A thematic analysis of the perceptions of a community-based exercise program on the health and well-being of ageing adults
- Authors: Dabkowski, Elissa , Porter, Joanne , Barbagallo, Michael
- Date: 2021
- Type: Text , Journal article
- Relation: Health and Social Care in the Community Vol. 29, no. 6 (2021), p. 1990-1997
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- Description: This study explores a weekly community-based exercise program (CBEP) for ageing adults in Gippsland, Victoria, Australia. This program aims to improve the health and well-being of ageing adults and was evaluated using an exploratory qualitative study design. Four focus group discussions and two individual interviews were conducted before a thematic analysis using Braun & Clark's (2006) six-step approach. A total of 23 participants were involved in the study over a 6-week period. The thematic analysis resulted in two main themes: (a) meeting community needs and (b) benefits to health and well-being. Five minor themes stemmed from these two themes, in which participants identified that a service gap existed within the community and the program was adaptive in its design to meet community needs. Participants reported benefits to health and well-being, specifically perceived improved mobility and independence, social connections and ‘recharging the batteries to feel good’. The inclusion of Tai Chi exercises was noted for increased vitality and pain management benefits. The role of the exercise instructor was deemed to be instrumental to the success of the CBEP. The CBEP provides motivation for older adults to attend, increasing physical activity. Future CBEPs for ageing adults should provide a social component and relevant health education for participants. Exercises should be safely adapted by the exercise instructor to suit people of various abilities and to promote a more ‘inclusive’ environment. © 2021 John Wiley & Sons Ltd.
Alcohol consumption in aquatic settings: a mixed-method study exploring young adults’ attitudes and knowledge
- Authors: Calverley, Hannah , Petrass, Lauren , Blitvich, Jennifer
- Date: 2021
- Type: Text , Journal article
- Relation: Drugs: Education, Prevention and Policy Vol. 28, no. 6 (2021), p. 595-605
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- Description: Retrospective studies have identified alcohol as a significant risk factor in drownings involving young adults. Few studies have explored this issue, therefore the current contextual understanding of alcohol consumption in aquatic settings is limited. This study used a survey (n = 182) and one-to-one and small group interviews (n = 23) to investigate knowledge and attitudes of United Kingdom and Australian young adults (aged 18–24 years) towards involvement in aquatic activity after consuming alcohol. Findings illustrated a poor level of general and aquatic-specific alcohol knowledge. Australian educated participants, and those self-reporting: stronger swimming competence; and/or completion of alcohol and water safety education; and/or participation in aquatic activity following alcohol consumption, achieved significantly higher knowledge scores. Most reported a neutral attitude, and those with previous experience of alcohol consumption in aquatic settings had more accepting attitudes of this behavior (p < 0.001). The aquatic activity, context and amount of alcohol consumed influenced attitudes. Participants reported a lack of alcohol-focused drowning prevention or water safety education for their age group, and many referred to their upbringing and parents’ behaviors as reference for what was safe. Drowning prevention practitioners should consider these results to ensure young adults understand the risks of consuming alcohol in all aquatic contexts. © 2020 Informa UK Limited, trading as Taylor & Francis Group.
Chinese mental health professionals’ perceptions of shared decision-making regarding people diagnosed with schizophrenia : a qualitative study
- Authors: Huang, Chongmei , Lam, Louisa , Zhong, Yaping , Plummer, Virginia , Cross, Wendy
- Date: 2021
- Type: Text , Journal article
- Relation: International Journal of Mental Health Nursing Vol. 30, no. 1 (2021), p. 189-199
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- Description: The implementation of shared decision-making regarding people diagnosed with schizophrenia is limited, although it is reported to have a positive impact on improving treatment adherence, therapeutic relationships and saving medical costs. The successful implementation of it is mainly dependent on the active engagement of mental health professionals. This study aims to identify mental health professionals’ perceptions of shared decision-making regarding people diagnosed with schizophrenia in collectivist cultures such as Chinese culture. A qualitative descriptive approach was used, involving ten individual interviews with psychiatrists and four focus groups with twenty-three mental health nurses from the psychiatry department of a tertiary hospital in mainland China. An inductive thematic approach was used to analyze the data. Two main themes with five subthemes generated: willingness to engage in shared decision-making and perceiving shared decision-making as unachievable. The last theme included five subthemes: (i) deference to authority, (ii) tension between family decision-making and patient autonomy, (iii) uncertainty of trusting therapeutic relationships, (iv) implicit persuasion and (v) insufficient consultation time. Patients often lack opportunity and support to engage in decision-making. Mental health nurses in other countries need to be aware that Chinese patients and patients with a similar background are not knowledgeable about or value shared decision-making to the extent that other countries might. They need to evaluate and support them, including encouraging them to engage in decision-making as well as providing appropriate information. Mental health nurses need to collaborate with patients and their families to achieve patient-centred care when family involvement is expected. © 2020 Australian College of Mental Health Nurses Inc.
