Lee Stewart

Chronic pain and the family: the experience of the partners of people living with chronic pain

AIMS AND OBJECTIVES The purpose of this study was to explore the impact of chronic pain on the partner and family of a person with chronic pain. BACKGROUND Chronic pain impacts not only on the individual but also their partner and/or other family members. Families of people with chronic pain have reported feeling powerless, alienated, emotionally distressed, and isolated. These impacts have affected their relationship with the person with chronic pain. DESIGN An interpretive qualitative design using in-depth interviews and thematic analysis was undertaken. METHODS Purposive sampling and in-depth interviewing were undertaken to develop a rich description of the experience. RESULTS Findings indicate the impact of chronic pain on the family is extensive, resulting in physical, social, and emotional changes. Four themes were revealed: (1) Family loss, (2) Life changes, (3) Emotional impact of pain, and (4) Future plans. CONCLUSION This study reinforces and expands current knowledge regarding the impact of chronic pain on partners and families. Understanding this phenomenon opens opportunities for nurses and other health workers to develop and implement strategies to better support partners/families in the future. RELEVANCE TO CLINICAL PRACTICE Nurses can help reduce the negative impact of pain by including families in assessment, education, referral and treatment processes, and by offering support and education to partners/families.

Through a Critical Lens: Indigenist Research and the Dadirri Method

Indigenous scholars have addressed the problematic nature of research by adopting methodologies that fit well with their communities and that relate effectively and culturally with how knowledge is shared to give indigenous people a voice. In this article we discuss Dadirri, an indigenous research method and way of life, as a vital research framework, connecting it to other relevant political and critical methodologies such as Freire’s transformative education process and Habermas’ theory of communicative action. In doing so, we illustrate how this methodology provides a significant framework for indigenous researchers undertaking liberatory studies that promote change.

Resilience in families with a member with chronic pain: a mixed methods study.

AIMS AND OBJECTIVE To measure and explore between 2007-2010 measure and explore the nature of family resilience in the context of families with a member with chronic pain. BACKGROUND Chronic pain impacts on the entire family. The literature suggests that it is possible to strengthen resilience in individuals with chronic conditions, but little is known about the impact of chronic pain on family resilience. DESIGN A explanatory sequential mixed method study was undertaken. METHODS In the initial quantitative phase, assessment measures were administered using the Connor-Davidson Resilience Scale, Family Impact of Pain Scale, Medical Outcomes Study Short Form 36 and Medical Outcomes Study Social Support Survey. Data were collected and analysed from 31 family cases (n = 67 participants). In the second, qualitative phase, follow-up semi-structured interviews were undertaken with 10 families to help explain the quantitative results. RESULTS The impact of pain on the family was high overall, but the perceived impact was greater for the person with pain. Resilience scores were above average for both the person with pain and other family members. However, the person with pain scored lower on the resilience scale than other members of the family. The families scored high for social support overall, while the person with pain perceived they had greater support than their family members. CONCLUSIONS Identifying the strengths or resilient properties inherent in families and using those strengths in the planning and implementation of care, especially of chronic conditions such as chronic pain, is pivotal to quality health outcomes. RELEVANCE TO CLINICAL PRACTICE It is important that nurses and healthcare professionals include family members when planning and delivering care for persons with chronic pain. Identification of strengths within families can help tailor nursing interventions to meet family needs.

Indigenous Australians' participation in pre-registration tertiary nursing courses: A mixed methods study

Abstract Indigenous nurses have the potential to improve access to health services for Indigenous people by ensuring that services are culturally safe and respectful of Indigenous peoples’ needs. Therefore, developing a well-educated Indigenous nursing workforce is one way to improve the poor health outcomes of Indigenous Australians. A mixed methods study was undertaken to determine the current rates of enrollment, progression and completion of Indigenous nursing students in Australia and to explore student and staff perceptions of barriers to completion and strategies for success. The results indicate that the national average completion rates are 36.3% for Indigenous nursing students and 64.6% for non-Indigenous nursing students – an average difference of 28.3%. Indigenous nursing students and academics identified barriers to completion, which were similar to those identified in previous research. Success strategies, however, revealed the importance of individual student characteristics; academics’ knowledge, awareness, and understanding; relationships, connections, and partnerships; institutional structures, systems, and processes; and, family and community knowledge, awareness, and understanding. This paper offers an overview of the integration and interpretation process that makes up the final phase of a mixed methods study.

