The moral imperative of designating patient safety and quality care as a national nursing research priority

Since the early 1990s, research studies conducted respectively in the USA, UK and Australia have found that between 4 and 16.6 per cent of patients suffer from some kind of harm (including permanent disability and death) as a result of human errors and adverse events while in hospital. It has been further estimated that approximately 50 per cent of these human errors/adverse events resulting in harm could have been prevented. In response to the significant financial, social, and political implications of these figures, a range of processes have been put in place in an attempt to improve patient safety and quality care in Australia. Nonetheless, it is evident that more can be done to improve the status quo. One process that warrants consideration is that of peak health professional groups and organisations providing active leadership in the promotion of patient safety, such as by making a visible and recognisable commitment to patient safety as a strategic research priority area. In this paper it is contended that, given the moral importance of patient safety and quality care in nursing and related health care domains, the inseparable link between nursing practice and patient safety, and the central role that research has to play in driving safety improvements in these domains, it is morally imperative that the nursing profession gives sustained and focussed public attention to patient safety and quality care as a national research priority.

Metaphysics of love as moral responsibility in nursing and midwifery

This study used a qualitative research design incorporating principles of social constructionism, hermeneutic dialectic method, Neo-Socratic dialogue and philosophy for reporting the tacit and social knowledge constructions underlying particular ways of knowing that inform the experiential reality of love in the practice of nursing and midwifery. The philosophy of Emmanuel Levinas, that culminated in his magnum opus of the ‘metaphysics of otherness’, provided the theoretical underpinning for the interpretation of the experiences nurses and midwives believed were examples of love in their clinical practice in Australia, Singapore and Bhutan. What is love in nursing and midwifery? The answer is moral responsibility. The relational context has a nurse and midwife constantly exposed to patient situations that give rise to expressions of love as moral responsibility. It is a form of love that centres on the ability of our being, or at least the possibility of our being, to transcend its everyday form to a metaphysical state of being moral. It enables a nurse and midwife to transcend the isolation associated with their personal being as a self-project, to be ‘for’ the patient as a first priority. But while the ‘Goodness’ of the ‘Good’ assigns the nurse and midwife responsible and is expressed to their personal being in the form of the ‘urge to do’, ‘what to do’ in caring for the patient is a matter of living out the command to be responsible and will be different for each nurse and midwife. However, no matter the outcome, love as moral responsibility will always leave a nurse and midwife feeling there is still more to be done in being responsible.

Factors affecting the engagement of experienced teachers in schools

With the changing age profile of teachers in Australian schools, considerable numbers of experienced teachers need to feature as educational leaders, before their workplace knowledge and expertise will be lost to schools with retirement. Stereotypes of veteran teachers depict individuals, wearied by decades of work experiences, entering professional decline when educational systems need these experienced practitioners to remain connected, communicative and motivated in their work. This thesis explores the careers and contemporary professional lives of experienced practitioners — predominantly classroom teachers — currently working in a school with a long standing commitment to student-centred education. The research identified the factors that influenced their career pathways and affected their engagement with their work. Critical incidents in the teachers’ careers and professional lives are discussed in relation to the theories of motivation and the nature of Professional Learning Communities. The study showed that necessary factors for engagement were: mutual alignment with a well-articulated and practised ethos; supportive leadership; experiencing professional influence; opportunities for learning; and variety in work. Disillusion resulted if school actions were contrary to the espoused ethos. Severely negative experiences of performance management were survived by withdrawing, and enduring management tenures but these remain very poignant memories. The teachers had few career regrets yet reflection revealed the arbitrary nature of their career progression. The research identified a need to recognise the global and societal factors influencing the nature of teachers’ work. It is argued that schools and systems need to have a greater alignment between these external forces and their internal goals whilst recapturing the moral purpose of education. Furthermore, it is asserted that educational systems need to provide better human resource management for the teaching workforce through emphasising life-balance and well-being. Additionally, professional appraisal and staff management would benefit from strong recognition and deployment of the workplace knowledge and expertise of experienced teachers. A serendipitous outcome of the research was the benefit participants gained from reflecting on their careers which proved extremely affirming, and contributed to enhanced professional identities and changed career plans.