Getting into the “Dad Zone” : how do primary caregiving fathers of young children experience social support?
- Authors: Gill, Peter , Scacco, Sarina , De Haan, Sarah , Gent, Angela , Chapin, Laurie , Ganci, Michael , Morda, Romana
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of Child and Family Studies Vol. 30, no. 4 (2021), p. 1028-1042
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- Description: Primary caregiving fathers (PCGFs) are a growing population that experience unique struggles on a day-to-day basis. The current study aimed to explore how fathers interpret and experience their daily responsibilities and interactions with social support, as they undertake their roles as primary caregivers. Using grounded theory, 14 PCGFs defined as those providing sole care for their 1–10 year olds for at least 25 h per week, participated in semi-structured interviews regarding their experiences of fatherhood and social supports. Participants highlighted the ways in which social support, particularly adult companionship, helped them find a social balance and allowed them to re-energise and be better fathers. In particular, the men reported that interaction with people with similar experiences was important in helping them to discursively negotiate their non-traditional roles. Analysis revealed a three-stage identity transition process where the men initially took on primary responsibility, then began to embody the primary care giver role, and finally transitioned to a new normal. The PCGFs in the study provide evidence that we may be observing a shift from what may be classed as outdated notions of one-dimensional fathering to a more well-informed masculine ideal that embraces caring and nurturing qualities. However, providing further avenues of support for PCFGs is important in order to mitigate possible social isolation and to enhance their wellbeing. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.
Powered mobility aid access on public transport : a validation study of compliance with disability standards
- Authors: Unsworth, Carolyn , Chua, Julian , Gudimetla, Prasad , Naweed, Anjum
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of Transport and Health Vol. 22, no. (2021), p.
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- Description: Introduction: Public transport accessibility is vital for people using powered mobility aids, particularly on buses which have the greatest travel reach into the community. In Australia, a new standard has been developed against which the fit of mobility aids can be determined prior to travel. However, the standard is documented in 2D and real-world tests have not been conducted. The aim of this study was to examine powered mobility aid access on test rigs specified in the standard to determine public transport conformance thus contributing to real-world validation of the standard, and identify the measurements of mobility aids most likely to access public transport. Methods: Life-size rigs were built according to the specifications within the standard to simulate and facilitate five types of test including the:180° turn; Pavement gap; Swept path; Allocated space; and Narrow access path. Thirty-five powered mobility aids were measured and driven through these test rigs and successful completion or collision points were recorded. Results: Nine of the 35 mobility aids were found to be noncompliant with the new standard. The Allocated space test, which represented manoeuvring into a designated travel space was most difficult, followed by completion of the 180° turn test. The measurements of powered mobility aids that are likely to comply with the standard for public transport access were found to be those with diagonal length (D) less than 1280 mm, overall length (L) less than 1110 mm, and a measured turn radius less than 760 mm. Conclusions: This research provides an empirical validation of the new 2D standard using real-world experimental testing standard by building the associated test rigs and driving a sample of powered mobility aids through them. Future research using field-based validation in bus light rail and trains is warranted. © 2021
Resident-to-resident elder mistreatment in residential aged care services : a systematic review of event frequency, type, resident characteristics, and history
- Authors: Woolford, Marta , Stacpoole, Susan , Clinnick, Lisa
- Date: 2021
- Type: Text , Journal article , Review
- Relation: Journal of the American Medical Directors Association Vol. 22, no. 8 (2021), p. 1678-1691.e6
