Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 19 de 19
Filtrar
1.
J Interprof Care ; 38(1): 182-185, 2024 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-37428655

RESUMO

While rural health-care settings are said to be ideal places for the facilitation of interprofessional education and collaborative practice (IPECP) in students, little is known about the rural-IPECP interface. This study explored this interface through student and clinical educator experiences following implementation of a structured IPECP student placement model. Data were gathered through 11 focus groups with 34 students and 24 clinical educators. Content analysis was used to analyze data and two categories were developed for reporting. The power of place and space, highlighting the importance of flexibility, co-location, and lack of hierarchy in promoting IPECP, as well as the role of shared accommodation in enhancing social connectedness within and outside placement were highlighted. This study unpacks the characteristics of rural health-care settings that make it ideal for IPECP despite the resource constraints. Future studies can investigate the rural-IPECP interface through a patient lens.


Assuntos
Educação Interprofissional , Relações Interprofissionais , Humanos , Comportamento Cooperativo , Pesquisa Qualitativa , Grupos Focais
2.
J Interprof Care ; 38(2): 403-408, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38019125

RESUMO

We describe the establishment and operation of a student-led interprofessional chronic disease prevention and management clinic in regional Australia. Our aim was twofold. First, to report on service delivery, student placement, and health outcome data; and second, to discuss key lessons learned during the first 3½ years of clinic operations. Between July 2019 and December 2022, 146 (79.3%) clinic participants completed the 4-month program and participated in an average of 48.4 occasions of service (total 7,060). The clinic supported 1,060 clinical placement weeks across 147 health students. There was a significant improvement across health measures reported at program completion, with the largest changes observed for the 6-min walk test and preference-adjusted quality of life. Nine key challenges and lessons were identified that affected operations and service delivery, which should be of interest to healthcare teams considering establishing an interprofessional student-led clinic.


Assuntos
Relações Interprofissionais , Qualidade de Vida , Humanos , Austrália , Estudantes , Instituições de Assistência Ambulatorial
3.
Aust J Rural Health ; 31(5): 1008-1016, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37694931

RESUMO

OBJECTIVE: To investigate the impact of the COVID-19 pandemic on clinical supervision practices of health care workers in health care settings in one Australian state. METHOD: A bespoke survey was developed and administered online using Qualtrics™. The survey consisted of Likert scale and closed questions, with options for free text comments. Numerical data were analysed descriptively and using Chi-Square tests. Textual data were analysed through content analysis. RESULTS: Of the 178 survey respondents, 42% were from allied health disciplines, 39% from nursing and midwifery, and 19% from medicine. The type and mode (i.e., face-to-face, telesupervision) of clinical supervision prior to the pandemic and at the time of survey completion (i.e., July-August 2021) were similar. Eighteen percent of respondents had a change in supervision arrangements but only 5% had a change in supervisor. For the 37% who changed roles due to COVID-19, 81% felt their current supervisor was still able to support them, 69% were still having their supervisory needs met. Analyses of textual data resulted in the development of two categories: Supervision deteriorating, and some clinical supervision functions (i.e., formative and restorative) being more impacted than others (i.e., normative). CONCLUSION: There were substantial disruptions to several parameters of clinical supervision due to COVID-19, that may pose a threat to high quality supervision. Health care workers reported pandemic-induced stress and mental health challenges that were not always addressed by effective restorative supervision practices.


Assuntos
COVID-19 , Humanos , Austrália/epidemiologia , Pandemias , Preceptoria , Inquéritos e Questionários , Atitude do Pessoal de Saúde
4.
Med J Aust ; 219 Suppl 3: S14-S19, 2023 08 07.
Artigo em Inglês | MEDLINE | ID: mdl-37544003

RESUMO

University departments of rural health are Commonwealth-funded to improve recruitment and retention of the rural allied health and nursing (including midwifery) workforce, primarily through student placements. We examined publications by university departments of rural health that were focused on allied health and nursing students undertaking placements in rural Australia, to understand the characteristics, main findings and implications of the research conducted. Interprofessional learning was a key feature of placements and placement education, although other activities such as community engagement added to placement experiences. Factors such as quality supervision and being involved in the community contributed to a positive placement experience and increased rural practice intention. Tracking studies showed a relationship between rural placements, rural practice intention and rural practice. Rural placements occurred across a variety of settings and in locations consistent with the policy framework. Embedding university departments of rural health in rural communities enabled staff to build relationships and increase placement capacity.


