Jill Downie - Academia.edu (original) (raw)
Papers by Jill Downie
This article describes the first stage of a three-stage pilot research project to establish a Hea... more This article describes the first stage of a three-stage pilot research project to establish a Healthy Ageing Unit, in a private hospital in Western Australia, based on a multidisciplinary model of transitional rehabilitation for the elderly acute patient. Results of the Stage One Developmental Needs Assessment and User Consultation indicated the need for post-acute intermediate care for the older patient. An audit of admissions and separations data found that patients aged 65 years and over had an average length of star of 33.4 days compared with the Australian norm of all patients of 3.7 days and that, in the pervious year, more than 322 acute general, medical and surgical patients had been unable to be admitted for treatment because of bed shortages. Moreover, anecdotal information suggested that both nursing staff and patients were frustrated by the lack of time available to adequately provide "enabling" care. The Unit proposed an innovative multidisciplinary model of s...
Grandparent-headed families are increasingly prevalent in Australia and are one of the fastest gr... more Grandparent-headed families are increasingly prevalent in Australia and are one of the fastest growing forms of out-of-home care of children in contact with our public welfare system. However, there is minimal information regarding the characteristics and experiences of Australian grandparent-headed families who assume care through the intervention of child protection services, or those who arrange parental care of their grandchildren privately. Evidence is needed on which to build a policy or service framework to address the health and wellbeing of these grandparents, and ensure quality and safe care of children and young people who are no longer able to live with their biological parents(s).
The Australian journal of advanced nursing : a quarterly publication of the Royal Australian Nursing Federation
The traditional role of the high school based community community health nurse has changed consid... more The traditional role of the high school based community community health nurse has changed considerably over recent decades. This article describes a qualitative study, in which nine community health nurses from eight different high schools completed a diary of the interventions and events during the course of two working days in order to identify the dimensions of their role. A short demographic questionnaire was also completed by the nurses and included two open-ended questions concerning their main professional issues and concerns. The researchers sought verification of the interpretation of the data through a focus group interview with the high school nurses. Data analysis indicated that the role of the high school community health nurses (CHN) consisted of seven categories. These were provider of clinical care, counsellor/ mediator, advocacy and support, liaison/referral, health promotion/education and resource agent, and professional management and research role. The findings ...
Nurse Education Today, 2004
The aim of any health care service is to provide optimal quality care to clients and families reg... more The aim of any health care service is to provide optimal quality care to clients and families regardless of their ethnic group. As today's Australian society comprises a multicultural population that encompasses clients with different cultural norms and values, this study examined undergraduate nursing students' self-efficacy in providing transcultural nursing care. A sample of 196 nursing students enrolled in the first and fourth year of a pre-registration nursing program in a Western Australian University were invited to participate in a survey incorporating a transcultural self-efficacy tool (TSET) designed by Jeffery [Unpublished instrument copyrighted by author, 1994]. The findings revealed that fourth year students, exposed to increased theoretical information and clinical experience, had a more positive perception of their self-efficacy in providing transcultural nursing skills than the first year students. In addition, the study found that age, gender, country of birth, languages spoken at home and previous work experience did not influence the nursing students' perception of self-efficacy in performing transcultural care. The study supports the notion that educational preparation and relevant clinical experience is important in providing nursing students with the opportunity to develop self-efficacy in performing effective and efficient transcultural nursing in today's multicultural health care system. It is for this reason that educators need to focus on providing students with relevant theoretical information and ensure sufficient clinical exposure to support student learning in the undergraduate program.
International journal of nursing practice, 2006
This paper reports a two-round Delphi study undertaken to identify the research priorities of mid... more This paper reports a two-round Delphi study undertaken to identify the research priorities of midwives at five public maternity hospitals in Western Australia's metropolitan area of Perth. In round one, 117 midwives identified 64 different problems or issues for research. Using thematic content analysis, these problems were grouped together and then collapsed to develop 17 specific research topics within four major categories. In round two, 152 midwives were asked to rank how important each of the topic statements were to women, their families and midwives. Research focusing on 'the postnatal experience' was ranked by midwives as the most important to the care of women and their families. From a midwife's perspective, the highest ranked topic was 'examining the professional issues that impact on midwives' clinical practice' (e.g. midwifery and medical collaboration, potential litigation and horizontal violence in the workplace). The results of the study s...
