Support Health Professionals Research Articles

OA32 A national survey of rheumatology telephone adviceline support in the United Kingdom: frontline perspectives

Abstract Background/Aims Telephone advicelines (TALs) are a core feature of rheumatology services and highly valued by patients for providing clinical advice and support. The demand for TALs has increased since the pandemic, placing pressure on current capacity. This study aimed to assess how TALs are currently provided and the impact on rheumatology nurses who routinely deliver this service. Methods An online questionnaire was developed and piloted with input from patients and stakeholders and advertised through the Royal College of Nursing Rheumatology Forum and the British Society for Rheumatology. The survey included health professional demographics, how TALs operate, reasons for contacting TALs, documentation recorded and the impact on provider wellbeing using closed and free text questions. The survey was available from March to September 2023 and had university ethics approval. Results 123 people completed the survey. The majority were rheumatology nurses (n = 118), over 45yrs (n = 96,81%), band 7 or above (n = 88;74%) with over 10 years experience (n = 77,65%), with a first degree or higher (n = 106, 90%). 45 (38%) nurses had a prescribing qualification. The majority of TALs provided a voicemail response (n = 90, 76%),with a triaging system (n = 75, 64%) conducted by clinical support workers (n = 44, 37%) and nurses (n = 29,25%). The number of calls received over a month ranged from 100 to over 800 with 68 (58%) respondents reporting between 500-700 calls. TALs were provided over 5 days (n = 93,79%) for 8 hours (n = 61, 52%), by rheumatology nurses (n = 118), with calls returned within 1-2 days (n = 96,81%) by 1-2 nurses (n = 72,61%), although some calls took over 7 days to respond to (n = 19). The three main reasons for contacting TALs included increased disease activity, managing pain, and concerns relating to DMARDs. There was often no standard operating procedure (n = 72, 61%) or provision for people whose first language is not English (n = 99,84%). Data were collected on the nature of the call (n = 74, 63%) and the response given (n = 47, 40%). Providing TALs negatively impacted on provider wellbeing; 89 (75%) felt anxious ‘sometimes to mostly’ and 79 (67%) found it ‘mostly-always’ stressful. 85 (72%) had not received any training to conduct TALs and 79 (67%) reported that cover was often not available for leave or sickness. The qualitative findings also confirmed that expert providers found delivering TALs stressful and felt underprepared. One respondent commented that “The adviceline is the most stressful aspect of the role but has the least support.” Many felt the adviceline had developed without adequate planning, contributing to the service being under resourced and under recognised. Conclusion TALs support patients with concerns about their symptoms and treatments on a daily basis, yet the increased demand for delivering TALs is impacting on nurse wellbeing. Consequently, national guidelines are required on optimal service requirements including resource allocation, training and health professional support. Disclosure S. Ryan: None. S. Hider: None. A. Hassell: None.

Supporting interdisciplinary mental health professionals through online professional development: eleven years of the MHPN webinar program in Australia

ABSTRACT Objective The Mental Health Professionals’ Network (MHPN) has been delivering webinars for professionals working in primary mental health care in Australia since 2010. This study aimed to investigate changes in engagement in and outcomes of MHPN webinars over 11 years from 2010 to 2020. Method Over 11-years, 75 webinars were delivered by a multi-disciplinary panel of mental health professionals, using a case-study format to stimulate discussion of collaborative care. Attendees were invited to complete a post-webinar online questionnaire to assess webinar effectiveness and impacts on work practice. Change over time was assessed using chi-square tests and analysis of variance. Results From 53,468 webinar attendances, 30,617 (57.3%) questionnaires were collated and analysed. There was a steady and significant increase in webinar attendance over time. The degree to which learning needs were met increased significantly over time, as did the relevance of the webinars and their anticipated impacts on improving work practice. Discussion The findings indicate that practitioner engagement in MHPN webinars and the associated positive impacts on work practice have both increased over the past decade. By improving the knowledge, attitudes and practice of mental health professionals, MHPN plays an important role in improving mental health promotion, prevention, early detection and treatment in Australia.

