Spiritual care for older people living in the community: A scoping review.

BACKGROUND: The population of older people should be supported to enjoy optimal quality of life. Health professionals should consider a range of interventions that support the older population to maintain their quality of life. One such interventional approach involves spiritual care. OBJECTIVE: To explore what is known about spiritual care approaches for older people living in the community. METHODS: Scoping review informed by Joanna Briggs Institute guidelines. Eight electronic databases were searched: CINAHL, Ageline, PubMed, ProQuest Nursing & Allied Health, PsycINFO, Scopus, Garuda, and Neliti. The review included quantitative and qualitative primary peer-reviewed research studies focusing on spiritual care interventions for older people living in the community published between 2011 and 2021 in English or Bahasa Indonesia. The search was uploaded into an electronic citation manager and imported into Covidence for screening. RESULTS: A total of 29 studies were included in the review. While the studies were conducted in five continents, most were reported from the Asian continent. Five key issues based on the outcome of interventions were found namely psychological, physical, spiritual, multidisciplinary approach, and social connection. CONCLUSION: This scoping review identifies spiritual interventions conducted across many countries have been implemented for older people living in the community. Although there are review limitations and further research is needed, these spiritual interventions, both faith-based and non-faith-based, are identified as useful to support the well-being of older people.

Effectiveness of a Multimodal Nursing Intervention on Quality of Sleep, Fatigue, and Level of Depression Among Indonesian Patients With Gynecological Cancer: A Pilot Study.

BACKGROUND: The use of nonpharmacological modalities in managing symptoms experienced by patients with cancer is increasingly important in providing holistic care. However, limited studies have reported on integrating nonpharmacological interventions to improve physical and psychological symptoms of women with gynecological cancer. OBJECTIVE: The aim of this study was to examine the effect of a multimodal nursing intervention (MNI) on sleep quality, fatigue, and level of depression among Indonesian women with gynecological cancer. METHODS: The quasi-experimental nonequivalent group design involved 50 patients in 2 groups and used convenience sampling. An experimental group (n = 25) received MNI including progressive muscle relaxation and a counseling session; the control group received routine hospital care (n = 25). Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI), depression levels by the Beck Depression Inventory-II, and fatigue by the Piper Fatigue Scale (PFS). Pretest data were collected after 3 days of hospital admission; posttest data were gathered after the intervention. RESULTS: The PSQI ( P = .000), Beck Depression Inventory-II ( P = .008), and PFS ( P = .000) changed significantly in the intervention group; the PSQI ( P = .000) and PFS ( P = .000) in the control group changed significantly. The PSQI ( P = .00) and PFS ( P = .000) scores differed significantly between the 2 groups before and after the intervention. The effect size of the MNI for difference scores before and after the intervention was medium effect size. CONCLUSIONS: The role of nonpharmacological modalities in managing symptoms experienced by patients with cancer is increasingly important to providing holistic care. IMPLICATION FOR PRACTICE: Gynecology nurses can lead the implementation of MNI to decrease patient fatigue and depression and to increase sleep quality.

Recognizing and Adapting to Cultural Differences: Influence of International Educational Programs on Future Nursing and Midwifery Practice.

INTRODUCTION: International educational programs build cultural humility and safety skills in nursing and midwifery students; however, long-term outcomes of these programs are unclear. The purpose of this study was to explore the impact of international educational programs on nurses' and midwives' future professional practice. METHOD: Using grounded theory informed by Charmaz, 13 general nurses, two mental health nurses, three midwives, and four dual-qualified nurse/midwives across eight different countries were interviewed. Three categories evolved from the analysis. This article reports on the category Recognizing and adapting to cultural differences. FINDINGS: Participants developed cultural safety and awareness from participation in programs extending into future practice. Experiencing and adapting to cultural similarities and differences, they developed culturally congruent practices many years after program completion. DISCUSSION: International programs contributed to participants' professional practice. Positive and ongoing influences are important for employers to promote patient safety and culturally congruent quality care. Findings are also relevant for education providers to inform quality cultural learning.

