ORCID Profile
0000-0002-8507-1283
Current Organisations
City University
,
University of Newcastle Australia
,
University of Plymouth
,
University of Technology Sydney
,
St Georges University of London
,
University of Exeter
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Publications
Screening swallowing function of patients with acute stroke. Part two: detailed evaluation of the tool used by nurses
Publisher: Wiley
Date: 20-07-2001
DOI: 10.1046/J.1365-2702.2001.00502.X
Abstract: Stroke is a common problem and a major consumer of health and social care budgets in the UK. Dysphagia is a frequent accompaniment and its management has the potential to exert significant influence within the rehabilitation process. This study explores in detail the performance of a screening tool (based on the Standardized Swallowing Assessment) used by nurses. Based on 68 complete screening episodes by independently competent nurses, with the effects of chance removed, the tool demonstrated good agreement with summative clinical judgement of swallow function (kappa = 0.88). The accuracy of results supported the full training and education programme for nurses. Not all components of the tool were required analyses suggested elimination of three variables but further exploration is warranted. As a component of evidence-based guidelines for nutritional support in acute stroke, the screening initiative contributed to improved patient outcomes.
The personal cancer screening behaviours of nurses and midwives
Publisher: Wiley
Date: 11-01-2017
DOI: 10.1111/JAN.13221
Abstract: The aim of this study was to identify the personal cancer screening behaviours of nurses and midwives in New South Wales, Australia, and identify factors predictive of cancer screening uptake. The nursing workforce may have a higher risk for some cancers and is ageing. In Australia, more than 40% are over 50 years - an age where cancer incidence rises rapidly, but when screening may reduce cancer mortality. Nurses and midwives are important health role models for the population, but their engagement in cancer screening is unknown. A cross-sectional survey conducted in 2014-2015. Data were obtained from the 'Fit for the Future' study on 5041 working nurses and midwives in New South Wales, Australia and analyses were conducted on subsets of age-eligible respondents. Demographic, geographical and occupational data were analysed in relation to population-based screening for breast, cervical and bowel cancers and opportunistic screening for prostate and skin cancer screening participation, in line with Australian recommendations. Nurses' and midwives' recent screening rates were higher than the Australian general population across relevant age groups. Compared with full-time nurses and midwives, part-time/casual ool workers were significantly more likely to undertake cervical, breast and bowel screening. Compared with those working office hours, shift workers were significantly less likely to undertake breast and bowel screening, but more likely to undertake skin screening. Disparities in reported screening prevalence and factors predictive of screening uptake indicate opportunities for targeted strategies to inform and/or promote workforce engagement with screening programmes and protect the health of this ageing workforce.
Exploring nurses’ perspectives of stroke care
Publisher: RCN Publishing Ltd.
Date: 12-2004
DOI: 10.7748/NS2004.12.19.12.33.C3768
Abstract: In recent years stroke has been recognised as a national clinical, research and policy priority. Stroke nurses and stroke nursing are important contributors, but previous studies have highlighted lack of clarity and contradictions in the nursing role. A stroke nursing conference in 2002 offered the opportunity to explore nurses' vision for the future through a series of focus group meetings. Many ex les of good practice were identified, for ex le, nursing contributions to risk factor management and secondary prevention, service co-ordination and development, follow-up and support of stroke patients and their families. However, areas for further development include realigning services to a patient focus and ensuring equitable access, integrating services, supporting development of the nursing research evidence base and providing career and educational frameworks for nurses in stroke care. Nurses set out a vision for stroke nursing in which current strengths and developments are consolidated and disseminated in a dynamic, multiprofessional, integrated patient-focused service.
Building expert agreement on the importance and feasibility of workplace health promotion interventions for nurses and midwives: A modified Delphi consultation
Publisher: Wiley
Date: 16-07-2017
DOI: 10.1111/JAN.13345
Abstract: To use a Delphi panel to determine the relative importance and feasibility of workplace health promotion interventions to promote and support the health of the Australian nursing and midwifery workforce. The nursing workforce experiences rates of ill health above that of other workforces, yet there is little investment in workplace health promotion. The study used a modified Delphi design conducted between September and November 2015. Eleven of 19 purposively selected expert panellists discussed, rated and provided feedback through two rounds of an electronic questionnaire about the relative importance and feasibility of 46 workplace health promotion interventions and processes for nurses and midwives. Scores for importance and feasibility were calculated and ranked and a composite score of importance multiplied by feasibility. Mental health strategies were prioritized as the most important and feasible of the intervention topics, followed closely by healthy eating and physical activity interventions smoking cessation ranked lowest. The most highly ranked interventions targeted healthy eating, stress management and resilience training. Highest ranked processes to support development of a healthy work environment included intersectoral collaboration and employee wellness groups. Study findings prompt consideration of health promotion opportunities to support nurses' health and well-being. Findings identified key workplace health promotion priorities and provide direction for policy makers and managers to promote nursing and midwifery workforce health.
User compliance with documenting on a track and trigger‐based observation and response chart: a two‐phase multi‐site audit study
Publisher: Wiley
Date: 08-05-2017
DOI: 10.1111/JAN.13302
Abstract: To examine user compliance and completeness of documentation with a newly designed observation and response chart and whether a rapid response system call was triggered when clinically indicated. Timely recognition and responses to patient deterioration in hospital general wards remain a challenge for healthcare systems globally. Evaluating practice initiatives to improve recognition and response are required. Two-phase audit. Following introduction of the charts in ten health service sites in Australia, an audit of chart completion was conducted during a short trial for initial usability (Phase 1 2011). After chart adoption as routine use in practice, retrospective and prospective chart audits were conducted (Phase 2 2012). Overall, 818 and 1,058 charts were audited during the two phases respectively. Compliance was mixed but improved with the new chart (4%-14%). Contrary to chart guidelines, numbers rather than dots were written in the graphing section in 60% of cases. Rates of recognition of abnormal vital signs improved slightly with new charts in use, particularly for higher levels of surveillance and clinical review. Based on local calling criteria, an emergency call was initiated in 33% of cases during the retrospective audit and in 41% of cases with the new chart. User compliance was less than optimal, limiting full function of the chart sections and compliance with local calling criteria. Overcoming apparent behavioural and work culture barriers may improve chart completion, aiding identification of abnormal vital signs and triggering a rapid response system activation when clinical deterioration is detected.
Health, workforce characteristics, quality of life and intention to leave: The 'Fit for the Future' survey of Australian nurses and midwives
Publisher: Wiley
Date: 19-06-2017
DOI: 10.1111/JAN.13347
Abstract: To examine the quality of life of nurses and midwives in New South Wales, Australia and compare values with those of the Australian general population to determine the influence of workforce, health and work life characteristics on quality of life and its effect on workforce intention to leave. Few studies have examined nurses' and midwives' quality of life and little is known of its effects on workforce longevity. This was a cross-sectional survey conducted in 2014-2015. The "Fit for the Future" electronic survey, delivered to nurses and midwives, examined demographic, work and health-related factors, which were compared with Australian general population normative values for physical and mental components of quality of life (the Short Form-12). Univariate and multivariate logistic regression models assessed associations with workforce intention to leave. Physical and mental component scores, calculated for 4,592 nurses and midwives, revealed significantly higher physical but lower mental component scores than the general population. Physical component scores decreased with increasing age higher scores were seen in nurses with better health indices and behaviours. Mental well-being scores increased with increasing age in nurses who reported job satisfaction, no work injury, sleep problems or frequent pain and non-smokers. The odds of intention to leave decreased with increasing mental well-being. Managers and decision-makers should heed study recommendations to implement health promotion strategies for nurses and midwives, aiming to improve mental health, specifically to promote workforce retention.
The mental health of nurses in acute teaching hospital settings: a cross-sectional survey.
