Rural community nurses : insights into health workforce and health service needs in Tasmania
- Terry, Daniel, Lê, Quynh, Hoang, Ha, Barrett, Annette
- Authors: Terry, Daniel , Lê, Quynh , Hoang, Ha , Barrett, Annette
- Date: 2015
- Type: Text , Journal article
- Relation: The International Journal of Health, Wellness, and Society Vol. 5, no. 3 (2015), p. 109-120
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- Description: Abstract: Community nurses often work in isolation, particularly in rural areas where many other non-government adjunct health services are absent. At times, they feel overwhelmed, stressed and undervalued while undertaking diverse responsibilities. The study aimed to examine the benefits and challenges community nurses experience when working in rural and remote areas of Tasmania, Australia while determining the specialty skills and practices to meet rural health needs. An explorative research design using a phenomenological approach was adopted. Data were collected through semi-structured interviews with a convenient sample of 15 community nurses from the North and North-west areas of Tasmania. This yielded insight into the rural workforce challenges, gaps in services and the community nurses' lived experience of providing adequate health services to these communities. The results indicated significant variations in the structure and type of community nursing services and a number of key challenges were identified within the profession. Despite these challenges community nurses interviewed indicated high levels of job satisfaction and long term employment. Given the diversity in both community nursing roles and factors impacting on the role further research is required to examine the exact roles and levels of integration between specialist and generalist community nursing roles while exploring and more clearly defining the role of the contemporary community nurse in Australia. Consideration should also be given to embracing community nursing diversity which is an important aspect of best practice for future community nursing.
- Authors: Terry, Daniel , Lê, Quynh , Hoang, Ha , Barrett, Annette
- Date: 2015
- Type: Text , Journal article
- Relation: The International Journal of Health, Wellness, and Society Vol. 5, no. 3 (2015), p. 109-120
- Full Text:
- Reviewed:
- Description: Abstract: Community nurses often work in isolation, particularly in rural areas where many other non-government adjunct health services are absent. At times, they feel overwhelmed, stressed and undervalued while undertaking diverse responsibilities. The study aimed to examine the benefits and challenges community nurses experience when working in rural and remote areas of Tasmania, Australia while determining the specialty skills and practices to meet rural health needs. An explorative research design using a phenomenological approach was adopted. Data were collected through semi-structured interviews with a convenient sample of 15 community nurses from the North and North-west areas of Tasmania. This yielded insight into the rural workforce challenges, gaps in services and the community nurses' lived experience of providing adequate health services to these communities. The results indicated significant variations in the structure and type of community nursing services and a number of key challenges were identified within the profession. Despite these challenges community nurses interviewed indicated high levels of job satisfaction and long term employment. Given the diversity in both community nursing roles and factors impacting on the role further research is required to examine the exact roles and levels of integration between specialist and generalist community nursing roles while exploring and more clearly defining the role of the contemporary community nurse in Australia. Consideration should also be given to embracing community nursing diversity which is an important aspect of best practice for future community nursing.
The perceptions of community change through promoting positive sexual health : a teenage pregnancy program evaluation
- Lê, Quynh, Auckland, Stuart, Nguyen, Hoang, Terry, Daniel
- Authors: Lê, Quynh , Auckland, Stuart , Nguyen, Hoang , Terry, Daniel
- Date: 2015
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 3, no. 2 (2015), p. 55-64
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- Description: Teenage pregnancy is associated with adverse social, economic and health outcomes for both mother and child. The factors frequently associated with teenage pregnancy or related sexual health issues include teenagers' knowledge, attitudes, and beliefs about sex and other social-economic factors such as levels of poverty, academic success or failure, and parents' education. This paper reports on the evaluation of a teenage pregnancy program conducted in the Southern and North Western regions of Tasmania to address the high levels of teenage pregnancy and sexually transmitted infection (STIs) in these regions. The aim of the study was to examine the effectiveness of the Teenage Pregnancy Programs by examining any evidence for a community change in attitudes and behaviours, and any changes in youth awareness about sexual health. The study adopted a qualitative approach and data were collected from a total of 25 participants (17 who were interviewed and eight who participated in focus groups) residing in the target regions. Data were analysed using thematic analysis using Nvivo 9.0. The study results indicated that the program was well managed and delivered. There were reported changes in the awareness, attitudes and behaviours regarding sexual health within the target communities, which were considered necessary for young people to make well informed choices. The evaluation of the program provides valuable knowledge regarding the processes and outcomes that may have application in future community based sexual health initiatives may be delivered into regional communities.
