Healthcare Staff Experience of Providing End-of-Life Care to Children: A Mixed Method Review

Background: Staff who provide end-of-life care to children not only have to deal with their own sense of loss, but also that of bereaved families. There is a dearth of knowledge on how they cope with these challenges.
Aim: The aim of this review is to explore the experiences of health care professionals who provide end-of-life care to children in order to inform the development of interventions to support them, thereby improving the quality of paediatric care for both children and their families.
Data sources: Searches included CINAHL, MEDLINE, Web of Science, EMBASE, PsychINFO, and The Cochrane Library in June 2015, with no date restrictions. Additional literature was uncovered from searching reference lists of relevant studies, along with contacting experts in the field of paediatric palliative care.
Design: This was a systematic mixed studies review. Study selection, appraisal and data extraction were conducted by two independent researchers. Integrative thematic analysis was used to synthesise the data.
Results: The 16 qualitative, six quantitative, and eight mixed-method studies identified included healthcare professionals in a range of settings. Key themes identified rewards and challenges of providing end-of-life care to children, the impact on staff’s personal and professional lives, coping strategies, and key approaches to help support staff in their role.
Conclusions: Education focusing on the unique challenges of providing end-of-life care to children and the importance of self-care, along with timely multidisciplinary debriefing are key strategies for improving healthcare staffs’ experiences, and as such the quality of care they provide.

A construção da identidade em ambientes digitais: estudo de caso sobre a construção da identidade online no Sapo Campus e em ambientes informais

O reconhecimento da dimensão criativa, participativa e social da rede trouxe profundas alterações à forma como se percebem e compreendem as questões relacionadas com a identidade, a educação, a prática e o conhecimento. Num cenário caraterizado pela conectividade e pela facilidade de acesso a pessoas e conteúdos, a rede oferece aos indivíduos um espaço onde podem interagir, trabalhar na sua aprendizagem, trocar experiências e construir uma identidade e reputação acessíveis a toda a comunidade. Quando se torna praticamente impossível permanecer fora do mundo digital e, consequentemente, da produção de uma identidade online (Costa e Torres, 2011; Warburton, 2009), a presença construída pelo indivíduo na rede surge como um currículo vitae ativo e dinâmico, revelador não apenas das competências adquiridas e certificadas em contextos de aprendizagem formais como daquelas desenvolvidas pela interação com os pares, pela partilha e pela comunicação. Partindo da análise da utilização de uma plataforma suportada institucionalmente (i.e. SAPO Campus), o presente trabalho de investigação tem como principal objetivo a análise e caraterização da construção da identidade online de um grupo de alunos do Mestrado em Comunicação Multimédia da Universidade de Aveiro num espaço providenciado pela instituição de ensino que frequentam. Com recurso a inquéritos por questionário, entrevistas em profundidade (realizadas aos participantes no estudo e a profissionais da área da comunicação e gestão de carreiras) e observação direta (análise quantitativa e qualitativa dos conteúdos publicados pelos participantes no SAPO Campus e em duas redes informais), procurou-se ainda caraterizar e analisar a identidade construída em espaços formais e informais, e aferir a importância – para alunos, instituição e mercado – da identidade online enquanto espaço de manifestação e divulgação de competências. Ainda que circunscrita ao contexto específico do Mestrado em Comunicação Multimédia e mais especificamente aos alunos cuja identidade online foi objeto de estudo, análise dos dados permite avançar que, de facto, os alunos estão conscientes da sua própria identidade online bem como da relevância de construir uma identidade e reputação sólidas e autênticas, que reflitam as suas competências e capacidades enquanto aprendentes e profissionais. Assim, poder-se-á avançar que no SAPO Campus os alunos estão a construir uma identidade online mais formal e cuidada, editando e selecionando os conteúdos de acordo com o contexto. Neste espaço, a maioria das publicações está diretamente relacionada com os trabalhos de investigação dos participantes, que recorrem à sua partilha nas redes informais para aumentar a visibilidade e exposição dos conteúdos publicados. Os participantes no estudo revelaram ainda valorizar o sentimento de segurança providenciado pelas tecnologias institucionais, bem como a possibilidade de construir uma identidade numa plataforma associada à sua instituição de ensino. Do estudo efetuado resultou ainda uma proposta de um modelo para a análise da identidade online, que poderá ser utilizado na análise da presença dos indivíduos em ambientes online formais e informais. Apresentando a identidade online como uma realidade assente na representação digital, na gestão da privacidade e na reputação construída na rede, o modelo foi aplicado aos dados recolhidos pelo estudo, conduzindo ao desenho de duas grandes formas de estar na rede: identidade orientada pelo contexto, e identidade orientada pelo utilizador. Quando as caraterísticas dos mundos digitais alteram a forma de produção da identidade e num cenário onde a contextualização de dados e informação assume uma importância crescente, este estudo de caso poderá contribuir para o conhecimento dos processos de construção da identidade em espaços formais e informais, da forma como os indivíduos gerem e constroem a sua identidade online, e ainda sobre a importância e o impacto da construção de uma identidade online consciente e credível para a reputação dos indivíduos e das Instituições de Ensino Superior.