Publisher: Springer Science and Business Media LLC
Date: 27-03-2015
Health care on the front line
Publisher: Wiley
Date: 15-10-2008
Cardiovascular medication adherence among patients with cardiac disease: a systematic review
Publisher: Wiley
Date: 28-07-2016
DOI: 10.1111/JAN.13062
Abstract: The aim of this study was to critically appraise and synthesize the best available evidence on the effectiveness of interventions suitable for delivery by nurses, designed to enhance cardiac patients' adherence to their prescribed medications. Cardiac medications have statistically significant health benefits for patients with heart disease, but patients' adherence to prescribed medications remains suboptimal. A systematic quantitative review of intervention effects. We conducted systematic searches for English-language, peer-reviewed randomized controlled trial publications via Medline, EMBASE, CINAHL, the Cochrane Library, ProQuest, Web of Science and Google Scholar published between January 2004-December 2014. According to pre-determined inclusion and exclusion criteria, eligible studies were identified and data extracted using a predefined form. Of 1962 identified papers 14 studies met the study inclusion criteria, were assessed for risk of bias using the Cochrane Collaboration tool and included in the review. Study findings were presented descriptively due to the heterogeneity of studies meta-analysis was not possible. Included papers described interventions categorized as: (1) multifaceted and (2) behavioural and educational, comprising: (a) text message and mail message (b) telephone calls (c) motivational interviewing and (d) nurse-led counselling and education. Substantial heterogeneity limited the robustness of conclusions, but this review indicated that motivational interviewing, education and phone or text messaging appeared promising as means to enhance cardiac medication adherence. Future research should integrate multifaceted interventions that target in idual behaviour change to enhance adherence to cardiovascular medications, to build on the beneficial outcomes indicated by this review.
Medication adherence and predictive factors in patients with cardiovascular disease: A comparison study between Australia and Iraq
Publisher: Elsevier BV
Date: 06-2019
Barriers and facilitators to healthy eating for nurses in the workplace: an integrative review
Publisher: Wiley
Date: 09-11-2017
DOI: 10.1111/JAN.13185
Abstract: The aim was to conduct an integrative systematic review to identify barriers and facilitators to healthy eating for working nurses. There is growing recognition of the influence of the workplace environment on the eating habits of the workforce, which in turn may contribute to increased overweight and obesity. Overweight and obesity exact enormous costs in terms of reduced well-being, worker productivity and increased risk of non-communicable diseases. The workplace is an ideal place to intervene and support healthy behaviours. This review aimed to identify barriers and facilitators to nurses' healthy eating in the workplace. Integrative mixed method review. Five electronic databases were searched: CINAHL, MEDLINE, PROQUEST Health and Medicine, ScienceDirect and PsycINFO. Reference lists were searched. Included papers were published in English between 2000-2016. Of 26 included papers, 21 were qualitative and five quantitative. An integrative literature review was undertaken. Quality appraisal of included studies used standardized checklists. A social-ecological framework was used to examine workplace facilitators and constraints to healthy eating, derived from the literature. Emergent themes were identified by thematic analysis. Review participants were Registered, Enrolled and/or Nurse Assistants primarily working in hospitals in middle or high income countries. The majority of studies reported barriers to healthy eating related to adverse work schedules, in idual barriers, aspects of the physical workplace environment and social eating practices at work. Few facilitators were reported. Overall, studies found the workplace exerts a considerable negative influence on nurses' dietary intake. Reorientation of the workplace to promote healthy eating among nurses is required.
Critical incidents, crucial issues: insights into the working lives of registered nurses
Publisher: Wiley
Date: 03-1997
Nursing in the best and worst of the time of COVID
Publisher: Wiley
Date: 06-2020
DOI: 10.1111/IJN.12871
Stroke units: the implementation of a complex intervention
Publisher: Informa UK Limited
Date: 12-2005
Collaboration amongst clinical nursing leadership teams: a mixed-methods sequential explanatory study
Publisher: Hindawi Limited
Date: 05-11-2014
DOI: 10.1111/JONM.12267
Abstract: To explore intra-professional collaboration amongst nursing leadership teams at a tertiary referral hospital in Sydney. Effective working within a wide network of alliances is critical to patient outcomes. An understanding of collaboration amongst nursing leadership teams is essential within this context. A sequential explanatory mixed-methods design was used. The Collaborative Behaviour scale was sent to 106 Nurse Unit Managers, Nurse Educators and Clinical Nurse Consultants to measure pairwise collaborative behaviours two follow-up focus groups with 15 participants were conducted. Data were collected between May 2012 and May 2013. A thematic analysis of focus group data provided a detailed explanation of the questionnaire findings. The findings identified high collaboration between dyad groups. Two themes emerged from the thematic analysis: (1) professional role and expectations with sub-themes of transparency and clarity of in idual roles and intra/interpersonal aspects of role functioning and (2) organisational infrastructure and governance. These leadership teams can be effective and powerful vehicles for change and are central to optimum patient outcomes. Organisational strategic planning and evaluation can benefit from understanding how to promote collaborative behaviours in these nurse leaders. To date, little research has explored collaboration amongst nursing leadership teams. Successful collaboration may contribute to the efficient use of nursing resources improve patient outcomes, and ultimately, nurse satisfaction and retention.
Critical incidents, crucial issues: insights into the working lives of registered nurses
Publisher: Wiley
Date: 03-1997
Web-Based Questionnaire for Healthcare Professionals on Psychosocial Support for Adolescents and Young Adults with Type 1 Diabetes
Publisher: Springer Science and Business Media LLC
Date: 02-2022
Assisted feeding
Publisher: Wiley
Date: 15-05-2008
Health care professionals talking: Are services for young adults with type 1 diabetes fit for purpose?
Publisher: Wiley
Date: 09-07-2020
DOI: 10.1111/JEP.13210
Abstract: The challenges of becoming a mature adult may distract young adults with type 1 diabetes from disease self-management, increasing risks for premature morbidity and mortality. Despite the importance of young adults with type 1 diabetes engaging with preventative diabetes-related health care services, few studies report health care professionals' experiences and perceptions of the support that is available, including during the period of transition. This study sought to determine these factors across erse contexts in one health jurisdiction. This qualitative study was undertaken in New South Wales, Australia. Recruitment was based on a snowball s ling technique, which began with members of an established diabetes service group. Data were collected by in idual semistructured interviews with 16 health care professionals, most of whom were registered nurses (75%), working at differing levels of expertise and responsibility across metropolitan and regional/rural areas. Data were analysed using thematic analyses. Participants overwhelmingly recognized the time and care needed to support young adults with type 1 diabetes to prepare them for adult self-management and to work with adult diabetes services, and the importance of youth-friendly services. They reported shortfalls and inequitous distribution in services for these young adults. Two themes, addressing the present and future possibilities, expressed their perceptions of services for this population: working with what is available and mapping a route to better services. Findings identify opportunities for development in the planning and provision of specialist multidisciplinary health care support for this population. New ideas are needed for policy and practice innovation and for the infrastructure to facilitate this, to ensure that young adults with type 1 diabetes have access to consistent and coordinated diabetes health care services, particularly in nonmetropolitan settings.
Screening for symptoms of eating disorders: Reliability of the SCOFF screening tool with written compared to oral delivery
Publisher: Wiley
Date: 17-10-2002
DOI: 10.1002/EAT.10093
Abstract: The validity of the SCOFF delivered orally as a screening tool for eating disorders has previously been established, but clinical screening for eating disorders also occurs via written format, for ex le, in occupational health settings. The objective was to compare responses to the SCOFF between verbal and written administration. In a volunteer group of nursing and midwifery students at a South London University SCOFF was delivered orally at interview and via written questionnaire. Order was allocated randomly with repeat administration interrupted by distraction questions. There were 185 students who participated, providing 178 fully completed responses. Twenty subjects were male. There was overall agreement in the scores of 157 subjects (88.2%), providing a kappa coefficient of 0.811, with agreement in prediction of eating disorder for 167 (93.8%) and a kappa value of 0.824 (both p < 0.001). For 82 subjects administered the SCOFF verbally first followed by the written version, the kappa statistic was 0.752 (p < 0.001). For 96 subjects with SCOFF administered in reverse order (written form first), kappa was 0.862 (p < 0.001). Results demonstrated overall good replicability of the SCOFF administered as a written questionnaire compared to oral interview. Two trends were noted. The first was towards higher scores with written versus oral delivery irrespective of order, possibly indicating enhanced disclosure via written format. The second was of less consistency where verbal preceded written responses. Altogether findings support use of the SCOFF where a concise, valid and reliable screening for eating disorders is required in written form.
