Social Psychiatry and Psychiatric Epidemiology, 2003
Combining qualitative methods alongside randomised controlled trials in the health field has been... more Combining qualitative methods alongside randomised controlled trials in the health field has been advocated but has only been used rarely in mental health services research. The aim of this study was to illuminate patients' understanding of the nature and purpose and outcomes of a trial designed to improve the management of neuroleptic medication. Qualitative interviews were carried out with a group of patients participating in a trial comparing a psycho-educational and therapeutic alliance intervention in managing anti-psychotic medication. Our findings highlighted aspects of the experience, process and outcome of the trial, which remain latent in the quantitative assessment. The issue of enlarged selfefficacy emerging when patients were involved in communications with professionals in the trial was important. Whilst the participants provided positive feedback about their involvement in the trial, they struggled to recall the details of the intervention to which they had been exposed. Patients did not readily identify the content and concepts characterising each condition; rather they prioritised the opportunity for communication and contact with the researchers. Qualitative research accompanying trials illuminates and adds to the quantitative outcomes. The key to interpreting participants' accounts of the process and outcomes of this trial suggests the need to give greater emphasis to participants' past and current experience of service contact.
Experiments were performed on the freshwater amphipod Paramelita nigroculus to determine the rout... more Experiments were performed on the freshwater amphipod Paramelita nigroculus to determine the route of uptake for Al, Cu and Mn. The extent of correlation between the concentrations of Al, Cu and Mn and those of macro-cations Na, Ca and Mg was investigated in order to determine appropriate strategies of water quality management. Indeed, active uptake of toxicants can be controlled
The influence of different antecedent conditions on hydrochemical response during storm events wa... more The influence of different antecedent conditions on hydrochemical response during storm events was investigated in a small, south-western Cape mountain catchment. Winter and summer storms (four in total) were sampled both before and after the catchment was deliberately burnt. During winter storms, discharge responded rapidly to rainfall, and direct runoff represented the major component of streamflow. Marked lags were observed
... 37 The major ion chemistry of some southern African saline systems JA Day Freshwater Research... more ... 37 The major ion chemistry of some southern African saline systems JA Day Freshwater Research Unit, Zoology Dept, University of Cape Town, Rondebosch 7700, South Africa Key woyds: Southern Africa, Namib Desert, hydrochemistry, saline waters, major ions Abstract ...
The study presented in this thesis provides a description and interpretation of the experiences o... more The study presented in this thesis provides a description and interpretation of the experiences of family members during their older loved one’s delirium. Fourteen women, aged 51 to 74 years, participated in the study and, over an interview period of nineteen months, described their experiences. These twelve daughters and two wives supported and cared for their loved one at home, in residential aged care and/or while hospitalised. The approach used to explore the women’s experiences was existential phenomenology, informed by the philosophies of Sartre and Merleau-Ponty. Changing family portraits: Sudden existential absence during delirium depicts the women’s experiences during their older loved one’s delirium. Existential absence for these women was experienced as the sudden absence of their familiar older loved one and the arrival of a stranger. The meaning of existential absence is further represented by the theme Living the fragility of a loved one’s presence and the sub-themes F...
To examine qualitative research findings about family experiences of absence or loss during older... more To examine qualitative research findings about family experiences of absence or loss during older person delirium, and provide a critical discussion of the similarities and differences in these experiences with conceptual understandings of absence and loss. Families who care for older people with chronic illnesses experience many losses. However, the nondeath loss experiences of family during an older loved one's delirium, an acute condition accompanied by marked changes in demeanour, have received little consideration. Discursive position paper. The findings from two qualitative research studies about family experiences during an older loved one's delirium are discussed in relation to the concepts of absence and nondeath loss. The uncharacteristic behaviours and cognitive changes that accompany delirium may estrange family who, despite the older person's corporeal presence, sense the profound absence or loss of their loved one. Although the notion of absence, a nondeath loss, is similar to the experiences of family of people with chronic conditions, there are differences that distinguish these encounters. The similarities and differences between absence during delirium and the concepts of psychological absence, nonfinite loss and psychosocial death are discussed. Psychosocial death, reversibility/irreversibility and partial marked change, are suggested as conceptual descriptions for the absence families experience during an older loved one's delirium. The sense of absence or loss that family may experience during their older loved one's delirium needs to be recognised, understood and addressed by healthcare staff. Understanding or appreciating conceptualisations of absence, as a nondeath loss, may enhance understandings of family member needs during delirium and enable better support strategies. Conceptualisations of absence enhance understandings of family distress and needs during their older loved one's delirium. The potential for family members to experience their loved one's absence during delirium, a nondeath loss, needs to be considered by healthcare staff. Family experiences of absence during delirium need to be recognised by healthcare staff, acknowledged as a potential source of distress, and considered when involving family in the older person's care. Nurses are ideally placed to respond compassionately and provide appropriate family member re-assurance, support and information during delirium. Information should include possible impacts on family and coping strategies.
