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1.
Explor Res Clin Soc Pharm ; 14: 100437, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-38660625

RESUMEN

Background: A Virtual Clinical Pharmacy Service (VCPS) was introduced in selected rural and remote NSW hospitals in 2020 to address a gap in onsite clinical pharmacy services. Follow-up research determined hospital staff and patients at these locations perceived the service as a safe, effective and efficient system for delivering clinical pharmacy services. Community pharmacists are key stakeholders in medication safety and continuity of management in these regions, however, their insight on the VCPS had not yet been sought. Objective: To understand perspectives of community pharmacists on the implementation of VCPS in rural and remote hospitals and impacts on medication management at transitions of care. Methods: Semi-structured interviews were conducted via videoconference with seven community pharmacists with at least three months exposure to VCPS following service implementation. Thematic analysis of transcribed interviews was conducted influenced by Appreciative Inquiry. Results: Participants identified that the VCPS had supported and enhanced their community pharmacy practice and acknowledged its future potential. Identified themes were interaction with VCPS, acceptability of VCPS, community pharmacy workflow, and involvement in patient care. Suggested improvements included involving community pharmacists early in the implementation of the service and establishing clear expectations and procedures. Conclusions: The experiences of community pharmacists with VCPS were positive and there was a consensus that the introduction of the service had assisted interviewees in providing medication management to patients at transition of care. The ease of communication and efficiency of the service were recognised as key factors in the success of VCPS for community pharmacists.

2.
BMC Health Serv Res ; 24(1): 100, 2024 Jan 18.
Artículo en Inglés | MEDLINE | ID: mdl-38238698

RESUMEN

BACKGROUND: Provision of critical care in rural areas is challenging due to geographic distance, smaller facilities, generalist skill mix and population characteristics. Internationally, the amalgamation telemedicine and retrieval medicine services are developing to overcome these challenges. Virtual emergency clinical advisory and transfer service (vCare) is one of these novel services based in New South Wales, Australia. We aim to describe patient encounters with vCare from call initiation at the referring site to definitive care at the accepting site. METHODS: This retrospective observational study reviewed all patients using vCare in rural and remote Australia for clinical advice and/or inter-hospital transfer for higher level of care between February and March 2021. Data were extracted from electronic medical records and included remoteness of sites, presenting complaint, triage category, camera use, patient characteristics, transfer information, escalation of therapeutic intervention and outcomes. Data were summarised using cross tabulation. RESULTS: 1,678 critical care patients were supported by vCare, with children (12.5%), adults (50.6%) and older people (36.9%) evenly split between sexes. Clinicians mainly referred to vCare for trauma (15.1%), cardiac (16.1%) and gastroenterological (14.8%) presentations. A referral to vCare led to an escalation of invasive intervention, skill, and resources for patient care. vCare cameras were used in 19.8% of cases. Overall, 70.5% (n = 1,139) of patients required transfer. Of those, 95.1% were transferred to major regional hospitals and 11.7% required secondary transfer to higher acuity hospitals. Of high-urgency referrals, 42.6% did not receive high priority transport. Imaging most requested included CT and MRI scans (37.2%). Admissions were for physician (33.1%) and surgical care (23.3%). The survival rate was 98.6%. CONCLUSION: vCare was used by staff in rural and remote facilities to support decision making and care of patients in a critical condition. Issues were identified including low utilisation of equipment, heavy reliance on regional sites and high rates of secondary transfer. However, these models are addressing a key gap in the health workforce and supporting rural and remote communities to receive care.


Asunto(s)
Servicios de Salud Rural , Telemedicina , Adulto , Niño , Humanos , Anciano , Australia , Nueva Gales del Sur , Hospitalización , Triaje , Población Rural
3.
Behav Genet ; 54(1): 4-23, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-38252380

RESUMEN

Undergraduate research experiences are crucial for fostering the next generation of behavior genetics researchers. However, incorporating undergraduates into research can be challenging for faculty mentors. In this article, we provide strategies for successfully integrating undergraduates into behavior genetics research based on our experiences mentoring undergraduates in our lab. These strategies include: (1) Practicing reflexivity, specifically an ongoing self-examination and critical self-awareness of personal biases, beliefs, and practices; (2) Implementing an Inclusion, Diversity, Equity, and Access (IDEA) centered approach; (3) empowering students through clear expectations; (4) Providing focused training and mentorship; (5) Aligning research projects with student interests; (6) Assigning meaningful tasks; and (7) Facilitating professional development opportunities. By following these strategies, faculty mentors can cultivate a supportive and inclusive research environment that empowers undergraduates for successful careers in behavior genetics research.


