What People With Aphasia Want: Towards Person-centred Goal-setting In Aphasia Rehabilitation
Funder
National Health and Medical Research Council
Funding Amount
$427,702.00
Summary
Consumers of health services expect their concerns and priorities to form part of their health care. People with aphasia have difficulty communicating their needs and speech pathologists are challenged to plan therapy to meet aphasic clients' needs. Family members of people with aphasia also have unrecognised concerns. The first aim of this study is to determine the goals of people with aphasia and their families and to gain their perspective of whether these goals were addressed in speech thera ....Consumers of health services expect their concerns and priorities to form part of their health care. People with aphasia have difficulty communicating their needs and speech pathologists are challenged to plan therapy to meet aphasic clients' needs. Family members of people with aphasia also have unrecognised concerns. The first aim of this study is to determine the goals of people with aphasia and their families and to gain their perspective of whether these goals were addressed in speech therapy. The study will then seek the perspective of their treating speech pathologists about the goals of therapy and the challenges that speech pathologists face in practising person-centered goal setting. This study will not only provide a framework for aphasia services in Australia but also provide data that will inform professional educational programs about person-centered practice for speech pathologists and other health professionals. It will also contribute to current theories on collaborative goal setting in a rehabilitation context.Read moreRead less
An Ethical Analysis Of The Disclosure Of Surgeons' Performance Data To Patients Within The Informed Consent Process
Funder
National Health and Medical Research Council
Funding Amount
$148,937.00
Summary
For over a decade, hospitals in the American state of New York have been collecting information about the mortality rates of surgeons conducting Coronary Artery Bypass Grafts, and making this information available to patients. The United Kingdom is set to make these and other performance indicators on the ability of surgeons ('report cards') available from 2004. There are good reasons to think a similar system may be introduced in Australia in the near future. Patients can use the information co ....For over a decade, hospitals in the American state of New York have been collecting information about the mortality rates of surgeons conducting Coronary Artery Bypass Grafts, and making this information available to patients. The United Kingdom is set to make these and other performance indicators on the ability of surgeons ('report cards') available from 2004. There are good reasons to think a similar system may be introduced in Australia in the near future. Patients can use the information contained in report cards when deciding whether or not to consent to have a particular surgeon conduct an operation on them. Contemporary bioethicists stress the importance of a proper informed consent process in medicine. This is a process in which a doctor advises a patient of relevant information and ensures that the patient comprehends that information, before the patient consents to an operation. Currently report cards in America are publicly disseminated on the internet, however there is no systematic attempt to incorporate the information contained in report cards into the informed consent process. We do not know if patients understand the information they are given, or if they incorporate it into their decision making procedures appropriately. In our study we will consider how information that is contained in report cards could best be used in the informed consent process. We will keep in mind the importance of helping patients to make their own informed decisions to consent to operations, the importance of respecting the professional integrity of surgeons and the importance of providing the best possible standard of care for patients. The result of our study will be a revised model of the informed consent process that incorporates report cards in an ethically acceptable way.Read moreRead less
Referral Of Men Newly Diagnosed With Prostate Cancer To A Telephone-based Support Program
Funder
National Health and Medical Research Council
Funding Amount
$299,125.00
Summary
Cancer diagnosis and treatments are stressors of major proportions. There is compelling evidence that providing information, education and counselling services helps reduce emotional distress and improves quality of life among newly-diagnosed cancer patients. The public health challenge for improving the supportive care of cancer patients is to find a cost-effective way to deliver these services to this population. Our response to this challenge is to test an innovative program that involves the ....Cancer diagnosis and treatments are stressors of major proportions. There is compelling evidence that providing information, education and counselling services helps reduce emotional distress and improves quality of life among newly-diagnosed cancer patients. The public health challenge for improving the supportive care of cancer patients is to find a cost-effective way to deliver these services to this population. Our response to this challenge is to test an innovative program that involves the cancer specialist referring newly-diagnosed cancer patients to the Cancer Council Victoria's telephone information service staffed by nurse counsellors, as an integral part of the patient's treatment management. The program involves the nurse counsellor contacting patients and providing information and support at key times in the first six months after diagnosis. In this study, we will focus on prostate and male colorectal patients. The most common registrable cancers in males are prostate and colorectal cancer; male cancer patients are a group known to underutilise support services and among whom less research has been conducted on ways to improve adjustment to a cancer diagnosis and treatment. If effective, this program could provide a way for supportive care to be included among cancer patients, even those treated in rural centres, or where a multidisciplinary team is not yet available.Read moreRead less
This study proposes to examine the quality of procedural medical care provided by rural doctors who are not specialists. The disciplines of Anaesthetics, Surgery and Obstetrics will be included. Most of these services in rural Australia are not provided by specialist medical practitioners, but rather by rural general practitioners who have obtained additional training, albeit shorter than that undertaken by specialist trainees, and who are supported by skilled nurses and other health professiona ....This study proposes to examine the quality of procedural medical care provided by rural doctors who are not specialists. The disciplines of Anaesthetics, Surgery and Obstetrics will be included. Most of these services in rural Australia are not provided by specialist medical practitioners, but rather by rural general practitioners who have obtained additional training, albeit shorter than that undertaken by specialist trainees, and who are supported by skilled nurses and other health professionals in relatively small rural hospitals. Patients and rural doctors often have little choice but to manage urgent cases locally and in some cases experienced and skilled local teams are able to offer a wider range of services, including a limited number of elective procedures. Despite underlying assumptions that the quality of the services cannot match that of specialist care in larger hospitals, there is no agreement on what constitutes quality of rural procedural care and little evidence that the quality is different. This issue is important as substantial government funds are spent on recruiting, training and retaining a qualified rural medical workforce, and yet fewer rural doctors are providing these services and fewer rural hospitals have the facilities to support those rural doctors still providing the services. Further, measuring the quality of care is a complex issue on which different stakeholders may have different views. This study proposes a multi-perspective approach to assessing the quality of care through a number of case studies provided by rural doctors.Read moreRead less
An Investigation Of The Relationship Between The Pharmaceutical Industry, Medical Profession And Medical Practitioners
Funder
National Health and Medical Research Council
Funding Amount
$186,449.00
Summary
In recent years there has been a rapid expansion in the number and range of interactions between the pharmaceutical industry and the medical profession. While this has the potential to advance research, education and health care, there are risks that such interactions may inappropriately serve commercial objectives and ultimately compromise the best interests of patients and society in general. Most major medical and pharmaceutical organisations have released guidelines of policy statements on t ....In recent years there has been a rapid expansion in the number and range of interactions between the pharmaceutical industry and the medical profession. While this has the potential to advance research, education and health care, there are risks that such interactions may inappropriately serve commercial objectives and ultimately compromise the best interests of patients and society in general. Most major medical and pharmaceutical organisations have released guidelines of policy statements on the relationship between the medical profession and the pharmaceutical industry. To date most debate has taken the form of personal observations or professional opinion , and there has been little objective research into medical industry interactions. This project aims to examine the relationship between the pharmaceutical industry, the medical profession and the medical practitioners. Specifically, the aim of this project is to establish whether this relationship as it currently exists, and as stated in guidelines from professional bodies, is appropriate in terms of justifiable ethical standards, empirical research and social perspectives. The results of this research will enable assessment of current guidelines and the development of further guidelines and regular process where appropriate.Read moreRead less