International guidance for advance care planning (ACP) supports the integration of spiritual and ... more International guidance for advance care planning (ACP) supports the integration of spiritual and religious aspects of care within the planning process. Religious leaders' perspectives could improve how ACP programs respect patients' faith backgrounds. This study aimed to examine: (i) how religious leaders understand and consider ACP and its implications, including (ii) how religion affects followers' approaches to end-of-life care and ACP, and (iii) their implications for healthcare. Interview transcripts from a primary qualitative study conducted with religious leaders to inform an ACP website, ACPTalk, were used as data in this study. ACPTalk aims to assist health professionals conduct sensitive conversations with people from different religious backgrounds. A qualitative secondary analysis conducted on the interview transcripts focussed on religious leaders' statements related to this study's aims. Interview transcripts were thematically analysed using an indu...
IntroductionThe population is ageing, with increasing health and supportive care needs. For older... more IntroductionThe population is ageing, with increasing health and supportive care needs. For older people, complex chronic health conditions and frailty can lead to a cascade of repeated hospitalisations and further decline. Existing solutions are fragmented and not person centred. The proposed Being Your Best programme integrates care across hospital and community settings to address symptoms of frailty.Methods and analysisA multicentre pragmatic mixed methods study aiming to recruit 80 community-dwelling patients aged ≥65 years recently discharged from hospital. Being Your Best is a codesigned 6-month programme that provides referral and linkage with existing services comprising four modules to prevent or mitigate symptoms of physical, nutritional, cognitive and social frailty. Feasibility will be assessed in terms of recruitment, acceptability of the intervention to participants and level of retention in the programme. Changes in frailty (Modified Reported Edmonton Frail Scale), c...
ObjectivesThe mental health impacts of the COVID-19 pandemic continue to be documented worldwide ... more ObjectivesThe mental health impacts of the COVID-19 pandemic continue to be documented worldwide with systematic reviews playing a pivotal role. Here we present updated findings from our systematic review and meta-analysis on the mental health impacts among hospital healthcare workers during COVID-19.MethodsWe searched MEDLINE, CINAHL, PsycINFO, Embase and Web Of Science Core Collection between 1st January 2000 to 17thFebruary 2022 for studies using validated methods and reporting on the prevalence of diagnosed or probable mental health disorders in hospital healthcare workers during the COVID-19 pandemic. A meta-analysis of proportions and odds ratio was performed using a random effects model. Heterogeneity was investigated using test of subgroup differences and 95% prediction intervals.ResultsThe meta-analysis included 401 studies, representing 458 754 participants across 58 countries. Pooled prevalence of depression was 28.5% (95%CI: 26.3-30.7), anxiety was 28.7% (95%CI: 26.5-31....
International Journal of Environmental Research and Public Health
Concerns regarding the physical and mental health impacts of frontline healthcare roles during th... more Concerns regarding the physical and mental health impacts of frontline healthcare roles during the COVID-19 pandemic have been well documented, but the impacts on family functioning remain unclear. This study provides a unique contribution to the literature by considering the impacts of the COVID-19 pandemic on frontline healthcare workers and their families. Thirty-nine frontline healthcare workers from Victoria, Australia, who were parents to at least one child under 18 were interviewed. Data were analysed using reflexive thematic analysis. Five superordinate and 14 subordinate themes were identified. Themes included more family time during lockdowns, but at a cost; changes in family responsibilities and routines; managing increased demands; healthcare workers hypervigilance and fear of bringing COVID-19 home to their family members; ways in which families worked to “get through it”. While efforts have been made by many healthcare organisations to support their workers during this...
Objective A growing body of research indicates that paramedics may have a greater role to play in... more Objective A growing body of research indicates that paramedics may have a greater role to play in health care service provision, beyond the traditional models of emergency health care. The aim of this study was to identify and synthesise the literature pertaining to the role of paramedic-initiated health education within Australia, with specific consideration of metropolitan, rural and remote contexts. Methods A literature review was undertaken using the Ovid Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE and Scopus databases. The search time frame was limited from January 2007 to November 2017. The search was performed using key paramedic search terms in combination with keywords such as health education, rural, metropolitan, remote and Australia. Reference lists from relevant papers were also reviewed. Results Fourteen articles met the inclusion criteria for synthesis. Health education in the Australian paramedic context relates largely to expan...