ABSTRACT Abstract: The experiences of family members may be missed, ignored and/or undervalued by... more ABSTRACT Abstract: The experiences of family members may be missed, ignored and/or undervalued by healthcare staff when older people are unwell. Within the ‘busyness’ and complexity of residential aged care and hospital care environments, family members of older people may not be asked about their issues, concerns or their loved ones changed demeanour. In a recent phenomenological study of the experiences of family members during their older loved one’s delirium, participants (n=14 women) revealed the need for compassion and understanding from healthcare staff. The women described their relationship with healthcare staff as contradictory; finding themselves both On the Fringe and Centre Stage during their loved one’s care. They were dismissed by staff and at times belittled by them, and yet they were responsible for helping the staff to care for their distressed loved one during delirium. The women in this study felt isolated, deeply troubled and frustrated by their relationship with staff rather than being reassured and relieved about their loved one’s care. These findings point to an opportunity for healthcare staff to respond to family members with compassion and to care about their well-being. Often the best care healthcare staff can offer is an understanding of the impact of an older person’s condition and its treatment on family member’s so they can be supported, acknowledged as an important part of the older person’s care, and understood as human beings.
ABSTRACT Title: Experiencing a loved one’s sudden absence during delirium: The perspectives of fa... more ABSTRACT Title: Experiencing a loved one’s sudden absence during delirium: The perspectives of family members of older people. Authors: DAY Jenny, Lecturer, University of Newcastle HIGGINS Isabel, Professor Older Person Care, University of Newcastle Aim: This presentation describes the main finding of an Australian phenomenological study which aimed to increase understanding of the experiences of family members during their older loved one’s delirium. Method: The approach used to explore family member experiences was existential phenomenology, informed by the philosophies of Sartre and Merleau-Ponty. Fourteen women, aged 51 to 74 years, participated and, over time, described their experiences during in-depth interviews. These twelve daughters and two wives supported and cared for their older loved one at home, in residential aged care and/or while hospitalised. Findings: Changing family portraits: Sudden existential absence during delirium depicts the essence of the women’s experiences in this study. The notion of existential absence describes how the women suddenly lost the familiar and taken-for-granted presence of their older loved one, and experienced the presence of a stranger. Conclusion: Analysis of the experiences shared by the women in this study revealed that being with an older loved one during delirium was a profound experience; one distressingly dominated by the sudden absence of their familiar loved one. It reveals that reaching beyond insights into delirium as a condition to understand its existential meaning for family members of older people offers health care staff the opportunity to better appreciate another person’s point of view, to respond with compassion, provide meaningful support and appropriately include family members in their older loved one’s care.
Social Psychiatry and Psychiatric Epidemiology, 2003
Combining qualitative methods alongside randomised controlled trials in the health field has been... more Combining qualitative methods alongside randomised controlled trials in the health field has been advocated but has only been used rarely in mental health services research. The aim of this study was to illuminate patients' understanding of the nature and purpose and outcomes of a trial designed to improve the management of neuroleptic medication. Qualitative interviews were carried out with a group of patients participating in a trial comparing a psycho-educational and therapeutic alliance intervention in managing anti-psychotic medication. Our findings highlighted aspects of the experience, process and outcome of the trial, which remain latent in the quantitative assessment. The issue of enlarged selfefficacy emerging when patients were involved in communications with professionals in the trial was important. Whilst the participants provided positive feedback about their involvement in the trial, they struggled to recall the details of the intervention to which they had been exposed. Patients did not readily identify the content and concepts characterising each condition; rather they prioritised the opportunity for communication and contact with the researchers. Qualitative research accompanying trials illuminates and adds to the quantitative outcomes. The key to interpreting participants' accounts of the process and outcomes of this trial suggests the need to give greater emphasis to participants' past and current experience of service contact.
Experiments were performed on the freshwater amphipod Paramelita nigroculus to determine the rout... more Experiments were performed on the freshwater amphipod Paramelita nigroculus to determine the route of uptake for Al, Cu and Mn. The extent of correlation between the concentrations of Al, Cu and Mn and those of macro-cations Na, Ca and Mg was investigated in order to determine appropriate strategies of water quality management. Indeed, active uptake of toxicants can be controlled
The influence of different antecedent conditions on hydrochemical response during storm events wa... more The influence of different antecedent conditions on hydrochemical response during storm events was investigated in a small, south-western Cape mountain catchment. Winter and summer storms (four in total) were sampled both before and after the catchment was deliberately burnt. During winter storms, discharge responded rapidly to rainfall, and direct runoff represented the major component of streamflow. Marked lags were observed
... 37 The major ion chemistry of some southern African saline systems JA Day Freshwater Research... more ... 37 The major ion chemistry of some southern African saline systems JA Day Freshwater Research Unit, Zoology Dept, University of Cape Town, Rondebosch 7700, South Africa Key woyds: Southern Africa, Namib Desert, hydrochemistry, saline waters, major ions Abstract ...
