ORCID Profile
0000-0003-3947-0571
Current Organisation
James Cook University
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Hindawi Limited
Date: 11-2005
DOI: 10.1111/J.1365-2524.2005.00586.X
Abstract: This paper explores the social support networks available to the informal carers of people living with motor neurone disease (MND). An ethnographic case study was undertaken using eco mapping, observation and conversational interviews to collect data from 18 primary carers of people living with MND. Interviews took place in participants' homes in metropolitan, regional and rural locations. Participants discussed the content of their support network and drew lines between in iduals to indicate the type and strength of relationship. Changes to the network were depicted on eco maps during subsequent interviews. While health policy-makers assume that healthy social capital exists in Australian communities and that social cohesion will ensure active and available support networks in times of illness or disability, data from this exploratory study indicated that this was not consistently the case. Support networks varied in size and composition however, age was identified as a discriminator of the availability and consistency of support. People in older age groups identified more erse but consistent support systems while people in younger age groups reported more fluctuations in the strength of relationships and declines in support as caregiving became more demanding. In idual assessment of support networks at regular intervals in the caregiving trajectory is vital for all carers. However carers in younger age groups may need specific support to manage the psychological crises that occur and more access to paid care. Older carers may need consistent support to handle more of the instrumental aspects of care and assistance to mobilise their support networks. Community workers should be alert to the possible need for crisis intervention when tensions in relationships threaten carers' ability to provide effective care.
Publisher: Wiley
Date: 19-04-2012
Publisher: CSIRO Publishing
Date: 24-06-2021
DOI: 10.1071/PY20265
Abstract: Current Australian Government policy aims to resettle refugees in regional Australia, but little is known about their primary and hospital healthcare experiences in these settings. By taking an interpretive approach to a narrative inquiry methodology, a qualitative study was performed to examine refugee perceptions of health care in a regional centre of northern Queensland, Australia. Purposive s ling and an interview guide were developed in partnership with the local refugee resettlement agency. Semi-structured interviews were performed with 14 refugees and involved interpreters. Transcripts were thematically organised into a story, validated by participants. Using QSR NVivo 12, all researchers analysed the transcripts. Themes were validated at a community event. Six themes were described: service issues, self-advocacy, knowledge and understanding that changes with time, interpreter issues, regional–metropolitan differentials, and the influence of the past on present behaviour. A conceptual framework involving engagement, access, trust and privacy, and the old versus the new, can be used to describe refugees’ experiences. Discrimination, transport, and reliance on family and peers may be experiences that are more prominent in regional Australia. Refugees require high-quality information-sharing practices, formal support systems, and better models of service delivery for interpreting support. Clinicians need to be culturally respectful with their interactions.
Publisher: CSIRO Publishing
Date: 23-11-2021
DOI: 10.1071/PY21178
Abstract: Co-location of services for refugees may be beneficial in addressing barriers to care. This model of care involves support for a specialist refugee nurse service with general practice, as well as developing partnerships with settlement support agencies and Primary Health Networks. We consider published literature on refugee perceptions of co-location, different models of care, upcoming research and priorities in the area.
Publisher: Elsevier BV
Date: 05-2020
DOI: 10.1016/J.JPAINSYMMAN.2019.12.008
Abstract: Advances in medicine have seen changes in mortality in Western countries. Simultaneously, countries such as Australia, Canada, U.S., New Zealand, U.K., and Germany have encouraged consumer-directed care and advance care plan (ACP) completion, giving patients a voice despite incapacity. Adhering to ACPs relies on the decision-making of treating doctors, making hospital doctors key partners, and their perspectives on ACP adherence critical. The aim of this review was to explore and map existing research on factors associated with hospital doctors adhering to adult patients' ACPs. A scoping review of English language publications within CINAHL, Emcare, Medline, PsycInfo, and Scopus was conducted, following PRISMA Extension for Scoping Reviews (PRISMA-ScR) guidelines. ACPs were defined as adult patient-generated, written health care directions or values statements. Studies of any design, which reported original research associated with hospital doctors adhering to ACPs, were included. Twenty-seven publications were included in the final analysis. Results suggested ACPs were thought potentially useful however, adherence has been associated with doctors' attributes (e.g., specialty, seniority), attitudes toward ACP (e.g., applicability), and legal knowledge. Current literature suggests doctors hold largely positive attitudes toward ACPs that provide useful patient information that enables doctors to make appropriate treatment decisions. Doctors often perceive limitations to ACP applicability due to legal requirements or ambiguity of patient outcome goals.