A qualitative exploration of the experience and quality of life of patients, and their family carers, admitted to a specialist eye hospital with microbial keratitis
Publisher: Research Square Platform LLC
Date: 05-12-2019
Abstract: Background Microbial keratitis is a vision-threatening condition requiring intensive treatment. Understanding patients’ and carers’ experience during and after hospitalisation can inform improvements in care and outcomes. This study explored the vision-related quality of life, and the experiences of patients with microbial keratitis and their family carers when admitted to a quaternary referral eye hospital in Australia Methods The study employed mixed methods, including qualitative interviews and a survey in hospital and a telephone interview post-discharge. A convenience s le was recruited of 33 patients with microbial keratitis who presented to hospital between March and October 2017, and 10 of their family carers. Semi-structured interviews were audiotaped, transcribed verbatim, coded and analysed using thematic analysis. Patient participants completed the National Eye Institute Visual Functioning Questionnaire – 25 (NEIVFQ-25). Results Qualitative analyses identified two main themes: Saving sight, with subthemes of costs of saving sight, and travel and transportation Safe-guarding home and normal life with subthemes of family, work and pastimes. A group mean NEIVFQ-25 score of 74 was similar to other ophthalmic disease groups but pain scores were higher. Conclusion Findings provide insights into the experiences and often unspoken concerns of microbial keratitis patients and their family carers, revealing the priority and the associated costs of saving sight, and the implications for family and lifestyles. These patients reported similarly reduced vision-related quality of life but greater pain compared to other ophthalmic groups. Findings point to ways to improve their experience and potentially reduce the high rates of unplanned representations of this patient group.
A qualitative exploration of the experience and quality of life of patients, and their family carers, admitted to a specialist eye hospital with microbial keratitis
Publisher: Research Square Platform LLC
Date: 12-04-2019
Abstract: Background: Microbial keratitis is a vision-threatening condition requiring intensive treatment. Understanding patients’ and carers’ experience during and after hospitalisation can inform improvements in care and outcomes. This study explored the vision-related quality of life, and the experiences of patients with microbial keratitis and their family carers when admitted to a quaternary referral eye hospital in Australia Methods: The study employed mixed methods, including qualitative interviews and a survey in hospital and a telephone interview post-discharge. A convenience s le was recruited of 33 patients with microbial keratitis who presented to hospital between March and October 2017, and 10 of their family carers. Semi-structured interviews were audiotaped, transcribed verbatim, coded and analysed using thematic analysis. Patient participants completed the National Eye Institute Visual Functioning Questionnaire – 25 (NEIVFQ-25). Results: Qualitative analyses identified two main themes: Saving sight, with subthemes of costs of saving sight, and travel and transportation Safe-guarding home and normal life with subthemes of family, work and pastimes. A group mean NEIVFQ-25 score of 74 was similar to other ophthalmic disease groups but pain scores were higher. Conclusion: Findings provide insights into the experiences and often unspoken concerns of microbial keratitis patients and their family carers, revealing the priority and the associated costs of saving sight, and the implications for family and lifestyles. These patients reported similarly reduced vision-related quality of life but greater pain compared to other ophthalmic groups. Findings point to ways to improve their experience and potentially reduce the high rates of unplanned representations of this patient group.
‘Mental health day’ sickness absence amongst nurses and midwives: workplace, workforce, psychosocial and health characteristics
Publisher: Wiley
Date: 07-12-2117
DOI: 10.1111/JAN.13212
Abstract: To examine the workforce, workplace, psychosocial and health characteristics of nurses and midwives in relation to their reported use of sickness absence described as 'mental health days'. The occupational stress associated with the nursing profession is increasingly recognized and nurse/midwifery absenteeism is a significant global problem. Taking a 'mental health day' as sickness absence is a common phenomenon in Australian health care. No previous studies have empirically explored the characteristics of nurses and midwives using such sickness absence. Online cross-sectional survey. Survey comprising validated tools and questions on workplace and health characteristics was distributed to nurses and midwives in New South Wales, Australia, between May 2014 - February 2015. S le characteristics were reported using descriptive statistics. Factors independently predictive of 'mental health day' reportage were determined using logistic regression. Fifty-four percentage of the n = 5041 nurse and midwife respondents took 'mental health days'. Those affected were significantly more likely to be at younger ages, working shifts with less time sitting at work to report workplace abuse and plans to leave having been admitted to hospital in previous 12 months to be current smokers to report mental health problems, accomplishing less due to emotional problems and current psychotropic medication use. Specific characteristics of nurses and midwives who report taking 'mental health day' sickness absence offer healthcare administrators and managers opportunities for early identification and intervention with workplace measures and support frameworks to promote well-being, health promotion and safety.
A qualitative exploration of the experience and quality of life of patients, and their family carers, admitted to a specialist eye hospital with microbial keratitis
Publisher: Research Square Platform LLC
Date: 03-11-2020
Abstract: Background: Microbial keratitis is a vision-threatening condition requiring intensive treatment. Understanding patients’ and carers’ experience during and after hospitalisation can inform improvements in care and outcomes. This study explored the vision-related quality of life, and the experiences of patients with microbial keratitis and their family carers when admitted to a quaternary referral eye hospital in Australia Methods: The study employed mixed methods, including qualitative interviews and a survey in hospital and a telephone interview post-discharge. A convenience s le was recruited of 33 patients with microbial keratitis who presented to hospital between March and October 2017, and 10 of their family carers. Semi-structured interviews were audiotaped, transcribed verbatim, coded and analysed using thematic analysis. Patient participants completed the National Eye Institute Visual Functioning Questionnaire – 25 (NEIVFQ-25). Results: Qualitative analyses identified two main themes: Saving sight, with subthemes of costs of saving sight, and travel and transportation Safe-guarding home and normal life with subthemes of family, work and pastimes . A group mean NEIVFQ-25 score of 74 was similar to other ophthalmic disease groups but pain scores were higher. Conclusion : Findings provide insights into the experiences and often unspoken concerns of microbial keratitis patients and their family carers, revealing the priority and the associated costs of saving sight, and the implications for family and lifestyles. These patients reported similarly reduced vision-related quality of life but greater pain compared to other ophthalmic groups. Findings point to ways to improve their experience and potentially reduce the high rates of unplanned representations of this patient group.
Implementing Guidelines and Changing Nursing Practice: Intentions and Outcomes
Publisher: Wiley
Date: 12-2004
Choosing nursing: becoming, staying, flourishing
Publisher: Wiley
Date: 20-06-2012
How many papers can be published from one study?
Publisher: Wiley
Date: 28-12-2014
DOI: 10.1111/JAN.12600
Machine learning: Great opportunities, but will it replace nurses?
Publisher: Wiley
Date: 02-2019
DOI: 10.1111/IJN.12725
A concept analysis of patient-centred nursing in the intensive care unit
Publisher: Wiley
Date: 27-02-2015
DOI: 10.1111/JAN.12644
Abstract: To report an analysis of the concept of patient-centred nursing in the context of intensive care. Clarification of patient-centred nursing in the intensive care unit is important because consensus definition of this concept is lacking. The severely compromised physiological state of these people and the sequelae of this differentiate patient-centred nursing in intensive care from that occurring in other hospital settings. While the broad concept has been analysed, it has not been examined in the context of intensive care. Concept analysis. CINAHL, PsycINFO, Medline and PubMed databases (2000-2014) were searched. Peer-reviewed papers were identified and reference lists of relevant articles searched. Walker and Avant's eight-stage approach was used. Patient-centred nursing in the intensive care unit incorporates antecedents of a physiologically compromised patient requiring biomedical intervention, a professional and competent nurse and organizational support. The concept's defining attributes entail maintenance of patient identity by a compassionate and professional nurse exercising biomedical expertise. Consequences include patient satisfaction, positive patient experience, nurse job satisfaction and better nurse workforce retention. Patient-centred nursing in intensive care is differentiated from other healthcare areas by the particular characteristics of critically ill patients, the critical care environment and the challenging bio-psycho-social demands made on intensive care nurses. Effective patient-centred nursing in this environment promotes beneficial outcomes for patients, nurses and healthcare service. Decision-makers and policymakers should support critical care nurses in this challenging role, to maintain delivery of patient-centred nursing and grow an effective nursing workforce.
Working well? Studying the nursing workforce
Publisher: Wiley
Date: 30-07-2015
DOI: 10.1111/IJN.12407
Continuing professional education: luxury or necessity?
Publisher: Wiley
Date: 04-1995
DOI: 10.1046/J.1365-2648.1995.21040766.X
Abstract: The author sets out to define what is meant by continuing professional education, the implications of the terminology and the contribution that it makes to nursing. She then moves on to discuss the distinction between education and learning, and the importance of 'life-long learning' to nursing. The relative merits of voluntary and compulsory education are considered and the attitudes and expectations of both nurses and their managers are examined. Obstacles to the up-take of educational opportunities are outlined, and some of the issues behind this are explored. The assessment of educational requirements and the evaluation of educational offerings are reviewed, along with the importance of assuring quality, not only in the context of proposals for postregistration education and the current market ethos in the United Kingdom, but also with regard to the potential benefits to be gained in the health care of the general public.