Aim. This article presents a discussion of the importance of providing meaningful advanced practi... more Aim. This article presents a discussion of the importance of providing meaningful advanced practice nursing role definition and clarity to improve international standards of nursing titles and scopes of practice. Background. A plethora of international literature exists discussing advanced practice nursing roles and their contribution to healthcare delivery in various countries. However, lack of consistency around title, role definition and scope of practice remains. Data sources. CINAHL and Medline databases were searched using 'nurse practitioner', 'nurse practitioner role', 'nurse practitioner practice', 'nurse practitioner in public health', 'advanced practice nursing roles' and 'development of new nursing roles' with articles limited to years 1995-2010. Citations used in those articles were also explored. All cited articles were in the English language. Discussion. This article supports the need to strengthen the Nurse Practitioner role in health care and professional clarity is identified as a strategy to enhance this. Themes around role clarity, professional identity, ability to enhance healthcare provision and inter-professional issues are examined. The need to more clearly articulate advanced nursing roles in light of the evolution of the Nurse Practitioner role is highlighted. Much work has already occurred in this domain and a means of adapting and broadening these developments for a wider, more global audience whilst maintaining local context is discussed. Conclusion. Although evidence exists that advanced practice nursing roles are increasing internationally, uncertainty around role clarity remains. This is problematic because the valuable contribution of nursing roles is lost, if the ability to clearly express their function does not exist.
Background: Advance care planning (ACP) promotes conversations about future health care needs, en... more Background: Advance care planning (ACP) promotes conversations about future health care needs, enacted if a person is incapable of making decisions at end-of-life that may be communicated through written documentation such as advance care directives. To meet the needs of multicultural and multifaith populations in Australia, an advance care planning website, ACPTalk, was funded to support health professionals in conducting conversations within diverse religious and cultural populations. ACPTalk aimed to provide religion-specific advance care planning content and complement existing resources. Objective: The purpose of this paper was to utilize the context, input, process, and product (CIPP) framework to conduct a formative and summative evaluation of ACPTalk. Methods: The CIPP framework was used, which revolves around 4 aspects of evaluation: context, input, process, and product. Context: health professionals' solutions for the website were determined through thematic analysis of exploratory key stakeholder interviews. Included religions were determined through an environmental scan, Australian population statistics, and documentary analysis of project steering committee meeting minutes. Input: Project implementation and challenges were examined through documentary analysis of project protocols and meeting minutes. Process: To ensure religion-specific content was accurate and appropriate, a website prototype was built with content review and functionality testing by representatives from religious and cultural organizations and other interested health care organizations who completed a Web-based survey. Product: Website analytics were used to report utilization, and stakeholder perceptions were captured through interviews and a website survey. Results: Context: A total of 16 key stakeholder health professional (7 general practitioners, 2 primary health nurses, and 7 palliative care nurses) interviews were analyzed. Website solutions included religious and cultural information, communication ideas, legal information, downloadable content, and Web-based accessibility. Christian and non-Christian faiths were to be included in the religion-specific content. Input: Difficulties gaining consensus on religion-specific content were overcome by further state and national religious organizations providing feedback. Process: A total of 37 content reviewers included representatives of religious and cultural organizations (n=29), health care (n=5), and community organizations (n=3). The majority strongly agree or agree that the content used appropriate language and tone (92%, 34/37), would support health professionals (89%, 33/37), and was accurate (83%, 24/29). Product: Resource usage within the first 9 months was 12,957 page views in 4260 sessions; majority were (83.45%, 3555/4260) from Australia. A total of 107 Australian-based users completed the website survey;
This pilot study intended to augment current literature in the clinical placement field by invest... more This pilot study intended to augment current literature in the clinical placement field by investigating the frequency and nature of adverse health events experiences by paramedic students undertaking ambulance clinical placements. Supports accessed post event were also reviewed. A purposive sample of fifty-six paramedic students completed the questionnaire. The results indicate that a number of students experience adverse health events while on clinical placement, with fourteen cases of verbal abuse, one case of physical abuse, nine cases of sexualised behavior and seven cases of psychological distress reported. While some case related incidents were flagged by ambulance services and followed up by peer support, students did not initiate any formal support processes themselves. Moreover, no student filed a formal report regarding any of the incidents raised. The results of this pilot study require further investigation. In the interim, the benefits of clinical placements must be weighed against their risks, and processes put in place to minimize the risk to students undertaking clinical placements.
