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Biomedical subjects

Debra Jackson

Publications and source records attributed to Debra Jackson.

At least 37 records · Page 2Linked to original sources
PubMed2005

Overweight and obese children: mothers' strategies.

AIM: This paper reports a study exploring the strategies a group of mothers of overweight and obese children were using and planned to use in the future to assist their children to achieve a healthy weight. BACKGROUND: Over the past two decades, the prevalence of childhood obesity has grown exponentially to become a major public health concern. Extant literature suggests that childhood obesity is associated with a range of physical, social and psychological effects, including poor self-esteem, depression, social isolation, and cardio-vascular and other morbidity. Parents are known to be important in determining early eating and exercise habits, and their involvement is crucial to achieving positive child health outcomes. METHODS: An exploratory-descriptive design informed by feminist research principles shaped the study, which was carried out in 2003-2004. Eleven mothers meeting the inclusion criteria took part in in-depth interviews. These were transcribed, and qualitatively analysed. FINDINGS: Participants revealed sound understandings of the concept and ramifications of obesity. They had initiated a range of strategies including role modelling, developing opportunities for increased physical activity, reducing the use of junk food, and heightened awareness of how they used food. Participants viewed the problem as a family rather than an individual problem, and aimed many of the interventions at the entire family to avoid targeting the focus child. CONCLUSIONS: Further research into how childhood obesity is managed within the context of family life is needed. Specifically, additional perspectives on how mothers from various socio-cultural groups address childhood obesity within family life, and longitudinal studies to explore the efficacy and sustainability of family-based lifestyle changes that are made in response to concerns about child weight issues. Additional research to explore the type and nature of family support that can best assist families to achieve sustainable lifestyle improvements is needed.

Adolescent↗
PubMed2005

Adolescent drug abuse: helping families survive.

Drug use and abuse carries risk in people of all ages. However, adolescents are particularly vulnerable to substance misuse. Adolescent drug use continues to be an area of concern with a number of adolescents developing problems associated with the use of various drugs. Negative sequelae associated with adolescent drug use include areas such as schooling, health, and family relationships. Difficulties with the legal system, schooling, or within the family are commonly the triggers for recognition of substance misuse problems in a young person. However, problems are usually well-established before they are recognized. The challenge of dealing with these problems will fall on families, particularly parents. This is a crisis for families, and ongoing support is needed if they are to overcome the challenges. Health workers (including nurses) are well-positioned to support families who are dealing with adolescent drug problems. In this paper we propose the adoption of a strengths approach as a strategy for developing resilience in families.

Adaptation, Psychological↗
PubMed2005

Role stress in nurses: review of related factors and strategies for moving forward.

The aim of this paper was to review the literature on factors related to role stress in nurses, and present strategies for addressing this issue based on the findings of this review while considering potential areas for development and research. Computerized databases were searched as well as hand searching of articles in order to conduct this review. This review identified multiple factors related to the experience of role stress in nurses. Role stress, in particular, work overload, has been reported as one of the main reasons for nurses leaving the workforce. This paper concludes that it is a priority to find new and innovative ways of supporting nurses in their experience of role stress. Some examples discussed in this article include use of stress education and management strategies; team-building strategies; balancing priorities; enhancing social and peer support; flexibility in work hours; protocols to deal with violence; and retention and attraction of nursing staff strategies. These strategies need to be empirically evaluated for their efficacy in reducing role stress.

Age Factors↗
PubMed2005

Preventing HIV transmission to children: quality of counselling of mothers in South Africa.

AIM: To assess the quality of counselling provided to mothers through the programme to prevent mother-to-child transmission (PMTCT) of HIV in South Africa. METHODS: Structured observations of consultations and exit interviews with 60 mothers attending clinics at three purposively selected PMTCT sites across South Africa were conducted. RESULTS: Twenty-two counsellors were observed. The general quality of communication skills was very good, and 73% of HIV-negative mothers were informed of the advantages of exclusive breastfeeding (EBF). However, only one of 34 HIV-positive mothers was informed about the possible side effects of nevirapine, and none was told what to do when it occurred. Only two HIV-positive mothers were asked about essential conditions for safe formula feeding before a decision about an infant feeding option was made. None of the 12 mothers choosing to breastfeed was shown how to position the baby correctly on the breast or asked whether they thought EBF was feasible. Fewer than a quarter of mothers expressed confidence in performing the actions required, and 85% could not define the term EBF. CONCLUSION: The poor quality of counselling in the PMTCT programme will reduce the effectiveness of these programmes. As they are being scaled up, there needs to be far more attention paid towards the counselling of mothers, especially with regards to optimal infant feeding.

Counseling↗
PubMed2005

Using the arts and humanities to support learning about loss, suffering and death.

