Evidence-based health care and community nursing : Issues and challenges
- Authors: McDonald, John , Smith, Janine
- Date: 2001
- Type: Text , Journal article
- Relation: Australian health review : a publication of the Australian Hospital Association Vol. 24, no. 3 (2001), p. 133-140
- Full Text: false
- Reviewed:
- Description: This paper examines the implications of the movement towards evidence-based health care for community-based, primary health care nursing in Australia. While both aim to improve health status, we argue that they are antithetical in many respects. Community nurse practitioners draw upon primary health care principles and adopt a holistic, preventive, empowering approach to working with and in communities. By contrast, evidence-based approaches utilise systematic reviews of primarily quantitative research to inform decisions about health at three levels: public health, the health care system, and individual patients. In response to this challenge, community nurses must reiterate their philosophies and practice models. Moreover, it is imperative to produce verifiable evidence of the effectiveness of their approach while mounting a thorough critique of the evidence-based movement.
- Description: 2003004331
Hip arthroscopy in the setting of hip osteoarthritis : Systematic review of outcomes and progression to hip arthroplasty
- Authors: Kemp, Joanne , MacDonald, David , Collins, Natalie , Hatton, Anna , Crossley, Kay
- Date: 2015
- Type: Text , Journal article
- Relation: Clinical Orthopaedics and Related Research Vol. 473, no. (2015), p. 1055-1073
- Full Text: false
- Reviewed:
- Description: Background: Hip arthroscopy is now commonly used to treat hip pain and pathology, including osteoarthritis (OA). Despite this, little is known about the effect of hip arthroscopy on outcomes of pain and function and progression to total hip arthroplasty (THA) in hip OA. Questions/purposes: This systematic review aimed to (1) determine pain and function outcomes after hip arthroscopy in people with hip OA; (2) compare the outcome after hip arthroscopy between people with and without hip OA; and (3) report the likelihood of progression to THA in patients with hip OA after hip arthroscopy. Methods: This review was conducted in accordance with the PRISMA statement. The Downs and Black checklist was used for quality appraisal. Studies scoring positively on at least 50% of items were included in final analyses. Standardized mean differences (SMDs) were calculated where possible or study conclusions are presented. Results: Twenty-two studies were included in the final analyses. Methodological quality and followup time varied widely. Moderate to large SMDs were reported for people with and without hip OA; however, the positive effects of the intervention were smaller for people with hip OA. Greater severity of hip OA and older age each predicted more rapid progression to THA. Conclusions: Patients with hip OA report positive outcomes from hip arthroscopy, although observed positive effects may be inflated as a result of methodological limitations of the included studies. Patients with hip OA had inferior results compared with those who did not. Chondropathy severity and patient age were associated with a higher risk and more rapid progression to THA. High-quality comparative studies are required to confirm the effects of hip arthroscopy on symptoms and structural change in people with hip OA.
Psychometric properties of patient-reported outcome measures for hip arthroscopic surgery
- Authors: Kemp, Joanne , Collins, Natalie , Roos, Ewa , Crossley, Kay
- Date: 2013
- Type: Text , Journal article
- Relation: American Journal of Sports Medicine Vol. 41, no. 9 (2013), p. 2065-2073
- Full Text: false
- Reviewed:
- Description: Background: Patient-reported outcomes (PROs) are considered the gold standard when evaluating outcomes in a surgical population. While the psychometric properties of some PROs have been tested, the properties of newer PROs in patients undergoing hip arthroscopic surgery remain somewhat unknown. Purpose: To evaluate the reliability, validity, responsiveness, and interpretability of 5 PROs (Copenhagen Hip and Groin Outcome Score [HAGOS], Hip Disability and Osteoarthritis Outcome Score [HOOS], Hip Outcome Score [HOS], International Hip Outcome Tool [iHOT-33], and Modified Harris Hip Score [MHHS]) in a population undergoing hip arthroscopic surgery and also to provide a recommendation of the best PROs in patients undergoing hip arthroscopic surgery. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: Study participants were adults (mean age, 37 ± 11 years) who had undergone hip arthroscopic surgery 12 to 24 months previously and pain-free, healthy age-matched controls (mean age, 35 ± 11 years). Baseline characteristics including age, height, weight, waist girth, physical activity, and occupation were collected for both groups. The hip arthroscopic surgery group completed the 5 PRO questionnaires on 3 occasions, while the healthy control group completed the PRO questionnaires on 1 occasion. The reliability (test-retest reliability [intraclass correlation coefficient, or ICC] and minimal detectable change [MDC]), validity (construct validity, ability to detect a difference between groups, acceptability including floor and ceiling effects), responsiveness, and interpretability (minimal important change [MIC]) of each measure were calculated. Results: The test-retest reliability of PROs was excellent (ICC, 0.91-0.97), with an MDC of<20%. The HOOS, HAGOS, and iHOT- 33 had acceptable content validity. All PROs demonstrated construct validity and were able to detect a difference between the hip arthroscopic surgery and control groups. No measures demonstrated a floor effect; however, the MHHS and subscales relating to activities of daily living of the HOOS, HOS, and HAGOS demonstrated a ceiling effect. The HOOS, iHOT-33, and MHHS demonstrated adequate responsiveness, and the MIC for all measures was<11 points of a possible 100 points. Conclusion: The PROs of the HOOS and iHOT-33 demonstrate psychometric properties that may enable researchers and clinicians to use them with confidence in a population undergoing hip arthroscopic surgery. The psychometric properties of the MHHS, HOS, and some subscales of the HAGOS are reduced, and these PROs may be less valuable in this group. © 2013 The Author(s). National Health and Medical Research Council (Australia) Health Professional Research Training (Postdoctoral) Fellowship (No. 628918).
