ORCID Profile
0000-0002-5936-1068
Current Organisation
Flinders University
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Psychology | Health and Community Services | Developmental Psychology and Ageing | Geriatrics And Gerontology | Public Health and Health Services | Developmental Psychology And Ageing | Aged Health Care | Geriatrics and Gerontology | Social And Community Psychology | Care for Disabled | Clinical Sciences | Social Work not elsewhere classified | Health Economics |
ANZSRC Socio-Economic Objective (SEO)
Health Related to Ageing | Health related to ageing | Ageing and Older People | The aged | Social Structure and Health | Ability and Disability | Expanding Knowledge in Psychology and Cognitive Sciences | Behaviour and Health | Evaluation of Health Outcomes | Families and Family Services | Social structure and health | Health status (e.g. indicators of “well-being”) | Behaviour and health | Health Policy Economic Outcomes
Related Links
Publications
A gendered lifecourse examination of sleep difficulties among older women
Publisher: Cambridge University Press (CUP)
Date: 14-03-2012
DOI: 10.1017/S0144686X11000201
Abstract: Recent research has suggested that understanding and addressing the high prevalence of sleep difficulties in older women requires going beyond a purely physiological focus to address the role of social contextual pressures and demands. We take a gendered lifecourse approach to explore how sleep difficulties have evolved and how their management might reflect the position of older women in society more broadly. We conducted in-depth interviews with 12 oldest-old (average age 86) community-dwelling women who currently experienced sleep difficulties. Five themes emerged from the analysis: significant life stages contingent lives daily concerns in relation to ageing attitudes and responses of women and general practitioners and stigma and sleeping pills, which provided a conceptual framework through which to explain the reality of sleep difficulties for these women. For all women, sleep difficulties were not related to physical aspects such as pain or discomfort, but were largely shaped by demands associated with family relationships at different times in the lifecourse. Furthermore, our findings suggest that responses by women themselves, and health professionals, reflect a sense of stigma around sleep difficulties and use of sleeping pills. More emphasis on the social contextual explanations underpinning sleep difficulties might lead to better prevention and treatment of such problems, and increase quality of life.
Marital Satisfaction among Older Couples: The Role of Satisfaction with Social Networks and Psychological Well-Being
Publisher: SAGE Publications
Date: 03-2013
DOI: 10.2190/AG.76.2.B
Abstract: Marital satisfaction is important for health and well-being, although determinants of satisfaction among older couples are unclear. Much of the marital literature has focused on the role of the spouse, in isolation from satisfaction with broader social relationships. We conducted separate semi-structured interviews with both members of n = 40 couples (mean age 76 years) to measure satisfaction with particular types of social networks (confidant, friend, children, other relatives) as well as levels of physical and psychological well-being. In order to account for the likely interdependence among observations within married couples, a series of multi-level models, culminating in a full actor-partner interdependence model, were fitted. Results indicate that an in idual's own depressive symptoms were related to their levels of marital satisfaction, whereby higher scores on the depression scale predicted lower marital satisfaction scores for the in idual. None of the in idual's other variables (physical well-being, sociodemographic, or social network satisfaction), nor any of the spouse variables, were related to in idual levels of marital satisfaction. These findings reinforce the importance of psychological well-being as influencing the quality of older couple relationships.
Increasing cesarean section rates: exploring the role of culture in an Australian community
Publisher: Wiley
Date: 21-05-2004
Cohort profile: The Australian Longitudinal Study of Ageing (ALSA)
Publisher: Oxford University Press (OUP)
Date: 12-2016
DOI: 10.1093/IJE/DYU196
Social partners and momentary affect in the oldest-old: The presence of others benefits affect depending on who we are and who we are with
Publisher: American Psychological Association (APA)
Date: 03-2014
DOI: 10.1037/A0033896
Mothers' views on feeding infants around the time of weaning
Publisher: Cambridge University Press (CUP)
Date: 09-2006
DOI: 10.1079/PHN2005915
Abstract: To describe women's views about aspects of infants' diets around the time of weaning, making comparisons with national guidelines. A survey of women with a 9-month-old child. Adelaide, South Australia. Five hundred and five women who joined a longitudinal study during pregnancy. Sources of information varied, with written material most commonly used (37%). Cows' milk was considered suitable as the main drink for weaned infants by 14% of women. There were ergent views about the suitability of eggs, with many women concerned about allergy. The majority of women (84%) viewed fruit juice as suitable although many qualified their response, often by stating that fruit juice should be diluted. Almost all women considered the amount of sugar mattered, primarily because of tooth decay, and that salt mattered although the reason was often uncertain. It was widely believed (77%) that additives in food could cause health problems, in particular hyperactivity and allergies, and half of the women reported avoiding specific foods because of concerns about allergies. Many women thought that giving their child food that was high in fat would encourage a liking for ‘junk’ food or lead to fatness in adulthood. There is considerable ersity in the views women express about aspects of infant feeding that have been the subject of guidelines. Further health promotion efforts are needed to achieve greater consistency with recommendations and to address other concerns women have. This will entail greater engagement with parents and shared development of responses.
A comparison of widowhood and well-being among older Greek and British-Australian migrant women
Publisher: Elsevier BV
Date: 12-2013
DOI: 10.1016/J.JAGING.2013.03.005
Abstract: The impact of widowhood on well-being has been well-documented, but to date has not focused extensively on the experience of older migrants who have aged in a foreign land. This study aimed to examine the well-being of older migrant widows from two groups in South Australia: British-born (n=61) and Greek-born (n=60) Australian migrants, who had been widowed, on average, 13 years. All participants completed a self-report questionnaire in their preferred language. Three indicators of current well-being (self-rated health, depression and loneliness) as well as variables expected to differ cross-culturally, and potentially influence well-being (mourning rituals continuing bonds to one's spouse religiosity social support) were measured. Greek-born widows displayed higher levels of mourning rituals, continuing bonds and religiosity than the British. Both groups perceived similarly high levels of familial social support. Greek widows also reported worse self-rated health, and increased symptoms of depression and loneliness compared to the British. This paper suggests that the detrimental impact of widowhood on well-being may be greater for non-English speaking migrants who are ageing outside of their country of origin, and who, despite residing in an English-speaking host country for several decades, have retained the linguistic, cultural and religious practices and traditions of their home country.
A behavioural activation intervention to increase engagement with life and wellbeing in older adults: Study protocol for a randomised controlled trial
Publisher: Springer Science and Business Media LLC
Date: 05-12-2022
DOI: 10.1186/S40359-022-00988-1
Abstract: Meaningful activity engagement is a critical element of ageing well. Interventions designed to increase activity engagement tend to be activity-specific and do not always meet the needs of older adults with erse interests and capacities. Behavioural activation (BA) provides a promising person-centred framework for promoting engagement in valued activities. This study will examine the effectiveness of a behavioural activation-based intervention for promoting engagement with life and wellbeing among older adults. Participants will be randomly allocated to one of two conditions (BA intervention, Active Control) and take part in a six-week intervention that consists of one-on-one weekly sessions of up to one hour to be administered either via telephone or online video conferencing with a trained facilitator. This study will recruit 120 + participants aged 65 + who score at or below the median on a test of life engagement. Participants will complete questionnaires of primary and secondary measures both pre-program, one-week and three months post-program. Participants will also complete a daily diary questionnaire during the fourth and fifth weeks of the intervention. The primary outcome measure is the Life Engagement Test, and secondary outcome measures include assessments of subjective wellbeing, psychological wellbeing, mental health, self-reported health, social engagement, loneliness and life satisfaction. The outcomes from this study will provide evidence as to whether a BA based approach represents an effective method for promoting engagement with life and wellbeing among older community-dwelling adults. Australian New Zealand Clinical Trials Registry (Reg no. ACTRN 12621001192875). Trial retrospectively registered 6th September, 2021.
