Eric Lim

Aim
This paper presents a pilot study evaluating the acceptability, feasibility and effectiveness of an education program incorporating virtual reality for teaching aggression management among final-year undergraduate nursing students at one university in Western Australia.

Background
Virtual reality can be useful for simulating high-risk clinical situations without exposing nursing students to the potential consequences of encountering the event in the real world. As such, virtual reality is useful when incorporated into education on the prevention and management of aggression, preparing students to be industry-ready. However, there is a gap in the literature regarding the use of virtual reality in teaching in this area of the curriculum.

Design
This is a pilot study that used a quantitative pre- and post-education survey design.

Methods
Nursing students completed pre-education surveys, participated in an educational program that incorporated virtual reality (VR) to teach aggression management and then completed post-education surveys.

Results
The participants (n = 11) completed both the pre- and post-education surveys, as well as provided qualitative responses. The findings showed that the education program was effective in increasing nursing students' confidence in managing aggression (p > 0.022). Participants also reported that the use of virtual reality was realistic to simulate the aggressive clinical scenario (M = 6.18, SD = 0.75), to stimulate experiential learning to manage aggressive persons (M = 6.18, SD = 0.60) and that the debrief helped them to reflect and consolidate their learning (M = 6.36, SD = 0.67). They also reported that the Virtual Reality Aggression Management education program was more effective than traditional didactic methods of teaching this subject area (M = 6.45, SD = 0.52).

Conclusions
The findings of this pilot study will be further explored and developed based on the findings of this pilot work. Further research will be conducted with a larger scale of nursing and other healthcare students.

Facilitating voluntary disclosures of non-suicidal self-injury (NSSI) has emerged as a promising approach to catalysing personal recovery and early support-seeking for people who self-injure. However, approximately half of individuals who self-injure have never disclosed their NSSI. To date, there is a lack of theoretical explanations available to conceptualise the decision to disclose NSSI. However, various anticipatory cognitions (e.g., anticipated stigma) have been implicated in the disclosure process. As such, this scoping review used Social Cognitive Theory as a theoretical framework to identify and synthesise the social cognitive factors underlying NSSI disclosure. This review considered all published empirical articles and theses that 1) reported on populations with a history of NSSI, 2) examined NSSI disclosures, and 3) reported on at least one social cognitive factor associated with NSSI disclosures. The review was guided by Arksey and O’Malley's 5-step methodological framework and Joanna Briggs Institute's guidelines for conducting scoping reviews. The findings from 43 studies support the applicability of Social Cognitive Theory in conceptualising NSSI disclosures. Specifically, factors underlying the decision to disclose often aligned with the theory's fundamental tenets of self-efficacy, outcome expectancies, and social modelling. Across the literature, we identified cognitions that were consistently implicated as barriers or facilitators of NSSI disclosure. The findings indicate that expectancy-challenge interventions may be effective in facilitating disclosures of NSSI. Despite this, the findings of the review call for future research validating the utility of Social Cognitive Theory in the disclosure context, particularly among culturally diverse populations.

Graduate nurses in Australia are now comprehensively prepared and have limited mental health knowledge and experiences to work in acute mental health settings. As such, they would require support from the nursing education of their respective mental health services to support them to progress from novice to advanced beginner. However, there is currently a variation in nursing education that supports graduate nurses in transitioning to mental health nursing. Therefore, it is important to understand graduate nurses’ viewpoints of nursing education and its effectiveness for helping them. This presentation presents a Q methodology study that was undertaken to generate an in-depth and accurate understanding of graduate nurses’ experiences in one of Western Australia's mental health services. The findings revealed four types of graduate nurses, and they were: (1) graduate nurses who experienced challenges of being accepted by their nursing team; (2) graduate nurses who had low self-confidence about their mental health nursing knowledge and skills to practice in acute mental health settings; (3) graduate nurses who felt confident about their mental health knowledge and skills but experienced challenges to apply them to difficult clinical situations; (4) graduate nurses who felt confident with their mental health knowledge and skills and accepted by their nursing team. The findings highlighted that nurse educators might need to tailor education to meet the needs of graduate nurses progressing from novice to advance beginner in mental health nursing.

