Suza Trajkovski’s research while affiliated with Western Sydney University and other places

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Publications (18)


Visual representation of the ‘perfect service model’ developed by the CFHNs (shading for ease of reading only).
Visual representation of the ‘perfect service model’ developed by healthcare interpreters (shading for ease of reading only).
Model of support for child and family health nursing services for CALD families.
Co-Design Model of Support for Child and Family Health Nurse Practice with Culturally and Linguistically Diverse Families
  • Article
  • Full-text available

September 2024

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17 Reads

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1 Citation

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Suza Trajkovski

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Culturally and linguistically diverse (CALD) mothers with young children face multiple inequities in accessing primary health services, such as language barriers, social isolation, low health literacy, and the availability of appropriate interpretation services. These inequities are persistent and indicate that child and family health nurse (CFHN) services, the providers of primary healthcare in many developed countries, require better support to address the needs of these families. This study engaged with CFHNs and healthcare interpreters to co-design a model of support for practice using workshops that included individual and collective brainstorming and visual representations. Transcripts of the discussion were analysed using thematic analysis. CFHNs and interpreters were able to articulate their perfect service model: a central multidisciplinary team of CFHNs, interpreters, and bilingual educators who could facilitate nurse–interpreter and nurse–interpreter–client relationships, allowing CFHNs and interpreters to do their jobs properly. This central structural component would support and be supported by rapport, trust, client choice and access, continuity of care, and cultural comfort. The study concluded that CALD mothers’ access and engagement require CFHNs to have support for their cultural comfort through the mechanism of bilingual educators and the expansion of healthcare interpreters’ role and scope in working with CFHNs in the delivery of services.

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Immigrant and minority parents' experiences in a neonatal intensive care unit: A meta-ethnography review

August 2024

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23 Reads

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1 Citation

Journal of Clinical Nursing

Suza Trajkovski

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Mahmoud A Al-Dabbas

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[...]

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Aims To examine immigrant and minority parents' experiences of having a newborn infant in the neonatal intensive care unit and explore healthcare professionals' experiences in delivering care to immigrant and minority families. Design A meta‐ethnographic review informed by eMERGe guidelines. Methods We conducted a systematic literature review. Studies were included if they explored immigrant or minority parent experiences in neonatal intensive care units and health professional experiences delivering care to immigrant and minority families in neonatal intensive care. Reporting followed ENTREQ guidelines. Data Sources Database searches included CINAHL, MEDLINE, PubMed, PsycINFO, Scopus and Google Scholar. Boolean search strategies were used to identify qualitative studies. No limitations on commencement date; the end date was 23rd August 2022. PRISMA guidelines used for screening and article quality assessed using Joanna Briggs Institute criteria for qualitative studies. Results Initial search yielded 2468 articles, and nine articles met criteria for inclusion. Three overarching themes were identified: (1) Overwhelming Emotions, (subthemes: Overwhelming Inadequacy; Cultural Expressions of Guilt; Not Belonging), (2) Circles of Support, (subthemes: Individual Level‐Spirituality; External Level‐Connecting with Family; Structured Peer‐to‐Peer Support), (3) Negotiating Relationships with Healthcare Professionals (subthemes: Connecting; Disconnected; Linguistic Barriers). Interactions between healthcare professionals and immigrant and minority parents were the strongest recurring theme. Conclusions There can be a mismatch between immigrant and minority families' needs and the service support provided, indicating improvements in neonatal intensive care are needed. Despite challenges, parents bring cultural and family strengths that support them through this time, and many neonatal intensive care staff provide culturally respectful care. Implications for the Profession and/or Patient Care Professionals should be encouraged to identify and work with family strengths to ensure parents feel supported in the neonatal intensive care unit. Findings can inform policy and practice development to strengthen health professionals capabilities to support immigrant and minority families in neonatal units. Reporting Method The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses checklists were used to report the screening process.


PRISMA flow diagram—search strategy for MT post NICU discharge. Adapted from the 2020 PRISMA statement [75].
MAXQDA creative coding map of integrative review themes.
Music Therapy with Preterm Infants and Their Families after Hospital Discharge: An Integrative Review

August 2024

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64 Reads

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2 Citations

After discharge from a neonatal unit, families of preterm infants may require therapeutic support to address challenges related to their infant/s’ development, changed family circumstances, and/or parent wellbeing. This integrative review (IR) sought to examine the impact of music therapy on preterm infants and their families post-hospital discharge. A systematic search encompassing seven databases resulted in 83 citations, with six studies initially meeting the inclusion criteria. A further six studies were evaluated and selected upon their publication during the review process. Each study was assessed using the Mixed Methods Appraisal Tool (MMAT), followed by the identification of major themes and sub-themes. Our results suggest that music therapy contributed to creating supportive physical and metaphorical environments for preterm infants and their families, in which they could acquire essential skills, tools, and resources for fostering communication and connection with one another. Preterm infants and toddlers may have also enhanced their developmental skills through music therapy sessions post-discharge. Further investigation into the impact of music therapy on preterm infants and their caregivers at different timepoints after hospital discharge is recommended, as well as a comparison of individual and group music therapy outcomes on infant development and parent health. Future research should include a broader spectrum of family members, along with caregivers from diverse family structures and gender identities, reflecting practices already established in some clinical settings.




