Search

Objectives: The Supportive and Palliative Care Indicators Tool (SPICT™) has been used to identify patients at risk of deteriorating and dying within 1 year. Early identification and integration of advance care planning (ACP) provides the opportunity for a better quality of life for patients. The aims of this study were to identify the number of patients who were SPICT™ positive; their mortality rates at 6 and 12 months of the SPICT™ assessment; and level of adherence to ACP documentation. Methods: A retrospective audit of the Supportive and Palliative Care database was conducted at an acute aged care precinct in a major metropolitan tertiary referral hospital in New South Wales, Australia. Data comprising demographics, clinical conditions, SPICT™ positivity and compliance with ACP documentation were collected. SPICT™‐positive patients and mortality were tracked at 6 and 12 months, respectively. Results: Data from 153 patients were collected. The mean age of the patients was 84.1 (±7.8) years, and the length of hospital stay was 10 (±24.7) (range 1–269) days. Approximately 37% were from residential care, and 80% had family deciding on their care. About 15% died during hospitalisation, and 48% were discharged to a care facility. The ACP documentation showed various levels of completion. Mortality rates at 6 and 12 months were 36% and 39%, respectively. Most patients (99%) were SPICT™‐positive, with indicators correlating with higher mortality rates at both follow‐ups. Conclusions: The study emphasises the critical need for addressing ACP and palliative care among older patients with life‐limiting conditions. It underscores the importance of timely discussions, documentation, and cessation of futile interventions. [ABSTRACT FROM AUTHOR]

Background: Intensive and critical care nurses need to demonstrate ethical sensitivity especially in recognizing and dealing with ethical dilemmas particularly as they often care for patients living with life-threatening conditions. Theories suggest that there is a convergence between nurses' empathy and ethical sensitivity. Evidence in the literature indicates that nurses' emotional, demographic, and work characteristics are associated with their level of empathy and ethical sensitivity. Aim: To investigate the relationship between nurses' empathy and ethical sensitivity, considering their emotional states (depression, anxiety, and stress), demographic and work characteristics, and test an empirical model describing potential predictors of empathy (as a mediator) and ethical sensitivity using path analysis. Research design: Using a cross-sectional design, the philosophical theory of care ethics and empathy was extended and adopted as a conceptual framework for this study and tested by path analysis. Participants and research context: Data were collected from 347 intensive care nurses recruited by ten educational-medical hospitals in Iran using a questionnaire between February and March 2021. Ethical considerations: The study was reviewed by the Ethical Advisory Board in Iran and conducted according to the Declaration of Helsinki. Findings: Study participants demonstrated a mild level of stress, anxiety, and depression, alongside a relatively high level of empathy and ethical sensitivity. Nurses with good socioeconomic status had higher empathetic behavior with patients than those with weak status. Nurses aged over 40 who had received ethics training and had higher work experience were associated with higher ethical sensitivity compared to nurses under 20 years of age. Empathy directly affected ethical sensitivity; however, anxiety had an indirect effect on ethical sensitivity through empathy. Among demographic factors, age had a positive direct effect on ethical sensitivity. Conclusions: Less anxiety and a high level of empathy contribute to higher levels of ethical sensitivity among intensive and critical care nurses. [ABSTRACT FROM AUTHOR]

Peripheral blood hematopoietic progenitor stem cells (HPSCs) are the most common source of stem cells for autologous and allogenic transplantation. Currently, systematic reviews comparing the collection efficiency of a continuous to an intermittent method are lacking despite the existence of primary studies. Therefore, the objective of this review was to synthesize the best available evidence to compare the efficiency of the continuous vs the intermittent method for the collection of hematopoietic progenitor stem cells required for HPC transplantation. A search using MEDLINE, CINAHL, EMBASE, Google scholar, and MedNar for both published and unpublished studies was conducted in December 2021. The systematic review was conducted in accordance with JBI methodology. A critical appraisal of the studies was undertaken by two independent reviewers using the JBI quasi‐experimental critical appraisal checklist. A total of six studies were included in the review. The findings of this review demonstrated that there was no statistically significant difference in the collection efficiency, length of procedure time, and total blood volume processed between the continuous and intermittent programs. The evidence suggests that the continuous method is as safe and effective as the intermittent method to collect HPSCs. Until further evidence becomes available clinicians should be guided by the policies of their individual hospitals. [ABSTRACT FROM AUTHOR]

