Tools for faculty assessment of interdisciplinary competencies of healthcare students: an integrative review.

Increasingly, interprofessional teamwork is required for the effective delivery of public health services in primary healthcare settings. Interprofessional competencies should therefore be incorporated within all health and social service education programs. Educational innovation in the development of student-led clinics (SLC) provides a unique opportunity to assess and develop such competencies. However, a suitable assessment tool is needed to appropriately assess student progression and the successful acquisition of competencies. This study adopts an integrative review methodology to locate and review existing tools utilized by teaching faculty in the assessment of interprofessional competencies in pre-licensure healthcare students. A limited number of suitable assessment tools have been reported in the literature, as highlighted by the small number of studies included. Findings identify use of existing scales such as the Interprofessional Socialization and Valuing Scale (ISVS) and the McMaster Ottawa Scale with Team Observed Structured Clinical Encounter (TOSCE) tools plus a range of other approaches, including qualitative interviews and escape rooms. Further research and consensus are needed for the development of teaching and assessment tools appropriate for healthcare students. This is particularly important in the context of interprofessional, community-partnered public health and primary healthcare SLC learning but will be of relevance to health students in a broad range of clinical learning contexts.

Exploring nurse practitioner practice in Australian rural primary health care settings: A scoping review.

INTRODUCTION: Australians in rural areas experience limited access to services and poorer health outcomes than residents of metropolitan areas. Nurse practitioners (NPs) were introduced in 2000 to reduce pressure on the health system, address workforce shortages and improve rural populations' access to health care services. OBJECTIVE: This scoping review sought to identify, examine and synthesise research evidence of NP practice in Australian rural primary health care services to better understand how NPs are addressing service gaps in rural areas and to identify existing gaps in our knowledge. DESIGN: Peer-reviewed and grey literature from July 2012 to June 2022 was accessed from seven electronic databases, grey literature and hand searching of reference lists and citations. FINDINGS: From 154 articles, 19 articles of relevance were identified. Several projects describe the processes required for success, whilst others reported the challenges and barriers encountered. Limited research evidence of rural NP practice exists with a significant gap about how roles operate and their value in primary health care. DISCUSSION: Uptake and envisaged benefits of rural primary health care NP roles have yet to be realised, with barriers to implementing and sustaining NP roles persisting. Low-level awareness with ambiguity at health service and community level adversely impact on systematic implementation of NP roles. CONCLUSIONS: Robust evaluations demonstrating the value of NP skills and practice are needed in combination with bipartisan support from all levels of health care and government providing adequate funding to enable effective implementation of NP roles in poorly resourced rural areas.

Hypoglycemia and glycemic variability of people with type 1 diabetes with lower and higher physical activity loads in free-living conditions using continuous subcutaneous insulin infusion with predictive low-glucose suspend system.

INTRODUCTION: Maintaining glycemic control during and after physical activity (PA) is a major challenge in type 1 diabetes (T1D). This study compared the glycemic variability and exercise-related diabetic management strategies of adults with T1D achieving higher and lower PA loads in nighttime-daytime and active- sedentary behavior hours in free-living conditions. RESEARCH DESIGN AND METHODS: Active adults (n=28) with T1D (ages: 35±10 years; diabetes duration: 21±11 years; body mass index: 24.8±3.4 kg/m2; glycated hemoglobin A1c: 6.9±0.6%) on continuous subcutaneous insulin delivery system with predictive low glucose suspend system and glucose monitoring, performed different types, duration and intensity of PA under free-living conditions, tracked by accelerometer over 14 days. Participants were equally divided into lower load (LL) and higher load (HL) by median of daily counts per minute (61122). Glycemic variability was studied monitoring predefined time in glycemic ranges (time in range (TIR), time above range (TAR) and time below range (TBR)), coefficient of variation (CV) and mean amplitude of glycemic excursions (MAGE). Parameters were studied in defined hours timeframes (nighttime-daytime and active-sedentary behavior). Self-reported diabetes management strategies were analysed during and post-PA. RESULTS: Higher glycemic variability (CV) was observed in sedentary hours compared with active hours in the LL group (p≤0.05). HL group showed an increment in glycemic variability (MAGE) during nighttime versus daytime (p≤0.05). There were no differences in TIR and TAR across all timeframes between HL and LL groups. The HL group had significantly more TBR during night hours than the LL group (p≤0.05). Both groups showed TBR above recommended values. All participants used fewer post-PA management strategies than during PA (p≤0.05). CONCLUSION: Active people with T1D are able to maintain glycemic variability, TIR and TAR within recommended values regardless of PA loads. However, the high prevalence of TBR and the less use of post-PA management strategies highlights the potential need to increase awareness on actions to avoid glycemic excursions and hypoglycemia after exercise completion.