Shining a Light in COVID-19 Darkness

Introduction: The World Health Organization officially declared COVID-19 a global pandemic in March 2020, resulting in travel restrictions, closure of non-essential shops and services, and the discontinuation of elective healthcare. The escalation of the pandemic impacted on hospital healthcare professionals, who experienced the deaths of colleagues and unprecedented changes in their working conditions. One area that received media attention in the United Kingdom during the pandemic was the role of hospital chaplaincy and spiritual care teams.Methods: An exploratory study advertised via social media, the press and professional bodies resulted in 86 healthcare professionals and 63 chaplains, who had worked clinically in the United Kingdom during the pandemic, completing an open, free text electronic survey. Seven chaplains participated in a follow-up telephone interview, with all the data collected in 2022.Results: The survey demographic data were analysed using descriptive statistics. Free text responses and interviews were subject to thematic analysis. A focus on the support of health professionals was widely reported by all respondents. Two overarching themes were identified: (1) organizational initiatives, with subthemes of structural and virtual support; (2) proactive intervention – “going to the frontline”, with subthemes of emotional and spiritual support, moral support and practical input.Discussion/Conclusion: The overarching finding was that hospital chaplains worked alongside healthcare staff on the clinical frontline. Staff described this as invaluable in its immediacy of support and provision of a valued presence. The chaplain’s role changed to becoming more focused on staff support, which appears to be ongoing, thus impacting on the future role and training for hospital chaplaincy teams.

Partnering Early to Provide for Infants At Risk of Cerebral Palsy (PĒPI ARC): protocol for a feasibility study of a regional hub for early detection of cerebral palsy in Aotearoa New Zealand.

Cerebral palsy (CP) can now be diagnosed in infants with identified CP risk factors as early as three months of age; however, many barriers prevent equitable access to early detection pathways. The "Partnering Early to Provide for Infants At Risk of Cerebral Palsy" feasibility study (PĒPI ARC) seeks to trial a new approach to decrease inequitable health service in Aotearoa New Zealand for high-risk infants and their families. PĒPI ARC incorporates face-to-face clinics, an in-person and virtual Hub, and the use of telehealth to enable flexible access to CP assessments and support for health professionals in early CP detection. A non-randomised feasibility study was conducted from a tertiary Neonatal Intensive Care Unit (NICU) in Wellington and included seven regional referral centres, servicing nearly 30% of the total population in New Zealand (NZ). The families of infants with a high risk of neurodevelopmental impairment and health professionals interacting with the Hub were invited to participate. Mixed methods were used to evaluate the (i) equitable implementation of an early detection pathway, (ii) acceptability, (iii) demand among families and health professionals, (iv) efficacy in relation to reducing the age of receipt of CP diagnosis, and (v) the experiences around communication and information sharing. The NZ Health and Disability Ethics Committee approved this study (HDEC: 2022 FULL 13434). The findings will be disseminated in peer-reviewed journals, in conference presentations, and via professional networks. Australian New Zealand Clinical Trials Registry: ACTRN12623000600640.

The sociocultural impact of COVID-19 on registered nurses employed at a regional health authority in a Caribbean island

PurposeThe purpose of this study is to examine the sociocultural implications of caring for persons with COVID-19 in a developing country context.Design/methodology/approachIn total, 156 nurses participated in the study. Stratified random sampling methodology was used. Data were collected via online self-administered questionnaire. Descriptive and inferential statistics, including ANOVA tests were done.FindingsNurses experienced stigmatization, discrimination and reduced income. Nurses functioned on the frontline during the COVID-19 pandemic and encountered negative sociocultural experiences from a personal, social and professional perspective. ANOVA showed statistically significant relationships between the conflicts between their work role, family commitments and level of physical interactions with a number of variables.Research limitations/implicationsData were collected from one Regional Health Authority and may not be representative of the national population of nurses. Further, as the researchers depended on gatekeepers to access participants, the recruitment process may not have been entirely based on randomization as originally agreed.Practical implicationsThe findings from this study can be used as a framework to develop context specific programmes and policies to support health professionals, including nurses.Social implicationsPandemics, while not new, contribute to serious sociocultural challenges for individuals and families, as well as nurses, as part of their professional roles. In this regard, maintaining effective social networks must be central to effective functioning in crisis situations, such as pandemics.Originality/valueNurses have played a key role, working both to identify, isolate and manage those with COVID-19 and supporting those who have non-COVID-19 related health needs. While nurses have been at the forefront delivering care in these uncertain times, doing so puts them at great risk, for not only contracting COVID-19 but also for experiencing negative psychosocial effects that may be due to the nature of their jobs.

