Public perception of medical errors : experiences and risks shared in Australia
- Kim, Jeong-ah, Terry, Daniel, Jang, Sunny, Nguyen, Hoang, Gilbert, Julia, Cruickshank, Mary
- Authors: Kim, Jeong-ah , Terry, Daniel , Jang, Sunny , Nguyen, Hoang , Gilbert, Julia , Cruickshank, Mary
- Date: 2020
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 8, no. 1 (2020), p. 35-41
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- Description: Background: Research into patient safety has largely focused on healthcare organisations bureaucratic routines, with little research available regarding the impact of patient perceptions on clinical practice. Acknowledging and openly discussing patient perceptions of medical errors may result in improved quality of healthcare. The research study aimed to gain a better understanding of the public's perception of medical errors to drive a structured approach to improve healthcare outcomes. Methods: In this study, we examined the public experiences of medical errors using an anonymous on-line survey to collect empirical data from April to December 2018. A total of 407 responses were obtained with 303 participants meeting the criteria for inclusion in the study. Results: The majority (74.9%) of these participants identified that they had experienced a medical error during receiving healthcare in Australia and 73% of these confirmed that they were harmed as a result of these errors. Conclusion: Findings from this study indicate that many participants have experienced medical errors when accessing healthcare in Australia. These findings provide information and a deeper understanding of patient experiences and perceptions of healthcare service delivery which can be used by healthcare organisations to improve healthcare services and promote patient participation in their care. Copyright©2020 by authors, all rights reserved. Authors agree that this article remains permanently open access under the terms of the Creative Commons Attribution License 4.0 International License
- Authors: Kim, Jeong-ah , Terry, Daniel , Jang, Sunny , Nguyen, Hoang , Gilbert, Julia , Cruickshank, Mary
- Date: 2020
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 8, no. 1 (2020), p. 35-41
- Full Text:
- Reviewed:
- Description: Background: Research into patient safety has largely focused on healthcare organisations bureaucratic routines, with little research available regarding the impact of patient perceptions on clinical practice. Acknowledging and openly discussing patient perceptions of medical errors may result in improved quality of healthcare. The research study aimed to gain a better understanding of the public's perception of medical errors to drive a structured approach to improve healthcare outcomes. Methods: In this study, we examined the public experiences of medical errors using an anonymous on-line survey to collect empirical data from April to December 2018. A total of 407 responses were obtained with 303 participants meeting the criteria for inclusion in the study. Results: The majority (74.9%) of these participants identified that they had experienced a medical error during receiving healthcare in Australia and 73% of these confirmed that they were harmed as a result of these errors. Conclusion: Findings from this study indicate that many participants have experienced medical errors when accessing healthcare in Australia. These findings provide information and a deeper understanding of patient experiences and perceptions of healthcare service delivery which can be used by healthcare organisations to improve healthcare services and promote patient participation in their care. Copyright©2020 by authors, all rights reserved. Authors agree that this article remains permanently open access under the terms of the Creative Commons Attribution License 4.0 International License
Supervision in healthcare : a critical review of the role, function and capacity for training
- Terry, Daniel, Nguyen, Hoang, Perkins, Alicia, Peck, Blake
- Authors: Terry, Daniel , Nguyen, Hoang , Perkins, Alicia , Peck, Blake
- Date: 2020
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 8, no. 1 (2020), p. 1-14
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- Description: This paper examines the notion of clinical supervision and takes a close look at what it means from the perspective of both the supervisee and the supervisor, considering how it can be of benefit to the learner, the teacher and the patient. Clinical supervision has been shown to be vital for the development and consolidation of undergraduate and postgraduate education, while having a positive impact on patient outcomes and as such is a fundamental component in healthcare education. Central to supervision is achieving the best outcomes for the supervisee, and effective supervision ensures the development of confidence, professional identity, and the consolidation of therapeutic knowledge. Clinical supervision provides a platform for extending the supervisor-supervisee relationship beyond the student-teacher model to one of mutual personal development in contemporary knowledge and skills for clinical practice. Despite the perceived importance of clinical supervision for healthcare more broadly, there is evidence to suggest that few supervisors are adequately prepared with the theory and practice of clinical supervision to adequately fulfill the expectations that the role entails. It follows therefore, that in many cases, there is an expectation that the health professionals will supervise without adequate preparation. This paper, although not a panacea, may assist those who are supervising and who seek or require some guidance and support.
- Authors: Terry, Daniel , Nguyen, Hoang , Perkins, Alicia , Peck, Blake
- Date: 2020
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 8, no. 1 (2020), p. 1-14
- Full Text:
- Reviewed:
- Description: This paper examines the notion of clinical supervision and takes a close look at what it means from the perspective of both the supervisee and the supervisor, considering how it can be of benefit to the learner, the teacher and the patient. Clinical supervision has been shown to be vital for the development and consolidation of undergraduate and postgraduate education, while having a positive impact on patient outcomes and as such is a fundamental component in healthcare education. Central to supervision is achieving the best outcomes for the supervisee, and effective supervision ensures the development of confidence, professional identity, and the consolidation of therapeutic knowledge. Clinical supervision provides a platform for extending the supervisor-supervisee relationship beyond the student-teacher model to one of mutual personal development in contemporary knowledge and skills for clinical practice. Despite the perceived importance of clinical supervision for healthcare more broadly, there is evidence to suggest that few supervisors are adequately prepared with the theory and practice of clinical supervision to adequately fulfill the expectations that the role entails. It follows therefore, that in many cases, there is an expectation that the health professionals will supervise without adequate preparation. This paper, although not a panacea, may assist those who are supervising and who seek or require some guidance and support.
Television as a career motivator and education tool : a final-year nursing student cohort study
- Authors: Terry, Daniel , Peck, Blake
- Date: 2020
- Type: Text , Journal article
- Relation: European Journal of Investigation in Health Psychology and Education Vol. 10, no. 1 (Mar 2020), p. 346-357
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- Description: Fictional medical programs are often used for more than just their recreational enjoyment; they can also influence career decision making. Very little research has examined the pedagogical value of fictional medical programs in terms of their motivational value in the choice of a nursing career. As such, the aim of this study was to examine what motivated nursing students to choose nursing careers, if fictional medical programs were motivators, and if they are used by students as a learning tool. The cross-sectional study collected data using a questionnaire and occurred between April and June 2018. The findings were generated from students' short answers and extended responses within the questionnaire. Data were analysed using descriptive and inferential statistics, while qualitative data were analysed thematically. A total of 291 students participated (82.6% response rate), with motivations for entering nursing being similar to other international studies; however, as motivators, fictional medical television programs were rated higher than job security. Overall, students engage with medical television programs along a television-learning continuum, ranging from limited watching time, recognising inaccuracies, understanding dialogue, through to using fictional medical television programs as tools for learning. However, this is dependent on time, interest, current level of understanding, and a program's perceived value.
- Authors: Terry, Daniel , Peck, Blake
- Date: 2020
- Type: Text , Journal article
- Relation: European Journal of Investigation in Health Psychology and Education Vol. 10, no. 1 (Mar 2020), p. 346-357
- Full Text:
- Reviewed:
- Description: Fictional medical programs are often used for more than just their recreational enjoyment; they can also influence career decision making. Very little research has examined the pedagogical value of fictional medical programs in terms of their motivational value in the choice of a nursing career. As such, the aim of this study was to examine what motivated nursing students to choose nursing careers, if fictional medical programs were motivators, and if they are used by students as a learning tool. The cross-sectional study collected data using a questionnaire and occurred between April and June 2018. The findings were generated from students' short answers and extended responses within the questionnaire. Data were analysed using descriptive and inferential statistics, while qualitative data were analysed thematically. A total of 291 students participated (82.6% response rate), with motivations for entering nursing being similar to other international studies; however, as motivators, fictional medical television programs were rated higher than job security. Overall, students engage with medical television programs along a television-learning continuum, ranging from limited watching time, recognising inaccuracies, understanding dialogue, through to using fictional medical television programs as tools for learning. However, this is dependent on time, interest, current level of understanding, and a program's perceived value.
