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BACKGROUND: The adoption of health-enhancing behaviours is essential to reduce the likelihood of recurrent coronary events. AIMS: This study assessed the magnitude of health behaviour change 6 months following a first acute myocardial infarction (AMI), and examined differences between cardiac rehabilitation attendees and non-attendees. METHODS: One hundred and six first AMI patients (males n=76, Australian-born n=71) participated in a 6-month follow-up of a descriptive longitudinal survey. Data on non-smoking behaviour, weight normalisation, adequate physical activity, low dietary fat intake, medication adherence and cardiac rehabilitation attendance were collected. The magnitude of change in health-enhancing behaviours from baseline to follow-up was calculated. RESULTS: Whilst there was an overall increase in health-enhancing behaviours at the 6-month follow-up (P<0.001), nonsmoking behaviour, low dietary fat intake and medication adherence were more likely to be achieved than adequate physical activity and weight normalisation. Attendees at cardiac rehabilitation were more likely to report positive lifestyle change (P=0.001) and feeling healthier (P=0.040) than non-attendees. CONCLUSION: The wide variation in the adoption of health-enhancing behaviours at the 6-month follow-up suggested that participants were selective about which behaviours they changed. Cardiac rehabilitation personnel need to emphasise the importance of undertaking all health-enhancing behaviours in order to maximise their multiplicative benefits. [ABSTRACT FROM AUTHOR]

Nurses are the main group of clinicians who activate the medical emergency team (MET), placing them in an excellent position to provide valuable insights regarding the effectiveness of this system. This descriptive study aimed to explore nurses' satisfaction with the MET, perceived benefits and suggestions for improvement. The study also sought to examine the characteristics of nurses who were more likely to activate the MET. Using a survey design, descriptive statistics as well as content analysis were used to analyse the data. Seventy-three nurses (79% response rate) returned their completed surveys. A positive and significant relationship was found between years of nursing experience and MET activation (p=0.018). Overall, nurses were satisfied with the MET, with suggestions for improvement including more education on medical emergencies for both ward and MET staff. Whilst the MET system is meeting the expectations of the majority of ward nurses, there is room for improvement, which includes a more positive attitude of the MET when summoned for 'borderline' cases. Investment in ongoing education of clinicians and interdisciplinary communication is likely to encourage less experienced nurses to utilise this system, whilst decreasing the reticence of some nurses to call the MET. [ABSTRACT FROM AUTHOR]

A growing number of courses in higher education are adopting a hybrid format of course delivery. Hybrid courses use both online learning activities with traditional classroom teaching and thus offer the efficiency and flexibility of online delivery without the complete loss of face-to-face contact. This paper explores students' satisfaction with a hybrid course delivery format, where students were required to attend the traditional tutorial session as well as complete the prescribed web-based learning activities. The study also sought to determine if age, part-time employment or academic performance were associated with satisfaction levels of the hybrid format. Participants were 143 undergraduate nursing students enrolled in a final year pathophysiology course at a university in Sydney, Australia. A survey design was used to evaluate hybrid versus traditional face-to-face classroom instruction, resulting in a high overall satisfaction with the hybrid course delivery format. Students' age and the hours they spent in part-time employment were not associated with satisfaction levels of the hybrid format. Students who achieved higher marks in the final examination expressed stronger preference for the traditional format of course delivery indicating a perceived reliance on teacher-based instruction. It is recommended that additional support be provided to students while they make the shift to a more active independent mode of learning when using web-based formats. [ABSTRACT FROM AUTHOR]

Although myocardial infarction (MI) is a leading cause of death and disablement for women internationally, little is known about women's recovery. This paper describes an exploratory descriptive study that was informed by feminist principles, and which aimed to explore the recovery experiences of a group of women survivors of first-time MI in the initial period following discharge from hospital. A total of 10 female survivors were interviewed using an open-ended semi-structured interview schedule administered at 7, 14 and 21 days post-hospital discharge. Findings revealed that recovery was experienced as a complex process, initially characterized by fear and uncertainty. Over the duration of the study these feelings were replaced with a more positive outlook, a return of energy, and a sense of confidence in the future. Participants identified an unmet need for reliable information which persisted over the duration of the study. The findings of this study have implications for nursing practice and research. Chief among these is the issue of effective provision of information to women following an acute MI. The importance of providing relevant information to be understood and retained by people experiencing crisis cannot be overstated. Equally important are the provision of opportunities for patients to have regular contact with health professionals to question and seek clarifying information. These findings should now be tested on larger populations. [ABSTRACT FROM AUTHOR]

Abstract Background Chronic heart failure (CHF) is a chronic debilitating condition with economic consequences, mostly because of frequent hospitalisations. Physical activity and adequate self-management capacity are important risk reduction strategies in the management of CHF. The Home-Heart-Walk is a self-monitoring intervention. This model of intervention has adapted the 6-minute walk test as a home-based activity that is self-administered and can be used for monitoring physical functional capacity in people with CHF. The aim of the Home-Heart-Walk program is to promote adherence to physical activity recommendations and improving self-management in people with CHF. Methods/Design A randomised controlled trial is being conducted in English speaking people with CHF in four hospitals in Sydney, Australia. Individuals diagnosed with CHF, in New York Heart Association Functional Class II or III, with a previous admission to hospital for CHF are eligible to participate. Based on a previous CHF study and a loss to follow-up of 10%, 166 participants are required to be able to detect a 12-point difference in the study primary endpoint (SF-36 physical function domain). All enrolled participant receive an information session with a cardiovascular nurse. This information session covers key self-management components of CHF: daily weight; diet (salt reduction); medication adherence; and physical activity. Participants are randomised to either intervention or control group through the study randomisation centre after baseline questionnaires and assessment are completed. For people in the intervention group, the research nurse also explains the weekly Home-Heart-Walk protocol. All participants receive monthly phone calls from a research coordinator for six months, and outcome measures are conducted at one, three and six months. The primary outcome of the trial is the physical functioning domain of quality of life, measured by the physical functioning subscale of the Medical Outcome Study Short Form -36. Secondary outcomes include physical functional capacity measured by the standard six minute walk test, self-management capacity, health related quality of life measured by Medical Outcome Study Short Form -36 and Minnesota Living With Heart Failure Questionnaire, self-efficacy and self-care behaviour. Discussion A self-monitoring intervention that can improve individual's exercise self-efficacy, self-management capacity could have potential significance in improving the management of people with chronic heart failure in community settings. Trial Registration Australian New Zealand Clinical Trial Registry 12609000437268

