Description:
The purpose of this study was to identify how healthcare clients achieve and maintain a sense of control over their health. The literature review conducted refers to: (i) key definitions of control, (ii) locus of control, and (iii) control and wellbeing. Participants with a range of acute and chronic health conditions and who had been hospitalised at some point were selected for the study. Symbolic interactionism (Blumer, 1969) and modified grounded theory of Strauss & Corbin (1998) provided the frameworks for this study. During the six month study period, data were collected from sixty participants and included interviews, participant observation, reviewing participants' records (nursing care plans, nursing notes and case histories), the nursing units' philosophy, organisational charts, policies and procedures, annual reports, consumer brochures and any other relevant information sources. Findings from the study indicated that participants moved from feeling vulnerable to having a sense of control through to being purposefully active. Vulnerability was associated with: (i) having limited choices in respect to their health, (ii) lacking adequate health information to make choices, (iii) being ignored by health providers with respect to their needs, and (iv) lacking friend/family supports. Purposefully activating was associated with three major categories: (i) reflecting, (ii) being self-determiningly involved and (iii) normalising. Findings from this study could be used by health care clients who want a sense of control over their health care, and also by health care providers who wish to support clients in the healthcare process.
Description:
The purpose of this study was to identify how healthcare clients achieve and maintain a sense of control over their health. The literature review conducted refers to: (i) key definitions of control, (ii) locus of control, and (iii) control and wellbeing. Participants with a range of acute and chronic health conditions and who had been hospitalised at some point were selected for the study. Symbolic interactionism (Blumer, 1969) and modified grounded theory of Strauss & Corbin (1998) provided the frameworks for this study. During the six month study period, data were collected from sixty participants and included interviews, participant observation, reviewing participants' records (nursing care plans, nursing notes and case histories), the nursing units' philosophy, organisational charts, policies and procedures, annual reports, consumer brochures and any other relevant information sources. Findings from the study indicated that participants moved from feeling vulnerable to having a sense of control through to being purposefully active. Vulnerability was associated with: (i) having limited choices in respect to their health, (ii) lacking adequate health information to make choices, (iii) being ignored by health providers with respect to their needs, and (iv) lacking friend/family supports. Purposefully activating was associated with three major categories: (i) reflecting, (ii) being self-determiningly involved and (iii) normalising. Findings from this study could be used by health care clients who want a sense of control over their health care, and also by health care providers who wish to support clients in the healthcare process.
Description:
The aim of this study was to investigate the experience of birth planning for pregnant women. Research in Australia and overseas has suggested that there are a number of conflicting issues with women's preparation and participation in childbirth. The researcher interviewed forty-two first time mothers in a variety of maternity settings around Victoria to ascertain the importance of birth planning in their approach to childbirth and the ways they went about making their plan and negotiating their needs with health professionals. The data from those interviews demonstrated that the means women used to negotiate their needs for childbirth with health professionals had little influence on their overall pregnancy and birth experience.
Description:
Caring is characterized by close and fragile relations between nurses and patients. At times, even with good intentions, nurses cause unintended harm of patients. We argue that the dominance of economic discourses in health care and their subsequent influence on service delivery and health care practices has the potential to increase unintended patient harm. Similar techniques and practices can result in either desired outcomes or harmful outcomes. We explore the notion of unintended harm and some of the ways it arises in nursing practice. We argue there is a clear link between the dominance of economic discourses and an increased risk of unintended harm. As a consequence of the dominance of economic rationalist discourses and the subsequent systems of control introduced, the practice of nursing has been significantly influenced. The challenge for nurses and the nursing profession is to develop strategies to refuse to give in to the dominance of economic interests over the need to prevent harm.
Description:
Caring is characterized by close and fragile relations between nurses and patients. At times, even with good intentions, nurses cause unintended harm of patients. We argue that the dominance of economic discourses in health care and their subsequent influence on service delivery and health care practices has the potential to increase unintended patient harm. Similar techniques and practices can result in either desired outcomes or harmful outcomes. We explore the notion of unintended harm and some of the ways it arises in nursing practice. We argue there is a clear link between the dominance of economic discourses and an increased risk of unintended harm. As a consequence of the dominance of economic rationalist discourses and the subsequent systems of control introduced, the practice of nursing has been significantly influenced. The challenge for nurses and the nursing profession is to develop strategies to refuse to give in to the dominance of economic interests over the need to prevent harm.
