COVID-19 and beyond: A systematic review of adaptations to psychosocial support in oncology.

AIMS: To understand the strategies used to continue providing psychosocial support to cancer patients during the pandemic, including outcomes and implications beyond the pandemic. DESIGN: A systematic review of original research. DATA SOURCES: ProQuest Health & Medicine, CINAHL Complete (via EBSCOhost), Scopus, and PubMed were searched for original work published between January 2020 and December 2022. METHODS: Abstract and title screening identified eligible articles for full-text review. Following a full-text review, data were extracted from eligible articles, and a risk of bias assessment was conducted. A synthesis without meta-analysis was performed. RESULTS: Thirty-four articles met the selection criteria. These articles provide evidence that systematic adaptations during the pandemic improved the assessment and screening of psychological needs and/or increased the number of clients accessing services. Additionally, while the pandemic was associated with decreased psychosocial well-being for cancer patients, five intervention studies reported improvements in psychosocial well-being. Barriers, strategies, and recommendations were described. CONCLUSION: Adapting psychosocial support during a pandemic can be successful, achieved relatively quickly, and can increase the uptake of support for people experiencing cancer. IMPLICATIONS FOR PATIENT CARE: It is imperative that these adaptations continue beyond the pandemic to maximize adaptive psychosocial outcomes for a group vulnerable to ongoing mental health concerns. IMPACT: While the COVID-19 pandemic was associated with increased psychosocial need for cancer patients, evidence in the review suggested that adaptations made to service delivery facilitated increased access for patients who may not previously have been able to access support. Additionally, improvements in psychosocial well-being were achieved. These findings are relevant for clinicians and decision-makers who fund and design psychosocial support services for cancer patients. REPORTING METHOD: The review was guided by PRISMA Guidelines and the SWiM Reporting Guideline. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Nursing/midwifery students' perceptions of caring pedagogy and online learning during the COVID-19 pandemic.

AIM: This study aimed to gain a better understanding of nursing/midwifery students' perspectives on a pedagogy of caring and online learning during the COVID-19 pandemic. In addition, it aimed to determine if the COVID-19 pandemic impacted students' perceptions and experience of online learning and students' desire to enter the nursing/midwifery workforce. DESIGN: Mixed methods. METHODS: A multi-centre cross-sectional survey of Australian nursing and midwifery students was undertaken to explore students' experience of learning during the COVID-19 pandemic. RESULTS: There are several key findings from this study that may be relevant for the future delivery of undergraduate health education, students transitioning to practice and healthcare workforce retention. The study found that although students were somewhat satisfied with online learning during COVID-19, students reported significant issues with knowledge/skill acquisition and barriers to the learning process. The students reported feeling less prepared for practice and identified how clinical staff were unable to provide additional guidance and support due to increased workloads and stress. The textual responses of participants highlighted that connection/disconnection, empathy and engagement/disengagement had an impact on learning during COVID-19. CONCLUSION: Connection, engagement and isolation were key factors that impacted nursing students' online learning experiences. In addition, graduates entering the workforce felt less prepared for entry into practice due to changes in education delivery during COVID-19 that they perceived impacted their level of clinical skills, confidence and ability to practice as new graduate nurses/midwives. PATIENT OR PUBLIC CONTRIBUTION: Not applicable. IMPACT: Attention must be given to the transition of new graduate nurses and midwives whose education was impacted by pandemic restrictions, to support their professional career development and to ensure retention of future healthcare workforce. Connection, engagement and isolation were key factors that impacted nursing students' online learning experiences. Educators should consider how connection and engagement can be actively embedded in the online learning environment.

Distress and psychosocial support seeking: A comparison of rural and metropolitan oncology patient experiences.