Asunto(s)
Tutoría , Mentores , Humanos , Estudiantes , Docentes , Investigadores/educación
4.
Aust J Prim Health ; 30(1): NULL, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37667463

RESUMEN

BACKGROUND: The Optimal Care Pathways (OCP) are a framework to promote high-quality and integrated cancer care for all Australians, from prevention through to end-of-life-care. Aboriginal and Torres Strait Islander people experience disproportionate cancer incidence and mortality, but little research has addressed whether cancer care for Aboriginal people meets the standards prescribed by the OCPs. This study aims to consider barriers and facilitators to quality cancer care for Aboriginal people. METHODS: Semi-structured interviews were conducted with 30 health professionals who deliver care to Aboriginal people with cancer in primary care and hospital settings in New South Wales, Australia. Health professionals included Aboriginal Health Workers, nurses, general practitioners, and community workers. Interviews were conducted in 2019-2020 and explored participant perspectives of barriers and facilitators of optimal cancer care, particularly related to prevention, early detection, diagnosis, and treatment for Aboriginal people. Data were qualitatively analysed using framework analysis. RESULTS: In general, participants perceived Aboriginal patients to have good access to preventive care. In terms of early detection and diagnosis, access to primary care, pathology, radiology, and some specialists (e.g. respiratory physicians) was seen as optimal. However, access to hospital-based gastroenterologists for colonoscopy was perceived to be poor due to long wait times. Access to optimal care for cancer treatment was perceived to be hindered due to the lack of bulk-billing for bowel cancer, breast cancer, and cardiothoracic surgery. Other barriers to care identified by participants included unclear referral pathways, poor communication between patient and the treating team, and a lack of timely provision of discharge summaries. CONCLUSIONS: Facilitators of optimal care during treatment and survivorship included: the Integrated Team Care and Close the Gap programs, and presence of key health workers to help patients navigate the health system. The major barriers to quality cancer care for Aboriginal people appeared to be to specialist and procedural access, demonstrating that the 'Inverse Care' law applied in reducing access for populations at higher risk of cancer.


Asunto(s)
Servicios de Salud del Indígena , Neoplasias , Humanos , Australia/epidemiología , Aborigenas Australianos e Isleños del Estrecho de Torres , Vías Clínicas , Neoplasias/diagnóstico , Neoplasias/terapia
5.
Air Med J ; 42(3): 184-190, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-37150572

RESUMEN

OBJECTIVE: This cross-sequential study examines whether the coronavirus disease 2019 pandemic affected the mental health of staff working at an Australian air medical service, the Royal Flying Doctors Service South Eastern (RFDSSE) Section. METHODS: The risk of anxiety and depression was measured using a prospective anonymized online survey using the Hospital Anxiety and Depression Scale, which was answered by 119 employees. This cross-sequential study was completed in December 2021 with reference to 2 time points: now and the beginning of the pandemic. A high risk of anxiety was defined using a Hospital Anxiety and Depression Scale score of 11 to 21 (low risk: 0-10). Chi-square testing was used to compare subgroups at single time points. McNemar testing was used to compare the risk of anxiety and depression between the beginning of the pandemic and December 2021. RESULTS: Employees recalled a higher risk of anxiety at the beginning of the pandemic (29%) compared with December 2021 (16%) (P = .012). At the beginning of the pandemic, nonoperational staff members were more anxious than operational staff (P = .019). One third (31%) of operational staff members were concerned about dying at the beginning of the pandemic. CONCLUSION: Our findings demonstrate that RFDSSE employees recalled higher levels of anxiety at the beginning of the pandemic compared with their risk in December 2021. Operational and nonoperational staff have different mental health needs; anxiety experienced by nonoperational staff during a pandemic should not be underestimated. The overall prevalence of anxiety and depression is high, suggesting health care staff in an air medical service may require extra psychological support. Other air medical organizations may reflect on our study findings and plan how to better support their own staff as a result.


