Ravani Duggan | Curtin University, Perth (original) (raw)
Papers by Ravani Duggan
Journal of Advanced Nursing, 2017
AIMS To examine understandings of global health issues among nursing students following participa... more AIMS To examine understandings of global health issues among nursing students following participation in an international clinical placement during their pre-registration university education. BACKGROUND Universities use international clinical placements, especially in developing countries, to develop cultural awareness in students; however, little is known about the longer term influences on students' understandings of global nursing. DESIGN A retrospective cross-sectional design was used, using an exploratory, descriptive qualitative approach. METHODS Individual semi-structured interviews were conducted in 2014 with a purposive sample of 25 pre-registration nursing students from four Western Australian universities who undertook clinical placements across five countries. Data were analysed using inductive thematic analysis. RESULTS Findings highlight that students developed new understandings around health systems including fragility of resource access, differences in clinical practice and variances in nursing roles between settings. Students also experienced challenges but were able to appreciate alternative world viewpoints. CONCLUSION International clinical placements can develop greater awareness and help students form realistic strategies for using their nursing skills globally. Pre-placement training in cultural awareness and health system realities, along with strong supervisory support, is critical to success.
Women and Birth, 2017
Background: When transfer in labour takes place from a birth centre to a tertiary maternity hospi... more Background: When transfer in labour takes place from a birth centre to a tertiary maternity hospital the woman, her partner and the midwife (the triad) are involved, representing three different perspectives. The purpose of this paper is to explore the integration of these intrapartum transfer experiences for the birth triad. Methods: Giorgi's descriptive phenomenological method of analysis was used to explore the 'lived' experiences of Western Australian women, their partners and midwives across the birth journey. Forty-five interviews were conducted. Findings: Findings revealed that experiences of intrapartum transfer were unique to each member of the triad (woman, partner and midwife) and yet there were also shared experiences. All three had three themes in common: 'The same journey through three different lenses'; 'In my own world' and 'Talking about the birth'. The woman and partner shared two themes: 'Lost birth dream' and 'Grateful to return to a familiar environment'. The woman and midwife both had: 'Gratitude for continuity of care model' and the partner and midwife both found they were: 'Struggling to adapt to a changing care model' and their 'Inside knowledge was not appreciated'. Conclusion: Insight into the unique integrated experiences during a birth centre intrapartum transfer can inform midwives, empowering them to better support parents through antenatal education before and by offering discussion about the birth and transfer after. Translation of findings to practice also reinforces how midwives can support their colleagues by recognising the accompanying midwife's role and knowledge of the woman.
Journal of Nursing Education, 2016
Nurse education in practice, 2016
Since 2011, Western Australian nursing and midwifery educators have been providing evidence-based... more Since 2011, Western Australian nursing and midwifery educators have been providing evidence-based continuing education to Tanzanian health professionals. Despite thorough preparation before departure, differences in local resource levels and available facilities have necessitated impromptu adaptation of curriculum content and delivery methods to ensure an effective program was delivered. This study explored the personal, cultural and teaching strategies utilised by Western Australian nursing and midwifery educators in Tanzania and examined if the transferability of education packages was influenced by the educators' cultural competence. Using a qualitative exploratory approach, data was collected from 15 Western Australian nursing and midwifery educators using a demographic survey and in-depth individual semi-structured interviews. The core themes identified from the analysis were Determination to learn, Assessing needs, Communication skills and Greater understanding. These find...
Women and birth : journal of the Australian College of Midwives, 2015
When transfer in labour takes place from a woman-centred, midwifery led centre to a tertiary mate... more When transfer in labour takes place from a woman-centred, midwifery led centre to a tertiary maternity hospital it is accepted that women are negatively affected, however the midwife's role is unevaluated, there is no published literature exploring their experience. This study aimed to describe these experiences. Giorgi's descriptive phenomenological method of analysis was used to explore the 'lived' experiences of the midwives. Seventeen interviews of transferring midwives took place and data saturation was achieved. The overall findings suggest that midwives find transfer in labour challenging, both emotionally and practically. Five main themes emerged: (1) 'The midwife's internal conversation' with subtheme: 'Feeling under pressure', (2) 'Challenged to find a role in changing circumstances' with subtheme: 'Varying degrees of support', (3) 'Feeling out of place' with subtheme: 'Caught in the middle of different models...
