The kids are alright : outcome of a safety programme for addressing childhood injury in Australia
- Authors: Peck, Blake , Terry, Daniel
- Date: 2021
- Type: Text , Journal article
- Relation: European Journal of Investigation in Health Psychology and Education Vol. 11, no. 2 (Jun 2021), p. 546-556
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- Description: Globally, injuries are the leading cause of death and represent the highest burden of ongoing disease amongst children 1–16 years of age. Increasingly, prevention programmes are recognising a growing need for intervention strategies that target children. The purpose of this study was to determine the efficacy of the SeeMore Safety Programme, designed to teach children (4–6 years of age) how to make conscious decisions about their own capabilities related to safety and how to manage risk. This retrospective study examined de-identified pre- and post-programme data from a sample of 1027 4 to 6-year-old pre-school children over the four-year period who participated in the SeeMore Safety Programme. Results show a significant improvement in each of the post-test scores and when compared to the pre-test scores (p < 0.001). Children from rural areas, as well as those from areas of greater disadvantage, also showed significant improvement in their pre- and post-test scores (p < 0.001). Overall, the findings highlight that the SeeMore Safety Programme over the four-year period demonstrates an increase in the children’s capacity to recognise and identify danger and safety amongst all children, offering great promise for reducing the burden of injury on children, their families and society.
- Authors: Peck, Blake , Terry, Daniel
- Date: 2021
- Type: Text , Journal article
- Relation: European Journal of Investigation in Health Psychology and Education Vol. 11, no. 2 (Jun 2021), p. 546-556
- Full Text:
- Reviewed:
- Description: Globally, injuries are the leading cause of death and represent the highest burden of ongoing disease amongst children 1–16 years of age. Increasingly, prevention programmes are recognising a growing need for intervention strategies that target children. The purpose of this study was to determine the efficacy of the SeeMore Safety Programme, designed to teach children (4–6 years of age) how to make conscious decisions about their own capabilities related to safety and how to manage risk. This retrospective study examined de-identified pre- and post-programme data from a sample of 1027 4 to 6-year-old pre-school children over the four-year period who participated in the SeeMore Safety Programme. Results show a significant improvement in each of the post-test scores and when compared to the pre-test scores (p < 0.001). Children from rural areas, as well as those from areas of greater disadvantage, also showed significant improvement in their pre- and post-test scores (p < 0.001). Overall, the findings highlight that the SeeMore Safety Programme over the four-year period demonstrates an increase in the children’s capacity to recognise and identify danger and safety amongst all children, offering great promise for reducing the burden of injury on children, their families and society.
The rural nursing workforce hierarchy of needs : decision-making concerning future rural healthcare employment
- Terry, Daniel, Peck, Blake, Baker, Ed, Schmitz, David
- Authors: Terry, Daniel , Peck, Blake , Baker, Ed , Schmitz, David
- Date: 2021
- Type: Text , Journal article
- Relation: Healthcare (Switzerland) Vol. 9, no. 9 (2021), p.
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- Description: Addressing nursing shortages in rural areas remains essential, and attracting nursing graduates is one solution. However, understanding what factors are most important or prioritized among nursing students contemplating rural employment remains essential. The study sought to understand nursing student decision-making and what aspects of a rural career need to be satisfied before other factors are then considered. A cross-sectional study over three years at an Australian university was conducted. All nursing students were invited to complete a Nursing Community Apgar Questionnaire to examine their rural practice intentions. Data were analyzed using principal component analysis, and mean scores for each component were calculated and ranked. Overall, six components encompassed a total of 35 items that students felt were important to undertake rural practice after graduating. Clinical related factors were ranked the highest, followed by managerial, practical, fiscal, familial, and geographical factors. Maslow’s Hierarchy of Needs provided a lens to examine nursing student decision-making and guided the development of the Rural Nursing Workforce Hierarchy of Needs model. Each element of the model grouped key factors that students considered to be important in order to undertake rural employment. In culmination, these factors provide a conceptual model of the hierarchy of needs that must be met in order to contemplate a rural career. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
- Authors: Terry, Daniel , Peck, Blake , Baker, Ed , Schmitz, David
- Date: 2021
- Type: Text , Journal article
- Relation: Healthcare (Switzerland) Vol. 9, no. 9 (2021), p.
