Professor Patricia Davidson RN, BA, MEd, PhD is a member of the Centre for Cardiovascular and Chronic Care at the University of Technology Sydney and Professor of Cardiovascular Research at St Vincent's Hospital Sydney.
Professor Davidson has an established program of research that focuses on chronic cardiovascular disease, heart failure, palliative care for non-malignant conditions, women's health and Indigenous cardiovascular health.
She has secured over $7 million in competitive research funding from national and international funding bodies, and co-authored over 260 peer-reviewed journal articles, 18 book chapters and over 150 peer-reviewed abstracts.
A primary objective of her work has been to improve cardiovascular health of women and underserved populations through development of innovative, acceptable, and sustainable initiatives within Australia and beyond.
Professor Davidson is a Fellow of the Royal College of Nursing Australia, co-chair of the NSW Health Clinical Expert Reference Group for Cardiovascular Disease, Immediate Past President of the Australasian Cardiovascular Nursing College, Chairperson of the Cardiac Nursing Council of Cardiac Society of Australia and New Zealand, Immediate Past Secretary of the International Nursing Doctoral Education, Counsel General of the International Council on Women's Health Issues (ICOWHI) and a Board member of the National Heart Foundation (NSW).
Professor Davidson has supervised and mentored over 33 nurse researchers (since 2003), is the Editor of Collegian and is on the Editorial Board of a number of other journals including the European Journal of Cardiovascular Nursing, Heart Lung and Circulation and the Journal of Cardiovascular Nursing.
Can supervise: YES
Davidson, P.M., Halcomb, E. & Gholizadeh, L. 2013, Research methods in Health, 2nd, Oxford University Press, Australia and Newzealand.
Research Methods in Health 2nd Edition is an introductory text that shows students different research techniques and how they are of value to the health professions. The text assumes no prior knowledge and is written in an appealing student-friendly style using examples to demonstrate the relevance of research to health care practice. Written to be inclusive of all health professions, fostering a team-based approach to health care practice. Covers qualitative, quantitative and mixed method research methods. Shows how to decide which research method to use and when. Draws sensible links between evidence-based practice and research methodology. Stop & Think boxes encourage students to critically reflect on the content. Research in Practice boxes demonstrate how research can be applied in clinical practice.
Sopina, E, Chenoweth, L, Luckett, T, Agar, M, Luscombe, GM, Davidson, P, Pond, CD, Phillips, J & Goodall, S 2019, 'Health-related quality of life in people with advanced dementia: a comparison of EQ-5D-5L and QUALID instruments', Quality of Life Research.View/Download from: UTS OPUS or Publisher's site
Assessing health-related quality of life (HRQOL) in people with advanced dementia is challenging but important for informed decision-making. Proxy measurement of this construct is difficult and is often rated lower than self-report. Accurate proxy rating of quality of life in dementia is related to identification of concepts important to the person themselves, as well as the sensitivity of the measures used. The main aim of this study was to compare the performance of two instruments-QUALID and EQ-5D-5L-on measuring HRQOL in people with advanced dementia.
In a sub-study nested within a cluster-RCT we collected proxy(nurse)-completed EQ-5D-5L and QUALID measures at baseline, 3, 6, 9 and 12 months' follow-up for people with advanced dementia, residing in 20 nursing homes across Australia. Spearman's rank correlations, partial correlations and linear regressions were used to assess the relationship between the HRQOL instrument scores and their changes over time.
The mean weight from 284 people for the EQ-5D-5L and QUALID at baseline were 0.004 (95% CI -0.026, 0.033) and 24.98 (95% CI 24.13, 25.82), respectively. At 12 months' follow-up, 115 participants remained alive. EQ-5D-5L weights and QUALID scores at baseline and at follow-up were moderately correlated (r=-0.437; p<0.001 at 12 months). Changes within QUALID and EQ-5D-5L across the same follow-up periods were also correlated (r=-0.266; p=0.005). The regression analyses support these findings.
Whilst these quality of life instruments demonstrated moderate correlation, the EQ-5D-5L does not appear to capture all aspects of quality of life that are relevant to people with advanced dementia and we cannot recommend the use of this instrument for use within this population. The QUALID appears to be a more suitable instrument for measuring HRQOL in people with severe dementia, but is not preference-based, which limits its application in economic evaluations of de...
Beaman, A, Asano, R, Sibbritt, D, Newton, PJ & Davidson, PM 2018, 'Global service learning and health systems strengthening: An integrative literature review.', Heliyon, vol. 4, no. 8, p. e00713.View/Download from: UTS OPUS or Publisher's site
The sustainability of many global interventions, in the absence of adequate local financial and human resources to sustain them in the long term, is questioned. In response, there has been a shift in focus among global health actors towards the strengthening of local health systems via global service learning to effectively, efficiently and sustainably deliver healthcare and build capacity. There has been considerable research examining the benefits of global service learning experiences for students, but limited research has been conducted to determine the impact that health sciences global service learning experiences are having on the host country health systems.An integrative review of the literature was conducted to examine the linkages between global service-learning and health systems strengthening. A comprehensive search of international literature from 2005 to 2017 in PubMed, CINAHL, Embase, ERIC, Scopus and Web of Science databases was conducted. The search was limited to peer-reviewed articles published in English language. Thematic analysis revealed three key themes: a dominant service-LEARNING typology, a unidirectional pattern from high-income to low and middle-income countries, and the preeminence of the nursing discipline in global service learning. There was limited evidence on sustainability and health systems strengthening.The healthcare workforce of the future is willing to meet the challenges facing health systems across the globe. Global service-learning has yet to be examined in the context of health systems strengthening and particularly within a context of reciprocity. The onus is on higher education institutions in high-income countries to develop and deliver evidence-based global service-learning that is beneficial and engaging for students while most effectively meeting the need of the global community.
Davidson, P, Rushton, CH, Kurtz, M, Wise, B, Jackson, D, Beaman, A & Broome, M 2018, 'A social-ecological framework: A model for addressing ethical practice in nursing.', Journal of Clinical Nursing, vol. 27, no. 5-6, pp. e1233-e1241.View/Download from: UTS OPUS or Publisher's site
To develop a framework to enable discussion, debate and the formulation of interventions to address ethical issues in nursing practice.Social, cultural, political and economic drivers are rapidly changing the landscape of health care in our local environments but also in a global context. Increasingly, nurses are faced with a range of ethical dilemmas in their work. This requires investigation into the culture of healthcare systems and organisations to identify the root causes and address the barriers and enablers of ethical practice. The increased medicalisation of health care; pressures for systemisation; efficiency and cost reduction; and an ageing population contribute to this complexity. Often, ethical issues in nursing are considered within the abstract and philosophical realm until a dilemma is encountered. Such an approach limits the capacity to tangibly embrace ethical values and frameworks as pathways to equitable, accessible, safe and quality health care and as a foundation for strengthening a supportive and enabling workplace for nurses and other healthcare workers.Conceptual framework development.A comprehensive literature review was undertaken using the social-ecological framework as an organising construct.This framework views ethical practice as the outcome of interaction among a range of factors at eight levels: individual factors (patients and families); individual factors (nurses); relationships between healthcare professionals; relationships between patients and nurses; organisational healthcare context; professional and education regulation and standards; community; and social, political and economic.Considering these elements as discrete, yet interactive and intertwined forces can be useful in developing interventions to promote ethical practice. We consider this framework to have utility in policy, practice, education and research.Nurses face ethical challenges on a daily basis, considering these within a social-ecological framework can ass...
Green, A, Abbott, P, Davidson, P, Delaney, P, Delaney, J, Patradoon-Ho, P & DiGiacomo, M 2018, 'Interacting with providers: an intersectional exploration of the experiences of carers of Aboriginal children with a disability', Qualitative Health Research, vol. 28, no. 12, pp. 1923-1932.View/Download from: UTS OPUS or Publisher's site
Intersectionality has potential to create new ways to describe disparities and craft meaningful solutions. This study aimed to explore Aboriginal carers' experiences of interactions with health, social, and education providers in accessing services and support for their child. Carers of Aboriginal children with a disability were recruited from an Australian metropolitan Aboriginal community-controlled health service. In-depth, semi-structured interviews were conducted with nineteen female carers. Transcripts underwent interpretative phenomenological analysis. Intersectionality was applied as an analytical framework due to the inherent power differentials for Aboriginal Australians and carers for people with a disability. Marginalisation and a lack of empowerment was evident in the experiences of interactions with providers due to cultural stereotypes and racism, lack of cultural awareness and sensitivity, and poverty and homelessness. Community-led models of care can help overcome the intersectional effects of these identities and forms of oppression in carers' interactions with providers and enhance access to care.
Maneze, D, Ramjan, L, DiGiacomo, M, Everett, B, Davidson, PM & Salamonson, Y 2018, 'Negotiating health and chronic illness in Filipino-Australians: A qualitative study with implications for health promotion', Ethnicity and Health, vol. 23, no. 6, pp. 611-628.View/Download from: UTS OPUS or Publisher's site
Objective: In spite of the healthy immigrant effect, the prevalence of lifestyle-related chronic diseases among migrants is reported to approximate that of the host country with longer duration of stay. For example, higher rates of chronic diseases such as Type 2 diabetes and hypertension have been observed among Filipino migrants and these have been linked to acculturation. The aim of this study was to explore the experiences of Filipino-Australian migrants in managing their chronic health conditions in a Western host country.
Design: This paper reports on qualitative findings of a mixed methods study that used an explanatory sequential design. Nine focus group discussions were undertaken with 58 Filipino-Australian migrants with chronic disease. Thematic analysis was undertaken using a five-stage general purpose thematic framework ensuring that themes closely identified key participants' experiences.
Results: Findings revealed that health benefits provided by the health system in Australia were considered advantageous. However, a lack of social and instrumental support compounded isolation and disempowerment, limiting self-management strategies for chronic illnesses. Cultural beliefs and practices influenced their knowledge, attitude to and management of chronic disease, which health service providers overlooked because of perceived acculturation and English language skills. Overall this study has clearly identified recognition of cultural beliefs, language needs and support as three core needs of Filipino-Australian migrants with the elderly the most vulnerable.
Conclusion: This paper highlights that self-management of chronic disease among elderly Filipino immigrants may be adversely affected by host language difficulties, a lack of social support and cultural issues, impacting on access to services, health-seeking behaviours and participation in health promotion initiatives. Language, culture-specific health interventions and resources and enhancing socia...
McDonagh, J, Martin, L, Ferguson, C, Jha, S, Macdonald, P, Davidson, P & Newton, P 2018, 'Frailty assessment instruments in heart failure: a systematic review.', European Journal of Cardiovascular Nursing, vol. 17, no. 1.View/Download from: UTS OPUS or Publisher's site
Frailty is an independent predictor of mortality across many conditions. Reported rates of frailty in heart failure range from 15% to 74%. There are several instruments available to assess frailty; however, to date there has been no consensus on the most appropriate instrument for use in individuals with heart failure.
To identify how frailty is assessed in individuals with heart failure and to elucidate which domains of frailty are most frequently assessed.
Key electronic databases were searched (MEDLINE, COCHRANE Central and CINAHL) to identify studies that assessed frailty in individuals with heart failure using a formal frailty instrument.
Twenty studies published in 24 articles were included, for which a total of seven unique frailty instruments were identified. The most commonly used instrument was the Frailty Phenotype (n= 11), with the majority of studies using a modified version of the Frailty Phenotype (n= 8). The second most commonly used instrument identified was the Comprehensive Geriatric Assessment (n= 4).
There is an increasing interest in the assessment of frailty, but, to date, there is no frailty instrument validated specifically in the heart failure population.
Prichard, R, Kershaw, L, Goodall, S, Davidson, P, Newton, P, McNeil, F, Homer, T & Hayward, C 2018, 'Left ventricular device implantation impacts on hospitalisation rates, length of stay and out of hospital time', Heart, Lung and Circulation, vol. 27, no. 6, pp. 708-715.View/Download from: UTS OPUS or Publisher's site
Background Widespread application of left ventricular assist devices (LVADs) in advanced heart failure, is limited by
costs, and access to technical expertise. Hospitalisation drives both cost and inversely, quality of life but
cross institutional and pre-surgical inpatient length of stay data is missing in the Australian literature. We
describe changes in hospitalisation rates, in the year before and after bridge to transplant LVAD therapy and
preceding heart transplant (HTX).
Methods Hospitalisation, Australian refined diagnosis group (ArDRG), and clinical data were assessed for 77/100
consecutive patients listed for heart transplant between July of 2009 and June of 2012. Twenty-five of the
patients required ventricular assist device (VAD) therapy whilst waitlisted. Hospitalisation was defined as
the proportion of ''days at risk' that were spent in hospital and included all public and private admissions
identified in the year before and after VAD implant, or before HTX, in a linked administrative dataset of
admissions across New South Wales.
Results Patients requiring VADs were clinically more unstable and spent proportionally more time in hospital than
pre-HTX patients, (13% (IQR 10-20%) vs 4% (IQR1-10%), p < 0.01). During the index admission, they spent
22 days (IQR 10-33) in hospital before implantation, including 13 days in non-transplant centres (IQR 7-20).
Following implantation, median inpatient stay was 31(IQR 26-70) – including rehabilitation in 8 of the 25
The number of admissions per patientreduced in the year after VAD-implant to two (IQR1-3), from five preimplant
(IQR 3-7) p = 0.002. This was similar to the pre-HTX group's three admissions (IQR1-6), p = 0.33.
Overall hospitalisation decreased in VAD patients beyond the first year from 14% (IQR 10-20%) at 1-year
to 0.5% (IQR 0-10%) at 2-year (p = 0.002). A high percentage of hospitalisation prior to VAD (41%) and HTX
(66%) occurred outside the transplant centre.
Conclusions A high prop...
Rao, A, Newton, P, DiGiacomo, M, Hickman, L, Hwang, C & Davidson, P 2018, 'Optimal gender specific strategies for the secondary prevention of cardiovascular disease in women: a systematic review', Journal of Cardiopulmonary Rehabilitation and Prevention, vol. 38, no. 5, pp. 279-285.View/Download from: Publisher's site
Rihari-Thomas, J, Newton, PJ, Sibbritt, D & Davidson, PM 2018, 'Rapid response systems: where we have come from and where we need to go?', Journal of Nursing Management, vol. 26, no. 1, pp. 1-2.View/Download from: UTS OPUS or Publisher's site
Smith, TA, Agar, M, Jenkins, CR, Ingham, JM & Davidson, PM 2018, 'Experience of acute noninvasive ventilation-insights from 'Behind the Mask': a qualitative study.', BMJ Supportive and Palliative Care.View/Download from: UTS OPUS or Publisher's site
Non-invasive ventilation (NIV) is widely used in the management of acute and acute-on-chronic respiratory failure. Understanding the experiences of patients treated with NIV is critical to person-centred care. We describe the subjective experiences of individuals treated with NIV for acute hypercapnic respiratory failure.Qualitative face-to-face interviews analysed using thematic analysis.Australian tertiary teaching hospital.Individuals with acute hypercapnic respiratory failure treated with NIV outside the intensive care unit. Individuals who did not speak English or were unable or unwilling to consent were excluded.13 participants were interviewed. Thematic saturation was achieved. Participants described NIV providing substantial relief from symptoms and causing discomfort. They described enduring NIV to facilitate another chance at life. Although participants sometimes appeared passive, others expressed a strong conviction that they knew which behaviours and treatments relieved their distress. Most participants described gaps in their recollection of acute hospitalisation and placed a great amount of trust in healthcare providers. All participants indicated that they would accept NIV in the future, if clinically indicated, and often expressed a sense of compulsion to accept NIV. Participants' description of their experience of NIV was intertwined with their experience of chronic disease.Participants described balancing the benefits and burdens of NIV, with the goal of achieving another chance at life. Gaps in recall of their treatment with NIV were frequent, potentially suggesting underlying delirium. The findings of this study inform patient-centred care, have implications for the care of patients requiring NIV and for advance care planning discussions.
Babatunde-Sowole, O, Power, TJ, Davidson, PM, Ballard, C & Jackson, D 2018, 'Exploring the diet and lifestyle changes contributing to weight gain among Australian West African women following migration: A qualitative study', Contemporary Nurse, vol. 54, no. 2, pp. 150-159.View/Download from: UTS OPUS or Publisher's site
Aims and objectives: This paper reports on women's experiences of weight gain and obesity as they became acculturated to the Australian diet and lifestyle.
Background: Migrants from sub-Saharan Africa have a much higher risk of obesity than the native population when settling in industrialised countries.
Results: Women in this study reported weight gain post-migration. This was attributed to increased access to a wide variety of food including takeaway food and more sedentary lifestyles.
Conclusions: Obesity has long-term consequences for health and well-being. Further research is needed to support a healthy transition to life in Australia.
Relevance to clinical practice: Gaining insight into the underlying reasons that West African immigrants to Australia become obese could contribute to assisting health professionals design culturally appropriate interventions and health education programmes to support new arrivals.
Hayes, CJ, Jackson, D, Davidson, PM, Daly, J & Power, T 2018, 'Pondering practice: Enhancing the art of reflection', Journal of Clinical Nursing, vol. 27, no. 1-2, pp. 345-353.View/Download from: UTS OPUS or Publisher's site
Aims and objectives
The aim of this study was to describe the effect that immersive simulation experiences and guided reflection can have on the undergraduate nurses' understanding of how stressful environments impact their emotions, performance and ability to implement safe administration of medications.
Patient safety can be jeopardised if nurses are unsure of how to appropriately manage and respond to interruptions. Medication administration errors are a major patient safety issue and often occur as a consequence of ineffective interruption management. The skills associated with medication administration are most often taught to, and performed by, undergraduate nurses in a controlled environment. However, the clinical environment in which nurses are expected to administer medications is often highly stressed and nurses are frequently interrupted.
This study used role-play simulation and written reflections to facilitate deeper levels of student self-awareness. A qualitative approach was taken to explore students' understanding of the effects of interruptions on their ability to undertake safe medication administration. Convenience sampling of second-year undergraduate nursing students enrolled in a medical–surgical subject was used in this study. Data were obtained from 451:528 (85.42%) of those students and analysed using thematic analysis.
Students reported increasing consciousness and the importance of reflection for evaluating performance and gaining self-awareness. They described self-awareness, effective communication, compassion and empathy as significant factors in facilitating self-efficacy and improved patient care outcomes.
Following a role-play simulation experience, student nurses reported new knowledge and skill acquisition related to patient safety, and new awareness of the need for empathetic and compassionate care during medication administration. Practicing medication administration in realis...
Disalvo, D, Luckett, T, Luscombe, G, Bennett, A, Davidson, P, Chenoweth, L, Mitchell, G, Pond, D, Phillips, J, Beattie, E, Goodall, S & Agar, M 2018, 'Potentially inappropriate prescribing in Australian nursing home residents with advanced dementia: a sub-study of the IDEAL Study', Journal of Palliative Medicine, vol. 21, no. 10, pp. 1472-1479.View/Download from: UTS OPUS
Cajita, MI, Denhaerynck, K, Dobbels, F, Berben, L, Russell, CL, Davidson, PM & De Geest, S 2017, 'Health literacy in heart transplantation: Prevalence, correlates and associations with health behaviors—Findings from the international BRIGHT study', Journal of Heart and Lung Transplantation, vol. 36, no. 3, pp. 272-279.View/Download from: UTS OPUS or Publisher's site
© 2017 International Society for Heart and Lung Transplantation Background Health literacy (HL) is a major determinant of health outcomes; however, there are few studies exploring the role of HL among heart transplant recipients. The objectives of this study were to: (1) explore and compare the prevalence of inad equate HL among heart transplant recipients internationally; (2) determine the correlates of HL; and (3) assess the relationship between HL and health-related behaviors. Methods A secondary analysis was conducted using data of the 1,365 adult patients from the BRIGHT study, an international multicenter, cross-sectional study that surveyed heart transplant recipients across 11 countries and 4 continents. Using the Subjective Health Literacy Screener, inadequate HL was operationalized as being confident in filling out medical forms none/a little/some of the time (HL score of 0 to 2). Correlates of HL were determined using backward stepwise logistic regression. The relationship between HL and the health-related behaviors were examined using hierarchical logistic regression. Results Overall, 33.1% of the heart transplant recipients had inadequate HL. Lower education level (adjusted odds ratio [AOR] 0.24, p < 0.001), unemployment (AOR 0.69, p = 0.012) and country (residing in Brazil, AOR 0.25, p < 0.001) were shown to be associated with inadequate HL. Heart transplant recipients with adequate HL had higher odds of engaging in sufficient physical activity (AOR 1.6, p = 0.016). HL was not significantly associated with the other health behaviors. Conclusions Clinicians should recognize that almost one third of heart transplant participants have inadequate health literacy. Furthermore, they should adopt communication strategies that could mitigate the potential negative impact of inadequate HL.
Deek, H, Chang, S, Newton, PJ, Noureddine, S, Inglis, SC, Arab, GA, Kabbani, S, Chalak, W, Timani, N, Macdonald, PS & Davidson, PM 2017, 'An evaluation of involving family caregivers in the self-care of heart failure patients on hospital readmission: Randomised controlled trial (the FAMILY study).', International Journal of Nursing Studies, vol. 75, pp. 101-111.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: The prevalence of heart failure is increasing in Lebanon but to date there is no systematic evaluation of a disease management intervention. OBJECTIVE: The aim of this study was to evaluate the effect of involving family caregivers in the self-care of patients with heart failure on the risk of hospital readmission. DESIGN: A multi-site, block randomised controlled trial. SETTINGS: The study was conducted over a 13-month period in three tertiary medical centres in Beirut and Mount Lebanon, Lebanon. PARTICIPANTS: Adult patients presenting for an exacerbation of heart failure to one of the study centres were included. Patients with limited life expectancy or physical functionality, planned cardiac bypass or valve replacement surgery, living alone or in nursing homes, or aged less than 18 years were excluded. METHODS: Patients allocated to the intervention group and their family caregivers were provided with a comprehensive, culturally appropriate, educational session on self-care maintenance and symptom management along with self-care resources. The usual care group received the self-care resources only. Follow-up phone calls were conducted 30days following discharge by a research assistant blinded to treatment assignment. The primary outcome was hospital readmission and the secondary outcomes were self-care, quality of life, major vascular events and healthcare utilization. RESULTS: The final sample included 256 patients hospitalized for heart failure randomised into control (130 patients) and intervention (126 patients) groups. The mean age was 67 (SD=8)years, and the majority (55%) were male. Readmission at 30days was significantly lower in the intervention group compared to the control group (n=10, 9% vs. n=20, 19% respectively, OR=0.40, 95% CI=0.02, 0.10, p=0.02). Self-care scores improved in both groups at 30days, with a significantly larger improvement in the intervention group than the control group in the maintenance and confidence sub-scales, b...
DiGiacomo, M, Green, A, Delaney, P, Delaney, J, Patradoon-Ho, P, Davidson, P & Abbott, P 2017, 'Experiences and needs of carers of Aboriginal children with a disability: a qualitative study', BMC Family Practice, vol. 18, pp. 1-11.View/Download from: UTS OPUS or Publisher's site
Background: Australian parents/carers of a person with a disability experience higher rates of depression, more financial stress, and are twice as likely to be in poor physical health than the general population. Aboriginal and Torres Strait Islander peoples experience worse health, social and economic outcomes than other Australians, and those with a disability face 'double disadvantage'. This study aimed to better understand the experiences and needs of parents/carers/families of Aboriginal children with a disability.
Methods: Semi-structured in-depth interviews were conducted with parents or primary carers of Aboriginal children aged zero-eight with disability. Interviews were analysed using thematic analysis.
Results: Nineteen women (sixteen mothers and three grandmothers) were interviewed. More than half were lone carers (without a partner or spouse). Participants described their experiences, including challenges and facilitators, to providing and accessing care, impacts on their health and wellbeing, and associated economic and non-economic costs of caregiving. Financial strain and social isolation was particularly prominent for lone carers.
Conclusions: Tailoring services to the needs of carers of Aboriginal children with a disability means supporting kinship caregiving, facilitating engagement with other Aboriginal families, and streamlining services and systems to mitigate costs. The experiences described by our participants depict an intersection of race, socio-economic status, gender, disability, and caregiving. Services and funding initiatives should incorporate such intersecting determinants in planning and delivery of holistic care.
Ferguson, C, Inglis, SC, Newton, PJ, Middleton, S, Macdonald, PS & Davidson, PM 2017, 'Barriers and enablers to adherence to anticoagulation in heart failure with atrial fibrillation: patient and provider perspectives', Journal of Clinical Nursing, vol. 26, no. 23-24, pp. 4325-4334.View/Download from: UTS OPUS or Publisher's site
Aims & Objectives
The purpose of this study was to elucidate the barriers and enablers to adherence to anticoagulation in individuals with chronic heart failure (CHF) with concomitant atrial fibrillation (AF) from the perspective of patients and providers.
CHF and AF commonly coexist and are associated with increased stroke risk and mortality. Oral anticoagulation significantly reduces stroke risk and improves outcomes. Yet, in approximately 30% of cases anticoagulation is not commenced for a variety of reasons.
Qualitative study using narrative inquiry.
Data from face to face individual interviews with patients and information retrieved from healthcare file note review documented the clinician perspective. This study is a synthesis of the two data sources, obtained during patient clinical assessments as part of the Atrial Fibrillation And Stroke Thromboprophylaxis in hEart failuRe (AFASTER) Study.
Patient choice and preference were important factors in anticoagulation decisions, including treatment burden, unfavourable or intolerable side effects and patient refusal. Financial barriers included cost of travel, medication cost and reimbursement. Psychological factors included psychiatric illness, cognitive impairment and depression. Social barriers included homelessness and the absence of a caregiver or lack of caregiver assistance. Clinician reticence included fear of falls, frailty, age, fear of bleeding and the challenges of multi-morbidity. Facilitators to successful prescription and adherence were caregiver support, reminders and routine, self-testing and the use of technology.
Many barriers remain to high risk individuals being prescribed anticoagulation for stroke prevention. There are a number of enabling factors that facilitate prescription and optimize treatment adherence. Nurses should challenge these treatment barriers and seek enabling factors to optimise therapy.
Relevance to clinical practice
Ferguson, C, Inglis, SC, Newton, PJ, Middleton, S, Macdonald, PS & Davidson, PM 2017, 'Multi-morbidity, frailty and self-care: important considerations in treatment with anticoagulation drugs. Outcomes of the AFASTER study.', European Journal of Cardiovascular Nursing, vol. 16, no. 2, pp. 113-124.View/Download from: UTS OPUS or Publisher's site
Chronic heart failure (CHF) and atrial fibrillation (AF) are complex cardiogeriatric syndromes mediated by physical, psychological and social factors. Thromboprophylaxis is an important part of avoiding adverse events in these syndromes, particularly stroke.This study sought to describe the clinical characteristics of a cohort of patients admitted to hospital with CHF and concomitant AF and to document the rate and type of thromboprophylaxis. We examined the practice patterns of the prescription of treatment and determined the predictors of adverse events.Prospective consecutive participants with CHF and concomitant AF were enrolled during the period April to October 2013. Outcomes were assessed at 12 months, including all-cause readmission to hospital and mortality, stroke or transient ischaemic attack, and bleeding.All-cause readmission to hospital was frequent (68%) and the 12-month all-cause mortality was high (29%). The prescription of anticoagulant drugs at discharge was statistically significantly associated with a lower mortality at 12 months (23 vs. 40%; p=0.037; hazards ratio 0.506; 95% confidence interval 0.267-0.956), but was not associated with lower rates of readmission to hospital among patients with CHF and AF. Sixty-six per cent of participants were prescribed anticoagulant drugs on discharge from hospital. Self-reported self-care behaviour and 'not for cardiopulmonary resuscitation' were associated with not receiving anticoagulant drugs at discharge. Although statistical significance was not achieved, those patients who were assessed as frail or having greater comorbidity were less likely to receive anticoagulant drugs at discharge.This study highlights multi-morbidity, frailty and self-care to be important considerations in thromboprophylaxis. Shared decision-making with patients and caregivers offers the potential to improve treatment knowledge, adherence and outcomes in this group of patients with complex care needs.
Gholizadeh, L, Ali Khan, S, Vahedi, F & Davidson, PM 2017, 'Sensitivity and specificity of Urdu version of the PHQ-9 to screen depression in patients with coronary artery disease.', Contemporary Nurse, vol. 53, no. 1, pp. 75-81.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: The Patient Health Questionnaire (PHQ-9) possesses many characteristics of a good screening tool and has the capacity to be used for screening depression in patients with coronary artery disease (CAD). AIM: To examine the psychometric properties and criterion validity of the PHQ-9 to screen and detect depression in patients with CAD in Pakistan. DESIGN: In this validation study, 150 patients with CAD completed the Urdu version of the PHQ-9. The major depressive episode module of the Mini International Neuropsychiatric Interview (MINI) was used as the gold standard. RESULTS: The Urdu version of the PHQ-9 revealed a good internal consistency with Cronbach's alpha of 0.83. Optimal sensitivity (76%) and specificity (76%) were achieved using the cut-off score of PHQ-9 6, with area under the ROC curve of 0.86. CONCLUSION: The Urdu version of the PHQ-9 has acceptable psychometric properties to screen and detect major depression in patients with CAD.
Gholizadeh, L, Shahmansouri, N, Heydari, M & Davidson, PM 2017, 'Screening and diagnosing depression in patients with coronary artery disease: Persian validation of the PHQ-9', Journal of Clinical Psychology in Medical Settings.
Gholizadeh, L, Shahzad, A, Vahedi, F & Davidson, PM 2017, 'Sensitivity and specificity of Urdu version of the Depression Module of the Patient Health Questionnaire to screen and diagnose major depression in patients with coronary artery disease', Journal of Transcultural Nursing, vol. 53, pp. 75-81.View/Download from: UTS OPUS
Hunt, L, Frost, SA, Newton, PJ, Salamonson, Y & Davidson, PM 2017, 'A survey of critical care nurses' knowledge of intra-abdominal hypertension and absdominal compartment syndrome', Australian Critical Care, vol. 30, no. 1, pp. 21-27.View/Download from: UTS OPUS or Publisher's site
Intra-abdominal hypertension and abdominal compartment syndrome are potentially life threatening conditions. Critical care nurses need to understand the factors that predispose patients to intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Predicting and managing IAH and ACS are important to improve health outcomes.
The aim of this paper was to (1) assess the knowledge of Australian critical care nurses about current IAH and ACS practice guidelines, measurement techniques, predictors for the development of IAH and ACS and (2) identify barriers in recognizing IAH, ACS and measuring IAP.
Between October 2014 and April 2015 86 registered nurses employed in the area of critical care were recruited via the form to participate in an on-line, 19-item questionnaire. The survey was distributed to critical care nurses via the Australian College of Critical Care Nurses (ACCCN) mailing list and directly to intensive care units via The majority of participants were women (n = 62) all participants were registered nurses employed in critical care the response rate was 3.2%. The study design was used to establish demographic data, employment data, and individuals' knowledge related to IAH and ACS. Participants had the option to write hand written responses in addition to selecting a closed question response.
The results showed that most survey participants were able to identify some obvious causes of IAH. However, less than 20% were able to recognize less apparent indices of risk. A lack of education related to IAP monitoring was identified by nearly half (44.2%) of respondents as the primary barrier to monitoring IAP.
Jackson, D, Durrant, L, Bishop, E, Walthall, H, Betteridge, R, Gardner, S, Coulton, W, Hutchinson, M, Neville, S, Davidson, PM & Usher, K 2017, 'Health service provision and the use of pressure-redistributing devices: mixed methods study of community dwelling individuals with pressure injuries', Contemporary Nurse, vol. 53, no. 3, pp. 378-389.View/Download from: UTS OPUS or Publisher's site
© 2017 Informa UK Limited, trading as Taylor & Francis Group. Background: Health care within the home setting is a vital and growing component of pressure injury (PI) prevention and management. Objectives: To describe the use of health services and pressure-redistributing devices in community dwelling patients with PI's. Design: Mixed-methods collective case study of a defined, diverse geographic postcode area in the United Kingdom. Methods: Quantitative retrospective analysis of electronic and paper medical records of adult PI patients from 2015 district nursing reports. Qualitative semi-structured interviews of community dwelling adult patients receiving, or received, treatment for PI in 2016. Results: Mandatory reports (n = 103) revealed that 90 patients were supplied with a variety of pressure-redistributing devices but only one-third of patients used the equipment as recommended. Qualitative interviews (n = 12), reported to COREQ guidelines, revealed that patients felt reliant on community health services, and were concerned about the consistency of their care. Conclusions: Authentic patient involvement is required to provide care and interventions that are acceptable to PI patients and can be incorporated into self-care strategies and effectively monitored.
Jackson, D, Durrant, L, Bishop, E, Walthall, H, Betteridge, R, Gardner, S, Coulton, W, Hutchinson, M, Neville, S, Davidson, PM & Usher, K 2017, 'Pain associated with pressure injury: A qualitative study of community-based, home-dwelling individuals.', Journal of Advanced Nursing, vol. 73, no. 12, pp. 3061-3069.View/Download from: UTS OPUS or Publisher's site
The aim of this study was to provide deep insights into the pain associated with pressure injuries in home-dwelling individuals using narrative accounts.Pressure injuries or pressure ulcers are burdensome and costly. Prevalence data, surveys and systematic reviews demonstrate that pain associated with pressure injury is widespread, but voices of home-dwelling patients have remained largely unheard.Concurrent mixed methods case study of a UK community of approximately 50,000 adults.Qualitative interviews, conducted in 2016, of 12 home-dwelling adult participants with a current pressure injury (n = 10), or a recently healed pressure injury (n = 2).Pain had an adverse impact on activities of daily living, mobility and sleep. Participants described days that were clouded in pain; a pain they felt was poorly understood and often out of control. Thematic content analysis revealed two major themes; these are: Poorly controlled pain: "I just want the pain to go away"; and, Uncertainty for the future: "it almost seems insurmountable."Findings of our study support the need to develop an appropriate assessment tool for pressure injury patients in the community to enable healthcare professionals and patients to recognize and manage pressure injury-related pain effectively.
Leyva, EWA, Beaman, A & Davidson, PM 2017, 'Health Impact of Climate Change in Older People: An Integrative Review and Implications for Nursing.', Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing, vol. 49, no. 6, pp. 670-678.View/Download from: UTS OPUS or Publisher's site
PURPOSE:Older people account for the highest proportion of mortality from extreme weather events associated with climate change. This article aims to describe the health impacts of climate change on older people. TYPE OF STUDY:An integrative review was conducted with 30 studies retrieved from PubMed, EBSCO, and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) on climate stressors, determinants of resilient capacity, risk factors, and health outcomes. FINDINGS:Heat, temperature variability, and air pollution increase mortality risk in older people, especially from cardiovascular and respiratory diseases. Floods are linked with increasing incidence of post-traumatic stress disorder, depression, and anxiety. Facing these adversities, older people exhibit both vulnerability and resilience. CONCLUSIONS:Research gaps exist in understanding the full spectrum of the resilience experience of older people, and appreciating areas wherein nursing can play a pivotal role. CLINICAL RELEVANCE:Recognizing the vulnerabilities of older people in the context of climate change is important. Identifying opportunities to promote resilience is an important focus for nurses to develop tailored and targeted nursing interventions.
Rihari-Thomas, J, DiGiacomo, M, Phillips, J, Newton, P & Davidson, PM 2017, 'Clinician Perspectives of Barriers to Effective Implementation of a Rapid Response System in an Academic Health Centre: A Focus Group Study', International Journal of Health Policy and Management, vol. 6, no. 8, pp. 447-456.View/Download from: UTS OPUS or Publisher's site
Background: Systemic and structural issues of rapid response system (RRS) models can hinder implementation. This study sought to understand the ways in which acute care clinicians (physicians and nurses) experience and negotiate care for deteriorating patients within the RRS.
Methods: Physicians and nurses working within an Australian academic health centre within a jurisdictional-based model of clinical governance participated in focus group interviews. Verbatim transcripts were analysed using thematic content analysis.
Results: Thirty-four participants (21 physicians and 13 registered nurses [RNs]) participated in six focus groups over five weeks in 2014. Implementing the RRS in daily practice was a process of informal communication and negotiation in spite of standardised protocols. Themes highlighted several systems or organisational-level barriers to an effective RRS, including (1) responsibility is inversely proportional to clinical experience; (2) actions around system flexibility contribute to deviation from protocol; (3) misdistribution of resources leads to perceptions of inadequate staffing levels inhibiting full optimisation of the RRS; and (4) poor communication and documentation of RRS increases clinician workloads.
Conclusion: Implementing a RRS is complex and multifactorial, influenced by various inter- and intra-professional factors, staffing models and organisational culture. The RRS is not a static model; it is both reflexive and iterative, perpetually transforming to meet healthcare consumer and provider demands and local unit contexts and needs. Requiring more than just a strong initial implementation phase, new models of care such as a RRS demand good governance processes, ongoing support and regular evaluation and refinement. Cultural, organizational and professional factors, as well as systems-based processes, require consideration if RRSs are to achieve their intended outcomes in dynamic healthcare settings.
Shishehgar, S, Gholizadeh, L, DiGiacomo, M, Green, A & Davidson, PM 2017, 'Health and socio-cultural experiences of refugee women: An integrative review', The Journal of Immigrant and Minority Health, vol. 19, no. 4, pp. 959-973.View/Download from: UTS OPUS or Publisher's site
Smith, TA, Disler, RT, Jenkins, CR, Ingham, JM & Davidson, PM 2017, 'Perspectives on advance care planning among patients recently requiring non-invasive ventilation for acute respiratory failure: A qualitative study using thematic analysis.', Palliative Medicine, vol. 31, no. 6, pp. 566-574.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: Patients requiring non-invasive ventilation for acute-on-chronic respiratory failure due to chronic obstructive pulmonary disease or heart failure exacerbations may have a poor prognosis underscoring the importance of advance care planning. AIM: We aimed to describe attitudes to, and experiences of, discussing the future among patients recently treated with non-invasive ventilation. DESIGN: Qualitative research using thematic analysis. SETTINGS AND PARTICIPANTS: Tertiary teaching hospital. Patients with acute hypercapnic respiratory failure requiring non-invasive ventilation. RESULTS: Individuals recently treated with non-invasive ventilation describe feeling the future is beyond their control and instead controlled by their illness. Participants often recognised their poor prognosis but avoided discussing some difficult topics. The majority preferred not to undergo cardiopulmonary resuscitation but most had not discussed this with healthcare professionals. When participants voiced concerns about their future health to family members, they were met with polarised responses. Some encountered willingness for further discussion, while others met deflection, deterring further conversation. An overarching narrative of 'Looking through my illness to an uncertain but concerning future' unites these themes. CONCLUSION: This study suggests opportunities and barriers for advance care planning in individuals with chronic disease. Patients' understanding of their prognosis and their attitudes to cardiopulmonary resuscitation suggests an opportunity for advance care planning. Structuring discussions around patients' preferences for care during future exacerbations may foster a sense of control over the future despite illness. The diversity of familial responses to patients' concerns about their future health has implications for advance care planning. These findings have the potential to improve care for patients with respiratory failure and suggest an important o...
Walczak, A, Butow, PN, Tattersall, MHN, Davidson, PM, Young, J, Epstein, RM, Costa, DSJ & Clayton, JM 2017, 'Encouraging early discussion of life expectancy and end-of-life care: A randomised controlled trial of a nurse-led communication support program for patients and caregivers', International Journal of Nursing Studies, vol. 67, pp. 31-40.View/Download from: UTS OPUS or Publisher's site
© 2016 Elsevier Ltd Background Patients are often not given the information needed to understand their prognosis and make informed treatment choices, with many consequently experiencing less than optimal care and quality-of-life at end-of-life. Objectives To evaluate the efficacy of a nurse-facilitated communication support program for patients with advanced, incurable cancer to assist them in discussing prognosis and end-of-life care. Design A parallel-group randomised controlled trial design was used. Settings This trial was conducted at six cancer treatment centres affiliated with major hospitals in Sydney, Australia. Participants 110 patients with advanced, incurable cancer participated. Methods The communication support program included guided exploration of a question prompt list, communication challenges, patient values and concerns and the value of discussing end-of-life care early, with oncologists cued to endorse question-asking and question prompt list use. Patients were randomised after baseline measure completion, a regular oncology consultation was audio-recorded and a follow-up questionnaire was completed one month later. Communication, health-related quality-of-life and satisfaction measures and a manualised consultation-coding scheme were used. Descriptive, Mixed Modelling and Generalised Linear Mixed Modelling analyses were conducted using SPSS version 22. Results Communication support program recipients gave significantly more cues for discussion of prognosis, end-of-life care, future care options and general issues not targeted by the intervention during recorded consultations, but did not ask more questions about these issues or overall. Oncologists' question prompt list and question asking endorsement was inconsistent. Communication support program recipients' self-efficacy in knowing what questions to ask their doctor significantly improved at follow-up while control arm patients' self-efficacy declined. The communication support program d...
Zwar, N, Hermiz, O, Halcomb, E, Davidson, PM & Bodenheimer, T 2017, 'Improving blood pressure control in general practice: A pilot study of the ImPress intervention.', Australian family physician, vol. 46, no. 5, pp. 306-311.View/Download from: UTS OPUS
Patients with hypertension and at high absolute cardiovascular disease risk are a priority group for improved blood pressure control. This study examined the impact of an intervention, primarily delivered by the general practice nurse, to identify, recall and manage patients with uncontrolled hypertension who are at high risk of cardiovascular disease.A before-and-after pilot study with a six-month follow-up period was conducted in eight general practices in Sydney, Australia.From 507 patients identified, 82 (16.2%) attended an assessment visit, were eligible and provided baseline data. Of these, 55 (67.1%) completed the six-month follow-up. The mean decrease in blood pressure was 14.5 mmHg systolic and 7 mmHg diastolic. Significant decreases were also found in mean weight (1.3 kg), body mass index (0.5 kg/m">22) and waist circumference (1.9 cm). Adherence to blood pressure treatment, as measured by the Hill-Bone scale, significantly improved (P = 0.01) DISCUSSION: The results of this study justify further investigation in a randomised trial. If effective, the approach could alter the way hypertension care is organised and delivered in Australian general practice.
Shehab, S, Allida, SM, Davidson, PM, Newton, PJ, Robson, D, Jansz, PC & Hayward, CS 2017, 'Right Ventricular Failure Post LVAD Implantation Corrected with Biventricular Support: An In Vitro Model.', ASAIO Journal, vol. 63, no. 1, pp. 41-47.View/Download from: UTS OPUS or Publisher's site
Right ventricular failure after left ventricular assist device (LVAD) implantation is associated with high mortality. Management remains limited to pharmacologic therapy and temporary mechanical support. Delayed right ventricular assist device (RVAD) support after LVAD implantation is associated with poorer outcomes. With the advent of miniaturized, durable, continuous flow ventricular assist device systems, chronic RVAD and biventricular assist device (BiVAD) support has been used with some success. The purpose of this study was to assess combined BiVAD and LVAD with delayed RVAD support within a four-elemental mock circulatory loop (MCL) simulating the human cardiovascular system. Our hypothesis was that delayed continuous flow RVAD (RVAD) would produce similar hemodynamic and flow parameters to those of initial BiVAD support. Using the MCL, baseline biventricular heart failure with elevated right and left filling pressures with low cardiac output was simulated. The addition of LVAD within a biventricular configuration improved cardiac output somewhat, but was associated with persistent right heart failure with elevated right-sided filling pressures. The addition of an RVAD significantly improved LVAD outputs and returned filling pressures to normal throughout the circulation. In conclusion, RVAD support successfully restored hemodynamics and flow parameters of biventricular failure supported with isolated LVAD with persistent elevated right atrial pressure.
Hosie, A, Agar, M, Lobb, E, Davidson, PM & Phillips, J 2017, 'Improving delirium recognition and assessment for people receiving inpatient palliative care: a mixed methods meta-synthesis.', International journal of nursing studies, vol. 75, pp. 123-129.View/Download from: UTS OPUS or Publisher's site
Delirium is a serious acute neurocognitive condition frequently occurring for hospitalized patients, including those receiving care in specialist palliative care units. There are many delirium evidence-practice gaps in palliative care, including that the condition is under-recognized and challenging to assess.To report the meta-synthesis of a research project investigating delirium epidemiology, systems and nursing practice in palliative care units.The Delirium in Palliative Care (DePAC) project was a two-phase sequential transformative mixed methods design with knowledge translation as the theoretical framework. The project answered five different research questions about delirium epidemiology, systems of care and nursing practice in palliative care units. Data integration and metasynthesis occurred at project conclusion.There was a moderate to high rate of delirium occurrence in palliative care unit populations; and palliative care nurses had unmet delirium knowledge needs and worked within systems and team processes that were inadequate for delirium recognition and assessment. The meta-inference of the DePAC project was that a widely-held but paradoxical view that palliative care and dying patients are different from the wider hospital population has separated them from the overall generation of delirium evidence, and contributed to the extent of practice deficiencies in palliative care units.Improving palliative care nurses' capabilities to recognize and assess delirium will require action at the patient and family, nurse, team and system levels. A broader, hospital-wide perspective would accelerate implementation of evidence-based delirium care for people receiving palliative care, both in specialist units, and the wider hospital setting.
Hayes, C, Jackson, D, Davidson, PM, Daly, J & Power, T 2017, 'Calm to chaos: Engaging undergraduate nursing students with the complex nature of interruptions during medication administration.', Journal of Clinical Nursing.View/Download from: UTS OPUS or Publisher's site
AIMS AND OBJECTIVES: To describe undergraduate student nurse responses to a simulated role-play experience focussing on managing interruptions during medication administration. BACKGROUND: Improving patient safety requires that we find creative and innovative methods of teaching medication administration to undergraduate nurses in real-world conditions. Nurses are responsible for the majority of medication administrations in health care. Incidents and errors associated with medications are a significant patient safety issue and often occur as a result of interruptions. Undergraduate nursing students are generally taught medication administration skills in a calm and uninterrupted simulated environment. However, in the clinical environment medication administration is challenged by multiple interruptions. DESIGN/METHODS: A qualitative study using convenience sampling was used to examine student perceptions of a simulated role-play experience. Data were collected from 451 of a possible 528 student written reflective responses and subject to thematic analysis. RESULTS: Students reported an increased understanding of the impacts of interruptions while administering medications and an improved awareness of how to manage disruptions. This study reports on one of three emergent themes: "Calm to chaos: engaging with the complex nature of clinical practice." CONCLUSIONS: Interrupting medication administration in realistic and safe settings facilitates awareness, allows for students to begin to develop management strategies in relation to interruption and increases their confidence. Students were given the opportunity to consolidate and integrate prior and new knowledge and skills through this role-play simulation.
Jha, SR, Hannu, MK, Newton, PJ, Wilhelm, K, Hayward, CS, Jabbour, A, Kotlyar, E, Keogh, A, Dhital, K, Granger, E, Connellan, M, Jansz, P, Spratt, PM, Montgomery, E, Smith, A, Harkess, M, Tunicliff, P, Davidson, PM & Macdonald, PS 2017, 'Reversibility of Frailty After Bridge-to-Transplant Ventricular Assist Device Implantation or Heart Transplantation.', Transplantation direct, vol. 3, no. 7, p. e167.View/Download from: UTS OPUS or Publisher's site
We recently reported that frailty is independently predictive of increased mortality in patients with advanced heart failure referred for heart transplantation (HTx). The aim of this study was to assess the impact of frailty on short-term outcomes after bridge-to-transplant ventricular assist device (BTT-VAD) implantation and/or HTx and to determine if frailty is reversible after these procedures.Between August 2013 and August 2016, 100 of 126 consecutive patients underwent frailty assessment using Fried's Frailty Phenotype before surgical intervention: 40 (21 nonfrail, 19 frail) BTT-VAD and 77 (60 nonfrail, 17 frail) HTx-including 17 of the 40 BTT-VAD supported patients. Postprocedural survival, intubation time, intensive care unit, and hospital length of stay were compared between frail and nonfrail groups. Twenty-six frail patients were reassessed at 2 months or longer postintervention.Frail patients had lower survival (63 ± 10% vs 94 ± 3% at 1 year, P = 0.012) and experienced significantly longer intensive care unit (11 vs 5 days, P = 0.002) and hospital (49 vs 25 days, P = 0.003) length of stay after surgical intervention compared with nonfrail patients. Twelve of 13 frail patients improved their frailty score after VAD (4.0 ± 0.8 to 1.4 ± 1.1, P < 0.001) and 12 of 13 frail patients improved their frailty score after HTx (3.2 ± 0.4 to 0.9 ± 0.9, P < 0.001). Handgrip strength and depression improved postintervention. Only a slight improvement in cognitive function was seen postintervention.Frail patients with advanced heart failure experience increased mortality and morbidity after surgical intervention with BTT-VAD or HTx. Among those who survive frailty is partly or completely reversible underscoring the importance of considering this factor as a dynamic not fixed entity.
Green, A, Luckett, T, Abbott, P, DiGiacomo, M, Delaney, P, Delaney, J & Davidson, PM 2017, 'A framework for an asset-informed approach to service mapping', Nurse Researcher, vol. 25, no. 3, pp. 19-25.View/Download from: UTS OPUS or Publisher's site
Background Asset-informed approaches are increasingly emphasised in public health, but
transferring this approach to planning health services requires prospective systematic methods.
Asset-informed approaches to service-mapping have started to develop, but there are no
standardised guidelines. These methods are becoming of particular interest, as nurses engage in
population health activities.
Aim To identify methods of asset-informed mapping for addressing health problems and develop a
framework to support the methodological rigour of service-mapping.
Discussion The authors undertook an integrative literature review using a systematic approach
and narrative synthesis. Ten articles met the inclusion criteria. Reported methods included the
formation of a core team to drive the process, as well as varying detail about methods of collecting
data and forming maps. Challenges and solutions included the effectiveness of the core team
depending on having a designated leader, frequent meetings and previous partnerships, using
community 'cultural brokers', and determining aims and scope.
Conclusion Results of the review can be used to modify existing generic resources for assetinformed
mapping to their application in health services. Four main stages seem especially
applicable and important: defining the parameters of the service-mapping process; identifying
services; mapping services; and consultation and implementation.
Implications for practice The shift towards asset-informed approaches in community and public
health is an important step in realising the potential of existing assets in communities to influence
health outcomes. The framework offered in this paper is intended to assist in developing an
evidence base, by promoting the systematic and rigorous reporting of methods used in assetinformed
approaches to service-mapping.
Virdun, C, Luckett, T, Lorenz, K, Davidson, PM & Phillips, J 2017, 'Dying in the hospital setting: A meta-synthesis identifying the elements of end-of-life care that patients and their families describe as being important.', Palliative medicine, vol. 31, no. 7, pp. 587-601.View/Download from: UTS OPUS or Publisher's site
Despite most expected deaths occurring in hospital, optimal end-of-life care is not available for all in this setting.To gain a richer and deeper understanding of elements of end-of-life care that consumers consider most important within the hospital setting.A meta-synthesis.A systematic search of Academic Search Complete, AMED, CINAHL, MEDLINE, EMBASE, PsycINFO, PubMed, Google, Google Scholar and CareSearch for qualitative studies published between 1990 and April 2015 reporting statements by consumers regarding important elements of end-of-life hospital care. Study quality was appraised by two independent researchers using an established checklist. A three-stage synthesis approach focusing on consumer quotes, rather than primary author themes, was adopted for this review.Of 1922 articles, 16 met the inclusion criteria providing patient and family data for analysis. Synthesis yielded 7 patient and 10 family themes including 6 common themes: (1) expert care, (2) effective communication and shared decision-making, (3) respectful and compassionate care, (4) adequate environment for care, (5) family involvement and (6) financial affairs. Maintenance of sense of self was the additional patient theme, while the four additional family themes were as follows: (1) maintenance of patient safety, (2) preparation for death, (3) care extending to the family after patient death and (4) enabling patient choice at the end of life.Consumer narratives help to provide a clearer direction as to what is important for hospital end-of-life care. Systems are needed to enable optimal end-of-life care, in accordance with consumer priorities, and embedded into routine hospital care.
Luckett, T, Chenoweth, L, Phillips, J, Brooks, D, Cook, J, Mitchell, G, Pond, D, Davidson, P, Beattie, E, Luscombe, G, Goodall, S, Fischer, T & Agar, M 2017, 'A facilitated approach to family case conferencing for people with advanced dementia living in nursing homes: Perceptions of Palliative Care Planning Coordinators and other health professionals in the IDEAL Study', International Psychogeriatrics, vol. 29, pp. 1713-1722.View/Download from: UTS OPUS
Brown, N, Luckett, T, Davidson, PM & DiGiacomo, M 2017, 'Family-focussed interventions to reduce harm from smoking in primary school-aged children: A systematic review of evaluative studies.', Preventive Medicine, vol. 101, pp. 117-125.View/Download from: UTS OPUS or Publisher's site
Children living in families where adults smoke are exposed to harmful effects of tobacco smoke and risk a predisposition to smoking initiation. Interventions to support families to reduce risk of harm from smoking have been developed and tested. The purpose of this review is to identify effective family-based interventions used to promote smoke-free home environments in families with primary school age children (aged 5-12years). A systematic search of MEDLINE, Cochrane and CINAHL electronic databases was conducted. Narrative synthesis of included articles was completed. Guidelines for reporting behaviour change interventions were used to summarise and compare intervention timing, content, intensity and delivery. Quality of included studies was critiqued using United States Preventative Services Taskforce (USPST) procedures for internal and external validity. Narrative synthesis was based on methods described by Popay and colleagues. Nineteen articles that evaluated 14 intervention studies focussed on child smoking prevention (n=5), parent smoking cessation (n=4) and environmental tobacco smoke reduction (n=6). Interventions and outcomes were heterogeneous, and were rarely informed by theoretical frameworks relating to family, parenting or child development. Family based interventions may be an important strategy to reduce the effects of smoking for children. There is a need for interventions to be informed by theory relevant to children, parenting and families.
Agar, M, Luckett, T, Luscombe, G, Phillips, J, Beattie, E, Pond, D, Mitchell, G, Davidson, P, Cook, J, Brooks, D, Houltram, J, Goodall, S & Chenoweth, L 2017, 'Effects of facilitated family case conferencing for advanced dementia: A cluster randomised clinical trial', PLoS ONE, vol. 12, no. 8, pp. e0181020-e0181020.View/Download from: UTS OPUS
Virdun, C, Luckett, T, Lorenz, K, Davidson, PM & Phillips, J 2017, 'Analyzing Consumer Priorities for Hospital End-of-Life Care Using a Systematic Review to Inform Policy and Practice', SAGE Research Methods Cases.View/Download from: UTS OPUS or Publisher's site
A systematic review is a useful method to answer a research question where prior studies have been conducted. A
well-designed and executed systematic review can inform policy and/or practice change. It can also identify gaps
and generate new research questions. Although the requirements considered essential for conducting a rigorous
systematic review are well defined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses
statement, the approaches taken to synthesize the data vary. This case study describes the narrative synthesis of
heterogeneous quantitative studies and the meta-synthesis of qualitative studies used to answer a complex
research question from the consumer perspective. The study design focused on the analysis of consumer data
only. As a result, the synthesis of both quantitative data and qualitative data has provided a detailed insight into
consumers' unique perspectives and needs. The synthesis approach for both datasets is described, and linkages
to key tools and resources to help facilitate this approach are provided. Processes used by the research team to
enable effective research governance and collaboration throughout are also detailed.
Luckett, T, Phillips, J, Johnson, M, Garcia, M, Bhattarai, P, Carrieri-Kohlman, V, Hutchinson, A, Disler, RT, Currow, D, Agar, M, Ivynian, S, Chye, R, Newton, PJ & Davidson, PM 2017, 'Insights from Australians with respiratory disease living in the community with experience of self-managing through an emergency department 'near miss' for breathlessness: a strengths-based qualitative study.', BMJ Open, vol. 7, no. 12, pp. 1-11.View/Download from: UTS OPUS or Publisher's site
Breathlessness 'crises' in people with chronic respiratory conditions are a common precipitant for emergency department (ED) presentations, many of which might be avoided through improved self-management and support. This study sought insights from people with experience of ED 'near misses' where they considered going to the ED but successfully self-managed instead.A qualitative approach was used with a phenomenological orientation. Participants were eligible if they reported breathlessness on most days from a diagnosed respiratory condition and experience of 1ED near miss. Recruitment was through respiratory support groups and pulmonary rehabilitation clinics. Semistructured interviews were conducted with each participant via telephone or face-to-face. Questions focused on ED-related decision-making, information finding, breathlessness management and support. This analysis used an integrative approach and independent coding by two researchers. Lazarus and Cohen's Transactional Model of Stress and Coping informed interpretive themes.Interviews were conducted with 20 participants, 15 of whom had chronic obstructive pulmonary disease. Nineteen interviews were conducted via telephone. Analysis identified important factors in avoiding ED presentation to include perceived control over breathlessness, self-efficacy in coping with a crisis and desire not to be hospitalised. Effective coping strategies included: taking a project management approach that involved goal setting, monitoring and risk management; managing the affective dimension of breathlessness separately from the sensory perceptual and building three-way partnerships with primary care and respiratory services.In addition to teaching non-pharmacological and pharmacological management of breathlessness, interventions should aim to develop patients' generic self-management skills. Interventions to improve self-efficacy should ensure this is substantiated by transfer of skills and support, including knowledge...
Alvarez, CP, Davidson, PM, Fleming, C & Glass, NE 2016, 'Elements of Effective Interventions for Addressing Intimate Partner Violence in Latina Women: A Systematic Review.', PloS one, vol. 11, no. 8, p. e0160518.View/Download from: Publisher's site
Intimate partner violence remains a global problem and is of particular concern in Latina diasporas.To identify effective elements of interventions to address intimate partner violence in Latina women.The systematic review was undertaken according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We focused the search on intervention studies assessing intimate partner violence as an outcome measure and on publications in English and Spanish from the last 11 years (2004-2015).Despite the scope of the problem, from the 1,274 studies screened only four met the search criteria and only a single study included an exclusive Latino population. Of the four interventions, one was only as effective as the control treatment. Heterogeneity of study populations and designs prohibited meta-analytic methods.Theoretically derived interventions that are gender specific, culturally appropriate, target mutual aid through group dynamics, and that are developed collaboratively with the target population are likely to be most effective.
Athari, F, Davidson, PM, Hillman, KM & Phillips, J 2016, 'Implementing a palliative approach in the intensive care unit: an oxymoron or a realistic possibility?', International journal of palliative nursing, vol. 22, no. 4, pp. 163-165.View/Download from: UTS OPUS or Publisher's site
Baptiste, D-L, Davidson, P, Groff Paris, L, Becker, K, Magloire, T & Taylor, LA 2016, 'Feasibility study of a nurse-led heart failure education program.', Contemporary nurse, vol. 52, no. 4, pp. 499-510.View/Download from: UTS OPUS or Publisher's site
To assess the feasibility of a nurse-led heart failure (HF) education program using the Self-Care Heart Failure Index (SCHFI) instrument.HF is a frequent and burdensome condition requiring support with self-care management strategies and education. Translating best practice to health services is important in improving health outcomes.Longitudinal quasi-experimental design.A convenience sample of (N = 41) patients with HF. We implemented a nurse-led education program with 30-day post-discharge home-based telephone follow-up. The SCHFI was used to measure self-care behaviors. 30-day readmission rates were assessed.A significant difference was found in scores for self-care maintenance (p .001) and self-care management (p .001) subscales, not self-care confidence. There was no statistically significant difference between 30-day HF readmission rates.Findings suggest that the nurse-led evidence-based HF education program improved self-care behaviors and decreased 30-day readmissions. There is a need for continued development of interventions focused on improving patient self-care confidence.
Bernal, DDL, Bereznicki, LRE, Chalmers, L, Castelino, RL, Thompson, A, Davidson, PM & Peterson, GM 2016, 'Medication Adherence Following Acute Coronary Syndrome: Does One Size Fit All?', American journal of cardiovascular drugs : drugs, devices, and other interventions, vol. 16, no. 1, pp. 9-17.View/Download from: UTS OPUS or Publisher's site
Guideline-based management of acute coronary syndrome (ACS) is well established, yet some may challenge that strict implementation of guideline recommendations can limit the individualization of therapy. The use of all recommended medications following ACS places a high burden of responsibility and cost on patients, particularly when these medications have not been previously prescribed. Without close attention to avoiding non-adherence to these medications, the full benefits of the guideline recommendations will not be realized in many patients. Using a case example, we discuss how the recognition of adherence barriers can be an effective and efficient process for identifying patients at risk of non-adherence following ACS. For those identified as at risk, the World Health Organization's model of adherence barriers is explored as a potentially useful tool to assist with individualization of therapy and promotion of adherence.
Currow, DC, Abernethy, AP, Allcroft, P, Banzett, RB, Bausewein, C, Booth, S, Carrieri-Kohlman, V, Davidson, P, Disler, R, Donesky, D, Dudgeon, D, Ekstrom, M, Farquhar, M, Higginson, I, Janssen, D, Jensen, D, Jolley, C, Krajnik, M, Laveneziana, P, McDonald, C, Maddocks, M, Morelot-Panzini, C, Moxham, J, Mularski, RA, Noble, S, O'Donnell, D, Parshall, MB, Pattinson, K, Phillips, J, Ross, J, Schwartzstein, RM, Similowski, T, Simon, ST, Smith, T, Wells, A, Yates, P, Yorke, J & Johnson, MJ 2016, 'The need to research refractory breathlessness', EUROPEAN RESPIRATORY JOURNAL, vol. 47, no. 1, pp. 342-343.View/Download from: UTS OPUS or Publisher's site
Currow, DC, Davidson, PM & Higginson, IJ 2016, '"Outcomes" Is Not an Oxymoron in Hospice/Palliative Care.', Journal of palliative medicine, vol. 19, no. 11, pp. 1128-1129.View/Download from: Publisher's site
Davidson, P & Cao, Y 2016, 'News From the International Council on Women's Health Issues.', Health care for women international, vol. 37, no. 4, p. 391.View/Download from: UTS OPUS or Publisher's site
Celebrating a silver jubilee is a phenomenal achievement in any life endeavour but this birthday for Heart, Lung and Circulation is a time for celebration, not just for the scientific endeavours of the journal, but the milestones achieved in cardiovascular health in Australia and New Zealand and the advancement of interdisciplinary, interprofessional practice models  and . Cardiovascular disease remains the leading cause of death and disability in Australia and New Zealand signalling that there is much work to be done . The number of people living with cardiovascular disease is increasing due to factors including population ageing and improved treatments . Population ageing and the increased longevity have changed the landscape of cardiovascular care demanding innovative practice models .
Davidson, PM 2016, 'Rockefeller Foundation-Lancet Commission report: A call to action for human health.', International journal of nursing studies, vol. 53, pp. 1-2.View/Download from: Publisher's site
Davidson, PM & Glass, N 2016, 'News From the International Council on Women's Health Issues.', Health care for women international, vol. 37, no. 5, p. 518.View/Download from: UTS OPUS or Publisher's site
Davidson, PM & Meleis, AI 2016, 'Sex and gender matters: The health of women and girls determines the health of our modern world.', Health care for women international, vol. 37, no. 8, p. 817.View/Download from: Publisher's site
Davidson, PM, Glass, N & DiGiacomo, M 2016, 'Global Women's Health Issues: Sex and Gender Matter', Medical Journal of Australia, vol. 205, no. 8, pp. 346-348.View/Download from: UTS OPUS or Publisher's site
Although the terms 'sex' and 'gender' are commonly used as synonyms, they refer to two distinct concepts. Sex refers to the biological differences between men and women, whereas gender refers to socially defined roles, behaviours and expectations. Being clear about the distinction between the two terms is important, as the contribution to women's health of sex and gender are likely to be different, and therefore also our solutions for reducing disparities. Sex differences are increasingly recognised as being important for conditions such as cardiovascular disease,1 for example, and while physiological differences in coronary vasculature can contribute to different presentations and manifestations of disease, gender influences health behaviours, risks, and access to health services.2 We argue that taking gender into account, as well as sex, is critical to improving health outcomes.
