Emergency department Nurses' narratives of burnout: Changing roles and boundaries.

PURPOSE: Emergency department nurses work in rapidly changing environments, which can contribute to occupational stress. Emergency department nurses utilise diverse strategies to mediate the impact of stress on their daily lives. There is a paucity of qualitative research which explores emergency department nurses' experiences and perspectives of burnout. This study aimed to explore emergency department nurses' experiences of burnout. Further, the study considered how emergency nurses conceptualised burnout and the strategies they used to manage the professional and personal effects of burnout. PROCEDURES: The COREQ research guidelines were used throughout the study from the design stage through to dissemination. Narrative inquiry was used as the underpinning theoretical framework. The researcher met individually with eight emergency department nurses from NSW hospitals to undertake a face-to-face semi-structured interview. An inductive approach was used to establish major themes within the narrative. FINDINGS: Two major themes were established: experiencing conflicting emotions and trying to establish a personal sense of control. Emergency nurses felt passionate about their professional roles, yet encountered difficulties due to management structures, time constraints and a sense of underappreciation. The misalignment between their expectations and the reality of emergency department nursing, resulted in experiences of burnout such as dissatisfaction and frustrations at work. Consequently, these nurses adopted diverse strategies within both their professional and personal domains. PRINCIPAL CONCLUSIONS: The conclusions of this study are transferable to a variety of acute health services. Health service management have a role to promote a positive workplace culture for nurses, which advocates for home life balance. This will support nurses to construct clear boundaries between professional identity and their personal lives.

Unringing the bell: Successful debriefing following a rich false memory study.

In rich false memory studies, familial informants often provide information to support researchers in planting vivid memories of events that never occurred. The goal of the current study was to assess how effectively we can retract these false memories via debriefing - i.e., to what extent can we put participants back the way we found them? We aimed to establish (1) what proportion of participants would retain a false memory or false belief following debriefing, and (2) whether richer, more detailed memories would be more difficult to retract. Participants (N = 123) completed a false memory implantation protocol as part of a replication of the "Lost in the Mall" study (Loftus & Pickrell, Psychiatric Annals, 25, 720-725, 1995). By the end of the protocol, 14% of participants self-reported a memory for the fabricated event, and a further 52% believed it had happened. Participants were then fully debriefed, and memory and belief for the false event were assessed again. In a follow-up assessment 3 days post-debriefing, the false memory rate had dropped to 6% and false belief rates also fell precipitously to 7%. Moreover, virtually all persistent false memories were found to be nonbelieved memories, where participants no longer accepted that the fabricated event had occurred. Richer, more detailed memories were more resistant to correction, but were still mostly retracted. This study provides evidence that participants can be "dehoaxed", and even very convincing false memories can be retracted.

Nurses' experiences when conducting the mental state examination (MSE): A scoping review.

The Mental State Examination (MSE) is an assessment framework used to facilitate the collection of subjective and objective data about a person's current mental state. There is a lack of understanding of nurses' experiences when conducting the MSE. The aim of this scoping review is to identify, examine and summarize the available literature relating to nurses' experiences when conducting the MSE. A scoping review was conducted using Arksey and O'Malley (2005) framework to review, examine and synthesize the available literature on nurses' experiences with the MSE. A PRISMA flow diagram was used to describe the systematic literature search. Six databases (APA PsycInfo, CINAHL, MEDLINE, PubMed, ProQuest, and Scopus) were searched including reference lists of eligible sources. Google Scholar, Trove and Proquest Dissertation and Thesis were searched for grey literature. Twelve articles included in this scoping review considered nurses experiences when conducting the MSE. The principles of thematic analysis were used to synthesize the studies. Three distinct themes were identified from the literature: (i) Nurses' role and the MSE, (ii) Nurses' competence and knowledge when conducting the MSE, and (iii) Nurses' confidence when conducting the MSE. The results of this scoping review identified the MSE as a component of the mental health nursing role and a core competency of mental health telephone triage services. The MSE was used by nurses in the Emergency department (ED), acute in-patient and community mental health settings, including mental health telephone triage services. Nurses working in EDs and acute in-patient mental health settings experienced a lack of confidence and competence, including a knowledge deficit in conducting the MSE in comparison to nurses working in community mental health settings. Community mental health nurses identified the importance of conducting an MSE higher than acute in-patient mental health nurses. This review identified the need for evidence-based research related to the MSE and its application in nursing practice. Evidence-based research will inform the development of MSE guidelines and policies, thus, enhance mental health nursing practice related to the MSE, including improving and strengthening consumer-nurse therapeutic alliance in acute in-patient mental health settings.

