ORCID Profile
0000-0001-9702-652X
Current Organisations
University of Melbourne
,
University of South Australia
,
James Cook University
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Publisher: Wiley
Date: 06-08-2023
DOI: 10.5694/MJA2.52032
Abstract: University departments of rural health are Commonwealth‐funded to improve recruitment and retention of the rural allied health and nursing (including midwifery) workforce, primarily through student placements. We examined publications by university departments of rural health that were focused on allied health and nursing students undertaking placements in rural Australia, to understand the characteristics, main findings and implications of the research conducted. Interprofessional learning was a key feature of placements and placement education, although other activities such as community engagement added to placement experiences. Factors such as quality supervision and being involved in the community contributed to a positive placement experience and increased rural practice intention. Tracking studies showed a relationship between rural placements, rural practice intention and rural practice. Rural placements occurred across a variety of settings and in locations consistent with the policy framework. Embedding university departments of rural health in rural communities enabled staff to build relationships and increase placement capacity.
Publisher: Hindawi Limited
Date: 09-09-2019
DOI: 10.1111/HSC.12653
Abstract: Almost one third of the South Australian population reside in regional locations, which are serviced by just 8% of the State's total psychiatrist workforce. Consequently, access to psychotropic medications in regional South Australia (SA) can be challenging. Granting prescribing rights to mental health nurses (MHNs) located in regional settings presents an opportunity to increase consumer access to psychotropic medications. The aim of the study was to understand the perspectives of mental health workers (MHWs) practising in regional and metropolitan settings towards MHN prescribing. The study adopted a qualitative approach. Seventeen MHWs participated in three focus groups, including two in regional SA and one in a metropolitan site within the State of SA. Participants reported difficulties in accessing medicines in regional areas. The regional focus groups indicated that MHN prescribing may help to release psychiatrists' time and provide quicker assessment and diagnosis. By contrast, the metropolitan focus group expressed reservations about MHN prescribing. Participants indicated that suitable governance structures supported by appropriate education programmes were a necessary prerequisite for MHN prescribing of psychotropic medications. MHN prescribing may help to mitigate the impact of psychiatrist shortages in regional South Australia and possibly in other areas of the world where recruitment is a challenge. The provision of adequate education and the establishment of a suitable governance and support framework are considered necessary steps to progress MHN prescribing.
Publisher: Hindawi Limited
Date: 08-01-2018
DOI: 10.1111/HSC.12532
Abstract: There are well-established training programmes available to support health and human services professionals working with people vulnerable to suicide. However, little is known about involving people with lived experience in the delivery of suicide prevention training with communities with increased rates of suicide. The aim of this paper was to report on a formative dialogical evaluation that explored the views of health and human services workers with regard to a suicide prevention training programme in regional (including rural and remote areas) South Australia which included meaningful involvement of a person with lived experience in the development and delivery of the training. In 2015, eight suicide prevention training workshops were conducted with health and human services workers. All 248 participants lived and worked in South Australian regional communities. We interviewed a subs le of 24 participants across eight sites. A thematic analysis of the interviews identified five themes: Coproduction is key, It is okay to ask the question, Caring for my community, I can make a difference and Learning for future training. The overall meta-theme was "Involvement of a person with lived experience in suicide prevention training supports regional communities to look out for people at risk of suicide." This paper highlights the need for suicide prevention training and other workforce development programmes to include lived experience participation as a core component in development and delivery.