Deek, H, Chang, S, Noureddine, S, Newton, PJ, Inglis, SC, Macdonald, PS, Al Arab, G & Davidson, PM 2016, 'Translation and validation of the Arabic version of the Self-care of Heart Failure Index.', Nurse researcher, vol. 24, no. 2, pp. 34-40.View/Download from: Publisher's site
Background Heart failure is a complex clinical syndrome with high demands for self-care. The Self-care of Heart Failure Index (SCHFI) was developed to measure self-care and has demonstrated robust psychometric properties across populations. Aim To assess the psychometric properties of the Arabic version of the SCHFI (A-SCHFI). Discussion The scores of the A-SCHFI administered to 223 Lebanese patients with heart failure were used to validate this instrument. Face and content validity, assessed by a panel of experts, were found sufficient. The three constructs of the A-SCHFI explained 37.5% of the variance when performing exploratory factor analysis. Adequate fit indices were achieved using the modification procedure of controlling error terms with the confirmatory factor analysis. The reliability coefficient was adequate in the maintenance, management and confidence scales. Conclusion Following adaptation, the modified A-SCHFI was shown to be a valid and reliable measure of self-care among the Lebanese population. Implications for practice Cross-cultural adaptation is a rigorous process involving complex procedures and analyses. The adaptation of the A-SCHFI should be further analysed, including sensitivity and test-retest analysis, with methods to assess the degree of agreement among the panel.
Deek, H, Hamilton, S, Brown, N, Inglis, SC, DiGiacomo, M, Newton, P, Noureddine, S, Macdonald, P, Davidson, PM & FAMILY Project Investigators 2016, 'Family-centred approaches to healthcare interventions in chronic diseases in adults: a quantitative systematic review.', Journal of Advanced Nursing, vol. 72, no. 5, pp. 968-979.View/Download from: UTS OPUS or Publisher's site
Increasingly there is a focus on self-care strategies for both malignant and non-malignant conditions. Models of self-care interventions have focussed on the individual and less on the broader context of family and society. In many societies, decision-making and health seeking behaviours, involve family members.To identify elements of effective family-centred self-care interventions that are likely to improve outcomes of adults living with chronic conditions.Review paper.MEDLINE (Ovid), CINAHL, Academic Search Complete, PsychInfo and Scopus between 2000-2014.Quantitative studies targeting patient outcomes through family-centred interventions in adults were retrieved using systematic methods in January, 2015. Search terms used were: 'family', 'spouse', 'carer', 'caregiver', 'chronic', 'chronic disease', 'self-care', 'self-management' and 'self-efficacy'. Reference lists were reviewed. Risk of bias assessment was performed using the Cochrane Collaboration's tool. Data were reported using a narrative summary approach.Ten studies were identified. Improvements were noted in readmission rates, emergency department presentations, and anxiety levels using family-centred interventions compared with controls. Elements of effective interventions used were a family-centred approach, active learning strategy and transitional care with appropriate follow-up.Involving the family in self-care has shown some positive results for patients with chronic conditions. The benefits of family-centred care may be more likely in specific socio-cultural contexts.The review has year limits and further research needs to identify support for both the patients and family caregivers.
Deek, H, Noureddine, S, Newton, PJ, Inglis, SC, MacDonald, PS & Davidson, PM 2016, 'A family-focused intervention for heart failure self-care: conceptual underpinnings of a culturally appropriate intervention', Journal of Advanced Nursing, vol. 72, no. 2, pp. 434-450.View/Download from: UTS OPUS or Publisher's site
Deek, HA, Newton, PJ, Noureddine, S, Inglis, SC, Kabbani, S, Macdonald, P, Davidson, PM, Al Arab, G, Chalak, W & Nadim, T 2016, 'Protocol for a block randomised controlled trial of an intervention to improve heart failure care', Nurse Researcher, vol. 23, no. 4, pp. 24-29.View/Download from: UTS OPUS or Publisher's site
Aim To describe the design of a randomised controlled trial conducted to evaluate a culturally tailored, nurse-led educational intervention.
Background Self-care strategies are critical to improving health outcomes in heart failure. The family unit is crucial in collectivist cultures, but little is known about involving the family in the self-care of patients with heart failure.
Discussion Involving the family in the self-care of heart failure is a novel approach. To the authors' knowledge, no one has evaluated it using a randomised controlled trial.
Conclusion A valid comparison of outcomes between the control group and the intervention group involved in the study was provided in this trial. The chosen design, randomised controlled trial, enabled the assessment of the intervention.
Implications for practice The application of a family self-care intervention in a collectivist culture was shown to improve clinical and quality outcomes of patients with heart failure. Considering the individual and the community needs is vital in improving these outcomes.
Everett, B, Salamonson, Y, Rolley, JX & Davidson, PM 2016, 'Underestimation of risk perception in patients at risk of heart disease.', European Journal of Cardiovascular Nursing, vol. 15, no. 3.View/Download from: UTS OPUS or Publisher's site
Accurate perception of cardiovascular risk is important if people with established, or at high risk of, coronary heart disease are to engage in risk-reducing behaviours.This study aimed to determine whether the risk perception of patients undergoing a percutaneous coronary procedure was related to their subsequent engagement in risk-reducing behaviours.Using a prospective correlational design, patients presenting to a tertiary referral hospital in Sydney, Australia for an interventional cardiology procedure were surveyed at baseline and again at six months. Data collected included demographic and clinical information, relative risk perception (RRP-2), psychological status using the Hospital Anxiety and Depression scale and the Perceived Stress Scale, and physical activity using the Physical Activity Scale. In addition, data on medication adherence and cardiac rehabilitation enrolment were collected at the six-month follow-up.The study cohort consisted of 220 participants. Statistical analysis revealed a reduction in anxiety (p<0.001), depression (p =0.004) and stress (p <0.001), and an increase in physical activity engagement (p <0.001) from baseline to six-month follow-up. Higher risk perception scores at baseline predicted an increased likelihood of enrolment in a cardiac rehabilitation programme (p =0.01) and adherence to medication regimen (p =0.007).This study revealed an overall underestimation of risk perception among a sample of 'high risk' cardiac patients admitted to hospital for an interventional coronary procedure, with those who reported lower risk perception being less likely to attend cardiac rehabilitation and less likely to adhere to their medication regimen.
Ferguson, C, Inglis, SC, Newton, PJ, Middleton, S, Macdonald, PS & Davidson, PM 2016, 'Education and practice gaps on atrial fibrillation and anticoagulation: a survey of cardiovascular nurses', BMC Medical Education, vol. 16, no. 9.View/Download from: UTS OPUS or Publisher's site
Patients' knowledge of their atrial fibrillation (AF) and anticoagulation therapy are determinants of the efficacy of thromboprophylaxis. Nurses may be well placed to provide counselling and education to patients on all aspects of anticoagulation, including self-management. It is important that nurses are well informed to provide optimal education to patients. Current practice and knowledge of cardiovascular nurses on AF and anticoagulation in the Australian and New Zealand (ANZ) context is not well reported.
This study aimed to; 1) Explore the nurse's role in clinical decision making in anticoagulation in the setting of AF; 2) Describe perceived barriers and enablers to anticoagulation in AF; 3) Investigate practice patterns in the management of anticoagulation in the ANZ setting; 4) Assess cardiovascular nurses' knowledge of anticoagulation.
A paper-based survey on current practices and knowledge of AF and anticoagulation was distributed during the Australian Cardiovascular Nursing College (ACNC) Annual Scientific Meeting, February 2014. This survey was also emailed to Cardiovascular Trials Nurses throughout New South Wales, Australia and nursing members of the Cardiac Society of Australia and New Zealand (CSANZ).
There were 41/73 (56 %) respondents to the paper-based survey. A further 14 surveys were completed online via nurse members of the CSANZ, and via an investigator developed NSW cardiovascular trials nurse email distribution list. A total of 55 surveys were completed and included in analyses. Prior education levels on AF, stroke risk, anticoagulation and health behaviour modification were mixed. The CHA2DS2VASc and HAS-BLED risk stratification tools were reported to be underused by this group of clinicians. Reported key barriers to anticoagulation included; fears of patients falling, fears of poor adherence to medication taking and routine monitoring. Patient self-monitoring and self-management were reported as underutilise...
Foronda, C, VanGraafeiland, B, Quon, R & Davidson, P 2016, 'Handover and transport of critically ill children: An integrative review.', International journal of nursing studies, vol. 62, pp. 207-225.View/Download from: UTS OPUS or Publisher's site
The handover and transport of critically ill pediatric patients requires communication amongst multiple disciplines. Poor communication is a leading cause of sentinel events and human factors affect handover and transport.To synthesize published data on pediatric handover and transport and identify gaps to provide direction for future investigation.Integrative literature review.Forty research studies were reviewed and revealed the following themes: risk for patient complications, standardized communication, and specialized teams and teamwork were associated with improved outcomes. No articles were identified regarding transportation of critically ill pediatric patients from the emergency room to the intensive care unit. There was a knowledge gap in best practices in handover and transport within the unique subsets of the pediatric population including neonate, toddler, school-aged, and adolescents.Research supported a combined approach of specialized teams using standardized communication in the handover and transport of the pediatric patient to improve outcomes. Further study is warranted on interprofessional (team to team) handover practices, select subsets of the pediatric population, and the handover and transport of critically ill patients from the emergency room to the intensive care unit.
Green, A, Abbott, P, Delaney, P, Patradoon-Ho, P, Delaney, J, Davidson, PM & DiGiacomo, M 2016, 'Navigating the journey of Aboriginal childhood disability: a qualitative study of carers' interface with services', BMC Health Services Research, vol. 16, no. 1, pp. 1-11.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: The disadvantage experienced by Aboriginal and Torres Strait Islander children with a disability is well recognized. The long term consequences of failing to address disability on health, education and employment underlies the importance of early intervention. Caregivers experience a disproportionate burden and have challenges accessing services. The aim of this study was to describe the carer journey of accessing support and services. METHODS: We conducted in-depth semi-structured interviews with nineteen parents and carers of Aboriginal children aged 0-8 years. The children were patients at a child developmental clinic at a metropolitan area Aboriginal health service in Eastern Australia. Interpretive phenomenological analysis was applied to transcribed verbatim accounts. RESULTS: Four themes were developed using the 'journey' metaphor to describe the carer pathway of accessing support and services at the community, service and policy levels. Themes included 1) the need for increased signage within communities via community education, information and awareness, 2) wrong way signs, roundabouts and roadblocks encountered when accessing services, 3) alternate routes can facilitate the journey, and 4) incompatibility of inflexible bureaucratic road rules and lived realities. CONCLUSIONS: The challenges of caring for a child with a disability are indisputable and these can be compounded for people experiencing socio-economic disadvantage and marginalisation. Overcoming challenges to service access faced by carers of Aboriginal children with a disability will require investment in community, services and policy to tailor culturally appropriate models of care.
Hickman, LD, Neville, S, Fischer, T, Davidson, PM & Phillips, JL 2016, 'Editorial: Call to action: greater investment in the registered nurse role is required to improve care outcomes for dementia patients living in residential aged care and their families.', Contemporary nurse, vol. 52, no. 2-3, pp. 137-139.View/Download from: UTS OPUS or Publisher's site
The number of people living with dementia will triple by 2050 (World Health Organization,
2012). Dementia is a complex terminal illness and international global public health priority
(World Health Organization, 2012). Whilst enormous efforts focus on dementia treatments,
there is an equally urgent need to address workforce issues and invest in increasing the registered
nurse role and ratios in residential aged care to meet the projections. In most high-income
countries residential aged care facilities have evolved over the past two to three decades from
homes for the aged into slow-stream hospices, caring for our most vulnerable community
members (Allen, Chapman, O'Connor, & Francis, 2008). This population has complex care
needs requiring the input of a range of health professionals, such as geriatricians, general practitioners,
registered nurses and care assistants (Hickman, Rolley, & Davidson, 2010; Phillips,
Heneka, Hickman, Lam, & Shaw, 2014). Over this same time period the number of registered
or enrolled nurses working in residential aged care facilities has fallen and those that remain
have been largely relegated to managerial responsibilities. As a result the bulk of nursing care
in residential aged care is now provided by a largely unskilled and unregulated workforce.
Without the prerequisite dementia knowledge, skills or training, these staff are supervised by a
small number of registered nurses (Hullick et al., 2016). This is in contrast to emerging evidence
from long-term care and acute care setting, that nurse qualifications impact outcome. It also differs
significantly from standards in countries like Germany, where a minimum RN ratio of 50% is
mandatory (Aiken et al., 2010)
Maneze, D, Everett, B, DiGiacomo, M, Davidson, PM & Salamonson, Y 2016, 'An examination of responses to surveys among Filipino-Australian migrants', Nurse Researcher, vol. 24, no. 2, pp. 30-33.View/Download from: UTS OPUS or Publisher's site
Maneze, D, Everett, B, Kirby, S, DiGiacomo, M, Davidson, PM & Salamonson, Y 2016, ''I have only little English': language anxiety of Filipino migrants with chronic disease', Ethnicity and Health, vol. 21, no. 6, pp. 596-608.View/Download from: UTS OPUS or Publisher's site
OBJECTIVE: This study investigates communication challenges faced by Filipino patients with chronic diseases when engaging with healthcare professionals (HCPs). DESIGN: Nine focus groups were conducted between November 2010 and June 2011. RESULTS: Two main categories of themes were identified: patient-related and HCP-related factors. Patient-related factors included three subthemes: (1) lack of confidence in their English language abilities in clinical situations; (2) cultural attitudes; and (3) strategies used to improve communication. Older Filipinos with chronic disease were anxious about their lack of ability to explain their symptoms in English and were concerned that asking questions was conveying distrust in the HCPs. Most of the elderly simply nodded their head to indicate they understood even if they did not, for fear of being thought 'stupid'. Many participants preferred Filipino GPs or have a relative interpret for them. Two subthemes were related to HCPs including (1) not being listened to and (2) assumptions of understanding. HCPs were thought to assume English language skills in Filipino patients and therefore were not careful about ensuring understanding. CONCLUSIONS: These findings highlighted the need for HCPs to be more aware of 'grey areas' in English-language proficiency and the cultural lens through which migrants understand health.
Maneze, D, Salamonson, Y, Poudel, C, DiGiacomo, M, Everett, B & Davidson, PM 2016, 'Health-seeking behavior of Filipino migrants in Australia: The influence of persisting acculturative stress and depression', Journal of Immigrant and Minority Health, vol. 18, no. 4, pp. 779-786.View/Download from: UTS OPUS or Publisher's site
This study examined the relationships among the constructs of acculturative stress, depression, English language use, health literacy, and social support and the influence of these factors on health-seeking behaviors of Filipino Australians. Using a self-administered questionnaire, 552 respondents were recruited from November 2010 to June 2011. Structural equation modelling was used to examine relationships. A direct and negative relationship between health-seeking behaviors and depression, and an indirect relationship with acculturative stress, was observed mediated through depression. Social support had an important moderating influence on these effects. Although there was an inverse relationship between age and English language usage and depression, age was positively related to health-seeking behavior. Despite their long duration of stay, Filipino Australian migrants continue to experience acculturative stress and depression leading to lower health-seeking behaviors. This study highlights the importance of screening for acculturative stress and depression in migrants and fostering social support.
Morgan, R, Glass, N & Davidson, PM 2016, 'Moving women's health forward: Mainstreaming gender into global women's health programming.', Health care for women international, vol. 37, no. 11, p. i.View/Download from: Publisher's site
Murray-Parahi, P, DiGiacomo, M, Jackson, D & Davidson, PM 2016, 'New Graduate Registered Nurse Transition into Primary Health Care roles: An integrative literature review', Journal of Clinical Nursing, vol. 25, pp. 3084-3101.View/Download from: UTS OPUS or Publisher's site
Aims and objectives. To summarise the literature describing new graduate nursetransition to professional practice within the primary health care (PHC) setting.Background. There is a plethora of research literature spanning several decadesabout new graduate nurse transition in the acute care setting. Yet, the experiencesof new graduate nurse in the PHC setting is unremarkable particularly consider-ing the increasing demand for skilled health care workers and focus of healthreform to provide care where people work and live.Design. Electronic data bases, Academic Search Complete, EBSCO, Medline, Psy-cINFO, CINHAL, and ERIC were searched using a combination of terms andsynonyms arising from three key concepts which identify the phenomenon; 'tran-sition', 'new graduate registered nurse' and 'primary health care. An inclusivesearch strategy placed no limits on language or publication date.Results. Of the 50 articles located and examined for relevance; 40 were sourcedthrough databases and 10 from Google Scholar/Alerts and hand-searching refer-ences. None of the 19 articles retained for analysis addressed all key concepts.Conclusions. Some challenges of researching the professional transition of gradu-ate nurses in PHC settings included, an absence of denitive transition models, adearth of literature and deference to acute care research.Relevance to clinical practice. Nursing in PHC settings, particularly the client'shome is notably different to hospital settings because of higher levels of isolationand autonomy. Societal changes, health reform and subsequent demand for skilledworkers in PHC settings has caused health care providers to question the logicthat such roles are only for experienced nurses. Implications arise for educationand health service providers who desire to close the theory practice gap and miti-gate risk for all stakeholders when next generation nurses have limited opportuni-ties to experience PHC roles as undergraduates and newly graduated registered...
Newton, PJ, Davidson, PM, Reid, CM, Krum, H, Hayward, C, Sibbritt, DW, Banks, E & MacDonald, PS 2016, 'Acute heart failure admissions in New South Wales and the Australian Capital Territory: the NSW HF Snapshot Study.', The Medical journal of Australia, vol. 204, no. 3, pp. 1-8.View/Download from: UTS OPUS or Publisher's site
The primary aim of the NSW Heart Failure (HF) Snapshot was to obtain a representative cross-sectional view of patients with acute HF and their management in New South Wales and Australian Capital Territory hospitals.A prospective audit of consecutive patients admitted to 24 participating hospitals in NSW and the ACT with a diagnosis of acute HF was conducted from 8 July 2013 to 8 August 2013.A total of 811 participants were recruited (mean age, 77 ± 13 years; 58% were men; 42% had a left ventricular ejection fraction 50%). The median Charlson Comorbidity Index score was 3, with ischaemic heart disease (56%), renal disease (55%), diabetes (38%) and chronic lung disease (32%) the most frequent comorbidities; 71% of patients were assessed as frail. Intercurrent infection (22%), non-adherence to prescribed medication (5%) or to dietary or fluid restrictions (16%), and atrial fibrillation/flutter (15%) were the most commonly identified precipitants of HF. Initial treatment included intravenous diuretics (81%), oxygen therapy (87%), and bimodal positive airways pressure or continuous positive airways pressure ventilation (17%). During the index admission, 6% of patients died. The median length of stay in hospital was 6 days, but ranged between 3 and 12 days at different hospitals. Just over half the patients (59%) were referred to a multidisciplinary HF service. Discharge medications included angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (59%), -blockers (66%) and loop diuretics (88%).Patients admitted to hospital with acute HF in NSW and the ACT were generally elderly and frail, with multiple comorbidities. Evidence-based therapies were underused, and there was substantial interhospital variation in the length of stay. We anticipate that the results of the HF Snapshot will inform the development of strategies for improving the uptake of evidence-based therapies, and hence outcomes, for HF patients.
Sayers, JM, Salamonson, Y, DiGiacomo, M & Davidson, PM 2016, 'Validation of the professional practice environment scale in nurse educators in hospitals', Nurse Researcher, vol. 23, no. 4, pp. 14-18.View/Download from: UTS OPUS or Publisher's site
© 2016 RCNi Ltd. Aim: To report an assessment of the psychometric properties of the Professional Practice Environment (PPE) scale in a sample of Australian nurse educators in acute care hospitals. Background: Although nurse educators are important in an enabling work environment, there has been no reported exploration of their satisfaction with work in acute care hospitals. Discussion: The factor structure and internal consistency of the PPE scale were consistent with Erickson's eight-factor model of the items, indicating the appropriateness of the scale as an assessment tool to measure the PPE of nurse educators. Conclusion: The PPE scale is useful for monitoring the work environment of nurse educators in clinical practice and the environmental effects influencing their recruitment, retention and job satisfaction. Implications for practice: This work may inform the development of integrated professional practice environments where the professional practice and workplace satisfaction of nurse educators are optimised, influencing safe, quality patient care.
Shaw, JM, Young, JM, Butow, PN, Badgery-Parker, T, Durcinoska, I, Harrison, JD, Davidson, PM, Martin, D, Sandroussi, C, Hollands, M, Joseph, D, Das, A, Lam, V, Johnston, E & Solomon, MJ 2016, 'Improving psychosocial outcomes for caregivers of people with poor prognosis gastrointestinal cancers: a randomized controlled trial (Family Connect).', Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, vol. 24, no. 2, pp. 585-595.View/Download from: Publisher's site
This study investigated the effectiveness of a structured telephone intervention for caregivers of people diagnosed with poor prognosis gastrointestinal cancer to improve psychosocial outcomes for both caregivers and patients.Caregivers of patients starting treatment for upper gastrointestinal or Dukes D colorectal cancer were randomly assigned (1:1) to the Family Connect telephone intervention or usual care. Caregivers in the intervention group received four standardized telephone calls in the 10 weeks following patient hospital discharge. Caregivers' quality of life (QOL), caregiver burden, unmet supportive care needs and distress were assessed at 3 and 6 months. Patients' QOL, unmet supportive care needs, distress and health service utilization were also assessed at these time points.Caregivers (128) were randomized to intervention or usual care groups. At 3 months, caregiver QOL scores and other caregiver-reported outcomes were similar in both groups. Intervention group participants experienced a greater sense of social support (p=.049) and reduced worry about finances (p=.014). Patients whose caregiver was randomized to the intervention also had fewer emergency department presentations and unplanned hospital readmissions at 3 months post-discharge (total 17 vs. 5, p=.01).This standardized intervention did not demonstrate any significant improvements in caregiver well-being but did result in a decrease in patient emergency department presentations and unplanned hospital readmissions in the immediate post-discharge period. The trend towards improvements in a number of caregiver outcomes and the improvement in health service utilization support further development of telephone-based caregiver-focused supportive care interventions.
Siabani, S, Driscoll, T, Davidson, PM & Leeder, SR 2016, 'Efficacy of a home-based educational strategy involving community health volunteers in improving self-care in patients with chronic heart failure in western Iran: A randomized controlled trial.', European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology, vol. 15, no. 5, pp. 363-371.View/Download from: UTS OPUS or Publisher's site
This study aimed to evaluate the effectiveness of a home-based educational strategy using community health volunteers (CHVs) in improving self-care of patients with chronic heart failure (CHF) in comparison with an educational strategy using formal health professionals (FHPs) at hospital, and also with a control group receiving usual care in western Iran.A three-arm controlled trial randomly allocated 231 patients with CHF into a control group and two intervention groups undertaking two different educational approaches - a face-to-face education program by CHVs at the patients' homes and a formal education program using paid FHPs at hospital. Data obtained through interviewing patients before and two months after interventions were analyzed. Self-care components significantly increased after the intervention in both interventional groups compared to the control group (p<0.001). Differences between the two strategies were not significant, except for self-care confidence being greater in the groups exposed to the health professionals (p=0.004). The mean and standard deviation (SD) of the changes in self-maintenance, self-management and self- confidence score (each with a maximum score of 100) for the CHVs group were 26.2±12.7, 29.4±11 9.5±17; for the health professional group were 29.5±12, 31.3±12, 18.1±17; and for the control group were 2.7±9, 10.2±10, -0.30±11 respectively.The home-based face-to-face education by CHVs improved self-care maintenance and self-care management in patients with CHF as effectively as the education provided by health professionals in a formal health education program, and much better than the usual care.
Siabani, S, Driscoll, T, Davidson, PM, Najafi, F, Jenkins, MC & Leeder, SR 2016, 'Self-care and Its Predictors in Patients With Chronic Heart Failure in Western Iran.', The Journal of cardiovascular nursing, vol. 31, no. 1, pp. 22-30.View/Download from: UTS OPUS or Publisher's site
Chronic heart failure (CHF) is an increasing and costly health problem worldwide. Effective self-care behaviors reduce the cost and improve CHF outcomes. Interventions targeting improvement of self-care need to identify the baseline status of patients and factors associated with self-care to tailor the programs to patients' needs.The aim of this study was to describe self-care and its predictors in patients with CHF in western Iran.In a cross-sectional study, 255 patients with CHF in Kermanshah were recruited and 231 (mean [SD] age, 66  years; 51.5% women) completed the interviews. Self-care maintenance, self-care management, and self-care confidence were evaluated using a Persian heart failure self-care index. Each of these 3 measures had a total possible score of 100, with 22 indicators.The mean (SD) self-care scores were low: maintenance, 33.8 (10.7); management, 32.2 (12.0); and confidence, 43.6 (15.6). Self-care maintenance was significantly and positively associated with education, disease duration, and living conditions. Self-care management was significantly and positively associated with education and number of hospital admissions. However, the parameter estimates in all those relationships were small.Self-care in patients with CHF in Iran needs major improvement, and many determinants of self-care identified by other studies were not consistently associated with poor self-care scores in Iran. Further research considering a wide range of factors associated with self-care (eg, socioeconomic and health system-related factors) and application of culturally relevant interventional strategies is recommended.
Sibbritt, D, Davidson, P, Peng, WB, Adams, J & Hickman, L 2016, 'Hypertension: What are the self-care and health-care-seeking behaviours in women over time?', Journal of human hypertension, vol. 30, pp. 783-787.View/Download from: Publisher's site
The aim of this study was to estimate the prevalence and incidence of hypertension in women, and describe their self-care and health-seeking behaviours. This research was conducted as part of the Australian Longitudinal Study on Women's Health, a study comprising a nationally representative sample of Australian women in three age groups. The focus of this research is 14099 women born in 1946-1951, who have been surveyed six times (1996-2010). Student t-tests were used to compare women who did or did not have hypertension by their health-care utilization. Longitudinal analyses were conducted using a Poisson generalized estimating equation model. The incidence of hypertension among this cohort during 1996 to 2010 ranged from 400 to 597 participants per survey, resulting in an increase in prevalence of hypertension from 20.9% in 1996 to 41.3% in 2010. For all survey periods, women with hypertension had a significantly higher average number of visits to doctors and allied health practitioners compared with women without hypertension (P<0.005). The use of complementary medicine (practitioners and self-prescribed treatments) by women with hypertension was significantly lower compared to women without hypertension (P<0.005). Over time, conventional health-care utilization was higher for women with hypertension compared with women without hypertension (adjusted RR=1.18; 95% CI: 1.14, 1.22; P<0.0001). Our findings show that women with hypertension are using a range of conventional and complementary and alternative medicine: with hypertensive women using more conventional medicine and less complementary and alternative medicine than non-hypertensive women. As such, health-care providers should communicate with their patients regarding their use of complementary and alternative medicine in their efforts to provide safe, effective and coordinate care.Journal of Human Hypertension advance online publication, 28 April 2016; doi:10.1038/jhh.2016.20.
Travaglia, J, Robertson, H, Davidson, PM & Daly, J 2016, 'Problematizing the practice of policy.', Journal of nursing management, vol. 24, no. 4, pp. 435-438.View/Download from: UTS OPUS or Publisher's site
Wyllie, A, DiGiacomo, M, Phillips, J, Davidson, PM & Jackson, D 2016, 'Acknowledging attributes that enable the career academic nurse to thrive in the tertiary education sector: a qualitative systematic review', Nurse Education Today, vol. 45, pp. 212-218.View/Download from: UTS OPUS or Publisher's site
Allida, SM, Inglis, SC, Davidson, PM, Hayward, CS, Shehab, S & Newton, PJ 2016, 'A survey of views and opinions of health professionals managing thirst in chronic heart failure.', Contemporary nurse, vol. 52, no. 2-3, pp. 244-252.View/Download from: UTS OPUS or Publisher's site
Thirst is a common and burdensome symptom of chronic heart failure (CHF) which affects adherence to self-care practices specifically fluid restriction. Despite this, there is no standard clinical practice for managing the symptom of thirst.The aim is to identify the current strategies recommended by health professionals to help relieve thirst in CHF patients and their perceived usefulness of these strategies.A survey was distributed to attendees of the 8th Annual Scientific Meeting of Australasian Cardiovascular Nursing College.There were 42 of 70 respondents to the survey. The majority (33 of 40; 82.5%) had recommended various strategies to alleviate thirst. The most recommended strategy was ice chips (36 of 38; 94.7%). Overall, the respondents reported 'some use' in all of the strategies.Information from this survey may help in the incorporation of thirst-relieving strategies into evidence-based guidelines; further improving the quality of care of patients.
Watts, GJ, Clark, K, Agar, M, Davidson, PM, McDonald, C, Lam, LT, Sajkov, D, McCaffrey, N, Doogue, M, Abernethy, AP, Currow, DC & Australian national Palliative Care Clinical Studies Collaborative (PaCCSC) 2016, 'Study protocol: a phase III randomised, double-blind, parallel arm, stratified, block randomised, placebo-controlled trial investigating the clinical effect and cost-effectiveness of sertraline for the palliative relief of breathlessness in people with chronic breathlessness.', BMJ open, vol. 6, no. 11, p. e013177.View/Download from: UTS OPUS or Publisher's site
Breathlessness remains a highly prevalent and distressing symptom for many patients with progressive life-limiting illnesses. Evidence-based interventions for chronic breathlessness are limited, and there is an ongoing need for high-quality research into developing management strategies for optimal palliation of this complex symptom. Previous studies have suggested that selective serotonin reuptake inhibitors such as sertraline may have a role in reducing breathlessness. This paper presents the protocol for a large, adequately powered randomised study evaluating the use of sertraline for chronic breathlessness in people with progressive life-limiting illnesses.A total of 240 participants with modified Medical Research Council Dyspnoea Scale breathlessness of level 2 or higher will be randomised to receive either sertraline or placebo for 28days in this multisite, double-blind study. The dose will be titrated up every 3days to a maximum of 100mg daily. The primary outcome will be to compare the efficacy of sertraline with placebo in relieving the intensity of worst breathlessness as assessed by a 0-100mm Visual Analogue Scale. A number of other outcome measures and descriptors of breathlessness as well as caregiver assessments will also be recorded to ensure adequate analysis of participant breathlessness and to allow an economic analysis to be performed. Participants will also be given the option of continuing blinded treatment until either study data collection is complete or net benefit ceases. Appropriate statistical analysis of primary and secondary outcomes will be used to describe the wealth of data obtained.Ethics approval was obtained at all participating sites. Results of the study will be submitted for publication in peer-reviewed journals and the key findings presented at national and international conferences.ACTRN12610000464066.
Hosie, A, Lobb, E, Agar, M, Davidson, P, Chye, R, Lam, L & Phillips, J 2016, 'Measuring delirium point-prevalence in two Australian palliative care inpatient units.', International journal of palliative nursing, vol. 22, no. 1, pp. 13-21.View/Download from: UTS OPUS or Publisher's site
Internationally, delirium prevalence in palliative care is reported to range between 26-88%, yet little is known about the occurrence of delirium in Australian palliative care inpatient populations.To: 1) ascertain 24-hour delirium point-prevalence in an Australian palliative care inpatient population; 2) test the feasibility and acceptability of the delirium measurement methodology.This was a prospective cross-sectional study. Delirium was measured in patients of two palliative care units using the Nursing Delirium Screening Scale, Memorial Delirium Assessment Scale and DSM-5 diagnostic criteria. Descriptive statistics were used to report patient demographics, palliative care phase, function, delirium measure completion, and proportion of patients with a positive screen and diagnosis.Patients (n=47) had a mean age of 74 years (SD+10) and mostly malignant diagnoses (96%). All patients were screened for delirium, but few were capable of completing the Memorial Delirium Assessment Scale (n=2). One-third of patients (34%) screened positive for delirium and 19% were diagnosed as delirious according to the DSM-5.The Nursing Delirium Screening Scale and physician application of DSM-5 proved feasible and acceptable, while the Memorial Delirium Assessment Scale did not. Patients' advanced age and proportions screening positive for delirium and diagnosed as delirious attest to the need to rapidly recognise, assess and respond to patients experiencing this distressing disorder while being cared for in palliative care inpatient settings.
Babatunde-Sowole, OO, Jackson, D, Davidson, PM & Power, T 2016, ''Coming to a Strange Land': The West African Migrant Women's Establishment of Home and Family in a New Culture Within Australia', Journal of Transcultural Nursing, pp. 1-9.View/Download from: UTS OPUS or Publisher's site
Purpose: Migrating and establishing a new life in another culture can have diverse health effects especially for women.
This article explores the struggles and social adjustment issues that might constitute negatively to the health of West
African migrant women living in Australia. Design: Qualitative storytelling. Audiotaped voluntary stories from 20 West
African migrant women living in Sydney, Australia were transcribed and analyzed. Findings: Three themes are presented for
discussion: (1) But it is different here: life in a new country; (2) I have to do it all by myself: communal versus individual living; and
(3) They don't listen to parents: perceived threats to the family unit. Conclusion/Implication for Practice: The demand for
and the importance of nurses and midwives in supporting migrant families is demonstrated by findings suggesting that social
adjustment into the Australian culture has a significant impact on both the nuclear and extended family unit of women.
Sowole, O, Power, T, Jackson, D, Davidson, PM & DiGiacomo, M 2016, 'Resilience of African migrant women: an integrative review', Health Care for Women International, vol. 37, no. 9, pp. 946-963.View/Download from: UTS OPUS or Publisher's site
African migrant women represent a rapidly growing cohort of new arrivals in many countries. Many of these women demonstrate strength and resilience throughout the stressful migration process. In this integrative review, we explore the literature on African migrants' resilience using an ecological framework. Nine peer-reviewed journal articles and six grey literature documents were reviewed. Key internal and external factors in achieving resilience were identified, discussed, and diagrammatically represented using Bronfenbrenner's Ecological Framework under micro-, meso-, exo-, and macro-levels. Our findings show that the capacity for resilience demonstrated during migration could have implications for policy and practice.
Jha, SR, Hannu, MK, Chang, S, Montgomery, E, Harkess, M, Wilhelm, K, Hayward, CS, Jabbour, A, Spratt, PM, Newton, P, Davidson, PM & Macdonald, PS 2016, 'The Prevalence and Prognostic Significance of Frailty in Patients With Advanced Heart Failure Referred for Heart Transplantation.', Transplantation, vol. 100, no. 2, pp. 429-436.View/Download from: UTS OPUS or Publisher's site
Frailty is a clinically recognized syndrome of decreased physiological reserve. The heightened state of vulnerability in these patients confers a greater risk of adverse outcomes after even minor stressors. Our aim was to assess the prevalence and prognostic significance of the frailty phenotype in patients referred for heart transplantation.Consecutive patients referred or on the waiting list for heart transplantation from March 2013 underwent frailty assessment. Frailty was defined as a positive response to 3 or more of the following 5 components: weak grip strength, slowed walking speed, poor appetite, physical inactivity, and exhaustion. In addition, markers of disease severity were obtained, and all patients underwent cognitive (Montreal Cognitive Assessment) and depression (Depression in Medical Illness-10) screening.One hundred twenty patients (83 men:37 women; age, 53 ± 12 years, range, 16-73 years; left ventricular ejection fraction, 27 ± 14%) underwent frailty assessment. Thirty-nine of 120 patients (33%) were assessed as frail. Frailty was associated with New York Heart Association class IV heart failure, lower body mass index, elevated intracardiac filling pressures, lower cardiac index, anemia, hypoalbuminemia, hyperbilirubinemia, cognitive impairment, and depression (all < 0.05). Frailty was independent of age, sex, heart failure duration, left ventricular ejection fraction, or renal function. Frailty was an independent predictor of increased all-cause mortality: 1 year actuarial survival was 79 ± 5% in the nonfrail group compared with only 54 ± 9% for the frail group (P < 0.005).Frailty is prevalent among patients with advanced symptomatic heart failure referred for heart transplantation and is associated with increased mortality.
Jha, SR, Hannu, MK, Gore, K, Chang, S, Newton, P, Wilhelm, K, Hayward, CS, Jabbour, A, Kotlyar, E, Keogh, A, Dhital, K, Granger, E, Jansz, P, Spratt, PM, Montgomery, E, Harkess, M, Tunicliff, P, Davidson, PM & Macdonald, PS 2016, 'Cognitive impairment improves the predictive validity of physical frailty for mortality in patients with advanced heart failure referred for heart transplantation', JOURNAL OF HEART AND LUNG TRANSPLANTATION, vol. 35, no. 9, pp. 1092-1100.View/Download from: UTS OPUS or Publisher's site
Luckett, T, Disler, R, Hosie, A, Johnson, M, Davidson, P, Currow, D, Sumah, A & Phillips, J 2016, 'Content and quality of websites supporting self-management of chronic breathlessness in advanced illness: a systematic review.', NPJ primary care respiratory medicine, vol. 26, p. 16025.View/Download from: UTS OPUS or Publisher's site
Chronic breathlessness is a common, burdensome and distressing symptom in many advanced chronic illnesses. Self-management strategies are essential to optimise treatment, daily functioning and emotional coping. People with chronic illness commonly search the internet for advice on self-management. A review was undertaken in June 2015 to describe the content and quality of online advice on breathlessness self-management, to highlight under-served areas and to identify any unsafe content. Google was searched from Sydney, Australia, using the five most common search terms for breathlessness identified by Google Trends. We also hand-searched the websites of national associations. Websites were included if they were freely available in English and provided practical advice on self-management. Website quality was assessed using the American Medical Association Benchmarks. Readability was assessed using the Flesch-Kincaid grades, with grade 8 considered the maximum acceptable for enabling access. Ninety-one web pages from 44 websites met the inclusion criteria, including 14 national association websites not returned by Google searches. Most websites were generated in the USA (n=28, 64%) and focused on breathing techniques (n=38, 86%) and chronic obstructive pulmonary disease (n=27, 61%). No websites were found to offer unsafe advice. Adherence to quality benchmarks ranged from 9% for disclosure to 77% for currency. Fifteen (54%) of 28 written websites required grade 9 reading level. Future development should focus on advice and tools to support goal setting, problem solving and monitoring of breathlessness. National associations are encouraged to improve website visibility and comply with standards for quality and readability.
Disalvo, D, Luckett, T, Agar, M, Bennett, A & Davidson, PM 2016, 'Systems to identify potentially inappropriate prescribing in people with advanced dementia: a systematic review', BMC GERIATRICS, vol. 16.View/Download from: UTS OPUS or Publisher's site
Davidson, PM, Phillips, JL, Dennison-Himmelfarb, C, Thompson, SC, Luckett, T & Currow, DC 2016, 'Providing palliative care for cardiovascular disease from a perspective of sociocultural diversity: a global view', CURRENT OPINION IN SUPPORTIVE AND PALLIATIVE CARE, vol. 10, no. 1, pp. 11-17.View/Download from: UTS OPUS or Publisher's site
Forber, J, DiGiacomo, M, Carter, B, Davidson, P, Phillips, J & Jackson, D 2016, 'In pursuit of an optimal model of undergraduate nurse clinical education: An integrative review', Nurse Education in Practice, vol. 21, pp. 83-92.View/Download from: UTS OPUS or Publisher's site
Clinical learning experiences are an essential part of nurse education programs. Numerous approaches to clinical education and student supervision exist. The aim of this integrative review was to explore how studies have compared or contrasted different models of undergraduate nurse clinical education. A search of eight databases was undertaken to identify peer-reviewed literature published between 2006 and 2015. Eighteen studies met the inclusion criteria. A diverse range of methodologies and data collection methods were represented, which primarily explored student experiences or perceptions. The main models of undergraduate nurse clinical education identified were: traditional or clinical facilitator model; the preceptorship or mentoring model; and the collaborative education unit model in addition to several novel alternatives. Various limitations and strengths were identified for each model with no single optimal model evident. Thematic synthesis identified four common elements across the models: the centrality of relationships; the need for consistency and continuity; the potential for variety of models; and the viability/sustainability of the model. The results indicate that effective implementation and key elements within a model may be more important than the overarching concept of any given model. Further research is warranted to achieve an agreed taxonomy and relate model elements to professional competence.
Abshire, M, Xu, J, Dennison Himmelfarb, C, Davidson, P, Sulmasy, D, Kub, J, Hughes, M & Nolan, M 2015, 'Symptoms and fear in heart failure patients approaching end of life: a mixed methods study.', Journal of clinical nursing, vol. 24, no. 21-22, pp. 3215-3223.View/Download from: UTS OPUS or Publisher's site
The purpose of this study was to consider how fear and symptom experience are perceived in patients with heart failure at the end of life.Heart failure is a burdensome condition and mortality rates are high globally. There is substantive literature describing suffering and unmet needs but description of the experience of fear and the relationship with symptom burden is limited.A convergent mixed methods design was used.Data from the McGill Quality of Life Questionnaire (n = 55) were compared to data from in-depth interviews (n = 5).Patients denied fear when asked directly, but frequently referred to moments of being afraid when they were experiencing symptoms. In addition, patients reported few troublesome symptoms on the survey, but mentioned many more symptoms during interviews.These data not only identify the relationship between psychological issues and symptom experience but also elucidate the benefit of a mixed method approach in describing such experiences from the perspective of the patient. Future research should examine relationships between and among symptom experience, fear and other psychological constructs across the illness trajectory.Conversations about the interaction of symptom burden and fear can lead to both a more robust assessment of symptoms and lead to patient centred interventions.
Alomari, A, Wilson, V, Davidson, PM & Lewis, J 2015, 'Families, nurses and organisations contributing factors to medication administration error in paediatrics: a literature review', International Practice Development Journal, vol. 5, no. 1, pp. 1-14.View/Download from: UTS OPUS
Background: Medication error is the most common adverse event for hospitalised children and can lead to significant harm. Despite decades of research and implementation of a number of initiatives, the error rates continue to rise, particularly those associated with administration.
Objectives: The objective of this literature review is to explore the factors involving nurses, families and healthcare systems that impact on medication administration errors in paediatric patients.
Design: A review was undertaken of studies that reported on factors that contribute to a rise or fall in medication administration errors, from family, nurse and organisational perspectives. The following databases were searched: Medline, Embase, CINAHL and the Cochrane library. The title, abstract and full article were reviewed for relevance. Articles were excluded if they were not research studies, they related to medications and not medication administration errors or they referred to medical errors rather than medication errors.
Results: A total of 15 studies met the inclusion criteria. The factors contributing to medication administration errors are communication failure between the parents and healthcare professionals, nurse workload, failure to adhere to policy and guidelines, interruptions, inexperience and insufficient nurse education from organisations. Strategies that were reported to reduce errors were double-checking by two nurses, implementing educational sessions, use of computerised prescribing and barcoding administration systems. Yet despite such interventions, errors persist. The review highlighted families that have a central role in caring for the child and therefore are key to the administration process, but have largely been ignored in research studies relating to medication administration.
Conclusions: While there is a consensus about the factors that contribute to errors, sustainable and effective solutions remain elusive. To date, families have not been included a...
Anuruang, S, Davidson, PM, Jackson, D & Hickman, L 2015, 'Strategies to enhance recruitment of rural-dwelling older people into community-based trials.', Nurse researcher, vol. 23, no. 1, pp. 40-43.View/Download from: Publisher's site
To describe strategies that can enhance the recruitment of rural-dwelling older people into clinical trials.Recruitment to studies can be time-consuming and challenging. Moreover, there are challenges associated with recruiting older people, particularly those living in rural areas. Nevertheless, an adequate sample size is crucial to the validity of randomised controlled trials (RCTs).The authors draw on the literature and their personal experiences, to present a range of flexible and inclusive strategies that have been successfully used to recruit older people into clinical trials.This paper describes attempts to improve recruitment of rural-dwelling, older Thai people to a clinical trial.To attract potential participants, researchers should consider minimising the burden of their study and maximising its benefits or convenience for participants. Three factors that may influence participation rates are: personal factors of participants, researchers' personal attributes, and protocol factors. In addition, three important strategies contribute to improving recruitment: understanding the culture of the research setting, identifying the 'gatekeepers' in the setting and building trust with stakeholders.Even though the study covered did not recruit a large number of participants, these understandings were crucial and enabled recruitment of a sufficient number of participants in a reasonable timeframe.These strategies may be of use in rural settings and with different communities including urban communities.
Azimzadeh, E, Hosseini, MA, Nourozi, K & Davidson, PM 2015, 'Effect of Tai Chi Chuan on balance in women with multiple sclerosis.', Complementary therapies in clinical practice, vol. 21, no. 1, pp. 57-60.View/Download from: UTS OPUS or Publisher's site
To examine the effect of Tai Chi Chuan on balance in women with multiple sclerosis in Iran.36 women with multiple sclerosis who were members of the Iranian Multiple Sclerosis Society participated in this study. 18 participants were allocated to the intervention group and 18 allocated to the control group. The intervention consisted of Yang style Tai Chi Chuan exercise sessions twice a week for 12 weeks.This study used a demographic questionnaire and the Berg Balance Scale (BBS) to collect data.After 12 weeks, the mean score of the BBS in the intervention group demonstrated a statistically significant improvement in comparison with baseline status.The results suggest that Tai Chi Chuan could be used as a safe complementary intervention to increase balance in patients with multiple sclerosis.
Betihavas, V, Frost, SA, Newton, PJ, Macdonald, P, Stewart, S, Carrington, MJ, Chan, YK & Davidson, PM 2015, 'An Absolute Risk Prediction Model to Determine Unplanned Cardiovascular Readmissions for Adults with Chronic Heart Failure.', Heart Lung and Circulation, vol. 24, no. 11, pp. 1068-1073.View/Download from: Publisher's site
Frequent readmissions are a hallmark of chronic heart failure (CHF). We sought to develop an absolute risk prediction model for unplanned cardiovascular readmissions following hospitalisation for CHF.An inception cohort was obtained from the WHICH? trial, a prospective, multi-centre randomised controlled trial which was a head-to-head comparison of the efficacy of a home-based intervention versus clinic-based intervention for adults with CHF. A Cox's proportional hazards model (taking into account the competing risk of death) was used to develop a prediction model. Bootstrap methods were used to identify factors for the final model. Based on these data a nomogram was developed.Of the 280 participants in the WHICH? trial 37 (13%) were readmitted for a cardiovascular event (including CHF) within 28 days, and a further 149 (53%) were readmitted within 18 months for a cardiovascular event. In the proposed competing risk model, factors associated with an increased risk of hospitalisation for CHF were: age (HR 1.07, 95% CI 0.90-1.26) for each 10-year increase in age; living alone (HR 1.09, 95% CI 0.74-1.59); those with a sedentary lifestyle (HR 1.44, 95% CI, 0.92-2.25) and the presence of multiple co-morbid conditions (HR 1.69, 95% CI 0.38-7.58) for five or more co-morbid conditions (compared to individuals with one documented co-morbidity). The C-statistic of the final model was 0.80.We have developed a practical model for individualising the risk of short-term readmission for CHF. This model may provide additional information for targeting and tailoring interventions and requires future prospective evaluation.
Cao, Y, DiGiacomo, M, Salamonson, Y, Li, Y, Huai, B & Davidson, PM 2015, 'Nurses' perceptions of their professional practice environment: a cross-sectional study.', Journal of Clinical Nursing, vol. 24, no. 23-24, pp. 3441-3448.View/Download from: UTS OPUS or Publisher's site
AIMS AND OBJECTIVES: To describe nurses' perceptions concerning their professional practice environment in mainland China and identify factors associated with these views. BACKGROUND: Globally, the environments in which nurses work influence the quality of nursing practice and health care. DESIGN: A cross-sectional descriptive survey using both paper- and online-based delivery modes was used. METHOD: A convenience sampling method was used. The survey questionnaire was composed of sociodemographic items and the 38-item Chinese version of Professional Practice Environment survey. The content of the paper-based questionnaire was identical to the online survey. Pearson's chi-square test was conducted to compare the demographic characteristics of these two data sets. Descriptive statistics analysis included frequency, percentage, mean and standard deviation. Multiple linear regression analysis using the Backwards method was applied to identify independent predictors of each subscale of the 38-item Chinese version of Professional Practice Environment. RESULTS: A total of 573 questionnaires were analysed. The mean score of each subscale of the 38-item Chinese version of Professional Practice Environment in this study ranged from 2·66-3·05. All subscales except work motivation (3·05, standard deviation: 0·44) scored less than 3·0. Areas rated as most in need of improvement included control over practice, interpersonal interaction, supportive leadership and handling conflict, and staff relationships with physicians and autonomy. CONCLUSION: This study has identified nurses' perspectives regarding their workplaces in contemporary China. These data have provided an important baseline for developing and implementing culturally appropriate strategies to improve the working environment of Chinese nurses. RELEVANCE TO CLINICAL PRACTICE: A supportive and enabling work environment promotes professional development and the safety and quality of health care. Addressing these factor...
Carryer, J, Halcomb, E & Davidson, PM 2015, 'Nursing: the answer to the primary health care dilemma.', Collegian (Royal College of Nursing, Australia), vol. 22, no. 2, pp. 151-152.
Chang, S, Davidson, PM, Newton, PJ, Macdonald, P, Carrington, MJ, Marwick, TH, Horowitz, JD, Krum, H, Reid, CM, Chan, YK, Scuffham, PA, Sibbritt, D & Stewart, S 2015, 'Composite outcome measures in a pragmatic clinical trial of chronic heart failure management: A comparative assessment', International Journal of Cardiology, vol. 185, pp. 62-68.View/Download from: UTS OPUS or Publisher's site
Chroinin, DN, Goldsbury, D, O'Connell, DL, Beveridge, A, Davidson, P, Girgis, A, Ingham, N, Phillips, JL, Wilkinson, A & Ingham, J 2015, 'Hospital services utilisation amongst older patients in the last year of life: a New South Wales (NSW) population-based study', AUSTRALASIAN JOURNAL ON AGEING, vol. 34, pp. 66-67.
Daly, J, Jackson, D, Rumsey, M, Patterson, K & Davidson, PM 2015, 'Building Nursing Leadership Capacity: An Australian Snapshot', Nurse Leader, vol. 13, no. 5, pp. 36-39.View/Download from: Publisher's site
© 2015 Mosby, Inc. Leadership is a highly prized commodity across a range of contemporary industries, and healthcare is no exception where the stakes are high. Healthcare, previously viewed as peripheral to many other societal structures, is now front and center, largely due to increasing costs and the increased consumption of gross domestic product. Australia is a culturally diverse and pluralistic society supporting a system of universal healthcare that is accountable and transparent. There are over 200,000 nurses in Australia, working in hospitals, clinics, aged care facilities, and schools, and these individuals are integrally important to the effective and functional health system. Moreover, Australia is intensely aware of the effects of globalization and the importance of a global strategy for human resources for health.
Davidson, P 2015, 'Author's response.', International journal of nursing studies, vol. 52, no. 1, p. 503.
Davidson, PM 2015, 'Another Piece of the Puzzle: Wait Times Call for Integrated Patient, Provider, and System Solutions for Cardiac Rehabilitation.', Circulation. Cardiovascular quality and outcomes, vol. 8, no. 6, pp. 539-540.View/Download from: Publisher's site
Davidson, PM & Du, H 2015, 'Nurses do not have proprietary rights on caring: but we do on clinical practice models.', Journal of nursing management, vol. 23, no. 4, pp. 409-410.View/Download from: Publisher's site
Davidson, PM, Newton, PJ, Tankumpuan, T, Paull, G & Dennison-Himmelfarb, C 2015, 'Multidisciplinary Management of Chronic Heart Failure: Principles and Future Trends', Clinical Therapeutics, vol. 37, no. 10, pp. 2225-2233.View/Download from: Publisher's site
Deek, HA, Newton, PJ, Inglis, S, Kabbani, S, Noureddine, S, Macdonald, P & Davidson, PM 2015, 'Heart health in Lebanon and considerations for addressing the burden of cardiovascular disease.', Collegian, vol. 22, no. 3, pp. 333-339.View/Download from: Publisher's site
To (1) aggregate and define the burden of cardiovascular disease in Lebanon and (2) describe implications for policy, practice and research to improve health outcomes in Lebanon.
DiGiacomo, M, Green, A, Rodrigues, E, Mulligan, K & Davidson, PM 2015, 'Developing a gender-based approach to chronic conditions and women's health: a qualitative investigation of community-dwelling women and service provider perspectives', BMC Women's Health, vol. 15, pp. 15-15.View/Download from: UTS OPUS or Publisher's site
Chronic conditions contribute to over 70 % of Australia's total disease burden, and this is set to increase to 80 % by 2020. Women's greater longevity means that they are more likely than men to live with disability and have unique health concerns related to their gender based roles in society. Cultural and social issues can impact on women's health and are important to consider in health services planning and research. In this study, we aimed to identify barriers and facilitators to providing a gender-based approach to chronic conditions and women's health in an eastern metropolitan region of Australia.
Focus groups were used to engage both community-dwelling women who had chronic conditions and relevant professional stakeholders in the target area. Recorded proceedings underwent thematic analysis.
Five focus groups were conducted with professional stakeholders and women community members in February and March 2014. Resultant themes included: women's disempowerment through interactions with health systems; social and economic constraints and caregiving roles act to exclude women from participating in self-care and society; and empowerment can be achieved through integrated models of care that facilitate voice and enable communication and engagement.
This study underscores the importance of including perspectives of sex and gender in health care services planning. Tailoring services to socio-demographic and cultural groups is critical in promoting access to health care services. Unique epidemiological trends, particularly the ageing of women and new migrant groups, require particular attention.
DiGiacomo, M, Lewis, J, Phillips, J, Nolan, M & Davidson, PM 2015, 'The business of death: a qualitative study of financial concerns of widowed older women', BMC Women's Health, vol. 15, pp. 1-10.View/Download from: UTS OPUS or Publisher's site
The feminisation of ageing and increasing number of widowed women in contemporary society has significant implications. Older women are at risk of poor health, social, and economic outcomes upon widowhood. The aim of the study was to describe women's experiences in the period soon after their husbands' death, including their financial issues and concerns, and the ways in which these experiences impacted on the transition to widowhood late in life.
This was a longitudinal study using serial in-depth semi-structured interviews with 21 community-dwelling women over the age of 65 in Australia. Verbatim transcripts underwent Interpretive Phenomenological Analysis.
Thematic analysis revealed: 1) administrative burden increases vulnerability; 2) gender roles impact on transitions; and 3) financial adjustments render housing insecurity and health risk. High administrative burden within the context of significant grief and mourning was a defining feature of the early bereavement period. Complicated protracted administrative processes, insensitive interactions, and reminders of loss contributed to distress, anxiety and feelings of demoralisation. Several women identified assumption of household financial management as the most difficult aspect of coping with their husband's death.
Older women may have unmet needs for assistance with administrative, financial, and legal issues immediately following spousal death and potentially for years afterward. Lack of familiarity and absence of instrumental support with financial and legal issues signal the need for policy reform, resources to improve financial literacy in women throughout the life course, increased advocacy, and consideration of different support and service models.
Disler, R, Inglis, S, Newton, P, Currow, D, Macdonald, P, Glanville, A, Donesky, D, Carrieri-Kohlman, V & Davidson, P 2015, 'ATTITUDES TO ONLINE DELIVERY OF HEALTH INFORMATION AND CHRONIC DISEASE MANAGEMENT IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE: FOCUS GROUP STUDY', Respirology, vol. 20, pp. 105-105.
Disler, R, Spiliopoulos, N, Inglis, S, Currow, D & Davidson, P 2015, 'INDIVIDUALS ATTITUDES TO COGNITIVE IMPAIRMENT AND IMPACT IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE: FOCUS GROUP STUDY', RESPIROLOGY, vol. 20, pp. 105-105.
Disler, RT, Inglis, SC, Newton, PJ, Currow, DC, Macdonald, PS, Glanville, AR, Donesky, D, Carrieri-Kohlman, V & Davidson, PM 2015, 'Patterns of Technology Use in Patients Attending a Cardiopulmonary Outpatient Clinic: A Self-Report Survey', Interactive Journal of Medical Research, vol. 4, no. 1, pp. 1-14.View/Download from: UTS OPUS or Publisher's site
Background: Self-management education for cardiopulmonary diseases is primarily provided through time-limited, face-to-face programs, with access limited to a small percentage of patients. Telecommunication tools will increasingly be an important component of future health care delivery.
Objective: The purpose of this study was to describe the patterns of technology use in patients attending a cardiopulmonary clinic in an academic medical center.
Methods: A prevalence survey was developed to collect data on participant demographics (age in years, sex, and socioeconomic status); access to computers, Internet, and mobile phones; and use of current online health support sites or programs. Surveys were offered by reception staff to all patients attending the outpatient clinic.
Results: A total of 123 surveys were collected between March and April 2014. Technological devices were a pervasive part of everyday life with respondents engaged in regular computer (102/123, 82.9%), mobile telephone (115/117, 98.3%), and Internet (104/121, 86.0%) use. Emailing (101/121, 83.4%), researching and reading news articles (93/121, 76.9%), social media (71/121, 58.7%), and day-to-day activities (65/121, 53.7%) were the most common telecommunication activities. The majority of respondents reported that access to health support programs and assistance through the Internet (82/111, 73.9%) would be of use, with benefits reported as better understanding of health information (16/111, 22.5%), avoidance of difficult travel requirements and time-consuming face-to-face appointments (13/111, 18.3%), convenient and easily accessible help and information (12/111, 16.9%), and access to peer support and sharing (9/111, 12.7%). The majority of patients did not have concerns over participating in the online environment (87/111, 78.4%); the few concerns noted related to privacy and security (10/15), information accuracy (2/15), and computer literacy and access (2/15).
Conclusions: Chronic disease bur...
Disler, RT, Inglis, SC, Newton, PJ, Currow, DC, Macdonald, PS, Glanville, AR, Donesky, D, Carrieri-Kohlman, V & Davidson, PM 2015, 'Patterns of Technology Use in Patients Attending a Cardiopulmonary Outpatient Clinic: A Self-Report Survey', JOURNAL OF MEDICAL INTERNET RESEARCH, vol. 17, no. 3.
Ferguson, C, Inglis, S, Newton, PJ, Middleton, S, Macdonald, P & Davidson, PM 2015, 'The caregiver role in thromboprophylaxis management in atrial fibrillation: A literature review', European Journal of Cardiovascular Nursing, vol. 14, no. 2, pp. 98-107.View/Download from: UTS OPUS or Publisher's site
Background: Atrial fibrillation is a common arrhythmia and a risk factor for adverse events including stroke. People living with atrial fibrillation are commonly elderly and have multiple comorbidities. The role of a caregiver in supporting the individual to manage a chronic and complex condition has received limited attention.
Fernandez, R, Everett, B, Miranda, C, Rolley, JX, Rajaratnam, R & Davidson, PM 2015, 'Migratory Implications For Coronary Heart Disease Risk Prevention In Asian Indians: Evidence From The Leading Health Indicators', Journal of cultural diversity, vol. 22, no. 1, pp. 30-38.View/Download from: UTS OPUS
OBJECTIVEctives of this descriptive comparative study were to (1) review data obtained from the World Health Organisation Statistical Information System (WHOSIS) database relating to the prevalence of risk factors for coronary heart disease (CHD) among Indians and Australians and (2) compare these data with published epidemiological studies of CHD riskfactors in adult migrant Asian Indians to provide a comprehensive and comparable assessment of risk factors relating to CHD and the mortality attributable to these risk factors. Design: ThDESIGNdy was undertaken using a database search and integrative review methodology. Data were obtained for comparison of CHD risk factors between Indians and Australians using the WHOSIS database. For the integrative review the MEDLINE, CINAHL, EMBASE, and Cochrane databases were searched using the keywords 'Migrants', 'Asian Indian', 'India', 'Migration', 'Immigration', 'Risk factors', and coronary heart disease. Two reviewers independently assessed the eligibility of the studies for inclusion in the review, the methodological quality and extracted details of eligible studies. Results from the integrative review on CHD risk factors in Asian Indians are presented in a narrative format, along with results from the WHOSIS database. Results: TRESULTSadjusted mortality for CHD was four times higher in migrant Asian Indians when compared to both the native population of the host country and migrants from other countries. Similarly when compared to migrants from other countries migrant Asian Indians had the highest prevalence of overweight individuals. Prevalence rates for hypercholesterolemia were up to 18.5 % among mgrant Asian Indians and migrant Asian Indian women had a higher prevalence of hypertriglyceridaemia compared to Caucasian females. Migrant Asian Indians also had a higher incidence of hypertension and upto 71 % of migrnt Asian Indian men did not meet current guidelines for participation in physical activity. Ethnic-specific...
Fernandez, R, Rolley, JX, Rajaratnam, R, Everett, B & Davidson, PM 2015, 'Reducing the risk of heart disease among Indian Australians: knowledge, attitudes, and beliefs regarding food practices - a focus group study.', Food & nutrition research, vol. 59, p. 25770.View/Download from: UTS OPUS or Publisher's site
Australia has a growing number of Asian Indian immigrants. Unfortunately, this population has an increased risk for coronary heart disease (CHD). Dietary adherence is an important strategy in reducing risk for CHD. This study aimed to gain greater understanding of the knowledge, attitudes and beliefs relating to food practices in Asian Indian Australians.Two focus groups with six participants in each were recruited using a convenience sampling technique. Verbatim transcriptions were made and thematic content analysis undertaken.Four main themes that emerged from the data included: migration as a pervasive factor for diet and health; importance of food in maintaining the social fabric; knowledge and understanding of health and diet; and elements of effective interventions.Diet is a complex constructed factor in how people express themselves individually, in families and communities. There are many interconnected factors influencing diet choice that goes beyond culture and religion to include migration and acculturation.Food and associated behaviors are an important aspect of the social fabric. Entrenched and inherent knowledge, attitudes, beliefs and traditions frame individuals' point of reference around food and recommendations for an optimal diet.
Fernandez, R, Rolley, JX, Rajaratnam, R, Sundar, S, Patel, NC & Davidson, PM 2015, 'Risk factors for coronary heart disease among Asian Indians living in Australia.', Journal of transcultural nursing : official journal of the Transcultural Nursing Society, vol. 26, no. 1, pp. 57-63.View/Download from: Publisher's site
The aim of this study was to assess the coronary heart disease risk factors in the Asian Indian community living in a large city in Australia. A cross-sectional survey was conducted at the Australia India Friendship Fair in 2010. All people of Asian Indian descent who attended the Fair and visited the health promotion stall were eligible to participate in the study if they self-identified as of Asian Indian origin, were aged between 18 and 80 years, and were able to speak English. Blood pressure, blood glucose, waist circumference, height, and weight were measured by a health professional. Smoking, cholesterol levels, and physical activity status were obtained through self-reports. Data were analyzed for 169 participants. More than a third of the participants under the age of 65 years had high blood pressure. Prevalence of diabetes (16%) and obesity (61%) was significantly higher compared with the national average. Ten women identified themselves as smokers. Physical activity patterns were similar to that of the wider Australian population. The study has provided a platform for raising awareness among nurses and promoting advocacy on the cardiovascular risk among Asian Indians. Strategies involving Asian Indian nurses and other Asian Indian health professionals as well as support from the private and public sectors can assist in the reduction of the coronary heart disease risk factors among this extremely susceptible population.
Glass, N, Cochran, W & Davidson, PM 2015, 'Editorial: Transformational experiences a key to improving global health: the role of the Peace Corps.', Journal of clinical nursing, vol. 24, no. 9-10, pp. 1149-1150.View/Download from: Publisher's site
Goldsbury, DE, O'Connell, DL, Girgis, A, Wilkinson, A, Phillips, JL, Davidson, PM & Ingham, JM 2015, 'Acute hospital-based services used by adults during the last year of life in New South Wales, Australia: a population-based retrospective cohort study', BMC HEALTH SERVICES RESEARCH, vol. 15.View/Download from: UTS OPUS or Publisher's site
Gresh, A, Dallman, E, Johnson, E, Mena-Carrasco, F, Rosales, L, Pantaleon, V, Davidson, PM & Sharps, P 2015, 'The Role of the World Health Organization Collaborating Centers: Perspectives of Future Global Nurse Leaders', Nurse Leader, vol. 13, no. 5, pp. 44-48.View/Download from: Publisher's site
© 2015 Mosby, Inc. The forces of globalization have shifted the way that healthcare is delivered and also how the global nursing workforce is conceptualized.1,2 Globally, the demand for healthcare is increasing, outpacing the growth in the workforce, primarily because of population growth, the aging population, and the increasing burden of noncommunicable diseases.3 This gap is known as the human resources for health crisis (HRH crisis).4 The deficits in the healthcare workforce are attributed to the aging healthcare workforce, experienced professionals leaving for better paying jobs, and labor migration both within and across countries.5 Moreover, globally, nursing workforce numbers are highly susceptible to political pressures, and a consistent workforce strategy has not been widely applied.6 Low- and middle-income countries experience an even greater workforce burden due to increasing demands for healthcare and are much more vulnerable to migration factors and the influence of pandemics.7 As more countries make a commitment for universal healthcare coverage, the demand for healthcare will continue to increase, and the HRH crisis will become even more acute. High-income countries are also not immune to this crisis as the demand for healthcare continues to grow in the face of and fiscal constraints.
