ORCID Profile
0000-0002-6789-8260
Current Organisation
Deakin University Geelong - Waterfront Campus
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: SAGE Publications
Date: 2023
DOI: 10.1177/20552076231167008
Abstract: Evaluate the feasibility and acceptability of an online guided self-determination (GSD) program to improve diabetes self-management skills among young adults with type 1 diabetes (YAD). An online program comprising seven structured interactive conversations was designed. A pre- and post- interventional study used a sequential, two-phase multiple method design. Phase one comprised a training program for diabetes educators (DEs). In Phase two YAD participated in program and completed pre- and post-surveys assessing motivation to self-manage, perceived competence in diabetes and communication with DEs. Both YAD and DEs provided a program evaluation. The online GSD program was acceptable, feasible and effective in improving autonomous motivation in self-management and communication with DEs. Easy access and program flexibility were highly appreciated by both participant groups and perceived to assist YAD to stay motivated. The program had a significant impact on the diabetes self-management of YAD and was a feasible and acceptable way to engage and communicate with DEs. The GSD platform contributes to age appropriate and person-centred diabetes self-management. It can potentially reach geographically distanced populations, or with social circumstances or other barriers impeding in-person service provision.
Publisher: Wiley
Date: 05-10-2020
DOI: 10.1111/JOCN.15506
Publisher: Elsevier BV
Date: 10-2021
Publisher: CSIRO Publishing
Date: 07-07-2021
DOI: 10.1071/PY20241
Abstract: The aim of this study is to identify, from the perspectives of key health policy decision-makers, strategies that address barriers to diabetes-related footcare delivery in primary care, and outline key elements required to support implementation into clinical practice. The study utilised a qualitative design with inductive analysis approach. Seven key health policy decisions-makers within Australia were interviewed. Practical strategies identified to support provision and delivery of foot care in primary care were: (a) building on current incentivisation structures through quality improvement projects (b) enhancing education and community awareness (c) greater utilisation and provision of resources and support systems and (d) development of collaborative models of care and referral pathways. Key elements reported to support effective implementation of footcare strategies included developing and implementing strategies based on co-design, consultation, collaboration, consolidation and co-commissioning. To the authors’ knowledge, this is the first Australian study to obtain information from key health policy decision-makers, identifying strategies to support footcare delivery in primary care. Implementation of preventative diabetes-related footcare strategies into ‘routine’ primary care clinical practice requires multiparty co-design, consultation, consolidation, collaboration and co-commissioning. The basis of strategy development will influence implementation success and thus improve outcomes for people living with diabetes.
Publisher: Wiley
Date: 07-04-2022
DOI: 10.1111/IMJ.15726
Abstract: The Coronavirus disease 2019 (COVID‐19) pandemic has had a major impact on healthcare services with many changes to telehealth care delivery. More information is needed about the patient perspective of telehealth in hospital services and the potential costs and benefits for patients. To measure patients' evaluation of telehealth, preferences for telehealth versus in‐person appointments, and potential cost savings by patient characteristics. A cross‐sectional online survey (including patient and appointment characteristics, telehealth evaluation, preferences for care and costs) of adult patients using video telehealth in four metropolitan tertiary hospital services in Melbourne, Victoria. A total of 1045 patients (median age 44 years interquartile range 29–59) participated with an overall response rate of 9.2%. For 98.7% patients, telehealth was convenient, 96.4% stated that it saved time, 95.9% found telehealth acceptable to receive care and 97.0% found that telehealth improved their access to care. Most (62.6%) preferred in‐person consultations, although 86.9% agreed that telehealth was equivalent to an in‐person consultation. Those in regional and rural areas were less likely to prefer in‐person consultations. Patients attending for medical reasons were less likely to prefer in‐person consultation compared with patients with surgical reasons. Patient preference to telehealth was independent of level of education, appointment type, self‐rated health status and socio economic status. Patients saved an average of A$120.9 (standard deviation A$93.0) per appointment, with greater cost savings for patients from low and middle socio economic areas and regional or rural areas. Telehealth video consultations were largely evaluated positively with most patients considering the service to be as good as in‐person. Understanding patient preference is critical to consider when implementing telehealth as mainstream across hospital health services.
Publisher: CSIRO Publishing
Date: 30-09-2022
DOI: 10.1071/AH22110
Abstract: Objective To describe self-reported general and psychological health for allied health practitioners at an Australian acute public health service over three time points within the coronavirus disease 2019 (COVID-19) pandemic. Methods This study collected data from cross-sectional online surveys at three time points: May–June 2020 (T1), October–November 2020 (T2) and November–December 2021 (T3). The self-report questionnaire consisted of demographic questions, a general health question and the 21-item version of the Depression Anxiety Stress Scales (DASS-21). Results A total of 308 responses were received (T1 n = 135, T2 n = 78, T3 n = 95) from representatives of eight allied health professions. The proportion of allied health practitioners reporting poor general health significantly increased over time, as did mean scores on all DASS-21 sub-scales. General health status was also significantly associated with DASS-21 subscale scores. Anxiety scores increased significantly between T1 and T2, while depression scores increased significantly between T2 and T3. Significant increases in stress scores were recorded across all time intervals. Between T1 and T3, the proportion of allied health practitioners reporting moderate, severe, or extremely severe symptoms increased for depression (10.3–30.9%), anxiety (5.2–18.2%) and stress (13.3–36.3%). Conclusion The general and psychological health of allied health practitioners appears to be worsening as the COVID-19 pandemic continues. Organisational strategies to support the health of the allied health workforce in acute care settings must address the cumulative effects of prolonged pressure on their general and psychosocial health. Support strategies need to be responsive to changes in psychological wellbeing at different phases of the pandemic.
