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The objective of the review is to assess the association between health literacy levels and self-management behaviors in people with coronary heart disease.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.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.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.PROSPERO CRD42021257407.

Background: Misconceptions about men in nursing may influence recruitment and retention, further perpetuating the gender diversity imbalance in the nursing workforce. Identifying misconceptions and implementing early intervention strategies to address these deep-rooted stereotypes remain challenging but is considered critical to support students who are commencing a nursing career. Objective: To develop and evaluate the psychometric properties of the ‘Gender Misconceptions of meN in nursIng (GEMINI) Scale. Design: Cross-sectional survey. Methods: Pre-registration nursing students enrolled in undergraduate nursing programmes across 16 nursing institutions in Australia were surveyed from July to September 2021. The17-item self-report GEMINI Scale measured the gender misconceptions of men in nursing. Results: Of the 1410 completed surveys, data from 683 (45%) women were used for exploratory factor analysis showing a one factor structure, while data from 727 men (47%)were used for confirmatory factor analysis of the 17-item GEMINI Scale, which showed a good model fit. The scale demonstrated high internal consistency (Cronbach’s alpha of0.892). Men were found to have higher gender misconceptions (p < 0.001) while respondents who: (a) identified nursing as their first career choice (p = 0.002); (b) were in their final year of programme enrolment (p = 0.016); and (c) engaged in health-related paid work (p = 0.002) had lower gender misconceptions. Conclusion: The GEMINI Scale is a robust, valid, reliable, and easy to administer tool to assess misconceptions about men in nursing, which may potentially influence academic performance and retention. Identifying and addressing specific elements of misconceptions could inform targeted strategies to support retention and decrease attrition among these students. Impact statement: Genderism harms nursing, as well as the men and women working in the profession. Recruitment and retention of men into nursing is needed to cultivate male role models and diversify the workforce, however this is impeded by negative portrayals in popular culture and misconceptions entrenched in society Refereed/Peer-reviewed

In the evaluation of interdisciplinary interventions for childhood overweight and obesity, behavioural determinants can provide valuable insight into the reasons behind lack of adherence, or ineffectiveness of the intervention. Therefore, it is vital to assess the behavioural determinants of staff when evaluating the implementation of such interdisciplinary interventions. This study aimed to develop and psychometrically evaluate the intention to engage in Children's Healthy Weight guideline (iCHeW) scale, which assesses the behavioural determinants influencing dental staff's intention to conduct children's growth assessments.Initial items were generated based on review of the literature and the dimensions of the integrative model of behavioural prediction (IM). To test this scale, a cross-sectional survey design was undertaken consisting of three phases: (i) face validity; (ii) content validity; and (iii) psychometric evaluation of the iCHeW scale with a national sample of 125 dental staff.The 35 items generated for the iCHeW scale were revised following feedback from a reference group. These 35 items were then appraised by an expert panel, yielding 27 items for psychometric testing. Using exploratory factor analysis, a five-factor solution was extracted, which corresponded to the IM domains, with the deletion of two items. Overall, Cronbach's alpha of the iCHeW scale was 0.95, with the following values for each subscale: (i) attitudes, 0.93; (ii) behavioural constraints, 0.83; (iii) perceived norms, 0.93; (iv) self-efficacy, 0.94; and (v) behavioural intention, 0.95.The iCHeW scale is valid and reliable for assessing dental staff's intention to provide routine growth assessments to children and demonstrates potential for use with non-dental staff.

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.

