OBJECTIVE:This study aimed to explore the perspectives on advance care planning (ACP) among older adults in Macao. METHODS:A qualitative descriptive approach was conducted by using three open-endead questions. A total of 285 purposively sampled older adults from senior day centers participated in this study. Content analysis was conducted using NVivo software. RESULTS:The study comprehensively understood older adults' perspectives on ACP, identifying key findings comprising 6 clusters and 15 meaning units. It summarized the willingness and unwillingness to participate, pivotal enabling factors, and the indispensable role played by family members throughout the ACP process. CONCLUSIONS:The findings demonstrated ACP has both positive and negative aspects for older adults and provided a nuanced and detailed picture of the complex family and cultural dynamics that shape older adults' end-of-life care decisions. The results can provide evidence to promote ACP for older people in other cities in China or countries with similar cultures.

Objective: This study aimed to explore the readiness for advance care planning (ACP) among older adults in Macau's day service centers and investigate the influencing factors. Methods: A cross-sectional study was conducted from October to December 2022 using a convenience sampling method. A total of 312 older adults were selected from 13 day service centers for older adults in Macau, China. The Advance Care Planning Acceptance Questionnaire and the Family Adaptation, Partnership, Growth, Affection, Resolve (APGAR) Scale were used to survey the older adults. Results: A total of 306 older adults completed the survey. The score for advance care planning readiness was 65.55 +/- 10.69, and 59.5% of participants (n = 182) were willing to participate in ACP. The family function score was 7.24 +/- 2.51, while 70.3% of participants were from a highly functional family. The higher family function indicating a higher readiness for advance care planning (r = 0.396, P < 0.001). The multiple linear regression analysis indicated that the variables "age," "knowledge of ACP," "experience with ACP," and "received resuscitation of yourself, relatives or friends" combined with "family function" can influence advance care planning readiness among older adults (R2 = 0.317, F = 27.898, P < 0.001). Conclusions: Older adults in Macau's day service centers were willing to engage in ACP. The importance of family involvement is highlighted in the ACP readiness. Health education and improved family communication are vital for promoting ACP, which ensures individuals receive care when they lack the capacity to make that choice. Additionally, healthcare professionals should enhance communication and education with older adults during the medical care process. (c) 2024 The Authors. Published by Elsevier B.V. on behalf of the Chinese Nursing Association. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

ObjectivesThis study aimed to systematically review and synthesize the perspectives and experiences of community-dwelling older adults who experience falling, to inform the subsequent development of fall prevention and management interventions, and to provide recommendations for healthcare policy and practice.MethodsThe review was a qualitative meta-aggregation study following the JBI qualitative systematic review methodology. Databases searched included MEDLINE (through PubMed), CINAHL, PsycINFO, Embase, and the Web of Science. Peer-reviewed articles published in the English language from January 2010 to May 2023 were retrieved. The JBI Qualitative Assessment and Review Instrument (JBI-QARI) was used to assess the quality of the methodology. The ConQual ranking system was used to establish confidence in the synthesized findings. The protocol was registered with PROSPERO (CRD 42023421789).ResultsThis review included ten qualitative studies with an overall quality score of 60%–90%. Data extracted from eligible studies resulted in 59 findings, which were then aggregated into seven categories based on the similarity in meaning. Three synthesized findings were generated and rated as moderate for synthesized finding 2 and low for synthesized finding 1 and 3 on the ConQual score. Synthesized finding 1: Older adults experience physical injuries and pain, restricted daily activities, and limitations in social activities, reduction or loss of in independence, and have feelings of fear and helplessness. Synthesized finding 2: After experiencing a fall, older adults reflect on the cause of the fall and recognize and interpret the risk factors. Synthesized finding 3: Older adults’ reflections on the causes and impact of falls reveal both positive and negative reactions. They perceive a number of strategies for coping with falls and their consequences, such as using assistive devices, correcting risk factors, seeking medical help, and receiving ongoing physical and psychological attention.ConclusionsHealthcare providers should pay attention to the feelings and experiences of older adults after falling, as well as their reflection on the causes and impacts of falling, and develop tailored plans for intervention. There is also a need for longitudinal studies to examine the longer-term impact of falls on older adults to provide insights into the stability and changes in their reflections, perceptions, attitudes, and preventive behaviors over time.

