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Research Objective: The aim of this article is to report a study that explores how spirituality is understood to be represented in the current Australian Nursing and Midwifery Board of Australia (NMBA) Registered Nurse (RN) standards for practice. Research Design: Fairclough's approach to critical discourse analysis was applied in the examination of participant interview texts for the language used in relation to spirituality as well as power mechanisms which influenced the way the participants viewed spirituality's representation in the RN Standards for Practice. Participants: Three members of the RN Standards for Practice research and development team. Results: Findings indicate three discourses shaped the way participants viewed how spirituality is presently represented in the RN Standards for Practice. Discourses are (1) spirituality as part of holistic care, (2) spirituality as part of person-centered care, and (3) the professionalization of nursing. Conclusions: Participant interviews revealed these discourses exerted power over how spirituality was represented within the RN Standards for Practice. This has implications for the inclusion of spirituality in the practice standards and the practice of spiritual care. [ABSTRACT FROM AUTHOR]

Spirituality has been a part of nursing for many centuries and represents an essential value for people, including nurses and patients. Cumulative evidence points to the positive contribution of spiritually on health and wellbeing. However, there is little clarity about what spirituality means. The literature reveals that nurses have ascribed a diversity of interpretations to spirituality. However, no studies have investigated how registered nurses construct their understanding of spirituality using a critical discourse analysis approach. Therefore, the aim of this study was to uncover how registered nurses construct their understanding of spirituality using a critical discourse analysis approach. Twenty registered nurses from a non‐denominational public hospital and a faith‐based private hospital were interviewed about their understanding of spirituality and practice of spiritual care. A critical discourse analysis approach was used in the examination of the interview texts to uncover underlying social and power features. Links were made between the linguistic features the registered nurses used in their interviews and the broader social context of the study. Three discourses emerged from the interview texts. These include constructing spirituality through personal religious beliefs discourse, holistic discourse and empathetic care discourse. The findings of this study have implications for nurse education and policy makers. [ABSTRACT FROM AUTHOR]

Music is frequently used in aged care, being easily accessible and cost-effective. Research indicates that certain types of musical engagement hold greater benefits than others. However, it is not clear how effectively music is utilized in aged care facilities and what the barriers are to its further use. This study used a mixed-methods paradigm, surveying 46 aged care workers and conducting in-depth interviews with 5, to explore how music is used in aged care facilities in Australia, staff perceptions of the impact of music on residents, and the barriers to more effective implementation of music in aged care settings. [ABSTRACT FROM AUTHOR]

Background: Husserl's descriptive phenomenology is a popular methodology in health research as it provides a way to understand people's experiences. Positioned in Husserl's phenomenology, Colaizzi's approach offers a way to analyse data and develop trustworthy findings. However, it can pose methodological and practical challenges. Aim: To present a discussion of the application and tailoring of Colaizzi's phenomenological approach to a study conducted in a hospital. Discussion: Applying Colaizzi's approach to interview data concerning health professionals' decisions about transferring older people in hospital to residential care provided a decision trail. However, Colaizzi's final step – member-checking – is controversial so was tailored to enhance the development of trustworthy findings. Conclusion: Validating findings is an important part of conducting research. Tailoring the final step of member-checking in Colaizzi's approach supports trustworthy findings while staying connected to phenomenological epistemology. Implications for practice: Phenomenology is a popular methodology for nurse researchers. Tailoring Colaizzi's approach provides strategies to augment phenomenological methods, ensuring dependable findings. Nurse researchers conducting phenomenological research can use these strategies. [ABSTRACT FROM AUTHOR]

Purpose: Government strategies are putting increasing emphasis on sustaining the capacity of older persons to continue living independently in their own homes to ease strain on aged care services. The aim of this study was to understand the experiences and strategies that older people utilize to remain living at home from their own perspective. Methods: A grounded theory methodology was used to explore the actions and strategies used by persons over the age of 65 to enable them to remain living in their own homes. Data were collected from 21 women and men in three focus group discussions and 10 in-depth semi-structured interviews. Results: The data revealed that the central process participants used to hold momentum and sustain living at home involves a circular process in which older people acknowledge change and make ongoing evaluations and decisions about ageing at home. Conclusion: These findings have implications for informing policy and service provision by identifying appropriate resources and services to promote successful ageing at home. [ABSTRACT FROM AUTHOR]

Objectives. Continuing to live at home is arguably one of the most important challenges older persons face as they age. The aim of this study was to clarify how older adults conceptualise home through age-related lifestyle changes. Methods. Principles from grounded theory were used to examine the perspectives of 21 older adults obtained from three focus group discussions and 10 in-depth semistructured interviews. Results. Four major categories were developed: "anchoring self," "enabling freedom," "being comfortable," and "staying in touch." Discussion. For the participants in this study remaining at home enabled a sense of independence and freedom, self-worth and identity, comfort, and an ongoing active role in the community. However, some aspects of home could be renegotiated despite changes to living location, with new social connections able to be forged and personal comforts being transferrable. This holds important implications for supporting older persons to both sustain living at home and to adjust to changing circumstances, suggesting the importance of drawing on the experiences of older persons themselves in developing strategies to promote successful aging. [ABSTRACT FROM AUTHOR]

