Search

Aims and objectives: To examine how the use of Social Interaction Maps, a tool in the EXCELLence in Cultural Experiential Learning and Leadership Program, can enhance the development of nurses’ intercultural/intraprofessional communication skills. Background: Nurses face communication challenges when interacting with others from similar background as well as those from a culturally and linguistically diverse background. We used the EXCELLence in Cultural Experiential Learning and Leadership Program's Social Interaction Maps tool to foster intercultural/intraprofessional communication skills in nurses. Social Interaction Maps describe verbal and nonverbal communication behaviours that model ways of communicating in a culturally appropriate manner. The maps include four stages of an interaction, namely Approach, Bridging, Communicating and Departing using the acronym ABCD. Design: Qualitative approach was used with a purposeful sample of nurses enrolled in a postgraduate course. Methods: Fifteen participants were recruited. The Social Interaction Map tool was taught to participants in a workshop where they engaged in sociocultural communication activities using scenarios. Participants were asked to apply Social Interaction Maps in their workplaces. Six weeks later, participants completed a semistructured open‐ended questionnaire and participated in a discussion forum on their experience of using Social Interaction Maps. Data were content‐analysed. Results: Four themes identified in the use of the Social Interaction Maps were (i) enhancing self‐awareness of communication skills; (ii) promoting skills in being nonconfrontational during difficult interactions; (iii) highlighting the importance of A (Approach) and B (Bridging) in interaction with others; and (iv) awareness of how others interpret what is said C (Communicating) and discussing to resolve issues before closure D (Departing). Conclusions: Application of the EXCELLence in Cultural Experiential Learning and Leadership Social Interaction Mapping tool was shown to be useful in developing intercultural/intraprofessional communication skills in nurses. Relevance to clinical practice: Professional development programmes that incorporate EXCELLence in Cultural Experiential Learning and Leadership Social Interaction Maps can enhance nurses’ intercultural/intraprofessional communication competencies when engaging with others from culturally and linguistically diverse backgrounds and improve the way nurses communicate with each other. [ABSTRACT FROM AUTHOR]

Previous research has shown that collecting and analysing metaphors is a useful strategy in seeking data that are difficult to collect via verbal interviews or that cannot be represented by statistics. This study explored nursing students' perceptions of the educator-student relationship using metaphorical interpretation. A qualitative study with a personal essay approach was adopted. A total of 124 students were recruited from a nursing school in Hong Kong. A personal essay form was distributed to the participants. They were asked to give a metaphor with explanations to describe the power dynamics in the educator-student relationship, within 200 words in English or Chinese. After some thought, the participants each gave their own metaphor individually, because the aim of this study was to collect their subjective experiences. The results were presented as follows: a) The overall description of the metaphors; b) The three groups of metaphors; c) The fives natures of metaphors; d) The most significant metaphors; and e) The four thematic meanings – (i) nurturing role; (ii) guiding role; (iii) insufficient connection; and (iv) promoting development. The implications for research methods and nurse education of collecting and analyzing metaphors were discussed. Discrepancies in metaphorical interpretations are to be expected, as interpretations are dependent on the researchers’ socio-cultural background, personal experiences, professional training, languages spoken, and other factors. [ABSTRACT FROM AUTHOR]

Background As the population is ageing, and with the rising incidence of type 2 diabetes, the demographics of people on dialysis therapy are changing, with an older population living with multiple co-morbidities. As such, the meaning of haemodialysis (HD) has shifted from a short-term therapy for those awaiting a kidney transplant to a palliative therapy that focuses on quality of life. Methods A narrative inquiry focused on nurses’ experiences of caring for adult persons on HD approaching end of life. Registered and enrolled nurses working in HD inpatient and outpatient units at one tertiary level hospital service in Southeast Queensland constituted the sample. Results Fifty-five of a possible 130 nurses (40% response) completed narratives. Just over half of the nurses had 10 or more years of nephrology nursing experience. Nurses experienced moral discomfort when challenges associated with: (1) poorly implemented end-of-life care; (2) contested decisions to start or stop HD; and (3) limited opportunities to settle disagreements within the service context. Conclusions Nephrology nursing practice has not kept up with changing patient demographics, leaving nurses unprepared for the emotional and moral decisions to be made in everyday practice. It is timely to make explicit the palliative intent of HD therapy for persons with multiple co-morbidities, providing a space for advance care planning, open and supported discussions about quality of life, and transparent shared decision making when patients are considering to cease therapy. [ABSTRACT FROM AUTHOR]

