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Beginning on a wage of £1 per week in 1934, Lesley Long was the first woman employed by the Commercial Union Insurance Company in Hobart, Tasmania. Long’s pay gradually increased to £2/10 per week and after five years of saving she was able to fulfil her dream of sailing to England in May 1939. Having found a job and a place to rent in London, Long spent one night each week and her Saturdays volunteering at Guy’s Hospital. Having been a member of a VA detachment in Hobart since 1934, Long was eager to continue as a VA in London. When war was declared in Europe only a few months after she had arrived, Long’s voluntary work became more important to her. But it also brought an end to her chance to holiday in Europe as she had planned. As the situation worsened and wartime restrictions in London began to take effect, Long said to herself, ‘What am I doing here? I might as well get home.’
At the conclusion of the war, Major General Roy Burston, the Army Director General of Medical Services and Chair of the national VAD Council, wrote, ‘The past seven years have brought about a complete change in our attitude towards the employment of women in the armed forces.’ Throughout the war Burston supported the employment and development of VAs and then the AAMWS in the military. Their indispensability had been recognised. Yet, with the end of the war, AAMWS were discharged and Burston’s suggestion to maintain a cohort of women ready to serve in the event of a future war was, as he wrote: ‘…that the [civilian] VADs provide an organisation under which this training could be most effectively carried out in peace time. In addition, it is felt that there would be many advantages in maintaining the [civilian] VADs with their tradition of service which has been built up over the past 30 years or more.’ The war had provided an environment for women to expand their job opportunities, and it gave servicewomen space in the military to demonstrate the value not only of historically female dominated duties but of women’s labour generally. But the end of the war effectively erased this recognition.
Honouring her strong character and sense of service, Alice Appleford was awarded the Florence Nightingale Medal in 1949. Administered by the International Committee of the Red Cross as the highest award for a member of the nursing profession internationally, part of Appleford’s citation reads: ‘No one who came in contact with Major Appleford could fail to recognise her as a leader of women. Her sense of duty, her sterling solidarity of character, her humanity, sincerity, and kindliness of heart set for others a very high example.’ Before her marriage to Sydney Appleford, Alice had achieved a distinguished career as a nurse. Known then as Alice Ross-King, she had trained at Melbourne’s Alfred Hospital and in November 1914 embarked for Egypt to serve with the AANS. Awarded both the Royal Red Cross and the Military Medal, Sister Ross King became one of Australia’s most highly decorated women of the First World War. The Florence Nightingale Medal in 1949 added to her deserved accolades, but this medal was awarded for her contribution during a different war and to a different service. Although a trained nurse with a dedicated career to the profession, it was Alice Appleford’s interest in training and organising VADs, those not technically part of the nursing profession, during the Second World War that saw her receive the Nightingale Medal.
Kathleen Best was a nurse to her core. Completing her training at the Western Suburbs Hospital in Sydney in 1932, Best went onto train in midwifery before holding leadership positions at several Sydney hospitals. In May 1940, she began her military career, joining the Australian Army Nursing Service (AANS) as Matron of the 2/5th Australian General Hospital (AGH). Breaking ground as the youngest matron of the AANS, Best soon demonstrated her strength of leadership and character. By 1942, she had seen service in the Middle East, had led her nurses of the 2/5th AGH through the evacuation from Greece, and had been awarded the Royal Red Cross for her courage and efficiency. Best’s service abroad with the Second Australian Imperial Force (AIF) early in the Second World War made her well versed in military organisation. Showing her understanding of the effective operation of the military medical service, in January 1943 she stated, ‘Every position in a medical unit is important for ultimate efficiency ... and every girl in this service is helping to save lives’. In this statement Best was not referring to the nurses of the AANS; the ‘life-saving’ work Best was referring to was that being undertaken by the Australian Army Medical Women’s Service (AAMWS).
The wartime priorities for Australia shifted during the summer of 1941–42 as tensions in the Pacific increased, with Japan and the United States entering and quickly mobilising for war after the bombing of Pearl Harbor on 7 December 1941. With the sinking of the HMAS Sydney off the West Australian coast in November 1941, Australia’s concern for the Indo-Pacific was already mounting. When Singapore then fell to the Japanese on 15 February 1942, and with it 18 000 Australian troops captured, Australia felt the situation worsening. With the first bombing of Darwin in February 1942, soon after the fall of Singapore, war had reached the nation’s shores, and the threat of invasion became immediate. Australia then withdrew its troops from the Middle East, where the majority had been serving, and the defence of its own territory dominated the nation’s consciousness. This sparked a change in attitude for Australia which caused a rapid growth in service enlistments, including with both the civilian and Army VAD organisations.
