ABSTRACT Aim To examine how nurses maintained and reconfigured boundaries between work and home in order to protect themselves and their families during the pre‐vaccination phase of the COVID‐19 pandemic. Design A qualitative descriptive study using a cross‐sectional online survey with open‐ended questions. Method A self‐designed online survey was conducted between October 2020 and February 2021 with a sample of nurses. Qualitative data from open‐ended survey responses were analysed using thematic analysis then deductively mapped onto the theories of boundary maintenance, spillover and crossover. Results A total of 69 nurses participated in this study, drawn from hospital, aged care, general practice and community settings, with ages ranging from 18 to 74 years. Five themes were identified: stress and work intensification; confusion arising from rapidly changing guidelines; resource constraints; anger and resentment towards colleagues able to work remotely; and deliberate strategies to protect family members from infection. The final two themes highlight how nurses actively constructed new physical, emotional and symbolic boundaries between work and home in response to the perceived risks of viral transmission. Conclusion Prior to vaccination, nurses created their own infection control rituals at home to shield their families, revealing how professional knowledge spilled into domestic life, becoming an extension to nurses' work. These critical boundary practices often remained unseen but are vital to frontline nursing labour work during an infection‐control crisis. Understanding and recognising these early responses provides valuable insight for future pandemic preparedness, workforce support and infection prevention policy. Patient or Public Contribution No patient or public contribution.

AIM:To understand how Registered Nurses perceive the impact of nursing leadership on managing moral distress and mitigating burnout. BACKGROUND:Moral distress and burnout are pervasive issues in nursing, compromising well-being, patient safety and workforce sustainability. Leadership is a critical factor in shaping workplace culture and mitigating these challenges, yet evidence remains limited. DESIGN:Qualitative systematic review. METHODS:A qualitative systematic review was conducted following JBI methodology and PRISMA guidelines. Comprehensive searches across MEDLINE, PsycINFO, Embase, CINAHL and Scopus identified 5927 articles, with two studies meeting the inclusion criteria. Data were appraised using the JBI Critical Appraisal Checklist and synthesised via meta-aggregation. Confidence in findings was assessed using the ConQual approach. RESULTS:Four major themes emerged: (1) Behind the barriers, (2) Breaking point, (3) Weathering the storm and (4) Leadership for lasting change. Leadership influenced nurses' psychological safety, ethical decision-making and resilience. Inadequate support amplified moral distress, and effective strategies included authentic communication, team solidarity and systemic interventions. CONCLUSIONS:Leadership plays a pivotal role in mitigating moral distress and burnout. Evidence highlights the need for structural changes and support to sustain registered nurses' well-being and retention. RELATIVE TO CLINICAL PRACTICE:Findings offer direction for leadership strategies that promote ethical workplaces, shared decision-making and mental health supports to enhance resilience and patient care. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE:Strengthening leadership capability is vital for workforce sustainability, care quality and nurse retention. REPORTING METHOD:Authors have adhered to relevant EQUATOR guidelines. PATIENT OR PUBLIC CONTRIBUTION:This study did not involve patients or the public in its design, conduct or reporting.

Despite extensive conversations about the need for partnerships and ways to work together, barriers remain to practising it and engaging together at the cultural interface in Australian remote Aboriginal communities. Based on a project that explored building community-based approaches for youth in remote Aboriginal communities and drawing on community-based participatory research and the Indigenous method of Yarning, this article identifies barriers towards engagement at the cultural interface. One of the major barriers is the limited capacity of outside service providers to engage at the cultural interface, in building trusted relationships with community members that recognise, understand and make room for Indigenous worldviews unique to the community. This level of engagement is essential in providing a ‘both ways’ learning model. The recommendations from community members suggest that interactions at the cultural interface can only be achieved when trusted outsiders work flexibly and relationally alongside them. By working in this way, people at all levels of government are essentially getting alongside, supporting, equipping and building community-based solutions.

