BACKGROUND:Australian Universities are the principal providers of nurse education for international students. While researchers have recognised the important issue of poor psychological well-being among nursing students, few have explored the factors which impact international nursing students. AIM:This review aimed to map the reported factors impacting psychological health, wellness and early help-seeking behaviours of international students enrolled in Bachelor of Nursing programmes. METHODS:A scoping review with a five-stage methodological framework to interpret and synthesise the available literature was utilised. The following databases were searched: CINAHL Complete, PsycINFO, MEDLINE, ERIC and Scopus for studies published in English from 2012 to 2022. Additional sources were also sought through a review of the references of included studies. Four studies met the inclusion criteria. RESULTS:Results revealed that all included studies were from Australia and utilised a quantitative approach. Factors impacting psychological health and wellbeing, as well as help-seeking behaviours included but were not limited to migrating alone, language spoken, marginalisation and the COVID-19 pandemic. Published literature on this topic is limited, with a notable absence from other countries. CONCLUSION:This review highlights a gap in evidence concerning ways to support international nursing students. PATIENT OR PUBLIC CONTRIBUTION:There were no patient or public contributions in the design, conduct, analysis or preparation of this manuscript.

BACKGROUND:Lacking nursing workforce is a persistent and predicted issue that negatively affects the nursing team's stability, clinical care quality and patient safety. Prior research has examined the significant effect of work-family conflict on turnover intention, but the exact mechanism remains unclear. OBJECTIVE:To examine how work-family conflict influenced nurses' turnover intention in China. To investigate the mediating effect of psychological capital in work-family conflict affecting turnover intention; and to investigate the moderating effect of transformational leadership and age on work-family conflict, psychological capital and turnover intention. DESIGN:A cross-sectional survey of 1235 nurses employed in 4 hospitals within a single province in China that provided care to approximately 5 million people each year. METHODS:Several measures including Work-Family Conflict Scale, Turnover Intention Scale, Psychological Capital Questionnaire and Transformational Leadership Questionnaire were utilized to collect data. Structural equation modeling approach as well as the multi-group analysis were conducted. RESULTS:Via psychological capital, work-family conflict significantly affected the nurses' turnover intention indirectly (β = 0.08, p < 0.001). The mediation association was significantly moderated by transformational leadership (p < 0.001). CONCLUSION:The association of work-family conflict affecting turnover intention among Chinese nurses was mediated by psychological capital, and transformational leadership moderated the relationship of work-family conflict, psychological capital and turnover intention.

Aim:To explore the status of job crafting, leisure crafting, and burnout among nurses and to examine the impact of job crafting and leisure crafting variations on burnout using machine learning-based models. Background:The prevalence of burnout among nurses poses a severe risk to their job performance, quality of healthcare, and the cohesiveness of nurse teams. Numerous studies have explored factors influencing nurse burnout; however, few involved job crafting and leisure crafting synchronously and elucidated the effect differences of the two crafting behaviors on nurse burnout. Methods:Multicentre cross-sectional survey study. Nurses (n = 1235) from four Chinese tertiary hospitals were included. The Maslach Burnout Inventory-General Survey, the Job Crafting Scale, and the Leisure Crafting Scale were employed for data collection. Four machine learning algorithms (logistic regression model, support vector machine, random forest, and gradient boosting tree) were used to analyze the data. Results:Nurses experienced mild to moderate levels of burnout and moderate to high levels of job crafting and leisure crafting. The AUC (in full) for the four models was from 0.809 to 0.821, among which the gradient boosting tree performed best, with 0.821 AUC, 0.739 accuracy, 0.470 sensitivity, 0.919 specificity, and 0.161 Brier. All models showed that job crafting was the most important predictor for burnout, while leisure crafting was identified as the second important predictor for burnout in the random forest model and gradient boosting tree model. Conclusion:Even if nurses experienced mild to moderate burnout, nurse managers should develop efficient interventions to reduce nurse burnout. Job crafting and leisure crafting may be beneficial preventative strategies against burnout among nurses at present. Implications for Nursing Management. Job and leisure crafting were identified as effective methods to reduce nurse burnout. Nurse managers should provide more opportunities for nurses' job crafting and encourage nurses crafting at their leisure time.

