End-of-life care in the intensive care unit : a systematic review of qualitative studies investigating the experiences and perceptions of the patient's family

Review question/objective The review objective is to synthesise the best available evidence on experiences and perceptions of family members of intensive care unit patients on the adequacy of end-of-life care, where life-support modalities have been withheld or withdrawn. Inclusion criteria Types of participants This review will consider studies that report on the experiences and perceptions of patients’ families on EOLC in the ICU, where life-support modalities have been withheld or withdrawn. The family is defined as “those who are closest to the patient... the family may include the biological family, family by acquisition, and the family of choice and friends”. Phenomena of interest The phenomena of interest for this review are the patients’ families experiences, perceptions or views on the adequacy of EOLC delivered in the ICU, where life-support modalities were withheld or withdrawn. These experiences may refer to the following views on domains of care considered important at the end-of-life in the ICU, which have been described already in the existing literature: timely, consistent, and compassionate communication, clinician availability, clinical decision making based on patients’ preferences, goals and values, physical care implemented to maintain patient comfort, holistic interdisciplinary care and bereavement care for families of patients who died.

Social media and tacit knowledge sharing : physicians' perspectives and experiences

Tacit knowledge sharing amongst physicians is known to have a significant impact on the quality of medical decisions. This thesis posits that social media can provide new opportunities for tacit knowledge sharing amongst physicians, and demonstrates this by presenting findings from a review of relevant literature and a qualitative survey conducted with physicians. Using thematic analysis, the study revealed five major themes and over twenty sub-themes as potential contributions of social media to tacit knowledge flow amongst physicians.

Teaching colour theory online : challenges, opportunities and experiences [Abstract]

Over the past decade, various paradigm shifts and challenges have rapidly changed learning and teaching in higher education including meeting student expectation for more engaging, more interactive learning experiences, the increased focus in the tertiary sector to deliver content online, and dealing with the complexities of fast-changing technologies. Rising to these challenges and responding to them is a complex and multi-faceted task. This paper discusses a case study undertaken applying a framework drawn from engineering education teaching and learning methods using the concept of academagogy, which is learner-centric, actively empowering students in building effective learning and engages facilitators in meaningful teaching and delivery methods.

Working with Behavioural and Emotional Problems in Young People

This chapter outlines specific issues relating to behavioural and emotional problems in Aboriginal and Torres Strait Islander young people. It describes the most common disorders and their consequences, and how young Aboriginal people are at higher risk for developing such problems than other young Australians. The chapter also discusses the importance of psychosocial, cultural and environmental issues that need to be recognised in assessing and treating Aboriginal young people with behavioural and emotional problems. Issues concerning the delivery of both universal and culturally responsive prevention and intervention programs to address social and emotional wellbeing and mental health are discussed and possible interventions to enhance student engagement at school are provided. Finally, a range of mental health services for Aboriginal families which offer a culturally responsive approach to mental health treatment are listed.

Rich evaluations of entertainment experience: bridging the interpretational gap

This paper reports a qualitative study of evaluating the ?experience? supported by a state-of-the-art interactive television application. Internet Protocol Television (IPTV) system is a new technology in the ever-growing industry of interactive entertainment. Focusing on the users? interpretations, we applied a set of rich evaluation strategies to collect data about users? experiences with the IPTV. The results show implications about how the users constructed complex and reflective understandings about the system. The evaluation suite helped us gather information about users? aspirations, expectations, and intellectual and emotional states of their understandings. The results also imply a strong support for taking into account the non-technical values of human-technology interaction.

Aspect-based model of user experience

Traditional HCI design and evaluation methods merely focus on functional and usability aspects of a product. Although these aspects are important, they do not guarantee product’s success, especially the consumer product. Many consumer products are now part of user’s everyday activities – that support fun, pleasure, entertainment, etc. Secondly, in today’s consumer market many of the products have become similar in terms of their technology, functionality, price and quality. In response, many companies have started designing products with added emotional and experiential values. This has challenged designer’s to explore and visualize directions in product design field that could evoke intended and desired experiences amongst its users. Subjective product qualities such as fun, pleasure, entertainment, etc. are not the part of a product, but they are better thought of as the outcome of user’s interaction with the product...