INTRODUCTION: Prevalence of distress in cancer patients is established at approximately 50%, yet uptake of psychosocial support is minimal. OBJECTIVE: This study aimed to understand why clinically distressed oncology patients choose not to access psychosocial support, including whether this differs by geographic location. It also aimed to determine the proportion of rural and metropolitan patients experiencing clinical levels of distress, and of these, the proportion who do not wish to access support. DESIGN: The study used a cross-sectional design. Two hundred and ninety-eight Australian cancer patients completed an online survey, including the Distress Thermometer and open-ended questions about reasons for declining support. Descriptive statistics and content analysis were used to analyse the data. FINDINGS: More than half (56%) of participants reported experiencing clinically significant levels of distress. Of these, almost half (47%) declined psychosocial support. Content analysis of reasons for declining psychosocial support resulted in six main concepts: I don't need support; I'm using personal resources to cope; negative perceptions and attitudes; life doesn't stop for cancer; I'm focussed on fighting cancer; and systemic barriers. Rural cancer patients most often indicated using personal resources to cope, while metropolitan participants most commonly indicated not needing support. A range of subconcepts were also identified. Perceiving distress as manageable or transient was almost exclusively reported by metropolitan participants, while stigma was almost exclusively reported by rural participants. DISCUSSION: The findings provided greater depth of insight into reasons cancer patients decline psychosocial support and identified several qualitative differences in the reasons provided by metropolitan and rural patients. Recommendations are provided for clinicians, in particular for clinicians who work with rural cancer patients and their supporters. CONCLUSION: These findings can inform equitable resourcing of psychosocial support in rural areas and the adaptation of psychosocial interventions to be more flexible and responsive to individual needs. This may help increase patient uptake of support, particularly in rural areas.

De-problematising Aboriginal young peoples' health and well-being through their voice: An Indigenous scoping review.

BACKGROUND: The continued use of a deficit discourse when researching Aboriginal and Torres Strait Islander Peoples of Australia is problematic. Understanding and challenging the researchers position and the power of the words they use is important. It will ensure we do not persist in framing Aboriginal and Torres Strait Islander People as a problem to be solved. DESIGN: Indigenist review of the evidence of Aboriginal young people's health and well-being. METHODS: This review was conducted using an Indigenist approach to identify texts which amplified the voices of Aboriginal young people of Australia and presents a narrative summary of their accounts. This review is reported in line with the PRISMA-ScR reporting guidelines. RESULTS: Culture and connection are critical components of Aboriginal young people's health and well-being. Aboriginal young people describe feeling of powerlessness to influence health and well-being of their community, and they understood the risks they and their communities faced. Young people identified the importance of connection to culture, community and Elders as crucial to their social and emotional well-being. CONCLUSION: By harnessing an Indigenous analysis, we were able to reveal a strong counter narrative of strength and resilience within their historical, social, and political contexts through the storied accounts of Aboriginal young people. RELEVANCE TO CLINICAL PRACTICE: Most of the currently available evidence about Aboriginal health and well-being is immersed in deficit discourse. Literature reviews being the foundation of research and informing nursing practice, we call for a purposeful shift towards the adoption of an Indigenist strength-based approach which emphasises the strength and resilience of Aboriginal young people.

Compassionate practice in a hospital setting. Experiences of patients and health professionals: A narrative inquiry.

