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Harris, C., Crozier, I., Smyth, J., Elliot, J., Watson, P. B., Sands, J., et al. (2007). An audit of percutaneous coronary intervention (PCI) patients representing acutely with chest pain within six months of PCI.
Abstract: This reports an audit of the assessment practices at Christchurch Hospital, compared to international guidelines. The clinical notes of all patients who were re- admitted acutely with chest pain within six months of PCI procedures performed between 1/4/05 and 30/9/05 were audited. Ethics approval was granted and an audit tool was designed based on the 2000 ACC/AHA Guidelines for the management of patients with unstable angina. The purpose of the audit was to determine to what extent best practice guidelines were followed in the assessment of patients re-admitted with chest pain and to determine if there were any indicators (lesional, procedural or risk factors for restenosis) that predicted a normal or abnormal repeat coronary angiogram. 448 consecutive patients had PCI procedures, 36 patients represented acutely with chest pain and had repeat coronary angiography. In 18 patients the coronary angiogram was unchanged, 11 patients demonstrated instent restenosis, one patient demonstrated thrombus and six patients developed new lesions. The authors concluded that at Christchurch Hospital assessment practices are consistent with international guidelines. Of the patients who had repeat angiography, 50% had no coronary obstruction for the cause of pain. There was a relatively low incidence of acute representation with chest pain. These results suggest a revision of the guidelines for repeat angiography following PCI is warranted.
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Watson, P. B. (1998). An understanding of family in the context of families facing the diagnosis of childhood cancer. Ph.D. thesis, , .
Abstract: The diagnosis of childhood cancer has a profound impact on the family. How nurses understand family affects their practice with families facing the diagnosis of childhood cancerShaped by Heideggerian phenomenology, van Manens methodology for hermeneutic phenomenology was used to construct an understanding of family from the experiences of family members facing the diagnosis of childhood cancer. Seven family members from two families, one mother, two fathers, two siblings, and two grandparents were interviewed about their experience of facing the diagnosis of childhood cancer.From the participants experience the meaning of family was interpreted as being-with-others, for-the-sake-of-others, who one might not distinguish from oneself. This understanding of family is recognisable, yet different from traditional definitions of family and may help nurses and family members to act more thoughtfully and tactfully with each other
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Watson, P. B. (1997). Evaluation of a self management plan for chronic obstructive pulmonary disease (Vol. 10). Ph.D. thesis, , .
Abstract: We hypothesized that the use of an Action Plan might assist self management for patients with chronic obstructive pulmonary disease (COPD).A pilot process and randomized, controlled study were undertaken to evaluate an action plan that provided advice on management of usual care and exacerbations, together with a booklet on self management. Fifty six subjects with COPD recruited through general practitioners (GPs) completed the six month study, 27 in the control group and 29 in the intervention group. The control group received usual care from their GP and the intervention group received a booklet and Action Plan from their practice nurse plus a supply of prednisone and antibiotic from their GP.The two groups were demographically similar with a mean age of 68 yrs. The resources were well received by GPs, practice nurses and the intervention group subjects. After six months there were no differences in quality of life scores or pulmonary function. There were significant changes in self management behaviour in the intervention group compared to controls. In response to seterioting symptoms, 34 versus7% (p= 0.014) initiated prednisone treatment and 44 versus 7 % (p=0.002 initiated antibiotics.Subjects in the intervention group readily adopted self management skills but did not shpw any difference in quality of life or lung function parameters. A larger prospective controlled clinical trial of this approach is warranted
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Watson, P. B. (1994). A study of cardiac inpatient participation in Canterbury Health's cardiac rehabilitation programme. Ph.D. thesis, , .
Abstract: A telephone survey was conducted with 61 randomly selected patients who had been admitted to the cardiology service with an Myocardial infarction but did not attend the cardiac rehabilitation programme. Findings show that many patients who would benefit from cardiac rehabilitation are denied access because it is only open to patients who have Myocardial Infarctions. Only a small percentage of MI admissions attend rehabilitation the main reason being patients are not informed the service is available. Women are under represented among rehabilitation participants and lack of transport is a major factor inhibiting women from attending. Improvements in referral systems and follow up are recommended
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Watson, P. B. (1990). Care or control questions and answers for psychiatric nursing practice (Vol. 6). Ph.D. thesis, , .
Abstract: An existential phenomenological approach is used to study the experience of six adults hospitalised with acute mental illness which they considered contribute to the stress of, or coping with mental illness. The phenomenological research methods used is described. The analysis of the data reveals that consumers of acute mental health care view being controlled as contributing to the stress of mental illness, and caring as contributing to them coping with mental illness. The implications of these findings for nursing practice and further research are discussed
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Watson, P. B., & Feld, A. (1996). Factors in stress and burnout among paediatric nurses in a general hospital. Nursing Praxis in New Zealand, 11(3), 38–46.
Abstract: High stress and staff turnover in a multi-specialty paediatric area prompted this study that aimed to :1) measure the burnout level of nurses in a multi-specialty paediatric area2) identify and validate causes of stress3) identify new ways of preventing stress on the wardFifty four percent (n=14) of the paediatric nurses completed the questionnaire booklet that included demographic data, the Maslach Burnout Inventory, the Nursing Situations Questionnaire the Hopkins Symptom Checklist-21 the Ways of Coping Checklist and open ended questions about sources of stress and satisfaction at work. Results indicated levelsof burnout and distress comparable with larger studies. Conflict with doctors was the major source of stress followed by workload, inadequate preparation in dealing with the emotional needs of patients and their families and death and dying. Conflict with doctors has not previously been identified as the major source of stress. However workload and death and dying are commonly identified as sources in the literature. Suggestions for further research and the low response rate are discussed
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