The purpose of this study was to determine the impact of stroke on survivors of the condition and to identify their physical and psychosocial needs in rural and regional settings. Data were collected via focus group interviews with stroke survivors, carers and key informants. Data were managed using NUD*IST and analysed using a content analysis method identifying major themes related to the impact of living in the community after having a stroke. It was found that stroke survivors suffered severe physical and emotional effects. The findings also identified the vulnerability of this group and a lack of organised, on-going psychosocial and rehabilitative support. Recommendations are made to enhance the current management of stroke after the acute and subacute phases.
A study exploring older people's participation in their care in acute hospital settings reveals both consumers' and nurses' views of participation. Using a critical ethnographic design, data were collected through participant observation and interviews from consumers in acute care settings who were over 70 years old and nurses who were caring from them. Thematic analysis identified that older people equated participation with being independent. Importantly, consumers highlighted the complexity of the notion of participation when describing situations where they were unable to participate in their own care. The difficulties in communicating with health professionals and an inability to administer their own medications in inpatient settings were identified as barriers to participation. Understanding what consumers believe participation means provides a starting point for developing meaningful partnerships between health professionals and people receiving care.
This paper will examine and discuss some of the strengths and weaknesses of conceiving nursing as a form of praxis, encompassing within this, the idea that in order to conceive nursing as a form of praxis, reflection has to be considered a key component. It will be argued that praxis can (and should) become a practical process and that, when applied to one's own nursing practice, changes, reshapes and allows one to discover new meanings (or, draws out the meanings which were always there). Clearly there are many different forms, understandings and applications of the term praxis and this paper will examine some of the tensions and the nexus that exist. These claims will be supported by using personal-professional journal extracts as a catalyst, showing that there is potential for closing the theory-practice gap through more in-depth reflection, and that this examination using reflective techniques will demonstrate that nurses, by using this process develop their own implicit personal nursing theories. Using one's colleagues as a critical resource allows what might be described as ongoing reflection to occur, where critical friends in both theoretical and practice worlds act as a dialectical catalyst for growth and change, moving toward closing the theory-practice gap.
Nurses live and work in complex practice worlds; worlds of shrinking resources and expanding needs. Reflection through journaling offers unique opportunities to gain insight into practice. What might we learn from one's journal? A reflective journal can be a source of interplay between the self as written and the self as other. Likewise, the journal may act to situate ourselves in practice, while at the same time enabling us to illuminate how and in what ways our understandings have become distorted. The extent to which one's journal is educative depends upon the manner in which one chooses to use it as a transformative tool, a tool that might well be described as a process of healing and enlightenment. In order to illustrate the reflexive nature of journaling, this paper is presented as a play reading, where a conversation about practice stories between the different aspects of the nurse's self is depicted. In adopting a play reading, an alternative pedagogical tool is used to illustrate different methodologies exemplifying the emergence of how and in what ways we develop and reconstruct our understanding in nursing.
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