Nurses' experience of managing adults living with multimorbidity: A qualitative study.

BACKGROUND: The number of adults living with two or more chronic conditions is increasing worldwide. Adults living with multimorbidity have complex physical, psychosocial and self-management care needs. AIM: This study aimed to describe Australian nurses' experience of care provision for adults living with multimorbidity, their perceived education needs and future opportunities for nurses in the management of multimorbidity. DESIGN: Qualitative exploratory. METHODS: Nurses providing care to adults living with multimorbidity in any setting were invited to take part in a semi-structured interview in August 2020. Twenty-four registered nurses took part in a semi-structured telephone interview. RESULTS: Three main themes were developed: (1) The care of adults living with multimorbidity requires skilled collaborative and holistic care; (2) nurses' practice in multimorbidity care is evolving; and (3) nurses value education and training in multimorbidity care. CONCLUSION: Nurses recognize the challenge and the need for change in the system to support them to respond to the increasing demands they face. IMPACT: The complexity and prevalence of multimorbidity creates challenges for a healthcare system configured to treat individual disease. Nurses are key in providing care for this population, but little is known about nurses' experiences and perceptions of their role. Nurses believe a person-centred approach is important to address the complex needs of adults living with multimorbidity. Nurses described their role as evolving in response to the growing demand for quality care and believed inter-professional approaches achieve the best outcomes for adults living with multimorbidity. The research has relevance for all healthcare providers seeking to provide effective care for adults living with multimorbidity. Understanding how best to equip and support the workforce to meet the issues and demands of managing the care of adults living with multimorbidity has the potential to improve patient outcomes. PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public contribution. The study only concerned the providers of the service.

Resilience of African migrants: An integrative review.

African migrant women represent a rapidly growing cohort of new arrivals in many countries. Many of these women demonstrate strength and resilience throughout the stressful migration process. In this integrative review, we explore the literature on African migrants' resilience using an ecological framework. Nine peer-reviewed journal articles and six grey literature documents were reviewed. Key internal and external factors in achieving resilience were identified, discussed, and diagrammatically represented using Bronfenbrenner's Ecological Framework under micro-, meso-, exo-, and macro-levels. Our findings show that the capacity for resilience demonstrated during migration could have implications for policy and practice.

Health screening and preventative health care in refugee women: A qualitative analysis.

Background: Regular health screening provides opportunities for early detection and effective treatment of disease. There is underutilisation of health services by migrants from culturally and linguistically diverse backgrounds, particularly refugees in Australia. Aim: To explore the beliefs, understandings, and use of health and healthcare screening services among African refugee women living in Australia. Design/Method: Qualitative secondary analysis. Method: Oral narratives derived from two primary qualitative datasets of Sub-Saharan women in New South Wales, Australia, underwent secondary thematic analysis. Findings: Twenty-two of the forty-two women had refugee status on migrating to Australia. Thematic findings reflection of misinformation, low health literacy, and health screening as not a priority. Conclusions: There is an urgent need to develop innovative strategies to engage refugee migrant women in health screening by provision of culturally meaningful health information. Relevance to clinical practice: Including refugee women's suggestions for information to be provided by health services may improve attitudes towards screening and preventative health care.

Resilience of African migrant women: Implications for mental health practice.

Migrants from areas affected by war, especially refugee migrants, are susceptible to mental health issues. In addition to recognising trauma, health professionals, such as mental health nurses, need to be aware of the strength and resilience of refugees and migrants. The capacity to provide trauma-informed care that is shaped by the recognition of clients' strength and resilience is required/paramount to meet the current demand of multiculturalism emanating from an increased global migration. To facilitate increased awareness about West African women's resilience prior to migration and support trauma-informed care, we used a qualitative strength-based storytelling approach with 22 West African women residing in Sydney, Australia. Thematic analysis of the women's stories identified two major themes: When the World Falls Apart and Battered but Strong. Findings revealed that past personal experiences significantly influenced participants' strength and resilience and contributed to their mental health. Mental health professionals such as nurses can play an important role by incorporating knowledge about the resilience of migrants and refugees into providing appropriate trauma-informed care.

Exploring the diet and lifestyle changes contributing to weight gain among Australian West African women following migration: A qualitative study.

AIMS AND OBJECTIVES: This paper reports on women's experiences of weight gain and obesity as they became acculturated to the Australian diet and lifestyle. BACKGROUND: Migrants from sub-Saharan Africa have a much higher risk of obesity than the native population when settling in industrialised countries. METHOD: Qualitative. RESULTS: Women in this study reported weight gain post-migration. This was attributed to increased access to a wide variety of food including takeaway food and more sedentary lifestyles. CONCLUSIONS: Obesity has long-term consequences for health and well-being. Further research is needed to support a healthy transition to life in Australia. RELEVANCE TO CLINICAL PRACTICE: Gaining insight into the underlying reasons that West African immigrants to Australia become obese could contribute to assisting health professionals design culturally appropriate interventions and health education programmes to support new arrivals.

"Coming to a Strange Land": The West African Migrant Women's Establishment of Home and Family in a New Culture Within Australia.

PURPOSE: Migrating and establishing a new life in another culture can have diverse health effects especially for women. This article explores the struggles and social adjustment issues that might constitute negatively to the health of West African migrant women living in Australia. DESIGN: Qualitative storytelling. Audiotaped voluntary stories from 20 West African migrant women living in Sydney, Australia were transcribed and analyzed. FINDINGS: Three themes are presented for discussion: (1) But it is different here: life in a new country; (2) I have to do it all by myself: communal versus individual living; and (3) They don't listen to parents: perceived threats to the family unit. CONCLUSION/IMPLICATION FOR PRACTICE: The demand for and the importance of nurses and midwives in supporting migrant families is demonstrated by findings suggesting that social adjustment into the Australian culture has a significant impact on both the nuclear and extended family unit of women.