Nurses' adoption of diabetes clinical practice guidelines in primary care and the impacts on patient outcomes and safety: An integrative review.

BACKGROUND: Complications related to diabetes mellitus impose substantial health and economic burdens to individuals and society. While clinical practice guidelines improve diabetes management in primary care settings, the variability in adherence to these guidelines persist. Hence, there is a need to comprehensively review existing evidence regarding factors influencing nurses' adherence to implementation of clinical practice guidelines to improve clinical care and patient safety. OBJECTIVE: This integrative review seeks to investigate nurses' adherence to clinical guidelines for diabetes management in primary healthcare settings and to explore factors influencing effective implementation, focusing on the role of nurses and impacts on patient outcomes. METHODS: A comprehensive search was conducted in March 2023 across six electronic databases. The search targeted studies that examined the use of Type 2 diabetes mellitus guidelines by nurses in primary healthcare settings with a focus on clinical management outcomes related to diabetes care or patient safety. Included studies were classified using the Effective Practice and Organisation of Care taxonomy, synthesised narratively and presented thematically. Reporting of the review adhered to PRISMA guidelines. (PROSPERO ID CRD42023394311). RESULTS: The review included ten studies conducted between 2000 and 2020, and the results were categorised into three themes. These were: (i) Implementation strategies to promote clinical practice guidelines adherence, including health professional development, reminders for clinicians, patient-mediated interventions, health information systems, role expansion, and comprehensive package-of-care. A multifaceted educational approach emerged as the most effective strategy. (ii) Impact of guidelines adherence: These strategies consistently improved clinical management, lowering HbA1c levels, improving blood pressure and lipid profiles, and enhancing patient self-care engagement, along with increased nurses' adherence to diabetes clinical guidelines. (iii) The role of nurses in guideline implementation, enabling independent practice within multidisciplinary teams. Their roles encompassed patient education, collaborative practice with fellow healthcare professionals, program planning and execution, and comprehensive documentation review. Nurse-led interventions were effective in improving patient outcomes, underscoring the necessity of empowering nurses with greater autonomy in providing primary diabetes care. CONCLUSION: Implementing a diverse range of strategies, focusing on comprehensive education for healthcare providers, is paramount for enhancing guideline adherence in diabetes care, to improve clinical management towards optimal patient health outcomes. Tailoring these strategies to meet local needs adds relevance to the guidelines. Empowering nurses to take a leading role in primary care not only enhances patient safety but also promotes quality of care, resulting in improved overall outcomes. TWEETABLE ABSTRACT: In primary care, empowering nurses with diabetes guideline education and tailoring strategies to local needs enhance guideline adherence and improve patient outcomes.

Development and psychometric evaluation of an expanded urinary catheter self-management scale: A cross-sectional study.

AIM: To develop and test the psychometric properties of an expanded catheter self-management scale for patients with in-dwelling urinary catheters. DESIGN: A cross-sectional validation study. Despite the utility of the original 13-item catheter self-management scale, this instrument did not include bowel management, general hygiene and drainage bag care, which are fundamental skills in urinary catheter self-management to prevent common problems resulting in unnecessary hospital presentations. The expanded catheter self-management scale was developed with 10 additional items to comprehensively assess all five essential aspects of urinary catheter self-management. METHODS: A total of 101 adult community-dwelling patients living with indwelling urinary catheters were recruited from Western Sydney, Australia. Using exploratory factor analysis with Varimax rotation, the number of factors to be extracted from the expanded 23-item expanded catheter self-management scale was determined using a scree plot. The reliability of the overall scale and subscales was measured using Cronbach's alpha. Convergent validity was assessed using Spearman's correlations between clinical characteristics, overall scale and subscales. RESULTS: The 23-item expanded catheter self-management scale yielded a 5-factor solution, labelled as: (i) self-monitoring of catheter function, (ii) proactive, help-seeking behaviour function, (iii) bowel self-care function, (iv) hygiene-related catheter site function and (v) drainage bag care function. Cronbach's alpha of the expanded catheter self-management scale indicating all 23 items contributed to the overall alpha value. Convergent validity results showed a negative correlation between the overall expanded catheter self-management scale and catheter-related problems. CONCLUSION: The 5-factor structure provided a comprehensive assessment of key aspects of urinary catheter self-management essential to reduce the likelihood of catheter-related hospital presentations. IMPLICATIONS: The expanded catheter self-management scale can be used to assess and monitor effective patient-centred interventions for optimal self-management to prevent catheter-related problems and improve the quality of life of patients. IMPACT: Many patients start their journey of living with a urinary catheter unexpectedly and are not supported with quality information to care for their catheter. The findings of this study show the correlation between catheter self-management skills and catheter-related problems. The expanded catheter self-management scale (E-CSM) assists with analysing the self-management skills of patients living with a catheter and developing tailored interventions to prevent problems and improve their quality of life. In addition, this screening tool can be included in policies, guidelines, and care plans as a standard for improving catheter management and developing educational resources for patients. REPORTING METHOD: STROBE checklist was used to report all aspects of this study comprehensively and accurately. PATIENT OR PUBLIC CONTRIBUTION: Patients living with indwelling urinary catheter and their carers have participated in surveys, interviews and co-designing interventions. This paper reports the psychometric analysis of the expanded catheter self-management scale (E-CSM) used in the patient survey as part of the main study 'Improving Quality of Life of Patients Living with Indwelling Urinary Catheters: IQ-IDC Study' (Alex et al. in Collegian, 29:405-413, 2021). We greatly value our consumers' contributions and continue to communicate the progress of the study to them. Their contributions will be acknowledged in all publications and presentations. In addition, all participants will be provided the option of receiving the interventions and publications generated from this study.

