Collegian - Articles in Press

Cultural challenges to secondary prevention: Implications for Saudi women - Corrected Proof

Hawazen O. Rawas, Patsy Yates, Carol Windsor, Robyn A. Clark — 2012-01-16

Abstract: Like other highly developed countries, cardiovascular disease (CVD) and coronary heart disease (CHD) are major health problems in Saudi Arabia. The aetiology of cardiovascular disease (CVD) burden within the Saudi population is similar to Western countries with atherosclerosis, hypertension, ischemic heart disease and diabetes highly prevalent with the main risk factors being smoking, obesity and inactivity. There are differences between Saudi men and women in epidemiology, risk factors and health service provision for CHD. These sex and gender based factors are important in considering the health and well-being of Saudi women. Currently, there is limited focus on the cardiovascular health of Saudi women. The aim of this paper is to examine culturally specific issues for Saudi women and the implications for secondary prevention.

Cardiovascular disease in women: Implications for improving health outcomes - Corrected Proof

2012-01-13

Summary: Objective: To collate data on women and cardiovascular disease in Australia and globally to inform public health campaigns and health care interventions.Design: Literature review.Results: Conclusions: Improvement in the prevention and management of CVD in women will require a deeper understanding of women's needs by the community, health care professionals, researchers and government.

Migration of women from the Philippines: Implications for healthcare delivery - Corrected Proof

Lourdes Marie S. Tejero, Cathrine Fowler — 2012-01-11

Summary: Filipinos have been an important part of the global workforce since the first half of the twentieth century. The initial migration of primarily men has shifted to an increasing numbers of women in recent decades. These changes are primarily attributed to a high demand for domestic workers, nurses and occupations that are female dominated. In 2005, about 70% of the international labour migrants are women from the Philippines. Living in a foreign land, these women face challenges that affect their physical, emotional and social well being. Especially on their first year living abroad, these women experience significant stress which affects their health as they adjust to a new work environment, culture, social norms, diet, and weather. The emotional strain can be greater for those who have left their families behind in the Philippines and aggravated by the financial need to send money to them. Striking examples, such as the homicide rate of Filipino women married to Australian men being 5.6 times higher than that of Australian-born women, underscores the importance of supportive health care environments and appreciating socio-cultural factors. In the delivery of healthcare services to migrant women, it is critical to consider the unique socio-cultural background of women as well as health beliefs and practices.

Interprofessional clinical education: Clinicians’ views on the importance of leadership - Corrected Proof

Karen Missen, Elisabeth R. Jacob, Tony Barnett, Lorraine Walker, Merylin Cross — 2011-11-24

Summary: The current shortage of health professionals necessitates new approaches to clinical education that can expand the number of undergraduate students undertaking clinical placements without increasing the burden on clinical staff or placing patients at risk. Interprofessional education has the potential to help increase clinical capacity whilst enriching students’ clinical experience. This paper reports on a project which investigated the potential for interprofessional education to increase undergraduate clinical placement capacity in clinical settings. The project utilised an exploratory descriptive methodology to obtain the views of health care professionals about the use of interprofessional education in clinical education at three rural health facilities in Victoria, Australia. Participants (n=57) had a key role with each health care facility in coordinating and facilitating undergraduate clinical placements. This paper examines the clinicians’ views about the central role that leadership plays in actioning interprofessional education in the clinical setting. Whilst interprofessional education was regarded favourably by the majority of participants, data indicated that leadership from education providers, health services, and regulatory authorities was crucial to enable interprofessional education to be implemented and sustained within the clinical learning environment. Without leadership from each of these three spheres of influence, interprofessional education will continue to be difficult to implement for undergraduate students and compromise their exposure to an important aspect of the working life of health care professionals. Such a failure will limit graduates’ readiness for collaborative and cross-disciplinary practice.

Autobiography as genre for qualitative data: A reservoir of experience for nursing research - Corrected Proof

Tamara Power, Debra Jackson, Roslyn Weaver, Lesley Wilkes, Bernie Carter — 2011-11-10

Summary: This paper is concerned with the use of published literary autobiographies that contain first-hand accounts of illness narratives, to explore their usefulness as a form of qualitative data to generate knowledge that can inform nursing practice. There is increasing realisation that the experiences of patients and families should be used to guide health care service delivery, and autobiographical accounts are a valuable resource, providing first-hand accounts of the ways illness, disability, and health care, are experienced by patients and their families.

