The Australian journal of advanced nursing : a quarterly publication of the Royal Australian Nursing Federation
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Controlled Clinical Trial
Patient advocacy and advance care planning in the acute hospital setting.
The aim of this study was to explain the role of patient advocacy in the Advance Care Planning (ACP-ing) process. Nurses rate prolonging the dying process with inappropriate measures as their most disturbing ethical issue and protecting patients' rights to be of great concern (Johnston et al 2002). Paradoxically ethical codes assume nurses have the autonomy to uphold patients' health-care choices. Advance Directives (AD) designed to improve end-of-life care are poorly taken up and acute hospitals are generally not geared for the few they receive. The Respecting Patient Choices Program (RPCP) improves AD utilisation through providing a supportive framework for ACP-ing and primarily equipping nurses as RPC consultants. Assisting patients with this process requires attributes consistent with patient advocacy arising out of nursing's most basic tenet, the care of others. ⋯ Findings suggested patient advocacy, fostered by the supportive RPC environment, effectuates the ACP-ing process. It is recommended that the RPCP should be recognised and developed as integral to promoting quality end-of-life assurance and associated job satisfaction.
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Comparative Study
A comparative study of patient perceived quality of life pre and post coronary artery bypass graft surgery.
Traditionally, evaluation of outcome post cardiac surgery has focused on objective measures of cardiovascular status. The emphasis has shifted to examining an individual's quality of life (QoL). However a gap in Australian prospective research assessing QoL from a pre-operative period to the early stage of six weeks post-operatively exists. The aim of this study was to investigate recovery from coronary artery bypass graft surgery (CABGS) on the basis of patient perceived QoL and in particular, physical and mental health. ⋯ The SF-36 demonstrates improvements in physical QoL six weeks after CABGS compared to preoperative results but no difference in mental QoL suggesting psychological adaptation. An increase in the pain score at six weeks suggests inadequate pain management in these patients.
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To investigate the incidence of pain following discharge from reproductive day surgery. ⋯ Younger patients, those who have had prior experience of day surgery and those who received inadequate information prior to surgery were most likely to report pain. Adequate individual patient assessment will ensure that patients' experience of pain following day surgery is minimised.
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The purpose of this study was to explore the attitudes of nurses working in a multi-purpose health service (MPHS) toward elderly people and their understanding of gerontic care. As there are no previous studies in this area of nursing it is anticipated that this study will provide the basis for further exploration. ⋯ This study is the first of its kind to investigate attitudes and knowledge of nurses working in an MPHS towards the elderly residents in their care. Due to the small sample size, these findings are not generalisable; nevertheless, these results assist with the identification of knowledge gaps and highlight areas for improved education which is essential in the delivery of high-quality, effective care.
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Father absence is associated with negative child and adolescent outcomes, including early sexual activity, teenage pregnancy, behavioural difficulties and life adversity. However there is a lack of literature that explores the lived experiences of daughters who grew up in father absent environments. This study aimed to generate insights into the lived experience of being a girl-child growing up in a father absent environment through the perspectives of daughters who experienced father absence during their childhood and/or adolescent years. ⋯ Nurses and other health workers are challenged to meet the needs of increasing numbers of father absent children and young people and to develop supportive strategies to ameliorate the effects of father absence so as to contribute to the best possible outcomes for young people and their families.