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Papers by Peter O'Halloran

Research paper thumbnail of Caregiver Burden in Informal Caregivers of Patients in Saudi Arabia Receiving Hemodialysis: A Mixed-Methods Study

Healthcare

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Adolescent Men's Attitudes in Relation to Pregnancy and Pregnancy Outcomes: A Systematic Review of the Literature From 1980–2009

Journal of Adolescent Health, 2010

This review article reveals a long-standing gender bias in academic and policy research on adoles... more This review article reveals a long-standing gender bias in academic and policy research on adolescent pregnancy, which has led to the neglect of adolescent men's perspectives. The review summarizes the available literature on adolescent men's attitudes in relation to pregnancy occurrence and pregnancy outcomes in the context of addressing three questions: (1) What are adolescent men's attitudes to an adolescent pregnancy? (2) What are adolescent men's attitudes in relation to pregnancy outcomes? (3) What explanations are offered for the identified attitudes to adolescent pregnancy and resolution? The review establishes a foundation for future quantitative and qualitative research on adolescent men's perspectives. It emphasizes that a greater understanding of adolescent men's perspectives could lead to a re-framing of adolescent pregnancy away from being seen solely as a woman's issue. Furthermore, it is argued that the inclusion of adolescent men would lead to more effective adolescent pregnancy prevention and counseling programmes. Ó

Research paper thumbnail of Planning a Cluster Randomized Controlled Trial: Methodological Issues

Nursing Research, 2009

The standard approach in a randomized controlled trial (RCT) is to randomize individuals to inter... more The standard approach in a randomized controlled trial (RCT) is to randomize individuals to intervention and control groups. Yet, nursing and other health interventions are often implemented at the levels of health service organizational unit or geographical area. It may be more appropriate to conduct a cluster RCT. However, cluster randomization requires consideration of a number of important issues. The objective of this study was to show how critical issues in relation to design and analysis can be addressed. Two cluster RCTs conducted by the authors are used as examples. Guidance on the conduct and reporting of cluster RCTs is also offered. A rationale for choosing this design was provided, and issues in relation to study design, calculation of sample size, and statistical analysis were clarified. A decision tree and checklist are provided to guide researchers through essential steps in conducting a cluster RCT. Cluster RCTs present special challenges in relation to design, conduct, and analysis. Nevertheless, they are an appropriate and potentially powerful tool for nursing research. With careful attention to the issues addressed in this article, researchers can use this approach successfully.

Research paper thumbnail of Testing of the Factor Structure of the Nursing Work Index-Revised

Worldviews on Evidence-based Nursing, 2009

Background: Recent research has questioned the reliability and validity of the Nursing Work Index... more Background: Recent research has questioned the reliability and validity of the Nursing Work Index-Revised (NWI-R) instrument, raising the possibility that managers reconfiguring hospitals in line with the factors derived from the NWI-R may be misdirecting resources.Aim: To test the factor structure of the NWI-R.Approach: A population of 864 acute hospital nurses was surveyed using the NWI-R, and a response rate of 449 (52%) was achieved. The statistical factor model was examined using SPSS 11.5 and based on guidelines of successful factor analysis. Measures of internal consistency were calculated for each of the factors to emerge from the data.Findings: The findings confirm appropriateness of conducting a factor analysis on the NWI-R. A core three-factor structure emerged from the findings that are generic to all but one of the studies exploring the factor structure of the NWI-R. These factors were adequate staffing and resources, nurse management, and the doctor–nurse relationship. The factors suggested good measures of internal consistency.Implications: The composition of the factors shares similarities with the original factors of the NWI-R. The authors recommend that the factors be renamed and the data reinterpreted in light of the new findings. The findings also raise interesting questions about the role a nurse's practice environment plays in a nurse's work life.

