Training and experience of nurses in responding to alcohol misuse in rural communities.

OBJECTIVE: Alcohol misuse by farmers continues to challenge rural nurses. This article reports on the experiences of Australian nurses participating in the Alcohol Intervention Training Program (AITP). DESIGN AND SAMPLE: Qualitative interviews of 15 rural and remote nurses. MEASURES: Semi-structured phone interviews were utilized to assess the response to and implementation of the AITP-an intervention designed to build nurses' knowledge, confidence and skills when responding to alcohol misuse. It comprises practical and theoretical components and was designed for rural and remote settings where nurses encounter alcohol misuse. RESULTS: Nurses found the training provided new-or built on existing-knowledge of alcohol misuse and offered practical hands-on "real life" skills. A range of workplace and personal situations where the content of the training was now being utilized were identified, and future use anticipated. Barriers to using the new knowledge and skills included both rural and generic issues. Constructive feedback to increasingly target the training to rural settings was recommended. CONCLUSIONS: The AITP is an effective training program. It can be further tailored to meet common needs of rural and remote nurses working with farmers who misuse alcohol, while recognizing diversity in rural practice.

The Alcohol Intervention Training Program (AITP): a response to alcohol misuse in the farming community.

BACKGROUND: Farm men and women in Australia have higher levels of problematic alcohol use than their urban counterparts and experience elevated health risks associated with excessive alcohol consumption. The Sustainable Farm Families (SFF) program has worked successfully with farm men and women to address health, well- being and safety and has identified that further research and training is required to understand and address alcohol misuse behaviours. This project will add an innovative component to the program by training health professionals working with farm men and women to discuss and respond to alcohol-related physical and mental health problems. METHODS/DESIGN: A mixed method design with multi-level evaluation will be implemented following the development and delivery of a training program (The Alcohol Intervention Training Program {AITP}) for Sustainable Farm Families health professionals. Pre-, post- and follow-up surveys will be used to assess both the impact of the training on the knowledge, confidence and skills of the health professionals to work with alcohol misuse and associated problems, and the impact of the training on the attitudes, behaviour and mental health of farm men and women who participate in the SFF project. Evaluations will take a range of forms including self-rated outcome measures and interviews. DISCUSSION: The success of this project will enhance the health and well-being of a critical population, the farm men and women of Australia, by producing an evidence-based strategy to assist them to adopt more positive alcohol-related behaviours that will lead to better physical and mental health.

Higher social distress and lower psycho-social wellbeing: examining the coping capacity and health of people with hearing impairment.

PURPOSE: The objectives of this paper are as follows: (1) propose an explanatory model as to how hearing disability may impact on health and (2) examine the model's utility. METHODS: Data were collected on the psycho-social wellbeing, disability and physical health of farmers (n = 56) participating in an intervention to manage the social impacts of hearing disability. Two models were proposed and examined using multiple hierarchical linear regression. Model 1 used self-rated quality of life and model 2 used capacity to manage hearing and listening impairments, as dependent variables. RESULTS: The analyses found that physical measures of hearing impairment (audiograms) were not correlated with physical or mental health outcomes. However, in model 1, self-confidence and self-rated ability to manage hearing impairment were most closely associated with reduced quality of life (anxiety and diastolic blood pressure were positively associated with quality of life). In model 2, higher anxiety and reduced self-confidence were associated with decreasing ability to successfully manage one's hearing impairment. CONCLUSIONS: The findings support the explanatory model that stress is higher and wellbeing lower when the fit between the person's coping capacity and environmental demands is poor. IMPLICATIONS FOR REHABILITATION: This paper demonstrates that anxiety is associated with coping with the psycho-social aspects of hearing disability. This finding has important implications for the many hearing services, which only provide assessment and devices. To negate anxiety and its long-term impacts, rehabilitation providers need to ensure people with hearing disability have the capacity to manage the psycho-social aspects of communication breakdown.