Heather Tan - Academia.edu (original) (raw)

Papers by Heather Tan

Research paper thumbnail of Tan, H., O’Connor, M., Peters, L., Howard, T. (2012). Evaluation of Community Palliative Care Settings: A discussion of the issues. Asia Pacific Journal of Health Management 7(1), 43-48

Research paper thumbnail of The evaluation of a triage tool for a community palliative care service provider

Journal of palliative care

Triage, widely used by the military and emergency departments, has not been reported in community... more Triage, widely used by the military and emergency departments, has not been reported in community palliative care services. Policy designed to improve equitable provision of this care has led to the development of a triage tool. Retrospective data were collected (50 percent of referrals, n = 204) and analyzed using the Wilcoxon signed-rank test to determine the accuracy of the tool in predicting patient status at the first visit. Semi-structured interviews (n = 7) with palliative care service staff added qualitative data. Although significant differences between triage scores compared to outcomes at first visit were observed, issues such as upgrading of triage category compared to priority score occurred in more than 30 percent of cases. When correction for this was made, the tool was found to be an accurate guide to patient needs. This tool, when used as intended, was effective in assessing the urgency of need, and it is potentially useful on a wider scale, subject to further evalu...

Research paper thumbnail of Tan, H., Wilson, A., Olver, I., Barton, C. (2011). The Family Meeting Addressing Spiritual Needs in a Palliative Care Setting: Some Practical Implications. Progress in Palliative Care. 19(2) 66-72

Progress in Palliative Care

Introduction: This study evaluated the use of a family meeting model to address the spiritual nee... more Introduction: This study evaluated the use of a family meeting model to address the spiritual needs of palliative patients and their family members in the context of two metropolitan palliative care (PC) services offering hospital, hospice, and home care. Murphy's family meeting model that incorporates a broad understanding of spirituality was utilized. Here we report the acceptability of this model to staff and patients in these settings. Methods: Qualitative methods, informed by an interpretive approach and underpinned by Hermeneutic phenomenology, were used to evaluate a trial of the family meeting model. Participants included 12 palliative patients and 35 family members. Twelve family meetings were facilitated, by the lead author (H.T.). Following each meeting individual in-depth interviews were conducted with consenting participants. Interviews were also held with 14 PC staff from a variety of disciplines, who had referred patients to the study. Transcribed interviews were analysed utilizing Ricoeur's theory of interpretation. Findings: Patients, family members, and staff indicated that participation in a family meeting of this type would be a valuable addition to regular PC services. However, practical barriers to its application were identified and included the need for specific meeting facilitation skills, funding priorities, staff time, and possible language and cultural issues. Conclusion: This model of family meeting is potentially a very useful intervention in a setting which promotes holistic care of patients and their family members, including attention to psychosocial and spiritual care. Strategies to overcome barriers to implementation such as time and cost issues need further investigation.

Research paper thumbnail of Impact of a death on other residents in aged care

Australian nursing journal (July 1993)

Research paper thumbnail of After hours palliative care

Australian nursing journal (July 1993)

Abstract Current Australian government policy encourages people receiving palliative care to rema... more Abstract Current Australian government policy encourages people receiving palliative care to remain in their own residence, be it their own home (Palmer and Short 2007) or a residential care facility, for as long as possible and to enable them to achieve a desire, ...

Research paper thumbnail of Managing terminal dementia

Australian nursing journal (July 1993)

Research paper thumbnail of The family meeting addressing spiritual and psychosocial needs in a palliative care setting: usefulness and challenges to implementation

Progress in Palliative Care, 2011

Methods Qualitative methods, informed by an interpretive approach and underpinned by Hermeneutic ... more Methods Qualitative methods, informed by an interpretive approach and underpinned by Hermeneutic phenomenology, were used to evaluate a trial of the family meeting model. Participants included 12 palliative patients and 35 family members. Twelve family ...

Research paper thumbnail of Transitioning from caregiver to visitor in a long-term care facility: the experience of caregivers of people with dementia

Aging & mental health, Jan 30, 2014

Objectives: Transitioning from the primary caregiver to the visitor in a long-term care facility ... more Objectives: Transitioning from the primary caregiver to the visitor in a long-term care facility may be challenging for the caregiver; they are required to surrender their caring duties to the medical and nursing staff. The aim of this study was to explore the experiences of caregivers during their transition from day-to-day caregiver of a person with dementia to a visitor in a long-term care facility. Methods: This study utilised a qualitative descriptive design. Twenty caregivers of people with dementia were recruited from the one Aged Rehabilitation and Geriatric Evaluation and Management facility, located in Victoria, Australia. Semi-structured interviews were used to explore the caregiver's experiences. Interviews were analysed using thematic analysis. Results: The interview data revealed that the participants were undergoing similar experiences. The findings revealed that it was difficult for the caregiver to transition to their new role of visitor; negative reactions of g...