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- Description: Addressing nursing shortages in rural areas remains essential, and attracting nursing graduates is one solution. However, understanding what factors are most important or prioritized among nursing students contemplating rural employment remains essential. The study sought to understand nursing student decision-making and what aspects of a rural career need to be satisfied before other factors are then considered. A cross-sectional study over three years at an Australian university was conducted. All nursing students were invited to complete a Nursing Community Apgar Questionnaire to examine their rural practice intentions. Data were analyzed using principal component analysis, and mean scores for each component were calculated and ranked. Overall, six components encompassed a total of 35 items that students felt were important to undertake rural practice after graduating. Clinical related factors were ranked the highest, followed by managerial, practical, fiscal, familial, and geographical factors. Maslow’s Hierarchy of Needs provided a lens to examine nursing student decision-making and guided the development of the Rural Nursing Workforce Hierarchy of Needs model. Each element of the model grouped key factors that students considered to be important in order to undertake rural employment. In culmination, these factors provide a conceptual model of the hierarchy of needs that must be met in order to contemplate a rural career. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
A narrative synthesis of childhood injury prevention programs for pre-school children
- Peck, Blake, Terry, Daniel, Ervin, Kaye
- Authors: Peck, Blake , Terry, Daniel , Ervin, Kaye
- Date: 2020
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 8, no. 6 (2020), p. 193-197
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- Description: Childhood injury is the leading cause of death and ongoing disability worldwide. While a cornerstone of injury prevention is education, current injury surveillance data is insufficiently nuanced to inform judgement of their effectiveness. A subsequent dearth of research evidence in the domain of childhood injury means that debate continues in regard to the most appropriate age or developmental stage of the child, as well as the most effective pedagogical approach. When considered together these issues culminate in programs that risk being inadequately targeted that are unable to justify their success in reducing injury and consequently are not sustainable. This paper reports the outcomes of a narrative synthesis approach to the review of literature in the area if childhood injury prevention programs targeted at pre-school children. Three studies met the inclusion criteria. The included studies were of poor quality and lacked convincing evidence of effectiveness due to the methods of evaluation, which in turn have shown to impact on the overall sustainability of each specific program. This paper culminates in recognition that there is insufficient evidence of the effectiveness of childhood injury prevention programs for pre-school children, requiring further high-quality studies to determine their overall effectiveness and longer-term sustainability. Copyright © 2020 by authors, all rights reserved.
- Authors: Peck, Blake , Terry, Daniel , Ervin, Kaye
- Date: 2020
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 8, no. 6 (2020), p. 193-197
- Full Text:
- Reviewed:
- Description: Childhood injury is the leading cause of death and ongoing disability worldwide. While a cornerstone of injury prevention is education, current injury surveillance data is insufficiently nuanced to inform judgement of their effectiveness. A subsequent dearth of research evidence in the domain of childhood injury means that debate continues in regard to the most appropriate age or developmental stage of the child, as well as the most effective pedagogical approach. When considered together these issues culminate in programs that risk being inadequately targeted that are unable to justify their success in reducing injury and consequently are not sustainable. This paper reports the outcomes of a narrative synthesis approach to the review of literature in the area if childhood injury prevention programs targeted at pre-school children. Three studies met the inclusion criteria. The included studies were of poor quality and lacked convincing evidence of effectiveness due to the methods of evaluation, which in turn have shown to impact on the overall sustainability of each specific program. This paper culminates in recognition that there is insufficient evidence of the effectiveness of childhood injury prevention programs for pre-school children, requiring further high-quality studies to determine their overall effectiveness and longer-term sustainability. Copyright © 2020 by authors, all rights reserved.