Onco'sport à l’épreuve des patients : expérience vécue des patients atteints d’un cancer pratiquant de l’activité physique adaptée dans le cadre du programme Onco'sport, une étude qualitative

Physical activity is a major determinant in the prevention of chronic diseases, equally on the side effects of treatments and the consequences of the disease. It improves quality of life, but also reduces morbidity and mortality, and therefore health expenses. A sedentary lifestyle is the fourth cause of premature death in the world, in the context of chronic non-communicable diseases. In France, the prescription for adapted physical activity (APA) has been included in the law since 2016. With the development of "Maisons Sport santé", the Onco'sport program was developed to enable people affected by cancer to participate in adapted physical activity. The objective of our work is to explore the lived experience of cancer patients practicing adapted physical activity as part of the Onco'sport program. This is a qualitative study of 10semi-directed individual interviews with patients participating in the Onco'sport program, recruited from the "Maison Sport Santé" from Nîmes and the association "Les Roses du Gard". A phenomenological analysis was carried out with a semiopragmatic approach. For all participants, the APA through a program provides professional supervision of Physical Activity, influences adherence and builds confidence. This program is at the origin of changes in lifestyle habits and improves the relationship with illness and their cancer thanks to the physical and psychological benefits felt. Thus, APA appears as a full-fledged supportive care which requires informing patients and promoting it so that access is facilitated and becomes a standard. Health professionals including general practitioners do not currently have an important place in the promotion of APA, and patients most often obtain documentation on their own or through associations of patient. An APA program like Onco'sport is often the cause of a return to physical activity in patients, brings overall well-being and changes lifestyle habits. It seems important to promote physical activity to patients but also to the general population, given the benefits. This promotion involves easier access to this type of supervised program, financial support and better training of health professionals.

Exploring the concerns, attitudes and experiences of health professionals regarding a vegan diet during pregnancy and early life; a mixed-method study

Vegan diet consumption is gaining popularity globally and in New Zealand. However, plant foods provide absent or limited quantities of important micronutrients such as vitamin B12, iron, zinc, and omega-three fatty acids(1). A restrictive and unplanned vegan diet may thus increase risks of nutrient deficiencies especially during pregnancy and early life if the nutrient demands are not fulfilled. Health professionals who provide primary support for pregnant women and their children are important figures in monitoring the nutritional statuses during the antenatal and postnatal periods(2). (Being knowledgeable about the nutritional risks of poorly-planned vegan diets, and having access to appropriate educational resources would support vegan mothers and children to achieve a well-balanced diet. Currently, there are insufficient studies investigating the perspectives of New Zealand’s health professionals within the realm of vegan diets during pregnancy and early life. The aim of the research is to utilise a mixed-methods approach to explore these concerns, attitudes, and experiences. Healthcare professionals, including dietitians, nurses, general practitioners and midwives were invited to participate in the study. Knowledge and attitude scores were collected with an online questionnaire and scores were recorded as a proportion of the participants. Subsequently, descriptions of experiences, concerns, and perspectives about the adoption of vegan diets during pregnancy and early life were collected with semi-structured interviews. A total of 14 health professionals completed the study. All health professionals showed positive attitudes towards the adoption of vegan diets during pregnancy but some exhibited greater concern about their restrictive nature especially in early childhood. Achieving intake adequacy and subjecting young children to intensive assessments for nutrient adequacy were among the concerns raised. More than 90% of health professionals were concerned about iron and vitamin B12 deficiencies while less than 50% were concerned about deficiencies in protein, omega-three fatty acids, iodine, zinc and vitamin D. Less than 50% of participants were aware that plant foods do not provide sufficient vitamin B12. More than 50% disagreed that sufficient information about vegan diets during pregnancy and early life is available. Insufficient evidence-based consensus and government guidelines, and limited access and referrals to dietitians for guidance on vegan diets were highlighted as challenges that reduce the overall knowledge and confidence. Hence, continual professional education and updated evidence-based resources would be important steps to support health professionals in providing guidance to individuals on vegan diets.

Effects of stress on sleep quality: multiple mediating effects of rumination and social anxiety.