Objectives Culture and religion are important in advance care planning (ACP), yet it is not well ... more Objectives Culture and religion are important in advance care planning (ACP), yet it is not well understood how this is represented in ACP online resources. The aim of the present study was to identify the availability of Australian-based ACP websites and online informational booklets containing cultural and religious information. Methods An environmental scanning framework was used with a Google search conducted from 30 June 2015 to 5 July 2015. Eligible Australian-based ACP websites and online informational booklets were reviewed by two analysts (APS & PM) for information pertaining to at least one culture or religion. Common characteristics were agreed upon and tabulated with narrative description. Results Seven Australian-based ACP websites were identified with varying degrees of cultural and religious information. Seven Australian-based ACP informational booklets were identified addressing culture or religion, namely of Aboriginal and Torres Strait Islander (n = 5), Sikh (n = 1...
There are three broad themes integrated throughout this thesis. The first relates to the developm... more There are three broad themes integrated throughout this thesis. The first relates to the development and implementation of a multimedia healthcare program called `Ambulances for Asthma'. The second relates to program evaluation within healthcare and recounts the methodological challenges related to the evaluation of this program. The third portrays the self reflective evaluation journey of the author informed by auto-ethnography. Six linked projects are presented, culminating in a metaevaluation of the health promotion [process, impact and outcome (PIO)] and realist evaluation models from healthcare practitioner and policy maker perspectives. This thesis aims to determine which approach has greater utility, feasibility, propriety and accuracy within healthcare. The first project undertook a needs analysis to identify barriers to optimal emergency management of asthma in the pre-hospital setting in rural Australia. The major barrier identified was a decision to use self transport...
The Journal of Mental Health Training, Education and Practice, 2018
PurposeThis critical review of historical and contemporary literature explores the role of televi... more PurposeThis critical review of historical and contemporary literature explores the role of television media in the prevalence of stigma towards persons experiencing a mental health challenge. In addition to this, the purpose of this paper is to examine the notion of perceived dangerousness, which is a concept where persons with mental illness are thought by others to be inherently dangerous.Design/methodology/approachA vigorous search of databases was undertaken for articles published between 2000 and 2016. Some seminal literature prior to 2000 was used to compare historical data with current literature. In total, 1,037 publications were reviewed against inclusion criteria.FindingsWhile mental illness stigma has received much attention in the literature, television media and public perceptions of dangerousness have not. While these concepts are complex and multi-factorial, what we do understand is that approaches to address stigma have been largely unsuccessful, and that persons exp...
To ascertain the feasibility and acceptability of the programme, a novel volunteer-peer postdisch... more To ascertain the feasibility and acceptability of the programme, a novel volunteer-peer postdischarge support programme for older patients after discharge from the emergency department (ED). A multicentre prospective mixed-methods feasibility study. Two tertiary hospital EDs in metropolitan Melbourne, Australia. A convenience sample of 39 discharged ED patients aged 70 years or over, with symptoms of social isolation, loneliness and/or depression. The intervention comprised weekly social support telephone calls delivered by volunteer peers for 3 months following ED discharge. The primary outcomes were feasibility of study processes, intervention acceptability to participants and retention in the programme. Secondary outcomes were changes in loneliness level (UCLA-3-3-item Loneliness Scale), mood (5-item Geriatric Depression Scale) and health-related quality of life (EQ-5D-5L and EQ-VAS) postintervention. Recruitment was feasible, with 30% of eligible patients successfully recruited....
