1,720,975 research outputs found
Taoist Tai Chi™: Patterns of practice and perceptions of its effects on the health and Well-being of Western Australian practitioners
Full text linkBackground: Tai Chi (TC) is a traditional Chinese martial art that has been adapted for use in Western societies as a means of improving people’s health. However, little is known regarding the characteristics of people who undertake TC, why they take it up and continue to participate, and how they perceive its effects on their health and well-being.
Aims: This study investigated the patterns of use of Taoist Tai Chi™ (TTC) in Western Australia (WA) and the characteristics held by its practitioners, including their demographics, health status, expectations, health locus of control (HLC), motivations and barriers to practise, in addition to their perceptions of the effect of TTC on their health and well-being.
Methodology: A cross-sectional survey questionnaire was designed to collect qualitative and quantitative data from a randomly chosen sample of 696 TTC practitioners who were registered members of the International Taoist Tai Chi™ Society of WA. A response rate of 54.9% (n = 382) was obtained and parametric and non-parametric tests were conducted to analyse descriptive data. In addition, exploratory factor analysis was used to analyse participants’ beliefs regarding the efficacy of TTC, while regression analysis was conducted on HLC data. All p levels lower than .05 were considered significant. Qualitative data regarding participants’ expectations of TTC and perceptions of its effect on health and well-being were analysed using content analysis.
Results: The majority of TTC practitioners were older Australians with a Caucasian background, female, retired, well-educated, and living in metropolitan areas. The 108 movement Yang-style TTC was practised most commonly in morning classes, twice per week for a period of 60 to 90 minutes per session in TTC clubs with other TTC practitioners. The majority had commenced TTC in the last ten years and had an average of 6.4 years experience of TC practice. Certain people who were older, female and those with chronic illness were more likely to hold a low internal HLC whilst high internal HLC scores were associated with increased levels of TTC practice. The combination of quantitative and qualitative data revealed there were a number of determinants that influenced the participants in their initiation, adoption, patterns of use and maintenance of TTC as a form of exercise. These included the desire to improve health and well-being, personal expectations and beliefs regarding health control and the efficacy of TTC, and environmental factors. However, motivations varied with exercise stage and socio-demographic variables, such as health status, which played an important role in TTC initiation and adherence. Most people reported multidimensional expectations related to undertaking TTC and perceived a wide range of benefits, including improvements in physical and mental health, relaxation, enjoyment, self-esteem, skill attainment and social connectedness. These positive perceptions of the effects of TTC on their physical and psychological health and well-being and social life had considerable impact in the context of their daily lives.
Conclusion: The experiences and perceptions reported by the participants indicated that TTC was more than just an exercise activity and that for many it represented a positive global health behaviour that had broad-reaching effects on physical, psychological, social and spiritual components of their lives
A Case Study of Low-Risk Women's Perceived Decision-Making for Induction of Labour
Full text linkThe purpose of this study was to investigate the question: ‘What are low-risk women’s perceptions of the influences that affect their decision-making regarding induction of labour?’ A qualitative case study method within the interpretive paradigm, guided by a feminist theoretical framework, explored the perspectives of both women who had recently birthed by induction, and midwives, within a South West Australian regional maternity unit.
The study was conducted in two phases. Phase one involved purposeful sampling of low-risk women (n = 18), while phase two employed convenience sampling of midwives (n = 10) by advertising for volunteers working within the maternity unit. Multiple data collection methods were used, including interviews, field notes and documentary information.
Thematic analysis of data from the low-risk women identified five themes: perceived health risks to themselves and their baby; fear of the childbirth experience; seeking support for themselves and their baby; shared decision-making related to induction; and adequacy and timeliness of information on which to base decisions. Three themes emerged from the data related to the midwife participants: having limited influence over women’s induction decisions; empathy for the constraints that limited women’s decision-making; and concerns relating to the appropriateness of information influencing women’s decisions. A comparison of the findings revealed three common themes: balancing risk with the choice to have an induction; the influence of contextual constraints on decision-making; and ensuring that timely, appropriate and adequate information is available for decision-making.
