Publications by authors named "Saras Henderson"

27 Publications

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Facilitating learning on clinical placement using near-peer supervision: A mixed methods study.

Nurse Educ Today 2021 Jul 24;102:104921. Epub 2021 Apr 24.

School of Nursing and Midwifery, Griffith University, Parklands Drive, Southport, QLD 4222, Australia.

Background: Graduating nursing students report lower competence in leadership and delegation skills, which may be due to lack of sufficient opportunities to practice leadership skills such as delegation and supervision. A near-peer clinical supervision model, in which third-year students supervise first-year students on placement, may provide a mechanism to develop graduating students' leadership skills while improving the learning experience for junior students.

Objectives: To evaluate nursing students' experiences and perceptions of participating in a near-peer clinical supervision model.

Design: A mixed methods design including an anonymous post-placement survey of students, and a group interview.

Settings: Medical and surgical wards in three Australian hospitals.

Method: Forty-three first-year nursing students were supervised by 92 third-year nursing students on clinical placement under the supervision of a registered nurse in a near-peer supervision model.

Results: Twenty-seven first-year (69.2%) and 43 third-year (46.7%) students completed the questionnaire. First-years reported that being supervised by a senior student was a positive experience and would recommend it to other students (4.49/5 ± 0.71), and indicated that third-year students behaved professionally, were knowledgeable, and provided opportunities to ask questions (4.52-4.81/5). Third-year students reported gaining confidence, teaching, delegation and leadership skills (4.21-4.49/5). Qualitative responses supported the quantitative findings. Additional findings were the need for greater preparation of ward registered nurses to work in the model.

Conclusions: Both groups enjoyed working in a near-peer clinical supervision model. The model provided opportunities for senior students to develop leadership and delegation skills and a positive experience of placement for junior students. Further attention to preparation of ward registered nurses would improve model delivery.
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http://dx.doi.org/10.1016/j.nedt.2021.104921DOI Listing
July 2021

Clinical facilitators' experience of near peer learning in Australian undergraduate nursing students: A qualitative study.

Nurse Educ Today 2020 Dec 21;95:104602. Epub 2020 Sep 21.

School of Nursing and Midwifery, Gold Coast campus, Griffith University, Southport, Queensland 4222, Australia. Electronic address:

Background: To mitigate escalating costs in clinical supervision of undergraduate nursing students and alleviate clinical facilitators' teaching burden, the near-peer learning model has become popular. Studies on near-peer learning have been on students' views of the model with a paucity of literature on clinical facilitators' experiences.

Aim: To explore clinical facilitator experiences of the near-peer learning model.

Design: A qualitative descriptive design was used with a purposeful sample of clinical facilitators involved in near-peer learning of nursing students.

Setting: Two teaching hospitals participated. Two medical and two surgical wards were selected from each.

Participants: Eleven clinical facilitators who had experienced using near-peer learning.

Methods: Focus group and individual interviews were conducted with clinical facilitators using a semi-structured interview guide following ethics approval. Data were analysed using content analysis.

Results: Four themes emerged: 1) Congruent student dyad characteristics 2) Clinical facilitator attributes of confidence in students' knowledge and effective time and conflict management, 3) Availability of suitable skills, and 4) Facilitator support and preparation on the model. These themes appear to promote optimum learning outcomes of the near-peer model including empowering students, junior students gaining practice in foundation skills and senior students gaining competence in leadership, mentoring and nurturing skills. Barriers included incongruent student characteristics resulting in conflict and trust issues, senior student not knowing how to teach, give feedback or teaching inaccurate information; facilitator's lack of confidence in students' knowledge level, inadequate time to manage the student dyad and resolve conflict; inadequate support and preparation from university staff; and unavailability of suitable skills.

Conclusion: Successful implementation requires careful selection of student dyads, appropriate clinical environment and support for clinical facilitators. Our findings provide a better understanding of the near-peer model for future implementation.
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http://dx.doi.org/10.1016/j.nedt.2020.104602DOI Listing
December 2020

Cultural competence in healthcare in the community: A concept analysis.

Health Soc Care Community 2018 07 7;26(4):590-603. Epub 2018 Mar 7.