Developing theory and practice: Creation of a Community of Practice through Action Research produced excellence in stroke care
Publisher: Informa UK Limited
Date: 26-08-2010
Lifestyle health promotion interventions for the nursing workforce: a systematic review
Publisher: Wiley
Date: 13-07-2012
DOI: 10.1111/J.1365-2702.2012.04213.X
Abstract: Aims and objectives. Study aims were to identify the efficacy of lifestyle health promotion interventions intended to improve behavioural health risk factors and/or behavioural or clinical outcomes of working‐age nurses. Background. Nurses constitute around half the health workforce but global shortages and an ageing profile challenge future supply. The occupational hazards and stresses of nursing are well known. Health promotion, possibly workplace‐based, presents opportunities to safeguard the health of nurses. Design. This was a systematic review undertaken in line with guidance for reviews in health care. Methods. Seven electronic databases were searched from 2000–2011 and references of relevant papers. Two reviewers independently reviewed and critiqued retrieved papers and extracted data. Methodological features were described using the CONSORT checklists risk of bias was assessed using the Cochrane Handbook classification. Results. With design inclusion criteria relaxed to include an uncontrolled trial, only three intervention studies were retrieved, from the United States, Canada and Taiwan. All had limitations and high risk of bias, but benefits were reported. Outcomes included fewer cigarettes smoked during the intervention period, down from mean (SD) 20 (8)–12 (9) per day ( p 0·001) significantly reduced fat mass (0·68 vs. 0·07 kg p = 0·028) and significant gains across a battery of fitness assessments. The paucity of work focused on nurses’ health behaviours was the important finding. Conclusion. The workplace is a potentially fruitful location for health promotion intervention but nurses have seldom been recognised as a target participant group. Given the international priority ascribed to nursing workforce retention, this is a missed opportunity for occupational health planning. Potential benefits to nurses’ welfare and well‐being may accrue from well‐designed intervention studies. Relevance to clinical practice. Nurse leaders have a key role in driving recognition, spearheading commitment and development of targeted, whole‐organisation programmes to promote health profile improvement for the nursing workforce.
Clinician researcher career pathway for registered nurses and midwives: A proposal
Publisher: Wiley
Date: 25-03-2018
DOI: 10.1111/IJN.12640
Abstract: To consider clinician researcher career frameworks and propose a new pathway, integrating university and health service components to support research career progression within nursing and midwifery practice. Hospitals with research-active clinicians report fewer adverse events and better patient outcomes. Nursing clinician researcher career development is therefore an international priority, yet positions and expectations associated with this are not always well articulated, with nurses and midwives challenged to accommodate research and clinical careers. This discussion paper describes nurse/midwife clinician researcher career frameworks and a new pathway that aligns academic and nursing role descriptions. The new framework was informed by a brief literature search for international framework documents, three Australian state-based Nurses and Midwives Awards: the Australian Qualifications Framework, publically available University Academic (Research) Award schedules and academic staff descriptions, and state health department and health services publications. The implementation of research-based practice is a key element of nursing and midwifery roles and "advanced practice" position descriptions have well-defined research expectations. This paper considers structures to support their achievement. This paper provides a blueprint for clinician researcher career development. It elevates the research domain as an equal alongside clinical, managerial and educational clinical career development.
An exploration of nutrition and eating disabilities in relation to quality of life at 6 months post-stroke
Publisher: Hindawi Limited
Date: 07-2004
A proposed clinical research support career pathway for noninvestigators
Publisher: Wiley
Date: 08-03-2018
DOI: 10.1111/IJN.12641
Abstract: To discuss the international experience of clinical research support for noninvestigator roles and to propose a new pathway for Australia, to promote a sustainable research support workforce capable of delivering high-quality clinical research. Noninvestigator research support roles are currently characterized by an ad hoc approach to training, with limited role delineation and perceived professional isolation with implications for study completion rates and participant safety. A focused approach to developing and implementing research support pathways has improved patient recruitment, study completion, job satisfaction, and research governance. The Queensland and New South Wales state-based Nurses' Awards, the Australian Qualifications Framework, and a University Professional (Research) Staff Award. Research nurses in the clinical environment improve study coordination, adherence to study protocol, patient safety, and clinical care. A career pathway that guides education and outlines position descriptions and skill sets would enhance development of the research support workforce. This pathway could contribute to changing the patient outcomes through coordination and study completion of high-quality research. A wide consultative approach is required to determine a cost-effective and feasible approach to implementation and evaluation of the proposed pathway.
Coping and adaptation at six months after stroke: experiences with eating disabilities
Publisher: Elsevier BV
Date: 02-2003
DOI: 10.1016/S0020-7489(02)00060-3
Abstract: Stroke produces a range of enduring impairments and survivors' coping and adaptation styles are influential features of life after stroke. Many stroke-sequelae affect ability to eat but survivors' perceptions and responses to these have not been explored.Methods. Survivors of a cohort of patients admitted to hospital with acute stroke March 1998-April 1999 participated in semi-structured interviews in their homes at 6 months post-stroke. Interviews were tape recorded and transcribed 113 interviews with eating-disabled subjects were entered onto QSR NUD*IST 4 for thematic analysis.Findings. Two major emergent themes of 'getting back to normal' and 'getting by' were revealed which encompassed a range of responses in relation to food and eating. A high level of congruence was demonstrated with pre-existent frameworks but with some unique features. Reportage demonstrated non-linear and inconsistent effects of impairments within patients' lives and the importance of this topic for survivors and healthcare professionals was clear.
Lifestyle health behaviors of nurses and midwives: The ‘fit for the future’ study
Publisher: MDPI AG
Date: 09-05-2018
Nursing interventions for improving nutritional status of stroke patients
Publisher: John Wiley & Sons, Ltd
Date: 16-07-2008
Nutritional Aspects of Stroke Care
Publisher: Wiley
Date: 03-02-2010
Family carers of stroke survivors: needs, knowledge, satisfaction and competence in caring
Publisher: Informa UK Limited
Date: 2007
DOI: 10.1080/09638280600731599
Abstract: To examine the support required by family carers for stroke survivors. Forty-two family carers were recruited for surveys of needs, knowledge, satisfaction, and competence in caring before and 4 - 6 weeks after discharge from an Acute Stroke Unit (ASU). Information deficits about dealing with psychological, emotional, and behavioural problems and local service information were priorities before and after discharge. Younger female carers (under 56 years) were least satisfied with communication with ASU staff. Face to face contact was valued. After discharge younger female carers, particularly of non-White ethnic groups, reported lower levels of competence in caring and higher burden. Knowledge of stroke risk factors was low in all groups. High satisfaction with treatment and therapy in the ASU, was not transferred to the community. Carers reported feeling alone and described uncoordinated services. Carers are able to anticipate and prioritise their needs, value communication with staff and involvement with discharge-planning, but particular difficulties were experienced by younger female carers and those from non-White ethnic groups. This requires particular attention when developing targeted interventions for family carers from a mixed ethnic community. In-depth and longitudinal studies are needed to detail psychosocial needs and guide practice particularly amongst non-White family carers.
Revision and evaluation of an ‘advanced’ nursing role in an Australian emergency department
Publisher: Elsevier BV
Date: 05-2011
Nutrition: a hard nut to crack. An exploration of the knowledge, attitudes and activities of qualified nurses in relation to nutritional nursing care
Publisher: Wiley
Date: 07-1997
Revision and evaluation of an emergency extended practice nursing role
Publisher: Elsevier BV
Date: 2011
Dementia care in European countries – findings from the RightTimePlaceCare study
Publisher: Wiley
Date: 21-04-2015
DOI: 10.1111/JAN.12671
A Qualitative Exploration of the Experience and Quality of Life of Patients, and their Family Carers, Admitted to a Specialist Eye Hospital with Microbial Keratitis
Publisher: Research Square Platform LLC
Date: 10-12-2020
DOI: 10.21203/RS.3.RS-121916/V1
Abstract: Background: Microbial keratitis is a vision-threatening condition requiring intensive treatment. Understanding patients’ and carers’ experience during and after hospitalisation can inform improvements in care and outcomes. This study explored the vision-related quality of life, and the experiences of patients with microbial keratitis and their family carers when admitted to a quaternary referral eye hospital in Australia Methods: The study employed mixed methods, including qualitative interviews and a survey in hospital and a telephone interview post-discharge. A convenience s le was recruited of 33 patients with microbial keratitis who presented to hospital between March and October 2017, and 10 of their family carers. Semi-structured interviews were audiotaped, transcribed verbatim, coded and analysed using thematic analysis. Patient participants completed the National Eye Institute Visual Functioning Questionnaire – 25 (NEIVFQ-25). Results: Qualitative analyses identified two main themes: Saving sight, with subthemes of costs of saving sight, and travel and transportation Safe-guarding home and normal life with subthemes of family, work and pastimes . A group mean NEIVFQ-25 score of 74 was similar to other ophthalmic disease groups but pain scores were higher. Conclusion : Findings provide insights into the experiences and often unspoken concerns of microbial keratitis patients and their family carers, revealing the priority and the associated costs of saving sight, and the implications for family and lifestyles. These patients reported similarly reduced vision-related quality of life but greater pain compared to other ophthalmic groups. Findings point to ways to improve their experience and potentially reduce the high rates of unplanned representations of this patient group.