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- Description: Objectives: Resident-to-resident elder mistreatment (R-REM) between residents living in residential aged care (RAC) services is a challenging issue in relation to the care of older people. Evidence suggests that R-REM, such as verbal, physical, and sexual conflict between residents, is a common and pervasive issue. This review examines the frequency with which R-REM occurs in RAC services; identifies the types of R-REM that occur; and provides an overview of the reported characteristics of both the victim and perpetrator involved in the R-REM event. Design: A systematic review was conducted. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, Ageline, and Cochrane Library to identify qualitative and quantitative studies published in the English language. Setting and Participants: Residents living in RAC services. Measures: Data on frequency and characteristics were collated, and aggregate proportions were calculated where possible. Results: Twenty-six studies were identified; most (n = 20) were published in the United States. The overall proportion of residents engaged in R-REM was provided by 7 quantitative studies with the estimated frequency reported to be 12% to 23%. For qualitative studies, the number of care staff reporting to have observed R-REM ranged from 18.7% to 98.0%. Physical and verbal abuse were the most commonly reported types of mistreatment. Characteristics of the perpetrator of R-REM were reported in 12 (46.2%) studies. Overall, the mean age of perpetrators was 80.93 years, most were men (83.2%), and 64.4% had dementia and/or Alzheimer diagnosis. Characteristics of the victim and the history of R-REM were largely omitted from the published studies. Conclusion and Implications: The findings from the review broaden understanding on the extent of R-REM; the individual and event characteristics and ultimately support care planning, policy, and direction for future research. To improve understanding, quality of care, and RAC residents’ well-being, further studies are recommended to address the identified gaps in knowledge. © 2021 AMDA – The Society for Post-Acute and Long-Term Care Medicine
Respecting alcohol, respecting the water : young adult perspectives on how to reduce alcohol-influenced drownings in Australia
- Authors: Calverley, Hannah , Petrass, Lauren , Blitvich, Jennifer
- Date: 2021
- Type: Text , Journal article
- Relation: Health Promotion Journal of Australia Vol. 32, no. S2 (2021), p. 218-228
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- Description: Issue addressed: Alcohol-influenced drowning among young Australians (aged 18-24 years) is a prominent health concern. However, effectiveness of targeted prevention campaigns for this age group is unknown, as this information is not typically published in peer-reviewed or easily accessed grey literature. Accordingly, future campaigns cannot build on prior efforts to address this health problem. Methods: Semi-structured interviews ascertained young Australian adults’ perspectives on preventing alcohol consumption in aquatic settings, and their awareness of appropriate safety strategies and Australian national and state drowning prevention campaigns. Discussions were transcribed verbatim and thematically analysed using an interpretative phenomenological approach. Results: Twenty-three individuals (mean age 20.65 years) participated in an interview. Participants had poor understanding of alcohol-focused drowning prevention campaigns and used logos and names to decipher key campaign messages. Education was recommended as the preferred method for prevention, and participants suggested preferences for delivery (eg social media, in schools, humour and shock tactics). The safety strategies discussed appeared to be transferred from strategies used in other contexts, rather than related to the specific risks of aquatic scenarios. Conclusions: Drowning prevention practitioners should ensure transparency and clarity of their campaign names and logos to enhance understanding of the messages. Practitioners should also consider using audience analysis during campaign design, delivery and evaluation, alongside best practice recommendations from literature, to enhance campaign suitability and effectiveness. So what?: Water safety practitioners and policy makers should acknowledge these findings when developing campaigns which address young adults’ lack of awareness of safe aquatic behaviours to encourage a sustained behaviour change. © 2020 Australian Health Promotion Association.
Sport and leisure activities in the heat: What safety resources exist?
