Description:
PURPOSE: The purpose of this study was to compare the effectiveness of bell-and-pad alarm therapy to body-worn alarm therapy for the management of monosymptomatic enuresis in children 6 to 16 years of age. DESIGN: A prospective, randomized, adaptive clinical control trial. SUBJECTS AND SETTING: The sample comprised 86 children who attended a continence clinic for treatment of monosymptomatic enuresis and met the criteria for enuresis alarm therapy as per International Children's Continence Society (ICCS) guidelines. Subjects were randomly allocated to an experimental group (body-worn alarm, n = 41) or a control group (bell-and-pad alarm, n = 45). The study setting was a single-site specialist continence service in regional Victoria, Australia. Treatment was administered in the child's home. METHODS: Alarm therapy was administered by the child and/or parent for an initial period of 8 weeks at which time the child underwent a review with the continence nurse specialist. If the child had achieved 14 consecutive dry nights, the therapy was deemed successful and ceased. Children who had not become dry continued therapy for a further 8 weeks up to a maximum of 16 weeks, with a final review was instituted. Each child kept a diary for the duration of alarm therapy to report on frequency of wet/dry nights, times of alarm, response to alarm, and response to sensation to void (without alarm). The 2 types of alarm devices were compared with respect to categorical variables using dichotomous cross-tabulations and χ tests of independence based on the most positive outcome versus the other outcomes. RESULTS: Dryness in accordance with the criteria outlined by the ICCS guidelines was achieved in 18 children (43.9%) in the body-worn alarm group versus 29 children (64.4%) in the routine (bell-and-pad) group (P = .056). The bell-and-pad alarm performed better on 7 out of the 9 indicators, including the primary outcome measure of the child attained dryness for 14 nights or more, nightly alarm use, alarm woke child, alarm woke parent (P = .022), false (positive) alarms (P = .039), child turned alarm off and went back to sleep (P = .003), and child was compliant with alarm use. The body-worn device produced higher proportions of the most positive outcomes for 2 of the 9 indicators: relapse (P = .076) and false (negative) nonalarms (P = .066). CONCLUSIONS: Study findings suggests that the bell-and-pad alarm is preferable to the body-worn alarm. Additional research is recommended using other body-worn alarm devices across a larger population in order to establish the more definitive findings needed for clinical decision-making.
Description:
The cornerstone of contemporary nursing practice is the provision of individualised nursing care. Sustaining and nourishing the stream of research frameworks that inform individualised care are the findings from qualitative research. At the centre of much qualitative research practice, however, is an assumption that experiential understanding can be delivered through a thematisation of meaning which, it will be argued, can lead the researcher to make unsustainable assumptions about the relations of language and meaning-making to experience. We will show that an uncritical subscription to such assumptions can undermine the researcher's capacity to represent experience at the high level of abstraction consistent with experience itself and to thus inform genuinely individualised care. Instead, using qualia as a touchstone for the possibilities of understanding and representing experience, we trace the ‘designative’ and ‘expressive’ distinction to language in order to raise critical questions concerning both these assumptions and common practices within qualitative research. Following the ‘expressive’ account of language, we foreground in particular the hermeneutic work of Gadamer through which we explore the possibilities for a qualitative research approach that would better seek the mot juste of individual experience and illuminate qualia in order to better inform genuinely individualised care.
Description:
This chapter focuses specifically on the use of three-dimensional multi-user virtual environments (3D MUVEs) for simulation-based teaching and learning in tertiary-level healthcare education. It draws on a broad range of extant research conducted over the past three decades, synthesizing this with newer developments and examples that have emerged since the advent and proliferation of the “3D Web.” The chapter adopts and advocates a research-informed approach to surveying and examining current initiatives and future directions, backed by relevant literature in the areas of online learning, constructivist learning theory, and simulations. Both opportunities and challenges are discussed, with the aim of making a contribution to the development of best practice in the field.
Description:
In Australia, the emerging use of technology in higher education has brought about significant change in the delivery of undergraduate nursing programs. Universities are now tasked with delivering a blend of online and face-to-face education, while students face new and sometimes challenging online learning environments with little technical support. This article explores the attitudes held by Bachelor of Nursing students toward the blended educational mode at a rural university in Victoria, Australia. A total of 109 participants constituted a convenience sample from a Bachelor of Nursing program across all 3-year levels. Responses provided by participants who completed an online self-report questionnaire were analyzed via descriptive and inferential statistics. The results indicated that participants struggled with inaccurate expectations of workload and the technical difficulties presented by online modules. Although this area requires further research, to an extent autonomy and flexibility were identified as two prominent traits exhibited by students who flourished in the blended modes. All in all, the results of this study strongly reflect the challenges faced by undergraduate nursing students navigating newly introduced online systems in a blended mode of study.