Women’s perspectives are essential to inform the development of induction guidelines in midwifery practice. This study’s findings provide many new insights relating to women’s perceived influences on their decision-making, including the effects of personal, socio-cultural and contextual factors. Recommendations for further research, policy development, midwifery practice and education include an investigation of consistent decision-making tools, the development of induction guidelines, a variety of facilitator-led antenatal education and increased antenatal midwifery contact
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Teachers' and mothers' perceptions of using creative arts to develop children's potential for critical thinking
Full text linkThis study is based on the contention that rich descriptions of the behaviour of the children during the process of creating an art piece, as perceived by teachers and mothers of the children, will provide a better understanding of the influence of creative arts on the development and expression of critical thinking. Developing critical thinking dispositions in young people affords them the skills to make thoughtful choices.
This qualitative naturalistic, interpretive study sought to investigate the impact of children's participation in a creative arts project on the development of critical thinking dispositions. The project was part of a major annual community event, during the first school term of 2010. Data on mothers' and teachers' perceptions were collected using focus groups and individual interviews, in addition to children's letters, video footage and photographs of the activities.
The themes identified related to environmental factors influencing children's creativity, the processes used to mobilise children's creativity, the growth of the children through the experience of creative arts, the children's development of confidence and the effects on the children having contributed to community event.
The finding of this study revealed creative arts participation was able to excite children's imagination and mobilise creativity leading to an increased awareness of self and others, including the environment around them. Through the creative process children developed confidence and displayed visible indicators of problem solving and perseverance. Importantly they also demonstrated the development of skills for collaborative engagement, which is so vital in building individual, social and community capacity. In addition, this study identified the need for children to be exposed to creative environments in order to develop creativity and self-expression. These findings have important implications for the development of future education curriculum in addition to the development of community generated activities
Building resilience in nursing students: Coping with aggression and violence at work
Full text linkBackground: Nursing students are at significant risk of aggression and violence in clinical settings, however, the prevalence and the impact of these on this vulnerable group remains unclear. Nursing students’ experiences of aggression and violence and their ability to develop resilience to these adverse events requires further study.
Aims: This study set out to identify the prevalence and characteristics of workplace aggression and violence experienced by nursing students enrolled in one university’s Bachelor of Nursing program. Another primary aim of the study was to aid students in the development of coping skills to manage aggression and violence encountered in the workplace through the delivery of focused education strategies informed by a positive psychology approach.
Methodology: A quasi-experimental design, using a mixed method repeated measures survey, was used to collect quantitative and qualitative data about personal experiences of aggression and violence from second and third year nursing students, in addition to their responses to two specially designed education interventions. Data were collected using Likert Scale and closed and open ended survey questions, the Resilience Scale, Attitude Towards Aggression (ATAS) Scale and the International Positive Affect Negative Affect Short Form (IPANAS-SF) Scale, at three different time points: baseline, immediately post intervention and post clinical practicum. A cinemeducation and a standard education intervention were designed to increase resilience and positivity in students when facing aggression and violence. Students’ resilience, positivity and attitudes towards aggression and violence were investigated and compared in response to exposure to the interventions.
The response rate at baseline was 87.5% (n=97) for the second year students and 60% (n=56) for the third year nursing students, however, there was significant attrition over time with large differences in the response rate at individual time points. Parametric and non-parametric tests were conducted to analyse the data. All p values lower than .05 were considered significant. Qualitative data regarding nursing students’ feelings and perceptions as a result of exposure to aggression and violence were examined using content analysis.
Results: Participants were mainly female with no children and aged 17 to 54 years. Almost 40% of all participants at baseline felt at risk of experiencing physical aggression in the clinical environment with 30% reporting they had actually experienced it. Non-physical aggression was even more prevalent with approximately 60% of students having personal experiences and nearly two thirds reporting they felt at risk.
A mixed ANOVA was used to examine the effectiveness of the two education interventions on student’s resilience in participants who completed surveys at all three time points. The cinemeducation group (n=9) had mean resilience scores of 12.67, 16.06 and 10.72 at baseline, post intervention and post clinical practicum respectively, compared to the standard education group (n=11) scores of 14.59, 23.68 and 8.82 respectively. There was no statistically significant interaction between the education and time on students’ resilience scores F(2,13) – 2.655, p=.84, partial n 2 .129. However, there was a statistically significant difference in resilience at different time points in this group as a whole (n=20) F(2,40) – 11.990, p<.0005, partial n 2 .400 with a statistically significant mean increase of 6.24 from baseline to post clinical practicum but a statistically significant mean decrease of 10.10 from post intervention to post clinical practicum.
