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Pressure injuries are a significant health concern in all clinical settings. The current body of research on pressure injuries reported in the literature presents primarily low level evidence. The purpose of the current study was to identify and prioritize pressure injury research issues. The approach entailed evidence scoping and implementing a formal consensus process using a modified nominal group technique based on the Research and Development/University of California at Los Angeles appropriateness method. Sixteen Australian pressure injury experts participated in five consensus voting rounds in May to June 2015. From 60 initial research issues, the experts reached agreement that 26 issues are a priority for future pressure injury research. The highest priorities were strategies to assess skin and tissues, appropriate outcome measures for indicators of pressure injury healing and recurrence, heel pressure off-loading and shear reduction strategies, economic cost of pressure injuries and their management and effectiveness of skin moisturizers and barrier products. Developing a prioritized research agenda, informed by clinical and academic pressure injury experts, can assist in reducing the burden of pressure injuries by identifying topics of the highest need for further research. A web-based nominal group voting process was successful in engaging expert decision-making and has wide-reaching international appeal in facilitating cost-effective consensus methodologies. The priority list generated from this research is currently used in Australia to inform government investment in pressure injury research.

https://journals.cambridgemedia.com.au/application/files/3616/0498/7140/2302_03.pdf Informit DOI: https://search.informit.org/doi/10.3316/informit.308994692790462

Aim: To identify organisational characteristics and practices that promote or inhibit the recognition of sexuality in the care of older people in health and aged care settings. Background: Sexuality in old age is poorly understood by health professionals and rarely addressed in care planning and delivery. Nurse managers are ideally placed to lead organisations in promoting a culture of acceptance that enables the expression of sexuality. Evaluation: A search for research/expert opinion papers published from January 2004 to February 2017 was undertaken. Two reviewers performed data extraction and appraisal of 34 included studies using Joanna Briggs Institute tools. The primarily qualitative research was analysed to identify 152 findings that were organised into 22 categories and combined into four syntheses. Key issue(s): An organisation's philosophies frame the way older people's sexuality is perceived. Cultivating a culture and environment of acceptance, engagement and knowledge and delivering care in a way that promotes opportunity for safe and private expression of sexuality are key enabling factors. Conclusion(s): Organisations and nurse leaders can support and facilitate older adults��� expression of their sexuality through the review and development of philosophies, policies, procedures, staff attitudes and knowledge and the creation of a conducive environment. Implications for Nursing Management: Nurse managers play a pivotal role in developing a sexuality-positive organisational ethos by ensuring policies, care practices, the environment and amenities are supportive of the expression of sexuality and by role modelling attitudes of respect and inclusivity.

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Background: Relational aspects of primary care are important, but we have no standard measure for assessment. The 'working alliance' incorporates elements of the therapeutic relationship, shared decision-making, goal setting and communication skills. The Working Alliance Inventory (short form) (WAI-SF) has been used in adult psychology, and a high score on the survey is associated with improved outcomes for clients. Objective: To adapt the WAI-SF for use between GPs and patients and to test its concurrent validity with measures of shared decision-making and the doctor-patient relationship and discriminant validity with measures of social desirability. Methods: Two rounds of online survey feedback from 55 GPs and 47 patients were used to adapt the WAI-SF - the WAI-GP. The tool was then completed by 142 patients in waiting rooms after seeing their GP and by 16 GPs at the end of their session. Concurrent validity with measures of shared decision-making and patient-doctor depth of relationship was determined using Spearman Rho correlations. Patients also completed two social desirability surveys, and discriminant validity with WAI-GP was assessed. Results: Following feedback, the survey was re-worded to remove phrases that were perceived as judgmental or irrelevant. The patient measure of the WAI-GP was strongly correlated with Dyadic OPTION (rho = 0.705, P = 0.0001) and Patient-Doctor Depth of Relationship scale (rho = 0.591, P = 0.0001) and not with measures of social desirability. Conclusion: The psychometric properties of the WAI-GP support its use for measuring GP-patient alliance. Possibilities for use include assessing the influence of therapeutic alliance on the effectiveness of interventions.

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This article reports on a systematic review of the strategies, practices, and organizational characteristics that promote constructive staff-family relationships in the care of older adults in the health care setting. Research evidence points to the need to address power and control issues, communication, and collaborative approaches to care. Interventions designed to promote family-staff relationships are more likely to achieve maximum benefit when implemented with accompanying information sharing, education, and managerial support.

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