The evolution of registration standards for internationally qualified midwives in Australia.

BACKGROUND: Registration as an internationally qualified midwife in Australia can be challenging, as the individual must meet rigorous education and professional competency assessment standards. AIM: The purpose of this discussion is to present an overview of the evolution of registration standards for internationally qualified midwives in Australia from 2000 to 2020 and evaluate their effectiveness in promoting internationally qualified midwives' professional integration. RESULTS: Australian registration policies for internationally qualified midwives have undergone significant change over the last 20 years. In 2010, registration policy and governance moved from state or territory to national jurisdiction, then these standards were upgraded in 2014, and finally transitioned to an outcome-based assessment (OBA) program in 2020. Inconsistency and lack of transparency in established registration policies and their implementation were revealed, most notably when bridging programs for internationally qualified midwives from non-English speaking backgrounds were discontinued in Australia in 2015, despite reference in the NMBA policy as an available transition program from 2000 to 2020. The implementation of OBA in 2020, which occurred after a significant delay, complicated registration processes further with inclusion of two levels of assessment (MCQ examination and OSCE) and associated expenses. CONCLUSION: Evidence-based strategies and regulatory adjustments are necessary to effectively register internationally qualified midwives in Australia, particularly those from non-English speaking backgrounds.

Transition experiences of Middle Eastern midwives into Australian practice: A multiple case narrative study.

AIM: To explore transition experiences of Middle Eastern qualified midwives into practice in Australia. DESIGN: This was a qualitative study using multiple case narrative approach underpinned by structuration theory. METHODS: A total of 19 Middle Eastern qualified midwives from different states of Australia participated in this study. Individual semi-structured interviews were conducted between November 2020 and September 2021, digitally recorded and then transcribed. Transcriptions were analysed in three stages, with three main categories generated in the second stage and a core category that was developed in third. RESULTS: Entering the Australian workforce, Middle Eastern qualified midwives had to reframe their professional identities to fit the new system by adjusting to three aspects of the practice, including preparation for practice, scope of practice and context of practice. While they were prepared by medically oriented curricula, worked in systems that had limitations for midwives to practise in antenatal and postnatal and lacked regulation standards, they learned to practise autonomously in their full scope in a standardized context in Australia. CONCLUSION: Middle Eastern qualified midwives in Australia re-evaluated their practice in their home countries, realized the gaps and adjusted to new ways of practising in Australia. IMPACT: To effectively use the potential of Middle Eastern midwives for workforce sustainability in Australia, support should be available to enable them to develop the necessary competencies for safe practice in Australia including provision of context-specific transition programmes prior to registration and supporting mentorship after their integration into the Australian healthcare workforce. PATIENT OR PUBLIC CONTRIBUTION: Patient or public contribution does not apply to this study as its purpose was to explore the transition experiences of Middle Eastern qualified midwives themselves.

Reported outcomes of nursing or midwifery students participating in international educational programs in their pre-registration education: A narrative systematic review.

OBJECTIVE: To identify outcomes of nursing or midwifery students participating in international educational programs in their pre-registration education. DESIGN: A systematic review of the literature was conducted in keeping with JBI methods. DATA SOURCES: A range of databases were searched, including Medline, Embase, ERIC, CINAHL, ProQuest Central and DOAJ. Studies published in English from 2010 to 2020 were considered. STUDY ELIGIBILITY CRITERIA: The review included qualitative and quantitative primary peer-reviewed research studies involving nursing or midwifery students who participated in international educational programs in their pre-registration education. REVIEW METHODS: Thematic analysis informed by Braun and Clarke was used to identify key outcomes emerging. RESULTS: 56 studies were included. The results highlight similarities in outcomes for students who had undertaken international educational programs in three thematic areas: Cultural learning, Personal growth, and Professional development. Short-term outcomes are well documented, however there is a lack of research investigating long-term outcomes. CONCLUSIONS: Further research is required to investigate long-term outcomes of international educational programs and means for measuring the effects on students' future professional practice. In addition, further research is needed to explore the perspectives of, and impact on, others including host communities and universities, and other stakeholders.