Research paper thumbnail of Impact of a death on other residents in aged care

Australian nursing journal (July 1993), 2012

Research paper thumbnail of Managing terminal dementia

Australian nursing journal (July 1993), 2012

Research paper thumbnail of Is the frequent death of residents in aged care facilities a significant cause of grief for residents with mild dementia?

Progress in Palliative Care, 2013

Research paper thumbnail of After hours palliative care

Australian nursing journal (July 1993), 2009

Abstract Current Australian government policy encourages people receiving palliative care to rema... more Abstract Current Australian government policy encourages people receiving palliative care to remain in their own residence, be it their own home (Palmer and Short 2007) or a residential care facility, for as long as possible and to enable them to achieve a desire, ...

Research paper thumbnail of The evaluation of a triage tool for a community palliative care service provider

Journal of palliative care, 2012

Triage, widely used by the military and emergency departments, has not been reported in community... more Triage, widely used by the military and emergency departments, has not been reported in community palliative care services. Policy designed to improve equitable provision of this care has led to the development of a triage tool. Retrospective data were collected (50 percent of referrals, n = 204) and analyzed using the Wilcoxon signed-rank test to determine the accuracy of the tool in predicting patient status at the first visit. Semi-structured interviews (n = 7) with palliative care service staff added qualitative data. Although significant differences between triage scores compared to outcomes at first visit were observed, issues such as upgrading of triage category compared to priority score occurred in more than 30 percent of cases. When correction for this was made, the tool was found to be an accurate guide to patient needs. This tool, when used as intended, was effective in assessing the urgency of need, and it is potentially useful on a wider scale, subject to further evalu...

Research paper thumbnail of Impact on residents with mild dementia of frequent death in aged care facilities

Research paper thumbnail of Addressing grief following patient death in aged-care facilities: The views of patients with mild dementia and staff

Research paper thumbnail of Brief Report End-of-life care in a rehabilitation centre for older people

Research paper thumbnail of Evaluation of community palliative care settings: A discussion of the issues

Research paper thumbnail of Spirituality and quality of life in older people with chronic illness in Thailand

Progress in Palliative Care, 2011

Research paper thumbnail of The Impact of the Hospice Environment on Patient Spiritual Expression

Oncology Nursing Forum, 2005

To understand how hospital inpatients express their spirituality and to investigate the impact of... more To understand how hospital inpatients express their spirituality and to investigate the impact of hospice environment on this expression. Qualitative. Two metropolitan hospice centers in southern Australia. 12 inpatients (7 males, 5 females) who were residents for at least four days. Influenced by Heidegger's Phenomenological Hermeneutics, semistructured interviews were conducted. Interview transcripts and field notes were analyzed to reduce data into codes and themes. Data were coded by extracting verbatim phrases used to describe spiritual expression and the impact of hospice environment on it. The nature of spiritual expression and the impact of the hospice environment on the spiritual expression of hospice inpatients. Participants were comfortable discussing their spiritual expression within the context of four main themes: Relationships, That Which Uplifts, Spiritual Practice, and Having Hope. Finding meaning was a common link among these themes. The impact of the hospice environment was variable. Most believed that it facilitated their spiritual expression to some degree. Spiritual expression is important but is facilitated by individualized spiritual care. Nurses play an important role in the provision of spiritual care within a hospice setting. Nurses are significant in assisting in patients' spiritual expression. Nurses' needs for training in listening skills, confidence in discussing spiritual issues, and time to provide individualized spiritual care should be assessed to ensure optimal patient expression.

Research paper thumbnail of The experience of family carers of people with dementia who are hospitalised

Dementia, 2014

Hospital admission of a person with dementia can have a significant impact on the family carer, w... more Hospital admission of a person with dementia can have a significant impact on the family carer, who temporarily relinquishes caring to health professionals. A descriptive qualitative design using in-depth interviews with a conversational approach was used to elicit data. Adjusting to the change in the carer's role can be challenging and result in feelings of helplessness, loneliness, loss of control and being undervalued. Family support can assist with the transition but family conflict increases anxiety. Good communication between clinicians and the carer is vital. The carer should be included in decision-making as the 'expert' in the care of the person with dementia. This article discusses findings of a larger study specifically related to the emotional support required for the carers of people with dementia, who are admitted to hospital. The carer and the patient must be considered as a dyad in relation to discharge planning.

