Karen Francis

Bio: Karen Francis is an academic researcher from University of Tasmania. The author has contributed to research in topics: Health care & Grounded theory. The author has an hindex of 35, co-authored 212 publications receiving 7482 citations. Previous affiliations of Karen Francis include University of Adelaide & Australian Catholic University.

Critical discourse analysis: understanding change in maternity services.

Abstract: This paper provides an example of the use of critical discourse analysis (CDA) in the area of maternity care policy and describes the process of CDA as an effective research method for understanding the influences of change in the context of Australian maternity services. CDA is a methodological approach that examines how discourse is formed and given power, as a result of how power is used, who uses it and the context within which this usage takes place. The application of CDA is described in this study for the purpose of examining key-stakeholder use of knowledge and power for the purpose of influencing the direction of the maternity services reform. The CDA theoretical framework guided discourse identification and analysis of the purpose behind the discourse through examination of power relationships between key stakeholders. The use of a theoretical lens in the form of neoliberalism to supplement the theoretical framework facilitated the exposure of forces intrinsic to the maternity care context driving change.

An integrative review of the role of registered nurses in remote and isolated practice

Abstract: Objective: To examine the role of the registered nurse in remote and isolated areas of Queensland, the Northern Territory, South Australia and Western Australia; and to illustrate the impact of the burden of disease on nursing practice. Data sources: A literature search was undertaken using electronic databases and the grey literature (including policy documents, project reports and position descriptions). Data synthesis: The role of the nurse in remote areas is diverse, and varies according to the context of practice. Although some states and territories offer formal programs to prepare nurses for the role, it is unclear whether this is routinely provided. The burden of disease is higher in remote Australia, and although nurses work to reduce the burden, the need to provide primary care can be at the expense of primary health care. Conclusions: Whilst the nature of nursing practice is influenced by many factors, considerable agreement exists between states and territories around the role of the registered nurses in remote and isolated communities. The higher burden of disease in remote and isolated areas of Australia impacts on nursing practice, and nurses are uniquely placed to assist in reducing the burden of disease. Greater agreement around what constitutes ‘remote’ is needed. What is known about the topic? Many papers have reported on the difficulties encountered by registered nurses in remote and isolated practice; however, there is a dearth of information describing the role of registered nurses in remote or isolated Australian communities. What does this paper add? This review describes the diverse role of nurses and their role in addressing the burden of disease in remote and isolated Australia. Comparison between states and territories highlights differences in preparation for the role. What are the implications for practitioners? National agreement is needed around preparation for practice, conditions of work, and what constitutes ‘remote’. Greater utilisation of the nursing workforce in remote and isolated areas would assist in addressing the burden of disease.

Triage, treat and transfer: Reconceptualising a rural practice model

Abstract: Aim: This article argues that the current model of emergency practice in rural Victorian hospitals, which relies heavily on visiting medical officers, needs to be reconceptualised if emergency services are to be supplied to rural communities. Background: Medical workforce shortages are manifesting in Victoria as a reduction in emergency care services from rural hospitals. The suggested alternative model of emergency care involves advancing nursing practice to enable a redistribution of clinical capacity across the health care team. Clinicians will need to work collaboratively and continuously negotiate their roles to meet the patient's and the clinical team's needs. Design: Systematic review. Methods: This article is based on a review of the Victorian and Australian literature on the subject of Victorian health services and policy, emergency care, collaboration, communication and rural nurse scope of practice and roles. Emergency care activity was drawn from data held in the Victorian Emergency Management Dataset and personal communications between one of the authors and hospital executives in a small selection of rural hospitals in Victoria. Results: The evidence reviewed suggests that the current emergency practice profile of rural hospitals in Victoria does not reflect the reconceptualised model of rural emergency practice. Instead, only a small proportion of non-urgent presentations is managed by nurses without medical support, and the data suggest that metropolitan nurses are more likely to manage without medical support than rural nurses. Conclusion: Reconceptualising rural emergency care in Victoria will require significantly greater investment in rural nurses' knowledge and skills to enable them to operate confidently at a more advanced level. Clinical teams that deliver emergency service in rural hospitals will be expected increasingly to work collaboratively and interprofessionally. Relevance to clinical practice: This article offers some directions for advancing nursing practice and strategies for improving interprofessional collaboration in the delivery of rural emergency care. © 2010 The Authors. Journal compilation

Jordan's vulnerability: a population at risk of HIV/AIDS.

Abstract: This paper describes the findings of an ethnographic study that sought to explore the influence of HIV/AIDS on the practice of primary care nurses in Jordan. The study was undertaken in three (3) rural and three (3) urban comprehensive primary health care centres. Data collection included participant observation, key informant interviews, field notation and document analysis. These data informed the development of descriptive ethnographic accounts that allowed for the subsequent identification of common and divergent themes reflective of factors recognized as influencing the practice of nurses.The findings indicate that the ability of the nurses to raise awareness and therefore reduce the spread of HIV/AIDS is unrealistic. Data shows that the population is at risk because the nurses’ knowledge and skill base is inadequate and the health care facilities are crippled by limited human and physical resources. Poor management and the lack of localised leadership are also factors identified as contribut...

From textual to visual: the use of concept mapping as an analytical tool in a grounded theory study:

Abstract: Dealing with a large amount of qualitative data during the analytical process can be challenging especially when the data needs to be regularly discussed with other research team members. For researchers employing grounded theory methodology and methods, using visual tools such as concept maps or diagrams can be a beneficial approach at all phases of the research. Concept maps can assist researchers to visualize emerging concepts from raw data, efficiently communicate the developing theory under construction and demonstrate progress in the analytical thinking process. However, despite the usefulness of concept mapping, there is limited and detailed information on the use of concept mapping to guide novice researchers. This research presents the distinctive experiences of the authors in utilizing concept mapping to facilitate the analytical process of theory generation they undertook when conducting a grounded theory study examining diabetes health education in an Indonesian context. It is recommended that researchers consider the flexibility and efficacy of concept mapping as a tool to assist them with the process of data analysis in qualitative research.

Document Analysis as a Qualitative Research Method

Abstract: This article examines the function of documents as a data source in qualitative research and discusses document analysis procedure in the context of actual research experiences. Targeted to research novices, the article takes a nuts‐and‐bolts approach to document analysis. It describes the nature and forms of documents, outlines the advantages and limitations of document analysis, and offers specific examples of the use of documents in the research process. The application of document analysis to a grounded theory study is illustrated.

The archaeology of knowledge

Abstract: We may not be able to make you love reading, but archaeology of knowledge will lead you to love reading starting from now. Book is the window to open the new world. The world that you want is in the better stage and level. World will always guide you to even the prestige stage of the life. You know, this is some of how reading will give you the kindness. In this case, more books you read more knowledge you know, but it can mean also the bore is full.