List of Titles

'Diabetes is nothing': the experience of older Singaporean women living and coping with type 2 diabetes

- Li, Jiemin, Drury, Vicki, Taylor, Beverley

Authors: Li, Jiemin , Drury, Vicki , Taylor, Beverley
Date: 2013
Type: Text , Journal article
Relation: Contemporary Nurse Vol. 45, no. 2 (2013), p. 188-196
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Description: Purpose: The purpose of this study was to describe, through qualitative methods, the experiences and ways of coping of older Singaporean Chinese women with type 2 diabetes. Methods: Using a qualitative approach, 10 Singaporean Chinese women between the ages of 60–69 described their experiences of living and coping with type 2 diabetes. Data were collected via semi-structured interviews and analysed using thematic analysis. Results: Three themes were identified in the analysis: (i) Living with diabetes; (ii) Coping with diabetes; and (iii) Caring for the self in diabetes. Conclusions: Findings indicate that women living and coping with diabetes confront numerous issues. In order to help these patients initiate and sustain lifestyle modifications, healthcare providers are encouraged to be empathetic and supportive and an understanding of the coping strategies used will ensure that effective coping strategies are utilised. Furthermore, diabetes education for family members will assist them to provide essential, ongoing support for the patient.

Assessing preregistration nursing students' clinical competence : A systematic review of objective measures

- Cant, Robyn, McKenna, Lisa, Cooper, Simon J.

Authors: Cant, Robyn , McKenna, Lisa , Cooper, Simon J.
Date: 2013
Type: Text , Journal article
Relation: International Journal of Nursing Practice Vol. 19, no. 2 (2013), p. 163-176
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Description: Nursing students are required to develop clinical knowledge, skills and attitudes for professional practice. However, objectivity and parity of students' clinical assessments has been questioned. In the last decade, more objective techniques have been developed, with increased use of Objective Structured Clinical Examinations. We reviewed objective clinical assessment measures used in preregistration nursing courses to determine utilization and the validity and reliability of assessment techniques. A systematic search was made of quantitative research publications between 2000 and May 2011, identifying 16 studies that were subsequently reviewed. The validity and reliability of studies varied, with six studies judged as high quality, using various methodologies. This paper describes methods of instrument development and reports on their application in preregistration nursing programs. © 2013 Wiley Publishing Asia Pty Ltd.

Assessment of clinical competence of pre-registration nursing students: a systematic review of objective measures

- Cant, Robyn, McKenna, Lisa, Cooper, Simon J.

Authors: Cant, Robyn , McKenna, Lisa , Cooper, Simon J.
Date: 2013
Type: Text , Journal article
Relation: International Journal of Nursing Practice Vol. 19, no. 2 (2013), p. 163-76
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Description: Nursing students are required to develop clinical knowledge, skills and attitudes for professional practice. However, objectivity and parity of students' clinical assessments has been questioned. In the last decade, more objective techniques have been developed, with increased use of Objective Structured Clinical Examinations. We reviewed objective clinical assessment measures used in preregistration nursing courses to determine utilization and the validity and reliability of assessment techniques. A systematic search was made of quantitative research publications between 2000 and May 2011, identifying 16 studies that were subsequently reviewed. The validity and reliability of studies varied, with six studies judged as high quality, using various methodologies. This paper describes methods of instrument development and reports on their application in preregistration nursing programs.

Attitudes, implementation and practice of family presence during resuscitation (FPDR): a quantitative literature review

