Biomedical subjects

Wendy Moyle

Publications and source records attributed to Wendy Moyle.

At least 19 recordsLinked to original sources

PubMed2006

Solution focused nursing: an evaluation of current practice.

This Australian study explored the extent to which solution focused nursing (SFN), a new philosophy of care underpinning a Bachelor of Nursing Programme, was understood by students and staff. Students and faculty perceptions of teaching and learning were explored using survey and semi-structured interview methods. The results showed that students did not have strong views about whether solutions or problems contribute best to a definition of nursing knowledge, but there were some differences between the year groups. This was hypothesised to be related to the way SFN is or is not being taught. Teachers were generally positive about SFN but perceived that they needed more education on the philosophy to ensure it could be translated into their teaching. A teaching and learning package is recommended to be produced and made available to all teachers within the program.

Adolescent↗

PubMed2006

Solution focused teaching: a transformative approach to teaching nursing.

Nurses work in complex health care systems, which today are based not only on medical treatment and cure, but also on enabling individuals and strengthening communities. This paper describes a curriculum approach to teaching nursing in an Australian university which seeks to prepare students for this environment. Underpinned by transformative education principles, and termed Solution Focused Nursing, specific teaching and learning strategies are discussed. A goal is to cultivate critical thinkers and knowledge workers, that is, nurses who are not only able to work skillfully, strategically, and respectfully with clients, but who also demonstrate discernment, optimism, and vision about nursing and health care.

Australia↗

PubMed2006

Long-term mechanical ventilation in a critical care unit: existing in an uneveryday world.

AIM: This paper reports a study to describe and interpret the meaning of being on long-term mechanical ventilation. BACKGROUND: Patients who require mechanical ventilation in a critical care unit for prolonged periods of time are typically sicker than those who are ventilated for shorter periods. Despite advances in treatment modalities for critically ill patients, many still require long-term mechanical ventilation for 7 days or more. Therefore, caring for a long-term ventilated patient is often an everyday occurrence for critical care nurses; however, there is insufficient evidence of the meaning of this experience from a patient perspective. METHOD: We used an ontological phenomenological approach informed by the ideas of Heidegger. Data were collected using unstructured audio-taped interviews with nine former patients from critical care units unit in Queensland, Australia. The data were collected between January 2000 and December 2001 and analysed thematically using the method developed by van Manen. FINDINGS: Thematic analysis revealed four themes. This paper presents the findings from the theme titled 'existing in an uneveryday world', which revealed what it meant for participants to exist, live through and survive the many physiological and psychological effects arising from their critical illness episode. For the most part, this was an unpleasant and frightening experience that involved bizarre nightmares and inability to distinguish time, place and the familiar body; disagreeable effects from the technology used and patient care activities; and reliance on external agents for survival. In addition, participants reported how they questioned their chances of surviving the critical illness ordeal. CONCLUSION: There is a need for further research in the areas of sedative and analgesic management in critically ill patients, methods of communicating with intubated and mechanically ventilated patients, and debriefing and follow-up support services for survivors.

Adult↗

PubMed2006

An exploration of modifiable health associated risk factors within a cohort of undergraduate nursing students.

So-called diseases of affluence, otherwise known as 'lifestyle diseases', are attributed to modifiable risk factors that are influenced by lifestyle and personal behaviour. Leading by example is an important way for public health principles to be communicated. In the university context, students of nursing can become aware of the challenge to integrate and apply health principles in their own life so that they become responsible health leaders in the community. The aim of this study was to explore the incidence of a number of behaviour-associated health risk factors within a group of undergraduate nursing students. Ninety-four students participated in the study. Seventy-seven students (82%) reported the presence of at least one modifiable health risk factor. Forty-four percent of respondents were either overweight or obese. Further research to explore whether a health promoting curriculum encourages nursing students to internalise/apply health knowledge to their own lives is recommended. A campaign of public health might be useful within the university community to educate students about risk factors and healthy living.

Adolescent↗

PubMed2005

Effectiveness of a counseling intervention after a traumatic childbirth: a randomized controlled trial.