The data deficit for asthma emergency presentations might surprise you : how RAHDaR addresses the data chasm
- Terry, Daniel, Peck, Blake, Kloot, Kate
- Authors: Terry, Daniel , Peck, Blake , Kloot, Kate
- Date: 2020
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 20, no. 2 (2020), p. 5776
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- Description: INTRODUCTION: National and state-based minimum data sets remain inadequate in providing a complete representation of emergency presentations, especially among paediatric asthma presentations. Thus, the aim of the study was to identify if a deficit exists in current emergency paediatric asthma hospital presentation datasets and how this may inform an understanding of childhood asthma in Victoria Methods: This retrospective cross-sectional study examined emergency hospital presentation data between 1 February 2017 and 31 January 2019. All paediatric (0-14 years) emergency asthma presentation data were collected from nine hospitals in south-western Victoria, Australia, using the Rural Acute Hospital Data Register (RAHDaR), which gathers both Victorian Emergency Minimum Dataset (VEMD) data from larger government hospitals, and non-VEMD data from smaller, more rural institutions. RESULTS: Of the 854 emergency presentations identified for children with asthma aged 0-14 years, 540 (63.2%) were managed initially at larger government-reporting hospitals. A total of 314 (36.8%) emergency presentations were initially managed at emergency facilities, such as urgent care centres. Overall, it was found that a total 278 (32.5%) of all emergency presentations did not appear in current government datasets. CONCLUSION: The RAHDaR database, a complete register of data, captures all emergency presentations in south-western Victoria and highlights as much as a 33% deficit in the data currently available to inform asthma resource initiatives including policy development, funding allocation, prevention and management initiatives in Victoria. More accurate data from sources such as RAHDaR are essential to fill the now-evident data chasm.
- Authors: Terry, Daniel , Peck, Blake , Kloot, Kate
- Date: 2020
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 20, no. 2 (2020), p. 5776
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- Description: INTRODUCTION: National and state-based minimum data sets remain inadequate in providing a complete representation of emergency presentations, especially among paediatric asthma presentations. Thus, the aim of the study was to identify if a deficit exists in current emergency paediatric asthma hospital presentation datasets and how this may inform an understanding of childhood asthma in Victoria Methods: This retrospective cross-sectional study examined emergency hospital presentation data between 1 February 2017 and 31 January 2019. All paediatric (0-14 years) emergency asthma presentation data were collected from nine hospitals in south-western Victoria, Australia, using the Rural Acute Hospital Data Register (RAHDaR), which gathers both Victorian Emergency Minimum Dataset (VEMD) data from larger government hospitals, and non-VEMD data from smaller, more rural institutions. RESULTS: Of the 854 emergency presentations identified for children with asthma aged 0-14 years, 540 (63.2%) were managed initially at larger government-reporting hospitals. A total of 314 (36.8%) emergency presentations were initially managed at emergency facilities, such as urgent care centres. Overall, it was found that a total 278 (32.5%) of all emergency presentations did not appear in current government datasets. CONCLUSION: The RAHDaR database, a complete register of data, captures all emergency presentations in south-western Victoria and highlights as much as a 33% deficit in the data currently available to inform asthma resource initiatives including policy development, funding allocation, prevention and management initiatives in Victoria. More accurate data from sources such as RAHDaR are essential to fill the now-evident data chasm.
Traversing the funambulist's fine line between nursing and male identity : A systematic review of the factors that influence men as they seek to navigate the nursing profession
- Terry, Daniel, Peck, Blake, Carden, Clarissa, Perkins, Alicia, Smith, Andrew
- Authors: Terry, Daniel , Peck, Blake , Carden, Clarissa , Perkins, Alicia , Smith, Andrew
- Date: 2020
- Type: Text , Journal article , Review
- Relation: European Journal of Investigation in Health Psychology and Education Vol. 10, no. 3 (2020), p. 691-703
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- Description: Nursing has seen a dominance of women within the profession, and today, the presence of men in the role remains less understood and appreciated. Males considering or entering nursing face challenges concerning role misconception, marginalization, and gender bias. With a looming shortage of nurses on the horizon, it is more important now than ever before to find better ways of engaging males into nursing. The aim of the study was to examine the psychological constructs that influence male perceptions of nursing as they seek to navigate the profession, and what aspects influence men to consider nursing as a career. To achieve this, a systematic review and mixed research synthesis (integrated design) was conducted. English language research published between 1999 and 2019 was eligible. The methodological rigor of qualitative articles followed the Critical Appraisal Skills Program, while the Best Evidence Medical Education guided the quantitative review. Among the 24 publications identified, three sub-themes emerged from the overarching theme of the funambulist or tightrope walker. Sub-themes included societal, inner and collective voices that inform men's place in nursing or their decision making about entering the profession. There is a need to re-visit what it means to be a nurse in order to address the gendered stereotypes that impact men entering the nursing profession.
- Authors: Terry, Daniel , Peck, Blake , Carden, Clarissa , Perkins, Alicia , Smith, Andrew
- Date: 2020
- Type: Text , Journal article , Review
- Relation: European Journal of Investigation in Health Psychology and Education Vol. 10, no. 3 (2020), p. 691-703
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- Description: Nursing has seen a dominance of women within the profession, and today, the presence of men in the role remains less understood and appreciated. Males considering or entering nursing face challenges concerning role misconception, marginalization, and gender bias. With a looming shortage of nurses on the horizon, it is more important now than ever before to find better ways of engaging males into nursing. The aim of the study was to examine the psychological constructs that influence male perceptions of nursing as they seek to navigate the profession, and what aspects influence men to consider nursing as a career. To achieve this, a systematic review and mixed research synthesis (integrated design) was conducted. English language research published between 1999 and 2019 was eligible. The methodological rigor of qualitative articles followed the Critical Appraisal Skills Program, while the Best Evidence Medical Education guided the quantitative review. Among the 24 publications identified, three sub-themes emerged from the overarching theme of the funambulist or tightrope walker. Sub-themes included societal, inner and collective voices that inform men's place in nursing or their decision making about entering the profession. There is a need to re-visit what it means to be a nurse in order to address the gendered stereotypes that impact men entering the nursing profession.
