Local Men Local Communities: A rural placed-based approach to increase men's engagement with mental health training and events.

ISSUE ADDRESSED: Suicide is the leading cause of death for Australians aged 15-49 (Department of Health and Aged Care Suicide in Australia, https://www.health.gov.au/health-topics/mental-health-and-suicide-prevention/suicide-in-australia, 2021). With the loss of one community member impacting the individual's family, friends, and wider community. The aim of the article is to showcase a process evaluation of a place-based approach to suicide prevention, exploring the elements of mental health training and events that can be tailored to increase engagement with the men living in a rural Local Government Area in Gippsland, Victoria, Australia. METHODS: Participation records and promotional material for the Local Men Local Communities project was utilised to explore similarities and differences between the training and events offered. RESULTS: Results indicated that men living in rural areas engaged best with events that included a social element such as food or an activity, highlighting that men may find it easier to talk and connect when they have something to do. CONCLUSION: Mental health training and events need to be tailored to meet the needs of the target population. Key details to consider include location, time, promotional material, content, and inclusion of a social element. SO WHAT?: When rural men were provided ownership of their conversations, they were more likely to have them. This challenges the stereotype that men do not talk and creates the opportunity for social connection within the community.

"I Just Know if I Keep Going, I'll End Up Hating Nursing." Lived Experiences of Emergency Nurses Three Years Into the Global COVID-19 Pandemic.

INTRODUCTION: As the coronavirus disease 2019 pandemic continues globally, the personal and professional pressure on health care workers continues to accumulate. Literature suggests that as the pandemic evolves, nurses are experiencing increased levels of anxiety, depression, and post-traumatic stress, ultimately leading them to voice intentions to leave the profession, if they have not done so already. METHODS: Informed by an interpretive hermeneutic phenomenological approach, this longitudinal study was designed to capture how the lived experiences of 9 emergency nurses evolved over the coronavirus disease 2019 pandemic, highlighting their feelings, attitudes, and perceptions toward working in the emergency department at this time in history. Interviews were undertaken in June 2022 and were analyzed using a thematic analysis approach. RESULTS: Data analysis resulted in a total of 2 major themes and 8 minor themes. The 2 major themes included "exposed wounds" and "Band-Aid solutions." Levels of burnout increased during the pandemic, with most of the emergency nurse participants dropping their hours, moving roles within the profession, or leaving the profession entirely. Findings elucidate where and how concerns may arise in clinical practice and holistic well-being among emergency nurses, particularly surrounding professional boundaries and protecting work-life balance and professional identity. DISCUSSION: As the world moves to managing coronavirus disease 2019 as a recognized common respiratory illness, providing time and space for emergency nurses to voice their concerns, design their well-being interventions, set professional boundaries, and reconnect with their professional passion may see lower attrition rates and higher levels of professional satisfaction in emergency nurses globally.

"I Don't Really Wanna Go Back. I Know What I've Got in Front of Me." Lived Experiences of Emergency Nurses 2 Years Into the Global COVID-19 Pandemic.

INTRODUCTION: As the coronavirus disease 2019 pandemic continued into 2021 and beyond, unrelenting work pressures continued to mount on the emergency nursing workforce. In the second year of this longitudinal study on emergency nurse lived experiences, staff outlined the continued strain of the profession, highlighting their increasing levels of burnout and identifying early stages of trauma response. METHODS: This research aimed to continue to explore lived experiences of Australian emergency nurses working on the frontline 2 years into the coronavirus disease 2019 pandemic. A qualitative research design was used, guided by an interpretive hermeneutic phenomenological approach. A total of 9 Victorian emergency nurses from both regional and metropolitan hospitals were interviewed between October and November 2021. Analysis was undertaken using a thematic analysis method. RESULTS: A total of 3 major themes and 12 subthemes were extracted from the data. The 3 overarching themes included "On the floor each day," "Can I keep going?" and "What's around the corner?" Increasing levels of emotional exhaustion and burnout were evident, with emergency nurses stating their intentions to leave the profession. DISCUSSION: Deep engagement with participant emergency nurses across 2 years of the coronavirus disease 2019 pandemic has revealed a need for greater emphasis on staff well-being for future maintenance of a resilient and healthy workforce. Without this, lack of support for subsequent nursing cohorts may affect the quality and reliability of care being provided in acute care centers.