In nursing, expectations of honesty and integrity are clearly stipulated throughout professional standards and codes of conduct, thus the concept of academic integrity has even more impetus in preparing students for graduate practice. However, a disparity between policy and practice misses the opportunity to instil the principles of academic integrity, and at its core honesty, a pivotal trait in the nursing profession. This study draws upon the experience of the nursing faculty to explore how academic integrity policy of deterrence operate in nursing education.While participants deplored cheating behaviours, they expressed frustration in having to ‘police’ large numbers of students who had little awareness of the academic standards to meet policy requirements. In addition, they were cynical because of a perceived lack of severity in sanctions for students who repeatedly breached integrity. Participants expressed a moral obligation as educators to meet student learning needs and preferred to engage with students in a more meaningful way to uphold academic integrity. The ambivalence to detect and report breaches in integrity undermines the effectiveness of policy. Therefore, faculty must recognise the importance of their role in detecting and escalating cases of dishonesty and execute deterrence in a more consistent way. To do this, greater support at an institutional level, such as smaller class sizes, inclusion in decision making around sanctions and recognition of additional workload, will enable faculty to uphold policy. Although policing was not their preferred approach, the role of faculty in detecting and reporting cases of misconduct is crucial to increase the certainty of students getting caught, which is essential if policy is to be effective in deterring dishonest behaviour.

Aim To identify and summarize evidence of objective achievements and subjective indicators associated with professional success of men in nursing. Background Despite being a minority group, men in nursing are purported to enjoy hidden advantages. Evaluation In this integrative review, studies from seven databases were retrieved and independently evaluated using the quality appraisal tools in accordance with PRISMA guidelines. Inductive content analysis and narrative synthesis were conducted, guided by the aim of this review. Key issues In total, 12 studies published between 1987 and 2021 were included. Two themes with related subthemes supporting or refuting professional success of men were identified. These were (a) evidence of professional success and (b) challenges to professional success. Conclusion As a minority group, men are highly visible in nursing, which is a double-edged sword. Although men were overrepresented in senior nursing positions of higher salaries than women, they also experienced gender stereotyping, prejudice, and discrimination, which reduced the duration of men staying in a specific nursing position. Implications for nursing management Findings of this study highlighted the need for nurse leaders to proactively address specific gender issues that are unique to men in the nursing workforce.

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.

Background Community-based urinary catheter-associated complications contribute to avoidable, costly hospital presentations. To minimise catheter-associated complications and improve the quality of life of patients living in the community, it is essential to improve catheter self-management through increasing patients’ and caregivers’ knowledge and self-efficacy. Aim To co-design, develop and evaluate a bundle-of-care intervention to improve catheter self-management, reduce catheter-associated complications, and improved quality of life. Design Mixed methods design underpinned by the principles of Appreciative Inquiry, micro- and spaced-learning pedagogies. Methods A co-designed care bundle will be developed, to support both patients and nurses in improving catheter care in both acute and community settings. Intervention bundles for patients will be delivered using “GoShare Healthcare” and for nurses, using QStream. The underpinning pedagogical approaches of these two digital platforms focus on increasing knowledge retention and improving patient health outcomes. A process evaluation of the intervention will be undertaken using data collected from surveys, electronic medical record audits, and participant interviews. The primary outcome is improved catheter self-management, and secondary outcomes are increased self-efficacy and patients’ knowledge of catheter self-management. Discussion The IQ-IDC study applies a two-pronged approach to co-design a bundle-of-care intervention that addresses important gaps in current catheter management. This study will contribute to new knowledge on effective implementation strategies to optimise self-management in urinary catheter care.

BACKGROUND The P -value is frequently used in research to determine the probability that the results of a study are chance findings. A value less than 0.05 was once typically considered only to mean that results are 'statistically significant', as it indicates the chance they are false positives is less than one in 20 (5%). However, P

Aim: To evaluate whether a two‐part culture improvement programme aimed at nurses in clinical and managerial positions in an inpatient mental health service was associated with culture change, and safety‐related behaviour and knowledge improvements. Background: Due to serious failings in the delivery of physiological care to mentally disordered inpatients, it was deemed important that interventions be applied to improve service culture. Methods: A pre‐test and post‐test study was conducted to evaluate change associated with a mandated intervention aimed at culture change. Nurses in clinical and managerial positions at all levels attended relevant sessions. All were invited to participate in evaluation measures. Results: N = 241 nurses participated in the evaluation (n = 137 and n = 104, pre‐test and post‐test, respectively). There was a small but significant change in organisational culture indicating greater adhocracy and less clan culture in the second survey period and a small decline in reported safety behaviour. Measures of safety culture, knowledge and emergency‐related educational satisfaction were unchanged. Conclusion: Only a small change in measured culture was associated with the programme. Implications for Nursing Management: Attempts to evaluate culture change need to align anticipated outcomes with appropriate outcome measures. A mandated programme of culture change had little tangible effect on the outcomes measured.