Strategies for improving diversity, equity, and inclusion in cardiovascular research: a primer.

This paper aims to empower cardiovascular (CV) researchers by promoting diversity, equity, and inclusion (DE&I) principles throughout the research cycle. It defines DE&I and introduces practical strategies for implementation in recruitment, retention, and team dynamics within CV research. Evidence-based approaches supporting underrepresented populations' participation are outlined for each research phase. Emphasizing the significance of inclusive research environments, the paper offers guidance and resources. We invite CV researchers to actively embrace DE&I principles, enhancing research relevance and addressing longstanding CV health disparities.

Undergraduate nursing students challenge misconceptions towards men in nursing: A mixed-method study.

AIMS: To examine misconceptions towards men in nursing from the perspective of undergraduate nursing students. Specifically, this study sought to explore contributing factors of misconceptions and attributions of the success of men in nursing. DESIGN: A convergent parallel mixed-method study. METHODS: A national survey was conducted (July-September 2021). The quantitative data included demographics and responses to the Gender Misconceptions of Men in Nursing (GEMINI) scale. The qualitative data included responses to a provocative statement related to characteristics of men and their career in nursing. The GRAMMS guideline was used in reporting. RESULTS: Undergraduate nursing students (n = 1245) from 16 Australian schools of nursing responded to the survey. Quantitative analysis demonstrated that most students (96%) did not have misconceptions about men in nursing. Those who did were more likely to be men, born overseas, not in health-related employment and did not have nursing as their first choice. Four broad overarching main themes were generated in response to the statement that suggested men do not have the right attributes for nursing: (1) 'This is a very misandristic viewpoint'; (2) 'Compassion and intelligence are distributed in men and women equally'; (3) 'Men bring a different quality to nursing' (4) 'Anyone can be whatever they want to be'. CONCLUSION: Overall, nursing students did not have misconceptions about men in nursing, despite experiencing ongoing social stigma regarding archaic gender norms. The findings from this study indicate that the next-generation nurses were championing to challenge the gender stereotype and support the needs of a gender diverse society. IMPACT: Attitudes and misconceptions that elicit gender inequalities must be addressed with comprehensive strategies and de-gendered language and imagery within the profession, schools, workplaces and the media. Shifting culture and attitudes towards inclusion, values the diversity in the workforce and supports healthy workplace environments. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Family visits and depression among residential aged care residents: An integrative review.

