ORCID Profile
0000-0002-0757-6948
Current Organisations
Curtin University of Technology
,
University of Western Australia
,
Griffith University
,
Western Australian Institute of Technology
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Publications
Cultural competence in healthcare in the community: A concept analysis
Publisher: Hindawi Limited
Date: 07-03-2018
DOI: 10.1111/HSC.12556
Abstract: This study aims to conduct a concept analysis on cultural competence in community healthcare. Clarification of the concept of cultural competence is needed to enable clarity in the definition and operation, research and theory development to assist healthcare providers to better understand this evolving concept. Rodgers' evolutionary concept analysis method was used to clarify the concept's context, surrogate terms, antecedents, attributes and consequences and to determine implications for further research. Articles from 2004 to 2015 were sought from Medline, PubMed, CINAHL and Scopus using the terms "cultural competency" AND "health," "cultural competence" OR "cultural safety" OR "cultural knowledge" OR "cultural awareness" OR cultural sensitivity OR "cultural skill" AND "Health." Articles with antecedents, attributes and consequences of cultural competence in community health were included. The 26 articles selected included nursing (n = 8), health (n = 8), psychology (n = 2), social work (n = 1), mental health (n = 3), medicine (n = 3) and occupational therapy (n = 1). Findings identify cultural openness, awareness, desire, knowledge and sensitivity and encounter as antecedents of cultural competence. Defining attributes are respecting and tailoring care aligned with clients' values, needs, practices and expectations, providing equitable and ethical care, and understanding. Consequences of cultural competence are satisfaction with care, the perception of quality healthcare, better adherence to treatments, effective interaction and improved health outcomes. An interesting finding is that the antecedents and attributes of cultural competence appear to represent a superficial level of understanding, sometimes only manifested through the need for social desirability. What is reported as critical in sustaining competence is the carers' capacity for a higher level of moral reasoning attainable through formal education in cultural and ethics knowledge. Our conceptual analysis incorporates moral reasoning in the definition of cultural competence. Further research to underpin moral reasoning with antecedents, attributes and consequences could enhance its clarity and promote a sustainable enactment of cultural competence.
Power imbalance between nurses and patients: A potential inhibitor of partnership in care
Publisher: Wiley
Date: 06-06-2003
DOI: 10.1046/J.1365-2702.2003.00757.X
Abstract: The Patient's Charter identifies the need for nurses to respect patients' rights to influence their care, and contemporary nursing practice advocates that nurses work in partnership with patients. Hence nurses are encouraged to share their power and facilitate empowerment in their patients by giving them information and support. However, the literature indicates that nurses are not very successful in making patients feel empowered to make informed decisions. This study, conducted in 1998, provides some answers as to why this may be the case. The aim of the study was to explore and describe nurses' and patients' views regarding partnership in care in hospital. Using the grounded theory approach, participants were drawn from four hospitals in Western Australia. A purposive s le of 33 nurses and 32 patients were interviewed in-depth. Participant observation was also conducted and field notes were written. The interviews were transcribed verbatim and analysed using the constant comparative method. The findings showed that nurses viewed involving patients in care as requiring them to give patients information and to share their decision-making powers with them. With the exception of a few, the majority of nurses were unwilling to share their decision-making powers. This created a situation of power imbalance with subsequent little patient input. Factors identified included nurses' beliefs that they "know best", the view that patients lacked medical knowledge and the perceived need for nurses to hold onto their power and maintain control. If nurses and patients are to work as partners, it is important that nurses make every effort to equalize the power imbalance. One way to do this is for nurses to share and give information to patients readily and to be open in their communication with them.
Resilience: The power within
Publisher: Oncology Nursing Society (ONS)
Date: 11-2010
The role of music participation in positive health and wellbeing outcomes for migrant populations: A systematic review
Publisher: SAGE Publications
Date: 19-09-2016
Abstract: The aim of this review was to identify possible positive health and wellbeing outcomes of participatory music activities for culturally and linguistically erse people who could be described as vulnerable or “at risk” in particular migrant populations. Nine databases were searched spanning 10 years (2002–2013). The search returned 977 results with 45 articles reviewed. Seven articles met the inclusion criteria with most studies involving adolescents. Despite the reported health outcomes the review identified a scarcity of generalisable quantitative research ( n = 2) and credible qualitative research ( n = 5) indicating a distinct need for robust future investigation in this pertinent area of research.
