Nursing - Research Publications

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    Education pathways for graduate entry registered nurses to transition to advanced practice roles: A realist review
    Jones, V ; McClunie-Trust, P ; Macdiarmid, R ; Turner, R ; Shannon, K ; Winnington, R ; Brown, A ; Dewar, J ; Jarden, R (CHURCHILL LIVINGSTONE, 2024-02)
    OBJECTIVE: Explore potential education and clinical pathways for nurses entering the profession through a Graduate Entry Nursing programme to transition to advanced practice roles. DESIGN: Realist review. REVIEW METHODS: A two stage process included 1) a systematic search of the following electronic databases EMCARE, MEDLINE, CINAHL, ERIC, and Scopus for published peer reviewed literature reporting academic pathways for graduates of graduate entry nursing programmes to progress to advanced nursing roles, and 2) consultation with key education programme stakeholders of graduate entry nursing programmes across Australasia, who undertook an inductive interpretive approach using realist logic to determine what works, for whom, and in what circumstances. RESULTS: Twelve published articles that explored advanced practice academic pathways for graduate entry nursing graduates were synthesised in terms of context, mechanisms, and outcomes. Data were then interpreted as to what works, for whom, in what context, and why, to develop new understandings of opportunities for advanced practice pathways for these students. No specific tailored academic pathway for graduate entry nursing graduates to progress to advanced practice was identified. Important relationships were identified between financial imperatives, political drivers, and registration requirements. CONCLUSIONS: Transformative strategies for new education pathways were identified as necessary to inspire innovation in nurturing graduate entry nurse graduates to progress to advanced practice roles. Effective collaboration and consultation within and across agencies and organisations are needed to both develop and implement accessible, expedient, and equitable programmes to enable this capable cohort to contribute to the health workforce.
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    Entry to practice nursing students' experiences of debriefing during clinical practice: A qualitative meta-synthesis*
    Cambridge, P ; Brockenshire, N ; Bridge, N ; Jarden, RJ (CHURCHILL LIVINGSTONE, 2023-09)
    OBJECTIVES: The objectives of this review were to identify, explore and synthesize existing evidence in the literature of nursing students' experiences of debriefing in their clinical practice placements. DESIGN: Qualitative meta-synthesis. DATA SOURCES: Databases included Cumulative Index of Nursing and Allied Health Literature, Education Resources Information Centre, Medical Literature Analysis and Retrieval System Online, and Scopus. Qualitative studies were considered for inclusion if published in English, reporting primary data analysis including experiences of nursing students. The final search was conducted on 22 October 2021, no time limit was applied. REVIEW METHODS: Qualitative studies were identified and appraised. Across the included studies, authors' themes and metaphors, and participant quotes were inductively analysed and interpreted, then expressed in the synthesis. RESULTS: Three new themes representing nursing students' experiences of debriefing were constructed. Theme one, 'It didn't happen formally, but I needed it', included students expressing the value of, and wanting to be involved in, debriefing to gain validation, reassurance, and guidance. Theme two, 'I had to release it and it helped' included students' positive experiences of debriefing with another student, nurse, or confidant, through various modalities. These experiences affirmed they were not alone in their feelings, which provided relief, confidence, and new ways of thinking and practicing. Theme three, 'Strengthened clinical experience and learning', included students feeling debriefing supported their awareness and understanding of practice and increased participation in clinical experiences. This awareness and understanding provided an opportunity for students to explore, and reflect on, the impact of patient care. CONCLUSIONS: Through debriefing student nurses found relief, confidence, and new ways of thinking through a shared understanding. Debriefing supported student learning and the clinical-academic education team had a key role in creating this opportunity.