Understanding childhood injuries in rural areas : using rural acute hospital data register to address previous data deficiencies
- Peck, Blake, Terry, Daniel, Kloot, Kate
- Authors: Peck, Blake , Terry, Daniel , Kloot, Kate
- Date: 2020
- Type: Text , Journal article
- Relation: EMA - Emergency Medicine Australasia Vol. 32, no. 4 (2020), p. 646-649
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- Description: Objective: The state of childhood injury in rural areas of Victoria is poorly understood. Currently only data on those children transferred from smaller hospital settings to larger settings appear in existing government datasets, significantly underestimating the characteristics of injury. Methods: Detailed emergency presentation data (Victorian Emergency Minimum Dataset [VEMD] and non-VEMD) that makes up the Rural Acute Hospital Data Register database was collected and compared among children (aged 0–14 years) who have a principal diagnosis of injury. Results: Of the 8647 episodes of care identified for injured children aged 0–14 years, 3257 children were managed initially at smaller hospitals that do not report episode data to existing datasets. Conclusions: The Rural Acute Hospital Data Register database captures the presentations at low-resource sites and highlights as much as a 35% deficit in the data that is currently available to inform injury prevention and safety initiatives in Victoria. © 2020 Australasian College for Emergency Medicine
- Authors: Peck, Blake , Terry, Daniel , Kloot, Kate
- Date: 2020
- Type: Text , Journal article
- Relation: EMA - Emergency Medicine Australasia Vol. 32, no. 4 (2020), p. 646-649
- Full Text:
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- Description: Objective: The state of childhood injury in rural areas of Victoria is poorly understood. Currently only data on those children transferred from smaller hospital settings to larger settings appear in existing government datasets, significantly underestimating the characteristics of injury. Methods: Detailed emergency presentation data (Victorian Emergency Minimum Dataset [VEMD] and non-VEMD) that makes up the Rural Acute Hospital Data Register database was collected and compared among children (aged 0–14 years) who have a principal diagnosis of injury. Results: Of the 8647 episodes of care identified for injured children aged 0–14 years, 3257 children were managed initially at smaller hospitals that do not report episode data to existing datasets. Conclusions: The Rural Acute Hospital Data Register database captures the presentations at low-resource sites and highlights as much as a 35% deficit in the data that is currently available to inform injury prevention and safety initiatives in Victoria. © 2020 Australasian College for Emergency Medicine
Workplace based assessment program for international medical graduates : an evaluation of an Australian trial site
- Terry, Daniel, Peck, Blake, Gazula, Swapnali
- Authors: Terry, Daniel , Peck, Blake , Gazula, Swapnali
- Date: 2020
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 8, no. 6 (2020), p. 198-206
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- Description: There is a need to understand Workplace Based Assessment programs in Australia to improve future offerings. This paper evaluates the efficacy of a Workplace Based Assessment program at a single regional Australian healthcare location using a mixed-method approach to collect data from three sources. Tools included Mini-Clinical Evaluation Exercise, case-based discussion and in-training assessment, and structured face-to-face interviews with eighteen key-stakeholders. The Workplace Based Assessment program itself was evaluated against a number of indicators, including the psychometric properties assessed by each of the tools used. In addition, the adequacy of the current program and specifically the tools used within it to determine the clinical competence and safety of International Medical Graduates was examined. Lastly, satisfaction of key-stakeholders with program preparation and usability of tools was investigated. The results indicate that the tools currently used within the Workplace Based Assessment program continue to be reliable, and assessors are assessing International Medical Graduates with a high degree of consistency across the program. In addition, this study found that both International Medical Graduates and assessors remain satisfied with regard to confidence, usability and user perception of the current Workplace Based Assessment methods to provide a more meaningful experience for those being assessed. Overall, this evaluation provides insights into the current Workplace Based Assessment program and makes recommendations for future improvements. These include clearer program guidelines; greater opportunities for support of International Medical Graduates, feedback for and further training of assessors. Copyright © 2020 by authors, all rights reserved.
- Authors: Terry, Daniel , Peck, Blake , Gazula, Swapnali
- Date: 2020
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 8, no. 6 (2020), p. 198-206
- Full Text:
- Reviewed:
- Description: There is a need to understand Workplace Based Assessment programs in Australia to improve future offerings. This paper evaluates the efficacy of a Workplace Based Assessment program at a single regional Australian healthcare location using a mixed-method approach to collect data from three sources. Tools included Mini-Clinical Evaluation Exercise, case-based discussion and in-training assessment, and structured face-to-face interviews with eighteen key-stakeholders. The Workplace Based Assessment program itself was evaluated against a number of indicators, including the psychometric properties assessed by each of the tools used. In addition, the adequacy of the current program and specifically the tools used within it to determine the clinical competence and safety of International Medical Graduates was examined. Lastly, satisfaction of key-stakeholders with program preparation and usability of tools was investigated. The results indicate that the tools currently used within the Workplace Based Assessment program continue to be reliable, and assessors are assessing International Medical Graduates with a high degree of consistency across the program. In addition, this study found that both International Medical Graduates and assessors remain satisfied with regard to confidence, usability and user perception of the current Workplace Based Assessment methods to provide a more meaningful experience for those being assessed. Overall, this evaluation provides insights into the current Workplace Based Assessment program and makes recommendations for future improvements. These include clearer program guidelines; greater opportunities for support of International Medical Graduates, feedback for and further training of assessors. Copyright © 2020 by authors, all rights reserved.
Acute circulatory complications in people with diabetes mellitus type 2 : How admission varies between urban and rural Victoria
- Gardiner, Samantha, Robins, Shalley, Terry, Daniel
- Authors: Gardiner, Samantha , Robins, Shalley , Terry, Daniel
- Date: 2019
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 27, no. 1 (2019), p. 49-56
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- Description: Objective: To identify the extent to which rurality influences the admission and mortality rates for acute circulatory complications among people with type 2 diabetes mellitus. Design: Retrospective study. Setting: All Victorian hospitals. Participants: State-wide hospital admissions from 1 July 2010 to 30 June 2015 using the Victorian Admitted Episodes Dataset. Data included patients with type 2 diabetes mellitus and diagnosis of acute cardiovascular events, acute cerebrovascular haemorrhage or infarction, acute peripheral vascular events or hypertensive diseases. Main outcome measure: Rates of admission and mortality were calculated for local government areas and Department of Health regions. Regression analysis identified the influence between admission rates and various predictor variables. Results: In total, 5785 emergency hospital admissions occurred during the study period, with the highest and lowest mortality and admission rates occurring in rural areas. Moderately high admission rates were identified in urban areas. Cardiovascular events far outnumbered other acute circulatory admissions. Regression analysis identified a number of significant socioeconomic variables, primarily for metropolitan residents. Socioeconomic disadvantage was the only significant factor in rural areas. Conclusion: Victorian admission and mortality rates for acute circulatory complications are greatest in rural areas; yet, there is considerable heterogeneity in the admission rates within both rural and metropolitan areas. Furthermore, socioeconomic status is more influential than remoteness in determining emergency admissions. Further research needs to investigate the particular variables that lead to poorer outcomes rurally, investigate socioeconomic disadvantage in rural areas and have greater emphasis on peripheral vascular disease prevention.
- Authors: Gardiner, Samantha , Robins, Shalley , Terry, Daniel
- Date: 2019
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 27, no. 1 (2019), p. 49-56
- Full Text:
- Reviewed:
- Description: Objective: To identify the extent to which rurality influences the admission and mortality rates for acute circulatory complications among people with type 2 diabetes mellitus. Design: Retrospective study. Setting: All Victorian hospitals. Participants: State-wide hospital admissions from 1 July 2010 to 30 June 2015 using the Victorian Admitted Episodes Dataset. Data included patients with type 2 diabetes mellitus and diagnosis of acute cardiovascular events, acute cerebrovascular haemorrhage or infarction, acute peripheral vascular events or hypertensive diseases. Main outcome measure: Rates of admission and mortality were calculated for local government areas and Department of Health regions. Regression analysis identified the influence between admission rates and various predictor variables. Results: In total, 5785 emergency hospital admissions occurred during the study period, with the highest and lowest mortality and admission rates occurring in rural areas. Moderately high admission rates were identified in urban areas. Cardiovascular events far outnumbered other acute circulatory admissions. Regression analysis identified a number of significant socioeconomic variables, primarily for metropolitan residents. Socioeconomic disadvantage was the only significant factor in rural areas. Conclusion: Victorian admission and mortality rates for acute circulatory complications are greatest in rural areas; yet, there is considerable heterogeneity in the admission rates within both rural and metropolitan areas. Furthermore, socioeconomic status is more influential than remoteness in determining emergency admissions. Further research needs to investigate the particular variables that lead to poorer outcomes rurally, investigate socioeconomic disadvantage in rural areas and have greater emphasis on peripheral vascular disease prevention.
