Lesley Batten - Academia.edu (original) (raw)
Papers by Lesley Batten
Nursing Praxis in New Zealand Inc, Nov 1, 2011
Help-seeking is an active process used by people of all ages to obtain assistance to solve proble... more Help-seeking is an active process used by people of all ages to obtain assistance to solve problems. This research sought to investigate a component of help-seeking related to health concerns. A health related help-seeking model, was adapted to frame questions for an anonymous, self-administered questionnaire. Seventy-five students aged between 16 and 24 years responded and data were analysed using content and descriptive statistical techniques. Findings indicated that young people perceived the need to seek advice when unwell, needing support or information, are resourceful, and were motivated to seek help from a variety of sources. Parents and whānau formed one usual source of advice, but young people reported one of the best sources of advice as General Practice nurses and doctors. Barriers to seeking advice included distrusting sources, and concerns about confidentiality. Unsurprisingly, many respondents used the Internet for health information, although some mistrusted that information. Nurses need to be aware of the sources of health advice and support that young people choose to use. Motivations for selecting services, providers, or sources clearly replicated what young people hold as important--sources with which they feel comfortable, have a relationship, trust, and which they perceived as maintaining confidentiality.
BMJ Supportive & Palliative Care, 2014
Background The Liverpool Care Pathway for the Dying Patient was introduced into parts of New Zeal... more Background The Liverpool Care Pathway for the Dying Patient was introduced into parts of New Zealand in 2005. Unique 'cultural goals' were added, in recognition of the importance of the provision of culturally appropriate care. Aims To assess the use of the cultural goals in practice and to investigate stakeholders' experiences and perspectives of how the cultural goals influence culturally appropriate end-of-life care. Methods A mixed method study including, in this phase, two clinical audits, semi-structured interviews with 20 stakeholders, and a focus group with 20 Maori clinical staff. Interview data were analysed thematically, and audit data were analysed using descriptive statistics and content analysis. Results Participants identified many factors that acted as constraints or enablers in the provision of culturally appropriate care. These factors operated at multiple levels, including at the
BMJ Supportive & Palliative Care, 2014
Background Clinical pathways including the Liverpool Care Pathway for the Dying Patient (LCP) con... more Background Clinical pathways including the Liverpool Care Pathway for the Dying Patient (LCP) construct the documentation of care in ways that can have benefits and consequences. In New Zealand unique cultural goals related to the care of patients and their families were added to the LCP, and research into their use is underway. Aims As part of an investigation into the utility, comprehensiveness and cultural appropriateness of the cultural goals, the aim was to examine the content of cultural care documentation to ascertain documentation practices. Methods A retrospective chart audit of 100 LCP documents, with 25 each from home care, aged residential care, hospital and hospice, and semi-structured interviews with stakeholders including clinical staff and managers. Results A number of patterns emerged including: very high rates (99% of 1360 entries) of the goals being recorded as 'achieved', even when one of the goals related to family needs and the family was not present; minimal documentation of cultural needs; and minimal variance documentation. In addition a further pattern related the use of the yes or no format in version 11 (rather than achieved or variance in version 12). A variance was documented
Annals of oncology : official journal of the European Society for Medical Oncology / ESMO, Jan 20, 2015
Comorbidity is very common among patients with cancer. Multidisciplinary team meetings (MDTs) are... more Comorbidity is very common among patients with cancer. Multidisciplinary team meetings (MDTs) are increasingly the context within which cancer treatment decisions are made internationally. Little is known about how comorbidity is considered, or impacts decisions, in MDTs. A systematic literature review was conducted to evaluate previous evidence on consideration, and impact, of comorbidity in cancer MDT treatment decision making. Twenty-one original studies were included. Lack of information on comorbidity in MDTs impedes the ability of MDT members to make treatment recommendations, and for those recommendations to be implemented among patients with comorbidity. Where treatment is different from that recommended due to comorbidity, it is more conservative, despite evidence that such treatment may be tolerated and effective. MDT members are likely to be unaware of the extent to which issues such as comorbidity are ignored. MDTs should systematically consider treatment of patients wit...