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    Nurses' experiences of supporting patients requesting voluntary assisted dying: A qualitative meta-synthesis
    Sandham, M ; Carey, M ; Hedgecock, E ; Jarden, R (WILEY, 2022-10)
    AIM: Describe the reported lived experiences of nurses who have participated at any stage of voluntary assisted dying (VAD), from the initial request to the end of life. DESIGN: A qualitative meta-synthesis. DATA SOURCES: Databases searched were CINAHL, MEDLINE, Emcare, Scopus and PsycInfo. The search was undertaken in September 2021 with no date limitations. Qualitative studies were considered if published in English, reported primary data analysis of nurses' experiences who had been involved in VAD and reported direct quotes from nurses. REVIEW METHODS: Qualitative studies meeting the selection criteria were critically appraised, then an open card-sort method was applied. Quotes from nurses were organized to group similar experiences, constructing themes and metaphors across studies as a new understanding of nurses' experiences of VAD. RESULTS: Eight studies were included. Three major themes were constructed: An orderly procedure, reflecting the need for structure to feel adequately prepared; A beautiful death, reflecting the autonomy the patient exercised when choosing VAD facilitated an exceptionally positive death; and Psychological and emotional impact, where nurses recognized the emotional and ethical weight that they carried for themselves and the team when undertaking VAD. CONCLUSION: Nurses may benefit from clear policy, supervision and communication training to support them as countries transition to providing VAD services. Policy provides nurses with confidence that they are undertaking the steps of VAD correctly and provides a layer of emotional protection. Communication training specific to VAD is necessary to prepare nurses to recognize their own emotional experiences when responding to the needs of the patient and their family. IMPACT: VAD is increasingly becoming a legal option that nurses are encountering in their professional practice. Understanding nurses' experiences of being involved in VAD is required to support nurses in countries where VAD is becoming available to prepare professionally and psychologically.
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    Nurses' well-being during the coronavirus (2019) pandemic: A longitudinal mixed-methods study
    Jarden, RJ ; Jarden, AJ ; Weiland, TJ ; Taylor, G ; Brockenshire, N ; Rutherford, M ; Carbery, C ; Moroney, K ; Joshanloo, M ; Gerdtz, M (WILEY, 2023-01)
    AIM: To determine prevalence, predictors and change over time of nurses' and student nurses' mental health and well-being, and explore nurses' perceptions, barriers and enablers of well-being. DESIGN: Longitudinal mixed-methods survey. METHODS: Forty-nine students and registered nurses participated from Victoria, Australia. Data were collected from December 2019 to July 2020. Validated psychometrics and free-text response questions were employed. Analysis used latent growth curve modelling, Pearson product-moment correlations and thematic analysis. RESULTS: A strong positive correlation was found between self-determination and work well-being, and a strong negative correlation between work well-being and flight risk. Several moderate relationships were found; a moderate positive correlation between work well-being and nurse manager ability, leadership and support, and a moderate negative correlation between burnout and staffing and resource adequacy. Collegial nurse-physician relationships deteriorated. Three themes, physical health, psychological well-being and social connection, were identified as important for nurses' well-being.