Communities of practice : a systematic review and meta-synthesis of what it means and how it really works among nursing students and novices
- Terry, Daniel, Nguyen, Hoang, Peck, Blake, Smith, Andrew, Phan, Hoang
- Authors: Terry, Daniel , Nguyen, Hoang , Peck, Blake , Smith, Andrew , Phan, Hoang
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Journal of Clinical Nursing Vol. 29, no. 3-4 (2020), p. 370-380
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- Description: Aims and objectives: To evaluate the enablers, barriers and impact that communities of practice have on novice nurses and students learning to become registered nurses. Background: Communities of practice have formed the basis for conceptualising the process of learning that occurs among groups of people within a place of work—a mainstay of healthcare practice. There is a dearth of literature that focuses specifically on the outcomes from student and novice engagement with existing communities of practice. Design: Systematic review and Meta-synthesis. Methods: MEDLINE, PubMed, EMBASE, CINAHL, ProQuest, Scopus and PsycINFO databases were accessed between 1997–2019. The screening and selection of studies were based on eligibility criteria and methodological quality assessment using the Critical Appraisal Skills Programme tool for qualitative research. Meta-synthesis was grounded in the original experiences and collectively synthesised into meaningful themes. The review follows the PRISMA reporting guidelines and PRISMA checklist. Results: The findings highlight three major themes and included enablers for successful communities of practice, barriers to successful communities of practice, and success in action as described by students and novice nurses. Discussion: We suggest successful communities of practice occur when safe and supported spaces ensure students and novices feel comfortable to experiment with their learning, and we emphasise the benefits of having more novice nurses situated within close proximity and under the direct influence of the established practices of more experienced or core group of peers. Relevance to clinical practice: Communities of practice that function successfully create an environment that prioritises the embedding of novices into the broader group. In so doing, students and novice nurses feel supported, welcomed, empowered, and able to make the transition from student to colleague and novice nurse to more experienced nurse. It allows them to experiment with ever new ways of fulfilling the role, while aiding better clinical outcomes. © 2019 John Wiley & Sons Ltd
- Authors: Terry, Daniel , Nguyen, Hoang , Peck, Blake , Smith, Andrew , Phan, Hoang
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Journal of Clinical Nursing Vol. 29, no. 3-4 (2020), p. 370-380
- Full Text:
- Reviewed:
- Description: Aims and objectives: To evaluate the enablers, barriers and impact that communities of practice have on novice nurses and students learning to become registered nurses. Background: Communities of practice have formed the basis for conceptualising the process of learning that occurs among groups of people within a place of work—a mainstay of healthcare practice. There is a dearth of literature that focuses specifically on the outcomes from student and novice engagement with existing communities of practice. Design: Systematic review and Meta-synthesis. Methods: MEDLINE, PubMed, EMBASE, CINAHL, ProQuest, Scopus and PsycINFO databases were accessed between 1997–2019. The screening and selection of studies were based on eligibility criteria and methodological quality assessment using the Critical Appraisal Skills Programme tool for qualitative research. Meta-synthesis was grounded in the original experiences and collectively synthesised into meaningful themes. The review follows the PRISMA reporting guidelines and PRISMA checklist. Results: The findings highlight three major themes and included enablers for successful communities of practice, barriers to successful communities of practice, and success in action as described by students and novice nurses. Discussion: We suggest successful communities of practice occur when safe and supported spaces ensure students and novices feel comfortable to experiment with their learning, and we emphasise the benefits of having more novice nurses situated within close proximity and under the direct influence of the established practices of more experienced or core group of peers. Relevance to clinical practice: Communities of practice that function successfully create an environment that prioritises the embedding of novices into the broader group. In so doing, students and novice nurses feel supported, welcomed, empowered, and able to make the transition from student to colleague and novice nurse to more experienced nurse. It allows them to experiment with ever new ways of fulfilling the role, while aiding better clinical outcomes. © 2019 John Wiley & Sons Ltd
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:
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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
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.
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
- Full Text:
- Reviewed:
- 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.
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:
- Reviewed:
- 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.
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
- 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.
- 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.
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
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- 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.
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
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- 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.
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- 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).
