School of Nursing

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The School of Nursing evolves with the latest research and needs of the healthcare sector. Our research focuses on advancing knowledge to improve patient outcomes and recovery.

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How the Tivaevae Methodology Can Be Used to Guide Ethical Research When Capturing Pacific Youth Voices
(Auckland University of Technology (AUT) Library, 2025-12-17) Henry, Amy
Introduction: Health research involving children and young people is essential to gain a better understanding of their unique perspectives, and health needs, particularly for Pacific populations in New Zealand, which are comparatively young. Research involving children and young people presents ethical challenges, as children and persons under 16 years of age are considered vulnerable and in need of protection. The capacity and appropriateness of children and young people providing individual consent or assent can be a contentious issue and for Pacific children and young people, individual consent may conflict with collectivist cultural values. Methods A review of the Cook Islands’ Tīvaevae research methodology was undertaken against the New Zealand health research ethical standards to assess its suitability for guiding consent processes involving Pacific youth. Conclusion: This paper argues that the values of the Cook Islands’ Tīvaevae methodology namely tu-inangaro (relationships) and akaari kite (a shared vision) can be used to reframe the consent process from an individual transaction to a collective dialogue to ease the tension in capturing informed consent for young Pacific people and children, thereby mitigating potential harm and fostering trust in research participation.
Understanding the Challenges and Opportunities for Pacific Allied Health Staff to Enable Culturally Responsive Care in Aotearoa New Zealand
(Auckland University of Technology (AUT) Library, 2025-12-09) Biggs, Larissa; Vaka, Sione; Cook, Catherine
Introduction: There are low numbers of Pacific allied health professionals in Aotearoa, which warrants urgent prioritisation of more Pacific allied health professionals. Life expectancy differentials persist among Pacific people in Aotearoa compared to non-Pacific. Methods: This qualitative study explored the challenges and opportunities for Pacific allied health staff to enable culturally responsive care in Aotearoa. The research explores the perspectives of five Pacific allied health professionals utilising Talanoa methodology and thematic analysis. Discussion: Four themes were identified: theme one, Cultural capability and capacity; theme two, Pacific values and responsibilities; theme three, “I struggle navigating white spaces”, and theme four, Emotional and cultural intelligence. Conclusion: This study identified three meta-themes: cultural isolation, cultural intelligence, and cultural load. Pacific cultural knowledge and expertise are crucial in helping non-Pacific allied health clinicians recognise and embrace culturally responsive healthcare. This study contributes to the gap in the literature by highlighting the challenges and opportunities Pacific allied health professionals experience in Aotearoa.
Evolving Nursing Roles in Assisted Dying Services in New Zealand: A Scoping Review
(Elsevier, 2025-10-16) Amankwaa, Isaac; Liu, Cathy; Coates-Harris, Jacqui; Chin, Mellisa; Brownie, Sharon; McClunie-Trust, Patricia
Background: The implementation of New Zealand's End-of-Life Choice Act 2019 provides a unique lens for examining the early-stage implementation of assisted dying policy. As legislation expands globally, nurses are emerging as central yet under-examined actors in delivering assisted dying care. This review addresses the urgent need to understand how nursing roles evolve in newly legalised contexts. Objective: This scoping review aimed to understand the experiences, roles, and challenges faced by registered nurses and nurse practitioners in delivering assisted dying services under the End-of-Life Choice Act in Aotearoa New Zealand. Method: The scoping review followed Joanna Briggs Institute guidelines. A systematic search was performed across ProQuest Central, Scopus, PubMed, and CINAHL to identify literature published between 2021 and 2025. Two screened the articles and extracted the data. A convergent, segregated approach was used for thematic synthesis. Results: Nineteen studies were included, spanning anticipatory commentary and experiential data after the End-of-Life Choice Act came into force. Four themes were identified. First, evolving nursing roles revealed fragmentation: nurse practitioners administer life-ending medication but remain excluded from eligibility assessments. In contrast, registered nurses act as frontline coordinators yet are legally barred from initiating discussions. Experiential accounts added unanticipated burdens, including family management, logistical coordination, and supporting colleagues without formal preparation. Second, ethical dimensions extended beyond legal safeguards. Anticipatory sources predicted value conflicts, while experiential studies described lived moral distress, fractured team dynamics from conscientious objection, and confidentiality risks in small communities. Third, preparedness and support showed a marked gap. While early literature assumed structured training and clear guidance, experiential findings reported uneven preparation, reliance on informal peer networks, and culturally unsafe or absent emotional support. Debriefing was valued but inconsistently delivered. Finally, contextual variations shaped implementation. Hospices diverged between integration and resistance, aged residential care exposed nurses to family conflict and role ambiguity, rural practice intensified inequities and professional isolation, and community nurses often became central coordinators of home-based deaths. Māori perspectives were largely absent. Conclusions: New Zealand's assisted dying policy creates a fragmented framework for nursing roles, confirmed by anticipatory projections and lived experience. This contrasts with integrated approaches in countries such as Canada, while also exposing gaps in preparedness, ethical support, and cultural responsiveness. Addressing these challenges requires legislative refinement, consistent support systems, and Māori-led, longitudinal research across diverse care contexts. Social media abstract: New Zealand's assisted dying policy fragments nursing roles, creates ethical tensions, and leads to access inequities. Cultural safety and the integration of the nurse practitioner role are essential. #PalliativeCare #NursingPolicy.
