ORCID Profile
0000-0002-5875-8493
Current Organisations
National Ageing Research Institute
,
University of Melbourne
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Publisher: Wiley
Date: 14-03-2019
DOI: 10.1111/AJAG.12639
Abstract: There are many studies investigating implementation of advance care planning (ACP) in aged care around the world, but few studies have investigated Australian settings. The objective of this study was to determine facilitators and barriers to implementation of ACP in Australian residential and community aged care. Evidence from Australian studies published between 2007 and September 2017 of ACP in residential and community aged care was sourced from electronic databases using predetermined search strategies. Data were extracted and synthesised using thematic analysis, and summarised according to themes. Nine studies described facilitators and barriers of ACP implementation. Six themes were identified: "Education and Knowledge," "Skills and Training," "Procedures and Resources," "Perceptions and Culture," "Legislation" and "Systems." A whole of systems approach is necessary to facilitate uptake of ACP in residential aged care settings. More research is needed to understand facilitators and barriers to ACP in community aged care.
Publisher: Wiley
Date: 25-04-2019
DOI: 10.1111/APPY.12355
Abstract: As Australia's aging population increases and ersifies, there will be a growing need to address the burden of dementia among culturally and linguistically erse (CALD) communities. Due to a lack of CALD-appropriate services and bilingual health professionals, older people from CALD backgrounds often receive a delayed diagnosis of dementia. The use of telemedicine (TM) to deliver video-interpreting services may overcome the barriers of interpreter availability when diagnosing and assessing dementia in older people from CALD backgrounds. This paper aims to present a review of the literature on the use of TM to deliver video-interpreting during dementia assessments. Factors affecting the reliability and agreement, feasibility, and satisfaction and acceptability when using TM or video-interpreting have been described. The review found evidence that dementia assessments conducted via TM are as reliable as face-to-face (FTF) assessments and that participants are satisfied and find TM acceptable. There was less evidence about the feasibility of TM from the health care perspective, particularly regarding the acceptability and potential financial cost-savings. Only five studies investigated the use of video-interpreting during clinical assessments with CALD patients. Although video-interpreting was found to be satisfactory among CALD patients and clinicians, a common finding was the preference for FTF interpreting. More research is needed to examine the financial feasibility and the health care perspective on the implementation and adoption of TM for dementia assessments. The use of TM to deliver video-interpreting for dementia assessments has never been investigated and represents a significant gap in the literature.
Publisher: SAGE Publications
Date: 30-03-2020
Abstract: Evidence in the literature demonstrates the reliability of cognitive screening assessments using video technology in English-speaking older populations. However, this has not been tested in older culturally and linguistically erse (CALD) populations who require an interpreter, and what the associated costs would be. The aim was to determine if the Rowland Universal Dementia Assessment Scale (RUDAS) and the Geriatric Depression Scale (GDS) could be reliably administered over video-interpreting methods compared with face-to-face interpreting. In addition, the study aims to compare the costs of video-interpreting with the costs of face-to-face interpreting. We compared similarity of the RUDAS and GDS scores when administered face-to-face and via video-interpreting. The similarity of scores between methods was analysed using paired t-tests and Bland–Altman plots. A costing analysis was done using a micro-costing approach to estimate the costs of video-interpreting compared with face-to-face, extrapolated to a national level. Analysis found no significant differences in the mean assessment scores between video-interpreting and face-to-face (RUDAS mean difference: −0.36 95% confidence interval (CI): −1.09, 0.38, GDS mean difference: 0.22 95% CI: −0.38, 0.83). Bland–Altman plots demonstrated that 71% of RUDAS scores and 82% of GDS scores were within the maximum allowed difference of ±2 units. Costing analysis showed a A$7 saving per assessment when using video-interpreting compared with face-to-face, with a total national saving of A$247,350. Video-interpreting was found to be as reliable as face-to-face interpreting for both RUDAS and GDS assessments. Cost analysis indicates that video-interpreting is cheaper than face-to-face interpreting.