Aims: To identify (a) determinants of glycated haemoglobin (HbA1c) at 18 and 30 months following transition in young people with Type 1 diabetes mellitus (T1DM) to a youth-specific diabetes service; and to (b) evaluate the impact of the service on acute admissions with diabetic ketoacidosis (DKA) over a 14-year period.Methods: An audit of records of youth with T1DM referred from paediatric services to the multidisciplinary transition service at Westmead Hospital, from 2001 to 2012, and followed-up to 2014.Results: Data from 439 adolescents and young adults (Median age: 18) were analysed. The recommended standard of glycaemic control, HbA1c < 7.5% (58 mmol/mol), was achieved by 23% at baseline, 22% at 18-months, and 20% at 30-month. After adjusting for lag time (>3 months) and diabetes duration (>7 years), glycaemic control at first visit predicted subsequent glycaemic control at 18-month and 30-month follow-up. From 2001 to 2014, only 8.6% were lost to follow-up; admissions and readmissions for DKA reduced from 72% (32/47) to 4% (14/340) (p < 0.001). Furthermore, mean length of stay (LOS) significantly decreased from 6.56 to 2.36 days (p < 0.001).Conclusions: Continuing engagement with the multidisciplinary transition service prevented deterioration in HbA1c following transition. Age-appropriate education and regular follow-up prevents DKA admissions and significantly reduced admission LOS. [ABSTRACT FROM AUTHOR]

Aims This study explored the strategies used by cardiac rehabilitation (CR) coordinators to overcome the obstacles to implementation of the evidence-based Reducing Risk in Heart Disease guidelines. Methods The study design used qualitative, semistructured in-depth interviews with 20 CR coordinators from New South Wales, Australia, to explore the strategies used to facilitate guideline implementation. Non-probability sampling was used to recruit CR coordinators to obtain a broad understanding of the issues. Interviews were transcribed and thematic content analysis was undertaken to identify common themes. Results Coordinators addressed the barriers to implementing guidelines through their commitment to best practice and striving to overcome the odds through providing opportunistic health education, alternate methods of secondary prevention, and partnering and engaging with local communities. Conclusions Although CR coordinators face multiple barriers to implementing evidence-based guidelines for patients with coronary heart disease, they use strategies such as harnessing community capacity and using available resources creatively. The development of a more integrated, multifactorial and coordinated approach to improving use of guidelines in clinical practice to improve the treatment and secondary prevention of coronary heart disease is urgently needed. [ABSTRACT FROM PUBLISHER]

Understanding factors that influence health-seeking behaviour of migrants is necessary to intervene for behaviour change. This paper explores Filipino migrants' perceptions of facilitators and barriers to maintaining health in Australia. Open-ended survey item responses reflecting factors that assisted and hindered health following migration to Australia were inductively analysed. Three hundred and thirty-seven of the 552 survey respondents (61%) provided open-ended responses. Responses were grouped into two major categories: individual factors, including personal resources and cultural influences, and environmental factors encompassing both the physical conditions in the host country and health service access. Awareness of practices that enhance health was a major personal facilitator of health-seeking behaviour; however, competing priorities of daily living were perceived as barriers. Cultural beliefs and practices influenced health-seeking behaviour. Despite high self-rated English language skills in this population, new migrants and the elderly cited communication difficulties as barriers to accessing health services. Insight into facilitators and barriers to health-seeking behaviour in this less researched migrant population revealed tools for enhancing engagement in health promotion programs addressing healthy lifestyle. [ABSTRACT FROM AUTHOR]

Despite an increasing focus on health literacy in the clinical setting and in the literature, there is still ongoing debate about its influence on diabetes self-management. The aim of the study was to examine the relationships of sociodemographic, clinical, and psychological factors on health literacy and diabetes self-management. A cross-sectional survey was undertaken on 224 patients with type 2 diabetes at two diabetes centres in Sydney, Australia. Findings showed that people with low health literacy were more likely to (a) have lower educational attainment; (b) be migrants; and (c) have depressed mood. Unexpectedly, those who met HbA1c threshold of good glucose control were more likely to have low health literacy. Predictors of low diabetes self-management included (a) younger age group (AOR: 2.58, 95% CI: 1.24–4.64); (b) having postsecondary education (AOR: 2.30, 95% CI: 1.05–5.01); (c) low knowledge of diabetes management (AOR: 2.29, 95% CI: 1.25–4.20); and (d) having depressed mood (AOR: 2.30, 95% CI: 1.30–4.06). The finding that depressed mood predicted both low health literacy and low diabetes self-management stresses the importance of screening for depression. Increasing people’s understanding of diabetes self-management and supporting those with depression are crucial to enhance participation in diabetes self-management. [ABSTRACT FROM AUTHOR]

Background Percutaneous coronary intervention (PCI) is a revascularisation intervention for patients with acute coronary syndrome. It is a common procedure, increasingly used over the past decade. Along with PCI, patients are also prescribed a number of medications and adherence to the pharmacological therapies is vital to improved morbidity and mortality. Objective This cross-sectional study sought to evaluate the long term adherence to medications in patients following PCI. Subjects 270 participants who underwent PCI between April 2003 and March 2004 and who met the inclusion criteria were followed up 12-24 months following the PCI. Methods Following obtaining informed consent, a self administered questionnaire was mailed to participants. Information was collected relating to the types of medications taken, medication taking behaviours and storage of medications. Results Overall high rates of self-reported medication adherence were reported. In spite of this, patients continued to miss medications or reported stopping medications if they felt better or worse. Knowledge of storage of medication in particular nitro-glycerine medications was poor. Conclusions Findings suggested that following PCI medication adherence is high, however knowledge about medication storage is limited and patients report cessation of medications which they consider to be deleterious or unnecessary. These findings are useful for informing development of nursing interventions. [ABSTRACT FROM AUTHOR]