- Authors: Lê, Quynh , Auckland, Stuart , Nguyen, Hoang , Terry, Daniel
- Date: 2015
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 3, no. 2 (2015), p. 55-64
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- Description: Teenage pregnancy is associated with adverse social, economic and health outcomes for both mother and child. The factors frequently associated with teenage pregnancy or related sexual health issues include teenagers' knowledge, attitudes, and beliefs about sex and other social-economic factors such as levels of poverty, academic success or failure, and parents' education. This paper reports on the evaluation of a teenage pregnancy program conducted in the Southern and North Western regions of Tasmania to address the high levels of teenage pregnancy and sexually transmitted infection (STIs) in these regions. The aim of the study was to examine the effectiveness of the Teenage Pregnancy Programs by examining any evidence for a community change in attitudes and behaviours, and any changes in youth awareness about sexual health. The study adopted a qualitative approach and data were collected from a total of 25 participants (17 who were interviewed and eight who participated in focus groups) residing in the target regions. Data were analysed using thematic analysis using Nvivo 9.0. The study results indicated that the program was well managed and delivered. There were reported changes in the awareness, attitudes and behaviours regarding sexual health within the target communities, which were considered necessary for young people to make well informed choices. The evaluation of the program provides valuable knowledge regarding the processes and outcomes that may have application in future community based sexual health initiatives may be delivered into regional communities.
Workplace health and safety issues among community nurses : a study regarding the impact on providing care to rural consumers
- Terry, Daniel, Lê, Quynh, Nguyen, Uyen, Hoang, Hoang
- Authors: Terry, Daniel , Lê, Quynh , Nguyen, Uyen , Hoang, Hoang
- Date: 2015
- Type: Text , Journal article
- Relation: BMJ Open Vol. 5, no. 8 (2015), p.
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- Description: Objectives: The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. Methods: The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. Results: The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client's homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Conclusions: Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the needs among all staff.
- Authors: Terry, Daniel , Lê, Quynh , Nguyen, Uyen , Hoang, Hoang
- Date: 2015
- Type: Text , Journal article
- Relation: BMJ Open Vol. 5, no. 8 (2015), p.
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- Description: Objectives: The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. Methods: The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. Results: The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client's homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Conclusions: Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the needs among all staff.
Satisfaction amid professional challenges : international medical graduates in rural Tasmania
- Terry, Daniel, Lê, Quynh, Hoang, Hoang
- Authors: Terry, Daniel , Lê, Quynh , Hoang, Hoang
- Date: 2014
- Type: Text , Journal article
- Relation: Australasian Medical Journal Vol. 7, no. 12 (2014), p. 500-517
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- Description: Background At the time of recruitment, migration, and placement, international medical graduates (IMGs) encounter professional challenges. These challenges may include a loss of status and professional identity, professional isolation in rural practice, restrictions on medical practice, and social isolation. Understanding the nature of these challenges may facilitate the recruitment, placement, and success of international medical graduates within rural Tasmania. Aims The aim of this study was to investigate the experiences, challenges, and barriers that IMGs encounter as they work and live in rural Tasmania. Methods The study used a mixed-methods design where data were collected using a questionnaire and semi-structured interviews across the south, north, and northwest of Tasmania. IMGs were recruited through purposive snowball and convenience sampling. Results A total of 105 questionnaires were returned (response rate 30.0 per cent) and 23 semi-structured interviews were conducted with IMGs across Tasmania. Questionnaire participants indicated that the majority of IMGs are satisfied in their current employment; however, interview participants indicated there were a number of barriers to practising medicine in Tasmania as well as factors that would influence ongoing employment in the state. Despite these challenges, professional support was recognised as a key contributor to professional satisfaction, particularly among IMGs who had just arrived. Conclusion The study contributes to the current knowledge and understanding of IMGs who live and work in rural areas. The study shows that there are high levels of satisfaction among IMGs with their current position; however, the research also provides insight into the complexities and factors that impact IMGs as they work and live within rural areas such as Tasmania. This study offers an understanding for policy to improve greater retention of IMGs across rural areas. © 2014 Australasion Medical Jaurnal. All rights received.