AIM: To explore how compassion is received by patients in a hospital setting and how compassion is expressed by health professionals in a hospital setting. BACKGROUND: Compassion is important to health professionals and patients. Perceived deficits in compassion in healthcare have led increasing concerns about the quality of care for patients. To better understand compassionate practice in a hospital setting we used narrative inquiry to explore the expression of compassion by health professionals and the experience of receiving compassion by patients. DESIGN: Narrative Inquiry. Reported in line with Consolidated Criteria for Reporting Qualitative Research (COREQ). METHODS: Qualitative interviews were conducted with 24 patients and health professionals in Australia. Data were collected between August 2018 and August 2019. Narrative analysis processes were used to develop a thematic framework. RESULTS: Compassionate practice is presented as an overarching theme and comprises of three themes: (1) Amalgamation of various knowledges and skills (2) Delivery of meaningful actions which alleviate suffering and (3) Meeting individual needs and prevention of further preventable suffering. The expression of compassion by health professionals involved the fusion of many skills and knowledges. Patients received compassion through the actions of the health professional which alleviated their suffering. CONCLUSION: Compassionate practice is both important, and complex. Presence, skilled and purposeful action and the alleviation of suffering are essential to the expression and receipt of compassion in the hospital setting. IMPACT: Findings from this study contribute to the growing body of literature on compassionate practice in health settings, specifically in how it is expressed and received in a hospital setting. The complexity of compassion is explained for health professionals. Compassion was shown to be embedded in the caring moments between health professionals and patients. This paper explains the different elements that comprise compassion which can guide health professional practice. The importance of seemingly small acts has a big impact on patients, families and health professionals. There is a need for greater stakeholder value and recognition of this aspect of practice.

Mixed Methods Study Integration: Nursing student experiences and opinions of intentional rounding.

AIMS: To explore pre-registration nursing students' understandings and experience of intentional rounding in education and clinical sectors. Intentional rounding is a patient safety intervention used in clinical settings to regularly check and document patients' welfare and environment throughout the course of a shift. DESIGN: An explanatory sequential mixed methods design using convenience sampling was used for this study, with an underlying pragmatic paradigm. Integration occurred in the design, methods, implementation and reporting phases of the study. METHODS: Data were collected between August 2017 and August 2018 using a previously validated Nursing Perceptions of Patient Rounding quantitative online survey followed by individual qualitative interviews using the same cohort. RESULTS: Using the Pillar Integration Process, this paper displays and discusses the final results. The integration and mixing throughout the study generated insights into the perceived benefits of intentional rounding for nursing students and patients but also indicated a theory-practice gap that affects nursing students' confidence in undertaking this intervention. CONCLUSION: Students find this patient safety intervention helpful, but further clarity in the education surrounding it is required. IMPACT: This study addresses pre-registration nursing students' understanding and perceptions of intentional rounding. Intentional rounding benefits nursing students as a patient safety strategy and organization tool. Educational opportunities around the topic could be enhanced, reducing the ongoing theory-practice gap. Clinicians, academics and educators who support pre-registration nursing students in clinical and tertiary education settings can benefit from this work.

Understanding maternal resilience; Lesson learnt from rural mothers caring for a child with a chronic health condition.

AIM: This study aimed to understand the lived experience of rural mothers caring for a child with a chronic health condition and to understand their perspectives on the support, services and resources they identify as necessary to effectively manage caregiving. BACKGROUND: Maternal caregivers in rural areas experience difficulty accessing specialist health care for their child and can also experience geographical and social isolation. Understanding the factors that enable these maternal caregivers to overcome the challenges and adversities faced is crucial to help nurses identify and facilitate avenues for support and resources. DESIGN: This study employed a phenomenological design. The study is reported in line with Consolidated criteria for reporting qualitative research guidelines (COREQ). METHODS: Semi-structured interviews were conducted with 17 maternal caregivers in rural New South Wales, Australia, who had at least one child with a chronic health condition aged between 2-18 years. Data were collected from March to June 2018. Thematic analysis was used to develop a thematic framework. This paper reports on one of the major themes identified in this research, specifically maternal resilience. RESULTS: Participants demonstrated maternal resilience by creating meaningful social connections, cultivating networks, developing problem-solving skills, enhancing their self-efficacy and finding a sense of purpose through hope and optimism. These strategies provide nurses insight into how some rural women overcome adversities associated with their maternal labour required in caring for a child with a chronic health condition. CONCLUSION: This study found that participants overcame the challenges related to their caregiving work, emerging as resilient caregivers. Understanding maternal resilience assists nurses to provide the services rural mothers in Australia need to care for their child with a CHC. RELEVANCE TO CLINICAL PRACTICE: Findings from this study provide insight into the experiences of rural maternal caregivers of children with a chronic health condition and identify the strategies they adopt to overcome caregiver challenges. Understanding these strategies allows nurses to improve care and support for rural mothers using a strength-based approach to build maternal resilience.