Aims and objectives: To identify final‐year undergraduate students and new graduate nurses' behavioural intentions towards medication safety across four countries. Background: Medication errors are a common and avoidable occurrence, being costly for not only patients but also for health systems and society. Design: A multi‐site cross‐sectional study. Methods: A self‐administered survey was distributed to students and new graduate nurses in South Africa, India, Turkey and Australia. Descriptive statistics were calculated for all survey items. Multiple linear regressions were performed to predict behavioural intentions using the three Theory of Planned Behaviour constructs: attitudes, behavioural control and subjective norms. This study adheres to the STROBE guidelines. Results: Data were analysed for 432 students and 576 new graduate nurses. Across all countries, new graduate nurses reported significantly higher scores on all the TPB variables compared with student nurses. Attitudes towards medication management were found significantly and positively related to intention to practice safe medication management for both student and new graduate nurses. Total perceived behavioural control was significantly and negatively related to intention to practice safe medication management for students. Conclusion: Student and new graduate nurses showed favourable attitude, subjective norm, perceived behaviour control and intention in practising medication safety. However, differences in countries require further exploration on the factors influencing attitudes towards medication safety among student nurses and new nurse graduates. Relevance to clinical practice: Understanding student and new graduate nurses' medication administration practices is important to inform strategies aimed at improving patient safety. The findings of this study highlight the need for an internationally coordinated approach to ensure safe medication administration by student and new graduate nurses. [ABSTRACT FROM AUTHOR]

Aim: This study was conducted in three phases. Phase 1 aimed to adapt the Cancer Information Overload Scale and conduct content validity testing. Phase 2 aimed to conduct factorial validity testing of the scale. Phase 3 aimed to assess information overload and the sources of information used by nurses and midwives to keep up‐to‐date about COVID‐19. Design: A cross‐sectional survey of nurses and midwives working in a metropolitan Local Health District in Sydney, Australia, was conducted from May to June 2020. Methods: Adaptation of the Cancer Information Overload Scale and content validity of the modified scale (as the Pandemic Information Overload Scale) was undertaken by an expert panel comprising of senior nurses and researchers. Factorial validity and reliability of the Pandemic Information Overload Scale were evaluated using exploratory factor analyses using one subsample of the data. Using the second subsample of the data, information overload and sources of information used by nurses and midwives to keep up‐to‐date about COVID‐19 were examined. Results: The Pandemic Information Overload Scale is a reliable and valid instrument for measuring information overload among nurses during a pandemic. Its internal consistency was high (α = 0.81, M = 3.84). Conclusion: The 8‐item PIO scale is a brief, reliable and psychometrically sound instrument for measuring nurses' and midwives' perceptions of information overload during COVID‐19. Mean scores across this study indicated that participants were experiencing above average information overload. Implementing strategies to reduce this overload would optimize clinical decision making and promote patient safety. Summary statement: What is already known about this topic?: The growth of available information for healthcare means health care professionals must filter and process information rapidly to make clinical decisions.A large volume of information has been available from a range of sources related to COVID‐19. This has caused challenges for clinicians to rapidly locate and evaluate information. What this paper adds?: This study offers a validated instrument to assess nurses' and midwives' perceptions of information overload during the COVID‐19 pandemic.Less experienced nurses and midwives had higher information overload compared with those with more experience.Nurses and midwives accessed reliable sources such as the official websites and emails from trusted Health executives for information on the pandemic. The implications of this paper: This instrument can be used to measure of information overload and consequently inform strategies to manage information levels in a clinical settingUnderstanding the sources of information nurses and midwives access can assist with using appropriate methods to deliver information so that nurses and midwives are equipped to make accurate decisions that are best for their patients.Nurses and midwives need support in managing large volumes of information and in gathering the range of information required. [ABSTRACT FROM AUTHOR]