- Authors: Gonsalves, Marlon , O'Brien, Brendan , Twomey, Dara
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 24, no. 8 (2021), p. 781-786
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- Description: Objectives: To conduct a document analysis of sports and leisure activity heat-related injury prevention resources in Australia and develop an understanding of the content within those resources. Design & Methods: Heat resources were included if they dealt specifically with, or could be extrapolated to, prevention of heat-related injuries. Collating strategies for the catalogue included: (1) a detailed search of the organisation's website and (2) an online search for sport specific heat resources. A content analysis of each resource was first performed, and descriptive codes were assigned to the data using qualitative data analysis software. Every coded text was recorded as an individual data point (n). Common sub-categories were identified by thematic analysis and collated under three broader categories. Results: A total of 468 data points were identified within the 64 heat resources found. Guidelines (n = 20) and policies (n = 18) were the most common type of resources followed by factsheets (n = 9), webpages (n = 8), laws and by-laws (n = 2). Three overarching categories emerged through the data analysis process: preventive strategies (n = 299, 63.9%), risk factors (n = 94, 20.1%), treatment (n = 75, 16.0%). Activity modification, which included information on rescheduling games and extra breaks, was the most common intervention. Cricket, soccer, swimming and triathlon had the most complete set of heat resources. Conclusions: The findings of this study provide an insight into the composition of heat-related sports injury prevention resources within Australia and identify areas for development. As the resources were incomplete for many sports, the development of more comprehensive heat safety resources is required to ensure the safety of participants. © 2021 Elsevier Ltd
The immediate and durable effects of yoga and physical fitness exercises on stress
- Authors: Tong, Jiajin , Qi, Xin , He, Zhonghui , Chen, Senlin , Cooley, Dean
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of American College Health Vol. 69, no. 6 (2021), p. 675-683
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- Description: Objective: This study aimed to examine the effects of yoga and physical fitness exercises on stress and the underlying mechanisms. Participants: Healthy undergraduates from four yoga and four fitness classes participated in Study 1 (n = 191) and Study 2 (n = 143), respectively (in 2017 Fall). Methods: Study 1 evaluated the immediate effect (a 60-minute practice) while Study 2 evaluated the durable effect (a 12-week intervention). Results: Results showed that immediate stress reduction was more salient in the yoga group than that in the fitness group in Study 1. Yoga group had a greater increase in mindfulness, which predicted stress reduction. Similar observations were made in Study 2 showing the durable effect of yoga on stress reduction through mindfulness. Conclusions: Yoga intervention is better than fitness exercises in helping undergraduates cultivate mindfulness and reduce stress. These findings may guide future interventions in stress management in college students. © 2020 Taylor & Francis Group, LLC.
Validation and utilisation of the spiritual well-being questionnaire : SHALOM
- Authors: Fisher, John
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of Religion and Health Vol. 60, no. 5 (2021), p. 3694-3715
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- Description: The Spiritual Well-Being Questionnaire (SWBQ) was developed from a theoretical understanding that spiritual well-being (SWB) is expressed in the quality of relationships that each person has across one or more of four domains, namely with self, others, environment and/or with a transcendent other. Based on the SWBQ, the Spiritual Health And Life-Orientation Measure (SHALOM) is unique in that it compares each person’s lived experience with their ideals on the 20 items reflecting the four domains of SWB. This paper builds on previous reviews of the SWBQ-SHALOM, by providing breadth and depth of data and their validity, from a wide range of sources, and expressing the instrument’s usefulness in a variety of settings. It provides an overview with details from 60 studies that started with the SWBQ-SHALOM. Presented herein are ideas on what can be done with further investigations of this vital aspect of life. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
“Before the training I just assumed they've done something bad”: Reporting on professional training for pharmacy assistants and pharmacy dispensary technicians on medically assisted treatment of opioid dependence
- Authors: Patil, Tejaswini , Mummery, Jane , Salman, Mohammed , Cooper, Simon J. , Williams, Dominic
- Date: 2021
- Type: Text , Journal article
- Relation: Research in Social and Administrative Pharmacy Vol. 17, no. 7 (2021), p. 1250-1258