Publisher: Springer Science and Business Media LLC
Date: 13-03-2013
Publisher: Elsevier BV
Date: 08-2015
DOI: 10.1016/J.JPAIN.2015.03.016
Abstract: This study investigated the cross-cultural factor stability and internal consistency of the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R), a measure of the quality of postoperative pain management used internationally. We conducted exploratory factor analysis (EFA) of APS-POQ-R data from 2 point prevalence studies comprising 268 and 311 surveys of Danish and Australian medical-surgical patients, respectively. Parallel analysis indicated 4- and 3-factor solutions for Danish and Australian patients, respectively, which accounted for 58.1% and 52.9% of variance. Internal consistency was unsatisfactory among both Danish (Cronbach α = .54) and Australian (Cronbach α = .63) cohorts. There was a high degree of between-group similarity in item-factor loadings of variables coded as "pain experience," but not "pain management." This finding reflected cross-cultural differences in ratings of treatment satisfaction. For Danish patients, satisfaction was associated with the degree of pain severity and activity interference, whereas for Australian patients, satisfaction was associated with their perceived ability to participate in treatment. To facilitate further cross-cultural comparison, we compared our findings with past research conducted in the United States and Iceland. EFA supported the construct validity of the APS-POQ-R as a measure of "pain experience" but indicated that items measuring "pain management" may vary cross-culturally. Findings highlighted the need for further validation of the APS-POQ-R internationally. This study revealed the APS-POQ-R as a valid measure of postoperative pain experience for Danish and Australian patients. Measures of patients' perception of pain management were not robust to group differences in treatment expectations and demonstrated cross-cultural instability. Results highlighted the difficulties in establishing stable cross-cultural, cross-population subscales for the APS-POQ-R.
Publisher: Wiley
Date: 02-06-2016
DOI: 10.1111/SCS.12248
Abstract: Type 2 diabetes (T2DM) prevalence is increasing rapidly worldwide with a significant increase in young adults. There is limited information about psychosocial and service needs of this group. To explore similarities and differences in how psychosocial factors impact on Australian and Danish young adults with T2DM and to identify unmet support needs during life transitions. A qualitative approach was adopted using thematic content analysis of 26 in-depth semi-structured interviews. An inductive descriptive content analysis was undertaken using a comparative coding system. Eligible participants were from Australia (12) and Denmark (14), aged 19-42 years who had T2DM for more than 10 months. In general, they reported diabetes management was difficult during transitions and diabetes self-care routines had to change to accommodate life changes. The underpinning sense of 'uncertainty' initiated by life transitions caused guilt that often resulted in low self-worth, anxiety and depression, which in turn had a negative impact on social and professional relationships. The participants emphasised the importance of connectedness to social networks, particularly with T2DM peers, and the need for flexible access to health professionals, age-specific tailored support and lower costs for Australians. Australian participants were more concerned than Danish participants about the cost associated with diabetes care and their ability to stay employed hence, they were reluctant to disclose diabetes at work. T2DM had a similar impact on life transitions of Australian and Danish young adults with T2DM, suggesting health care needs to encompass managing life transitions. Participants had to cope with uncertainty and the impact of people's responses to diabetes, particularly at work and in relationships. Health professionals are urged to integrate these factors in care plans and education, which must be in idualised and focus on the psychosocial aspects that operate during life transitions.
Publisher: Elsevier BV
Date: 03-2015
DOI: 10.1016/J.WOMBI.2014.11.001
Abstract: Women with type 1 diabetes (T1DM) face many challenges during their pregnancy, birth and in the postnatal period, including breastfeeding initiation and continuation while maintaining stable glycaemic control. In both Sweden and Australia the rates of breastfeeding initiation are high. However, overall there is limited information about the breastfeeding practices of women with T1DM and the factors affecting them. Similarities in demographics, birth rates and health systems create bases for discussion. The aim of this paper is to discuss psychosocial factors, policies and practices that impact on the breastfeeding practices of women with T1DM. Swedish research indicates that the overall breastfeeding rate in women with T1DM remains significantly lower than in women without diabetes in the first 2 and 6 months after childbirth with no differences in exclusive breastfeeding. Breastfeeding initiation and continuation among women with T1DM in Sweden has been shown to be influenced by health services delivery, supportive breastfeeding policies and socio-economic factors, particular perceived support from social networks and health professionals. There is limited research on the impact of attitudes towards breastfeeding, emotional and social well-being and diabetes-related stress on the decision of women with T1DM to initiate and continue to breastfeed for at least 6 months. A more comprehensive understanding of the breastfeeding practices and psychosocial factors operating during the first 6 months after birth for women with T1DM will be instrumental in the future design of interventions promoting initiation and continuation of breastfeeding in Sweden, Australia and elsewhere.