Assuntos
Serviços de Saúde Rural , Saúde da População Rural , Humanos , Universidades , População Rural , Austrália , Estudantes
6.
PLoS One ; 18(7): e0288314, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37432963

RESUMO

INTRODUCTION: Many healthcare workers have switched from face-to-face clinical supervision to telesupervision since the onset of the COVID-19 pandemic. Given the rise in prevalence of telesupervision and continuing remote working arrangements, telesupervision is no longer only limited to rural areas. As this remains an under-investigated area, this study aimed to explore supervisor and supervisee first hand experiences of effective telesupervision. METHODS: A case study approach combining in-depth interviews of supervisors and supervisees, and document analysis of supervision documentation was used. De-identified interview data were analysed through a reflective thematic analysis approach. RESULTS: Three supervisor-supervisee pairs from occupational therapy and physiotherapy provided data. Data analysis resulted in the development of four themes: Benefits vs limitations and risks, not often a solo endeavour, importance of face-to-face contact, and characteristics of effective telesupervision. DISCUSSION: Findings of this study have confirmed that telesupervision is suited to supervisees and supervisors with specific characteristics, who can navigate the risks and limitations of this mode of clinical supervision. Healthcare organisations can ensure availability of evidence-informed training on effective telesupervision practices, as well as investigate the role of blended supervision models to mitigate some risks of telesupervision. Further studies could investigate the effectiveness of utilising additional professional support strategies that complement telesupervision, including in nursing and medicine, and ineffective telesupervision practices.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , Pandemias/prevenção & controle , Análise de Dados , Análise Documental , Documentação
7.
Aust J Rural Health ; 31(3): 484-492, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36762896

RESUMO

OBJECTIVE: To investigate student supervisor experiences of supervising students on clinical placements since the onset of the COVID-19 pandemic. BACKGROUND: Studies on the impact of COVID-19 on student clinical placements have focused largely on student reports and have been specific to individual professions or topic areas. There is a need to investigate student supervisor experiences. This study was conducted in Queensland (Australia) in four regional and rural public health services and four corresponding primary health networks. METHODS: The anonymous, mixed methods online survey, consisting of 35 questions, was administered to student supervisors from allied health, medicine, nursing and midwifery between May and August 2021. Numerical data were analysed descriptively using chi-square tests. Free-text comments were analysed using content analysis. RESULTS: Complete datasets were available for 167 respondents. Overall trends indicated perceived significant disruptions to student learning and support, plus mental health and well-being concerns for both students and supervisors. Extensive mask wearing was noted to be a barrier to building rapport, learning and teaching. Some positive impacts of the pandemic on student learning were also noted. CONCLUSIONS: This study has highlighted the perceived impact of the pandemic on supervisors' mental health, and on the mental health, learning and work readiness of students. This study provides evidence of the pandemic impacts on student clinical placements from a supervisor point of view. Findings can assist in future-proofing clinical education and ensuring that students continue to receive learning experiences of benefit to them, meeting curriculum requirements, in the event of another pandemic.


Assuntos
COVID-19 , Pandemias , Humanos , COVID-19/epidemiologia , Estudantes , Atenção à Saúde , Pessoal de Saúde
8.
J Interprof Care ; 37(5): 767-773, 2023 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-36694383

RESUMO

This unique study investigated the educational and service delivery impacts of a team-based, innovative model of interprofessional education (IPE) namely the Rural Interprofessional Education and Supervision (RIPES) model on participating students, clinical educators, and their workplaces, in rural Australian healthcare settings. Participating professions included dietetics, occupational therapy, physiotherapy, and speech pathology. Outcomes from the RIPES model were compared with regular uni-professional placement models. A multi-site, pre-post, comparative design was used. The main data collection measures included were the Students Perceptions of Interprofessional Clinical Education - Revised scale, the Interprofessional Socialization and Valuing Scale, and time-usage data. The RIPES model resulted in significant improvement in students' beliefs, behaviors, and attitudes that underpin interprofessional socialization and collaborative practice in healthcare settings. Importantly, students were able to benefit from the RIPES learning activities without compromising their contact time with patients. Clinical educators spent significantly more time in non-patient contact activities than the uni-professional group. This important work was undertaken in response to previous calls to address a gap in IPE models in rural areas. It involved students from multiple professions and universities, measured impacts on multiple stakeholders, and followed international best practice interprofessional education research recommendations.


