Abstract: To explore the conceptual underpinnings of self-efficacy to address the barriers to participating in physical activity and propose a model of intervention.
Abstract: BACKGROUND: The self-identification of nursing students with the profession has been linked with a successful transition, from being a student to being a professional nurse. Although there is no empirical evidence, there are suggestions that students with high professional identity are more likely to persist and complete their studies in their chosen profession. OBJECTIVES: The purpose of this study was to evaluate the psychometric properties of a professional identity scale and to determine the relationship between professional identity and student retention in a large group of first year nursing students. DESIGN AND METHODS: A survey design was used to examine the professional identity of first year nursing students, as measured by the Macleod Clark Professional Identity Scale (MCPIS-9). Baseline data obtained from the initial surveys were then compared with student drop-out rates 12months later. RESULTS: Exploratory factor analysis of the MCPIS-9 yielded a one-component solution, accounting for 43.3% of the variance. All 9 items loaded highly on one component, ranging from 0.50 to 0.79. Cronbach's alpha coefficient of the MCPIS-9 was 0.83 and corrected item-total correlation values all scored well above the 0.3 cut-off. Students who: were females, had previous nursing-related vocational training, reported nursing as their first choice, or engaged in nursing-related paid work, had statistically significant higher professional identity scores. Using logistic regression analysis, students with high professional identity scores at baseline were more likely to be still enrolled in the nursing program at 12months, controlling for gender, language spoken at home and engagement in nursing-related employment. These results support the psychometric properties of the MCPIS-9. CONCLUSIONS: Professional identity has a direct relationship with student retention in the nursing program. It is important to adequately measure professional identity in nursing students for the purpose of monitoring and identifying students who are at risk of leaving nursing programs.
Abstract: BACKGROUND: Although the number of clinical trials assessing health related quality of life (HRQoL) in chronic heart failure (CHF) has increased exponentially over the last decade, little is known about the quality of reporting. The purpose of this review was to assess the methodological and reporting rigor of HRQoL in RCTs of pharmacological therapy in CHF. METHODS: The electronic data bases, Medline and EMBASE were searched from 1990 to 2009 using the key search terms 'heart failure' combined with 'quality of life', 'pharmacological therapy' and 'randomized controlled trials'. A total of 136 articles were identified and evaluated according to the "Minimum Standard Checklist (MSC) for Evaluating HRQoL Outcomes". RESULTS: According to the MSC criteria, 26 (19.1%) studies were considered 'very limited', 91 (66.9%) were 'limited' and only 19 (14.0%) studies were considered to be of a 'probably robust' in terms of methodological and reporting rigor. In fact, the quality of HRQoL reporting has not improved over time. CONCLUSION: HRQoL is a critical consideration in CHF management, yet reporting is highly variable. There is a need to develop a standardized method for measuring and reporting HRQoL measures in clinical trials to aid in the interpretation and application of findings.
Abstract: BACKGROUND: Patients' knowledge, attitudes, and beliefs toward acute coronary syndrome are important predictors of delay in seeking medical attention. Currently, there is no instrument in China to measure these factors. Without such an instrument, there is limited understanding of the knowledge, attitudes and beliefs of Chinese patients. The Acute Coronary Syndrome Response Index is a validated instrument to measure patients' knowledge, attitudes, and beliefs about the symptoms and responses to acute coronary syndrome. OBJECTIVES: The study aims to translate and validate a Chinese version of the Acute Coronary Syndrome Response Index and to assess the knowledge, attitudes, and beliefs of individuals in mainland China with a history of coronary heart disease. DESIGN: Cross-sectional study. SETTING: Two tertiary teaching general hospitals and community in Shandong province, Eastern China. PARTICIPANTS: Individuals with a history of coronary heart disease. METHOD: The Acute Coronary Syndrome Response Index was professionally translated and piloting was undertaken to ensure equivalence of meaning and cultural appropriateness. Two means were used for participant recruitment: (1) direct approach in hospital and (2) advertisement in a popular health magazine in Shandong province. Principal component analysis was performed to examine the construct validity, and internal consistency was assessed using Cronbach's alpha values. RESULTS: 224 participants with coronary heart disease were recruited, including 158 in-patients and 66 individuals living in the community. Participants' mean age was 64.3±13.8 years. The majority of participants (61.7%) were male. Cronbach's coefficient for total scores of the Chinese version of Acute Coronary Syndrome Response Index was 0.81, 0.79 for knowledge, 0.87 for attitudes, and 0.71 for the beliefs scale. Pearson's method of bivariate correlation test demonstrated convergent validity. CONCLUSION: The Chinese version of Acute Coronary Syndrome Response Index can be considered as a reliable and valid instrument. Further testing of the instrument which is needed to assess the acceptability and to ensure the utility of the instrument is warranted.
