Moira Stephens

Religious Perspectives on Abortion and a Secular Response

This paper concerns the medical, religious, and social discourse around abortion. The primary goal of this paper is to better understand how seven of the world’s major religious traditions (Roman Catholic, Lutheran, Jewish, Islamic, Buddhist, Confucian, and Hindu) address abortion ‘in the clinic’. We do not aim to critique these commentaries but to draw out some of the themes that resonate through the commentaries and place these within complex social contexts. We consider the intersection of ontology and morality; the construction of women’s selfhood; the integration of religious beliefs and practices in a secular world. We suggest that for many women, religious doctrine may be balanced with secular logic as both are important and inextricably linked determinants of decision making about the termination of pregnancy.

The significance of personal learning environments (PLEs) in nursing education: extending current conceptualizations.

BACKGROUND Personal learning environments (PLEs) have been shown to be a critical part of how students negotiate and manage their own learning. Understandings of PLEs appear to be constrained by narrow definitions that focus primarily on technological engagement with a range of web tools and associated applications. This paper addresses a gap in the literature around PLEs for students currently enrolled in undergraduate nursing degrees. PURPOSE To provide in-depth insights into how undergraduate students of nursing manage and experience their learning. METHODS This was an international multi-site qualitative study, utilizing focus groups. A schedule of 10 questions and nominal group techniques were used. FINDINGS Whilst the focus groups took place in very different geographical locations, there were strong similarities in student understandings of effective PLEs. These went well beyond current technological definitions. Findings were organized into three major themes; technologies, learning modalities and influencing factors. DISCUSSION We propose a broader understanding of PLEs that acknowledges individual personal and cultural contexts which we call the personally significant learning environment (PSLE). There is a need for greater investigation of how students understand and systematize their PSLE. CONCLUSIONS This paper and our findings will be of interest to educators, researchers and institutions for developing appropriate frameworks that may maximize learning outcomes, encourage cultural sensitivities and facilitate greater understandings of how to support students to create appropriate PSLEs.

Burnout and the provision of psychosocial care amongst Australian cancer nurses.

PURPOSE To assess the prevalence of burnout amongst Australian cancer nurses as well as investigate the systemic and individual factors associated with burnout, including training and supervision for nurses in psychosocial care. Burnout amongst cancer nurses can have serious consequences for the individual nurse, the hospital and patients. Psychosocial care has been demonstrated in many studies to reduce distress in cancer patients; however, previous studies have suggested that providing psychosocial care can be stressful if nurses feel they lack appropriate training. Psychosocial skill training and supervision may be a way of improving job satisfaction and reducing burnout amongst nurses. METHOD Two hundred and thirty cancer nurses were recruited between November 2010 and April 2011 and completed an online questionnaire. RESULTS Burnout levels within this population were found to be below nursing norms. Adequacy of training and supervision, frequency of supervision and percentage of role spent managing psychosocial care were found to be associated with burnout. Workload, Control, Reward and Community were independent predictors of burnout, and nurses with a greater mismatch in these areas identified as having High levels of burnout. CONCLUSIONS Strategies to reduce burnout include providing cancer nurses with a varied and sustainable workload, awarding financial and social recognition of efforts and encouraging nurses to develop a sense of control over their work. Providing regular training and supervision in psychosocial care that is perceived to be adequate may also assist in reducing burnout.

The health and health preparation of long-term Australian travellers

A growing number of Australians are travelling domestically for extended periods. This creates challenges in both continuity of health care and burdens on health services. This paper reports a cross-sectional survey aimed to explore the health needs and health planning of long-term travellers. In total, 316 respondents who had travelled for more than 3 months consecutively in the last year participated. Most respondents were retired (n=197; 62.3%); however, ages ranged from 26 to 89 years. Nearly half of the respondents or their travel companion had a long-term illness that affected their daily life (n=135; 42.7%). Nearly half of respondents visited a GP (n=133; 42.1%), nearly one-quarter visited an Emergency Department (n=72; 22.8%) and 19.9% (n=63) visited another health provider while travelling. The level of preparation around health while travelling varied between participants. This study highlights that long-term travellers have significant health needs and are likely to require health services during their extended travel. Additionally, it identifies that currently few strategies are used to plan for health care during travel. This raises issues for rural and remote health services in terms of both capacity and continuity of care.