Transition experiences of internationally qualified health care professionals: A narrative scoping review.

BACKGROUND: The migration of health care professionals exposes the individual to a variety of challenges as they adjust to the host country's workforce system. While there is a growing body of literature on the individual transition stage of internationally qualified health care professionals, little is known about the overall process and how each stage interacts with the others. AIM: To examine what is known about factors impacting transition experiences of internationally qualified health care professionals at various stages from pre- to post-arrival in their new country. DESIGN: Scoping review incorporating narrative synthesis was conducted. DATA SOURCES: A range of databases were searched, including CINAHL, Medline, Scopus, and ProQuest, as well as reference lists. REVIEW METHODS: The adapted framework methodology described by the Joanna Briggs Institute informed this review. The review included qualitative and quantitative primary peer-reviewed research studies focusing on transition experiences of internationally qualified health care professionals. Included studies were analysed and synthesised using a three-step narrative synthesis. RESULTS: A total of 48 studies were included in the review from nursing, medicine, dentistry, physiotherapy, occupational therapy, and midwifery, with the majority from nursing. The majority of the internationally qualified health care professionals migrated from Philippine, India, and South Africa to the US, UK, Canada, and Australia. Four themes emerged from the review: misguided migration (pre-arrival), a shocking reality (early arrival), challenging accreditation and orientation (registration), and multidimensional work challenge (post-registration). Identified issues impacting the transition experience of internationally qualified health care professionals across different disciplines and nations were generally similar. CONCLUSIONS: Misinformation resulted in unexpected realities upon arrival in destination countries, ineffective accreditation procedures during registration and inadequate support in destination countries led to workplace challenges. With ongoing recruitment of international health care workers, a holistic approach that considers the various stages of transition is necessary to assist in establishing new identities and integrating into the destination country's workforce. This includes informing internationally qualified health professionals accurately about professional and cultural expectations in host countries prior to migration, implementing culturally specific training upon arrival in the destination country, developing and implementing effective accreditation and registration policies, and providing structured mentorship and support following employment.

Becoming an adolescent mother: The experiences of young Indonesian new mothers living with their extended families.

OBJECTIVE: Adolescent motherhood brings many challenges. While much is written about young mothers' transition to motherhood and their support needs, there is little from South-East Asian countries such as Indonesia. The aim of this study was to understand the new motherhood experiences of Indonesian adolescent females living with their extended families. DESIGN: Eleven semi-structured interviews were conducted with new adolescent mothers. SETTING: a large women and children's hospital in Makassar, South Sulawesi, Indonesia. PARTICIPANTS: Purposive sampling was undertaken. Eleven adolescent mother participated in this study. The mean age of the mothers was 17 years, ranging from 16 to 19 years of age. FINDINGS: Four themes emerged: demonstrate transfer of knowledge between generations, sharing tasks with extended family, feeling blessed with extended family and local myth and cultural practice related to caring for the baby. Findingsdemonstrated that transfer of knowledge between generations was important for these adolescent mothers. They shared responsibilities with and felt blessed having their extended families, along with local beliefs and cultural practice related to caring fortheir babies. DISCUSSION AND IMPLICATIONS FOR PRACTICE: Our findings contribute to understandings of experiences to becoming mothers among Indonesian adolescents living with extended family. Results can be used by healthcare providers, especially nurses and midwives, to develop cultural care interventions and educational program for maternity and psychosocial care for adolescent mothers and their families towards success in the transition period and maternal role attainment.

Midwifery in Middle Eastern and North African countries: A scoping review.