BACKGROUND AND OBJECTIVES:General practice nurses (GPNs) work with a varied scope of practice alongside general medical practitioners. The aim of this study is to identify generational differences among GPNs in work satisfaction, intention to stay and the pursuit of further education. METHOD:Data from 1427 GPNs were obtained from the 2023 cross-sectional Australian Primary Health Care Nurses' Association Workforce Survey. Data were stratified by three generational age groups: Veterans/ Baby Boomers, Generation (Gen) X and Gen Y/Z. RESULTS:Nurses from all three age groups reported overall satisfaction with their current positions. Gen X and Gen Y/Z were more highly educated and more likely to seek further education and to remain in general practice over the next 5 years when compared with Veterans/Baby Boomers. DISCUSSION:In light of recent federal directives for primary care, these results provide information for policy directions that may encourage younger nurses to stay in general practice and increase interdisciplinary care.

BACKGROUND:Early childhood plays a vital role in long-term outcomes such as health, learning, behaviour and wellbeing. Evidence shows that developmental screening of children aged 0-5 years is currently inadequate and understanding of key factors influencing child development in the years before school remain limited. This study aimed to examine the associations between a child's age, gender, family background, remoteness of residence, community socio-economic level and developmental status. METHODS:This study analysed data from a Paediatric Nurse Practitioners and Registered Nurses-led initiative, which offered Child Health Development Checks and referral support, for children attending Australian early learning centres from August 2022 to August 2023. The Brigance Screen III packages were used to do the child development screening, which assessed three domains for children aged 0-2 and five domains for those aged 2-5. Data from 1002 children (convenience sampling with children who attended the early learning centres) were included; univariable and multivariable logistic regression models and chi-square tests were performed. RESULTS:After controlling for other explanatory variables, children aged 2-3, were approximately six times more likely to have developmental concerns in language and self-help domains (p < 0.05, p < 0.001), when compared to children aged 5. Boys were around twice as likely to have developmental concern in academic and self-help domains (p < 0.01). Children from culturally and linguistically diverse backgrounds were approximately two to three times more likely to have developmental concerns in language and social-emotional domains (p < 0.01, p < 0.001). Children living in mid-level socio-economic communities were more than twice as likely to have developmental concerns in academic domains, when compared to children living in most advantaged areas (p < 0.05). CONCLUSIONS:This study suggests that male children, those from culturally and linguistically diverse backgrounds, or children from mid-level socio-economic communities may be at higher risk of experiencing developmental concerns.

General practice nurses (GPNs) are essential members of multidisciplinary primary care teams. Understanding their demographics, career trajectories, and professional challenges is crucial for workforce sustainability. This study examines the demographic characteristics, professional experiences, and career intentions of GPNs in Australia, focusing on workforce sustainability, job satisfaction, and professional development. A cross-sectional survey was conducted among GPNs across Australia. Descriptive analysis, factor analysis, and logistic regression examined demographic trends and professional outcomes. The workforce is aging, with many nearing retirement and an underrepresentation of younger and culturally diverse nurses, including Aboriginal and Torres Strait Islanders. Job satisfaction was moderate, influenced by work-life balance, remuneration, and professional development. Barriers to continuing education included financial constraints and limited institutional support. Logistic regression identified employment status, pay, and professional development as key predictors of job satisfaction and retention. Sustaining the GPN workforce requires strategies to retain experienced nurses, attract younger and diverse entrants, and enhance professional development. Stable funding, an expanded scope of practice, and stronger continuing education support are essential for meeting Australia's evolving primary care needs.