Aim: This study aims to evaluate the effectiveness of an oral health educational intervention designed for undergraduate nursing students., Background: The role of oral health promotion and screening has been extended to non-dental health professionals, for example, nurses. To prepare the future workforce for these responsibilities, an educational intervention underpinned by Mezirow's Transformative Learning Theory was codesigned and implemented in an Australian undergraduate nursing program., Methods: A concurrent mixed methods design was used to evaluate the educational intervention Semi-structured interviews with second-year nursing students and faculty staff along with pre-post-test surveys (validated tool) were used to assess changes in attitude and confidence among nursing students regarding oral healthcare. Directed Content Analysis and univariate and bivariate analyses were used to analyse the data., Results: Nursing students experienced a positive change in attitude following the educational intervention, which was also observed by faculty staff. This was corroborated by statistically significant improvements in attitude (5.89 versus 6.22, p=0.002) with the main area of improvement being a positive recognition of the role that nurses have in oral health assessment (21% increase). Students demonstrated a positive shift in confidence, which was supported by the quantitative data which showed an increase in mean scores post intervention (4.73 versus 5.26, p<0.001). Marked improvement in confidence was observed around the recognition of periodontitis (24-25% increase) which was the key focus of the educational intervention., Conclusion: This is the first time an oral health educational intervention has been implemented and found to be effective in improving the attitude and confidence of nursing students when undertaking oral healthcare activities in Australia. Adopting a transformative approach to teaching oral health is recommended for undergraduate nursing education providers as this learning approach can positively influence practice and behaviour changes., Competing Interests: Declaration of competing interest No conflict of interest has been declared by the authors., (Copyright © 2025 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Nurses play a critical role in supporting patients in self-managing their indwelling urinary catheters and preventing avoidable hospital presentations. This study aimed to explore the effectiveness of a co-designed educational approach developed to enhance nurses' ability to provide optimal care for patients with catheters., Aim: The primary aim of this study was to enhance nurses' knowledge and skills in urinary catheterisation, care, and management. The secondary aim was to transform their current catheter management practices to improve patient outcomes., Setting: Nurses (n = 127) from one New South Wales, Australia region participated in the study. These nurses provided healthcare across various community settings. Ethics approval was received from the Local Health District (HREC/2019/ETH12575) and the study was registered in ANZCTR (ACTRN12621000683831)., Methods: A mixed-methods approach was used, collecting data at baseline and after the intervention. Quantitative data were analysed using descriptive statistics, tests for normality, and bivariate analysis with the Wilcoxon Signed Ranks test to identify differences between variables. Qualitative data were analysed using a directed content analysis approach to categorise occurrences of specific phenomena., Results: The composite mean knowledge score increased from 65.03 to 84.30 following the intervention (p < 0.001). In addition, the magnitude of knowledge score improvement in seven out of eight questions following the intervention were: Financial support: 1.1 %; Bladder spasm/urine leakage: 3.3 %; Blockage: 3.5 %; Catheter-Associated Urinary Tract Infection (CAUTI): 4.4 %; Self-management: 6.1 %; Sexuality: 7.9 %; and Urinary catheterisation: 11.3 %. Qualitative findings confirmed that the eLearning module was effective in transforming participants' clinical practice, towards improving patient outcomes., Conclusions: The co-designed eLearning module effectively addressed the learning needs of nurses, enhancing their knowledge and skills in urinary catheter management. Incorporating a theoretical model and contextual approach in the intervention delivery increased relevance, personalisation, and engagement, facilitating the behaviour change required to transform current practices., Competing Interests: Declaration of competing interest No conflict of interest has been declared by the authors., (Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.)

Aim: To explore how undergraduate nursing students develop knowledge during a breastfeeding module., Design: A qualitative study using a single case-study approach., Methods: This study was conducted in Australia over 2 years during the period between July 2021 and December 2022. Semi-structured interviews and artefact collection were conducted with a purposive sample of undergraduate nurses (n = 10) who completed a paediatric elective subject that included a breastfeeding module. Thematic and content analysis were used. The specialisation dimension in Legitimation Code Theory (LCT) was used for the content analysis, and students' data was mapped on the specialisation plane., Results: This study reveals how participants developed knowledge by linking personal breastfeeding experiences to theoretical components within the nursing program. Using the LCT dimension of specialisation, this study provides new insights into how participants move through distinct quadrants of the specialisation plane. Learners tour between the knowledge, knower, and elite quadrants of the plane as they integrate their knowledge. The research maps the journey towards becoming the 'right kind of knower' and reveals how personal experience and theoretical knowledge intersect to create disciplinary expertise. This study advances the LCT dimension of specialisation by illustrating the fluid, non-linear nature of knowledge acquisition and knower development., Conclusions: This study highlights the value of integrating personal experiences into nursing education, demonstrating how students use these to build knowledge and professional identity. The findings emphasise the dynamic knowledge development process in preparing future healthcare professionals., Implications for the Profession and Patient Care: Integrating lived experiences and interprofessional education equips nurses to address complex health issues, leading to more effective, personalised care and better health outcomes for breastfeeding mothers and infants. This approach signals a transformative shift in nursing education., Impact: By personalising and contextualising learning, fostering reflective practice, deepening disciplinary knowledge, and promoting a collaborative practice environment, this approach enriches nursing education., Reporting Method: The consolidated criteria for reporting qualitative research (COREQ)., Patient or Public Contribution: No patient or public contribution., (© 2024 John Wiley & Sons Ltd.)

