Nursing Online – July 2009

New nursing research

Here’s a snapshot of the latest  research on nursing from the Australian Journal of Advanced Nursing.

Health and the global financial crisis
Ged Kearney, Federal Secretary, Australian Nursing Federation

It has been said health care and nursing are recession-proof industries because health care will continue to be needed. Indeed, given that health is directly related to social determinants such as adequate income and well being, our services may well be in even higher demand, with people out of work and under general stress regarding welfare.

To an extent this is true. But the crisis is and will affect us. Governments are under pressure to make savings. Private health providers will be concerned about returns on investments. Aged care, already under pressure and underfunded, may well find less funding coming its way. Nurses working in aged care, who in Australia are paid considerably less than nurses working in other sectors might, due to financial pressure, have to leave the sector to ensure a more adequate income elsewhere. We are already hearing of state governments in this country who want to freeze public sector wages and even renege on agreements. There is great temptation to strip resources from the costly health budget and that is worrying.
www.ajan.com.au/Vol26/26-4_GuestEditorial.pdf

Living the experience of breast cancer treatment: The younger woman‘s perspective
Elisabeth Coyne and Sally Borbasi

The object of this research was to explore the experience of breast cancer for young women under 50 years of age and describe their personal experience of coping with breast cancer treatment.
The researchers found that treatment for breast cancer began so quickly following diagnosis that little time was left to adjust to the concept of a life threatening disease. The severity of the effects from treatment influenced the women’s sense of person and ability to care for family. Fatigue, nausea and early onset menopausal changes were particularly troubling. Women described a positive resolve to survive.

The researchers conclude that treatment concerns for younger women are qualitatively different from those of older women. They consider they are too young to assume ‘the sick role’ and are not prepared for its sudden onset, neither are their support networks. The right kind of support can assist younger women and their families to cope during the early stages of diagnosis and intervention.
www.ajan.com.au/Vol26/26-4_Coyne.pdf

Nurse practitioners in drug and alcohol: where are they?
Stephen Ling

The role of nurse practitioner encompasses advanced levels of practice with the potential to prescribe a range of medications within a recognised area of practice along with the use of appropriate ordering of pathology tests and referral practices.
The nurse practitioner in drug and alcohol has the potential to support and enhance existing medical models of patient care in a variety of settings.

Employment of nurse practitioners may be a way of addressing workforce issues. The advanced level of practice and resultant responsibility also requires higher levels of remuneration, which need to be accepted within an advanced practice framework. In many cases this model of care may in fact be acknowledging existing practices in areas where nursing staff are forced to undertake more advanced roles, due to the shortage of appropriately-trained medical staff. Collaborative care involving nurse practitioners can lead to increased access, reduced waiting times and longer consultation times.

Nurse practitioners in the alcohol and other drugs field have enormous potential to support other experts in collaborative care for patients with substance use disorders. This potential does not come without some additional financial costs but the potential benefits to a health service in employing a nurse practitioner skilled in the management of substance use disorders can be enormous. However, the full potential of nurse practitioners in drug and alcohol will not be realised until financial arrangements for outpatient care become a reality.
www.ajan.com.au/Vol26/26-4_Ling.pdf

The relationship between clinical outcomes and quality of life for residents of aged care facilities
Professor Mary Courtney, Maria O’Reilly and Professor Helen Edwards

It is widely assumed that improving care in residential facilities will improve quality of life, but little research has explored this relationship. The Clinical Care Indicators Tool was developed to fill an existing gap in quality assessment within Australian residential aged care facilities and it was used to explore potential links between clinical outcomes and quality of life. Social and spiritual quality of life was particularly affected by clinical outcomes and poorer status in hydration, falls and depression were most strongly associated with lower quality of life scores. Poorer clinical status as a whole was also significantly correlated with poorer quality of life.

The researchers concluded that hydration, falls and depression were most often associated with poorer resident quality of life and, as such, appear to be key areas for clinical management in residential aged care. However, poor clinical outcomes overall also adversely affected quality of life, which suggests maintaining optimum clinical status through high quality nursing care would not only be important for resident health but also for enhancing general life quality.
www.ajan.com.au/Vol26/26-4_O’Reilly.pdf

The latest edition of Australian Journal of Advanced Nursing is available at www.ajan.com.au