This cross-sectional survey study conducted between May and August 2017 on Arabic-speaking refugees resettled in Australia examined factors associated with willingness to donate organs. Of the 239 respondents, those who expressed greater willingness to donate organs and tissues were more likely to: (a) be Christians; (b) have obtained information from healthcare professionals (HCPs); (c) have higher organ and tissue donation (OTD) knowledge; (d) have a positive attitude towards OTD; and (e) have high English language acculturation levels. Nevertheless, after controlling for English language usage and religion, having a positive attitude towards OTD and receiving information from HCPs emerged as independent predictors of willingness to donate, underscoring the importance of educational interventions by HCPs

Aim: To explore the impact of educational interventions for patients living with indwelling urinary catheters. Methods: Systematic scoping review in accordance with PRISMA guidelines, guided by Coc...

Aims and objectives This study sought to explore undergraduate nursing students' perceptions of the role and value of their bioscience tutors in a blended learning curriculum. Background Blended learning approaches typically have reduced face-to-face contact with tutors-particularly in bioscience subjects which nursing students have traditionally found difficult, and the move to more web-based learning resources may compound this difficulty. Design Qualitative descriptive study. Methods This qualitative study was conducted with 19 undergraduate nursing students enrolled in bioscience subjects, at a large university in outer metropolitan Sydney, Australia in 2016. Semi-structured interviews were conducted over the telephone or face-to-face. Duration of interviews ranged from 13 to 71 min. Results were thematically analysed. EQUATOR guidelines for qualitative research (COREQ) applied. Results Two main themes with accompanying sub-themes were identified. The first theme identified the importance of the tutor in bioscience, including their qualities, expertise and contextualisation of learning. The second theme provided insights into students' perceptions of what they considered good and poor approaches to learning. Conclusions This study has clearly shown that while nursing students appreciated the flexibility offered by the online component of a blended learning curriculum, they still wanted an experienced bioscience tutor with clinical experience for their face-to-face classes. While the tutor was seen as crucial to providing clarification and context for content that was often challenging, they also played a key role in engaging and motivating students and creating a learning environment where students felt empowered to ask questions and debate issues with their peers. Given the increased use of online learning, further research could determine if the current study findings are also applicable in nonscience areas of study. Relevance to clinical practice The importance of students having a sound understanding of the biosciences for safe, effective clinical practice cannot be underestimated.

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.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.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.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.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.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.To mandate or not to mandate COVID-19 vaccination for healthcare workers: A synthesis of published opinions in health, law, and bioethics.

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.To provide insights into the experiences and satisfaction levels of Registered Nurses who supported nursing students during clinical placement using a facility-based model.A quasi-experimental design.Three wards in an acute care facility and Primary and Community Health within the Southwest of Sydney, New South Wales, Australia.Participants included Registered Nurses/Midwives, Facility-based liaison support staff, and Nurse Managers.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.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.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.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.

