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Professor Jane Stein-Parbury

Jane Stein-Parbury

Professor of Mental Health Nursing, Faculty of Health
Director, Mental Health Nursing Professorial Unit

RN, BSN (Pitt), MEd (Pitt), PhD (Adel)

Member, Australian College of Mental Health Nurses
Fellow, Royal College of Nursing, Australia

Email: Jane.Stein-Parbury@uts.edu.au
Phone: +61 2 9514 4846
Fax: +61 2 9514 4835
Room: CB10.07.207 (map)
Mailing address: PO Box 123, Broadway NSW 2007, Australia

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Biography

Director of the Mental Health Nursing Professorial Unit

Previously, Director of Research for the Faculty, Course Coordinator for the Bachelor of Nursing, Standing alternate Dean of the University Graduate School.

Professional

Advisory and consultancy activities
NSW Institute of Psychiatry, Standing Committee for Research (2009-present)
Review of National Accreditation Standards for Aged Care Residential Facilities, with Price Waterhouse Coopers, member of team (2010), Australian Department of Health and Ageing, A$259,000.
Chairperson (Vice-Chancellor’s appointment) of UTS Human Research Ethics Committee 2002- 2010 Research
Deputy Chair and Group Panel Member, National Health & Medical Research Council (NHMRC) project grants review (2009).
Group Panel Member, NHMRC project grants review (2011, 2008).
Australian Vice Chancellors’ Committee representative on the NHMRC working party to revise the national statement on the ethical conduct of research (2004-2007).
Editorial Review Board of Online Journal of Issues in Nursing. (1997-present)
Peer Reviewer for merican Journal of Critical Care, International Journal of Nursing Practice, Australian and New Zealand Journal of Psychiatry, Collegian, European Journal of Cardiovascular Nursing
Reviewer, NHMRC funding applications (2000-present)
Consultant to Nursing Executive at Prince Henry/ Prince of Wales Hospitals (Sydney) in developing leadership capacity (2000-2003), approximately A$10,000 in workshop fees.
Consultant to Reflective Practice Nursing Group at Royal North Shore Hospital (Sydney) in implementing practice change through reflection (2001-2003), pro bono Faculty work.
Consultant to Hope Health Care North, conducting reflective practice/clinical supervision sessions for nurses at Neringah and Greenwich Hospitals (2003-2004) A$13,210.00, contract continuing at Greenwich until 2007, A$25,740.

Teaching areas

Mental Health Nursing - Postgraduate
Health Care Relationship, Interactions and Management - Undergraduate and Postgraduate
Nursing Leadership - Postgraduate

Research

Research interests
Person-centred care in residential dementia care
Psychotropic medications in acute care
Resilience in chronic schizophrenia
Communication in the Emergency Department
Person-centred care in residential dementia care
Mental Health Inpatient Ward Structure and Patient Staff Conflict

Research supervision: Yes
Registered at Level 1

Jane is currently supervising 7 research degree students and have supervised to completion 5 doctorates and 3 master's degrees. In addition, have examined 7 theses.

Research areas
Mental Health Nursing
Interpersonal Communication
Aged and Extended Care
Ethnography

Projects

Publications

Books

Stein-Parbury, M.J. 2009, Patient & person: Interpersonal skills in nursing, 4th ed., Elsevier, Sydney, Australia.

Stein-Parbury, M.J. 2005, Patient & Person: Developing interpersonal skills in nursing, 3rd, Elsevier Australia, Sydney.

Stein-Parbury, M.J. 2004, Patient and Person: Empowering interpersonal relationships in nursing, Elsevier, London.

Book chapters

Stein-Parbury, M.J. 2010, 'Cognitive disorders (Chapter 17)' in Varcarolis, E; Jordan Halter, M (eds), Foundations of psychiatric mental health nursing: A clinical approach (6th ed), Elsevier, St Louis, United States, pp. 369-401.

Stein-Parbury, M.J. 2008, 'Communication for effective nursing' in Esther Chang & John Daly (eds), Transitions in Nursing, Elsevier/Churchill Livingstone, Sydney, pp. 163-179.

