862 resultados para Education, Nursing -- methods


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The inquiry documented in this thesis is located at the nexus of technological innovation and traditional schooling. As we enter the second decade of a new century, few would argue against the increasingly urgent need to integrate digital literacies with traditional academic knowledge. Yet, despite substantial investments from governments and businesses, the adoption and diffusion of contemporary digital tools in formal schooling remain sluggish. To date, research on technology adoption in schools tends to take a deficit perspective of schools and teachers, with the lack of resources and teacher ‘technophobia’ most commonly cited as barriers to digital uptake. Corresponding interventions that focus on increasing funding and upskilling teachers, however, have made little difference to adoption trends in the last decade. Empirical evidence that explicates the cultural and pedagogical complexities of innovation diffusion within long-established conventions of mainstream schooling, particularly from the standpoint of students, is wanting. To address this knowledge gap, this thesis inquires into how students evaluate and account for the constraints and affordances of contemporary digital tools when they engage with them as part of their conventional schooling. It documents the attempted integration of a student-led Web 2.0 learning initiative, known as the Student Media Centre (SMC), into the schooling practices of a long-established, high-performing independent senior boys’ school in urban Australia. The study employed an ‘explanatory’ two-phase research design (Creswell, 2003) that combined complementary quantitative and qualitative methods to achieve both breadth of measurement and richness of characterisation. In the initial quantitative phase, a self-reported questionnaire was administered to the senior school student population to determine adoption trends and predictors of SMC usage (N=481). Measurement constructs included individual learning dispositions (learning and performance goals, cognitive playfulness and personal innovativeness), as well as social and technological variables (peer support, perceived usefulness and ease of use). Incremental predictive models of SMC usage were conducted using Classification and Regression Tree (CART) modelling: (i) individual-level predictors, (ii) individual and social predictors, and (iii) individual, social and technological predictors. Peer support emerged as the best predictor of SMC usage. Other salient predictors include perceived ease of use and usefulness, cognitive playfulness and learning goals. On the whole, an overwhelming proportion of students reported low usage levels, low perceived usefulness and a lack of peer support for engaging with the digital learning initiative. The small minority of frequent users reported having high levels of peer support and robust learning goal orientations, rather than being predominantly driven by performance goals. These findings indicate that tensions around social validation, digital learning and academic performance pressures influence students’ engagement with the Web 2.0 learning initiative. The qualitative phase that followed provided insights into these tensions by shifting the analytics from individual attitudes and behaviours to shared social and cultural reasoning practices that explain students’ engagement with the innovation. Six indepth focus groups, comprising 60 students with different levels of SMC usage, were conducted, audio-recorded and transcribed. Textual data were analysed using Membership Categorisation Analysis. Students’ accounts converged around a key proposition. The Web 2.0 learning initiative was useful-in-principle but useless-in-practice. While students endorsed the usefulness of the SMC for enhancing multimodal engagement, extending peer-topeer networks and acquiring real-world skills, they also called attention to a number of constraints that obfuscated the realisation of these design affordances in practice. These constraints were cast in terms of three binary formulations of social and cultural imperatives at play within the school: (i) ‘cool/uncool’, (ii) ‘dominant staff/compliant student’, and (iii) ‘digital learning/academic performance’. The first formulation foregrounds the social stigma of the SMC among peers and its resultant lack of positive network benefits. The second relates to students’ perception of the school culture as authoritarian and punitive with adverse effects on the very student agency required to drive the innovation. The third points to academic performance pressures in a crowded curriculum with tight timelines. Taken together, findings from both phases of the study provide the following key insights. First, students endorsed the learning affordances of contemporary digital tools such as the SMC for enhancing their current schooling practices. For the majority of students, however, these learning affordances were overshadowed by the performative demands of schooling, both social and academic. The student participants saw engagement with the SMC in-school as distinct from, even oppositional to, the conventional social and academic performance indicators of schooling, namely (i) being ‘cool’ (or at least ‘not uncool’), (ii) sufficiently ‘compliant’, and (iii) achieving good academic grades. Their reasoned response therefore, was simply to resist engagement with the digital learning innovation. Second, a small minority of students seemed dispositionally inclined to negotiate the learning affordances and performance constraints of digital learning and traditional schooling more effectively than others. These students were able to engage more frequently and meaningfully with the SMC in school. Their ability to adapt and traverse seemingly incommensurate social and institutional identities and norms is theorised as cultural agility – a dispositional construct that comprises personal innovativeness, cognitive playfulness and learning goals orientation. The logic then is ‘both and’ rather than ‘either or’ for these individuals with a capacity to accommodate both learning and performance in school, whether in terms of digital engagement and academic excellence, or successful brokerage across multiple social identities and institutional affiliations within the school. In sum, this study takes us beyond the familiar terrain of deficit discourses that tend to blame institutional conservatism, lack of resourcing and teacher resistance for low uptake of digital technologies in schools. It does so by providing an empirical base for the development of a ‘third way’ of theorising technological and pedagogical innovation in schools, one which is more informed by students as critical stakeholders and thus more relevant to the lived culture within the school, and its complex relationship to students’ lives outside of school. It is in this relationship that we find an explanation for how these individuals can, at the one time, be digital kids and analogue students.