Hickman, LD, Phillips, JL, Newton, PJ, Halcomb, EJ, Al Abed, N & Davidson, PM 2015, 'Multidisciplinary team interventions to optimise health outcomes for older people in acute care settings: A systematic review', Archives of Gerontology and Geriatrics, vol. 61, no. 3, pp. 322-329.View/Download from: UTS OPUS or Publisher's site
Hosseini, M, Davidson, PM, Khoshknab, MF & Nasrabadi, AN 2015, 'Experience of Spiritual Care in Cardiac Rehabilitation: An Interpretative Phenomenological Analysis.', The journal of pastoral care & counseling : JPCC, vol. 69, no. 2, pp. 68-76.View/Download from: UTS OPUS or Publisher's site
The aim of the study was to explore the experience of spiritual care among a cardiac rehabilitation team. Spiritual care is an important dimension of providing comprehensive care, and understanding the views of health professionals is pivotal to making recommendations for caring. This study used an interpretive phenomenological approach. Semi-structured interviews were undertaken with 13 cardiac rehabilitation professionals. Seven persons participated in individual interviews and six in focus group discussions. Data were analyzed using Smith and Osborn's interpretative phenomenological analysis method. Study data were categorized into more than 150 initial themes, 12 clustered and four superordinate themes, included: 'Helping patients to obtain a meaningful sense of being', 'Providing religious/spiritual focused care', 'holistic approach to rehabilitation is needed' and 'spirituality as a neglected aspect of rehabilitation'. Participants described that they did not have sufficient training in providing spiritual care. Nurses' awareness of spiritual care meaning among a cardiac rehabilitation team is helping to respond to rehabilitation care in a holistic approach. Helping patients to get a meaningful sense of being is an important part of assisting in recovery and adjustment following an acute cardiac event. Providing clear guidelines and support for providing spiritual care in cardiac rehabilitation is required.
Hunt, L, Frost, SA, Alexandrou, E, Hillman, K, Newton, PJ & Davidson, PM 2015, 'Reliability of intra-abdominal pressure measurements using the modified Kron technique.', Acta Clinica Belgica, vol. 70, no. 2, pp. 116-120.View/Download from: Publisher's site
OBJECTIVES: Assessment of intra-abdominal pressure (IAP) and the likelihood of abdominal compartment syndrome using valid and reliable measures is an important tool in the assessment of critically ill patients. The current method of relying on a single IAP per measurement period to determine patient clinical status raises the question: is a single intermittent IAP measurement an accurate indicator of clinical status or should more than one measurement be taken per measurement period? METHODS: This study sought to assess the reliability of IAP measurements. Measurements were taken using the modified Kron technique. A total of two transvesical intra-abdominal pressure measurements were undertaken per patient using a standardized protocol. Recordings were taken at intervals of 5 minutes. RESULTS: The majority of participants (58%) were surgical patients. Thirty-two were males and the mean age was 58 years (SD: 16·7 years). The concordance correlation coefficient between the two measurements was 0·95. Both the scatter and Bland-Altman plots demonstrate that the comparisons of two measurements are highly reproducible. CONCLUSION: The findings of this study suggest that conducting two IAP measurements on single patient produce comparable results; therefore, there appears to be no advantage in doing two IAP measurements on a single patient. The measurement of an IAP requires the implementation of a standardized protocol and competent and credentialed assessors trained in the procedure.
Jha, SR, Ha, HSK, Hickman, LD, Hannu, M, Davidson, PM, Macdonald, PS & Newton, PJ 2015, 'Frailty in advanced heart failure: a systematic review', Heart Failure Reviews, vol. 20, no. 5, pp. 553-560.View/Download from: UTS OPUS or Publisher's site
Koch, J, Everett, B, Phillips, J & Davidson, PM 2015, 'Is there a relationship between the diversity characteristics of nursing students and their clinical placement experiences? A literature review', Collegian, vol. 22, no. 3, pp. 307-318.View/Download from: UTS OPUS or Publisher's site
Background: There has been an increase in ethno-cultural, linguistic, and socio-demographical diversity in students enrolling in undergraduate nursing programs. Diversity also involves other characteristics, but little is known about how diversity impacts on the clinical experiences of nursing students. Aim: The aim of this review is to identify studies which describe the clinical placement experiences of nursing students who have a broad range of diversity characteristics. Methods: Major databases were searched and original studies published from 2003 to 30 June 2013 were eligible for inclusion. An expanded definition of diversity was used to include characteristics such as ethnicity, language, age, religion, gender, socioeconomic status, carer responsibilities, sexual orientation and special needs/disability. Findings: Male gender and speaking English as a second language are diversity characteristics associated with a less positive clinical experience. These students are also more likely to leave their nursing program. Mature-aged students and those from ethnic minority groups were also noted to have a less positive clinical experience and in some cases, this also increased attrition. However, it was difficult to determine the impact of these characteristics alone as they appeared to be linked with other characteristics such as financial difficulties and carer responsibilities in the case of mature-aged students, and language and international student status in the case of ethnicity. Conclusions: Given the significant benefits associated with preparing a diverse nursing workforce, it is an imperative to better understand the impact of diversity on nursing students to ensure that every placement becomes a positive and valuable learning experience. © 2014 Australian College of Nursing Ltd.
MacIntyre, CR, Chughtai, AA, Seale, H, Richards, GA & Davidson, PM 2015, 'Uncertainty, risk analysis and change for Ebola personal protective equipment guidelines.', International journal of nursing studies, vol. 52, no. 5, pp. 899-903.View/Download from: Publisher's site
Maneze, D, DiGiacomo, M, Salamonson, Y, Descallar, J & Davidson, PM 2015, 'Facilitators and Barriers to Health-Seeking Behaviours among Filipino Migrants: Inductive Analysis to Inform Health Promotion', BioMed Research International.View/Download from: UTS OPUS or Publisher's site
Sayers, J, Salamonson, Y, DiGiacomo, M & Davidson, PM 2015, 'Nurse educators in Australia: High job satisfaction despite role ambiguity', Journal of Nurse Education and Practice, vol. 5, no. 4, pp. 41-51.View/Download from: UTS OPUS or Publisher's site
Purpose: The purpose of this study was to describe the nurse educator role in Australian hospitals, including their practice and performance standards.
Methods: A cross-sectional, online survey of nurse educators employed in acute care hospitals in Australia was administered over a three-month period. The survey comprised established and researcher-developed scales, and a single open-ended question. Quantitative data was analysed using descriptive statistics. Qualitative data was analysed using a general inductive approach.
Results: Nurse educators who were more likely to fulfill nurse educator competency practice domains had master's degrees in education, defined professional development needs, and met regularly with their managers. These educators also had higher levels of job satisfaction. Participants identified that role ambiguity and role confusion adversely impacted nurse educator role expectations, responsibilities, and job satisfaction. Despite this, the majority of educators intended to stay in their role for the foreseeable future.
Conclusions: Role ambiguity influenced professional identity and job satisfaction, highlighting the need for clarification of nurse educator roles. These findings suggest the need for review of the nurse educator role and incorporation of professional
and educational requirements and practice competencies. Ongoing role monitoring is recommended to identify the effects of role change.
Shishehgar, S, Gholizadeh, L, DiGiacomo, M & Davidson, PM 2015, 'The impact of migration on the health status of Iranians: An integrative literature review', BMC International Health and Human Rights, vol. 15, no. 20.View/Download from: UTS OPUS or Publisher's site
Sibbritt, D, Davidson, P, DiGiacomo, M, Newton, P & Adams, J 2015, 'Use of Complementary and Alternative Medicine in Women With Heart Disease, Hypertension and Diabetes (from the Australian Longitudinal Study on Women's Health)', AMERICAN JOURNAL OF CARDIOLOGY, vol. 115, no. 12, pp. 1691-1695.View/Download from: UTS OPUS or Publisher's site
Smith, TA, Davidson, PM, Jenkins, CR & Ingham, JM 2015, 'Life behind the mask: the patient experience of NIV.', The Lancet. Respiratory medicine, vol. 3, no. 1, pp. 8-10.View/Download from: Publisher's site
Spiliopoulos, N, Inglis, SC, Currow, DC, Davidson, PM & Disler, RT 2015, 'Attitudes To Cognitive Impairment And Testing In Patients With Chronic Obstructive Pulmonary Disease: Focus Group Study', Am J Respir Crit Care Med, vol. 191, pp. A5291-A5291.
Velez, RP, Becker, KL, Davidson, P & Sloand, E 2015, 'A quality improvement intervention to address provider behaviour as it relates to utilisation of CA-MRSA guidelines.', Journal of clinical nursing, vol. 24, no. 3-4, pp. 556-562.View/Download from: UTS OPUS or Publisher's site
To evaluate the impact of a provider focused quality improvement educational intervention on appropriate prescribing for community associated methicillin-resistant Staphylococcus aureus infection.Patient, provider and health system factors contribute to appropriate antibiotic prescription. Achieving appropriate prescribing is critical in decreasing the burden of antibiotic resistance. Knowledge of appropriate prescribing for community associated methicillin-resistant Staphylococcus aureus infection is the first step in shifting prescriber behaviour to evidence-based recommendations.Quality Improvement Project.Following a review of best practice guidelines and application of the Stetler Research Utilization model, a brief educational intervention was delivered using voice over PowerPoint. Items in the educational intervention included indications for screening, particularly focusing on the role of watch and wait after culturing for simple abscesses. The intervention was delivered in a for-profit, nonacademic, urgent care setting, and assessed prescribing providers' knowledge and practice.Out of 48 medical doctor, physician assistant and nurse practitioner providers, 18 (37·5%) participated; 12 of the 18 (67%) participants showed an increase in knowledge. Forty three per cent of prescribers' charts demonstrated improved practice through use of the guidelines. Out of 18 prescribers, 44% sent a total of 21 cultures for abscesses. There was no difference in practice behaviours between professional groups.In spite of the increase in knowledge scores, this improvement in knowledge did not translate in dramatic change in practice, although trends in a positive direction were noted.This quality improvement project underscores the complexity of changing prescriber behaviour and the need for ongoing interventions.
Walczak, A, Henselmans, I, Tattersall, MHN, Clayton, JM, Davidson, PM, Young, J, Bellemore, FA, Epstein, RM & Butow, PN 2015, 'A qualitative analysis of responses to a question prompt list and prognosis and end-of-life care discussion prompts delivered in a communication support program.', Psycho-oncology, vol. 24, no. 3, pp. 287-293.View/Download from: Publisher's site
OBJECTIVE: Discussing end-of-life (EOL) care is challenging when death is not imminent, contributing to poor decision-making and EOL quality-of-life. A communication support program (CSP) targeting these issues may facilitate discussions. We aimed to qualitatively explore responses to a nurse-led CSP, incorporating a question prompt list (QPL-booklet of questions patients/caregivers can ask clinicians), promoting life expectancy and EOL-care discussions. METHODS: Participants met a nurse-facilitator to explore an EOL-focussed QPL. Prognosis and advance care planning (ACP) QPL content was highlighted. Thirty-one transcribed meetings were analysed using thematic text analysis before reaching data saturation. RESULTS: Thirty-one advanced cancer patients (life expectancy <12months) and 11 family caregivers were recruited from six medical oncology clinics in Sydney, Australia. Intent to use the QPL related to information needs, involvement in care and readiness to discuss EOL issues. Many participants did not want life expectancy estimates, citing unreliable estimates, unknown treatment outcomes, or coping by not looking ahead. Most displayed interest in ACP, often motivated by a loved one's EOL experiences, clear treatment preferences, concerns about caregivers or recognition that ACP is valuable regardless of life expectancy. Timing emerged as a reason not to discuss EOL issues; many maintaining it was too early. CONCLUSION: Patients and caregivers appear ambivalent about acknowledging approaching death by discussing life expectancy but value ACP. Given heterogeneity in responses, individualised approaches are required to guide EOL discussion conduct and content. Further exploration of the role of prognostic discussion in ACP is warranted.
Ferguson, C, Davidson, PM, Scott, PJ, Jackson, D & Hickman, LD 2015, 'Augmented reality, virtual reality and gaming: an integral part of nursing.', Contemporary nurse, vol. 51, no. 1, pp. 1-4.View/Download from: UTS OPUS or Publisher's site
Hosie, A, Lobb, E, Agar, M, Davidson, PM, Chye, R & Phillips, J 2015, 'Nurse perceptions of the Nursing Delirium Screening Scale in two palliative care inpatient units: a focus group study', JOURNAL OF CLINICAL NURSING, vol. 24, no. 21-22, pp. 3276-3285.View/Download from: UTS OPUS or Publisher's site
Hayes, C, Jackson, D, Davidson, PM & Power, T 2015, 'Medication errors in hospitals: a literature review of disruptions to nursing practice during medication administration.', Journal of clinical nursing, vol. 24, no. 21-22, pp. 3063-3076.View/Download from: UTS OPUS or Publisher's site
The purpose of this review was to explore what is known about interruptions and distractions on medication administration in the context of undergraduate nurse education.Incidents and errors during the process of medication administration continue to be a substantial patient safety issue in health care settings internationally. Interruptions to the medication administration process have been identified as a leading cause of medication error. Literature recognises that some interruptions are unavoidable; therefore in an effort to reduce errors, it is essential understand how undergraduate nurses learn to manage interruptions to the medication administration process.Systematic, critical literature review.Utilising the electronic databases, of Medline, Scopus, PubMed and CINAHL, and recognised quality assessment guidelines, 19 articles met the inclusion criteria. Search terms included: nurses, medication incidents or errors, interruptions, disruption, distractions and multitasking.Researchers have responded to the impact of interruptions and distractions on the medication administration by attempting to eliminate them. Despite the introduction of quality improvements, little is known about how nurses manage interruptions and distractions during medication administration or how they learn to do so. A significant gap in the literature exists in relation to innovative sustainable strategies that assist undergraduate nurses to learn how to safely and confidently manage interruptions in the clinical environment.Study findings highlight the need for further exploration into the way nurses learn to manage interruptions and distractions during medication administration. This is essential given the critical relationship between interruptions and medication error rates.Better preparing nurses to safely fulfil the task of medication administration in the clinical environment, with increased confidence in the face of interruptions, could lead to a reduction in errors and concom...
Hayes, C, Power, T, Davidson, PM, Daly, J & Jackson, D 2015, 'Nurse interrupted: Development of a realistic medication administration simulation for undergraduate nurses.', Nurse education today, vol. 35, no. 9, pp. 981-986.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: Medication errors are a global phenomenon. Each year Australia-wide there are up to 96,000 preventable medication errors and in the United States there are approximately 450,000 preventable medication errors. One of the leading causes of errors is interruption yet some interruptions are unavoidable. In the interest of patient safety, nurses need to not only understand the impact of interruptions, but also be empowered with the knowledge and skills required to develop effective interruption management strategies. Well-planned simulation experiences have the potential to expose students to authentic clinical cases, otherwise unavailable to them, building critical thinking and clinical reasoning skills and preparing them for practice. AIM: This paper describes a simulated role-play experience that was developed to enable undergraduate nurses to experience, reflect on and analyse their responses to interruptions during medication administration. METHODS: The simulation design presented in this paper was underpinned by both nursing and educational theorists, in combination with established simulation frameworks. SETTING AND PARTICIPANTS: Embedded within a clinical subject in 2013, the simulation experience was run over two campuses within a large Australian University. Participants included 528 second year undergraduate nursing students and 8 academic teaching staff. OUTCOME MAPPING: To stimulate reflective learning debriefing immediately followed the simulation experience. Written reflections were completed and submitted over the following 4weeks to extend the reflective learning process and review the impact of the experience from the student perspective. CONCLUSIONS: Undergraduate student nurses often have limited experiential background from which to draw knowledge and develop sound clinical judgements. Through exposure to clinical experiences in a safe environment, simulation technologies have been shown to create positive learning experiences and imp...
Phillips, JL, Lovell, M, Luckett, T, Agar, M, Green, AR & Davidson, PM 2015, 'Australian survey of current practice and guideline use in adult cancer pain assessment and management: The community nurse perspective', Collegian, vol. 22, no. 1, pp. 33-41.View/Download from: UTS OPUS or Publisher's site
Cancer pain remains a major public health concern. Despite effective treatmentsbeing available to manage the majority of cancer pain, this debilitating symptom is frequentlyunder treated. As cancer has becomes a chronic disease a range of health professionals, includ-ing community nurses in Australia are increasingly caring for people living with cancer relatedpain. Yet, little is known about community nurses capacity to assess and manage cancer painin accordance with best available evidence.
Brown, N, Luckett, T, Davidson, PM & DiGiacomo, M 2015, 'Interventions to Reduce Harm from Smoking with Families in Infancy and Early Childhood: A Systematic Review', International Journal of Environmental Research and Public Health, vol. 12, no. 3, pp. 3091-3119.View/Download from: UTS OPUS or Publisher's site
Exposure to adult smoking can have deleterious effects on children. Interventions that assist families with smoking cessation/reduction and environmental tobacco smoke (ETS) avoidance can improve child health outcomes and reduce the risk of
smoking initiation. The purpose of this review was to describe the state of the science of interventions with families to promote smoke-free home environments for infants and young children, including parent smoking reduction and cessation interventions, ETS reduction, and anti-smoking socialisation interventions, using the socio-ecological framework as a guide. A systematic review of peer-reviewed articles identified from journal databases from 2000 to 2014 was undertaken. Of 921 articles identified, 28 were included in the review. Considerable heterogeneity characterised target populations, intervention types, complexity and intensity, precluding meta-analysis. Few studies used socio-ecological approaches, such as family theories or concepts. Studies in early parenthood (child age newborn to one
year) tended to focus on parent smoking cessation, where studies of families with children aged 1–5 years were more likely to target household SHSe reduction. results suggest that interventions for reduction in ETS may be more successful than for smoking cessation and relapse prevention in families of children aged less than 5 years. There is a need for a range of interventions to support families in creating a smoke free home environment that are both tailored and targeted to specific populations. Interventions that target the social and psychodynamics of the family should be considered further, particularly in reaching vulnerable populations. Consideration is also required for approaches to interventions that may further stigmatise families containing smokers. Further research is required to identify
successful elements of interventions and the contexts in which they are most effective.
Lovell, M, Luckett, T, Boyle, F, Stubbs, J, Phillips, J, Davidson, PM, Olver, I, von Dincklage, J & Agar, M 2015, 'Adaptation of international guidelines on assessment and management of cancer pain for the Australian context', ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, vol. 11, no. 2, pp. 170-177.View/Download from: UTS OPUS or Publisher's site
Virdun, C, Luckett, T, Davidson, PM & Phillips, J 2015, 'Dying in the hospital setting: A systematic review of quantitative studies identifying the elements of end-of-life care that patients and their families rank as being most important.', Palliative Medicine, vol. 29, no. 9, pp. 774-796.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: The majority of expected deaths occur in hospitals where optimal end-of-life care is not yet fully realised, as evidenced by recent reviews outlining experience of care. Better understanding what patients and their families consider to be the most important elements of inpatient end-of-life care is crucial to addressing this gap. AIM AND DESIGN: This systematic review aimed to ascertain the five most important elements of inpatient end-of-life care as identified by patients with palliative care needs and their families. DATA SOURCES: Nine electronic databases from 1990 to 2014 were searched along with key internet search engines and handsearching of included article reference lists. Quality of included studies was appraised by two researchers. RESULTS: Of 1859 articles, 8 met the inclusion criteria generating data from 1141 patients and 3117 families. Synthesis of the top five elements identified four common end-of-life care domains considered important to both patients and their families, namely, (1) effective communication and shared decision making, (2) expert care, (3) respectful and compassionate care and (4) trust and confidence in clinicians. The final domains differed with financial affairs being important to families, while an adequate environment for care and minimising burden both being important to patients. CONCLUSION: This review adds to what has been known for over two decades in relation to patient and family priorities for end-of-life care within the hospital setting. The challenge for health care services is to act on this evidence, reconfigure care systems accordingly and ensure universal access to optimal end-of-life care within hospitals.
Luckett, T, Bhattarai, P, Phillips, J, Agar, M, Currow, D, Krastev, Y & Davidson, PM 2015, 'Advance care planning in 21st century Australia: a systematic review and appraisal of online advance care directive templates against national framework criteria', AUSTRALIAN HEALTH REVIEW, vol. 39, no. 5, pp. 552-560.View/Download from: UTS OPUS or Publisher's site
Agar, M, Beattie, E, Luckett, T, Phillips, J, Luscombe, G, Goodall, S, Mitchell, G, Pond, D, Davidson, PM & Chenoweth, L 2015, 'Pragmatic cluster randomised controlled trial of facilitated family case conferencing compared with usual care for improving end of life care and outcomes in nursing home residents with advanced dementia and their families: the IDEAL study protocol', BMC Palliative Care, vol. 14, no. 63.View/Download from: UTS OPUS or Publisher's site
Virdun, C, Brown, N, Phillips, JL, Luckett, T, Agar, M, Green, AR & Davidson, PM 2015, 'Elements of optimal paediatric palliative care for children and young people: An integrative review using a systematic approach', Collegian, vol. 22, no. 4, pp. 421-431.View/Download from: UTS OPUS or Publisher's site
Background: Models of palliative care need to address the unmet needs of children, youngpeople and families.Objective: To undertake an integrative review to identify the key elements of optimal paediatric palliative care from the perspectives of children and young people with palliative care needs and their parents.
Allida, SM, Inglis, SC, Davidson, PM, Lal, S, Hayward, CS & Newton, PJ 2015, 'Thirst in chronic heart failure: a review.', Journal of clinical nursing, vol. 24, no. 7-8, pp. 916-926.View/Download from: UTS OPUS or Publisher's site
This review will (1) explore factors related to thirst in chronic heart failure and (2) describe interventions to alleviate thirst in chronic heart failure patients.Thirst is a common and troublesome symptom of chronic heart failure. Despite the burden and prevalence of this symptom, there are limited strategies to assist in its management.This is a review of literature on the burden of thirst, contributors to thirst and potential management strategies of thirst in patients with chronic heart failure.Medline, Cumulative Index for Nursing and Allied Health, PubMed and Scopus were searched using the key words thirst, chronic heart failure, angiotensin II, fluid restriction and intervention. Of the 165 citations yielded, nine studies (n = 9) were included. The eligibility criteria included participants with confirmed diagnosis of chronic heart failure, randomised controlled studies or any studies with thirst as primary or secondary outcome, in humans and in English. There was no limit to the years searched.Factors related to thirst in chronic heart failure were condition; prolonged neurohormonal activation, treatment; pharmacological interventions and fluid restriction and emotion. No intervention studies were found in chronic heart failure patients. Interventions such as artificial saliva and chewing gum have been investigated for their effectiveness as a thirst reliever in haemodialysis patients.Thirst is a frequent and troublesome symptom for individuals with chronic heart failure. It is highly likely that this contributes to poor adherence with fluid restrictions. Chewing gum can help alleviate thirst, but investigation in people with heart failure is needed.Increasing awareness of thirst and interventions to relieve it in clinical practice is likely to improve the quality of care for people with chronic heart failure.
Forber, J, DiGiacomo, M, Davidson, PM, Carter, B & Jackson, D 2015, 'The context, influences and challenges for undergraduate nurse clinical education: Continuing the dialogue', Nurse Education Today, vol. 35, no. 11, pp. 1114-1118.View/Download from: UTS OPUS or Publisher's site
Approaches to clinical education are highly diverse and becoming increasingly complex to sustain in complex milieu
To identify the influences and challenges of providing nurse clinical education in the undergraduate setting and to illustrate emerging solutions.
A discursive exploration into the broad and varied body of evidence including peer reviewed and grey literature.
Internationally, enabling undergraduate clinical learning opportunities faces a range of challenges. These can be illustrated under two broad themes: (1) legacies from the past and the inherent features of nurse education and (2) challenges of the present, including, population changes, workforce changes, and the disconnection between the health and education sectors. Responses to these challenges are triggering the emergence of novel approaches, such as collaborative models.
Maneze, D, Salamonson, Y, Attwood, N & Davidson, PM 2014, 'Acculturative stress in Filipino migrants with functional English: implications for health promotion', International Journal of Culture and Mental Health, vol. 7, no. 4, pp. 357-369.View/Download from: Publisher's site
© 2013, © 2013 Taylor & Francis. The lack of host language proficiency is an important source of acculturative stress among new immigrants and is known to negatively impact on both physical and mental health. However, the acculturative stress and stressors of migrants from culturally and linguistically diverse (CALD) backgrounds with functional English language skills in Australia are less well-explored. Using the Filipino migrants as examplar, this paper reviews acculturative stress in three sub-population groups in this community: family migrants, Filipino spouses of Australian men and skilled, professional migrants. Despite English language ability, socioeconomic difficulties upon migration are a common source of acculturative stress. Intergenerational and cultural gaps within the family are conflict points that may cause depression and suicidal ideation. Changes in lifestyle and diet, incongruence of Western health practices with cultural beliefs may unfavourably affect health. Skilled and professional migrants experience stress due to underemployment, non-utilisation or non-recognition of qualifications obtained overseas. The health issues of CALD communities with functional English language skills are often overlooked in comparison with migrants lacking host population language skills. Taking sociocultural issues into consideration is pivotal when designing health promotion initiatives to meet the needs of Australian migrants with functional English language skills.
Al Abed, NA, Davidson, PM & Hickman, L 2014, 'Healthcare needs of older Arab migrants: a systematic review', Journal Of Clinical Nursing, vol. 23, no. 13-14, pp. 1770-1784.View/Download from: Publisher's site
Aims and objectives To explore the healthcare needs of older Arab migrants, focussing on Arab-Australians and their socio-cultural characteristics.
Al Abed, NA, Hickman, L, Jackson, DE, DiGiacomo, M & Davidson, PM 2014, 'Older Arab migrants in Australia: Between the hammer of prejudice and the anvil of social isolation', Contemporary Nurse, vol. 46, no. 2, pp. 259-262.View/Download from: UTS OPUS
Alexandrou, E, Spencer, TR, Frost, SA, Mifflin, N, Davidson, PM & Hillman, KM 2014, 'Central Venous Catheter Placement by Advanced Practice Nurses Demonstrates Low Procedural Complication and Infection Rates—A Report From 13 Years of Service*', Critical Care Medicine, vol. 42, no. 3, pp. 536-543.View/Download from: Publisher's site
Anuruang, S, Hickman, L, Jackson, DE, Dharmendra, T, Van Balen, J & Davidson, PM 2014, 'Community-based interventions to promote management for older people: an integrative review', Journal Of Clinical Nursing, vol. 23, no. 15-16, pp. 2110-2120.View/Download from: Publisher's site
Aims and objectives To review community programmes promoting self-care or self-management for older people with chronic disease in Thailand. Background Identifying successful elements of culturally appropriate and effective community-based interventions to promote self-care with chronic illness is increasingly important. Design Integrative review. Data sources CINAHL, Medline, Health Source Nursing Academic databases. Methods Integrative review of peer-reviewed articles written between 19462012. Articles were included if they described self-care, self-management, chronic disease and community care interventions targeting older people in Thailand. Results Of the 58 articles retrieved, only 13 articles met the eligibility criteria. Elements of effective interventions included: (1) providing culturally sensitive information, (2) including approaches of shared decision-making and mutual goal setting and (3) flexibility within the intervention to adapt to participant needs. Conclusions Shared decision-making and mutual goal setting between interventionists and patients improved health behaviours and outcomes. Moreover, the flexibility to adopt the intervention to local characteristics demonstrated positive results.
Brandes, K, Butow, PN, Tattersall, MHN, Clayton, JM, Davidson, PM, Young, J, Epstein, RM & Walczak, A 2014, 'Advanced cancer patients' and caregivers' use of a Question Prompt List', Patient Education and Counseling, vol. 97, no. 1, pp. 30-37.View/Download from: Publisher's site
Objective: The objective of this study was to provide insight into how advanced cancer patients and their caregivers use a Question Prompt List (QPL) during a consultation and for preparation for future consultations. Methods: Audiotaped consultations and follow-up phone calls of 28 advanced cancer patients were coded and content analyzed. Questions asked and concerns expressed in consultations were coded for initiator, content, inclusion in the QPL and exact wording. Patients' reported and future use of the QPL were coded from the phone calls. Results: The majority of patients reported that they used the QPL. Questions asked by patients and caregivers predominately coincided with questions from the prognosis section of the QPL. Questions were rarely asked literally from the QPL, instead questions were tailored to patients' own circumstances. Conclusion: QPLs are useful to stimulate discussion on prognosis among advanced cancer patients and caregivers. Patients tailored questions from the QPL to their own circumstances which may suggest high involvement and engagement. The development of more specific tailored communication interventions for advanced cancer patients is warranted. Practice implications: Implementation of QPLs in the advanced cancer setting may be beneficial for patients, caregivers and healthcare providers to facilitate discussion of topics such as prognosis. © 2014 Elsevier Ireland Ltd. All rights reserved.
Close, GR, Newton, PJ, Fung, SC, Denniss, AR, Halcomb, E, Kovoor, P, Stewart, S & Davidson, PM 2014, 'Socioeconomic status and heart failure in Sydney', Heart Lung and Circulation, vol. 23, no. 4, pp. 320-324.View/Download from: UTS OPUS or Publisher's site
Socioeconomic disadvantage is associated with an increased risk of developing heart failure and with inferior health outcomes following diagnosis. Methods Data for hospitalisations and deaths due to heart failure in the Sydney metropolitan region were extracted from New South Wales hospital records and Australian Bureau of Statistics databases for 19992003. Standardised rates were analysed according to patients residential local government area and correlated with an index of socioeconomic disadvantage. Results Eight of the 13 local government areas with standardised separation rate ratios significantly higher than all NSW, and those with the six highest standardised separation rate ratios, were in Greater Western Sydney. Rates of heart failure hospitalisations per local government area were inversely correlated with level of socioeconomic status. Conclusions Higher rates of heart failure hospitalisations among residents of socioeconomically disadvantaged regions within Sydney highlight the need for strategies to lessen the impact of disadvantage and strategies to improve cardiovascular health.
Daly, J, Jackson, D, Mannix, J, Davidson, P & Hutchinson, M 2014, 'The importance of clinical leadership in the hospital setting', Journal of Healthcare Leadership, vol. 6, pp. 75-83.View/Download from: UTS OPUS or Publisher's site
In many areas of the developed world, contemporary hospital care is confronted by workforce challenges, changing consumer expectations and demands, fiscal constraints, increasing demands for access to care, a mandate to improve patient centered care, and issues concerned with levels of quality and safety of health care. Effective governance is crucial to efforts to maximize effective management of care in the hospital setting. Emerging from this complex literature is the role of leadership in the clinical setting. The importance of effective clinical leadership in ensuring a high quality health care system that consistently provides safe and efficient care has been reiterated in the scholarly literature and in various government reports. Recent inquiries, commissions, and reports have promoted clinician engagement and clinical leadership as critical to achieving and sustaining improvements to care quality and patient safety. In this discursive paper, we discuss clinical leadership in health care, consider published definitions of clinical leadership, synthesize the literature to describe the characteristics, qualities, or attributes required to be an effective clinical leader, consider clinical leadership in relation to hospital care, and discuss the facilitators and barriers to effective clinical leadership in the hospital sector. Despite the widespread recognition of the importance of effective clinical leadership to patient outcomes, there are some quite considerable barriers to participation in clinical leadership. Future strategies should aim to address these barriers so as to enhance the quality of clinical leadership in hospital care.
Deek, H, Newton, P, Sheerin, N, Noureddine, S & Davidson, PM 2014, 'Contrast media induced nephropathy: A literature review of the available evidence and recommendations for practice', Australian Critical Care, vol. 27, no. 4, pp. 166-171.View/Download from: Publisher's site
Driscoll, A, Currey, J, Allen, JA, George, M & Davidson, PM 2014, 'New cardiac models of care reduce patient access to specialist nurses: A Victorian cross-sectional pilot study', Australian Critical Care, vol. 27, pp. 17-27.View/Download from: Publisher's site
Aim: To describe the workforce and workplace resources of adult CCUs in Victoria, Australia. Method: This pilot study used an investigator-developed survey to audit all adult CCUs operating in Victoria in 2010.
Ferguson, C, Inglis, S, Newton, PJ, Cripps, PJ, Macdonald, P & Davidson, PM 2014, 'Social media: A tool to spread information: A case study analysis of Twitter conversation at the Cardiac Society of Australia & New Zealand 61st Annual Scientific Meeting 2013', Collegian, vol. 21, no. 2, pp. 89-93.View/Download from: UTS OPUS or Publisher's site
Background The World Wide Web has changed the way in which people communicate and consume information. More importantly, this innovation has increased the speed and spread of information. There has been recent increase in the percentage of cardiovascular professionals, including journals and associations using Twitter to engage with others and exchange ideas. Evaluating the reach and impact in scientific meetings is important in promoting the use of social media. Objective This study evaluated Twitter use during the recent 61st Annual Scientific Meeting at the Cardiac Society of Australia and New Zealand. Methods During the Cardiac Society of Australia and New Zealand 2013 61st Annual Scientific Meeting Symplur was used to curate conversations that were publicly posted with the hashtag #CSANZ2013. The hashtag was monitored with analysis focused on the influencers, latest tweets, tweet statistics, activity comparisons, and tweet activity during the conference. Additionally, Radian6 social media listening software was used to collect data. A summary is provided. Results There were 669 total tweets sent from 107 unique Twitter accounts during 8th August 9 a.m. to 11th August 1 p.m. This averaged nine tweets per hour and six tweets per participant. This assisted in the sharing of ideas and disseminating the findings and conclusions from presenters at the conference with a total 1,432,573 potential impressions in Twitter users tweet streams. Conclusion This analysis of Twitter conversations during a recent scientific meeting highlights the significance and place of social media within research dissemination and collaboration. Researchers and clinicians should consider using this technology to enhance timely communication of findings. The potential to engage with consumers and enhance shared decision-making should be explored further.
Ferguson, C, Inglis, S, Newton, PJ, Middleton, S, MacDonald, PS & Davidson, PM 2014, 'Atrial Fibrillation: Stroke Prevention in Focus', Australian Critical Care, vol. 27, no. 2, pp. 92-98.View/Download from: UTS OPUS or Publisher's site
Introduction: Atrial fibrillation (AF) is a common arrhythmia and a risk factor for stroke and other adverse events. Internationally there have been recent advancements in the therapies available for stroke prevention in AF. Nurses will care for individuals with AF across a variety of primary and acute care settings and should be familiar with evidence based therapies. Aim: This paper provides a review of the epidemiology of AF and stroke, stroke and bleeding risk assessment tools and evidence based treatments for the prevention of stroke in AF including the use of novel anti-thrombin agents. Method: A review of key databases was conducted from 2002 - 2012 using the key search terms 'atrial fibrillation' 'anticoagulation' 'risk assessment' and 'clinical management'. The following electronic databases were searched: CINAHL, Medline, Scopus, the Cochrane Library and Google Scholar. Reference lists were manually hand searched. Key clinical guidelines from National Institute for Clinical Excellence (NICE, UK), American Heart Association (AHA, USA), American College of Cardiology (ACC, USA) and the European Society of Cardiology (ESC) and key government policy documents were also included. Articles were included in the review if they addressed nursing management with a focus on Australia. Results: Many treatment options exist for AF. Best practice guidelines make a variety of recommendations which include cardioversion, ablation, pulmonary vein isolation, pharmacological agents for rate or rhythm control approaches, and antithrombotic therapy (including anticoagulation and antiplatelet therapy). Treatment should be patient centred and individualised based upon persistency of the rhythm, causal nature, risk and co-morbid conditions. Conclusion: AF is a common and burdensome condition where treatment is complex and not without risk. Nurses will encounter individuals with AF across a variety of primary and acute care areas understanding the risk of AF and appropriate...
Ferguson, C. & Davidson, P.M. 2014, 'The importance of communicating your research: The 3 Minute Thesis', Advances in Nursing Doctoral Education and Research, vol. 2, no. 1, pp. 11-14.View/Download from: UTS OPUS
Fernandez, R, Davidson, PM, Miranda, C, Everett, B & Salamonson, Y 2014, 'Attribution of Risk for Coronary Heart Disease in a Vulnerable Immigrant Population: A Survey Study', Journal of Cardiovascular Nursing, vol. 29, no. 1, pp. 48-54.View/Download from: UTS OPUS or Publisher's site
The aim of this survey was to investigate the attribution of risk factors for CHD among the Asian Indian community in Australia.
Gholizadeh, L, Davidson, PM, Heydari, M & Salamonson, Y 2014, 'Heart disease and depression: is culture a factor?', Journal of Transcultural Nursing, vol. 25, no. 3, pp. 290-295.View/Download from: UTS OPUS or Publisher's site
Abstract Purpose: This article seeks to review and discuss the evidence linking depression, coronary heart disease (CHD), and culture. Method: PsychInfo, CINAHL, PubMed, and Google were searched for pertinent evidence linking depression, culture, and CHD, and retrieved articles were analyzed using thematic content analysis. Findings: Identified themes were the followings: depression is a factor in development and prognosis of CHD and affects the capacity to self-manage and adhere to treatment recommendations; culture mediates mental health/illness representations and treatment-seeking behaviors; screening and assessment of depression can be affected by cultural factors; and there is a need for culturally appropriate screening and therapeutic strategies. Discussion and Conclusions: As depression is a predictor and moderating variable in the genesis and progression of CHD, understanding how factors such as culture affect screening and management of the disease is important to inform the development of culturally and linguistically competent strategies that ensure accurate screening, detection, and treatment of depression in cardiac patients in clinical practice.
Halcomb, EJ, Salamonson, Y, Davidson, PM, Kaur, R & Young, SA 2014, 'The evolution of nursing in Australian general practice: a comparative analysis of workforce surveys ten years on.', BMC Family Practice, vol. 15, pp. 1-10.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: Nursing in Australian general practice has grown rapidly over the last decade in response to government initiatives to strengthen primary care. There are limited data about how this expansion has impacted on the nursing role, scope of practice and workforce characteristics. This study aimed to describe the current demographic and employment characteristics of Australian nurses working in general practice and explore trends in their role over time. METHODS: In the nascence of the expansion of the role of nurses in Australian general practice (2003-2004) a national survey was undertaken to describe nurse demographics, clinical roles and competencies. This survey was repeated in 2009-2010 and comparative analysis of the datasets undertaken to explore workforce changes over time. RESULTS: Two hundred eighty four nurses employed in general practice completed the first survey (2003/04) and 235 completed the second survey (2009/10). Significantly more participants in Study 2 were undertaking follow-up of pathology results, physical assessment and disease specific health education. There was also a statistically significant increase in the participants who felt that further education/training would augment their confidence in all clinical tasks (p < 0.001). Whilst the impact of legal implications as a barrier to the nurses' role in general practice decreased between the two time points, more participants perceived lack of space, job descriptions, confidence to negotiate with general practitioners and personal desire to enhance their role as barriers. Access to education and training as a facilitator to nursing role expansion increased between the two studies. The level of optimism of participants for the future of the nurses' role in general practice was slightly decreased over time. CONCLUSIONS: This study has identified that some of the structural barriers to nursing in Australian general practice have been addressed over time. However, it also identifies c...
Hunt, LM, Frost, S, Hillman, K, Newton, PJ & Davidson, PM 2014, 'Management of intra-abdominal hypertension and abdominal compartment syndrome: a review', Journal of Trauma Management and Outcomes, vol. 8, no. 2, pp. 1-8.View/Download from: UTS OPUS or Publisher's site
Patients in the intensive care unit (ICU) are at risk of developing of intra abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Aim: This review seeks to define IAH and ACS, identify the aetiology and presentation of IAH and ACS, identify IAP measurement techniques, identify current management and discuss the implications of IAH and ACS for nursing practice. A search of the electronic databases was supervised by a health librarian. The electronic data bases Cumulative Index of Nursing and Allied Health Literature (CINAHL); Medline, EMBASE, and the World Wide Web was undertaken from 1996- January 2011 using MeSH and key words which included but not limited to: abdominal compartment syndrome, intra -abdominal hypertension, intra-abdominal pressure in adult populations met the search criteria and were reviewed by three authors using a critical appraisal tool. Data derived from the retrieved material are discussed under the following themes: (1) etiology of intra-abdominal hypertension; (2) strategies for measuring intra-abdominal pressure (3) the manifestation of abdominal compartment syndrome; and (4) the importance of nursing assessment, observation and interventions. Intra-abdominal pressure (IAP) and abdominal compartment syndrome (ACS) have the potential to alter organ perfusion and compromise organ function.
Johnson, MJ, Bland, JM, Davidson, PM, Newton, PJ, Oxberry, SG, Abernethy, AP & Currow, DC 2014, 'The Relationship Between Two Performance Scales: New York Heart Association Classification and Karnofsky Performance Status Scale', Journal of Pain and Symptom Management, vol. 47, no. 3, pp. 652-658.View/Download from: Publisher's site
Koch, J, Everett, B, Phillips, J & Davidson, PM 2014, 'Diversity characteristics and the experiences of nursing students during clinical placements: A qualitative study of student, faculty and supervisors' views.', Contemporary Nurse, vol. 49, pp. 15-26.View/Download from: UTS OPUS or Publisher's site
Background: Little is known about which diversity characteristics if any, impact on nursing students' clinical placements or how these may affect the quality of their learning experiences. There is therefore a need to better understand these effects not only from the student's perspective but also from the perspective of the staff who supervise them, in order to ensure students obtain maximal benefit from their placements. AIM: To describe the clinical experiences of nursing students and the diversity characteristics that affect this learning experience. METHODS: Data were collected from a series of open-ended questions embedded within a larger anonymous web-based survey, from August 2011 to March 2012. Participants included first, second and third year undergraduate Bachelor of Nursing students (N = 704) and faculty members involved in the clinical learning environment (N = 165) from seven Australian universities. FINDINGS: Qualitative findings were clustered into three main themes: differences, difficulty and discrimination, each with three sub-themes. CONCLUSION: FINDINGS suggest a need to offer appropriate support for nursing students who feel different because of diversity characteristics. Whilst some of the participant perceptions are confronting they provide valuable insights for universities developing curricula and the clinical placement facilities where students obtain their experience.
Lewis, J, DiGiacomo, M, Currow, DC & Davidson, PM 2014, 'Social capital in a lower socioeconomic palliative care population: a qualitative investigation of individual, community and civic networks and relations', BMC Palliative Care, vol. 13, no. 30, pp. 1-9.View/Download from: UTS OPUS or Publisher's site
The article reports findings from a qualitative investigation of the needs and experiences of palliative care patients and caregivers who are experiencing financial hardship or disadvantage. This article highlights the individual, community and civic networks and relations relevant to these experiences.
MacIntyre, CR, Chughtai, AA, Seale, H, Richards, GA & Davidson, PM 2014, 'Respiratory protection for healthcare workers treating Ebola virus disease (EVD): Are facemasks sufficient to meet occupational health and safety obligations?', International Journal of Nursing Studies, vol. 51, no. 11, pp. 1421-1426.View/Download from: Publisher's site
MacIntyre, CR, Chughtai, AA, Seale, H, Richards, GA & Davidson, PM 2014, 'Response to Martin-Moreno et al. (2014) Surgical mask or no mask for health workers not a defensible position for Ebola', International Journal of Nursing Studies, vol. 51, no. 12, pp. 1694-1695.View/Download from: Publisher's site
O'Connell, DL, Goldsbury, DE, Davidson, PM, Girgis, A, Phillips, JL, Piza, M, Wilkinson, A & Ingham, JM 2014, 'Acute hospital-based services utilisation during the last year of life in New South Wales, Australia: methods for a population-based study', BMJ Open, vol. Online (4), no. 3.View/Download from: UTS OPUS or Publisher's site
The aim of this study is to describe healthcare utilisation in the last year of life for people in Australia, to help inform health services planning. The methods and datasets that are being used are described in this paper.
Page, K, Marwick, TH, Lee, R, Grenfell, R, Abhayaratna, WP, Aggarwal, A, Briffa, TG, Cameron, J, Davidson, PM, Driscoll, A, Garton-Smith, J, Gascard, DJ, Hickey, A, Korczyk, D, Mitchell, J-A, Sanders, R, Spicer, D, Stewart, S, Wade, V & National Heart Foundation of Australia 2014, 'A systematic approach to chronic heart failure care: a consensus statement.', The Medical journal of Australia, vol. 201, no. 3, pp. 146-150.View/Download from: Publisher's site
The National Heart Foundation of Australia assembled an expert panel to provide guidance on policy and system changes to improve the quality of care for people with chronic heart failure (CHF). The recommendations have the potential to reduce emergency presentations, hospitalisations and premature death among patients with CHF. Best-practice management of CHF involves evidence-based, multidisciplinary, patient-centred care, which leads to better health outcomes. A CHF care model is required to achieve this. Although CHF management programs exist, ensuring access for everyone remains a challenge. This is particularly so for Aboriginal and Torres Strait Islander peoples, those from non-metropolitan areas and lower socioeconomic backgrounds, and culturally and linguistically diverse populations. Lack of data and inadequate identification of people with CHF prevents efficient patient monitoring, limiting information to improve or optimise care. This leads to ineffectiveness in measuring outcomes and evaluating the CHF care provided. Expanding current cardiac registries to include patients with CHF and developing mechanisms to promote data linkage across care transitions are essential. As the prevalence of CHF rises, the demand for multidisciplinary workforce support will increase. Workforce planning should provide access to services outside of large cities, one of the main challenges it is currently facing. To enhance community-based management of CHF, general practitioners should be empowered to lead care. Incentive arrangements should favour provision of care for Aboriginal and Torres Strait Islander peoples, those from lower socioeconomic backgrounds and rural areas, and culturally and linguistically diverse populations. Ongoing research is vital to improving systems of care for people with CHF. Future research activity needs to ensure the translation of valuable knowledge and high-quality evidence into practice.
Prichard, RA, Juul, M, Gazibarich, G, Davidson, PM, Mason, C, Keogh, AM, Macdonald, PS & Hayward, CS 2014, 'Six-minute walk distance predicts VO2 (max) in patients supported with continuous flow left ventricular assist devices', The International Journal of Artificial Organs, vol. 37, no. 7, pp. 539-545.View/Download from: Publisher's site
Salamonson, Y, Everett, B, Cooper, M, Lombardo, L, Weaver, R & Davidson, PM 2014, 'Nursing as first choice predicts nursing program completion', Nurse Education Today, vol. 34, pp. 127-131.View/Download from: Publisher's site
Background: Attrition from nursing programs is common, costly and burdensome to individuals, nursing faculties and the health care system. Increasingly, nursing faculties are requested to monitor attrition rates as a measure of performance, but little is known of the influence of career choice on program completion.
Sheerin, NJ, Newton, PJ, MacDonald, PS, Leung, D, Sibbritt, D, Spicer, T, Johnson, K, Krum, H & Davidson, PM 2014, 'Worsening renal function in heart failure: The need for a consensus definition', International Journal of Cardiology, vol. 174, no. 3, pp. 484-491.View/Download from: UTS OPUS or Publisher's site
Acute decompensated heart failure is a common cause of hospitalisation. This is a period of vulnerability both in altered pathophysiology and also the potential for iatrogenesis due to therapeutic interventions. Renal dysfunction is often associatedwith heart failure and portends adverse outcomes. Identifying heart failure patients at risk of renal dysfunction is important in preventing progression to chronic kidney disease or worsening renal function, informing adjustment to medication management and potentially preventing adverse events. However, there is no working or consensus definition in international heart failure management guidelines for worsening renal function. In addition, there appears to be no concordance or adaptation of chronic kidney disease guidelines by heart failure guideline development groups for the monitoring of chronic kidney disease in heart failure. Our aim is to encourage the debate for an agreed definition given the prognostic impact of worsening renal function in heart failure. Wepresent the case for the uptake of the Acute Kidney Injury Network criteria for acute kidney injurywith some minor alterations. This has the potential to inform study design and meta-analysis thereby building the knowledgebase for guideline development. Definition consensus supports data element, clinical registry and electronic algorithm innovation as instruments for quality improvement and clinical research for better patient outcomes. In addition, we recommend all community managed heart failure patients have their baseline renal function classified and routinely monitored in accordance with established renal guidelines to help identify those at increased risk for worsening renal function or progression to chronic kidney disease.
Siabani, S, Driscoll, T, Davidson, PM & Leeder, SR 2014, 'A randomized controlled trial to evaluate an educational strategy involving community health volunteers in improving self-care in patients with chronic heart failure: Rationale, design and methodology', SpringerPlus, vol. 3, pp. 1-6.View/Download from: UTS OPUS or Publisher's site
© 2014, Siabani et al.; licensee Springer. Background: Chronic heart failure (CHF) is an increasingly important health problem worldwide. Effective self-care can improve the outcomes and quality of life in patients with CHF. Acknowledging the important role of educational interventions for improving self-care, we sought to assess a new educational strategy involving community health volunteers (CHVs) that could reduce the cost and, hypothetically, increase the effectiveness of self-care education in patients with CHF. Methods/Design: In this ongoing three-arm controlled trial, approved by two human research ethics committees in Australia and Iran, 231 patients with CHF registered at a referral cardiovascular hospital in Iran were randomly allocated into three groups -trained by community health volunteers at patients' homes, rained by formal health professionals at hospital; and a control group with no formal educational exposure. Data obtained through interviewing participants and using the Persian self-care of CHF index (pSCHFI) before and two months after interventions will be analysed using SAS and SPSS. Discussion: The results of this study may help health service systems, especially in countries with limited resources, make use of community volunteers to teach patients with CHF to develop self-care behaviors and skills, reducing the cost of care and improving CHF outcomes. Also, this home-based educational strategy using face-to-face training, if successful, may provide psychosocial supports for patients suffering from chronic illnesses. Trial registration number: ACTRN12614000788673(Australian New Zealand Clinical Trials Registry).
Siabani, S, Leeder, SR, Davidson, PM, Najafi, F, Hamzeh, B, Solimani, A, Siahbani, S & Driscoll, T 2014, 'Translation and Validation of the Self-care of Heart Failure Index Into Persian', The Journal of Cardiovascular Nursing, vol. 29, no. 6, pp. E1-E5.View/Download from: Publisher's site
Smith, TA, Kim, M, Piza, M, Davidson, PM, Clayton, JM, Jenkins, CR & Ingham, JM 2014, 'Specialist respiratory physicians' attitudes to and practice of advance care planning in COPD. A pilot study', Respiratory Medicine, vol. 108, no. 6, pp. 935-939.View/Download from: Publisher's site
Stewart, S, Carrington, MJ, Horowitz, JD, Marwick, TH, Newton, PJ, Davidson, PM, MacDonald, PS, Thompson, DR, Chan, Y, Krum, H, Reid, C & Scuffham, PA 2014, 'Prolonged impact of home versus clinic-based management of heart failure on all-cause hospitalization and mortality: results from a pragmatic, multicentre randomized trial', International Journal of Cardiology, vol. 174, no. 3, pp. 600-610.View/Download from: Publisher's site
We compared the longer-term impact of the two most commonly applied forms of post-discharge management designed to minimize recurrent hospitalization and prolong survival in typically older patients with chronic heart failure (CHF). Methods We followed a multi-center randomized controlled trial cohort of Australian patients hospitalized with CHF and initially allocated to home-based or specialized CHF clinic-based intervention for 1368 ± 216 days. Blinded endpoints included event-free survival from all-cause emergency hospitalization or death, all-cause mortality and rate of all-cause hospitalization and stay. Results 280 patients (73% male, aged 71 ± 14 years and 73% left ventricular systolic dysfunction) were initially randomized to home-based (n = 143) or clinic-based (n = 137) intervention. During extended follow-up (complete for 274 patients), 1139 all-cause hospitalizations (7477 days of hospital stay) and 121 (43.2%) deaths occurred. There was no difference in the primary endpoint; 20 (14.0%) home-based versus 13 (7.4%) clinic-based patients remained event-free (adjusted HR 0.89, 95% CI 0.70 to 1.15; p = 0.378). Significantly fewer home-based (51/143, 35.7%) than clinic-based intervention (71/137, 51.8%) patients died (adjusted HR 0.62, 95% CI 0.42 to 0.90: p = 0.012). Home-based versus clinic-based intervention patients accumulated 592 and 547 all-cause hospitalizations (p = 0.087) associated with 3067 (median 4.0, IQR 2.0 to 6.8) versus 4410 (6.0, IQR 3.0 to 12.0) days of hospital stay (p < 0.01 for rate and duration of hospital stay). Conclusions Relative to clinic-based intervention, home-based intervention was not associated with prolonged event-free survival. Home-based intervention was, however, associated with significantly fewer all-cause deaths and significantly fewer days of hospital stay in the longer-term.
Thompson, SC, Shahid, S, DiGiacomo, M, Pilkington, L & Davidson, PM 2014, 'Making progress: the role of Cancer Councils in Australia in Indigenous cancer control', BMC Public Health, vol. 14, no. 347, pp. 1-13.View/Download from: UTS OPUS or Publisher's site
Indigenous Australians have poorer outcomes from cancer for a variety of reasons including poorer participation in screening programs, later diagnosis, higher rates of cancer with poor prognosis and poorer uptake and completion of treatment. Cancer prevention and support for people with cancer is part of the core business of the State and Territory Cancer Councils. To support sharing of lessons learned, this paper reports an environmental scan undertaken in 2010 in cancer councils (CCs) nationwide that aimed to support Indigenous cancer control.
The methods replicated the approach used in a 2006 environmental scan of Indigenous related activity in CCs. The Chief Executive Officer of each CC nominated individuals for interview. Interviews explored staffing, projects, programs and activities to progress cancer control issues for Indigenous Australians, through phone or face-to-face interviews. Reported initiatives were tabulated using predetermined categories of activity and summaries were returned to interviewees, the Aboriginal and Torres Strait Islander Subcommittee and Chief Executive Officers for verification.
All CCs participated and modest increases in activity had occurred in most states since 2006 through different means. Indigenous staff numbers were low and no Indigenous person had yet been employed in smaller CCs; no CC had an Indigenous Board member and efforts at capacity building were often directed outside of the organisation. Developing partnerships with Indigenous organisations were ongoing. Acknowledgement and specific mention of Indigenous people in policy was increasing. Momentum increased following the establishment of a national subcommittee which increased the profile of Indigenous issues and provided collegial and practical support for those committed to reducing Indigenous cancer disparities. Government funding of 'Closing the Gap' and research in the larger CCs have been other avenues for increasing knowled...
Walczak, A, Butow, PN, Clayton, JM, Tattersall, MH, Davidson, PM, Young, J & Epstein, RM 2014, 'Discussing prognosis and end-of-life care in the final year of life: a randomised controlled trial of a nurse-led communication support programme for patients and caregivers.', BMJ Open, vol. 4, no. 6, pp. 1-12.View/Download from: UTS OPUS or Publisher's site
Timely communication about life expectancy and end-of-life care is crucial for ensuring good patient quality-of-life at the end of life and a good quality of death. This article describes the protocol for a multisite randomised controlled trial of a nurse-led communication support programme to facilitate patients' and caregivers' efforts to communicate about these issues with their healthcare team.This NHMRC-sponsored trial is being conducted at medical oncology clinics located at/affiliated with major teaching hospitals in Sydney, Australia. Patients with advanced, incurable cancer and life expectancy of less than 12months will participate together with their primary informal caregiver where possible. Guided by the self-determination theory of health-behaviour change, the communication support programme pairs a purpose-designed Question Prompt List (QPL-an evidence-based list of questions patients/caregivers can ask clinicians) with nurse-led exploration of QPL content, communication challenges, patient values and concerns and the value of early discussion of end-of-life issues. Oncologists are also cued to endorse patient and caregiver question asking and use of the QPL. Behavioural and self-report data will be collected from patients/caregivers approximately quarterly for up to 2.5years or until patient death, after which patient medical records will be examined. Analyses will examine the impact of the intervention on patients' and caregivers' participation in medical consultations, their self-efficacy in medical encounters, quality-of-life, end-of-life care receipt and quality-of-death indicators.Approvals have been granted by the human ethics review committee of Royal Prince Alfred Hospital and governance officers at each participating site. Results will be reported in peer-reviewed publications and conference presentations.Australian New Zealand Clinical Trials Registry ACTRN12610000724077.
Davidson, PM, Newton, PJ, Ferguson, C, Daly, J, Elliott, D, Homer, CS, Duffield, CM & Jackson, DE 2014, 'Rating and Ranking the Role of Bibliometrics and Webometrics in Nursing and Midwifery', The Scientific World Journal, vol. 2014.View/Download from: UTS OPUS or Publisher's site
Background. Bibliometrics are an essential aspect of measuring academic and organizational performance. Aim. This review seeks to describe methods for measuring bibliometrics, identify the strengths and limitations of methodologies, outline strategies for interpretation, summarise evaluation of nursing and midwifery performance, identify implications for metric of evaluation, and specify the implications for nursing and midwifery and implications of social networking for bibliometrics and measures of individual performance.
Allida, SM, Inglis, SC, Davidson, PM, Hayward, CS & Newton, PJ 2014, 'Measurement of thirst in chronic heart failure - A review.', Contemporary Nurse, vol. 48, no. 1, pp. 2-9.View/Download from: UTS OPUS or Publisher's site
Abstract Background: Thirst is a bothersome symptom of chronic heart failure (CHF) which impacts adversely on quality of life. Despite this, limited work has been done to investigate thirst as a symptom or to develop reliable and valid measures of thirst in CHF. The purpose of this manuscript is to establish which tools have been used in research to measure thirst in CHF.Medline, PubMed, Cumulative Index for Nursing and Allied Health, and Scopus were searched using following key words thirst, heart failure, measure, scale, randomised controlled trials and multicentre studies.The search discovered 37 studies of which 6 studies met the inclusion criteria. One study was a research abstract and five were full-text studies. To date, there are only three measurement tools utilised in studies examining thirst in CHF patients [Visual Analogue Scale (VAS), Numeric Rating Scale and Thirst Distress Scale].Thirst in CHF is measured in a non-systematic way. In recent studies, the VAS has been used to measure thirst intensity. While this measurement tool is very easy and quick to administer, using a uni-dimensional tool in conjunction with a multi-dimensional tool may be beneficial to capture all dimensions of thirst. In order to manage thirst efficiently, consistent measurement of thirst in CHF is vital.
Hosie, A, Lobb, E, Agar, M, Davidson, PM & Phillips, J 2014, 'Identifying the barriers and enablers to palliative care nurses' recognition and assessment of delirium symptoms: a qualitative study.', Journal of pain and symptom management, vol. 48, no. 5, pp. 815-830.View/Download from: UTS OPUS or Publisher's site
CONTEXT: Delirium is underrecognized by nurses, including those working in palliative care settings where the syndrome occurs frequently. Identifying contextual factors that support and/or hinder palliative care nurses' delirium recognition and assessment capabilities is crucial, to inform development of clinical practice and systems aimed at improving patients' delirium outcomes. OBJECTIVES: The aim of the study was to identify nurses' perceptions of the barriers and enablers to recognizing and assessing delirium symptoms in palliative care inpatient settings. METHODS: A series of semistructured interviews, guided by critical incident technique, were conducted with nurses working in Australian palliative care inpatient settings. A hypoactive delirium vignette prompted participants' recall of delirium and identification of the perceived factors (barriers and enablers) that impacted on their delirium recognition and assessment capabilities. Thematic content analysis was used to analyze the qualitative data. RESULTS: Thirty participants from nine palliative care services provided insights into the barriers and enablers of delirium recognition and assessment in the inpatient setting that were categorized as patient and family, health professional, and system level factors. Analysis revealed five themes, each reflecting both identified barriers and current and/or potential enablers: 1) value in listening to patients and engaging families, 2) assessment is integrated with care delivery, 3) respecting and integrating nurses' observations, 4) addressing nurses' delirium knowledge needs, and 5) integrating delirium recognition and assessment processes. CONCLUSION: Supporting the development of palliative care nursing delirium recognition and assessment practice requires attending to a range of barriers and enablers at the patient and family, health professional, and system levels.
Hosie, A, Agar, M, Lobb, E, Davidson, PM & Phillips, JL 2014, 'Palliative care nurses' recognition and assessment of delirium symptoms: a qualitative study using Critical Incident Technique.', International Journal of Nursing Studies, vol. 51, no. 10, pp. 1353-1365.View/Download from: UTS OPUS or Publisher's site
Delirium is prevalent in palliative care inpatient settings and management is often challenging. Despite nurses integral patient care role, little is known about palliative care nurses capacity to recognise, assess and respond to patients delirium symptoms.
Hayes, C, Power, TJ, Davidson, PM & Jackson, DE 2014, 'Editorial: Interruptions and medication: Is 'Do not disturb' the answer?', Contemporary Nurse, vol. 47, no. 1-2, pp. 3-6.View/Download from: UTS OPUS
Medication related incidents and errors continue to be a significant patient safety issue in health care settings internationally and despite decades of research and quality improvement initiatives, we have failed to identify innovative and sustainable solutions. The importance and significance of this problem not only challenges us, but emphasises the need to develop and implement sustainable interventions that are realistic and appropriate for the clinical setting. Nurses are not only the largest group of health professionals who administer medications, but are also considered to be in the best position to recognise and prevent medication errors before patient safety is compromised. Hence the need to adequately prepare student nurses by providing appropriate learning opportunities. Such approaches are likely able to afford benefits for patients, nurses and others involved in medication administration, and the broader health care system.
Jackson, D, Hickman, LD, Power, T, Disler, R, Potgieter, I, Deek, H & Davidson, PM 2014, 'Small group learning: Graduate health students' views of challenges and benefits', Contemporary Nurse, vol. 48, no. 1, pp. 117-128.View/Download from: UTS OPUS or Publisher's site
Background: For health-care professionals, particularly nurses, the need to work productively and efficiently in small groups is a crucial skill required to meet the challenges of the contemporary health-care environment. Small group work is an educational technique that is used extensively in nurse education. The advantage of group work includes facilitation of deep, active and collaborative learning. However, small group work can be problematic and present challenges for students. Many of the challenges occur because group work necessitates the coming together of collections of individuals, each with their own personalities and sets of experiences. Aim: This study aimed to identify challenges and benefits associated with small group work and to explore options for retaining the positive aspects of group work while reducing or eliminating the aspects the students experienced as negative. Method: Online survey; thematic analysis. Results: Over all, students experienced a range of challenges that necessitated the development of problem-solving strategies. However, they were able to elucidate some enjoyable and positive aspects of group work. Implications for teaching and learning are drawn from this study. Conclusion: The ability to work effectively in small groups and teams is essential for all health-care workers in the contemporary health environment. Findings of this study highlight the need for educators to explore novel and effective ways in which to engage nurses in group work.
Lovell, MR, Luckett, T, Boyle, FM, Phillips, J, Agar, M & Davidson, PM 2014, 'Patient Education, Coaching, and Self-Management for Cancer Pain', JOURNAL OF CLINICAL ONCOLOGY, vol. 32, no. 16, pp. 1712-+.View/Download from: UTS OPUS or Publisher's site
Luckett, T, Davidson, PM, Boyle, F, Liauw, W, Agar, M, Green, A, Lovell, M, Care, IIP & Cooperative, PP 2014, 'Australian survey of current practice and guideline use in adult cancer pain assessment and management: Perspectives of oncologists', ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, vol. 10, no. 2, pp. E99-E107.View/Download from: UTS OPUS or Publisher's site
Green, A, DiGiacomo, M, Luckett, T, Abbott, P, Davidson, PM, Delaney, J & Delaney, P 2014, 'Cross-sector collaborations in Aboriginal and Torres Strait Islander childhood disability: a systematic integrative review and theory-based synthesis', International Journal of Equity in Health, vol. 13, pp. 126-126.View/Download from: UTS OPUS or Publisher's site
Aboriginal and Torres Strait Islander children in Australia experience a higher prevalence of disability and socio-economic disadvantage than other Australian children. Early intervention is vital for improved health outcomes, but complex and fragmented service provision impedes access. There have been international and national policy shifts towards inter-sector collaborative responses to disability, but more needs to be known about how collaboration works in practice.
A systematic integrative literature review using a narrative synthesis of peer-reviewed and grey literature was undertaken to describe components of inter- and intra-sector collaborations among services to Aboriginal and Torres Strait Islander children with a disability and their families. The findings were synthesized using the conceptual model of the ecological framework.
Thirteen articles published in a peer-reviewed journal and 18 articles from the grey literature met inclusion criteria. Important factors in inter- and intra-sector collaborations identified included: structure of government departments and agencies, and policies at the macro- (government) system level; communication, financial and human resources, and service delivery setting at the exo- (organizational) system level; and relationships and inter- and intra-professional learning at the meso- (provider) system level.
