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Cancer survivor preferences for breast cancer follow-up care: A discrete choice experiment
No full textMeasurement of spiritual wellbeing in an Australian hospital population using the functional assessment of chronic illness therapy: Spiritual wellbeing scale (FACIT-Sp-12)
No full textSpiritual wellbeing is known to be a predictor of increased patient coping in hospital settings. Therefore, access to a valid and reliable measure of spiritual wellbeing amongst general hospital patients is highly recommended. The aim of this study was to investigate the dimensionality, reliability, and validity of the Functional Assessment of Chronic Illness Therapy Spiritual Wellbeing scale (FACIT-Sp-12) in a heterogeneous cohort of hospital patients. A cross-sectional survey was administered to 897 adult patients across six hospitals in Sydney, Australia. Confrmatory factor analysis for the three-factor FACIT-12-Sp indicated a poor ft, but after removal of Item 12, the three-factor FACIT-11-Sp presented a good ft to the data. Reliability testing indicated acceptable to good internal consistency. Validity was supported by statistically signifcant diferences between patients who considered themselves ‘both spiritual and religious’ and ‘not religious or spiritual’. While some caution should be taken when using the FACIT-Sp due to several limitations, nevertheless, in a general hospital population in Australia, the three-factor FACIT-11-Sp indicated good dimensionality, reliability, and validity
Protocol for Improving Care by FAster risk-STratification through use of high sensitivity point-of-care troponin in patients presenting with possible acute coronary syndrome in the EmeRgency department (ICare-FASTER): A stepped-wedge cluster randomised quality improvement initiative
No full textIntroduction: Clinical assessment in emergency departments (EDs) for possible acute myocardial infarction (AMI) requires at least one cardiac troponin (cTn) blood test. The turn-around time from blood draw to posting results in the clinical portal for central laboratory analysers is ~1–2 hours. New generation, highsensitivity, point-of-care cardiac troponin I (POC-cTnI) assays use whole blood on a bedside (or near bedside) analyser that provides a rapid (8 min) result. This may expedite clinical decision-making and reduce length of stay. Our purpose is to determine if utilisation of a POCcTnI testing reduces ED length of stay. We also aim to establish an optimised implementation process for the amended clinical pathway.
Methods and analysis: This quality improvement initiative has a pragmatic multihospital stepped-wedge cross-sectional cluster randomised design. Consecutive patients presenting to the ED with symptoms suggestive of possible AMI and having a cTn test will be included. Clusters (comprising one or two hospitals each) will change from their usual-care pathway to an amended pathway using POC-cTnI—the ‘intervention’. The dates of change will be randomised. Changes occur at 1month intervals, with a minimum 2month ‘run-in’ period. The intervention pathway will use a POC-cTnI measurement as an alternate to the laboratory-based cTn measurement. Clinical decision-making steps and logic will otherwise remain unchanged. The POC-cTnI is the Siemens (Erlangen Germany) Atellica VTLi high-sensitivity cTnI assay. The primary outcome is ED length of stay. The safety outcome is cardiac death or AMI within 30 days for patients discharged directly from the E
A comprehensive analysis of well-being frameworks applied in Australia and their suitability for Indigenous peoples
No full textPurpose: Well-being is a complex, multi-dimensional, dynamic, and evolving concept, covering social, economic, health, cultural and spiritual dimensions of human living, and often used synonymously with happiness, life satisfaction, prosperity, and quality of life. We review the existing key wellbeing frameworks applied in Australia both for the wider public and Indigenous peoples. The aim is to provide a comprehensive overview of various applied frameworks, along with a critical analysis of domains or dimensions comprising those frameworks, and to analyse the role of nature in those frameworks.
Methodology: We conducted a critical analysis of the main frameworks applied in Australia to date to measure the well-being of the mainstream (mainly non-Indigenous) and Indigenous populations. This study is particularly timely given the Australian Government’s interest in revising the well-being frameworks as mentioned in the Government “Measuring What Matters” statement.
Results: The existing well-being frameworks in Australia either overlook or hardly consider the role of nature and its services which are important to support human well-being. Likewise, for Indigenous peoples “Country” (Indigenous clan land) is vital for their well-being as their living is imbued with ”Country”. The role of nature/”Country” needs to be considered in revising the well- being frameworks, indicators and measures to inform and develop appropriate policies and programs in Australia.
Conclusion: To develop appropriate welfare policies and programs for achieving socio- economic and other wellbeing outcomes, it is essential to evolve and conceptualize well-being frameworks (and related indicators and measures) in line with people’s contemporary values, particularly considering the role of nature and its services
This is why we are staying: Job satisfaction among Physiotherapists in the Kimberley region of Western Australia
No full textIntroduction: The Kimberley region of Western Australia (WA) is classified by the Modified Monash Model as MM6 & 7 (‘Remote/Very Remote’). Many physiotherapists in the Kimberley are considered ‘rural generalists’ and require a diverse set of clinical and non-clinical skills to work successfully within this setting.