Research paper thumbnail of Tan, H., O’Connor, M., Peters, L., Howard, T. (2012). Evaluation of Community Palliative Care Settings: A discussion of the issues. Asia Pacific Journal of Health Management 7(1), 43-48

Research paper thumbnail of The evaluation of a triage tool for a community palliative care service provider

Journal of palliative care

Triage, widely used by the military and emergency departments, has not been reported in community... more Triage, widely used by the military and emergency departments, has not been reported in community palliative care services. Policy designed to improve equitable provision of this care has led to the development of a triage tool. Retrospective data were collected (50 percent of referrals, n = 204) and analyzed using the Wilcoxon signed-rank test to determine the accuracy of the tool in predicting patient status at the first visit. Semi-structured interviews (n = 7) with palliative care service staff added qualitative data. Although significant differences between triage scores compared to outcomes at first visit were observed, issues such as upgrading of triage category compared to priority score occurred in more than 30 percent of cases. When correction for this was made, the tool was found to be an accurate guide to patient needs. This tool, when used as intended, was effective in assessing the urgency of need, and it is potentially useful on a wider scale, subject to further evalu...

Research paper thumbnail of Tan, H., Wilson, A., Olver, I., Barton, C. (2011). The Family Meeting Addressing Spiritual Needs in a Palliative Care Setting: Some Practical Implications. Progress in Palliative Care. 19(2) 66-72

Progress in Palliative Care

Introduction: This study evaluated the use of a family meeting model to address the spiritual nee... more Introduction: This study evaluated the use of a family meeting model to address the spiritual needs of palliative patients and their family members in the context of two metropolitan palliative care (PC) services offering hospital, hospice, and home care. Murphy's family meeting model that incorporates a broad understanding of spirituality was utilized. Here we report the acceptability of this model to staff and patients in these settings. Methods: Qualitative methods, informed by an interpretive approach and underpinned by Hermeneutic phenomenology, were used to evaluate a trial of the family meeting model. Participants included 12 palliative patients and 35 family members. Twelve family meetings were facilitated, by the lead author (H.T.). Following each meeting individual in-depth interviews were conducted with consenting participants. Interviews were also held with 14 PC staff from a variety of disciplines, who had referred patients to the study. Transcribed interviews were analysed utilizing Ricoeur's theory of interpretation. Findings: Patients, family members, and staff indicated that participation in a family meeting of this type would be a valuable addition to regular PC services. However, practical barriers to its application were identified and included the need for specific meeting facilitation skills, funding priorities, staff time, and possible language and cultural issues. Conclusion: This model of family meeting is potentially a very useful intervention in a setting which promotes holistic care of patients and their family members, including attention to psychosocial and spiritual care. Strategies to overcome barriers to implementation such as time and cost issues need further investigation.

Research paper thumbnail of Impact of a death on other residents in aged care

Australian nursing journal (July 1993)

Research paper thumbnail of After hours palliative care

Australian nursing journal (July 1993)

Abstract Current Australian government policy encourages people receiving palliative care to rema... more Abstract Current Australian government policy encourages people receiving palliative care to remain in their own residence, be it their own home (Palmer and Short 2007) or a residential care facility, for as long as possible and to enable them to achieve a desire, ...

Research paper thumbnail of Managing terminal dementia

Australian nursing journal (July 1993)

Research paper thumbnail of The family meeting addressing spiritual and psychosocial needs in a palliative care setting: usefulness and challenges to implementation

Progress in Palliative Care, 2011

Methods Qualitative methods, informed by an interpretive approach and underpinned by Hermeneutic ... more Methods Qualitative methods, informed by an interpretive approach and underpinned by Hermeneutic phenomenology, were used to evaluate a trial of the family meeting model. Participants included 12 palliative patients and 35 family members. Twelve family ...

Research paper thumbnail of Transitioning from caregiver to visitor in a long-term care facility: the experience of caregivers of people with dementia

Aging & mental health, Jan 30, 2014

Objectives: Transitioning from the primary caregiver to the visitor in a long-term care facility ... more Objectives: Transitioning from the primary caregiver to the visitor in a long-term care facility may be challenging for the caregiver; they are required to surrender their caring duties to the medical and nursing staff. The aim of this study was to explore the experiences of caregivers during their transition from day-to-day caregiver of a person with dementia to a visitor in a long-term care facility. Methods: This study utilised a qualitative descriptive design. Twenty caregivers of people with dementia were recruited from the one Aged Rehabilitation and Geriatric Evaluation and Management facility, located in Victoria, Australia. Semi-structured interviews were used to explore the caregiver's experiences. Interviews were analysed using thematic analysis. Results: The interview data revealed that the participants were undergoing similar experiences. The findings revealed that it was difficult for the caregiver to transition to their new role of visitor; negative reactions of g...