ISRN nursing, 2011
This paper reports on an evaluation of a Clinical Scholar Program initiated at a hospital in West... more This paper reports on an evaluation of a Clinical Scholar Program initiated at a hospital in Western Australia. The aim of the program was to build the capacity of nurses and midwives to conduct research and evidence-based practice within the hospital. The program was based on a previous program and consisted of six teaching days and four hours per month release for proposal preparation. At the end of the program participants were asked to complete a short anonymous questionnaire. The answers were analysed using standard processes of qualitative analysis. Themes emerging from the data included program strengths, individual gains, ability to conduct research, and areas for improvement. The findings highlighted that, while the participants considered that they were more knowledgeable and confident to conduct research, they still required support. The Clinical Scholar Program has provided a way to increase the capacity of clinicians to participate in research activities.
International Journal of Orthopaedic and Trauma Nursing, 2015
Strategies within the public health system to curtail costs, increase efficiency and service util... more Strategies within the public health system to curtail costs, increase efficiency and service utilisation have resulted in reduced hospital stays following elective orthopaedic procedures. Although there are advantages that support the concept of early discharge from hospital, very little is known about how patients manage the transition from hospital to home. The aim of this qualitative study was to describe the post-discharge experience of elderly patients following primary total hip replacement (THR). Ten patients, six women and four men, provided descriptions of their experience. Data were collected by face-to-face interviews and the analysis process was based on Giorgi's phenomenological scientific methodology (Giorgi, 1994, 1997, 2000). The analysis of the data resulted in four themes, namely; an inadequate assessment of suitable adaptive aids and personal needs; personal frustration; coping with the physical and mobility and limited social interaction. Findings from this study demonstrated a need to review the discharge process and implement strategies to prepare patients for the stressors that the participants in this study encountered as a result of their early discharge.
Australasian journal on ageing, 2015
This paper aims to describe a practical example of the use of adapted versions of a resident sati... more This paper aims to describe a practical example of the use of adapted versions of a resident satisfaction questionnaire for quality improvement purposes in a large aged care service organisation. Residential care and home care questionnaires each covered 11 aspects, the 'housing' questionnaire nine. Each aspect included Likert scale-type satisfaction questions. Questionnaires were distributed for completion by residents or by a friend/family member where a resident was unable to self-complete (e.g. because of dementia). Over the six separate customer satisfaction surveys conducted by the organisation since 1999, the analysis scheme has been refined and forms the basis of a report to the Board highlighting major findings and making recommendations regarding future actions. Most recently, the Board has decided to focus on three main areas, with actions identified for each, namely satisfaction with staff (e.g. enhanced staff training), social activities and involvement (e.g. in...
Advances in Mental Health, 2014
ABSTRACT The prevalence and consequences of mental health challenges amongst university students ... more ABSTRACT The prevalence and consequences of mental health challenges amongst university students is now widely acknowledged and university staff provide an important but often hidden service to these students. While completing a university degree is important to the student’s long-term outcomes there remains a paucity of literature on the support role provided to these students by staff . To contribute to knowledge in this area, a qualitative exploratory study was completed with academic and professional staff at two Australian universities in 2013. Data were collected using semi-structured interviews with 26 participants to document their experiences and to identify the barriers and enablers to their support role to students.
Midwifery, 2015
the aim of this Western Australian study was to describe the overall labour and birth experience ... more the aim of this Western Australian study was to describe the overall labour and birth experience of partners within the context of an intrapartum transfer occurring from a low risk midwifery-led, woman-centred unit to an obstetric unit. a descriptive phenomenological design was used. 15 male partners were interviewed in the first 8 weeks post partum between July and October, 2013 to explore their experience of the intrapartum transfer. a midwifery-led birth centre set on the grounds of a tertiary maternity referral hospital. partners of women who were transferred from the birth centre to the onsite tertiary hospital due to complications during the first and second stages of labour. five main themes emerged: (1) 'emotional roller coaster'; (2) 'partner׳s role in changing circumstances' with subthemes: 'acknowledgement for his inside knowledge of her' and 'challenges of being a witness'; (3) 'adapting to a changing model of care' with subthemes: 'moving from an inclusive nurturing and continuity model' and 'transferring to a medicalised model'; (4) 'adapting to environmental changes' with subthemes: 'feeling comfortable in the familiar birth centre',…
Archives of Psychiatric Nursing, 2014
BMC pregnancy and childbirth, Jan 8, 2016
The aim of this Western Australian study was to describe the overall labour and birth experience ... more The aim of this Western Australian study was to describe the overall labour and birth experience of women who were transferred during the first and second stages of labour from a low risk woman-centred, midwifery-led birth centre to a co-located tertiary maternity referral hospital. Using a descriptive phenomenological design, fifteen women were interviewed up to 8 weeks post birth (July to October, 2013) to explore their experience of the intrapartum transfer. Giorgi's method of analysis was used. The following themes and subthemes emerged: 1) The midwife's voice with subthemes, a) The calming effect and b) Speaking up on my behalf; 2) In the zone with subthemes, a) Hanging in there and b) Post birth rationalizing; 3) Best of both worlds with subthemes a) The feeling of relief on transfer to tertiary birth suite and b) Returning back to the comfort and familiarity of the birth centre; 4) Lost sense of self; and 5) Lost birth dream with subthemes a) Narrowing of options and ...
