BACKGROUND:Variation in how nursing students conceptualise mental health (MH) has significant implications for curriculum design and patient care. While phenomenography is well-established for mapping such variation, clarity on how variations are derived is often lacking. Marton and Booth's (1997) structure of awareness (SoA) framework provides a method for sophisticated analysis of a concept and, in this study, was employed to derive the components and configuration of students' awareness. OBJECTIVE:This study aimed to illustrate and advance the application of the SoA framework in phenomenographic analysis, uncovering both the range and the formation of undergraduate nursing students' understandings of MH. METHODS:A qualitative, phenomenographic design was employed. Nineteen diverse undergraduate nursing students from an Australian Bachelor of Nursing program participated in individual, semi-structured interviews. Data were analysed using Dahlgren and Fallsberg's 7-phase process, with systematic application of Martin and Booth's SoA framework to each emergent category. RESULTS:Seven hierarchical categories of description were identified, representing a progression from fear-based and stigma-based views to holistic, inclusive conceptions of MH. Each category's SoA foregrounded different aspects of MH, reflecting influences such as cultural context, personal experience, and educational exposure. CONCLUSIONS:Applying the SoA framework enriched phenomenographic analysis by revealing not only what students understood about MH but how their awareness was constructed and enacted. The insights assisted in the development of targeted strategies to enhance MH literacy, reduce stigma, and support the development of holistic, person-centred care in nursing education.

This study explores undergraduate nursing students' perception of mental health nursing as a potential career path. Utilising a qualitative phenomenographic approach, semi-structured interviews were conducted with nineteen nursing students enrolled in a comprehensive Bachelor of Nursing program from one metropolitan university located in Melbourne, Australia. Data analysis revealed five distinct categories of description, ranging from unclear role definition and polarised attitudes to a more nuanced understanding of the skills involved. These findings are significant as it illustrates that variations in students' understandings of the mental health nursing role persist even following targeted education, suggesting that deeply held perceptions are not easily shifted within existing curricular approaches.

Mental health nurses (MHNs) face unique occupational challenges, including high emotional demands, frequent exposure to workplace violence, and risk of burnout. Social support is widely recognised as a protective factor that can enhance well-being and job satisfaction in this high-stress profession. In this research, social support is defined as the emotional, informational, and instrumental assistance that MHNs receive from interpersonal relationships in the workplace, such as from colleagues, immediate supervisors, and informal peer networks. HR support or organisational support, by contrast, refers to formal structures and resources provided by the organisation itself. Despite this, little is known about MHNs' perceptions of the availability, accessibility, and value of social support within their workplace settings. This qualitative study explored the perceived levels and effects of social support among MHNs using semi-structured interviews. Six MHNs were recruited via purposive and snowball sampling. Interviews were conducted online, transcribed, and analysed thematically to identify common patterns and variations in participants' experiences. Thematic analysis identified five key themes: agency in seeking support, forming alliances, the informal nature of support, its varying availability, and the necessity of support to sustain a career in MHN. Peer support was described as essential, informal, and self-initiated, while formal organisational support was often viewed as lacking. Digital platforms emerged as supplementary sources. The findings underscore social support's crucial role in MHNs resilience and well-being, and highlight the need for healthcare organisations to strengthen both informal and formal support structures to improve job satisfaction, reduce burnout, and promote retention.

This research explored the variation in undergraduate nursing students' understandings of mental health (MH) at a Melbourne metropolitan university. Using phenomenography, a qualitative research methodology, the study involved interviewing 19 students at different stages of a 3-year Bachelor of Nursing or Bachelor of Nursing and Midwifery degree. The research was undertaken as part of a PhD study undertaken between 2016 and 2020. The findings revealed seven distinct categories of understanding of MH, ranging from fear-driven misconceptions of mental health disorder (MHD) to a holistic perspective recognising MH on a spectrum potentially fluctuating throughout an individual's lifespan. This research revealed an improvement in nursing students' understanding of MH with initial responses marked by fear and anxiety rooted in cultural beliefs and personal safety concerns. As understanding developed, students focused on physical symptoms and causality, sometimes attributing MHDs to personal misfortune or choice. The most advanced level demonstrated a sophisticated, integrated view recognising the interconnectedness of mental and physical health. These findings highlight the challenges students face in understanding MH and the critical need to address misconceptions within nursing curricula. The study recognises the importance of innovative educational strategies to enhance MH literacy among nursing students. The findings contribute valuable insights into teaching practices and the development of targeted educational interventions in MH nursing education.