Review of transnational nursing education programme curricula: process, findings, and recommendations

BACKGROUND The University of Wollongong (UOW) delivers two Transnational International Programmes (TNEP) in Hong Kong (HK): a 1-year undergraduate Bachelor of Nursing (Conversion) degree and a 2-year postgraduate Master of Nursing degree. A curriculum review of these programmes has been undertaken to ensure the quality of the programme remains consistently high and competitive in an international environment. AIM The aim of the Curriculum Review Project was to utilise the experience of expert academic staff to review the TNEP curricula delivered by an Australian University in Hong Kong (HK) to ensure it met contemporary needs of students, the university, and the Hong Kong Authority. METHODS The curriculum review projects followed a qualitative research methodology. Thematic analysis was undertaken utilising Braun and Clarkes six-phase method (2006), as this method facilitated an inductive semantic approach where themes are strongly linked to the data and sourced from the explicit meaning of the discourse within the interview (Braun and Clarke, 2006). RESULTS In total, there were 6 participants who were all permanent academic staff members within the School of Nursing at the UOW. The results of this project have been reported within a strengths, weaknesses, opportunity, and threats (SWOT) framework. Participants recognised the value and challenges to both individual students and the broader nursing profession in HK. Overall, there was a perception that being involved as an academic staff member in a TNEP developed both their subject knowledge and teaching skills. CONCLUSIONS This project has demonstrated that the TNEP makes an important contribution to the nursing profession in HK, while also facilitating the growth and development of academic staff at UOW.

Forward thinking: using phenomenography to explore the meaning of safety in acute mental health inpatient units

Paper abstract: Australian College of Mental Health Nurses 40th International Mental Health Nursing Conference Honouring the Past, Shaping the Future, 7-9 October 2014, Melbourne, Vic Australia. Disciplines Medicine and Health Sciences | Social and Behavioral Sciences Publication Details Douglas, A., Patterson, C., Watson, S., Gruber, E. & Gagan, A. (2014). Active engagement of consumers in a healthy lifestyle program: outcomes of a multidisciplinary pilot project in a mental health rehabilitation unit. International Journal of Mental Health Nursing, 23 (Suppl. 1), 9-9. This journal article is available at Research Online: http://ro.uow.edu.au/smhpapers/2282 ACTIVE ENGAGEMENT OF CONSUMERS IN A HEALTHY LIFESTYLE PROGRAM: OUTCOMES OF A MULTIDISCIPLINARY PILOT PROJECT IN A MENTAL HEALTH REHABILITATION UNIT Angela Douglas , Christopher Patterson , Elise Gruber , Sarah Watson 2b and Alex Gagan 2b Faculty of Science, Medicine and Health, University of Wollongong, NSW, Australia; 2 Illawarra Shoalhaven Local Health District, NSW Australia ( The Wollongong Hospital, b Shellharbour Mental Health Rehabilitation Unit) The National Mental Health Commission identifies the physical health of those living with a mental illness as worse than the general community on just about every measure. This paper presents the results of a pilot healthy lifestyle program aimed at engaging consumers with targeted and individualised health activities within a recovery-orientated rehabilitation unit. The ACTive program ran for 18 weeks in 2013, delivered by a team of mental health staff, dietitian, exercise physiologist, academic, and nursing and allied health students. Approval to evaluate the program was received through the Joint UOW/ISLHD Health and Medical HREC. Evaluation targeted quantitative physical health measures for consumers, and qualitative measures for consumers, staff and students. Preliminary results show a grouped average weight loss of 1.1kg, which has clinical significance given the weight-gain challenges associated with serious mental illness. Statistical comparison with a control group is currently underway. Consumers also improved in functional exercise capacity, with 80-metre average increase for the 6-Minute Walk Test, and 2.6 repetition increase in the Sit-to-Stand test for functional leg strength. Feedback provided has identified a number of key challenges to the sustainability and management of this type of program within current mental health service provision environments. Targeted and individualised health programs integrated into mental health services have great potential to reduce the existing disparity in physical health. However, the capacity for collaborative involvement of multidisciplinary health professionals is critical. Furthermore, programs that foster allied health student placement may enhance vocational scope for allied health within mental health services.