Patient and family members' experiences with language and environment when receiving bad news: A qualitative exploratory study.

OBJECTIVES: Receiving bad news about one's health can be devastating, yet little is known about how the therapeutic nature of the environment where bad news is delivered affects the experience. The current study aimed to explore how patients and their families were affected by the language and the built, natural, social, and symbolic environments when receiving bad news, through the Therapeutic Landscapes theoretical framework. METHODS: Patients diagnosed with a life-limiting illness living in regional Victoria who had a hospital admission within 24 months and a diagnostic/prognostic conversation were invited to participate, as well as a family member who witnessed the conversation. Participants were recruited through social media and snowballing, resulting in 14 online semi-structured interviews being conducted between November 2021 and March 2022, audio-recorded, and transcribed verbatim. Reflexive thematic analysis was used to develop the themes. RESULTS: Fourteen semi-structured interviews were conducted with women aged between 30 and 77 years. Interviews lasted between 45 and 120 minutes, with an average of 69 minutes, and were conducted online or via mobile phone. Four central themes were developed: "Hearing bad news for the first time," "Preferences for having hard conversations," "Creating a sense of safety for ongoing care," and "The therapeutic nature of the ward." SIGNIFICANCE OF RESULTS: This body of work will help inform practice and future policy regarding bad news delivery and the design and aesthetics of environments where bad news is delivered. It is essential that bad news is delivered within a quiet, calm, and emotionally safe environment within a supportive therapeutic relationship.

The benefit and limitations of an online physical activity program in response to the COVID-19 pandemic: A quantitative analysis of the virtual Latrobe Streetgames program.

ISSUE ADDRESSED: The COVID-19 pandemic led to the closure of many physical activity programs, with many online programs being created in place to maintain physical activity engagement. This study explored the outcomes of an online physical program on its participants. METHOD: A validated survey was used to explore Virtual Streetgames (VSG) participants' perceptions about their physical, mental, and social health while participating in VGS. Descriptive and inferential statistics were used to evaluate the impact of the online format. RESULTS: Many VSG participants were not achieving their daily physical activity recommendations, with a considerable portion of individuals feeling frustrated at not being able to socialise. A substantial difference was seen between adults and adolescents, with increased adult activity rates for those adults participating in VSG. Despite this influence on physical well-being, VSG did not seem to influence mental or social wellbeing. CONCLUSIONS: The results give detail into how the COVID-19 pandemic has influenced adolescent and young adult physical, mental, and social health, noting that the reduction of in-person contact influenced motivation for exercise. Online physical activity programs may have some positive impact in improving adult physical activity rates, but they are not as effective as face-to-face programs in improving overall well-being. SO WHAT?: The findings of this study suggest that online physical activity programs may not be as effective as face-to-face programs in improving overall well-being. Future research should explore ways to improve the social and motivational aspects of online physical activity programs to maximise their benefits for participants.

"If I Can't Do It, Who Will?" Lived Experiences of Australian Emergency Nurses During the First Year of the COVID-19 Pandemic.

INTRODUCTION: The World Health Organization estimates that approximately 180,000 health care workers have died in the fight against COVID-19. Emergency nurses have experienced relentless pressure in maintaining the health and well-being of their patients, often to their detriment. METHODS: This research aimed to gain an understanding of lived experiences of Australian emergency nurses working on the frontline during the first year of the COVID-19 pandemic. A qualitative research design was used, guided by an interpretive hermeneutic phenomenological approach. A total of 10 Victorian emergency nurses from both regional and metropolitan hospitals were interviewed between September and November 2020. Analysis was undertaken using a thematic analysis method. RESULTS: A total of 4 major themes were produced from the data. The 4 overarching themes included mixed messages, changes to practice, living through a pandemic, and 2021: here we come. DISCUSSION: Emergency nurses have been exposed to extreme physical, mental, and emotional conditions as a result of the COVID-19 pandemic. A greater emphasis on the mental and emotional well-being of frontline workers is paramount to the success of maintaining a strong and resilient health care workforce.