AimTo assess the knowledge, attitudes and practices of Registered Nurses working in residential aged care facilities pertaining to pain management for residents living with dementia.BackgroundSub-optimal pain management continues for people living with dementia in residential aged care. Registered Nurses are the pivotal staff responsible for complex assessment and management of people residing in residential aged care facilities.Design and methods:This integrative literature review was informed by Whittemore (2005). Searching and screening followed the PRISMA guidelines.ResultsThirteen papers were identified, the major themes identified were gaps in knowledge and skills, uncertainty of assessment, and delays in treatment.ConclusionRegistered Nurses require education on pain management for people living with dementia in residential aged care. Broader issues in residential aged care contribute to the problem and require examination. Research pertaining to Registered Nurses' roles pain management for residents living with dementia is required.

Abstract Introduction Emergency department clinicians, and particularly nurses in triage, frequently perform routine blood tests on patients whose allocated triage category is not time critical (triage categories 3, 4 and 5 of the Australasian Triage Scale). Some observers have questioned the utility of routine blood testing in these acute healthcare settings given the cost and workload implications. Methods A quantitative method using retrospective observational design was utilised guided by STROBE checklist. Electronic medical records of patient data collected at a quaternary Australian metropolitan hospital emergency department were reviewed. Results and discussion A total of 74,878 adult patients attended the emergency department between 1st January and 31st December 2021 and a sample of 383 were randomly allocated for this study. Of the 383 patients included, 51% were female, age ranges were 18–99 years (mean 51.6). The majority were Australasian Triage scale (ATS) triage category 3 (55%) and 62% had blood tests performed. Blood test performance was found to be associated with advancing age (p < 0.001) but not with department occupancy as determined by the national emergency department overcrowding scale (p = 0.230). Conclusion Blood testing in the emergency department in triaged non-time critical patients was found to be frequent thereby affecting nurses’ already stretched time resource. Older patients were found to be more likely to have a blood test. There is a positive correlation between blood test performance and length of stay in the emergency department.

BACKGROUND:Studying in a foreign country can be accompanied by challenges, including difficulty understanding the curriculum, culture shock, and a new language. These additional challenges place international students at risk and predispose them to developing mental health problems compared to domestic student. AIMS:This study explores psychological well-being and help-seeking behaviours of international nursing students who commenced their program onshore or in a remote learning capacity. MATERIALS & METHODS:This paper reports the findings of the mixed-methods study. Research was conducted among international students enrolled in the Bachelor of Nursing programs across multiple campuses at two Victorian universities in 2022. Data was collected using a survey questionnaire with open-response questions and incorporated a validated Student Stress Survey. RESULTS:Findings indicated that international students require support financially and to settle in Australia upon arrival. Participants highlighted that they require additional support to keep up with academic workloads and require further academic support tailored for international students. There was no patient or public contribution in the design, conduct, analysis or preparation of this manuscript. DISCUSSION & CONCLUSION:Participants highlighted that they require additional support to keep up with academic workloads and require further academic support tailored for international students. There was no patient or public contribution in the design, conduct, analysis or preparation of this manuscript.

Introduction: An understanding of emergency nurses' roles, challenges, and preparedness in the context of armed conflict is necessary to capture in-depth insights into this specialty and their preparational needs when working in these unique environments. Unfortunately, the evidence about emergency nurses' work in the context of armed conflict is scant.Method: Semi-structured interviews were conducted with 23 participants and analyzed using qualitative content analysis. The COREQ guideline for reporting qualitative research was followed.Results: The emergency nurses' roles, challenges, and preparedness in hospitals in the context of armed conflict were explored in detail. The main challenges that these nurses faced included poor orientation, access block, and communication barriers. Various perspectives about preparation, including education, training, and strategies for preparing emergency nurses were identified. The most striking findings in these settings were the diversity of armed conflict injuries, clinical profiles of patients, triage of mass casualties, trauma care, surge capacity, orientation, communication, and strategies for preparing nurses.Conclusions: This study provided an exploration of the scope of emergency nurses' roles, and how they were prepared and expected to function across multiple hospitals in armed conflict areas. The resultant snapshot of their experiences, challenges, and responsibilities provides an informative resource and outlines essential information for future emergency nursing workforce preparedness. There is a broad range of preparational courses being undertaken by emergency nurses to work effectively in settings of armed conflict; however, required education and training should be carefully planned according to their actual roles and responsibilities in these settings.

