Rebekkah Middleton - Academia.edu (original) (raw)

Papers by Rebekkah Middleton

Nurse researcher, Jun 12, 2024

International Journal of Educational Research

The Australian Nursing and Midwifery Journal, Nov 1, 2017

It is well known that Australian rural communities are confronted with significantly greater heal... more It is well known that Australian rural communities are confronted with significantly greater health disparities than their metropolitan counterparts (Rural Health Standing Committee 2011).

Nurse Education in Practice, Aug 1, 2022

The Australian Nursing and Midwifery Journal, Oct 1, 2020

Journal of Advanced Nursing, Jul 21, 2022

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-... more This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Collegian, Dec 1, 2021

Background : The emergence of COVID-19 has substantially impacted frontline health care workers, ... more Background : The emergence of COVID-19 has substantially impacted frontline health care workers, including nurse managers. To date, no studies have been conducted to examine the impact COVID-19 has had on Nurse Managers’ mental health, coping strategies and organisational commitment. Aim : To investigate the mental health, coping behaviours and organisational commitment among Nurse Managers during the COVID-19 pandemic. Methods : Cross-sectional study involving 59 Nursing Managers from one Local Health District in Sydney Australia during the first wave of the COVID-19 pandemic. Data were collected relating to demographics, anxiety, coping strategies and organisational commitment. Results : Overall, approximately three quarters of the Nurse Managers had high anxiety scores. Managers who had worked longer as a nurse had higher scores for adaptive coping strategies and 41% of Nurse Managers considered leaving their job. Conclusions : Strategies to minimise anxiety and enable coping as part of organisational disaster, emergency or crisis planning for Nurse Managers may result in decreased anxiety and stress levels, increased use of adaptive coping strategies and lower intent to leave the organisation and the nursing profession.

Nurse Researcher, Sep 9, 2021

Action research (AR) provides a robust platform for collaboration to develop and evaluate nursing... more Action research (AR) provides a robust platform for collaboration to develop and evaluate nursing practice. It results in several outcomes, including changes in evidence-based practice, the development of research capacity, and the evaluation and sustainability of interventions, all of which can be seen as benefits compared to other approaches. However, the methodology involves cycles of action, reflection, theory and practice, so it can be challenging to maintain momentum when engaging with teams over long periods of time. To offer strategies for maintaining momentum when using AR in nursing research. Three strategies for maintaining momentum when undertaking AR are covered. Theory, literature and experience of using AR in which the strategies of 'connecting as people', 'working with the context' and 'understanding the influence of the leadership team' made a considerable difference in maintaining momentum and are drawn on. Maintaining momentum in studies that use AR can be arduous, but critical reflection enables researchers to identify and overcome the challenges that arise. Researchers undertaking AR can apply the three strategies provided or other approaches to maintain momentum during all phases of a study. Maintaining momentum in AR studies is more successful when researchers connect with those with whom they are undertaking research. It is advantageous for nurse researchers to reflect on and understand the influence of the leadership team and context rather than try to adapt them to the study's or their own needs.

Journal of Advanced Nursing, Jun 16, 2023

Nursing Ethics, Jun 6, 2023

Undertaking research involving vulnerable groups, such as those requiring resuscitation involves ... more Undertaking research involving vulnerable groups, such as those requiring resuscitation involves careful analysis during the ethical review process. When a person lacks the capacity to make an informed choice about their participation in a research study, a waiver of consent offers an alternative. This paper is based on a doctoral research study using ethnography to explore the resuscitative practices and experiences of rural nurses through observation and interviews. This paper aims to explore the ethical issues raised by the Human Research Ethics Committee relating to consent of vulnerable patients requiring resuscitation within a rural context. In particular, the challenges of addressing risk (privacy) vs benefit (public) associated with a waiver of consent. This paper will consider why the rural context should be championed during the ethical review process, when decisions about public benefit are being deliberated. Utilising a communitarianism approach that advocates for greater rural representation during the ethical review processes will ensure that rural research involving vulnerable groups can be addressed safely and benefit not only the experiences and practices of rural nurses but also the wider rural communities they serve.