Chronic ill health in a regional Victoria setting: A 13-year comparison
- Glenister, Kristen, Bourke, Lisa, Terry, Daniel, Simmons, David
- Authors: Glenister, Kristen , Bourke, Lisa , Terry, Daniel , Simmons, David
- Date: 2019
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 27, no. 6 (2019), p. 527-534
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- Description: Objective: High-quality data regarding the prevalence of chronic disease in rural areas are essential in understanding the challenges faced by rural populations and for informing strategies to address health care needs. This study compared the prevalence of a range of self-reported chronic conditions and utilisation of GP services and emergency department in a regional Victorian setting between two studies conducted in the same region in 2001-2003 and 2014. Design: Repeat cross-sectional studies conducted over a decade apart. Setting: The projects were conducted in the Goulburn Valley in regional Victoria. Participants: The earlier study randomly selected households from local government lists. The later study randomly selected householders from the telephone directory. Main outcome measures: Participants were asked whether they had been diagnosed with a range of chronic health conditions and how often they had visited a general practitioner or emergency department in the past 12 months. Results: The age-standardised prevalence of depression was higher in the 2014 study than the 2001-2003 study in men (increased by 8.0% (95% CI 4.5, 11.5%)) and women (increased by 13.7% (95% CI 8.4, 19.0%)). Similarly, the prevalence of age-standardised diabetes and hypertension was higher in 2014 than 2001-2003 (men increased by 3.6% (95% CI 0.7, 6.5% (diabetes)) and 13.6% (95% CI 8.6, 18.6% (hypertension)), women increased by 3.1% (95% CI 0.3, 6.5% (diabetes)) and 8.4% (95% CI 2.3, 14.5% (hypertension))). Conclusion: The results of this study indicate that the prevalence of self-reported depression, diabetes and hypertension has increased in this regional Victorian area over the past 13 years. The reasons for these observed increases and the subsequent impact on the health care needs of regional communities warrants further investigation. © 2019 National Rural Health Alliance Ltd.
- Authors: Glenister, Kristen , Bourke, Lisa , Terry, Daniel , Simmons, David
- Date: 2019
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 27, no. 6 (2019), p. 527-534
- Full Text:
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- Description: Objective: High-quality data regarding the prevalence of chronic disease in rural areas are essential in understanding the challenges faced by rural populations and for informing strategies to address health care needs. This study compared the prevalence of a range of self-reported chronic conditions and utilisation of GP services and emergency department in a regional Victorian setting between two studies conducted in the same region in 2001-2003 and 2014. Design: Repeat cross-sectional studies conducted over a decade apart. Setting: The projects were conducted in the Goulburn Valley in regional Victoria. Participants: The earlier study randomly selected households from local government lists. The later study randomly selected householders from the telephone directory. Main outcome measures: Participants were asked whether they had been diagnosed with a range of chronic health conditions and how often they had visited a general practitioner or emergency department in the past 12 months. Results: The age-standardised prevalence of depression was higher in the 2014 study than the 2001-2003 study in men (increased by 8.0% (95% CI 4.5, 11.5%)) and women (increased by 13.7% (95% CI 8.4, 19.0%)). Similarly, the prevalence of age-standardised diabetes and hypertension was higher in 2014 than 2001-2003 (men increased by 3.6% (95% CI 0.7, 6.5% (diabetes)) and 13.6% (95% CI 8.6, 18.6% (hypertension)), women increased by 3.1% (95% CI 0.3, 6.5% (diabetes)) and 8.4% (95% CI 2.3, 14.5% (hypertension))). Conclusion: The results of this study indicate that the prevalence of self-reported depression, diabetes and hypertension has increased in this regional Victorian area over the past 13 years. The reasons for these observed increases and the subsequent impact on the health care needs of regional communities warrants further investigation. © 2019 National Rural Health Alliance Ltd.
Communication training and its effects on carer and care-receiver outcomes in dementia settings : A systematic review
- Nguyen, Hoang, Terry, Daniel, Phan, Hoang, Vickers, James, McInerney, Fran
- Authors: Nguyen, Hoang , Terry, Daniel , Phan, Hoang , Vickers, James , McInerney, Fran
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Journal of Clinical Nursing Vol. 28, no. 7-8 (2019), p. 1050-1069
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- Description: Aims and objectives To review communication interventions that aim to improve regular care interactions between people with dementia and their carers in various settings; and to examine the impact of such interventions on both carer and care-receiver outcomes. Background Effective communication is imperative to ensure quality of care for people living with dementia. Due to neurodegenerative changes, people with dementia encounter ongoing and progressive difficulties in both understanding and expressing themselves. This in turn creates challenges for carers, which highlights the need for equipping them with necessary communication skills to respond to the specific communication needs of people with dementia. Design Systematic review and meta-analysis. Method Medline, Embase, CINAHL, ProQuest and PsycINFO databases were searched for eligible interventions with any date of the publication. Hand searching was also conducted through reviewing the reference lists of relevant articles. The screening and selection of studies were based on the inclusion/exclusion criteria for eligibility and the methodological quality assessment checklist. Random-effects meta-analyses were conducted on comparable quantitative data. The review is reported following the PRISMA reporting guidelines. Results Seventeen studies were included in the final review, including 12 randomised controlled trials (RCTs), three nonrandomised controlled trials (NRCTs) and two controlled before-after interventions. The intervention designs, settings and outcome measures were varied. The findings suggest that the communication training had a positive impact on both carer and care-receiver outcomes, albeit to different degrees. The intervention effects were found to be strongest on carer communication skills and knowledge. Conclusion There is solid evidence for the positive impact of communication training on the skills and knowledge of carers. More research is needed regarding the effects of such educational interventions on carer physio-psychological outcomes and care-receiver neuropsychiatric symptoms. It is important to establish best practices in training design, develop validated outcome measures and adopt consistent reporting approaches. Relevance to clinical practice The increasing global prevalence of people with dementia manifests across clinical and community contexts. The profound impact of dementia on communication and associated care raises the imperative for enhanced health worker and carer communication skills to meet the needs of this particular client group. The findings of this review indicate that educational interventions incorporating face-to-face and diverse instructional delivery methods in dementia communication showed positive outcomes for communication skills in all carer groups and warrant inclusion as strategies in dementia training.
- Authors: Nguyen, Hoang , Terry, Daniel , Phan, Hoang , Vickers, James , McInerney, Fran
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Journal of Clinical Nursing Vol. 28, no. 7-8 (2019), p. 1050-1069
- Full Text:
- Reviewed:
- Description: Aims and objectives To review communication interventions that aim to improve regular care interactions between people with dementia and their carers in various settings; and to examine the impact of such interventions on both carer and care-receiver outcomes. Background Effective communication is imperative to ensure quality of care for people living with dementia. Due to neurodegenerative changes, people with dementia encounter ongoing and progressive difficulties in both understanding and expressing themselves. This in turn creates challenges for carers, which highlights the need for equipping them with necessary communication skills to respond to the specific communication needs of people with dementia. Design Systematic review and meta-analysis. Method Medline, Embase, CINAHL, ProQuest and PsycINFO databases were searched for eligible interventions with any date of the publication. Hand searching was also conducted through reviewing the reference lists of relevant articles. The screening and selection of studies were based on the inclusion/exclusion criteria for eligibility and the methodological quality assessment checklist. Random-effects meta-analyses were conducted on comparable quantitative data. The review is reported following the PRISMA reporting guidelines. Results Seventeen studies were included in the final review, including 12 randomised controlled trials (RCTs), three nonrandomised controlled trials (NRCTs) and two controlled before-after interventions. The intervention designs, settings and outcome measures were varied. The findings suggest that the communication training had a positive impact on both carer and care-receiver outcomes, albeit to different degrees. The intervention effects were found to be strongest on carer communication skills and knowledge. Conclusion There is solid evidence for the positive impact of communication training on the skills and knowledge of carers. More research is needed regarding the effects of such educational interventions on carer physio-psychological outcomes and care-receiver neuropsychiatric symptoms. It is important to establish best practices in training design, develop validated outcome measures and adopt consistent reporting approaches. Relevance to clinical practice The increasing global prevalence of people with dementia manifests across clinical and community contexts. The profound impact of dementia on communication and associated care raises the imperative for enhanced health worker and carer communication skills to meet the needs of this particular client group. The findings of this review indicate that educational interventions incorporating face-to-face and diverse instructional delivery methods in dementia communication showed positive outcomes for communication skills in all carer groups and warrant inclusion as strategies in dementia training.