Strategies used by nurses, academics and students to overcome intercultural communication challenges
Publisher: Elsevier BV
Date: 2016
DOI: 10.1016/J.NEPR.2015.08.010
Abstract: Nurse clinicians and academics need to understand intercultural communication challenges to improve their communication skills and better support students' learning. Gaps exist in the literature regarding intercultural communication resources for students, academics and clinicians. The aim of this study was to explore the experiences of clinical nurses, nurse academics, and student nurses regarding intercultural communication challenges. Data were collected using focus group interviews with nineteen clinical facilitators (nurses who supervise nursing students in clinical practice), five clinical nurses, and ten nursing students. Seven nurse academics were interviewed via telephone. The purposive s le was drawn from a tertiary hospital and a university in Australia. Participants were invited to discuss challenging intercultural scenarios they had experienced including strategies they used to overcome such challenges. Using qualitative content analysis data were analysed resulting in four categories which were: 1) prejudice based on cultural ersity 2) unfamiliarity with cultural boundaries 3) stereotyping cultural behaviours and 4) difficulty understanding English. Strategies participants used to mitigate challenges included resorting to cultural validation through alliance building, proactively seeking clarification, and acquiring cultural awareness knowledge. This study highlights intercultural challenges students, clinicians and academics face and signpost the way forward with useful strategies to better inform nurse education.
Knowing the patient and the impact on patient participation: A grounded theory study
Publisher: Wiley
Date: 06-1997
DOI: 10.1111/J.1440-172X.1997.TB00083.X
Abstract: Currently, there is an emphasis on patient participation. Studies have demonstrated that when patients participate in their care, they experience positive outcomes such as greater satisfaction with care and decreased vulnerability. Nurses are of the opinion that patients should participate in their care. Literature and research indicate, however, that there is an incongruence between nurses' pro-participatory attitudes and actual practice. Grounded theory was used to identify factors relevant to patient participation from the nurses' and patients' perspectives. Using purposive s ling from four hospitals in Western Australia, in-depth interviews and participant observation were conducted. The constant comparative method of analysis was used. As this study is in progress, the core category and sub-categories are still being refined. One category that has emerged strongly is 'knowing the patient' and the outcome on patient participation. This paper will discuss this category from the nurses and patients perspective including recommendations.
International medical graduates' reflections on facilitators and barriers to undertaking the Australian medical council examination
Publisher: CSIRO Publishing
Date: 2012
DOI: 10.1071/AH11082
Abstract: Objective. In Australia, 25% of international medical graduates (IMGs) make up the medical workforce. Concern is expressed in the literature about the lack of awareness and knowledge of issues that impinge on IMGs’ education. Although there is literature alluding to difficulties IMGs face with undertaking the Australian Medical Council (AMC) examination, there is little research detailing this experience. We therefore explored IMGs’ reflections on facilitators and barriers in undertaking the AMC examination. Methods. After ethics approval, in-depth telephone interviews were conducted with 30 IMGs selected from a hospital in Queensland. Data were coded and analysed using thematic analysis principles. Results. Two facilitating themes were identified: ability to sit for the first part of the examination in country of origin and having access to resources such as bridging courses and study groups. Three themes represented barriers: not understanding procedural steps financial issues and lack of information on examination content and standards. Conclusion. The themes provide new insights and add depth to existing literature that can be used to improve procedural processes and education for IMGs towards successful outcomes in the AMC examination. What is known about the topic? There is concern expressed in the literature about the lack of awareness and knowledge of issues that impinge on IMGs education. The Australian work that is available only depicts educational experience of fellowships or education and training strategies after IMGs have passed their AMC examination. What does this paper add? The findings indicate that the process of sitting for the AMC examination is perceived as one of the major difficulties associated with entering and integrating into the Australian health system. The findings indicate a range of practical, financial and resource problems faced by IMGs attempting to sit for the AMC examination. What are the implications for practitioners? The detailed accounts from IMGs about their experience with undertaking the AMC examination will provide up-skilling program coordinators with the information they need to better assist IMGs to prepare for the examination. The provision of appropriate medical training and educational support will contribute to more effective integration of IMGs into the healthcare system.