A Critical Tiriti Analysis of the New Zealand Cancer Control Strategy
(Elsevier, 2020-02-01) Came, H; Kidd, J; Goza, T
Objectives: Te Tiriti o Waitangi is foundational to health policy in Aotearoa (New Zealand). Systemic breaches of te Tiriti have contributed to enduring health inequities between Māori (the indigenous peoples of New Zealand) and other New Zealanders. There are significant inequities in cancer morbidity and mortality rates between Māori and non-Māori. With the development of a new Cancer Control Strategy underway in Aotearoa it is timely to critically review the current Strategy with a view to strengthen efforts to minimise the harm of cancer through stronger alignment to te Tiriti responsibilities. Design: Within this paper the authors undertake a critical Tiriti analysis of the current New Zealand Cancer Control Strategy. This process involves interrogating the policy against the preamble, and the articles of the Māori text of te Tiriti; focussing on kāwanatanga (governance), tino Rangatiratanga (sovereignty), ōritetanga (equity) and wairuatanga (spirituality). Results: We found that the Strategy contained little tangible connection to te Tiriti or other Māori health strategic documents. The significance of such a gap can be clearly seen in the continuing inequities of access and outcomes for Māori with cancer. Conclusions: We recommend that future cancer control strategies in Aotearoa be developed with te Tiriti and tikanga (Māori protocols) as the central considerations. Strengthening Indigenous content in policy is likely to improve the efficacy of health policy for Indigenous peoples and reorientate health policy to address enduring health inequities.
Tū Kaha: He Mōhio ki ngā Māori o Te Kōmaoa Waewae (Stand Strong: A Qualitative Study of Māori With Venous Leg Ulcers in Aotearoa New Zealand)
(SAGE Publications, 2024-10-18) Kidd, J; Wharakura, MK; Laking, G; McGregor, D; Dobson, R; Jull, A
Venous leg ulcers have impact on people’s lives far beyond that of a skin lesion but these impacts have not been explored from an Indigenous perspective. We used a Māori-centered narrative approach to interview 13 Māori in Aotearoa New Zealand with venous leg ulcers. Data analysis was informed by a reflexive thematic approach and four themes were identified: Ko waewae ahau (I wear the leg); Ngā mea hōhā (annoying things); Ka tangi te ngākau (heartfelt grief); and Mamae (pain, sore, hurt). Recognizing patients’ expertise in their condition, the inclusion of whānau (family) in care planning and provision, while providing consistent advice and resource access, would all enhance the experience of venous ulcer management. Training in venous leg ulcer care needs to move beyond a focus on the leg and toward a more holistic approach that encompasses a broader understanding of patient experiences and cultural contexts when managing venous ulcers.
