Showing papers by "Desley Hegney published in 2011"

The effect of shift rotation on employee cortisol profile, sleep quality, fatigue, and attention level: a systematic review.

Abstract: Background: Disrupted circadian rhythm, especially working night duty together with irregular sleep patterns, sleep deprivation, and fatigue, creates an occupational health risk associated with diminished vigilance and work performance. Purpose: This study reviewed the effect of shift rotations on employee cortisol profile, sleep quality, fatigue, and attention level. Methods: Researchers conducted a systematic review of relevant articles published between 1996 and 2008 that were listed on the following databases: SCOPUS, OVID, Blackwell Science, EBSCO Host, PsycINFO, Cochrane Controlled Trials Register, and CEPS. A total of 28 articles were included in the review. Results: Previous research into the effects of shift work on cortisol profiles, sleep quality, fatigue, and attention used data assessed at evidence Levels Ⅱ to Ⅳ. Our systematic review confirmed a conflict between sleep-wake cycle and light-dark cycle in night work. Consequences of circadian rhythm disturbance include disruption of sleep, decreased vigilance, general feeling of malaise, and decreased mental efficiency. Shift workers who sleep during the day (day sleepers) experience cortisol secretion increases, which diminish the healing power of sleep and enjoy 1 to 4 hours less sleep on average than night sleepers. Sleep debt accumulation results in chronic fatigue. Prolonged fatigue and inadequate recovery result in decreased work performance and more incidents. Rotation from day shift to night shift and its effect on shift workers was a special focus of the articles retained for review. Conclusions: Disturbed circadian rhythm in humans has been associated with a variety of mental and physical disorders and may negatively impact on work safety, performance, and productivity.

Factors affecting effective communication between registered nurses and adult cancer patients in an inpatient setting: a systematic review.

Abstract: Aim: To establish the best available evidence regarding the factors affecting effective communication between registered nurses and inpatient cancer adults. Method: Electronic databases (CINAHL, Ovid, PubMed, ScienceDirect, Scopus and Wiley InterScience) were searched using a three-step search strategy to identify the relevant quantitative and qualitative studies published in English. The grey literature was not included in the review. The identified studies were evaluated using the guidelines from the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information. A total of three studies were included in the quantitative component of the review, and the data were presented in a narrative summary. Five studies were included in the qualitative component of the review, and the findings were categorised in a meta-synthesis which generated four synthesised findings. Results: The factors that were found to influence effective communication were identified in the characteristics of nurses, patients and the environment. The promoting factors in nurses included genuineness, competency and effective communication skills. The role of post-basic training in improving nurse-patient communication remained inconclusive. Conversely, nurses who were task-orientated, who feared death and who had low self-awareness of their own verbal behaviours inhibited communication. Nurses were also observed to communicate less effectively when delivering psychosocial aspects of care and in emotionally charged situations. On the other hand, patients who participated actively in their own care and exhibited information-seeking behaviour promoted communication with the nurses. However, patients' unwillingness to discuss their disease/feelings, their preference to seek emotional support from their family/friends and their use of implicit cues were some of the factors that were found to inhibit communication. A supportive ward environment increased facilitative behaviour in nurses, whereas conflict among the staff led to increased use of blocking behaviours. Cultural norms within the Chinese society were also found to inhibit nurse-patient communication. Conclusion: Within the constraints of the study and the few quality papers available, it appeared that personal characteristics of patients and nurses are the key factors that influence effective nurse-patient communication within the oncology setting. Very little evidence exists to explain the role of environment in effective nurse-patient communication, particularly within an Asian setting. Implications for practice: Training can be implemented to inform nurses about the communication challenges, to equip them with effective communication skills and improve their receptivity to patient cues. Information-sharing can be used as a non-threatening approach to initiate rapport-building and open communication. Nurses should consider patients' psychological readiness to communicate and respect their preference as to whom they wish to share their thoughts/emotions with. Hospitals/institutions also need to ensure a supportive ward culture and appropriate workload that will enable nurses to provide holistic care to patients. Implications for research: Further research on the effect of the Asian culture on effective communication within the oncology setting is required to expand the knowledge in this area. Studies to ascertain the effect of the patient's age and place within the oncology treatment cycle are also warranted. The lack of evidence on the effectiveness of post-basic communication education also requires further investigation. © 2011 The Authors. International Journal of Evidence-Based Healthcare.

