ORCID Profile
0000-0002-6705-2652
Current Organisation
University of Sydney
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Social policy | Health services and systems | People with disability
Publisher: Springer Science and Business Media LLC
Date: 12-2005
Abstract: As in all western countries, Australia's older population experiences high levels of hearing impairment coupled with relatively low levels of hearing device usage. Poor hearing diminishes the quality of life of affected in iduals and their families. This paper discusses how to improve Australian hearing health policies in order to better combat this impairment amongst older Australians. We searched the databases Medline , Meditext and Web of Science to find articles that discussed strategies and innovations to assist the hearing health of older people, and related this material to observations made during the Blue Mountains Hearing Study in NSW between 1997 and 2003. The literature search identified five areas for inclusion in a comprehensive hearing health policy in Australia. These are: early intervention addressing of hearing aid expense the use of assisted listening devices hearing rehabilitation, and screening and education. Further research in Australia is critical if we are to develop a strong approach to the increasing prevalence of age-related hearing loss. Australia needs to act now to address hearing impairment as it is a major cause of disability in those aged 55 and over. Federal and State governments should collaborate to construct a comprehensive hearing health policy that tackles poor levels of hearing health through early intervention, addressing hearing aid expense, encouraging the use of assisted listening devices, rehabilitation, screening and education. A good start would be to declare age related hearing impairment as a National Health Priority Area.
Publisher: Informa UK Limited
Date: 2008
DOI: 10.5172/JAMH.7.3.176
Publisher: Springer Singapore
Date: 2019
Publisher: AMPCo
Date: 08-2018
DOI: 10.5694/MJA18.00394
Publisher: Wiley
Date: 03-2007
DOI: 10.1111/J.1440-1800.2007.00355.X
Abstract: Critical discourse analysis is a useful and productive qualitative methodology but has been underutilized within nursing research. In order to redress this deficiency the research presented in this article represents an exploration of the way in which critical discourse analysis may be applied to the analysis of public debates around policy for nursing practice. In this article the author discusses the history of the application of critical discourse analysis and provides an ex le of its application to the debate around the use of nurse practitioners within the Australian healthcare system.
Publisher: Oxford University Press (OUP)
Date: 29-01-2016
Abstract: To explore the applicability of a patient complaint taxonomy to data on serious complaint cases. Qualitative descriptive study. Complaints made to the New South Wales (NSW) Health Care Complaints Commission, Australia between 2005 and 2010. All 138 cases of serious complaints by patients about public hospitals and other health facilities investigated in the 5-year period. A thematic analysis of the complaints was conducted to identify particular complaint issues and the Reader et al. (Patient complaints in healthcare systems: a systematic review and coding taxonomy. BMJ Qual Saf 2014 :678-89.) patient complaint taxonomy was then used to classify these issues into categories and sub-categories. The 138 investigated cases revealed 223 complaint issues. Complaint issues were distributed into the three domains of the patient complaint taxonomy: clinical, management and relationships. Complaint issue most commonly related to delayed diagnosis, misdiagnosis, medication errors, inadequate examinations, inadequate/nil treatment and quality of care including nursing care. The types of complaints from patients about their healthcare investigated by the NSW Commission were similar to those received by other patient complaint entities in Australia and worldwide. The application of a standard taxonomy to large numbers of complaints cases from different sources would enable the creation of aggregated data. Such data would have better statistical capacity to identify common safety and quality healthcare problems and so point to important areas for improvement. Some conceptual challenges in devising and using a taxonomy must be addressed, such as inherent problems in ensuring coding consistency, and giving greater weight to patient concerns about their treatment.
Publisher: Springer Science and Business Media LLC
Date: 10-08-2018
Publisher: Oxford University Press (OUP)
Date: 29-09-2015
Abstract: Preventable patient harm due to adverse events (AEs) is a significant health problem today facing contemporary health care. Knowledge of patients' experiences of AEs is critical to improving health care safety and quality. A systematic review of studies of patients' experiences of AEs was conducted to report their experiences, knowledge gaps and any challenges encountered when capturing patient experience data. Key words, synonyms and subject headings were used to search eight electronic databases from January 2000 to February 2015, in addition to hand-searching of reference lists and relevant journals. Titles and abstracts of publications were screened by two reviewers and checked by a third. Full-text articles were screened against the eligibility criteria. Data on design, methods and key findings were extracted and collated. Thirty-three publications demonstrated patients identifying a range of problems in their care most commonly identified were medication errors, communication and coordination of care problems. Patients' income, education, health burden and marital status influence likelihood of reporting. Patients report distress after an AE, often exacerbated by receiving inadequate information about the cause. Investigating patients' experiences is h ered by the lack of large representative patient s les, data over sufficient time periods and varying definitions of an AE. Despite the emergence of policy initiatives to enhance patient engagement, few studies report patients' experiences of AEs. This information must be routinely captured and utilized to develop effective, patient-centred and system-wide policies to minimize and manage AEs.