School of Human Services and Social Work, Menzies Health Institute, Meadowbrook, Qld, Australia.

This study aims to conduct a concept analysis on cultural competence in community healthcare. Clarification of the concept of cultural competence is needed to enable clarity in the definition and operation, research and theory development to assist healthcare providers to better understand this evolving concept. Rodgers' evolutionary concept analysis method was used to clarify the concept's context, surrogate terms, antecedents, attributes and consequences and to determine implications for further research. Articles from 2004 to 2015 were sought from Medline, PubMed, CINAHL and Scopus using the terms "cultural competency" AND "health," "cultural competence" OR "cultural safety" OR "cultural knowledge" OR "cultural awareness" OR cultural sensitivity OR "cultural skill" AND "Health." Articles with antecedents, attributes and consequences of cultural competence in community health were included. The 26 articles selected included nursing (n = 8), health (n = 8), psychology (n = 2), social work (n = 1), mental health (n = 3), medicine (n = 3) and occupational therapy (n = 1). Findings identify cultural openness, awareness, desire, knowledge and sensitivity and encounter as antecedents of cultural competence. Defining attributes are respecting and tailoring care aligned with clients' values, needs, practices and expectations, providing equitable and ethical care, and understanding. Consequences of cultural competence are satisfaction with care, the perception of quality healthcare, better adherence to treatments, effective interaction and improved health outcomes. An interesting finding is that the antecedents and attributes of cultural competence appear to represent a superficial level of understanding, sometimes only manifested through the need for social desirability. What is reported as critical in sustaining competence is the carers' capacity for a higher level of moral reasoning attainable through formal education in cultural and ethics knowledge. Our conceptual analysis incorporates moral reasoning in the definition of cultural competence. Further research to underpin moral reasoning with antecedents, attributes and consequences could enhance its clarity and promote a sustainable enactment of cultural competence.
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http://dx.doi.org/10.1111/hsc.12556DOI Listing
July 2018

Shaping a valued learning journey: Student satisfaction with learning in undergraduate nursing programs, a grounded theory study.

Nurse Educ Today 2018 May 22;64:175-179. Epub 2018 Feb 22.

The Hopkins Centre Research for Rehabilitation and Resilience, Women's Wellness Research Group, Menzies Health Institute Queensland, School of Nursing and Midwifery, Griffith University, Gold Coast campus, Quensland 4222, Australia. Electronic address:

Background: Student satisfaction is a quality measure of increasing importance in undergraduate programs, including nursing programs. To date theories of student satisfaction have focused primarily on students' perceptions of the educational environment rather than their perceptions of learning. Understanding how students determine satisfaction with learning is necessary to facilitate student learning across a range of educational contexts and meet the expectations of diverse stakeholders.

Objectives: To understand undergraduate nursing students' satisfaction with learning.

Design: Constructivist grounded theory methodology was used to identify how nursing students determined satisfaction with learning.

Settings: Two large, multi-campus, nursing schools in Australia.

Participants: Seventeen demographically diverse undergraduate nursing students studying different stages of a three year program participated in the study.

Methods: Twenty nine semi-structured interviews were conducted. Students were invited to describe situations where they had been satisfied or dissatisfied with their learning. A constructivist grounded theory approach was used to analyse the data.

Results: Students are satisfied with learning when they shape a valued learning journey that accommodates social contexts of self, university and nursing workplace. The theory has three phases. Phase 1 - orienting self to valued learning in the pedagogical landscape; phase 2 - engaging with valued learning experiences across diverse pedagogical terrain; and phase 3 - recognising valued achievement along the way.

Conclusion: When students experience a valued learning journey they are satisfied with their learning. Student satisfaction with learning is unique to the individual, changes over time and maybe transient or sustained, mild or intense. Finding from the research indicate areas where nurse academics may facilitate satisfaction with learning in undergraduate nursing programs while mindful of the expectations of other stakeholders such as the university, nurse registering authorities, employers and the receivers of nursing care.
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http://dx.doi.org/10.1016/j.nedt.2018.02.020DOI Listing
May 2018

Developing nurses' intercultural/intraprofessional communication skills using the EXCELLence in Cultural Experiential Learning and Leadership Social Interaction Maps.

