bluuebunny/crossref_metadata_2025 huggingface dataset:
Advanced practice nurse’s role in alcohol abuse group therapy
Authors: Puskar Kathryn , McClure Elizabeth , McGinnis Kelly
Published: June 2024

The purpose of this paper is to discuss the importance of conducting groups for alcohol abuse and to present implications for the advanced practice nurse (APN) in leading these groups. The APN is situated to assist in this process not only in a competent and efficacious manner, but in a cost effective fashion. Many studies validate the need and benefit for using group therapy as an intervention for alcohol abuse. The APN can perform this task with positive outcomes, using the American Nurses Association Psychiatric Mental Health Scope and Standards of Practice (ANA 2000) as guidelines for assessing and diagnosing patients, identifying patient outcomes, planning patient care, implementing that plan, and evaluation. Many other sources, such as the USA Department of Health and Human Services Healthy People 2010 (2000), the USA President’s New Freedom Commission on Mental Health (New Freedom Commission on Mental Health 2003), and the USA Report of the Surgeon General on Mental Health (1999), can be referenced to ensure that the patient is provided with the best prevention, as well as treatment.
Importance of nutrition for elderly persons with pressure ulcers or a vulnerability for pressure ulcers: a systematic literature review
Authors: Holm Brigitta , Mesch Lisa , Ove Hellzén
Published: June 2024

The number of elderly people, usually with multiple illnesses, is increasing in our society. In the public debate, many scientists predict that this could lead to a considerable increase in pressure ulcers. Since elderly care was reorganised in Sweden in 1993, the situation for older people has changed. In many cases, access to geriatric expertise and nurses has been reduced and the mortality rate among patients with pressure ulcers is increasing. A literature review, including a content analysis of 16 peer‑reviewed articles published between 1995 and 2005, was conducted. The aim was to describe the importance of nutrition in reducing the risk of pressure ulcers and to focus on nursing interventions. The result shows that the analysis can be summarised around four areas: nutrition, prevention, nursing and economic aspects, which elucidate the importance of ensuring that an elderly person’s need for energy is met and that nutritional supplements are effective for this group of patients. Early nursing intervention and the use of questionnaires are also stressed as being important. The economic aspects of pressure ulcers are also discussed.
The changing role of practice nurses in Australia: an action research study
Authors: Mills Jane , Fit Mary
Published: June 2024

Objective: The original aim of the study was to report on the methods used to develop a new model of service delivery, namely nurse led well women’s clinics. However participants identified several key barriers to an expansion of their role that had not been accounted for in either the original policy directive or in the continuing professional development delivered as preparation for their accreditation to deliver cervical screening services from a general medical practice. How the group addressed these barriers became the objective of this action research study.
Design: This paper reports the findings from an action research study with three registered nurses working in general practice credentialed to provide cervical screening services. Six reflective group meetings were held over a six‑month time frame facilitated by the lead researcher. During the meetings a variety of creative techniques were used to stimulate discussion, The meetings were audio-recorded and partially transcribed. Feedback from the concurrent data generation and analysis was provided to participants the following week.
Setting: A regional division of general practice.
Subjects: Three registered nurses employed by the general medical practice.
Main outcome measures: The barriers identified by participants in the process of implementing change in their clinical practice to incorporate the provision of cervical screening services.
Results: There were three themes identified in the findings from this study that related to the myth of interdisciplinary collaboration in general practice. These were: nurses in general practice renegotiating their roles; identifying and negotiating gendered patterns of cervical screening; and multidisciplinary collaboration and retention of practice nurses. Another important outcome of this study that relates to change management is the role of practice champions in implementing new models of primary care.
Conclusion: The potential role of nurses in general medical practice in Australia has broadened considerably in recent years, mainly due to Australian Government driven initiatives which reward general practitioners for employing nurses; a recognition by the nursing profession that general practice nursing is a specialist area of nursing practice; the establishment of a national professional association for nurses working in general practice; an increase in the availability of continuing professional development for nurses working in general practice; and additional Medicare Benefit Schedule (MBS) item numbers relating to general practice nursing, which gives the general practice a rebate for the services the nurse provides independently of the general practitioner. Suggestions are made that address the barriers identified by participants in the process of implementing change in their clinical practice to incorporate the provision of cervical screening services.
The impact of therapeutic relationship on preoperative and postoperative patient anxiety
Authors: Erci Behice , Sezgin Serap , Kaçmaz Zennure
Published: June 2024