On 14 June 1943 the full strength of 84 civilian VAs were withdrawn from service at the Sydney Hospital. The Sun described their removal as owing to the ‘disagreeable attitude’ and protest arising from the trained nursing staff. Deputy Controller of the New South Wales civilian VAD, Dorothy Wilby, demanded that the voluntary service of these women ‘should be recognised by civilian nurses’, and threatened that if civil hospitals did not want the help of the VAs they would easily find work elsewhere. These women did not return to their voluntary duties as orderlies and hospital assistants for four days.
The AAMWS training school in Yeronga, Queensland, was established in November 1942. Set on a five-acre property, the location for the school was the former home of a Brisbane doctor. With an intake of just 27 students, the school’s first course was used as a trial to familiarise women with Army organisation. The AAMWS had only recently been established as a military service and so the newly enlisted women were drilled, taught to salute, and lectured on Army organisation and operations. Regarded as a successful exercise, the course would become known as ‘rookies’ and was continued in Queensland and implemented throughout the other states. Before the school was moved to Enoggera in August 1943, 642 AAMWS passed through Yeronga undertaking one of the eight three-week so-called rookies’ courses. A Toowoomba school teacher before the war, AAMWS officer, Lieutenant Florence Fuller established the Yeronga school as its first chief instructor. ‘Our ambition is to make recruits into good members of the AAMWS’, declared Fuller. Supported by other training staff, including AANS nurse, Patricia Chomley, Fuller explained that their objective was to train AAMWS so that, ‘when they get to their units, they know how to pull their weight’.
Jessie Laurie commenced her affiliation with nursing in 1939, joining the Dugan VA Detachment in Adelaide. Eager to volunteer for the Army when the opportunity came, Laurie was one of just 24 South Australian women to serve in the Middle East as a VA during the war. A clerk in her civilian life, Laurie was first allocated to general duties in the Middle East with the 2/1st AGH and then the 2/6th (shown in Figure 7.1). While with the 2/6th AGH, Laurie was assigned to the service of Major George Halliday. An ear, nose, and throat (ENT) specialist, Halliday ran a clinic for troops in the area and Laurie was selected to work as his assistant. After the Australian forces were withdrawn from the Middle East in 1942 and redirected to the Pacific Campaign, Laurie, now a Private in the AAMWS, joined Halliday as his assistant and helped staff his small mobile hearing clinic in Far North Queensland for troops camped on the Atherton Tableland.
It was a common assumption during the war that VAs and AAMWS servicewomen wanted to be nurses, and it was this desire that motivated them to join this service rather than take up one of the other available wartime opportunities. As Sheila Sibley confessed in 1943, before she began her work as an AAMWS, she was ‘dreaming dreams’ of becoming ‘an angel of mercy, the wounded man’s guide … the Rose of No-Man’s Land’. Sibley imagined that she would ‘float down the wards in my nifty blue uniform, and tender sighs would float right after this war’s Florence Nightingale’. Both Hitchcock and Sibley suggest there was some truth in the assumption that VAs and then AAMWS saw themselves as akin to, or aspired to be, nurses. Like Hitchcock, Sibley’s references show a clear association with the nurse in her understanding of the VAD and AAMWS. But Sibley admits that once she joined her first military hospital, she learnt the reality of the AAMWS’ work and conceded, ‘better leave that noble figure in my imagination.’
Writing encouragingly with the aim of providing constructive feedback in 1979 Mary Critch asked of Enid Herring, ‘Is ‘They wanted to be Nightingales’ a title for the finished book?’. Both were former members of the AAMWS working on their own separate compilations of the VAD/AAMWS in the Second World War. Critch, however, was alarmed by Herring’s choice of a title, and put the question to Herring, asking: ‘Is it not rather embarrassing to the hundreds of AAMW [sic.] who worked as General Duty and Mess Orderlies, as clerks, cooks etc and never saw the inside of a ward?’ Referencing Florence Nightingale, the woman noted for her humanitarian efforts during the Crimean War and cited by some as shaping modern nursing, Herring chose to perpetuate the stereotype of VAs and AAMWS. The First World War myth that all VAs either aspired to be nurses, or already saw themselves as nurses, was a common perception that tainted the VAD and AAMWS in the Second World War. While writing her own account of the VAD/AAMWS, Herring could have chosen to debunk this myth. However, she claimed its truth.
To examine the relationships between patient activation, depressive symptoms, and quality of life among older adults receiving palliative oncology care.
Methods
A cross-sectional correlational study was conducted among 145 adults aged ≥60 years receiving palliative oncology care at King Khalid Hospital, Saudi Arabia, using stratified random sampling. Data were collected via a demographic and clinical questionnaire, the Patient Activation Measure-13 (PAM-13), the Patient Health Questionnaire-9 (PHQ-9), and the McGill Quality of Life Questionnaire–Revised (MQOL-R). Descriptive statistics, Pearson correlation, independent t-tests, one-way ANOVA, and multiple linear regression were performed using SPSS version 26.