J Clin Nurs 2018 Sep 4;27(17-18):3276-3286. Epub 2017 Dec 4.

Department of International Business and Asian Studies, Griffith Business School, Griffith University, Nathan, Qld, Australia.

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.
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http://dx.doi.org/10.1111/jocn.14089DOI Listing
September 2018

Metaphorical interpretations of the educator-student relationship: An innovation in nursing educational research.

Nurse Educ Pract 2018 Jan 18;28:46-53. Epub 2017 Sep 18.

School of Nursing and Midwifery, Griffith University, Australia. Electronic address:

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.
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http://dx.doi.org/10.1016/j.nepr.2017.09.012DOI Listing
January 2018

Power dynamics in the student-teacher relationship in clinical settings.

Nurse Educ Today 2017 Feb 7;49:174-179. Epub 2016 Dec 7.

School of Nursing and Midwifery, Griffith University, Australia. Electronic address:

Background: Among many factors that influence clinical learning, the teacher-student relationship has been found to be crucial. The imbalance of power in that relationship tends to be regarded as negative, but how students actually perceive the power within the relationship is unknown.

Aim: This study explored nurse students' perceptions of the power dynamics in the teacher-student relationship during their clinical placement.

Design: A descriptive qualitative study.

Methods: A total of 51 students were recruited from a nursing school in Hong Kong. Seven focus group interviews consisted of three groups of Year 3 students (n=26) and four groups of final year students (n=25). A semi-structured interview guideline was designed. Content analysis was employed to analyse the research data.

Results: The three core themes that emerged from the qualitative data were: (1) meanings of power - avoiding doing harm to patients; (2) the desired power dynamics - master vs apprentice; and (3) enhancing the clinical learning experience.

Conclusions: The dominant theme in the participants' discourse was that teachers should possess more power than students in order to prevent students from causing harm to patients. The consensus was that the teacher's power in supervising students' clinical practice is accepted and necessary for the benefit of patient safety. The cultural relevance of the power dynamics in the teacher-student relationship should be embraced in order to understand the student's perspective.
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http://dx.doi.org/10.1016/j.nedt.2016.11.026DOI Listing
February 2017

Uncovering nursing students' views of their relationship with educators in a university context: A descriptive qualitative study.

Nurse Educ Today 2017 Feb 27;49:110-114. Epub 2016 Nov 27.

School of Nursing and Midwifery, Griffith University, Australia. Electronic address:

Introduction: Power dynamics is a key element in the educator-student relationship, and can be influential to the learning outcomes of students.

Background: Power relations are inherent in the interaction between educators and students. The educator-student relationship is still an under-explored area of power dynamics.

Aim: The aim of the study was to investigate nursing students' perceptions of the power dynamics in the educator-student relationship in a university learning context in order to offer educators some understanding of how such a relationship was perceived by students.

Design: A descriptive qualitative study using focus group inquiry.

Methods: Through convenience sampling, a total of 56 students were recruited and eight focus group interviews were conducted. Thematic analysis was adopted to capture the meanings extracted from the student narratives.

Results: Four core themes of the educator-student relationship were identified. Referring to these themes, some implications were drawn, such as the significance of the educator-student relationship; an educator's power matters; and polarized views among the students on whether or not an educator should be a friend.

Conclusions: The power dynamics varied depending on an educator's personality, communication skills, ability to effectively monitor large classes, and teaching style. More efforts are needed to investigate the preferred conceptions and types of educator-student relationships in order to evaluate the impact that these have on learning.
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http://dx.doi.org/10.1016/j.nedt.2016.11.020DOI Listing
February 2017

Using Interprofessional Learning for Continuing Education: Development and Evaluation of the Graduate Certificate Program in Health Professional Education for Clinicians.

J Contin Educ Health Prof 2016 ;36(3):211-7

Dr. Henderson: Associate Professor and Director, Health Professional Education, School of Nursing and Midwifery, Griffith University, Logan, Australia, and Menzies Health Institute, Queensland, Australia. Dr. Dalton: Deputy Dean, Learning and Teaching, School of Human, Health and Social Sciences, CQ University Rockhampton, Queensland, Australia. Dr. Cartmel: Senior Lecturer, School of Human Services and Social Work, Griffith University, Logan, Australia, and Menzies Health Institute, Queensland, Australia.

