Contemporary nurse最新文献

Background: The development of First Nations nurses and midwives is crucial to addressing health inequities stemming from systemic injustices. However, this workforce is significantly underrepresented globally. Understanding the reasons for this underrepresentation and identifying key challenges and opportunities for leadership is necessary.

Aim: This scoping review aimed to explore the challenges and opportunities in leadership development of First Nations nursing and midwifery professionals internationally.

Design: A scoping review was conducted following the framework developed by Arksey and O'Malley (2005).

Data sources: Six databases including PubMed, CINAHL, Scopus, PsychInfo, Proquest and Australian Indigenous HealthInfoNet were searched.

Methods: The search was performed on 30 January 2024. Items were included if the research focus was on First Nations nursing and midwifery leadership. Full texts were then thematically analysed for overarching themes, and extracted data was charted. After charting, key findings were reviewed, and emerging themes were grouped into common categories.

Results: The scoping review identified a paucity in the contemporary literature, with only ten articles retrieved. Analysis revealed five main theses: (1) systemic injustices impacting leadership opportunities, (2) complex responsibilities beyond typical roles, (3) underrepresentation in leadership positions, (4) shifting from colonial leadership models and (5) effective methods for leadership development. Opportunities identified included promoting equitable leadership, fostering integrated relationships, building cultural resilience and emphasising community-orientated leadership approaches.

Conclusion: Promoting adequate representation and developing culturally safe leadership models are essential steps towards empowering First Nations nurses and midwives in their leadership development. The study highlights the need for targeted leadership development strategies for First Nations nurses and midwives to enhance representation and impact within healthcare systems globally.

Background: The COVID-19 pandemic has abruptly enforced the adoption of online learning approaches in nursing education, which have placed both students and educators under various challenges such as student academic achievement, reduced curricular completion, reduced teacher-student interaction, and decreased information retention.

Aim: This study aimed to explore the engagement, satisfaction, and motivation in online and hybrid learning environments among Lebanese and Turkish nursing students.

Methods: A sample of 650 Lebanese and 654 Turkish nursing students took part in this study. A quantitative cross-sectional research design was adopted.

Results: The results of independent T-tests showed that Lebanese students scored significantly higher on the level of self-efficacy (5.49 ± .098), yet Turkish students scored higher on the level of distance learning satisfaction with connectivity (3.40 ± 0.72). The regression analysis showed that higher motivation (p < 0.001), lower satisfaction (p < 0.001), and the type of education (p = 0.001) were predictors of higher engagement. The effect of nationality on these outcomes needs to be further investigated, as the comparison showed association only in two subscales.

Conclusion: This implies that nurse educators are encouraged to investigate the factors that increase nursing student satisfaction thus to increase their engagement. This research encourages further educational and psychological research among nursing students to explore the factors and predictors of academic achievement in online and hybrid learning environments.

Background: Continuity of Care Experience is a mandated inclusion in all Australian degrees leading to registration as a midwife.

Aim: Translating the objectives and learning outcomes of the midwifery student Continuity of Care Experience learning model into practice via an infographic.

Design: Underpinned by an Appreciative Inquiry approach, this process used a strengths-based approach to engage participants to develop the design of an infographic.

Method: Participants were Australian midwives working in a healthcare clinical or academic setting and were invited to provide feedback via an online survey on the design elements to inform the development of an infographic.

Results: An expert midwifery panel included 11 participants representing midwives in clinical practice and academic positions. Content analysis of the survey identified strengths such as flow and visual appeal and what design elements needed improvement to enhance the sense-making of the infographic.

Discussion: This study describes a process that engages participants meaningfully to contribute to how research findings are communicated. The process used in this study engaged participants meaningfully to develop an infographic for the midwifery student Continuity of Care Experience. This infographic provides a visual representation of learning objectives and outcomes for this learning model to aid translation into practice.

Conclusion: Infographics are an effective tool in education and healthcare settings. Engaging participants in how an infographic is depicted can enhance the translation of learning outcomes and objectives of the midwifery student Continuity of Care Experience in education settings.

Aim: The purpose of this paper is to explore the need for historically informed, culturally safe nursing and midwifery literature about Australian Indigenous people.

Background: The cultural safety framework, developed by Irihapeti Ramsden, has long identified the importance of historical literacy in delivering culturally safe nursing and midwifery care. However, little evidence is available exploring the links between these domains. In the Australian setting, this is particularly relevant due to the health gap and, therefore, life differentials between Indigenous and non-Indigenous Australians and the potential of culturally safe nursing and midwifery care to contribute to rectifying this.