Description:
This paper presents the findings of a doctoral research project that involved a state-wide investigation into mental health triage nursing in Victoria, Australia. Mental health triage is a specialized domain of nursing practice that has emerged within the context of wider mental health reform in the State. The overall aim of the study was to produce a comprehensive definition and description of psychiatric triage nursing in Victoria. Methodological triangulation was used in the design of the study to enable the use of both survey (n = 139) and semi-structured interview (n = 21) data collection methods. Mental health triage nursing was found to be a complex, stressful role that involves high levels of responsibility, clinical decision making, and multiple role functions, many of which overlap into areas of practice previously the exclusive domain of medicine, such as assessment, diagnosis, and referral. The paper raises discussion on contemporary professional issues of concern to mental health triage nursing, and concludes with recommendations for the future development of the discipline.
Description:
The purpose of this study was to evaluate the effectiveness of the Home Fall Hazards Assessment (HFHA) tool adjusted for Chinese homes to raise awareness of the dangers of falling among Chinese older adults. This descriptive study of 415 Chinese adults age 60 and older was completed in the older adults’ homes in the community. The study was an assessment by nurses of hazards in the home setting using the HFHA. The hazards identified by nurses were compared with those reported by the elderly individuals. The study identified the most frequently found hazards in the homes and showed that a large discrepancy existed between the actual hazards assessed by trained nurses using the HFHA and the perceived hazards reported by the participants (p < .001). The study suggests that the HFHA can be an effective health education method and that the involvement of older adults in the assessment process will effectively raise their awareness of existing risk factors for falls in their everyday life.
Description:
Aims and objectives. To identify the effect of music on preprocedure anxiety levels of Hong Kong Chinese patients undergoing day procedures in a local community based hospital. Design. Pre and post-test quasi experimental design with non-random assignment. Method. A total of 113 participants were assigned to the control group or intervention group depending on the day of their procedure. Participants' anxiety levels were measured objectively by comparing their vital signs and subjectively by the Spielberger State Trait Anxiety Scale. Participants' physiological parameters (blood pressure, pulse and respiration) and State Trait Anxiety Scale were measured at two time periods. The control group undertook the usual relaxing activities provided in the waiting room compared with the intervention group who listened to music of their own choice in reclining chairs while waiting for the procedure. Results. The physiological parameters for both the control and intervention groups dropped significantly during the waiting period, however, only the intervention group had a significant reduction in reported anxiety levels. Conclusions. These results suggest that providing self-selected music to day procedure patients in the preprocedure period assists in the reduction of physiological parameters and anxiety, yet, a relaxing environment can assist in the reduction of physiological parameters. Relevance to clinical practice. The administration of self-selected music to day procedure patients in the preprocedure period can be effective in the reduction of physiological parameters and anxiety.
Description:
An Australian Institute of Criminology report (1999) highlighted the health industry as the most violent industry in Australia with registered nurses recording the second highest number of violence. related workers compensation claims, ranking higher than prison and police officers. Workplace violence has become such a common phenomenon that many nurses accept it as a part of nursing. Nurses employed in emergency departments (EDs) are considered to be especially vulnerable to workplace violence. Although there have been a number of studies reporting on the incidence of workplace violence and its consequences upon nurses, to date there have been no empirical studies that have evaluated interventions which are thought to reduce its occurrence and impact. This study investigated the effectiveness of a oneday training program in which ED nurses participated. In particular, their knowledge, skiUs and attitudes relating to management of workplace violence were examined. Results show that a training program has many positive outcomes which enhance nurses' ability to manage aggressive behaviours. With some basic training, ED nurses can be more prepared to manage violent and potentially violent situations, and by doing so may in fact reduce the incidence of aggression in their workplace by 50%. This has largely been achieved by raising the awareness of ED nurses to the nature of the problem, developing their knowledge and skills in managing aggressive behaviour, and improving their attitudes toward potentially violent patients.