Publisher: BMJ
Date: 20-03-2015
Publisher: Wiley
Date: 08-06-2020
DOI: 10.1111/AJO.13199
Publisher: Wiley
Date: 31-08-2020
DOI: 10.1111/JOCN.15422
Publisher: Wiley
Date: 09-05-2005
DOI: 10.1111/J.1365-2648.2005.03434.X
Abstract: This paper explores the use of ecomaps as a research tool for capturing data, using the ex le of the dynamic nature of social networks from which informal carers of people living with motor neurone disease draw their support. The need for social support in relation to health maintenance and disease management has been identified in the literature but little has been published about ways to investigate support networks. Existing discussion in the literature about the use of ecomaps as a clinical tool in social work creates a valuable framework for data collection which can be readily adapted by nurse researchers. We used ecomaps as part of a repertoire of research tools to gather data about the social networks of carers of people living with motor neurone disease. Primary carers participated in three interviews and collaborated in ecomap construction over a period of 10 months during 2003. Analytical correlations were made between ecomaps and interview data. Ecomaps provided a visual means of facilitating discussions around the structure and strength of networks. Being able to represent the social networks visually through ecomapping enabled people to identify each member of the network, examine the strength of each relationship and ascertain the sources of nurture and tension over time. Limitations to this type of data collection arise when participants try to quantify relationships that have been visually produced. Ecomapping is a valuable research tool because it provides visual representation of supportive care networks, capturing strategic data through symbols expressing relationships that may be inadequately portrayed in words. The ecomap incorporates the use of consistent symbols that standardize recipient responses, enabling data comparisons to be made.
Publisher: SAGE Publications
Date: 22-12-2010
Abstract: This article introduces the concept of socio-connective trust, the synapse between the social structures and processes that underpin relationships in supportive care networks. Data from an ethnographic case study of 18 informal caregivers providing in-home care for people with life-limiting illness were analysed drawing on theoretical concepts from the work of Giddens and writings on social capital, as well as the construction of trust in the caregiving literature. While conceptions of trust were found to contribute to understanding supportive care relationships, they did not account for the dynamic nature of the availability and use of support networks. Instead, informal caregivers undertook ongoing reflexive negotiation of relationship boundaries in response to their own conception of the current situation and their perception of trust in their relationships with the various members of the support network. The concept of socio-connective trust describes the movement and flow of the flexible bonds that influence relationships among care networks and determine the type and range of support accessed by informal caregivers. Understanding the complexities of socio-connective trust in caregiving relationships will assist health and social care workers to mobilize relevant resources to support informal caregivers.
Publisher: Springer Science and Business Media LLC
Date: 25-03-2015
Publisher: Informa UK Limited
Date: 12-2021
DOI: 10.2147/JMDH.S345792
Publisher: Wiley
Date: 21-07-2006
DOI: 10.1111/J.1365-2648.2006.03977.X
Abstract: This paper reports a study of how family members caring for people living with motor neurone disease managed the deteriorating body, their own bodywork and the associated emotional labour. People living with the neurodegenerative condition of motor neurone disease face the prospect of dying in 3-5 years from progressive loss of voluntary muscle mass and function, culminating in respiratory failure. Theories concerning the body in illness have been used to illustrate patient perspectives however, family caregivers' experiences of the body have been neglected. An ethnographic case study was undertaken with 18 primary family caregivers and six peripheral caregivers. Primary caregivers participated over 10 months in three face-to-face, semi-structured interviews which included mapping their support networks using ecomaps. Observational data were also recorded as field notes. Peripheral caregivers were interviewed once during the same time period. The data were generated between 2003 and 2004. Informal caregiving requires engagement in various aspects of bodywork. Three body concepts were identified: the visible body--how the disease affected the patient and caregivers the dependent body--the resulting care requirements and the social body--how living with motor neurone disease affected their social support networks. The visible body is a continual reminder of the ravages of the disease, while the dependent body demands physical and emotional care. Social interactions decline over time, depriving family caregivers of the much needed support for sustaining their commitment to the bodywork required in caregiving. The demands of bodywork for family caregivers are increased by the continual presence of emotional labour as they seek to implement the best way to support their relative with motor neurone disease. Nurses and allied healthcare workers need to assess each family situation, asking appropriate questions to establish the most appropriate interventions to facilitate supportive care.