Background
Attention-Deficit/Hyperactivity Disorder (ADHD)/Hyperkinetic Disorder (HD) is linked to increased risks of morbidity, comorbidity and mortality, with higher prevalence in clinical populations. The differential prevalence of ADHD/HD across adult and pediatric clinical populations, influenced by factors such as time trends, sex, age, geographic regions, and comorbidities, has not been systematically assessed.

Methods
MEDLINE, CINAHL, Embase and PsycINFO databases were searched from inception to 1st August 2023 for eligible full-text papers published in English, and reviewing reference lists of identified studies and review papers. Studies reporting ADHD/HD prevalence in adult and pediatric clinical populations were included. Meta-regression evaluated the effects of geographic region, year of publication and sample size.

Results
From 30,740 citations, we reviewed 521 full-text articles, yielding 311 studies for inclusion (including 653,558 pediatric and 43,311 adult participants). Overall, worldwide pooled prevalence of ADHD/HD in clinical settings for pediatrics was 32.4% (95% CI 31–34%), and in adults 21.4% (95% CI 20–23%). Prevalence was higher in outpatient settings than inpatient settings. Prevalence based on rating scales was higher than studies using diagnostic interviews or clinical record review. Prevalence varied significantly across subspecialist settings for children and adults. No significant time trend was detected between 1981–2023. Pediatric prevalence appears influenced by geographic region but not year of publication or sample size. For adults, larger sample sizes were associated with lower prevalence estimates.

Conclusions
ADHD/HD prevalence in clinical populations is 8-9-fold higher than community estimates. With these patients at risk for many adverse outcomes, our findings underscore the critical importance of resource allocation for screening, diagnosing and treatment.

Facilitating voluntary disclosures of non-suicidal self-injury (NSSI) has emerged as a promising approach to catalysing personal recovery and early support-seeking for people who self-injure. However, approximately half of individuals who self-injure have never disclosed their NSSI. To date, there is a lack of theoretical explanations available to conceptualise the decision to disclose NSSI. However, various anticipatory cognitions (e.g., anticipated stigma) have been implicated in the disclosure process. As such, this scoping review used Social Cognitive Theory as a theoretical framework to identify and synthesise the social cognitive factors underlying NSSI disclosures. This review considered all published and unpublished empirical studies that 1) reported on populations with a history of NSSI, 2) examined NSSI disclosures, and 3) reported on at least one social cognitive factor associated with NSSI disclosures. The review was guided by Arksey and O’Malley’s 5-step methodological framework and Joanna Briggs Institute’s guidelines for conducting scoping reviews. The findings from 40 studies support the applicability of Social Cognitive Theory in conceptualising NSSI disclosures. Specifically, factors underlying the decision to disclose often aligned with the theory’s fundamental tenets of self-efficacy, outcome expectancies, and social modelling. Across the literature, we identified cognitions that were consistently implicated as barriers or facilitators of NSSI disclosure. The findings indicate that expectancy-challenge interventions may be effective in facilitating disclosures of NSSI. Despite this, the findings of the review call for future research validating the utility of Social Cognitive Theory in the disclosure context, particularly among culturally diverse populations.

Background and Aim: Micro‐elimination education can improve access to life‐saving treatments for patients with hepatitis C, co‐occurring mental health conditions, and alcohol and other drug use disorders. The Hepatitis C virus (HCV) is disproportionately prevalent among people with mental health conditions and alcohol and other drug issues, reducing their life expectancy. Although hepatitis C is a curable condition, this population frequently remains untested and untreated. Micro‐elimination programs are necessary to enhance hepatitis C virus screening and treatment rates. This study aims to evaluate the impact of micro‐elimination education on healthcare providers' confidence in identifying high‐risk HCV populations, conducting HCV screenings and treatments, and managing comorbid substance use disorders. Additionally, it will assess referrals to a nurse‐led HCV treatment clinic.

Methods: A quasi‐experimental pre‐posttest intervention design was used. The intervention was an education program targeted at HCV micro‐elimination and linkage to care.

Results: Questionnaires were administered to (n = 101) healthcare providers to measure changes in confidence in screening and treating HCV in people with comorbid mental health conditions and alcohol and other drug disorders pre‐ and post‐ intervention. Pre‐intervention, healthcare providers reported the highest confidence levels in treating mental health conditions. A significant increase in post‐education confidence in screening and treating the HCV across all healthcare provider roles was observed (p < 0.05). Twenty‐three referrals were received at the nurse‐led hepatitis C virus treatment clinic, with the majority (n = 11) of referrals received from nurses.