Women and Birth, 2007
There is limited midwifery research that focuses on midwives experiences and attitudes to providi... more There is limited midwifery research that focuses on midwives experiences and attitudes to providing care for women who experience the death of a baby. There is also limited research investigating care components, and evidence to inform the basis of clinical practice in Australia and internationally. This paper presents the qualitative findings of a small study that aimed to investigate midwives experience, confidence and satisfaction with providing care for women who experienced perinatal loss. Eighty-three Western Australian midwives responded to an open ended question asking them to describe the most and least satisfying aspects of their role when providing care to women who experienced a perinatal loss. Thematic analysis was used to analyse the data. The analysis revealed that Australian midwives gained most satisfaction from providing skilled midwifery care that they considered made a difference to women. This was enabled when midwives were afforded the opportunity to provide continuity of midwifery carer to women throughout the labour, birth and early postnatal period. In terms of the least satisfying aspects of care, midwives identified that they struggled with the emotional commitment needed to provide perinatal loss care, as well as with how to communicate openly and share information with women. Within the context of the study setting, midwifery care for women following perinatal loss reflects the care components espoused in the literature. There are, however, organisational issues within health care that require commitment to continuity of care and further education of practitioners to enhance outcomes for clients.
Midwifery, 2005
to explore and describe the labour and birth expectations of a cohort of Western Australian women... more to explore and describe the labour and birth expectations of a cohort of Western Australian women, and to identify the factors that influence these expectations. a qualitative study using an explorative descriptive design and techniques associated with constant comparison. Data were collected from tape-recorded telephone interviews. : Perth, Western Australia. two hundred and two women who were pregnant or who had birthed within the last 12 months. five major themes were identified. Three of the five themes reflected a positive outlook on birth. These were labelled, 'owning and believing in birth as a natural event', 'satisfaction with the birth process and outcome' and 'involvement and participation in the birthing experience'. The remaining two themes 'birth is a negative event' and 'birth is a medical event' encapsulated the women's statements that described childbirth as a potential negative and unaffirming experience. Particularly influential on the formation of childbirth expectations were the public and private discourses of childbirth, especially those related to books and magazines, and the stories of mothers and sisters. Professional discourses, women's own history, and factors such as age and life-style choices also influenced decisions and contributed to how women perceived their experiences. the findings of the study challenge the anecdotal evidence that many contemporary western women willingly and knowingly choose or expect birth to be a medicalised event. Although midwives and other maternity healthcare providers need to help women develop realistic expectations, there is also a need to examine the influence of healthcare professionals in perpetuating a technical approach to birth. The findings do, however, confirm that some women are anxious, scared and frightened of the childbirth experience. It is essential that research continues to focus on developing strategies to assist women confront and deal with these fears.
The Journal of Pediatrics, 2006
To determine whether maternal prepregnancy overweight or obesity has an independent effect on bre... more To determine whether maternal prepregnancy overweight or obesity has an independent effect on breastfeeding duration. A prospective birth cohort study of 1803 live-born children and their mothers ascertained through antenatal clinics at the major tertiary obstetric hospital in Perth, Australia, were followed until 3 years of age. Unconditional logistic, Cox regression, and Kaplan Meier analyses were used to model the association between maternal prepregnancy overweight and obesity and the duration of predominant or any breastfeeding allowing for adjustment of confounders (infant factors: gender, birth weight, gestational age, age solids introduced, and older siblings; maternal factors: smoking, education, age, race, marital status, pregnancy and birth complications, cesarean section, and socioeconomic status). Overweight and obese women were more likely to have discontinued breastfeeding at any time before 6 months than normal weight women (P < .0005) following adjustment for potential confounders. We have shown that prepregnancy body mass index is associated with reduced breastfeeding duration, and that mothers who are overweight or obese before pregnancy tend to breastfeed their infants for a shorter duration than normal weight mothers independent of maternal socioeconomic and demographic characteristics.