Objective: The aim of this study was to determine the effectiveness of Peplau’s Interpersonal Relations Model on preoperative and postoperative patient anxiety.
Design: The study used a randomised clinical trial design.
Setting: The sample of this study consisted of 120 patients who attended the surgery clinic at Atatürk University Hospital in Erzurum, Turkey between 1 June and 30 October 2004.
Subjects: The patients were randomly assigned to the study group (n=60) and the control group (n=60).
Interventions: Peplau’s Interpersonal Relations Model intervention was implemented with the study group.
Main Outcome Measure: The effectiveness of Peplau’s Interpersonal Relations Model intervention with preoperative and postoperative patient’s level of anxiety.
Results: The level anxiety of patients in the study group  decreased considerably preoperatively. There was a statistically significant difference between the study group and the control group in terms of the mean anxiety score postoperatively and before discharge from the hospital.
Conclusion: The researchers concluded that decreased patient anxiety was likely to be associated with intervention based on Peplau’s Interpersonal Relations Model. Peplau’s model can be recommended as an intervention for nurses to improve patient care by decreasing anxiety in the preoperative and postoperative period.
The effect of education on knowledge, self management behaviours and self efficacy of patients with type 2 diabetes
Authors: Atak Nazil , Gurkan Tanju , Kose Kenan
Published: June 2024

Objective: The study was conducted to evaluate the effect of patient education on knowledge, self management behaviours and self efficacy in patients with type 2 diabetes.
Design: A randomised single blind controlled study was designed to assess the effect of education using a pre and post test design.
Setting: The study was conducted in an outpatient clinic in the Department of Endocrinology and Metabolism, School of Medicine, Ankara University, Turkey.
Subjects: The study population consisted of eighty patients with type 2 diabetes who were randomly assigned to the intervention or control group by recruitment number.
Intervention: An education program was developed and delivered to the intervention group. Knowledge and self reported self management behaviours were tested before and after the education program. For the evaluation of self efficacy of patients with type 2 diabetes, mean scores of diabetes self efficacy scale were analysed. The control group received routine treatment.
Main outcome measures: The improvements in knowledge and in self reported self management behaviours were measured by knowledge test; self efficacy of patients was measured by mean scores of diabetes self efficacy scale.
Results: There were significant differences between the intervention and control groups. Improvements were observed in taking regular walks (p=0.043), recognising nutrients with high caloric content (p=0.037), recommended daily fat distribution (p=0.024), regulating blood glucose levels to avoid complications (p=0.002), and in diabetes self efficacy mean scores (p=0.006).
Conclusion: Patient education had a limited effect on knowledge and self reported self management behaviours but a significant effect on self efficacy in patients with type 2 diabetes.
Nurse caring in Iran and its relationship with patient satisfaction
Authors: Rafii Forough , Hajinezhad  , Beck Hamid
Published: June 2024

Objective: The aim of this study was to determine the relationship between patients’ reports of nurse caring and patient satisfaction with nursing care.
Design: The study used a cross sectional design. The Persian versions of the Revised Caring Behaviors Inventory (CBI) and the Patient Satisfaction Instrument (PSI) were used to establish the strength of association between nurse caring and patient satisfaction with nursing care. Data were analysed using SPSS version 10.
Setting: The setting was the educational hospitals affiliated to Iran University of Medical Sciences (IUMS). Heavy workloads and severe staff shortages are common characteristics of Tehran educational hospitals and the time that nurses previously allotted to direct care has been reduced.
Subjects: Two hundred and fifty patients who were hospitalised for medical conditions or surgical procedures were selected through a quota sampling method during 2007.
Results: The findings indicated a statistically significant relationships between patient reports of nurse caring and satisfaction with nursing care (r=0.72, p=0.000; CI 95%; 178.31‑189.99 for the CBI and 82.81‑86.71 for the PSI). Male patients were more satisfied with nursing care than female patients. Admissions to hospital during the last five years were positively correlated with patients’ perceptions of nurse caring and satisfaction with nursing care.
Conclusion: This study which was carried out in Tehran, Iran supports earlier western evidence that nurse caring is associated with patient satisfaction with nursing care. It is important to reflect on the impact of the current health care environment and cultural religion of Iran on caring behaviors of nurses and patient satisfaction with nursing care. Heavy workloads and severe staff shortages are common characteristics of Tehran educational hospitals and the time that nurses previously allotted to direct care has been reduced which may contribute to changes in patients’ perceptions of nurse caring and satisfaction with nursing care possibly reducing the effects of nursing care services. Iranian nurse managers need to consider the religious and cultural barriers to nurse caring and recompense it by providing more human resources.
Barriers that inhibit nurses reporting suspected cases of child abuse and neglect
Authors: Piltz Anne , Wachtel Tracey
Published: June 2024

