Search

The Connor-Davidson Resilience Scale's (CD-RISC) 10 item variant has previously demonstrated acceptable psychometric properties of its test scores using traditional methods (e.g., confirmatory factor analysis), and concurrent validity with resilience-related outcomes, particularly in samples of younger adults. While alternative methods of examining the psychometric properties of the long-form CD-RISC exist in the literature, the short-form measure has unclear evidence of local item independence and a unidimensional structure, which are key assumptions of a polytomous Rasch model approach to examining the measure's psychometric properties. The current study employed a sample of young adult university students (n = 708, xage = 26.43 years (s = 7.77)) on their nursing practicum placements to examine the CD-RISC-10 against the polytomous Rasch measurement model criteria. The analyses suggested a seven-item variant of the CD-RISC-10 performed acceptably, and omitted issues with local item dependence and item misfit. Effect sizes of the standardized parameters estimated for the 7-item and original 10-item versions of the CD-RISC-10, when predicting compassion fatigue and compassion satisfaction, were small (s = -0.24, s = -0.23) and moderate (s = 0.48, s = 0.47) for the respective measures, which suggested similar efficacy when examining the test scores' concurrent validity. The shorter version of the CD-RISC-10 consequently demonstrated generally acceptable psychometric properties for its test scores, and remained a parsimonious approach to examining individual psychological resilience that will benefit from further development. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

In this article, we discuss the origins, epistemology, and forms of Yarning as derived from the literature, and its use in research and clinical contexts. Drawing on three Yarns, the article addresses the extent to which non-Indigenous researchers and clinicians rightfully use and adapt this information-gathering method, or alternatively, may engage in yet another form of what can be described as post-colonialist behavior. Furthermore, we argue that while non-Indigenous researchers can use Yarning as an interview technique, this does not necessarily mean they engage in Indigenous methodologies. As we note, respectfully interviewing Aboriginal and Torres Strait Islander peoples can be a challenge for non-Indigenous researchers. The difficulties go beyond differences in language to reveal radically different expectations about how relationships shape information giving. Yarning as a method for addressing cross-cultural clinical and research differences goes some way to ameliorating these barriers, but also highlights the post-colonial tensions.

Aim This study evaluated a workplace resilience intervention involving registered nurses working in rural and remote settings in Queensland, Australia. Background The nature of nursing work provides a range of challenges to the psychological well-being of nurses. To address these challenges, research in the area of building resilience to enhance psychological well-being among nurses is growing rapidly, although few studies have investigated these phenomena in rural and remote settings. Design/methods The study implemented and evaluated a Mindfulness Self-Care and Resiliency (MSCR) program delivered to registered nurses (N = 32) working in rural or remote locations, to enhance workplace resilience. Registered nurses who attended the program were invited to evaluate the program via a semi-structured telephone interview. Results/findings Qualitative analysis showed that most nurses found the MSCR program valuable and relevant in terms of learning new knowledge and skills to help build resilience to stress in the workplace. Conclusion The MSCR intervention was received positively by the registered nurses who participated and may have broader application across the rural healthcare sector.

University employees experience high levels of workplace stress, with the perception that it is increasing, due to less autonomy, increased student numbers, excessive administrative work and role a...

Background Patients with complex chronic conditions experience fragmentation of care, unnecessary hospitalization and reduced quality of life, with an increased incidence of poor health outcomes. Aim(s) The aim of this paper was to explore how nurse navigators manage client care. This was achieved through an examination of narratives provided by the nurse navigator that evaluated their scope of practice. Method(s) All nurse navigators employed by Queensland Health were invited to participate in a study evaluating the effectiveness of the service. Eighty‐four self‐reported vignettes were thematically analysed to understand the work from the nurses’ perspectives. Results Two themes emerged from the vignettes. Theme 1, the layers of complexity, is comprised of three sub‐themes: the complex patient, the complex system and patient outcomes. Theme 2, professional attributes, has two sub‐themes: person‐centred care and clinical excellence. Conclusion Navigators innovatively integrate services and address the fragmented nature of the health system. They apply expert clinical and social skills, through consistent and robust communication, to meet the needs of those with multiple chronic conditions. Implications for nursing management Results provide insight into the new role, illuminating the work they achieve, despite system complexities.

Aim To further develop and validate a new model of the early career transition pathway in the speciality of community nursing. Design Delphi policy approach, guided by a previous systematic review and semi‐structured interviews. Methods Four rounds of an expert panel (N = 19). Rounds one, two and four were questionnaires consisting of a combination of closed (Likert response) and open‐ended questions. Round three comprised of a focus group conducted using virtual meeting technology. Results The final model demonstrated reliable and valid measures. There were deficiencies in “pre‐entry”—where the marketing of community nursing was negligible and the support around orientation informal and minimal, mainly due to tight budgetary concerns. Community practice holds a whole new dimension for nurses transitioning from acute care as the concept of “knowing your community” took time and support—time to be accepted reciprocally and develop a sense of belonging to the community.