What Is Known About Asthma Care and Management for Children and Young People Under 18 Years of age in New Zealand. A Scoping Review
(Wiley, 2025-12-02) Blamires, J; Foster, M; Kanengoni‐Nyatara, B
Introduction Asthma is the most common chronic health condition affecting children in Aotearoa New Zealand, with Māori and Pacific children disproportionately burdened by high morbidity and inequitable care. Despite clinical guidelines and growing research, inconsistencies in diagnosis, treatment adherence, and education persist. This scoping review identifies and maps literature on care models, service delivery, education and support strategies, and experiences of children, young people, and their family/whānau in asthma care and management for those under 18 in Aotearoa New Zealand. Methods This scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐analyses Extension for Scoping Reviews (PRISMA‐ScR) guidelines. We searched MEDLINE, CINAHL, Scopus, PsychINFO, and grey literature for articles published between 2014 and 2024 on asthma care for children under 18 in Aotearoa New Zealand. Eligible articles from health or community settings were thematically analysed using conventional content analysis. Results Twenty‐one articles met inclusion criteria, including qualitative, quantitative, mixed‐methods, and policy or guideline documents. Thematic analysis revealed four interconnected themes: (1) medications and adherence, (2) education and health literacy, (3) children and whānau experiences, and (4) culture and beliefs. Findings reflect persistent inequities in asthma outcomes and care access, especially for Māori and Pacific children and highlight opportunities to strengthen culturally safe and family/whānau‐centred care to improve asthma care, treatment and its management. Conclusion This review identifies key gaps in asthma care for children in Aotearoa New Zealand and calls for more responsive, culturally grounded models to improve asthma outcomes across diverse settings.
Co-Designing a Web-Based, Gamified, Auditory-Cognitive Dual-Task Training System for Older Adults with Hearing Loss
(MDPI AG, 2025-11-15) Zhao, Ivy Yan; Lau, Tsz Wai; Li, Chen; Ng, Janet Ho-Yee; Holroyd, Eleanor; Sweetow, Robert; Chan, Engle Angela; Leung, Angela YM
Background: Age-related hearing loss (ARHL) is associated with decreased communication, reduced social engagement, cognitive decline and an increased risk of dementia globally. Although increasing studies report the benefits of combing auditory and cognitive training for older adults with ARHL, more evidence is needed to examine its effects. Moreover, existing training programs have been developed with minimal end-user involvement leading to low adherence rates. This study aimed to investigate the role of co-design in the development of an auditory-cognitive training system for older adults with ARHL. Methods: A co-design methodology was employed. Digital recordings of the co-design workshops were transcribed verbatim. An established reflexive thematic analysis methodology was used. Results: Fifteen older adults with ARHL, referred to as "co-researchers", participated in three co-design workshops until data saturation was achieved. Consultations were held with two key service providers. Three key themes emerged: (1) older adults with ARHL prefer a user-friendly auditory-cognitive training system; (2) clear, localized and colloquial instructions for the training tasks are necessary; and (3) diversified, tailor-made and dual-task training tasks, performed in an interactive and game-like mode, can motivate and sustain usage of the training system. As a result, a prototype of a web-based, gamified, and adaptive auditory-cognitive dual-task training system was co-designed. Conclusions: Our findings affirmed the importance of genuinely listening to the voices of end-users and creating a system that is responsive to their needs and preferences. Future study is recommended to examine the effects of this system on older adults with ARHL.
General Well-being of Intensive Care Nurses: A Prototype Analysis
(Wiley, 2021-08-21) Jarden, RJ; Sandham, M; Siegert, RJ; Koziol-McLain, J
Background: Prototype analyses of well-being have identified central characteristics and prototypicality for New Zealand teachers, lawyers, adolescents, and work well-being of nurses. What has not yet been explored is the broad construct of well-being in intensive care nurses. Aims and objectives: To identify intensive care nurses' conceptions of general well-being and investigate whether their general well-being is prototypically organized. Design: Prototype analysis. Methods: Three linked studies conceptualize well-being in this prototype analysis. In study 1, nurses reported features of well-being. Study 2 investigated the organization of these features. Study 3 sought confirmation of prototypical organization. Results: Sixty-five New Zealand nurses participated. For study 1 (n = 23), the most frequently reported elements of well-being included physical health (n = 26), work-life balance (n = 20), and personal relationships (n = 18). For study 2 (n = 25), the highest rated elements included mental and emotional health, [general] health, work-life balance, and love. Work-life balance, physical health, and personal relationships were in the top five most frequently reported and were rated in the top 12 most central. Overall, ratings of centrality and the number of times reported were positively correlated (r = 0.33, P <.005). For study 3 (n = 17), confirmatory analyses did not reach statistical significance (P =.15). Conclusions: Physical health, work-life balance, and personal relationships are key characteristics of well-being for intensive care nurses. Mental, emotional, and general health and work-life balance were considered most important for well-being. Relevance to clinical practice: Physical health, work-life balance, and personal relationships are key characteristics of well-being for intensive care nurses. These characteristics of the broad construct of well-being are helpful in both defining and identifying conceptual models of well-being that may be used to inform the development and measurement of well-being programmes.