The Australian journal of advanced nursing : a quarterly publication of the Royal Australian Nursing Federation
To investigate women's perceptions of the contribution of cardiac rehabilitation to their rec... more To investigate women's perceptions of the contribution of cardiac rehabilitation to their recovery from a myocardial infarction. Cardiac rehabilitation programs have been based on research with almost exclusively male participants. It was unclear if cardiac rehabilitation programs meet the needs of women. Ten women who had experienced one or more myocardial infarctions were interviewed. Data from these interviews were analysed using Glaserian grounded theory. The core category that emerged from the data was 'regaining everydayness'. Participants worked to regain their 'everydayness' through a basic social process of 'reframing'. Reframing involved coming to terms with what they had experienced and fitting it into their lives. Other categories related to symptom recognition and recovery. Cardiac rehabilitation programs contributed to overall recovery from a myocardial infarction in different ways for each participant. Although programs provided information...
Nursing praxis in New Zealand inc, 2011
Help-seeking is an active process used by people of all ages to obtain assistance to solve proble... more Help-seeking is an active process used by people of all ages to obtain assistance to solve problems. This research sought to investigate a component of help-seeking related to health concerns. A health related help-seeking model, was adapted to frame questions for an anonymous, self-administered questionnaire. Seventy-five students aged between 16 and 24 years responded and data were analysed using content and descriptive statistical techniques. Findings indicated that young people perceived the need to seek advice when unwell, needing support or information, are resourceful, and were motivated to seek help from a variety of sources. Parents and whānau formed one usual source of advice, but young people reported one of the best sources of advice as General Practice nurses and doctors. Barriers to seeking advice included distrusting sources, and concerns about confidentiality. Unsurprisingly, many respondents used the Internet for health information, although some mistrusted that inf...
Health Promotion International, 2011
Timelines are universal features of health promotion programmes, which often receive little in th... more Timelines are universal features of health promotion programmes, which often receive little in the way of detailed analysis. Prospectively, timelines form supportive structures; they assist in planning and provide key milestones. However, they may also simultaneously constrain action or force the prioritization of some actions over others. This article uses the case of one health promotion programme to explore the multiple timelines in action: the contract, evaluation, usual programme phases and specific to a community garden project in the programme, the seasons. This exploration demonstrates the complexity of these timelines and how they affected programme implementation and were reflected in community participation. The discussion also demonstrates the importance of skilled facilitation of programmes, especially those based on a community development approach.
Asia-Pacific Journal of Clinical Oncology, 2013
Inequities exist in the outcomes of patients diagnosed with lung cancer in New Zealand, with Māor... more Inequities exist in the outcomes of patients diagnosed with lung cancer in New Zealand, with Māori (the indigenous population) having significantly higher diagnosis rates and poorer survival. We investigated the feasibility of introducing epidermal growth factor receptor (EGFR) testing into New Zealand as one step to address these inequities. An anonymous electronic questionnaire was distributed to clinicians from specialties involved in lung cancer management. Questions were grouped around topics including challenges in lung cancer management, EGFR testing, targeted therapy, costs and interest in the development of a national lung tissue bank. In total, 61 clinicians responded and noted that few of their non-small-cell lung cancer patients were tested for EGFR mutations. Most clinicians (84%) would prefer a centralized testing service and 95% would use an overseas laboratory if publicly funded; however 62% did not know or had no preference for test procedures. Under half (46%) had used tyrosine kinase inhibitors with only a small number of patients and 79% supported the development of a lung tissue bank. While most respondents had little experience with EGFR testing, clinicians supported its introduction into New Zealand. However, a number of potential issues, including cost, laboratory expertise and the need for improved access to first-line targeted therapies that could be used if tests were mutation positive were also identified. Respondents identified potential cultural sensitivities related to sending tissue samples abroad for genetic tests that would necessitate clinicians discussing this option with individual patients.
Qualitative health research, Jan 3, 2014
Little research has been undertaken on the actual decision-making processes in cancer care multid... more Little research has been undertaken on the actual decision-making processes in cancer care multidisciplinary meetings (MDMs). This article was based on a qualitative observational study of two regional cancer treatment centers in New Zealand. We audiorecorded 10 meetings in which 106 patient cases were discussed. Members of the meetings categorized cases in varying ways, drew on a range of sources of authority, expressed different value positions, and utilized a variety of strategies to justify their actions. An important dimension of authority was encountered authority-the authority a clinician has because of meeting the patient. The MDM chairperson can play an important role in making explicit the sources of authority being drawn on and the value positions of members to provide more clarity to the decision-making process. Attending to issues of process, authority, and values in MDMs has the potential to improve cancer care decision making and ultimately, health outcomes.