Publisher: AMPCo
Date: 06-2012
DOI: 10.5694/MJA12.10665
Publisher: MDPI AG
Date: 03-08-2018
DOI: 10.3390/GERIATRICS3030049
Abstract: (1) Background: Studies have shown that older people prefer to continue living in their own home and community as they age however this is dependent upon available services and social support. In Australia about two thirds of people will age at home. The Australian Government provides home care packages to support ageing in place yet in rural areas not all services are available. The lack of employment opportunities in rural areas often results in family residing at a distance reducing available social support. This study aims to evaluate informal social support and its influence on ageing in place amongst older people in three Australian rural communities in Australia. (2) Methods: A multiple embedded case study was undertaken in three erse rural communities. Eleven older rural residents ageing in place aged 65+ were interviewed about their ageing experience and plans for their future in the light of available social support along with 15 members of their social networks. Social networks were then visually depicted with the use of ecomaps and network members were interviewed. (3) Results show that kin and non-kin social networks support ageing in place however ageing is a time of change and reflection. (4) Conclusions: There is a need for more discussion within these networks when it comes to future planning.
Publisher: International College of Surgeons
Date: 2016
DOI: 10.9738/INTSURG-D-15-00105.1
Abstract: This systematic review aimed to assess surgical safety checklist compliance and evaluate surgical team perceptions and attitudes, post-checklist implementation in the operating room. The World Health Organization (WHO) surgical safety checklist (SSC) has decreased complications and mortality. However, it is unclear whether this reduction is influenced by the vicarious enhancement in teamwork, communication, and staff awareness established by SSC implementation. The preferred reporting items for systematic reviews and meta-analyses model of review guided a search across MEDLINE, PubMed, and Embase databases. English-language studies using any adapted form of the WHO-SSC in operating rooms were reviewed by abstract and full text. Twenty-six studies, 13 assessing SSC compliance and 13 investigating surgical team perceptions of SSC, were evaluated. Compliance studies showed a checklist initiation rate of & %, but actual observed completion rate varied widely across studies. Sign out was the most poorly performed phase of the checklist (& %) with time out being the best. Verification of patient identity and procedure demonstrated a high degree (& %) of compliance across studies, but “verification of team-members” was significantly less compliant. Studies assessing surgical team perceptions found that SSC improved participants' perception of teamwork, communication, patient safety, and staff awareness of adverse events. However, when stakeholders placed differing degrees of importance on SSC completion, results indicated the SSC might actually antagonize team relationships. SSC compliance varies significantly across studies, being highly dependent on staff perceptions, training, and effective leadership. Surgical teams have positive perceptions of SSC thus with effective implementation strategies, compliance rates across all phases can be substantially improved.
Publisher: Oxford University Press (OUP)
Date: 14-09-2023
DOI: 10.1093/IJPP/RIAD064
Publisher: Elsevier BV
Date: 09-2021
Publisher: Wiley
Date: 28-09-2020
DOI: 10.1111/AJR.12647
Publisher: Wiley
Date: 03-2007
DOI: 10.1111/J.1365-2702.2006.01722.X
Abstract: This paper aims to add to nurses' knowledge concerning the losses and emotional labour family caregivers face caring for people living with neurodegenerative, life-limiting illnesses such as motor neurone disease. Motor neurone disease is a relentless, progressive illness resulting in progressive loss of voluntary muscle mass and function. Previous caregiver research presents the salient losses such as social, financial and relationship loss. However, the non-finite, unpredictable losses faced every day by caregivers and the emotional labour experienced are not effectively represented and have not been explored for caregivers of adult patients with life-limiting, degenerative, illness. Semi-structured interviews, ecomaps of social support networks and field notes were used to collect data for this ethnographic case study. Data were attained at three time points over a 10-month period from 18 primary caregivers and once from six peripheral caregivers. Data revealed new information about the psychosocial and emotional losses experienced daily, when living with motor neurone disease. The impact of the constancy of voluntary muscle degeneration and the uncertainty of the illness progression in terms of available time and functional loss, threatened people's understanding and expectations of life, their relationships, their personal identity and their future. Managing their relationship with the patient and their reactions to the devastation of motor neurone disease is consistent with the concept of emotional labour. Family caregivers living with relentless, life-limiting illness experience non-finite losses and emotional labour on a daily basis. While each in idual's experience of loss is unique, nurses need to include caregivers as well as patients, in their spectrum of supportive care. Nurses can be independent confidants who share the emotional labour and work with caregivers to develop interventions to assist them to manage their losses and their changing needs for psychological and emotional support.