Publisher: Oxford University Press (OUP)
Date: 03-2018
Abstract: Evidence of the patient experience of hospitalization is an essential component of health policy and service improvement but studies often lack a representative population s le or do not examine the influence of patient and hospital characteristics on experiences. We address these gaps by investigating the experiences of a large cohort of recently hospitalized patients aged 45 years and over in New South Wales (NSW), Australia who were identified using data linkage. Cross-sectional survey. Hospitals in NSW, Australia. The Picker Patient Experience Survey (PPE-15) was administered to a random s le of 20 000 patients hospitalized between January and June 2014. Multivariable negative binomial regression was used to investigate factors associated with a higher PPE-15 score. There was a 40% response rate (7661 completed surveys received). Respondents often reported a positive experience of being treated with dignity and respect, yet almost 40% wanted to be more involved in decisions about their care. Some respondents identified other problematic aspects of care such as receiving conflicting information from different care providers (18%) and feeling that doctors spoke in front of them as if they were not there (14%). Having an unplanned admission or having an adverse event were both very strongly associated with a poorer patient experience (P < 0.001). No other factors were found to be associated. Patient involvement in decision-making about care was highlighted as an important area for improvement. Further work is needed to address the challenges experienced by patients, carers and health professionals in achieving a genuine partnership model.
Publisher: Wiley
Date: 02-04-2023
DOI: 10.5694/MJA2.51899
Publisher: JMIR Publications Inc.
Date: 26-03-2019
DOI: 10.2196/11084
Abstract: Over the past 2 decades, online forums for mental health support have emerged as an important tool for improving mental health and well-being. There has been important research that analyzes the content of forum posts, studies on how and why in iduals engage with forums, and how extensively forums are used. However, we still lack insights into key questions on how they are experienced from the perspective of their users, especially those in rural and remote settings. The aim of our study was to investigate the dynamics, benefits, and challenges of a generalized peer-to-peer mental health online forum from a user perspective in particular, to better explore and understand user perspectives on connection, engagement, and support offered in such forums information and advice they gained and what issues they encountered. We studied experiences of the forums from the perspective of both people with lived experience of mental illness and people who care for people with mental illness. To understand the experience of forum users, we devised a qualitative study utilizing semistructured interviews with 17 participants (12 women and 5 men). Data were transcribed, and a thematic analysis was undertaken. The study identified 3 key themes: participants experienced considerable social and geographical isolation, which the forums helped to address participants sought out the forums to find a social connection that was lacking in their everyday lives and participants used the forums to both find and provide information and practical advice. The study suggests that online peer support provides a critical, ongoing role in providing social connection for people with a lived experience of mental ill-health and their carers, especially for those living in rural and remote areas. Forums may offer a way for in iduals to develop their own understanding of recovery through reflecting on the recovery experiences and peer support shown by others and in iduals enacting peer support themselves. Key to the success of this online forum was the availability of appropriate moderation, professional support, and advice.
Publisher: Oxford University Press (OUP)
Date: 18-04-2013
DOI: 10.1093/SHM/HKT009
Publisher: Springer Science and Business Media LLC
Date: 10-10-2007
Publisher: Springer Science and Business Media LLC
Date: 22-08-2015
Publisher: Springer Science and Business Media LLC
Date: 2023
Publisher: Wiley
Date: 21-09-2020
DOI: 10.1002/HPJA.408
Abstract: We currently know very little about the attitudes of young adult Australians from migrant backgrounds towards health service utilisation. This qualitative study aimed to explore their experiences of accessing health services and identify barriers and facilitators to health service utilisation. Semi‐structured interviews were conducted with young people aged between 18‐24 and living in Greater Western Sydney. Interview questions focused on facilitators and barriers to health service access. NVivo 11 was used to facilitate thematic analysis of the interviews. Twenty‐five young adults between 18‐24 years from migrant backgrounds participated. Twenty semi‐structured in idual interviews and one group interview with five participants were conducted. Analysis identified themes relating to health literacy, cultural factors and quality of care and showed the importance of families, the education system and service outreach in facilitating access. Findings indicate that more effective delivery of health services information in education, positive engagement between service‐providers and service‐users, and age‐appropriate, culturally considerate health promotion strategies are needed to overcome barriers to health services accessibility. The results show the importance of families and communities, the education system and health service outreach in facilitating health service access for young people from migrant backgrounds. The paper highlights the need for more effective health promotion strategies targeting this group, their families and communities. To increase access, health promotion practitioners need to actively reach out to families and young people from migrant backgrounds through education and community‐relevant forums.
Publisher: Ubiquity Press, Ltd.
Date: 08-12-2014
DOI: 10.5334/IJIC.1956
Publisher: Springer Science and Business Media LLC
Date: 2011
Publisher: SAGE Publications
Date: 21-03-2013
Abstract: “Recovery” has become a key element in Scottish mental health policy and practice, despite continuing uncertainty over just what is meant by the term. This article draws on social movement theory to explore the processes underlying the growth of recovery in Scotland. Based on documentary analysis and semi-structured interviews with key actors, it looks at the emergence of a “recovery movement” in Scotland and in particular at how that movement articulated a “recovery frame” that subsequently came to inform policy and practice. It then reflects on the dilemmas posed by this success, as the recovery movement expanded to intersect with state agencies and the recovery frame was adapted to accommodate the needs of government policy. It concludes that the future of the recovery movement in Scotland will depend on its ability to maintain a sufficiently broad and inclusive framing of recovery even as it becomes associated with specific policies and practice.
Publisher: JMIR Publications Inc.
