandemic (which in Austria was November 2020 to March 2021) containing questions on demographics and fear of infection, their current workload compared with pre-pandemic workload, their perceptions of the influence of the pandemic on teamwork, their levels of stress measured using the Perceived Stress Scale (PSS), and the physical, psychological and social consequences of working during the pandemic. Results: Most respondents (95%) had to undertake more or much more work than usual during the pandemic, while just over half (52%) perceived that the influence of the pandemic on teamwork had been positive throughout or partially positive. Overall, the respondents’ level of stress was moderate, as measured by the PSS. Around 28% of respondents were afraid of infecting someone other than themselves, notably their families, employees and patients. Fear for themselves, their families and their patients or residents were commonly reported psychological consequences of working during the pandemic, while confusion due to information overload was the second most commonly reported psychological consequence. Conclusion: Comparing results with previous research is difficult due to the lack of research of nurse managers’ experiences of the pandemic. Fear appears to have been a major issue for nurse managers during the pandemic, particularly in relation to infection and information overload. This emphasises the need for healthcare organisations to focus on the mental health and well-being of nurse managers, as well as front-line staff, during and after crisis situations such as a pandemic. Organisations may consider reworking and adopting already-established COVID-19 regulations, schedules and local guidelines, particularly in terms of communication and infection control, which could help to reduce nurse managers’ fear in future crisis situations. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise the important role of nurse managers in ensuring that nursing staff feel supported • To identify how nurse managers can support staff when there are concerns about practice • To consider ways of fostering a climate of psychological safety in your practice. The nursing profession is under growing pressure and many nursing staff find it increasingly challenging to maintain standards and provide safe, effective and efficient care that meets the needs of patients. Nurses’ job satisfaction is predicated on feeling supported, including when there are concerns about practice – whether their own or that of their colleagues. This article discusses how nurse managers can support staff to challenge suboptimal practice, admit their own errors and learn from these by fostering a climate of psychological safety. This includes adopting a relational model of leadership; cultivating open communication; providing clarity on roles and expectations; ensuring transparency and fairness in performance management; having supportive ‘tough conversations’ with staff; demonstrating objectivity when investigating concerns; and promoting a ‘just culture’. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the challenges of managing diabetes mellitus alongside dementia • To learn about the importance of sharing patient information among healthcare professionals in various settings • To consider how the use of IT might promote more effective communication between specialties. Background: Managing diabetes mellitus alongside the onset and development of dementia poses many challenges for those living with these conditions as well as their families, carers and service providers. Aim: To describe nurses’ positive experiences when managing adults with diabetes and dementia, as well as the issues and challenges. Method: Qualitative, semi-structured focus group interviews were conducted with community and diabetes specialist nurses drawn from five health and social care trusts. Findings: Four themes were identified: whose responsibility is it?; community and diabetes specialist nurses – the pivot point; education to manage comorbidities; and interprofessional communication. Conclusion: Community and diabetes specialist nurses experience many challenges when supporting individuals living with diabetes and dementia. Sharing patient information among practitioners in different settings is critically important. IT could overcome the limitations of note-keeping ‘silos’, but further education is recommended to establish more effective communication and partnership working. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise that health inequalities can act as barriers to cervical screening • To read about a general practice project that aims to increase uptake of cervical screening through addressing health inequalities • To acknowledge the importance of co-production in interventions that aim to reduce health inequalities. Cervical screening is a crucial intervention to detect cervical cancer at an early stage and reduce mortality rates. Early detection through regular screening can significantly improve treatment outcomes and survival rates. However, health inequalities can obstruct access to cervical screening services, which leads to disparities in outcomes among different population groups. This article discusses barriers to cervical screening and describes a general practice project in Suffolk that aims to address health inequalities related to uptake of cervical screening through various interventions, including training for clinical and non-clinical staff and provision of patient information and education. [ABSTRACT FROM AUTHOR]

