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1.
J Child Health Care ; : 1367493520919305, 2020 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-32301329

RESUMO

Aboriginal and Torres Strait Islander children experience a higher prevalence of disability and socio-economic disadvantage than other Australian children. Early intervention from across the health, education and social service sectors is vital for improving outcomes, but families face a number of barriers to service access which impede intervention. This study aimed to inform ways to improve access to services for families of urban-dwelling Aboriginal children with a range of disabilities. A qualitative approach was taken to explore providers' perceptions of factors that either impeded or enabled families' access to services. In this research, the term 'provider' refers to individuals who are employed in a range of sectors to deliver a service involving assessment or management of an individual with a disability. Semi-structured in-depth interviews with 24 providers were conducted. Data analysis was informed by the general inductive approach and then applied deductively to the candidacy framework to generate additional insights. Candidacy focuses on how potential users access the services they need and acknowledges the joint negotiation between families and providers regarding such access. Our research identified that candidacy was influenced by the historical legacy of colonisation and its ongoing socio-cultural impact on Aboriginal people, as well as funding and current policy directives. Enacting culturally sensitive and meaningful engagement to better understand families' needs and preferences for support, as well as support for providers to develop their understanding of family contexts, will contribute to facilitating service access for Aboriginal children with a disability.

2.
Contemp Nurse ; : 1-18, 2020 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-32141400

RESUMO

Background: Regular health screening provides opportunities for early detection and effective treatment of disease. There is underutilisation of health services by migrants from culturally and linguistically diverse backgrounds, particularly refugees in Australia.Aim: To explore the beliefs, understandings, and use of health and healthcare screening services among African refugee women living in Australia.Design/Method: Qualitative secondary analysis.Method: Oral narratives derived from two primary qualitative datasets of Sub-Saharan women in New South Wales, Australia, underwent secondary thematic analysis.Findings: Twenty-two of the forty-two women had refugee status on migrating to Australia. Thematic findings reflection of misinformation, low health literacy, and health screening as not a priority.Conclusions: There is an urgent need to develop innovative strategies to engage refugee migrant women in health screening by provision of culturally meaningful health information.Relevance to clinical practice: Including refugee women's suggestions for information to be provided by health services may improve attitudes towards screening and preventative health care.

3.
Scand J Caring Sci ; 2020 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-31985863

RESUMO

OBJECTIVE: For people managing chronic illness, such as heart failure, adequate health literacy is crucial to understand the complex information that underpins self-care, yet evidence suggests poor understanding in this patient population. To better understand patients' heart failure comprehension and why knowledge gaps may exist, this study sought to explore perceptions of patient-provider communication and ascertain unmet educational needs and preferences. METHODS: Semi-structured in-depth interviews were conducted with 15 symptomatic inpatients with heart failure. Data collection and analysis occurred simultaneously until saturation was reached. Transcripts were analysed using thematic analysis. RESULTS: Participants relied heavily on providers for HF information and support, expressed numerous unmet educational needs and had mixed feelings about quality of communication. Participants expressed the need for credible, tailored heart failure information that accounted for comorbid conditions and preference for face-to-face information delivery. Knowledge gaps included heart failure pharmacotherapy, symptom appraisal and management, cause and chronicity of heart failure, and a specific action plan for heart failure symptom exacerbation. Barriers to effective patient-provider communication included providers using complex medical terminology, lack of adequately detailed information, relationships that did not foster open communication and participants' memory problems. CONCLUSION: Gaps in knowledge and poor communication may indicate inadequate availability of multidisciplinary heart failure management programmes and/or fidelity to guideline recommendations. PRACTICE IMPLICATIONS: Evaluating heart failure management programmes is important to ensure consistent delivery of best-practice education and care. Nurses play a key role in the delivery of patient-focused health information.

