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Showing papers by "Karen Francis published in 2009"


Journal ArticleDOI
TL;DR: The aim of the article is to demystify the dense language used and present the fundamental beliefs of each philosopher in a format that is accessible to novice phenomenologists.
Abstract: Introduced as an alternative to empirical science, phenomenology offers nursing an insightful means for understanding nursing phenomena specifically in relation to lived experiences. However, not all phenomenologies were created equal, a point which has left many a nursing researcher not only confused. Furthermore, this confusion might result in the choosing of a philosophical framework that is neither cognizant with the research question nor the epistemological lens through which the researcher operates. Drawing on common nursing examples to illustrate concepts, the authors closely examine and debate the disparities between Husserl's transcendental phenomenology and Heidegger's hermeneutic approach to phenomenology. The aim of the article is to demystify the dense language used and present the fundamental beliefs of each philosopher in a format that is accessible to novice phenomenologists.

219 citations


Journal ArticleDOI
TL;DR: In this article, a systematic review was conducted to answer the question: What is the impact of the primary and community care nurse on patient health outcomes compared with usual doctor-led care in primary care settings?
Abstract: This paper reports on a systematic review that sought to answer the research question: What is the impact of the primary and community care nurse on patient health outcomes compared with usual doctor-led care in primary care settings? A range of pertinent text-words with medical subject headings were combined and electronic databases were searched. Because of the volume of published articles, the search was restricted to studies with high-level evidence. Overall, 31 relevant studies were identified and included in the review. We found modest international evidence that nurses in primary care settings can provide effective care and achieve positive health outcomes for patients similar to that provided by doctors. Nurses are effective in care management and achieve good patient compliance. Nurses are also effective in a more diverse range of roles including chronic disease management, illness prevention and health promotion. Nevertheless, there is insufficient evidence about primary care nurses' roles and impact on patient health outcomes.

132 citations


Journal ArticleDOI
TL;DR: The results indicated that those with M/ARLC and their families experience diagnosis and treatment as being filled with unpredictability and fear, and their experience is complicated by unpredictability, lack of information and the rural location.
Abstract: INTRODUCTION It is anticipated that in Australia the number of cases of mesothelioma will continue to rise significantly over the next 15 years with power station workers having a risk second only to asbestos mill workers. Mesothelioma responds poorly to treatment and is almost always fatal, yet there have been few studies related to the palliative care needs of this diagnostic group and none focussing on the Latrobe Valley, Victoria, Australia. The aims of this pilot study were to identify common issues and to explore the needs and experiences of people with mesothelioma and asbestos-related lung cancer (M/ARLC), their carers, and service providers in the Latrobe Valley community, in particular in relation to palliative care. METHODS The study employed a case study design using in-depth interviews, media reports, local authority and employer reports and historical data, which were content analysed. The constant comparative method was used to identify common themes and issues. RESULTS The Latrobe Valley is the fourth largest regional area in Victoria. The electricity industry and brown coal mining at the town of Yallourn were the primary industries. Former power workers are contracting mesothelioma at a rate seven times the national average. A total of 13 participants from the Latrobe Valley were interviewed, comprising five key stakeholders who were local legal and healthcare providers; two people who had been diagnosed with mesothelioma; and six family carers. Most people with M/ARLC in the Latrobe Valley are older males who were employed by the electricity and related industries, while their carers are mostly female wives and daughters. There were three major themes identified in the data: illness experience; carer and family roles; and services and service gaps. The results indicated that those with M/ARLC and their families experience diagnosis and treatment as being filled with unpredictability and fear. The older males with M/ARLC were characterised as stoic and reluctant to seek help, contributing to a delayed diagnosis. However, their rural health services compounded these delays because of the unpredictability of health professional availability. Although there are some cancer treatment and legal services locally, people with M/ARLC are often required to travel to metropolitan services for care and advice. The effort and time required to seek compensation at a time of declining health was particularly burdensome. Participants expressed the tension between feelings of loyalty to their employers and anger at the perceived betrayal of the same employers, who were reported to have ignored asbestos warnings. Access to palliative care was delayed by a discomfort associated with acknowledgement of dying and resulted in poor symptom control and a lack of support to significantly burdened carers. People with M/ARLC have a strong desire to die at home but issues of rurality, isolation and late referral to palliative care services often complicate their care. CONCLUSIONS This pilot study explored the needs of people with M/ARLC in the Latrobe Valley and the results indicated that their experience is complicated by unpredictability, lack of information and the rural location. The study recommended that innovative models of care be investigated to improve communication and continuity of care in the Latrobe Valley community, in addition to the barriers and enablers to local health and legal service provision. Further, the study indicates that a comprehensive education strategy for local health providers and community members, and strategies to prevent and manage volunteer and health professional burnout are needed.

