Journal of prevention & intervention in the community
It is important to consider the nature of home in more detail when thinking about living environm... more It is important to consider the nature of home in more detail when thinking about living environments for vulnerable groups of people, especially as it has been found that the nature of home can impact on the quality of life. The aim of this study was to understand the "lived experience" of home for a group of young people with complex disabilities who had recently relocated to a specially designed residential apartment building. Multiple domains of home, as they were experienced over time, were examined through a series of semi-structured interviews conducted with seven residents at their apartments. The findings revealed two major themes ("perceived quality of the place" and "identity in place") that were inextricably interlinked. To the extent that they overlapped, the experience of home was enhanced. The interaction between the two themes was associated with a dynamic ongoing process whereby the sense of home was either created or damaged ("dec...
International quarterly of community health education, 2016
Settings-based health promotion involving multiple strategies and partners is complex, especially... more Settings-based health promotion involving multiple strategies and partners is complex, especially in disadvantaged areas. Partnership development and organizational integration are examined in the literature; however, there is more to learn from the examination of practice stakeholders' experience of intersectoral partnership processes. This case study examines stakeholder experiences of challenges in new partnership work in the context of a culturally diverse and socioeconomically disadvantaged region in Queensland, Australia. Health promotion staff and community representatives participated in interviews and focus groups, and the thematic analysis included observations and documentary analyses. Our findings highlight the retrogressive influence of broader system dynamics, including policy reform and funding changes, upon partnership working. Partnership enablers are disrupted by external political influences and the internal politics (individual and organizational) of health p...
Journal of Prevention & Intervention in the Community, 2016
In recent years, there has been growing interest in the relationship between the characteristics ... more In recent years, there has been growing interest in the relationship between the characteristics of neighborhoods and the health and well-being of residents. The focus on neighborhood as a health determinant is based on the hypothesis that residing in a disadvantaged neighborhood can negatively influence health outcomes beyond the effect of individual characteristics. In this article, we examine three possible ways of measuring neighborhood socio-economic status, and how they each impact on self-reported health status beyond the effect contributed by individual-level factors. Using individual-level data from the Household Income and Labor Dynamics Australia survey combined with neighborhood-level (suburb) data, we tested the proposition that how one measures neighborhood socio-economic characteristics may provide an important new insight into understanding the links between individual-level outcomes and neighborhood-level characteristics. The findings from the analysis illustrate that although individual-level factors may be important to understanding health outcomes, how one accounts for neighborhood-level socio-economic status may be equally important. The findings suggest that in developing place-based health programs, policy makers need to account for the complex interactions between individual drivers and the potential complexities of accounting for neighborhood socio-economic status.
Journal of Prevention & Intervention in the Community, 2016
This paper introduces the special issue focused on the relationship between residence and health ... more This paper introduces the special issue focused on the relationship between residence and health in Australia. We present six papers conducted in different Australian states that demonstrate different elements of the complex impact of residential context on health. Through this series of papers, we demonstrate the impact of housing quality and safety on vulnerable populations, but also the way in which processes around housing (e.g., data collection, renewal, allocation) can have either negative or positive outcomes. The broader residential context (i.e., neighborhood, community, geographic location) also must be considered in housing decisions, along with variables that closely track housing (e.g., stigma, poverty). Australia is in the middle of a housing crisis that can still be resolved in positive ways if adequate attention is given to the nuances and complexities of housing decisions.
Anecdotal evidence suggests that care farming practices have the potential to provide positive ou... more Anecdotal evidence suggests that care farming practices have the potential to provide positive outcomes for young people in foster-care and residential care environments. A systematic review (searching; CINAHL, Web of Knowledge, PsychInfo) was conducted to explore how participation in care farming initiatives impacts attachment in children in foster-care and what aspects of care farming initiatives provides positive attachment outcomes. The systematic review did not identify any research publication in care farming and foster-care. Therefore, it is imperative that practitioners realise that the evidence is lacking when using these types of interventions and keep a close account of the benefit and harms that may be encountered during the interaction processes.
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2015
Quality of care for comorbid physical disorders in psychiatric patients can be assessed by the nu... more Quality of care for comorbid physical disorders in psychiatric patients can be assessed by the number of avoidable admissions for ambulatory care sensitive (ACS) conditions. These are admissions for physical conditions that, with appropriate primary care, should not require inpatient treatment. Avoidable admissions for ACS conditions feature prominently in Australia's National Health Performance Framework and have been used to assess health care provision for marginalized groups, such as Indigenous patients or those of lower socioeconomic status. They have not been applied to people with mental illness. A population-based, record-linkage analysis was used to measure ACS admissions for physical disorder in psychiatric patients of state-based facilities in Queensland, Australia, during 5 years. There were 77 435 males (48.0%) and 83 783 females (52%) (total n = 161 218). Among these, 13 219 psychiatric patients (8.2%) had at least 1 ACS admission, the most common being for diabete...
