List of Titles

Overseas trained nurses working in regional and rural practice settings: do we understand the issues?

- Wellard, Sally, Stockhausen, Lynette

Authors: Wellard, Sally , Stockhausen, Lynette
Date: 2010
Type: Journal article
Relation: Rural and Remote Health Vol. 10, no. 3 (2010), p. 1458
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Description: Introduction: Issues associated with the employment of overseas trained nurses (OTNs) in regional and rural practice settings have received little professional attention in Australia. The global nursing workforce crisis has dominated discussion about the migration of nurses. This review explored the contemporary understandings of the employment of OTNs in Australian regional and rural practice settings. Methods: An integrative literature review was undertaken to incorporate a range of literature types related to OTN employment. A search of electronic databases and relevant web pages was undertaken for the publication period 1995-2008. Integrative literature reviews incorporate assessment of empirical research as well as theoretical and opinion-based literature to present a broad synthesis of the topic of interest. Following identification of relevant literature, thematic analysis was undertaken to reveal patterns and relationships among concepts facilitating synthesis of findings across the range of literature. Results: There is an abundance of literature exploring the international migration of nurses that demonstrates an imbalance of migration from poorer countries to more affluent countries. This review identified a number of economic and ethical issues, together with risks for potential exploitation of migrant nurses. There was minimal literature specific to the experiences of OTNs working in regional and rural areas. However, there has been some exploration of issues associated with medical recruitment to rural areas. Conclusions: The employment of OTNs is accompanied by complex and varied issues which require resourceful and proactive responses by healthcare employers. Further research is needed to understand the challenges OTNs have in working in rural settings, particularly in Australia. Increased understanding in clinical settings of factors that influence nurses to migrate, as well as the range of barriers they face in working and living in host countries, may assist in the retention of these nurses.

Validation of physical activity measurement for people on dialysis treatment

- Wellard, Sally

Authors: Wellard, Sally
Date: 2003
Type: Text , Journal article
Relation: EDTNA/ERCA Journal Vol. XXIX3, no. (2003), p. 140-142
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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: C1
Description: 2003000407

Problematising autonomy and advocacy in nursing

- Cole, Clare, Wellard, Sally, Mummery, Jane

Authors: Cole, Clare , Wellard, Sally , Mummery, Jane
Date: 2014
Type: Text , Journal article
Relation: Nursing Ethics Vol. 21, no. 5 (2014), p. 576-582
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Description: Customarily patient advocacy is argued to be an essential part of nursing, and this is reinforced in contemporary nursing codes of conduct, as well as codes of ethics and competency standards governing practice. However, the role of the nurse as an advocate is not clearly understood. Autonomy is a key concept in understanding advocacy, but traditional views of individual autonomy can be argued as being outdated and misguided in nursing. Instead, the feminist perspective of relational autonomy is arguably more relevant within the context of advocacy and nurses' work in clinical healthcare settings. This article serves to highlight and problematise some of the assumptions and influences around the perceived role of the nurse as an advocate for patients in contemporary Western healthcare systems by focusing on key assumptions concerning autonomy inherent in the role of the advocate. © The Author(s) 2014.

The phenomenon of presence within contemporary nursing practice : A literature review

- Welch, Di, Wellard, Sally

Authors: Welch, Di , Wellard, Sally
Date: 2005
Type: Text , Journal article
Relation: Australian Journal of Holistic Nursing Vol. 12, no. 1 (2005), p. 4-10
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Description: Nursing practice underpinned by humanistic values may promote presence experiences within nurse-patient interactions. These interactions are powerful and beneficial both to nurse and patient. However, the phenomenon of presence is surrounded by competing and confused definitions. Whilst presence is arguably a core aspect of nursing practice, current health care environments significantly influence nurses' opportunities to experience presence.
Description: C1
Description: 2003001053