Aim: To identify key factors that influence personal care workers' (PCW) intention to stay in residential aged care (RAC)., Background: PCWs are the 'backbone' of providing direct care in RAC settings. The well-being of older people hinges upon their dedication and commitment; thus, enhancing their intention to stay is a priority to reduce turnover and ensure continuity of care., Methods: Six databases were searched for articles focusing on factors influencing PCWs' intention to stay in RAC. Studies were independently assessed for quality using the Joanna Briggs Institute Methodology for systematic review tools. Reporting of the results followed the PRISMA guidelines., Findings: Eight articles published between 2010 and 2022 were included. The key issues were categorized as: (a) sociodemographic characteristics; (b) psychological factors; (c) workplace factors and (d) job satisfaction. Older age, being married and immigration status were positively associated with intention to stay. Work stress and burnout contributed towards demotivation, while a supportive and engaging organizational culture that recognized workers' contributions and provided appropriate remuneration and benefits, enhanced job satisfaction and retention., Conclusion: This review affirms the complexity of the decision-making process influencing workers' intention to stay. A comprehensive understanding of the interplay of these factors and the personal and sociocultural challenges faced by PCWs is essential to design strategies to provide support and enhance job satisfaction and retention., Implications for Aged Care: This review showed that support from the organization is critical in improving PCWs' intention to stay in aged care. Given the interconnectedness of a range of key factors, decision-makers need to address modifiable factors holistically. Including PCWs in planning retention strategies could be the missing link in tailoring interventions towards workforce retention., Impact: Personal, psychological and workplace factors alone and in combination influence personal care workers' intention to stay in residential aged care (RAC). The interrelationships among the factors impacting PCWs' intention to stay are complex, wherein a change in one often influences other factors. Addressing the causes of psychological stress, improving workplace culture and understanding their interrelationships provide a foundation for co-designing strategies to promote intention to stay among PCWs in RAC., Reporting Method: The authors have adhered to relevant EQUATOR guidelines PRISMA., No Patient or Public Contribution: This integrative review is conducted with no involvement or contribution from patients or the public., (© 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Aim: To develop and test the psychometric properties of a self-administered scale to assess the knowledge, skills, attitudes and behaviour of nurses to support the self-management of patients living with indwelling urinary catheters., Background: Nurses are pivotal in supporting patients with urinary catheter self-management to prevent potentially avoidable hospital presentations. However, no validated scale is available to assess nurses' attitudes and readiness for this task., Design: A quasi-experimental design was used to collect survey data both at baseline and after the completion of the intervention. A total of 128 participants were recruited from the Western Sydney region (New South Wales, Australia), who were working in community healthcare settings. Research Electronic Data Capture (REDCap™) database was used to manage the survey data collected for data analysis purposes. This study has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN126210 0 0683831) METHODS: Using a three-stage process of concept identification, item construction and pilot testing to develop the Catheter Assessment, Management and Performance (CAMP) scale, followed by factorial and discriminant validity and reliability testing. This 23-item CAMP scale is theoretically informed by the COM-B (Capability, Opportunity, Motivation-Behaviour) model, recognised for its effectiveness in understanding and influencing behaviour change. The scale was distributed to nurses working in three community health care settings to assess their knowledge, attitude and behaviour regarding catheter management and performance., Results: Four factors were identified using scree plot, accounting for 63.36 % of total explained variance, which reflected the four dimensions of the COM-B model. Cronbach's alpha of the overall CAMP scale (0.93) and subscales (0.92, 0.87, 0.85 and 0.86) indicate good internal consistencies. The CAMP scale was able to detect changes in nurses' self-reported behaviour change following educational intervention (85.53 versus 95.98, p < 0.001)., Conclusion: The CAMP scale is valid and reliable scale, capable of assessing nurses' capability, opportunity and motivation to support patients, through delivery of catheter self-management education that can potentially prevent catheter-related complications and avoid hospital presentations. Future research could explore using CAMP scale among non-specialist nurses and in various clinical settings to enhance its effectiveness and generalisability., Competing Interests: Declaration of Competing Interest No conflict of interest has been declared by the authors., (Crown Copyright © 2024. Published by Elsevier Ltd. All rights reserved.)