Empowering clinical supervisors to flourish though critical companionship

Education for professional nursing practice has undergone a significant shift over the last few decades impacting nursing practice and the relationship between nurses. Enhancing professional practice and acting as a conduit for empowering nurses to be active participants in their learning and development is Practice Development. This action research project with philosophical premises of critical companionship and human flourishing aimed to develop the knowledge and skills of registered nurses in their ability to provide clinical supervision of nursing students in practice. The overall project consisted of two action research cycles in two different health facilities. Participants in both projects identified similar issues and common learning needs including; how to better understand and develop skills in reflective practice; how to provide a positive learning and enabling environment; and how to provide effective solution focused feedback. Workshop facilitators witnessed the flourishing of participants as they were enabled to negotiate their learning requirements; grow and develop in their roles over the workshop series. Participants themselves identified personal growth in skills, knowledge and confidence in being a preceptor as a result of the workshops in the study. Overall, this study has resulted in the development and capacity building of the nursing workforce clinical placement capacity through the development of clinical supervisors.

The experience of waiting for a kidney transplant: A qualitative study

BACKGROUND In Australia over 1100 people are living on dialysis while waiting for a kidney transplant from a deceased donor. Worldwide there are an estimated 170,000 people who wait an average of three years before an organ becomes available. OBJECTIVE To provide an understanding of the lived experience of people waiting on dialysis for a kidney transplant from a deceased donor. APPROACH A qualitative descriptive research design was used. Participants were recruited from a large metropolitan hospital. Two focus groups were conducted with six participants ranging in age from 29-63 years, with dialysis experience of 10-72 months. Data saturation was achieved and thematic analysis was used to interpret the data providing a descriptive account of the experience of waiting for a kidney transplant. FINDINGS Waiting for a kidney transplant takes place in the context of living on dialysis. Four main themes were identified: living on dialysis is physically and mentally demanding; living with uncertainty; altered relationship dynamics; and feelings towards the deceased donor. CONCLUSIONS This study provides a descriptive summary of what it is like to live on dialysis while waiting for a kidney transplant from a deceased donor from the perspective of the person waiting. People are burdened by; uncertainty; the experience of the dialysis therapy; and the thought of the human cost of transplantation. These findings suggest that this cohort may benefit from strategies to relieve uncertainty such as effective communication from the treating team and peer support from the dialysis community.

My time; your time; the time of living with myeloma

Abstract of a poster presentation presented at the Joint Meeting of the COSA 39th Annual Scientific Meeting and IPOS 14th World Congress of Psycho-Oncology, 13-15 November 2012, Brisbane Convention and Exhibition Centre.

Role clarification: an examination of cancer nurses' attitudes towards providing psychosocial support and training needs

The current study aimed to improve the ecological validity of objective cognitive assessment in two ways: (1) by testing prospective memory, a type of cognition that involves remembering to carry out an action when there are distracting ongoing tasks, and (2) by using a virtual reality environment that is more similar to participants’ everyday cognitive challenges than standard neuropsychological tests. The study examined whether prospective memory (PM) performance among breast cancer survivors (BCS) exposed to chemotherapy differed from that seen in a demographically matched control group. Twenty-six female survivors of breast cancer who received chemotherapy that finished 0.5-5 years prior to the time of testing were compared with 25 age- and education-matched women with no history of cancer. Participants completed event-, time- and activity-based PM measures; standardized neuropsychological tests assessing attention and concentration, executive function and verbal memory; and self-report measures of cognitive dysfunction and PM failures. The BCS group showed significantly slower speed of processing on the test of attention and concentration as well as trends towards slower dual task performance. The BCS group reported significantly more cognitive complaints and PM failures than the control group on five of six self-report measures. The groups did not differ on other prospective memory or neuropsychological measures. PM tasks correlated significantly with both standard neuropsychological tasks and with self-reported cognitive function in everyday life. The results provide some evidence for correspondence between more ecologically valid objective measures and self-reported cognitive impairment following chemotherapy treatment. Further research into PM performance in this clinical group appears warranted.