Conducting ethical misinformation research: Deception, dialogue, and debriefing.

Misinformation research can present many ethical challenges to researchers. These challenges are not insurmountable, but recent research suggests that as a field, we should be adopting and reporting stronger ethical practices. In this review, we consider the three D's of ethical misinformation research; the need to balance deception with informed consent, the value of maintaining an open dialogue with research participants to gather their insights and perspectives, and perhaps most importantly, the essential requirement for effective post-experimental debriefing. We make some specific and straightforward recommendations for misinformation researchers to increase the visibility of their ethical practices and outline the benefits for individual researchers and for the field.

Do deepfake videos undermine our epistemic trust? A thematic analysis of tweets that discuss deepfakes in the Russian invasion of Ukraine.

Deepfakes are a form of multi-modal media generated using deep-learning technology. Many academics have expressed fears that deepfakes present a severe threat to the veracity of news and political communication, and an epistemic crisis for video evidence. These commentaries have often been hypothetical, with few real-world cases of deepfake's political and epistemological harm. The Russo-Ukrainian war presents the first real-life example of deepfakes being used in warfare, with a number of incidents involving deepfakes of Russian and Ukrainian government officials being used for misinformation and entertainment. This study uses a thematic analysis on tweets relating to deepfakes and the Russo-Ukrainian war to explore how people react to deepfake content online, and to uncover evidence of previously theorised harms of deepfakes on trust. We extracted 4869 relevant tweets using the Twitter API over the first seven months of 2022. We found that much of the misinformation in our dataset came from labelling real media as deepfakes. Novel findings about deepfake scepticism emerged, including a connection between deepfakes and conspiratorial beliefs that world leaders were dead and/or replaced by deepfakes. This research has numerous implications for future research, societal media platforms, news media and governments. The lack of deepfake literacy in our dataset led to significant misunderstandings of what constitutes a deepfake, showing the need to encourage literacy in these new forms of media. However, our evidence demonstrates that efforts to raise awareness around deepfakes may undermine trust in legitimate videos. Consequentially, news media and governmental agencies need to weigh the benefits of educational deepfakes and pre-bunking against the risks of undermining truth. Similarly, news companies and media should be careful in how they label suspected deepfakes in case they cause suspicion for real media.

Face/Off: Changing the face of movies with deepfakes.

There are growing concerns about the potential for deepfake technology to spread misinformation and distort memories, though many also highlight creative applications such as recasting movies using other actors, or younger versions of the same actor. In the current mixed-methods study, we presented participants (N = 436) with deepfake videos of fictitious movie remakes (such as Will Smith staring as Neo in The Matrix). We observed an average false memory rate of 49%, with many participants remembering the fake remake as better than the original film. However, deepfakes were no more effective than simple text descriptions at distorting memory. Though our findings suggest that deepfake technology is not uniquely placed to distort movie memories, our qualitative data suggested most participants were uncomfortable with deepfake recasting. Common concerns were disrespecting artistic integrity, disrupting the shared social experience of films, and a discomfort at the control and options this technology would afford.

Bias and constructive processes in a self-memory system.

Martin Conway's influential theorising about the self-memory system (Conway, M. A., & Pleydell-Pearce, C. W. (2000). The construction of autobiographical memories in the self-memory system. Psychological Review, 107(2), 261-288) illuminated how the "working self" influences the construction of autobiographical memories. Moreover, his constructive view of self and memory is compatible with the occurrence of various kinds of errors and distortions in remembering. Here we consider one of the "seven sins" of memory Schacter, D. L. (2021). The seven sins of memory updated edition: How the mind forgets and remembers. Houghton Mifflin Harcourt) that we believe is most closely related to the operation of Conway's self-memory system: bias, which refers to the role of current knowledge, beliefs, and feelings in shaping and sometimes distorting memories for past experiences and attitudes. More specifically, we discuss recent research on three forms of bias - consistency, self-enhancing, and positivity biases - that illuminate their role in influencing how people remember the past and also imagine the future. We consider both theoretical and applied aspects of these biases and, consistent with Conway's perspective, argue that despite sometimes contributing to inaccuracies, bias also serves adaptive functions.

Lost in the mall again: a preregistered replication and extension of Loftus & Pickrell (1995).