Does 2% Lignocaine Gel Reduce Urethral Catheterisation Pain in Women? A Systematic Review and Meta‐Analysis
(Wiley, 2025-11-24) Varndell, Wayne; Blamires, Julie; Sheppard‐Law, Suzanne
Urinary catheterisation is an important aspect of patient care yet commonly causes discomfort or pain. Current international guidelines recommend water‐based sterile lubricant during catheterisation of women, whereas local anaesthetic gel (e.g., lignocaine gel) is advocated in men, potentially highlighting a gender bias in clinical care. The purpose of this systematic literature review was to evaluate the effectiveness of 2% lignocaine gel compared to water‐based lubricant in reducing pain during urethral catheterisation of women. A systematic search using key terms and their alternate spellings was used to identify relevant studies. Studies were included that examined the use of 2% lignocaine during urethral catheterisation of women. This review searched Cochrane Library, Cumulated Index in Nursing and Allied Health Literature (CINAHL), Emcare Nursing and Allied Health Database, Excerota Medica Database (EMBASE), Maternity and Infant Care Database, MEDLINE, OVID, ProQuest, PubMed and SCOPUS. In addition, clinical trial and systematic review registries were also searched from inception to May 2025. A total of 2030 studies were identified and screened. Three randomised controlled studies involving 214 female participants were included in this review. Pooled results indicated a statistically significant difference in favour of 2% lignocaine gel compared to water‐based lubricant during urethral catheterisation in women (mean difference −10.81, 95% CI: −15.81 to −5.35). The application of 2% lignocaine gel is more effective in reducing catheterisation‐associated pain in women compared to water‐based lubricant. Current clinical guidelines suggest the use of a water‐based lubricant for women, but an anaesthetic‐based lubricant for men. The belief that women do not require local anaesthesia before catheterisation may be influenced by historical perspectives and warrants further investigation.
Indigenous People’s Experiences and Expectations of Health Care Professionals When Accessing Care for Family Violence: A Qualitative Evidence Synthesis
(Sage, 2020-10-07) Fiolet, R; Cameron, J; Tarzia, L; Gallant, D; Hameed, M; Hooker, L; Koziol-McLain, Jane; Glover, K; Spangaro, J; Hegarty, K
Although many Indigenous peoples demonstrate resilience and strength despite the ongoing impact colonization has on their peoples, evidence suggests poor experiences and expectations of health care professionals and access to health care. Health care professionals play an essential role in responding to family violence (FV), yet there is a paucity of evidence detailing Indigenous people’s experiences and expectations of health care professionals in the context of FV. Using a meta-synthesis of qualitative studies, this article aims to address the following research question: What are Indigenous people’s experiences and expectations of health care professionals when experiencing FV? The inclusion criteria comprised a qualitative study design, Indigenous voices, and a focus on expectations and experiences of health care professionals when FV is experienced. Reviewers independently screened article abstracts, and the findings from included papers were subject to a thematic analysis. Six studies were included in the final meta-synthesis representing studies from Australia, the Americas, and New Zealand. Three themes were identified. Health care professionals need to center the Indigenous person in the care they provide and demonstrate cultural awareness of how history and culture influence an individual’s care requirements. Health care professionals also need to ensure they are connecting for trust with the Indigenous person, by slowly developing a rapport, yarning, and investing in the relationship. Finally, Indigenous peoples want their health care professional to work on strengthening safety from culturally inappropriate care, institutional control, and potential lack of confidentiality associated with tight-knit communities.