ObjectiveTo explore and interpret the experiences of pregnant women in Macao, China during the COVID-19 pandemic.MethodsRecruitment advertisements were published through multiple social platforms in Macao, China. A purposive snowball sampling method was adopted to select interviewees. Eighteen women who were confirmed as pregnant from January to May 2020 participated in this qualitative study. Data was collected from November to December 2020 using in-depth personal interviews. One-to-one interviews were conducted by telephone to avoid personal contact. Thematic analysis was used to perform the data analysis and identify emergent themes.ResultsFive themes emerged from the data analysis: changes in daily life, psychological distress, unique experiences of pregnancy follow-up, trying to pay attention to health information but also feeling overwhelmed, and change in hygiene behaviors due to fear of infection. Six sub-themes were identified: being confined at home but understanding the reasons, financial pressures and timely support from the government, perceived risk of catching the infection, retaining optimism with various help and support, adequate personal protections, and obsessive hygiene behaviors.ConclusionDuring a pandemic, there is a risk of greater individual isolation, particularly for vulnerable groups such as women in pregnancy. The humanized attention to and support for the residents from the government buffered the adverse impact on the study participants. Preplanning for such events is needed to focus on psychological distress, financial constraints, and prenatal health services. Alternative service delivery, such as telemedicine, online counseling, and virtual reality (VR) technology, should be applied to offer pregnant women timely support and avoid a crisis.

Background: Incivility during the learning process has consequences for instructors and learners. The purpose of this study was to explore the strategies clinical instructors use in the prevention of nursing students’ incivility during their preparatory nursing training.Method: This study was conducted using qualitative methods involving semi-structured interviews of clinical instructors who were selected by purposive sampling. 10 interviews were conducted and data saturation was achieved. The text of the interviews was transcribed verbatim and analyzed using thematic content analysis (Graneheim and Lundman 2004).Results: In order to prevent incivility, strategies included restating the rules and boundaries, culture shaping through group work, reenergizing the students, and coordinating instruction. Incivility requires a range of active management approaches and pre-planning to reduce incidence.Conclusion: Clinical instructors and educational managers should continually monitor incivility within their educational systems and seek innovative and effective approaches to address issues as they arise. Incidence of incivility is an increasing likelihood and planning is necessary to raise awareness for students and instructors of these behaviors, in order to establish a closer working relationship and become familiar with each others’ perspectives. This will help foster a culture conducive to learning rather than conflict.

Objectives: To investigate the adversity quotient (AQ) of Macao undergraduate nursing students and analyse its influencing factors. Methods: A cross-section design was used, and a convenience sample of nursing students (n = 158 valid) was selected from a tertiary institute in Macao. In addition to demographic questions, the Chinese versions of the Adversity Quotient Scale, the Emotional Intelligence (EI) Scale, the Simplified Coping Style Questionnaire and the Parenting Styles Scale were used to assess the students' characteristics. Results: The average AQ score of the students was 116.72 +/- 11.39. AQ scores were negatively correlated with coping-negative, and maternal style (excessive interference, excessive protection) (r = -0.332, P < 0.001; r = -0.167, P = 0.036). Coping-negative entered the regression equation (F = 19.154, P < 0.001). The female nursing students had higher scores in ownership dimension of AQ than their male counterparts (31.98 +/- 3.26 vs. 29.21 +/- 3.08, t = -4.442, P < 0.001). Conclusions: The average AQ scores of Macao undergraduate nursing students were moderate. The female nursing students are more likely to attribute the cause of adversity to themselves, and specific psychosocial and cultural issues may be at play. There is a necessity for Macao nursing students to improve their ability to overcome setbacks. Special attention should be paid to the cultivation of students' positive coping styles. (c) 2021 The authors. Published by Elsevier B.V. on behalf of the Chinese Nursing Association. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Purpose This study aimed to examine the degree of cross-cultural competency among UK mental health student nurses, and the care delivery challenges arising from their internalized cultural assumptions. Design and Methods This study adopted a mixed-methods design. Participants were final-year nursing students in the United Kingdom. Findings The results revealed participants had a moderate level of cultural awareness and competency but highlighted many challenges to providing cross-cultural care arising from the meanings, enablers, and values they attributed to culturally competent mental health care. Practice Implications As cultural competency is considered an essential characteristic of effective nursing care, greater attention should be paid to how student nurses assimilate cultural awareness to develop confidence in their day-to-day practice.

BackgroundWorkplace violence (WV) remains problematic and highly prevalent in healthcare with nursing students being particularly vulnerable.AimTo investigate the impact of WV from the perspective of nursing students.MethodsA qualitative design was employed. A total of 444 nursing students in the UK participated in the study.FindingsThe qualitative data were analysed, coded and three main themes emerged; (1) violence culture in nursing, (2) tolerating violence and (3) the impact of violence.DiscussionThe undesirable truth is each year nearly more than half of the students face WV in environments where such a behaviour becomes culturally embedded and passed between generations of nurses. This process of normalisation requires intervention that will break this cycle to enable more appropriate workplace behaviours to flourish.ConclusionThe impact of WV can be extremely destructive for the individual, the profession and ultimately patient care with large numbers choosing to leave at a time when there is a national shortage of qualified staff.

