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Article ; Online: A Heideggerian analysis of good care in an acute hospital setting: Insights from healthcare workers, patients and families.

Dewar, Jan / Cook, Catherine / Smythe, Elizabeth / Spence, Deborah

2023 Volume 30, Issue 4, Page(s) e12561

Abstract: This study articulates the relational constituents of good care beyond techno-rational competence. Neoliberal healthcare means that notions of care are readily commodified and reduced to quantifiable assessments and checklists. This novel research ... ...

Abstract	This study articulates the relational constituents of good care beyond techno-rational competence. Neoliberal healthcare means that notions of care are readily commodified and reduced to quantifiable assessments and checklists. This novel research investigated accounts of good care provided by nursing, medical, allied and auxiliary staff. The Heideggerian phenomenological study was undertaken in acute medical-surgical wards, investigating the contextual, communicative nature of care. The study involved interviews with 17 participants: 3 previous patients, 3 family members and 11 staff. Data were analysed iteratively, dwelling with stories and writing and rewriting to surface the phenomenality of good care. The data set highlighted the following essential constituents: authentic care: caring encompassing solicitude (fürsorge); impromptu care: caring beyond role category; sustained care: caring beyond specialist parameters; attuned care: caring encompassing family and culture; and insightful care: caring beyond assessment and diagnosis. The findings are clinically significant because they indicate the importance of nurse leaders and educators harnessing the potential capacity of all healthcare workers to participate in good care. Healthcare workers reported that participating in or witnessing good care was uplifting and added meaning to their work, contributing to a sense of shared humanity.
Language	English
Publishing date	2023-05-17
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1483798-5
ISSN	1440-1800 ; 1320-7881
ISSN (online)	1440-1800
ISSN	1320-7881
DOI	10.1111/nin.12561
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Article ; Online: An analysis of time conceptualisations and good care in an acute hospital setting.

Dewar, Jan / Cook, Catherine / Smythe, Elizabeth / Spence, Deborah

Nursing inquiry

2023 Volume 31, Issue 2, Page(s) e12613

Abstract: This study articulates the relationship between conceptualisations of time and the accounts of good care in an acute setting. Neoliberal healthcare services, with their focus on efficiencies, predominantly calculate quality care based on time-on-the- ... ...

Abstract	This study articulates the relationship between conceptualisations of time and the accounts of good care in an acute setting. Neoliberal healthcare services, with their focus on efficiencies, predominantly calculate quality care based on time-on-the-clock workforce management planning systems. However, the ways staff conceptualise and then relate to diverse meanings of time have implications for good care and for staff morale. This phenomenological study was undertaken in acute medical-surgical wards, investigating the contextual, temporal nature of care embedded in human relations. The study interviews involved 17 participants: 11 staff, 3 previous patients and 3 family members. Data were analysed iteratively to surface the phenomenality of temporality and good care. The following constituents of the data set are explored that together illustrate the relationship between the conceptualisations of time and the accounts of good care in an acute setting: patient time as a relational journey; patient time, sovereign time and time ethics and time, teamwork and flow. The findings are clinically significant because they offer a contrasting narrative about the relationship between time and care quality. The experiences of giving and receiving good care are indivisible from how temporality is experienced and the social relations within which care is embedded. Healthcare staff experience temporality differently from patients and families, a point that healthcare participants in this study appeared to comprehend and accommodate. For all parties involved in providing care or being the recipient of care, however, the capacity to be present was valued as a humanising ethic of care. Our study reinforces the importance of not creating presumptive binaries about which temporal structures are more or less humanising-there is a place for a fast-paced tempo, which can be experienced as being in the flow of human relations with one's team and on behalf of patients.
MeSH term(s)	Humans ; Concept Formation ; Qualitative Research ; Family ; Quality of Health Care ; Hospitals
Language	English
Publishing date	2023-11-05
Publishing country	Australia
Document type	Journal Article
ZDB-ID	1483798-5
ISSN	1440-1800 ; 1320-7881
ISSN (online)	1440-1800
ISSN	1320-7881
DOI	10.1111/nin.12613
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Evaluation of a Remote Symptom Assessment and Management (SAM) System for People Receiving Adjuvant Chemotherapy for Breast or Colorectal Cancer: Mixed Methods Study.