ABSTRACTThe seminal Lost in the Mall study [Loftus, E. F., & Pickrell, J. E. (1995). The formation of false memories. Psychiatric Annals, 25(12), 720-725. https://doi.org/10.3928/0048-5713-19951201-07] has been enormously influential in psychology and is still cited in legal cases. The current study directly replicated this paper, addressing methodological weaknesses including increasing the sample size fivefold and preregistering detailed analysis plans. Participants (N = 123) completed a survey and two interviews where they discussed real and fabricated childhood events, based on information provided by an older relative. We replicated the findings of the original study, coding 35% of participants as reporting a false memory for getting lost in a mall in childhood (compared to 25% in the original study). In an extension, we found that participants self-reported high rates of memories and beliefs for the fabricated event. Mock jurors were also highly likely to believe the fabricated event had occurred and that the participant was truly remembering the event, supporting the conclusions of the original study.

Lost in the mall again: a preregistered replication and extension of Loftus & Pickrell (1995).

The seminal Lost in the Mall study has been enormously influential in psychology and is still cited in legal cases. The current study directly replicated this paper, addressing methodological weaknesses including increasing the sample size fivefold and preregistering detailed analysis plans. Participants (N = 123) completed a survey and two interviews where they discussed real and fabricated childhood events, based on information provided by an older relative. We replicated the findings of the original study, coding 35% of participants as reporting a false memory for getting lost in a mall in childhood (compared to 25% in the original study). In an extension, we found that participants self-reported high rates of memories and beliefs for the fabricated event. Mock jurors were also highly likely to believe the fabricated event had occurred and that the participant was truly remembering the event, supporting the conclusions of the original study.

The efficacy of interventions in reducing belief in conspiracy theories: A systematic review.

Conspiracy beliefs have become a topic of increasing interest among behavioural researchers. While holding conspiracy beliefs has been associated with several detrimental social, personal, and health consequences, little research has been dedicated to systematically reviewing the methods that could reduce conspiracy beliefs. We conducted a systematic review to identify and assess interventions that have sought to counter conspiracy beliefs. Out of 25 studies (total N = 7179), we found that while the majority of interventions were ineffective in terms of changing conspiracy beliefs, several interventions were particularly effective. Interventions that fostered an analytical mindset or taught critical thinking skills were found to be the most effective in terms of changing conspiracy beliefs. Our findings are important as we develop future research to combat conspiracy beliefs.

How do participants feel about the ethics of rich false memory studies?

ABSTRACTDeception is often a necessity in rich false memory studies, but is this deception acceptable to participants? In the current study, we followed up with 175 participants who had taken part in a replication of the Lost in the Mall childhood false memory study (Loftus & Pickrell, 1995), as either a research subject or a familial informant. We found that both participants and informants were generally very positive about their experience, did not regret taking part and found the deceptive methods acceptable. Importantly, the vast majority reported that they would still have taken part had they known the true objectives from the beginning. Participants also reported learning something interesting about memory and enjoying the nostalgia and family discussions that were prompted by the study. We would encourage other researchers to assess the ethical implications of false memory research paradigms and to incorporate the valuable feedback from participants and informants.

Debriefing works: Successful retraction of misinformation following a fake news study.

In recent years there has been an explosion of research on misinformation, often involving experiments where participants are presented with fake news stories and subsequently debriefed. In order to avoid potential harm to participants or society, it is imperative that we establish whether debriefing procedures remove any lasting influence of misinformation. In the current study, we followed up with 1547 participants one week after they had been exposed to fake news stories about COVID-19 and then provided with a detailed debriefing. False memories and beliefs for previously-seen fake stories declined from the original study, suggesting that the debrief was effective. Moreover, the debriefing resulted in reduced false memories and beliefs for novel fake stories, suggesting a broader impact on participants' willingness to accept misinformation. Small effects of misinformation on planned health behaviours observed in the original study were also eliminated at follow-up. Our findings suggest that when a careful and thorough debriefing procedure is followed, researchers can safely and ethically conduct misinformation research on sensitive topics.

Social network and severe lower respiratory tract infections in older adults: findings from a Swedish longitudinal population-based study.

OBJECTIVES: To investigate the association between social network and the risk and prognosis of severe lower respiratory tract infections (LRTIs) in older adults. METHODS: Data from Swedish hospital records were matched with the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). Social network was operationalized as social connections and social support, based on different self-reported variables, and categorized as low, medium, and high. The risk of severe LRTI and related outcomes were assessed using Cox, Poisson, and logistic regression models where appropriate. RESULTS: A total of 362 individuals experienced LRTI-related hospitalizations between 2001 and 2016 (479 total hospitalizations). High levels of social support decreased the hazard of incident LRTI by 29% (hazard ratio 0.71, 95% confidence interval [CI] 0.52-0.96), the hospital length of stay by 21% (incidence rate ratio 0.79, 95% CI 0.65-0.97), and the risk of 30-day mortality by 92% (odds ratio 0.08, 95% CI 0.01-0.68), but was a risk factor for 30-day readmission (odds ratio 3.16, 95% CI 1.38-7.24). High levels of social connections were associated with a higher risk of incident LRTI in women and those with dementia and/or slow walking speed (Pinteraction <0.05). CONCLUSION: Older individuals' quality of social support seems to be a stronger determinant of LRTI incidence and prognosis than the quantity of their social connections. These findings may inform evidence-based policies aimed at preventing LRTIs in older adults.