Background and Aims This study explored the dimensions of violence experienced by Iranian nursing students, during their nursing education. Violence toward students has become a major concern in recent years, and strategies are needed to reduce the incidence. Methods A qualitative study was conducted. Participants were seven male and nine female third-year undergraduate nursing students. Purposive sampling was used, and qualitative data from semistructured interviews were analyzed using thematic content analysis. Results From the qualitative data, five categories emerged: instances of violence, causes of violence, emotions after experiencing violence, reactions after violence, and violence prevention strategies. Conclusion To reduce the incidence of violence and provide safer learning environments, nursing students need to be taught preventive measures, but moreover, they need to receive appropriate support from nurses, instructors, and educational managers, Forensic nurses should be active stakeholders in monitoring, supporting, and referring nursing students who experience workplace violence.

Despite growing literature surrounding the use of patient diaries in intensive care units within general health care and the positive effects these may have on a patient's psychological recovery from such an admission, no studies exist examining the effects of similar patient diaries in psychiatric intensive care units when used with people experiencing an acute exacerbation of psychosis. This article hypothesises the potential positive effects of diaries kept for patients in psychiatric intensive care units. In the development of strategies to help people in psychiatric crisis understand and manage their own distress and psychological trauma, diaries may be helpful for the prevention of further psychological problems and aid recovery post discharge. Research is required to consider the possible effects of therapeutic diaries and the role of the multidisciplinary team in keeping these within psychiatric intensive care settings.

PURPOSE:The study aimed to determine how culture can affect mental healthcare delivery in order to make recommendations for improving care pathways supported by culturally competent care.METHODS:Three international databases were systematically and independently searched by two researchers. FİNDİNGS: The results were grouped under three themes-quality of cross-cultural mental health care, expectations of people receiving cross-cultural mental health care, and perspectives of healthcare providers on cross-cultural mental health care. CONCLUSİONS: The study indicates how important it is for nurses to understand the complex interplay between culture and mental health and to develop cultural awareness and sensitivity. PRACTİCE IMPLİCATİONS: The study seeks to identify best practice and make recommendations for enhancing positive attitudes toward the cultural needs of people with mental health problems.

PURPOSE:The aim of this study was to understand how cancer survivors and nurses define and experience cultural care and to make recommendations toward improvements in nursing practice.METHODS:The study used a descriptive qualitative design. Data were collected from 29 cancer survivors and 23 oncology nurses by using in-depth semi-structured interviews. Data were transcribed and themes identified.RESULTS:Three themes emerged from the data; 1) cross-cultural care expectations, 2) reality of cross-cultural care activities, and 3) improving culturally sensitive care.CONCLUSIONS:The data reveals that relationship between the nurse and cancer survivor is critical to an awareness of cultural needs but that nurses need help in raising their own awareness and appreciation of the benefits and impact of culturally competent care. It is only through creating self-awareness amongst nurses, in the context of each survivor and their needs and beliefs, will the standards of practice improve delivering the health outcomes that those in their care deserve.

Background Workplace violence (WV) within nursing has been recognised internationally as a significant problem. In developing countries, such as Turkey, where nurses face WV frequently, it is an under-researched area and there is an absence of an effective system for reporting such acts. Aim This study aimed to identify the incidence of WV experienced by Turkish nursing students, and to explore the implications and actions needed to reduce the incidence and impact. Methods This study employed a cross-sectional design. Data were collected from 1216 nursing students using the student nurse datasheet and the workplace violence scale. Findings The workplace has a considerable impact on nursing students and to varying degrees, WV affects more than half of nursing students in Turkey. The types of WV ranged from receiving racist remarks and being shouted at, to being kicked or having an unwanted advances for intimate physical contact. Discussion The findings from this study add to the evidence that violence amongst nursing students is almost a daily occurrence, and is also underreported. Having an understanding of nursing students' experiences and the impacts of WV, along with effective systems for reporting, can help mitigate the risk of violence occurring during clinical practice. Undergraduate nursing programs and continuing education for nurses should include preparation and role play on how to handle and report WV to improve the resilience of students. It is only through such a concerted and proactive approach will we promote more positive perceptions towards nursing programmes and the nursing profession as a whole.

Worldwide, health services are interested in supporting the speedy adoption of research findings into practice. To promote the translation of research into practice, a university in the South of England along with a partner NHS Trust piloted a new role - Translation Fellow (TF). This article describes and analyses the experience of implementing this role. It outlines the successes achieved as a result of this partnership between a university and a healthcare organisation as well as describing the challenges involved in establishing such a role. The successes included submitting a joint abstract to a conference; collaboratively developing articles for publication; organizing a visit overseas to compare similar services; co-designing a database to assist in collecting data for service planning and research, and setting up a 'one click access' web space populated with evidence informed material to support the work of the clinical staff. The pilot acted as a proof of concept in which the TF role demonstrated its potential. Additional roles are already being established in other services in the locality and the role merits wider discussion and testing nationally.

