Ruth Wei

Background
The Enhanced Advance care planning and life Review Longitudinal Intervention (EARLI) Project is a cluster randomised controlled trial of proactive screening, reminiscence-based life story work and facilitated advance care planning (ACP), among older adults receiving home care services in Australia.

Methods
The life story work process involves facilitated reflection upon meaningful memories and co-production of a life story project to promote values clarification, communication with carers and meaning-based coping. The life story work and ACP discussions occur across four home visits, with the final session involving consultation with the participant’s general practitioner. The EARLI trial tests the effect of the four-session program, against an active control condition providing ‘usual care’ ACP (single home visit session focused on ACP discussion and education). Primary outcome measures include ACP engagement and ACP documentation in home care provider client records, both of which are hypothesised to increase at post-trial follow-up. Secondary outcomes include preferences regarding care and treatment scenarios, dyadic congruence in preferences, decisional conflict, anxiety, depression, meaning-based coping and relationship quality.

Results
A cross-sectional pilot survey of planned outcome measures was collected from 432 participants during 2022. Between October 2022 and February 2025 12 home care organisations participated in the EARLI trial, referring 284 clients, of whom 96 care recipients have been recruited along with 16 care partners. Data from recruited trial participants indicates a culturally diverse sample with moderate levels of baseline ACP engagement (M= 12.8, SD= 4.55 on the 4-item ACP engagement scale [range 5–20]) and low rates of formal ACP documentation (11/96, 11.5%).

Discussion
Primary and secondary outcomes will be reported, along with findings from a concurrent process evaluation. ANZCTR Trial Registration ID: ACTRN12622001399785.

Unique Contribution
This is the first randomised controlled trial of a combined life story work and advance care planning (ACP) program. Engagement with culture-specific aged care providers has enabled a culturally diverse study sample, reflecting four language groups (English, Italian, Mandarin, Cantonese). Detailed longitudinal follow up (baseline, 4-week, 8-week and 12-week) among participants in both groups provides rare information on the process of ACP engagement and preference stability in the short- to mid-term period.

Implications for Policy and Practice
There are well-known challenges associated with initiating advance care planning (ACP) in acute situations or during admission to residential aged care. This study demonstrates the feasibility of using entry into formalised home care services as a trigger for a comprehensive, holistic and person-centred approach to ACP.

Objectives:
This scoping review aims to examine the current literature on using extended reality (XR) technologies to teach communication skills in nursing education.

Design:
This scoping review was conducted using the Joanna Briggs Institute (JBI) method.

Data sources:
Searches were conducted in five electronic databases: CINAHL Ultimate, Cochrane Library, ERIC, PsycINFO, and PubMed, in February 2024.

Review methods:
The research procedure was assessed using the PRISMA-ScR checklist.

Results:
The analysis generated four overarching categories that described key characteristics of the integration of XR technologies: program overview, pedagogical approaches, evaluation, and nursing students’ experiences.

Conclusion:
This review underscored the effectiveness of XR technologies, particularly VR, as the predominant tool for enhancing communication skills in nursing education. It identifies gaps in the diversity of communication scenarios covered and recommends expending future research to include diverse clinical settings and scenarios. Furthermore, this review highlights a paucity of research utilizing mixed reality (MR) technology for communication training. The insights gained from this review are instrumental in directing further research into MR-based simulations for communication skills training across various nursing contexts.

Objective
Decisional conflict is used increasingly as an outcome measure in advance care planning (ACP) studies. When the Decisional Conflict Scale (DCS) is used in anticipatory decision-making contexts, the scale is typically tethered to hypothetical scenarios. This study reports preliminary validation data for hypothetical scenarios relating to life-sustaining treatments and care utilisation to inform their broader use in ACP studies.

Methods
Three hypothetical scenarios were developed by a panel of multidisciplinary researchers, clinicians and community representatives. A convenience sample of 262 older adults were surveyed. Analyses investigated comprehensibility, missing data properties, sample norms, structural, convergent and discriminant validity.

