Understanding the role of knowledge in the practice of expert nephrology nurses in Australia

This paper, which is abstracted from a larger study into the acquisition and exercise of nephrology nursing expertise, aims to explore the role of knowledge in expert practice. Using grounded theory methodology, the study involved 17 registered nurses who were practicing in a metropolitan renal unit in New South Wales, Australia. Concurrent data collection and analysis was undertaken, incorporating participants' observations and interviews. Having extensive nephrology nursing knowledge was a striking characteristic of a nursing expert. Expert nurses clearly relied on and utilized extensive nephrology nursing knowledge to practice. Of importance for nursing, the results of this study indicate that domain-specific knowledge is a crucial feature of expert practice.

Evaluating parent-child group music therapy programmes: challenges and successes for Sing & Grow

Sing & Grow is an early intervention music therapy programme for families with children from birth to 3 years of age, who are socially, economically, or physically disadvantaged. It aims to improve parenting skills and confidence, promote positive parent–child interactions, stimulate child development, and provide social networking opportunities. Music and song activities are used in a therapeutic context to enhance parenting skills, improve parent–child interactions, provide essential developmental stimulation for children, promote social support for parenting, and strengthen links between parents and community services.

Validating the is-impact model in the Malaysian public sector

This research is one of several ongoing studies conducted within the IT Professional Services (ITPS) research programme at Queensland University of Technology (QUT). In 2003, ITPS introduced the IS-Impact model, a measurement model for measuring information systems success from the viewpoint of multiple stakeholders. The model, along with its instrument, is robust, simple, yet generalisable, and yields results that are comparable across time, stakeholders, different systems and system contexts. The IS-Impact model is defined as “a measure at a point in time, of the stream of net benefits from the Information System (IS), to date and anticipated, as perceived by all key-user-groups”. The model represents four dimensions, which are ‘Individual Impact’, ‘Organizational Impact’, ‘Information Quality’ and ‘System Quality’. The two Impact dimensions measure the up-to-date impact of the evaluated system, while the remaining two Quality dimensions act as proxies for probable future impacts (Gable, Sedera & Chan, 2008). To fulfil the goal of ITPS, “to develop the most widely employed model” this research re-validates and extends the IS-Impact model in a new context. This method/context-extension research aims to test the generalisability of the model by addressing known limitations of the model. One of the limitations of the model relates to the extent of external validity of the model. In order to gain wide acceptance, a model should be consistent and work well in different contexts. The IS-Impact model, however, was only validated in the Australian context, and packaged software was chosen as the IS understudy. Thus, this study is concerned with whether the model can be applied in another different context. Aiming for a robust and standardised measurement model that can be used across different contexts, this research re-validates and extends the IS-Impact model and its instrument to public sector organisations in Malaysia. The overarching research question (managerial question) of this research is “How can public sector organisations in Malaysia measure the impact of information systems systematically and effectively?” With two main objectives, the managerial question is broken down into two specific research questions. The first research question addresses the applicability (relevance) of the dimensions and measures of the IS-Impact model in the Malaysian context. Moreover, this research question addresses the completeness of the model in the new context. Initially, this research assumes that the dimensions and measures of the IS-Impact model are sufficient for the new context. However, some IS researchers suggest that the selection of measures needs to be done purposely for different contextual settings (DeLone & McLean, 1992, Rai, Lang & Welker, 2002). Thus, the first research question is as follows, “Is the IS-Impact model complete for measuring the impact of IS in Malaysian public sector organisations?” [RQ1]. The IS-Impact model is a multidimensional model that consists of four dimensions or constructs. Each dimension is represented by formative measures or indicators. Formative measures are known as composite variables because these measures make up or form the construct, or, in this case, the dimension in the IS-Impact model. These formative measures define different aspects of the dimension, thus, a measurement model of this kind needs to be tested not just on the structural relationship between the constructs but also the validity of each measure. In a previous study, the IS-Impact model was validated using formative validation techniques, as proposed in the literature (i.e., Diamantopoulos and Winklhofer, 2001, Diamantopoulos and Siguaw, 2006, Petter, Straub and Rai, 2007). However, there is potential for improving the validation testing of the model by adding more criterion or dependent variables. This includes identifying a consequence of the IS-Impact construct for the purpose of validation. Moreover, a different approach is employed in this research, whereby the validity of the model is tested using the Partial Least Squares (PLS) method, a component-based structural equation modelling (SEM) technique. Thus, the second research question addresses the construct validation of the IS-Impact model; “Is the IS-Impact model valid as a multidimensional formative construct?” [RQ2]. This study employs two rounds of surveys, each having a different and specific aim. The first is qualitative and exploratory, aiming to investigate the applicability and sufficiency of the IS-Impact dimensions and measures in the new context. This survey was conducted in a state government in Malaysia. A total of 77 valid responses were received, yielding 278 impact statements. The results from the qualitative analysis demonstrate the applicability of most of the IS-Impact measures. The analysis also shows a significant new measure having emerged from the context. This new measure was added as one of the System Quality measures. The second survey is a quantitative survey that aims to operationalise the measures identified from the qualitative analysis and rigorously validate the model. This survey was conducted in four state governments (including the state government that was involved in the first survey). A total of 254 valid responses were used in the data analysis. Data was analysed using structural equation modelling techniques, following the guidelines for formative construct validation, to test the validity and reliability of the constructs in the model. This study is the first research that extends the complete IS-Impact model in a new context that is different in terms of nationality, language and the type of information system (IS). The main contribution of this research is to present a comprehensive, up-to-date IS-Impact model, which has been validated in the new context. The study has accomplished its purpose of testing the generalisability of the IS-Impact model and continuing the IS evaluation research by extending it in the Malaysian context. A further contribution is a validated Malaysian language IS-Impact measurement instrument. It is hoped that the validated Malaysian IS-Impact instrument will encourage related IS research in Malaysia, and that the demonstrated model validity and generalisability will encourage a cumulative tradition of research previously not possible. The study entailed several methodological improvements on prior work, including: (1) new criterion measures for the overall IS-Impact construct employed in ‘identification through measurement relations’; (2) a stronger, multi-item ‘Satisfaction’ construct, employed in ‘identification through structural relations’; (3) an alternative version of the main survey instrument in which items are randomized (rather than blocked) for comparison with the main survey data, in attention to possible common method variance (no significant differences between these two survey instruments were observed); (4) demonstrates a validation process of formative indexes of a multidimensional, second-order construct (existing examples mostly involved unidimensional constructs); (5) testing the presence of suppressor effects that influence the significance of some measures and dimensions in the model; and (6) demonstrates the effect of an imbalanced number of measures within a construct to the contribution power of each dimension in a multidimensional model.

