Bullying in Fly-In-Fly-Out employees in the Australian resources sector: A cross-sectional study.

BACKGROUND: Workplace bullying has diverse consequences at both the organisational and individual level. Anecdotal reports indicate that workplace bullying is an issue of particular concern for Australian FIFO workers, which may impact on psychosocial distress. However, no prior studies have examined this issue empirically in a FIFO worker cohort. METHODS AND MATERIALS: A cross-sectional survey study design was used to establish the prevalence of bullying in Australian FIFO, antecedents of bullying, and its association with psychosocial distress. Responses were received from 580 FIFO workers in the Australian resources sector. Primary outcome measures were Negative Acts Questionnaire-Revised, Beck Depression Inventory II, and Beck Hopelessness Scale. Logistic regression models were constructed to examine the association between bullying, suicide risk, and clinical depression. RESULTS: Over half of the respondents experienced workplace bullying (55.7%), and about one-third reported moderate or more severe depression (32.3%). Being above the median age (OR = 0.51; 95% CI = 0.31-0.83) and having a supervisor who failed to promote collaboration (OR = 3.04; 95% CI = 1.84-5.04) were both significantly associated with experiencing bullying. Bullying was associated with an almost threefold increase in the likelihood of participants reporting increased suicide risk (OR = 2.70; 95% CI = 1.53-4.76). Bullying was also associated with participants being almost two and a half times more likely to report clinical depression (OR = 2.38; 95% CI = 1.40-4.05). CONCLUSION: The incidence of bullying in Australian FIFO workers has reached alarming proportions. Bullying was significantly associated with higher levels of clinical depression and suicide risk. The results highlight the need to implement in the Australian resource sector interventions that reduce workplace bullying.

Australian mental health caregiver burden: a smallest space analysis.

OBJECTIVES: To explore Australian mental health carers' prioritisation of key elements of caregiving and establish the extent to which particular issues contribute to carer burden. DESIGN: Cross-sectional survey. SETTING: All Australian States and Territories. PARTICIPANTS: Responses were received from 231 Australian mental health caregivers. MAIN OUTCOME MEASURES: The Involvement Evaluation Questionnaire was used to assess caregiver burden. RESULTS: Smallest space analysis identified three distinct regions, which we conceptualise as: 1) promoting the safety and health of mental health consumers; 2) impact of caring on caregivers' personal lives and 3) enabling daily living functional recovery of mental health consumers. The analysis demonstrates that carers are most concerned with enabling daily living functional recovery, for which the mean value was considerably higher than the personal impact and promoting safety and health regions. In terms of the individual questionnaire items, the issues of most importance are assisting with self-care, worrying about consumers' future, finances and general health, encouraging consumer involvement in activities and concerns over the treatment consumers are receiving. CONCLUSION: Caregiving often came at significant personal cost. The burden that results from caring for mental health consumers could perhaps be alleviated through the expansion of psychiatric disability services, increasing government financial support and providing tailored psychosocial interventions that meet the needs of families.

Revisiting the Pain Resource Nurse Role in Sustaining Evidence-Based Practice Changes for Pain Assessment and Management.

BACKGROUND: Effective pain management is unlikely to occur without consistent and timely assessments. To improve assessment and management of pain, ward-based pain resource nurses were introduced in 2007 to facilitate hospital-wide evidence-based practice changes using three key targets. One-year post implementation of this quality improvement project, promising results were revealed. AIMS: The purpose of this study, 8 years post implementation, was to (a) evaluate sustained practice improvements in pain assessment and management, (b) assess current pain resource nurse knowledge and attitudes to pain, (c) explore characteristics of the pain resource nurse role, as well as (d) any perceived contextual changes regarding study findings. METHODS: A mixed-methods approach was used to address study aims. Quantitative data were collected from documentation audits and a "Knowledge and Attitudes Survey Regarding Pain." Qualitative interviews explored the characteristics of the pain resource nurse role, and a focus group discussion explored the context of change. RESULTS: Significant improvements were observed for the documentation of pain scores on admission and for each nursing shift. Survey results highlighted potential knowledge deficits in key practice areas, even though interview findings suggested that pain resource nurses provided a resource for peers, raised awareness of best practice, and imparted knowledge to other ward staff. An important facilitator for the pain resource nurse role was the ongoing collaboration and support from specific pain teams, and barriers to engage in the role were competing workload priorities, and limited awareness among other ward staff. LINKING EVIDENCE TO ACTION: Implementing and sustaining evidence-based practice change in clinical practice is challenging. Ongoing evaluation is necessary for identifying the long-term implications of practice improvement interventions and issues that influence the adoption of evidence-based practice. Strategies to address barriers, and to increase awareness and engagement of the pain resource nurse role with wider collaboration require further investigation.

Antipsychotic medication side effect assessment tools: A systematic review.

OBJECTIVE: The aim of this systematic review was to critically appraise the psychometric properties of antipsychotic medication side effect assessment tools. METHODS: Systematic searches were undertaken in PubMed, CINAHL and CENTRAL from inception to October 2014. Studies were included if they detailed the evaluation of psychometric properties of antipsychotic medication side effect assessment tools in mental health populations. Studies were excluded if they examined the use of antipsychotic medication side effect assessment tools in non-mental health populations, including people suffering from dementia, Parkinsonism and Alzheimer's. Narrative reviews and studies published in any language other than English were also excluded. RESULTS: Content validity was appropriately established for only one of the tools, reliability was inappropriately evaluated for all but one tool, and the assessment of responsiveness was not acceptable for any tool. CONCLUSION: Further psychometric studies are warranted to consolidate the psychometric properties of the included antipsychotic medication side effect assessment tools before any of these tools can be confidently recommended for either research or clinical purposes.