Introduction: The demand for occupational therapy services in Australia has experienced considerable growth in the last decade. Despite an increase in occupational therapy numbers, there remains a substantial workforce shortage. One reason for this shortage is difficulty with the retention of occupational therapists and subsequent workforce attrition. The literature attributes planning to leave as being influenced by high workloads, insufficient time, a negative workplace culture, and stress impacting well‐being. However, much of this research is specific to a practice area, such as mental health, and does not explore the experiences of those who have already left. Knowing why people leave occupational therapy will inform our understanding of how to support and retain our occupational therapy workforce. Methods: A qualitative study was undertaken using narrative inquiry in an Australian context. In 2022, stories were gathered from six former occupational therapists who left within the previous 5 years. Data were collected via semi‐structured in‐depth interviews using Zoom. Interviews were recorded and transcribed verbatim. The data were analysed using narrative and thematic analysis. Findings: Four themes were developed: "I just want to help this person"; "there was no real understanding"; "Trying to find where occupational therapy fits for me"; and "I'm not able to continue ... anymore." Participants experienced dissonance between enacting their occupational therapy values and the expectations of their management. They were challenged by unsupportive workplace cultures and leadership styles that undermined their autonomy. They responded with resilience, and trying new ways to continue being occupational therapists, but became increasingly uncomfortable and stressed until they reached a tipping point where they decided to leave. Conclusion: Increasing leadership development within the profession is essential, along with creative strategies for meeting funding requirements and fulfilling occupational therapy values. Workplaces that provide autonomy and respect the occupational therapy role are likely to support retention. PLAIN LANGUAGE SUMMARY: Occupational therapists are leaving the profession, leading to not having enough occupational therapists in the workforce to meet the needs in Australia. This research asked people who had left the occupational therapy profession to share their stories about why they chose to leave. Six people agreed to participate in an interview, and analysis of this data led to the development of four themes to represent their collective experiences. We found that participants were frustrated by being unable to help their clients in ways that aligned with their occupational therapy values, and they did not always feel supported by their managers when they expressed their concerns. They described their autonomy as constrained by funding models and external processes, and while they tried different strategies to address their growing disillusionment, they eventually decided to leave the profession. This decision was accelerated by issues arising with their health and well‐being, which they attributed to the stressors they were experiencing. This research highlighted a need to closely align work processes with the occupational therapy role and instill workplace cultures that are supportive with sufficient flexibility for occupational therapists to have appropriate autonomy. A review of leadership structures and creative strategies for meeting both the employer and employee expectations is recommended. The participants were all women, but they came from diverse practice areas with a wide range of years of experience prior to leaving. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the complexities of assessing pain in older people with normal, mildly impaired or severely impaired cognition • To recognise the benefits and limitations of different tools for assessing pain in older people with normal, mildly impaired or severely impaired cognition • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers). Pain is a relatively common experience among older people, but unrelieved pain has significant functional, cognitive and emotional consequences for this population. A comprehensive and accurate pain assessment is essential for effective pain management. Self-report tools are suitable to assess pain in older people with normal or mildly impaired cognition, while observational tools are suitable for use with those with significant cognitive impairment or communication difficulties. However, pain assessment in older people can be challenging. The use of one tool on its own is rarely sufficient and it is crucial to involve family carers in assessment of pain in older people with severe cognitive impairment. This article discusses different tools and strategies, including the benefits and limitations, for assessing pain in older people. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To refresh your knowledge of what critical reflection entails and its potential benefits • To enhance your understanding of some of the reflective models that nurses can use to support them • To consider how you could use critical reflection to enhance your practice. Reflection is an essential aspect of nursing practice that facilitates continuing professional development and practice improvement. Critical reflection is a more in-depth form of reflection and can be described as a creative, dynamic and transformative learning process that enhances practice by promoting self-awareness and critical thinking. Older adults often present with complex and multiple healthcare needs. Engaging in critical reflection can assist nurses to provide the high-quality, person-centred care required to meet those needs, support older people to retain their independence and enhance their well-being. This article discusses critical reflection within the context of nursing older people and describes various models that can be used to support the reflective process. The authors use a practice example to illustrate how using critical reflection in practice can enable nurses to develop a deeper understanding of themselves and use what they have learned to enhance their delivery of person-centred care. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand how skin tears commonly develop in older people with fragile skin • To appreciate that while skin tears are normally acute, they can develop into chronic, non-healing wounds • To learn more about prevention, evaluation and treatment of skin tears in older people. Skin tears are common injuries that result from mechanical forces. Older people with fragile skin are at greater risk of this type of wound. They are usually categorised as acute wounds that typically heal in 7-21 days but the healing process can be disrupted, leading to chronic, non-healing wounds. They have the potential to compromise quality of life and disrupt daily activities, so it is important to identify risk factors and implement prevention strategies for those at risk. An interdisciplinary approach has a pivotal role in promptly and precisely identifying skin tears, and the use of evidence-based interventions for efficient skin damage management can enhance the recovery process. This article adopts a case study approach to explore the prevention, evaluation and treatment of skin tears, using the case of an individual living with a skin tear in a community setting. [ABSTRACT FROM AUTHOR]

Objective: The limited research funding available needs to be directed towards stakeholder-identified priorities that will have the largest positive impacts on mental health. This study aimed to identify consensus mental health research priorities across lived experience and mental health professional panels. Method: A modified Delphi study with two panels (lived and professional experience in mental health) was used to identify priorities over three rounds. Priorities were rated on a 9-point scale from not important, important but not critical, to critical. Consensus (≥80% agreement on items rated ≥ 6 in importance across both panels) was analysed descriptively. Results: 1015 initial potential priorities and 18 additional priorities were rated by panel members (N = 120, 52 lived experience, 68 professionals), with 608 priorities achieving consensus across 23 mental health domains. Priority themes included: services; prevention, early intervention, detection and health promotion; intersectionality; determinants of mental health; translation; culture, spirituality and wellbeing (identity); suicide and self-harm; data and technology; capacity building; trauma; physical health; stigma and shame; help-seeking and coping; and co-design. Conclusions: There was high agreement across stakeholders on mental health research priorities, which may provide a basis for funding allocations for impactful research that would improve the mental health of the community. Key Points: What is already known about this topic: There is very limited funding for research in mental health. It is essential to identify what areas of mental health research would be most relevant and meaningful to the community. Co-design is important for authentic participation in priority-setting between different stakeholders in the community. What this paper adds: People with lived and/or professional experience identified research priorities across a broad array of mental health challenges, populations, and settings in the Australian community. The mental health research priorities can be used to guide policy, funding, and researchers in conducting future projects. Results pointed to the need for more research in a range of critical areas within the themes of services-based research; prevention, early intervention, detection and health promotion; and intersectionality. [ABSTRACT FROM AUTHOR]

The Chiropractic Educators Research Forum convened a conference on June 22, 2024. During this meeting, attendees shared what chiropractic programs are doing, specifically focusing on education research related to technology. Presenters and panelists discussed what technology chiropractic programs should be using to educate chiropractors for the future. [ABSTRACT FROM AUTHOR]

Racial and ethnic minority groups are underrepresented in chiropractic education and the profession, and are less likely than individuals identifying as White to have access to or use chiropractic care. Stakeholders with leadership positions in USA-based chiropractic colleges and organizations participated in 3 online diversity, equity, and inclusion (DEI) summit meetings to foster a deeper understanding of DEI, identify DEI objectives, and develop action steps and drive change. Summit I (51 attendees) comprised 3 presentations that provided background about DEI in chiropractic education and practice. Summit II (32 attendees), comprised 4 breakout sessions addressing organizational issues in DEI. Summit III (65 attendees) comprised 5 collaborative sessions focused on implementation of DEI objectives. We use aggregate data and qualitative summaries to provide a descriptive narrative. Data sources include pre/post-summit quantitative surveys, items from open-ended questionnaires, and a spreadsheet of recommendations for increasing organizational DEI. Before attending Summit I, 48% rated their understanding of DEI issues as "moderately" or "very" high, compared with 74% afterward. Summit II participants suggested actions that should be taken by their institutions and the profession. Summit III participants stressed the need for DEI-supportive data, policies, and resources. They identified > 150 action steps to address DEI objectives. A listserv was established to facilitate ongoing institutional collaboration. Summit participants recognized the importance of developing a diverse, culturally aware chiropractic workforce. The summits provided structure and support for stakeholders to effectively plan for and implement DEI in their organizations and institutions. [ABSTRACT FROM AUTHOR]

