Maureen Boughton

Home alone: Patient and carer uncertainty surrounding discharge with continuing clinical care needs

Abstract As a result of advances in anaesthesia and surgical procedures, increasing numbers of patients in Australia are being discharged ‘early’ into the home environment with residual care requirements. As many of these patients have undergone surgery that in the past would have required a period of hospitalisation and care from qualified staff lasting several days, this situation has the potential to create problems for both patients and their carers. A total of fourteen interviews were conducted with seven patient/carer dyads. Analysis identified three themes related to the uncertainty both patients and carers experienced attributed to a lack of sufficient discharge preparation and information, pointing to gaps in continuity of care and also in discharge planning and home-health care. It is suggested that the identified issues have applicability for the development of patient education in a day surgery/acute context and that the use of evidenced-based and innovative interventions among health professionals might improve both patient and caregiver outcomes.

The experience of chemotherapy‐induced alopecia for Australian women with ovarian cancer

This article describes the experience of chemotherapy-induced alopecia. Data resulted from an ongoing study, which sought to explore the experience of Australian women with a primary diagnosis of ovarian cancer. Phenomenological analysis of written accounts or interviews with 15 Australian women resulted in 13 of these 15 women giving priority to describing their experience of alopecia. The women described alopecia as the most distressing corporeal feature of the ovarian cancer experience. Factors which contributed to womens distress included: loss of sense of self and altered body image; reminder of their illness and potential for an early death; public statement about their private life, practical issues and re-growth. No literature was located, worldwide, which specifically explores the experience of alopecia for women with ovarian cancer. This article presents the first in-depth exploration of the experience of alopecia for Australian women with ovarian cancer. Insight gained from this study will inform understanding of the issues associated with alopecia for women with ovarian cancer and may facilitate the provision of optimal supportive care provided by health care professionals for female cancer patients with chemotherapy-induced alopecia.

Exploring the concept of uncertain fertility, reproduction and motherhood after cancer in young adult women

Exploring the concept of uncertain fertility, reproduction and motherhood after cancer in young adult women The topics of uncertainty in illness and infertility--as separate entities--are well covered and critiqued in the literature. Conversely, no research has been identified that specifically relates to the uncertain fertility, reproduction and motherhood challenges faced by young women after cancer. Therefore, there has been no opportunity to extend understanding, adequately acknowledge or effectively manage the needs of young women who may face unique reproductive uncertainties after cancer. The objective of this article is to provide a descriptive review of the literature and present what is currently known about uncertainty in the context of cancer and in relation to fertility, reproduction and motherhood. This article sets out the need for an increased research focus into this aspect of cancer survivorship to minimise the unique psychosocial challenges these women often face. Raising awareness and acknowledging the significance and impact of uncertain reproductive capacity on younger womens psychosocial health will aid cancer co-ordinators, nurses and other health professionals to formulate and deliver timely and appropriate education, management and support.

Development and psychometric testing of the Nursing Workplace Relational Environment Scale (NWRES)

AIMS AND OBJECTIVES The aim of this study was to develop and test the psychometric properties of the Nursing Workplace Relational Environment Scale (NWRES). BACKGROUND A positive relational environment in the workplace is characterised by a sense of connectedness and belonging, support and cooperation among colleagues, open communication and effectively managed conflict. A poor relational environment in the workplace may contribute to job dissatisfaction and early turnover of staff. DESIGN Quantitative survey. METHOD A three-stage process was used to design and test the NWRES. In Stage 1, an extensive literature review was conducted on professional working relationships and the nursing work environment. Three key concepts; collegiality, workplace conflict and job satisfaction were identified and defined. In Stage 2, a pool of items was developed from the dimensions of each concept and formulated into a 35-item scale which was piloted on a convenience sample of 31 nurses. In Stage 3, the newly refined 28-item scale was administered randomly to a convenience sample of 150 nurses. Psychometric testing was conducted to establish the construct validity and reliability of the scale. RESULTS Exploratory factor analysis resulted in a 22-item scale. The factor analysis indicated a four-factor structure: collegial behaviours, relational atmosphere, outcomes of conflict and job satisfaction which explained 68.12% of the total variance. Cronbachs alpha coefficient for the NWRES was 0.872 and the subscales ranged from 0.781-0.927. CONCLUSION The results of the study confirm the reliability and validity of the NWRES. Replication of this study with a larger sample is indicated to determine relationships among the subscales. RELEVANCE TO CLINICAL PRACTICE The results of this study have implications for health managers in terms of understanding the impact of the relational environment of the workplace on job satisfaction and retention.

Mothering and self-othering: the impact of uncertain reproductive capability in young women after hematological malignancy.

We explored the experiences of uncertain fertility, pregnancy, and motherhood in 12 young women treated for hematological malignancy during their reproductive years. It is demonstrated how, through interpretations of the womens own words, these women lived and coped with a sense of “otherness” in relation to their peers. The concept of otherness is described and discussed in relation to relevant existing literature and it is concluded that, regardless of their cancer history, young womens uncertainty in this context has a broad impact on their psychosocial health and requires sensitive and empathic information, discussion, and support.

The diagnostic journey of ovarian cancer: a review of the literature and suggestions for practice.

Ovarian cancer is the most lethal form of gynaecological cancer. It can be difficult to diagnose, with the majority of diagnoses made at a late stage of disease. An integrative literature review was conducted to explore the ovarian cancer diagnostic journey of women and to examine the potential contribution of using a person-centred approach. Factors associated with ovarian cancer diagnostic delay were described in terms of two phases. The principles of person-centred health care (PCHC) were identified. This paper proposes utilising the principles of PCHC to improve women’s experience of the diagnostic journey. Specific strategies are suggested for each delay phase to enhance the experience for women. Whilst the challenges in diagnosing the disease are likely to remain until a screening test is available, it is hoped that by implementing strategies based upon PCHC, nurses may facilitate the ovarian cancer diagnostic process and improve the diagnostic experience for women.

Liminal Reproductive Experiences After Therapies for Hematological Malignancy

In this article, we discuss the psychosocial health of young women related to fertility, pregnancy, and motherhood after therapies for hematological malignancies. We utilized a hermeneutical phenomenological approach to conduct in-depth interviews with 12 women who had previously received treatment for a hematological malignancy and had experienced uncertainty surrounding their ability to start or extend their biological family. Our presented findings are interpretations of the women’s own words as they articulated how they inhabited a liminal space. We concluded that although fertility and motherhood possibly might not be immediate concerns when they received a diagnosis of hematological malignancy, young women could subsequently experience ongoing issues and concerns related to reproductive uncertainty and motherhood capabilities, which have the potential to affect emotionally and psychosocially on their lives. These issues might possibly require longer-term support, counseling, and informational resources. We also discuss the strengths, limitations, and implications of the study.

Knowledge, Attitudes, and Practices Associated With Menopause: A Multi-ethnic, Qualitative Study in Singapore

We explored knowledge, attitudes, and practices associated with the menopause transition particular to women in the multi-ethnic cultural context of Singapore. Fifty-eight Chinese, Malay, and Indian Singaporean women participated in interviews that were audiorecorded, transcribed verbatim, and analyzed using thematic analysis. Women from all three ethnicities described an attitude of acceptance surrounding menopause and the changes associated with it. While they thought it was important to be informed, they did not seek out information about menopause and did not view health professionals as useful sources of information. Management practices were diverse and rarely involved accessing health professionals.