Unprepared for the depth of my feelings' - capturing grief in older people through research poetry
- Gerber, Katrin, Brijnath, Bianca, Lock, Kayla, Bryant, Christina, Hills, Danny, Hjorth, Larissa
- Authors: Gerber, Katrin , Brijnath, Bianca , Lock, Kayla , Bryant, Christina , Hills, Danny , Hjorth, Larissa
- Date: 2022
- Type: Text , Journal article
- Relation: Age and Ageing Vol. 51, no. 3 (2022), p.
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- Description: Background: Older people are more likely to experience bereavements than any other age group. However, in healthcare and society, their grief experiences and support needs receive limited attention. Through innovative, arts-based research poetry, this study aimed to capture older people's bereavement stories and the effects of grief on their physical and mental health. Method: Semi-structured in-depth interviews with 18 bereaved older adults were analysed using thematic and poetic narrative analysis, following a five-step approach of immersion, creation, critical reflection, ethics and engagement. Results: Research poems were used to illustrate three themes of bereavement experiences among older adults: feeling unprepared, accumulation of losses and ripple effects of grief. While half of participants reported that the death of their family member was expected, many felt unprepared despite having experienced multiple bereavements throughout their life. Instead, the accumulation of losses had a compounding effect on their health and well-being. While these ripple effects of grief focussed on emotional and mental health consequences, many also reported physical health effects like the onset of a new condition or the worsening of an existing one. In its most extreme form, grief was connected with a perceived increased mortality risk. Conclusions: By using poetry to draw attention to the intense and often long-lasting effects of grief on older people's health and well-being, this article offers emotional, engaging and immersive insights into their unique bereavement experiences and thereby challenges the notion that grief has an expiry date. © 2022 The Author(s) 2022. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.
- Authors: Gerber, Katrin , Brijnath, Bianca , Lock, Kayla , Bryant, Christina , Hills, Danny , Hjorth, Larissa
- Date: 2022
- Type: Text , Journal article
- Relation: Age and Ageing Vol. 51, no. 3 (2022), p.
- Full Text:
- Reviewed:
- Description: Background: Older people are more likely to experience bereavements than any other age group. However, in healthcare and society, their grief experiences and support needs receive limited attention. Through innovative, arts-based research poetry, this study aimed to capture older people's bereavement stories and the effects of grief on their physical and mental health. Method: Semi-structured in-depth interviews with 18 bereaved older adults were analysed using thematic and poetic narrative analysis, following a five-step approach of immersion, creation, critical reflection, ethics and engagement. Results: Research poems were used to illustrate three themes of bereavement experiences among older adults: feeling unprepared, accumulation of losses and ripple effects of grief. While half of participants reported that the death of their family member was expected, many felt unprepared despite having experienced multiple bereavements throughout their life. Instead, the accumulation of losses had a compounding effect on their health and well-being. While these ripple effects of grief focussed on emotional and mental health consequences, many also reported physical health effects like the onset of a new condition or the worsening of an existing one. In its most extreme form, grief was connected with a perceived increased mortality risk. Conclusions: By using poetry to draw attention to the intense and often long-lasting effects of grief on older people's health and well-being, this article offers emotional, engaging and immersive insights into their unique bereavement experiences and thereby challenges the notion that grief has an expiry date. © 2022 The Author(s) 2022. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Nursing perspectives on reducing sedentary behaviour in sub-acute hospital settings : a mixed methods study
- Hills, Danny, Ekegren, Christina, Plummer, Virginia, Freene, Nicole, Kunstler, Breanne, Robinson, Tracy, Healy, Ellen, Vo, Jennifer, Gasevic, Danijela, Crabtree, Amelia
- Authors: Hills, Danny , Ekegren, Christina , Plummer, Virginia , Freene, Nicole , Kunstler, Breanne , Robinson, Tracy , Healy, Ellen , Vo, Jennifer , Gasevic, Danijela , Crabtree, Amelia
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 31, no. 9-10 (2022), p. 1348-1361