International journal of nursing studies, Jan 6, 2018
Falls are a major problem for patients and hospitals, resulting in death, disability and increase... more Falls are a major problem for patients and hospitals, resulting in death, disability and increased costs of healthcare. This study aimed to estimate the resource allocation across a partnership of large health services, in an attempt to understand the amount and variability of resource allocation to various falls prevention activities. A cross sectional survey using semi-structured interviews. Six tertiary health services in Australia. A collaboration of six health services, spanning twenty-eight hospitals, was formed to investigate falls prevention resource allocation. We interviewed 186 health service staff who were involved in falls prevention activities, such as projects, audits and risk management, clinical and operational managers responsible for falls prevention resource allocation and clinical staff on targeted acute, subacute and mental health wards. This study used a mixed methods, cross sectional, observational design. To collect data, we used key informant interviews wit...
IntroductionThe frequency of disasters is increasing around the world with more people being at r... more IntroductionThe frequency of disasters is increasing around the world with more people being at risk. There is a moral imperative to improve the way in which disaster evaluations are undertaken and reported with the aim of reducing preventable mortality and morbidity in future events. Disasters are complex events and undertaking disaster evaluations is a specialized area of study at an international level.Hypothesis/ProblemWhile some frameworks have been developed to support consistent disaster research and evaluation, they lack validation, consistent terminology, and standards for reporting across the different phases of a disaster. There is yet to be an agreed, comprehensive framework to structure disaster evaluation typologies.The aim of this paper is to outline an evolving comprehensive framework for disaster evaluation typologies. It is anticipated that this new framework will facilitate an agreement on identifying, structuring, and relating the various evaluations found in the disaster setting with a view to better understand the process, outcomes, and impacts of the effectiveness and efficiency of interventions.MethodsResearch was undertaken in two phases: (1) a scoping literature review (peer-reviewed and “grey literature”) was undertaken to identify current evaluation frameworks and typologies used in the disaster setting; and (2) a structure was developed that included the range of typologies identified in Phase One and suggests possible relationships in the disaster setting.ResultsNo core, unifying framework to structure disaster evaluation and research was identified in the literature. The authors propose a “Comprehensive Framework for Disaster Evaluation Typologies” that identifies, structures, and suggests relationships for the various typologies detected.ConclusionThe proposed Comprehensive Framework for Disaster Evaluation Typologies outlines the different typologies of disaster evaluations that were identified in this study and brings them together into a single framework. This unique, unifying framework has relevance at an international level and is expected to benefit the disaster, humanitarian, and development sectors. The next step is to undertake a validation process that will include international leaders with experience in evaluation, in general, and disasters specifically. This work promotes an environment for constructive dialogue on evaluations in the disaster setting to strengthen the evidence base for interventions across the disaster spectrum. It remains a work in progress.WongDF,SpencerC,BoydL,BurkleFMJr.,ArcherF.Disaster metrics: a comprehensive framework for disaster evaluation typologies.Prehosp Disaster Med.2017;32(5):501–514.
Older people presenting to an emergency department (ED) have a higher likelihood of social isolat... more Older people presenting to an emergency department (ED) have a higher likelihood of social isolation, loneliness and depression; which are all associated with negative health outcomes and increased health service use, including higher rates of ED attendance. The HOW R U? study aims to ascertain the feasibility and acceptability of a postdischarge telephone support programme for older ED patients following discharge. The intervention, which aims to improve quality of life, will be delivered by hospital-based volunteers. A multicentre prospective uncontrolled feasibility study will enrol 50 community-dwelling patients aged ≥70 years with symptoms of loneliness or depression who are discharged home within 72 hours from the ED or acute medical ward. Participants will receive weekly supportive telephone calls over a 3-month period from a volunteer-peer. Feasibility will be assessed in terms of recruitment, acceptability of the intervention to participants and level of retention in the pr...
