ORCID Profile
0000-0002-0602-0702
Current Organisation
National Ageing Research Institute
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Publisher: Wiley
Date: 14-03-2019
DOI: 10.1111/AJAG.12639
Abstract: There are many studies investigating implementation of advance care planning (ACP) in aged care around the world, but few studies have investigated Australian settings. The objective of this study was to determine facilitators and barriers to implementation of ACP in Australian residential and community aged care. Evidence from Australian studies published between 2007 and September 2017 of ACP in residential and community aged care was sourced from electronic databases using predetermined search strategies. Data were extracted and synthesised using thematic analysis, and summarised according to themes. Nine studies described facilitators and barriers of ACP implementation. Six themes were identified: "Education and Knowledge," "Skills and Training," "Procedures and Resources," "Perceptions and Culture," "Legislation" and "Systems." A whole of systems approach is necessary to facilitate uptake of ACP in residential aged care settings. More research is needed to understand facilitators and barriers to ACP in community aged care.
Publisher: Springer Science and Business Media LLC
Date: 12-05-2021
DOI: 10.1186/S12877-021-02233-7
Abstract: This protocol describes an ongoing study of the impact of befriending on depression, anxiety and loneliness in older people living in residential aged care facilities in Australia. While systematic reviews of befriending have indicated positive benefits of befriending for people in a range of ages and settings, there have been no randomised controlled trials (RCTs) of befriending for older people living in residential aged care with depression and no studies of the cost effectiveness of befriending in residential aged care facilities (RACFs) in Australia. We are conducting a single blind pragmatic RCT comparing two groups of older people living in RACFs, one receiving an intervention consisting of weekly befriending for 4 months from a trained volunteer and the other receiving treatment as usual. Participants undergo eligibility screening for depression (GDS-15 ≥ 4) and cognitive impairment (GPCog ≥ 4) and assessments at three measurement time points: baseline prior to randomisation, 2 months post-baseline and 4 months post-baseline. The primary outcome measure is depression, and secondary outcome measures are anxiety, loneliness, social isolation and quality of life. The economic evaluation will take the form of a cost-utility analysis based on the outcome of quality of life. The primary and secondary outcomes will be analysed using negative binomial and logistic regressions utilizing the Generalised Estimating Equations approach. To our knowledge, this is the first RCT evaluating the effectiveness of befriending on older people with depression living in residential aged care. It is expected that the befriending intervention will reduce the severity of depression symptoms experienced by older people living in residential aged care. If the intervention proves effective it may be incorporated into volunteer training programs and adopted as a way of supporting older people’s mental health. Trial registered with the Australian and New Zealand Clinical Trial Registry (ANZCTR) Number: ACTRN12619000676112 , registered 06/05/2019 – retrospectively registered.
Publisher: Wiley
Date: 21-06-2010
DOI: 10.1111/J.1365-2516.2010.02200.X
Abstract: The main focus of lower limb physical performance assessment in people with haemophilia (PWH) has usually been on function, muscle strength and joint flexibility. The impact of haemophilic arthropathy on balance and falls risk is relatively under-explored. The aim of this study was to evaluate balance and related performance in PWH compared with age and gender matched healthy controls. It involved a comprehensive suite of clinical and laboratory measures of static and dynamic balance, mobility, strength, physical activity and falls efficacy completed in 20 PWH (mean age 39.4, 100% male) and 20 controls. Fifty percent of PWH reported falls in the past 12 months. Moderate impairment of balance and related measures were identified in PWH compared with the controls, with an average 35% difference between groups. Significant differences were evident between groups on both clinical and laboratory measures, including measures of dynamic bilateral stance balance [limits of stability measures on the laboratory test, functional reach (P < 0.001) dynamic single leg balance (Step Test, P < 0.001)], gait and mobility (gait speed, step width and turning measures on the laboratory test, timed up and go test P < 0.001) muscle strength (timed sit to stand, P = 0.002 quadriceps strength, P < 0.001) and activity level and falls efficacy, (P < 0.004). The dynamic clinical and laboratory measures testing similar domains of balance, gait and mobility had moderate correlations (0.310 < r < 0.531, P < 0.01). Moderate impairments in balance, mobility and related measures were identified in PWH, compared with the control group. Clinicians should include assessments of balance and related measures when reviewing adults with haemophilia.