UNLABELLED: Adverse childbirth experiences can evoke fear and overwhelming anxiety for some women and precipitate posttraumatic stress disorder. The objective of this study was to assess a midwife-led brief counseling intervention for postpartum women at risk of developing psychological trauma symptoms. METHOD: Of 348 women screened for trauma symptoms, 103 met inclusion criteria and were randomized into an intervention (n = 50) or a control (n = 53) group. The intervention group received face-to-face counseling within 72 hours of birth and again via telephone at 4 to 6 weeks postpartum. Main outcome measures were posttraumatic stress symptoms, depression, self-blame, and confidence about a future pregnancy. RESULTS: At 3-month follow-up, intervention group women reported decreased trauma symptoms, low relative risk of depression, low relative risk of stress, and low feelings of self-blame. Confidence about a future pregnancy was higher for these women than for control group women. Three intervention group women compared with 9 control group women met the diagnostic criteria for posttraumatic stress disorder at 3 months postpartum, but this result was not statistically significant. DISCUSSION: A high prevalence of postpartum depression and trauma symptoms occurred after childbirth. Although most women improved over time, the intervention markedly affected participants' trajectory toward recovery compared with women who did not receive counseling. CONCLUSIONS: A brief, midwife-led counseling intervention for women who report a distressing birth experience was effective in reducing symptoms of trauma, depression, stress, and feelings of self-blame. The intervention is within the scope of midwifery practice, caused no harm to participants, was perceived as helpful, and enhanced women's confidence about a future pregnancy.

Adult↗

PubMed2005

An investigation of aged care mental health knowledge of Queensland aged care nurses.

Older people are at risk for developing psychiatric disorders and require highly skilled and knowledgeable nurse practitioners to provide early recognition and intervention of psychiatric problems. This study sought to identify the aged care mental health knowledge of registered nurses (RNs) employed in long-term aged care and test the validity and reliability of a North American tool for use in an Australian context. The Mary Starke Harper Ageing Knowledge Exam (MSHAKE) was sent to RNs (n = 350) in 70 long-term care facilities (LTCF) in Queensland, Australia, and 107 surveys were returned (30.5% response). Participants were found to be unprepared for the reality of caring for the mental health needs of an older population and to have knowledge deficits related to suicide, prevalence of mental illness, mental health and ethnicity, and a number of issues regarding dementia.

Adult↗

PubMed2004

Breastfeeding duration in an Australian population: the influence of modifiable antenatal factors.

Despite well-documented health benefits of breastfeeding for mothers and babies, most women discontinue breastfeeding before the recommended 12 months to 2 years. The purpose of this study was to assess the effect of modifiable antenatal variables on breastfeeding outcomes. A prospective, longitudinal study was conducted with 300 pregnant, Australian women. Questionnaires containing variables of interest were administered to women during their last trimester; infant feeding method was assessed at 1 week and 4 months postpartum. Intended breastfeeding duration and breastfeeding self-efficacy were identified as the most significant modifiable variables predictive of breastfeeding outcomes. Mothers who intended to breastfeed for < 6 months were 2.4 times as likely to have discontinued breastfeeding at 4 months compared to those who intended to breastfeed for > 12 months (35.7% vs 87.5%). Similarly, mothers with high breastfeeding self-efficacy were more likely to be breastfeeding compared to mothers with low self-efficacy (79.3% vs 50.0%).

Adolescent↗

PubMed2004

Mental health knowledge in residential aged care: a descriptive review of the literature.

Health care staff knowledge of mental health is vital in the provision of quality care for older people in residential aged care settings. This paper aims to describe mental health knowledge competence of health care staff in residential aged care through a review of existing literature and to explore the link between knowledge, attitudes and education about older people and mental health. A literature review was conducted using electronic databases and library catalogues to identify articles published in English during the period 1982-2002. There is insufficient evidence within the literature to draw conclusions about staff knowledge levels in relation to mental health, however, the literature identified a link between continuing education, knowledge levels and staff attitudes to older people with mental health disorders. Future studies are needed to investigate existing levels of mental health knowledge among health care staff in residential aged care and to identify and evaluate strategies to enhance their ability to provide care for this population.