This article explores the potential for health promotion capacity building across boundaries in a... more This article explores the potential for health promotion capacity building across boundaries in a place-based health promotion learning network generated as part of a recent Australian Research Council-funded project in Queensland, Australia. We emphasise in particular the potential of creating new 'at the boundary' spaces of knowing that encourage and enable health promotion workers to work in interdisciplinary and intersectoral ways. The article discusses the way that diverse health promotion workers from different disciplines and government and non-government organisations came together to learn 'how to do' in new or re-invigorated ways. For many network participants, this cross-boundary space of knowing and capacity building provided a welcome respite from their daily contexts of practice which may be limited by institutional, disciplinary or other boundaries.
The health of an individual is determined by the interaction of genetic and individual factors wi... more The health of an individual is determined by the interaction of genetic and individual factors with wider social and environmental elements. Public health approaches to improving the health of disadvantaged populations will be most effective if they optimise influences at each of these levels, particularly in the early part of the life course. In order to better ascertain the relative contribution of these multi-level determinants there is a need for robust studies, longitudinal and prospective in nature, that examine individual, familial, social and environmental exposures. This paper describes the study background and methods, as it has been implemented in an Australian birth cohort study, Environments for Healthy Living (EFHL): The Griffith Study of Population Health. EFHL is a prospective, multi-level, multi-year longitudinal birth cohort study, designed to collect information from before birth through to adulthood across a spectrum of eco-epidemiological factors, including genetic material from cord-blood samples at birth, individual and familial factors, to spatial data on the living environment. EFHL commenced the pilot phase of recruitment in 2006 and open recruitment in 2007, with a target sample size of 4000 mother/infant dyads. Detailed information on each participant is obtained at birth, 12-months, 3-years, 5-years and subsequent three to five yearly intervals. The findings of this research will provide detailed evidence on the relative contribution of multi-level determinants of health, which can be used to inform social policy and intervention strategies that will facilitate healthy behaviours and choices across sub-populations.
Culturally and linguistically diverse (CALD) communities in Australia experience both significant... more Culturally and linguistically diverse (CALD) communities in Australia experience both significant health disparities and a lack of access to services. Consequently, there have been calls for culturally appropriate services for people with chronic disease in CALD populations. This paper presents a systematic review of the literature on the effectiveness of culturally appropriate interventions to manage or prevent chronic disease in CALD communities. Evidence was sought from randomized controlled trials and controlled studies that examined strategies for promoting cultural competence in health service delivery to CALD communities. The outcomes examined included changes in consumer health behaviours, utilisation/satisfaction with the service, and the cultural competence of health-care providers. Of the 202 studies that were identified only 24 met the inclusion criteria. The five categories of intervention that were identified included: (1) the use of community-based bi-lingual health workers; (2) providing cultural competency training for health workers; (3) using interpreter service for CALD people; (4) using multimedia and culturally sensitive videos to promote health for CALD people and (5) establishing community point-of-care services for CALD people with chronic disease. The review supported the use of trained bi-lingual health workers, who are culturally competent, as a major consideration in the development of an appropriate health service model for CALD communities.
The journal of trauma and acute care surgery, 2012
This study explored the relationships between health-related quality of life and postacute factor... more This study explored the relationships between health-related quality of life and postacute factors such as patients' perceived access to information and support, perceptions of illness and ability to provide self-care after traumatic injury. Adults (18 years or older) admitted to hospital for ≥ 24 hours for the acute treatment of trauma in two hospitals in Queensland, Australia, were enrolled in a prospective cohort study. Questionnaires completed at hospital discharge and 3 months and 6 months incorporated the following: demographic data; psychological factors (Revised Illness Perception Questionnaire, Information, Autonomy and Support Scale, and Therapeutic Self-Care Scale); and outcome data (medical short form-36). Data on injury and hospital stay were obtained from health care records and the Queensland Trauma Registry. One hundred ninety-four patients with a median Injury Severity Score 9 (interquartile range, 5-14) were enrolled, with 125 (64%) completing questionnaires at 6 months. More than half the cohort reported symptoms of pain, fatigue, stiff joints, sleep difficulties, and loss of strength. All subscale scores on the short form-36 were below Australian norms 6 months after injury. Predictors of poor physical health included older age, lower extremity injury, and increased perceived consequences of their injuries, whereas predictors of poor mental health included younger age, female gender, and lower perceived control over their environment. Patients with minor to moderate injury based on anatomic injury scoring systems have ongoing challenges with recovery including problematic symptoms and low quality of life. Interventions aimed toward assisting recovery should not be limited to trauma patients with major injury. Prognostic study, level III.