Abstract: BACKGROUND: Nursing students in higher education are spending more time in paid employment despite evidence that this can impact negatively on academic performance. OBJECTIVES: To examine the effect of paid work on academic performance in undergraduate nursing students. DESIGN: Descriptive, correlational survey with longitudinal follow-up. PARTICIPANTS: Nursing students in metropolitan Sydney, Australia. METHODS: First year nursing students surveyed at baseline were followed up at the end of the final year of their nursing program to examine factors influencing academic performance. RESULTS: Of the 566 Year 1 nursing students who were surveyed in the second semester of their Bachelor of Nursing program, 182 students (32%) completed the follow-up survey in Year 3. The percentage of students engaging in paid work during term-time had increased (p<0.001), from 70% in Year 1 to 84% in Year 3. There was an inverse relationship between mean hours in paid work during term-time and nursing students' GPA in their final year. Taking into account demographic factors, the mean hours spent in paid work during term-time had a negative impact on nursing students' GPA (p<0.001). CONCLUSION: In view of these findings, we suggest that new models of undergraduate nursing education be explored to include faculty approved nursing-related employment with defined opportunities for learning. This would accommodate the dual roles of undergraduate nursing students as students and employees and therefore not endanger their academic performance.
Abstract: To develop an instrument to assess consumer satisfaction with nursing in general practice to provide feedback to nurses about consumers' perceptions of their performance.
Abstract: Attrition from undergraduate nursing programs continues to warrant investigation particularly in the climate of nursing shortages and fiscal reflection on academic institutional programs. This three-year study used a prospective longitudinal survey design to determine entry characteristics of students, attrition, progression and completion in an undergraduate program. Students were surveyed in the first three weeks of commencing their program and gave permission for academic grades to be collected during their six session, three year Bachelor of Nursing program. Of the 740 students enrolled 48% (357 students) were surveyed and 352 students (99%) gave consent for their grades to be collected. One-third of the student cohort graduated in the expected three-year timeframe, one-third had dropped out and one-third was still completing their studies. A higher Grade Point Average and being a native English speaker were most predictive of students completing their course in the minimum expected timeframe.
Abstract: The growth of accelerated graduate entry nursing programs has challenged traditional approaches to teaching and learning. To date, limited research has been undertaken in the role of learning preferences, language proficiency and academic performance in accelerated programs. Sixty-two first year accelerated graduate entry nursing students, in a single cohort at a university in the western region of Sydney, Australia, were surveyed to assess their learning preference using the Visual, Aural, Read/write and Kinaesthetic (VARK) learning preference questionnaire, together with sociodemographic data, English language acculturation and perceived academic control. Six months following course commencement, the participant's grade point average (GPA) was studied as a measurement of academic performance. A 93% response rate was achieved. The majority of students (62%) reported preference for multiple approaches to learning with the kinaesthetic sensory mode a significant (p=0.009) predictor of academic performance. Students who spoke only English at home had higher mean scores across two of the four categories of VARK sensory modalities, visual and kinaesthetic compared to those who spoke non-English. Further research is warranted to investigate the reasons why the kinaesthetic sensory mode is a predictor of academic performance and to what extent the VARK mean scores of the four learning preference(s) change with improved English language proficiency.
Abstract: Cardiac rehabilitation (CR) is a long term multifactorial rehabilitation program aimed at the secondary prevention of cardiovascular events. However, delivery of CR services is less than optimal.
Abstract: This review aims to examine critically, the methods and modes of delivery of handover used in contemporary health care settings and explore the feasibility of a computerised handover system for improving patient safety.
Abstract: Population ageing and the increasing burden of chronic conditions challenge traditional metrics of assessing the efficacy of health care interventions and as a consequence policy and planning. Using chronic heart failure (CHF) as an exemplar this manuscript seeks to describe the importance of patient-reported outcomes to inform policy decisions.
Abstract: Sessional teachers are taking an increasing role in classroom teaching in Schools of Nursing. However, there is a paucity of literature reporting the experiences of, and impact on, career academics working with or alongside the burgeoning numbers of sessional teachers. Therefore, the purpose of this paper is to explore the experiences of continuing academics working with sessional teachers. This qualitative study used purposive sampling to recruit nurse academics and collect narrative data related to their experiences of working with sessional teachers. Four major themes emerged from the data, namely: They have got real credibility - perceptions of clinical currency, We've got people who are very good clinically, but don't know how to teach - lacking skills and confidence, No allegiance to the school or the students - perceived lack of commitment and accountability, and A terrible burden - workload implications for continuing academics. The development and implementation of standards for the recruitment and employment of sessional teachers would benefit both continuing academics and sessional teachers, and assist in the delivery of quality teaching and learning to nursing students.
Abstract: There is an increasing need to address the educational needs of students with English as a second language. The authors assessed the value of a Web-based activity to meet the needs of students with English as a second language in a bioscience subject. Using telephone contact, we interviewed 21 Chinese students, 24 non-Chinese students with English as a second language, and 7 native English-speaking students to identify the perception of the value of the intervention. Four themes emerged from the qualitative data: (1) Language is a barrier to achievement and affects self-confidence; (2) Enhancement intervention promoted autonomous learning; (3) Focusing on the spoken word increases interaction capacity and self-confidence; (4) Assessment and examination drive receptivity and sense of importance. Targeted strategies to promote language acculturation and acquisition are valued by students. Linking language acquisition skills to assessment tasks is likely to leverage improvements in competence.
Abstract: This study investigated the psychometric properties of the 'Palliative care self-efficacy scale', an instrument designed to assess clinicians' degree of confidence in engaging in patient and family interactions at the end-of-life.
Abstract: An individual's perception of the risk of, and their susceptibility to, future cardiovascular events is crucial in engaging in effective secondary prevention.