Publisher: Springer Science and Business Media LLC
Date: 25-11-2015
Publisher: Springer Science and Business Media LLC
Date: 12-2016
Publisher: Informa UK Limited
Date: 04-10-2018
DOI: 10.1080/07481187.2018.1504836
Abstract: Improvements in the diagnosis and disclosure of dying mean that nowadays dying people typically live with an awareness of their status for longer than they have previously. However, little is known regarding how transitions between living and dying roles occur during this time. In this grounded theory study, we investigated role transitions at end-of-life. We found that dying people periodically foreground and background living and dying selfhoods, focus on living day-by-day and goal-by-goal and reframe dying roles with an orientation to living. We argue that with better understanding of role transitions at end-of-life more compassionate and responsive care becomes possible.
Publisher: Springer Science and Business Media LLC
Date: 27-04-2016
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.JTV.2019.04.004
Abstract: This study proposed to (1) develop a metric graduated colour tool and (2) demonstrate the effectiveness of the tool for use in the assessment of neonatal skin injuries. Findings from wound literature informed the metric graduated colour tool's development. Tool development included consideration of colours, size (comparative to neonatal skin injuries), cost, materials, feasibility and suitability for the neonatal clinical setting. Assessment of the tool's applicability with clinical images was then tested using digital cameras with specific evaluation of image sharpness and colour. Further evaluation was conducted within a case series of neonatal skin injuries. The metric graduated colour tool comprised of 15 colours, measures 60 mm, displays metric dimensions, and offers a discernible reference for clinical images and injury/wound bed comparison. Images collected appeared enhanced with clear wound edges compared to previous methods. Four neonates who acquired skin injuries were included in the case series for which the tool provided reliable metric and colour comparison of epidermal stripping, extravasation, birth injury, and pressure injury. When used to compare injury assessments for series subjects measurements of both increased and decreased severity were obtained. A metric and colour tool can be used in conjunction with digital photographs to enhance objective assessment of neonatal skin injuries/wounds. The metric and colour tool provides the foundation for vital skin injury assessment and documentation essentials including injury bed colour, size and consideration of depth of damage.
Publisher: MDPI AG
Date: 23-03-2020
Abstract: Some students struggle through medical school and do not have the confidence to seek help. This pilot study sought to explore the challenges and needs of medical students experiencing academic difficulty. Semi-structured interviews and online surveys were used to collect data from an academic advisor and thirteen medical students who had experienced academic difficulty. Unexpected academic failure and the loss of self-efficacy contributed to students hiding their academic difficulty and avoiding available support systems. Despite the s ling limitations, the findings of this pilot study have value in giving direction to future research. Programs that will change the current attitudes to academic difficulty, normalising access to support and encouraging early intervention, are needed to build the capacity for excellence among these students.
Publisher: Informa UK Limited
Date: 09-08-2019
DOI: 10.1080/07481187.2019.1648330
Abstract: In this Australian, constructivist grounded theory study, we undertook in-depth interviews with 11 dying people and 8 caregivers to examine their perspectives on role relations at end-of-life. We found that situations of role alignment between dying people and their family and friends support positive relational and practical outcomes, whereas role mismatch can cause considerable distress. Factors contributing to role mismatch at end-of-life were: dying people and their caregivers' efforts to shield each other from emotional harm fear of social exclusion and unwanted focus on the dying identity. Our findings highlight a need for flexibility and adaptability in end-of-life role relations.
Publisher: Springer Science and Business Media LLC
Date: 19-06-2014
No related grants have been discovered for Robin A Ray.