AIM:This study explored the knowledge and confidence levels of nursing academics in teaching both the theories and practical skills of digital health in undergraduate nursing programs. DESIGN:A cross-sectional study. METHODS:A structured online survey was distributed among nursing academics across Australian universities. The survey included two sections: (1) the participants' demographics and their nursing and digital health teaching experience; (2) likert scales asking the participants to rate their knowledge and confidence to teach the theories and practical skills of four main themes; digital health technologies, information exchange, quality and digital professionalism. RESULTS:One hundred and nineteen nursing academics completed part one, and 97 individuals completed part two of the survey. Only 6% (n = 5) of the participants reported having formal training in digital health. Digital health was mainly taught as a module (n = 57, 45.9%), and assessments of theory or practical application of digital health in the nursing curriculum were uncommon, with 79 (69.9%) responding that there was no digital health assessment in their entry to practice nursing programs. Among the four core digital health themes, the participants rated high on knowledge of digital professionalism (22.4% significant knowledge vs. 5.9% no knowledge) but low on information exchange (30% significant knowledge vs. 28.3% no knowledge). Statistically significant (p < .001) associations were found between different themes of digital health knowledge and the level of confidence in teaching its application. Nursing academics with more than 15 years of teaching experience had a significantly higher level of knowledge and confidence in teaching digital health content compared with those with fewer years of teaching experience. CONCLUSION:There is a significant gap in nursing academics' knowledge and confidence to teach digital health theory and its application in nursing. Nursing academics need to upskill in digital health to prepare the future workforce to be capable in digitally enabled health care settings. IMPLICATIONS FOR THE PROFESSION:Nursing academics have a limited level of digital knowledge and confidence in preparing future nurses to work in increasingly technology-driven health care environments. Addressing this competency gap and providing sufficient support for nursing academics in this regard is essential. IMPACT:What problem did the study address? Level of knowledge and confidence among nursing academics to teach digital health in nursing practice. What were the main findings? There is a significant gap in nursing academics' knowledge and confidence to teach digital health theory and its application in nursing. Where and on whom will the research have an impact? Professional nursing education globally. REPORTING METHOD:The STROBE guideline was used to guide the reporting of the study. PATIENT OR PUBLIC CONTRIBUTION:The call for participation from nursing academics across Australia provided an introductory statement about the project, its aim and scope, and the contact information of the principal researcher. A participant information sheet was shared with the call providing a detailed explanation of participation. Nursing academics across Australia participated in the survey through the link embedded in the participation invite.

Background Australian nursing programs aim to introduce students to digital health requirements for practice. However, innovation in digital health is more dynamic than education providers’ ability to respond. It is uncertain whether what is taught and demonstrated in nursing programs meets the needs and expectations of clinicians with regard to the capability of the nurse graduates. Objective This study aims to identify gaps in the National Nursing and Midwifery Digital Health Capability Framework , based on the perspectives of clinical nurses, and in nurse educators’ confidence and knowledge to teach. The findings will direct a future co-design process. Methods This study triangulated the findings from 2 studies of the Digital Awareness in Simulated Health project and the National Nursing and Midwifery Digital Capability Framework. The first was a qualitative study that considered the experiences of nurses with digital health technologies during the COVID-19 pandemic, and the second was a survey of nurse educators who identified their confidence and knowledge to teach and demonstrate digital health concepts. Results The results were categorized by and presented from the perspectives of nurse clinicians, nurse graduates, and nurse educators. Findings were listed against each of the framework capabilities, and omissions from the framework were identified. A series of statements and questions were formulated from the gap analysis to direct a future co-design process with nursing stakeholders to develop a digital health capability curriculum for nurse educators. Conclusions Further work to evaluate nursing digital health opportunities for nurse educators is indicated by the gaps identified in this study.