Aged↗

PubMed2003

Psychometric characteristics of the breastfeeding self-efficacy scale: data from an Australian sample.

Many new mothers discontinue breastfeeding prematurely because of difficulties encountered rather than maternal choice. Research has shown that a significant predictor of breastfeeding duration is a mother's confidence in her ability to breastfeed. To measure breastfeeding confidence, the Breastfeeding Self-Efficacy Scale (BSES) was developed and psychometrically tested at 1 week postpartum. The purpose of this methodological study was to psychometrically test the BSES antenatally and at 1 week and 4 months postpartum in a sample of Australian women and to determine predictive validity. The psychometric assessment of the original BSES study was replicated, including internal consistency, principal components factor analysis, comparison of contrasted groups, and correlations with a similar construct. Support for predictive validity was demonstrated through positive correlations and significant mean differences between antenatal BSES scores and infant-feeding method at 1 week and 4 months postpartum. The BSES is now considered ready for both research and clinical use (a) to identify new mothers with low breastfeeding confidence who require additional assistance, (b) to assess breastfeeding behaviors and cognitions in order to have individualized confidence-building strategies, and (c) to assist in the evaluation of various nursing interventions.

Adult↗

PubMed2003

Traditional postpartum practices among Thai women.

BACKGROUND: Culture is often related to notions of well-being, illness, healing and health that inform individuals in their day-to-day activities. The postpartum period is noted for traditional practices related to rest, healing and the consumption of food and drinks, but a contemporary view of these practices is needed. AIMS: To gain an understanding of the traditional practices that Thai women follow in relation to postpartum care and the rationales underpinning such practices. METHODS: This descriptive study surveyed 500 Thai women living in Ubon Ratchathani, Thailand and attending their first postpartum hospital clinic appointment. A self-completion questionnaire was specially developed and pilot tested, and then administered to women attending the clinic. DATA ANALYSIS: Descriptive statistics were used in relation to the incidence of particular behaviours. Chi-square analyses were conducted to determine relationships between demographic characteristics and traditional practices. RESULTS: The majority of Thai women adhered to traditional postpartum practices related to the notion of regaining 'heat'. These included 'lying by fire', food restrictions, taking hot baths and consuming hot drinks. Other activities involved not exposing the body to heat loss by keeping covered, not shampooing the hair, avoiding the wind and sexual abstinence. Younger, less educated, primiparous women were more likely to report traditional practices. Mothers and mothers-in-law were most influential in recommending these behaviours. CONCLUSIONS: Traditional postpartum practices are still dominant in contemporary Thai culture and are perpetuated by close female family relatives. Health professionals need to be aware of clients' culture and consider the extent to which professional care complements the mothers' traditional beliefs. Nurses need to educate women about the benefits of contemporary postpartum care and to provide strategies to help them to integrate their beliefs and the practices recommended in contemporary health care practice.

Adolescent↗

PubMed2003

Thai nurses' beliefs about breastfeeding and postpartum practices.

Cultural beliefs are important determinants of health care behaviours. Nurses have an important influence on infant feeding decisions and maternal postpartum care, but little is known about the extent to which their practice is influenced by traditional beliefs and/or recent innovations driven by evidence-based research. The aim of this study was to investigate Thai nurses' traditional beliefs about breastfeeding and related postpartum care, and their impact on nursing practice. A survey of 372 nurses working in hospitals and health services in Ubon Ratchathani, Thailand was undertaken. Questionnaire items were developed from a review of the literature and exploratory interviews with Thai women. Descriptive statistics were used to represent the incidence of particular beliefs and behaviours. Chi-square analyses were conducted to determine relationships between demographic characteristics and traditional beliefs and practices. There were discrepancies between nurses' beliefs and contemporary evidence-based practices. Many nurses supported traditional Thai postpartum practices such as food restrictions and encouraging hot baths. Some traditional beliefs supported by nurses may be detrimental to women and babies such as "lying by fire", discarding of colostrum, and giving boiled water to neonates. Only half the nurses reported that they encouraged mothers to breastfeed immediately following birth. The study was undertaken in the North-East of Thailand, where the population is known to have strong belief systems. Reliability and content validity of the tool would be enhanced through replication studies and qualitative investigations of other breastfeeding issues. There is a need for professional development strategies such as peer review and mentoring to address inadequate knowledge and outdated practices of some health professionals, as well as continuity of care models to assess quality care outcomes that are culturally appropriate.