Aim: This study aimed to cross-culturally adapt and test the psychometric properties of the Chinese version of Missed Nursing Care Infection Prevention and Control (MNCIPC-CV).Design: A cross-sectional and psychometric study.Methods: The study adhered to the guidelines for the translation of the original English scale and involved two rounds of correspondence with 16 experts. Data from 483 nurses working at a general hospital were collected and analyzed to evaluate the psychometric properties of the MNCIPC-CV using classical test theory (CTT) and item response theory (IRT).Results: The MNCIPC-CV consists of three subscales and tests for Sub-B/Sub-C. Its Cronbach's alpha was 0.934/0.946. While the majority of scale dimensions and items met the criteria for unidimensionality, stability, and reliability, Items s, r, and v did not meet the fitting index and were removed. Three items, z16, z11, and z10, for gender and four items, s, v, 1, and 20, for education were exited differential item functioning. The final MNCIPC-CV consisted of 36 items in Sub-B and 24 items in Sub-C.Conclusions: This study not only enriches the scientific basis for the revision and application of the MNCIPC-CV but also underscores the significance of employing diverse methodological frameworks in nursing research to ensure rigor and validity.

The death of a resident, caused by another resident in Residential Aged Care Facilities (RACFS) is uncommon, yet under-reported. The perpetrator of the violent act may not be legally culpable, and the act may be unintended; however, media reports suggest that this is an increasing phenomenon. This article reports an integrated review that sought to critically report homicide or an unintentional incident where one resident causes the death of another in RACFs and to explain and understand how older people are supported within and external to RACFs and their under-representation in policy. The search was registered with PROSPERO registration number CRD42023409775. The databases CINHAL ultimate, Cochrane review, Embase, Psych Info, PubMed were searched. Additionally, a grey literature search was conducted of Analysis and Policy Observatory, Google Search, and Trove. Identified themes included: exhibitor and target attributes, incident details, staff and facility experiences, incident reporting and improved resident safety related to un/intentional homicide. From the findings, we extracted two discursive elements: (1) Space and perception of a person living with dementia and unequipped environments and (2) The disregarded deaths in RACFs and other systematic problems. Within RACFs factors, such as unacceptably low staffing numbers, a lack of clinically trained nurses, poorly designed environments and a lack of skills in caring for people who have dementia or mental illness were identified. More emphasis on research into this area is essential. Several key risk factors are identified in this review on the issue of un/intentional homicides in RACFs. There is a need for governments and policy makers to consider different models of care, responsive to the needs of people who live with dementia.

Introduction: Effective self-management is essential for individuals with Type 2 Diabetes Mellitus (T2DM), yet patients in Indonesia often encounter persistent barriers. This study explores patients’ perspectives on the challenges they face as well as the perceived supports available within the primary healthcare system. Methods: A qualitative case study approach, based on Yin’s methodology, was employed. Guided by Habermas’s theory of communicative action and Honneth’s theory of recognition, data were collected through in-depth interviews with 14 patients, 28 clinical observations of patient–provider encounters, and one focus group with five healthcare professionals. Participants were recruited from a suburban primary healthcare center in Indonesia using purposive sampling. Reflexivity and field notes were maintained throughout the data collection process. Data were analyzed using thematic qualitative analysis. Triangulation across data sources helped enhance credibility and trustworthiness. Results: Five key themes emerged: (1) Medical dominance in care provision, (2) Communication gaps, (3) Regulation-centered care, (4) Care quality, and (5) Patient self-empowerment. These themes reveal systemic, structural, and interpersonal barriers that constrain effective diabetes self-management in primary care. Conclusions: Understanding the lived experiences of patients with T2DM is critical to informing practice and policy. To overcome these barriers, a shift toward patient-centered care, improved communication, and more inclusive support systems is essential within Indonesia’s healthcare system.