Results
All participants demonstrated Level 2 patient activation, with a mean PAM-13 score of 50.83 (SD = 1.04). Moderate depressive symptoms were prevalent (mean PHQ-9 = 13.56, SD = 3.48), and overall quality of life was moderate (mean MQOL-R = 55.21, SD = 10.14). Patient activation was weakly but significantly inversely correlated with depressive symptoms (r = −0.179, p < 0.05). No significant associations were found between patient activation and quality of life, or between depressive symptoms and quality of life. Regression analysis showed that patient activation, depressive symptoms, and demographics accounted for only 3.2% of the variance in quality of life (R2 = 0.032, p = 0.714).
Significance of results
Patient activation may modestly reduce depressive symptoms but is not sufficient to improve quality of life in older adults receiving palliative oncology care. Quality of life appears influenced by broader multidimensional factors beyond activation and mood, highlighting the need for comprehensive interventions in palliative care settings.
Nursing Aids at War: The Australian Army Medical Women's Service in the Second World War explores the chronological history of the Australian Army Medical Women's Service (AAMWS) and challenges our understanding of servicewomen and gendered work in the Australian Army. Arranged in three parts, the book first introduces the nursing aid and how the Voluntary Aid Detachments (VADs) became intertwined with the nursing service in the First and Second World Wars. It then investigates disruptions, tensions and controversies faced by the VAD as they transitioned into the AAMWS; in particular, the training schemes for AAMWS to become professionally trained nurses in military hospitals. Lastly, the book explores and challenges representations and reflections of the VAD and AAMWS, including building a national identity separate to practising nurses, and acknowledging their history as largely being forgotten amongst discussion of Australia's wider military history.
The aim of this study was to determine the health problems of individuals who survived the 2023 Kahramanmaraş earthquake according to the Omaha System.
Methods
This descriptive cross-sectional study was conducted in Adıyaman, Türkiye, and included 297 earthquake survivors. Data were collected using the Problem Classification Scheme of the Omaha System.
Results
The majority of individuals who survived the earthquake were women and had at least one chronic disease. Of the 42 problems listed in the Omaha Problem Classification Scheme, 38 were identified. Most of the identified problems were actual and individual-level issues. Income, Sanitation, Residence, Living/workplace safety, Communication with community resources, Communicable/infectious condition, and Nutrition problems were identified in all earthquake survivors.
Conclusions
The Omaha System provides nurses with pertinent data to organize health services and prioritize interventions in the post-disaster period. The problems identified highlight the urgent need to improve health and living conditions in temporary shelters.
This chapter considers conformation of communal sharing by means of consubstantial assimilation: making essential substances or surfaces of bodies alike, or contact between bodies, or engaging in synchronous rhythmic movement of the torso and limbs; blood sacrifice; classic anthropological theories of commensalism; and milk kinship. In a number of cultures, drinking alcohol together creates strong commitments. Among North American Indians, smoking the sacred pipe together is a way to make peace or cement bonds. In Homeric Greece and in other Bronze Age and early Iron Age societies around the Mediterranean, men created host–guest bonds by hospitably welcoming and feeding a travelling stranger, and exchanging gifts. In Africa and elsewhere, there are practices in which two men each cut themselves and bleed into a vessel in which they mix the blood, and then drink it. This creates extremely strong commitments to mutual aid in blood brotherhood.
Diabetes mellitus is a prevalent chronic illness worldwide and largely impacts migrants who have settled in developed countries. In diabetes care, patients play a central role and are natural partners in self-care education for improving health. Upon reviewing the literature, no studies were found that evaluated culturally adapted education models led by a nurse and delivered by a multi-professional team from the perspective of migrants in a group setting. Therefore, this study aims to explore patients’ evaluation of the content and implementation of a person-centred, group-based diabetes education model for migrants with type 2 diabetes led by a nurse and delivered by a multi-professional team.
Method:
Qualitative exploratory study, using semi-structured interviews in focus groups and individually to collect data. Eleven migrants who had participated in an intervention testing the education model aged 45–70, who had been living in Sweden between 4–32 years participated. Inductive qualitative content analysis of data was undertaken.
Results:
Participants gave a positive picture of their experiences concerning the content and organisation of the person-centred, group-based, culturally adapted diabetes education model. The education sessions were described as providing new and evidence-based knowledge. The multi-professional education staff and the interpreter were perceived as having a professional and familiar approach. They wanted to recommend the education model to others.