Description:
Grit is the capacity to persevere, to have passion, and be committed to achieve goals long-term regardless of adversity or challenge. Grit provides an insight into why some nursing students succeed academically or clinically, while others do not. This quantitative cross-sectional correlational study measured levels of grit among nursing students undertaking a three-year bachelor's degree program. All students (n = 2349) within the program were invited to complete a questionnaire which included the short grit scale (Grit-S) which measured each student's level of perseverance and passion. Overall, it was highlighted that increased levels of grit correlated with an increase in the student's year of study, greater perceived clinical and academic performance, not using television as a motivator for entry to nursing, being lower on the socio-economic spectrum, and being older in age. Grit was found to develop exponentially as students entered second and third years, suggesting that a balance of constant academic and clinical challenge was an impetus for many to achieve in the face of adversity, and is reminiscent of the journey of the koi fish. This paper culminates in a call for educators to consider the inclusion of creative grit forming challenges that focus on developing a student's sense of open-mindedness within first year of undergraduate nursing programs.
Description:
Grit is the capacity to persevere, to have passion, and be committed to achieve goals long-term regardless of adversity or challenge. Grit provides an insight into why some nursing students succeed academically or clinically, while others do not. This quantitative cross-sectional correlational study measured levels of grit among nursing students undertaking a three-year bachelor's degree program. All students (n = 2349) within the program were invited to complete a questionnaire which included the short grit scale (Grit-S) which measured each student's level of perseverance and passion. Overall, it was highlighted that increased levels of grit correlated with an increase in the student's year of study, greater perceived clinical and academic performance, not using television as a motivator for entry to nursing, being lower on the socio-economic spectrum, and being older in age. Grit was found to develop exponentially as students entered second and third years, suggesting that a balance of constant academic and clinical challenge was an impetus for many to achieve in the face of adversity, and is reminiscent of the journey of the koi fish. This paper culminates in a call for educators to consider the inclusion of creative grit forming challenges that focus on developing a student's sense of open-mindedness within first year of undergraduate nursing programs.
Description:
This thesis begins with contemporary qualitative research, where the extent of what is understood about human experience is reduced to the representations constructed by researchers. In this situation, where the qualitative researcher has a monopoly on the representation produced, there is no scope for a consideration of the expressive nature of language – in particular, the way that language discloses the world differently for each individual person. Thus, the aim of this thesis is to develop a theoretical approach for understanding the personal realities of the people involved in qualitative research that reinstates the centrality of the dialogic in understanding.
Description:
This thesis begins with contemporary qualitative research, where the extent of what is understood about human experience is reduced to the representations constructed by researchers. In this situation, where the qualitative researcher has a monopoly on the representation produced, there is no scope for a consideration of the expressive nature of language – in particular, the way that language discloses the world differently for each individual person. Thus, the aim of this thesis is to develop a theoretical approach for understanding the personal realities of the people involved in qualitative research that reinstates the centrality of the dialogic in understanding.
Description:
Nursing and nurses rely upon qualitative research to understand the intricacies of the human condition. Acknowledging the subjective nature of reality and commonly founded in a constructivist epistemology, qualitative approaches offer opportunities for uncovering insights from the perspective of the individual participants, the insider's view, and the construction of representations that maintain an intimacy with the subject's realities. Debate continues, however, about what is needed for a qualitative construction to be considered an authentic understanding of a subject's realities. Authenticity in the context of qualitative research has been described as entailing consideration of a number of well‐trodden dimensions: fairness, ontological, educative, catalytic and tactical. Taking these dimensional requirements as key, this paper argues that authenticity may not always be as well‐developed through some of the standard practices in qualitative research as perhaps expected. In particular, qualitative understandings of authenticity stress that participants should not be merely reported on but instead should be dynamically involved in and changed by the constructions and interpretations of data developed throughout the research process. As this paper illustrates, such engagements appear problematic for qualitative research approaches that are beholden to designative commitments in the context of language and meaning‐making and which tend to prioritise commonality and generality at the expense of individual authenticity. An alternative qualitative approach, Hermeneutic Constructivism, is proposed as better able to achieve the requirements of the dimensions of authenticity. As outlined, this approach is well‐placed to present an understanding of human experience through a genuinely expressivist approach and transcends the stress upon the common or the general that can be pervasive and problematic.
Description:
Nursing and nurses rely upon qualitative research to understand the intricacies of the human condition. Acknowledging the subjective nature of reality and commonly founded in a constructivist epistemology, qualitative approaches offer opportunities for uncovering insights from the perspective of the individual participants, the insider's view, and the construction of representations that maintain an intimacy with the subject's realities. Debate continues, however, about what is needed for a qualitative construction to be considered an authentic understanding of a subject's realities. Authenticity in the context of qualitative research has been described as entailing consideration of a number of well‐trodden dimensions: fairness, ontological, educative, catalytic and tactical. Taking these dimensional requirements as key, this paper argues that authenticity may not always be as well‐developed through some of the standard practices in qualitative research as perhaps expected. In particular, qualitative understandings of authenticity stress that participants should not be merely reported on but instead should be dynamically involved in and changed by the constructions and interpretations of data developed throughout the research process. As this paper illustrates, such engagements appear problematic for qualitative research approaches that are beholden to designative commitments in the context of language and meaning‐making and which tend to prioritise commonality and generality at the expense of individual authenticity. An alternative qualitative approach, Hermeneutic Constructivism, is proposed as better able to achieve the requirements of the dimensions of authenticity. As outlined, this approach is well‐placed to present an understanding of human experience through a genuinely expressivist approach and transcends the stress upon the common or the general that can be pervasive and problematic.