Anne Williams Emerita Professor

There is a gap between children's right to report on their own experience of inpatient care, and availability of a validated measure to facilitate consistent reporting by children and young people. This study aimed to understand children and young peoples (aged 12-18 years) preferences for reporting their own experience of inpatient health care, and validate a revised question set. A three-phase study assessed: content analysis of focus group discussions; face and content validity of an adapted question set; construct validity using confirmatory factor analysis. Children and young people chose to adapt a survey titled 'Australian Hospital Patient Experience Question Set'. Suggested changes to wording reflected their experiences of feeling listened to, heard, and safe, in contrast to feeling overlooked or overpowered. Assessment of construct validity demonstrated a sound one-factor model (
= 193, Root Mean Square Error of Approximation 0.033, Comparative Fit Index 0.997, Tucker Lewis Index 0.996, composite reliability 0.951). Children and young people valued participating in survey design. The resulting question set is a reliable and valid tool to measure self-reported experience of care for children and young people aged 12 to 17 years on their own or with their parent.

Background: There are several studies investigating the effectiveness and participation rates of the Australian National Bowel Cancer Screening Program (NBCSP), but there is limited literature pertaining to the role and processes that general practitioners (GPs) follow after a positive immunochemical faecal occult blood test (iFOBT) result. The aim of this paper is to review evidence examining GP involvement in the follow-up of positive iFOBT results from the NBCSP and identify knowledge gaps.

Methods: A scoping review was undertaken involving the search of the Cochrane Library, Informit, PubMed and Scopus electronic databases. Inclusion criteria were the follow-up processes and practices by GPs subsequent to notification of a positive iFOBT from this program. Searches were limited to English and publication was from January 2006 to January 2024. A combination of keywords was used and adapted to each search engines' requirements: general practitioner AND bowel cancer AND screening AND Australia.

Results: Relevant sources of evidence were reviewed, and 24 records met inclusion criteria. Results are represented across three themes: (i) screening process and GP follow-up; (ii) follow-up rates and facilitation; and (iii) recommendations for improved follow-up.

Conclusion: This scoping review provides insight into the central role GPs play in the implementation of the NBCSP and highlights the lack of information regarding steps taken and systems employed in general practice to manage positive iFOBTs.

Cancer patients and carers have a recognized need for ongoing social support outside the confines of the healthcare setting in which they have received their diagnosis and treatment. Peer support groups have come to be recognized as a crucial part of the cancer support domain. While psychosocial support for patients was always considered an important part of cancer survivorship, the significance of community self-help and peer-to-peer support, rooted in principles of patient empowerment, has gained increased recognition. This article reviews information available online on cancer peer support groups in Australia, focusing on the presentation of the relevant information on the websites of cancer support organizations. It provides a snapshot of cancer peer support group activity in Australia. It aims to serve the information needs of cancer support navigators, coordinators and advocates who may be working in roles that involve sharing information about cancer peer support groups with patients and carers, as well as the information needs of patients and carers themselves. It offers a representative overview of cancer peer support group activity in Australia with the aim of facilitating further exploration of this domain.

Background Neurological conditions produce considerable disease burden. Aims To describe quality of life in patients with neurological conditions and informal caregivers receiving postdischarge generic community neurological nursing services, and caregiver burden. Method A descriptive cross-sectional design was used with researchers administering the WHOQOL-BREF Australian Version questionnaire and Zarit Burden Interview. Results Most patients and caregivers rated quality of life as ‘Good’. The patients’ physical, psychological and environment domain scores, and caregivers’ physical domain scores, were below norms. Half of the caregivers experienced burden and 42% had risk for depression. Conclusion A heterogeneous group of patients with neurological conditions had considerable care and support needs for fundamental functioning postdischarge. Quality of life and caregiver burden measures highlight the impact of their circumstances on their health and wellbeing. Research is warranted to determine a comprehensive set of generic needs to guide integrated community nursing services for building patient and caregiver self-management capacity.

Background
The Australian Commission on Safety and Quality in Health Care developed the Australian Hospital Patient Experience Question Set to ask adult patients about their experience of inpatient care. This question set was not validated for paediatric care.

Aim
To adapt and validate the Australian Hospital Patient Experience Question Set for parents and carers of children who received inpatient care.

Methods
Interviews with fourteen parents and carers were conducted. Content analysis was used to revise the question set and to identify experience specific to children and parents. The Question Set was revised, including three new questions to reflect parent experience. Content validity of each new question was assessed. Data was split and construct validity assessed using exploratory and confirmatory factor analysis (n=1500).