Journal of Advanced Nursing, 2003
Journal of Advanced Nursing, 2002
Australian and New Zealand Journal of Mental Health Nursing, 2000
The preparedness of comprehensive nurses to work with the mentally ill is of concern to many ment... more The preparedness of comprehensive nurses to work with the mentally ill is of concern to many mental health professionals. Discussion as to whether current undergraduate nursing programs in Australia prepare a graduate to work as a beginning practitioner in the mental health area has been the centre of debate for most of the 1990s. This, along with the apparent lack of interest and motivation of these nurses to work in the mental health area following graduation, remains a major problem for mental health care providers. With one in five Australians now experiencing the burden of a major mental illness, the preparation of a nurse who is competent to work with the mentally ill would appear to be a priority. The purpose of the present study was to determine third year undergraduate nursing students' perceived level of preparedness to work with mentally ill clients. The results suggested significant differences in students' perceived level of confidence, knowledge and skills prior to and following theoretical and clinical exposure to the mental health area. Pre-testing of students before entering their third year indicated that the philosophy of comprehensive nursing: integration, although aspired to in principle, does not appear to occur in reality.
Depression and Anxiety, 2008
Contemporary Nurse, 2005
Volunteers represent a growing, but often undervalued, section of service delivery in many areas ... more Volunteers represent a growing, but often undervalued, section of service delivery in many areas in the community, particularly in health care. This paper is centred on volunteers' perceptions and experiences of home visiting gained through the implementation of the Community Mothers (CM) program in Western Australia (WA). Further, the paper aims to inform debate about the issue of professional versus non-professional home visitors and offers a perspective on the issue that may provide direction for policy makers and practitioners. This qualitative study involved individual telephone interviews with a volunteer sample of 12 participants, purposefully selected. Transcription data from each interview were examined and coded utilising an adapted method of content analysis described by Burnard (1991). Three main themes emerged in the findings as to why volunteers became involved in the Community Mothers Program: (1) Empathetic concern; (2) Contribution to community life; and (3) Lifecourse issues and personal development. With experiences of volunteers in home visiting, four main themes reflected the participants' views: (1) Facilitating client empowerment; (2) Facilitating personal empowerment; (3) Promoting social connectedness; and (4) Enabling goal setting. Although programs such as the Community Mothers Program aim to benefit and support mothers in the parenting role it is clear that there are benefits that emerge also for the individual volunteer, such as increased self-esteem, self-efficacy and satisfaction. Hence, measuring the overall outcomes that result from such program remains a major challenge.
Contemporary Nurse, 2005
This paper discusses a strategic collaborative partnership between a Western Australian universit... more This paper discusses a strategic collaborative partnership between a Western Australian university and a community health service based on a Practice-Research Model. The partnership has involved a senior academic (0.2 FTE) working in the community health setting as a Nurse Research Consultant since 1998. The first section of the paper draws on the nursing literature on collaborative models and describes the broad background to the partnership and development of the Model. The second section presents in detail the results of a recent evaluation that involved a brief survey and follow-up interviews to determine community health nurses' understanding and perceptions of the partnership Model. Three main themes emerged from the interviews: (1) Advancement of learning captured the extent to which the Nurse Research Consultant position helped to educate nurses and promote and develop research and best-practice; (2) Job satisfaction and self-confidence encompassed the extent to which participants felt nursing management were supportive of their professional education and pursuit of best-practice solutions, and (3) Situational opportunity, which reflected the more negative comments expressed by participants and related mostly to the restricted availability of Nurse Research Consultant and a focus on mainstream research priorities. The results suggest that the partnership Model provided the nurses with the opportunity to develop an increased understanding of the role of research in clinical practice and confidence in their own ability to reflect on current nursing practice. This allowed them to identify clinical problems in order to deliver and evaluate best-practice solutions, as evidenced by a change in attitude from the previous evaluation. However, it was also noted that the operational performance of the Model needs continual monitoring to ensure that all nurses have equitable access opportunities.
Contemporary Nurse, 2004
Many parents lack support in their parenting role that was once provided through extended familie... more Many parents lack support in their parenting role that was once provided through extended families and community structures. Thus, some new parents experience high levels of stress and low self-esteem associated with the challenges of parenting. The lack of support also results in family discord and breakdown with the family environment having the potential to adversely impact children's mental and physical wellbeing and development. The Community Mothers Program (CMP) was initially developed in England and offers support to families during the first year of parenting. The program aims to provide parents with the support once experienced from within the extended family. It also aims to enrich community development by building the capacity of community members living in local communities to support parents. This paper describes the impact of the CMP when implemented into Western Australian as well as the changes to the professional practice role of community child health nurses involved in the program. The Community Mothers Program has proved to be very successful. The success is attributed to the partnership model established between community members, parents, and child health nurses.