OBJECTIVES: To identify subject matter, pedagogical approaches and assess outcomes of interventions implemented to educate nurses in urinary catheterisation care and management. DESIGN: A systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. DATA SOURCES: Databases (CINAHL; MEDLINE; ProQuest; ERIC; Scopus; Cochrane; and APA PsycINFO) were searched using key concepts: education interventions, indwelling urinary catheter and nurses, from inception to July 2021. REVIEW METHODS: Two researchers searched the databases, whereupon data were extracted using a standardised proforma and were analysed applying an abductive approach. The Joanna Briggs Institute Critical Appraisal tool was used to assess the quality of the included studies. Findings were analysed and reported using narrative synthesis. RESULTS: Out of 1159 studies screened, nine educational intervention studies related to upskilling nurses in catheter management were identified. Subject matter addressed included pathophysiology of the urinary system, clinical indications and management of indwelling catheter and associated complications. Although the subject matter and pedagogical approaches varied, all identified studies reported positive effects in improving participants' knowledge. CONCLUSIONS: Upskilling nurses and increasing their confidence to deliver patient-centred catheter care practices is an important intervention to improve outcomes for patients with long-term indwelling urinary catheters. However, actively engaging nurses who provide direct patient care is essential, in planning and implementing targeted educational interventions specific to learning needs. This review has identified a gap in the educational interventions for nurses, in better supporting the psychosocial needs of patients living with indwelling catheter. Codesigning educational interventions with nurses that are tailored to their contextual learning needs is likely to enhance behaviour change and improve current practice.

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. 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. 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. 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. Healthcare 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.

Aims and objectives To explore the experiences of food choice and meal service in residential aged care facilities and its impact on autonomy, self-determination and quality of life from the perspectives of both residents and staff. Background Globally, residential aged care is a principal provider of care for older people who can no longer live independently at home. Within this setting, lack of food choice has been identified as a significant factor impacting on residents' self-determination, sense of autonomy and quality of life. Design This study used an exploratory descriptive qualitative approach guided by self-determination theory. Method A total of 14 participants (seven residents and seven staff members) from two Australian residential aged care facilities were recruited through purposive and snowball sampling with assistance from one independent contact nurse at each facility. In-depth, semi-structured interviews were conducted, digitally recorded and transcribed. The COREQ checklist was used in this qualitative study. Results Three main themes were identified from the interview data provided by residents and staff, which were as follows: (a) catering for the masses; (b) organisational barriers to providing choice; and (c) food impacts well-being. Conclusions This study explored the experiences of food choice and service in residential aged care facilities, from the perspectives of both residents and staff. Results of interviews highlighted the importance of providing adequate food choice which has become an enduring issue that requires more attention and commitment to make a positive change for residents living in residential aged care facilities. Relevance to clinical practice Nurses and other staff working in residential aged care facilities need to be aware of the importance of providing adequate food choice, including for residents who require modified diets. As advocates for residents, nursing staff must address the persistent lack of food choice. However, this will require a radical change in organisational culture and strong leadership.

We aimed to examine the prevalence of obesity among adolescents living in a refugee camp in Jordan and analyze the factors influencing their weight perceptions.Cross-sectional survey.We examined the body weight perception, and the influence of psychological, cultural, and social factors, among Palestinian refugee adolescents living in Jordan using a cross-sectional survey. Univariate, bivariate, and multiple logistic regression analyses were used to investigate the relationships between body weight status, weight perception, satisfaction with weight, screen time, and depression status of these adolescents.A total of 620 adolescents participated in the study, of which 24% were either overweight or obese. Overweight or obese adolescents were more likely to underestimate their weight (p.001), while those with depressive symptoms (Patient Health Questionnaire for Adolescents score14), were more likely to overestimate their body weight (p = .021). Having symptoms indicative of depression (adjusted odds ratio [AOR] = 1.70; 95% confidence interval [CI] = 1.16-2.50) and having a body mass index in the overweight/obese range (AOR = 4.16; 95% CI = 2.73-6.35) were predictors of discordant weight perception.This study showed that excess body weight is a significant issue among Palestinian refugee adolescents living in a refugee camp in Jordan. Underlying depression is an important factor in excess weight and distorted weight perceptions especially among this vulnerable group.The study highlights the importance of addressing discordant body weight perception and depression in weight management in nursing interventions for vulnerable adolescent groups.