Towards an integration of theories of achievement motivation

This thesis investigated children's school achievement in terms of an integration of three theories of achievement motivation. The three theoretical outlooks were expectancy-value theory (EVT), implicit theories of intelligence (ITI), and flow theory (FT). The first of two studies was an exploratory investigation of the effectiveness of each theory independently and combined to predict children's achievement in four school subjects. The subject areas were maths, reading, instrumental music and sport. Participants were 84 children (40 females and 44 males) aged 9 to 10 years, one of each child's parents, and school teachers of each child in the four subject areas. All data were collected through questionnaires based on the three models. The results indicated that EVT and FT but not ITI accounted for a significant amount of the variance in children's achievement, including effects for subject area and gender. A second confirmatory study tested EVT, FT and an integrated model for the prediction of achievement in maths, reading and instrumental music. The participants were a further 141 children (74 females and 67 males) aged 10 to 11 years, and a parent and teachers of each child. Data collection using questionnaires occurred early in the school year (Timel) and approximately five months later (Time2). For EVT, children and parents’ competence beliefs were significant predictors of children's achievement in each subject area. Females tended to believe themselves more competent at reading and instrumental music and also valued these subjects more highly than boys. Modeling results for flow theory indicated that children's emotional responses to classes (happiness and confusion) were significant predictors of achievement, the type of emotion varying between subject areas and time periods. Females generally had a more positive emotional reaction to reading and instrumental music classes than males did. The integrated model results indicated significant relationships between EVT and flow theories for each subject area, with EVT explaining most achievement variance in the integrated model. Children's and parents’ competence beliefs were the main predictors of achievement at Timel and 2, Subject area and gender differences were found which provide direction for future research. Anecdotal reports of parents and teachers often attest to individual differences in children's involvement in various school domains. Even among children of apparently similar intelligence, it is not uncommon to find one who likes nothing better than to work on a mathematics problem while another much prefers to read a novel or play a musical instrument Some children appear to achieve good results for most of the activities in which they are engaged while others achieve in a less consistent manner, sometimes particularly excelling in one activity. Some children respond to failure experiences with a determination to improve their performance in the future while others react with resignation and acceptance of their low ability. Some children appear to become totally absorbed in the activity of playing sport while others cannot wait for the game to end. The primary research objective guiding the current thesis is how children's thoughts and feelings about school subjects differ and are related to their school achievement. A perusal of the achievement motivation literature indicates several possible models and concepts that can be applied to explain individual differences in children's school achievement. Concepts such as academic self-concept, multiple intelligences, intrinsic and extrinsic motivation, self-beliefs, competence beliefs, subjective task values, mastery and performance goals, ‘Flow’ experiences and social motivation are just some of the constructs used to explain children's achievement motivation, both within and between various activity domains. These constructs are proposed by researchers from different theoretical perspectives to achievement motivation. Although there is much literature relevant to each perspective, there is little research indicating how the various perspectives may relate to each other. The current thesis will begin by reviewing three currently popular theoretical orientations cited in achievement motivation research: subjective beliefs and values; implicit theories of intelligence, and flow experience and family complexity. Following this review, a framework will be proposed for testing the determinants of children's school achievement, both within each of the three theoretical perspectives and also in combination.

On strangers, ‘moral panics’ and the neo-liberalization of teacher education

This paper explores the convergence of neo-liberal managerialism with the neo-conservative technologies of creating ‘moral panics’ about teacher education, English language and literacy curriculum and traditional values that allegedly fail to address the issues of public safety and cultural integration in the post- September 11th world. It problematises the neo-conservative vision of managing ‘strangers’ and public risks through dominant cultural literacy. The paper counters the neo-conservative backlash with a framework that emphasizes dialogical ethics in teaching for difference and conceptualizes transcultural literacy as an alternative model of education in multicultural conditions. This model is presented both as a way of resisting the subliminal infiltration of neo-conservative thinking in teacher education today and as a way of imagining a ‘cosmopolitan’ professional.