- Porter, Joanne, Cooper, Simon J., Sellick, Kenneth

Authors: Porter, Joanne , Cooper, Simon J. , Sellick, Kenneth
Date: 2013
Type: Text , Journal article
Relation: International Emergency Nursing Vol. 21, no. 1 (2013), p. 26-34
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Description: Aim To undertake a review of the quantitative research literature, to determine emergency staff and public attitudes, to support the implementation and practice of family presence during resuscitation in the emergency department. Background FPDR although endorsed by numerous resuscitation councils, cardiac, trauma and emergency associations, continues to be topical, the extent to which it is implemented and practiced remains unclear. Review methods A review of the quantitative studies published between 1992 and October 2011 was undertaken using the following databases: CINAHL, Ovid Medline, PSYCHINFO, Pro-Quest, Theses Database, Cochrane, and Google Scholar search engine. The primary search terms were ‘family presence’, and ‘resuscitation’. The final studies included in this paper were appraised using the Critical Appraisal Skills Programme criteria. Results Fourteen studies were included in this literature review. These included quantitative descriptive designs, pre and post-test designs and one randomized controlled trial (RCT). The studies were divided into three main research areas; investigation of emergency staff attitudes and opinions, family and general public attitudes, and four papers evaluating family presence programs in the emergency department. Studies published prior to 2000 were included in the background. Conclusion FPDR in the emergency department is well recognised and documented among policy makers, the extent in which it is implemented and practiced remains unclear. Further research is needed to assess how emergency staff are educated and trained in order to facilitate family presence during resuscitation attempts.

Cardiovascular risk and androgenic anabolic steroids

- Sculthorpe, Nicholas, Grace, Fergal, Angell, Peter, Baker, Julien, George, Keith

Authors: Sculthorpe, Nicholas , Grace, Fergal , Angell, Peter , Baker, Julien , George, Keith
Date: 2013
Type: Text , Journal article
Relation: British Journal of Cardiac Nursing Vol. 7, no. 6 (2013), p. 266-275
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Description: Although several drugs are purported to improve exercise performance, androgenic anabolic steroids (AAS) are the most widespread. Furthermore, unlike other drugs, their use has expanded beyond competition, to non-competitive and recreational athletes. Correspondingly health professionals are more likely to come into contact with users of AAS than with users of other performance-enhancing drugs. While there are numerous reports outlining serious cardiovascular consequences to high-dose AAS abuse, this evidence is often limited by difficulties in gaining access to users due to the legal status of AAS. Additionally the co-abuse of other substances (as additional muscle mass enhancers, or to mitigate possible side effects) is a further confounding factor. This review examines the evidence for AAS having a negative effect on the cardiac and vascular tissue and the corresponding risk of developing cardiovascular disease. Possible mechanisms of action by which AAS bring about these changes are also discussed.

Changing philosophies: A paradigmatic nursing shift from Nightingale

- Warelow, Philip

Authors: Warelow, Philip
Date: 2013
Type: Text , Journal article
Relation: Australian Journal of Advanced Nursing Vol. 31, no. 1 (2013), p. 36-45
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Description: To consider the changing philosophical and theoretical construction of nursing which has moved from an initial focus on positivism and science, and undergone a paradigmatic shift so that it is now being interpreted by some nursing theorists in alternative ways. Primary Argument A theoretical review of some nursing theorists and a critical consideration of the wider concepts which have been influential in theoretical constructions gradually moving from the received (positivistic) to the perceived view. The perceived view encompasses the emergence and influence of non-positivist philosophies, which shift the theoretical focus away from causation to a more interpretive, unscientific standpoint, with foundations in phenomenology, humanism, holistic care and qualitative research. The paper demonstrates that many of the theories offered are esoteric, complicated and constructed in an academic way that tends to escape the everyday nurse practitioner. Conclusion That multiple options which capture the philosophies and ideologies of both paradigms should/could be considered.