Publisher: Elsevier BV
Date: 12-2018
Publisher: Wiley
Date: 11-10-2012
DOI: 10.1111/OPN.12004
Abstract: Health and social care practitioners collaborate in discharge planning for older people. Difficulties securing timely and quality discharge information and unclear role boundaries can be challenging. There are limited reports in the literature describing community-based practitioners' roles communicating client information. To describe the roles of community-based practitioners in communication of older clients' information in an Australian context. A descriptive and exploratory qualitative research design was applied. Four focus groups were conducted in 2009 with a small s le (n = 16) of district nurses, practice nurses and aged care case managers. All participants described communication as a core characteristic of their role focused on minimising risks for older people. Participants valued dialogue with other health and social care providers in real time with an emphasis on telephone communication, face-to-face meetings, and case conferences. Telephone communication was considered important where there was an urgent need to problem solve. Written communication was noted as less effective. There is an increasing need for stronger models of communication in community-based settings to facilitate safe, efficient and sustainable health and social outcomes for older people. There is limited available research with this focus to guide practice. Findings from this exploratory study indicate a number of important areas for further research: (i) to understand how communication feedback systems and pathways between community and inpatient providers could improve information exchange and (ii) to describe community nurses' roles in communication and medication risks for older people.
Publisher: Wiley
Date: 15-10-2008
DOI: 10.1111/J.1365-2702.2008.02342.X
Abstract: The aim of the study was to explore and describe the strategies young women with type 1 diabetes used to manage life transitions. The paper describes one aspect of how guilt dynamic often operates between mothers and daughters and how the women managed the guilt dynamic to create stability in their lives. When a child is diagnosed with diabetes, major transitional changes occur in the relationships between the mother and her child. The changes affect the psychological and social aspects of their lives and have a major impact on how young women manage their diabetes. A guilt dynamic between mothers and young women with diabetes emerged as a major theme in a larger study that investigated how young women with diabetes managed life transitions. Although the literature indicates that mothers of chronically ill children experience guilt feelings towards their children, little research was identified that addressed the emotional dynamics between mothers and daughters with diabetes. Using grounded theory method, interviews were conducted with 20 women with type 1 diabetes and five mothers during 2002 and 2003. Constant comparative analysis was used to analyse the data and develop an in-depth understanding of the experience of living with diabetes during life transitions. The findings revealed that guilt feelings created a two-way dependency between mothers and their daughters with diabetes. The two-way dependency involved feelings of being a burden to each other, difficulty balancing responsibilities for diabetes management, difficulty relinquishing emotional and social dependency especially during life transitions. In addition, these issues were rarely discussed openly with each other or with health professionals. The findings provide additional information about the human experience of the mother-daughter relationship and the effect on coping with diabetes in the context of life transitions. Understanding the impact diabetes has on the emotional and social well being of both women with type 1 diabetes and their mothers is critical in planning appropriate support for both groups. Most importantly, it is critical to understand the guilt dynamic that operates during young women with diabetes' life transitions when the daughters' dependency on their mother's control and responsibility for diabetes management undergo changes resulting in emotional responses, especially guilt feelings. Health professionals need to understand the emotional and social impact of the guilt dynamics between young women with type 1 diabetes and their mothers. Adequate and appropriate support can minimize the guilt feelings and enhance stability and quality of life for both mothers and their daughters, especially during major life transitions, such as motherhood.
Publisher: Wiley
Date: 05-05-2011
DOI: 10.1111/J.1365-2702.2010.03657.X
Abstract: Aim. To identify life transitions likely to impact diabetes self‐care among young adults with Type 1 diabetes and their coping strategies during transition events. Background. Relationships among psychosocial stress, adjustment, coping and metabolic control affect clinical outcomes and mental health. Life transitions represent major change and are associated with stress that temporarily affects in iduals’ problem‐solving, coping abilities and blood glucose levels. Design. A qualitative interpretive inquiry. Method. Semi‐structured interviews were conducted with 20 young adults with Type 1 diabetes and a constant comparative analysis method. Data and analysis was managed using QSR © NV ivo 7 software. Results. Participants identified two significant transition groups: life development associated with adolescence, going through the education system, entering new relationships, motherhood and the workforce and relocating. Diabetes‐related transitions included being diagnosed, developing diabetes complications, commencing insulin pump treatment and going on diabetes c s. Participants managed transitions using ‘strategic thinking and planning’ with strategies of ‘self‐negotiation to minimise risks’ ‘managing diabetes using previous experiences’ ‘connecting with others with diabetes’ ‘actively seeing information to ‘patch’ knowledge gaps’ and ‘putting diabetes into perspective’. Conclusions. Several strategies are used to manage diabetes during transitions. Thinking and planning strategically was integral to glycaemic control and managing transitions. The impact of transitions on diabetes needs to be explored in larger and longitudinal studies to identify concrete strategies that assist diabetes care during life transitions. Relevance to clinical practice. It is important for health professionals to understand the emotional, social and cognitive factors operating during transitions to assist young adults with Type 1 diabetes to achieve good health outcomes by prioritising goals and plan flexible, timely, in idualised and collaborative treatment.
Publisher: Informa UK Limited
Date: 2023
Publisher: Oxford University Press (OUP)
Date: 10-2023
Publisher: Wiley
Date: 21-10-2021
DOI: 10.1111/NHS.12778
Abstract: The aim of this systematic review was to examine the clinical cues used by acute care nurses to recognize changes in clinical states of adult medical and surgical patients that occurred as usual consequence of acute illness and treatment. The Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines and checklist were followed. Four databases and reference lists of included studies were searched: from 1,049 studies, 38 were included. There were 26 subjective and 147 objective cues identified only 6% of all cues described improvements in patients' clinical states. The most common clinical cues used were heart rate, blood pressure and temperature. Many studies ( n = 31) focused on only one element of assessment, such as physiological stability, pain, or cognition. There was a paucity of studies detailing the complexity of acute care nurses' assessment practices as they would occur in clinical practice and a disproportionate focus on the objective assessment of deterioration. Studies are needed to understand the full breadth of cues acute care nurses use to recognize clinical change that includes both improvement and deterioration.
