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Sally Borbasi

Publications and source records attributed to Sally Borbasi.

17 recordsLinked to original sources
PubMed2005

Nursing research programs gather strength in Australia.

To shed light on programmatic research through direct experience is highly beneficial to nursing scholarship. Following a recent description of a successful Australian program of research centered around people's chronic illness experience we are inspired to continue the commentary (Koch et al 2005). Koch et al's (2005) case study reported on several 'core elements' they believe have contributed to the growth and effectiveness of their program. In this paper we consider some of these in light of current literature and our own challenging experiences within several Australian universities. Koch et al (2005) also makes a not too subtle distinction between dedicated research units independent of universities and research programs emanating from academia, suggesting the former are more productive. While one of the authors in the above paper, a UK scholar and nursing academic, makes interesting observations about this assertion, we contend that his UK perspective fails to capture the urgency of establishing nursing research programs in Australian universities. Consequently, we have chosen to extend the discussion about nursing research programs from the perspective of Australian academe, including comment on building productive relationships, strengthening a track record, research and practice as symbiotic processes, competitive funding strategies, and the integral role of research students. The entire commentary is located in a celebratory context of 20 years of Australian nursing education in the university sector, a context not without controversy. We give consideration to the best way ahead for the future of nursing research programs and hope our ideas spark further sharing of experiences.

Australia↗
PubMed2005

Fieldwork in nursing research: positionality, practicalities and predicaments.

AIMS: This paper draws on the literature to explore some of the issues of concern to nurses undertaking fieldwork in contemporary healthcare settings. BACKGROUND: The emergence of poststructuralist and postmodern perspectives has raised questions about ethnographic approaches, and problematized the role of researchers in the construction of plausible and credible ethnographic accounts. As a practice discipline, nursing needs to negotiate a thorny path between methodological purity and practical application, with nurse researchers required to take account of both philosophical and pragmatic concerns. DISCUSSION: There is general agreement that researching with an individual or group rather than researching on an individual or group is the more effective way to approach fieldwork. Feminist writers appear to have dealt with this issue best, advocating intimacy, self-disclosure, and reciprocity in encounters with research participants. The duality of the nurse researcher role; power and politics and the moral implications of fieldwork are acknowledged as factors influencing nurses in the planning and conduct of fieldwork. Nurses as researchers may be better equipped than other social researchers to deal with contingencies in the field. CONCLUSIONS: Laying the epistemological ground for the participant observer role during fieldwork and understanding its impact on the resultant ethnographic account is essential to methodological rigour in field research. Consideration of some of the practicalities and predicaments experienced by nurses as researchers when conducting fieldwork prior to going out into the field is an important research strategy and will facilitate methodological potency.

Anthropology, Cultural↗
PubMed2002

Effect of support programme to reduce stress in spouses whose partners 'fall off' clinical pathways post cardiac surgery.

Cardiac surgery is flourishing in today's health care industry and looks to prosper well into the future. More than ever, improved technology, surgical skill and the worldwide trend of increasing longevity means that surgical intervention is offered to patients rarely seen in cardiac units in previous years. Patients are now much older, with multiple co-morbidity including repeat cardiac surgery. In line with advances in cardiac surgery, critical pathways to map the expected recovery route for the patient have been introduced. These maps are used extensively as guides for treatment and care. It is not only health professionals who use the pathways; patients and their relatives also refer to them as indicators of a 'normal' post-operative route. As a result, the critical pathway provides an avenue for expectations of predicted progress through to discharge. These predictors appear to give spouses hope, access to earliest possible visitation and confidence in a positive outcome. Nevertheless, it has recently become increasingly clear that for partners of patients who fail to proceed as expected, who apparently 'fall off' the predicted road to recovery, the critical pathway is problematic. Partners of such patients tend to demonstrate greatly heightened anxiety and nurses often have to deal with them at the point of crisis. In the cardio-thoracic unit at which this study was undertaken, the significant number of spouses who ended up in crisis drew attention to the need for additional support to be built into the post open-heart surgery critical recovery pathway. This study sought therefore to examine how nurses might assist spouses to adapt in the event of a complicated recovery following bypass surgery. A convenience sample of 39 spouses of cardiac surgical patients admitted to the cardio-thoracic recovery unit was obtained to assess stress responses at a critical post-operative data point, 5 days post-surgery. A symptoms of stress inventory was used to measure 94 items of physiological stress in 10 specific subscale categories. As a result of this study, it was found that incorporating a spousal support programme into the critical pathway of open-heart surgical patients significantly reduced stress suffered by spouses of patients who deviated from pre-determined recovery goals. The findings suggest that nurses need to understand the implications of the critical pathway and provide families with information concerning issues associated with complicated recovery. An unexpected finding of the study pointed to an apparent difference in the stress experienced by male spouses to that of female spouses. Recommendations from this study are to further explore the qualitative component of the stress felt by spouses and the negative association of stress with morbidity and mortality for women and patients without spouses. Nurses need to consider developing and implementing a stress management programme for spouses, establishing spousal support groups and exploring the possibility of incorporating spousal support strategies into the critical pathways of patients across hospital settings.