Stigma and stereotypes: Women and sexually transmitted infections - Corrected Proof

Leah East, Debra Jackson, Louise O’Brien, Kathleen Peters — 2011-11-10

Summary: Sexually transmitted infections have long been associated with stigma and stereotypes due to their very nature. Throughout history sexually transmitted infections have been associated with female prostitution and deviant immoral behaviour making women who contract these infections particularly vulnerable to being stigmatised and stereotyped. Although the stigma attached to such infections has previously been documented in the literature, the aim of this research was to gain in depth insight into young Australian women's experiences of having a sexually transmitted infection from a feminist perspective. Findings from this study provide insight into the onerous effects stigma can have on women with these infections and sheds light on how these effects can influence self-perceptions, fear of rejection and feelings of unworthiness. These findings can provide nurses with greater understanding and insight into the effects of stigma on women's experiences of having a sexually transmitted infection. Having this understanding and insight has the potential to promote therapeutic care and minimise the stigma that may be felt among women who have contracted this type of infection.

Supporting rural and remote area nurses to utilise and conduct research: An intervention study - Corrected Proof

Anne Gardner, Wendy Smyth, Bronia Renison, Tina Cann, Mary Vicary — 2011-10-20

Summary: Background: Nurses are expected to embrace research and evidence-based practice but in rural/remote facilities it is particularly difficult to develop and utilise research skills.Objectives: This collaborative study aimed to explore nurses’ orientation to research and address known inhibitors to engagement with research in rural/remote north Queensland locations.Participants: The sample comprised nurses from two rural/remote areas within a regional health service. Methods A pre-test post-test intervention study with two levels of data collection: responses to Edmonton Research Orientation Scale administered 3 times to all nurses, and number of research proposals developed. This intervention comprised provision of face-to-face workshops, paper-based resources, and informal videoconference, email and telephone contact.Results: Survey response rates varied from 56% to 34%. Two-thirds of respondents were over 40years old; 75% were Registered Nurses. One quarter rated understanding of journal articles as poor or very poor and 50% rated their knowledge of research similarly. However, 50% said research had changed the way they practiced. Older nurses, nurses with tertiary qualifications and those with senior appointments had more positive orientation to research scores. Several locally relevant research proposals were developed from one site; two received internal funding for further development and implementation. The intervention also led to increased utilisation of library resources which has continued past this study's end.Conclusions: The variation in uptake between sites reinforces the need for locally targeted support. This study has gone beyond measuring research utilisation by including evaluation of support mechanisms to engage nurses in developing research proposals.

Factors that affect acceptance of HIV microbicides among women - Corrected Proof

Catherine A. Domanska, Anne M. Teitelman — 2011-10-20

Summary: Globally, women make up more than half of those infected with HIV. For women in nearly every region around the world, the primary mode of HIV transmission is through heterosexual sex. However, over thirty years into the HIV/AIDS epidemic women still lack sufficient means of protecting themselves against HIV. Vaginal HIV microbicides (VHMs) are a promising new method to prevent HIV infection. VHMs are chemical substances that can destroy HIV, block its entry into or fusion with the target cell or inhibit HIV replication once the virus has entered a target cell. They can be applied through various delivery methods intravaginally. VHMs are designed to be used by women and to that end it is crucial to understand women's preferences for formulation, use and other characteristics in order to determine how to increase adherence and acceptability. Of particular consideration is how relationship dynamics will affect microbicide usage. The purpose of this review is to examine the most recent body of literature regarding male and female perceptions of VHMs to prevent male to female transmission of HIV in order to gain a greater understanding of the factors that affect adherence and acceptability of VHM usage among women. A greater understanding of the factors that affect adherence and acceptance of VHMs will have an impact on the uptake of VHMs, allow nurses and other health care providers to counsel clients more effectively about their use and point to new directions needed on the research and development of future microbicides.