Intensive and Critical Care Nursing

Journal of University Teaching and Learning Practice

Artificial intelligence and large-language model chatbots have generated significant attention in... more Artificial intelligence and large-language model chatbots have generated significant attention in higher education, and in research practice. Whether ChatGPT, Bard, Jasper Chat, Socratic, Bing AI, DialoGPT, or something else, these are all shaping how education and research occur. In this Editorial, we offer five editorial principles to guide decision-making for editors, which will also become policy for the Journal of University Teaching and Learning Practice. First, we articulate that non-human authorship does not constitute authorship. Second, artificial intelligence should be leveraged to support authors. Third, artificial intelligence can offer useful feedback and pre-review. Fourth, transparency of artificial intelligence usage is an expectation. And fifth, the use of AI in research design, conduct, and dissemination must comply with established ethical principles. In these five principles, we articulate a position of optimism for the new forms of knowledge and research we mig...

Journal of University Teaching and Learning Practice

Compassion in higher education is viewed in different ways by educators. In recent years a focus ... more Compassion in higher education is viewed in different ways by educators. In recent years a focus on using compassionate pedagogy and being authentic, compassionate educators has arisen. Often associated with ‘care’, compassion has been labelled at times to be ‘soft’ or even ‘fluffy’ and holding emotion. Rather, we argue – through critically exploring discourses of compassion and care – that by acknowledging higher education has a relational element encompassing purposeful and trusting relationships, interactions can hold more meaning and benefit. This Editorial seeks to position the role of compassion in higher education, challenging how compassion focused pedagogy and research can be incorporated and enacted so it can benefit the future of higher education. We consider compassion in learning and teaching practices and in assessment, looking with hope to the future where we may see educational values lived in and through our teaching practices.

Nursing educators, and indeed almost every healthcare practitioner, advocates the notion of refle... more Nursing educators, and indeed almost every healthcare practitioner, advocates the notion of reflection on practice (deVries & Timmins, 2016). With healthcare aspiring to bridge the theory-practice gap, critical reflection is required so that healthcare professionals are empowered and have capacity for change. Then they are able to contribute to improving health outcomes. We know this is true, but can reflection be overdone with nursing students so that the meaning and value of reflection is lost

Physical activity is vital in providing positive health improvements in people with diabetes. Bal... more Physical activity is vital in providing positive health improvements in people with diabetes. Balducci et al. (2014 p13) states however, that medical officers and/ or general practitioners rarely prescribe exercise as a \u27therapy\u27 for people with diabetes

Too often we forget that men can be diagnosed with breast cancer. And too often men forget they c... more Too often we forget that men can be diagnosed with breast cancer. And too often men forget they can be subject to it, hence postponing seeking medical care and potentially presenting with advanced cancer

Australian Journal of Advanced Nursing, 2022

The aim of this study was to understand the challenges that nurses and midwives face when seeking... more The aim of this study was to understand the challenges that nurses and midwives face when seeking to practice social distancing within the various clinical settings in a hospital work environment during COVID-19. Background: COVID-19 has had a significant impact on nurses and midwives internationally. With the ease of transmission of COVID-19 and the limitations in pharmaceutical interventions, other measures had to be implemented across communities and in healthcare settings. These public health measures were enacted in various ways throughout the world. A key measure employed globally was social distancing. Australia was no different, initiating community wide interventions to apply social distancing principles and action, in an effort to reduce transmission. Whilst at their places of work, nurses and midwives were also encouraged to practice social distancing. Design and methods: Using convenience sampling, 579 nurses and midwives employed within one local health district in NSW, Australia completed an online questionnaire during the COVID-19 pandemic. Subsequently, a thematic analysis was undertaken as a way of categorising data from the 216 (37%) qualitative responses with regards to social distancing. This study adhered to The Standards for Reporting Qualitative Research (SRQR) guidelines. 1 aUthOrs cassaNDra hOBBs 1,2 lOrNa MOXhaM 3,4,5 heiDi GreeN 2 elhaM alMasi 2,6