Home rehabilitation following hip fracture repair for nursing home residents improves mobility outcomes
Publisher: OMICS Publishing Group
Date: 2016
The chaotic journey: Recovering from hip fracture in a nursing home
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.ARCHGER.2016.07.004
Abstract: To understand the journey experienced by nursing home residents following hip fracture and impressions of an outreach rehabilitation program offered after their return home. A qualitative investigation was undertaken in parallel with a randomised controlled trial investigating the efficacy and cost utility of providing a hospital outreach rehabilitation program for older nursing home residents who have recently returned from hospital following hip fracture. Family members and nursing home staff of 28 (out of the first 30) participants (14 from intervention and 14 from control) agreed to participate in interviews and focus groups to provide information and perceptions of each person's journey. NVivo 10 qualitative data analysis software package was used to identify major themes (via open, then axial and finally selective coding). Both family members and staff described nursing home residents with dementia as receiving poor post-operative care from hospital staff who seemed unfamiliar with dementia and delirium. Discharge from hospital soon after surgery (median 4.5days) occurred with poor transfer of information. Difficulties with residents' emotions, pain management and commencing mobilisation seemed more prevalent within usual care group, whereas fewer overall problems were encountered by those with access to a geriatrician and additional therapy. This research suggests that an integrated care pathway including the hospital stay and first weeks back at nursing homes should be developed. Performance indicators should include carer measures on the quality of the transfer, pain management measures in the first month and return to walking.
Barriers and Facilitators in Supporting People with Intellectual Disability to Report Sexual Violence: Perspectives of Australian Disability and Mainstream Support Providers.
Publisher: Emerald
Date: 12-02-2018
Abstract: Evidence from Australia and worldwide has highlighted the ongoing marginalisation, discrimination, abuse, violence and neglect of people with disability. One of the main areas of concern is that despite such evidence there remain fundamental barriers for people with disability to report violence and/or access supports. Significantly few studies have canvased the perspectives of people with intellectual disability (ID), family members or disability service providers. Accordingly as a first step, the purpose of this paper is to explore the perceptions of disability and violence-response professionals’ regarding the barriers and facilitators of effective support for people with ID reporting sexual violence and accessing mainstream supports. A qualitative research design informed the basis of this study. Semi-structured interviews were conducted with seven participants who held roles within disability services and mainstream violence response. Interviews were recorded and transcribed. These transcripts were then analysed in idually using a combination of thematic analysis and discourse analysis to bring to light the social and material structures within service systems in terms of how they disempower or empower supports for people with ID. Participants from both services reported that professionals (particularly those outside the disability sector) lacked awareness of practical ways in which they could support people with ID to report and access services outside of disability-specific services. Participants also felt the capacity for people with ID to have a voice about what happens in the “aftermath” of reporting sexual violence was rarely acknowledged. Participants called for education and development of resources which could guide professional practice across disability and wider violence-response services. Participants saw investment in building interagency relationships across sectors as key to supporting the citizenship of people with ID. This study suggests that there is a strong need for better community engagement and understanding of the multi-faceted issues surrounding responses to violence concerning people with ID. The findings of this study also outline implications for practice and policy which may be of interest to professionals both within disability and wider violence-response sectors in Australia and internationally.
Perceived confidence relates to driving habits post-stroke
Publisher: Informa UK Limited
Date: 09-09-2014
DOI: 10.3109/09638288.2014.958619
Abstract: Returning to driving post-stroke is a step towards independence. On return to driving following stroke, confidence is related to performance in on-road assessment and self-regulation of driving behaviours occurs. The aim of this study was to examine the relationship between driver's confidence and driving habits post-stroke. Structured telephone surveys were completed with 40 stroke survivors (62% men), of mean age 65 years SD 12.17 who returned to driving post-stroke within the previous 3 years. The survey included: (1) socio-demographics, (2) Adelaide Driving Self Efficacy Scale (ADSES) and (3) Driving Habits Questionnaire (DHQ). Male stroke survivors were more likely to return to driving, drive further and more often. Stroke survivors under 65 years were likely to drive further. Driving confidence was significantly associated with kilometres driven (p = 0.006), distance driven (p = 0.027) and self-limiting driving (p = 0.00). Findings indicate a relationship between confidence and driving behaviours post-stroke. Early recognition of driving confidence will help professionals target specific strategies, encouraging stroke survivors to return to full driving potential, access activities and positively influence quality of life. Implications for Rehabilitation Findings indicate a relationship between confidence and driving behaviours post-stroke. Early recognition of driving confidence will help professionals target specific strategies, encouraging stroke survivors to return to full driving potential, access activities and positively influence quality of life.
Subjective Well-Being Dynamics in Couples from the Australian Longitudinal Study of Aging
Publisher: S. Karger AG
Date: 08-07-2010
DOI: 10.1159/000318633
Abstract: i Background: /i There is growing evidence for spousal associations in late-life development among key functional domains. Spousal interrelations in subjective well-being (SWB) have primarily been discussed in the context of a model of ‘transmission’, an indicator of well-being. Typically, depression is used to mark this, but few studies have examined if such transmission can be found over the long term in older couples’ SWB. i Objective: /i We aimed to determine whether longitudinal dyadic interrelations exist among older couples in the SWB domain, as indicated by morale. i Methods: /i We applied dynamic models to 11-year longitudinal data of 316 couples from the Australian Longitudinal Study of Aging (median age = 75 years at baseline) to explore whether the levels of SWB for one partner predict change in SWB for the other. i Results: /i Spousal interrelations emerged and were found to be gender-specific with wives predicting subsequent change among husbands, but not the reverse pattern of influence. Husbands whose wives reported higher initial SWB showed a relatively shallower decline over time relative to husbands whose wives reported lower initial SWB levels. These associations were robust after covarying for differences in age, education, health and marital characteristics (number of children and length of marriage). i Conclusion: /i Our study is consistent with, and illustrates empirically that close relationships shape in idual developmental outcomes. The findings suggest that wives play an important role in setting the affective tone in older couples. We discuss possible factors underlying such interrelations.
The Index of Relative Socio-economic Disadvantage: General population views on indicators used to determine area-based disadvantage
Publisher: Elsevier BV
Date: 10-2005
DOI: 10.1111/J.1467-842X.2005.TB00224.X
Abstract: To ascertain general population perceptions of the importance of indicators comprising the Index of Relative Socio-economic Disadvantage (IRSD). Data for this study came from a face-to-face Health Omnibus survey of 3,001 residents in metropolitan and country South Australia, conducted in 2003. Overall, respondents viewed the IRSD indicators as important. Of the 14 indicators, seven were seen as important by more than two-thirds of respondents (ranging from 90% perceiving the number of families with children and a low income important to 68% perceiving the number of one-parent families with dependent children as important). Younger respondents and those of lower educational attainment were more likely to perceive the indicators as unimportant, compared with older people. For ex le, 14% of people aged 15-24 vs. 5% of people aged 55-64 (p < or = 0.001) viewed the indicator 'number of one-parent families and dependent children' as unimportant. While the general population generally recognises the IRSD indicators as important measures of area-based disadvantage, there were systematic age differences in the degree to which in idual indicators were deemed important. There was a general lack of support for several indicators (such as proportion of people separated/ orced, houses with no cars). This research raises the question of which factors are important in representing area-based disadvantage for young people and equally the use of this index when examining variations in the health of young Australians.