Burnout, stress and resilience of an Australian regional hospital during COVID-19: a longitudinal study.

Coronavirus disease 2019 (COVID-19) has placed huge strain on hospital staff around the world. The aim of the current longitudinal study was to investigate the resilience, stress and burnout of hospital staff located at a large, regional hospital in Victoria, Australia during the COVID-19 pandemic over time via cross-sectional surveys. The surveys were disseminated six times from August 2020 to March 2021, with the first three data collection points distributed during a state-wide lockdown. A total of 558 responses from various professional roles within the hospital over the survey period were included in the sample. Analysis of variance indicated significant main effects for the psychological variables across time, age, and workload. Hospital staff reported an increase in burnout levels throughout the eight-months. Significant negative relationships were observed between resilience and burnout, and between resilience and stress. A backward regression highlighted the contribution of resilience, stress, age, and nursing roles on burnout. Hierarchical regression analysis indicated that resilience contributed to the stress-burnout relationship. This study strengthens the evidence between resilience and burnout among healthcare workers and hospital staff and highlights the need for psychological wellbeing programs to be implemented for hospital staff impacted by a prolonged worldwide pandemic.

Nurses, physicians and patients' knowledge and attitudes about nurse prescribing.

BACKGROUND: One of the roles that nurses have acquired in recent years is the role of prescribing. This study aimed to investigate the knowledge and attitudes of critical care nurses, physicians and patients about nurse prescribing. METHODS: A descriptive cross-sectional study with the participation of 152 nurses, 53 physicians and 75 patients was carried out. Participants were selected by stratified random sampling from the critical care units of six hospitals in Tabriz, Iran. Demographics and participants' knowledge and attitudes about nurse prescribing questionnaires were used to collect data. The collected data were analyzed using SPSS-22 software. RESULTS: The mean scores of total knowledge about nurse prescribing in nurses, patients and physicians' were 15.41 ± 1.85,16.45 ± 2.31, 14.74 ± 1.7 respectively (from a range of 10 -20), and the mean score of knowledge by physicians was significantly higher than others (P = 0.000) and they had more knowledge about nurse prescribing. The mean scores of the attitudes towards nurse prescribing in nurses, physicians and patients were 40.62 ± 3.68, 37.98 ± 5.92 and 39.38 ± 4.39 respectively (from a range of 10 -50). However, the total mean score of attitudes among nurses was significantly higher than others (P = 0.000) and nurses had more positive attitudes toward prescribing. CONCLUSION: The results showed that the participants have a good understanding and attitudes toward nurse prescribing. Nurse prescribing as a new duty and authority can be considered in providing more effective care by specialist nurses. The results of this study can also be used in the future planning of health policy for nurses to have the right to prescribe and ultimately improve the quality of patient care.

The experiences of health professionals, patients, and families with truth disclosure when breaking bad news in palliative care: A qualitative meta-synthesis.

OBJECTIVE: Disclosing the truth when breaking bad news continues to be difficult for health professionals, yet it is essential for patients when making informed decisions about their treatment and end-of-life care. This literature review aimed to explore and examine how health professionals, patients, and families experience truth disclosure during the delivery of bad news in the inpatient/outpatient palliative care setting. METHODS: A systemized search for peer-reviewed, published papers between 2013 and 2020 was undertaken in September 2020 using the CINAHL, Medline, and PsycInfo databases. The keywords and MeSH terms ("truth disclosure") AND ("palliative care or end-of-life care or terminal care or dying") were used. The search was repeated using ("bad news") AND ("palliative care or end-of-life care or terminal care or dying") terms. A meta-synthesis was undertaken to synthesize the findings from the eight papers. RESULTS: Eight papers were included in the meta-synthesis and were represented by five Western countries. Following the synthesis process, two concepts were identified: "Enablers in breaking bad news" and "Truth avoidance/disclosure." Several elements formed the concept of Enablers for breaking bad news, such as the therapeutic relationship, reading cues, acknowledgment, language/delivery, time/place, and qualities. A conceptual model was developed to illustrate the findings of the synthesis. SIGNIFICANCE OF RESULTS: The conceptual model demonstrates a unique way to look at communication dynamics around truth disclosure and avoidance when breaking bad news. Informed decision-making requires an understanding of the whole truth, and therefore truth disclosure is an essential part of breaking bad news.