Adult↗

PubMed2003

Views of job satisfaction and dissatisfaction in Australian long-term care.

The existing job satisfaction literature has tended towards an overemphasis on job satisfaction instruments. In the study reported here the views of 27 nurses and assistants-in-nursing, collected through focus group interviews, were examined to determine the factors that contribute to workplace satisfaction and dissatisfaction in long-term care of older people. Content analysis of focus group interview data revealed that job satisfaction was related to workplace flexibility, residents, working within a team environment and dedication to the service of optimal resident care. Dissatisfaction was linked to working with unskilled or inappropriately trained staff, laborious tasks such as documentation, staffing levels, tensions within role expectations and the increasing need to be available for overtime. In spite of different role expectations, long-term nursing home care is reported to be a very satisfying area in which to work. However, care managers need to put in place strategies for building improved job satisfaction and workplace incentives to encourage graduates to consider long-term care opportunities. Limitations of the study include the small number of participants, bias towards one organization and lack of generalizability of the results. However, the findings confirm many earlier job satisfaction studies and further support the need to consider these issues in relation to recruitment and retention in long-term care.

Adult↗

PubMed2003

Nurse-patient relationship: a dichotomy of expectations.

The nurse-patient relationship has traditionally been viewed as the essence of nursing practice. This paper disputes that the ideals of such a relationship occur effortlessly in nursing practice. Findings from a phenomenological study of individuals hospitalized with a depressive illness found that a therapeutic relationship did not come instinctively to the mental health nurses, and that there was a dichotomy between the close relationship expected by patients and the distant relationship provided by nurses. It is unclear whether nurses' distancing behaviour was as a result of the participant's depressive illness, a normal part of nursing practice, or whether other features such as nurses' workloads were an influencing factor. Further research is required to explore this issue.

Depressive Disorder↗

PubMed2002

The postmodern heart: a discourse analysis of a booklet on pacemaker implantation.

This paper provides a deconstructive reading of an education booklet aimed at patients who may be scheduled for permanent cardiac pacemakers, and argues that pacemaker implantation is being constructed as a routine, uncomplicated procedure. The way language and image in the booklet convey a dominant preferred perspective on pacemaker implantation will be questioned. Some of the major issues explored are: the patient is stereotyped as a male patriarch; the fundamental right of informed choice is omitted; the ownership of decision-making is given to the physician; and the cardiac pacemaker is portrayed as remarkable and trouble-free. Implications for the meaning of these dominant perspectives for nursing practice are explored.

Australia↗

PubMed2002

Unstructured interviews: challenges when participants have a major depressive illness.

BACKGROUND: There is debate about undertaking sensitive research with vulnerable populations. Primarily, the literature has focused on informed consent, confidentiality and the principle of beneficence, with little discussion about data collection methods. AIM: This paper discusses the challenges of conducting unstructured interviews when participants have a major depressive illness. Issues arose during a phenomenological study that explored the meaning of being nurtured with seven people who were hospitalized for depression. FINDINGS: The depressive illness and treatment were found to impact on participants' articulation and recalling of their experience, and raised ethical concerns about their informed consent. Personal engagement with participants raised the ethical issue of research vs. therapy. Furthermore, participants being in a hospital complicated the necessity for privacy. The methodological issue of bracketing of assumptions was deemed to be important to 'see' the phenomenological relevance of patients' experiences. CONCLUSION: Knowledge and experience are required when conducting unstructured interviews. Debates about the challenges of unstructured interviewing needs to be highlighted in research texts to assist novice researchers. Support from an experienced research mentor would assist novice interviewers through the interview process and provide post-interview debriefing.