Validity of the ACTS Intimate Partner Violence Screen in Antenatal Care: A Cross Sectional Study
(BioMed Central, 2021-09-24) Hegarty, K; Spangaro, J; Kyei-Onanjiri, M; Valpied, J; Walsh, J; Chapman, J; Koziol-McLain, Jane
Background: Intimate partner violence (IPV) is a major public health problem with harmful consequences. In Australia, there is no national standard screening tool and screening practice is variable across states. The objectives of this study were to assess in the antenatal healthcare setting: i) the validity of a new IPV brief screening tool and ii) women’s preference for screening response format, screening frequency and comfort level. Methods: One thousand sixty-seven antenatal patients in a major metropolitan Victorian hospital in Australia completed a paper-based, self-administered survey. The survey included four screening items about whether they were Afraid/Controlled/Threatened/Slapped or physically hurt (ACTS) by a partner or ex-partner in the last 12 months; and the Composite Abuse Scale (reference standard). The ACTS screen was presented firstly with a binary yes/no response format and then with a five-point ordinal frequency format from ‘never’ (0) to ‘very frequently’ (4). The main outcome measures were test statistics of the four-item ACTS screening tool (sensitivity, specificity, predictive values, and area under the curve) against the reference standard and women’s screening preferences. Results: Twelve-month IPV prevalence varied depending on the ACTS response format with 8% (83) positive on ACTS yes/no format, 12.8% (133) positive on ACTS ordinal frequency format and 10.5% (108) on the reference Composite Abuse Scale. Overall, the ACTS screening tool demonstrated clinical utility for the ordinal frequency format (AUC, 0.80; 95% CI = 0.76 to 0.85) and the binary yes/no format (AUC, 0.74, 95% CI = 0.69 to 0.79). The frequency scale (66%) had greater sensitivity than the yes/no scale (51%). The positive and negative predictive values were 56 and 96% for the frequency scale and 68 and 95% for the yes/no scale. Specificity was high regardless of screening question response options. Half (53%) of the women categorised as abused preferred the yes/no scale. Around half of the women (48%, 472) thought health care providers should ask pregnant women about IPV at every visit. Conclusions: The four-item ACTS tool (using the frequency scale and a cut-off of one on any item) is recommended for written self-administered screening of women to identify those experiencing IPV to enable first-line response and follow-up.
A Quest for Quality Care: Exploration of a Model of Leadership Relationships, Work Engagement, and Patient Outcomes
(Wiley, 2020-10-12) Koziol-McLain, Jane; Teo, S; Parr, JM
AIM: To explore the effects of resonant leadership, leader exchange relationships and perceived organizational support on work engagement and patient outcomes. DESIGN: A cross-sectional survey design. METHODS: Data were collected in June and July 2016 from 252 nurses and clerical staff and institutional patient safety (falls rates) and patient satisfaction (Friends and Family Test) in New Zealand. Data were analysed with structural equation modelling (SEM). RESULTS: The final model was an excellent fit to the data (χ2 (22, N = 252) = 39.048, p = 0.014). Resonant leadership was significantly and positively associated with relationships at work, perception of unit care quality (β = 0.28, p < 0.001), reduced falls rates (β = -0.14, p < 0.05) and better patient satisfaction (β = -0.41, p < 0.001). A direct effect of resonant leadership was demonstrated on patient satisfaction (β = 0.20, p < 0.01). Perceived organization support (β = 0.40, p < 0.001) and leader-member exchange (β = 0.46, p < 0.001) were confirmed antecedents of work engagement. Work engagement was confirmed as an antecedent of nurse perception of unit care quality (β = 0.21, p < 0.001). Where social exchanges exist, work engagement mediates these. Three further mediated paths bypassed work engagement altogether. CONCLUSION: Existing literature investigating the drivers and impacts of work engagement predominantly focuses on staff outcomes rather than patient outcomes. The findings identify modifiable factors to improve staff experience, patient safety, and ultimately patient satisfaction. Resonant leadership, a relational style, is a core antecedent of quality care and positively associated with staff experience and patient outcomes. IMPACT: This investigation into a real-world problem for nurse leaders also confirmed that an organizational focus on work engagement is not always required. Resonant leadership improves staff work experience, patient safety, and patient satisfaction. Nurse leaders should measure, foster, and develop resonant leadership in practice.