4.
Int J Ment Health Nurs ; 29(1): 92-101, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31917517

RESUMO

Migrants from areas affected by war, especially refugee migrants, are susceptible to mental health issues. In addition to recognising trauma, health professionals, such as mental health nurses, need to be aware of the strength and resilience of refugees and migrants. The capacity to provide trauma-informed care that is shaped by the recognition of clients' strength and resilience is required/paramount to meet the current demand of multiculturalism emanating from an increased global migration. To facilitate increased awareness about West African women's resilience prior to migration and support trauma-informed care, we used a qualitative strength-based storytelling approach with 22 West African women residing in Sydney, Australia. Thematic analysis of the women's stories identified two major themes: When the World Falls Apart and Battered but Strong. Findings revealed that past personal experiences significantly influenced participants' strength and resilience and contributed to their mental health. Mental health professionals such as nurses can play an important role by incorporating knowledge about the resilience of migrants and refugees into providing appropriate trauma-informed care.

5.
J Interprof Care ; : 1-12, 2019 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-31821054

RESUMO

Aboriginal and Torres Strait Islander children experience a higher prevalence of disability than other Australian children. Early intervention from across the health, education, and social service sectors is vital for improving outcomes, but families face lack of coordination between services. This study aimed to inform improvements in service access for families of urban-dwelling Aboriginal children with disability through exploring providers' perceptions of factors that influenced working together across sectors. Semi-structured interviews were conducted. Data analysis was informed by the general inductive approach and the Collaborative Practice to Enhance Patient Care Outcomes framework. Twenty-four providers participated. Interprofessional collaborative practice was influenced by interdependent interactional and organizational factors. Interactional factors fit within one of two dimensions: the ability of providers to share common goals and vision within a complex cross-sector service landscape, and influence of interpersonal relationships on their sense of belonging working in a cross-cultural space. Organizational factors also fit within one of two dimensions: the influence of governance in relation to its role in coordination and unlocking the strength of schools as service settings, and the need to formalize processes for effective interprofessional communication. Interprofessional collaborative practice was managed within the context of systemic factors relating to policy and funding. These findings demonstrate the complex interplay of factors related to the cross-sector involvement of providers in early intervention service provision. Consideration of these factors is required to facilitate collaborative cross-sector responses to improve service access for Aboriginal families.Abbreviations: WHO: world health organization; ACCHS: aboriginal community controlled health service; GP: general practitioner; NDIS: national disability insurance scheme.

6.
Australas J Ageing ; 2019 Nov 03.
Artigo em Inglês | MEDLINE | ID: mdl-31680413

RESUMO

OBJECTIVE: To identify caregiving characteristics that are associated with financial stress in Australian carers of people with a chronic disease. METHODS: Data were collected via the South Australian Health Omnibus, an annual population-based, cross-sectional survey. Individuals who provided care to someone with prevalent chronic conditions were asked about financial stress and caregiving characteristics. RESULTS: Of 32.4% (988/3047) who were carers, 13.4% (132/988) experienced financial stress. Adjusting for age and household income, providing more than 20 hours of care per week (AOR = 2.39, 95% CI = 1.48-3.86), transport assistance (AOR = 1.89, 95% CI = 1.15-3.09) and assistance with household tasks (AOR = 1.92, 95% CI = 1.14-3.26) and caring for a person with a mental illness (AOR = 2.01, 95% CI = 1.24-3.28) were associated with a significant increase in odds of experiencing financial stress. Caring for a person with cancer (AOR = 0.49, 95% CI = 0.30-0.81) or dementia (AOR = 0.40, 95% CI = 0.21-0.76) was associated with decrease in odds. CONCLUSIONS: Financial stress was reported by more than 13% of carers, and factors other than household income were implicated.