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    Strengthening Community End-of-Life Care through Implementing Measurement-Based Palliative Care
    Sandham, MH ; Hedgecock, E ; Hocaoglu, M ; Palmer, C ; Jarden, RJ ; Narayanan, A ; Siegert, RJ (MDPI, 2022-07)
    The increasing demand for palliative care in New Zealand presents a potential threat to the quality of service delivery. One strategy to overcome this is through the implementation of valid and reliable patient-reported outcome measures. This mixed-methods study aimed to (1) implement measurement-based palliative care (MBPC) in a community palliative care service in Auckland, New Zealand; (2) evaluate the clinical utility of MBPC perceived by clinicians; (3) describe patient characteristics as measured by the Integrated Palliative Care Outcome Scale (IPOS), the Australasian Modified Karnofsky Performance Scale (AKPS), and Phase of Illness (POI); and (4) evaluate the internal consistency of the IPOS. Participants were over 18 years of age from a community outpatient palliative care service. In a phased approach to implementation, healthcare staff were educated on each instrument used for patient assessment. Uptake and internal consistency were evaluated through descriptive statistics. An interpretive descriptive methodology was used to explore the clinical utility of MBPC through semi-structured interviews with seven clinical staff members. Individual patient assessments (n = 1507) were undertaken predominantly on admission, with decreasing frequency as patients advanced through to the terminal phase of their care. Mean total IPOS scores were 17.97 (SD = 10.39, α = 0.78). The POI showed that 65% of patients were in the stable phase, 20% were in the unstable phase, 9% were in the deteriorating phase, and 2% were in the terminal phase. Clinicians reported that MBPC facilitated holistic and comprehensive assessments, as well as the development of a common interdisciplinary language. Clinicians expressed discomfort using the psychosocial and spiritual items. Measurement-based palliative care was only partially implemented but it was valued by staff and perceived to increase the quality of service delivery. Future research should determine the optimal timing of assessments, cultural responsivity for Māori and Pacific patients, and the role of MBPC in decision support for clinicians.
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    Predictors of Life Satisfaction in New Zealand: Analysis of a National Dataset
    Jarden, RJ ; Joshanloo, M ; Weijers, D ; Sandham, MH ; Jarden, AJ (MDPI, 2022-05)
    The study aim was to determine prevalence and predictors of life satisfaction in New Zealand. In this observational cross-sectional study, a sample of 10,799 participants from NZ were drawn from the Gallup World Poll from 2006 to 2017. Data were analysed using regression analysis and ANOVA. Prevalence of life satisfaction across time varied little from a high of 7.61 (SD = 1.6) in 2007 to a low of 7.23 (SD = 1.73) in 2011 (range 0-10). Satisfaction with standards of living predicted life satisfaction regardless of age or gender. For males across all age groups and females up to age 40 years, positive experiences and satisfaction with household income were important predictors. Being married was an important predictor for males over 40 years and feeling satisfied with their current city was important for females across all ages and for men under 40. The levels of life satisfaction changed over time, possibly due to major national events. Satisfaction with standards of living was found to predict life satisfaction regardless of age or gender. These results provide a path for policy focus towards increased life satisfaction.
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    An Evaluation of the Psychometric Properties of the Temporal Satisfaction With Life Scale
    Guitard, J ; Jarden, A ; Jarden, R ; Lajoie, D (FRONTIERS MEDIA SA, 2022-04-14)
    The Temporal Satisfaction with Life Scale measures judgements of life satisfaction using 15 items, according to three temporal dimensions: past, present, and future. However, only seven studies have looked at the psychometric properties of the Temporal Satisfaction with Life Scale, and this has been individually across vastly different countries and cultures (Canada, China, Germany, Spain, Switzerland, Turkey, and United-States), and with different populations, such as undergraduate students, adults, and older adults. In addition, these studies have highlighted issues regarding the replicability of the validity of the scale structure and optimal number of items. In this study we use a large international and multicultural sample (n = 6,912) from the International Wellbeing Study and investigate the scale structure of the Temporal Satisfaction with Life Scale, resulting in the recommendation that a shortened 12-item version provides a better model fit compared to the original 15-item version. More in-depth correlates with aspects of wellbeing and illbeing, in relation to past, present, and future life satisfaction, are also presented than have been previously, which found positive correlations between the temporal dimensions of the Temporal Satisfaction with Life Scale and wellbeing, as well as negative correlations with illbeing measures.