Abstract: Chronic heart failure (CHF) is a chronic debilitating condition with economic consequences, mostly because of frequent hospitalisations. Physical activity and adequate self-management capacity are important risk reduction strategies in the management of CHF. The Home-Heart-Walk is a self-monitoring intervention. This model of intervention has adapted the 6-minute walk test as a home-based activity that is self-administered and can be used for monitoring physical functional capacity in people with CHF. The aim of the Home-Heart-Walk program is to promote adherence to physical activity recommendations and improving self-management in people with CHF.
Abstract: halcomb e.j., salamonson y., raymond d. & knox n. (2011) Graduating nursing students perceived preparedness for working in critical care areas. Journal of Advanced Nursing00(0), 000-000. doi: 10.1111/j.1365-2648.2011.05911.x ABSTRACT: Aims.  This article reports a study examining the relationships between undergraduate students' demographics, educational preparation and clinical experience and their self reported preparedness for employment in critical care. Background.  Increasing demand for critical care services internationally, creates a need to grow the critical care nursing workforce. Limited data are available on factors affecting new graduate nurses' career choices. Methods.  Final year nursing students from a multi-campus Australian university were surveyed during 2009. Results.  Over half of the participants were interested in seeking employment in critical care following graduation. Main reasons for choosing critical care nursing were: (i) like varied and challenging work; (ii) opportunities for professional development; and (iii) like working one-on-one with patients. The main barriers identified by participants were related to the lack of knowledge and clinical skills required to work in critical care. Using the 9-item Confidence and Interest in Critical Care Nursing scale, the study revealed that male participants and those who spent more than 1 week clinical placement in critical care were significantly more likely to report greater confidence and interest in seeking employment in critical care areas. Conclusions.  The value of placing nursing students in critical care areas for more than 1 week during undergraduate clinical placements is affirmed. Whilst most final year students report feeling prepared to work in critical care areas, the next step is to explore the transition of students as new graduates in critical care to identify professional and educational issues that impact on their retention.
Abstract: There is a considerable body of literature scrutinising and theorising negative and hostile behaviour such as violence and interpersonal conflict in the nursing workplace. However, relatively little empirical work has examined the experiences of undergraduate nursing students in the context of negative workplace cultures, and even fewer studies have explored how students develop and enact strategies to counter hostile behaviours in the clinical workplace. Based on qualitative analysis of open-ended survey questions, this study explored undergraduate students' experiences of negative behaviours in the clinical environment to identify strategies used to manage and resist such behaviours. While dominant individuals in the clinical environment sought to enforce and uphold their version of legitimacy--one where students were relegated to complete subordination--the tenacity and resourcefulness of students was evident in their attempts to counter this oppression with acts of resistance. Our findings provide new and valuable insights into organisational aggression and acts of resistance in the nursing workplace. The resistance offered by these students draws attention to the struggles for legitimacy within institutions. In drawing attention to organisational aggression as a mechanism by which students are 'othered' through pejorative behaviour, homogenisation, and de-authentication, and the dynamics of resistance offered by these student nurses, we provide an alternative explanation of nursing socialisation.
Abstract: The aim of this paper is to present a set of nursing clinical practice guidelines for individuals undergoing percutaneous coronary interventions (PCIs) together with a summary of the evidence to support these recommendations.
Abstract: This study was undertaken to assess the correlation between a self-administered, adapted Six Minute Walk Test (the Home-Heart-Walk) and the standard Six Minute Walk Test based on the American Thoracic Society guideline. A correlational study was conducted at a university campus in Sydney, Australia. Thirteen healthy volunteers underwent the Home-Heart-Walk and the standard Six Minute Walk Test on a single occasion. The distance that participants walked during the two tests was assessed using Pearson's correlation. The correlation between the Home-Heart-Walk and the Six Minute Walk Test distance was 0.81. The Home-Heart-Walk distance was highly correlated to the standard Six Minute Walk Test distance in this study. This relationship provides confidence for further research in populations to facilitate monitoring and evaluation.
Abstract: To better understand Australia-dwelling Middle Eastern women's lack of service utilization in cardiovascular health, we undertook a study to investigate their understandings and meanings of cardiovascular disease (CVD) and its risk factors. Eight focus groups were conducted in community settings with Turkish, Persian, and Arab women. We found that the women understated their risk of CVD, faced many barriers in reducing their risks, and perceived stress as the most significant contributor to CVD. Women described their stress as primarily emanating from issues surrounding migration and acculturation. Implications for development and delivery of tailored health interventions for Middle Eastern women are discussed.
Abstract: This paper is drawn from a larger study that sought to identify and examine issues around the employment of sessional academic staff in baccalaureate nurse education. Twelve sessional teachers and 12 continuing academics participated in the interviews. Examination of the data revealed the PhD was perceived as a hurdle to continuing employment in nurse education in the university sector. In the current climate, sessional teachers continue to be an essential part of the nursing academic workforce and are necessary to meet the teaching and learning demands associated with implementing nursing curricula. Findings suggest a need for scrupulous processes in relation to the recruitment of sessional staff, and highlight the difficulties that sessional teachers may have in securing continuing academic employment. We provide recommendations to facilitate the appointment of appropriate individuals into sessional roles and highlight the need to mentor and support sessional teachers wishing to pursue a career as nurse academics. Questions are raised about how nursing can plan for future academic workforce needs in a context of an aging academic workforce, the demand for doctoral training for nurse academics, and widespread casualisation of the nursing academic workforce.