Improving youth physical, mental and social health through physical activity: A Systematic literature review.

BACKGROUND: Across various parts of the world there is an increasing trend in adolescent and young adult physical inactivity, which has been linked to a multitude of illnesses throughout the lifespan. To further understand the link between physical inactivity and illness, it is important to determine the effect that physical activity has various components of wellbeing. The primary aim of this review was to compile and synthesise the recent evidence on physical activity and its effect on physical, mental and social wellbeing across younger populations. The secondary aim was to determine whether there is relationship between the amount, type and intensity of exercise, and changes in wellbeing outcomes. METHODS: Main databases were searched using MeSH terms for the population of interest (young adult, adolescent), intervention (physical activity) and outcome (wellbeing). Upon screening papers of eligibility, quality appraisal was completed through the Critical Appraisals Skills Programme (CASP). RESULTS: Nineteen studies were included in this review. The majority of studies found an associated link between the participation of physical activity and improvements in physical, mental and social wellbeing outcomes. There was evidence to suggest that lower levels of physical intensity produced similar results in mental and social outcomes when compared to higher levels of physical intensity. CONCLUSION: This review supports the encouragement of adolescent and young adult physical activity, noting the improvements seen across the physical, mental and social wellbeing outcomes. Future research is still required to further understand the benefits of lower intensity exercise within the adolescent and young adult population.

A creative approach for undergraduate nursing students to learn anatomy and physiology: a qualitative exploratory study.

Anatomy and Physiology (A&P) courses in undergraduate nursing programs are often considered challenging for students. Typically, a wide variety of teaching strategies, including dissection, experiments, illustrations and photographs are used to engage students. This study aimed to explore and describe the learning experiences of an open creative assessment task on undergraduate nursing students of learning A&P. A total of eight students participated in semi-structured interviews. Two major themes emerged from the data, this included 'Bringing A&P to life' which included two sub-themes of 'Learning through peer teaching' and 'An easy way to learn', with the second major theme, 'Custom made learning' which included four sub-themes, 'To grade or not to grade', 'Catering for different learning styles', 'Logistics of group work', and 'Effect of group dynamics'. This qualitative exploratory study contributes to further pedagogical insights into art and/or creative approaches to teaching.

A review of Code Blue activations in a single Regional Australian Healthcare Service: A retrospective descriptive study of RISKMAN data.

BACKGROUND: In the case of life-threatening conditions such as respiratory or cardiac arrest, or the clinical deterioration of the patient, a Code Blue activation may be instigated. A Code Blue activation involves a team of advanced trained clinicians attending the emergency needs of the patient. AIMS AND OBJECTIVES: The aim of the study was to explore the number of cases of Code Blue activations, looking at the timing, clinical ward, diagnosis and activation criteria while noting cases where escalation from a Medical Emergency Team (MET) call occurs in one Regional Healthcare Service in Victoria, Australia, over a six-year period. METHODS: A quantitative retrospective descriptive study of Code Blue emergencies over a six-year period from June 2010 to June 2016 was conducted. Data collected from the RISKMAN program operating at a single site was imported into SPSS (V 22) for descriptive statistical analysis. A STROBE EQUATOR checklist was used for this study (see File S1). FINDINGS: The majority of Code Blue activations were male (59%, n = 127) and aged between 70 and 89 years of age (43%, n = 93). A Code Blue activation was more likely to occur at 08:00 hr, 14:00 hr or 22:00 hr, corresponding to the nurses' change in shift, with the majority of Code Blues (27.8%, n = 60) occurring in the emergency department. Cardiac arrest was the main activation criterion with 54.6% (n = 118) cases followed by respiratory arrest (14%, n = 32). Interestingly, 20% (n = 45) of the Code Blue activations were upgraded from a Medical Emergency Team (MET) call. CONCLUSION: This project has produced several interesting findings surrounding Code Blue activations at one regional healthcare service which are not present in existing literature and is worthwhile for further investigation. RELEVANCE TO CLINICAL PRACTICE: Understanding Code Blue activation criteria, common timings (month, time of day) and patient demographics ensures clinicians can remain vigilant in watching for the signs of patient deterioration and improve staff preparedness Code Blue events.

