Holly Northam

The rates of Aboriginal and/or Torres Strait Islander infant removal are disproportionately rising, affecting mother–infant attachment, disrupting breastfeeding and preventing infants' access to optimal nutrition. This significantly contributes to negative long‐term health and wellbeing outcomes of children. Operating at the intersection of midwifery care and child protection services presents an ethical dilemma for midwives, who are required to provide culturally safe and respectful care while working with women during the perinatal period. The aim of this article is to present the exploration of breastfeeding experiences of Aboriginal women, in the Australian Capital Territory, in the context of a child protection intervention or child removal. Using an Aboriginal Participatory Action Research approach, data were collected using a social and research‐topic yarning method, with five Aboriginal women. Data were analysed using reflexive thematic network analysis and then reanalysed through an interpretivist lens to present the data as vignettes. Women who had child protection involvement reported a lack of breastfeeding support from midwives and nurses that resulted in disrupted and unsupported breastfeeding. The women's involvement with child protection services led to experiences of stigma, oppressive practices and judgemental attitudes from midwives and nurses, that are evidence of professional breaches which impacted the mothers and infants' ability to benefit from breastfeeding. These findings point to the urgent need for midwives, nurses, and child protection workers to 1. Be accountable to work in culturally safe ways; 2. To privilege breastfeeding and 3. Provide supports to empower women to breastfeed to enable infants to have the ‘best start in life’ for an equitable future. Restorative approaches are proposed as a way forward to address these relational harms.

Background/Objectives: Qualitative research suggests there may be identifiable characteristics that form a health professional (HCP) archetype associated with habitual seasonal influenza vaccination (SIV). However, the validity of this archetype requires further investigation, ideally within a theoretical framework that can elucidate this association and its generalisability to other vaccines. This study aims to confirm key HCP archetype characteristics associated with SIV, as informed by prior qualitative research findings, and test the generalisability of the association between this archetype and SIV to COVID-19 vaccine acceptance. Method: A cross-sectional survey was designed and distributed to an Australian HCP sample consisting of practicing nurses, midwives, pharmacists, and medical practitioners. The anonymous online survey measured key characteristics that predict vaccination behaviour and intention. Results: Most participants (n = 173) demonstrated habitual SIV behaviour (77.91%) associated with the intention to vaccinate in the future. Survey findings supported the HCP archetype, as key constructs were associated with vaccination intention and behaviour, including heightened professional responsibility, vaccine confidence, and protection of self and patients. Furthermore, results suggested progressing vaccination intention to behaviour, overcoming vaccine complacency, is possible through the provision of free, accessible vaccination services. These critical factors were broadly generalisable to the COVID-19 vaccine. Conclusions: A vaccination-positive HCP archetype, supported by access to free, convenient vaccination services, was associated with the likelihood of future vaccination behaviour, including in future pandemic response scenarios. However, it will be important to ensure that HCP vaccine knowledge gaps are minimised to enhance trust in this cohort to enable broad success.

To illuminate opportunities for care in the context of deceased organ donation by exploring pre-existing family and healthcare professional characteristics, in-hospital experiences, and ongoing adjustment through the lenses of grief theory, systems theory, meaning-making, narrative, and organ donation literature. Qualitative longitudinal case studies explored individual and family change in five Australian families who had consented to Donation after Circulatory Determination of Death at a single centre. Participants attended semi-structured interviews at four, eight, and twelve months after the death. Family values, pre-existing relationships, and in-hospital experiences influenced first responses to their changed lives, understanding of the patient’s death, and ongoing family adjustment. Novel behaviour that was conguent with family values was required at the hospital, especially if the patient had previously played a key role in family decision-making. This behaviour and emerging interactional patterns were drawn into family life over the first year of their bereavement. Training that includes lenses introduced in this study will enable healthcare professionals to confidently respond to individual and family psychosocial needs. The lenses of grief theory and systems thinking highlight opportunities for care tailored to the unique in-hospital context and needs that emerge in the months that follow.

