Medicine and Health Sciences Commons^™

Using Digital Health Technology To Optimise Older People’S Pain Self-Management Capabilities: A Mixed Methods Study (The Digitech Pain Project), Priyanka Bhattarai

Theses

Background

Arthritic pain is a major cause of illness and disability among older people. As the use of smartphones and apps increases in the lives of older people, there is an opportunity to explore the role of these apps in helping older people better manage their arthritic pain.

Aim

To explore the feasibility and acceptability of older people using an arthritic pain selfmanagement app to improve their pain symptoms.

Methods

A parallel convergent, mixed methods design underpinned by Bandura’s Self-Efficacy Theory and the Technology Acceptance Model 2; comprising of the following five studies:

(i) Study 1a: an integrative review;

(ii) …

A Qualitative Descriptive Study About The Experiences And Views Of Undergraduate And Postgraduate Nursing Students: What Influenced Them To Choose The Mental Health Specialty, Kaile Moon

Theses

Nurses perform a vital role in the mental health (MH) speciality. The mental health nurse (MHN) role is complex with expectations to manage a safe milieu, practice person-centred care, crisis management, and therapeutic skills, teach coping skills, provide emotional support, and set professional boundaries. However, MHN recruitment and retention continues to be a global struggle. Nursing students typically have low interest in choosing the MH speciality. Strategies to reduce stigma and improve attitudes and beliefs about MH nursing and mental illness have been successful among nursing students, globally and in Australia. However, these successful strategies have not extended to an …

Socio-Spatial And Quality Of Life Themes In Aged Care Architecture: A Qualitative Methods Protocol, Sarah Mcgann, Caroline Bulsara, Holly Farley

Arts Papers and Journal Articles

Aim: To evaluate the connection between residential aged care architecture, the residents’ ability to find home and Quality of Life themes.

Design: This study uses convergent qualitative mixed methods approach across the three phases of the research project to explore the lived experience of residential aged care residents, their family members, and direct care staff.

Methods: The chosen qualitative methodology is based on a constructionist paradigm and uses a combination of observations, photo production and prompted discussions, and architectural visual data collection methods. Funding was approved in March 2018.

Discussion: This research will provide a novel approach to understanding ways …

Using A Clinical Deterioration Scenario (Video) As An Approach For Interprofessional Learning, Kylie P. Russell, Heidi Waldron, Elina Tor, Nick Waldron

Nursing Papers and Journal Articles

For effective management of clinical deterioration, health professionals must work together to recognise and respond to the patients changing health status. This paper provides an overview of the clinical deterioration video, used as a learning tool to engage medical, nursing and physiotherapy students and junior clinicians for the purpose of identifying the deteriorating patient and to support the development of interprofessional teamwork skills. This paper describes the perspectives of educators who have used this resource, a description of the resource, its evaluation, and access to the resource. The educators felt that the clinical deterioration video provides a learning environment in …

Clinically Significant Depressive Symptoms Are Prevalent In People With Extremely Short Prognoses - A Systematic Review, Wei Lee, Marley Pulbrook, Caitlin Sheehan, Slavica Kochovska, Sungwon Chang, Annmarie Hosie, Elizabeth Lobb, Deborah Parker, Brian Draper, Meera R. Agar, David Currow

Nursing Papers and Journal Articles

Context: Currently, systematic evidence of prevalence of clinically significant depressive symptoms in people with extremely short prognoses is not available to inform its global burden, assessment, and management.

Objectives: To determine the prevalence of clinically significant depressive symptoms in people with advanced life-limiting illnesses and extremely short prognoses (range of days to weeks).