Confidentiality↗

PubMed2002

Nurses' attitudes towards clients who self-harm.

BACKGROUND: Deliberate self-harm is frequently encountered by emergency department (ED) nurses. However, clients are often dissatisfied with the care provided and clinicians feel ambivalent, helpless or frustrated when working with clients who self-harm. AIM: The aim of the study was to develop and test a scale to identify relevant dimensions of ED nurses' attitudes to clients who present with self-injury. METHODS: Items on Attitudes Towards Deliberate Self-Harm Questionnaire (ADSHQ) were drawn from a literature review and focus group discussions with ED nurses. The tool was piloted with 20 ED nurses not working in the target agencies. A survey of nurses working within 23 major public and 14 major private EDs in Queensland, Australia (n = 1008) was then undertaken. RESULTS: A total of 352 questionnaires were returned (35% response). Analysis revealed four factors that reflected nurses' attitudes toward these clients. The factors related to nurses' perceived confidence in their assessment and referral skills; ability to deal effectively with clients, empathic approach; and ability to cope effectively with legal and hospital regulations that guide practice. There was a generally negative attitude towards clients who self-harm. Correlations were found between years of ED experience and total score on the ADSHQ, and years of ED experience and an empathic approach towards clients who deliberately self-harm. CONCLUSION: There is a need for continuing professional development activities to address negative attitudes and provide practical strategies to inform practice and clinical protocols.

Attitude of Health Personnel↗

PubMed2002

Study of Queensland emergency department nurses' actions and formal and informal procedures for clients who self-harm.

Emergency department nurses are often required to assess and manage the needs of people who self-harm. A survey of 352 nurses working within 23 major public and 14 major private emergency departments in Queensland, Australia, investigated the extent to which formal and informal procedures are available and the extent to which these procedures guide how nurses respond to clients who present with deliberate self-harm. The Risk Assessment Questionnaire was developed and found that nurses are frequently called to respond to clients presenting because of deliberate self-harm, but most have no formal training in this area. In some services there is a lack of formal and comprehensive procedures for assessment and treatment. Where procedures do exist, significant therapeutic areas related to assessment are not explored with clients. These findings have implications for continuing professional development activities, nursing education programs and clinical practice procedures.

Emergency Nursing↗

PubMed2002

Effect of maternal confidence on breastfeeding duration: an application of breastfeeding self-efficacy theory.

BACKGROUND: Although much research has focused on identifying factors that influence breastfeeding initiation and duration, many high-risk factors are nonmodifiable demographic variables. Predisposing factors for low breastfeeding duration rates that are amenable to supportive interventions should be identified. The purpose of this study was to assess the effect of maternal confidence (breastfeeding self-efficacy) on breastfeeding duration. METHOD: A prospective survey was conducted with 300 women in the last trimester of pregnancy recruited from the antenatal clinic of a large metropolitan hospital in Brisbane, Australia. Telephone interviews were conducted at 1 week and 4 months postpartum to assess infant feeding methods and breastfeeding confidence using the Breastfeeding Self-Efficacy Scale. RESULTS: Although 92 percent of participants initiated breastfeeding, by 4 months postpartum almost 40 percent discontinued and only 28.6 percent were breastfeeding exclusively; the most common reason for discontinuation was insufficient milk supply. Antenatal and 1-week Breastfeeding Self-Efficacy Scale scores were significantly related to breastfeeding outcomes at 1 week and 4 months. Mothers with high breastfeeding self-efficacy were significantly more likely to be breastfeeding, and doing so exclusively, at 1 week and 4 months postpartum than mothers with low breastfeeding self-efficacy. CONCLUSIONS: Maternal breastfeeding self-efficacy is a significant predictor of breastfeeding duration and level. Integrating self-efficacy enhancing strategies may improve the quality of healthcare that healthcare professionals deliver and may increase a new mother's confidence in her ability to breastfeed, and to persevere if she does encounter difficulties.

Adult↗