"Complexity, safety and challenges: Emergency responders' experience of people affected by methamphetamines".

Providing care to methamphetamine-related callout events in the prehospital environment is often complex and resource-intensive, requiring staff to manage agitation and violence-related side effects of methamphetamines. In Australia, emergency responders are increasingly required to attend events related to methamphetamines, even though reports suggest methamphetamine use across Australia has declined. The aim of the study was to explore Australian police and paramedic experiences attending methamphetamine-related events. A qualitative descriptive phenomenology design was employed using semi-structured interviews with employed police (10) and paramedics (8) from Australia. Data were analyzed using thematic analysis. Participants described the complexities associated with providing prehospital care to people affected by methamphetamines. Participants described associated domestic/family violence, increased levels of violence, challenges with communication, and responder emotional and psychological distress and physical injury. Violence associated with methamphetamine use is a critical factor in prehospital care. Workplace violence and family/domestic violence are important issues that require further research to ensure families and staff are well supported and have the services they need to continue responding to people affected by methamphetamine use.

Models and frameworks of mental health recovery: a scoping review of the available literature.

BACKGROUND: The recovery approach involves providing a holistic and integrated service that is centered on and adapts to the aspirations and needs of consumers, who are seen as the expert on their health and well-being. Evidence is needed to address the current ambiguities related to the concept of recovery and its application. AIM: A scoping review was conducted to identify papers describing theories, models, and frameworks of recovery to delineate the central domains of recovery. METHODS: Three literature search strategies were used: electronic database searching; hand-searching of key journals; and a reference list review of included papers. Inclusion criteria outlined theories, models and frameworks developed to support consumers' recovery and those supporting mental health professionals (MHPs) to deliver recovery-oriented services. RESULTS: Twelve studies (eleven articles and one book) were included in the review. The dimensions of recovery were synthesized into a framework named the Consolidated Framework for Recovery-oriented Services (CFRS). There are three domains within the framework: mechanisms/strategies; recovery as an internal process; and recovery as an external process. Each of these domains, as well as their relationships, are discussed. CONCLUSIONS: The CFRS can be used by practitioners, researchers, funders, and collaborative members to conceptualize, implement, and evaluate recovery-oriented services.

The impact of COVID-19 on Bangladeshi readymade garment (RMG) workers.

This paper describes the potential impact of the coronavirus disease 2019 (COVID-19) pandemic on the readymade garment (RMG) workers of Bangladesh. It articulates the RMG workers' existing vulnerability during the COVID-19 pandemic based on currently available evidence and personal conversations/communications with RMG workers. COVID-19 has already impacted RMG workers' health (both physical and mental health status) and wellbeing, and resulted in loss of employment. We argue that the COVID-19 pandemic will have long-lasting effects on the garment workers, especially related to their health issues, financial hardship and inability to pay for essentials such as food, and future employment opportunities. The stakeholders (such as the international retailers/brands, Bangladesh Garment Manufacturers and Exporters Association, Government of Bangladesh) responsible for the global supply chain RMG factories should reconsider the health and overall wellbeing needs of the RMG workers during the ongoing COVID-19 pandemic.

Public Sentiment and Discourse on Domestic Violence During the COVID-19 Pandemic in Australia: Analysis of Social Media Posts.

