The invisible contract: Shifting care from the hospital to the home
- Authors: Dow, Briony , McDonald, John
- Date: 2007
- Type: Text , Journal article
- Relation: Australian Health Review Vol. 31, no. 2 (May 2007), p. 193-202
- Full Text:
- Reviewed:
- Description: The ageing population and associated burgeoning health care costs have resulted in a shift of care from institutional settings to home and community-based care. As one example, rehabilitation-in-the-home (RITH) programs are becoming increasingly prevalent. These programs either substitute or supplement in-hospital treatment by providing multidisciplinary rehabilitation and support services in the client's own home. This paper investigates the impact of RITH programs on informal carers. Semi-structured interviews carried out with caregivers and staff revealed a complex and contradictory interpretation of informal caring. Analysis of carers' interviews revealed: an assumption by themselves and others (including RITH staff) that they would provide care; the intimate, arduous and relentless work of caring; lack of consultation about discharge; lack of recognition and reimbursement; and low levels of program support for them as carers. Carers are integral to the successful rehabilitation of the client, but they occupy a marginal status within the program. An invisible contract consigns to them substantial care-work that was previously provided by the hospital. Informal carers in RITH programs can be seen as disenfranchised care contractors. This has implications for policy makers, program managers and researchers.
- Description: C1
- Description: 2003005828
- Authors: Dow, Briony , McDonald, John
- Date: 2007
- Type: Text , Journal article
- Relation: Australian Health Review Vol. 31, no. 2 (May 2007), p. 193-202
- Full Text:
- Reviewed:
- Description: The ageing population and associated burgeoning health care costs have resulted in a shift of care from institutional settings to home and community-based care. As one example, rehabilitation-in-the-home (RITH) programs are becoming increasingly prevalent. These programs either substitute or supplement in-hospital treatment by providing multidisciplinary rehabilitation and support services in the client's own home. This paper investigates the impact of RITH programs on informal carers. Semi-structured interviews carried out with caregivers and staff revealed a complex and contradictory interpretation of informal caring. Analysis of carers' interviews revealed: an assumption by themselves and others (including RITH staff) that they would provide care; the intimate, arduous and relentless work of caring; lack of consultation about discharge; lack of recognition and reimbursement; and low levels of program support for them as carers. Carers are integral to the successful rehabilitation of the client, but they occupy a marginal status within the program. An invisible contract consigns to them substantial care-work that was previously provided by the hospital. Informal carers in RITH programs can be seen as disenfranchised care contractors. This has implications for policy makers, program managers and researchers.
- Description: C1
- Description: 2003005828
Dimensions of pastoral care: Student wellbeing in rural Catholic schools
- Ollerenshaw, Alison, McDonald, John
- Authors: Ollerenshaw, Alison , McDonald, John
- Date: 2006
- Type: Text , Journal article
- Relation: Australian Journal of Primary Health Vol. 12, no. 2 (2006), p. 137-145
- Full Text:
- Reviewed:
- Description: This paper investigates the health and welfare needs of students (n = 15,806) and the current service model in Catholic schools in the Ballarat Diocese of Victoria, Australia. Catholic schools use a service model underpinned by an ethos of pastoral care; there is a strong tradition of self-reliance within the Catholic education system for meeting students' health and welfare needs. The central research questions are: What are the emerging health and welfare needs of students? How does pastoral care shape the service model to meet these needs? What model/s might better meet students' primary health care needs? The research methods involved analysis of(1) extant databases of expressed service needs including referrals (n = 1,248) to Student Services over the last 2.5 years, (2) trends in the additional funding support such as special needs funding for students and the Education Maintenance Allowance for families, and (3) semi-structured individual and group interviews with 98 Diocesan and school staff responsible for meeting students' health and welfare needs. Analysis of expressed service needs revealed a marked increase in service demand, and in the complexity and severity of students' needs. Thematic analysis of qualitative interview data revealed five pressing issues: the health and welfare needs of students; stressors in the school community; rural isolation; role boundaries and individualised interventions; and self-reliant networks of care. Explanations for many of these problems can be located in wider social and economic forces impacting upon the church and rural communities. It was concluded that the pastoral care model-as it is currently configured-is not equipped to meet the escalating primary health care needs of students in rural areas. This paper considers the implications for enhanced primary health care in both rural communities and in schools.