Intensive care unit (ICU) transition programmes and discharge liaison nurse roles have emerged be... more Intensive care unit (ICU) transition programmes and discharge liaison nurse roles have emerged because the move from the ICU to the general wards has been found to be problematic for patients, their families and even health care professionals As these programmes are costly, it is essential that they are delivered to those for whom positive outcomes are most likely to be achieved. This paper reports on the use of the Blaylock Risk Assessment Screening Score (BRASS) to identify ICU patients who are at risk of complex hospital discharge needs Use of BRASS at admission was not particularly specific: that is, it was not able to identify consistently those at risk of prolonged ICU and hospital stay and ICU readmission. BRASS was fairly sensitive, correctly identifying over 95% of individuals who did not have a prolonged hospital stay BRASS is easy to use, but may be no better than severity of illness scoring systems in identifying ICU patients who potentially have complex hospital discharge planning needs; if used, it should not be completed on ICU admission alone.
The article outlines the evaluation framework devised for a semi-formal disability service projec... more The article outlines the evaluation framework devised for a semi-formal disability service project in central Queensland, Australia, which was implemented using a community-based, participatory model. Utilising a service framework known as Community-Based Rehabilitation and an implementation strategy adapted from Participatory Rural Appraisal, this model is presented as a potential alternative for rehabilitation and disability services in the light of concerns that such services are poorly tailored and inadequate in remote and rural areas of Australia. In recognition of the difficulty of evaluating such participatory and community-based initiatives, this evaluation was based on the analysis of large amounts of qualitative data from multiple sources, which were categorised against key themes drawn from the literature, using a SWOT analysis (strengths, weaknesses, opportunities and threats). It is suggested that this innovative and multifaceted evaluation methodology may have broader application. Findings of the service evaluation indicated positive informal, community and social outcomes. Formal structural and organisational outcomes were found to be limited with a possibility of compromising the long-term viability of the initiative. Suggestions are made regarding the process of implementing similar research initiatives. The model may have application in similar rural community-based initiatives internationally.
Introduction Clinical expertise is one source of evidence that is generally under-utilised in the... more Introduction Clinical expertise is one source of evidence that is generally under-utilised in the development of an evidence-base in rehabilitation. The current study aimed to incorporate this valuable clinical expertise in determining the utility of multiple predictors of return-to-work outcome following injury. Methods Following systematic review of the rehabilitation literature and review, a total of 85 predictors were evaluated for clinical relevance by an expert panel of rehabilitation practitioners (n = 12). Each predictor was rated according the importance of the predictor in rehabilitation, its potential for modification and its classification into one of seven broad areas. In addition, practitioners were asked to provide a rationale as to why the predictor was important to rehabilitation. Analyses were conducted using inter-rater agreement statistics and text analysis. Results Predictors that were most commonly reviewed in the literature were not considered to be of greatest clinical utility, according to the current sample. From the total predictor set, only nine predictors were identified as clinically useful (i.e., both highly important and highly modifiable). Text analysis of the qualitative data revealed that these nine predictors highlighted the significance of time, context and engagement in rehabilitation practice. Conclusion In the current study, predictors that were considered most clinically relevant were those that generally described workplace related processes. The findings confirmed the underlying supportive and collaborative processes that integrate predictors and account for their influence on outcome. Future rehabilitation efforts and indeed, individual outcomes, could benefit by incorporating these key predictors in targeted programs.
Coping efforts have been recognised as an important aspect of resilience following traumatic brai... more Coping efforts have been recognised as an important aspect of resilience following traumatic brain injury, but little is known about what constitutes effective coping in this population. This longitudinal research examined the usefulness of the Goodness-of-Fit hypothesis, drawn from the Lazarus and Folkman [(1984). Stress, appraisal and coping. NY: Springer.] theory of stress and coping, as a way of understanding coping effectiveness. The hypothesis suggests that the nature and success of specific coping strategies will be associated with the controllability of the event. If an event is relatively uncontrollable, then emotion-focused or perception-focused coping may be more effective than problem-focused coping. In contrast, a controllable event may be best managed through problem-focused coping. Ninety people with traumatic brain injury, drawn from the inpatient rehabilitation unit of a major metropolitan hospital in Australia, and their relatives participated in this longitudinal study. No support was found for the Goodness-of-Fit model, either in the short term or the long term. Although the use of problem-focused coping strategies was positively associated with short-term and long-term role functioning, it was not associated with long-term emotional well-being if the situation was perceived to be controllable. The findings suggest that the persistent use of problem-focused coping in response to the difficulties created by traumatic brain injury can be associated with emotional distress in the long term. Reasons for this finding are explored and its implications are discussed.