Academic misconduct is a problem of growing concern across the tertiary education sector. While plagiarism has been the most common form of academic misconduct, the advent of software programs to detect plagiarism has seen the problem of misconduct simply mutate. As universities attempt to function in an increasingly complex environment, the factors that contribute to academic misconduct are unlikely to be easily mitigated. A multiple case study approach examined how academic misconduct is perceived in universities in in Australia, New Zealand and the United Kingdom via interviews with academics and administrators. The findings show that academic misconduct is a systemic problem that manifests in various ways and requires similarly diverse approaches to management. Greater consistency in policies and procedures, including a focus on preventative education for both staff and students, is key to managing the mutations of academic misconduct that continue to plague the higher education sector globally.

OBJECTIVE:The aim of this study was to reduce or eliminate the stressors to enhance nursing students' clinical learning experience through implementation of an iterative approach that developed a personalised response to student stress.METHODS:A prospective cohort research design was applied to collect data from a sample of undergraduate nursing students across the four study years. An iterative approach was employed to improve students' learning experience and the Stressors in Nursing Students Scale-Chinese Version (SINS-CN) was used to measure student stress. Key problems encountered by students were identified, refined and the responding solutions were worked out and implemented among this group of students through their first year to fourth year.RESULTS:The overall SINS-CN mean score (2.17-2.82) of students was declined to a moderate level.CONCLUSIONS:Having implemented iterative approach to address factors that led to stressful environments encountered by the nursing students, the overall stress score and each sub-dimension score decreased significantly. Therefore, it is recommended that this approach could be adopted by other colleagues in the nursing arena around the world.

Objectives: Newly qualified nurses leave the profession at a higher rate than any other year of experience. Undergraduate education influences nurse retention following qualification. However, it is unclear if the factors associated with intent to leave are included within programmes to aid retention once qualified. A scoping review was conducted to explore the literature within nursing as well as social work undergraduate education to obtain viewpoints from an allied profession with similar retention barriers. Design and data sources: Following PRISMA extension guidelines for scoping review, the research question used to explore the literature was: What is the impact of undergraduate nurse and social work education on retention when newly qualified? Databases searched were BNI, CINAHL complete, Science Direct, PsycINFO, Medline Complete, Academic Search Complete and ERIC. Review method: One author undertook a comprehensive electronic and hand-search of relevant research articles. These were then discussed with two authors for inclusion within the review and data extracted for thematic analysis. Results: Limited through search inclusion and quality of research, ten research papers met the criteria for this review. Main themes found were resilience and commitment, perceived knowledge and confidence, preparation for transition and expectation of supervision. Conclusion: The literature presents the need to strengthen resilience-building within undergraduate education in the transition to newly qualified practitioner, support to cope with the emotional and physical impact of professional practice as well as developing confidence in ones skills, guidance for career progression, promotion of authentic leadership in work-place mentors and commitment of both the University and health or social organisation to support staff to be healthy and feel valued.

Summary: Nurse shortages are of global concern. This presentation reports the findings from the first of two linked projects exploring an evidence-based model to improve nurse retention. Whilst the project setting is an acute hospital setting in the United Kingdom (UK), there is transferability to more universal care settings internationally. Content Outline:

BACKGROUND:Although teamwork and interprofessional collaboration are critical to patient safety, nursing, medical, and allied health graduates often feel ill-prepared to confidently communicate and collaborate with other team members. While interprofessional education (IPE) has been advocated as a way of addressing this issue, there are multiple barriers to its systematic and sustained integration in undergraduate healthcare programs. Despite these challenges, examples of effective IPE initiatives have emerged.INNOVATION:This article profiles seven case studies of innovative interprofessional education activities that have been successfully implemented across five countries, for a variety of learners, using different delivery modalities, and with evaluation results attesting to their success.CONCLUSIONS:The case studies demonstrate innovative ideas that have the potential to overcome some of the barriers to IPE through the use of creative and targeted approaches. This article provides a wealth of ideas for the successful design and implementation of IPE initiatives and will be of benefit to educators wishing to expand their repertoire of teaching approaches.CLINICAL RELEVANCE:A body of research attests to the relationship between interprofessional communication, teamwork, and patient outcomes. IPE is imperative for facilitating the development of nursing graduates' communication and teamwork skills; however, innovative approaches are needed to overcome the perceived and actual impediments to its implementation.