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The extent to which the analysis of the state of play of doctoral education and suggested ways forward are seen as being radical is of course dependent on the context within which nursing research programs currently exist. We are aware that no one size fits all contexts, but we are also aware of a critical need to challenge dominant perspectives and practices and work toward a radical repositioning of the nursing PhD. At a time when the narrative of nursing shortages is pervasive, we need to be positioning nursing research and researchers at the heart of the solution. Without a radical reconsideration of how we build sustainable research teams, the opportunity will bypass us. The special issue on doctoral education deliberately set out to be disruptive, to surface critical questions and trigger a conversation that needs to be had. We are open to continuing this conversation.
The rise in smartphone use presents opportunities and challenges in clinical settings. Despite guidelines restricting mobile phone use, nurses frequently rely on them for various purposes. While beneficial, smartphone use poses risks to information security, patient safety, and care quality, prompting the need for monitoring.
This study examined smartphone usage among nursing students and their perspectives on acceptable and unacceptable use during clinical placements.
This cross-sectional study used convenience sampling to recruit undergraduate nursing students from five universities in Australia and New Zealand. Participants completed the Attitude Towards Digital Device Use during Clinical Placement (Adduct) Scale online between September 2021 and August 2022. The survey included closed and open-ended questions. Descriptive and inferential analyses were conducted using SPSS. Exploratory factor analysis identified attitudinal dimensions, while group comparisons assessed demographic variations. Qualitative responses were thematically analysed. Reporting followed the Consensus-Based Checklist for Reporting of Survey Studies (CROSS).
Among 279 respondents, drawn from an eligible population of 2682 students, the response rate was 10.4%. Age significantly influenced perceptions of unacceptable smartphone use. Younger students (mean age = 25.0, SD = 9.8) were more likely to view such use as acceptable, with those up to 21 years reporting higher scores on the Unacceptable Use sub-scale compared to older peers (p = 0.024). Most respondents found smartphone use beneficial for accessing information and learning, though concerns included distractions and confidentiality breaches. Younger students were at greater risk of non-adherence to guidelines.
Smartphones can enhance learning and efficiency, but clear guidelines and education are needed to balance benefits with risks, particularly for younger students.
This study highlights the need for clear guidelines and structured training to balance educational benefits of smartphone use with the risks of distraction and breaches of patient confidentiality in clinical practice.
No patient or public pontribution.
To explore the perceptions and experiences of managers in residential aged care settings regarding personal care workers' intention to stay and build a career. Specifically, this study sought to identify enablers and challenges influencing personal care workers' retention and to explore strategies that could improve workforce sustainability.
A qualitative study utilising semi-structured interviews underpinned by the Theory of Planned Behaviour.
The study was conducted in Australia from July 2023 to March 2024. Eleven managers participated in this study. Data were analysed using inductive thematic analysis.
Four themes emerged from the analysis and were conceptualised to illustrate the intricate relationship between recruitment practices, work environment, organisational culture and leadership in influencing personal care workers' intentions to stay in residential aged care. A botanical metaphor was used for each theme. The ‘Diverse Seeds of Varied Potential’ theme highlighted how ad-hoc recruitment processes were a primary driver of workforce instability. Challenging work conditions and differing expectations from personal care workers and management led to ‘Wilting in Adverse Environments’, which also contributed to a broader misalignment between facility culture and values, encapsulated within ‘Mismatched Habitats’. Participants emphasised the need for ‘Building a Greenhouse’, a metaphor for cultivating sustainable leadership and workforce development to address these issues.
This study's findings underscore the critical need for a cohesive approach to workforce development strategies in residential aged care. Transitioning from reactive, ad-hoc recruitment to strategic workforce planning, fostering a supportive organisational culture that aligns with personal care workers' expectations, and prioritising sustainable leadership practices are essential steps. Addressing these interconnected challenges can help build a more stable, committed and skilled workforce, ultimately enhancing the quality and continuity of care for residents.
Strategic workforce planning and sustainable leadership development are essential for building a stable workforce, which directly impacts the quality and continuity of resident care.
