Emotional effort and perceived support in renal nursing: A comparative interview study

Background: Social support is an important moderator of poor well-being outcomes for nurses engaged in emotional labour with patients; however, the most effective support for renal nurses is not well understood compared with other specialties. Objectives: To identify patterns and themes in how renal nurses and two other specialties engage with patients’ emotional expressions, express their own emotion and access and provide support for emotional expenditure. Method: Renal, emergency and palliative care nurses from Perth, Western Australia, were interviewed. Results: Renal nurses engage in significant amounts of emotional labour with patients, and identify co-workers as the most important source of support due to their availability and a sense of shared experience. However, comparative analysis showed that renal nurses do not recognise their emotional expenditure as readily and have less certainty of co-worker support. Conclusions: Because their high levels of emotional engagement with patients are mostly positive, renal nurses are less prepared than other nurses to manage difficult emotional situations. As co-worker support is highly valued, organisations should train renal nurses specifically to support one another.

Key beliefs of hospital nurses’ hand-hygiene behaviour: Protecting your peers and needing effective reminders

Issues addressed: Hand hygiene in hospitals is vital to limit the spread of infections. This study aimed to identify key beliefs underlying hospital nurses’ hand-hygiene decisions to consolidate strategies that encourage compliance. Methods: Informed by a theory of planned behaviour belief framework, nurses from 50 Australian hospitals (n = 797) responded to how likely behavioural beliefs (advantages and disadvantages), normative beliefs (important referents) and control beliefs (barriers) impacted on their hand-hygiene decisions following the introduction of a national ‘5 moments for hand hygiene’ initiative. Two weeks after completing the survey, they reported their hand-hygiene adherence. Stepwise regression analyses identified key beliefs that determined nurses’ hand-hygiene behaviour. Results: Reducing the chance of infection for co-workers influenced nurses’ hygiene behaviour, with lack of time and forgetfulness identified as barriers. Conclusions: Future efforts to improve hand hygiene should highlight the potential impact on colleagues and consider strategies to combat time constraints, as well as implementing workplace reminders to prompt greater hand-hygiene compliance. So what? Rather than emphasising the health of self and patients in efforts to encourage hand-hygiene practices, a focus on peer protection should be adopted and more effective workplace reminders should be implemented to combat forgetting.

Weight-related risk perception among healthy and overweight pregnant women: A cross-sectional study

Objective The objective of this study was to evaluate weight-related risk perception in early pregnancy and to compare this perception between women commencing pregnancy healthy weight and overweight. Study design Pregnant women (n=664) aged 29±5 (mean±s.d.) years were recruited from a metropolitan teaching hospital in Australia. A self-administered questionnaire was completed at around 16 weeks of gestation. Height measured at baseline and self-reported pre-pregnancy weight were used to calculate body mass index. Cross-sectional analysis was conducted. Differences between groups were assessed using chi-squared tests for categorical variables and t-tests or Mann–Whitney U tests for continuous variables depending on distribution. Result Excess gestational weight gain (GWG) during pregnancy was more important in leading to health problems for women or their child compared with pre-pregnancy weight. Personal risk perception for complications was low for all women, although overweight women had slightly higher scores than healthy-weight women (2.4±1.0 vs 2.9±1.0; P<0.001). All women perceived their risk for complications to be below that of an average pregnant woman. Conclusion Women should be informed of the risk associated with their pre-pregnancy weight (in the case of maternal overweight) and excess GWG. If efforts to raise risk awareness are to result in preventative action, this information needs to be accompanied by advice and appropriate support on how to reduce risk.

Use of online health information to manage children’s health care: A prospective study investigating parental decisions

Background The use of the internet to access information is rapidly increasing; however, the quality of health information provided on various online sites is questionable. We aimed to examine the underlying factors that guide parents' decisions to use online information to manage their child's health care, a behaviour which has not yet been explored systematically. Methods Parents (N=391) completed a questionnaire assessing the standard theory of planned behaviour (TPB) measures of attitude, subjective norm, perceived behavioural control (PBC), and intention as well as the underlying TPB belief-based items (i.e., behavioural, normative, and control beliefs) in addition to a measure of perceived risk and demographic variables. Two months later, consenting parents completed a follow-up telephone questionnaire which assessed the decisions they had made regarding their use of online information to manage their child's health care during the previous 2 months. Results We found support for the TPB constructs of attitude, subjective norm, and PBC as well as the additional construct of perceived risk in predicting parents' intentions to use online information to manage their child's health care, with further support found for intentions, but not PBC, in predicting parents' behaviour. The results of the TPB belief-based analyses also revealed important information about the critical beliefs that guide parents' decisions to engage in this child health management behaviour. Conclusions This theory-based investigation to understand parents' motivations and online information-seeking behaviour is key to developing recommendations and policies to guide more appropriate help-seeking actions among parents.