Exploring the ‘grey nomad’ travelling population of Australia and its health: an integrative literature review
Publisher: CSIRO Publishing
Date: 29-03-2021
DOI: 10.1071/PY20023
Abstract: With increasing numbers of baby boomers retiring and taking to the road in rural and remote Australia, often for extended periods, this review aimed to identify the characteristics of these ‘grey nomads’ travelling across Australia, their experiences in relation to their health and social needs and their access to health care. To this end, an integrative literature review with narrative analysis was conducted. Studies of Australian grey nomad travellers published from 1999 to January 2020 were sourced from Ovid Emcare, Medline/PreMedline, Embase, PsychINFO, Academic Search Complete and Google Scholar. Fourteen records based on 11 studies described grey nomads as predominantly older heterosexual couples who defied the conventional view of aging by seeking adventure and new experiences. Many planned for their health needs while travelling, and their health was overwhelmingly reported to improve with the nomadic lifestyle. This review demonstrates the paucity of data about grey nomads. Information on travellers’ health care needs and service usage is a significant gap, undermining regional and rural service planning and the provision of healthcare services, and represents a considerable challenge for healthcare providers such as GPs, pharmacies and emergency departments.
Screening for Dysphagia and Aspiration in Acute Stroke: A Systematic Review
Publisher: Springer Science and Business Media LLC
Date: 2001
DOI: 10.1007/PL00021290
Abstract: Stroke is a common problem, producing a variety of neurological problems that affect eating. Dysphagia is a particular concern because of its potential for airway obstruction, malnutrition, and aspiration pneumonia. With chest infection reported in up to 32% of stroke patients, this is a major clinical issue. The following research questions are raised: (1) What are the incidence and outcomes of dysphagia and aspiration in acute stroke? (2) What screening interventions are available to detect dysphagia in patients with acute stroke and what effect have they on patient outcomes? A systematic review was carried out using methods and quality criteria of the NHS Centre for Reviews and Dissemination (1996), focusing on studies of adults with acute stroke. Data were extracted, collated, and presented descriptively. Two hundred forty-eight articles were retrieved with 26 meeting inclusion and quality criteria. Clinical dysphagia is common, associated with a range of deleterious outcomes and clearly linked to development of chest infection. Interpretation of aspiration on videofluoroscopy is not as straightforward but probably also confers additional risk. Further work is required on the relationship between aspiration and pneumonia, and pneumonia prevention. This will include exploration of the effects of screening, and the further development and validation of screening methods. While studies indicate current "best practice," in this important area of patient care further work is urgently required.
Safer medicines To reduce falls and refractures for OsteoPorosis (#STOP): a study protocol for a randomised controlled trial of medical specialist-initiated pharmacist-led medication management review
Publisher: BMJ
Date: 08-2023
DOI: 10.1136/BMJOPEN-2023-072050
Abstract: Minimal trauma fractures (MTFs) often occur in older patients with osteoporosis and may be precipitated by falls risk-increasing drugs. One category of falls risk-increasing drugs of concern are those with sedative/anticholinergic properties. Collaborative medication management services such as Australia’s Home Medicine Review (HMR) can reduce patients’ intake of sedative/anticholinergics and improve continuity of care. This paper describes a protocol for an randomised controlled trial to determine the efficacy of an HMR service for patients who have sustained MTF. Eligible participants are as follows: ≥65 years of age, using ≥5 medicines including at least one falls risk-increasing drug, who have sustained an MTF and under treatment in one of eight Osteoporosis Refracture Prevention clinics in Australia. Consenting participants will be randomised to control (standard care) or intervention groups. For the intervention group, medical specialists will refer to a pharmacist for HMR focused on reducing falls risk predominately through making recommendations to reduce falls risk medicines, and adherence to antiosteoporosis medicines. Twelve months from treatment allocation, comparisons between groups will be made. The main outcome measure is participants’ cumulative exposure to sedative and anticholinergics, using the Drug Burden Index. Secondary outcomes include medication adherence, emergency department visits, hospitalisations, falls and mortality. Economic evaluation will compare the intervention strategy with standard care. Approval was obtained via the New South Wales Research Ethics and Governance Information System (approval number: 2021/ETH12003) with site-specific approvals granted through Human Research Ethics Committees for each research site. Study outcomes will be published in peer-reviewed journals. It will provide robust insight into effectiveness of a pharmacist-based intervention on medicine-related falls risk for patients with osteoporosis. We anticipate that this study will take 2 years to fully accrue including follow-up. ACTRN12622000261718.
Clinical utility of an observational and response chart with human factors design characteristics and a track and trigger system: study protocol of a two-phase multi-site multiple methods design
Publisher: JMIR Publications Inc.
Date: 12-08-2014
DOI: 10.2196/RESPROT.3300
An investigation of family carers' needs following stroke survivors' discharge from acute hospital care in Australia
Publisher: Informa UK Limited
Date: 2011
DOI: 10.3109/09638288.2011.553702
Abstract: To expand understanding of informal stroke care-giving, validated tools previously used in Hong Kong and in the U.K. were used with Australian stroke carers to assess their stroke-related knowledge, perceived needs, satisfaction with services received and sense of burden after stroke patients' discharge home from acute hospital care. Record audit and telephone interviews with two cohorts of 32 carers recruited in Sydney and Brisbane 1 and 3 months post-hospital discharge, using validated scales and open questions in May-July 2006. Female carers, those with prior care-giving responsibility, and those interviewed at three compared to one month post-discharge reported greatest needs and burden from the care-giving role needs alone significantly predicted burden. Getting information and being prepared for life after discharge were central concerns. Some felt this was accomplished, but inadequate information giving and communication mismatches were apparent. Service providers need to develop partnership working with stroke families and provide a network of services and inputs that cut across conventional boundaries between health and social care, public, private and voluntary organisations, with care plans that deliver what they delineate. Stroke care-givers have common issues across countries and healthcare systems collaborative research-based service development is advocated.
Eating and dietary intake in communication-impaired stroke survivors: a cohort study from acute-stage hospital admission to 6 months post-stroke
Publisher: Elsevier BV
Date: 12-2004
DOI: 10.1016/J.CLNU.2004.04.009
Abstract: Stroke is a major cause of chronic morbidity but despite the importance of nutrition for recovery and rehabilitation, nutritional features have received limited attention, particularly amongst those with communication impairments. This study reports a group of patients followed through acute hospital admission and at 6 months post-stroke. Subjects were survivors of a consecutive cohort admitted to a South London hospital with clinical diagnosis of acute stroke March-August 2001, with motor and communication deficits at initial assessment. Sequential assessments were undertaken from one week after admission to hospital discharge then in normal residence at 6 months. Assessments focused on stroke-related impairments functional abilities in activities of daily living and eating nutritional indices dietary intake derived from food diaries maintained by carers. Local Research Ethics Committee approval was obtained. Thirty-six participants were studied in hospital 18 at 6 months. Severely impaired and disabled at initial assessment (median Barthel Index score 1), significant improvements occurred by hospital discharge (to median score 7) despite substantial nutritional inadequacies and significant body tissue loss mean energy intake met 60% Estimated Average Requirements. At 6 months the median Barthel Index score of survivors was 12.5 but multiple eating-related difficulties persisted, linked with dietary deficits mean energy intake was 81% of Estimated Average Requirements. Body tissue losses continued across domiciliary settings. Closer attention to assessment and monitoring of nutrition-related aspects of stroke management is warranted across the continuum of care.
