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

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

The mental health impact of COVID-19 on pre-registration nursing students in Australia: Findings from a national cross-sectional study.

AIM: The study aimed to measure and describe the mental health impact of COVID-19 on Australian pre-registration nursing students. BACKGROUND: The COVID -19 pandemic has had a swift and significant impact on nursing students across the globe. The pandemic was the catalyst for the closure of schools and universities across many countries. This necessary measure caused additional stressors for many students, including nursing students, leading to uncertainty and anxiety. There is limited evidence available to identify the mental health impact of COVID-19 on Australian pre-registration nursing students currently. DESIGN: A cross-sectional study was conducted across 12 Australian universities. METHODS: Using an anonymous, online survey students provided demographic data and self-reported their stress, anxiety, resilience, coping strategies, mental health and exposure to COVID-19. Students' stress, anxiety, resilience, coping strategies and mental health were assessed using the Impact of Event Scale-Revised, the Coronavirus Anxiety Scale, the Brief Resilience Scale, the Brief Cope and the DASS-21. Descriptive and regression analyses were conducted to investigate whether stress, anxiety, resilience and coping strategies explained variance in mental health impact. Ethical Approval was obtained from the University of New England Human Research Ethics Committee (No: HE20-188). All participating universities obtained reciprocal approval. RESULTS: Of the 516 students who completed the survey over half (n = 300, 58.1%) reported mental health concerns and most students (n = 469, 90.9%) reported being impacted by COVID-19. Close to half of students (n = 255, 49.4%) reported signs of post-traumatic stress disorder. Mental health impact was influenced by students' year level and history of mental health issues, where a history of mental health and a higher year level were both associated with greater mental health impacts. Students experienced considerable disruption to their learning due to COVID-19 restrictions which exacerbated students' distress and anxiety. Students coped with COVID-19 through focusing on their problems and using strategies to regulate their emotions and adapt to stressors. CONCLUSION: The COVID-19 pandemic has considerably impacted pre-registration nursing students' mental health. Strategies to support nursing students manage their mental health are vital to assist them through the ongoing pandemic and safeguard the recruitment and retention of the future nursing workforce. IMPACT STATEMENT: This study adds an Australian understanding to the international evidence that indicates student nurses experienced a range of negative psychosocial outcomes during COVID-19. In this study, we found that students with a pre-existing mental health issue and final-year students were most affected. The changes to education in Australian universities related to COVID-19 has caused distress for many nursing students. Australian nursing academics/educators and health service staff need to take heed of these results as these students prepare for entry into the nursing workforce. PATIENT OR PUBLIC INVOLVEMENT: The study was designed to explore the impact of COVID-19 on the mental health of undergraduate nursing students in Australia. Educators from several universities were involved in the design and conduct of the study. However, the study did not include input from the public or the intended participants.

Covid-19 en la Región de las Américas.

No disponible.

The reflective risk assessment model of professional quality of life in Chinese nurses.

AIM: To apply the reflective risk assessment model in a Chinese health care setting to investigate the relationships between professional quality of life and mental health risk profiles. BACKGROUND: Few studies have connected the quality of work life with contributing and coexisting factors such as depression, anxiety and stress, but none to date in a Chinese health care setting. METHOD: A cross-sectional survey of 950 registered Chinese nurses was employed. RESULTS: 299 of 861 participants (34.7%) were categorized into four of five professional quality of life risk profiles, consistent with the reflective risk assessment model. Significant differences were seen with large-sized effects in the mean scores of stress, anxiety and depression among the participants, with participants of the very distressed profile having significantly higher mean scores in stress, anxiety and depression, followed by the at-risk profile group. CONCLUSION: The reflective risk assessment model and professional quality of life five risk profiles are supported by this study. IMPLICATIONS FOR NURSING MANAGEMENT: The reflective risk assessment model can be used to detect risk factors for mental health in nurses and for the design of interventions that promote nurses' mental health.

