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BackgroundThe role of eHealth programs to support patients through surgical pathways, including total hip arthroplasty (THA), is rapidly growing and offers the potential to improve patient engagement, self-care, and outcomes. ObjectiveThe aim of this study is to compare the effects of an eHealth program (intervention) versus standard care for pre- and postoperative education on patient outcomes for primary THA. MethodsA prospective parallel randomized controlled trial with two arms (standard care and standard care plus access to the eHealth education program) was conducted. Participants included those who underwent THA. Outcome measures were collected preadmission, at 6 weeks, and at 3 and 6 months after surgery. The primary outcome was the Hip Dysfunction and Osteoarthritis Outcome Score. Secondary outcomes were a 5-level 5-dimension quality of life measure and the self-efficacy for managing chronic disease scale. Demographic and clinical characteristics were also collected. A satisfaction survey was completed by all participants 6 weeks after surgery, and those in the intervention arm completed an additional survey specific to the eHealth program. ResultsA total of 99 patients were recruited: 50 in the eHealth program (intervention) and 49 in standard care (control). Clinical improvements were demonstrated in both groups across all time points. Per-protocol analysis demonstrated no differences between the groups for all outcome measures across all time points. Participants in the eHealth program reported that the program was accessible, that they felt comfortable using it, and that the information was helpful. ConclusionsThis study demonstrated that the eHealth program, in addition to standard care, had no additional benefit to THA recovery compared with standard care alone. The study found that the eHealth program was highly valued by participants, and it supported the preoperative preparation, recovery, and postoperative rehabilitation of participants. Trial RegistrationAustralian New Zealand Clinical Trial Registry ACTRN12617001433392; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373657

BackgroundThe Symptom Assessment and Management (SAM) program is a structured, online, nurse-supported intervention to support symptom self-management in people receiving adjuvant chemotherapy post surgery for breast or colorectal cancer. ObjectiveThe objective of this study was to describe the development, implementation strategy, and evaluation of the SAM system. MethodsThe development of the SAM program involved 3 phases. In phase 1, the web app was developed through consultation with consumers and clinicians and of the literature to ensure that the system was evidence-based and reflected the realities of receiving treatment and supporting patients through treatment. In phase 2, 7 participants recorded the severity of 6 symptoms daily over the course of 1 cycle of chemotherapy. In phase 3, 17 participants recorded their symptoms daily over the course of 3 cycles of chemotherapy. Once symptoms were recorded, participants received immediate feedback on the severity of their symptoms and self-management recommendations, which could include seeking immediate medical attention. Data on quality of life, symptom burden, anxiety and depression, distress, and self-efficacy were collected during treatment; participants’ perceptions of the SAM program were evaluated following participation via interview. ResultsThe outcomes of the SAM project include the development of a system that is reliable and easy to use and navigate. Participants reported benefits related to using the SAM program that included feeling more in control of managing their symptoms and feeling reassured. Engagement with the system on a daily basis was variable, with some participants completing the symptom tracker daily and others engaging some of the time. The feedback from all participants was that the system was easy to navigate and the information was relevant and supportive. ConclusionsThe SAM program has the potential to enhance the management of symptoms for people receiving chemotherapy treatment. The system creates an accurate repository of symptoms that can be accessed easily and highlight patterns in symptom experience. These can be shared with clinicians, with patient permission, to inform and support treatment plans. The potential to predict the risk of developing severe symptoms can be developed to anticipate the need for care and support. Further considerations on how to increase engagement with the system, the value of the system for people diagnosed with other tumor types and treatment regimes, and the incorporation of the system into everyday clinical practice are needed.