BACKGROUND: Measuring public response during COVID-19 is an important way of ensuring the suitability and effectiveness of epidemic response efforts. An analysis of social media provides an approximation of public sentiment during an emergency like the current pandemic. The measures introduced across the globe to help curtail the spread of the coronavirus have led to the development of a situation labeled as a "perfect storm," triggering a wave of domestic violence. As people use social media to communicate their experiences, analyzing public discourse and sentiment on social platforms offers a way to understand concerns and issues related to domestic violence during the COVID-19 pandemic. OBJECTIVE: This study was based on an analysis of public discourse and sentiment related to domestic violence during the stay-at-home periods of the COVID-19 pandemic in Australia in 2020. It aimed to understand the more personal self-reported experiences, emotions, and reactions toward domestic violence that were not always classified or collected by official public bodies during the pandemic. METHODS: We searched social media and news posts in Australia using key terms related to domestic violence and COVID-19 during 2020 via digital analytics tools to determine sentiments related to domestic violence during this period. RESULTS: The study showed that the use of sentiment and discourse analysis to assess social media data is useful in measuring the public expression of feelings and sharing of resources in relation to the otherwise personal experience of domestic violence. There were a total of 63,800 posts across social media and news media. Within these posts, our analysis found that domestic violence was mentioned an average of 179 times a day. There were 30,100 tweets, 31,700 news reports, 1500 blog posts, 548 forum posts, and 7 comments (posted on news and blog websites). Negative or neutral sentiment centered on the sharp rise in domestic violence during different lockdown periods of the 2020 pandemic, and neutral and positive sentiments centered on praise for efforts that raised awareness of domestic violence as well as the positive actions of domestic violence charities and support groups in their campaigns. There were calls for a positive and proactive handling (rather than a mishandling) of the pandemic, and results indicated a high level of public discontent related to the rising rates of domestic violence and the lack of services during the pandemic. CONCLUSIONS: This study provided a timely understanding of public sentiment related to domestic violence during the COVID-19 lockdown periods in Australia using social media analysis. Social media represents an important avenue for the dissemination of information; posts can be widely dispersed and easily accessed by a range of different communities who are often difficult to reach. An improved understanding of these issues is important for future policy direction. Heightened awareness of this could help agencies tailor and target messaging to maximize impact.

The expression and receipt of compassion through touch in a health setting; a qualitative study.

AIM: To investigate and understand how compassion is expressed by nurses and received by patients in a hospital setting. BACKGROUND: Concerns regarding the absence of compassion in a healthcare setting has necessitated further research in the field. To define and measure compassion is difficult and problematic. Compassion is subjective and in the contemporary literature the views of patients are under-represented. Touch is an important component of nursing practice and can also be considered problematic. DESIGN: Secondary analysis of narrative interviews. METHODS: Secondary analysis of 12 participant interviews with nurses (n-4) and patients (n-8). Data were collected between August 2018 and August 2019. FINDINGS: Compassion was expressed and received through touch for nurses and patients. Patients receive compassion through the touch of the nurse and this touch conveyed comfort and safety. Touch allowed for the establishment of an authentic connection between nurse and patient. Nurses used touch to express compassion and patients received compassion when they were comforted with touch. Compassion was present in incidental touch and deliberate comforting touch. Nurses were respectful of the meanings of touch. Patients describe nurses knowing when to touch and using touch appropriately. CONCLUSIONS: Nurses in our study were respectful of the meaning of touch for their patients and described using touch to convey compassion. Patients in our study perceived compassion through the touch by the nurse. Through these narratives, touch is revealed as an essential part of compassionate practice conveying safety, authenticity and connection. IMPACT: Patients in this study describe receiving compassion through the use of touch which made them feel safe. Nurses in this study used touch to create an authentic connection with patients and were aware of the different meanings of touch. Avoiding touch, being wary of touch, or considering touch taboo robs patients of compassion moments.

Learning to be a doctoral supervisor: Experiences and views of nurse supervisors of higher degree research students.