Factors contributing to COPD hospitalisations from 2010 to 2015 : Variation among rural and metropolitan Australians
- Terry, Daniel, Nguyen, Hoang, Kim, Jeong-Ah, Islam, Rafiqul
- Authors: Terry, Daniel , Nguyen, Hoang , Kim, Jeong-Ah , Islam, Rafiqul
- Date: 2019
- Type: Text , Journal article
- Relation: Clinical Respiratory Journal Vol. 13, no. 5 (2019), p. 306-313
- Full Text:
- Reviewed:
- Description: Introduction: Rural and remote populations experience the greatest burden of chronic obstructive pulmonary disease (COPD), the fifth leading cause of death in Australia. Currently there is a need to prioritise health services to improve health outcomes among those at higher risk of COPD. Objectives: To investigate the differences in COPD hospitalisation between rural and urban populations and determine predictive factors contributing to COPD hospitalisation. Methods: Statewide hospitalisation data from 2010 to 2015 were obtained through the Victorian Admitted Episodes Dataset and other key data sets. The rates of hospitalisation were analysed using hierarchical multiple regression to examine the association between COPD hospitalisations and a number of predictor variables. Results: The highest COPD incidence occurred in metropolitan males aged 85 years of age and older (35.092 hospitalisations per 1000 population). Among metropolitan residents, smoking, population density and household income had a significant association with COPD hospitalisations for both sexes. Among rural males, smoking rates, household income and rural land use (farming) were significant predictors of COPD hospitalisations. There was an overall stability in statewide COPD hospitalisation over the 5 years to 2015, P = 0.420. Conclusion: This investigation highlights many rural and regional areas have much lower COPD hospitalisation rates than metropolitan areas. Between males and females, there are heterogenetic factors that contribute to the significant variation associated with COPD hospitalisation in metropolitan and rural areas, such as rural land use among rural males. This indicates that risk factor assessments, beyond smoking alone, need to be individualised and prioritised in practice to optimise care.
- Authors: Terry, Daniel , Nguyen, Hoang , Kim, Jeong-Ah , Islam, Rafiqul
- Date: 2019
- Type: Text , Journal article
- Relation: Clinical Respiratory Journal Vol. 13, no. 5 (2019), p. 306-313
- Full Text:
- Reviewed:
- Description: Introduction: Rural and remote populations experience the greatest burden of chronic obstructive pulmonary disease (COPD), the fifth leading cause of death in Australia. Currently there is a need to prioritise health services to improve health outcomes among those at higher risk of COPD. Objectives: To investigate the differences in COPD hospitalisation between rural and urban populations and determine predictive factors contributing to COPD hospitalisation. Methods: Statewide hospitalisation data from 2010 to 2015 were obtained through the Victorian Admitted Episodes Dataset and other key data sets. The rates of hospitalisation were analysed using hierarchical multiple regression to examine the association between COPD hospitalisations and a number of predictor variables. Results: The highest COPD incidence occurred in metropolitan males aged 85 years of age and older (35.092 hospitalisations per 1000 population). Among metropolitan residents, smoking, population density and household income had a significant association with COPD hospitalisations for both sexes. Among rural males, smoking rates, household income and rural land use (farming) were significant predictors of COPD hospitalisations. There was an overall stability in statewide COPD hospitalisation over the 5 years to 2015, P = 0.420. Conclusion: This investigation highlights many rural and regional areas have much lower COPD hospitalisation rates than metropolitan areas. Between males and females, there are heterogenetic factors that contribute to the significant variation associated with COPD hospitalisation in metropolitan and rural areas, such as rural land use among rural males. This indicates that risk factor assessments, beyond smoking alone, need to be individualised and prioritised in practice to optimise care.
Is nursing student personality important for considering a rural career?
- Terry, Daniel, Peck, Blake, Smith, Andrew, Stevenson, Tyrin, Baker, Ed
- Authors: Terry, Daniel , Peck, Blake , Smith, Andrew , Stevenson, Tyrin , Baker, Ed
- Date: 2019
- Type: Text , Journal article
- Relation: Journal of Health Organization and Management Vol. 33, no. 5 (2019), p. 617-634
- Full Text:
- Reviewed:
- Description: Purpose: Identifying and measuring personality traits assists to understanding professional career choices, however, what impact personality traits have on nursing student rural career choice remains absent. The purpose of this paper is to identify personality traits among nursing students that may be predictive of pursuing a rural career. Design/methodology/approach: A cross-sectional design was used to examine the importance Bachelor of Nursing students place on undertaking rural careers. All nursing students (n=1,982) studying a three-year bachelor’s degree were invited to complete a questionnaire examining personality traits and rural practice intentions. Findings: Students who saw themselves working rurally after graduation had higher levels of conscientiousness than those who wanted metropolitan careers. Students with higher levels of agreeableness or open-mindedness were more likely to consider rural practice when individual community factors were carefully considered. Finally, students with higher levels of neuroticism were less likely to consider rural practice as a future career pathway. Research limitations/implications: The cohort had high numbers of student from rural and regional settings, which may limit the ability to generalise the findings. In addition, student respondents of the survey may not be representative of the whole student cohort given the low response rate. Originality/value: Key personality traits are identifying factors that contribute to nursing student decision making regarding rural practice. Students who displayed higher levels of agreeableness and conscientiousness and open-mindedness have traits that are most likely to impact the consideration of rural practice across their nursing career, which gives additional insight into targeted recruitment strategies. © 2019, Emerald Publishing Limited.
- Authors: Terry, Daniel , Peck, Blake , Smith, Andrew , Stevenson, Tyrin , Baker, Ed
- Date: 2019
- Type: Text , Journal article
- Relation: Journal of Health Organization and Management Vol. 33, no. 5 (2019), p. 617-634
- Full Text:
- Reviewed:
- Description: Purpose: Identifying and measuring personality traits assists to understanding professional career choices, however, what impact personality traits have on nursing student rural career choice remains absent. The purpose of this paper is to identify personality traits among nursing students that may be predictive of pursuing a rural career. Design/methodology/approach: A cross-sectional design was used to examine the importance Bachelor of Nursing students place on undertaking rural careers. All nursing students (n=1,982) studying a three-year bachelor’s degree were invited to complete a questionnaire examining personality traits and rural practice intentions. Findings: Students who saw themselves working rurally after graduation had higher levels of conscientiousness than those who wanted metropolitan careers. Students with higher levels of agreeableness or open-mindedness were more likely to consider rural practice when individual community factors were carefully considered. Finally, students with higher levels of neuroticism were less likely to consider rural practice as a future career pathway. Research limitations/implications: The cohort had high numbers of student from rural and regional settings, which may limit the ability to generalise the findings. In addition, student respondents of the survey may not be representative of the whole student cohort given the low response rate. Originality/value: Key personality traits are identifying factors that contribute to nursing student decision making regarding rural practice. Students who displayed higher levels of agreeableness and conscientiousness and open-mindedness have traits that are most likely to impact the consideration of rural practice across their nursing career, which gives additional insight into targeted recruitment strategies. © 2019, Emerald Publishing Limited.
