ORCID Profile
0000-0003-0559-9553
Current Organisation
University of Wollongong
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Publisher: Wiley
Date: 18-08-2018
DOI: 10.1111/JOCN.13930
Abstract: To describe the experiences of registered nurses who transition from acute to primary health care (PHC) employment. Internationally the provision of health care in PHC settings is increasing. Nurses are moving from acute care employment to meet the growing demand for a PHC workforce. However, little is known about the transition experiences of these nurses. A sequential mixed-methods study comprising a survey, and semi-structured interviews. This study reports on survey findings relating to the transition experience. Convenience and snowballing techniques were used to recruit 111 registered nurses who had transitioned from Australian acute settings to PHC employment within the last 5 years. An online survey gathered data relating to personal and professional demographics, type of PHC setting and transition experiences. Most respondents (n = 90, 81.1%) reported receiving some orientation, although the length and content varied considerably. Those working in metropolitan locations were more likely to report concerns associated with their orientation, with respondents from rural or remote locations more likely to have access to a preceptor than city/metropolitan respondents. Just under half of respondents found prioritising workload (n = 47 42.7%) or organisational knowledge (n = 45 40.9%) difficult or very difficult, and 47.7% (n = 53) felt isolated or unsupported. 49.5% (n = 55) reported being overwhelmed with the new role either sometimes or regularly. Barriers to transitioning successfully included limited employer support to attend professional development activities. Availability of specific support measures may assist in the transition process. Findings from our study should be considered by employers when recruiting nurses new to PHC, and when designing orientation and ongoing education programmes. This study highlights the challenges faced by nurses who transition from acute care into PHC employment. Understanding the barriers and facilitators to successful transitions enhances the process for future recruitment and retention of PHC nurses. This evidence can inform managers, educators and policymakers in developing support programmes for nurses moving into PHC.
Publisher: Wiley
Date: 27-11-2018
DOI: 10.1111/JOCN.13984
Abstract: To describe the experiences of acute care registered nurses transitioning to primary healthcare settings. The worldwide increasing demand for primary healthcare services has resulted in skilled acute care nurses transitioning to primary healthcare settings to meet workforce requirements. Little is known about the experiences and challenges associated with the transition. Knowledge of this will enable employers to design appropriate support processes and transitioning nurses can make informed choices. Semistructured interviews were conducted with nurses who had transitioned into primary healthcare employment in the last 5 years. Data analysis was undertaken using Braun and Clarke's (2006) thematic analysis approach. Thirteen nurses were interviewed, and two themes identified-role learning: the new environment, and role socialisation: transition validation. Role learning was influenced according to the quality of orientation programmes, previous experience, clinical knowledge and professional support. Support and professional respect from mentors and/or employers greatly assisted with role socialisation and the transition experience. Transitioning to primary healthcare employment provides unique challenges which must be considered by employers if they are to attract and retain experienced acute care registered nurses. Understanding the experiences of nurses who transition from acute to primary healthcare employment can inform the design of orientation programmes and ongoing professional supports to address barriers and challenges. Targeted orientation and support has the potential to enhance recruitment and retention of experienced nurses in primary health care.
Publisher: Wiley
Date: 12-2020
DOI: 10.1111/NAE2.7
Publisher: BMJ
Date: 08-2021
DOI: 10.1136/BMJOPEN-2021-049095
Abstract: This study sought to explore the experiences of Australian primary healthcare (PHC) nurses in the use of telehealth during COVID-19. Telehealth was defined as the use of any telecommunications mode (eg, telephone and videoconferencing) to deliver healthcare. Thematic analysis of qualitative interviews undertaken in Australian PHC. Twenty-five PHC nurses who had participated in a national survey about their experiences during COVID-19 were recruited using purposive s ling. Semistructured telephone interviews were conducted from June to August 2020. Interviews lasted a mean of 38.5 min. They were audio-recorded and transcribed before thematic analysis was undertaken. The consolidated criteria for reporting qualitative research were followed. Four overarching themes were identified: preparedness, accessibility of telehealth, care experience and impacts on the PHC nurses’ role. Some nurses were experienced in the use of telehealth, while others indicated a lack of preparation and limited appropriate technology to support its use. Telehealth enabled patients to access care but did not support complex clinical assessment. Participants indicated that patient engagement in telehealth was dependent on access and confidence using technology, perceived safety when physically attending the practice and the value they placed on care via telehealth. Many participants expressed frustration about telehealth funding and its impact on facilitating nurses to practise to their full scope. Telehealth has provided a means to continue PHC service delivery during COVID-19. While there are advantages to adopting this technology, considerations of the challenges and lessons from this experience are important to inform the future implementation of telehealth initiatives.