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- Description: Aim and objectives: To determine the factors influencing nurses’ decisions and capacity to reduce sedentary behaviour in hospital inpatients in sub-acute hospital settings. Background: Sedentary behaviour in hospital inpatients is a complex issue that can be resistant to resolution. There is little research investigating factors influencing nurses’ promotion of reduced levels of sedentary behaviour in sub-acute hospital settings. Design: An explanatory sequential design was employed, comprising quantitative and qualitative phases. Methods: An online survey was conducted with a convenience sample of 138 nurses from five Australian states. Logistic regression modelling identified demographic and behavioural characteristics of nurses who often encouraged patients to reduce their sedentary behaviour. In-depth interviews were conducted with 11 ward nurses and nurse managers, with the content subjected to thematic analysis. STROBE and GRAMMS checklists were employed. Results: Nurses recognised their role in promoting reduced sedentary behaviour but faced a range of personal and organisational barriers in achieving this outcome for patients. Few nurses were aware of national physical activity and sedentary behaviour guidelines. Five themes emerged from interviews (nursing role, care challenges, expectations of advocates, teamwork and improving the experience). Overall, many nurses experienced a lack of agency in promoting reduced sedentary behaviour and cognitive dissonance in feeling unable to undertake this role. Conclusions: The results of this study are significant in confirming that reducing sedentary behaviour in hospital inpatients is influenced by a range of complex and multi-level factors. There is a fundamental need for organisational and clinical leadership in building a culture and climate in which staff feel empowered to promote reduced sedentary behaviour in their patients. Relevance to clinical practice: The results of this study highlight the importance of taking action to reduce sedentary behaviour in sub-acute hospital settings. A co-design approach to developing interventions in local health services is warranted. © 2021 John Wiley & Sons Ltd.
- Authors: Hills, Danny , Ekegren, Christina , Plummer, Virginia , Freene, Nicole , Kunstler, Breanne , Robinson, Tracy , Healy, Ellen , Vo, Jennifer , Gasevic, Danijela , Crabtree, Amelia
- Date: 2022
- Type: Text , Journal article
- Relation: Journal of Clinical Nursing Vol. 31, no. 9-10 (2022), p. 1348-1361
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- Description: Aim and objectives: To determine the factors influencing nurses’ decisions and capacity to reduce sedentary behaviour in hospital inpatients in sub-acute hospital settings. Background: Sedentary behaviour in hospital inpatients is a complex issue that can be resistant to resolution. There is little research investigating factors influencing nurses’ promotion of reduced levels of sedentary behaviour in sub-acute hospital settings. Design: An explanatory sequential design was employed, comprising quantitative and qualitative phases. Methods: An online survey was conducted with a convenience sample of 138 nurses from five Australian states. Logistic regression modelling identified demographic and behavioural characteristics of nurses who often encouraged patients to reduce their sedentary behaviour. In-depth interviews were conducted with 11 ward nurses and nurse managers, with the content subjected to thematic analysis. STROBE and GRAMMS checklists were employed. Results: Nurses recognised their role in promoting reduced sedentary behaviour but faced a range of personal and organisational barriers in achieving this outcome for patients. Few nurses were aware of national physical activity and sedentary behaviour guidelines. Five themes emerged from interviews (nursing role, care challenges, expectations of advocates, teamwork and improving the experience). Overall, many nurses experienced a lack of agency in promoting reduced sedentary behaviour and cognitive dissonance in feeling unable to undertake this role. Conclusions: The results of this study are significant in confirming that reducing sedentary behaviour in hospital inpatients is influenced by a range of complex and multi-level factors. There is a fundamental need for organisational and clinical leadership in building a culture and climate in which staff feel empowered to promote reduced sedentary behaviour in their patients. Relevance to clinical practice: The results of this study highlight the importance of taking action to reduce sedentary behaviour in sub-acute hospital settings. A co-design approach to developing interventions in local health services is warranted. © 2021 John Wiley & Sons Ltd.