Development and review of vignettes representing older people with cognitive impairment

This paper describes a process undertaken to develop and review five clinical vignettes to be used in geriatric nursing educational research. The purpose of this process was to provide valid depictions of delirium and its subtypes and distinguish delirium from dementia. Five vignettes depicting hospital bedside interactions between nursing staff, family, and an older patient who displayed signs of one of the following conditions: delirium (hyper and hypo-active types respectively), dementia, or delirium (both types) superimposed on dementia were constructed. Vignette accuracy and reliability was established using a multistage process that culminated in formal review by a group of ten international nursing and medical delirium experts. The final five vignettes accurately depicted the given scenario as agreed by the experts and were at an appropriate level of simplicity and clarity. Given the increased interest in vignettes for both nursing research and educational purposes, the described method of vignette development and review has the ability to assist other vignette developers in creating reliable representations of their desired clinical scenarios.

Peer-led diabetes self-management programme for community-dwelling older people in China : study protocol for a quasi-experimental design

Aim. A protocol for a new peer-led self-management programme for communitydwelling older people with diabetes in Shanghai, China. Background. The increasing prevalence of type 2 diabetes poses major public health challenges. Appropriate education programmes could help people with diabetes to achieve self-management and better health outcomes. Providing education programmes to the fast growing number of people with diabetes present a real challenge to Chinese healthcare system, which is strained for personnel and funding shortages. Empirical literature and expert opinions suggest that peer education programmes are promising. Design. Quasi-experimental. Methods. This study is a non-equivalent control group design (protocol approved in January, 2008). A total of 190 people, with 95 participants in each group, will be recruited from two different, but similar, communities. The programme, based on Social Cognitive Theory, will consist of basic diabetes instruction and social support and self-efficacy enhancing group activities. Basic diabetes instruction sessions will be delivered by health professionals, whereas social support and self-efficacy enhancing group activities will be led by peer leaders. Outcome variables include: self-efficacy, social support, self-management behaviours, depressive status, quality of life and healthcare utilization, which will be measured at baseline, 4 and 12 weeks. Discussion. This theory-based programme tailored to Chinese patients has potential for improving diabetes self-management and subsequent health outcomes. In addition, the delivery mode, through involvement of peer leaders and existing community networks,is especially promising considering healthcare resource shortage in China.