AIMS AND OBJECTIVES: Given the importance of doctoral training to the future of the discipline, we sought to gain insight into nurse doctoral supervisor's experiences of supervision training and preparation and their views on what quality training for doctoral supervisors in nursing would look like. BACKGROUND: Doctorally prepared nurses have been found to contribute significantly to improvements in knowledge to inform patient care; yet there is little focus on the development of this aspect of the nursing workforce, and little evaluation of supervisor training, confidence and competence. DESIGN: Qualitative storytelling, semi-structured interviews were conducted via a videoconferencing programme, audio-recorded and thematically analysed with twenty-one experienced nurse doctoral supervisors. Findings are reported in line with the COREQ guidelines. RESULTS: Thematic analysis revealed four themes: 'I had a great mentor': the importance of mentorship and role modelling; 'Sometimes it's just trial and error': learning through experience; 'It's like tick a box': strengths and limitations of formal supervisor training; and 'The training should be more holistic': what should be in supervisor training. CONCLUSIONS: We recommend doctoral supervisors be encouraged to seek mentoring for supervision, formal mentoring and clinical supervision for the first five completions and the formation of discipline-based supervisor learning groups in nursing as an adjunct to generic mandatory supervisor training. RELEVANCE TO CLINICAL PRACTICE: Further development of clinical nursing is inextricably linked to quality nurse-led research, and doctorally prepared nurses are essential to the continued development of nursing as an evidence-informed practice discipline. Quality doctoral supervision for and by nurses is crucial and we argue that focus must be given to ensuring the development of a skilled doctoral supervision workforce in nursing.

Preparedness for viral respiratory infection pandemic in residential aged care facilities: A review of the literature to inform post-COVID-19 response.

AIMS AND OBJECTIVES: To examine what was known about disaster preparedness in residential care and to consider this in the light of the current COVID-19 pandemic. BACKGROUND: Care homes provide long-term care to vulnerable, frail older people, as well as to young people with profound disabilities. The COVID-19 pandemic has shown that the residential care sector has been seriously affected in many parts of the world and has exposed major flaws and vulnerabilities in infection control and other processes that have resulted in considerable loss of life of residents of these facilities. DESIGN: Discursive paper informed by a systematic literature. Review was carried out in line with PRISMA reporting guidelines. The review protocol was registered with PROSPERO on 2020 [CRD42020211847]. RESULTS: The review identified six papers meeting inclusion criteria across care residential facilities in different countries. Several prevention and mitigation strategies were identified to manage and reduce the spread and severity of viral respiratory infection pandemics. These strategies include isolation, restriction of movement, personal protective and hygienic measures, health education and information sharing, monitoring and coordination, and screening and treatment. Preparedness strategies identified were contingency planning such as reporting/communication, leadership, human resource, insurance, occupational health and resource availability. The prevention/mitigation and preparedness strategies helped to achieve decline in disease severity, reduced prevalence, reduced spread of the disease, improved readiness criteria, resource usefulness and increased intervention acceptability. This paper presents a conceptual framework exploring the interconnectedness of preparedness and prevention/ mitigation strategies and associated outcomes. We discuss areas of concern in the context of workforce employment patterns in the sector. Concerns related to the unintended consequences of strategies placed on aged care facilities, which may worsen mental health outcomes for residents, are discussed. CONCLUSIONS: Persons in residential care settings are at greater risk of infection during a pandemic, and therefore, strict measures to protect their safety are warranted. However, they are also a group who already experience social isolation and so any measures involving restrictions to visiting and social interaction, particularly over the longer term, must be accompanied by strategies to mitigate potential loneliness and mental health sequelae arising from long-term pandemic restrictions. RELEVANCE TO CLINICAL PRACTICE: Though there was evidence of activity in preparedness for disasters within the residential care sector, various contextual factors affecting the sector were clearly not adequately considered or addressed in pre-pandemic disaster planning, particularly in the areas of staff movements between care homes and the length of time that social isolation and restriction measures would need to be in place. Future pandemic planning should consider the nature of the workforce model in the care home sector, and factor in strategies to better support the mobile and highly casualised workforce.

