bluuebunny/crossref_metadata_2025 huggingface dataset:
MENTAL HEALTH LIAISON NURSING IN THE EMERGENCY DEPARTMENT: ONSITE EXPERTISE AND ENHANCED COORDINATION OF CARE
Authors: Wand Timothy
Published: June 2024

Objective: To evaluate the Mental Health Liaison Nurse (MHLN) service based in the emergency department (ED) of a large, inner city teaching hospital in Sydney, Australia.
Design: Data were gathered over the first two years of the position. Information is presented regarding the length of time that patients waited to be seen by the MHLN. Results from two rounds of surveys conducted with ED nursing and medical staff are tabulated.
Results: Data obtained from the Emergency Department Information System (EDIS) demonstrates that the Mental Health Nurse Practitioner (MHNP) is able to see a majority of patients at, or close to, the point of triage. These findings are reinforced by ED staff who rate highly the readily available access to mental health assessment and enhanced coordination of care. The strong clinical focus of the role is acknowledged by the ED staff who perceive that patients are better supported therapeutically and spend less time waiting in the department due to MHLN intervention
Conclusions: This evaluation suggests that the MHLN role has significant benefit for patients presenting to the ED by reducing waiting times, streamlining transition through the department and improving follow-up. The MHLN is highly regarded by the staff as an on-site source of clinical expertise. The information obtained supports the established model and will be used to guide the direction of the service.
A COMPARISON OF THE OUTCOMES OF PARTNERSHIP CASELOAD MIDWIFERY AND STANDARD HOSPITAL CARE IN LOW RISK MOTHERS
Authors: Johnson Maree , Stewart Helen , Langdon Rachel , Kelly Pauline , Yong Lian
Published: June 2024

Background: Maternal and infant clinical outcomes were compared for low risk mothers receiving a partnership caseload model of midwifery care, known as Primary Health Midwifery Care (PHMC), and standard hospital care (SHC).
Methods: Using secondary analysis of data from the Obstet Data System routine collection (PHMC n=976, SHC n=976) from a large metropolitan hospital, maternal and infant clinical outcomes were examined.
Results: Odds ratios (OR) demonstrated reduced rates of interventions for multiparous women (OR 0.62 [CI 0.49-0.80]), with multiparous women receiving PHMC being more likely to have a normal delivery (OR 1.75 [CI 1.22-2.5]). A higher proportion of both primiparous and multiparous women receiving PHMC received pethidine during labour (OR 1.78 [1.33-2.39], OR 1.55 [1.19-2.01] respectively). Primiparous women receiving PHMC underwent fewer episiotomies with an associated increase in the proportion of women experiencing perineal tears (OR 1.93, CI 2.35-2.78), although perineum trauma rates were similar for both care models. Similar and very small numbers of infants in both parity groups and care models had an Apgar of less than seven at five minutes or were admitted to the neonatal intensive care unit or special care unit.
Conclusion: This study, within the limitations of its design, supports the safety of the partnership caseload midwifery care model, in addition to reduced rates of interventions experienced by multiparous women and fewer episiotomies in primiparous low risk English speaking women receiving caseload care.
NURSES’ PERCEPTIONS OF PATIENTS’ REQUIREMENTS FOR NURSING RESOURCES
Authors: Dunn Sandra , Schmitz Karl
Published: June 2024

The study used semi-structured interviews in an interpretive research design to explore nurses’ perceptions of patients requiring disproportionate amounts of nursing resources, and factors influencing those perceptions. A total of 50 senior nurses from a variety of medical and surgical settings, including a high dependency unit, were interviewed and the data analysed to determine common themes and differences between participants.
The four major themes of patient characteristics, family needs, staffing and organisational context defined the factors nurses perceived as influencing their perceptions of patients’ dependency. Patient requirements for nursing resources were seen as a continuum rather than a specific point, and were balanced on the combined influences of the four themes. At times, demands imposed on nursing resources lead to nurses’ perceptions of delivering less than ideal care, stress and frustration. The latter applied particularly to factors that were outside of the control of nurses such as staffing levels and skill mix.
HOW TO RECOGNISE A ‘QUALITY’ GROUNDED THEORY RESEARCH STUDY
Authors: Elliott Naomi , Lazenbatt Anne
Published: June 2024

Background: The quality of a research study is a key issue for clinical practitioners committed to the delivery of ‘best-practice’ patient care. With the increasing use of grounded theory in nursing research, attention is now focusing on the quality of studies using this research methodology. Indeed, within the growing body of grounded theory in nursing some methodological problems are emerging that raise questions about the quality of the research.
Aim: This paper recognises that clinical practitioners need to be critical readers of grounded theory research, so that they recognise ‘quality’ research studies and can develop their clinical practice based on sound research findings.
Conclusion: Grounded theory should be viewed as a package of research methods that includes the use of concurrent data collection and constant comparative analysis, theoretical sampling and memoing, all of which can create an awareness and an appreciation of the scientific merit required of grounded theory research and promote quality standards relating to research practices in grounded theory methodology.
PRE-TEST AND POST-TEST EVALUATION OF STUDENTS’ PERCEPTIONS OF A COLLABORATIVE CLINICAL EDUCATION MODEL ON THE LEARNING ENVIRONMENT
Authors: Henderson Amanda , Heel Alison , Twentyman Michelle , Lloyd Belinda
Published: June 2024

