Emma Phillips

Australian findings on Aboriginal cultural practices associated with clothing, hair, possessions and use of name of deceased persons

There is a significant cultural gap between westernized Australian and Aboriginal cultures, especially in regards to care of the dying. Thus, cultural sensitivity and respect, coupled with knowledge of the traditions and practices in respect of the death and dying, are of utmost importance in communicating with Aboriginal peoples. In order to make a contribution to furthering cultural safety in nursing practice, this article provides important insights on a wide range of Aboriginal cultural practices in relation to the clothing, hair, possessions and name of deceased persons that impact on the nursing care of the dying Aboriginal person.There is a significant cultural gap between westernized Australian and Aboriginal cultures, especially in regards to care of the dying. Thus, cultural sensitivity and respect, coupled with knowledge of the traditions and practices in respect of the death and dying, are of utmost importance in communicating with Aboriginal peoples. In order to make a contribution to furthering cultural safety in nursing practice, this article provides important insights on a wide range of Aboriginal cultural practices in relation to the clothing, hair, possessions and name of deceased persons that impact on the nursing care of the dying Aboriginal person.

‘I wanted desperately to have a natural birth’: Mothers’ insights on Vaginal Birth After Caesarean (VBAC)

Abstract There is scant research available on the psycho-social aspects of births subsequent to Caesarean Section (CS). In particular, there is little psycho-social research available in regard to women who seek to have a Vaginal Birth After Caesarean (VBAC). To address this lack of information in the literature, this article explores, from a phenomenological perspective, the reasons motivating women to try for a VBAC, from the perspectives of four women who have tried for or achieved a VBAC. The findings indicate that these mothers differed to other women interviewed in the study who opted for repeat CS. The VBAC mothers expressed a strong belief in the importance of a natural birth as the best start for their infant, strived to reduce where possible drug interventions during labour and birth and believed in the importance of breastfeeding. The VBAC mothers viewed achieving a natural birth as a significant aspect of their femininity and a major life event for a woman.

'It is very hard': Treatment for childhood Lymphoma from the parents' perspective

This article presents the findings of a five-year longitudinal study exploring the treatment experience for families coping with leukemia and lymphoma to address the dearth of psycho-social research documenting the experience of childhood lymphoma patients. The participants noted that the predominant differences for lymphoma families, as compared with other childhood hematological conditions, center around the issues of, firstly, the intensity of treatment. While the treatment protocol is comparatively shorter, the parents perceive it to be more arduous due to the intense and continuous nature of treatment. Important issues noted in this regard were the negative impact of the toxicity of the chemotherapeutic drugs, the stress associated with the invasiveness of accessing the childs veins for blood samples and to inject medications and the experience of undergoing lumbar punctures. Secondly, the relatively rare occurrence of pediatric lymphoma was reported to result in feelings of isolation from other families with children with a hematological malignancy and the unavailability of information and support services focusing specifically on childhood lymphoma. Thirdly, the relatively high curative success rate of lymphomas can have the effect that the parents feel that their angst is somewhat trivialized by other parents at the hospital. Recommendations include the importance of the availability of the full range of supportive care services, attention to the difficult emotional states the child patients experience, clinical strategies that lessen the trauma of treatment, and the use of positive role models by way of contact with or information of children who have successfully completed treatment.

Speaking Out! Qualitative Insights on the Experience of Mothers Who Wanted a Vaginal Birth after a Birth by Cesarean Section