In this article, the benefits of using the arts and humanities as teaching and learning strategies are explored. Their contribution to undergraduate nursing curricula, as a means of promoting a deeper understanding of the experiences of loss, suffering and death, cannot be undervalued. They need to be present equally alongside the physical and social sciences in nursing curricula. More than ever, is the need for all undergraduate nursing students to participate in self-reflection of these experiences, in order that they may meet the needs of their patients and families adequately, in a range of healthcare settings.

Death↗
PubMed2004

WHO guidelines for management of severe malnutrition in rural South African hospitals: effect on case fatality and the influence of operational factors.

BACKGROUND: WHO case-management guidelines for severe malnutrition aim to improve the quality of hospital care and reduce mortality. We aimed to assess whether these guidelines are feasible and effective in under-resourced hospitals. METHODS: All children admitted with a diagnosis of severe malnutrition to two rural hospitals in Eastern Cape Province from April, 2000 to April, 2001, were studied and their case-fatality rates were compared with the rates in a period before guidelines were implemented (March, 1997 to February, 1998). Quality of care was assessed by observation of medical and nursing practices, review of medical records, and interviews with carers and staff. A mortality audit was used to identify cause of death and avoidable contributory factors. FINDINGS: At Mary Theresa Hospital, case-fatality rates fell from 46% before implementation to 21% after implementation. At Sipetu Hospital, the rates fell from 25% preimplementation to 18% during 2000, but then rose to 38% during 2001, when inexperienced doctors who were not trained in the treatment of malnutrition were deployed. This rise coincided with less frequent prescribing of potassium (13% vs 77%, p<0.0001), antibiotics with gram-negative cover (15% vs 46%, p=0.0003), and vitamin A (76% vs 91%, p=0.018). Most deaths were attributed to sepsis. For the two hospitals combined, 50% of deaths in 2000-01 were due to doctor error and 28% to nurse error. Weaknesses within the health system--especially doctor training, and nurse supervision and support--compromised quality of care. INTERPRETATION: Quality of care improved with implementation of the WHO guidelines and case-fatality rates fell. Although major changes in medical and nursing practice were achieved in these under-resourced hospitals, not all tasks were done with adequate care and errors led to unnecessary deaths.

Cause of Death↗
PubMed2004

An insight into Australian nurses' experience of withdrawal/withholding of treatment in the ICU.

BACKGROUND: The success of biotechnology has created moral and ethical dilemmas concerning end-of-life care in the Intensive Care Unit (ICU). Whilst the competent individual has the right to refuse or embrace treatment, ICU patients are rarely able to exercise this right. Thus, decision-making is left to medical professionals and family/significant others. AIM: This study aimed to explore the lived experience of ICU nurses caring for clients having treatment withdrawn or withheld, and increase awareness and understanding of this experience amongst other health professionals. METHODS: Van Manens' (1990) phenomenological framework formed the basis of this study as it provided an in-depth insight into the human experience. A convenience sample of ten ICU Nurses participated in the study. Conversations were transcribed verbatim and analysed using a process of thematic analysis. RESULTS: Five major themes emerged during the analysis. These were: (1) comfort and care, (2) tension and conflict, (3) do no harm, (4) nurse-family relationships and (5) invisibility of grief and suffering. CONCLUSION: The experience of providing care for the adult having treatment withdrawn or withheld in the ICU represents a significant personal and professional struggle. Improvements in communication between health professionals, debriefing and education about the process of withdrawing or withholding treatment would be beneficial to both staff and families and has the potential to improve patient care and reduce burden on nurses.

Australia↗
PubMed2004

Giving voice to the burden of blame: a feminist study of mothers' experiences of mother blaming.

Mother blaming has been identified as a pervasive and serious problem and it is known that the professional literature has strong and entrenched mother-blaming messages. Using a feminist approach, this paper explores mother blaming as it has been experienced by a group of mothers themselves. Analysis of narrative exposes mother blaming as a burden that complicates the already-complex responsibilities that comprise mothering. Health providers are among those identified by women as being particularly likely to attribute problems with (even grown) children to maternal fault. Implications for practice and research are drawn from the findings of this paper.

Adolescent↗
PubMed2004

Current challenges and issues facing nursing in Australia.

This column is a discussion of nursing in Australia. The authors present current challenges and issues related to recruitment and retention, an aging workforce, violence and bullying, diversity, undergraduate and graduate education, professional development, information technology, clinical pathways, models of care delivery, and funding models. They also present what is happening in Australia in relation to nursing's scope of practice, development of the nurse practitioner role, nursing leadership, and nursing research.

Australia↗
PubMed2003

Periodicity of cell attachment patterns during Escherichia coli biofilm development.

The complex architecture of bacterial biofilms inevitably raises the question of their design. Microstructure of developing Escherichia coli biofilms was analyzed under static and laminar flow conditions. Cell attachment during early biofilm formation exhibited periodic density patterns that persisted during development. Several models for the origination of biofilm microstructure are considered, including an activator-inhibitor or Turing model.