Asunto(s)
Ansiedad , COVID-19 , Depresión , Personal de Salud , Humanos , Ansiedad/epidemiología , Australia/epidemiología , COVID-19/epidemiología , COVID-19/psicología , Pandemias , Estudios Prospectivos , Personal de Salud/psicología , Depresión/epidemiología
6.
J Appl Gerontol ; 42(7): 1466-1476, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-36724235

RESUMEN

Social prescribing is a non-clinical approach to addressing social, environmental, and economic factors affecting how people feel physical and/or emotionally. It involves connecting people to "community assets" (e.g., local groups, organizations, and charities) that can contribute to positive well-being. We sought to explain in what ways, for whom, and why the cultural sector can support social prescribing with older people. We conducted semi-structured interviews with 28 older people (aged 60+) and 25 cultural sector staff. The following nine concepts, developed from interview data, progressed the understanding of tailoring cultural offers, which came from our previous realist review-immersion, buddying, café culture, capacity, emotional involvement, perseverance, autonomy, elitism, and virtual cultural offers. Through tailoring, we propose that older people might experience one or more of the following benefits from engaging with a cultural offer as part of social prescribing-being immersed, psychological holding, connecting, and transforming through self-growth.


Asunto(s)
Estado de Salud , Anciano , Humanos , Inclusión Social
7.
Aust J Rural Health ; 31(1): 90-97, 2023 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-36053275

RESUMEN

OBJECTIVE: This study explored experiences of rural cancer patients who were receiving treatments by remote video-assisted chemotherapy (RVAC) or participating in clinical trials remotely. SETTING: Participants lived in Coonabarabran or Dubbo in western NSW. PARTICIPANTS: Seven cancer patients undergoing treatment for breast, bladder or colon cancer, renal cell carcinoma or lymphoma. DESIGN: Appreciative inquiry informed this qualitative study. Semi-structured interviews were conducted between July 2018 and January 2019 and thematically analysed. RESULTS: The patient experience of teleoncology was overwhelmingly positive. Patients explained the value of relationships that developed with the local and virtual care team. Patients felt they received better care if they saw the same oncologist for the duration of their treatment and felt RVAC had accommodated this. Teleoncology allowed patients to remain independent because they were able to maintain their usual support mechanisms including family, friends and health care team. Patients described the reduced physical and emotional travel burden in addition to reduction in travel time and cost. CONCLUSIONS: These findings highlight the acceptability of teleoncology for rural patients as chemotherapy can be added to the health care and social and emotional supports, which exist in their hometown. Expansion of teleoncology should be codesigned with local communities with a focus on establishing care teams with consistent staffing to build trust between the treating team and the patient. These relationships improve the patient experience and enhance patient independence, which is a desirable attribute of cancer survivorship. Recruitment to clinical trials using teleoncology is acceptable and should be factored into trial development.


Asunto(s)
Neoplasias , Telemedicina , Humanos , Oncología Médica , Pan , Neoplasias/terapia , Evaluación del Resultado de la Atención al Paciente
8.
Int Rev Psychiatry ; 35(7-8): 591-604, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-38461379

RESUMEN

There is clear evidence that university students are experiencing significant mental health difficulties, further exacerbated by the temporary closure of university campuses during the height of the COVID-19 pandemic. Against this backdrop, our study - Student Wellbeing and Experiential Learning Spaces (SWELS) - explored the role of experiential learning spaces in supporting student wellbeing. We adopted a mixed-methods approach, consisting of an online survey and interviews with students from three research intensive UK Universities. The survey results revealed that compared to the national average of 16-25-year-olds from the UK Office for National Statistics' (ONS) wellbeing questionnaire, the sampled students exhibited significantly lower levels of life satisfaction, happiness, perceived worthwhileness and higher levels of anxiety. The qualitative results further confirmed that students perceived their wellbeing to be affected by their university experience and the COVID pandemic. However, the results also suggest that experiential learning spaces (such as museums, collections, libraries, and gardens) hold strong potential to support student mental health. Accordingly, the study indicates that diversifying module content and conscientiously considering both physical and digital learning spaces can positively impact students. In short, curricula that are cognisant of the physical learning environment and embed a focus on wellbeing into their content might help to bolster student wellbeing.