Whitehead, Lisa / Emery, Laura / Kirk, Deborah / Twigg, Diane / Brown, Deborah / Dewar, Joanna

JMIR cancer

2020 Volume 6, Issue 2, Page(s) e22825

Abstract: Background: The Symptom Assessment and Management (SAM) program is a structured, online, nurse-supported intervention to support symptom self-management in people receiving adjuvant chemotherapy post surgery for breast or colorectal cancer.: Objective! ...

Abstract	Background: The Symptom Assessment and Management (SAM) program is a structured, online, nurse-supported intervention to support symptom self-management in people receiving adjuvant chemotherapy post surgery for breast or colorectal cancer. Objective: The objective of this study was to describe the development, implementation strategy, and evaluation of the SAM system. Methods: The development of the SAM program involved 3 phases. In phase 1, the web app was developed through consultation with consumers and clinicians and of the literature to ensure that the system was evidence-based and reflected the realities of receiving treatment and supporting patients through treatment. In phase 2, 7 participants recorded the severity of 6 symptoms daily over the course of 1 cycle of chemotherapy. In phase 3, 17 participants recorded their symptoms daily over the course of 3 cycles of chemotherapy. Once symptoms were recorded, participants received immediate feedback on the severity of their symptoms and self-management recommendations, which could include seeking immediate medical attention. Data on quality of life, symptom burden, anxiety and depression, distress, and self-efficacy were collected during treatment; participants' perceptions of the SAM program were evaluated following participation via interview. Results: The outcomes of the SAM project include the development of a system that is reliable and easy to use and navigate. Participants reported benefits related to using the SAM program that included feeling more in control of managing their symptoms and feeling reassured. Engagement with the system on a daily basis was variable, with some participants completing the symptom tracker daily and others engaging some of the time. The feedback from all participants was that the system was easy to navigate and the information was relevant and supportive. Conclusions: The SAM program has the potential to enhance the management of symptoms for people receiving chemotherapy treatment. The system creates an accurate repository of symptoms that can be accessed easily and highlight patterns in symptom experience. These can be shared with clinicians, with patient permission, to inform and support treatment plans. The potential to predict the risk of developing severe symptoms can be developed to anticipate the need for care and support. Further considerations on how to increase engagement with the system, the value of the system for people diagnosed with other tumor types and treatment regimes, and the incorporation of the system into everyday clinical practice are needed.
Language	English
Publishing date	2020-12-07
Publishing country	Canada
Document type	Journal Article
ISSN	2369-1999
ISSN	2369-1999
DOI	10.2196/22825
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Impact of stroke co-morbidities on cortical collateral flow following ischaemic stroke.

Biose, Ifechukwude J / Dewar, Deborah / Macrae, I Mhairi / McCabe, Christopher

Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism

2019 Volume 40, Issue 5, Page(s) 978–990

Abstract: Acute hyperglycaemia and chronic hypertension worsen stroke outcome but their impact on collateral perfusion, a determinant of penumbral life span, is poorly understood. Laser-speckle contrast imaging (LSCI) was used to determine the influence of these ... ...

Abstract	Acute hyperglycaemia and chronic hypertension worsen stroke outcome but their impact on collateral perfusion, a determinant of penumbral life span, is poorly understood. Laser-speckle contrast imaging (LSCI) was used to determine the influence of these stroke comorbidities on cortical perfusion after permanent middle cerebral artery occlusion (pMCAO) in spontaneously hypertensive stroke prone rats (SHRSP) and normotensive Wistar rats. Four independent studies were conducted. In animals without pMCAO, cortical perfusion remained stable over 180 min. Following pMCAO, cortical perfusion was markedly reduced at 30 min then gradually increased, via cortical collaterals, over the subsequent 3.5 h. In the contralateral non-ischaemic hemisphere, perfusion did not change over time. Acute hyperglycaemia (in normotensive Wistar) and chronic hypertension (SHRSP) attenuated the restoration of cortical perfusion after pMCAO. Inhaled nitric oxide did not influence cortical perfusion in SHRSP following pMCAO. Thus, hyperglycaemia at the time of arterial occlusion or pre-existing hypertension impaired the dynamic recruitment of cortical collaterals after pMCAO. The impairment of collateral recruitment may contribute to the detrimental effects these comorbidities have on stroke outcome.
MeSH term(s)	Animals ; Brain/blood supply ; Cerebrovascular Circulation/physiology ; Collateral Circulation/physiology ; Comorbidity ; Hyperglycemia/physiopathology ; Hypertension/physiopathology ; Infarction, Middle Cerebral Artery/physiopathology ; Male ; Rats ; Rats, Inbred SHR ; Rats, Wistar
Language	English
Publishing date	2019-06-24
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	604628-9
ISSN	1559-7016 ; 0271-678X
ISSN (online)	1559-7016
ISSN	0271-678X
DOI	10.1177/0271678X19858532
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Correction: Is Remodelling of Corticospinal Tract Terminations Originating in the Intact Hemisphere Associated with Recovery following Transient Ischaemic Stroke in the Rat?