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Recent releases from the International Federation of Accountants (IFAC) highlight the importance of ethics education. Academic institutions employ varying methods of teaching ethics and place varying levels of emphasis on ethics teaching during a business/accounting degree. This paper attempts to evaluate whether teaching ethics to final year accountancy students is beneficial. At the commencement of a semester 85 final year accounting students were given five ethical scenarios on which to make an ethical decision. During the semester they were subject to two different methods of teaching ethics, a traditional lecture/tutorial process and a group assignment. ----- After a significant gap, students were re-presented with the ethical scenarios and asked what action they now considered appropriate. In all five instances students offered a more ethical response the second time. When asked to evaluate the methodologies the students considered both training methods to have a positive effect on their ethical thinking. The results suggest it is beneficial to include ethics teaching in accountancy courses, if the profession’s goal of ethical practitioners is to be achieved.

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Early and rich conversations with a range of stakeholders – academics, professionals and graduates in their early years of practice – quickly clarified that the singular challenge for most parties centres on the ways in which courses prepare graduates for the pace, diversity and flux of contemporary professional practice.---------In pursuing understanding of this central challenge this study has focused on new graduates in BED disciplines by canvassing their views and those of two other major stakeholder groups (academic staff and professional practitioners in the disciplines studied). The first crucial years of a young graduate’s life in the workforce are shaped by a number of factors including the quality of the transition-to-work experience. The quality of this life-shaping transition is dependent on a range of factors including the ways in which graduates are educated in universities, their personal developmental characteristics and those of the professional people around them and the preparedness of workplaces and other professional groups to guide new recruits through the transition experience. This study makes recommendations about how the variations in transition experience, resulting from the vagaries of all these factors across a range of worksites, may be better understood, perhaps normalised, and, at least, supported. . Early and rich conversations with a range of stakeholders – academics, professionals and graduates in their early years of practice – quickly clarified that the singular challenge for most parties centres on the ways in which courses prepare graduates for the pace, diversity and flux of contemporary professional practice. The study proceeded through literature review, focus group interviews, national online survey and workshops. Through all these methods a number of challenges and factors essential to the transition experience, and the quality of education which precedes it, were identified. Firstly the study found further evidence of the importance of higher-order graduate capabilities, namely, the development of judgment, critical enquiry and strategic thinking. Alongside these capabilities the importance of the development of emotional intelligence, particularly interpersonal and social skills, was stressed by all stakeholders. At the time of writing the global economic crisis was providing challenges to the sector and its young graduates. This phenomenon proved the value of the development of resilience and persistence in graduates, the education system was called upon by all stakeholders as a place where the future-proofing of neophytes would ensure that the unknown challenges of the future could also be confronted. The study found that the challenges of transition to work are best supported by authentic undergraduate experiences both on and off campus, inside and outside classrooms, and that commencing professional life is made easier for new graduates when university courses and workplace settings develop, sustain and support high standards and high expectations of students. All these findings indicate the importance of stakeholder expectations, roles and responsibilities in respect of the transition-to-work experience. Whilst full agreement about how these things should occur is not necessary, a process (amongst stakeholders) which seeks value alignment around transition through discussion, debate and agenda-setting would probably assist to address what is seen as a major challenge in built environment and design education.