Publisher: Public Library of Science (PLoS)
Date: 21-09-2023
Publisher: Wiley
Date: 28-02-2023
DOI: 10.1111/AJR.12974
Abstract: To examine the principal place of practice after graduation of students who participated in the Rural Health Multidisciplinary Training (RHMT) program and allied health students' place of origin. Cross‐sectional study. Graduates who completed their degree in podiatry, occupational therapy and physiotherapy in 2019. Principal place of practice at first and third years after graduation. In 2020, 40 allied health professionals (AHPs) who graduated from the University of South Australia in 2019 were practising in rural areas but only 26 of them remained in the rural practice in 2022. The retention rate for rural practice was 65% within 2 years. However, in 2022, 25 allied health professionals left their metropolitan employment location and transitioned to rural practice. Of the 25 allied health graduates who joined the rural practice in 2022, most of them (80%, 20/25) had either rural exposure through the RMHT program or were from rural origin. Rural exposure via the RHMT program and allied health students' rural place of origin have an important role for rural principal place of practice at first and third years after graduation.
Publisher: Wiley
Date: 04-2020
DOI: 10.1111/AJR.12611
Publisher: Wiley
Date: 10-2021
DOI: 10.1111/AJR.12816
Abstract: To describe the distribution of 3 allied health professionals—occupational therapists, physiotherapists and podiatrists—in South Australia stratified by the Modified Monash Model and the Index of Relative Socio‐Economic Disadvantage. A descriptive data linkage cross‐sectional study. The state of South Australia, Australia. Distribution of the 3 registered allied health professional groups stratified by Modified Monash Model and Index of Relative Socio‐Economic Disadvantage. The largest proportion of the 3 allied health professional groups (occupational therapists, physiotherapists and podiatrists) were found in areas classified as Modified Monash 1 and Modified Monash 2 (86.5%). The lowest proportion of allied health professionals were found in Modified Monash 7. The largest number of allied health professionals per 10 000 population was found in areas classified as Modified Monash 1 and Modified Monash 2. The lowest number of allied health professionals per 10 000 population was found in Modified Monash 7 areas. The largest number of allied health professionals per 10 000 population was found in areas with Index of Relative Socio‐Economic Disadvantage quintile 2, while the lowest number of allied health professionals per 10 000 population was found in areas with Index of Relative Socio‐Economic Disadvantage quintile 1. The distribution of allied health professionals according to geographical remoteness, socio‐economic disadvantage and per 10 000 population varies widely in South Australia. The number of allied health professionals per 10 000 population was lowest in rural and remote/very remote areas, explaining the typically poor access to allied health services for communities in these areas. The number of allied health professionals per 10 000 population according to Index of Relative Socio‐Economic Disadvantage was variable within the context of both urban and rural areas.
Publisher: Edith Cowan University
Date: 12-2018
Publisher: Wiley
Date: 30-06-2020
DOI: 10.1111/JRH.12472
Abstract: Accessibility and availability of health care services roviders is an increasing concern for many regional communities, particularly regional South Australia. Assessing the level of health service rovider utilization within a region (ie, expressed demand) can be useful in determining health care need and health service/workforce demand. The regional South Australia health (RESONATE) survey aimed to determine the expressed demand for health care services and the health workforce in a regional South Australian population. The study was open to adults living in regional South Australia and was promoted using a comprehensive multimodal recruitment c aign. Data were collected between April 2017 and March 2018 using the consumer utilization, expectations and experiences of healthcare instrument. A total of 3,926 adults completed the questionnaire. Participants reported using 47 different health care providers in the previous 12 months. Whilst almost all (92.9%) participants had seen a general practitioner in the past 12 months, yoga instructors, chiropractors, pharmacists, and physiotherapists were visited most frequently. Proportionally fewer participants in more remote locations received conventional services/treatments, though a significantly greater proportion of those in more remote locations had received complementary medicine services/treatments (relative to inner regional areas). Findings of the RESONATE survey point to a high level of expressed demand for conventional and complementary health care services among study participants, possibly higher than that reported in the general population. Examining the extent to which the health needs of this and other regional populations are met should be the focus of further research to better inform future health workforce/services planning.
