Factors influencing oncology nurses' approaches to accommodating cultural needs in palliative care

Aims and objectives: The purpose of this study is to explore the social construction of cultural issues in palliative care amongst oncology nurses. ---------- Background: Australia is a nation composed of people from different cultural origins with diverse linguistic, spiritual, religious and social backgrounds. The challenge of working with an increasingly culturally diverse population is a common theme expressed by many healthcare professionals from a variety of countries. ---------- Design: Grounded theory was used to investigate the processes by which nurses provide nursing care to cancer patients from diverse cultural backgrounds. ---------- Methods: Semi-structured interviews with seven Australian oncology nurses provided the data for the study; the data was analysed using grounded theory data analysis techniques. ---------- Results: The core category emerging from the study was that of accommodating cultural needs. This paper focuses on describing the series of subcategories that were identified as factors which could influence the process by which nurses would accommodate cultural needs. These factors included nurses' views and understandings of culture and cultural mores, their philosophy of cultural care, nurses' previous experiences with people from other cultures and organisational approaches to culture and cultural care. ---------- Conclusions: This study demonstrated that previous experiences with people from other cultures and organisational approaches to culture and cultural care often influenced nurses' views and understandings of culture and cultural mores and their beliefs, attitudes and behaviours in providing cultural care. ---------- Relevance to clinical practice: It is imperative to appreciate how nurses' experiences with people from other cultures can be recognised and built upon or, if necessary, challenged. Furthermore, nurses' cultural competence and experiences with people from other cultures need to be further investigated in clinical practice.

Accommodating the diverse cultural needs of cancer patients and their families in palliative care

Cultural issues have become an increasingly important consideration in healthcare. Such cultural issues, however, are underresearched in Australia, especially in palliative care. This study has sought to address this gap, exploring the social construction of cultural issues in palliative care by oncology nurses. A grounded theory approach was used. Semistructured interviews with 7 Australian oncology nurses provided the data for the study. The core category emerging from the study was that of accommodating cultural needs whereby to meet patients' specific cultural requirements, nurses actively found ways to accommodate the needs of patients and their families. This process often included compromise and negotiation whereby limits were set. In addition, the use of cross-cultural communication strategies emerged from the data as an important feature of cultural care. A series of subcategories were also identified as factors that could influence the process by which nurses would accommodate cultural needs.

BESTUFS policy and research recommendations IV: environmental zones in European cities, accommodating the needs of passenger and freight transport in cities, and BESTUFS Project recommendations

Recommendations report produced as part of the EC-funded BESTUFS project on urban freight transport.

Accommodating special needs users in the evaluation of an m-Learning application:a case study

Adult illiteracy rates are alarmingly high worldwide. The portability, affordability, and ease of use of mobile (or handheld) devices offer a realistic opportunity to provide novel, context-sensitive literacy resources to adults with limited literacy skills. To this end, we developed the concept of ALEX – a mobile Adult Literacy support application for EXperiential learning (Lumsden et al., 2005). On the basis of a medium-fidelity prototype of this application, we conducted an evaluation of ALEX using participants from our in tended user group. This evaluation had two goals: (a) to assess the usefulness of the ALEX concept and the usability of its current design; and (b) to reflect on the appropriateness of our evaluation process given the literacy-related needs of our participants. This paper outlines our approach to this evaluation as well as the results we obtained and our reflections on the process.

Analyzing the literature for the link between the conservative Islamic culture of Saudi Arabia and the design of sustainable housing

Saudi Arabia experiences housing shortage for mid and low-income families, which is caused by rapid population growth. This condition is worsened by the fact that the current housing supply has problems in meeting both sustainable requirements and cultural needs of those families. This paper aims to investigate the link between the unique conservative Saudi culture and the design of sustainable housing, while keeping the housing cost affordable for mid and low-income families. The paper is based on a review of literatures on the issues of the Islamic culture and how can they be integrated into the design process of a Saudi house. Findings from literature reveiw suggest several design requirements for accommodating the conservative Saudi Culture in low cost sustainable houses. Such requirements include the implementation of proper usage of windows, and house orientation with a courtyard inside rather than facing the main street will provide natural ventilation while maintaining privacy. The main contribution to the body of knowledge is that this is a new approach to sustainable housing in Saudi Arabia considering not only energy use and architectural design issues but also socio-cultural issues as an essential part of sustainability.