Injuries and alcohol management plans in remote Indigenous communities: a two-community comparison.

To curb high rates of alcohol-related violence and injury in Indigenous communities, alcohol management plans (AMPs) were implemented in 2002-2003 and tightened in 2008. This project compares injury presentations and alcohol involvement from two Indigenous Cape York communities, one that entered full prohibition and one that did not. Aclinical file audit was performed for the period 2006-2011, capturing changes in alcohol availability. Medical files were searched for injury presentation documenting type of injury, cause of injury (including alcohol), date of injury and outcomes of all presenting injuries for the time period 1 January 2006 to 31 December 2011, capturing the major changes of the 2008 AMP restrictions. Findings indicated injury presentation rates were higher in both communities before prohibition than afterwards andreduction was more pronounced in community 2 (prohibition). Ongoing research is imperative, as this area is characterised by a near-absence of evidence.

Alcohol management plans in Aboriginal and Torres Strait Islander (Indigenous) Australian communities in Queensland: community residents have experienced favourable impacts but also suffered unfavourable ones.

BACKGROUND: In Australia, 'Alcohol Management Plans' (AMPs) provide the policy infrastructure for State and Commonwealth Governments to address problematic alcohol use among Aboriginal and Torres Strait Islanders. We report community residents' experiences of AMPs in 10 of Queensland's 15 remote Indigenous communities. METHODS: This cross-sectional study used a two-stage sampling strategy: N = 1211; 588 (48%) males, 623 (52%) females aged ≥18 years in 10 communities. Seven propositions about 'favourable' impacts and seven about 'unfavourable' impacts were developed from semi-structured interviews. For each proposition, one-sample tests of proportions examined participant agreement and multivariable binary logistic regressions assessed influences of gender, age (18-24, 25-44, 45-64, ≥65 years), residence (≥6 years), current drinking and Indigenous status. Confirmatory factor analyses estimated scale reliability (ρ), item loadings and covariances. RESULTS: Slim majorities agreed that: AMPs reduced violence (53%, p = 0.024); community a better place to live (54%, 0.012); and children were safer (56%, p < 0.001). More agreed that: school attendance improved (66%, p < 0.001); and awareness of alcohol's harms increased (71%, p < 0.001). Participants were equivocal about improved personal safety (53%, p = 0.097) and reduced violence against women (49%, p = 0.362). The seven 'favourable' items reliably summarized participants' experiences of reduced violence and improved community amenity (ρ = 0.90). Stronger agreement was found for six 'unfavourable' items: alcohol availability not reduced (58%, p < 0.001); drinking not reduced (56%, p < 0.001)); cannabis use increased (69%, p < 0.001); more binge drinking (73%, p < 0.001); discrimination experienced (77%, p < 0.001); increased fines, convictions and criminal records for breaching restrictions (90%, p < 0.001). Participants were equivocal (51% agreed, p = 0.365) that police could enforce restrictions effectively. 'Unfavourable' items were not reliably reflected in one group (ρ = 0.48) but in: i) alcohol availability and consumption not reduced and ii) criminalization and discrimination. In logistic regressions, longer-term (≥ 6 years) residents more likely agreed that violence against women had reduced and that personal safety had improved but also that criminalization and binge drinking had increased. Younger people disagreed that their community was a better place to live and strongly agreed about discrimination. Current drinkers' views differed little from the sample overall. CONCLUSIONS: The present Government review provides an opportunity to reinforce 'favourable' outcomes while targeting: illicit alcohol, treatment and diversion services and reconciliation of criminalization and discrimination issues.

Preregistration student nurses' self-reported preparedness for practice before and after the introduction of a capstone subject.