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Specialised support for student nurses making the transition to graduate nurse can be crucial to successful and smooth adjustment, and can create a path to positive and stable career experiences. This paper describes an enhanced model of final year nursing student placements which was trialled in 2006 at the Queensland University of Technology. The model involved collaboration with two major urban health services and resources were developed to support effective transition experiences. Ninety-two students, including 29 trial participants and 63 non-trial participants were assessed on preparedness for professional practice, before and after the trial semester. Results indicated an increase in preparedness across the entire sample, but students participating in the trial did not differ significantly in overall preparedness change from those who did not participate. Higher baseline preparedness in the trial group highlighted the possibility that proactive students who choose enrichment experiences tend to be likelier to gain benefit from such options than those who do not. Qualitative findings from focus groups conducted with 12 transition group students highlighted that one of the main beneficial aspects of the experience for students was the sense of belonging to a team that understood their learning needs and could work constructively with them.

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The call to innovate is ubiquitous across the Australian educational policy context. The claims of innovative practices and environments that occur frequently in university mission statements, strategic plans and marketing literature suggest that this exhortation to innovate appears to have been taken up enthusiastically by the university sector. Throughout the history of universities, a range of reported deficiencies of higher education have worked to produce a notion of crisis. At present, it would seem that innovation is positioned as the solution to the notion of crisis. This thesis is an inquiry into how the insistence on innovation works to both enable and constrain teaching and learning practices in Australian universities. Alongside the interplay between innovation and crisis is the link between resistance and innovation, a link which remains largely unproblematized in the scholarly literature. This thesis works to locate and unsettle understandings of a relationship between innovation and Australian higher education. The aim of this inquiry is to generate new understandings of what counts as innovation within this context and how innovation is enacted. The thesis draws on a number of postmodernist theorists, whose works have informed firstly the research method, and then the analysis and findings. Firstly, there is an assumption that power is capillary and works through discourse to enact power relations which shape certain truths (Foucault, 1990). Secondly, this research scrutinised language practices which frame the capacity for individuals to act, alongside the language practices which encourage an individual to adopt certain attitudes and actions as one’s own (Foucault, 1988). Thirdly, innovation talk is read in this thesis as an example of needs talk, that is, as a medium through which what is considered domestic, political or economic is made and contested (Fraser, 1989). Fourthly, relationships between and within discourses were identified and analysed beyond cause and effect descriptions, and more productively considered to be in a constant state of becoming (Deleuze, 1987). Finally, the use of ironic research methods assisted in producing alternate configurations of innovation talk which are useful and new (Rorty, 1989). The theoretical assumptions which underpin this thesis inform a document analysis methodology, used to examine how certain texts work to shape the ways in which innovation is constructed. The data consisted of three Federal higher education funding policies selected on the rationale that these documents, as opposed to state or locally based policy and legislation, represent the only shared policy context for all Australian universities. The analysis first provided a modernist reading of the three documents, and this was followed by postmodernist readings of these same policy documents. The modernist reading worked to locate and describe the current truths about innovation. The historical context in which the policy was produced as well as the textual features of the document itself were important to this reading. In the first modernist reading, the binaries involved in producing proper and improper notions of innovation were described and analysed. In the process of the modernist analysis and the subsequent location of binary organisation, a number of conceptual collisions were identified, and these sites of struggle were revisited, through the application of a postmodernist reading. By applying the theories of Rorty (1989) and Fraser (1989) it became possible to not treat these sites as contradictory and requiring resolution, but rather as spaces in which binary tensions are necessary and productive. This postmodernist reading constructed new spaces for refusing and resisting dominant discourses of innovation which value only certain kinds of teaching and learning practices. By exploring a number of ironic language practices found within the policies, this thesis proposes an alternative way of thinking about what counts as innovation and how it happens. The new readings of innovation made possible through the work of this thesis were in response to a suite of enduring, inter-related questions – what counts as innovation?, who or what supports innovation?, how does innovation occur?, and who are the innovators?. The truths presented in response to these questions were treated as the language practices which constitute a dominant discourse of innovation talk. The collisions that occur within these truths were the contested sites which were of most interest for the analysis. The thesis concludes by presenting a theoretical blueprint which works to shift the boundaries of what counts as innovation and how it happens in a manner which is productive, inclusive and powerful. This blueprint forms the foundation upon which a number of recommendations are made for both my own professional practice and broader contexts. In keeping with the conceptual tone of this study, these recommendations are a suite of new questions which focus attention on the boundaries of innovation talk as an attempt to re-configure what is valued about teaching and learning at university.