Hidden Behind a Cloak of Silence and Exclusion: A Qualitative Study of Healthcare Professionals and Mandated COVID-19 Vaccinations
(Informa UK Limited, 2025-03-12) Dewar, Jan; Barbarich-Unasa, Te Wai; Pacheco, Gail; Meehan, Lisa; Wilson, Denise
Aotearoa New Zealand (Aotearoa), like many countries, experienced widespread demand for health services, threatening to collapse the health system. In addition to stringent border control, isolation policies for those with COVID-19, and instituting lockdowns, the government imposed a COVID-19 vaccine mandate for groups of essential workers, including healthcare professionals. Some literature argues that the COVID-19 vaccine mandates restrict individuals’ freedoms through the loss of employment, income, and status as a healthcare professional. This qualitative research explored how COVID-19 vaccine mandates impacted healthcare professionals. Data from eight in-depth interviews with former healthcare professionals who experienced termination of their employment, and four managers or business owners were thematically analysed. The theme, Mandate-Induced Traumatic Decision-Making and Loss and two sub-themes, A Change in Attitudes and Ongoing Impacts on Lives, were identified. We found the COVID-19 vaccine mandates had detrimental impacts on those healthcare professionals affected by their decision not to have or complete COVID-19 vaccinations. Despite what participants believed were legitimate reasons for not being vaccinated, they experienced ongoing trauma and psychological, unemployment, and financial harm. The findings question the public good benefits of the vaccine mandate when it restricts the freedom, autonomy, and agency of much-needed healthcare professionals, which provide useful insights.
Does the Implementation of a Model of Care Improve the Value for Money of Mental Health Services in Prisons?
(Wiley, 2025-08-13) Rouse, P; Pillai, K; McKenna, B; Simpson, A; Cavney, J; Skipworth, J; Tapsell, R; Madell, D
BACKGROUND: There is little research into appropriate measures of value for money in prison mental health services. AIMS: To develop and evaluate an accountability framework for an enhanced Prison Model of Care for people with serious mental illness in five New Zealand prisons. A key objective was to identify people with such illnesses who were missing from existing caseloads. METHODS: A generic public sector accountability framework was modified to provide measures of value for money around efficiency in its three component criteria of effectiveness and economy using a pre/post design, allowing measurement of flows between successive stages of this prison healthcare model. Measures were arranged into common dimensions around outcomes, outputs, inputs and costs, varied across the stages. The framework was populated with data collected from five prisons for the pre- and post-implementation periods. RESULTS: Improvements in the three criteria were generally obtained across all five areas of service delivery but especially in the screening, assessment, intervention and reintegration stages. Since these three criteria are major components of value for money, they provide evidence for improvement in value for money of the mental health services in these prisons. Other desired operational changes achieved were a threefold increase in the nurse to doctor ratio at the triage stage and slight increase in doctor to nurse ratio at the treatment stage. Overall, the implementation of this model of care achieved an increase in the size of caseload from 6.1% to 7.3% of the prison muster, equivalent to an increase in caseload of 21%. CONCLUSIONS: This accountability framework confirmed the value for money of the Prison Model of Care for severe mental illness, highlighting areas of good performance as well as areas requiring further development. The framework also provides measures that can be used as key performance indicators in ongoing monitoring.
Nurses and Consumer Consultants Perspectives on the Implementation of a Novel Violence Risk Assessment and Intervention Framework
(Wiley, 2025-09-18) Maguire, Tessa; McKenna, Brian; Furness, Trentham; Daffern, Michael
Interventions to prevent aggression and reduce use of restrictive practices are essential for recovery‐oriented mental health nursing care. This study explored how nurses can best enhance employment of a structured risk assessment instrument paired with an aggression prevention protocol. Fourteen nurses with responsibilities for reducing restrictive practices attended focus groups, and three consumer consultants working with mental health nursing staff participated in one‐to‐one interviews. The focus groups and interviews were designed to elicit recommendations to assist nurses use of the violence risk assessment instrument and apply the protocol interventions. Thematic analysis was used to analyse the data. Four themes were interpreted from the data. Theme one: The nurses are experiencing incredible difficulty talking about how they can be supported. Theme two: ‘calming the farm’: The need to self‐regulate, with the subthemes: (1) some nurses may need support to ‘calm the farm’ and (2) if you can't ‘calm the farm’ another nurse may need to step in. Theme three was the need for robust training and education and the final theme was: The need for ‘decompressing’ before leaving the shift. Participants suggested while some nurses were very skilled at regulating their emotions while intervening to prevent violence, some had difficulty, or were not aware of their emotional state, and may need support from colleagues when intervening. Suggestions for enhancing the application of aggression prevention interventions include use of mental wellness check‐in forms, engaging in clinical supervision and safety huddles at the end of the shift to assist nurses to decompress before leaving.