Evaluation of a Blended Online and Digital Learning Mode of Anatomy and Physiology for Undergraduate Nursing Students.

Blended online and digital learning includes a variety of activities that combine engaging classroom-based education with online learning. The aim of this study is to evaluate undergraduate students' perceptions of a blended online and digital curriculum for anatomy and physiology in the nursing degree program. A quantitative methodology was used with a sample of 100 undergraduate nursing students from a single Australian University. Descriptive statistics are and presented in this article. Of the 100 participants, 90% were enrolled in the standard mode compared to 10% in a flexible mode of delivery. Results indicated that 29% of participants preferred laboratory classes as having the most impact. Participants (46%) also agreed that recorded lectures were useful, with 36% indicating that the online platform was easy to navigate going as far as wanting more online quizzes (49%). More than half of the participants (54%) acknowledged that anatomy and physiology was important for their future careers. The blended online and digital learner preferences in delivering anatomy and physiology-related courses should be adjusted in order for learning to be effective for undergraduate students in the future.

Cultural aspects of death notification following cardiopulmonary resuscitation.

AIMS: To explore the lived experience of resuscitation team members involved in notifying family members when a patient dies following a resuscitation event in an Iranian cultural context. BACKGROUND: Death notification to the family is indeed a difficult and an important issue for resuscitation team members. The way health professionals deliver news to family members should incorporate elements of sensitivity, timing and adequate clinical explanations with emphasis on the efforts made by the professionals during the resuscitation. DESIGN: A phenomenological study. METHOD: Over a period of 5 months (June 2016-November 2016) eleven nurses and six physicians were interviewed using an in-depth interview process applying Van Manen's hermeneutic phenomenological approach for data collection and analysis. The participants were recruited from six tertiary hospitals in Tabriz, Iran. FINDINGS: There were two main themes that emerged from the data analysis including: "contributing factors on the impact of notification" and "notification strategies". A further 13 subthemes emerged under the main themes. Several culturally related issues emerged with the participants feeling more comfortable informing male rather than female relatives about the death of the patient following a resuscitation. CONCLUSIONS: Notifying family members of a patient's death is a stressful and culturally sensitive task for the resuscitation team members. The nature of the patient's presenting condition, together with the various resuscitation interventions can result in relatives responding unpredictably. Providing health professionals with the appropriate training and skills to effectively communicate with family members will ensure that the families' level of preparedness, understanding and cultural beliefs are taken into consideration.

Family Presence During Resuscitation: A Double-Edged Sword.

PURPOSE: To illuminate the meaning of the lived experiences of resuscitation team members with the presence of the patient's family during resuscitation in the cultural context of Iran. DESIGN: An interpretative phenomenology was used to discover the lived experiences of the nurses and physicians of Tabriz hospitals, Iran, with family presence during resuscitation (FPDR). A total of 12 nurses and 9 physicians were interviewed over a 6-month period. METHODS: The interviews were audio recorded and semistructured, and were transcribed verbatim. Van Manen's technique was used for data analysis. FINDINGS: Two major themes and 10 subthemes emerged, including destructive presence (cessation of resuscitation, interference in resuscitation, disruption to the resuscitation team's focus, argument with the resuscitation team, and adverse mental image in the family) and supportive presence (trust in the resuscitation team, collaboration with the resuscitation team, alleviating the family's concern and settling their nerves, increasing the family's satisfaction, and reducing conflict with resuscitation team members). CONCLUSIONS: Participants stated that FPDR may work as a double-edged sword for the family and resuscitation team, hurting or preserving quality. It is thus recommended that guidelines be created to protect patients' and families' rights, while considering the positive aspects of the phenomenon for hospitals. CLINICAL RELEVANCE: A liaison support person would act to decrease family anxiety levels and would be able to de-escalate any potentially aggressive or confrontational events during resuscitation. Well-trained and expert cardiopulmonary resuscitation team members do not have any stress in the presence of family during resuscitation. Resuscitation events tend to be prolonged when family members are allowed to be present.