- Description: C1
- Description: 2003001995
- Authors: Ollerenshaw, Alison , McDonald, John
- Date: 2006
- Type: Text , Journal article
- Relation: Australian Journal of Primary Health Vol. 12, no. 2 (2006), p. 137-145
- Full Text:
- Reviewed:
- Description: This paper investigates the health and welfare needs of students (n = 15,806) and the current service model in Catholic schools in the Ballarat Diocese of Victoria, Australia. Catholic schools use a service model underpinned by an ethos of pastoral care; there is a strong tradition of self-reliance within the Catholic education system for meeting students' health and welfare needs. The central research questions are: What are the emerging health and welfare needs of students? How does pastoral care shape the service model to meet these needs? What model/s might better meet students' primary health care needs? The research methods involved analysis of(1) extant databases of expressed service needs including referrals (n = 1,248) to Student Services over the last 2.5 years, (2) trends in the additional funding support such as special needs funding for students and the Education Maintenance Allowance for families, and (3) semi-structured individual and group interviews with 98 Diocesan and school staff responsible for meeting students' health and welfare needs. Analysis of expressed service needs revealed a marked increase in service demand, and in the complexity and severity of students' needs. Thematic analysis of qualitative interview data revealed five pressing issues: the health and welfare needs of students; stressors in the school community; rural isolation; role boundaries and individualised interventions; and self-reliant networks of care. Explanations for many of these problems can be located in wider social and economic forces impacting upon the church and rural communities. It was concluded that the pastoral care model-as it is currently configured-is not equipped to meet the escalating primary health care needs of students in rural areas. This paper considers the implications for enhanced primary health care in both rural communities and in schools.
- Description: C1
- Description: 2003001995
A rural perspective of telephone counselling and referral
- Watson, Robert, McDonald, John
- Authors: Watson, Robert , McDonald, John
- Date: 2004
- Type: Text , Journal article
- Relation: Australian Journal of Primary Health Vol. 10, no. 2 (2004), p. 97-103
- Full Text:
- Reviewed:
- Description: A telephone survey was used to examine rural residents' (n=102) perceptions and knowledge of a well-established national telephone counselling and referral service-Lifeline. Residents in rural Australia experience generally poorer access and availability to health-related services than their metropolitan counterparts. They may also have problems with confidentiality and stigmatisation in using what services are available in their area. Although this was a non-comparative study, it was reasoned that these barriers to help-seeking in rural areas would mean their population would know and value a service such as Lifeline, which provides equitable and anonymous support and referrals to all Australians. The results showed that the service was known, valued, and supported strongly by the respondents. The findings supported the belief that telephone counselling and referral has an important and unique place in rural health support and referral.
- Description: C1
- Description: 2003000949
- Authors: Watson, Robert , McDonald, John
- Date: 2004
- Type: Text , Journal article
- Relation: Australian Journal of Primary Health Vol. 10, no. 2 (2004), p. 97-103
- Full Text:
- Reviewed:
- Description: A telephone survey was used to examine rural residents' (n=102) perceptions and knowledge of a well-established national telephone counselling and referral service-Lifeline. Residents in rural Australia experience generally poorer access and availability to health-related services than their metropolitan counterparts. They may also have problems with confidentiality and stigmatisation in using what services are available in their area. Although this was a non-comparative study, it was reasoned that these barriers to help-seeking in rural areas would mean their population would know and value a service such as Lifeline, which provides equitable and anonymous support and referrals to all Australians. The results showed that the service was known, valued, and supported strongly by the respondents. The findings supported the belief that telephone counselling and referral has an important and unique place in rural health support and referral.