Assuntos
Relações Interprofissionais , Terapia Ocupacional , Humanos , Austrália , Estudantes , Atenção à Saúde , Atitude do Pessoal de Saúde
9.
BMJ Open ; 12(10): e064646, 2022 10 03.
Artigo em Inglês | MEDLINE | ID: mdl-36192093

RESUMO

On a global scale, many major rural health issues have persisted for decades despite the introduction of new health interventions and public health policies. Although research efforts have generated valuable new knowledge about the aetiology of health, disease and health inequities in rural communities, rural health systems remain to be some of the most deprived and challenged in both the developing and developed world. While the reasons for this are many, a significant factor contributing to the current state of play is the pressing need for methodological innovation and relevant scientific approaches that have the capacity to support the translation of novel solutions into 'real world' rural contexts. Fortunately, complex systems approaches, which have seen an increase in popularity in the wider public health literature, could provide answers to some of the most resilient rural health problems in recent times. The purpose of this article is to promote the value and utility of a complex systems approach in rural health research. We explain the benefits of a complex systems approach and provide a background to the complexity sciences, including the main characteristics of complex systems. Two popular computational methods are described. The next step for rural health research involves exploring how a complex systems approach can help with the identification and evaluation of new and existing solutions to policy-resistant rural health issues. This includes generating awareness around the analytical trade-offs that occur between the use of traditional scientific methods and complex systems approaches.


Assuntos
Saúde da População Rural , População Rural , Humanos , Análise de Sistemas
10.
Artigo em Inglês | MEDLINE | ID: mdl-36078449

RESUMO

Interprofessional student placements can not only cater to the added pressures on student placement numbers but can also enhance the work readiness of new graduates. For rural areas, there is a potential for interprofessional student placements to attract the future healthcare workforce. However, tried and tested models of interprofessional placements in rural areas backed up by rigorous evaluation, remain scarce. The Rural Interprofessional Education and Supervision (RIPES) model was developed, implemented, and evaluated across four rural health services in Queensland to address this gap. Students from two or more professions undertook concurrent placements at RIPES sites, with a placement overlap period of at least five weeks. Eleven focus groups (n = 58) with clinical educators (CEs) and students were conducted to explore student and clinical educator experiences and perspectives. Content analysis of focus group data resulted in the development of the following categories: value of the RIPES placement model, unintended benefits to CEs, work units and rural areas, tension between uni-professional and IPE components, and sustainability considerations. Students and CEs alike valued the learning which arose from participation in the model and the positive flow-on effects to both patient care and work units. This unique study was undertaken in response to previous calls to address a gap in interprofessional education models in rural areas. It involved students from multiple professions and universities, explored perspectives and experiences from multiple stakeholders, and followed international best practice interprofessional education research recommendations. Findings can inform the future use and sustainability of the RIPES model.


Assuntos
Educação Interprofissional , Serviços de Saúde Rural , Pessoal de Saúde/educação , Humanos , Relações Interprofissionais , Estudantes , Universidades
11.
Artigo em Inglês | MEDLINE | ID: mdl-35564949

RESUMO

The COVID-19 pandemic has caused significant disruptions to healthcare student placements worldwide, including already challenged rural areas in Australia. While accounts are emerging of student experiences in larger centers and from a student perspective, there is a need for in-depth exploration of student supervisor experiences in rural areas at the onset of the pandemic. This study aims to address this gap through 23 individual, semi-structured interviews with healthcare workers from ten health professions who were either direct student supervisors or in roles supporting student supervisors A reflexive thematic analysis approach was used to develop four themes, namely compounding stress, negative impacts on student learning, opportunity to flex and innovate, and targeted transitioning support strategies. The findings indicate that healthcare workers with student supervision responsibilities at the onset of the pandemic experienced high levels of stress and wellbeing concerns. This study sheds light on the importance of supporting student supervisors in rural areas, and the need for implementing targeted support strategies for new graduates whose placements were impacted by the pandemic. This is not only essential for supporting the rural healthcare workforce but is also imperative for addressing inequalities to healthcare access experienced in rural communities.


Assuntos
COVID-19 , Serviços de Saúde Rural , COVID-19/epidemiologia , Atenção à Saúde , Humanos , Pandemias , Preceptoria , População Rural , Estudantes
12.
Int J Qual Health Care ; 34(2)2022 Apr 28.
Artigo em Inglês | MEDLINE | ID: mdl-35425977

RESUMO

The importance of clinical supervision, a professional support and clinical governance mechanism, to patients, healthcare workers and organizations has been well documented. Clinical supervision has been shown to support healthcare workers during challenging times, by reducing burnout, enhancing mental health and wellbeing at work, and improving job satisfaction. However, clinical supervision participation and effectiveness are pre-requisites for realising these benefits. During times of stress and increased workloads (e.g. during the Coronavirus pandemic), healthcare workers tend to prioritise clinical duties and responsibilities over clinical supervision. Effective supervision practices can be restored, and healthcare workers can be better supported in their roles during and in the post-pandemic period only if healthcare workers, policy makers, healthcare organizations, clinical supervision trainers and researchers join forces. This paper sheds light on this important topic and offers a number of practical recommendations to reboot effective clinical supervision practices at the point of care.