Introduction: Health professionals may be expert clinicians but do not automatically make effective teachers and need educational development. In response, a team of health academics at an Australian university developed and evaluated the continuing education Graduate Certificate in Health Professional Education Program using an interprofessional learning model.

Methods: The model was informed by Collins interactional expertise and Knowles adult learning theories. The team collaboratively developed and taught four courses in the program. Blended learning methods such as web-based learning, face-to-face workshops, and online discussion forums were used. Twenty-seven multidisciplinary participants enrolled in the inaugural program. Focus group interview, self-report questionnaires, and teacher observations were used to evaluate the program.

Results: Online learning motivated participants to learn in a collaborative virtual environment. The workshops conducted in an interprofessional environment promoted knowledge sharing and helped participants to better understand other discipline roles, so they could conduct clinical education within a broader health care team context. Work-integrated assessments supported learning relevance. The teachers, however, observed that some participants struggled because of lack of computer skills.

Discussion: Although the interprofessional learning model promoted collaboration and flexibility, it is important to note that consideration be given to participants who are not computer literate. We therefore conducted a library and computer literacy workshop in orientation week which helped. An interprofessional learning environment can assist health professionals to operate outside their "traditional silos" leading to a more collaborative approach to the provision of care. Our experience may assist other organizations in developing similar programs.
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http://dx.doi.org/10.1097/CEH.0000000000000093DOI Listing
February 2018

USEFUL TIPS FOR TEACHING INTERNATIONAL NURSING STUDENTS.

Authors:
Saras Henderson

Aust Nurs Midwifery J 2016 09;24(3):39

International students studying nursing in Australia has increased (Glew, 2013). For most of these students, English may not be their first language. The style of teaching and learning international students had previously experienced differ vastly from the Western style of teaching.
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September 2016

Needs-gap analysis on culturally and linguistically diverse grandparent carers' 'hidden issues': a quality improvement project.

Aust J Prim Health 2016 Feb;22(6):477-482

Blue Care Multicultural Services, 129 Dennis Road, Springwood, Qld 4127, Australia.

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 and Maori 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.
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http://dx.doi.org/10.1071/PY15051DOI Listing
February 2016

Strategies used by nurses, academics and students to overcome intercultural communication challenges.

Nurse Educ Pract 2016 Jan 1;16(1):71-8. Epub 2015 Sep 1.

Centre for Applied Psychology, Faculty of Health, Locked Bag 1, University of Canberra, ACT 2601, Australia. Electronic address:

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.
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http://dx.doi.org/10.1016/j.nepr.2015.08.010DOI Listing
January 2016

How Does Culture Shape Roles and Relationships in Taiwanese Family Caregiving for an Adolescent With Cancer?

Cancer Nurs 2015 May-Jun;38(3):E35-41

Author Affiliations: School of Nursing, Kang-Ning Junior College of Medical Care and Management, Taipei, Taiwan, Republic of China (Dr Yeh); School of Nursing and Midwifery, Griffith University, Nathan Campus (Dr Kellet); and School of Nursing and Midwifery, Griffith University, Gold Coast Campus, Southport (Dr Henderson), Queensland, Australia; and School of Nursing, Chang Gung University, Taoyuan (Dr Chen), Taiwan, Republic of China.

Background: Chinese culture plays a significant part in how Taiwanese families view life events. Caregivers envisage themselves as guardians of their children in all facets of family life, including wellness and strive to maintain harmonious relationships within the family. However, it remains unclear what impact caring for an adolescent with cancer has on family roles and relationships in Taiwanese families, nor are the processes for managing change in family roles and relationships associated with caregiving well understood.

Objective: This study explores the impact of caregiving for an adolescent with cancer on the roles and relationships within Taiwanese families.

Methods: Seven families were recruited from a medical hospital in Taiwan. Data were collected through qualitative interviews and analyzed following Strauss and Corbin's grounded theory.