International guidance for advance care planning (ACP) supports the integration of spiritual and ... more International guidance for advance care planning (ACP) supports the integration of spiritual and religious aspects of care within the planning process. Religious leaders' perspectives could improve how ACP programs respect patients' faith backgrounds. This study aimed to examine: (i) how religious leaders understand and consider ACP and its implications, including (ii) how religion affects followers' approaches to end-of-life care and ACP, and (iii) their implications for healthcare. Interview transcripts from a primary qualitative study conducted with religious leaders to inform an ACP website, ACPTalk, were used as data in this study. ACPTalk aims to assist health professionals conduct sensitive conversations with people from different religious backgrounds. A qualitative secondary analysis conducted on the interview transcripts focussed on religious leaders' statements related to this study's aims. Interview transcripts were thematically analysed using an indu...
IntroductionThe population is ageing, with increasing health and supportive care needs. For older... more IntroductionThe population is ageing, with increasing health and supportive care needs. For older people, complex chronic health conditions and frailty can lead to a cascade of repeated hospitalisations and further decline. Existing solutions are fragmented and not person centred. The proposed Being Your Best programme integrates care across hospital and community settings to address symptoms of frailty.Methods and analysisA multicentre pragmatic mixed methods study aiming to recruit 80 community-dwelling patients aged ≥65 years recently discharged from hospital. Being Your Best is a codesigned 6-month programme that provides referral and linkage with existing services comprising four modules to prevent or mitigate symptoms of physical, nutritional, cognitive and social frailty. Feasibility will be assessed in terms of recruitment, acceptability of the intervention to participants and level of retention in the programme. Changes in frailty (Modified Reported Edmonton Frail Scale), c...
ObjectivesThe mental health impacts of the COVID-19 pandemic continue to be documented worldwide ... more ObjectivesThe mental health impacts of the COVID-19 pandemic continue to be documented worldwide with systematic reviews playing a pivotal role. Here we present updated findings from our systematic review and meta-analysis on the mental health impacts among hospital healthcare workers during COVID-19.MethodsWe searched MEDLINE, CINAHL, PsycINFO, Embase and Web Of Science Core Collection between 1st January 2000 to 17thFebruary 2022 for studies using validated methods and reporting on the prevalence of diagnosed or probable mental health disorders in hospital healthcare workers during the COVID-19 pandemic. A meta-analysis of proportions and odds ratio was performed using a random effects model. Heterogeneity was investigated using test of subgroup differences and 95% prediction intervals.ResultsThe meta-analysis included 401 studies, representing 458 754 participants across 58 countries. Pooled prevalence of depression was 28.5% (95%CI: 26.3-30.7), anxiety was 28.7% (95%CI: 26.5-31....
International Journal of Environmental Research and Public Health
Concerns regarding the physical and mental health impacts of frontline healthcare roles during th... more Concerns regarding the physical and mental health impacts of frontline healthcare roles during the COVID-19 pandemic have been well documented, but the impacts on family functioning remain unclear. This study provides a unique contribution to the literature by considering the impacts of the COVID-19 pandemic on frontline healthcare workers and their families. Thirty-nine frontline healthcare workers from Victoria, Australia, who were parents to at least one child under 18 were interviewed. Data were analysed using reflexive thematic analysis. Five superordinate and 14 subordinate themes were identified. Themes included more family time during lockdowns, but at a cost; changes in family responsibilities and routines; managing increased demands; healthcare workers hypervigilance and fear of bringing COVID-19 home to their family members; ways in which families worked to “get through it”. While efforts have been made by many healthcare organisations to support their workers during this...
Objective A growing body of research indicates that paramedics may have a greater role to play in... more Objective A growing body of research indicates that paramedics may have a greater role to play in health care service provision, beyond the traditional models of emergency health care. The aim of this study was to identify and synthesise the literature pertaining to the role of paramedic-initiated health education within Australia, with specific consideration of metropolitan, rural and remote contexts. Methods A literature review was undertaken using the Ovid Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE and Scopus databases. The search time frame was limited from January 2007 to November 2017. The search was performed using key paramedic search terms in combination with keywords such as health education, rural, metropolitan, remote and Australia. Reference lists from relevant papers were also reviewed. Results Fourteen articles met the inclusion criteria for synthesis. Health education in the Australian paramedic context relates largely to expan...
