2018 Inaugural HDR Student conference abstracts
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College of Nursing and Health Sciences at Flinders University are pleased to present the inaugural HDR Student conference. This is an annual event to provide HDR students an opportunity to present their research work, network with students and academic staff, meet their milestone expectations of oral presentations, and participate in professional development activities.
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ItemThanatology: Theories on death, dying and end-of-life care(Flinders University, 2018-11-5)During the middle ages, death and life were considered to coexist. Death evoked no great fear or awe since it was familiar, unhidden and inevitable. Over the centuries, with the growth of religion, there occurred a change in the attitude towards death to one of fear and also fascination. In the nineteenth century, as science increasingly gained ground in western industrial societies, death was no longer viewed as a part of life, but rather a break with life. Death was equated with uncertainty and disorder. In keeping with the scientific view of the time, the solution to the disorder of death and dying was perceived as a need for control. In achieving control, death and dying increasingly became medicalised and hence, an increase in presentations to emergency departments. Today, a significant number of people either die in emergency departments or are dead on arrival. Despite the significant amount of contact with dying patients, accepting death and the provision of quality end of life care within the emergency department remains difficult because of the focus on medical treatment, resuscitation and interventions. This presentation will focus on the history and principles of palliative care, and theories on death and dying. This theoretical knowledge will underpin the research into nurses and doctors' perspectives of death and dying in emergency departments.
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ItemContextualising acute coronary syndrome standards and guidelines for Aboriginal people residing in Central Australian and Top End Aboriginal communities.(Flinders University, 2018-11-5)Introduction: The National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian Clinical Guidelines for the Management of Acute Coronary Syndrome 2016 (in consultation with the Australian and New Zealand Society of Cardiac and Thoracic Surgeons) provide guidelines for the management of myocardial revascularisation. In addition, the European System for Cardiac Operative Risk Evaluation (euroSCORE I and II) are models used to calculate risk of mortality 30 days post cardiac surgery. The euroSCORE I and II have been validated for European, Japanese and North American populations; however, they have not been validated for Aboriginal and Torres Strait Islander populations and there is still much debate on whether they can be attributed to this, and other Indigenous populations. This study aims to explore the contextual factors (barriers and enablers) informing the guidelines for cardiac surgery and revascularisation for Aboriginal and Torres Strait Islander people residing in central Australian and Top End Northern Territory communities. Subsequently, recommendations will be put forward for culturally effective cardiac pathways of care. Methodology: This study uses an Indigenous research methodology, through the lens of the Essential Service Standards for Equitable National Cardiovascular Care (ESSENCE) framework, to better understand Aboriginal world views and experiences of cardiac surgery. Data collection: Semi-structured and/or open-ended questions will be posed 30-90 days post-discharge from Flinders Medical Centre and used to elicit free flowing narratives and storytelling once the participant is back residing in their community. Analysis: Indigenous narrative analysis, by means of storytelling, will be used to develop themes and codes for the purpose of identifying "experience" commonalities and distinctions and mapped to relevant acute coronary syndrome (ACS) and revascularisation standards and guidelines. Conclusion: The practical outcomes of the proposed study will identify cultural service gaps to make recommendations aligned to revised recommendations for new ACS and revascularisation standards, guidelines and care pathways for Aboriginal and Torres Strait Islander populations.
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ItemTransformative consumer focussed research(Flinders University, 2018-11-5)Transformative research designs and consumer focussed approaches
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ItemFood service satisfaction in aged care facilities: Development of a toolkit of instruments for the measurement of change(Flinders University, 2018-11-5)Introduction: Although the average life span of Australian citizens is increasing, the final ten years may be accompanied by illness and disability thereby increasing the demand for residential aged care. Satisfaction with food service is a major factor in overall satisfaction and is important for the resident, resident's family, staff, cooks and management of the facility. There are currently limited valid and reliable tools available for measuring this construct and most tools investigate only the resident's perspective. As nursing homes are a complex system, a key gap is investigating other stakeholders that contribute to the food service setting as ultimately, this impacts the experience of the resident. Methods: Mixed method study underpinned by systems theory utilising qualitative interviews with stakeholders to develop quantitative instruments for measuring satisfaction. Transcripts will be analysed thematically to understand the factors (themes) relevant to stakeholders. Items for each questionnaire will be developed and content validity determined through an expert panel. Ethics approval has been obtained to recruit participants in nursing homes across Australia. Each instrument will undergo test/retesting and factor analysis will be conducted using SPSS to refine the tool. Implications: The development of a tool kit of instruments to measure change will enable residential aged care facilities to monitor quality improvement and detect areas of dissatisfaction within the food service system. Further, the revised Aged Care Quality Standards have a focus on stakeholder engagement and require homes to provide evidence of same, this tool kit will provide a valid and reliable way of ensuring this criteria is met.
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ItemGoal setting with older adults: Client and staff experiences in Transition Care Program(Flinders University, 2018-11-5)Goals are a fundamental component of health care and promote person-centred practice by encouraging collaborative discussions and shared decision making. Transition Care Program (TCP) is a federally funded, goal-orientated, therapy-focussed program that provides additional time after an acute health event for older adults to improve functional ability and decide on final discharge destination. This research investigated the client and staff experiences of goals in TCP through interviews and focus groups. Through thematic analysis, clear intrinsic and extrinsic facilitators were identified, including the visceral pull of 'home' and the effectiveness of explicit, consistent goal language. Client-related barriers emerged, such as the physical, cognitive and emotional effects of fatigue. These were compounded by service barriers. This research provides opportunity to improve person-centred care for older adults by integrating consistent language, addressing service barriers in clinical practice and incorporating client goals into the service KPIs.
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ItemIdentifying food group targets to improve the diet quality of individuals(Flinders University, 2018-11-5)Aim/Objective To distinguish how diet quality components vary between individual cases, and sub-groups of personal characteristics. Introduction/Background Literature Diet is a key modifiable risk factor for non-communicable diseases. Interventions have commonly focused on the same food groups to improve health outcomes, with little effectiveness. Tailoring dietary interventions to personal characteristics may be more beneficial. Methodology Cross-sectional, data-driven analysis with a priori knowledge of self-reported food intake data was conducted. Methods/Design – includes setting, sampling, ethical review, data collection and data analysis Diet quality data was analysed from 198,637 Australian adults, collected using a validated online short food survey. Overall and individual component scores were compared between individual cases and sub-groups (diet quality quintiles, age, gender, weight or a mixture) using percentage agreement and Cohen’s kappa. Findings/Results Of the nine diet quality components, four key components were frequently shown as the lowest scoring at both the individual and sub-groups levels: Variety, Dairy, Discretionary, Healthy fats. The percentage agreement and kappa coefficients only improved marginally as sub-group levels became more personalised, when compared to individual cases. Dairy and healthy fats fell in the bottom four scores 66% and 58% of the time for all groups, respectively. Discretionary fell in the bottom four scores for all sub-groups 68% of the time (k=0.16, p<0.01) and variety frequency agreement also remained unchanged (k=0.35, p<0.01). The same four lowest scoring components occurred ~60% of the time for all groups. Conclusion/Summary Using personal characteristics may be an effective way to personalise interventions, however complexity of personalisation may not be needed beyond demographic characteristics. Implications/recommendations for Practice To consider in which order the frequently occurring lowest scoring food groups should be targeted.