Results: The core category, underpinned by Chinese culture, proved to be experiencing the broken chain of family life. This was the central issue brought about by 4 consequences for the broken chain of family life. The expression "the broken chain of family life" encapsulates how important Chinese cultural values are in defining caregiver task performance.

Conclusions: The findings have implications for Taiwanese families in perceiving, adjusting to, and fulfilling the altered roles and relationships associated with caring for an adolescent with cancer at home.

Implications For Practice: The delivery of exceptional care and services depends on gaining insight into how caregiving influences family roles and relationships. How families failed to manage the process of caregiving provides valuable insight for informing and providing recommendations for services and support.
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http://dx.doi.org/10.1097/NCC.0000000000000168DOI Listing
December 2016

Reflecting on the tensions faced by a community-based multicultural health navigator service.

Aust Health Rev 2014 Nov;38(5):584-8

Centre for National Research on Disability and Rehabilitation Research (CONROD) and Centre for Community Science, Griffith Health Institute, Griffith University, Parklands Drive, Southport, Qld 4215, Australia. Email:

The community navigator model was developed to assist four culturally and linguistically diverse communities (Sudanese, Burmese, Pacific Islander Group, Afghani) in south-east Queensland to negotiate the Australian health system and promote health. Using participatory action research, we developed the model in partnership with community leaders and members, the local health department and two non-governmental organisations. Following implementation, we evaluated the model, with the results published elsewhere. However, our evaluation revealed that although the model was accepted by the communities and was associated with positive health outcomes, the financial, social and organisational durability of the model was problematic. Ironically, this situation was inadvertently created by critical decisions made during the development process to enhance the durability and acceptability of the model. This paper explores these critical decisions, our rationale for making those decisions and the four hidden tensions that subsequently emerged. Using a reflective case study method to guide our analysis, we provide possible resolutions to these tensions that may promote the longevity and utility of similar models in the future. WHAT IS KNOWN ABOUT THE TOPIC?: The use of community navigators to assist culturally diverse communities to access health services is not new. Many benefits have been documented for communities, individuals and heath service providers following the use of such models. What is not well documented is how to maintain these models in a safe and cost-effective way within the Australian health system while respecting cultural and community practices and reducing the burden of service delivery on the navigators. WHAT DOES THIS PAPER ADD?: This paper provides a perspective on how the development of community-based service models inherently places them in a position of tension that must be resolved if they are to be long lasting. Four core tensions experienced during the development and implementation of our model in south-east Queensland are explored to develop potential resolutions. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Reducing the tensions inherent in culturally appropriate community-based service models will increase the durability of the approach. By addressing these tensions, we can create a more durable pool of community navigators that can facilitate community empowerment, self-governance of health issues and a sense of community ownership of health services.
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http://dx.doi.org/10.1071/AH13168DOI Listing
November 2014

Partnership functioning: a case in point between government, nongovernment, and a university in Australia.

Prog Community Health Partnersh 2013 ;7(4):385-93

Background: Culturally and linguistically diverse (CALD) communities in Queensland, Australia, do not access health services, contributing to poor health outcomes. To improve health in CALD communities, a partnership was formed between the state government, two nongovernment CALD-specific organizations (NGOs), and a university to develop a service that could facilitate health service use. This qualitative research explored the partners' perspectives on how the partnership functioned and its outcomes.

Objectives: We sought to (1) explore how participants engaged with the principles of partnership, the processes they used, and their beliefs about the facilitators and barriers to intersectoral collaboration and (2) gain insights into how the partners perceived the development and functioning of the partnership.

Methods: Qualitative, semistructured interviews were conducted with each of the key stakeholders in the partnership (n = 4). A focus group was also conducted with those working within the two NGO partners in the delivery of the service (n = 8). Open-ended questions drawn from the literature on partnership principles were used to guide the interviews and focus group data collection. The data were transcribed and analyzed using thematic principles.

Results: The four themes identified were: (1) Perceived benefits of the partnership outweighed organizational differences; (2) respectful relationships sustained the partnership; (3) mitigating conflict enabled the purpose of the partnership to be fulfilled; and (4) a neutral interpersonal space enabled the partnership to be enacted.