Mitchell, Emma J / Dewar, Deborah / Maxwell, David J

PloS one

2016 Volume 11, Issue 5, Page(s) e0155665

Abstract: This corrects the article DOI: 10.1371/journal.pone.0152176.]. ...

Abstract	[This corrects the article DOI: 10.1371/journal.pone.0152176.].
Language	English
Publishing date	2016
Publishing country	United States
Document type	Published Erratum
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0155665
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Protecting children from smoking in the home: an ethics of care perspective.

Rowa-Dewar, Neneh / Ritchie, Deborah

British journal of community nursing

2014 Volume 19, Issue 5, Page(s) 214, 216–8

Abstract: Community nurses are uniquely placed to help protect child health by facilitating the creation of smoke-free homes. However, there are a number of perceived barriers that may concern community nurses in their role of supporting parents in the creation of ...

Abstract	Community nurses are uniquely placed to help protect child health by facilitating the creation of smoke-free homes. However, there are a number of perceived barriers that may concern community nurses in their role of supporting parents in the creation of smoke-free homes, particularly those faced by disadvantaged parents. Arguments against intervening within the private domain of the home focus on concerns about protecting parents' autonomy to smoke within their own home and the potential for stigmatising parents who smoke, particularly mothers. Drawing on an ethics of care perspective, the authors propose an alternative perspective to the intervention in private settings. An ethics of care perspective may help to justify and encourage parents and community nurses to work in partnership to create a healthy environment for children and decrease the likelihood of children becoming smokers in the future.
MeSH term(s)	Air Pollution, Indoor/prevention & control ; Child ; Child Welfare ; Child, Preschool ; Community Health Nursing ; Environmental Exposure/prevention & control ; Ethics, Nursing ; Health Status Disparities ; Housing ; Humans ; Infant ; Infant, Newborn ; Nurse's Role ; Socioeconomic Factors ; Tobacco Smoke Pollution/prevention & control
Chemical Substances	Tobacco Smoke Pollution
Language	English
Publishing date	2014-04-29
Publishing country	England
Document type	Journal Article
ZDB-ID	2146386-4
ISSN	1462-4753
ISSN	1462-4753
DOI	10.12968/bjcn.2014.19.5.214
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Zs.A 5888: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MG 36: Show issues
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Article ; Online: Is Remodelling of Corticospinal Tract Terminations Originating in the Intact Hemisphere Associated with Recovery following Transient Ischaemic Stroke in the Rat?

Mitchell, Emma J / Dewar, Deborah / Maxwell, David J

PloS one

2016 Volume 11, Issue 3, Page(s) e0152176

Abstract: Following large strokes that encompass the cerebral cortex, it has been suggested that the corticospinal tract originating from the non-ischaemic hemisphere reorganises its pattern of terminal arborisation within the spinal cord to compensate for loss of ...