BackgroundVirtual reality (VR) delivered through immersive headsets creates an opportunity to deliver interventions to improve physical, mental, and psychosocial health outcomes. VR app studies with older adults have primarily focused on rehabilitation and physical function including gait, balance, fall prevention, pain management, and cognition. Several systematic reviews have previously been conducted, but much of the extant literature is focused on rehabilitation or other institutional settings, and little is known about the effectiveness of VR apps using immersive headsets to target health outcomes among community-dwelling older adults. ObjectiveThe objective of this review was to evaluate the effectiveness of VR apps delivered using commercially available immersive headsets to improve physical, mental, or psychosocial health outcomes in community-dwelling older adults. MethodsPeer-reviewed publications that included community-dwelling older adults aged ≥60 years residing in residential aged care settings and nursing homes were included. This systematic review was conducted in accordance with the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness evidence. The title of this review was registered with JBI, and the systematic review protocol was registered with the International Prospective Register of Systematic Reviews. ResultsIn total, 7 studies that specifically included community-dwelling older adults were included in this review. VR apps using a head-mounted display led to improvements in a number of health outcomes, including pain management, posture, cognitive functioning specifically related to Alzheimer disease, and a decreased risk of falls. A total of 6 studies reported a statistically significant difference post VR intervention, and 1 study reported an improvement in cognitive function to reduce navigational errors. Only one study reported on the usability and acceptability of the interventions delivered through VR. While one study used a distraction mechanism for pain management, none of the studies used gaming technology to promote enjoyment. ConclusionsInterventions to improve health outcomes through VR have demonstrated potential; however, the ability to synthesize findings by primary outcome for the older adult population is not possible. A number of factors, especially related to frailty, usability, and acceptability, also need to be explored before more substantial recommendations on the effectiveness of VR interventions for older adults can be made. Trial RegistrationPROSPERO CRD42019143504; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=143504

BackgroundThe majority of Internet-mediated studies use measures developed as paper-and-pencil measures or face-to-face-delivered material. Previous research suggests that the equivalence between online and offline measures must be demonstrated rather than assumed. ObjectiveThe objective of this study was to explore the equivalence 4 measures completed in an online or offline setting. MethodsA sample of students (n = 1969) was randomly assigned to complete 4 popular scales (the SF-12v2, the Hospital Anxiety and Depression Scale (HADS), the Fatigue Symptom Inventory, and a single-item fatigue measure) either online or by mail survey (pencil and paper). The response rate was 52.51% (n = 1034) and comparable between the online and offline groups. ResultsSignificant differences were noted in fatigue levels between the online and offline group (P = .01) as measured by the Fatigue Symptom Inventory, with the online sample demonstrating higher levels of fatigue. Equivalency was noted for the SF-12v2, the Hospital Anxiety and Depression Scale, and the single-item fatigue measure. Internal consistency was high except for the SF-12v2. The SF-12v2 may not be an ideal measure to use for remote administration. ConclusionsEquivalency of the Hospital Anxiety and Depression Scale (HADS) and the Physical Component Score and Mental Component Score of the SF-12v2 for online and offline data were demonstrated. Equivalency was not demonstrated for the Fatigue Symptom Inventory. Explanations for the difference in fatigue score between the online and offline samples are unclear. Research that seeks to match samples and control for extraneous online and offline variables is called for, along with exploration of factors that may mediate the completion of questionnaires or alter the respondents’ relationship with the same, to enhance progress in this area.

Aim: To explore the health beliefs and health behaviours of older Vietnam‐born people living with chronic disease in Western Australia. Design: This study was designed as a focused ethnography guided by the interpretative research paradigm and Leininger's Theory of Culture Care. Methods: Data were collected through participant observation and interviews undertaken at participants' homes in Western Australia over 7 months in 2019. Data were analysed using Wolcott's approach for transferring qualitative data, comprising three phases: description, thematic analysis and interpretation. Results: This study included 12 participants. The health perspectives and practices of older Vietnam‐born Australians significantly reflected the traditional Vietnamese values. These included the stigma towards chronic disease as an inevitable consequence of ageing; self‐blame thoughts about chronic disease causations and maintained traditional dietary practices. However, some aspects of their health behaviours such as beliefs and practices in traditional medicine, Western medicine and physical exercise reflected a blended approach combining both Vietnamese‐oriented and Westernized‐orientated practices. Individual factors were also identified as contributing to chronic disease self‐care among participants. Conclusion: This study emphasizes culture played a significant role in shaping the way that older Vietnam‐born Australians believed and behaved while living with chronic conditions. However, it also indicates that culture is not a stationary concept, it evolves gradually and is socially constructed. Implications: A better understanding of the health beliefs and practices of older Vietnam‐born Australians is expected to contribute to the delivery of culturally safe and effective support for this population. The achievement of culturally safe care requires a systemic approach and collaboration of strategies across sectors. Patient and public contribution: This study encompassed the contribution of 12 older Vietnam‐born Australians who offered the researcher the privilege to enter their world and the staff of social care organization who opened the gate for the researcher to approach participants. [ABSTRACT FROM AUTHOR]