Introduction Clinical supervision and transitional support programs are important in supporting the successful transition and retention of new graduate nurses and their intention to work in specialty settings. However, little is known about which elements of support programs influence this intention. This study aimed to examine new graduate nurses' perceptions of clinical supervision and the practice environment, and how these influenced their intention to stay in critical and non-critical care areas following their transitional support program. Methods Between May 2012 and August 2013, new graduate nurses (n = 87) were surveyed towards the end of their 12-month transitional support program. In addition to demographic and ward details, participants completed the Manchester Clinical Supervision Scale (MCSS) and the Practice Environment Scale Australia (PES-AUS). The ‘Intention to Stay in a Clinical Specialty’ survey was used to measure new graduate nurses’ intention to remain working in their current ward or unit. Results Predictors of new graduate nurses' intention to stay in their current ward/unit were not having to practise beyond personal clinical capability (AOR: 4.215, 95% CI: 1.099–16.167) and working in a critical care specialty (AOR: 6.530, 95% CI: 1.911-22.314). Further analysis of those nurses who indicated an intention to remain in critical care revealed that high satisfaction with clinical supervision (AOR: 3.861, 95% CI: 1.320–11.293) and high satisfaction with unit orientation (AOR: 3.629, 95% CI: 1.236–10.659) were significant predictors. Conclusion While this study identified that new graduates who worked within their scope of practice were more likely to report their intention to remain in their current ward, new graduates assigned to critical care were six times more likely to indicate their intention to remain than new graduates in other wards/units. Ensuring new graduate nurses assigned to critical care areas receive good unit orientation and clinical supervision increases their intention to remain in this setting.

Aims and objectives To explore the experiences of first-year nursing students, their motivations for working and how they juggled study and other commitments while engaging in paid work. Background There has been a global rise in the number of students balancing full-time study, paid work and other commitments, with the main antecedent financial reasons. Design Qualitative exploratory study. Methods Drawn from a larger Australasian sequential exploratory mixed-method study, this qualitative study was conducted with fifty first-year undergraduate nursing and midwifery students who commenced their nursing studies in 2017. Telephone or face-to-face interviews were conducted with purposively selected students engaged in either nursing or non-nursing fields of work. Interviews were conducted from April-July 2017. Interviews lasted from 15-40 min. Results were thematically analysed. EQUATOR guidelines for qualitative research (COREQ) applied. Findings Two main themes and accompanying subthemes were identified. The first theme explored students' motivation behind combining work and study and identified the need for financial security and "me time". The second theme "Juggling many balls" provided insights into the benefits students perceived, how they kept the "balls" in the air and at times dropped "balls" while balancing work, study and other commitments. Conclusions The motivation behind paid work was mainly financial; however, students also reported work allowed an escape and time for self which had social and health benefits. Working provided a range of positive benefits, including a sense of achievement, improved self-esteem and financial independence. Relevance to clinical practice Being able to juggle and multi-task improved skills such as organisation and the ability to prioritise, all skills that have applicability for the role as registered nurse.

Aim and objectives To examine the factors that influence nursing students' mathematics self-efficacy, the effect of numeracy instruction on self-efficacy, and the association between self-efficacy and numeracy test performance. Background Medication administration errors, including administering incorrect dosages or infusion rates, can result in serious harm to patients. Hence, it is essential that nursing students are adequately prepared with the necessary numeracy skills during their nursing program. Design This quasi-experimental cohort study used a pre- and post-test survey design. The study complied with the STROBE checklist for cohort research. Methods In total, n = 715 undergraduate first year nursing students participated in the study from June to October 2017 at a single multi-campus university in the Western Sydney region of Australia. Data were collected at three time-points: (a) baseline, including assessing pre-instruction mathematics self-efficacy (NSE-Math scale); (b) 6-week follow-up; including assessing post-instruction mathematics self-efficacy; and (c) numeracy test performance was collected at 7-week follow-up. Findings At baseline, those with high NSE-Math scale scores were more likely to be male and have at least high school advanced mathematics level education. Following structured numeracy instruction, NSE-Math scale scores increased significantly, and those who obtained a satisfactory grade in their numeracy assessment were more likely to have high NSE-Math scale scores and high academic performance in the previous semester. Conclusion The study shows that structured numeracy instruction improved mathematics self-efficacy, which in turn influenced numeracy test performance. Relevance to clinical practice Using a structured medication numeracy pedagogical approach, to teach skills in nursing undergraduate programs, provides students with the foundations to improve mathematics self-efficacy and to be successful and safe with medication numeracy calculations and administration in clinical practice.