Aim: To report on the design and results of an innovative nurse practitioner (NP)-led specialist primary care service for children facing housing instability.Background: During 2017-2018, children aged 0-14 years represented 23% of the total population receiving support from specialist homeless services in Australia. The impact of housing instability on Australian children is considerable, resulting in disengagement from social institutions including health and education, and poorer physical and mental health outcomes across the lifespan. Current services fail to adequately address health and educational needs of children facing housing insecurity. Research identifies similar circumstances for children in other high-income countries. This paper outlines the design, and reports on results of, an innovative NP-led primary care service for children facing housing instability introduced into three not-for-profit faith-based services in one Australian state.Methods: Between 2019 and 2021, 66 children of parents experiencing housing instability received standardized health assessment and referral where appropriate by a NP. Data from the standardized tool, such as condition and severity, were recorded to determine common conditions. In addition, comprehensive case notes recorded by the NP were used to understand potential causes of conditions, and referral needs, including potential barriers.Findings: The 66 children assessed were aged between 7 weeks to 16 years. Developmental delay, low immunization rates, and dental caries were the most common conditions identified. Access to appropriate services was inhibited by cost, disengagement, and COVID-19.Conclusion: Given their advanced skills and knowledge, embedding NPs in specialist homeless services is advantageous to help vulnerable children.

[This corrects the article DOI: 10.1016/j.heliyon.2023.e19031.].

Introduction: Moral distress is a phenomenon that is increasing in nursing practice. Many factors can contribute to moral distress such as the quality of leadership, the rationing of care, the skill mix assigned to the unit or failure of leadership to respond to the nurse's patient advocacy. While there is a significant amount of research on moral distress in nurses' fewer studies have focused on the role of leadership in managing the moral distress experienced by Registered Nurses. Objective: To explore the relationship between leadership and moral distress in nursing, to identify the role of leadership in supporting and mitigating moral distress. Inclusion Criteria: Studies published from 2022-November 2024 were included. The populations were Registered Nurses, and the phenomenon of interest is the role of leaders in supporting nurses and mitigating moral distress. Methods: A scoping review using Arksey and O'Malley five-stage framework. Results: From the 2892 records retrieved, 20 met the inclusion criteria. Three themes were identified: (1) Qualities of the manager, (2) Workload and resource management, and (3) Culture and values. Conclusion: Nurse leaders play an important role in supporting nursing staff through distressing events and situations. Nurse managers must display qualities of a good leader, including being authentic and ethical in decision-making. Nurse leaders must work between policy and procedure requirements and the needs of individual staff to support a wider culture of safety and advocacy.

Child maltreatment is a global public health concern. A high percentage of children working in rural informal sectors in Bangladesh experiences physical maltreatment. This area of study, however, remains understudied. The aim of this study was to assess the prevalence and risk factors of physical maltreatment of child laborers in rural Bangladesh. A total of 200 child laborers and parents were recruited in this cross-sectional study. Data were collected using structured questionnaires, including the ICAST-CH and ICAST-P survey tools. Multivariable linear regression was performed using SPSS and STATA software to analyze data. Above 66

Abuse and neglect among child laborers are serious public health concerns. In particular, neglect of child laborers both at home and in the workplace exacerbates their social and health risks. Despite this, the issue continues to be overlooked by researchers and policy makers. In this study, we investigated the prevalence and factors of child labor neglect in rural Bangladesh. Using the snowball sampling method, 200 parents and employers were recruited for this cross-sectional study. We performed a multivariable linear regression analysis using SPSS 28 version. Child laborers are found to be severely neglected, primarily deprived of food and water, and are inadequately supervised. Elements of parental risk, including poor household income (β = 0.07, CI = 0.03, 0.11, p < 0.01) and a history of their own early childhood maltreatment (β = 0.22, CI = 0.07, 0.36, p < 0.01) were identified as significant predictors of neglect among child laborers. Further, child laborers working in agriculture were significantly more likely to experience neglect than those in the domestic sectors.This finding was based on their vulnerable traits, such as working with more than five co-workers (β = 0.08, CI = 0.02, 0.15, p < 0.01), working for extended hours (β = 0.14, CI = 0.01, 0.28, p = 0.04), and suffering from malnutrition (β = 0.30, CI = 0.04, 0.57, p = 0.03). The findings of this study suggest further research on outcome variables are required. Specifically, the study suggests that two intervention strategies could be implemented to alleviate child labor and neglect in Bangladesh, namely financial support programs and amendments to existing policies.