Adult↗
PubMed2002

Nursing and the 21st century: what's happened to leadership?

This paper has stemmed from several conversations between the authors over recent times about the current state of leadership in nursing. The authors believe a lack of effective leadership has much to do with the times in which we live. As a result, this paper explores leadership against a backdrop of social and political change and seeks to revise the concept in light of 21st century developments. The demise of leadership is discussed and ideas about the emergence of new leadership brought to light. Finally the need for nurses and nursing to shake off the depressive effects of economic rationalism, join forces and unite for a cause is recommended.

Australia↗
PubMed2002

Our interest is swelling: a collaborative venture to establish the world's first free public screening for lymphoedema.

This article describes the collaborative processes involved in the implementation of a free public health screening program for people at risk of lymphoedema following the removal of lymph nodes during surgery to control breast, prostate and other cancers, or injury. The planning phase of the program is described with emphasis on the need to secure a well situated venue, the commitment of a cohort of key health professionals, service club and lay volunteers, and the need to carefully target and publicise the event widely. The implementation phase requires careful consideration of the physical layout of the event, the direction and management of the flow of human traffic, information and equipment requirements, and recognition that screening programs place people in vulnerable positions. Effective communication skills are essential, as is a knowledge of where people can be referred should the need arise. A budget is provided together with discussion regarding the success of the program and recommendations for future consideration such as the need to target men to attend screening and for long term follow up of the outcomes.

Australia↗
PubMed2002

Measuring the outputs of Australian nursing research published 1995-2000.

AIMS: To analyse the research published in refereed nursing journals by Australian authors from 1995 to 2000. BACKGROUND: Analysis of the research topics and types of methodologies used by Australian nurse researchers has not been recently undertaken. The study was similar to an analysis of United Kingdom (UK) nursing research between 1988 and 1995 to allow comparison between the two countries. DESIGN: A quantitative approach analysed the research abstracts for the topic researched, source of data, location of data collection, paradigm and methodology used and funding source. RESULTS: A total of 509 articles from 11 generalist Australian and UK nursing journals were analysed. The highest numbers of articles were published in Australian Journal of Advanced Nursing and Journal of Advanced Nursing. The most popular topics were education of nurses (18.7%, n=95) and practice issues relating to patient care (15.3%, n=78). However, scant attention was paid to major Australian health issues. Most research was undertaken in the hospital setting (55.8%, n=247). Data were most often drawn from nurses themselves (40.7%, n=206), followed by patients (25.5%, n=129). Both quantitative (41%, n=203) and qualitative approaches (47%, n=230) were employed. A minority of studies acknowledged any funding (14.9%, n=76). CONCLUSIONS: Research findings need to be applied in practice to improve patient care. Nurse researchers need to publish their findings and align their research interests to meet national health priorities. They need to be involved in setting these health priorities to ensure that nursing has a place in health research.

Australia↗
PubMed2002

Continuing competence and the regulation of nursing practice.

A study commissioned by the Australian Nursing Council Inc. sought to develop an approach to the maintenance of continuing competence in nursing that is broadly acceptable to nurses in all States and Territories. The study involved a comprehensive review of the international literature and this paper provides an overview of statutory regulation of professions with particular reference to regulation of the nursing profession. A definition of competence and competencies and a discussion of beginning and continuing professional competence are presented, followed by a review of current indicators of continuing professional competence used by a variety of professions in Australia.

Australia↗
PubMed2002

More than a sore mouth: patients' experience of oral mucositis.

PURPOSE/OBJECTIVES: To explore patients' experience of chemotherapy-induced oral mucositis. DESIGN: Interpretive descriptive, phenomenologic. SETTING: The cancer center of a metropolitan teaching hospital in South Australia. SAMPLE: A purposive sample of six participants undergoing intensive cytotoxic therapy associated with autologous hematopoietic stem cell transplantation. METHODS: Patients were interviewed at different stages of their treatment trajectory and asked to relate their experience of oral mucositis as it developed and resolved. FINDINGS: Participants' reports indicated three distinct phases representing linear time in the course of their mucositis: the preparatory phase, the peak phase, and the persisting phase. Five themes further abstracted were the presence of nurses, therapeutic interventions, manifestations of mucositis, the distress of eating (and not eating), and whether the treatment was worthwhile. CONCLUSIONS: Oral mucositis is much more than a sore mouth. The effects of mucositis are widespread and can have a marked effect on patients' psychological well-being. IMPLICATIONS FOR NURSING: Care centers often focus on pain control through pharmacologic intervention and overlook the effects of other sequelae. Nurses' role in helping patients to cope with mucositis should encompass more than providing pharmacologic pain relief.

Adaptation, Psychological↗
PubMed2002

Perceptions of the researcher: in-depth interviewing in the home.

In this paper we explore the home as a setting to collect qualitative data. The text is drawn from a collaborative research initiative that sought to interview people with cardiac disease. The literature pays little attention to the home as a venue for in-depth data gathering and yet from our experience it is very different to other settings. We argue the need for extra consideration to aspects such as trust, self-disclosure and safety, and draw these conclusion from the data gathered in the field.

