Rural Health - Research Publications
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ItemImplementation of an older person's nurse practitioner in rural aged care in Victoria, Australia: a qualitative study(BMC, 2019-11-01)BACKGROUND: There are staff shortages nation-wide in residential aged care, which is only predicted to grow as the population ages in Australia. The aged care staff shortage is compounded in rural and remote areas where the health service workforce overall experiences difficulties in recruitment and retention. There is evidence that nurse practitioners fill important service gaps in aged care and rural health care but also evidence that barriers exist in introducing this extended practice role. METHODS: In 2018, 58 medical and direct care staff participated in interviews and focus groups about the implementation of an older person's nurse practitioner (OPNP) in aged care. All 58 interviewees had previously or currently worked in an aged care setting where the OPNP delivered services. The interviews were analysed using May's implementation theory framework to better understand staff perceptions of barriers and enablers when an OPNP was introduced to the workplace. RESULTS: The major perceived barrier to capacity of implementing the OPNP was a lack of material resources, namely funding of the role given the OPNP's limited ability to self-fund through access to the Medicare Benefits Schedule (MBS). Staff perceived that benefits included timely access to care for residents, hospital avoidance and improved resident health outcomes. CONCLUSION: Despite staff perceptions of more timely access to care for residents and improved outcomes, widespread implementation of the OPNP role may be hampered by a poor understanding of the role of an OPNP and the legislative requirement for a collaborative arrangement with a medical practitioner as well as limited access to the MBS. This study was not a registered trial.
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ItemWhy Australia needs to define obesity as a chronic condition(BMC, 2017-05-23)BACKGROUND: In Australia people with a diagnosed chronic condition can be managed on unique funded care plans that allow the recruitment of a multidisciplinary team to assist in setting treatment goals and adequate follow up. In contrast to the World Health Organisation, the North American and European Medical Associations, the Australian Medical Association does not recognise obesity as a chronic condition, therefore excluding a diagnosis of obesity from qualifying for a structured and funded treatment plan. BODY: The Australian guidelines for management of Obesity in adults in Primary Care are structured around a five step process -the '5As': Ask & Assess, Advise, Assist and Arrange'. This article aims to identify the key challenges and successes associated with the '5As' approach, to better understand the reasons for the gap between the high Australian prevalence of overweight and obesity and an actual diagnosis and treatment plan for managing obesity. It argues that until the Australian health system follows the international lead and defines obesity as a chronic condition, the capacity for Australian doctors to diagnose and initiate structured treatment plans will remain limited and ineffective. CONCLUSION: Australian General Practitioners are limited in their ability manage obesity, as the current treatment guidelines only recognise obesity as a risk factor rather than a chronic condition.
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ItemDo Not "Let Them Eat Cake": Correlation of Food-Consumption Patterns among Rural Primary School Children from Welfare and Non-Welfare Households(MDPI, 2017-01)Physical and financial access impacts food choice and consumption, while educational attainment, employment, income, gender, and socioeconomic status are also influential. Within this context, the aim of the paper is to examine the association between various foods consumed and eating patterns of children between low and higher income households. A paper-based survey was completed by parents/carers of children in 41 primary schools in rural and regional areas of Victoria. Data collected included demographics and the consumption of fruit, vegetable, and other foods including drinks. Ordinal data were analysed using Spearman's rank-order correlation. The main findings were that children who consumed more fruit and vegetables tended to have a higher intake of healthy drinks (plain milk and water) as well as a lower intake of unhealthy snacks and drinks (sugar sweetened drinks). Those who perceived that fruit and vegetables cost too much reported greater consumption of unhealthy snacks and sugar-sweetened beverages, which was more prominent in low-income households. Changing food consumption behaviours requires a complex systems-based approach that addresses more than just individual issues variables. A participatory approach that works with local communities and seeks to build an understanding of unique challenges within sub-groups has potential for embedding long-lasting and meaningful change in eating behaviours.
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ItemEvaluation of Activities in the park(university of melbourne, 2016)
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ItemHRICs final report( 2016)
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ItemImplementation of Shared Decision-Making in Australia(AUSTRALIAN COLL HEALTH SERVICE MANAGEMENT, 2016)
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ItemUtilizing Research to Facilitate Organizational Change(Scholink Co, Ltd., 2016)<p><em>This study aimed to facilitate organisational change through research to implement a workplace smoking ban. Previous appeals to the executive management had been unsuccessful, as the health service complied with legal requirements. </em><em>This small exploratory research study, utilized</em><em> the employee survey developed by QUIT Victoria, to gather evidence of staff opinions about workplace smoking.</em><em> Approximately 25% of the workforce smoked. The majority of the workforce in the study supported a workplace smoking ban, citing adverse effects of smoking on them and the environment. Staff also support quit smoking initiatives for staff and a small percentage of those who smoke (27%) reported it would encourage them to quit. Four staff reported that a workplace smoking ban would create difficulties for them, highlighting the importance of support for these staff. A smoke free workplace policy was introduced as a result of the research project. Utilizing a research approach, facilitated positive change for local level workforce and workplace issues.</em></p>
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ItemThe Value of Rural Isolated Practice Endorsed Registered Nurses in a Small Rural Health Service(Scholink Co, Ltd., 2016)<p><em>Three Registered Nurses (RN’s) undertook training and commenced practice as Rural Isolated Practice Endorsed Registered Nurses (RIPERNs) in a small rural Victorian health service, Australia. This advanced practice role is new to the health service and allows RIPERN’s to undertake some procedures usually performed by medical practitioners. As a form of evaluation, interviews were conducted with seven General Practitioners (GP’s) who have admitting privileges at the health service and three RIPERN’s who had commenced the extended scope of practice role. </em></p><p><em>Data was analysed and findings revealed strong benefits from the perspective of the GP’s and the RIPERN’s. These benefits included overall improved work-life balance for the GP’s, increased confidence and capabilities for the RIPERN’s and overall perceived improvement in the delivery of services at this small rural health service. Negative findings included misconceptions about the RIPERN extended scope of practice and increased demands experienced by RIPERN’s.</em></p>
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ItemSelf-Management Support (SMS) from a Chronic Disease Worker in a Rural Primary Health Service, a Pilot Study(OMICS Publishing Group, 2015-01-01)
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ItemStaff perceptions of families in rural residential aged care(Sciedu Press, 2013)Abstract:Objective – The aim of the project was to identify staff opinions of working with families rural in residential aged care. Method – Staff from 3 aged care facilities completed and returned a questionnaire on their opinion about working with families and family participation in aged care settings. Results – There was a 46.9% return rate, with 85% of staff reporting that families should be encouraged to participate in the care of their relatives. However, the findings also report 87% of staff perceived that family members were hostile without good reason and 76% report families were angry with aged care workers and undermined their treatment efforts. Conclusions – Family participation in aged care settings is essential for provision of person-centred care practices. The current negative perceptions of families expressed by rural aged care staff requires further research or at a minimum the use of a tool to monitor organisations performance in relations with families. Key Words Aged care, Family participation, Person-centred care, Residential care, Staff/Family relationships