7.
Soc Sci Med ; 242: 112599, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31644975

RESUMO

An emphasis on individual intervention and psychological complexity has characterised research on bereavement following an experience of life-limiting illness. Exploration of "structural vulnerability" as a positionality produced by social and structural inequity could provide insights into areas of practice and policy in need of development. This scoping review sought to summarise published research on experiences of social and structural inequities in the context of bereavement due to life-limiting illness. Underpinned by recognised methodological frameworks, systematic searches were conducted of four electronic databases. Eligible studies attended to bereavement experience following the death of an adult due to life-limiting illness, included consideration of social and structural inequities, and were undertaken in high income countries between 1990 and 2018. Following thematic analysis, a conceptual framework was developed. Of 322 records, 62 full text articles were retrieved and 15 papers met inclusion criteria. Studies highlighted unequal social status in bereavement related to gender, class, sexuality, ethnicity and age, with structural inequity experienced in interactions with institutions and social networks. Studies also identified that the experience of bereavement itself may be accompanied by exposure to disenfranchising systems and processes. Structural vulnerability appeared to be associated with outcomes including psychological distress, social disenfranchisement and practical concerns such as financial strain, housing insecurity and employment issues. Social and structural inequities potentially contribute to layered and patterned experiences of disadvantage and disenfranchisement following expected death, with implications for individual agency. Findings point to the need for consideration of socio-ecological approaches within and beyond specialist palliative care, involving development of more responsive social policy, coordinated advocacy, and systemic capacity building regarding experiences of grief, to better support populations positioned as structurally vulnerable in bereavement.

8.
Psychooncology ; 28(11): 2149-2156, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31418503

RESUMO

OBJECTIVES: To compare physical and mental health status between cancer carers versus non-carers in a population-based sample and explore sociodemographic and caring characteristics associated with poor carer health status. METHODS: The South Australian Health Omnibus is a population-based cross-sectional survey. Carer status was self-defined by participants as having cared for someone with cancer in the last 5 years. Health status was considered poor if it was 0.5 standard deviation lower than Australian norms on the Medical Outcomes Study 12-Item Short-Form (SF-12) physical and mental component summary scores (PCS and MCS). Regression analyses compared mean PCS/MCS between carers versus non-carers, controlling for sociodemographic variables, and explored associations between poor health status and caring and support among carers. RESULTS: The weighted sample included 2962 people, of whom 374 (12.6%) were cancer carers and 1993 (67.3%) non-carers. Carers had significantly worse PCS/MCS, controlling for sociodemographic variables, but did not differ significantly regarding proportions with poor health status. Carer characteristics associated with poor PCS and MCS included socio-economic indicators and involvement in medication management. Assisting with household tasks was protective. CONCLUSIONS: This population-based study followed those previous ones in finding cancer carers to have poorer mean health status than non-carers. However, differences were less pronounced than previously reported, likely because of the sample being drawn from a general rather than cancer service population and including past as well as current carers, as well as all cancer types and stages. Future longitudinal research is needed to identify factors that predict recovery post caring.

9.
Contemp Nurse ; 55(2-3): 221-236, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31403398

RESUMO

Background: Quality improvement projects have been widely adopted to prevent complications in the ICU. Objective: This paper describes nurses' perceptions of implementation strategies and the potential sustainability of a practice change intervention to prevent complications in a Malaysian ICU. Design: A participatory action research using five focus group discussions were undertaken with 19 nurses in a single ICU in regional Malaysia. Focus group transcripts were analysed using thematic analysis. Results: The main themes derived from the interviews were: [1] Empowering staff to embrace evidence-based practices; [2] Staff knowledge, attitudes, and beliefs that impact on behaviour; and [3] management support and leadership are influential in staff behaviours (acceptance & perseverance of change process). Discussion: Resistance to change was recognized as a barrier to adopting evidence based recommendations. There is a need to improve nurses' knowledge, attitude and awareness of the importance of assessment for VAP, CRBSI and PIs in the ICU.


Assuntos
Atitude do Pessoal de Saúde , Cuidados Críticos/normas , Complicações Intraoperatórias/diagnóstico , Complicações Intraoperatórias/prevenção & controle , Recursos Humanos de Enfermagem no Hospital/psicologia , Guias de Prática Clínica como Assunto , Medição de Risco/normas , Adulto , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Malásia , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Inquéritos e Questionários
10.
Int J Older People Nurs ; 14(3): e12248, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31173482

