Globalization: Migrant nurses' acculturation and their healthcare encounters as consumers of healthcare.

Globally, one of every eight nurses is a migrant, but few studies have focused on the healthcare experiences of migrant nurses (MNs) as consumers or recipients of healthcare. We address this gap by examining MNs and their acculturation, barriers to healthcare access, and perceptions of healthcare encounters as consumers. For this mixed-methods study, a convenience sample of MNs working in Europe and Israel was recruited. The quantitative component's methods included testing the reliability of scales contained within the questionnaire and using Hayes Process Model #4 to test for mediation. The qualitative component's methods included analyzing interviews with iterative inductive thematic analysis. Quantitative findings on MNs (n = 73) indicated that the association between acculturation and perception of the healthcare encounter, which MNs experienced as healthcare consumers, was mediated by barriers to healthcare access, even after adjusting for age and gender (p = 0.03). Qualitative interviews with MNs (n = 13) provided possible explanations for the quantitative findings. Even after working in the host country's healthcare system for several years, MNs reported difficulties with their healthcare encounters as healthcare consumers, not only due to their limited knowledge about the culture and healthcare resources but also due to the biased responses they received.

Research, education and capacity building priorities for violence, abuse and mental health in low- and middle-income countries: an international qualitative survey.

PURPOSE: Despite the World Health Organization and United Nations recognising violence, abuse and mental health as public health priorities, their intersection is under-studied in low- and middle-income countries (LMICs). International violence, abuse and mental health network (iVAMHN) members recognised the need to identify barriers and priorities to develop this field. METHODS: Informed by collaborative discussion between iVAMHN members, we conducted a pilot study using an online survey to identify research, education and capacity building priorities for violence, abuse and mental health in LMICs. We analysed free-text responses using thematic analysis. RESULTS: 35 senior (29%) and junior researchers (29%), non-government or voluntary sector staff (18%), health workers (11%), students (11%) and administrators (3%) completed the survey. Respondents worked in 24 LMICs, with 20% working in more than one country. Seventy-four percent of respondents worked in sub-Saharan Africa, 37% in Asia and smaller proportions in Latin America, Eastern Europe and the Middle East. Respondents described training, human resource, funding and sensitivity-related barriers to researching violence, abuse and mental health in LMICs and recommended a range of actions to build capacity, streamline research pathways, increase efficiency and foster collaborations and co-production. CONCLUSION: The intersection between violence, abuse and mental health in LMICs is a priority for individuals with a range of expertise across health, social care and the voluntary sector. There is interest in and support for building a strong network of parties engaged in research, service evaluation, training and education in this field. Networks like iVAMHN can act as hubs, bringing together diverse stakeholders for collaboration, co-production and mutually beneficial exchange of knowledge and skills.

The role of family in supporting adherence to diabetes self-care management practices: An umbrella review.

AIMS: Synthesize a review of reviews of the family's role in supporting adherence to diabetes self-care management practices (DSMP) for adults with type 2 diabetes (DM2). DESIGN: An umbrella review. DATA SOURCES: Scopus, Web of Science including MEDLINE, CINAHL via EBSCO, PubMed and Science Direct were searched for systematic reviews from their year of establishment until June 2021. REVIEW METHODS: The review followed the Joanna Briggs Institute (JBI) guidelines for umbrella reviews. The JBI data extraction form for systematic reviews and research syntheses was used for data extraction. Methodological quality was assessed using the JBI Critical Appraisal Checklist for Systematic reviews and Research Syntheses. RESULTS: Nineteen reviews met the inclusion criteria. The key findings were summarized using a narrative and thematic analysis methods. Four main themes were identified: family interactions and diabetes self-management, family support as informal social support, factors affecting families' roles, and tailoring culturally sensitive family-based interventions. CONCLUSION: There appears to be a consensus regarding the impact of family on adults' self-management of DM2. Additional research is needed to comprehend the role of the family in underrepresented populations and examine what constitutes a family and the diverse family functions in different groups. IMPACT: Enhancing adherence to self-care management practices is crucial for the well-being of adults with DM2. Family support is a key to successful self-care management at home. However, understanding the unique needs of adults with DM2 and their families can help healthcare professionals plan appropriate support strategies and sustainable family-based interventions. NO PATIENT OR PUBLIC CONTRIBUTION: This review did not incorporate direct patients or public input as it summarizes evidence from previously published systematic reviews.

Digital capability: An essential nursing skill for proficiency in a post-COVID-19 world.