The second year nursing students’ attitude towards aggression was analysed across five domains: communicative, offensive, protective, destructive and intrusive. A Wilcoxon signed rank test indicated that a significant change in attitude occurred over time, with students viewing aggressive incidents as having less personal destructive impact at post clinical practicum compared to baseline T = 22.5, z = -3.13 (corrected for ties) n – Ties = 20, p = .002, two tailed. This effect can be considered “large”, r = .70. No significant changes in the other domains were observed.
The IPANAS-SF provided information of the students’ overall perception of aggression related to specific clinical scenarios as well as their feelings about their last personal experience of aggression and violence. The only statistically significant change observed from baseline to post clinical practicum was an overall increase in the students’ negative affect in relation to the last aggressive incident (p = .046). Neither education intervention received by the second year nursing students had a statistically significant effect on either their attitudes or positivity towards aggression. However, the qualitative data identified more positive feedback for the cinemeducation intervention and the students receiving this intervention reported they were able to relate the information to real life situations and apply the knowledge obtained in their clinical practice.
Results from a follow up analysis of a third year cohort (n=71) provided similar results to those obtained from the baseline third year students, however, they had a statistically significant higher range of scores (p= 008 - .031) in the ATAS, compared to the third year baseline students, with only a “small” effect, range r = .19 - .24. The third year follow up group of nursing students level of resilience (Mean Rank = 69.35, n = 71) was significantly higher compared to the third year nursing students baseline scores (Mean Rank = 53.32, n = 53), U = 2,368, z = 2.459, p = .0.14, two tailed, although this effect was also small, r = .22.
The qualitative findings from the study for all the students combined identified two main themes from the data collected. The first theme that arose was ‘overpowered and controlled by personal experience of aggression and violence’ and captured the negative effect of aggression and violence on nursing students. This indicates that aggression and violence in the clinical setting is perceived by this sample of students as having a significant personal impact. Interestingly, some of the students described developing their personal coping mechanisms for dealing with the events and the aftermath of aggression and violence, which was evidenced in the second main theme ‘developing attributes of resilience’. The themes arising from the nursing students’ qualitative data support their reported negative experience of aggression and violence and the existence of individual qualities and skills within the student group that help to build personal resilience in the sample group.
Conclusion and recommendations: The sample of nursing students involved in this study experience, and perceive themselves to be at risk of, considerable physical and non-physical aggression and violence in the workplace, resulting in feelings of uncertainty, distress and anxiety. It is clear that clinical workplace settings need to continue to develop safe work environments. At the same time educational institutions can assist students in developing personal skills to help them cope with aggressive situations in clinical practice. It is recommended that aggression management education be integrated into undergraduate nursing curriculum specifically aimed at nursing students and effective strategies to enhance and improve nursing students’ resilience and positivity when dealing with the aftermath of aggressive and violent incidents in the clinical environment are developed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Bindjareb Yorgas Health Program: Promoting Aboriginal women's health in a regional community setting
Full text linkThis study addresses the self-identified health issues experienced by yorgas (women) in an Aboriginal Bindjareb (region) community in the Nyungar nation of south west Western Australia. In collaboration with yorga Elders and Leaders from the Murray Districts Aboriginal Association (MDAA), Caroline Nilson, a non-Indigenous researcher, academic and health professional, developed, coordinated, facilitated, and implemented a culturally appropriate health promotion initiative, the Bindjareb Yorgas Health Program [BYHP], which was the topic of Caroline's PhD research project.
The BYHP aims were to foster the development of personal knowledge and skills in achieving and maintaining wellness, and the strengthening of community actions towards improving health by facilitating improved individual and group health literacy. Further, the study sought an understanding of the ways in which the BYHP facilitated healthy lifestyle change in the Bindjareb yorgas and their families and whether the structure and delivery of the program provided a supportive environment for the women to engage in sustainable health promotion activities.
The BYHP was underpinned by the ideals of the Aboriginal model of health, which encompasses all aspects of a person's life (Lock, 2007). This concept places significant emphasis on social and emotional components and is linked to the sense of being Aboriginal, through connection with the environment (social and economic), community, relationships, land, the physical body and the mind, and traditional cultural lore (law) and knowledge (Nyungar kaartdijin). The BYHP study consisted of four components: nutrition and cooking classes, group fitness classes (including walking group sessions), a community vegetable garden project and health 'yarning' sessions (a culturally appropriate method of communicating about important matters), which comprised informal and formal discussions.