Asunto(s)
Pandemias , Aprendizaje Basado en Problemas , Humanos , Universidades , Estudiantes , Reino Unido
9.
BMC Med ; 20(1): 260, 2022 08 24.
Artículo en Inglés | MEDLINE | ID: mdl-35999539

RESUMEN

BACKGROUND: Non-medical issues (e.g. loneliness, financial concerns, housing problems) can shape how people feel physically and psychologically. This has been emphasised during the Covid-19 pandemic, especially for older people. Social prescribing is proposed as a means of addressing non-medical issues, which can include drawing on support offered by the cultural sector. METHOD: A rapid realist review was conducted to explore how the cultural sector (in particular public/curated gardens, libraries and museums), as part of social prescribing, can support the holistic well-being of older people under conditions imposed by the pandemic. An initial programme theory was developed from our existing knowledge and discussions with cultural sector staff. It informed searches on databases and within the grey literature for relevant documents, which were screened against the review's inclusion criteria. Data were extracted from these documents to develop context-mechanism-outcome configurations (CMOCs). We used the CMOCs to refine our initial programme theory. RESULTS: Data were extracted from 42 documents. CMOCs developed from these documents highlighted the importance of tailoring-shaping support available through the cultural sector to the needs and expectations of older people-through messaging, matching, monitoring and partnerships. Tailoring can help to secure benefits that older people may derive from engaging with a cultural offer-being distracted (absorbed in an activity) or psychologically held, making connections or transforming through self-growth. We explored the idea of tailoring in more detail by considering it in relation to Social Exchange Theory. CONCLUSIONS: Tailoring cultural offers to the variety of conditions and circumstances encountered in later life, and to changes in social circumstances (e.g. a global pandemic), is central to social prescribing for older people involving the cultural sector. Adaptations should be directed towards achieving key benefits for older people who have reported feeling lonely, anxious and unwell during the pandemic and recovery from it.


Asunto(s)
COVID-19 , Pandemias , Anciano , Humanos , Incertidumbre
10.
Health Soc Care Community ; 30(6): e5305-e5313, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-35869795

RESUMEN

Older people's well-being can be bolstered by engaging with cultural activities and venues. They may be encouraged to try cultural offers by a link worker as part of social prescribing. However, the cultural sector, like all parts of life, was affected by the COVID-19 pandemic; this has had implications for cultural offers available to link workers. A study was conducted to explore the views and experiences of link workers in using the cultural sector within social prescribing, particularly for older people (aged 60+) during the pandemic. An online questionnaire was distributed to and completed by link workers in the UK. Data were analysed mainly using descriptive statistics. Open text responses were clustered into similar ideas to create key concepts. Useable responses were received from 148 link workers. They highlighted a general lack of interaction between link workers and the cultural sector about how the latter could support social prescribing. Results suggested that personal familiarity with cultural offers might prompt link workers to refer to them. Some respondents proposed that cultural offers were regarded as elitist, which deterred them from referring there. However, there was a general acknowledgement that the cultural sector could contribute to social prescribing. Link workers need to regard the cultural sector as accessible, appropriate, adequate, affordable and available before referring older people to cultural offers as part of social prescribing. Link workers may benefit from becoming more familiar with cultural sector staff and offers, including online resources, so they can then propose them to patients with confidence.


Asunto(s)
COVID-19 , Humanos , Anciano , COVID-19/epidemiología , Pandemias
11.
Aust N Z J Public Health ; 46(4): 517-523, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35557019

RESUMEN

OBJECTIVE: Despite much effort and goodwill, the gap in health status between Aboriginal and non-Aboriginal Australians persists. Bringing Aboriginal cultural protocols and teaching strategies into healthcare could improve the fit between healthcare services provided and Aboriginal peoples. This approach to making healthcare more accessible has not been tested in mainstream health settings. This study aimed to introduce '8 Aboriginal Ways of Learning' to a mainstream health organisation and observe how learning about Aboriginal perspectives and processes shaped work-related project or program design. METHODS: Program and network coordinators (n=18) employed in a state-wide health organisation joined in-person workshops and virtual sessions. Participatory Action Research methods guided the process and framework analysis transformed data. RESULTS: Introducing '8 Ways' generated conversations which went beyond deficits in Aboriginal health. Learning about cultural processes provided scaffolding to show how services and models of care can change. CONCLUSIONS: This strategy demonstrated potential to improve approachability, acceptability and appropriateness of mainstream healthcare for Aboriginal peoples. IMPLICATIONS FOR PUBLIC HEALTH: Introduction of Aboriginal pedagogies were welcomed by mainstream healthcare workers as they provided scaffolding and support to plan and work in new ways. Future studies could examine outcomes on program design and access to services for Aboriginal peoples.


