To determine the barriers, benefits, and enablers of acute home-based care in Australia for older people (aged 65 and over). A systematic review for people aged 65 and over receiving acute home-based care in Australia was conducted using various databases (CINAHL, Medline, PsycINFO, SCOPUS, Web of Science, PubMed, Informit) and citation searching in September 2023. The Critical Appraisal Skills Program (CASP) was used to assess the quality of the evidence and a thematic analysis approach was utilized to narratively synthesize results. Ten studies were included, consisting mostly of cohort studies in metropolitan areas. Barriers included inefficacy, patient demographics, and carers. Benefits included efficacy, high satisfaction, and medical management. Enablers included education, holistic assessments, and support interventions. Within the literature there was a significant research gap regarding HITH for older people in rural areas of Australia. Patient outcomes were closely aligned with admission pathways.

Background: Understanding the experiences of patients’ family members witnessing resuscitation helps develop care plans. Accordingly, this study aimed to explore the experiences of witnessing resuscitation among the patients’ family members. Methods: A total of 15 patients’ family members were interviewed over a 4-month period (from April to July 2019). The participants were recruited through purposive sampling, and they were enlisted from three educational hospitals in Tabriz. Data were analyzed using Smith’s interpretative phenomenological analysis (IPA) via the MAXQDA12 software. Results: Data analysis led to the identification of four main themes and nine subthemes. The main themes included "the insistence on being present", "achieving calmness", "partnership and collaboration" and "hindrance". Conclusion: Although family members reported feelings of agitation towards the health professionals, there was also strong evidence of the benefits of witnessing resuscitation such as open communication, psychological support, and facilitating acceptance of the patient’s prognosis. The study highlighted the importance of developing formal policies based on a family-centered care (FCC) approach to observe family presence during resuscitation while maintaining the patient’s and family’s rights.

INTRODUCTION:As the coronavirus disease 2019 pandemic continues globally, the personal and professional pressure on health care workers continues to accumulate. Literature suggests that as the pandemic evolves, nurses are experiencing increased levels of anxiety, depression, and post-traumatic stress, ultimately leading them to voice intentions to leave the profession, if they have not done so already. METHODS:Informed by an interpretive hermeneutic phenomenological approach, this longitudinal study was designed to capture how the lived experiences of 9 emergency nurses evolved over the coronavirus disease 2019 pandemic, highlighting their feelings, attitudes, and perceptions toward working in the emergency department at this time in history. Interviews were undertaken in June 2022 and were analyzed using a thematic analysis approach. RESULTS:Data analysis resulted in a total of 2 major themes and 8 minor themes. The 2 major themes included "exposed wounds" and "Band-Aid solutions." Levels of burnout increased during the pandemic, with most of the emergency nurse participants dropping their hours, moving roles within the profession, or leaving the profession entirely. Findings elucidate where and how concerns may arise in clinical practice and holistic well-being among emergency nurses, particularly surrounding professional boundaries and protecting work-life balance and professional identity. DISCUSSION:As the world moves to managing coronavirus disease 2019 as a recognized common respiratory illness, providing time and space for emergency nurses to voice their concerns, design their well-being interventions, set professional boundaries, and reconnect with their professional passion may see lower attrition rates and higher levels of professional satisfaction in emergency nurses globally.