Publisher: SAGE Publications
Date: 03-2007
Abstract: The authors used grounded theory to explore and develop a substantive theory to explain how 20 young women with type 1 diabetes managed their lives when facing turning points and undergoing transitions. The women experienced a basic social problem: being in the grip of blood glucose levels (BGLs), which consisted of three categories: (a) the impact of being susceptible to fluctuating BGLs, (b) the responses of other people to the in idual woman’s diabetes, and (c) the impact of the in idual women’s diabetes on other people’s lives. The women used a basic social process to overcome the basic social problem by creating stability, which involved using three interconnected subprocesses: forming meaningful relationships, enhancing attentiveness to blood glucose levels, and putting things in perspective. Insights into the processes and strategies used by the women have important implications for provision of care and service delivery.
Publisher: Scandinavian University Press / Universitetsforlaget AS
Date: 04-03-2019
Publisher: Wiley
Date: 06-09-2023
DOI: 10.1111/DME.14943
Abstract: Commencing university presents particular challenges for young adults with diabetes. This integrative literature review aimed to synthesise the research exploring the experiences and support needs of university students with diabetes. Medline, CINAHL, PsychInfo and EMBASE databases were searched for quantitative and qualitative studies, among undergraduate and postgraduate students with type 1 or type 2 diabetes conducted in the university setting. Two reviewers independently screened titles, abstracts and full‐text articles. Data were analysed thematically and synthesised narratively utilising the ecological model as a framework for interpreting findings and making recommendations. We identified 25 eligible papers (20 studies) utilising various methods: in idual interview, focus group, survey, online forum. Four themes were identified: barriers to self‐care (e.g. lack of structure and routine) living with diabetes as a student identity, stigma and disclosure and strategies for managing diabetes at university. Students in the early years at university, recently diagnosed or moved away from home, reported more self‐care difficulties, yet few accessed university support services. Risky alcohol‐related behaviours, perceived stigma and reluctance to disclose diabetes inhibited optimal diabetes management. Despite the heterogeneity of studies, consistent themes related to diabetes self‐care difficulties and risky behaviours were reported by young adults with diabetes transitioning to university life. No effective interventions to support students with diabetes were identified in this setting. Multilevel approaches to support students to balance the competing demands of study and diabetes self‐care are needed, particularly in the early years of university life.
Publisher: MDPI AG
Date: 17-01-2022
Abstract: Consumers access health professionals with varying levels of diabetes-specific knowledge and training, often resulting in conflicting advice. Conflicting health messages lead to consumer disengagement. The study aimed to identify capabilities required by health professionals to deliver diabetes education and care to develop a national consensus capability-based framework to guide their training. A 3-staged modified Delphi technique was used to gain agreement from a purposefully recruited panel of Australian diabetes experts from various disciplines and work settings. The Delphi technique consisted of (Stage I) a semi-structured consultation group and pre-Delphi pilot, (Stage II) a 2-phased online Delphi survey, and (Stage III) a semi-structured focus group and appraisal by health professional regulatory and training organisations. Descriptive statistics and central tendency measures calculated determined quantitative data characteristics and consensus. Content analysis using emergent coding was used for qualitative content. Eighty-four diabetes experts were recruited from nursing and midwifery (n = 60 [71%]), allied health (n = 17 [20%]), and pharmacy (n = 7 [9%]) disciplines. Participant responses identified 7 health professional practice levels requiring differences in diabetes training, 9 capability areas to support care, and 2 to 16 statements attained consensus for each capability—259 in total. Additionally, workforce solutions were identified to expand capacity for diabetes care. The rigorous consultation process led to the design and validation of a Capability Framework for Diabetes Care that addresses workforce enablers identified by the Australian National Diabetes Strategy. It recognises ersity, creating shared understandings of diabetes across health professional disciplines. The findings will inform diabetes policy, practice, education, and research.
Publisher: AOSIS
Date: 14-10-2022
DOI: 10.4102/JIR.V5I1.73
Abstract: Background: Insulin resistance (IR) and type 2 diabetes (T2DM) promote myocardial dysfunction in the absence of traditional cardiovascular risk factors such as hypertension or coronary heart disease. Termed diabetic cardiomyopathy (DMCM), this type of cardiomyopathy often evolves to heart failure (HF), therefore worsening outcomes for people living with T2DM. Low-fat diets (LF) have been recommended for patients with cardiovascular disease but have provided limited symptom relief.Aim: The aim of this research is to examine the effect of a low-carbohydrate (LC) diet compared with usual care (UC) in patients with DMCM. This study hypothesises that the LC diet will improve symptoms of HF and quality of life (QoL) in patients with DMCM.Setting: For this 16-week randomised controlled trial 80 adult patients ( 18 years of age) with T2DM (HbA1c ≥ 6.5) or IR (triglyceride glucose index value [TyG] 4.49) and HF from an outpatient HF clinic in Victoria, Australia were recruited.Methods: Participants will be randomised to a LC or a LF diet (UC) group. The primary outcome is a composite endpoint of changes in New York Heart Association (NYHA) class, hospital admissions, thirst distress and QoL. The secondary endpoint is a 2% change in HbA1c from baseline. Outcomes will be assessed at baseline, week 6 and week 16.Results: This article describes a protocol for a radomised controlled trial (RCT). The results of this trial will be published at the completion of the study.Conclusion: The results from this trial will provide an insight into the future dietary management of DMCM for both patients and healthcare practitioners.