In contemporary society, with the accelerated pace of work and life, more and more people feel different degrees of stress. Long-term stress may not only lead to insomnia, but also to mental health problems (e.g., anxiety and depression), which has a significant impact on people's quality of life and mental health. This study primarily investigates the mechanism through which stress affects sleep quality among college students. We conducted research on 1653 Chinese college students using four scales with high reliability and validity: stress, the Pittsburgh Sleep Quality Index, social anxiety, and rumination. The study found: (1) Stress can significantly and positively predict sleep quality and rumination; (2) Rumination can positively predict social anxiety; (3) Social anxiety can positively predict sleep quality; (4) Stress can affect sleep quality through social anxiety and rumination separately, and stress can also affect sleep quality through the chained mediation of rumination and social anxiety. This study reveals the relationship and mechanisms between stress and sleep quality. It not only deepens the research on the impact of stress on sleep quality but also provides theoretical support and new methods for mental health professionals to help clients improve their sleep quality. In practice, in addition to using some common psychological intervention methods to help individuals reduce stress, we should pay more attention to how to help clients reduce rumination and social anxiety, This is significant in improving the quality of an individual's sleep.

Self-help mobile messaging intervention for depression among older adults in resource-limited settings: a randomized controlled trial

Scalable solutions to treat depression in older adults in low-resourced settings are urgently needed. The PRODIGITAL-D pragmatic, single-blind, two-arm, individually randomized controlled trial assessed the effectiveness of a mobile messaging psychosocial intervention in improving depressive symptomatology among older adults in socioeconomically deprived areas of Guarulhos, Brazil. Older adults (aged 60+ years) registered with 24 primary care clinics and identified with depressive symptomatology (9-item Patient Health Questionnaire (PHQ-9) scores ≥ 10) received the 6-week Viva Vida intervention based on psychoeducation and behavioral activation (n = 298) or a single message (n = 305). No health professional support was offered. The primary outcome was improvement from depressive symptomatology (PHQ-9 < 10) at 3 months. Of the 603 participants enrolled (mean age = 65.1 years; 451 (74.8%) women), 527 (87.4%) completed the follow-up assessment. In the intervention arm, 109 of 257 (42.4%) participants had an improved depressive symptomatology, compared with 87 of 270 (32.2%) participants in the control arm (adjusted odds ratio = 1.57; 95% confidence interval = 1.07–2.29; P = 0.019). No severe adverse events related to trial participation were observed. These results demonstrate the usefulness of a digital messaging psychosocial intervention in the short-term improvement from depressive symptomatology that can potentially be integrated into primary care programs for treating older adults with depression. Brazilian Registry of Clinical Trials registration: ReBEC (RBR-4c94dtn).

Relationship between quality of life, emotional symptomology and perceived emotional intelligence in a sample of burn victims

The main objective of this study is to analyse the association between Quality of Life (QOL), Emotional Symptomology and perceived Emotional Intelligence (EI) in burn patients. Additionally, it is intended determine the predictor models of QOL, and confirm the mediating effect of emotional symptomology between QOL and perceived EI. This is a transversal study developed in the Hospital da Prelada, Porto, Portugal, with a sample of 92 patients that were hospitalized in the Burn Unit and the Reconstructive Plastic Surgery Service. The assessment protocol consisted of a sociodemographic and clinical data sheet. To assess the perception of QOL of the burn patient it was used the Burn Specific Health Scale – Revised (BSHS-R), the emotional symptomology was measured by the Brief Symptom Inventory (BSI) and Trait Met-Mood Scale-24 (TMMS) was used to assess Emotional Intelligence (EI). The cross-sectional and correctional data were analysed through descriptive statistics, correlations, regressions and simple mediations. The results obtained suggest significant associations between QOL, perceived EI and Emotional Symptomology in burn patients. The results of the predictor models of the QOL domains encompass the Positive Symptom Distress Index (PSDI of Emotional Symptomology), where the total variance is explained mainly by the models of QOL Affect and Body Image 46% and Treatment 31%. The mediating effect of the PSDI in the relationship between QOL in the Affect and Body Image dimension and the Mood Repairs (MR) was also tested, having proved to have a total mediation (the Mood Repairs loses its contribution in the QOL model when the PSDI variable is introduced). This study underscores the importance of perceived Emotional Intelligence and its association with the burn impact in the different dimensions of QOL of the patients. The intention of this study is to alert health professionals for patient support in the search for strategies that aim for positive adaptation which promotes QOL and emotional adjustment of burn patients to their new condition.

Meeting the Health and Social Needs of America's Unhoused and Housing-Unstable Populations: A Position Paper From the American College of Physicians.