Domains of reality (Fletcher, 2017).
Yin’s (2018) case study approach, adapted to the current project.
Reducing Ontology into Epistemology (Adapted From Alderson, 2021).
The Synergy of Critical Realism and Case Study: A Novel Approach in Nursing Research

May 2024

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166 Reads

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2 Citations

Critical realism is a framework that explains causations of observable events. It is useful in exploring and explaining complex nursing phenomena. It is grounded in the stratification of reality and the understanding that the world is complex, open, and has interactions that support or cancel each other whether we observe it or not. It can be used as a theoretical foundation of case study approach, an in-depth inquiry that seeks to understand a particular phenomenon within specific settings. This paper introduces the basic concepts of critical realism and how it can inform a qualitative case study methodology. To support this approach, we present a study on caregiving experiences for older people with dementia from culturally and linguistically diverse backgrounds which we believe highlights the value of combining critical realism and case study to inform future nursing research.


Scoping review of systematic reviews of nursing interventions in a neonatal intensive care unit or special care nursery

February 2024

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41 Reads

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6 Citations

Journal of Clinical Nursing

Aim(s) To identify, synthesise and map systematic reviews of the effectiveness of nursing interventions undertaken in a neonatal intensive care unit or special care nursery. Design This scoping review was conducted according to the JBI scoping review framework. Methods Review included systematic reviews that evaluated any nurse‐initiated interventions that were undertaken in an NICU or SCN setting. Studies that reported one or more positive outcomes related to the nursing interventions were only considered for this review. Each outcome for nursing interventions was rated a ‘certainty (quality) of evidence’ according to the Grading of Recommendations, Assessment, Development and Evaluations criteria. Data Sources Systematic reviews were sourced from the Cochrane Database of Systematic Reviews and Joanna Briggs Institute Evidence Synthesis for reviews published until February 2023. Results A total of 428 articles were identified; following screening, 81 reviews underwent full‐text screening, and 34 articles met the inclusion criteria and were included in this review. Multiple nursing interventions reporting positive outcomes were identified and were grouped into seven categories. Respiratory 7/34 (20%) and Nutrition 8/34 (23%) outcomes were the most reported categories. Developmental care was the next most reported category 5/34 (15%) followed by Thermoregulation, 5/34 (15%) Jaundice 4/34 (12%), Pain 4/34 (12%) and Infection 1/34 (3%). Conclusions This review has identified nursing interventions that have a direct positive impact on neonatal outcomes. However, further applied research is needed to transfer this empirical knowledge into clinical practice. Implications for the profession and/or patient care Implementing up‐to‐date evidence on effective nursing interventions has the potential to significantly improving neonatal outcomes. Patient or public contribution No patient or public involvement in this scoping review.


Having to manage: culturally and linguistically diverse mothers’ lived experiences with sustained nurse home visiting programs

April 2023

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61 Reads

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2 Citations

BMC Health Services Research

Background Culturally and linguistically diverse (CALD) mothers with young children with limited English proficiency (LEP) encounter multiple barriers in accessing and engaging with primary healthcare services. The aim of this study was to explore the lived experiences and perceptions of CALD mothers with LEP in receiving child and family health nursing (CFHN) services and sustained nurse home visiting (SNHV) programs. Methods Fourteen mothers were interviewed from two large Local Health Districts in Sydney. All interviews were audio-recorded for transcription purposes. Interpretative Phenomenology Analysis (IPA) was used for analysis and the socioecological approach was applied to interpret the data. Results CALD mothers with LEP experienced both challenges and facilitators in their access and engagement with CFHN services and SNHV programs that were identified in four themes: managing culture; managing the service system; managing the relationship; and strengths and weaknesses of CFHN services. Conclusion The integration of strategies such as building trusting relationships, using female professional interpreters and better understanding of CALD mothers’ cultural practices may address CALD mothers’ needs and facilitate communication. Design and development of model of support involving CALD mothers with LEP in ways that voice their ideas could meet their needs and contribute to better engagement of this vulnerable population with CFHN services and SNHV programs.