Levels of fatigue in people with ESRD living in far North Queensland

- Bonner, Ann, Wellard, Sally, Caltabiano, Marie

Authors: Bonner, Ann , Wellard, Sally , Caltabiano, Marie
Date: 2008
Type: Text , Journal article
Relation: Journal of Clinical Nursing Vol. 17, no. 1 (Jan 2008), p. 90-98
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Description: Aims. Levels of fatigue as experienced by people with end stage renal disease (ESRD), were assessed using the Fatigue Severity Scale (FSS). Background. Fatigue, a common symptom reported by people with ESRD, is a multifaceted, subjective experience, which is readily understood by individuals but difficult to measure. There is limited understanding of the level of fatigue experienced by people with ESRD, with research currently limited to people treated with haemodialysis. Method. The FSS was completed by 92 people with ESRD who were patients of a renal service in far North Queensland, Australia. Demographic and renal health history data were also collected with the self-report survey. Results. Comparisons were preformed between overall fatigue levels and different renal disorders, genders, ethnicity and renal replacement therapy (RRT). Participants in this study were more fatigued than the general population; there was no difference in levels of fatigue between gender and ethnicity. Participants with diabetic nephropathy and those who were predialysis were the most fatigued. A significant difference between mean fatigue scores was found for type of RRT [F(3,88) = 2.4, p < 0.05], with participants using peritoneal dialysis reporting the most fatigue. Additionally, participants categorized according to type of RRT, erythropoietin replacement therapy and current haemoglobin levels revealed significant mean differences on fatigue levels [F(3,88) = 2.74, p < 0.05]. Relevance to clinical practice. People with ESRD experience considerable fatigue; it is particularly important for nurses to understand this level of fatigue impacts on the daily life of patients. These findings provide the preliminary evidence to support the development of renal nursing practice guidelines related to symptom recognition and management of fatigue.
Description: C1

Are laboratories useful fiction? A comparison of Norwegian and Australian undergraduate nursing skills laboratories

- Wellard, Sally, Heggen, Kristin

Authors: Wellard, Sally , Heggen, Kristin
Date: 2010
Type: Text , Journal article
Relation: Nursing & Health Sciences Vol. 12, no. 1 (2010), p. 39-44
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Description: Drawing on the findings from studies in Australia and Norway that explored the use of laboratories in the preparation of nursing students for entry to practice, this article identifies the pedagogical challenges for the undergraduate education of nurses. The findings from both countries are compared and, in spite of distinct differences in the level of financial investment, there are striking similarities between the ways in which laboratories are used in the two countries. The laboratories were designed to predominately represent acute care hospital environments. The participants demonstrated a high level of commitment and strongly held beliefs in the laboratory as a safe place to facilitate self-paced learning and as an environment where students can practice until they become competent and confident. However, at the same time, there was a striking lack of evidence to support these views. The participants in both countries reported a common approach to instruction: a proce! ss of teacher demonstration, followed by student repetition and practice. Variability in students' motivation also was reported and the participants especially expressed concern for those students with a low level of interest in the basic skills associated with personal care. The possibilities and limitations of using skill laboratories as part of the practical preparation for nursing are discussed, using the metaphor of laboratories as "fiction".

Quality of life in recipients before and after liver transplantation in Turkey

- Ordin, Yaprak, Dicle, Aklime, Wellard, Sally

Authors: Ordin, Yaprak , Dicle, Aklime , Wellard, Sally
Date: 2011
Type: Text , Journal article
Relation: Progress in Transplantation Vol. 21, no. 3 (September 2011 2011), p. 260-267
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Description: Context: Liver transplantation has become the treatment of choice for patients with end-stage liver disease. Most studies show a positive effect on quality of life after liver transplantation, but most studies are based on data from Western countries and little is known about quality of life in liver transplant recipients in Turkey or other developing countries. Objective: To investigate liver transplant recipients' quality of life and factors affecting it, before and 3 months after transplantation in western Turkey. Design: Descriptive and comparative, with data collected prospectively. Setting: Two medical centers in Western Turkey. Patients: Sixty-five adult recipients of a liver transplant between May 15 and December 31,2007. Instruments: Quality of life was measured by using the Nottingham Health Profile Turkish version, and sociodemographic and clinical data were collected from patients' records. Results: Scores on all subscales of the Nottingham Health Profile differed significantly from before to after liver transplantation. The differences between the mean scores for quality of life before and after transplantation varied significantly with the patients' sex and disease severity.

The impact of fatigue on daily activity in people with chronic kidney disease

- Bonner, Ann, Wellard, Sally, Caltabiano, Marie

Authors: Bonner, Ann , Wellard, Sally , Caltabiano, Marie
Date: 2010
Type: Text , Journal article
Relation: Journal of Clinical Nursing Vol. 19, no. 21-22 (2010), p. 3006-3015
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Description: Aims and objectives: To examine the impact of fatigue on the daily activity levels of people with chronic kidney disease, compare whether being predialysis or receiving different renal replacement therapies had any effect on fatigue and activity and identify whether any items in the fatigue severity scale were more predictive of daily activity levels. Background: Chronic kidney disease is a complex and long-term disease where people commonly experience fatigue and reduced levels of fitness; both of which impact on an individual's ability to carry out routine activities of daily life. Design: A descriptive cross-sectional design. Methods: A convenience sample of 112 people completed the fatigue severity scale and Human Activity Profile. Participants differed in their renal history and were either predialysis or receiving renal replacement therapy. Results: Women or older participants were significantly more fatigued and less active than men or younger participants. A significant difference between mean fatigue and activity scores was found for type of renal replacement therapy, with participants receiving peritoneal dialysis being the most fatigued and the least active. Additionally, lower levels of albumin were significantly correlated with greater levels of fatigue and the ability to engage in fewer activities. Conclusion: People with chronic kidney disease regardless of whether they are predialysis or receiving either peritoneal or haemodialysis experience high levels of fatigue and are able to engage in fewer daily activities. The fatigue severity scale and the Human Activity Profile are useful indicators of fatigue and physical activities which can be used in routine assessment practices. Relevance to clinical practice: Renal nurses are ideally positioned to engage in early identification and regular monitoring of both fatigue and activity levels in people with chronic kidney disease. Individual care plans can be developed to incorporate supportive rehabilitative strategies which aim to reduce fatigue and maximise activity levels.
Description: 2003008244