AIMS AND OBJECTIVES: To assess changes in perceptions of confidence and preparedness for practice of preregistration nursing students before and after the introduction of a capstone subject, and factors associated with perceptions of preparedness. BACKGROUND: Preregistration nursing student 'readiness' or 'preparedness' for practice has been highlighted in the literature in recent years, along with employer concerns that university graduate nurses are not work ready. Few studies have examined Australian preregistration nursing students' perceptions of preparedness for clinical practice following their final clinical placement or assessed whether preregistration student nurses' perceptions of preparedness change as the result of undertaking a capstone subject. DESIGN: A capstone subject was introduced at a regional northern Australian university in 2013. Perceptions of preparedness were assessed in two different cohorts of final year nursing students; one of which undertook a capstone subject. METHODS: Two separate cohorts of third year nursing students were surveyed regarding their perceptions of preparedness for practice at the conclusion of their final 240 hour clinical placement. The 2012 cohort did not experience a capstone subject, whereas the 2013 cohort were the first nursing students to experience the new capstone subject. RESULTS: Both cohorts were uncomfortable performing invasive procedures and reported low levels of confidence in the area of professional identity. An overall trend of decreasing confidence as patient assignment size increased was observed for both cohorts, and higher confidence was associated with previous health care experience. Perceptions of preparedness for practice did not increase significantly following the introduction of a capstone subject. CONCLUSIONS: Although Australian undergraduate nursing student report feeling prepared for practice there are areas of knowledge, skills and patient care in which confidence is low. The results of this study highlight the importance of experience in building confidence and competence. RELEVANCE TO CLINICAL PRACTICE: This study highlights that while final year nursing students report feeling prepared for practice there are areas where additional support can be provided. It is recommended that nurse educators and health care facilities tailor their programs to provide support focused on the areas highlighted by this study.

Post-traumatic stress disorder among survivors two years after the 2010 Mount Merapi volcano eruption: A survey study.

The Mount Merapi volcanic eruption in October 2010 was one of Indonesia's largest and most recent natural disasters. A cross-sectional study was undertaken to measure the psychosocial impact of the eruption on survivors in two locations in Yogyakarta, Java, Indonesia. The Impact of Event Scale Revised was used to assess participants' symptoms of post-traumatic stress disorder. Post-Traumatic Stress Disorder responses and demographic characteristics were compared in both locations by conducting bivariate analysis using Mann-Whitney and t tests. The relative contributions of demographic variables and psychosocial impact were examined using multiple linear regression analyses. Two years after the eruption, survivors from the area closest to the eruption had significantly higher Impact of Event Scale Revised scores than those in the comparison area. In particular, females, adults between the ages of 18 and 59, and people who owned their own home experienced the highest levels of psychosocial impact. Nurses and other health professionals need to be aware of the impact of natural disasters on survivors and develop interventions to help people adjust to the psychosocial impact of these events.

Cross-sectional survey of the disaster preparedness of nurses across the Asia-Pacific region.

Healthcare workers who have received disaster preparedness education are more likely to report a greater understanding of disaster preparedness. However, research indicates that current nursing curricula do not adequately prepare nurses to respond to disasters. This is the first study to assess Asia-Pacific nurses' perceptions about their level of disaster knowledge, skills, and preparedness. A cross-sectional survey was conducted with 757 hospital and community nurses in seven Asia-Pacific countries. Data were collected using the modified Disaster Preparedness Evaluation Tool. Participants were found to have overall low-to-moderate levels of disaster knowledge, skills and preparedness, wherein important gaps were identified. A majority of the variance in disaster preparedness scores was located at the level of the individual respondent, not linked to countries or institutions. Multilevel random effects modelling identified disaster experience and education as significant factors of positive perceptions of disaster knowledge, skills, and management. The first step toward disaster preparedness is to ensure frontline health workers are able to respond effectively to disaster events. The outcomes of this study have important policy and education implications.

Psychosocial and environmental distress resulting from a volcanic eruption: Study protocol.