Objective: This study investigated the impact of a collaborative clinical education model on students’ perception of the psycho-social learning environment.
Design: A pre-test and post-test quasi experimental design.
Setting: A tertiary referral centre.
Subjects: Second and third year undergraduate nursing students were asked to rate their perceptions of the psycho-social learning environment at the completion of the clinical practicum.
Tool: The tool used to measure psycho-social perceptions of the clinical learning environment was the Clinical Learning Environment Inventory previously validated in Australian health care contexts.
Intervention: A collaborative arrangement with the university and ward staff where eight students are placed on a ward and a ward staff member is paid by the university to be ‘off-line’ from a clinical workload to supervise the students. This is in contrast to thestandard facilitation model where students are placed with registered nurses in different localities under the supervision of a ‘roving’ registered nurse paid by the university.
Results: No significant differences were found in pre-test mean scores when comparing wards. Significant differences in post-test scores for the intervention group were identified in the sub scales of Student Involvement, Satisfaction, Personalisation and TaskOrientation.
Conclusions: The adoption of a collaborative clinical education model where students are integrated into the ward team and the team is responsible for student learning can positively enhance capacity for student learning during their clinical practicum.
CLINICAL PLACEMENTS IN RESIDENTIAL AGED CARE FACILITIES: THE IMPACT ON NURSING STUDENTS’ PERCEPTION OF AGED CARE AND THE EFFECT ON CAREER PLANS
Authors: Abbey Jennifer , Abbey Brian , Bridges Pamela , Elder Ruth , Lemcke Pam , Liddle Jacki , Thornton Robert
Published: June 2024

Objectives: Undergraduate nursing students have often found clinical placements in aged care unsatisfactory and/or unsettling, dissuading them from considering aged care as an employment option on graduation. This study asked which elements of the clinical placement experience produced that outcome; and what changes could yield more positive outcomes.
Design: A descriptive qualitative pilot study was carried out in late 2003. A combination of nominal groups and semi-structured interviews was used with students and experienced nurses to identify commonalities and variations in issues nominated as important and in the views expressed on those issues. Transcripts were independently analysed by two experienced investigators. Themes identified were discussed among the researchers.
Subjects: Fourteen volunteer undergraduate nursing students, all of whom had completed clinical placements in residential care and some of whom had prior experience in such facilities, participated in the nominal groups. Twelve registered nurses who had acted as clinical teachers in aged care facilities were interviewed.
Results: Perceived issues included: unexamined assumptions about nursing’s core skills; lack of pre-placement orientation to the residential care environment; the appeal of and apprehension aroused by autonomous practice; and status, income and career progression considerations.
Conclusions: Analysis of the sometimes ambivalent and conflicting views expressed pointed to possible changes, all within the domain of training and employing institutions, capable of bringing submerged issues to the surface for examination and resolution as part of raising student understanding of gerontology as a demanding specialty and residential care as a rewarding career.
TRIALING COLLABORATIVE NURSING MODELS OF CARE: THE IMPACT OF CHANGE
Authors: Fowler Joanna , Hardy Jennifer , Howarth Teresa
Published: June 2024

Objective: The aim of the project was to develop and trial a nursing Model of Care (MoC) and devise a framework to investigate the impact of nursing staff mix on patient outcomes and job satisfaction (nurses).
Setting and Subjects: In 2001-2002 a pilot project was undertaken to explore issues related to the delivery of patient care by nurses on two medical inpatient wards, one acute and one subacute, at a referral teaching hospital in New South Wales (NSW), Australia. The framework employed was an adaptation of, and based on, the Clinical Practice Improvement (CPI) model developed by NSW Health.
Primary Argument: Countries across the world are seeking solutions to a shortage of registered nurses and their ability to sustain quality care services. It becomes imperative that organisations develop strategies to attract and retain nurses in the health care system.
Conclusions: Results of the project highlighted areas related to the quality of care delivery: clinical supervision; continuity of staffing; trust; employer of choice; more effective nurse to patient ratios; educational preparation; and recognition of prior experience.
ASSESSMENT AND MANAGEMENT OF CHRONIC PAIN IN THE OLDER PERSON LIVING IN THE COMMUNITY
Authors: Dewar Anne
Published: June 2024