The moral reasoning abilities of Australian and Malaysian accounting students : a comparative analysis

If national culture is a significant determinant of ethical attitudes, it is not unreasonable to expect ethical decision-making to be influenced by one's culture. However, problems arise when the notion of right differs from one culture to another. The question addressed in this paper is whether the moral reasoning abilities of Australian and Malaysian accounting students in their final year of study differ because of their cultural upbringing. This study uses primary data collected from 34 final year accounting students (12 Australian and 22 Malaysian) enrolled in an Australian degree program. The test scores collected at the beginning and end of the academic year indicate that culture and other explanatory variables do not have an affect on students' moral judgment. The findings in this study suggest that culture as an independent variable does not influence the way accounting students analyse and resolve ethical dilemmas.

Media reports of heroin overdose spates: public health messages, moral panics or risk advertisements?

This article reports on an investigation of the public health utility of media messages concerning spates (temporal clusters) of heroin-related overdose (HOD) from the perspective of some injecting drug users (IDUs). In-depth qualitative interviews were carried out with a convenience sample of 60 IDUs, in the setting of two Needle and Syringe Programs in an Australian regional city (Geelong) between April and May 2000. Very few interviewees reported that they had personally experienced a spate of overdoses. None of the interviewees reported communicating the existence of a killer batch to other IDUs. No interviewees reported having changed either their injecting practices or the amount of heroin they used following such a media alert. Indeed, a substantial minority of the interviewees reported seeking out these stronger batches and participant narratives illustrate that, for a substantial group of interviewees, the media reporting of a hypothetical 'killer batch' of heroin may have implications for their drug-seeking and health-related behaviour. It was found that the accuracy of information available to IDUs is mixed and that the flow of information within this social network was slow. Findings demonstrate that media reporting of killer batches of heroin has little value as a public health strategy and provide an example of how some activities that are proposed as public health measures may in fact have the opposite effect.

Motivation and coercion among mandated and voluntary drug treatment clients

Voluntary and mandated drug treatment clients were interviewed to investigate the role that motivation and perceived coercion had on their outcomes. The major findings were first, there were few differences between these two groups, and second, motivation was an important predictor of treatment outcome.

Harmony in and between aesthetic experience and moral experience

The thesis finds that the notion of harmony has been integral to the concepts of beauty and goodness from the earliest times, in Eastern and Western philosophy. It also argues that the experience of beauty and the experience of goodness are related through the human propensity to avoid disorder.

Investigation of motivation for behavior change among pedophilic sex offenders

This investigation found that certain cognitive, emotive and behavioral factors were related to motivation for behavior change among men incarcerated for sexual offences against children. Overall, the results have important implications for understanding motivation for change among these offenders, their assessment and treatment, and so the prevention of re-offending.

Moral rights, heritage and Australian contemporary architecture : thoughts & designs of Peter Muller

Peter Muller is one of the most unique Australian architects of the 20th century possessing a passion for organic architecture realised in several significant Australian and Indonesian design exemplars. His inquiry in the organic style of architecture stylistically mirrors that of Frank Lloyd Wright whom wrote to Muller expressing his pleasure in his successful pursuit of this style in Australia.3 This paper considers the position of moral rights under the Australian Copyright Act 19684 having regard to the Australian exemplars of Muller. It considers recent Australian debates about moral rights and projects that implicate several architectural and landscape architecture projects, the interpretations the legal fraternity are taking in approaching this topic, and positions the ideas, values, and attitudes of Muller in this context. Muller’s personal opinion is expressed providing an insight into the thoughts of one senior contemporary Australia architect as to 'their' architecture and ‘heritage’.