Objective: An integrative review of the literature was undertaken to identify barriers that inhibit nurses from reporting suspected cases of child abuse and neglect.
Primary Argument: Nurses in all states and territories of Australia except Western Australia are legally required to report suspicions of child abuse and neglect to relevant child protection services. Nurses often have first contact with abused children, yet they do not make the top five list of people who notify. There is limited evidence on what motivates the reporting process and it appears that while nurses are in a key position to report suspected cases of abuse, barriers may exist that hinder this process. These barriers must be identified and addressed.
Findings: Limited education on recognising signs and symptoms of abuse was found to be a major barrier to reporting. Other barriers include limited experience, poor documentation, low opinion of child protection services, fear of perceived consequences, and lack of emotional support for nurses through the reporting process.
Conclusion: Although nurses are mandatory notifiers; that is, they are required by law to report child abuse and neglect, education in this area is not compulsory. While most Australian nursing degrees provide some content on child abuse and neglect, this is not a legal requirement nor is the content standardised. The introduction of compulsory mandatory reporting education should be considered for all undergraduate and post graduate nurses. Further research is needed to evaluate the effects of mandatory reporting education on outcomes and to reduce identified barriers to reporting. This in turn may offer greater protection for children, the most vulnerable members of society.
Staff perspectives of a cardiology short stay unit
Authors: Narasimhan Seshasayee , McKay Katrina , Attia John
Published: June 2024

Objective: To evaluate staff perceptions about working environment, efficiency and the clinical safety of a cardiovascular intervention short stay unit (SSU) during the first year of operation.
Design: Postal questionnaire.
Setting: Cardiac catheterisation laboratory (CCL), coronary care unit (CCU), general cardiology ward (GCW) and the short stay unit (SSU) of a tertiary referral hospital situated in the mid coastal region of NSW.
Subjects: Cardiologists (including visiting medical officers [VMO]), cardiology fellows, cardiology advanced trainees and nurses.
Results: Responses on the working environment of the SSU and the discharge process were statistically significant. A substantial proportion of both nurses and doctors had concerns about patient safety, even though no adverse events were formally recorded in the database.
Conclusions: Though the participants of the survey agree on the efficiency of the SSU in providing beds to the hospital, they disagree on aspects that are important in the functioning of the SSU, including the working environment, patient selection and clinical safety. The results highlight potential issues that could be improved or addressed and are relevant to the rollout of SSUs across NSW.
Comparison of the predictive validity among pressure ulcer risk assessment scales for surgical ICU patients
Authors: Kim Eun‑Kyung , Lee Sun-Mi , Lee Eunpyo , Eom Mi-Ran
Published: June 2024

Objective: To compare the predictive validity of three pressure ulcer risk scales: the Braden scale; the Song and Choi scale; and the Cubbin and Jackson scale and to choose the most appropriate calculator for predicting pressure ulcer risk in the Surgical Intensive Care Unit (SICU) in South Korea.Design: Non‑experimental prospective study.
Setting: A 1,053 bed tertiary educational hospital in South Korea.
Subjects:219 SICU patients at a hospital in South Korea from 1 November 2006 to 31 March 2007.
Main outcome measures: Sensitivity, specificity, predictive value positive and predictive value negative and the AUC (area under the curve) of the ROC (receiver operating characteristic) curve of the three pressure ulcer risk assessment scales.
Results: Based on the cut‑off points presented in this study, the sensitivity, specificity, predictive value positive and predictive value negative were as follows: the Braden scale (cut‑off 14) had values of 92.5%, 69.8%, 40.6%, 97.6%, respectively; the Song and Choi scale (cut‑off 21) had 95.0%, 69.2%, 40.8%, 98.4%, respectively; the Cubbin and Jackson scale (cut‑off 28) had 95.0%, 81.5%, 53.5%, 98.6%, respectively. The AUCs of the ROC curve were 0.881 for the Braden, 0.890 for the Song and Choi and 0.902 for the Cubbin and Jackson.
Conclusions: The results of this research sample showed that the Cubbin and Jackson scale was most effective in predicting pressure ulcer risk compared to the other two scales in the SICU.
Acute care and older people: challenges and ways forward
Authors: Edvardsson David , Nay Rhonda
Published: June 2024

Objective: This article aims to (a) suggest ways in which acute hospital environments might be modified to better meet the needs of the older person and (b) question whether options other than acute care should be canvassed for older people.
Setting: Acute hospital settings.
Subjects: Older people and people with cognitive impairment
Primary argument: Older people are large consumers of acute hospital care, and acute hospitals are known to pose significant risks for this vulnerable population. Such risks include delirium, falls, restraints, drug side effects, and general de‑conditioning entailing loss of function and independence. Eight dimensions of person‑centred care are presented to promote assessing and meeting the needs of older people in acute care. Alternatives to acute hospital admission are also suggested, such as developing ‘older people centres’ to which older people could be admitted for triage in older‑friendly environments staffed by geriatric experts, places in which their multidimensional care needs could be better met.
Conclusions: As an alternative to acute hospital admission, ‘older people centres’ could be developed to which older people could be admitted for triage in older‑friendly environments staffed by experts in care of older people. In the mean time, why not provide a balanced approach that provides some environmental adjustments for older people, core knowledge and skills for all staff, and access to gerontic expertise in the acute hospital care of older people.
Reasons for and barriers to influenza vaccination among healthcare workers in an Australian emergency department
Authors: Osman Abdi
Published: June 2024