Aim. This article presents a discussion of the importance of providing meaningful advanced practi... more Aim. This article presents a discussion of the importance of providing meaningful advanced practice nursing role definition and clarity to improve international standards of nursing titles and scopes of practice. Background. A plethora of international literature exists discussing advanced practice nursing roles and their contribution to healthcare delivery in various countries. However, lack of consistency around title, role definition and scope of practice remains. Data sources. CINAHL and Medline databases were searched using 'nurse practitioner', 'nurse practitioner role', 'nurse practitioner practice', 'nurse practitioner in public health', 'advanced practice nursing roles' and 'development of new nursing roles' with articles limited to years 1995-2010. Citations used in those articles were also explored. All cited articles were in the English language. Discussion. This article supports the need to strengthen the Nurse Practitioner role in health care and professional clarity is identified as a strategy to enhance this. Themes around role clarity, professional identity, ability to enhance healthcare provision and inter-professional issues are examined. The need to more clearly articulate advanced nursing roles in light of the evolution of the Nurse Practitioner role is highlighted. Much work has already occurred in this domain and a means of adapting and broadening these developments for a wider, more global audience whilst maintaining local context is discussed. Conclusion. Although evidence exists that advanced practice nursing roles are increasing internationally, uncertainty around role clarity remains. This is problematic because the valuable contribution of nursing roles is lost, if the ability to clearly express their function does not exist.
Background: Advance care planning (ACP) promotes conversations about future health care needs, en... more Background: Advance care planning (ACP) promotes conversations about future health care needs, enacted if a person is incapable of making decisions at end-of-life that may be communicated through written documentation such as advance care directives. To meet the needs of multicultural and multifaith populations in Australia, an advance care planning website, ACPTalk, was funded to support health professionals in conducting conversations within diverse religious and cultural populations. ACPTalk aimed to provide religion-specific advance care planning content and complement existing resources. Objective: The purpose of this paper was to utilize the context, input, process, and product (CIPP) framework to conduct a formative and summative evaluation of ACPTalk. Methods: The CIPP framework was used, which revolves around 4 aspects of evaluation: context, input, process, and product. Context: health professionals' solutions for the website were determined through thematic analysis of exploratory key stakeholder interviews. Included religions were determined through an environmental scan, Australian population statistics, and documentary analysis of project steering committee meeting minutes. Input: Project implementation and challenges were examined through documentary analysis of project protocols and meeting minutes. Process: To ensure religion-specific content was accurate and appropriate, a website prototype was built with content review and functionality testing by representatives from religious and cultural organizations and other interested health care organizations who completed a Web-based survey. Product: Website analytics were used to report utilization, and stakeholder perceptions were captured through interviews and a website survey. Results: Context: A total of 16 key stakeholder health professional (7 general practitioners, 2 primary health nurses, and 7 palliative care nurses) interviews were analyzed. Website solutions included religious and cultural information, communication ideas, legal information, downloadable content, and Web-based accessibility. Christian and non-Christian faiths were to be included in the religion-specific content. Input: Difficulties gaining consensus on religion-specific content were overcome by further state and national religious organizations providing feedback. Process: A total of 37 content reviewers included representatives of religious and cultural organizations (n=29), health care (n=5), and community organizations (n=3). The majority strongly agree or agree that the content used appropriate language and tone (92%, 34/37), would support health professionals (89%, 33/37), and was accurate (83%, 24/29). Product: Resource usage within the first 9 months was 12,957 page views in 4260 sessions; majority were (83.45%, 3555/4260) from Australia. A total of 107 Australian-based users completed the website survey;
This pilot study intended to augment current literature in the clinical placement field by invest... more This pilot study intended to augment current literature in the clinical placement field by investigating the frequency and nature of adverse health events experiences by paramedic students undertaking ambulance clinical placements. Supports accessed post event were also reviewed. A purposive sample of fifty-six paramedic students completed the questionnaire. The results indicate that a number of students experience adverse health events while on clinical placement, with fourteen cases of verbal abuse, one case of physical abuse, nine cases of sexualised behavior and seven cases of psychological distress reported. While some case related incidents were flagged by ambulance services and followed up by peer support, students did not initiate any formal support processes themselves. Moreover, no student filed a formal report regarding any of the incidents raised. The results of this pilot study require further investigation. In the interim, the benefits of clinical placements must be weighed against their risks, and processes put in place to minimize the risk to students undertaking clinical placements.