BACKGROUND: Depression in older people living in residential aged care is a serious and highly prevalent health issue, with loneliness and social isolation being major contributors. The COVID-19 pandemic underscored the harm visiting restrictions have on the mental wellbeing of older people in residential aged care. However, there is a need to systematically review the relationship between family visits and depression in this population. OBJECTIVE: This literature review seeks to explore the association between family visits and depression among those living in residential aged care. METHODS: An integrative review was conducted in March 2022, based on a search of seven databases from inception to 2022. Papers were included if the studies were situated in a residential aged care facility and explored the impact of in-person family visits on depression of residents. Those that examined impact of family visits on community-dwelling older people and papers examining virtual family visits were excluded. The quality of the included papers was assessed using appropriate critical appraisal tools. Guided by the aim of this study, the included papers were narratively synthesised and presented thematically (PROSPERO ID CRD42022325895). RESULTS: Ten papers, published between 1991 and 2022, were included in the final synthesis. Multiple categorisations of frequency of visits and different scales were used to assess depression. Depression among residents in aged care facilities varied from 20 % to 58.7 % with 40 % of studies showing a positive association between the frequency of family visits and lower rate of depression. Three themes influencing the association between family visits and depression in residential aged care were identified. These were: (i) intersection of culture, filial values, and depression; (ii) resident-related factors including whether admission was voluntary and presence of functional impairment; and (iii) non-resident-related factors such as social activities for residents and staff involvement. CONCLUSION: Family visits ameliorated loneliness and depression among residents in aged care however, other factors such as culture, comorbidities and functional impairment, opportunities for socialisation and the social involvement of facility staff also influenced depression. Whilst the low number of studies reviewed limited comparison and generalisation of results, the review highlighted the broader and crucial role of healthcare staff in facilitating socialisation and promoting mental wellbeing of residents especially those who are not visited by families. TWEETABLE ABSTRACT: Family visits ameliorate depression in institutionalised older people but may not be the "silver bullet" as depression is multifactorial.

Are men treated differently in clinical placements during nursing studies? A cross-sectional study.

AIM AND OBJECTIVE: To explore the perceptions of nursing students regarding the treatment of men in nursing during their clinical placement. BACKGROUND: Negative placement experiences of men who are nursing students is a risk factor for student attrition. Hence, exploring gender disparity in treatment during placement from both men and women studying nursing will contribute to improving student experience and reducing attrition. DESIGN: Survey capturing both quantitative and qualitative data. METHODS: Nursing students were surveyed between July and September 2021 across 16 Schools of Nursing in Australia. In addition to the Clinical Learning Environment Inventory (CLEI-19), an open-ended question explored if men received different treatment during clinical placement. RESULTS: Those who expressed difference in treatment of men were less satisfied with their clinical learning experience (p < .001). Of the 486 (39.6%) who responded to the open-ended question, 152 (31%) indicated a difference in the treatment of men, reporting that men received: (a) better (39%); (b) different, not exclusively better or worse (19%); and (c) worse (42%) treatment from either the clinical facilitator or ward staff. While both men and women perceived gender differences in the treatment of men during placement, men were more likely to report worse treatment. CONCLUSION: Despite the advances achieved in recruiting men in nursing, negative experiences during clinical placement are characterised by stereotypes, prejudice and discrimination, adversely impact retention. RELEVANCE TO CLINICAL PRACTICE: Nurse educators need to recognise specific support students require during placement regardless of gender. Our findings reinforce the adverse impacts of inequitable treatment on both men and women nursing students on learning, clinical performance, morale and ultimately on retention in the nursing workforce. Addressing gender stereotyping and discrimination in the undergraduate nursing program is an important step in promoting diversity and inclusivity in the nursing workforce.

The needs of older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care: An integrative review.

AIMS AND OBJECTIVES: To synthesise information about the needs of older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care from the perspectives of the residents, families and care staff. BACKGROUND: Older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care have care needs that are complex. Identifying these needs is critical to ensure quality care is delivered. DESIGN: An integrative review of literature. METHODS: Five databases were searched for relevant articles: APA PsychINFO, CINAHL, MEDLINE, Scopus and Google Scholar. The search and screening were guided by PRISMA guidelines and Whittemore and Knafl's five-step framework. RESULTS: Fifteen papers were included in this review consisting of 4 quantitative, 9 qualitative and 2 mixed method studies. Two themes described the needs of older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care. The first was related to culture-specific needs, and the second was related to dementia-specific care needs. Culture-specific needs comprised of three subthemes: (a) common language, (b) traditional food, and (c) social and spiritual requirements. Dementia-specific needs comprised of (a) focusing on comfort in addition to clinical requirements and (b) individualised care that addresses behavioural symptoms of dementia. CONCLUSIONS: Identifying and meeting the needs of older people with dementia from culturally and linguistically diverse backgrounds will improve quality care delivery in addition to increased caregiving satisfaction among residents, families and care staff, and the management of behaviours that characterise dementia. RELEVANCE TO CLINICAL PRACTICE: Care needs of older people with dementia from culturally and linguistically diverse backgrounds living in the residential setting can be complex. Education and training of care staff including nurses must be considered so that provision of care is inclusive of the cultural and dementia needs for older people in residential aged care.

