Kath Peters

Disrupted sense of self: young women and sexually transmitted infections

AIM This article is an exploration of young womens experiences of having a sexually transmitted infection. BACKGROUND Sexually transmitted infections are prevalent worldwide and have serious physical and psychological sequelae. Although some aspects of having sexually transmitted infections have been identified in the literature, the stigmatised nature of these infections means that relatively little is known about the experiential aspects of these conditions. DESIGN This research used a qualitative feminist approach. METHODS Data were collected in 2007 via online interviews with ten women. Thematic analysis was guided by a feminist narrative technique. RESULTS Findings revealed the women had not believed themselves to be at risk of sexually transmitted infections because of perceptions they held about the sorts of women who contract these infections. Because these perceptions were incompatible with their self-perceived views, the women initially experienced a disruption in their sense of self. To facilitate the restoration of their previously held sense of self, these women engaged in wishful thinking and denial. CONCLUSION This study illuminates how perceptions of sexually transmitted infections influence the way young women perceive themselves in the context of these infections. Awareness of the detrimental impact contracting sexually transmitted infections can have on young women can help nurses to provide services that facilitate positive and effective coping strategies among this group. RELEVANCE TO CLINICAL PRACTICE Nurses providing care to women with sexually transmitted infections should promote positive coping strategies that could help curb non-disclosure and denial among young women who contract these infections. Education focused on sexually transmitted infections should emphasis that all sexually active individuals are at risk of these infections, which could potentially minimise the shame felt by persons who contract these infections. Further, recognition of the gender issues that limit womens ability to practise safer sex should be incorporated into safer sex education and campaigns.

Whistleblowing: An integrative literature review of data-based studies involving nurses.

Abstract Aim: To summarise and critique the research literature about whistleblowing and nurses. Background: Whistleblowing is identified as a crucial issue in maintenance of healthcare standards and nurses are frequently involved in whistleblowing events. Despite the importance of this issue, to our knowledge an evaluation of this body of the databased literature has not been undertaken. Method: An integrative literature review approach was used to summarise and critique the research literature. A comprehensive search of five databases including Medline, CINAHL, PubMed and Health Science: Nursing/Academic Edition, and Google, were searched using terms including: ‘Whistleblow*,’ ‘nurs*.’ In addition, relevant journals were examined, as well as reference lists of retrieved papers. Papers published during the years 2007–2013 were selected for inclusion. Findings: Fifteen papers were identified, capturing data from nurses in seven countries. The findings in this review demonstrate a growing body of research for the nursing profession at large to engage and respond appropriately to issues involving suboptimal patient care or organisational wrongdoing. Conclusions: Nursing plays a key role in maintaining practice standards and in reporting care that is unacceptable although the repercussions to nurses who raise concerns are insupportable. Overall, whistleblowing and how it influences the individual, their family, work colleagues, nursing practice and policy overall, requires further national and international research attention.

‘I thought I was just going to teach’: Stories of new nurse academics on transitioning from sessional teaching to continuing academic positions

Abstract Currently many nursing faculties and schools employ high numbers of sessional teachers to meet the demands of teaching. Sessional teachers are a source for future continuing academic staff; however, there is little exploration on the experiences of sessional teachers as they transition into the full-time nurse academic role. A qualitative study of 14 registered nurse participants used a story-telling approach to explore the experiences of sessional teachers as they transitioned into full-time and continuing academic roles. Findings revealed that participants had only a very limited understanding of the requirements of the academic role when appointed to it. Thematic analysis revealed two major themes. These were: ‘Uncertainty: Dealing with role expectation’ and ‘Mitigating lack of confidence’. The implications of this paper contributes to and enhances knowledge of the transition experiences of sessional teachers and provides new evidence to suggest that adequate support processes are essential for sessional staff transitioning into permanent, full-time academic positions.

Intergenerational reflections on doctoral supervision in nursing

Abstract Increasing numbers of nurses seek to undertake doctoral education as nursing continues to develop as a discrete area of clinical and theoretical scholarship. Effective supervision is a crucial aspect of doctoral education and has been identified as essential to successful completion of doctoral training. Relatively little, however, is written about the relationship aspects of doctoral supervision in nursing. This paper presents some reflections on doctoral education in nursing from the perspective of four people who have established intergenerational supervisory relationships.