Abstract	Following large strokes that encompass the cerebral cortex, it has been suggested that the corticospinal tract originating from the non-ischaemic hemisphere reorganises its pattern of terminal arborisation within the spinal cord to compensate for loss of function. However many strokes in humans predominantly affect subcortical structures with minimal involvement of the cerebral cortex. The aim of the present study was to determine whether remodelling of corticospinal terminals arising from the non-ischaemic hemisphere was associated with spontaneous recovery in rats with subcortical infarcts. Rats were subjected to transient middle cerebral artery occlusion or sham surgery and 28 days later, when animals exhibited functional recovery, cholera toxin b subunit was injected into the contralesional, intact forelimb motor cortex in order to anterogradely label terminals within cervical spinal cord segments. Infarcts were limited to subcortical structures and resulted in partial loss of corticospinal tract axons from the ischaemic hemisphere. Quantitative analysis revealed there was no significant difference in the numbers of terminals on the contralesional side of the spinal grey matter between ischaemic and sham rats. The results indicate that significant remodelling of the corticospinal tract from the non-ischaemic hemisphere is not associated with functional recovery in animals with subcortical infarcts.
MeSH term(s)	Animals ; Axons/pathology ; Disease Models, Animal ; Forelimb/physiopathology ; Gray Matter ; Humans ; Infarction, Middle Cerebral Artery ; Male ; Motor Cortex/physiopathology ; Nerve Regeneration ; Neuronal Plasticity ; Pyramidal Tracts/physiopathology ; Pyramidal Tracts/surgery ; Rats ; Recovery of Function ; Spinal Cord/physiopathology ; Spinal Cord/surgery ; Stroke/physiopathology ; Stroke/surgery
Language	English
Publishing date	2016-03-25
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0152176
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Correction

Emma J Mitchell / Deborah Dewar / David J Maxwell

PLoS ONE, Vol 11, Iss 5, p e

Is Remodelling of Corticospinal Tract Terminations Originating in the Intact Hemisphere Associated with Recovery following Transient Ischaemic Stroke in the Rat?

2016 Volume 0155665

Abstract: This corrects the article DOI:10.1371/journal.pone.0152176.]. ...

Abstract	[This corrects the article DOI:10.1371/journal.pone.0152176.].
Keywords	Medicine ; R ; Science ; Q
Language	English
Publishing date	2016-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Correction: Corticospinal and Reticulospinal Contacts on Cervical Commissural and Long Descending Propriospinal Neurons in the Adult Rat Spinal Cord; Evidence for Powerful Reticulospinal Connections.

Mitchell, Emma J / McCallum, Sarah / Dewar, Deborah / Maxwell, David J

PloS one

2016 Volume 11, Issue 5, Page(s) e0155664

Abstract: This corrects the article DOI: 10.1371/journal.pone.0152094.]. ...

Abstract	[This corrects the article DOI: 10.1371/journal.pone.0152094.].
Language	English
Publishing date	2016
Publishing country	United States
Document type	Published Erratum
ISSN	1932-6203
ISSN (online)	1932-6203
DOI	10.1371/journal.pone.0155664
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Is Remodelling of Corticospinal Tract Terminations Originating in the Intact Hemisphere Associated with Recovery following Transient Ischaemic Stroke in the Rat?

Emma J Mitchell / Deborah Dewar / David J Maxwell

PLoS ONE, Vol 11, Iss 3, p e

2016 Volume 0152176

Abstract	Following large strokes that encompass the cerebral cortex, it has been suggested that the corticospinal tract originating from the non-ischaemic hemisphere reorganises its pattern of terminal arborisation within the spinal cord to compensate for loss of function. However many strokes in humans predominantly affect subcortical structures with minimal involvement of the cerebral cortex. The aim of the present study was to determine whether remodelling of corticospinal terminals arising from the non-ischaemic hemisphere was associated with spontaneous recovery in rats with subcortical infarcts. Rats were subjected to transient middle cerebral artery occlusion or sham surgery and 28 days later, when animals exhibited functional recovery, cholera toxin b subunit was injected into the contralesional, intact forelimb motor cortex in order to anterogradely label terminals within cervical spinal cord segments. Infarcts were limited to subcortical structures and resulted in partial loss of corticospinal tract axons from the ischaemic hemisphere. Quantitative analysis revealed there was no significant difference in the numbers of terminals on the contralesional side of the spinal grey matter between ischaemic and sham rats. The results indicate that significant remodelling of the corticospinal tract from the non-ischaemic hemisphere is not associated with functional recovery in animals with subcortical infarcts.
Keywords	Medicine ; R ; Science ; Q
Subject code	616
Language	English
Publishing date	2016-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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