AIM: We explored the importance of digital technologies to health responses during the COVID-19 pandemic. The benefits, challenges and barriers to developing digital capabilities are identified, and strategies to establish enduring digital proficiency among nurses and healthcare colleagues gained during the pandemic are canvassed. BACKGROUND: Since the mid-20th century, technology uptake by health practitioners has prioritised digital information and communication technology. The COVID-19 pandemic accelerated the need to adapt digital communication to dangerous clinical workplaces. Organisational policies enabled digital capabilities to replace in-person processes while preserving regulatory compliance, safety and security of patient information and staff deployment. SOURCES OF EVIDENCE: All evidence was accessed from publicly available sources. DISCUSSION: The COVID-19 pandemic was a catalyst for implementing Technology Enhanced Care Services. Health practitioners need appropriate digital capabilities for their roles and scope of practice. Nursing proficiency includes technological skills. Combining the Jisc Digital Capability Framework and the Health and Care Digital Capabilities Framework helps nurses achieve the technical expertise needed for clinical proficiency in contemporary healthcare environments. CONCLUSION: Healthcare workforce digital capability requires policies that resource digital technologies and individual user skills in dangerous COVID-19 workplaces. All involved must be abreast of technological changes and monitor technology effectiveness in innovation in patient care, professional education and evidence-based infectious disease management of healthcare systems. IMPLICATIONS FOR NURSING PRACTICE AND POLICY: Nurses and other practitioners in COVID-19-compromised settings must be able to use the embedded digital technologies in patient care, clinical management and education. Policies securing resources for nurses to learn to use digital technologies will ensure that digital systems are regularly upgraded and that nurses develop proficiency in using technology in their clinical practice. Work and workplace redesign needs compatible computer systems and software to support nursing innovation and digital proficiency.

Preparedness of Australian and British nurses and midwives about domestic violence and abuse.

BACKGROUND: Domestic violence and abuse (DVA) is a major health problem that affects individuals across the world. Nurses, midwives and healthcare providers need to be confident and competent in identifying and responding to DVA. AIMS: To measure current levels of knowledge, opinions and preparedness towards DVA and how it is managed by registered nurses and midwives residing in Australia and the UK. METHODS: A cross-sectional study design was used. Data were collected using the Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS) measuring the perceived preparation and knowledge, actual knowledge, opinions and practice issues. Australian data were collected in 2018 and UK data were collected in 2017-2018. Descriptive and inferential statistics were used to analyse the data and differences in knowledge and attitudes of British and Australian nurses. FINDINGS: Nurses and midwives (n = 368; 130 from Australia; 238 from the UK) responded to the survey. Minimal previous DVA training was reported by the participants. Participants had minimal knowledge about DVA, though had a positive attitude towards engaging with women experiencing DVA. DISCUSSION: Most participants felt unprepared to ask relevant questions about DVA and had inadequate knowledge about available resources. Australian participants scored better than British participants; however, the mean difference in all aspects remained statistically insignificant. CONCLUSION: Australian and British nurses and midwives have a positive attitude towards women experiencing DVA; however, the knowledge and skills to support women experiencing DVA are limited. IMPLICATIONS FOR NURSING POLICY: Nursing institutions should develop strategic policies regarding mandatory preparation and training of nurses for domestic violence assessment and management.

Enhancing nurses' involvement in policy making: A qualitative study of nurse leaders.

BACKGROUND: Nurses can play a valuable role in not only the implementation but development of general and health policies. However, evidence indicates limited involvement of nurses in politics and general health policy making owing to individual, interpersonal, and systematic barriers. INTRODUCTION: Strategies are required to increase nurses' participation and engagement in policymaking. However, no studies explored the perspective of nurse leaders in policy making roles and how to improve nurses' involvement in policy making. PURPOSE: To explore strategies to enhance nurses' involvement in policy making from the perspective of nurse leaders. METHODS: A qualitative descriptive study was conducted. Semistructured interviews were conducted with a purposive sample of 11 nurse leaders with at least one year of experience in policy making. Data were analyzed using a thematic analysis approach. The COREQ guidelines were followed for reporting. FINDINGS: Five themes were generated: strategically revisit and implement educational approaches, becoming transformative leaders, improving social image of nurses, developing triadic partnerships, and empowering nurses through reflective and supportive mechanisms. DISCUSSION: Nurses' involvement in policymaking can be enhanced by implementing grassroots-level educational strategies, managerial-level empowerment efforts, and social mechanisms focused on improving the social image of nursing. CONCLUSIONS: Self and professional role empowerment through education, increasing awareness, and improving the social image of nursing can boost nurses' involvement in policymaking. IMPLICATIONS FOR NURSING POLICY: Nurse leaders, national and global nursing associations, and nursing regulatory bodies should collaborate with associations of nursing colleges to design nurse policymaking competencies framework and contextually tailored strategies to enhance nurses' engagement in policymaking.