This study addressed the critical issue of high turnover among personal care workers in residential aged care facilities, specifically examining managers' perspectives on retention challenges: an underexplored area that is crucial for developing sustainable workforce strategies. The findings revealed that current ad hoc recruitment practices, misalignment between diverse personal care worker profiles and established organisational cultures, have great impact on long-term engagement and retention. These insights are particularly valuable for residential aged care facilities struggling with staffing stability, industry bodies focused on workforce development and educational institutions preparing future aged care workers. Furthermore, the findings can inform policy development aimed at strengthening the aged care workforce, ultimately benefiting the quality of care received by residents.
The Consolidated Criteria for Reporting Qualitative Research (COREQ).
There was no patient or public contribution.
While health services leaders rely heavily on information gathered via environmental scans (ESs) to guide strategic decision-making, formal guidance on how to conduct these scans is notably absent. The purpose of this study was to determine the level of agreement on essential components of a definition and a methodological framework for ESs. The goals were to (1) advance our working definition to a concept definition for ESs and (2) develop a methodological framework to guide health service researchers conducting ESs.
We used a real-time, modified Delphi survey in a virtual platform setting to seek perspectives on statements related to ESs from individuals who were recruited based on having verifiable experience designing or conducting ESs in health services delivery research. Surveylet, an online software, was used to facilitate asynchronous data collection and to determine the level of agreement on the statements with an a priori threshold of 75% set for agreement on each statement.
21 panellists provided opinions on 59 statements related to a proposed ES definition and on 69 statements specific to components of a methodological framework for ESs.
Panellists from four countries participated in the survey representing 2 to ≥11 years of experience with ESs and having completed 1 to ≥7 ESs. Agreement was achieved in 28 of the 59 statements related to the ES definition and for 51 of 69 statements related to a methodological framework.
The agreement on many elements deemed essential for a definition of ES support development of a proposed concept definition of ES in health service delivery research. As well, the agreement on components deemed necessary for a methodological framework will help in future development of such a framework to guide stakeholders in the planning and implementation of ESs. These results provide a starting point for a common understanding of ESs in the field of health services delivery research.
The global rise in the population aged over 65 has led to a corresponding increase in cognitive impairment diagnoses, with dementia as a predominant condition characterised by diverse aetiopathogenetic profiles. Behavioural and psychological symptoms of dementia (BPSD) encompass a range of psychiatric, behavioural and cognitive symptoms associated with cognitive impairment. BPSD significantly affects patients, caregivers and healthcare providers, often necessitating interventions like sedatives or physical restraints that may worsen patient outcomes. Emerging evidence underscores the need for innovative, non-pharmacological interventions to manage BPSD effectively.
The current study intends to investigate the feasibility and acceptability of customised, immersive virtual reality environments (iVRe) to reduce responsive behaviours among individuals with dementia. Building on prior findings demonstrating virtual reality (VR) potential in reducing anxiety and fostering positive emotional states, this pilot study assesses the feasibility, safety and user engagement of customised iVRe interventions.
A longitudinal, mixed-methods design will be employed, enrolling 20 elderly participants with varying levels of cognitive impairment from the APSP ‘Margherita Grazioli’ long-term care facility in Trento. Participants undergo three VR exposure sessions featuring tailored environments adjusted in real-time for visual and auditory preferences. Data collection integrates standardised self-report questionnaires, observational tools and clinical records. Measures include the Functional Assessment Staging Tool, Neuropsychiatric Inventory and Cohen-Mansfield Agitation Inventory, as well as tools assessing pain, anxiety and emotional states before, during and after VR sessions.
The study protocol has been approved by the Comitato Etico Territoriale della Provincia Autonoma di Trento per le Sperimentazioni Cliniche, Azienda Provinciale per i Servizi Sanitari—Trento, Italy (Rep. Int. 12090, 15 May 2025). All participants or their legal representatives will provide written informed consent prior to enrolment. Deidentified data will be securely stored on institutional servers at the Fondazione Bruno Kessler and the APSP ‘Margherita Grazioli’, curated in compliance with the General Data Protection Regulation, and retained for 3 years after study completion. Any data shared externally will be provided in fully anonymised form, and only for scientific purposes, subject to prior ethical and legal approval. Study findings will be disseminated through peer-reviewed publications, conference presentations and executive summaries shared with participating institutions and stakeholders.