Not addressing the root cause:An analysis of submissions made to the South Australian Government on a Proposal to Protect Midwifery Practice

BACKGROUND Reports of unregulated birth workers attending birth at home, with no registered midwife in attendance (freebirth), have become more frequent in Australia in recent years. A Coronial Inquiry (2012) into the deaths of three babies born at home in South Australia resulted in a call for legislation to restrict the practice of midwifery to registered midwives. A Proposal to Protect Midwifery Practice in South Australia was issued as a consultation paper in January 2013. AIM To report the views of those making a submission to the Proposal to Protect Midwifery Practice in South Australia. METHODS Thirty submissions to the South Australian Government were downloaded, read and thematically analysed. FINDINGS Twenty-five (81%) submissions supported the legislation, 5 (16%) opposed it and 2 (6%) were neither for nor against. Support for the proposed legislation was strong, however the underlying root causes that have led to the rise of UBWs attending homebirth in Australia were not addressed. Recommendations called for all stakeholders to work with women to develop a better framework of care that respected and met their needs and choices whilst safeguarding maternal and neonatal health. CONCLUSIONS The Proposal to Protect Midwifery Practice may promote greater protection of midwifery practice however, Private Indemnity Insurance (PII), collaborative agreements and power struggles associated with the medical domination of childbirth continue to marginalise homebirth and prevent women from accessing the care they want and need. These unresolved issues represent the root causes for UBWs attending homebirth; hence the proposal is only a partial solution.

Narrative literature review: Health, activity and participation issues for women following traumatic brain injury

Abstract Objective: This narrative review will draw attention to the current limitations within the literature related to women following traumatic brain injury in order to stimulate discussion and inform future directions for research. Background: There is a wide-ranging body of research about traumatic brain injury with the higher incidence of brain injury among males reflected in this body of work. As a result, the specific gendered issues facing women with traumatic brain injury are not as well understood. Method: A search of electronic databases was conducted using the terms “traumatic brain injury”, “brain injury”, “women”, “participation”, “concussion” and “outcomes”. Results: The 36 papers revealed the following five themes (1) Relationships and life satisfaction; (2) Perception of self and body image; (3) Meaningful occupation; (4) Sexuality and sexual health; and (5) Physical function. Conclusions: Without research, which focuses specifically on the experience of women and girls with traumatic brain injury there is a risk that clinical care, policy development and advocacy services will not effectively accommodate them. Implications for rehabilitation Exploring the gendered issues women may experience following traumatic brain injury will enhance clinicians understanding of the unique challenges they face. Such information has the potential to guide future directions for research, policy, and practice. Screening women for hormonal imbalances such as hypopituitarism following traumatic brain injury is recommended as this may assist clinicians in addressing the far reaching implications in regard to disability, quality of life and mood. The growing literature regarding the cumulative effect of repeat concussions following domestic violence and women’s increased risk of sport-related concussion may assist clinicians in advocating for appropriate rehabilitation and community support services.

Why do women choose an unregulated birth worker to birth at home in Australia: a qualitative study

BackgroundIn Australia the choice to birth at home is not well supported and only 0.4% of women give birth at home with a registered midwife. Recent changes to regulatory requirements for midwives have become more restrictive and there is no insurance product that covers private midwives for intrapartum care at home. Freebirth (planned birth at home with no registered health professional) with an unregulated birth worker who is not a registered midwife or doctor (e.g. Doula, ex-midwife, lay midwife etc.) appears to have increased in Australia. The aim of this study is to explore the reasons why women choose to give birth at home with an unregulated birth worker (UBW) from the perspective of women and UBWs.MethodsNine participants (five women who had UBWs at their birth and four UBWs who had themselves used UBWs in the past for their births) were interviewed in-depth and the data analysed using thematic analysis.ResultsFour themes were found: ‘A traumatising system’, ‘An inflexible system’; ‘Getting the best of both worlds’ and ‘Treated with love and respect versus the mechanical arm on the car assembly line’. Women interviewed for this study either experienced or were exposed to mainstream care, which they found traumatising. They were not able to access their preferred birth choices, which caused them to perceive the system as inflexible. They interpreted this as having no choice when choice was important to them. The motivation then became to seek alternative options of care that would more appropriately meet their needs, and help avoid repeated trauma through mainstream care.ConclusionWomen who engaged UBWs viewed them as providing the best of both worlds – this was birthing at home with a knowledgeable person who was unconstrained by rules or regulations and who respected and supported the woman’s philosophical view of birth. Women perceived UBWs as not only the best opportunity to achieve a natural birth but also as providing ‘a safety net’ in case access to emergency care was required.