Research paper thumbnail of A model for developing, implementing, and evaluating a strategy to improve nursing and midwifery care

Practice Development in Health Care, 2005

Background: Health care organizations world wide are faced with the need to develop and implement... more Background: Health care organizations world wide are faced with the need to develop and implement strategic organizational plans to meet the challenges of modern health care. There is a need for models for developing, implementing and evaluating strategic plans that engage practitioners, and make a measurable difference to the patients that they serve. This article describes the development of such a model to underpin a strategy for nursing and midwifery in an acute hospital trust.An integrated model: The processes for strategy development (values clarification, critical companionship and focus groups) are discussed, together with the development of processes for implementation, based upon a modification of the PARIHS (Promoting Action on Research Implementation in Health Services) conceptual framework. Finally, the methods for evaluating the strategy (a pre-test–post-test approach measuring the quality of nursing care, the degree to which the organization supports professional nursing care, the leadership styles of ward managers, and patient satisfaction with care) are described.Conclusion: The model is offered as one that may be of use to others who wish to develop an integrated approach to strategic change – an approach in which the development, implementation and evaluation of strategic plans are informed by the core values of nurses and midwives. Copyright © 2005 John Wiley & Sons, Ltd.

Research paper thumbnail of Patient-controlled analgesia compared with nurse-controlled infusion analgesia after heart surgery

Intensive and Critical Care Nursing, 1997

A randomized, controlled clinical trial was conducted on 66 patients undergoing elective cardiac ... more A randomized, controlled clinical trial was conducted on 66 patients undergoing elective cardiac surgery to compare patient-controlled analgesia (PCA) to nurse-controlled analgesia (NCA) with continuous morphine infusion. Hourly assessment of pain (at rest and on movement) using a visual analogue scale (VAS), of respiratory rate, and level of sedation took place for the 24h following extubation. The incidence of nausea was also recorded. Mean pain scores were calculated, and peak pain and sedation scores, together with lowest respiratory rates, were identified. Morphine consumption was measured at 24h. No significant differences were found between the groups' scores for pain or sedation. The PCA group had significantly lower respiratory rates (P=0.02) and a lower incidence of nausea (P=0.008). The PCA group also consumed significantly more morphine (P=0.0001). The study suggests a beneficial effect from PCA after cardiac surgery in reducing nausea, compared to NCA. It confirms nursecontrolled infusion analgesia as an effective form of pain relief in an intensive care and high-dependency setting.

Research paper thumbnail of Caregiver Burden in Informal Caregivers of Patients in Saudi Arabia Receiving Hemodialysis: A Mixed-Methods Study

Healthcare

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

Research paper thumbnail of Adolescent Men's Attitudes in Relation to Pregnancy and Pregnancy Outcomes: A Systematic Review of the Literature From 1980–2009

Journal of Adolescent Health, 2010

This review article reveals a long-standing gender bias in academic and policy research on adoles... more This review article reveals a long-standing gender bias in academic and policy research on adolescent pregnancy, which has led to the neglect of adolescent men's perspectives. The review summarizes the available literature on adolescent men's attitudes in relation to pregnancy occurrence and pregnancy outcomes in the context of addressing three questions: (1) What are adolescent men's attitudes to an adolescent pregnancy? (2) What are adolescent men's attitudes in relation to pregnancy outcomes? (3) What explanations are offered for the identified attitudes to adolescent pregnancy and resolution? The review establishes a foundation for future quantitative and qualitative research on adolescent men's perspectives. It emphasizes that a greater understanding of adolescent men's perspectives could lead to a re-framing of adolescent pregnancy away from being seen solely as a woman's issue. Furthermore, it is argued that the inclusion of adolescent men would lead to more effective adolescent pregnancy prevention and counseling programmes. Ó

Research paper thumbnail of Planning a Cluster Randomized Controlled Trial: Methodological Issues

Nursing Research, 2009

The standard approach in a randomized controlled trial (RCT) is to randomize individuals to inter... more The standard approach in a randomized controlled trial (RCT) is to randomize individuals to intervention and control groups. Yet, nursing and other health interventions are often implemented at the levels of health service organizational unit or geographical area. It may be more appropriate to conduct a cluster RCT. However, cluster randomization requires consideration of a number of important issues. The objective of this study was to show how critical issues in relation to design and analysis can be addressed. Two cluster RCTs conducted by the authors are used as examples. Guidance on the conduct and reporting of cluster RCTs is also offered. A rationale for choosing this design was provided, and issues in relation to study design, calculation of sample size, and statistical analysis were clarified. A decision tree and checklist are provided to guide researchers through essential steps in conducting a cluster RCT. Cluster RCTs present special challenges in relation to design, conduct, and analysis. Nevertheless, they are an appropriate and potentially powerful tool for nursing research. With careful attention to the issues addressed in this article, researchers can use this approach successfully.