Date: 18-05-2018
Abstract: ver the past 2 decades, online forums for mental health support have emerged as an important tool for improving mental health and well-being. There has been important research that analyzes the content of forum posts, studies on how and why in iduals engage with forums, and how extensively forums are used. However, we still lack insights into key questions on how they are experienced from the perspective of their users, especially those in rural and remote settings. he aim of our study was to investigate the dynamics, benefits, and challenges of a generalized peer-to-peer mental health online forum from a user perspective in particular, to better explore and understand user perspectives on connection, engagement, and support offered in such forums information and advice they gained and what issues they encountered. We studied experiences of the forums from the perspective of both people with lived experience of mental illness and people who care for people with mental illness. o understand the experience of forum users, we devised a qualitative study utilizing semistructured interviews with 17 participants (12 women and 5 men). Data were transcribed, and a thematic analysis was undertaken. he study identified 3 key themes: participants experienced considerable social and geographical isolation, which the forums helped to address participants sought out the forums to find a social connection that was lacking in their everyday lives and participants used the forums to both find and provide information and practical advice. he study suggests that online peer support provides a critical, ongoing role in providing social connection for people with a lived experience of mental ill-health and their carers, especially for those living in rural and remote areas. Forums may offer a way for in iduals to develop their own understanding of recovery through reflecting on the recovery experiences and peer support shown by others and in iduals enacting peer support themselves. Key to the success of this online forum was the availability of appropriate moderation, professional support, and advice.
Publisher: JMIR Publications Inc.
Date: 03-01-2022
DOI: 10.2196/31126
Abstract: For people with disabilities to live a good life, it is essential that funded research in health and social care addresses their interests, meets their needs, and fills gaps in our understanding of the impact that services, systems, and policies may have on them. Decisions about research funding should be based on an understanding of the research priorities of people with disabilities, their supporters and allies, disability researchers, service providers, and policy makers working in the field. The aim of this protocol is to describe the research design and methods of a large-scale, disability research agenda–setting exercise conducted in 2021 in Australia. The research agenda–setting exercise involves 3 integrated phases of work. In the first phase, a previous audit of disability research in Australia is updated to understand previous research and continuing gaps in the research. Building on this, the second phase involves consultation with stakeholders—people with disabilities and their supporters and family members, the disability workforce, and people working within services and connected sectors (eg, aging, employment, education, and housing), academia, and public policy. Data for the second phase will be gathered as follows: a national web-based survey a consultation process undertaken through the government and nongovernment sector and targeted consultation with Aboriginal and Torres Strait Islander people, children with disabilities and their families, people with cognitive disability, and people with complex communication needs. The third phase involves a web-based survey to develop a research agenda based on the outcomes of all phases. We have started working on 2 parts of the research prioritization exercise. Through the research-mapping exercise we identified 1241 journal articles and book chapters (referred to as research papers) and 225 publicly available reports (referred to as research reports) produced over the 2018-2020 period. Data collection for the national survey has also been completed. We received 973 fully completed responses to the survey. Analysis of these data is currently underway. This multi-method research agenda–setting study will be the first to provide an indication of the areas of health and social research that people across the Australian disability community consider should be prioritized in disability research funding decisions. Project results from all phases will be made publicly available through reports, open-access journal publications, and Easy Read documents. DERR1-10.2196/31126
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/AH15248
Abstract: Objective The Partners in Recovery (PIR) program is an Australian government initiative designed to make the mental health and social care sectors work in more coordinated ways to meet the needs of those with severe and complex mental illness. Herein we reflect on demographic data collected during evaluation of PIR implementation in two Western Sydney sites. The aims of the present study were to: (1) explore whether two Sydney-based PIR programs had recruited their intended population, namely people living with severe and persistent mental illness and (2) learn more about this relatively unknown population and their self-identified need priorities. Methods Routinely collected initial client assessment data were analysed descriptively. Results The data suggest that the two programs are engaging the intended population. The highest unmet needs identified included psychological distress, lack of daytime activities and company, poor physical health and inadequate accommodation. Some groups remain hard to connect, including people from Aboriginal and other culturally erse communities. Conclusions The data confirm that the PIR program, at least in the two regions evaluated, is mostly reaching its intended audience. Some data were being collected inconsistently, limiting the usefulness of the data and the ability to build on PIR findings to develop ongoing support for this population. What is known about the topic? PIR is a unique national program funded to engage with and address the needs of Australians living with severe and persistent mental illness by facilitating service access. What does this paper add? This paper reports on recruitment of people living with severe and persistent mental illness, their need priorities and data collection. These are three central elements to successful roll-out of the much anticipated mental health component of the National Disability Insurance Scheme, as well as ongoing PIR operation. What are the implications for practitioners? Active recruitment, exploration of self-reported need priorities and routine outcome measurement are essential yet challenging work practices when working with people living with severe and persistent mental illness.
Publisher: Ubiquity Press, Ltd.