Asunto(s)
Servicios de Salud del Indígena , Australia , Investigación sobre Servicios de Salud , Humanos , Pueblos Indígenas , Nativos de Hawái y Otras Islas del Pacífico
12.
Clin Teach ; 19(4): 316-322, 2022 08.
Artículo en Inglés | MEDLINE | ID: mdl-35606156

RESUMEN

BACKGROUND: While ward rounds offer a rich opportunity for learning, the environment is chaotic, and medical students can struggle to maximise this potential. Few studies have focused on the best way to equip students for ward round learning. One proposed tool developed to orient students' learning on the ward round is called the Seek, Target, Inspect and reflect, Closure and clerk (STIC) model. This study examines the effect of using this model on the student experience of ward round learning. METHODS: Seven medical students with clinical attachments on medical wards in two rural hospitals in New South Wales, Australia, participated in three sequential focus groups over an 8-week period. Students were asked about learning practices on ward rounds, what factors influenced their learning and how using the STIC model impacted on their experience. Thematic analysis was applied to focus group transcripts. FINDINGS: Students valued learning opportunities from ward rounds but felt the learning potential was largely dependent on the team to which they were attached. Students reported the STIC model promoted greater agency and enabled them to be more self-directed and able to negotiate the chaotic context. Students also valued the focus group discussions about their learning as an avenue to share and better understand their experiences of learning on ward rounds. CONCLUSION: Student experience of ward rounds can be influenced via (1) structured learning tools (STIC model) to better orient students and (2) facilitated discussions with peers to assist in developing skills of negotiating and directing one's own learning. Both should be more explicitly integrated in medical curricula.


Asunto(s)
Entrenamiento Simulado , Estudiantes de Medicina , Rondas de Enseñanza , Curriculum , Humanos , Aprendizaje
14.
BMJ Open ; 12(12): e065972, 2022 12 09.
Artículo en Inglés | MEDLINE | ID: mdl-36600329

RESUMEN

OBJECTIVES: Research capacity building programmes usually only examine short-term outcomes, following up participants after 1 or 2 years. Capacity building in health research requires a long-term view to understand the influence and impact of capacity building endeavours. This study examined long-term outcomes for individuals regarding the maintenance and use of research skills and the conduct of real-world research in a rural area. We also explored the changes individuals had seen in their career, work team or organisation as a result of this training. DESIGN: A qualitative study underpinned by critical realism and based on interviews and focus groups with graduates of the Rural Research Capacity Building Programme (RRCBP), a researcher development programme that has been delivered since 2006. SETTING: Rural and remote areas of New South Wales, Australia. PARTICIPANTS: 22 graduates of the RRCBP from the 2006 to 2015 cohorts (20 female, 2 male). All were experienced rural-based health workers at the time of training. RESULTS: Focus groups and interviews yielded three themes about capacity building outcomes: (1) developed research capable individuals; (2) embedded research capability into teams and (3) real-world research that makes a difference within an organisation. CONCLUSIONS: Research training improved graduates' skill, experience, confidence and employability. Research capable individuals enabled others, enhancing team research capacity and raising the profile of research within their organisation.Training in research, alongside tangible organisational support for research activity, creates real-world impacts for policy and clinical practice. Providing ongoing opportunities for researchers to undertake research would enhance return on investment and assist with retention of experienced staff.


Asunto(s)
Creación de Capacidad , Servicios de Salud Rural , Humanos , Masculino , Femenino , Australia , Salud Rural , Nueva Gales del Sur , Investigación Cualitativa
15.
BMC Health Serv Res ; 21(1): 1306, 2021 Dec 04.
Artículo en Inglés | MEDLINE | ID: mdl-34863164