- Authors: Terry, Daniel , Lê, Quynh , Hoang, Hoang
- Date: 2014
- Type: Text , Journal article
- Relation: Australasian Medical Journal Vol. 7, no. 12 (2014), p. 500-517
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- Description: Background At the time of recruitment, migration, and placement, international medical graduates (IMGs) encounter professional challenges. These challenges may include a loss of status and professional identity, professional isolation in rural practice, restrictions on medical practice, and social isolation. Understanding the nature of these challenges may facilitate the recruitment, placement, and success of international medical graduates within rural Tasmania. Aims The aim of this study was to investigate the experiences, challenges, and barriers that IMGs encounter as they work and live in rural Tasmania. Methods The study used a mixed-methods design where data were collected using a questionnaire and semi-structured interviews across the south, north, and northwest of Tasmania. IMGs were recruited through purposive snowball and convenience sampling. Results A total of 105 questionnaires were returned (response rate 30.0 per cent) and 23 semi-structured interviews were conducted with IMGs across Tasmania. Questionnaire participants indicated that the majority of IMGs are satisfied in their current employment; however, interview participants indicated there were a number of barriers to practising medicine in Tasmania as well as factors that would influence ongoing employment in the state. Despite these challenges, professional support was recognised as a key contributor to professional satisfaction, particularly among IMGs who had just arrived. Conclusion The study contributes to the current knowledge and understanding of IMGs who live and work in rural areas. The study shows that there are high levels of satisfaction among IMGs with their current position; however, the research also provides insight into the complexities and factors that impact IMGs as they work and live within rural areas such as Tasmania. This study offers an understanding for policy to improve greater retention of IMGs across rural areas. © 2014 Australasion Medical Jaurnal. All rights received.
Views and perceptions of local council partners concerning a regional-scale health promotion initiative in rural Australia
- Lê, Quynh, Auckland, Stuart, Nguyen, Hoang, Terry, Daniel
- Authors: Lê, Quynh , Auckland, Stuart , Nguyen, Hoang , Terry, Daniel
- Date: 2014
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 2, no. 7 (2014), p. 181-188
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- Description: There are a number of risk factors which increasingly impact the health and wellbeing of Australians, particularly in rural communities. To address the health and wellbeing of communities, local governments are taking on a more focused role by supporting healthy community initiatives (HCI). This paper presents local council partners perceptions concerning a regional-scale health promotion initiative that was undertaken in rural Tasmania, Australia. The evaluation provides insight into the future decisions and strategies that may be developed to improve processes, methods and outcomes of health initiatives undertaken by local governments. The study used a mixed methods approach collecting data through a questionnaire, focus group discussions and interviews with stakeholders and participating councils to provide an understanding of the effectiveness and success of, and barriers to, the health promotion initiative. It was found that there was an emphasis by local councils on programs that promoted physical activities, while programs that focused on healthy food and other health promotion topics, such as quit smoking and healthy workplaces were less emphasised. Overall, the health promotion initiative was perceived to be effective; however, there was little measureable evidence as to the outcomes of the various projects within the initiative and there was concern regarding the sustainability of the initiative beyond the funding timeframe. Community based, health promotion interventions are complex. Local government are suitably placed to deliver health promotion initiatives, as they have a greater understanding and can affect the greatest change by investing in projects with the highest priority among those communities within their boundaries. Nevertheless, sustainability of projects beyond funding allocation, while building and improving partnerships among local governments, and service agencies to pool resources and capture specific target groups must be central to ongoing initiatives.