Managing the elephant in the room: responding to COVID-19's impact on data collection.

BACKGROUND: The global COVID-19 pandemic has affected data collection for many researchers, in particular research that involves face-to-face interviews. AIM: To share learning about the challenges encountered when face-to-face interviews could not continue as planned in a study and how to adapt data collection so that it can continue despite severe disruption. DISCUSSION: This article examines the considerations and actions taken by the authors to ensure the continuity of data collection. The research aimed to use narrative inquiry to understand the experiences of significant others supporting people in intensive care units with severe burn injuries. But the pandemic meant the researchers could not meet face-to-face with participants as originally intended and so they had to consider new ways to approach data collection. The authors explore the process of adapting the interviews to video conferencing and telephone use while preserving the study's person-centred focus to remain coherent with narrative methodology. CONCLUSION: Adapting data collection is valuable in ensuring the continuity of research. Careful consideration and planning are required to ensure the research remains robust and ethically sound. IMPLICATIONS FOR PRACTICE: Adapting data collection methods can allow for greater flexibility when participants cannot attend face-to-face interviews.

A systematic review of the effects of gut microbiota depletion on social and anxiety-related behaviours in adult rodents: Implications for translational research.

The microbiota-gut-brain axis is associated with several behaviours, including those relevant to anxiety or sociability in rodents, however, no conceptual framework has yet been available. Summary of the effects of antibiotic-mediated gut microbiota depletion on anxiety and sociability is essential to both inform further preclinical investigations and to guide translational research into human studies. The main objective is to examine the role of gut microbiota depletion on anxiety and sociability in rodents, and to consider how the findings can be translated to inform the design of research in humans. We reviewed 13 research articles, indicating significant changes in gut microbiota composition and diversity have been found in animals treated with a mix or a single antibiotic. Nonetheless, there is no consensus regarding the impact of gut microbiota depletion on anxiety-like or social behaviour. Gut microbiota depletion may be a useful strategy to examine the role of gut microbes in anxiety and sociability, but the lack of data from rigorous animal investigations precludes any definitive interpretations for a translational impact on human health.

False memories for true and false vaccination information form in line with pre-existing vaccine opinions.

Misinformation continually threatens efforts to control the COVID-19 pandemic, with vaccine misinformation now a key concern. False memories for misinformation can influence behavioural intentions, yet little is known about the factors affecting (false) memories for vaccine-related news items. Across two experiments (total n = 1481), this paper explores the effects of pre-existing vaccine opinions on reported memories for true and false news items. In Study 1, participants (n = 817) were exposed to fabricated pro- or anti-vaccine news items, and then asked if they have a memory of this news event having occurred. In Study 2, participants (n = 646) viewed true pro- or anti-vaccine news items. News items were more likely to be remembered when they aligned with participants' pre-existing vaccine beliefs, with stronger effects for pro-vaccine information. We conclude by encouraging researchers to consider the role of attitudinal bias when developing interventions to reduce susceptibility to misinformation.

Measuring the effects of misinformation exposure and beliefs on behavioural intentions: a COVID-19 vaccination study.

Misinformation has been a pressing issue since the beginning of the COVID-19 pandemic, threatening our ability to effectively act on the crisis. Nevertheless, little is known about the actual effects of fake news on behavioural intentions. Does exposure to or belief in misinformation about COVID-19 vaccines affect people's intentions to receive such a vaccine? This paper attempts to address this question via three preregistered experiments (N = 3463). In Study 1, participants (n = 1269) were exposed to fabricated pro- or anti-vaccine information or to neutral true information, and then asked about their intentions to get vaccinated. In Study 2, participants (n = 646) were exposed to true pro- and anti-vaccine information, while Study 3 (n = 1548) experimentally manipulated beliefs in novel misinformation about COVID-19 vaccines by increasing exposure to the information. The results of these three studies showed that exposure to false information about the vaccines had little effect on participants' intentions to get vaccinated, even when multiple exposures led them to believe the headlines to be more accurate. An exploratory meta-analysis of studies 1 and 3, with a combined sample size of 2683, showed that exposure to false information both supporting and opposing COVID-19 vaccines actually increased vaccination intentions, though the effect size was very small. We conclude by cautioning researchers against equating exposure to misinformation or perceived accuracy of false news with actual behaviours.