Research paper thumbnail of Testing of the Factor Structure of the Nursing Work Index-Revised

Worldviews on Evidence-based Nursing, 2009

Background: Recent research has questioned the reliability and validity of the Nursing Work Index... more Background: Recent research has questioned the reliability and validity of the Nursing Work Index-Revised (NWI-R) instrument, raising the possibility that managers reconfiguring hospitals in line with the factors derived from the NWI-R may be misdirecting resources.Aim: To test the factor structure of the NWI-R.Approach: A population of 864 acute hospital nurses was surveyed using the NWI-R, and a response rate of 449 (52%) was achieved. The statistical factor model was examined using SPSS 11.5 and based on guidelines of successful factor analysis. Measures of internal consistency were calculated for each of the factors to emerge from the data.Findings: The findings confirm appropriateness of conducting a factor analysis on the NWI-R. A core three-factor structure emerged from the findings that are generic to all but one of the studies exploring the factor structure of the NWI-R. These factors were adequate staffing and resources, nurse management, and the doctor–nurse relationship. The factors suggested good measures of internal consistency.Implications: The composition of the factors shares similarities with the original factors of the NWI-R. The authors recommend that the factors be renamed and the data reinterpreted in light of the new findings. The findings also raise interesting questions about the role a nurse's practice environment plays in a nurse's work life.

Research paper thumbnail of A model for developing, implementing, and evaluating a strategy to improve nursing and midwifery care

Practice Development in Health Care, 2005

Background: Health care organizations world wide are faced with the need to develop and implement... more Background: Health care organizations world wide are faced with the need to develop and implement strategic organizational plans to meet the challenges of modern health care. There is a need for models for developing, implementing and evaluating strategic plans that engage practitioners, and make a measurable difference to the patients that they serve. This article describes the development of such a model to underpin a strategy for nursing and midwifery in an acute hospital trust.An integrated model: The processes for strategy development (values clarification, critical companionship and focus groups) are discussed, together with the development of processes for implementation, based upon a modification of the PARIHS (Promoting Action on Research Implementation in Health Services) conceptual framework. Finally, the methods for evaluating the strategy (a pre-test–post-test approach measuring the quality of nursing care, the degree to which the organization supports professional nursing care, the leadership styles of ward managers, and patient satisfaction with care) are described.Conclusion: The model is offered as one that may be of use to others who wish to develop an integrated approach to strategic change – an approach in which the development, implementation and evaluation of strategic plans are informed by the core values of nurses and midwives. Copyright © 2005 John Wiley & Sons, Ltd.

Research paper thumbnail of Patient-controlled analgesia compared with nurse-controlled infusion analgesia after heart surgery

Intensive and Critical Care Nursing, 1997

A randomized, controlled clinical trial was conducted on 66 patients undergoing elective cardiac ... more A randomized, controlled clinical trial was conducted on 66 patients undergoing elective cardiac surgery to compare patient-controlled analgesia (PCA) to nurse-controlled analgesia (NCA) with continuous morphine infusion. Hourly assessment of pain (at rest and on movement) using a visual analogue scale (VAS), of respiratory rate, and level of sedation took place for the 24h following extubation. The incidence of nausea was also recorded. Mean pain scores were calculated, and peak pain and sedation scores, together with lowest respiratory rates, were identified. Morphine consumption was measured at 24h. No significant differences were found between the groups' scores for pain or sedation. The PCA group had significantly lower respiratory rates (P=0.02) and a lower incidence of nausea (P=0.008). The PCA group also consumed significantly more morphine (P=0.0001). The study suggests a beneficial effect from PCA after cardiac surgery in reducing nausea, compared to NCA. It confirms nursecontrolled infusion analgesia as an effective form of pain relief in an intensive care and high-dependency setting.