Background Delays in reperfusion therapy for myocardial infarction (MI) are associated with increased mortality and morbidity, and most of this delay is due to delay in patients initiating contact with emergency services. This study assesses the impact of the Australian National Heart Foundation media campaign and identifies patient characteristics and presenting symptoms that may contribute to delay. Methods This prospective cohort study identified patients with a diagnosis of MI admitted to a single tertiary metropolitan hospital in Perth, Western Australia from July 2013 to January 2014. Patients were interviewed and responses were categorised to determine their reasons for delaying treatment and the impact of mass media campaigns. Delay times were analysed using multivariable linear regression models for the Whole Cohort (all patients admitted to the tertiary hospital, including patients from rural and peripheral hospitals) and the Direct Admission Cohort (patients admitted directly to the tertiary hospital). Results Of 376 patients, 255 patients provided consent, and symptom onset-time was available for 175 patients. While almost two thirds of the cohort was aware of media campaigns, awareness was not associated with decreased prehospital delay. Median delay was 3.9 hours for the Whole Cohort and 3.5 hours for the Direct Admission Cohort. Delay was associated with being widowed, symptom onset on a weekday compared with weekend, past medical history of MI and coronary artery bypass graft, private compared with ambulance transport to hospital, and lack of symptoms of sweating and weakness. In addition, for the Direct Admission Cohort, age and income were also associated with delay. Conclusions This study did not find an association between awareness of media campaigns and delay. This study identified important characteristics and presenting symptoms that are associated with delay, and possibly relevant to future media campaigns.

Objective Burnout is a significant problem affecting the nursing workforce and is associated with significant personal suffering and high rates of nurse turnover. Efforts to further understand the variables that explain burnout are needed. The aim of this cross-sectional study was to examine both environmental and individual factors that may explain burnout among nurses. Method We recruited 1848 Australian nurses to complete several online questionnaires measuring the practice environment (Practice Environment Scale of the Nursing Work Index), burnout (Professional Quality of Life Scale), trait negative affect ( Spielberger State-Trait Anxiety Inventory form Y2) and resilience (Connor Davidson Resilience Scale). Correlational analysis as well as hierarchical regression was used to determine the relative importance of variables in explaining burnout scores. Results All of the practice environment scales were significantly related to burnout in the negative direction, and these relationships were above .3 for all except the relationship scale ( r = –.256) and the participation in hospital affairs scale ( r = –.285). Overall, the regression model accounted for 62% of the variance in nurse burnout scores. Trait negative affect, resilience and two aspects of practice environment (Manager sub-scale and Staffing sub-scale) all explained significant variance in burnout scores. The largest contribution came from the two individual variables (resilience and trait negative affect) that together explained 55% of the variance in burnout scores. Conclusions Findings suggest that health service administrators should provide nursing staff with education and support to build individual resilience. Workplaces that attend to staffing and resource issues and have managers who provide high levels of support to their staff appear to be essential strategies to help prevent nurse burnout.

Despite the important contribution of nongovernmental organizations (NGOs) to the community healthcare sector, the building and maintenance of occupational resilience in community health workers has received little attention. However, it is recognized that employees in this sector are exposed to significant stressors from the high demand work environment which negatively impacts on their well-being. Therefore, this research examined the acceptability, feasibility, and sustainability of a mindful resiliency program by employing a qualitative analysis of participant subjective experience of the program in this cohort. This was the first study to be conducted with senior managers and frontline healthcare providers in the nongovernmental organizations community sector. A 1-month post-delivery qualitative review of the program identified four major themes: applicability, changes to participant's skills, social support, and coping with COVID-19. A major finding was the ability of the participants to immediately recognize their stress levels and then manage them. Additionally, lessons from the program were shown to be usefully applied with colleagues and clients within the work environment, and with family members.

This report identified the emergent success of the navigators in improving the care of people living with multiple chronic conditions. These results are achieved through the delivery of person-centred care, evidenced by an ongoing improvement of patients’ self-reported wellbeing and self-management of their illness alongside indicative cost savings resulting from a reduction in unnecessary hospital admissions. Navigators are not new; however, there is a paucity of literature that identifies the role of nurses as navigators in the co-ordination of multimorbid conditions. Therefore, the Queensland navigators are novel. Furthermore, their uniqueness lies is in the diversity of the context within which they work, particularly regarding disparate geographic regions and cultural diversity. These factors add to the challenges that navigators face in supporting patients to achieve effective access to multiple levels of health service delivery and numerous specialist services involved in their care.

OBJECTIVE: The objective of this review is to identify and map the literature that describes the individual and environmental factors that influence nurses and midwives to stay in or leave their discipline within the first three years of practice. INTRODUCTION: The turnover rate of newcomers within their first three years of nursing and midwifery is higher than in later years and is contributing to a worldwide shortage. Both individual and environmental factors, often in combination, contribute to this attrition. Many studies demonstrate the associations of factors with turnover or intention to stay; however, the scope of factors has not been documented. INCLUSION CRITERIA: Newcomers are defined as registered nurses and registered midwives within the first three years of entering their discipline. Quantitative and qualitative studies and systematic reviews that explore individual or environmental factors that influence the decision to leave or to remain in nursing and midwifery in any context will be considered. Factors may include coping, anxiety, mindfulness, practice environment, or combinations such as resilience, satisfaction, and burnout. Articles must have been peer reviewed. Literature published since 1974 in English will be considered. Newcomers who have completed skills-based training will be excluded. METHODS: The JBI method for scoping reviews will be followed. An extensive search of multiple databases and gray literature will be undertaken. Retrieval of full-text studies and data extraction will be performed independently by two reviewers. Data extracted will be synthesized and results reported using a mind map, tables, and narrative form.