Aim: This paper reviews the nursing research literature on chronic pain in the older person living in the community and suggests areas for future research.
Background: Chronic pain is a pervasive and complex problem that is difficult to treat appropriately. Nurses managing chronic pain in older people in domiciliary/home/community nursing settings face many challenges. To provide care, the many parameters of chronic pain which include the physical as well as the psycho-social impact and the effect of pain on patients and their families, must be carefully assessed. Beliefs of the older person about pain and pain management are also important.
Method: Relevant nursing studies were searched using CINAHL, Cochrane Database of Systematic Reviews, EMBASE and PUBMED databases using key words about pain and the older person that were appropriate to each database.
Results: Tools to assess pain intensity in the older person have been studied but there has been less research on the other parameters of pain assessment or how the older person manages pain. An effective nurse-patient relationship is an important component of this process and one that needs more study. Few research studies have focused on how nurses can be assisted, or on the challenges, nurses’ face, when managing this vulnerable population.
Conclusion: A broad approach at the organisational level will assist nurses to manage this health care issue.
THE IMPORTANCE OF LANGUAGE FOR NURSING: DOES IT CONVEY COMMONALITY OF MEANING AND IS IT IMPORTANT TO DO SO
Authors: Allen Sonia , Chapman Ysanne , O'Connor Margaret , Francis Karen
Published: June 2024

Objective: Language is the medium by which communication is both conveyed and received. To understand and communicate meaning it is necessary to examine the theoretical basis of word conceptualisation. The determinants of understanding language however are somewhat elusive and idiosyncratic by nature. This paper will examine briefly the development of language and how language is used in the health care setting, while recognising that nursing is an internationally recognised profession.
Setting: In nursing, language is used to facilitate quality care and inform and educate recipients of that care. In today’s somewhat litigious society, it is essential that what is transmitted is commonly interpreted by nurses and patients alike. Questions are posed relating to an elitist language for nurses and its placement for communicating with other health care professionals.
Primary argument: Through exploring language with a small group of nurses, this paper alludes to consumer expectations; how nurses use a common language; and where and when they move toward a more elitist communication. The paper examines consumer expectations of health care communication and how it facilitates consumer choice and the quality care agenda.
Conclusion: Communication for the nursing profession poses a challenge as there are differing requirements for specific situations. Nurses acknowledge that language facilitates commonality of understanding and hence meaning. An elitist language when communicating with other health professionals does exist within specialist units, though where commonality of language ends and an elite language begins is difficult to determine. Language does elicit power and authority when educating and communicating with patients while proving difficult in the context of international global nursing requirements.
Determinants of burnout among public hospital nurses
Authors: Spooner-Lane Rebecca , Patton Wendy
Published: June 2024

Objective: The present study extends our knowledge of the main determinants of burnout among nurses working in public hospitals and investigates the impact of work support on the stress‑burnout relationship.
Design: A cross‑sectional, survey design.
Setting: Data were collected from three public hospitals in south east Queensland, Australia.
Subjects: A convenience sample of 273 nursing staff (235 females, 38 males) participated in the study.
Main outcome measures: The influence of work stressors (ie. job‑specific stressors and role stressors) and work support (ie. supervisor and coworker support) on burnout amongst public hospital nurses.
Results: Overall, nurses reported moderate levels of burnout (emotional exhaustion, depersonalisation and reduced personal accomplishment). Hierarchical regression analyses revealed that socio‑demographic factors play a small, but significant role in predicting burnout. Role Overload, Job Conflicts and Role Boundary contributed to higher levels of Emotional Exhaustion. Role Boundary and Professional Uncertainty contributed to higher levels of Depersonalisation and Role Boundary and Role Ambiguity contributed to lower levels of Personal Accomplishment. Only Supervisor Support had a significant effect on Depersonalisation and Personal Accomplishment. No evidence was found to indicate that work support had a buffering effect on the stress‑burnout relationship.
Conclusions: The results highlight the need for organisational interventions to reduce the workload placed on nurses. Supervisors are in a better position than co‑workers to reduce burnout among nurses by clearly outlining the boundaries and expectations of the nursing role.
Prevalence rate of delirium at two hospitals in Western Australia
Authors: Speed Gaye , Wynaden Dianne , McGowan Sunita , Hare Malcolm , Landsborough Ian
Published: June 2024