Research paper thumbnail of Impact of a death on other residents in aged care

Australian nursing journal (July 1993), 2012

Research paper thumbnail of Managing terminal dementia

Australian nursing journal (July 1993), 2012

Research paper thumbnail of Is the frequent death of residents in aged care facilities a significant cause of grief for residents with mild dementia?

Progress in Palliative Care, 2013

Research paper thumbnail of After hours palliative care

Australian nursing journal (July 1993), 2009

Abstract Current Australian government policy encourages people receiving palliative care to rema... more Abstract Current Australian government policy encourages people receiving palliative care to remain in their own residence, be it their own home (Palmer and Short 2007) or a residential care facility, for as long as possible and to enable them to achieve a desire, ...

Research paper thumbnail of The evaluation of a triage tool for a community palliative care service provider

Journal of palliative care, 2012

Triage, widely used by the military and emergency departments, has not been reported in community... more Triage, widely used by the military and emergency departments, has not been reported in community palliative care services. Policy designed to improve equitable provision of this care has led to the development of a triage tool. Retrospective data were collected (50 percent of referrals, n = 204) and analyzed using the Wilcoxon signed-rank test to determine the accuracy of the tool in predicting patient status at the first visit. Semi-structured interviews (n = 7) with palliative care service staff added qualitative data. Although significant differences between triage scores compared to outcomes at first visit were observed, issues such as upgrading of triage category compared to priority score occurred in more than 30 percent of cases. When correction for this was made, the tool was found to be an accurate guide to patient needs. This tool, when used as intended, was effective in assessing the urgency of need, and it is potentially useful on a wider scale, subject to further evalu...

Research paper thumbnail of Impact on residents with mild dementia of frequent death in aged care facilities

Research paper thumbnail of Addressing grief following patient death in aged-care facilities: The views of patients with mild dementia and staff

Research paper thumbnail of Brief Report End-of-life care in a rehabilitation centre for older people

Research paper thumbnail of Evaluation of community palliative care settings: A discussion of the issues

Research paper thumbnail of Spirituality and quality of life in older people with chronic illness in Thailand

Progress in Palliative Care, 2011

Research paper thumbnail of The Impact of the Hospice Environment on Patient Spiritual Expression

Oncology Nursing Forum, 2005

To understand how hospital inpatients express their spirituality and to investigate the impact of... more To understand how hospital inpatients express their spirituality and to investigate the impact of hospice environment on this expression. Qualitative. Two metropolitan hospice centers in southern Australia. 12 inpatients (7 males, 5 females) who were residents for at least four days. Influenced by Heidegger's Phenomenological Hermeneutics, semistructured interviews were conducted. Interview transcripts and field notes were analyzed to reduce data into codes and themes. Data were coded by extracting verbatim phrases used to describe spiritual expression and the impact of hospice environment on it. The nature of spiritual expression and the impact of the hospice environment on the spiritual expression of hospice inpatients. Participants were comfortable discussing their spiritual expression within the context of four main themes: Relationships, That Which Uplifts, Spiritual Practice, and Having Hope. Finding meaning was a common link among these themes. The impact of the hospice environment was variable. Most believed that it facilitated their spiritual expression to some degree. Spiritual expression is important but is facilitated by individualized spiritual care. Nurses play an important role in the provision of spiritual care within a hospice setting. Nurses are significant in assisting in patients' spiritual expression. Nurses' needs for training in listening skills, confidence in discussing spiritual issues, and time to provide individualized spiritual care should be assessed to ensure optimal patient expression.

Research paper thumbnail of The experience of family carers of people with dementia who are hospitalised

Dementia, 2014

Hospital admission of a person with dementia can have a significant impact on the family carer, w... more Hospital admission of a person with dementia can have a significant impact on the family carer, who temporarily relinquishes caring to health professionals. A descriptive qualitative design using in-depth interviews with a conversational approach was used to elicit data. Adjusting to the change in the carer's role can be challenging and result in feelings of helplessness, loneliness, loss of control and being undervalued. Family support can assist with the transition but family conflict increases anxiety. Good communication between clinicians and the carer is vital. The carer should be included in decision-making as the 'expert' in the care of the person with dementia. This article discusses findings of a larger study specifically related to the emotional support required for the carers of people with dementia, who are admitted to hospital. The carer and the patient must be considered as a dyad in relation to discharge planning.