Paediatric death and dying: Exploring coping strategies of health professionals and perceptions of support provision

Without question a child’s death is a devastating event for parents and their families. Health professionals working with the dying child and family draw upon their expertise and experience to engage with children, parents, and families on this painful journey. A delicate and sensitive area of practice, it has strong and penetrating effects on health professionals. They employ physical, emotional, spiritual and problem solving strategies to continue to perform this role effectively and to protect their continued sense of well-being. Aim To explore health professionals’ perceptions of bereavement support surrounding the loss of a child. Methods The research was underpinned by social constructionism. Semi-structured interviews were held with 10 health professionals including doctors, nurses and social workers who were directly involved in the care of the dying child and family in 7 cases of paediatric death. Health professional narratives were analysed consistent with Charmarz’s (2006) approach. Results For health professionals, constructions around coping emerged as peer support, personal coping strategies, family support, physical impact of support and spiritual beliefs . Analysis of the narratives also revealed health professionals’ perceptions of their support provision. Conclusion Health professionals involved in caring for dying children and their families use a variety of strategies to cope with the emotional and physical toll of providing support. They also engage in self-assessment to evaluate their support provision and this highlights the need for self-evaluation tools in paediatric palliative care.

Practice uncertainty: Changing perceptions

Practice uncertainty occurs when health care providers feel uncomfortable in response to unfamiliar or challenging patient care situations. Practice uncertainty is inevitable in health care, and there are many contextual factors that can lead to either good or bad outcomes for patients and health care providers. Practice uncertainty is not a well-established concept in the literature, perhaps because of the predominant empirical paradigm and the high value placed on certainty within current health care culture. This study was conducted to explore practice uncertainty and bring this topic into the foreground as a first step toward practice evolution. A shift in the perception of practice uncertainty may change the way in which practitioners experience this phenomenon. This process must start with nursing educators recognizing and acknowledging this phenomenon when it occurs.

Designing 'other' citizens into the city: Investigating perceptions of architectural opportunities for wildlife habitat in the Brisbane CBD

Traditional perceptions of the human-animal relationship in the urban context typically see the spatial rejection of wildlife from the built environment and limiting of biodiversity conservation programs to areas of natural reserve. As urban growth places further spatial demands on natural habitat and contributes to continued global biodiversity loss, the recently introduced conservation approach of reconciliation ecology makes a call promoting ecological stewardship through embedding wildlife habitat within human dominated areas. Coinciding with this, the architectural sphere has seen a recent trend of design investigation addressing artificial animal habitat as features of the built environment. Although these precedents are currently a niche and scattered trend they show potential to address the human-animal dualism challenging the framework of reconciliation ecology. This research explores the role design plays in influencing perceptions of urban wildlife habitat, particularly considering the need to create and communicate value around wildlife biodiversity as a component of urban cultural place-making and ecological literacy. The study purpose sets out to establish a set of approaches and cultural preferences with which to direct further classification and development of this architectural trend. Brisbane is utilised as a case study city, as a locale containing proximities of relatively high wildlife and human populations in an urban setting and an established legislative biodiversity heritage and ethic. Through use of a qualitative and quantitative questionnaire targeting Brisbane residents, the research methodology established that although respondents perceptions generally aligned with traditional prejudice against wildlife around human buildings, artificial habitat intervention would be supported within the CBD provided it allowed for adequate distancing of humans from wildlife and conformed with contextual surroundings, or otherwise addressed habitat through redevelopment at an urban scale. As such further research directions for artificial habitat should focus on integration of artificial habitat as a component of façade design or green infrastructure programs.

Public use and perceptions of emergency departments: A population survey

Objectives To inform demand management strategies aimed at reducing congestion in EDs by: (i) identifying public use of EDs, decision-making and reasons; and (ii) measuring acceptance of alternative care models. Methods A cross-sectional telephone survey of a random sample of Queensland population aged 18 years or older residing in a dwelling unit in Queensland that could be contacted on a land-based telephone service was conducted. One person per household was selected according to a predetermined algorithm to ensure sex and regional balance were interviewed. The main outcome measures were: ED use, attitudes towards ED staff and services, and alternative models of care. Results The final sample included a total of 1256 respondents (response rate = 40.3%). Twenty-one per cent attended EDs in the preceding 12 months. The decision to attend was made by patients (51%), health and medical professionals (31%), and others (18%). The main reasons included perceived severity of the illness (47%), unavailability of alternative services (26%) and better care (11%). Most respondents agreed with more flexible care models of service delivery including incentives for general practitioners (90%), private health insurance coverage for ED use (89%), and enhanced roles for paramedics and nurses. Conclusions Main reason for attending ED is perceived severity of illness, followed by lack of alternative care. The majority of both consumers and the public are in favour of more flexible care models. However, further research is necessary to detail those alternatives and to test and validate their effectiveness.