Comprehensive systematic review of healthcare workers’ perceptions of risk and use of coping strategies towards emerging respiratory infectious diseases

Abstract: AimTo determine healthcare workers' perceptions of risk from exposure to emerging acute respiratory infectious diseases and the perceived effectiveness of strategies used to facilitate healthy coping in acute hospital and community healthcare settings.MethodsElectronic databases (Cumulative

Memory and communication support in dementia: Research-based strategies for caregivers

Abstract: Background: Difficulties with memory and communication are prominent and distressing features of dementia which impact on the person with dementia and contribute to caregiver stress and burden. There is a need to provide caregivers with strategies to support and maximize memory and communication abilities in people with dementia. In this project, a team of clinicians, researchers and educators in neuropsychology, psychogeriatrics, nursing and speech pathology translated research-based knowledge from these fields into a program of practical strategies for everyday use by family and professional caregivers. Methods: From the available research evidence, the project team identified compensatory or facilitative strategies to assist with common areas of difficulty, and structured these under the mnemonics RECAPS (for memory) and MESSAGE (for communication). This information was adapted for presentation in a DVD-based education program in accordance with known characteristics of effective caregiver education. Results: The resultant DVD comprises (1) information on the nature and importance of memory and communication in everyday life; (2) explanations of common patterns of difficulty and preserved ability in memory and communication across the stages of dementia; (3) acted vignettes demonstrating the strategies, based on authentic samples of speech in dementia; and (4) scenarios to prompt the viewer to consider the benefits of using the strategies. Conclusion: Using a knowledge-translation framework, information and strategies can be provided to family and professional caregivers to help them optimize residual memory and communication in people with dementia. Future development of the materials, incorporating consumer feedback, will focus on methods for enabling wider dissemination. © 2010 International Psychogeriatric Association.

How is medication prescribing ceased? A systematic review.

Abstract: Background: Medication prescribing is a complex process where the focus tends to be on starting new medication, changing a drug regimen, and continuing a drug regimen. On occasion, a prudent approach to prescribing may necessitate ending an ongoing course of medication, either because it should not have been started in the first place; because its continued use would cause harm; or because the medication is no longer effective.

The Experience of Hypoglycaemia and Strategies Used for Its Management by Community-Dwelling Adults with Diabetes Mellitus: A Systematic Review

Abstract: Objectives The review objective is to synthesise the evidence on the experience of hypoglycaemia and the strategies used for its control by community-dwelling adults with type 1 and type 2 diabetes mellitus. Questions • What is the evidence on how the person with diabetes mellitus experiences hypoglycaemia? • What is the evidence on experiences of people with diabetes mellitus living in the community and the strategies they use to manage hypoglycaemia? Criteria for considering studies for this review Types of participants The review will consider publications that include community dwelling adults (18 years of age and over) who have experienced hypoglycaemia from type 1 or type 2 diabetes mellitus and/or who have experienced self-management strategies for hypoglycaemia. There are no restrictions for gender, ethnicity, geographical location or socio-economic conditions. Types of phenomena The review will consider studies that investigate the experiences of hypoglycaemia and of the strategies used by community dwelling adults with type 1 and type 2 diabetes mellitus to self manage hypoglycaemia.

What nurses need to know about Buddhist perspectives of end-of-life care and dying

Abstract: Palliative care professionals, particularly nurses, understand that it is crucial to deliver culturally and religiously appropriate care to the dying while attending to their physical needs. This article provides a brief overview of the different types of Buddhism and the major beliefs of Buddhists, particularly around suffering and death. It explores the impact of some of the current practices of end-of-life care from the Buddhist perspective, with an emphasis on Buddhist goals, beliefs, and practices at the time of death. It outlines the importance of advanced care planning, particularly with respect to the use of analgesia, palliative sedation, and any special dietary requirements. It notes that regardless of advanced care planning, nurses should continue to assess the needs of the patient, and in discussion with family, titrate medication and provide an environment that helps the Buddhist reach his/her spiritual goals. It outlines the importance of the environment in achieving this goal, particularly as the Buddhist practitioner will wish to use non-medication practices, such as meditation and chanting, to finish the last meditation before death. The paper provides guidance on how nurses can ensure a good death for the dying Buddhist, and their family or loved ones, especially in the area of choice in terminal pain management and palliative sedation therapy.