House Calls↗
PubMedDate not supplied

Health professionals' perspectives of providing care to people with dementia in the acute setting: Toward better practice.

This article reports an interpretative research project about the care of patients with dementia admitted to the acute setting with a non-dementia-related illness. Open-ended interviews were conducted with 25 medical, nursing, and other health care professionals drawn from 3 metropolitan teaching hospitals in Australia. Qualitative data analysis generated 5 major themes relating to the built environment and organizational "system" as determinants of practice, the influence of key players, current dementia care management, and ideal dementia care management. Results showed acute care hospitals are not the best place for people with dementia and can negatively influence health outcomes such as functional independence and quality of life. Participants reported attempts to provide best practice but experienced major constraints stemming largely from environmental, sociocultural, and economic issues. Recommendations include the delivery of acute services in tandem with dementia services and a whole organization shift in thinking away from what conveniently suits the institution to thinking that is person-centered and dementia-friendly. With support from executive-level management, nurses can play a leading role in the implementation of practice change.

Activities of Daily Living↗
PubMedDate not supplied

When all else has failed: Nurses' perception of factors influencing palliative care for patients with end-stage heart failure.

The purpose of this study was to describe registered nurses' (RNs') perceptions of factors influencing care for patients in the palliative phase of end-stage heart failure (ESHF). Seventeen senior RNs across 3 acute care and 5 community centres in metropolitan Adelaide, Australia, participated in the study. In this descriptive, exploratory research project, we analyzed audiotaped indepth, semistructured interviews, using a computer-assisted (NVIVO) thematic procedure. According to participants, the care of patients with ESHF is dominated by a focus on symptom management and optimal pharmacologic therapies, with a perceived deficit in other aspects of palliative management. Key mitigating factors against quality palliative care for this population included the difficulty in recognising ESHF and reluctance by physicians to negotiate end-of-life decisions. In the acute care sector, nurses believed ESHF was medicalized and characterized by paternalistic care, with treatment generally curative to the last breath. Nursing care and patient advocacy were also negatively influenced by a lack of awareness in patients and families concerning the inevitability of death in ESHF until the last few days or hours before death. Involvement of the palliative care team was often an afterthought rather than an integral component of care. Nurses in acute care settings embraced the concept of a multidisciplinary team approach, but stressed the need for the cardiac team to be the overall coordinator of care for the ESHF population. Care of patients with ESHF should promote the amalgamation of technological and pharmaceutical advances in the treatment of heart failure with more timely end-of-life care. All involved parties must work toward advancing a common middle ground for appropriate end-of-life care for patients with ESHF. Recommendations for practice include the need for greater education for patients and their families and greater collaboration between the members of the multidisciplinary healthcare team to assist patients with ESHF and their families prepare more timely for the final trajectory of the illness.

Adult↗
PubMedDate not supplied

Dementia related aggression in the acute sector: is a Code Black really the answer?

OBJECTIVE: This paper presents the findings of one facet of a larger study that explored the management of people with dementia as inpatients of acute care. The aim of the study is to provide a comprehensive multiprofessional view of the experience of providing care to people with dementia in an acute setting. DESIGN: Descriptive exploratory study. SETTING: Three acute care hospitals in South Australia. PARTICIPANTS: 25 health professionals who regularly provided care to people admitted to hospital with concurrent dementia. RESULTS: The information gathered provided a rich understanding of the frailty, dependency and unpredictable behaviour of people living with some form of dementia and how that creates tensions in a place that is environmentally, culturally and resourcefully bereft of what is required for truly effective care. CONCLUSION: The study showed that people with dementia are increasingly being admitted to hospital across almost every specialty and that many staff are ill prepared for meeting their needs. The heavily medically dominated environment of an acute care system lends itself to increased confusion and agitation in these people that may rapidly escalate to aggression and violence. Due to various shortfalls in that system, staff will often resort to restraint in managing disruptive behaviour--which is not in the best interest of the patient or the health care system. The way forward is to foster a multifactorial approach to a 'dementia friendly' system of care supported by education.

Acute Disease↗
PubMedDate not supplied

Measuring the outputs of nursing research and development in Australia: the researchers.

It is vital for nurses to publish in order to provide evidence of their practice and to increase the knowledge base of their discipline. This paper is one of two that reports on an investigation of the nursing research published by Australian authors from 1995-2000 in 11 nursing journals based in Australia, the UK and the USA. The focus of this article is on the researchers drawn from a total of 509 articles that were content analysed and categorised according to topics of research, paradigm, methods used and funding acknowledgment. The researchers were analysed on the basis of gender, discipline, employment base and location. Publications had from one to 10 authors, averaging two, with 26 authors claiming 23.6% of research articles. The most common discipline area was nursing and universities were the leading area of employment. Authorship was not limited to capital cities reflecting the spread of university campuses in rural areas. Research papers made up 12.5% of possible articles, supporting the notion that few nurses publish research papers in the refereed general nursing journals we focused on.

Australia↗