Methods: A scoping literature review was conducted by searching four databases for both articles and grey literature that explored historically informed, culturally safe nursing and midwifery practice for Indigenous people internationally. This search spanned from 2003 onwards and required discussion of clinical practice by registered nurses or midwives. A discursive method was utilised to analyse the discourse surrounding these domains.

Results: The review found only two texts that explored the connection between Indigenous peoples, history, cultural safety, nursing and midwifery in depth. This highlights a large literature gap internationally. Following this review, a discursive argument was created that highlights how a lack of culturally safe, historically informed care in Australia has resulted in unsafe and racist health experiences for Indigenous people.

Conclusions: Australian nurses, midwives, healthcare organisations and health academics are provided with recommendations on how they can create the mandated cultural safety through historically informed environments and care practices. These include but are not limited to, ongoing Indigenous-led professional development, appropriate remuneration for Indigenous knowledge holders, and professional development for all nursing and midwifery academics.

Background: Haemodialysis (HD) patients face difficulties adapting to the drastic life changes associated with their treatment, emphasising the crucial role of psychosocial adaptation in improving long-term health outcomes. The level of psychosocial adaptation and its predictors are different according to the duration of HD therapy.

Aim: The objective was to compare the predictors of psychosocial adaptation in HD patients based on the duration of haemodialysis, with a reference point of one year since initiating HD.

Design: A comparative cross-sectional survey design was used.

Methods: Patients from one outpatient and four community-based haemodialysis centres in South Korea completed a paper-based survey during their dialysis admission. The survey included self-report questionnaires on psychosocial adaptation, depression, perceived social support, dialysis-related symptoms, and self-management.

Results: The adaptation score of short-term patients was below the average and lower than that of long-term patients. The predictors of adaptation were dialysis symptoms, social support, depression, and self-management for short-term patients, and depression and self-management for long-term patients.

Conclusions: The findings highlight the need for interventions that address depression and promote self-management in HD patients, regardless of the duration of HD. Strategies aimed at increasing social support and effectively managing dialysis-related symptoms should also be considered, particularly for short-term patients within one year of initiating HD. Based on the identified predictors of adaptation in this study, tailored nursing interventions that effectively promote adaptation, consideringthe duration of the patient's HD, should be developed, and implemented in clinical practice.

Background: Death, harm, or adverse outcomes as a result of accessing healthcare were recognised as a global endemic in the late 1990s and the trigger for the contemporary patient safety discipline.

Aim: To critically review the development of the patient safety movement; and, to determine the influence of the practitioner, in particular, nurses on patient safety.

Design: A discursive narrative using a conceptual framework.

Methods: We developed a conceptual framework consisting of the patient, practitioner, clinical setting, profession, clinical setting, culture of risk, wider society, and the healthcare system, to analyse the development of the patient safety movement. The data sources were considered across three eras commencing with Ancient Greece to the twenty-first century.

Findings: There has been no reduction in patient harm rates across two decades either in Australia or globally, despite resourcing and financial investment. The application of a conceptual model to analyse the influences on the development of the patient safety movement is the contemporary innovation of this discursive narrative. The importance of the practitioner and their influence across all eras was illustrated. The practitioner is the final critical line of defence to maintain the minimum requirement of patient safety.

Conclusion: Patients are no safer accessing healthcare then they were two decades ago. Nurses spend more time with patients than any other health discipline and therefore have a critical role in monitoring and maintaining safe care. Yet, the influence of the nursing profession on the development of the patient safety movement is largely absent in the literature. There is a need for a standardised approach to teaching and evaluating patient safety curricula.

Reporting method: No EQUATOR guidelines were discovered for the discursive paper format.

Aim: To explore nurses' adoption of digital technologies during the COVID-19 pandemic and their perceived impact on nursing practice in Australia, focusing on technology-supported workforce preparedness for future public health emergencies.

Design: A cross-sectional survey design.

Methods: Nurses who worked in clinical settings during the COVID-19 lockdown period were eligible to participate in this study. Participants (N = 94) completed a 41-item online survey of forced-choice responses, free-text open-ended questions, and a system usability rating. Data were analysed using descriptive statistics and content analysis.

Results: Ninety-four respondents representing various fields of nursing reported on 102 distinct digital technologies. These technologies were categorized into online communication (n = 42; 41.2%), patient monitoring/data sharing (n = 20; 19.6%), virtual appointments (n = 16; 15.7%), electronic medical records (n = 15; 14.7%), mobile applications (n = 5; 4.9%), information systems (n = 3; 2.9%), and e-prescribing (n = 1; 0.9%). System usability varied across different types of technology. Barriers to successful technology use included inadequate infrastructure, low staff and patient digital literacy, lack of organizational support and training, particularly when redeployed, and clinician attitudes.