The policy shift towards inter-sector collaborative approaches represents an opportunity for the health, education and social service sectors and their providers to work collaboratively in innovative ways to improve service access for Aboriginal and Torres Strait Islander children with a disability and their families. The findings of this review depict a national snapshot of collaboration, but as each community is unique, further research into collaboration within local contexts is required to ensure collaborative solutions to improve service access are responsive to local n...
Luckett, T, Phillips, JL, Agar, M, Virdun, C, Green, AR & Davidson, PM 2014, 'Elements of effective palliative care models: a rapid review', BMC Health Services Research, vol. 14, pp. 1-22.View/Download from: UTS OPUS or Publisher's site
Background: Population ageing, changes to the profiles of life-limiting illnesses and evolving societal attitudes prompt a critical evaluation of models of palliative care. We set out to identify evidence-based models of palliative care to inform policy reform in Australia.
Disler, RT, Green, AR, Luckett, T, Newton, PJ, Inglis, S, Currow, D & Davidson, PM 2014, 'Experience of advanced chronic obstructive pulmonary disease: Metasynthesis of qualitative data.', Journal of Pain and Symptom Management, vol. 48, no. 6, pp. 1182-1199.View/Download from: Publisher's site
Context. Chronic obstructive pulmonary disease (COPD) is a life-limiting illness. Despite best available treatments, individuals continue to experience symptom burden and have high health-care utilization. Objectives. To increase understanding of the experience and ongoing needs of individuals living with COPD.
Chang, S, Newton, PJ, Inglis, S, Luckett, T, Krum, H, MacDonald, PS & Davidson, PM 2014, 'Are all outcomes in chronic heart failure rated equally? An argument for a patient-centred approach to outcome assessment', Heart Failure Reviews, vol. 19, no. 2, pp. 153-162.View/Download from: UTS OPUS or Publisher's site
Chronic heart failure (CHF) is a multi-dimensional and complex syndrome. Outcome measures are important for determining both the efficacy and quality of care and capturing the patient's perspective in evaluating the outcomes of health care delivery. Capturing the patient's perspective via patient-reported outcomes is increasingly important; however, including objective measures such as mortality would provide more complete account of outcomes important to patients. Currently, no single measure for CHF outcomes captures all dimensions of the quality of care from the patient's perspective.
Betihavas, V, Newton, PJ, Frost, S, Alexandrou, E, MacDonald, PS & Davidson, PM 2013, 'Importance of Predictors of Rehospitalisation in Heart Failure: A Survey of Heart Failure Experts', Heart Lung and Circulation, vol. 22, no. 3, pp. 179-183.View/Download from: UTS OPUS or Publisher's site
Aims: We investigated the opinion of clinical experts and researchers involved in chronic heart failure disease management regarding the ranking of patient, provider and system factors that predict the risk of rehospitalisation.
Betihavas, V, Newton, PJ, Frost, S, MacDonald, PS & Davidson, PM 2013, 'Patient, provider and system factors influencing rehospitalisation in adults with heart failure', Contemporary Nurse, vol. 43, no. 2, pp. 244-256.View/Download from: UTS OPUS or Publisher's site
Objectives: To identify patient, provider and system factors predicting rehospitalisation in adults with heart failure (HF).
Chang, S, Davidson, PM, Newton, PJ, Krum, H, Salamonson, Y & MacDonald, PS 2013, 'What is the methodological and reporting quality of health related quality of life in chronic heart failure clinical trials?', International Journal of Cardiology, vol. 164, no. 2, pp. 133-140.View/Download from: UTS OPUS or Publisher's site
Background: Although the number of clinical trials assessing health related quality of life (HRQoL) in chronic heart failure (CHF) has increased exponentially over the last decade, little is known about the quality of reporting. The purpose of this review was to assess the methodological and reporting rigor of HRQoL in RCTs of pharmacological therapy in CHF.
Davidson, P, DiGiacomo, M, Leslie, G, Soh, KL & Soh, KG 2013, 'Nurses' perceptions of standardised assessment and prevention of complications in a Malaysian intensive care unit', Journal of Clinical Nursing, vol. 22, no. 5-6, pp. 856-865.View/Download from: UTS OPUS or Publisher's site
Davidson, P.M. & Dennison- Himmelfarb, C. 2013, 'Population Health Studies - What Do They Tell Us?', Heart, Lung and Circulation, vol. 22, no. 11.
The burden of cardiovascular disease (CVD) is a globalconcern. People living in resource-limited set-tings are affected disproportionately, with more than 80% of CVD deaths occurring in low and middle-income countries. Although inflammatory and rheumatic heart diseases remain common in these countries atherosclerosis is becoming a critical concern.
This article seeks to identify factors to be considered in embracing perspectives of diversity in doctoral programs from the perspective of the extant literature and personal reflec-tion of experienced supervisors
Davidson, PM 2013, 'Tailoring and targeting interventions for women with heart disease: the need for gender-based approaches', Evidence-Based Nursing, vol. 16, no. 2, pp. 45-46.View/Download from: UTS OPUS or Publisher's site
This study used a two-group, single-blind, randomised clinical trial methodology to compare physiological and psychosocial outcomes in women recruited from an outpatient CR programme in the USA following an acute cardiac event (medical and surgical admissions). Women participated in either a traditional (usual care) 12-week CR programme (n=111) or a tailored programme guided by the transtheoretical model (n=141) of behaviour change augmented by motivational interviewing techniques and a dedicated exercise programme for women. Usual care and intervention groups adopted a case-management model. Random sequence generation occurred using a computerised number sequence, and allocation concealment was accomplished using sequentially numbered opaque envelopes.
Davidson, PM & Dennison-Himmelfarb, C 2013, 'Population Health Studies - What Do They Tell Us?', Heart, Lung and Circulation, vol. 22, pp. 885-886.
The burden of cardiovascular disease (CVD) is a global concern. People living in resource-limited settings are affected disproportionately, with more than 80% of CVD deaths occurring in low and middle-income countries. Although inflammatory and rheumatic heart diseases remain common in these countries atherosclerosis is becoming a critical concern.
Davidson, PM & Dennison-Himmelfarb, C 2013, 'Population Health Studies - What Do They Tell Us?', Heart, Lung and Circulation, vol. 22, no. 11, pp. 885-886.View/Download from: UTS OPUS or Publisher's site
Davidson, PM, Abernethy, AP, Newton, PJ, Clark, K & Currow, DC 2013, 'The caregiving perspective in heart failure: a population based study', BMC Health Services Research, vol. 13, no. 342.View/Download from: UTS OPUS or Publisher's site
Davidson, PM, Daly, J & Hill, MN 2013, 'Editorial: Looking to the future with courage, commitment, competence and compassion', Journal Of Clinical Nursing, vol. 22, pp. 2665-2667.
Healthcare systems are in a state of flux and change (Casabonne & Kenny 2012, Naylor & Naylor 2012). Globally, there are pressures to meet the increasing and diversifying healthcare needs of individuals and populations.
Davidson, PM, Inglis, S & Newton, PJ 2013, 'Self-care In Patients With Chronic Heart Failure', Expert Review of Pharmacoeconomics & Outcomes Research, vol. 13, no. 3, pp. 351-359.View/Download from: UTS OPUS or Publisher's site
Globally, chronic heart failure is a common, complex syndrome characterized by high levels of healthcare utilization, reduced quality of life and premature mortality. Self-care is a complex decision-making process involving symptom recognition, action and evaluation.
Davidson, PM, Jiwa, M, DiGiacomo, M, McGrath, S, Newton, PJ, Durey, A, Bessarab, D & Thompson, SC 2013, 'The experience of lung cancer in Aboriginal and Torres Strait Islander peoples and what it means for policy, service planning and delivery', Australian Health Review, vol. 37, no. 1, pp. 70-78.View/Download from: UTS OPUS or Publisher's site
Background. Aboriginal and Torres Strait Islander peoples experience inferior outcomes following diagnosis of lung cancer. Aim. To examine the experience of lung cancer in this population and identify reasons for poorer outcomes and lower levels of treatment compared with non-Aboriginal and Torres Strait Islander peoples, and opportunities for early intervention.
Davidson, PM, Sindhu, S & Meleis, A 2013, '19th International Council on Women's Health Issues (ICOWHI) Congress on "Women's Health 2012: Partnering for a Brighter Global Future" The Emerald Hotel, Bangkok November 14, 2012, 10:00-11:00 a.m. Abstract', HEALTH CARE FOR WOMEN INTERNATIONAL, vol. 34, no. 9, pp. 729-735.View/Download from: Publisher's site
Deek, HA, Abbott, P, Moore, L, Davison, J, Cameron, S, DiGiacomo, M, McGrath, S, Dharmendra, T & Davidson, PM 2013, 'Pneumococcus in Aboriginal and Torres Strait Islanders: the role of Aboriginal Health Workers and implications for nursing practice', Contemporary Nurse, vol. 46, no. 1, pp. 54-58.View/Download from: UTS OPUS or Publisher's site
Background: Pneumonia is a common cause of hospitalization in Aboriginal and Torres Strait Islander men and women. Aim: This article seeks to describe the importance of immunizing against pneumonia in Aboriginal Australians and suggest strategies for screening and follow-up. Method: An integrative literature review, using both published and gray literature was undertaken to identify methods of screening and surveillance strategies for pneumococcus. Results: The literature was summarized under the following themes: Pneumococcal disease; prevention strategies; access to care; improving access to vaccinations; culturally competent interventions and the role of Aboriginal health professionals. Conclusion: Community controlled conditions and the role of the Aboriginal Health Workers are seen as critical to reducing health disparities. Nurses can play a critical role in bridging the gap between mainstream and community controlled organizations. Working to increase the numbers of Aboriginal health professionals is a critical step in improving health outcomes for Aboriginal and Torres Strait Islander peoples.
DeVito Dabbs, A., Song, M., De Geest, S. & Davidson, P.M. 2013, 'Promoting Patient and Caregiver Engagement in Self-Management of Chronic Illness', Nursing Research and Practice, vol. 2013, pp. 1-2.
As a nursing professional you are no doubt aware of the growing prevalence of people with chronic conditions and the problems they face interacting and getting support from health care systems that are designed to deal with acute problems. Chronic diseases, such as heart disease, stroke, cancer, respiratory diseases and diabetes, are by far the leading cause of morbidity and mortality in the world. Furthermore, more than half of individualswith one chronic condition have multiple chronic conditions, increasing the complexity and burden of managing their health.
DiGiacomo, M, Davidson, PM, Abbott, PA, Delaney, P, Dharmendra, T, McGrath, S, Delaney, J & Vincent, F 2013, 'Childhood disability in Aboriginal and Torres Strait Islander peoples: a literature review', International Journal for Equity in Health, vol. 12, no. 7.View/Download from: UTS OPUS or Publisher's site
Aboriginal and Torres Strait Islander children have higher rates of disability than non-Indigenous children and are considered doubly disadvantaged, yet there is very little data reflecting prevalence and service access to inform design and delivery of services. Failing to address physical, social, and psychological factors can have life-long consequences and perpetuate longstanding health disparities. Methods A narrative literature review was undertaken to identify peer reviewed literature describing factors impacting on the prevention, recognition, and access to support and management of disability in Indigenous Australian children. Results Twenty-seven peer-reviewed journal articles met inclusion criteria. The majority of articles focused on the hearing loss and learning disabilities consequent of otitis media. Few articles reported data on urban or metropolitan Indigenous populations or described interventions. Individual/community-, provider-, and systems level factors were identified as impacting on recognition and management of disability in young Indigenous children. Conclusions Given the burden of childhood disability, the limited literature retrieved is concerning as this is a barometer of activity and investment. Solutions addressing childhood disability will require collaboration between health, social and educational disciplines as well as an increased investment in prevention, identification and promotion of access.
DiGiacomo, M, Davidson, PM, Byles, JE & Nolan, M 2013, 'An integrative and socio-cultural perspective of health, wealth, and adjustment in widowhood', Health Care for Women International, vol. 34, no. 12, pp. 1067-1083.View/Download from: UTS OPUS or Publisher's site
Women comprise a larger proportion of the ageing population, often outlive their spouses, and face a variety of challenges upon widowhood. Discrete aspects of the health impact of widowhood have been described in the literature; however, the expanse of sociocontextual issues that impact on older women's adjustment is less prominent. We undertook a literature review to synthesize recent research and interventions and identify current trends and gaps in knowledge and services. Although many health, social, cultural, and economic factors impact on recently widowed older women throughout the world, we found few interventions targeting this population incorporating these factors.
DiGiacomo, M, Delaney, P, Abbott, P, Davidson, PM, Delaney, J & Vincent, F 2013, ''Doing the hard yards': carer and provider focus group perspectives of accessing Aboriginal childhood disability services', BMC Health Services Research, vol. 13, no. 326.View/Download from: UTS OPUS or Publisher's site
Background: Despite a high prevalence of disability, Aboriginal Australians access disability services in Australia less than non-Aboriginal Australians with a disability. The needs of Aboriginal children with disability are particularly poorly understood. They can endure long delays in treatment which can impact adversely on development. This study sought to ascertain the factors involved in accessing services and support for Aboriginal children with a disability. Methods: Using the focus group method, two community forums, one for health and service providers and one for carers of Aboriginal children with a disability, were held at an Aboriginal Community Controlled Health Service (ACCHS) in the Sydney, metropolitan area of New South Wales, Australia. Framework analysis was applied to qualitative data to elucidate key issues relevant to the dimensions of access framework. Independent coding consistency checks were performed and consensus of analysis verified by the entire research team, several of whom represented the local Aboriginal community. Results: Seventeen health and social service providers representing local area government and non-governmentfunded health and social service organisations and five carers participated in two separate forums between September and October 2011. Lack of awareness of services and inadequate availability were prominent concerns in both groups despite geographic proximity to a major metropolitan area with significant health infrastructure. Carers noted racism, insufficient or non-existent services, and the need for an enhanced role of ACCHSs and AHWs in disability support services. Providers highlighted logistical barriers and cultural and historical issues that impacted on the effectiveness of mainstream services for Aboriginal people. Conclusions: Despite dedicated disability services in an urban community, geographic proximity does not mitigate lack of awareness and availability of support. This paper has enumerated a numb...
DiGiacomo, M, Lewis, J, Nolan, M, Phillips, JL & Davidson, PM 2013, 'Transitioning From Caregiving to Widowhood', Journal of Pain and Symptom Management, vol. 46, no. 6, pp. 817-825.View/Download from: UTS OPUS or Publisher's site
Older women commonly assume a caregiving role for their husbands at the end of life and are more vulnerable to poorer health, well-being, and social and economic challenges. The aim of this study was to ascertain older women's experiences of spousal caregiving at the end of life and the ways in which this experience impacts on the transition to widowhood.
DiGiacomo, M, Lewis, J, Nolan, MT, Phillips, J & Davidson, PM 2013, 'Health transitions in recently widowed older women: a mixed methods study', BMC Health Services Research, vol. 13, no. 143.View/Download from: UTS OPUS or Publisher's site
Disler, RT, Inglis, S & Davidson, PM 2013, 'Non-pharmacological management interventions for COPD: an overview of Cochrane systematic reviews (Protocol)', The Cochrane Database of Systematic Reviews, vol. 2, pp. 1-8.View/Download from: UTS OPUS or Publisher's site
summarise the evidence, b) identify gaps in the evidence base and c) describe elements of non-pharmacological, non-surgical and non-device interventions for the management of COPD using a standardised taxonomy for disease management adapted from the American Heart Association (Krumholz 2006).
Driscoll, A, Currey, JA, George, M & Davidson, PM 2013, 'Changes In Health Service Delivery For Cardiac Patients: Implications For Workforce Planning And Patient Outcomes', Australian Critical Care, vol. 26, no. 2, pp. 55-57.View/Download from: UTS OPUS or Publisher's site
Background: Traditional dedicated coronary care units (CCU) are being decommissioned and cardiology precincts are evolving. These precincts often have cardiac and non-cardiac patients with a diverse array of acuity levels. Critical care trained cardiac nurses are frequently caring for lower acuity patients resulting in a deskilling of this experienced workforce. Aim: The aim of this paper was to discuss the implications of restructuring CCUs on nursing workforce and patient outcomes. Method: An integrated literature review was conducted. The following databases were searched for articles published between January 2000 and December 2011: Ovid Medline, CINHAL, EMBASE and Cochrane. Additional studies obtained from the articles searched and policy documents from key professional organisations and government departments were reviewed. Results: This review has highlighted the association between workforce, qualifications and quality of care. Studies have shown the relationship between an increase in critical care qualified nursing staff and an improvement in patient outcomes. Inadequate staffing levels were also shown to be associated with an increase in adverse events. Cardiology precincts have the potential to adversely impact on critical care trained cardiac nursing workforce and patient outcomes. Conclusion: The implications that these new models have on the critical care cardiac nurse workforce are crucial to health care reform, quality of in-hospital care, sentinel events and patient outcomes
Driscoll, A, Tonkin, A, Stewart, A, Worrall-Carter, L, Thompson, DR, Riegel, B, Hare, DL, Davidson, PM, Mulvany, C & Stewart, S 2013, 'Complexity of management and health outcomes in a prospective cohort study of 573 heart failure patients in Australia: does more equal less?', Journal Of Clinical Nursing, vol. 22, no. 11-12, pp. 1629-1638.View/Download from: UTS OPUS or Publisher's site
Aims and objectives. To compare the efficacy of chronic heart failure management programmes (CHF-MPs) according to a scoring algorithm used to quantify the level of applied interventionsthe Heart Failure Intervention Score (HF-IS).
Ferguson, C, Inglis, S, Newton, PJ, Middleton, S, Macdonald, P & Davidson, PM 2013, 'Atrial fibrillation and thromboprophylaxis in heart failure: The need for patient centered approaches to address adherence', Vascular Health and Risk Management, vol. 9, pp. 3-11.View/Download from: UTS OPUS or Publisher's site
Atrial fibrillation is a common arrhythmia in heart failure and a risk factor for stroke. Risk assessment tools can assist clinicians with decision-making in the allocation of thromboprophylaxis. This review provides an overview of current validated risk assessment tools for AF and emphasises the importance of addressing both tailoring individual risk for stroke and weighing the benefits of treatment. Further, this review provides details of innovative and patient centered methods for ensuring optimal adherence to prescribed therapy. Prior to initiating oral anticoagulant therapy a comprehensive risk assessment should include evaluation of associated cardio-geriatric conditions, potential for adherence to prescribed therapy, frailty, functional and cognitive ability.
Gholizadeh, L, Salamonson, Y, Heydari, M & Davidson, PM 2013, 'Cardiac patients' causal attributions for coronary heart disease', International Journal of Research in Nursing, vol. 4, no. 1, pp. 22-28.View/Download from: UTS OPUS or Publisher's site
Accurate casual attributions for CHD have been associated with more congruent risk reduction behaviours and improved health outcomes. This article aimed to assess causal attributions for Coronary Heart Disease (CHD) of Middle Eastern women diagnosed with heart disease using different risk targets and compare these attributions with participants actual.
Hosseini, M, Davidson, PM, Khoshknab, MF & Green, AR 2013, 'Spiritual and religious interventions in health care: an integrative review', Iranian Rehabilitation Journal, vol. 11, no. 17, pp. 120-129.View/Download from: UTS OPUS
Objective: To describe research on spiritual and religious interventions in Iran.
Hosseini, M, Salehi, A, Khoshknab, MF, Rokofian, A & Davidson, PM 2013, 'The Effect of a Preoperative Spiritual/Religious Intervention on Anxiety in Shia Muslim Patients Undergoing Coronary Artery Bypass Graft Surgery A Randomized Controlled Trial', Journal of Holistic Nursing, vol. 31, no. 3, pp. 164-172.View/Download from: UTS OPUS or Publisher's site
Background: Coronary artery bypass grafting (CABG) is associated with anxiety. Preoperative anxiety is considered a predictor for a range of suboptimal postsurgical outcomes. Objective: To evaluate the effect of a spiritual/religious training intervention on anxiety in Shia Muslim individuals scheduled for CABG.
Kim Lam, S, Kim Geok, S & Davidson, PM 2013, 'The role of culture in quality improvement in the intensive care unit: A literature review', Journal of Hospital Administration, vol. 2, no. 2, pp. 97-104.View/Download from: UTS OPUS or Publisher's site
Improving the quality of patient care and patient outcomes is a major concern internationally. In a developing health care system, implementing quality improvement is challenging due not only to resource and workforce issues but also cultural factors. Using the method of a focused literature review, this paper discusses the importance of assessing a societal view of culture, social mores and customs, and power relationships in quality improvement activities using the intensive care unit as an exemplar. We conclude that implementing quality improvement strategies in a developing health care system needs to address the broader perspectives of social and cultural systems particularly hierarchical relationships and issues of non-disclosure.
Krum, H, Forbes, A, Yallop, J, Driscoll, A, Croucher, J, Chan, B, Clark, R, Davidson, PM, Huynh, L, Kasper, EK, Hunt, D, Egan, H, Stewart, S, Piterman, L & Tonkin, A 2013, 'Telephone Support to Rural and Remote Patients with Heart Failure: The Chronic Heart Failure Assessment by Telephone (CHAT) study', Cardiovascular Therapeutics, vol. 31, no. 1, pp. 230-237.View/Download from: UTS OPUS or Publisher's site
Heart failure (HF) remains a condition with high morbidity and mortality. We tested a telephone support strategy to reduce major events in rural and remote Australians with HF, who have limited healthcare access. Telephone support comprised an interactive telecommunication software tool (TeleWatch) with follow-up by trained cardiac nurses.
Macdonald, P, Newton, PJ & Davidson, PM 2013, 'The SNAPSHOT ACS study: getting the big picture on acute coronary syndrome', Medical Journal Of Australia, vol. 199, no. 3, pp. 147-148.View/Download from: UTS OPUS or Publisher's site
How snapshot methodology identifies factors limiting translation of evidence to practice
Saltman, D, Jackson, DE, Newton, PJ & Davidson, PM 2013, 'In pursuit of certainty: can the systematic review process deliver?', BMC Medical Informatics and Decision Making, vol. 13, no. 25.View/Download from: UTS OPUS or Publisher's site
There has been increasing emphasis on evidence-based approaches to improve patient outcomes through rigorous, standardised and well-validated approaches. Clinical guidelines drive this process and are largely developed based on the findings of systematic reviews (SRs). This paper presents a discussion of the SR process in providing decisive information to shape and guide clinical practice, using a purpose-built review database: the Cochrane reviews; and focussing on a highly prevalent medical condition: hypertension. Methods We searched the Cochrane database and identified 25 relevant SRs incorporating 443 clinical trials. Reviews with the terms `blood pressure or `hypertension in the title were included. Once selected for inclusion, the abstracts were assessed independently by two authors for their capacity to inform and influence clinical decision-making. The inclusions were independently audited by a third author. Results Of the 25 SRs that formed the sample, 12 provided conclusive findings to inform a particular treatment pathway. The evidence-based approaches offer the promise of assisting clinical decision-making through clarity, but in the case of management of blood pressure, half of the SRs in our sample highlight gaps in evidence and methodological limitations. Thirteen reviews were inconclusive, and eight, including four of the 12 conclusive SRs, noted the lack of adequate reporting of potential adverse effects or incidence of harm. Conclusions These findings emphasise the importance of distillation, interpretation and synthesis of information to assist clinicians. This study questions the utility of evidence-based approaches as a uni-dimensional approach to improving clinical care and underscores the importance of standardised approaches to include adverse events, incidence of harm, patients needs and preferences and clinicians expertise and discretion.
Siabani, S, Leeder, S & Davidson, PM 2013, 'Barriers and facilitators to self-care in chronic heart failure: a meta-synthesis of qualitative studies', SpringerPlus, vol. 2, pp. 1-14.View/Download from: UTS OPUS or Publisher's site
Chronic heart failure (CHF) is a costly condition that places large demands on self-care. Failure to adhere with self-care recommendations is common and associated with frequent hospitalization. Understanding the factors that enable or inhibit self-care is essential in developing effective health care interventions. This qualitative review was conducted to address the research question, "What are the barriers and facilitators to self-care among patients with CHF? Electronic databases including Medline, EMBASE, CINAHL, Web of Science, Scopus and Google scholar were searched. Articles were included if they were peer reviewed (1995 to 2012), in English language and investigated at least one contextual or individual factor impacting on self-care in CHF patients?>?18years. The criteria defined by Kuper et al. including clarity and appropriateness of sampling, data collection and data analysis were used to appraise the quality of articles. Twenty-three articles met the inclusion criteria. Factors impacting on self-care were included factors related to symptoms of CHF and the self-care process; factors related to personal characteristics; and factors related to environment and self-care system. Important factors such as socioeconomic situation and education level have not been explored extensively and there were minimal data on the influence of age, gender, self-confidence and duration of disease. Although there is an emerging literature, further research is required to address the barriers and facilitators to self-care in patients with CHF in order to provide an appropriate guide for intervention strategies to improve self-care in CHF.
Walczak, A, Mazer, B, Butow, PN, Tattersall, MHN, Clayton, JM, Davidson, PM, Young, J, Ladwig, S & Epstein, RM 2013, 'A question prompt list for patients with advanced cancer in the final year of life: development and cross-cultural evaluation.', Palliative medicine, vol. 27, no. 8, pp. 779-788.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: Clinicians and patients find prognosis and end-of-life care discussions challenging. Misunderstanding one's prognosis can contribute to poor decision-making and end-of-life quality of life. A question prompt list (booklet of questions patients can ask clinicians) targeting these issues may help overcome communication barriers. None exists for end-of-life discussions outside the palliative care setting. AIM: To develop/pilot a question prompt list facilitating discussion/planning of end-of-life care for oncology patients with advanced cancer from Australia and the United States and to explore acceptability, perceived benefits/challenges of using the question prompt list, suggestions for improvements and the necessity of country-specific adaptations. DESIGN: An expert panel developed a question prompt list targeting prognosis and end-of-life issues. Australian/US semi-structured interviews and one focus group elicited feedback about the question prompt list. Transcribed data were analysed using qualitative methods. SETTING/PARTICIPANTS: Thirty-four patients with advanced cancer (15 Australian/19 US) and 13 health professionals treating such patients (7 Australian/6 US) from two Australian and one US cancer centre participated. RESULTS: Most endorsed the entire question prompt list, though a minority queried the utility/appropriateness of some questions. Analysis identified four global themes: (1) reinforcement of known benefits of question prompt lists, (2) appraisal of content and suggestions for further developments, (3) perceived benefits and challenges in using the question prompt list and (4) contrasts in Australian/US feedback. These contrasts necessitated distinct Australian/US final versions of the question prompt list. CONCLUSIONS: Participants endorsed the question prompt list as acceptable and useful. Feedback resulted in two distinct versions of the question prompt list, accommodating differences between Australian and US approaches to end-o...
Walczak, W, Butow, P, Davidson, PM, Bellemore, FA, Tattersall, M, Clayton, J, Young, J, Mazer, B, Ladwig, S & Epstein, RM 2013, 'Patient perspectives regarding communication about prognosis and end-of-life issues: How can it be optimised?', Patient Education And Counselling, vol. 90, pp. 307-314.View/Download from: UTS OPUS or Publisher's site
Objective: To explore patients perspectives across two cultures (Australia and USA) regarding communication about prognosis and end-of-life care issues and to consider the ways in which these discussions can be optimised. Methods: Fifteen Australian and 11 US patients completed individual semi-structured qualitative interviews. A further 8 US patients participated in a focus group. Interviews and focus group recordings were transcribed verbatim and interpreted using thematic text analysis with an inductive, data-driven approach. Results: Global themes identified included readiness for and outcomes of discussions of prognosis and end-of-life issues. Contributing to readiness were sub themes including patientsâ adjustment to and acceptance of their condition (together with seven factors promoting this), doctor and patient communication skills, mutual understandings and therapeutic relationship elements. Outcomes included sub themes of achievement of control and ability to move on. A model of the relationships between these factors, emergent cross cultural differences, and how factors may help to optimise these discussions are presented. Conclusion: Identified optimising factors illustrate Australian and US patients perspectives regarding how prognosis and end-of-life issues can be discussed with minimised negative impact. Practice implications: Recognition of factors promoting adjustment, acceptance and readiness and use of the communication skills and therapeutic relationship elements identified may assist in optimising discussions and help patients plan care, achieve more control of their situation and enjoy an optimal quality-of-life.
Waller, A, Girgis, A, Davidson, PM, Newton, PJ, Lecathelinais, C, Macdonald, P, Hayward, C & Currow, D 2013, 'Facilitating needs-based support and palliative care for people with chronic heart failure: preliminary evidence for the acceptability, inter-rater reliability and validity of a needs assessment tool', Journal of Pain and Symptom Management, vol. 45, no. 5, pp. 912-925.View/Download from: UTS OPUS or Publisher's site
Context. Understanding the types and extent of need is critical to informing needs-based care for people with chronic heart failure (CHF). Objectives. To explore the psychometric quality of a newly developed rapid screening measure to assess the supportive and palliative care needs of people with CHF.
Westlake, C, Sethares, K & Davidson, PM 2013, 'How Can Health Literacy Influence Outcomes in Heart Failure Patients? Mechanisms and Interventions', Current Heart Failure Reports, vol. 10, no. 3, pp. 232-243.
Health literacy is discussed in papers from 25 countries where findings suggest that approximately a third up to one half of the people in developed countries have low health literacy.
Whitty, JA, Stewart, S, Carrington, MJ, Calderone, A, Marwick, T, Horowitz, JD, Krum, H, Davidson, PM, Macdonald, PS, Reid, C & Scuffham, PA 2013, 'Patient preferences and willingness-to-pay for a home or clinic based program of chronic heart failure management: findings from the Which? trial.', PloS one, vol. 8, no. 3, p. e58347.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: Beyond examining their overall cost-effectiveness and mechanisms of effect, it is important to understand patient preferences for the delivery of different modes of chronic heart failure management programs (CHF-MPs). We elicited patient preferences around the characteristics and willingness-to-pay (WTP) for a clinic or home-based CHF-MP. METHODOLOGY/PRINCIPAL FINDINGS: A Discrete Choice Experiment was completed by a sub-set of patients (n=91) enrolled in the WHICH? trial comparing home versus clinic-based CHF-MP. Participants provided 5 choices between hypothetical clinic and home-based programs varying by frequency of nurse consultations, nurse continuity, patient costs, and availability of telephone or education support. Participants (aged 71±13 yrs, 72.5% male, 25.3% NYHA class III/IV) displayed two distinct preference classes. A latent class model of the choice data indicated 56% of participants preferred clinic delivery, access to group CHF education classes, and lower cost programs (p<0.05). The remainder preferred home-based CHF-MPs, monthly rather than weekly visits, and access to a phone advice service (p<0.05). Continuity of nurse contact was consistently important. No significant association was observed between program preference and participant allocation in the parent trial. WTP was estimated from the model and a dichotomous bidding technique. For those preferring clinic, estimated WTP was AU$9-20 per visit; however for those preferring home-based programs, WTP varied widely (AU$15-105). CONCLUSIONS/SIGNIFICANCE: Patient preferences for CHF-MPs were dichotomised between a home-based model which is more likely to suit older patients, those who live alone, and those with a lower household income; and a clinic-based model which is more likely to suit those who are more socially active and wealthier. To optimise the delivery of CHF-MPs, health care services should consider their patients' preferences when designing CHF-MPs.
Yacopetti, N, Davidson, PM, Blacka, J & Spencer, T 2013, 'Preventing contamination at the time of central venous catheter insertion: a literature review and recommendations for clinical practice', Journal Of Clinical Nursing, vol. 22, pp. 611-620.View/Download from: UTS OPUS or Publisher's site
Aims and objectives. To evaluate the evidence base and rationale underpinning the various infections control strategies during central venous catheter insertion and to promote discussion about the key, recurring concepts and recommendations in the literature. Logistical and organisational factors relating to central venous catheter insertion are also examined.
Hosie, A, Davidson, PM, Agar, M, Sanderson, CR & Phillips, JL 2013, 'Delirium prevalence, incidence, and implications for screening in specialist palliative care inpatient settings: A systematic review', Palliative Medicine, vol. 27, no. 6, pp. 486-498.View/Download from: UTS OPUS or Publisher's site
Background: Delirium is a serious neuropsychiatric syndrome frequently experienced by palliative care inpatients. This syndrome is under-recognized by clinicians. While screening increases recognition, it is not a routine practice. Aim and design: This systematic review aims to examine methods, quality, and results of delirium prevalence and incidence studies in palliative care inpatient populations and discuss implications for delirium screening.
Phillips, JL, West, P, Davidson, PM & Agar, M 2013, 'Does case conferencing for people with advanced dementia living in nursing homes improve care outcomes: Evidence from an integrative review?', International Journal of Nursing Studies, vol. 50, no. 8, pp. 1122-1135.View/Download from: UTS OPUS or Publisher's site
Objective: This integrative review aimed to appraise the evidence for case conferencing as an intervention to improve palliative care outcomes for older people living with advanced dementia in nursing homes.
Lewis, J, DiGiacomo, M, Luckett, T, Davidson, PM & Currow, D 2013, 'A Social Capital Framework for Palliative Care: Supporting Health and Well-Being for People With Life-Limiting Illness and Their Carers Through Social Relations and Networks', Journal of Pain and Symptom Management, vol. 45, no. 1, pp. 92-103.View/Download from: UTS OPUS or Publisher's site
This paper summarizes the literature on social capital, well-being, and quality of life for key outcomes to inform a model of social capital in palliative care.
Luckett, T, Davidson, PM, Lam, L, Phillips, JL, Currow, D & Agar, M 2013, 'Do Community Specialist Palliative Care Services That Provide Home Nursing Increase Rates of Home Death for People with Life-Limiting Illnesses? A Systematic Review and Meta-Analysis of Comparative Studies', Journal of Pain and Symptom Management, vol. 45, no. 2, pp. 279-297.View/Download from: UTS OPUS or Publisher's site
Context. Systematic reviews and meta-analyses suggest that community specialist palliative care services (SPCSs) can avoid hospitalizations and enable home deaths. But more information is needed regarding the relative efficacies of different models. Family caregivers highlight home nursing as the most important service, but it is also likely the most costly.
Luckett, T, Davidson, PM, Green, AR, Boyle, F, Stubbs, J & Lovell, M 2013, 'Assessment and Management of Adult Cancer Pain: A Systematic Review and Synthesis of Recent Qualitative Studies Aimed at Developing Insights for Managing Barriers and Optimizing Facilitators Within a Comprehensive Framework of Patient Care', Journal of Pain and Symptom Management, vol. 46, no. 2, pp. 229-253.View/Download from: UTS OPUS or Publisher's site
Objectives: To develop insights for managing barriers and optimizing facilitators to adult cancer pain assessment and management within a comprehensive framework of patient care.
Lovell, M, Agar, M, Luckett, T, Davidson, PM, Green, AR & Clayton, J 2013, 'Australian survey of current practice and guideline use in adult cancer pain assessment and management: Perspectives of palliative care physicians', Journal of Palliative Medicine, vol. 16, no. 11, pp. 1403-1409.View/Download from: UTS OPUS or Publisher's site
Background: Cancer pain continues to be undertreated, despite the availability of evidence-based guidelines. The Australian National Pain Strategy identified establishment of systems and guidelines to adequately manage cancer pain as a high priority.
Inglis, S, Hermis, A, Shehab, S, Newton, PJ, Lal, S & Davidson, PM 2013, 'Peripheral arterial disease and chronic heart failure: a dangerous mix', Heart Failure Reviews, vol. 18, no. 4, pp. 457-464.View/Download from: UTS OPUS or Publisher's site
Chronic heart failure (CHF) is associated with a high comorbidity burden, adverse impact on quality of life and high health care utilisation. Peripheral arterial disease (PAD) and CHF share many risk, pathophysiological and prognostic features, and each has been associated with increased morbidity and mortality. PAD often goes undetected, and yet in spite of the availability of screening tools, this is not commonly considered in CHF care. A review of the electronic databases Medline, CINAHL and Cochrane CENTRAL was undertaken using the MeSH terms peripheral arterial disease, peripheral vascular disease, intermittent claudication and heart failure to identify studies examining the prevalence and clinical outcomes of coexisting PAD in patients with CHF. Five studies were identified. There are limited data describing the impact of PAD on CHF outcomes. As PAD may contribute to decreased capacity to exercise and other self-care behaviours, identifying those at risk and providing appropriate therapy are important. Based on this review, patients who are smokers and those with diagnosed coronary heart disease and diabetes should be targeted for the screening of PAD.
Marie, N, Luckett, T, Davidson, PM, Lovell, M & Lal, S 2013, 'Optimal patient education for cancer pain: a systematic review and theory-based meta-analysis', Supportive Care in Cancer, vol. 21, no. 12, pp. 3529-3537.View/Download from: UTS OPUS or Publisher's site
Purpose: Previous systematic reviews have found patient education to be moderately efficacious in decreasing the intensity of cancer pain, but variation in results warrants analysis aimed at identifying which strategies are optimal. Methods: A systematic review and meta-analysis was undertaken using a theory-based approach to classifying and comparing educational interventions for cancer pain. The reference lists of previous reviews andMEDLINE, PsycINFO, and CENTRAL were searched in May 2012. Studies had to be published in a peer-reviewed English language journal and compare the effect on cancer pain intensity of education with usual care. Meta-analyses used standardized effect sizes (ES) and a random effects model. Subgroup analyses compared intervention components categorized using the Michie et al. (Implement Sci 6:42, 2011) capability, opportunity, and motivation behavior (COM-B) model.
Alexandrou, E, Murgo, M, Calabria, E, Spencer, TR, Carpen, H, Brennan, K, Frost, S, Davidson, PM & Hillman, KM 2012, 'Nurse-led central venous catheter insertion- Procedural characteristics and outcomes of three intensive care based catheter placement services', International Journal of Nursing Studies, vol. 49, pp. 162-168.View/Download from: UTS OPUS or Publisher's site
Background: Nurse-led central venous catheter placement is an emerging clinical role internationally. Procedural characteristics and clinical outcomes is an important consideration in appraisal of such advanced nursing roles. Objectives: To review characteristics and outcomes of three nurse-led central venous catheter insertion services based in intensive care units in New South Wales, Australia. Design: Using data from the Central Line Associated Bacteraemia project in New South Wales intensive care units. Descriptive statistical techniques were used to ascertain comparison rates and proportions. Participants: De-identified outcome data of patients who had a central venous catheter inserted as part of their therapy by one of the four advanced practice nurses working in three separate hospitals in New South Wales. Results: Between March 2007 and June 2009, 760 vascular access devices were placed by the three nurse-led central venous catheter placement services. Hospital A inserted 520 catheters; Hospital C with 164; and Hospital B with 76. Over the study period, insertion outcomes were favourable with only 1 pneumothorax (1%), 1 arterial puncture (1%) and 1 CLAB (1%) being recorded across the three groups. The CLAB rate was lower in comparison to the aggregated CLAB data set [1.3 per 1000 catheters (95% CI = 0.03-7.3) vs. 7.2 per 1000 catheters (95% CI = 5.9-8.7)]. Conclusion: This study has demonstrated safe patient outcomes with nurse led CVC insertion as compared with published data. Nurses who are formally trained and credentialed to insert CVCs can improve organisational efficiencies. This study adds to emerging data that developing clinical roles that focus on skills, procedural volume and competency can be a viable option in health care facilities.
Bernal, DD, Stafford, L, Bereznicki, LR, Castelino, RL, Davidson, PM & Peterson, GM 2012, 'Home medicines reviews following acute coronary syndrome: study protocol for a randomized controlled trial', Trials, vol. 13, pp. 1-17.View/Download from: UTS OPUS or Publisher's site
Despite continual improvements in the management of acute coronary syndromes, adherence to guideline-based medications remains suboptimal. We aim to improve adherence with guideline-based therapy following acute coronary syndrome using an existing service that is provided by specifically trained pharmacists, called a Home Medicines Review. We have made two minor adjustments to target the focus of the existing service including an acute coronary syndrome specific referral letter and a training package for the pharmacists providing the service.
Betihavas, V, Davidson, PM, Newton, PJ, Frost, SA, Macdonald, PS & Stewart, S 2012, 'What are the factors in risk prediction models for rehospitalisation for adults with chronic heart failure?', Australian Critical Care, vol. 25, no. 1, pp. 31-40.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: Risk prediction models can assist in identifying individuals at risk of adverse events and also the judicious allocation of scare resources. Our objective was to describe risk prediction models for the rehospitalisation of individuals with chronic heart failure (CHF) and identify the elements contributing to these models. METHODS: The electronic data bases MEDLINE, PsychINFO, Ovid Evidence-Based Medicine Reviews and Scopus (1950-2010), were searched for studies that describe models to predict all-cause hospital readmission for individuals with CHF. Search terms included: patient readmission; risk; chronic heart failure, congestive heart failure and heart failure. We excluded non-English studies, pediatric studies, and publications without original data. RESULTS: Only 1 additional model was identified since the review undertaken by Ross and colleagues in 2008. All models were derived from data sets collected in the United States and patients were followed from 60 days to 18 months. The only common predictors of re-hospitalisation in the models identified by Ross and colleagues were a history of diabetes mellitus and a history of prior hospitalisation. The additional model extends its scope to include the non clinical factors of social instability and socioeconomic status as predictors of rehospitalisation. CONCLUSIONS: In spite of the burden of hospitalisation in CHF, there are limited tools to assist clinicians in assessing risk. Developing risk prediction models, based on patient, provider and system characteristics may assist in identifying individuals in the community at greatest risk and in need of targeted interventions to improve outcomes.
Betihavas, V, Newton, PJ & Davidson, PM 2012, 'An overview of risk prediction models and the implications for nursing practice', British Journal of Cardiac Nursing, vol. 7, no. 6, pp. 259-265.View/Download from: UTS OPUS or Publisher's site
Chronic heart failure is a common and costly condition and is one of the most common causes of hospitalisation and emergency department presentations in the elderly. This paper discusses risk prediction models in chronic heart failure, their utility in clinical practice and describes the implications for nursing practice. Based on a review of the literature, a description is presented of current risk models for chronic heart failure; the use of risk models in other conditions and the benefits of applying valid and reliable measurement tools in clinical practice. Consideration is given for clinical as well as non-clinical factors being incorporated into risk prediction models.
Cao, X, Cao, Y, Salamonson, Y, DiGiacomo, M, Chen, Y, Chang, S, Riegel, B & Davidson, PM 2012, 'Translation and validation of the Chinese version of the Acute Coronary Syndrome Response Index (C-ACSRI)', International Journal of Nursing Studies, vol. 49, no. 10, pp. 1277-1290.View/Download from: UTS OPUS or Publisher's site
The study aims to translate and validate a Chinese version of the Acute Coronary Syndrome Response Index and to assess the knowledge, attitudes, and beliefs of individuals in mainland China with a history of coronary heart disease.
Davidson, PM & Reid, C 2012, 'Population Screening An Important Step In Identifying And Increasing Awareness Of Cardiovascular Disease In Developing Countries', Heart, Lung and Circulation, vol. 21, pp. 61-62.
Once considered a problem of the developed world, cardiovascular disease (CVD) has emerged as a global health problem contributing up to 30% of deaths in low to middle income countries [1,2]. Increasing urbanisation, industrialisation and globalisation contribute to the complex mosaic of the contemporary epidemiology of cardiovascular disease . A rising prevalence of risk factors particularly tobacco usage, lower levels of physical activity and a higher intake of fats and salts contribute to the rising levels of hypertension, diabetes and hyperlipidaemia . Many communities in the developing world are experiencing rapid epidemiological transitions leading to an increased CVD risk .
Davidson, PM, MacIsaac, A, Cameron, J, Jeremy, R, Mahar, L & Anderson, I 2012, 'Problems, solutions and actions: addressing barriers in acute hospital care for indigenous Australians and New Zealanders.', Heart, lung & circulation, vol. 21, no. 10, pp. 639-643.View/Download from: UTS OPUS or Publisher's site
The burden of cardiovascular disease for Indigenous people in Australia and New Zealand is high and reflects the failings of our health care system to meet their needs. Improving the hospital care for Indigenous people is critical in improving health outcomes. This paper provides the results from a facilitated discussion on the disparities in acute hospital care and workforce issues. The workshop was held in Alice Springs, Australia at the second Cardiac Society of Australia and New Zealand (CSANZ) Indigenous Cardiovascular Health Conference. Critical issues to be addressed include: addressing systemic racism; reconfiguring models of care to address the needs of Indigenous people; cultural competence training for all health professionals; increasing participation of Indigenous people in the health workforce; improving information systems and facilitating communication across the health care sector and with Indigenous communities.
Davidson, PM, Meleis, A, McGrath, S, DiGiacomo, M, Dharmendra, T, Puzantian, HV, Song, M & Riegel, BJ 2012, 'Improving Womens Cardiovascular Health: Position Statement From the International Council on Womens Health Issues', Health Care for Women International, vol. 33, no. 10, pp. 943-955.View/Download from: UTS OPUS or Publisher's site
The International Council on Women's Health Issues is an international nonprofit association dedicated to the goals of promoting the health, health care, and the well-being of women. Presented in this article are key recommendations discussed at its 18th biannual meeting where delegates aimed to raise awareness about the potent influence of gender-specific factors on the development, progression, and outcomes of CVD. Key recommendations for decreasing the burden of CVD are are discussed.
Davidson, PM, Mitchell, J, DiGiacomo, M, Inglis, S, Newton, PJ, Harman, J & Daly, J 2012, 'Cardiovascular disease in women: implications for improving health outcomes', Collegian, vol. 19, no. 1, pp. 5-13.View/Download from: UTS OPUS or Publisher's site
This literature review collated data on women and cardiovascular disease in Australia and globally to inform public health campaigns and health care interventions. If found that women with acute coronary syndromes show consistently poorer outcomes than men, independent of comorbidity and management, despite less anatomical obstruction of coronary arteries and relatively preserved left ventricular function. Higher mortality and complication rates are best documented amongst younger women and those with STsegment-elevation myocardial infarction. Sex differences in atherogenesis and cardiovascular adaptation have been hypothesised, but not proven. Atrial fibrillation carries a relatively greater risk of stroke in women than in men, and anticoagulation therapy is associated with higher risk of bleeding complications. The degree of risk conferred by single cardiovascular risk factors and combinations of risk factors may differ between the sexes, and marked postmenopausal changes are seen in some risk factors. Sociocultural factors, delays in seeking care and differences in self-management behaviours may contribute to poorer outcomes in women. Differences in clinical management for women, including higher rates of misdiagnosis and less aggressive treatment, have been reported, but there is a lack of evidence to determine their effects on outcomes, especially in angina. Although enrolment of women in randomised clinical trials has increased since the 1970s, women remain underrepresented in cardiovascular clinical trials. Improvement in the prevention and management of CVD in women will require a deeper understanding of womenâs needs by the community, health care professionals, researchers and government.
Davidson, PM, Sindhu, S & Meleis, A 2012, 'Women's health is now core business and a global health issue', Collegian, vol. 19, pp. 1-3.
For several decades the policy focus on women's health within society was viewed by many to be faltering. This lack of prominence was not due to the diminishing importance of women's health, nor the passion and hard work of many advocates (Auerbach & Figert, 1995).
Deasy, C, Bray, JE, Smith, K, Harriss, LR, Bernard, SA, Davidson, PM & Cameron, P 2012, 'Resuscitation of out-of-hospital cardiac arrests in residential aged care facilities in Melbourne, Australia', Resuscitation, vol. 83, no. 1, pp. 58-62.View/Download from: UTS OPUS or Publisher's site
Introduction: CPR in patients in residential aged care facilities (RACF) deserves careful consideration. We examined the characteristics, management and outcomes of out-of-hospital cardiac arrest (OHCA) in RACF patients in Melbourne, Australia. Methods: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was searched for all OHCAs occurring in RACFs in Melbourne. The characteristics and outcomes were compared to non-RACF patients in the VACAR. Results: Between 2000 and 2009 there were 30,006 OHCAs, 2350 (7.8%) occurring in a RACF. A shockable rhythm was present in 179 (7.6%) patients on arrival of paramedics of whom bystander CPR had been performed in 118 (66%); 173 (97%) received an EMS attempted resuscitation. ROSC was achieved in 71 (41%) patients and 15 (8.7%) patients survived to leave hospital. Non shockable rhythm was present in 2171 patients (92%) of whom 804 (37%) had an attempted resuscitation by paramedics. ROSC was achieved in 176 patients (22%) and 10 patients (1.2%) were discharged alive. Survival from OHCA occurring in a RACF was less than survival in those aged >70 years of age who suffered OHCA in their own homes (1.8% vs. 4.7%, p = 0.001). On multivariable analysis, witnessed OHCA (OR 3.0, 95% CI 2.4-3.7) and the presence of bystander CPR (OR 4.6, 95% CI 3.7-5.8) was associated with the paramedic decision to resuscitate. Conclusion: Resuscitation of patients in RACF is not futile. However, informed decisions concerning resuscitation status should be made by patients and their families on entry to a RACF. Where it is appropriate to perform resuscitation, outcomes may be improved by the provision of BLS training and possibly AED equipment to RACF staff.
Disler, R, Inglis, SC, Currow, DC & Davidson, PM 2012, 'Palliative and Supportive Care in Chronic Obstructive Pulmonary Disease: Research Priorities to Decrease Suffering', Open Access Scientific Reports, vol. 1, no. 6, pp. 1-3.View/Download from: UTS OPUS or Publisher's site
Chronic obstructive pulmonary disease (COPD) affects 80 million people worldwide, is the fourth most prevalent
cause of death globally and accounts for 3.5% of total years lost due to disability. Despite the similarities with
malignant disease, many individuals suffer unnecessarily and continue to have limited access to palliative and endof-life
care. Changing this will require a shift in focus and approach as well as support for clinical decision making.
Lack of communication regarding care plans and prognosis and coordination across care settings has been identified
as barriers to end-of-life care. Research specifically should focus on improving the use of comprehensive and
collaborative approaches to end-stage COPD care such as those illustrated in the Chronic Care Model which has
demonstrated improved outcomes for chronic conditions. Revision of funding models and workforce organisation,
aided by clinical pathways may improve end of life care for COPD.
Disler, RT, Currow, DC, Phillips, JL, Davidson, PM, Johnson, MJ & Smith, T 2012, 'Interventions to support a palliative care approach in patients with chronic obstructive pulmonary disease: An integrative review.', International Journal of Nursing Studies, vol. 49, no. 11, pp. 1443-1458.View/Download from: UTS OPUS or Publisher's site
End-stage chronic obstructive pulmonary disease (COPD) is a debilitating, life-limiting condition. A palliative approach is appropriate for individuals with end-stage COPD, yet currently few interventions embrace this holistic, multidisciplinary and inclusive perspective.
Disler, RT, Gallagher, RD & Davidson, PM 2012, 'Factors influencing self-management in chronic obstructive pulmonary disease: An integrative review', International Journal of Nursing Practice, vol. 49, pp. 230-242.View/Download from: UTS OPUS or Publisher's site
Background: Chronic obstructive pulmonary disease is a common, chronic and burdensome condition requiring the individual to engage in a range of self-management strategies. The capacity to engage in self-management is dependent on a range of internal (e.g. personal) and external (e.g. health service) factors. Objectives: This paper seeks to define self-management, identify the determinants which influence the individualâs ability to cope and adjust to living with chronic obstructive pulmonary disease in the community, and identify implications for clinical practice and research. Design: Integrative review. Data sources: Medline, Embase, PubMed, CINAHL, Google Scholar. Review methods: Integrative review using prospective research questions. Papers were included in the review if they were published in peer reviewed journals and written in English between 2000 and 2010. Articles were accepted for inclusion if they discussed the determinants that influenced self-management of chronic obstructive pulmonary disease in the community. Confirmation of results and discussion themes was validated by specialists in chronic obstructive pulmonary disease and complex care. Findings: Self-management is less well characterised in chronic obstructive pulmonary disease compared with other chronic conditions. Functional limitation and the need to balance disease management with everyday life are the two key elements that patients face in managing their condition. Provider characteristics, socioeconomic status and health literacy are sparsely discussed yet are known to influence chronic obstructive pulmonary disease self-management. Conclusions: Chronic obstructive pulmonary disease self-management must be a key focus internationally as the disease incidence increases. Collaborative care is required between patients and health providers in order facilitate patients in confident management of their condition.
Du, H, Everett, B, Newton, PJ, Salamonson, Y & Davidson, PM 2012, 'Self-efficacy: a useful construct to promote physical activity in people with stable chronic heart failure', Journal of Clinical Nursing, vol. 21, no. 3-4, pp. 301-310.View/Download from: UTS OPUS or Publisher's site
Aim. To explore the conceptual underpinnings of self-efficacy to address the barriers to participating in physical activity and propose a model of intervention. Background. The benefits of physical activity in reducing cardiovascular risk have led to evidence-based recommendations for patients with heart disease, including those with chronic heart failure. However, adherence to best practice recommendations is often suboptimal, particularly in those individuals who experience high symptom burden and feel less confident to undertake physical activity. Self-efficacy is the degree of confidence an individual has in his/her ability to perform behaviour under several specific circumstances. Four factors influence an individualâs level of self-efficacy: (1) past performance, (2) vicarious experience, (3) verbal persuasion and (4) physiological arousal. Design. Discursive. Methods. Using the method of a discursive paper, this article seeks to explore the conceptual underpinnings of self-efficacy to address the barriers to participating in physical activity and proposes a model of intervention, the Home-Heart-Walk, to promote physical activity and monitor functional status. Conclusions. Implementing effective interventions to promote physical activities require appreciation of factors impacting on behaviour change. Addressing concepts relating to self-efficacy in physical activity interventions may promote participation and adherence in the longer term.
Durey, A, Wynaden, D, Thompson, S, Davidson, PM, Bessarab, D & Katzenellenbogen, J 2012, 'Owning Solutions: A Collaborative Model To Improve Quality In Hospital Care For Aboriginal Australians', Nursing Inquiry, vol. 19, no. 2, pp. 144-152.View/Download from: UTS OPUS or Publisher's site
Well-documented health disparities between Aboriginal and Torres Strait Islander (hereafter referred to as Aboriginal) and non-Aboriginal Australians are underpinned by complex historical and social factors. The effects of colonisation including racism continue to impact negatively on Aboriginal health outcomes, despite being under-recognised and under-reported. Many Aboriginal people find hospitals unwelcoming and are reluctant to attend for diagnosis and treatment, particularly with few Aboriginal health professionals employed on these facilities. In this paper, scientific literature and reports on Aboriginal health-care, methodology and cross-cultural education are reviewed to inform a collaborative model of hospital-based organisational change. The paper proposes a collaborative model of care to improve health service delivery by building capacity in Aboriginal and non-Aboriginal personnel by recruiting more Aboriginal health professionals, increasing knowledge and skills to establish good relationships between non-Aboriginal care providers and Aboriginal patients and their families, delivering quality care that is respectful of culture and improving Aboriginal health outcomes. A key element of model design, implementation and evaluation is critical reflection on barriers and facilitators to providing respectful and culturally safe quality care at systemic, interpersonal and patient/family-centred levels. Nurses are central to addressing the current state of inequity and are pivotal change agents within the proposed model.
Gallagher, RD, Kirkness, A, Armari, E & Davidson, PM 2012, 'Participants' perspectives of a multi-component, group-based weight loss programme supplement for cardiac rehabilitation: A qualitative study', International Journal of Nursing Practice, vol. 18, no. 1, pp. 28-35.View/Download from: UTS OPUS or Publisher's site
Addressing overweight and obesity in people with cardiovascular risk factors is an important aspect of cardiac rehabilitation, but minimal implementation of targeted strategies has occurred. The aim of this study was to describe participants perspectives of a multi-component, group-based weight loss supplement to cardiac rehabilitation programmes. Four focus groups of participants completing the intervention (n = 16) and maintenance phases (n = 19) of the Healthy Eating and Exercise Lifestyle Program (HEELP) were conducted. Interviews were transcribed and thematically analyzed using an inductive process. The overall theme of participants responses was that HEELP helped them reprogramme their lifestyle behaviours to achieve weight loss. The programme was unique compared with other weight loss programmes because it was delivered and developed by familiar and expert health professionals who tailored the programme to participants' health status. Themes included the process of recognizing and deciding to make a commitment to managing their weight problem and feeling supported by the group and the staff to do this. Participants valued the group-based structure and the specific tools used in the programme. The programme content and structure provides a framework for the development of supplemental programmes for overweight and obese people at high cardiovascular risk.
Gallagher, RD, Kirkness, A, Armari, E & Davidson, PM 2012, 'Weight management issues and strategies for people with high cardiovascular risk undertaking an Australian weight loss program: A focus group study', Nursing & Health Sciences, vol. 14, no. 1, pp. 18-24.View/Download from: UTS OPUS or Publisher's site
Obesity is particularly hazardous for people with multiple cardiovascular risk factors and existing cardiovascular disease, although few studies investigate experiences and perceptions of weight loss in this population. This study provides an understanding of participants knowledge, attitudes, and experiences of managing multiple risk factors and/or existing cardiovascular disease of participants who were undertaking a weight loss program. Thirty-five participants were recruited from the first 50 completing a multicomponent group-based weight loss intervention designed to follow cardiovascular disease and diabetes disease management programs. Four focus group interviews were conducted using a semistructured interview schedule. Data were analyzed using an inductive approach, and themes developed. Participants found the process of weight loss to be complex, dynamic, and challenging, as the conflicting needs of existing health conditions, social support, ambivalence, and time limitations required careful balance. In response, participants determinedly developed and tested strategies based on simplified principles, establishing routines for new health habits and portion control, and going back to basics in food selection. Therefore, weight loss programs for this population need to be specifically tailored to support patients efforts and strategies.
Hunt, L, Van Luenen, H, Alexandrou, E, Frost, SA, Davidson, PM, Hillman, K & D¿Amours, S 2012, 'A comparison of fluid instillation volumes to assess intra-abdominal pressure using Kron's methods', Journal of Trauma and Acute Care Surgery, vol. 73, no. 1, pp. 152-155.View/Download from: UTS OPUS or Publisher's site
Intra-abdominal pressure (IAP) measurement has become an important tool in the assessment of critically ill patients. The World Society of the Abdominal Compartment Syndrome consensus guidelines recommend using a maximum volume of 25 mL of sterile saline instilled into the bladder for intermittent IAP measurements. It is postulated that the volume of fluid instilled may have an impact on the estimation of IAP.
Inglis, S, Du, H, Newton, P, DiGiacomo, M, Omari, A & Davidson, PM 2012, 'Disease management interventions for improving self-management in lower-limb peripheral arterial disease', Cochrane Database of Systematic Reviews, no. 3.View/Download from: UTS OPUS or Publisher's site
Jiwa, M, Davidson, PM, Newton, PJ, DiGiacomo, M, McGrath, S & Lotriet, C 2012, 'Patient, Provider and System Factors Impacting on the Diagnosis and Management of Lung Cancer Care in Australia', Journal of Cancer Therapy, vol. 3, pp. 406-411.View/Download from: UTS OPUS or Publisher's site
Background: Lung cancer is the leading cause of cancer death in Australia, with only modest improvements in survival. This study aims to identify factors impacting on diagnosis and management of lung cancer with particular reference to Australian primary care. Methods: A sequential mixed method modified approach employing interview and a two- phased survey technique. Following telephonic interviews with 31 health professionals (individuals representing general practitioners, specialized physicians, nurses and allied health practitioners), interview data was analysed using qualita-tive thematic analysis, and surveys using descriptive statistics. Emergent themes were organised under patient, provider and system factors. Interviews ceased upon saturation of data. Results: Multiple patient, provider and systems issues were seen to contribute to adverse health outcomes. There is a strong relationship between smoking and outcomes, and factors related to higher smoking rates such as a lower socioeconomic status. For smokers, guilt and/or denial was con-sidered a reason for delay in the decision to seek medical care for cough or shortness of breath. Aboriginal people un-der-report morbidity related to smoking and chronic obstructive pulmonary disease; other patients fail to recognise the significance of their symptoms. Discussion: Despite the poor prognosis of lung cancer diagnosis, increased awareness of presentation and treatment options can address disparities in health outcomes.
Juntasopeepun, P, Davidson, PM & Srisomboon, J 2012, 'Issues and challenges in implementing cervical cancer screenings in the emergence of HPV vaccination in Thailand', Collegian, vol. 19, no. 1 Special Issue, pp. 45-50.View/Download from: UTS OPUS or Publisher's site
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.
Juntasopeepun, P, Davidson, PM, Suwan, N, Phianmongkhol, Y & Srisomboon, J 2012, 'Human Papillomavirus Vaccination Intention among Young Women in Thailand', Asian Pacific Journal Of Cancer Prevention, vol. 13, no. 12, pp. 3213-3219.View/Download from: UTS OPUS
Aims: The aims of this study were to examine knowledge and beliefs regarding HPV and cervical cancer and to predict HPV vaccination intention among young women in Thailand using a cross-sectional descriptive study design. Methods: A sample of young women aged 18-24 years (n = 391) were recruited from universities/colleges located in Chiang Mai, Thailand. An online survey was carried out to obtain young women's demographic, HPV and cervical cancer-related health characteristics, knowledge, and beliefs toward HPV and cervical cancer. Multivariate logistic regression analysis was used to determine significant independent predictors of HPV vaccination intention. Findings: Five participants (1.2%) had received at least one shot of the HPV vaccine. Of 386 participants, 218 (56.5%) reported high intention to obtain the HPV vaccine. Young women's knowledge about HPV and cervical cancer was moderate. The mean knowledge score was 7.89 (SD, 3.99; range, 0-15). Knowledge was significantly and positively related to perceived susceptibility, perceived seriousness, and perceived benefits of HPV vaccination, but negatively related to perceived barriers to HPV vaccination. Participants with a higher level of knowledge were significantly more likely to obtain the vaccine. A multivariate logistic regression model identified predictors of HPV vaccination intention: recommendations from significant others, perceived susceptibility, perceived benefits, and feeling embarrassed about getting the HPV vaccine. Conclusions: Health education efforts are needed to promote further understanding of HPV and cervical cancer, particularly with more attention to the HPV vaccination.
Moser, D, McKinley, SM, Riegel, B, Doering, L, Meischke, H, Pelter, MM, Davidson, PM, Baker, H & Dracup, K 2012, 'The impact on anxiety and perceived control of a short one-on-one nursing intervention designed to decrease treatment seeking delay in people with coronary heart disease', European Journal of Cardiovascular Nursing, vol. 11, no. 2, pp. 160-167.View/Download from: UTS OPUS or Publisher's site
Background: Patient delay in seeking treatment for acute coronary syndrome symptoms remains a problem. Thus, it is vital to test interventions to improve this behavior, but at the same time it is essential that interventions not increase anxiety.
Newton, PJ, Davidson, PM & Sanderson, C 2012, 'An online survey of Australian physicians reported practice with the off-label use of nebulised frusemide.', BMC Palliative Care, vol. 11, no. 6, pp. 1-6.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: Off-label prescribing is common in palliative care. Despite inconsistent reports of the benefit of nebulised frusemide for breathlessness, its use continues to be reported. METHODS: An online survey was emailed to 249 members of the Australian and New Zealand Society of Palliative Medicine to estimate the use of nebulised frusemide for breathlessness by Australian physicians involved in palliative care in the previous 12 months. RESULTS: There were 52/249 (21%) respondents to the survey. The majority (44/52; 85%) had not prescribed nebulised frusemide in the previous 12 months. The most common (18/44; 43%) reason for not prescribing nebulised frusemide was a belief that there was not enough evidence to support its use. Whilst only a few respondents (8/52; 15%) reported having used nebulised frusemide, all that had used it thought there was at least some benefit in relieving breathlessness. CONCLUSION: This report adds to the series of case studies reporting some benefit from nebulised frusemide in relieving breathlessnes.
Newton, PJ, Davidson, PM, Krum, H, Ollerton, R & Macdonald, P 2012, 'The acute haemodynamic effect of nebulised frusemide in stable, advanced heart failure', Heart Lung and Circulation, vol. 21, no. 5, pp. 260-266.View/Download from: UTS OPUS or Publisher's site
Purpose: To assess the acute haemodynamic effects of nebulised frusemide in a stable advanced heart failure population. In this randomised, double blind, placebo controlled trial, people with stable, advanced heart failure under-going right heart catheterisation were randomised to receive either 40 mg (4 ml) of nebulised frusemide or 4 ml of normal saline. Following inhalation of the study medication, subjects pulmonary pressures were recorded every 15 min for 1 h. There were no significant changes in the weighted average time course data of the subjects (n = 32) in either group over the study period, in particular no differences were observed in haemodynamic parameters between the two groups. Weighted average pulmonary capillary wedge pressure after 60 min in the frusemide group was 22.5 (SD 6.5) mmHg (n = 14) compared to the placebo group's 24.0 (SD 7.3) mmHg (n = 18), p = 0.55. The frusemide group had a significantly greater change in the median volume of urine in the bladder over the study period (186 ml IQR 137.8-260.8) compared to the placebo group (76 ml IQR 39.0-148.0) p = 0.02. This study showed that nebulised frusemide had no significant clinical effect on the haemodynamic characteristics of the subjects.