Abstract: This paper reports a study which evaluated a brief, embedded academic support workshop as a strategy for improving academic writing skills in first-year nursing students with low-to-medium English language proficiency.
Abstract: Readmission to intensive care during the same hospital stay has been associated with a greater risk of in-hospital mortality and has been suggested as a marker of quality of care. There is lack of published research attempting to develop clinical prediction tools that individualise the risk of readmission to the intensive care unit during the same hospital stay.
Abstract: This study explored the strategies used by cardiac rehabilitation (CR) coordinators to overcome the obstacles to implementation of the evidence-based Reducing Risk in Heart Disease guidelines.
Abstract: This paper is a report of a study conducted to explore the reasons behind the decision to blow the whistle and provide insights into nurses' experiences of being whistleblowers.
Abstract: The Cardiac Depression Scale (CDS) is a disease-specific instrument for measuring depression in cardiac patients. This study was designed to validate the CDS in an Iranian population.
Abstract: This paper reports a study aiming to present and describe the effects of whistleblowing episodes on nurses' workplace relationships. Eighteen participants with direct experience of whistleblowing were recruited into the study, which was informed by a qualitative narrative inquiry design. Findings were clustered into four main themes, namely: Leaving and returning to work-The staff don't like you; Spoiled collegial relationships-Barriers between me and my colleagues; Bullying and excluding-They've just closed ranks; and, Damaged inter-professional relationships-I did lose trust in doctors after that. Findings suggest a need to facilitate a climate in which it is safe for nurses (and others) to raise concerns about patient care or organisational wrongdoing, and to eliminate the existing belief that whistleblowing is a negative act fuelled by revenge or sedition.
Abstract: Although the global nursing faculty shortage has led to increasing reliance upon sessional staff, limited research has explored the impact of these sessional staff on the quality of teaching in higher education. We aim to examine differences in (a) student satisfaction with sessional and tenured staff and (b) assessment scores awarded by sessional and tenured staff in students' written assignments.
Abstract: Unplanned admission to the intensive care unit has been shown to significantly increase the risk of inhospital mortality. Medical advances and increased expectations have resulted in a greater number of very elderly patients (80 years and over) being admitted to the ICU. The risk of in-hospital death associated with unplanned admission to the ICU in very elderly patients has not been clearly defined.
Abstract: This study assessed the reliability and viability of the Home-Heart-Walk (HHW) test, adapting a standardized 6-minute walk test protocol for self-administration.
Abstract: Tailoring information to the needs of the learner is an important strategy in contemporary education settings. Web-based learning support, informed by multimedia theory, comprising interactive quizzes, glossaries with audio, short narrated Power Point(R) presentations, animations and digitised video clips were introduced in a first year Bachelor of Nursing biological sciences subject at a university in metropolitan Sydney. All students enrolled in this unit were invited to obtain access to the site and the number of hits to the site was recorded using the student tracking facility available on WebCT, an online course delivery tool adopted widely by many educational institutions and used in this study. Eighty-five percent of students enrolled in the subject accessed the learning support site. Students' perception of the value of a learning support site was assessed using a web-based survey. The survey was completed by 123 participants, representing a response rate of 22%. Three themes emerged from the qualitative data concerning nursing students' perception of the web-based activities: 'enhances my learning', 'study at my own pace', and 'about the activities: what I really liked/disliked'. Web-based interventions, supplementing a traditionally presented nursing science course were perceived by students to be beneficial in both learning and language development. Although students value interactive, multimedia learning they were not ready to completely abandon traditional modes of learning including face-to-face lectures. The findings of this study contribute to an understanding of how web-based resources can be best used to support students' learning in bioscience.
Abstract: Internationally, nursing faculty shortages have been reported and there is a potential for them to worsen into the next decade as existing faculty age. To, in part, address this issue, across disciplines there is clearly an international trend towards the increasing casualisation of the higher education workforce. Despite the potential impact of this two-tiered workforce structure, there has been limited examination of the discipline specific issues related to the employment of a growing number of sessional nursing staff. This paper provides a critical review of the literature related to the employment of sessional teachers in higher education. The paper advances the discourse around the role and implications of employing sessional teachers in undergraduate nursing schools. Recommendations for supporting sessional staff and further research are presented.
Abstract: This article describes the theoretical foundation of risk perception as a key component of changing deleterious health behaviours associated with cardiovascular disease (CVD). Furthermore, perception in increasing cardiovascular risk-reducing behaviours in a socio-cultural framework is discussed, and an empirical development conceptual model presented.
Abstract: Although there is high-level evidence to guide optimal medical care for percutaneous coronary interventions, there are less explicit guidelines to support nurses in providing care.
Abstract: Casualisation of the academic workforce has resulted in an increase in the employment of sessional teachers in Bachelor of Nursing (BN) programs. Many of these teachers are drawn from specialty clinical areas and continue to work clinically while teaching part-time. The aim of this study was to explore the perceptions of sessional teachers about their perceived contribution to an undergraduate Bachelor of Nursing program in a single Australian university. Twelve sessional teachers participated in semi-structured interviews as part of a larger mixed method study exploring the issues related to sessional teaching in the Bachelor of Nursing program. Three themes emerged from the data; (1) "Bringing 'reality' to the classroom", (2) "Privileging experiential knowledge", and (3) "Establishing boundaries with students". Underpinning the narratives was a strong subtext related to the theory-practice gap. Proactive strategies to facilitate the potential of sessional staff are articulated in the paper.