Publisher: Wiley
Date: 04-08-2021
DOI: 10.1111/JNU.12698
Abstract: COVID‐19 has presented health care professionals with unprecedented challenges. Significant risks have emerged as nurses have continued to work in delivering frontline health care during the pandemic. Feeling “at risk” has significant deleterious effects on nurses. The study sought to explore the perceptions of risk by Australian primary health care nurses (PHC) during COVID‐19. Twenty‐five Australian PHC nurses were purposively recruited from survey respondents who indicated a willingness to be interviewed. Phone interviews were undertaken between June and August 2020. Audio‐recordings were transcribed and analyzed thematically. Participants shared concerns about risks in the workplace that emerged during COVID‐19 and described the strategies used to mitigate these identified risks. Three themes were identified: (a) Professional concerns, (b) Personal/family concerns, and (c) Patient needs. Understanding PHC nurses’ perceptions of risk during COVID‐19 provides an important insight into how they can be better supported to manage the risks that they face and feel safer in their workplace. Ensuring that PHC nurses are well‐supported is important to optimize job satisfaction, reduce burnout and improve patient care. There is a need to ensure that nurses feel safe during crises such as pandemics to protect both in idual nurses and the broader workforce. Protecting the health workforce is essential to optimizing service delivery and promoting health outcomes.
Publisher: Wiley
Date: 31-07-2020
DOI: 10.1111/JNU.12589
Publisher: Cold Spring Harbor Laboratory
Date: 20-06-2020
DOI: 10.1101/2020.06.19.20135996
Abstract: To identify Australian primary healthcare nurses immediate support needs during the COVID-19 pandemic. COVID-19 has had widespread implications for primary healthcare nurses. Supporting these nurses’ capacity to deliver quality care ensures that ongoing health needs can be met. Primary healthcare nurses were recruited to an online survey via social media and professional organisations in April 2020. Six-hundred and thirty-seven responses were included in analysis. Participants provided 1213 statements about perceived supports required to provide quality clinical care. From these, seven key categories emerged, namely personal protective equipment, communication, funding, industrial issues, self-care, workplace factors and valuing nurses. A number of key issues relating to personal health and safety, care quality, and job security need to be addressed to support primary healthcare nurses during the COVID-19 pandemic. Addressing these support issues can assist in retaining nurses and optimising the role of primary healthcare nurses during a pandemic. Responding to the needs of primary healthcare nurses has the potential to facilitate their role in providing community based healthcare. This knowledge can guide the provision of support for primary healthcare nurses during the current pandemic, as well as informing planning for future health crises.
Publisher: Wiley
Date: 25-04-2021
DOI: 10.1111/JOCN.15711
Abstract: The aim of this paper is to explore the perceptions, attitudes and beliefs of middle‐aged Australians around their health, lifestyle risks and chronic disease. Health promotion and risk reduction are important to stem the rising prevalence of chronic disease. While there has been much emphasis on supporting these strategies in older Australians, there has been less attention on those in middle age. However, as this group age, their health will inevitably be impacted by lifestyle risk. A qualitative descriptive study using semi‐structured interviews. Reporting was guided by the COREQ checklist. Thirty‐four participants aged 40–65 years were recruited across South Eastern New South Wales, Australia, using convenience s ling. Semi‐structured interviews were conducted by four registered nurses with qualitative research experience. Verbatim transcripts were analysed using thematic analysis. Sixteen women and 18 men participated in the interviews. Four themes emerged, namely: adopting healthy lifestyles denial an impetus for change and sustaining change. Perceptions about what constituted good health varied, with male participants being more ambivalent about their health. Impetus for change was mostly influenced by family history, awareness of health risks and identification of risks by health professionals. Participants found sustaining change challenging, particularly with regard to smoking cessation and dietary modifications. Understanding the perceptions of health of middle‐aged people is important and enables health professionals to engage in early behavioural change conversations that consider perceived barriers to lifestyle modification. Findings from this study emphasise the importance of discussions about lifestyle risk to reduce the future burden of chronic disease. These findings illustrate the importance of understanding perceptions of health to guide primary health care nurses to develop person‐centred health promotion and chronic disease prevention strategies in this age group.