Date: 11-07-2017
DOI: 10.5334/IJIC.3174
Publisher: Informa UK Limited
Date: 2019
DOI: 10.2147/RMHP.S180359
Publisher: Wiley
Date: 11-11-2003
Publisher: Informa UK Limited
Date: 28-04-2019
DOI: 10.1080/09638237.2018.1466029
Abstract: Despite significant need for mental health services targeting the requirements of inmates transitioning into the community there is little research about successful recovery-oriented or person-centred transition programs. This systematic narrative review brings together existing evidence to inform policymakers and practitioners about current practice in transition support, and barriers and facilitators of effective practice. We carried out a systematic narrative review of recovery-oriented or person-centred mental health support programs supporting transition from incarceration to the community. Results were obtained from a systematic search of Medline, PubMed and Scopus databases. We found 23 papers which met the paper inclusion criteria along with four other papers which were identified incidentally. Identified barriers to the implementation of effective transition support programs are: administrative problems leading to ineffective in-reach into correctional facilities or untimely support, lack of support for immediate needs meaning that inmates deprioritise their mental health needs, a lack of ongoing program resources and poor communication between correctional facilities and mental health services. Enablers for transition reflect the inverse of these barriers, alongside other successful strategies including medical home models, regionalised programs, programs which target connections with primary care, nurse-led patient-centred health programs and peer support initiatives.
Publisher: Cambridge University Press (CUP)
Date: 21-03-2017
DOI: 10.1017/JRC.2017.1
Abstract: This study aimed to understand the coping strategies used by men with Adult Onset Epileptic Seizures (AOES) following elective neurosurgery, and in particular, how those adaptive skills relate to their subjective wellbeing (SWB). Open-ended qualitative interviews were conducted with five men with a history of neurosurgery for AOES (aged 34–59). The interview data was thematically analysed utilising interpretive phenomenological analysis. The findings indicated that the men experienced significant role marginalisation by family and co-workers, and also poor communication provided by health care professionals. They reported a higher sense of SWB with the use of ego-buffering strategies, such as positive reframing, threat minimisation, emotional self-acceptance and engaging in wish-fulfilling fantasies. Self-blame led to lower SWB. Findings imply that agentic behaviour is important to successful living with AOES following neurosurgery.
Publisher: Informa UK Limited
Date: 23-04-2019
Publisher: Emerald
Date: 12-2008
DOI: 10.1108/13619322200800024
Abstract: This paper reports the first phase of a research project on mental health policy in Scotland that investigates the way knowledge is mobilised in the policy process. In this first phase of the project, the authors' concern has been to map the organisational domain of mental health policy in Scotland, paying attention to the form and structure of agencies and organisations as well as to the relationships between them. The paper describes a set of organisations in which central government is dominant but notes also a range of organisational forms and functions, and a ersity of sources of knowledge, expertise and information on which they draw. A dense network of linkages between agencies is identified.
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/AH16138
Abstract: Objective This paper explores how hospital complaints managers react to recommendations for systemic quality reforms by health complaints commissions in response to complaints by patients in Queensland and New South Wales. Methods Semi-structured qualitative interviews were conducted with complaints managers in 17 hospitals. Interview transcripts were then thematically analysed and data on responses to health complaint commissions was organised in relation to Valerie Braithwaite’s typology of motivational postures. Results Respondents supported involvement by an independent authority where patients had serious complaints about the services they received in hospital, but wanted more negotiation with commissions on service improvement recommendations. Conclusions Hospital complaints managers mostly responded as virtuous or rational actors to the symbolic power of complaints commissions. This may be context dependent because Australian health commissions operate within a pro-reform context as a result of recent publicity around health system failures. What is known about the topic? Little is known about regulatory relationships between complaints commissions and hospitals. There has been no Australian research considering how complaints managers respond to commission recommendations for quality improvements and reforms to hospital services. What does the paper add? The paper uses a novel theoretical framework based on regulatory theory to understand and describe the reactions of complaints managers to commission recommendations. What are the implications for practitioners? Commissions should seek commentary from complaints managers through open dialogue before making final recommendations. This will ease the progress of reforms and make recommendations more acceptable and ‘genuine’ in the specific context of the hospital.
Publisher: Informa UK Limited
Date: 28-03-2018
DOI: 10.1080/17549507.2018.1448895
Abstract: With an ageing population, speech-language pathologists (SLPs) can expect to encounter legal and ethical challenges associated with palliative and end-of-life care more frequently. An awareness of the medico-legal and ethical framework for palliative dysphagia management will better equip SLPs to work effectively in this area. This narrative review examines a range of legislation, legal, ethical and SLP literature that is currently available to orient SLPs to legal and ethical palliative dysphagia management in the Australian context. Relevant legal and ethical considerations in palliative and end-of-life care are described. SLPs have a role in palliative dysphagia management, however, this can involve unique legal and ethical challenges. The legal position on provision and cessation of nutrition and hydration differs between Australian States and Territories. Decisions by the courts have established a body of relevant case law. This article introduces SLPs to some of the important considerations for legal and ethical palliative care, but is not intended to be directive. SLPs are encouraged to explore their local options for ethical and medico-legal guidance. It is hoped that increasing SLPs awareness of many of the concepts discussed in this article enhances the provision of high-quality patient-centred care.