Pelter, MM, Riegel, B, McKinley, SM, Moser, D, Doering, L, Meischke, H, Davidson, PM, Baker, H, Yang, W & Dracup, K 2012, 'Are there symptom differences in patients with coronary artery disease presenting to the ED ultimately diagnosed with or without ACS?', American Journal of Emergency Medicine, vol. 30, pp. 1822-1828.View/Download from: UTS OPUS or Publisher's site
Objectives: Symptoms are compared among patients with coronary artery disease (CAD) admitted to the emergency department with or without acute coronary syndrome (ACS). Sex and age are also assessed. Methods: A secondary analysis from the PROMOTION (Patient Response tO Myocardial Infarction fOllowing a Teaching Intervention Offered by Nurses) trial, an multicenter randomized controlled trial, was conducted. Results: Of 3522 patients with CAD, at 2 years, 565 (16%) presented to the emergency department, 234 (41%) with non-ACS and 331 (59%) with ACS. Shortness of breath (33% vs 25%, P = .028) or dizziness (11% vs 3%, P = .001) were more common in non-ACS. Chest pain (65% vs 77%, P = .002) or arm pain (9% vs 21%, P = .001) were more common in ACS. In men without ACS, dizziness was more common (11% vs 2%; P = .001). Men with ACS were more likely to have chest pain (78% vs 64%; P = .003); both men and women with ACS more often had arm pain (men, 19% vs 10% [P = .019]; women, 26% vs 13% [P = .023]). In multivariate analysis, patients with shortness of breath (odds ratio [OR], 0.617 [confidence interval [CI], 0.410-0.929]; P = .021) or dizziness (OR, .0311 [CI, 0.136-0.708]; P = .005) were more likely to have non-ACS. Patients with prior percutaneous coronary intervention (OR, 1.592 [CI, 1.087-2.332]; P = .017), chest pain (OR, 1.579 [CI, 1.051-2.375]; P = .028), or arm pain (OR, 1.751 [CI, 1.013-3.025]; P b.042) were more likely to have ACS. Conclusions: In patients with CAD, shortness of breath and dizziness are more common in non-ACS, whereas prior percutaneous coronary intervention and chest or arm pain are important factors to include during ACS triage.
Phillips, JL, Rolley, JX & Davidson, PM 2012, 'Developing Targeted Health Service Interventions Using the PRECEDE-PROCEED Model: Two Australian Case Studies', Nursing Research and Practice, vol. 2012, pp. 1-8.View/Download from: UTS OPUS or Publisher's site
Aims and Objectives. This paper provides an overview of the applicability of the PRECEDE-PROCEED Model to the development of targeted nursing led chronic illness interventions. Background. Changing health care practice is a complex and dynamic process that requires consideration of social, political, economic, and organisational factors. An understanding of the characteristics of the target population, health professionals, and organizations plus identification of the determinants for change are also required. Synthesizing this data to guide the development of an effective intervention is a challenging process. The PRECEDE-PROCEED Model has been used in global health care settings to guide the identification, planning, implementation, and evaluation of various health improvement initiatives. Design. Using a reflective case study approach, this paper examines the applicability of the PRECEDE-PROCEED Model to the development of targeted chronic care improvement interventions for two distinct Australian populations: a rapidly expanding and aging rural population with unmet palliative care needs and a disadvantaged urban community at higher risk of cardiovascular disease. Results. The PRECEDE-PROCEED Model approach demonstrated utility across diverse health settings in a systematic planning process. In environments characterized by increasing health care needs, limited resources, and growing community expectations, adopting planning tools such as PRECEDE-PROCEEDModel at a local level can facilitate the development of the most effective interventions. Relevance to Clinical Practice. The PRECEDE-PROCEED Model is a strong theoretical model that guides the development of realistic nursing led interventions with the best chance of being successful in existing health care environments.
Salamonson, Y, Everett, B, Koch, J, Andrew, S & Davidson, PM 2012, 'The impact of term-time paid work on academic performance in nursing students: A longitudinal study', International Journal of Nursing Studies, vol. 49, pp. 579-585.View/Download from: UTS OPUS or Publisher's site
Background: Nursing students in higher education are spending more time in paid employment despite evidence that this can impact negatively on academic performance. Objectives: To examine the effect of paid work on academic performance in undergraduate nursing students. Design: Descriptive, correlational survey with longitudinal follow-up. Participants: Nursing students in metropolitan Sydney, Australia. Methods: First year nursing students surveyed at baseline were followed up at the end of the final year of their nursing program to examine factors influencing academic performance.
Stewart, S, Carrington, MJ, Marwick, T, Davidson, PM, Macdonald, P, Horowitz, JD, Krum, H, Newton, PJ, Reid, C, Chan, Y & Scuffham, PA 2012, 'Impact of Home Versus Clinic-Based Management of Chronic Heart Failure: The WHICH? (Which Heart Failure Intervention Is Most Cost-Effective & Consumer Friendly in Reducing Hospital Care) Multicenter, Randomized Trial', Journal Of The American College Of Cardiology, vol. 60, no. 14, pp. 1239-1248.View/Download from: UTS OPUS or Publisher's site
Although direct patient contact appears to be best in delivering CHF management overall, the precise form to optimize health outcomes is less clear.
Wan Chik, WZ, Salamonson, Y, Everett, B, Ramjan, LM, Attwood, N, Weaver, R, Saad, Z & Davidson, PM 2012, 'Gender difference in academic performance of nursing students in a Malaysian university college', International Nursing Review, vol. 59, pp. 387-393.View/Download from: UTS OPUS or Publisher's site
Purpose: To examine differences in academic performance between male and female nursing students, and to identify whether professional identity and language usage were explanatory factors of academic performance. Background: Although the numbers of men entering the nursing profession are increasing, societal stereotypes and the lack of male role models in nursing may have a negative impact on motivation, and hence, academic performance. Methods: A total of 147 students who were enrolled in an undergraduate nursing programme in Peninsula Malaysia were surveyed in January 2011. In addition to demographic and academic data, three instruments were administered to measure language acculturation and professional identity. Findings: The mean age of participants was 20.0 (SD: 1.5) years with 81% being female. Almost all students spoke the Malay language at home. Although there were no differences between male and female nursing students in relation to professional identity (P = 0.496), male nursing students reported a lower mean English language usage score (9.9 vs. 10.9, P = 0.011) and a higher mean Malay language usage score (20.4 vs. 18.8, P = 0.017). Males were also found to have lower academic performance than female students, as measured by grade point average (GPA) (2.7 vs. 3.2, P < 0.001). Regression analysis revealed gender was the only significant predictor of academic performance (b = -0.44, P < 0.001). Conclusions: Males represent less than 10% of the nursing workforce in developed countries, with some developing countries experiencing even lower participation rates. Promoting academic support of male nursing students may assist in increasing the number of male registered nurses in the nursing workforce.
Worrall-Carter, L, Ski, CF, Thompson, DR, Davidson, PM, Cameron, J, Castle, D & Page, K 2012, 'Recognition and referral of depression in patients with heart disease', European Journal of Cardiovascular Nursing, vol. 11, no. 2, pp. 231-238.View/Download from: UTS OPUS or Publisher's site
Background: Routine screening and assessment for depression occurs rarely in clinical practice for a variety of reasons, including the absence of systems to facilitate the process. Aim: To identify nurses knowledge and practice regarding depression screening and referral for cardiac patients following the implementation of education workshops and a validated screening tool with referral actions. Methods: Pre and post-test design using surveys and semi-structured interviews was conducted with a purposive sample of nurses in a large Australian metropolitan tertiary referral hospital. Prior to the introduction of the screening and referral tool, nurses engaged in an interactive one hour education workshop on the topic of depression and the tool; introduced to improve depression screening following an acute cardiac event. Results: In the pre and post-survey 40 and 30 nurses, respectively, participated with 14 also engaging in semi-structured interviews. Eighty percent reported a good understanding of depression post-program compared to 30% at baseline. Sixty percent reported routinely using the depression screening and referral tool. The interviews identified three main themes that supported the utility of the education and instrument: knowledge improvement; perceived self-efficacy and new knowledge into practice. Conclusion: The vast majority of participants reported increased skill, knowledge and confidence to screen and refer for depression post an acute cardiac event. The substantial increase in the number of nurses who engaged in screening and referral actions further demonstrated the success of the program. These encouraging results provide evidence that screening for depression can be achieved through adopting formalised processes.
Smith, TA, Davidson, PM, Lam, LT, Jenkins, CR & Ingham, JM 2012, 'The use of non-invasive ventilation for the relief of dyspnoea in exacerbations of chronic obstructive pulmonary disease; a systematic review', Respirology, vol. 17, no. 2, pp. 300-307.View/Download from: UTS OPUS or Publisher's site
Background and objective: Non-invasive ventilation (NIV) improves outcomes in patients with acute exacerbations of COPD (AECOPD); however, the efficacy in relieving dyspnoea is uncertain. The objective of this systematic review was to identify, synthesize and interpret the data regarding the relief of dyspnoea afforded by NIV in patients admitted with acute respiratory failure occurring during AECOPD. Methods: Randomized controlled trials (RCTs) comparing usual medical care (UMC) to UMC plus NIV and reporting dyspnoea as a patient-reported outcome were identified by searching relevant databases and manual searching. The full text of potentially relevant articles was retrieved. Data describing the impact of NIV on dyspnoea was extracted. Results: Four RCTs met the review criteria.One found NIV did not relieve dyspnoea. The other three RCTs reported NIV relieving dyspnoea. The degree of dyspnoea relief was clinically significant in two of these three studies. However, in all but one RCT, methodological or reporting limitations constrain the confidence that can be had in this conclusion. Conclusions: Limited data exist to determine if NIV relieves subjective dyspnoea in AECOPD. Due to limitations in these studies, it is not possible to definitively conclude if NIV relieves dyspnoea. Standardized reporting and analysis of patient reported outcomes will facilitate objective comparisons of interventions with respect to symptom relief. Future studies involving NIV should routinely incorporate patient reported outcomes in order to answer the important clinical question: 'Does NIV relieve dyspnoea?'
Disler, RT, Green, AR, Luckett, T, Newton, PJ, Inglis, S, Currow, D & Davidson, PM 2012, 'Unmet needs in chronic obstructive pulmonary disease: a metasynthesis protocol', International Journal of Research in Nursing, vol. 3, no. 1, pp. 15-20.View/Download from: UTS OPUS or Publisher's site
Abstract: Problem statement: Chronic obstructive pulmonary disease is a chronic progressive illness. Despite the high burden experienced by individuals in the advanced stages of illness, individuals with advanced COPD continue to have unmet needs and limited access to palliative care. This Metasynthesis seeks to describe: the barriers and facilitators care access and provision; the unmet needs of individuals with advanced COPD, their families and carers; and the experiences of health professionals. Data sources: Medline, PsychINFO, AMED, CINAHL and Sociological Abstracts were searched for articles published between 1990 and December 31st 2011. Medical Subject Headings (MeSH) and key words will be used to guide the search. The strategy will be reviewed by the CareSearch palliative knowledge network and a health informatics expert. Approach: Metasyntheses are increasingly used to gain new insights and understandings of complex research questions through the amalgamation of data from individual qualitative studies. The principles of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and thematic synthesis will be used to achieve consistent reporting and transparency of methods. Results: Inclusion of studies, quality assessment and allocation of free codes into EPPI-Reviewer 4 software will be carried out by two independent investigators. Auditing of random cases will be undertaken and disagreements resolved through group discussion of an expert panel. Descriptive and analytical themes will be developed through thematic synthesis and expert panel discussion. Conclusion: Qualitative data provide useful information in understanding the individual's unique experience. Combining discrete qualitative studies provides an important opportunity to provide a voice to patients, their families and professional careers in managing advanced COPD.
Alexandrou, E, Ramjan, LM, Spencer, T, Frost, SA, Salamonson, Y, Davidson, PM & Hillman, KM 2011, 'The Use of Midline Catheters in the Adult Acute Care Setting- Clinical Implications and Recommendations for Practice', Journal of the Association for Vascular Access, vol. 16, no. 1, pp. 35-41.View/Download from: Publisher's site
Aim and objectives: The aim of this paper was to review published manuscripts on the use of midline catheters, the implications of study findings and recommendations for clinical practice in the acute care setting. Design: Modified integrative literature review Methods: Using key MeSH terms, we searched the electronic databases: CINAHL, Medline, and Embase. The Cochrane and Joanna Briggs databases, Google Search Engine and the reference lists of published materials were also searched. Studies were included if they were in the English language and reported the use of midline catheters in adult acute care populations. Manuscripts that described midlines made of aquavene were excluded. Results: Two hundred and thirty two (232) papers were identified using the search strategy. From these identified papers, thirty (30) were included in the final review. Thematic analysis identified three major themes. These included: (i) advantages of using midline catheters (ii) disadvantages of using midline catheters (iii) insertion and management issues. Conclusion: Midline catheters have both positive and negative implications for clinical practice. They can be used for extended periods of intravenous therapy without requiring repeated cannulations but are not without risk. Midline catheters have been associated with mechanical and chemical phlebitis along with intravascular thrombosis. As such they are not suitable across the entire adult acute population. Midline catheters reduce the number of repeated cannulations which reduces patient discomfort, increases patient satisfaction and also contributes to organisational efficiency.
Andrew, S, Salamonson, Y, Everett, B, Halcomb, E & Davidson, PM 2011, 'Beyond the ceiling effect: Using a mixed methods approach to measure patient satisfaction', International Journal of Multiple Research Approaches, vol. 5, no. 1, pp. 52-63.View/Download from: UTS OPUS or Publisher's site
This study reports patient satisfaction with the nursing care on a neurosurgical critical care unit. A modified version of the Ludwig-Beymer Patient Satisfaction Questionnaire (PSQ-7) was used, and included structured items and semi-structured interview questions. Data were collected from 149 patients. Participants rated their satisfaction as high (Mean = 25.14; SD = 2.96). The distribution of scores was skewed and every item demonstrated a ceiling effect. Principal component analysis yielded a one-component solution which explained 48% of the variance. NVivoÂ® was used to match PSQ-7 scores with qualitative data. Participantsâ comments were categorised as positive, negative or âyes, butâ. Just over half the patients made positive comments and 29% of patients in the low group made negative comments. Three categories: âcommunicationâ, ânursing care deliveryâ and âthe hospital environmentâ emerged from the qualitative data. A mixed method approach enables researchers to move beyond the ceiling effect of quantitative measures of patient satisfaction and to gain a more meaningful explanation of patient satisfaction.
Astley, CM, MacDougall, CJ, Davidson, PM & Chew, DP 2011, 'Lost in Translation: Health Resource Variability in the Achievement of Optimal Performance and Clinical Outcome', Circulation. Cardiovascular Quality and Outcomes, vol. 4, no. 5, pp. 512-520.View/Download from: UTS OPUS or Publisher's site
Background: An evidence-practice gap in acute coronary syndromes (ACS) is commonly recognized. System, provider, and patient factors can influence guideline adherence. Through using guideline facilitators in the clinical setting, the uptake of evidence-based recommendations may be increased. We hypothesized that facilitators of guideline recommendations (systems, tools, and workforce) in acute cardiac care were associated with increased guideline adherence and decreased adverse outcome. Methods and Results: A cross-sectional evaluation of guideline facilitators was conducted in Australian hospitals. The population was derived from the Acute Coronary Syndrome Prospective Audit (ACACIA) and assessed performance, death, and recurrent myocardial infarction (death/re-MI) at 30 days and 12 months. Thirty-five hospitals and 2392 patients participated. Significant associations with decreased death/re-MI were observed with hospital strategies to facilitate primary percutaneous coronary intervention for ST-elevation MI patients (38/428 [8.9%] versus 30/154 [19.5%], P0.001) and after adjustment (odds ratio [OR], 0.47 [95% confidence interval (CI), 0.24 to 0.90], P0.023), electronic discharge checklists (none: 233/1956 [11.9%], integrated; 43/251[17.1%], P0.069, electronic; 6/124 [4.8%], P0.001) and after adjustment (integrated versus none: OR, 1.66 [95% CI, 0.98 to 2.80], P0.057 and electronic versus none: OR, 0.49 [95% CI, 0.35 to 0.68], P 0.001), and intensive cardiac care unit (ICCU) staff-to-patient ratios (neither: 200/1257 (15.9%), CCU: 135/1051 (12.8%), ICCU: 8/84 (9.5%), P 0.049 and after adjustment (CCU versus neither: OR, 0.74 [95% CI, 0.47 to 1.14], P 0.172 and ICCU versus neither: OR, 0.55; [95% CI, 0.38 to 0.81] P 0.003). Conclusions: Facilitating uptake of evidence in clinical practice may need to consider quality improvement systems, tools and workforce to achieve optimal ACS outcomes.
Astley, CM, Tonkin, AM, Mahar, LJ, Davidson, PM, Boyden, AN, Brieger, DB, Pradhan, M, George, M, Mattschoss, SF & Chew, DP 2011, 'Clinical effectiveness in everyday practice: improving outcomes for all patients through a national acute coronary syndrome data collaborative', Internal Medicine Journal, vol. 41, pp. 206-210.View/Download from: UTS OPUS or Publisher's site
The management of acute coronary syndromes (ACS) has an extensive and impressive evidence-base with which to guide clinical practice. Despite this, translation to the clinical environment has proved to be challenging and incomplete and can be attributed to patient, provider and system factors. Causes of suboptimal guideline adherence relate to diverse issues, including patient complexity, barriers in knowledge translation of guideline recommendations and a limited capacity within health services. Addressing these factors may enable more effective guideline implementation. In Australia, the infrastructure for clinical data management is fragmented, uncoordinated and often administratively driven, compromising access to important information, which might improve clinical effectiveness. An integrated approach is required to improve clinical effectiveness in ACS care in Australia. Greater access to information both to assist in clinical decision-making and monitoring outcomes may help direct the focus towards understudied populations and improve performance and clinically relevant outcomes. A peer-led initiative based on common datasets, providing rapid feedback, while developing and disseminating a âtoolboxâ of proven and sustainable interventions, could improve clinical effectiveness in the Australian management of ACS and provides a rationale for a national ACS registry.
Berry, A, Davidson, PM, Masters, J, Rolls, KD & Ollerton, R 2011, 'Effects of three approaches to standardized oral hygiene to reduce bacterial colonization and ventilator associated pneumonia in mechanically ventilated patients: A randomised control trial', International Journal of Nursing Studies, vol. 48, no. 6, pp. 681-688.View/Download from: UTS OPUS or Publisher's site
Berry, AM, Davidson, PM, Nicholson, L, Pasqualotto, C & Rolls, K 2011, 'Consensus based clinical guideline for oral hygiene in the critically ill', Intensive and Critical Care Nursing, vol. 27, no. 4, pp. 180-185.View/Download from: UTS OPUS or Publisher's site
Objectives: Oropharyngeal colonisation has been identified as a factor contributing to ventilator associated pneumonia (VAP) in the Intensive Care Unit (ICU). We sought to develop a clinical practice guideline for providing oral hygiene in the critically ill. Research methodology: Following a systematic literature review a prospectively derived consensus development conference was convened and sponsored by a clinical governance unit. Results: The consensus development conference generated 12 recommendations for tools and solutions; frequency and duration of cleaning; oral assessment tools and oral hygiene protocols. These recommendations underwent a validation process. Conclusions: In light of sparse high level evidence to inform guidelines, further research is needed inform clinical practice. Oral hygiene is a critical element of nursing care and a standardised approach has the potential to improve clinical outcomes.
Betihavas, V, Newton, PJ, Du, H, Macdonald, P, Frost, S, Stewart, S & Davidson, PM 2011, 'Australia's health care reform agenda: implications for the nurses' role in chronic heart failure management', Australian Critical Care, vol. 24, no. 3, pp. 189-197.View/Download from: UTS OPUS or Publisher's site
Introduction: The importance of the nursing role in chronic heart failure (CHF) management is increasingly recognised. With the recent release of the National Health and Hospitals Reform Commission (NHHRC) report in Australia, a review of nursing roles in CHF management is timely and appropriate. Aim: This paper aims to discuss the implications of the NHHRC report and nursing roles in the context of CHF management in Australia. Method: The electronic databases, Thomson Rheuters Web of Knowledge, Scopus and the Cumulative Index to Nursing and Allied Health Literature (CINAHL), were searched using keywords including; ``heart failure, ``management, ``Australia and ``nursing. In addition, policy documents were reviewed including statements and reports from key professional organisations and Government Departments to identify issues impacting on nursing roles in CHF management. Results: There is a growing need for the prevention and control of chronic conditions, such as CHF. This involves an increasing emphasis on specialist cardiovascular nurses in community based settings, both in outreach and inreach health service models. This review has highlighted the need to base nursing roles on evidence based principles and identify the importance of the nursing role in coordinating and managing CHF care in both independent and collaborative practice settings. Conclusion: The importance of the nursing role in early chronic disease symptom recognition and implementing strategies to prevent further deterioration of individuals is crucial to improving health outcomes. Consideration should be given to ensure that evidence based principles are adopted in models of nursing care.
Chang, S, Gholizadeh, L, Salamonson, Y, DiGiacomo, M, Betihavas, V & Davidson, PM 2011, 'Health span or life span: the role of patient reported outcomes in informing health policy', Health Policy, vol. 100, no. 1, pp. 96-104.View/Download from: UTS OPUS or Publisher's site
OBJECTIVES: Population ageing and the increasing burden of chronic conditions challenge traditional metrics of assessing the efficacy of health care interventions and as a consequence policy and planning. Using chronic heart failure (CHF) as an exemplar this manuscript seeks to describe the importance of patient-reported outcomes to inform policy decisions. METHODS: The method of an integrative review has been used to identify patient-reported outcomes (PROs) in assessing CHF outcomes. Using the Innovative Care for Chronic Conditions the case for developing a metric to incorporate PROs in policy planning, implementation and evaluation is made. RESULTS: In spite of the increasing use of PROs in assessing CHF outcomes, their incorporation in the policy domain is limited. CONCLUSIONS: Effective policy and planning is of health care services is dependent on the impact on the individual and their families. Epidemiological transitions and evolving treatment paradigms challenge traditional metrics of morbidity and mortality underscoring the importance of assessing PROs.
Clark, AM, Jaarsma, T, Strachan, P, Davidson, PM, Jerke, M, Beattie, JM, Duncan, AS, Ski, CF & Thompson, DR 2011, 'Effective communication and ethical consent in decisions related to ICDs', Nature Reviews Cardiology, vol. 8, pp. 694-705.View/Download from: UTS OPUS or Publisher's site
This Review examines recommendations and principles that promote good decision-making with regard to the insertion, deactivation, and potential malfunction of implantable cardioverter-defibrillators (ICDs). This guidance is important because ICDs are now used for primary and secondary prevention of arrhythmias in more than 20 diverse clinical populations, which accounts for the exponential increase in insertion rates over the past decade. Current guidelines require clinicians to provide personalized, culturally appropriate, and easy to understand information to patients on the benefits and harms of proposed treatment choices; however, obtaining valid informed consent for insertion and deactivation of ICDs is challenging. Initiating early conversations with patients and continuing this dialogue over time, implementation of localized care protocols, increased collaboration (particularly between cardiac and palliative care teams), and the provision of training for all health professionals involved in the care of these patients, can help to ensure that adequate informed consent is maintained throughout their care. In addition to providing information, health professionals should identify and address high levels of anxiety in patients and their next of kin and promote effective communication throughout decision making. In the future, use of standardized checklists or decision aids based on a clear understanding of the principles underlying key topics could support this process.
Damarell, R, Tieman, J, Sladek, RM & Davidson, PM 2011, 'Development Of A Heart Failure Filter For Medline: An Objective Approach Using Evidence-Based Clinical Practice Guidelines As An Alternative To Hand Searching', BMC Medical Research Methodology, vol. 11, no. 12, pp. 1-10.View/Download from: UTS OPUS or Publisher's site
Background: Heart failure is a highly debilitating syndrome with a poor prognosis primarily affecting the elderly. Clinicians wanting timely access to heart failure evidence to provide optimal patient care can face many challenges in locating this eviden
Globally social and health systems are rallying to address the tsunami of chronic disease and the burden of population ageing (Partridge, Mayer-Davis, Sacco, & Balch, 2011). Although technology and innovation have rampaged ahead in scientific advances, our health and education systems have been slower to adapt to changing times. In the scholarly literature and popular press we are continually reminded of the frailties and inadequacies of our health care system and nurses are often the target of criticism (Jackson & Daly, 2008). In particular the method and standards of educational preparation of nurses has been a focus of discussion and debate (Shields, Purcell, & Watson, 2011). Current methods of nursing education in universities, have been accused of failing to prepare nurses for the challenges of contemporary health care systems. These censures can be readily challenged as they commonly fail to address the broader social, political and economic contexts that shape the role and scope of health care and specifically nursing and midwifery practice. Albeit important, nursing and midwifery education is only but one dimension of the complex mosaic of contemporary health care systems. Therefore considering methods of nursing and midwifery education in isolation from other factors influencing health care systems is futile and a disservice to the communities we serve.
Davidson, PM & Johnson, MJ 2011, 'Update on the role of palliative oxygen', Current Opinion in Supportive and Palliative Care, vol. 5, no. 2, pp. 87-91.View/Download from: UTS OPUS or Publisher's site
On the basis of the findings of this review, the routine use of palliative oxygen therapy without detailed assessment of pathogenesis and reversibility of symptoms cannot be justified. Promoting self-management strategies, such as cool airflow across the face, exercise and psychological support for patients and carers, should be considered before defaulting to oxygen therapy. If palliative oxygen therapy is considered for individuals with transient or mild hypoxaemia, a therapeutic trial should be conducted with clinical review after 3 days to assess the net clinical benefit and patient preference
Davidson, PM & Macdonald, P 2011, 'Interventions for Modern Times: Complex, Collaborative, and Culturally Appropriate', Circulation. Cardiovascular Quality and Outcomes, vol. 4, pp. 584-586.View/Download from: Publisher's site
Approximately 1 in 3 adults in the United States has cardiovascular disease (CVD), and this burden is more pronounced in those who are socioeconomically disadvantaged and from certain minority ethnic groups.1 Modest sustained lifestyle adjustments can decrease CVD burden, but initiating and maintaining these changes is challenging. A complex interplay of patient, provider, and system factors causes and can provide solutions to reduce CVD risk. Addressing social determinants of health and shifting to a collaborative model in which the individual is supported and enabled to engage in their own health care
Davidson, PM, Daly, J, Leung, D, Ang, E, Paull, G, DiGiacomo, M, Hancock, K, Cao, Y, Du, H & Thompson, DR 2011, 'Health-seeking beliefs of cardiovascular patients: A qualitative study', International Journal of Nursing Studies, vol. 48, no. 11, pp. 1367-1375.View/Download from: UTS OPUS or Publisher's site
The study aims were to (a) describe the experiences of Chinese Australians with heart disease following discharge from hospital for an acute cardiac event; (b) identify patterns and cultural differences of Chinese Australians following discharge from hospital; and (c) illustrate the illness/health seeking behaviors and health beliefs of Chinese Australians. Design Qualitative study Methods Interview data were obtained from the following sources: (a) focus groups of Chinese community participants without heart disease; (b) interviews with patients recently discharged from hospital following an admission for an acute cardiac event; and (c) interviews with Chinese-born health professionals working in Australia. Qualitative thematic analysis was undertaken. Results Study themes generated from the data were: (1) linking traditional values and beliefs with Western medicine; (2) reverence for health professionals and family; and (3) juxtaposing traditional beliefs and self-management. Conclusions Considering the influence of cultural values in developing health care plans and clinical decision making is important.
Davidson, PM, DiGiacomo, M & McGrath, S 2011, 'The Feminization of Aging: How Will This Impact on Health Outcomes and Services?', Health Care for Women International, vol. 32, no. 12, pp. 1031-1045.View/Download from: UTS OPUS or Publisher's site
We conducted an integrative review to identify issues and challenges that face aging women and to distinguish areas for future research. We found that many older women continue to face inequities related to health and often are invisible within the discourse of aging policy. In this article we argue for a greater focus on the unique needs of women, a gendered approach to policy and intervention development, and promotion of the health of women across the life span. Policymakers, health care workers, and researchers need to consider the perspective of gender as well as age when implementing and evaluating effective interventions.
Davidson, PM, DiGiacomo, M, Thompson, SC, Abbott, PA, Davison, J, Moore, L, Daly, J, McGrath, S, Taylor, K & Usherwood, T 2011, 'Health workforce issues and how these impact on Indigenous Australians', Journal of Australian Indigenous Issues, vol. 14, no. 4, pp. 69-84.View/Download from: UTS OPUS
Indigenous Australians suffer a disproportionate burden of iII health estimated to be 2.5 times higher than other Australians. A number of complex and multifaceted factors impact not only on health inequity but also imbalance in the health workforce. Addressing workforce issues for both Indigenous and non-Indigenous health workers is vital in decreasing the gap in health and social outcomes for Indigenous Australians. It is widely recognised that the capacity of the lndigenous health workforce is a crucial factor in responding effectively to Indigenous health needs. Using the typology of workforce imbalances proposed by Zurn and colleagues, this paper critically analyses issues within Australia impacting on the health workforce, arguing that it is impossible to consider workforce issues for Indigenous health without regard for global, sociodemographic, cultural, geographic and economic factors.
Davidson, PM, McGrath, S, Meleis, A, Stern, P, DiGiacomo, M, Dharmendra, T, Correa-De-Araujo, R, Campbell, J, Hochleitner, M, Messias, D, Brown, H, Teitelman, A, Sindhu, S, Reesman, A, Richter, S, Sommers, M, Schaeffer, D, Stringer, M, Sampselle, C, Anderson, D, Tuazon, J, Cao, Y & Covan, EK 2011, 'The health of women and girls determines the health and well-being of our modern world: A white paper from the International Council on Women's Health Issues', Health Care for Women International, vol. 32, no. 8, pp. 870-886.View/Download from: Publisher's site
The International Council on Women's Health Issues (ICOWHI) is an international nonprofit association dedicated to the goal of promoting health, health care, and well-being of women and girls throughout the world through participation, empowerment, advocacy, education, and research. We are a multidisciplinary network of women's health providers, planners, and advocates from all over the globe. We constitute an international professional and lay network of those committed to improving women and girl's health and quality of life. This document provides a description of our organization mission, vision, and commitment to improving the health and well-being of women and girls globally.
Davidson, PM, Salamonson, Y, Rolley, JX, Everett, B, Fernandez, RS, Andrew, S, Newton, PJ, Frost, S & Denniss, R 2011, 'Perception of cardiovascular risk following a percutaneous coronary intervention: A cross sectional study', International Journal of Nursing Studies, vol. 48, no. 8, pp. 973-978.View/Download from: UTS OPUS or Publisher's site
Background: An individuals' perception of the risk of, and their susceptibility to, futurecardiovascular events is crucial in engaging in effective secondary prevention. Aim: To investigate the perception of a cardiovascular event by examining the level of agreement between individuals with CHD views of their actual and perceived risk.
DiGiacomo, M, Davidson, PM, Abbott, PA, Davison, J, Moore, L & Thompson, SC 2011, 'Smoking cessation in indigenous populations of Australia, New Zealand, Canada, and the United States: elements of effective interventions.', International journal of environmental research and public health, vol. 8, no. 2, pp. 388-410.View/Download from: UTS OPUS or Publisher's site
Indigenous people throughout the world suffer a higher burden of disease than their non-indigenous counterparts contributing to disproportionate rates of disability. A significant proportion of this disability can be attributed to the adverse effects of smoking. In this paper, we aimed to identify and discuss the key elements of individual-level smoking cessation interventions in indigenous people worldwide. An integrative review of published peer-reviewed literature was conducted. Literature on smoking cessation interventions in indigenous people was identified via search of electronic databases. Documents were selected for review if they were published in a peer-reviewed journal, written in English, published from 1990-2010, and documented an individual-level intervention to assist indigenous people to quit smoking. Studies that met inclusion criteria were limited to Australia, New Zealand, Canada, and the USA, despite seeking representation from other indigenous populations. Few interventions tailored for indigenous populations were identified and the level of detail included in evaluation reports was variable. Features associated with successful interventions were integrated, flexible, community-based approaches that addressed known barriers and facilitators to quitting smoking. More tailored and targeted approaches to smoking cessation interventions for indigenous populations are required. The complexity of achieving smoking cessation is underscored as is the need to collaboratively develop interventions that are acceptable and appropriate to local populations.
DiGiacomo, M, Davidson, PM, Zecchin, RP, Lamb, K & Daly, J 2011, 'Caring for others, but not themselves: implications for health care interventions in women with cardiovascular disease', Nursing Research and Practice, vol. 2011.View/Download from: UTS OPUS or Publisher's site
Cardiovascular disease is the largest killer of women internationally and women often suffer inferior outcomes following an acute cardiac event as compared to men. A gendered approach to investigating cardiovascular disease in women incorporates the unique social, cultural, and economic circumstances that being a woman brings to the health encounter. The multiple roles enacted by many women may be important factors in this health discrepancy. In order to more fully understand the impact of the roles of women on health, a questionnaire was administered to participants of the Heart Awareness for Women group cardiac rehabilitation program which assessed womenâs role perceptions followed by discussions. We found that caregiving can be both positive and negative. It gives a sense of purpose, meaning, and community connection as well as burden and conflict. Emphasis must be placed on promoting strategies in women to achieve a balance between caregiving responsibilities and prioritisation of cardiovascular health.
Driscoll, A, Tonkin, A, Stewart, A, Thompson, DR, Worrall-Carter, L, Riegel, B, Hare, DL, Davidson, PM & Stewart, S 2011, 'Development of an evidence-based scoring system (HF-IS) to assess the quality of heart failure programmes for patients postdischarge from hospital', Journal Of Clinical Nursing, vol. 20, no. 21-22, pp. 3011-3019.View/Download from: UTS OPUS or Publisher's site
Aim. The aim of this study was to develop a potential scoring algorithm for interventions in a chronic heart failure management programme â the Heart Failure Intervention Score â to facilitate quality improvement and programme auditing. Background. The overall efficacy of chronic heart failure management programmes has been demonstrated in several metaanalyses. However, meta-analyses did not determine individual interventions in a programme that resulted in beneficial patient outcomes. Design. A prospective cross-sectional survey design. Method. All chronic heart failure management programmes in Australia (n = 62), identified by a national register, were surveyed to determine programme characteristics and interventions. Results. Of the 62 national chronic heart failure management programmes, 48 (77%) completed the survey and 27 individual interventions were identified. Variability in the use of the key interventions was common among the programmes. Each intervention was given an arbitrary weighted score according to the level of supportive evidence available and a total score calculated. Programmes were then categorised into low or high complexity based on several interventions implemented and their weighted score. A total score of â¡190 (median = 178, interquartile range 176â195) was used to divide programmes into two groups. Nine programmes were categorised into high Heart Failure Intervention Score group and majority of these were based in the acute hospital setting (78%). In the low Heart Failure Intervention Score group, there were 39 programmes of which there were a higher proportion of community-based programmes (38%) and programmes in small community hospitals (10%). Conclusion. The Heart Failure Intervention Score provides a potential evidence-based quality improvement tool through which a set of minimum standards can be developed. Implementation of the Heart Failure Intervention Score provides guidance to programme coordinators to enable monitoring of s...
Driscoll, A, Worrall-Carter, L, Hare, DL, Davidson, PM, Riegel, B, Tonkin, A & Stewart, S 2011, 'Evidence-based chronic heart-failure management programmes: reality or myth?', BMJ Quality & Safety, vol. 20, no. 1, pp. 31-37.View/Download from: UTS OPUS or Publisher's site
Background: Chronic heart-failure management programmes (CHF-MPs) have become part of standard care for patients with chronic heart failure (CHF). Objective: To investigate whether programmes had applied evidence-based expert clinical guidelines to optimise patient outcomes. Design: A prospective cross-sectional survey was used to conduct a national audit. Setting: Community setting of CHF-MPs for patients postdischarge. Sample: All CHF-MPs operating during 2005e2006 (nÂ¼55). Also 10e50 consecutive patients from 48 programmes were recruited (nÂ¼1157). Main outcome measures: (1) Characteristics and interventions used within each CHF-MP; and (2) characteristics of patients enrolled into these programmes. Results: Overall, there was a disproportionate distribution of CHF-MPs across Australia. Only 6.3% of hospitals nationally provided a CHF-MP. A total of 8000 postdischarge CHF patients (median: 126; IQR: 26e260) were managed via CHF-MPs, representing only 20% of the potential national case load. Significantly, 16% of the caseload comprised patients in functional New York Heart Association Class I with no evidence of these patients having had previous echocardiography to confirm a diagnosis of CHF. Heterogeneity of CHF-MPs in applied models of care was evident, with 70% of CHF-MPs offering a hybrid model (a combination of heart-failure outpatient clinics and home visits), 20% conducting home visits and 16% conducting an extended rehabilitation model of care. Less than half (44%) allowed heart-failure nurses to titrate medications. The main medications that were titrated in these programmes were diuretics (nÂ¼23, 96%), b-blockers (nÂ¼17, 71%), ACE inhibitors (ACEIs) (nÂ¼14, 58%) and spironolactone (nÂ¼9, 38%). Conclusion: CHF-MPs are being implemented rapidly throughout Australia. However, many of these programmes do not adhere to expert clinical guidelines for the management of patients with CHF. This poor translation of evidence into practice highlights the inconsi...
Du, H, Davidson, PM, Everett, B, Salamonson, Y, Zecchin, R, Rolley, JX, Newton, PJ & Macdonald, P 2011, 'Correlation between a self-administered walk test and a standard six minute walk test in adults', Nursing and Health Sciences, vol. 13, no. 2, pp. 114-117.View/Download from: UTS OPUS or Publisher's site
This study was undertaken to assess the correlation between a self-administered, adapted Six Minute Walk Test (the Home-Heart-Walk) and the standard Six MinuteWalk Test based on the American Thoracic Society guideline.A correlational study was conducted at a university campus in Sydney,Australia. Thirteen healthy volunteers underwent the Home-Heart-Walk and the standard Six MinuteWalk Test on a single occasion.The distance that participants walked during the two tests was assessed using Pearsons correlation.The correlation between the Home-Heart-Walk and the Six Minute Walk Test distance was 0.81. The Home-Heart-Walk distance was highly correlated to the standard Six Minute Walk Test distance in this study. This relationship provides confidence for further research in populations to facilitate monitoring and evaluation.
Du, H, Newton, PJ, Zecchin, R, Denniss, AR, Salamonson, Y, Everett, B, Currow, D, Macdonald, P & Davidson, PM 2011, 'An intervention to promote physical activity and self-management in people with stable chronic heart failure The Home-Heart-Walk study: study protocol for a randomized controlled trial', Trials, vol. 12, no. 63.View/Download from: UTS OPUS or Publisher's site
Background: Chronic heart failure (CHF) is a chronic debilitating condition with economic consequences, mostly because of frequent hospitalisations. Physical activity and adequate self-management capacity are important risk reduction strategies in the management of CHF. The Home-Heart-Walk is a self-monitoring intervention. This model of intervention has adapted the 6-minute walk test as a home-based activity that is self-administered and can be used for monitoring physical functional capacity in people with CHF. The aim of the Home-Heart-Walk program is to promote adherence to physical activity recommendations and improving self-management in people with CHF. Methods/Design: A randomised controlled trial is being conducted in English speaking people with CHF in four hospitals in Sydney, Australia. Individuals diagnosed with CHF, in New York Heart Association Functional Class II or III, with a previous admission to hospital for CHF are eligible to participate. Based on a previous CHF study and a loss to follow-up of 10%, 166 participants are required to be able to detect a 12-point difference in the study primary endpoint (SF-36 physical function domain). All enrolled participant receive an information session with a cardiovascular nurse. This information session covers key self-management components of CHF: daily weight; diet (salt reduction); medication adherence; and physical activity. Participants are randomised to either intervention or control group through the study randomisation centre after baseline questionnaires and assessment are completed. For people in the intervention group, the research nurse also explains the weekly Home-Heart-Walk protocol. All participants receive monthly phone calls from a research coordinator for six months, and outcome measures are conducted at one, three and six months.
Everett, B, DiGiacomo, M, Rolley, JX, Salamonson, Y & Davidson, PM 2011, 'You won't know if you don't ask: discrepancy and ambivalence in attitudes toward behavior change', Journal of Cardiovascular Nursing, vol. 26, no. 6, pp. 460-465.View/Download from: UTS OPUS or Publisher's site
Background: Behavior change is challenging following an acute cardiac event, and commonly, individuals are ambivalent. Aim: The objective of this study was to describe the experience of behavior change of survivors of an acute cardiac event. Method: Semistructured interviews were undertaken with 25 participants attending 3 cardiac rehabilitation programs. An inductive process of qualitative thematic analysis was used to analyze the transcripts. Results: Analysis revealed ambivalence to change, misconceptions, and confusion about terminology. Discrepancies between what participants felt they should be doing and what they actually were doing reflected their ambivalence. Further inconsistencies were reflected in participants' misunderstandings and confusion regarding disease processes and management of heart disease. Conclusions: These findings reflect the misconception and ambivalence regarding behavior change that individuals experience. Clinicians may require greater skills in detecting conflicting or ambivalent discourse to support patients through sustainable health behavior change.
Fernandez, RS, Davidson, PM, Griffiths, R & Salamonson, Y 2011, 'Improving cardiac rehabilitation services - Challenges for cardiac rehabilitation coordinators', European Journal of Cardiovascular Nursing, vol. 10, no. 1, pp. 37-43.View/Download from: UTS OPUS or Publisher's site
Background: Cardiac rehabilitation (CR) is a long term multifactorial rehabilitation program aimed at the secondary prevention of cardiovascular events. However, delivery of CR services is less than optimal. Aim: This study explored the perceptions of ca
Gholizadeh, L, DiGiacomo, M, Salamonson, Y & Davidson, PM 2011, 'Stressors influencing Middle Eastern womens perceptions of the risk of cardiovascular disease: a focus group study', Health Care for Women International, vol. 32, no. 8, pp. 723-745.View/Download from: UTS OPUS or Publisher's site
To better understand Australia-dwelling Middle Eastern womens lack of service utilization in cardiovascular health, we undertook a study to investigate their understandings and meanings of cardiovascular disease (CVD) and its risk factors. Eight focus groups were conducted in community settings with Turkish, Persian, and Arab women. We found that the women understated their risk of CVD, faced many barriers in reducing their risks, and perceived stress as the most significant contributor to CVD. Women described their stress as primarily emanating from issues surrounding migration and acculturation. Implications for development and delivery of tailored health interventions for Middle Eastern women are discussed.
Haghshenas, A & Davidson, PM 2011, 'Quality service delivery in cardiac rehabilitation: cross-cultural challenges in an Australian setting', Quality in Primary Care, vol. 19, no. 4, pp. 215-221.View/Download from: UTS OPUS
Background Cardiac rehabilitation is an evidencebased health service model for providing secondary prevention strategies following an acute cardiac event. In spite of the benefits of cardiac rehabilitation, there are striking cultural and ethnic disparities with regard to access to and usage of these programmes. Objective To investigate the challenges in providing cardiac rehabilitation to culturally diverse populations in Australia to inform culturally competent care. Method This was a qualitative study using interviews with 25 health professionals from diverse professional and language backgrounds working in cardiac rehabilitation and participant observation of educational and counselling sessions in four cardiac rehabilitation programmes in metropolitan Sydney, Australia. Results Providing cardiac rehabilitation to patients from culturally and linguistically diverse backgrounds presented greater challenges than did provision to themainstream population. These challenges resulted from the interaction of multiple and complex factors such as patients, providers, structural and organisational characteristics within the treatment setting. Communication issues, reconciling health messages with culturally specific issues such as diet, social and family structure and implementation of self-management strategies are significant challenges. Conclusion Strategies are needed to overcome cross-cultural challenges and ensure effective and equitable cardiac rehabilitation service delivery.
Haghshenas, A, Davidson, PM & Rotem, A 2011, 'Negotiating norms, navigating care: findings from a qualitative study to assist in decreasing health inequity in cardiac rehabilitation', Australian Health Review, vol. 35, pp. 185-190.View/Download from: UTS OPUS or Publisher's site
Purpose. People from culturally and linguistically diverse backgrounds (CaLDBs) have lower rates of participation in cardiac rehabilitation (CR). Systematically evaluating barriers and facilitators to service delivery may decrease health inequalities. This study investigated approaches for promoting cultural competence in CR. Methods. A qualitative study of 25 health practitioners was undertaken across three CR programs using a purposive sampling strategy. Interviews and participant observation were undertaken to identify factors to promote culturally competent care. Results. Three key foci were identified for implementing cultural competence approaches: (1) point of contact; (2) point of assessment; and (3) point of service. Based upon study findings and existing literature, a conceptual model of cultural competency in CR was developed. Conclusion. Culturally competent strategies for identifying and tailoring activities in the CR setting may be a useful approach to minimise health inequities. The findings from this study identified that, in parallel with mainstream health services, CR service delivery in Australia faces challenges related to cultural and ethnic diversity. Encouragingly, study findings revealed implementation and integration of culturally competent practices in rehabilitation settings, in spite of significant odds.
Halcomb, E, Caldwell, B, Salamonson, Y & Davidson, PM 2011, 'Development and Psychometric Validation of the General Practice Nurse Satisfaction Scale', Journal Of Nursing Scholarship, vol. 43, no. 3, pp. 318-327.View/Download from: UTS OPUS or Publisher's site
Purpose: To develop an instrument to assess consumer satisfaction with nursing in general practice to provide feedback to nurses about consumers perceptions of their performance. Design: Prospective psychometric instrument validation study. Methods: A literature review was conducted to generate items for an instrument to measure consumer satisfaction with nursing in general practice. Face and content validity were evaluated by an expert panel, which had extensive experience in general practice nursing and research. Included in the questionnaire battery was the 27-item General Practice Nurse Satisfaction (GPNS) scale, as well as demographic and health status items. This survey was distributed to 739 consumers following intervention administered by a practice nurse in 16 general practices across metropolitan, rural, and regional Australia. Participants had the option of completing the survey online or receiving a hard copy of the survey form at the time of their visit. These data were collected between June and August 2009. Findings: Satisfaction data from 739 consumers were collected following their consultation with a general practice nurse. From the initial 27-item GPNS scale, a 21-item instrument was developed. Two factors, confidence and credibility and interpersonal and communication were extracted using principal axis factoring and varimax rotation. These two factors explained 71.9% of the variance. Cronbachs was 0.97. Conclusions: The GPNS scale has demonstrated acceptable psychometric properties and can be used both in research and clinical practice for evaluating consumer satisfaction with general practice nurses. Relevance to Clinical Practice: Assessing consumer satisfaction is important for developing and evaluating nursing roles. The GPNS scale is a valid and reliable tool that can be utilized to assess consumer satisfaction with general practice nurses and can assist in performance management and improving the quality of nursing services.
Hickman, L, Davidson, PM, Chang, E & Chenoweth, L 2011, 'INHospital study: Do older people, carers and nurses share the same priorities of care in the acute aged care setting?', International Journal of Multiple Research Approaches, vol. 5, no. 1, pp. 76-88.View/Download from: UTS OPUS or Publisher's site
The aim of the INHospital study was to compare the level of importance of care priorities and satisfaction levels with care among patients, carers, and nurse caregivers in the acute aged care setting. The INHospital study used sequential mixed methods approach for data collection. Survey data was completed within fi ve metropolitan acute aged care wards on patients (n = 78), their carers (n = 45) and nurses (n = 37). The caring activity scale (CAS) survey was administered to participants in order to determine and compare the perceptions of the importance and satisfaction of care. Semistructured interviews of patients (n = 7) and carers (n = 7) were conducted after completion of the CAS survey. This qualitative data aimed to probe more deeply into the patients and carers care priorities and satisfaction as measured in the CAS. The CAS data demonstrated that patients, carers and nurses rated implementing, observing and reporting doctors orders similarly, while differences between groups were observed in relation to prioritising physical and psychosocial care and discharge. There were signifi cant differences between patients, carers and nurses on overall importance (p = 0.001) and satisfaction with respect to nursing care (p = 0.001). Qualitative data generated fi ve themes (1) Nurses doing the best they can in challenging circumstances; (2) Achieving a balancing act in a pressured environment; (3) Striving to maintain and sustain independence; (4) The discharge process: not a shared priority; and (5) Challenges of the carer role. A key implication of this study is the incongruence between what patients consider a priority for care and the priority ascribed to those tasks by nurses.
Juntasopeepun, P, Davidson, PM, Chang, S, Suwan, N, Phianmongkhol, Y & Srisomboon, J 2011, 'Development and psychometric evaluation of the Thai Human Papillomavirus Beliefs Scale', Nursing and Health Sciences, vol. 13, no. 4, pp. 475-480.View/Download from: UTS OPUS or Publisher's site
In this study, we developed and evaluated the psychometric properties of the Thai Human Papillomavirus Beliefs Scale. The Scale was tested on 386 young women aged 18â24 years in Chiang Mai, Thailand. Content validity of the Scale was evaluated by a panel of experts, construct validity was determined using exploratory factor analysis, and reliability was assessed for stability and internal consistency. Factor analysis provided empirical support for the existence of four factors, which accounted for 67.7% of the total variance: perceived susceptibility, perceived seriousness, perceived benefits, and perceived barriers. Cronbach's a reliability coefficients for the four subscales ranged from 0.59 to 0.86. Factors predicting intention to receive the papillomavirus vaccine were perceived susceptibility, perceived benefits, and perceived barriers. The Thai Human Papillomavirus Beliefs Scale demonstrated promising psychometric properties, indicating that it might be a useful instrument for assessing young women's human papillomavirus and cervical cancer-associated beliefs, and for predicting human papillomavirus vaccination intention.
Koch, J, Salamonson, Y, Du, H, Andrew, S, Frost, S, Dunncliff, K & Davidson, PM 2011, 'Value of Web-Based Learning Activities for Nursing Students Who Speak English as a Second Language', Joournal of Nursing Education, vol. 50, no. 7, pp. 373-380.View/Download from: UTS OPUS or Publisher's site
There is an increasing need to address the educational needs of students with English as a second language. The authors assessed the value of a web-based activity to meet the needs of students with English as a second language in a bioscience subject. Using telephone contact, we interviewed 21 Chinese students, 24 non-Chinese students with English as a second language, and 7 native English-speaking students to identify the perception of the value of the intervention. Four themes emerged from the qualitative data: (1) Language is a barrier to achievement and affects self-confidence; (2) Enhancement intervention promoted autonomous learning; (3) Focusing on the spoken word increases interaction capacity and self-confidence; (4) Assessment and examination drive receptivity and sense of importance. Targeted strategies to promote language acculturation and acquisition are valued by students. Linking language acquisition skills to assessment tasks is likely to leverage improvements in competence.
Koch, J, Salamonson, Y, Rolley, J & Davidson, PM 2011, 'Learning preference as a predictor of academic performance in first year accelerated graduate entry nursing students: A prospective follow-up study', Nurse Education Today, vol. 31, pp. 611-616.View/Download from: UTS OPUS or Publisher's site
The growth of accelerated graduate entry nursing programs has challenged traditional approaches to teaching and learning. To date, limited research has been undertaken in the role of learning preferences, language proficiency and academic performance in accelerated programs. Sixty-two first year accelerated graduate entry nursing students, in a single cohort at a university in the western region of Sydney, Australia, were surveyed to assess their learning preference using the Visual, Aural, Read/write and Kinaesthetic (VARK) learning preference questionnaire, together with sociodemographic data, English language acculturation and perceived academic control. Six months following course commencement, the participant's grade point average (GPA) was studied as a measurement of academic performance. A 93% response rate was achieved. The majority of students (62%) reported preference for multiple approaches to learning with the kinaesthetic sensory mode a significant (p=0.009) predictor of academic performance. Students who spoke only English at home had higher mean scores across two of the four categories of VARK sensory modalities, visual and kinaesthetic compared to those who spoke non-English. Further research is warranted to investigate the reasons why the kinaesthetic sensory mode is a predictor of academic performance and to what extent the VARK mean scores of the four learning preference(s) change with improved English language proficiency.
Kuhn, L, Page, K, Davidson, PM & Worrall-Carter, L 2011, 'Triaging Women With Acute Coronary Syndrome A Review of the Literature', Journal of Cardiovascular Nursing, vol. 26, no. 5, pp. 395-407.View/Download from: UTS OPUS or Publisher's site
Aims and Objectives: This article analyzes the literature describing factors affecting nursesâ triage of emergency department (ED) patients with potential acute coronary syndrome (ACS), with particular attention paid to gender-based differences. Introduction: Acute coronary syndrome is one of the most time-critical conditions requiring ED nurse triage. This literature review will provide examination of how triage nurses prioritize patients with possible ACS, reflecting on challenges specifically associated with evaluating women for ACS in the ED. The article presents a description of the research findings that may help improve the timely revascularization of ACS in women. Methods: An electronic search of EBSCOhost CINAHL, Health Source Nursing Academic Edition, MEDLINE, Psychology and Behavioral Sciences Collection databases, online theses, the Cochrane Library, the Joanna Briggs Institute, and National Guideline Clearinghouse resources were used to identify all relevant scientific articles published between 1990 and 2010. Google and Google Scholar search engines were used to undertake a broader search of the World Wide Web to improve completeness of the search. This search technique was augmented by hand searching these articlesâ reference lists for publications missed during the primary search. Results: Review of the literature suggests factors such as patient age, sex, and symptoms at ED presentation affect the accuracy of nursesâ triage of ACS, particularly for women. However, research examining delays due to ED triage is scant and has predominantly been undertaken by one researcher. Little research has examined triage of ACS specifically in women. Conclusions: The literature search revealed a small number of articles describing challenges associated with nurse triage of women with ACS. Although most of this published research is North American, the themes uncovered are well supported by broader international research on acute assessment and management of ...
Lanuza, DM, Davidson, PM, Dunbar, SB, Hughes, S & De Geest, S 2011, 'Preparing nurses for leadership roles in cardiovascular disease prevention', European Journal of Cardiovascular Nursing, vol. 10, pp. 51-57.
Cardiovascular disease (CVD) is a critical global health issue, and cardiovascular nurses play a vital role in decreasing the global burden and contributing to improving outcomes in individuals and communities. Cardiovascular nurses require the knowledge, skills, and resources that will enable them to function as leaders in CVD. This article addresses the education, training, and strategies that are needed to prepare nurses for leadership roles in preventing and managing CVD. Building on the World Health Organization core competencies for 21st-century health care workers, the specific competencies of cardiovascular nurses working in prevention are outlined. These can be further strengthened by investing in the development of cultural, system change and leadership competencies. Mentorship is proposed as a powerful strategy for promoting the cardiovascular nursing role and equipping individual nurses to contribute meaningfully to health system reform and community engagement in CVD risk reduction.
Lanuza, DM, Davidson, PM, Dunbar, SB, Hughes, S & De Geest, S 2011, 'Preparing Nurses for Leadership Roles in Cardiovascular Disease Prevention', Journal of Cardiovascular Nursing, vol. 26, no. 4S, pp. 56-63.View/Download from: UTS OPUS or Publisher's site
Cardiovascular disease (CVD) is a critical global health issue, and cardiovascular nurses play a vital role in decreasing the global burden and contributing to improving outcomes in individuals and communities. Cardiovascular nurses require the knowledge, skills, and resources that will enable them to function as leaders in CVD. This article addresses the education, training, and strategies that are needed to prepare nurses for leadership roles in preventing and managing CVD. Building on the World Health Organization core competencies for 21st-century health care workers, the specific competencies of cardiovascular nurses working in prevention are outlined. These can be further strengthened by investing in the development of cultural, system change and leadership competencies. Mentorship is proposed as a powerful strategy for promoting the cardiovascular nursing role and equipping individual nurses to contribute meaningfully to health system reform and community engagement in CVD risk reduction.
Lewis, J, DiGiacomo, M, Currow, D & Davidson, PM 2011, 'Dying in the margins: understanding palliative care and socioeconomic deprivation in the developed world', Journal of Pain and Symptom Management, vol. 42, no. 1, pp. 105-118.View/Download from: UTS OPUS or Publisher's site
Individuals from low socioeconomic (SE) groups have less resources and poorer health outcomes. Understanding the nature of access to appropriate end-of-life care services for this group is important. This article evaluated the literature in the developed world for barriers to access for low SE groups. Electronic databases searched in the review included MEDLINE (1996â2010), CINAHL (1996â2010), PsychINFO (2000â2010), Cochrane Library (2010), and EMBASE (1996â2010). Publications were searched for key terms âsocioeconomic disadvantage,â âsocioeconomic,â âpoverty,â âpoorâ paired with âend-of-life care,â âpalliative care,â âdying,â and âterminal Illness.â Articles were analyzed using existing descriptions for dimensions of access to health services, which include availability, affordability, acceptability, and geographical access. A total of 67 articles were identified for the literature review. Literature describing end-of-life care and low SE status was limited. Findings from the review were summarized under the headings for dimensions of access. Low SE groups experience barriers to access in palliative care services. Identification and evaluation of interventions aimed at reducing this disparity is required.
Matic, J, Davidson, PM & Salamonson, Y 2011, 'Review: bringing patient safety to the forefront through structured computerisation during clinical handover', Journal Of Clinical Nursing, vol. 20, no. 1-2, pp. 184-189.View/Download from: UTS OPUS or Publisher's site
Aims and objectives. This review aims to examine critically, the methods and modes of delivery of handover used in contemporary health care settings and explore the feasibility of a computerised handover system for improving patient safety. Background. Clinicians play a critical role in promoting patient safety, and the handover ritual is recognised as important in exchanging information and planning patient care. Communication failures have been identified as an important cause of adverse incidents in hospitals. Design. Integrative literature review.
McKinley, SM, Aitken, LM, Marshall, AP, Buckley, T, Baker, H, Davidson, PM & Dracup, K 2011, 'Delays In Presentation With Acute Coronary Syndrome In People With Coronary Artery Disease In Australia And New Zealand', Emergency Medicine Australasia, vol. 23, pp. 153-161.View/Download from: UTS OPUS or Publisher's site
Objectives: To report time from the onset of symptoms to hospital presentation in Australian and New Zealand patients with subsequently confirmed acute coronary syndrome, and to identify factors associated with prehospital delay time in these patients. M
Moser, D, McKinley, SM, Riegel, BJ, Doering, L, Meischke, H, Pelter, M, Davidson, PM, Baker, H & Dracup, K 2011, 'Relationship of Persistent Symptoms of Anxiety to Morbidity and Mortality Outcomes in Patients With Coronary Heart Disease', Psychosomatic Medicine, vol. 73, no. 9, pp. 803-809.View/Download from: UTS OPUS or Publisher's site
Objective: To examine the association of symptoms of persistent anxiety with the development of acute cardiac events in patients with coronary heart disease (CHD) followed for 2 years. The prevalence of symptoms of anxiety is high in patients with CHD, but their effect on cardiac events and mortality has not been well characterised.
Phillips, JL, Halcomb, E & Davidson, PM 2011, 'End-of-Life Care Pathways in Acute and Hospice Care: An Integrative Review', Journal of Pain and Symptom Management, vol. 41, no. 5, pp. 940-955.View/Download from: UTS OPUS or Publisher's site
Context. Over the past decade, there has been widespread adoption of end-of life care pathways as a tool to better manage care of the dying in a variety of care settings. The adoption of various end-of-life care pathways has occurred despite lack of robust evidence for their use. Objectives. This integrative review identified published studies evaluating the impact of an end-of-life care pathway in the acute and hospice care setting from January 1996 to April 2010. Methods. A search of the electronic databases Scopus and Cumulative Index of Nursing and Allied Health Literature as well as Medline and the World Wide Web were undertaken. Articles were reviewed by two authors using a critical appraisal tool. Results. The search revealed 638 articles. Of these, 26 articles met the inclusion criteria for this integrative review. No randomized controlled trials were reported. The majority of these articles reported baseline and post implementation pathway chart audit data, whereas a smaller number were local, national, or international benchmarking studies. Most of the studies emerged from the United Kingdom, with a smaller number from the United States, The Netherlands, and Australia. Conclusion. Existing data demonstrate the utility of the end-of-life pathway in improving care of the dying. The absence of randomized controlled trial data, however, precludes definitive recommendations and underscores the importance of ongoing research.
Phillips, JL, Salamonson, Y & Davidson, PM 2011, 'An instrument to assess nurses' and care assistants' self-efficacy to provide a palliative approach to older people in residential aged care: A validation study', International Journal of Nursing Studies, vol. 48, no. 9, pp. 1096-1100.View/Download from: UTS OPUS or Publisher's site
Objective: This study investigated the psychometric properties of the 'Palliative care self-efficacy scale', an instrument designed to assess clinicians' degree of confidence in engaging in patient and family interactions at the end-of-life. Design: The
Riegel, B, Elmi, A, Moser, D, McKinley, SM, Meischke, H, Doering, L, Davidson, PM, Pelter, M, Baker, H & Dracup, K 2011, 'Who listens to our advice? A secondary analysis of data from a clinical trial testing an intervention designed to decrease delay in seeking treatment for acute coronary syndrome', Patient Education And Counseling, vol. 85, pp. e33-e38.View/Download from: UTS OPUS or Publisher's site
Objective: Prolonged prehospital delay in persons experiencing acute coronary syndrome (ACS) remains a problem. Understanding which patients respond best to particular interventions designed to decrease delay time would provide mechanistic insights into the process by which interventions work. Methods: In the PROMOTION trial, 3522 at-risk patients were enrolled from 5 sites in the United States (56.4%), Australia and New Zealand; 490 (N = 272 intervention, N = 218 control) had an acute event within 2 years. Focusing on these 490, we (1) identified predictors of a rapid response to symptoms, (2) identified intervention group subjects with a change in these predictors over 3 months of follow-up, and (3) compared intervention group participants with and without the favorable response pattern. Hypothesized predictors of rapid response were increased perceived control and decreased anxiety. Knowledge, attitudes, and beliefs were hypothesized to differ between responders and non-responders. Results: Contrary to hypothesis, responders had low anxiety and low perceived control. Only 73 (26.8%) subjects showed this pattern 3 months following the intervention. No differences in ACS knowledge, attitudes, or beliefs were found. Conclusion: The results of this study challenge existing beliefs. Practice implications: New intervention approaches that focus on a realistic decrease in anxiety and perceived control are needed.
Rolley, J, Salamonson, Y, Wensley, C, Dennison, C & Davidson, PM 2011, 'Nursing clinical practice guidelines to improve care for people undergoing percutaneous coronary interventions', Australian Critical Care, vol. 24, no. 1, pp. 18-38.View/Download from: UTS OPUS or Publisher's site
Aim: The aim of this paper is to present a set of nursing clinical practice guidelines for individuals undergoing percutaneous coronary interventions (PCIs) together with a summary of the evidence to support these recommendations. Background: Percutaneous coronary intervention is a common procedure requiring expert nursing care delivered within an interdisciplinary team. Although evidence-based medical practice guidelines exist, they include minimal information to guide nursing-specific care.
Rolley, JX, Smith, J, DiGiacomo, M, Salamonson, Y & Davidson, PM 2011, 'The caregiving role following percutaneous coronary intervention', Journal Of Clinical Nursing, vol. 20, no. 1-2, pp. 227-235.View/Download from: UTS OPUS or Publisher's site
Aim. The aim of this study is to describe the experience of caregivers of individuals who have had a percutaneous coronary intervention (PCI). Background. Decreased lengths of hospital stay and an increased emphasis on chronic disease self-management inc
Sayers, J, DiGiacomo, M & Davidson, PM 2011, 'The nurse educator role in the acute care setting in Australia: important but poorly described', Australian Journal of Advanced Nursing, vol. 28, no. 4, pp. 44-52.View/Download from: UTS OPUS
Objective The purpose of this paper is to describe the nurse educator role in the acute care setting in Australia. Method A literature review using Ganongâs (1987) method of analysis was undertaken. Computerised databases were searched for articles published in English between 2000 and 2008 using the key words: âeducationâ, ânursingâ, ânurseâ`educatorâ, âteachingmethodsâ, âclinicalâ, âoutcomes health careâ and âAustraliaâ. Information was summarised to identify issues impacting on the nurse educator role using a standardised data extraction tool. Results The search strategies generated 152 articles and reports. The review identified that the nurse educator role is fundamental in supporting clinical practice and integral to developing a skilled and competent health workforce. Conclusion Confusion in nursing roles and role ambiguity contribute to the challenges for nurse educators in acute care. The absence of a national, standardised approach to role description and scope of practice in Australia may adversely impact role enactment. Further discussion and debate of the nurse educator role in Australia is warranted.