Twinning with Tonga : the experiences of Tongan stakeholders with a long-term partnership with regional Victoria, Australia
- Mornane, Carolyn, Franc, Michelle, Waddington, Maureen, Peck, Blake, Terry, Daniel
- Authors: Mornane, Carolyn , Franc, Michelle , Waddington, Maureen , Peck, Blake , Terry, Daniel
- Date: 2019
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 7, no. 3 (2019), p. 144-150
- Full Text:
- Reviewed:
- Description: Twinning programs in health have gained increased recognition as a WHO preferred strategy for providing a sustainable strategy for enhancing the delivery of best practice healthcare globally. The Tonga Twinning Program (TTP), represents a longstanding relationship of some twenty-five years between The Ministry of Health in Tonga and St John of God Hospital, Ballarat, Australia and provides a compelling example of what can be achieved. This article presents the findings from a longitudinal exploration of the experiences and perceptions of the TTP through the voices of those key-stakeholders situated in Tonga who have engaged with the program. Informed by the tenets of hermeneutic phenomenology, a modified thematic analysis highlighted two major themes, ‘A shared mission’ and ‘The outcomes are more than the tangibles’, which supported by a series of sub-themes, identify the core components of the experience of the TTP. This study suggests that the TTP has supported a collective sense of bringing the very best available knowledge and skills to the people of Tonga and has fostered a genuine and open dialogue between partners as a mechanism for change that goes well beyond simply a capacity to replicate skills and instead has establish a genuine reciprocity akin to being a family.
- Authors: Mornane, Carolyn , Franc, Michelle , Waddington, Maureen , Peck, Blake , Terry, Daniel
- Date: 2019
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 7, no. 3 (2019), p. 144-150
- Full Text:
- Reviewed:
- Description: Twinning programs in health have gained increased recognition as a WHO preferred strategy for providing a sustainable strategy for enhancing the delivery of best practice healthcare globally. The Tonga Twinning Program (TTP), represents a longstanding relationship of some twenty-five years between The Ministry of Health in Tonga and St John of God Hospital, Ballarat, Australia and provides a compelling example of what can be achieved. This article presents the findings from a longitudinal exploration of the experiences and perceptions of the TTP through the voices of those key-stakeholders situated in Tonga who have engaged with the program. Informed by the tenets of hermeneutic phenomenology, a modified thematic analysis highlighted two major themes, ‘A shared mission’ and ‘The outcomes are more than the tangibles’, which supported by a series of sub-themes, identify the core components of the experience of the TTP. This study suggests that the TTP has supported a collective sense of bringing the very best available knowledge and skills to the people of Tonga and has fostered a genuine and open dialogue between partners as a mechanism for change that goes well beyond simply a capacity to replicate skills and instead has establish a genuine reciprocity akin to being a family.
Competing food consumption discourses and proper gendered behaviour among over 50s: are you really what you eat?
- Malatzky, Christina, Terry, Daniel, Bourke, Lisa, Glenister, Kristen, Ervin, Kaye
- Authors: Malatzky, Christina , Terry, Daniel , Bourke, Lisa , Glenister, Kristen , Ervin, Kaye
- Date: 2018
- Type: Text , Journal article
- Relation: Journal of Research for Consumers Vol. , no. 32 (2018), p. 1-31
- Full Text:
- Reviewed:
- Description: The national narratives about proper food consumption and its relationship to health and wellbeing has been articulated in many Australian public health campaigns. These shape awareness, knowledge and behaviours as well as reporting on food consumption. This paper reports on the findings of a large-scale community health survey, conducted in four Victorian regional areas, related to the self-reported eating practices of respondents aged 50 years and over. It was found that women were more likely to report trying to eat a diet consistent with public health messages than men. Overall, however there was strong agreement amongst respondents that they tried to eat a healthy diet. These findings are contextualised within broader societal discourses, including the Australian national narrative about food consumption, proper gendered behaviour, good, moral, responsible citizenship, and the competing social meanings attached to food and food consumption. It is argued that understanding the social circumstances in which people report their dietary behaviours is essential to understanding why behavioural change is such a complex goal for public health and health promotion.
- Authors: Malatzky, Christina , Terry, Daniel , Bourke, Lisa , Glenister, Kristen , Ervin, Kaye
- Date: 2018
- Type: Text , Journal article
- Relation: Journal of Research for Consumers Vol. , no. 32 (2018), p. 1-31
- Full Text:
- Reviewed:
- Description: The national narratives about proper food consumption and its relationship to health and wellbeing has been articulated in many Australian public health campaigns. These shape awareness, knowledge and behaviours as well as reporting on food consumption. This paper reports on the findings of a large-scale community health survey, conducted in four Victorian regional areas, related to the self-reported eating practices of respondents aged 50 years and over. It was found that women were more likely to report trying to eat a diet consistent with public health messages than men. Overall, however there was strong agreement amongst respondents that they tried to eat a healthy diet. These findings are contextualised within broader societal discourses, including the Australian national narrative about food consumption, proper gendered behaviour, good, moral, responsible citizenship, and the competing social meanings attached to food and food consumption. It is argued that understanding the social circumstances in which people report their dietary behaviours is essential to understanding why behavioural change is such a complex goal for public health and health promotion.
Health professional students' rural placement satisfaction and rural practice intentions : a national cross-sectional survey
- Smith, Tony, Sutton, Keith, Pit, Sabrina, Muyambi, Kuda, Terry, Daniel, Farthing, Annie, Courtney, Claire, Cross, Merylin
- Authors: Smith, Tony , Sutton, Keith , Pit, Sabrina , Muyambi, Kuda , Terry, Daniel , Farthing, Annie , Courtney, Claire , Cross, Merylin
- Date: 2018
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 26, no. 1 (2018), p. 26-32
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- Reviewed:
- Description: Objective: The aim of this study was to profile students undertaking placements at University Departments of Rural Health (UDRHs) and investigate factors affecting students' satisfaction and intention to enter rural practice. Design: Cross-sectional survey comprising 21 core questions used by all UDRHs. Setting: Eleven UDRHs across Australia that support students' placements in regional, rural and remote locations. Participants: Medical, nursing and allied health students who participated in UDRH placements between July 2014 and November 2015 and completed the questionnaire. Main outcome measures: Key dependent variables were placement satisfaction and rural practice intention. Descriptive variables were age, gender, Aboriginal or Torres Strait Islander (ATSI) background, location of placement, healthcare discipline, year of study and type and length of placement. Results: A total of 3328 students responded. The sample was predominantly female (79%), the mean age was 26.0 years and 1.8% identified as ATSI. Most placements (69%) were >2 but ≤12 weeks, 80% were in Modified Monash 3, 4 or 5 geographical locations. Public hospitals and community health made up 63% of placements. Students satisfied with their placement had 2.33 higher odds of rural practice intention. Those satisfied with Indigenous cultural training, workplace supervision, access to education resources and accommodation had higher odds of overall satisfaction and post-placement rural practice intention. Conclusions: The majority of students were highly satisfied with their placement and the support provided by rural clinicians and the UDRHs. UDRHs are well placed to provide health professional students with highly satisfactory placements that foster rural practice intention. © 2017 National Rural Health Alliance Inc.
- Authors: Smith, Tony , Sutton, Keith , Pit, Sabrina , Muyambi, Kuda , Terry, Daniel , Farthing, Annie , Courtney, Claire , Cross, Merylin
- Date: 2018
- Type: Text , Journal article
- Relation: Australian Journal of Rural Health Vol. 26, no. 1 (2018), p. 26-32
- Full Text:
- Reviewed:
- Description: Objective: The aim of this study was to profile students undertaking placements at University Departments of Rural Health (UDRHs) and investigate factors affecting students' satisfaction and intention to enter rural practice. Design: Cross-sectional survey comprising 21 core questions used by all UDRHs. Setting: Eleven UDRHs across Australia that support students' placements in regional, rural and remote locations. Participants: Medical, nursing and allied health students who participated in UDRH placements between July 2014 and November 2015 and completed the questionnaire. Main outcome measures: Key dependent variables were placement satisfaction and rural practice intention. Descriptive variables were age, gender, Aboriginal or Torres Strait Islander (ATSI) background, location of placement, healthcare discipline, year of study and type and length of placement. Results: A total of 3328 students responded. The sample was predominantly female (79%), the mean age was 26.0 years and 1.8% identified as ATSI. Most placements (69%) were >2 but ≤12 weeks, 80% were in Modified Monash 3, 4 or 5 geographical locations. Public hospitals and community health made up 63% of placements. Students satisfied with their placement had 2.33 higher odds of rural practice intention. Those satisfied with Indigenous cultural training, workplace supervision, access to education resources and accommodation had higher odds of overall satisfaction and post-placement rural practice intention. Conclusions: The majority of students were highly satisfied with their placement and the support provided by rural clinicians and the UDRHs. UDRHs are well placed to provide health professional students with highly satisfactory placements that foster rural practice intention. © 2017 National Rural Health Alliance Inc.