Journal articles

Jeon, Y., Luscombe, G., Chenoweth, L.L., Stein-Parbury, M.J., Brodaty, H., King, M.T. & Haas, M.R. 2012, 'Staff outcomes from the Caring for Aged Dementia Care REsident Study (CADRES): A cluster randomised trial', International Journal of Nursing Studies, vol. 49, no. 5, pp. 508-518.
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BACKGROUND: Dementia care mapping and person centred care are well-accepted as processes for improving care and well-being for persons with dementia living in the residential setting. However, the impact of dementia care mapping and person centred care on staff has not been well researched. OBJECTIVES: The impact of person centred care and dementia care mapping compared to each other and to usual dementia care on staff outcomes was examined in terms of staff burnout, general well-being, attitudes and reactions towards resident behavioural disturbances, perceived managerial support, and quality of care interactions. DESIGN: A cluster-randomised, controlled trial. SETTINGS: The study was conducted between 2005 and 2007 in 15 residential aged care sites in the Sydney metropolitan area, Australia, with comparable management structures, staffing mix and ratios, and standards of care. PARTICIPANTS: 194 consenting managers, nurses, therapists and nurse assistants working in the participating sites.

Smith, R., Fleming, R., Chenoweth, L.L., Jeon, Y., Stein-Parbury, M.J. & Brodaty, H. 2012, 'Validation Of The Environmental Audit Tool In Both Purpose-built And Non-purpose-built Dementia Care Settings', Australian Journal of Ageing, vol. 31, no. 3, pp. 159-163.
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Aim: To provide further validation of the Environmental Audit Tool (EAT) by describing data on scores from 56 facilities and comparing the scores of facilities with a purpose-built dementia environment with those with non-purpose-built designs. Methods:

Stein-Parbury, M.J., Gallagher, R.D., Chenoweth, L.L. & Luscombe, G. 2012, 'Factors associated with good self-management in older adults with a schizophrenic disorder compared with older adults with physical illnesses', Journal of Psychiatric and Mental Health Nursing, vol. 19, no. 2, pp. 146-153.
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The number of older people living with a schizophrenic disorder (SD) is increasing yet little attention paid has been paid to the needs of this population relative to people with other chronic illnesses. In order to achieve optimal functioning people with a SD need to manage their illness and its impact; therefore, this study set out to determine the factors associated with self-management in this population.

Stein-Parbury, M.J., Chenoweth, L.L., Jeon, Y., Brodaty, H., Haas, M.R. & Norman, R. 2012, 'Implementing person-centered care in residential dementia care', Clinical Gerontology, vol. 35, no. 5, pp. 404-424.
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This article provides a detailed overview of the PCC intervention arm of the study and describes the training and procedures used to facilitate implementation of PCC. Training emphasized the impact of the social world on the person with dementia and promoted the skills of interpersonal engagement, especially in relation to feeling expression. Facilitated on-site learning involved care planning that included obtaining a life story of the person with dementia and observing social interactions.

Chenoweth, L.L., King, M.T., Luscombe, G., Forbes, I., Jeon, Y., Stein-Parbury, M.J., Brodaty, H., Fleming, R. & Haas, M.R. 2011, 'PerCEN: Study Protocol of a Randomised Controlled Group Trial of Client and Care Outcomes in the Residential Dementia Care Setting', Worldviews on Evidence-Based Nursing, vol. 8, no. 3, pp. 153-165.
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Purpose: Literature suggests that quality of life (QOL), quality of care (QOC) and Behavioural and Psychological Symptoms of Dementia (BPSD) can be improved by relatively simple and inexpensive person-centred approaches to nursing care practices (PCC) and modifications to physical environment (PCE). Most research on this topic is observational and few randomised controlled trials have included an economic evaluation of PCC and PCE together. The PerCEN study aims to confirm the value of evidence-based nursing by evaluating the efficacy and cost effectiveness of implementing PCC and PCE in residential dementia care services. This article describes the PerCEN study protocol (ANZCTR 12608000095369).

Chenoweth, L.L., King, M.T., Luscombe, G., Forbes, I., Yun-Hee, J., Stein-Parbury, M.J., Brodaty, H., Fleming, R. & Haas, M.R. 2011, 'Study Protocol of a Randomised Controlled Group Trial of Client and Care Outcomes in the Residential Dementia Care Setting', Worldviews on Evidence-Based Nursing, vol. 8, no. 3, pp. 153-165.
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Literature suggests that quality of life (QOL), quality of care (QOC) and Behavioural and Psychological Symptoms of Dementia (BPSD) can be improved by relatively simple and inexpensive person-centred approaches to nursing care practices (PCC) and modifications to physical environment (PCE). Most research on this topic is observational and few randomised controlled trials have included an economic evaluation of PCC and PCE together. The PerCEN study aims to confirm the value of evidencebased nursing by evaluating the efficacy and cost effectiveness of implementing PCCand PCE in residential dementia care services. This article describes the PerCEN study protocol (ANZCTR 12608000095369).