Objective: To estimate the prevalence of delirium in patients on 15 medical and surgical wards at two hospitals in Western Australia.
Design: Following a review of the literature on delirium a standardised data collection tool was developed and four prevalence audits were conducted over a four week period at the target hospitals. The nurse coordinator on each ward was asked to identify any patient who was experiencing a delirium or who was confused. These patient’s records were then examined for documentation that confirmed the presence of delirium or confusion.
Main outcome measures: The audit measured those patients with a confirmed documented delirium and identified patients who had a possible delirium superimposed on a confirmed or suspected dementia or unconfirmed organic brain disorder. Patients with a known dementia or organic brain disorder who displayed symptoms of confusion but had no evidence of delirium were also identified.
Results: Of 1209 patients surveyed in four prevalence audits, 132 patients (10.9%) displayed behaviours suggestive of the presence of delirium; however only 48 of the 132 patients had a confirmed diagnosis of delirium. The remaining 84 patients displayed features of delirium that were superimposed on symptoms of dementia (diagnosed/undiagnosed) or an organic brain disorder. An additional 51 (4.2%) of the 1209 patients were identified with confusion resulting from other causes.
Conclusions: Accurate assessment of delirium is particularly important in elderly people where behaviours associated with delirium are often assumed to be caused by dementia. This may result in delirium going undiagnosed and untreated.
Progression from gastric tube feeds to full suckle feeds and discharge home of preterm infants
Authors: Flint Anndrea , Mark  , Collie Li-An , Palmer-Field Kristina
Published: June 2024

Objective: To estimate the time taken for preterm infants to progress from 50% suckle feeds to full suckle feeds and then to discharge.
Design: An observational, retrospective cohort study.
Setting: A level 2 and 3 neonatal nursery in a tertiary teaching and referral hospital in Queensland, Australia.
Subjects: 61 consecutive infants born between July 2002 and December 2002 who were born <35 weeks gestational age; admitted for ≥14 days; and discharged directly home from hospital.
Main outcome measures: Time taken to progress from 50% suckle feeds to full suckle feeds and then to discharge.
Results: Infants spent an average of eight days in hospital after they attained four out of eight suckle feeds, six days in hospital after they attained five out of eight suckle feeds, and four days in hospital after reaching full suckle feeds.
Conclusions: Most infants will be able to be discharged home within two or three days of achieving five out of eight suckle feeds if discharge planning is started at this stage. This may decrease overall length of stay for these infants.
The development of a critical thinking conceptual model to enhance critical thinking skills in middle‑eastern nurses: a middle‑eastern experience
Authors: Simpson Elaine , Courtney Mary
Published: June 2024

Objective: This paper aims to describe the development of a critical thinking conceptual model which was constructed to guide the teaching and evaluation of critical thinking skills to Middle‑Eastern nurses.
Setting: A large tertiary hospital situated in the Middle‑East, which adopted North American standards of healthcare.
Subjects: Twenty Middle‑Eastern female nurses who graduated from a nursing college in the Middle‑East, wherein basic nursing subjects were taught, but critical thinking was not included in the curriculum of the nursing content.
Primary Argument: Critical thinking is an essential element for nurses who function in today’s complex healthcare domain. Nursing organisations worldwide have recognised the need to develop and stimulate higher‑order critical thinking by using innovative strategies to stimulate critical thinking abilities. This Middle‑Eastern hospital sought to promote critical thinking skills in Middle‑Eastern nurses, and a Professional Development Nursing Program was established. An education component to promote critical thinking was developed and integrated into the curriculum of this program.
Conclusion: Nurses and nurse educators favoured a model that supported critical thinking. Reasons given refer to improving professional standards of practice, stimulating inquiry and promoting sound reasoning in practice, as well as contributing to personal and professional development. The model was effective for this nursing educational program and could be duplicated by other programs to create a learning environment for developing critical thinking, as well as promoting professionalism in nursing.
Evaluating the Family Partnership Model (FPM) program and implementation in practice in New South Wales, Australia
Authors: Keatinge Diana , Fowler Catherine , Briggs Carolyn
Published: June 2024

Objective: This study investigates participants’ experiences of implementing and educating colleagues in the Family Partnership Model (FPM).
Design: Qualitative research approaches using content analysis.
Setting: NSW child and family health services.
Subjects: Seven child and family health professionals.
Intervention: Implementation of the FPM facilitators education program to develop the competence of participants as FPM facilitators.
Main Outcome: Findings from this study identify that the FPM built on and extended existing knowledge and was relevant and useful to clinical practice. Further, the FPM’s value is evident in participants’ positive comments about it and their ability to successfully implement it in their practice and educate and encourage colleagues to do the same.
Conclusions: The study has identified that the sustainability of FPM program and implementation depends on adequate support for practitioners/facilitators, and the commitment of resources to this process overall.
Can I do everything? time management in neonatal unit
Authors: Litchfield Catherine , Chater Keri
Published: June 2024

This paper presents the findings of a study which explored the lived experience of ‘managed time’ for new graduate nurses working in a neonatal unit in the public health system in Australia. Information was collected through conducting in‑depth focused interviews with six nurses. The data generated was analysed using Colaizzi’s (1978) method of data analysis. Five themes emerged including: knowing, planning, support, fulfilment, adapting and being flexible. These exhaustive themes were integrated into a fundamental structure of ‘managed time’. The findings of this study have revealed detailed insight into the phenomenon of managed time for new graduate nurses working in a neonatal unit.
Practice development: a critique of the process to redesign an assessment
Authors: Cioffi Jane , Leckie Clair , Tweedie Jan
Published: June 2024