The Benefits of a Life-first employment program for Indigenous Australian families: Implications for ‘Closing the Gap’
Publisher: School of Human Services and Social Work, Griffith University
Date: 07-09-2017
DOI: 10.36251/JOSI.118
Encyclopedia of Quality of Life and Well-Being Research
Publisher: Springer Netherlands
Date: 2014
How older people cope with frailty within the context of transition care in Australia: implications for improving service delivery
Publisher: Hindawi Limited
Date: 27-11-2015
DOI: 10.1111/HSC.12142
Abstract: Transition care is increasingly common for older people, yet little is known about the subjective experience of the transition care 'journey' from the perspective of clients themselves. This study examines how older people cope with frailty within the context of a dedicated transition care programme and discusses implications for improving service delivery. Qualitative in-depth interviews were carried out during 2011 in the homes of 20 older people who had recently been discharged from a transition care programme operating in Adelaide, South Australia (average age 80 years, 65% female). Thematic analysis identified three key themes: 'a new definition of recovery', 'complexities of control' and 'the disempowering system'. Despite describing many positive aspects of the programme, including meeting personal milestones and a renewed sense of independence, participants recognised that they were unlikely to regain their previous level of functioning. For some, this was exacerbated by lacking control over the transition care process while adapting to their new level of frailty. Overall, this research highlighted that benefits associated with transition care can be undermined by fragmentation in service delivery, loss of control and uncertainties around future support.
The health and relationship dynamics of late-life couples: a systematic review of the literature
Publisher: Cambridge University Press (CUP)
Date: 05-03-2009
DOI: 10.1017/S0144686X08007903
Abstract: Late-life husband and wife relationships are increasingly recognised as an important factor in promoting wellbeing, particularly in terms of the health, social, emotional, financial and practical needs of older people. Knowledge of marital dynamics and how they affect both members of a couple remains scarce. This systematic review aimed to identify and appraise research that has focused explicitly on the dynamics of the relationship, as evinced by data from both spouses. Implementing rigorous identification strategies, 45 articles were identified and reviewed. These studies were grouped into three broad thematic areas: marital relations and satisfaction concordance in emotional state or physical health and the interplay between marital quality and wellbeing. The issues found to affect marital relations and satisfaction in late life included equality of roles, having adequate communication, and transitions to living apart. There is strong evidence for couple concordance in depression, that marital relationships affect ill-health, longevity and recovery from illness, and reciprocally that ill-health impacts on the marriage itself. The research also suggests important gender differences in the impact of marital dynamics on health. It has led to the conclusion that there is a need for more erse studies of late-life marriages, particularly ones that examine the dynamics of non-traditional elderly couples and that extend beyond a predominant focus on the Caucasian population of the United States.
Does one size fit all? Assessing the preferences of older and younger people for attributes of quality of life
Publisher: Springer Science and Business Media LLC
Date: 23-08-2016
DOI: 10.1007/S11136-016-1391-6
Abstract: To systematically compare, via ranking and best worst tasks, the relative importance of key dimensions of quality of life for younger and older people. A web-based survey was developed for administration to two Australia-wide community-based s les comprising younger people aged 18-64 years and older people aged 65 years and above. Respondents were asked to rank 12 quality of life dimensions. Respondents also completed a successive best worst task using the same 12 quality of life dimensions. The relative importance of the quality of life dimensions differed for younger and older person s les. For older people, the ability to be independent and to have control over their daily lives were particularly important for their overall quality of life whereas for younger people, mental health was considered most important. Many interventions accessed by older people in geriatric medicine and aged care sectors have a broader impact upon quality of life beyond health status. The findings from this study indicate that a focus on broader aspects of quality of life may also be consistent with the preferences of older people themselves as to what constitutes quality of life from their perspective.
Older Adults’ Views on Characteristics of Groups to Support Engagement
Publisher: Informa UK Limited
Date: 26-08-2023
Barriers to activity engagement in older adulthood: Results of a community survey
Publisher: Wiley
Date: 12-08-2022
DOI: 10.1111/AJAG.13124
Abstract: Losses that occur with age can create barriers to meaningful activity engagement, a crucial aspect of ageing well. Research on this topic is frequently qualitative, with few studies accessing large community s les. This study (a) assessed the frequency specific personal and environmental barriers (such as poor health and limited transport access), identified by older adults in previous research, were endorsed (b) used latent class analysis (LCA) to identify population subgroups based on combinations of these barriers, and (c) examined associations of subgroups with purpose in life and quality of life. Four hundred and thirty‐two randomly selected Australian adults aged 65+ years (average age 76.7, 58% female) completed a telephone survey. They were asked whether certain barriers affected engagement and provided data on sense of purpose and quality of life. Physical health/mobility were the most frequently reported barriers, followed by sensory difficulties, financial limitations, and caring responsibilities. The LCA revealed up to three subgroups/classes of participants according to the barriers endorsed. Class 1 had low endorsement of all barriers, including physical health. The majority of Class 2 endorsed physical health barriers and other barriers more frequently than Class 1. Class 3 were comparable to Class 2, but also frequently endorsed community access barriers. Class 1 were younger and reported a greater sense of purpose and higher quality of life. Physical health/mobility barriers to engagement are those most frequently endorsed by older adults. These barriers may increase vulnerability to, or exacerbate the impact of additional barriers, such as sensory difficulties, access to transport and lack of finances.
Places and health: A qualitative study to explore how older women living alone perceive the social and physical dimensions of their neighbourhoods.
Publisher: Elsevier BV
Date: 09-2007
DOI: 10.1016/J.SOCSCIMED.2007.04.031
Abstract: There is growing interest in the impact that neighbourhood environment might have on the health of older people. Although the number of older Australian women, particularly those living alone, is projected to increase in coming decades, their experiences of neighbourhood have not been exclusively examined. The aims of this paper are: (1) to explore, from the perspective of these women, the social and physical dimensions of neighbourhoods and (2) to investigate variation in these accounts according to whether women lived in areas of higher or lower socioeconomic status. Twenty women aged between 75 and 93 years, residing in metropolitan Adelaide, South Australia (SA), participated in a series of two in-depth interviews. Women's perceptions of their neighbourhood, and accounts of every-day activities in the community were analysed to determine how both social and physical aspects of neighbourhood might relate to health and wellbeing. Findings suggest that a reciprocal and trusting relationship with neighbours underpinned older women's sense of satisfaction with, and feeling of security within, the neighbourhood. Other factors such as living in close proximity to services and existing social networks were also seen as important. Women's stories demonstrated that they were able to draw on both existing social networks and neighbours to sustain their independence and social connection within the community. Women living in more disadvantaged areas were more conscious of social disconnection in their neighbourhoods, and to the way that traffic noise and pollution detracted from their neighbourhood environment. These findings indicate that, for older women living alone, trusting and reciprocal relationships with neighbours are likely to form an important part of their broader social support network and should be recognised in relation to the process of maintaining the health of older women living in the community.