Background Scientific literature is presented in complex language, most frequently in English, and includes technical jargon that represents a challenge to comprehension of an English as a foreign language (EFL) nursing student. Yet scientific literature is a powerful and trustworthy source of evidence to guide nursing practice. Purpose The aim is to examine two reading interventions (Translation vs Synthesization) and to determine which one produces long-term sustainability effects in scientific research reading comprehension. Method A two-group posttest-only randomized comparative design was used in which 120 participants were randomly assigned to two groups. Several instruments were used to collect the data. Results Study findings showed that the synthesization group significantly produced better results when compared with the translation group on both the immediate (p = 0.01) and the delayed (p = 0.013) reading comprehension tests. It shows also that gender differences have a significant impact on reading comprehension with a favor to males in the long-term reading comprehension outcome (p = 0.038) of synthesization and females in the short-term reading comprehension outcome (p = 0.015) of translation. English proficiency was significant with determination, metacognitive, and social skills in the synthesization group (p = 0.00, p = 0.01, p = 0.007 respectively). Conclusion The results suggested that synthesization could be an effective reading approach in improving EFL nursing students’ reading comprehension of scientific literature.

OBJECTIVE Parents who lose an only child in China are stressed and traumatized due to social identity threat (SIT). This qualitative study aimed to interpret their experience to inform culturally and socially sensitive intervention strategies. METHODS Using a phenomenological approach, 17 bereaved parents who lost an only child were interviewed. The transcripts were analyzed using Colaizzi's method. RESULTS Three themes were identified, namely, "assuming a new social identity," "triggering social identity threat," and "resisting social identity threat and maintaining resilience." The study showed that SIT initially began with identity reconstruction, where self-identity and social identity occurred 1 after another. Once labeled with such social identity, the bereaved parents suffered social identity threat triggered by inner inferiority and external stigmatization. The bereaved parents undertook a variety of coping strategies to resist the threat and to maintain resilience; of these strategies, 4 patterns depicting resilience and threat were interpreted. CONCLUSION The findings offer an understanding of the multifaceted bereavement dilemma and lay a foundation for developing intervention strategies. Promoting or maintaining resilience and alleviating SIT are 2 important ways that help parents move on. To help them with identity reconstruction, the development of culturally sensitive resilience-based programs and the linking of social resources to solve practical problems are recommended. Community health professionals should encourage parents to maintain good health management to prevent their predicament from worsening. Raising economic assistance, building an elderly care support system, and promoting social acceptance are strategies that could be considered by policymakers. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Objective: Escalating global challenges (such as disasters, conflict, and climate change) underline the importance of addressing Chemical, Biological, Radiological, and Nuclear (CBRN) terrorism for sustainable public health strategies. This study aims to provide a comprehensive epidemiological analysis of CBRN incidents in the Middle East and North Africa (MENA) region, emphasizing the necessity of sustainable responses to safeguard healthcare infrastructures.Method: Utilizing a retrospective approach, this research analyzes data from the Global Terrorism Database (GTD) covering the period from 2003 to 2020. The study focuses on examining the frequency, characteristics, and consequences of CBRN incidents in the MENA region to identify patterns and trends that pose significant challenges to public health systems.Results: The analysis revealed a significant clustering of CBRN incidents in Iraq and Syria, with a predominant involvement of chemical agents. These findings indicate the extensive impact of CBRN terrorism on healthcare infrastructures, highlighting the challenges in providing immediate health responses and the necessity for long-term recovery strategies.Conclusions: The study underscores the need for improved healthcare preparedness, robust emergency response systems, and the development of sustainable public health policies. Advocating for international collaboration, the research contributes to the strategic adaptation of healthcare systems to mitigate the impacts of CBRN terrorism, ensuring preparedness for future incidents in the MENA region and beyond.

BACKGROUND:Armed conflicts are usually associated with high mortality and morbidity rates, with unpredictable workload, injuries and illnesses. Identifying emergency nurses' views of the core competencies required to enable them to work effectively in hospitals in areas of armed conflict is critical. It is important to inform the requisite standards of care and facilitate the translation of knowledge into safe, quality care. AIM:The aim of this study was to identify emergency nurses' perceptions of core competencies necessary to work in hospitals in the context of armed conflict. METHOD:A descriptive qualitative phase of a mixed-method study using semi-structured interviews with participants was conducted from June to July 2019. The COREQ guideline for reporting qualitative research was followed. FINDINGS:A sample of 15 participants was interviewed. The participant perceptions provided a different perspective of core competencies required for emergency nurses in the context of armed conflict, culminating in four main areas: (i) personal preparedness , (ii) leadership, (iii) communication and (iv) assessment and intervention. CONCLUSION:This study identified emergency nurses' perceptions of their core competencies. Personal preparedness, leadership, communication, assessment and intervention were identified as contributing to calmness of character, confidence in care and cultural awareness for care in this setting and were essential for them to work effectively when managing victims of armed conflict in emergency departments. IMPLICATIONS FOR NURSING PRACTICE AND HEALTH POLICY:The findings of this study are important and novel because the researchers sought the perspectives of emergency nurses who have experience in receiving patients from armed conflict firsthand. The findings will inform policymakers in those settings regarding standard of care, education and drills for hospital nurses in optimizing armed conflict care response outcomes.