Results from the GAD-7 and PHQ-9 questionnaires taken before and after a 4-week intervention cons... more Results from the GAD-7 and PHQ-9 questionnaires taken before and after a 4-week intervention consisting of learning a new dance step every working day.
Nurse Education in Practice
BMC Pregnancy and Childbirth
Background Being ‘with woman’ is a central construct of the midwifery profession however, minimal... more Background Being ‘with woman’ is a central construct of the midwifery profession however, minimal research has been undertaken to explore the phenomenon from the perspective of midwives. The aim of this study was to describe Western Australian midwives’ perceptions of the phenomenon of being ‘with woman’ during the intrapartum period. Methods Descriptive phenomenology was selected as the methodology for this study. Thirty one midwives working across a variety of care models participated in individual interviews. Giorgi’s four stage phenomenological approach was employed to analyse data. Results Three themes were extracted 1) Essential to professional identity; 2) Partnership with women; and 3) Woman-Centred Practice. Midwives described the importance of being ‘with woman’ to the work and identification of midwifery practice. Developing a connection with the woman and providing woman-centred care inclusive of the woman’s support people was highlighted. Conclusions For the first time,...
Journal of Advanced Nursing, 2017
AIMS To examine understandings of global health issues among nursing students following participa... more AIMS To examine understandings of global health issues among nursing students following participation in an international clinical placement during their pre-registration university education. BACKGROUND Universities use international clinical placements, especially in developing countries, to develop cultural awareness in students; however, little is known about the longer term influences on students' understandings of global nursing. DESIGN A retrospective cross-sectional design was used, using an exploratory, descriptive qualitative approach. METHODS Individual semi-structured interviews were conducted in 2014 with a purposive sample of 25 pre-registration nursing students from four Western Australian universities who undertook clinical placements across five countries. Data were analysed using inductive thematic analysis. RESULTS Findings highlight that students developed new understandings around health systems including fragility of resource access, differences in clinical practice and variances in nursing roles between settings. Students also experienced challenges but were able to appreciate alternative world viewpoints. CONCLUSION International clinical placements can develop greater awareness and help students form realistic strategies for using their nursing skills globally. Pre-placement training in cultural awareness and health system realities, along with strong supervisory support, is critical to success.
Women and Birth, 2017
Background: When transfer in labour takes place from a birth centre to a tertiary maternity hospi... more Background: When transfer in labour takes place from a birth centre to a tertiary maternity hospital the woman, her partner and the midwife (the triad) are involved, representing three different perspectives. The purpose of this paper is to explore the integration of these intrapartum transfer experiences for the birth triad. Methods: Giorgi's descriptive phenomenological method of analysis was used to explore the 'lived' experiences of Western Australian women, their partners and midwives across the birth journey. Forty-five interviews were conducted. Findings: Findings revealed that experiences of intrapartum transfer were unique to each member of the triad (woman, partner and midwife) and yet there were also shared experiences. All three had three themes in common: 'The same journey through three different lenses'; 'In my own world' and 'Talking about the birth'. The woman and partner shared two themes: 'Lost birth dream' and 'Grateful to return to a familiar environment'. The woman and midwife both had: 'Gratitude for continuity of care model' and the partner and midwife both found they were: 'Struggling to adapt to a changing care model' and their 'Inside knowledge was not appreciated'. Conclusion: Insight into the unique integrated experiences during a birth centre intrapartum transfer can inform midwives, empowering them to better support parents through antenatal education before and by offering discussion about the birth and transfer after. Translation of findings to practice also reinforces how midwives can support their colleagues by recognising the accompanying midwife's role and knowledge of the woman.
