Creina Anne Mitchell

Intervening to reduce depression after birth: A systematic review of the randomized trials

A systematic review and meta-analysis of randomized trials of nonpharmaceutical and nonhormonal interventions to reduce postnatal depression was carried out to summarize the effectiveness of interventions grouped in terms of the nature and timing of the intervention and whether the trial population was universal, selective, or indicated.

The transition experience of Enrolled Nurses to a Bachelor of Nursing at an Australian university.

Abstract Endorsed Enrolled Nurses (EENs) articulating from diploma level to Bachelor of Nursing (BN) studies at university experience many transitional barriers. Flexible credit arrangements can create further difficulties because students may enter directly into the second year of a degree program, thus foregoing supportive interventions targeting first year students. This qualitative study explored the transitional barriers faced by EENs articulating to the second year of a BN program and the processes employed to adapt to the university learning environment. Lizzio’s (2006) Five Senses of Success Model provided a framework for data analysis. Lizzio’s model highlights how students’ success at university depends on their sense of purpose, capability, resourcefulness, connectedness and academic culture. This study revealed EENs grapple with their dual identity, have difficulty reconciling their academic and clinical competence, and struggle to assimilate to the academic learning environment. Findings illuminate the importance of tailoring orientation and engagement activities to the specific transitional needs of articulating students.

Social media used as a health intervention in adolescent health: A systematic review of the literature

Objective Adolescents are known to be high users of social media, and social media is beginning to be used in health care. The primary objective of this review was to determine the current state of play on the use of social media as a health intervention in addressing the health of adolescents. Methods Six databases were searched: CINAHL, Medline, Scopus, ProQuest, Psych Info and Science Direct, from 2000–2013. The review process followed PRISMA guidelines with quality assessments of the selected articles undertaken. Results Three studies used social media as a health intervention in adolescent health. Facebook was the social media of choice. The way this social media tool was incorporated as the intervention varied. None of the social media interventions had a significant or sustained impact on the primary outcomes of the studies reviewed. Measures of social media process were limited and lacked meaning. Conclusions The selected papers provided insight into the beginning phase of using social media as a health intervention to address adolescent health. The review highlights three important areas for consideration when undertaking research on the use of social media as a health intervention for adolescents: the newness of using social media as a health intervention, the importance of the use of rigorous methodological processes when using social media as a health intervention, and the need to develop further knowledge on adolescents’ use of social media, in particular their hidden world of social media.

Risk factors for hepatitis C transmission in the Victorian population: a telephone survey

OBJECTIVE To measure knowledge and prevalences of risk factors for hepatitis C infection in the Victorian community. METHOD Telephone survey of 757 Victorian householders aged 15+ years, March 1996. RESULTS An estimated 2.2% of Victorians have injected illicit drugs; 4.8% have tattoos and 49.6% have skin piercings; 11.4% received a blood transfusion before screening for HCV was introduced; 10.9% have had a test for HCV antibody. A majority of respondents perceived sexual contact and receipt of a transfusion to be risks for HCV transmission. CONCLUSIONS Risk factors associated with the spread of HCV are widespread in the Victorian community; however, the most important risk factor--injecting drug use--has low prevalence. Considerable uncertainty exists about risk factors for hepatitis C. IMPLICATIONS A very small percentage of Victorians are injecting drug users and therefore at highest risk of hepatitis C infection, therefore transmission control programs can be efficiently focused on this group. The Victorian community needs to be better educated about risk factors for hepatitis C, in particular that transfusions and blood donations are safe.

Improving population-level maternal health: a hard nut to crack? Long term findings and reflections on a 16-community randomised trial in Australia to improve maternal emotional and physical health after birth [ISRCTN03464021].

Background Community level interventions to improve maternal and child health have been supported and well evaluated in resource poor settings, but less so in developed countries. PRISM - Program of Resources, Information and Support for Mothers - was a primary care and community-based cluster-randomised trial in sixteen municipalities in Victoria, Australia, which aimed to reduce depression in mothers and improve their physical health. The aim of this paper is to report the longer term outcomes of PRISM and to reflect on lessons learned from this universal community intervention to improve maternal health. Methods Maternal health outcome data in PRISM were collected by postal questionnaire at six months and two years. At two years, the main outcome measures included the Edinburgh Postnatal Depression Scale (EPDS) and the SF-36. Secondary outcome measures included the Experience of Motherhood Scale (EOM) and the Parenting Stress Index (PSI). A primary intention to treat analysis was conducted, adjusting for the randomisation by cluster. Results 7,169/18,424 (39%) women responded to the postal questionnaire at two years −3,894 (40%) in the intervention arm and 3,275 (38%) in the comparison arm. Respondents were mostly representative on available population data comparisons. There were no differences in depression prevalence (EPDS≥13) between the intervention and comparison arms (13.4% vs 13.1%; ORadj = 1.06, 95%CI 0.91–1.24). Nor did womens mental health (MCS: 48.6 vs 49.1) or physical health scores (PCS: 49.1 vs 49.0) on the SF-36 differ between the trial arms. Conclusion Improvement in maternal mental and physical health outcomes at the population level in the early years after childbirth remains a largely unmet challenge. Despite the lack of effectiveness of PRISM intervention strategies, important lessons about systems change, sustained investment and contextual understanding of the workability of intervention strategies can be drawn from the experience of PRISM. Trial Registration. Controlled-Trials.com ISRCTN03464021

Learning among nursing faculty: insights from a participatory action research project about teaching international students.