Abstract: Despite the established benefits of cardiac rehabilitation (CR) in improving health outcomes for people with cardiovascular disease, adherence to regular physical activity at recommended levels remains suboptimal. Self-efficacy has been shown to be an important mediator of health behaviour, including exercise.
Abstract: Promoting self-management and monitoring physical activity are important strategies in chronic heart disease (CHD) management. The six-minute walk test (6MWT) is a commonly used sub-maximal exercise test for measuring physical functional capacity.
Abstract: Risk-factor modification after an acute coronary event is imperative, and intervention strategies are continuously being developed to assist patients with behavioral change and, consequently, decreasing the risk of further coronary episodes. This article describes the development of the health-related lifestyle self-management (HeLM) intervention, which is a brief structured intervention embedded within the transtheoretical model of behavioral change. The HeLM intervention was developed by undertaking three discrete yet interrelated studies and consisted of the following components: goal-setting, the HeLM booklet, feedback regarding personal risk, team-building and communication with the patient's family physician, three supportive telephone calls, trained interviewers, a refrigerator magnet, and a health diary for self-monitoring. The HeLM intervention has been successfully implemented in 50 patients with acute coronary syndrome after discharge from hospital and has been demonstrated to be feasible and practical and could easily be delivered by health care professionals.
Abstract: The aim of this study was to examine the psychometric properties, including predictive validity, of the newly-developed nursing self-efficacy for mathematics (NSE-Math). The NSE-Math is a 12 item scale that comprises items related to mathematic and arithmetic concepts underpinning medication calculations. The NSE-Math instrument was administered to second year Bachelor of Nursing students enrolled in a nursing practice subject. Students' academic results for a compulsory medication calculation examination for this subject were collected. One-hundred and twelve students (73%) completed both the NSE-Math instrument and the drug calculation assessment task. The NSE-Math demonstrated two factors 'Confidence in application of mathematic concepts to nursing practice' and 'Confidence in arithmetic concepts' with 63.5% of variance explained. Cronbach alpha for the scale was 0.90. The NSE-Math demonstrated predictive validity with the medication calculation examination results (p=0.009). Psychometric testing suggests the NSE-Math is a valid measure of mathematics self-efficacy of second year nursing students.
Abstract: Almost one in every 10 patients who survive intensive care will be readmitted to the intensive care unit (ICU) during the same hospitalisation. The association between increasing severity of illness (widely calculated in ICU patients) with risk of readmission to ICU has not been systematically summarized.
Abstract: This pilot study was to assess the feasibility of the health-related lifestyle self-management (HeLM) intervention as a strategy to decrease cardiovascular risk following acute coronary syndrome.
Abstract: Unplanned admission to an intensive care unit (ICU) is associated with high mortality, having the highest incidence among patients who are emergency admissions to the hospital. This study was designed to identify factors associated with unplanned ICU admission in emergency admissions to hospital and develop an absolute risk tool to individualise the risk of an event during a hospital stay.
Abstract: Connecting students with learning activities to promote academic engagement has been a focus of higher education over the past decade, partly driven by an increasing rate of student participation in part-time employment, and a growing concern about the quality of the student experience. Using a prospective survey design, this study selected three elements of academic engagement (homework completion, lecture attendance, and study hours) and academic disengagement (part-time work), to identify predictors of academic performance in a pathophysiology subject in 126 second year nursing students. Homework completion emerged as the strongest positive predictor of academic performance, followed by lecture attendance; however, time spent studying was not a significant predictor of academic performance. Of concern was the finding that the amount of part-time work had a significant and negative impact on academic performance. Combining all elements of academic engagement and disengagement, and controlling for age and ethnicity, the multiple regression model accounted for 34% of the variance in the academic performance of second year nursing students studying pathophysiology. Results from these findings indicate the importance of active learning engagement in influencing academic success, and provide some direction for nursing academics to design effective learning approaches to promote academic engagement of nursing students.
Abstract: Coronary heart disease (CHD) is a major cause of morbidity and mortality globally, and risk factors for CHD are associated with social and cultural attribution as well as individual psychological factors. The aims of this study were to explore the causal attributions of risk factors for CHD and to describe the relationship between their physiological status and causal attributions among immigrant Arabic, Turkish, and Iranian women living in Australia.
Abstract: Interprofessional education (IPE), where two or more professions learn with, from, and about each other to improve collaboration and the quality of care, has been proposed as a curriculum strategy to promote mutual understanding between professions, thus helping to prepare health professionals to work in challenging contemporary health systems. Although there is support for IPE initiatives within health professional education, differences in student motivation and learning strategies are likely to contribute to the success of these initiatives.
Abstract: To evaluate the existing literature to inform nursing management of people undergoing percutaneous coronary intervention. BACKGROUND. Percutaneous coronary intervention is an increasingly important revascularisation strategy in coronary heart disease management and can be an emergent, planned or rescue procedure. Nurses play a critical role in delivering care in both the independent and collaborative contexts of percutaneous coronary intervention management.