Publisher: Wiley
Date: 15-07-2023
DOI: 10.1002/HPJA.779
Abstract: With an ageing population and growing complexity and fragmentation of health care systems, health literacy is increasingly important in managing health. This study investigated health literacy strengths and challenges reported by older Australians (people aged 65 or over) and identified how socio‐demographic and health factors related to their health literacy profiles. The s le comprised 1578 in iduals responding to the Australian Government's 2018 Health Literacy Survey, conducted between January and August. Regression modelling was used to estimate the association between each of nine domains of the Health Literacy Questionnaire (HLQ) and in idual socio‐demographic and health characteristics. The model allowed for correlation between HLQ scores that was linked to unobserved characteristics of in iduals. Across the health literacy domains, few in iduals received mean scores in the lowest score range. Key in idual characteristics associated with higher health literacy were increasing age, English proficiency, higher education levels, better self‐assessed health and having certain chronic conditions (cancer, hypertension and arthritis). Our findings suggest that, among those aged 65 or over, being older or living with chronic illnesses were associated with greater confidence in engaging with providers, accessing information and navigating health services compared to in iduals aged 65–69 and those older in iduals without chronic illness. Lower health literacy was associated with psychological distress and low English proficiency. Interventions to improve in idual health literacy and organisation health literacy responsiveness to minimise complexity of the Australian health system are required. This may enhance uptake and use of health information and services for the underserviced members of the community.
Publisher: Elsevier BV
Date: 05-2022
Publisher: Public Library of Science (PLoS)
Date: 25-07-2018
Publisher: John Benjamins Publishing Company
Date: 11-08-2021
Abstract: Many health and social care services are implementing video remote interpreting (VRI) to deal with supply shortages and high costs of language interpreting for linguistically erse clients. This qualitative study examines stakeholders’ perspectives on using VRI for home-based cognitive assessments, which are routinely performed with older people during aged care assessments in Australia. We conducted 25 semi-structured interviews with clients, assessors and interpreters in Melbourne and a regional Victorian city. We found that across stakeholder groups participants usually regard VRI as an acceptable alternative to face-to-face interpreting when the latter is not possible. Freelance interpreters said VRI saved on travel time and expenditure and afforded them financial and practical benefits that enabled them to better meet the high demand for their work. However, stakeholders also pointed to the limitations of VRI, including technical challenges, sound and video quality, and difficulties with positioning equipment optimally during interviews. The assessors and interpreters agreed that VRI was inappropriate when clients are known to be cognitively impaired, and that face-to-face interpreting is necessary to support these clients and ensure assessment accuracy. We suggest that plans by health or social care services to replace face-to-face interpreting with VRI should be balanced against the needs of clients and any impacts on professional practice.
Publisher: Wiley
Date: 07-2020
DOI: 10.1111/JOCN.15390
Publisher: Wiley
Date: 2022
DOI: 10.1002/TRC2.12349
Abstract: The number of Australian residents with dementia is projected to double by 2058, with 28% currently being migrants from non‐Anglophone countries. There will be growing demand for professional interpreters for cognitive assessments and dementia‐related health consultations in the future. Interpreting cognitive assessments can be challenging for interpreters inaccurate interpreting can influence assessment outcomes. The Improving Interpreting for Dementia Assessments (MINDSET) project will upskill interpreters through an online training course in dementia and cognitive assessments. The training has been co‐designed with key stakeholders from the interpreting sector, dementia‐related services, and family caregivers, and has been user‐tested with 12 interpreters. The training aims to improve the quality of interpreter‐mediated communication during cognitive assessments, and thereby improve the accuracy and acceptability of cognitive assessments with older people who have limited English proficiency. We are conducting a single‐blinded randomized controlled trial to evaluate the effectiveness of the training. We aim to enroll 150 interpreters, and allocate them to equal parallel groups. The intervention group will receive access to the MINDSET training, which comprises 4 hours of resources covering five domains: dementia knowledge, cross‐cultural communication, briefings and debriefings, interpreting skills, and interpreting ethics. The control group will be assigned to a wait list, and will receive access to the training after the trial. Participants will be assessed according to the five domains, via the Dementia Knowledge and Assessment Scale, multiple‐choice questions, video‐simulated assessments, and ethical scenarios. Assessments will occur at baseline (prior to the intervention group completing the training), 3 months after enrollment, and 6 months after enrollment. The trial is ongoing. Recruitment began in June 2022. This is the first time a training resource for interpreters in dementia has been trialed. If successful it may represent a technologically innovative way to offer training to both trainee and practicing interpreters. Interpreters are crucial in facilitating cognitive assessments for allophone speakers. Interpreters would benefit from training to improve assessment accuracy. Our study has co‐designed specialized dementia training for interpreters. This is a protocol to evaluate the training's efficacy in a randomized controlled trial.