Gallagher, R.D., Warwick, M.R., Chenoweth, L.L., Stein-Parbury, M.J. & Milton-Wildey, K.K. 2011, 'Medication knowledge, adherence, and associated factors in people with congestive heart failure and chronic obstructive pulmonary disease', Journal of Nursing and Healthcare of Chronic Illness, vol. 3, no. 1, pp. 30-40.
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Background. Although medicines are a key component in the self-management of chronic illness, lack of adherence is a common problem. Aim. To describe medication adherence and predictors in relation to the Multidimensional Adherence Model among older adults with chronic illness. Method. During a home interview, we collected data from 118 patients with chronic illnesses (chronic obstructive pulmonary disease and heart failure), following a recent illness exacerbation, to determine self-reported medication adherence, medication knowledge and capacity for self-management of their illness. We used the Medication Adherence Model as an organising framework and performed multivariate analyses to determine the independent predictors. We conducted the study between April 2005+June 2006. Results. Participants had an average age of 75À54 years (SD 8À38), with marginally more men (56À8%) than women, and were prescribed an average 4À68 (SD 2À11) medications for their primary diagnosis of either chronic obstructive pulmonary disease or heart failure. Most participants (75À2%) were adherent to their prescribed medicines; however, medication knowledge was low [mean score 47À61 (SD 18À73) out of a potential 100]. Predictors of better adherence to medicines were patient-related: female gender and higher self-management capacity, and condition-related: heart failure diagnosis. Socioeconomic and treatment-related factors were not identified as independent predictors of medication adherence. Predictors of better medication knowledge were higher capacity for self-management, more concurrent conditions, younger age and taking fewer medicines.

Smith, R., Fleming, R., Chenoweth, L.L., Jeon, Y., Stein-Parbury, M.J. & Brodaty, H. 2011, 'Validation of the Environmental Audit Tool in both purpose-built and non-purpose-built dementia care settings', Australian Journal of Ageing, vol. 31, no. 3, pp. 159-163.
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Aim: To provide further validation of the Environmental Audit Tool (EAT) by describing data on scores from 56 facilities and comparing the scores of facilities with a purpose-built dementia environment with those with non-purpose-built designs.

Thomson Mangnall, L.J., Gallagher, R.D. & Stein-Parbury, M.J. 2011, 'Postoperative Delirium in After Colorectal Surgery in Older Patients', American Journal Of Critical Care, vol. 20, no. 1, pp. 45-55.
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Background: Postoperative delirium in older patients results in worse outcomes and increased costs. The prevalence and predictors of postoperative delirium in patients undergoing major colorectal surgery are not clear. Objectives: To determine the prevalence and predictors of postoperative delirium in older patients after major colorectal surgery. Methods: Patients older than 50 years, without preexisting cognitive impairment, were recruited before surgery. These patients were assessed after surgery for delirium daily for 3 days by using the Confusion Assessment Method. Regression analysis was used to determine independent predictors of postoperative delirium. Results: Patients (n=118) had a mean age of 71.81 years, and approximately half were women (54%). Most participants (64%) were married, and comorbid conditions were common. Delirium developed in 35% of the patients in the 3 days after surgery and in 21% in the first 24 hours. New cases of delirium were identified on each of the 3 days after surgery, and a few patients (7%) had delirium for the entire 3 days. Odds for delirium in the first 24 hours were increased for patients who had early admission (odds ratio [OR]=4.48; P=.06) and decreased for patients who were married (OR=0.25; P=.01). Odds for delirium in the first 3 days after surgery were increased for men (OR=4.27; P=.02), older patients (OR=1.05; P=.04), and patients who stayed overnight in the critical care unit (OR=2.97; P=.06).