Background and AimsMore than 70% of current smokers in Australia have a definite plan to stop smoking and around half of them try to quit every year. Latrobe Community Health Service (LCHS) was commissioned by Gippsland Primary Health Network to establish Latrobe Smoking Support Service (LSSS) to break down barriers to accessing services and increase support for smoking cessation. This research aims to assess the feasibility of an ongoing smoking cessation support service and determine the effect the LSSS has on client smoking behavior.MethodsQuantitative data were collected for the LSSS situated at LCHS during the period from September 2021 to March 2022. A new client survey, a returning client survey, and a 6-week follow-up survey were conducted by Clinic staff. The consent forms were obtained from the clients. A total of 117 clients attended the LSSS at least once, and a further 315 returning client sessions were conducted. The data analysis was undertaken by means of various descriptive and inferential statistical techniques, such as multiple linear regression analysis.ResultsThe research findings demonstrate the strong positive effect of the LSSS in helping clients to change their smoking behavior. Results of multiple regression analysis highlight the significant role of behavioral intervention strategies in the LSSS's success. A combination of both nicotine replacement therapy (NRT) and counseling was a key contributor to the project's success.ConclusionThis research proposed and tested the model of a smoking cessation support service that combines a comprehensive mix of services for smokers including free NRT, free counseling, and ongoing support of counselors or/and nurse practitioners.

AIM:This systematic review aims to describe and compare the characteristics of Hospital in the Home (HITH) models of care within Australia. DESIGN:A systematic review of peer-reviewed Australian literature. DATA SOURCES:Seven databases were searched in January 2024, followed by citation searching. Articles were included if they were described the HITH model of care and were published between 1994 and 2024. REVIEW METHODS:Covidence was used to facilitate the removal of duplicates, independent total and abstract screening and full text review. The Critical Appraisal Skills Program (CASP) was used to assess the quality of evidence, and title and abstract screening and full text review were completed by multiple authors. This ensured that all articles met the inclusion criteria and were then assessed, and the final articles were assessed using matrix analysis, and results were presented using narrative synthesis. RESULTS:Ten articles met the inclusion criteria, highlighting three models care; the medical model, the nursing model and the brokerage model. CONCLUSIONS:There is limited research available that includes the model of care and patient outcomes. Future research needs to consider the differences between HITH programs, such as the model of care, admission pathway, utilisation of telehealth and geography of the population. IMPLICATIONS FOR THE PROFESSION:This review may assist Australian HITH health professionals to improve the efficacy of the HITH model of care delivered within their health service and increase translatability of future HITH research. IMPACT:This study highlighted for the first time the models of HITH care utilised within Australia. Three models of care are currently utilised within Australia, this knowledge may assist health services seeking to enhance their HITH model of care and policy writers. REPORTING METHOD:This review adhered to the EQUATOR guidelines, Preferred Reporting Items for Systematic Reviews and Meta-Analysis. PATIENT OR PUBLIC CONTRIBUTION:No patient or public contribution. TRIAL REGISTRATION:Registered with the international prospective register for protocols of systematic reviews in health social care CRD42024500950.

Introduction: Undergraduate nursing students often work part-time or even full-time while studying at university completing their bachelor’s degrees. The aim of this study is to explain the meaning of the lived experiences of nursing students working as students in clinical field. Methods: A phenomenological study was conducted at the nursing and midwifery school of Tabriz, Iran. Purposefully, 20 baccalaureate nursing students with experience working as student worker nurses were recruited. The sample size was determined according to data saturation. Semi-structured, face-to-face interviews were held with the participants over 3 months (April 2020 to June 2020), and Van Manen’s hermeneutic phenomenological approach was used to analyze the data. Results: Five main themes extracted from the data analysis, including "students’ clinical competency", "nurse-student relationships", "shift work", "mislearning", and "chaotic wards". A further 12 sub-themes extracted under the five main themes. Conclusion: The work of nursing students in clinical environments as student worker nurses is a two-dimensional phenomenon with advantages and disadvantages. The benefits are improving the nursing students’ clinical and communication skills, increasing their self-confidence, learning and practicing discipline and nursing responsibilities, and the disadvantages are facing reality shock stress, and mislearning.