Domesticating the condition: Design lessons gained from a marathon on how to cope with barriers imposed by type 1 diabetes.

Through analytical autoethnographic analysis of marathon preparation, this study examines challenges faced by people with Type 1 Diabetes (T1D) who engage in high-performance sports. Autoethnographer and second-person perspectives (T1D runners, family members, and health providers) were collected through introspective activities (autoethnographic diary and in-depth interviews) to understand the T1D runner's coping experience. Six insights involved in T1D self-management were identified and analyzed with reference to related design tools (prototyping, archetyping and journey mapping). Finally, we conclude with a discussion of how endurance physical activity (PA) such as running helps to "domesticate" T1D, a term coined to reflect the difficulties that T1D presents for PA accomplishment and how T1D runners' experiences give them an opportunity to overcome PA barriers promoting physical culture and enriching further health psychology studies.

Recognising and responding to communication and swallowing difficulties in Parkinson's disease.

BACKGROUND: Communication difficulties, including hypokinetic dysarthria and swallowing difficulties (dysphagia), affect a large percentage of people diagnosed with Parkinson's disease. Onset of these symptoms has been identified in up to 78% of people with early-stage Parkinson's disease. Communication difficulties are frequently disregarded until they have a significant impact on quality of life, while the person may often be unaware of indicators of dysphagia and the associated risk of aspiration pneumonia. OBJECTIVE: The aim of this article is to increase awareness of the importance of identifying and addressing the communication and swallowing difficulties experienced by people living with Parkinson's disease. DISCUSSION: Early identification, regular review and monitoring enable the clinician to support the implementation of evidence-based, effective interventions. Collaboration with the multidisciplinary team, including speech pathology, is needed to enable the person to live well with Parkinson's disease and to prevent aspiration pneumonia, a leading cause of death in Parkinson's disease. A vignette prepared in collaboration with a person living with Parkinson's disease and his wife provides an 'insider perspective' of the pervasive impact of difficulties with communication and swallowing.

Non-motor symptoms of Parkinson's disease.

BACKGROUND: Parkinson's disease is characterised by a complex array of motor and non-motor symptoms. Motor symptoms are often prioritised for assessment and treatment. Growing evidence highlights the importance of recognising the impact of non-motor symptoms on the person's quality of life. OBJECTIVE: The aim of this article is to increase awareness of the importance of identifying and addressing non-motor symptoms experienced by people living with Parkinson's disease. DISCUSSION: A vignette developed in collaboration with a person living with Parkinson's disease and his wife provides an 'insider perspective'. Regular assessment and monitoring of non-motor symptoms enable the clinician to support the implementation of effective interventions. Team-based care and connections with Parkinson's support groups are essential to enable the person to live well with Parkinson's disease and provide informal carers with the support and information needed.

Green Tea for Cancer Prevention.

Editor's note: The mission of Cochrane Nursing is to provide an international evidence base for nurses involved in delivering, leading, or researching nursing care. Cochrane Corner provides summaries of recent systematic reviews from the Cochrane Library. For more information, see https://nursing.cochrane.org.

The Use of Vitamins and Supplements for Lung Cancer Prevention.

Editor's note: The mission of Cochrane Nursing is to provide an international evidence base for nurses involved in delivering, leading, or researching nursing care. Cochrane Corner provides summaries of recent systematic reviews from the Cochrane Library. For more information, see https://nursing.cochrane.org.

Nursing and values-based leadership: A literature review.

AIM: To explore literature that supports an understanding of values-based leadership in nursing. BACKGROUND: Understanding values-based leadership in nursing means understanding several leadership theories such as authentic, servant and congruent leadership. EVALUATION: Electronic databases were systematically searched to locate studies with the terms values-based, authentic, servant and congruent leadership. The literature was assessed with the Joanna Briggs Institute Critical Appraisal Tools and the Preferred Reporting Items for Systematic Reviews and meta-analysis approach and a thematic analysis. KEY ISSUES: Existing evidence focuses on specific perspectives within three dominant leadership approaches under the umbrella of values-based leadership: authentic, servant and congruent leadership. Limited literature suggests that values-based leadership can support professional collaboration, enhanced trust and voice for nurses, support for staff well-being, empowerment, job satisfaction, patient-focused outcomes and quality care. CONCLUSIONS: A dearth of empirical literature concerning values-based leadership and nursing exists. Evidence suggests that authentic, servant and congruent leadership correlate with values-based leadership theories and core nursing values. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should recognize the potential benefits of a values-based leadership approach for staff well-being, enhanced professional collaboration and the nurses voice, improved insight into clinical leadership attributes and improvements in quality patient care.

The 'work' of self-care for people with cardiovascular disease and prediabetes: An interpretive description.