Nurses', midwives' and students' knowledge, attitudes and practices related to domestic violence: A cross-sectional survey.

AIMS: To measure registered nurses', registered midwives', and nursing and midwifery students' current levels of knowledge, attitude and practices related to intimate partner violence. BACKGROUND: Nurses and midwives whether registered or students need to be confident and competent in identifying and responding to intimate partner violence. DESIGN: A cross-sectional survey. METHODS: Data were collected through online surveys using the Physician Readiness to Manage Intimate Partner Violence Survey. Descriptive and inferential statistics were used to analyse the data. RESULTS: Nursing and midwifery students were less knowledgeable and prepared than nurses and midwives. Midwives had more positive attitudes compared with nurses towards women experiencing intimate partner violence. CONCLUSIONS: Heath care institutions and regulatory bodies should provide resources and support to nursing and midwifery professionals. Personal experiences of domestic abuse and professional experience of supporting victims of domestic abuse/intimate partner violence affected practitioner's abilities to identify and manage intimate partner violence. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse and midwifery managers can ensure that clinical and organisational policies and protocols are revisited and updated regularly and that interdisciplinary collaboration is promoted and emphasized for prompt identification and management of intimate partner violence.

Advanced practice nurse roles in Europe: Implementation challenges, progress and lessons learnt.

BACKGROUND: Advanced practice nursing (APN) roles offer improved access to care and increased quality and more timely care. Despite the advantages of APN roles, there is a disparity between European countries when it comes to implementing APN roles. AIM: To explore the implementation of APN roles in a range of European countries and to explore what factors facilitate or hinder the implementation of these roles. METHODS: A case study evaluation of the process of implementing APN roles. The sample included four countries where APN roles were well developed (Ireland, Spain, Norway and the United Kingdom) and four where APN roles were implemented (Estonia, Slovenia, Cyprus and Romania). Interviews were conducted with key informants (n = 28) from government departments, regulatory bodies, nursing associations and universities. The consolidated criteria for reporting qualitative research (CPREQ) has been used throughout. LIMITATIONS: The small number of countries when considering the size of the region and key informants representing the view of only three to four people in each country. RESULTS: Four themes were identified, including the rationale for the development of the roles, influence, the evolutionary nature of role development and evidence. The data also revealed a mismatch between the perceptions of how the roles develop among the different countries in the early stages of implementation. CONCLUSION: Successful role implementation is dependent upon a tripartite approach between managers, practitioners and educators. An evolutionary approach to role development was used. Regulation and policy come later on in the process of implementation. IMPLICATIONS FOR NURSING POLICY: APN policy should be based on patient needs rather than on the workforce or professional imperatives. The process of implementation can take 15-20 years in total. Recognising the importance of the relationships between service managers and educators is key to the early development of these roles.

Perceptions of COVID-19-related risk and mortality among ethnically diverse healthcare professionals in the UK.

BACKGROUND: A number of Healthcare Practitioners (HCPs), mostly from Black, Asian and minority ethnic (BAME) origin have died with COVID-19. This survey aimed to explore the views of an ethnically diverse sample of HCPs in the UK about COVID-19-related deaths among HCPs in general and BAME HCPs in particular. METHODS: It is a cross-sectional prospective survey of HCPs in UK and was conducted online using Google Forms between 28th April and 4th May 2020. FINDINGS: A total of 1119 UK HCPs (aged 45.0 ± 9.5 years, 56% males, 71% BAME) participated. Seventy-two per cent of respondents reported being worried about COVID-19 and 84% had concerns about personal protective equipment (PPE). Almost all (93%) respondents felt that inadequate PPE may be a contributory factor to HCP deaths. Half of the respondents, especially younger and BAME, reported feeling unable to say 'no', if asked to work without adequate PPE. BAME HCPs were considered at a higher-risk of acquiring coronavirus and dying with COVID-19. Reasons for excess BAME HCP deaths were believed to be comorbidities, inadequate PPE and working in high-risk areas. Majority (81%) of respondents felt that the government has been slow to respond to COVID-19 related deaths in HCPs and 67% HCPs were of the opinion that BAME workers with risk factors should be removed from direct clinical care. INTERPRETATION: HCPs have significant COVID-19-related concerns. BAME HCPs are considered at increased risk due to comorbidities, working in high-risk areas, and inadequate PPE. BAME HCP should have a thorough risk assessment and high-risk HCPs may need work adjustment or redeployment. All HCPs must have appropriate training and provision of PPE.