The study presented in this thesis provides a description and interpretation of the experiences o... more The study presented in this thesis provides a description and interpretation of the experiences of family members during their older loved one’s delirium. Fourteen women, aged 51 to 74 years, participated in the study and, over an interview period of nineteen months, described their experiences. These twelve daughters and two wives supported and cared for their loved one at home, in residential aged care and/or while hospitalised. The approach used to explore the women’s experiences was existential phenomenology, informed by the philosophies of Sartre and Merleau-Ponty. Changing family portraits: Sudden existential absence during delirium depicts the women’s experiences during their older loved one’s delirium. Existential absence for these women was experienced as the sudden absence of their familiar older loved one and the arrival of a stranger. The meaning of existential absence is further represented by the theme Living the fragility of a loved one’s presence and the sub-themes F...
To examine qualitative research findings about family experiences of absence or loss during older... more To examine qualitative research findings about family experiences of absence or loss during older person delirium, and provide a critical discussion of the similarities and differences in these experiences with conceptual understandings of absence and loss. Families who care for older people with chronic illnesses experience many losses. However, the nondeath loss experiences of family during an older loved one's delirium, an acute condition accompanied by marked changes in demeanour, have received little consideration. Discursive position paper. The findings from two qualitative research studies about family experiences during an older loved one's delirium are discussed in relation to the concepts of absence and nondeath loss. The uncharacteristic behaviours and cognitive changes that accompany delirium may estrange family who, despite the older person's corporeal presence, sense the profound absence or loss of their loved one. Although the notion of absence, a nondeath loss, is similar to the experiences of family of people with chronic conditions, there are differences that distinguish these encounters. The similarities and differences between absence during delirium and the concepts of psychological absence, nonfinite loss and psychosocial death are discussed. Psychosocial death, reversibility/irreversibility and partial marked change, are suggested as conceptual descriptions for the absence families experience during an older loved one's delirium. The sense of absence or loss that family may experience during their older loved one's delirium needs to be recognised, understood and addressed by healthcare staff. Understanding or appreciating conceptualisations of absence, as a nondeath loss, may enhance understandings of family member needs during delirium and enable better support strategies. Conceptualisations of absence enhance understandings of family distress and needs during their older loved one's delirium. The potential for family members to experience their loved one's absence during delirium, a nondeath loss, needs to be considered by healthcare staff. Family experiences of absence during delirium need to be recognised by healthcare staff, acknowledged as a potential source of distress, and considered when involving family in the older person's care. Nurses are ideally placed to respond compassionately and provide appropriate family member re-assurance, support and information during delirium. Information should include possible impacts on family and coping strategies.
ABSTRACT Abstract: The experiences of family members may be missed, ignored and/or undervalued by... more ABSTRACT Abstract: The experiences of family members may be missed, ignored and/or undervalued by healthcare staff when older people are unwell. Within the ‘busyness’ and complexity of residential aged care and hospital care environments, family members of older people may not be asked about their issues, concerns or their loved ones changed demeanour. In a recent phenomenological study of the experiences of family members during their older loved one’s delirium, participants (n=14 women) revealed the need for compassion and understanding from healthcare staff. The women described their relationship with healthcare staff as contradictory; finding themselves both On the Fringe and Centre Stage during their loved one’s care. They were dismissed by staff and at times belittled by them, and yet they were responsible for helping the staff to care for their distressed loved one during delirium. The women in this study felt isolated, deeply troubled and frustrated by their relationship with staff rather than being reassured and relieved about their loved one’s care. These findings point to an opportunity for healthcare staff to respond to family members with compassion and to care about their well-being. Often the best care healthcare staff can offer is an understanding of the impact of an older person’s condition and its treatment on family member’s so they can be supported, acknowledged as an important part of the older person’s care, and understood as human beings.
ABSTRACT Title: Experiencing a loved one’s sudden absence during delirium: The perspectives of fa... more ABSTRACT Title: Experiencing a loved one’s sudden absence during delirium: The perspectives of family members of older people. Authors: DAY Jenny, Lecturer, University of Newcastle HIGGINS Isabel, Professor Older Person Care, University of Newcastle Aim: This presentation describes the main finding of an Australian phenomenological study which aimed to increase understanding of the experiences of family members during their older loved one’s delirium. Method: The approach used to explore family member experiences was existential phenomenology, informed by the philosophies of Sartre and Merleau-Ponty. Fourteen women, aged 51 to 74 years, participated and, over time, described their experiences during in-depth interviews. These twelve daughters and two wives supported and cared for their older loved one at home, in residential aged care and/or while hospitalised. Findings: Changing family portraits: Sudden existential absence during delirium depicts the essence of the women’s experiences in this study. The notion of existential absence describes how the women suddenly lost the familiar and taken-for-granted presence of their older loved one, and experienced the presence of a stranger. Conclusion: Analysis of the experiences shared by the women in this study revealed that being with an older loved one during delirium was a profound experience; one distressingly dominated by the sudden absence of their familiar loved one. It reveals that reaching beyond insights into delirium as a condition to understand its existential meaning for family members of older people offers health care staff the opportunity to better appreciate another person’s point of view, to respond with compassion, provide meaningful support and appropriately include family members in their older loved one’s care.
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