INTRODUCTION:As the coronavirus disease 2019 pandemic continued into 2021 and beyond, unrelenting work pressures continued to mount on the emergency nursing workforce. In the second year of this longitudinal study on emergency nurse lived experiences, staff outlined the continued strain of the profession, highlighting their increasing levels of burnout and identifying early stages of trauma response.METHODS:This research aimed to continue to explore lived experiences of Australian emergency nurses working on the frontline 2 years into the coronavirus disease 2019 pandemic. A qualitative research design was used, guided by an interpretive hermeneutic phenomenological approach. A total of 9 Victorian emergency nurses from both regional and metropolitan hospitals were interviewed between October and November 2021. Analysis was undertaken using a thematic analysis method.RESULTS:A total of 3 major themes and 12 subthemes were extracted from the data. The 3 overarching themes included "On the floor each day," "Can I keep going?" and "What's around the corner?" Increasing levels of emotional exhaustion and burnout were evident, with emergency nurses stating their intentions to leave the profession.DISCUSSION:Deep engagement with participant emergency nurses across 2 years of the coronavirus disease 2019 pandemic has revealed a need for greater emphasis on staff well-being for future maintenance of a resilient and healthy workforce. Without this, lack of support for subsequent nursing cohorts may affect the quality and reliability of care being provided in acute care centers.

OBJECTIVES:Receiving bad news about one's health can be devastating, yet little is known about how the therapeutic nature of the environment where bad news is delivered affects the experience. The current study aimed to explore how patients and their families were affected by the language and the built, natural, social, and symbolic environments when receiving bad news, through the Therapeutic Landscapes theoretical framework. METHODS:Patients diagnosed with a life-limiting illness living in regional Victoria who had a hospital admission within 24 months and a diagnostic/prognostic conversation were invited to participate, as well as a family member who witnessed the conversation. Participants were recruited through social media and snowballing, resulting in 14 online semi-structured interviews being conducted between November 2021 and March 2022, audio-recorded, and transcribed verbatim. Reflexive thematic analysis was used to develop the themes. RESULTS:Fourteen semi-structured interviews were conducted with women aged between 30 and 77 years. Interviews lasted between 45 and 120 minutes, with an average of 69 minutes, and were conducted online or via mobile phone. Four central themes were developed: "Hearing bad news for the first time," "Preferences for having hard conversations," "Creating a sense of safety for ongoing care," and "The therapeutic nature of the ward." SIGNIFICANCE OF RESULTS:This body of work will help inform practice and future policy regarding bad news delivery and the design and aesthetics of environments where bad news is delivered. It is essential that bad news is delivered within a quiet, calm, and emotionally safe environment within a supportive therapeutic relationship.

Preceptorship is considered an essential component in undergraduate nursing student's clinical placement, especially those in speciality units such as mental health. During the preceptorship relationship students are granted the opportunity to work alongside experienced nurses in the ward observing their interactions with patients and other professionals. In addition, students are able to build clinical confidence and competence. There is currently a gap in the literature around the preceptorship experience in the mental health clinical environment which warrants further exploration. The aim of this study was to explore the experiences of Registered Nurses precepting undergraduate nursing students during mental health clinical placements. A qualitative, exploratory approach was performed. A total of eight registered nurses working in an acute in-patient mental health unit in a large regional hospital, were recruited and interviewed using a semi-structured interview technique. Thematic analysis was utilised to analyse the data resulting in the development of four overarching themes; (1) Time consuming and additional workload, (2) creating a safe environment, (3) providing and receiving feedback and (4) precepting is not a choice, it is an expectation. The results highlighted that preceptoring students was considered to be an extra workload that required significant time and effort. Preceptors also expressed concerns about student safety, emphasised the importance of feedback and acknowledged preceptorship as an expectation of registered nurses working in mental health. These findings underscore the necessity for further research to delve deeper into the experience of preceptors in mental health settings.