Publisher: Wiley
Date: 03-2007
DOI: 10.1111/J.1365-2702.2006.01657.X
Abstract: The aim of the current study was to explore and describe the strategies young women with Type 1 diabetes used to manage transitions in their lives. This paper will describe one aspect of the findings of how women with Type 1 diabetes used the Internet to interact with other people with diabetes and create stability in their lives. In iduals living with diabetes develop a range of different strategies to create stability in their lives and enhance their well-being. Changing social and emotional conditions during life transitions have a major impact on diabetes management. Although the literature indicates that strategies enabling the in iduals to cope with transitions are important, they remain under-researched. Using grounded theory, interviews were conducted with 20 women with Type 1 diabetes. Constant comparative data analysis was used to analyse the data and develop an understanding of how young women with Type 1 diabetes used the Internet to create stability in their lives. The findings revealed that the women valued their autonomy and being in control of when and to whom they reveal their diabetic status, especially during life transitions and at times of uncertainty. However, during these times they also required health and social information and interacting with other people. One of the women's main strategies in managing transitions was to use Internet chat lines as a way of obtaining information and communicating with others. This strategy gave women a sense of autonomy, enabled them to maintain their anonymity and interact with other people on their own terms. Having meaningful personal interactions, social support and being able to connect with others were fundamental to the women's well being. Most importantly, preserving autonomy and anonymity during such interactions were integral to the way the women with Type 1 diabetes managed life transitions. Health professionals need to explore and incorporate Internet communication process or anonymous help lines into their practice as a way to assist people manage their diabetes.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2012
Publisher: Wiley
Date: 29-03-2022
DOI: 10.1111/JAN.15236
Publisher: Medical Association of Pharmacopuncture Institute
Date: 09-2009
Publisher: CSIRO Publishing
Date: 16-04-2021
DOI: 10.1071/PY20235
Abstract: This study explored the perceived healthcare system and process barriers and enablers experienced by GPs and Credentialled Diabetes Educators (CDEs) in Australian primary care, in the delivery of preventative and early intervention foot care to people with diabetes. A qualitative design with inductive analysis approach was utilised and reported according to the Consolidated Criteria for Reporting Qualitative Studies (COREQ). Semi-structured interviews were conducted with two GPs and 14 CDEs from rural, urban and metropolitan areas of Australia. Participants were from New South Wales, South Australia, Victoria, Western Australia, the Northern Territory and Queensland. Barriers to providing foot care constituted five broad themes: (1) lack of access to footcare specialists and services (2) education and training insufficiencies (3) human and physical resource limitations related to funding inadequacies (4) poor care integration such as inadequate communication and feedback across services and disciplines, and ineffectual multidisciplinary care and (5) deficient footcare processes and guidelines including ambiguous referral pathways. Enablers to foot care were found at opposing ends of the same spectra as the identified barriers or were related to engaging in mentorship programs and utilising standardised assessment tools. This is the first Australian study to obtain information from GPs and CDEs about the perceived barriers and enablers influencing preventative and early intervention diabetes-related foot care. Findings offer an opportunity for the development and translation of effective intervention strategies across health systems, policy, funding, curriculum and clinical practice, in order to improve outcomes for people with diabetes.
Publisher: Springer Science and Business Media LLC
Date: 27-02-2013
Publisher: Wiley
Date: 08-06-2013
DOI: 10.1111/JOCN.12043
Abstract: This study is drawn from a larger project that aimed to identify the staffing and organisational factors influencing the quality of diabetes care for older people living in residential care in regional Victoria, Australia. The focus of the current study is on medication management for residents with diabetes. With a continuous rise in diabetes in the population, there is an associated increase in the prevalence of diabetes in aged care residential settings. However, there is little specific guidance on how to manage diabetes in older people living in institutional settings who experience multiple concurrent chronic conditions. A triangulation strategy consisting of three phases. A one-shot cross-sectional survey (n = 68) focus group interviews and a case file audit (n = 20). Data were collected between May 2009-January 2010. Staff knowledge of diabetes and its contemporary medication management was found to be suboptimal. Challenges to managing residents with diabetes included limited time, resident characteristics and communication systems. Additionally, the variability in medical support available to residents and a high level of polypharmacy added to the complexity of medication management of resident. The current study suggests administering medicine to residents in aged care settings is difficult and has potentially serious medical, professional and economic consequences. Limitations to staff knowledge of contemporary diabetes care and medications potentially place residents with diabetes at risk of receiving less than optimal diabetes care. Providing evidence-based guidelines about diabetes care in residential care settings is essential to achieve acceptable outcomes and increase the quality of life for residents in public aged care. Continuing education programs in diabetes care specifically related to medication must be provided to all health professionals and encompass scope of practice.
