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Sense of coherence moderates job demand‐resources and impact on burnout among nurses and midwives in the context of the COVID‐19 pandemic: A cross‐sectional survey

Abstract

Aim

This study aimed to test the propositions using the job demands-resources (JD-R) model for main/moderation/mediation effects of a sense of coherence and practice environment support on mental well-being (anxiety, depression and burnout) outcomes in nurses and midwives in Australia during the COVID-19 pandemic.

Design

Cross-sectional quantitative survey.

Data Sources

The study was a cross-sectional design using self-report questionnaires reported as per the Reporting of Observational Studies in Epidemiology Guidelines. Following human research ethics approval (2020.ETH.00121) participants were recruited to take part in an online anonymous survey using self-report instruments to test the JD-R model in Australia.

Results

156 participant nurses and midwives experienced anxiety, depression and emotional burnout during COVID-19. While a considerable proportion of participants indicated high levels of emotional exhaustion, their responses showed low levels of depersonalization (detached response to other people) and high levels of personal accomplishment (high levels of work performance and competence). A sense of coherence was a significant protective factor for mental health well-being for the participants, which is to say, high levels of sense of coherence were predictive of lower levels of anxiety, depression and burnout in this study sample.

Conclusion

It is evident that both nursing and midwifery professions require psychosocial support to preserve their health both in the short and long term. Ensuring individualized tailored support will require a layered response within organizations aimed at individual self-care and collegial peer support.

Patient or Public Contribution

There was no patient or public contribution in this study, as the focus was on nurses and midwives.

A Bayesian generating function approach to adverse drug reaction screening

by Tom Northardt

Determining causality of an adverse drug reaction (ADR) requires a multifactor assessment. The classic Naranjo algorithm is still the dominant assessment tool used to determine causality. But, in spite of its effectiveness, the Naranjo algorithm is manually intensive and impractical for assessing very many ADRs and drug combinations. Thus, over the years, many “automated” algorithms have been developed in an attempt to determine causality. By-and-large, these algorithms are either regression-based or Bayesian. In general, the automatic algorithms have several major drawbacks that preclude fully automated causality assessment. Therefore, signal detection (or causality screening) plays a role in a “first pass” of large ADR databases to limit the number of ADR/drug combinations a skilled human further assesses. In this work a Bayesian signal detector based on analytic combinatorics is developed from a point of view commonly adopted by engineers in the field of radar and sonar signal processing. The algorithm developed herein addresses the commonly encountered issues of misreported data and unreported data. In the framework of signal processing, misreported ADRs are identified as “clutter” (unwanted data) and unreported ADRs are identified as “missed detections”. Including the aforementioned parameters provides a more complete probabilistic description of ADR data.

Understanding the needs and preferences for cancer care among First Nations people: An integrative review

Abstract

Aim

This systematic review aimed to identify the needs and preferences for cancer care services among Australian First Nations people.

Design

Integrative review.

Data Sources

An integrative review was conducted. A wide range of search terms were used to increase the sensitivity and specificity of the searches in electronic databases. Methodological quality assessment, data extraction, was conducted independently by two reviewers, and a narrative synthesis was conducted.

Results

Forty-two studies were included. A total of 2965 Australian First Nations adults, both men and women of various ages across the lifespan, were represented; no First Nations children affected by cancer were represented in the studies. Three themes emerged which included: (1) discrimination, racism and trauma, resulting from colonization, directly impacted First National people's cancer care experience; (2) cultural ways of knowing, being and doing are fundamental to how First Nations people engage with cancer care services; and (3) First Nations people need culturally safe person-centred cancer care services that address practical needs.

Conclusion

Most participants represented in this review experienced discrimination, racism and trauma, resulting from colonization, which directly negatively impacted Aboriginal peoples' cancer care experience. While the Optimal Cancer Pathway (OCP) was launched in Australia several years ago, people with cancer may continue to experience distressing unmet care needs.

Patient or Public Contribution

Our team includes both First Nations people, non-First Nations researchers and healthcare professionals with expertise in cancer care. The researchers employed decolonizing restorative approaches to ensure voice, respect, accountability and reciprocity in this review work.

Implications for Nursing Practice

Members of the multidisciplinary team including nurses and policymakers should reflect on these findings, ensure that they have up-to-date cultural safety training and stand together with Indigenous and non-Indigenous cancer leaders to take proactive steps to stamp out and dismantle oppression in health, and safely implement the OCP.

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