Fishing for understanding: nurses knowledge and attitudes in relation to nutritional care
Publisher: Elsevier BV
Date: 12-1997
DOI: 10.1016/S0020-7489(97)00032-1
Abstract: Many studies have demonstrated that malnutrition is a significant problem amongst hospital patients, but little is known about what nurses actually do, and what factors influence this. This study aimed to explore the nutritional attitudes, knowledge base and nursing care of qualified nurses in an acute hospital. A survey of nurses' records for documented nutrition related activities was carried out for all (141) patients from five wards for two weeks, followed by a questionnaire, focused on nutrition-related attitudes, activities and knowledge, to all qualified nurses of these and a further four wards (110 nurses). Results revealed evidence of some knowledgeable and pro-active attitudes and nursing care however, there was little association between knowledge, stated attitudes and behaviour and discrepancies were observed between questionnaire responses and documented activities. Ajzen and Fishbein's (1980) theory relating beliefs, attitudes, intentions and behaviour was not supported although this might be attributed, in part at least, to nurses not regarding weighing patients as nutritional assessment. Behaviour appeared to have been influenced by a variety of factors and relationships between attitudes, knowledge and activities seemed far from straightforward.
Imagining the future for diabetes nursing
Publisher: Wiley
Date: 10-2020
DOI: 10.1111/IJN.12894
Changing clinical team practices in preparation of patients for Total Knee Replacement: Using Social Cognitive Theory to examine outcomes of an action research study
Publisher: Elsevier BV
Date: 08-2013
Nursing interventions for improving nutritional status of stroke patients
Publisher: John Wiley & Sons, Ltd
Date: 20-04-2005
A systematic review of prevalence and impact of symptoms of pelvic floor dysfunction in identified workforce groups
Publisher: Wiley
Date: 17-02-2016
DOI: 10.1111/JAN.12909
Abstract: To investigate the prevalence and impact of symptoms of pelvic floor dysfunction in identified workforce groups. Productivity of workforce groups is a concern for ageing societies. Symptoms of pelvic floor dysfunction are associated with ageing and negatively influence psychosocial health. In the general population, lower urinary tract symptoms negatively influence work productivity. A systematic review of observational studies. Electronic searches of four academic databases. Reference lists were scanned for relevant articles. The search was limited to English language publications 1990-2014. The Centre for Reviews and Dissemination procedure guided the review method. Data extraction and synthesis was conducted on studies where the workforce group was identified and the type of pelvic floor dysfunction defined according to accepted terminology. Quality appraisal of studies was performed using a Joanna Briggs Institute critical appraisal tool. Twelve studies were identified of variable quality, all on female workers. Nurses were the most frequently investigated workforce group and urinary incontinence was the most common subtype of pelvic floor dysfunction examined. Lower urinary tract symptoms were more prevalent in the studied nurses than related general populations. No included study investigated pelvic organ prolapse, anorectal or male symptoms or the influence of symptoms on work productivity. Lower urinary tract symptoms are a significant issue among the female nursing workforce. Knowledge of the influence of symptoms on work productivity remains unknown. Further studies are warranted on the impact of pelvic floor dysfunction subtypes in workforce groups.
Service usage and vascular complications in young adults with type 1 diabetes
Publisher: Springer Science and Business Media LLC
Date: 09-05-2014
Nursing Interventions for Improving Nutritional Status and Outcomes of Stroke Patients: Descriptive Reviews of Processes and Outcomes
Publisher: Wiley
Date: 04-06-2012
DOI: 10.1111/J.1741-6787.2012.00255.X
Abstract: Stroke produces many effects that impact eating. Nutrition is fundamental for recovery and rehabilitation, but the nursing nutritional role and associated outcomes have not been delineated. (1) To identify nursing interventions intended to improve nutritional status and related outcomes of stroke survivors, and (2) To examine the outcomes of identified nursing interventions on nutrition-related outcomes, including dietary intake, functional status, complications, activities of daily living, mortality, and quality of life for stroke survivors. A modified version of Cochrane literature searching and review methods was used to identify studies that described and evaluated nursing nutritional interventions for adult stroke patients in hospital and community settings. A minimum of 10 years content of seven databases and nine journals was searched to March 2011. Findings were presented descriptively. In total 27 papers from 26 studies were included: 5 randomized controlled trials, 5 clinical trials, 6 quasi-experiments, 4 case studies, and 6 qualitative/observational studies. Stroke nursing nutritional care encompassed screening of nutritional status and swallowing function assessment of nutritional characteristics and preferences referral mealtime organization, supervision and monitoring mealtime assistance and feeding skills. Nurses in idualized care, coordinated or managed meal delivery and enteral feeding systems, were responsible for the dining environment and conduct of mealtimes they taught staff, patients, and carers. There was little indication of integrated or psychosocial nursing nutritional care, or concepts, theories or models of nursing nutritional care. Many interventions were described but not evaluated. Little high quality evidence was of available. This review indicated the parameters of nursing nutritional care, and provided a framework for future research. A functional, supportive, and educational nursing nutritional role was described but little evidence was of sufficient quality to support policy and practice development or inform education. Nutritional care was revealed as an essential but under-recognized element of stroke nursing.
Factors associated with return to work following myocardial infarction: A systematic review of observational studies
Publisher: Wiley
Date: 26-11-2020
DOI: 10.1111/JOCN.15562
Predicting Return to Work Following Myocardial Infarction: A Prospective Longitudinal Cohort Study
Publisher: MDPI AG
Date: 30-06-2022
Abstract: This study aimed to determine the proportion of patients who returned to work within three months post-myocardial infarction and the factors that predicted return to work. A total of 136 participants with myocardial infarction completed the study questionnaires at baseline and three months post-discharge between August 2015 and February 2016. At the three-month follow-up, 87.5% (n = 49) of the participants who were working pre-infarction had resumed work. Age, gender, education, smoking, readmission after discharge, number of comorbidities, diabetes, social support, anxiety, and depression were significantly associated with returning to work at three months post-discharge. Age, gender, smoking, anxiety, and depression significantly predicted those patients with myocardial infarction that returned to work, using binary logistic regression. The majority of patients in work who experience myocardial infarction have the capacity to achieve a work resumption by three months post-discharge. Interventions that facilitate returning to work should focus on modifiable risk factors, such as improving these patients’ mental health, comorbid conditions, risk of readmission, smoking, and social support. Healthcare providers should work in partnership with patients’ family members, friends, and employers in developing and implementing interventions to address these modifiable factors to facilitate patients’ return to work.
Promoting evidence-based practice in stroke care in Australia
Publisher: RCN Publishing Ltd.
Date: 03-05-2006
DOI: 10.7748/NS2006.05.20.34.35.C4140
Abstract: To explore approaches to the promotion of evidence-based practice from academic and clinical perspectives by visiting acute stroke units and collaborating centres of the Joanna Briggs Institute, an international network of academic centres. A semi-structured interview schedule was developed, piloted and used to guide interviews with academic and clinical staff in five state capital cities in Australia. Data were analysed and findings reviewed by clinical and academic participants. Four distinct but not mutually exclusive models and common but variously applied pathways for translation of evidence into clinical practice were identified. Key influential factors included context and local culture, the nature of evidence and role of clinical expertise. Implementation and change management strategies were recognised as emerging priorities. A range of methods to advance research synthesis, dissemination and knowledge transfer into clinical practice were demonstrated and may warrant consideration for the UK.
Pelvic floor health: a concept analysis
Publisher: Wiley
Date: 10-02-2015
DOI: 10.1111/JAN.12628
Abstract: To report an analysis of the concept 'pelvic floor health'. 'Pelvic floor health' is a term used by multiple healthcare disciplines, yet as a concept is not well defined. Rodger's evolutionary view was used to guide this analysis. Academic literature databases and public domain websites viewed via the Internet search engine Google. Literature in English, published 1946-July 2014 was reviewed. Websites were accessed in May 2014, then analysed of presentation for relevance and content until data saturation. Thematic analysis identified attributes, antecedents and consequences of the concept. Based on the defining attributes identified in the analysis, a contemporary definition is offered. 'Pelvic floor health' is the physical and functional integrity of the pelvic floor unit through the life stages of an in idual (male or female), permitting an optimal quality of life through its multifunctional role, where the in idual possesses or has access to knowledge, which empowers the ability to prevent or manage dysfunction. This analysis provides a definition of 'pelvic floor health' that is based on a current shared meaning and distinguishes the term from medical and lay terms in a complex, multifaceted and often under-reported area of healthcare knowledge. This definition provides a basis for theory development in future research, by focusing on health rather than disorders or dysfunction. Further development of the meaning is required in an in idual's social context, to ensure a contemporaneous understanding in a dynamic system of healthcare provision.