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- Description: Background: A study that examined the lived experiences of Medically Assisted Treatment of Opioid Dependence (MATOD) consumers suggested that they had experienced discrimination and stigma in pharmacies in regional Victoria, Australia. To address this, the need for professional training opportunities for Pharmacy Assistants (PAs) and Pharmacy Dispensary Technicians (PTDs) had been emphasised. A research project was undertaken to develop training modules using Social Determinants of Health (SDH) for PAs and PDTs involved in providing MATOD pharmacy services in regional Victoria, and to evaluate their effectiveness. Objectives: The study aimed to examine and evaluate changes in attitudes and practices amongst PAs and PDTs involved in MATOD services in regional Victoria, Australia and who had undertaken the training modules. Methods: The paper reports primarily on the in-depth qualitative interviews that were completed after the training with PAs and PTDs. Thematic analysis was employed to code the data. Results: Thematic analysis generated five themes: understanding of the professional role of PAs and PTDs, initial judgements concerning MATOD consumers, reflection on the SDH, training content analysis, and the post-training impact upon Professional Practice. These themes reflected participants’ insights with regards both to MATOD consumers and the impact the training itself had had on their professional practice. Conclusion: “Consciousness-raising” from participation in the training can positively influence the development of participants’ professional attitudes and practices with regards to MATOD service delivery. This development supports that training informed by SDH and ideas of critical reflection can help facilitate the creation of knowledge around the social construction of health and increased understanding of the impacts of language-use, attitudes and behaviour. © 2020
“They don't think it will ever happen to them” : exploring factors affecting participation in alcohol-influenced aquatic activity among young Australian adults
- Authors: Calverley, Hannah , Petrass, Lauren , Blitvich, Jennifer
- Date: 2021
- Type: Text , Journal article
- Relation: Health Promotion Journal of Australia Vol. 32, no. S2 (2021), p. 229-237
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- Description: Issue addressed: Young adults are over-represented in alcohol-related drownings in high-income countries; however, little research has investigated their behaviours and decision-making to inform prevention efforts. Methods: Semi-structured interviews were conducted with 23 young Australian adults (aged 18-24 years). Questions, informed by previous research, inquired about behavioural practices in aquatic contexts and influences on involvement in alcohol-influenced aquatic activity. Interviews were transcribed verbatim. Thematic and interpretative phenomenological analysis followed. Results: Two main themes: personal and contextual awareness, and the impact of other people affected perceptions and involvement in alcohol-influenced aquatic activity. Perceived control of situations and self-confidence affected how these influences impacted individuals’ involvement. Participants acknowledged some young adults likely overestimate their aquatic abilities. This awareness was not discussed in relation to their own capabilities. Conclusion: Drowning prevention efforts should inform young adults of the dangers of combining alcohol and aquatic activities, and make risks appear more immediate and applicable. Consideration should be given to measuring both perceived and actual aquatic abilities within various aquatic environments, to determine whether self-reported perceived competence is an accurate proxy measure for actual aquatic ability. The influence of alcohol should also be highlighted. Steps are required for a positive shift in Australian norms of alcohol use in aquatic settings and the social and cultural attitudes towards this. So what?: This study provides new insight into young adults’ perceptions and involvement in alcohol-influenced aquatic activity. It enhances the evidence base for drowning prevention and health promotion practitioners and should inform more focused campaigns to prevent alcohol-related drownings among young Australian adults. © 2021 Australian Health Promotion Association
A narrative review of pharmacotherapy treatment for opioid addiction and application in a community-based model in Victoria, Australia
- Authors: Vishwanath, Tejaswini , Cash, Penelope , Penney, Wendy , Cant, Robyn
- Date: 2020
- Type: Text , Journal article
- Relation: International Journal of Mental Health and Addiction Vol. 18, no. 1 (2020), p. 66-76
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- Description: To review the literature regarding the value and consumer focus of research on opioid replacement therapy (ORT) programs, relevant to the Australian rural context and community pharmacy. We conducted a narrative review of literature published between 1995 and 2015, searching EBSCOhost, PubMed and Google Scholar. Three authors collaborated to screen and synthesise studies. Effectiveness, cost affordability, diversion and retention benefits were reported from pharmacological or prescribers’ or dispensers’ standpoint. Research was fragmented and evaluated contributions of these individual types of stakeholders with less discussion of consumers, or consumers’ everyday experiences of ORT. No studies took into account consumers’ psychosocial aspects or power discourses. We found ORT as a beneficial treatment for opioid dependence is well researched, although overall Australian program evaluation was lacking. A gap within ORT literature should be addressed by making consumer experiences central in designs for future research and for program evaluation. © 2018, Springer Science+Business Media, LLC, part of Springer Nature.