Nurse-led clinics in primary health care : a scoping review of contemporary definitions, implementation enablers and barriers and their health impact
- Terry, Daniel, Hills, Danny, Bradley, Cressida, Govan, Linda
- Authors: Terry, Daniel , Hills, Danny , Bradley, Cressida , Govan, Linda
- Date: 2024
- Type: Text , Journal article , Review
- Relation: Journal of Clinical Nursing Vol. 33, no. 5 (2024), p. 1724-1738
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- Description: Aims: To define nurse-led clinics in primary health care, identify barriers and enablers that influence their successful implementation, and understand what impact they have on patient and population health outcomes. Background: Nurse-led clinics definitions remain inconsistent. There is limited understanding regarding what enablers and barriers impact successful nurse-led clinic implementation and their impact on patient health care. Design: Scoping review using narrative synthesis. Methods: PubMed, MEDLINE, Web of Science, Scopus, CINAHL and PsycINFO were searched to identify nurse-led clinic definitions and models of care between 2000 and 2023. Screening and selection of studies were based on eligibility criteria and methodological quality assessment. Narrative synthesis enabled to communicate the phenomena of interest and follows the PRISMA for Scoping Reviews (PRISMA-ScR) checklist. Results: Among the 36 identified studies, key principles of what constitutes nurse-led clinics were articulated providing a robust definition. Nurse-led clinics are, in most cases, commensurate with standard care, however, they provide more time with patients leading to greater satisfaction. Enablers highlight nurse-led clinic success is achieved through champions, partners, systems, and clear processes, while barriers encompass key risk points and sustainability considerations. Conclusion: The review highlights several fundamental elements are central to nurse-led clinic success and are highly recommended when developing interventional nurse-led strategies. Nurse-led clinics within primary health care seek to address health care through community driven, health professional and policy supported strategies. Overall, a robust and contemporary definition of nurse-led care and the clinics in which they operate is provided. Relevance to Clinical Practice: The comprehensive definition, clear mediators of success and the health impact of nurse-led clinics provide a clear framework to effectively build greater capacity among nursing services within primary health care. This, in addition, highlights the need for good health care policy to ensure sustainability. Patient or Public Contribution: No Patient or Public Contribution. © 2024 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.
- Authors: Terry, Daniel , Hills, Danny , Bradley, Cressida , Govan, Linda
- Date: 2024
- Type: Text , Journal article , Review
- Relation: Journal of Clinical Nursing Vol. 33, no. 5 (2024), p. 1724-1738
- Full Text:
- Reviewed:
- Description: Aims: To define nurse-led clinics in primary health care, identify barriers and enablers that influence their successful implementation, and understand what impact they have on patient and population health outcomes. Background: Nurse-led clinics definitions remain inconsistent. There is limited understanding regarding what enablers and barriers impact successful nurse-led clinic implementation and their impact on patient health care. Design: Scoping review using narrative synthesis. Methods: PubMed, MEDLINE, Web of Science, Scopus, CINAHL and PsycINFO were searched to identify nurse-led clinic definitions and models of care between 2000 and 2023. Screening and selection of studies were based on eligibility criteria and methodological quality assessment. Narrative synthesis enabled to communicate the phenomena of interest and follows the PRISMA for Scoping Reviews (PRISMA-ScR) checklist. Results: Among the 36 identified studies, key principles of what constitutes nurse-led clinics were articulated providing a robust definition. Nurse-led clinics are, in most cases, commensurate with standard care, however, they provide more time with patients leading to greater satisfaction. Enablers highlight nurse-led clinic success is achieved through champions, partners, systems, and clear processes, while barriers encompass key risk points and sustainability considerations. Conclusion: The review highlights several fundamental elements are central to nurse-led clinic success and are highly recommended when developing interventional nurse-led strategies. Nurse-led clinics within primary health care seek to address health care through community driven, health professional and policy supported strategies. Overall, a robust and contemporary definition of nurse-led care and the clinics in which they operate is provided. Relevance to Clinical Practice: The comprehensive definition, clear mediators of success and the health impact of nurse-led clinics provide a clear framework to effectively build greater capacity among nursing services within primary health care. This, in addition, highlights the need for good health care policy to ensure sustainability. Patient or Public Contribution: No Patient or Public Contribution. © 2024 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd.
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