Gallagher, R.D., Donoghue, J.M., Chenoweth, L.L. & Stein-Parbury, M.J. 2010, 'Medication knowledge and assistance in older chronic heart failure patients', Circulation, vol. 116, no. 16 Supplement, pp. 633-634.
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Medication knowledge and assistance in older chronic heart failure (CHF) patients. Medication adherence is central to the optimal management of CHF. Little is known about older patients´+¢ knowledge of their medications or the factors that contribute to this knowledge. Aim: To describe and identify the predictors of medication knowledge in older CHF patients. Method: Subjects (n = 62) aged over 55 years with moderate heart failure (New York Heart Association Class II and III) who identified as self-managing were recruited from hospital or rehabilitation. Interviews occurred at home four weeks post-discharge using a medication checklist and the Self-Efficacy in Chronic Illness Scale (Lorig et al, 2001). Multiple regression analysis determined the predictors of medication knowledge. Results: Patients were aged mean 78.4 years (sd 8.54 years), mostly male (57%) and had an average 8 (median, range 3-22) medications to take daily, of which 6 (median, range 3-14) were for CHF. Most managed their own medications (54%) but more than a quarter (28%) were assisted by reminding, dispensing and supervision. Compliance with medications was high (84%), although only half (53%) knew the name, main purpose and side effect of their medications. Patients with better self-efficacy (B = 2.88) and no help with medication (B = -21.05) had better medication knowledge (model F = 13.6, p = .000, R = .61, r2 = .37). Conclusion: Older CHF patients have poor knowledge of their medications, which may be improved by promoting overall self-efficacy for disease management. Less knowledgeable patients received appropriate assistance with medications, but the consequence may be less knowledge and thus warrants further investigation.

Warwick, M.R., Gallagher, R.D., Chenoweth, L.L. & Stein-Parbury, M.J. 2010, 'Self-management and symptom monitoring among older adults with chronic obstructive pulmonary disease', Journal of Advanced Nursing, vol. 66, no. 4, pp. 784-793.
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To describe self-management, symptom monitoring and the associated influences among older adults with chronic obstructive pulmonary disease. Background. Optimal self-management and monitoring of key symptoms in patients with chronic obstructive pulmonary disease reduces dyspnoea and preventable hospitalizations. Method. A prospective, descriptive survey design was used and data collected from patients with moderate severity chronic obstructive pulmonary disease during home interviews between April 2005 and June 2006. Predictors of self-management and symptom monitoring were determined by linear regression analyses. Results. Patients+ ( n = 78) mean age was 73À37 years (sd 7À52); 55À1% were male and 66À7% were married. Most (92À3%) had concurrent illnesses, and 48À7% had been admitted to hospital for chronic obstructive pulmonary disease in the past 6 months. Self-management was good to very good, with poorer self-management predicted by lower self-efficacy (? = -0À21), a weaker sense of coherence (? = -0À03), and no hospitalization in the past 6 months (? = -05). Symptom monitoring was not ideal, with more than 20% of patients not monitoring any of the key symptoms. More frequent symptom monitoring occurred among participants who were married (? = 5.14) and had more severe disease (? = 0À79). Conclusion. As self-management and symptom monitoring ensure better outcomes among patients with chronic obstructive pulmonary disease, health professionals should encourage these behaviours. Involving partners, promoting self-efficacy and understanding of sense of coherence are helpful in this process.

Chenoweth, L.L., King, M.T., Jeon, Y., Brodaty, H., Stein-Parbury, M.J., Norman, R., Haas, M.R. & Luscombe, G. 2009, 'Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: A cluster-randomised trial', Lancet Neurology, vol. 8, no. 4, pp. 317-325.
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Background Evidence for improved outcomes for people with dementia through provision of person-centred care and dementia-care mapping is largely observational. We aimed to do a large, randomised comparison of person-centred care, dementia-care mapping, and usual care. Methods In a cluster randomised controlled trial, urban residential sites were randomly assigned to person-centred care, dementia-care mapping, or usual care. Carers received training and support in either intervention or continued usual care. Treatment allocation was masked to assessors. The primary outcome was agitation measured with the Cohen-Mansfield agitation inventory (CMAI). Secondary outcomes included psychiatric symptoms including hallucinations, neuropsychological status, quality of life, falls, and cost of treatment. Outcome measures were assessed before and directly after 4 months of intervention, and at 4 months of follow-up. Hierarchical linear models were used to test treatment and time effects. Analysis was by intention to treat. This trial is registered with the Australia and New Zealand Clinical Trials Registry, number ACTRN12608000084381. Findings 15 care sites with 289 residents were randomly assigned. Pairwise contrasts revealed that at follow-up, and relative to usual care, CMAI score was lower in sites providing mapping (mean difference 10À9, 95% CI 0À7+21À1; p=0À04) and person-centred care (13À6, 3À3+23À9; p=0À01). Compared with usual care, fewer falls were recorded in sites that used mapping (0À24, 0À08+0À40; p=0À02) but there were more falls with person-centred care (0À15, 0À02+0À28; p=0À03). There were no other significant effects. Interpretation Person-centred care and dementia-care mapping both seem to reduce agitation in people with dementia in residential care.