A review of code blue activations in a single regional Australian healthcare service : a retrospective descriptive study of RISKMAN data
- Authors: Porter, Joanne , Peck, Blake , McNabb, Tiffinee , Missen, Karen
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 29, no. 1-2 (2020), p. 221-227
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- Description: Background: In the case of life-threatening conditions such as respiratory or cardiac arrest, or the clinical deterioration of the patient, a Code Blue activation may be instigated. A Code Blue activation involves a team of advanced trained clinicians attending the emergency needs of the patient. Aims and objectives: The aim of the study was to explore the number of cases of Code Blue activations, looking at the timing, clinical ward, diagnosis and activation criteria while noting cases where escalation from a Medical Emergency Team (MET) call occurs in one Regional Healthcare Service in Victoria, Australia, over a six-year period. Methods: A quantitative retrospective descriptive study of Code Blue emergencies over a six-year period from June 2010 to June 2016 was conducted. Data collected from the RISKMAN program operating at a single site was imported into SPSS (V 22) for descriptive statistical analysis. A STROBE EQUATOR checklist was used for this study (see File S1). Findings: The majority of Code Blue activations were male (59%, n = 127) and aged between 70 and 89 years of age (43%, n = 93). A Code Blue activation was more likely to occur at 08:00 hr, 14:00 hr or 22:00 hr, corresponding to the nurses’ change in shift, with the majority of Code Blues (27.8%, n = 60) occurring in the emergency department. Cardiac arrest was the main activation criterion with 54.6% (n = 118) cases followed by respiratory arrest (14%, n = 32). Interestingly, 20% (n = 45) of the Code Blue activations were upgraded from a Medical Emergency Team (MET) call. Conclusion: This project has produced several interesting findings surrounding Code Blue activations at one regional healthcare service which are not present in existing literature and is worthwhile for further investigation. Relevance to clinical practice: Understanding Code Blue activation criteria, common timings (month, time of day) and patient demographics ensures clinicians can remain vigilant in watching for the signs of patient deterioration and improve staff preparedness Code Blue events. © 2019 John Wiley & Sons Ltd
Confirming a beneficial effect of the six-minute walk test on exercise confidence in patients with heart failure
- Authors: Toukhsati, Samia , Mathews, Stephanie , Sheed, A. , Freijah, Isabella , Moncur, L. , Cropper, P , Ha, F. , Hare, David
- Date: 2020
- Type: Text , Journal article
- Relation: European Journal of Cardiovascular Nursing Vol. 19, no. 2 (2020), p.165-171
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- Description: Background: Low confidence to exercise is a barrier to engaging in exercise in heart failure patients. Participating in low to moderate intensity exercise, such as the six-minute walk test, may increase exercise confidence. Aim: To compare the effects of a six-minute walk test with an educational control condition on exercise confidence in heart failure patients. Methods: This was a prospective, quasi-experimental design whereby consecutive adult patients attending an out-patient heart failure clinic completed the Exercise Confidence Scale prior to and following involvement in the six-minute walk test or an educational control condition. Results: Using a matched pairs, mixed model design (n=60; 87% male; Mage=58.87±13.16), we identified a significantly greater improvement in Total exercise confidence (F(1,54)=4.63, p=0.036, partial η2=0.079) and Running confidence (F(1,57)=4.21, p=0. 045, partial η2=0.069) following the six-minute walk test compared to the educational control condition. These benefits were also observed after adjustment for age, gender, functional class and depression. Conclusion: Heart failure patients who completed a six-minute walk test reported greater improvement in exercise confidence than those who read an educational booklet for 10 min. The findings suggest that the six-minute walk test may be used as a clinical tool to improve exercise confidence. Future research should test these results under randomized conditions and examine whether improvements in exercise confidence translate to greater engagement in exercise behavior. © The European Society of Cardiology 2019.