Methods: A systematic review and meta-analysis (random effects model) were performed (PROSPERO: CRD42019125119). MEDLINE, Embase, PsycINFO, CINAHL, and CareSearch were searched for studies (1994-2019). Data were screened for prevalence of clinically significant depressive symptoms (assessed using validated depression-specific screening tools or diagnostic criteria) of adults with advanced …

Being On Track: A Phenomenological Study Of The Lived Experience Of Staff Development Nurses’ Transition From A Ward-Based Role To The Role Of Staff Development Nurse In A Hospital In Western Australia, Penny Keogh

Theses

Continuing education is widely accepted as a means to remain competent in nursing and knowledgeable about the numerous changes in health care and the health care environments in which nurses work. The ward-based staff development nurse (SDN) role is considered a vital support for clinical staff (Armstrong & Laschinger, 2006; Conway & Elwin, 2007), with the role responsible for organising orientation and continuing education for nursing staff in their respective area of specialty. There is a dearth of research on the lived experience of the hospital-based SDN, most of whom have no formal training or preparation for their role. Newly …

Systematic Review And Meta-Analysis Of Patient Reported Outcomes For Nurse-Led Models Of Survivorship Care For Adult Cancer Patients, Leanne Monterosso, Violet Platt, Max Bulsara, Melissa Berg

Nursing Papers and Journal Articles

Purpose: This systematic review aimed to determine the effectiveness of nurse-led cancer survivorship care, compared with existing models of care, on patient reported outcomes for cancer survivors.

Methods: Randomised and non-randomised controlled trials and controlled before-after studies published in English between 1 January 2007 and 28 July 2017 were identified in bibliographic databases including Medline, Pubmed and PsychINFO. Included studies described nurse-led cancer care after treatment to adults (age ≥18 years) <2 years post treatment completion. Risk of bias was assessed using Joanna Briggs Institute’s tools and meta-analysis was undertaken.

Results: Twenty one publications were included describing 15 tumour-specific trials involving 3278 survivors of breast (n = 5), gynecological (n = 3), head and neck (n = 2), colorectal …

Effects Of Person-Centered Care At The Organizational-Level For People With Dementia. A Systematic Review, Lynette Chenoweth, Jane Stein-Parbury, Samuel Lapkin, Alex Wang, Zhixin Liu, Anna Williams

Nursing Papers and Journal Articles

The aim of the systematic review was to determine the effectiveness of organizational-level person-centered care for people living with dementia in relation to their quality of life, mood, neuropsychiatric symptoms and function. ALOIS, the Cochrane Dementia and Cognitive Improvement Group Specialised Register databases, were searched up to June 2018 using the terms dementia OR cognitive impairment OR Alzheimer AND non-pharmacological AND personhood OR person-centered care. Reviewed studies included randomized controlled trials (RCTs), cluster-randomized trials (CRTs) and quasi-experimental studies that compared outcomes of person-centered care and usual (non-person-centered) care, for people with a diagnosis of dementia. The search yielded 12 eligible …

The Nursing History Of Ngala Since 1890: An Early Parenting Organisation In Western Australia, Elaine Bennett, Selma Alliex, Caroline Bulsara

Nursing Papers and Journal Articles

Background: This study was the first phase of a larger study which explored the past, present and future of nursing in early parenting services in Australia.

Aim: The aim of this paper is to describe the history of nursing within an early parenting service in Western Australia (WA).

Methods: Triangulation of multiple data sources was used to summarise the nursing role over 120 years. The history was discovered through a document analysis of archives, including oral histories, organisational documents, focus groups, nurses’ diaries and interviews with nurses.

Findings: The nursing role and context is described over three time periods: 1890–1960; …

General Practice Physicians' And Nurses' Self- Reported Multidisciplinary End-Of-Life Care: A Systematic Review, Hugh Senior, Matthew Grant, Joel J. Rhee, Michèle Aubin, Peta Mcvey, Claire Johnson, Leanne Monterosso, Harriet Nwachukwu, Julia Fallon-Ferguson, Patsy Yates, Briony Williams, Geoffrey Mitchell

Nursing Papers and Journal Articles

Background: General practitioners (GPs) and general practice nurses (GPNs) face increasing demands to provide end-of-life care (EoLC) as the population ages. To enhance primary palliative care (PC), the care they provide needs to be understood to inform best practice models of care.