Assuntos
COVID-19 , COVID-19/epidemiologia , Pessoal de Saúde/psicologia , Humanos , Pandemias , Preceptoria , SARS-CoV-2
13.
Aust J Rural Health ; 30(2): 197-207, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35103353

RESUMO

OBJECTIVE: To investigate students' perceptions of the impact of coronavirus SARS-CoV-2 on rural and remote placements facilitated by 16 University Departments of Rural Health in Australia in 2020. DESIGN: A mixed-method design comprising an online survey and semi-structured interviews. SETTING: Australia. PARTICIPANTS: Allied health, nursing and medical students with a planned University Departments of Rural Health-facilitated rural or remote placement between February and October 2020. INTERVENTION: A planned rural or remote placement in 2020 facilitated by a University Departments of Rural Health, regardless of placement outcome. MAIN OUTCOME MEASURES: Questionnaire included placement outcome (completed or not), discipline of study (nursing, allied health, medicine), and Likert measures of impact to placement (including supervision, placement tasks, location, accommodation, client contact and student learning) and placement experience (overall, support, supervision, university support). Semi-structured interviews asked about placement planning, outcome, decisions, experience and student perceptions. RESULTS: While coronavirus SARS-CoV-2 reportedly impacted on the majority of planned placements, most students (80%) were able to complete their University Departments of Rural Health-facilitated placement in some form and were satisfied with their placement experience. Common placement changes included changes to tasks, setting, supervisors and location. Allied health students were significantly more likely to indicate that their placement had been impacted and also felt more supported by supervisors and universities than nursing students. Interview participants expressed concerns regarding the potential impact of cancelled and adapted placements on graduation and future employment. CONCLUSIONS: The coronavirus SARS-CoV-2 pandemic was reported to impact the majority of University Departments of Rural Health-facilitated rural and remote placements in 2020. Fortunately, most students were able to continue to undertake a rural or remote placement in some form and were largely satisfied with their placement experience. Students were concerned about their lack of clinical learning and graduating on time with adequate clinical competence.


Assuntos
COVID-19 , Serviços de Saúde Rural , Estudantes de Medicina , Austrália , Humanos , Área de Atuação Profissional , SARS-CoV-2
14.
Aust J Rural Health ; 30(3): 352-362, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35122463

RESUMO

OBJECTIVE: To investigate coronavirus disease 2019 community transmission concerns and adherence to social distancing and hygiene practices across metropolitan, regional, rural and remote areas in Australia. DESIGN: Cross-sectional online survey of Australian adults conducted between April and May 2020 through convenience snowball sampling. SETTING: A range of locations across all states and territories of Australia. PARTICIPANTS: Six hundred and seventy-seven Australian adults, of which 78.8% lived outside of a metropolitan area. MAIN OUTCOME MEASURES: Perceived threat of coronavirus disease 2019; social distancing guidelines and adherence; infection concerns; hygiene practices; frequency of leaving the house; impact of coronavirus disease 2019 on day-to-day life. RESULTS: Almost all respondents perceived the threat of the coronavirus disease 2019 pandemic was serious. There were high levels of support for the Australian Government's social distancing guidelines, although the perception that social distancing guidelines in participants' communities were 'too strict' increased with remoteness area classification. Most respondents reported adherence with Australian Government social distancing guidelines. There was an association between remoteness and risk perception, with non-metropolitan respondents more likely to feel safe when leaving the house. However, there was no association between geographical remoteness and self-reported adherence with Australian Government social distancing guidelines. CONCLUSIONS: This study provides an important initial insight into Australian perceptions and behaviours relating to the coronavirus disease 2019 pandemic, and how perceptions and behaviours varied by geographical remoteness. The geographical remoteness of communities should be considered by policy makers to ensure effective communication with the Australian public regarding coronavirus disease 2019 and ongoing adherence with preventative health behaviours.