Evidence-based practice, risk and reconstructions of responsibility in nursing

- Heggen, Kristin, Wellard, Sally

Authors: Heggen, Kristin , Wellard, Sally
Date: 2011
Type: Text , Book chapter
Relation: Professional responsibility new horizons of praxis p. 144-158
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Description: "Professional Responsibility: New Horizons of Praxis addresses the manifold and complex challenges inherent in professional responsibility. Since the beginning of the 20th Century, professions have been accorded a conjoined mandate - political and moral responsibility - to serve the interests of individual's and society. The quality of professional work, how professionals understand and live out their responsibilities in practice, is a matter of pervasive concern since increasingly they have such a prominent presence in most people's lives. Until the late 1960's, professionals' roles and responsibilities were rarely questioned, but such trust has since given way to collective scepticism concerning their commitment and willingness to live up to their moral and societal obligations. Abuse of power and privilege by some professionals has contributed to decline in trust by publics, the concept of 'good work' is increasingly challenged, and politicians and policy-makers have sought to regulate and hold professions to account. It is timely, therefore, to investigate critically conflicting discourses and practices on what counts as professional responsibility, to question how professionals understand and are prepared for a life of professional responsibility, and what acting with integrity and authority looks like in practice. One of the distinctive features of this book is the combination of normative and empirical dimensions that are used to dissect this question. The authors indicate from a diversity of disciplinary perspectives how professional responsibility includes particular thoughts and warranted actions yet remains multifaceted and inarticulate"-- Provided by publisher.
Description: 2003009457

Framework of intent for selecting research approaches in nursing

- Wellard, Sally, Ordin, Yaprak

Authors: Wellard, Sally , Ordin, Yaprak
Date: 2011
Type: Text , Journal article
Relation: Deuhyo Edergi Vol. 4, no. 4 (2011), p. 189-195
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Description: Research in nursing is growing rapidly, and there is increased use of qualitative and mixed methods approaches to investigations. However, frequently researchers’ adopt a research approach with little understanding of the philosophical assumptions underpinning their choice. Using a framework of research intent, this paper aims to identify the different philosophical assumptions associated with different research intents and therefore provide a foundation for more informed decision making in selection of methodologies.
Description: 2003009387

Clinical nursing professoriate : Reflections on Australian experiences

- Wellard, Sally, Heggen, Kristin

Authors: Wellard, Sally , Heggen, Kristin
Date: 2006
Type: Text , Journal article
Relation: Norwegian Journal of Nursing Research Vol. 2, no. 8 (2006), p. 13-21
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Description: Nursing, as a new discipline in the academic world, has to combine scientific traditions with its identity as a clinical profession. Joint clinical professorial appointments have been established in order to combine these two worlds.
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Description: 2003001976

Nursing assessment of older people who are in hospital : Exploring registered nurses' understanding of their assessment skills

- Penney, Wendy, Poulter, Nola, Cole, Clare, Wellard, Sally

Authors: Penney, Wendy , Poulter, Nola , Cole, Clare , Wellard, Sally
Date: 2016
Type: Text , Journal article
Relation: Contemporary Nurse Vol. 52, no. 2-3 (2016), p. 313-325
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Description: Background: Nurses worldwide are expected to take a leading role in caring for older people. Considerable literature dedicated to the range and application of assessment skills used by nurses vary. There is limited knowledge of registered nurses' (RNs) views of their assessment of older adults.Aim: The aim of this project was to explore RNs current perceptions of nursing assessment, and the core skills they identified as necessary.Design: A qualitative descriptive design study was conducted in three inpatient units in one regional hospital in Victoria.Method: Date were collected through participant observation of RNs (n = 13) followed by 1:1 semi-structured interviews. Data were analysed thematically.Conclusion: This research has illuminated that an ill-defined repertoire of skills was used by RNs when assessing older persons. Skills identified appeared to be based on years of personal-professional experience. Differences were noted between the descriptions nurses gave and what was observed during interactions with older persons.

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