RESUMO

AIMS AND OBJECTIVES: This study sought to assess the effect of a community-based intervention influencing adherence status at baseline, 1, 3 and 6 months, and to evaluate the impact that a community-based intervention and socio-economic factors have on adherence. BACKGROUND: Although high-quality treatment and modern hypertension clinical practice guidelines have been developed worldwide, the outcomes of patients with hypertension in Thailand are not optimal. Implementing a person-centred and integrated health services model to improve hypertension management, such as a community-based intervention, is challenging for healthcare providers in Thailand. DESIGN: An observational study of a community-based intervention. METHODS: The study comprised residents in 17 villages in one province of Thailand. A sample of 156 participants was allocated into the intervention and the control groups. Inclusion criteria were people aged 60 years or older diagnosed with hypertension. Exclusion criteria included the latest record of extreme hypertension and having a documented history of cognitive impairment. The intervention group received the 4-week community-based intervention programme. Multiple linear regression was applied to predict the adherence status at each phase. Multiple logistic regression was then implemented to predict influencing factors between the groups. RESULTS: Patients who received the intervention had significantly lower adherence scores (reflecting a higher level of adherence) at 3 and 6 months after intervention by 1.66 and 1.45 times, respectively, when adjusting for other variables. After 6 months, the intervention was associated with a significant improvement in adherence when adjusting for other variables. CONCLUSION: This study provides evidence to support the use of community-based interventions as an effective adjunct to hospital-based care of hypertension patients in Thailand. IMPLICATIONS FOR PRACTICE: Understanding factors between health outcomes and social determinants of health is crucial for informing the development of culturally appropriate interventions.


Assuntos
Redes Comunitárias/organização & administração , Hipertensão/enfermagem , Cooperação do Paciente , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Determinantes Sociais da Saúde , Fatores Socioeconômicos , Tailândia
11.
Contemp Nurse ; 55(2-3): 139-155, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31225768

RESUMO

Background: Clinical deterioration and adverse events in hospitals is an increasing cause for concern. Rapid response systems have been widely implemented to identify deteriorating patients. Aim: We aimed to examine the literature highlighting major historical trends leading to the widespread adoption of rapid response systems, focussing on Australian issues and identifying future focus areas. Method: Integrative literature review including published and grey literature. Results: Seventy-eight sources including journal articles and Australian government matierlas resulted. Pertinent themes were the increasing acuity and aging of the population, importance of hospital cultures, the emerging role of the consumer, and proliferation, evolution and standardisation of rapid response systems. Discussion: Translating evidence to usual care practice is challenging and strongly driven by local factors and political imperatives. Conclusion: Rapid response systems are complex interventions requiring consideration of contextual factors at all levels. Appropriate resources, a skilled workforce and positive workplace cultures are needed for these systems to reach their full potential.


Assuntos
Deterioração Clínica , Serviços Médicos de Emergência/estatística & dados numéricos , Serviços Médicos de Emergência/tendências , Equipe de Respostas Rápidas de Hospitais/estatística & dados numéricos , Equipe de Respostas Rápidas de Hospitais/tendências , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália , Feminino , Previsões , Humanos , Masculino , Pessoa de Meia-Idade
12.
Nurse Educ Today ; 76: 68-72, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30771612

RESUMO

OBJECTIVE: This study aimed to explore the experiences of early career academic nurses as they shape their career path in one Australian university. BACKGROUND: The early years of academic career development can be challenging as individuals learn to adjust to the teaching, research and service mission of universities. Tertiary institutions have an obligation to provide future nursing leaders with relevant and timely support during the formative phase of career development, to be successful in a competitive global environment. DESIGN: A qualitative descriptive approach was used and data were analysed thematically using Braun and Clarke (2006) six phase process. METHODS: Eleven early career academic nurses who were interviewed, had completed, or were near completion of a doctorate and were within seven years of full-time academic employment. RESULTS: The four themes that emerged from the analysis were: embarking on the journey; the toil of the journey; fellow travellers on the journey, and strategies for a successful journey. CONCLUSIONS: Findings from this study can be used to inform customised mentorship programs for nurse academics during their initial stage of career employment.