AIM: To examine the psychosocial and environmental distress resulting from the 2010 eruption of the Merapi volcano and explore the experience of living in an environment damaged by a volcanic eruption. BACKGROUND: Natural disasters cause psychosocial responses in survivors. While volcanic eruptions are an example of a natural disaster, little is currently known about the psychosocial impact on survivors. Volcanic eruptions also cause degradation of the environment, which is linked to environmental distress. However, little is currently known of this phenomenon. DESIGN: An explanatory mixed method study. METHODS: The research will be divided into three phases. The first phase will involve instrument modification, translation and testing. The second phase will involve a survey to a larger sample using the modified and tested questionnaire. The third phase will involve the collection of interviews from a sub set of the same participants as the second phase. DISCUSSION: Quantitative data will be analyzed to determine the extent of psychosocial and environmental distress experienced by the participants. Qualitative data will be analyzed to explain the variation among the participants. The results of the study will be used to develop strategies to support survivors in the future and to help ameliorate distress.

Undergraduate student nurses' self-reported preparedness for practice.

BACKGROUND: Tertiary nurse education programmes aim to produce novice nurses able to meet the Nursing and Midwifery Board of Australia competency standards for registration. On the other hand, employers expect graduate nurses to not only be competent and able to function safely and independently but also to be ready to "hit the ground running" in relation to providing clinical care. AIMS: The study aimed to explore the perceptions of third-year nursing students enrolled in their final semester with regard to their preparedness for practice. METHOD: Following their last clinical placement, all third-year nursing students at a regional northern Australian university were emailed a link to an online version of the Casey-Fink Readiness for Practice Survey tool and invited to participate in the study. A total of 113 questionnaires were completed from the sample of 235, giving a response rate of 48%. RESULTS: The majority of students reported feeling prepared for practice and felt that simulation experiences were helpful in attaining this state. Confidence in caring for multiple patients was inversely associated with age indicating higher levels of confidence in younger nursing students. Expanded placements, increased use of simulation for clinical skills practice, smaller clinical skills class sizes and modern equipment were identified as areas for improvement to facilitate and enhance students' levels of confidence and readiness for practice. CONCLUSIONS: Students in this study highly valued clinical placements as a method of increasing their levels of perceived preparedness to practice independently after graduation. Caring for multiple patients involves a high level of complexity and a learning curve is indicated in which confidence and competence is likely to grow with experience.

Study protocol--resilience in individuals and families coping with the impacts of alcohol related injuries in remote indigenous communities: a mixed method study.

BACKGROUND: Alcohol Management Plans (AMPs) were first implemented by the Queensland Government a decade ago (2002-03). In 2008, further stringent controls were implemented and alcohol was effectively prohibited in some of the affected remote Indigenous communities. With the Queensland Government currently reviewing AMPs, prohibitions may be lifted making alcohol readily available once more in these communities. As yet no work explores the impact of alcohol related injuries in relation to individual, family and community resilience in Indigenous Australians. A resilience model recognises individuals and families for their strengths rather than their deficits. By revealing how some individuals and families survive and thrive, new ways of working with families who need support may be identified and adopted. The research will explore in detail the long-term impact of this kind of injury on individuals, families and communities. METHODS/DESIGN: This project will use a sequential explanatory mixed method design. Four discrete Indigenous communities in Cape York, far north Queensland are included in this program of research, chosen because there is previous data available regarding injury and alcohol related injuries. Four sequential studies will be conducted in order to address the research questions and provide a rich description of the impact of alcohol related injuries and resilience in these populations. The time period January 2006 to December 2011 was chosen because it captures the three years before and three years after 2008 when tight alcohol restrictions were implemented in the four communities. DISCUSSION: Long term effects of the AMPs are as yet unknown and only fragmented attempts to look at the impact of injury related to alcohol have been conducted. A well-structured research program that explores the long-term impact of alcohol related injuries in these communities will help inform policy development to capture the current situation and so that appropriate benchmarking can occur.The project has been approved by the James Cook University Human Research Ethics Committee H5618 & H5241.