Change for the better: An innovative Model of Care delivering positive patient and workforce outcomes - Corrected Proof

Tina Cann, Anne Gardner — 2011-10-17

Summary: Objective: To evaluate patient and workforce outcomes following the implementation of the Practice Partnership Model of Care.Design: Pre-test–post-test design.Setting: A 29-bed surgical ward at a tertiary-level regional hospital.Subjects: Summary de-identified data from all patients and ward nursing staff in the study period.Interventions: The Practice Partnership Model of Care has four main components: working in partnership; clinical handover at the bedside; comfort rounds; and environmental modifications. These reflect patient-centered and quality focused initiatives and use a total quality improvement framework that aims to transform care at the bedside.Main outcome measures: Patient outcomes: changes in patient safety (measured by numbers of medication errors and patient falls); satisfaction with care (use of the call bell system, number of complaints and compliments). Workforce outcomes: changes in staff satisfaction (measured through staff sick leave).Results: A statistically significant reduction in use of nurse call bells (p=<0.001) post-implementation. Medication errors and patient falls reduced, with an overall reduction of 4% in staff sick leave.Conclusions: The Practice Partnership Model of Care positively affected patient and workforce outcomes, suggesting further exploration of this model in other hospital contexts is warranted.

High Fidelity Patient Silicone Simulation: A qualitative evaluation of nursing students’ experiences - Corrected Proof

Kerry Reid-Searl, Brenda Happell, Lea Vieth, Anne Eaton — 2011-10-17

Summary: Clinical experience is recognised as a source of fear and anxiety for undergraduate nursing students. Simulated learning experiences have been identified as potentially increasing confidence, however most techniques do not always reflect clinical reality or are too costly. The aim of the current study is to explore nursing students’ perceptions of the use of High Fidelity Silicone Simulation, developed by one university academic to overcome these limitations. A simulated patient with a personal and medical history is developed and brought to life through wearing life-like silicone props including face, hands and torso. The academic is able to adapt responses to direct student learning. This paper presents the findings from a qualitative exploratory study of nursing students’ responses to this technique. Twenty-one students in second or third year of the nursing program participated in one of three focus groups to discuss their experiences. Data were analysed using a thematic approach. Data analysis revealed three main themes: preparation for clinical reality, reducing fear/increasing confidence, and taking out of comfort zone. These findings suggest that this technique has the potential to increase nursing students’ sense of preparedness for their clinical experience, thus reducing the negative impact of fear and apprehension.

Women and cardiovascular disease: At a social disadvantage? - Corrected Proof

Linda Worrall-Carter, Karen-leigh Edward, Karen Page — 2011-10-17

Summary: Background: Cardiovascular disease is the most common cause of death in Australian women. The genesis and progression of cardiovascular disease is modulated by a complex interplay of genetic, physiological, social and economic circumstances. Increasingly the impact of racial, ethic, social and economic inequalities is identified as predictors of cardiovascular disease outcome. Despite important advances over the last 30 years in reducing age adjusted mortality from cardiovascular disease, it continues to represent a major social and economic burden nationally and internationally.Aim: This paper provides a critical review of the social issues impacting upon women in Australia. It also identifies areas for future interventions with a view to improving outcomes in women with cardiovascular disease.Method: The bibliographic databases; CINAHL, MEDLINE, PsycARTICLES, were searched for relevant studies using the search terms ‘women’, ‘cardiovascular disease’, and ‘socio-economic status’.Findings: While some gains have been made in reducing the risk factor profile and rates of death from cardiovascular disease, it is clear that gender, race and socioeconomic disparities persist.Conclusions: New approaches are required to improve health differentials for CVD, and reduce the impact of gender, racial, ethic, social and economic factors on health disparities.

Issues and challenges in implementing cervical cancer screenings in the emergence of HPV vaccination in Thailand - Corrected Proof

Phanida Juntasopeepun, Patricia M. Davidson, Jatupol Srisomboon — 2011-09-19

Summary: The discovery of the HPV vaccine has been a major breakthrough in preventing cervical cancer and other HPV-related diseases around the globe. Cervical cancer is a significant public health problem in Thailand. Despite the long-time availability of cervical cancer screening programs in Thailand, the uptake among the target female population remains low. HPV vaccines were approved by the Food and Drug Administration of Thailand in 2007. As of March 2011, due to financial limitations, HPV vaccines have still not been included in the national immunization program under the public health benefit plans although individuals has the option to pay privately for the vaccine. This paper discusses the issues and challenges in implementing cervical cancer screening programs in the era of HPV vaccination in Thailand. Recommendations to increase the uptake of cervical cancer screening and further research to inform a policy regarding the cervical cancer screening measures are proposed.