Assuntos
Docentes de Enfermagem , Enfermeiras e Enfermeiros/psicologia , Papel Profissional , Adulto , Atitude do Pessoal de Saúde , Austrália , Bacharelado em Enfermagem , Docentes de Enfermagem/psicologia , Feminino , Humanos , Liderança , Masculino , Mentores , Pessoa de Meia-Idade , Pesquisa Qualitativa
13.
J Cardiopulm Rehabil Prev ; 38(5): 279-285, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30074521

RESUMO

BACKGROUND: There is a paucity of evidence on gender-specific, individually tailored secondary prevention (cardiac rehabilitation [CR]) services for women with heart disease. Women participate less in CR programs, thus increasing their risk of further cardiac events. This review aims to (1) determine the effectiveness of gender-specific interventions specifically designed for women with heart disease, delivered in outpatient CR settings; and (2) classify key elements of effective CR strategies/models for women with heart disease. METHODS: Using the PRISMA guidelines, this is a systematic review of CR models tailored to women to improve cardiovascular risk. Four databases were searched for randomized controlled trials (RCTs) between January 1974 and July 2017 published in peer-reviewed English language journals. RESULTS: Three RCTs comprising 725 women of gender-specific CR strategies were identified. Significant improvements were found in one-third (1 study) of the included multicomponent CR strategies for outcomes including general health, social functioning, vitality, mental health, depression, and quality of life. CONCLUSION: Further large-scale RCTs are required to replicate positive findings and accurately assess the capacity for gender-specific multicomponent CR programs that incorporate participant-driven collaborative models to moderate psychological risk and improve functional capacity and quality of life for women with heart disease.


Assuntos
Reabilitação Cardíaca/métodos , Cardiopatias/prevenção & controle , Cardiopatias/reabilitação , Prevenção Secundária/métodos , Feminino , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores Sexuais
14.
Qual Health Res ; 28(12): 1923-1932, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-30101663

RESUMO

Intersectionality has potential to create new ways to describe disparities and craft meaningful solutions. This study aimed to explore Aboriginal carers' experiences of interactions with health, social, and education providers in accessing services and support for their child. Carers of Aboriginal children with a disability were recruited from an Australian metropolitan Aboriginal community-controlled health service. In-depth, semistructured interviews were conducted with 19 female carers. Intersectionality was applied as an analytical framework due to the inherent power differentials for Aboriginal Australians and carers for people with a disability. Marginalization and a lack of empowerment were evident in the experiences of interactions with providers due to cultural stereotypes and racism, lack of cultural awareness and sensitivity, and poverty and homelessness. Community-led models of care can help overcome the intersectional effects of these identities and forms of oppression in carers' interactions with providers and enhance access to care.


Assuntos
Cuidadores/psicologia , Crianças com Deficiência , Grupo com Ancestrais Oceânicos/psicologia , Satisfação do Paciente/etnologia , Atitude do Pessoal de Saúde/etnologia , Austrália , Criança , Pré-Escolar , Competência Cultural , Feminino , Acesso aos Serviços de Saúde , Serviços de Saúde do Indígena , Disparidades em Assistência à Saúde/etnologia , Pessoas em Situação de Rua , Humanos , Lactente , Recém-Nascido , Entrevistas como Assunto , Masculino , Pobreza , Relações Profissional-Família , Pesquisa Qualitativa , Racismo , Professores Escolares/psicologia , Assistentes Sociais/psicologia
15.
Aust Health Rev ; 2018 Jun 14.
Artigo em Inglês | MEDLINE | ID: mdl-29898812