In Australia, a significant number of culturally and linguistically diverse (CALD) grandparents are sole carers for their grandchildren. Available information on the impact of caring on CALD grandparents and the ability of service providers to respond to their needs is limited. Our needs-gap analysis quality improvement project aimed to uncover 'hidden issues' for CALD grandparent carers so that services can be improved. One hundred service providers, such as community and aged-care services, child and/or grandparent support services and CALD-specific services, were approached using six structured questions. Six consultative forums on the caring role, issues encountered, and what needed to be done, were conducted with African, Asian, Spanish, Middle Eastern, European, Pacific Island andMaori grandparent carers in Queensland. The data were qualitatively analysed. Six themes emerged: 1) service provider and grandparent carer perception that there was limited research on CALD grandparents; 2) inadequate legal and financial support; 3) barriers to accessing information; 4) lack of childcare options; 5) transport difficulties; and 6) inadequate technological skills. Our findings provide insight to health service providers on the 'hidden issues' so that they can better assist CALD grandparent carers by improving access to relevant information, referrals and resources. [ABSTRACT FROM AUTHOR]

Nurse clinicians and academics need to understand intercultural communication challenges to improve their communication skills and better support students' learning. Gaps exist in the literature regarding intercultural communication resources for students, academics and clinicians. The aim of this study was to explore the experiences of clinical nurses, nurse academics, and student nurses regarding intercultural communication challenges. Data were collected using focus group interviews with nineteen clinical facilitators (nurses who supervise nursing students in clinical practice), five clinical nurses, and ten nursing students. Seven nurse academics were interviewed via telephone. The purposive sample was drawn from a tertiary hospital and a university in Australia. Participants were invited to discuss challenging intercultural scenarios they had experienced including strategies they used to overcome such challenges. Using qualitative content analysis data were analysed resulting in four categories which were: 1) prejudice based on cultural diversity; 2) unfamiliarity with cultural boundaries; 3) stereotyping cultural behaviours; and 4) difficulty understanding English. Strategies participants used to mitigate challenges included resorting to cultural validation through alliance building, proactively seeking clarification, and acquiring cultural awareness knowledge. This study highlights intercultural challenges students, clinicians and academics face and signpost the way forward with useful strategies to better inform nurse education. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to report research findings on the perspectives of overseas trained psychiatrists (OTPs) on the “The Overseas Trained Specialist Up-Skilling Programme” (OTSUP), initiated in Queensland, Australia to assist OTP's to prepare for the Royal Australian and New Zealand College of Psychiatrist (RANZCP) Fellowship examination. Ascertaining and utilisation of OTP's views about the programme will enable improvements to be made to the programme and better implementation. Design/methodology/approach – An exploratory qualitative design was utilised for the study in order to provide insights on the quality and effectiveness of the OTSUP. Findings – Centred around two main themes. The first theme included participant's knowledge about the up-skilling programme with its subthemes of “finding out about the programme”; “perceived aims of the programme”; and “educational events supporting the programme”. The second theme revolved around participants’ perceived benefits of the up-skilling programme with its four subthemes such as, first, individualised support, second, the opportunity to improve practical and communication skills through OTSUP educational events, third, access to peer support and fourth, provision of specific information on the RANZCP examination process. Research limitations/implications – Limitations as this was a qualitative study, the findings can only be applicable to a similar context. Nevertheless, the findings do provide support for an educational initiative that assisted the OTS to better prepare for the RANZCP examination. To gain further insight into challenges faced by OTS with successfully passing the examination in less frequent attempts, programmes such as the OTSUP need to be improved and sustained. Originality/value – The findings provide valuable insight into how OTPs view the up-skilling programme. Moreover, the findings pave the way forward in how the programme can be improved in the future to assist OTPs prepare for the RANZCP examination. [ABSTRACT FROM AUTHOR]

Objective. In Australia, 25% of international medical graduates (IMGs) make up the medical workforce. Concern is expressed in the literature about the lack of awareness and knowledge of issues that impinge on IMGs' education. Although there is literature alluding to difficulties IMGs face with undertaking the Australian Medical Council (AMC) examination, there is little research detailing this experience. We therefore explored IMGs' reflections on facilitators and barriers in undertaking the AMC examination. Methods. After ethics approval, in-depth telephone interviews were conducted with 30 IMGs selected from a hospital in Queensland. Data were coded and analysed using thematic analysis principles. Results. Two facilitating themes were identified: ability to sit for the first part of the examination in country of origin; and having access to resources such as bridging courses and study groups. Three themes represented barriers: not understanding procedural steps; financial issues; and lack of information on examination content and standards. Conclusion. The themes provide new insights and add depth to existing literature that can be used to improve procedural processes and education for IMGs towards successful outcomes in the AMC examination. What is known about the topic? There is concern expressed in the literature about the lack of awareness and knowledge of issues that impinge on IMGs education. The Australian work that is available only depicts educational experience of fellowships or education and training strategies after IMGs have passed their AMC examination. What does this paper add? The findings indicate that the process of sitting for the AMC examination is perceived as one of the major difficulties associated with entering and integrating into the Australian health system. The findings indicate a range of practical, financial and resource problems faced by IMGs attempting to sit for the AMC examination. What are the implications for practitioners? The detailed accounts from IMGs about their experience with undertaking the AMC examination will provide up-skilling program coordinators with the information they need to better assist IMGs to prepare for the examination. The provision of appropriate medical training and educational support will contribute to more effective integration of IMGs into the healthcare system. [ABSTRACT FROM AUTHOR]