Background Hospitals and other health care providers frequently experience difficulties contacting patients and their carers who live remotely from the town where the health service is located. In 2016 Nurse Navigator positions were introduced into the health services by Queensland Health, to support and navigate the care of people with chronic and complex conditions. One hospital in Far North Queensland initiated an additional free telephone service to provide another means of communication for patients and carers with the NNs and for off-campus health professionals to obtain details about a patient utilising the service. Calls made between 7am and 10pm, seven days per week are answered by a nurse navigator. Aim To report utilisation of the service by navigated clients and remotely located clinicians compared to use of navigators’ individual work numbers and direct health service numbers. We report the reason for calls to the free number and examine features of these calls. Methods Statistical analysis examined the call reason, duration of calls, setting from where calls originated and stream of calls. Interactions between the reasons for calls and the features of calls, such as contact method, were examined. Results The major reason for calls was clinical issues and the source of calls was primarily patients and carers. Clinical calls were longer in duration. Shorter calls were mainly non-clinical, made by a health professional. Setting for calls was not related to the reason. The most frequent number used was the individual mobile number of the NN, followed by the hospital landline. Although the free number was utilised by patients and carers, it was not the preferred option. Conclusion As patients and carers preferred to access their NN directly than via the 1800 number, further research should explore options best suited to this group of patients outside normal business hours.

To explore nurses' perceptions of factors affecting workloads and their impact on patient care. Fiscal restraints and unpredictable patient illness trajectories challenge the provision of care. Cost containment affects the number of staff employed and the skill-mix for care provision. While organisations may acknowledge explicit rationing of care, implicit rationing takes place at the point of service as nurses are forced to make decisions about what care they can provide. A self-report cross sectional study was conducted using an on-line survey with 2,397 nurses in Queensland, Australia. Twenty to forty per cent reported being unable to provide care in the time available; having insufficient staff; and an inadequate skill-mix. The respondents reported workload and skill-mix issues leading to implicit care rationing. Over 60% believed that the processes to address workload issues were inadequate. Institutional influences on staffing levels and skill-mix are resulting in implicit care rationing. Adequate staffing should be based on patient acuity and the skill-mix required for safe care. Managers should be more assertive about adequate clinical workloads, involve staff in decision-making, and adopt a systematic planning approach. Failure to do so results in implicit care rationing impacting on patient safety.

This article reports findings from a 2016 survey exploring the working life of nurses/midwives in Queensland, Australia. Responses related to occupational violence (OV) are reported. OV is linked to high rates of burnout. It is imperative to continue efforts to understand how to avoid burnout and build nurse/midwives' resilience. A total of 2397 nurse/midwives working in Queensland responded to the survey and were asked to answer 8 questions related to OV. In the last 3 months, 53% of nurses/midwives had experienced OV. Those respondents had significantly higher rates of burnout and lower resilience and rated the practice environment lower than their counterparts who had not experienced violence. The experience of OV significantly impacts nurse resilience and levels of burnout. To retain nurses, attention must be given to reduce OV and support nurses who have experienced it.

Nursing is recognized as a stressful occupation where the incidence of negative outcomes such as burnout and high attrition has been well documented. Studies have consistently found that a higher level of resilience is related to retention in the nursing workforce. Mindfulness has been shown to lower levels of burnout and may play an important role in resilience to vicarious trauma. A brief mindful self-care and resiliency (MSCR) program aimed specifically at reducing compassion fatigue, and enhancing nurses’ resilience was piloted in a tertiary acute care hospital in Australia. This paper reports findings from the qualitative component of a mixed methods study which aimed to explore nurses’ responses to the MSCR program including its perceived feasibility, acceptability, and applicability. A sample of 20 nurses completed the MSCR program, of which 16 nurses (80% response) participated in individual unstructured interviews. Verbatim transcripts of the audio recorded interviews were subjected to thematic analysis. Five themes emerged that described participants’ perceptions of how the program benefitted nurses and its applicability in routine practice: Gaining perspective and insight; developing feelings of inner calm; taking time to care for self; feasibility and acceptability of the MSCR program; and using self-care strategies. The MSCR program was found to be feasible and acceptable from the perspective of nurse participants working in this acute care hospital. Fifteen nurses (94%) reported using mindful awareness and self-regulation after completing the program indicating that the strategies offered were practicable in this work setting.

Introduction The objectives of this research were to: (1) determine the extent of Australian radiation therapists (RTs) research participation; (2) evaluate the impact of research involvement on career perceptions (3) explore which research topics require investigation and (4) identify benefits and barriers to research participation. Methods This study used mixed methods to collect qualitative and quantitative data using an online survey from a larger workforce study of RTs and radiation oncology medical physicists. Participants practising in Australia completed questions about their research involvement. Chi‐square tests and logistic regression were used to analyse quantitative data and content analysis was used to explore qualitative data. Results Two hundred and ninety‐six RTs answered the research questions. Forty‐six percent had been involved in research. Of these, 91% had been involved in departmental, 28% in national, 14% in international and 29% in informal or self‐directed research studies. Eleven RTs (8%) had received funding as a chief/principal investigator. Involvement in research was associated with a desire to make a career change. However, it also appeared to be associated with greater satisfaction with career progression and staying in the career. Respondents identified a range of potential research topics, benefits of participating in research and barriers which included lack of time, support and cost. Conclusion Almost half of the RT participants identified that they were participating in research. Our data suggest that continued involvement in research, and opportunities to participate, improve RT job satisfaction. RTs' research activities are likely to be extended through provision of additional time and support.