Objective: To examine attitudes and beliefs to influenza vaccination among healthcare workers in an Australian emergency department and to assess the vaccine uptake for 2007 influenza season and intentions for the 2008 season.
Design: Cross‑sectional study using a self administered questionnaire.
Setting: Emergency department of an urban teaching hospital in Australia.
Subjects: Participants included all ED staff both clinical and non‑clinical/administrative.
Main outcome measure: Self reported reasons for and barriers against vaccination; proportion of staff vaccinated in 2007 and willingness to get vaccinated in 2008 in staff categories were asked.
Results: The response rate was 90% (63 of 70). The overall vaccination rate reported in 2007 was 58.7% and the reported rate of those willing to be vaccinated in 2008 was 71.4 % (p=0.057). Vaccine was freely provided to all staff by the institution and 88.9% stated they had no problems in accessing vaccine. Performance of the vaccination in relation to knowledge and attitudes with particular interest in reasons for having or not having the vaccine was investigated.
Conclusion: Despite campaigns by the infectious disease unit and an outbreak of influenza A in Australia with confirmed cases by laboratory tests being in the department, misconceptions about the vaccine were common and only 56.4% of nurses and 58.7% of all staff including nurses were vaccinated in 2007 with an expected uptake of 71.4% in 2008. Some staffs attitude towards the vaccine remained unchanged; therefore combined strategies in campaigns
Women’s experience of postnatal depression – beliefs and attitudes as barriers to care
Authors: Bilszta Justin , Ericksen Jennifer , Buist Anne , Milgrom Jeannette
Published: June 2024

Objective: Despite the increasing use of screening instruments to identify women with postnatal depression (PND), many do not access services and supports. It is unclear how women’s experiences of PND influence their beliefs and attitudes and their choice to seek help. We will also explore ways family, friends and health professionals can facilitate help seeking behaviours.
Design: A qualitative study which explored: ‘experiences after having a baby’, ‘recognition of symptoms’, ‘seeking help’, ‘treatment experiences and options’ and ‘ideal treatment’.
Setting: Participants were recruited from either hospital based outpatient PND treatment programs or community based mutual support programs.
Subjects: Forty women experiencing PND and either receiving treatment or attending support groups.
Main Outcome Measure: To gain an insight into the ways women experience PND and perceive their distress, and how this influences their beliefs and attitudes towards acknowledging their distress and seeking treatment.
Results: Findings suggest the lived experience of PND and associated attitudes and beliefs result in significant barriers to accessing help. Eight theme clusters were identified: expectations of motherhood; not coping and fear of failure; stigma and denial; poor mental health awareness and access; interpersonal support; baby management; help‑seeking and treatment experiences and relationship with health professionals.
Conclusion: Implications for improved identification and management include helping health professionals to be aware of the personal and societal barriers preventing mothers from acknowledging their distress. Media campaigns may also be helpful in challenging community views of PND, as well as highlighting the range of treatment options available to mitigate concerns over medical/pharmacological approaches.
Reasons for entering and leaving nursing: an Australian regional study
Authors: Eley Robert , Eley Diann , Rogers-Clark Cath
Published: June 2024

Objective: To compare and contrast the reasons that nurses and nursing students provide for entering and leaving nursing.
Design: A quantitative cross‑sectional cohort design with online survey.
Setting:  Regional public health service district and regional university nursing school.
Subjects: Nurses (n= 272) and nursing students (n=259).
Main outcome measures: Demographics of nurses and nursing students including age, sex and length of time as a nurse, and reasons for entering and leaving the profession.
Results: Among the nurses 88.4% were female and 37% 50 years of age or older. Almost half (45.3%) of the nursing students were 30 years of age or older and 44.1% of all students were working as nursing assistants or enrolled nurses whilst studying. Of these working students 32.5% had been nursing in excess of five years. Self interest, vocation and altruism were identified by both students and nurses as the main reasons for entering nursing. Respondents above and below 30 years of age gave the same reasons for entering nursing. Choice of factors for considering leaving nursing differed between groups and ages. Compared to students, nurses were most likely to cite disillusionment with nursing. Students under 30 years of age indicated pursuit of another career and starting a family to be the major factors while older students offered disillusionment with nursing and health concerns.
Conclusions: Retention strategies may need to differ for the age of nurse. However, recruitment needs to be informed by the altruistic and vocational reasons why nurses and nursing students are drawn to nursing rather than focussing on perceived generational differences.
Scope of emergency nurse practitioner practice: where to beyond clinical practice guidelines?
Authors: Lowe Grainne
Published: June 2024