Sheehan, M, Newton, PJ, Stobie, P & Davidson, PM 2011, 'Implantable cardiac defibrillators and end-of-life care - Time for reflection, deliberation and debate?', Australian Critical Care, vol. 24, no. 4, pp. 279-284.View/Download from: Publisher's site
Summary Heart failure (HF) is a common condition associated with high rates of morbidity and mortality. Implantable cardiac defibrillators (ICDs) are an important management strategy in HF management and decrease mortality for both primary and secondary prevention. An emerging body of literature identifies the challenges of managing ICDs at the end of life. This report discusses a critical incident experienced by a HF team in a referral centre and outlines the issues to be considered in advancing discussion and debate of managing ICDs at the end of life. Engaging in debate, discussion and consensus guidelines is likely to be crucial in minimising distress and burden for clinicians, patients and their families alike.
Soh, KL, Davidson, PM, Leslie, G & Rahman, A 2011, 'Action research studies in the intensive care setting: A systematic review', International Journal of Nursing Studies, vol. 48, pp. 258-268.View/Download from: UTS OPUS or Publisher's site
Objectives: To review published studies using action research in the intensive care unit (ICU) in order to provide an intervention framework to improve clinical outcomes. Design: Systematic review. Methods: Searches of the electronic databases: Cumulative Index of Nursing and Allied Health Literature (CINAHL); Scopus, Medline, Embase, PsycINFO, and the World Wide Web were undertaken using MeSH key words including: âaction researchâ; âhealth care researchâ, âhealth services evaluationâ; âintensive care unitâ. Reference lists of retrieved articles was also undertaken to identify further articles. All studies were reviewed by two authors using a critical appraisal tool. Results: The search strategy generated 195 articles. Only 21 studies projects were identified using action research in the ICU. The majority of studies were conducted in the United Kingdom. The participants in the action research studies ranged from 6 to 253. Predominately studies using action research involved nurses in collaboration with patients and family and other health care practitioners to address identified problems in the ICU. Conclusions: Based on this review it appears that action research is a promising methodological approach to address clinical practice improvement in the ICU. Studies retrieved focussed primarily on process and formative evaluation but not on clinical outcomes. There is a need to incorporate outcome assessment in action research in the ICU to increase the framework of action research to improve clinical outcomes.
Soh, KL, Davidson, PM, Leslie, G, DiGiacomo, M, Rolley, JX, Soh, K & Rahman, A 2011, 'Factors to drive clinical practice improvement in a Malaysian intensive care unit: assessment of organizational readiness using a mixed method approach', International Journal of Multiple Research Approaches, vol. 5, no. 1, pp. 104-121.View/Download from: UTS OPUS or Publisher's site
This study assessed organisational readiness and factors to drive clinical practice improvement for VAP, CRBSI and PU in a Malaysian intensive care unit (ICU). A mixed method study approach was undertaken in a 16-bed ICU in regional Malaysia using an environmental scan, key informant interviews, staff surveys, and patient audit to elucidate factors contributing to planning for clinical practice improvement. Measurements of sustainability of practice and regard for the practice environment were assessed using validated measures. An environmental scan demonstrated high patient occupancy and case load. Nineteen percent of ICU patients developed complications according to validated measures. Survey results indicated that the majority of nurses had a good knowledge of strategies to prevent ICU complications and a positive attitude toward change processes. Engaging executive leadership was identifi ed as crucial in priming the clinical site for practice change. Providing nurses with tools to monitor their clinical practice and empowering them to change practices are important in improving clinical outcomes.
Soh, KL, Soh, K, Japar, S, Raman, RA & Davidson, PM 2011, 'A cross-sectional study on nurses' oral care practice for mechanically ventilated patients in Malaysia', Journal Of Clinical Nursing, vol. 20, pp. 733-742.View/Download from: UTS OPUS or Publisher's site
Aims and objectives. This study sought to determine the strategies, methods and frequency of oral care provided for mechanically ventilated patients in Malaysian intensive care units. The study also described nursesâ attitudes to providing oral care and their knowledge of the mode of transmission of ventilator-associated pneumonia. Background. Oral care is an important nursing intervention in the intensive care unit to reduce dental plaque. Dental plaque provides a repository for respiratory pathogens contributing to ventilator-associated pneumonia in the critically ill. Design. Cross-sectional study. Methods. This study used both survey and observational methods. The observational study was conducted by a nurse, trained in the study protocol. The observation period a selected shift over three weeks in 2007. Findings. Intensive care unit nurses (n = 284) participated in the survey. Respondents had a positive attitude towards providing oral care. On a 10-point Likert scale, aspiration of contaminated secretions from the oropharynx was identified by nurses as the highest risk factor for ventilator-associated pneumonia (mean response 6Ã8, SD 2Ã0). The majority of nurses used cotton and forceps for oral care. Toothbrushes were not used in any of the study sites. Conclusions. Although nurses had a positive attitude to oral hygiene, this study found no intensive care units incorporated a soft toothbrush in oral care protocols which is recommended in best practice guidelines. A review of strategies to implement evidence-based practice in the intensive care unit is warranted. Relevance to clinical practice. This study has identified a failure to adhere with evidence-based practice. Implementing and evaluating protocols for oral hygiene in the intensive care unit has the potential to improve patient outcomes.
Stewart, S, Carrington, MJ, Marwick, T, Davidson, PM, Macdonald, P, Horowitz, JD, Krum, H, Newton, PJ, Reid, C & Scuffham, PA 2011, 'The WHICH? trial: rationale and design of a pragmatic randomized, multicentre comparison of home- vs. clinic-based management of chronic heart failure patients', European Journal of Heart Failure, vol. 13, no. 8, pp. 909-916.View/Download from: UTS OPUS or Publisher's site
To describe the rationale and design of the Which Heart failure intervention is most Cost-effective & consumer friendly in reducing Hospital care (WHICH?) trial.
Thompson, DR, Chair, SY, Chan, SW, Astin, F, Davidson, PM & Ski, CF 2011, 'Motivational interviewing: a useful approach to improving cardiovascular health?', Journal Of Clinical Nursing, vol. 20, pp. 1236-1244.View/Download from: UTS OPUS or Publisher's site
Aim. To review and synthesise, systematically, the research findings regarding motivational interviewing and to inform education, research and practice in relation to cardiovascular health. Background. Motivational interviewing is designed to engage ambivalent or resistant clients in the process of health behaviour change, and it has been widely used in different clinical conditions such as substance abuse, dietary adherence and smoking cessation. Motivational interviewing has also been proposed as a method for improving modifiable coronary heart disease risk factors of patients. Design. Systematic review. Method. Eligible studies published in 1999â2009 were identified from the following databases: CINAHL, Medline, PsycINFO, Cochrane Library, EBSCO, Web of Science, Embase and British Nursing Index. A manual search was conducted of bibliographies of the identified studies and relevant journals. Two researchers independently reviewed the studies. Results. Four meta-analyses, one systematic review and three literature reviews of motivational interviewing and five primary studies of motivational interviewing pertaining to cardiovascular health were identified. Despite a dearth of primary studies in cardiovascular health settings, there appears to be strong evidence that motivational interviewing is an effective approach focusing on eliciting the personâs intrinsic motivation for change of behaviour. Conclusion. Motivational interviewing is an effective approach to changing behaviour. It offers promise in improving cardiovascular health status. Relevance to clinical practice. This review indicates that motivational interviewing is a useful method to help nurses improve health behaviour in people with coronary risk factors.
Thompson, SC, Shahid, S, Bessarab, D, Durey, A & Davidson, PM 2011, 'Not just bricks and mortar: planning hospital cancer services for Aboriginal people', BMC Research Notes, vol. 4, no. Article 62, pp. 1-9.View/Download from: UTS OPUS or Publisher's site
Background: Aboriginal people in Australia experience higher mortality from cancer compared with non- Aboriginal Australians, despite an overall lower incidence. A notable contributor to this disparity is that many Aboriginal people do not take up or continue with cancer treatment which almost always occurs within major hospitals. Thirty in-depth interviews with urban, rural and remote Aboriginal people affected by cancer were conducted between March 2006 and September 2007. Interviews explored participants' beliefs about cancer and experiences of cancer care and were audio-recorded, transcribed verbatim and coded independently by two researchers. NVivo7 software was used to assist data management and analysis. Information from interviews relevant to hospital services including and building design was extracted. Findings: Relationships and respect emerged as crucial considerations of participants although many aspects of the hospital environment were seen as influencing the delivery of care. Five themes describing concerns about the hospital environment emerged: (i) being alone and lost in a big, alien and inflexible system; (ii) failure of open communication, delays and inefficiency in the system; (iii) practicalities: costs, transportation, community and family responsibilities; (iv) the need for Aboriginal support persons; and (v) connection to the community. Conclusions: Design considerations and were identified but more important than the building itself was the critical need to build trust in health services. Promotion of cultural safety, support for Aboriginal family structures and respecting the importance of place and community to Aboriginal patients are crucial in improving cancer outcomes.
Watts, GF, Sullivan, DR, Poplawski, N, van Bockxmeer, F, Hamilton-Craig, I, Clifton, PM, Oâ¿¿Brien, R, Bishop, W, George, P, Barter, PJ, Bates, T, Burnett, JR, Coakley, J, Davidson, PM, Emery, J, Andrew, M, Farid, W, Freeman, L, Geelhoed, E, Juniper, A, Kidd, A, Kostner, K, Krass, I, Livingston, M, Maxwell, S, O'Leary, P, Owaimrin, A, Redgrave, TG, Reid, N, Southwell, L, Suthers, G, Tonkin, A, Towler, S & Trent, RJ 2011, 'Familial hypercholesterolaemia: A model of care for Australasia', Atherosclerosis Supplements, vol. 12, pp. 221-263.View/Download from: UTS OPUS or Publisher's site
Familial hypercholesterolaemia (FH) is a dominantly inherited disorder present from birth that causes marked elevation in plasma cholesterol and premature coronary heart disease. There are at least 45,000 people with FH in Australia and New Zealand, but the vast majority remains undetected and those diagnosed with the condition are inadequately treated. To bridge this major gap in coronary prevention the FH Australasia Network (Australian Atherosclerosis Society) has developed a consensus model of care (MoC) for FH. The MoC is based on clinical experience, expert opinion, published evidence and consultations with a wide spectrum of stakeholders, and has been developed for use primarily by specialist centres intending starting a clinical service for FH. This MoC aims to provide a standardised, high-quality and cost-effective system of care that is likely to have the highest impact on patient outcomes.
Daly, J, Davidson, PM, Duffield, CM, Campbell, T & Ward, R 2011, 'Interdisciplinary, cross- institutional collaborations: The Academic Health Sciences Centre as a key to addressing complex health problems and advancing research-based health care', Collegian, vol. 15, no. 1, pp. 1-2.View/Download from: Publisher's site
Changes in disease patterns and the economic climate have created challenges for contemporary health care systems (Bennett, 2009). Meeting increased demands for care in a fiscally responsible manner requires new collaborative approaches involving not only health care professionals but also, managers, researchers, educators and basic scientists. In addition it is increasingly recognised that unless we engage consumers, policy makers and clinicians actively in the research process, the relevance, application and uptake of research findings are limited (Lavis et al., 2005). Unfortunately, efforts to ensure the collaboration and synergy required between all of these stakeholders are often challenged by organisational boundaries, and differences in research cultures and paradigms (Smith, Mitton,Peacock,Cornelissen, & MacLeod, 2009). It is not uncommon for researchers and clinicians working in the same organisation to have limited conversations and dialogue. Yet when they come together solutions to challenging problems are often enabled by merging unique perspectives and the sharing of knowledge (Boivin et al., 2009).
It is a given that university research underpins economic and social developments. In 2010, it was reported that Â£3.5 Billion of publicly funded research generates Â£45 Billion a year in job creation and new products (THE, 2010). However, the benefits are not limited to industrial innovation and products. In the United Kingdom (UK), the Arts and Humanities Research Council asserted that for every Â£1 spent on arts and humanities research each year, the UK reaps up to Â£10 in immediate benefit and another Â£15-Â£20 in the long term (Owens, 2010). Similar metrics have been provided in Australia with similar returns on investment for research dollars spent. In Australia it has been estimated that there is a $5 AUD return for every $1 AUD invested in health and medical research (National Health & Medical Research Council, 2003).
Davidson, PM, Homer, CS, Duffield, CM & Daly, J 2011, 'A moment in history and a time for celebration: The performance of nursing and midwifery in Excellence in Research for Australia', Collegian, vol. 18, no. 2, pp. 43-44.View/Download from: Publisher's site
The long awaited and much anticipated results of Australia's first national university system wide research evaluation exercise were delivered in February this year. The Excellence in Research Assessment (ERA) examined `research quality within Australia's higher education institutions using a combination of indicators and expert review by committees comprising experienced, internationally-recognised experts' (Australian Research Council, 2011). In the discipline review for nursing some twenty three universities were assessed. Midwifery was included in the Nursing category as the Field of Research (FoR) code (the way the groups were clustered together) for nursing includes midwifery. The results for nursing and midwifery were impressive and they demonstrated that nine of the twenty three research programs in this category that were assessed were world class or above world class. In fact, nursing and midwifery in the FoR code 1110 was noted to be a `particularly strong performer' (Australian Research Council, 2011). This demonstrates that nurses and midwives in Australia are engaged in high quality research which is influencing practice and policy and making a difference to the health care of Australians. In addition, the research of many nurses and midwives was also considered in other categories including public health, health services and clinical medicine. This shows that our disciplines are well represented across the health field and the commitment to interdisciplinary practice to solve complex health care problems.
Daly, J, Davidson, P, Duffield, CM, Campbell, T & Ward, R 2011, 'Interdisciplinary, cross- institutional collaborations: The Academic Health Sciences Centre as a key to addressing complex health problems and advancing research-based health care', Collegian, vol. 18, no. 1, pp. 1-2.View/Download from: UTS OPUS
Davidson, PM, Jiwa, M, Goldsmith, AJ, McGrath, S, DiGiacomo, M, Phillips, JL, Agar, M, Newton, PJ & Currow, D 2011, 'Decisions for lung cancer chemotherapy: the influence of physician and patient factors', Supportive Care in Cancer, vol. 19, no. 8, pp. 1261-1266.View/Download from: UTS OPUS or Publisher's site
Purpose The purpose of this study is to review the literature examining how the beliefs and behaviours of physicians and patients influence clinical communication, doctor-patient interaction and treatment decisions for lung cancer treatment. Methods Literature was obtained via electronic database searches and hand searching of journals from 1990 to 2011. Results Wide variability in perceptions of the value of chemotherapy in lung cancer is present among both physicians and patients. There is a mismatch in the degree patients and physicians weigh survival, such that patients value survival benefits highly whilst physicians strongly emphasize toxicity and associated symptoms. This lack of congruence between patients and clinicians is influenced by a range of factors and has implications for treatment decisions, long-term survival and quality of life in people affected by lung cancer. Conclusion The divergence of treatment priorities indicates a need for improved communication strategies addressing the needs and concerns of both patients and clinicians. Patients should understand the benefits and risks of treatment options, while clinicians can gain a greater awareness of factors influencing patients' decisions on treatments. Reflecting these perspectives and patient preferences for lung cancer treatment in clinical guidelines may improve clinician awareness.
Alexandrou, E, Spencer, T, Frost, S, Parr, M, Davidson, PM & Hillman, K 2010, 'A review of the nursing role in central venous cannulation: implications for practice policy and research', Journal Of Clinical Nursing, vol. 19, no. 11-12, pp. 1485-1494.View/Download from: UTS OPUS or Publisher's site
Aims and objectives. The aim of this article is to review published studies about central vein cannulation to identify implications for policy, practice and research in an advanced practice nursing role. Design. Modified integrative literature review. Methods. Searches of the electronic databases: Cumulative Index of Nursing and Allied Health Literature (CINAHL); Medline, Embase, and the World Wide Web were undertaken using MeSH key words. Hand searching for relevant articles was also undertaken. All studies relating to the nurses role inserting central venous cannulae in adult populations met the search criteria and were reviewed by three authors using a critical appraisal tool.
Alexandrou, E, Spencer, T, Frost, S, Parr, M, Davidson, PM & Hillman, K 2010, 'Establishing a nurse-led central venous catheter insertion service', The Journal of Vascular Access, vol. 15, no. 1, pp. 21-27.View/Download from: UTS OPUS or Publisher's site
Background: Health care systems provide care models that deliver both quality and safety. Nurse-led vascular access teams show promise as a model to achieve hospital efficiencies and improve patient outcomes. The aim of this paper is to discuss the process of establishing a nurse-led central venous catheter (CVC) insertion service in a university affiliated hospital using a process evaluation method.
Askham, J, Kuhn, L, Frederiksen, K, Davidson, PM, Edward, K & Worrall-Carter, L 2010, 'The information and support needs of Faroese women hospitalised with an acute coronary syndrome', Journal Of Clinical Nursing, vol. 19, no. 9-10, pp. 1352-1361.View/Download from: UTS OPUS or Publisher's site
Aim and objectives. The aim of this study was to describe the information and support needs of Faroese women after their hospitalisation for acute coronary syndrome. The Faroe Islands are located between Iceland and Norway. There are no published studies examining recovery for women following an acute cardiac event. Background. Coronary heart disease remains the greatest killer of women worldwide, including on the Faroe Islands. Describing womens experiences of their recovery processes following acute coronary syndrome can enable timely information and support for the women who are affected. It is important that this information is tailored to the cultural context of women. Design. This qualitative study used a descriptive-exploratory approach. Method. Data were obtained by semi-structured interviews with participants three to four weeks after hospital discharge for their first acute coronary syndrome event.
Cao, Y, Davidson, PM, DiGiacomo, M & Yang, M 2010, 'Pre-hospital delay for acute coronary syndrome in China', Journal of Cardiovascular Nursing, vol. 25, no. 6, pp. 487-496.View/Download from: UTS OPUS or Publisher's site
Background: Despite the effectiveness of timely reperfusion therapy for acute coronary syndrome, prehospital delay remains a global concern. Objective: This article assesses the state-of-the-science regarding prehospital delay for acute coronary syndrome in China. Method: Electronic databases and hand searching were undertaken using key words such as prehospital delay, care-seeking delay, coronary heart disease, heart disease, acute coronary syndrome, unstable angina pain, acute myocardial infarction, cardiovascular disease, chest pain, and Chin (China/Chinese). The Chinese search was supervised by a Chinese health librarian. Results: Based on the search criteria, 28 studies were identified and reviewed using a standardized data extraction tool. Older age, attribution of symptoms to noncardiac causes, lack of health insurance coverage, poor access to transportation, and female sex were identified as contributing to prehospital delay. Conclusion: Health system reforms in China are necessary, particularly with regard to addressing the needs of older people, women, and other vulnerable populations in the context of the rising number of people with coronary heart disease. Developing targeted strategies, learned from both national and international experience, are required to develop targeted interventions
Chang, E, Easterbrook, S, Hancock, K, Johnson, A & Davidson, PM 2010, 'Evaluation of an information booklet for caregivers of people with dementia: An Australian perspective', Nursing and Health Sciences, vol. 12, no. 1, pp. 45-51.View/Download from: UTS OPUS or Publisher's site
The need for improved communication around end-of-life issues has been identified in cancer care. However, caregivers assisting those with dementia have been given scant attention. This study investigated the application of a new dementia information booklet for family caregivers, accessing those that were both community-based and linked to a residential aged-care facility through the distribution of 672 information booklets. This occurred via 14 dementia advisory services and 48 residential aged-care facilities throughout New South Wales, Australia. A total of 233 carers (33%) completed the booklet questionnaire evaluation. The descriptive statistics indicated that most carers found the booklet useful and thought that the booklet should be freely available to them. Almost half of the carers said that they wanted to receive the information at the time of, or soon after, the diagnosis of dementia. Only a small group of respondents considered the information to be confronting. The reported anxiety was thought to be part of a larger issue of dementia education and dealing with loss and not specifically related to the booklet itself.
Clark, A, Davidson, PM, Currie, K, Karimi, M, Duncan, A & Thompson, D 2010, 'Understanding and promoting effective self-care during heart failure', Current Treatment Options in Cardiovascular Medicine, vol. 12, pp. 1-9.View/Download from: UTS OPUS or Publisher's site
Heart failure (HF) self-care relates to the decisions made outside clinical settings by the individual with HF to maintain life, healthy functioning, and well-being. The people who help patients most (ie, caregivers/family members) should be involved in care, and general principles of health behavior change should be used to guide support. Medicines should be prescribed with once-daily dosing, with pharmacists providing medication review and support. Pill boxes should be provided and patients health literacy levels assessed. Psychosocial interventions for smoking cessation should be undertaken. Regular aerobic exercise may benefit patients with mild to moderate HF and some with severe but stable HF; therefore, referral to cardiac rehabilitation should be considered. Exercise regimen must take into account patient-related factors, including functional status, comorbid conditions, and patient preferences. Intake of salt, alcohol, and fluid should be restricted, although these steps are supported by limited evidence. Patients should be educated on appropriate sources of help. They should seek help immediately for persistent chest pain, palpitations, syncope, breathlessness at rest, or a weight increase of = 2 lb. Depression, if present, should be addressed with antidepressants (sertraline and citalopram), cognitive behavioral therapy, and regular exercise. HF disease management programs should be offered if available.
Davidson, P, Bigerelle, M, Bounichane, B, Giazzon, M & Anselme, K 2010, 'Definition of a simple statistical parameter for the quantification of orientation in two dimensions: application to cells on grooves of nanometric depths.', Acta biomaterialia, vol. 6, no. 7, pp. 2590-2598.View/Download from: Publisher's site
Contact guidance is generally evaluated by measuring the orientation angle of cells. However, statistical analyses are rarely performed on these parameters. Here we propose a statistical analysis based on a new parameter sigma, the orientation parameter, defined as the dispersion of the distribution of orientation angles. This parameter can be used to obtain a truncated Gaussian distribution that models the distribution of the data between -90 degrees and +90 degrees. We established a threshold value of the orientation parameter below which the data can be considered to be aligned within a 95% confidence interval. Applying our orientation parameter to cells on grooves and using a modelling approach, we established the relationship sigma=alpha(meas)+(52 degrees -alpha(meas))/(1+C(GDE)R) where the parameter C(GDE) represents the sensitivity of cells to groove depth, and R the groove depth. The values of C(GDE) obtained allowed us to compare the contact guidance of human osteoprogenitor (HOP) cells across experiments involving different groove depths, times in culture and inoculation densities. We demonstrate that HOP cells are able to identify and respond to the presence of grooves 30, 100, 200 and 500 nm deep and that the deeper the grooves, the higher the cell orientation. The evolution of the sensitivity (C(GDE)) with culture time is roughly sigmoidal with an asymptote, which is a function of inoculation density. The sigma parameter defined here is a universal parameter that can be applied to all orientation measurements and does not require a mathematical background or knowledge of directional statistics.
Globally there is an epidemic of chronic illnesses challenging individuals, health care providers and systems.9 In contemporary society, many people live for extended periods with conditions which were in previous decades an immediate death sentence. However, these welcome changes in longevity do not defy the future certainty of death.
Breathlessness is a common and distressing symptom in both malignant and non-malignant conditions. Both pharmacological and non-pharmacological strategies are necessary to minimise symptom burden and distress. Assessing the individualâs needs and clarifying the goals of treatment is an important first step in determining an effective treatment plan. Although the evidence supporting the use of some of these therapies is variable, there is an increasing evidence base to inform clinical decision making and treatment plans. Pharmacotherapy with opioids is a common and effective strategy for managing breathlessness, yet requires judicious titration and management. The adverse effects of opioid therapy, including constipation and drowsiness, can be anticipated and managed with adjunctive therapies. The use of oxygen in people who are hypoxaemic is supported, but is of limited value in people who are not hypoxaemic. Individualised strategies and advance care planning is important to avoid unnecessary hospitalisations and futile treatments at the end of life. There is a clear mismatch between the prevalence and burden of this problem and data to inform evidence-based guidelines. Refractory breathlessness is a fertile area for ongoing research and requires increased attention to address the burden of this highly prevalent symptom.
Davidson, PM, Abbott, P, Davison, J & DiGiacomo, M 2010, 'Improving Medication Uptake in Aboriginal and Torres Strait Islander Peoples', Heart, Lung and Circulation, vol. 19, no. 5-6, pp. 372-377.View/Download from: UTS OPUS or Publisher's site
Background: Poor medication adherence is associated with adverse health outcomes. Improving access and adherence to pharmacological therapy is important in achieving optimal health outcomes for Indigenous populations. In spite of the impressive evidence base for cardiovascular pharmacotherapy, strategies for promoting adherence and evidence based practice are less well refined and the challenges for Indigenous populations are more pronounced. Aim:To identify factors impacting on medication adherence in Aboriginal Australians and identify solutions to improve the quality use of medicines.
Davidson, PM, Cockburn, J, Newton, PJ, Webster, J & Betihavas, V 2010, 'Can a heart failure-specific cardiac rehabilitation program decrease hospitalizations and improve outcomes in high-risk patients?', European Journal of Cardiovascular Prevention & Rehabilitation, vol. 17, no. 4, pp. 392-402.View/Download from: UTS OPUS
Background Heart failure is a common and costly condition, particularly in the elderly. A range of models of interventions have shown the capacity to decrease hospitalizations and improve health-related outcomes. Potentially, cardiac rehabilitation models can also improve outcomes. Aim To assess the impact of a nurse-coordinated multidisciplinary, cardiac rehabilitation program to decrease hospitalizations, increase functional capacity, and meet the needs of patients with heart failure.
Davidson, PM, Cockburn, J, Newton, PJ, Webster, JK, Betihavas, V, Howes, L & Owensby, DO 2010, 'Can a heart failure-specific cardiac rehabilitation program decrease hospitalizations and improve outcomes in high-risk patients?', European Journal of Cardiovascular Prevention and Rehabilitation, vol. 17, no. 4, pp. 393-402.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: Heart failure is a common and costly condition, particularly in the elderly. A range of models of interventions have shown the capacity to decrease hospitalizations and improve health-related outcomes. Potentially, cardiac rehabilitation models can also improve outcomes. AIM: To assess the impact of a nurse-coordinated multidisciplinary, cardiac rehabilitation program to decrease hospitalizations, increase functional capacity, and meet the needs of patients with heart failure. METHOD: In a randomized control trial, a total of 105 patients were recruited to the study. Patients in the intervention group received an individualized, multidisciplinary 12-week cardiac rehabilitation program, including an individualized exercise component tailored to functional ability and social circumstances. The control group received an information session provided by the cardiac rehabilitation coordinator and then follow-up care by either their cardiologist or general practitioner. This trial was stopped prematurely after the release of state-based guidelines and funding for heart failure programs. RESULTS: During the study period, patients in the intervention group were less likely to have been admitted to hospital for any cause (44 vs. 69%, P = 0.01) or after a major acute coronary event (24 vs. 55%, P = 0.001). Participants in the intervention group were more likely to be alive at 12 months, (93 vs. 79%; P = 0.03) (odds ratio = 3.85; 95% confidence interval=1.03-14.42; P = 0.0042). Quality of life scores improved at 3 months compared with baseline (intervention t = o/-4.37, P<0.0001; control t = /-3.52, P<0.01). Improvement was also seen in 6-min walk times at 3 months compared with baseline in the intervention group (t = 3.40; P = 0.01). CONCLUSION: This study shows that a multidisciplinary heart failure cardiac rehabilitation program, including an individualized exercise component, coordinated by a specialist heart failure nurse can substantially reduce both all-ca...
Davidson, PM, De Geest, S & Hill, MN 2010, 'Nurses addressing the challenges of chronic illness: From primary to palliative care', Collegian, vol. 17, no. 2, pp. 43-45.View/Download from: Publisher's site
The 20th century has heralded unprecedented technological advances in health care and also considerable social change (Koh et al., 2010). Introducing innovative practices in prevention and treatment has decreased mortality for many conditions, previously causing premature death. These welcome advances in health outcomes have paradoxically created a new set of problems and challenges equally as complex and challenging as those of previous centuries (Daar et al., 2007; Wagner, 1998)
Davidson, PM, Gholizadeh, L, Haghshenas, A, Rotem, A, DiGiacomo, M, Eisenbruch, M & Salamonson, Y 2010, 'A review of the cultural competence view of cardiac rehabilitation', Journal of Clinical Nursing, vol. 19, no. 9-10, pp. 1335-1342.View/Download from: UTS OPUS or Publisher's site
Aims and objectives. This paper describes cultural competence issues within the scientific and scholarly discourse surrounding cardiac rehabilitation (CR). Background. CR is an important secondary prevention strategy, improving health-related outcomes and reducing the risks of subsequent cardiovascular events. Internationally, it is widely accepted as a discrete health service model and is endorsed by government and professional bodies. Over past decades, low participation rates in CR remain a concern, particularly among minority groups and culturally and linguistically diverse populations. Design. Systematic review. Methods. Search of electronic databases. Conclusions. Few studies to date have described cultural competence in CR service design and as a consequence, there are minimal data to assist CR professionals and policy makers in tailoring health service delivery models. The limited scholarly debate and discussion regarding cultural competence in the CR literature limits the development and evaluation of culturally appropriate interventions. Relevance to clinical practice. There needs to be greater attention to the concept of cultural competence, both in practice and research settings, to ensure access to CR for people from culturally and linguistically diverse backgrounds.
Background: Chronic heart failure is common, particularly in older individuals, and comorbidities are frequent. Patients with end stage heart failure can be highly symptomatic and require careful monitoring and treatment adjustment to improve symptoms.
BACKGROUND: Chronic heart failure is common, particularly in older individuals, and comorbidities are frequent. Patients with end stage heart failure can be highly symptomatic and require careful monitoring and treatment adjustment to improve symptoms. OBJECTIVE: This article summarises the fundamentals of implementing palliative care in general practice and provides guidelines on caring for chronic heart failure patients at the end of life. DISCUSSION: The high mortality in chronic heart failure underscores the importance of effective communication, symptom management and advanced care planning. The unpredictability and uncertainty around the timing of death mean that individuals, and their families, may be less likely to have an understanding of their prognosis or have access to supportive and palliative care. Ideally, patients with symptomatic chronic heart failure should be managed in collaboration with a multidisciplinary heart failure program. Symptom management can be achieved by additive therapies and access to specialist palliative care services should be considered when the symptom burden is high.
DiGiacomo, M, Abbott, P, Davison, J, Moore, L & Davidson, PM 2010, 'Facilitating uptake of Aboriginal adult health checks through community engagement and health promotion', Quality in Primary Care, vol. 18, no. 1, pp. 57-64.View/Download from: UTS OPUS
Background Adult Health Checks (AHCs) for Aboriginal and Torres Strait Islander people (MBS Item 710) promote comprehensive physical and psychosocial health assessments. Despite the poor uptake of health assessments in Aboriginal and Torres Strait Islander people, a small number of successful implementation initiatives have been reported. In order to ensure uptake of these screening initiatives, there remains a need to demonstrate the feasibility of models of implementing AHCs.
DiGiacomo, M, Davidson, PM, Taylor, K, Smith, J, Dimer, L, Ali, M, Wood, M, Leahy, T & Thompson, S 2010, 'Health information system linkage and coordination are critical for increasing access to secondary prevention in Aboriginal health: a qualitative study', Quality in Primary Care, vol. 18, no. 1, pp. 17-26.View/Download from: UTS OPUS
Background: Aboriginal Australians have low rates of participation in cardiac rehabilitation (CR), despite having high rates of cardiovascular disease. Barriers to CR participation reflect multiple patientrelated issues. However, an examination of the broader context of health service delivery design and implementation is needed. Aims: To identify health professionalsâ perspectives of systems related barriers to implementation of the National Health and Medical Research Council (NHMRC) Guidelines Strengthening Cardiac Rehabilitation and Secondary Prevention for Aboriginal and Torres Strait Islander Peoples.
DiGiacomo, M, Lam, P, Roberts, B, Lau, TC, Song, R & Davidson, PM 2010, 'Exploring the Reasons for Adherence to Tai Chi Practice', Journal of Alternative & Complementary Medicine, vol. 16, no. 12, pp. 1245-1246.View/Download from: UTS OPUS or Publisher's site
The bene?ts of physical activity are indisputable, but engaging individuals to take part in sustained activity is challenging. 1 Although of particular consideration in older adults, adherence to physical activity is a challenge across the lifespan and is dependent on personality characteristics
DiGiacomo, M, Thompson, S, Smith, JV, Taylor, K, Dimer, L, Ali, M, Wood, M, Leahy, TG & Davidson, PM 2010, ''I Don't Know Why They Don't Come': Barriers To Participation In Cardiac Rehabilitation', Australian Health Review, vol. 34, no. 4, pp. 452-457.View/Download from: UTS OPUS or Publisher's site
Objectives. To describe health professionals' perceptions of Aboriginal people's access to cardiac rehabilitation (CR) services and the role of institutional barriers in implementing the National Health and Medical Research Council (NHMRC) guidelines. Strengthening Cardiac Rehabilitation and Secondary Prevention for Aboriginal and Torres Strait Islander peoples. Design. Qualitative study.
Doering, L, Moser, D, Riegel, BJ, McKinley, SM, Davidson, PM, Baker, H, Meischke, H & Dracup, K 2010, 'Persistent Comorbid Symptoms Of Depression And Anxiety Predict Mortality In Heart Disease', International Journal Of Cardiology, vol. 145, no. 2, pp. 188-192.View/Download from: UTS OPUS or Publisher's site
Background: Incident anxiety and depression are associated separately with cardiac events and mortality in patients after acute coronary syndromes, but the influence of persistent comorbid depression and anxiety on mortality remains unknown.
Du, H, Davidson, PM, Everett, B, Salamonson, Y, Zecchin, R, Rolley, JX, Newton, PJ & Macdonald, P 2010, 'Assessment of a self-administered adapted 6-minute walk test', Journal of Cardiopulmonary Rehabilitation and Prevention, vol. 30, no. 2, pp. 116-120.View/Download from: UTS OPUS or Publisher's site
PURPOSE: This study assessed the reliability and viability of the Home- Heart-Walk (HHW) test, adapting a standardized 6-minute walk test protocol for self-administration. ¡ METHODS: Twenty-nine volunteers with documented coronary heart disease (CHD) undertook a structured 7-day program using the HHW. ¡ RESULTS: The intervention was well received by participants. The intraclass correlation coefficient of the test distance over 7 days was 0.98, and the correlations between investigator and participant measures were high (r 0.99 for day 1 [first test], r 0.99 for day 1 [second test], and r 0.99 on day 7). ¡ CONCLUSION: These data demonstrate the potential of the HHW as a tool to promote and monitor physical activity in community-based settings. These observations require further investigation and testing in other populations.
Fernandez, RS, Davidson, PM, Griffiths, R & Salamonson, Y 2010, 'Overcoming barriers to guideline implementation: the case of cardiac rehabilitation', Quality and Safety in Health Care, vol. 19, no. 6, pp. 1-5.View/Download from: UTS OPUS or Publisher's site
Aims This study explored the strategies used by cardiac rehabilitation (CR) coordinators to overcome the obstacles to implementation of the evidence-based Reducing Risk in Heart Disease guidelines. Methods The study design used qualitative, semistructure
Frost, S, Tam, V, Alexandrou, E, Hunt, LM, Salamonson, Y, Davidson, PM, Parr, M & Hillman, K 2010, 'Readmission to Intensive Care: Development of a Nomogram for Individualising Risk', Critical Care and Resuscitation, vol. 12, no. 2, pp. 83-89.View/Download from: UTS OPUS
Background: Readmission to intensive care during the same hospital stay has been associated with a greater risk of in-hospital mortality and has been suggested as a marker of quality of care. There is lack of published research attempting to develop clinical prediction tools that individualise the risk of readmission to the intensive care unit during the same hospital stay. Objective: To develop a prediction model using an inception cohort of patients surviving an initial ICU stay. Design, setting and participants: The study was conducted at Liverpool Hospital, Sydney. An inception cohort of 14 952 patients aged 15 years or more surviving an initial ICU stay and transferred to general wards in the study hospital between 1 January 1997 and 31 December 2007 was used to develop the model. Binary logistic regression was used to develop the prediction model and a nomogram was derived to individualise the risk of readmission to the ICU during the same hospital stay. Main outcome measure: Readmission to the ICU during the same hospital stay.
Frost, SA, Davidson, PM, Alexandrou, E, Hunt, L, Salamonson, Y, Tam, V, Parr, MJ, Aneman, A & Hillman, KM 2010, 'Unplanned admission to the intensive care unit in the very elderly and risk of in-hospital mortality.', Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine, vol. 12, no. 3, pp. 171-176.
Unplanned admission to the intensive care unit has been shown to significantly increase the risk of inhospital mortality. Medical advances and increased expectations have resulted in a greater number of very elderly patients (80 years and over) being admitted to the ICU. The risk of in-hospital death associated with unplanned admission to the ICU in very elderly patients has not been clearly defined.To estimate the risk of in-hospital mortality associated with unplanned admission to the ICU in patients aged 80 years and over.Retrospective review of an adult intensive care database. The setting was Liverpool Hospital, a large teaching hospital in Sydney, Australia, with a 28-bed ICU that has about 2000 admissions per year. We analysed data on very elderly patients (n = 1680), aged 80 years or more, admitted to the ICU between 1 January 1997 and 31 December 2007.Baseline risk factors for inhospital mortality.Mortality among patients with unplanned ICU admissions was 47%, compared with 25% in patients with planned admissions (adjusted rate ratio [RR], 1.92 [95% CI, 1.59-2.32]). An estimated 50% of the overall risk of inhospital death among very elderly patients was attributable to a combination of unplanned admission to the ICU, the presence of at least one comorbid condition, acute renal failure and respiratory failure requiring intubation.Unplanned admission to the ICU increases the risk of in-hospital mortality in very elderly patients. At least 50% of the risk of in-hospital death in this age group is attributable to a combination of unplanned ICU admission, comorbidity (1 comorbid condition), acute renal failure and respiratory failure.
Gholizadeh, L, Davidson, PM, Salamonson, Y & Worrall-Carter, L 2010, 'Theoretical considerations in reducing risk for cardiovascular disease: implications for nursing practice', Journal Of Clinical Nursing, vol. 19, no. 15-16, pp. 2137-2145.View/Download from: UTS OPUS or Publisher's site
Aims and objectives. This article describes the theoretical foundation of risk perception as a key component of changing deleterious health behaviours associated with cardiovascular disease (CVD). Furthermore, perception in increasing cardio- vascular risk-reducing behaviours in a socio-cultural framework is discussed, and an empirical development conceptual model presented. Background. Perception of risk is strongly linked with health-seeking behaviours. Understanding how to reduce risk and maximise cardiovascular health is an increasing focus of clinicians, researchers and policy makers. Increasing cultural diversity in contemporary society means that nurses need to develop and evaluate interventions in this context. Design. An integrative literature review. Method. An integrative literature review method was used to assess conceptual models relating to risk perception of developing CVD. On the basis of the findings, a model was developed to inform future intervention studies, considering individual, social and cultural factors. Discussion. Studies examining CVD and health behaviours report that there is limited concordance between actual and per- ceived risk in people with CVD. This mismatch risk likely impedes the adoption of risk-reducing behaviours. Conclusion. There is a critical need to develop interventions for enhancing an accurate perception of CVD risk considering not only individual but social factors. Relevance to clinical practice. There is limited correlation between knowledge and behaviours, and health behaviours are influenced by individual, social and cultural factors. Appraising the congruence between actual and perceived risk is an important step in developing effective care plans to reduce cardiovascular risk.
Gholizadeh, L, Salamonson, Y, Davidson, PM, Parvan, K, Frost, S, Chang, S & Hare, D 2010, 'Cross-cultural validation of the Cardiac Depression Scale in Iran', British Journal of Clinical Psychology, vol. 49, no. 4, pp. 517-528.View/Download from: UTS OPUS or Publisher's site
Background: The Cardiac Depression Scale (CDS) is a disease-specific instrument for measuring depression in cardiac patients. This study was designed to validate the CDS in an Iranian population. Methods: Translation and back translation of the 26- Item CDS scale was performed using recommended procedures. The Iranian translation of the CDS (I-CDS) was administered to 261 individuals in Iran, concurrently with the Beck Depression Inventory. The factor structure of the I-CDS was examined using exploratory factor analysis procedures to enable comparison with previous psychometric evaluation of the CDS. Receiver operating characteristic (ROC) curves were used to examine the ability of the I-CDS to discriminate between categories of depression. Results: First-order exploratory factor analysis uncovered two robust factors, consistent with the second-order dimensions originally reported by the developers of this instrument. Cronbachâs alpha was 0.88 for the total 26-item I-CDS, indicating satisfactory internal consistency of the I-CDS. Intercorrelation between the total scores for the I-CDS and BDI was 0 .62 (P< .001). For the I-CDS cut off of 90, the sensitivity was 85%, and specificity was 61% with a computed area under the curve (AUC) of .81 (95% CI, .76- .87). For the I-CDS cut off of 100, the sensitivity was 81% and specificity was 63% with a computed AUC of .81 (95% CI, .76- .87). Conclusion: This validation study of the Iranian version of the CDS proved that it is an acceptable, a reliable and valid measure of depression in cardiac patients.
The aim of the project was to create a supervised professional experience placement model involving undergraduate nursing students, families of children with intellectual disabilities and nursing lecturers. Action research provided the methodological framework for developing a new placement model. Five families with children with disabilities, nine nursing students and two nurse academics worked together through the cycles of the action research process to develop a family health promotion intervention to improve the health and wellness of the family members and reduce risk for illness. Awareness, valuing and understanding were key themes derived from the qualitative data. Findings of this project indicatethat this model of university-initiated, community-focused professional experience placement is effective in achieving the competency-based learning outcomes required of undergraduate nursing students and is worthy of ongoing exploration.
Halcomb, E, Davidson, PM & Brown, N 2010, 'Uptake of Medicare chronic disease items in Australia by general practice nurses and Aboriginal Health Workers.', Collegian, vol. 17, no. 2, pp. 57-61.View/Download from: UTS OPUS or Publisher's site
The Australian health care system is currently in a state of reform and there is increasing pressure to provide care in community settings. Rising costs, demands and population ageing underscore the importance of adopting models of health care delivery to address changing epidemiological patterns. Population ageing and the increase of chronic conditions challenge models based on acute care. Changes to the Medicare benefits schedule have facilitated the development of a range of expanded nursing services in the general practice setting. In particular, item number 10997 was introduced to reimburse practice nurses and Aboriginal health workers (AHWs) for providing monitoring and support to people with a chronic disease for and on behalf of a general practitioner (GP)_ The uptake of Medicare Item 100997 from 2007 to 2009, to monitor chronic disease interventions provided by general practice nurses has increased dramatically. The rate of uptake of Item 100997 has not been consistent across States and Territories, even allowing for population distributions. Exploring reasons for these regional variations and linking uptake of Medicare Item numbers to patient outcomes is important in developing the nursing role in Australian general practice.
Halcomb, E, Davidson, PM, Caldwell, B, Salamonson, Y & Rolley, J 2010, 'Validation of the Professional Practice Environment Scale in Australian General Practice', Journal Of Nursing Scholarship, vol. 42, no. 2, pp. 207-213.View/Download from: UTS OPUS or Publisher's site
Purpose: To validate the Professional Practice Environment Scale (PPE) in Australian general practice. Methods: The PPE was modified slightly for appropriateness for the practice setting and administered to a sample of 342 Australian general practice nurses via an online survey tool. The factor structure of the 38-item PPE was examined using principal components analysis with Varimax rotation.
Hickman, L, Rolley, J & Davidson, PM 2010, 'Can principles of the Chronic Care Model be used to improve care of the older person in the acute care sector?', Collegian, vol. 17, no. 2, pp. 63-69.View/Download from: UTS OPUS or Publisher's site
Chronic care; Models of care; Aged care; Acute care; Nursing
Koch, J, Andrew, S, Salamonson, Y, Everett, B & Davidson, PM 2010, 'Nursing Students' Perception Of A Web-Based Intervention To Support Learning', Nurse Education Today, vol. 30, no. 6, pp. 584-590.View/Download from: UTS OPUS or Publisher's site
Tailoring information to the needs of the learner is an important strategy in contemporary education settings. Web-based learning support, informed by multimedia theory, comprising interactive quizzes, glossaries with audio, short narrated Power Point pr
Page, K, Davidson, PM, Edward, K, Allen, J, Cummins, R, Thompson, D & Worrall-Carter, L 2010, 'Recovering from an acute cardiac event - the relationship between depression and life satisfaction', Journal Of Clinical Nursing, vol. 19, no. 5-6, pp. 736-743.View/Download from: UTS OPUS or Publisher's site
Aims. This study sought to measure the rates and trajectory of depression over six months following admission for an acute cardiac event and describe the relationship between depression and life satisfaction. Background. Co-morbid depression has an impact on cardiac mortality and is associated with the significant impairment of quality of life and well-being, impairments in psychosocial function, decreased medication adherence and increased morbidity. Design. This was a descriptive, correlational study. Method. The study was undertaken at a large public hospital in Melbourne. Participants were asked to complete a survey containing the cardiac depression scale (CDS) and the Personal Well-being Index.
Rapley, P & Davidson, PM 2010, 'Enough of the problem: a review of time for health care transition solutions for young adults with a chronic illness', Journal Of Clinical Nursing, vol. 19, no. 3-4, pp. 313-323.View/Download from: UTS OPUS or Publisher's site
Aims and objectives. In this article, we critically assess the state of the science of transition care in chronic conditions using diabetes care as an exemplar and provide a case for the adoption of the principles of the Chronic Care Model in driving health care reform. Background. Globally, there is an increasing burden of chronic conditions including among adolescents and young adults. As a consequence adolescents are transitioning, at an increasing rate, from paediatric services into mainstream adult services, which are often ill equipped to meet their needs. Design. Integrative literature review.
Riegel, BJ, Hanlon, A, McKinley, SM, Moser, D, Meischke, H, Doering, L, Davidson, PM, Pelter, M & Dracup, K 2010, 'Differences In Mortality In Acute Coronary Syndrome Symptom Clusters', American Heart Journal, vol. 159, no. 3, pp. 392-398.View/Download from: UTS OPUS or Publisher's site
Background The timely and accurate identification of symptoms of acute coronary syndrome (ACS) is a challenge for patients and clinicians. It is unknown whether response times and clinical outcomes differ with specific symptoms. We sought to identify whi
Rolley, J, Salamonson, Y, Dennison, C & Davidson, PM 2010, 'Nursing Care Practices Following a Percutaneous Coronary Intervention: Results of a Survey of Australian and New Zealand Cardiovascular Nurses', Journal of Cardiovascular Nursing, vol. 25, no. 1, pp. 75-84.View/Download from: UTS OPUS or Publisher's site
Although there is high-level evidence to guide optimal medical care for percutaneous coronary interventions, there are less explicit guidelines to support nurses in providing care. Aim: This study describes the practice standards and priorities of care of cardiovascular nurses in Australia and New Zealand. Method: Item generation for the survey was informed by an integrative literature review and existing clinical guidelines. A 116-item Web-based survey was administered to cardiovascular nurses, via electronic mail lists of professional cardiovascular nursing organizations, using a secure online data collection system. Results: Data were collected from March 2008 to March 2009. A total of 148 respondents attempted the survey, with 110 (74.3%) completing all items. All respondents were registered nurses with an average of 12.3 (SD, 7.61) years of clinical experience in the cardiovascular setting. A range of practice patterns was evident in ambulation time after percutaneous coronary intervention, methods of sheath removal, pain relief, and patient positioning. Respondents consistently rated psychosocial care a lower priority than other tasks and also identified a knowledge deficit in this area. Conclusion: This survey identified diversity of practice patterns and a range of educational needs. Increasing evidence to support evidence-based practice and guideline development is necessary to promote high-quality care and improved patient outcomes.
Rolley, JX, Salamonson, Y, Dennison, CR & Davidson, PM 2010, 'Development of clinical practice guidelines for the nursing care of people undergoing percutaneous coronary interventions: An Australian & New Zealand collaboration.', Australian critical care : official journal of the Confederation of Australian Critical Care Nurses, vol. 23, no. 4, pp. 177-187.View/Download from: Publisher's site
AIM: This paper describes the development of nursing practice guidelines for percutaneous coronary intervention (PCI). BACKGROUND: Clinical practice guidelines (CPGs) supporting PCI nursing care are limited. METHOD: The National Health and Medical Research Council's (NH&MRC) health and medical practice development guidelines were used for the guideline development process. A panel of experts (clinicians and consumers) attended a consensus conference to review existing evidence. Subsequently, nurses' opinions were identified via an online survey. This was followed by a modified Delphi method was used to refine a draft set of guidelines over two rounds. RESULTS: The consensus conference was attended by 41 participants (39 cardiovascular nurses and 2 consumer representatives). Eight additional members joined the panel for the modified Delphi rounds with 27 participants completing the online survey. The final guideline document consisted of 75 recommendations. Endorsement was then sought from key peak cardiovascular bodies in Australia and New Zealand. DISCUSSION/CONCLUSION: Inconclusive evidence precludes definitive recommendations. Therefore, consultation and consensus are important in developing guidelines to achieve standardised nursing care and monitoring of outcomes. IMPLICATIONS FOR PRACTICE: Nurses play a crucial role in PCI care, yet currently there are limited guidelines to inform practice. This paper describes the method developing clinical practice guideline and deriving consensus.
Warner, P, Jelinek, H & Davidson, PM 2010, 'A university clinic: an innovative model for improving clinical practice', Australian Journal of Advanced Nursing, vol. 27, no. 4, pp. 38-42.View/Download from: UTS OPUS or Publisher's site
This paper discusses interprofessional learning through interdisciplinary collaboration between undergraduate nursing and podiatry students at a university based cardiovascular screening clinic.
Woods, JA, Katzenellenbogen, JM, Davidson, PM & Thompson, SC 2010, 'Heart failure among Indigenous Australians: a systematic review', BMC Cardiovascular Disorders, vol. 10, no. NA, p. 99.View/Download from: UTS OPUS or Publisher's site
Cardiovascular diseases contribute substantially to the poor health and reduced life expectancy of Indigenous Australians. Heart failure is a common, disabling, progressive and costly complication of these disorders. The epidemiology of heart failure and the adequacy of relevant health service provision in Indigenous Australians are not well delineated.
Yacopetti, N, Alexandrou, E, Spencer, T, Frost, S, Davidson, PM, O'Sullivan, G & Hillman, K 2010, 'Central venous catheter insertion by a clinical nurse consultant or anaesthetic medical staff: a single-centre observational study', Critical Care and Resuscitation, vol. 12, no. 2, pp. 90-95.View/Download from: UTS OPUS
Objective: To compare clinical outcomes of elective central venous catheter (CVC) insertions performed by either a clinical nurse consultant (CNC) or anaesthetic medical staff (AMS). Design, setting and participants: Prospective audit of a convenience sample of consecutive CVC insertions between July 2005 and October 2007 at a metropolitan teaching hospital in Sydney, Australia. The sample included all outpatients and inpatients requiring a CVC for either acute or chronic conditions. Main outcome measures: Number of CVC lines inserted;differences between outcomes in the CNC and AMS groups; complications during and after insertion.
Currow, D, Smith, J, Davidson, PM, Newton, PJ, Agar, M, Care, MP & Abernethy, A 2010, 'Do the Trajectories of Dyspnea Differ in Prevalence and Intensity By Diagnosis at the End of Life? A Consecutive Cohort Study', Journal of Pain and Symptom Management, vol. 39, no. 4, pp. 680-690.View/Download from: UTS OPUS
Context. Breathlessness reportedly worsens as death approaches for many people, but the differences in intensity and time course between underlying causes are not well described. Objectives. To determine differences in the intensity of breathlessness by diagnosis over time as death approaches in a consecutive cohort seen by a specialist palliative care service. Methods. Patients referred to Silver Chain Hospice Care Service over a period of four years (January 2004 to December 2007) had dyspnea evaluated at every clinical encounter until death. A numeric rating scale (NRS) was used to measure the intensity. Patients were categorized into five clusters (lung cancer, secondary cancer to lung, heart failure, end-stage pulmonary disease, and no identifiable cardiorespiratory cause) at three time points (60e53 [T3], 30e23 [T2], and 7e0 [T1] days before death [T0]). Group differences were assessed using analysis of variance. Joinpoint regression models defined significant changes in mean breathlessness intensity.
Arndt, M, Murchie, F, Schembri, A & Davidson, PM 2009, '"Others had similar problems and you were not alone": Evaluation of an open-group mutual aid model in cardiac rehabilitation', Journal of Cardiovascular Nursing, vol. 24, no. 4, pp. 328-335.View/Download from: UTS OPUS or Publisher's site
Background: Dealing with psychological and social issues is an important aspect of comprehensive cardiac rehabilitation (CR) programs. Study aim: This study aims to evaluate the use of an open-group mutual aid model facilitated by a social worker and occupational therapist in a secondary prevention CR program. Method: A mixed-method study, using questionnaires, focus group data, and reflective interviews of group facilitators, was used to evaluate the program. Study findings: Key themes emerging from this study were (1) the need for provision of hope; (2) a desire for structure and support; (3) appreciation of support of fellow group participants; and (4) the need for individuals to review, process, and interpret their illness trajectory. Conclusions: In this single site study, an open-group model using a mutual aid model was acceptable and helpful as a method to facilitate adjustment after an acute cardiac event. Further evaluation of this approach using experimental methods is warranted.
Briffa, T, Kinsman, L, Maiorana, A, Zecchin, R, Redfern, J, Davidson, PM, Paull, G, Nagle, A & Denniss, AR 2009, 'An integrated and coordinated approach to preventing recurrent coronary heart disease events in Australia: Policy statement from the Australian Cardiovascular Health and Rehabilitation Association', Medical Journal of Australia, vol. 190, no. 12, pp. 683-686.View/Download from: UTS OPUS
Implementing existing knowledge about cardiac rehabilitation (CR) and heart failure management could markedly reduce mortality after acute coronary syndromes and revascularisation therapy. Contemporary CR and secondary prevention programs are cost-effective, safe and beneficial for patients of all ages, leading to improved survival, fewer revascularisation procedures and reduced rehospitalisation. Despite the proven benefits attributed to these secondary prevention interventions, they are not well attended by patients. Modern programs must be flexible, culturally safe, multifaceted and integrated with the patients primary health care provider to achieve optimal and sustainable benefits for most patients.
Briffa, TG, Kinsman, L, Maiorana, AJ, Zecchin, R, Redfern, J, Davidson, PM, Paull, G, Nagle, A & Denniss, AR 2009, 'An integrated and coordinated approach to preventing recurrent coronary heart disease events in Australia.', The Medical journal of Australia, vol. 190, no. 12, pp. 683-686.
Implementing existing knowledge about cardiac rehabilitation (CR) and heart failure management could markedly reduce mortality after acute coronary syndromes and revascularisation therapy. Contemporary CR and secondary prevention programs are cost-effective, safe and beneficial for patients of all ages, leading to improved survival, fewer revascularisation procedures and reduced rehospitalisation. Despite the proven benefits attributed to these secondary prevention interventions, they are not well attended by patients. Modern programs must be flexible, culturally safe, multifaceted and integrated with the patient's primary health care provider to achieve optimal and sustainable benefits for most patients.
Cao, Y, Davidson, PM & DiGiacomo, M 2009, 'Cardiovascular disease in China: an urgent need to enhance the nursing role to improve health outcomes', Journal Of Clinical Nursing, vol. 18, no. 5, pp. 687-693.View/Download from: UTS OPUS or Publisher's site
Aims. This paper reviews the role of cardiac nursing in China and the potential of this professional group to take an important role in secondary and tertiary prevention initiatives. Background. China is undergoing unprecedented economic growth, yet globalisation of Chinese society has caused an increase in the prevalence of chronic conditions, particularly cardiovascular disease. studies recognise that health providers and members of the public are not fully aware of the risks associated with cardiovascular disease and consequently are not equipped to deal with this looming epidemic.
Cao, Y, Digiacomo, M, Du, HY & Davidson, PM 2009, 'Chinese nurses' perceptions of heart health issues facing women in China: a focus group study.', The Journal of cardiovascular nursing, vol. 24, no. 6, pp. E23-E29.View/Download from: Publisher's site
BACKGROUND: China is in a state of rapid economic growth and epidemiological transition. Morbidity and mortality relating to heart disease in women have increased dramatically. OBJECTIVES: The aim of this study was to obtain the views of nurses regarding heart health issues for women in contemporary China. DESIGN: : This study used focus group interviews. SETTINGS: Convenience sampling was used to recruit nurses working in acute care hospitals in metropolitan China. METHODS: Five focus groups containing 28 female participants were conducted. Focus groups were moderated by 2 bilingual Chinese nurses, audiotaped, and analyzed using thematic analysis. RESULTS: Four themes emerged from the focus group data: (1) mixed perceptions of disease burden in women, (2) modern life impacts upon women's health, (3) need for focus on prevention and coordination, and (4) education and support are keys to driving healthcare improvements. CONCLUSIONS: Heart disease, as a significant health issue for women in China, is underappreciated among Chinese nurses.
Davidson, PM 2009, 'Inpatient care to community care: improving clinical handover in the private mental health setting.', The Medical journal of Australia, vol. 190, no. 11 Suppl.
OBJECTIVES: To develop and test a standardised clinical handover discharge strategy for improving information transfer between private mental health hospitals and community practitioners. DESIGN, SETTING AND PARTICIPANTS: A quality improvement intervention using collaborative, iterative methods to develop a standardised discharge and outcome assessment strategy. 150 patient participants were consecutively recruited from two private mental health care hospitals in New South Wales between April and September 2008. Opinions of community practitioners and patients on the discharge process and discharge documentation were solicited by written questionnaires and telephone interviews. MAIN OUTCOME MEASURES: Community practitioner satisfaction; patient satisfaction; documentation of discharge date at least 48 hours before discharge; faxing of discharge summaries to community practitioners within 48 hours of discharge; proportion of patients receiving a follow-up telephone call within 7 days or 14 days of discharge. RESULTS: Both community practitioners and patients believed the intervention was positive. Between Cycle 2 and Cycle 3, documentation of the discharge date at least 48 hours before discharge remained unchanged at 50%; the proportion of discharge summaries faxed within 48 hours of discharge went from 0 to 82% in Cycle 2 and fell to 65% in Cycle 3. Telephone follow-up of patients within 7 days and within 14 days improved by 10% and 6%, respectively, between Cycle 2 and Cycle 3. CONCLUSIONS: A standardised discharge communication strategy improved the timeliness, content, and format of information provided to community practitioners. The intervention was well accepted by patients and providers.
Chronic heart failure (CHF) is a common, costly and frequently fatal condition and the prevalence of this condition increases with age . Although not a new condition, improved treatments for conditions such as coronary heart disease and hypertension mean that there are increasing numbers of people living for extended periods with a chronic progressive condition. A defining feature of CHF is the potential for episodic periods of deterioration and decompensation .
Dracup, K, McKinley, SM, Riegel, BJ, Moser, D, Meischke, H, Doering, L, Davidson, PM, Paul, SM, Baker, H & Pelter, M 2009, 'A randomized clinical trial to reduce patient prehospital delay to treatment in acute coronary syndrome', Circulation. Cardiovascular Quality and Outcomes, vol. 2, no. 6, pp. 524-532.View/Download from: UTS OPUS or Publisher's site
Background: Delay from onset of acute coronary syndrome (ACS) symptoms to hospital admission continues to be prolonged. To date, community education campaigns on the topic have had disappointing results. Therefore, we conducted a clinical randomized trial to test whether an intervention tailored specifically for patients with ACS and delivered one-on-one would reduce prehospital delay time. Methods and Results: Participants (n=3522) with documented coronary heart disease were randomized to experimental (n=1777) or control (n=1745) groups. Experimental patients received education and counseling about ACS symptoms and actions required. Patients had a mean age of 67-11 years, and 68% were male. Over the 2 years of follow-up, 565 patients (16.0%) were admitted to an emergency department with ACS symptoms a total of 842 times. Neither median prehospital delay time (experimental, 2.20 versus control, 2.25 hours) nor emergency medical system use (experimental, 63.6% versus control, 66.9%) was different between groups, although experimental patients were more likely than control to call the emergency medical system if the symptoms occurred within the first 6 months following the intervention (P=0.036). Experimental patients were significantly more likely to take aspirin after symptom onset than control patients (experimental, 22.3% versus control, 10.1%, P=0.02). The intervention did not result in an increase in emergency department use (experimental, 14.6% versus control, 17.5%). Conclusionsï½ The education and counseling intervention did not lead to reduced prehospital delay or increased ambulance use. Reducing the time from onset of ACS symptoms to arrival at the hospital continues to be a significant public health challenge.
Driscoll, A, Davidson, PM, Clark, R, Huang, N & Aho, Z 2009, 'Tailoring consumer resources to enhance self-care in chronic heart failure', Australian Critical Care, vol. 22, no. 3, pp. 133-140.View/Download from: UTS OPUS or Publisher's site
Background: Chronic heart failure (CHF) is associated with high hospitalisation and mortality rates and debilitating symptoms. In an effort to reduce hospitalisations and improve symptoms individuals must be supported in managing their condition. Patient
Driscoll, A, Worrall-Carter, L, Hare, D, Davidson, PM, Riegel, B, Tonkin, A & stewart, S 2009, 'Evidence-based chronic heart failure management programs: reality or myth?', Quality and Safety in Health Care, vol. 18, no. 6, pp. 450-455.View/Download from: UTS OPUS or Publisher's site
Background: Chronic heart-failure management programmes (CHF-MPs) have become part of standard care for patients with chronic heart failure (CHF). Objective: To investigate whether programmes had applied evidence-based expert clinical guidelines to optimise patient outcomes.
Du, H, Newton, PJ, Salamonson, Y, Carrieri-Kohlman, VL & Davidson, PM 2009, 'A review of the six-minute walk test: Its implication as a self-administered assessment tool', European Journal of Cardiovascular Nursing, vol. 8, no. 1, pp. 2-8.View/Download from: UTS OPUS or Publisher's site
Background: Promoting self-management and monitoring physical activity are important strategies in chronic heart disease (CHD)management. The six-minute walk test (6MWT) is a commonly used sub-maximal exercise test for measuring physical functional capacity. Aim: The aim of this paper is to review the current literature on 6MWT relating to methodological issues as well as exploring the potential of the protocol to be adopted as a self-administered exercise test. Method: The Medline, CINAHL, Science Direct and the World Wide Web using the search engine Google, were searched for articles describing the administration, reliability and validity of the 6MWT. Findings of the integrative literature review The 6MWT is a simple, safe and inexpensive sub-maximal exercise test. The 6MWT distance is strongly associated with functional capacity, and it is a useful prognostic tool. To date, the capacity for self-administration of the 6MWT has not been investigated. Conclusions: Adapting the 6MWT as a patient-reported outcome measure may enhance the capacity, not only for clinicians to monitor functional status, but also promote self-management by enabling individuals to monitor changes in their functional capacity.
Everett, B, Salamonson, Y & Davidson, PM 2009, 'Bandura's exercise self-efficacy scale: Validation in an Australian cardiac rehabilitation setting', International Journal of Nursing Studies, vol. 46, no. 6, pp. 824-829.View/Download from: UTS OPUS or Publisher's site
Background: Despite the established benefits of cardiac rehabilitation (CR) in improving health outcomes for people with cardiovascular disease, adherence to regular physical activity at recommended levels remains suboptimal. Self-efficacy has been shown to be an important mediator of health behaviour, including exercise. Objectives: To assess the psychometric properties of Bandura's exercise self-efficacy (ESE) scale in an Australian CR setting. Design: Validation study. Setting: Cardiac rehabilitation.