Introduction: The objective of this review is to synthesise and present the best available evidence on the prevalence, predictors and information needs about sexual health among female Arab cancer survivors. Methods: The databases searched included MEDLINE, Embase and CINAHL from inception of the database until March 2020. The review was undertaken according to the JBI guidelines. Proportional meta‐analysis using a random effects model was used for statistical pooling through JBI SUMARI. Results: Seven studies involving female Arab cancer survivors were included in the review. The overall prevalence of sexual dysfunction ranged from 16.7 to 67% (pooled estimate 51%, 95% CIs 21.7% to 80.2%). Dyspareunia and erectile dysfunction were the two main types of sexual dysfunction reported after diagnosis, and the overall prevalence ranged from 42.5% to 65% and 38% to 61%, respectively. The prevalence of vaginal dryness was ranged from 19.8% to 54.2%, and dyspareunia ranged from 22.2% to 65%. The lack of sexuality information and communication with health care providers (HCPs) was also reported in the included studies. Conclusion: Cancer and its treatment may result in significant difficulties with sexual activity and sexual functioning among cancer survivor. Communication between the health care professionals and cancer survivors is essential to overcome this problem and improve the quality of life of female Arab cancer survivors. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to explore the association between economic wellbeing and ethnicity, socioeconomic status, and remoteness during the COVID‐19 pandemic. Design: A cross‐sectional study via SurveyMonkey was conducted in Australia between August 2020 and October 2020. Descriptive and inferential statistics were used to analyze the data. Results: A total of 1211 individuals responded to the survey. Income loss was significantly associated with those from low socioeconomic status (OR = 1.65; 95% CI 1.01–2.68). Access of superannuation was significantly associated with those in outer regional (OR = 3.61; 95% CI 0.81–16.03) and low socioeconomic status (OR = 2.72; 95% CI 1.34–5.53). Financial inability to pay for services was significantly associated with living in remote areas (OR = 2.26; 95% CI 0.88–5.80). Conclusions: The economic wellbeing of people who identify as Aboriginal and Torres Strait Islander, live in regional or remote areas, and reside in low socioeconomic areas have been substantially impacted during the pandemic. Findings call for policies to address the underlying social determinants of health. [ABSTRACT FROM AUTHOR]

The social determinants of health affect an individual's capacity to cope during a crisis such as the COVID‐19 pandemic which could potentially impact their well‐being. The aim of this study was to examine the relationship between well‐being and the social determinants of health among Australian adults during the COVID‐19 pandemic. A cross‐sectional study of adults residing in Australia was conducted using SurveyMonkey between 20 August and 14 October 2020. Participants were recruited via social media. Well‐being was measured using the 10‐item Multicultural Quality of Life Index and social determinants of health were measured using validated tools and investigator developed questions. Data were analysed using SPSS version 25. Inferential statistics, including independent t‐test and one‐way ANOVA, were undertaken. Multiple regression analysis was used to investigate the predictors of well‐being. In total, 1211 responses were received. Females accounted for 80.7% of the responses, men 16.7% and transgender/non‐binary 2.6%. The mean age of the respondents was 43 years (SD 14.2). The mean score for total well‐being was 62.58 (SD 21.22). The significant predictors of higher well‐being were housing security (p = 0.000), food security (p = 0.000), social support (p = 0.000) and access to healthcare (p = 0.000). This study demonstrates that those with poor social support, difficulty accessing healthcare, insecure housing and food insecurity had significantly poorer well‐being during the COVID‐19 pandemic. It shows that the COVID‐19 pandemic has exacerbated social vulnerabilities and highlights the need for action to address the social determinants of health and inequalities. [ABSTRACT FROM AUTHOR]