Bacterial Adhesion↗
PubMed2003

Then suddenly he went right off the rails: mothers' stories of adolescent cannabis use.

Adolescent drug use provides challenges for parents, health professionals and the wider community. Of those adolescents who use drugs, cannabis is often the drug of choice. A number of adolescents will develop problems associated with cannabis use, and the burden of managing these problems will fall on the family, particularly the mother. This paper explores adolescent cannabis use from the perspective of mothers of affected young people. Twelve women took part in conversational style audio-taped interviews. Stories were extracted from the resulting narratives and were analysed guided by the work of Anderson and Jack (1991). Detailed findings are grouped under the themes: First awareness: 'I couldn't deny it was happening'; Constant vigilance: 'I watched his every move'; Cannabis and family life: 'I'd start to shake when he walked into the house'; Disrupted lives: 'I was terrified he'd go to prison'; Shifting aspirations: 'just staying alive'; and, Maintaining a loving relationship: 'always told him I loved him'. Implications for nursing practice are drawn from the findings.

Adolescent↗
PubMed2003

Coronary heart disease in Indians: a review of literature.

A literature review utilising literary databases, World Wide Web and hand checking of written articles was conducted to determine the magnitude of the problem of coronary heart disease (CHD) in Indians with a particular emphasis on those in Australia. Health care professionals need to be aware that Indians have a higher than average risk of CHD at an earlier age and poorer survival and this is impacted on by genetic, social and cultural factors. The experiences of Indians with CHD needs to be researched so that prevention and rehabilitation programs can be individualised for this well developed community group in Australia.

Australia↗
PubMed2003

Coronary heart disease in Aboriginal communities: towards a model for self-management.

Coronary heart disease (CHD) is one of the main causes of death and disability in the Aboriginal population, and is the major cause of the twenty-year gap in life expectancy of Aboriginal and non-Aboriginal Australians. This paper explores Aboriginal health in relation to CHD, and suggests self-management as a culturally acceptable therapeutic and sustainable ideology from which positive outcomes may be achieved.

Adult↗
PubMedDate not supplied

Australian women and heart disease: trends, epidemiological perspectives and the need for a culturally competent research agenda.

Heart disease commonly manifests as acute coronary syndromes (unstable angina pectoris, or myocardial infarction) and heart failure (HF). These conditions are major causes of morbidity and mortality in Australia and internationally. Australian faces particular challenges in health care delivery given the cultural and ethnic diversity of society and unique issues related to rurality. These factors have significant implications for health care delivery. Following an acute cardiac event women have poorer outcomes: higher mortality rates, higher incidence of complications and greater psychological morbidity compared with men. Language barriers, socioeconomic factors, psychological trauma related to migration and alternate health seeking behaviors and varying perceptions of risk are likely to impact adversely on health outcomes. Self-management in chronic cardiovascular disease underscores the importance of models of care that incorporate aspects related to self-care and promotion of adherence to primary and secondary prevention initiatives. Implicit in this statement is the inclusion of the individual in negotiating and developing their care plan. Therefore health professionals need to be aware of the patient's needs, values, beliefs and health seeking behaviours. These factors are strongly influenced by culture and ethnicity. The cultural diversity of Australian society mandates cultural competence in health care. This paper presents an overview of nursing science related to women and heart disease in Australia and suggests directions for culturally-competent research and development and evaluation of models of care to improve health outcomes for all Australians.

Attitude to Health↗
PubMedDate not supplied

Current state of knowledge on child-to-mother violence: a literature review.

Child-to-mother violence is a common aspect of family violence, and presents nurses and health workers with continuing challenges. Though noted in the literature as early as the 1950's, this phenomenon remains poorly understood. A number of reasons for the lack of research scrutiny are proposed, the most compelling being that child-to-mother violence has been framed within the discourse of juvenile delinquency rather than family violence. Thus, unlike other forms of family violence, it has escaped close examination by health and welfare workers. A literature review was conducted to examine current knowledge of child-to-mother violence. Study of the literature reveals only partial understandings of this neglected aspect of family pathology. Directions for research to address these gaps in knowledge are drawn from the findings of this literature review.

Adolescent↗
PubMedDate not supplied

Raising families: urban women's experiences of requiring support.

Rapid social changes and the pressures of contemporary living have put families under increasing stress. Nurses have the potential to offer support for families experiencing stress. Therefore, it behoves nurses to develop a greater understanding of the stressors affecting families in contemporary Australia. This paper reports an exploratory descriptive study of urban women's experiences of dealing with difficult and demanding situations in their lives as mothers and family carers in contemporary Australian society, and explores women's experiences of seeking support for family issues. Participants' insights about the nature and availability of support for themselves and their families when in these stressful situations are revealed. Participants sought support from various personal networks, community and self help groups, and professional helpers. However, adequate support was not always available. Nurses have the potential to further develop their role in relation to providing support to women raising families.

Adaptation, Psychological↗