Is prior aspirin use associated with reduced severity in patients with acute pancreatitis?
- Lim, Alvin, Iyengar, Vasudha, Terry, Daniel, Islam, Rafiqul
- Authors: Lim, Alvin , Iyengar, Vasudha , Terry, Daniel , Islam, Rafiqul
- Date: 2017
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 5, no. 4 (2017), p. 151-156
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- Description: Clinical severity of Acute Pancreatitis (AP) following the use of Aspirin is inconclusive in previous studies. This study investigated predicting the severity of AP using Ranson criteria at admission and at 48 hours and, the length of hospital stay by prior aspirin use. Medical records of first-presentation AP patients during the five years between 2010 and 2015 were examined in the Goulburn Valley Base Hospital, Victoria, Australia. Uses of aspirin at admission with some co-morbidity, Ranson criteria at admission and at 48 hours, duration of hospital stay including other information were collected. A total of 245 AP medical records were reviewed, of them, 178 used and 67 did not use aspirin prior attending to the hospital. In simple regression analysis, Ranson score was 60% higher at admission (P< 0.001) and 64% higher at 48 hours (P <0.01) among aspirin users compared to non-aspirin users. These findings remained statistically significant after adjusting for other potential indicators. Aspirin use was also found associated with a longer hospital stay both in the unadjusted and adjusted analysis (P<0.01). Further studies using revised Atlanta classification instead of Ranson scoring for the diagnosis of AP severity in aspirin users are critical for clinical guidance.
- Authors: Lim, Alvin , Iyengar, Vasudha , Terry, Daniel , Islam, Rafiqul
- Date: 2017
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 5, no. 4 (2017), p. 151-156
- Full Text:
- Reviewed:
- Description: Clinical severity of Acute Pancreatitis (AP) following the use of Aspirin is inconclusive in previous studies. This study investigated predicting the severity of AP using Ranson criteria at admission and at 48 hours and, the length of hospital stay by prior aspirin use. Medical records of first-presentation AP patients during the five years between 2010 and 2015 were examined in the Goulburn Valley Base Hospital, Victoria, Australia. Uses of aspirin at admission with some co-morbidity, Ranson criteria at admission and at 48 hours, duration of hospital stay including other information were collected. A total of 245 AP medical records were reviewed, of them, 178 used and 67 did not use aspirin prior attending to the hospital. In simple regression analysis, Ranson score was 60% higher at admission (P< 0.001) and 64% higher at 48 hours (P <0.01) among aspirin users compared to non-aspirin users. These findings remained statistically significant after adjusting for other potential indicators. Aspirin use was also found associated with a longer hospital stay both in the unadjusted and adjusted analysis (P<0.01). Further studies using revised Atlanta classification instead of Ranson scoring for the diagnosis of AP severity in aspirin users are critical for clinical guidance.
The urban-rural divide : hypertensive disease hospitalisations in Victoria 2010–2015
- Robins, Shalley, Gardiner, Samantha, Terry, Daniel
- Authors: Robins, Shalley , Gardiner, Samantha , Terry, Daniel
- Date: 2017
- Type: Text , Journal article
- Relation: Australasian Medical Journal Vol. 10, no. 11 (2017), p. 953-963
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- Description: Background Hypertension is present in 23–32 per cent of Australians, making it one of the most prevalent diseases in the country. It is the greatest risk factor for cardiovascular disease, the leading cause of death in Australia and it affects rural populations at a higher rate than urban residents. Aims The aims of this study were to investigate the differences in hypertensive disease hospitalisations across rural and urban Victoria, and to determine predicting variables. Methods Hospital admission data from 1 July 2010 to 30 June 2015 were obtained through the Victorian Admitted Episodes Dataset and other organisations. Data included various patient demographics for each hospital admission entry. The rates of hospitalisation for each Local Government Area were analysed. Further regression analysis was undertaken to examine the association between hypertensive disease hospitalisation and various predictor variables. Results From 2010–2015 11,205 hypertensive disease hospital admissions were recorded of which 64.8 per cent were female, 74.7 per cent admissions were at urban hospitals, and 65.0 per cent were public patients. Hospitalisation rates were consistently higher in rural areas than in urban areas, and rural residents on average stayed in hospital for longer. Significant predictor variables for hypertensive disease hospitalisation included various indicators of socioeconomic disadvantage, GPs per 1,000 population and GP attendance per 1,000 population. Conclusion Hypertensive disease hospitalisation in Victoria continues to rise and rates of hospitalisation of rural Victorians continue to be higher than their urban counterparts. Females were hospitalised almost twice as often as males. Further research is required to identify the specific factors that impede access to health services, particularly in the identified high-risk populations. © 2017, Australasian Medical Journal Pty Ltd. All rights reserved.