Conclusions: Our study showed how contextual pressures created within the system can damage tenuous connections that have been developed between otherwise competitive organizations, leading to dissolution of partnerships. However, the study has also shown that partnerships may be purpose and time bound, not necessarily with respect to longevity. Through strategic negotiations, partnerships can be sustained until the goal of the partnership is attained, which in this instance was the development of a new service delivery model.
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http://dx.doi.org/10.1353/cpr.2013.0049DOI Listing
April 2014

International medical graduates' reflections on facilitators and barriers to undertaking the Australian medical council examination.

Aust Health Rev 2012 Aug;36(3):296-300

Population and Social Health Research Program, Centre of National Research on Disability and Rehabilitation Medicine, Griffith Health Institute, Griffith University, Brisbane, QLD 4131, Australia.

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.
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http://dx.doi.org/10.1071/AH11082DOI Listing
August 2012

Community-based child health nurses: an exploration of current practice.

Contemp Nurse 2011 Dec;40(1):71-86

Valley and Hills Child and Adolescent Health Service, Department of Health, Western Australia, Perth, Australia.

The purpose of this research was to define, the practice domain of community-based child health nursing in light of widespread 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.
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http://dx.doi.org/10.5172/conu.2011.40.1.71DOI Listing
December 2011

'Community navigators': making a difference by promoting health in culturally and linguistically diverse (CALD) communities in Logan, Queensland.

Aust J Prim Health 2011 ;17(4):347-54

Population and Social Health Research Program, Griffith Health Institute, School of Nursing and Midwifery, Griffith University, Southport, Qld 4215, Australia.

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.
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http://dx.doi.org/10.1071/PY11053DOI Listing
February 2012

Culturally and linguistically diverse peoples' knowledge of accessibility and utilisation of health services: exploring the need for improvement in health service delivery.

Aust J Prim Health 2011 ;17(2):195-201

School of Nursing and Midwifery, Griffith Health Institute, Gold Coast Campus, Griffith University, Qld 4222, Australia.

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.
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http://dx.doi.org/10.1071/PY10065DOI Listing
August 2011

The effectiveness of culturally appropriate interventions to manage or prevent chronic disease in culturally and linguistically diverse communities: a systematic literature review.

Health Soc Care Community 2011 May 6;19(3):225-49. Epub 2011 Jan 6.

Griffith Health Institute, Griffith University, Gold Coast Campus, Queensland, Australia.

Culturally and linguistically diverse (CALD) communities in Australia experience both significant health disparities and a lack of access to services. Consequently, there have been calls for culturally appropriate services for people with chronic disease in CALD populations. This paper presents a systematic review of the literature on the effectiveness of culturally appropriate interventions to manage or prevent chronic disease in CALD communities. Evidence was sought from randomized controlled trials and controlled studies that examined strategies for promoting cultural competence in health service delivery to CALD communities. The outcomes examined included changes in consumer health behaviours, utilisation/satisfaction with the service, and the cultural competence of health-care providers. Of the 202 studies that were identified only 24 met the inclusion criteria. The five categories of intervention that were identified included: (1) the use of community-based bi-lingual health workers; (2) providing cultural competency training for health workers; (3) using interpreter service for CALD people; (4) using multimedia and culturally sensitive videos to promote health for CALD people and (5) establishing community point-of-care services for CALD people with chronic disease. The review supported the use of trained bi-lingual health workers, who are culturally competent, as a major consideration in the development of an appropriate health service model for CALD communities.
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http://dx.doi.org/10.1111/j.1365-2524.2010.00972.xDOI Listing
May 2011

Resilience: the power within.

Oncol Nurs Forum 2010 Nov;37(6):698-705

Research Centre for Clinical and Practice Innovation and School of Nursing and Midwifery, Griffith University, Gold Coast Campus, in Southport, Queensland, Australia.

Purpose/objectives: To advance understanding of resilience as an innate resource and its potential and relevance in the management of workplace stress for oncology nurses.

Data Sources: Journal articles and research results, particularly seminal literature from a variety of Australian and international journals and published texts, including government and nursing organizations.

