Depression is the most prevalent mental illness among older adults. However, help-seeking by older adults is frequently delayed, resulting in longer duration of untreated symptoms, poorer health outcomes, and consequent higher healthcare use. Early help-seeking and access to appropriate support benefits individuals, while providing better outcomes from health systems constrained by limited resources. The aim of this study, which is abstracted from a larger study, was to identify the factors that inhibited and enabled formal help-seeking in older adults with a diagnosis of moderate depression. Corbin and Strauss' approach to grounded theory informed data collection and analysis. Two themes and related subthemes concerning help-seeking barriers and facilitators were abstracted from the data. Help-seeking barriers were attributable to stigma, self-motivation, accessing formal support, ageism, and difficulty obtaining an initial diagnosis. Help-seeking facilitators were accepting personal responsibility, mental health literacy, therapeutic alliances, and informal support. Findings have implications for the role of mental health nurses, who are well-placed to provide support to community-based older adults with depression. More broadly, mental health nurses and other clinicians should seek to reduce help-seeking barriers and implement ways to facilitate help-seeking in this cohort.

Global population ageing has meant a rapid increase in the numbers of older people with dementia, most of whom live in their own homes. Staying at home is an important determinant of health and well-being. As care needs increase, the quality of community support which older people receive directly influences their capacity to remain in their own homes. While many are supported informally by family carers, formal support provided by home care workers often enables them to remain at home for longer period. However, providing community-based care for people with dementia can be challenging. Workers often lack training in dementia-specific care for clients with increasingly complex needs, and typically work without direct supervision.As the demand for person-centred home care for people with dementia increases, specialist dementia training for home care workers is urgently needed. In this qualitative study, we used in-depth interviews of a purposive sample, comprising 15 family carers and four older people with dementia, to understand the experience of receiving community care. Data analysis was guided by Braun and Clarke's approach to thematic analysis and revealed the following five overlapping themes, relating to home care workers' understanding of dementia, person-centred care, communication and rapport, mutual collaboration, and the influence of organisational constraints on continuity of care. Although participants acknowledged that service providers operated under challenging circumstances, they were frustrated with home care workers' lack of dementia knowledge and inconsistent staff rostering. Conversely, an understanding of the lived experience of dementia, effective communication and rapport, and continuity of care contributed significantly to a positive experience of receiving care.The findings of this study will be used to inform the essential elements of a training

A deeper understanding of the risks of predatory publishing is needed. Clear guidelines should be followed by nursing and midwifery researchers seeking to publish their work in open access journals.

BackgroundAffected family members (AFMs) play an important role in supporting relatives with alcohol and/or other drug (AOD) misuse. However, they frequently lack support and experience considerable challenges to their own well‐being.AimTo explore the experience of AFMs who support a close relative with AOD misuse.MethodThirty‐one AFMs were recruited through AOD helplines and through their social media accounts in the Australian state of Victoria. A semi‐structured interview guide was used to inform data collection, focusing on their general experiences, impact of support‐giving and support options. Interviews were audio‐recorded and conducted by telephone.ResultsOne overarching theme and six related subthemes were abstracted from the data. The overarching theme was conceptualised as Feeling overwhelmed by, and struggling with, the experience. Subthemes were as follows: Emotionally draining and exhausting, Maintaining constant vigilance: curbing social activities, Grappling with the financial impact, Struggling to cope with harmful family dynamics, Avoiding and containing aggression and Fearfulness and hopelessness about the future.ConclusionAffected family members experienced wide‐ranging harms, which affected their emotional, social and financial well‐being, safety and family dynamics, and instilled a persistent sense of fearfulness and hopelessness about the future. The findings have implications for mental health nurses and other clinicians in AOD services to identify AFMs’ needs and provide them with timely, accessible and appropriate support to help sustain their important role.

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Objectives: A considerable body of work addresses prevalence and treatment options for depression in older adults. However, less is known about their capacity to selfmanage their depression. Effective self-management of depression has the potential to improve individuals' quality of life through information, empowerment and perceived control, while enabling more efficient health service utilisation. The aim of this paper was to identify the barriers and facilitators to self-management of depression in older adults. Method: A qualitative study comprising in-depth, semi-structured interviews with 32 older adults with a diagnosis of moderate depression. Results: Three over-arching themes captured the barriers and facilitators to participants' capacity to self-manage their depression. Perspectives on age and depression represented how views of older age and mental health influenced the approach to self-management. Ability to access the health care system concerned the ability to identify and engage with different services and support. Individual capacity for self-management reflected participants' views on and the resources required for effective self-management. Conclusion: This study offers a better understanding of the factors that positively or negatively influence older adults' ability to self-manage their depression. Strategies to improve self-management should address misconceptions about age and depression, and older adults' interest in and capacity to embrace self-management practices.

Providing nursing students with appropriate clinical practice during their undergraduate programme is critical to ensuring that graduates meet the competency requirements to gain registration as a nurse. In response to the predicted nursing workforce shortage, universities have been significantly increasing the enrolment of undergraduate nurses into Bachelor of Nursing courses. This has placed a demand on the availability of clinical placements and often universities struggle to find appropriate places. In this study, a Bachelor of Nursing course incorporated an Integrated Clinical Learning Model (ICLM) for the first time during a mental health placement. The model offered students the flexibility of attending their clinical placement over a 16-week period instead of a traditional block of 4 weeks. The aim of this study was to evaluate the student perspective of this model and whether it prepared them for the nursing workforce. Focus groups were conducted with undergraduate nursing students following their mental health clinical placement at an acute and extended care inpatient unit. Data were analysed using thematic analysis. Main themes included preparedness for practice, maintaining a work-life balance, and perceiving they were part of a team. The ICLM deepened students' knowledge and had a positive impact on their overall clinical learning.

BackgroundMental health service users have high rates of medical co-morbidity but frequently experience problems accessing and transitioning between tertiary medical and primary care services. The aim of this study was to identify ways to improve service users’ with medical co-morbidity care and experience during their transition between tertiary medical hospitals and primary care services.MethodExperience-based co-design (EBCD) qualitative study incorporating a focus group discussion. The study took place in a large tertiary medical service, incorporating three medical hospitals, and primary care services, in Melbourne, Australia. A purposive sample of service users and their caregivers and tertiary medical and primary care clinicians participated in the focus group discussion, in August 2014. A semi-structured interview guide was used to inform data collection. A thematic analysis of the data was undertaken.ResultsThirteen participants took part in the focus group interview, comprising 5 service users, 2 caregivers and 6 clinicians. Five themes were abstracted from the data, illustrating participants’ perspectives about factors that facilitated (clinicians’ expertise, engagement and accessibility enhancing transition) and presented as barriers (improving access pathways; enhancing communication and continuity of care; improving clinicians’ attitudes; and increasing caregiver participation) to service users’ progress through tertiary medical and primary care services. A sixth theme, enhancing service users’ transition, incorporated three strategies to enhance their transition through tertiary medical and primary care services.ConclusionEBCD is a useful approach to collaboratively develop strategies to improve service users’ with medical co-morbidity and their caregivers’ transition between tertiary medical and primary care services. A whole-of-service approach, incorporating policy development and implementation, change of practice philosophy, professional development education and support for clinicians, and acceptance of the need for caregiver participation, is required to improve service users’ transition.