Life histories of music service histories, the past in inductees' present

This article discusses inductee music service teachers (to 25 years of age). It explores how their lives, as perceived, shape current identities in teaching and result in several career problems. Respondents were drawn from a comprehensive life history study of 28 Local Education Authority employees. Of this larger cohort, four were age 25 years and below, and the remaining 24 teachers made retrospective comments. Data were collected and analysed between October 2002 and March 2004. Principal findings suggest that schooling failed to address these educators' needs as musical learners; key childhood experiences were external of schools. This often resulted in an idealistic trajectory, in teenage years, towards an occupation as a performer. An occupation in music education was entirely disregarded. Consequently, inductees now consider training experiences an inappropriate platform for their professional lives. Managing group teaching and children's behaviour engenders considerable anxiety. Music service work is also deemed a transient state of affairs. There are implications for training, retention and professional development.

Metaphors are good mirrors: reflecting on change for teacher educators

In this paper we discuss the use of metaphor as an educative tool for reflection. In the instance of this paper we use metaphor to reflect on the personal images of change that were used by some women teacher educators to make sense of their professional lives and practices over the last decade. This last decade in teacher education has seen significant institutional and cultural change. The paper discusses the strengths and limitations of the use of metaphor. The different interpretations of these metaphors illustrates how these women have used metaphor for explaining facets of change in their professional lives. The challenge of professional renewal is apparent in the metaphors in the ways that complexity, change, journeys, and movement are indicated. Reflection on change in professional practice needs to be continuous. Use of metaphor in the way described in this paper encourages that ongoing process.

Identifying the underlying dimensions of teachers' emotional intelligence

Within the area of educational research that has its focus on individual differences, the concept of emotional intelligence and its study in relation to the professional lives of teachers has raised considerable interest over the past decade. This article reports on data from a new measure of emotional intelligence specifically related to situations in the teaching environment. The four underlying dimensions that are identified in this study appear to be a more relevant way of characterising emotional intelligence for those in the teaching profession than other conceptualisations of emotional intelligence. The article concludes with an examination of the contention that emotional intelligence is strongly connected to effective teaching practice

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.

Helping teachers surf the information and communication technology tsunami

A range of factors, both internal and external, is creating changes in teaching and teachers’ professional lives. Information and Communication Technology (ICT) is just one of the major changes impacting on the teaching profession. As teachers face intense pressure to adapt to this tsunami, this study aims to investigate ways in which teachers can be helped. In South Australia, where this study is set, all teachers in Government schools are expected to be "ICT Smart", i.e. able to use appropriate forms of ICT to enhance the teaching and learning environment of their classrooms. From the researcher’s involvement for over a decade in professional development for teachers, and from visits to many schools, it appears that numerous teachers have not reached this standard. The greatest need is in Reception to Year 7 schools where the average age of teachers is nearly 50. Because no state-wide data exists, this study is intended to establish if there is a problem and if there is, to identify specific needs and offer possible solutions. The study is comprised of four parts: Part A, the Introduction gives an overview of the inter-relationships between these parts and the overall Folio. It establishes the setting and provides a rationale for the study and its focus on Professional Development in Information and Communication Technology. Part B, the Elective Research Studies, follows the writer’s involvement in this field since the 1980s. It establishes the theme of "Moving best practice in ICT from the few to the many" which underlies the whole study. Part C, the Dissertation, traces the steps taken to investigate the need for professional development in ICT. This is achieved by analysing and commenting on data collected from a state-wide survey and a series of interviews with leading figures, and by providing a review of the relevant literature and past and existing models of professional development. Part D, Final Comments, provides an overview of the whole Folio and a reflection on the research that has been conducted. The findings are that there is widespread dissatisfaction with existing models and that there is an urgent need for professional development in this area, because nearly 20% of teachers either do not use computers or are considered to be novice users. Another 25% are considered to be below not yet "ICT Smart". Less than 10% of ICT co-ordinators have a formal qualification in the field but more than 85% of them are interested in a Masters program. The study offers solutions in Part B where there is a discussion of a range of strategies to provide on-going professional development for teachers. Chapter 9 provides an outline of a proposed Masters level program and offers suggestions on how it could be best delivered. This program would meet the identified needs of ICT co-ordinators. The study concludes with a series of recommendations and suggestions for further research. The Education Department must address these urgent professional development needs of teachers, particularly those in the more remote country regions. There needs to be a follow-up survey to establish to what extent teachers in South Australia are now "ICT Smart ".