- Authors: Lê, Quynh , Auckland, Stuart , Nguyen, Hoang , Terry, Daniel
- Date: 2014
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 2, no. 7 (2014), p. 181-188
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- Description: There are a number of risk factors which increasingly impact the health and wellbeing of Australians, particularly in rural communities. To address the health and wellbeing of communities, local governments are taking on a more focused role by supporting healthy community initiatives (HCI). This paper presents local council partners perceptions concerning a regional-scale health promotion initiative that was undertaken in rural Tasmania, Australia. The evaluation provides insight into the future decisions and strategies that may be developed to improve processes, methods and outcomes of health initiatives undertaken by local governments. The study used a mixed methods approach collecting data through a questionnaire, focus group discussions and interviews with stakeholders and participating councils to provide an understanding of the effectiveness and success of, and barriers to, the health promotion initiative. It was found that there was an emphasis by local councils on programs that promoted physical activities, while programs that focused on healthy food and other health promotion topics, such as quit smoking and healthy workplaces were less emphasised. Overall, the health promotion initiative was perceived to be effective; however, there was little measureable evidence as to the outcomes of the various projects within the initiative and there was concern regarding the sustainability of the initiative beyond the funding timeframe. Community based, health promotion interventions are complex. Local government are suitably placed to deliver health promotion initiatives, as they have a greater understanding and can affect the greatest change by investing in projects with the highest priority among those communities within their boundaries. Nevertheless, sustainability of projects beyond funding allocation, while building and improving partnerships among local governments, and service agencies to pool resources and capture specific target groups must be central to ongoing initiatives.
Current programs and future needs in health literacy for older people : a literature review
- Lê, Quynh, Terry, Daniel, Woodroffe, Jess
- Authors: Lê, Quynh , Terry, Daniel , Woodroffe, Jess
- Date: 2013
- Type: Text , Journal article , Review
- Relation: Journal of Consumer Health on the Internet Vol. 17, no. 4 (2013), p. 369-388
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- Description: Inadequate health literacy occurs more amongst older adults and can result in difficulties synthesising information and communicating with health professionals, increased emergency visits and hospitalizations, poor uptake of preventative interventions, increased mortality, and ultimately greater health care costs. A literature review was conducted that identified 12 articles that discussed and examined health literacy interventions among older adults. It revealed few papers exist which highlight programs that examine health literacy outcomes for older adults. The review identified evidence-based best-practice models of health literacy interventions need to be further developed to meet the health literacy needs of aging population. © 2013 Copyright Quynh Le, Daniel R. Terry, and Jess Woodroffe.
- Authors: Lê, Quynh , Terry, Daniel , Woodroffe, Jess
- Date: 2013
- Type: Text , Journal article , Review
- Relation: Journal of Consumer Health on the Internet Vol. 17, no. 4 (2013), p. 369-388
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- Description: Inadequate health literacy occurs more amongst older adults and can result in difficulties synthesising information and communicating with health professionals, increased emergency visits and hospitalizations, poor uptake of preventative interventions, increased mortality, and ultimately greater health care costs. A literature review was conducted that identified 12 articles that discussed and examined health literacy interventions among older adults. It revealed few papers exist which highlight programs that examine health literacy outcomes for older adults. The review identified evidence-based best-practice models of health literacy interventions need to be further developed to meet the health literacy needs of aging population. © 2013 Copyright Quynh Le, Daniel R. Terry, and Jess Woodroffe.
Patient-held logbooks for cancer care treatment : the users’ evaluative perspective
- Lê, Quynh, Auckland, Stuart, Nguyen, Hoang, Terry, Daniel, Lê., Dustin
- Authors: Lê, Quynh , Auckland, Stuart , Nguyen, Hoang , Terry, Daniel , Lê., Dustin
- Date: 2013
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 1, no. 2 (2013), p. 15-19
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- Description: The quality and usefulness of patient held logbooks as a record to improve communication between healthcare professionals providing cancer care was evaluated. Its aim was to facilitate greater coordination and information sharing between patients, carers, clinicians and other health professionals. A mixed-method exploratory study conducted 12-week post distribution of logbooks to patients undertaking cancer care. Data was gathered through questionnaires returned by 66 participants (response rate of 57.4%) and interviews with five clinical oncology nurses at a Tasmanian hospital. The logbook quality was evaluated against two sets of indicators, including content and layout. The general effectiveness of the patient logbook was also assessed based on its usefulness, usability, efficiency and satisfaction. The logbook was considered useful among 63 (95.1%) participants. They acknowledged the logbook enabled them to be better informed, created a feeling of empowerment and greater control over their medical condition. The logbook was observed to improve communication between clinicians, their patients and families. The evaluation generated rich, in-depth information and provided useful insights into the general quality and usefulness of the logbook for cancer care. The strengths and weaknesses of the logbook were highlighted and how to better utilise its functions in the current medical system.