The translation of information into practice is a well-recognised challenge for the health sector... more The translation of information into practice is a well-recognised challenge for the health sector. In the primary healthcare sector, the last decade has seen an explosion of information generated by health systems, universities and a range of other sources. Without a system for translating that knowledge into practice and sharing it in a comprehensible form, it will remain meaningless to most practitioners. We propose the establishment of Knowledge Networks as a promising method for supporting the rapid adoption and generation of health information within the primary health care sector to advance health care services. These networks will be particularly important to the implementation of the national reform agenda, responsive decision-making and the translation of new frameworks or competencies into practice. This paper describes how interdisciplinary Knowledge Networks could be established focusing on a number of priority health research areas. Local Knowledge Networks would be used as a platform to support a collaborative web of evidence designed to influence health policy and planning. Our experience with Knowledge Networks indicates that they must be comprised of health professionals from Divisions of General Practice, researchers, policy-makers, consumers, government and non-government sectors. This paper will describe these networks and show how they might support the translation of knowledge into practice, thus driving systematic and institutional change.
chaboyer w., ringdal m., aitken l. & kendall e. (2012) Self-care after traumatic injury and the u... more chaboyer w., ringdal m., aitken l. & kendall e. (2012) Self-care after traumatic injury and the use of the therapeutic self-care scale in trauma populations. Journal of Advanced Nursing69(2), 286–294 doi: 10.1111/j.1365-2648.2012.06005.x.chaboyer w., ringdal m., aitken l. & kendall e. (2012) Self-care after traumatic injury and the use of the therapeutic self-care scale in trauma populations. Journal of Advanced Nursing69(2), 286–294 doi: 10.1111/j.1365-2648.2012.06005.x.AbstractAims. To report a correlational study of the relationship between gender, age, severity of injury, length of hospital stay and self-care behaviour in patients with traumatic injuries.Background. This study may provide a foundation for targeted nursing intervention and education programmes to help patients better recover from their injury, which is a fundamental aspect of nursing.Design. A longitudinal cohort study.Method. This study of patients hospitalized for traumatic injury was conducted from May 2006–November 2007. The Therapeutic Self Care Scale along with demographic and clinical data, were completed at 3 and 6 months after hospital discharge. Using data from the 3-month survey, the validity and reliability of the scale was calculated. Multiple regression was used to identify predictors of self-care at 3 and 6 months.Finding. Participants (n = 125) completed the questionnaire at 3 months and 103 participants completed it at 6 months. Self-care was high on both occasions and high self-care at 3 months was related to high self-care at 6 months. Older participants reported higher self-care at 3 months compared with younger patients. Factor analysis of the scale revealed three clear components; taking medication, recognition and managing symptoms and managing changes in health conditions, which explained a total of 59·8% of the variance. The 10-item revised scale was reliable.Conclusion. The findings indicate that self-care remains fairly high and stable in the first 6 months after trauma. The revised Therapeutic Self Care Scale was valid and reliable in the trauma population.Aims. To report a correlational study of the relationship between gender, age, severity of injury, length of hospital stay and self-care behaviour in patients with traumatic injuries.Background. This study may provide a foundation for targeted nursing intervention and education programmes to help patients better recover from their injury, which is a fundamental aspect of nursing.Design. A longitudinal cohort study.Method. This study of patients hospitalized for traumatic injury was conducted from May 2006–November 2007. The Therapeutic Self Care Scale along with demographic and clinical data, were completed at 3 and 6 months after hospital discharge. Using data from the 3-month survey, the validity and reliability of the scale was calculated. Multiple regression was used to identify predictors of self-care at 3 and 6 months.Finding. Participants (n = 125) completed the questionnaire at 3 months and 103 participants completed it at 6 months. Self-care was high on both occasions and high self-care at 3 months was related to high self-care at 6 months. Older participants reported higher self-care at 3 months compared with younger patients. Factor analysis of the scale revealed three clear components; taking medication, recognition and managing symptoms and managing changes in health conditions, which explained a total of 59·8% of the variance. The 10-item revised scale was reliable.Conclusion. The findings indicate that self-care remains fairly high and stable in the first 6 months after trauma. The revised Therapeutic Self Care Scale was valid and reliable in the trauma population.
