Biomedical subjects

Linda Kristjanson

Publications and source records attributed to Linda Kristjanson.

10 recordsLinked to original sources

PubMed2006

Enhancing palliative care delivery in a regional community in Australia.

Although access to palliative care is a fundamental right for people in Australia and is endorsed by government policy, there is often limited access to specialist palliative care services in regional, rural and remote areas. This article appraises the evidence pertaining to palliative care service delivery to inform a sustainable model of palliative care that meets the needs of a regional population on the mid-north coast of New South Wales. Expert consultation and an eclectic literature review were undertaken to develop a model of palliative care service delivery appropriate to the needs of the target population and resources of the local community. On the basis of this review, a local palliative care system that is based on a population-based approach to service planning and delivery, with formalized integrated network agreements and role delineation between specialist and generalist providers, has the greatest potential to meet the palliative care needs of this regional coastal community.

Aged↗

PubMed2006

Residential aged care: the last frontier for palliative care.

AIM: This paper is a report of an explorative study describing the perceptions and beliefs about palliative care among nurses and care assistants working in residential aged care facilities in Australia. BACKGROUND: Internationally, the number of people dying in residential aged care facilities is growing. In Australia, aged care providers are being encouraged and supported by a positive policy platform to deliver a palliative approach to care, which has generated significant interest from clinicians, academics and researchers. However, a little is known about the ability and capacity of residential aged care services to adopt and provide a palliative approach to care. METHODS: Focus groups were used to investigate the collective perceptions and beliefs about palliative care in a convenience sample of nurses and care assistants working in residential aged care facilities in Australia. Thematic content analysis was used to analyse the data, which were collected during 2004. RESULTS: Four major themes emerged: (1) being like family; (2) advocacy as a key role; (3) challenges in communicating with other healthcare providers; (4) battling and striving to succeed against the odds. Although participants described involvement and commitment to quality palliative care, they also expressed a need for additional education and support about symptom control, language and access to specialist services and resources. CONCLUSION: The residential aged care sector is in need of support for providing palliative care, yet there are significant professional and system barriers to care delivery. The provision of enhanced palliative care educational and networking opportunities for nurses and care assistants in residential aged care, augmented by a supportive organizational culture, would assist in the adoption of a palliative approach to service delivery and requires systematic investigation.

Aged↗

PubMed2005

The role of the neonatal intensive care nurse in decision-making: advocacy, involvement in ethical decisions and communication.

Neonatal intensive care unit (NICU) nurses are often faced with complex clinical and ethical problems. Little is known about the role of the NICU nurse in ethical decision-making, or processes that inform decision-making in this setting. The purpose of this study was to explore and describe nurses' perceptions of their role as patient advocate, clinical situations that cause them concern and the extent of their involvement in ethical decision-making. A combined quantitative and qualitative research design was used. A questionnaire was administered to nurses working in the NICU of the sole perinatal tertiary referral centre of Western Australia, Australia. Findings showed that NICU nurses saw their role in ethical decision-making primarily as advocating for the best interests of the infant and family, that they used clinical knowledge and experience to guide ethical decision-making, they were able to clearly articulate ethical problems and respond to them according to the clinical scenario and, while being primarily assertive in presenting their views, some nurses took a more passive approach. These findings support the need for development of a multidisciplinary model for ethical decision-making, where the view of all team members are considered.

Australia↗

PubMed2005

Men, culture and hegemonic masculinity: understanding the experience of prostate cancer.

Following a diagnosis of, and treatment for prostate cancer, there is an expectation that men will cope with, adjust to and accept the psychosocial impact on their lives and relationships. Yet, there is a limited qualitative world literature investigating the psychosocial experience of prostate cancer, and almost no literature exploring how masculinity mediates in such an experience. This paper will suggest that the experience of prostate cancer, the process by which it is investigated, and the way in which it is understood has been shaped by an essentialist interpretation of gender, exemplified by hegemonic masculinity as the archetypal mechanism of male adaptation. In response to this static and limiting view of masculinity, this paper will offer a reframe of hegemonic masculinity. This reframe, being more aligned with common experience, will portray masculinity as a dynamic and contextual construct, better understood as one of a number of cultural reference points around which each man organises and adopts behaviour. It will be suggested that the extant literature, in being organised around hegemonic masculinity, obfuscates the experience of prostate cancer and acts to render covert any collateral masculinities, public or private, that may also be operating.

Adaptation, Psychological↗

PubMed2005

Evaluation of a nurse education workshop on children's grief.

This paper provides an overview of the development and evaluation of an educational program to increase the knowledge of hospice and paediatric nurses who support grieving children and improve their attitudes toward death and bereavement. The specific target groups for the project included nurses providing care through community-based hospice services and inpatient palliative care units, as well as nurses providing inpatient and community-based care at a children's teaching hospital. Fifty-nine nurses from hospice, community and inpatient settings participated in three workshops. Results indicated that the workshop produced a sustained improvement in bereavement knowledge among the nurses and an improvement in their attitudes toward death and bereavement.

Adolescent↗

PubMed2004

A Delphi study on research priorities for emergency nurses in Western Australia.