Objective: To understand physiotherapists’ perspectives regarding job satisfaction within the Kimberley region a ‘rural and remote’ areas of Australia.
Design: An exploratory case study approach examined physiotherapists\u27 job sat-is faction in the Kimberley. Each participant completed a demographic survey and a one-on-one face-to-face interview lasting for approximately 60 minutes. Transcriptions were analysed and presented thematically. Eleven physiotherapists(nine women, two men, median age = 32 [27–60] years) participated in the study. Participants\u27 median time working in the Kimberley was 2 (1–15) years; eight participants completed a rural placement, and eight participants had a rural background.
Findings and Discussion: Two overarching themes relating to job satisfaction emerged: ‘personal factors’ and ‘workplace factors’. Furthermore, several sub-themes illustrated high levels of job satisfaction. Positive sub-themes relating to personal factors included ‘belonging to the community and a rural lifestyle’. ‘Diversity in caseloads’ and ‘workplace culture’ were examples of positive work-place sub- themes. Subthemes that challenged the participants personally were ‘family arrangements’ including schooling, ‘spousal employment and family separation’ and the ‘transiency and social issues’ within these remote communities. Workplace challenges comprised of ‘barriers to providing best practice’ and the ‘workforce and clinical experience’ found within the Kimberley physiotherapy community and the wider health care workforce. The primary challenge of jobs satisfaction that encompassed both personal and workplace factors was ‘accommodation’, with ‘cost’, ‘lack of availability’, and ‘perceived unsafe location’ challenging physiotherapists’ decisions to remain in the Kimberley.
Conclusion: This study describes the many factors impacting job satisfaction among physiotherapists in a rural and remote location in WA Australia. These factors warrant consideration by organisations interested in improving recruitment and retention in this context. Improving recruitment and retention in physiotherapists in rural and remote Australia has the potential to positively influence health service provision, and therefore improve health outcomes for those living in rural and remote communities
‘Two sides of the same coin’: reflecting on people-centred and place-based culture-nature conservation and management
Get PDFThe Culture-Nature Journey (CNJ) program at the 2023 ICOMOS General Assembly and Scientific Symposium in Sydney, Australia presented an opportunity to bring together perspectives that were inter-disciplinary, inter-organizational and inter-generational. A program was framed that showcased research and applied works that are being undertaken worldwide, with a priority given to people-centred and place-based solutions. What started as a toss of coin at the commencement of the sessions to demonstrate the inter-relations between culture and nature became an appropriate metaphor to establish the various permutations through the lens of which we explored its heritage dynamics. This presentation by the Emerging Professional, Australian and International co-chairs of the Journey will not only discuss the contextual questions that played a critical role in the delivery of the CNJ program, but also reflect on the navigation that was undertaken to materialize a multi-format space for co-creating dialogues (formal and informal yarning sessions) and co-facilitating presentations (paper and posters). Inherently connecting with the Indigenous Heritage theme to reduce the separation between First Nations’ cultural and natural epistemologies, discussions focused on investment on knowledge and skills transfer to the next generation and reducing disciplinary boundaries for holistically understanding human, non-human and more-than human entities. Linkages to Culture-Nature as evidenced during simultaneous events (https://icomosga2023.org/) will be additionally highlighted including the engagement in Youth Forum and keynote by Dr June Oscar AO
Consensus-based recommendations for the care of women with a breech presenting fetus
No full textObjective: To establish consensus related to aspects of breech presentation and care.
Design: A multinational, three round e-Delphi study. Participants: A panel of 15 midwives, four obstetricians and an academic with knowledge and/or experience of caring for women with a breech presenting fetus.
Methods: An initial survey of 45 open-ended questions. Answers were coded and amalgamated to form 448 statements in the second round and three additional statements in the third round. Panellists were asked to provide their level of agreement for each statement using a 5-point Likert scale. Consensus was deemed met if 70% of panellists responded with strongly agree to somewhat agree, or strongly disagree to somewhat disagree after the second round. Findings: Results led to the development of a consensus-based care pathway for women with a breech presenting fetus and a skills development framework for clinicians.
Key conclusions: A cultural shift is beginning to occur through the provision of physiological breech workshops offered by various organisations and may result in greater access to skilled and experienced clinicians for women desiring a vaginal breech birth, ultimately improving the safety of breech birth.
Implications for practices: The care pathway and skills development framework can be used by services wishing to make changes to their current practices related to breech presentation and increase the level of skill in their workforce