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Aim: The purpose of the study was to explore why Aboriginal women participate in cancer screening programs but appear reluctant to following-up results, or accept medical advice about treatment. Methods: Interpretive ethnography, a qualitative methodology, was used to explore Aboriginal women’s perception of cancer, and the cultural context in which meaning was constructed and influenced treatment decision. Data collection, which occurred over two years, involved fieldwork, participant-observation, face-to-face interviews and focus groups, in two rural Aboriginal communities. Forty eight interviews were recorded from a cross section of the communities, including cancer survivors and patients, family members, health care providers and other women from the community. Results: Key findings were that Aboriginal women’s had a fearful and fatalistic attitude toward cancer, doubted the efficacy of treatment and carried an enduring ambivalence toward the authority of whiteman’s medicine. The women faced a dilemma of wanting access to cancer treatment options but feared entering hospital or clinics not attuned to their cultural needs. Conclusion: The findings highlight the need for a culture-centred approach that decentres the authority of conventional services and instead gives prominence to Aboriginal cultural values as a focal point in cancer control. It should be the responsibility of cancer nurses and others to engage with their local Aboriginal communities to build relationships that foster an exchange of learning about cultural differences that make a difference to how cancer control is practiced.

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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.

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Aims. To explore differences in self-care behaviour according to demographic and illness characteristics; and relationships among self-care behaviour and demographic and illness characteristics, efficacy expectations and outcome expectations of people with type 2 diabetes in Taiwan. Background. Most people with diabetes do not control their disease appropriately in Taiwan. Enhanced self-efficacy towards managing diseases can be an effective way of improving disease control as proposed by the self-efficacy model which provides a useful framework for understanding adherence to self-care behaviours. Design and methods. The sample comprised 145 patients with type 2 diabetes aged 30 years or more from diabetes outpatient clinics in Taipei. Data were collected using a self-administered questionnaire for this study. One-way anova, t-tests, Pearson product moment correlation and hierarchical regression were analysed for the study. Results. Significant differences were found: between self-care behaviour and complications (t = −2·52, p < 0·01) and patient education (t = −1·96, p < 0·05). Self-care behaviour was significantly and positively correlated with duration of diabetes (r = 0·36, p < 0·01), efficacy expectations (r = 0·54, p < 0·01) and outcome expectations (r = 0·44, p < 0·01). A total of 39·1% of variance in self-care behaviour can be explained by duration of diabetes, efficacy expectations and outcome expectations. Conclusions. Findings support the use of the self-efficacy model as a framework for understanding adherence to self-care behaviour. Relevance to clinical practice. Using self-efficacy theory when designing patient education interventions for people with type 2 diabetes will enhance self-management routines and assist in reducing major complications in the future.