Publisher: Emerald
Date: 06-03-2017
DOI: 10.1108/IJHG-01-2016-0005
Abstract: In 2010, Australia introduced the National Registration and Accreditation Scheme for the health professions (the Australian scheme) creating a legislative framework for a national system of health workforce regulation, delivering a model of collective (and multi-level) government involvement in regulatory activities. The purpose of this paper is to examine how its governance arrangement compares to different national systems and other health regulatory bodies in Australia. This qualitative case study is informed by documentary analysis in conjunction with policy mapping. This is part of a larger project investigating the policy pathway which led to establishment of the Scheme. The authors compare the Scheme with other Australian health standard setting and regulatory bodies. The Australian scheme’s governance model supported existing constitutional arrangements, and enabled local variations. This facilitated the enduring interest of ministers (and governments) on matters of health workforce and articulated the activities of the new regulatory player. It maintains involvement of the six states and two territories, with the Commonwealth Government, and profession-specific boards and accreditation agencies. This resulted in a unique governance framework delivering a new model of collective ministerial responsibility. The governance design is complex, but forges a new way to embed existing constitutional arrangements within a tripartite arrangement that also delivers National Boards specific to in idual health professions and an organisation to administer regulatory activities. This study demonstrates that effective design of governance arrangements for regulatory bodies needs to address regulatory tasks to be undertaken as well as the existing roles, and ongoing interests of governments in participating in those regulatory activities. It highlights that a unique arrangement, while appearing problematic in theory may in practice deliver intended regulatory outcomes.
Publisher: JMIR Publications Inc.
Date: 10-06-2021
Abstract: or people with disabilities to live a good life, it is essential that funded research in health and social care addresses their interests, meets their needs, and fills gaps in our understanding of the impact that services, systems, and policies may have on them. Decisions about research funding should be based on an understanding of the research priorities of people with disabilities, their supporters and allies, disability researchers, service providers, and policy makers working in the field. he aim of this protocol is to describe the research design and methods of a large-scale, disability research agenda–setting exercise conducted in 2021 in Australia. he research agenda–setting exercise involves 3 integrated phases of work. In the first phase, a previous audit of disability research in Australia is updated to understand previous research and continuing gaps in the research. Building on this, the second phase involves consultation with stakeholders—people with disabilities and their supporters and family members, the disability workforce, and people working within services and connected sectors (eg, aging, employment, education, and housing), academia, and public policy. Data for the second phase will be gathered as follows: a national web-based survey a consultation process undertaken through the government and nongovernment sector and targeted consultation with Aboriginal and Torres Strait Islander people, children with disabilities and their families, people with cognitive disability, and people with complex communication needs. The third phase involves a web-based survey to develop a research agenda based on the outcomes of all phases. e have started working on 2 parts of the research prioritization exercise. Through the research-mapping exercise we identified 1241 journal articles and book chapters (referred to as i research papers /i ) and 225 publicly available reports (referred to as i research reports /i ) produced over the 2018-2020 period. Data collection for the national survey has also been completed. We received 973 fully completed responses to the survey. Analysis of these data is currently underway. his multi-method research agenda–setting study will be the first to provide an indication of the areas of health and social research that people across the Australian disability community consider should be prioritized in disability research funding decisions. Project results from all phases will be made publicly available through reports, open-access journal publications, and Easy Read documents. ERR1-10.2196/31126
Publisher: BMJ
Date: 29-03-2017
DOI: 10.1136/BMJQS-2016-006339
Abstract: Understanding a patient's hospital experience is fundamental to improving health services and policy, yet, little is known about their experiences of adverse events (AEs). This study redresses this deficit by investigating the experiences of patients in New South Wales hospitals who suffered an AE. Data linkage was used to identify a random s le of 20 000 participants in the 45 and Up Cohort Study, out of 267 153 adults aged 45 years and over, who had been hospitalised in the prior 6 months. A cross-sectional survey was administered to these patients to capture their experiences, including whether they had an AE and received honest communication about it. Of the 18 993 eligible participants, 7661 completed surveys were received (40% response rate) and 474 (7%) reported having an AE. Most AEs related to clinical processes and procedures (33%), or medications and intravenous fluids (21%). Country of birth and admission through emergency were significant predictors of the occurrence of an event. An earlier admission in the prior 6 months or a transfer to another healthcare facility was also associated with more AEs. Of those who suffered an AE, 58% reported serious or moderate effects. Given the exclusions in our s le population (under 45 years), the AE rate reported by patients of 7% is similar to the approximately 10% rate reported in the general population by retrospective medical record reviews. AE data that include patient experience may provide contextual information currently missing. Capturing and using patient experience data more effectively is critical there may be opportunities for applying co-design methodology to improve the management of AEs and be more responsive to patients' concerns.
Publisher: Inderscience Publishers
Date: 2013
Publisher: Informa UK Limited
Date: 08-08-2016
Publisher: Wiley
Date: 27-01-2023
DOI: 10.1111/SPOL.12898
Abstract: In Australia there is a significant gap in employment rates between people with disability and those without. This is in the context of general gaps in the disability sector workforce, which has been the subject of recent policy concern. Our study critically investigates (a) data on the employment of people with disability in Australian disability services (b) data on disability awareness training in disability services (c) these results in the context of the National Disability Insurance Scheme (NDIS) National Workforce Plan: 2021–2025 and the NDIS workforce Capability Framework. We undertook a mixed methods study that brought together descriptive statistics from the National Disability Services Workforce Census data and qualitative content analysis of the NDIS National Workforce Plan and the NDIS workforce Capability Framework. We found that 50% of disability service organisations employ at least one person with disability in their organisations, with 20% employing less than three people with disability. Only 24% of organisations include a person with disability on their board, and 19% of organisations employ people with disability in management positions. Policy document analysis shows policies support key areas for increasing employment of people with disability and disability inclusion. Employment of people with disability at all levels of disability services remains poor in Australia. We argue that ‘soft’ approaches to addressing low employment levels need to be supplemented by harder approaches that take full advantage of the levers available to government through the operation of the NDIS.
