Nursing - Research Publications
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ItemMultisite cross-sectional survey of nurses’ perceptions of implementation of a parent-targeted video and recommended pain management, for improving newborn pain treatment(Elsevier, 2024-01)Background: Synthesized evidence of analgesic effects of breastfeeding, skin-to-skin care, and sucrose for newborns undergoing painful procedures exists; however, these interventions are inconsistently used in practice. Although a parent-targeted video demonstrating these interventions is publicly accessible, its implementation has not been rigorously evaluated. Purpose: To evaluate clinical nurses' and nurse unit managers’ perceptions of the video implementation which portrays three pain-reducing interventions, and barriers and facilitators to implementing the video and interventions in practice. Methods: This study was part of a larger multisite s study in eight maternal-newborn centres in Ontario, Canada. This current study used online cross-sectional surveys with open and closed-ended questions administered following a 6-month intervention period where the parent-targeted video was made available for staff to share with parents before blood sampling for newborn screening. Two surveys were used: one for clinical nurses and one for nurse unit managers from participating maternal/newborn units. Participants provided their perceptions of the video's implementation and barriers and facilitators of using the pain management strategies. Descriptive statistics were used for quantitative data, and reflexive content analysis was applied to qualitative data. Results: Thirty of 205 (15 %) eligible nurses and nine unit managers from the eight participating sites completed the surveys. Eighteen (60 %) nurses and five managers (55 %) perceived the video was offered to less than half of the parents, highlighting the video was not implemented into their units as planned. Key barriers reported by both groups were being too busy to show the video with parents in the post-natal period and a preference for not involving parents in pain treatments. Facilitators included working towards Baby Friendly Hospital Initiatives endorsement and single-room units. Implications: Increasing parents' involvement during painful procedures is widely recommended. However, as the parent-targeted video alone was not implemented as planned, and staff preferences and unit cultures do not consistently facilitate parents' involvement, further work is needed to improve parents’ advocacy and role in the care of their newborns.
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ItemNo Preview AvailableUmsetzung von Evidenz – Schmerztherapie bei Neugeborenen, Säuglingen und Kleinkindern während Nadelstichverfahren = Translating evidence: pain treatment in newborns, infants, and toddlers during needle-related procedures [German version](Springer, 2024-03-04)INTRODUCTION: Treatment of pain in preterm, sick, and healthy newborns and infants and toddlers (up to 2 years of age) is consistently reported to be inadequate, and effective strategies are poorly implemented. OBJECTIVES: To present existing evidence of effective pain treatment strategies during needle-related procedures and to highlight initiatives focused on translating evidence into practice. METHODS: This Clinical Update focuses on the 2022 International Association for the Study of Pain Global Year for Translating Pain Knowledge to Practice in the specific population of newborns, infants, and toddlers. Best evidence is reviewed, and existing knowledge translation strategies and programs available to implement evidence into practice are presented. RESULTS: Effective strategies for newborn and young infants during frequently occurring needle procedures include small volumes of sweet solutions, breastfeeding, or skin-to-skin care when feasible and culturally acceptable. In addition, strategies such as nonnutritive sucking, positioning, swaddling, gentle touch, facilitated tucking, and secure holding can be used. For toddlers, the evidence is less robust, and discerning between pain and distress is challenging. However, strategies recommended for needlerelated procedures include upright secure comfort holding by parents/caregivers, age-appropriate distraction, and topical anesthetics. Translation of effective pain management needs to involve the family, who need to be supported and empowered to comfort their child during painful procedures. Organizational, nationwide, and global initiatives aimed at improving implementation of effective pain treatments exist. CONCLUSION: There is evidence of effective pain management strategies for newborns, infants, and toddlers, and a great deal of effort is being made to translate knowledge into action.