Mandatory COVID-19 vaccination for healthcare workers: A discussion paper.

BACKGROUND: The devastating effects of COVID-19 sparked debates among professionals in the fields of health, law, and bioethics regarding policies on mandatory vaccination for healthcare workers. Suboptimal vaccine uptake among healthcare workers had been implicated in the increased risk of nosocomial spread of COVID infection and absenteeism among healthcare workers, impacting the quality of patient care. However, mandatory vaccine policies were also seen to encroach on the autonomy of healthcare workers. AIMS AND OBJECTIVES: To synthesise the arguments for and against mandatory vaccination for healthcare workers (HCWs) and its long-term impact on the healthcare workforce, through an analysis of texts and opinions of professionals from different fields of study. METHODS: This is a systematic review of opinions published in peer-reviewed journals. After initial search in Cochrane and JBI systematic review databases to ensure no previous review had been done, five databases were searched (PsychInfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline and Scopus). Inclusion criteria were: 1) focused on COVID-19; 2) healthcare workers specific; 3) specific to mandatory vaccination; 4) opinion piece with an identified author; and 5) in English. EXCLUSION: 1) focus on other vaccine preventable diseases, not COVID-19 and 2) discussion on mandatory vaccination not-specific to healthcare workers. The Joanna Briggs Critical Appraisal tool for Text and Opinions was used to assess quality. Data were synthesised in the summary table. RESULTS: The review included 28 opinion and viewpoint articles. Of these, 12 (43 %) adopted a pro-mandatory vaccination stance, 13 (46 %) were neutral or had presented arguments from both sides of the debate and only three (11 %) were against. The overall arguments among those who were pro-, neutral and anti-mandatory COVID-19 vaccination were underpinned by ethical, moral and legal principles of such a mandate on a vulnerable healthcare workforce. This review highlighted the polarised opinions concerning choices, human rights, professional responsibilities and personal risks (i.e. health risks, losing a job) with the introduction of vaccination mandate. However, the articles found in this review discussed mandatory vaccination of healthcare workers in the USA, Europe and Australia only. CONCLUSION: The review underscores the need to balance the rights of the public to safe and quality care with the rights and moral obligations of healthcare workers during a public health emergency. This can be achieved when policies and mandates are guided by reliable scientific evidence which are flexible in considering legal and ethical dilemmas. TWEETABLE ABSTRACT: To mandate or not to mandate COVID-19 vaccination for healthcare workers: A synthesis of published opinions in health, law, and bioethics.

The Making of Age-Friendly Universities: A Scoping Review.

BACKGROUND AND OBJECTIVES: The age-friendly university (AFU) initiative embodies the collaborative efforts of promoting age inclusivity and diversity in higher education, embracing lifelong learning and civic participation in older people. This scoping review aims to explore the conceptualization of AFU, the experiences, and the strategies used in operationalizing the AFU principles of participating universities in becoming members of the age-friendly university network. RESEARCH DESIGN AND METHODS: A search of peer-reviewed papers published from 2012 to July 2021, conducted in nine databases using JBI scoping review methodology, found 1,752 articles. Of these, 13 papers were eligible for inclusion. RESULTS: Three themes were identified as key to becoming an AFU: (a) interdisciplinary collaboration within the university; (b) strong partnership with the community; and (c) alignment with global priorities and initiatives. Furthermore, identifying barriers to physical access in universities, such as signage, walkways, and transportation, addressing the less tangible issues of ageism and promoting intergenerational learning were essential to promote engagement of older people. DISCUSSION AND IMPLICATIONS: This review underscores the need for a multidisciplinary approach within the university, the reciprocal benefits of authentic university-community collaborations, and the advantages of harnessing international resources and global influence to becoming an AFU. Although the principles of the AFU remain aspirational, the ideals championed by the pioneering universities in the AFU network brought the mutual benefits of intergenerational learning, the challenges and support required for older learners to the fore, propelling the AFU agenda forward.

