Phenomenography: a qualitative research approach for exploring understanding in health care.

Phenomenography is a little-known qualitative research approach that has potential for health care research, particularly when people's understanding of their experience is the goal. Phenomenography is explained as a qualitative, nondualistic research approach that identifies and retains the discourse of research participants. This article seeks to present the major assumptions associated with phenomenographic research. An example of the way in which research outcomes are presented is included to emphasize its distinctiveness. It is noted that phenomenography has potential in the area of qualitative health research and will benefit from ongoing development and application.

Evaluation of a self-paced education package on violence against women for rural community-based health workers.

There are no reported education programs specifically focusing on the needs of rural health workers in the area of violence against women. The most commonly reported contact sought by women experiencing injuries and health problems associated with violence and abuse is with health workers. Women report a failure by health workers to make direct enquires, which may be due to their lack of education and confidence in responding to these issues. A convenience sample of 60 community-based rural health workers from a range of occupations and settings within the Wide Bay Health Region, Queensland, participated in the evaluation of a self-paced, distance education package on violence against women. The package contained seven modules. These included written and audio tape material, and activities that together formed a community development approach to addressing the needs in the participants' local community. Participants were given a mentor and teleconference support during the 8 weeks allocated to complete the package. A pre- and post-course evaluation, containing quantitative and qualitative data, was completed. Analysis of the quantitative data identified significant changes in participants' knowledge, and the qualitative data highlighted an increased sense of confidence in assisting women, forming support networks and using resources more effectively. Participants reported the most useful aspects of the package were: (i) modular- and user-friendly format; (ii) flexible, practical, health-focused content; and (iii) real world examples.

Violence against women: an education program for rural community health workers.

This study aimed to identify the educational needs of community-based rural health professionals regarding violence against women, and was funded under the Rural Health Support, Education and Training (RHSET) program. Focus groups and teleconferences were conducted with health workers, organisations and key individuals in the Wide Bay Region, Queensland, Australia. As a result, an education package has been designed that will provide specific training in violence against women for rural and remote health professionals working in the field. Rural health community workers identified the need to enhance their intervention skills and understanding on the issue of violence against women. A distance education framework based on adult and guided learning principles has been developed to meet this need. Six areas were identified as important learning needs and included: (i) violence against women as a public health concern; (ii) The role of the community health worker; (iii) How the community health worker can empower women experiencing violence in their lives; (iv) Enhancing and developing supportive networks; (v) Building on community development action; and (vi) 'Where to next' for community health workers.

Community health workers' response to violence against women.

This paper reports on a qualitative study of community health workers from a predominantly rural based region in Queensland. The purpose of this study was to determine the community health worker barriers to identification, assessment and intervention on the issue of violence against women. The qualitative research method comprised five structured focus group interviews with 28 community health workers using open-ended questions to explore their perceptions. Analysis of the focus group data revealed that community health workers expressed reluctance to become involved in cases of violence against women. The reasons they provided are grouped under three main themes: barriers to identification; barriers to assessment; and barriers to intervention. Training programs offered to rural community health workers need to be aware of the barriers to identifying, assessing and intervening in cases of violence against women that are highlighted by this study. Further studies are needed to assess the wider relevance of these findings to other groups of community health workers in rural and non-rural settings.

Ventilator circuitry in neonatal intensive care: extending the period between changes from 4 to 7 days. A pilot study.

OBJECTIVE: To determine the effect of increasing the time span between changes of disposable ventilator tubing from 4 to 7 days. DESIGN: A prospective non-randomised study comparing levels of bacterial colonisation amongst babies who had ventilator circuits changed on either the 4th or 7th day. Data was collected sequentially with data collection from the '4-day group' preceding data collection from the '7-day group'. SETTING: A tertiary neonatal intensive care nursery. PATIENTS: All babies requiring ventilation at the time when data collection was possible. Ten babies were included in the first group (4 days) and 33 babies in the second group. INTERVENTIONS: Inspiratory and expiratory lines were swabbed and water from the humidifier trap sampled before the line was changed at either 4 or 7 days. Results of routine endotracheal aspirates, taken before and after the change of circuitry, were noted. MAIN OUTCOME MEASURE: The level of bacterial contamination of ventilator circuits. RESULTS AND CONCLUSIONS: In this small sample, no differences were found in terms of bacterial colonisation of ventilator lines. This has resulted in a change of practice in the hospital and a cost saving of over $15,000.

Cardiac monitoring in the neonatal intensive care unit: an evaluation of electrodes.

Two types of electrodes were evaluated over a six-week period in a neonatal intensive care nursery. Babies requiring monitoring were alternately assigned to either of two groups: Klear-Trace (n = 37) or Sentry (n = 51). Nursing staff monitored a range of variables daily. Klear-Trace electrodes, although slightly more expensive, lasted significantly longer than Sentry electrodes (p > .0001). Factors such as incubator temperature and the weight of the neonate did not affect results, nor was there any difference in the frequency of repositioning electrodes between the two products. Because Klear-Trace electrodes last three times as long as Sentry electrodes (six days as opposed to two days), there may be cost advantages in using Klear-Trace electrodes.