The effects of parental illness and other ill family members on the adjustment of children

Background This study addresses limitations of prior research that have used group comparison designs to test the effects of parental illness on youth. Purpose This study examined differences in adjustment between children of a parent with illness and peers from ‘healthy’ families controlling for the effects of whether a parent or non-parent family member is ill, illness type, demographics and caregiving. Methods Based on questionnaire data, groups were derived from a community sample of 2,474 youth (‘healthy’ family, n = 1768; parental illness, n = 336; other family member illness, n = 254; both parental and other family illness, n = 116). Results The presence of any family member with an illness is associated with greater risk of mental health difficulties for youth relative to peers from healthy families. This risk is elevated if the ill family member is a parent and has mental illness or substance misuse. Conclusions Serious health problems within a household adversely impact youth adjustment.

Hosting asylum seekers and attitudes toward cultural diversity in Australia

In 2012, the Australian government in office introduced a novel scheme of housing asylum seekers as guests of Australians in the community. A number of Australians participated in the scheme and volunteered as hosts. This study compared those who volunteered to assist asylum seekers with general members of the community to explore the impact attitudes towards cultural diversity and demographic factors had upon willingness to support asylum seekers. Further, the two groups were combined to examine the factors that can contribute to positive attitudes to diversity in society in general. Participants (N = 142; aged from 24-79 years) completed online questionnaires assessing demographic variables, attitudes towards cultural diversity and acculturation. Various analysis of variance procedures, Chi-squared tests and correlations were conducted. Group comparisons indicated that volunteers’ attitudes did not impact on willingness to support asylum seekers. However, some demographic differences between groups emerged. Volunteers were more likely to be professionals with stable jobs, ethnically diverse and well-travelled individuals. Analyses on the combined groups indicated age, education and not having a strong religious affiliation enhanced Australians’ positive attitudes to cultural diversity. The findings have implications for promoting positive attitudes to diversity in individuals, organisations and communities. Potential opportunities for professionals and policy-makers to promote support for cultural diversity in the community are discussed.

Somali perspectives on physical activity: PhotoVoice to address barriers and resources in San Diego

Although many immigrants enter the United States with a healthy body weight, this health advantage disappears the longer they reside in the United States. To better understand the complexities of obesity change within a cultural framework, a community-based participatory research (CBPR) approach, PhotoVoice, was used, focusing on physical activity among Muslim Somali women. The CBPR partnership was formed to identify barriers and resources to engaging in physical activity with goals of advocacy and program development. Muslim Somali women (n = 8) were recruited to participate, trained and provided cameras, and engaged in group discussions about the scenes they photographed. Participants identified several barriers, including safety concerns, minimal culturally appropriate resources, and financial constraints. Strengths included public resources and a community support system. The CBPR process identified opportunities and challenges to collaboration and dissemination processes. The findings laid the framework for subsequent program development and community engagement.

Physical activity in Latino men and women: Facilitators, barriers, and interventions

Latinos report less leisure time physical activity (PA) than non–Latino Whites and suffer disproportionately from diseases related to sedentary lifestyle, yet remain underserved and understudied. Gaining a better understanding of PA behavior in Latinos is critical to intervene on this significant public health issue. This article discusses the growing literature on the facilitators and barriers of PA in Latino men and women and reviews recent interventions to promote activity. Apart from acculturation influences, facilitators of PA in Latinos are similar to those of non–Latino Whites, with most research focusing on self-efficacy and social support. Barriers for Latinas, however, are more culturally distinct, such as a focus on caregiving and cultural standards for body shape. Barriers unique to Latino men largely have not been studied. Researchers have adopted a variety of approaches to increase PA, including using promotores and incorporating culturally appropriate activities, and have had mixed success. However, the community and randomized controlled trials almost exclusively included only women. Studies reviewed here suggest that interventions should target culturally specific barriers beyond language to successfully increase PA in Latinos and highlight a need for formative research and design of interventions for Latino men.

Awareness and knowledge of Human Papillomavirus (HPV) among ethnically diverse women varying in generation status

Although Human papillomavirus (HPV) is a common sexually transmitted infection, there is limited knowledge of HPV with ethnic/racial minorities experiencing the greatest disparities. This cross-sectional study used the most recent available data from the California Health Interview Survey to assess disparities in awareness and knowledge of HPV among ethnically/racially diverse women varying in generation status (N = 19,928). Generation status emerged as a significant predictor of HPV awareness across ethnic/racial groups, with 1st generation Asian-Americans and 1st and 2nd generation Latinas reporting the least awareness when compared to same-generation White counterparts. Also, generation status was a significant predictor of HPV knowledge, but only for Asian-Americans. Regardless of ethnicity/race, 1st generation women reported lowest HPV knowledge when compared to 2nd and 3rd generation women. These findings underscore the importance of looking at differences within and across ethnic/racial groups to identify subgroups at greatest risk for poor health outcomes. In particular, we found generation status to be an important yet often overlooked factor in the identification of health disparities.