Background: In Jordan, cancer is the second leading cause of death after cardiac disease. The impact of cancer on sexual relationships is a taboo subject and hence, such issues are underreported research among Jordanian people examining unmet needs. Aim: To examine the experiences and preferences of Jordanian cancer survivors related to communication regarding their sexual needs. Methods: Qualitative study conducted between May and June 2020 using semi-structured face-to-face interviews using the snow-balling approach for recruitment. Participants were recruited until data saturation was obtained and data were analyzed using qualitative thematic analysis. Results: Analysis of participants' interview data identified three main categories: 1) The psychological impact of cancer of sexual relationships; 2) Physician support; 3) Variations in sexual life and sexual experiences. Conclusion: The study revealed that there is a substantial psychological impact of cancer on sexual relationships among Arab Jordanian cancer survivors. Feeling powerless, being labelled as 'sexually disabled', and lack of communication with physicians were emphasized by participants as a barrier to discuss sexual needs with their physicians. Lack of physicians support negatively impact Jordanian cancer survivors sexual experience and led to increased their sense of powerlessness and loss of control over sexual relationships. Implications for practice: Overall, the study indicated a crucial need for physicians to encourage patients to disclose their sexual experience to help them maintain their sexual and mental health while in the fight against cancer. The physicians, nurses and allied health professionals should be engaged in the conversation with patients by taking an active role in the discussion. Additionally, the family and partners of the patients should also be approached and engaged by health professionals in the discussion to address their needs or sexual issues. [ABSTRACT FROM AUTHOR]

BACKGROUND Rapid alterations to study environments during COVID-19 raised concerns for nursing students about their academic progression. AIM The study aim was to investigate the psychometric properties of the Altered Student Study Environment Tool (ASSET) and the relationship between students' concerns, demographics, COVID-19-related knowledge, and communication received from the university. METHOD The 11-item ASSET and investigator-developed questions were administered to prelicensure nursing students using an anonymous online survey. RESULTS Responses were obtained from234 students. Exploratory factor analysis supported a three-factor structure, namely, attending clinical placement, completion of clinical placement, and grade attainment. Students with higher scores on knowledge had significantly lower concerns for the subscale attending clinical placement. Full-time students had significantly higher concerns for the subscale completion of clinical placement. CONCLUSION The ASSET is a valid and reliable instrument that can be used to measure concerns relating to the effects of altered study environments on academic progression. [ABSTRACT FROM AUTHOR]

Objective: To synthesize the best available evidence on the relationship between the social determinants of health and health outcomes among adults during the COVID‐19 pandemic. Introduction: COVID‐19 has created widespread global transmission. Rapid increase in individuals infected with COVID‐19 prompted significant public health responses from governments globally. However, the social and economic impact on communities may leave some individuals more susceptible to the detrimental effects. Methods: A three‐step search strategy was used to find published and unpublished papers. Databases searched included: MEDLINE, CINAHL, EMBASE, and Google Scholar. All identified citations were uploaded into Endnote X9, with duplicates removed. Methodological quality of eligible papers was assessed by two reviewers, with meta‐synthesis conducted in accordance with JBI methodology. Results: Fifteen papers were included. Three synthesized‐conclusions were established (a) Vulnerable populations groups, particularly those from a racial minority and those with low incomes, are more susceptible and have been disproportionately affected by COVID‐19 including mortality; (b) Gender inequalities and family violence have been exacerbated by COVID‐19, leading to diminished wellbeing among women; and (c) COVID‐19 is exacerbating existing social determinants of health through loss of employment/income, disparities in social class leading to lack of access to health care, housing instability, homelessness, and difficulties in physical distancing. Conclusion: Reflection on social and health policies implemented are necessary to ensure that the COVID‐19 pandemic does not exacerbate health inequalities into the future. [ABSTRACT FROM AUTHOR]