BACKGROUND: Cardiovascular disease and sustained high blood glucose (prediabetes) are established concurrent diagnoses. People with these concomitant conditions carry out self-care which is overt (e.g., daily weighing or taking a specific diet), plus there are also concealed facets of self-care (e.g., accessing information about diet or medications). Also of note is the need to 'work' to achieve a self-determined level of self-care. The 'work' put into self-care is currently under-reported when people discuss their progress with health professionals. OBJECTIVE: Our research aimed to demonstrate that aspects of self-care are typically concealed. A further objective was to reveal the extent of 'work' dedicated to self-care. DESIGN: Interviews were conducted with 23 participants to reveal their experiences of long-term conditions, cardiovascular disease and prediabetes. Interpretive description underpinned the development of a thematic representation of the data. SETTING AND PARTICIPANTS: Recruitment was from a tertiary hospital coronary care unit in New Zealand. Included participants were those with an acute coronary event, also found to have a high blood glucose. Those people known to have diabetes prior to admission were not included. METHOD: Participants were interviewed once, for approximately 60 min, nine months after discharge home. The data is analysed using thematic analysis, organising an interpretation into themes. RESULTS: Self-care requires 'work', the work itself was frequently understated by participants, they trivialised their important role in their self-care. Participants often required prompting to discuss the responsibilities, choices and behaviours they participated in to support self-care to improve their health and well-being. Participant data showed how the 'work' of self-care aligned to three work themes: solo self-care, teamwork, and constant companion self-care. CONCLUSION: Nurses can improve the outcomes for people with long-term conditions by acknowledging and incorporating the often concealed 'work' of self-care when assessing, planning and implementing health care in any clinical setting. A important recommendation for nurses is to support people-as-patients, by encouraging self-determination and working with the preferences patients have for self-care, in order to enhance their quality of life while living with ill-health.

Home-based chemically induced whitening (bleaching) of teeth in adults: A summary of a systematic review.

The demand for whiter teeth has been increasing, and home-based remedies are a popular way of whitening the teeth. These products may be prescribed by the dentist or purchased over the counter and comprise different modes to whiten the teeth and are administered in a range of ways by the person. This review found that the evidence was insufficient to draw reliable conclusions about the intervention, i.e., the use of these whitening products. The results indicated that people may experience side effects that irritate the mouth and gums. Therefore, nurses should direct people who are interested in teeth whitening to their dental professional for a discussion.

Adverse Effects of Dexamethasone in Surgical Patients.

Editor's note: This is a summary of a nursing care-related systematic review from the Cochrane Library. For more information, see http://nursingcare.cochrane.org.

An International Scoping Exercise Examining Practice Experience Hours Completed by Nursing Students.

BACKGROUND: There is global acceptance of the need for prelicensure nursing students to complete practice experience hours during their program of education. Yet questions remain about these practice experiences, including those related to duration. METHOD: This article reports findings of a scoping exercise that compared the number of practice experience hours mandated for students undertaking courses that lead to RN licensure in Australia, New Zealand, the United Kingdom, and the United States. RESULTS: Substantial differences were evident between the four countries regarding the number of mandated practice experience hours. There is no clearly linked research evidence to justify the decision made in relation to the mandated number of hours. CONCLUSION: Internationally, there is a need to reexamine the rationale for mandating a minimum number of practice experience hours for students in programs of education that lead to licensing as an RN. [J Nurs Educ. 2019;58(1):33-41.].

Circuit class therapy for improving mobility after stroke: A Cochrane review summary.

After a stroke, people characteristically experience a loss of function. Reviewers (English et al., 2017) provide evidence-based insights into the value of instigating CCT into post-stroke rehabilitation. The review examines the effectiveness of CCT for people who have experienced stroke. The meta-analysis includes seventeen trials comprising 1297 participants. Results demonstrate that CCT is a worthwhile intervention to establish and support mobility post-stroke. The primary effect of CCT was to improve walking capacity, measured by a walk test. CCT improves gaining independence in activities of daily living.

The Yerin Dilly Bag Model of Indigenist Health Research.

In this article, we discuss indigenist approaches to health research, including indigenist knowledges, cultural proficiency, and core values. We also highlight the importance of conducting Indigenous research in ways that are congruent with the needs and interests of Indigenous peoples. The discussion includes consideration of how indigenist approaches can be utilized to generate new Indigenous knowledges, in culturally appropriate ways. We then introduce the Yerin Dilly Bag Model for indigenist health research, an approach that allows for indigenist knowledges to be employed and created by the research/er/ed within an Indigenous framework. Use of the Yerin Dilly Bag Model enables research/er/ed concordance, together with the privileging of Indigenous voices. This is achieved by guiding researchers to align their research with the core values of the researched, with the Yerin Dilly Bag a metaphor for the holder of these core values.