Infant feeding practices in the first 2 years of life are linked to long-term weight trajectories. Despite the importance of obesity prevention interventions, there are no randomised controlled trials (RCTs) evaluating early childhood education and care (ECEC) and primary caregiver-targeted interventions on child weight and feeding outcomes.
To assess the efficacy of an 18-month digital health intervention (Tiny Bites) delivered to ECEC services and primary caregivers of children aged 4 to ≤12 months on child age-adjusted and sex-adjusted body mass index-for-age z-score (zBMI) relative to usual care control in the Hunter New England (HNE) region of New South Wales, Australia.
This type 1 hybrid cluster RCT will include up to 60 ECEC services and 540 children/caregiver dyads. The intervention supports ECEC services and caregivers to deliver recommended responsive feeding practices to infants. ECEC services will receive access to an online assessment platform, training and resources, and implementation support. Primary caregivers will receive text messages, monthly e-newsletters, online links and direct communication from ECEC services. We will assess the impact on child zBMI at 18-month follow-up. Secondary outcomes include duration of consuming any breastmilk, child diet and caregiver responsive feeding practices. We will also assess ECEC policy and practice implementation related to targeted feeding practices, programme cost effectiveness, adverse effects and engagement with the programme (ECECs and caregivers). For the primary outcome, between-group differences will be assessed for paired data using two-level hierarchical linear regression models.
Ethics approval has been provided by HNE Human Research Ethics Committee (HREC) (2023/ETH01158), Deakin University (2024-202) and University of Newcastle HREC (R-2024-0039). Trial results will be submitted for publication in peer-reviewed journals, presented at scientific conferences locally and internationally and to relevant practice stakeholders.
ACTRN12624000576527.
This study explored the perceptions of weight, shape and physical activity of Palestinian refugee adolescent girls and their mothers living in Baqa'a camp, Jordan.
A descriptive qualitative design.
A purposive sampling approach was employed to recruit 12 Palestinians (six adolescent girls and their mothers) from a Palestinian refugee camp between March 2019 and mid-January 2020.
The socioecological model framed the analysis process and revealed four main themes. At the individual level: ‘The Perfect Body’ explained how mothers and daughters conceptualised ideal body weight and shape and factors that influenced this perception. At the relationship level: ‘it's tough love I give, it's tough love I accept’ explored the tumultuous mother–daughter relationship and impact on weight, shape and physical activity. At the community level: ‘The camp community is insular and the setting, spartan’ highlighted how people within the community and the environment itself impacted on healthy behaviours, and at the society level: ‘The influence of where you are and who you are’ explored how the broader levels of society and the culture determined attitudes and perpetuated body weight and shape ideals among women.
Greater effort involves collaboration among nurses, educators, community leaders, parents, media professionals and researchers to deliver positive health messaging on weight, shape and the importance of physical activity, with further investment in resources and infrastructure to support behaviour change.
Findings assist nurses in addressing sociocultural issues regarding body image among women and girls in refugee camps and in advocating for policies and practices that reduce health disparities.
The findings provide nurses, educators and community leaders' insight in designing interventions that incorporate family dynamics and parenting styles to promote healthy body image, weight management and physical activity among adolescents and their mothers. Schools, with the support of school nurses, can implement programmes that promote open communication and positive modelling of body image, leading to healthier self-esteem and attitudes among adolescents.
We have adhered to relevant EQUATOR guidelines using the COREQ reporting framework for qualitative research.
No patient or public contribution.
Effective haemorrhage control is crucial in cases of limb trauma involving arterial injury, such as shark attacks, to prevent potentially fatal outcomes. International first aid consensus recommends the use of arterial tourniquets (proprietary or makeshift) as a primary treatment for life-threatening external bleeding. Manual pressure applied directly over a major artery proximal to the injury, such as inguinal fist compression (IFC), is more accessible in a first-aid situation, but is currently not recommended due to limited evidence. The purpose of this study is to determine whether the application of IFC is superior to commercial windlass tourniquets (CWTs) in reducing blood flow in the femoral artery when performed by untrained bystanders.