Destination brand performance measurement over time: Tracking consumer perceptions of a competitive set of destinations over a 10 year period

There has been a paucity of research published in relation to the temporal aspect of destination image change over time. Given increasing investments in destination branding, research is needed to enhance understanding of how to monitor destination brand performance, of which destination image is the core construct, over time. This article reports the results of four studies tracking brand performance of a competitive set of five destinations, between 2003 and 2012. Results indicate minimal changes in perceptions held of the five destinations of interest over the 10 years, supporting the assertion of Gartner (1986) and Gartner and Hunt (1987) that destination image change will only occur slowly over time. While undertaken in Australia, the research approach provides DMOs in other parts of the world with a practical tool for evaluating brand performance over time; in terms of measures of effectiveness of past marketing communications, and indicators of future performance.

Addressing the road trauma burden in China: Exploring attitudes, behaviours, risk perceptions and cultural uniqueness

As China continues to motorise rapidly, solutions are needed to reduce the burden of road trauma that is spread inequitably across the community. Little is currently known about how new drivers are trained to deal with on-road challenges, and little is also known about the perceptions, behaviours and attitudes of road users in China. This paper reports on a pilot study conducted in a driver retraining facility in one Chinese city where people who have had their licence suspended for accrual of 12 demerit points in a one year period must attend compulsory retraining in order to regain their licence. A sample of 239 suspended drivers responded to an anonymous questionnaire that sought information about preferred driving speeds and perceptions of safe driving speeds across two speed zones. Responses indicated that speeds higher than the posted limits were commonly reported, and that there was incongruence between preferred and safe speeds, such that a greater proportion of drivers reported preferred speeds that were substantially faster than what were reported as safe speeds. Participants with more driving experience reported significantly fewer crashes than newly licensed drivers (less than 2 years licensed) but no differences were found in offences when compared across groups with different levels of driving experience. Perceptions of risky behaviours were assessed by asking participants to describe what they considered to be the most dangerous on-road behaviours. Speeding and drink driving were the most commonly reported by far, followed by issues such as fatigue, ignoring traffic rules, not obeying traffic rules, phone use while driving, and non-use of seatbelts, which attracted an extremely low response which seems consistent with previously reported low belt wearing rates, unfavourable attitudes towards seatbelt use, and low levels of enforcement. Finally, observations about culturally specific considerations are made from previous research conducted by the authors and others. Specifically, issues of saving face and the importance and pervasiveness of social networks and social influence are discussed with particular regard to how any future countermeasures need to be informed by a thorough understanding of Chinese customs and culture.

Job uncertainty and personal control during downsizing: A comparison of survivors and victims

This study developed and tested a model of job uncertainty for survivors and victims of downsizing. Data were collected from three samples of employees in a public hospital, each representing three phases of the downsizing process: immediately before the announcement of the redeployment of staff, during the implementation of the downsizing, and towards the end of the official change programme. As predicted, levels of job uncertainty and personal control had a direct relationship with emotional exhaustion and job satisfaction. In addition, there was evidence to suggest that personal control mediated the relationship between job uncertainty and employee adjustment, a pattern of results that varied across each of the three phases of the change event. From the perspective of the organization’s overall climate, it was found that levels of job uncertainty, personal control and job satisfaction improved and/or stabilized over the downsizing process. During the implementation phase, survivors experienced higher levels of personal control than victims, but both groups of employees reported similar levels of job uncertainty. We discuss the implications of our results for strategically managing uncertainty during and after organizational change.

Linking client and employee perceptions of the organization: A study of client satisfaction with health care services

Client satisfaction with health care services has usually been researched in terms of socio-demographic and predispositional characteristics associated with the client. The present study included organizational characteristics as predictors of client satisfaction with health care services. Participants in the research were clients and employees of an Australian public-sector health care organization who responded to separate client and employee questionnaires. Hierarchical regression analyses indicated that, after controlling for a number of client characteristics, organizational characteristics, as perceived by employees, accounted for a significant proportion of additional variance in client satisfaction with health care services. Results of the present study provided some support for the proposition that employee perceptions of the working environment should be considered in a more comprehensive understanding of client satisfaction with health care services. Limitations of the study highlight practical difficulties in the assessment of client outcomes and methodological complexities in linking individual and organizational processes.