Objective: This paper presents a brief description of an activity to redesign a nursing assessment followed by a critique of the practice development process used.
Setting: Adult acute care general hospital wards.
Primary argument: Practice development can address shortfalls in clinical practice by using a systematic process to change practice so improving health care. Through the application of a professional development activity addressing assessment the described process provides the basis for a critique that gives directions for ongoing similar activities.
Conclusions: Directions identified for ongoing practice development activities are: engage all staff in the change process who own the practice; appoint alternative persons with delegated authority for key facilitators; build professional development into the practice change; provide service users (eg patient representatives) with mentoring; develop transformational strategies that address not only the dominant organisational culture but also existing subcultures; and employ an emancipatory practice development process. The main recommendation for practice development in bureaucratic organisations is to develop and establish the evidence base necessary to ensure the process is effective.
Pre‑registration nurses: an investigation of knowledge, experience and comprehension of e‑health
Authors: Edirippulige Sisira , Smith Anthony , Beattie Heather , Davies Elizabeth , Wootton Richard
Published: June 2024

Objective: The present study investigates the perceptions and attitudes of nursing students with regard to e‑health, the level of their knowledge in e‑health and their expectations of e‑health. Barriers which impede the development of knowledge and skills in e‑health within a nursing curriculum are also explored.
Design: The study design was a cross‑sectional survey questionnaire. A questionnaire focusing on the attitudes and perceptions of nursing students toward e‑health was distributed to 60 second year nursing students at a university nursing school in Queensland, Australia.
Setting: A tertiary education centre for nurses.
Subjects: Second year undergraduate nursing students.
Results: 77% (43) respondents admitted they were not familiar with the term e‑health. 82% (46) rated their knowledge of e‑health technologies as minimal. 87% (49) admitted they never had e‑health education in any form. Over 50% (34) of all respondents said they were not sure if e‑health has any relevance to their future practice. 82% respondents rated their computer skills as advanced or intermediate; while 39% (22) responded the main barrier for them to improve their knowledge and skills in e‑health is lack of systematic education and training.
Conclusions: Despite the fact that the majority of respondents regularly used computers and the internet in their day to day activities and nursing education, their awareness and knowledge with regard to e‑healthcare was very limited. In order for nurses to be equipped with the skills required to facilitate e‑healthcare applications there is a need for undergraduate students to be provided with formal e‑healthcare training.
After the graduate year: a phenomenological exploration of how new nurses develop their knowledge and skill over the first 18 months following graduation
Authors: McKenna Lisa , Newton Jennifer
Published: June 2024

Aim: This study sought to explore how new nurses develop their knowledge and skill over the first 18 months following graduation, as well as factors promoting or inhibiting their development.
Background and Purpose: The graduate year requires the new nurse to make the transition from student in an academic setting to nurse employed within the health workforce. To facilitate the transition, many public and private hospitals in Australia offer formalised twelve-month duration graduate nurse programs that provide graduates with rotations through a number of clinical areas; preceptor support; and study days. Initially twenty five participants were followed for a period of eighteen months, incorporating the graduate year as well as the next six months when they no longer had support from a structured program. Findings from the focus groupsafter completion of the final six months are reported in this study at which time nine participants from three hospitals continued in the study.
Method: A qualitative approach using focus groups was adopted to allow for rich data to emerge. Four different hospitals in Victoria, Australia allowed graduates to be recruited into the research project. These included public and private hospitals, as well as metropolitan and rural hospitals. For the phase of the study being reported here, focus group interviews were conducted between 16 and 18 months following commencement of the graduate program. Data from all focus groups were analysed using Colaizzi’s (1978) framework.
Findings: Three main themes emerged from these focus groups: ‘sense of belonging’, ‘knowing’ and ‘moving on’. It is only after the completion of a graduate year that new nurses gain a sense of belonging and are able to complete their socialisation into the clinical workplace.
Conclusions: The development of nurses beyond the graduate year does not end with the completion of their transition program. They may still be working to develop a sense of belonging, independence in their practice and exploring their future development. Further work is needed to explore the period beyond the graduate year in the development of the registered nurse.
Innovative practice in the management of chronic Hepatitis C: introducing the nurse practitioner model
Authors: Nazareth Saroj , Piercey Carol , Tibbet Patricia , Cheng Wendy
Published: June 2024