Background. Older Australians are consumers of high levels of complementary medicines. The aim of this study was to examine health literacy in a population of older Australians related to their use of complementary medicine. Methods. A two-phase sequential mixed method design incorporating quantitative and qualitative methods was used in this study. The first phase consisted of a cross-sectional survey using a validated health literacy questionnaire and follow-up interviews with 11 residents of retirement villages. Interviews explored low scoring domains on the health literacy questionnaire. Results. Health literacy competencies scored higher for the domains of having sufficient information to manage their health; felt understood and supported by health care providers; actively managed their health; and having social support for health. Three health literacy domains scored low including appraisal of health information; ability to find good information; and navigating the health care system. The findings suggest that participants had different experiences navigating the health care system to access information and services relating to complementary medicines. Two themes of “trust” and “try and see” provide insight into how this group of older Australians appraised health information in relation to complementary medicines. Conclusions. With a focus on self-care there is a need for improved health literacy skills. [ABSTRACT FROM AUTHOR]

The present study takes a motivational perspective that views youths' educational and career engagement as influential and potentially competing for the same motivational resources in the transition to adulthood. We investigated whether motivational engagement with educational and career goals in the year after high-school graduation was differentially associated with educational, career-related and subjective well-being outcomes 2 and 4 years after school graduation. Our longitudinal study of a multi-ethnic sample of Los Angeles high-school graduates followed participants 2 years ( N = 561; 61.5 % female) and 4 years ( N = 364; 59.8 % female) after high school graduation. The findings indicate that motivational engagement with educational goals after high school graduation predicted educational attainments and psychological well-being at follow-up 2 and 4 years after graduation, and occupational progress at 4 years after graduation. Work hours assessed shortly after high school graduation were associated with poorer educational outcomes both at 2 and 4 years after high school. Occupational goal engagement was not associated with better outcomes, but predicted less educational attainment 4 years after graduating. Thus, educational goal engagement predicted favorable outcomes, whereas career-related goal engagement for the most part was neutral with some select associations with negative educational outcomes. A strong motivational commitment to educational goals, but not to career goals, is an important component of a successful transition to adulthood. [ABSTRACT FROM AUTHOR]

This article presents the mental health aspects of ‘touch’ associated with a funded research project:Avoiding ‘high tech’ through ‘high touch’ in end-stage dementia: Protocol for care at the end-of-life. These mental health aspects highlight the human need for touch that continues up until and inclusive of the final stages of life. This study was informed by Simard's (2007) ‘high touch’ protocol based on the End-of-Life Namaste Care programme for people with dementia. The article is situated in relation to the research project which used a three-phase mixed methods approach. Data explored in this article are derived from focus groups conducted at three residential aged care facilities located in metropolitan and regional areas of NSW, Australia. The exploration of touchvis-a-vismental health fell under two broad themes: touch by others and touch by the person. Sub-elements of these themes comprised touch towards a physical objective, touch towards an emotional objective, touch of objects and touch of others. The overarching outcome of interconnectedness embraced environmental awareness and human and life awareness. These two broad themes, with their accompanying elements, express the essential nature of mental health as a reciprocal connectedness, with reciprocal impacts on both those people with advanced dementia and their carers. [ABSTRACT FROM PUBLISHER]

This study explored the perceptions of bereavement support offered to clients and their carers and family by community nurses ( CNs) in three community health centres located in a single area health service. In the context of an ageing population, it is pertinent to review CNs' perceptions in providing bereavement services. Early assessment and intervention is likely to prevent complicated grief occurring in the community. The bereavement support provided by CNs, considered here within a person-centred framework, enables identification of complicated grief. Semistructured interviews were held with 10 CNs and were transcribed verbatim. Transcriptions were analysed for major themes, and responses were grouped in relation to the study aims and themes emerging from the interviews. The themes discussed in this paper are as follows: the carer as a focus of palliative care; bereavement support as an outlet for carers; and the ending of the relationship between carers and CNs that is facilitated through bereavement support. The study provides evidence that supports the adoption of a model of bereavement support delivered by CNs as a means of reducing the likelihood of complicated grief occurring in the community. Further, the visits provide an important opportunity for nurses and carers to satisfactorily complete their relationship. [ABSTRACT FROM AUTHOR]

Community (district) nurses play a significant role in assisting and supporting bereaved informal carers (family members and friends) of recently deceased clients of palliative care. Bereavement care demands a wide range of competencies including clinical decision-making. To date, little has been known about the decision-making role of community nurses in Australia. The aim of this study was to conduct in-depth examination of an existing data set generated from semi-structured interviews of 10 community nurses providing follow-up bereavement care home visits within an area health service of a metropolitan region of Sydney, Australia. A grounded theory approach to data analysis generated a model, which highlights an interaction between 'the relationship', 'the circumstances' (surrounding the bereavement), 'the psychosocial variant', 'the mix of nurses', 'the workload', and 'the support' available for the bereaved and for community nurses, and elements of 'the visit' (central to bereavement care). The role of community nurses in bereavement care is complex, particularly where decision-making is discretionary and contingent on multiple variables that effect the course of the family's grief. The decision model has the potential to inform community nurses in their support of informal carers, to promote reflective practice and professional accountability, ensuring continuing competence in bereavement care. J [ABSTRACT FROM AUTHOR]