Conclusion: Although study participants demonstrated high agility and adaptability when digital technologies were rapidly implemented, the data suggests a need for greater organizational support and proactive preparation for similar public health emergencies. One of the most critical lessons learned from the COVID-19 pandemic is that even though digital technologies may need to be rapidly deployed to effectively support healthcare delivery during public health emergencies, this deployment needs to be thoughtful. As climate change increases the frequency and severity of such crises, investing in the digital preparedness of the nursing workforce emerges as a strategic imperative and as an essential component to fostering workforce resilience and long-term sustainability.

Background: Loneliness and lack of social support are theoretically distinguished phenomena, but simultaneously overlap and mutually influence each other, challenging the measurement of these phenomena within health research.

Objective: To contribute to the understanding of the interplay and divergence of loneliness and lack of social support by investigating the convergent validity between two social support questionnaires and a loneliness questionnaire, in a population of patients treated for cardiac disease.

Method: In total, 573 patients >18 years of age treated for cardiac disease were approached from October 2022 to May 2023 and answered two social support questionnaires and one loneliness questionnaire, and 365 patients (63.7%) completed the questionnaire. The interplay and divergence between loneliness and lack of social support were assessed by calculating convergent validity between the questionnaires.

Results: The correlation coefficients between the two social support questionnaires ranged between r² = 0.281-0.568, which is comparable to the correlation coefficient between the social support questionnaire and the loneliness questionnaire, ranging from r² = 0.317-0.601, suggesting a dynamic interplay between social support and loneliness, yet also a challenge for maintaining conceptual and measurement-based divergence.

Conclusion: This finding implies that, although loneliness and lack of social support are conceptually distinct, differentiating between these dimensions in a questionnaire survey is challenging.

Background: Risk assessment tools are intended to support nurses' decision-making in the continuous Nursing Process of comprehensive assessment, planning, implementation and evaluation for each patient in their care. While patient distress is common during periods of ill-health, tools to formally assess distress are not routinely used by nurses.

Aim: The purpose of this study was to explore the utility of the distress thermometer by nurses for general medical and surgical inpatients.

Methods: An audit of 2370 electronic medical records was used to extract data on risk assessment completion for adult patients admitted across three wards from December 2020 to March 2021. An online survey using the System Usability Scale and free-text comments collected data on nurses' perceptions of the Distress Thermometer.

Results: Only 33% of patients had the Distress Thermometer tool completed by nurses during patient risk assessment on their admission to the hospital ward (393/2370). Only 12.86% of nurses reported scores indicating acceptable usability of the Distress Thermometer in electronic medical records (greater than 68). Distress Thermometer completion was significant between wards (chi-square analysis X² (2, N = 2,370) = 84.902, p = <.001). Factors contributing to low usability included unnecessary addition to their workload and tool perceived as not useful to care planning.

Discussion: Nurses reported the Distress Thermometer was an unnecessary addition to their workload and not perceived to add any value to patient assessment in general medical and surgical inpatients.

Conclusion: Nursing risk assessments in electronic medical records carry a high workload burden. The perceived usability, usefulness and suitability for specific patient groups are important considerations for uptake and implementation of any additional tools.

Background: Co-designing technologies for people living with dementia can develop a product that benefits their needs and preferences.

Aims: To systematically evaluate the use of co-designed technologies for dementia, assess the extent of involvement of people living with dementia in the studies, and analyse the impact of co-design on the final technology and its usage.

Design: This qualitative systematic review followed the Joanna Briggs methodology.

Methods: Five electronic databases (CINAHL, EMBASE, PubMed, PsycINFO, Medline) were searched for qualitative papers published before November 2023. Inclusion criteria were established according to the PICO principle. Four independent reviewers used Covidence to independently screen abstracts and then full text of selected articles. Quality assessments were performed using the JBI quality assessment tool.

Results: The review included nine primary studies involving 354 participants from three countries and identified three interconnected themes. Various technologies were developed, with apps being the most popular tool. The technologies were not well developed, with the majority (n = 7) developed in the early stages of development. Participants' main involvement was in the consultation stage, where they were asked about an assessment of their needs to determine a product, followed by their involvement in the useability and acceptability of the products.

Conclusions: While co-design is employed in developing certain technologies for people living with dementia, its effectiveness is hindered by the lack of involvement of people living with dementia in the actual conceptualization and design stages. Researchers, nursing professionals, and developers must embrace co-design as standard practice and employ consistent terminology in this process.