Study timeline
Interpreters’ survey reported attitudes, knowledge, experience and confidence
Interpreter use in sustained nurse home visiting: interpreter experience and support

February 2023

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83 Reads

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3 Citations

BMC Health Services Research

Background The aim of this study was to explore the experiences of healthcare interpreters working with child and family health nurses (CFHNs) in providing child and family health nursing (CFHN) services and sustained nurse home visiting (SNHV) programs to culturally and linguistically diverse (CALD) families with limited English proficiency. Methods A mixed methods longitudinal research design was conducted to develop, implement and evaluate a training and practice support model for healthcare interpreters working with nurses and CALD families in providing CFHN services and SNHV programs in three major local health services in Sydney, Australia. One pre-training survey with 24 healthcare interpreters was conducted; field notes were recorded during training and implementation; and a post-implementation focus group with six healthcare interpreters was conducted. Quantitative survey data were analysed descriptively using Alchemer. The focus group was audio-recorded for transcription purposes, and this and the field notes were thematically analysed applying a socioecological framework. Results Three themes were identified from the initial, pre-training survey: facilitate communication and delivery accurately; a bridge linking the clients and the healthcare practitioners; and make everybody feel comfortable. Practice support implementation was negatively impact by system and COVID-19 related barriers. Four themes were developed from evaluative phase of the study including: system-related issues; interpreters’ challenges; working with nurses; and client session related issues. Conclusion Quality interpreting was favourably influenced by adequate time for interpreting the session including a pre- and post-briefing session with CFHNs, an appropriate mode of interpretation, allocation of female interpreters and the same interpreters with CALD mothers and clarity about interpreter role and cultural comfort. These strategies support the quality of communication and relationships in delivery of CFHN services and SNHV programs to CALD mothers with limited English proficiency.


The needs of older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care: An integrative review

January 2023

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75 Reads

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9 Citations

Journal of Clinical Nursing

Aims and objectives: To synthesise information about the needs of older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care from the perspectives of the residents, families and care staff. Background: Older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care have care needs that are complex. Identifying these needs is critical to ensure quality care is delivered. Design: An integrative review of literature. Methods: Five databases were searched for relevant articles: APA PsychINFO, CINAHL, MEDLINE, Scopus and Google Scholar. The search and screening were guided by PRISMA guidelines and Whittemore and Knafl's five-step framework. Results: Fifteen papers were included in this review consisting of 4 quantitative, 9 qualitative and 2 mixed method studies. Two themes described the needs of older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care. The first was related to culture-specific needs, and the second was related to dementia-specific care needs. Culture-specific needs comprised of three subthemes: (a) common language, (b) traditional food, and (c) social and spiritual requirements. Dementia-specific needs comprised of (a) focusing on comfort in addition to clinical requirements and (b) individualised care that addresses behavioural symptoms of dementia. Conclusions: Identifying and meeting the needs of older people with dementia from culturally and linguistically diverse backgrounds will improve quality care delivery in addition to increased caregiving satisfaction among residents, families and care staff, and the management of behaviours that characterise dementia. Relevance to clinical practice: Care needs of older people with dementia from culturally and linguistically diverse backgrounds living in the residential setting can be complex. Education and training of care staff including nurses must be considered so that provision of care is inclusive of the cultural and dementia needs for older people in residential aged care.


Citations (17)


... Nurses employed methods such as fostering relationships through casual conversations and gradually building trust through written correspondence to maintain connections, even under restricted contact conditions. This aligns with studies from Italy and Australia, where nurses reported that maintaining personal connections through informal communication helped alleviate patient anxiety and fostered trust during the COVID-19 pandemic [17,18]. Mothers facing underlying challenges often struggle to accept support, making relationship-building essential [16]. ...

Reference:

Outreach by Municipal Public Health Nurses to Vulnerable Pregnant Women During the COVID-19 Pandemic: A Qualitative Study
Co-Design Model of Support for Child and Family Health Nurse Practice with Culturally and Linguistically Diverse Families

... De facto, a tipologia de doentes habitualmente admitidos nas UCIN implica uma exposição significativa dos profissionais de saúde e das famílias ao sofrimento e à morte, que constituem momentos de crise em que determinadas especificidades culturais, sobretudo de carácter religioso e espiritual, se tornam mais evidentes. [4][5][6] Segundo a literatura, uma das dificuldades mais frequentemente relatadas pelas famílias é a falta de respostas às suas necessidades, começando pela barreira linguística, que limita a transmissão de informações clínicas aos pais e a sua participação nos cuidados. Esta situação culmina na impossibilidade de uma tomada de decisão partilhada, resultando num aumento significativo dos níveis de stress e angústia a que os pais estão expostos. ...