Chronic hepatitis C is a major health burden world wide. Only 1% of people with hepatitis C in Australia have access to treatment. This paper addresses the issue of motivating people with hepatitis C to seek treatment and the strategy of introducing the nurse practitioner role to effect this change.
Objective: To demonstrate that the introduction of a nurse practitioner service model is an effective and safe way of increasing access to treatment for people with chronic hepatitis C.
Setting: A multidisciplinary liver service at Royal Perth Hospital, a tertiary referral centre in Perth, Western Australia.
Subjects: People with chronic hepatitis C managed in a state wide chronic hepatitis C service.
Primary Argument: To make any impact on controlling the hepatitis C epidemic in Australia, the number of people in treatment will have to triple annually. Improved access to treatment includes the removal of mandatory liver biopsy as a requirement to treatment and an increase in the accessibility and availability of effective medicines. Nurse practitioners can function independently within clinical protocols approved by the designated service and the Director General of Health. The scope of practice of nurse practitioners includes the legislated right to prescribe specific medications and initiate diagnostic investigations as specified in clinical protocols. The hepatology nurse practitioner works in collaboration with medical practitioners, co-ordinates the treatment of patients with chronic hepatitis C, and helps to facilitate interdisciplinary referrals within the multidisciplinary team.
Conclusion: The introduction of the nurse practitioner model with the ability to prescribe specific medicines and initiate diagnostic investigations within approved clinical protocols can facilitate improved access to hepatitis C treatment programs. It is expected that the nurse practitioner’s expert knowledge and skill and the application of evidence based practice in the hepatitis specialty will assist in the provision of a safe, competent and high quality standard of care to patients.
Sampling methods: methodological issues involved in the recruitment of older people into a study of sexuality
Authors: Gledhill Susan , Abbey Jennifer , Schweitzer Robert
Published: June 2024

Objective: Sexual desire experienced by people over 65 years of age is a sensitive topic deserving serious and ethical research. The recruitment of participants into a potentially sensitive study poses particular difficulties including ethical challenges such as informed consent and confidentiality. This paper, drawing on a study of sexual desire in an older aged population group, outlines a range of purposive sampling methods that resulted in a high rate of recruitment, thus validating the methodology employed. The paper reports the outcomes of four recruitment strategies: word of mouth, advertising, community‑based seminars and direct solicitation that were employed in a study onsexual desire and ageing. The paper aims to encourage researchers and health professionals to consider looking more closely at topics often considered to be socially forbidden and outside the ambit of nursing research. Some of the ethical issues involved in recruitment for the study will also be considered.
Setting: An urban older population group living in the community.
Subjects: Fifteen women and 21 men aged 65 years and over.
Primary Argument: There is little research exploring sexual desire in older people due in part to the methodological demands inherent in conducting such research. Most research which has been undertaken in this area employs quantitative rather than qualitative methods. One reason for the paucity of qualitative data on sexual desire and ageing is the perception that older people are reluctant to discuss intimate details of their lives. In addition, older people are demographically situated within a marginalised and therefore vulnerable population group, creating an ethical challenge for health related research. Consequently, it is imperative that researchers give due consideration to accepted ethical principles that govern properly conducted research and that are critically important when researching a potentially vulnerable population group. This paper outlines four sampling strategies and discusses some of the ethical issues involved in recruiting older people into a qualitative study. The paper argues that the findings will add to an understanding of a key element of the experience of sexual desire in older people and some of the ethics involved in achieving that understanding.
Conclusion: The adoption of a variety of sampling approaches has been shown to be successful in recruiting members of the older population into a phenomenological study exploring sexual desire.
The duration of clinical placements: a key influence on nursing students’ experience of belongingness
Authors: Levett-Jones Tracey , Lathlean Judith , Higgins Isabel , McMillan Maragaret
Published: June 2024

Objective: This paper reports selected findings from a study that investigated nursing students’ experience of belongingness. The manner in which this experience is influenced by the duration of students’ clinical placements is the focus of the discussion.
Design:  A mixed method, multi‑site case study approach using an anonymous online survey: the Belongingness Scale ‑ Clinical Placement Experience was completed by 362 students, 18 of whom also participated in semi‑structured interviews.
Setting: The setting for the study was two Australian universities and one university in the United Kingdom offering undergraduate nursing programs.
Subjects: Third year undergraduate students (n=362) were recruited into the study.
Main outcome measure: Nurses experience of belongingness and the influence of the duration of clinical placement on the experience of belongingness.
Results: Students’ self‑concept, degree of self‑efficacy, confidence, resilience, willingness to question or conform to poor practice, career decisions, capacity and motivation to learn were all impacted by the extent to which they experienced belongingness. Differences in belongingness scores between the students from the three sites were statistically significant, with participants from the United Kingdom scoring higher than those from either of the Australian sites, F(2, 355) = 21.70, p = <.001, ηp2 = 0.11. Although the reasons for these results are multifactorial, this study found the duration and structure of clinical placements to be one of the most important factors affecting students’ belongingness.
Conclusion: A consolidated period of practice for students to ‘settle in’ and establish collegial relationships is an important influence on their experience of belonging and a necessary precursor to their active and participative learning. Findings from this study call for a re‑examination of the assumptions, educational philosophies, policies and practices that underpin the duration of clinical placements in contemporary undergraduate nursing programs.
How do university clinical school of nursing graduates choose their graduate nurse year program?
Authors: Scanlon Andrew
Published: June 2024