Publisher: BMJ
Date: 06-2022
DOI: 10.1136/BMJOPEN-2021-056404
Abstract: Behavioural activation (BA) is an effective treatment for depression however, it is unclear if it can be used to manage pain. To conduct a scoping review of primary research that reported using BA to support people living with chronic pain to understand how BA had been used in relation to pain. In addition, we wanted to understand whether there were any reported changes in that pain, and how and who delivered BA. Primary research published in English. We searched seven databases MEDLINE, Ovid Embase, Ovid Emcare, PsycINFO, CINAHL, Scopus and Web of Science, for primary research. No initial date limit was used with the date the searches were conducted used as the end date limit (1 July 2021). A customised data extraction table was developed, piloted and used. 551 papers were screened for inclusion, with 15 papers included in our review. Studies were conducted in North America and in Canada. These included three case studies, nine uncontrolled trials and three randomised controlled trials. Only two studies reported pain as the primary outcome. BA was applied across a range of pain related conditions. The dose of BA ranged from 3 to 16 sessions. Duration of treatment was 3 weeks to 12 months. Most studies reported reductions in pain following exposure to BA. BA has the potential to reduce pain. Caution needs to be exercised in the interpretation of these findings as a high risk of bias was observed in most studies. High-quality research is required to test if BA is an effective intervention for chronic pain.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-06-2020
Publisher: Wiley
Date: 10-2021
DOI: 10.1111/AJR.12817
Publisher: BMJ
Date: 06-2021
DOI: 10.1136/BMJOPEN-2020-041036
Abstract: Chronic pain is a distressing condition and often poorly treated and managed. Psychological therapies are considered first-line intervention for people with chronic pain. Common psychological therapies require extensive clinician training and specialist qualifications. One approach that does not need lengthy training nor specialist qualification, but has empirical support in other health domains, is behavioural activation (BA). BA seeks to increase engagement in behaviours that are valued by the person and progress through behaviours that can increase mood and develop skills that build satisfying routines. BA can help people to manage their condition through scheduling behaviours, promoting routine and mastery over their condition. The extent to which BA has been used to support people living with chronic pain is not clear. This scoping review aims to identify published studies describing the application of BA to support people living with chronic pain. To map the evidence regarding BA and chronic pain, including the study type and the associated evidence, a scoping review was adopted. The search will be conducted in bibliographic databases, clinical trial registries and grey literature. No date limits will be applied to the search strategy. Screening of titles and abstracts, and full-text screening, will be independently undertaken by two investigators using Covidence software. Any disagreement between investigators will be resolved by a third investigator. Data from included publications will be extracted using a customised data extraction tool. The scoping review is an analysis of existing data and therefore ethics approval is not required. The findings of this scoping review will further our understanding of how BA has been used to support people living with chronic pain and inform future training and education programmes in this area.
Publisher: Hindawi Limited
Date: 26-08-2022
DOI: 10.1111/HSC.13978
Publisher: Cold Spring Harbor Laboratory
Date: 16-03-2023
DOI: 10.1101/2023.03.15.23287337
Abstract: Post-stroke depression (PSD) affects one third of stroke survivors and substantially impacts recovery, so it is important to identify effective treatments for PSD. Behavioural activation (BA), a relatively simple intervention, has demonstrated efficacy in the treatment of adults with unipolar depression. However, its use and efficacy in the treatment of PSD has not been documented in a systematic review. This systematic review and meta-analysis considers: What effect does BA have on reducing depression symptoms in in iduals diagnosed with PSD? MEDLINE, Embase, Emcare, Cochrane Library, and PsycINFO, were searched for randomised controlled trials (RCTs) published in English, on 13 July 2021. To chart the data, we employed a customized extraction sheet. The Cochrane Collaboration risk-of-bias 2 tool was used to determine study quality. Two papers, written by the same lead authors, met the inclusion criteria. The Communication and Low Mood trial and the Behavioural Activation Therapy for Post-Stroke Depression trial were conducted in the United Kingdom and published in 2012 and 2019, respectively. Meta-analysis showed BA was associated with a decrease in depression symptoms in patients with PSD relative to treatment as usual (standard mean difference (SMD) -0.54 95% confidence interval (CI) -0.90 to -0.18). BA may be more effective when compared to treatment as usual in reducing depression symptoms in in iduals with PSD. Although our meta-analysis found positive effects of BA, the evidence is inconclusive due to the small number of studies. High-quality RCTs are needed to confirm the benefits of BA in PSD. This review followed PRISMA guidelines with a protocol published in advance of the review being conducted. This is the first review to consider whether BA is effective in reducing PSD. We focused on depression as a single primary outcome other outcome measures, such as quality of life, could have been considered. Based on the review questions inclusion was limited to experimental designs. Other designs provide additional insights into the application of BA to PSD that is beyond the scope of this study. Our review was restricted to studies published in English and did not examine grey literature therefore, some studies may not have been included.