The aim of the INHospital study was to compare the level of importance of care priorities and satisfaction levels with care among patients, carers, and nurse caregivers in the acute aged care setting. The INHospital study used sequential mixed methods approach for data collection. Survey data was completed within five metropolitan acute aged care wards on patients (n = 78), their carers (n = 45) and nurses (n = 37). The caring activity scale (CAS) survey was administered to participants in order to determine and compare the perceptions of the importance and satisfaction of care. Semi-structured interviews of patients (n = 7) and carers (n = 7) were conducted after completion of the CAS survey. This qualitative data aimed to probe more deeply into the patient's and carer's care priorities and satisfaction as measured in the CAS. The CAS data demonstrated that patients, carers and nurses rated implementing, observing and reporting doctor's orders similarly, while differences between groups were observed in relation to prioritising physical and psychosocial care and discharge. There were significant differences between patients, carers and nurses on overall importance (p = 0.001) and satisfaction with respect to nursing care (p = 0.001). Qualitative data generated five themes (1) Nurses doing the best they can in challenging circumstances; (2) Achieving a balancing act in a pressured environment; (3) Striving to maintain and sustain independence; (4) The discharge process: not a shared priority; and (5) Challenges of the carer role. A key implication of this study is the incongruence between what patients consider a priority for care and the priority ascribed to those tasks by nurses. Qualitative findings added depth to the survey data and qualified responses by confirming that patients thought that nurses did the best they could within a culture of busyness, while patients strived to maintain and sustain their own independence. However, the themes of managing the discharge process and carer burden arose mainly from the carer semi-structured interviews. [ABSTRACT FROM AUTHOR]

Aims and objectives: This article presents the generation of a model of care encompassing "function" and "affect" based on findings from a 2011 research project aimed at improving care delivery for people with advanced dementia. Objectives were to provide comprehensive and sustainable care, honouring and respecting the person. Background: Dementia is a debilitating, progressive, and terminal disease with a trajectory ranging from approximately 3 to 16 years, yet attention to end‐of‐life care, promoting comfort, alleviating suffering, and maximizing quality of life is frequently overlooked for people living in the advanced stages of the disease. Methods: The research project from which the model was drawn used a three‐phase mixed methods approach at three residential aged care facilities (nursing homes) providing high care in New South Wales, Australia. Thematic analysis was elicited from focus group discussions with staff, family members, and carers of residents. Findings Themes describe distinct dimensions of a model of care: "function" (dedication, designation, and deliberation) and "affect" (the personal outcomes revealed in relaxation, stimulation, and transformation). Conclusion: Reframing nursing practice from task and disease orientation to person centred and relationship focused is essential in meeting the complete needs of people with advanced dementia. This transformational model of care may be useful in adapting to other end‐of‐life care settings. SUMMARY STATEMENT: What is already known about this topic? Worldwide, the number of people aged 60 years and older is projected to nearly triple by 2050, placing a significant burden on health care systems.Sensory stimulation influences emotions and their expression.As residents progress along the dementia trajectory, they have less opportunities for engaging in meaningful activities. What this paper adds? A new model of care that has a positive effect on quality of life for people with advanced dementia.The model addresses functional and affective needs of residents by focusing on their preferences and personal outcomes.An approach for all health professionals in providing person‐centred care. The implications of this paper: Knowing and engaging the residents' personal history and understanding their physical, psychosocial, and spiritual needs are integral in improving the quality of life for people with advanced dementia, their families, and carers.Redesigning residential aged care facility environments to incorporate home comforts offers an opportunity to enhance health professionals' capacity for improved care. [ABSTRACT FROM AUTHOR]

This study focuses on the plans, goals, and concerns of foster care youth prior to leaving care. Participants were 179 pre-emancipated youth between the ages of 17 and 20 years old ( M = 17.82, SD = 0.79) from a large metropolitan area in Southern California. Self-articulated immediate plans were grouped into 4 major categories and self-articulated life goals were grouped into 10 categories while also examining the prioritization of, estimated time frame for, and youth's sense of control over their life goals. Survey and interview data reveal the importance of educational and occupational life goals and their prioritization. Youth reported a high level of certainty in their immediate plans, but the youth were less explicit in describing their immediate plans for the year after foster care. Foster youth may have difficulty identifying concrete steps to make plans a reality despite their ideas for the future. Youths' worries and concerns about their post-emancipation plans and life goals typically centered around academics and finances. This study contributes to the limited literature on the life goals and plans for foster youth; these results reinforce the need for greater support in planning and goal setting prior to emancipation. [ABSTRACT FROM AUTHOR]