It is imperative that nursing education addresses the issues arising from globalization. The adjustment challenges faced by international nursing students globally highlight the need to understand how nursing faculty experience and teach nursing classes with a mix of domestic and foreign students. This article reports on a participatory action research (PAR) study to examine and enhance the scholarly teaching of international nursing students. The overarching research question for this PAR was: How did participation in a PAR study contribute to shared learning and professional development of nursing faculty teaching international students? Five major themes were identified across the PAR: creating sharing spaces, recognizing and respecting diversity, developing and acknowledging teaching capabilities, utilizing precious time, and valuing the research. In summary, PAR was a useful approach to engage faculty in research by providing a process and a space to address concerns about the teaching and learning of international students.

Group work: Facilitating the learning of international and domestic undergraduate nursing students.

Background: Devising innovative strategies to address internationalization is a contemporary challenge for universities. A Participatory Action Research (PAR) project was undertaken to identify issues for international nursing students and their teachers. The findings identified group work as a teaching strategy potentially useful to facilitate international student learning. Methods: The educational intervention of structured group work was planned and implemented in one subject of a Nursing degree. Groups of four to five students were formed with one or two international students per group. Structural support was provided by the teacher until the student was learning independently, the traditional view of scaffolding. The group work also encouraged students to learn from one another, a contemporary understanding of scaffolding. Evaluation of the group work teaching strategy occurred via anonymous, self-completed student surveys. The student experience data were analysed using descriptive statistical techniques, and free text comments were analysed using content analysis. Results: Over 85% of respondents positively rated the group work experience. Overwhelmingly, students reported that class discussions and sharing nursing experiences positively influenced their learning and facilitated exchange of knowledge about nursing issues from an international perspective. Discussion: This evaluation of a structured group work process supports the use of group work in engaging students in learning, adding to our understanding of purposeful scaffolding as a pathway to enhance learning for both international and domestic students. By explicitly using group work within the curriculum, educators can promote student learning, a scholarly approach to teaching and internationalization of the curriculum.

Information and communication technology (ICT) use in child and family nursing: What do we know and where to now?

Abstract Whilst the use of information and communication technology (ICT) in acute care services has been well documented, less is known about the impact of computerising community-based primary care such as child and family health nursing services. This self-complete survey of 606 nurses working in the Victorian Maternal and Child Health (MCH) service (response rate 60%) found that the predominately older workforce were confident with the use of ICT. This contrasts with findings from the acute sector where older nurses had lower ICT confidence. The survey revealed a variation in ICT support and a lack of data collection system compatibility. Professional education resources were not able to be effectively used in all locally supplied computers. Although MCH nurses have adapted well to computerisation, there is room for improvement. Appropriate resourcing, education and infrastructure support are areas that need to be addressed and would benefit from an overarching body responsible for development and quality assurance.

Developing a Systematic Literature Review on the Use of Social Media as a Health Intervention in Adolescent Health: A Case Study

A systematic literature review provides the basis for identifying consistency in research processes, quality of research methodology, current knowledge, and gaps in knowledge. This information is important as it provides researchers with guidance on a particular area of knowledge, including what worked well, what did not work well, and the direction that future research may take. A systematic review is different to other forms of literature reviews, and this difference is reflected in the method. The following case study looks at the process undertaken when systematically reviewing the literature on “the use of social media as a health intervention in adolescent health.” In particular, the case study highlights the importance of clearly identifying the topic under review, the use of a tested or proven tool to assess the literature, and the dissemination of the findings, that is, writing up the review so that others may understand and if required replicate the study. The case study provides an opportunity to reflect on the processes of a systematic literature review with examples to demonstrate that process.

Preceptor Education for Specialty Community-Based Nurses: A Pre- and Postevaluation

BACKGROUND Quality preceptorship is an integral aspect of nursing education. Evidence suggests that preceptor education programs can be designed to support RNs in their capacity as preceptors. Little has been reported on the effectiveness of preceptor programs for community-based nurses who provide primary health care for preschool children and their families. METHOD The project evaluated the effectiveness of a 4-hour face-to-face tailored preceptor education program undertaken by 59 nurses in Victoria, Australia. Pre- and postsurveys were undertaken to evaluate the program. RESULTS Participants had improved understanding of the role of preceptor after the education program. They had increased confidence in their ability to give feedback, assess clinical skills, and use the clinical assessment tool. They were also surer of the standard of performance expected of students. CONCLUSION A strategically designed preceptor program was effective in improving some preceptorship skills of community-based nurses who supervise postgraduate nursing students. J Contin Educ Nurs. 2018;49(3):111-118.