Cervical cancer screening programs in Australia have been developed to detect early precancerous changes in women with a cervix aged between 25 and 74. Yet, many barriers remain to the uptake of cervical screening. Barriers include a lack of culturally appropriate service provision, physical access, poor health literacy, emotional difficulties, socio-economic disadvantage and not having access to a female service provider. In remote and very remote areas of Australia, additional barriers experienced by Aboriginal or Torres Strait Islander peoples include a distrust of healthcare providers and a lack of services, resulting in a much higher rate of diagnosis and death from cervical cancer. General practice nurses (GPNs) are well placed to conduct cervical screening tests (CSTs) after they have undertaken additional education and practical training. GPNs' increase in scope of practice is beneficial to general practice as it helps to remove some barriers to cervical screening. In addition, GPNs conducting CSTs reduce GP workload and burnout and increase teamwork. GPNs working in metropolitan clinics have greater access to training facilities, whereas those working in rural and remote clinics are required to travel potentially long distances to complete practical assessments. This highlights the need for training to be made available in rural and remote areas. The aim of this forum paper is therefore to generate further discussion on the need for training programs to be made available in rural and remote areas to aid the upskilling of GPNs.

IMPORTANCE:Physical activity during menopause can be effective in reducing the physiological changes associated with reproductive aging that increase risks for noncommunicable diseases, yet many women do not meet the recommendations for physical activity.OBJECTIVE:This study aimed to synthesize factors influencing physical activity for women across menopausal transition phases using a socioecological approach.EVIDENCE REVIEW:The Preferred Reporting Items for Systematic Reviews and Meta-Analysis was used to systematically search 10 databases between 2001 and 2021. A comprehensive search strategy was used to identify studies on physical activity of women in various stages of menopause. A socioecological model was used to categorize the reported barriers and enablers.FINDINGS:Twenty studies met the inclusion criteria. The findings highlight several intrapersonal barriers such as existing health complaints versus enablers such as awareness of the health benefits of physical activity during menopause. Ensuring women's safety, preventing injury, and enhancing exercise self-efficacy were important components of programs. Social support was also an important enabler of women's engagement in activities.CONCLUSIONS AND RELEVANCE:Several barriers and enablers were identified and can inform practitioners and future interventions to encourage physical activity among women in various stages of menopause. For instance, when encouraging physical activity during menopause, practitioners should consider other health complaints, safety, and injury prevention while discussing the benefits of physical activity related to managing menopausal symptoms. There was a lack of theoretically informed studies exploring the barriers and enablers to physical activity for women in various stages of menopause; thus, research designs may not have fully accounted for influences. Future research that combines socioecological and individual theories of behavior is needed to comprehensively understand the complexity of physical activity among women across the menopausal transition.

Purpose In the recovery phase of COVID-19 disaster management, Emergency Department (ED) nurses are attempting to return to normal workforce operations, despite significant impacts on personal and professional lives. This review aims to examine and synthesise current literature for the learnings and recommendations from the lived experiences of ED nurses during the COVID-19 pandemic. Procedures Electronic databases CINAHL Complete, Web of Science, Scopus (Elsevier) and PubMed were utilised using a 5-year timeframe that aligned with COVID-19 in Australia. Final date of accepted papers was 28th February 2024. A JBI Mixed Methods Convergent Integrated Approach was used. Findings A total of 15 studies were included in the final review, representing seven countries of origin and included 649 ED nurses. Seven major themes related to learnings and recommendations were generated from data synthesis including (1) professional identity, (2) wellbeing support, (3) camaraderie, (4) effective communication, (5) working conditions and professional boundaries, (6) education and training, and (7) external support. Conclusion With the likelihood of future epidemic and pandemic events globally, it is vital to explore and collate evidence on the learnings and recommendations from ED during the COVID-19 pandemic to continue to build a sustainable, resilient, and supported workforce.