Background : Electronic Medical Records (EMRs) are a widely used technology within health care. Nursing students require preparation during undergraduate education for the use of EMR. Nursing educators in universities also need to be proficient with EMR. This study reports the experiences and attitudes of nursing students and nurse educators using a simulated Academic Electronic Medical Record (AEMR) system within a nursing degree. Aim : To determine nursing student and nursing educator experience with and attitudes towards EMR and AEMR. Methods : Nursing students across three years of a Bachelor of Nursing program and nurse educators teaching with an AEMR system completed an online survey. Results : Findings from participating nursing students (n=103) revealed a favourable view of the learning and clinical relevance of AEMR (87.5%). Less than half (45.5%) of the surveyed students had been exposed to EMR whilst on clinical placements. In contrast most of the students (38.8%) who had been employed in a health care setting within the previous five years had used an EMR. Nurse educator responses (n=7) showed that most (n=5) had experience with EMR and viewed AEMR as important for student learning, with fewer (n=3) regarding it as an easy system to use. Conclusion : The survey revealed that both students and educators were satisfied with AEMR - and that AEMR use was acceptable for use in the University setting. However, the survey shows student exposure to EMR on placement is low. AEMR applications have the potential to bridge the gap in student experience however adequate support and training for academic staff in the use of AEMR is required.

Background The COVID-19 pandemic has accelerated the use of digital health innovations, which has greatly impacted nursing practice. However, little is known about the use of digital health services by nurses and how this has changed during the pandemic. Objective This study explored the sociotechnical challenges that nurses encountered in using digital health services implemented during the pandemic and, accordingly, what digital health capabilities they expect from the emerging workforce. Methods Five groups of nurses, including chief nursing information officers, nurses, clinical educators, nurse representatives at digital health vendor companies, and nurse representatives in government bodies across Australia were interviewed. They were asked about their experience of digital health during the pandemic, their sociotechnical challenges, and their expectations of the digital health capabilities of emerging nurses to overcome these challenges. Interviews were deductively analyzed based on 8 sociotechnical themes, including technical challenges, nurse-technology interaction, clinical content management, training and human resources, communication and workflow, internal policies and guidelines, external factors, and effectiveness assessment of digital health for postpandemic use. Results Sixteen participants were interviewed. Human factors and clinical workflow challenges were highly mentioned. Nurses’ lack of knowledge and involvement in digital health implementation and evaluation led to inefficient use of these technologies during the pandemic. They expected the emerging workforce to be digitally literate and actively engaged in digital health interventions beyond documentation, such as data analytics and decision-making. Conclusions Nurses should be involved in digital health interventions to efficiently use these technologies and provide safe and quality care. Collaborative efforts among policy makers, vendors, and clinical and academic industries can leverage digital health capabilities in the nursing workforce.

WHAT IS KNOWN ON THE SUBJECT?: There is evidence that social isolation and loneliness is more prevalent in people living with mental illness than in the general population. People living with mental illness frequently experience stigma, discrimination, rejection, repeated psychiatric admissions, low self-esteem, low self-efficacy, and increased symptoms of paranoia, depression, and anxiety. There is evidence of common interventions that can be used to improve loneliness and social isolation such as psychosocial skills training and cognitive group therapy. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This paper offers a comprehensive assessment of the evidence between mental illness, loneliness, and recovery. The results suggest that people living with mental illness experience elevated levels of social isolation and loneliness leading to poor recovery and quality of life. Social deprivation, social integration and romantic loneliness are related to loneliness, poor recovery, and reduced quality of life. A sense of belonging, ability to trust and hope are important aspects of improved loneliness, quality of life and recovery. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The existing culture in mental health nursing practice needs to be examined to address loneliness in people living with mental illness and its impact on recovery. Existing tools to research loneliness do not consider dimensions in loneliness experience as reflected in the literature. Practice needs to demonstrate an integrated approach to recovery, optimal service delivery and augmentation of evidence-based clinical practice to improve individual's loneliness, social circumstances, and relationships. Practice needs to demonstrate nursing knowledge in caring for people living with mental illness experiencing loneliness. Further longitudinal research is required to clearly understand the relationship between loneliness, mental illness, and recovery.ABSTRACT:INTRODUCTION: To our knowledge, there are no previous reviews on the impact of loneliness experienced by people aged 18-65, who are living with mental illness and their recovery experience.AIM/QUESTION:To explore the experience and impact of loneliness in people living with mental illness during recovery.METHOD:An integrative review.RESULTS:A total of 17 papers met the inclusion criteria. The search was conducted using four electronic databases: MEDLINE, CINAHL, Scopus and PsycINFO. Across these 17 papers, participants were most commonly, diagnosed with schizophrenia or psychotic disorders and recruited from community mental health services.DISCUSSION:The review revealed loneliness to be substantial in people living with mental illness and that loneliness affected their recovery, and their quality of life. The review identified many factors that contribute to loneliness including unemployment, financial strain, social deprivation, group housing, internalized stigma and mental illness symptoms. Individual factors such as social/community integration and social network size as well as an inability to trust, a sense of not belonging, hopelessness and lack of romance were also evident. Interventions targeting social functioning skills and social connectedness were found to improve social isolation and loneliness.IMPLICATIONS FOR PRACTICE:It is vital for mental health nursing practice to employ an approach integrating physical health as well as social recovery needs, optimal service delivery and augmentation of evidence-based clinical practice to improve loneliness, recovery, and quality of life.