'There is nothing that identifies me to that place’: Indigenous Women’s Perceptions of Health Spaces and Places

This chapter provides an overview of the gendered realities of Indigenous men’s and Indigenous women’s lives and gendered Indigenous health perspectives. It offers the nurse some examples of the role of the nurse in working within gendered Indigenous health care.

How religiosity influences consumption: The impact of consumer religiosity on perceptions of psychological and social risk

For some people, religion is an important influence in decision-making. This thesis investigates the relationship between the religiosity of consumers and their perceived risk in adopting new products. Two studies gathered data from religious consumers living in Saudi Arabia, Australia, Canada, New Zealand, the UK and the USA. The results confirm the significant impact of religion on perceived risk, and suggest why this may lead to delays in adoption. Theoretically, these studies provide a better explanation of how religion influences consumption decisions, and offer brand managers options to improve the adoption of new products in religious markets.

Undergraduate public health students and perceptions of qualitative research: A trajectory of understanding from airy fairy to a valuable tool

Many undergraduate public health students enter introductory qualitative research units with limited or negative perceptions of qualitative research, potentially compromising learning outcomes. Unit teaching, structure and assessment provide opportunities for students to develop positive perceptions of qualitative research. Through a mixed-methods study of undergraduate public health students enrolled in a qualitative research unit, we establish students’ perceptions of qualitative research at the commencement and conclusion of the unit, and determine the critical teaching and learning events which contributed to positive changes in students’ perceptions. This study demonstrates that the structuring of an introductory qualitative research unit around varied opportunities for experiential learning provides a positive introductory learning experience and enables undergraduate public health students to recognise the real-world uses and value of qualitative research.

A longitudinal investigation of coping processes during a merger: Implications for job satisfaction and organizational identification

This study tested the utility of a stress and coping model of employee adjustment to a merger. Two hundred and twenty employees completed both questionnaires (Time 1: 3 months after merger implementation; Time 2: 2 years later). Structural equation modeling analyses revealed that positive event characteristics predicted greater appraisals of self-efficacy and less stress at Time 1. Self-efficacy, in turn, predicted greater use of problem-focused coping at Time 2, whereas stress predicted a greater use of problem-focused and avoidance coping. Finally, problem-focused coping predicted higher levels of job satisfaction and identification with the merged organization (Time 2), whereas avoidance coping predicted lower identification.

Local experiences, global similarities: Teacher perceptions of the impacts of national testing

Since 2008, Australian schoolchildren in Years 3, 5, 7 and 9 have sat a series of tests each May designed to assess their attainment of basic skills in literacy and numeracy. These tests are known as the National Assessment Program – Literacy and Numeracy (NAPLAN). In 2010, individual school NAPLAN data were first published on the MySchool website which enables comparisons to be made between individual schools and statistically like schools across Australia. NAPLAN represents the increased centrality of the federal government in education, particularly in regards to education policy. One effect of this has been a recast emphasis of education as an economic, rather than democratic, good. As Reid (2009) suggests, this recasting of education within national productivity agendas mobilises commonsense discourses of accountability and transparency. These are common articles of faith for many involved in education administration and bureaucracy; more and better data, and holding people to account for that data, must improve education...

NAPLAN, MySchool and accountability: Teacher perceptions of the effects of testing

This paper explores Rizvi and Lingard’s (2010) idea of the “local vernacular” of the global education policy trend of using high-stakes testing to increase accountability and transparency, and by extension quality, within schools and education systems in Australia. In the first part of the paper a brief context of the policy trajectory of National Assessment Program – Literacy and Numeracy (NAPLAN) is given in Australia. In the second part, empirical evidence drawn from a survey of teachers in Western Australia (WA) and South Australia (SA) is used to explore teacher perceptions of the impacts a high-stakes testing regime is having on student learning, relationships with parents and pedagogy in specific sites. After the 2007 Australian Federal election, one of Labor’s policy objectives was to deliver an “Education Revolution” designed to improve both the equity and excellence in the Australian school system1 (Rudd & Gillard, 2008). This reform agenda aims to “deliver real changes” through: “raising the quality of teaching in our schools” and “improving transparency and accountability of schools and school systems” (Rudd & Gillard, 2008, p. 5). Central to this linking of accountability, the transparency of schools and school systems and raising teaching quality was the creation of a regime of testing (NAPLAN) that would generate data about the attainment of basic literacy and numeracy skills by students in Australian schools.