The purpose of this research was to define, the practice domain of community-based child health nursing in light of wide-spread political, economic and social changes in Western Australia. The project was conducted by a group of nurse researchers with experience in child health nursing from the School of Nursing and Midwifery at Curtin University and the Child and Adolescent Community Health Division at the Department of Health, Western Australia. The overall aim of the project was to map the scope of nursing practice in the community child health setting in Western Australia and to identify the decision making framework that underpins this nursing specialty. Given the widespread social, economic and health service management changes, it was important for nurses involved with, or contemplating a career in, community-based child health to have the role accurately defined. In addition, consumer expectations of the service needed to be explored within the current climate. A descriptive qualitative study was used for this project. A purposive sample of 60 participants was drawn from the pool of child health nurses in the South Metropolitan Community Health Service, North Metropolitan Health Service and Western Australian Country Health Service. Following ethical approval data was collected via participants keeping a 2-week work diary. The data was coded and thematic analysis was applied. Several themes emerged from the analysis which were validated by follow up focus group interviews with participants. This clearly demonstrated common, recurring issues. The results identified that the community-based child health nurses are currently undertaking a more complex and expanded child health service role for an increasingly diverse client population, over their traditional practices which are still maintained. Excessive workloads and lack of human and non human resources also presented challenges. There are increasing requirements for child health nurses to engage in community development and capacity building, often through a multidisciplinary partnership, which requires them to have sound brokerage and facilitation skills to enable community inclusion and inter-agency collaboration at the local level. The study has highlighted the importance and multifaceted nature of the role of the community-based child health nurse. To enable them to function optimally, the following suggestions/recommendations are offered. These being: • More physical resources be allocated to community-based child health nursing • More resources allocated to assist community-based child health nurses to support culturally and linguistically diverse families • Mapping of child health nurses' workloads • The development of community health client dependency rating criteria reflecting the social determinants of health in order for health service refinement of staffing allocations based on an acuity scale • Specific staff development opportunities to reflect the increased workload complexity • Managerial support for the implementation of formal clinical (reflective) supervision • Additional clerical assistance with non-nursing duties. [ABSTRACT FROM AUTHOR]

A key component of the 2011 Australian National Health Reform, via the Access and Equity Policy, is to improve access to quality health services for all Australians including CALD communities. Awareness has been raised that certain CALD communities in Australia experience limited access to health care and services, resulting in poor health outcomes. To address this issue, the Community Navigator Model was developed and implemented in four CALD communities in Logan, Queensland, through a partnership between government and non-government organisations. The model draws on local natural leaders selected by community members who then act as a conduit between the community and health service providers. Nine 'navigators' were selected from communities with low service access including the Sudanese, Burmese, Afghan and Pacific Islander communities. The navigators were trained and employed at one of two local non-government organisations. The navigators' role included assessing client needs, facilitating health promotion, supporting community members to access health services, supporting general practitioners (GPs) to use interpreters and making referrals to health services. This paper explores the 'lived experience' of the navigators using a phenomenological approach. The findings revealed three common themes, namely: (1) commitment to an altruistic attitude of servility allowing limitless community access to their services; (2) becoming knowledge brokers, with a focus on the social determinants of health; and (3) 'walking the walk' to build capacity and achieving health outcomes for the community. These themes revealed the extent to which the role of CALD community navigators has the potential to make a difference to health equity in these communities, thus contributing to the Australian National Health Reform. [ABSTRACT FROM AUTHOR]

With 28% of Australia's population having a culturally and linguistically diverse (CALD) background, the health system faces an increasing challenge to provide accessible and culturally competent health care. The view that all CALD communities are homogenous and solutions can be developed for the entire nation is detrimental. Despite available health services, CALD communities are reluctant to use them due to cultural differences, perceived racism and misunderstandings leading to the existing health disparities. Therefore, gathering data from four prominent CALD communities, such as the Sudanese, Afghani, Pacific Islander and Burmese communities in Logan, Queensland, about how they perceive and use health services can provide insightful information towards development of a service model that will better suit these CALD communities. The objective of the study was to examine the extent to which four prominent CALD communities (Sudanese, Afghani, Pacific Islander and Burmese) access and use health services in Logan, Queensland. Six focus group interviews using interpreters were conducted in English with Sudanese, Afghani, Pacific Islander and Burmese people. The results indicated that even long-standing CALD communities, such as the Pacific Islander people, were unfamiliar with health services and experienced difficulties accessing appropriate health care. Most wanted doctors to use traditional healing methods alongside orthodox medicine, but did not feel respected for their beliefs. Language difficulties impeded communication with health professionals who were hindered by ineffective use of interpreters. In conclusion, a clear role for bilingual community-based navigators was identified by CALD participants to address concerns about the health system, and to improve accessibility and health service usage. [ABSTRACT FROM AUTHOR]