Aim To synthesize existing research to determine if nurses who work shifts have poorer psychological functioning and resilience than nurses who do not work shifts. Background Research exploring the impact of shift work on the psychological functioning and resilience of nurses is limited compared with research investigating the impact of shifts on physical outcomes. Design Integrative literature review. Data Sources Relevant databases were searched from January 1995–August 2016 using the combination of keywords: nurse, shift work; rotating roster; night shift; resilient; hardiness; coping; well-being; burnout; mental health; occupational stress; compassion fatigue; compassion satisfaction; stress; anxiety; depression. Review Methods Two authors independently performed the integrative review processes proposed by Whittemore and Knafl and a quality assessment using the mixed-methods appraisal tool by Pluye et al. Results A total of 37 articles were included in the review (32 quantitative, 4 qualitative and 1 mixed-methods). Approximately half of the studies directly compared nurse shift workers with non-shift workers. Findings were grouped according to the following main outcomes: (1) general psychological well-being/quality of life; (2) Job satisfaction/burnout; (3) Depression, anxiety and stress; and (4) Resilience/coping. We did not find definitive evidence that shift work is associated with poorer psychological functioning in nurses. Overall, the findings suggest that the impact of shift work on nurse psychological functioning is dependent on several contextual and individual factors. Conclusion More studies are required which directly compare the psychological outcomes and resilience of nurse shift workers with non-shift workers.

Purpose To explore the self-perceived role of the Aboriginal peer support worker working with families with young children. This study was a component of a larger participatory action research study undertaken in a Western Australian metropolitan setting to develop and evaluate the suitability, feasibility and effectiveness of an Aboriginal peer-led home visiting program. Methods Focus group interviews were carried out with peer support workers using unstructured and semi-structured interviews within Action Learning Sets. Data were analysed using thematic analysis. Results The overarching theme on the self-perceived role of the Aboriginal peer support worker was Giving Parent Support, with subsidiary themes relating to development and ongoing sustainability of the support. Discussion The peer support workers viewed their role as providing parent support through enabling strategies which developed client acceptance and trust, delivered culturally relevant support, advocated for families, developed therapeutic engagement and communication strategies, and created safe home visiting practices. They recognised the importance of linking families with community support such as community child health nurses which was important for improving long term physical and psychosocial health outcomes for children. Conclusion Aboriginal Peer Support Workers identified their emerging integral role in the development of this unique culturally acceptable home visitingsupport for Aboriginal parents. Innovative approaches towards client engagement demonstrated their value in developing creative ways of working in partnership with families, community support services and child health nurses across a range of challenging psychosocial environments.

As part of a study of the radiation oncology workforce, radiation oncology medical physicists (ROMPs) who had worked in Australia were surveyed regarding their attitudes to participating in research. Responses from 88 ROMPs were available for analysis, representing a broad mix of employment situations and research experience. Greater than 70% of ROMPs described their involvement in research as "liking it" or "loving it", with associated identified benefits including skills development, job satisfaction and career progression. Over half of respondents agreed that involvement in research inspired them to stay in their profession. However, lack of time, support and motivation were all identified as barriers to participation in research. Areas of research interest were identified. This study highlights the importance of a research culture for job satisfaction and staff retention.

Background Designing child and family health services to meet the diverse needs of contemporary families is intended to minimize impacts of early disadvantage and subsequent lifelong health and social issues. Innovative programs to engage families with child and family support services have led to interest in the potential value of peer-led home visiting from parents in local communities. There is a range of benefits and challenges identified in a limited number of studies associated with home visiting peer support. Objectives The objective of the review is to identify: INCLUSION CRITERIA PARTICIPANTS: Families/parents with one or more children aged zero to four years, peer support workers and their supervisors. Intervention and phenomenon of interest Peer-led home visiting parenting support programs that use volunteer or paraprofessional home visitors from the local community compared to standard community maternal-child care. The phenomenon of interest will be the relationships between participants in the program. Types of studies Quantitative studies: randomized control trials (RCTs). Qualitative studies: grounded theory and qualitative descriptive studies. Outcomes Parental attitudes and beliefs, coping skills and confidence in parenting, parental stress, compliance with child health checks/links with primary healthcare services, satisfaction with peer support and services and the nature of the relationship between parents and home visitors. Search strategy The search strategy will include both published and unpublished studies. Seven journal databases and five other sources will be searched. Only studies published in the English language from 2000 to 2015 will be considered. Methodological quality Studies were assessed by two independent reviewers using standardized critical appraisal tools from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) and the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) as appropriate. Data extraction Both quantitative and qualitative data were independently extracted by two reviewers using standardized data extraction tools from the JBI-MAStARI and the JBI-QARI, respectively, including qualitative and quantitative details about setting of interventions, phenomena of interest, participants, study methods and outcomes or findings. Data synthesis For quantitative findings, statistical pooling was not possible due to differences in interventions and outcome measures. Findings were presented in narrative form. Qualitative findings were aggregated into categories based on similarity of meaning from which synthesized findings were generated. Results Quantitative results from two RCTs demonstrated positive impacts of peer-led home visiting parent support programs including more positive parenting attitudes and beliefs, and more child preventative health care visits.Fifteen qualitative findings from two studies were aggregated into five categories from which two synthesized findings emerged. Parents and home visitors identified similar components as contributing to their program's success, these being quality of relationships between parents and home visitors with elements being mutual respect, trust and being valued within the partnership. In addition, home visitors identified importance of enabling strategies to develop relationships. They also needed supportive working environments with clinical staff and management. Conclusion The current review indicates a positive impact of peer-led home visiting parent support programs, incorporating a framework of partnership between parents and home visitors, on mother-infant dyads. Positive changes in parenting attitudes and beliefs, and increased number of child preventative healthcare visits are supported by the quality of the relationship between parent and home visitor, and home visitors' working environments. Implications for practice The essential characteristics of an effective parent support program are strategies for relationship building between parents and home visitors; ongoing staff and home visitor education to enhance communication, collaboration and working in partnership; supervision by team leaders; and continuous quality improvement. Implications for research The focus of further research should be on confirmatory studies using an action research methodology and the cost-effectiveness of these models.