Conclusion: This study underscores the significance of micro‐elimination education programs in enhancing healthcare provider confidence in treating hepatitis C. Leveraging the mental health nursing workforce to connect high‐risk populations with hepatitis C care will expand timely access to life‐saving treatments and optimize healthcare outcomes. Targeted hepatitis C micro‐elimination education will further accelerate progress toward the 2030 elimination goals, enhancing the overall well‐ being of vulnerable populations.

Background and aim: Research on international students conducted during the COVID-19 pandemic has persistently highlighted the vulnerabilities and challenges that they experienced when staying in the host country to continue with their studies. The findings from such research can inevitably create a negative image of international students and their ability to respond to challenges during unprecedented times. The aim of this study is two-fold: (1). To provide insights into the pandemic’s impact on CaLD international nursing students. (2). To explore the lived experiences of CaLD international students in overcoming the challenges during the pandemic.

Method: A descriptive qualitative research design guided by constructivist grounded theory was used in this study. Students were recruited via flyers posted on the institutional digital learning platform. Nineteen in-depth 1 to 1 online interviews were conducted using an interview guide. Verbatim transcripts were analyzed using constant comparison analysis.

Results: Three themes emerged from the collected data that described the participants’ lived experiences, and they were (1) viewing international education as the pursuit of a better life, (2) focusing on personal growth, and (3) coming out of the ashes we rise. Discussion: The findings highlight the importance of recognizing the investments and sacrifices that CaLD international students and their families make in pursuit of international tertiary education. The findings also underscore the importance of acknowledging the qualities that CaLD international students have to achieve self-growth and ultimately self-efficacy as they stay in the host country during a pandemic.

Conclusion: Future research should aim to identify effective strategies that support CaLD international nursing students in achieving personal growth and self-efficacy. This is particularly important during times of uncertainty, such as a pandemic, to ensure that they can continue their studies successfully in the host country. Recognizing the investments and sacrifices made by these students and their families, as well as acknowledging their qualities and resilience, is crucial for developing supportive educational policies and practices.

Introduction and Background: Virtual reality (VR) is an effective way to overcome the cost, time, and logistic problems of planning and delivering education and can be used to simulate high-risk clinical situations without exposing the person to the potential consequences of encountering the event in the real world. Therefore, it is likely that VR could be incorporated into education on aggression management for nursing students without the actual consequences of doing it in real-life clinical settings.

Aims/Objectives/Hypotheses: A pilot study to evaluate an education on aggression management that incorporated VR for teaching aggression management. The research questions guiding this study were to: Determine pre- and post-education differences in nursing students’ attitudes and confidence of managing aggression in clinical settings, and their empathy, knowledge, and attitudes toward persons with a mental illness? Evaluate nursing students’ experiences regarding the use of VR in their education on managing aggression?

Methods: Quantitative pre- and post-education surveys were used to collect data. The surveys included (i) Confidence in coping with Patient Aggression Instrument(CCPA), (ii) Jefferson Scale of Empathy Health Professions Student(JSE-HPS), (iii) Management of Aggression and Violence Attitude Scale (MAVAS), (iv) Mental Health Literacy Scale(MHLS), and (v) Opening Minds Scale for Healthcare Providers(OMS-HC). The collected pre- and post-education measures were analysed using SPSS and the selected statistical significance level for testing the hypotheses were p < 0.05. Basic demographic data were collected pre-education and the Virtual Reality Neuroscience Questionnaire(VRNQ) and session evaluation data were collected post-education.

Outcomes/Significance/Implications for the Profession: Eleven nursing students participated in this study. There was a significant difference in median total scores of MAVAS factors external and situational/interactional, and CCPA scale. However, there were no significant differences between the other pre- and post-education JSE-HPS, MHLS, and OMS-HC measures. Most participants reported that the sessions in the education were conducted in an engaging manner (6.45, SD = 0.820) and that the debrief session was useful for consolidating their learning (6.36, SD = 0.674).

Translation to Practice: The use of VR in nursing education is potentially beneficial to prepare nursing students for real-life clinical challenges and should be further explored to develop evidence-based practice.