Cultural relevance of the quality-of-life tools for people with kidney failure

- Ayoub, Abdelbasit, Nelson, Katherine, Wood, Pamela

Authors: Ayoub, Abdelbasit , Nelson, Katherine , Wood, Pamela
Date: 2013
Type: Text , Journal article
Relation: Journal of Renal Care Vol. 39, no. 4 (2013), p. 236-245
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Description: Background Many tools are used to examine the Quality of Life (QOL) of patients with kidney disease, but little is known about how culturally relevant they are and why one should utilise one tool over another. As part of a larger study on the QOL of dialysis patients in United Arab Emirates, the cultural relevance of two tools (SF-36 and the QOL Index) was examined. This paper suggests a model to establish cultural relevance of QOL tools. Method A descriptive comparative survey design using a mixed method design was used in 2007 to study the QOL of 161 patients on dialysis and 350 people from the community. The cultural relevance of each tool was assessed by (i) examining missed questions, (ii) asking respondents about the cultural relevance of each tool, (iii) asking respondents what questions could be added or deleted to make the tools more culturally relevant and (iv) asking respondents to identify the factors that might contribute to their QOL. Results Of respondents, 94.7% from the dialysis sample and 90.4% from the community sample considered both tools culturally relevant. The QOL Index tool had more missing data. Many of the themes generated from the analysis of the qualitative data were addressed by the subscales of both tools. Themes not addressed by either tool were concerned with values, safety and country. Conclusion Cultural adaptation of QOL tools needs to follow well-established guidelines. The target population should be involved in establishing the cultural relevance of QOL tools.

Curriculum learning designs : Teaching health assessment skills for advanced nursing practitioners through sustainable flexible learning

- Fitzgerald, Les, Wong, Pauline, Hannon, John, Solberg Tokerud, Marte, Lyons, Judith

Authors: Fitzgerald, Les , Wong, Pauline , Hannon, John , Solberg Tokerud, Marte , Lyons, Judith
Date: 2013
Type: Text , Journal article
Relation: Nurse Education Today Vol. 33, no. 10 (2013), p. 1230-1236
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Description: Background: Innovative curriculum designs are vital for effective learning in contemporary nursing education where traditional modes of delivery are not adequate to meet the learning needs of postgraduate students. This instance of postgraduate teaching in a distributed learning environment offered the opportunity to design a flexible learning model for teaching advanced clinical skills. Aim: To present a sustainable model for flexible learning that enables specialist nurses to gain postgraduate qualifications without on-campus class attendance by teaching and assessing clinical health care skills in an authentic workplace setting. Methods: An action research methodology was used to gather evidence and report on the process of curriculum development of a core unit, Comprehensive Health Assessment (CHA), within 13 different postgraduate speciality courses. Qualitative data was collected from 27 teaching academics, 21 clinical specialist staff, and 7 hospital managers via interviews, focus groups and journal reflections. Evaluations from the initial iteration of CHA from 36 students were obtained. Data was analyzed to develop and evaluate the curriculum design of CHA. Results: The key factors indicated by participants in the curriculum design process were coordination and structuring of teaching and assessment; integration of content development; working with technologies, balancing specialities and core knowledge; and managing induction and expectations. Conclusions: A set of recommendations emerged as a result of the action research process. These included: a constructive alignment approach to curriculum design; the production of a facilitator's guide that specifies expectations and unit information for academic and clinical education staff; an agreed template for content authors; and the inclusion of synchronous communication for real-time online tutoring. The highlight of the project was that it built curriculum design capabilities of clinicians and students which can sustain this alternative model of online learning. © 2012 Elsevier Ltd.

Developing team based acute care scenarios: a rural hospital experience

- Missen, Karen, Sparkes, Louise, Porter, Joanne, Cooper, Simon J., McConnell-Henry, Tracy

Authors: Missen, Karen , Sparkes, Louise , Porter, Joanne , Cooper, Simon J. , McConnell-Henry, Tracy
Date: 2013
Type: Text , Journal article
Relation: International Emergency Nursing Vol. 21, no. 3 (2013), p. 186-189
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Description: Background Health professionals work in teams in a variety of health care settings especially in medical emergency teams at times of crisis. However, Registered Nurses (RNs) rarely have the chance to partake in educational programs designed for teams of nurses to practice working together in life-threatening situations. Further RN’s employed in rural setting have less opportunities for professional development than their city based counterparts. Simulated scenarios with a patient actor in a rural hospital have been utilised in this study to provide nurses with the opportunity to work as a team in the early recognition and management of patients with acute medical conditions. Aim This discussion paper focuses on one aspect of a larger research project with the aim of describing the development of team based scenarios for a rural hospital setting, focusing on the detection and management of a deteriorating patient. Methods Three team based scenarios, the related assessments and feedback techniques are all described. Conclusion Team based simulation provides a unique opportunity to assist registered nurses in rural settings in re-skilling or maintaining their emergency management skills.