Health literacy and self-management in people with coronary heart disease: a systematic review protocol.

OBJECTIVE: The objective of the review is to assess the association between health literacy levels and self-management behaviors in people with coronary heart disease. INTRODUCTION: Initiating and maintaining self-management behaviors following a coronary event can be challenging. The capacity to initiate behavioral changes requires adequate health literacy, which is the ability to understand and use health care information to make appropriate health decisions. INCLUSION CRITERIA: This review will consider studies including individuals at any age who have been diagnosed with coronary heart disease. Studies that used a standardized measure of health literacy with the primary outcome of self-management behaviors or an element of self-management (eg, medication adherence) will be considered for inclusion. METHODS: The review will be conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Databases to be searched include CINAHL, Embase, PubMed, APA PsycINFO, Cochrane, Scopus, ScienceDirect, ProQuest Dissertations and Theses, Google Scholar, and OpenGrey. This will be followed by a forward and backward search of relevant articles. Cross-sectional, case-control, cohort, and mixed methods studies (quantitative component only) will be included. Studies will be screened by 2 independent reviewers and undergo a critical appraisal process. Included studies will be assessed for methodological quality, and data will be extracted using a JBI data extraction tool in the JBI System for the Unified Management, Assessment and Review of Information. The results will be presented as a narrative synthesis and, where possible, a meta-analysis will be conducted. The Grading of Recommendations, Assessment, Development, and Evaluation approach will be used to assess the certainty of evidence. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021257407.

The impact of a pandemic on dental professionals' work and personal lives: A qualitative study with implications for primary healthcare workers.

During a pandemic, dentists face enormous challenges due to restrictions placed on their practice and the need to comply with biosafety measures. This study aimed to explore the impact of the COVID-19 pandemic and infection control measures on dentists and their practice in Jordan and the global implications for other primary healthcare workers. A qualitative exploratory study employing face-to-face or telephone interviews, was conducted with ten dentists from the 9th May to 20th September 2020. An inductive thematic approach to analysis was used identifying three themes, each with two accompanying subthemes: (1) Response to COVID-19 pandemic: (1a) Government response and (1b) People's response; (2) The effects of the pandemic and response measures: (2a) Impact on work and practice and (2b) Impact on personal and social life; (3) The unanticipated gains: (3a) Altruism and (3b) Leadership and change. Stringent infection control measures were implemented to slow the spread of the virus, however limited government support made implementation unsustainable and caused financial hardship. Lack of clear guidelines, changes in practice, social distancing measures, and altered social interactions, adversely impacted daily life, triggering mental distress. Misinformation influenced response to COVID safety measures. Despite the negatives, working during the pandemic reaffirmed dental professionals' roles and purpose, with strong leadership boosting morale. Education, adequate biosafety resources and clear guidelines or policies to support and sustain stringent infection control procedures are crucial in ensuring that measures are implemented to meet the safety requirements of the pandemic response. Promoting the well-being of the healthcare workforce is equally important. Finally, altruism and strong leadership among healthcare workers can contribute to a meaningful and humane pandemic response.

Educational programs to improve nurses' knowledge, attitude, and practice in adolescent and young adult health: An integrative review.

OBJECTIVE: Nurses working in adolescent health often lack educational opportunities to develop their knowledge and practical skills to address the challenges faced by adolescents and young adults. This integrative review synthesised the evidence from peer-reviewed research that focused on educational programs to improve nurses' knowledge, attitude, and practice in adolescent and young adult health. DESIGN: The five-stage framework by Whittemore and Knafl guided the integrative literature review and was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement. DATA SOURCES: A single search strategy was replicated across five electronic databases (CINAHL Plus, APA PsycInfo, PubMed, Scopus, and ERIC). Studies of educational interventions or training programs for nurses on adolescent and young adult health, published in English in the last 10 years were included. REVIEW METHODS: All studies found were reviewed for relevance independently by two authors, who likewise critically appraised the quality using the "Critical appraisal checklist for an article on an educational intervention" adapted from Morrison et al. (1999), with a third author providing consensus. Data were extracted using study specific standardised proforma and thematically analysed. RESULTS: Seven studies met the inclusion criteria. Topics covered included cancer care, mental health and self-harm, with only one program including general adolescent health. A mix of face-to-face and digital asynchronous mode of delivery was employed in these programs with multi-strategic approaches used to enhance accessibility and engagement. While all studies reported improvement in knowledge and practice, including enhanced communication skills, some studies reported limited change in attitude. Success of the interventions was attributed to the flexibility of programs to accommodate nurses' workloads. CONCLUSION: Education interventions for nurses delivering care to adolescent and young adults enhance knowledge and skills, however, programs with institutional support for flexibility and accessibility are needed to influence a positive change in attitude.