Study Protocol--Alcohol Management Plans (AMPs) in remote indigenous communities in Queensland: their impacts on injury, violence, health and social indicators and their cost-effectiveness.

BACKGROUND: In 2002/03 the Queensland Government responded to high rates of alcohol-related harm in discrete Indigenous communities by implementing alcohol management plans (AMPs), designed to include supply and harm reduction and treatment measures. Tighter alcohol supply and carriage restrictions followed in 2008 following indications of reductions in violence and injury. Despite the plans being in place for over a decade, no comprehensive independent review has assessed to what level the designed aims were achieved and what effect the plans have had on Indigenous community residents and service providers. This study will describe the long-term impacts on important health, economic and social outcomes of Queensland's AMPs. METHODS/DESIGN: The project has two main studies, 1) outcome evaluation using de-identified epidemiological data on injury, violence and other health and social indicators for across Queensland, including de-identified databases compiled from relevant routinely-available administrative data sets, and 2) a process evaluation to map the nature, timing and content of intervention components targeting alcohol. Process evaluation will also be used to assess the fidelity with which the designed intervention components have been implemented, their uptake and community responses to them and their perceived impacts on alcohol supply and consumption, injury, violence and community health. Interviews and focus groups with Indigenous residents and service providers will be used. The study will be conducted in all 24 of Queensland's Indigenous communities affected by alcohol management plans. DISCUSSION: This evaluation will report on the impacts of the original aims for AMPs, what impact they have had on Indigenous residents and service providers. A central outcome will be the establishment of relevant databases describing the parameters of the changes seen. This will permit comprehensive and rigorous surveillance systems to be put in place and provided to communities empowering them with the best credible evidence to judge future policy and program requirements for themselves. The project will inform impending alcohol policy and program adjustments in Queensland and other Australian jurisdictions.The project has been approved by the James Cook University Human Research Ethics Committee (approval number H4967 & H5241).

The psychosocial impact of natural disasters among adult survivors: an integrative review.

The aim of this review was to identify the psychosocial impact of natural disasters on adult (over the age of 18 years) survivors. Databases searched included PsycInfo, CINAHL, Proquest, Ovid SP, Scopus, and Science Direct. The search was limited to articles written in English and published between 2002 and 2012. A total of 1,642 abstracts and articles were obtained during the first search; 39 articles were retained. The results indicate that PTSD is the most-studied psychosocial impact after a disaster. Mental health nurses have a significant role to play in supporting survivors and can assist with the development of resilience in community members.

Preparedness for and impact of tropical cyclone Yasi in North Queensland, Australia.

INTRODUCTION: Tropical cyclone (TC) Yasi, thought to be the largest and most severe cyclone to cross the Queensland coast since 1918, made landfall on the southern tropical coast near Mission Beach and continued to track westward across Northern Queensland on February 3, 2011. The warning and response model (WRM) suggests that situational factors, personal characteristics, and social contextual variables influence the degree of threat perceived and protective actions taken. Aim The aim of this study was to examine preparation for this impending natural disaster by residents of the affected regions, and to identify the residents' resource losses and symptoms of psychological distress following TC Yasi. METHODS: A cross-sectional survey was conducted 6-12 months after the cyclone using an adapted tool designed to measure preparedness, loss and psychosocial distress. Four hundred and thirty-three responses were received. Statistical analysis was conducted using Statistical Package for the Social Sciences (SPSS). Categorical characteristics were described using sample size and percentages. RESULTS: Almost all respondents perceived the cyclone warning as serious or very serious, and more than a third started preparing for the cyclone at least three days before it reached landfall. Overall, 115 (26.7%) respondents reported moderate and 59 (13.7%) reported major property damage; 72 (17.1%) reported a moderate and 49 (11.6%) reported a major change in their feeling of whether they have control over their life; 55 (13.1%) reported a major change in their motivation of getting things done; and 33 (7.9%) reported a major change in their perception of feeling valuable to others. Overall, 142 (34.1%) documented at least one of five symptoms of acute distress. CONCLUSION: The findings document the experiences of Australians who have lived through tropical cyclone Yasi. The results support the WRM theory which proposes that people with previous experience take threatened disasters seriously.