Background: In response to the increasing diversity in nursing education, the Legitimation Code Theory (LCT) offers a transformative approach to understanding and addressing the unique learning needs of students from various backgrounds., Objectives: To identify how Legitimation Code Theory has informed the design of professional education in biological and health sciences., Design: An integrative review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) and guided by the five-step process by Whittemore and Knafl., Data Sources: A comprehensive search of eight databases was conducted (IEEEXplore, Scopus, Web of Science, ProQuest central, EBSCOHost, MEDLINE with full text, CINAHL and INFORMIT) using key concepts: Legitimation Code Theory and professional education from inception until November 2023., Review Methods: All studies were reviewed by two researchers independently. The same authors appraised the studies using the Mixed Methods Appraisal Tool with a third author providing consensus. The findings were coded and analysed using narrative synthesis., Results: From the initial 518 records screened, 11 studies were identified where Legitimation Code Theory was used in biological and health science education. There were four themes identified in the review: a) Legitimation Code Theory as a framework for data analysis; b) Identifying and enhancing learning outcomes through Legitimation Code Theory; c) Pedagogy design informed by Legitimation Code Theory; and d) Legitimation Code Theory to contextualise disciplinary knowledge., Conclusion: This review highlights the significant influence of Legitimation Code Theory on professional education, particularly in the biological and health sciences. The versatility and effectiveness of Legitimation Code Theory are evident across various disciplines, including nursing education. As a comprehensive framework, Legitimation Code Theory not only aids in pedagogy design but also facilitates the transfer of learning, thereby promoting critical thinking. This demonstrates its robustness as a tool in the realm of professional education., Competing Interests: Declaration of competing interest No conflict of interest has been declared by the authors., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Aim: To develop and test the psychometric properties of an expanded catheter self-management scale for patients with in-dwelling urinary catheters., Design: A cross-sectional validation study. Despite the utility of the original 13-item catheter self-management scale, this instrument did not include bowel management, general hygiene and drainage bag care, which are fundamental skills in urinary catheter self-management to prevent common problems resulting in unnecessary hospital presentations. The expanded catheter self-management scale was developed with 10 additional items to comprehensively assess all five essential aspects of urinary catheter self-management., Methods: A total of 101 adult community-dwelling patients living with indwelling urinary catheters were recruited from Western Sydney, Australia. Using exploratory factor analysis with Varimax rotation, the number of factors to be extracted from the expanded 23-item expanded catheter self-management scale was determined using a scree plot. The reliability of the overall scale and subscales was measured using Cronbach's alpha. Convergent validity was assessed using Spearman's correlations between clinical characteristics, overall scale and subscales., Results: The 23-item expanded catheter self-management scale yielded a 5-factor solution, labelled as: (i) self-monitoring of catheter function, (ii) proactive, help-seeking behaviour function, (iii) bowel self-care function, (iv) hygiene-related catheter site function and (v) drainage bag care function. Cronbach's alpha of the expanded catheter self-management scale indicating all 23 items contributed to the overall alpha value. Convergent validity results showed a negative correlation between the overall expanded catheter self-management scale and catheter-related problems., Conclusion: The 5-factor structure provided a comprehensive assessment of key aspects of urinary catheter self-management essential to reduce the likelihood of catheter-related hospital presentations., Implications: The expanded catheter self-management scale can be used to assess and monitor effective patient-centred interventions for optimal self-management to prevent catheter-related problems and improve the quality of life of patients., Impact: Many patients start their journey of living with a urinary catheter unexpectedly and are not supported with quality information to care for their catheter. The findings of this study show the correlation between catheter self-management skills and catheter-related problems. The expanded catheter self-management scale (E-CSM) assists with analysing the self-management skills of patients living with a catheter and developing tailored interventions to prevent problems and improve their quality of life. In addition, this screening tool can be included in policies, guidelines, and care plans as a standard for improving catheter management and developing educational resources for patients., Reporting Method: STROBE checklist was used to report all aspects of this study comprehensively and accurately., Patient or Public Contribution: Patients living with indwelling urinary catheter and their carers have participated in surveys, interviews and co-designing interventions. This paper reports the psychometric analysis of the expanded catheter self-management scale (E-CSM) used in the patient survey as part of the main study 'Improving Quality of Life of Patients Living with Indwelling Urinary Catheters: IQ-IDC Study' (Alex et al. in Collegian, 29:405-413, 2021). We greatly value our consumers' contributions and continue to communicate the progress of the study to them. Their contributions will be acknowledged in all publications and presentations. In addition, all participants will be provided the option of receiving the interventions and publications generated from this study., (© 2024 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Background: Complications related to diabetes mellitus impose substantial health and economic burdens to individuals and society. While clinical practice guidelines improve diabetes management in primary care settings, the variability in adherence to these guidelines persist. Hence, there is a need to comprehensively review existing evidence regarding factors influencing nurses' adherence to implementation of clinical practice guidelines to improve clinical care and patient safety., Objective: This integrative review seeks to investigate nurses' adherence to clinical guidelines for diabetes management in primary healthcare settings and to explore factors influencing effective implementation, focusing on the role of nurses and impacts on patient outcomes., Methods: A comprehensive search was conducted in March 2023 across six electronic databases. The search targeted studies that examined the use of Type 2 diabetes mellitus guidelines by nurses in primary healthcare settings with a focus on clinical management outcomes related to diabetes care or patient safety. Included studies were classified using the Effective Practice and Organisation of Care taxonomy, synthesised narratively and presented thematically. Reporting of the review adhered to PRISMA guidelines. (PROSPERO ID CRD42023394311)., Results: The review included ten studies conducted between 2000 and 2020, and the results were categorised into three themes. These were: (i) Implementation strategies to promote clinical practice guidelines adherence, including health professional development, reminders for clinicians, patient-mediated interventions, health information systems, role expansion, and comprehensive package-of-care. A multifaceted educational approach emerged as the most effective strategy. (ii) Impact of guidelines adherence: These strategies consistently improved clinical management, lowering HbA1c levels, improving blood pressure and lipid profiles, and enhancing patient self-care engagement, along with increased nurses' adherence to diabetes clinical guidelines. (iii) The role of nurses in guideline implementation, enabling independent practice within multidisciplinary teams. Their roles encompassed patient education, collaborative practice with fellow healthcare professionals, program planning and execution, and comprehensive documentation review. Nurse-led interventions were effective in improving patient outcomes, underscoring the necessity of empowering nurses with greater autonomy in providing primary diabetes care., Conclusion: Implementing a diverse range of strategies, focusing on comprehensive education for healthcare providers, is paramount for enhancing guideline adherence in diabetes care, to improve clinical management towards optimal patient health outcomes. Tailoring these strategies to meet local needs adds relevance to the guidelines. Empowering nurses to take a leading role in primary care not only enhances patient safety but also promotes quality of care, resulting in improved overall outcomes., Tweetable Abstract: In primary care, empowering nurses with diabetes guideline education and tailoring strategies to local needs enhance guideline adherence and improve patient outcomes., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Aims: To examine misconceptions towards men in nursing from the perspective of undergraduate nursing students. Specifically, this study sought to explore contributing factors of misconceptions and attributions of the success of men in nursing., Design: A convergent parallel mixed-method study., Methods: A national survey was conducted (July-September 2021). The quantitative data included demographics and responses to the Gender Misconceptions of Men in Nursing (GEMINI) scale. The qualitative data included responses to a provocative statement related to characteristics of men and their career in nursing. The GRAMMS guideline was used in reporting., Results: Undergraduate nursing students (n = 1245) from 16 Australian schools of nursing responded to the survey. Quantitative analysis demonstrated that most students (96%) did not have misconceptions about men in nursing. Those who did were more likely to be men, born overseas, not in health-related employment and did not have nursing as their first choice. Four broad overarching main themes were generated in response to the statement that suggested men do not have the right attributes for nursing: (1) 'This is a very misandristic viewpoint'; (2) 'Compassion and intelligence are distributed in men and women equally'; (3) 'Men bring a different quality to nursing' (4) 'Anyone can be whatever they want to be'., Conclusion: Overall, nursing students did not have misconceptions about men in nursing, despite experiencing ongoing social stigma regarding archaic gender norms. The findings from this study indicate that the next-generation nurses were championing to challenge the gender stereotype and support the needs of a gender diverse society., Impact: Attitudes and misconceptions that elicit gender inequalities must be addressed with comprehensive strategies and de-gendered language and imagery within the profession, schools, workplaces and the media. Shifting culture and attitudes towards inclusion, values the diversity in the workforce and supports healthy workplace environments., Patient or Public Contribution: No patient or public contribution., (© 2023 The Authors. Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Aim: To use Legitimation Code Theory as a framework to inform the design of nursing education and gain insights into student perspectives of this design., Background: Internationally, the World Health Organization's breastfeeding recommendations are not being met. One contributing factor is that healthcare providers including registered nurses lack the knowledge to support breastfeeding women on an ongoing basis and rely on their personal experiences to inform the care they provide. Undergraduate nursing students should receive education to assist breastfeeding women in practice., Design: The study is underpinned by case-study methodology. The Legitimation Code Theory (LCT) dimension of Semantics and the concepts of semantic gravity and semantic density were used to theoretically frame and develop an intervention module to teach undergraduate nurses about breastfeeding., Methods: This module was part of an elective seven-week paediatric nursing course. University Human Research Ethics Committee (HREC201/203) reviewed the study. Participants (n = 9) completed semi-structured interviews and thematic analysis helped us to understand their experiences of the module. The Template for Intervention and Description and Replication (TIDeR) framework was used to report the intervention., Results: The breastfeeding module was positively received by participants who noted the module's structure differed from previous courses. Three main themes were identified in the student experience. These are: a) threads and links; b) engaging structure; and c) seedlings., Conclusion: Legitimation Code Theory is an effective course development framework to harness the learners' prior informal knowledge and weave learning activities between theory and contextual practice to develop cumulative knowledge., Impact: With an increased understanding of how undergraduate nursing students develop knowledge, the LCT dimension of Semantics can be ussed to structure content knowledge in instructional design. This approach builds explicit bridges between knowledge development in the nursing curriculum and learners' informal knowledge and contextual practice in clinical settings., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: Depression in older people living in residential aged care is a serious and highly prevalent health issue, with loneliness and social isolation being major contributors. The COVID-19 pandemic underscored the harm visiting restrictions have on the mental wellbeing of older people in residential aged care. However, there is a need to systematically review the relationship between family visits and depression in this population., Objective: This literature review seeks to explore the association between family visits and depression among those living in residential aged care., Methods: An integrative review was conducted in March 2022, based on a search of seven databases from inception to 2022. Papers were included if the studies were situated in a residential aged care facility and explored the impact of in-person family visits on depression of residents. Those that examined impact of family visits on community-dwelling older people and papers examining virtual family visits were excluded. The quality of the included papers was assessed using appropriate critical appraisal tools. Guided by the aim of this study, the included papers were narratively synthesised and presented thematically (PROSPERO ID CRD42022325895)., Results: Ten papers, published between 1991 and 2022, were included in the final synthesis. Multiple categorisations of frequency of visits and different scales were used to assess depression. Depression among residents in aged care facilities varied from 20 % to 58.7 % with 40 % of studies showing a positive association between the frequency of family visits and lower rate of depression. Three themes influencing the association between family visits and depression in residential aged care were identified. These were: (i) intersection of culture, filial values, and depression; (ii) resident-related factors including whether admission was voluntary and presence of functional impairment; and (iii) non-resident-related factors such as social activities for residents and staff involvement., Conclusion: Family visits ameliorated loneliness and depression among residents in aged care however, other factors such as culture, comorbidities and functional impairment, opportunities for socialisation and the social involvement of facility staff also influenced depression. Whilst the low number of studies reviewed limited comparison and generalisation of results, the review highlighted the broader and crucial role of healthcare staff in facilitating socialisation and promoting mental wellbeing of residents especially those who are not visited by families., Tweetable Abstract: Family visits ameliorate depression in institutionalised older people but may not be the "silver bullet" as depression is multifactorial., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background and Objectives: The age-friendly university (AFU) initiative embodies the collaborative efforts of promoting age inclusivity and diversity in higher education, embracing lifelong learning and civic participation in older people. This scoping review aims to explore the conceptualization of AFU, the experiences, and the strategies used in operationalizing the AFU principles of participating universities in becoming members of the age-friendly university network., Research Design and Methods: A search of peer-reviewed papers published from 2012 to July 2021, conducted in nine databases using JBI scoping review methodology, found 1,752 articles. Of these, 13 papers were eligible for inclusion., Results: Three themes were identified as key to becoming an AFU: (a) interdisciplinary collaboration within the university; (b) strong partnership with the community; and (c) alignment with global priorities and initiatives. Furthermore, identifying barriers to physical access in universities, such as signage, walkways, and transportation, addressing the less tangible issues of ageism and promoting intergenerational learning were essential to promote engagement of older people., Discussion and Implications: This review underscores the need for a multidisciplinary approach within the university, the reciprocal benefits of authentic university-community collaborations, and the advantages of harnessing international resources and global influence to becoming an AFU. Although the principles of the AFU remain aspirational, the ideals championed by the pioneering universities in the AFU network brought the mutual benefits of intergenerational learning, the challenges and support required for older learners to the fore, propelling the AFU agenda forward., (© The Author(s) 2022. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Aim and Objective: To explore the perceptions of nursing students regarding the treatment of men in nursing during their clinical placement., Background: Negative placement experiences of men who are nursing students is a risk factor for student attrition. Hence, exploring gender disparity in treatment during placement from both men and women studying nursing will contribute to improving student experience and reducing attrition., Design: Survey capturing both quantitative and qualitative data., Methods: Nursing students were surveyed between July and September 2021 across 16 Schools of Nursing in Australia. In addition to the Clinical Learning Environment Inventory (CLEI-19), an open-ended question explored if men received different treatment during clinical placement., Results: Those who expressed difference in treatment of men were less satisfied with their clinical learning experience (p < .001). Of the 486 (39.6%) who responded to the open-ended question, 152 (31%) indicated a difference in the treatment of men, reporting that men received: (a) better (39%); (b) different, not exclusively better or worse (19%); and (c) worse (42%) treatment from either the clinical facilitator or ward staff. While both men and women perceived gender differences in the treatment of men during placement, men were more likely to report worse treatment., Conclusion: Despite the advances achieved in recruiting men in nursing, negative experiences during clinical placement are characterised by stereotypes, prejudice and discrimination, adversely impact retention., Relevance to Clinical Practice: Nurse educators need to recognise specific support students require during placement regardless of gender. Our findings reinforce the adverse impacts of inequitable treatment on both men and women nursing students on learning, clinical performance, morale and ultimately on retention in the nursing workforce. Addressing gender stereotyping and discrimination in the undergraduate nursing program is an important step in promoting diversity and inclusivity in the nursing workforce., (© 2023 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