If you don’t know, you can’t help: A practical guide for alcohol and other drug screening in psychological services

Alcohol is implicated in over 60 diseases and injuries and accounted for 6.2 per cent of all male deaths globally in 2004 (WHO, 2011). Alcohol and other drug (AOD) abuse causes significant individual, family and social harms at all age levels and across all socioeconomic groups. These may result from intoxication (e.g., overdose, vulnerability to physical injury/trauma or death, consequences of impulsive behaviour, aggression and driving under the influence) and longer-term consequences (e.g., alcohol or drug-related brain injury, cardiovascular and liver diseases, blood borne viruses e.g., Chikritzhs et al., 2003, Roxburgh et al., 2013). Mental health problems may be triggered or exacerbated, and family breakdown, poor self-esteem, legal issues and lack of community engagement may also be evident. Despite the prevalence of substance use disorders and evident consequences for the individual, family and wider community, it would seem that health professionals, including psychologists, are reluctant to ask about substance use.

Characterizing fatigue: The effects of ethnicity and acculturation

It is unknown if fatigue measures like the Multidimensional Fatigue Symptom Inventory-Short Form (MFSI-SF; Stein, Jacobsen, Blanchard, & Thors, 2004) appropriately describe fatigue in Hispanics or if acculturation plays a role in fatigue. This study compared fatigue in community samples of Hispanics and Anglos. The MFSI-SF and pertinent questionnaires were administered to adults in San Diego County via telephone survey. Some differences in fatigue were observed in initial comparisons between Hispanics and Anglos, including when acculturation was considered. When age and education were controlled, Hispanics reported less general fatigue than Anglos, regardless of acculturation status, p = < .01. Exploratory factor analyses indicate that the MFSI-SF general-fatigue subscale was problematic for Hispanics. Implications, limitations, and future directions are discussed.

Cultural adaptation and resilience: Controversies, issues and emerging models

What enables people to bounce back from stressful experiences? How do certain individuals maintain a sense of purpose and direction over the long term, even in the face of adversity? This is the first book to move beyond childhood and adolescence to explore resilience across the lifespan. Coverage ranges from genetic and physiological factors through personal, family, organizational, and community processes. Contributors examine how resilience contributes to health and well-being across the adult life cycle; why—and what happens when—resilience processes fail; ethnic and cultural dimensions of resilience; and ways to enhance adult resilience, including reviews of exemplary programs.

Community development and community resilience: An integrative approach

Throughout history, communities and civilizations have sought to enhance the quality of community life and the well-being of its people. However, more recently there has been greater interest in attending to the details of community development by capitalizing on the improved ability to capture community well-being and successes scientifically. That interest invites greater attention to the development of indicators that can quantify those qualities of life that lead to strong and healthy communities. The selection of meaningful indicators is dependent upon several factors including a process that stimulates meaningful involvement of community stakeholders, but the single most important is the identification of an underlying model to guide the work. Indicators do not have meaning in themselves. For these measures to provide a coherent assessment of the community, an integrative approach to understanding what constitutes a healthy and strong community in a dynamic environment is required. A resilience perspective serves that purpose and provides a framework that is broad, neutral, and conceptually strong enough to structure development of significant sets of indicators. Exemplary community indicator processes across the nation, particularly recent efforts in the Phoenix, Arizona region, provide evidence supporting the value of indicator development for community building.

Overcoming language barriers in healthcare: A protocol for investigating safe and effective communication when patients or clinicians use a second language

Background Miscommunication in the healthcare sector can be life-threatening. The rising number of migrant patients and foreign-trained staff means that communication errors between a healthcare practitioner and patient when one or both are speaking a second language are increasingly likely. However, there is limited research that addresses this issue systematically. This protocol outlines a hospital-based study examining interactions between healthcare practitioners and their patients who either share or do not share a first language. Of particular interest are the nature and efficacy of communication in language-discordant conversations, and the degree to which risk is communicated. Our aim is to understand language barriers and miscommunication that may occur in healthcare settings between patients and healthcare practitioners, especially where at least one of the speakers is using a second (weaker) language. Methods/Design Eighty individual interactions between patients and practitioners who speak either English or Chinese (Mandarin or Cantonese) as their first language will be video recorded in a range of in- and out-patient departments at three hospitals in the Metro South area of Brisbane, Australia. All participants will complete a language background questionnaire. Patients will also complete a short survey rating the effectiveness of the interaction. Recordings will be transcribed and submitted to both quantitative and qualitative analyses to determine elements of the language used that might be particularly problematic and the extent to which language concordance and discordance impacts on the quality of the patient-practitioner consultation. Discussion Understanding the role that language plays in creating barriers to healthcare is critical for healthcare systems that are experiencing an increasing range of culturally and linguistically diverse populations both amongst patients and practitioners. The data resulting from this study will inform policy and practical solutions for communication training, provide an agenda for future research, and extend theory in health communication.