Screening swallowing function of patients with acute stroke. Part one: identification, implementation and initial evaluation of a screening tool for use by nurses
Publisher: Wiley
Date: 20-07-2001
DOI: 10.1046/J.1365-2702.2001.00501.X
Abstract: Stroke is a major cause of acute and chronic disability in the developed world, producing a wide range of impairments, including dysphagia, which impact upon eating. Dysphagia affects between one and two thirds of patients with acute stroke, with the potential for life-threatening airway obstruction, aspiration pneumonia and malnutrition. Whilst associated with increased impairment, dysphagia may present in isolation or accompanied by minimal disability universal screening of swallowing function is recommended. This study describes the process undertaken to review the evidence for dysphagia screening methods in patients with acute stroke. It also identifies, implements and establishes sensitivity and specificity of a screening tool (the Standardized Swallowing Assessment, SSA) for use by nurses. Not all ward staff had completed training to use the SSA by conclusion of the patient audit. Nonetheless 123 out of 165 assessable patients (74.5%) had their swallow function screened, 64 by SSA (52%). Based on 68 completed screening episodes by independently competent nurses, a comparison with summative clinical judgement of swallow function revealed a sensitivity of 0.97 and specificity of 0.9 for detection of dysphagia, with positive and negative predictive values of 0.92 and 0.96. This was significantly better than gag reflex performance, supporting the use of the SSA by competent ward nurses.
Eating difficulties after stroke
Publisher: Wiley
Date: 25-07-2003
DOI: 10.1046/J.1365-2648.2003.02724.X
Abstract: Stroke is a common and enduring problem, producing a wide range of effects that may impact on all aspects of life. One area that has seldom been investigated is the effects of stroke on ability to eat and, particularly, stroke survivors' subjective experiences of eating-related difficulties. To investigate stroke survivors' reports of eating-related experiences 6 months after stroke. Participants were 206 survivors of acute stroke who were admitted to hospital between March 1998 and April 1999. Those able to communicate and who gave informed consent participated in a semi-structured interview and assessment of eating abilities in their homes 6 months after their stroke. Interviews were tape recorded and transcribed and 113 interviews with eating disabled participants were entered onto QSR NUD*IST 4 for thematic analysis. Analyses were later checked independently. At 6 months, 34%, 61% and 5% had no, slight and moderate eating disablements, respectively. A range and variety of difficulties were discussed, but relationships between degrees of disablement and handicap were not straightforward effects seemed more closely related to participants' responses than objective difficulties. Eating and related activities were clearly important aspects of life for these stroke survivors, socially and psychologically, as well as functionally. Prestroke activities were sometimes maintained, with considerable effort. Findings indicated issues of relevance for those involved with early rehabilitation interventions and highlighted aspects of continuing care service delivery that warrant review. The relative lack of attention paid to eating-related aspects of care is an important oversight.
Stroke Care: A Practical Manual
Publisher: Wiley
Date: 11-02-2008
Prevention of Adolescent Pregnancy in Anglophone Sub-Saharan Africa: A Scoping Review of National Policies
Publisher: Maad Rayan Publishing Company
Date: 05-10-2020
Abstract: Background: Despite the existence of preventive policies across sub-Saharan Africa, countries within the sub-region lead global rankings for rates of adolescent pregnancy. The aim of this scoping review was to identify and review national policies on the prevention of adolescent pregnancy in Anglophone sub-Saharan Africa. Methods: Relevant policies were identified from searches of national government websites and the search engine Google. Recognised screening and data extraction processes were used data were subjected to content analysis using a published Framework for Evaluating Program and Policy Design on Adolescent Reproductive Health. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews guidelines was used in reporting the review. Results: In line with the inclusion criteria that guided the selection of relevant policies in this study, 17 of 75 national policies were suitable for the analysis. All were backed by political recognition, were government and public initiatives, acknowledged a range of determinants of adolescent pregnancy and allocated human resources to policy activities. Few specified financial resourcing. Most policies acknowledged the importance of coordination and collaboration among public and private actors. All policies had objectives that addressed adolescent pregnancy but none were measurable or included timeframes. Provision of comprehensive sexuality education and adolescent reproductive health services were the most common recommendations. Monitoring and evaluation plans were present in all the policies. However, youth involvement in policy formulation, and plans for implementation, monitoring and evaluation was scarce. Conclusion: Overall, national policy strengths were seen in relation to their political recognition, and all aspects of policy formulation. Policy implementation strengths and weaknesses were identified, the latter in relation to clear descriptions of financial resources. Importantly, the absence of measurable and time-bound objectives or formal evaluation of policy effectiveness confounds demonstration of what has been delivered and achieved. Youth involvement was notably absent in many policies. For future policy-setting, governments and policy-makers should make efforts to engage young people in policy development and to be transparent, realistic and address the necessary financial resourcing. They should set quantifiable policy objectives that provide a basis for assessing the adoption, uptake and effectiveness of policies in relation to measurable objectives.
Who writes, whose rights, and who's right? Issues in authorship
Publisher: Wiley
Date: 15-11-2013
DOI: 10.1111/JAN.12265
Prevalence of vascular complications and factors predictive of their development in young adults with type 1 diabetes: systematic literature review
Publisher: Springer Science and Business Media LLC
Date: 02-09-2014
Culture, teams, and organizations: A qualitative exploration of female nurses’ and midwives’ experiences of urinary symptoms at work
Publisher: Wiley
Date: 12-02-2019
DOI: 10.1111/JAN.13951
Abstract: To explore nurses' and midwives' experiences of urinary symptoms at work. Lower urinary tract symptoms are common in female nurses and midwives. There is limited understanding of the relationship between urinary symptoms, bladder health practices, and work. Qualitative design providing in-depth exploration of nurses' and midwives' experiences of urinary symptoms at work through focus group discussions. Twelve focus groups were held July-September 2016 with 96 Registered Nurses and midwives working at two tertiary-referral hospitals in urban New South Wales, Australia. A semi-structured question schedule was used. An inductive process guided thematic analysis of data using a socioecological framework of health behaviours. Nurses' and midwives' experiences of urinary symptoms at work primarily relate to delaying voiding. This practice is explained by a work culture of "patient-first" care at expense of self-care, relationships in the nursing team, demands of the nursing role, and inadequacy of workplace amenities. The first two themes reflect cultural and social caring dilemmas central to nursing. The second two themes identify issues with workforce management and physical workplace environments. Nurses' and midwives' urinary symptoms and behaviours in response to sensory cues for bladder emptying are dependent on several socioecological influences. Occupational health initiatives in the workforce are required to break cultural norms that deter self-care and to promote work environments that support healthy bladder practices. Workforce management and physical workplace environments are key influences on nurses' timely and dignified access to amenities.
Delaying voiding, limiting fluids, urinary symptoms, and work productivity: A survey of female nurses and midwives
Publisher: Wiley
Date: 05-08-2019
DOI: 10.1111/JAN.14128
Abstract: To examine the relationships between workplace bladder practices, urinary symptoms, and work productivity. Cross-sectional observational survey. Surveys were distributed June-November 2016 to at least 600 female nurses and midwives at three urban hospitals in New South Wales, Australia. Nurses self-reported restricted workplace access to toilets, delaying voiding, limiting of fluid intakes and urinary symptoms at work. Logistic modelling was used to examine whether nurses' bladder practices impaired their time management, ability to concentrate or perform physical demands. Of 353 useable surveys, one in five nurses (22.4% N = 79) reported restricted access to toilets at work, most (77.1% N = 272) delayed voiding and one in four (26.9% N = 95) limited fluid intakes to delay voiding at work. Almost half the s le had urinary symptoms at work (46.7% N = 165) delaying voiding increased the likelihood of impaired mental concentration and limiting fluid intakes increased the likelihood of impaired time management. As workplace access to toilets and related bladder practices are modifiable, associated urinary symptoms and productivity loss may be preventable. Nurses' often experience restricted accesses to amenities due to job demands and workplace environments. The impact of nurses' poor bladder practices in the workplace is not known. In this study most nurses delayed voiding and many purposefully limited fluid intakes at work. These behaviours impacted a nurse's ability to manage time and/or concentrate at work. Results have implications for nurses' personal health, the design of workplace environments, workforce management, occupational health policy, and patient care.