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Theory-of-Mind has been defined as the ability to explain and predict human behaviour by imputing mental states, such as attention, intention, desire, emotion, perception and belief, to the self and others (Astington & Barriault, 2001). Theory-of-Mind study began with Piaget and continued through a tradition of meta-cognitive research projects (Flavell, 2004). A study by Baron-Cohen, Leslie and Frith (1985) of Theory-of-Mind abilities in atypically developing children reported major difficulties experienced by children with autism spectrum disorder (ASD) in imputing mental states to others. Since then, a wide range of follow-up research has been conducted to confirm these results. Traditional Theory-of-Mind research on ASD has been based on an either-or assumption that Theory-of-Mind is something one either possesses or does not. However, this approach fails to take account of how the ASD population themselves experience Theory-of-Mind. This paper suggests an alternative approach, Theory-of-Mind continuum model, to understand the Theory-of-Mind experience of people with ASD. The Theory-of-Mind continuum model will be developed through a comparison of subjective and objective aspects of mind, and phenomenal and psychological concepts of mind. This paper will demonstrate the importance of balancing qualitative and quantitative research methods in investigating the minds of people with ASD. It will enrich our theoretical understanding of Theory-of-Mind, as well as contain methodological implications for further studies in Theory-of-Mind

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Historically, distance education consisted of a combination of face-to-face blocks of time and surface mailed packages. However, advances in information technology literacy and the abundance of personal computers has placed e-learning in increased demand. The authors describe the planning, implementation, and evaluation of the blending of e-learning with face-to-face education in the postgraduate nursing forum. Experiences of this particular student group are also discussed.

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Objective: Walking is commonly recommended to help with weight management. We measured total energy expenditure (TEE) and its components to quantify the impact of increasing exercise-induced energy expenditure (ExEE) on other components of TEE. Methods: Thirteen obese women underwent an 8-week walking group intervention. TEE was quantified using doubly labeled water, ExEE was quantified using heart rate monitors, daily movement was assessed by accelerometry and resting metabolic rate was measured using indirect calorimetry. Results: Four of the 13 participants achieved the target of 1500 kcal wk−1 of ExEE and all achieved 1000 kcal wk−1. The average ExEE achieved by the group across the 8 weeks was 1434 ± 237 kcal wk−1. Vigorous physical activity, as assessed by accelerometry, increased during the intervention by an average of 30 min per day. Non-exercise activity thermogenesis (NEAT) decreased, on average, by 175 kcal d−1 (−22%) from baseline to the intervention and baseline fitness was correlated with change in NEAT. Conclusions: Potential alterations in non-exercise activity should be considered when exercise is prescribed. The provision of appropriate education on how to self-monitor daily activity levels may improve intervention outcomes in groups who are new to exercise. Practice implications: Strategies to sustain incidental and light physical activity should be offered to help empower individuals as they develop and maintain healthy and long-lasting lifestyle habits.

