Synthesis in nursing knowledge: an analysis of two approaches

The need for synthesis in nursing knowledge development has been attested to by many authors. It is consistent with nursing's holistic focus and is the mark of a mature discipline. This paper examines two approaches to synthesis: the use of multiple paradigms and the possible emergence of a new paradigm based on chaos theory. It argues that in their current form both approaches have flaws and neither achieves synthesis as it is here defined. However, both may make significant contributions to the development of nursing knowledge.     

The evolution of palliative care and the relevance to residential aged care: Understanding the past to inform the future

Improving the experience of dying in residential aged care units became a significant project of the Australian Government’s National Palliative Care Program in 2004. This initiative resulted in an expectation that residential aged care facilities would adopt the recommended palliative approach to underpin service delivery. Recognising palliative care as a specialist area of health care practice is a recent development which has influenced the expectations of community and government. This paper traces the global history of palliative care and how historical factors influenced its development in Australia. This discussion presents an overview of the positioning of dying and death within society, explaining how with the shifting emphasis on care of the dying accordingly has been the focus on palliative care specialists. Care of the dying in residential aged care units has largely been overlooked in the context of specialist involvement. This paper acknowledges dying and death as occurring in residential aged care facilities, illuminating the advantages of adopting a palliative approach and offers recommendations.     

Towards an ontological theory of wellness: a discussion of conceptual foundations and implications for nursing

In this article a discussion of the phenomenon of wellness and its relevance to contemporary nursing practice is developed. Drawing on phenomenology, the research literature and the author's own wellness research, an exposition of the concept of wellness is presented. It is proposed that the experience of being well is lived as a continuity of time and that it involves both a taking-for-granted of the body and containment of the horizon of concern. The state of actually being well is also clarified and contrasted with the more common understanding of wellness as an optimal or future state. This discussion has significance for nursing knowledge development, in terms of our understanding of the experience of wellness and illness. It also has implications for how nurses approach their practice, particularly in the area of health promotion.     

Case study approach to removing physical restraint

The pathway to discarding the use of restraints on older people with a dementing illness is cluttered with misinformation. While exploring the reasons restraints are used as an intervention on an older person with a dementing illness, we find duty of care is an important aspect. This paper presents the process that occurred when an aged care facility used an education and consultation approach in an attempt to remove the need for physical and chemical restraint. This case involved the family of an older person with a dementing illness and staff of the aged care facility.