Publisher: Elsevier BV
Date: 2012
DOI: 10.1016/J.GERINURSE.2011.11.002
Abstract: For residents in long-term care facilities, falling is a major concern requiring preventive intervention. A prospective cohort study measured the impact of falls reduction following the implementation of evidence-based fall prevention interventions in 9 Australian residential care facilities. An external project team provided a comprehensive audit of current practice. Facilitated by an action research approach, interventions were in idualized to be facility- and patient-specific and included the following: environmental modifications such as low beds and height-adjustable chairs, movement alarms, hazard removal, and hip protectors. Participants included 670 residents and 650 staff from 9 facilities across 3 states. A significant reduction of falls were observed per site in the proportion of fallers (P = .044) and single fallers (P = .04). However, overall the number of falls was confounded by multiple falls in residents. Reduction in fallers was sustained in the 6-month follow-up phase. Positive outcomes from interventions varied between facilities. Further research is necessary to target frequent fallers.
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/AH17056
Abstract: The number of older people in the population is increasing faster than for any other age group. This population growth, while positive, is associated with increasing incidence of chronic and progressive diseases such as dementia. This requires older people to navigate services that may not be designed to meet their needs. This issue can be further lified in culturally and linguistically erse populations who often have limited English language proficiency and limited knowledge of diseases such as dementia. Health literacy, a person’s ability to access, understand, appraise and apply information about their health and health care, including navigating health services, is low among older people and even lower among older people born overseas. This paper describes findings from a recent research study which developed and used the Cultural Exchange Model. The model is based on a process of collaboration, whereby researchers, service providers and community members work together to build evidence about a particular topic, in this case dementia. The study demonstrated that the Cultural Exchange Model facilitates opportunities for researchers, health professionals, community workers and carers to improve their knowledge of conditions such as dementia and rapidly translate evidence into practice. It also showed that it is possible to recruit, engage and generate new knowledge within populations that are traditionally excluded from research but have high prevalence of dementia. This study shows health literacy is an evolving process. Access to ongoing education for professionals, not only of the clinical condition and the service system, but also the cultural elements of the communities they are working with, requires consideration. What is known about the topic? We know there is limited health literacy among older people and among older people from culturally and linguistically erse (CALD) backgrounds. We also know that the older CALD population is increasing rapidly and with that comes increased chronic illness and chronic diseases, including mental health issues and dementia. What does this paper add? This case study has added to the knowledge base in relation to health literacy and older people from CALD backgrounds. The use of the Cultural Exchange Model is documented in terms of how it enhances our improved understanding of both the barriers and enablers older Chinese and Vietnamese people with dementia face when seeking help. This paper highlights key findings from a study, which could be used by researchers and practitioners when working with older people from CALD backgrounds more broadly. What are the implications for practitioners? This paper highlights findings from research that has reinforced that health literacy is an evolving process. It requires professionals to recognise the gaps in their own understanding of conditions such as dementia and understand how these gaps might influence help-seeking behaviours of older people and their carers. Access to ongoing education of clinical conditions and the service system is required, but also the cultural elements of the communities they are working with should be considered.
Publisher: Cambridge University Press (CUP)
Date: 29-04-2013
DOI: 10.1017/S1041610213000471
Abstract: Background: Health services are encouraged to adopt a strong person-centered approach to the provision of care and services for older people. The aim of this project was to establish a user-friendly, psychometrically valid, and reliable measure of healthcare staff's practice, attitudes, and beliefs regarding person-centered healthcare. Methods: Item reduction (factor analysis) of a previously developed “benchmarking person-centred care” survey, followed by psychometric evaluations of the internal consistency reliability and construct validity, was conducted. The initial survey was completed by 1,428 healthcare staff from 17 health services across Victoria, Australia. Results: After removing 17 items from the previously developed “benchmarking person-centred care” survey, the revised 31-item survey (Person-Centred Health Care for Older Adults Survey) attained eight factors that explain 62.7% of the total variance with a Cronbach's α coefficient of 0.91, indicating excellent internal consistency. Expert consultation confirmed that the revised survey had content validity. Conclusions: The results indicated that the Person-Centred Health Care for Older Adults Survey is a user-friendly, psychometrically valid, and reliable measure of staff perceptions of person-centered healthcare for use in hospital settings.