Objective: To provide a comprehensive description of the self-reported role and performance of GPs and GPNs in (1) specific medical/nursing roles, (2) communication, (3) care co-ordination, (4) access and out-of-hours care, and (5) multidisciplinary care.

Method: Systematic literature review. Data included papers (2000 to 2017) sought from Medline, Psychinfo, Embase, Joanna Briggs Institute and Cochrane databases. …

Father Inclusive Practice In A Parenting And Early Childhood Organisation: The Development And Analysis Of A Staff Survey, Dawson Cooke, Elaine Bennett, Wendy Simpson, Keith Read, Garth Kendall

Nursing Papers and Journal Articles

Aim: The successful embedding of father inclusive practice (FIP) in parenting and early childhood organisations is relatively new and therefore challenging to assess. The purpose of this study was to describe the process of adapting an existing tool, the Knowledge about fatherhood checklist (KAFC), to suit the parenting service context and apply the modified survey to establish a baseline of attitudes and practice of all staff at an established parenting and early childhood service in Western Australia, Ngala.

Method: Following the application of the KAFC at Ngala in 2016, feedback provided by the staff led to a reflective and iterative …

The Art Of Clinical Supervision Program: Its Impact On Nurses Attitudes Towards Nursing Students, Kylie Russell, Selma Alliex, Heather Gluyas

Nursing Papers and Journal Articles

Background: Increasing health professional student numbers in Australia, in response to looming predicted workforce shortages, resulted in a Federal Government call for action to provide clinical supervision education to health professionals.

Objectives: This research aimed to develop, implement and evaluate the programme, ‘The Art of Clinical Supervision’ (ACS), designed to support nurses facilitate a positive learning environment for student nurses.

Method: The ACS programme was presented (n = 199) across Western Australia as a doctoral study, with participants from both the public and private healthcare sector working in a variety of specialties. A triangulation approach of surveys, reflective entries and …

"Bridging Two Worlds?”: Towards Cultural Safety Within Schools Of Nursing In Australian Universities, Samantha Petric

Theses

Cultural safety has been a developing movement within the nursing profession in Australia over the past decade, led by the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives. This thesis explores this progress towards cultural safety; with a focus upon the Schools of Nursing in Australia. The philosophical and educational shifts from cultural awareness and competence, towards cultural safety are required within these very Schools that prepare nurses for their profession and its practice.

This thesis utilises a descriptive survey method, derived from the Aboriginal and Torres Strait Islander Health Framework, to gather information about the Schools of …

"Taming The Beast": Exploring The Lived Experience Of Relapsing Remitting Multiple Sclerosis Using A Life History Approach, Therese Burke

Theses

Multiple Sclerosis (MS) is a complex neurological disease affecting the central nervous system and is driven by a complex autoimmune cascade. The peak age of onset is between the ages of 20 and 40 years and shows a female preponderance of 3:1. The most common form of the disease affecting 85% of people living with the illness is called relapsing remitting MS (RRMS), and is characterised by unpredictable relapses or exacerbations which usually last a few weeks before returning to baseline function. There is the possibility of disease progression and non-reversible disability after many years. RRMS is also characterised by …

A Qualitative Evaluation Of A Young Parents Program (Ypp) - Parent And Facilitator Perspectives, Cecily Strange, Elaine Bennett, Maggie Tait, Yvonne Hauck

Nursing Papers and Journal Articles

Issue addressed: Young parents (<25 years) have lower engagement with health and community services and are more likely to experience negative outcomes in the perinatal period compared to older parents. The aim of this study was to evaluate the short to medium‐term outcomes of the Young Parents Program (YPP), specifically designed to engage and support young parents, using responsive and codesign strategies in a community setting.