'Community navigators': Making a difference by promoting health in culturally and linguistically diverse (CALD) communities in Logan, Queensland
Publisher: CSIRO Publishing
Date: 2011
DOI: 10.1071/PY11053
Abstract: A key component of the 2011 Australian National Health Reform, via the Access and Equity Policy, is to improve access to quality health services for all Australians including CALD communities. Awareness has been raised that certain CALD communities in Australia experience limited access to health care and services, resulting in poor health outcomes. To address this issue, the Community Navigator Model was developed and implemented in four CALD communities in Logan, Queensland, through a partnership between government and non-government organisations. The model draws on local natural leaders selected by community members who then act as a conduit between the community and health service providers. Nine ‘navigators’ were selected from communities with low service access including the Sudanese, Burmese, Afghan and Pacific Islander communities. The navigators were trained and employed at one of two local non-government organisations. The navigators’ role included assessing client needs, facilitating health promotion, supporting community members to access health services, supporting general practitioners (GPs) to use interpreters and making referrals to health services. This paper explores the ‘lived experience’ of the navigators using a phenomenological approach. The findings revealed three common themes, namely: (1) commitment to an altruistic attitude of servility allowing limitless community access to their services (2) becoming knowledge brokers, with a focus on the social determinants of health and (3) ‘walking the walk’ to build capacity and achieving health outcomes for the community. These themes revealed the extent to which the role of CALD community navigators has the potential to make a difference to health equity in these communities, thus contributing to the Australian National Health Reform.
A systematic review of interventions to increase physical activity among South Asian adults
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.PUHE.2018.05.009
Abstract: To identify interventions aimed at increasing physical activity (PA) levels among South Asian (SA) adults and identify the specific changes in the content and delivery mode of interventions designed to increase PA levels among SA people aged ≥18 years. A systematic review of quantitative studies. Extracted data were synthesized using a narrative approach. ASSIA, CINHAL, EMBASE, Medline, SPORTDiscus and PsychINFO were searched. Included articles met the following criteria: (1) population: community-dwelling SA adults aged ≥18 years and (2) outcome: reporting determinants of PA, exercise, or a combination of the two, measured objectively or using self-report. The search was restricted to articles published in the English language up to 31 January 2017. Fifteen trials rogrammes (16 articles) met the review criteria. The findings show that involving the target community in developing culturally appropriate interventions appears to be important in their acceptability, delivery and uptake. Using community-based participation in intervention planning, evaluation and research appears to produce culturally and linguistically tailored interventions that address core values, attitudes, beliefs and norms, and encourage participation in PA. Furthermore, the use of community health workers and underpinning the interventions with a psychological theory show promise in increasing PA uptake. This systematic review suggests that making cultural adaptations to PA interventions shows promise, but the evidence base presented is not strong. This does not mean that adopting such an approach is ineffective but that the evidence base is currently lacking.
Australian overseas trained psychiatrists' perspective of up-skilling programme
Publisher: Emerald
Date: 03-06-2014
DOI: 10.1108/JMHTEP-12-2013-0038
Abstract: – The purpose of this paper is to report research findings on the perspectives of overseas trained psychiatrists (OTPs) on the “The Overseas Trained Specialist Up-Skilling Programme” (OTSUP), initiated in Queensland, Australia to assist OTP's to prepare for the Royal Australian and New Zealand College of Psychiatrist (RANZCP) Fellowship examination. Ascertaining and utilisation of OTP's views about the programme will enable improvements to be made to the programme and better implementation. – An exploratory qualitative design was utilised for the study in order to provide insights on the quality and effectiveness of the OTSUP. – Centred around two main themes. The first theme included participant's knowledge about the up-skilling programme with its subthemes of “finding out about the programme” “perceived aims of the programme” and “educational events supporting the programme”. The second theme revolved around participants’ perceived benefits of the up-skilling programme with its four subthemes such as, first, in idualised support, second, the opportunity to improve practical and communication skills through OTSUP educational events, third, access to peer support and fourth, provision of specific information on the RANZCP examination process. – Limitations as this was a qualitative study, the findings can only be applicable to a similar context. Nevertheless, the findings do provide support for an educational initiative that assisted the OTS to better prepare for the RANZCP examination. To gain further insight into challenges faced by OTS with successfully passing the examination in less frequent attempts, programmes such as the OTSUP need to be improved and sustained. – The findings provide valuable insight into how OTPs view the up-skilling programme. Moreover, the findings pave the way forward in how the programme can be improved in the future to assist OTPs prepare for the RANZCP examination.