Publisher: Wiley
Date: 23-09-2022
DOI: 10.1111/JAN.15046
Abstract: To validate the ‘safe and effective staffing tool’ and explore the impact of COVID‐19 on the quality of Australian primary health care (PHC). A national survey was conducted from October to December 2020. The online survey was distributed via social media and professional organisations to PHC nurses. Three‐hundred fifty‐nine PHC nurses participated. A two‐factor solution was found with factors named ‘Perception of quality of care provided’ and ‘Personal satisfaction with care delivered’. Cronbach's alpha demonstrated good internal consistency for the total scale ( α = .915) and each subscale ( α = .879/ α = .864). Nearly three‐quarters of participants (71.3%) were satisfied with the quality of care they delivered. Participants working in general practice, and those with more nursing experience had significantly higher scores in the factor ‘perceptions of quality of care provided’ and the total ‘quality and satisfaction with care’. A lack of time, inadequate supervision and support, and performing non‐nursing duties were reported to be impacting care quality. Most participants (80.5%) reported that COVID‐19 had impacted negatively on the detection and management of non‐COVID related health conditions. The ‘safe and effective staffing tool’ is a valid and reliable measure of perceived quality of care and satisfaction with care delivered. Many PHC nurses perceive that there has been an overall reduction in the quality of care delivered due to COVID‐19 and feel that there is a lack of adequate supervision and workplace support. Given the limited baseline data, further research is required to understand the extent that COVID‐19 impacts these findings. However, this study demonstrates that strategies need to be implemented to support PHC nurses to provide high‐quality care to optimise health outcomes and maintain nurse satisfaction. This is the first attempt to evaluate care quality in Australian PHC. Policymaking requires this evidence to drive changes to better support PHC nurses.
Publisher: Elsevier BV
Date: 08-2022
Publisher: Hindawi Limited
Date: 10-2022
DOI: 10.1111/JONM.13816
Publisher: Hindawi Limited
Date: 09-2020
DOI: 10.1111/JONM.13108
Publisher: BMJ
Date: 2023
DOI: 10.1136/BMJOPEN-2022-065478
Abstract: This study aimed to investigate Australian primary healthcare professionals’ experiences of the rapid upscaling of telehealth during COVID-19. A cross-sectional survey. Two hundred and seventeen general practitioners, nurses and allied health professionals employed in primary healthcare settings across Australia were recruited via social media and professional organisations. An online survey was disseminated between December 2020 and March 2021. The survey comprised items about in idual demographics, experiences of delivering telehealth consultations, perceived quality of telehealth consultations and future perceptions of telehealth. Telephone was the most widely used method of providing telehealth, with less than 50% of participants using a combination of telephone and video. Key barriers to telehealth use related to the inability to undertake physical examination or physical intervention. Telehealth was perceived to improve access to healthcare for some vulnerable groups and those living in rural settings, but reduced access for people from non-English-speaking backgrounds. Quality of telehealth care was considered mostly or somewhat the same as care provided face-to-face, with actual or perceived negative outcomes related to missed or delayed diagnosis. Overwhelmingly, participants wanted telehealth to continue with guaranteed ongoing funding. Some 43.7% of participants identified the need to further improve telehealth models of care. The rapid shift to telehealth has facilitated ongoing care during the COVID-19 pandemic. However, further work is required to better understand how telehealth can be best harnessed to add value to service delivery in usual care.
Publisher: Hindawi Limited
Date: 02-01-2022
DOI: 10.1111/JONM.13534
Abstract: The aim of this study is to explore primary health care nurses' mental health, concerns and perceived safety and supports during COVID-19. Respiratory pandemics have negative impacts on nurses' wellbeing. While literature is replete with hospital nurses' experiences, there is less exploration of COVID-19 impacts on primary health care nurses. Given the importance of primary health care nurses in the health system, understanding their experiences is vital. Three hundred and fifty nine primary health care nurses responded to an online cross-sectional survey. The Depression Anxiety Stress Scales (DASS-21) was used to measure emotional state. Data were analysed using descriptive and inferential statistics. DASS-21 scores indicated that 39.6% of participants were experiencing symptoms of depression, anxiety or stress. Of those, 41.8% were experiencing symptoms on one scale, 26.9% were experiencing symptoms on two scales and 31.2% were experiencing symptoms across all three scales. Most participants identified that their feelings were related to COVID-19. COVID-19 is having a significant impact on primary health care nurses' mental health. Nurse managers need to develop strategies to effectively address nurses' concerns and effectively support them to sustain the workforce during and after the pandemic. Findings from this study can inform the design of effective nurse support programmes to reduce mental health impacts and promote staff wellbeing during the pandemic.
Publisher: Hindawi Limited
Date: 12-02-2018
DOI: 10.1111/JONM.12597
Abstract: To explore registered nurses' reflections on transitioning from acute to primary health care employment, and future career intentions. Reforms in primary health care have resulted in increasing demands for a skilled primary health care nursing workforce. To meet shortfalls, acute care nurses are being recruited to primary health care employment, yet little is known about levels of satisfaction and future career intentions. A sequential mixed methods study consisting of a survey and semi-structured interviews with nurses who transition to primary health care. Most reported positive experiences, valuing work/life balance, role ersity and patient/family interactions. Limited orientation and support, loss of acute skills and inequitable remuneration were reported negatively. Many respondents indicated an intention to stay in primary health care (87.3%) and nursing (92.6%) for the foreseeable future, whilst others indicated they may leave primary health care as soon as convenient (29.6%). Our findings provide guidance to managers in seeking strategies to recruit and retain nurses in primary health care employment. To maximize recruitment and retention, managers must consider factors influencing job satisfaction amongst transitioning nurses, and the impact that nurses' past experiences may have on future career intentions in primary health care.