Data Synthesis: Resilience is defined as an innate energy or motivating life force present to varying degrees in every individual, exemplified by the presence of particular traits or characteristics that, through application of dynamic processes, enable an individual to cope with, recover from, and grow as a result of stress or adversity. Literature from a wide variety of fields, including physics, medicine, theology, philosophy, psychology, and spirituality, was reviewed to build an overview of existing knowledge and evolving theories on the subject of resilience and further the understanding of resilience as an innate personal resource.

Conclusions: Innate resilience can be developed or enhanced through cognitive transformational practices, education, and environmental support. Such processes may have use in ameliorating the effects of workplace stress.

Implications For Nursing: The complex nature of oncology and other specialty nursing roles creates a certain amount of inevitable stress that depletes the self and may lead to compassion fatigue and burnout. A greater understanding of resilience as an innate stress response resource highlights the need for processes that support resilience development and organizational and personal stress-management strategies for nurses to be part of mainstream nursing education.
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http://dx.doi.org/10.1188/10.ONF.698-705DOI Listing
November 2010

Community Child Health (CCH) nurses' experience of home visits for new mothers: a quality improvement project.

Authors:
Saras Henderson

Contemp Nurse 2009 Dec-2010 Jan;34(1):66-76

School of Nursing and Midwifery, Griffith Health, Gold Coast Campus, Griffith University, QLD, Australia.

This paper explores Community Child Health (CCH) nurses' experience of home visits for new mothers in a health service region of Western Australia. Reported benefits of home visits include improvement in maternal and child health and better parenting skills leading to positive maternal-child interaction. Despite CCH nurses' support for home visits factors such as costs, lack of resources and staffing issues have made home visits increasingly difficult. Twelve child health nurses participated in a focus group taped interview to explore how these nurses experienced home visits for new mothers in order to evaluate and improve home visits. Data were transcribed verbatim and content analysed. Three themes emerged from the nurses' experience of home visits. These were: (1) finding out about home visits with sub-themes such as scheduling first home visits and making the first phone call, (2) staying safe during home visits with sub-themes such as managing high risk clients and scheduling subsequent visits and (3) building positive partnerships with clients during home visits. The findings indicated CCH nurses followed a set pathway towards successfully completing home visits. This may provide valuable insights for other CCH nurses.
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http://dx.doi.org/10.5172/conu.2009.34.1.066DOI Listing
July 2010

Factors impacting on nurses' transference of theoretical knowledge of holistic care into clinical practice.

Authors:
Saras Henderson

Nurse Educ Pract 2002 Dec;2(4):244-50

Senior Lecturer, School of Nursing and Midwifery, Curtin University of Technology, GPO Box U1987, Perth, WA 6845, Australia.

Since nurse education moved to universities, a reoccurring concern of health consumers, health administrators, and some practising nurses is that nurses are not able to transfer the theoretical knowledge of holistic care into practice. Much has been written about this concern usually under the heading of the theory-practice gap. A common reason that has been highlighted as the cause of this gap is that the theoretical knowledge that nurses learn in academia is predicated on concepts such as humanism and holistic caring. In contrast, the bureaucratic organisation where nurses provide care tends to be based on management concepts where cost containment and outcome measures are more acceptable. Hence nurses' learned values of holistic caring are pitted against the reality of the practice setting. So what is this practice reality? This paper attempts to provide an insider view of why the theoretical knowledge of holistic care may be difficult to enact in the clinical setting. In-depth taped interviews with nurses and participant observation were conducted in acute care hospitals in Western Australia. The interviews were transcribed verbatim and analysed using the constant comparative method. The findings indicated that utilitarian nursing and role models had impacted on the transference of theoretical knowledge of holistic care into practice. The paper outlines some measures that nurses themselves can undertake to ensure the narrowing of the theory-practice gap in this area.
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http://dx.doi.org/10.1016/s1471-5953(02)00020-3DOI Listing
December 2002

The association of maternal overweight and obesity with breastfeeding duration.

J Pediatr 2006 Aug;149(2):185-91

Telethon Institute for Child Health Research, Centre for Child Health Research, University of Western Australia, PO Box 855, West Perth, Perth, Western Australia 6872, Australia.

Objective: To determine whether maternal prepregnancy overweight or obesity has an independent effect on breastfeeding duration.