Access to safe and stable housing has both a direct and indirect effect on health. Experiencing homelessness and housing instability can induce stress and trauma, worsening behavioral health and substance use. The absence of safe and stable living conditions can make it challenging to rest, recuperate, and recover from health ailments and can pose barriers to treatment adherence. Homelessness and housing instability is associated with high rates of numerous diseases and chronic conditions. Its cyclical relationship with other social drivers of health can exacerbate health disparities. As a result, unhoused persons experience unique health challenges and require a health care system and professionals designed to meet their distinct needs. Physicians and other health professionals have a role in educating themselves about the needs of unhoused patients as well as making themselves aware of community and government resources available to these populations. Policymakers must support health professionals in these efforts by supporting the data infrastructure needed to facilitate these referrals to resources, supporting research into best practices for caring for these populations, and investing in community-based organization capacity. Policy action is needed to address the underlying drivers of homelessness, including a dearth of affordable housing, while also addressing the short-term need for safe shelter now. In this position paper, the American College of Physicians (ACP) recognizes the need to address universal access to housing to fulfill one's right to health. ACP offers several recommendations to prevent homelessness and promote the necessary health care and social needs of unhoused populations.

Learning About Resilience from Rural Interprofessional Healthcare Teams: Insights from the “First Wave” of COVID-19

Building resilience is a key concern for adult educators today as we face unprecedented global challenges such as the coronavirus disease-19 (COVID-19). Nowhere is this more apparent than in educational initiatives with health professionals who experience many stressors in their work, now amplified by the pandemic. This paper reports the results of focus groups with three interprofessional primary healthcare teams in rural Nova Scotia, Canada, in the fall of 2021. The aim was to learn about their lived experience during the first year of the pandemic, as a basis for considering how resilience could be nurtured and supported in rural team-based collaborative practices settings. Findings reveal that, while each collaborative team experienced recognized COVID-19 workplace stressors, they leveraged a store of collective resilience to navigate the pandemic. The trust, sense of purpose, and shared problem-solving skills they derived from working in collaborative structures over time enabled them to regain equilibrium and to adapt to new norms, and to transform thier practices. The study highlights the power of collaborative learning to strengthen overall ability for resilient performance, and the adaptive capacity that is required to deliver and sustain quality healthcare. The study highlights the need for continuing professional education that values naturally occurring practice-based learning. Adult educators are well positioned to support health professionals and health systems to nurture and support resilient action. They bring an understanding of effective collaborative tools and processes that foster dialogue and collective awareness that leads to a shared identity and understanding. As this study reveals, it is this shared identity and capacity arising within a group that enables them to draw on their collective sources of support to deal with adversity.

Safe Transportation of Children With Disabilities and Medical Conditions in Motor Vehicles: Experiences and Perspectives of Australian Health Professionals and Organisations

Providing safe and accessible transportation for children with disabilities and medical conditions can be challenging and complex, as they are particularly vulnerable during road vehicle transportation. Health professionals and organisations play a vital role in supporting families and other involved individuals to ensure their child is transported safely. To obtain a better understanding of the experiences and perspectives of health professionals and organisations involved in the safe transportation of children with disabilities and medical conditions, a large-scale national survey was undertaken in Australia. A total of 295 responses were obtained from 234 health professionals and 61 organisations. Responses were analysed to explore the experiences, difficulties, and demands related to supporting the provision of safe transportation for these children. Although these key stakeholders believed safe transportation to be an important right, health professionals faced many challenges and had low confidence in their abilities to address the barriers associated with it. The findings suggest that health professionals may benefit from additional training, support, and resources. Organisations need access to evidence-based information to address this transportation topic in their strategies and plans. Without adequate support for health professionals to improve their knowledge and capability in this area, and organisational commitment in their strategies and plans that include the transport needs of children with disabilities and medical conditions, these children and their families will remain at a disproportionate risk of injury and fatality on the roads.

Living with unsettled baby behaviours: Qualitative interview study exploring parental perceptions and experiences of help-seeking.