The integration of mixed methods data to develop the quality of life – aged care consumers (QOL-ACC) instrument
Publisher: Springer Science and Business Media LLC
Date: 12-2021
DOI: 10.1186/S12877-021-02614-Y
Abstract: This paper describes the collection and integration of mixed methods data to facilitate the final selection of items for the Quality of Life – Aged Care Consumers (QOL-ACC) instrument. The aim of the wider project is to develop a preference-based quality of life instrument that can be used for quality assessment and economic evaluation. Older people have been involved at every stage of the development of the QOL-ACC to ensure that the final instrument captures their perspectives and preferences. Mixed methods data was collected on draft items for the QOL-ACC instrument across six key quality of life dimensions (mobility, pain management, emotional well-being, independence, social connections, and activities). Qualitative face validity data was collected from older people (aged 66 to 100 years) living in the community and in residential aged care via semi-structured interviews ( n = 59). Quantitative data was collected from older people (aged 65 to 91 years) receiving aged care services in the community via an online survey ( n = 313). A traffic light pictorial approach was adopted as a practical and systematic way to categorise and present data in a meaningful way that was easy for non-academic workshop members to understand and to be able to discuss the relative merits of each draft item. The traffic light approach supported the involvement of consumer and aged care provider representatives in the selection of the final items. Six items were selected for the QOL-ACC instrument with one item representing each of the six dimensions. This methodological approach has ensured that the final instrument is psychometrically robust as well as meaningful, relevant and acceptable to aged care consumers and providers.
Parents' experiences of their child's return to school following acquired brain injury (ABI): A systematic review of qualitative studies
Publisher: Informa UK Limited
Date: 08-04-2016
DOI: 10.3109/02699052.2016.1146963
Abstract: To examine parents' experiences during their child's return to school following ABI. Systematic literature review. Six electronic databases relevant to the fields of brain injury and education were searched between 1980-2015. In addition, two qualitative journals and references from articles were hand-searched for further literature. Search results were screened independently by two reviewers for relevance. Studies meeting the inclusion criteria were analysed using the McMasters Critical Review Form for Qualitative Studies. Two hundred and sixteen articles were screened after duplicates had been removed and 11 were assessed for relevance, resulting in six full text articles for review. The quality of studies was mixed, with only two presenting a high number of quality indicators for qualitative research. Ten themes were identified and grouped into three clusters: influencing factors (environment, school, parent and child factors) features of interaction (information, communication and collaboration) and quality levels of outcome (conflict, coping and construction of new roles and identities). Parents' experiences are influenced by the quality of information, communication and collaboration between the school, health professionals and the family. Further well designed qualitative studies examining parents' experiences and support needs are required.
Abstracts
Publisher: SAGE Publications
Date: 12-08-2011
Planning for the future among older parents’ of adult offspring with intellectual disability living at home and in the community: A systematic review of qualitative studies
Publisher: Informa UK Limited
Date: 18-06-2017
Perception of Blind Rehabilitation Services Among Adults with Acquired Blindness in Nigeria
Publisher: SAGE Publications
Date: 03-09-2019
Abstract: Like other sub-Saharan African nations, Nigeria has a relatively high proportion of adults with acquired vision loss. This study investigates the impacts of becoming blind in adulthood and how the use of blind rehabilitation services addresses functional needs, supports activities of daily living, and enhances participation in educational, vocational, and community activities. Adopting a qualitative and interpretative approach, we conducted in-depth interviews with eight adult users of blind rehabilitation services. Three broad themes were identified: (1) psycho-emotional responses to vision loss (2) impacts on participation in education, employment, and community and (3) positive impact of blind rehabilitation services. Findings are discussed in the context of the international literature, and suggestions that may enhance the blind rehabilitation services are made.
Perspectives of professionals on the safety and accessibility of aged care for Care Leavers and Forgotten Australians
Publisher: Wiley
Date: 05-2017
DOI: 10.1111/AJAG.12948
Abstract: Little is known about how prepared the aged care system is to meet the specific needs of Care Leavers and Forgotten Australians. We explored service provider and advocate perspectives about the barriers and facilitators for appropriate and safe care for this group. Three focus groups with sixteen professional stakeholders examined the ways aged care support is accessible and inaccessible for Forgotten Australians. Participants noted structural and organisational features that act as barriers to best practice aged care. It was perceived that funding models and processes provide insufficient opportunity to develop trust with professionals and access tailored care. Once engaged with aged care services, the sector lacks the psychological literacy required to tailor care to manage the complex needs and preferences of Forgotten Australians. Systemic and organisational change that promotes increased flexibility, trauma‐informed care and non‐residential housing options will improve the safety and accessibility of aged care for Forgotten Australians.
Developing dimensions for a new preference-based quality of life instrument for older people receiving aged care services in the community
Publisher: Springer Science and Business Media LLC
Date: 29-09-2021
DOI: 10.1007/S11136-020-02649-5
Abstract: To identify the salient quality of life characteristics relevant to older people in receipt of community aged care services in order to develop dimensions for a draft descriptive system for a new preference-based quality of life instrument. Forty-one in-depth semi-structured interviews were undertaken with older people (65 years and over) receiving community aged care services across three Australian states to explore quality of life characteristics of importance to them. The data were analysed using framework analysis to extract broader themes which were organised into a conceptual framework. The data were then summarised into a thematic chart to develop a framework matrix which was used to interpret and synthesise the data. Care was taken throughout to retain the language that older people had adopted during the interviews to ensure that appropriate language was used when identifying and developing the quality of life dimensions. The analysis resulted in the identification of five salient quality of life dimensions: independence, social connections, emotional well-being, mobility, and activities. This research finds that quality of life for older people accessing aged care services goes beyond health-related quality of life and incorporates broader aspects that transcend health. The findings represent the first stage in a multiphase project working in partnership with older people to develop a new preference-based instrument of quality of life for informing quality assessment and economic evaluation in community aged care. In future work, draft items will be developed from these dimensions and tested in face validity interviews before progressing to further psychometric testing.
An examination of resilience and coping in the oldest old using life narrative method
Publisher: Oxford University Press (OUP)
Date: 28-10-2015
Abstract: We aimed to identify aspects of late-life resilience and sense of self-identity and locate them within a life narrative to provide insights into methods of coping with the challenges of aging. To do this, in-depth interviews were conducted with 20 oldest-old adults (aged 88-98 years) recruited from the Australian Longitudinal Study of Ageing. Design, analysis, and interpretation of the study were informed by McAdams' life narrative theory, using concepts of redemption and contamination. Participants discussed their autobiographies and recounted significant life events. Interviews drew on McAdams' approach to elicit positive, negative, vivid, and turning point experiences. Analysis involved coding transcripts of the emergent personal narratives specifically to understand a "resilience story." This included data immersion and review of interview transcripts. Emergent codes were identified and discussed among the researchers. Although no contamination events were narrated, we identified the following themes: Adapting to aging-related physical challenges Changing social networks Continuity in sense of identity to maintain unity and life's purpose and Redemptive capacity to cope positively with life challenges. This study fills a gap in knowledge on resilience from a personal perspective by the oldest old. Older people may benefit from interventions that harness positive coping strategies and foster social connections and meaningful activities, especially at times of loss or grief.
Health and disability care providers’ experiences and perspectives on end-of-life care needs of individuals with long-standing physical disability
Publisher: SAGE Publications
Date: 20-10-2023
DOI: 10.1177/02692163221128702
Abstract: Little is known about the specific needs and experiences of in iduals with long-standing physical disability at end of life. To explore health and disability care providers perspectives and experiences in relation to end-of-life care needs of in iduals with long-standing physical disability. Qualitative study using reflexive thematic analysis. Semi-structured interviews were conducted with nine health and disability care providers from two Australian states. Five themes were constructed from the data: (1) The significance of place. All participants described how the end-of-life care experience was significantly impacted by the place in which dying occurred. (2) Knowing the person and their needs. Knowledge and familiarity with the in idual with long-standing disability were seen as invaluable in terms of providing continued high-quality care. (3) Navigating a new care landscape. For disability support workers, struggling to adapt from providing disability support to end-of-life care was difficult. (4) Complexities of family involvement. Past experiences of families within the healthcare system had resultant impacts on care received by the in idual with long-standing disability. (5) Being prepared. Participants felt more was needed in terms of end-of-life planning and discussions around end of life for this cohort. This research highlights a significant lack of continuity of care and problems at the intersection of the disability and health systems when providing end-of-life care for this cohort. Suggested areas for improvement include team approaches to enable continuity of care and dying in place, and a need for knowledge and skills in this area for all stakeholders.