Understanding the information literacy experiences of EFL (English as a Foreign Language) students

This thesis investigated the information literacy experiences of EFL (English as a Foreign Language) students in a higher education institution in the United Arab Emirates (UAE). Phenomenography was used to investigate how EFL students' 'used information to learn' (ie. information literacy). The study revealed that EFL students' experienced information literacy across four categories and had varying experiences of information and learning. The research also showed that EFL students' faced a number of challenges and barriers due to language that impacted on their experiences of reading, understanding, accessing and translating information.

Self-regulation from birth to age seven : associations with maternal mental health, parenting, and social, emotional and behavioural outcomes for children

Self-regulation refers to our individual capacities to regulate our behaviours, emotions, and thoughts, with these skills developing rapidly across early childhood. This thesis examined sleep, emotional, and cognitive regulation development, and related parental influences, for children participating in the Longitudinal Study of Australian Children. Important longitudinal associations among children's self-regulation, maternal mental health, parenting, and later behaviour problems for children were also investigated. A unique contribution of this research was a prevalence estimate of early childhood self-regulation problems in Australian children that was documented for the first time.

The relevance of shared experiences : a multi-level study of collective efficacy as a moderator of job control in the stressor-strain relationship

Karasek's Job Demand-Control model proposes that control mitigates the positive effects of work stressors on employee strain. Evidence to date remains mixed and, although a number of individual-level moderators have been examined, the role of broader, contextual, group factors has been largely overlooked. In this study, the extent to which control buffered or exacerbated the effects of demands on strain at the individual level was hypothesized to be influenced by perceptions of collective efficacy at the group level. Data from 544 employees in Australian organizations, nested within 23 workgroups, revealed significant three-way cross-level interactions among demands, control and collective efficacy on anxiety and job satisfaction. When the group perceived high levels of collective efficacy, high control buffered the negative consequences of high demands on anxiety and satisfaction. Conversely, when the group perceived low levels of collective efficacy, high control exacerbated the negative consequences of high demands on anxiety, but not satisfaction. In addition, a stress-exacerbating effect for high demands on anxiety and satisfaction was found when there was a mismatch between collective efficacy and control (i.e. combined high collective efficacy and low control). These results provide support for the notion that the stressor-strain relationship is moderated by both individual- and group-level factors.

The ENHANCES study--Enhancing Head and Neck Cancer patients' Experiences of Survivorship: study protocol for a randomized controlled trial

Background Few cancers pose greater challenges than head and neck (H&N) cancer. Residual effects following treatment include body image changes, pain, fatigue and difficulties with appetite, swallowing and speech. Depression is a common comorbidity. There is limited evidence about ways to assist patients to achieve optimal adjustment after completion of treatment. In this study, we aim to examine the effectiveness and feasibility of a model of survivorship care to improve the quality of life of patients who have completed treatment for H&N cancer. Methods This is a preliminary study in which 120 patients will be recruited. A prospective randomised controlled trial of the H&N Cancer Survivor Self-management Care Plan (HNCP) involving pre- and post-intervention assessments will be used. Consecutive patients who have completed a defined treatment protocol for H&N cancer will be recruited from two large cancer services and randomly allocated to one of three study arms: (1) usual care, (2) information in the form of a written resource or (3) the HNCP delivered by an oncology nurse who has participated in manual-based training and skill development in patient self-management support. The trained nurses will meet patients in a face-to-face interview lasting up to 60 minutes to develop an individualised HNCP, based on principles of chronic disease self-management. Participants will be assessed at baseline, 3 and 6 months. The primary outcome measure is quality of life. The secondary outcome measures include mood, self-efficacy and health-care utilisation. The feasibility of implementing this intervention in routine clinical care will be assessed through semistructured interviews with participating nurses, managers and administrators. Interviews with patients who received the HNCP will explore their perceptions of the HNCP, including factors that assisted them in achieving behavioural change. Discussion In this study, we aim to improve the quality of life of a patient population with unique needs by means of a tailored self-management care plan developed upon completion of treatment. Delivery of the intervention by trained oncology nurses is likely to be acceptable to patients and, if successful, will be a model of care that can be implemented for diverse patient populations.