Journal of prevention & intervention in the community
It is important to consider the nature of home in more detail when thinking about living environm... more It is important to consider the nature of home in more detail when thinking about living environments for vulnerable groups of people, especially as it has been found that the nature of home can impact on the quality of life. The aim of this study was to understand the "lived experience" of home for a group of young people with complex disabilities who had recently relocated to a specially designed residential apartment building. Multiple domains of home, as they were experienced over time, were examined through a series of semi-structured interviews conducted with seven residents at their apartments. The findings revealed two major themes ("perceived quality of the place" and "identity in place") that were inextricably interlinked. To the extent that they overlapped, the experience of home was enhanced. The interaction between the two themes was associated with a dynamic ongoing process whereby the sense of home was either created or damaged ("dec...
International quarterly of community health education, 2016
Settings-based health promotion involving multiple strategies and partners is complex, especially... more Settings-based health promotion involving multiple strategies and partners is complex, especially in disadvantaged areas. Partnership development and organizational integration are examined in the literature; however, there is more to learn from the examination of practice stakeholders' experience of intersectoral partnership processes. This case study examines stakeholder experiences of challenges in new partnership work in the context of a culturally diverse and socioeconomically disadvantaged region in Queensland, Australia. Health promotion staff and community representatives participated in interviews and focus groups, and the thematic analysis included observations and documentary analyses. Our findings highlight the retrogressive influence of broader system dynamics, including policy reform and funding changes, upon partnership working. Partnership enablers are disrupted by external political influences and the internal politics (individual and organizational) of health p...
Journal of Prevention & Intervention in the Community, 2016
In recent years, there has been growing interest in the relationship between the characteristics ... more In recent years, there has been growing interest in the relationship between the characteristics of neighborhoods and the health and well-being of residents. The focus on neighborhood as a health determinant is based on the hypothesis that residing in a disadvantaged neighborhood can negatively influence health outcomes beyond the effect of individual characteristics. In this article, we examine three possible ways of measuring neighborhood socio-economic status, and how they each impact on self-reported health status beyond the effect contributed by individual-level factors. Using individual-level data from the Household Income and Labor Dynamics Australia survey combined with neighborhood-level (suburb) data, we tested the proposition that how one measures neighborhood socio-economic characteristics may provide an important new insight into understanding the links between individual-level outcomes and neighborhood-level characteristics. The findings from the analysis illustrate that although individual-level factors may be important to understanding health outcomes, how one accounts for neighborhood-level socio-economic status may be equally important. The findings suggest that in developing place-based health programs, policy makers need to account for the complex interactions between individual drivers and the potential complexities of accounting for neighborhood socio-economic status.
Journal of Prevention & Intervention in the Community, 2016
This paper introduces the special issue focused on the relationship between residence and health ... more This paper introduces the special issue focused on the relationship between residence and health in Australia. We present six papers conducted in different Australian states that demonstrate different elements of the complex impact of residential context on health. Through this series of papers, we demonstrate the impact of housing quality and safety on vulnerable populations, but also the way in which processes around housing (e.g., data collection, renewal, allocation) can have either negative or positive outcomes. The broader residential context (i.e., neighborhood, community, geographic location) also must be considered in housing decisions, along with variables that closely track housing (e.g., stigma, poverty). Australia is in the middle of a housing crisis that can still be resolved in positive ways if adequate attention is given to the nuances and complexities of housing decisions.
Anecdotal evidence suggests that care farming practices have the potential to provide positive ou... more Anecdotal evidence suggests that care farming practices have the potential to provide positive outcomes for young people in foster-care and residential care environments. A systematic review (searching; CINAHL, Web of Knowledge, PsychInfo) was conducted to explore how participation in care farming initiatives impacts attachment in children in foster-care and what aspects of care farming initiatives provides positive attachment outcomes. The systematic review did not identify any research publication in care farming and foster-care. Therefore, it is imperative that practitioners realise that the evidence is lacking when using these types of interventions and keep a close account of the benefit and harms that may be encountered during the interaction processes.
Canadian journal of psychiatry. Revue canadienne de psychiatrie, 2015
Quality of care for comorbid physical disorders in psychiatric patients can be assessed by the nu... more Quality of care for comorbid physical disorders in psychiatric patients can be assessed by the number of avoidable admissions for ambulatory care sensitive (ACS) conditions. These are admissions for physical conditions that, with appropriate primary care, should not require inpatient treatment. Avoidable admissions for ACS conditions feature prominently in Australia's National Health Performance Framework and have been used to assess health care provision for marginalized groups, such as Indigenous patients or those of lower socioeconomic status. They have not been applied to people with mental illness. A population-based, record-linkage analysis was used to measure ACS admissions for physical disorder in psychiatric patients of state-based facilities in Queensland, Australia, during 5 years. There were 77 435 males (48.0%) and 83 783 females (52%) (total n = 161 218). Among these, 13 219 psychiatric patients (8.2%) had at least 1 ACS admission, the most common being for diabete...
This article explores the potential for health promotion capacity building across boundaries in a... more This article explores the potential for health promotion capacity building across boundaries in a place-based health promotion learning network generated as part of a recent Australian Research Council-funded project in Queensland, Australia. We emphasise in particular the potential of creating new 'at the boundary' spaces of knowing that encourage and enable health promotion workers to work in interdisciplinary and intersectoral ways. The article discusses the way that diverse health promotion workers from different disciplines and government and non-government organisations came together to learn 'how to do' in new or re-invigorated ways. For many network participants, this cross-boundary space of knowing and capacity building provided a welcome respite from their daily contexts of practice which may be limited by institutional, disciplinary or other boundaries.
The health of an individual is determined by the interaction of genetic and individual factors wi... more The health of an individual is determined by the interaction of genetic and individual factors with wider social and environmental elements. Public health approaches to improving the health of disadvantaged populations will be most effective if they optimise influences at each of these levels, particularly in the early part of the life course. In order to better ascertain the relative contribution of these multi-level determinants there is a need for robust studies, longitudinal and prospective in nature, that examine individual, familial, social and environmental exposures. This paper describes the study background and methods, as it has been implemented in an Australian birth cohort study, Environments for Healthy Living (EFHL): The Griffith Study of Population Health. EFHL is a prospective, multi-level, multi-year longitudinal birth cohort study, designed to collect information from before birth through to adulthood across a spectrum of eco-epidemiological factors, including genetic material from cord-blood samples at birth, individual and familial factors, to spatial data on the living environment. EFHL commenced the pilot phase of recruitment in 2006 and open recruitment in 2007, with a target sample size of 4000 mother/infant dyads. Detailed information on each participant is obtained at birth, 12-months, 3-years, 5-years and subsequent three to five yearly intervals. The findings of this research will provide detailed evidence on the relative contribution of multi-level determinants of health, which can be used to inform social policy and intervention strategies that will facilitate healthy behaviours and choices across sub-populations.
Culturally and linguistically diverse (CALD) communities in Australia experience both significant... more Culturally and linguistically diverse (CALD) communities in Australia experience both significant health disparities and a lack of access to services. Consequently, there have been calls for culturally appropriate services for people with chronic disease in CALD populations. This paper presents a systematic review of the literature on the effectiveness of culturally appropriate interventions to manage or prevent chronic disease in CALD communities. Evidence was sought from randomized controlled trials and controlled studies that examined strategies for promoting cultural competence in health service delivery to CALD communities. The outcomes examined included changes in consumer health behaviours, utilisation/satisfaction with the service, and the cultural competence of health-care providers. Of the 202 studies that were identified only 24 met the inclusion criteria. The five categories of intervention that were identified included: (1) the use of community-based bi-lingual health workers; (2) providing cultural competency training for health workers; (3) using interpreter service for CALD people; (4) using multimedia and culturally sensitive videos to promote health for CALD people and (5) establishing community point-of-care services for CALD people with chronic disease. The review supported the use of trained bi-lingual health workers, who are culturally competent, as a major consideration in the development of an appropriate health service model for CALD communities.
The journal of trauma and acute care surgery, 2012
This study explored the relationships between health-related quality of life and postacute factor... more This study explored the relationships between health-related quality of life and postacute factors such as patients' perceived access to information and support, perceptions of illness and ability to provide self-care after traumatic injury. Adults (18 years or older) admitted to hospital for ≥ 24 hours for the acute treatment of trauma in two hospitals in Queensland, Australia, were enrolled in a prospective cohort study. Questionnaires completed at hospital discharge and 3 months and 6 months incorporated the following: demographic data; psychological factors (Revised Illness Perception Questionnaire, Information, Autonomy and Support Scale, and Therapeutic Self-Care Scale); and outcome data (medical short form-36). Data on injury and hospital stay were obtained from health care records and the Queensland Trauma Registry. One hundred ninety-four patients with a median Injury Severity Score 9 (interquartile range, 5-14) were enrolled, with 125 (64%) completing questionnaires at 6 months. More than half the cohort reported symptoms of pain, fatigue, stiff joints, sleep difficulties, and loss of strength. All subscale scores on the short form-36 were below Australian norms 6 months after injury. Predictors of poor physical health included older age, lower extremity injury, and increased perceived consequences of their injuries, whereas predictors of poor mental health included younger age, female gender, and lower perceived control over their environment. Patients with minor to moderate injury based on anatomic injury scoring systems have ongoing challenges with recovery including problematic symptoms and low quality of life. Interventions aimed toward assisting recovery should not be limited to trauma patients with major injury. Prognostic study, level III.
