Showing papers by "Karen Francis published in 2019"

Grounded theory research: A design framework for novice researchers.

Abstract: Background:Grounded theory is a well-known methodology employed in many research studies. Qualitative and quantitative data generation techniques can be used in a grounded theory study. Grounded th...

How people living with diabetes in Indonesia learn about their disease: A grounded theory study.

Abstract: Background Diabetes education has been found to impact positively on self-management by people with diabetes although little is known about the process by which they assimilate information. The aim of this study was to generate a theory explaining the process by which people with diabetes learn about their disease in Indonesia. Methods This study employed a grounded theory methodology influenced by constructivism and symbolic interactionism. A total of twenty-eight face-to-face or telephone interviews with participants from Indonesia that included people with diabetes, healthcare professionals, health service providers and families of people with diabetes were conducted in both Indonesia and Australia. Results This study discloses a core category of Learning, choosing, and acting: self-management of diabetes in Indonesia as the basic social process of how people learn about their diabetes. The process includes five distinctive major categories. People with diabetes acted after they had received recommendations that they considered to be trustworthy. Factors that influenced their choice of recommendations to adopt are also identified. Conclusions Awareness of the complexity involved in their decision making will assist healthcare professionals to engage effectively with people living with diabetes.

Tissue and nitrogen-linked expression profiles of ammonium and nitrate transporters in maize.

Abstract: In order to grow, plants rely on soil nutrients which can vary both spatially and temporally depending on the environment, the soil type or the microbial activity. An essential nutrient is nitrogen, which is mainly accessible as nitrate and ammonium. Many studies have investigated transport genes for these ions in Arabidopsis thaliana and recently in crop species, including Maize, Rice and Barley. However, in most crop species, an understanding of the participants in nitrate and ammonium transport across the soil plant continuum remains undefined. We have mapped a non-exhaustive set of putative nitrate and ammonium transporters in maize. The selected transporters were defined based on previous studies comparing nitrate transport pathways conserved between Arabidopsis and Zea mays (Plett D et. al, PLOS ONE 5:e15289, 2010). We also selected genes from published studies (Gu R et. al, Plant and Cell Physiology, 54:1515-1524, 2013, Garnett T et. al, New Phytol 198:82-94, 2013, Garnett T et. al, Frontiers in Plant Sci 6, 2015, Dechorgnat J et. al, Front Plant Sci 9:531, 2018). To analyse these genes, the plants were grown in a semi-hydroponic system to carefully control nitrogen delivery and then harvested at both vegetative and reproductive stages. The expression patterns of 26 putative nitrogen transporters were then tested. Six putative genes were found not expressed in our conditions. Transcripts of 20 other genes were detected at both the vegetative and reproductive stages of maize development. We observed the expression of nitrogen transporters in all organs tested: roots, young leaves, old leaves, silks, cobs, tassels and husk leaves. We also followed the gene expression response to nitrogen starvation and resupply and uncovered mainly three expression patterns: (i) genes unresponsiveness to nitrogen supply; (ii) genes showing an increase of expression after nitrogen starvation; (iii) genes showing a decrease of expression after nitrogen starvation. These data allowed the mapping of putative nitrogen transporters in maize at both the vegetative and reproductive stages of development. No growth-dependent expression was seen in our conditions. We found that nitrogen transporter genes were expressed in all the organs tested and in many cases were regulated by the availability of nitrogen supplied to the plant. The gene expression patterns in relation to organ specificity and nitrogen availability denote a speciality of nitrate and ammonium transporter genes and their probable function depending on the plant organ and the environment.

A practical example of using theoretical sampling throughout a grounded theory study: A methodological paper

Abstract: Purpose: The purpose of this paper is to discuss the practical use of theoretical sampling as a method for selecting data that provide a richer and deeper understanding of the phenomenon being investigated. Design/methodology/approach: Theoretical sampling is a well-known method in grounded theory studies to seek additional data based on concepts developed from initial data analysis. This method involves following where the data have led to expand and refine the evolving theory during the analytical process. However, there is a dearth of information detailing the practical steps needed to undertake theoretical sampling. Findings: The authors used the theoretical sampling method in their study in four ways: asking additional interview questions and/or widening the scope of existing interview questions; recruiting participants with additional diversity of attributes within the same group; and adding a new group of participants and expanding research settings. Originality/value: Theoretical sampling is a valuable and practical method for the purpose of addressing gaps in the data in qualitative research. When using theoretical sampling, it is essential to consider potential strategies for countering challenges that may arise. Practical recommendations are offered on the use of theoretical sampling during data analysis, for the purpose of achieving theoretical integration.