AbstractBackground: Despite the documented rise in the rates of births by cesarean section (CS) in Australia, there is scant work on the psycho-social aspects of such birth choices. To address the lack of research on this topic, this article presents a subset of findings from a research project that explored, from the mothers’ perspectives, the birthing experience and process of decision making about the mode of delivery for a subsequent birth after a previous CS. Objective: The focus of this article is on the subset of findings that recorded the frustration of women who valued a vaginal delivery but who delivered by CS. Methods: The study utilized descriptive phenomenology, with in-depth, open-ended interviews conducted with the research participants. The setting was a small regional hospital in Queensland, Australia, with about 20% of patients managed on the midwifery model of care. This article is based on the subset of findings that record the frustration of women (eight mothers of a total participant group of 20) who valued a vaginal delivery but who delivered by CS. The women all had a previous CS and had a subsequent birth at the Redland Hospital 6 weeks prior to the interviews, which were held in June 2008. Results: The findings establish that this group of mothers felt frustrated by their body’s inability to give birth naturally, disappointed that they had no option but a CS, and carried emotional pain about the unfairness of the judgment that they should have achieved a vaginal birth after a birth byCS. Conclusions: These women expressed a strong desire to have their story told. It is the hope and expectation that this article will enable their voice to be heard and, in so doing, make a contribution towards deepening our understanding of the multiplicity of perspectives that women bring to their birthing experiences. The findings are a strong argument against any generalization that women who opt for an elective CS are doing so simply for reasons of ease and convenience.

Insights from the Northern Territory on factors that facilitate effective palliative care for Aboriginal peoples

This article aims to assist remote communities to develop their own palliative care services by providing findings on successful strategies identified through a 2-year research project which developed an innovative model for Indigenous palliative care. The discussion is set in the context of an understanding of the notion of cultural safety and discusses the positive experiences of the benefits of palliative care from the perspectives of both consumers and health professionals. The findings show that successful outcomes are derived from generic factors associated with palliative care philosophy and practice and from more specific factors, including the provision of pragmatic support to overcome practical problems, and community visits by health professionals. Factors specific to cultural respect are important, including familiarity and continuity of health care providers, cultural respect for grieving practices, provision of comfort food and bush tucker, development of culturally appropriate built environments, use of traditional healers and respect for spiritual practices.

Ethical Decision-making in an Emergency Department: Findings on Nursing Advocacy

The purpose of this article is to share with the reader the specific findings on the role of nurse as consumer advocate from a study on ethical decision-making in an emergency department (ED). Qualitative interviews were conducted with 11 health professionals (doctors and nurses) working in the ED of a hospital. The interviews were audio-recorded, transcribed verbatim and thematically analysed.In ED, where the decision-making is described as medico-centric, advocacy ipso facto necessitates a challenge to doctor decision-making. The findings indicate that ED nurses experience with advocacy varied depending on the democratic qualities and communication skills of the particular doctor who had care of the consumer. It is noted that seeing the need for advocacy does not necessarily translate into effective action, as management support is essential for productive advocacy. A phenomenon of the desire not to rock the boat was reported. The findings indicate that the support of other nurses is essential for advocacy and affirm the importance of focusing on the ethical nature of the organisation as opposed to an exclusive focus on the individual.

Bioethics and birth: insights on risk decision-making for an elective caesarean after a prior caesarean delivery.

This article presents the findings of qualitative research which explored, from the mothers’ perspective, the process of decision-making about mode of delivery for a subsequent birth after a previous Caesarean Section. In contradiction to the clinical literature, the majority of mothers in this study were strongly of the opinion that a vaginal birth after caesarean (VBAC) posed a higher risk than an elective caesarean (EC). From the mothers’ perspective, risk discussions were primarily valuable for gaining support for their pre-determined choice, rather than obtaining information. The findings posit ethical concerns with regards to informed consent and professional obstetric practice at a time when there is a documented and worrying trend towards an increase in births by caesarean section (CS).

Insights on Aboriginal Grief Practices from the Northern Territory, Australia

The rich data drawn from a study to develop an innovative model for Indigenous palliative care are presented to help address the paucity of authentic Indigenous voices describing their grief practices. Interviews with patients, carers, Aboriginal health care workers, health care workers and interpreters were conducted in four geographical areas of the Northern Territory in Australia. Insights and descriptions of the cultural processes and beliefs that follow the death of an Aboriginal person led to the identification of a number of key themes. These included: the emotional pain of grief; traditionalist ways of dealing with grief; the importance of viewing the body; the sharing of grief among large family and community networks, with crying, wailing, ceremonial singing, telling stories and dealing with blame all playing a part in the bereavement processes. Ways for Westerners to offer assistance in culturally sensitive ways were also identified by the participants, and are reported here to enable health workers to begin to understand and respond appropriately to traditionalist ways of experiencing and reacting to grief.