Effective interprofessional collaboration in rural contexts : A research protocol

- Mitchell, Rebecca, Paliadelis, Penny, McNeil, Karen, Parker, Vicki, Giles, Michelle, Higgins, Isabel, Parmenter, Glenda, Ahrens, Yvonne

Authors: Mitchell, Rebecca , Paliadelis, Penny , McNeil, Karen , Parker, Vicki , Giles, Michelle , Higgins, Isabel , Parmenter, Glenda , Ahrens, Yvonne
Date: 2013
Type: Text , Journal article
Relation: Journal of Advanced Nursing Vol. 69, no. 10 (2013), p. 2317-2326
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Description: Abstract AIM: To describe the research protocol that will be used to investigate factors contributing to effective interprofessional practice in a rural context in Australia. BACKGROUND: Interprofessional practice is a key strategy for overcoming rural health challenges; however, our knowledge of interprofessional initiatives and consequences in rural areas is limited. DESIGN: A modified realistic evaluation approach will be used to explore the structures, systems, and social processes contributing to effective interprofessional outcomes. This 'context-mechanism-outcome' approach provides a useful framework for identifying why and how interprofessional practice works in rural contexts. METHOD: Initial propositions regarding the factors that explain effective collaborative practice will be generated through interviews with lead clinicians, policy-makers, and clinician managers. Clinician interviews, document analysis, and multi-participant focus groups will be used as evidence to support, refine, or redevelop the initial propositions. This will allow the development of a model of rural interprofessional practice that will explain how and why collaborative approaches work in rural environments. This study is funded by an Institute of Rural Clinical Services and Teaching grant (January 2010). DISCUSSION: Rural healthcare challenges are well documented; however, studies investigating the nature of interprofessional practice in rural contexts are not common. Rural contexts also present research design, particularly data collection, challenges. This proposed research is one of the first to identify the factors that facilitate or constrain effective interprofessional work in rural settings. This is particularly important, given the continuing workforce shortages and maldistribution and poorer health outcomes in rural communities globally.

Emergency and palliative care nurses' levels of anxiety about death and coping with death : A questionnaire survey

- Peters, Louise, Cant, Robyn, Payne, Sheila, O'Connor, Margaret, McDermott, Fiona, Hood, Kerry, Morphet, Julia, Shimoinaba, Kaori

Authors: Peters, Louise , Cant, Robyn , Payne, Sheila , O'Connor, Margaret , McDermott, Fiona , Hood, Kerry , Morphet, Julia , Shimoinaba, Kaori
Date: 2013
Type: Text , Journal article
Relation: Australasian Emergency Nursing Journal Vol. 16, no. 4 (2013), p. 152-159
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Description: Background: Caring for dying patients and their families presents many challenges, and may be negatively affected by nurses' Fear of Death. This study investigates attitudes of emergency and palliative care nurses towards death and dying. Methods: A mixed methods design including questionnaire and interview, was utilised. This paper reports questionnaire results from the Death Attitude Profile-Revised Scale and coping skills. Results: Twenty-eight emergency nurses and 28 palliative care nurses from two health services participated. Nurses held low to moderate Fear of Death (44%), Death Avoidance (34%), Escape Acceptance (47%) and Approach Acceptance (59%). Emergency nurses reported higher death avoidance and, significantly lower coping skills than palliative care nurses. Both reported high acceptance of the reality of death (Neutral Acceptance 82%), and indicated they coped better with a patient who was dying than with, the patient's family. Conclusions: Nurses generally held positive attitudes towards death and dying. Participants could cope with caring for dying patients, but were significantly less comfortable coping with patients' family members. Nurses should be aware of the impact their attitude towards death may have on providing supportive nursing care for the dying. © 2013 College of Emergency Nursing Australasia Ltd.