Aims and objectives: To explore the determinants of and behaviour change models for seasonal influenza vaccination compliance among healthcare personnel.Background: COVID‐19 vaccine hesitancy among healthcare personnel may be better understood by exploring determinants of seasonal influenza vaccine hesitancy.Design: Integrative literature review.Methods: A systematic search was conducted in accordance with PRISMA guidelines. Six thousand and forty‐eight articles were screened. Seventy‐eight met inclusion criteria. Due to the heterogeneity of included articles, a narrative synthesis was conducted utilising a conceptual matrix to identify thematic categories.Results: Six thematic categories were identified as influencing HCP SIV compliance: ‘perceived vulnerability’, ‘trust’, ‘past behaviour’, ‘professional duty’, ‘access and convenience’ and ‘knowledge and experience’. The Health Belief Model (HBM) was the most commonly utilised health behaviour change model within the seasonal influenza vaccination context. Few studies have examined seasonal influenza vaccine acceptance and uptake within the Australian HCP context, particularly involving community care and aged care.Conclusions: Factors that appear to relate to influenza vaccination compliance among HCP can be grouped according to several thematic categories, and they also appear influential in COVID‐19 vaccine uptake. In particular, an emerging focus on ‘trust’ or the more emotive considerations of decision‐making around health‐protective behaviours requires further exploration in the context of a pandemic. Efforts to influence these domains to increase compliance, however, are likely to be impeded by a lack of a well‐developed and tested behaviour change model.Relevance to clinical practice: Healthcare personnel (HCP) face high levels of occupational exposure to seasonal influenza every year. An emerging focus on ‘trust’ and the more emotive considerations of decision‐making around health‐protective behaviours requires further exploration in the context of a pandemic.

The organ donation process is complex and stressful for the family of the potential donor and members of the multidisciplinary team who may experience grief, ethical dilemmas, vicarious trauma, or compassion fatigue. Several studies each explore the role of a specific healthcare group and the impact of inhospital processes on group members. We conducted a systematic literature search to identify such studies and a qualitative synthesis to consolidate findings and highlight features of the interaction and relationships between role players. Our results suggest that, while healthcare professionals have different roles, attitudes, and views, the experience of stressors and interdisciplinary tension is common. Nevertheless, staff are united by the goal of caring for the patient and family. We therefore propose that, while focusing on bereavement care and other aspects of the family’s experience, staff can find other shared goals and develop understanding, trust, empathy, and respect for each other’s positions, thereby improving functioning in the complex adaptive system that forms at this time. Education and training can equip staff to facilitate anticipatory mourning, family-led activities, and a meaningful parting from their relative, assisting families with their grief and increasing staff members’ efficacy, confidence, and interdisciplinary teamwork. Knowledge of systems thinking and opportunities to share ideas and experiences will enable staff to appreciate each other’s roles, while supportive mentors, self-care strategies, and meaningful feedback between role players will foster healthy adjustment and shared learning. A focus on psychosocial outcomes such as family satisfaction with the process, collaboration within the multidisciplinary team, and reduction in the role stress of healthcare professionals will contribute to family well-being as well as personal and professional growth for staff.

Critical care nursing involves the specialised nursing care of critically ill patients who are vulnerable and may be unable to voice their needs or have their human rights recognized or addressed. The World Federation of Critical Care Nurses (WFCCN) accepts and supports the Universal Declaration of Human Rights and the need for critically ill patients to be cared for with humanity, and to advocate for the rights of their families and communities. In the above context, WFCCN determined the need to create a document that was focused more specifically on the rights of critically ill patients. To this end, in August 2007, the WFCCN released its first Position Statement on the Rights of the Critically Ill Patient - The Declaration of Manila (WFCCN, 2007). The fundamental aim of this Declaration was to inform and assist critical care nursing associations, health services, educational facilities, and other interested parties to realize the rights of critically ill patients. Due to changes in critical care worldwide, as well as increased global migration, the WFCCN Board of Directors commissioned a review of the 2007 Declaration. As a result of this review, revisions were undertaken. This document represents the 2019 revised WFCCN Position Statement on the Rights of the Critically Ill Patient.