Nursing - Research Publications

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    Meeting the support and information needs of women with advanced breast cancer: a randomised controlled trial
    Aranda, S ; Schofield, P ; Weih, L ; Milne, D ; Yates, P ; Faulkner, R (NATURE PUBLISHING GROUP, 2006-09-18)
    Addressing psychosocial and quality of life needs is central to provision of excellent care for people with advanced cancer. This study tested a brief nurse-delivered intervention to address the needs of urban women with advanced breast cancer. This study was conducted at four large urban hospitals in Australia. One hundred and five women with advanced breast cancer were recruited and randomised to receive the intervention or usual care, then asked to complete the European Organisation of Research and Treatment of Quality of life Q-C30 version (2.0) (EORTC Q-C30) (version 2) and Supportive Care Needs Survey (SCNS) at 1 month and 3 months postrecruitment. No significant differences were detected between intervention and usual care groups in the SCNS or the EORTC Q-C30 subscale scores. However, when the groups were divided into high needs (score of above 50) and low baseline needs (score of 50 or below) for each SCNS subscale, a significant difference between intervention and usual care groups was found in the psychological/emotional subscale among women with high baseline needs. In conclusions, this study demonstrated that a face-to-face session and follow-up phone call with a breast care nurse significantly reduced the psychological and emotional needs of those with high initial needs. There was no evidence of the intervention influencing the quality of life; or perceived needs of women with low initial psychological/emotional needs or perceived needs in other domains. Possibly, the intervention was not sufficiently intense to achieve an effect.
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    Socio-demographic and clinical characteristics of re-presentation to an Australian inner-city emergency department: implications for service delivery
    Moore, G ; Gerdtz, M ; Manias, E ; Hepworth, G ; Dent, A (BMC, 2007-11-10)
    BACKGROUND: People who have complex health care needs frequently access emergency departments for treatment of acute illness and injury. In particular, evidence suggests that those who are homeless, or suffer mental illness, or have a history of substance misuse, are often repeat users of emergency departments. The aim of this study was to describe the socio-demographic and clinical characteristics of emergency department re-presentations. Re-presentation was defined as a return visit to the same emergency department within 28 days of discharge from hospital. METHODS: A retrospective cohort study was conducted of emergency department presentations occurring over a 24-month period to an Australian inner-city hospital. Characteristics were examined for their influence on the binary outcome of re-presentation within 28 days of discharge using logistic regression with the variable patient fitted as a random effect. RESULTS: From 64,147 presentations to the emergency department the re-presentation rate was 18.0% (n = 11,559) of visits and 14.4% (5,894/40,942) of all patients. Median time to re-presentation was 6 days, with more than half occurring within one week of discharge (60.8%; n = 6,873), and more than three-quarters within two weeks (80.9%; n = 9,151). The odds of re-presentation increased three-fold for people who were homeless compared to those living in stable accommodation (adjusted OR 3.09; 95% CI, 2.83 to 3.36). Similarly, the odds of re-presentation were significantly higher for patients receiving a government pension compared to those who did not (adjusted OR 1.73; 95% CI, 1.63 to 1.84), patients who left part-way through treatment compared to those who completed treatment and were discharged home (adjusted OR 1.64; 95% CI, 1.36 to 1.99), and those discharged to a residential-care facility compared to those who were discharged home (adjusted OR 1.46: 95% CI, 1.03 to 2.06). CONCLUSION: Emergency department re-presentation rates cluster around one week after discharge and rapidly decrease thereafter. Housing status and being a recipient of a government pension are the most significant risk factors. Early identification and appropriate referrals for those patients who are at risk of emergency department re-presentation will assist in the development of targeted strategies to improve health service delivery to this vulnerable group.
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    Family meetings in palliative care: Multidisciplinary clinical practice guidelines.