Assuntos
COVID-19 , Pandemias , Adulto , Austrália/epidemiologia , COVID-19/epidemiologia , Estudos Transversais , Humanos , Pandemias/prevenção & controle , População Rural , Inquéritos e Questionários
15.
Artigo em Inglês | MEDLINE | ID: mdl-34769921

RESUMO

This national study investigated the positives reported by residents experiencing the large-scale public health measures instituted in Australia to manage the first wave of the COVID-19 pandemic in 2020. Most Australians had not previously experienced the traditional public health measures used (social distancing, hand hygiene and restriction of movement) and which could potentially impact negatively on mental well-being. The research design included qualitative semi-structured phone interviews where participants described their early pandemic experiences. Data analysis used a rapid identification of themes technique, well-suited to large-scale qualitative research. The ninety participants (mean age 48 years; 70 women) were distributed nationally. Analysis revealed five themes linked with mental well-being and the concept of silver linings: safety and security, gratitude and appreciation, social cohesion and connections, and opportunities to reset priorities and resilience. Participants demonstrated support for the public health measures and evidence of individual and community resilience. They were cognisant of positives despite personal curtailment and negative impacts of public health directives. Stories of hope, strength, and acceptance, innovative connections with others and focusing on priorities and opportunities within the hardship were important strategies that others could use in managing adversity.


Assuntos
COVID-19 , Pandemias , Austrália/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Saúde Pública , SARS-CoV-2
16.
Artigo em Inglês | MEDLINE | ID: mdl-34682432

RESUMO

Changes in health-seeking behaviours and challenges in accessing care have been reported during the COVID-19 pandemic. This qualitative study examines Australian experiences related to healthcare access during the early months of the pandemic. The study aimed to identify key areas of concern as well as opportunities for services to prevent, manage and treat health concerns when normal access was disrupted. Fifty-nine semi-structured interviews were analysed. Participants were interviewed between August and December in 2020 over telephone or Zoom and were located across Australia. Rapid identification of themes with an audio recordings technique was used to generate themes from the data. Participants described a variety of influences on their health-seeking behaviours, resulting in decisions to delay care or being unable to reach care. Many individuals accessed health services via telehealth and offered a range of perceptions and views on its effectiveness and appropriateness. The findings illustrate that maintenance of health and access to healthcare and psychosocial support were compromised for some individuals, leading to negative impacts on both mental and physical health. This highlights the need to provide mechanisms to facilitate a person's ability to access care in a timely manner during a pandemic.


Assuntos
COVID-19 , Pandemias , Austrália/epidemiologia , Acessibilidade aos Serviços de Saúde , Humanos , SARS-CoV-2
17.
Artigo em Inglês | MEDLINE | ID: mdl-34068044

RESUMO

Evidence is mounting regarding the positive effects of Interprofessional Education and Collaborative Practice (IPECP) on healthcare outcomes. Despite this, IPECP is only in its infancy in several Australian rural healthcare settings. Whilst some rural healthcare teams have successfully adopted an interprofessional model of service delivery, information is scarce on the factors that have enabled or hindered such a transition. Using a combination of team surveys and individual semi-structured team member interviews, data were collected on the enablers of and barriers to IPECP implementation in rural health settings in one Australian state. Using thematic analysis, three themes were developed from the interview data: IPECP remains a black box; drivers at the system level; and the power of an individual to make or break IPECP. Several recommendations have been provided to inform teams transitioning from multi-disciplinary to interprofessional models of service delivery.


Assuntos
Comportamento Cooperativo , Relações Interprofissionais , Austrália , Educação Interprofissional , Equipe de Assistência ao Paciente , Saúde da População Rural
19.
Int J Qual Methods ; 20: 16094069211051937, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-35185444

RESUMO

Australia responded to the emergence of the COVID-19 global pandemic in 2020 by initiating a border and bio-security zone lockdown and policies emphasising social distancing and hand hygiene. To understand the public response to this, Southern Queensland Rural Health commenced a two-phase research project exploring attitudes and practices towards the COVID-19 pandemic in Australia. An initial online survey foreshadowed 90 qualitative interviews with respondents to explore what the pandemic meant for everyday life. This paper details use of a qualitative approach by a national collaborative of investigators from 9 rural university departments in Australia who came together to research the qualitative phase of the project. Our methodological approach aligned with extant literature describing the management of large-scale interviewing and coding in the context of unfolding and dynamic contexts. The 'RITA' model (Rapid Identification of Themes from Audio recordings) entails a five-step process designed to progress from identifying research foci, through deductive and iterative coding to identify key concepts. We used a combination of coding templates, organisation and tagging of field notes and real-time sharing through a secure cloud drive to create a data set for immersive analysis and generation of ideas. Use of this method has added to the collective knowledge about successful rapid research investigations, recognising the inherent tension between speed and rigour. This is not a binary but a dialectic; trustworthiness is integral to qualitative research. However, use of fresh approaches is accommodated by new technologies and can preserve adequate rigour while enabling collaboration, research capacity building and increasing the pace of data collection and analysis. This project has presented methodological challenges and highlights some strengths of such an approach. It is hoped that reporting our approach and experiences is useful for the broader health and research community considering large-scale qualitative research.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA