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Research Interests

Children, Cystic Fibrosis, Fathers of children with Chronic Illness

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I have worked in nursing since 1988 as a general nurse, midwife and children’s nurse. This valuable experience has helped inform my thinking. Before joining the School of Nursing and Midwifery in 2005, I had worked most recently as a Cystic Fibrosis Clinical Nurse Specialist for children and adults for five years. During this period I was aware of spending more time with mothers than fathers in helping them manage their children’s chronic progressive disease. This lead me to question the service provided for fathers and whether their needs were being addressed. In my masters by research I identified fathers involvement in their children’s day to day care; their search for information which for many was not being met by health care professionals; the emotional impact of caring for fathers and the toll that caring for their children’s with CF had on their personal relationships.

These findings have been disseminated locally, nationally and internationally in oral and poster format to nurses and other health care professionals within the multidisciplinary team. I have also published these findings in an attempt to reach a greater audience. I have collaborated with another children’s nurse lecturer in Dublin who also researched fathers of children with chronic illness (epilepsy) to write a paper on the similarities that both groups experienced. Few studies have explored fathers’ perspectives, particularly in an Irish context, which highlight the importance of our findings to date and the need to develop this research area further. I am currently reading around interventions with a view to researching what fathers could access to support their care giving even when they are unable to be physically present during clinic visits.

I am employed in the School of Nursing and Midwifery as a Lecturer Practitioner which gives me great potential to collaborate with my clinical colleagues. I have written two papers with another Childrens Nurse Lecturer and the Immunisation CNMII on the current changes that have been made to the Primary Immunisation Schedule since last July. We are exploring further research on perceptions and information needs of Irish parents as a consequence of these changes.

The appointment of Lecturer Practitioners has been a new departure from the traditional lecturer role, in that, I work with students on the ward and receive a patient case load. We sought to evaluate our role last summer from student and staff perspectives in an attempt to identify our effectiveness. We were portrayed as being very effective in teaching students and were perceived as being a valuable member of the nursing team. These findings have been presented throughout 2008 at both national and international conferences.  We also, have two articles being considered for publication by education journals Nurse Education Today and the International Journal of Nursing Scholarship. We hope that our evaluation will encourage further posts to be created to enhance student learning; to bridge the theory practice gap and to inform our teaching

To date, existing knowledge on how parents manage the care of their children with CF is predominately based on research from mothers’ perspectives. Studies suggest that mothers are the principal caregivers. Mothers have reported that the unequal sharing of responsibility for caregiving between them and their partners is stressful and isolating. Much of what is known about fathers is based on proxy accounts from mothers. Few studies have consulted fathers or included them in equal numbers to mothers. Using a descriptive qualitative design I interviewed eight fathers in their own homes for approximately one hour. Fathers described their participation in caregiving; particularly performing chest physiotherapy; checking medication stocks and ordering from pharmacy; and attending out patient clinics. However, fathers identified that when they were unable to attend clinics because of work they found it difficult to stay abreast of changes made to their children’s medication and physiotherapy routines. This highlights the need to include fathers in identifying methods in which health care professionals can improve communication between fathers and the multidisciplinary team. Fathers spoke about searching the internet for information and the depressing negative information they found. Information can support coping strategies. Health care professionals could help fathers by offering information that is specific to their childrens stage of disease progression and could assist in interpreting the significance of research available on the internet. Fathers also explained that they tried to be strong for their wives but caring for their children with CF was emotionally stressful and isolating. Again fathers need to be consulted to identify what supportive strategies could be put in place to promote their emotional wellbeing. In disseminating these findings I identified another children’s nurse lecturer in Dublin who also researched fathers of children with chronic illness (epilepsy). We have collaborated to write a paper on the similarities that both groups experienced, namely fathers level of involvement and the impact that caring for their children with chronic illness can have on their relationships with others.

In the summer of 2007 questionnaires containing Likert type rating scales and open ended questions on the impact of the Lecturer Practitioner (LP) in clinical practice were distributed to student nurses (n=211) with a response rate of 36.6% (n=78) and registered nurses (n=134), of whom 66%  (n=88) responded. Seven LPs also took part in a focus group. The results identified that LPs were very effective in teaching students in clinical areas. In particular students commented that LP’s knew what to expect from them and their level of education; had more time on the wards to teach them and to link practice to theory and were a familiar face. LPs indicated that clinical practice is essential in staying abreast with current practices; informs their teaching in that subject areas that students have trouble understanding are identified. The demands of staying research active; teaching and working in clinical practice was reported as challenging and in keeping with international studies, LPs were concerned about the possibility of role burnout in the future.   

Using the teaching for understanding framework, students were encouraged to put their knowledge of children’s growth and development into practice. They read widely about a particular age group, formulated questions to ask parents and their case study to illustrate the stage of development; practiced performing age appropriate development tests and reflected why knowledge of each stage of development was relevant to children’s nursing and how they could apply this knowledge to reduce the impact of hospitalisation for children. This form of assessment offers many advantages over the formal exam question. In a focus group with students held at the end of this module, one student commented that this form of assessment would help her remember what she had learned; another student stated that she could use her assessment as a point of reference to be able to assess children in other age groups. Using a case study approach students can actively engage in their learning, develop questioning and development assessment skills and gain confidence presenting in a supportive environment.

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