Objective Sex and intimacy are basic needs and important aspects of quality of life among humans. This focus of this review was to synthesise and present the best available qualitative evidence on the sexual life experiences and needs of Chinese adults living with cancer. Moreover, the first‐hand experience, meaning and perspective about the sexual life changes and support needs during the survival and extended treatment period were synthesised in this study. Methods: A systematic review of qualitative studies was undertaken using the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI‐SUMARI). A comprehensive search of five databases: CINAHL, MEDLINE, PubMed, Scopus and Google Scholar were undertaken from 2010 until February 2020 using defined criteria. Methodological quality and data extraction were undertaken using JBI‐SUMARI. Results: Eight studies were included in the review. A total of 39 findings were extracted and aggregated into eight categories based on similarity of meaning. Three synthesised themes were generated: (i) misconceptions and lack of education or information regarding sexual activity exists for patients with cancer, (ii) concerns for overall health and well‐being as well as physical and psychological changes can alter sexual desire and behaviours in patients with cancer and (iii) lack of sexual activity and intimacy can create relationship problems. Conclusions: Sexual relationships are intimate, personal and private in Chinese culture and beliefs. Chinese adults living with cancer report many neglected issues on sexual well‐being in various domains. Adequate and consistent education about sexual intimacy issues from health care providers was identified as an important need. Unaddressed needs might affect adults' coping strategies in managing their sexual relations during various stages of cancer treatment and beyond. It must be noted that there are many Chinese ethnic minorities living with cancer outside the Greater China region. The evidence provides valuable recommendations to health care providers globally to consider the specific sexual needs and initiate culturally sensitive sexuality education and care support for Chinese adults living with cancer. [ABSTRACT FROM AUTHOR]

Abstract Background Each year medical providers from wealthy countries participate in short-term medical volunteer work in resource-poor countries. Various authors have raised concern that such work has the potential to be harmful to recipient communities; however, the social science and medical literature contains little research into the perceptions of short-term medical volunteer work from the perspective of members of recipient communities. This exploratory study examines the perception of short-term medical volunteer work in Guatemala among groups of actors affected by or participating in these programs. Methods The researchers conducted in-depth, semi-structured interviews with 72 individuals, including Guatemalan healthcare providers and health authorities, foreign medical providers, non-medical personnel working on health projects, and Guatemalan parents of children treated by a short-term volunteer group. Detailed notes and summaries of these interviews were uploaded, coded and annotated using Atlas.ti (Scientific Software Development GmbH, Berlin) to identify recurrent themes from the interviews. Results Informants commonly identified a need for increased access to medical services in Guatemala, and many believed that short-term medical volunteers are in a position to offer improved access to medical care in the communities where they serve. Informants most frequently cited appropriate patient selection and attention to payment systems as the best means to avoid creating dependence on foreign aid. The most frequent suggestion to improve short-term medical volunteer work was coordination with and respect for local Guatemalan healthcare providers and their communities, as insufficient understanding of the country's existing healthcare resources and needs may result in perceived harm to the recipient community. Conclusion The perceived impact of short-term medical volunteer projects in Guatemala is highly variable and dependent upon the individual project. In this exploratory study, project characteristics were identified that are consistently perceived to be either positive or negative. These findings have direct implications for anyone involved in the planning and execution of short-term medical volunteer projects, including local and foreign medical team members, project planners and coordinators, and health authorities. Most importantly, this preliminary study suggests avenues for future study and evaluation of the impact of short-term medical volunteer programs on local health care services.

A high-quality and effective local neonatal teaching programme is essential for the education and development of paediatric trainees and the wider multidisciplinary team. Trainees themselves may be best placed to guide and develop educational provision, having the greatest insight into their educational requirements. We demonstrate the redesign of a multidisciplinary postgraduate teaching programme in a regional level 3 neonatal intensive care unit through an easily replicable quality improvement project. [ABSTRACT FROM AUTHOR]

Highlights • Explored experiences of clinical practice using Waterlow. • Administered a purpose-developed questionnaire. • Care practices elucidated. [ABSTRACT FROM AUTHOR]