- Authors: Robins, Shalley , Gardiner, Samantha , Terry, Daniel
- Date: 2017
- Type: Text , Journal article
- Relation: Australasian Medical Journal Vol. 10, no. 11 (2017), p. 953-963
- Full Text:
- Reviewed:
- Description: Background Hypertension is present in 23–32 per cent of Australians, making it one of the most prevalent diseases in the country. It is the greatest risk factor for cardiovascular disease, the leading cause of death in Australia and it affects rural populations at a higher rate than urban residents. Aims The aims of this study were to investigate the differences in hypertensive disease hospitalisations across rural and urban Victoria, and to determine predicting variables. Methods Hospital admission data from 1 July 2010 to 30 June 2015 were obtained through the Victorian Admitted Episodes Dataset and other organisations. Data included various patient demographics for each hospital admission entry. The rates of hospitalisation for each Local Government Area were analysed. Further regression analysis was undertaken to examine the association between hypertensive disease hospitalisation and various predictor variables. Results From 2010–2015 11,205 hypertensive disease hospital admissions were recorded of which 64.8 per cent were female, 74.7 per cent admissions were at urban hospitals, and 65.0 per cent were public patients. Hospitalisation rates were consistently higher in rural areas than in urban areas, and rural residents on average stayed in hospital for longer. Significant predictor variables for hypertensive disease hospitalisation included various indicators of socioeconomic disadvantage, GPs per 1,000 population and GP attendance per 1,000 population. Conclusion Hypertensive disease hospitalisation in Victoria continues to rise and rates of hospitalisation of rural Victorians continue to be higher than their urban counterparts. Females were hospitalised almost twice as often as males. Further research is required to identify the specific factors that impede access to health services, particularly in the identified high-risk populations. © 2017, Australasian Medical Journal Pty Ltd. All rights reserved.
Community assets and capabilities to recruit and retain GPs : the community apgar questionnaire in rural Victoria
- Terry, Daniel, Baker, Ed, Schmitz, David
- Authors: Terry, Daniel , Baker, Ed , Schmitz, David
- Date: 2016
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 16, no. 4 (2016), p.