Intensive care unit (ICU) transition programmes and discharge liaison nurse roles have emerged be... more Intensive care unit (ICU) transition programmes and discharge liaison nurse roles have emerged because the move from the ICU to the general wards has been found to be problematic for patients, their families and even health care professionals As these programmes are costly, it is essential that they are delivered to those for whom positive outcomes are most likely to be achieved. This paper reports on the use of the Blaylock Risk Assessment Screening Score (BRASS) to identify ICU patients who are at risk of complex hospital discharge needs Use of BRASS at admission was not particularly specific: that is, it was not able to identify consistently those at risk of prolonged ICU and hospital stay and ICU readmission. BRASS was fairly sensitive, correctly identifying over 95% of individuals who did not have a prolonged hospital stay BRASS is easy to use, but may be no better than severity of illness scoring systems in identifying ICU patients who potentially have complex hospital discharge planning needs; if used, it should not be completed on ICU admission alone.
The article outlines the evaluation framework devised for a semi-formal disability service projec... more The article outlines the evaluation framework devised for a semi-formal disability service project in central Queensland, Australia, which was implemented using a community-based, participatory model. Utilising a service framework known as Community-Based Rehabilitation and an implementation strategy adapted from Participatory Rural Appraisal, this model is presented as a potential alternative for rehabilitation and disability services in the light of concerns that such services are poorly tailored and inadequate in remote and rural areas of Australia. In recognition of the difficulty of evaluating such participatory and community-based initiatives, this evaluation was based on the analysis of large amounts of qualitative data from multiple sources, which were categorised against key themes drawn from the literature, using a SWOT analysis (strengths, weaknesses, opportunities and threats). It is suggested that this innovative and multifaceted evaluation methodology may have broader application. Findings of the service evaluation indicated positive informal, community and social outcomes. Formal structural and organisational outcomes were found to be limited with a possibility of compromising the long-term viability of the initiative. Suggestions are made regarding the process of implementing similar research initiatives. The model may have application in similar rural community-based initiatives internationally.
Introduction Clinical expertise is one source of evidence that is generally under-utilised in the... more Introduction Clinical expertise is one source of evidence that is generally under-utilised in the development of an evidence-base in rehabilitation. The current study aimed to incorporate this valuable clinical expertise in determining the utility of multiple predictors of return-to-work outcome following injury. Methods Following systematic review of the rehabilitation literature and review, a total of 85 predictors were evaluated for clinical relevance by an expert panel of rehabilitation practitioners (n = 12). Each predictor was rated according the importance of the predictor in rehabilitation, its potential for modification and its classification into one of seven broad areas. In addition, practitioners were asked to provide a rationale as to why the predictor was important to rehabilitation. Analyses were conducted using inter-rater agreement statistics and text analysis. Results Predictors that were most commonly reviewed in the literature were not considered to be of greatest clinical utility, according to the current sample. From the total predictor set, only nine predictors were identified as clinically useful (i.e., both highly important and highly modifiable). Text analysis of the qualitative data revealed that these nine predictors highlighted the significance of time, context and engagement in rehabilitation practice. Conclusion In the current study, predictors that were considered most clinically relevant were those that generally described workplace related processes. The findings confirmed the underlying supportive and collaborative processes that integrate predictors and account for their influence on outcome. Future rehabilitation efforts and indeed, individual outcomes, could benefit by incorporating these key predictors in targeted programs.
Coping efforts have been recognised as an important aspect of resilience following traumatic brai... more Coping efforts have been recognised as an important aspect of resilience following traumatic brain injury, but little is known about what constitutes effective coping in this population. This longitudinal research examined the usefulness of the Goodness-of-Fit hypothesis, drawn from the Lazarus and Folkman [(1984). Stress, appraisal and coping. NY: Springer.] theory of stress and coping, as a way of understanding coping effectiveness. The hypothesis suggests that the nature and success of specific coping strategies will be associated with the controllability of the event. If an event is relatively uncontrollable, then emotion-focused or perception-focused coping may be more effective than problem-focused coping. In contrast, a controllable event may be best managed through problem-focused coping. Ninety people with traumatic brain injury, drawn from the inpatient rehabilitation unit of a major metropolitan hospital in Australia, and their relatives participated in this longitudinal study. No support was found for the Goodness-of-Fit model, either in the short term or the long term. Although the use of problem-focused coping strategies was positively associated with short-term and long-term role functioning, it was not associated with long-term emotional well-being if the situation was perceived to be controllable. The findings suggest that the persistent use of problem-focused coping in response to the difficulties created by traumatic brain injury can be associated with emotional distress in the long term. Reasons for this finding are explored and its implications are discussed.