Publisher: Springer Science and Business Media LLC
Date: 12-05-2015
Publisher: CSIRO Publishing
Date: 30-08-2021
DOI: 10.1071/AH21118
Abstract: Objective The aim of this study was to describe nurses’ and midwives’ experiences following the first phase of the implementation of an electronic medical record (EMR) system at a large public health service in metropolitan Melbourne, Australia. Methods Four focus groups were held 8–10 months after implementation of the EMR. Transcripts were analysed using thematic analysis. Results Of 39 participants, 25 were nurses (64%), 12 were midwives (31%) and two did not provide this information. The mean (±s.d.) duration of clinical experience was 15.6 ± 12.2 years (range 2–40 years). Three main themes were identified: (1) effects on workflow: although some participants reported that EMR facilitated easier access to real-time patient data, others indicated that workflow was disrupted by the EMR being slow and difficult to navigate, system outages and lack of interoperability between the EMR and other systems (2) effects on patient care and communication: some participants reported that the EMR improved their communication with patients and reduced medication errors, whereas others reported a negative effect on patient care and communication and (3) negative effects of the EMR on nurses’ and midwives’ personal well-being, including frustration, stress and exhaustion. These experiences were often reported in the context of cognitive workload due to having to use multiple systems simultaneously or extra work associated with EMR outages. Conclusion Nurses’ and midwives’ experiences of the EMR were complex and mixed. Nurses and midwives require significant training and ongoing technical support in the first 12 months after implementation of an EMR system. Including nurses and midwives in the design and refinement of the EMR will ensure that the EMR aligns with their workflow. What is known about the topic? Studies reporting nurses’ and midwives’ experiences of using EMR are scarce and mostly based in countries where whole-of-service implementations are carried out, funded by governments. What does this paper add? Nurses and midwives perceive benefits of using an EMR relatively soon after implementation in terms of their workflow and patient care. However, in the first year after EMR implementation, nurses and midwives experience some negative effects on workflow, patient care and their own well-being. The effects on clinical workflow are further compounded by EMR downtime (scheduled and unscheduled) and hybrid systems that require users to access other technology systems alongside the EMR. What are the implications for practitioners? In countries like Australia, whole-of-service, simultaneous implementation of EMR systems using best-available server technology may not be possible due to funding constraints. In these circumstances, nurses and midwives may initially experience increased workload and frustration. Ongoing training and technical support should be provided to nurses and midwives for several months following implementation. Including nurses and midwives in the design of the EMR will result in better alignment with their specific workflow, thus maximising benefits of EMR implementation.
Publisher: JMIR Publications Inc.
Date: 06-11-2020
DOI: 10.2196/19488
Abstract: People of low socioeconomic position (SEP) are disproportionately affected by type 2 diabetes (T2D), partly due to unhealthy eating patterns that contribute to inadequate disease self-management and prognosis. Digital technologies have the potential to provide a suitable medium to facilitate diabetes education, support self-management, and address some of the barriers to healthy eating, such as lack of nutritional knowledge or shopping or cooking skills, in this target group. This study aims to test the feasibility, appeal, and potential effectiveness of EatSmart, a 12-week, evidence-based, theoretically grounded, fully automated web-based and mobile-delivered healthy eating behavior change program to help disadvantaged people living with T2D to eat healthily on a budget and improve diabetes self-management. EatSmart is a mixed methods (quantitative and qualitative) pre-post design pilot study. Sixty socioeconomically disadvantaged people with T2D aged 18 to 75 years will be recruited. Participants will complete self-reported baseline assessments of their basic demographic and clinical data, dietary intake, dietary self-efficacy, and barriers to healthy eating. They will be provided with login access to the EatSmart web program, which includes six progressive skill-based modules covering healthy eating planning smart food budgeting and shopping time-saving meal strategies, healthy cooking methods, modifying recipes and a final reinforcement and summary module. Over the 3-month intervention, participants will also receive 3 text messages weekly, encouraging them to review goals, continue to engage with different components of the EatSmart web program, and eat healthily. Participants will undertake follow-up assessments directly following the intervention 3 months post baseline and again after a 6-month postintervention follow-up period (9 months post baseline). Feasibility will be evaluated using the number of participants recruited and retained and objective indicators of engagement with the website. Program appeal and potential effects on primary and secondary outcomes will be assessed via the same surveys used at baseline, with additional questions asking about experience with and perceptions of the program. In-depth qualitative interviews will also be conducted 6 months post intervention to provide deeper insight into experiences with EatSmart and a more comprehensive description of the program’s appeal. The EatSmart website has been developed, and all participants have viewed the modules as of May 2020. Results are expected to be submitted for publication in December 2020. This study will provide data to address the currently limited evidence regarding whether disadvantaged populations with T2D may benefit from digitally delivered behavior change programs that facilitate eating healthily on a budget. Australian New Zealand Clinical Trials Registry, ACTRN12619001111167 anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12619001111167 DERR1-10.2196/19488
Publisher: Elsevier BV
Date: 05-2020
DOI: 10.1016/J.WOMBI.2019.06.008
Abstract: Breastfeeding has significant health benefits for maternal and infant health, yet women with pre-pregnancy diabetes (type 1 or type 2 diabetes mellitus) are often less likely to breastfeed compared with other childbearing women. Intention to breastfeed and making the decision to breastfeed during pregnancy are significant predictors of breastfeeding in the general population, but intention to breastfeed has not been assessed during pregnancy among women with pre-pregnancy diabetes. To investigate factors associated with breastfeeding to three months postpartum, including demographic, health and reproductive characteristics, perceived support and pre-birth intention to breastfeed, among women with pre-pregnancy diabetes. A prospective cohort of women with pre-pregnancy diabetes was recruited at three metropolitan hospitals in Melbourne, Australia. Women completed surveys during the third trimester of pregnancy (including intention to breastfeed) and at approximately 3 months postpartum (including current breastfeeding). Factors associated with any breastfeeding at 3 months postpartum were investigated using logistic regression. Pregnancy surveys were completed by 79 women three-month postpartum data were available for 47 women. Of these, more than two-thirds (n=32, 68%) indicated that they were breastfeeding. Controlling for other relevant variables, only pre-birth intention to breastfeed was significantly associated with any breastfeeding at three months (Adjusted Odds Ratio (95% confidence intervals, p)=20.49 (20.18-20.80, 0.017)). Pre-birth intention to breastfeed was the only significant predictor of continued breastfeeding to 3 months postpartum. Pregnancy provides an important opportunity for health professionals to educate and support women with pre-pregnancy diabetes about their breastfeeding intentions.