Individual and environmental determinants of burnout among nurses

Abstract: Objective Burnout is a significant problem affecting the nursing workforce and is associated with significant personal suffering and high rates of nurse turnover. Efforts to further understand the variables that explain burnout are needed. The aim of this cross-sectional study was to examine both environmental and individual factors that may explain burnout among nurses. Method We recruited 1848 Australian nurses to complete several online questionnaires measuring the practice environment (Practice Environment Scale of the Nursing Work Index), burnout (Professional Quality of Life Scale), trait negative affect (Spielberger State-Trait Anxiety Inventory form Y2) and resilience (Connor Davidson Resilience Scale). Correlational analysis as well as hierarchical regression was used to determine the relative importance of variables in explaining burnout scores. Results All of the practice environment scales were significantly related to burnout in the negative direction, and these relationships were above .3 for all except the relationship scale (r = –.256) and the participation in hospital affairs scale (r = –.285). Overall, the regression model accounted for 62% of the variance in nurse burnout scores. Trait negative affect, resilience and two aspects of practice environment (Manager sub-scale and Staffing sub-scale) all explained significant variance in burnout scores. The largest contribution came from the two individual variables (resilience and trait negative affect) that together explained 55% of the variance in burnout scores. Conclusions Findings suggest that health service administrators should provide nursing staff with education and support to build individual resilience. Workplaces that attend to staffing and resource issues and have managers who provide high levels of support to their staff appear to be essential strategies to help prevent nurse burnout.

The implications of isolation for remote industrial health workers.

Abstract: Introduction: Recent literature has explored the health and social implications of industrial workers who are involved in a variety of long-distance commute (LDC) work arrangements including fly-in, fly-out; bus-in, bus-out; and drive-in, drive-out. However, the role of an industrial health worker in caring for this special population of workers is poorly understood and documented in current literature. In Australia, the health role has existed primarily to meet minimum standards of safety legislation and carry out compliance activities. The combination of low social risk tolerance, increasingly remote locations and changing health and safety legislation are driving changes to accountability for the health as well as the safety of remote industrial workers. Health staff are recruited from the ranks of registered nurses, paramedics and diploma-qualified medics. Often, they work in autonomous transdisciplinary roles with little connection to other health workers. The lack of a clear professional identity contributes to increased tension between the regulatory requirements of the role and organisations who don't always value input from a specialist health role. The aim of this study was to understand the experience of isolation for health workers in industrial settings to better inform industry and education providers. Methods: A phenomenological methodology was chosen for this study owing to the paucity of qualitative literature that explored this role. This study utilised face-to-face or telephone interviews with nurses and paramedics working in remote offshore and onshore industrial health roles seeking to understand their experience of working in this context of health practice. Results: Three thematically significant experiences of the role related to role dissonance, isolation, and gaining and maintaining skills. The second theme, isolation, will be presented to provide context for nurses' and paramedics' experiences of geographical, personal and professional isolation. Conclusions: Nurses and paramedics working in remote industrial roles are not prepared for the broad scope of practice of the role, and the physical and profession isolation presents barriers to obtaining skills and confidence necessary to meet the needs of the role. Limited resources in rural and remote areas combined with the isolation of many industrial sites pose challenges for industrial staff in accessing primary healthcare services, yet industrial organisations are resisting attempts to make them responsible for the health as well as the safety of their onsite workers, particularly in off-duty hours. Health workers in remote locations have to cope with their own experience of isolation but also have to treat and counsel other industrial workers experiencing chronic illness complications, separation from family and other consequences of the fly-in, fly-out 'workstyle'. In addition to the tyranny presented by distance and the emotional isolation common to all remote industrial workers, health workers are isolated from professional networks, access to education/professional development opportunities and other remote industrial peers. Their inclusion within a professional network and educational framework would help to mitigate these factors and provides opportunities for collaboration between industrial and rural health staff.

Using storylines for bilingual dissemination of a grounded theory.

Abstract: Background: A storyline in a grounded theory study plays two important roles: an analytical tool and a research product. Using more than one language in a study affects the research, including the dissemination of its findings. Very little literature discusses how to develop and disseminate a storyline. Aim: This paper offers insight into the crafting of a storyline to disseminate a grounded theory study describing how people in Indonesia with diabetes learn about their disease. Discussion: This paper explains how the researchers developed the storyline. The authors then address considerations in the storyline’s development and explain how they disseminated it, as well as the factors that influenced that dissemination. Conclusion: Disseminating findings through a storyline written in the local language ensures that the target audience all have access to a study's outcomes through an easily readable publication. Implication: for practice Sharing a storyline helps to disseminate the outcomes of a grounded theory study. It informs the wider community of new knowledge and enables it to review, understand and apply the outcomes of research.