Integration of Saudi Arabia’s conservative Islamic culture in sustainable housing design

The cities of Saudi Arabia have perhaps the largest growth rates of cities in the Middle East, such that it has become a cause in shortage of housing for mid and low-income families, as is the case in other developing countries. Even when housing is found, it is not sustainable nor is it providing the cultural needs of those families. The aim of this paper is to integrate the unique conservative Islamic Saudi culture into the design of sustainable housing. This paper is part of a preliminary study of an on-going PhD thesis, which utilises a semistructured interview of a panel of nine experts in collecting the data. The interviews consisted of ten questions ranging from general questions such as stating their expertise and work position to more specific question such as listing the critical success factors and/or barriers for applying sustainability to housing in Saudi Arabia. Since the participants were selected according to their experience, the answers to the interview questions were satisfactory where the generation of the survey questions for the second stage in the PhD thesis took place after analysing the participant’s answers to the interview questions. This paper recommends design requirements for accommodating the conservative Islamic Saudi Culture in low cost sustainable houses. Such requirements include achieving privacy through the use of various types of traditional Saudi architectural elements, such as the method of decorative screening of windows, called Mashrabiya, and having an inner courtyard where the house looks inward rather than outward. Other requirements include educating firms on how to design sustainable housing, educating the public on the advantages of sustainable housing and implementing new laws that enforce the utilisation of sustainable methods to housing construction. This paper contributes towards the body of knowledge by proposing initial findings on how to integrate the conservative Islamic culture of Saudi Arabia into the design of a sustainable house specifically for mid and low-income families. This contribution can be implemented on developing countries in the region that are faced with housing shortage for mid and low-income families.

Cross-cultural web user interface design for Indigenous internet users

This project investigated 1) Australian web designers’ cultural perceptions towards Australian Indigenous users and 2) Australian Indigenous cultural features in terms of user interface design. In doing so, it reviews the literature of cross-cultural user interface design by focusing on feasible models and arguments to articulate and integrate Australian Indigenous Internet users’ cultural needs of web user interface. The online survey results collected from 101 Indigenous users and 126 Web designers showed a distinctive difference between them on the integration of Indigenous users' cultural in Web sites. The interview data collected from 14 Indigenous users and 14 web designers suggested practical approaches to the design implications of Indigenous culture.

Psychometric properties of an Australian supportive care needs assessment tool for Indigenous patients with cancer

BACKGROUND There are significant disparities in cancer outcomes between Indigenous and non-Indigenous Australians. Identifying the unmet supportive care needs of Indigenous Australians with cancer is imperative to improve their cancer care. The purpose of this study was to test the psychometric properties of a supportive care needs assessment tool for Indigenous Australian (SCNAT-IP) cancer patients. METHODS The SCNAT-IP was administered to 248 Indigenous Australians diagnosed with a range of cancer types and stages, and received treatment in one of four Queensland hospitals. All 39 items were assessed for ceiling and floor effects and analysed using exploratory factor analysis (EFA) to determine construct validity. Identified factors were assessed for internal consistency and convergent validity to validated psychosocial tools. RESULTS EFA revealed a four-factor structure (physical and psychological, hospital care, information and communication, and practical and cultural needs) explaining 51% of the variance. Internal consistency of four subscales was good, with Cronbach Alpha reliability coefficients ranging from 0.70-0.89. Convergent validity was supported by significant correlations between the SCNAT-IP with the Distress Thermometer (r=0.60, p<0.001), and The Cancer Worry Chart (r=0.58, p<0.001) and a moderately strong negative correlation with Assessment of Quality of Life questionnaire (r=-0.56, p<0.001). CONCLUSION These data provide initial support for the SCNAT-IP a measure of multiple supportive care needs domains specific to Indigenous Australian cancer patients undergoing treatment.

Research Monograph: The role of community and lifestyle in the making of a knowledge city

Our brief is to investigate the role of community and lifestyle in the making of a globally successful knowledge city region. Our approach is essentially pragmatic. We start by broadly examining knowledge-based urban development from a number of different perspectives. The first view is historical. In this context knowledge work and knowledge workers are seen as vital parts of a new emergent mode of production reliant on the continual production of abstract knowledge. We briefly develop this perspective to encompass the work of Richard Florida who has, notedly, claimed: “Wherever talent goes, innovation, creativity, and economic growth are sure to follow.” Our next perspective examines concepts of knowledge and modes of its production to discover knowledge is not an unchanging object but a human activity that changes in form and content through history. The suggestion emerges that not only is the production of contemporary ‘knowledge’ organised in a specific (and new) manner but also the output of this networked production is a particular type of knowledge (i.e. techné). The third perspective locates knowledge production and its workers in the contemporary urban context. As such, it co-ordinates the knowledge city in the increasingly global structure of cities and develops a typology of different groups of knowledge workers in their preferred urban environment(s). We see emerging here a distinctive geography of knowledge production. It is an urban phenomenon. There is, in short, something about the nature of cities that knowledge workers find particularly attractive. In the next, essentially anthropological, perspective we start to explore the needs and desires of the individual knowledge worker. Beyond the needs basic to any modern human household an attempt is made to deduce, from a base understanding of knowledge work as mental labour, the compensatory cultural needs of the knowledge worker when not at work - and the expression of these needs in the urban fabric. Our final perspective consists of two case studies. In a review of the experiences of Austin, Texas and Singapore’s one-north precinct we collect empirical data on, respectively, a knowledge city that has sustained itself for over 50 years and an urban precinct newly launched into the global market for knowledge work and knowledge workers. Interwoven The Role of Community and Lifestyle in the Making of a Knowledge City Urban Research Program 8 through all perspectives, in the form of apposite citation, is that of ‘expert opinion’ gathered in a rudimentary poll of academic and industry sources. This opinion appears in text boxes while details of the survey can be found in Appendix A. In the conclusion of the report we interpret the wide range of evidence gathered above in a policy frame. It is our hope this report will leave the reader with a clearer picture of the decisive organisational, infrastructural, aesthetic and social dimensions of a knowledge precinct.