- Full Text:
- Reviewed:
- Description: Introduction: Rural communities continue to experience significant challenges recruiting and retaining physicians. The Community Apgar Questionnaire (CAQ) was developed in Idaho in the USA to comprehensively assess the characteristics associated with successful recruitment and retention of rural physicians. The CAQ has been utilised and validated across the USA; however, its value in rural Australia has not been examined. The objective of this study was to use the CAQ in rural Australia to examine its utility and develop a greater understanding of the community factors that impact general practitioner (GP) recruitment and retention. Method: The project conducted structured face-to-face interviews with hospital chief executive officers (CEOs) and directors of clinical services (DCSs) from 14 of the 21 (76%) health services that agreed to participate in rural north-eastern Victoria, Australia. The interviews were undertaken to complete the CAQ, which contains 50 questions centred on factors that influence physician recruitment and retention. Once completed, CAQs were scored by assigning quantitative values to a community's strengths and challenges including the level of importance placed on each factor. As such, the most important factors in physician recruitment, whether they are advantages or challenges for that community, were then weighed for their relative importance. Scores were then combined to create a CAQ score. To ensure reliability and validity of the results, three additional CAQs were purposefully administered to key general practices within the region. Results: The 14 rural communities exhibited cumulative CAQ scores ranging from a high of 387 to a low score of 61. This suggests the tool was sensitive enough to differentiate between communities that were high and low performers in terms of physician recruitment. The groups of factors that had the greatest impact on recruitment and retention were ranked highest to lowest and included medical support, hospital/community support, economic, scope of practice and geographic factors. Overall, the highest individual factors to impact recruitment and retention were perception of quality, hospital leadership, nursing workforce and transfer arrangements. Conversely, the lowest factors and challenges to recruitment and retention were family related, specifically spousal satisfaction and access to schools. Conclusions: Hume, in rural Victoria, was the first international site to implement the CAQ to differentially diagnose a community's relative strengths and challenges in recruiting and retaining GPs, while supporting health facilities to prioritise achievable goals to improve long-term retention strategies. It provided each community with a tailored gap analysis, while confidentially sharing best practices of other health facilities. Within Hume, open communication and trust between GPs and health facility leadership and nursing staff ensures that GPs can feel valued and supported. Possible solutions for GP recruitment and retention must consider the social, employment and educational opportunities that are available for spouses and children. Participation in the program was useful as it helped health facilities ascertain how they were performing while highlighting areas for improvement. © James Cook University 2016.
- Authors: Terry, Daniel , Baker, Ed , Schmitz, David
- Date: 2016
- Type: Text , Journal article
- Relation: Rural and Remote Health Vol. 16, no. 4 (2016), p.
- Full Text:
- Reviewed:
- Description: Introduction: Rural communities continue to experience significant challenges recruiting and retaining physicians. The Community Apgar Questionnaire (CAQ) was developed in Idaho in the USA to comprehensively assess the characteristics associated with successful recruitment and retention of rural physicians. The CAQ has been utilised and validated across the USA; however, its value in rural Australia has not been examined. The objective of this study was to use the CAQ in rural Australia to examine its utility and develop a greater understanding of the community factors that impact general practitioner (GP) recruitment and retention. Method: The project conducted structured face-to-face interviews with hospital chief executive officers (CEOs) and directors of clinical services (DCSs) from 14 of the 21 (76%) health services that agreed to participate in rural north-eastern Victoria, Australia. The interviews were undertaken to complete the CAQ, which contains 50 questions centred on factors that influence physician recruitment and retention. Once completed, CAQs were scored by assigning quantitative values to a community's strengths and challenges including the level of importance placed on each factor. As such, the most important factors in physician recruitment, whether they are advantages or challenges for that community, were then weighed for their relative importance. Scores were then combined to create a CAQ score. To ensure reliability and validity of the results, three additional CAQs were purposefully administered to key general practices within the region. Results: The 14 rural communities exhibited cumulative CAQ scores ranging from a high of 387 to a low score of 61. This suggests the tool was sensitive enough to differentiate between communities that were high and low performers in terms of physician recruitment. The groups of factors that had the greatest impact on recruitment and retention were ranked highest to lowest and included medical support, hospital/community support, economic, scope of practice and geographic factors. Overall, the highest individual factors to impact recruitment and retention were perception of quality, hospital leadership, nursing workforce and transfer arrangements. Conversely, the lowest factors and challenges to recruitment and retention were family related, specifically spousal satisfaction and access to schools. Conclusions: Hume, in rural Victoria, was the first international site to implement the CAQ to differentially diagnose a community's relative strengths and challenges in recruiting and retaining GPs, while supporting health facilities to prioritise achievable goals to improve long-term retention strategies. It provided each community with a tailored gap analysis, while confidentially sharing best practices of other health facilities. Within Hume, open communication and trust between GPs and health facility leadership and nursing staff ensures that GPs can feel valued and supported. Possible solutions for GP recruitment and retention must consider the social, employment and educational opportunities that are available for spouses and children. Participation in the program was useful as it helped health facilities ascertain how they were performing while highlighting areas for improvement. © James Cook University 2016.
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
- 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.
- 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
- Full Text:
- Reviewed:
- 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.