Objective To identify and synthesize the primary evidence on the effectiveness of Protection Motivation Theory on and cardiovascular disease and diseases that are risk factors for cardiovascular disease. Method An integrative review was conducted using the Whittemore and Knafl method (2005). Results Eleven articles met the inclusion and quality assessment criteria. The integration of evidence was abundant in three themes 1) Physical activity 2) Weight and Body Mass Index, and 3) Food consumption and each theme having the same six sub-themes of self-efficacy, response-efficacy, response cost, severity, vulnerability and reward. No studies have addressed all clinical factors and behavioral changes associated with cardiovascular disease. Conclusion Due to the limited literature on the effectiveness of Protection Motivation Theory on behavioral changes in patients with cardiovascular diseases, generalizations and practice recommendations are limited. Further research is required to evaluate the effectiveness of this theory in patient outcomes.

AIMS AND OBJECTIVE:To assess the implementation of standards by Australian Nursing higher education providers as set by accrediting and regulating bodies and to identify any barriers or enablers to optimizing Professional Experience Placement. To recommend strategies for safeguarding and improving any identified enablers as well as mitigating factors for any identified barriers. BACKGROUND:Professional Experience Placement is an essential element of all accredited Nursing Programs in Australia. The Australian Nursing and Midwifery Accreditation Council is responsible for developing accreditation standards and mandates minimum of 800 h of Professional Experience Placement scaffolded across curriculum which some Higher Education Providers set as their exact baseline for clinical placement duration. DESIGN:Descriptive study using; questionnaire survey with qualitative thematic analysis and CROSS checklist. METHOD:Quantitative method with descriptive qualitative thematic analysis and purposive sampling was used to target 37 higher education institutions that offer BN and BN/BM programs, 33 of these institutions were randomly selected for inclusion. Data was collected over a six-week period from 24th May to 4th July 2022 using Qualtrics online survey. RESULTS:Out of the 33 Higher Education providers who were invited to participate, 51.5 % (n = 17) responded. The respondent's demographics were: 94 % Bachelor of Nursing only placements coordinators while one respondent reported covering both Bachelor of Nursing and Bachelor of Midwifery; Most of the respondents (65 %) were in 40-55 years age group. The respondents reported to have overall responsibility across one to 6 campuses (Mean = 2.2) and having support/administrative staffs ranging from 0 to 15 (Mean = 4.11). Student population among the institutions ranged from 500 to 7500 with a mean of 2365.38. The number of campuses covered had statistically significant relationship with the student population (p < 0.001; 0.392-0.929 confidence interval) however no statistically significant relationship with the number of administrative staff allocated (p = 0.319; -0.297 to 0.704 confidence interval). CONCLUSIONS:While great processes are in place across higher education sector in formalizing nursing professional experience placement, important challenges still exist across the nation that need to be addressed. The quantitative findings should be interpreted with caution given the low questionnaire response rate.

Background: The growing frequency of disasters increases health system demands, increasing the need for emergency departments to provide public health messaging to prevent illness and reduce risk. This study aims to explore emergency nurse practice and attitudes in providing public health messages from the emergency department during disasters in Australia.Methods: Quantitative phase of a mixed methods study, using an explanatory sequential design. Australian emergency nurses were surveyed using a validated online questionnaire. Data was analysed using descriptive and inferential statistics, an enumerative content analysis, participant profiling and a factor analysis.Results: Disaster experience varied in 143 nurse participants. The perception of the emergency nurse's role in providing public health messages is influencing practice. Embracing teachable moments and health promotion responsibilities, attributes to positive attitudes and practice. In contrast, negative attitudes, lack of confidence, time, policy, and training, are barriers to public health messages being provided in the emergency setting.Conclusions: These barriers suggest that Australian emergency nurses may not have the capability, the opportunity, nor the motivation, to provide preventative messages to their patients during disasters. Intrinsic and extrinsic factors need to be addressed, ensuring nurses are confident and supported in their public health messaging practice during disasters.& COPY; 2022 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