Extending and validating the is-impact model in Saudi Arabia : accounting for computer network quality

Organizations from every industry sector seek to enhance their business performance and competitiveness through the deployment of contemporary information systems (IS), such as Enterprise Systems (ERP). Investments in ERP are complex and costly, attracting scrutiny and pressure to justify their cost. Thus, IS researchers highlight the need for systematic evaluation of information system success, or impact, which has resulted in the introduction of varied models for evaluating information systems. One of these systematic measurement approaches is the IS-Impact Model introduced by a team of researchers at Queensland University of technology (QUT) (Gable, Sedera, & Chan, 2008). The IS-Impact Model is conceptualized as a formative, multidimensional index that consists of four dimensions. Gable et al. (2008) define IS-Impact as "a measure at a point in time, of the stream of net benefits from the IS, to date and anticipated, as perceived by all key-user-groups" (p.381). The IT Evaluation Research Program (ITE-Program) at QUT has grown the IS-Impact Research Track with the central goal of conducting further studies to enhance and extend the IS-Impact Model. The overall goal of the IS-Impact research track at QUT is "to develop the most widely employed model for benchmarking information systems in organizations for the joint benefit of both research and practice" (Gable, 2009). In order to achieve that, the IS-Impact research track advocates programmatic research having the principles of tenacity, holism, and generalizability through extension research strategies. This study was conducted within the IS-Impact Research Track, to further generalize the IS-Impact Model by extending it to the Saudi Arabian context. According to Hofsted (2012), the national culture of Saudi Arabia is significantly different from the Australian national culture making the Saudi Arabian culture an interesting context for testing the external validity of the IS-Impact Model. The study re-visits the IS-Impact Model from the ground up. Rather than assume the existing instrument is valid in the new context, or simply assess its validity through quantitative data collection, the study takes a qualitative, inductive approach to re-assessing the necessity and completeness of existing dimensions and measures. This is done in two phases: Exploratory Phase and Confirmatory Phase. The exploratory phase addresses the first research question of the study "Is the IS-Impact Model complete and able to capture the impact of information systems in Saudi Arabian Organization?". The content analysis, used to analyze the Identification Survey data, indicated that 2 of the 37 measures of the IS-Impact Model are not applicable for the Saudi Arabian Context. Moreover, no new measures or dimensions were identified, evidencing the completeness and content validity of the IS-Impact Model. In addition, the Identification Survey data suggested several concepts related to IS-Impact, the most prominent of which was "Computer Network Quality" (CNQ). The literature supported the existence of a theoretical link between IS-Impact and CNQ (CNQ is viewed as an antecedent of IS-Impact). With the primary goal of validating the IS-Impact model within its extended nomological network, CNQ was introduced to the research model. The Confirmatory Phase addresses the second research question of the study "Is the Extended IS-Impact Model Valid as a Hierarchical Multidimensional Formative Measurement Model?". The objective of the Confirmatory Phase was to test the validity of IS-Impact Model and CNQ Model. To achieve that, IS-Impact, CNQ, and IS-Satisfaction were operationalized in a survey instrument, and then the research model was assessed by employing the Partial Least Squares (PLS) approach. The CNQ model was validated as a formative model. Similarly, the IS-Impact Model was validated as a hierarchical multidimensional formative construct. However, the analysis indicated that one of the IS-Impact Model indicators was insignificant and can be removed from the model. Thus, the resulting Extended IS-Impact Model consists of 4 dimensions and 34 measures. Finally, the structural model was also assessed against two aspects: explanatory and predictive power. The analysis revealed that the path coefficient between CNQ and IS-Impact is significant with t-value= (4.826) and relatively strong with â = (0.426) with CNQ explaining 18% of the variance in IS-Impact. These results supported the hypothesis that CNQ is antecedent of IS-Impact. The study demonstrates that the quality of Computer Network affects the quality of the Enterprise System (ERP) and consequently the impacts of the system. Therefore, practitioners should pay attention to the Computer Network quality. Similarly, the path coefficient between IS-Impact and IS-Satisfaction was significant t-value = (17.79) and strong â = (0.744), with IS-Impact alone explaining 55% of the variance in Satisfaction, consistent with results of the original IS-Impact study (Gable et al., 2008). The research contributions include: (a) supporting the completeness and validity of IS-Impact Model as a Hierarchical Multi-dimensional Formative Measurement Model in the Saudi Arabian context, (b) operationalizing Computer Network Quality as conceptualized in the ITU-T Recommendation E.800 (ITU-T, 1993), (c) validating CNQ as a formative measurement model and as an antecedent of IS Impact, and (d) conceptualizing and validating IS-Satisfaction as a reflective measurement model and as an immediate consequence of IS Impact. The CNQ model provides a framework to perceptually measure Computer Network Quality from multiple perspectives. The CNQ model features an easy-to-understand, easy-to-use, and economical survey instrument.