INTRODUCTION: The Delphi Study on Research Priorities for Emergency Nurses in Western Australia Project was designed to allow emergency nurses to design research questions and then rank them in order of priority. METHODS: A qualitative methodology allowed the researchers to determine expert opinions from the membership of the Emergency Nurses Association of Western Australia to reach a general consensus related to research questions. RESULTS: The results placed nurse-initiated analgesia as the top research priority, with ED staffing issues in second place and ED violence issues in third place. In all, 25 research questions were developed and ranked according to priority. DISCUSSION: Development of these ranked research questions enables researchers not only to pick a research question "off the shelf" but also to be assured that the research question is clinically relevant and is a priority for practicing emergency nurses. These attributes will encourage potential researchers to conduct studies, but they also underscore the importance of the topics for the benefit of those who fund studies.

Adult↗

PubMed2003

The parenting competency framework: learning to be a parent of a child with asthma.

Every parent who faces an illness in their child might doubt their competence to care. When a chronic illness is diagnosed, competence can be severely challenged because of the sustained and multiple disruptions to daily life. A conceptual framework entitled 'Learning to be a Parent of a Child with Asthma' was developed from the results of a descriptive phenomenological study completed in Perth, Western Australia. It describes the stages of challenges to competency that parents experience as they learn to care for their asthmatic children. The impact of this illness on parents and the extent to which they are able to help their children respond to the demands of asthma are critical components in understanding the effect of this disease on parental competency. Insight into parental competency and the relationship to chronic illness will help health professionals provide the support and information needed by parents to manage asthma in their children.

Adaptation, Psychological↗

PubMed2003

Human research ethics committees: issues in palliative care research.

Palliative care research is fraught with many difficulties. There are challenges associated with conducting research with vulnerable patients and families, difficulties with obtaining informed consent, and methodological complexities. Thoughtful construction of research protocols may overcome many of these problems. However, researchers may be powerless to overcome the discomfort of members of human research ethics committees (HRECs) who disallow access to palliative care patients and families. The notion of conducting research with this group is often perceived as abhorrent by those who do not practise in palliative care. This is because of a persistent idea that dying people and their families are so burdened by the dying process and so vulnerable to exploitation that they should not be approached to be involved in research. This over-protectiveness regarding palliative care research often distorts the proper gate-keeping role of HRECs and health-care professionals. This article draws on the authors' experiences of presenting applications to HRECs over the last 20 years. It explores the responsibilities of HRECs, the responsibilities of palliative care researchers and the rights of patients and families. HRECs and health professionals who endeavour to undertake palliative care research are encouraged to reflect and re-examine the role of ethics committees.

Attitude of Health Personnel↗

PubMed2002

Dignity in the terminally ill: a developing empirical model.

Despite use of the term dignity in arguments for and against a patient's self-governance in matters pertaining to death, there is little empirical research on how this term has been used by patients who are nearing death. The objective of this study was to determine how dying patients understand and define the term dignity, in order to develop a model of dignity in the terminally ill. A semi-structured interview was designed to explore how patients cope with their advanced cancer and to detail their perceptions of dignity. Interviews were audiotaped and transcribed verbatim. A consecutive sample of 50 consenting patients with advanced terminal cancer were recruited over a 15-month period of time from an urban extended care hospital housing a specialized unit for palliative care. This unit provides both inpatient services. and coordinates end-of-life care community based programming. Data were analysed using latent content analysis and constant comparison techniques. Four members of the research team independently coded the transcribed data, to develop conceptually meaningful categories of responses. Operational definitions were written for major categories, themes and sub-themes. Three major categories emerged from the qualitative analysis, including illness-related concerns; dignity conserving repertoire; and social dignity inventory. These broad categories and their carefully defined themes and sub-themes form the foundation for an emerging model of dignity amongst the dying. The concept of dignity and the dignity model offer a way of understanding how patients face advancing terminal illness. This will serve to promote dignity and the quality of life of patients nearing death.

Activities of Daily Living↗

PubMedDate not supplied

Neuromotor development and the physiologic effects of positioning in very low birth weight infants.

OBJECTIVE: To provide a comprehensive literature review of neuromotor development and related physiologic effects of positioning in very low birth weight infants. DATA SOURCES: MEDLINE, CINHAL, Health Star, Current Contents, and the Australian Medical Index (1966-2000) databases were searched. Unpublished studies (e.g., dissertations, conference proceedings) and all relevant references listed in articles also were examined. STUDY SELECTION: One hundred and eighty theoretical writings, research studies, and clinical papers related to neuromotor development, the physiologic effects of positioning, and interventions to minimize or prevent short- and long-term effects of positioning in very low birth weight infants were reviewed. DATA EXTRACTION: Studies were assessed for scientific rigor, evidence of theoretical foundation, and clinical relevance. Comparisons were made across data sources to determine the most reliable, valid, and consistent findings. DATA SYNTHESIS: Three compelling results emerged: (a) The development of posture and mobility in newborn infants requires an optimal balance between active and passive muscle tone, (b) the prone position is physiologically more beneficial for the preterm infant than supine and lateral positions, and (c) the prone position can lead to short- and long-term postural and associated developmental problems. CONCLUSION: Use of empirically tested postural interventions appropriate for an infant's gestational age, health status, and overall organizational capacity is recommended.

Child Development↗