96 citations



Journal ArticleDOI
TL;DR: In this article, the authors explored the use of storyline in grounded theory research and potentially other research methodologies that seek to explain phenomena in the context of nursing, and proposed a storyline as a research strategy.
Abstract: This paper explores the use of storyline in grounded theory research and potentially other research methodologies that seek to explain phenomena. Storyline as a research strategy has had limited discussion in the literature. Although stories have been used as both a source of data and a means of reporting research findings, the use of storyline is underutilised and undeveloped as a method of constructing and conveying grounded theory. Construction of a theory that is grounded in the data and not influenced by external concepts is possible through the use of storyline. In presenting grounded theory in the form of a storyline, the nurse researcher is able to explain and describe the theoretical contribution in the context of nursing knowledge. Theoretical precedence, variation, limited gaps, the use of evidence and appropriate style are characteristics of an effective storyline. As both a means and an end in itself, storyline enhances the development, presentation and comprehension of the outcomes of grounded theory research in nursing.

55 citations


Journal ArticleDOI
TL;DR: There is a need for national training standards and a process of accreditation for practice nursing in Australia to support the development of a responsive and sustainable nursing workforce in primary care and to provide quality education and career pathways.
Abstract: Nurses in Australia are often not educated in their pre registration years to meet the needs of primary care. Careers in primary care may not be as attractive to nursing graduates as high-tech settings such as intensive or acute care. Yet, it is in primary care that increasingly complex health problems are managed. The Australian government has invested in incentives for general practices to employ practice nurses. However, no policy framework has been developed for practice nursing to support career development and post-registration education and training programs are developed in an ad hoc manner and are not underpinned by core professional competencies. This paper reports on a systematic review undertaken to establish the available evidence on education models and career pathways with a view to enhancing recruitment and retention of practice nurses in primary care in Australia. Search terms describing education models, career pathways and policy associated with primary care (practice) nursing were established. These search terms were used to search electronic databases. The search strategy identified 1394 citations of which 408 addressed one or more of the key search terms on policy, education and career pathways. Grey literature from the UK and New Zealand internet sites were sourced and examined. The UK and New Zealand Internet sites were selected because they have well established and advanced developments in education and career pathways for practice nurses. Two reviewers examined titles, abstracts and studies, based on inclusion and exclusion criteria. Disagreement between the reviewers was resolved by consensus or by a third reviewer. Significant advances have been made in New Zealand and the UK towards strengthening frameworks for primary care nursing education and career pathways. However, in Australia there is no policy at national level prepare nurses to work in primary care sector and no framework for education or career pathways for nurses working in that sector. There is a need for national training standards and a process of accreditation for practice nursing in Australia to support the development of a responsive and sustainable nursing workforce in primary care and to provide quality education and career pathways.

38 citations


Journal ArticleDOI
TL;DR: In this article, the authors argue that using a traditional approach to the production of a doctoral dissertation does not focus strongly enough on developing the important skills of writing for publication and knowing how to effectively and strategically disseminate research findings.
Abstract: Internationally universities are increasingly challenged by government and industry to boost their research profile. Undertaking successful research studies is a means of generating income while enhancing the credibility of both institutions and individual academic staff. Research training therefore is an important strategy to support this endeavour. Traditionally, the process of research training culminates in the completion of a doctoral qualification. Undertaking doctoral studies requires candidates to commit to an extensive period of indenture during which they develop their knowledge about a particular methodology, refine skills in using research methods, and produce research findings in the form of a dissertation. A key part of this process is developing skills in writing for publication and the dissemination of their doctoral research findings. We argue that using a traditional approach to the production of a doctoral dissertation develops student’s knowledge and skills in conducting an independent piece of research. However, the production of a traditional thesis does not focus strongly enough on developing the important skills of writing for publication and knowing how to effectively and strategically disseminate research findings. Choosing to submit a doctoral dissertation by publication or partial publication provides candidates with the opportunity to complete research training and produce an authoritative research report, while at the same time developing skills in publishing journal articles and other manifests. Producing a dissertation by partial or full publication also opens the work up to independent scrutiny at various points during the candidate’s research training which strengthens the final results.