Background The COVID-19 pandemic has accelerated the uptake of digital health innovations due to the availability of various technologies and the urgent health care need for treatment and prevention. Although numerous studies have investigated digital health adoption and the associated challenges and strategies during the pandemic, there is a lack of evidence on the impact on the nursing workforce. Objective This study aims to identify the impact of digital health transformation driven by COVID-19 on nurses. Methods The online software Covidence was used to follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. Relevant scientific health and computing databases were searched for papers published from January 2020 to November 2021. Using the 8D sociotechnical approach for digital health in health care systems, the papers were analyzed to identify gaps in applying digital health in nursing practice. Results In total, 21 papers were selected for content analysis. The analysis identified a paucity of research that quantifies the impact of the digital health transformation on nurses during the pandemic. Most of the initiatives were teleconsultation, followed by tele–intensive care unit (tele-ICU), and only 1 (5%) study explored electronic medical record (EMR) systems. Among the sociotechnical elements, the human-related factor was the most explored and the system measurement was the least studied item. Conclusions The review identified a significant gap in research on how implementing digital health solutions has impacted nurses during the COVID-19 pandemic. This gap needs to be addressed by further research to provide strategies for empowering the nursing workforce to be actively involved in digital health design, development, implementation, use, and evaluation.

The nursing workforce constitutes the largest professional health workforce in Australia. Nursing is traditionally a female dominated profession. This study reviewed Australian universities that provide entry to practice nursing education. The study identified the distribution of females and males in leadership in nursing education, the positioning of the discipline in the university, and where nurses occupy leadership roles above the nursing discipline (faculty/college). Of the 37 universities that offered entry to practice nursing, more females were evident. However, more men were evident in academia than the proportion of men in nursing outside of the academic setting. Leadership nomenclature varied within each nursing discipline group reviewed. This study demonstrated that the number of nursing academics has decreased since the late 1990’s. The nursing workforce is still a significant contributor to the academic workforce and yet numbers of nurse academics working in roles senior to their discipline were few. This paper discusses how the nursing workforce as predominantly female, has implications to both females and males, and may impact opportunities for leadership and promotion to senior roles.

Aim To understand nurses’ perceptions of quality nursing care in the dementia-specific care unit. As the world’s population ages, the incidence of dementia is projected to rise in tandem. The requirement for skilled, dementia-trained registered nurses who can provide quality nursing care will need to increase accordingly to meet the needs of these individuals. Extensive research has been completed on dementia nursing care in a variety of settings; however, little research has been undertaken into nurses’ perceptions of quality nursing care in the dementia-specific care unit. Understanding how registered nurses perceive quality nursing care in the dementia-specific care unit is important and provides valuable information about nursing practice in this environment for nurses and decision-makers. Gaining a better understanding of quality nursing care in this care unit may result in better nurse education and an improved patient experience. It may also assist nursing organisations, residential aged-care facilities, government bodies and nongovernment agencies that support, manage, and oversee dementia-specific care units. Method A grounded theory study was conducted to understand nurses’ perceptions of quality nursing care in dementia-specific care units. The study involved interviewing nine registered nurses working in two dementia-specific care units on the Gold Coast, Queensland. Data were collected during semi-structured interviews and analysed using both constant comparison and thematic analysis. Findings Three themes emerged from this study— Caring at the Coalface, Labour of love and the Business of Dementia Healthcare. The largest theme, Labour of love, represents the personal reward and feeling of satisfaction six nurses said they experienced when interacting with individuals living in the dementia-specific care unit. They identified and repeatedly discussed the joy and fulfilment they experienced when caring for them, and considered this to be an essential element of quality nursing care. It was evident from the data that the nurses cared very deeply about these individuals, and despite increased risks to personal safety at work, they did not want to work anywhere else. This article reports on the largest and key theme identified in the study Labour of Love.

