Description:
Autonomous mobility is fundamental for older Australians to participate in the activities that occupy and inspire daily life. Should a mobility difficulty arise, a powered mobility device (PMD) can assist to supplement or restore mobility, choice, and control. A PMD continues to be a valued resource once a person moves into residential aged care. However, increasing frailty among people within this group means that incidents can result in serious injury for PMD users or others living, visiting, or working in this environment. Guidelines for PMD use are available, however, there are no regulations or mandates to seek professional guidance for assessment of competence, equipment prescription, or training. Occupational therapy theory and practice can support all parts of this process. This thesis presents a three-part study using a mixed methods approach to (i) examine PMD use related incidents and injuries within residential aged care, (ii) to evaluate existing measurement tools, and (iii) to develop and undertake initial validation of a new screening tool developed for residents who use PMDs, based on classical test theory (De Vellis, 2006). The new screening tool will address a gap identified among screening tools for PMD capacity and performance skills specific to this population, to improve the balance between much needed autonomy and safety for all stakeholders.
Description:
Autonomous mobility is fundamental for older Australians to participate in the activities that occupy and inspire daily life. Should a mobility difficulty arise, a powered mobility device (PMD) can assist to supplement or restore mobility, choice, and control. A PMD continues to be a valued resource once a person moves into residential aged care. However, increasing frailty among people within this group means that incidents can result in serious injury for PMD users or others living, visiting, or working in this environment. Guidelines for PMD use are available, however, there are no regulations or mandates to seek professional guidance for assessment of competence, equipment prescription, or training. Occupational therapy theory and practice can support all parts of this process. This thesis presents a three-part study using a mixed methods approach to (i) examine PMD use related incidents and injuries within residential aged care, (ii) to evaluate existing measurement tools, and (iii) to develop and undertake initial validation of a new screening tool developed for residents who use PMDs, based on classical test theory (De Vellis, 2006). The new screening tool will address a gap identified among screening tools for PMD capacity and performance skills specific to this population, to improve the balance between much needed autonomy and safety for all stakeholders.
Description:
Although the idealisation of nurses as advocates is popularised in nursing literature and supported within nursing frameworks, codes and standards, there has been little critical examination of these ideas within contemporary Australian healthcare settings and nursing practice. The Australian Healthcare system is a complicated system of interacting service providers and consumers. Institutions that regulate healthcare professionals and organisations normalise understandings of nursing and nursing practice, including conceptualisations of the importance of autonomy and advocacy and how each is to be supported and/or practised. This study used the perceptions of practising Registered Nurses (RNs) to examine the actualities of advocacy and support for autonomy as they are carried out within clinical practice, and to highlight, problematise and then analyse differences between the rhetoric and realities of practice. Firstly, a phenomenological lens, including an ethnographic model of observation, was used to thematically map and examine the RNs’ lived experience of their practice, paying particular attention to their conceptions of and responsibilities toward advocacy and autonomy. This thematic analysis brought to the fore a range of assumptions that, although clearly normative within nursing practice, are in evident tension with one other. These were then re-examined using a range of Michel Foucault’s concepts concerning the construction and maintenance of regimes of truth. Designed to unpack the operations of power and knowledge, and to make visible the techniques of disciplinarity and governmentality that inform and support them, an engagement of these concepts has allowed this thesis to critically examine the normative constructions and enactments of nursing practice with regards to ideas and practices concerning advocacy and autonomy. What this thesis provides is a detailed examination of the contrasting constructions of power and knowledge within nursing practice in relation to advocacy and autonomy, how and why these concepts have been operationalised within nursing practice, and how they could be re-visioned into the future.