This article explores the concept of resilience from the perspective of Australian Aboriginal and Torres Strait Islander health professionals and practitioners, with the aim of describing what it is and how it is practiced in the workplace. Interviews in the form of Yarns were conducted with ten Aboriginal and Torres Strait Islander health professionals in regional North Queensland. We found that for Aboriginal and Torres Strait Islander health professionals and practitioners, resilience encompasses cultural identity and an ability to manage both Indigenous and western cultures and structures. Resilience, understood as 'Strength', draws on strong relationships to family and Country, often nurtured through strong women, who have overcome intergenerational trauma. For Aboriginal and Torres Strait Islander health professionals and practitioners, resilience is practiced through challenging the existing structural barriers experienced by Aboriginal and Torres Strait Islander clients who must deal with racism and a system not organised to meet their needs. Further research on the relationship between culture and resilience/strength is required.

Extant research has focused more on entry into employment for people with disabilities and less on the reasons why their employment was terminated. As a result, very little is known about the impact of acquired disabilities on employment outcomes. This scoping review outlines the gaps in knowledge on the identification, definition, and characterization of acquired disabilities, and the impact on employment in the Organisation for Economic Co-operation and Development (OECD) countries.1 Peer reviewed literature published between January, 1990 and April 2023 was retrieved and screened between September 10, 2022 and April 16, 2023. A total of 43 papers are included and data was extracted focussing on the representation of acquired disabilities in research, disability models, policy, and the views of employers. The results highlighted that the term, ‘acquired disabilities’ is not clearly identified and defined in the literature. Future research needs to study the impact of acquired disabilities on employment to improve interventions and theoretical frameworks that guide employers, disability service providers, and policy makers.

Background The phenomenon of missed care has received increasing interest over the past decade. Previous studies have used a missed care framework to identify missed nursing tasks, although these have primarily been within the acute care environment. The aim of this research was to identify missed care specific to the role of the general practice nurse. Methods An integrative review method was adopted, using The Mixed Methods Appraisal Tool to assist in a methodological appraisal of both experimental, theoretical, and qualitative studies. Thematic analysis was then used to analyse and present a narrative synthesis of the data. Data sources: CINAHL, SCOPUS, Web of Science and Google Scholar databases were searched between 2011 and 2022 for empirical research that reported missed care and the general practice nurse. Results Of the 787 papers identified, 10 papers met the inclusion criteria. Three themes identified missed care in relation to primary healthcare nurses: under-staffing and resourcing, communication difficulties, and role confusion. Conclusion Isolating missed care by general practice nurses was challenging because much of the research failed to separate out general practice nurses from community and primary health care nurses. This challenge was exacerbated by disparity in the way that a general practice nurse is defined and presented in the various databases. While some themes such as those related to communication and understaffing and resourcing demonstrate some parallels with the acute sector, more research is required to identify missed care specific to the general practice nurse.

Purpose The current study focused on exploring the impact of maltreatment of child laborers on their psychosocial health condition from the views of their parents.Methods A total of 100 parents of child laborers were recruited using snowball sampling. The structured questionnaire comprised two validated scales including ISPCAN Child Abuse Screening Tool (ICAST-P), and Paediatric Symptom Checklist (PSC) were used for the survey. Factor analysis and multivariable linear regression analysis were performed to examine the data using SPSS version 26, and Stata version 16.1.Results A three-factor model consisting of internalizing, externalizing, and attention associated psycho-social impairments of child laborers were derived from the 35-item scale of PSC tool and represented a good fit to the data. A mean estimate of maltreatment indicates that a majority of child laborers are maltreated psychologically, followed by physical maltreatment and neglect. The factor analysis resulted that maltreated child laborers are highly prone to exhibit internalized psycho-social difficulties, followed by externalized and attention-associated emotional and behavioral difficulties among child laborers. The regression model further depicts that child laborers, who had been physically and psychologically maltreated, are significantly more likely to be affected by internalized and attention-related psycho-social impairments.Conclusions The study concluded that victimized child laborers exhibited significant internalized, as well as attention-related problems. These findings may be useful for future studies that examine emotional and behavioral problems among maltreated child laborers and, therefore, for developing prevention strategies.