ObjectivesThis study aimed to test and further develop the ‘Early Career and Rapid Transition to a Nursing Specialty’ (TRANSPEC) model to a nursing specialty developed from a systematic review. Semi-structured interviews of specialist clinically based nurses and a consensus Delphi study with an expert panel were used to expand and achieve consensus, agreement, reliability and stability of the model.DesignA modified Delphi, two rounds (64 and 52 Likert items) of reiterative online questionnaires and one round as a nominal group technique, was informed by qualitative thematic analysis of semi-structured interviews.Setting and participantsInterviews with 14 specialists clinical practicing registered nurses and a panel of 25 national experts participated in the Delphi study.ResultsThe interview participants experienced 14 rapid transitions and three were early career transition. The overarching themes from the preliminary model were confirmed and further expanded. These were the self (personal and professional); the transition processes (final and informal); a sense of belonging; and the overarching context of practice over a time continuum. In the Delphi, the highest rating item was ‘Specialty work colleagues respect, include, support, and accept specialist nurse on completion of transition processes’. Pre-entry was highlighted as an important time point prior to transition. All items reaching consensus were included in the final model. Cronbach α increased from 0.725 to 0.875 for the final model.ConclusionsThe TRANSPEC model is a valid and reliable evidence-based tool for use in the career pathway and development of nursing specialists. Using the Benner model ‘Novice to Expert’ after the novice incomer phase is achieved, further lifelong learning development will transform the novice specialist over time continuum.

Objective: Rural doctors are difficult to recruit and retain. Burnout and stress in the medical workforce fluctuates according to location. Overall, doctors have an elevated risk of depression and suicide compared to the general population and other professionals. Higher levels of occupational stress also effect patient care, levels of work satisfaction and relationships with others. This study evaluated the effectiveness, acceptability, feasibility and sustainability of the Mindful Self-Care and Resiliency Program. Design: This was a sequential mixed-method study involving the collection of both quantitative and qualitative data. Setting: The study was conducted in Emerald, Queensland. Participants: Thirteen doctors took part in the program with seven providing pre and post survey responses. Qualitative data were collected via semi-structured telephone interviews with an additional four rural doctors. Intervention The Mindful Self-Care and Resiliency program consisted of a 4-hour face-to-face session and three 1-hour video-conference follow up sessions. Main outcome measures Burnout, negative affect, well-being and psychological strain were assessed using self-report measures before and after taking part in the program. Results The majority (six out of seven) of the doctors showed reductions in burnout, psychological strain and negative affect following participation in the program. The qualitative data indicated that all doctors gained new skills: self-awareness, reflection and self-care. They also reported improved interaction with colleagues and patients, to whom they passed on their new learning. Conclusion This preliminary investigation of the effectiveness and feasibility of Mindful Self-Care and Resiliency for rural doctors indicates that the program has promise in improving the emotional well-being of this occupational group. Although this study captured approximately one-third of the Emerald workforce, further research with a larger sample is required to confirm these findings.