Everett, B, Salamonson, Y, Zecchin, R & Davidson, PM 2009, 'Reframing the dilemma of poor attendance at cardiac rehabilitation: an exploration of ambivalence and the decisional balance', Journal Of Clinical Nursing, vol. 18, no. 13, pp. 1842-1849.View/Download from: UTS OPUS or Publisher's site
Aim. To discuss the problem of poor attendance at cardiac rehabilitation from the alternative perspective of patient ambivalence. Background. Evidence supports the benefits of cardiac rehabilitation as a means for secondary prevention of coronary heart disease, yet current literature continues to document poor attendance at these programmes. Whilst extrinsic factors, such as transportation and lack of physician support have been identified as barriers, patients who choose not to attend these programmes are often described as lacking motivation or being non-compliant. However, it is possible that non-attendance is the result of ambivalence the experience of simultaneously wanting to and yet not wanting to, or the I want to, but I dont want to dilemma.
Fernandez, RS, Davidson, PM, Griffiths, R, Juergens, C & Salamonson, Y 2009, 'Development of a health-related lifestyle self-management intervention for patients with coronary heart disease', Heart & Lung: the journal of acute and critical care, vol. 38, no. 6, pp. 491-498.View/Download from: UTS OPUS or Publisher's site
Risk-factor modification after an acute coronary event is imperative, and intervention strategies are Continuously being developed to assist patients with behavioral change and, consequently, decreasing the risk Of further coronary episodes. This article
Fernandez, RS, Davidson, PM, Griffiths, R, Juergens, C, Stafford, B & Salamonson, Y 2009, 'A pilot randomised controlled trial comparing a health-related lifestyle self-management intervention with standard cardiac rehabilitation following an acute cardiac event: Implications for a larger clinical trial', Australian Critical Care, vol. 22, no. 1, pp. 17-27.View/Download from: UTS OPUS or Publisher's site
Purpose: This pilot study was to assess the feasibility of the health-related lifestyle self-management (HeLM) intervention as a strategy to decrease cardiovascular risk following acute coronary syndrome. Methods: Participants in this randomised controll
Frost, S, Alexandrou, E, Bogdanovski, T, Salamonson, Y, Davidson, PM, Parr, M & Hillman, K 2009, 'Severity of illness and risk of readmission to intensive care: A meta-analysis', Resuscitation, vol. 80, pp. 505-510.View/Download from: UTS OPUS or Publisher's site
Background: Almost one in every 10 patients who survive intensive care will be readmitted to the intensive care unit (ICU) during the same hospitalisation. The association between increasing severity of illness (widely calculated in ICU patients) with risk of readmission to ICU has not been systematically summarized. Objective: The meta-analysis was designed to combine information from published studies to assess the relationship between severity of illness in ICU patients and the risk of readmission to ICU during the same hospitalisation.
Gholizadeh, L, Salamonson, Y, Worrall-Carter, L, DiGiacomo, M & Davidson, PM 2009, 'Awareness and Causal Attributions of Risk Factors for Heart Disease among Immigrant Women Living in Australia', Journal of Women's Health, vol. 18, no. 9, pp. 1385-1393.View/Download from: UTS OPUS or Publisher's site
Abstract Objective: Coronary heart disease (CHD) is a major cause of morbidity and mortality globally, and risk factors for CHD are associated with social and cultural attribution as well as individual psychological factors. The aims of this study were to explore the causal attributions of risk factors for CHD and to describe the relationship between their physiological status and causal attributions among immigrant Arabic, Turkish, and Iranian women living in Australia. Methods: Fifty-five women of Turkish, Iranian, and Persian backgrounds were recruited from community groups in metropolitan Sydney using snowball sampling and the assistance of bilingual health care workers. Body weight and blood pressure were assessed, and a questionnaire, including investigator-developed instruments and the Depression, Anxiety and Stress Scale, was administered. Health interpreters assisted with study procedures and translation of study instruments. Results: There was a low level of awareness of the risk of heart disease among women, although participants had knowledge of risk factors for heart disease broadly. The most highly attributed risk factors for CHD among participants were obesity, physical inactivity, and psychological distress. Women who rated highly on psychological distress scores were more likely to attribute negative emotions as causative factors for heart disease. Conclusions: Strategies to promote the awareness of the association between heart disease and women are required among migrant women. Further investigation is required to overcome the barriers to engaging in effective risk minimizing behaviors for heart disease.
Phillips, JL, Davidson, PM & Willcock, S 2009, 'An Insight Into the Delivery of a Palliative Approach in Residential Aged Care : The General Practitioner Perspective', Journal of Applied Gerontology, vol. 28, no. 3, pp. 395-405.View/Download from: UTS OPUS or Publisher's site
Managing the complex care needs of older people is a global concern. General practitioners (GPs) play a pivotal role in aged care, yet little is known abouttheir capacity to provide palliative care in nursing homes. This study aimed to investigate GPs' perceptions and understanding of a palliative approach. A convenience sample of rural GPs (n = 13) participated in a series of three focus groups undertaken in August, 2005. These focus groups were all audio-taped, transcribed, and analyzed using thematic content analysis. Four key themes emerged: uncertainty about a palliative approach, a need to reorientate providers, the challenges of managing third parties, and making it work and moving forward. These preliminary findings suggest that integrating a palliative approach in aged care requires GPs to have a greater awareness of this paradigm and to be more effectively engaged in multidisciplinary care planning.
Rolley, J, Davidson, PM, Salamonson, Y, Fernandez, R & Dennison, C 2009, 'Review of nursing care for patients undergoing percutaneous coronary intervention: a patient journey approach', Journal Of Clinical Nursing, vol. 18, no. 17, pp. 2394-2405.View/Download from: UTS OPUS or Publisher's site
Aim. To evaluate the existing literature to inform nursing management of people undergoing percutaneous coronary intervention. Background. Percutaneous coronary intervention is an increasingly important revascularisation strategy in coronary heart disease management and can be an emergent, planned or rescue procedure. Nurses play a critical role in delivering care in both the independent and collaborative contexts of percutaneous coronary intervention management. Design. Systematic review. Method. The method of an integrative literature review, using the conceptual framework of the patient journey, was used to describe existing evidence and to determine important areas for future research. The electronic data bases CINAHL, Medline, Cochrane and the Joanna Briggs data bases were searched using terms including: (angioplasty, transulminal, percutaneous coronary), nursing care, postprocedure complications (haemorrhage, ecchymosis, haematoma), rehabilitation, emergency medical services (transportation of patients, triage).
Salamonson, Y, Everett, B, Koch, J, Wilson, I & Davidson, PM 2009, 'Learning strategies of first year nursing and medical students: A comparative study', International Journal of Nursing Studies, vol. 46, no. 12, pp. 1541-1547.View/Download from: UTS OPUS or Publisher's site
Background: Interprofessional education (IPE), where two or more professions learn with, from, and about each other to improve collaboration and the quality of care, has been proposed as a curriculum strategy to promote mutual understanding between professions, thus helping to prepare health professionals to work in challenging contemporary health systems. Although there is support for IPE initiatives within health professional education, differences in student motivation and learning strategies are likely to contribute to the success of these initiatives.
Thompson, S, DiGiacomo, M, Smith, J, Taylor, K, Dimer, L, Ali, M, Wood, M, Leahy, T & Davidson, PM 2009, 'Are the processes recommended by the NHMRC for improving Cardiac Rehabilitation (CR) for Aboriginal and Torres Strait Islander people being implemented?: an assessment of CR Services across Western Australia', Australia and New Zealand Health Policy, vol. 6, no. 29.View/Download from: UTS OPUS
Background: Cardiovascular disease is the major cause of premature death of Indigenous Australians, and despite evidence that cardiac rehabilitation (CR) and secondary prevention can reduce recurrent disease and deaths, CR uptake is suboptimal. The National Health and Medical Research Council (NHMRC) guidelines Strengthening Cardiac Rehabilitation and Secondary Prevention for Aboriginal and Torres Strait Islander peoples, published in 2005, provide checklists for services to assist them to reduce the service gap for Indigenous people. This study describes health professionals' awareness, implementation, and perspectives of barriers to implementation of these guidelines based on semi-structured interviews conducted between November 2007 and June 2008 with health professionals involved in CR within mainstream health services in Western Australia (WA). Twenty-four health professionals from 17 services (10 rural, 7 metropolitan) listed in the WA Directory of CR services were interviewed.
Walker, PM, Wood, RJ, Dracoulis, GD, Kibedi, T, Bark, RA, Bruce, AM, Byrne, AP, Davidson, PM, El-Masri, HM, Lane, GJ, Moon, C, Orce, JN, Estevez, FMP, Wheldon, C & Wilson, AN 2009, 'Fast decay of a three-quasiparticle isomer in Tm-171', PHYSICAL REVIEW C, vol. 79, no. 4.View/Download from: Publisher's site
Wood, SK, Campbell, AK, Marden, JD, Schmidtman, L, Blundell, GH, Sheerin, NJ & Davidson, PM 2009, 'Inpatient care to community care: improving clinical handover in the private mental health setting', MEDICAL JOURNAL OF AUSTRALIA, vol. 190, no. 11, pp. S144-S149.
Alexandrou, E, Spencer, T & Davidson, PM 2008, 'Nursing central line service prevents catheter related infections', Australian Nursing Journal, vol. 15, no. 11, p. 49.
Butterfield, JA, Faddy, SC, Davidson, PM & Ridge, B 2008, 'Exercise training in patients with stable chronic heart failure - Effects onthoracic impedance cardiography and B-type natriuretic peptide', Journal of Cardiopulmonary Rehabilitation and Prevention, vol. 28, no. 1, pp. 33-37.View/Download from: UTS OPUS
PURPOSE: Recent evidence has suggested that patients with stable chronic heart failure (CHF) may respond favorably to a progressive exercise program. The use of noninvasive hemodynamic monitoring and B-type natriuretic peptide (BNP) measurement in these patients is not well reported. This study investigated the utility of noninvasive hemodynamic monitoring and point-of-care BNP in a cardiac rehabilitation outpatient setting.
Cao, Y, DiGiacomo, M, Du, H, Ollerton, E & Davidson, PM 2008, 'Cardiovascular disease in Chinese women - An emerging high-risk population and implications for nursing practice', Journal of Cardiovascular Nursing, vol. 23, no. 5, pp. 386-394.View/Download from: UTS OPUS or Publisher's site
Background: Globally, cardiovascular disease (CVD) is the leading cause of death among women. In China, the burden of CVD is increasing at an alarming rate, yet, it is underestimated and has important primary, secondary, and tertiary prevention issues. A
Davidson, PM, Cockburn, J & Newton, PJ 2008, 'Unmet needs following hospitalization with heart failure: Implications for clinical assessment and program planning', Journal of Cardiovascular Nursing, vol. 23, no. 6, pp. 541-546.View/Download from: UTS OPUS or Publisher's site
Background: Measuring health status is increasingly important in both clinical practice and research. The Heart Failure Needs Assessment Questionnaire (HFNAQ) is a self-administered, disease-specific, 30-item questionnaire that measures an individuals perception of his/her needs in the physical, psychological, social, and spiritual domains. Objectives: To assess the prevalence of needs in patients with heart failure (HF)recently discharged from hospital. Methods: The HFNAQ was administered to participants (n = 132; mean [SD] age, 72.3 [9.69]years; 63% male) consenting to attend an HF-specific cardiac rehabilitation program. Results: The total mean HFNAQ score was 67.3 (95% confidence interval, 65.03Y69.75), indicating an average level of need around the midrange of the scale. In this vulnerable postdischarge phase, there was evidence of predominance of psychological and social concerns over physical needs. None of the variables that were examined for associations with the measures of needs reached statistical significance, highlighting the strongly individualized perception of need.
Davidson, PM, DiGiacomo, M, Abbott, P, Sheerin, N, Heal, P, Mieni, L, Bradbery, B, Zecchin, R, Smith, J, Mark, A & Davison, J 2008, 'A partnership model in the development and implementation of a collaborative, cardiovascular education program for Aboriginal health workers', Australian Health Review, vol. 32, no. 1, pp. 139-146.View/Download from: UTS OPUS or Publisher's site
A partnership model was established among key education providers, policy makers, non-government organisations, the local area health service and Aboriginal community controlled organisations aimed at increasing collaboration, skill development, cultural competence and increasing access to mentorship and expertise for Aboriginal Health Workers (AHWs). A group of 21 AHWs, within two cohorts, undertook the program between October 2005 and June 2006. A mixed-method evaluation using quantitative and qualitative data collection methods was undertaken prospectively.
Davidson, PM, DiGiacomo, M, Zecchin, R, Clarke, M, Paul, G, Lamb, K, Hancock, K, Chang, E & Daly, J 2008, 'A cardiac rehabilitation program to improve psychosocial outcomes of women with heart disease', Journal of Women's Health, vol. 17, no. 1, pp. 123-134.View/Download from: UTS OPUS or Publisher's site
Background and aims: Heart disease in women is characterised by greater disability and a higher rate of morbidity and early death after an acute coronary event compared with men. Women also have lower participation rates than men in cardiac rehabilitation. This study sought to describe development of a nurse-directed cardiac rehabilitation program tailored to the needs of women following an acute cardiac event to address their psychological and social needs. Methods: The Heart Awareness for Women program (HAFW) commenced in 2003 with phase I involving development of program elements and seeking validation through consumers and clinical experts. The program was then trialed in an 8-week program in a convenience sample of 6 women. Phase II applied the revised program using action research principles focusing on enabling clinical staff to implement the ongoing program. A total of 54 women participated in this phase, 48 of whom completed baseline questionnaires. A mixed-method evaluation, using questionnaires, interviews, and observation, assessed the impact of the intervention on psychological and social aspects of womens recovery following an acute coronary event. Results: Women welcomed the opportunity to discuss their individual stories, fears, and challenges and to derive support from contact with other women. Via health professional facilitation, women were able to develop strategies collectively to address risk factor modification and achieve optimal cardiovascular health. No statistically significant changes in depression, anxiety, stress, cardiac control, role integration, or perceived social support were found; however, descriptive and qualitative findings revealed decreases in anxiety and an increased sense of social support.
Davidson, PM, Dracup, K, Phillips, JL, Daly, J & Padilla, G 2008, 'Preparing for the worst while hoping for the best: The relevance of hope in the heart failure illness trajectory', Journal of Cardiovascular Nursing, vol. 22, no. 3, pp. 159-165.View/Download from: UTS OPUS or Publisher's site
Background: Patients with heart failure have higher mortality rates than those with most malignant diseases. The heart failure illness trajectory is one of gradual decline characterized by unpredictable events such as acute decompensation of heart failure or a sudden cardiac death. Health professionals have an obligation to give patients and their families concise and honest information concerning their prognosis. The challenge exists to give what ostensibly may seem a bleak prognosis within a context of hope and optimism. Aim: To explore the role of hope in heart disease and the potential utility of this construct in the development of nursing interventions. Methods: The electronic databases CINAHL, MEDLINE, EmBASE, and PSYCHlit were searched from 1982 to August 2004 using the key words "hope," "hopelessness," "heart disease," and "heart failure." Articles were subsequently sorted to meet the inclusion criteria of (1) a philosophical discussion of the construct of hope and/or (2) investigation of hope in heart disease. Results: This search retrieved 768 articles, and 24 met the inclusion criteria. Key findings from the review indicate that "hope" and "hopelessness" are underdeveloped, yet important constructs and conceptually linked with depression and spirituality. Intriguing findings from descriptive, observational studies have demonstrated the positive impact of expression of hope on cardiovascular outcomes. These findings need to be validated in randomized controlled trials.
Davidson, PM, Driscoll, A, Clark, R, Newton, PJ & Stewart, S 2008, 'Heart failure nursing in Australia: challenges, strengths and opportunities', Progress in Cardiovascular Nursing, vol. 23, no. 4, pp. 195-197.View/Download from: UTS OPUS or Publisher's site
Australia has a land mass similar to the United States of America, supporting a population of just over 20 million, which is distributed predominantly across the coastal perimeter. The Australian society is rich in cultural diversity fostered by decades of migration. Both these factors present challenges for health care. First, because resources are scare in rural and remote regions, health outcomes are poorer in these regions, especially among indigenous populations. Second, the cultural diversity of Australians is a challenge to providing evidence-based treatment recommendations .
Davidson, PM, Salamonson, Y, Webster, J, Andrew, S, DiGiacomo, M, Gholizadeh, L, Newton, PJ & Moser, D 2008, 'Changes in depression in the immediate post-discharge phase in a cardiac rehabilitation population assessed by the Cardiac Depression Scale.', Journal of Cardiopulmonary Rehabilitation and Prevention, vol. 28, no. 5, pp. 312-315.View/Download from: UTS OPUS
Introduction: Depression is increasingly a focus of attention in the management of heart disease. Clinicians in cardiac rehabilitation (CR) are well placed to assess and facilitate management of symptoms of depression, yet the timing and interpretation of measurements remain unclear. Metods: We administered the Hare-Davis Cardiac Depression Scale (CDS) in a usual care, outpatient CR program in a metropolitan setting. As part of routine assessment and monitoring of outcomes in a 6-week outpatient CR program, we administered the CDS at entry, at completion of the 6-week program, and at 12 months. Results: Data were available on 151 patients for the 3 measurement points. At baseline, the mean CDS score was 76.07 (22.38), which dropped at 6 weeks to 64.85 (21.69) but increased slightly at 12 months to 69.79 (24.36). The changes in these scores were statistically significant for all measurement points (P <.03). The trend of change for the CDS was reflected in the subscale scores, which dropped at 6 weeks but increased slightly at 12 months. Discussion: Findings demonstrate a positive impact of CR on CDS scores at 6 weeks and 12 months, although there was a trend for increased scores at 1 year. This observation requires further investigation and underscores the importance of longitudinal studies.
he high rate (50%) of smoking among Aboriginal people (ABS 2005) coupled with limited culturally appropriate smoking cessation interventions makes addressing this important public health issue a challenge. The Aboriginal Medical Service of Western Sydney (AMSWS) offers a high intensity smoking cessation program which provides support, counselling, and subsidised nicotine replacement therapy to its clients through theleadership and community advocacy of Aboriginal Health Workers. The Butt Busters program arose from significant community consultation in 2005 and has now screened over 120 clients, several of whom have quit smoking and many others who are making positive steps toward this behavioural change.
Everett, B, Davidson, PM, Sheerin, N, Salamonson, Y & DiGiacomo, M 2008, 'Pragmatic insights into a nurse-delivered motivational interviewing intervention in the outpatient cardiac rehabilitation setting', Journal of Cardiopulmonary Rehabilitation and Prevention, vol. 28, no. 1, pp. 61-64.View/Download from: UTS OPUS or Publisher's site
Despite an increasing interest in motivational interviewing as a strategy to facilitate behavior change in people with cardiovascular disease, its use in cardiac rehabilitation (CR) appears minimal. Therefore, it is unclear whether the clinical method of motivational interviewing requires modification for the CR population, in which it could be argued that people are motivated and engaged. The purposes of this report are to describe processes in incorporating motivational interviewing in the CR setting and to discuss insights gained regarding the use of this intervention. METHODS: As part of a randomized controlled trial currently recruiting in the CR setting, patients allocated to the intervention group participate in 2 motivational interviewing sessions with a motivational interviewing-trained nurse. To ascertain treatment fidelity, this process review comprised 3 sources: (1) the extant literature on motivational interviewing, (2) reflections of the project team, and (3) data derived from audiotaped interviews.
Fernandez, RS, Davidson, PM & Griffiths, R 2008, 'Cardiac rehabilitation coordinators' perceptions of patient-related barriers to implementing cardiac evidence-based guidelines', Journal of Cardiovascular Nursing, vol. 23, no. 5, pp. 449-457.View/Download from: UTS OPUS or Publisher's site
Background: Coronary heart disease remains the leading cardiovascular cause of mortality and morbidity globally. Implementing evidence-based guidelines after a coronary event is vital to prevent recurrence of an acute episode. However, various barriers t
Fernandez, RS, Salamonson, Y, Griffiths, R, Juergens, C & Davidson, PM 2008, 'Awareness of risk factors for coronary heart disease following interventional cardiology procedures: A key concern for nursing practice', International journal of nursing practice, vol. 14, no. 6, pp. 435-442.View/Download from: UTS OPUS or Publisher's site
Cardiovascular risk factor modification to prevent progression of coronary heart disease is important for patients following percutaneous coronary intervention. The aims of this study were to assess patient's awareness of modifiable cardiac risk factors
Fernandez, RS, Salamonson, Y, Griffiths, R, Juergens, C & Davidson, PM 2008, 'Sociodemographic predictors and reasons for participation in an outpatient cardiac rehabilitation programme following percutaneous coronary intervention', International Journal Of Nursing Practice, vol. 14, no. 3, pp. 237-242.View/Download from: UTS OPUS or Publisher's site
Evidence-based guidelines recommend participation in cardiac rehabilitation (CR) to reduce subsequent cardiovascular events following percutaneous coronary intervention (PCI). The objective of this study was to investigate the reasons for and the demogra
Fernandez, RS, Salamonson, Y, Juergens, C, Griffiths, R & Davidson, PM 2008, 'Development and preliminary testing of the Cardiac Rehabilitation Enrolment Obstacles (CREO) scale: Implications for service development', European Journal of Cardiovascular Nursing, vol. 7, no. 2, pp. 96-102.View/Download from: UTS OPUS or Publisher's site
Background: In spite of the benefit in participating in cardiac rehabilitation (CR) programs, low participation rates are well documented. Participation rates are potentially lower in people who have undergone percutaneous coronary interventions (PCI). Assessment of the barriers to CR participation in PCI patients could provide vital information for the development of alternate strategies for coronary risk factor modification. Aim: The aim of this study was to develop and evaluate the sychometric properties of a scale to assess obstacles to cardiac rehabilitation enrolment in patients following PCI. Methods: Item generation for the 15 items of this scale was based on a comprehensive review of the literature and data collected from telephone interviews of CR coordinators related to cardiac rehabilitation enrolment obstacles (CREO). Content validity of the scale was undertaken using a reference group comprising of clinicians and patients. Construct validity was undertaken using a factor analysis. Data for the CREO scale was collected from December 2004 to March 2005 from 114 PCI patients recruited from a cardiology database in a Sydney metropolitan hospital. Results: Factor analysis revealed a two-factor structure: patient-related obstacles and health service-related obstacles, which accounted for 58%of cumulative explained variance. The scale showed good internal consistency (Cronbach's alpha=0.89) and satisfactory divergent validity. Conclusion: This scale can be used as a useful tool for the early identification of patients who would not normally enrol into CR and offer them alternate strategies for health-related lifestyle modification.
Gholizadeh, L & Davidson, PM 2008, 'More Similarities Than Differences: An International Comparison of CVD Mortality and Risk Factors in Women', Health Care for Women International, vol. 29, no. 1, pp. 3-22.View/Download from: UTS OPUS or Publisher's site
In this article we describe global cardiovascular risk factor trends in women, both physiological and behavioral, in order to improve the understanding of cardiovascular health of women. Our aim in presenting this information is to inform interventions and policies to improve the cardiovascular health of women. Although differences are apparent between developing and developed countries, a range of commonalities exist that allow a global approach to improving womenâs health. A multifaceted approach considering physiological, social, economic, and political determinants is critical to improve the cardiovascular health outcomes of women.
Goddard, L, Davidson, PM, Daly, J & Mackey, S 2008, 'People with an intellectual disability in the discourse of chronic and complex conditions: an invisible group?', Australian Health Review, vol. 32, no. 3, pp. 405-414.View/Download from: UTS OPUS or Publisher's site
People with an intellectual disability and their families experience poorer health care compared with the general population. Living with an intellectual disability is often challenged by coexisting complex and chronic conditions, such as gastrointestina
Goddard, L., Davidson, P.M., Daly, J. & Mackey, S. 2008, 'People with an intellectual disabilitiy in the discourse of chronic and complex conditions: an invisible group?', Australian Health Review, vol. 32, no. 3, pp. 405-414.View/Download from: UTS OPUS
People with an intellectual disability and their families experience poorer health care compared with the general population. Living with an intellectual disability is often challenged by coexisting complex and chronic conditions, such as gastrointestinal and respiratory conditions. A literature review was undertaken to document the needs of this vulnerable population, and consultation was undertaken with mothers of children with disabilities and with professionals working within disability services for people with an intellectual disability and their families. Based on this review, there is a need to increase the profile of people with an intellectual disability in the discourse surrounding chronic and complex conditions. Strategies such as guideline and competency development may better prepare health professions to care for people with disabilities and chronic and complex care needs and their families
Greenwood, DLV, Crock, P, Braye, S, Davidson, P & Sentry, JW 2008, 'Autoimmune gastritis and parietal cell reactivity in two children with abnormal intestinal permeability.', European journal of pediatrics, vol. 167, no. 8, pp. 917-925.View/Download from: Publisher's site
Autoimmune gastritis is characterised by lymphocytic infiltration of the gastric submucosa, with loss of parietal and chief cells and achlorhydria. Often, gastritis is expressed clinically as cobalamin deficiency with megaloblastic anaemia, which is generally described as a disease of the elderly. Here, we report on two prepubertal children who developed autoimmune gastritis. One child developed autoimmune gastritis as part of a polyglandular autoimmune disease from a family with polyglandular autoimmune disease type II (PGA type II) and the other as part of a classic "thyro-gastric cluster," which may have been triggered by emotional trauma. Both children presented with normal small bowel biopsies, with abnormal gut permeability, which subsequently resolved. These patients are among the youngest reported to date. The immune systems targetted the gastric parietal cell autoantigens (ATP4A and ATP4B) in both children, similar to the elderly. The study of children with autoimmune gastritis and their families may provide additional insights into the disease's pathogenesis and may also lead to the identification of inheritable factors influencing susceptibility. This report underlines the necessity to screen paediatric patients with organ-specific autoimmune diseases for co-existent conditions. Children with polyglandular autoimmune disease are at particularly high risk.
Halcomb, E, Davidson, PM & Hardaker, L 2008, 'Using the consensus development conference method in healthcare research', Nurse Researcher, vol. 16, no. 1, pp. 56-71.View/Download from: UTS OPUS or Publisher's site
Consensus methods are increasingly being used in healthcare research, particularly for formulating policy and strategic directions. This paper discusses the issues central to the planning and conduct of the consensus development conference, and offers practical recommendations to researchers intending to use this approach.
Halcomb, E, Davidson, PM & Patterson, E 2008, 'Promoting leadership and management in Australian general practice nursing: what will it take?', Journal of Nursing Management, vol. 16, no. 7, pp. 846-852.View/Download from: UTS OPUS or Publisher's site
Aim:This paper outlines the current state of Australian practice nursing, describes the context of general practice and establishes the importance of promoting leadership and management in this setting. Background Australian general practice nurses have emerged as key stakeholders in primary health care. However, their role in leadership and management has been largely invisible. The reasons for this are multifactorial, including the delay to establish a strong professional organization, their negative power relationships with general medical practitioners, limited nursing leadership and poorly defined roles. To date, the impetus for practice nurse growth has been largely external to the nursing profession. Growth has been driven by the increasing burden of chronic disease and workforce shortages. This has further weakened the control of nurse leaders over the development of the specialty. Conclusions The Australian practice nurse role is at a crossroads. While the practice nurse role is a viable force to improve health outcomes, the growing strength of the practice nurse challenges traditional professional roles and practice patterns.
Halcomb, E, Davidson, PM, Griffiths, R & Daly, J 2008, 'Cardiovascular disease management: time to advance the practice nurse role?', Australian Health Review, vol. 32, no. 1, pp. 44-53.View/Download from: UTS OPUS or Publisher's site
More than two-thirds of health expenditure is attributable to chronic conditions, of which a significant proportion are related to cardiovascular disease. This paper identifies and explores the factors cited by practice nurses as impacting on the development of their role in cardiovascular disease management. Sequential mixed methods design combining postal survey and telephone interviews with general practice nurses were used. The most commonly cited barriers to role extension were legal implications (51.6%), lack of space (30.8%), a belief that the current role is appropriate (29.7%), and general practitioner attitudes (28.7%). Australian government policy demonstrates a growing commitment to an extended role for general practice in primary health care and cardiovascular disease management. By addressing the barriers and enabling features identified in this investigation, there is potential to further develop the Australian practice nurse role in cardiovascular disease management.
Halcomb, E, Davidson, PM, Salamonson, Y, Ollerton, R & Griffiths, R 2008, 'Nurses in Australian general practice: implications for chronic disease management', Journal Of Clinical Nursing, vol. 17, no. 5a, pp. 6-15.View/Download from: UTS OPUS or Publisher's site
Aims. The purpose of this study was to describe the demographic and employment characteristics of Australian practice nurses and explore the relationship between these characteristics and the nurses role. Background. Nursing in general practice is an integral component of primary care and chronic disease management in the United Kingdom and New Zealand, but in Australia it is an emerging specialty and there is limited data on the workforce and role. Design. National postal survey embedded in a sequential mixed method design. Methods. 284 practice nurses completed a postal survey during 2003â2004. Descriptive statistics and factor analysis were utilized to analyse the data.
Newton, PJ, Davidson, PM, Macdonald, P, Ollerton, R & Krum, H 2008, 'Nebulized furosemide for the management of dyspnea: Does the evidence support its use?', Journal of Pain and Symptom Management, vol. 36, no. 4, pp. 424-441.View/Download from: UTS OPUS
Dyspnea is a common and distressing symptom associated with multiple chronic illnesses and high levels of burden for individuals, their families and health care systems. The subjective nature dyspnea and a poor understanding of pathophysiological mechanisms challenge the clinician in developing management plans. Nebulized furosemide has been dentified as a novel approach to dyspnea management. This review summarizes published studies, both clinical and experimental, reporting the use of nebulized furosemide. The search criteria yielded 42 articles published in the period 1988 to 2004. Although nebulized furosemide appeared to have a positive influence on dyspnea and physiological measurements, caution must be taken with the results primarily coming from small-scale clinical trials or observation trials. Despite the limitations of the studies reported, given the range of conditions reporting effectiveness of nebulized furosemide, further investigation of this potential novel treatment of dyspnea is warranted.
Phillips, JL, Davidson, PM, Jackson, DE & Kristjanson, L 2008, 'Multi-Faceted Palliative Care Intervention: Aged Care Nurses' And Care Assistants' Perceptions And Experiences', Journal of Advanced Nursing, vol. 62, no. 2, pp. 216-227.View/Download from: UTS OPUS or Publisher's site
Aim. This paper is a report of a study to describe residential aged care nurses' and care assistants' perceptions of a multi-faceted palliative care intervention to identify potential areas to be addressed during subsequent action research phases. Backgr
Phillips, JL, Davidson, PM, Newton, PJ & DiGiacomo, M 2008, 'Supporting patients and their caregivers after-hours at the end of life: the role of telephone support', Journal of Pain and Symptom Management, vol. 36, no. 1, pp. 11-21.View/Download from: UTS OPUS or Publisher's site
Twenty-four hour access is accepted as a gold standard for palliative care service delivery, yet minimal data exist to justify the cost of this initiative to health care planners and policy makers. Further, there is scant information concerning optimal and efficient methods for delivering after-hours palliative care advice and support, particularly in regional and rural settings. This article reports on an evaluation of a local after-hours telephone support service in regional Australia. A centralized after-hours telephone support service was provided by generalist nurses at a Multipurpose Service in a rural community. A mixed-method evaluation, including semistructured interviews, was undertaken after 20 months of operation. During the period March 31, 2005 until November 15, 2006, 357 patients were registered as part of the Mid North Coast Rural Palliative Care Program. Ten percent of patients or their caregivers accessed the After-Hours Telephone Support Service, representing 55 occasions of service.
Rapley, P & Davidson, PM 2008, 'Adolescent health and diabetes: Time to rethink service delivery', Australian Nursing Journal, vol. 16, no. 1, pp. 30-31.
or adolescents with diabetes the transition to adutt health care coincides with transitions on many levels including psychosocial development, family and peer relationships, and school. The task of seif-management determines long term outcomes yet health risktaking is de rigueur for adolescents trying to establish their identity and independence (CarrGreg et al 2003).
Rolley, J, Davidson, PM, Dennison, C, Ong, A, Everett, B & Salamonson, Y 2008, 'Medication Adherence Self-report Instruments Implications for Practice and Research', Journal of Cardiovascular Nursing, vol. 23, no. 6, pp. 497-505.View/Download from: UTS OPUS or Publisher's site
Background: After an acute cardiac event, adhering to recommendations for pharmacologic therapy is important in achieving optimal health outcomes. Considering the impressive evidence base for cardiovascular pharmacotherapy, strategies for promoting adherence are less well developed. Furthermore, accessing reliable, valid, and cost-effective mechanisms of monitoring adherence in the research and clinical settings is challenging. Aim: The aim of this article was to review published self-report measures assessing and monitoring medication adherence in cardiovascular disease and provide recommendations for research into medication adherence.
Salamonson, Y, Everett, B, Koch, J, Andrew, S & Davidson, PM 2008, 'English-Language Acculturation Predicts Academic Performance in Nursing Students Who Speak English as a Second Language', Research in Nursing and Health, vol. 38, no. 31, pp. 86-94.View/Download from: UTS OPUS or Publisher's site
Students who speak English as a second language (ESL) face considerable challenges in English language universities, but little is known about the relationship betweenEnglish-language acculturation and academic performance. A prospective, correlational design was used to validate the English Language Acculturation Scale (ELAS), a measure of the linguistic aspect of acculturation, and to determine the relationship between English language acculturation and academic achievement among 273 first-year nursing students. Exploratory factor analyses demonstrated that the ELAS was a valid and reliable measure (a Â¼.89).WhenELAS scoreswere examined in relation to students grades, students with the lowest ELAS scores also had the lowest mean subject grades, highlighting the need to place greater emphasis on identifying English-language acculturation among ESL students.
Astley, C, Portelli, L, Whalley, G & Davidson, PM 2007, 'Coming of Age: Affiliate Member Profile and Participation in the Annual Scientific Meeting of the Cardiac Society of Australiaand New Zealand', Heart, Lung and Circulation, vol. 16, pp. 447-451.View/Download from: UTS OPUS or Publisher's site
Background: Nursing, allied health and technical personnel are increasingly being recognised as pivotal in the diagnosis and management of heart disease. This recognition is mirrored in research, scholarship and professional development activities. Documenting the evolution and progression of a groupâs professional development is a useful strategy in informing future strategic initiatives.
Berry, A, Davidson, PM, Masters, J & Rolls, K 2007, 'Systematic Literature Review of Oral Hygiene Practices for Intensive Care Patients Receiving Mechanical Ventilation', American Journal Of Critical Care, vol. 16, no. 6, pp. 552-562.View/Download from: UTS OPUS
Background Oropharyngeal colonization with pathogenic organisms contributes to the development of ventilator associated pneumonia in intensive care units. Although considered basic and potentially nonessential nursing care, oral hygiene has been proposed as a key intervention for reducing ventilator-associated pneumonia. Nevertheless, evidence from randomized controlled trials that could inform best practice is limited.
Brookes, K, Davidson, PM, Halcomb, E & Daly, J 2007, 'Role theory: A framework to investigate the community nurse role in contemporary health care systems', Contemporary Nurse, vol. 25, no. 1-2, pp. 146-155.View/Download from: UTS OPUS
Nurses' perceptions of their role are influenced by societal attitudes, government policies and trends in professional issues. Dynamic factors in contemporary health environments challenge traditional nursing roles, in particular those of community nurses. Role theory is a conceptual framework that defines how individuals behave in social situations and how these behaviours are perceived by external observers. This paper reviews the role theory literature as a conceptual framework to explore community nurses' perceptions of their role. Three theoretical perspectives of role theory have emerged from the literature review: 1. social structuralism; 2. symbolic interactionism; and 3. the dramaturgical perspective. These philosophical perspectives provide a useful framework to investigate the role of community nurses in the contemporary health care system
Bryant, RA, Salmon, K, Sinclair, E & Davidson, P 2007, 'A prospective study of appraisals in childhood posttraumatic stress disorder.', Behaviour research and therapy, vol. 45, no. 10, pp. 2502-2507.View/Download from: Publisher's site
This study investigated the predictors of posttraumatic stress disorder (PTSD) in children following a diagnosis of traumatic injury. Children (N=76) aged between 7 and 13 who were admitted to hospital following injury were assessed within a month of trauma for acute stress disorder (ASD), negative appraisals, as well as parental stress reactions. Children (N=62) were re-assessed 6-months later for PTSD and negative appraisals. The majority of the variance of chronic posttraumatic stress was accounted for by negative appraisals about future harm. This study supports cognitive models of PTSD, and suggests that younger children who exaggerate their vulnerability after trauma exposure are high risk for PTSD after trauma.
Bryant, RA, Salmon, K, Sinclair, E & Davidson, P 2007, 'Heart rate as a predictor of posttraumatic stress disorder in children.', General hospital psychiatry, vol. 29, no. 1, pp. 66-68.View/Download from: Publisher's site
OBJECTIVE: This study indexed the relationship between resting heart rates (HRs) after injury and subsequent posttraumatic stress disorder (PTSD) in children. METHOD: Children aged between 7 and 12 years who were hospitalized after traumatic injury (n=76) had their resting HR assessed after injury and were assessed for PTSD 6 months after injury (n=62). RESULTS: Full/subsyndromal PTSD was diagnosed in 27% of children. Children with full/subsyndromal PTSD had higher HRs after trauma than those without PTSD. Children with an elevated HR were more likely to develop PTSD after controlling for age, sex and injury severity (adjusted odds ratio=5.89). CONCLUSIONS: These findings accord with the proposal that fear conditioning shortly after trauma contributes to PTSD in children.
Bryant, RA, Salmon, K, Sinclair, E & Davidson, P 2007, 'The relationship between acute stress disorder and posttraumatic stress disorder in injured children.', Journal of traumatic stress, vol. 20, no. 6, pp. 1075-1079.View/Download from: Publisher's site
This study indexed the relationship between acute stress disorder (ASD) and subsequent posttraumatic stress disorder (PTSD) in injured children. Consecutive children between 7-13 years admitted to a hospital after traumatic injury (n = 76) were assessed for ASD. Children were followed up 6-months posttrauma (n = 62), and administered the PTSD Reaction Index. Acute stress disorder was diagnosed in 10% of patients, and 13% satisfied criteria for PTSD. At 6-months posttrauma, PTSD was diagnosed in 25% of patients who were diagnosed with ASD. Acute stress reactions that did not include dissociation provided better prediction of PTSD than full ASD criteria. These findings suggest that the current ASD diagnosis is not optimal in identifying younger children who are high risk for PTSD development.
Chang, E, Hancock, K, Hickman, L, Glasson, J & Davidson, PM 2007, 'Outcomes of acutely ill older hospitalized patients following implementation of tailored models of care: A repeated measures (pre- and post-intervention) design', International Journal of Nursing Studies, vol. 44, no. 7, pp. 1079-1092.View/Download from: UTS OPUS or Publisher's site
Background: There is a lack of research investigating models of nursing care for older hospitalised patients that address the nursing needs of this group. Objectives: The objective of this study is to evaluate the efficacy of models of care for acutely older patients tailored to two contexts: an aged care specific ward and a medical ward. Design: This is a repeated measures design. Efficacy of the models was evaluated in terms of: patient and nursesâ satisfaction with care provided; increased activities of daily living; reduced unplanned hospital readmissions; and medication knowledge. Settings: An aged care specific ward and a medical ward in two Sydney teaching hospitals. Participants: There were two groups of patients aged 65 years or older who were admitted to hospital for an acute illness: those admitted prior to model implementation (n Â¼ 232) and those admitted during model implementation (n Â¼ 116). Patients with moderate or severe dementia were excluded. The two groups of nurses were the pre-model group (n Â¼ 90) who were working on the medical and aged care wards for the study prior to model implementation, and the post-model group (n Â¼ 22), who were the nurses working on the wards during model implementation. Methods: Action research was used to develop the models of care in two wards: one for an aged care specific ward and another for a general medical ward where older patients were admitted. The models developed were based on empirical data gathered in an earlier phase of this study.
Clayton, JM, Hancock, KM, Butow, PN, Tattersall, MHN, Currow, DC, Australian and new Zealand Expert Advisory Group, Adler, J, Aranda, S, Auret, K, Boyle, F, Britton, A, Chye, R, Clark, K, Davidson, P, Davis, JM, Girgis, A, Graham, S, Hardy, J, Introna, K, Kearsley, J, Kerridge, I, Kristjanson, L, Martin, P, McBride, A, Meller, A, Mitchell, G, Moore, A, Noble, B, Olver, I, Parker, S, Peters, M, Saul, P, Stewart, C, Swinburne, L, Tobin, B, Tuckwell, K, Yates, P, Australasian Society of HIV Medicine, Australian and New Zealand Society of Palliative Medicine, Australasian Chapter of Palliative Medicine, Royal Australasian College of Physicians, Australian College of Rural and Remote Medicine, Australian General Practice Network, Australian Society of Geriatric Medicine, Cancer Voices Australia, Cardiac Society of Australia and New Zealand, Clinical Oncological Soceity of Australia, Motor Neurone Disease Association of Australia, Palliative Care Australia, Palliative Care Nurses Australia, Royal Australian College of General Practitioners, Royal College of Nursing, Australia & Thoracic Society of Australia and New Zealand 2007, 'Clinical practice guidelines for communicating prognosis and end-of-life issues with adults in the advanced stages of a life-limiting illness, and their caregivers.', The Medical journal of Australia, vol. 186, no. 12 Suppl, pp. S77-108.
Davidson, PM 2007, 'Difficult conversations and chronic heart failure: do you talk the talk or walk the walk?', Current opinion in supportive and palliative care, vol. 1, no. 4, pp. 274-278.View/Download from: Publisher's site
PURPOSE OF REVIEW: Effective communication is critical for palliative and supportive care in heart failure. This article contains a review of available information to assist clinicians in undertaking discussions regarding prognosis, treatment decisions and advance care planning. RECENT FINDINGS: Emerging from a range of studies at the end of life is that patients and their families appreciate honesty and do not want to be abandoned by healthcare providers. Further, the receptivity of patients and their carers to information is highly variable, underscoring the importance of an individualized approach. SUMMARY: When having these difficult conversations, clinicians need to assess the individual's need and wishes for information as well as their social and cultural background. They also need to consider the setting, timing and content of the discussion, as well as strategies to promote coping and adjustment. Most importantly, patients need a treatment plan to address palliative and supportive care needs to be implemented at the time of breaking this bad news, so that they and their families do not feel abandoned. Learning effective communication skills, implementing strategies for debriefing and the fostering of a team approach, may minimize burden on health providers and improve palliative and supportive care for people with heart failure.
Davidson, PM, Dracup, K, Phillips, JL, Padilla, G & Daly, J 2007, 'Maintaining hope in transition: A conceptual framework to guide interventions for people with heart failure', Journal of Cardiovascular Nursing, vol. 22, no. 1, pp. 58-64.View/Download from: UTS OPUS or Publisher's site
Theoretical frameworks provide a structure for the planning and delivery of nursing care and for research. Heart failure (HF), a condition of increasing prevalence in communities internationally, is responsible for high rates of morbidity, mortality, and great societal burden. The HF illness trajectory can be unpredictable and uncertain. Markers of transition, such as functional decline and increasing dependence, can signal the need for transition to a more palliative approach. This transition challenges clinicians to deliver information and interventions and to support patients and their families not only in relation to their physical status but also in the social, psychological, and existential dimensions. This article describes a theoretical framework, Maintaining Hope in Transition, informed by transition theory, to assist patients to cope with a diagnosis of HF and to guide development of nursing interventions. Transition theory provides a useful context to assist clinicians, patients, and their families adjust to the challenges inherent in a diagnosis of HF and negotiating the illness trajectory. Key factors acknowledged in the Maintaining Hope in Transition framework that determine its utility in models of care for HF patients are (1) acknowledging the changing of life circumstances, (2) restructuring reality, (3) dealing with vulnerability, (4) achieving normalization, and (5) resolving uncertainty. It is likely that incorporation of these factors in care planning, information, and interventions can facilitate patients' and their families' abilities to negotiate the HF illness trajectory, particularly in the advanced stages.
Davidson, PM, Halcomb, E & Patterson, E 2007, 'Practice nursing in Australia: ready for prime time', Contemporary Nurse, vol. 26, no. 1, pp. 5-6.
Davidson, PM, Macdonald, P, Moser, D, Ang, E, Paull, G, Choucair, S, Daly, J, Gholizadeh, L & Dracup, K 2007, 'Cultural diversity in heart failure management: Findings from the Discover Study (Part 2)', Contemporary Nurse, vol. 25, no. 1-2, pp. 50-62.View/Download from: UTS OPUS
Self-management is a critical dimension in managing chronic conditions, particularly in heart failure (HF). Knowledge, attitudes and beliefs, relating to both illness and wellness, are strongly influenced by culture and ethnicity, impacting upon an individual's capacity to engage in self-care behaviours. Effective management of HF is largely dependent on facilitation of culturally informed, self-care behaviours to increase adherence to both pharmacological and non- pharmacological strategies. The understanding the cultural experiences of individuals with chronic heart failure (CHF) in South East Health (DISCOVER) study is an exploratory, observational study investigating health patterns, information needs and the adjustment process for overseas-born people with HF living in Australia. An integrative literature review was augmented by qualitative data derived from key informant interviews, focus groups and individual interviews. A key finding of this study is that culture provides an important context to aid interpretations of attitudes, values, beliefs and behaviours, not only in illness but in health. While individual differences in attitudes and beliefs were observed among participants, common themes and issues were identified across cultural groups. Data from the DISCOVER study revealed the primacy of family and kinship ties. These relationships were important in making decisions about treatment choices and care plans.
DiGiacomo, M, Davidson, PM, Davison, J, Moore, L & Abbott, P 2007, 'Stressful life events, resources, and access: key considerations in quitting smoking at an Aboriginal Medical Service', Australian & New Zealand Journal of Public Health, vol. 31, no. 2, pp. 174-176.View/Download from: UTS OPUS or Publisher's site
Objective: Aboriginal and Torres Strait Islander people experience adverse health outcomes and have high rates of smoking and related illnesses. This brief report describes stress as a barrier to quitting smoking derived from reflections within an Aboriginal Medical Service and makes recommendations for intervention development.
DiGiacomo, M, Davidson, PM, Vanderpluym, A, Snell, R & Worrall-Carter, L 2007, 'Depression, anxiety and stress in women following acute coronary syndrome: implications for secondary prevention', Australian Critical Care, vol. 20, no. 2, pp. 69-76.View/Download from: UTS OPUS
Objective To document incidence of depression, anxiety, and stress in women more than 6 months following an acute coronary syndrome. Design Participants were identified from a coronary care unit database. The Depression Anxiety Stress Scales 21 (DASS 21) was sent to potential participants via postal survey. Setting A metropolitan teaching hospital in Melbourne, Australia. Participants The cohort of women was aged between 55 and 70 years. They had been admitted to hospital with a diagnosis of acute coronary syndrome (ACS) between 6 and 14 months prior to participating in this study. Main outcome measures Scores on Depression, Anxiety, and Stress Scale (DASS 21). Results Of the 117 posted questionnaires, 39 women with a mean age of 63 (S.D. 4.97) responded to the survey, representing a response rate of 33.3%. Most participants scored within normal levels of depression (66.7%), anxiety (60.5%), and stress (70.3%), however, mild to extremely severe levels of each construct (33.4%, 39.6%, and 29.7%, respectively) were found. Conclusions The reporting of elevated levels of depression, anxiety and stress in a subset of women more than 6 months following an ACS event underscores the importance of ongoing screening for risk factors impacting on psychological well-being and the inclusion of this information in education and counseling strategies in both the inpatient and outpatient settings. Based on these pilot data, consideration of a screening system in the immediate post discharge period for women at risk and an education or support service are recommended.
Fernandez, R, Davidson, PM, Griffiths, R, Juergens, C & Salamonson, Y 2007, 'What do we know about the long term medication adherence in patients following percutaneous coronary intervention?', Australian Journal of Advanced Nursing, vol. 25, no. 2, pp. 53-61.View/Download from: UTS OPUS
Background Percutaneous coronary intervention (PCI) is a revascularisation intervention for patients with acute coronary syndrome. It is a common procedure, increasingly used over the past decade. Along with PCI, patients are also prescribed a number of medications and adherence to the pharmacological therapies is vital to improved morbidity and mortality. Objective This cross sectional study sought to evaluate the long term adherence to medications in patients following PCI. Subjects 270 participants who underwent PCI between April 2003 and March 2004 and who met the inclusion criteria were followed up 12 -24 months following the PCI.
Fernandez, R, Davidson, PM, Salamonson, Y, Griffiths, R & Juergens, C 2007, 'The Health-Related Quality of Life Trajectory in Patients After Percutaneous Coronary Intervention', Journal of Cardiopulmonary Rehabilitation and Prevention, vol. 27, no. 4, pp. 223-226.View/Download from: UTS OPUS
PURPOSE: The purpose of this study was to describe the trajectory of cardiac patient's perceptions of health-related quality of life (HRQoL) during a 24-month period in a community-based population. METHODS: After obtaining informed consent, a self-administered questionnaire was mailed to participants. Using the MacNew questionnaire, which assesses the emotional, physical, social, and global domains, HRQoL outcomes were assessed.
Fernandez, R, Salamonson, Y, Juergens, C, Griffiths, R & Davidson, PM 2007, 'Validation of the Revised Cardiac Rehabilitation Preference Form in Patients With Post-Percutaneous Coronary Intervention', Journal of Cardiopulmonary Rehabilitation and Prevention, vol. 27, no. 6, pp. 390-394.View/Download from: UTS OPUS
BACKGROUND: Challenges in achieving optimal participation rates in cardiac rehabilitation (CR) are well described and include factors pertaining to health system and patient and clinical characteristics. Of note, participation rates of patients following percutaneous coronary intervention (PCI) are low. AIM: The aim of this study was to examine the psychometric properties of the Revised Cardiac Rehabilitation Preference Form (CRPF-R) in an Australian sample following a PCI and to determine the preferences of PCI patients in relation to CR.
Fernandez, R., Griffiths, R., Everett, B., Davidson, P.M., Salamonson, Y. & Andrew, S. 2007, 'Effectiveness of brief structured interventions on risk factor modification for patients with coronary heart disease: a systematic review', International Journal of Evidence-Based Healthcare, vol. 5, no. 4, pp. 370-405.View/Download from: UTS OPUS
Background The physical and psychosocial benefits of participation in cardiac rehabilitation following a coronary event have well been established. Despite these benefits there is strong evidence that participation in traditional cardiac rehabilitation programs remains low. Various models of cardiac rehabilitation have been implemented including the use of brief structured interventions to enable modification of coronary risk factors.
Halcomb, E, Davidson, PM & Patterson, E 2007, 'Exploring the development of Australian general practice nursing: Where we have come from and where to from here?', Advances in Contemporary Nursing, vol. 26, no. 1, pp. 145-154.View/Download from: UTS OPUS
Significant development has occurred in the role and scope of Australian general practice nursing in the last decade. Although there has been a nursing presence in Australian general practice for many years (Linn 1977), current workforce shortages and the growing need for chronic and complex disease management and provision of preventive health care in the community have fuelled role development (Halcomb, Patterson & Davidson 2006). In an effort to explore and document the evolution of scholarship and professional development in Australian general practice nursing a content analysis of the proceedings of the four Australian practice nursing conferences was undertaken.This framework allows the mapping of the trajectory related to professional development issues, policy, research and scholarship. Content analysis revealed that the papers presented at each of the four conferences could be broadly divided into six major themes, namely: (1) role of the practice nurse, (2) education and training, (3) research, (4) legal, ethical and risk issues, (5) innovation in clinical practice, and (6) operational and management issues in general practice. Documenting the evolution of this emerging specialty is important in planning initiatives to maximise practice nurses important contribution to primary health care.
Halcomb, E, Davidson, PM, Yallop, J, Griffiths, R & Daly, J 2007, 'Strategic directions for developing the Australian general practice nurse role in cardiovascular disease management', Advances in Contemporary Nursing, vol. 26, no. 1, pp. 125-135.View/Download from: UTS OPUS
Practice nursing is an integral component of British and New Zealand primary care, but in Australia it remains an emerging specialty. Despite an increased focus on the Australian practice nurse role, there has been limited strategic role development, particularly relating to national health priority areas. This paper reports the third stage of a project exploring the Australian practice nurse role in the management of cardiovascular disease (CVD). This stage involved a consensus development conference, undertaken to identify strategic, priority recommendations for practice nurse role development. Key issues arising from the conference included: 1. practice nurses have an important role in developing systems and processes for CVD management; 2. a change in the culture of general practice is necessary to promote acceptance of nurse-led CVD management; 3. future research needs to evaluate specific models of care, incorporating outcome measures sensitive to nursing interventions; 4. considerable challenges exist in conducting research in general practice; and 5. changes in funding models are necessary for widespread practice nurse role development. The shifting of funding models provides evidence to support interdisciplinary practice in Australian general practice. The time is ripe, therefore, to engage in prospective and strategic planning to inform development of the practice nurse role.
Halcomb, E, Gholizadeh, L, DiGiacomo, M, Phillips, JL & Davidson, PM 2007, 'Considerations in undertaking focus group research with culturally and linguistically diverse groups in Bibliographies and Literature Reviews', Journal of Clinical Nursing, pp. 1000-1011.
Focus groups are a popular, widely accepted, and legitimate research method to determine attitudes, experiences, perceptions, and knowledge on a wide range of topics in many fields of endeavor. Focus groups lead to the voicing of attitudes and insights not readily attainable from other qualitative forms of data collection. The spectrum of interest in focus groups covers virtually all disciplines, and the variety of the applications for this technique is extraordinary. As part of the SAGE Benchmarks in Social Research Methods series, Graham Walden explores what a focus group is, how they are best used, the strengths and weaknesses of focus groups and the ethical issues surrounding focus groups, amongst other things. Volume 2, Part 2, 'Bibliographies and Literature Reviews' contains Halcomb et al.'s "Considerations in undertaking focus group research with culturally and linguistically diverse groups". URL: http://www.sagepub.com/books/Book235672/toc
Halcomb, E, Gholizadeh, L, DiGiacomo, M, Phillips, JL & Davidson, PM 2007, 'Literature review: considerations in undertaking focus group research with culturally and linguistically diverse groups', Journal Of Clinical Nursing, vol. 16, no. 6, pp. 1000-1011.View/Download from: UTS OPUS or Publisher's site
Aims. This integrated literature review seeks to identify the key considerations in conducting focus groups and discusses the specific considerations for focus group research with culturally and linguistically diverse groups. Background. The focus group method is a technique of group interview that generates data through the opinions expressed by participants. Focus groups have become an increasingly popular method of data collection in health care research. Although focus groups have been used extensively with Western populations, they are a particularly useful tool for engaging culturally and linguistically diverse populations. The success of focus groups in this context is dependent upon the cultural competence of the research team and the research questions.
Halcomb, E., Moujalli, S., Griffiths, R. & Davidson, P.M. 2007, 'Effectiveness of general practice nurse interventions in cardiac risk factor reduction among adults', International Journal of Evidence-Based Healthcare, vol. 5, no. 3, pp. 269-295.View/Download from: UTS OPUS
Background Cardiovascular disease is the leading cause of death for adults in Australia. In recent years there has been a shift in health service delivery from institutional to community-based care for chronic conditions, including cardiovascular disease. The general practice setting is seen to offer greater flexibility, higher levels of efficiency and more client focused healthcare delivery than is possible in the acute care sector. It has been suggested that practice nurses represent a useful adjunct to current models of cardiovascular disease management. To date, significant descriptive research has been conducted exploring the demographics, roles, educational needs and issues facing practice nurses. However, there is a need to evaluate the effectiveness of practice nurse interventions in terms of patient outcomes, clinician satisfaction and cost-effectiveness.
Hammond, J, Salamonson, Y, Davidson, PM, Everett, B & Andrew, S 2007, 'Why do women underestimate the risk of cardiac disease? A literature review', Australian Critical Care, vol. 20, no. 2, pp. 53-59.View/Download from: UTS OPUS
Background: Despite the quantity of information available to women about risk factors for cardiovascular disease (CVD), many women do not perceive this risk. Aim: This paper seeks to identify factors in the published literature that influence womens risk perception of heart disease, and how these perceptions influence health outcomes. Method: A literature search from 1985 to 2006 using the CINAHL, Medline, Embase and PsycINFO electronic databases was undertaken. The keywords used were perceived risk, cardiac risk factors, cardiovascular disease, risk misconception, and heart disease, combined with women and/or gender. Additional data was obtained by manual searches of bibliographies of articles identified in the electronic searches, and Internet searches. Findings: Until the late 1980s, CVD was perceived as a disease which primarily affected men, as few large clinical trials recruited women. This resulted in a lack of data documenting the relationship between known risk factors and gender. Until recently, health professionals have not focused on disseminating gender-specific information about CVD risks to women, causing women to underestimate their risk of developing CVD even when risk factors are clearly evident. Furthermore, women are less likely than men to recognise the signs and symptoms of CVD, delay in seeking treatment, and fail to adopt healthy lifestyles, all of which increase the incidence of mortality and morbidity in a disease that is largely preventable. Conclusion: This review highlights the need for health professionals to bridge the gap between perceived and actual risk of CVD in women, and to develop educational programs that specifically target women.
Hickman, L, Newton, PJ, Halcomb, E, Chang, E & Davidson, PM 2007, 'Best practice interventions to improve the management of older people in acute care settings: a literature review', Journal of Advanced Nursing, vol. 60, no. 2, pp. 113-126.View/Download from: UTS OPUS or Publisher's site
Aim. This paper is a report of a literature review of experimental evidence describing interventions to manage the older adult in the acute care hospital setting. Background. Older people are increasingly being cared for in a system largely geared toward
J, P, Davidson, PM, Ollerton, R, Jackson, DE & Kristjanson, L 2007, 'Pain is a common symptom at the end of life in Residential Aged Care and Targeted Education can improve symptom managament: P1154', Pain Practice, vol. 7, no. Supplement 1, pp. 62-62.View/Download from: Publisher's site
Newton, PJ, Halcomb, E, Davidson, PM & Denniss, A 2007, 'Barriers and facilitators to the implementation of the collaborative method: reflections from a single site', Quality and Safety in Health Care, vol. 16, no. 6, pp. 409-414.View/Download from: UTS OPUS or Publisher's site
Background: A collaborative is an effective method of implementing evidence-based practice across multiple sites through the sharing of experience and knowledge of others in a similar setting, over a short period of time. Collaborative methods were first used in the USA but have been adopted internationally. Aim: This paper sought to document the facilitators and barriers to the implementation of the collaborative method, based on a single sites experience of participating in a multisite, state-wide heart failure collaborative. Method: Qualitative data was collected using three complementary methods: participant observation, reflective journalling and key informant interviews. Quantitative monitoring of team performance occurred monthly according to prespecified performance indicators. Findings: Barriers and facilitators that were identified by this study included: organisational factors, team composition, dynamics and networking, changing doctor behaviour, clinical leadership and communication. Conclusion: The findings from this study underscore the importance of leadership, communication and team cohesion for the successful implementation of the collaborative method at individual sites. In addition, the importance of a preparatory stage that deals with known barriers and facilitators to the collaborative method before the commencement of the official study period was highlighted. The potential for the collaborative approach to improve clinical outcomes warrants further systematic evaluation of process issues and consideration of the barriers and facilitators to implementation in various settings.
Parry, A, Worrall-Carter, L, Page, K, Kuhn, L, DiGiacomo, M & Davidson, PM 2007, 'Returning to work: Exploring the experiences of women with acute coronary syndromes', British Journal of Cardiac Nursing, vol. 2, no. 6, pp. 292-301.View/Download from: UTS OPUS
Aims: The aim of this study was to explore the transition experiences of Australian women in resuming paid employment after an acute coronary syndrome (ACS) event. Background: Until recently cardiovascular research has focused predominantly on men but this is changing and research exploring womens experiences of ACS has increased. Despite knowing that many women do not resume paid employment following an ACS event, little is known about the experience of those women who do, even though it is understood that returning to the previous level of employment after an ACS event is a positive outcome. Design: An exploratory qualitative approach underpinned by naturalistic inquiry was undertaken. Methods: A purposive sample of seven women who had experienced their first ACS event 12 months ago was selected. Each woman was interviewed using a semistructured format and their interviews were transcribed verbatim. Thematic analysis of the transcript set and conceptual mapping were employed to formulate key themes. Findings: All women (mean age 52.6 years) resumed paid employment at various stages during their recovery, but reported similar transition processes. Three key themes representing this process were identified: primary motivation; influence through guidance and support; and resuming paid employment. Conclusions: Study findings revealed that these women required substantial support from family, friends and employers, with ongoing guidance from health professionals to return to paid work. The timeframes for their return varied and some modified their roles within the workforce to enable them to return to paid work. However, formal cardiac rehabilitation did not appear to have a significant impact on these participants decisions to return to work. They felt that more information about this decision may have been helpful if given at the time of cardiac rehabilitation.
The increasing burden of chronic conditions, shortages in the health care workforce and adverse health outcomes of socially marginalised and disadvantaged populations, challenge contemporary health care systems to provide acceptable, accessible, affordable, equitable and sustainable health care (World Health Organization, 2003). These epidemiological, social, economic and political factors, are driving health policy, practice and research from focussing predominantly on the secondary and tertiary care sectors to looking to the primary care setting for viable and sustainable solutions. Australian general practice has responded to this trend through a range of initiatives, including employing increasing numbers of nurses and developing their scope of practice (Pascoe, Foley, Hutchinson, Watts, Whitecross & Snowden, 2005). Currently in Australia, 60% of general practices employ a practice nurse indicating that they are primed to be a driving force in
Phillips, JL, Davidson, PM, Ollerton, R, Jackson, DE & Kristjanson, L 2007, 'A survey of commitment and compassion among nurses in residential aged care', International Journal of Palliative Nursing, vol. 13, no. 6, pp. 282-290.View/Download from: UTS OPUS or Publisher's site
To assess the views and attitudes of aged care staff providing direct care towards palliative care and to identify their learning needs. Design: Survey design using purposive sampling methods. Findings: Nurses and care assistants (n=222) employed within nine residential aged care facilities in regional Australia completed the survey. The majority had received on the job training and were committed to providing end-of-life care. Differences in the level of confidence to deal with patient/family interactions and manage complex palliative care scenarios were evident between nurses and care assistants (p<0.05). Both nurses and care assistants perceived a need for further education in symptom management and communication, yet their content need differed significantly between groups. Conclusions: Nurses and care assistants in residential aged care facilities demonstrate commitment to the delivery of palliative care and express a need for increased palliative care competencies. The heterogeneity of roles and educational preparation within the aged care workforce indicate that tailored palliative care education initiatives are required to meet the learning needs of aged care nurses and care assistants, particularly in relation to end-of-life care. These data have implications for skill-mix and model of care development.
In Australia, cardiovascular disease [CVD] remains the leading cause of death for both men and women and is also a msyor cause of disability (NSW Health 2006). The process of recovery following an acute cardiac event can impact on physical, social and psychological ac^ustment and factors such as returning to paid work. Heart disease occurs at a younger age for men than women and men have unique needs and concerns
Salamonson, Y, Everett, B, Andrew, S, Koch, J & Davidson, PM 2007, 'Differences in universal diverse orientation among nursing students in Australia', Nursing Outlook, vol. 55, no. 6, pp. 296-302.View/Download from: UTS OPUS
With globalization and intensified migration, an attitude of awareness and acceptance of both similarities and differences among peopleâknown as universal diverse orientation (UDO)âis a positive benefit that students may bring to a nursing program. Using a cross-sectional survey design, this study measured studentsâ UDO using the Miville-Guzman Universality-Diversity Scale-Short Form (M-GUDS-S). Among 816 nursing students, those born in a non-Englishâspeaking country had higher M-GUDS-S scores (P < 0.001), and those who spoke both English and non-English at home had consistently higher scores in all three M-GUDS-S subscales. However, those who never spoke English at home had low scores in the âComfort with Differencesâ subscale if they had lived in Australia for only a few years. Nursing students from a non-Englishâspeaking background could potentially enrich crosscultural educational experiences for all students, but students who have recently settled in Australia may need support to feel a sense of connectedness.