RESUMEN

BACKGROUND: The use of medications is the most common intervention in healthcare. However, unsafe medication practices and medication errors are a leading cause of injury and avoidable harm in healthcare systems across the world. A Virtual Clinical Pharmacy Service (VCPS) was introduced in rural and remote New South Wales public hospitals to support safe and effective use of medications. In this model clinical pharmacy services are delivered via a telehealth cart at the patient's bedside and through electronic medical and pharmaceutical record systems. The aim of this research was to understand healthcare staff perspectives of the VCPS and identify areas for improvement. METHODS: A qualitative approach informed by Appreciative Inquiry was used to investigate healthcare staff perceptions of the VCPS. Focus group discussions (n = 15) with hospital staff and medical officers were conducted via videoconference at each study site. Focus groups explored issues, benefits and barriers 3 months after service implementation. Transcribed data were analysed using thematic analysis and team discussion to synthesise themes. RESULTS: Focus group participants identified the value of the VCPS to patients, to the health service and to themselves. They also identified enhancements to increase value for each of these groups. Perceived benefits to patients included access to specialist medication advice and improved medication knowledge. Staff valued access to an additional, trusted workforce who provided back-up and guidance. Staff also reported confidence in improved patient safety and identification of medication errors. Enhanced compliance with antimicrobial stewardship and hospital accreditation standards were beneficial to the health service. Suggested improvements included extending virtual service hours and widening patient eligibility to include aged care patients. CONCLUSIONS: The VCPS brought a positive, collegiate culture regarding medications. Healthcare staff perceived the VCPS was effective and an efficient way for the health service to supply pharmacy services to smaller hospitals. The ease of use, model of delivery, availability, local knowledge and responsiveness of highly skilled pharmacists was the key to user satisfaction. TRIAL REGISTRATION: ANZCTR ACTRN12619001757101 , 11/12/2019.


Asunto(s)
Servicio de Farmacia en Hospital , Anciano , Australia , Hospitales Públicos , Humanos , Farmacéuticos , Recursos Humanos
16.
Addict Sci Clin Pract ; 15(1): 31, 2020 08 18.
Artículo en Inglés | MEDLINE | ID: mdl-32811549

RESUMEN

BACKGROUND: First Nations peoples of Australia, New Zealand, the United States of America (USA) and Canada are more likely to be non-drinkers than other people in these countries. However, those who do drink may be at greater risk of alcohol-related harms (at a population level) due to the ongoing impacts from colonisation and associated oppression. Addressing unhealthy drinking (drinking above recommended limits including alcohol use disorders) in primary care settings is one important way to increase accessibility of treatment. METHODS: This systematic review identifies peer-reviewed studies of alcohol treatments delivered in primary care or other non-residential settings for First Nations peoples of Australia, New Zealand, USA and Canada. Literature searches were conducted in seven academic databases from their inception until March, 2020. We assessed evidence of treatment or implementation effectiveness, perceived acceptability or accessibility, and the study quality as assessed by the AXIS tool and by a measure of community participation in the research process. RESULTS: Twenty-eight studies were included, published between 1968 and 2018. Studies reported on a range of alcohol treatments, from brief intervention to ambulatory withdrawal management, relapse prevention medicines, and cultural therapies. Brief intervention was the most studied approach. Cultural healing practices and bicultural approaches were a key theme amongst several studies. Four studies measured treatment effectiveness, including one randomised controlled trial (naltrexone vs naltrexone plus sertraline vs placebo) and two uncontrolled trials of disulfiram. Of the six implementation studies, three were (hybrid) effectiveness-implementation designs. Most of the remaining studies (n = 21) focused on treatment accessibility or acceptability. Community participation in the research process was poorly reported in most studies. CONCLUSIONS: Research evidence on how best to care for First Nations peoples with unhealthy alcohol use is limited. Trials of naltrexone and disulfiram presented promising results. Cultural and bicultural care were perceived as highly important to clinical staff and clients in several studies. More effectiveness studies on the full scope of alcohol treatments are needed. Greater community participation in research and more transparent reporting of this in study methods will be key to producing quality research that combines scientific rigour with cultural appropriateness.


Asunto(s)
Alcoholismo/terapia , Pueblos Indígenas/psicología , Atención Primaria de Salud , Australia , Humanos , Nueva Zelanda , América del Norte
17.
Health Res Policy Syst ; 18(1): 67, 2020 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-32539865

RESUMEN

BACKGROUND: The calls for increased numbers of researchers in rural health are growing. To meet this demand, training is needed. If training is to be effective, the value placed on research, the organisational need for research training and key targets for research skill development within a rural health organisation must be understood. METHODS: This qualitative study was underpinned by a critical realist perspective that allowed exploration of the organisational, cultural and structural contexts of research training and of the ability of individuals to act within these contexts. Individual interviews with purposively selected key informants from the organisation's board, executive and facility management (n = 7) and two focus groups with a convenience sample of frontline health workers with interests in research (total n = 11) were held. Data were analysed using NVivo software and thematic analysis. RESULTS: The themes emerging from this study were the fragmentation of research activity, a need for systems that support research and collaboration for expertise. CONCLUSIONS: This study has identified an overreliance on individual activity leading to a fragmented approach to research. There is a need for supportive structures, coordination and workplace leadership to overcome a longstanding culture that views research as out of the rural scope of practice. Identifying research training targets, partnering for educational expertise and planning for long-term sustainability are necessary steps toward increasing research activity in the longer term.


