The early postnatal period : exploring women's views, expectations and experiences of care using focus groups in Victoria, Australia

Background: There is growing evidence from Australia and overseas that the care provided in hospital in the early postnatal period is less than ideal for both women and care providers. Many health services face increasing pressure on hospital beds and have limited physical space available to care for mothers and their babies. We aimed to gain a more in-depth understanding of women's views, expectations and experiences of early postnatal care.

Methods: We conducted focus groups in rural and metropolitan Victoria, Australia in 2006. Fifty-two people participated in eight focus groups and four interviews. Participants included eight pregnant women, of whom seven were pregnant with their first baby; 42 women who were in the postpartum period (some up to twelve months after the birth of their baby); and two partners. All participants were fluent in English. Focus group guides were developed specifically for the study and explored participants' experiences and/or expectations of early postnatal care in hospital and at home, with an emphasis on length of hospital stay, professional and social support, continuity of care, and rest. Discussions were audio-taped and transcribed verbatim. A thematic network was constructed to describe and connect categories with emerging basic, organizing, and global themes.

Results: Global themes that emerged were: anxiety and/or fear; and the transition to motherhood and parenting. The needs of first time mothers were considered to be different to the needs of women who had already experienced motherhood. The women in this study were generally concerned about the safety of their new baby, and lacked confidence in themselves as new mothers regarding their ability to care for their baby. There was a consistent view that the physical presence and availability of professional support helped alleviate these concerns, and this was especially the case for women having a first baby.

Conclusion: Women have anxieties and fears around early parenting and their changing role, and may consider that the physical availability of professional care providers will help during this time. Care providers should be cognisant of these potential issues. It is crucial that women's concerns and needs be considered when service delivery changes are planned. If anxiety around new parenting is a predominant view then care providers need to recognise this and ensure care is individualised to address each woman's/families particular concerns.

Incongruence between nurses' and patients' understandings and expectations of rehabilitation

Aims and objectives. To explore nurses' understandings and expectations of rehabilitation and nurses' perceptions of patients' understandings and expectations of rehabilitation.
Background. Within the context of a broadening appreciation of the benefits of rehabilitation, interest in the nature of rehabilitation is growing. Some believe that rehabilitation services do not adequately meet the needs of patients. Others are interested in the readiness of patients to participate in rehabilitation.
Design. Qualitative.
Method. Grounded theory using data collected during interviews with nurses in five inpatient rehabilitation units and during observation of the nurses' everyday practice.
Findings. According to nurses working in inpatient rehabilitation units, there is a marked incongruence between nurses' understandings and expectations of rehabilitation and what they perceive patients to understand and expect.
Conclusion. Given these different understandings, an important nursing role is the education of patients about the nature of rehabilitation and how to optimise their rehabilitation.

Relevance to clinical practice. Before patients are transferred to rehabilitation, the purpose and nature of rehabilitation, in particular the roles of patients and nurses, needs to be explained to them. The understandings of rehabilitation that nurses in this study possessed provide a framework for the design of education materials and orientation programmes that inform patients (and their families) about rehabilitation. In addition, reinforcement of the differences between acute care and rehabilitation will assist patients new to rehabilitation to understand the central role that they themselves can play in their recovery.

Understanding the older food consumer, present day behaviours and future expectations

The main aim of this study was to determine whether Baby boomers know how they would manage to maintain a healthy diet on lower incomes in retirement. A cross-sectional survey was conducted at two shopping centres in Melbourne, Australia with 352 respondents. Contingency table analyses (using chi-square tests) were used to examine differences in present and future cooking habits between gender, age and socio-economic groups as well as anticipated changes to food shopping if they had less money in the future. The findings suggest that the most common food preparation behaviours were making meals from scratch ingredients (80% of participants) or using a combination of fresh and convenience foods (55% of participants), with socio-economic and demographic factors significantly influencing specific behaviours. Nearly 50% responded that if they had reduced income they would make a change to their food shopping habits. The most common changes were to the types of food purchased and seeking out special offers or cheaper brands. The results suggest that when faced with a lower standard of living, people will make changes to their food consumption habits. The challenge facing health promotion practitioners, is to ensure that these changes are well informed, leading to healthy options.

The relationship between familiarity and expectations

This study examines the effects of prior experience in the context of a cultural arts service. This is an exploratory study designed to investigate the role familiarity plays in shaping visitor expectations. A cross sectional sample of novice and experienced visitors to a major art exhibition was conducted to investigate expectations, perceptions and service quality. Although the results are inconclusive, the findings provide some support for the proposition that novices have more fragmented expectations in certain dimensions.

Geelong community's priorities and expectations of public health care

Abstract This thesis set out to achieve the following objectives: (1) To identify the priorities and expectations that the Geelong community has of its public health care system. (2) To determine if there is a common view on the attributes of a just health system. (3) To consider a method of utilising the data in the determination of health care priority setting in Barwon Health. (4) To determine a model of community participation which enables ongoing input into the decision making processes of Barwon Health. The methodology involved a combination of qualitative and quantitative research. The qualitative work involved the use of focus groups that were conducted with 64 members of the Geelong community. The issues raised informed the development of the interview schedule that was the basis of the quantitative study, which surveyed a representative sample of 400 members of the Geelong community. Prior to reporting on this work, the areas of distributive justice, scarcity and community participation in health care were considered. The research found that timely access to public hospitals, emergency care and aged care services were the major priorities; for many people, the cost was less relevant than a quality service. Shorter waiting times and increased staffing levels were strongly supported. Increased taxes were nominated as the best means of financing the health system they sought. Community based services were less relevant than hospital services but health education was supported. An egalitarian approach to resource distribution was favoured although the community was prepared to discriminate in favour of younger people and against older people. There was strong support for the community to be involved in decision making in the public health care system through surveys or focus groups but very little support was given to priorities being determined by politicians, administrators and to a lesser extent, medical professionals.