Needs-gap analysis on culturally and linguistically diverse grandparent carers' 'hidden issues': A quality improvement project
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/PY15051
Abstract: In Australia, a significant number of culturally and linguistically erse (CALD) grandparents are sole carers for their grandchildren. Available information on the impact of caring on CALD grandparents and the ability of service providers to respond to their needs is limited. Our needs-gap analysis quality improvement project aimed to uncover ‘hidden issues’ for CALD grandparent carers so that services can be improved. One hundred service providers, such as community and aged-care services, child and/or grandparent support services and CALD-specific services, were approached using six structured questions. Six consultative forums on the caring role, issues encountered, and what needed to be done, were conducted with African, Asian, Spanish, Middle Eastern, European, Pacific Island and Maori grandparent carers in Queensland. The data were qualitatively analysed. Six themes emerged: 1) service provider and grandparent carer perception that there was limited research on CALD grandparents 2) inadequate legal and financial support 3) barriers to accessing information 4) lack of childcare options 5) transport difficulties and 6) inadequate technological skills. Our findings provide insight to health service providers on the ‘hidden issues’ so that they can better assist CALD grandparent carers by improving access to relevant information, referrals and resources.
Perceptions of infection control practices among health professionals.
Publisher: Informa UK Limited
Date: 07-2006
DOI: 10.5172/CONU.2006.22.1.109
Abstract: Infection control practice is a cornerstone of modern health care. However, there is minimal research into health professionals' perception of infection control practices and how those perceptions influence staff compliance with recommended protocols. The objective of this study was to explore health care professionals' perceptions of infection control practices in relation to the management of infectious diseases. A grounded theory approach was used as the research framework. Semi-structured interviews were completed with a s le of 16 nurses and doctors working at hospitals in Western Australia. Four major categories emerged from the data. These were: knowledge, culture, conflict, and risk assessment. The findings indicate the importance of both in idual and organisational factors in determining clinicians' levels of compliance with recommended infection control practices. Identification of the factors that influence health professionals' level of compliance can be used to develop strategies to support long-term compliance with infection control practices.
Metaphorical interpretations of the educator-student relationship: An innovation in nursing educational research
Publisher: Elsevier BV
Date: 2018
DOI: 10.1016/J.NEPR.2017.09.012
Abstract: Previous research has shown that collecting and analysing metaphors is a useful strategy in seeking data that are difficult to collect via verbal interviews or that cannot be represented by statistics. This study explored nursing students' perceptions of the educator-student relationship using metaphorical interpretation. A qualitative study with a personal essay approach was adopted. A total of 124 students were recruited from a nursing school in Hong Kong. A personal essay form was distributed to the participants. They were asked to give a metaphor with explanations to describe the power dynamics in the educator-student relationship, within 200 words in English or Chinese. After some thought, the participants each gave their own metaphor in idually, because the aim of this study was to collect their subjective experiences. The results were presented as follows: a) The overall description of the metaphors b) The three groups of metaphors c) The fives natures of metaphors d) The most significant metaphors and e) The four thematic meanings - (i) nurturing role (ii) guiding role (iii) insufficient connection and (iv) promoting development. The implications for research methods and nurse education of collecting and analyzing metaphors were discussed. Discrepancies in metaphorical interpretations are to be expected, as interpretations are dependent on the researchers' socio-cultural background, personal experiences, professional training, languages spoken, and other factors.
Using Interprofessional Learning for Continuing Education: Development and Evaluation of the Graduate Certificate Program in Health Professional Education for Clinicians
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2016
Factors impacting on nurses' transference of theoretical knowledge of holistic care into clinical practice
Publisher: Elsevier BV
Date: 12-2002
DOI: 10.1016/S1471-5953(02)00020-3
Abstract: Since nurse education moved to universities, a reoccurring concern of health consumers, health administrators, and some practising nurses is that nurses are not able to transfer the theoretical knowledge of holistic care into practice. Much has been written about this concern usually under the heading of the theory-practice gap. A common reason that has been highlighted as the cause of this gap is that the theoretical knowledge that nurses learn in academia is predicated on concepts such as humanism and holistic caring. In contrast, the bureaucratic organisation where nurses provide care tends to be based on management concepts where cost containment and outcome measures are more acceptable. Hence nurses' learned values of holistic caring are pitted against the reality of the practice setting. So what is this practice reality? This paper attempts to provide an insider view of why the theoretical knowledge of holistic care may be difficult to enact in the clinical setting. In-depth taped interviews with nurses and participant observation were conducted in acute care hospitals in Western Australia. The interviews were transcribed verbatim and analysed using the constant comparative method. The findings indicated that utilitarian nursing and role models had impacted on the transference of theoretical knowledge of holistic care into practice. The paper outlines some measures that nurses themselves can undertake to ensure the narrowing of the theory-practice gap in this area.