Background Optimal nutrition during the first year of life is critical to infants’ healthy growth and development. Hence, it is vital that undergraduate health professional curricula provide good quality learning environments to enable students to acquire the necessary knowledge and skills to support breastfeeding mothers. Aims To examine the change in knowledge and attitude in Taiwanese nursing students following theoretical and clinical learning experiences on breastfeeding. Methods This study used a pre-test/post-test survey design with two cohorts of nursing students (N = 215). Knowledge and attitude were assessed before and after: (a) theoretical (didactic and skills laboratory) education in Cohort One, and (b) clinical placement in Cohort Two. Findings Students in both cohorts demonstrated significant improvements in knowledge and attitude post-theoretical education, and post-clinical placement. Prior to theoretical education in Cohort One, those with experience of close family members being breastfed were more than 14 times (adjusted odds ratio: 14.09, 95% confidence interval: 1.73–114.64) to be in the high knowledge group. However, following theoretical or clinical education, there were no sociodemographic group differences in breastfeeding knowledge or attitude in Cohorts One or Two. Conclusion Results revealed that the current breastfeeding education program in Taiwan, both theoretical and clinical components, increased nursing students’ knowledge and improved positive attitudes towards breastfeeding, and any sociodemographic differences in knowledge and attitude about breastfeeding were ameliorated following theoretical and clinical placement experience focused on breastfeeding.

BACKGROUND Periodontal disease is associated with cardiovascular disease, and patients should be aware of this risk and seek dental care. OBJECTIVE In this study, the authors sought to identify the barriers and predictors for seeking oral healthcare among patients with cardiovascular disease. METHODS With the use of a cross-sectional descriptive study design, 307 patients with cardiovascular disease attending cardiac rehabilitation/outpatient cardiac clinics were surveyed between 2016 and 2017 in Sydney, Australia. Survey items included the prevalence of accessing dental services and a new "barriers to seeking frequent dental care" scale. RESULTS Most respondents (81%) reported at least 1 oral health problem, yet only 10% received any oral health information and more than half (58%) saw a dentist in the preceding 12 months. The barriers to seeking frequent dental care scale was internally consistent (Cronbach's α = 0.82) with 2 subscales, identified as personal-related and system-related barriers to accessing oral healthcare. Respondents were more likely to have seen a dentist in the previous 12 months if they received oral health information (adjusted odds ratio [AOR], 5.08; 95% confidence interval [CI], 1.62-15.93), had private health insurance (AOR, 3.33; 95% CI, 1.91-5.83), reported low barriers (AOR, 2.68; 95% CI, 1.61-4.47), or were born overseas (AOR, 2.13; 95% CI, 1.25-3.63). CONCLUSIONS The accessibility and affordability of dental care, as well as lack of oral health awareness, are key barriers and predictors for patients with cardiovascular disease accessing dental care. Greater emphasis on oral health is needed in the cardiac setting, along with appropriate dental referral pathways.

Background Improving breastfeeding support to mothers has been the focus of several national and international health organisations. There is evidence that theoretical and clinical education improves breastfeeding knowledge and attitudes among nursing and other health professional students prior to clinical placement, to support women who are breastfeeding. Aims and objectives To explore the expectations and experiences of Taiwanese nursing students in supporting breastfeeding on clinical placement. To gain additional insight into student experience, we also sought the perspectives of mothers, nursing staff and teachers about the role of nursing students in supporting breastfeeding mothers. Design A qualitative descriptive approach guided this study. Methods Focus groups and small group interviews were conducted with four participant groups in southern Taiwan. Ethical approval was obtained prior to data collection. The consolidated criteria for reporting qualitative research checklist was used. Findings Three main themes emerged from the data that captured the nursing students' experiences during clinical practice, which were "High expectations"; "The reality is different"; and "Improving confidence in students." The study found that students lacked confidence in supporting breastfeeding in the clinical setting. Students were expected to support women to achieve their breastfeeding goals under the supervision. The students highlighted the importance of establishing trust to effectively support mothers, and for the students to feel confident to provide the breastfeeding information. Conclusions Despite structured theoretical breastfeeding education prior to clinical placement, students did not feel they were adequately prepared to support women who are breastfeeding during their clinical placement. The findings demonstrated the need for further support in developing effective communication skills and building confidence prior to clinical placement. Relevance to clinical practice Enhancing the content of theoretical and simulated breastfeeding education to incorporate women's breastfeeding experience combined with realistic clinical student allocation could serve to improve students' confidence in supporting breastfeeding.