Using images to communicate the hidden struggles of life on dialysis

Background: Nurse-patient communication in the hemodialysis context is unique given the amount of time spent together in a confined clinical room. Poor communication may lead to low quality nursing care and undesirable patient outcomes. Aim: To explore the use of images as a visual communication technique for nurses and patients in the hemodialysis context. Methods: Descriptive qualitative design. Fifty two cards containing specific photos, illustrations and words were used in conversations between patients (n = 9) and one of two nurse interviewers about being on hemodialysis. Interview transcripts were thematically analysed. Findings: An overall theme titled ‘revealing the hidden struggles of living on dialysis’ conceptually captured three sub-themes: (1) the increased importance of relationships; (2) the struggle with money; and (3) quality over quantity of life. The cards assisted in uncovering these often covert (to nurses) aspects of dialysis patients’ lives. Conclusion: Nurses may need to be aware of the dialysis patients’ hidden struggles which include the importance of relationships, financial issues and the importance of quality aspects such as travel. The use of images may assist in revealing the important issues for each patient struggling with the restrictive life that is imposed by dialysis.

Building research capacity in the nursing workforce : the design and evaluation of the nurse researcher role

Objectives: The Nurse Researcher Project (NRP) was initiated to support development of a nursing research and evidence based practice culture in Cancer Care Services (CCS) in a large tertiary hospital in Australia. The position was established and evaluated to inform future directions in the organisation.---------- Background: The demand for quality cancer care has been expanding over the past decades. Nurses are well placed to make an impact on improving health outcomes of people affected by cancer. At the same time, there is a robust body of literature documenting the barriers to undertaking and utilising research by and for nurses and nursing. A number of strategies have been implemented to address these barriers including a range of staff researcher positions but there is scant attention to evaluating the outcomes of these strategies. The role of nurse researcher has been documented in the literature with the aim to provide support to nurses in the clinical setting. There is, to date, little information in relation to the design, implementation and evaluation of this role.---------- Design: The Donabedian’s model of program evaluation was used to implement and evaluate this initiative.---------- Methods: The ‘NRP’ outlined the steps needed to implement the nurse researcher role in a clinical setting. The steps involved the design of the role, planning for the support system for the role, and evaluation of outcomes of the role over two years.---------- Discussion: This paper proposes an innovative and feasible model to support clinical nursing research which would be relevant to a range of service areas.---------- Conclusion: Nurse researchers are able to play a crucial role in advancing nursing knowledge and facilitating evidence based practice, especially when placed to support a specialised team of nurses at a service level. This role can be implemented through appropriate planning of the position, building a support system and incorporating an evaluation plan.

Teaching undergraduate students community nursing : using action research to increase engagement and learning

Nurses play a pivotal role in responding to the changing needs of community health care. Therefore, nursing education must be relevant, responsive, and evidence based. We report a case study of curriculum development in a community nursing unit embedded within an undergraduate nursing degree. We used action research to develop, deliver, evaluate, and redesign the curriculum. Feedback was obtained through self-reflection, expert opinion from community stakeholders, formal student evaluation, and critical review. Changes made, especially in curriculum delivery, led to improved learner focus and more clearly linked theory and practice. The redesigned unit improved performance, measured with the university's student evaluation of feedback instrument (increased from 0.3 to 0.5 points below to 0.1 to 0.5 points above faculty mean in all domains), and was well received by teaching staff. The process confirmed that improved pedagogy can increase student engagement with content and perception of a unit as relevant to future practice.