Barriers to breast and cervical cancer screening for women with physical disability: A review

ABSTRACT This review critically examined the barriers to breast and cervical cancer screening services for women with physical disability and discussed ways forward to change practice. When compared to the rest of the community, women with disability were less likely to use preventive health screening services for multiple reasons. Moreover, women with disability live longer than in previous years, and as age is linked to an increased risk of developing cancer, it is imperative that the barriers to screening for these women become a focus of discussion. We designed an integrative literature review to investigate this. Multiple databases were systematically searched for literature published between 2001 and 2013. Search terms used were a combination (AND/OR) of key terms. After excluding duplicates and articles not meeting the eligibility criteria, twenty-five articles were systematically and critically reviewed. Sociodemographic factors were associated with less access to preventive health screening for women with disability. The literature reviewed indicated that this was complicated further by three prominent barriers: health insurance, health care workers, and physical barriers. Sociodemographic, health insurance, health workers, and physical barriers impair access for disabled women to breast and cervical cancer screening, which are vital measures in the timely detection of breast and cervical cancers and preventable morbidity and mortality. Measures are needed to address these limiting factors for women with disability so that they can be active participants in health care, rather than being marginalized because of their disability.

Debriefing as a form of reflection and catharsis for researchers

Background The collection of sensitive data can arouse emotional reactions and researchers may have difficulty distancing themselves from personal stories. Debriefing can address the emotional effect of an experience on researchers. Aim To explore the debrief responses of three research assistants who were involved in the review of retrospective charts and medical notes in a study that examined the risk factors for readmission in young people with anorexia nervosa. Discussion Based on a review of the responses, the principal research team reflected on the value and effectiveness of a debrief tool for research assistants entering sensitive quantitative data. The paper highlights these reflections. Conclusion The use of an electronic debrief tool, while not without its challenges, provides an opportunity for individual reflection and a platform for emotional release for researchers engaged in sustained and intensive collection of sensitive data. This type of tool may serve as a guide for research teams and assist them in monitoring the well-being of those collecting sensitive data. We also advocate that a debriefing tool may contribute to closure for research assistants who become emotionally invested and affected by meticulous quantitative data entry. Implications for practice This paper provides recommendations for future use of an electronic debrief tool for researchers collecting sensitive data.

Violated and vulnerable: Women's experiences of contracting a sexually transmitted infection from a male partner

AIMS AND OBJECTIVES To explore womens stories of contracting a sexually transmitted infection from a male partner and elucidate the gendered constructs and violence experienced that made the women vulnerable to these infections. BACKGROUND Violence against women can result in both physical and psychological consequences and expose women to multiple health risks including sexual health adversity. DESIGN Feminist storytelling approach. METHODS Qualitative interviews were conducted with 10 women. All data underwent thematic analysis. FINDINGS Findings from this study revealed the women were vulnerable to contracting sexually transmitted infection/s from their male sexual partners as a result of unequal gender and abusive relationship dynamics. Subsequently, contracting a sexual infection within this context potentially increased their vulnerability in both current and future relationships, through their loss of self-confidence and perceived ability to have a trusting loving heterosexual relationship as women with sexually transmitted infection/s. CONCLUSION Women in relationships in which they are subordinate to their male partner are at heightened risk of sexual health adversity, including contracting a sexually transmitted infection. Contracting a sexually transmitted infection within the context of an abusive relationship can further increase womens vulnerability to dominant male partners, thus further exposure to sexual risk and adversity. RELEVANCE TO CLINICAL PRACTICE Nurses working in clinical settings are well placed to conduct opportunistic screening of womens sexual health, including assessment of sexually transmitted infections and the nature of the encounter in which they were contracted. Thorough assessment can potentially identify relationship and personal factors that can increase a womans risk to both sexual adversity and forms of abuse. Also, if women do divulge that they have suffered abuse, nurses are positioned to provide support and guidance in implementing strategies to minimise risk as well as referring them to specialised services.