Nurse Education Today, 2021

BACKGROUND Attrition in pre-registration nursing degrees is a global issue. Students' percept... more BACKGROUND Attrition in pre-registration nursing degrees is a global issue. Students' perceptions of belonging is a factor that influences attrition. OBJECTIVE The objective of this study was to evaluate students' perception of belonging to a School of Nursing, as well as their intention to complete the pre-registration Bachelor of Nursing (BN) program following implementation of the Initiatives for Retention (IR) intervention. DESIGN A prospective cross-sectional survey of student nurses was undertaken using an online questionnaire. SETTING A large regional university in Australia. PARTICIPANTS Pre-registration nursing students. METHODS Perceptions of Belonging were evaluated using the 24-item Belonging questionnaire comprising three subscales. Data were analysed using SPSS version 25. Pearson's correlation, Student's t-tests and one way ANOVA were used to assess associations and differences in belonging scores and student demographics, study status and participation in the Initiatives for Retention (IR) intervention. RESULTS A total of 201 students responded to the voluntary questionnaire. The mean score for overall Belonging was 70.5 (maximum obtainable 96), mean Scores for University affiliation, University support and acceptance, and staff relations with students were 34.7, 24.1 and 11.8 respectively. Female students, those who were studying at the university for less than a year and those who participated in the IR intervention activities reported significantly higher University Belonging scores compared to their contemporaries. Logistic regression revealed that students studying the BN course for more than 3 years (OR: 0.43 95% CI 0.20-0.93, p = 0.031), and those employed (OR: 0.435, 95% CI 0.16-0.16, p = 0.022) were significant predictors of not attending the IR sessions. There were no significant differences in overall University Belonging scores based on other demographic characteristics and, study status. The majority of the students (84%) stated that they plan to continue and complete the BN program. CONCLUSIONS Measures designed to develop student involvement may positively contribute a successful relationship between the institution and the student, increasing the students' sense of belonging and decreasing attrition among student nurses. PRACTICE IMPLICATIONS Initiatives for Retention (IR) facilitate a greater sense of belonging in nursing students hence Schools of Nursing should consider embedding such strategies.

BMJ Open, 2021

ObjectivesTo summarise the evidence relating to the prevalence of anxiety and depression among he... more ObjectivesTo summarise the evidence relating to the prevalence of anxiety and depression among healthcare workers (HCWs) during the COVID-19 pandemic.DesignAn umbrella review of systematic reviews was undertaken using the Joanna Briggs Institute (JBI) methods.Data sourcesThe Cochrane database of systematic reviews, JBI Evidence Synthesis, MEDLINE, Web of Science, PsycINFO, Embase and CINAHL were searched in March 2021 for reviews published in English.Eligibility criteriaSystematic reviews reporting the prevalence of anxiety and depression among HCWs during the COVID-19 pandemic. Two researchers screened each abstract and independently reviewed full text articles. Study quality was assessed using the JBI critical appraisal tool for systematic reviews, and the degree of overlap in primary studies was calculated.ResultsTen systematic reviews (100 unique studies), including 169 157 HCWs from 35 countries were included. The prevalence of anxiety among all HCWs ranged from 22.2% (95% CI 2...

Nurse researcher, Jun 12, 2024

International Journal of Educational Research

The Australian Nursing and Midwifery Journal, Nov 1, 2017

It is well known that Australian rural communities are confronted with significantly greater heal... more It is well known that Australian rural communities are confronted with significantly greater health disparities than their metropolitan counterparts (Rural Health Standing Committee 2011).

Nurse Education in Practice, Aug 1, 2022

The Australian Nursing and Midwifery Journal, Oct 1, 2020

Journal of Advanced Nursing, Jul 21, 2022

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-... more This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Collegian, Dec 1, 2021

Background : The emergence of COVID-19 has substantially impacted frontline health care workers, ... more Background : The emergence of COVID-19 has substantially impacted frontline health care workers, including nurse managers. To date, no studies have been conducted to examine the impact COVID-19 has had on Nurse Managers’ mental health, coping strategies and organisational commitment. Aim : To investigate the mental health, coping behaviours and organisational commitment among Nurse Managers during the COVID-19 pandemic. Methods : Cross-sectional study involving 59 Nursing Managers from one Local Health District in Sydney Australia during the first wave of the COVID-19 pandemic. Data were collected relating to demographics, anxiety, coping strategies and organisational commitment. Results : Overall, approximately three quarters of the Nurse Managers had high anxiety scores. Managers who had worked longer as a nurse had higher scores for adaptive coping strategies and 41% of Nurse Managers considered leaving their job. Conclusions : Strategies to minimise anxiety and enable coping as part of organisational disaster, emergency or crisis planning for Nurse Managers may result in decreased anxiety and stress levels, increased use of adaptive coping strategies and lower intent to leave the organisation and the nursing profession.

