Mixed methods evaluation research for a mental health screening and referral clinical pathway.

Rationale: This study is an exemplar of mixed method evaluation research for development of a clinical pathway.

Aim: To develop and evaluate an evidence-based, feasible mental health screening and referral clinical pathway for Department of Veterans' Affairs-funded community nursing care of war veterans and war widows in the Australian context.

Methods: Mixed methods were applied to formulate and clinically evaluate an appropriate pathway.

An evaluation of a mental health screening and referral pathway for community nursing care: nurses' and general practitioners' perspectives.

Aims And Objectives: To evaluate a feasible, best practice mental health screening and referral clinical pathway for generalist community nursing care of war veterans and war widow(er)s in Australia.

Background: War veterans commonly experience mental health difficulties and do not always receive required treatment, as can also occur for war widow(er)s. Whenever opportunity arises, such as during community nursing care, it is vital to identify mental health problems in a health promotion framework.

A literature review of the application of the Geriatric Depression Scale, Depression Anxiety Stress Scales and Post-traumatic Stress Disorder Checklist to community nursing cohorts.

Aims And Objectives: To explore through literature review the appropriateness of three common tools for use by community nurses to screen war veteran and war widow(er) clients for depression, anxiety and post-traumatic stress disorder.

Background: War veterans and, to a lesser extent, war widow(er)s, are prone to mental health challenges, especially depression, anxiety and post-traumatic stress disorder. Community nurses do not accurately identify such people with depression and related disorders although they are well positioned to do so.

A systematic review of the effectiveness of in-home community nurse led interventions for the mental health of older persons.

Aims And Objectives: The aim was to systematically review evidence about the effectiveness of in-home community nurse-led interventions for older persons with, or at risk of, mental health disorders, to inform best practice nursing care with this focus. The primary review question was 'How effective are in-home community nurse-led interventions for older persons with or at risk of mental health disorders for improving mental health?' The outcome indices of interest were nursing actions to determine incidence or prevalence of mental health disorders, any change in a patient's attitude towards their mental health condition, any change in objective measurement of mental health, or a change in diagnostic status.

Background: The rising incidence of mental health disorders in older persons is a major concern for community nurses in developed countries.

Compression bandaging for venous leg ulcers: the essentialness of a willing patient.

Aim: To describe and explore reasons for use or non-use by district nurses of compression bandaging, a best practice component of venous leg ulcer management.

Background: Leg ulcers are costly to both individuals and communities. The most prevalent of leg ulcers are venous leg ulcers, which are common wounds treated by district nurses.

Where does practice nursing fit in primary health care?

Practice nursing is an integral and growing part of primary health care internationally and increasingly within the Australian health care system. The potential for practice nursing being considered as a specialty of community nursing, boundary issues in community nursing, and defining characteristics of practice nursing as a model of community-based nursing are discussed in this paper. As the author has worked as a practice nurse, personal reflections on the evolving practice nurse role are provided.

Developing a web-based information resource for palliative care: an action-research inspired approach.

Background: General Practitioners and community nurses rely on easily accessible, evidence-based online information to guide practice. To date, the methods that underpin the scoping of user-identified online information needs in palliative care have remained under-explored. This paper describes the benefits and challenges of a collaborative approach involving users and experts that informed the first stage of the development of a palliative care website 1.

A grounded theory: seeking relief from flatus as relevant client-nurse action and interaction.

Flatus problems are not uncommon among gastroenterological clients and those in other care settings. Yet what clients and nurses do productively about those problems in regard to their actions and interactions and why they do so has not previously been the focus of research. Holistic health management requires trustworthy qualitative evidence to guide best practice in this regard.

Screening for depression in older district nursing clients: feasibility study.

Depression is a common condition among older district nursing clients. This two-cycle feasibility study trialled a process for depression screening by using the 15-item Geriatric Depression Scale (GDS) with a sample of older clients in an Australian district nursing organization. An education session about depression and use of the GDS preceded the screening process.

Health-promoting education needs of middle-aged persons in a rural community in Taiwan.

The purpose of this study was to identify the health-promoting education needs of middle-aged people in a rural community of Taiwan. A randomized sample of 1100 potential respondents was mailed a survey questionnaire with a response rate of 29.7%.

The experience of flatus incontinence from a bowel ostomy: a hermeneutic phenomenology.

Objective: To interpret and present possible meanings in the stories of people with bowel ostomies about their experience of impact of flatus incontinence on their life and being.

Design: Hermeneutic phenomenology guided by a Gadamerian perspective.

Setting And Subjects: Six people with a bowel ostomy were recruited from a city in Australia.

Triangulation of qualitative approaches: hermeneutical phenomenology and grounded theory.

Aim: In this paper, suggestions are offered about the appropriate use of hermeneutic phenomenology and grounded theory in one study.

Background: As an alternative to selecting only one qualitative research approach to illuminate a topic of interest about which little is known, two qualitative approaches could be used in a study. Fear of 'method slurring' may prevent this alternative being used.

A Delphi study of district nursing research priorities in Australia.

This study, using a Delphi approach, sought the opinion of a self-selected panel of 320 district nurses regarding research priorities for district nursing in Australia. Over three rounds of questionnaires, the 419 research clinical problem areas requiring research as suggested by the panel were each rated in importance by the panel and then ranked through analysis from high to low average rating scores, thereby, whittling down the list to the top 15% (68) research questions and to a final list of the top 10 research priorities overall. Research questions focusing on discharge planning are dominant in these top 10 priorities, with documentation issues the second most common focus.

Constipation and the preached trio: diet, fluid intake, exercise.

A survey of 90 older community-dwelling people's constipation experience is reported in part. The focus is the participants' efforts to use diet, fluid intake and exercise as preventive strategies. Most feel that they have been preached to in this regard.

Older people seeking solutions to constipation: the laxative mire.

This article reports an extensive descriptive survey of 90 older people (65+ years) living in the community who sought through in-depth, semistructured interviews to explore their experiences and responses to constipation. The composite story of these older people is that seeking a solution to constipation may be fraught with great difficulty. Most commonly tried are laxatives, yet laxative use can be like a mire.

Using caregivers-as-proxies to retrospectively assess and measure quality of dying of palliative care clients.

This study evaluated two quality-of-life assessment and measurement tools, the Client Generated Index and the McGill Quality of Life questionnaire, within palliative care nursing. Primarily tested was the feasibility of the tools to assess clients' QOL at admission and, if necessary, when their condition altered. The reliability of the tools has previously been ascertained Additionally, quality of dying during the last two days of life for 14 participants who died during the study was assessed and measured retrospectively by these tools, using the client's nominated caregiver as proxy for the client.

Quality of life issues identified by palliative care clients using two tools.

Reported are issues impacting upon the Quality of Life (QoL) of 59 palliative care clients within a district nursing service. These issues reinforce the emerging conceptualisation of QoL as being subjective and multidimensional. The issues were identified during a trial of two QoL assessment and measurement tools, the Client Generated Index (CGI) and the McGill Quality of Life (MQOL).

Faecal impaction: older people's experiences and nursing practice.

A number of authors have identified the paucity of evidence available to inform community nursing practice in relation to faecal impaction. Little is known of its incidence or its impact. In an attempt to address this, this article reports part of an extensive descriptive survey in Australia that sought to explore the experience of, and response to, constipation of older people living in the community.