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Aim Background Methods Finding Conclusion Implications for nursing and health policy To explore the interplay between the perceived nursing work environment, general self‐efficacy, and compassion fatigue among registered nurses in Chinese hospitals.Compassion fatigue emerges as a significant occupational stress response globally, with the nursing work environment being a pivotal influencer. There is a knowledge gap in understanding how the nursing work environment and general self‐efficacy interrelate to affect compassion fatigue, particularly among Chinese nurses.Employing a cross‐sectional, descriptive design, this study utilized validated questionnaires to gather data from 7085 nurses across public and private hospitals in China. The analysis focused on assessing the interrelations among the perceived nursing work environment, general self‐efficacy, and different dimensions of compassion fatigue.More than half (65.67%) of the participants experienced moderate or high burnout levels, with 76.43% experiencing secondary traumatic stress. The lowest rating in the nursing work environment was for nurse/physician collaboration (10 ± 2.07), while general self‐efficacy scored higher (27.54 ± 6.26). A positive relationship existed between the work environment and both general self‐efficacy and compassion satisfaction, with a negative correlation to burnout and traumatic stress. General self‐efficacy was a partial mediator in the link between work environment and compassion fatigue, suggesting that improving the work environment can decrease compassion fatigue by boosting nurses' self‐efficacy.This study underscores the profound impact of the nursing work environment on compassion fatigue, mediated by general self‐efficacy. It highlights the necessity of fostering a supportive work environment to enhance nurses' self‐efficacy and overall well‐being.Healthcare managers and institutions must create supportive work environments to reduce compassion fatigue among nurses. This includes professional development programs to enhance self‐efficacy and job satisfaction. Policies should address high workloads and inadequate support. Nurse leaders should foster environments that promote psychological well‐being, improving outcomes for both nurses and patients. Regular assessments and adjustments of work conditions are essential to maintain a healthy work environment. [ABSTRACT FROM AUTHOR]

Background: Early- to mid-career academics (EMCAs) represent a core component of the Australian higher education workforce. These academics experience major challenges to their wellbeing, driving a strong desire to leave academia. Objectives: Determine (1) EMCA awareness of, and engagement with, previous University- and Faculty-level diversity and inclusion events/initiatives and (2) opportunities and solutions to address previously reported diversity and inclusion issues experienced in the workplace. Methods: 114 EMCAs in medicine, dentistry and health sciences completed an electronic cross-sectional survey. The survey contained a list of University- and Faculty-provided diversity and inclusion initiatives and sought respondent ratings of interest, awareness (knowing/hearing about) and engagement (attending/applying/participating). Two in-person focus groups comprising participants who opted in during the survey or who responded to broader advertising were conducted. Both groups explored opportunities and solutions to address diversity and inclusion issues reported in an earlier organisation-wide survey. Results: Whilst early- and mid-career academics reported high interest in diversity and inclusion events, they also reported limited awareness and engagement with these events, feeling unsupported to engage or perceiving consequences for workload. Focus groups identified five themes related to opportunities and solutions to address diversity and inclusion issues experienced in the workplace (1) enhanced relational support for career progression, (2) clear and transparent processes for efficient working, (3) reducing structural barriers to create opportunity, (4) improved financial renumeration, and (5) improved transitions and pathways. Conclusion: Early- and mid-career academics often felt unable to engage with activities outside of their immediate work responsibilities, such as events about diversity and inclusion, due to feelings of high workload. A systems approach to deploying targeted strategies to address these wellbeing challenges is recommended to sustain and retain this critical workforce. [ABSTRACT FROM AUTHOR]