Predicting emotional exhaustion among haemodialysis nurses : a structural equation model using Kanter’s structural empowerment theory

Aim To test an explanatory model of the relationships between the nursing work environment, job satisfaction, job stress and emotional exhaustion for haemodialysis nurses, drawing on Kanter's theory of organizational empowerment. Background Understanding the organizational predictors of burnout (emotional exhaustion) in haemodialysis nurses is critical for staff retention and improving nurse and patient outcomes. Previous research has demonstrated high levels of emotional exhaustion among haemodialysis nurses, yet the relationships between nurses' work environment, job satisfaction, stress and emotional exhaustion in this population are poorly understood. Design A cross-sectional online survey. Methods 417 nurses working in haemodialysis units completed an online survey between October 2011–April 2012 using validated measures of the work environment, job satisfaction, job stress and emotional exhaustion. Results Overall, the structural equation model demonstrated adequate fit and we found partial support for the hypothesized relationships. Nurses' work environment had a direct positive effect on job satisfaction, explaining 88% of the variance. Greater job satisfaction, in turn, predicted lower job stress, explaining 82% of the variance. Job satisfaction also had an indirect effect on emotional exhaustion by mitigating job stress. However, job satisfaction did not have a direct effect on emotional exhaustion. Conclusion The work environment of haemodialysis nurses is pivotal to the development of job satisfaction. Nurses' job satisfaction also predicts their level of job stress and emotional exhaustion. Our findings suggest staff retention can be improved by creating empowering work environments that promote job satisfaction among haemodialysis nurses.

A design approach to the study of people's experiences with technologies in the context of public transport

Relevant to the study of people’s attitudes towards public transport use is the consideration to the role of technology as part of the travel experience. Technologies aim to enhance daily tasks but tend to change the way people interact with products and can be perceived as difficult to use. This is critical in the context of “public use” where products and services are to be used by the population at large: adults, children, elderly, people with disabilities, and tourists. From different perspectives, the topic of users and the use of technologies have been studied in the social sciences and human computer interaction fields; however, earlier approaches fail to address the ways in which experiential knowledge informs people’s interactions with products and technologies, and how such information could guide the design of future technologies. This paper describes a pilot study, part of a larger ongoing exploratory research that investigates people’s experiences with infrastructure, systems, and technologies in the context of public transport. The methodological approach included focus groups, field observations, and retrospective verbal reports. At this stage, the study found that four context led factors were the primary source of reference informing participants’ actions and interactions; they are: (i) context >> experience, (ii) context >> interface, (iii) context >> knowledge, (iv) context >> emotion.

The experiences of teachers teaching children with Down syndrome in the early years of schooling

This innovative collective case study research documented teachers' experiences of teaching children with Down syndrome in the early years of schooling in Australia. Results indicated differences in teachers' conceptualisation of children with Down syndrome as learners and how these variations impacted the way the child was included within the class. Unique to this research was the utilisation of a mind-mapping technique of data collection which effectively captured the individual nature of teachers' experiences, making implicit knowledge explicit through description and interpretation of these experiences. Overall findings indicated that teachers were more likely to include children with Down syndrome into general education classrooms if they operated within a contemporary understanding of disability, had positive support from key stakeholders such as school principals and parents/caregivers, and had access to current information on Down syndrome from professional bodies.

A study of the emotional climate of a science education class for pre-service teachers in Bhutan

This thesis studied the emotional climate (EC) of a pre-service science teachers' class in Bhutan. It examined the types of activities students engaged in and the relationship between the tutor and students whose interactions produced both positive and negative EC in the class. The major finding was that the activities involving students' presentations using video clips and models, group activity, and coteaching valenced the class EC positively. Negative EC was identified when the tutor ignored students' responses, during formal lectures, and when the tutor was uncertain of the subject knowledge. The replication of activities that produce positive EC by other Bhutanese tutors may improve the standard of science education in the country.