The meaning of cancer for Australian Aboriginal women : changing the focus of cancer nursing

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.

Transition to day care for older people in Taiwan : a grounded theory study

Adult day care centres provide a means whereby frail or disabled older people can remain living at home particularly when their family care-givers engage in waged work. In Taiwan, adult day care services appear to meet the cultural needs of both older people and their families for whom filial care is vital. Little research attention has been paid to the use of day care services in Taiwan, the uptake rate of which is low. This grounded theory study explored the ways in which older people and family care-givers construct meanings around the use of day care services in Taiwan. Forty-four semi-structured interviews were undertaken with older people, care-givers and day care centre managers. The findings from grounded theory data analysis bring focus to the assumptions and structures that underpin the process of transition to day care services. A key feature of this process is the reconstruction of personal identity as both the older people and family care-givers work to make sense of the relationship between the self and a changing social structure. Reconstructing identity in a shifting world is the core category of the study and reflects a process of reframing whereby older people came to new definitions of social responsibility and independence within the context of the day care centre. Similarly, the family care-givers actively reformulated the concept of filial piety as they interacted with and interpreted the changes in economic and social conditions in Taiwan.

…Where did I lose you? Accessing the literacy demands of assessment

In this study we sought to find out how teachers could make assessment fairer for Indigenous students in learning mathematics, given the context of the high stakes of the National Assessment Program Literacy and Numeracy (NAPLAN). Today, teachers are experiencing the full range of demands from their own students who require individual attention, through to system level expectations of improved performances for all students. Many staff experience reform fatigue with limited time for critical reflection and a reduction in support for the use and the analysis of the overwhelming amount of data that has become available in recent years. Over the past three years we worked with teachers in seven schools to gradually refine our research focus to centre on how we might best support teachers in this demanding context with the important outcome of improved teaching and learning of mathematics with particular consideration of how to respond to the cultural needs of Indigenous (Aboriginal and Torres Strait Islander) students.

REFRAME : a new approach to evaluation in higher education

Evaluation practices in the higher education sector have been criticised for having unclear purpose and principles; ignoring the complexity and changing nature of learning and teaching and the environments in which they occur; relying almost exclusively on student ratings of teachers working in classroom settings; lacking reliability and validity; using data for inappropriate purposes; and focusing on accountability and marketing rather than the improvement of learning and teaching. In response to similar criticism from stakeholders, in 2011 Queensland University of Technology began a project, entitled REFRAME, to review its approach to evaluation, particularly the student survey system it had been using for the past five years. This presentation will outline the scholarly, evidence based methodology used to undertake institution-wide change, meet the needs of stakeholders suitable to the cultural needs of the institution. It is believed that this approach is broadly applicable to other institutions contemplating change with regard to evaluation of learning and teaching.

How to meet stakeholders' expectations, not manage them?

Evaluation practices in the higher education sector have been criticised for having unclear purpose and principles; ignoring the complexity and changing nature of learning and teaching and the environments in which they occur; relying almost exclusively on student ratings of teachers working in classroom settings; lacking reliability and validity; using data for inappropriate purposes; and focusing on accountability and marketing rather than the improvement of learning and teaching. In response to similar criticism from stakeholders, in 2011 Queensland University of Technology began a project, entitled REFRAME, to review its approach to evaluation, particularly the student survey system it had been using for the past five years. This presentation will outline the scholarly, evidence based methodology used to undertake institution-wide change, meet the needs of stakeholders suitable to the cultural needs of the institution. It is believed that this approach is broadly applicable to other institutions contemplating change with regard to evaluation of learning and teaching.

REFRAME: a new approach to evaluation in higher education

Evaluation practices in the higher education sector have been criticised for having unclear purpose and principles; ignoring the complexity and changing nature of learning and teaching and the environments in which they occur; relying almost exclusively on student ratings of teachers working in classroom settings; lacking reliability and validity; using data for inappropriate purposes; and focusing on accountability and marketing rather than the improvement of learning and teaching. In response to similar criticism from stakeholders, in 2011 Queensland University of Technology began a project, entitled REFRAME, to review its approach to evaluation, particularly the student survey system it had been using for the past five years. This presentation will outline the scholarly, evidence based methodology used to undertake institution-wide change, meet the needs of stakeholders suitable to the cultural needs of the institution. It is believed that this approach is broadly applicable to other institutions contemplating change with regard to evaluation of learning and teaching.