Background: Nurses provide technical and relational skills that are integral to the care of people with intellectual disability (ID) in Australia. However, little is known about the demographic profile of this section of the nursing workforce. Method: Administration of a survey to nurses whose primary role it is to care for people with ID nationwide. Results: This brief report provides a description of the demographics of participants in the national survey. Of 101 participants, 78% were women and the mean age was 53.21 years. Participants held a variety of educational qualifications to prepare them for the care of people with ID. Conclusion: The findings suggest the need to consider the future unmet needs of people with ID given the ageing of this workforce. The ongoing support needs of people with ID depend upon the ongoing presence of nurses well prepared to meet the need of this group of people.

Background: Enhancing patient confidence in their ability (self‐efficacy) is vital to ensure people are equipped to maintain home dialysis protocols. Bandura's social cognitive theory provided a framework for understanding the role of self‐efficacy in patients managing home dialysis. Objectives: To identify self‐reported levels of self‐efficacy, the measurements used to assess self‐efficacy and the effectiveness of interventions to enhance self‐efficacy in patients undergoing home dialysis. Design: An integrative review approach was employed using Whittemore and Knafl's methodology. Methods: A comprehensive search was conducted to identify literature on self‐efficacy in patients managing home dialysis. Searches were conducted in CINAHL, MEDLINE, Embase and Scopus databases without a date limit. The included literature was critically appraised for methodological quality. Data extraction was conducted to report the study characteristics, measurement tools used and interventions conducted along with the synthesis of findings in a narrative format. Results: Fifteen studies were included in the review were predominantly quantitative examining training programmes promoting self‐efficacy in adults conducting home dialysis. The finding that self‐efficacy builds over time was structured into two themes; gaining skills to develop self‐efficacy and building and maintaining knowledge of self‐efficacy. Conclusion: The findings highlighted the importance of employing multifaceted strategies with support from health professionals including nurses, families and peer support to develop self‐efficacy in patients undergoing home dialysis. [ABSTRACT FROM AUTHOR]

Depression is a cause of disability globally and affects not only the person living with the condition, but the whole family. How people construct meaning to 'live well' and make sense of the reality of living with a person diagnosed with depression were explored through narrative inquiry and stories. The purpose of this article is to justify the use of narrative inquiry methodology to explore how people make meaning and find ways to live well and live with a family member who lives with depression. An interpretivist epistemological perspective, with the ontological principles of critical realism, and a social constructionist approach were chosen to guide the methodological framework. This was because how people construct the stories about their experiences will influence how those stories are told and what meaning is given to them. Eight people who live with a family member diagnosed with depression told their stories for this study. A realist approach to data analysis was taken, transcribed data were re-storied with redundancies removed, and member checked for accuracy. Using McCormack's and Chases' Lenses, the data revealed the strengths and challenges individuals faced when living with a family member with depression. Narrative Inquiry was an appropriate methodology to reveal how participants made sense of and constructed meaning about living well when living with a family member who lives with depression. Through the cyclical nature of depressive illness, participants navigated the fluctuations and uncertainties to find ways to live well and live with their family member. The research has the potential to adopt aspects of a family strengths-based and family systems approach into clinical practice, which would be valuable in supporting families living with depression and other mental health conditions. [ABSTRACT FROM AUTHOR]

Australia attracts international nursing students from China to maintain its economic advantage and to alleviate the projected nursing shortage; conversely, China needs its best and brightest citizens who have trained abroad in nursing to return to cope with current challenges within its healthcare system and nursing education. This paper explores whether China can lure its foreign-trained nurses home to achieve its goals; whether China or Australia will win the nursing talent war; and do Chinese nursing students want to remain abroad or return home. The insight gained can support the development of successful human capital investment for all parties involved.