Results
Response characteristics suggested that two of the scenarios had adequate comprehensibility and response spread. Missing response rates were unrelated to demographic characteristics. Predicted associations between DCS scores and anxiety (r's = .31–.37, p < .001), and ACP engagement (r's = −.41 to −.37, p < .001) indicated convergent validity.

Conclusion
A substantial proportion of older adults reported clinically significant levels of decisional conflict when responding to a range of hypothetical scenarios about care or treatment. Two scenarios showed acceptable comprehensibility and response characteristics. A third scenario may be suitable following further refinement.

Patient or Public Contribution
The scenarios tested here were designed in collaboration with a community representative and were further piloted with two groups of community members with relevant lived experiences; four people with life-limiting conditions and five current or former care partners.

Background
Anxiety disorders are one of the most common mental health disorders experienced by children, and they have a negative effect on social, academic, and health functioning. While traditional psychotherapy has focused on methods such as cognitive behavioural therapy and parental anxiety management to treat these children, interest is growing in animal-assisted therapy (AAT) as a therapeutic modality, and recent research suggests the benefits of AAT within the realms of psychotherapy for children with anxiety.

Aim
This review aimed to perform a critical appraisal of the available literature relating to dog-assisted psychotherapy for children with anxiety and investigate the effectiveness of this therapy method in reducing anxiety.

Method
This structured literature review was guided by the 12 steps recommended by Kable et al. (2012). The search was conducted in August and September 2021 through the databases ScienceDirect, PsycInfo, and PubMed to locate published peer-reviewed literature on the therapeutic benefits of including a dog in psychotherapy sessions for children with anxiety. After critical appraisal, 10 articles were included in the review.

Results
General agreement exists that dog-assisted therapy can boost positive emotions and reduce anxiety levels in children, and that interacting with dogs and experiencing their unconditional acceptance help reduce children’s stress and physical pain levels as well as stress in families. The key themes that emerged from this review included the human–animal bond, children’s attachment styles, hospitalisation and environmental considerations, the AAT methods used, and the effects of AAT.

Conclusion
This review revealed many benefits of the presence of a therapy dog during psychotherapy sessions, including reducing anxiety, increasing positive emotions, and enabling social interactions for children with anxiety. Counsellors and psychotherapists can feel confident to undertake the required training and implement the necessary systems to accommodate a therapy dog in their therapeutic setting in order to support children with anxiety. It is noteworthy that the positive effects of dog-assisted therapy were not consistent throughout the literature, and most research studies focused on children in hospital settings. Therefore, further research is required regarding the effectiveness and clinical implications of the nature, type of intervention, length, and duration of dog-assisted therapy.

Background: Insufficient wound care knowledge in nursing students affects confidence and competence. Scarce research on wound care content and delivery leads to curriculum disparities. Integrating essential content is vital for improved wound care education.

Aims: This study aimed to determine Australian wound care curriculum content for a 3-year Bachelor of Nursing program and identify the optimal year for introducing each topic, as recognised by experts.

Methodology: A three-round Delphi survey involved 17 wound care experts in Australia. The survey used the Standards for wound prevention and management to identify 74 wound care topics within the three categories of anatomy and physiology (A & P), assessment and treatment/therapies, requiring >70% agreement on the year of introduction for each topic.

Results: The Delphi process established consensus on the initial introduction year for 65 of the 74 wound care topics. A total of 19 topics garnered consensus exceeding 70% in the first year, 19 in the second year, 15 in the third year, and 12 for postgraduate study. Expert consensus enabled a progressive development of knowledge and skills in wound theory, assessment, care planning, patient education and prevention over the 3-year program.

Conclusion: The gathering of this data has allowed for conceptual scaffolding of these topics according to the stage at which wound care topics are recommended for introduction into nursing curricula.