Authors and readers beware the dark side of Open Access
Publisher: Wiley
Date: 12-12-2014
DOI: 10.1111/JAN.12589
The health and health behaviours of Australian metropolitan nurses: An exploratory study
Publisher: Springer Science and Business Media LLC
Date: 03-09-2015
Dysphagia: the management and detection of a disabling problem
Publisher: Mark Allen Group
Date: 12-07-2001
DOI: 10.12968/BJON.2001.10.13.837
Abstract: Dysphagia represents a varying group of swallowing difficulties commonly encountered in patients in both acute and community settings. It accompanies a variety of disease states, can be neuromuscular or mechanical/obstructive in origin and encompasses varied prognoses and outcomes. Its consequences include dehydration, malnutrition, bronchospasm, airways obstruction, aspiration pneumonia and chronic chest infection, social isolation, depression and detrimental psychosocial effects. Current ‘best evidence’ in screening, assessment and management is of variable quality but demonstrates that nurses have an important role to play in interventions entailing multiprofessional collaboration within in idually tailored programmes. Clear benefits for patients have been indicated. There are gaps in the knowledge base, especially in relation to psychosocial effects and treatment strategies and the nursing contribution in this area.
Examination of the utility of the Promoting Action on Research Implementation in Health Services framework for implementation of evidence based practice in residential aged care settings
Publisher: Wiley
Date: 28-04-2011
DOI: 10.1111/J.1365-2648.2011.05655.X
Abstract: This study examined the relevance and fit of the PARiHS framework (Promoting Action on Research Implementation in Health Services) as an explanatory model for practice change in residential aged care. Translation of research knowledge into routine practice is a complex matter in health and social care environments. Examination of the environment may identify factors likely to support and hinder practice change, inform strategy development, predict and explain successful uptake of new ways of working. Frameworks to enable this have been described but none has been tested in residential aged care. This paper reports preliminary qualitative analyses from the Encouraging Best Practice in Residential Aged Care Nutrition and Hydration project conducted in New South Wales in 2007-2009. We examined congruence with the PARiHS framework of factors staff described as influential for practice change during 29 digitally recorded and transcribed staff interviews and meetings at three facilities. Unique features of the setting were flagged, with facilities simultaneously filling the roles of residents' home, staff's workplace and businesses. Participants discussed many of the same characteristics identified by the PARiHS framework, but in addition temporal dimensions of practice change were flagged. Overall factors described by staff as important for practice change in aged care settings showed good fit with those of the PARiHS framework. This framework can be recommended for use in this setting. Widespread adoption will enable cross-project and international synthesis of findings, a major step towards building a cumulative science of knowledge translation and practice change.
Stakeholders’ perceptions of a research capacity development project for nurses, midwives and allied health professionals
Publisher: Hindawi Limited
Date: 04-2008
DOI: 10.1111/J.1365-2834.2007.00801.X
Abstract: To evaluate stakeholders perceptions of the extent to which a research facilitator post was addressing aims of: * providing academic support to enable research involvement of nurses, midwives and allied health professionals * supporting dissemination of research into practice * contributing to research strategy development. Barriers to research capacity development have been recognized for nurses, midwives and allied health professionals. A project established in a London NHS trust aimed to address these. A mixed methods approach was used. Responses were generally very positive. The post effected improvements in the research culture and perceived increase in research-related activities. The post made substantial progress towards its aims. This approach may be useful in other healthcare locations to build research capacity. Challenged by increasing priority accorded to research capacity and service research implementation yet recognition of barriers to achievement, this study offers insights from one means to address this.
Glycaemic control and its associated factors in patients with type 2 diabetes in the Middle East and North Africa: An updated systematic review and meta‐analysis
Publisher: Wiley
Date: 27-05-2022
DOI: 10.1111/JAN.15255
Abstract: To examine the patient‐related factors that have been linked to glycaemic control in people living with type 2 diabetes mellitus in Middle Eastern countries. A systematic review and meta‐analysis. A computerized search was conducted using the databases MEDLINE (via PubMed and Ovid), EMBASE, Scopus and CINAHL to identify peer‐reviewed articles published in English between 1 January 2010 and 21 May 2020. On 28 June 2021, the search was updated with the same keywords and databases however, no further relevant studies were identified. Extracted data were analysed using Review Manager 5.4. The final s le consisted of 54 articles with a total of 41,079 participants. Pooled data showed an increased risk of inadequate glycaemic control in smokers [OR = 1.26, 95% confidence interval (CI): 1.05, 1.52 p = .010], obese patients (OR = 1.30, 95% CI: 1.10, 1.54 p = .002), patients with elevated waist to hip ratio (OR = 1.62, 95% CI: 1.16, 2.26 p = .004) and longer disease duration (OR = 2.01, 95% CI: 1.64, 2.48 p .001). A lower risk of inadequate control was associated with physical activity (OR = 0.40, 95% CI: 0.24, 0.67 p .001) and self‐management (OR = 0.49, 95% CI: 0.29, 0.82 p = .006). These findings highlight the opportunity to address factors to improve glycaemic control. Further longitudinal studies are required to better understand these variations, to assess all predictors of glycaemic control in participants with type 2 diabetes, and to provide a strong basis for future measures to optimize glycaemic control.
Self‐care behaviours and related cultural factors among Chinese immigrants with cardiovascular disease in western countries: an integrative review
Publisher: Wiley
Date: 10-11-2021
DOI: 10.1111/JOCN.16120
Abstract: This review aimed to demonstrate the self‐care behaviours of first‐generation Chinese immigrants with cardiovascular disease in western countries and identify related cultural factors. Self‐care is the cornerstone to mitigate disease symptoms and maintain health status. Chinese immigrants to western countries, operating within a cross‐cultural context, may find self‐care to manage their cardiovascular disease challenging. An integrative review was conducted. Seven databases were searched Scopus, ProQuest Health & Medicine, Medline (Ovid), Embase (Ovid), AMED (Ovid), PsycINFO and CINAHL, with output limited to peer‐reviewed studies published from 2000 to 2020 in English or Chinese. Initially, 2037 papers were screened. Six papers were retained and critiqued using the Joanna Briggs Institute critical appraisal tools. Deductive and inductive approaches were utilised to analyse the findings. The PRISMA 2020 checklist informed review reportage. In general, Chinese immigrants with cardiovascular disease took an active role in management of their cardiovascular disease, including through diet and activity adaptation and adherence to western medication. Families also played a significant role in disease decision‐making and management. However, language and cultural barriers impeded their access to health information and resources in host countries. Understanding self‐care behaviours and associated cultural factors among Chinese immigrants with cardiovascular disease is important to improve nurses’ culturally sensitive practices and provide tailored health education interventions to promote self‐care behaviours among immigrant populations. The scarcity of literature on self‐care behaviours among Chinese first‐generation immigrants with cardiovascular disease indicates the need for further research in this area. Development of culturally and linguistically sensitive health resources and education programs is urgently needed.
A new approach to improving hand hygiene practice in an inner city acute hospital in Australia
Publisher: Elsevier BV
Date: 06-2012
DOI: 10.1071/HI12007
Evidence-based nursing interventions warrant rigorous development methods
Publisher: Wiley
Date: 15-02-2011
Nutrition: a hard nut to crack. An exploration of the knowledge, attitudes and activities of qualified nurses in relation to nutritional nursing care
Publisher: Wiley
Date: 07-1997
Gut feelings about gut feeding: enteral feeding for ventilated patients in a district general hospital
Publisher: Elsevier BV
Date: 09-1993
DOI: 10.1016/0964-3397(93)90023-Q
Abstract: This article looks at the role that nutrition plays in the maintenance of gut integrity and function in the critically ill patient. It refers to previous studies that have highlighted the relevance of facilitating the bacteriocidal function of gastric secretions as a means to minimize the development of nosocomial pneumonias in ventilated patients. A small trial was set up to investigate the merits and difficulties associated with two different enteral feeding regimes for ventilated patients in the intensive therapy unit (ITU) of a district general hospital. This project and its results are described and evaluated conclusions and issues for practice are highlighted.
Related Organisations
City University
Location: United Kingdom of Great Britain and Northern Ireland
University Of Plymouth
Location: United Kingdom of Great Britain and Northern Ireland
St Georges University Of London
Location: United Kingdom of Great Britain and Northern Ireland
University Of Exeter
Location: United Kingdom of Great Britain and Northern Ireland
Related Funding Activities
No related grants have been discovered for Lin Perry.