Description:
Collaboration between the education and service providers assists with the development of enhanced clinical and educational experiences for students. This paper describes an innovative collaborative program developed by the School of Nursing, University of Ballarat and Grampians Psychiatric Services, Ballarat Health Services. Mental health clinical nursing staff are the student off-campus clinical supervisors and on-campus lecturers, supported by two jointly appointed co-ordinators. Program evaluation reveals that this collaborative approach assists in the provision of a supportive learning environment, increases enthusiasm about psychiatric nursing and draws on relevant mental health nursing skills in the university and service sectors.
Description:
Aggression within the health industry has been wideiy reported as a serious problem with registered nurses frequently being on the receiving end of physical, verbal and sexual abuse. Some authors have reported aggression is so prevalent nurses accept it as part of their job. What has not been recorded is the impact of workplace aggression on the professional and emotional status of nurses as reported by nurses themselves. This study utilized a phenomenological approach involving in-depth interviews and thematic analysis to gain insights into how 33 nurses responded to workplace aggression. Three shared themes, professional incompetency, expectation to cope and emotional confusion, which encapsulate the meanings conveyed by nurses to being victims of aggression were identified. The themes serve to remind both individual nurses and the nursing profession as awhole to become more aware of the impact of workplace aggression and its relevance for themselves, their colleagues and the profession. Thus, nurses should be educated through in-service or continuing education programs that admission to negative emotions is acceptable and to develop coping strategies that deal effectively with their feelings of anger or frustration. Perhaps the most important implication emanating from this investigation is that the profession as awhole should become aware of the extent of the problem and the role nurse colleagues, nurse managers and medical staff play in its genesis.
Description:
INTRODUCTION: This phenomenological study, conducted in rural Australia, explored the experiences of registered nurses (RNs) responsible for assessing the clinical competence of undergraduate nursing students. The purpose of the study was to gain insight into the experiences of a group of registered nurses who assess student competence by exploring how they perform the assessment process. A key assumption on which this study was based is that the participants are 'expert nurses', as defined by Benner. METHOD: Participants were recruited using purposive sampling from a population of registered nurses who assessed the clinical performance of undergraduate nursing students studying at a rural university in New South Wales, Australia. Individual unstructured interviews were conducted and audiotaped with the participants' permission. The analysed data were given to all participants to check for accuracy and validation and a thematic analysis of the data was conducted. RESULTS: Four themes were identified; the major theme, described in this article, was identified in all the narratives. The participants all acknowledged that they use their expert nursing knowledge to assist them when assessing the clinical competence of nursing students. The participants used a variety of terms to describe this type of knowledge such as intuition, instinct, gut feeling and 'just knowing'. CONCLUSION: While the findings of this study confirmed that experienced nurses unconsciously use their expert nursing knowledge when making decisions about students' competence, the findings also indicated a lack of awareness or underestimation of the value of expert clinical knowledge. These findings reinforce the need for further investigation to determine the role of expert nursing knowledge in the clinical competency assessment process. This is particularly significant for rural registered nurses employed in small health-care facilities, who often assume the role of assessors of student clinical competence.
Description:
Consumer partnerships have been embraced as an important component of building high quality health care services. While nurses have the greatest contact with clients in hospital, little is known of their views about consumer participation or how they facilitate that participation at the bedside. Using focus group interviews and participant observation methods, this project explored nurses' approaches to working with consumers to support their participation in health care delivery. Findings indicate a sharp contrast between the ideas that nurses expressed and the actions observed in practice. It was clear from the interviews that nurses had adopted the rhetoric surrounding consumer participation, yet observational data revealed nursing practices that excluded active participation by consumers. Factors influencing nurses' facilitation of consumer participation were identified as the division of nursing labour in the setting, limited communication between nurses and patients and environmental constraints.
Description:
This study investigated the curative effects of notoginseny cream versus Hirudoid cream in the treatment of postinfusion phlebitis. Sixty-five patients who received peripheral infusion therapy during a 20-month period and had developed phlebitis were divided randomly into two groups. Group A was treated with notoginseny cream, a topical Chinese medicine developed and produced by the pharmacological department of The Second Affiliated Hospital of Sun Yat-Sen University. Group B was treated with heparinoid cream (Hirudoid, a commercial product from Germany). Significantly fewer applications of notoginseny cream were required to bring about the disappearance of signs and symptoms of phlebitis in the group A patients as compared with the group B patients for the same effect. The actual time of disappearance of the signs and symptoms of phlebitis also were significantly shorter in patients treated with notoginseny cream than with heparinoid cream.