Midwifery, 2007
to explore and describe the influence of childbirth expectations on women&amp... more to explore and describe the influence of childbirth expectations on women's perception of their birthing experience and expectations for subsequent births. This was the second phase of a study, the purpose of which its purpose was to determine the childbirth expectations of a cohort of Western Australian women and ascertain factors that influenced these expectations. a qualitative study which used an exploratory descriptive design. Data were collected from in-depth individual interviews. Perth, Western Australia. 20 women, 11 primiparae and nine multiparae, who between them had experienced 31 births. These women had participated in phase one when they were either pregnant or had birthed within the preceding 12 months. Phase two interviews occurred 5-6 months after phase one. the themes and sub-themes revealed in phase one of the study were supported in phase two. Although women held multiple expectations for birth, specific expectations were regarded as priority. Consequently, to perceive birth as positive, a woman had to achieve her priority expectations. Multiparae reported more positive birth experiences, having altered expectations as a result of previous experiences. Unaffirming birth experiences due to unmet expectations were more common after a first birth. Women with unfulfilled expectations subsequently adapted their expectations to be more achievable thus avoiding disappointment. Supportive behaviours of maternity health-care providers assisted women to evaluate their birth experience as positive even when expectations could not be achieved. the evaluation of birth experiences as positive or negative is contingent upon achieving most, or at least the priority, childbirth expectation. Knowing a woman's expectations assists the midwife in her advocacy role. This role in assisting women to achieve their expectations is reinforced by this research. Caregivers become even more important when expectations are not able to be realised. Behaviours that encourage involvement and participation in decision-making during birth promote feelings of control, coping and feeling supported, which ultimately are needed for women to assess their birth experience as positive. Achievable expectations, such as 'being flexible' and 'only having a healthy baby' could be regarded as a lessening of ideals. The issue of whether these changing expectations are contributing to the increasing technocratic approach to birth and the resulting devaluing of the normal birth experience requires further debate.
This article describes the first stage of a three-stage pilot research project to establish a Hea... more This article describes the first stage of a three-stage pilot research project to establish a Healthy Ageing Unit, in a private hospital in Western Australia, based on a multidisciplinary model of transitional rehabilitation for the elderly acute patient. Results of the Stage One Developmental Needs Assessment and User Consultation indicated the need for post-acute intermediate care for the older patient. An audit of admissions and separations data found that patients aged 65 years and over had an average length of star of 33.4 days compared with the Australian norm of all patients of 3.7 days and that, in the pervious year, more than 322 acute general, medical and surgical patients had been unable to be admitted for treatment because of bed shortages. Moreover, anecdotal information suggested that both nursing staff and patients were frustrated by the lack of time available to adequately provide "enabling" care. The Unit proposed an innovative multidisciplinary model of s...
Grandparent-headed families are increasingly prevalent in Australia and are one of the fastest gr... more Grandparent-headed families are increasingly prevalent in Australia and are one of the fastest growing forms of out-of-home care of children in contact with our public welfare system. However, there is minimal information regarding the characteristics and experiences of Australian grandparent-headed families who assume care through the intervention of child protection services, or those who arrange parental care of their grandchildren privately. Evidence is needed on which to build a policy or service framework to address the health and wellbeing of these grandparents, and ensure quality and safe care of children and young people who are no longer able to live with their biological parents(s).
The Australian journal of advanced nursing : a quarterly publication of the Royal Australian Nursing Federation
The traditional role of the high school based community community health nurse has changed consid... more The traditional role of the high school based community community health nurse has changed considerably over recent decades. This article describes a qualitative study, in which nine community health nurses from eight different high schools completed a diary of the interventions and events during the course of two working days in order to identify the dimensions of their role. A short demographic questionnaire was also completed by the nurses and included two open-ended questions concerning their main professional issues and concerns. The researchers sought verification of the interpretation of the data through a focus group interview with the high school nurses. Data analysis indicated that the role of the high school community health nurses (CHN) consisted of seven categories. These were provider of clinical care, counsellor/ mediator, advocacy and support, liaison/referral, health promotion/education and resource agent, and professional management and research role. The findings ...