Investigating false memories among "winners" and "losers" in the prisoner's dilemma.

Many legal cases hinge on evaluating the veracity of two versions of events ("he said, she said"). Expert witnesses are often called upon to testify on the malleability of memory, most often testifying for the defence. This may lead to the theoretically unfounded assumption that it is only victims who are vulnerable to distorted memories of a crime. Inspired by this question, we conducted a series of five experiments in which 2010 participants played a novel version of the Prisoner's Dilemma. Participants could either betray their partner in the game ("winners") or be betrayed by their partner ("losers"). We exposed participants to misinformation concerning the other player's statements to assess whether winners and losers may be differentially susceptible to false memories of the event in question. Across our experiments, including where real financial rewards were at stake, we found that winners were just as susceptible as losers to memory distortion. We highlight the need to consider the possibility of faulty memory affecting all parties to in legal cases, though further research is needed beyond this highly artificial paradigm.

Being tied down-The experience of being physically restrained while mechanically ventilated in ICU.

AIMS: To explore the experience of physical restraints during mechanical ventilation in intensive care from the perspectives of patients and family members. DESIGN: This research was a qualitative study with a naturalistic inquiry framework adhering to the Consolidated Criteria for Reporting Qualitative Research guidelines. METHOD: In-depth, semi-structured conversations were conducted with five patients and six family members who had either personally experienced or witnessed their loved ones being physically restrained during mechanical ventilation in intensive care. Data collection occurred between March 2018 and June 2019. These conversations were audio-recorded and transcribed. Reflexive thematic analysis was used to analyse the data. RESULTS: Three major themes emerged from the data. These themes were: Being tied down; Feeling helpless; and Finding light in the darkness. CONCLUSION: The experience of physical restraints during mechanical ventilation in intensive care leads to traumatic experiences which can impact patients and families long after their ICU stay. Holistic care, which considers the physical, emotional and psychological needs of patients and families, should be more thoroughly explored when managing treatment interference to minimize harm. IMPACT: This study gained insight into the physical, emotional and psychological consequences of applying physical restraints to patients who are mechanically ventilated as an intervention for preventing treatment interference. The findings of this study have the potential to improve ICU patient and family outcomes by influencing current physical restraint practices. Recommendations from this research can contribute to practice change by informing policy, shifting workplace culture and norms about restraints, and encouraging education and training.

A scoping review: Treatment attitudes and adherence for adults with schizophrenia.

AIM AND OBJECTIVES: This scoping review presents an exploration of literature on the relationship between treatment attitudes and adherence in adults experiencing schizophrenia. BACKGROUND: Strategies to address adherence and improve treatment outcomes are described in literature. However, adherence remains a challenge for people experiencing mental illness in practice. Transformational frameworks, evidence-based practice and patient-centred approaches have been established and implemented but non-adherence incidence rates continue to rise among people with schizophrenia. Moreover, the relationship between treatment attitudes and adherence in adults diagnosed with schizophrenia remains unclear. DESIGN: A scoping review using the framework offered by Implementation Science, 5, 2010, 1. The PRISMA-ScR checklist was used to ensure integrity of the review. METHODS: Four databases PsychINFO, Medline, Cochrane and CINAHL databases were searched for literature along with the reference lists of eligible sources. Original research, peer-reviewed articles published between 2010 and 2020 in English language were included. Articles were included if study participants were adults with a diagnosis of schizophrenia or related psychosis. Methodological quality was evaluated using a quality assessment checklist, the Critical Appraisal Skills Programme tool. RESULTS: Ten articles were included in the study. Five main themes about treatment adherence emerged from the literature: (i) severity of symptoms, (ii) side effects, (iii) beliefs and attitudes, (iv) insight and (v) support and relationships. CONCLUSIONS: This scoping review concluded that attitude influenced adherence to medication in people with schizophrenia. The five main themes reported directly influenced attitude, impacting on treatment adherence in people experiencing schizophrenia. This review makes recommendations for a person-centred and recovery framework that aims to improve adherence. RELEVANCE TO CLINICAL PRACTICE: Nurses in all healthcare settings could use evidence-based strategies to enhance treatment adherence in people with a range of physical and mental health conditions.