With increasing age and chronicity in populations, the need to reduce the costs of care while enhancing quality and hospital avoidance, is important. Nurse-led co-ordination is one such model of care that supports this approach. The aim of this research was to assess the impact that newly appointed Navigators have on service provision; social and economic impact; nurses' professional quality of life and compassion fatigue; and analysis of the change that has occurred to models of care and service delivery.A concurrent mixed-method approach was selected to address the research aims.The research project was funded in July 2018 and will conclude in December 2020. Several cohorts will be studied including; patients assigned to a navigator, patients not assigned to a navigator, family members of patients assigned a navigator; and a sample sized estimated at 140 navigators.This study provides a comprehensive international longitudinal and mixed method framework for evaluating the impact of nurse navigators on quality of care outcomes for patients with chronic conditions. IMPACT-WHAT PROBLEM WILL THE STUDY ADDRESS?: Even with specialty focused co-ordinated care, patients get lost in the system, increasing the incidence of non-compliance and exacerbation of condition. Navigators work with patients across service boundaries allowing for care that is patient responsive, and permitting variables in clinical, social and practical elements of care to be addressed in a timely manner. This novel nurse-led approach, supports hospital avoidance and patient self-management, while encouraging expansion and opportunity for the nursing and midwifery workforce.目的: 随着人口年龄和慢性化的增加,在提高质量和避免住院的同时降低护理成本的需求显得非常重要。护士引导型协调就是支持这种方法的护理模式之一。这项研究目的在于评估新任导航员对服务提供的影响;社会和经济影响;护士职业生活质量与同情心疲乏;以及对护理和服务提供模式所发生变化的分析。 设计: 选择了并行混合方法来解决研究目标。 方法: 研究项目于2018年7月获得资助,将于2020年12月结束。将研究几个队列,包括:分配给导航员的患者、未分配给导航员的患者、分配给导航员的患者家属;和估计为140个航海家的样本量。 讨论: 本研究为评估护士导航员对慢性病患者护理结果质量的影响提供了一个全面型国际纵向和混合方法框架。 影响--研究将解决什么问题?以下内容;: 即使有了专业专注型协调护理,患者也会迷失在身体系统中,从而增加不遵从和病情恶化的发生率。导航员跨越服务边界与患者合作,考虑患者响应型护理,并允许及时处理临床、社会和实际护理要素中的变量。这种新颖的护士主导型方法有助于避免住院和患者自我管理,同时鼓励护理和助产人员的壮大和机遇。.

Aim To understand the impact and causes of ‘Failure to Attend’ (FTA) labelling, of patients with chronic conditions. Background Nurse navigators are registered nurses employed by public hospitals in Queensland, Australia, to coordinate the care of patients with multiple chronic conditions, who frequently miss hospital appointments. The role of the nurse navigator is to improve care management of these patients. Evidence for this is measured through improvement in patient self-management of their conditions, a reduction in preventable hospital admissions and compliance with attendance at outpatient clinics. Failure to attend (FTA) is one measure of hospital utilisation, identifying outpatient appointments that are cancelled or not attended. Method The cohort for this study was patients with multiple chronic conditions, and nurse navigators coordinating their care. Data describing the concept of FTA were thematically analysed twelve months into this three year evaluation. Results Although the patient is blamed for failing to attend appointments, the reasons appear to be a mixture of systems error/miscommunication between the patient and the health services or social reasons impacting on patient’s capacity to attend. Themes emerging from the data were: access barriers; failure to recognise personal stigma of FTA; and bridging the gap. Conclusion The nurse navigators demonstrate their pivotal role in engaging with outpatient services to reduce FTAs whilst helping patients to become confident in dealing with multiple appointments. There are many reasons why a patient is unable to attend a scheduled appointment. The phrase ‘Failure to Attend’ has distinctly negative connotations and can lead to a sense of blame and shame for those with complex chronic needs. We propose the use of the neutral phrase “appointment did not proceed” to replace FTA. Implications for Nursing management This article advocates for further consideration of collaborative models that engage the patient in their care journey and for consideration of the language used within the outpatient acute hospital setting, proposing the term ‘appointment did not proceed.’

It is now well established that a significant number of nurses have less than optimal levels of wellness as a result of the stressful nature of their work. Identifying effective workplace strategies to help improve the resilience of nurses is therefore a high priority. In this study, we evaluated the feasibility of a mindfulness-based intervention aimed at reducing compassion fatigue and improving emotional well-being in nurses. A total of 21 nurses recruited from a large teaching hospital in Western Australia, participated in a mindful self-care and resiliency (MSCR) intervention. The intervention consisted of a 1-day compassion fatigue prevention educational workshop, followed by a series of weekly mindfulness training seminars conducted over 4 weeks (12 h total intervention time). Participants completed a number of standardized measures at pre, post, and 1-month follow-up. Significant improvements were observed following the intervention for compassion satisfaction, burnout, trait-negative affect, obsessive passion, and stress scores. At pre-intervention, 45 % of the sample had high burnout scores, but this reduced to just 15 % by post-intervention. No significant changes were observed for general resilience, anxiety, or secondary traumatic stress post-intervention or at follow-up. The results of this preliminary study indicate that MSCR may represent a feasible approach to improving resilience and well-being among nurses. Further research utilizing a control group is required to strengthen conclusions.

Objective: This study aims to ascertain if differences exist in the perception of the professional practice environment and personal well-being of nurses across different geographical areas in Queensland. Design: This paper was performed on a prospective, self-report cross-sectional on-line survey. Setting: The study was conducted among the nurses employed in public and private health care settings: acute hospitals, community health and aged care in Queensland, Australia. Participants: Participants of this study were 1608 registered and enrolled nurses and assistants in nursing, current members of the Queensland Nurses Union in 2013 and who provided a workplace postcode. One thousand eight of these participants worked in major cities, while 382 in rural locations and 238 in remote areas. Interventions: None. Main outcome measures: Scores of well-being as determined by the following scales: the Depression, Anxiety and Stress Scale, the Professional Quality of Life Scale version 5, the Connor–Davidson Resilience Scale and of the Professional Practice Environment using the Practice Environment Scale – Nursing Work Index Revised. Results: Nurses employed in major cities perceived 'nursing foundations for quality care' more favourably than those from other settings. Remote area nurses had lower levels of secondary traumatic stress than nurses in major cities and rural areas. There was no difference between nurses across their geographical locations for stress, anxiety, depression, compassion satisfaction, burnout, resilience and the four other measures of the Practice Environment Scale. Conclusions: The study findings provide new data suggesting that, with the exception of secondary traumatic stress, the personal well-being of nurses does not differ across geographical settings. Similarly, with the exception of the subscale of 'nursing foundations for quality care' there was no difference in perceptions of the professional practice environment. As secondary traumatic stress is associated with burnout, this finding needs to be investigated further.