PRM101 A think aloud study comparing the validity and acceptability of discrete choice and best worst scaling methods
Publisher: Elsevier BV
Date: 11-2012
Magnetic Resonance Imaging in Cerebral Small Vessel Disease and its Use as a Surrogate Disease Marker
Publisher: SAGE Publications
Date: 04-01-2011
DOI: 10.1111/J.1747-4949.2010.00552.X
Abstract: Cerebral small vessel disease is an important cause of vascular cognitive impairment and dementia. On brain imaging, discrete lacunar infarcts and/or more diffuse regions of white matter hyperintensities or leucoaraiosis are seen. Magnetic resonance imaging plays a crucial role in diagnosis, and advanced magnetic resonance imaging techniques are providing new information on disease mechanisms and offering potential as surrogate disease markers. Longitudinal studies have demonstrated detectable progression of lesion load over short time periods, and weak correlations with cognition. Stronger correlations with cognition have been found with diffusion tensor imaging, which is more sensitive to white matter tract structure, supporting a role for disconnection in the pathogenesis of cognitive impairment. Brain volume also consistently correlates with cognition in asymptomatic small vessel disease, sporadic small vessel disease, and Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy. Gradient echo magnetic resonance imaging identifies microbleeds in a significant proportion of patients with small vessel disease, although their role in clinical management remains to be determined. Surrogate markers to monitor disease progression and evaluate new therapies would have major clinical use. The greater sensitivity of diffusion tensor imaging parameters and brain volume to change, and the stronger correlation of these parameters with cognition, suggest that they may be more powerful surrogates. However, data from longitudinal and intervention studies are required to determine if this is indeed the case. In this systematic review, we describe the use of both conventional and advanced magnetic resonance imaging techniques in patient groups with the full spectrum of clinical small vessel disease, from normal populations with WMH to patients groups with lacunar stroke and dementia.
Caregiving dynamics and futures planning among ageing parents of adult offspring with intellectual disability
Publisher: Cambridge University Press (CUP)
Date: 21-03-2018
DOI: 10.1017/S0144686X18000144
Abstract: The number of older parents ageing in tandem with their adult children with intellectual disability (ID) is increasing. This unique situation calls for greater research that investigates how older parents experience this extended care-giving role, including the extent to which they are engaging in futures planning. Participants were recruited via disability service providers in South Australia. Using the theoretical perspective of hermeneutic phenomenology to understand lived experiences, semi-structured in-depth interviews were carried out with older parents (N = 17, mean age 70 years). Six offspring were living in the family home while the remainder were in supported accommodation. Main themes to emerge from the data were: (a) perpetual parenting, (b) costs and rewards and (c) planning to plan. Parents were providing care across a range of areas, regardless of whether their offspring lived at home or in supported accommodation. While aware of the need to plan for the future, most did not have a firm plan in place. Parents are providing a high level of support to their adult children with ID regardless of whether they live in supported accommodation or the family home. While some have started to think about future care arrangements, most appear unclear over what the future holds.
Food and nutrient intakes of 9-month-old infants in Adelaide, Australia
Publisher: Cambridge University Press (CUP)
Date: 30-04-2009
DOI: 10.1017/S1368980009005552
Abstract: To describe the food and nutrient intakes of 9-month-old infants. A survey undertaken as part of a longitudinal study of child growth and development. Infant diet was characterised through a structured interview in which consumption frequency and portion size of foods were obtained. This method was compared with a 4 d diary and had adequate relative validity. Adelaide, Australia. Three hundred and forty-one infants for whom dietary data were plausible according to pre-specified criteria. At 9 months of age, the median body weights for 161 girls and 180 boys were 8·8 and 9·6 kg, respectively. Differences in intakes between boys and girls largely reflected differences in size. Median daily energy intake was 3541 kJ and median contributions of protein, fat and carbohydrate to total energy were 13 %, 36 % and 50 %. Using published Estimated Average Requirements, Zn intake was inadequate for % of children not breast-fed at this age while Fe intake was inadequate for 9 %. Infants who were still breast-fed (35 %) had more ersity in the foods that provided additional energy, compared with those not receiving breast milk, and were less likely to consume nutrient-displacing drinks such as juice or cordial. Cow’s milk was the main drink for 5 % of infants. In a group of Australian-born children, an important proportion had weaning diets that were low in Fe. Fat intake of many children was below current recommendations and cow’s milk was the main milk source for a small minority.
What quality of life domains are most important to older adults in residential care?
Publisher: Informa UK Limited
Date: 17-10-2022
Caring for a family member with intellectual disability into old age
Publisher: Wiley
Date: 18-02-2020
DOI: 10.1111/JAR.12710
Facilitators and barriers to developing romantic and sexual relationships
Publisher: Informa UK Limited
Date: 02-01-2022
DOI: 10.1080/07434618.2022.2046852
Abstract: The aims of this study were to investigate the lived experiences of people with complex communication needs in developing romantic and sexual relationships, and identify and explore barriers and facilitators they encountered in pursuing these relationships. For the study, nine participants were interviewed. All were at least 21-years-old, used augmentative and alternative communication, and had physical and communication disabilities since childhood. A methodology employing critical hermeneutics, a form of interpretive phenomenology, and Feminist Standpoint Theory was utilized. The World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) model (2013) was used to develop questions for the semi-structured interviews. Interview data were analyzed using reflexive thematic analysis, with the ICF model and the concept of ableism used to identify four main themes: (a) Attitudes of others (ableism), (b) Communication Within Intimate Moments, (c) Assistance of Support Workers, and (d) Additional Education Related to Sexuality and Disability. Most of the barriers participants encountered related to ableist attitudes they experienced from others. Facilitators included creative communication strategies for intimate moments and using dating websites. The participants' experiences bring attention to the need for changes in policies, practice, and research to further support people with complex communication needs in their quest to develop intimate relationships.
What factors influence older people in the decision to relinquish their driver's licence? A discrete choice experiment
Publisher: Elsevier BV
Date: 06-2013
DOI: 10.1016/J.AAP.2013.02.034
Abstract: To investigate the relative importance of a number of key factors that influence older people in the decision to relinquish their driver's licence. A discrete choice experiment (DCE) was administered as an online survey to Australian adults, 65 years plus (N=114) who drive, recruited from an online panel. The survey was composed of three main sections. (A) The Adelaide Driving Self Efficacy Scale to assess confidence in driving. The scale is generated from in idual's responses about confidence in their driving ability in various situations. (B) The DCE in which respondents were presented with a series of hypothetical binary choice situations and asked to indicate in which situation they would be more likely to relinquish their driving licence. (C) Socio-demographic and health status questions. A conditional logit regression model was adopted to analyse the DCE data. Older people would be more likely to relinquish their driver's licence due to advanced age, low confidence in driving ability and in situations where their local doctor advises them to cease driving. Other transport options availability and the cost of public transport were not found to be influential to this decision. Factors pertaining to the in idual themselves including advanced old age and low confidence in driving ability may be more influential than environmental factors such as availability of other transport options and the cost of public transport in an older person's decision to relinquish their driving licence.