BACKGROUND: While midwives are positioned as critical providers for improving sexual, reproductive, maternal and newborn health outcomes in the Middle East and North African (MENA) countries, the standards of midwifery have not been explored systematically in this region. AIM: The purpose of this scoping review was to provide an overview of existing literature on midwifery practice, education, and regulation in MENA countries in the context of ICM standards. METHODS: A search was conducted inclusive of English and Persian written studies published between 2000 and 2019 in CINAHL plus; Ovid MEDLINE; PubMed; Scopus; and grey literature. Title and abstract and full-text review were performed in Covidence, and data extraction and synthesis performed using NVivo 12. RESULTS: The initial search identified 7,994 articles. Overall, 139 studies were included in the review. Although, the primary concept of most included studies was "midwifery practice", "midwifery regulation" was addressed in limited way. Approximately 90% were from Middle Eastern countries. Forty-two per cent of studies used cross-sectional designs, and most originated from Iran, Jordan, and Palestine. Diversity was found in midwifery education, practice and regulation across the MENA countries. Midwives from different nations had uneven levels of proficiency, scope of practice, and education. Midwifery curricula were aligned with ICM competencies in some countries. Most countries had midwifery associations and were members of ICM. Some countries had regulations recognising midwifery as an autonomous profession. CONCLUSION: Midwifery practice, education and regulation in MENA countries were not always comparable with ICM standards, although some progress was evident.

Retraction of publications in nursing and midwifery research: A systematic review.

BACKGROUND: Rates of manuscript retraction in academic journals are increasing. Papers are retracted because of scientific misconduct or serious error. To date there have been no studies that have examined rates of retraction in nursing and midwifery journals. DESIGN: A systematic review of Journal Citation Report listed nursing science journals. DATA SOURCES: The Medline database was searched systematically from January 1980 through July 2017, and www.retractionwatch.com was manually searched for relevant studies that met the inclusion criteria. REVIEW METHODS: Two researchers undertook title and abstract and full text screening. Data were extracted on the country of the corresponding author, journal title, impact factor, study design, year of retraction, number of citations after retraction, and reason for retraction. Journals retraction index was also calculated. RESULTS: Twenty-nine retracted papers published in nursing science journals were identified, the first in 2007. This represents 0.029% of all papers published in these journals since 2007. We observed a significant increase in the retraction rate of 0.44 per 10,000 publications per year (95% CI; 0.03-0.84, p = .037). There was a negative association between a journal's retraction index and impact factor with a significant reduction in retraction index of -0.57 for a one-point increase in impact factor (95% CI; -1.05 to -0.09, p = .022). Duplicate publication was the most common reason for retraction (n = 18, 58%). The mean number of citations manuscripts received after retraction was seven, the highest was 52. Most (n = 27, 93.1%) of the retracted papers are still available online (with a watermark indicating they are retracted). CONCLUSION: Compared to more established academic disciplines, rates of retraction in nursing and midwifery are low. Findings suggest that unsound research is not being identified and that the checks and balances incumbent in the scientific method are not working. In a clinical discipline, this is concerning and may indicate that research that should have been removed from the evidence base continues to influence nursing and midwifery care.

Midwifery student reactions to workplace violence.

PROBLEM: Workplace violence, incidents against people in their workplaces, is a growing problem in Australia causing untold personal suffering as well as costing Australian businesses in productivity. Midwives have been highlighted as a group particularly at risk, yet in Australia there is little research into workplace violence against midwives and even less into midwifery students. AIM: This study aimed to explore Australian midwifery students' responses to workplace violence as well as to gauge the impact of workplace violence on them. METHODS: Cross-sectional survey design was employed. Second and third year students were invited to participate at the end of a scheduled lecture. Fifty-two female midwifery students who had completed their work placement completed a survey indicating their immediate responses to workplace violence as well as the Impact of Event Scale. Data were analysed using descriptive statistics. FINDINGS: Most students notified a co-worker immediately after a workplace violence incident, yet few completed an incident form or received official debriefing. DISCUSSION: There is a need for the reporting of workplace violence against midwifery students to be made easier to access thereby ensuring they can receive the assistance they require. Midwifery students need to understand the processes and supports in place for managing instances of workplace violence. CONCLUSION: Clinical placements can impact on midwifery students' future careers. Universities need to prepare students for the possibility of workplace violence and arm them with appropriate strategies for safely dealing with it.