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ItemMultilevel interventions as climate change adaptation response to protect maternal and child health: a scoping review protocol(BMJ PUBLISHING GROUP, 2023-07)INTRODUCTION: Growing evidence suggests that climate change-related extreme weather events adversely impact maternal and child health (MCH) outcomes, which requires effective, sustainable and culturally appropriate interventions at individual, community and policy levels to minimise these impacts. This scoping review proposes to map the evidence available on the type, characteristics and outcomes of multilevel interventions implemented as adaptational strategies to protect MCH from the possible adverse effects of climate change. METHODS: The following databases will be searched: Embase, MEDLINE, Emcare, EPPI-Centre database of health promotion research (BiblioMap) EPPI-Centre Database for promoting Health Effectiveness Reviews (DoPHER), Global Health, CINAHL, Joanna Briggs Institute EBP Database, Maternity and Infant Care Database, Education Resource Information Center, PsycINFO, Scopus, Web of Science and Global Index Medicus, which indexes Latin America and the Caribbean, Index Medicus for the South-East Asia Region, African Index Medicus, Western Pacific Region Index Medicus. Cochrane Central Register of Controlled Trials, WHO International Clinical Trials Registry Platform, ClinicalTrials.gov, conference proceedings, thesis and dissertations, policy and guidelines and their reference lists will also be searched. Two reviewers will independently screen titles and abstracts and full text based on predefined eligibility criteria. The Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews using the Population, Concept and Context framework and the Template for Intervention Description and Replication checklist will be used to structure and report the findings. ETHICS AND DISSEMINATION: Ethics permission to conduct the scoping review is not required as the information collected is publicly available through databases. Findings will be disseminated through a peer-reviewed publication and conference presentations.
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ItemNo Preview AvailableA multicentre point prevalence study of delirium assessment and management in patients admitted to Australian and New Zealand intensive care units(AUSTRALASIAN MED PUBL CO LTD, 2020-12)Objective: To characterise the assessment and management of delirium in patients admitted to intensive care units (ICUs) in Australia and New Zealand. Methods: We conducted a multicentre observational point prevalence study across 44 adult Australian and New Zealand ICUs. Data were extracted for all patients in the ICU in terms of assessment and treatment of delirium. ICU-level data were collected regarding the use of explicit protocols related to delirium. Results: We studied 627 patients, with 54% (336/627) having at least one delirium screening assessment performed. The Confusion Assessment Method for the ICU (CAM-ICU) was the most frequently used tool (88%, 296/336). Of patients assessed, 20% (68) were identified to have delirium. Eighteen per cent (111) of patients were administered a drug to manage delirium, with 41% (46) of those receiving a drug having no recorded assessment for delirium on that day. Of the drugs used to treat delirium, quetiapine was the most frequently administered. Physical restraints were applied to 8% (48/626) of patients, but only 17% (8/48) of such patients had been diagnosed with delirium. Most physically restrained patients either did not have delirium diagnosed (31%, 15/48) or had no formal assessment recorded (52%, 25/48) on that day. Conclusions: On the study day, more than 50% of patients had a delirium screening assessment performed, with 20% of screened patients deemed to have delirium. Drugs that are prescribed to treat delirium and physical restraints were frequently used in the absence of delirium or the formal assessment for its presence.
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ItemNo Preview AvailableEducation pathways for graduate entry registered nurses to transition to advanced practice roles: A realist review(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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ItemNo Preview AvailableThe case for and Against Doing Virtual Photovoice(SAGE PUBLICATIONS INC, 2023-07-13)Photovoice offers creative participatory action methods for conveying community strengths and challenges with the goal of addressing health inequities. Accelerated by COVID-19 restrictions, photovoice has increasingly become virtual, and this shift has given rise to new considerations including navigating online recruitment and data collection, e-participatory action trends and working with multi-site large qualitative data sets. Within these contexts, the current article discusses the case for and against virtual photovoice, drawing from a large study comprising 110 men’s experiences of, and perspectives about, equitable and sustainable intimate partner relationships. The findings are shared across three themes. The first theme, e-Efficiencies and concessions contrasts increased recruitment reach and data collection cost-savings with vulnerabilities to phishing and challenges for working with participants’ wide-ranging internet literacies and practices. Theme two, Participatory action changed, chronicles the participants’ varied relationships to photography including sourcing third-party and archived photographs. Revealed also were privacy concerns whereby some participants opted for audio only interviews and/or restricted the use of their photographs. The third theme, Reckoning breadth and depth in a large dataset, discusses emergent study design considerations including analytics for interpreting and contextually representing large multi-site projects that are made possible through virtual photovoice. While technological advances and COVID-19 have forged photovoice virtually, the case for and against this trend reveals complex considerations that will likely manifest a continuum of approaches ranging virtual, hybrid and in-person models. In summary, we suggest that integral to weighing the case for and against virtual photovoice researchers will need to thoughtfully adapt to changing technologies, as well as potential post COVID-19 tilts for returning to in-person.
