Aboriginal and Non-Aboriginal Emergency Department Presentations Involving Suicide-Related Thoughts and Behaviors.

Background: Rates of hospital admission for suicide-related thoughts and behaviors (SRTBs) are elevated in the Northern Territory (NT) of Australia, especially by Aboriginal people, but very little is known about emergency department (ED) presentations. Aim: We aimed to profile ED presentations in the NT involving SRTBs by Indigenous status and compare discharge arrangements. Method: Logistic regression analyses were performed on data from electronic patient records of consecutive ED presentations involving SRTBs. Results: During the study period, 167 presentations were observed. Aboriginal patients were more likely to present from remote areas and to report substance misuse and family conflict or violence compared with non-Aboriginal patients. In both groups, males were more likely than females to be admitted as were persons presenting with self-harm compared with those who had suicidal thoughts only. No differences in discharge arrangements were identified by Indigenous status. Limitations: The small scale of the study and use of administrative records points to the need for further research to improve the quality of the evidence. Conclusion: While presentations by high-risk groups are more likely to be admitted for further care, the assessment of psychosocial risks and needs in EDs is vital to informing decisions for aftercare that support recovery in the community for Aboriginal patients and patients discharged from EDs.

Secondary analysis of data can inform care delivery for Indigenous women in an acute mental health inpatient unit.

There is a paucity of research exploring Indigenous women's experiences in acute mental health inpatient services in Australia. Even less is known of Indigenous women's experience of seclusion events, as published data are rarely disaggregated by both indigeneity and gender. This research used secondary analysis of pre-existing datasets to identify any quantifiable difference in recorded experience between Indigenous and non-Indigenous women, and between Indigenous women and Indigenous men in an acute mental health inpatient unit. Standard separation data of age, length of stay, legal status, and discharge diagnosis were analysed, as were seclusion register data of age, seclusion grounds, and number of seclusion events. Descriptive statistics were used to summarize the data, and where warranted, inferential statistical methods used SPSS software to apply analysis of variance/multivariate analysis of variance testing. The results showed evidence that secondary analysis of existing datasets can provide a rich source of information to describe the experience of target groups, and to guide service planning and delivery of individualized, culturally-secure mental health care at a local level. The results are discussed, service and policy development implications are explored, and suggestions for further research are offered.

Acute mental health service delivery to Indigenous women: What is known?

The Australian College of Mental Health Nurses directs that mental health nurses must 'enable cultural safety in practice, taking into account age, gender, spirituality, ethnicity and health values'. The present study is a review of the existing literature undertaken in order to identify current knowledge and knowledge gaps regarding the experience of Indigenous women in acute mental health inpatient facilities. In particular, studies that identified environments and practices promoting the development of culturally-safe healing spaces for Indigenous women, and studies that identified women's experience of seclusion, were sought. The results showed that there is little literature directly relevant to Indigenous women's experiences of inpatient mental health units in Australia. The present study consolidates existing knowledge and knowledge gaps, and advances the argument for gender-disaggregated future research. Implications for professional practice and service development are also noted.

Challenges in oral communication for internationally educated nurses.

Achieving English language proficiency, while key to successful adaptation to a new country for internationally educated nurses (IENs), has presented more difficulties for them and for educators than previously recognized. Professional communication within a culturally diverse client population and maintaining collaborative relationships between nurses and other team members were perceived as new challenges for IENs. Learning an additional language is a long-term, multistage process that must also incorporate social and cultural aspects of the local society and the profession. This article provides a descriptive review of current research literature pertaining to English language challenges, with a focus on oral language, experienced by IENs. Educational strategies for teaching technical language skills as well as the socio-pragmatics of professional communication within nursing programs are emphasized. Bridging education programs must not only develop students'academic language proficiency but also their ability to enter the workforce with the kind of communication skills that are increasingly highlighted by employers as essential attributes. The results of this review are intended to facilitate a clearer understanding of the English language and communication challenges experienced by IENs and identify the implications for designing effective educational programs.

Developing a prelicensure exam for Canada: an international collaboration.

Nine previously conducted studies indicate that Elsevier's HESI Exit Exam (E(2)) is 96.36%-99.16% accurate in predicting success on the National Council Licensure Examination for Registered Nurses. No similar standardized exam is available in Canada to predict Canadian Registered Nurse Examination (CRNE) success. Like the E(2), such an exam could be used to evaluate Canadian nursing students' preparedness for the CRNE, and scores on the numerous subject matter categories could be used to guide students' remediation efforts so that, ultimately, they are successful on their first attempt at taking the CRNE. The international collaboration between a HESI test construction expert and a nursing faculty member from Canada, who served as the content expert, resulted in the development of a 180-item, multiple-choice/single-answer prelicensure exam (PLE) that was pilot tested with Canadian nursing students (N = 175). Item analysis data obtained from this pilot testing were used to develop a 160-item PLE, which includes an additional 20 pilot test items. The estimated reliability of this exam is 0.91, and it exhibits congruent validity with the CRNE because the PLE test blueprint mimics the CRNE test blueprint.

Student life - Wheel of learning support.

There are many reasons why nursing students drop out of pre-registration courses, but a known contributory factor is the quality of support and learning experiences on practice placements.

Hepatitis C: experiencing stigma.

The purpose of this study was to identify and categorize stigmas associated with hepatitis C. This article will address the qualitative analysis of participants' written narratives describing stigmatic events. These narratives were in response to a question that incorporated a functional definition of stigma. The sample consisted of 39 participants who completed a survey during support group meetings. Of the participants, 84.6% experienced hepatitis C-related stigma. With the qualitative data saturated, a total of five themes and 16 concepts were found. The idea that ignorance precedes all stigmas was refuted with the finding that some concepts may not involve ignorance, as defined in this study, about hepatitis C. This notion was further applied to existing theories concerning disease-related stigma. The findings in this study expand our current knowledge of the complexity of stigma. Implications for nursing practice will include comprehensive structural and institutional application of policy. Furthermore, population and peer education about hepatitis C and against stigma will be a worthy opponent to the problem at hand.

Hepatitis C: studying stigma.

The purpose of this study was to examine hepatitis C-related stigma within a population of liver disease support group attendees. In total, 39 participants completed a quantitative/qualitative survey during support group meetings. This article reports on the quantitative data. Data collected included the source and location of stigma and stigma's effects on health-seeking behavior and disclosure practices (DISCs). Of the participants, 84.6% experienced hepatitis C-related stigma. All who were Hispanic or older than 65 years experienced stigma. The most common source of stigma was healthcare professionals. More participants reported a decrease in DISCs than in health-seeking behavior. A small portion of participants reported increases in both. Those persons who were stigmatized by healthcare professionals were significantly more likely to subsequently decrease their health-seeking behavior. Of those who reported decreases in DISCs after being stigmatized, more than half (54.5%) were stigmatized by healthcare professionals. The most common location for stigmatization was in the home setting. The findings hold important implications for learning needs of healthcare professionals.