Publisher: Wiley
Date: 06-2021
DOI: 10.1111/AJR.12727
Publisher: Public Library of Science (PLoS)
Date: 23-11-2021
DOI: 10.1371/JOURNAL.PONE.0260250
Abstract: As part of significant mental health reform, the Community Mental Health Rehabilitation Service (CMHRS) was implemented in rural South Australia. The CMHRS is a 10-bed mental health residential program offering rehabilitative mental health support to rural residents. To analyse the CMHRS service delivery model and its impact on recovery outcomes for consumers. A mixed method, realist evaluation approach was utilised. A purposive s le of CMHRS staff (n = 6) and consumers (n = 8) were recruited. Consumer recovery was measured using the RAS-DS (on admission and discharge). Participants’ perspectives of the service were gained via one staff focus group (n = 6) and in idual semi-structured interviews (consumers n = 6 staff n = 2). Pre-post RAS-DS scores were analysed using paired t-tests/Wilcoxon paired-signed rank test, with qualitative data analysed thematically. Significant positive increases in RAS-DS total scores were observed at discharge, supported by the qualitative themes of (re)building relationships and social connections and recovering health and wellbeing. Contextual factors (e.g. staffing) and program mechanisms (e.g. scheduling) impacting on service implementation were identified. Maintaining a rehabilitation recovery-focused approach, balanced with an appropriately trained multi-disciplinary team, are vital for maximising positive consumer outcomes. This realist evaluation identifies critical factors impacting rural mental health rehabilitation service delivery.
Publisher: Elsevier BV
Date: 12-2021
Publisher: SAGE Publications
Date: 2020
Abstract: Qualitative research plays an important role in helping us describe, interpret and generate theories about complex phenomena in healthcare. Complete and transparent reporting of research informs readers about the significance and rigor of the work. The aim of this scientometric study was to determine the quality of reporting of qualitative research in nursing social science. Studies were identified by manually searching the table of contents for qualitative papers published in the June (or closest subsequent) 2018 issue of 115 nursing journals. Adherence with the 32-item Consolidated Criteria for REporting Qualitative (COREQ) research was determined for each study by two researchers. Additional information about the study (e.g., s le size, field of nursing) and the publishing journal (e.g., endorsement of COREQ) were also extracted. Using established criteria, COREQ compliance was coded either good (≥ 25 items), moderate (17 to 24), poor (9 to 16), very poor (≤ 8) based on the number of items addressed in each study. One hundred and ninety-seven manuscripts were included. The quality of reporting was generally rated as either moderate (57%) or poor (38%). Journal endorsement of qualitative reporting guidelines was associated with better reporting. The reporting of qualitative research in nursing social science journals is suboptimal. Researchers, authors, reviewers and journal editors need to ensure their papers comprehensively address the requirements of COREQ to ensure comprehensive and transparent reporting of their research.