The top eight issues Queensland Australia's aged-care nurses and assistants-in-nursing worried about outside their workplace: a qualitative snapshot.

Abstract: The attainment of a work–life balance is an important issue for recruitment, retention and workforce planning. This paper aims to report on the free text data provided by the aged-care sector nurses around perceptions of important work–life issues. Data were written responses of aged-care nurses to the open-ended request at the end of a survey, which asked them to list up to five political/social/environmental issues concerning them outside of their work. For aged-care nurses, when asked to list political/social/environmental issues they were concerned about outside of work in late 2007, there emerged considered issues around work and life. Among the top eight themes there is an intriguing balance between the themes work, industrial relations, aged care/elder care and health-care services compared with the themes environment, water, societal values and housing. Qualitative insights into the political/social/environmental issues aged-care nurses are concerned about outside of your work suggest their desire for a labour/life or work/life harmony. Aged-care nurses place an equal importance on the nature of labour and the basics of life. The findings provide information for aged-care sector managers and workforce planners on areas in need of consideration to recruit and retain a workforce within aged care.

Quality of life in women during and after treatment for breast cancer: a systematic review of qualitative evidence

Abstract: Background Breast cancer is the most common cancer in women. With increasing numbers of women surviving breast cancer, there is a need to move beyond the traditional ways of evaluating clinical outcomes and include patient-based outcomes such as the quality of life. Objectives To integrate and summarise the best evidence related to the quality of life of women diagnosed with breast cancer during and up to ten years after treatment for breast cancer. Inclusion criteria Types of participants Adult women (over the age of 18 years) diagnosed with breast cancer who are or have received treatment for breast cancer in the last ten years (i.e. surgery, chemotherapy, radiation therapy and/or hormonal therapy). Phenomena of interest The quality of life of women diagnosed with breast cancer during and up to ten years after treatment. Context Women with breast cancer from both developed and developing countries. Types of studies Studies that focused on qualitative data including, but not limited to, designs such as phenomenology, grounded theory and ethnography, action research and feminist research. Search strategy The search sought to find both published and unpublished studies between 1990 and 2010, limited to the English language. Eleven electronic databases were searched including CINAHL, PubMed, Scopus and PsycArticles. Methodological quality Methodological quality was assessed independently by two reviewers using a standardised critical appraisal instrument from the Joanna Briggs Institute. Data extraction Qualitative data were extracted from the included studies using a standardised data extraction tool from the Joanna Briggs Institute. Results A total of 42 findings from seven qualitative studies were extracted and rated as unequivocal or credible. Eleven categories were produced. Three synthesised findings were generated based on the meta-aggregation of the categories: (1) “effective care for patients will be achieved if clinicians are aware of the impact of breast cancer and its treatment on the physical and psychosocial domains of women‟s quality of life”; (2) “for effective patient-centred care, clinicians must be cognisant of the ways breast cancer and its treatment modalities affect social relationships”; (3) “clinicians should be aware that women use religion and spirituality to cope with breast cancer treatment and improve their quality of life”. Conclusions This review concludes that the breast cancer diagnosis and its treatment can have a significant effect on several domains of women‟s quality of life. Healthcare providers caring for patients need to be well informed about each individual woman‟s physical and psychosocial concerns and be cognisant that any attempt to offer support must be targeted to meet the specific challenges faced by each individual woman.