Burden experienced by community health volunteers in Taiwan: a survey

BackgroundVolunteers in Taiwan complement the delivery of health services by paid health professionals. However, in doing so, community health volunteers experience burdens associated with their activities. The reasons for these burdens and degree to which they are experienced are explored in this paper. Our study adds to international research regarding the burden experienced by volunteers. This project is the first to assess how community health volunteers in Taiwan experience burden.MethodsThe 20 item Burden on Community Health Volunteer (BCHV) instrument, specifically designed for this project, was administered to 435 volunteers attached to Community Health Promotion Development Centres in northern Taiwan.ResultsThe overall burden experienced by volunteers is relatively low. However, a multivariate adjusted regression analysis revealed significant differences in volunteer burden depending on the number of people each volunteer served on average per week, as well as the volunteer’s marital status and their perceptions about personal health. Volunteers who served many people and who perceived their own health as poor experienced a higher level of burden. Those who were a widow or a widower felt less burdened than others.ConclusionsThe results of the study identify areas where burden is high and where strategies can be developed to reduce the level of burden experienced by community health volunteers in Taiwan. Community health volunteers in Taiwan complement the role of nurses and other health care providers so their retention is important to ongoing service delivery.

The epidemiology of Staphylococcus aureus bacteraemia in Tasmania

Abstract Background The seriousness of Staphylococcus aureus bacteraemia (SAB), coupled with the potential to reduce its occurrence, suggests that each case of SAB demands rigorous investigation and epidemiological understanding. To accurately determine the incidence and better understand the epidemiology of SAB at a population level, detailed data about SAB need to be collected from all settings, not just publicly funded hospitals. The aim of this study was to understand the epidemiology of SAB in Tasmania and to quantify the extent to which SAB incidence is under reported if only public hospital data are reported. Methods A population-based observational study for all people who had laboratory-identified SAB during 2009 and 2010 in Tasmania was conducted. The incidence of SAB was calculated using population data. Results Incidence of SAB was calculated as 21.3 per 100 000 population per year (95% CI 18.51–24.31). The majority of SAB cases were community associated (58.4%) and were caused by methicillin-sensitive Staphylococcus aureus (90.7%). Fifty-five percent of healthcare-associated SAB cases were associated with an intravascular device. Eleven percent of all SAB cases were identified in a private hospital. Conclusion This study represents the first known Australian study to capture and analyse data from all cases of SAB in a well-defined population, enabling calculation of incidence. The incidence of SAB in Tasmania is lower than in other Australian studies. Community-associated SAB is more common than healthcare-associated SAB yet little attention is paid to this community burden nationally. Current national surveillance programs for SAB focus only on public hospitals and, in doing so, a significant number of cases of SAB are missed.

A literature review supporting the proposed national Australian definition for Staphylococcus aureus bacteraemia

Staphylococcus aureus bacteraemia (SAB) is a major cause of morbidity and mortality. During 2009, a national surveillance definition for SAB was developed through the Australian Commission on Safety and Quality in Healthcare (ACSQHC). The aim of this paper is to review the literature surrounding SAB surveillance and in doing so, evaluate the recently developed Australian national definition for SAB. The issues examined in this paper that relate to SAB surveillance include detection, the management of duplicates, classification and acquisition of SAB. Upon reviewing the literature, it was clear that the national Australian SAB surveillance definitions developed by the ACSQHC Healthcare Associated Infection Surveillance Committee are consistent with the majority of literature. Where inconsistencies exist, for example the lack of acquisition information in SAB surveillance programs in the United Kingdom, it is clear that the Australian surveillance definitions are more robust and provide more useful information. The national surveillance definitions for SAB developed by the ACSQHC surveillance committee sets an improved standard for other countries.

Carspecken's Critical Approach as a Way to Explore Nursing Leadership Issues

Nursing leaders are attempting to provide effective support for staff as well as optimal client care in the most challenging of times for the health care industry globally. Regardless of where leaders practice, their health care setting will have its own socially constructed way of getting the work done. In this article the authors suggest Carspeckens critical methodology, particularly his use of the pragmatic horizon, as a useful method to assist leaders in recognizing their own behaviors as a first step to providing leadership that is more emancipatory. The aim of this reflection and resulting action is increasing leadership effectiveness to improve health care outcomes.

Burden experienced by community health volunteers in Taiwan: A qualitative study

In Taiwan, volunteers of each Community Health Promotion Development Centres help to diffuse healthy lifestyle education and complement the paid workforce, especially community nurses. An interpretive, descriptive qualitative design, using focus groups, was conducted to explore the burden experienced by community health volunteers in Taiwan. The data were analyzed inductively, and emergent themes were explored. The majority of participants were female between 50 and 59 years old with an average of 4.5 years experience as a volunteer. Thematic analysis resulted in four themes: preparation and scope of practice, lack of support for the role, work overload and expectations of the role. Volunteers in Taiwan do not always have the necessary skills to care for their clientele because of an inadequate programme of orientation, lack of continuing education and support for the role, role overload and expectations placed upon them by the clients and others.