Asunto(s)
Personal de Salud/educación , Necesidades y Demandas de Servicios de Salud , Investigación/educación , Salud Rural , Lugar de Trabajo , Femenino , Grupos Focales , Humanos , Entrevistas como Asunto , Masculino , Investigación Cualitativa
19.
Rural Remote Health ; 20(2): 5493, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32299219

RESUMEN

INTRODUCTION: Research training is conducted within rural health organisations without a clear understanding of the role of research within the structure of the organisation itself, potentially limiting the effectiveness of that training. This study sought to identify the role of research within the organisational structure of a large rural health organisation in Australia. Specifically, the study sought the answer to the following questions: Is research identified within the strategic documents of the organisation? If so at what level of the organisation is responsibility for research attributed? Is research identified within the position descriptions of staff? If so, at what level of the organisation are staff expected to conduct research? Is there evidence of research activity elsewhere within the organisational structure? METHODS: This qualitative study used a critical realist approach and content analysis to identify and contextualise the terms 'research' and 'evaluation' within publicly available and internal documents from a large rural health organisation in New South Wales, Australia. Secondary thematic analysis identified organisational factors influencing research activity. Data were sourced from strategic, operational and other documents from the 2015 calendar year, with key documents extracted from 1654 external and internal websites, 159 position descriptions and approvals for research projects active in 2015 (n=53). RESULTS: Only a third of research conducted in the organisation was locally instigated or involved local staff as researchers. Matching between positional responsibility for research and research activity was limited. Research was a strategic goal for the organisation; however, this was not well represented in operational documents. A lack of research in operational documents devolves responsibility for research to individuals. Individuals with greater levels of individual agency were more likely to be engaged in research. A low critical mass of local researchers means that collaboration, both internal and external, is essential to strengthen research capacity. CONCLUSION: Health services can create conditions for local health research in a rural environment by addressing structural barriers such as a lack of operational planning for research. Identifying research-active individuals as champions to build internal research collaboration is an important strategy, as is partnering with external organisations for necessary expertise.


Asunto(s)
Investigación/organización & administración , Servicios de Salud Rural/organización & administración , Conducta Cooperativa , Humanos , Nueva Gales del Sur , Cultura Organizacional , Objetivos Organizacionales , Investigación Cualitativa , Investigadores/organización & administración
20.
Aust J Rural Health ; 27(5): 392-397, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31245898

RESUMEN

OBJECTIVE: The objective of this study was to determine the effect of the Rural Research Capacity Building Program on self-reported research experience of rural health workers. DESIGN: A repeat cross-sectional study design was used to assess self-reported research experience at the commencement and completion of a novice researcher development program. SETTING: Candidates in the Rural Research Capacity Building Program are health workers employed in the rural NSW public health service who have not completed research higher degrees. PARTICIPANTS: One hundred and thirty candidates of the Rural Research Capacity Building Program from the 2006 to 2013 cohorts were participated. INTERVENTIONS: The Rural Research Capacity Building Program is an experiential learning program in which candidates gain research experience by undertaking a new, self-selected, local health service endorsed research project over a 2-year period, supported by 10 days face-to-face teaching, weekly teleconferencing and mentoring. MAIN OUTCOME MEASURES: Change in self-assessed research experience using a validated 10-item measurement tool known as the Research Spider which measures 10 domains of research experience. RESULTS: Reported research experience demonstrated statistically significant increases across all 10 domains of research experience. The largest change was 'writing and presenting a research report' and 'writing a research protocol'. CONCLUSIONS: Significant increases in Research Spider results across all 10 domains demonstrated that completing the Rural Research Capacity Building Program significantly improves self-assessed research experience. Rural health workers who are experienced and confident to undertake research are more capable of studying health problems and finding solutions unique to the rural setting.


Asunto(s)
Creación de Capacidad/métodos , Educación en Salud Pública Profesional , Investigación sobre Servicios de Salud , Salud Rural/educación , Adulto , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nueva Gales del Sur , Evaluación de Programas y Proyectos de Salud , Encuestas y Cuestionarios
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