Publisher: AMPCo
Date: 12-2020
DOI: 10.5694/MJA2.50881
Publisher: BMJ
Date: 2020
DOI: 10.1136/BMJOPEN-2019-034400
Abstract: The health workforce is an integral component of the healthcare system. Comprehensive, high-quality data on the health workforce are essential to identifying gaps in health service provision, as well as informing future health workforce and health services planning, and health policy. While many data sources are used in Australia for these purposes, the quality of the data sources with respect to relevance, accessibility and accuracy is not clear. This scoping review aims to identify and appraise publicly available data sources describing the Australian health workforce. The review will include any data source (eg, registry, administrative database and survey) or document reporting a data source (eg, journal article, report) on the Australian health workforce, which is publicly available and describes the characteristics of the workforce. The search will be conducted in 10 bibliographic databases and the grey literature using an iterative process. Screening of titles and abstracts will be undertaken by two investigators, independently, using Covidence software. Any disagreement between investigators will be resolved by a third investigator. Documents/data sources identified as potentially eligible will be retrieved in full text and reviewed following the same process. Data will be extracted using a customised data extraction tool. A customised appraisal tool will be used to assess the relevance, accessibility and accuracy of included data sources. The scoping review is a secondary analysis of existing, publicly available data sources and does not require ethics approval. The findings of this scoping review will further our understanding of the quality and availability of data sources used for health workforce and health services planning in Australia. The results will be submitted for publication in peer-reviewed journals and presented at conferences targeted at health workforce and public health topics.
Publisher: Wiley
Date: 06-2016
DOI: 10.1111/JPM.12308
Abstract: WHAT IS KNOWN ON THE SUBJECT?: People diagnosed with schizophrenia or bipolar disorder have a life expectancy 10-15 years less than the general population. In rural and remote Australia, there is a shortage of health care professionals to provide physical health care for people living with a serious mental illness (SMI). A large proportion of the care for people living with a SMI is provided by non-government organizations (NGOs), often employing workers without formal qualifications. There has been minimal research regarding the experiences of NGO workers who have been trained to complete health checks to help people living with SMI to access primary care services. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first study to examine the experiences of preparing NGO workers to use the health improvement profile (HIP) to support the physical health of people with SMI. It builds on previous studies that examined the use of the HIP by trained/qualified staff. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This study highlights that NGO employees may have an important role in helping people with a SMI to address their physical health. Engaging lay workers to use the HIP increases their awareness of the importance of providing good physical health care for people with SMI. The use of a tool, such as the HIP, prepares NGO workers to support the physical health needs and enables them to describe meaningful improvements in the health of people with a SMI. Background The life expectancy of people living with a serious mental illness (SMI) is up to 10-15 years less than the general population. They experience difficulties in accessing timely and appropriate physical health care. People with SMI living in regional Australia experience additional barriers to accessing services. This is in part due to the difficulties associated with recruiting and retaining health professionals in regional Australia. Aim To explore the regional non-government organization (NGO) workforce views of using a physical health care check list - the health improvement profile (HIP) - with people with a SMI. Gain insights into the workers' experiences of using the HIP. Understand which aspects of the HIP workers perceived as being most and least helpful. Learn how the HIP and the training program could be modified to better support its application in regional Australia. Method A focus group using a semi-structured interview was conducted with seven NGO employees who had been trained to use the HIP and subsequently used the HIP in their everyday work with patients. A mental health nurse (MHN) and a Psychology graduate working for the University of South Australia Department of Rural Health conducted the focus group. Results Using thematic analysis, the focus group discussion generated four main themes: taking control accessing services guiding my conversation and working with others. The overall meta-theme was that lay workers can work effectively to address physical health problems in SMI patients. Conclusion Our observations highlight the important role lay workers in regional Australia have in helping people with SMI to address their physical health needs. They have an opportunity to extend their role in parts of the world where it is difficult to recruit MHNs.