An exploratory qualitative study was performed to evaluate the experiences of nursing staff (N = 10) working in a residential aged care facility (RACF) during the coronavirus disease 2019 (COVID-19) pandemic lockdown. Semi-structured, in-person interviews were performed, and thematic analysis was used to analyze the data. Care staff had little or no knowledge of how to cope with a lockdown necessitated by a pandemic. However, management developed proactive plans as they aligned with the changing care circumstances and ongoing government directives. Five major themes were identified: Prolonged Use and Shortage of Personal Protective Equipment; “Blind Leading the Blind”; Communication and Teamwork; Lack of Education; and Resident Response. RACF staff described working under stressful conditions during the initial COVID-19 pandemic lockdown; yet with experience, care staff and the management team adapted to pandemic requirements to meet the needs of residents in their care. RACFs should be prepared for the impact of pandemics on staff and ensure care resources and support are available for the continuity of safe and quality care of residents.

Background: Information literacy (IL) skills are essential for the translation of current knowledge into evidence-based practice (EBP) in healthcare, which in turn improves patient outcomes. However, students enter pre-registration nursing programs with variable IL skills, which can present challenges when preparing research-literate nursing graduates. Objectives: To develop an online module for nursing students to learn the IL skills they require to effectively implement EBP. Project design: A self-paced, interactive online module was developed for final year pre-registration nursing students at an Australian university and launched in late January 2019. Four different digital tools, including screen-capture videos, split-screen tutorials, e-portfolio/learning journey platforms, and digital badges, were integrated to create an interactive module on database searching and systematic reviews. A student feedback survey was added to collect information on the students’ learning experience. Results: Students reported the online module was challenging but engaging and that its self-paced interactive nature assisted their learning. Digital badges were reported as a motivating factor by students, and their attitudes toward EBP were positive. Students were able to complete the module on their own, but a handful required face-to-face assistance. Conclusion: This project successfully integrated screen-capture videos, split-screen tutorials, e-portfolios and micro-credentialing into one online learning module to assist nursing students with developing the IL skills required for effective EBP.

Academic work environments are becoming progressively more digitalised and focused on performativity and commodification, increasing the potential to force an unwanted merge of the boundary between work and non-work domains. This study aimed to explore academic wellbeing and the role played by factors related to work-life merge. Data were collected from a cross sectional survey of 605 Australian and 313 UK academics, who were found to have a short version Warwick-Edinburgh Mental Wellbeing Score of 21.47 ± 4.11 and 21.35 ± 4 respectively, which is significantly below population norms. Australian men’s scores were significantly lower than Australian women (20.7 ± .31, p = .007). Job strain was evidenced by excessive work hours, high levels of intrusive work-related thoughts, reduced physical activity and a self-perception that work-life merge adversely affected psychological and physical health, and mostly only occurred to meet work demands. Action by government education and university leaders is urgently required to identify policy and management practices that are contributing to this ongoing health concern. The establishment of national and university based advisory groups and consideration of a data warehouse to curate a public dataset on the wellbeing of staff within universities could assist in ensuring the outcomes of any action are continually assessed.

Objective: This review aims to identify and synthesize the best qualitative evidence on the experiences of Chinese immigrants receiving palliative care in their country of residence where the culture is predominantly Western, and the experiences of their family carers. Introduction: The recent increase in international immigration has led to challenges in providing culturally appropriate palliative care. Chinese populations have particular beliefs, values and practices surrounding death and filial piety. These differ considerably from those in Western cultures and have significant implications for palliative care service provision. This review will explore the experiences and perceptions of Chinese immigrants and how their cultural beliefs shape their acceptance and decision making related to palliative care. Inclusion criteria: The review will include studies on the experiences of Chinese immigrants over 18 years of age with a terminal medical condition receiving palliative care in outpatient units, hospitals, hospices, specialist palliative care units, homes and community settings in their country of residence where the culture is predominantly Western. Methods: Eligible studies will be studies with qualitative data including designs such as phenomenology, grounded theory, ethnography, narrative research, qualitative description, action research and feminist research published in English and Chinese. CINAHL, PsycINFO, MEDLINE, Scopus and Web of Science Core Collection will be used and grey literature will be searched using ProQuest Dissertations and Theses, OpenGrey and Caresearch. Appraisal of selected studies will be done with the Joanna Briggs Institute Qualitative Assessment and Review tool. Findings will be synthesized through a meta-aggregative approach to produce a comprehensive set of synthesized findings that can be used as a basis for evidence-based practice.