Conclusions:
The study revealed a well-functioning diabetes education model tailored to individual beliefs and cultural aspects. It improved perceived knowledge about type 2 diabetes among migrants, thus increasing self-care behaviour and health. In today’s multicultural society, the study offers insights into migrants’ feelings, ideas, concerns, knowledge, and experience regarding the content, structure, and outcome of a group-based, culturally adapted diabetes education model that can improve self-care behaviour to promote health and prevent illness. As a result, the education model can be used in primary healthcare as a central and natural partner in self-care education to improve health.
The COVID-19 pandemic has placed unprecedented strain on global health systems, significantly affecting both the physical and emotional well-being of populations. Nursing students represent a particularly vulnerable group due to the pandemic’s impact on their mental health and academic progression. This study aims to assess the level of resilience among Spanish university nursing students during the pandemic.
Method
A longitudinal study was conducted with 361 nursing students from March to October 2020. Self-report questionnaires measured emotional intelligence, resilience, anxiety, depression, optimism, and self-efficacy during the first and second COVID-19 waves. Analyses included descriptive statistics, Spearman’s correlations, and hierarchical multiple regression.
Results
Resilience slightly decreased from March to October 2020, while anxiety increased and depression remained stable. Resilience was positively correlated with optimism, self-efficacy, and emotional intelligence, particularly emotion regulation. Higher resilience was predicted by not living alone, greater optimism, and stronger emotion regulation skills.
Conclusions
Spanish nursing students showed variable resilience during COVID-19, positively associated with optimism, self-efficacy, emotional intelligence, and mental health factors like anxiety and depression. Findings highlight the psychological impact of the pandemic and support resilience-focused interventions in nursing education.
This study was conducted to identify dyspnea, anxiety, and death anxiety in patients with Chronic Obstructive Pulmonary Disease (COPD).
Method
The study was carried out with 200 COPD patients who applied to the chest diseases outpatient clinic of a state hospital between December 2022 and June 2023.
Results
A total of 73.0% of the patients with COPD participating in the study were male and their mean age was 66.73 ± 8.45 years. Their mean scores were 5.21 ± 2.46 on Modified Borg Scale, 2.62 ± 1.03 on the Modified Medical Research Council scale, 17.87 ± 7.96 on the Beck Anxiety Inventory, and 10.07 ± 4.02 on the Death Anxiety Scale. Patients with high dyspnea levels also had high levels of anxiety and death anxiety (p < 0.001).
Significance of results
The patients with COPD had high levels of dyspnea, anxiety, and death anxiety. Based on the results of the study, it is recommended to plan evidence-based studies to alleviate dyspnea, anxiety, and death anxiety in patients with COPD.
The women of the loyalist zone were a crucial component of the antifascist imagined community the volunteers believed they were fighting for. Chapter five shows that Spanish women ߝ although largely absent from subsequent accounts of the International Brigades ߝ were a major presence in the volunteersߣ lives, whether in the form of loyalist posters depicting heroic mothers beneath the shadows of German aircraft, news articles highlighting the tireless antifascist work taking place in rearguard factories, or letters from relatives back home encouraging the soldiers to fulfil their masculine duty by continuing to fight the enemy at the gates. Encounters could be even more direct, with many volunteers striking up relationships with young women in villages, finding themselves looked after by Spanish nurses in hospitals and pursuing opportunities for sex in brothels. To understand the origins, reception and impact of these encounters, this chapter investigates the volunteersߣ gendered assumptions about masculinity and femininity at a time of war. In so doing, it argues that encounters with women directly fed into their overlapping identities as men, as soldiers and as antifascists.
The present study was conducted to determine self-management and influencing factors in dialysis patients who experienced the earthquake.
Methods
The study was conducted descriptively with 125 patients receiving dialysis in a city affected by the earthquake in Türkiye. Data were collected with the “Personal Information Form” and the “Chronic Illness Self-Management Scale” (CISMS). Kolmogorov-Smirnov, Mann Whitney U, Kruskall Wallis, Spearman Correlation tests, Wilcoxon, and Linear Regression were used in the statistical analysis.
Results
The study found that 9.6% of the patients were trapped under the rubble in the earthquake, 71.2% lost a relative, 43.8% changed dialysis centers, 36.8% missed dialysis sessions, and 51.2% could not comply with the diet after the earthquake. Women (p < 0.001), those with secondary school or lower educational levels (p < 0.05), those with another chronic disease, and those who lost a relative in the earthquake had lower health care maintenance efficacy (p < 0.05). The treatment adherence of those who adhered to the diet was higher than those who did not (p < 0.05).
Conclusion
It was determined that the level of self-stigma of the patients after the earthquake was low, their treatment adherence was high, and there were many variables affecting their self-management.
The importance of cohorting observation unit patients in one location or unit, having adequate nursing staffing with specific nurse to patient ratios, design, equipment/supplies, dealing with variations in hourly and daily census, the negatives of floating nursing/support staff to other units, and nursing/physician administration are discussed.