Publisher: Wiley
Date: 18-06-2021
DOI: 10.1111/JAN.14937
Abstract: To explore primary healthcare nurses' psychological well‐being related to the COVID‐19 pandemic. Qualitative descriptive study. Semi‐structured interviews were conducted with 25 participants between June and August 2020 who indicated their willingness to participate in an interview following a national survey. Interviews were audio‐recorded and transcribed verbatim by professional transcribers. Data were analysed using thematic analysis. The importance of professional and public support and acknowledgement of the nurses' role during the pandemic positively influenced feelings of being valued. The psychological impact of negative experiences increased anxiety and stress levels. Participants reported a range of self‐care strategies, including increased vigilance with infection control at home and work and attention to physical exercise and diet. Most participants remained positive about their roles and career decisions, although some indicated that the negative psychological impacts prompted re‐evaluation of their career. Primary healthcare nurses have been exposed to a range of personal and professional stressors during the pandemic that have impacted their psychological well‐being. Awareness of stressors and an understanding of what has helped and what has impacted well‐being are important in guiding future workplace support systems. Further work to explore the long‐term impact of these stressors and the effectiveness of coping strategies employed by primary healthcare nurses is warranted. Managers and professional organisations need to consider the personal and professional stressors that have impacted on primary healthcare nurses' psychological well‐being to promote health and well‐being among nurses following COVID‐19.
Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/PY20030
Abstract: Increasingly, middle-aged people are demonstrating lifestyle risk factors that increase their risk of developing chronic disease. Reducing lifestyle risk in middle age can significantly reduce future morbidity and mortality and improve quality of life. Understanding peoples’ perceptions of health support is important to inform health professionals and policymakers regarding strategies to support lifestyle risk reduction. This paper seeks to explore middle-aged Australians’ perceptions of support for lifestyle risk reduction. Thirty-four middle-aged Australians were interviewed using a semi-structured interview schedule. Interviews were audio-recorded, transcribed and analysed using thematic analysis. The overarching theme ‘support for healthy lifestyles’ comprised three subthemes. ‘Engagement with general practice’ highlighted gender differences in why people attend and what impacts their access to general practice. ‘Providing information’ emphasised participants’ experiences of lifestyle risk communication in general practice. Finally, ‘Sources of support’ revealed participants’ current health advice-seeking behaviours. Findings highlight a need for general practices to better engage middle-aged people in behaviour change and educate them about the role of general practice in prevention and health promotion. Consistent messaging across the community and strategies that focus on gender-specific concerns are likely to ensure that middle-aged people are able to make informed choices about seeking support for lifestyle risk reduction.
Publisher: Hindawi Limited
Date: 25-12-2021
DOI: 10.1111/JONM.13230
Publisher: Hindawi Limited
Date: 10-01-2022
DOI: 10.1111/HSC.13710
Abstract: This qualitative study describes the impact of the first wave of the COVID-19 pandemic on the provision of care by Australian primary health care (PHC) nurses. Participants were purposefully recruited following completion of a national survey about PHC nurses' experiences during the pandemic. Twenty-five semi-structured interviews were conducted by two experienced researchers and professionally transcribed. The mean duration of interviews was 38.5 min. Thematic analysis revealed three themes about the impact of COVID-19 on PHC nurses' provision of care. These were: workplace adjustments, changes in healthcare delivery and concerns about long-term health impacts of COVID-19. The sudden disruption and de-stabilisation of care delivery was reported as significantly impacting on initial service provision, although participants reported adapting quickly and finding new ways to deliver care. The impact of the pandemic on high risk communities and mental health support needs of clients created additional challenges, although some participants reported positive outcomes such as increased confidence of some clients to provide self-care. There were concerns about the potential long-term health impact on communities due to reduced levels of cancer screening, disrupted management of chronic conditions and reduced opportunistic health assessments. Findings from this study demonstrated how PHC nurses played an important role in the continued provision of PHC by adapting quickly to changed circumstances, adjusting and modifying clinical activities, and by monitoring for future potential negative outcomes from the pandemic. These findings are important for the future management of pandemics and inform the long-term planning of PHC services.
Location: Australia
No related grants have been discovered for Christine Ashley.