Chiropractic Observation and Analysis Study (COAST): Providing an understanding of current chiropractic practice
- Authors: French, Simon , Charity, Melanie , Forsdike, Kirsty , Gunn, Jane , Polus, Barbara , Walker, Bruce , Chondros, Patty , Britt, Helena
- Date: 2013
- Type: Text , Journal article
- Relation: Medical Journal of Australia Vol. 199, no. 10 (2013), p. 687-691
- Full Text: false
- Reviewed:
- Description: Objectives: COAST (Chiropractic Observation and Analysis Study) aimed to describe the clinical practices of chiropractors in Victoria, Australia. Design: Cross-sectional study using the BEACH (Bettering the Evaluation and Care of Health) methods for general practice. Setting and participants: 180 chiropractors in active clinical practice in Victoria were randomly selected from the list of 1298 chiropractors registered on Chiropractors Registration Board of Victoria. Twenty-four chiropractors were ineligible, 72 agreed to participate, and 52 completed the study. Main outcome measures: Each participating chiropractor documented encounters with up to 100 consecutive patients. For each chiropractor-patient encounter, information collected included patient health profile, patient reasons for encounter, problems and diagnoses, and chiropractic care. Results: Data were collected on 4464 chiropractor-patient encounters from 52 chiropractors between 11 December 2010 and 28 September 2012. In most (71%) encounters, patients were aged 25-64 years; 1% of encounters were with infants (age < 1 year; 95% CI, 0.3%-3.2%). Musculoskeletal reasons for encounter were described by patients at a rate of 60 per 100 encounters (95% CI, 54-67 encounters) and maintenance and wellness or check-up reasons were described at a rate of 39 per 100 encounters (95% CI, 33-47 encounters). Back problems were managed at a rate of 62 per 100 encounters (95% CI, 55-71 encounters). The most frequent care provided by the chiropractors was spinal manipulative therapy and massage. Conclusions: A range of conditions are managed by chiropractors in Victoria, Australia, but most commonly these conditions are musculoskeletal-related. These results can be used by stakeholders of the chiropractic profession in workforce development, education and health care policy.
Internet-based treatment for panic disorder: Does frequency of therapist contact make a difference?
- Authors: Klein, Britt , Austin, David , Pier, Ciaran , Kiropoulos, Litza , Shandley, Kerrie , Mitchell, Joanna , Gilson, Kathryn , Ciechomski, Lisa
- Date: 2009
- Type: Text , Journal article
- Relation: Cognitive Behaviour Therapy Vol. 38, no. 2 (2009), p. 100-113
- Full Text: false
- Reviewed:
- Description: Internet-based interventions with therapist support have proven effective for treating a range of mental health conditions. This study examined whether frequency of therapist contact affected treatment outcomes. Fifty-seven people with panic disorder (including 32 with agoraphobia) were randomly allocated to an 8-week Internet-based cognitive behavioural treatment intervention (Panic Online) with either frequent (three e-mails per week) or infrequent (one e-mail per week) support from a psychologist. Posttreatment, intention-to-treat analyses revealed that both treatments were effective at improving panic disorder and agoraphobia severity ratings, panic-related cognitions, negative affect, and psychological and physical quality of life domains, with no differences between conditions. High end-state functioning was achieved by 28.6% of the frequent and infrequent participants, respectively. Therapist alliance, treatment credibility, and satisfaction also did not differ between groups, despite significantly greater therapist time invested in the frequent contact condition. The results provide evidence that the effectiveness of Internet-based mental health interventions may be independent of the frequency of therapist support and may, therefore, be more cost-effective than previously reported. © 2009 Taylor & Francis.