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ItemNo Preview AvailableDesigning Men's Health Programs: The 5C Framework(SAGE PUBLICATIONS INC, 2023-07)Men are less likely than women to access or engage with a range of generic health programs across a diversity of settings. Designing health programs that mitigate barriers associated with normative ideals of masculinity has been widely viewed as a key factor in how health systems should respond, but strategies to engage men have often narrowly conceptualized male health behavior and risk inadvertently reinforcing negative and outdated gender stereotypes. Currently absent from the men's health literature is practical guidance on gender-transformative approaches to men's health program design-those which seek to quell harmful gender norms and purposefully promote health equity across wide-ranging issues, intervention types, and service contexts. In this article, we propose a novel conceptual model underpinned by gender-transformative goals to help guide researchers and practitioners tailor men's health programs to improve accessibility and engagement. The "5C framework" offers key considerations and guiding principles on the application of masculinities in program design irrespective of intervention type or service context. By detailing five salient phases of program development, the framework is intended as a designate approach to the design of accessible and engaging men's health programs that will foster progressive changes in the ways in which masculinity can be interpreted and expressed as a means to achieve health for all.
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ItemNo Preview Available"Hey Amir, How Are You REALLY Doing?": Participant Perspectives of a Peer-Based Suicide Prevention Campaign for Men(SAGE PUBLICATIONS INC, 2023-09)Suicide is a major public health concern and leading cause of death among men in Canada. This study reports the feasibility and acceptability of Buddy Up, a peer-based suicide prevention campaign for men. A mixed-methods approach was used to analyze respondent survey questionnaires (n = 48) and individual participant interviews (n = 19) collected from campaign users. Survey respondents reported that they enjoyed their involvement in the campaign (92%), were more confident to talk with men about mental health and suicide (95%), and would recommend Buddy Up to others (95%). Qualitative interviews were thematically analyzed to develop three inductively derived themes: (a) Engaging men with relatable masculine content and design: "Buddy Up really spoke to them in their language," highlighting the importance of understanding and working with gendered practices and motivations to legitimize and motivate involvement in suicide prevention; (b) Leveraging campaign participation to initiate conversations and promote mental health: "It gives men language and license to start asking questions," revealing ways in which participants utilized Buddy Up to negotiate and norm checking-in to promote men's mental health; and (c) Driving new masculine cultures: "We start every meeting with a mental health moment," identifying how participants fostered healthy milieus for disclosing mental health challenges with teamwork and preventive action under the banner of Buddy Up. The study findings support the feasibility of Buddy Up and highlight the acceptability of peer-based approaches to mental health promotion. The findings can also empirically guide future efforts for systematically building men's peer-based suicide prevention programs.
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ItemNo Preview AvailableSilence and its manifestations in men’s mental illness(Springer Science and Business Media LLC, 2023-07-01)
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ItemNo Preview AvailableNeo-traditionalist, egalitarian and progressive masculinities in men's heterosexual intimate partner relationships(PERGAMON-ELSEVIER SCIENCE LTD, 2023-09)Shifts in gender roles, identities and relations since the 1980s are continuing to influence masculinities within intimate partner relationships. Forefront in men's contemporary heterosexual relationships have been calls for gender equality and gender equity as a means to promoting the mental health and well-being of partners and their families. Most previous research has focused on a pathologized role of men in relationships (e.g., intimate partner violence). Little is known about how men perceive intimate partner relationships using a strength-based perspective. The current photovoice study addressed the research question, 'What are the connections between masculinities and men's heterosexual intimate partner relationships?' to highlight young men's (19-43 years-old) experiences of, and perspectives about their intimate partner relationships. Drawing from individual Zoom interviews with 92 heterosexual, cisgender men from 14 countries, we abductively derived three masculine typologies: 1) neo-traditionalist, 2) egalitarian and 3) progressive. Twenty-two (24%) participants embodied neo-traditionalist masculinities characterized by reliance's on traditional masculine norms that assign domesticities as feminine and prize masculine breadwinner and protector roles. Half of the participants (50%, n = 46) purposefully distanced themselves from traditional masculine norms to engage egalitarian masculinities. These men idealized equal (50-50) contributions and reciprocity wherein counts were often used to evaluate each partner's relative efforts and contributions to the relationship. Progressive masculinities were evident in 26% (n = 24) of participants who focused on fairness and social justice, checking their own privilege to justly operate within the relationship, and more broadly in society. The three typologies are grounded in men's heterosexual intimate partner gender relations, and advance masculinity frameworks to guide future health-research, policy and practice. In addition, there are opportunities for men's mental health promotion by prompting readers' reflexivity to thoughtfully consider what they idealize, and where they map in relation to the masculine typologies featured in the current article.