- Description: C1
- Description: 2003000949
Strengthening primary health care : Building the capacity of rural communities to access health funding
- McDonald, John, Brown, Leann, Murphy, Angela
- Authors: McDonald, John , Brown, Leann , Murphy, Angela
- Date: 2002
- Type: Text , Journal article
- Relation: Australian journal of rural health Vol. 10, no. 3 (2002), p. 173-177
- Full Text:
- Reviewed:
- Description: Present health funding models can place onerous pressures on rural health services. Staff may lack the time, resources, access to data, and the expertise needed to complete complex and lengthy funding submissions. This present study describes an innovative capacity-building approach to working with Victorian rural communities seeking to access health care funding through the Regional Health Services Program. This approach used several strategies: engaging stakeholders in targeted rural communities, developing an information kit and running a workshop on preparing submissions to the Regional Health Services Program, facilitating community consultations, and providing ongoing support with submissions. Six rural communities were supported in this way. Four have been funded to date, with a combined annual recurrent budget for new primary health care services of over $2.5 million. Each community has developed a service delivery model that meets the particular needs of their local area. This capacity-building approach is both effective and replicable to other health funding opportunities. The definitive version of this article is available at www3.interscience.wiley.com
- Description: 2003000079
- Authors: McDonald, John , Brown, Leann , Murphy, Angela
- Date: 2002
- Type: Text , Journal article
- Relation: Australian journal of rural health Vol. 10, no. 3 (2002), p. 173-177
- Full Text:
- Reviewed:
- Description: Present health funding models can place onerous pressures on rural health services. Staff may lack the time, resources, access to data, and the expertise needed to complete complex and lengthy funding submissions. This present study describes an innovative capacity-building approach to working with Victorian rural communities seeking to access health care funding through the Regional Health Services Program. This approach used several strategies: engaging stakeholders in targeted rural communities, developing an information kit and running a workshop on preparing submissions to the Regional Health Services Program, facilitating community consultations, and providing ongoing support with submissions. Six rural communities were supported in this way. Four have been funded to date, with a combined annual recurrent budget for new primary health care services of over $2.5 million. Each community has developed a service delivery model that meets the particular needs of their local area. This capacity-building approach is both effective and replicable to other health funding opportunities. The definitive version of this article is available at www3.interscience.wiley.com
- Description: 2003000079
Ballarat health consortium : A case study of influential factors in the development and maintenance of a health partnership
- McDonald, John, Murphy, Angela, Payne, Warren
- Authors: McDonald, John , Murphy, Angela , Payne, Warren
- Date: 2001
- Type: Text , Journal article
- Relation: Australian Journal of Primary Health Vol. 7, no. 2 (2001), p. 75-82
- Full Text:
- Reviewed:
- Description: Intersectoral partnerships in health have a central role in current policy and programs. Partnerships are seen to be an effective strategy for maximising health outcomes. However, theoretical models of health partnerships are underdeveloped. Moreover, the research literature contains inconsistent findings about their effectiveness, and there has been very little evaluative research on health partnerships in this country. This paper reports on a case study of an intersectoral consortium using a health promotion approach to cardiovascular disease. A model of partnership formation and development is presented. From this, a research strategy was devised and carried out. Results indicate that the health consortium was formed inresponse to a critical health issue, and as a separate legal entity without recurrent funding, it has been sustained through the commitment of individual members. Project funding has, in large part, dictated its operations. The case study reveals the strengths, vulnnerabilities and achievements of this consortium over five years. To produce sustainable health outcomes, the researchers conclude, partnerships require strategic management to capitalise on individual endeavours, organisational alignments, and government or funder priorities. Ideological zeal for intersectoral health partnerships must be balanced by rigorous evaluation; together with more sophisticated indicators for measuring success in partnerships in health promotion. Theoretical development of models of health partnerships will also contribute to their enhanced effectiveness.
- Description: 2003004325
- Authors: McDonald, John , Murphy, Angela , Payne, Warren
- Date: 2001
- Type: Text , Journal article
- Relation: Australian Journal of Primary Health Vol. 7, no. 2 (2001), p. 75-82
- Full Text:
- Reviewed:
- Description: Intersectoral partnerships in health have a central role in current policy and programs. Partnerships are seen to be an effective strategy for maximising health outcomes. However, theoretical models of health partnerships are underdeveloped. Moreover, the research literature contains inconsistent findings about their effectiveness, and there has been very little evaluative research on health partnerships in this country. This paper reports on a case study of an intersectoral consortium using a health promotion approach to cardiovascular disease. A model of partnership formation and development is presented. From this, a research strategy was devised and carried out. Results indicate that the health consortium was formed inresponse to a critical health issue, and as a separate legal entity without recurrent funding, it has been sustained through the commitment of individual members. Project funding has, in large part, dictated its operations. The case study reveals the strengths, vulnnerabilities and achievements of this consortium over five years. To produce sustainable health outcomes, the researchers conclude, partnerships require strategic management to capitalise on individual endeavours, organisational alignments, and government or funder priorities. Ideological zeal for intersectoral health partnerships must be balanced by rigorous evaluation; together with more sophisticated indicators for measuring success in partnerships in health promotion. Theoretical development of models of health partnerships will also contribute to their enhanced effectiveness.
- Description: 2003004325
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