Interprofessional simulation of birth in a non-maternity setting for pre-professional students.

BACKGROUND: Simulation-based learning is an approach recommended for teaching undergraduate health professionals. There is a scarcity of research around interprofessional simulation training for pre-professional students in obstetric emergencies that occur prior to arrival at the maternity ward. OBJECTIVES: The primary aims of the study were to examine whether an interprofessional team-based simulated birth scenario would improve undergraduate paramedic, nursing, and midwifery students' self-efficacy scores and clinical knowledge when managing birth in an unplanned location. The secondary aim was to assess students' satisfaction with the newly developed interprofessional simulation. DESIGN: Quasi-experimental descriptive study with repeated measures. SETTING: Simulated hospital emergency department. PARTICIPANTS: Final year undergraduate paramedic, nursing, and midwifery students. METHODS: Interprofessional teams of five students managed a simulated unplanned vaginal birth, followed by debriefing. Students completed a satisfaction with simulation survey. Serial surveys of clinical knowledge and self-efficacy were conducted at three time points. RESULTS: Twenty-four students participated in one of five simulation scenarios. Overall, students' self-efficacy and confidence in ability to achieve a successful birth outcome was significantly improved at one month (p<0.001) with a magnitude of increase (effect) of 40% (r=0.71) and remained so after a further three months. Clinical knowledge was significantly increased in only one of three student groups: nursing (p=0.04; r=0.311). Students' satisfaction with the simulation experience was high (M=4.65/5). CONCLUSIONS: Results from this study indicate that an interprofessional simulation of a birth in an unplanned setting can improve undergraduate paramedic, nursing and midwifery students' confidence working in an interprofessional team. There was a significant improvement in clinical knowledge of the nursing students (who had least content about managing birth in their program). All students were highly satisfied with the interprofessional simulation experience simulation.

Paramedic and midwifery student exposure to workplace violence during clinical placements in Australia - A pilot study.

OBJECTIVES:   The objective of this pilot study was to identify the type of workplace violence experienced by undergraduate paramedic and midwifery students. METHODS: The study used a cross-sectional methodology with the self-administered paper-based Paramedic Workplace Violence Exposure Questionnaire to elicit undergraduate paramedic and midwife responses to workplace violence whilst on clinical placements. There were 393 students eligible for inclusion in the study. A convenience sample was used. The anonymous questionnaire took 10 to 20 minutes to complete. Descriptive statistics are used to summarise the data with a two-tailed t-test used to compare groups. RESULTS: The main form of workplace violence was verbal abuse 18% and intimidation 17%.  There was a statistically significant difference between midwifery and paramedic students for intimidation (t(134)=-3.143, CI: -0.367 to -0.082, p=0.002) and between females and males for sexual harassment (t(134)=2.029, CI: 0.001 to 0.074, p=0.045), all other results were not statistically different. CONCLUSIONS: This pilot study is the first of its kind in Australia and internationally to identify exposure rates of workplace violence by undergraduate paramedic students during clinical placements and one of very few to identify midwifery students' exposure rates of workplace violence. The study identified that students were exposed to a range of workplace violence acts from verbal abuse through to sexual harassment. These findings highlight a need for investigation of workplace violence exposure of medical, nursing and allied health students during the clinical phase of their studies.

Advancing medical education: connecting interprofessional collaboration and education opportunities with integrative medicine initiatives to build shared learning.

BackgroundImproved teamwork between conventional and complementary medicine (CM) practitioners is indicated to achieve effective healthcare. However, little is known about interprofessional collaboration and education in the context of integrative medicine (IM). MethodsThis paper reports the findings from a constructivist-grounded theory method study that explored and highlighted Australian medical students' experiences and opportunities for linking interprofessional collaboration and learning in the context of IM. Following ethical approval, in-depth semi-structured interviews were conducted with 30 medical students from 10 medical education faculties across Australian universities. Results Medical students recognised the importance of interprofessional teamwork between general medical practitioners and CM professionals in patient care and described perspectives of shared responsibilities, profession-specific responsibilities, and collaborative approaches within IM. While students identified that limited interprofessional collaboration currently occurred in the medical curriculum, interprofessional education was considered a means of increasing communication and collaboration between healthcare professionals, helping coordinate effective patient care, and understanding each healthcare team members' professional role and value. Conclusions The findings suggest that medical curricula should include opportunities for medical students to develop required skills, behaviours, and attitudes for interprofessional collaboration and interprofessional education within the context of IM. While this is a qualitative study that reflects theoretical saturation from a selected cohort of medical students, the results also point to the importance of including CM professionals within interprofessional collaboration, thus contributing to more person-centred care.