ISSUE ADDRESSED:Suicide is the leading cause of death for Australians aged 15-49 (Department of Health and Aged Care Suicide in Australia, https://www.health.gov.au/health-topics/mental-health-and-suicide-prevention/suicide-in-australia, 2021). With the loss of one community member impacting the individual's family, friends, and wider community. The aim of the article is to showcase a process evaluation of a place-based approach to suicide prevention, exploring the elements of mental health training and events that can be tailored to increase engagement with the men living in a rural Local Government Area in Gippsland, Victoria, Australia. METHODS:Participation records and promotional material for the Local Men Local Communities project was utilised to explore similarities and differences between the training and events offered. RESULTS:Results indicated that men living in rural areas engaged best with events that included a social element such as food or an activity, highlighting that men may find it easier to talk and connect when they have something to do. CONCLUSION:Mental health training and events need to be tailored to meet the needs of the target population. Key details to consider include location, time, promotional material, content, and inclusion of a social element. SO WHAT?: When rural men were provided ownership of their conversations, they were more likely to have them. This challenges the stereotype that men do not talk and creates the opportunity for social connection within the community.

Objectives: The current study aimed to explore regional nurses' perspectives of how bad news is delivered and the physical, natural, social, and symbolic environments where these conversations occur. Background: In regional hospitals within Victoria, Australia, palliative and end-of-life patients are cared for in acute wards that are often busy, noisy, and do not have a palliative psychosocial focus. On the other hand, Palliative Care Units (PCUs) have more home-like dedicated spaces, yet nearly all these facilities are in metropolitan areas. Diagnostic/prognostic (bad news) conversations about life-limiting illnesses often occur at the bedside in both environments. Method: Nurses providing palliative or end-of-life care in regional or metropolitan Victorian hospital inpatient wards were invited to interview and recruited through social media and snowballing. Six semi-structured, audio-recorded online interviews were conducted between March and May 2022, and themes were developed using reflexive thematic analysis. Results: Semi-structured online interviews were conducted with six female, registered nurses, four of whom worked in regional Victorian hospitals and two in metropolitan PCUs as Nurse Unit Managers. Three central themes were developed: "conducting family meetings," "palliative care practice," and "the environment matters." Conclusions: A therapeutic environment for palliative patients and their families consists of home-like ambience and aesthetics and a psychosocial environment created by staff who can provide holistic palliative care. Holistic palliative care requires mentoring and mirroring of expert practice to increase the expertise and capacity of the palliative care workforce in acute general hospital wards.

Background: Preceptorship in nursing has been a valued concept in nursing. Speciality area such as mental health nursing has a massive gap in research study. To develop sturdy mental health nursing workforce, it is necessary to conduct more studies. Aim: This literature review aims to explore preceptor's experience in precepting undergraduate nursing students in mental health. Design: Systematic review of literature. Methods: The systematic review was conducted from January 2021 to August 2021. Population of the studies included Registered Nurses supervising nursing students in the clinical area. Only studies conducted in English were included. A systematic search using EBSCO Host databases, CINAHL Complete, MEDLINE APA Psycinfo & APA PsycArticles, has been used in this review paper. Papers were also selected from the citation reference of included papers. The new version of the PRISMA 2020 guidelines used to represent the process of selection of papers has been incorporated as part of this review. The final set of data included 14 original papers meeting the eligibility criteria which involved quantitative (n = 5), qualitative (n =4) and mixed-method studies (n = 5). Result: Results were presented under three major themes: time-consuming, lack of recognition and need extra support. Further research is required in the mental health clinical setting to effectively explore the impact of relationships between preceptors and the preceptees. Conclusion: Preceptors reported supervising students in the clinical area has many benefits. However, some challenges they raised were increase in workload, requiring some guidance and acknowledgement from the organization.

INTRODUCTION:The World Health Organization estimates that approximately 180,000 health care workers have died in the fight against COVID-19. Emergency nurses have experienced relentless pressure in maintaining the health and well-being of their patients, often to their detriment.METHODS:This research aimed to gain an understanding of lived experiences of Australian emergency nurses working on the frontline during the first year of the COVID-19 pandemic. A qualitative research design was used, guided by an interpretive hermeneutic phenomenological approach. A total of 10 Victorian emergency nurses from both regional and metropolitan hospitals were interviewed between September and November 2020. Analysis was undertaken using a thematic analysis method.RESULTS:A total of 4 major themes were produced from the data. The 4 overarching themes included mixed messages, changes to practice, living through a pandemic, and 2021: here we come.DISCUSSION:Emergency nurses have been exposed to extreme physical, mental, and emotional conditions as a result of the COVID-19 pandemic. A greater emphasis on the mental and emotional well-being of frontline workers is paramount to the success of maintaining a strong and resilient health care workforce.