A Think Aloud Study Comparing the Validity and Acceptability of Discrete Choice and Best Worst Scaling Methods
Publisher: Public Library of Science (PLoS)
Date: 23-04-2014
Why choose caesarean section? (letter)
Publisher: Elsevier BV
Date: 02-2001
The silver tsunami: an enquiry into the financial needs, preferences and behaviours of retirees
Publisher: Wiley
Date: 22-12-2019
DOI: 10.1111/ACFI.12589
Assessing the relative importance of key quality of life dimensions for people with and without a disability: an empirical ranking comparison study
Publisher: Springer Science and Business Media LLC
Date: 12-2021
DOI: 10.1186/S12955-021-01901-X
Abstract: In economic evaluation, the quality of life of people with a disability has traditionally been assessed using preference-based instruments designed to measure and value quality of life. To provide robust measurement of the effectiveness of programs designed to improve the quality of life of people living with a disability, preference-based measures need to be sufficiently sensitive to detect incremental changes in the quality of life dimensions that are most important to people who have a disability. This study sought to explore whether there was a difference in the ranked order of importance of quality of life dimensions between people with a disability and people without a disability. An online survey was developed and administered Australia wide. The first s le (n = 410) comprised adults (aged ≥ 18 years) with a disability (n = 208) and family carers of person/s with a disability who were asked to respond on behalf of the person with a disability (n = 202). The second s le included adults without disability (n = 443). Respondents were asked to rank the importance of 12 quality of life dimensions extracted from the content of established preference-based quality of life measures (EQ-5D, AQoL and ASCOT). People with a disability placed relatively higher importance on broader quality of life dimensions (e.g. Control, Independence, Self-care ) relative to health status focused dimensions (e.g. Vision, Hearing, Physical mobility ). This distinction was less differentiable for those ‘without a disability’. The biggest differences in ranked importance of dimensions were in: Vision (‘with disability’ = 10th, ‘without disability’ = 4th), Self-care (‘with disability’ = 3rd, ‘without disability’ = 7th) and Mental well-being (‘with disability’ = 6th, ‘without disability’ = 2nd). The relative importance of quality of life dimensions for people with a disability differs to people without a disability. Quality of life is a key outcome for economic evaluation and for assessing the impact of disability care policy and practice in Australia and internationally. It is important that the effectiveness of interventions is measured and valued in ways which are fully reflective of the quality of life preferences of people with a disability.
The Perspectives of Older Greek-Australians Toward Changes in the Nature of Family Support: Implications for Family Care Policies
Publisher: Informa UK Limited
Date: 10-2013
DOI: 10.1080/08959420.2013.816194
Abstract: Internationally, public policies encourage "aging in place," and the majority of older Australians requiring care in the community receive informal care, supplemented by publicly subsidized formal services. The effect of contemporary social changes on informal care in aging migrant communities is poorly understood. This articles explores the perceptions of older Greek-Australians toward changes in the nature of family support. Bicultural and bilingual researchers carried out in-depth interviews (n = 27) and five focus groups (n = 63 total participants) with older Greek-Australians in modern Greek. While "cultures of care" remain among Greek-Australian families, the means for a family to assist have shifted, and these compromises are met with considerable powerlessness among older Greek-Australians. Implications for policy include the need to better involve older migrants and their families in decisions about their care needs, potentially involving consumer-directed care models. Service providers may also need to adopt the use of new technologies to communicate with increasingly time-pressured family members.
The case for trauma-informed aged care
Publisher: Wiley
Date: 27-01-2020
DOI: 10.1002/GPS.5247
What Quality-of-Life Dimensions Are Most Important to Older Adults from Culturally and Linguistically Diverse Backgrounds Receiving Aged Care Services? An Exploratory Study
Publisher: MDPI AG
Date: 19-12-2022
DOI: 10.3390/GERIATRICS7060144
Abstract: There is little research on what aspects of quality of life (QoL) are most important to culturally and linguistically erse (CALD) older adults. This study aimed to identify what QoL dimensions were most important to CALD older adults receiving aged care services, and therefore, how relevant a new six dimensions QoL instrument developed for use in aged care is to this population. A three-stage, mixed-methods study was undertaken. Stage 1: n = 3 focus groups with aged care providers. Stage 2: n = 30 semi-structured interviews with Italian-born older adults in ethno-specific residential aged care. Stage 3: survey of n = 63 older adults from mixed CALD backgrounds receiving community aged care services. Overall, older adults asserted the importance of the six dimensions of the new QoL instrument. The importance of ‘identity’ and ‘purpose and meaning’ were identified via the focus groups however, the community-based CALD older adults identified these aspects of quality of life as more important than older Italians in residential care. Being in ethno-specific residential aged care where needs relating to language, food, and religion were met and they continued to live with others from their community may have meant that the meeting of cultural needs was more taken for granted.
Access and acceptability of community-based services for older Greek migrants in Australia: User and provider perspectives
Publisher: Hindawi Limited
Date: 25-09-2013
DOI: 10.1111/HSC.12000
Abstract: In most developed nations, ageing migrants represent a growing proportion of the older population. Policies that emphasise care in the community depend on older migrants having access to formal services along with informal support, yet little is known about how older migrants experience community-based formal services. By examining the views of both Greek elders in Australia and those of formal service providers, this research fills an important gap in the literature around access to and acceptability of formal community-based services for older migrants. A research team including two Greek background researchers used existing social groups and a snowball s ling method to conduct face-to-face interviews and focus groups with seventy older Greeks in Adelaide, Australia. In addition, 22 community-based service providers were interviewed over the telephone. Results from users and providers showed that while many older Greeks experience service access issues, they also relied heavily on family for support and assistance at home. Reliance on family was both in preference to formal services or where formal services were used, to locate, negotiate and monitor such services. Common barriers identified by both groups included cost, transport and availability, but additional challenges were posed by language, literacy and cultural attitudes. Demographic changes including greater employment mobility and female workforce participation among adult children will have implications for both formal and informal care providers. Formal service providers need to ensure that services are promoted and delivered to take account of the important role of family in informal support while also addressing the access challenges posed by language and literacy. Research conducted by researchers from the same cultural background in the respondent's native language can further advance knowledge in this area.
Developing a new quality of life instrument with older people for economic evaluation in aged care: Study protocol
Publisher: BMJ
Date: 05-2019
DOI: 10.1136/BMJOPEN-2018-028647
Abstract: The ageing of the population represents a significant challenge for aged care in Australia and in many other countries internationally. In an environment of increasing resource constraints, new methods, techniques and evaluative frameworks are needed to support resource allocation decisions that maximise the quality of life and well-being of older people. Economic evaluation offers a rigorous, systematical and transparent framework for measuring quality and efficiency, but there is currently no composite mechanism for incorporating older people’s values into the measurement and valuation of quality of life for quality assessment and economic evaluation. In addition, to date relatively few economic evaluations have been conducted in aged care despite the large potential benefits associated with their application in this sector. This study will generate a new preference based older person-specific quality of life instrument designed for application in economic evaluation and co-created from its inception with older people. A candidate descriptive system for the new instrument will be developed by synthesising the findings from a series of in-depth qualitative interviews with 40 older people currently in receipt of aged care services about the salient factors which make up their quality of life. The candidate descriptive system will be tested for construct validity, practicality and reliability with a new independent s le of older people (n=100). Quality of life state valuation tasks using best worst scaling (a form of discrete choice experiment) will then be undertaken with a representative s le of older people currently receiving aged care services across five Australian states (n=500). A multinomial (conditional) logistical framework will be used to analyse responses and generate a scoring algorithm for the new preference-based instrument. The new quality of life instrument will have wide potential applicability in assessing the cost effectiveness of new service innovations and for quality assessment across the spectrum of ageing and aged care. Results will be disseminated in ageing, quality of life research and health economics journals and through professional conferences and policy forums. This study has been reviewed by the Human Research Ethics Committee of the University of South Australia and has ethics approval (Application ID: 201644).