Brunero, S. & Stein-Parbury, M.J. 2008, 'The effectiveness of clinical supervision in nursing: An evidenced based literature review', Australian Journal of Advanced Nursing, vol. 25, no. 3, pp. 86-94.
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Clinical supervision (CS) is attracting attention in the Australian nursing context with efforts underway to embed CS into mental health settings and to extend it to the general nursing population. The purpose of this paper is to review the available evidence regarding the effectiveness of CS in nursing practice in order to inform these efforts.

Chenoweth, L.L., Gallagher, R.D., Sheriff, J.N., Donoghue, J.M. & Stein-Parbury, M.J. 2008, 'Factors Supporting Self-Management in Parkinson's Disease: Implications for Nursing Practice', International Journal of Older People Nursing, vol. 3, no. 3, pp. 187-193.
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To identify the factors associated with better self-management in people with moderate to high levels of Parkino's disease following an acute illness event. PD affects many dimensions of life, including threats to self-identity and confidence in self-management. The presence of informal support plays an important role in sustaining self-efficacy and sense of coherence nad self-management in persons with PD.

Gallagher, R.D., Donoghue, J.M., Chenoweth, L.L. & Stein-Parbury, M.J. 2008, 'Self-management in older patients with chronic illness', International journal of nursing practice, vol. 14, no. 5, pp. 373-382.
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Chronic illness causes the majority of disease burden and health costs in developed countries; however, this could be substantially reduced by optimal patient self-management. This study examined the levels of self-management in patients (n = 300) with chronic illness (chronic heart failure, chronic respiratory disease, Parkinson's disease and chronic schizophrenia) of moderate severity who had experienced an illness exacerbation in the last month. Patient's perceptions of self-efficacy in relation to their self-management and their sense of coherence were also assessed at baseline and 1 month later. No changes occurred in self-perceptions or self-management from baseline to follow-up. Patients at risk of poor self-management included people with low self-efficacy, poor sense of coherence, older age and a primary diagnosis of chronic schizophrenia. As self-efficacy is the only predictor known to be amenable to intervention, self-efficacy enhancing support should be promoted.

Slade, D.M., Scheeres, H.B., Manidis, M., Iedema, R.A., Dunston, R., Stein-Parbury, M.J., Matthiessen, C., Herkes, G. & McGregor, J. 2008, 'Emergency Communication: the discursive challenges facing emergency clinicians and patients in emergency departments', Discourse and Communication, vol. 2, no. 3, pp. 271-298.
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Effective communication and interpersonal skills have long been recognized as fundamental to the delivery of quality health care. However, there is mounting evidence that the pressures of communication in high stress work areas such as hospital emergency departments (EDs) present particular challenges to the delivery of quality care. A recent report on incident management in the Australian health care system (NSW Health, 2005a) cites the main cause of critical incidents (that is, adverse events such as an incorrect procedure leading to patient harm), as being poor and inadequate communication between clinicians and patients. This article presents research that describes and analyses spoken interactions between health care practitioners and patients in one ED of a large, public teaching hospital in Sydney, Australia. The research aimed to address the challenges and critical incidents caused by breakdowns in communication that occur between health practitioners and patients and by refining and extending knowledge of discourse structures, to identify ways in which health care practitioners can enhance their communicative practices thereby improving the quality of the patient journey through the ED. The research used a qualitative ethnographic approach combined with discourse analysis of audio-recorded interactions. Some key findings from the analysis of data are outlined including how the absence of information about processes, the pressure of time within the ED, divergent goals of clinicians and patients, the delivery of diagnoses and professional roles impact on patient experiences. Finally, the article presents an in-depth linguistic analysis on interpersonal and experiential patterns in the discursive practices of patients, nurses and doctors.