Nursing Praxis in New Zealand Inc, Nov 1, 2011
Help-seeking is an active process used by people of all ages to obtain assistance to solve proble... more Help-seeking is an active process used by people of all ages to obtain assistance to solve problems. This research sought to investigate a component of help-seeking related to health concerns. A health related help-seeking model, was adapted to frame questions for an anonymous, self-administered questionnaire. Seventy-five students aged between 16 and 24 years responded and data were analysed using content and descriptive statistical techniques. Findings indicated that young people perceived the need to seek advice when unwell, needing support or information, are resourceful, and were motivated to seek help from a variety of sources. Parents and whānau formed one usual source of advice, but young people reported one of the best sources of advice as General Practice nurses and doctors. Barriers to seeking advice included distrusting sources, and concerns about confidentiality. Unsurprisingly, many respondents used the Internet for health information, although some mistrusted that information. Nurses need to be aware of the sources of health advice and support that young people choose to use. Motivations for selecting services, providers, or sources clearly replicated what young people hold as important--sources with which they feel comfortable, have a relationship, trust, and which they perceived as maintaining confidentiality.
BMJ Supportive & Palliative Care, 2014
Background The Liverpool Care Pathway for the Dying Patient was introduced into parts of New Zeal... more Background The Liverpool Care Pathway for the Dying Patient was introduced into parts of New Zealand in 2005. Unique 'cultural goals' were added, in recognition of the importance of the provision of culturally appropriate care. Aims To assess the use of the cultural goals in practice and to investigate stakeholders' experiences and perspectives of how the cultural goals influence culturally appropriate end-of-life care. Methods A mixed method study including, in this phase, two clinical audits, semi-structured interviews with 20 stakeholders, and a focus group with 20 Maori clinical staff. Interview data were analysed thematically, and audit data were analysed using descriptive statistics and content analysis. Results Participants identified many factors that acted as constraints or enablers in the provision of culturally appropriate care. These factors operated at multiple levels, including at the
BMJ Supportive & Palliative Care, 2014
Background Clinical pathways including the Liverpool Care Pathway for the Dying Patient (LCP) con... more Background Clinical pathways including the Liverpool Care Pathway for the Dying Patient (LCP) construct the documentation of care in ways that can have benefits and consequences. In New Zealand unique cultural goals related to the care of patients and their families were added to the LCP, and research into their use is underway. Aims As part of an investigation into the utility, comprehensiveness and cultural appropriateness of the cultural goals, the aim was to examine the content of cultural care documentation to ascertain documentation practices. Methods A retrospective chart audit of 100 LCP documents, with 25 each from home care, aged residential care, hospital and hospice, and semi-structured interviews with stakeholders including clinical staff and managers. Results A number of patterns emerged including: very high rates (99% of 1360 entries) of the goals being recorded as 'achieved', even when one of the goals related to family needs and the family was not present; minimal documentation of cultural needs; and minimal variance documentation. In addition a further pattern related the use of the yes or no format in version 11 (rather than achieved or variance in version 12). A variance was documented
Annals of oncology : official journal of the European Society for Medical Oncology / ESMO, Jan 20, 2015
Comorbidity is very common among patients with cancer. Multidisciplinary team meetings (MDTs) are... more Comorbidity is very common among patients with cancer. Multidisciplinary team meetings (MDTs) are increasingly the context within which cancer treatment decisions are made internationally. Little is known about how comorbidity is considered, or impacts decisions, in MDTs. A systematic literature review was conducted to evaluate previous evidence on consideration, and impact, of comorbidity in cancer MDT treatment decision making. Twenty-one original studies were included. Lack of information on comorbidity in MDTs impedes the ability of MDT members to make treatment recommendations, and for those recommendations to be implemented among patients with comorbidity. Where treatment is different from that recommended due to comorbidity, it is more conservative, despite evidence that such treatment may be tolerated and effective. MDT members are likely to be unaware of the extent to which issues such as comorbidity are ignored. MDTs should systematically consider treatment of patients wit...
The Australian journal of advanced nursing : a quarterly publication of the Royal Australian Nursing Federation
To investigate women's perceptions of the contribution of cardiac rehabilitation to their rec... more To investigate women's perceptions of the contribution of cardiac rehabilitation to their recovery from a myocardial infarction. Cardiac rehabilitation programs have been based on research with almost exclusively male participants. It was unclear if cardiac rehabilitation programs meet the needs of women. Ten women who had experienced one or more myocardial infarctions were interviewed. Data from these interviews were analysed using Glaserian grounded theory. The core category that emerged from the data was 'regaining everydayness'. Participants worked to regain their 'everydayness' through a basic social process of 'reframing'. Reframing involved coming to terms with what they had experienced and fitting it into their lives. Other categories related to symptom recognition and recovery. Cardiac rehabilitation programs contributed to overall recovery from a myocardial infarction in different ways for each participant. Although programs provided information...
Nursing praxis in New Zealand inc, 2011
Help-seeking is an active process used by people of all ages to obtain assistance to solve proble... more Help-seeking is an active process used by people of all ages to obtain assistance to solve problems. This research sought to investigate a component of help-seeking related to health concerns. A health related help-seeking model, was adapted to frame questions for an anonymous, self-administered questionnaire. Seventy-five students aged between 16 and 24 years responded and data were analysed using content and descriptive statistical techniques. Findings indicated that young people perceived the need to seek advice when unwell, needing support or information, are resourceful, and were motivated to seek help from a variety of sources. Parents and whānau formed one usual source of advice, but young people reported one of the best sources of advice as General Practice nurses and doctors. Barriers to seeking advice included distrusting sources, and concerns about confidentiality. Unsurprisingly, many respondents used the Internet for health information, although some mistrusted that inf...
Health Promotion International, 2011
Timelines are universal features of health promotion programmes, which often receive little in th... more Timelines are universal features of health promotion programmes, which often receive little in the way of detailed analysis. Prospectively, timelines form supportive structures; they assist in planning and provide key milestones. However, they may also simultaneously constrain action or force the prioritization of some actions over others. This article uses the case of one health promotion programme to explore the multiple timelines in action: the contract, evaluation, usual programme phases and specific to a community garden project in the programme, the seasons. This exploration demonstrates the complexity of these timelines and how they affected programme implementation and were reflected in community participation. The discussion also demonstrates the importance of skilled facilitation of programmes, especially those based on a community development approach.
Asia-Pacific Journal of Clinical Oncology, 2013
Inequities exist in the outcomes of patients diagnosed with lung cancer in New Zealand, with Māor... more Inequities exist in the outcomes of patients diagnosed with lung cancer in New Zealand, with Māori (the indigenous population) having significantly higher diagnosis rates and poorer survival. We investigated the feasibility of introducing epidermal growth factor receptor (EGFR) testing into New Zealand as one step to address these inequities. An anonymous electronic questionnaire was distributed to clinicians from specialties involved in lung cancer management. Questions were grouped around topics including challenges in lung cancer management, EGFR testing, targeted therapy, costs and interest in the development of a national lung tissue bank. In total, 61 clinicians responded and noted that few of their non-small-cell lung cancer patients were tested for EGFR mutations. Most clinicians (84%) would prefer a centralized testing service and 95% would use an overseas laboratory if publicly funded; however 62% did not know or had no preference for test procedures. Under half (46%) had used tyrosine kinase inhibitors with only a small number of patients and 79% supported the development of a lung tissue bank. While most respondents had little experience with EGFR testing, clinicians supported its introduction into New Zealand. However, a number of potential issues, including cost, laboratory expertise and the need for improved access to first-line targeted therapies that could be used if tests were mutation positive were also identified. Respondents identified potential cultural sensitivities related to sending tissue samples abroad for genetic tests that would necessitate clinicians discussing this option with individual patients.
Qualitative health research, Jan 3, 2014
Little research has been undertaken on the actual decision-making processes in cancer care multid... more Little research has been undertaken on the actual decision-making processes in cancer care multidisciplinary meetings (MDMs). This article was based on a qualitative observational study of two regional cancer treatment centers in New Zealand. We audiorecorded 10 meetings in which 106 patient cases were discussed. Members of the meetings categorized cases in varying ways, drew on a range of sources of authority, expressed different value positions, and utilized a variety of strategies to justify their actions. An important dimension of authority was encountered authority-the authority a clinician has because of meeting the patient. The MDM chairperson can play an important role in making explicit the sources of authority being drawn on and the value positions of members to provide more clarity to the decision-making process. Attending to issues of process, authority, and values in MDMs has the potential to improve cancer care decision making and ultimately, health outcomes.