Social networks and memory over 15 years of followup in a cohort of older Australians: Results from the Australian longitudinal study of ageing
Publisher: Hindawi Limited
Date: 2012
DOI: 10.1155/2012/856048
Abstract: The purpose was to examine the relationship between different types of social networks and memory over 15 years of followup in a large cohort of older Australians who were cognitively intact at study baseline. Our specific aims were to investigate whether social networks were associated with memory, determine if different types of social networks had different relationships with memory, and examine if changes in memory over time differed according to types of social networks. We used five waves of data from the Australian Longitudinal Study of Ageing, and followed 706 participants with an average age of 78.6 years (SD 5.7) at baseline. The relationships between five types of social networks and changes in memory were assessed. The results suggested a gradient of effect participants in the upper tertile of friends or overall social networks had better memory scores than those in the mid tertile, who in turn had better memory scores than participants in the lower tertile. There was evidence of a linear, but not quadratic, effect of time on memory, and an interaction between friends’ social networks and time was apparent. Findings are discussed with respect to mechanisms that might explain the observed relationships between social networks and memory.
Understanding what matters: an exploratory study to investigate the views of the general public for priority setting criteria in health care
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.HEALTHPOL.2017.03.003
Abstract: Health care policy makers internationally are increasingly expressing commitment to consultation with, and incorporation of, the views of the general public into the formulation of health policy and the process of setting health care priorities. In practice, however, there are relatively few opportunities for the general public to be involved in health care decision-making. In making resource allocation decisions, funders, tasked with managing scarce health care resources, are often faced with difficult decisions in balancing efficiency with equity considerations. A mixed methods (qualitative and quantitative) approach incorporating focus group discussions and a ranking exercise was utilised to develop a comprehensive list of potential criteria for setting priorities in health care formulated from the perspective of members of the general public in Australia. A strong level of congruence was found in terms of the rankings of the key criteria with the size of the health gain, clinical effectiveness, and the ability to provide quality of life improvements identified consistently as the three most important criteria for prioritising the funding of an intervention. Findings from this study will be incorporated into a novel DCE framework to explore how decision makers and members of the general public prioritize and trade off different types of health gain and to quantify the weights attached to specific efficiency and equity criteria in the priority setting process.
The development and process evaluation of an information-based intervention for pregnant women aimed at addressing rates of caesarean section
Publisher: Wiley
Date: 22-11-2005
DOI: 10.1111/J.1471-0528.2005.00753.X
Abstract: Few strategies aimed at addressing rising rates of caesarean section have explicitly involved information-based approaches for pregnant women. This study describes the development and evaluation of such an intervention for pregnant women, encompassing p hlets and a peer support network (PSN). Process evaluation. The study was undertaken at a metropolitan teaching hospital in Adelaide, South Australia. A consecutive s le of pregnant women attending the ultrasound clinic over a two-month period, recruited at 18 weeks of gestation. Participants received two p hlets at 18 weeks of gestation and information on a PSN at around 28 weeks of gestation. A questionnaire was sent to women at seven weeks postnatal, asking them to evaluate the intervention. The extent to which the intervention resources were used and participants were satisfied with the resources they received. Ninety-two women returned questionnaires (response rate of 62%). Women generally resisted engaging with the informational resources, citing irrelevance to their situation, for ex le, 53% (49/92) read all of the p hlets. None of the women used the PSN. Women who had experienced childbirth previously and those of higher education were significantly more likely to read the p hlets. While generally satisfied with p hlet content, one in five women reported feeling distressed by some of the information. This exploratory study casts doubt on the notion of information provision for pregnant women as a panacea for addressing rising rates of caesarean section.
Dementia assessment services: What are the perceptions of older people?
Publisher: Wiley
Date: 10-10-2017
DOI: 10.1111/AJAG.12455
Abstract: To determine how older people with dementia and their family caregivers experience dementia assessment services and preferences for future configuration of diagnostic services. Qualitative, semistructured in-depth interviews were conducted with nine in iduals with dementia. In seven instances, the caregiver also took part in the interview, and on two occasions, the interview was with the person with dementia only. An important contact during assessment of dementia was the general practitioner, in particular working in a way or timeframe which provides clarity and comfort to the person with dementia and their family members. A problematic factor in clear diagnosis was when probable dementia was suspected during hospitalisation for another complaint. Participants expressed a wide range of views in terms of preferred settings for diagnostic services. These findings highlight some key considerations, which should be included in future research leading to decisions about the design of dementia client services.
‘I’d rather die in the middle of a street’
Publisher: Wiley
Date: 17-12-2021
DOI: 10.1111/AJAG.12851
Abstract: To explore perceptions and expectations regarding aged care among older Forgotten Australians, informing better ways of delivering safe and inclusive care for this group. In‐depth interviews were undertaken with sixteen Forgotten Australians to understand their perspectives, hopes and perceived barriers to receiving appropriate aged care. Qualitative data were analysed using Ritchie and Spencer's framework approach. Participants were highly averse to receiving aged care in residential settings, particularly where delivered by religious organisations. Limited perceived opportunities to develop trust and maintain control and independence while managing re‐traumatising situations shaped Forgotten Australians negative perceptions of the aged care system. Participants also spoke of how their lifelong marginalisation could limit their access to choice and quality in aged care. The aged care industry could provide safe and inclusive care by adopting a person‐centred and trauma‐informed model that recognises and addresses the specific needs and challenges of Forgotten Australians.
Older people's attitudes towards resuming driving in the first four months post-stroke
Publisher: Wiley
Date: 28-04-2014
DOI: 10.1111/AJAG.12135
Abstract: Little is known about how older people recovering from stroke perceive their return to driving, particularly in the early stages of recovery when they may receive driving information. Semistructured interviews were conducted with 21 participants (52% female, mean age 74.5 years) within the first 16 weeks post-stroke, while inpatients in either acute or rehabilitation stroke wards. Interview data were analysed using content analysis. Three main themes emerged: 'driving as independence', 'emphasis on physical recovery', and 'limits on driving pre-stroke'. For the most part, driving was not a key consideration for participants during this phase of their recovery. Physical restrictions and confidence were seen as the main deterrent to driving post-stroke however, this varied according to gender. Driving information is generally not retained in the first four weeks of recovery post-stroke. This has implications for the content and timing of driving information given post-stroke.
Strategies to address global cesarean section rates: a review of the evidence
Publisher: Wiley
Date: 03-2002
DOI: 10.1046/J.1523-536X.2002.00153.X
Abstract: The steadily increasing global rates of cesarean section has become one of the most debated topics in maternity care. This paper reviews and reports on the success of strategies that have been developed in response to this continuing challenge. A literature search identified studies conducted between 1985 and 2001 from the Cochrane Database of Systematic Reviews, Medline, Sociofile, Current Contents, Psyclit, Cinahl, and EconLit databases. An additional search of electronic databases for Level 1 evidence (systematic reviews), Level 2 (randomized controlled trials), Level 3 (quasi-experimental studies), or Level 4 (observational studies) was performed. Selection criteria used to identify studies for review included types of study participant, intervention, outcome measure, and study. Interventions that have been used in an attempt to reduce cesarean section rates were identified they are categorized as psychosocial, clinical, and structural strategies. Two clinical interventions, (external cephalic version, vaginal birth after a previous cesarean) and one psychosocial intervention (one-to-one trained support during labor) demonstrated Level 1 evidence for reducing cesarean section rates. Although the evidence for one-to-one care and external cephalic version came from both developed and developing settings, the systematic review for vaginal birth after a cesarean was restricted to studies conducted in the United States. The effective implementation of the preceding strategies to reduce cesarean rates may depend on the social and cultural milieu and on associated beliefs and practices.