Background With the widening of participation in higher education, it is essential in the discipline of nursing that students are able to communicate proficiently to deliver quality patient care. However, undergraduate students can experience significant difficulties with spoken communication critical to professional nursing, which places them ‘at risk’ of failure during the nursing course. Objectives To examine the relationship between students' use of academic literacy support and oral communication skills. Design Prospective, correlational survey design. Setting A large multi-campus university in Western Sydney, Australia. Participants A total of 1699 assessment ratings of first and second year nursing students were completed at both baseline and at the 6-month follow-up in 2015. Methods The CLIP index was embedded as an assessment requirement in four clinical skills-based units and assessed at the end of each semester in the first two years of the Bachelor of Nursing program. In this study, first and second year students were assessed in Semester 1 at baseline and also six months later in Semester 2. Results From Semester 1 to Semester 2, the mean CLIP scores improved from 15.8 (SD: 3.7) to 17.2 (SD: 3.3) and all four components of the mean CLIP index improved. The smallest improvement was in the area of pronunciation while the lexical component had the greatest improvement. In addition, students who attended an academic literacy consultation or workshop for oral language support were over 1.5 times more likely to achieve an improvement in CLIP score (AOR: 1.58, 95% CI: 1.26 to 1.98). Conclusion The CLIP tool can be used to track and monitor students' oral language skills over the course of their study, and identify ‘at risk’ students requiring additional support through on-campus language support programs.

Aims and objectives To synthesise evidence regarding vaccination intention, identify factors contributing to vaccine hesitancy among healthcare professionals and the general populations globally. Background As COVID-19 vaccine becomes available worldwide, attention is being directed to community vaccine uptake, to achieve population-wide immunity. A number of factors have been reported to influence vaccine intention. Methods Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search of COVID-19 vaccination intention related literature published on or before 31 December 2020 from seven databases was undertaken. Results Thirty articles were included in this systematic review. Overall COVID-19 vaccination intention during the first year of the pandemic ranged from 27.7% to 93.3%. Findings highlighted that socio-demographic differences, perceptions of risk and susceptibility to COVID-19 and vaccine attributes influenced vaccination intention. Healthcare professionals particularly, nurses have higher vaccine hesitancy reportedly due to concerns regarding vaccine safety and efficacy and mistrust of health authorities. Negative information about COVID-19 vaccines in the social media and low confidence in the health system were associated with lower acceptability among the community. Interestingly, cumulative increase in COVID-19 caseloads of countries over time was not associated with vaccination intention. Conclusions The significant variability in vaccine intention rates worldwide would hamper efforts to achieve immunity against COVID-19. Nurses' concerns about vaccine safety and efficacy need to be addressed to increase vaccine acceptance and maximise their influence on vaccination decision in the community. As misinformation through social media negatively impacts vaccination uptake, authoritative and reliable information on vaccine attributes, disease risks and vaccination benefits are needed. Relevance to clinical practice Concerns about vaccine safety and efficacy including misinformation are important contributors to vaccine hesitancy. Addressing these factors, particularly among nurses who are considered trusted influencers of vaccination decisions in the community is an important strategy for pandemic preparedness.