Stopping Haemorrhage by Application of Randomised Compression or Tourniquet (SHARC-2) is a superiority, assessor-blinded, cross-over, randomised controlled trial conducted with healthy untrained adult volunteers in non-clinical settings. Participants will be rotated as providers and recipients of both IFC and CWT, with providers randomised to the order that they perform the techniques. Providers will be exposed to an educational infographic before applying that technique to a recipient behind a drop sheet. A sonographer, blinded to the technique, will measure the peak systolic velocity of blood flow in the superficial femoral artery using Doppler ultrasound at baseline and then during application of each technique for 5 min. The mean percentage reduction in peak systolic velocity will be compared between IFC and CWT groups.
Ethics approval for this study was granted by the Bond University Human Research Ethics Committee (BUHREC JF01036) on 23 January 2023. All participants will be provided with written informed consent prior to enrolment and the trial will involve healthy adult volunteers. To minimise risk, preintervention screening, sonographic assessment and postintervention follow-up will be implemented with adverse events monitored and reported in accordance with HREC guidelines. Results will be disseminated through peer-reviewed journals, academic conferences, local resuscitation forums and public health education initiatives. A lay summary will also be shared with relevant community groups and via social media platforms to enhance public accessibility.
ACTRN12624001054505.
Women with severe mental illness (SMI) face barriers to cervical cancer screening, leading to lower participation and poorer outcomes. This research aimed to develop and test an informed-choice tool to help women with SMI make informed decisions about screening attendance.
The tool was developed using a realist review of physical health interventions and a systematic review of informed-choice tools for people with SMI. A mixed-methods approach informed its development. Usability and acceptability were assessed through semistructured interviews and the think-aloud method with service users (n=18), clinicians (n=16) and key informants. A preliminary proof-of-concept (n=25) evaluated the impact on decisional conflict—the uncertainty around making value-sensitive choices.
Conducted in two National Health Service (NHS) Mental Health Trusts (urban and rural). Participants included women with SMI accessing secondary mental healthcare, clinicians and service user groups. A key informants’ group guided clinical content.
A cervical screening informed-choice leaflet and an accompanying video.
The tool was usable and acceptable, especially for women overdue or never screened. It may reduce decisional conflict and increase screening uptake, potentially improving survival. An National Institute for Health and Care Research (NIHR)-funded feasibility trial (Impr
Future research may involve further assessments of the real-world impact of the tool and its adaptation to other health-related decisions.
Objetivo: Valorar los beneficios del uso de la PEEP frente a su ausencia, así como identificar los daños que pueda ocasionar un uso indebido de ella. Métodos: Revisión sistemática cuya pregunta PICO fue ¿El establecimiento de un nivel de PEEP en el paciente someti-do a VMI sin patología pulmonar asociada proporciona beneficios en oxigenación y ventilación frente al no establecimiento de PEEP? El período de búsqueda fue de diciembre de 2019 a marzo de 2020 en las bases de datos Medline/Pubmed, Cochrane, Cuiden, Y Science-direct. Los descriptores MeSH utilizados fueron “positive end final expiration’’, “artificial respiration’’, “zero end expiratory pressure’’, “lung’’, “general anesthesia’’, seleccionándose 220 artículos de los que se excluyeron 215. Resultados: Fueron incluidos 5 artículos; el uso de la PEEP presentó mejores resultados en la dinámica respiratoria en aquellos pacientes que fueron sometidos a ventilación invasi-va, frente aquellos que no la tuvieron. Este fenómeno fue debido a una mejora de la oxigenación, disminución de la aparición del número de atelectasias y mejora en la mecánica ventilatoria. Conclusiones: El uso de un nivel adecuado de PEEP en pacientes bajo ventilación invasiva presentó mejores resultados en la dinámica pulmonar.
FreshRSS 