Objectives Culture and religion are important in advance care planning (ACP), yet it is not well ... more Objectives Culture and religion are important in advance care planning (ACP), yet it is not well understood how this is represented in ACP online resources. The aim of the present study was to identify the availability of Australian-based ACP websites and online informational booklets containing cultural and religious information. Methods An environmental scanning framework was used with a Google search conducted from 30 June 2015 to 5 July 2015. Eligible Australian-based ACP websites and online informational booklets were reviewed by two analysts (APS & PM) for information pertaining to at least one culture or religion. Common characteristics were agreed upon and tabulated with narrative description. Results Seven Australian-based ACP websites were identified with varying degrees of cultural and religious information. Seven Australian-based ACP informational booklets were identified addressing culture or religion, namely of Aboriginal and Torres Strait Islander (n = 5), Sikh (n = 1...
There are three broad themes integrated throughout this thesis. The first relates to the developm... more There are three broad themes integrated throughout this thesis. The first relates to the development and implementation of a multimedia healthcare program called `Ambulances for Asthma'. The second relates to program evaluation within healthcare and recounts the methodological challenges related to the evaluation of this program. The third portrays the self reflective evaluation journey of the author informed by auto-ethnography. Six linked projects are presented, culminating in a metaevaluation of the health promotion [process, impact and outcome (PIO)] and realist evaluation models from healthcare practitioner and policy maker perspectives. This thesis aims to determine which approach has greater utility, feasibility, propriety and accuracy within healthcare. The first project undertook a needs analysis to identify barriers to optimal emergency management of asthma in the pre-hospital setting in rural Australia. The major barrier identified was a decision to use self transport...
The Journal of Mental Health Training, Education and Practice, 2018
PurposeThis critical review of historical and contemporary literature explores the role of televi... more PurposeThis critical review of historical and contemporary literature explores the role of television media in the prevalence of stigma towards persons experiencing a mental health challenge. In addition to this, the purpose of this paper is to examine the notion of perceived dangerousness, which is a concept where persons with mental illness are thought by others to be inherently dangerous.Design/methodology/approachA vigorous search of databases was undertaken for articles published between 2000 and 2016. Some seminal literature prior to 2000 was used to compare historical data with current literature. In total, 1,037 publications were reviewed against inclusion criteria.FindingsWhile mental illness stigma has received much attention in the literature, television media and public perceptions of dangerousness have not. While these concepts are complex and multi-factorial, what we do understand is that approaches to address stigma have been largely unsuccessful, and that persons exp...
To ascertain the feasibility and acceptability of the programme, a novel volunteer-peer postdisch... more To ascertain the feasibility and acceptability of the programme, a novel volunteer-peer postdischarge support programme for older patients after discharge from the emergency department (ED). A multicentre prospective mixed-methods feasibility study. Two tertiary hospital EDs in metropolitan Melbourne, Australia. A convenience sample of 39 discharged ED patients aged 70 years or over, with symptoms of social isolation, loneliness and/or depression. The intervention comprised weekly social support telephone calls delivered by volunteer peers for 3 months following ED discharge. The primary outcomes were feasibility of study processes, intervention acceptability to participants and retention in the programme. Secondary outcomes were changes in loneliness level (UCLA-3-3-item Loneliness Scale), mood (5-item Geriatric Depression Scale) and health-related quality of life (EQ-5D-5L and EQ-VAS) postintervention. Recruitment was feasible, with 30% of eligible patients successfully recruited....