Methods: A qualitative case study used data from interviews with participating parents (n = 20) and a focus group with YPP facilitators (n = 5).

Results: The findings report on the following short to medium‐term YPP outcomes for parents and children. Young parents: are engaged in early parenting services that are welcoming, non-judgemental and holistic; build parenting skills, knowledge, confidence and are tuned into their infants’ needs; are empowered to codesign program activities to meet their parenting and non-parenting needs; have developed friendships and a social support network in their local community; and, are linked …

Perceptions Of Parental Awareness, Knowledge And Anxiety Levels Regarding Infant Cardiopulmonary Resuscitation Training Amongst Parents Residing In Southern Tasmania, Nakita Stephens

Theses

Prenatal and postnatal education help to prepare parents to care appropriately for their newborn child. This education however, rarely includes learning infant cardiopulmonary resuscitation or CPR. CPR for Infants differs from both adult and paediatric resuscitation techniques, and most people who do learn CPR usually only learn adult techniques. Research shows that bystander intervention with CPR improves the chances of both survival and survival without sequelae in out of hospital arrests. Including Infant CPR education as part of the general parent education could assist in scenarios of Sudden Infant Death Syndrome (SIDS) or other emergency situations. Some concern has been …

The Steering Towards Readiness Framework : The Lived Experience Of Clinical Facilitators In Identifying, Assessing And Managing Students At Risk Of Not Being Ready To Practice As Beginning Practitioners Within Western Australian Health Settings, Rosealie Southwell

Theses

Clinical facilitators (CFs) are a fundamental resource for student registered nurses (RNs) as they facilitate the consolidation of theory and practice in preparation for registration with the Nursing and Midwifery Board of Australia (NMBA). Health service providers (HSPs) and higher education providers (HEPs) require CFs to identify, assess and manage (I, A & M) the risks of final placement nursing students and, in doing so, protect risk to patient safety. This research aimed to explore the lived experience of CFs in Western Australia in identifying, assessing and managing risk of a student progressing to be a RN. The study used …

'Through The Eyes Of The Dying' - Identifying Who May Benefit From Bereavement Follow-Up: A Qualitative Study, Jane L. Phillips, Elizabeth A. Lobb, Francis Bellemore, Terrence Hays, David C. Currow

Medical Papers and Journal Articles

Introduction: Bereavement support is an integral element of palliative care. Emerging evidence stipulates that bereavement support should be reserved for those most at risk of poor outcomes. While this evidence makes identifying those at risk of experiencing a complex bereavement a necessary first step, it has been difficult to arrive at a consensus as to whom that should be.

Aim: To explore whether palliative care in-patients with advanced disease are concerned about the bereavement needs of others and, if so, is it their next-of-kin.

Design: A qualitative study using semi-structured interviews, and thematic analysis using a constant comparative method.

Setting/participants: …

Care After Lymphoma (Caly) Trial: A Phase Ii Pilot Pragmatic Randomised Controlled Trial Of A Nurse-Led Model Of Survivorship Care, Karen Taylor, Paola Chivers, Caroline Bulsara, David Joske, Max Bulsara, Leanne Monterosso

Nursing Papers and Journal Articles

Purpose: Post-treatment follow-up for lymphoma potentially fails to address the supportive care needs of survivors. A nurse-led lymphoma survivorship model of care was developed and tested in a phase II pilot pragmatic randomised controlled trial (RCT). The intervention comprised three face-to-face appointments, delivery of tailored resources and an individualised survivorship care plan and treatment summary (SCPTS), shared with the general practitioner (GP).