RESUMO

Objective The aim of the present study was to compare the health status of South Australians with recent experience of caring for an adult with chronic disease with non-carers drawn from the same population.Methods Data were collected via the South Australian Health Omnibus, an annual population-based, cross-sectional survey. Respondents were asked whether they had provided care or support in the last 5 years to someone with cancer, heart disease, respiratory disease, mental illness, neurological disease or dementia. Health status was measured using the Short Form-12 version 1 (SF-12) physical and mental component scale summary scores (PCS and MCS respectively), with poor health status defined as ≥0.5 standard deviation below the normative mean. Logistic regression explored characteristics associated with poor health status.Results Of 3033 respondents analysed, 987 (32.5%) reported caring experience. Poor PCS and MCS were associated with carer status, lower-than-degree-level education, employment status other than employed and annual household income less than A$60000. Being Australian born was a protective factor for PCS, whereas factors protective for MCS were being married or in a de facto relationship and age ≥65 years.Conclusions Providing care or support in the last 5 years is independently associated with poorer health status, but not with the magnitude found in studies of current carers. Future research should explore health status recovery after completion of the caring role, and investigate whether relationships between health and socioeconomic status differ for carers versus non-carers.What is known about the topic? Population-based survey studies in Australia and overseas have consistently found that informal carers have worse health status than non-carers.What does this paper add? Including recent as well as current carers in a population-based sample was associated with less effect on health status compared with studies focused on current carers only. This finding is consistent with the possibility that health status recovers during the 5 years after caring.What are the implications for practitioners? Support for Australian carers is warranted to ensure their continuing contributions to society and return to productivity after their caring role is completed.

16.
Nurse Educ Today ; 63: 69-75, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29407264

RESUMO

BACKGROUND: The nursing profession has a significant evidence to practice gap in an increasingly complex and dynamic health care environment. OBJECTIVE(S): To evaluate effectiveness of teaching and learning strategies related to a capstone project within a Masters of Nursing program that encourage the development of evidence based practice capabilities. DESIGN: Systematic review that conforms to the PRISMA statement. SAMPLE: Master's Nursing programs that include elements of a capstone project within a university setting. DATA SOURCES/REVIEW METHODS: MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, ERIC and PsycInfo were used to search for RCT's or quasi experimental studies conducted between 1979 and 9 June 2017, published in a peer reviewed journal in English. RESULTS: Of 1592 studies, no RCT's specifically addressed the development of evidence based practice capabilities within the university teaching environment. Five quasi-experimental studies integrated blended learning, guided design processes, small group work, role play and structured debate into Masters of Nursing research courses. All five studies demonstrated some improvements in evidence based practice skills and/or research knowledge translation, with three out of five studies demonstrating significant improvements. CONCLUSIONS: There is a paucity of empirical evidence supporting the best strategies to use in developing evidence based practice skills and/or research knowledge translation skills for Master's Nursing students. As a profession, nursing requires methodologically robust studies that are discipline specific to identify the best approaches for developing evidence-based practice skills and/or research knowledge translation skills within the university teaching environment. Provision of these strategies will enable the nursing profession to integrate the best empirical evidence into nursing practice.


Assuntos
Prática Clínica Baseada em Evidências , Lacunas da Prática Profissional , Estudantes de Enfermagem , Competência Clínica , Currículo , Educação de Pós-Graduação em Enfermagem , Humanos , Aprendizagem
18.
Ethn Health ; 23(6): 611-628, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-28271720

RESUMO

OBJECTIVE: In spite of the healthy immigrant effect, the prevalence of lifestyle-related chronic diseases among migrants is reported to approximate that of the host country with longer duration of stay. For example, higher rates of chronic diseases such as Type 2 diabetes and hypertension have been observed among Filipino migrants and these have been linked to acculturation. The aim of this study was to explore the experiences of Filipino-Australian migrants in managing their chronic health conditions in a Western host country. DESIGN: This paper reports on qualitative findings of a mixed methods study that used an explanatory sequential design. Nine focus group discussions were undertaken with 58 Filipino-Australian migrants with chronic disease. Thematic analysis was undertaken using a five-stage general purpose thematic framework ensuring that themes closely identified key participants' experiences . RESULTS: Findings revealed that health benefits provided by the health system in Australia were considered advantageous. However, a lack of social and instrumental support compounded isolation and disempowerment, limiting self-management strategies for chronic illnesses. Cultural beliefs and practices influenced their knowledge, attitude to and management of chronic disease, which health service providers overlooked because of perceived acculturation and English language skills. Overall this study has clearly identified recognition of cultural beliefs, language needs and support as three core needs of Filipino-Australian migrants with the elderly the most vulnerable. CONCLUSION: This paper highlights that self-management of chronic disease among elderly Filipino immigrants may be adversely affected by host language difficulties, a lack of social support and cultural issues, impacting on access to services, health-seeking behaviours and participation in health promotion initiatives. Language, culture-specific health interventions and resources and enhancing social support are likely important strategies in promoting chronic disease self-management among the elderly. These interventions have the potential to empower and encourage individuals to take control and better manage their chronic disease.


