Bandura's exercise self-efficacy scale: Validation in an Australian cardiac rehabilitation setting

Background. Despite the established benefits of cardiac rehabilitation (CR) in improving health outcomes for people with cardiovascular disease, adherence to regular physical activity at recommended levels remains suboptimal. Self-efficacy has been shown to be an important mediator of health behaviour, including exercise. Objectives. To assess the psychometric properties of Bandura's exercise self-efficacy (ESE) scale in an Australian CR setting. Design. Validation study. Setting. Cardiac rehabilitation. Participants. One hundred and ten patients (Mean: 60.11, S.D.: 10.57 years). Methods. Participants completed a six-minute walk test (6MWT) and Bandura's exercise self-efficacy scale at enrolment and on completion of a 6-week CR program. Results. Bandura's ESE scale had a single factor structure with high internal consistency (0.95), and demonstrated no floor or ceiling effects. A comparison of ESE scores by distance walked on 6MWT indicated those who recorded more than 500m at baseline had significantly higher ESE scores (Mean: 116.26, S.D.: 32.02m) than those patients who only achieved up to 400m on the 6MWT at baseline (Mean: 89.94, S.D.: 29.47m) (p=0.044). A positive and significant correlation between the change in scores on the ESE scale and the change in the 6MWT distance (r=0.28, p=0.035) was seen. Conclusions. The ESE scale was a robust measure of exercise self-efficacy over the range of patients attending this outpatient cardiac rehabilitation program. Interventions to improve self-efficacy may increase CR patient's efficacy for regular physical activity

Nurse educators in Australia: High job satisfaction despite role ambiguity

Purpose: The purpose of this study was to describe the nurse educator role in Australian hospitals, including their practice and performance standards. Methods: A cross-sectional, online survey of nurse educators employed in acute care hospitals in Australia was administered over a three-month period. The survey comprised established and researcher-developed scales, and a single open-ended question. Quantitative data was analysed using descriptive statistics. Qualitative data was analysed using a general inductive approach. Results: Nurse educators who were more likely to fulfill nurse educator competency practice domains had master’s degrees in education, defined professional development needs, and met regularly with their managers. These educators also had higher levels of job satisfaction. Participants identified that role ambiguity and role confusion adversely impacted nurse educator role expectations, responsibilities, and job satisfaction. Despite this, the majority of educators intended to stay in their role for the foreseeable future. Conclusions: Role ambiguity influenced professional identity and job satisfaction, highlighting the need for clarification of nurse educator roles. These findings suggest the need for review of the nurse educator role and incorporation of professional and educational requirements and practice competencies. Ongoing role monitoring is recommended to identify the effects of role change

Overcoming barriers to guideline implementation: the case of cardiac rehabilitation

Aims: This study explored the strategies used by cardiac rehabilitation (CR) coordinators to overcome the obstacles to implementation of the evidence-based Reducing Risk in Heart Disease guidelines. Methods: The study design used qualitative, semistructured in-depth interviews with 20 CR coordinators from New South Wales, Australia, to explore the strategies used to facilitate guideline implementation. Non-probability sampling was used torecruit CR coordinators to obtain a broad understandingof the issues. Interviews were transcribed and thematic content analysis was undertaken to identify common themes. Results: Coordinators addressed the barriers to implementing guidelines through their commitment tobest practice and striving to overcome the odds through providing opportunistic health education, alternate methods of secondary prevention, and partnering and engaging with local communities.Conclusions: Although CR coordinators face multiplebarriers to implementing evidence-based guidelines for patients with coronary heart disease, they use strategies such as harnessing community capacity and using available resources creatively. The development ofa more integrated, multifactorial and coordinated approach to improving use of guidelines in clinical practice to improve the treatment and secondary prevention of coronary heart disease is urgently needed

Heart Disease and Depression: Is Culture a Factor?

Purpose: This article seeks to review and discuss the evidence linking depression, coronary heart disease (CHD), and culture. Method: PsychInfo, CINAHL, PubMed, and Google were searched for pertinent evidence linking depression, culture, and CHD, and retrieved articles were analyzed using thematic content analysis. Findings: Identified themes were the followings: depression is a factor in development and prognosis of CHD and affects the capacity to self-manage and adhere to treatment recommendations; culture mediates mental health/illness representations and treatment-seeking behaviors; screening and assessment of depression can be affected by cultural factors; and there is a need for culturally appropriate screening and therapeutic strategies. Discussion and Conclusions: As depression is a predictor and moderating variable in the genesis and progression of CHD, understanding how factors such as culture affect screening and management of the disease is important to inform the development of culturally and linguistically competent strategies that ensure accurate screening, detection, and treatment of depression in cardiac patients in clinical practice. © 2014, SAGE Publications. All rights reserved

Facilitators and Barriers to Health-Seeking Behaviours among Filipino Migrants: Inductive Analysis to Inform Health Promotion

Understanding factors that influence health-seeking behaviour of migrants is necessary to intervene for behaviour change. This paper explores Filipino migrants’ perceptions of facilitators and barriers to maintaining health in Australia. Open-ended survey item responses reflecting factors that assisted and hindered health following migration to Australia were inductively analysed. Three hundred and thirty-seven of the 552 survey respondents (61%) provided open-ended responses. Responses were grouped into two major categories: individual factors, including personal resources and cultural influences, and environmental factors encompassing both the physical conditions in the host country and health service access. Awareness of practices that enhance health was a major personal facilitator of health-seeking behaviour; however, competing priorities of daily living were perceived as barriers. Cultural beliefs and practices influenced health-seeking behaviour. Despite high self-rated English language skills in this population, new migrants and the elderly cited communication difficulties as barriers to accessing health services. Insight into facilitators and barriers to health-seeking behaviour in this less researched migrant population revealed tools for enhancing engagement in health promotion programs addressing healthy lifestyle