Aims and Objectives: To synthesise information about the needs of older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care from the perspectives of the residents, families and care staff., Background: Older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care have care needs that are complex. Identifying these needs is critical to ensure quality care is delivered., Design: An integrative review of literature., Methods: Five databases were searched for relevant articles: APA PsychINFO, CINAHL, MEDLINE, Scopus and Google Scholar. The search and screening were guided by PRISMA guidelines and Whittemore and Knafl's five-step framework., Results: Fifteen papers were included in this review consisting of 4 quantitative, 9 qualitative and 2 mixed method studies. Two themes described the needs of older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care. The first was related to culture-specific needs, and the second was related to dementia-specific care needs. Culture-specific needs comprised of three subthemes: (a) common language, (b) traditional food, and (c) social and spiritual requirements. Dementia-specific needs comprised of (a) focusing on comfort in addition to clinical requirements and (b) individualised care that addresses behavioural symptoms of dementia., Conclusions: Identifying and meeting the needs of older people with dementia from culturally and linguistically diverse backgrounds will improve quality care delivery in addition to increased caregiving satisfaction among residents, families and care staff, and the management of behaviours that characterise dementia., Relevance to Clinical Practice: Care needs of older people with dementia from culturally and linguistically diverse backgrounds living in the residential setting can be complex. Education and training of care staff including nurses must be considered so that provision of care is inclusive of the cultural and dementia needs for older people in residential aged care., (© 2023 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.)