Stein-Parbury, M.J., Reid, K., Smith, N.F., Mouhanna, D. & Lamont, F. 2008, 'Use of pro re nata medications in acute inpatient care', Australian And New Zealand Journal Of Psychiatry, vol. 42, no. 4, pp. 283-292.
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Objectives: Available evidence suggests that the use of 'as needed' ( PRN; from the Latin pro re nata: for an occasion that has arisen) medications has remained a standard aspect of treatment in acute inpatient mental health units over a number of years

Stein-Parbury, M.J. & Liaschenko, J. 2007, 'Understanding collaboration between nurses and physicians as knowledge at work', American journal of critical care, vol. 16, no. 5, pp. 470-477.
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BACKGROUND: Collaboration between nurses and physicians is linked to positive outcomes for patients, especially in the intensive care unit. However, effective collaboration poses challenges because of traditional barriers such as sex and class differences, hierarchical organizational structures in health-care, and physicians' belief that they are the final arbiter of clinical decisions. OBJECTIVE: To further analyze the results of an investigation on how intensive care unit culture, expressed through everyday practices, affected the care of patients who became confused. METHODS: A model of the types of knowledge (case, patient, and person) used in clinical work was used to analyze the breakdown in collaboration detected in the original study. RESULTS: Breakdown of collaboration occurred because of the types of knowledge used by physicians and nurses. Certain types of knowledge were privileged even when not applicable to the clinical problem, whereas other types were dismissed even when applicable. CONCLUSION: Viewing collaboration through the conceptual lens of knowledge use reveals new insights. Collaboration broke down in the specific context of caring for patients with confusion because the use of case knowledge, rather than patient knowledge, was prominent in the intensive care unit culture.

Stein-Parbury, M.J. 2006, 'The Students Guide To Research Ethics', Journal Of Advanced Nursing, vol. 53, no. 2, pp. 256-256.
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McKinley, S.M., Stein-Parbury, M.J., Chehelnabi, A. & Lovas, J.M. 2004, 'Assessment of anxiety in intensive care patients by using the faces anxiety scale', American Journal of Critical Care, vol. 13, no. 2, pp. 146-152.
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Background Anxiety is difficult to detect in patients receiving mechanical ventilation because clinical signs are confounded and patients often cannot respond to validated anxiety measures. Most patients can respond to the single-item Faces Anxiety Scale. + Objectives To assess the validity of the Faces Anxiety Scale, the frequency and severity of state anxiety, and correlates of anxiety in intensive care patients. + Methods A research assistant made a single clinical judgment of anxiety in the range of 1 to 10 on the basis of patients+ nonverbal responses (ie, nods) to 9 questions about mood and their physical and behavioral signs. Patients then responded to the Faces Anxiety Scale. Demographic, clinical, and pharmacological data were obtained from the patients+ charts. + Results Mean age of the 106 patients was 61 years; 62% were men. Admission diagnoses were cardiovascular in 26% of patients, respiratory in 26%, trauma in 18%, neurological in 12%, gastrointestinal in 12%, and other in 6%. At the time of anxiety assessment, 89% were receiving mechanical ventilation. The correlation between patients+ self-reports of anxiety on the Anxiety Faces Scale and the research assistant+s assessments was 0.64 (P < .001). Some anxiety was reported by 85% of patients (mean level 2.9; SD 1.2). Anxiety levels were lower in patients who had recently received sedatives or opioids but were not related to heart rate or blood pressure. + Conclusions The Faces Anxiety Scale is a valid means of measuring anxiety in intensive care patients. Anxiety is common in these patients and is often moderate to severe.

McKinley, S.M., Coote, K. & Stein-Parbury, M.J. 2003, 'Development and testing of a Faces Scale for the assessment of anxiety in critically ill patients', Journal Of Advanced Nursing, vol. 41, no. 1, pp. 73-79.
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McKinley, S.M., Nagy, S.A., Stein-Parbury, M.J., Bramwell, M. & Hudson, J. 2002, 'Vulnerability and security in seriously ill patients in intensive care', Intensive and Critical Care Nursing, vol. 18, no. 1, pp. 27-36.
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The purpose of this research was to gain an understanding of the experience of being a seriously ill patient in an intensive care unit (ICU). Fourteen former patients, aged 17 71 years old, who had been in ICU 3 53 days, participated in focus group interviews 3 6 months after discharge. The focus groups met 3 times each for 1.5 hours, resulting in 13 14 hours of audiotaped discussions. The transcribed data were qualitatively analysed to identify themes representing participants' experiences. Vulnerability emerged as a central concept that captured the identified themes. The data reveal that patient vulnerability while in ICU was related to extreme physical and emotional dependency. Lack of information and depersonalizing care were associated with fear, anxiety and increased vulnerability. Lack of sleep and rest also contributed to patient fear and anxiety. Vulnerability decreased when patients were kept informed of what was occurring while in ICU, received care that was personalized to their individual needs, and when their families were present. The results of this study suggest that ICU patients' vulnerability may be decreased by the security that they experience when they are adequately informed about what is happening, and when nursing and medical care is personalized to their individual needs.