Leadership and teamwork in medical emergencies: performance of nursing students and registered nurses in simulated patient scenarios.

AIMS AND OBJECTIVES: To examine nursing students' and registered nurses' teamwork skills whilst managing simulated deteriorating patients. BACKGROUND: Studies continue to show the lack of timely recognition of patient deterioration. Management of deteriorating patients can be influenced by education and experience. DESIGN: Mixed methods study conducted in two universities and a rural hospital in Victoria, and one university in Queensland, Australia. METHODS: Three simulation scenarios (chest pain, hypovolaemic shock and respiratory distress) were completed in teams of three by 97 nursing students and 44 registered nurses, equating to a total of 32 student and 15 registered nurse teams. Data were obtained from (1) Objective Structured Clinical Examination rating to assess performance; (2) Team Emergency Assessment Measure scores to assess teamwork; (3) simulation video footage; (4) reflective interview during participants' review of video footage. Qualitative thematic analysis of video and interview data was undertaken. RESULTS: Objective structured clinical examination performance was similar across registered nurses and students (mean 54% and 49%); however, Team Emergency Assessment Measure scores differed significantly between the two groups (57% vs 38%, t = 6·841, p < 0·01). In both groups, there was a correlation between technical (Objective Structured Clinical Examination) and nontechnical (Team Emergency Assessment Measure) scores for the respiratory distress scenario (student teams: r = 0·530, p = 0·004, registered nurse teams r = 0·903, p < 0·01) and hypovolaemia scenario (student teams: r = 0·534, p = 0·02, registered nurse teams: r = 0·535, p = 0·049). Themes generated from the analysis of the combined quantitative and qualitative data were as follows: (1) leadership and followership behaviours; (2) help-seeking behaviours; (3) reliance on previous experience; (4) fixation on a single detail; and (5) team support. CONCLUSIONS: There is scope to improve leadership, team work and task management skills for registered nurses and nursing students. Simulation appears to be beneficial in enabling less experienced staff to assess their teamwork skills. RELEVANCE TO CLINICAL PRACTICE: There is a need to encourage less experienced staff to become leaders and for all staff to develop improved teamwork skills for medical emergencies.

The Lived Experience of Nursing Students from Student Work in Clinical Environments: A Hermeneutic Phenomenological Study.

Introduction: Undergraduate nursing students often work part-time or even full-time while studying at university completing their bachelor's degrees. The aim of this study is to explain the meaning of the lived experiences of nursing students working as students in clinical field. Methods: A phenomenological study was conducted at the nursing and midwifery school of Tabriz, Iran. Purposefully, 20 baccalaureate nursing students with experience working as student worker nurses were recruited. The sample size was determined according to data saturation. Semi-structured, face-to-face interviews were held with the participants over 3 months (April 2020 to June 2020), and Van Manen's hermeneutic phenomenological approach was used to analyze the data. Results: Five main themes extracted from the data analysis, including "students' clinical competency", "nurse-student relationships", "shift work", "mislearning", and "chaotic wards". A further 12 sub-themes extracted under the five main themes. Conclusion: The work of nursing students in clinical environments as student worker nurses is a two-dimensional phenomenon with advantages and disadvantages. The benefits are improving the nursing students' clinical and communication skills, increasing their self-confidence, learning and practicing discipline and nursing responsibilities, and the disadvantages are facing reality shock stress, and mislearning.

Preceptor's experience in supervising undergraduate nursing students in mental health: A qualitative study.