Living with diabetes and disadvantage: A qualitative, geographical case study.

AIMS AND OBJECTIVES: To elucidate the experiences of people living with diabetes, residing in an urban diabetogenic area. BACKGROUND: Community-level social and environmental factors have a role to play in the development of type 2 diabetes mellitus. Socio-economic deprivation; high obesity rates; high access to fast foods; and multiculturalism contribute to higher rates of diabetes in some geographical areas. However, there is a lack of research examining people's experiences of living with diabetes in diabetogenic areas. The word diabetogenic implies that the phenomenon of interest contributes to the development of diabetes. DESIGN: Qualitative, geographical case study approach. METHODS: A convenience sample of 17 people living with diabetes in a diabetogenic, low-socio-economic urban area participated in face-to-face, semi-structured interviews. Interviews were audio-recorded, transcribed and analysed thematically. This paper adheres to the COREQ guidelines. FINDINGS: Four main themes were identified: 1. Diabetes fatalism: Inevitability and inertia; 2. Living with Inequity: Literacy and intersectionality; 3. Impersonal services: Intimidating and overwhelming; and, 4. Education in the community: Access and anecdotes. CONCLUSIONS: This study has highlighted the need to develop local solutions for local problems. In this geographical area, solutions need to address generally lower health literacy, how the community would prefer to receive diabetes education and the issue of diabetes fatalism. RELEVANCE TO CLINICAL PRACTICE: Findings from this study have highlighted a need to re-examine how diabetes education is delivered in communities that are already experiencing multiple disadvantages. There are research and practice connotations for how fatalism is positioned for people at high risk of developing diabetes.

Health Professionals as Mothers of Adult Children With Schizophrenia.

In this qualitative narrative study, we critically reflected upon mothering experiences of health professionals with adult children with schizophrenia. Thirteen participants from Australia, Canada, Scotland, and the United States were interviewed. The thematic analysis of the interviews resulted in one overarching theme-mothering in the context of uncertainty: unbalancing and rebalancing as mothers, and three major themes: disrupted mothering, reconfigured mothering, and resolute mothering. The findings suggested participants experienced difficulties in separating their professional role from their maternal responsibilities. The mothers gained expertise by using their dual knowledge to advocate for and support their children's mental health. The mothers' dual roles had a positive impact on their relatedness to others within their professional practice. Health care organizations might benefit from the expertise of health professionals with dual roles in the development of support, care, treatment, and delivery of services for people and their family members who live with schizophrenia.

Post-traumatic growth: Health professionals as mothers of adult children with schizophrenia.

Worldwide, mothers provide lifelong care for their ill children. Our aim in this paper was to describe the development of post-traumatic growth in an international group of mothers. Interviews with a feminist storytelling approach were conducted with 13 health professionals who were mothers of adult children with schizophrenia. Using thematic analysis, we found they had experienced a complex traumatic process complicated by gender and health care's dominant ruling relations. Over time, the women grew and became experts by experience due to their combined mothering and professional knowledges. Health professionals can play a central role and support their peers to care for family members with mental illnesses.

Personal characteristics, coping strategies, and resilience impact on compassion fatigue in critical care nurses: A cross-sectional study.

Compassion fatigue is known to impact the well-being of nurses and patient safety outcomes. Currently, there is limited academic understanding of the role of demographic factors in contributing to compassion fatigue in critical care nurses. The aim of this study was to examine the relationship between nurse demographic characteristics and the development of compassion fatigue, as indicated by level of burnout and compassion satisfaction in critical care nurses in Saudi Arabia. The cross-sectional study design included administering three surveys to critical care nurses (n = 321) in four Saudi public hospitals to examine the nurse demographic variables in relation to compassion fatigue, the compassion fatigue coping strategies of nurses, and nurse resilience. The results show both demographic and workplace structural elements, such as length of work shift, education level, and nationality, were all significant factors in resilience to compassion fatigue among Saudi critical care nurses, whereas factors of age and sex were not significant. This study concludes that the demographic characteristics of critical care nurses enable the identification of levels of compassion fatigue and compassion satisfaction, and their resilience to the effects of compassion fatigue.