Journal of Nursing Education, 2016
Nurse education in practice, 2016
Since 2011, Western Australian nursing and midwifery educators have been providing evidence-based... more Since 2011, Western Australian nursing and midwifery educators have been providing evidence-based continuing education to Tanzanian health professionals. Despite thorough preparation before departure, differences in local resource levels and available facilities have necessitated impromptu adaptation of curriculum content and delivery methods to ensure an effective program was delivered. This study explored the personal, cultural and teaching strategies utilised by Western Australian nursing and midwifery educators in Tanzania and examined if the transferability of education packages was influenced by the educators' cultural competence. Using a qualitative exploratory approach, data was collected from 15 Western Australian nursing and midwifery educators using a demographic survey and in-depth individual semi-structured interviews. The core themes identified from the analysis were Determination to learn, Assessing needs, Communication skills and Greater understanding. These find...
Women and birth : journal of the Australian College of Midwives, 2015
When transfer in labour takes place from a woman-centred, midwifery led centre to a tertiary mate... more When transfer in labour takes place from a woman-centred, midwifery led centre to a tertiary maternity hospital it is accepted that women are negatively affected, however the midwife's role is unevaluated, there is no published literature exploring their experience. This study aimed to describe these experiences. Giorgi's descriptive phenomenological method of analysis was used to explore the 'lived' experiences of the midwives. Seventeen interviews of transferring midwives took place and data saturation was achieved. The overall findings suggest that midwives find transfer in labour challenging, both emotionally and practically. Five main themes emerged: (1) 'The midwife's internal conversation' with subtheme: 'Feeling under pressure', (2) 'Challenged to find a role in changing circumstances' with subtheme: 'Varying degrees of support', (3) 'Feeling out of place' with subtheme: 'Caught in the middle of different models...
ISRN nursing, 2011
This paper reports on an evaluation of a Clinical Scholar Program initiated at a hospital in West... more This paper reports on an evaluation of a Clinical Scholar Program initiated at a hospital in Western Australia. The aim of the program was to build the capacity of nurses and midwives to conduct research and evidence-based practice within the hospital. The program was based on a previous program and consisted of six teaching days and four hours per month release for proposal preparation. At the end of the program participants were asked to complete a short anonymous questionnaire. The answers were analysed using standard processes of qualitative analysis. Themes emerging from the data included program strengths, individual gains, ability to conduct research, and areas for improvement. The findings highlighted that, while the participants considered that they were more knowledgeable and confident to conduct research, they still required support. The Clinical Scholar Program has provided a way to increase the capacity of clinicians to participate in research activities.
International Journal of Orthopaedic and Trauma Nursing, 2015
Strategies within the public health system to curtail costs, increase efficiency and service util... more Strategies within the public health system to curtail costs, increase efficiency and service utilisation have resulted in reduced hospital stays following elective orthopaedic procedures. Although there are advantages that support the concept of early discharge from hospital, very little is known about how patients manage the transition from hospital to home. The aim of this qualitative study was to describe the post-discharge experience of elderly patients following primary total hip replacement (THR). Ten patients, six women and four men, provided descriptions of their experience. Data were collected by face-to-face interviews and the analysis process was based on Giorgi's phenomenological scientific methodology (Giorgi, 1994, 1997, 2000). The analysis of the data resulted in four themes, namely; an inadequate assessment of suitable adaptive aids and personal needs; personal frustration; coping with the physical and mobility and limited social interaction. Findings from this study demonstrated a need to review the discharge process and implement strategies to prepare patients for the stressors that the participants in this study encountered as a result of their early discharge.