Nurse Education Today, 2004
The aim of any health care service is to provide optimal quality care to clients and families reg... more The aim of any health care service is to provide optimal quality care to clients and families regardless of their ethnic group. As today's Australian society comprises a multicultural population that encompasses clients with different cultural norms and values, this study examined undergraduate nursing students' self-efficacy in providing transcultural nursing care. A sample of 196 nursing students enrolled in the first and fourth year of a pre-registration nursing program in a Western Australian University were invited to participate in a survey incorporating a transcultural self-efficacy tool (TSET) designed by Jeffery [Unpublished instrument copyrighted by author, 1994]. The findings revealed that fourth year students, exposed to increased theoretical information and clinical experience, had a more positive perception of their self-efficacy in providing transcultural nursing skills than the first year students. In addition, the study found that age, gender, country of birth, languages spoken at home and previous work experience did not influence the nursing students' perception of self-efficacy in performing transcultural care. The study supports the notion that educational preparation and relevant clinical experience is important in providing nursing students with the opportunity to develop self-efficacy in performing effective and efficient transcultural nursing in today's multicultural health care system. It is for this reason that educators need to focus on providing students with relevant theoretical information and ensure sufficient clinical exposure to support student learning in the undergraduate program.
International journal of nursing practice, 2006
This paper reports a two-round Delphi study undertaken to identify the research priorities of mid... more This paper reports a two-round Delphi study undertaken to identify the research priorities of midwives at five public maternity hospitals in Western Australia's metropolitan area of Perth. In round one, 117 midwives identified 64 different problems or issues for research. Using thematic content analysis, these problems were grouped together and then collapsed to develop 17 specific research topics within four major categories. In round two, 152 midwives were asked to rank how important each of the topic statements were to women, their families and midwives. Research focusing on 'the postnatal experience' was ranked by midwives as the most important to the care of women and their families. From a midwife's perspective, the highest ranked topic was 'examining the professional issues that impact on midwives' clinical practice' (e.g. midwifery and medical collaboration, potential litigation and horizontal violence in the workplace). The results of the study s...
Women and Birth, 2007
There is limited midwifery research that focuses on midwives experiences and attitudes to providi... more There is limited midwifery research that focuses on midwives experiences and attitudes to providing care for women who experience the death of a baby. There is also limited research investigating care components, and evidence to inform the basis of clinical practice in Australia and internationally. This paper presents the qualitative findings of a small study that aimed to investigate midwives experience, confidence and satisfaction with providing care for women who experienced perinatal loss. Eighty-three Western Australian midwives responded to an open ended question asking them to describe the most and least satisfying aspects of their role when providing care to women who experienced a perinatal loss. Thematic analysis was used to analyse the data. The analysis revealed that Australian midwives gained most satisfaction from providing skilled midwifery care that they considered made a difference to women. This was enabled when midwives were afforded the opportunity to provide continuity of midwifery carer to women throughout the labour, birth and early postnatal period. In terms of the least satisfying aspects of care, midwives identified that they struggled with the emotional commitment needed to provide perinatal loss care, as well as with how to communicate openly and share information with women. Within the context of the study setting, midwifery care for women following perinatal loss reflects the care components espoused in the literature. There are, however, organisational issues within health care that require commitment to continuity of care and further education of practitioners to enhance outcomes for clients.
Midwifery, 2005
to explore and describe the labour and birth expectations of a cohort of Western Australian women... more to explore and describe the labour and birth expectations of a cohort of Western Australian women, and to identify the factors that influence these expectations. a qualitative study using an explorative descriptive design and techniques associated with constant comparison. Data were collected from tape-recorded telephone interviews. : Perth, Western Australia. two hundred and two women who were pregnant or who had birthed within the last 12 months. five major themes were identified. Three of the five themes reflected a positive outlook on birth. These were labelled, 'owning and believing in birth as a natural event', 'satisfaction with the birth process and outcome' and 'involvement and participation in the birthing experience'. The remaining two themes 'birth is a negative event' and 'birth is a medical event' encapsulated the women's statements that described childbirth as a potential negative and unaffirming experience. Particularly influential on the formation of childbirth expectations were the public and private discourses of childbirth, especially those related to books and magazines, and the stories of mothers and sisters. Professional discourses, women's own history, and factors such as age and life-style choices also influenced decisions and contributed to how women perceived their experiences. the findings of the study challenge the anecdotal evidence that many contemporary western women willingly and knowingly choose or expect birth to be a medicalised event. Although midwives and other maternity healthcare providers need to help women develop realistic expectations, there is also a need to examine the influence of healthcare professionals in perpetuating a technical approach to birth. The findings do, however, confirm that some women are anxious, scared and frightened of the childbirth experience. It is essential that research continues to focus on developing strategies to assist women confront and deal with these fears.