In this rapid review, we critically scrutinize the disaster management infrastructure in Saudi Arabia, illuminating pivotal issues of interoperability, global cooperation, established procedures, community readiness, and the integration of cutting-edge technologies. Our exploration uncovers a significant convergence with international benchmarks, while pinpointing areas primed for enhancement. We recognize that continual commitments to infrastructural progression and technology adoption are indispensable. Moreover, we underscore the value of robust community involvement and cross-border collaborations as key factors in bolstering disaster response capabilities. Importantly, we spotlight the transformative influence of emerging technologies, such as artificial intelligence and the Internet of Things, in elevating the effectiveness of disaster management strategies. Our review champions in all-encompassing approach to disaster management, which entails harnessing innovative technologies, nurturing resilient communities, and promoting comprehensive disaster management strategies, encapsulating planning, preparedness, response, and recovery. As a result of our analysis, we provide actionable recommendations to advance Saudi Arabia’s disaster management framework. Our insights are timely and crucial, considering the escalating global focus on disaster response in the face of increasing disaster and humanitarian events.

• Evidence is lacking on advanced practice nursing during war and terrorism crises. • War and terrorism provide unique, complex challenges pre, intra and post deployment. • Nurse practitioners are ideally positioned to support military deployments.

(1) Background: The amount of time nurses spend with their patients is essential to improving the quality of patient care. Studies have shown that nurses spend a considerable amount of time on a variety of activities––which are often not taken into account while estimating nurse-to-patient care time allocation––that could potentially be eliminated, combined or delegated with greater productivity. The current study aimed to calculate standard time for each activity category by quantifying the amount of time required by nurses to complete an activity category and determine the adjustment time that can be given during work, as well as determine factors that can be altered to improve the efficiency of nursing care on inpatient general wards of a governmental hospital. (2) Method: A time and motion study was conducted over two weeks using 1-to-1 continuous observations of nurses as they performed their duties on inpatient general wards, while observers recorded each single activity, and specifically the time and movements required to complete those activities. (3) Result: There was 5100 min of observations over 10 working days. Nurses spent 69% (330 min) of time during their 8 h morning shift on direct patient care, (19.4%) ward/room activities (18%), documentation (14%), indirect patient care (12%) and professional communication (5%). Around 94 min of activities seem to be wasted and can be potentially detrimental to nurses’ overall productivity and threaten patient care quality. The standard number of hours that represents the best estimate of a general ward nurse regarding the optimal speed at which the staff nurse can provide care related activities was computed and proposed. (4) Conclusions: The findings obtained from time–motion studies can help in developing more efficient and productive nursing work for more optimal care of patients.

AIM:To identify nurses' perspectives of their core competencies for emergency care in the context of armed conflict.INTRODUCTION:Emergency department's (ED) capacity is frequently overwhelmed by a sudden surge of patients when located near armed conflict. Although emergency nurses are key frontline responders, evidence detailing core competencies needed to work in these areas remains limited.METHOD:The study used a cross-sectional survey design and is reported using STROBE guidelines. A validated questionnaire was administered in hospitals near the southern Kingdom of Saudi Arabia and Yemen border, where emergency nurses regularly manage large numbers of patients from armed conflict.RESULT:A total of 163 questionnaires were returned (68% response rate). Most participants were female and had more than six years of ED experience. The core competencies for emergency nurses working near armed conflict were identified and highly rated by participants: the highest mean value was 9.47/10 and the lowest was 8.89/10. Analysis revealed regular education, training and drills were needed to provide quality emergency nursing care for victims of armed conflict.CONCLUSION AND IMPLICATIONS FOR NURSING AND HEALTH POLICY:This study provides new evidence regarding core competencies in emergency nursing care in the context of armed conflict. The identified competencies should be incorporated into future education, curricula, training programmes and evaluations to enable emergency nurses to function effectively in the context of armed conflict. The findings will assist decision-makers to develop plans and strategies for mitigating risk and improving the future nursing response in similar contexts.

Little is known about the theoretical foundation underling the response of people with diabetes managing their everyday routines during COVID-19 pandemic lockdown. Aim: To explore the experience of people with diabetes during COVID-19 pandemic lockdown in light of the risk perception, response and behavioral change theories. Method: A qualitative descriptive design was employed, and Braun and Clark’s six step analysis were used for thematic analysis. Semi-structured interviews were conducted online using Zoom Videos Communication. Result: Five themes were defined as follows: (1) perceived the threat and faced their fears, (2) appraised the damage, (3) identified the challenges, (4) modified their routine, and (5) identified the strengths that facilitate the efficacy of their response. There were eight sub-themes within the themes. Conclusion: The results of this study may provide an opportunity for nurses to reflect on issues highlighted by the patients regarding more effective communication, knowledge and skill development for people to support self-care during national emergencies.