Description:
The aim of this qualitative study was to gain insight into the experiences of fathers living with their chronically ill children in rural Australia. Data were collected via unstructured interviews with four fathers. Analysis followed the procedural steps for phenomenological data as outlined by Colaizzi (1978). Fathers described their experience of living with their chronically ill child as being filled with progressive losses for themselves and their child, including loss of: 1) pre-conceived expectations of future life; 2) a normal parenting relationship with their child; 3) normal partner relationship; and, 4) control of time and freedom. Findings contribute to knowledge and understanding of the complex nature of fathering a chronically ill child in rural Australia.
Description:
The aim of this qualitative study was to gain insight into the experiences of fathers living with their chronically ill children in rural Australia. Data were collected via unstructured interviews with four fathers. Analysis followed the procedural steps for phenomenological data as outlined by Colaizzi (1978). Fathers described their experience of living with their chronically ill child as being filled with progressive losses for themselves and their child, including loss of: 1) pre-conceived expectations of future life; 2) a normal parenting relationship with their child; 3) normal partner relationship; and, 4) control of time and freedom. Findings contribute to knowledge and understanding of the complex nature of fathering a chronically ill child in rural Australia.
Description:
Chronic illness frequently contributes to diminished levels of activity, a consequent increased dependence on health related support services and reduced quality of life. Surprisingly few studies have described activity among people with end-stage renal disease (ESRD). The current study examined the utility and validity of the Human Activity Profile (HAP) for describing activity in a sample of Australians with ESRD. A descriptive design supported the primary objective of validating the use of HAP for an Australian renal population. Data was collected from 65 adults with ESRD under the care of one regional and one metropolitan renal unit in Victoria. The HAP measures physical activity across a range of activities of daily living, including a dyspnoea scale. The Sickness Impact Profile (SIP) describes activities associated with daily living in the areas of physical, psychological and independence. The HAP, SIP and a questionnaire summarising demographic and diagnostic details were administered while each person was undergoing dialysis and the results subsequently compared. This study demonstrates that HAP is a valid measure of activity levels for people with ESRD undergoing maintenance haemodialysis. Additionally, scores on SIP and HAP indicate that this group have low levels of daily activity. These findings support the use of HAP in research to understand the activity levels of ESRD patients and the factors associated with decline.
Description:
Aim. To present findings from a study conducted between 1996 and 1998 to investigate participants' perceptions of illness causation following a myocardial infarction. Rationale. The underlying assumption of many practitioners is that perceptions of illness causation will influence emotions and adjustment to illness. Design. Phenomenology was the research methodology used to examine perceptions of illness causation. A convenience sample was taken of 24 men and women who were admitted to a regional hospital in Victoria, Australia, with a provisional diagnosis of myocardial infarction. Participants were interviewed shortly after hospitalization, and interviews were taped, transcribed and thematically analysed. Findings. Stress was the most commonly cited cause of illness. Men and women demonstrated distinct differences in illness attribution. Participants who verbalized concerns about their loss of autonomy and their subsequent ability for self-management were predominantly female and uniformly members of the lowest socio-economic group. Conclusion. The article concludes with a discussion of implications of the findings for practice.
Description:
Depression following childbirth is a common, distressing but frequently underreported disorder. It involves a spectrum of symptoms, some of which may be self-limiting, while others can have major mental health implications in the post partum period. A range of health professionals, including midwives and mental health nurses, come into contact with women who suffer from postnatal depression; however, there is often little attempt made to integrate maternity and mental health care approaches. More collaborative frameworks of care are vital if health professionals are to adequately meet the needs of 'unhappy' women in the postnatal period.
Description:
Many nursing scholars have examined the negative effects of rituals in nursing practice, and have argued for nurses to abolish these ritual practices; however, rituals remain resilient. There must be reasons that nurses are keeping these rituals alive. This study aimed to explore the meanings of the 'morning tea break ritual' to a group of nurses in a medical ward. The study employed an ethnographic methodology and found that the morning tea break ritual provided time, space and an environment where nurses can ventilate their feelings and gain each other's support. Thus, the morning tea break ritual has positive contribution to nurses' work and both nurses and patients are the beneficiaries of this ritual act.