Aim: To develop and test the psychometric properties of the attitude and confidence with oral healthcare among nursing students (ACORN) scale., Background: Delivering oral healthcare is an essential component of care, which is often overlooked and omitted. A nurse's attitude or confidence may influence how oral healthcare is prioritised. To date, there are no scales that assess both attitude and confidence for nurses when undertaking oral healthcare and thus the ACORN scale was developed., Methods: The 24-item scale was developed following a three-stage process, which included concept identification and item construction, pilot testing, factorial and discriminant validity and reliability testing. The survey was distributed to nursing students to assess their attitude and confidence in providing oral healthcare. This study has been registered with the Registry of Efficacy and Effectiveness Studies (12940.1v1)., Results: Using a before and after intervention survey design, the psychometric properties of the ACORN scale were examined with data collected from two student groups. Exploratory Factor Analysis yielded a two-factor structure, which was verified using Confirmatory Factor Analysis. Importantly, aggregated scale scores were able to detect differences in attitude and confidence following oral healthcare education (4.95 versus 5.66, p < 0.01). The Cronbach's alpha for the 24-item scale was 0.94., Conclusion: The ACORN scale is a valid and reliable tool that can be used to assess differences in attitude and confidence of students following oral health education. Further research is recommended to test the utility of this scale using other educational interventions with different groups of healthcare providers., Competing Interests: Declaration of Competing Interest No conflict of interest has been declared by the authors., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Due in part to medical complications, adults with a pediatric onset spinal cord injury (SCI) are at higher risk of experiencing dissatisfaction with life and lower perceived physical health when compared to their peers with no disability. To support the prevention of medical complications, young people with SCI must successfully transition to adult health care. Health care transition (HCT) interventions can support young people with chronic conditions in their move to adult health care., Objectives: To evaluate the feasibility and acceptability of a web-based HCT intervention codesigned with young people with SCI and parents/caregivers., Methods: Semi-structured individual interviews were conducted online with young people with SCI and parents/caregivers who transitioned or were preparing for the transition from pediatric to adult health care. Interviews were also conducted with health care professionals. The interviews were analyzed using a hybrid deductive and inductive qualitative content analysis process. Feasibility and acceptability were measured using Bowen and colleagues' framework, which includes eight focus areas: acceptability, demand, implementation, practicality, adaption, integration, expansion, and limited efficacy., Results: Overall, participants responded positively to the intervention and believed that it would be useful to young people with SCI and parents/caregivers. Two areas of Bowen et al.'s framework, implementation and integration, require further consideration in terms of how to embed the intervention into the current transition process., Conclusion: This study found the HCT intervention to be an innovative approach to support young people with SCI and their parent/caregivers that demonstrates promise in the areas of feasibility and acceptability., Competing Interests: Conflicts of Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 American Spinal Injury Association.)

To build a nursing workforce that is equipped to undertake oral health promotion and screening, an educational program was needed. With codesign being used in multiple settings, it was selected as the approach to use, with Mezirow's Transformative Learning theory as the underpinning framework. This study aimed to develop an oral healthcare educational intervention for nursing students. Using a six-step codesign framework, nursing students and faculty staff were invited to participate in two Zoom™ Video Communication workshops to codesign the learning activities to be used in the classroom. The codesign process was evaluated through focus groups and analysed using a hybrid content analysis approach. A multifaceted oral healthcare educational intervention was developed. Learning material was delivered using a range of different learning and teaching resources such as dental models, podcasts, and an oral health assessment across two subjects. Multiple approaches to recruitment, the inclusion of participants, and good facilitation of workshop discussions were critical to the codesign of the educational intervention. Evaluation revealed that preparing participants prior to the workshops acted as a catalyst for conversations, which facilitated the codesign process. Codesign was a useful approach to employ in the development of an oral healthcare intervention to address an area of need.

Background: An ageing workforce and increased vacancies has seen a steady growth in nursing student enrolments. This has created a need to re-think how to optimise existing clinical placement opportunities while ensuring quality student experiences and staff satisfaction in their support role., Objectives: To provide insights into the experiences and satisfaction levels of Registered Nurses who supported nursing students during clinical placement using a facility-based model., Design: A quasi-experimental design., Settings: Three wards in an acute care facility and Primary and Community Health within the Southwest of Sydney, New South Wales, Australia., Participants: Participants included Registered Nurses/Midwives, Facility-based liaison support staff, and Nurse Managers., Intervention: Within the 24/7 facility-based model, each nursing student was allocated to one Registered Nurse for the duration of the clinical placement period. The pair was rostered to complete the same day, evening, night, and weekend shifts., Methods: A cross-sectional survey related to staff satisfaction was administered to participants at two time points: (a) prior to the commencement of the intervention (baseline survey); and (b) at the completion of the intervention. Following the intervention participants were invited to a focus group or an individual interview., Results: There were no statistically significant changes in the levels of staff satisfaction from baseline to post-intervention; with personal fulfilment scoring the highest and workload the lowest. Staff who worked in the Primary and Community Health settings were less satisfied with this model of student support. Overall, most participants reported high personal satisfaction, professional growth and development opportunities yet acknowledged this came at a cost, with an increased workload., Conclusions: Participants were satisfied with the facility-based model in supporting student learning on clinical placement. The model is fit for purpose however it does need to be tailored to the contextual needs of nurses working in Primary and Community settings., Competing Interests: Declaration of competing interest No conflict of interest has been declared by the authors., (Copyright © 2022. Published by Elsevier Ltd.)