Development and psychometric testing of the gender misconceptions of men in nursing (GEMINI) scale among nursing students.

BACKGROUND: Misconceptions about men in nursing may influence recruitment and retention, further perpetuating the gender diversity imbalance in the nursing workforce. Identifying misconceptions and implementing early intervention strategies to address these deep-rooted stereotypes remain challenging but is considered critical to support students who are commencing a nursing career. OBJECTIVE: To develop and evaluate the psychometric properties of the 'Gender Misconceptions of meN in nursIng (GEMINI) Scale. DESIGN: Cross-sectional survey. METHODS: Pre-registration nursing students enrolled in undergraduate nursing programmes across 16 nursing institutions in Australia were surveyed from July to September 2021. The 17-item self-report GEMINI Scale measured the gender misconceptions of men in nursing. RESULTS: Of the 1410 completed surveys, data from 683 (45%) women were used for exploratory factor analysis showing a one factor structure, while data from 727 men (47%) were used for confirmatory factor analysis of the 17-item GEMINI Scale, which showed a good model fit. The scale demonstrated high internal consistency (Cronbach's alpha of 0.892). Men were found to have higher gender misconceptions (p < 0.001) while respondents who: (a) identified nursing as their first career choice (p = 0.002); (b) were in their final year of programme enrolment (p = 0.016); and (c) engaged in health-related paid work (p = 0.002) had lower gender misconceptions. CONCLUSION: The GEMINI Scale is a robust, valid, reliable, and easy to administer tool to assess misconceptions about men in nursing, which may potentially influence academic performance and retention. Identifying and addressing specific elements of misconceptions could inform targeted strategies to support retention and decrease attrition among these students. IMPACT STATEMENT: Genderism harms nursing, as well as the men and women working in the profession. Recruitment and retention of men into nursing is needed to cultivate male role models and diversify the workforce, however this is impeded by negative portrayals in popular culture and misconceptions entrenched in society.

Development and psychometric testing of the intention to engage in children's healthy weight (iCHeW) guideline scale for dental staff.

STATEMENT OF PROBLEM: In the evaluation of interdisciplinary interventions for childhood overweight and obesity, behavioural determinants can provide valuable insight into the reasons behind lack of adherence, or ineffectiveness of the intervention. Therefore, it is vital to assess the behavioural determinants of staff when evaluating the implementation of such interdisciplinary interventions. This study aimed to develop and psychometrically evaluate the intention to engage in Children's Healthy Weight guideline (iCHeW) scale, which assesses the behavioural determinants influencing dental staff's intention to conduct children's growth assessments. METHODS: Initial items were generated based on review of the literature and the dimensions of the integrative model of behavioural prediction (IM). To test this scale, a cross-sectional survey design was undertaken consisting of three phases: (i) face validity; (ii) content validity; and (iii) psychometric evaluation of the iCHeW scale with a national sample of 125 dental staff. RESULTS: The 35 items generated for the iCHeW scale were revised following feedback from a reference group. These 35 items were then appraised by an expert panel, yielding 27 items for psychometric testing. Using exploratory factor analysis, a five-factor solution was extracted, which corresponded to the IM domains, with the deletion of two items. Overall, Cronbach's alpha of the iCHeW scale was 0.95, with the following values for each subscale: (i) attitudes, 0.93; (ii) behavioural constraints, 0.83; (iii) perceived norms, 0.93; (iv) self-efficacy, 0.94; and (v) behavioural intention, 0.95. CONCLUSIONS: The iCHeW scale is valid and reliable for assessing dental staff's intention to provide routine growth assessments to children and demonstrates potential for use with non-dental staff.

The codesign of implementation strategies for children's growth assessment guidelines in the dental setting.