- Authors: Lê, Quynh , Auckland, Stuart , Nguyen, Hoang , Terry, Daniel , Lê., Dustin
- Date: 2013
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 1, no. 2 (2013), p. 15-19
- Full Text:
- Reviewed:
- Description: The quality and usefulness of patient held logbooks as a record to improve communication between healthcare professionals providing cancer care was evaluated. Its aim was to facilitate greater coordination and information sharing between patients, carers, clinicians and other health professionals. A mixed-method exploratory study conducted 12-week post distribution of logbooks to patients undertaking cancer care. Data was gathered through questionnaires returned by 66 participants (response rate of 57.4%) and interviews with five clinical oncology nurses at a Tasmanian hospital. The logbook quality was evaluated against two sets of indicators, including content and layout. The general effectiveness of the patient logbook was also assessed based on its usefulness, usability, efficiency and satisfaction. The logbook was considered useful among 63 (95.1%) participants. They acknowledged the logbook enabled them to be better informed, created a feeling of empowerment and greater control over their medical condition. The logbook was observed to improve communication between clinicians, their patients and families. The evaluation generated rich, in-depth information and provided useful insights into the general quality and usefulness of the logbook for cancer care. The strengths and weaknesses of the logbook were highlighted and how to better utilise its functions in the current medical system.
Migrants' perceptions of health promotion messages in rural Tasmania: Negotiating and communicating health risk
- Terry, Daniel, Lê, Quynh, Hoang, Ha
- Authors: Terry, Daniel , Lê, Quynh , Hoang, Ha
- Date: 2012
- Type: Text , Journal article
- Relation: Health, Risk and Society Vol. 14, no. 7-8 (2012), p. 639-653
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- Description: Asian migrants living in rural Tasmania experience a social and cultural environment dissimilar to larger Australian cities. This study investigated Asian migrants' lived experiences, their intercultural views with a focus on health risk behaviours within the challenge of a new rural environment. Certain health risks were identified and possible social and cultural connections. This exploratory study used a qualitative approach focussing on the personal experience of the Asian migrants living in rural Tasmania, Australia. Interviews were conducted from October to December 2011 with 36 Asian migrants residing in rural Tasmania, recruited through purposive sampling. Sub-populations such as Asian migrants residing in less dense culturally and linguistically diverse communities, including Tasmania, continue to maintain health and health risk beliefs from their culture. Migrant sub-population selectively adapted to their new environment, with longer term migrants acquiring western health conditions. The research provided insights about Asian migrant's views regarding non-communicable health issues in less dense culturally and linguistically diverse communities. In addition to adding to existing knowledge, the study provided some specific insights for better understanding of the relationship between health, risk and society and hopefully for improving primary health care access and delivery of care in rural and other small communities where sparse and less cohesive culturally and linguistically diverse communities exist. © 2012 Copyright Taylor and Francis Group, LLC.
- Authors: Terry, Daniel , Lê, Quynh , Hoang, Ha
- Date: 2012
- Type: Text , Journal article
- Relation: Health, Risk and Society Vol. 14, no. 7-8 (2012), p. 639-653
- Full Text:
- Reviewed:
- Description: Asian migrants living in rural Tasmania experience a social and cultural environment dissimilar to larger Australian cities. This study investigated Asian migrants' lived experiences, their intercultural views with a focus on health risk behaviours within the challenge of a new rural environment. Certain health risks were identified and possible social and cultural connections. This exploratory study used a qualitative approach focussing on the personal experience of the Asian migrants living in rural Tasmania, Australia. Interviews were conducted from October to December 2011 with 36 Asian migrants residing in rural Tasmania, recruited through purposive sampling. Sub-populations such as Asian migrants residing in less dense culturally and linguistically diverse communities, including Tasmania, continue to maintain health and health risk beliefs from their culture. Migrant sub-population selectively adapted to their new environment, with longer term migrants acquiring western health conditions. The research provided insights about Asian migrant's views regarding non-communicable health issues in less dense culturally and linguistically diverse communities. In addition to adding to existing knowledge, the study provided some specific insights for better understanding of the relationship between health, risk and society and hopefully for improving primary health care access and delivery of care in rural and other small communities where sparse and less cohesive culturally and linguistically diverse communities exist. © 2012 Copyright Taylor and Francis Group, LLC.
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