The association of maternal overweight and obesity with breastfeeding duration
Publisher: Elsevier BV
Date: 08-2006
DOI: 10.1016/J.JPEDS.2006.04.005
Abstract: To determine whether maternal prepregnancy overweight or obesity has an independent effect on breastfeeding duration. A prospective birth cohort study of 1803 live-born children and their mothers ascertained through antenatal clinics at the major tertiary obstetric hospital in Perth, Australia, were followed until 3 years of age. Unconditional logistic, Cox regression, and Kaplan Meier analyses were used to model the association between maternal prepregnancy overweight and obesity and the duration of predominant or any breastfeeding allowing for adjustment of confounders (infant factors: gender, birth weight, gestational age, age solids introduced, and older siblings maternal factors: smoking, education, age, race, marital status, pregnancy and birth complications, cesarean section, and socioeconomic status). Overweight and obese women were more likely to have discontinued breastfeeding at any time before 6 months than normal weight women (P < .0005) following adjustment for potential confounders. We have shown that prepregnancy body mass index is associated with reduced breastfeeding duration, and that mothers who are overweight or obese before pregnancy tend to breastfeed their infants for a shorter duration than normal weight mothers independent of maternal socioeconomic and demographic characteristics.
Clinical facilitators' experience of near peer learning in Australian undergraduate nursing students: A qualitative study
Publisher: Elsevier BV
Date: 12-2020
Developing nurses’ intercultural/intraprofessional communication skills using the EXCELLence in Cultural Experiential Learning and Leadership Social Interaction Maps
Publisher: Wiley
Date: 04-12-2018
DOI: 10.1111/JOCN.14089
Abstract: To examine how the use of Social Interaction Maps, a tool in the EXCELLence in Cultural Experiential Learning and Leadership Program, can enhance the development of nurses' intercultural/intraprofessional communication skills. Nurses face communication challenges when interacting with others from similar background as well as those from a culturally and linguistically erse background. We used the EXCELLence in Cultural Experiential Learning and Leadership Program's Social Interaction Maps tool to foster intercultural/intraprofessional communication skills in nurses. Social Interaction Maps describe verbal and nonverbal communication behaviours that model ways of communicating in a culturally appropriate manner. The maps include four stages of an interaction, namely Approach, Bridging, Communicating and Departing using the acronym ABCD. Qualitative approach was used with a purposeful s le of nurses enrolled in a postgraduate course. Fifteen participants were recruited. The Social Interaction Map tool was taught to participants in a workshop where they engaged in sociocultural communication activities using scenarios. Participants were asked to apply Social Interaction Maps in their workplaces. Six weeks later, participants completed a semistructured open-ended questionnaire and participated in a discussion forum on their experience of using Social Interaction Maps. Data were content-analysed. Four themes identified in the use of the Social Interaction Maps were (i) enhancing self-awareness of communication skills (ii) promoting skills in being nonconfrontational during difficult interactions (iii) highlighting the importance of A (Approach) and B (Bridging) in interaction with others and (iv) awareness of how others interpret what is said C (Communicating) and discussing to resolve issues before closure D (Departing). Application of the EXCELLence in Cultural Experiential Learning and Leadership Social Interaction Mapping tool was shown to be useful in developing intercultural/intraprofessional communication skills in nurses. Professional development programmes that incorporate EXCELLence in Cultural Experiential Learning and Leadership Social Interaction Maps can enhance nurses' intercultural/intraprofessional communication competencies when engaging with others from culturally and linguistically erse backgrounds and improve the way nurses communicate with each other.