Abstract: Depression is increasingly a focus of attention in the management of heart disease. Clinicians in cardiac rehabilitation (CR) are well placed to assess and facilitate management of symptoms of depression, yet the timing and interpretation of measurements remain unclear.
Abstract: Most of the attrition from nursing courses occurs in the first year of study. Devising university strategies to reduce attrition requires an understanding of why students leave. The aim of this study was to explore whether students who leave a nursing course in the first semester leave for the same or different reasons than students who leave in the second semester of study. Seventeen students who had left the course were interviewed by telephone: seven in the first semester and ten in the second. In the first semester, students who leave consider themselves unprepared for university, have competing roles outside university and develop a strong dislike of the nursing course. They decide quickly that the course is unsuitable and leave. Those who leave in second semester would prefer to stay but events in their life create a crisis where they can no longer cope with university studies. These students hope to return to nursing whereas students who leave in the first semester are unlikely to consider returning. Attempts to retain students in the first semester may be futile as these students may be unsuited or uncommitted whereas there is greater scope to retain those who leave in the second semester.
Abstract: The purpose of this study was to describe the demographic and employment characteristics of Australian practice nurses and explore the relationship between these characteristics and the nurses' role.
Abstract: Although unplanned admissions to the intensive care unit (ICU) are associated with poorer prognoses, there is no published prognostic tool available for predicting this risk in an individual patient. We developed a nomogram for calculating the individualised absolute risk of unplanned ICU admission during a hospital stay.
Abstract: Evidence-based guidelines recommend participation in cardiac rehabilitation (CR) to reduce subsequent cardiovascular events following percutaneous coronary intervention (PCI). The objective of this study was to investigate the reasons for and the demographic characteristics of patients who participate in CR programmes following PCI in a single metropolitan setting in Australia. Logistic regression models were used to examine the data obtained using self-reports through mailed questionnaires from 202 patients 12-24 months following the index PCI. Thirty-five per cent of subjects reported to have participated in CR programmes, of whom less than a quarter were female. In this sample the main reason for programme participation was a recommendation given by the general practitioner (GP). The likelihood of participating in a CR programme decreased with age and absence of a partner. Additional research on determinants of participation in CR programmes among this cohort of patients could assist in the development of new strategies to encourage healthy behaviours and reduce the risk of further cardiac events.
Abstract: Students who speak English as a second language (ESL) face considerable challenges in English language universities, but little is known about the relationship between English-language acculturation and academic performance. A prospective, correlational design was used to validate the English Language Acculturation Scale (ELAS), a measure of the linguistic aspect of acculturation, and to determine the relationship between English-language acculturation and academic achievement among 273 first-year nursing students. Exploratory factor analyses demonstrated that the ELAS was a valid and reliable measure (alpha = .89). When ELAS scores were examined in relation to students' grades, students with the lowest ELAS scores also had the lowest mean subject grades, highlighting the need to place greater emphasis on identifying English-language acculturation among ESL students.
Abstract: Cardiovascular risk factor modification to prevent progression of coronary heart disease is important for patients following percutaneous coronary intervention. The aims of this study were to assess patient's awareness of modifiable cardiac risk factors and examine if patients with modifiable risk factors were more likely to identify these risk as amenable to change. Awareness of risk factors was measured using the Indiana Cardiac Rehabilitation Knowledge Questionnaire in a cohort of prospective, consecutive participants post percutaneous coronary intervention. Completed questionnaires were received from 75% of the participants. The majority were able to identify high cholesterol (87%), smoking (83%) and hypertension (82%) as modifiable risk factors. Less than half (46%) of the respondents identified diabetes as a modifiable risk factor. Only a third of participants recognized all six modifiable risk factors. A large proportion of patients who were smokers, or who had high cholesterol or hypertension, identified these as risk factors. A third of people with documented diabetes did not recognize this condition as a risk factor for heart disease. The findings have important implications for nursing practice in terms of directing educational efforts for the modification of risk factors for coronary heart disease.
Abstract: In spite of the benefit in participating in cardiac rehabilitation (CR) programs, low participation rates are well documented. Participation rates are potentially lower in people who have undergone percutaneous coronary interventions (PCI). Assessment of the barriers to CR participation in PCI patients could provide vital information for the development of alternate strategies for coronary risk factor modification.
Abstract: Despite an increasing interest in motivational interviewing as a strategy to facilitate behavior change in people with cardiovascular disease, its use in cardiac rehabilitation (CR) appears minimal. Therefore, it is unclear whether the clinical method of motivational interviewing requires modification for the CR population, in which it could be argued that people are motivated and engaged. The purposes of this report are to describe processes in incorporating motivational interviewing in the CR setting and to discuss insights gained regarding the use of this intervention.
Abstract: After an acute cardiac event, adhering to recommendations for pharmacologic therapy is important in achieving optimal health outcomes. Considering the impressive evidence base for cardiovascular pharmacotherapy, strategies for promoting adherence are less well developed. Furthermore, accessing reliable, valid, and cost-effective mechanisms of monitoring adherence in the research and clinical settings is challenging.