Serving the community : a biography of two primary teachers in rural Victoria 1922-1970

This biographical history investigates the formative influences, motivations and professional lives of wife and husband Ellen Cahalane Jennings (nee Murray) and Joseph Kevin Jennings in the context of their career as employees of the Victorian Education Department.

Using the art of trompe l’oeil to research induction and mentoring

This paper reveals how the art device of trompe l’oeil provided a way of thinking about the induction and mentoring experiences of seven beginning teachers in secondary school settings in the state of Victoria, Australia. The research study – a phenomenological, narrative inquiry – drew on Bourdieu’s theorising of ‘misrecognition’ and ‘symbolic violence’ to analyse data collected from interviews and the participants’ diary entries (written narratives). Both the trompe l’oeil art device and the theoretical lens illuminated the reframing of the participants’ initial understandings of mentor relationships to gain a different perspective on their early professional lives.

Mudanças na Natureza do Comércio no Mundo conectado através do E-commerce

The Internet has taken the world by storm. It has eliminated the barriers of technology, and unlocked the doors to electronic commerce and the 'Virtual Economy'. It has given us a glimpse into the future of 'Business' itself, and it has created a bewildering variety of choices in our personal and professional lives. It has taken on a life of its own, and we are all frantically trying to keep up. Many overwhelmed companies are asking questions like: 'What should our Internet Strategy be?' Or 'How do we put our business on the Internet like everybody else is doing?' or 'How do we use this thing to make money without spending any?'. These questions may seem reasonable on the surface, but they miss the point because they focus on the technologies rather than the core issues of conducting day-to-day business. The Internet can indeed offer fast returns in marketing reach, speed, director consumer sales and so on, and many companies are using it to good advantage, but the highest and best use of any such technology is to support, enhance and even re-invent the fundamentals of general business practice. When the initial excitement is over, and companies gain experience and confidence with the new business models, this larger view will begin to assert itself. Companies will then start to position their 'Internet Strategies' in context of where the business world itself is going over time, and how they can prepare for what is to come. Until now, the business world has been very fragmented, its collective progress limited (in part) by the inability to communicate within and between companies. Now that the technical remedy seems to be at hand and standards are beginning to emerge, we are starting to see a trend toward consolidation, cooperation, and economic synergy. Companies are improving their internal business processes with Intranets, and Electronic Commerce initiatives have sprung up using EDI, the World Wide Web, E-Mail, secure credit card payments and other tools. Companies are using the Internet to talk to each other and to sell their goods and services to the end consumer. Like Berlin, the walls are coming down because they have to. Electronic 'Communities of Common Interest' are beginning to surface, with the goal of supporting and aligning similar industries (such as Government, Insurance, Transportation and Health care) or similar business functions (such as Purchasing, Payments, and Human Resources). As these communities grow and mature, their initial scope will broaden and their spheres of influence will expand. They will begin to overlap into other communities, creating a synergistic effect and reshaping the conduct of business. The business world will undergo a gradual evolution toward globalization, driven by economic imperatives and natural selection in the marketplace, and facilitated by Electronic Commerce and Internet technologies. The business world 'beyond 2000' will have a substantially different look and feel than that which we see today.

Prevalência e fatores associados à dor em professores de educação física em academias de ginástica da cidade do Salvador-BA

Physical Education professionals are usually exposed to excessive physical workloads that evolve into painful symptomatology and muscle and bone disorders that originate from the work-related exercises. Purposo: The goal of this study was to investigate the prevalence and factors associated with pain painful symptomatology in teachers in gymnastics academies. An analytical transversal cut study was performed involving 163 gymnastics teachers working in the main gyms in the city of Salvador-BA. For evaluation of pain, validated versions in Portuguese of the McGill Protocol and the Wisconsin Pain Inventory were used. For obtain results of descriptive statistical analysis of the collected data was performed, followed by TStudent, and Pearson and Spearman correlation tests to verify possible correlations between the presence of pain and other variables which were considered independent. Finally, for the identification of potential risk factors associated with pain, a binary logistic regression analysis was performed. For all statistical analysis, we cnsidered p< 0.05. Results: The painful symptoms was reported by 88.3% of the subjects surveyed. High pain levels were observed in 63.8% of the interviewed professionals, where the intensity varied from moderate to severe. Pain in the lumbar region was present in 55.2% of subjects. Positive correlations were found between the level of pain intensity and the variables related with the workload activity and daily life of the teachers in almost all body joints analyzed. Some factors had been verified associates to the painful sintomatologia as the age of the professionals, the daily hours load of labor work, and the lack of interval of rest between the lessons. Conclusions: We found a high prevalence in gym teachers working in the city of Salvador-BA, which interfered in various daily activities of their home and professional lives. The most affected region was the lumbar region, followed by the knees, neck, shoulders, ankles, hands, hips, feet, elbows and forearms. The factors associated with development of painful symptomatology were the age of the professionals, daily hours of work and the lack of rest intervals between lessons. The high prevalence of pain in Physical Education teachers can be regarded as a serious occupational health problem, which would demand the urgent deployment of preventive intervention programs to minimize the impact of pain among these professionals