Publisher: Informa UK Limited
Date: 02-2016
DOI: 10.2147/COPD.S100859
Publisher: British Medical Journal Publishing Group
Date: 12-2019
Publisher: Informa UK Limited
Date: 2007
DOI: 10.1080/09638280600902760
Abstract: This paper compares the service models of three different types of rehabilitation programmes provided in Victoria, Australia: One hospital-based and two types of rehabilitation in the home (RITH). Nine focus group interviews were conducted with multidisciplinary staff working in rehabilitation teams in one hospital-based and eight RITH programmes. Additional data were collected for 164 clients and 75 carers from eight of these programmes at admission, discharge and three months post discharge. Interviews were conducted with 32 clients and 14 carers. The criteria for admission and model of rehabilitation adopted in the three programmes were similar. There were differences in programme aims, characteristics of the clients admitted and the type and level of therapy clients received, both between hospital and home-based programmes and between the three programmes. In general, staff and clients saw the home as providing a relevant context that enabled in idualized, goal directed therapy for medically stable rehabilitation clients. The hospital offered an opportunity to socialize with others and specialized equipment. Results of this study suggest clients and carers require a mix of hospital and home-based rehabilitation that is able to respond to their needs and preferences at each phase of the rehabilitation continuum.
Publisher: Wiley
Date: 22-05-2017
DOI: 10.1111/BJHP.12245
Publisher: Informa UK Limited
Date: 26-09-2022
DOI: 10.1080/07317115.2022.2126809
Abstract: Depression and cognitive impairment are disabling conditions that commonly occur together in older adults. The interaction is challenging when choosing appropriate measurement scales. This review aimed to summarize the scales to measure depression symptoms in older people with cognitive impairment, investigating how cognitive impairment is related to the choice of measurement, and how the setting may affect the choice of measurement. A scoping review of literature published between 2015 and 2021. After screening 1580 articles, 26 were included in the review with 11 different measures of depression symptoms identified. The measures mostly commonly used were the Geriatric Depression Scale (GDS), Cornell Scale for Depression in Dementia (CSDD) and the Neuropsychiatric Inventory (NPI-Q). Most studies did not report on the usability of depression scales used with people with cognitive impairment and only two scales (CSDD and NPI-Q, not GDS) have been validated for use with this population. Severe cognitive impairment was under-represented in the identified studies, and no association was detected between study setting, cognitive impairment and type of measure used. Clinicians and researchers should consider both the cognitive status of participants and the setting they live in when choosing a measure of depression symptoms.
Publisher: Human Kinetics
Date: 07-2007
Abstract: This study evaluated health benefits of a supported physical activity program for 116 older carers (mean age 64.4 [ SD = 7.9], 85% women). Participants undertook a 6-month center-based physical activity program (strength training, yoga, or Tai Chi). Eighty-eight participants (76%) completed the program. Multivariate repeated-measures ANOVA identified overall significant improvement postint-ervention ( p = .004). Univariate analyses revealed significant improvements for balance, strength, gait endurance, depression, and SF-36 (physical component p .05). There was no change in the Zarit Carer Burden Scale ( p .05). Change in performance scores did not differ significantly between those with higher and lower attendance at classes, although there was significantly greater improvement in gait endurance and balance ( p .05) in those attending classes run twice weekly than in those attending once-weekly classes. In conclusion, a carer physical activity program, providing additional carer support to facilitate participation, can achieve high levels of involvement by carers and significant health benefits.
Publisher: Informa UK Limited
Date: 10-02-2017
Publisher: Wiley
Date: 29-12-2010
DOI: 10.1111/J.1365-2516.2009.02110.X
Abstract: Adults with haemophilia and other bleeding disorders often develop lower limb musculoskeletal problems associated with bleeds into joints and muscles, which may affect balance performance and increase likelihood of falling. The aim of this study was to evaluate the effectiveness of an in idualized balance and strength home exercise programme on improving balance and related outcomes for adults with haemophilia and other bleeding disorders. Twenty male adults with haemophilia and other bleeding disorders (mean age 39.4 years, 95% CI = 33.7-45.1) were recruited to participate. They underwent a comprehensive clinical and force platform assessment of balance and related measures. Based on assessment findings, the assessing physiotherapist provided an in idualized home exercise programme of balance, strengthening and walking exercises. Re-assessment occurred after the 4-month exercise programme. Twelve participants (60%) completed the programme and were re-assessed. There were no safety problems or dropouts associated with the exercise programme aggravating joint status. Although there were no statistically significant changes in any of the measures (adjusted for multiple comparisons), there were improvements of between 5% and 22% on 10 of the 16 measures, with the Neurocom modified Clinical Test of Sensory Interaction on Balance (P = 0.036) and Timed Sit to Stand (P = 0.064) approaching significance. A tailored home exercise programme targeting balance, strengthening and walking is feasible for adults with haemophilia and other bleeding disorders. These results suggest that positive physical outcomes including improved balance and mobility may be achieved with this type of programme.
Publisher: Informa UK Limited
Date: 06-01-2021
No related grants have been discovered for Marcia Fearn.