Falls risk score removal does not impact inpatient falls : a stepped-wedge, cluster-randomised trial
- Authors: Jellett, Joanna , Williams, Cylie , Clayton, Diana , Plummer, Virginia , Haines, Terry
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 29, no. 23-24 (2020), p. 4505-4513
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- Description: Aims and objectives: To investigate the impact of removing a falls risk screening tool from an overall falls risk assessment programme on the rate of falls, injurious falls and completion of falls prevention activities by staff. Background: Falls in older patients are common adverse events in hospital settings. Screening and assessing individual patients for risk of falls are a common, but controversial element of falls prevention strategies in hospitals. Design: A stepped-wedge, cluster-randomised controlled trial using a disinvestment approach. Methods: This trial was carried out according to the Consolidated Standards of Reporting Trials (CONSORT). All patients were admitted to 20 health service wards (9 units) over the 10-month study period. The control condition contained a falls risk screening tool element, a full falls risk factor assessment and intervention provision section. In the intervention condition, only the full falls risk factor assessment and intervention provision section was applied, and the falls risk screening tool element was removed. Fall rates were extracted from hospital level data, files were audited for tool completion, and nurses surveyed about tool use. Results: There did not appear to be an impact on the falls rate per month when the risk screening tool component was removed (incidence rate ratio (IRR) = 0.84—favours intervention, 95%CI = 0.67 to 1.05, p =.14) nor on the falls rate with serious injury (IRR = 0.90, 95%CI = 0.26 to 3.09, p =.87). There was a thirty-six second reduction of time per patient reported by staff to complete paperwork (p <.001). There was no difference in the proportion of patients for whom the tool was completed, nor the number of falls prevention interventions identified for implementation. Conclusion: Removing the falls risk screening tool section did not negatively impact falls and reduced time spent completing falls prevention paperwork. Relevance to clinical practice: Falls prevention is an important issue in health services. Removal of a screening risk tool is unlikely to impact falls. This has the potential to reduce nursing administration time that may be otherwise redirected to individual approaches to falls prevention. © 2020 John Wiley & Sons Ltd
High-intensity interval training improves cardiorespiratory fitness in cancer patients and survivors : a meta-analysis
- Authors: Wallen, Matthew , Hennessy, Declan , Brown, Stephen , Evans, Luke , Rawstorn, Jonathan , Wong Shee, Anna , Hall, Adrian
- Date: 2020
- Type: Text , Journal article , Review
- Relation: European Journal of Cancer Care Vol. 29, no. 4 (2020), p.
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- Description: Objective: The primary objective of this systematic review and meta-analysis was to compare the effects of high-intensity interval training (HIIT) versus moderate-intensity continuous training (MICT) and usual care (UC) on cardiorespiratory fitness (peak V̇O2) in cancer patients and survivors. Secondary objectives were to compare the effects of HIIT versus MICT and UC on other cardiopulmonary exercise testing (CPET) indices. Safety and adherence to HIIT were also evaluated. Methods: A systematic review and meta-analysis of controlled trials were undertaken using eligible studies from electronic database searching (inception—December 2019). Mean differences (MD) with 95% confidence intervals (CI) were compared and heterogeneity assessed using Cochran's Q and I2 statistic. Results: Twelve eligible studies included 516 participants with post-intervention CPET data. No serious adverse events occurred. Adherence to HIIT ranged between 71.2% and 95.6%. HIIT had significantly higher peak V̇O2 compared with UC (MD = 2.11 ml kg−1 min−1, 95% CI 0.75–3.47, p =.002). No significant difference was found between HIIT and MICT (MD = 2.03 ml kg−1 min−1, 95%CI −0.75–4.83, p =.15). HIIT was more effective than UC to improve peak oxygen pulse (MD = 1.59 ml/beat, 95%CI 0.06–3.12, p =.04). Conclusions: Quantitative assessment of HIIT studies indicates good compliance, with a significant effect on peak V̇O2 and peak oxygen pulse compared with UC in cancer patients and survivors. HIIT demonstrates a comparable effect with MICT to improve peak V̇O2. © 2020 John Wiley & Sons Ltd
- Description: Western Alliance Academic Health Science Centre , WA-739501
I am the person who knows myself best : perception on shared decision-making among hospitalized people diagnosed with schizophrenia in China
- Authors: Huang, Chongmei , Plummer, Virginia , Wang, Yun , Lam, Louisa , Cross, Wendy
- Date: 2020
- Type: Text , Journal article
- Relation: International Journal of Mental Health Nursing Vol. 29, no. 5 (2020), p. 846-855
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- Description: Shared decision-making is related to better health outcomes in serious mental illness. It is not well addressed in non-Western cultures, for example Chinese culture. Chinese could be influenced by both paternalism and familism when making treatment decisions. However, this is unexplored. The study purpose is to explore shared decision-making from perspectives of inpatients diagnosed with schizophrenia in China. This study adopted qualitative descriptive approach. Through semi-structured interviews, twelve participants from the psychiatry department of a tertiary hospital shared their perceptions of shared decision-making. An inductive thematic approach was used to analyse the transcripts. Primary results included three main themes with nine subthemes: (1) Having a positive attitude: i) wanting my voice to be heard, ii) needing my family to be involved, and iii) preferring the psychiatrist to decide; (2) Feeling excluded: i) having limited financial capacity, ii) lacking interactive communication, iii) too few psychiatrists, and iv) being unsatisfied with informed consent process; and (3) Self-motivation in decision-making by: i) easing the burden on the family and ii) actively collecting health information. In this context, patients have fewer treatment options and a limited role in SDM. Yet, they have preference for SDM, actively seeking health information from mental health professionals particularly nurses. © 2020 Australian College of Mental Health Nurses Inc.