Aim: The aim of this paper is to discuss some of the issues around continuing development of the Emergency Nurse Practitioner (ENP) role in a Victorian metropolitan Emergency Department (ED) setting. More specifically the discussion will consider the evolving clinical practice of the ENP in relation to clinical practice guidelines (CPG) and optimal utilisation of ENP skills and expertise.
Background: Internationally the mainstay of ENP practice is predominantly minor injury/minor illness models of care. This trend reflects traditional areas of need, or service gap. It is recognised however, that for a service to be sustainable and effective, it must be flexible, dynamic and prepared for future challenges.The development of CPGs to inform ‘scope of practice’, has become contentious. The restrictive nature of ENP specific guidelines has become evident over time, and together with the labour intensive nature of their development, continuing use is questionable. The trend towards the use of multidisciplinary clinical practice guidelines that utilise existing clinical protocols has gained support for future nurse practitioner (NP) role development. These guidelines are generally of a robust, evidence based nature, with regular review and update and don’t apply to any specific clinician group.
Method: An exploration of the progression of the ENP role and service model at a large metropolitan hospital ED was undertaken. An examination of the ongoing changes in demand for ENP service within this organisation was carried out together with the strategies in place, or required, for ENP role expansion and flexibility.
Setting: The setting for this discussion is a large metropolitan Emergency and Trauma centre in Melbourne, Victoria, Australia. The ENP team consists of endorsed ENP and those in training, generally referred to as Emergency Nurse Practitioner Candidates (ENPC). This ENP/C team is employed and cover sixteen hours per day, seven days per week, primarily in the ‘fast-track’ area of the department. ‘Fast-track’ is an area within the ED specifically treating patients presenting with minor injury and minor illness deemed likely to be seen, treated and discharged within a four hour time frame.
Conclusion: The ENP model of care at this organisation confirms ongoing evolvement and expansion of the role in terms of increasing numbers of ENP/C. Questions continue as to the most efficient utilisation of the role to best benefit the ED as a whole and more specifically, patient outcomes. The need for a continued, cooperative and collaborative approach by stakeholders to inform role progression and continuing clinical practice expansion is paramount for continuing department improvements and better patient outcomes.
How useful is the expert practitioner role of the clinical nurse consultant to the generalist community nurse?
Authors: Jannings Wendy , Underwood Emma , Almer Mary , Luxford Bronwin
Published: June 2024

Objective: The objective was to draw attention to the clinical component of the clinical nurse consultants’ (CNC) role in the community.
Design: Quasi‑experimental research design that used descriptive statistics for data analysis.
Setting: An urban community nursing organisation comprising six community nursing Centres within the northern part of a major Australian city.
Subjects: A self selected sample of nine generalist community nurses (GCN) for a focus group. Information gained from this group informed the development of a questionnaire, which was sent to a convenience sample (n=125) of GCNs. Participation was voluntary and participants were not identified. Seventy‑eight questionnaires were returned within the specified time frame, providing a return rate of 62.4%.
Results: Three main themes emerged:

enabling the community nurses’ role;
accessing clinical knowledge\expert practitioner; and
valuable resource.

The main reasons community nurses accessed CNCs were for clinical knowledge (73%) and problem solving (70%); the majority (82.9%) indicated visiting patient’ homes with the CNCs was most useful.
Conclusion: As the complexity of patients’ needs at home increase, CNCs have taken on an integral clinical role within the organisation. The positive working relationship between the CNCs and GCNs presumably had enhanced patient outcomes and improved patient health status. A significant strength of the survey was the consistent responses in favour of CNCs working in the community with the GCNs. A limitation is that the response rate was small (n=78) and results cannot be generalised. Results of this survey could serve to inform future work force planning.
Is it me? Or is there something in the water? Client decision making in nursing
Authors: Rees Merridie , May Jenny , Rae Kym
Published: June 2024

Objective: This paper aims to retrospectively explore client decision making via two case studies prompting us as nurses to reflect on the factors that lead to this. Clients do not always act in ‘their own best interests’ as ‘defined by health professionals’. Our response and understanding of this is key if we are to support and devise strategies encouraging more appropriate decisions and improved outcomes.
Setting: Sole nurse practitioner in community health practice in isolated rural Australia.
Primary Argument: In the rush of daily chronic care caseload management, factors affecting client decision making are often overlooked. Client decisions around care often result in poor outcomes for isolated rural clients. Improved client outcomes can be gained if nurses, (aware of these decision making factors), are able to assist clients to overcome their decision making barriers.
Conclusion: In rural nursing practice client decision making is multifactorial. By reflecting on clients decisions and addressing barriers in this context, short term and long term strategies can be implemented to improve the decision making process resulting in improved outcomes for isolated rural clients.
The nurse educator role in the acute care setting in Australia: important but poorly described
Authors: Sayers Jan , DiGiacomo Michelle , Davidson Patricia
Published: June 2024

Objective: The purpose of this paper is to describe the nurse educator role in the acute care setting in Australia.
Method: A literature review using Ganong’s (1987) method of analysis was undertaken. Computerised databases were searched for articles published in English between 2000 and 2008 using the key words: ‘education’, ‘nursing’, ‘nurse‑educator’, ‘teaching methods’, ‘clinical’, ‘outcomes health care’ and ‘Australia’. Information was summarised to identify issues impacting on the nurse educator role using a standardised data extraction tool.
Results: The search strategies generated 152 articles and reports. The review identified that the nurse educator role is fundamental in supporting clinical practice and integral to developing a skilled and competent health workforce.
Conclusion: Confusion in nursing roles and role ambiguity contribute to the challenges for nurse educators in acute care. The absence of a national, standardised approach to role description and scope of practice in Australia may adversely impact role enactment. Further discussion and debate of the nurse educator role in Australia is warranted.
The long haul: Caring for bone marrow transplant patients in regional Australia
Authors: Bray Louisa , Jordens Christopher , Rowlings Philip , Bradstock Ken , Ian
Published: June 2024

Objective: To evaluate the experience of, and services to, patients from rural and regional Australia referred to a large urban tertiary referral hospital for allogeneic haematopoietic cell transplantation (allo‑HCT) and to compare their quality of life with similar populations.
Design and setting: A cross‑sectional survey of allo‑HCT recipients referred from the Calvary Mater Newcastle to Westmead Hospital, Sydney, NSW.
Subjects: Thirty‑seven of forty adult survivors of allo‑HCT (92.5%) who underwent transplant between 1999 and 2008 and were at least three months post transplant.
Intervention: All subjects completed a validated measure of quality‑of‑life (QoL) in bone marrow transplant recipients (FACT‑BMT Version 4) and the Regional/Rural BMT Needs Assessment Survey.
Results: Most patients (79%) were between one and five years post transplant. Almost all reported having been sufficiently prepared for transplant and received most information and support from the Nurse Coordinator. Despite the fact that 89% of patients reported significant adverse effects of allo‑HCT, >60% still reported an acceptable quality of life. Importantly, however, about a third of patients experienced financial difficulties associated with transplantation and felt pressure to return to work.
Conclusion: Patients referred for allo‑HCT should be advised about the arduousness of transplant but also reassured that most survivors will experience acceptable levels of functioning and QoL one to two years after transplant. With sufficient local support and with appropriate nursing care and coordination the experiences of regional/rural patients is comparable with other allo‑HCT patient populations. Further investigation into vocational rehabilitation is warranted due to the significant financial and occupational pressures reported by survivors of allo‑HCT.
Sleep in residential aged care: A review of the literature
Authors: Dowson Leslie , Moore Kirsten , Tinney Jean , Ledgerwood Kay , Dow Briony
Published: June 2024

Objective: Sleep is necessary for good health at all stages of life. This literature review aims to identify evidence‑based strategies to improve sleep in residential care, and offer recommendations for further research.
Design: A literature search was conducted for articles published between April 2003 and May 2010 and 34 papers were reviewed. These were classified according to the National Health and Medical Research Council’s (NHMRC) 2005‑2007 pilot program of additional levels of evidence.
Setting: Residential aged care.
Primary argument: Strategies for improving sleep were described and evaluated in the 34 papers reviewed. These included pharmacological therapies, cognitive behavioural therapy, light therapy, various alternative therapies and multi‑factorial interventions. There are no clear guidelines for effective and safe sleep promotion interventions in residential aged care.
Conclusions: Given the prevalence of sleep disorders amongst older people in residential care, there is a clear need for further research to enable guidelines to be developed.
Conditions in which nurses are exposed to the hepatitis viruses and precautions taken for prevention
Authors: Özdelikara Afitap , Tan Mehtap
Published: June 2024

Objective: The aim of this study is to evaluate the exposure status of nurses to hepatitis B and C, and to determine the precautionary measures taken for protection from these infections.
Design: This descriptive study was performed between February and May 2008 among nurses working in surgery and internal medicine wards.
Setting: A total of 300 nurses working in the Aziziye Research Hospital and Yakutiye Research Hospital.
Subject: The nurses included in the study comprised those who had three different levels of education, namely undergraduate, associate degree and high school. The data were collected via a questionnaire composed of 34 questions. The questionnaire consisted of questions on socio‑demographic characteristics, questions for estimating the frequency of exposure to blood and bodily fluids, questions about precautions, and questions for estimating HBV, HCV and the vaccination status of the nurses. Main outcome measure(s) A questionnaire developed by the researchers and data collected through a review of literature.
Result: The results of completed questionnaires were collated, and Chi‑square test and percentage tests was used for analysis. 94.9% of the nurses participating in the study stated they had contact with blood and bodily fluids, and 75.8% of them had taken precautions during contact. The mostly commonly used preventive methods were hand washing before and after the invasive procedures on the patients (85.6%), hand washing between the invasive procedures on different patients (69%), and use of gloves (67.9%), respectively. The least used method was wearing protective glasses (0.2%). Among the distribution, injuries whilst replacing the cap of the syringe were leading (87.7%), and the least frequent were injuries sustained during the disposal of medical waste (54.6%). It was seen that 20.5% of the nurses in the study had undergone vaccination for hepatitis B. Majority of the nurses who had not had the vaccination (12.6%) stated they had not yet had the opportunity.
Conclusions: As a result of the study, it was found almost all of the nurses had been in contact with blood and bodily fluids. Above all healthcare workers should receive periodic training on universal precautions, with a view on improving the overall safety of patients and healthcare workers.
Lifestyle risk factor modification in midlife women with type 2 diabetes: theoretical modelling of perceived barriers
Authors: McGuire Amanda M , Anderson Debra
Published: June 2024

Objective: The aim of this paper is to highlight the importance of the concept of perceived barriers in health promotion for risk factor reduction, and to describe a ‘Perceived barriers and lifestyle risk factor modification model’ which could potentially be incorporated into existing frameworks for diabetes education to enhance lifestyle risk factor education in women with type 2 diabetes.
Setting: Diabetes education, community health.
Primary argument: ‘Perceived barriers’ is a health promotion concept that has been found to be a significant predictor of health promotion behaviour. There is evidence that women face a range of perceived barriers that prevent them from engaging in healthy lifestyle activities. Despite this evidence, current Australian and international evidence based frameworks for diabetes education do not explicitly incorporate the concept of perceived barriers to action. Building on existing frameworks for diabetes education and elements of Pender’s Health Promotion Model (1982, 2006, 2010), a model of risk factor reduction which incorporates ‘perceived barriers’ is described.
Conclusion: Although further research is required, it is argued that current approaches to risk factor reduction in type 2 diabetes could be enhanced by assessment and goal setting to reduce an individual’s perceived barriers to lifestyle behaviour change. A ‘Lifestyle risk factor modification and perceived barriers model’ could potentially provide an innovative approach to support this.
Research and evidence based practice in a rural Victorian cohort
Authors: Koschel Alison , Cross Maddalena , Haines Helen , Ervin Kaye , Skinner-Louis Debbie , Carbone Daniel
Published: June 2024

Background: There is little evidence of the prevalence of research driven evidence based practice (EBP) or the supportive nature of organisations in a rural Australian setting.
Objective: The aim of this paper is to identify the research capacity and value of research that translates to EBP in organisations in rural Victoria, Australia.
Design: A snowball technique was used for recruitment. Data was collected using a modified version of a survey originally developed by the Australian Nursing Federation to determine eHealth literacy. The survey was supplemented to measure respondent’s perceptions relating to organisational research ability and value.
Setting: Hospitals, aged care facilities, and general practice surgeries.
Subjects: Nurses in rural Victoria, Australia.
Main outcome measures: Use of research, ability to locate and analyse research, to determine if research was valid, high quality, relevant and applicable, organisations value of research and EBP, linkage of research to quality care of organisation.
Results: Approximately a third of respondents report they have skilled staff for research and evidence assessment. However more than 50% report limited time to research or gather evidence. Research is reported as a priority for the organisation by approximately 40% of respondents. The translation of research to EBP was noted by approximately 50% of respondents who report that decision makers in their organisations consider high quality relevant research when making choices about quality care activities.
Conclusions: This paper demonstrates a need to improve the ability to access quality research and to improve organisations uptake of research and its translation to EBP.
Incidence of phlebitis in patients with peripheral intravenous catheters: The influence of some risk factors
Authors: Salgueiro‑Oliveira Anabela , Parreira Pedro , Veiga Pedro
Published: June 2024

Objective: To identify the incidence of phlebitis and the risk factors which contribute to its development in patients with peripheral intravenous catheters.
Design: Prospective observational study.
Setting: Medical ward of a central hospital in Portugal.
Subjects: Patients with peripheral intravenous catheters hospitalised in the medical ward.
Interventions: Nurses observed the peripheral intravenous (IV) catheterisation site daily. If there were complications, the catheter was replaced, and both the development of phlebitis and the procedure were recorded.
Results: A total of 1,244 catheters were observed, and 317 were removed/inserted. Incidence of phlebitis was 11.09%. A multivariate analysis of risk factors for phlebitis showed patients with KCI (OR: 2.112; CI: 1.124‑3.969), who were on antibiotics (OR: 1.877; CI: 1.141‑3.088) and who had a catheter in an upper limb (OR: 0.31; CI: 0.111‑0.938) were at higher risk for phlebitis.
Conclusion: Despite the patients’ profile (high mean age and high level of dependency), the risk factors are related to the use of prescribed medication and the catheterised limb. Although these findings show the development of phlebitis is not solely related to nurses’ practices, the authors believe these professionals can have an important impact on the prevention of phlebitis. The results show the accurate selection of the catheterisation site, which relies entirely on the nursing intervention, is an important factor for phlebitis.
The effect of light therapy on the sleep quality of the elderly: an intervention study
Authors: Akyar Imatullah , Akdemir Nuran
Published: June 2024

Objective: The study was conducted to determine the effect of light therapy on the sleep quality of older adults.
Design: This interventional study was conducted with a single group pre-test, post-test model.
Setting: The study was conducted in a nursing home in Ankara, Turkey.
Subjects: Twenty-four older adults with poor sleep quality were included in the study.
Intervention: During the study procedure, a 10,000 Lux light was administered continuously for a half-hour duration in the morning over a one-month period.
Main outcome measures: The main outcome measures included global and subcomponents of sleep quality, which were assessed by the Pittsburgh Sleep Quality Index, and were repeatedly measured at the baseline, pre-intervention (four weeks at baseline), post-intervention (at the end of intervention/eight weeks at baseline), and follow-up (four weeks at intervention).
Results: At the end of light therapy intervention and during the four-week follow-up period, the global sleep quality scores were found to be higher compared with pre-intervention and baseline scores (p < 0.001). The ‘daytime dysfunction’ and ‘sleep latency’ sub-scores were found to be the most positively changed, whereas the change in ‘duration of sleep’ sub-score was less.
Conclusion: Light therapy has been shown to be effective non-pharmacological therapy for improving sleep quality amonghealthy elders.
Burnout levels in neonatal intensive care nurses and its effects on their quality of life
Authors: Aytekin Aynur , Yilmaz Fatma , Kuguoglu Sema
Published: June 2024

Objective: The purpose of this study was to investigate burnout levels of nurses working in a neonatal intensive care unit (NICU) and the effects of burnout on their quality of life.
Design: This was a descriptive and correlational study. The researchers obtained data using a questionnaire to uncover the demographic and occupational characteristics of the nurses, and conducted face-to-face interviews via the MaslachBurnout Inventory (MBI) and the World Health Organization Quality of Life -BREF (WHOQOL-BREF).
Setting: The NICU of two state hospitals located in the north of Turkey.
Subjects: A total of 80 nurses.
Main outcome measures: Levels of burnout experienced.
Results: The score means of emotional exhaustion, depersonalisation and personal accomplishment were 14.90±5.53, 3.87±2.77 and 11.43±4.63, respectively. The results showed the nurses had burnout at moderate levels with regard to emotional exhaustion and personal accomplishment, and low levels of depersonalisation. In addition, the study showed a significant negative relationship in many sub-scales of the burnout and quality of life scale.
Conclusion: The nurses experienced moderate burnout in emotional exhaustion and personal accomplishment. The study found that, as burnout level increased, the quality of life of the nurses decreased. It is suggested that several measures must be taken to prevent burnout in nurses.
The effects of mindfulness training program on reducing stress and promoting well-being among nurses in critical care units
Authors: Lan Hee Kim , Subramanian Pathmawathi , Rahmat Norsiah , Kar Phang Cheng
Published: June 2024

Objective: This study was conducted to evaluate the effectiveness of a brief mindfulness-based training program in reducing stress and promoting well-being among critical care nurses.
Design: A quasi-experimental, single-group, pre-post study design was used to evaluate the effectiveness of the program.
Setting: This study was conducted in a tertiary referral centre in Malaysia.
Subjects: A non–probability voluntary sample of 41 critical care nurses participated in the program. Thirty seven (90%) completed the program, with at least 80% attendance.
Intervention: The intervention is an adapted and brief version of Mindfulness-based Cognitive Therapy (b-MBCT) using the local promotional name of ‘Mindful-Gym’. b-MBCT is a group-based program, carried out for five weeks at two hours per week with practice sessions in between. It was delivered as part of the hospital’s continuing nursing education program.
Main outcome measures: Perceived Stress Scale (PSS) and Depression Anxiety Stress Scale (DASS) were used to measure the stress related outcomes. As for the well-being outcomes, the Mindfulness Attention and Awareness Scale and SubjectiveHappiness Scale (SHS) were used.
Results: After completing the program, the participants reported significant improvement in the level of perceived stress (PSS: p < .001; r = 0.50), stress (DASS-S: p = .002; d = 0.56), anxiety (DASS-A: p < .001; r =0.38), depression (DASS-D: p < .001; r = 0.37), mindfulness (MAAS: p < .001; d = 1.002), and happiness (SHS: p = .028; d = 0.57), with a moderate to large effect size.
Conclusion: Results support the effectiveness of b-MBCT in reducing stress and promoting well-being among critical care nurses.
The effects of workplace bullying on physicians and nurses
Authors: Ekici Dilek , Beder Alper
Published: June 2024

Objective: This cross-sectional and descriptive study assessed workplace bullying and its effects on work performance and depression status of physicians and nurses in a university hospital, Turkey.
Methods: The study sample consisted of 201 physicians and 309 nurses. The variables are demographical characteristics of the participants, their perception of bullying, workload, the impact of bullying on work performance and their depression status.
Results: A large percentage of physicians (74%) and nurses (82%) reported having experienced bullying in the workplace. No significant differences were found between the physicians and nurses in terms of experienced workplace bullying. However, there was an association between performance, depression and experienced violent behaviours.
Conclusion: In order to solve the problem caused by workplace bullying, the rate of awareness amongst healthcare professionals needs to be raised. The researchers believe that unless organisations realise bullying’s harmful effects on the employees and work performance, it is not easy to overcome the problem. Therefore, workplace bullying should be dealt with not only at an individual level, but also at organisational levels.