Purpose: Receiving a cancer diagnosis for young people is likely to adversely impact the individual's quality of life. Mindfulness-based interventions (MBIs) are an emerging strategy used to improv...

Introduction There is increasing evidence linking poor oral health with cardiovascular disease (CVD) and it is recommended that all cardiac care clinicians incorporate oral health into their practice. Yet, it appears oral health is not considered a priority during cardiac care in Australia and cardiovascular patients are not seeking dental care. The focus of this feasibility study was to explore the oral health perceptions, knowledge and practices of patients with CVD and cardiac care clinicians as well as their views of integrating oral health care in cardiac settings. Methods A mixed methods approach was undertaken involving: focus groups/phone interviews with cardiac care clinicians (n=30, mostly nurses) across Australia; interviews (n=12); and surveys (n=318) with patients with CVD across four metropolitan hospitals and outpatient cardiology clinics in Sydney. Thematic analysis, descriptive, inferential and logistic regression statistics were used to summarise the findings. Results Most clinicians interviewed encountered a number of patients with dental problems, yet oral health was not routinely discussed in clinical practice. Many were also unaware of the relationship between oral health and CVD and attributed this knowledge gap to lack of training. Most (82%) patients reported having at least one dental problem and around half had seen a dentist in the last 12 months. Patients had poor oral health knowledge (52%) and only 10.7% had received any information regarding oral healthcare from cardiac care clinicians. Those who received oral health information in the cardiac setting were six times more likely to have seen a dentist in the last 12 months (AOR 5.97, 95% CI: 1.91-18.74). Cardiac clinicians were receptive to the idea of promoting oral health if identified barriers such as availability of resources, training, time constraints and referral pathways were addressed. Patients were also receptive of cardiac nurses providing education (81%), performing oral health assessments (58%) and referral (82%). Discussions There is a high prevalence of dental problems among patients with CVD yet many have limited knowledge and awareness about the importance of oral health. There is also a lack of emphasis regarding oral health among cardiac clinicians due to various barriers. Cardiac nurses are in unique position to promote oral health and they are receptive to this idea along with patients, provided current barriers are addressed. Conclusions Integrating oral health into cardiac care is warranted in Australia. A new model of care is proposed where cardiac nurses are trained to promote oral health, provide risk assessment and referrals to appropriate dental services. Lessons learned Oral health is a neglected part of cardiac care practice in Australia and is an area that could be addressed through an interdisciplinary oral health model of care. Limitations The findings may not be relevant to culturally and linguistically diverse populations with CVD or those living in regional areas Suggestions for future research. A new model of care inclusive of a validated oral health risk assessment tool, evidence based oral health resources and training program needs to be developed and evaluated in the cardiac setting.

BACKGROUND Self-management is important in reducing coronary risk factors and in preventing recurrent cardiac events. An enabling factor that promotes self-management among patients with coronary heart disease (CHD) is self-efficacy. However, there is no standardized measure that captures self-efficacy and self-management concurrently in this population. AIM The authors of this study report on the development and validation of a brief scale to measure self-efficacy and self-management in patients with CHD. METHODS Scale development and testing comprised (1) item generation, (2) content validity, and (3) pilot testing. The Heart Health Self-Efficacy and Self-Management (HH-SESM) scale includes 2 constructs: self-efficacy and self-management, measured concurrently. Components of the HH-SESM scale consisted of items related to behavioral and coronary risk factor modification. Survey data from 143 participants were used in exploratory factor analyses to test the factorial validity and internal consistency of the scale. RESULTS Twelve items with the same response format were included in the exploratory factor analysis. The factor analysis revealed a single-factor solution accounting for 36.7% and 36.5% of the variance in scores of the self-efficacy and self-management scales, respectively. The correlation (r = 0.72, P < .001) between the self-efficacy and self-management constructs indicates moderate convergent validity. Cronbach α of self-efficacy (0.83) and self-management (0.81) constructs showed good internal consistency. CONCLUSION The HH-SESM is a brief, easy-to-administer, and reliable measure of self-efficacy and self-management in patients with CHD.