Publisher: JMIR Publications Inc.
Date: 20-04-2020
Abstract: eople of low socioeconomic position (SEP) are disproportionately affected by type 2 diabetes (T2D), partly due to unhealthy eating patterns that contribute to inadequate disease self-management and prognosis. Digital technologies have the potential to provide a suitable medium to facilitate diabetes education, support self-management, and address some of the barriers to healthy eating, such as lack of nutritional knowledge or shopping or cooking skills, in this target group. his study aims to test the feasibility, appeal, and potential effectiveness of EatSmart, a 12-week, evidence-based, theoretically grounded, fully automated web-based and mobile-delivered healthy eating behavior change program to help disadvantaged people living with T2D to eat healthily on a budget and improve diabetes self-management. atSmart is a mixed methods (quantitative and qualitative) pre-post design pilot study. Sixty socioeconomically disadvantaged people with T2D aged 18 to 75 years will be recruited. Participants will complete self-reported baseline assessments of their basic demographic and clinical data, dietary intake, dietary self-efficacy, and barriers to healthy eating. They will be provided with login access to the EatSmart web program, which includes six progressive skill-based modules covering healthy eating planning smart food budgeting and shopping time-saving meal strategies, healthy cooking methods, modifying recipes and a final reinforcement and summary module. Over the 3-month intervention, participants will also receive 3 text messages weekly, encouraging them to review goals, continue to engage with different components of the EatSmart web program, and eat healthily. Participants will undertake follow-up assessments directly following the intervention 3 months post baseline and again after a 6-month postintervention follow-up period (9 months post baseline). Feasibility will be evaluated using the number of participants recruited and retained and objective indicators of engagement with the website. Program appeal and potential effects on primary and secondary outcomes will be assessed via the same surveys used at baseline, with additional questions asking about experience with and perceptions of the program. In-depth qualitative interviews will also be conducted 6 months post intervention to provide deeper insight into experiences with EatSmart and a more comprehensive description of the program’s appeal. he EatSmart website has been developed, and all participants have viewed the modules as of May 2020. Results are expected to be submitted for publication in December 2020. his study will provide data to address the currently limited evidence regarding whether disadvantaged populations with T2D may benefit from digitally delivered behavior change programs that facilitate eating healthily on a budget. ustralian New Zealand Clinical Trials Registry, ACTRN12619001111167 anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12619001111167 ERR1-10.2196/19488
Publisher: Springer Science and Business Media LLC
Date: 02-02-2018
Publisher: Wiley
Date: 18-07-2023
DOI: 10.1111/JOCN.16824
Abstract: To evaluate evidence that examined nurses' work experiences in hospital wards with single rooms. The research question was ‘What does the research tell us about nurses’ work experiences in hospital wards with single rooms?’ In the last decades, new hospital builds have moved towards including a high proportion of single rooms. Yet, single rooms create ‘complex environments’ that impact the nurses. A structured integrative review was undertaken of empirical evidence. Original, peer‐reviewed articles, written in English, were sourced from four databases: CINAHL, PubMed, Embase and Web of Science. The initial searches were performed in April 2021 and repeated in December 2022. Quality appraisal was undertaken using the Mixed Methods Appraisal Tool. A narrative synthesis approach was used to analyse the data. Reporting was guided by the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement. Twelve studies, published between 2006 and 2022, with an international origin, and representing n = 826 nurses, were included in this review. The synthesis revealed mixed perspectives about nurses' work experiences in wards with single rooms. Whilst single rooms are ‘all good in theory (and) a good idea’, the reality was quite different. Synthesised findings are presented in four categories: (i) aesthetics and the physical space, (ii) privacy vs. isolation, (iii) safety, which includes situational awareness and (iv) communication and collaboration. This review describes how single rooms affects nurses' work experience. Whilst nurses shared multiple concerns about single rooms and the challenges they also acknowledged patient preference for the privacy and space afforded by single rooms. Findings from this review highlight the need for careful planning to maintain and strengthen teamwork, prevent nurses' sense of working in isolation, as well as creating opportunities for mentorship, and collaboration among nurses when working in single‐room settings.
Publisher: JMIR Publications Inc.
Date: 30-11-2017
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/PY16106
Abstract: Meeting men’s health needs by improving healthcare service access is a key objective of comprehensive primary health care. The aims of this qualitative study were to explore the perception of nurses in men’s health services and to describe men’s expectation of the nurse. The comparative component identifies the barriers and facilitators to improved access to health services. A purposive s le of 19 nurses and 20 men was recruited from metropolitan and regional settings in the state of Victoria, Australia, and each participant was interviewed in idually or as part of three focus groups. The main findings were: nurses and men were unclear on the role of the nurse in men’s health and health promotion provided by nurses was predominantly opportunistic. Both participant groups indicated barriers to healthcare access related to: the culture and environment in general practice limitation of Australia’s Medicare healthcare financing system out-of-pocket costs, waiting time and lack of extended hours and men not wanting to be perceived as complainers. Facilitators related to: positive inter-professional relations effective communication personal qualities and level of preparedness of nurse education. The findings demonstrate a need for the role to be better understood by both men and nurses in order to develop alternative approaches to meeting men’s healthcare needs.