The Journal of Pediatrics, 2006
To determine whether maternal prepregnancy overweight or obesity has an independent effect on bre... more To determine whether maternal prepregnancy overweight or obesity has an independent effect on breastfeeding duration. A prospective birth cohort study of 1803 live-born children and their mothers ascertained through antenatal clinics at the major tertiary obstetric hospital in Perth, Australia, were followed until 3 years of age. Unconditional logistic, Cox regression, and Kaplan Meier analyses were used to model the association between maternal prepregnancy overweight and obesity and the duration of predominant or any breastfeeding allowing for adjustment of confounders (infant factors: gender, birth weight, gestational age, age solids introduced, and older siblings; maternal factors: smoking, education, age, race, marital status, pregnancy and birth complications, cesarean section, and socioeconomic status). Overweight and obese women were more likely to have discontinued breastfeeding at any time before 6 months than normal weight women (P < .0005) following adjustment for potential confounders. We have shown that prepregnancy body mass index is associated with reduced breastfeeding duration, and that mothers who are overweight or obese before pregnancy tend to breastfeed their infants for a shorter duration than normal weight mothers independent of maternal socioeconomic and demographic characteristics.
Journal of Advanced Nursing, 2003
Journal of Advanced Nursing, 2002
Australian and New Zealand Journal of Mental Health Nursing, 2000
The preparedness of comprehensive nurses to work with the mentally ill is of concern to many ment... more The preparedness of comprehensive nurses to work with the mentally ill is of concern to many mental health professionals. Discussion as to whether current undergraduate nursing programs in Australia prepare a graduate to work as a beginning practitioner in the mental health area has been the centre of debate for most of the 1990s. This, along with the apparent lack of interest and motivation of these nurses to work in the mental health area following graduation, remains a major problem for mental health care providers. With one in five Australians now experiencing the burden of a major mental illness, the preparation of a nurse who is competent to work with the mentally ill would appear to be a priority. The purpose of the present study was to determine third year undergraduate nursing students' perceived level of preparedness to work with mentally ill clients. The results suggested significant differences in students' perceived level of confidence, knowledge and skills prior to and following theoretical and clinical exposure to the mental health area. Pre-testing of students before entering their third year indicated that the philosophy of comprehensive nursing: integration, although aspired to in principle, does not appear to occur in reality.
Depression and Anxiety, 2008
Contemporary Nurse, 2005
Volunteers represent a growing, but often undervalued, section of service delivery in many areas ... more Volunteers represent a growing, but often undervalued, section of service delivery in many areas in the community, particularly in health care. This paper is centred on volunteers' perceptions and experiences of home visiting gained through the implementation of the Community Mothers (CM) program in Western Australia (WA). Further, the paper aims to inform debate about the issue of professional versus non-professional home visitors and offers a perspective on the issue that may provide direction for policy makers and practitioners. This qualitative study involved individual telephone interviews with a volunteer sample of 12 participants, purposefully selected. Transcription data from each interview were examined and coded utilising an adapted method of content analysis described by Burnard (1991). Three main themes emerged in the findings as to why volunteers became involved in the Community Mothers Program: (1) Empathetic concern; (2) Contribution to community life; and (3) Lifecourse issues and personal development. With experiences of volunteers in home visiting, four main themes reflected the participants' views: (1) Facilitating client empowerment; (2) Facilitating personal empowerment; (3) Promoting social connectedness; and (4) Enabling goal setting. Although programs such as the Community Mothers Program aim to benefit and support mothers in the parenting role it is clear that there are benefits that emerge also for the individual volunteer, such as increased self-esteem, self-efficacy and satisfaction. Hence, measuring the overall outcomes that result from such program remains a major challenge.