BACKGROUND: Considering the interdisciplinary role dental staff can play in addressing overweight and obesity in childhood, this study aimed to codesign guideline implementation strategies for children's growth assessment and dietary advice guidelines in the dental setting. METHODS: This qualitative study utilised principles of codesign and appreciative inquiry through a series of four, two-hour focus groups with dental staff and parents. Focus groups were analysed using content analysis. RESULTS: Discussion fell into two main themes, engaging patients throughout their care journey and supporting staff to engage with the guidelines. Six strategies were developed within these themes: (1) providing growth assessment information to patients and families before appointments, (2) providing refresher training to staff, (3) involving dental assistants in the growth assessment, (4) keeping dental staff updated regarding referral outcomes, (5) culturally appropriate information resources for patients and families, and (6) enabling longitudinal growth tracking in patient information systems. CONCLUSIONS: This study successfully designed six implementation strategies for children's growth assessment guidelines in the dental setting. Further research is required to determine their impact on guideline adherence.

Being above a healthy weight in childhood is a major public health issue. In parts of Australia, dental staff need to screen for and promote healthy weight among children. As this is not a normal part of dental care, it could be hard for this change to come about. So, this study aimed to create strategies to help dental staff to screen for and promote healthy weight among children. As we wanted those impacted by the strategies to have a say, we worked with public dental staff and parents. When health staff and the community come together to design ways to improve health care, this is known as codesign. In groups, these people codesigned a series of strategies. Strategies for parents included: (1) informing parents about what to expect in their child's appointment; and (2) creating resources for parents from other cultures. Strategies for dental staff included (1) ensuring staff were trained; (2) involving the whole dental team to save time; (3) ensuring dental staff heard back from services they sent children to for healthy weight support; and (4) creating a way to record children's growth over time. Bringing in both parents and dental staff gave them a voice to codesign strategies to help dental staff screen and promote healthy weight among children. This produced a suite of strategies that were appropriate for all involved.

Effectiveness of nurse-targeted education interventions on clinical outcomes for patients with indwelling urinary catheters: A systematic review.

OBJECTIVES: To identify subject matter, pedagogical approaches and assess outcomes of interventions implemented to educate nurses in urinary catheterisation care and management. DESIGN: A systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement. DATA SOURCES: Databases (CINAHL; MEDLINE; ProQuest; ERIC; Scopus; Cochrane; and APA PsycINFO) were searched using key concepts: education interventions, indwelling urinary catheter and nurses, from inception to July 2021. REVIEW METHODS: Two researchers searched the databases, whereupon data were extracted using a standardised proforma and were analysed applying an abductive approach. The Joanna Briggs Institute Critical Appraisal tool was used to assess the quality of the included studies. Findings were analysed and reported using narrative synthesis. RESULTS: Out of 1159 studies screened, nine educational intervention studies related to upskilling nurses in catheter management were identified. Subject matter addressed included pathophysiology of the urinary system, clinical indications and management of indwelling catheter and associated complications. Although the subject matter and pedagogical approaches varied, all identified studies reported positive effects in improving participants' knowledge. CONCLUSIONS: Upskilling nurses and increasing their confidence to deliver patient-centred catheter care practices is an important intervention to improve outcomes for patients with long-term indwelling urinary catheters. However, actively engaging nurses who provide direct patient care is essential, in planning and implementing targeted educational interventions specific to learning needs. This review has identified a gap in the educational interventions for nurses, in better supporting the psychosocial needs of patients living with indwelling catheter. Codesigning educational interventions with nurses that are tailored to their contextual learning needs is likely to enhance behaviour change and improve current practice.

Development and Validation of a Scale to Measure Self-efficacy and Self-management in People With Coronary Heart Disease.