Method: Three months’ post-treatment completion, eligible lymphoma patients were randomised 1:1 to usual care (control) or usual care plus intervention. Survivorship unmet needs (Short-Form Survivor Unmet Needs Survey), distress (Depression Anxiety Stress Scale 21), adjustment to cancer (Mini-Mental …

Test-Retest Reliability Of The Short Form Survivor Unmet Needs Survey, Karen Taylor, Max Bulsara, Leanne Monterosso

Nursing Papers and Journal Articles

Objective: Reliable and valid needs assessment measures are important assessment tools in cancer survivorship care. A new 30‑item short‑form version of the Survivor Unmet Needs Survey (SF‑SUNS) was developed and validated with cancer survivors, including hematology cancer survivors; however, test–retest reliability has not been established. The objective of this study was to assess the test–retest reliability of the SF‑SUNS with a cohort of lymphoma survivors (n = 40).

Methods: Test–retest reliability of the SF‑SUNS was conducted at two time points: baseline (time 1) and 5 days later (time 2). Test–retest data were collected from lymphoma cancer survivors (n …

Addressing Challenges In Gaining Informed Consent For A Research Study Investigating Falls In People With Intellectual Disability, Portia Ho, Caroline Bulsara, Shane Patman, Jenny Downs, Anne-Marie Hill

Nursing Papers and Journal Articles

Background: People with intellectual disability encounter multiple barriers to accessing quality, evidence based health care which is detrimental to their quality of life (Qol) and mortality. Engaging people with intellectual disability when conducting research is vital to address these QoL issues. People with intellectual disability have the right to engage in research pertinent to them but at present, they are under-represented in research and there are limited methods available to ensure that people with intellectual disability are fully supported to provide informed consent. Therefore the aim of this paper is to describe an informed consent process and reflect on the …

Qualitative Results From A Phase Ii Pilot Randomised Controlled Trial Of A Lymphoma Nurse-Led Model Of Survivorship Care, Karen Taylor, Leanne Monterosso, Caroline Bulsara

Nursing Papers and Journal Articles

Purpose: To explore and describe lymphoma survivors’ thoughts and perceptions of the components of a nurse led lymphoma survivorship clinic intervention.

Methods: An exploratory, qualitative descriptive study using interviews from 10 participants who had transitioned post-treatment into the survivorship phase via a nurse-led lymphoma survivorship clinic intervention.

Results: Thematic analysis revealed three major themes: Reassurance and individualised care; Information and support; and Empowerment. Participants described the reassurance they gained from having contact with a health professional post-treatment who individualised information and support. A survivorship care plan and treatment summary was developed for this study and was believed to be very …

The Factors Influencing Nurse Graduates Use Of Mobile Technology In Clinical Settings In Perth Western Australia: A Mixed Method Study, Benjamin Hay

Theses

The ubiquitous use of mobile technology in today’s society extends to the learning and teaching environment. Most academics in universities encourage its use, aided by libraries offering online resources. Whilst the literature highlights benefits of using mobile technology in learning, particularly for nurses to keep up-to-date, there is limited evidence on such use in clinical settings by graduate nurses in Western Australia (WA). Additionally, there is a lack of information and clarification on the use of such technology in WA hospitals. The purpose of this study was to identify and explore factors influencing the use of mobile technology by newly …

The Identification Of The Role And Competencies Of The Graduate Nurse In Recognising And Responding To The Deteriorating Patient In An Acute Ward Environment: A Mixed Methods Study, Steven Hardman

Theses

The identification of the role and competencies of the graduate nurse in recognising and responding to the deteriorating patient in an acute ward environment: A mixed method study. Patients’ physiological condition can be unstable for prolonged periods before transfer to critical care units. Thus, it is imperative that ward based nurses are able to recognise, respond and initially manage patients with a deteriorating condition. Unfortunately, warning signs of physiological decline are often missed, or ignored by both experienced and newly graduated registered nurses. Complex systems and processes to recognise and respond to clinical deterioration have been developed to try to …

Evaluation Of An E-Learning Training Package By Nurses For Various Designations For Developing Clinical Skills And Knowledge., Nitasha A. Narayan

Theses

An essential component of nurses delivering good healthcare is continuous education. However, nurses’ [participation in continuing education can be hampered by lack of time, limited access to educational resources and cost concerns. Globally, electronic learning has emerged in the last decade as a flexible mechanism to provide education for nurses.