Publisher: MDPI AG
Date: 27-01-2022
Abstract: Redressing the maldistribution of the health workforce in regional, rural, and remote geographical areas is a global issue and crucial to improving the accessibility of primary health care and specialist services. Geographical classification systems are important as they provide an objective and quantifiable measure of access and can have direct policy relevance, yet they are not always consistently applied in rural health research. It is unclear how research focusing on the graduate health workforce in Australia has described, measured, and analyzed place of practice. To examine approaches used, this review systematically scopes Australian rural studies focusing on dentistry, medicine, nursing, and allied health graduates that have included place of practice as an outcome measure. The Joanna Brigg’s Institute Scoping Review Methodology was used to guide the review. Database searches retrieved 1130 unique citations, which were screened, resulting in 62 studies for inclusion. Included studies were observational, with most focusing on the practice locations of medical graduates and predicators of rural practice. Variations in the use of geographical classification approaches to define rurality were identified and included the use of systems that no longer have policy relevance, as well as adaptations of existing systems that make future comparisons between studies challenging. It is recommended that research examining the geographical distribution of the rural health workforce use uniform definitions of rurality that are aligned with current government policy.
Publisher: Elsevier BV
Date: 12-2023
Publisher: Hindawi Limited
Date: 07-08-2021
DOI: 10.1111/HSC.13124
Publisher: Elsevier BV
Date: 12-2021
Publisher: Springer Science and Business Media LLC
Date: 12-12-2022
DOI: 10.1186/S13049-022-01053-X
Abstract: Aeromedical emergency retrieval services play an important role in supporting patients with critical and often life-threatening clinical conditions. Aeromedical retrieval services help to provide fast access to definitive care for critically ill patients in under-served regions. Typically, fixed-wing aeromedical retrieval becomes the most viable transport option compared with rotary-wing aircraft when distances away from centres of definitive care extend beyond 200 kms. To our knowledge, there are no studies that have investigated fixed-wing aeromedical services in the member countries of the organisation for economic cooperation and development (OECD). A description of the global characteristics of aeromedical services will inform international collaboration to optimise clinical outcomes for patients. In this scoping review, we aimed to describe the features of government- and not-for-profit organisation-owned fixed-wing aeromedical retrieval services in some of the member countries of the OECD. We followed scoping review methodology based on the grey literature search strategy identified in earlier studies. This mostly involved internet-based searches of the websites of fixed-wing aeromedical emergency retrieval services affiliated with the OECD member countries. We identified 460 potentially relevant records after searching Google Scholar (n = 24) and Google search engines (n = 436). After removing ineligible and duplicate information, this scoping review identified 86 government-and not-for-profit-operated fixed-wing aeromedical retrieval services as existing in 17 OECD countries. Concentrations of the services were greatest in the USA followed by Australia, Canada, and the UK. The most prevalent business models used across the identified OECD member countries comprised the government, not-for-profit, and hybrid models. Three-quarters of the not-for-profit and two-fifths of the hybrid business models were in the USA compared to other countries studied. The government or state-funded business model was most common in Australia (11/24, 46%), Canada (4/24, 17%), and the UK (4/24, 17%). The frequently used service delivery models adopted for patients of all ages included primary/secondary retrievals, secondary retrievals only, and service specialisation models. Of these service models, primary/secondary retrieval involving the transportation of adults and children from community clinics and primary health care facilities to centres of definitive care comprised the core tasks performed by most of the aeromedical retrieval services studied. The service specialisation model provided an extra layer of specialist health care dedicated to the transportation of neonates and paediatrics. At least eight aeromedical retrieval services catered solely for children from birth to 16 years of age. One aeromedical service, the royal flying doctor service in Australia also provided primary health care and telehealth services in addition to primary retrieval and interhospital transfer of patients. The doctor and registered nurse aramedic (Franco-German model) and the nurse and/or paramedic (Anglo-American model) configurations were the most common staffing models used across the aeromedical services studied. The development and composition of fixed-wing aeromedical emergency retrieval services operated by not-for-profit organisations and governments in the OECD countries showed ersity in terms of governance arrangements, services provided, and staffing models used. We do not fully understand the impact of these differences on the quality of service provision, including equitable service access, highlighting a need for further research.
No related grants have been discovered for Sandra Walsh.