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    Doing Case Study Research Collaboratively: The Benefits for Researchers
    Mcclunie-Trust, P ; Jones, V ; Winnington, R ; Shannon, K ; Donaldson, AE ; Macdiarmid, R ; Jarden, RJ ; Turner, R ; Merrick, E ; Andersen, P (SAGE PUBLICATIONS INC, 2022-04)
    Collaborative research teams are an effective strategy to combine the knowledge and skills of like-minded researchers across tertiary education settings and international borders. Research collaborations have the potential to increase research capacity for both individuals and the team alike. The purpose of the study was to explore the experiences and perceptions of a team of seven Australasian nurse academics undertaking a longitudinal multi-site case study. We used a nominal group technique in this deductive qualitative exploratory study. The key findings from this study indicate establishing safe academic relationships is paramount to successful collaborative teams. Collaborative research teams offer opportunities to learn research processes from other members through sharing of expertise and skillsets, together with upholding a positive engagement with technology to ensure full research participation is achievable irrespective of geographical location. To conclude, in this study we have identified multi-site collaborative research teams provide an opportunity to leverage the strengths of individuals to enhance research outcomes across organisations. The synergistic effect of the team builds research blue skies thinking and capacity building through mentorship and support. The potential for positive change through mentorship and support, alongside the forged new relationships, are all key drivers of researcher wellbeing, never more important as we transition into new ways of working both now and into the future.
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    Advancing Nursing Informatics Through Clinical Placements: Pilot Study.
    Lokmic-Tomkins, Z ; Brar, S ; Lin, N ; Khor, M ; Mathews, K ; Lawlor, K (IOS Press, 2021-12-15)
    Work integrated learning in the space of nursing informatics is a new concept in Australian nursing curriculum. This study examined nursing students' experiences in the pilot nursing informatics clinical placement centered on electronic medical records, their use in patient care and clinical decision making. Students completed reflective diaries of their learning during the four-week placement. Data was explored by thematic analysis. Emergent themes included: importance of adequate training in using EMR; impact of EMR on nursing workflow and patient care; shaping future career choices; forming rewarding relationships; and potential for improvements. These themes will be used to enhance teaching and learning opportunities as this pilot placement evolves into permeant part of the nursing curriculum.
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    Methodological approaches to measuring the incidence of unplanned emergency department presentations by cancer patients receiving systemic anti-cancer therapy: a systematic review
    Dufton, PH ; Gerdtz, MF ; Jarden, R ; Krishnasamy, M (BMC, 2022-03-21)
    BACKGROUND: The need to mitigate the volume of unplanned emergency department (ED) presentations is a priority for health systems globally. Current evidence on the incidence and risk factors associated with unplanned ED presentations is unclear because of substantial heterogeneity in methods reporting on this issue. The aim of this review was to examine the methodological approaches to measure the incidence of unplanned ED presentations by patients receiving systemic anti-cancer therapy in order to determine the strength of evidence and to inform future research. METHODS: An electronic search of Medline, Embase, CINAHL, and Cochrane was undertaken. Papers published in English language between 2000 and 2019, and papers that included patients receiving systemic anti-cancer therapy as the denominator during the study period were included. Studies were eligible if they were analytical observational studies. Data relating to the methods used to measure the incidence of ED presentations by patients receiving systemic anti-cancer therapy were extracted and assessed for methodological rigor. Findings are reported in accordance with the Synthesis Without Meta-Analysis (SWiM) guideline. RESULTS: Twenty-one articles met the inclusion criteria: 20 cohort studies, and one cross-sectional study. Overall risk of bias was moderate. There was substantial methodological and clinical heterogeneity in the papers included. Methodological rigor varied based on the description of methods such as the period of observation, loss to follow-up, reason for ED presentation and statistical methods to control for time varying events and potential confounders. CONCLUSIONS: There is considerable diversity in the population and methods used in studies that measure the incidence of unplanned ED presentations by patients receiving systemic anti-cancer therapy. Recommendations to support the development of robust evidence include enrolling participants at diagnosis or initiation of treatment, providing adequate description of regular care to support patients who experience toxicities, reporting reasons for and characteristics of participants who are lost to follow-up throughout the study period, clearly defining the outcome including the observation and follow-up period, and reporting crude numbers of ED presentations and the number of at-risk days to account for variation in the length of treatment protocols.