The purpose of this research is to evaluate an e-learning training package used by nurses of various designations for developing clinical skills and knowledge at a private hospital in Perth, Western Australia (‘The Hospital’). This study employs descriptive correlational design – a non-experimental quantitative approach. Data was collected via a …

Psychometric Testing Of The Endotracheal Suction Assessment Tool© (Esat©): An Exploratory Sequential Mixed Methods Study, Kylie Davies

Theses

Background: Endotracheal tube (ETT) suction is a common nursing procedure performed in paediatric intensive care settings. Significant side effects of this procedure can dramatically affect the stability of the critically ill ventilated paediatric patient. The lack of clear standards for determining when the procedure is warranted, especially in paediatrics, can present challenges for the inexperienced paediatric intensive care nurse when assessing a patient’s need for ETT suction. Previous research underpinned the development of an Endotracheal Suction Assessment Tool© (ESAT©) to guide inexperienced nurses through the decision making process to determine suction requirements. The aim of the ESAT© is to improve …

Narratives Of Experience: Senior Registered Nurses Working With New Graduate Nurses In The Intensive Care Unit, Susan Whittam

Theses

The experiences and perceptions of New Graduate Nurses as they transition into professional practice and into intensive care units abounds in the literature. However, there is a dearth of literature exploring the experiences of Senior Registered Nurses who work with New Graduate Nurses in intensive care units.

The aim of this inquiry was to contribute to nursing knowledge by examining Senior Registered Nurses’ stories of experience around the complexity of enabling development of New Graduate Nurses whilst working in clinical or team leading roles in the intensive care unit. Thus, allowing the Senior Registered Nurses’ voice to be heard in …

Aboriginal Women Yarning About Experiences As Undergraduate Nursing Students In Western Australian Universities, Melanie Robinson

Theses

The inequities and poor health outcomes experience by Aboriginal people in Western Australia are well documented. It has been suggested that such issues could be better addressed if more Aboriginal nurses are employed, as there appears to be a link between improved health outcomes and the inclusion of Aboriginal health professionals in practice. In recent years the number Aboriginal nursing students undertaking tertiary studies has increased, but their completion rates could be improved. Aboriginal nursing students continue to struggle to achieve success.

The aim of this study was to investigate factors that enabled (supported) or inhibited (prevented) the progress of …

Development Of A Professional Practice Competency For Undergraduate Nursing Students At A Private Catholic University In Western Australia: A Mixed-Method Study, Christine Adams

Theses

This research investigating professional student nursing practice occurred at a private Catholic university in Western Australia. The objects of this university articulate the provision of education in the context of Catholic faith and values. The objects are further expressed through the university’s 10 graduate attributes, which every student should have achieved by graduation. These attributes aim to foster and grow the qualities of ethical practice, interpersonal skills, professionalism, specialist knowledge and skills to support local and global communities. Suggested university strategies for attaining these attributes include undertaking high-quality work-integrated learning and building strong and mutually beneficial relationships with industry partners …

Effect Of A Nurse-Led Lymphoma Survivorship Model Of Care: A Pragmatic Phase Ii Pilot Randomised Controlled Trial, Karen Taylor

Theses

Background: Cancer survivorship is recognised as an integral component of the cancer continuum. Robust evidence on how best to deliver tailored survivorship care is limited, particularly for individuals affected by rarer cancers such as lymphoma, a potentially curable haematological cancer. These survivors may face long-term and late effects affecting quality of life due to the aggressiveness of the disease and treatment that may not be adequately addressed in current follow-up models of care.

Aim: To develop and pilot test a nurse-led model of survivorship care intervention that utilises an individualised survivorship care plan and treatment summary (SCPTS), motivational interviewing, tailored …