“Waiting for Someone to Ask”: Successful Implementation of an IPV Response by Bicultural Settlement Staff with Refugee Women in Australia
(Informa UK Limited, 2025-09-01) Cameron, J; Spence, N; Spangaro, J; Toole-Anstey, C; Hegarty, K; Koziol-McLain, Jane; Zwi, A; Walsh, J; McMahon, T; Perry-Indermaur, A
Refugee women are less likely to seek support for intimate partner violence (IPV). This study examined an IPV intervention by bicultural settlement staff in Australia, aiming to enhance the capacity of settlement services to address IPV. The Safety and Health After Arrival (SAHAR) study was conducted in five settlement services in New South Wales. Bicultural caseworkers were trained to use the ACTS IPV screening tool and follow-up protocol, translated into several languages. Data were collected through focus groups (24 caseworkers, 4 IPV specialists) and interviews (5 managers). Seven themes emerged: (1) Confidence grew rapidly; (2) Clear and simple tools matter; (3) Language matching facilitates connection; (4) Settlement services can do this; (5) Disclosing is more complex for refugee women; (6) Care and inclusivity enable disclosure and help-seeking; (7) Women choose different pathways. Culturally tailored interventions and bicultural workers are crucial for supporting IPV disclosure and response. Implementing IPV screening in settlement services is feasible, increasing IPV awareness and providing disclosure opportunities. Ongoing training, support, and further research on long-term sustainability are needed.
Knowledge, Attitude, and Practice Regarding Trauma-Informed Care Among Nursing Students in Eastern China: A Cross-Sectional Study
(Belitung Raya Foundation, 2025-08-03) Zhang, Di; Songwathana, Praneed; Vachprasit, Ratjai; Holroyd, Eleanor
BACKGROUND: Patients with a history of traumatic life events who enter the healthcare system are especially vulnerable, often posing greater challenges to care delivery. However, little is known about the capacity of nursing staff, especially nursing students, to deliver trauma-informed care (TIC). OBJECTIVE: This study aimed to assess the knowledge, attitude, and practice of trauma-informed care among Chinese nursing students. METHODS: A cross-sectional study was employed to survey undergraduate nursing students from a medical college in eastern China. Data were collected using an established self-administered questionnaire on TIC knowledge, attitude, and practice (KAP) consisting of 21 items. The content validity scale-level CVI was 0.950, and the reliability with Cronbach's α coefficient was 0.963. RESULTS: A total of 118 undergraduate nursing students, ranging from first to fourth year, participated in the survey, and ultimately, 117 students were included in the study, yielding an effective response rate of 99.15%. The average scores for KAP were 70.83±14.58, 77.78±11.11, and 66.67±16.67; however, the good levels of KAP accounted for 16.2%, 45.3% and 6.0%, respectively. Additional analysis showed a weak positive correlation between knowledge and attitude (rs = 0.211, p = 0.022), while there was a moderate positive correlation between knowledge and practice, attitude and practice (rs = 0.309, p < 0.001; rs = 0.310, p < 0.001). Univariate analysis indicated that year of study and experience in caring for trauma patients were significantly related to practice (p = 0.039, p = 0.002). CONCLUSION: The students' KAP on trauma-informed care was not at a good level, especially regarding practice and knowledge, and required further strengthening. The findings provide baseline information for further development of a KAP-TIC comprehensive course and exploration of practice ability-centered TIC education for nursing students. Assessing the effectiveness of the newly developed TIC course and learning outcomes in clinical practice is also recommended.