- Description: China Scholarship Council, CSC, [2017] 3109
Management of hyperlactation using pseudoephedrine — a case report
- Authors: Russell, Judith , King, Rosemary
- Date: 2020
- Type: Text , Journal article
- Relation: Breastfeeding Review Vol. 28, no. 1 (2020), p. 33-38
- Full Text: false
- Reviewed:
- Description: Hyperlactation refers to excessive breastmilk production over and above the infant’s needs. It may cause a range of distressing and uncomfortable symptoms for mother and infant, potentially affecting breastfeeding duration. The majority of cases will resolve through common, supportive management strategies that aim to reduce breastmilk supply through the negative feedback mechanism of milk production. Some herbal and pharmaceutical agents are considered to reduce breastmilk production and may be used to manage hyperlactation. One of these medications, pseudoephedrine, has been reported anecdotally to reduce breastmilk production, but there is a lack of evidence to support its use in this context. This case report details the use of pseudoephedrine as a ‘last resort’ treatment for a mother experiencing hyperlactation which had not responded to the usual management strategies. By titrating the dose according to her milk production, the mother was able to effectively self-manage hyperlactation and maintain an adequate breastmilk supply without any apparent adverse effects to herself or her baby. This suggests that pseudoephedrine has potential for use in the management of severe hyperlactation. However, pseudoephedrine should be used with caution and in conjunction with professional lactation support and supervision. © 2020, Australian Breastfeeding Association. All rights reserved.
Practice priorities for acute care nursing : a Delphi study
- Authors: Connell, Clifford , Plummer, Virginia , Crawford, Kimberley , Endacott, Ruth , Foley, Pieternella , Griffiths, Debra , Innes, Kelli , Schwerdtle, Patricia , Walker, Lorraine , Morphet, Julia
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 29, no. 13-14 (2020), p. 2615-2625
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- Reviewed:
- Description: Aims and objectives: To describe the risk and frequency of challenges in acute care nursing, and the practice priorities in Australian hospital wards based upon expert consensus. Background: Health care is facing increasing demands that are negatively impacting upon the safety and quality of nursing care. Design: Delphi Method. Method: A three-round electronic Delphi method was used to collect and synthesise expert consensus opinion of 30 participants in Rounds One and Two of the survey, and 12 participants in Round Three. The study was carried out from July to December 2016. This study complied with the STROBE checklist. Results: High patient acuity or complexity, as well as inadequate bed space on wards, are “very high” risks that occur “often” and “very often,” respectively. The pressure to admit patients, delayed medical review and patient boarding are all “high” risks that occur “often.” Though only occurring “sometimes,” inadequate numbers and skill mix of staff, suboptimal communication and early or inappropriate discharge all pose a “very high” risk to patient care. Conclusion: The key practice priorities for nurse managers should include the design, implementation and evaluation of sustainable system-wide frameworks, processes and models of care that address patient boarding, communication and discharge processes, job satisfaction, staffing numbers and expertise. Relevance to clinical practice: This study provides a description of the challenges that face acute care nursing in the provision of safe and high-quality care. © 2020 John Wiley & Sons Ltd