Physical assessment skills—use them
Publisher: Informa UK Limited
Date: 03-1995
Maternal psychosocial well-being in pregnancy and breastfeeding duration
Publisher: Wiley
Date: 30-01-2008
DOI: 10.1111/J.1651-2227.2007.00602.X
Abstract: An increased duration of breastfeeding has many advantages for the child and mother. However, little research to date has investigated the influence of maternal psychosocial well-being during pregnancy on the duration of breastfeeding. This study aimed to examine whether experience of life stress events, social contact/support in pregnancy and postpartum emotional disturbance had an effect on breastfeeding duration. Using data from the Western Australian Pregnancy Cohort Study for 2420 women followed from 18 weeks gestation, we analyzed prevalent breastfeeding for 4 months or longer and its association with maternal psychosocial and socio-demographic factors in pregnancy, using multivariable logistic regressions. Experience of stressful life events during pregnancy increased the odds for the early cessation of prevalent breastfeeding (OR 1.34, p < 0.05, 95% CI 1.04-1.71) independent of maternal socio-demographic characteristics and biomedical factors. Stress events associated with separation or orce, financial problems and residential moves in pregnancy were important predictors for a shorter duration of prevalent breastfeeding. Experience of stressful life events during pregnancy increased the odds for the early cessation of prevalent breastfeeding. Interventions that move beyond hospital-based antenatal care to address the causes of maternal stress in pregnancy and socioeconomic disparities between women are required to increase breastfeeding duration.
The effectiveness of culturally appropriate interventions to manage or prevent chronic disease in culturally and linguistically diverse communities: A systematic literature review
Publisher: Hindawi Limited
Date: 06-01-2011
DOI: 10.1111/J.1365-2524.2010.00972.X
Abstract: Culturally and linguistically erse (CALD) communities in Australia experience both significant health disparities and a lack of access to services. Consequently, there have been calls for culturally appropriate services for people with chronic disease in CALD populations. This paper presents a systematic review of the literature on the effectiveness of culturally appropriate interventions to manage or prevent chronic disease in CALD communities. Evidence was sought from randomized controlled trials and controlled studies that examined strategies for promoting cultural competence in health service delivery to CALD communities. The outcomes examined included changes in consumer health behaviours, utilisation/satisfaction with the service, and the cultural competence of health-care providers. Of the 202 studies that were identified only 24 met the inclusion criteria. The five categories of intervention that were identified included: (1) the use of community-based bi-lingual health workers (2) providing cultural competency training for health workers (3) using interpreter service for CALD people (4) using multimedia and culturally sensitive videos to promote health for CALD people and (5) establishing community point-of-care services for CALD people with chronic disease. The review supported the use of trained bi-lingual health workers, who are culturally competent, as a major consideration in the development of an appropriate health service model for CALD communities.
Shaping a valued learning journey: Student satisfaction with learning in undergraduate nursing programs, a grounded theory study
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.NEDT.2018.02.020
Abstract: Student satisfaction is a quality measure of increasing importance in undergraduate programs, including nursing programs. To date theories of student satisfaction have focused primarily on students' perceptions of the educational environment rather than their perceptions of learning. Understanding how students determine satisfaction with learning is necessary to facilitate student learning across a range of educational contexts and meet the expectations of erse stakeholders. To understand undergraduate nursing students' satisfaction with learning. Constructivist grounded theory methodology was used to identify how nursing students determined satisfaction with learning. Two large, multi-c us, nursing schools in Australia. Seventeen demographically erse undergraduate nursing students studying different stages of a three year program participated in the study. Twenty nine semi-structured interviews were conducted. Students were invited to describe situations where they had been satisfied or dissatisfied with their learning. A constructivist grounded theory approach was used to analyse the data. Students are satisfied with learning when they shape a valued learning journey that accommodates social contexts of self, university and nursing workplace. The theory has three phases. Phase 1 - orienting self to valued learning in the pedagogical landscape phase 2 - engaging with valued learning experiences across erse pedagogical terrain and phase 3 - recognising valued achievement along the way. When students experience a valued learning journey they are satisfied with their learning. Student satisfaction with learning is unique to the in idual, changes over time and maybe transient or sustained, mild or intense. Finding from the research indicate areas where nurse academics may facilitate satisfaction with learning in undergraduate nursing programs while mindful of the expectations of other stakeholders such as the university, nurse registering authorities, employers and the receivers of nursing care.
Power dynamics in the student-teacher relationship in clinical settings
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.NEDT.2016.11.026
Abstract: Among many factors that influence clinical learning, the teacher-student relationship has been found to be crucial. The imbalance of power in that relationship tends to be regarded as negative, but how students actually perceive the power within the relationship is unknown. This study explored nurse students' perceptions of the power dynamics in the teacher-student relationship during their clinical placement. A descriptive qualitative study. A total of 51 students were recruited from a nursing school in Hong Kong. Seven focus group interviews consisted of three groups of Year 3 students (n=26) and four groups of final year students (n=25). A semi-structured interview guideline was designed. Content analysis was employed to analyse the research data. The three core themes that emerged from the qualitative data were: (1) meanings of power - avoiding doing harm to patients (2) the desired power dynamics - master vs apprentice and (3) enhancing the clinical learning experience. The dominant theme in the participants' discourse was that teachers should possess more power than students in order to prevent students from causing harm to patients. The consensus was that the teacher's power in supervising students' clinical practice is accepted and necessary for the benefit of patient safety. The cultural relevance of the power dynamics in the teacher-student relationship should be embraced in order to understand the student's perspective.
Culturally and linguistically diverse peoples' knowledge of accessibility and utilisation of health services: Exploring the need for improvement in health service delivery
Publisher: CSIRO Publishing
Date: 2011
DOI: 10.1071/PY10065
Abstract: With 28% of Australia’s population having a culturally and linguistically erse (CALD) background, the health system faces an increasing challenge to provide accessible and culturally competent health care. The view that all CALD communities are homogenous and solutions can be developed for the entire nation is detrimental. Despite available health services, CALD communities are reluctant to use them due to cultural differences, perceived racism and misunderstandings leading to the existing health disparities. Therefore, gathering data from four prominent CALD communities, such as the Sudanese, Afghani, Pacific Islander and Burmese communities in Logan, Queensland, about how they perceive and use health services can provide insightful information towards development of a service model that will better suit these CALD communities. The objective of the study was to examine the extent to which four prominent CALD communities (Sudanese, Afghani, Pacific Islander and Burmese) access and use health services in Logan, Queensland. Six focus group interviews using interpreters were conducted in English with Sudanese, Afghani, Pacific Islander and Burmese people. The results indicated that even long-standing CALD communities, such as the Pacific Islander people, were unfamiliar with health services and experienced difficulties accessing appropriate health care. Most wanted doctors to use traditional healing methods alongside orthodox medicine, but did not feel respected for their beliefs. Language difficulties impeded communication with health professionals who were hindered by ineffective use of interpreters. In conclusion, a clear role for bilingual community-based navigators was identified by CALD participants to address concerns about the health system, and to improve accessibility and health service usage.
Community-based child health nurses: An exploration of current practice
Publisher: Informa UK Limited
Date: 12-2011
DOI: 10.5172/CONU.2011.40.1.71
Abstract: The purpose of this research was to define, the practice domain of community-based child health nursing in light of widespread political, economic and social changes in Western Australia. The project was conducted by a group of nurse researchers with experience in child health nursing from the School of Nursing and Midwifery at Curtin University and the Child and Adolescent Community Health Division at the Department of Health, Western Australia. The overall aim of the project was to map the scope of nursing practice in the community child health setting in Western Australia and to identify the decision making framework that underpins this nursing specialty. Given the widespread social, economic and health service management changes, it was important for nurses involved with, or contemplating a career in, community-based child health to have the role accurately defined. In addition, consumer expectations of the service needed to be explored within the current climate. A descriptive qualitative study was used for this project. A purposive s le of 60 participants was drawn from the pool of child health nurses in the South Metropolitan Community Health Service, North Metropolitan Health Service and Western Australian Country Health Service. Following ethical approval data was collected via participants keeping a 2-week work diary. The data was coded and thematic analysis was applied. Several themes emerged from the analysis which were validated by follow up focus group interviews with participants. This clearly demonstrated common, recurring issues. The results identified that the community-based child health nurses are currently undertaking a more complex and expanded child health service role for an increasingly erse client population, over their traditional practices which are still maintained. Excessive workloads and lack of human and non human resources also presented challenges. There are increasing requirements for child health nurses to engage in community development and capacity building, often through a multidisciplinary partnership, which requires them to have sound brokerage and facilitation skills to enable community inclusion and inter-agency collaboration at the local level. The study has highlighted the importance and multifaceted nature of the role of the community-based child health nurse. To enable them to function optimally, the following suggestions/recommendations are offered. These being: More physical resources be allocated to community-based child health nursing More resources allocated to assist community-based child health nurses to support culturally and linguistically erse families Mapping of child health nurses' workloads The development of community health client dependency rating criteria reflecting the social determinants of health in order for health service refinement of staffing allocations based on an acuity scale Specific staff development opportunities to reflect the increased workload complexity Managerial support for the implementation of formal clinical (reflective) supervision Additional clerical assistance with non-nursing duties.