Publisher: Springer Science and Business Media LLC
Date: 03-05-2023
DOI: 10.1007/S00127-022-02280-4
Abstract: People with mental illness are a vulnerable and stigmatised group with poor health outcomes including greater premature mortality. This study aimed to investigate trends and rates of change in unintentional drug-related deaths for people with mental illness, describe types of medicines involved, and identify populations at risk in a cohort from New South Wales, Australia. Features of unintentional drug-related deaths for people with mental illness between 2012 and 2016 were identified in a retrospective review of data from the National Coronial Information System. A total of 495 unintentional drug-related deaths were identified (1.6 deaths/100,000 population), showing an upward trend ( p 0.01). The most common substance involved was diazepam in both genders (males 135/319, 42%, female 76/176, 43%) and more than one contributory drug was included in 80% of cases. Between 2012 and 2016, hetamine-related deaths showed the highest increase (3.2-fold), followed by codeine (2.5-fold) and quetiapine (2.5-fold). Males (RR 1.8, 95% CI 1.5–2.2) and people aged 35–44 (RR 1.7, CI 1.3–2.2) were more likely to die from unintentional drug-related deaths compared with the reference (females and people aged 25–34). This study found that the drugs commonly involved in deaths are also the drugs commonly used by and prescribed to people with mental illness. There were also significant differences between gender, age group, and marital status in the trend and rate of unintentional drug-related deaths for people with mental illness. A multifaceted approach encompassing both pharmaceutical prescribing and targeted public health messaging is required to inform intervention and prevention strategies.
Publisher: Springer Publishing Company
Date: 12-2014
Publisher: Informa UK Limited
Date: 09-2013
Publisher: BMJ
Date: 10-2014
DOI: 10.1136/BMJOPEN-2014-006599
Abstract: Evidence of patients’ experiences is fundamental to creating effective health policy and service responses, yet is missing from our knowledge of adverse events. This protocol describes explorative research redressing this significant deficit investigating the experiences of a large cohort of recently hospitalised patients aged 45 years and above in hospitals in New South Wales (NSW), Australia. The 45 and Up Study is a cohort of 265 000 adults aged 45 years and above in NSW. Patients who were hospitalised between 1 January and 30 June 2014 will be identified from this cohort using data linkage and a random s le of 20 000 invited to participate. A cross-sectional survey (including qualitative and quantitative components) will capture patients’ experiences in hospital and specifically of adverse events. Approximately 25% of respondents are likely to report experiencing an adverse event. Quantitative components will capture the nature and type of events as well as common features of patients’ experiences. Qualitative data provide contextual knowledge of their condition and care and the impact of the event on in iduals. Respondents who do not report an adverse event will report their experience in hospital and be the control group. Statistical and thematic analysis will be used to present a patient perspective of their experiences in hospital the characteristics of patients experiencing an adverse event experiences of information sharing after an event (open disclosure) and the other avenues of redress pursued. Interviews with key policymakers and a document analysis will be used to create a map of the current practice. Dissemination via a one-day workshop, peer-reviewed publications and conference presentations will enable effective clinical responses and service provision and policy responses to adverse events to be developed.
Publisher: SAGE Publications
Date: 02-2003
Publisher: CSIRO Publishing
Date: 2019
DOI: 10.1071/AH17179
Abstract: Objective Since Australia initiated national open disclosure standards in 2002, open disclosure policies have been adopted in all Australian states and territories. Yet, research evidence regarding their adoption is limited. The aim of the present study was to determine the frequency with which patients who report an adverse event had information disclosed to them about the incident, including whether they participated in a formal open disclosure process, their experiences of the process and the extent to which these align with the current New South Wales (NSW) policy. Methods A cross-sectional survey about patient experiences of disclosure associated with an adverse event was administered to a random s le of 20000 participants in the 45 and Up Study who were hospitalised in NSW, Australia, between January and June 2014. Results Of the 18993 eligible potential participants, completed surveys were obtained from 7661 (40% response rate), with 474 (7%) patients reporting an adverse event. Of those who reported an adverse event, a significant majority reported an informal or bedside disclosure (91% 430/474). Only 79 patients (17%) participated in a formal open disclosure meeting. Most informal disclosures were provided by nurses, with only 25% provided by medical practitioners. Conclusions Experiences of open disclosure may be enhanced by informing patients of their right to full disclosure in advance of or upon admission to hospital, and recognition of and support for informal or bedside disclosure for appropriate types of incidents. A review of the open disclosure guidelines in relation to the types of adverse events that require formal open disclosure and those more suitable to informal bedside disclosure is indicated. Guidelines for bedside disclosure should be drafted to assist medical practitioners and other health professionals facilitate and improve their communications about adverse events. Alignment of formal disclosure with policy requirements may also be enhanced by training multidisciplinary teams in the process. What is known about the topic? While open disclosure is required in all cases of serious adverse events, patients’ experiences are variable, and lack of, or poor quality disclosures are all too common. What does this paper add? This paper presents experiences reported by patients across New South Wales in a large cross-sectional survey. Unlike previous studies of open disclosure, recently hospitalised patients were identified and invited using data linkage with medical records. Findings suggest that most patients receive informal disclosures rather than a process that aligns with the current policy guidance. What are the implications for practitioners? Experiences of open disclosure may be enhanced by informing patients of their right to full disclosure in advance of or upon admission to hospital, and recognition of and support for informal or bedside disclosure for appropriate types of incidents.