Twenty-two women from the two kinship groups in two towns in the research setting were invited to take part in the project. Purposive and snowball sampling were used to recruit the yorga participants and the consent processes were conducted by the yorga Elders and Leaders and resulted in 17 Bindjareb yorgas consenting to participate.
There were a total of 24 cooking and nutrition classes and all 17 participants each took part in between 3 and 22 classes. Attendance at the 33 group fitness classes varied, with 16 of the 17 participants taking part in between 1 and 29 classes; as did attendance at the 24 walking group sessions where 13 yorgas participated in between 3 and 22 sessions each. Six participants volunteered to share the vegetable garden management over a 24 week period resulting in an average weekly attendance of 5.5 visits between them. A number of yarning sessions (individual and group) were also facilitated by Caroline in collaboration with Karrie-Anne Kearing-Salmon, an Aboriginal woman Leader appointed as the research assistant.
An ethnographic action research [EAR] approach was used in the research, which combines the methodologies of ethnography, participatory techniques and action research (Tacchi, Slater & Hearn, 2003; Tacchi, et al., 2007). The data was collected with the assistance of the yorga Elders and Leaders during which time Caroline was also mentored by Gloria Kearing, a yorga Elder. Data sources included audio recorded yarning groups, audio recorded individual yarning, direct observations and participant-observations, and Caroline's personal diary notes audio recorded during fieldwork.
A narrative art project was also conducted as a culturally appropriate method of gathering data and was used as an opportunity to facilitate informal health yarning. The works of art were shared with the wider community in a public gallery exhibition, which ran for six weeks during August and September 2013.
Thematic analysis of the data was undertaken in consultation and collaboration with the selected yorga Elders and Leaders for each component of the research, and was assisted using Artichoke ™ (Fetherston, 2013), a computer-based program.
Results that have captured the main findings are presented in the thesis in a number of peer-reviewed published and under review articles and other manuscripts have been prepared and are in the process of submission.
The themes identified from the cooking and nutrition component related to experiences of overwhelming loss, acknowledging collective shame, finding change too hard, being crippled by the lack of resources, mistrust, and tensions, community control empowering individuals through engagement, learning for life purpose, and planning for community determination.
The themes derived from the group fitness component related to the loss of traditional knowledge and practices, withdrawal due to shame, community facilitation enabling enjoyment in engagement, and experiencing a sense of place and connection to land and culture.
The community vegetable garden component themes related to feelings of ownership: "deadly, unna?" (very good, isn’t it?), "ngnaailak" (belongs to us); a sense of place: "nalaru boodjar" (our own country), "kwobbrup" (a good place); reconnection to traditional land: "boodjar, mundak and ponar" (land, the bush and the seasons); pride in learning new skills: "djinanginy kaartdijin" (seeing, learning, and understanding); and hoping for continued community engagement and partnership support: "patpatan mila" (worried for the future).
The health yarning component themes related to patience in the ways of talking with the yorgas "moorditj bandjar tarwagin" (patient way of talking with us), feelings of safety to talk about health issues and coming together as equals to become strong in health; "djaliny moordidjabiny kootamiara quab" (listening to become strong in health).
The narrative art project themes related to the overall connectedness and the mobilisation of community members in coming together to consolidate relationships for their health and wellbeing; individuals coming together for their health and wellbeing, and processes in mobilising community social relationships. The additional themes related to the yorgas developing self-identity through painting their experiences and their creativity contributing to community empowerment.
In regards to sustainable lifestyle change, themes from the group fitness and cooking and nutrition components around the real challenges and barriers also emerged. The acknowledgement of shame was identified as a psychosocial barrier and previously experienced reduced health literacy was seen as having a negative impact on food security and healthy lifestyle choices. Several themes relating to the importance of a 'sense of place' and 'feelings of safety', and the 'rekindled connection to land' were threaded through all the components, particularly the vegetable garden project. These themes were critical in answering the research questions regarding community ownership and the culturally appropriate structure and delivery of the BYHP. Themes from the cooking and nutrition component also related to the impact of historical events on nutritional health of Indigenous Australians, and on the undermining effect of mistrust within the community and towards outsiders and the need to plan to achieve a real sense of community determination and address issues of limited resources. These themes were pertinent in answering the research question regarding the required community action to lead to the sustainability of the program.