Ethical issues in health-care inquiry: a discussion paper

- Ignacio, Jeanette, Taylor, Beverley

Authors: Ignacio, Jeanette , Taylor, Beverley
Date: 2013
Type: Text , Journal article
Relation: International journal of nursing practice Vol. , no. 19 (Supplement S1) (2013), p. 56-61
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Description: This paper is a discussion of the possible ethical dilemmas that may arise in both qualitative and quantitative research despite stringent methodological protocols. Three categories of ethical issues will be elaborated on, namely, researcher–participant relations, informed consent and confidentiality and privacy. These are of note because ethical dilemmas most often arise in these areas. Both qualitative and quantitative research types may thus present with problems associated with any, or a combination, of these categories. Methodological rigour will also be discussed as a vital component of any research study. Critics of the qualitative approach have often suggested that the innate lack of methodological rigour has resulted in the preponderance of ethical issues in qualitative studies. Qualitative studies, similar to quantitative studies, have mechanisms that guarantee rigour, quality and trustworthiness. These checks are at par with those of quantitative research but based on different criteria. Both types of research, then, can be considered equal in terms of methodological rigour, regardless of the nature. As no research approach can be perfectly free from threats of ethical issues, it is the researcher's responsibility to address these in ways that will be less harmful to the participants, bearing in mind ethical problems can arise at any time during the research endeavour.

Family needs and involvement in the intensive care unit : A literature review

- Al Mutair, Abbas, Plummer, Virginia, O'Brien, Anthony, Clerehan, Rosemary

Authors: Al Mutair, Abbas , Plummer, Virginia , O'Brien, Anthony , Clerehan, Rosemary
Date: 2013
Type: Text , Journal article , Review
Relation: Journal of Clinical Nursing Vol. 22, no. 13-14 (2013), p. 1805-1817
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Description: Aims and objectives: To understand the needs of critically ill patient families', seeking to meet those needs and explore the process and patterns of involving family members during routine care and resuscitation and other invasive procedures. Methods: A structured literature review using Cumulative Index to Nursing and Allied Health Literature, Pubmed, Proquest, Google scholar, Meditext database and a hand search of critical care journals via identified search terms for relevant articles published between 2000 and 2010. Results: Thirty studies were included in the review either undertaken in the Intensive Care Unit or conducted with critical care staff using different methods of inquiry. The studies were related to family needs; family involvement in routine care; and family involvement during resuscitation and other invasive procedures. The studies revealed that family members ranked both the need for assurance and the need for information as the most important. They also perceived their important needs as being unmet, and identified the nurses as the best staff to meet these needs, followed by the doctors. The studies demonstrate that both family members and healthcare providers have positive attitudes towards family involvement in routine care. However, family members and healthcare providers had significantly different views of family involvement during resuscitation and other invasive procedures. Conclusion: Meeting Intensive Care Unit family needs can be achieved by supporting and involving families in the care of the critically ill family member. More emphasis should be placed on identifying the family needs in relation to the influence of cultural values and religion held by the family members and the organisational climate and culture of the working area in the Intensive Care Unit. © 2013 Blackwell Publishing Ltd.

Hermeneutic phenomenology: a methodology of choice for midwives

- Miles, Maureen, Francis, Karen, Chapman, Ysanne, Taylor, Beverley

Authors: Miles, Maureen , Francis, Karen , Chapman, Ysanne , Taylor, Beverley
Date: 2013
Type: Text , Journal article
Relation: International journal of nursing practice Vol. 19, no. 4 (2013), p. 409-414
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Description: Hermeneutic phenomenology has been used widely by researchers to understand lived experiences. This methodology asserts that individual people are as unique as their life stories. The practice of midwifery is underpinned by a philosophy that values women and the uniqueness of their child-bearing journey. The tenets of hermeneutics phenomenology align with those of contemporary midwifery practice, making it a useful research methodology for providing insights into issues relevant to the profession. The purpose of this paper is to unravel some foundational concepts of hermeneutic phenomenology and recommend it as a methodology of choice for midwives to apply to their application to midwifery-in-action.