A Critical Reading of Solastalgia Through Indigenous and Care Ethics Lenses
(Informa UK Limited, 2025-08-06) Baker, Eridani; Jones, David Kukutai; Brannelly, Tula
Solastalgia is the emotional response elicited by ecological degradation, originating from the concepts of solace, desolation, and pain. Climate change has profound societal and health impacts especially for marginalised communities who face food shortages, poverty and forced displacement. Indigenous peoples have deep relational ancestral connections with the land that are beyond connection to place, and experience unique intensified forms of distress resulting from environmental degradation. For Indigenous peoples, connections with land are disrupted through extractive politics such as colonisation and now climate emergency, legacies that leave deleterious effects on wellbeing. In collective Indigenous cultures, distress is embedded within wider contexts of community, history, and the earth itself. This paper critically reviews solastalgia from Māori and care ethics perspectives to demonstrate the power of adding relational, contextual, and embodied elements to the concept. This paper argues for the incorporation of Indigenous knowledge in the conceptualisation of climate-related distress. Māori notions of voice and place inform research approaches that are in solidarity with Indigenous voice to examine the impacts of climate degradation.
The Tīvaevae Methodology and its Application to Palliative Care Research
(Macmillan Brown Centre for Pacific Studies, 2025-08) Henry, Amy
Health researchers have an ethical responsibility to ensure their research aligns with the health and wellbeing needs, solutions, and aspirations of the communities they study. This ethical responsibility is often heightened in palliative care research. This article reflects on the use of the Tīvaevae methodology – a Cook Islands research methodology – in a study which aimed to understand what palliative care means to Cook Islands families in New Zealand. There is limited research on the needs and understanding of palliative care for Pacific peoples and a near absence of literature that focuses on the needs of Cook Islands peoples in palliative care. More broadly, there is little documented on Cook Islands cultural understandings and knowledge on death, dying, and end-of-life care. As the majority of Cook Islanders reside in New Zealand, and new generations of Cook Islanders in New Zealand find themselves in the position of becoming caregivers to palliative (and often older) family members, understanding what their needs are will be important for families and clinicians alike. In this article, I argue that the Tīvaevae methodology can be used as a guide in the process of contextualising the concept of palliative care to understand palliative care within a Cook Islands context.
Patterns, Advances, and Gaps in Using ChatGPT and Similar Technologies in Nursing Education: A PAGER Scoping Review
(Elsevier BV, 2025-07-05) Amankwaa, Isaac; Ekpor, E; Cudjoe, D; Kobiah, E; Fuseini, AKJ; Diebieri, M; Gyamfi, S; Brownie, S
Background and aim: Generative AI (GenAI) can transform nursing education and modernise content delivery. However, the rapid integration of these tools has raised concerns about academic integrity and teaching quality. Previous reviews have either looked broadly at artificial intelligence or focused narrowly on single tools like ChatGPT. This scoping review uses a structured framework to identify patterns, advances, gaps, evidence, and recommendations for implementing GenAI in nursing education. Methods: This scoping review followed the JBI methodology and PRISMA-ScR guidelines. We searched PubMed, CINAHL, SCOPUS, ERIC, and grey literature (October to November 2024). Data synthesis utilised the PAGER framework as a mapping tool to organise and describe patterns, advances, gaps, evidence for practice, and recommendations. Results: Analysis of 107 studies revealed GenAI implementation across four key domains: assessment and evaluation, clinical simulation, educational content development, and faculty/student support. Three distinct implementation patterns emerged: restrictive, integrative, and hybrid approaches, with hybrid models demonstrating superior adoption outcomes. Technical advances showed significant improvement from GPT-3.5 (75.3 % accuracy) to GPT-4 (88.67 % accuracy) in NCLEX-style assessments, with enhanced capabilities in multilingual assessment, clinical scenario generation, and adaptive content creation. Major gaps included limited methodological rigour (29.0 % of empirical studies), inconsistent quality control, verification challenges, equity concerns, and inadequate faculty training. Geographic distribution showed North American (42.1 %) and Asian (29.9 %) dominance, with ChatGPT representing 83.2 % of tool implementations. Key recommendations include developing institutional policies, establishing quality verification protocols, enhancing faculty training programs, and addressing digital equity concerns to optimise GenAI integration in nursing education. Conclusions: GenAI has transformative potential in nursing education. To realise its full potential and ensure responsible use, research should focus on developing standardised governance frameworks, empirically validating outcomes, developing faculty in AI literacy, and improving technical infrastructure for low-income contexts. Such efforts should involve international collaboration, highlighting the importance of the audience's role in the global healthcare community.

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