Nursing Online – February 2010

The Australian Journal of Advanced Nursing aims to provide a vehicle for nurses to publish original research and scholarly papers about all areas of nursing. The latest edition of AJAN is available free online at

AJAN Research Highlights

The Experience of Socially Isolated Older People in Accessing and Navigating the Health Care System
By Moira Greaves, RN, BN, MHealth, PhD student and Professor Cath Rogers-Clark, Head, Department of Nursing and Midwifery, University of Southern Queensland.

This article reports findings from a study exploring the challenges experienced by socially isolated and unwell older people as they attempted to access the health-care system. Understanding the specific issues confronting these individuals would inform the development of more appropriate models of community-based aged care.

This study was conducted in metropolitan Brisbane, with frail older people who were accessed via their GP service. Six participants who met predetermined selection criteria were recruited to this longitudinal study and interviewed twice over a six-month period. The study found that fear emerged as a common experience embracing aspects of daily life such as depletion of social networks, being dependent on others, loss of mobility and diminishing ability to drive. Inadequate or unreliable public transport resulted in extended waiting times to attend medical appointments. Despite efforts to address the specific issues of frail older people living independently, this study highlights the suffering experienced by those who are socially isolated and lack the knowledge, skills, physical wellbeing and support to locate and access relevant health services.

Rethinking Student Night Duty Placements
Dr Lisa McKenna, Associate Professor, School of Nursing and Midwifery, Monash University, and Ms Jill French, Lecturer, School of Nursing and Midwifery, Monash University.

Student clinical placements principally occur over morning and afternoon shifts. This paper reports findings from a qualitative study that investigated experiences and value of night duty placements for undergraduate nursing students.

Final-year students from one university were invited to participate in a two-week night shift placement. A qualitative approach involving focus groups with students and ward nurses, prior to and following the clinical placements was used. In addition, individual interviews were conducted with other key stakeholders from the university and health-care service. The study was conducted in one metropolitan public hospital in Victoria, Australia. A clinical teacher was employed by the university to provide student support during the placement. Three themes emerged from pre-placement interviews: nature of night shift, preparing to be a graduate, and change and adjustment. Post-placement interviews revealed the themes: time to learn and time to teach, adjusting, continuity and preparing to be a graduate.

The study concludes that night duty placements offered a range of possibilities and challenges. They provided opportunities for skills consolidation, enhanced understanding of nursing work, and were perceived to contribute to readiness for graduate practice. Further research is needed to explore such placements on a larger scale.

Factors Affecting Sexual Satisfaction in Korean Women Who Have Undergone a Hysterectomy
Mi Hae Sung, Associate Professor, Department of Nursing, Inje University, Korea, and Young Mi Lim, Professor, Department of Nursing, Yonsei University, Korea.

This study was undertaken to examine the factors affecting sexual satisfaction in women who had undergone a hysterectomy. A descriptive correlational study was conducted. The model contained three stages including antecedents, interpersonal influence and outcome perception. The antecedents included perception variables (eg. negative body image and depression) and individual characteristics (eg. age, education, employment and physical state before and after the hysterectomy). Interpersonal influence focused on social support and the outcome perception variable was sexual satisfaction.

The setting was a gynaecology outpatient clinic in a suburban general hospital in Korea. A total of 118 women who had had a hysterectomy participated. Results show spousal support and negative body image explained 30% of the variance in sexual satisfaction. Spousal support, as a mediating variable, was the highest factor predicting sexual satisfaction of women who have had a hysterectomy.

Findings suggest the causal relationships of sexual satisfaction can guide researchers and gynaecology nurses to understand the relative strength of predictors for sexual satisfaction. Nurse Practitioners should play a leading role in assisting women who undergo hysterectomy to ensure they have emotional support from their spouse, as this can dramatically impact on their sexual satisfaction.