Impact of demographic change, socioeconomics, and health care resources on life expectancy in Cambodia, Laos, and Myanmar

- Chan, Moon Fai, Taylor, Beverley

Authors: Chan, Moon Fai , Taylor, Beverley
Date: 2013
Type: Text , Journal article
Relation: Public Health Nursing Vol. 30, no. 3 (2013), p. 183-192
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Description: Objectives: Demographic and socioeconomic changes and the availability of health care resources were collected to examine the impacts on life expectancy in Cambodia, Laos, and Myanmar. Design and Sample: An ecological design collecting 29 years (1980 –2008) data for three Southeast Asian countries. Measures: Life expectancy, demographics, socioeconomic status, and health care resources were collected. Results: The structural equation model indicates that more available health care resources and socioeconomic advantages were more likely to increase life expectancy. By contrast, demographic change was more likely to increase life expectancy by way of health care resources. Conclusions: Results show that factors that had direct impacts on life expectancy in all three countries were socioeconomic status and health care resources. Demographic changes had an indirect influence on life expectancy via health care resources. These findings suggest that policymakers should be focusing on how to remove the barriers that impede access to health care services during economic downturns. In addition, how to increase preventive care for the populations that have less access to health care in communities

Investigating factors that have an impact on nurses' performance of patients' conscious level assessment: a systematic review

- Chan, Moon Fai, Mattar, Ihsan, Taylor, Beverley

Authors: Chan, Moon Fai , Mattar, Ihsan , Taylor, Beverley
Date: 2013
Type: Text , Journal article
Relation: Journal of Nursing Management Vol. 21, no. 1 (2013), p. 31-46
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Description: Aim To identify factors that have an impact on nurses’ performance of patients’ conscious level assessment. Background There is a need for nurses to accurately assess a patient’s conscious level to detect neurological changes and initiate prompt action. Methods Nine databases were systematically searched (1990–February 2010) to review experimental, cohort, case control, cross-sectional and descriptive studies that addressed factors which affected nurses’ performance of patient conscious level assessment. Participants in the studies reviewed were nursing staff. The Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instrument was used for quality assessment. Results Eleven studies were analysed in this review. Knowledge and experience were found to be the most significant factors in determining nurses’ performance of patient conscious level assessment. Formal training was found to be effective in improving assessment skills and experience greatly affected the accuracy of assessment. Conclusion Knowledge and experience are the most significant factors on nurses’ performance of consciousness level assessment. Implications for nursing management Formal training is needed on a continual basis to maintain skills in consciousness level assessment, and nurses who are more experienced in the use of assessment should mentor those that are less experienced

Managing patient deterioration: assessing teamwork and individual performance

- Cooper, Simon J., Cant, Robyn, Porter, Joanne, Missen, Karen, Sparkes, Louise, McConnell-Henry, Tracy, Endacott, Ruth

Authors: Cooper, Simon J. , Cant, Robyn , Porter, Joanne , Missen, Karen , Sparkes, Louise , McConnell-Henry, Tracy , Endacott, Ruth
Date: 2013
Type: Text , Journal article
Relation: Emergency Medicine Journal Vol. 30, no. 5 (2013), p.
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Description: Objective To assess the ability of rural Australian nurse teams to manage deteriorating patients. Methods This quasi-experimental design used pre- and post-intervention assessments and observation to evaluate nurses' simulated clinical performance. Registered nurses (n=44) from two hospital wards completed a formative knowledge assessment and three team-based video recorded scenarios (Objective Structured Clinical Examinations (OSCE)). Trained patient actors simulated deteriorating patients. Skill performance and situation awareness were measured and team performance was rated using the Team Emergency Assessment Measure. Results Knowledge in relation to patient deterioration management varied (mean 63%, range 27–100%) with a median score of 64%. Younger nurses with a greater number of working hours scored the highest (p=0.001). OSCE performance was generally low with a mean performance of 54%, but performance was maintained despite the increasing complexity of the scenarios. Situation awareness was generally low (median 50%, mean 47%, range 17–83%, SD 14.03) with significantly higher levels in younger participants (r=−0.346, p=0.021). Teamwork ratings averaged 57% with significant associations between the subscales (Leadership, Teamwork and Task Management) (p<0.006), the global rating scale (p<0.001) and two of the OSCE measures (p<0.049). Feedback from participants following the programme indicated significant improvements in knowledge, confidence and competence (p<0.001). Conclusion Despite a satisfactory knowledge base, the application of knowledge was low with notable performance deficits in these demanding and stressful situations. The identification and management of patient deterioration needs to be taught in professional development programmes incorporating high fidelity simulation techniques. The Team Emergency assessment tool proved to be a valid measure of team performance in patient deterioration scenarios.