Findings
Two main qualitative categories of care included ‘parent experience’ and ‘children being heard’. Emotional support was an integral aspect of parent experience. The revised question set (13-question, one-factor model of good fit) demonstrated construct validity (n=500: Root Mean Square Error of Approximation=0.042, Confirmatory Fit Index=0.997, Tucker Lewis Index=0.996, Composite reliability=0.962).

Discussion
This study adds empirical support for a common measurement framework for experience of care in children's health services. Parents spoke of the value of having a parent and a child reported survey. The next step is for children to report on their own experience.

Conclusion
The revised (parent-reported) question set provides a validated tool which reflects the unique experience of parents and facilitates consistent monitoring and improvement of patient experience in a paediatric inpatient setting.

Nursing can be a stressful occupation with many nurses struggling to cope with stress on a day-to-day basis. Considerable evidence suggests that positive coping strategies can be an effective part of stress management education programs. This article describes the theoretical rationale for a cognitive framework for stress management that was developed as part of a well-being educational program for cancer nurses. This framework included an associated mnemonic (www.pst) to assist in the recall and utilization of positive coping strategies. The stress management framework was intended to increase nurses’ perceptions of personal control which is central to stress management. The academic coping literature is complex, jargon laden and often conceptually abstract, and may not easily be understood by a nonacademic audience. The cognitive framework described here is an evidence-based, user-friendly tool that could be used and evaluated by counsellors, educators, and researchers in different settings.

Objective Remote area nurses provide primary health care services to isolated communities across Australia. They manage acute health issues, chronic illness, health promotion and emergency responses. This article discusses why their generalist scope of practice should be formally recognised as a specialist nursing practice area. Design Constructivist grounded theory, using telephone interviews (n = 24) with registered nurses and nurse practitioners. Setting Primary health care clinics, in communities of 150–1500 residents across Australia. Participants A total of 24 nurses participated in this study. Results Nurses' perceived their clinical knowledge and skill as insufficient for the advanced, generalist, scope of practice in the remote context, especially when working alone. Experience in other settings was inadequate preparation for working in remote areas. Knowledge and skill developed on the job, with formal learning, such as nurse practitioner studies, extending the individual nurse's scope of practice to meet the expectations of the role, including health promotion. Conclusion Remote area nursing requires different knowledge and skills from those found in any other nursing practice setting. This study supports the claim that remote area nursing is a specialist–generalist role and presents a compelling case for further examination of the generalist education and support needs of these nurses. Combined with multidisciplinary collaboration, developing clinical knowledge and skill across the primary health care spectrum increased the availability of health resources and subsequently improved access to care for remote communities. Further research is required to articulate the contemporary scope of practice of remote area nurses to differentiate their role from that of nurse practitioners.

Introduction: This study aimed to synthesise the best available evidence on the safety and efficacy of using moxibustion and/or acupuncture to manage cancer-related insomnia (CRI). Methods: The PRISMA framework guided the review. Nine databases were searched from its inception to July 2020, published in English or Chinese. Randomised clinical trials (RCTs) of moxibustion and or acupuncture for the treatment of CRI were selected for inclusion. Methodological quality was assessed using the method suggested by the Cochrane collaboration. The Cochrane Review Manager was used to conduct a meta-analysis. Results: Fourteen RCTs met the eligibility criteria. Twelve RCTs used the Pittsburgh Sleep Quality Index (PSQI) score as continuous data and a meta-analysis showed positive effects of moxibustion and or acupuncture (n = 997, mean difference (MD) = −1.84, 95% confidence interval (CI) = −2.75 to −0.94, p < 0.01). Five RCTs using continuous data and a meta-analysis in these studies also showed significant difference between two groups (n = 358, risk ratio (RR) = 0.45, 95% CI = 0.26–0.80, I2 = 39%). Conclusion: The meta-analyses demonstrated that moxibustion and or acupuncture showed a positive effect in managing CRI. Such modalities could be considered an add-on option in the current CRI management regimen.

Patient experience surveys have a user focus and measure the quality of person-centered health care for hospital inpatients and consumers of community health services, providing a governance process to evaluate the quality of care and to action improvement. Experience of care has been described as effective communication, respect and dignity, and emotional support. Measurement criteria for these domains are not standardized, leading to inconsistent reporting of patient experience. The objective of this scoping review was to synthesize evidence for measuring experience of care in children’s community health services using the Joanna Briggs Institute framework for scoping review method. Three parent-reported surveys met the inclusion criteria, and 50 survey items were assessed by expert reviewers for fit to domains of healthcare experience. Conceptual domains of parent experience in children’s community health services included respect and dignity, effective communication, and emotional support. A gap was identified, in that few items in identified surveys measured emotional support. This contribution will promote consistent reporting of healthcare experience, informing policy and practice for person-centered health care.