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/AH15154
Abstract: Objective Australian mental health care remains hospital centric and fragmented it is riddled with gaps and does little to promote recovery. Reform must be built on better knowledge of the shape of existing services. Mental health atlases are an essential part of this knowledge base, enabling comparison with other regions and jurisdictions, but must be based on a rigorous classification of services. The main aim of this study is to create an integrated mental health atlas of the Western Sydney LHD in order to help decision makers to better plan informed by local evidence. Methods The standard classification system, namely the Description and Evaluation of Services and Directories in Europe for Long-term Care model, was used to describe and classify adult mental health services in the Western Sydney Local Health District (LHD). This information provided the foundation for accessibility maps and the analysis of the provision of care for people with a lived experience of mental illness in Western Sydney LHD. All this data was used to create the Integrated Mental Health Atlas of Western Sydney LHD. Results The atlas identified four major gaps in mental health care in Western Sydney LHD: (1) a lack of acute and sub-acute community residential care (2) an absence of services providing acute day care and non-acute day care (3) low availability of specific employment services for people with a lived experience of mental ill-health and (4) a lack of comprehensive data on the availability of supported housing. Conclusions The integrated mental health atlas of the Western Sydney LHD provides a tool for evidence-informed planning and critical analysis of the pattern of adult mental health care. What is known about the topic? Several reports have highlighted that the Australian mental health system is hospital based and fragmented. However, this knowledge has had little effect on actually changing the system. What does this paper add? This paper provides a critical analysis of the pattern of adult mental health care provided within the boundaries of the Western Sydney LHD using a standard, internationally validated tool to describe and classify the services. This provides a good picture of the availability of adult mental health care at the local level that was hitherto lacking. What are the implications for practitioners? The data presented herein provide a better understanding of the context in which mental health practitioners work. Managers and planners of services providing care for people with a lived experience of mental illness can use the information herein for better planning informed by local evidence.
Publisher: Informa UK Limited
Date: 02-04-2016
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/AH13173
Abstract: Objective The processes of research ethics and research governance are core to the conduct of research in health. Each aims to facilitate research that is both ethical and practical in order to produce new knowledge about the health system and improve the lives of those who use it. However, our experience has demonstrated that the process of obtaining ethical approval for a low-risk and low-resource research project was severely confounded by the multiple layers of research governance in operation at hospitals in Queensland (Qld) and New South Wales (NSW). Methods We analysed our own experience of gaining research governance approval with the aim of improving governance processes for multicentre research projects. Our project aimed to interview and survey one person at each of 57 hospitals in NSW and 18 in Qld. We recorded and compared the steps, documents and time-frame related to research governance approval at each of these research sites. Results We found that the progress of our project was significantly impeded by the multiple steps related to research governance processes in hospitals. Research governance approval took an average of 160 days in NSW and 316 in Qld. There was inconsistency between hospitals regarding documentation and significant duplication of documentation already approved through ethical review processes. The necessity for separate research contracts for all Qld research sites also added to research delays. Conclusion Based on our experiences we make recommendations about changes to research governance including clarification of responsibility, reform of areas of duplication and inconsistency, time limitations for approval and, in Qld, reform of financial and legal oversight. What is known about the topic? The implementation of the National Statement on Ethical Conduct in Human Research in 2007 has resulted in a restructuring that separates out ethics approval from research governance approval. Although in most jurisdictions single ethical review for multicentre sites has been implemented effectively as a result of these reforms, research governance approval still needs to be obtained for each separate research site. What does this paper add? The research governance approval experiences of one large-scale, ethically low-risk research project are discussed in order to draw attention to the problems associated with the disparate and time-consuming research governance processes operating as a result of this system. What are the implications for practitioners? Policy makers and research governance administrators need to urgently address the significant problems caused by the delays and inconsistencies involved in gaining approval for research conducted in public hospitals. Researchers and those working within university ethics offices who provide support for research need to be aware of the problems associated with research governance and factor this into their decisions about research budgeting and timeframes.
Publisher: Springer Singapore
Date: 2019
Publisher: Bristol University Press
Date: 05-2020
DOI: 10.1332/174426419X15700265131524
Abstract: Evidence-based policy has at its foundation a set of ideas about what makes evidence valid so that it can be trusted in the creation of policy. This validity is frequently conceptualised in terms of rigour deriving from scientific studies which adhere to highly structured processes around data collection, analysis and inscription. In comparison, the knowledge gained from lived experience, while viewed as important for ensuring that policy meets the needs of the people it is trying to serve, is characterised by its tacit nature, unstructure and difficulty in transferring from one actor to another. Validity of experiential knowledge in policy arises from the connection of policy knowledge to the lived experience of in iduals. This paper considers validity in this context through exploring four modes in which experiential knowledge is currently utilised within policy. The tensions surrounding validity in the policy context find resolution through the development of a situated notion of validity decoupled from structural rigour and recoupled to context.