Abstract: Background  The physical and psychosocial benefits of participation in cardiac rehabilitation following a coronary event have well been established. Despite these benefits there is strong evidence that participation in traditional cardiac rehabilitation programs remains low. Various models of cardiac rehabilitation have been implemented including the use of brief structured interventions to enable modification of coronary risk factors. Objectives  The objective of this review was to determine the effect of brief structured interventions on risk factor modification in patients with coronary heart disease. Search strategy  A literature search was performed using the following databases MEDLINE (1966-2006), CINAHL (1982-2006), EMBASE (1980-current) and up to the Cochrane Controlled Trials Register (Issue 2, 2006 of Cochrane Library). In addition, the reference lists of relevant trials and conference proceedings were also scrutinised. Company representatives, experts and investigators were contacted to elicit further information. Selection criteria  All randomised and quasi-randomised controlled trials that compared the effects of brief structured interventions on risk factor modification in patients with coronary heart disease were considered for inclusion in the review. Data collection and analysis  Eligibility of the trials for inclusion in the review, details of eligible trials and the methodological quality of the trials were assessed independently by two reviewers. Relative risks for dichotomous data and a weighted mean difference for continuous data were calculated with 95% confidence intervals. Where synthesis was inappropriate, trials were considered separately. Main results  Seventeen trials involving a total of 4725 participants were included in the final review: three trials compared the effects of brief structured interventions on diet modification; seven on smoking cessation; and seven on multiple risk factors. Two trials involving 76 patients compared brief structured intervention versus usual care for dietary modification. Although there was a tendency for more participants in the intervention arm to lose weight at the 12-week follow up and achieve target cholesterol levels at the 6-month follow up, these results were not statistically significant. Only one small trial involving 36 patients compared brief structured intervention and extensive intervention for dietary modification and demonstrated a significant reduction in the percentage of energy obtained from fat and saturated fat intake among participants receiving extensive intervention. However, no difference in fish, fruit and vegetable intake between the groups was evident. Six trials involving 2020 patients compared brief structured intervention versus usual care for smoking cessation. There was no difference in the smoking cessation rates at the 3- and 6-week follow up, however, there was evidence of a benefit of brief structured interventions for smoking cessation at the 3-, 6- and 12-month follow up. In the only trial that and compared brief structured intervention and extensive intervention for smoking cessation in 254 participants there was no clear difference of a likelihood of smoking cessation between the two groups. In the seven trials that compared brief structured intervention and usual care for multiple risk factor modification there was evidence of a benefit of the intervention on behavioural changes such as fat intake, weight loss and consequently on reduction in the body mass index, smoking cessation and physical activity among the participants. The findings concerning the effect on blood pressure, blood glucose levels and the lipid profile, however, remain inconclusive. Conclusions  There is suggestive but inconclusive evidence from the trials of a benefit in the use of brief interventions for risk factor modification in patients with coronary heart disease. This review, however, supports the concept that brief interventions for patients with coronary heart disease can have beneficial effects on risk factor modification and consequently on progression of coronary heart disease. Further trials using larger sample sizes need to be undertaken to demonstrate the benefits of brief structured intervention targeted at the modification of single or multiple risk factors.
Abstract: Despite the quantity of information available to women about risk factors for cardiovascular disease (CVD), many women do not perceive this risk.
Abstract: The purpose of this study was to describe the trajectory of cardiac patient's perceptions of health-related quality of life (HRQoL) during a 24-month period in a community-based population.
Abstract: Challenges in achieving optimal participation rates in cardiac rehabilitation (CR) are well described and include factors pertaining to health system and patient and clinical characteristics. Of note, participation rates of patients following percutaneous coronary intervention (PCI) are low.
Abstract: With globalization and intensified migration, an attitude of awareness and acceptance of both similarities and differences among people-known as universal-diverse orientation (UDO)-is a positive benefit that students may bring to a nursing program. Using a cross-sectional survey design, this study measured students' UDO using the Miville-Guzman Universality-Diversity Scale-Short Form (M-GUDS-S). Among 816 nursing students, those born in a non-English-speaking country had higher M-GUDS-S scores (P < 0.001), and those who spoke both English and non-English at home had consistently higher scores in all three M-GUDS-S subscales. However, those who never spoke English at home had low scores in the "Comfort with Differences" subscale if they had lived in Australia for only a few years. Nursing students from a non-English-speaking background could potentially enrich cross-cultural educational experiences for all students, but students who have recently settled in Australia may need support to feel a sense of connectedness.
Abstract: Nurses are the main group of clinicians who activate the medical emergency team (MET), placing them in an excellent position to provide valuable insights regarding the effectiveness of this system. This descriptive study aimed to explore nurses' satisfaction with the MET, perceived benefits and suggestions for improvement. The study also sought to examine the characteristics of nurses who were more likely to activate the MET. Using a survey design, descriptive statistics as well as content analysis were used to analyse the data. Seventy-three nurses (79% response rate) returned their completed surveys. A positive and significant relationship was found between years of nursing experience and MET activation (p = 0.018). Overall, nurses were satisfied with the MET, with suggestions for improvement including more education on medical emergencies for both ward and MET staff. Whilst the MET system is meeting the expectations of the majority of ward nurses, there is room for improvement, which includes a more positive attitude of the MET when summoned for 'borderline' cases. Investment in ongoing education of clinicians and interdisciplinary communication is likely to encourage less experienced nurses to utilise this system, whilst decreasing the reticence of some nurses to call the MET.