Lived experiences and insights into the advantages important to rural recruitment and retention of general practitioners
- Terry, Daniel, Nguyen, Hoang, Schmitz, David, Baker, Ed
- Authors: Terry, Daniel , Nguyen, Hoang , Schmitz, David , Baker, Ed
- Date: 2018
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 18, no. 3 (2018), p. 1-16
- Full Text:
- Reviewed:
- Description: INTRODUCTION: Despite existing studies in this field, community factors behind recruiting and retaining rural general practitioners (GPs) are not fully understood. To address this issue, the Community Apgar Questionnaire (CAQ) was developed to extend the understanding of communities' assets and capabilities that impact GP recruitment and retention. However, more in-depth insights are vital to develop a comprehensive approach. METHODS: This mixed methods study was administered using face-to-face structured interviews with a total of 40 health service representatives. All interviews lasted 35-40 minutes and were audio-taped. Qualitative data were generated from the extended responses to the structured questions of the CAQ and later transcribed. Thematic analysis was conducted in relation to explanations, elaborations, and relevant strategic approaches to improving workforce retention. RESULTS: The qualitative findings illuminated the most important advantages of recruiting and retaining GPs were linked to medical support, hospital and community support, and economic factors, while the challenges were related to geographic factors. The underlying reasons for and nature of those advantages and challenges reinforce that health professionals' decisions to stay or leave are complex and multifactorial. CONCLUSION: The originality of the study rests on the administration of the CAQ accompanied by the opportunity for participants to provide extended responses, which gives critical insights into the complexities of rural recruitment and retention. As such, the results confirm the need for a flexible multifaceted response to improving rural GP workforce and informs decision-making in terms of addressing workforce issues within the scope of available resources and capacity.
- Authors: Terry, Daniel , Nguyen, Hoang , Schmitz, David , Baker, Ed
- Date: 2018
- Type: Text , Journal article
- Relation: Rural and remote health Vol. 18, no. 3 (2018), p. 1-16
- Full Text:
- Reviewed:
- Description: INTRODUCTION: Despite existing studies in this field, community factors behind recruiting and retaining rural general practitioners (GPs) are not fully understood. To address this issue, the Community Apgar Questionnaire (CAQ) was developed to extend the understanding of communities' assets and capabilities that impact GP recruitment and retention. However, more in-depth insights are vital to develop a comprehensive approach. METHODS: This mixed methods study was administered using face-to-face structured interviews with a total of 40 health service representatives. All interviews lasted 35-40 minutes and were audio-taped. Qualitative data were generated from the extended responses to the structured questions of the CAQ and later transcribed. Thematic analysis was conducted in relation to explanations, elaborations, and relevant strategic approaches to improving workforce retention. RESULTS: The qualitative findings illuminated the most important advantages of recruiting and retaining GPs were linked to medical support, hospital and community support, and economic factors, while the challenges were related to geographic factors. The underlying reasons for and nature of those advantages and challenges reinforce that health professionals' decisions to stay or leave are complex and multifactorial. CONCLUSION: The originality of the study rests on the administration of the CAQ accompanied by the opportunity for participants to provide extended responses, which gives critical insights into the complexities of rural recruitment and retention. As such, the results confirm the need for a flexible multifaceted response to improving rural GP workforce and informs decision-making in terms of addressing workforce issues within the scope of available resources and capacity.
The importance of adequate referrals for chronic kidney disease
- Wright, Julian, Glenister, Kristen, Thwaites, Rebecca, Terry, Daniel
- Authors: Wright, Julian , Glenister, Kristen , Thwaites, Rebecca , Terry, Daniel
- Date: 2018
- Type: Text , Journal article
- Relation: Australian journal of general practice Vol. 47, no. 1-2 (2018), p. 58-62
- Full Text:
- Reviewed:
- Description: DISCUSSION: Regional Australia remains a district of workforce shortage for nephrology. Thus, it is imperative that patients who have the greatest need for nephrologist services are effectively identified upon referral. The aim of this study was to assess referrals to a regional nephrology service against Australian guidelines by assessing the patient’s renal function and the information contained in the referral document at the time of first consultation. We conducted a retrospective study of all referrals to a regional Australian nephrology service between 2013 and 2015. The 582 referrals that met the inclusion criteria were compared with Australian nephrology referral guidelines. Less than half of the referral documents (n = 253; 43.5%) described a clinical situation that met referral guidelines, typically due to insufficient pathology investigation. However, after consideration of renal functional test results performed at the initial consultation, an additional 82 cases met referral guidelines (n = 335; 57.6%). More than 40% of nephrology referrals to a regional Australian service did not meet Australian nephrology referral guidelines. This has implications for a regional nephrology service that is experiencing workforce pressures, in addition to the health system more broadly, and for patients. Many referrals contained insufficient information to allow differentiation of patients who would benefit most from nephrology care from patients who could be appropriately managed within primary care.
- Authors: Wright, Julian , Glenister, Kristen , Thwaites, Rebecca , Terry, Daniel
- Date: 2018
- Type: Text , Journal article
- Relation: Australian journal of general practice Vol. 47, no. 1-2 (2018), p. 58-62
- Full Text:
- Reviewed:
- Description: DISCUSSION: Regional Australia remains a district of workforce shortage for nephrology. Thus, it is imperative that patients who have the greatest need for nephrologist services are effectively identified upon referral. The aim of this study was to assess referrals to a regional nephrology service against Australian guidelines by assessing the patient’s renal function and the information contained in the referral document at the time of first consultation. We conducted a retrospective study of all referrals to a regional Australian nephrology service between 2013 and 2015. The 582 referrals that met the inclusion criteria were compared with Australian nephrology referral guidelines. Less than half of the referral documents (n = 253; 43.5%) described a clinical situation that met referral guidelines, typically due to insufficient pathology investigation. However, after consideration of renal functional test results performed at the initial consultation, an additional 82 cases met referral guidelines (n = 335; 57.6%). More than 40% of nephrology referrals to a regional Australian service did not meet Australian nephrology referral guidelines. This has implications for a regional nephrology service that is experiencing workforce pressures, in addition to the health system more broadly, and for patients. Many referrals contained insufficient information to allow differentiation of patients who would benefit most from nephrology care from patients who could be appropriately managed within primary care.
Asthma hospitalisation trends from 2010 to 2015 : variation among rural and metropolitan Australians
- Terry, Daniel, Robins, Shalley, Gardiner, Samantha, Wyett, Ruby, Islam, Md Rafiqul
- Authors: Terry, Daniel , Robins, Shalley , Gardiner, Samantha , Wyett, Ruby , Islam, Md Rafiqul
- Date: 2017
- Type: Text , Journal article
- Relation: BMC Public Health Vol. 17, no. 1 (2017), p.