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.PEC.2015.10.015
Abstract: Person-centred care [PCC] can engage people in living well with a chronic condition. However, translating PCC into practice is challenging. We aimed to compare the translational potentials of three approaches: motivational interviewing [MI], illness integration support [IIS] and guided self-determination [GSD]. Comparative analysis included eight components: (1) philosophical origin (2) development in original clinical setting (3) theoretical underpinnings (4) overarching goal and supportive processes (5) general principles, strategies or tools for engaging peoples (6) health care professionals' background and training (7) fidelity assessment (8) reported effects. Although all approaches promoted autonomous motivation, they differed in other ways. Their original settings explain why IIS and GSD strive for life-illness integration, whereas MI focuses on managing ambivalence. IIS and GSD were based on grounded theories, and MI was intuitively developed. All apply processes and strategies to advance professionals' communication skills and engagement GSD includes context-specific reflection sheets. All offer training programs MI and GSD include fidelity tools. Each approach has a primary application: MI, when ambivalence threatens positive change IIS, when integrating newly diagnosed chronic conditions and GSD, when problem solving is difficult, or deadlocked. Professionals must critically consider the context in their choice of approach.
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.AUCC.2021.09.006
Abstract: Rounding by the Rapid Response team (RRT) is an integral part of safety and quality care of the deteriorating patient. Rounding enables Intensive Care Units (ICU) liaison nurses to proactively identify deteriorating patients in the general wards and minimize the time spent by general nursing staff to call for assistance. The study examined nurses' and midwives' experiences of proactive rounding by a RRT/ICU Liaison service, including the impact on workflow and patient care as well as enablers and barriers to utilization of the service. A mixed method approach was used: an online survey and semi-structured interviews with nurses and midwives in an acute care setting. 52 respondents completed the online survey and 6 participated in a semi-structured interviews. The majority of survey respondents found the service useful and indicated that rounding by the ICU Liaison service improves patient care. Participants also believed that pro-active rounding increases staff confidence and builds rapport when utilizing the ICU Liaison service. Barriers to use of the service included the lack of out of normal business hours support and obtaining prompt support. Proactive rounding was perceived by nurses and midwives to be beneficial for both themselves and patients, and ensured that deteriorating patients were identified.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2013
Publisher: Wiley
Date: 15-09-2001
DOI: 10.1046/J.1365-2702.2001.00550.X
Abstract: Despite increasing interest in consumer awareness and participation in health care service delivery, there has been little exploration of consumer views in relation to services for people with type I diabetes. The purpose of this qualitative exploratory study was to identify strategies people with type I diabetes used to access health services and the barriers they perceived in accessing the services they needed. Data gathered in semi-structured interviews revealed that consumers experience significant barriers when navigating the health care system. Three dominant themes were identified. They relate to access to specialist medical skill, to the transition from teenager to young adult and to pre-pregnancy and obstetric care. Directions for change in service delivery and policy development are discussed.
Publisher: Sciedu Press
Date: 20-02-2019
DOI: 10.5430/JNEP.V9N6P23
Abstract: The aim of the study was to provide insights into the transitional experience of women newly diagnosed with breast cancer progressing to their primary treatment. The psychosocial impact of patients in the recovery phase after breast cancer treatment has been investigated in recent years, however, little is known about the transition experience and psychosocial needs of Danish breast cancer patients during the phase of transition from diagnosis to treatment. This study employed a qualitative descriptive design with data collection including 12 semi-structured interviews with women undergoing radiation-or chemotherapy treatment. The transcribed interviews were analysed which identified five main themes 1) Uncertainty, 2) Sense of powerlessness, 3) Sustaining normality, 4) Worrying about the future, 5) Fortunate only having radiotherapy. Understanding care needs of women in transition, from diagnosis to treatment, and how it impacts on their lives, is essential to enable health professionals to tailor in idualized care. Early support is critical to ensure that women understand step-by-step what is involved in the treatment and care and thereby to assist them towards a positive psychosocial trajectory.
Publisher: Informa UK Limited
Date: 02-2023
DOI: 10.2147/PPA.S391340
Publisher: Elsevier BV
Date: 02-2010
DOI: 10.1016/J.APNU.2009.04.009
Abstract: The aim of this article is to present a current discussion related to the nursing care of clients treated with atypical antipsychotic medicines and who have a risk of developing metabolic instability and/or Type 2 diabetes. The importance of such a discussion is to provide both the novice and the experienced nurse with additional knowledge of this current health issue with which to inform their nursing practice. The potential for psychosis to be a chronic condition is very high, and often people require antipsychotic medicine for lengthy periods throughout their lives. Sometimes, treatment is for life. The second generation of antipsychotic medicines was greeted with much enthusiasm since it was better tolerated than the first generation. However, each medication has desired and adverse effects and, when taken for lengthy periods, these effects may produce physical illness. Studies show that the prevalence of Type 2 diabetes and the metabolic syndrome was significantly higher in clients with a chronic psychiatric disorder, particularly schizophrenia. Metabolic instability, especially weight gain, is associated with some psychotropic medicines. Nursing interventions need to include care assessment, planning, intervention, and evaluation for clients treated with antipsychotic medicines in terms of risk minimization strategies in routine nursing care.
Publisher: Springer Science and Business Media LLC
Date: 23-11-2013
No related grants have been discovered for Bodil Rasmussen.