To explore parents' perceptions/experiences of help-seeking for unsettled baby behaviours, including views and experiences of obtaining advice from primary healthcare professionals. Semi-structured qualitative interviews. Recruitment occurred via social media, general practice and health visiting teams. Remote semi-structured interviews were conducted with parents of babies. Babies were under 12 months old at time of interview, and parents had perceived unsettled baby behaviours in their first 4 months of life. Interviews were transcribed and data analysed using reflexive thematic analysis. Based on interviews with 25 mothers, four main themes were developed. 'The need for answers' highlighted parental uncertainty about what constitutes normal baby behaviour, leading to help-seeking from multiple sources. 'The importance of health professionals' and 'Experiencing health professional support' identified perceptions about limited access, communication, mixed advice and how these influenced parental perception/management of behaviours. 'Foundations to help-seeking' highlighted important roles of social support and online help for valued shared experiences, emotional and practical support. Health professional access and advice are important to parents, despite the increasing role of online help and importance of social support. More support and improved access to reliable sources of information is needed for parents. Findings will inform future research and clinical practice to address parental uncertainties. Qualitative research with front-line health professionals is necessary. Findings can inform the development of resources to support professionals/families managing unsettled babies. Standards for Reporting Qualitative Research. A public contributor was involved throughout all stages of the research. Emerging findings were discussed at a parent group. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: Addressing parental uncertainties is important; about what is normal, non-pharmacological approaches and when pharmacological intervention is required. A digital information/self-management intervention may be useful for parents/clinicians.

Role of lactation specialists in maternal health and improvement of maternal mental health

Lactation specialists, comprising certified lactation consultants or counselors, play a significant role in fostering and safeguarding maternal mental health throughout the perinatal period. Their expertise in breastfeeding support transcends mere technical guidance, extending into the realm where emotional support and mental health advocacy converge. During consultations, lactation specialists create a safe, empathetic space, allowing mothers to openly discuss concerns and challenges related to breastfeeding. This nurturing environment fosters trust and confidence, which is crucial for mothers navigating the complex journey of breastfeeding. Importantly, breastfeeding itself is deeply intertwined with maternal mental health. Lack of milk, lack of breastfeeding support, and painful experiences all negatively affect maternal mental health greatly. Lactation specialists, attuned to emotional cues and stressors during breastfeeding interactions, play a critical role in identifying signs of distress or anxiety. They offer compassionate listening and, when necessary, provide resources or referrals to mental health professionals for specialized support. Moreover, these specialists serve as educators, equipping mothers with knowledge about the emotional aspects of breastfeeding and its potential impact on mental well-being. By empowering mothers with information and strategies to manage stress or challenges, lactation specialists contribute significantly to mitigating potential mental health concerns during the perinatal period. Beyond individual consultations, lactation specialists often facilitate support groups or communities for breastfeeding mothers. These forums create a sense of camaraderie and solidarity among mothers, alleviating feelings of isolation, which is a common trigger for maternal mental health challenges. Their multifaceted approach emphasizes the holistic nature of breastfeeding support, recognizing its impact on both the physical health of the child and the mother’s mental well-being. By providing comprehensive care that combines technical guidance with emotional support, lactation specialists play a vital role in promoting and preserving maternal mental health during the transformative phase of childbirth and early motherhood.

Rapid nursing redeployment from a specialist ward to a COVID-19 high-dependency setting.

Redeployment in health care can have a negative impact on the mental wellbeing of staff. Advanced planning and provisions for wellbeing support for health professionals has been recommended following previous pandemics. At the authors' institution nurses were redeployed overnight from a specialist cystic fibrosis ward to a COVID-19 high-dependency unit. To evaluate nurses' wellbeing following this redeployment during the first wave of the COVID-19 pandemic. A mixed online survey, consisting of both open and closed questions, based on literature, preliminary results of the Impact of COVID-19 on the Nursing and Midwifery Workforce (ICON) study and staff feedback. This was sent to 28 nurses to explore their feelings and experiences of redeployment to a COVID-19 environment. Purposive sampling was used to select study participants while thematic analysis and descriptive statistics were used to analyse the data. The survey had an 86% response rate. Using thematic analysis three key themes emerged: redeployment anxiety, lack of organisational preparedness and newfound teamworking. More than half (57%) of respondents expressed anxiety and concern when told of their redeployment; 52% reported that they did not receive adequate support from senior staff and management. However, 74% reported that they felt their nursing was positively influenced by support and teamwork from those in patient-facing roles. Twenty-five percent reported that they were looking for a new job or leaving their current role. This study examines the effects that redeployment to a COVID-19 environment has had on nurses. It highlights the need for further improvement to ensure redeployed staff are supported to safeguard their mental wellbeing.

Exploring the smoking cessation needs of individuals with diabetes using the Information-Motivation-Behavior Skills model.

