List of Titles

Developing advanced rural nursing practice: A whole new scope of responsibility

- Cant, Robyn, Birks, Melanie, Porter, Joanne, Jacob, Elisabeth, Cooper, Simon J.

Authors: Cant, Robyn , Birks, Melanie , Porter, Joanne , Jacob, Elisabeth , Cooper, Simon J.
Date: 2011
Type: Text , Journal article
Relation: Collegian Vol. 18, no. 4 (2011), p. 177-182
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Description: Rural registered nurses' experiences of advanced clinical nursing practice were explored whilst they were enrolled in an advanced primary care course of study. Thirty-two nurses employed in rural health services in Victoria, Australia, studied advanced practice nursing by distance education with a clinical component. At course conclusion, focus groups and a quantitative on-line survey were conducted to explore outcomes. Nurses reported positive self-perceptions of their educational preparation with scores of >7/10 for competence, confidence, preparedness for advanced practice and job satisfaction. Focus group discussions concurred with positive survey results. The course was valuable in developing skills and knowledge, enabling more holistic patient care. The main themes that emerged related to the advancement of the nurse as a professional, and enhancement of patient care. Within their scope of practice, nurses assessed, diagnosed and treated minor patient illness presentations either independently or collaboratively with medical advice. The context of rural health services dictated practice and levels of autonomy. Nurses perceived the new role reduced an overload of medical work, whilst increasing patients' access to care. As a result of the course 24% of participants reported a change in their work role. Nurses employed in rural health services reported positive potential for advanced collaborative practice in rural health care, in association with medical professionals. Defined role boundaries, role responsibilities and dedicated advanced practice positions will be required to achieve implementation of the role. Â© 2011 Royal College of Nursing, Australia.

‘I walk from trouble’ : exploring safeguards with adults with intellectual disabilities – an Australian qualitative study

- Ottmann, Goetz, McVilly, Keith, Maragoudaki, Margarita

Authors: Ottmann, Goetz , McVilly, Keith , Maragoudaki, Margarita
Date: 2016
Type: Text , Journal article
Relation: Disability and Society Vol. 31, no. 1 (2016), p. 47-63
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Description: People living with intellectual disabilities have a right to be safe from abuse and neglect and have a right to be included in the decision-making process determining safeguards that will affect them. However, the research evidence that could underpin good professional practice in terms of co-producing safeguards against abuse and neglect directly involving people with intellectual disabilities is largely missing. This article, based on qualitative research involving semi-structured interviews conducted during the first half of 2014, seeks to strengthen this evidence base. It reports on the prevention strategies identified by 12 adults with intellectual disabilities about how to stay safe and compares these with the findings of similar research. The article suggests that a comprehensive safeguarding approach comprises both life course-focused safety training and access to assisted decision-making. The article argues that given the plethora of risk situations encountered by people living with intellectual disability, assisted decision-making should take the form of a co-creation process that is situation specific and grounded in everyday life. © 2016 Taylor & Francis.

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 experiences of health professionals, patients, and families with truth disclosure when breaking bad news in palliative care : a qualitative meta-synthesis

- Miller, Elizabeth, Porter, Joanne, Barbagallo, Michael

Authors: Miller, Elizabeth , Porter, Joanne , Barbagallo, Michael
Date: 2022
Type: Text , Journal article , Review
Relation: Palliative and Supportive Care Vol. 20, no. 3 (2022), p. 433-444
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Description: Objective Disclosing the truth when breaking bad news continues to be difficult for health professionals, yet it is essential for patients when making informed decisions about their treatment and end-of-life care. This literature review aimed to explore and examine how health professionals, patients, and families experience truth disclosure during the delivery of bad news in the inpatient/outpatient palliative care setting. Methods A systemized search for peer-reviewed, published papers between 2013 and 2020 was undertaken in September 2020 using the CINAHL, Medline, and PsycInfo databases. The keywords and MeSH terms (truth disclosure) AND (palliative care or end-of-life care or terminal care or dying) were used. The search was repeated using (bad news) AND (palliative care or end-of-life care or terminal care or dying) terms. A meta-synthesis was undertaken to synthesize the findings from the eight papers. Results Eight papers were included in the meta-synthesis and were represented by five Western countries. Following the synthesis process, two concepts were identified: Enablers in breaking bad news and Truth avoidance/disclosure. Several elements formed the concept of Enablers for breaking bad news, such as the therapeutic relationship, reading cues, acknowledgment, language/delivery, time/place, and qualities. A conceptual model was developed to illustrate the findings of the synthesis. Significance of results The conceptual model demonstrates a unique way to look at communication dynamics around truth disclosure and avoidance when breaking bad news. Informed decision-making requires an understanding of the whole truth, and therefore truth disclosure is an essential part of breaking bad news. Copyright © The Author(s), 2021. Published by Cambridge University Press.

Optimising social conditions to improve autonomy in communication and care for ethnic minority residents in nursing homes: A meta‐synthesis of qualitative research

- Xiao, Lily, Chen, Li, Han, Weifeng, Meyer, Claudia, Müller, Amanda, Low, Lee‐Fay, Brijnath, Bianca, Mohammadi, Leila

Authors: Xiao, Lily , Chen, Li , Han, Weifeng , Meyer, Claudia , Müller, Amanda , Low, Lee‐Fay , Brijnath, Bianca , Mohammadi, Leila
Date: 2022
Type: Text , Journal article
Relation: Nursing Inquiry Vol. 29, no. 3 (2022), p. e12469-n/a
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Description: A large proportion of nursing home residents in developed countries come from ethnic minority groups. Unmet care needs and poor quality of care for this resident population have been widely reported. This systematic review aimed to explore social conditions affecting ethnic minority residents' ability to exercise their autonomy in communication and care while in nursing homes. In total, 19 studies were included in the review. Findings revealed that ethno‐specific nursing homes create the ideal social condition for residents to express their care needs and preferences in a language of choice. In nonethno‐specific nursing homes, staff cultural competence and nursing home commitment to culturally safe care are crucial social conditions that enable this group of residents to fulfil their autonomy in communicating and in participating in their care. In contrast, social conditions that undermine residents' ability to express their care needs and preferences include low levels of staff cultural awareness and cultural desire, negative attitudes towards residents and limited organisational support for staff to improve culturally responsive and culturally safe care. In conclusion, it is important to optimise the social conditions to support ethnic minority residents to communicate their care needs and preferences.

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