An examination of responses to surveys among Filipino-Australian migrants

© 2016 RCNi Ltd. All rights reserved. Background Surveys are frequently used to collect data. Although paper surveys are commonly used, online surveys are gaining in popularity, with the inclusion of open-ended questions (OEQs) allowing respondents to freely express their views. Little is known about how Filipino-Australian migrants respond to surveys. There is some concern about the usefulness of OEQs administered to culturally and linguistically diverse migrants, who may have limited capacity to articulate their thoughts in writing. Aim To examine the responses of Filipino-Australian migrants to a survey. Discussion A total of 552 respondents were recruited, of whom 428 (78%) completed the questionnaire online. The overall response rate to the OEQs was 69%, with higher completion rates among those given a paper-based questionnaire and those with university educations. Conclusion Filipino migrants with functional English language skills responded well to the online survey. Paper-based administration elicited more OEQ responses, which is attributed to greater interaction between participants and researchers. Those with university educations may have more capacity to express themselves in English and were therefore more likely to complete the OEQs. Implications for practice The high response rate obtained in this study suggests that among Filipino-Australian migrants who rated their English language skills and educational level highly, the translation of OEQs may not be necessary. This has important implications for resources in research. Face-to-face interaction between participants and researchers is an important strategy for increasing the rates of response to OEQs

The evolution of nursing in Australian general practice: A comparative analysis of workforce surveys ten years on

Background: Nursing in Australian general practice has grown rapidly over the last decade in response to government initiatives to strengthen primary care. There are limited data about how this expansion has impacted on the nursing role, scope of practice and workforce characteristics. This study aimed to describe the current demographic and employment characteristics of Australian nurses working in general practice and explore trends in their role over time. Methods. In the nascence of the expansion of the role of nurses in Australian general practice (2003-2004) a national survey was undertaken to describe nurse demographics, clinical roles and competencies. This survey was repeated in 2009-2010 and comparative analysis of the datasets undertaken to explore workforce changes over time. Results: Two hundred eighty four nurses employed in general practice completed the first survey (2003/04) and 235 completed the second survey (2009/10). Significantly more participants in Study 2 were undertaking follow-up of pathology results, physical assessment and disease specific health education. There was also a statistically significant increase in the participants who felt that further education/training would augment their confidence in all clinical tasks (p < 0.001). Whilst the impact of legal implications as a barrier to the nurses' role in general practice decreased between the two time points, more participants perceived lack of space, job descriptions, confidence to negotiate with general practitioners and personal desire to enhance their role as barriers. Access to education and training as a facilitator to nursing role expansion increased between the two studies. The level of optimism of participants for the future of the nurses' role in general practice was slightly decreased over time. Conclusions: This study has identified that some of the structural barriers to nursing in Australian general practice have been addressed over time. However, it also identifies continuing barriers that impact practice nurse role development. Understanding and addressing these issues is vital to optimise the effectiveness of the primary care nursing workforce. © 2014Halcomb et al.; licensee BioMed Central Ltd

Development of a health-related lifestyle self-management intervention for patients with coronary heart disease

Risk-factor modification after an acute coronary event is imperative, and intervention strategies are continuously being developed to assist patients with behavioral change and, consequently, decreasing the risk of further coronary episodes. This article describes the development of the health-related lifestyle self-management (HeLM) intervention, which is a brief structured intervention embedded within the transtheoretical model of behavioral change. The HeLM intervention was developed by undertaking three discrete yet interrelated studies and consisted of the following components: goal-setting, the HeLM booklet, feedback regarding personal risk, team-building and communication with the patient's family physician, three supportive telephone calls, trained interviewers, a refrigerator magnet, and a health diary for self-monitoring. The HeLM intervention has been successfully implemented in 50 patients with acute coronary syndrome after discharge from hospital and has been demonstrated to be feasible and practical and could easily be delivered by health care professionals

A review of the six-minute walk test: Its implication as a self-administered assessment tool

Promoting self-management and monitoring physical activity are important strategies in chronic heart disease (CHD) management. The six-minute walk test (6MWT) is a commonly used sub-maximal exercise test for measuring physical functional capacity. The aim of this paper is to review the current literature on 6MWT relating to methodological issues as well as exploring the potential of the protocol to be adopted as a self-administered exercise test. The Medline, CINAHL, Science Direct and the World Wide Web using the search engine Google, were searched for articles describing the administration, reliability and validity of the 6MWT. Findings of the integrative literature review the 6MWT is a simple, safe tool. To date, the capacity for self-administration of the 6MWT has not been investigated. Adapting the 6MWT as a patient-reported outcome measure may enhance the capacity, not only for clinicians to monitor functional status, but also promote self-management by enabling individuals to monitor changes in their functional capacity

Health-Seeking Behaviors of Filipino Migrants in Australia: The Influence of Persisting Acculturative Stress and Depression

© 2015, Springer Science+Business Media New York. This study examined the relationships among the constructs of acculturative stress, depression, English language use, health literacy, and social support and the influence of these factors on health-seeking behaviors of Filipino Australians. Using a self-administered questionnaire, 552 respondents were recruited from November 2010 to June 2011. Structural equation modelling was used to examine relationships. A direct and negative relationship between health-seeking behaviors and depression, and an indirect relationship with acculturative stress, was observed mediated through depression. Social support had an important moderating influence on these effects. Although there was an inverse relationship between age and English language usage and depression, age was positively related to health-seeking behavior. Despite their long duration of stay, Filipino Australian migrants continue to experience acculturative stress and depression leading to lower health-seeking behaviors. This study highlights the importance of screening for acculturative stress and depression in migrants and fostering social support