Preceptorship is considered an essential component in undergraduate nursing student's clinical placement, especially those in speciality units such as mental health. During the preceptorship relationship students are granted the opportunity to work alongside experienced nurses in the ward observing their interactions with patients and other professionals. In addition, students are able to build clinical confidence and competence. There is currently a gap in the literature around the preceptorship experience in the mental health clinical environment which warrants further exploration. The aim of this study was to explore the experiences of Registered Nurses precepting undergraduate nursing students during mental health clinical placements. A qualitative, exploratory approach was performed. A total of eight registered nurses working in an acute in-patient mental health unit in a large regional hospital, were recruited and interviewed using a semi-structured interview technique. Thematic analysis was utilised to analyse the data resulting in the development of four overarching themes; (1) Time consuming and additional workload, (2) creating a safe environment, (3) providing and receiving feedback and (4) precepting is not a choice, it is an expectation. The results highlighted that preceptoring students was considered to be an extra workload that required significant time and effort. Preceptors also expressed concerns about student safety, emphasised the importance of feedback and acknowledged preceptorship as an expectation of registered nurses working in mental health. These findings underscore the necessity for further research to delve deeper into the experience of preceptors in mental health settings.

Indigenous experiences and underutilisation of disability support services in Australia: a qualitative meta-synthesis.

Purpose: Aboriginal and Torres Strait Islander People with a disability continue to experience barriers to service engagement such as mistrust of government services, lack of culturally appropriate support, marginalisation and disempowerment. This meta-synthesis reviews current literature regarding these experiences to explain why services are underutilised.Methods: The meta-synthesis was conducted using a meta-ethnographic approach to synthesise existing studies into new interpretive knowledge. The approach was supported by a search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).Results: Ten original research papers utilising a qualitative methodology were extracted. Synthesis of the articles revealed four concepts that were developed into a conceptual model. These include:1) History Matters; 2) Cultural Understanding of Disability Care; 3) Limitations to Current Service Provision; and 4) Delivery of Effective Services.Conclusions: Disability services do not adequately consider the cultural needs of Aboriginal and Torres Strait Islander People or communicate in a culturally appropriate manner. There are expectations that Aboriginal and Torres Strait Islander People acknowledge their disability in alignment with western definitions of disability in order to access services. More work is needed to align disability services with culturally appropriate support to provide better health outcomes.Implications for RehabilitationAboriginal and Torres Strait Islander people with a disability continue to experience barriers to service engagement which must be addressed.An essential gap that must be filled in providing disability services to Aboriginal and Torres Strait Islander people is the acknowledgment of culture as a resolute influence on all client interactions with providers.A cultural model of disability may better align with the experiences of Aboriginal and Torres Strait Islander people than current medical and social models used in healthcare.Disability services need to align better with culturally appropriate support to provide better health outcomes for Aboriginal and Torres Strait Islander people.

The Latrobe Smoking Support Service: A quantitative study of participants in a regional area.

Background and Aims: More than 70% of current smokers in Australia have a definite plan to stop smoking and around half of them try to quit every year. Latrobe Community Health Service (LCHS) was commissioned by Gippsland Primary Health Network to establish Latrobe Smoking Support Service (LSSS) to break down barriers to accessing services and increase support for smoking cessation. This research aims to assess the feasibility of an ongoing smoking cessation support service and determine the effect the LSSS has on client smoking behavior. Methods: Quantitative data were collected for the LSSS situated at LCHS during the period from September 2021 to March 2022. A new client survey, a returning client survey, and a 6-week follow-up survey were conducted by Clinic staff. The consent forms were obtained from the clients. A total of 117 clients attended the LSSS at least once, and a further 315 returning client sessions were conducted. The data analysis was undertaken by means of various descriptive and inferential statistical techniques, such as multiple linear regression analysis. Results: The research findings demonstrate the strong positive effect of the LSSS in helping clients to change their smoking behavior. Results of multiple regression analysis highlight the significant role of behavioral intervention strategies in the LSSS's success. A combination of both nicotine replacement therapy (NRT) and counseling was a key contributor to the project's success. Conclusion: This research proposed and tested the model of a smoking cessation support service that combines a comprehensive mix of services for smokers including free NRT, free counseling, and ongoing support of counselors or/and nurse practitioners.