Nurse Researcher, Sep 9, 2021

Action research (AR) provides a robust platform for collaboration to develop and evaluate nursing... more Action research (AR) provides a robust platform for collaboration to develop and evaluate nursing practice. It results in several outcomes, including changes in evidence-based practice, the development of research capacity, and the evaluation and sustainability of interventions, all of which can be seen as benefits compared to other approaches. However, the methodology involves cycles of action, reflection, theory and practice, so it can be challenging to maintain momentum when engaging with teams over long periods of time. To offer strategies for maintaining momentum when using AR in nursing research. Three strategies for maintaining momentum when undertaking AR are covered. Theory, literature and experience of using AR in which the strategies of 'connecting as people', 'working with the context' and 'understanding the influence of the leadership team' made a considerable difference in maintaining momentum and are drawn on. Maintaining momentum in studies that use AR can be arduous, but critical reflection enables researchers to identify and overcome the challenges that arise. Researchers undertaking AR can apply the three strategies provided or other approaches to maintain momentum during all phases of a study. Maintaining momentum in AR studies is more successful when researchers connect with those with whom they are undertaking research. It is advantageous for nurse researchers to reflect on and understand the influence of the leadership team and context rather than try to adapt them to the study's or their own needs.

Journal of Advanced Nursing, Jun 16, 2023

Nursing Ethics, Jun 6, 2023

Undertaking research involving vulnerable groups, such as those requiring resuscitation involves ... more Undertaking research involving vulnerable groups, such as those requiring resuscitation involves careful analysis during the ethical review process. When a person lacks the capacity to make an informed choice about their participation in a research study, a waiver of consent offers an alternative. This paper is based on a doctoral research study using ethnography to explore the resuscitative practices and experiences of rural nurses through observation and interviews. This paper aims to explore the ethical issues raised by the Human Research Ethics Committee relating to consent of vulnerable patients requiring resuscitation within a rural context. In particular, the challenges of addressing risk (privacy) vs benefit (public) associated with a waiver of consent. This paper will consider why the rural context should be championed during the ethical review process, when decisions about public benefit are being deliberated. Utilising a communitarianism approach that advocates for greater rural representation during the ethical review processes will ensure that rural research involving vulnerable groups can be addressed safely and benefit not only the experiences and practices of rural nurses but also the wider rural communities they serve.

Intensive and Critical Care Nursing

Journal of University Teaching and Learning Practice

Artificial intelligence and large-language model chatbots have generated significant attention in... more Artificial intelligence and large-language model chatbots have generated significant attention in higher education, and in research practice. Whether ChatGPT, Bard, Jasper Chat, Socratic, Bing AI, DialoGPT, or something else, these are all shaping how education and research occur. In this Editorial, we offer five editorial principles to guide decision-making for editors, which will also become policy for the Journal of University Teaching and Learning Practice. First, we articulate that non-human authorship does not constitute authorship. Second, artificial intelligence should be leveraged to support authors. Third, artificial intelligence can offer useful feedback and pre-review. Fourth, transparency of artificial intelligence usage is an expectation. And fifth, the use of AI in research design, conduct, and dissemination must comply with established ethical principles. In these five principles, we articulate a position of optimism for the new forms of knowledge and research we mig...

Journal of University Teaching and Learning Practice

Compassion in higher education is viewed in different ways by educators. In recent years a focus ... more Compassion in higher education is viewed in different ways by educators. In recent years a focus on using compassionate pedagogy and being authentic, compassionate educators has arisen. Often associated with ‘care’, compassion has been labelled at times to be ‘soft’ or even ‘fluffy’ and holding emotion. Rather, we argue – through critically exploring discourses of compassion and care – that by acknowledging higher education has a relational element encompassing purposeful and trusting relationships, interactions can hold more meaning and benefit. This Editorial seeks to position the role of compassion in higher education, challenging how compassion focused pedagogy and research can be incorporated and enacted so it can benefit the future of higher education. We consider compassion in learning and teaching practices and in assessment, looking with hope to the future where we may see educational values lived in and through our teaching practices.

Nursing educators, and indeed almost every healthcare practitioner, advocates the notion of refle... more Nursing educators, and indeed almost every healthcare practitioner, advocates the notion of reflection on practice (deVries & Timmins, 2016). With healthcare aspiring to bridge the theory-practice gap, critical reflection is required so that healthcare professionals are empowered and have capacity for change. Then they are able to contribute to improving health outcomes. We know this is true, but can reflection be overdone with nursing students so that the meaning and value of reflection is lost

Physical activity is vital in providing positive health improvements in people with diabetes. Bal... more Physical activity is vital in providing positive health improvements in people with diabetes. Balducci et al. (2014 p13) states however, that medical officers and/ or general practitioners rarely prescribe exercise as a \u27therapy\u27 for people with diabetes

Too often we forget that men can be diagnosed with breast cancer. And too often men forget they c... more Too often we forget that men can be diagnosed with breast cancer. And too often men forget they can be subject to it, hence postponing seeking medical care and potentially presenting with advanced cancer