    Hudson, P ; Quinn, K ; O'Hanlon, B ; Aranda, S (Springer Science and Business Media LLC, 2008-08-19)
    BACKGROUND: Support for family carers is a core function of palliative care. Family meetings are commonly recommended as a useful way for health care professionals to convey information, discuss goals of care and plan care strategies with patients and family carers. Yet it seems there is insufficient research to demonstrate the utlility of family meetings or the best way to conduct them. This study sought to develop multidisciplinary clinical practice guidelines for conducting family meetings in the specialist palliative care setting based on available evidence and consensus based expert opinion. METHODS: The guidelines were developed via the following methods: (1) A literature review; (2) Conceptual framework; (3) Refinement of the guidelines based on feedback from an expert panel and focus groups with multidisciplinary specialists from three palliative care units and three major teaching hospitals in Melbourne, Australia. RESULTS: The literature review revealed that no comprehensive exploration of the conduct and utility of family meetings in the specialist palliative care setting has occurred. Preliminary clinical guidelines were developed by the research team, based on relevant literature and a conceptual framework informed by: single session therapy, principles of therapeutic communication and models of coping and family consultation. A multidisciplinary expert panel refined the content of the guidelines and the applicability of the guidelines was then assessed via two focus groups of multidisciplinary palliative care specialists. The complete version of the guidelines is presented. CONCLUSION: Family meetings provide an opportunity to enhance the quality of care provided to palliative care patients and their family carers. The clinical guidelines developed from this study offer a framework for preparing, conducting and evaluating family meetings. Future research and clinical implications are outlined.
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    Medical receptionists in general practice: Who needs a nurse?
    PATTERSON, E ; Del Mar, C ; Najman, J (Wiley, 2000)
    The aim of this study was to determine the extent to which receptionists,working in general medical practices, are undertaking clinical tasks traditionally within the domain of nursing. A survey of 164 solo and principal general practitioners (GPs) practising within one division of general practice in south-east Queensland,Australia, yielded 84 responses (55%). The study found that some receptionists, while primarily employed for reception and clerical duties, were performing tasks that involved direct patient assessment, monitoring and therapy. Sixty percent of the GPs did not employ a nurse because of financial constraints and a perceived lack of need. These findings could be illustrative of the current trend in health care to appropriate the work of nurses to lesser-paid workers. Further investigation is indicated in order to determine the most appropriate non-medical staffing mix in general practice to achieve both quality care and financial viability.
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    Nursing's contribution to general practice" General practitioners' and practice nurses' views
    PATTERSON, E ; Del Mar, C ; Najman, J (Elsevier, 1999)
    This study was instigated by the paucity of knowledge relating to the work of nurses employed by general practitioners in Australia and the phenomenal development of the practice nurse role in the United Kingdom. A mailed survey of general practitioners and practice nurses within one Division of General Practice in South-East Queensland, sought, among other things, their views about the current and potential contribution of nursing to general practice. Eighty-four out of 164 (51%) general practitioners and 37 out of 67 (55%) practice nurses responded to the survey. Results indicated that both general practitioners and practice nurses appreciated the value of nursing services in general practice and would sanction the employment of more nurses especially for the purpose of preventive care. The majority of nurses were agreeable to the notion that the nurse's role could, and should, be expanded to include autonomous functioning while most of the doctors were amenable to some extension of nursing practice but reticent or opposed to any independent interventions.
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    A descriptive study of nurses employed by general practitioners in south-east Queensland
    PATTERSON, E ; Del Mar, C ; Najman, J (ANF, 1999)
    The aim of this study was to describe the demographic and occupational characteristics of a sample of nurses employed by general medical practitioners and the factors perceived to be influential in their role development. Telephone and mail surveys were undertaken within one general practice division in South-East Queensland. Thirty-seven of the 67 (55%) practice nurses responded to the mailed questionnaire. Of these respondents, ten were collectively interviewed to elaborate on the survey results. Findings indicated that the primary work of these nurses is one of assistant to the doctor. Autonomous nursing initiatives are largely opportunistic. Perceived barriers to role expansion included Medicare restrictions, inadequate basic and ongoing education programs, financial and space limitations of the practice, reluctance of general practitioners, and a lack of professional support.
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    Promoting purposeful partnerships.
    Patterson, E ; Cruickshank, D (Informa UK Limited, 1996-03)
    The clinical experience component of university based nursing courses has often attracted criticism from students, faculty and clinical agency staff. One way of addressing these difficulties is for stakeholders to engage in open and consistent dialogue. To this end, faculty from the School of Nursing at Griffith University (Gold Coast) initiated a trial of reflection sessions attended by students, clinical facilitators, faculty and clinical agency staff at the completion of each clinical experience. While the outcomes were essentially positive, personal, professional and political risks were revealed as inherent in the reflective process. Awareness of such risks is essential for the development of purposeful partnerships in clinical education.
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    A sharing in critical thought
    Hendricks, J ; Patterson, E (Wiley, 1995)