Paramedics׳ involvement in planned home birth: A one-year case study.

OBJECTIVE: to report findings from a study performed prior to the introduction of publicly funded home birth programmes in Victoria, Australia, that investigated the incidence of planned home births attended by paramedics and explored the clinical support they provided as well as the implications for education and practice. METHODS: retrospective data previously collected via an in-field electronic patient care record (VACIS(®)) was provided by a state-wide ambulance service. Cases were identified via a comprehensive filter, manually screened and analysed using SPSS version 19. RESULTS: over a 12-month period paramedics attended 26 intended home births. Eight women were transported in labour, most for failure to progress. Three called the ambulance service and their pre-organised midwife simultaneously. Paramedics were required for a range of complications including post partum haemorrhage, perineal tears and neonatal resuscitation. Procedures performed for mothers included IV therapy and administering pain relief. For infants, paramedics performed intermittent positive pressure ventilation, endotracheal intubation and external cardiac compression. Of the 23 women transferred to hospital, 22 were transported to hospital within 32minutes. CONCLUSIONS: findings highlight that paramedics can provide clinical support, as well as efficient transportation, during perinatal emergencies at planned home births. Cooperative collaboration between ambulance services, privately practising midwives and maternity services to develop guidelines for emergency clinical support and transportation service may minimise risk associated with planned home births. This could also lead to opportunities for interprofessional education between midwives and paramedics.

Resourcing the clinical complementary medicine information needs of Australian medical students: Results of a grounded theory study.

The aim of this study was to identify Australian medical students' complementary medicine information needs. Thirty medical students from 10 medical education faculties across Australian universities were recruited. Data were generated using in-depth semi-structured interviews and constructivist grounded theory method was used to analyze and construct data. Students sought complementary medicine information from a range of inadequate sources, such as pharmacological texts, Internet searches, peer-reviewed medical journals, and drug databases. The students identified that many complementary medicine resources may not be regarded as objective, reliable, differentiated, or comprehensive, leaving much that medical education needs to address. Most students sought succinct, easily accessible, evidence-based information to inform safe and appropriate clinical decisions about complementary medicines. A number of preferred resources were identified that can be recommended and actively promoted to medical students. Therefore, specific, evidence-based complementary medicine databases and secondary resources should be subscribed and recommended to medical schools and students, to assist meeting professional responsibilities regarding complementary medicines. These findings may help inform the development of appropriate medical information resources regarding complementary medicines.

Midwifery student exposure to workplace violence in clinical settings: An exploratory study.

Evidence indicates that nurses regularly experience bullying within the workplace which has the potential for health and social effects, as well as worker attrition. Literature suggests that nursing students are exposed to workplace violence during clinical placements including from health professionals and mentors, however little is known about midwifery students. This study sought to examine undergraduate midwifery students' experiences of workplace violence during clinical placements. A cross-sectional approach using a paper-based survey, the Paramedic Workplace Questionnaire, was used to solicit the information. Students were exposed to workplace violence with the main act being intimidation (30%), verbal abuse (17%), physical abuse (3%), and sexual harassment (3%). In more than three-quarters of the incidents the students had some level of apprehension or were frightened as a result of the violence. Students responded to the acts of violence with changes to emotions, self-confidence, and a desire to "give up". This paper demonstrates ways in which midwifery students are vulnerable to potential workplace violence from various sources. Support mechanisms need to be developed to ensure this can be minimised.