Contemporary Nurse, 2005
This paper discusses a strategic collaborative partnership between a Western Australian universit... more This paper discusses a strategic collaborative partnership between a Western Australian university and a community health service based on a Practice-Research Model. The partnership has involved a senior academic (0.2 FTE) working in the community health setting as a Nurse Research Consultant since 1998. The first section of the paper draws on the nursing literature on collaborative models and describes the broad background to the partnership and development of the Model. The second section presents in detail the results of a recent evaluation that involved a brief survey and follow-up interviews to determine community health nurses' understanding and perceptions of the partnership Model. Three main themes emerged from the interviews: (1) Advancement of learning captured the extent to which the Nurse Research Consultant position helped to educate nurses and promote and develop research and best-practice; (2) Job satisfaction and self-confidence encompassed the extent to which participants felt nursing management were supportive of their professional education and pursuit of best-practice solutions, and (3) Situational opportunity, which reflected the more negative comments expressed by participants and related mostly to the restricted availability of Nurse Research Consultant and a focus on mainstream research priorities. The results suggest that the partnership Model provided the nurses with the opportunity to develop an increased understanding of the role of research in clinical practice and confidence in their own ability to reflect on current nursing practice. This allowed them to identify clinical problems in order to deliver and evaluate best-practice solutions, as evidenced by a change in attitude from the previous evaluation. However, it was also noted that the operational performance of the Model needs continual monitoring to ensure that all nurses have equitable access opportunities.
Contemporary Nurse, 2004
Many parents lack support in their parenting role that was once provided through extended familie... more Many parents lack support in their parenting role that was once provided through extended families and community structures. Thus, some new parents experience high levels of stress and low self-esteem associated with the challenges of parenting. The lack of support also results in family discord and breakdown with the family environment having the potential to adversely impact children's mental and physical wellbeing and development. The Community Mothers Program (CMP) was initially developed in England and offers support to families during the first year of parenting. The program aims to provide parents with the support once experienced from within the extended family. It also aims to enrich community development by building the capacity of community members living in local communities to support parents. This paper describes the impact of the CMP when implemented into Western Australian as well as the changes to the professional practice role of community child health nurses involved in the program. The Community Mothers Program has proved to be very successful. The success is attributed to the partnership model established between community members, parents, and child health nurses.
Midwifery, 2007
to explore and describe the influence of childbirth expectations on women&amp... more to explore and describe the influence of childbirth expectations on women's perception of their birthing experience and expectations for subsequent births. This was the second phase of a study, the purpose of which its purpose was to determine the childbirth expectations of a cohort of Western Australian women and ascertain factors that influenced these expectations. a qualitative study which used an exploratory descriptive design. Data were collected from in-depth individual interviews. Perth, Western Australia. 20 women, 11 primiparae and nine multiparae, who between them had experienced 31 births. These women had participated in phase one when they were either pregnant or had birthed within the preceding 12 months. Phase two interviews occurred 5-6 months after phase one. the themes and sub-themes revealed in phase one of the study were supported in phase two. Although women held multiple expectations for birth, specific expectations were regarded as priority. Consequently, to perceive birth as positive, a woman had to achieve her priority expectations. Multiparae reported more positive birth experiences, having altered expectations as a result of previous experiences. Unaffirming birth experiences due to unmet expectations were more common after a first birth. Women with unfulfilled expectations subsequently adapted their expectations to be more achievable thus avoiding disappointment. Supportive behaviours of maternity health-care providers assisted women to evaluate their birth experience as positive even when expectations could not be achieved. the evaluation of birth experiences as positive or negative is contingent upon achieving most, or at least the priority, childbirth expectation. Knowing a woman's expectations assists the midwife in her advocacy role. This role in assisting women to achieve their expectations is reinforced by this research. Caregivers become even more important when expectations are not able to be realised. Behaviours that encourage involvement and participation in decision-making during birth promote feelings of control, coping and feeling supported, which ultimately are needed for women to assess their birth experience as positive. Achievable expectations, such as 'being flexible' and 'only having a healthy baby' could be regarded as a lessening of ideals. The issue of whether these changing expectations are contributing to the increasing technocratic approach to birth and the resulting devaluing of the normal birth experience requires further debate.