Study Design: A prospective birth cohort study of 1803 live-born children and their mothers ascertained through antenatal clinics at the major tertiary obstetric hospital in Perth, Australia, were followed until 3 years of age. Unconditional logistic, Cox regression, and Kaplan Meier analyses were used to model the association between maternal prepregnancy overweight and obesity and the duration of predominant or any breastfeeding allowing for adjustment of confounders (infant factors: gender, birth weight, gestational age, age solids introduced, and older siblings; maternal factors: smoking, education, age, race, marital status, pregnancy and birth complications, cesarean section, and socioeconomic status).

Results: Overweight and obese women were more likely to have discontinued breastfeeding at any time before 6 months than normal weight women (P < .0005) following adjustment for potential confounders.

Conclusion: We have shown that prepregnancy body mass index is associated with reduced breastfeeding duration, and that mothers who are overweight or obese before pregnancy tend to breastfeed their infants for a shorter duration than normal weight mothers independent of maternal socioeconomic and demographic characteristics.
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http://dx.doi.org/10.1016/j.jpeds.2006.04.005DOI Listing
August 2006

Perceptions of infection control practices among health professionals.

Contemp Nurse 2006 Jul;22(1):109-19

Division of Health Sciences, Curtin University of Technology, Perth WA, Australia.

Infection control practice is a cornerstone of modern health care. However, there is minimal research into health professionals' perception of infection control practices and how those perceptions influence staff compliance with recommended protocols. The objective of this study was to explore health care professionals' perceptions of infection control practices in relation to the management of infectious diseases. A grounded theory approach was used as the research framework. Semi-structured interviews were completed with a sample of 16 nurses and doctors working at hospitals in Western Australia. Four major categories emerged from the data. These were: knowledge, culture, conflict, and risk assessment. The findings indicate the importance of both individual and organisational factors in determining clinicians' levels of compliance with recommended infection control practices. Identification of the factors that influence health professionals' level of compliance can be used to develop strategies to support long-term compliance with infection control practices.
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http://dx.doi.org/10.5172/conu.2006.22.1.109DOI Listing
July 2006

Power imbalance between nurses and patients: a potential inhibitor of partnership in care.

Authors:
Saras Henderson

J Clin Nurs 2003 Jul;12(4):501-8

School of Nursing and Midwifery, Curtin University of Technology, GPO Box U 1987, Perth, Western Australia 6845, Australia.

The Patient's Charter identifies the need for nurses to respect patients' rights to influence their care, and contemporary nursing practice advocates that nurses work in partnership with patients. Hence nurses are encouraged to share their power and facilitate empowerment in their patients by giving them information and support. However, the literature indicates that nurses are not very successful in making patients feel empowered to make informed decisions. This study, conducted in 1998, provides some answers as to why this may be the case. The aim of the study was to explore and describe nurses' and patients' views regarding partnership in care in hospital. Using the grounded theory approach, participants were drawn from four hospitals in Western Australia. A purposive sample of 33 nurses and 32 patients were interviewed in-depth. Participant observation was also conducted and field notes were written. The interviews were transcribed verbatim and analysed using the constant comparative method. The findings showed that nurses viewed involving patients in care as requiring them to give patients information and to share their decision-making powers with them. With the exception of a few, the majority of nurses were unwilling to share their decision-making powers. This created a situation of power imbalance with subsequent little patient input. Factors identified included nurses' beliefs that they "know best", the view that patients lacked medical knowledge and the perceived need for nurses to hold onto their power and maintain control. If nurses and patients are to work as partners, it is important that nurses make every effort to equalize the power imbalance. One way to do this is for nurses to share and give information to patients readily and to be open in their communication with them.
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http://dx.doi.org/10.1046/j.1365-2702.2003.00757.xDOI Listing
July 2003

Influences on patient participation and decision-making in care.

Authors:
Saras Henderson

Prof Nurse 2002 May;17(9):521-5

School of Nursing and Midwifery, Curtin University of Technology, Western Australia.

Encouragement for patients to participate in their own care and to share decision-making with nurses and doctors is a common theme in the literature and government directives. But how do patients feel about it? An observation-and-interview-based study found five main factors that influenced patients' willingness and ability to actively participate in their care.
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May 2002
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