Abstract: This paper reports a study examining the influence of age, ethnicity and part-time employment on nursing students' academic performance for second year pathophysiology and nursing practice subjects.
Abstract: Percutaneous coronary intervention (PCI) is a widely performed revascularization technique for coronary heart disease; however, there is limited research investigating the risk factor status of patients 1 year after the procedure.
Abstract: The purpose of this study was to examine differences in opioid consumption in patients prescribed patient-controlled analgesia (PCA) versus intramuscular injection (IMI) in the early postoperative period after open abdominal surgery. A retrospective audit of 115 patients elicited demographic and clinical data. No significant differences were found between the demographic variables of the PCA and IMI groups. There was a significant difference in the mean opioid dose used during the first 3 postoperative days (p < .01). Mean opioid consumption was 136.89 mg for the PCA group and 50.79 mg for the IMI group. Although there was a reduction in the amount of opioid consumed over the first 3 postoperative days, the PCA group consistently consumed more opioid analgesia compared with the IMI group. Furthermore, there was a disproportionate reduction in opioid consumption between the two groups from Day 1 (r = .34; p < .01) to Day 3 (r = .14; p = .14). This study shows that the amount of analgesia consumed during the postoperative period by patients who had abdominal surgery varied markedly depending on the mode of analgesia (PCA or IMI). The difference in analgesic consumption was also found to increase throughout the 3-day postoperative period. This divergence in the amount of opioid consumption between patients who were prescribed PCA and patients who were prescribed IM analgesia heightens the need for vigilance in assessment and management of pain during the early postoperative period, particularly in patients prescribed IM analgesia on an "as-needed" basis.
Abstract: A growing number of courses in higher education are adopting a hybrid format of course delivery. Hybrid courses use both online learning activities with traditional classroom teaching and thus offer the efficiency and flexibility of online delivery without the complete loss of face-to-face contact. This paper explores students' satisfaction with a hybrid course delivery format, where students were required to attend the traditional tutorial session as well as complete the prescribed web-based learning activities. The study also sought to determine if age, part-time employment or academic performance were associated with satisfaction levels of the hybrid format. Participants were 143 undergraduate nursing students enrolled in a final year pathophysiology course at a university in Sydney, Australia. A survey design was used to evaluate hybrid versus traditional face-to-face classroom instruction, resulting in a high overall satisfaction with the hybrid course delivery format. Students' age and the hours they spent in part-time employment were not associated with satisfaction levels of the hybrid format. Students who achieved higher marks in the final examination expressed stronger preference for the traditional format of course delivery indicating a perceived reliance on teacher-based instruction. It is recommended that additional support be provided to students while they make the shift to a more active independent mode of learning when using web-based formats.
Abstract: To determine whether the introduction of the Medical Emergency Team (MET) system designed to provide immediate help for seriously ill patients: (i) changed the pattern of ICU patient transfers from the wards; and (ii) improved hospital survival rates.
Abstract: Although low molecular weight heparin (LMWH) is increasingly being used in the treatment of acute coronary syndrome (ACS), unfractionated intravenous (IV) heparin infusion is still widely used in Australian hospitals for the treatment of ACS. This paper evaluates the effectiveness of a non-weight based heparin regimen in achieving a therapeutic activated partial thromboplastin time (aPTT) within 24 hours of IV heparin commencement. A sequential retrospective chart review of 99 medical records of ACS patients in a district hospital in south western Sydney, Australia, was performed. These patients were prescribed IV heparin and did not receive thrombolytic or warfarin therapy. Only 35 per cent reached a therapeutic aPTT level within 24 hours of commencement of IV heparin therapy. Comparison of therapeutic aPTT and non-therapeutic aPTT groups revealed that body weight was the only factor that was significantly different in the two groups. Patients who reached the therapeutic aPTT threshold within 24 hours weighed significantly less (mean body weight: 70.3 kg versus 80.3 kg) than those who did not reach the therapeutic threshold within 24 hours of heparin commencement (t = 3.80, d.f. = 86, p < 0.001). Given that a significant proportion of patients who require IV heparin therapy exceed the 70 kg body weight, the findings from this study suggest that a non-weight based heparin regimen is ineffective in the rapid achievement of therapeutic aPTT.
Abstract: Although myocardial infarction (MI) is a leading cause of death and disablement for women internationally, little is known about women's recovery. This paper describes an exploratory descriptive study that was informed by feminist principles, and which aimed to explore the recovery experiences of a group of women survivors of first-time MI in the initial period following discharge from hospital. A total of 10 female survivors were interviewed using an open-ended semi-structured interview schedule administered at 7, 14 and 21 days post-hospital discharge. Findings revealed that recovery was experienced as a complex process, initially characterized by fear and uncertainty. Over the duration of the study these feelings were replaced with a more positive outlook, a return of energy, and a sense of confidence in the future. Participants identified an unmet need for reliable information which persisted over the duration of the study. The findings of this study have implications for nursing practice and research. Chief among these is the issue of effective provision of information to women following an acute MI. The importance of providing relevant information to be understood and retained by people experiencing crisis cannot be overstated. Equally important are the provision of opportunities for patients to have regular contact with health professionals to question and seek clarifying information. These findings should now be tested on larger populations.
Abstract: The period immediately after discharge from the hospital after an acute myocardial infarction is a stressful and vulnerable time about which little is known.