- Full Text:
- Reviewed:
- Description: Background: Asthma remains a leading cause of illness, where primary care can assist to reduce hospitalisations through prevention, controlling acute episodes, and overall management of asthma. In Victoria, Asthma hospitalisations were as high as 3.1 hospitalisations per 1000 population in 1993-94. The primary aims of this study are to: determine if changes in asthma hospitalisations have occurred between 2010 and 2015; determine the key factors that impact asthma hospitalisation over time; and verify whether rural and urban asthma hospitalisations are disparate. A secondary aim of the study is to compare 2010-2015 results with asthma data prior to 2010. Methods: Hospital separation data from 1 July 2010 to 30 June 2015 were obtained through the Victorian Admitted Episodes Dataset and other agencies. Data included sex, age, Local Government Area, private or public patient, length of stay, and type of discharge. Asthma and predictor variables were analysed according to hospital separation rates after adjusting for smoking and sex. Hierarchical multiple regression examined the association between asthma and predictor variables. Results: During the study period, 49,529 asthma hospital separations occurred, of which 77.5% were in metropolitan hospitals, 55.4% hospital separations were aged 0-14 years, and 21.7% were privately funded. State-wide hospital separations were 1.85 per 1000 population and were consistently higher in metropolitan compared to rural areas (1.93 vs 1.64 per 1000 population). When data among metropolitan adults aged 15 and over were analysed, an increase in the proportion of smokers in the population was reflected by an increase in the number of hospital separations (Adj OR 1.035). Further, among rural and metropolitan children aged 0-14 the only predictor of asthma hospital separations was sex, where metropolitan male children had higher odds of separation than metropolitan females of the same age (Adj OR 4.297). There was no statistically meaningful difference for separation rates between males and females in rural areas. Conclusions: We demonstrated a higher overall hospital separation rate in metropolitan Victoria. For children in metropolitan areas, males were hospitalised at higher rates than females, while the inverse was demonstrated for children residing in rural areas. Therefore, optimising asthma management requires consideration of the patient's age, gender and residential context. Primary health care may play a leading role in increasing health literacy for patients in order to improve self-management and health-seeking behaviour. © 2017 The Author(s).
Asthma hospitalisation trends from 2010 to 2015 : variation among rural and metropolitan Australians
- Authors: Terry, Daniel , Robins, Shalley , Gardiner, Samantha , Wyett, Ruby , Islam, Md Rafiqul
- Date: 2017
- Type: Text , Journal article
- Relation: BMC Public Health Vol. 17, no. 1 (2017), p.
- Full Text:
- Reviewed:
- Description: Background: Asthma remains a leading cause of illness, where primary care can assist to reduce hospitalisations through prevention, controlling acute episodes, and overall management of asthma. In Victoria, Asthma hospitalisations were as high as 3.1 hospitalisations per 1000 population in 1993-94. The primary aims of this study are to: determine if changes in asthma hospitalisations have occurred between 2010 and 2015; determine the key factors that impact asthma hospitalisation over time; and verify whether rural and urban asthma hospitalisations are disparate. A secondary aim of the study is to compare 2010-2015 results with asthma data prior to 2010. Methods: Hospital separation data from 1 July 2010 to 30 June 2015 were obtained through the Victorian Admitted Episodes Dataset and other agencies. Data included sex, age, Local Government Area, private or public patient, length of stay, and type of discharge. Asthma and predictor variables were analysed according to hospital separation rates after adjusting for smoking and sex. Hierarchical multiple regression examined the association between asthma and predictor variables. Results: During the study period, 49,529 asthma hospital separations occurred, of which 77.5% were in metropolitan hospitals, 55.4% hospital separations were aged 0-14 years, and 21.7% were privately funded. State-wide hospital separations were 1.85 per 1000 population and were consistently higher in metropolitan compared to rural areas (1.93 vs 1.64 per 1000 population). When data among metropolitan adults aged 15 and over were analysed, an increase in the proportion of smokers in the population was reflected by an increase in the number of hospital separations (Adj OR 1.035). Further, among rural and metropolitan children aged 0-14 the only predictor of asthma hospital separations was sex, where metropolitan male children had higher odds of separation than metropolitan females of the same age (Adj OR 4.297). There was no statistically meaningful difference for separation rates between males and females in rural areas. Conclusions: We demonstrated a higher overall hospital separation rate in metropolitan Victoria. For children in metropolitan areas, males were hospitalised at higher rates than females, while the inverse was demonstrated for children residing in rural areas. Therefore, optimising asthma management requires consideration of the patient's age, gender and residential context. Primary health care may play a leading role in increasing health literacy for patients in order to improve self-management and health-seeking behaviour. © 2017 The Author(s).
Do not “let them eat cake” : Correlation of food-consumption patterns among rural primary school children from welfare and non-welfare households
- Terry, Daniel, Ervin, Kaye, Soutter, Erin, Spiller, Renata, Nogare, Nicole, Hamilton, Andrew
- Authors: Terry, Daniel , Ervin, Kaye , Soutter, Erin , Spiller, Renata , Nogare, Nicole , Hamilton, Andrew
- Date: 2017
- Type: Text , Journal article
- Relation: International Journal of Environmental Research and Public Health Vol. 14, no. 1 (2017), p. 1-10
- Full Text:
- Reviewed:
- Description: Physical and financial access impacts food choice and consumption, while educational attainment, employment, income, gender, and socioeconomic status are also influential. Within this context, the aim of the paper is to examine the association between various foods consumed and eating patterns of children between low and higher income households. A paper-based survey was completed by parents/carers of children in 41 primary schools in rural and regional areas of Victoria. Data collected included demographics and the consumption of fruit, vegetable, and other foods including drinks. Ordinal data were analysed using Spearman’s rank-order correlation. The main findings were that children who consumed more fruit and vegetables tended to have a higher intake of healthy drinks (plain milk and water) as well as a lower intake of unhealthy snacks and drinks (sugar sweetened drinks). Those who perceived that fruit and vegetables cost too much reported greater consumption of unhealthy snacks and sugar-sweetened beverages, which was more prominent in low-income households. Changing food consumption behaviours requires a complex systems-based approach that addresses more than just individual issues variables. A participatory approach that works with local communities and seeks to build an understanding of unique challenges within sub-groups has potential for embedding long-lasting and meaningful change in eating behaviours. © 2016 by the authors; licensee MDPI, Basel, Switzerland.
- Authors: Terry, Daniel , Ervin, Kaye , Soutter, Erin , Spiller, Renata , Nogare, Nicole , Hamilton, Andrew
- Date: 2017
- Type: Text , Journal article
- Relation: International Journal of Environmental Research and Public Health Vol. 14, no. 1 (2017), p. 1-10
- Full Text:
- Reviewed:
- Description: Physical and financial access impacts food choice and consumption, while educational attainment, employment, income, gender, and socioeconomic status are also influential. Within this context, the aim of the paper is to examine the association between various foods consumed and eating patterns of children between low and higher income households. A paper-based survey was completed by parents/carers of children in 41 primary schools in rural and regional areas of Victoria. Data collected included demographics and the consumption of fruit, vegetable, and other foods including drinks. Ordinal data were analysed using Spearman’s rank-order correlation. The main findings were that children who consumed more fruit and vegetables tended to have a higher intake of healthy drinks (plain milk and water) as well as a lower intake of unhealthy snacks and drinks (sugar sweetened drinks). Those who perceived that fruit and vegetables cost too much reported greater consumption of unhealthy snacks and sugar-sweetened beverages, which was more prominent in low-income households. Changing food consumption behaviours requires a complex systems-based approach that addresses more than just individual issues variables. A participatory approach that works with local communities and seeks to build an understanding of unique challenges within sub-groups has potential for embedding long-lasting and meaningful change in eating behaviours. © 2016 by the authors; licensee MDPI, Basel, Switzerland.
English learning strategies among EFL learners : a narrative approach
- Nguyen, Hoang, Terry, Daniel
- Authors: Nguyen, Hoang , Terry, Daniel
- Date: 2017
- Type: Text , Journal article
- Relation: IAFOR Journal of Language Learning Vol. 3, no. 1 (2017), p. 4-19
- Full Text:
- Reviewed:
- Authors: Nguyen, Hoang , Terry, Daniel
- Date: 2017
- Type: Text , Journal article
- Relation: IAFOR Journal of Language Learning Vol. 3, no. 1 (2017), p. 4-19
- Full Text:
- Reviewed: