The concept of capability in pre-registration nursing education: A scoping review.

BACKGROUND: Capability in nursing education is an emerging concept that includes various requisites, which can be applied in complex or unfamiliar clinical settings. Despite growing research for practising nurses, the requisites of capability for pre-registration nursing students entering the workforce remain unclear. OBJECTIVE: The objective was to identify the requisites that constitute capability for practice among pre-registration nursing students as well as the enablers to develop capabilities. DESIGN: A scoping review was performed using the Joanna Briggs Institute methodology. DATA SOURCES: Records published without date restriction were searched using MEDLINE, Embase, Emcare, CINAHL, and Scopus databases. Grey literature and reference list searching was conducted. REVIEW METHODS: Sources explicitly reporting requisites of capability or enablers of capability development in pre-registration nursing education were eligible. All global sources written in English and available in full text were included. Data were extracted and synthesised using a specifically designed extraction tool. RESULTS: The number of records reviewed totalled 896. Twenty-three studies met the criteria for inclusion in the synthesis. Nineteen capability requisites for practice were reported. Whilst various enablers to support development of capability requisites were reported, some challenges were also identified. CONCLUSION: This study identified requisites of capability for practice and enablers that may support development of capability in pre-registration nursing education. This holistic set of capabilities has previously not been reported. Given the emerging nature of the concept, this collective set of requisites may not be indicative of all required capabilities of nursing students upon graduation. Efforts to develop a definitive set of requisites and explore strategies to support and enable capability development are needed to advance this concept in the pre-registration nursing education context.

Patient activation in advanced chronic kidney disease: a cross-sectional study.

BACKGROUND: Patient activation refers to the knowledge, confidence and skills required for the management of chronic disease and is antecedent to self-management. Greater self-management in chronic kidney disease (CKD) results in improved patient experience and patient outcomes. AIM: To examine patient activation levels in people with CKD stage 5 pre-dialysis and determine associations with sociodemographic characteristics, treatment adherence and healthcare utilisation. METHODS/DESIGN: People with CKD stage 5 not receiving dialysis from one Australian kidney care service. Patient activation was measured using the 13-item Patient Activation Measure (PAM-13). Sociodemographic and clinical outcome data (emergency department visits, admissions) were collected from medical records. Morisky Medication Adherence Scale was used to determine self-report medication adherence. RESULTS: Two hundred and four participants completed the study. The mean PAM-13 score was 53.4 (SD 13.8), with 73% reporting low activation levels (1 and 2). Patient activation scores significantly decreased with increased age (P < 0.001) and significantly increased with higher educational levels (P < 0.001). Higher patient activation level was associated with fewer hospital emergency department visits (P = 0.03) and increased medication adherence (P < 0.001). CONCLUSION: Patient activation levels are low in people with CKD stage 5 not receiving dialysis suggesting limited ability for self-management and capacity for optimally informed decisions about their healthcare. Efforts to improve patient activation need to consider age and education level.

Investigating individual- and area-level socioeconomic gradients of pulse pressure among normotensive and hypertensive participants.

Socioeconomic status is a strong predictor of cardiovascular disease. Pulse pressure, the difference between systolic and diastolic blood pressure, has been identified as an important predictor of cardiovascular risk even after accounting for absolute measures of blood pressure. However, little is known about the social determinants of pulse pressure. The aim of this study was to examine individual- and area-level socioeconomic gradients of pulse pressure in a sample of 2,789 Australian adults. Using data from the North West Adelaide Health Study we estimated the association between pulse pressure and three indices of socioeconomic status (education, income and employment status) at the area and individual level for hypertensive and normotensive participants, using Generalized Estimating Equations. In normotensive individuals, area-level education (estimate: -0.106; 95% CI: -0.172, -0.041) and individual-level income (estimate: -1.204; 95% CI: -2.357, -0.050) and employment status (estimate: -1.971; 95% CI: -2.894, -1.048) were significant predictors of pulse pressure, even after accounting for the use of medication and lifestyle behaviors. In hypertensive individuals, only individual-level measures of socioeconomic status were significant predictors of pulse pressure (education estimate: -2.618; 95% CI: -4.878, -0.357; income estimate: -1.683, 95% CI: -3.743, 0.377; employment estimate: -2.023; 95% CI: -3.721, -0.326). Further research is needed to better understand how individual- and area-level socioeconomic status influences pulse pressure in normotensive and hypertensive individuals.