Immigrant and minority parents' experiences in a neonatal intensive care unit: A meta-ethnography review
  • Citing Article
  • August 2024

Journal of Clinical Nursing

... This has also been studied in the interdisciplinary "Transition to home" study in Switzerland (Haemmerli et al., 2021;Schütz Hämmerli et al., 2022) and in an international longitudinal multicenter study (Gaden et al., 2022). In a recent integrative review the authors suggest that music therapy could play an important role also after discharge (Clemencic-Jones et al., 2024). In our study, interviews were conducted with parents from both the intervention and control groups. ...

Music Therapy with Preterm Infants and Their Families after Hospital Discharge: An Integrative Review

... oder mit Kindern als pflegende Angehörige[24].Beziehungen zwischen Geschwistern sind die längsten, die ein Mensch im Lauf seines Lebens hat. Studien zu Besuchen von Geschwistern chronisch kranker Kinder[25] oder Neugeborener auf neonatologischen Stationen[26] berichten von möglichen Vorteilen sowohl für die erkrankten Kinder als auch für ihre Geschwister. Studien zu Geschwisterbesuchen auf Kinderintensivstationen untersuchten das Erleben der gesunden Geschwister mittels Interviews [27][28]. ...

Sibling experiences in the neonatal intensive care unit: An integrative review
  • Citing Article
  • July 2024

Journal of Neonatal Nursing

... Equally, however, these same researchers are committed to making ontological claims about what happened, what works, etc. While critical realism initially lacked methodological elaboration, efforts have been made to rectify that gap (e.g., Allana & Clark, 2018;Cabote et al., 2024;Mercier et al., 2023). Yet, despite interviewing being a key data generation practice in many qualitative methods, we have struggled to find broadly applicable guidance on how to conduct critical realist interviewing. ...

The Synergy of Critical Realism and Case Study: A Novel Approach in Nursing Research

... Up to 17% of all newborn babies will require transfer to a neonatal intensive care unit (NICU) or special care nursery. 1 Over time NICU processes have improved for newborns, including mechanical ventilation, feeding supplementation, infection control, pain management and medical stabilization. Infant survival and the rate and severity of adverse neurological outcomes, including cerebral palsy, have also improved. ...

Scoping review of systematic reviews of nursing interventions in a neonatal intensive care unit or special care nursery
  • Citing Article
  • February 2024

Journal of Clinical Nursing

... For culturally diverse parents, traditional support networks are often missing, approaches to child-rearing or birthing may not be recognised and a lack of culturally acceptable information may be supplied [10]. Lack of social support is known to play a role in the development and maintenance of perinatal distress for women from culturally diverse backgrounds [9,[11][12][13][14] and may contribute to adverse maternal and child outcomes [15]. This suggests a need for further understanding of what culturally appropriate integrated interventions may facilitate the development of social support, to buffer against perinatal depression or distress [9]. ...

Having to manage: culturally and linguistically diverse mothers’ lived experiences with sustained nurse home visiting programs

BMC Health Services Research

... Evidence suggests that using professional interpreters enhances trust within nursemother relationships and facilitates a better understanding of CALD mothers' cultural practices [12,17]. However, Bonakdar Tehrani et al. [18] recognised that healthcare interpreters have ongoing challenges working with CFHNs in the delivery of child and family health nursing services to CALD families. These include factors such as a lack of sufficient time for pre-and post-briefing sessions with CFHNs and uncertainty about the interpreters' role beyond language translation. ...

Interpreter use in sustained nurse home visiting: interpreter experience and support

BMC Health Services Research

... Aging and aged care are also shaped by locally situated social and cultural values that reflect the needs and expectations of the community. 5 These social needs and expectations are not static or normative but reflect an increasingly diverse population. Many older people belong to groups that are often marginalized as a result of their differences from the majority, such as people living with disability, people who identify as lesbian, gay, bisexual, transgender, queer, intersex, asexual (LGBTQIAþ), and people who live in rural and remote areas. ...

The needs of older people with dementia from culturally and linguistically diverse backgrounds living in residential aged care: An integrative review

Journal of Clinical Nursing

... Music is often used in the hospital setting for the management of psychological wellbeing. For instance, a study in progress uses music therapy to reduce antenatal anxiety in those who are hospitalised (Schmied & Kearney, 2018) and has been previously used in homebased perinatal care (Short, 1993). Two current projects are also addressing uses of music to decrease stress and anxiety related to fertility treatment (Alison Short & Natasha Andreadis, see Table 1 and Box 5). ...

Tackling Maternal Anxiety in the Perinatal Period: Reconceptualising Mothering Narratives