IntroductionThe management of patients who need chronic and complex care is a focus of attention internationally, brought about by an increase in chronic conditions, requiring significantly more care over longer periods of time. The increase in chronic conditions has placed pressure on health services, financially and physically, bringing about changes in the way care is delivered, with hospital avoidance and home-based care encouraged. In this environment, nurses play an important role in co-ordinating care across services. This review formed one part of a funded project that explored the nurse navigator role within a proposed 24-hour telephone-call service in one regional area that has a diverse population in terms of cultural identity and geographical location in relation to service access.AimThe review reports on the extant literature on the nurse's role in the provision of afterhours telephone services for patients with chronic and complex conditions. The specific aim was to explore the effectiveness of services for patients in geographically isolated locations.MethodsThe methodological approach to the review followed the Preferred Reporting System for Meta-Analyses (PRISMA) guidelines. A thematic analysis was used to identify themes with chronic care models underpinning analysis.ResultsThree themes were identified; nurse-led decision making; consumer profile; and program outcomes. Each theme was divided into two sub-themes. The two sub-themes for decision making were: the experience of the staff who provided the service and the tool or protocol used. The two sub-themes for consumers profile were; the geographic/demographic identity of the consumers, and consumer satisfaction. The final theme of outcomes describes how the effectiveness of the service is measured, broken into two sub-themes: the economic/workforce outcomes and the consumer outcomes.DiscussionThe provision of an after-hours telephone service, in whatever model used should align with a Chronic Care Model. In this way, after-hours telephone services provided by experienced nurses, supported by ongoing professional development and relevant protocols, form part of the ongoing improvement for chronic and complex care management as a health priority.

The aim of this study was to explore the stressors and coping of nursing students with differing levels of resilience and burnout during clinical placement. A qualitative descriptive study was conducted with twenty-four final-year baccalaureate nursing students, who were identified in the quantitative phase of the study as having scores indicating either: a) low resilience and high burnout; or b) high resilience and low burnout. Ten focus group interviews were conducted using a semi-structured interview guide. A thematic analysis of the data identified two main themes: a) stressors arising from the students aligning their expectations with the demands of the clinical placement (i.e., practice demands in busy wards, striving for learning opportunities, and discovering the social rules), and b) coping as a process of fitting into the ward culture. Those students with high resilience and low burnout scores had self-directed goals and coped by using self-regulation strategies. Those with low resilience and high burnout adopted external orientation and self-blame strategies. As suggested by the findings, the following approaches are recommended: offering interventions to enable students to fit actively into the clinical environment; encouraging engagement in reflection to facilitate self-awareness; and encouraging flexible use of personal and external resources.

To investigate the impact of shift work on the psychological functioning and resilience of nurses by comparing nurses who work shifts and nurses who work regular hours.A comparative descriptive design using an online self-report questionnaire.Data were collected from employed Registered and Enrolled Nurses (N = 1,369) who were members of the Queensland Nurses and Midwives Union (QNMU) in 2013. The survey included standardized measures of resilience, depression, anxiety, compassion satisfaction, compassion fatigue, and intention to leave the profession.Generalized Linear Mixed Model analysis revealed shift workers had significantly lower levels of compassion satisfaction. However, there were no significant differences between the groups on resilience, depression, anxiety, stress, compassion fatigue or intention to leave nursing.The findings suggest that shift work is not associated with worse psychological functioning or lower resilience in nurses. However, this study requires replication using a longitudinal design to confirm these findings.目的: 通过对轮班护士和定时上班的护士之间的比较,调查轮班制对护士心理功能和心理复原力的影响。 设计: 使用在线自我报告问卷的比较描述性设计。 方法: 数据来自2013年昆士兰护士和助产士联盟(QNMU)成员里的聘用注册护士和注册护士(人数为1369人)。这项调查包括复原力、抑郁、焦虑、同情心满意度、同情疲劳和离职打算的标准化措施。 结果: 广义线性混合模型分析显示,轮班员工的同情心满意度明显较低。但是,在复原力、抑郁、焦虑、压力、同情疲劳或离职意向等方面,两组之间没有明显差异。 结论: 调查结果表明,轮班工作与护士的心理功能变糟和复原力降低没有关系。然而,这项研究需要使用纵向设计来证实这些发现。.