Social Capital, Social Relationships and Adults with Acquired Visual Impairment: A Nigerian Perspective.
Publisher: Informa UK Limited
Date: 31-01-2018
DOI: 10.1080/09638288.2017.1423401
Abstract: This study investigates the social capital implications of vision loss among working-age adults in Nigeria. The study explores the challenges of acquiring and maintaining social relationships post-vision loss, and investigates the extent to which visual rehabilitation services support social goals. A qualitative study using a phenomenological approach was undertaken. Eight adults (18-59 years) were recruited from disability service organizations in Nigeria. Telephone interviews were recorded and transcribed, and thematic content analysis was used to analyze the data gathered in this study. Three broad themes were developed from participants' accounts of their experiences: (1) changes to relationships with friends and others (2) finding strength in family relationships and (3) rehabilitation and the confidence to interact. The findings indicate that the relationship between participants and their family members improved post vision impairment, enhancing bonding social capital. However, participants experienced reduced bridging and linking social capital due to diminished or broken relationships with managers, coworkers, friends, and others in the community. As social connectedness and relationships are highly valued in Nigeria's erse society, we suggest that adults with visual impairment would significantly benefit from visual rehabilitation services placing greater emphasis on addressing the social goals of participants. Implications for Rehabilitation Visual impairment in working-age adults can strengthen family relationships (homogenous groups), creating bonding capital that is associated with access to important resources including emotional and moral support, and some financial and material resources. Visual impairment can negatively impact relationships with managers, coworkers, and others in the community (heterogeneous groups), resulting in diminished bridging and linking capital. Visual impairment can reduce access to resources such as an income, social status, and reduces participation in the wider community. Visual Rehabilitation Services could significantly benefit participants by placing greater emphasis on social goals, such as building and maintaining social networks, particularly with erse (heterogeneous groups), which are valued in Nigeria's erse cultural climate.
Early rehabilitation management after stroke: What do stroke patients prefer?
Publisher: Medical Journals Sweden AB
Date: 2011
Abstract: Stroke rehabilitation is moving towards more intense therapy models that incorporate technologies such as robotics and computer games. It is unclear how acceptable these changes will be to stroke survivors, as little is known about which aspects of rehabilitation programmes are currently valued. Discrete choice experiments are a potential approach to assessing patient preferences, as they reveal the characteristics of programmes that are most important to consumers. A discrete choice experiment was presented as a face-to-face interview to assess the priorities and preferences of stroke survivors (n=50, mean age 72 years) for alternative rehabilitation service configurations. The discrete choice experiment was presented to the participants while they were on the stroke rehabilitation ward (approximately 3-4 weeks following stroke). Participants were highly focused on recovery and expressed strong preferences for therapy delivered one-to-one, but they did not favour very high intensity programmes (6 hours per day). While the attitudinal statements indicated high levels of agreement for programmes to incorporate the latest technology, the results from the discrete choice experiment indicated that participants were averse to computer-delivered therapy. Whilst rehabilitation therapy is highly valued, stroke survivors exhibited stronger preferences for low-intensity programmes and rest periods. High-intensity therapy protocols or approaches dependent on new technologies will require careful introduction to achieve uptake and acceptability.
Examining older patient preferences for quality of care in postacute transition care and day rehabilitation programs
Publisher: Scientific Research Publishing, Inc.
Date: 2013
How Important Is Health Status in Defining Quality of Life for Older People? An Exploratory Study of the Views of Older South Australians
Publisher: Springer Science and Business Media LLC
Date: 20-11-2013
DOI: 10.1007/S40258-013-0068-3
Abstract: Cost-effectiveness analyses of interventions for older adults have traditionally focused on health status. However, there is increasing recognition of the need to develop new instruments to capture quality of life in a broader sense in the face of age-associated increasing frailty and declining health status, particularly in the economic evaluation of aged and social care interventions that may have positive benefits beyond health. To explore the relative importance of health and broader quality of life domains for defining quality of life from the perspective of older South Australians. Older adults (n=21) from a day rehabilitation facility in Southern Adelaide, South Australia attended one of two audio-recorded focus groups. A mixed methods (qualitative and quantitative) study design was adopted. The study included three main components. First was a general group discussion on quality of life and the factors of importance in defining quality of life. Second was a structured ranking exercise in which in iduals were asked to rank domains from the brief Older People's Quality of Life (OPQOL-brief) questionnaire and Adult Social Care Outcomes Toolkit (ASCOT) in order of importance. Third, participants were asked to self-complete the EuroQol five-dimension (EQ-5D), a measure of health status, and two broader quality-of-life measures: the OPQOL-brief and ASCOT. Mean scores on the EQ-5D, OPQOL-brief and ASCOT were 0.71 (standard deviation [SD] 0.20, range 0.06-1.00), 54.6 (SD 5.5, range 38-61) and 0.87 (SD 0.13, range 0.59-1.00), respectively, with higher scores reflecting better ratings. EQ-5D scores were positively associated with OPQOL-brief (Spearman's Rho: 0.730 p<0.01), but not ASCOT. Approximately half (52.4%) of the participants ranked either 'health' or 'psychological and emotional well-being' as the domain most important to their quality of life. However, one-third (33.3%) of the total s le ranked a non-health domain from the ASCOT or OPQOL-brief (safety, dignity, independence) as the most important contributing factor to their overall quality of life. Qualitative analysis of focus group transcripts supported the high value of both health-related (health, psychological well-being) and social (independence, safety) domains to quality of life. Older adults value both health and social domains as important to their overall quality of life. Future economic evaluations of health, community and aged-care services for older adults should include assessment of both health-related and broader aspects of quality of life.
Is oestrogen therapy justified in the treatment of hereditary haemorrhagic telangiectasia: A biochemical evaluation
Publisher: Wiley
Date: 06-2000
DOI: 10.1046/J.1365-2273.2000.00415.X
Abstract: Systemic and topical oestrogen can provoke squamous metaplasia of epithelium. In Hereditary Haemorrhagic Telangiectasia (HHT) the underlying telangiectasia may be protected from trauma and epistaxis reduced. Oestrogens have been advocated but their efficacy is unclear. Recent advances have now identified two oestrogen and one progesterone receptors. The aim of this study is to analyse the sex receptor status of HHT nasal mucosa to determine if oestrogen therapy is biochemically justified. Five HHT patients (three men, two women) and eight controls (four men, four women) underwent nasal mucosa biopsy. S les were fixed in formalin and paraffin embedded. Alpha oestrogen (ERalpha) and beta oestrogen (ERss) and progesterone (PgR) receptors were identified using mouse monoclonal antibodies by the Streptavidin-biotin peroxidase method. ERss was detected in two HHT subjects (1 M: 1F) and two control subjects. ERalpha and PgR was absent in HHT subjects. This pilot study demonstrated that a subgroup of HHT patients were ERss positive. Oestrogen therapy therefore has a potential therapeutic role on a biochemical basis in these patients. ERss status should be determined before considering oestrogen therapy.
Cumulative Load of Depressive Symptoms Is Associated With Cortisol Awakening Response in Very Old Age
Publisher: Informa UK Limited
Date: 03-04-2014
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View Funded ActivityLinkage Projects - Grant ID: LP100200413
Start Date: 2011
End Date: 12-2014
Amount: $273,331.00
Funder: Australian Research Council
View Funded ActivityLinkage Projects - Grant ID: LP200200326
Start Date: 06-2021
End Date: 06-2024
Amount: $319,061.00
Funder: Australian Research Council
View Funded Activity