Background: Smoking cessation campaigns aim to decrease the prevalence of smoking in the community. However, smoking cessation campaigns can be expensive to develop and implement, therefore is it essential that campaigns have high impact and broad reach to ensure the most efficient use of resources. Method: A systematic review was conducted in October 2020 to assess the efficacy of positively framed and negatively framed messages used in televised smoking cessation advertisements. The search was restricted to quantitative primary research published between 2010-2020, yielding 4640 results. Study selection was performed using the PRISMA method. Population was inclusive of all ages and smoking status. A total of 15 articles met the criteria for review. Results: Negative messages were found to increase the likelihood of a smoker intending to quit, attempting to quit, successfully quitting, or calling a quitline, while some studies found that positive messages increased confidence to quit and calls to quitline. Combination of negative and positive messages were found to complement one another and were more successful at influencing quit behaviour than using either message type alone. However, findings were not consistent across all studies. Conclusion: The results of this review may be used to inform the development of future smoking cessation advertisements to ensure content is relevant, effective, and cost-efficient. Further exploration of the efficacy of positive and negative messages on target populations would be valuable to advise the design of cessation campaigns. Keywords: Cessation, Negative messaging, Positive messaging, Smoking, Television advertisement

Purpose: Aboriginal and Torres Strait Islander People with a disability continue to experience barriers to service engagement such as mistrust of government services, lack of culturally appropriate support, marginalisation and disempowerment. This meta-synthesis reviews current literature regarding these experiences to explain why services are underutilised.Methods: The meta-synthesis was conducted using a meta-ethnographic approach to synthesise existing studies into new interpretive knowledge. The approach was supported by a search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).Results: Ten original research papers utilising a qualitative methodology were extracted. Synthesis of the articles revealed four concepts that were developed into a conceptual model. These include:1) History Matters; 2) Cultural Understanding of Disability Care; 3) Limitations to Current Service Provision; and 4) Delivery of Effective Services.Conclusions: Disability services do not adequately consider the cultural needs of Aboriginal and Torres Strait Islander People or communicate in a culturally appropriate manner. There are expectations that Aboriginal and Torres Strait Islander People acknowledge their disability in alignment with western definitions of disability in order to access services. More work is needed to align disability services with culturally appropriate support to provide better health outcomes.Implications for RehabilitationAboriginal and Torres Strait Islander people with a disability continue to experience barriers to service engagement which must be addressed.An essential gap that must be filled in providing disability services to Aboriginal and Torres Strait Islander people is the acknowledgment of culture as a resolute influence on all client interactions with providers.A cultural model of disability may better align with the experiences of Aboriginal and Torres Strait Islander people than current medical and social models used in healthcare.Disability services need to align better with culturally appropriate support to provide better health outcomes for Aboriginal and Torres Strait Islander people.

This review explored the impact of physical literacy programs designed to engage two- to five-year-old preschool children. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used. Six EBSCO host databases were searched for the period 2011 to April 2021 using the search terms "physical literacy," "early childhood," and "impact." Articles were excluded if physical literacy was not the focal intervention. The final data set consisted of seven-peer reviewed articles meeting the eligibility criteria and quality assessment for this review. Three themes were created using Braun and Clark's (2006) approach to thematic analysis: Holistic benefits of physical literacy, Barriers to physical literacy and Education begins at home. Early childhood physical literacy programs provide holistic benefits for children; however, further research is needed in an Australian context. Families and community members working in the early childhood sector could benefit from further education and training to improve physical literacy awareness.