Older adults are at increased risk of pressure injuries (PIs) due to age-related changes. Traditionally, PI knowledge and education have been delivered in hospitals and residential aged care facilities, however, there remains a critical gap in understanding how PI knowledge on prevention and management is shared with older adults and their carers living in the community. We aimed to describe the nature and characteristics of structured and unstructured PI education programs available to community-dwelling older adults and their carers. As coping review was undertaken. We searched five databases: CINAHL, Medline, Scopus, Cochrane Library and ProQuest from 2009 to August 2023. The review was guided by Arksey and O'Malley's six-step framework and adhered to the PRISMA-ScR guidelines. It included primary peer-reviewed papers published in English, which focus on PI education for older adults and/or their carers living in community settings. Data extraction was organised in a table, and findings presented as a narrative summary. One-hundred and thirty-six papers were screened and four included in the review. Results indicate that consideration was placed on literacy levels and cognitive status of older adults and their carers when designing PI education materials. Educational materials such as leaflets/brochures, in-person training sessions or a combination of both were used. However, duration of these interventions varied, lasting for 1-4 weeks while others were completed over 12 months. Some improvements in PI knowledge such as how to treat PI, dietary requirements and importance of mobility were noted. However, information retention and its translation into effective long-term behaviour change remained unclear. In conclusion, adopting a multifaceted educational approach increases the effectiveness of PI knowledge translation. Continuous education, support and reinforcement on PIs over time are necessary when interacting with older adults and caregivers to ensure long-term management and prevention success. Conversations on PIs should start at the primary care levels when older adults and carers are visiting their GP clinics and accessing support services for other healthcare needs. Understanding older adults' and carers' literacy levels, cognitive status and cultural background can assist clinicians in designing and delivering fit-for-purpose PI educational interventions that are accessible, relatable and effective in promoting knowledge transfer and behaviour change. Carers are vital conduits in the care continuum. These factors will lead to a more informed, collaborative and person-centred approaches to PI management and prevention.

INTRODUCTION:Nurse Navigators were introduced in Queensland, Australia, in 2016. Nurse Navigators coordinate person-centred care, create partnerships, improve care coordination and outcomes and facilitate system improvement, independently of hospital or community models. They navigate across all aspects of hospital and social services, liaising, negotiating and connecting care as needed. People stay with Nurse Navigators for as long as required, though the intent is to transition them from high-care needs to self-management. Nurse Navigators are a working model in rural and remote areas of Queensland.OBJECTIVE:To describe where the rural and remote Nurse Navigator position fits within the Rural Remote Nursing Generalist Framework and to define the depth and breadth of the rural and remote Nurse Navigator's scope of practice.DESIGN:Using template analysis, data from focus groups and interviews were analysed against the domains of the recently released National Rural and Remote Nursing Generalist Framework. Navigators working in rural and remote areas across Queensland Health were invited to an interview (n = 4) or focus group (n = 9), conducted between October 2019 and August 2020.FINDINGS:Rural and remote Nurse Navigators are proficient in all domains of the framework and actively champion for their patients, carers and the communities where they live and work.DISCUSSION:This research demonstrates that rural and remote Nurse Navigators are a working model of advanced nursing practice, acting as 'champions' of The Framework.CONCLUSION:The Nurse Navigator model of care introduced to Queensland exemplifies proficient registered nurse practice to the full extent of their knowledge and skill.