Nurse managers don't get the corner office

- Paliadelis, Penny

Authors: Paliadelis, Penny
Date: 2013
Type: Text , Journal article
Relation: Journal of Nursing Manager Vol. 21, no. 2 (Special Issue) (2013), p. 377-386
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Description: To provide an original perspective on the power and status of first-line nurse managers by observing their working environment. BACKGROUND: The role of first-line nurse managers includes clinical, administrative and managerial components, with their responsibilities not always reflected in their level of organizational power. The business literature suggests that an appropriately resourced workspace is not merely functional, it also confers power and status. METHOD: Twenty Australian rural nurse managers' workspaces were observed, as part of a larger qualitative study that explored their role and organizational power using semi-structured interviews. The observational data consisted of detailed researcher notes that were analysed thematically. RESULTS: The nurse managers' workspaces were suboptimal and did not provide sufficient physical space or resources for the participants' to manage tasks effectively. These results were considered using Kanter's theory of organizational power. IMPLICATIONS FOR NURSING MANAGEMENT: The findings support those reported in the business literature that inadequate physical workspaces are counterproductive in terms of both functionality and organizational power. Suggestions are made regarding the workspace needs of first-line nurse managers, based on a closer alignment between the work environment and their role responsibilities. These findings have implications for decisions regarding organizational support of first-line nurse managers.

Postoperative pain management experiences among school-aged children: a qualitative study

- Sng, Qian, Taylor, Beverley, Liam, Joanne, Klainin-Yobas, Piyanee, Wang, Wenru, He, Hong-Gu

Authors: Sng, Qian , Taylor, Beverley , Liam, Joanne , Klainin-Yobas, Piyanee , Wang, Wenru , He, Hong-Gu
Date: 2013
Type: Text , Journal article
Relation: Journal of Clinical Nursing Vol. 22, no. 7-8 (2013), p. 958-968
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Description: Aims and objectives To explore postoperative pain management experiences among school-aged children. Background Ineffective postoperative pain management among children has been commonly reported. School-aged children are able to evaluate how their pain is managed and what their preferred strategies are. Most studies in pain management have adopted quantitative methods and have overlooked children's pain management experiences. Design This is a qualitative study using face-to-face interviews. Methods Data were collected from 15 school-aged children admitted to a tertiary hospital in Singapore by in-depth interviews conducted between November 2010 and January 2011. Data were analysed by thematic analysis. Results Five themes were identified: children's self-directed actions to relieve their postoperative pain (e.g. using cognitive-behavioural methods of distraction and imagery, physical method of positioning, sleeping and drinking, seeking other people's help by informing parents and crying and using pain medications); children's perceptions of actions parents take for their postoperative pain relief (assessing pain, administering pain medications, using various cognitive-behavioural, physical methods and emotional support strategies, assisting in activities and alerting health professionals); children's perception of actions nurses take for their postoperative pain relief (administering medication, using cognitive-behavioural methods, emotional support strategies and helping with activities of daily living) and suggestions for parents (using distraction and presence) and nurses (administering medications, distraction and positioning) for their postoperative pain relief improvement. Conclusions This study contributed to the existing knowledge about children's postoperative pain management based on their own experiences. Children, their parents and nurses used various strategies, including pain medication and non-pharmacological methods, especially distraction, for children's postoperative pain relief.

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