Assuntos
Doença Crônica/etnologia , Cultura , Emigrantes e Imigrantes , Promoção da Saúde , Idoso , Idoso de 80 Anos ou mais , Austrália , Feminino , Grupos Focais , Humanos , Masculino , Pessoa de Meia-Idade , Filipinas/etnologia , Pesquisa Qualitativa , Apoio Social
19.
Nurse Res ; 25(3): 19-25, 2017 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-29251444

RESUMO

BACKGROUND: Asset-informed approaches are increasingly emphasised in public health, but transferring this approach to planning health services requires prospective systematic methods. Asset-informed approaches to service-mapping have started to develop, but there are no standardised guidelines. These methods are becoming of particular interest, as nurses engage in population health activities. AIM: To identify methods of asset-informed mapping for addressing health problems and develop a framework to support the methodological rigour of service-mapping. DISCUSSION: The authors undertook an integrative literature review using a systematic approach and narrative synthesis. Ten articles met the inclusion criteria. Reported methods included the formation of a core team to drive the process, as well as varying detail about methods of collecting data and forming maps. Challenges and solutions included the effectiveness of the core team depending on having a designated leader, frequent meetings and previous partnerships, using community 'cultural brokers', and determining aims and scope. CONCLUSION: Results of the review can be used to modify existing generic resources for asset-informed mapping to their application in health services. Four main stages seem especially applicable and important: defining the parameters of the service-mapping process; identifying services; mapping services; and consultation and implementation. IMPLICATIONS FOR PRACTICE: The shift towards asset-informed approaches in community and public health is an important step in realising the potential of existing assets in communities to influence health outcomes. The framework offered in this paper is intended to assist in developing an evidence base, by promoting the systematic and rigorous reporting of methods used in asset-informed approaches to service-mapping.


Assuntos
Planejamento em Saúde , Enfermagem em Saúde Pública , Humanos
20.
BMC Fam Pract ; 18(1): 96, 2017 Nov 29.
Artigo em Inglês | MEDLINE | ID: mdl-29187141

RESUMO

BACKGROUND: Australian parents/carers of a person with a disability experience higher rates of depression, more financial stress, and are twice as likely to be in poor physical health than the general population. Aboriginal and Torres Strait Islander peoples experience worse health, social and economic outcomes than other Australians, and those with a disability face 'double disadvantage'. This study aimed to better understand the experiences and needs of parents/carers/families of Aboriginal children with a disability. METHODS: Semi-structured in-depth interviews were conducted with parents or primary carers of Aboriginal children aged zero-eight with disability. Interviews were analysed using thematic analysis. RESULTS: Nineteen women (sixteen mothers and three grandmothers) were interviewed. More than half were lone carers (without a partner or spouse). Participants described their experiences, including challenges and facilitators, to providing and accessing care, impacts on their health and wellbeing, and associated economic and non-economic costs of caregiving. Financial strain and social isolation was particularly prominent for lone carers. CONCLUSIONS: Tailoring services to the needs of carers of Aboriginal children with a disability means supporting kinship caregiving, facilitating engagement with other Aboriginal families, and streamlining services and systems to mitigate costs. The experiences described by our participants depict an intersection of race, socio-economic status, gender, disability, and caregiving. Services and funding initiatives should incorporate such intersecting determinants in planning and delivery of holistic care.


Assuntos
Cuidadores , Crianças com Deficiência , Grupo com Ancestrais Oceânicos , Apoio Social , Austrália , Criança , Efeitos Psicossociais da Doença , Crianças com Deficiência/reabilitação , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pesquisa Qualitativa , Reabilitação/economia , Irmãos , Pais Solteiros
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