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Advances in symptom management strategies through a better understanding of cancer symptom clusters depend on the identification of symptom clusters that are valid and reliable. The purpose of this exploratory research was to investigate alternative analytical approaches to identify symptom clusters for patients with cancer, using readily accessible statistical methods, and to justify which methods of identification may be appropriate for this context. Three studies were undertaken: (1) a systematic review of the literature, to identify analytical methods commonly used for symptom cluster identification for cancer patients; (2) a secondary data analysis to identify symptom clusters and compare alternative methods, as a guide to best practice approaches in cross-sectional studies; and (3) a secondary data analysis to investigate the stability of symptom clusters over time. The systematic literature review identified, in 10 years prior to March 2007, 13 cross-sectional studies implementing multivariate methods to identify cancer related symptom clusters. The methods commonly used to group symptoms were exploratory factor analysis, hierarchical cluster analysis and principal components analysis. Common factor analysis methods were recommended as the best practice cross-sectional methods for cancer symptom cluster identification. A comparison of alternative common factor analysis methods was conducted, in a secondary analysis of a sample of 219 ambulatory cancer patients with mixed diagnoses, assessed within one month of commencing chemotherapy treatment. Principal axis factoring, unweighted least squares and image factor analysis identified five consistent symptom clusters, based on patient self-reported distress ratings of 42 physical symptoms. Extraction of an additional cluster was necessary when using alpha factor analysis to determine clinically relevant symptom clusters. The recommended approaches for symptom cluster identification using nonmultivariate normal data were: principal axis factoring or unweighted least squares for factor extraction, followed by oblique rotation; and use of the scree plot and Minimum Average Partial procedure to determine the number of factors. In contrast to other studies which typically interpret pattern coefficients alone, in these studies symptom clusters were determined on the basis of structure coefficients. This approach was adopted for the stability of the results as structure coefficients are correlations between factors and symptoms unaffected by the correlations between factors. Symptoms could be associated with multiple clusters as a foundation for investigating potential interventions. The stability of these five symptom clusters was investigated in separate common factor analyses, 6 and 12 months after chemotherapy commenced. Five qualitatively consistent symptom clusters were identified over time (Musculoskeletal-discomforts/lethargy, Oral-discomforts, Gastrointestinaldiscomforts, Vasomotor-symptoms, Gastrointestinal-toxicities), but at 12 months two additional clusters were determined (Lethargy and Gastrointestinal/digestive symptoms). Future studies should include physical, psychological, and cognitive symptoms. Further investigation of the identified symptom clusters is required for validation, to examine causality, and potentially to suggest interventions for symptom management. Future studies should use longitudinal analyses to investigate change in symptom clusters, the influence of patient related factors, and the impact on outcomes (e.g., daily functioning) over time.

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BACKGROUND: Support and education for parents faced with managing a child with atopic dermatitis is crucial to the success of current treatments. Interventions aiming to improve parent management of this condition are promising. Unfortunately, evaluation is hampered by lack of precise research tools to measure change. OBJECTIVES: To develop a suite of valid and reliable research instruments to appraise parents' self-efficacy for performing atopic dermatitis management tasks; outcome expectations of performing management tasks; and self-reported task performance in a community sample of parents of children with atopic dermatitis. METHODS: The Parents' Eczema Management Scale (PEMS) and the Parents' Outcome Expectations of Eczema Management Scale (POEEMS) were developed from an existing self-efficacy scale, the Parental Self-Efficacy with Eczema Care Index (PASECI). Each scale was presented in a single self-administered questionnaire, to measure self-efficacy, outcome expectations, and self-reported task performance related to managing child atopic dermatitis. Each was tested with a community sample of parents of children with atopic dermatitis, and psychometric evaluation of the scales' reliability and validity was conducted. SETTING AND PARTICIPANTS: A community-based convenience sample of 120 parents of children with atopic dermatitis completed the self-administered questionnaire. Participants were recruited through schools across Australia. RESULTS: Satisfactory internal consistency and test-retest reliability was demonstrated for all three scales. Construct validity was satisfactory, with positive relationships between self-efficacy for managing atopic dermatitis and general perceived self-efficacy; self-efficacy for managing atopic dermatitis and self-reported task performance; and self-efficacy for managing atopic dermatitis and outcome expectations. Factor analyses revealed two-factor structures for PEMS and PASECI alike, with both scales containing factors related to performing routine management tasks, and managing the child's symptoms and behaviour. Factor analysis was also applied to POEEMS resulting in a three-factor structure. Factors relating to independent management of atopic dermatitis by the parent, involving healthcare professionals in management, and involving the child in the management of atopic dermatitis were found. Parents' self-efficacy and outcome expectations had a significant influence on self-reported task performance. CONCLUSIONS: Findings suggest that PEMS and POEEMS are valid and reliable instruments worthy of further psychometric evaluation. Likewise, validity and reliability of PASECI was confirmed.