Initial psychometric evaluation of the Wayfinding Effectiveness Scale

This study evaluates three versions of the Wayfinding Effectiveness Scale (WES), developed to differentiate problems of wayfinding and wandering behavior of community-residing elders with dementia (EWD), in 266 dyads (EWD and caregiver) recruited from Alzheimer's Association chapters. Factor analyses yield a five-factor solution (explained variance = 62.6%): complex wayfinding goals, analytic strategies, global strategies, simple wayfinding goals, and being stimulus bound. Overall, internal consistencies are high: WES (.94-.95), and subscales are stable across all versions. Testretest reliability is acceptable for the overall WES and two subscales (complex and simple wayfinding goals) for the care recipient current behavior version. Construct validity is supported by the pattern of correlations among subscales and analyses of variance (ANOVAs) showing significant differences among the care recipient (current vs. prior behavior) and caregiver versions overall and for all subscales. Results support the WES as a valid and reliable measure of wayfinding effectiveness in persons with dementia.

Implementation and evaluation of a new model of nursing practice in radiation oncology

Patients undergoing radiation therapy for cancer face a series of challenges that require support from a multidisciplinary team which includes radiation oncology nurses. However, the specific contribution of nursing, and the models of care that best support the delivery of nursing interventions in the radiotherapy setting, is not well described. In this case study, the Interaction Model of Client Health Behaviour and the associated principles of person-centred care were incorporated into a new model of care that was implemented in one radiation oncology setting in Brisbane, Australia. The new model of care was operationalised through a Primary Nursing/Collaborative Practice framework. To evaluate the impact of the new model for patients and health professionals, multiple sources of data were collected from patients and clinical staff prior to, during, and 18 months following introduction of the practice redesign. One cohort of patients and clinical staff completed surveys incorporating measures of key outcomes immediately prior to implementation of the model, while a second cohort of patients and clinical staff completed these same surveys 18 months following introduction of the model. In-depth interviews were also conducted with nursing, medical and allied health staff throughout the implementation phase to obtain a more comprehensive account of the processes and outcomes associated with implementing such a model. From the patients’ perspectives, this study demonstrated that, although adverse effects of radiotherapy continue to affect patient well-being, patients continue to be satisfied with nursing care in this specialty, and that they generally reported high levels of functioning despite undergoing a curative course of radiotherapy. From the health professionals’ perspective, there was evidence of attitudinal change by nursing staff within the radiotherapy department which reflected a greater understanding and appreciation of a more person-centred approach to care. Importantly, this case study has also confirmed that a range of factors need to be considered when redesigning nursing practice in the radiotherapy setting, as the challenges associated with changing traditional practices, ensuring multidisciplinary approaches to care, and resourcing a new model were experienced. The findings from this study suggest that the move from a relatively functional approach to a person-centred approach in the radiotherapy setting has contributed to some improvements in the provision of individualised and coordinated patient care. However, this study has also highlighted that primary nursing may be limited in its approach as a framework for patient care unless it is supported by a whole team approach, an appropriate supportive governance model, and sufficient resourcing. Introducing such a model thus requires effective education, preparation and ongoing support for the whole team. The challenges of providing care in the context of complex interdisciplinary relationships have been highlighted by this study. Aspects of this study may assist in planning further nursing interventions for patients undergoing radiotherapy for cancer, and continue to enhance the contribution of the radiation oncology nurse to improved patient outcomes.

A discussion of the research performance evaluation in building and construction management discipline : the journal impact factors and SCI-index journals

The trend of diminished funding, demands for greater efficiency and higher public accountability have led to a rapid expansion of interest in the bibliometric assessment of research performance of universities. A pilot research is conducted to provide a preliminary overview of the research performance of the building and construction schools or departments through the analysis of bibliometric indicators including the journal impact factor (JIF) published by Institute for Scientific Information (ISI). The suitability of bibliometric evaluation approaches as a measure of research quality in building and construction management research field is discussed.