Background: The devastating effects of COVID-19 sparked debates among professionals in the fields of health, law, and bioethics regarding policies on mandatory vaccination for healthcare workers. Suboptimal vaccine uptake among healthcare workers had been implicated in the increased risk of nosocomial spread of COVID infection and absenteeism among healthcare workers, impacting the quality of patient care. However, mandatory vaccine policies were also seen to encroach on the autonomy of healthcare workers., Aims and Objectives: To synthesise the arguments for and against mandatory vaccination for healthcare workers (HCWs) and its long-term impact on the healthcare workforce, through an analysis of texts and opinions of professionals from different fields of study., Methods: This is a systematic review of opinions published in peer-reviewed journals. After initial search in Cochrane and JBI systematic review databases to ensure no previous review had been done, five databases were searched (PsychInfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline and Scopus). Inclusion criteria were: 1) focused on COVID-19; 2) healthcare workers specific; 3) specific to mandatory vaccination; 4) opinion piece with an identified author; and 5) in English., Exclusion: 1) focus on other vaccine preventable diseases, not COVID-19 and 2) discussion on mandatory vaccination not-specific to healthcare workers. The Joanna Briggs Critical Appraisal tool for Text and Opinions was used to assess quality. Data were synthesised in the summary table., Results: The review included 28 opinion and viewpoint articles. Of these, 12 (43 %) adopted a pro-mandatory vaccination stance, 13 (46 %) were neutral or had presented arguments from both sides of the debate and only three (11 %) were against. The overall arguments among those who were pro-, neutral and anti-mandatory COVID-19 vaccination were underpinned by ethical, moral and legal principles of such a mandate on a vulnerable healthcare workforce. This review highlighted the polarised opinions concerning choices, human rights, professional responsibilities and personal risks (i.e. health risks, losing a job) with the introduction of vaccination mandate. However, the articles found in this review discussed mandatory vaccination of healthcare workers in the USA, Europe and Australia only., Conclusion: The review underscores the need to balance the rights of the public to safe and quality care with the rights and moral obligations of healthcare workers during a public health emergency. This can be achieved when policies and mandates are guided by reliable scientific evidence which are flexible in considering legal and ethical dilemmas., Tweetable Abstract: To mandate or not to mandate COVID-19 vaccination for healthcare workers: A synthesis of published opinions in health, law, and bioethics., Competing Interests: Declaration of Competing Interest None., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Purpose: To determine the scope of published literature on healthcare transition (HCT) interventions that have been co-designed with adolescents and young adults with chronic conditions, and to undertake feasibility assessments., Methods: Using Scopus, CINAHL, Medline-Ovid, Cochrane and PsycINFO databases, publications that included a HCT intervention to support paediatric to adult healthcare transition were included. Study location, design, population, description of the intervention, co-design methods, feasibility evidenced using Bowen and colleagues' framework, and outcome measures were extracted for review., Results: A total of 21 studies were included, relating to 17 co-designed HCT interventions that ranged across multiple medical specialties. There was no standard HCT intervention; characteristics, format and delivery mode varied. Only three studies reported a detailed description of the co-design method(s) used and none reported on the facilitators or barriers. Among the studies, five of Bowen and colleagues' eight dimensions of feasibility were measured., Conclusions: Despite the co-design process being neither described or evaluated extensively, all co-designed HCT interventions included in this review were considered to be feasible. Nevertheless, HCT interventions varied in their format and delivery method making it difficult to compare between them. Furthermore, interventions were often condition-specific and not representative of the extensive range of chronic conditions.Implications for RehabilitationHealthcare transition interventions can improve adherence to care, health outcomes, ongoing rehabilitation, and quality of life of adolescents and young adults with chronic conditions.Healthcare transition interventions should maximise long-term functioning and prioritise rehabilitation aimed at enhancing independence and self-management skills, while reducing hospitalisations.The engagement of individuals with lived experience in the co-design of interventions has been strongly advocated as it brings unique knowledge and experience to the research process.Minimal attention has been given to the involvement of adolescents and young adults with chronic conditions in the development of healthcare transition interventions, however, healthcare transition interventions co-designed with adolescents and young adults with chronic conditions are both feasible and acceptable.

Objectives: Healthcare transition (HCT) interventions are pivotal to paediatric rehabilitation. However, there has been limited research focusing on HCT in young people with spinal cord injury (SCI). To date, little has been reported on key factors that may contribute to a positive or negative transition experience and what, if any, are the gaps in the transition process. This study explored the experiences of transition from paediatric to adult healthcare for young people with SCI and parents/caregivers in pursuit of co-designing and developing an intervention to support transition., Design, Setting and Participants: This qualitative study forms part of the planning phase of a larger participatory action research project. It supports obtaining a rich understanding of the phenomenon and the issues and actions necessary to achieve change. Semi-structured individual interviews were conducted online between April and June 2021 with young people with SCI and parents/caregivers who had transitioned or were preparing for the transition from paediatric to adult healthcare in NSW, Australia. The interviews were analysed using an inductive reflexive thematic analysis approach., Results: The study recruited nine participants, five young people with SCI and four parents/caregivers. The interviews provided invaluable insight into young people with SCI and their parents'/caregivers' experiences of HCT. As HCT experiences were often less than optimal and needs were not adequately met, some recommendations were offered. These included a coordinated and streamlined handover from paediatric to adult healthcare providers, and a 'one-stop shop' for young people with SCI and their parents/caregivers to access transition information, such as how it occurs, who to call for ongoing support and advice, and tips on how to transition successfully., Conclusion: Providing a coordinated and streamlined handover process as well as access to more context-related information could improve the transition experiences of young people with SCI and parents/caregivers, resulting in improved health outcomes and greater independence., Trial Registration: ACTRN12621000500853., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: The objective of the review is to assess the association between health literacy levels and self-management behaviors in people with coronary heart disease., Introduction: Initiating and maintaining self-management behaviors following a coronary event can be challenging. The capacity to initiate behavioral changes requires adequate health literacy, which is the ability to understand and use health care information to make appropriate health decisions., Inclusion Criteria: This review will consider studies including individuals at any age who have been diagnosed with coronary heart disease. Studies that used a standardized measure of health literacy with the primary outcome of self-management behaviors or an element of self-management (eg, medication adherence) will be considered for inclusion., Methods: The review will be conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Databases to be searched include CINAHL, Embase, PubMed, APA PsycINFO, Cochrane, Scopus, ScienceDirect, ProQuest Dissertations and Theses, Google Scholar, and OpenGrey. This will be followed by a forward and backward search of relevant articles. Cross-sectional, case-control, cohort, and mixed methods studies (quantitative component only) will be included. Studies will be screened by 2 independent reviewers and undergo a critical appraisal process. Included studies will be assessed for methodological quality, and data will be extracted using a JBI data extraction tool in the JBI System for the Unified Management, Assessment and Review of Information. The results will be presented as a narrative synthesis and, where possible, a meta-analysis will be conducted. The Grading of Recommendations, Assessment, Development, and Evaluation approach will be used to assess the certainty of evidence., Systematic Review Registration Number: PROSPERO CRD42021257407., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 JBI.)