Transition to parenthood and the conflict of unrealized role expectations

Attempts to evaluate the effects of role expectations on transition to parenthood. Resultant changes in the partnership are measured. Highlights the enormity and complexity of the transition and underlying influences.

Students' expectations of the virtual maternity clinic

The aim for the Virtual Maternity Clinic (VMC) is to engage students in learning about the role of the midwife and care of women during early pregnancy. The VMC, using Deakin Studies Online as a platform, includes LiveSim, videoed characters and Adobe Flash of four pregnant women with diverse issues. From an evaluation distributed to students prior to access of the VMC to identify their expectations, we found that undergraduate students wanted to learn how to interact with women during early pregnancy, whereas postgraduate students wanted strategies to learn about midwifery practice. Further development of the VMC is progressing to include a suite of programs incorporating the care of women during late pregnancy, labour and birth; and the time after birth.

Beliefs, practices, and expectations of oral teachers of the deaf

This study investigated the beliefs and practices of 28 teachers of the deaf about their practices. The teachers were all working in oral settings either as visiting teachers or teachers in a mainstream school facility supporting groups of students with hearing loss. Teachers who used an Auditory Verbal approach largely adopted a positivist paradigm, whereas those using an Auditory Oral approach were more likely to adopt a constructivist paradigm. Those using a mixed approach (AV/AO) adopted a paradigm that was a mix of both positivist and constructivist. Results suggest that there is a strong relationship between the underlying beliefs of teachers and the model of practice that they adopt, and that professional experience, professional development and the inclusion movement exert an influence on those beliefs and practices.

Expectations and perceptions of overseas students in a Post-graduate corporate accounting subject : a research note

This study examines the expectations and perceptions of overseas students undertaking the post-graduate corporate accounting subject taught at an Australian university. An understanding
of students’ perceptions and expectations in learning of the subject is important in assisting
accounting academics to enhance their teaching programmes, and to manage the diverse student
cohorts which are now a feature of university classrooms in Australia. The findings show that
overseas students expected the post-graduate corporate accounting subject to be challenging and
interesting. Moreover, they expressed a strong desire that the subject should emphasise the
practicalities of accounting.

Balancing comfort expectations and greenhouse gas emissions, thermal comfort in office buildings in a changing climate

According to the Fourth Assessment Report of the Intergovernmental Panel on Climate Change (IPCC), the construction sector has the greatest potential for climate change mitigation. This work investigates the potential for climate change mitigation in naturally ventilated and mixed mode office buildings, by evaluating the range of influence of building design and occupants on greenhouse gas emissions as well as thermal and visual comfort.

Thermal comfort is evaluated according to the EN 15251 adaptive thermal comfort model, visual comfort is based on daylight autonomy and view. Parametric studies have been conducted based on building simulation for the climate of Athens, Greece. Input data are based on a literature review, and on results from a field study conducted among office occupants and architects in Athens.

The results show that the influence of occupants on greenhouse gas emissions is larger than the influence of building design. Energy saving office equipment, as well as active use of building controls for shading and lighting by occupants are crucial parameters regarding the reduction of CO2 emissions. In mixed mode buildings, the coefficient of performance of the cooling system is an important parameter as well. Regarding thermal and visual comfort, the influence of building design is predominant. A green building, well protected against heat from the sun and able to balance solar and internal heat gains, provides higher comfort levels and is less affected by the influence of occupants. In mixed mode buildings, building design is the predominant influence on the magnitude of cooling loads. A hot summer including heat waves can significantly reduce thermal comfort and increase the resulting greenhouse gas emissions. Green buildings are least affected by these influences.

The EN 15251 adaptive thermal comfort model provides a thermal comfort evaluation method valid throughout Europe. However, for the Mediterranean climate of Athens, Greece, most of the configurations investigated within this study do not meet the requirements according to this model. EN 15251 refers to an adaptive thermal comfort model for naturally ventilated and to a static model for mechanically ventilated buildings. For mixed mode buildings, the static model is recommended, but literature indicates that occupants in those buildings might be more tolerant towards higher temperatures. The hypothetical application of the EN 15251 adaptive thermal comfort model in mixed mode offices, as investigated in this study, shows potential for greenhouse gas emission savings. However, this influence is small compared to that of building design and occupants. Conclusions are drawn regarding the categorisation and exceeding criteria according to EN 15251 adaptive thermal comfort model for offices in a Mediterranean climate.

The results of this work show, that not only green buildings, but also green occupants can significantly contribute to the mitigation of the climate change. Mechanisms of the real estate market as well as the lifestyle of occupants are important influences in this context. Sustainability therefore refers to finding the right balance between occupant’s comfort expectations and resulting greenhouse gas emissions for a specific building, rather than optimisation of single parameters