Objective: To assess the decision making process of nursing undergraduates when choosing a graduate nurse year program and to explore whether clinical school experience affects the decision making process.
Design: A descriptive exploratory survey was distributed to all nursing graduates (n=166) from one cohort (single year) three months after completion of their course at a metropolitan university in Victoria, Australia. This cohort of students attended either of two metropolitan clinical schools and approximately 37.9% returned (n=62) the survey within 2 months of initial mail out. Responses from this cohort were assessed in relation to how preferences were ranked in choosing a GNY program.
Setting: The setting was a metropolitan university and two metropolitan clinical schools of nursing in Victoria, Australia.
Subjects: Nursing graduates (166 with 62 participating).
Results: Data from respondents indicated that the overall experience at the clinical schools was positive with 59.7% (n=37) stating it was very good and another 35.5% (n=22) stating it was good. The majority of respondents (82.3% n=51) received their first preference however only 22.5% (n=14) chose to return to their original clinical school for their graduate nurse year program. Reasons for not returning to their clinical school included: nursing specialisation, support, rotations offered, past clinical experience, and ongoing career prospects.
Conclusion: The high percentage of respondents receiving their first preference for GNY programs suggests the clinical school model for undergraduate nursing students is highly valued by hospitals and health care networks. In addition, undergraduate nursing students are choosing which GNY will best suit their present and future career needs, regardless of past (positive) experience in a clinical school. Choice of GNY is strongly associated with past clinical experience and nursing specialisation offered. This is of value to health care institutions or hospitals when developing or promoting their GNY program or undergraduate study programs to potential employees or students.
Comorbid illness affects health‑related quality of life after coronary artery bypass graft surgery
Authors: Lee Geraldine
Published: June 2024

Objective: The purpose of this study was primarily to examine patients’ health related quality of life (HRQoL) and secondarily to examine the effect of comorbid illness on HRQoL five years after coronary artery bypass graft surgery (CABGS).
Design: A prospective study using the Short‑Form 36 health survey (SF‑36) was performed.
Setting: The study was performed at a central London hospital, United Kingdom.
Subjects: From a previous study with 162 patients enrolled, one hundred and twenty‑eight (79%) agreed to participate in a follow‑up study five years after cardiac surgery by either a face‑to‑face or postal method.
Intervention: Participants were asked to complete questionnaires about their HRQoL, current illnesses and medication five years after CABGS.
Main outcome measures: Physical and mental HRQoL was recorded using a self report and the effect that comorbid illness has onHRQoL five years post CABGS was determined.
Results: Fifty five percent of the sample reported concomitant illness at the time of follow‑up and lower scores were observed in the physical domains of the SF‑36 reflecting poorer HRQoL. The domains of physical functioning, physical role limitations, social functioning and bodily pain and the summary physical score were significantly lower in those with comorbid illness (p<0.001). Significantly higher rates of hospitalisation following CABGS were also noted. However no significant differences were observed in mental HRQoL (p=0.593) compared to those with no comorbid illness.
Conclusion: The presence of comorbid illness impacts significantly on physical HRQoL five years after CABGS but no such effect is noted in mental wellbeing. From a nursing perspective, the importance of comorbid illness should be taken into account when planning physical activities after CABGS, when educating patients about the benefits of CABGS and when setting realisticexpectations after surgery.
The evaluation of the impact of the use of wool in patients with fibromyalgia on life quality
Authors: Kiyak Emine , Akdemir Nuran , Fesci Hatice
Published: June 2024

Objective:  The study was conducted to evaluate the impact of the use of wool on the quality of life of patients with fibromyalgia.
Design: The study was conducted in two stages with a single‑group pre‑test/post‑test model (before trial test model).
Setting: The research was conducted in a physical therapy and rehabilitation outpatient clinic and in patient’s homes in Ankara, Turkey.
Subjects: 36 patients diagnosed with fibromyalgia according to the criteria of the American College of Rheumatology were included in the study.
Interventions: The patients did not use wool in the first stage (7 weeks) and used woollen underwear, bed coverings, mattresses and woollen cushions in the following second stage (20 weeks).
Main outcome measures: Study data was collected using a general questionnaire, a Life Quality Scale (Nottingham Health Profile), Visual Analogue Scale (VAS 0‑10), Pittsburg Sleep Quality Index, the number of tender points, andchecklists.
Results: During the period when the patients used wool, it was found there were significant improvements in pain score (before using wool=7.26±1.42; after using wool=1.93±0.74), tender points count (before=14.88±2.43; after=5.97±2.56), Nottingham Health Profile (before=74.28±10.73; after=5.98±1.07) and Pittsburg Sleep Quality Index (before=10.02±3.59; after=2.52±1.69) (p<0.001).
Conclusion: There were significant improvements in pain score, tender points count, Nottingham Health Profile in all sections, and the Pittsburg Sleep Quality Index and its components, as a result of the use of woollen underwear, woollen bed coverings, wolleen mattress cover and woollen cushions in patients with fibromyalgia.
Implementing clinical guidelines for acute stroke management: do nurses have a lead role?
Authors: Hill Kelvin , Middleton Sandy , O'Brien Elizabeth , Lalor Erin
Published: June 2024