Interprofessional education (IPE) is a teaching method that improves collaboration and communication across health professions. There are consistent reports of poor interprofessional collaboration and communication between conventional health professionals and traditional and complementary medicine (TCM) professions. The application of IPE within courses that provide training in TCM requires close examination. This research aimed to identify the state of the art in IPE in TCM teaching. A scoping review was conducted. Thirteen databases were searched to identify citations up to March 2021. Thirty articles were selected after filtering for relevance against the inclusion criteria. The included articles were categorized into four a priori categories: Knowledge and Attitudes of students and professionals about TCM and IPE; Competencies of IPE in TCM; Teaching about TCM using IPE and Challenges and Opportunities for IPE in TCM. Nineteen of the included articles reported empirical research and primarily presented the evaluation of IPE activities within TCM courses or workshops; six studies consisted of texts with propositions and theoretical analyses; and five were case/experiential reports of IPE and TCM interventions, with or without evaluation of results. The studies report all health science students (undergraduate and graduate) exposed to IPE demonstrate a decrease in prejudice and an increase in knowledge about TCM. A sense of partnership developed through the collaborative competencies common to IPE and TCM and integrated care of patients. IPE in the context of TCM has been used for fostering integrative health care through the collaborative work of professional teams. Implementing IPE in TCM teaching requires inclusion in the curriculum, primarily undergraduate and research training. [ABSTRACT FROM AUTHOR]

Context: A comprehensive understanding of the patient's decision-making process helps a dentist to successfully present a range of treatment possibilities. Aim: The purpose of this study was to examine how patients choose dental services and clinics and how they make decisions about those visits. Materials and Method: From April 2023 and September 2023, 584 participants who were seen in the Dental Outpatient Department participated in a cross-sectional survey. Willing participants were given a questionnaire with 15 questions addressing different facets of patient perception. Informed consent was obtained from the parents. Both English and local Tamil languages were used to structure the questions, which centered on patient viewpoints, expectations, decision-making, lowering anxiety, and recommendations for new dental procedures. Result: Important behavioral insights were collected from the study. The majority of participants stated that they will ask their opinion on dental care. They prefer to visit dental clinics when problems arise. They knew about dental clinics through the Internet and per group preference. The majority of participants reported that dental clinic preference is based on proximity and popularity. They prefer specialist and multispecialty dentistry. The majority of participants prefer brand and longevity for the purchase of dental procedures. Social media is a major factor in dental clinical search. The majority of participants preferred an explanation of procedure before and anxiety reduction if a complaint is addressed. The majority of participants prefer the quality of treatment and truthfulness of dentist recommendations. Conclusion: Dental professionals must comprehend the decision-making processes of their patients. Establishing patient satisfaction and trust requires open communication, high-quality care, and honesty. To properly meet patients' expectations, dentists should be honest in addressing their worries and offering assurances on the course of treatment. [ABSTRACT FROM AUTHOR]

Multiple stakeholders are impacted by the quality and efficacy of MSW education and training, the most important of which are the clients and communities whom social workers serve. Unfortunately, a persistent gap between MSW education and translation and applicability into practice post-graduation has been identified. The current stakeholder feedback project was undertaken as part of a Canadian School of Social Work community-engaged approach to curriculum review and development. Seven focus groups were conducted with 53 stakeholders, representing MSW faculty and staff, students newly entering the program, students nearing graduation, alumni, field instructors, employers of graduates, and the provincial regulatory college. Stakeholders were invited to share their perspectives on various elements of the MSW program and experience, including knowledge and skills training. A qualitative content analysis of feedback shared across stakeholders highlighted three overarching themes associated with knowledge and skills training: 1) required knowledge, 2) required skills, and 3) site of learning. Considerations for those involved in MSW curriculum development, review, and evaluation are proposed and discussed; with an emphasis on the importance of bridging the gap between theory and practice. [ABSTRACT FROM AUTHOR]

Introduction: Psychological exhaustion, disengagement, and diminished performance are the hallmarks of burnout. It can impact individuals engaged in employment involving interpersonal interactions, particularly in high-demand fields like healthcare. There exists a strong correlation between a significant degree of burnout among healthcare personnel and a notable decline in productivity. The purpose of the study is to examine the incidence of burnout and the related factors amidst the Covid-19 pandemic, among healthcare practitioners (HCP) working in governmental health clinics in Kuantan, Pahang, Malaysia. Materials and methods: From October 2021 to October 2022, a cross-sectional study of HCP who work at 14 government health clinics in Kuantan, Pahang, Malaysia, was conducted. A validated, self-administered Malay version of the Oldenburg exhaustion Inventory (OLBI-M) was used to assess the level of exhaustion among participants. The average score was used to classify the degree of exhaustion. Using logistic regression, the association between burnouts and socio-demographic profile was examined. Results: With a response rate of 93.5%, a total of 332 individuals were enlisted. Participants with burnout were 29.5% of the total. Factors that was significantly associated with burnout were the position as doctors (AOR 0.24, 95% CI = 0.12, 0.48) and perception of underpaid (AOR=1.85, 95% CI=1.04, 3.31). Conclusion: The current study indicates a lower rate of burnout among healthcare professionals (HCP) compared to prior research findings. Nevertheless, this number holds significance for our purposes. Prioritising the mitigation of burnout among healthcare professionals should be regarded as a crucial imperative for ensuring the sustainable provision of patient care amidst the ongoing epidemic. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate factors associated with burnout among healthcare workers (HCWs) in a tertiary hospital in Singapore. Methods: All HCWs from the Singapore General Hospital were invited to participate in a survey using a secure online platform. Participant demographic data were collected. Instruments used included the Oldenburg Burnout Inventory (OLBI), the Connor-Davidson Resilience Scale, the Patient Health Questionnaire-4, a brief form of the Perceived Social Support Questionnaire, the Demand-Control-Support Questionnaire, and the Leisure Time Satisfaction Scale. Results: Of 9888 staff, 742 (7.5%) responded. The mean OLBI score was 43.7, whereas the mean exhaustion subscale score was 22.5 and the mean disengagement subscale score was 21.2. Of the participants, 53.6% and 50.0% met the cut-off values for disengagement and exhaustion, respectively. In the linear regression analysis, those aged 20 to 29 years had higher OLBI scores than those aged >40 years (ß = 1.88, p = 0.001). Higher OLBI scores were associated with higher Patient Health Questionnaire-4 scores (ß = 0.52, p < 0.001), including the subscales of anxiety ß= 0.30, p = 0.038) and depression (ß = 0.70, p < 0.001), lower scores for resilience (ß = -0.20, p < 0.001), particularly in the subscales of self-efficacy (ß = -0.37, p = 0.018) and cognitive focus (ß = -1.02, p < 0.001), higher psychological demand subscale scores (ß = 0.62, p < 0.001) and lower decision latitude subscale scores (ß = -0.33, p < 0.001) and lower social support subscale scores (ß = -0.47, p < 0.001), and lower Leisure Time Satisfaction Scale score (ß = -0.55, p < 0.001). Conclusion: Among HCWs in a Singaporean hospital, burnout was associated with age <40 years, the presence of anxiety and depressive symptoms, low resilience, high psychological demands and low decision latitude and social support, and low leisure time satisfaction. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To refresh your knowledge of the aims of and processes involved in triage • To enhance your understanding of the strategies you can use to make triage as safe and effective as possible for patients and staff • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers). Triage is the first stage of a patient’s journey through the emergency department and is used to determine patient acuity. There is no single quantifiable metric for determining acuity, which amalgamates different factors that are more or less relevant depending on the patient’s presentation. This article explains the aim and process of triage and how nurses can ensure the process is effective and safe. The author discusses strategies nurses can use to mitigate uncertainty and to make their acuity assessments rapid, targeted and comprehensive. The author also highlights triage safety considerations, including infection prevention and control and the physical and emotional safety of patients and staff. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To consider the use of body-worn cameras for nurses in EDs in response to increasing violent and aggressive incidents • To read about one hospital’s experience of introducing body-worn cameras for ED nurses • To recognise the importance of testing and evaluating the use of body-worn cameras before full implementation of such equipment. Nurses and other emergency department (ED) staff often experience verbal and physical abuse as part of their everyday work. Body-worn cameras are one tool that ED staff can use to try to reduce workplace violence and abuse and have been shown to be effective in other healthcare environments, such as mental health units. This article describes a pilot service evaluation which used a survey to assess the effectiveness of using body-worn cameras for staff in the author’s ED. Findings suggest that nurses believed the cameras provided support when they were confronted by abusive or aggressive patients or relatives and in some instances diffused potentially violent situations. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your understanding of the training needs of ward nurses who manage major trauma patients • To read about the development and evaluation of a bespoke major trauma course for ward nurses • To identify potential challenges in quality improvement projects and how they can be addressed. Nurses working with major trauma patients in ward environments in the UK are expected to evidence their knowledge and skills in a set of national competencies. This article describes a bespoke major trauma course and a coaching and portfolio development programme designed to enhance ward nurses’ knowledge and skills, help them evidence their competence and support their professional development. Evaluation of the course showed an overall improvement in nurses’ self-rated competence and confidence in a range of relevant major trauma topics and clinical skills. Evaluation of the coaching and portfolio development programme showed that nurses believed their knowledge and skills had improved after taking part and that they valued the opportunity for professional development. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the link between severe mental illness and suboptimal physical health • To enhance your knowledge of the complex and multifaceted causes of diagnostic overshadowing • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers). People with severe mental illness (SMI) often have suboptimal physical health and associated outcomes. An important issue for mental health nurses to be aware of is diagnostic overshadowing, which occurs when healthcare professionals misattribute a person’s physical health symptoms to their existing mental illness. This misattribution increases the likelihood of delays in treatment, potentially giving rise to complications that further negatively influence health outcomes. While the causes of diagnostic overshadowing are complex and multifaceted, mental health nurses need to ensure that their practice is not a contributing factor, which requires ongoing self-reflection on their knowledge, skills and attitudes. This article defines diagnostic overshadowing, proposes potential explanations for why it may occur and offers practical strategies to prevent it. Raising awareness of diagnostic overshadowing could help to improve physical health outcomes for people with SMI. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To be aware of the factors that can increase military veterans’ risk of mental health issues • To recognise the barriers to accessing support and treatment for harmful alcohol use among veterans • To consider how nurses could use a culturally competent compassionate approach when caring for veterans. Most military veterans adjust to civilian life successfully, but some may experience challenges related to their life before enlistment, their military service and/or their transition back to civilian life. These challenges can result in the development of mental health issues, including alcohol-related harm. Despite significant investment in veteran-specific healthcare services, some veterans delay or avoid accessing support for alcohol-related issues for various reasons related to military culture, perceptions of stigma and feelings of shame. Nurses are well placed to assist veterans to access support and/or to support their recovery by providing culturally competent compassionate care and interventions. This article provides an overview of alcohol use among veterans and explains some of the barriers to seeking treatment and support. The authors discuss concepts of self-compassion and consider how nurses can use a culturally competent compassionate approach to assist veterans to develop self-compassion through concepts that are acceptable to them. The authors also consider how nurses can enhance their cultural competence in this context through education and training. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To identify the importance of prioritising oral and dental health education for children, starting from birth, to prevent tooth decay and promote overall well-being • To be aware of advice that can be shared with parents to improve their child’s oral and dental health • To recognise the crucial role of nurses, midwives and community practitioners in promoting oral health in early childhood, particularly as children’s exposure to dentists is usually delayed. Tooth decay remains one of the most common preventable oral health concerns in children. After birth, advice to caregivers predominantly focuses on medical health with little attention paid to dental health. Before discharge from the maternity unit and during future hospital and community appointments, opportunistic dental advice should be provided by midwives, nurses and health visitors where possible, with the aim of preventing early onset dental disease. Registering with a dentist at birth is crucial due to long NHS dental waiting lists. Simple advice on toothbrushing should be offered, including brushing twice a day with a soft toothbrush using an age-appropriate amount of fluoride toothpaste. Mothers should be provided with information on the benefits of breastfeeding for oral health alongside tailored preventive care. Appropriate advice on bottle-feeding and weaning is required, including minimising the use of added sugar, drinking from free-flow cups after six months of age, and discouraging the use of milk bottles at bedtime and in general after one year of age. Written visual summaries can be shared with parents to consolidate verbal advice on oral and dental health. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To improve your knowledge of atopic eczema and its prescribed treatment regimens • To enhance your awareness of the challenges encountered in the self-management of atopic eczema • To read about strategies nurses can use to support families to self-manage atopic eczema successfully. Atopic eczema is common in childhood and can continue into adulthood. Adherence to treatment is a significant factor in its effective management, but the complexity of treatment regimens can make adherence challenging. Additionally, living with the condition can have adverse psychosocial consequences for young people in particular. This article discusses treatment regimens for moderate-to-severe atopic eczema and some of the challenges encountered by children, young people and families in self-managing the condition. The authors discuss strategies that can support families to achieve optimal self-management, namely online support tools, written action plans and nurse-led eczema clinics. [ABSTRACT FROM AUTHOR]