Prevalência e fatores associados à dor em bailarinos profissionais

To investigate the prevalence and factors associated to painful symptomatology in professional ballet dancers. Methodos: An analytical transversal cut study was performed with 141 professional ballet dancers in the main capital cities of the Brazilian Northeast. McGill`s Pain Questionnaire and the Wisconsin Brief Pain Inventory, both validated for Portuguese, were used to assess painful symptomatology. Descriptive statistical analysis of the results was carried out, followed by Student`s t-test and Pearson s correlation with pvalue < 0.05. Results: High pain tolerance levels were observed in 70.2% of the subjects, where the intensity varied from moderate to severe. Pain in the lumbar region was present in 85.8% of the individuals. Positive correlations were verified between the degree of pain intensity and activities how to dance (60,3%), general activities (32,6%), sleep (28,4%), mood (27,7%), march (20,6%) and relations with others (16,3%). Conclusions: High pain prevalence was found in professional ballet dancers in the main capital cities of the northeast, and the most affected area was the lumbar followed by knees, neck, hip and feet, with substantial interference of pain symptoms in several activities of the personal and professional lives of these people

Vacinação e biossegurança: o olhar dos profissionais de enfermagem

The present study analyzes the conceptions and the nursing workers' practices about the relationship between vaccination and biosecurity in a public hospital of reference in communicable diseases in Natal/RN. It is treated, therefore, of a exploratory/descriptive study with qualitative and quantitative approach. They were constituted as collaborators of the research twenty-two nursing professionals, being five nurses, three auxiliary and fourteen technicians in nursing. The information were obtained through the interview technique with semi-structured route. In the quantitative approach, the information were analyzed by statistics and presented in form of tables and graphs to characterize the workers and the aspects related to the vaccination situation of the same ones; and in the qualitative approach, we used the method of content analysis. The analysis was accomplished starting from the categories empiric coming from the process of analysis of the field material, measure through inferences and interpretations based on the authors studied in the theoretical referential of the research. Starting from the analysis of the results, we verified that the nursing interviewees' workers establish in a clear way and it aims at, in your speeches, a direct relationship between vaccination and biosecurity besides attributing a meaning of great importance with relationship to the use of the vaccines in your professional lives in what refers to the control and decrease of the risks, above all the biological ones, to the which are exposed in the daily exercise of your functions. However, when analyzing those workers' vaccination situation, we verified that the vaccination covering still meets on this side of the expected for the vaccines of occupational interest, with prominence just for the vaccines against diphtheria and tetanus and to against hepatitis B, that presented coverings considered very good and above the national average. Considering that the institution, although has a service of health occupational active and offer some vaccines of occupational interest, it still presents a work of little mobilization in what refers to the consciousness and the workers' permanent education with relationship to the need and importance of the occupational vaccination, not only for your workers' protection, as well as measure in the infection control and, therefore, as safety for your patients/clients. We understood that that work type didn't still become politics guided by ministries of Health or of the Labor, however, it falls to the institutions that work for the interest of the workers' health to struggle for all and any action and mobilization that have as objective protects the workers of the risks in your work atmosphere

How Communication experts express communicative competence

Este estudo teve por objetivo compreender como especialistas brasileiros em comunicação expressam sua competência comunicativa. Investigou-se um grupo de professores universitários de enfermagem, especialistas na área de comunicação, utilizando-se a seguinte pergunta norteadora: Como você expressa sua competência comunicativa? Os entrevistados referiram expressar sua competência comunicativa vivenciando-a em sua vida profissional e em sua rotina diária, ouvindo outras pessoas, percebendo a comunicação não-verbal, validando a compreensão de mensagens, quebrando barreiras de comunicação, demonstrando afetividade e desenvolvendo o autoconhecimento. Os resultados obtidos a partir deste estudo nos permitiram compreender a comunicação como algo a ser aprendido, sentido e vivenciado, ou seja, percebendo as nossas próprias emoções e sentimentos assim como os de outras pessoas, tanto no cuidado em enfermagem quanto em ações da vida diária.