Australian Journal of Advanced Nursing, 2022

The aim of this study was to understand the challenges that nurses and midwives face when seeking... more The aim of this study was to understand the challenges that nurses and midwives face when seeking to practice social distancing within the various clinical settings in a hospital work environment during COVID-19. Background: COVID-19 has had a significant impact on nurses and midwives internationally. With the ease of transmission of COVID-19 and the limitations in pharmaceutical interventions, other measures had to be implemented across communities and in healthcare settings. These public health measures were enacted in various ways throughout the world. A key measure employed globally was social distancing. Australia was no different, initiating community wide interventions to apply social distancing principles and action, in an effort to reduce transmission. Whilst at their places of work, nurses and midwives were also encouraged to practice social distancing. Design and methods: Using convenience sampling, 579 nurses and midwives employed within one local health district in NSW, Australia completed an online questionnaire during the COVID-19 pandemic. Subsequently, a thematic analysis was undertaken as a way of categorising data from the 216 (37%) qualitative responses with regards to social distancing. This study adhered to The Standards for Reporting Qualitative Research (SRQR) guidelines. 1 aUthOrs cassaNDra hOBBs 1,2 lOrNa MOXhaM 3,4,5 heiDi GreeN 2 elhaM alMasi 2,6

Nurse Education Today, 2021

BACKGROUND Attrition in pre-registration nursing degrees is a global issue. Students' percept... more BACKGROUND Attrition in pre-registration nursing degrees is a global issue. Students' perceptions of belonging is a factor that influences attrition. OBJECTIVE The objective of this study was to evaluate students' perception of belonging to a School of Nursing, as well as their intention to complete the pre-registration Bachelor of Nursing (BN) program following implementation of the Initiatives for Retention (IR) intervention. DESIGN A prospective cross-sectional survey of student nurses was undertaken using an online questionnaire. SETTING A large regional university in Australia. PARTICIPANTS Pre-registration nursing students. METHODS Perceptions of Belonging were evaluated using the 24-item Belonging questionnaire comprising three subscales. Data were analysed using SPSS version 25. Pearson's correlation, Student's t-tests and one way ANOVA were used to assess associations and differences in belonging scores and student demographics, study status and participation in the Initiatives for Retention (IR) intervention. RESULTS A total of 201 students responded to the voluntary questionnaire. The mean score for overall Belonging was 70.5 (maximum obtainable 96), mean Scores for University affiliation, University support and acceptance, and staff relations with students were 34.7, 24.1 and 11.8 respectively. Female students, those who were studying at the university for less than a year and those who participated in the IR intervention activities reported significantly higher University Belonging scores compared to their contemporaries. Logistic regression revealed that students studying the BN course for more than 3 years (OR: 0.43 95% CI 0.20-0.93, p = 0.031), and those employed (OR: 0.435, 95% CI 0.16-0.16, p = 0.022) were significant predictors of not attending the IR sessions. There were no significant differences in overall University Belonging scores based on other demographic characteristics and, study status. The majority of the students (84%) stated that they plan to continue and complete the BN program. CONCLUSIONS Measures designed to develop student involvement may positively contribute a successful relationship between the institution and the student, increasing the students' sense of belonging and decreasing attrition among student nurses. PRACTICE IMPLICATIONS Initiatives for Retention (IR) facilitate a greater sense of belonging in nursing students hence Schools of Nursing should consider embedding such strategies.

BMJ Open, 2021

ObjectivesTo summarise the evidence relating to the prevalence of anxiety and depression among he... more ObjectivesTo summarise the evidence relating to the prevalence of anxiety and depression among healthcare workers (HCWs) during the COVID-19 pandemic.DesignAn umbrella review of systematic reviews was undertaken using the Joanna Briggs Institute (JBI) methods.Data sourcesThe Cochrane database of systematic reviews, JBI Evidence Synthesis, MEDLINE, Web of Science, PsycINFO, Embase and CINAHL were searched in March 2021 for reviews published in English.Eligibility criteriaSystematic reviews reporting the prevalence of anxiety and depression among HCWs during the COVID-19 pandemic. Two researchers screened each abstract and independently reviewed full text articles. Study quality was assessed using the JBI critical appraisal tool for systematic reviews, and the degree of overlap in primary studies was calculated.ResultsTen systematic reviews (100 unique studies), including 169 157 HCWs from 35 countries were included. The prevalence of anxiety among all HCWs ranged from 22.2% (95% CI 2...