Ego-resilience and psychological wellness in rural communities

Abstract: Resilience in the context of rural communities is defined as the capacity to move through and beyond adversity. The literature recognises that rural people suffer particular stressors: high exposure to global economic pressures and government policy changes; droughts, floods and other extreme weather conditions; and the challenges of keeping a farm financially viable and family intact. Owing to the necessities of survival in 'the bush', rural people tend to be stoic and self-reliant and therefore reluctant to seek help except in dire emergencies. Rural men have been shown to draw on inner strengths to regain control after difficult experiences, along with using formal and social supports, and strategies such as taking breaks. Individual and community resilience are mutually supportive and researchers argue that balanced social and economic development is needed to enhance resilience and wellbeing in rural areas, in addition to improved access to mental health and other health services.

Patients' experiences towards the donation of their residual biological samples and the impact of these experiences on the type of consent given for secondary use: A systematic review.

Abstract: REVIEW OBJECTIVE: The review will examine the experiences of patients towards their residual biological samples and the impact upon the type of consent given for their future use. REVIEW QUESTION: What is the meaningfulness of the experiences of patients towards the donation of their residual biological samples and the impact of these experiences on the type of consent given for their future use? INLCUSION CRITERIA: TYPE OF PARTICIPANTS: This systematic review will consider publications that include all male and female adults patients (over 18 years of age) who are involved in the donation of their residual biological samples for research. TYPE OF INTERVENTION (PHENOMENA OF INTEREST): This review will consider publications that investigate the patients’ experiences to the donation of their residual tissues. The review will also consider publications that include the patient’s experiences to the different types of consent for the left‐over residual tissue and the use of their leftover tissues, as well as how the different types of consent may influence their decision to donate.

A qualitative systematic review on the experiences of self-management in community-dwelling older women living with chronic illnesses

Abstract: Objectives The aim of this review is to critically appraise, synthesize and present the best available evidence related to the experiences of self-management among community-dwelling older women with chronic illnesses, specifically non-communicable illnesses which include cardiovascular disease (CVD), chronic respiratory diseases, diabetes mellitus (DM) and arthritis. Specific questions on their experiences include the following: -What does living with chronic illnesses mean to community-dwelling older women? -What self-management strategies do community dwelling older women with chronic illnesses use? -What issues do community-dwelling older women with chronic illnesses face in self-management? -What feelings do community-dwelling older women with chronic illnesses have about self-management? INCLUSION CRITERIA Types of participants The review will consider publications that include all older women who have the following characteristics: -Age sixty-five years and above (with no limitations to any specific age groups within this population) -Live in their own community dwelling -Community setting is rural, suburban or urban -May live alone or with others (i.e. families) -Have comorbidity/comorbidities, defined as having at least two non-cancer chronic illnesses, which include the following four common chronic diseases: cardiovascular disease (CVD), chronic respiratory diseases, diabetes mellitus (DM) and arthritis. The rationale for excluding cancer as a chronic illness is to draw focus on the experience of living with non-cancer chronic illnesses, which likely present challenges different from cancer. -Have chronic illnesses for a minimum duration of one year Phenomenon of interest The review will consider studies that investigate the experiences of self-management among community-dwelling older women with chronic illnesses.

The meaningfulness of quality of life in women diagnosed with breast cancer: a systematic review

Abstract: Review Objectives: The objective of this systematic review is to critically appraise, sythesise and present the best available evidence related to meaningfulness of QoL of women diagnosed with breast cancer, during and up to ten years after treatment for breast cancer. The specific areas of interest relate to : 1. what is the meaning of QoL from the perspective of women diagnosed with breast cancer; and 2. what are the domains of QoL most strongly affected by women diagnosed with breast cancer? 3. what are the domains of QoL most strongly affected by women during and after receiving treatment for breast cancer? Inclusion Criteria: Types of participants: The review will consider studies that include women 1) with breast cancer of early stages i.e. stage 0 to IIIA according to tumour node metastases (TNM) staging 2) receiving or completed breast cancer treatment i.e. surgery, chemotherapy, radiation therapy and/or hormonal therapy 3) within 10 years of surviving breast cancer treatment 4) over the age of 18 years 5) who are inpatients or outpatients 6) living with or without partners 7) regardless of race, culture, ethnicity or other social and economic backgrounds 8) without other medical co-morbidities. Phenomena of interest The review will consider primary studies that explore the meaning of changes in the QoL of women diagnosed with breast cancer, during and after treatment for breast cancer.