Nursing beyond the pandemic: Resilience and determination will shape our future options.

The years 2020-21 have been significant for nurses, midwives and all healthcare professionals across the world. While nurses and midwives faced immense pressure and challenges in performing their roles, the pandemic has contributed to bringing a spotlight to the work that nurses, midwives do and the significance of that work. In this article, the author introduces herself as the Editor-in-Chief of International Nursing Review and shares her vision for the journal.

Umbrella review of family-focused care interventions supporting families where a family member has a long-term condition.

AIM: The aim of this study was to summarize reviews of family-focused care interventions that support families with a family member with a long-term condition across the life course. DESIGN: Umbrella review. DATA SOURCES: Medline (1946-2019), Cochrane Database of Systematic Reviews (2019), Database of Abstracts of Reviews of Effect and EMBASE (1947-2019), CINAHL (1981-2019), Health Technology Assessment Database (2019) and PsycInfo (1806-2019). REVIEW METHODS: All authors independently undertook title/abstract screening, data extraction and quality appraisal on a cluster of papers, working in groups of two or three to reach a consensus. The AMSTAR tool was used to appraise the quality of the studies and descriptive syntheses were undertaken. RESULTS: Fifteen reviews met the selection criteria. Overall family-focussed care and associated terms were poorly defined. Typically interventions were educational or psychological therapy/counselling with the goal of empowering individuals to manage their condition. There is some evidence that family-focused care interventions can improve clinical/biological health measures and self-care outcomes such as treatment adherence. Multicomponent psychosocial interventions that include cognitive-behavioural therapy, skills training, education and support and are focused on wider family members appear to improve family relationships and martial functioning. CONCLUSION: Long-term conditions have an impact on individual and family health and well-being, yet the impact of family-focused care interventions on family outcomes was overall inconclusive. A better understanding of how family-focused care interventions improve the health and well-being of individuals and their families is needed to promote the inclusion of family-focused care into practice. IMPACT: Supporting people with a long-term condition is a key health and social care priority. Family-focused care interventions have potential to improve the health and well-being of individuals and families, but there is a need to evaluate their clinical and cost-effectiveness. The findings from this review could be used by funding bodies when commissioning research for long-term conditions.

Spousal Violence: A Mokken Scaling Analysis of Attitudes of South Asian Men and Women.

Attitudes toward intimate partner violence (IPV) are usually explored by asking participants to respond to some statements describing various instances or situations. Currently, we do not know if responses to such questions or statements are random, leading to a total score which is hard to compare between respondents, or in a hierarchical manner which makes such comparison much more meaningful. The study was conducted to explore the structure of an "attitudes to intimate partner" violence scale used in the Demographic and Health Surveys Program (DHS), for a hierarchy of items according to the criteria of Mokken scaling. Secondary analyses of the data related to attitudes to IPV of South Asian men and women, collected by the DHS from Pakistan, India, Bangladesh, Maldives, and Nepal between 2006 and 2014. A strong Mokken scale was apparent in the data with IPV by men being most justified in cases where the wife neglected the children and least endorsed in the case of refusing to have sex. Men and women endorsed the items in the same order, but some inter country differences were apparent.

From envy to social anxiety and rumination: How social media site addiction triggers task distraction amongst nurses.

AIM: To investigate the effect of social networking site addiction on task distraction among nurses. BACKGROUND: Most of the existing literature focuses only on positive aspects of social networking site, while negative aspects thereof have rarely been highlighted. The current study focuses on finding the impact of social networking site addiction and mental states like envy, social anxiety and rumination on task distraction among nurses. METHOD: Data were collected through self-administrated questionnaires from 378 nurses in Pakistan. The study used descriptive and inferential statistics including correlation and structural equation modelling techniques to test the hypothesized model. RESULTS: The results suggest that social networking site addiction results in task distraction which is further enhanced by envy, social anxiety and rumination among nurses. CONCLUSION: The study contends that social networking site addiction stimulates various stressors among nurses such as envy, social anxiety and rumination that augment its negative effects on task distraction. IMPLICATIONS FOR NURSING MANAGEMENT: Findings of the study can be used develop strategies to control task distraction among nurses to limit its negative impact and to enhance work performance. Awareness campaigns can help nurses and other healthcare professionals to comprehend the effects of using social media at work.