Description:
Although the idealisation of nurses as advocates is popularised in nursing literature and supported within nursing frameworks, codes and standards, there has been little critical examination of these ideas within contemporary Australian healthcare settings and nursing practice. The Australian Healthcare system is a complicated system of interacting service providers and consumers. Institutions that regulate healthcare professionals and organisations normalise understandings of nursing and nursing practice, including conceptualisations of the importance of autonomy and advocacy and how each is to be supported and/or practised. This study used the perceptions of practising Registered Nurses (RNs) to examine the actualities of advocacy and support for autonomy as they are carried out within clinical practice, and to highlight, problematise and then analyse differences between the rhetoric and realities of practice. Firstly, a phenomenological lens, including an ethnographic model of observation, was used to thematically map and examine the RNs’ lived experience of their practice, paying particular attention to their conceptions of and responsibilities toward advocacy and autonomy. This thematic analysis brought to the fore a range of assumptions that, although clearly normative within nursing practice, are in evident tension with one other. These were then re-examined using a range of Michel Foucault’s concepts concerning the construction and maintenance of regimes of truth. Designed to unpack the operations of power and knowledge, and to make visible the techniques of disciplinarity and governmentality that inform and support them, an engagement of these concepts has allowed this thesis to critically examine the normative constructions and enactments of nursing practice with regards to ideas and practices concerning advocacy and autonomy. What this thesis provides is a detailed examination of the contrasting constructions of power and knowledge within nursing practice in relation to advocacy and autonomy, how and why these concepts have been operationalised within nursing practice, and how they could be re-visioned into the future.
Description:
Drawing on the work of Webb Keane and Joel Robbins in the anthropology of Christianity, furnished with the influential work of Charles Hirschkind in the anthropology of Islam, and the ethnographic studies of Tom Wagner and Mark Jennings on Pentecostal worship music, this article critically examines ideas of sincerity in the musical practices of Pentecostal megachurches. Making use of ethnographic data from research on congregational music in South Africa, including interviews with a variety of Pentecostal musicians, this article argues that the question of Protestant sincerity, understood following Keane as emphasizing individual moral autonomy and suspicion of external material religious forms for expressing one’s inner state, is particularly acute in the case of the Hillsong megachurch. Employing the full array of spectacular possibilities made available by the contemporary culture industry, Hillsong churches centralize cultural production and standardize musical performance whilst simultaneously emphasizing individual religious experience. It is argued that Pentecostal megachurches seek to realize a form of sincere mimicry grounded in learned and embodied practices.
Description:
Drawing on the work of Webb Keane and Joel Robbins in the anthropology of Christianity, furnished with the influential work of Charles Hirschkind in the anthropology of Islam, and the ethnographic studies of Tom Wagner and Mark Jennings on Pentecostal worship music, this article critically examines ideas of sincerity in the musical practices of Pentecostal megachurches. Making use of ethnographic data from research on congregational music in South Africa, including interviews with a variety of Pentecostal musicians, this article argues that the question of Protestant sincerity, understood following Keane as emphasizing individual moral autonomy and suspicion of external material religious forms for expressing one’s inner state, is particularly acute in the case of the Hillsong megachurch. Employing the full array of spectacular possibilities made available by the contemporary culture industry, Hillsong churches centralize cultural production and standardize musical performance whilst simultaneously emphasizing individual religious experience. It is argued that Pentecostal megachurches seek to realize a form of sincere mimicry grounded in learned and embodied practices.
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.
Description:
Nursing texts laud the role of nurses as advocates for patients. With increased acknowledgement of patient-centred care, is it appropriate or desired for nurses to presume this as their role? An examination of concepts of advocacy and autonomy highlight potential conflicts between the nurses' adoption of the roles of advocate and surveyor in renal care. There is no clear and definitive answer to 'who can speak for whom' when considering advocacy for people involved in renal replacement therapies. It is evident that what is required is clearer articulation of how renal nurses can act as advocates for patients within the context of their multiple roles and with a goal of partnerships in care.
Description:
Nursing texts laud the role of nurses as advocates for patients. With increased acknowledgement of patient-centred care, is it appropriate or desired for nurses to presume this as their role? An examination of concepts of advocacy and autonomy highlight potential conflicts between the nurses' adoption of the roles of advocate and surveyor in renal care. There is no clear and definitive answer to 'who can speak for whom' when considering advocacy for people involved in renal replacement therapies. It is evident that what is required is clearer articulation of how renal nurses can act as advocates for patients within the context of their multiple roles and with a goal of partnerships in care.