Background There is considerable literature outlining the high levels of occupational stress nurse academics experience, and the potential effect of workplace pressure on mental health and wellbeing. Objectives/Aims/Hypotheses To support the notion that to succeed in an academic environment, academics are more successful when working in a team, two academics conducted a Participation Action Research study. Design The PAR study was developed in line with a Clinical Skill Project to better understand the experiences of nurse academics working in a team. The Clinical Skills Project involved the write up of 40 nursing skills for publication. Twenty-seven academics were recruited into the project and allocated skills to write, in teams of 2-3, according to clinical expertise and interest. The Participatory Action Research (PAR) approach formed the framework for the project, as well as, provided an opportunity for the nurse academics to 'come together' at fortnightly team meetings to discuss the project and talk about their experience working in a team. Methods Using the PAR cyclical process of observing, reflecting, planning, and acting there was ongoing opportunity for the academic nurses to discuss, question and share knowledge about academic practices. These Interactive reflections were recorded in a team reflective diary during the meetings. Participants were also asked to reflect on their individual experience of working in the team, before, during and after the project. At the completion of the project all reflective comments were transcribed to form a combined narrative. Results Thematic and content analysis was then undertaken to identify any similarities and or differences in academic staff experience. Conclusions The analysis revealed the following key themes. Working in a team creates better staff relationships, Working in a team can change workplace culture and Working in a team can Improve staff health and well-being.

The biomedical model of health care is at one end of a continuum while the other end is represented by a psychosocial model. Different health professional disciplines aim to practice at points along this imaginary continuum. Overemphasis on biomedical, technical, and standardized approaches to health care negatively impact care and compassion in health care. Health care perceived to be compassionate from providers who are caring and empathic is associated with improved patient satisfaction and better health outcomes. Individual perceptions of compassionate care mean that a one-size-fits-all approach is not suitable. Different backgrounds, beliefs, and experiences along with context of care delivery and timing give rise to a layered pattern of preferences for the way compassionate care is enacted. The caring health professional needs to focus on the individual needs of each person from a standpoint of genuine curiosity, desire to be compassionately caring and a foundation of emotional stability. The affective domain is as important as the more objectively measured domains related to skill and competence in quality health care.

A self-directed learning laboratory (SDL Lab) was established in which undergraduate nursing students were provided access to experienced nurses in a simulated ward environment to enhance preparedness for clinical practice. The aim of this study was to explore perspectives of final year, undergraduate student nurses about the SDL Lab and directed self-guidance, with particular focus on the impact on learning and preparedness for professional practice. The study was framed within a qualitative descriptive approach using semi-structured, digitally recorded face-to-face interviews. The purposive sample included undergraduate students enrolled in their final year of a Bachelor of Nursing program, who had accessed the SDL Lab on at least two occasions. Thematic analysis was used. Twelve students participated. Three main themes were identified: 1) A safe environment that fosters effective learning; 2) Directed self-guidance strengthens confidence and competence during workplace experiences; 3) Enhancing accessibility and realism will improve learning. Reports of increased confidence in performing nursing skills was found in this study. Evaluation of the SDL Lab found that this alternative teaching strategy was favourable, and students appreciated the safe learning environment. Future research might explore measurement of the effect of directed self-guidance in an SDL facility on competence and confidence.

BACKGROUND:The purpose of this extensive international and national literature review was to explore how phenomenography identifies nursing students' experiences of learning within preregistration (or prelicensure) nursing education.METHOD:Data were collected utilizing a comprehensive search of electronic databases. Full text, peer-reviewed, and scholarly articles published in English using the search terms phenomengraph*, nurs*, student, education, and learning were reviewed.RESULTS:Two discreet themes emerged exploring students' experiences of learning within preregistration nursing education: (a) Phenomenography was a beneficial method to expose variation in students' understandings of a challenging concept or topic and (b) phenomenography was beneficial to evaluate teaching methods in attempt to improve student learning of challenging and complex concepts.CONCLUSION:On the basis of these findings, future research utilizing phenomenography within nursing education has potential to uncover variation in students' understandings of mental health, with future consideration of implications to nursing curriculum design and development. [J Nurs Educ. 2017;56(10):591-598.].

Mothers are at risk of domestic violence (DV) and its harmful consequences postpartum. There is no evidence to date for sustainability of DV screening in primary care settings. We aimed to test whether a theory-informed, maternal and child health (MCH) nurse-designed model increased and sustained DV screening, disclosure, safety planning and referrals compared with usual care.