Introduction The Mindful Self-Care and Resiliency (MSCR) programme is a brief psychosocial intervention designed to promote resilience among various occupational groups. The intervention is based on the principles of mindfulness and also incorporates an educational self-care component. The current paper presents the protocol for a pilot study that will evaluate the effectiveness of this programme among general practitioners working in rural Queensland, Australia. Methods and analysis We will measure the impact of the MSCR programme on levels of employee resilience (Connor-Davidson Resilience Scale; State-Trait Assessment of Resilience STARS), compassion satisfaction and compassion fatigue (Professional Quality of Life Scale), self-compassion (Self-Compassion Scale) and mood (Positive and Negative Affect Scale). We will also assess the impact of the programme on job satisfaction (The Abridged Job in General Scale), absenteeism/presenteeism (The WHO Health and Work Performance Questionnaire) and general well-being (WHO Five Well-being Index). Repeated measures analysis of variance will be used to analyse the impact of the intervention on the outcome measures taken at pre, post, 1-month, 3-month and 6-month follow-ups. We will conduct individual interviews with participants to gather data on the feasibility and acceptability of the programme. Finally, we will conduct an initial cost-effectiveness analysis of the programme. Ethics and dissemination Approval for this study was obtained from the Curtin University Human Research ethics committee and the study has been registered with the Australian Clinical Trials Registry. Results will be published and presented at national and international congresses. Trial registration number ACTRN12617001479392p; Pre-results.

This study aimed to determine and compare Radiation Therapists' (RTs') and Radiation Oncology Medical Physicists' (ROMPs') perspectives about their profession and workplace, satisfaction with career progression opportunities, and leaving the current workplace. RTs and ROMPs who were currently or had previously worked in Australia were invited to complete an online survey. Univariate and multivariate methods were used for analysis. Participants were 342 RTs and 112 ROMPs with estimated response rates of 14% and 26% respectively. Both professions rated workload poorly and identified the need for improvement in: communication between professions' members, support for junior staff/new graduates, staff morale, on-site training and multidisciplinary communication. RTs, more than ROMPs, perceived their profession was recognised and respected, but RTs were less likely to be satisfied with career progression/advancement, job promotion prospects and opportunities to specialise. At least 20% of RTs and ROMPs were thinking about leaving their workplace and 13% of RTs and 8% of ROMPs were thinking about leaving their profession. Different factors contributed to workforce satisfaction and retention within each profession. Staff satisfaction and career progression are critical to retain RTs and ROMPs. Further research is required to explore strategies to address workplace dissatisfaction, recruitment and retention.

Participatory action research (PAR) is a credible, culturally appropriate methodology that can be used to effect collaborative change within vulnerable populations.This PAR study was undertaken in a Western Australian metropolitan setting to develop and evaluate the suitability, feasibility and effectiveness of an Aboriginal peer-led home visiting programme. A secondary aim, addressed in this paper, was to explore and describe research methodology used for the study and provide recommendations for its implementation in other similar situations.PAR using action learning sets was employed to develop the parent support programme and data addressing the secondary, methodological aim were collected through focus groups using semi-structured and unstructured interview schedules. Findings were addressed throughout the action research process to enhance the research process.The themes that emerged from the data and addressed the methodological aim were the need for safe communication processes; supportive engagement processes and supportive organisational processes.Aboriginal peer support workers (PSWs) and community support agencies identified three important elements central to their capacity to engage and work within the PAR methodology. This research has provided innovative data, highlighting processes and recommendations for child health nurses to engage with the PSWs, parents and community agencies to explore culturally acceptable elements for an empowering methodology for peer-led home visiting support. There is potential for this nursing research to credibly inform policy development for Aboriginal child and family health service delivery, in addition to other vulnerable population groups. Child health nurses/researchers can use these new understandings to work in partnership with Aboriginal communities and families to develop empowering and culturally acceptable strategies for developing Aboriginal parent support for the early years. Impact Statement Child health nurses and Aboriginal communities can collaborate through participatory action research to develop peer-led support for the early years. Indigenous Australian peoples are people who identify as Aboriginal or Torres Strait Islander. Respectfully, throughout this paper, they will be described as Aboriginal.

Aims and objectives This study was positioned within a larger action research study relating to a peer-led Aboriginal home visiting parent support program in an urban Western Australian setting. The aims for this study component were to identify program elements, exploring participants’ perceptions of the program's suitability, feasibility, acceptability and effectiveness to inform program model recommendations and add to the body of knowledge on effective Aboriginal peer-led program models. Background The ability of Aboriginal parents to develop positive family environments is crucial, with parent support needing to be reflexive to local needs and sociocultural influences. Culturally appropriate service provision needs meaningful and acceptable strategies. Design This study was situated within a critical paradigm supporting Participatory Action Research methodology, using Action Learning Sets as the participant engagement and data collection setting. Methods Within ten Action Learning Sets, focus group interviews were carried out with Aboriginal peer support workers, a non-Aboriginal parent support worker, an Aboriginal program coordinator, an Aboriginal education support officer and non-Aboriginal program managers (n = 8), and individual interviews with parents (n = 2) and community agencies (n = 4). Data were analysed using thematic analysis. Results Five themes were derived from peer support worker and community agency cohorts: peer support worker home visiting skills; responding to impacts of social determinants of health; client support and engagement; interagency collaboration; and issues addressing program sustainability. Parent responses augmented these themes. Conclusions Participants identified five key elements relating to peer-led home visiting support for Aboriginal parents. These are uniquely placed to inform ongoing program development as there is little additional evidence in wider national and international contexts. Relevance to clinical practice Engagement with communities and peer support workers to develop culturally relevant partnerships with Aboriginal families is integral to contemporary child health practice. Ongoing nurse support is needed for peer support worker role development. Indigenous Australian peoples are people who identify as Aboriginal or Torres Strait Islander. Respectfully, throughout this paper, they will be described as Aboriginal.