US Cosmic Visions: New Ideas in Dark Matter 2017: Community Report

This white paper summarizes the workshop "U.S. Cosmic Visions: New Ideas in Dark Matter" held at University of Maryland on March 23-25, 2017.Comment: 102 pages + reference

The role of empowerment in the care of patients who experience severe pain : the nurse’s perspective

Hospitalised patients continue to experience significant levels of pain despite advances in pain management knowledge and techniques. Evidence from nurses practicing in specialty and community settings suggests that caring for patients who experience persisting pain has implications, both personally and professionally. This grounded theory study described and explained the effect of caring for patients who experienced severe pain on nurses working in medical and surgical wards of a Western Australian hospital. Data were collected from a sample of 33 nurses through 30 semi-structured interviews and 93 hours of participant observation. Eleven patients who were experiencing severe pain participated in structured observations Audio-recordings of interviews and field notes were transcribed verbatim and analysed using the constant comparative method.The substantive theory of seeking empowerment to provide comfort was developed in this grounded theory study. This substantive theory explained the emotional effects on nurses and their response to caring for patients with severe pain. The provision of comfort to patients and the maintenance of the well-being of the nurse were key elements.The substantive theory of seeking empowerment to provide comfort was developed in this grounded theory study. This substantive theory explained the emotional effects on nurses and their response to caring for patients with severe pain. The provision of comfort to patients and the maintenance of the well-being of the nurse were key elements.In this study, empowerment was found to be an outcome and a process and the core category that integrated the substantive theory. As an outcome, empowerment was the psychological state nurses experienced when they felt able to provide comfort. As a process, empowerment was the means by which nurses sought to avoid the shared problem of feelings of disempowerment to enhance their patients’ and their own wellness. The process of seeking empowerment to provide comfort explained nurses’ actions and interactions to avoid feelings of disempowerment by building connections with patients and colleagues, finding alternative ways to comfort when pain relief was ineffective and quelling emotional turmoil to conserve their resources and protect their own well-being. Nurses were shown to progress through these stages as their experiences of disempowerment escalated.This research illuminates the problem encountered by nurses when they care for patients who experience severe pain and the process they use to manage this problem. A striking finding of this study was the depth of emotional distress experienced by some nurses who felt powerlessness to assist patients in pain. Evidence also emerged of behaviours used by nurses to protect themselves from ongoing feelings of disempowerment. There are significant implications for both patients and nurses in these findings. This study provides direction for interventions to support nurses who practice in acute hospital settings and to facilitate patient comfort and nurse well-being. A number of indications for areas of further research are also provided

Barriers and enablers to retention of Aboriginal Diploma of Nursing students in Western Australia: An exploratory descriptive study

Background: Nursing education appropriate to the learning needs of Aboriginal and Torres Strait Islander students is essential to prepare them for registration as nurses. Despite incentives to encourage the recruitment and retention of such students, a disproportionate number commence but do not finish their nursing studies. Objectives: To describe the barriers and enablers to the retention of Aboriginal students in a Diploma of Nursing course (Enrolled/Division 2) in Western Australia. Design: An exploratory descriptive design was used. Settings: One metropolitan educational facility catering for Aboriginal people offering an 18-month course in a block release format. Participants: A convenience sample of 16 students aged 18 + years. Methods: Newly enrolled students (n = 10) participated in an investigator-developed survey to explore their motivation for entering the course. Nine of these students and a further seven students who were nearing the end of their course participated in focus groups to explore their experiences of nursing education. Results: Survey respondents had a mean age of 32.7 years; most were female, had nominated family as influential in the decision to enrol, and commenced with a friend. Regarding recruitment and retention, the qualitative data highlighted the importance of students': perceptions of the training organisation, characteristics, experiences of nursing education, and sources of support. Conclusions: Strategies that develop individual's resilience and engage supportive networks can assist Aboriginal students to negotiate tertiary nursing study. Academic skills assessments supplemented with tailored educational support at entry can resource students to navigate increasingly complex course content. Flexibility throughout the course enables students to negotiate study in a context of ongoing family and financial obligations

Adaptation and pretesting of the College Persistence Questionnaire V3 (Short Form) for measuring intention to persist among Aboriginal Diploma of Nursing students

© 2017 Elsevier Ltd Background Culturally appropriate health care delivery is essential to improve health outcomes for Aboriginal peoples. There is a shortage of Aboriginal and Torres Strait Islander nurses partly due to disproportionately high non-completion rates among tertiary sector students. The College Persistence Questionnaire V3 (Short Form) provides scales for gauging major predictors of retention. Objective To adapt an instrument for measuring intention to persist among Aboriginal Diploma of Nursing students. Design Instrument adaptation and pretesting. Participants A convenience sample of Aboriginal Diploma of Nursing students (N = 21) at a registered training organisation in Australia. Methods The instrument was mapped against the domain of interest and modified. Ten experts reviewed its content validity; its reading ease and educational grade reading level were assessed. Results The expert panel endorsed individual items as valid (item-level Content Validity Index 0.90–1.00) and scale-level validation was acceptable (average scale-level Content Validity Index = 0.98). The minimally-adapted instrument was ‘fairly easy’ to read and suitable for general adult audiences (Flesch Reading Ease score 71.3) and was below the United States 8th grade reading level (Flesch-Kincaid Grade Level 6.7). Students took < 30 min to complete the questionnaire. All understood its purpose, found instructions clear, and questions easy to answer. Most rated its length ‘Just right’. Conclusion The College Persistence Questionnaire – Registered Training Organisation Version appears suitable for assessing factors influencing retention/attrition among Aboriginal Diploma of Nursing students. Piloting and psychometric evaluation is recommended

Development and pilot testing of the “focus on the person” form: Supporting care transitions for people with dementia

When people with dementia are hospitalised, their capacity to communicate with the staff may be limited, compounding risks of distress and other adverse outcomes. Opportunities for carers to share relevant information to inform appropriate person-centred care are also limited. This four-phase mixed methods study aimed to develop an evidence-based family carer–staff communication form, the Focus on the Person form, to address this concern. In Phase I, a literature review plus consultation with clinicians and carers informed form development. In Phase II, the professionally formatted form was piloted by 31 family carers, who were then interviewed about their experiences. These data, combined with data from 30 hospital staff members who participated in Phase III focus groups, led to final, Phase IV, refinements of the form. The form now provides an opportunity for families to inform the person-centred care of people with dementia in hospital, potentially improving outcomes for this vulnerable group