Journal Articles

Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915

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    Understanding ethical drift in professional decision making: dilemmas in practice
    (Informa UK Limited trading as Taylor & Francis Group, 2021-11-29) Bourke R; Pullen R; Mincher N
    Educational psychologists face challenging decisions around ethical dilemmas to uphold the rights of all children. Due to finite government resources for supporting all learners, one of the roles of educational psychologists is to apply for this funding on behalf of schools and children. Tensions can emerge when unintended ethical dilemmas arise through decisions that compromise their professional judgement. This paper presents the findings from an exploratory study around educational psychologists’ understandings and concerns around ethical dilemmas they faced within New Zealand over the past 5 years. The study set out to explore how educational psychologists manage the ethical conflicts and inner contradictions within their work. The findings suggest that such pressures could influence evidence-based practice in subtle ways when in the course of decision making, practitioners experienced some form of ethical drift. There is seldom one correct solution across similar situations. Although these practitioners experienced discomfort in their actions they rationalised their decisions based on external forces such as organisational demands or funding formulas. This illustrates the relational, contextual, organisational and personal influences on how and when ‘ethical drift’ occurs.
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    Transforming evidence: A discursive evaluation of narrative therapy case studies
    (The Australian Psychological Society Limited, 2007) Busch, Robbie
    A recent shift in American Psychological Association policy for what constitutes as evidence in psychotherapy has resulted in the inclusion of qualitative methodologies. Narrative therapy is a discursive therapy that is theoretically incongruent with the prevailing gold standard of experimental methodology in psychotherapy outcome evaluation. By using a discursive evaluation methodology that is congruent with narrative therapy this study of six peer-reviewed narrative therapy case articles found shifts in client positioning in the transformation from medical pathology discourses to strength-based discourses. It is concluded that five out of six case studies coherently demonstrated the effectiveness of narrative therapy with positive outcomes for clients and that a discursive evaluation has utility in producing a thick description of therapeutic outcome.
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    Understanding factors that contribute to variations in bronchiolitis management in acute care settings: a qualitative study in Australia and New Zealand using the Theoretical Domains Framework.
    (BioMed Central Limited, 1/05/2020) Haskell L; Tavender EJ; Wilson C; Babl FE; Oakley E; Sheridan N; Dalziel SR; Paediatric Research in Emergency Departments International Collaborative (PREDICT) nectwork, Australia
    BACKGROUND: Bronchiolitis is the most common reason for infants under one year of age to be hospitalised. Despite management being well defined with high quality evidence of no efficacy for salbutamol, adrenaline, glucocorticoids, antibiotics or chest x-rays, substantial variation in practice occurs. Understanding factors that influence practice variation is vital in order to tailor knowledge translation interventions to improve practice. This study explores factors influencing the uptake of five evidence-based guideline recommendations using the Theoretical Domains Framework. METHODS: Semi-structured interviews were undertaken with clinicians in emergency departments and paediatric inpatient areas across Australia and New Zealand exploring current practice, and factors that influence this, based on the Theoretical Domains Framework. Interview transcripts were coded using thematic content analysis. RESULTS: Between July and October 2016, 20 clinicians (12 doctors, 8 nurses) were interviewed. Most clinicians believed chest x-rays were not indicated and caused radiation exposure (beliefs about consequences). However, in practice their decisions were influenced by concerns about misdiagnosis, severity of illness, lack of experience (knowledge) and confidence in managing infants with bronchiolitis (skills), and parental pressure influencing practice (social influences). Some senior clinicians believed trialling salbutamol might be of benefit for some infants (beliefs about consequences) but others strongly discounted this, believing salbutamol to be ineffective, with high quality evidence supporting this (knowledge). Most were concerned about antibiotic resistance and did not believe in antibiotic use in infants with bronchiolitis (beliefs about consequences) but experienced pressure from parents to prescribe (social influences). Glucocorticoid use was generally believed to be of no benefit (knowledge) with concerns surrounding frequency of use in primary care, and parental pressure (social influences). Nurse's reinforced evidence-based management of bronchiolitis with junior clinicians (social/professional role and identity). Regular turnover of medical staff, a lack of 'paediatric confident' nurses and doctors, reduced senior medical coverage after hours, and time pressure in emergency departments were factors influencing practice (environmental context and resources). CONCLUSIONS: Factors influencing the management of infants with bronchiolitis in the acute care period were identified using the Theoretical Domains Framework. These factors will inform the development of tailored knowledge translation interventions.