Australasian journal on ageing, 2015
This paper aims to describe a practical example of the use of adapted versions of a resident sati... more This paper aims to describe a practical example of the use of adapted versions of a resident satisfaction questionnaire for quality improvement purposes in a large aged care service organisation. Residential care and home care questionnaires each covered 11 aspects, the 'housing' questionnaire nine. Each aspect included Likert scale-type satisfaction questions. Questionnaires were distributed for completion by residents or by a friend/family member where a resident was unable to self-complete (e.g. because of dementia). Over the six separate customer satisfaction surveys conducted by the organisation since 1999, the analysis scheme has been refined and forms the basis of a report to the Board highlighting major findings and making recommendations regarding future actions. Most recently, the Board has decided to focus on three main areas, with actions identified for each, namely satisfaction with staff (e.g. enhanced staff training), social activities and involvement (e.g. in...
Advances in Mental Health, 2014
ABSTRACT The prevalence and consequences of mental health challenges amongst university students ... more ABSTRACT The prevalence and consequences of mental health challenges amongst university students is now widely acknowledged and university staff provide an important but often hidden service to these students. While completing a university degree is important to the student’s long-term outcomes there remains a paucity of literature on the support role provided to these students by staff . To contribute to knowledge in this area, a qualitative exploratory study was completed with academic and professional staff at two Australian universities in 2013. Data were collected using semi-structured interviews with 26 participants to document their experiences and to identify the barriers and enablers to their support role to students.
Midwifery, 2015
the aim of this Western Australian study was to describe the overall labour and birth experience ... more the aim of this Western Australian study was to describe the overall labour and birth experience of partners within the context of an intrapartum transfer occurring from a low risk midwifery-led, woman-centred unit to an obstetric unit. a descriptive phenomenological design was used. 15 male partners were interviewed in the first 8 weeks post partum between July and October, 2013 to explore their experience of the intrapartum transfer. a midwifery-led birth centre set on the grounds of a tertiary maternity referral hospital. partners of women who were transferred from the birth centre to the onsite tertiary hospital due to complications during the first and second stages of labour. five main themes emerged: (1) 'emotional roller coaster'; (2) 'partner׳s role in changing circumstances' with subthemes: 'acknowledgement for his inside knowledge of her' and 'challenges of being a witness'; (3) 'adapting to a changing model of care' with subthemes: 'moving from an inclusive nurturing and continuity model' and 'transferring to a medicalised model'; (4) 'adapting to environmental changes' with subthemes: 'feeling comfortable in the familiar birth centre',…
Archives of Psychiatric Nursing, 2014
BMC pregnancy and childbirth, Jan 8, 2016
The aim of this Western Australian study was to describe the overall labour and birth experience ... more The aim of this Western Australian study was to describe the overall labour and birth experience of women who were transferred during the first and second stages of labour from a low risk woman-centred, midwifery-led birth centre to a co-located tertiary maternity referral hospital. Using a descriptive phenomenological design, fifteen women were interviewed up to 8 weeks post birth (July to October, 2013) to explore their experience of the intrapartum transfer. Giorgi's method of analysis was used. The following themes and subthemes emerged: 1) The midwife's voice with subthemes, a) The calming effect and b) Speaking up on my behalf; 2) In the zone with subthemes, a) Hanging in there and b) Post birth rationalizing; 3) Best of both worlds with subthemes a) The feeling of relief on transfer to tertiary birth suite and b) Returning back to the comfort and familiarity of the birth centre; 4) Lost sense of self; and 5) Lost birth dream with subthemes a) Narrowing of options and ...
Results from the GAD-7 and PHQ-9 questionnaires taken before and after a 4-week intervention cons... more Results from the GAD-7 and PHQ-9 questionnaires taken before and after a 4-week intervention consisting of learning a new dance step every working day.
Nurse Education in Practice
BMC Pregnancy and Childbirth
Background Being ‘with woman’ is a central construct of the midwifery profession however, minimal... more Background Being ‘with woman’ is a central construct of the midwifery profession however, minimal research has been undertaken to explore the phenomenon from the perspective of midwives. The aim of this study was to describe Western Australian midwives’ perceptions of the phenomenon of being ‘with woman’ during the intrapartum period. Methods Descriptive phenomenology was selected as the methodology for this study. Thirty one midwives working across a variety of care models participated in individual interviews. Giorgi’s four stage phenomenological approach was employed to analyse data. Results Three themes were extracted 1) Essential to professional identity; 2) Partnership with women; and 3) Woman-Centred Practice. Midwives described the importance of being ‘with woman’ to the work and identification of midwifery practice. Developing a connection with the woman and providing woman-centred care inclusive of the woman’s support people was highlighted. Conclusions For the first time,...