Smoking cessation is an important aspect of diabetes management. Despite the increased risk for diabetes complications when smoking, evidence suggests that people living with type 1 and type 2 diabetes are less likely to quit smoking when compared to those without diabetes. Guided by the Information-Motivation-Behavioral Skills model, this study aimed to identify the needs of individuals living with type 1 and type 2 diabetes to quit smoking. A qualitative descriptive design was adopted. Semi-structured telephone interviews were held between April and June 2021, with 20 former and current Maltese smokers living with type 1 or type 2 diabetes, recruited from the diabetic clinics within the two main acute public hospitals. The interview transcriptions were analyzed using applied thematic analysis. Individuals with diabetes need more information on the effects of smoking on diabetes to encourage cessation. Preventing diabetic complications was reported as a motivator to quit smoking. However, having diabetes was identified as a challenge to quitting. Participants welcomed the provision of health professional support for quitting smoking, identifying the need to provide smoking cessation support within diabetic clinics. The provision of information on tobacco-associated diabetic complications, by using video messages featuring former smokers' stories was also suggested. To promote smoking cessation among individuals with diabetes, they need to be informed about how smoking affects their condition. Utilizing video messages featuring real-life stories of former smokers with diabetes who experienced tobacco-associated diabetic complications may be influential. Additionally, providing diabetes-specific intensive smoking cessation support is crucial to help them quit.

Experiences with neonatal jaundice management in hospitals and the community: interviews with Australian health professionals

IntroductionWorldwide, neonatal jaundice accounts for considerable morbidity and mortality. Although severe adverse outcomes, such as hyperbilirubinaemia and kernicterus, are uncommon in high-income countries, these outcomes do occur, have enormous lifelong...

Communicating about sexual activity and intimacy after a heart attack: a cross-sectional survey of Australian health professionals.

Sexual activity and intimacy improve quality of life for heart attack survivors. After a heart attack, patients frequently experience sexual dysfunction and anxiety about resuming sexual activity. However, most health professionals do not discuss sex or intimacy with their patients. The aim of this research was to explore the perceptions and practices of Australian health professionals in discussing sexual activity and intimacy with heart attack survivors and the barriers to achieving this. This study employed a cross-sectional study design and online self-administered survey questionnaire. Study participants were a convenience sample of Australian health professionals working with cardiac patients, including general practitioners, cardiologists, cardiac rehabilitation specialists, registered nurses, and allied health professionals. Data were analysed using descriptive statistics and cross-tabulations to understand the different perspectives of health professional groups and the overall sample. Of 252 respondents, almost all believed discussing sex and intimacy with heart attack survivors was important, yet less than a quarter reported regularly doing so. About three-quarters reported feeling comfortable discussing sex and intimacy with either men or women, with half comfortable to do so with patients from diverse cultures. Barriers included lack of time, privacy, consumer resources, and protocols to guide discussions. This research supports the need for structural changes such as a clinical protocol, longer and more private consultations, staff training, and culturally appropriate patient-oriented resources to support health professionals to guide discussions about sexual activity and intimacy with patients who have had a heart attack.

"The People Criticized Me and Insulted Me Due to Having a Child with Defect": Experiences of Somali Parents of Children with Anorectal Malformation.

Treatment of anorectal malformations (ARM) and the management of clinical outcomes are challenging for families. While most studies focus on mothers suffering from care burden, high stress, and low quality of life, there is limited knowledge of what fathers of children with ARM experience; therefore, this study aimed to examine how both mothers and fathers have experience caring for children with ARM and how beliefs and cultural issues affect the perception of congenital anomalies. A qualitative design. Consolidated criteria for reporting the qualitative research guidelines were used in this study. The guidelines for thematic analysis were followed for data analysis. Ten mothers and six fathers were interviewed, and their mean age was 32.5 ± 4.2 years. Of the 75% (n = 12) illiterate and 93.7% (n = 15) had an expanded family type, all their religious affiliations were Muslim. The four main themes were (1) ambiguity, (2) challenges, (3) stigma, and (4) coping, which were determined in line with the results of the data analysis of parents' views on having and caring for children with ARM. In this study, many Somali parents reported that they lacked disease and treatment knowledge, physical exhaustion, and some difficulties related to a lack of access to the hospital because of living in rural areas, caring for the child, and dealing with long-term complications, colostomy, anal dilatation, and enema before or after anoplasty. While all parents mentioned that having a child with ARM was a fate, it was seen as punishment by their close social environment. Consequently, this study could serve as a foundation for planning comprehensive healthcare and physical and psychosocial support for multidisciplinary health professionals.