The findings suggest that historical colonisation processes greatly influence current Aboriginal health and wellbeing. It has impacted on individual and community esteem and determination, resulting in feelings of inadequacy, racial demoralisation and mistrust, towards others and within their own groups. Feelings of a sense of place, the reconnection to land and culture, and a sense of safety were a common thread to have emerged from the BYHP. These correlated with further findings that identify the need for community collaboration and control. The acknowledgement of shame was identified as a psychosocial barrier influencing health literacy, food security and healthy lifestyle choices. The real challenges of change around healthy eating and physical activity were highlighted, however the sense of purpose gained through learning new skills and knowledge was found to be a key driver towards change. To achieve sustainability the findings highlighted the need for continued partnership development and ongoing planning for skills and employment opportunity and these were identified as important to achieving a real sense of community determination
Length of stay as an indicator for efficient and effective trauma management pre and post implementation of a State Major Trauma Unit in Western Australia.
Full text linkBackground: Trauma is the leading cause of death of Australians aged between 14 and 50 years with trauma admissions to hospitals costing governments millions of dollars per year. Managing health budgets set by governments whilst still delivering quality health care is an important issue. Strategies for addressing effectiveness and efficiency are often focused on providing high quality, cost effective services, which are aimed at reducing hospital length of stay while providing appropriate care. One such strategy adopted by Royal Perth Hospital (RPH) has been the creation of a new State Major Trauma Unit (SMTU) that offers increased trauma services by allowing for greater contact between patients, nursing medical and allied health teams.
Aim: The aim of this study was to evaluate the new Western Australian State Major Trauma Unit and its impact on length of hospital stay in major trauma patients. Results can be used to analyse one indicator of effectiveness; namely, length of stay in relation to differing types of services offered pre and post impementation of the SMTU. This provides the basis for recommendations for further studies into effectiveness and efficiency in trauma management in areas such as cost analysis, delayed discharges and unplanned admissions.
Methodology: A retrospective analysis was conducted using data from the Trauma Registry from Royal Perth Hospital. Data on the length of stay (LOS) of patients with an Injury Severity Score (ISS) >15 who were admitted to any general ward at RPH in 2007, prior to establishment of the SMTU, were compared with data from patients who were admitted to the SMTU during the same period in 2008. Descriptive analysis included comparisons of median and interquartile range of age, sex, admission, specialty, discharge destination and ISS. A Chi Square Test of Contingencies or Mann Whitney U test was used to test for any differences in demographic data and the length of stay between these two groups. All p values < .05 are considered significant.
Results: There was no statistically significant difference found between the length of stay or Injury Severity Score of major trauma patients who were admitted to RPH in 2007 and 2008.
Conclusions: The results are useful in providing an indicator of trauma patient management in terms of length of stay. The lack of a significant finding suggests the need for a longer term analysis of the LOS for patients admitted to the SMTU and further research into other indicators of effectiveness and efficiency
Western Australian women's experiences of breastfeeding support
Full text linkExclusive breastfeeding for the first six months is recommended for the significant maternal and infant health benefits it conveys across the lifespan. Australia boasts high breastfeeding initiation rates, however the duration of breastfeeding falls well short of national and global targets. A deeper understanding of mothers’ interactions with breastfeeding supports could assist to further inform how the service of support is currently being received and the meaning it has for individual mother’s breastfeeding success.
Narrative Inquiry examined the stories of seven Western Australian women’s lived experiences of support whilst establishing breastfeeding. Data included stories from semi-structured indepth narrative-based interviews, retold narratives and background related to demographic details, family breastfeeding history and pregnancy, birth and general health information. Clandinin and Connelly’s (2000) three-dimensional space structure of temporality, sociality and situation was used to enable an understanding of the relational aspects and the changeable nature of mothers’ breastfeeding support experiences.
Thematic data analysis revealed four major themes: Trusting in the ‘natural’, navigating the complexity of the breastfeeding journey, battling others’ assumptions, and finding strength in supportive environments. All mothers found strength in the supportive interactions they experienced from professional, peer and family support, particularly from those whose guidance and assistance reflected the mother’s own personal beliefs about how important breastfeeding was to them. However, many barriers were also encountered, indicating there are still deficits in the support offered to breastfeeding mothers that need addressing.
The support experienced could have been improved by more positive societal attitudes and a more knowledgeable, non-judgemental health system that delivered anticipatory, rather than reactive support responses, and recognised individuality, and the importance of self-efficacy and the role of family support in overcoming breastfeeding difficulties
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