Publisher: Wiley
Date: 26-10-2021
DOI: 10.1002/NOP2.1099
Abstract: To trial three mobile translation apps in the healthcare setting to address language barriers in everyday care between healthcare staff and older people with limited English proficiency (LEP). A mixed‐methods exploratory study. A two‐month trial of three translation apps was conducted across four aged‐care hospital wards. Observed interactions during use of translation apps were recorded, and staff surveys regarding the use of translation apps were collected at the end of the trial. Data were analysed using descriptive statistics and thematic content analysis of open‐ended responses in the surveys and observations. Findings from the thematic content analysis are reported using the Standards for Reporting of Qualitative Research (SRQR) checklist. Translation apps were mostly used for identifying pain and assisting with activities of daily living. Qualitative findings revealed that translation apps aided staff in providing care and improved rapport however, practical shortcomings were identified.
Publisher: Elsevier BV
Date: 06-2020
Publisher: Springer Science and Business Media LLC
Date: 20-06-2022
DOI: 10.1186/S12913-022-08195-9
Abstract: Older Australians make up 46% of all potentially preventable hospitalisations (PPHs) and people living with dementia are at significantly greater risk. While policy reforms aim to reduce PPHs, there is currently little evidence available on what drives this, especially for people living with dementia. This study examines patterns of PPHs in people living with dementia to inform service delivery and the development of evidence-based interventions. We used the Victorian Admitted Episodes Dataset from Victoria, Australia, to extract data for people aged 50 and over with a diagnosis of dementia between 2015 and 2016. Potentially avoidable admissions, known as ambulatory care sensitive conditions (ACSCs), were identified. The chi-square test was used to detect differences between admissions for ACSCs and non-ACSCs by demographic, geographical, and administrative factors. Predictors of ACSCs admissions were analysed using univariate and multiple logistic regression. Of the 8156 hospital records, there were 3884 (48%) ACSCs admissions, of which admissions for urinary tract infections accounted for 31%, followed by diabetes complications (21%). Mean bed-days were 8.26 for non-ACSCs compared with 9.74 for ACSCs ( p ≤ 0.001). There were no differences between admissions for ACSCs and non-ACSCs by sex, marital status, region (rural vs metro), and admission source (private accommodation vs residential facility). Culture and language predicted ASCS admission rates in the univariate regression analyses, with ACSC admission rates increasing by 20 and 29% if English was not the preferred language or if an interpreter was required, respectively. Results from the multiple regression analysis confirmed that language was a significant predictor of ACSC admission rates. Improved primary health care may help to reduce the most common causes of PPHs for people living with dementia, particularly for those from culturally and linguistically erse backgrounds.
Publisher: CSIRO Publishing
Date: 17-05-2021
DOI: 10.1071/PY20162
Abstract: Carers play an important role in assisting older care recipients with their daily lives and attending to their health care. Yet research has largely overlooked the barriers to health care that carers of older Australians themselves experience. This study finds that, among those attempting to access care, approximately 31.2% of carers of older Australians reported a barrier to health care, with one-third of this group reporting barriers at many points in the healthcare system. Barriers to care were considerable for those attempting to access dental, GP and medical specialist services (27.8%, 18.3% and 15.2% respectively), but lower for accessing hospital services (8.6%). People living with a disability or those in high carer distress had a minimum threefold increase in the odds of experiencing a barrier to care, with odds ratios (95% confidence intervals) of 3.35 (2.10–5.36) and 3.37 (2.33–4.88) respectively. Carers of older Australians noted cost as an important barrier to care, but between 20% and 40% cited being too busy or not having enough time to access dental, GP and medical specialist services (21%, 39% and 26% respectively). Addressing the barriers to health care reported by carers is critical not only to their own health and well-being, but also to that of care recipients.
No related grants have been discovered for Kerry Hwang.