36 citations


Journal Article
TL;DR: Mature aged undergraduate students have different needs to younger students including academic and pastoral support, on campus subsidised childcare and creative timetabling.
Abstract: Objective: This study describes how mature aged people reconstruct themselves as nursing students. Design: This is a constructivist grounded theory study that used grounded theory methods of concurrent data generation and analysis, coding, developing categories and memoing. Setting: The study was undertaken at the rural campuses of two major Australian universities. The universities were in two different states of Australia. Subjects: Data were gathered through semi-structured interviews and focus groups over an eighteen month period between January 2006 and June 2007 with fourteen mature aged undergraduate nursing students. These students were in the second or third year of three year baccalaureate degrees that led to registration as registered nurses (titled Registered Nurse Division 1 in the state of Victoria, Australia). Participants' backgrounds were all slightly different. Two participants were currently employed as enrolled nurses (titled Registered Nurse Division 2 in the state of Victoria, Australia). Three participants were married, two were supporting parents and one participant was in a committed defacto relationship. Only one participant had no children with other participants having between one and seven children aged between one week old and twenty years. Results: This study found that mature aged students experienced three stages in their trajectory of 'Becoming a registered nurse'. These phases were called: Taking the first step; Keeping going; and finally, Letting go and moving forward. Conclusion: Mature aged undergraduate students have different needs to younger students including academic and pastoral support, on campus subsidised childcare and creative timetabling. During each phase of their university journey mature aged undergraduate nursing students developed different skills and knowledge and identified different needs that resulted in both professional and personal growth.

29 citations


Journal ArticleDOI
TL;DR: In this paper, a pragmatic and innovative approach to the data analysis of oral testimonies when used within a methodological framework of Historiography is discussed, which can be easily used by nurses and many other disciplines in their efforts to efficiently analyse the qualitative data obtained from oral testimonies.
Abstract: This paper discusses a pragmatic and innovative approach to the data analysis of oral testimonies when used within a methodological framework of Historiography. Oral testimony is increasingly perceived as an exciting research method within the nursing discipline. However, the availability of a clear method to guide the researcher in their analysis of oral testimonies as the primary data for a Historiography is limited. A practical approach to the interpretation of oral testimony is needed to ensure the continued and successful use of Historiography as a valued research methodology in nursing science. The primary discussion revolves around the explication of a four-stage method proposed as a pragmatic tool for the analysis of oral testimonies. Theoretical literature from the Historian, Paul Thompson and Pragmatist Philosopher, Richard Rorty is drawn upon to bring validity and reliability to the proposed method of analysis. This new technique can be easily used by nurses and many other disciplines in their efforts to efficiently analyse the qualitative data obtained from oral testimonies.

24 citations


Journal ArticleDOI
TL;DR: This article explores how sociocultural factors merge with the oppression of nursing globally to influence the status of nursing in Malaysia.
Abstract: Since the emergence of nursing as a distinct discipline, its status has mirrored that of women in society in general. As a predominantly female profession, nursing has been subject to oppressive forces that have affected women at various stages of history. Despite improvements in the standing of both women and nursing during the past century, nursing has still failed to achieve its full potential. In Malaysia, sociocultural factors combine to further limit the development of the profession. This article explores how such factors merge with the oppression of nursing globally to influence the status of nursing in Malaysia.

20 citations


Journal ArticleDOI
TL;DR: It was found that cultural factors particular to these communities influence the way such behavior is defined in an Aboriginal context, notably the practice of female hair cutting.
Abstract: In this small qualitative grounded theory study (21 interviews and focus groups with a total of 26 participants) investigating the understandings of and attitudes toward suicide and self-harm of Aboriginal peoples in a coastal region of New South Wales, Australia, we found that cultural factors particular to these communities influence the way such behavior is defined in an Aboriginal context. A continuation of certain "traditional" cultural forms of self-harm behavior was evident in participant definitions, notably the practice of female hair cutting, also described as a mourning ritual, which appears to serve as a marker both to the individual and others.

Journal Article
TL;DR: The project, funded by the Australian Government's Australia Malaysia Institute, and implemented by a group of Australian nurse academics, provided a rare professional development opportunity to nurses in urban and remote areas of Malaysia.
Abstract: Objective: This paper describes a project to promote a research culture amongst nurses in Malaysia The project, funded by the Australian Government's Australia Malaysia Institute, and implemented by a group of Australian nurse academics, provided a rare professional development opportunity to nurses in urban and remote areas of Malaysia Setting: The Malaysian capital of Kuala Lumpur and the remote town of Sibu, on the Island of Borneo, were the setting for this project The diversity of Malaysia was epitomized in the locations chosen for the implementation of tailored professional development seminars Conclusions: Evidence based practice in nursing is a global phenomenon The importance of basing nursing care on scientifically derived, current evidence is a critical element of contemporary nursing practice This notion is appreciated and accepted by nurses in Malaysia who, despite being impacted upon by barriers to the conduct and implementation of research in the clinical area, seek opportunities to enhance patient outcomes through evidence based practice Projects such as the one described in this paper provide a means for nurses to undertake professional development through collaborative activities that are not limited by geographic, socioeconomic or cultural boundaries

Journal ArticleDOI
TL;DR: The findings indicate that the experience of learning and acquisition of knowledge was well beyond what was expected, resulting in a sense of achievement that was similarly unanticipated.
Abstract: Changes to the nursing profession over recent decades have provoked an increasing migration of nursing education into the tertiary sector. For nurses who live and work in developing nations, such as Malaysia, opportunities for further study might be limited, particularly for those located in more remote regions. This paper reports on a research study of registered nurses who undertook baccalaureate degree studies in off-campus mode in Malaysian Borneo. A grounded theory methodology was employed in this research, which is part of a larger study into the nature and outcomes of change experienced as a result of postregistration degree studies. This paper explores the reasons why nurses in this location enrolled in one such course and the extent to which completion of their studies addressed their motivational goals. The findings indicate that the experience of learning and acquisition of knowledge was well beyond what was expected, resulting in a sense of achievement that was similarly unanticipated.