Sebuah Storyline Mengenai Proses Bagaimana Penderita Diabetes di Indonesia Mempelajari Mengenai Penyakitnya

Abstract: Abstrak Latar Belakang: Edukasi diabetes bermanfaat pada perbaikan dalam pengelolaan diabetes secara mandiri serta peningkatan pengendalian kadar gula darahnya. Tetapi, sampai dengan saat ini belum terdapat penelitian dan publikasi mengenai proses bagaimana penderita diabetes di Indonesia mempelajari tentang penyakitnya. Tujuan: Adapun tujuan dari penulisan artikel ini adalah untuk menyampaikan hasil penelitian melalui sebuah storyline /alur cerita yang dikembangkan dari sebuah penelitian grounded theory. Metode: Studi penelitian yang dimaksud ini bertujuan untuk memahami lebih baik proses bagaimana penderita diabetes mempelajari mengenai penyakitnya melalui metodologi grounded theory. Dua puluh enam partisipan diperoleh melalui metode purposive dan theoretical sampling . Wawancara dilakukan kepada partisipan. Hasil: hasil penelitian menunjukan pengembangan sebuah teori “Learning, choosing, and acting: self-management of diabetes in Indonesia” (Mempelajari, memilih dan bertindak: manajemen diri diabetes di Indonesia) yang merupakan proses penderita diabetes mempelajari tentang penyakitnya, yang bersifat siklus dan linier. Kesimpulan: Sebuah storyline atau alur cerita digunakan untuk menjelaskan teori mengenai proses mempelajari, memilih dan bertindak dalam manajemen diri diabetes ini. Rekomendasi ditekankan pada perbaikan dalam memberikan edukasi pada penderita diabetes. Abstract Background: Diabetes education is beneficial to enhance both knowledge and attitudes towards self-care management and glycemic control improvement. However, little is known about the process of how people with diabetes in Indonesia receive and engage in education that promotes their health. Objective: The purpose of this article is to share the findings in the form of a storyline developed from a grounded theory study. Method: The aim of th e study was to better understand this process using grounded theory methodology. Twenty-six participants were recruited through purposive and theoretical sampling methods. The participants were interviewed. Result: The results showed a cyclic and dynamic process that lead to the development of a theory entitled Learning, choosing, and acting: self-management of diabetes in Indonesia. Conclusion: This theory will be explicated using a storyline, along with recommendations to help improve the provision of diabetes education.

Nurses’ experiences and perceptions of hourly rounding: a private Australian catholic hospital single case study

Abstract: Aim: This research paper reports on nurses’ experiences and perceptions of hourly rounding undertaken at private Catholic acute care regional hospital in Australia. Background: Evidence suggests that structured nursing rounds are associated with positive outcomes. However, a number of barriers to effective hourly rounding have been reported. Rounding practices were implemented in a medical/ surgical ward at a regional hospital in Australia, in 2014, aiming to reduce the risk of patient falls and enhance the patient experience. Methods: A qualitative, exploratory descriptive single case study design was utilised. Fifteen (15) nurses participated in the study and data were generated using Hermeneutic phenomenological interview technique. Transcriptions of each interview were analysed using both content and thematic analysis approaches. Results: The experiences and perceptions of the nurse participants involved in the study were found to centre on the following themes and subthemes: 1. Support for rounding practice 2. Barriers to rounding practice a) High workload and time-pressure b) Documentation Conclusion: The implementation of rounding was perceived to be useful and overall supported by the participants. Relocating nursing documentation and reviewing the model of care were highlighted as recommendations to improve compliance and support ongoing sustainability of rounding.

Implementing the macro level of the ICCCF

Abstract: LEARNING OBJECTIVES After studying this chapter, you should be able to: • explain how the meso level of the Innovative Care for Chronic Conditions Framework addresses care for the person with a chronic condition • understand how to build a supportive environment with the person with a chronic condition and other health partners • explore aspects of health promotion and education within chronic care nursing • consider the available resources within the community that support the care of the person with a chronic condition, and identify methods to develop future resources within health care organisations • describe the impact of stigma in relation to chronic illness. Introduction This chapter describes the meso level of the Innovative Care for Chronic Conditions Framework (ICCCF), which focuses on the health care environment and how care is organised. Tools and expertise that are required by nurses to provide evidence-based care within health care organisations, and the need to provide health education and promotion are discussed. This level of the ICCCF, with its focus on the entire organisation, is where other members of the team are valued for their involvement and support of the client. The benefits of information systems and community resources in order to provide comprehensive chronic care are addressed. The combining of large health care organisations and community groups to provide health care can lead to very effective interventions, but may require assistance to coordinate and to support clients who may have difficulty understanding the roles of such a variety of groups and people. Nurses are in a unique position to coordinate such care and to advise clients (Anderson & Malone, 2015) about what is available both within their own organisations and in the community, and thereby ensure the best possible outcomes. The meso level of the ICCCF is the link between the interaction of the client and the health care team (the micro level) and the overall environment in which care is provided (the macro level). In this way, the meso level supports the interaction with clients by providing the space and services where the interaction takes place, while the macro level provides the regulation and funding to ensure the safety and functioning of the meso-level organisations and community.