"My life's not my own": A qualitative study into the expectations of head and neck cancer carers.

INTRODUCTION: Cancers that originate from the upper aerodigestive tract are collectively known as head and neck cancer. The most common are squamous cell carcinomas of the oropharynx, larynx, and oral cavity. Head and neck cancer patients experience significant physical and psychological changes because of the disease and treatment. There is a substantial strain on family carers who have extensive responsibilities over most aspects of the patient's life. The aim of the study was to understand the perspectives of being an HNC carer and their perceived expectations of the role. METHODS: The study adopted a qualitative research design with a social constructionist epistemology. Interviews were conducted with 20 carers who were currently caring for someone diagnosed with head and neck cancer. RESULTS: Three overarching themes were identified: taking responsibility for the patient's nutrition, navigating a new and different relationship, and "my life's not my own." Participants felt responsible for ensuring the patient was eating and became increasingly frustrated when the patient was unable to intake food. Carers prioritised the patients' needs at the expense of their own, and several came to resent the role. CONCLUSION: Carers' expectations of their role informed how they approached giving care. Carers need to be supported from diagnosis and encouraged to prioritise their own wellbeing.

'Torn in two': Experiences of Mothers Who Are Pregnant when Their Child Is Diagnosed With Cancer.

Mothers of children diagnosed with cancer have been shown to experience high rates of psychological distress and poor physical health. Pregnancy further increases the healthcare needs of mothers due to the marked physiological changes and psychological adaptations. Our study aimed to explore the experiences of mothers who were pregnant and/or had a baby while their older child was receiving treatment for cancer. Our study employed a qualitative description methodology using semi-structured interviews. Participants were recruited from across Australia via notices on social media sites and the distribution of flyers. The sample comprised 13 mothers who were pregnant and/or had a baby and had a child diagnosed with cancer who was under 17 years old. Thematic analysis was used to analyse the data from which six themes were identified: (1) an impossible balancing act, (2) mother's health and well-being, (3) creating certainty: birthing plans, (4) a bit of sunshine and a time to rest, (5) challenges of caring for the baby and (6) an unenviable position: doing my best versus feeling guilty. Our study demonstrates the additional challenges faced by mothers who are pregnant while their child is receiving cancer treatment. There is a need for a comprehensive and coordinated program that provides pregnant mothers with practical and psychological support. The implementation of such a program has the potential to improve health outcomes for all family members, particularly the mother and their newborn.

Issues affecting nurses' capability to use digital technology at work: An integrative review.

BACKGROUND: Digital capability, that is the ability to live, work, participate and thrive in a digital world, is imperative for nurses because increasingly nurses' work and patient outcomes are influenced by technology. AIM: To evaluate and synthesise the evidence regarding the development of digital capability in nurses and the strategies that support effective integration of digital skills into the workplace. DESIGN: Whittemore and Knafl's methodology, following the preferred reporting items for systematic reviews (PRISMA) guidelines. DATA SOURCES: CINAHL, Embase, PsychINFO, Medline (Ovid) and PubMed databases were searched for articles published in English from 2008-2019. Search terms included; digital capabil*, digital literacy, informatics, nursing informatics, health informatics, nurs*, knowledge, knowledge integration, competency, continuing education, nursing skills, workplace and work environment. REVIEW METHODS: A total of 35 studies were retrieved for quality assessment by two reviewers using standardised critical appraisal instruments from the Joanna Briggs Institute (JBI-MAStARI and JBI-QARI). Minimum essential criteria and scores were agreed prior to appraisal. RESULTS: The 17 studies included comprised quantitative (n = 7), qualitative (n = 8) and mixed methods (n = 2). Integration of digital capability in nurses' workplaces is dependent on user proficiency and competence (theme 1). Nurses use technology to access data at the point of care, specifically accessing evidence to guide care (theme 2a) as well as accessing the medical records (theme 2b). Nurses have several concerns related to the use of technology at point of care (theme 3), some of which can be resolved through investment for implementation (theme 4). CONCLUSIONS: There are key attributes of digitally proficient nurses. Nurses with these attributes are more inclined to use digital technology in their work. Involvement of the nurses as end users in the development of digital systems to ensure they are fit for purpose, alongside investment in professional development opportunities for nurses to develop digital capability, should be prioritised.

Student Nurses' Digital Literacy Levels: Lessons for Curricula.

The rapid uptake of technology is changing the way health professionals provide care to patients and communities. While this presents opportunities to improve, enhance, and positively transform care and treatment, graduates must have the requisite knowledge, skills, and attitudes to make effective use of the technology and data available to them. This research explored nursing students' self-reported digital literacy levels. We undertook a student survey at one university in Australia, utilizing the validated Self-Assessment Nursing Informatics Competencies Scale-SF30 instrument. Overall, 90% of students rated their basic computer knowledge and skills as at least "competent" including performing basic troubleshooting, using the Internet, and conducting online literature searches. However, only 55% of students considered their overall applied computer skills as at least "competent," which included using applications for diagnostic coding and to extract data from clinical data sets. Students have digital literacy in everyday settings; however, their ability to translate this into practice is limited, restricting their access to and use of digital tools in the workplace. Our findings provide the opportunity to address practice issues related to digital literacy and to embed appropriate content in curricula to enable the delivery of improved patient care and the appropriate use of data in various settings.

Welcome to the techno highway: development of a health assessment CD-ROM and website.

Traditionally teaching nursing students psychomotor skills took place in a laboratory setting; however, recent developments in computer technology have revolutionised how educators can transfer knowledge. To meet the need for an efficient and interactive learning experience a software product was required to educate nursing students about health assessment techniques. This paper presents how existing 'old technology' of a video was given new life by embracing new technology, resulting in development of an interactive CD-ROM with supporting WebCT. This innovation reflects a more flexible approach to learning as it is dynamic, portable, self-paced and more convenient for adult learners especially those in remote areas.

Looking to the future: nursing as a career goal.

Career paths selected by completing nursing students are of significant interest to educators and professional agencies. This paper presents part of a larger study which investigated students' influences and motivations for selecting nursing as a career path. The aim of this study was to identify career goals of completing nursing students, what factors influence these goals, preferred areas in which to work and if aged care is considered a career option. The study employed a cross sectional approach utilizing Ford's (1986) taxonomy of human goals as a theoretical framework. A questionnaire was administered to 25 students in the final semester of their nursing degree. Preliminary findings showed goals for future practice were limited to midwifery and paediatrics whilst elder care was not perceived as a viable career option. Negative images of nurses continue to prevail and implications for nursing are considered. Despite the small sample, the study provides evidence that to provide suitable care for all members of the community it is essential that all career options within the profession are positively promoted.

Perceived status of nurses compared to other health care professionals.

The global shortage of nurses indicates that strategies must be in place to attract individuals to the profession. The purpose of this study was to explore the specific motivations/influences that encourage students to undertake a nursing career, their perceived status of nurses, their perceived goals as nurses and their future career pathways. The study involved a cross sectional approach using Ford's (1986) taxonomy of human goals as a theoretical framework. A questionnaire was administered to 126 nursing students enrolled in the first semester of a nursing degree and 80 students in the final semester. Results revealed the image of nurses continues to be influenced by the media. Findings also show how the perceived status of nurses, within a hospital and community setting differ compared to other health care workers. This result highlights the participants' lack of knowledge in regard to the role of professionals within the health care industry. Results have implications for nurse education (long and short term) in relation to the role of nurses.