Journal ArticleDOI
TL;DR: Findings from a survey of Papua New Guinean registered nurse who completed the Integrated Management of Adult and Adolescent Illness (IMAI) Chronic HIV Care training conducted between November 2005 and December 2006 identified that registered nurses who participated in the IMAI Chronic HIV cared perceive the program to be beneficial for improving the way HIV care is provided.
Abstract: This study reports findings from a survey of Papua New Guinean registered nurse who completed the Integrated Management of Adult and Adolescent Illness (IMAI) Chronic HIV Care training conducted between November 2005 and December 2006. The survey conducted is one component of a mixed method evaluation of the IMAI program in Papua New Guinea. Data from the questionnaires were entered into version 16 of the Statistical Package for the Social Sciences (SPSS) software program. The responses on the effect of the IMAI training program had on various aspects of how care is provided, learning needs and other program outcomes were analysed with a chi-square test being applied to detect any difference in the response given by the different demographic subgroups in terms of gender, age, care status, current employer and past educational attainment. The survey revealed that all thirty-five respondents have a positive impression of the IMAI program and expressed the view that the IMAI program had a positive effect on various aspects of patient care and their learning and experience. Overall, the survey identified that registered nurses who participated in the IMAI Chronic HIV Care training program perceive the program to be beneficial for improving the way HIV care is provided.

01 Jan 2009
TL;DR: The common nursing history shared between Australia and Malaysia is traced and attention is paid to the collective trends effecting contemporary practice.
Abstract: The culture of nursing is reflective of the country where it is practised. In nations that have been colonised, the impact of the dominant culture shapes the nature of how the profession evolves. Australia and Malaysia share a common colonial history that has influenced how their individual health care systems have developed and from that, how their nursing professions have progressed. In the past, it has been easy to distinguish between the evolutionary trajectories of both countries, particularly in relation to the development of nursing. Today however, with the tyranny of distance almost negated, the differences are less palpable and challenges for the future are universal. This paper traces the common nursing history shared between Australia and Malaysia and pays attention to the collective trends effecting contemporary practice.

Journal ArticleDOI
TL;DR: This study sought to address the service deficits of the current health service delivery system and to identify strategies to ensure continuity of care for vulnerable populations with permanent disability and long-term health needs.
Abstract: As a consequence of the global trend towards new managerialism the New Zealand government undertook reforms of the health-care system during the 1980s and 1990s. These reforms, to a system that had functioned essentially unchanged since the 1930s, improved fiscal accountability at the expense of ensuring continuity of care. The restructuring particularly affected vulnerable populations with permanent disability and long-term health needs. This study sought to address the service deficits of the current health service delivery system and to identify strategies to ensure continuity of care for this group. The development of a clinical pathway and the appointment of a clinical care coordinator to oversee the delivery of comprehensive seamless health-care services were the major recommendations resulting from this study.

Journal Article
TL;DR: A team of researchers from Monash University's School of Nursing and Midwifery used a multiple case study design to address the aims of the research, to identify the requisite competencies and training required by a registered nurse to function effectively in a remote or isolated community.

Journal Article
TL;DR: The 2008 research project Nursing in remote or isolated areas of Queensland: A multiple case study was commissioned by Queensland Health's Office of the Chief Nursing Officer as mentioned in this paper, which identified the similarities and differences in the role of the registered nurse working in single nurse posts in remote and isolated centres in Queensland compared to like communities in Northern Territory, Western Australia and South Australia.
Abstract: [Extract] The 2008 research project Nursing in remote or isolated areas of Queensland: A multiple case study was commissioned by Queensland Health’s Office of the Chief Nursing Officer. A team of researchers from Monash University's School of Nursing and Midwifery used a multiple case study design to address the aims of the research, which were to: • identify the similarities and differences in the role of the registered nurse working in single nurse posts in remote or isolated centres in Queensland compared to like communities in Northern Territory, Western Australia and South Australia; • align the core role of the registered nurse working in remote or isolated practice with the burden of disease/model of care in the community; and • identify the requisite competencies and training required by a registered nurse to function effectively in a remote or isolated community.