Reflecting on the tensions faced by a community-based multicultural health navigator service
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/AH13168
Abstract: The community navigator model was developed to assist four culturally and linguistically erse communities (Sudanese, Burmese, Pacific Islander Group, Afghani) in south-east Queensland to negotiate the Australian health system and promote health. Using participatory action research, we developed the model in partnership with community leaders and members, the local health department and two non-governmental organisations. Following implementation, we evaluated the model, with the results published elsewhere. However, our evaluation revealed that although the model was accepted by the communities and was associated with positive health outcomes, the financial, social and organisational durability of the model was problematic. Ironically, this situation was inadvertently created by critical decisions made during the development process to enhance the durability and acceptability of the model. This paper explores these critical decisions, our rationale for making those decisions and the four hidden tensions that subsequently emerged. Using a reflective case study method to guide our analysis, we provide possible resolutions to these tensions that may promote the longevity and utility of similar models in the future. What is known about the topic? The use of community navigators to assist culturally erse communities to access health services is not new. Many benefits have been documented for communities, in iduals and heath service providers following the use of such models. What is not well documented is how to maintain these models in a safe and cost-effective way within the Australian health system while respecting cultural and community practices and reducing the burden of service delivery on the navigators. What does this paper add? This paper provides a perspective on how the development of community-based service models inherently places them in a position of tension that must be resolved if they are to be long lasting. Four core tensions experienced during the development and implementation of our model in south-east Queensland are explored to develop potential resolutions. What are the implications for practice? Reducing the tensions inherent in culturally appropriate community-based service models will increase the durability of the approach. By addressing these tensions, we can create a more durable pool of community navigators that can facilitate community empowerment, self-governance of health issues and a sense of community ownership of health services.
Partnership functioning: A case in point between government, nongovernment, and a University in Australia
Publisher: Project MUSE
Date: 2013
Abstract: Culturally and linguistically erse (CALD) communities in Queensland, Australia, do not access health services, contributing to poor health outcomes. To improve health in CALD communities, a partnership was formed between the state government, two nongovernment CALD-specific organizations (NGOs), and a university to develop a service that could facilitate health service use. This qualitative research explored the partners' perspectives on how the partnership functioned and its outcomes. We sought to (1) explore how participants engaged with the principles of partnership, the processes they used, and their beliefs about the facilitators and barriers to intersectoral collaboration and (2) gain insights into how the partners perceived the development and functioning of the partnership. Qualitative, semistructured interviews were conducted with each of the key stakeholders in the partnership (n = 4). A focus group was also conducted with those working within the two NGO partners in the delivery of the service (n = 8). Open-ended questions drawn from the literature on partnership principles were used to guide the interviews and focus group data collection. The data were transcribed and analyzed using thematic principles. The four themes identified were: (1) Perceived benefits of the partnership outweighed organizational differences (2) respectful relationships sustained the partnership (3) mitigating conflict enabled the purpose of the partnership to be fulfilled and (4) a neutral interpersonal space enabled the partnership to be enacted. Our study showed how contextual pressures created within the system can damage tenuous connections that have been developed between otherwise competitive organizations, leading to dissolution of partnerships. However, the study has also shown that partnerships may be purpose and time bound, not necessarily with respect to longevity. Through strategic negotiations, partnerships can be sustained until the goal of the partnership is attained, which in this instance was the development of a new service delivery model.
Uncovering nursing students' views of their relationship with educators in a university context: A descriptive qualitative study
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.NEDT.2016.11.020
Abstract: Power dynamics is a key element in the educator-student relationship, and can be influential to the learning outcomes of students. Power relations are inherent in the interaction between educators and students. The educator-student relationship is still an under-explored area of power dynamics. The aim of the study was to investigate nursing students' perceptions of the power dynamics in the educator-student relationship in a university learning context in order to offer educators some understanding of how such a relationship was perceived by students. A descriptive qualitative study using focus group inquiry. Through convenience s ling, a total of 56 students were recruited and eight focus group interviews were conducted. Thematic analysis was adopted to capture the meanings extracted from the student narratives. Four core themes of the educator-student relationship were identified. Referring to these themes, some implications were drawn, such as the significance of the educator-student relationship an educator's power matters and polarized views among the students on whether or not an educator should be a friend. The power dynamics varied depending on an educator's personality, communication skills, ability to effectively monitor large classes, and teaching style. More efforts are needed to investigate the preferred conceptions and types of educator-student relationships in order to evaluate the impact that these have on learning.
How Does Culture Shape Roles and Relationships in Taiwanese Family Caregiving for an Adolescent With Cancer?
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2015
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