BACKGROUND: Self-management is important in reducing coronary risk factors and in preventing recurrent cardiac events. An enabling factor that promotes self-management among patients with coronary heart disease (CHD) is self-efficacy. However, there is no standardized measure that captures self-efficacy and self-management concurrently in this population. AIM: The authors of this study report on the development and validation of a brief scale to measure self-efficacy and self-management in patients with CHD. METHODS: Scale development and testing comprised (1) item generation, (2) content validity, and (3) pilot testing. The Heart Health Self-Efficacy and Self-Management (HH-SESM) scale includes 2 constructs: self-efficacy and self-management, measured concurrently. Components of the HH-SESM scale consisted of items related to behavioral and coronary risk factor modification. Survey data from 143 participants were used in exploratory factor analyses to test the factorial validity and internal consistency of the scale. RESULTS: Twelve items with the same response format were included in the exploratory factor analysis. The factor analysis revealed a single-factor solution accounting for 36.7% and 36.5% of the variance in scores of the self-efficacy and self-management scales, respectively. The correlation ( r = 0.72, P < .001) between the self-efficacy and self-management constructs indicates moderate convergent validity. Cronbach α of self-efficacy (0.83) and self-management (0.81) constructs showed good internal consistency. CONCLUSION: The HH-SESM is a brief, easy-to-administer, and reliable measure of self-efficacy and self-management in patients with CHD.

COVID-19 vaccination intention in the first year of the pandemic: A systematic review.

AIMS AND OBJECTIVES: To synthesise evidence regarding vaccination intention, identify factors contributing to vaccine hesitancy among healthcare professionals and the general populations globally. BACKGROUND: As COVID-19 vaccine becomes available worldwide, attention is being directed to community vaccine uptake, to achieve population-wide immunity. A number of factors have been reported to influence vaccine intention. METHODS: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic search of COVID-19 vaccination intention related literature published on or before 31 December 2020 from seven databases was undertaken. RESULTS: Thirty articles were included in this systematic review. Overall COVID-19 vaccination intention during the first year of the pandemic ranged from 27.7% to 93.3%. Findings highlighted that socio-demographic differences, perceptions of risk and susceptibility to COVID-19 and vaccine attributes influenced vaccination intention. Healthcare professionals particularly, nurses have higher vaccine hesitancy reportedly due to concerns regarding vaccine safety and efficacy and mistrust of health authorities. Negative information about COVID-19 vaccines in the social media and low confidence in the health system were associated with lower acceptability among the community. Interestingly, cumulative increase in COVID-19 caseloads of countries over time was not associated with vaccination intention. CONCLUSIONS: The significant variability in vaccine intention rates worldwide would hamper efforts to achieve immunity against COVID-19. Nurses' concerns about vaccine safety and efficacy need to be addressed to increase vaccine acceptance and maximise their influence on vaccination decision in the community. As misinformation through social media negatively impacts vaccination uptake, authoritative and reliable information on vaccine attributes, disease risks and vaccination benefits are needed. RELEVANCE TO CLINICAL PRACTICE: Concerns about vaccine safety and efficacy including misinformation are important contributors to vaccine hesitancy. Addressing these factors, particularly among nurses who are considered trusted influencers of vaccination decisions in the community is an important strategy for pandemic preparedness.

Psychometric evaluation of the 11-item English language usage scale in commencing nursing students.

BACKGROUND: Globalisation has increased the number of students from culturally and linguistically diverse backgrounds enrolling in nursing programs where English is the primary medium of instruction. These students may experience challenges with English language usage and need to be identified early to ensure academic success. OBJECTIVE: To develop and test the psychometric properties of a self-report English language usage scale (ELUS-11). METHODS: Prospective, correlational study of commencing nursing students enrolled in a communication unit at a university in the western Sydney region of Australia. English-language usage was measured using the ELUS-11, an 11-item self-report tool with a 5-point Likert scale response format. Factorial validity was examined using exploratory and confirmatory factor analysis and logistic regression was used to compute the predictive validity of the ELUS. RESULTS: Of the 1723 students enrolled, 1100 (64%) returned surveys with all items of the ELUS-11 completed. The mean age of respondents was 25.4 years (SD: 8.0 years), 85% were female and 67% spoke a language other than English at home. Exploratory factor analysis yielded a one-factor structure that explained 65% of the variance, with factor loadings ranging from 0.72 to 0.86; and high internal consistency (α = 0.96). The ELUS-11 was able to discriminate among different groups of students based on age, domestic/international enrolment status and language spoken at home (all p < 0.001). Logistic regression revealed the ELUS-11 had good predictive validity, with those in the high ELUS-11 group over three times more likely to obtain a pass grade in their first written assessment (Adjusted odds ratio: 3.01, 95% CI: 2.05-4.43). CONCLUSION: The ELUS-11 is a valid and reliable measure of English-language usage, and appropriate for use in an undergraduate nursing population to identify students at risk of poor academic performance.