Publisher: Wiley
Date: 17-04-2012
Publisher: SAGE Publications
Date: 12-2015
Abstract: Print media retains a significant role in shaping social discourses about mental health. Recent Australian studies have identified a significant social stigma and poor mental health literacy concerning anxiety disorders which prevents in iduals from seeking help. No studies to date have explored the representation of anxiety in Australian print media. Targeting this research gap, our study explores models of disability present in 83 articles specifically covering anxiety disorders and published by The Australian newspaper between 2000 and 2015. Using a critical approach to content analysis, the analysis identified the presence of established traditional and progressive media models of disability. Our analysis also identified further supplementary discourses of awareness, nature and risk, thereby extending existing models identified by Clogston (1990) and Haller (2000). These discourses can be seen to both support and challenge traditional discourses of mental ill health according to the context in which the discussion of anxiety is presented. As this study reveals an ongoing potential for newspaper discussion of anxiety to increase stigma, it is important that students, journalists and editors (where necessary) work to challenge dominant discourses which promote traditional stigmatizing discourses of mental ill health.
Publisher: Oxford University Press (OUP)
Date: 06-2012
DOI: 10.1016/J.POLSOC.2012.04.002
Abstract: The success of practitioner involvement in a policy consultation process is usually taken to be evident in the extent to which the resulting policy document is shaped by their views. Taking as its case study a public consultation for a new Scottish mental health policy, and drawing on theories of knowledge, this paper finds that for practitioner involvement in this consultation it is not possible to measure impact in this way. This is because the experiential and verbal knowledge of practitioners is not easily transferable through the different stages of the consultation process and into the final policy document. Instead, another significant effect resulting from practitioner involvement in the consultation is identified. Practitioner participation in the consultation is found to be a productive process of learning or education which produces a policy community more aware of its role in relation to the new policy.
Publisher: BMJ
Date: 21-01-2015
Publisher: Oxford University Press (OUP)
Date: 13-12-2018
DOI: 10.1093/PHE/PHX023
Publisher: Policy Press
Date: 29-04-2014
Publisher: Mary Ann Liebert Inc
Date: 09-2018
Abstract: This study aims to provide a comprehensive systematic review of the literature relating to the representation of women within video games in consideration of adult female wellbeing. The research question of the study assessed whether the representation of women in video games leads to female self-objectification and negative body image in adult women. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) review method was used comprising a thorough keyword database search, followed by literature screening and data extraction. Adult women were the focus of the study, with video games as the study exposure. Only 2 of the 22 studies directly assessed female wellbeing in relation to video game play. Results showed that women do report self-objectification and low levels of self-efficacy, as a result of exposure to objectified female content within video games, compared with participants exposed to nonobjectified content. Male and female belief in real-life female competence was jeopardized after exposure to objectified content of women within video games. Results demonstrated that female characters within video games are unevenly represented compared with male characters, with female characters mostly shown as subordinate to the male hero of the game, objectified, and hypersexualized with disproportionate body parts. The review also uncovered the propensity for men exposed to objectified and sexualized female characters within video games to hold sexist attitudes toward women in a real-life setting, and being more lenient to accept cultural rape myths.
Publisher: Springer Science and Business Media LLC
Date: 04-05-2018
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/AH17004
Abstract: Objective Partners in Recovery (PIR) is an Australian government initiative designed to provide support and service linkage for in iduals with complex needs living with severe and persistent mental illness. The aim of the present study was to examine whether consumers engaged in PIR programs in two large regions of Sydney experienced: (1) a reduction in unmet needs (either via self- or staff report) and (2) progress in their self-reported mental health recovery. Methods Unmet needs were measured using the Camberwell Assessment of Need Short Appraisal Scale and recovery was measured using the Recovery Assessment Scale – Domains and Stages. For in iduals with initial and follow-up data, paired t-tests were used to examine change over time. Results At follow-up, in iduals reported an average of two to three fewer unmet needs, and recovery scores increased by approximately 5% across each domain and the total score. At follow-up, the most common unmet needs were in the areas of ‘company’ and ‘daytime activities’. Conclusions The results of the present study suggest that PIR services in these two geographical regions have achieved positive results. In iduals with severe and persistent mental illness engaged with PIR appear to have reduced their unmet needs and enhanced their mental health recovery. What is known about the topic? PIR services were established to support in iduals with severe and persistent mental illness by creating service linkages to address unmet needs in order to facilitate recovery. Services were delivered through the new role of ‘support facilitator’. What does this paper add? By examining routinely collected outcome measures, this paper shows the success of the PIR program. In iduals engaged with PIR reported fewer unmet needs and enhanced recovery over the time they were involved with the program. However, they still faced serious challenges in building successful social interactions, such as developing friendships, and participating in meaningful activities. What are the implications for practitioners? The support facilitator role developed as part of PIR appears to be a useful method of supporting in iduals to reduce unmet needs and enhance recovery. However, further work is required to address the challenges associated with overcoming social isolation and participation in meaningful activities.
Publisher: Informa UK Limited
Date: 28-04-2016
Publisher: Informa UK Limited
Date: 16-07-2020
Start Date: 07-2023
End Date: 06-2028
Amount: $2,582,419.00
Funder: Australian Research Council
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