Student performance on practical gross anatomy examinations is not affected by assessment modality.

Anatomical education is becoming modernized, not only in its teaching and learning, but also in its assessment formats. Traditional "steeplechase" examinations are being replaced with online gross anatomy examinations. The aims of this study were to: (1) determine if online anatomy practical examinations are equivalent to traditional anatomy practical examinations; and (2) to examine if students' perceptions of the online or laboratory testing environments influenced their performance on the examinations. In phase one, 10 third-year students were interviewed to generate perception items to which five anatomy lecturers assigned content validity. In phase two, students' gross anatomical knowledge was assessed by examinations in two modes and their perceptions were examined using the devised survey instrument. Forty-five second-year chiropractic students voluntarily participated in Phase Two. The two randomly allocated groups completed the examinations in a sequential cross-over manner. Student performance on the gross anatomy examination was not different between traditional "steeplechase" (mean ± standard deviation (SD): 69 ± 11%) and online (68 ± 15%) modes. The majority of students (87%) agreed that they felt comfortable using computers for gross anatomy examinations. However, fewer students found it easy to orientate images of cadaver specimens online. The majority of students (85%) agreed that they felt comfortable working with cadavers but there was less agreement on the effect of moving around the laboratory during practical examinations. This data will allow anatomists to confidently implement online assessments without fear of jeopardizing academic rigor or student performance.

Perspectives of Indigenous people in the Pilbara about the delivery of healthcare services.

AIM: To identify Indigenous people's views about gaps and practical solutions for the delivery of healthcare services in the Pilbara. METHODS: A structured guide was used to interview three Indigenous language groups from the Pilbara region of Western Australia. The responses were analysed with the use of content analysis. In the first stage, codes were developed by assigning names to small sections of the interview transcripts. Next, the most salient incisive codes were identified and developed into themes that captured the most important issues. RESULTS: Many respondents said that there were insufficient health professionals near country, which was compounded by a lack of adequate transport to reach healthcare services. Moreover, respondents commonly indicated that they would be unable to secure adequate accommodation for themselves and any carer when needing to leave country to undergo medical care. The importance of secondary healthcare interventions was highlighted, particularly health promotion initiatives that improved diet and exercise levels and reduced substance abuse. Assuming responsibility for one's own health was seen as integral to improving the overall health of communities. The respondents saw role models as the most important influence in leading people to take responsibility for improving their own health. CONCLUSION: This study provides Indigenous perspectives about gaps and solutions in healthcare service delivery in the Pilbara region of Western Australia. Although initiatives have commenced to address the shortfall in health professionals and inadequate transport to healthcare, there are still gaps in service provision. Mobile health services were strongly supported as an integral measure to address these gaps. WHAT IS KNOWN ABOUT THIS TOPIC? About two out of every three Indigenous adults in the Pilbara experience a chronic health condition. Moreover, compared with non-Indigenous people in the region, Indigenous people experience a significantly higher mortality rate for numerous chronic health conditions. Although some information is available about the provision of health services for Indigenous people in the Pilbara, little is known about Indigenous people's perspectives about its adequacy or how it should be delivered. WHAT DOES THIS PAPER ADD? This study details three local language groups' views about the gaps and solutions to delivery of healthcare for Indigenous people in the Pilbara. It highlights the need for secondary healthcare interventions given difficulties around providing adequate primary care in remote settings. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? Health promotion initiatives need to be prioritised to improve the health of Australian Indigenous people in the Pilbara and the initiatives should be delivered with the involvement of the local communities. Innovative solutions are required to improve the continuity of healthcare in the Pilbara, including increased use of mobile services.

Health professionals' views on Indigenous Health and the delivery of healthcare services in the Pilbara.

PURPOSE: To explore health professionals' views about Australian Indigenous people's health and the delivery of healthcare to them in the Pilbara region of Western Australia. METHODS: An open-ended questionnaire was used to gather information from health professionals located across diverse regions in the Pilbara. The responses were analysed with the use of thematic analysis. In the first stage, codes were developed by assigning names to small sections of the interview transcripts. Next, the most salient incisive codes were identified and developed into themes that captured the most important issues. FINDINGS: Twenty-eight health professionals indicated that the most important health issues were chronic diseases, substance abuse and ear disease. These health issues were often attributed to a cycle of poor health perpetuated throughout generations. Educational initiatives were thought to be integral to intervening in this cycle. Of particular importance in improving the effectiveness of educational initiatives was facilitating the participation of Australian Indigenous peoples to determine the content of such initiatives. The other main issues the health professionals identified were lifting the standard of Australian Indigenous housing and implementing strategies to improve the continuity of healthcare. CONCLUSION: Educational initiatives need to be prioritised to improve the health of Australian Indigenous people in the Pilbara and the initiatives should be delivered with the involvement of the local community in order to increase the likelihood of sustained behavioural change. Innovative solutions are required to improve the continuity of healthcare in the Pilbara, including increased use of mobile services.