Objective: Health professionals should be aware of, and implement, best practice clinical guidelines for stroke care. Using the latest National Stroke Foundation Clinical Guidelines for Acute Stroke Management this study aimed to determine which member of themultidisciplinary team would most likely be responsible for taking the lead role for implementing each recommendation.
Methods:  Three nurses and one allied health professional independently classified each of the 148 recommendations according to whom they thought most likely to take the lead role in implementing each recommendation. A teleconference was held to discussany differences of opinion and gain consensus.
Results: The multidisciplinary team was identified as responsible for taking the lead role most often (n=54, 36%), followed by medical practitioners (n=52, 35%) and nurses (n=13, 8%). Nurses were identified as being involved either as the lead initiator or as part ofthe multidisciplinary team in implementing 79 (53%) of recommendations. A significantly higher percentage of recommendations where implementation was determined to be led by medical practitioners were attributed a Grade A or B strength of evidence (iehigher strength) (49%) when compared with those recommendations determined to be led by nurses (6%) (p=0.04). There was no significant difference between the number of Level I or II based recommendations determined to be led by medical practitionerscompared to those led by nurses (59%; 11% respectively; p=0.26).
Conclusions: Neuroscience nurses have a key role in the multidisciplinary stroke team and should contribute to the implementation of many of the evidence-based guideline recommendations for acute stroke.
Using the ‘six thinking hats’ model of learning in a surgical nursing class: sharing the experience and student opinions
Authors: Karadağ Mevlüde , Saritaş Serdar , Erginer Ergin
Published: June 2024

Objective:  The purpose of the study was to test the use of a creative teaching method in developing nursing students’ critical thinking skills The ‘six thinking hats’ model, which was developed by Edward DeBono in 1994, is a teaching method for developing creative thinking by presenting and systematising thoughts and suggestions within a specific structure. The six different hats (white, yellow, black, red, green, and blue) symbolise the thinking system. In this method the students are expected to change their perspectives symbolised by a colour at regular intervals. 
Setting: This study was conducted during the 2006‑2007 academic year at Gaziosmanpaşa University.
Subjects: The research population was comprised of 41 students who were registered for the surgical nursing class in the Department of Nursing at Tokat School for Health Sciences. Purposive sampling was not undertaken for the study with the entire population of students targeted.
Method: The ‘six thinking hats’ model was used in theoretical lessons about breast cancer, spinal cord trauma and transplantation nursing in a surgical nursing class. At the end of the theoretic section of the class, the students’ opinions were sought about the ‘sixthinking hats’ model of learning. Data were analysed with percentage and Chi square test reporting of the responses.
Findings: The majority of the students stated that this method facilitated their empathising with the patient; sharing different ideas and opinions; considering the patient holistically; generating creative ideas; looking at an event from positive and negativeaspects; and developing their system of thinking. They recommended that this class be taught using this method.
Conclusion: This study is important because it tested the use of a creative teaching method that is useful for the development of nursing students’ critical thinking skills. The study is also important because there are a limited number of references in the literature about the use of the ‘six thinking hats’ model of learning in university education, and only one in nursing education, and having this type of study in the nursing literature adds to the improvement and enrichment of nursing education.
Surviving survival: nursing care at Bergen‑Belsen 1945
Authors: Ben-Sefer Ellen
Published: June 2024

Objective: The purpose of this paper was to explore the previously little known contribution of nursing care at the liberation of Bergen‑Belsen concentration camp.
Setting: Bergen‑Belsen concentration camp. 
Primary argument: The liberation of Bergen‑Belsen concentration camp became a widespread symbol of suffering when it was liberated by British forces. Films of the liberation and the appalling condition of the survivors were widely disseminated in the western Allied countries. Despite the earlier liberation of Majdanek and Auschwitz in Poland, Bergen‑Belsen became fixed in the minds of the British public as an icon of the holocaust. Due to the catastrophic conditions found in the camp, doctors, nurses, medical students and aid organisations were quickly drafted into the relief effort. The work of doctors has been well publicised, however little has appeared that details the contribution of nurses. The diaries and letters of Muriel Knox Dougherty, the Australian nurse who became chief matron of the camp’s nursing services have been published only in recent years. No other material has been made public; consequently the work of the nurses has yet to be fully detailed.
Conclusion: This paper presents the reflections and recollections of several nurses who served in the liberation nursing services. Primary sources for this paper include relevant literature, archival material including correspondence, diaries, testimonies and personal correspondence. The conclusion formed on the basis of these documents is that the work of the nurses during the liberation period was life‑saving for their patients and life‑changing for the nurses.