Salamonson, Y, Everett, B, Davidson, PM & Andrew, S 2007, 'Magnitude of change in cardiac health-enhancing behaviours 6 months following an acute myocardial infarction', European Journal of Cardiovascular Nursing, vol. 6, no. 1, pp. 66-71.View/Download from: UTS OPUS
Background: The adoption of health-enhancing behaviours is essential to reduce the likelihood of recurrent coronary events. Aims: This study assessed the magnitude of health behaviour change 6 months following a first acute myocardial infarction (AMI), and examined differences between cardiac rehabilitation attendees and non-attendees. Methods: One hundred and six first AMI patients (males n=76, Australian-born n=71) participated in a 6-month follow-up of a descriptive longitudinal survey. Data on non-smoking behaviour, weight normalisation, adequate physical activity, low dietary fat intake, medication adherence and cardiac rehabilitation attendance were collected. The magnitude of change in health-enhancing behaviours from baseline to follow-up was calculated. Results: Whilst there was an overall increase in health-enhancing behaviours at the 6-month follow-up (P<0.001), nonsmoking behaviour, low dietary fat intake and medication adherence were more likely to be achieved than adequate physical activity and weight normalisation. Attendees at cardiac rehabilitation were more likely to report positive lifestyle change (P=0.001) and feeling healthier (P=0.040) than non attendees. Conclusion: The wide variation in the adoption of health-enhancing behaviours at the 6-month follow-up suggested that participants were selective about which behaviours they changed. Cardiac rehabilitation personnel need to emphasise the importance of undertaking all health enhancing behaviours in order to maximise their multiplicative benefits.
Smith, L, Davidson, PM, Halcomb, E & Andrew, S 2007, 'Can lay responder defibrillation programmes improve survival to hospital discharge following an out-of-hospital cardiac arrest?', Australian Critical Care, vol. 20, no. 4, pp. 137-145.View/Download from: UTS OPUS
Introduction: The importance of early defibrillation in improving outcomes and reducing morbidity following out-of-hospital cardiac arrest underscores the importance of examining novel approaches to treatment access. The increasing evidence to support the importance of early defibrillation has increased attention on the potential for lay responders to deliver this therapy. Aim: This paper seeks to critically review the literature that evaluates the impact of lay responder defibrillator programs on survival to hospital discharge following an out-of-hospital cardiac arrest in the adult population. Method: The electronic databases, Medline and CINAHL, were searched using keywords including; first responder, lay responder, defibrillation and cardiac arrest. The reference lists of retrieved articles and the Internet were also searched. Articles were included in the review if they reported primary data, in the English language, which described the effect of a lay responder defibrillation program on survival to hospital discharge from out-of-hospital cardiac arrest in adults. Results: Eleven studies met the inclusion criteria. The small number of published studies, heterogeneity of study populations and study outcome methods prohibited formal meta-analysis. Therefore, narrative analysis was undertaken. Studies included in this report provided inconsistent findings in relation to survival to hospital discharge following out-of-hospital cardiac arrest. Conclusion: Although there are limited data, the role of the lay responder appears promising in improving the outcome from out-of-hospital cardiac arrest following early defibrillation. Despite the inherent methodological difficulties in studying this population, future research should address outcomes related to morbidity, mortality and cost-effectiveness.
Urlic, K, Davidson, PM & DiGiacomo, M 2007, 'Illness perceptions influence involvement in rehabilitation programs and adoption of lifestyle changes following acute myocardial infarction', Australian Occupational Therapy Journal, vol. 54, no. 4, pp. 318-319.View/Download from: UTS OPUS or Publisher's site
Research objective: To explore illness perceptions of women following acute myocardial infarction. Design: Qualitative. Setting: Three district general hospitals in south-east England. Participants: Purposive sample of 10 women who had been admitted and since discharged from one of the three hospitals in the study with acute myocardial infarction (AMI). They participated in the study 3 months after their AMI. Their ages ranged from 30 to 80 years with a mean of 72.
Halcomb, EJ & Davidson, PM 2006, 'Erratum: The role of practice nurses in an integrated model of cardiovascular disease management in Australian general practice (Australian Journal of Primary Health (August 2006) 12, 2 (37))', Australian Journal of Primary Health, vol. 12, no. 3, p. 126.
Berry, A & Davidson, PM 2006, 'Beyond comfort: oral hygiene as a critical nursing activity in the intensive care unit', Intensive and Critical Care Nursing, vol. 22, no. 6, pp. 318-328.View/Download from: UTS OPUS
Background: The role of oral hygiene in maintaining the health and well being of patients in the intensive care unit (ICU) is indisputable. This importance is not reflected in the body of research related to ICU practice. While a number of studies have examined oral hygiene practices in oncological patients there is significantly less attention devoted to these practices in the critically ill. Aim: This paper has two discrete yet interrelated aims. Firstly, in relation to current available evidence and based on a sound knowledge of oral physiology, identify barriers to effective oral hygiene and subsequent effectiveness of the most commonly used and recommended methods of providing oral hygiene in the critically ill population. Secondly, informed by the critical review, identify recommendations for practice and future intervention studies. Findings: To date, there is no definitive evidence to determine the most appropriate method of oral hygiene including the use of beneficial mouth rinses. Barriers identified in this review to providing optimal hygiene include: (1) mechanical barriers and equipment issues, (2) perceptions of the importance of mouth care and empathy with patient discomfort by nurses, (3) altered patient sensory perception and discomfort and (4) difficulties in patient communication. In spite of these challenges opportunities for collaborative research and increasing expertise in nurse researchers creates a climate to derive solutions to these factors. Conclusions: It is clearly evident from this review of oral hygiene practices in intensive care that the need for ongoing research is of paramount importance. ICU nurses undeniably require rigorous research studies in order to inform their practice in the provision of oral hygiene for critically ill patients.
Berry, A., Davidson, P.M., Masters, J. & Rolls, K. 2006, 'Towards a model for best practice for oral hygiene in ICU: a systematic review of the literature', Australian Critical Care, vol. 19, no. 4, pp. 154-154.
The high rate of cardiovascular morbidity and mortality among Indigenous Australians is of k ^ concern and demands novel aiid innovative strategies (Brown et al 2005). Aboriguial Healtli Workers (AHW) play a vital role in accessing communities in order to address cardiovascular risk factor modification
Davidson, PM, Elliott, D & Daly, J 2006, 'Clinical leadership in contemporary clinical practice: implications for nursing in Australia', Journal of Nursing Management, vol. 14, no. 3, pp. 180-187.View/Download from: UTS OPUS or Publisher's site
Leadership in the clinical practice environment is important to ensure both optimal patient outcomes and successive generations of motivated and enthusiastic clinicians. The present paper seeks to define and describe clinical leadership and identify the facilitators and barriers to clinical leadership. We also describe strategies to develop clinical leaders in Australia. Key drivers to the development of nursing leaders are strategies that recognize and value clinical expertise. These include models of care that highlight the importance of the nursing role; evidence-based practice and measurement of clinical outcomes; strategies to empower clinicians and mechanisms to ensure participation in clinical decision-making. Significant barriers to clinical leadership are organizational structures that preclude nurses from clinical decision making; the national shortage of nurses; fiscal constraints; absence of well evaluated models of care and trends towards less skilled clinicians. Systematic, strategic initiatives are required to nurture and develop clinical leaders. These strategies need to be collegial collaborations between the academic and health care sectors in order to provide a united voice for advancing the nursing profession.
Davidson, PM, Halcomb, E, Hickman, L, Phillips, JL & Graham, B 2006, 'Beyond the rhetoric: what do we mean by a model of care?', Australian Journal of Advanced Nursing, vol. 23, no. 3, pp. 47-55.View/Download from: UTS OPUS
This paper aims to define what is meant by the term 'model of care' and document the pragmatic systems and processes necessary to develop, plan, implement and evaluate novel models of care delivery.
Cardiovascular disease (CVD) is the leading cause of death in the AiLstralian Indigenous population (ABS and AIHW 2001). Unfortunately, Australian Aboriginals have not benefited from the reductions in CVD seen in other sectors of the population
Fernandez, R, Griffiths, R, Juergens, C, Davidson, PM & Salamonson, Y 2006, 'Persistence of coronary risk factor status in participants 12 to 18 months after percutaneous coronary intervention', Journal of Cardiovascular Nursing, vol. 21, no. 5, pp. 379-387.View/Download from: UTS OPUS or Publisher's site
Background: Percutaneous coronary intervention (PCI) is a widely performed revascularization technique for coronary heart disease; however, there is limited research investigating the risk factor status of patients 1 year after the procedure. Objective: This cross-sectional study was conducted to investigate the self-reported risk factor status by patients who had undergone a PCI at a major teaching hospital in Sydney, Australia. Subjects: Two hundred seventy participants who underwent PCI between April 2003 and March 2004 and who met the inclusion criteria were followed up 1 year after the PCI. Methods: After obtaining informed consent, a follow-up self-administered questionnaire was mailed to participants. Information was collected relating to the following coronary risk factors: smoking, and physical activity status, blood pressure and cholesterol levels, body mass index, depression, anxiety, and stress levels.
Verbatim transcription of interview data has become a common data management strategy in nursing research and is widely considered to be integral to the analysis and interpretation of verbal data. As the benefits of verbal data are becoming more widely embraced in health care research, interviews are being increasingly used to collect information for a wide range of purposes. In addition to purely qualitative investigations, there has been a significant increase in the conduct of mixed-method inquiries. This article examines the issues surrounding the conduct of interviews in mixed-method research, with particular emphasis on the transcription and data analysis phases of data management. It also debates on the necessity to transcribe all audio recorded interview data verbatim, particularly in relation to mixed-method investigations. Finally, it provides an alternative method to verbatim transcription of managing audiorecorded interview data.
Halcomb, E & Davidson, PM 2006, 'The role of practice nurses in an integrated model of cardiovascular disease management in Australian general practice', Australian Journal of Primary Health, vol. 12, no. 2, pp. 34-44.View/Download from: UTS OPUS
While various models of chronic disease management have been developed and evaluated, minimal data is available relating specifically to Australian general practice and, in particular; the role of the nurse within the multidisciplinary general practice team. This paper presents a multidisciplinary model of cardio vascular disease management, focused on Australian general practice, and identifies barriers and facilitators to its implementation. This model was developed from data arising from a series of investigations that (1) examined the epidemiology and current general practice management of cardiovascular disease (2) explored the demographics and role of the pmctice nurse, and (3) established strategic recommendations for future practice development. The model proposes an integrated and multidisciplinary cardiovascular disease management framework to inform policy-makers and health planners in the development of primary health services in Australian general practice.
Aim. This paper describes the evolution of Australian practice nursing and documents seminal events in crystallizing the importance of the nursing role in general practice. Background. Internationally, the potential for nurses to improve health in primary care settings is acknowledged. The general practice setting is a focal point for primary care in many health systems. Despite the important role played in the delivery of primary health care by nurses working in general practice in the United Kingdom and New Zealand, the role of nurses in Australian general practice is much less clearly defined, as reflected by the paucity of research and scholarship in this area. Fuelled by the increasing challenges of workforce shortages and the increasing need for multidisciplinary care, interest in the developing role of the Australian practice nurse among clinicians, researchers and policy makers is increasing. Discussion. Australian practice nursing has reached a critical point in its evolution. It is imperative for the promotion of nursing in general practice that knowledge from descriptive, exploratory research be used to inform strategic decision-making in terms of professional development issues, policy, research and scholarship. These data also need to inform systematic outcome studies. To date, the embryonic nature of practice nursing as a discrete professional entity in Australia has inhibited its representation in nursing curricula and professional bodies. Conclusion. In order to advance the Australian practice nurse movement and demonstrate its important contribution to primary health care, nurses need to take the lead in strategic planning of this emerging specialty. As well as leadership from an academic, research and policy perspective, clinical leaders need to be fostered among the ranks of practice nurse clinicians to drive clinical practice development and the delivery of evidence-based primary care.
Hancock, K, Chang, E, Johnson, A, Harrison, K, Daly, J, Easterbrook, S, Noel, M, Luhr-Taylor, M & Davidson, PM 2006, 'Palliative care for people with advanced dementia: Illuminating evidence-based practice needs', Alzheimer's Care Quarterly, vol. 7, no. 1, pp. 49-57.View/Download from: UTS OPUS
AB The aims of this article are to (1) identify the barriers associated with palliative care for persons with advanced dementia, (2) argue the need for increased collaboration and partnerships between aged care and palliative key providers, and (3) discuss the need for the development and evaluation of evidence-based guidelines for care. Studies addressing these issues are discussed. A key finding of the material reviewed for this article underscores the importance of the development, implementation, and evaluation of guidelines that are empirically based, developed collaboratively, and incorporated into models of care for people with advanced dementia
Krum, H, Jelinek, MV, Stewart, S, Sindone, A, Atherton, JJ, Hawkes, AL & CHF Guidelines Core Writers 2006, 'Guidelines for the prevention, detection and management of people with chronic heart failure in Australia 2006.', The Medical journal of Australia, vol. 185, no. 10, pp. 549-557.
Chronic heart failure (CHF) is found in 1.5%-2.0% of Australians. Considered rare in people aged less than 45 years, its prevalence increases to over 10% in people aged >/= 65 years. CHF is one of the most common reasons for hospital admission and general practitioner consultation in the elderly (>/= 70 years). Common causes of CHF are ischaemic heart disease (present in > 50% of new cases), hypertension (about two-thirds of cases) and idiopathic dilated cardiomyopathy (around 5%-10% of cases). Diagnosis is based on clinical features, chest x-ray and objective measurement of ventricular function (eg, echocardiography). Plasma levels of B-type natriuretic peptide (BNP) may have a role in diagnosis, primarily as a test for exclusion. Diagnosis may be strengthened by a beneficial clinical response to treatment(s) directed towards amelioration of symptoms. Management involves prevention, early detection, amelioration of disease progression, relief of symptoms, minimisation of exacerbations, and prolongation of survival.
Newton, PJ, Davidson, PM, Halcomb, E, Denniss, AR & Westgarth, F 2006, 'An introduction to the collaborative methodology and its potential use for the management of heart failure', Journal of Cardiovascular Nursing, vol. 21, no. 3, pp. 161-168.View/Download from: UTS OPUS or Publisher's site
Background: Heart failure (HF) is responsible for significant disease burden in developed countries internationally. Despite significant advances and a strong evidence base in therapies and treatment strategies for HF, access to these therapies continues to remain elusive to a significant proportion of the HF population. The reasons for this are multifactorial and range from the financial cost of treatments to the individual attitudes and beliefs of clinicians. The collaborative methodology, based upon a quality improvement philosophy, has been identified as a potentially useful tool to address this treatment gap. Aim: In this manuscript, we review the published literature on the collaborative methodology and assess the evidence for achieving improvement in the management of HF. Methods: Searches of electronic databases, the reference lists of published materials, policy documents, and the Internet were conducted using key words including collaborative methodology, breakthrough series,quality improvement,total quality improvement, and heart failure. Because of the paucity of high-level evidence, all English-language articles were included in the review. Results: On the basis of the identified search strategy, 43 articles were retrieved. Key themes that emerged from the literature included the following: (1) The collaborative methodology has a significant potential to reduce the treatment gap. (2) Leadership is an important characteristic of the collaborative method. (3) The collaborative methodology facilitates sustainability of the quality improvement process. Conclusion: The collaborative methodology, when implemented and conducted according to key conceptual principles, has significant potential to improve the outcomes of patients, particularly those with HF and chronic cardiovascular disease.
Newton, PJ, Davidson, PM, Halcomb, E, Denniss, R & Westgarth, F 2006, 'An introduction to the collaborative methodology and its potential use for the management of heart failure', Journal of Cardiovascular Nursing, vol. 21, no. 3, pp. 161-168.View/Download from: UTS OPUS
Background: Heart failure (HF) is responsible for significant disease burden in developed countries internationally. Despite significant advances and a strong evidence base in therapies and treatment strategies for HF, access to these therapies continues to remain elusive to a significant proportion of the HF population. The reasons for this are multifactorial and range from the financial cost of treatments to the individual attitudes and beliefs of clinicians. The collaborative methodology, based upon a quality improvement philosophy, has been identified as a potentially useful tool to address this treatment gap. Aim: In this manuscript, we review the published literature on the collaborative methodology and assess the evidence for achieving improvement in the management of HF. Methods: Searches of electronic databases, the reference lists of published materials, policy documents, and the Internet were conducted using key words including "collaborative methodology," "breakthrough series," "quality improvement," "total quality improvement," and "heart failure." Because of the paucity of high-level evidence, all English-language articles were included in the review.
Phillips, JL, Davidson, PM, Jackson, DE, Kristjanson, L, Bennett, M & Daly, J 2006, 'Enhancing palliative care delivery in a regional community in Australia', Australian Health Review, vol. 30, no. 3, pp. 370-379.View/Download from: UTS OPUS
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.
Phillips, JL, Davidson, PM, Jackson, DE, Kristjanson, L, Daly, J & Curran, J 2006, 'Residential aged care: The last frontier for palliative care', Journal Of Advanced Nursing, vol. 55, no. 4, pp. 416-424.View/Download from: UTS OPUS or Publisher's site
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.
Salamonson, Y, van Heere, B, Everett, B & Davidson, PM 2006, 'Voices from the floor: Nurses' perceptions of the medical emergency team', Intensive and Critical Care Nursing, vol. 22, no. 3, pp. 138-143.View/Download from: UTS OPUS
Nurses are the main group of clinicians who activate the medical emergency team (MET), placing them in an excellent position to provide valuable insights regarding the effectiveness of this system. This descriptive study aimed to explore nurses satisfaction with the MET, perceived benefits and suggestions for improvement. The study also sought to examine the characteristics of nurses who were more likely to activate the MET. Using a survey design, descriptive statistics as well as content analysis were used to analyse the data. Seventy-three nurses (79% response rate) returned their completed surveys. A positive and significant relationship was found between years of nursing experience and MET activation (p = 0.018). Overall, nurses were satisfied with the MET, with suggestions for improvement including more education on medical emergencies for both ward and MET staff. Whilst the MET system is meeting the expectations of the majority of ward nurses, there is room for improvement, which includes a more positive attitude of the MET when summoned for borderline cases. Investment in ongoing education of clinicians and interdisciplinary communication is likely to encourage less experienced nurses to utilise this system, whilst decreasing the reticence of some nurses to call the MET.
Yallop, J., Chan, B., Piterman, L., Tonkin, A., Forbes, A., Davidson, P.M., Halcomb, E., Clark, R., Nangle, A., Stewart, S., Croucher, J. & Krum, H. 2006, 'The Chronic Heart-failure Assistance by Telephone (CHAT) Study:Assessment of telephone support for vulnerable patients with chronic disease', Asia Pacific Family Medicine, vol. 2006, no. 5, pp. 30-39.View/Download from: UTS OPUS
Aim: To determine whether telephone support using an evidence-based protocol for chronic heart failure (CHF) management will improve patient outcomes and will reduce hospital readmission rates in patients without access to hospital-based management programs. Methods: The rationale and protocol for a cluster-design randomised controlled trial (RCT) of a semi-automated telephone intervention for the management of CHF, the Chronic Heart-failure Assistance by Telephone (CHAT) Study is described. Care is coordinated by trained cardiac nurses located in Heartline, the national call center of the National Heart Foundation of Australia in partnership with patients general practitioners (GPs). Conclusions: The CHAT Study model represents a potentially cost-effective and accessible model for the Australian health system in caring for CHF patients in rural and remote areas. The system of care could also be readily adapted for a range of chronic diseases and health systems.
Chang, E, Hancock, K, Harrison, K, Daly, J, Johnson, A, Easterbrook, S, Noel, M, Luhr-Taylor, M & Davidson, PM 2005, 'Palliative care for end-stage dementia: A discussion of the implications for education of health care professionals', Nurse Education Today, vol. 25, no. 4, pp. 326-332.View/Download from: UTS OPUS or Publisher's site
The increasing burden of chronic disease demands that palliative care clinicians address the needs of patients with non-malignant disease. This discussion document seeks to address some of the challenges to providing palliative care for end-stage dementia (ESD) and the need for skill enhancement in key providers of care. In spite of the intent, there is an apparent lack of appropriate, co-ordinated and comprehensive palliative care available for these individuals and their families. There is an absence of well-articulated models to assist health care providers of ESD clients. It would appear that the development and evaluation of guidelines, implementation of education programs and collaborative associations between palliative and aged-care providers of care are key strategies to facilitate palliative care for ESD clients.
Davidson, P.M. 2005, 'Caring, coordination and communication: the challenge to write about it!', Transplant Nurses Journal, vol. 4, no. 2, pp. 4-5.
Davidson, PM, Paull, G, Rees, D, Daly, J & Cockburn, J 2005, 'Activities of home-based heart failure nurse specialists: A modified narrative analysis', American Journal Of Critical Care, vol. 14, no. 5, pp. 426-433.View/Download from: UTS OPUS
Background Heart failure nurse specialists strive to optimize patients outcomes in home-based settings. Objective To document the activities of home-based heart failure nurse specialists. Method A modified narrative analysis of clinical notes of home-based heart failure nurse specialists during a 12-month period was used. Results Data analysis revealed 7 key activities of home-based heart failure nurse specialists: (1) monitoring signs and symptoms and reinforcing patients self-management: identifying trends and appropriate action; (2) organization, liaison, and consultation with other health professionals to deal with changes in clinical status; (3) clarifying and reinforcing patients self-care strategies; (4) assisting patients in their desire to avoid institutionalized care; (5) identifying patients psychosocial issues: dealing with social isolation; (6) providing support: journeying with patients and patients families; and (7) helping patients and patients families deal with death and dying. Conclusions A major proportion of the activities of home-based heart failure nurse specialists are related to facilitating communication between health professionals and providing information and support to patients and patients families.
Davidson, PM, Worrall-Carter, L, Finn, J & Stewart, S 2005, 'Beyond competition: a new paradigm for collaborative cardiovascular research in Australia', European Journal of Cardiovascular Nursing, vol. 4, no. 3, pp. 181-182.View/Download from: Publisher's site
Traditionally, health-based research has been confined within boundaries arbitrarily defined by the range of disciplines that combine their skills and knowledge to address health care needs. Furthermore, health research is usually conducted in academic institutions that promote competition and individualism in order to both protect research-derived funding and sustain a culture of survival of the fittest. Not surprisingly, cardiovascular disease and its successful management involve a complex interplay of biological, psychological, sociological and economic determinants that defy the one dimensional approach that typifies traditional health-based research. A range of political and health system-related variables also mediate outcomes of cardiovascular disease. In order to truly improve cardiovascular-related health outcomes cardiovascular nurses have to interface with, and operate within, each of these dimensions. It is within this context that, cardiovascular nurses have risen to the complex challenges imposed by a growing epidemic of cardiovascular disease within our ageing population. Not only have they been leaders in undertaking collaborative, interdisciplinary research projects  but, with none of the resources and funding available to commercially attractive medical research, have established truly collaborative networks that lay the foundation for multi-site research at national and international levels .
This paper seeks to highlight the utility of the Corbin and Strauss Chronic Illness Trajectory Framework in describing recovery from traumatic injury and encourages consideration of its implementation into contemporary trauma nursing (Corbin and Strauss, 1991; 1992).To date, few such frameworks have been proposed to sensitize health professionals to the path of recovery following traumatic injury. Although this framework was initially conceived for use in the domain of chronic illness, the lasting effects of severe traumatic injury have significant parallels to chronic conditions such as stroke (Burton, 2000) and multiple sclerosis (Miller, 1993) to which the framework has previously been applied.This paper demonstrates the Trajectory Framework as a useful structure to potentially enhance the development of post-discharge interventions for trauma survivors and encourages consideration of its implementation into the nursing management of this complex patient group.
Halcomb, E, Daly, J, Davidson, PM, Elliott, D & Griffiths, R 2005, 'Life beyond severe traumatic injury: an integrative review of the literature', Australian Critical Care, vol. 18, no. 1, pp. 17-23.View/Download from: UTS OPUS or Publisher's site
It is only recently that recognition of the serious and debilitating sequelae of trauma has prompted exploration of outcomes beyond survival, such as disability, health status and quality of life. This paper aims to review the literature describing outcomes following severe traumatic injury to provide clinicians with a greater understanding of the recovery trajectory following severe trauma and highlight the issues faced by those recovering from such injury. Electronic databases, published reference lists and the Internet were searched to identify relevant literature. The heterogeneous nature of published literature in this area prohibited a systematic approach to inclusion of papers in this review. Trauma survivors report significant sequelae that influence functional status, psychological wellbeing, quality of life and return to productivity following severe injury. Key themes that emerge from the review include: current trauma systems which provide inadequate support along the recovery trajectory; rehabilitation referral which is affected by geographical location and provider preferences; a long-term loss of productivity in both society and the workplace; a high incidence of psychological sequelae; a link between poor recovery and increased drug and alcohol consumption; and valued social support which can augment recovery. Future research to evaluate interventions which target the recovery needs of the severely injured patients is recommended. Particular emphasis is required to develop systematic, sustainable and cost-effective follow-up to augment the successes of existing acute trauma services in providing high quality acute resuscitation and definitive trauma management.
Halcomb, E, Davidson, PM, Daly, J, Griffiths, R, Yallop, J & Tofler, G 2005, 'Nursing in Australian general practice: directions and perspectives', Australian Health Review, vol. 29, no. 2, pp. 156-166.View/Download from: UTS OPUS
Primary health care services, such as general practices, are the first point of contact for many Australian health care consumers. Until recently, the role of nursing in Australian primary care was poorly defined and described in the literature. Changes in policy and funding have given rise to an expansion of the nursing role in primary care. This paper provides a review of the literature and seeks to identify the barriers and facilitators to implementation of the practice nurse role in Australia and identifies strategic directions for future research and poiicy development.
Hancock, K, Davidson, PM, Daly, J, Webber, D & Chang, E 2005, 'An exploration of the usefulness of motivational interviewing in facilitating secondary prevention gains in cardiac rehabilitation.', Journal of cardiopulmonary rehabilitation, vol. 25, no. 4, pp. 200-206.View/Download from: Publisher's site
Motivational interviewing is a client-centered, directive counseling approach aimed at promoting motivation in clients to change certain behaviors. Its effect is to reduce defensiveness and promote disclosure, engagement, and participation, thereby motivating the client to make behavioral changes. Motivational interviewing marries well with the principles of cardiac rehabilitation (CR) in terms of increasing motivation among CR clients, promoting a client-centered approach and in the cost- and time-effective practices of CR. Very little research has been conducted examining the effectiveness of motivational interviewing in enhancing CR outcomes. This article discusses research that has been conducted in motivational interviewing that relates to the components of CR, provides examples of how motivational interviewing can be applied to CR, and recommends further exploration, development, and investigation of the usefulness of motivational interviewing in the field of CR.
Hancock, K., Davidson, P.M., Daly, J., Weber, D. & Chang, E. 2005, 'An exploration of the usefulness of motivational interviewing in facilitating secondary prevention gains in cardiac rehabilitation', Journal of Cardiopulmonary Rehabilitation and Prevention, vol. 25, no. 1, pp. 200-206.View/Download from: UTS OPUS
Motivational interviewing is a client-centered, directive counseling approach aimed at promoting motivation in clients to change certain behaviors. Its effect is to reduce defensiveness and promote disclosure, engagement, and participation, thereby motivating the client to make behavioral changes. Motivational interviewing marries well with the principles of cardiac rehabilitation (CR) in terms of increasing motivation among CR clients, promoting a client-centered approach and in the cost- and time-effective practices of CR. Very little research has been conducted examining the effectiveness of motivational interviewing in enhancing CR outcomes.
Ketefian, S, Davidson, P, Daly, J, Chang, E & Srisuphan, W 2005, 'Issues and challenges in international doctoral education in nursing.', Nursing & health sciences, vol. 7, no. 3, pp. 150-156.View/Download from: Publisher's site
Education is a driving force in improving the health and welfare of communities globally. Doctoral education of nurses has been identified as a critical factor for provision of leadership in practice, scholarship, research, policy and education. Since the genesis of doctoral education in nursing in the USA in the 1930s, this movement has burgeoned to over 273 doctoral programs in over 30 countries globally. The present article seeks to identify the issues and challenges in nursing doctoral education globally, and those encountered by doctoral program graduates in meeting the challenges of contemporary health care systems. Information was derived from a comprehensive literature review. Electronic databases and the Internet, using the Google search engine, were searched using the key words "doctoral education"; "nursing"; "International Network for Doctoral Education in Nursing"; "global health"; "international research collaboration". Doctoral education has been a critical force in developing nurse leaders in education, management, policy and research domains. An absence of consensus in terminology and of accurate minimum data sets precludes comparison and debate across programs. The complexity and dynamism of contemporary globalized communities render significant challenges in the conduct of doctoral programs. Addressing funding issues and faculty shortages are key issues for doctoral programs, especially those in developing countries, to achieve an identity uniquely their own. These challenges can also afford considerable opportunities for discussion, debate and the formulation of innovative and collaborative solutions to advance nursing knowledge and scholarship. In spite of discrete differences between countries and regions, the similarities in the issues facing the development of doctoral programs internationally are more striking than the differences. The harnessing of a global collective to address these issues will likely serve to not only forge the future...
Ketefian, S., Davidson, P.M., Daly, J., Chang, E. & Srisuphan, W. 2005, 'Issues and challenges in international doctoral education in nursing (solicited paper)', Nursing and Health Sciences, vol. 7, no. 3, pp. 150-156.View/Download from: UTS OPUS
Education is a driving force in improving the health and welfare of communities globally. Doctoral education of nurses has been identified as a critical factor for provision of leadership in practice, scholarship, research, policy and education. Since the genesis of doctoral education in nursing in the USA in the 1930s, this movement has burgeoned to over 273 doctoral programs in over 30 countries globally. The present article seeks to identify the issues and challenges in nursing doctoral education globally, and those encountered by doctoral program graduates in meeting the challenges of contemporary health care systems. Information was derived from a comprehensive literature review. Electronic databases and the Internet, using the Google search engine, were searched using the key words 'doctoral education'; 'nursing'; 'International Network for Doctoral Education in Nursing'; 'global health'; 'international research collaboration'. Doctoral education has been a critical force in developing nurse leaders in education, management, policy and research domains. An absence of consensus in terminology and of accurate minimum data sets precludes comparison and debate across programs. The complexity and dynamism of contemporary globalized communities render significant challenges in the conduct of doctoral programs. Addressing funding issues and faculty shortages are key issues for doctoral programs, especially those in developing countries, to achieve an identity uniquely their own
McKinley, S.M., Dracup, K., Moser, D., Aitken, L.M., Baker, H., Davidson, P.M. & Marshall, A.P. 2005, 'The Association Of Anxiety, Depression And Hostility With Acute Coronary Syndrome Events', Circulation, vol. 112, no. 17, pp. 1-1.
Mott, B, Zarb, N, Nolan, J, Arnison, V, Chan, R, Jenkins, B, Ulrych, G, Blackburn, C, Codner, T, Glandfield, L, Halcomb, E & Davidson, PM 2005, 'Clinical nurses knowledge of evidence based practice: Constructing a framework to evaluate a mulitfaceted intervention for implementing EBP', Contemporary Nurse, vol. 19, no. 1, pp. 96-104.View/Download from: UTS OPUS
Critical reflection upon nursing practice is pivotal in achieving optimal patient outcomes. Implicit in this statement is knowledge about and an understanding of the implementation of evidence-based practice (EBP). This study sought to evaluate baseline knowledge in order to assess and inform a multifaceted intervention to promote EBP in a multi-site facility in Western Sydney, Australia. On two consecutive days in February 2003, a convenience sample of 229 nurses were surveyed using a five-item, investigator developed, written survey tool. Data were analysed using descriptive statistics. Although the majority of respondents (n=143: 62%) stated that they were aware of EBP, a considerable number (n=86: 38%) stated they had not previously heard of the term. Of concern, 43% (n=99) of respondents were unable to identify a source of information and resources about EBP. The results of this observational, descriptive survey underscore the importance of ongoing strategic interventions to improve knowledge, access and implementation of EBP amongst clinical nurses. This study also provides baseline data upon which to evaluate local interventions to promote knowledge of EBP amongst clinicians.
Ulrych, G, Blackburn, C, Glanfield, L, Halcomb, E & Davidson, PM 2005, 'Clinical nurses' knowledge of evidence-based practice: constructing a framework to evaluate a multifaceted intervention for implementing EBP.', Contemporary nurse : a journal for the Australian nursing profession, vol. 19, no. 1-2, pp. 96-104.
Critical reflection upon nursing practice is pivotal in achieving optimal patient outcomes. Implicit in this statement is knowledge about and an understanding of the implementation of evidence-based practice (EBP). This study sought to evaluate baseline knowledge in order to assess and inform a multifaceted intervention to promote EBP in a multi-site facility in Western Sydney, Australia. On two consecutive days in February 2003, a convenience sample of 229 nurses were surveyed using a five-item, investigator developed, written survey tool. Data were analysed using descriptive statistics. Although the majority of respondents (n = 143: 62%) stated that they were aware of EBP, a considerable number (n = 86: 38%) stated they had not previously heard of the term. Of concern, 43% (n = 99) of respondents were unable to identify a source of information and resources about EBP. The results of this observational, descriptive survey underscore the importance of ongoing strategic interventions to improve knowledge, access and implementation of EBP amongst clinical nurses. This study also provides baseline data upon which to evaluate local interventions to promote knowledge of EBP amongst clinicians.
Davidson, PM, Cockburn, J, Daly, J & Sanson-Fisher, R 2004, 'Patient-centered needs assessment: Rationale for a psychometric measure for assessing needs in heart failure', Journal of Cardiovascular Nursing, vol. 19, no. 3, pp. 164-171.View/Download from: UTS OPUS
Determining an individual's unique perspective of an illness experience remains a challenge for clinicians, administrators, and researchers. A range of concepts and psychometric measures have been developed and evaluated to capture this information. These include patient satisfaction, quality of life, and utility measures. Needs assessment as a tool for evaluating perceptions of health status and determining patient satisfaction and treatment plans has been explored in oncology. Studies have demonstrated that a high proportion of patients have unmet needs in relation to activities of daily living, information sources, and comfort. Heart failure (HF), a condition with significant individual and societal burden, mirrors the illness of experience of cancer, as individuals process issues related to prognosis, treatment regimens, and decreased functional status. A needs-based assessment of health status, expectations, and perceptions is patient-centered and has the capacity to not only evaluate current health status but also plan and project care plans.
Davidson, PM, Daly, J & Hancock, K 2004, 'Community health nursing in Australia: a critical literature review and implications for professional development.', Contemporary Nurse, vol. 16, no. 3, pp. 195-207.View/Download from: UTS OPUS
BACKGROUND: Increasing emphasis on community-based mandates an examination of the community health nurse (CHN). AIM: A critical literature review of the CHN role internationally, with an emphasis on Australia, was undertaken in order to understand historical precedents and inform policy and strategic directions for the CHN. METHOD: A search of the CINAHL, EMBASE, and COCHRANE electronic data-bases from 1982 to June 2002 using community' and 'nursing' as key words and hand searching of books and government reports was undertaken. FINDINGS: This search strategy revealed a lack of literature compared with other areas of nursing. Key themes emerging from this review are: (1) an absence of clear role definitions and lack of clarity of roles; (2) variability in educational requirements for CHNs; (3) diminished CHN power in policy decision making; (3) conflicting role expectations between different facets of the health care system; (4) underutilisation and untapped potential of the role of the CHN in the contemporary health care system; (5) the emerging influence of specialist nurses in community based-care; (6) uptake of traditional nursing roles by non-nurses and (7) an absence of a cohesive model of professional development of CHN that is able to articulate with contemporary social, political and economic trends in health care delivery.
Davidson, PM, Macdonald, P, Ang, E, Paull, G, Choucair, S, Daly, J, Moser, D & Dracup, K 2004, 'A case for consideration of cultural diversity in heart failure management - part 1: rationale for the DISCOVER Study.', Contemporary Nurse, vol. 17, no. 3, pp. 204-210.View/Download from: UTS OPUS
Heart failure is a condition increasing in prevalence and responsible for high health care utilisation, morbidity and mortality. Randomised controlled trials of nurse-coordinated interventions have determined self care and the incorporation of the patient and their family in care planning as critical elements of service delivery. Coping with a chronic illness, such as heart failure, forces the individual to adjust to changed physical, social and emotional functioning and to modify their lifestyle according. Clinicians increasingly use models of care that focus care delivery on the community setting. In order to develop strategies to assist patients and their families with self care it is important that clinicians understand the healthcare seeking behaviours of all individuals targeted in the community. Australia is a culturally diverse nation, yet evaluations of models of care have been undertaken largely in individuals from predominately Anglo-Celtic origins. The end result of this approach is failure to understand the full range of diverse perspectives that individuals hold that can have an impact on self care behaviours. Consideration of cultural diversity should extend beyond language to a broader appreciation of cultural values, health seeking beliefs and engagement of culturally unique communities.
Davidson, PM, Paull, G, Introna, K, Cockburn, J, Davis, JM, Rees, D, Gorman, D, Magann, L, Lafferty, M & Dracup, K 2004, 'Integrated, collaborative palliative care in heart failure: the St. George Heart Failure Service experience 1999-2002.', The Journal of cardiovascular nursing, vol. 19, no. 1, pp. 68-75.View/Download from: Publisher's site
BACKGROUND: Chronic heart failure (HF) is the only heart condition increasing in prevalence and is primarily a condition of aging. This condition has outcomes worse than many cancers; however, patients are often denied the benefits of palliative care with its important emphasis on symptom management, spirituality, and emotional health and focus on family issues. AIM: To describe the development of a model of an integrated, consultative, palliative care approach within a comprehensive HF community-focussed disease management program. METHOD: A collaborative model was developed following a systematic needs assessment and documentation of local resources. Principles underpinning this model were based upon fostering of communication, consultancy, and skill development. Within this model a health care system, based upon universal coverage, supported co-management of patients and their families. The place of death, level of social support available at home, and degree of palliative care involvement was documented in 121 consecutive deaths from 1999-2002. FINDINGS: Following a period of skill sharing and program development, only 8.3% of HF patients in the collaborative program required specialized palliative care intervention for complex symptom management, carer support, and issues related to spirituality. Twenty percent of this cohort died in nursing homes underscoring the importance of supporting our nursing colleagues in this setting. CONCLUSIONS: In spite of well-documented difficulties in determining prognosis, it is the St George experience that key principles of a palliative care strategy can be implemented in a HF disease management program with support and consultancy from expert palliative care services.
Davidson, PM, Rees, D, Brighton, T, Enis, J, McCrohon, J, Elliott, D, Cockburn, J, Paull, G & Daly, J 2004, 'Non-valvular atrial fibrillation and stroke: implications for nursing practice and therapeutics', Australian Critical Care, vol. 17, pp. 65-73.View/Download from: UTS OPUS or Publisher's site
Atrial fibrillation (AF) is the most common sustained cardiac rhythm disturbance and is increasing in prevalence due to the ageing of the population, and rates of chronic heart failure. Haemodynamic compromise and thromboembolic events are responsible for significant morbidity and mortality in Australian communities. Non-valvular AF is a significant predictor for both a higher incidence of stroke and increased mortality. Stroke affects approximately 40,000 Australians every year and is Australia's third largest killer after cancer and heart disease. The burden of illness associated with AF, the potential to decrease the risk of stroke and other embolic events by thromboprophylaxis and the implications of this strategy for nursing care and patient education, determine AF as a critical element of nursing practice and research. A review of the literature was undertaken of the CINAHL, Medline, EMBASE and Cochrane Databases from 1966 until September 2002 focussing on management of atrial fibrillation to prevent thrombotic events. This review article presents key elements of this literature review and the implications for nursing practice.
Dracup, K, McKinley, SM, Doering, L, Riegel, BJ, Davidson, PM, Meischke, H & Pelter, M 2004, 'What Do Cardiac Patients Know About Heart Attack Symptoms?', Circulation, vol. 110, no. 17, pp. 663-664.
Halcomb, E, Daly, J, Jackson, DE & Davidson, PM 2004, 'An insight into Australian nurses' experience of withdrawal/withholding of treatment in the ICU', Intensive and Critical Care Nursing, vol. 20, no. 4, pp. 214-222.View/Download from: UTS OPUS
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) nursefamily 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
Halcomb, E, Davidson, PM, Daly, J, Yallop, J & Tofler, G 2004, 'Australian nurses in general practice based heart failure management: Implications for innovative collaborative practice', European Journal of Cardiovascular Nursing, vol. 3, no. 2, pp. 135-147.View/Download from: UTS OPUS
The growing global burden of heart failure (HF) necessitates the investigation of alternative methods of providing co-ordinated, integrated and client-focused primary care. Currently, the models of nurse-coordinated care demonstrated to be effective in randomized controlled trials are only available to a relative minority of clients and their families with HF. This current gap in service provision could prove fertile ground for the expansion of practice nursing [The Nurse in Family Practice: Practice Nurses and Nurse Practitioners in primary health care. 1988, Scutari Press, London: Impact of rural living on the experience of chronic illness. Australian Journal of Rural Health, 2001. 9: 235240]. Aim: This paper aims to review the published literature describing the current and potential role of the practice nurse in HF management in Australia. Methods: Searches of electronic databases, the reference lists of published materials and the internet were conducted using key words including `Australia, `practice nurse, `office nurse, `nurs*, `heart failure, `cardiac and `chronic illness. Inclusion criteria for this review were English language literature; nursing interventions for heart failure (HF) and the role of practice nurses in primary care.
Lambert, V, Lambert, CE, Daly, J, Davidson, PM, Kunaviktikul, W & Shin, KR 2004, 'Nursing education on women's health care in Australia, Japan, South Korea and Thailand', Journal of Transcultural Nursing, vol. 15, no. 1, pp. 44-53.View/Download from: UTS OPUS
Only within the last 3 decades have a select number of countries addressed issues surrounding the all-inclusive health and well-being of women. This factor has had a major influence on nursing education within these countries and the subsequent development of curricula. Because the preparation of nurses is pivotal in shaping a societys health care agenda, this article compares and contrasts demographic characteristics, curricular frameworks, the role of the nurse, quality control of nursing curricula, and the focus of nursing courses related to womens health care among the countries of Australia, Japan, South Korea, and Thailand. Recommendations based on infant mortality rates, life expectancy, leading causes of death, and country-based health care issues are provided to inform and guide the future focus of nursing education courses on womens healthcare within these countries.
Winn, RD, Laura, S, Douglas, C, Davidson, P & Gani, JS 2004, 'Protocol-based approach to suspected appendicitis, incorporating the Alvarado score and outpatient antibiotics.', ANZ journal of surgery, vol. 74, no. 5, pp. 324-329.View/Download from: Publisher's site
BACKGROUND: There is evidence that antibiotics can be used as primary treatment for appendicitis, however, delayed surgical treatment might still be associated with perforation. Most patients at risk of perforation have high Alvarado scores. We designed a protocol-based approach to suspected appendicitis, in which the Alvarado score was used to select patients for early treatment with surgery or outpatient antibiotics. METHODS: Patients included in the present study were adults and children referred to the surgical service at John Hunter Hospital (Newcastle, Australia) with suspected appendicitis in the 12 months from July 2000. Treatment groups: no treatment (Alvarado score 1-4); antibiotics alone (Alvarado 5-7); early surgery (Alvarado 8-10). OUTCOME MEASURES: time to operation; duration of hospital stay; non-therapeutic operations; delayed treatment in association with perforation; recurrent appendicitis (for those treated with antibiotics). Comparison group: 142 patients managed with 'best clinical practice' as part of an earlier trial. RESULTS: One hundred and twenty-two patients were enrolled. Median time to operation was 3.9 h (comparison group 7.3 h, P = 0.014). Median length of stay was 38.5 h (comparison group 44.2 h, P = 0.041). There were two cases of delayed treatment in association with perforation (2/122 = 1.6%, comparison group 2/142 = 1.4%, P = 0.88) and 10 non-therapeutic operations (10/122 = 8.1%, comparison group 15/142 = 10.6%, P = 0.51). Of those whose initial illness was treated successfully with antibiotics, 2/42 (4.8%) subsequently required appendicectomy. CONCLUSIONS: This protocol-based approach to suspected appendicitis is feasible. A prospective controlled study would be required to confirm potential benefits (in terms of short hospital stay) and to confirm that there is not an increase in adverse outcomes.
Davidson, P, Macdonald, P, Paull, G, Rees, D, Howes, L, Cockburn, J & Brown, M 2003, 'Diuretic therapy in chronic heart failure: Implications for heart failure nurse specialists', Australian Critical Care, vol. 16, no. 2, pp. 59-69.View/Download from: Publisher's site
Chronic heart failure (CHF) is a syndrome precipitated by inadequate cardiac output and neurohormonal activation, leading to sodium and water retention. With increasing prevalence of CHF, heart failure nurse specialists (HFNS) are becoming involved in collaborative models of care in community and outpatient settings. Diuretic therapy in both acute and chronic heart failure is effective in relieving symptoms of congestion and improving cardiovascular haemodynamics. Best practice guidelines dictate diuretics should not be used as monotherapy but serve as an adjunctive therapy to agents with demonstrated survival benefit, such as angiotensin-converting enzyme (ACE) inhibitors and beta-blocker therapy. Despite the widespread use of diuretic therapy, limited clinical trial evidence exists upon which to base treatment decisions and algorithms. This article seeks to review diuretic therapy and flexible diuretic regimes in CHF and to discuss implications for patient management and advanced nursing practice. © 2003 Australian College of Critical Care Nurses Ltd. Published by Elsevier Australia (a division of Reed International Books Australia Pty Ltd.).
Davidson, P.M., Hancock, K., Daly, J., Cockburn, J., Moser, D., Goldston, K., Elliott, D., Webster, J., Speerin, R., Wade, V., Clarke, M., Anderson, M., Newman, C. & Chang, E. 2003, 'A cardiac rehabilitation program to enhance the outcomes of older women with heart disease: development of the group rehabilitation for older women (GROW) program', Journal of the Australasian Rehabilitation Nurses Association, vol. 6, no. 4, pp. 8-15.View/Download from: UTS OPUS
Davidson, PM, Daly, J, Hancock, K & Jackson, DE 2003, 'Australian women and heart disease: trends, epidemiological perspectives and the need for a culturally competent research agenda', Contemporary Nurse, vol. 16, no. 1-2, pp. 62-73.View/Download from: UTS OPUS
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.
Davidson, PM, Daly, J, Hancock, K, Moser, D, Chang, E & Cockburn, J 2003, 'Perceptions and experiences of heart disease: A literature review and identification of a research agenda in older women', European Journal of Cardiovascular Nursing, vol. 2, no. 4, pp. 255-264.View/Download from: UTS OPUS
Background: Following diagnosis of heart disease women have poorer health related outcomes compared with men. Nursing science lacks well-evaluated interventions to address the specific rehabilitative needs of older women with heart disease. AIMS: This paper seeks to inform the development of nursing intervention studies by a review of published studies on the experiences and rehabilitative needs of older women with heart disease.
Davidson, PM, Hancock, K, Leung, D, Ang, E, Chang, E, Thompson, D & Daly, J 2003, 'Traditional Chinese Medicine and heart disease: What does Western medicine and nursing science know about it?', European Journal of Cardiovascular Nursing, vol. 2, no. 3, pp. 171-181.View/Download from: UTS OPUS
Interest in Traditional Chinese Medicine (TCM) is growing rapidly beyond China. This interest is driven by a combination of factors including recognition of potential benefits of TCM; dissatisfaction with the traditional Western medical model; an increasing commitment to holistic care and increasing evidence for the interaction of psychological factors and outcomes of disease and treatment and health consumer demand. AIMS: This review article was prompted by the need to understand and interpret the increasing trend towards the use of TCM in heart disease. In particular, this article defines and describes TCM, and analyses implications and challenges for Western health care delivery models. LITERATURE SEARCH: This article provides a review of accessible evidence, to English speaking health care professionals. The CINAHL, MEDLINE, HealthSTAR, Academic ASAP and Cochrane databases were searched, identifying literature published from 1982. Search engines on the Internet were also used. Examples of keywords used were `Traditional Chinese Medicine and `heart. CONCLUSION: Difficulties in accessing information regarding TCM have implications for health education in coronary heart disease and patient safety. The rapid uptake of TCM in both Western and Chinese societies mandates an understanding of the principles and potential interactions when TCM is complemented with Western medical treatment for heart disease. Development of this knowledge and understanding is essential in order to provide safe and effective health care to patients who use combination therapies.
Davidson, PM, Introna, K, Daly, J, Paull, G, Jarvis, R, Angus, J, Wilds, T, Cockburn, J, Dunford, M & Dracup, K 2003, 'Cardiorespiratory nurses' perceptions of palliative care in nonmalignant disease: Data for the development of clinical practice', American Journal Of Critical Care, vol. 12, no. 1, pp. 47-53.View/Download from: UTS OPUS
Nurses lack a comprehensive body of scientific knowledge to guide the palliative care of patients with nonmalignant conditions. Current knowledge and practice reveal that nurses in many instances are not well prepared to deal with death and dying. Focus groups were used in an exploratory study to examine the perceptions of palliative care among cardiorespiratory nurses (n = 35). Content analysis was used to reveal themes in the data. Four major themes were found: (1) searching for structure and meaning in the dying experience of patients with chronic disease, (2) lack of a treatment plan and a lack of planning and negotiation, (3) discomfort in dealing with death and dying, and (4) lack of awareness of palliative care philosophies and resources. The information derived from this sample of cardiorespiratory nurses represents a complex interplay between personal, professional, and organizational perspectives on the role of palliative care in cardiorespiratory disease. The results of the study suggest a need for nurses to be equipped on both an intellectual and a practical level about the concept of palliative care in nonmalignant disease.
Davidson, PM, Meleis, A, Daly, J & Douglas, M 2003, 'Globalization as we enter the 21st century: Reflections and directions for nursing education, science, research and clinical practice', Advances in Contemporary Nursing, vol. 15, no. 3, pp. 162-174.View/Download from: UTS OPUS
The events of September 11th, 2001 in the United States and the Bali bombings of October 2002 are chastening examples of the entangled web of the religious, political, health, cultural and economic forces we experience living in a global community. To view these forces as independent, singular, linearly deterministic entities of globalisation is irrational and illogical.
Lambert, CE, Lambert, VA, Davidson, PM, Anders, R, O'Brien, L, Yunibhand, J, Wong, TKS, Lee, S, Kim, S & Kawano, M 2003, 'Nurse faculty perceptions regarding psychiatric-mental health nursing behavioral interventions: a cross-cultural comparison.', Contemporary nurse, vol. 15, no. 3, pp. 333-346.View/Download from: Publisher's site
Mental disorders are internationally responsible for significant disease burden and disability. However, limited cross-culturally comparisons, related to psychiatric-mental health nurses and the care they deliver, have been conducted. Therefore, the purpose of this article is to present information obtained from nurse faculty from Australia, Hong Kong, Japan, South Korea, Thailand and the USA (State of Hawaii) about: a) titles and educational preparation of the psychiatric-mental health nurses; b) the role and perception of others about the psychiatric-mental health nurses; c) nursing behavioral interventions, including medications; d) length of stay of hospitalized psychiatric patients; e) leading mental health problems; and, f) the profile of the population with a mental illness. The findings reflect diversity in the role and educational preparation of psychiatric-mental health nurses, as well as how psychiatric-mental health patients are treated.
Webster, RA, Thompson, DR & Davidson, PM 2003, 'The first 12 weeks following discharge from hospital: the experience of Gujarati South Asian survivors of acute myocardial infarction and their families.', Contemporary nurse, vol. 15, no. 3, pp. 288-299.View/Download from: Publisher's site
The period following discharge from hospital after an acute myocardial infarction (MI) is associated with vulnerability and psychosocial and physical morbidity for many survivors and their families. It is reported that people experience interpersonal, family and financial problems, self-care obstacles, work and physical difficulties. Culture and ethnicity undeniably influence the illness experience and the process of recovery and adjustment. This study investigated the perceptions of Gujarati survivors of acute MI and their families in Leicester, United Kingdom in the first 12 weeks following discharge in order to develop a profile of their health seeking beliefs and needs. Thirty-one interviews with 19 Gujarati MI survivors and their families (representing approximately 31 hours of dialogue) were analysed using grounded theory. Qualitative data revealed a period of vulnerability not only for survivors but also their families as they processed recent events and faced the future. Data analysis revealed nine interrelated themes describing the post-discharge experience for Gujarati survivors and their families. Data revealed that normal life was often markedly changed by the MI experience. Reflection, contemplation and resignation characterize this period of vulnerability. Overwhelmingly, data analysis revealed that the Gujarati culture, beliefs and customs influenced the recovery experience.
Daly, J, Davidson, PM, Chang, E, Hancock, K, Rees, D & Thompson, D 2002, 'Cultural aspects of adjustment to coronary heart disease in Chinese-Australians : A review of the literature', Journal of Advanced Nursing, vol. 39, no. 4, pp. 391-399.View/Download from: Publisher's site
The burden of illness associated with Coronary Heart Disease (CHD) has determined this as a key focus for research at a basic science, individual and population level. Although considerable research has been conducted on specific aspects of the experience of CHD, such as anxiety or depression, there is a lack of research investigating the global aspects of the illness experience from the individual's perspective. Furthermore, there is a paucity of research examining the cross-cultural experiences of patients from Non-English Speaking Backgrounds (NESB). Given the multicultural nature of Australian society, and that health and illness are culturally constructed experiences (Manderson 1990), it is important to include the perspectives of people from minority cultures in health related research in order to provide culturally sensitive and appropriate health care and information during an illness. Further, the potential to prevent and modulate the course of CHD, by strategies such as smoking cessation and lipid management, mandate a health promotion agenda based on equity and access for all members of society. This article discusses cultural aspects of CHD in relation to nursing and allied health care during the recovery phase of an acute cardiac event. It reviews the research that has been conducted in this area, focusing on the Chinese-Australian population. Chinese-Australians are one of the fastest growing populations in Australia, and are at increased risk of CHD upon settling to Australia. Recommendations for future research and for the practice of nursing are provided.
Daly, J, Sindone, A, Thompson, D, Hancock, K, Chang, E & Davidson, PM 2002, 'Barriers to participation in and adherence to cardiac rehabilitation programs: A critical literature review', Progress in Cardiovascular Nursing, vol. 17, no. 1, pp. 8-17.
Clinical and technical skill may not be sufficient to fulfil society's expectations of surgeons. Other skills, which have been well defined in the published literature, include those of the professional, communicator, collaborator, manager, scholar and health advocate. It is the purpose of this review to explore the current understanding of these different domains and make comment about ways to improve training that will ensure that the surgeon of the future has the opportunity to develop broader expertize.
Davidson, PM, Introna, K, Cockburn, J, Daly, J, Dunford, M, Paull, G & Dracup, K 2002, 'Synergizing acute care and palliative care to optimise nursing care in end-stage cardiorespiratory disease', Australian Critical Care, vol. 15, no. 2, pp. 64-69.
Advances in the practice of medicine and nursing science have increased survival for patients with chronic cardiorespiratory disease. Parallel to this positive outcome is a societal expectation of longevity and cure of disease. Chronic disease and the inevitability of death creates a dilemma, more than ever before, for the health care professional, who is committed to the delivery of quality care to patients and their families. The appropriate time for broaching the issue of dying and determining when palliative care is required is problematic. Dilemmas occur with a perceived dissonance between acute and palliative care and difficulties in determining prognosis. Palliative care must be integrated within the health care continuum, rather than being a discrete entity at the end of life, in order to achieve optimal patient outcomes. Anecdotally, acute and critical care nurses experience frustration from the tensions that arise between acute and palliative care philosophies. Many clinicians are concerned that patients are denied a good death and yet the moment when care should be oriented toward palliation rather than aggressive management is usually unclear. Clearly this has implications for the type and quality of care that patients receive. This paper provides a review of the extant literature and identifies issues in the end of life care for patients with chronic cardiorespiratory diseases within acute and critical care environments. Issues for refinement of acute and critical care nursing practice and research priorities are identified to create a synergy between these philosophical perspectives
Davidson, P, Stewart, S, Elliott, D, Daly, J, Sindone, A & Cockburn, J 2001, 'Addressing the burden of heart failure in australia: the scope for home-based interventions', Journal of Cardiovascular Nursing, vol. 16, no. 1, p. 1392.
Davidson, PM, Daly, J, Romanini, J & Elliott, D 2001, 'Quality use of medicines (QUM) in critical care: an imperative for best practice', Australian Critical Care, vol. 14, no. 3, pp. 122-126.View/Download from: UTS OPUS or Publisher's site
Quality use of medicines (QUM) as a discrete concept is gaining increasing importance in Australia and is supported by a policy platform which has federal government and health professional support. The QUM movement is also supported by a strong consumer base and this lobby group has been responsible for endorsement as a major health initiative. However, the importance of QUM to achievement of optimal patient outcomes has not achieved sufficient recognition in the critical care literature. Implicit in the discussion of QUM is the rational, ethical, safe and effective use of drugs within a best practice framework. Successful implementation of QUM requires appropriate infrastructure and the commitment and cooperation of medical, nursing and pharmacy staff. Support, education and training provide the prerequisites of knowledge, skills and awareness for quality use of medicines for all groups. An emphasis upon evidence based practice and the prevalence of polypharmacy in contemporary health care systems requires examination of factors that are barriers to best practice. QUM in critical care areas requires appropriately skilled staff who are competent to manage patients with a wide range of selected drugs, often in highly stressful situations. In many situations in critical care, the role of the critical care nurse is one of patient advocate. It is important to note that the delivery of critical care is not limited to a discrete setting and is inclusive of management at the trauma scene, assessment and delivery of care in the emergency department, through to intensive, coronary care and high dependency units. This paper presents a discussion of the concept of QUM and its relevance in the critical care context. Key theoretical, policy and research considerations for establishment of QUM in critical care are reviewed and discussed. This paper seeks to describe key issues in QUM and endorse the need for a research agenda in critical care.
Davidson, PM, Stewart, S, Elliott, D, Daly, J, Sindone, A & Cockburn, J 2001, 'Addressing the burden of heart failure in Australia: the scope of home based interventions', Journal of Cardiovascular Nursing, vol. 16, no. 1, pp. 56-68.View/Download from: UTS OPUS
The growing burden of heart failure (HF) challenges health practitioners to implement and evaluate models of care to facilitate optimal health related outcomes. Australia supports a publicly funded universal health insurance system with a strong emphasis on primary care provided by general practitioners. The burden of chronic HF, and a social and political framework favoring community-based, noninstitutionalized care, represents an ideal environment in which home-based HF programs can be implemented successfully. Cardiovascular nurses are well positioned to champion and mentor implementation of evidence-based, patient-centered programs in Australian communities. This paper describes the facilitators and barriers to implementation of best practice models in the Australian context. These include the challenge of providing care in a diverse, multicultural society and the need for clinical governance structures to ensure equal access to the most effective models of care.
Pauil, G & Daly, J 2001, 'Synergising acute care and palliative care philosophies to optimise nursing care in cardiorespiratory disease', Respirology, vol. 6, no. SUPPL. 1.
Advances in the practice of acute care medicine and nursing science have created more favourable mortality outcomes for patients with chronic cardiorespiratory disease. However, in the chronic disease illness experience, the inevitability of death is raising a dilemma, more than ever before, for the health care professional involved in delivering appropriate care to patients and their families. The appropriate time for broaching of this issue with patients and their families and determining when related intervention is required is problematic. This may be attributed to the perceived dissonance between acute and palliative care and difficulties in determining prognosis. Focus groups were conducted to assess the needs and attitudes of nurses working in acute care areas in respect of palliative care. Within these focus groups frustration was expressed by acute care nurses as to what appears to be the tensions between acute and palliative care nursing philosophies. A lack of understanding of palliative care principles was also evident. It was the concern of many clinicians that patients were often denied a good death, and that palliative care was viewed as a discrete entity in the last days of life rather than a phenomenon entrenched within the health continuum. Qualitative thematic analysis identified lack of planning and communication between patients, relatives and health care professionals as a major theme. This poster identifies the issues in the care of patients with chronic diseases within acute care environments as provided by focus groups and review of the extant literature. Issues for refinement of acute nursing practice and research priorities are identified to create a synergy between acute care and palliative care nursing philosophies.
Daly, J, Elliott, D, Cameron-Traub, E, Salamonson, Y, Davidson, PM, Jackson, DE, Chin, C & Wade, V 2000, 'Health status, perceptions of coping, and social support immediately after discharge of survivors of acute myocardial infarction', American Journal of Critical Care, vol. 9, pp. 62-69.
BACKGROUND: The period immediately after discharge from the hospital after an acute myocardial infarction is a stressful and vulnerable time about which little is known. OBJECTIVE: To explore health status, perceptions of coping, and social support among survivors of a recent myocardial infarction in the first 3 weeks after discharge from hospitals in southwestern Sydney, Australia. METHODS: A descriptive, exploratory approach with a triangulated methodology was used to assess the experiences of 38 survivors, detect patterns in these experiences, explore the health-support needs of survivors, and determine changes in health status in the first 3 weeks after discharge. Quantitative data were collected with the Medical Outcomes Study SF-36, New York Heart Association classification, Canadian Cardiovascular Society Angina Scale, and the Jalowiec Coping Scale. A semistructured interview schedule provided additional qualitative data about the experiences of the survivors. RESULTS: The health status of participants was relatively stable during the 3-week period; most had no activity limitation due to dyspnea or angina. However, the subjects' health status was considerably lower than that of their age-matched population. The most common and most effective coping strategies adopted during this period were confrontation, optimism, and self-reliance. In addition, the subjects experienced anxiety, depression, ambiguity and uncertainty, fear of recurrence of the infarction and of deterioration in health, of boredom and of inertia. CONCLUSION: These findings can help nurses in hospital and community settings assist survivors of acute myocardial infarction to prepare for and deal effectively with experiences during convalescence.
Douglas, CD, Macpherson, NE, Davidson, PM & Gani, JS 2000, 'Randomised controlled trial of ultrasonography in diagnosis of acute appendicitis, incorporating the Alvarado score.', BMJ (Clinical research ed.), vol. 321, no. 7266, pp. 919-922.View/Download from: Publisher's site
OBJECTIVES: To determine whether diagnosis by graded compression ultrasonography improves clinical outcomes for patients with suspected appendicitis. DESIGN: A randomised controlled trial comparing clinical diagnosis (control) with a diagnostic protocol incorporating ultrasonography and the Alvarado score (intervention group). SETTING: Single tertiary referral centre. PARTICIPANTS: 302 patients (age 5-82 years) referred to the surgical service with suspected appendicitis. 160 patients were randomised to the intervention group, of whom 129 underwent ultrasonography. Ultrasonography was omitted for patients with extreme Alvarado scores (1-3, 9, or 10) unless requested by the admitting surgical team. MAIN OUTCOME MEASURES: Time to operation, duration of hospital stay, and adverse outcomes, including non-therapeutic operations and delayed treatment in association with perforation. RESULTS: Sensitivity and specificity of ultrasonography were measured at 94. 7% and 88.9%, respectively. Patients in the intervention group who underwent therapeutic operation had a significantly shorter mean time to operation than patients in the control group (7.0 v 10.2 hours, P=0.016). There were no differences between groups in mean duration of hospital stay (53.4 v 54.5 hours, P=0.84), proportion of patients undergoing a non-therapeutic operation (9% v 11%, P=0.59) or delayed treatment in association with perforation (3% v 1%, P=0.45). CONCLUSION: Graded compression ultrasonography is an accurate procedure that leads to the prompt diagnosis and early treatment of many cases of appendicitis, although it does not prevent adverse outcomes or reduce length of hospital stay.
Jackson, DE, Daly, J, Davidson, PM, Elliott, D, Cameron-Traub, E, Wade, V, Chin, C & Salamonson, Y 2000, 'Women recovering from first-time myocardial infarction (MI): A feminist qualitative study', Journal of Advanced Nursing, vol. 32, no. 6, pp. 1403-1411.View/Download from: Publisher's site
Although myocardial infarction (MI) is a leading cause of death and disablement for women internationally, little is known about women's recovery. This paper describes an exploratory descriptive study that was informed by feminist principles, and which aimed to explore the recovery experiences of a group of women survivors of ®rst-time MI in the initial period following discharge from hospital.
Daly, J, Jackson, D & Davidson, PM 1999, 'The experience of hope for survivors of acute myocardial infarction (AMI): a qualitative research study.', The Australian journal of advanced nursing : a quarterly publication of the Royal Australian Nursing Federation, vol. 16, no. 3, pp. 38-44.
This qualitative study was undertaken to explore the relevance and meaning of the experience of hope for survivors of acute myocardial infarction (AMI). Depth interviews were conducted with eight survivors (n = 8) of AMI at four weeks following discharge from hospital. Analysis of transcribed interviews revealed three distinct narrative themes. These were holding on to human connectedness, finding and harnessing the 'will' to live, and, having faith in the primacy of a higher power. Study findings are discussed in relation to the literature. Findings of the study assist in building knowledge and understanding of the complex phenomenon of hope. Implications for nursing practice and research are drawn from study findings.
Lenton, S & Davidson, PM 1999, 'Raves, drugs, dealing and driving: qualitative data from a West Australian sample', Drug And Alcohol Review, vol. 18, no. 2, pp. 153-161.
This qualitative paper from a study of 83 people