Motivations to nurse: an exploration of what motivates students in Pacific Island countries to enter nursing.

The aim of this study was to explore the motivations of student nurses enrolled in nursing courses across a variety of Pacific Island countries. The image of nursing, the desire to help others, family and friends in the profession, personal experience, security, travel opportunities and flexibility have all been identified as motivators for people to enter nursing. To date, what motivates students in Pacific Island countries to enrol in a nursing course has not been investigated. An exploratory qualitative approach using focus group interviews with 152 nursing students was undertaken. Data were analysed using thematic content analysis, revealing four themes: (i) helping others; (ii) 'making a difference for my people'; (iii) following in the footsteps of others; and (iv) financial and professional gain. In a time of health and nursing workforce shortages, developing a deeper understanding of what drives people can be used to improve recruitment strategies in the future.

Accidental insider: living the PhD study.

This paper explores the concept of 'insider' and 'outsider' and the challenges involved in conducting research when the researches finds themself living the phenomenon under study. Recent literature has been drawn on to explain the context of the 'insider' and 'outsider' in regard to the stance of the researcher. This is followed by an overview of the personal experiences of the author. The advantages and disadvantages of being an insider within the context of the phenomenon of study are discussed along with the challenges and implications for a researcher 'living their PhD research'.

The meaning of resilience to persons living with chronic pain: an interpretive qualitative inquiry.

AIM: The purpose of this study was to explore the meaning of resilience, or adaptation in the face of adversity, to people living with chronic pain. BACKGROUND: Little research on the usefulness of resilience, strength-based approach to health care has been undertaken to date in the area of pain yet this approach has recently been proposed as a new model for chronic pain management. However, the meaning of resilience to people with chronic pain remains unknown. DESIGN: An interpretive qualitative design using in-depth interviews and phenomenological type analysis was undertaken. METHODS: Purposive sampling and in-depth interviewing were undertaken to develop a rich description of the experience. RESULTS: The findings from this study revealed that while living with chronic pain is generally a negative experience, the participants also told positive stories around the following themes: (i) Recognising individual strength; (ii) Looking for the positives in life; (iii) Accepting the pain; and (iv) Learning to accept help. CONCLUSION: Chronic pain influences all aspects of life. Resilient individuals with chronic pain recognise the value of remaining positive, accepting help and learning to live with the pain. RELEVANCE TO CLINICAL PRACTICE: It is important for health professionals to recognise the role of supporting positive attributes in people living with chronic pain as a way of enhancing resilience.

Chronic pain and the family: the experience of the partners of people living with chronic pain.

AIMS AND OBJECTIVES: The purpose of this study was to explore the impact of chronic pain on the partner and family of a person with chronic pain. BACKGROUND: Chronic pain impacts not only on the individual but also their partner and/or other family members. Families of people with chronic pain have reported feeling powerless, alienated, emotionally distressed, and isolated. These impacts have affected their relationship with the person with chronic pain. DESIGN: An interpretive qualitative design using in-depth interviews and thematic analysis was undertaken. METHODS: Purposive sampling and in-depth interviewing were undertaken to develop a rich description of the experience. RESULTS: Findings indicate the impact of chronic pain on the family is extensive, resulting in physical, social, and emotional changes. Four themes were revealed: (1) Family loss, (2) Life changes, (3) Emotional impact of pain, and (4) Future plans. CONCLUSION: This study reinforces and expands current knowledge regarding the impact of chronic pain on partners and families. Understanding this phenomenon opens opportunities for nurses and other health workers to develop and implement strategies to better support partners/families in the future. RELEVANCE TO CLINICAL PRACTICE: Nurses can help reduce the negative impact of pain by including families in assessment, education, referral and treatment processes, and by offering support and education to partners/families.