The translation of information into practice is a well-recognised challenge for the health sector... more The translation of information into practice is a well-recognised challenge for the health sector. In the primary healthcare sector, the last decade has seen an explosion of information generated by health systems, universities and a range of other sources. Without a system for translating that knowledge into practice and sharing it in a comprehensible form, it will remain meaningless to most practitioners. We propose the establishment of Knowledge Networks as a promising method for supporting the rapid adoption and generation of health information within the primary health care sector to advance health care services. These networks will be particularly important to the implementation of the national reform agenda, responsive decision-making and the translation of new frameworks or competencies into practice. This paper describes how interdisciplinary Knowledge Networks could be established focusing on a number of priority health research areas. Local Knowledge Networks would be used as a platform to support a collaborative web of evidence designed to influence health policy and planning. Our experience with Knowledge Networks indicates that they must be comprised of health professionals from Divisions of General Practice, researchers, policy-makers, consumers, government and non-government sectors. This paper will describe these networks and show how they might support the translation of knowledge into practice, thus driving systematic and institutional change.
chaboyer w., ringdal m., aitken l. & kendall e. (2012) Self-care after traumatic injury and the u... more chaboyer w., ringdal m., aitken l. & kendall e. (2012) Self-care after traumatic injury and the use of the therapeutic self-care scale in trauma populations. Journal of Advanced Nursing69(2), 286–294 doi: 10.1111/j.1365-2648.2012.06005.x.chaboyer w., ringdal m., aitken l. & kendall e. (2012) Self-care after traumatic injury and the use of the therapeutic self-care scale in trauma populations. Journal of Advanced Nursing69(2), 286–294 doi: 10.1111/j.1365-2648.2012.06005.x.AbstractAims. To report a correlational study of the relationship between gender, age, severity of injury, length of hospital stay and self-care behaviour in patients with traumatic injuries.Background. This study may provide a foundation for targeted nursing intervention and education programmes to help patients better recover from their injury, which is a fundamental aspect of nursing.Design. A longitudinal cohort study.Method. This study of patients hospitalized for traumatic injury was conducted from May 2006–November 2007. The Therapeutic Self Care Scale along with demographic and clinical data, were completed at 3 and 6 months after hospital discharge. Using data from the 3-month survey, the validity and reliability of the scale was calculated. Multiple regression was used to identify predictors of self-care at 3 and 6 months.Finding. Participants (n = 125) completed the questionnaire at 3 months and 103 participants completed it at 6 months. Self-care was high on both occasions and high self-care at 3 months was related to high self-care at 6 months. Older participants reported higher self-care at 3 months compared with younger patients. Factor analysis of the scale revealed three clear components; taking medication, recognition and managing symptoms and managing changes in health conditions, which explained a total of 59·8% of the variance. The 10-item revised scale was reliable.Conclusion. The findings indicate that self-care remains fairly high and stable in the first 6 months after trauma. The revised Therapeutic Self Care Scale was valid and reliable in the trauma population.Aims. To report a correlational study of the relationship between gender, age, severity of injury, length of hospital stay and self-care behaviour in patients with traumatic injuries.Background. This study may provide a foundation for targeted nursing intervention and education programmes to help patients better recover from their injury, which is a fundamental aspect of nursing.Design. A longitudinal cohort study.Method. This study of patients hospitalized for traumatic injury was conducted from May 2006–November 2007. The Therapeutic Self Care Scale along with demographic and clinical data, were completed at 3 and 6 months after hospital discharge. Using data from the 3-month survey, the validity and reliability of the scale was calculated. Multiple regression was used to identify predictors of self-care at 3 and 6 months.Finding. Participants (n = 125) completed the questionnaire at 3 months and 103 participants completed it at 6 months. Self-care was high on both occasions and high self-care at 3 months was related to high self-care at 6 months. Older participants reported higher self-care at 3 months compared with younger patients. Factor analysis of the scale revealed three clear components; taking medication, recognition and managing symptoms and managing changes in health conditions, which explained a total of 59·8% of the variance. The 10-item revised scale was reliable.Conclusion. The findings indicate that self-care remains fairly high and stable in the first 6 months after trauma. The revised Therapeutic Self Care Scale was valid and reliable in the trauma population.
Uploads
Papers by Elizabeth Kendall