International journal of nursing studies, Jan 6, 2018
Falls are a major problem for patients and hospitals, resulting in death, disability and increase... more Falls are a major problem for patients and hospitals, resulting in death, disability and increased costs of healthcare. This study aimed to estimate the resource allocation across a partnership of large health services, in an attempt to understand the amount and variability of resource allocation to various falls prevention activities. A cross sectional survey using semi-structured interviews. Six tertiary health services in Australia. A collaboration of six health services, spanning twenty-eight hospitals, was formed to investigate falls prevention resource allocation. We interviewed 186 health service staff who were involved in falls prevention activities, such as projects, audits and risk management, clinical and operational managers responsible for falls prevention resource allocation and clinical staff on targeted acute, subacute and mental health wards. This study used a mixed methods, cross sectional, observational design. To collect data, we used key informant interviews wit...
IntroductionThe frequency of disasters is increasing around the world with more people being at r... more IntroductionThe frequency of disasters is increasing around the world with more people being at risk. There is a moral imperative to improve the way in which disaster evaluations are undertaken and reported with the aim of reducing preventable mortality and morbidity in future events. Disasters are complex events and undertaking disaster evaluations is a specialized area of study at an international level.Hypothesis/ProblemWhile some frameworks have been developed to support consistent disaster research and evaluation, they lack validation, consistent terminology, and standards for reporting across the different phases of a disaster. There is yet to be an agreed, comprehensive framework to structure disaster evaluation typologies.The aim of this paper is to outline an evolving comprehensive framework for disaster evaluation typologies. It is anticipated that this new framework will facilitate an agreement on identifying, structuring, and relating the various evaluations found in the disaster setting with a view to better understand the process, outcomes, and impacts of the effectiveness and efficiency of interventions.MethodsResearch was undertaken in two phases: (1) a scoping literature review (peer-reviewed and “grey literature”) was undertaken to identify current evaluation frameworks and typologies used in the disaster setting; and (2) a structure was developed that included the range of typologies identified in Phase One and suggests possible relationships in the disaster setting.ResultsNo core, unifying framework to structure disaster evaluation and research was identified in the literature. The authors propose a “Comprehensive Framework for Disaster Evaluation Typologies” that identifies, structures, and suggests relationships for the various typologies detected.ConclusionThe proposed Comprehensive Framework for Disaster Evaluation Typologies outlines the different typologies of disaster evaluations that were identified in this study and brings them together into a single framework. This unique, unifying framework has relevance at an international level and is expected to benefit the disaster, humanitarian, and development sectors. The next step is to undertake a validation process that will include international leaders with experience in evaluation, in general, and disasters specifically. This work promotes an environment for constructive dialogue on evaluations in the disaster setting to strengthen the evidence base for interventions across the disaster spectrum. It remains a work in progress.WongDF,SpencerC,BoydL,BurkleFMJr.,ArcherF.Disaster metrics: a comprehensive framework for disaster evaluation typologies.Prehosp Disaster Med.2017;32(5):501–514.
Older people presenting to an emergency department (ED) have a higher likelihood of social isolat... more Older people presenting to an emergency department (ED) have a higher likelihood of social isolation, loneliness and depression; which are all associated with negative health outcomes and increased health service use, including higher rates of ED attendance. The HOW R U? study aims to ascertain the feasibility and acceptability of a postdischarge telephone support programme for older ED patients following discharge. The intervention, which aims to improve quality of life, will be delivered by hospital-based volunteers. A multicentre prospective uncontrolled feasibility study will enrol 50 community-dwelling patients aged ≥70 years with symptoms of loneliness or depression who are discharged home within 72 hours from the ED or acute medical ward. Participants will receive weekly supportive telephone calls over a 3-month period from a volunteer-peer. Feasibility will be assessed in terms of recruitment, acceptability of the intervention to participants and level of retention in the pr...
Uploads
Papers by Lee Boyd