Modes of Informed Caring: Perspectives of Health Professionals Who Are Mothers of Adult Children with Schizophrenia.

Schizophrenia is a global concern, and, this paper, describes the caring roles of health professionals who are mothers of adult children with schizophrenia. A thematic analysis of data from a doctoral study identified a blending of expertise into an informed care model. Caring roles included: constant carer; coordinator carer; watchful bystander carer; and life coach carer. Previous research has not explored these dual roles. This paper elucidates their responsive approaches and contributions to mothering and caregiving roles. Informed by a fusion of professional and mothering knowledges, their insights into mental health care have been forged by their experiences and is an untapped resource.

Compassion fatigue in critical care nurses and its impact on nurse-sensitive indicators in Saudi Arabian hospitals.

AIM: To examine the previously untested relationship between the level of compassion fatigue (CF) in critical care nurses and the rates of three nurse-sensitive indicators in four critical care units in hospitals in Saudi Arabia. BACKGROUND: CF can manifest in nurses who provide direct, intimate care to patients with different levels of illness including nurses working in specialty areas such as critical care where they care for patients experiencing challenging illnesses. Pressure injuries, patient falls, and medication errors are key nurse-sensitive indicators that identify critical care nurses as the primary causal agent. These indicators also correlate with burnout and poor multidisciplinary team communication, both factors that govern CF. METHODS: A multisite survey was conducted to collate and examine the number of reported pressure injuries, falls, and medication errors over 3 months at four hospitals in two Saudi Arabian cities during 2018 to determine the relationship between the occurrence of these nurse-sensitive indicators and the level of CF in critical care (intensive care unit [ICU]) nurses. A survey of 516 critical care nurses was undertaken; analysis was performed using the Professional Quality of Life Scale, version 5 (ProQol-5), and results were further analysed using Pearson's correlations and three-way analysis of variance. RESULTS: The results of the regression analysis indicated resilience as a predictor explained 66% of the compassion satisfaction (CS) variance (B = 0.318, R2 = 0.436, F(2, 12.495) = 123.013, p < 0.001) and 26% of the burnout (BO) variance (B = 0.152, R2 = 0.067, F(2, 11.500) = 3.279, p < 0.001). In addition, the level of resilience as a predictor explained 15.4% of the secondary traumatic stress (STS) variance (B = 0.063, R2 = 0.024, F(2, 7.758) = 2.785, p = 0.006). Conversely, coping strategies did not predict CS, BO, or STS (p > 0.05) at a statistically significant level. The concurrent measure of CF, BO, and STS found that almost 20% of the critical care nurse participants reported having very low CS, indicating increased potential for the development of CF. In addition, male nurses reported experiencing higher levels of stress and BO than female nurses. This study also found that neither the number of patients being treated nor the number of beds in the care setting affected the rate of the nominated nurse-sensitive indicators. The results for rates of pressure injuries did vary among the hospitals, with the worst performing hospital reporting pressure injury rates of one in every 40 patients and the better performing hospital reporting no cases of pressure injuries after treating more than 100 patients. Patient falls and medication errors were rare occurrences and did not vary between hospitals. SIGNIFICANCE: This study indicates that there is a possible issue contributing to the differential level of care between hospitals. The mode and length of time nurses spend on handover may also reflect communication issues that increase both the rate of nurse-sensitive indicators and the level of CF reported by nurses. Therefore, the implications of this study, in terms of improving nursing practice, occurs in handover to ensure that information on aspects of nonpatient critical care are fully covered, such as time of patient turning to avoid pressure injuries.