McKinley, S.M. & Stein-Parbury, M.J. 2000, 'Patients' experiences of being in an intensive care unit: a select literature review', American Journal of Critical Care, vol. 9, no. 1, pp. 20-27.

Stein-Parbury, M.J. 2000, 'Nursing around the world: Australia', Online Journal of Issues in Nursing, vol. 5, no. 2, pp. 10-17.
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Early nursing in Australia was influenced strongly by the British nursing tradition, characterized by an apprenticeship style of nurse education. However, this influence has been replaced by the transfer of all registered nursing education into the higher education sector. This article will discuss the development of the discipline of nursing in Australia as well as the Australian health care system and nursing work force. Nursing educational programs, registration, organizations, and research will be will be described. Finally current issues in Australian nursing and health care will be presented.

Stein-Parbury, M.J. & McKinley, S.M. 2000, 'Patients' experiences of being in an intensive care unit: a select literature review', American Journal of Critical Care, vol. 9, no. 1, pp. 20-27.

Conference papers

Orr, F.R., Kelly, M.A., Stein-Parbury, M.J., White, H.L. & McGarry, D. 2012, '"It was real": Use of actors in simulation to learn therapeutic communication', Society in Europe for Simulation Applied to Medicine (SESAM), Stavanger, Norway, June 2012.
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The students' evaluations of role plays with actors were rated as slightly higher than those with fellow students. Analysis of self-efficacy scores showed mixed results; some students reported increased confidence with therapeutic communication, while others reported a decrease. When aggregated, the results demonstrated that students' confidence increased, related to 'uncovering strong feelings' and 'ending a conversation by summarizing'. Nursing focus group results revealed that role plays with actors created emotional arousal that 'felt real' and 'put me under pressure', whilst role plays with students were limited by 'knowing each other' and 'not taking the emotion too far'.

Chenoweth, L.L., Haas, M.R., Jeon, Y., Stein-Parbury, M.J., Anstey, K., Brodaty, H., King, M.T., Luscombe, G. & Norman, R. 2008, 'Can we improve well-being and quality of care for people with dementia by providing person-centred care?', 13th National Health Outcomes Conference, Canberra, Australia, April 2008 in 13th National Health Outcomes Conference, ed Barr, A; Rodgers, L & Sansoni, J, University of Wollongong, Wollongong, Australia, pp. 1-11.
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To test the effectiveness and cost-effectiveness of two models of nursing care, person-centred care (PCC) and Dementia Care Mapping (DCM), relative to Usual Care (UC), in improving well-being and quality of care and reducing agitation and other behaviourial disturbances, for people with Demetia in residential care facilities.

King, M.T., Chenoweth, L.L., Brodaty, H., Jeon, Y., Stein-Parbury, M.J., Haas, M.R., Luscombe, G. & Norman, R. 2007, 'Can we improve well-being for people with dementia by providing person-centred nursing care?', Toronto, Canada, October 2007 in 14th Annual Conference of the International Society for Quality of Life Research, ed -, International Society for Quality of Life Research, London, England.
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To test the effectiveness and cost-effectiveness of the two models of nursing care, person-centred care (PCC) and Dementia Care Mapping (DCM), relative to usual care (UC), in improving well-being and quality of care and reducing agitation and other behavioural disturbances, for people with dementia in residential care facilities.

Stein-Parbury, M.J. 2006, 'Self-efficacy, sympton monitoring and self-management in chronic illness', 12th Annual National Health Outcomes Conference, Canberra, Australia, August 2006 in 12th Annual National Health Outcomes Proceedings.

Other activity

Norman, R., Haas, M.R., Chenoweth, L.L., Jeon, Y., King, M.T., Brodaty, H., Stein-Parbury, M.J., Luscombe, G. 2008, 'Dementia Care Mapping and Patient-Centred Care in Australian Residential Homes: An Economic Evaluation of the CARE Study, CHERE Working Paper 2008/4', CHERE, Sydney.

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