A therapist-assisted cognitive behavior therapy internet intervention for posttraumatic stress disorder: Pre-, post- and 3-month follow-up results from an open trial
- Authors: Klein, Britt , Mitchell, Joanna , Abbott, Jo-Anne , Shandley, Kerrie , Austin, David , Gilson, Kathryn , Kiropoulos, Litza , Cannard, Gwenda , Redman, Tomi
- Date: 2010
- Type: Text , Journal article
- Relation: Journal of Anxiety Disorders Vol. 24, no. 6 (2010), p. 635-644
- Full Text: false
- Reviewed:
- Description: This study was an open trial evaluation of a 10-week therapist-assisted cognitive behavior therapy (CBT) internet intervention (PTSD Online) undertaken with people with a primary clinical diagnosis of posttraumatic stress disorder (PTSD) (n= 22) at pre-assessment. Participants were re-assessed at post-assessment and 3-month follow-up. Significant improvements on PTSD severity ratings and related PTSD symptomatology were observed at post-assessment and maintained at 3-month follow-up. At post-assessment, 69.2% of the sample showed clinically significant improvement and 77% of the sample at follow-up assessment. Non-significant, yet improved, change was observed on all other general psychological measures. Overall, treatment satisfaction was good (69%), participant therapeutic alliance ratings were high (87.5%), and the average total therapist time required was 194.5. min. PTSD Online appears to be an efficacious treatment option for people with PTSD that can be provided entirely remotely, with far less therapist time than traditional face-to-face treatment, and without compromising therapeutic alliance. © 2010 Elsevier Ltd.
Rural v metro : Geographical differences in sports injury hospital admissions across Victoria
- Authors: Shee, Anna Wong , Clapperton, Angela , Finch, Caroline
- Date: 2015
- Type: Text , Journal article , Short Report
- Relation: Medical Journal of Australia Vol. 203, no. 7 (2015), p. 288-288e.1
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
- Full Text: false
- Reviewed:
- Description: Injury prevention is one of the Australian National Health Priority Areas.1 Injuries requiring medical attention place considerable demands on the health care system and are increasingly being recognised as a significant public health problem.2 Recent statewide data from Victoria show that the public health burden of sports injury, as a particular context for hospitalised injury, has increased significantly in recent times.3,4 Understanding whether sports injury rates vary by geographic regions in Vic would inform better health service delivery to redress identified health inequalities across regions and aid targeting of preventive programs.
Development of an online intervention for bipolar disorder. www.moodswings.net.au
- Authors: Lauder, Sue , Chester, Andrea , Castle, David , Dodd, Seetal , Berk, Lesley , Klein, Britt , Austin, David , Gilbert, Monica , Chamberlain, James , Murray, Greg , White, Carolynne , Piterman, Leon , Berk, Michael
- Date: 2013
- Type: Text , Journal article
- Relation: Psychology, Health and Medicine Vol. 18, no. 2 (2013), p. 155-165
- Full Text: false
- Reviewed:
- Description: We describe the development process and completed structure, of a self-help online intervention for bipolar disorder, known as MoodSwings (www.moodswings.net.au). The MoodSwings program was adapted as an Internet intervention from an efficacious and validated face-to-face, group-based psychosocial intervention. The adaptation was created by a psychologist, who had previously been involved with the validation of the face-to-face program, in collaboration with website designers. The project was conducted under the supervision of a team of clinician researchers. The website is available at no cost to registered participants. Self-help modules are accessed sequentially. Other features include a mood diary and a moderated discussion board. There has been an average of 1,475,135 hits on the site annually (2008 and 2009), with some 7400 unique visitors each year. A randomised controlled trial based on this program has been completed. Many people with bipolar disorder are accepting of the Internet as a source of treatment and, once engaged, show acceptable retention rates. The Internet appears to be a viable means of delivering psychosocial self-help strategies. © 2013 Copyright Taylor and Francis Group, LLC.
Belief in conspiracy theories : the predictive role of schizotypy, machiavellianism, and primary psychopathy
- Authors: March, Evita , Springer
- Date: 2019
- Type: Text , Journal article
- Relation: PLoS ONE Vol. 14, no. 12 (2019), p.
- Full Text:
- Reviewed:
- Description: A conspiracy theory refers to an alternative explanation of an event involving a conspirator plot organised by powerful people or organisations. Belief in conspiracy theories is related to negative societal outcomes such as poor medical decisions and a decrease in prosocial behaviour. Given these negative outcomes, researchers have explored predictors of belief in conspiracy theories in an attempt to understand and possibly manage these beliefs. In the current study, we explored the utility of personality in predicting belief in conspiracy theories. The aim of the current study was to explore the utility of the odd beliefs/magical thinking subtype of schizotypy, Machiavellianism, grandiose narcissism, vulnerable narcissism, primary psychopathy, and secondary psychopathy in predicting belief in conspiracy theories. Participants (N = 230; 44.7% male, 55.3% female) completed an anonymous, confidential online questionnaire which comprised demographics and measures of personality traits and belief in conspiracy theories. The total regression model indicated odd beliefs/magical thinking, trait Machiavellianism, and primary psychopathy were significant, positive predictors of belief in conspiracy theories. No other predictors reached significance. Results of the current study highlight individuals who might be more susceptible to believing conspiracy theories. Specifically, these results indicate that the individual more likely to believe in conspiracy theories may have unusual patterns of thinking and cognitions, be strategic and manipulative, and display interpersonal and affective deficits. © 2019 March, Springer. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.