Australian Journal of Rural Health最新文献

{"title":"Measuring Food and Water Security in an Aboriginal Community in Regional Australia","authors":"Loretta Weatherall,&nbsp;Alinta Trindall,&nbsp;Trish Tonkin,&nbsp;Joseph Alvin Santos,&nbsp;Dori Patay,&nbsp;Ruth McCausland,&nbsp;Wendy Spencer,&nbsp;Greg Leslie,&nbsp;Eileen Baldry,&nbsp;Keziah Bennett-Brook,&nbsp;Julieann Coombes,&nbsp;Tamara Mackean,&nbsp;Janani Shanthosh,&nbsp;Ty Madden,&nbsp;Bruce Moore,&nbsp;Ann-Marie Deane,&nbsp;Niall Earle,&nbsp;Christine Corby GDip,&nbsp;Melissa Nathan,&nbsp;Sera L. Young,&nbsp;Emalie Rosewarne,&nbsp;Jacqui Webster","doi":"10.1111/ajr.13214","DOIUrl":"10.1111/ajr.13214","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To measure current levels and experiences of food and water security in Walgett to guide a community-led program and to provide a baseline measure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A community-led cross-sectional survey conducted in April 2022 by trained local researchers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Walgett, a regional town in NSW, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>A total of 251 Aboriginal adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measured</h3>\u0000 \u0000 <p>Food and water security levels and experiences were measured using the Household Food Insecurity Access Scale (HFIAS) and Household Water InSecurity Experiences (HWISE) Scale. The relationship between food and water insecurity was determined through linear regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Almost half of the respondents experienced food insecurity (46%) or water insecurity (44%) in the last 12 months. Most participants attributed food insecurity to difficulties with food affordability (71%) and availability (63%). More than four in five participants reported relying on purchased or donated bottled water due to main water source interruption (83%) or quality concerns (86%). Water insecurity was associated with food insecurity; HFIAS score increased by 0.43 points for every point higher on the HWISE scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study is the first to measure levels and experiences of food and water security in an Aboriginal community in Australia using validated tools. The results highlight the interconnectedness of food and water insecurity and provide evidence of levels far higher than Australian national level estimates and comparable to low- and middle-income countries. A holistic government response alongside community-led efforts are needed to increasefood and water security to improve health and well-being in remote Aboriginal communities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Student-Led Falls Prevention Program for Community-Dwelling Older Adults in a Rural Community: A Pilot Study","authors":"Asmita Mudholkar,&nbsp;Stephanie Burke,&nbsp;Kehinde Obamiro","doi":"10.1111/ajr.13221","DOIUrl":"10.1111/ajr.13221","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>A third of community-dwelling adults over the age of 65 years fall each year, making falls a significant concern for the elderly. Older people living in community-dwellings account for 73% of fall-related hospitalisations in older populations. Little is known about identifying, reaching at-risk people, and delivering these interventions in rural communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <div>Our aim was two-fold.\u0000\u0000 <ol>\u0000 \u0000 <li>To test the utility of a student-led program in identifying community-dwelling elderly people at high risk for falls in a rural and remote setting.</li>\u0000 \u0000 <li>To determine client satisfaction with the falls prevention program.</li>\u0000 </ol>\u0000 </div>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Rural and remote community settings in Queensland, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Forty community-dwelling older adults from the MMM 4 and 6 regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This pilot study utilised a cross-sectional design and convenience sampling approach. A validated falls risk self-reported checklist and a screening checklist for general practitioners were used to identify older adults at risk of falling. During the home visit, participants were assessed for their cognition, balance and home safety. A client satisfaction survey was completed via telephone 3 months following the home visits.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Several risk factors for falls were identified, including unsafe use of equipment, absence of Medi alerts, insufficient supervision, lack of support, inappropriate footwear, behavioural concerns and environmental hazards. Most participants reported that the home assessment was valuable and made their homes safer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>An innovative student-led placement model has the potential to provide much-needed access to falls prevention services and minimise falls among community-dwelling older adults in rural and remote locations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Paramedicine Models of Care: A Novel Macro Analysis Using the RESPIGHT Framework","authors":"Anthony Weber,&nbsp;Scott Devenish,&nbsp;Louisa Lam","doi":"10.1111/ajr.13215","DOIUrl":"10.1111/ajr.13215","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the alignment of undergraduate paramedicine curricula in Australia with the RESPIGHT model, focusing on diverse aspects such as emergency response, community engagement and governance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Deductive thematic analysis was conducted to assess the alignment of curricula from 16 Australian universities with the RESPIGHT framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The study reviewed undergraduate pre-registration paramedicine programmes across Australian universities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>The study included a comprehensive analysis of curricula from 16 universities offering undergraduate paramedicine programmes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measure</h3>\u0000 \u0000 <p>The degree of alignment of paramedicine curricula with the RESPIGHT categories: emergency response, community engagement, situated practice, primary healthcare, integration with health services, governance, leadership and treatment and transport.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The analysis revealed varying degrees of alignment across the RESPIGHT categories, with notable discrepancies in areas such as community engagement and governance. Some universities demonstrated strong alignment in emergency response and treatment, while others showed weaker integration with primary healthcare and community engagement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study highlights significant disparities in the preparedness of paramedicine students for the broad scope of practice required in modern healthcare. The findings underscore the need for curriculum reform to better prepare students for community care models and the evolving healthcare landscape, ensuring a more comprehensive and integrated approach to paramedicine education in Australia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142933714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inequitable Ethnic and Rural Variations in Mammographic Surveillance of Breast Cancer Survivors in Regional Aotearoa New Zealand","authors":"Maximilian O. Joret,&nbsp;Emily Davenport","doi":"10.1111/ajr.13219","DOIUrl":"10.1111/ajr.13219","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>New Zealand and international guidelines recommend surveillance mammography in breast cancer survivors. Ethnic breast cancer-specific diagnosis, treatment and survival inequities exist in Aotearoa New Zealand. Surveillance mammography uptake remains poorly studied internationally and has never been studied in AoNZ. We aim to study surveillance mammography uptake in our region and to probe for unrecognised ethnic and rural inequities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Taranaki, Aotearoa New Zealand.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Surveillance mammogram candidates who received potentially curative surgery for breast cancer between January 2008 and December 2010.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measure</h3>\u0000 \u0000 <p>Patients' surveillance mammogram opportunity fulfilment rates in the first 10 post-operative years were analysed using a multivariable logistic regression analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Only two thirds of all surveillance mammogram opportunities in our patient's first ten post-operative years were fulfilled. Fulfilment rates decrease significantly with time. Māori and those living rurally are significantly less likely to reach fulfilment rates of ≥ 70% even when accounting for covariates such as age, deprivation, healthcare system and oncology follow up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Healthcare providers have a responsibility to distribute the benefits of health care equitably. This study reports previously unrecognised inequities affecting Māori and rural patients and calls for further research and policy to improve engagement of breast cancer survivors with surveillance mammography and healthcare equity in AoNZ.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep patterns among Aboriginal and Torres Strait Islander Peoples and non-Indigenous Australians: A South Australian descriptive exploratory study","authors":"Jainy Shah BDS,&nbsp;Sneha Sethi PhD,&nbsp;Brianna F. Poirier PhD,&nbsp;Joanne Hedges MPhil,&nbsp;Lisa Jamieson PhD","doi":"10.1111/ajr.13210","DOIUrl":"10.1111/ajr.13210","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Irregularities with sleep patterns and behaviours are commonly observed in Australia, but there is lack of information regarding sleep patterns among Aboriginal or Torres Strait Islander adults. This study explores sleep patterns in Aboriginal or Torres Strait Islander adults, comparing it with non-Indigenous Australian adults in addition to investigating any potential effects on daytime behaviour.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 730 Aboriginal and Torres Strait Islander Peoples aged 18 years and above were included in the study. The participants completed a self-reported questionnaire on various aspects of sleep, such as difficulty falling asleep, waking up during the night, feeling well-rested upon waking, snoring loudly, gasping/choking during sleep, use of prescription medication and experiencing fatigue or sleepiness during the day. Additionally, the participants were interviewed using the ‘Top End Sleepiness Scale’ to report increased sleepiness during daily activities. The responses were compared with those of non-Indigenous Australians in the 2016 Sleep Health Foundation national survey, using questions that measures similar variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Aboriginal and Torres Strait Islander Peoples experienced higher rates of sleep disturbances, including difficulty in falling asleep and waking in the night. Snoring and breathing pauses during sleep were more common in middle-aged men, and sleeping difficulties and daytime symptoms related to insufficient or unrefreshing sleep were more common in women. Sleep issues increased with age among adult Australians but were more common in the age group of 25–34 years for Aboriginal and Torres Strait Islander Peoples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The data suggest that Aboriginal and Torres Strait Islander adults report irregularities in sleep patterns. Early interventions and management of sleep habits could potentially have benefits for overall physical and mental health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Utility of a Digital Glucose-Like Peptide-1 Receptor Agonist-Supported Weight-Loss Service in Regional Australia: A Qualitative Analysis of Interviews With Current Patients of the Eucalyptus Program","authors":"Louis Talay,&nbsp;Matt Vickers,&nbsp;Sarah Loftus","doi":"10.1111/ajr.13220","DOIUrl":"10.1111/ajr.13220","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Against the backdrop of alarming obesity rates and growing concerns about access to specialist care across Australia, this study aims to assess the utility of the nation's largest digital weight-loss service (DWLS) in regional Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>This study focuses on patients of the Eucalyptus DWLS who live in regional Australia (Monash Modified Model classification 3–6).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Thirty-two adults living with overweight or obesity who have been subscribed to the Eucalyptus DWLS for at least 3 weeks were invited to participate in phone-based interviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Interviewers prompted discussion around 6 questions, pertaining to reasons for Eucalyptus subscription, previous attempts at weight loss, views on the service's comprehensiveness, access to face-to-face alternatives, areas for program improvement and general program satisfaction. Investigators conducted a Braun and Clarke thematic analysis of all interview transcripts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six key themes were identified in the analysis, including unmanageable travel times to face-to-face obesity services; inadequate Eucalyptus app functionality; satisfaction with Eucalyptus care continuity; frustration with previously attempted standalone lifestyle interventions; aversion to or dissatisfaction with surgical interventions; and early weight loss increases confidence and exercise motivation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Comprehensive DWLSs such as Eucalyptus have the potential to significantly increase access and adherence to continuous obesity care for regional Australians. However, platforms need to contain special provisions for users with lower literacy and integrate advanced lifestyle trackers to ensure patients are not simply using the DWLS to access weight-loss medications.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural nursing and allied health placements during the latter stage of the COVID-19 public health emergency: A national study","authors":"Belinda Jessup PhD,&nbsp;Anthea Brand PhD,&nbsp;Melissa Kirschbaum PhD,&nbsp;Penny Allen PhD,&nbsp;Lisa Bourke PhD,&nbsp;Jodie Bailie PhD,&nbsp;Susan Heaney PhD,&nbsp;Lyndal Sheepway PhD,&nbsp;Tegan Podubinski DPsych(Clin),&nbsp;Ha Hoang PhD,&nbsp;Kehinde Obamiro PhD,&nbsp;Santosh Jatrana PhD,&nbsp;Sabina Knight MTH,&nbsp;Robyn Fitzroy BApSci,&nbsp;Rohan Rasiah PhD","doi":"10.1111/ajr.13209","DOIUrl":"10.1111/ajr.13209","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore changes to rural nursing and allied health placements during the latter stage of the COVID-19 public health emergency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Regional, rural and remote Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Nursing and allied health students with a scheduled University Department of Rural Health (UDRH) facilitated rural placement between 1 January 2022 and 31 October 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Cross-sectional online survey (<i>n</i> = 333), followed by semi-structured interviews (<i>n</i> = 21).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Almost all students surveyed (98.5%) were able to undertake their placement, although 13.1% reported changes to the setting, timing or delivery of training. Placement tasks (47.3%), experience of the local community (39.0%) and connection with other students (39.6%) were the placement aspects most commonly reported to have changed. However, most students were satisfied with their placement (86.0%), agreed their placement provided quality clinical training (79.3%) and wanted to work rurally after their experience (73.2%). Nursing students had lower odds of reporting satisfaction with placement (OR, 0.49 [95% CI 0.24–0.99, <i>p</i> = 0.03]), while placements longer than 4 weeks had almost twice the odds of promoting rural intention (OR, 1.84 [95% CI 1.09–3.15, <i>p</i> = 0.02]). Placement changes were associated with: fear of contracting COVID-19; circulating illness; health workforce shortages; and health and safety compliance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite changes, most students found rural placements undertaken during 2022 to be quality learning experiences which left them satisfied and wanting to work rurally. UDRHs should advocate for longer placements, improve remote supervision and accommodation infrastructure, and help prepare and support students for challenging learning environments to promote positive rural training experiences during public health emergencies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.13209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Royal Far West's Allied Health Telehealth Services for Children Post-Bushfires","authors":"Michael Curtin,&nbsp;Tayla Iellamo,&nbsp;Donnah Anderson,&nbsp;Mehdi Rassafiani,&nbsp;Tracey Parnell,&nbsp;Sarah Eagland,&nbsp;Rachel Whitsed","doi":"10.1111/ajr.13218","DOIUrl":"10.1111/ajr.13218","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the effectiveness of Royal Far West allied health telehealth services to support the health and well-being of children affected by the bushfires.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>In response to the 2019/2020 Black Summer bushfires, Royal Far West (RFW) implemented the Community Recovery Services (CRS) targeting the health and well-being of affected children. One component of the CRS was the delivery of allied health telehealth services to children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>One hundred and thirty-five children participated in occupational therapy, psychology and/or speech pathology telehealth. Forty-eight parents/carers completed a telehealth satisfaction survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Measures used to determine effectiveness included child and parent/carer satisfaction surveys, the Canadian Occupational Performance Measure (COPM), the Goal Attainment Scale (GAS) and the Strengths and Difficulties Questionnaire (SDQ).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The children overwhelmingly stated that they felt listened to (89%), enjoyed telehealth sessions (84%) and learned new ways to cope with their feelings (87%). Parents/carers reported that children had developed effective emotional regulation and coping strategies. COPM outcomes indicated the children demonstrated statistically significant large improvements in their self-perceived performance of and satisfaction with their identified goals, <i>p</i> &lt; 0.001. The GAS outcomes indicated that 86% of children attained or exceeded their set goals. A statistically significant improvement in children's mental health outcomes post-telehealth was found, as measured by the SDQ (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Occupational therapy, psychology and speech pathology telehealth sessions contributed to positive health and well-being outcomes for children affected by the bushfires. The findings support the implementation of RFW's five key principles for telehealth services: (1) Access to a multidisciplinary team; (2) Practical resources; (3) Flexible delivery; (4) Providing in-person session to support telehealth and (5) Take a ‘whole of child’ approach. Innovative telehealth offered children in geographically remote areas access to effective allied health support post-disaster that was not readily available in their local communities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges of Dementia Care in a Regional Australian Hospital: Exploring Interventions to Minimise Length of Stay for Dementia Patients","authors":"Sandeep Reelh,&nbsp;Rahul Suri,&nbsp;Matthew Hiskens,&nbsp;Clement Tan,&nbsp;Alok Rana","doi":"10.1111/ajr.13212","DOIUrl":"10.1111/ajr.13212","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>There are significant difficulties associated with the management of dementia patients in hospitals, leading to adverse patient outcomes, prolonged length of stay (LOS), strain on resources and high readmission rates. This study aimed to investigate these factors in the context of a regional hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This study retrospectively reviewed all dementia admissions in a publicly funded Australian regional hospital from January 2022 to December 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All admissions including an ICD-10 coded dementia diagnosis were assessed, and data extracted using the integrated electronic medical record.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Overall, 257 bed Australian regional hospital in an area with a Modified Monash Model rating of 2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>There were 105 dementia patients admitted within the study period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcomes Measures</h3>\u0000 \u0000 <p>Dementia severity, LOS, consultation liaison (CL) psychiatry involvement, readmission rates, and discharge destinations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The LOS in patients with dementia was 23.3 (± 35.2) days compared to age-matched patients without dementia admitted in the same period with a LOS of 8.2 (± 4.7) days. Dementia patients who died in hospital had the longest acute LOS at 14.4 (± 8.8) days. Dementia patients who were admitted from their usual residential aged care facility had the longest maintenance LOS at 69 (± 83.3) days.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This research contributes information to the current knowledge gap of dementia care in regional hospitals. Data from this study may help to inform the development of strategies for effective hospital-based dementia care and interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-creating an Indigenous-led virtual health services model for Indigenous Australians living with chronic disease","authors":"Bushra Farah Nasir PhD,&nbsp;William MacAskill PhD,&nbsp;Floyd Leedie,&nbsp;Priya Martin PhD,&nbsp;Khorshed Alam PhD,&nbsp;Katharine Wallis PhD,&nbsp;Matthew McGrail PhD,&nbsp;Srinivas Kondalsamy-Chennakesavan MBBS","doi":"10.1111/ajr.13206","DOIUrl":"10.1111/ajr.13206","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe the co-design process and understand consumer perspectives of a virtual health services (VHS) model of primary healthcare delivery, for Indigenous Australians with chronic disease and living in regional, rural, and remote Queensland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Using decolonising methodologies, the study used an Indigenous consensus method to undertake the co-design process and generate findings. For analysis, a qualitative interpretive-description framework was applied. Thematic analysis generated themes, describing consumer perspectives of virtual healthcare models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The Goondir Health Services (Aboriginal Community Controlled Health Organisation) operating clinics in rural and remote Queensland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Fourteen Indigenous VHS consumers who resided in Modified Monash Model 3–7 communities across Queensland, met the eligibility criteria and provided informed consent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two themes emerged: (1) personalised approaches to autonomous care using digital technologies, with two sub-themes of the benefits and challenges of technology, and the integration of culturally inclusive healthcare elements; (2) person-centred, culturally appropriate healthcare elements within a VHS model, with three sub-themes on the vital role of health coaches, the importance of community connections, and enabling holistic personalised healthcare access.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study provides important consumer perspectives on the potential of VHS models of health care to empower Indigenous healthcare service consumers. VHS holds promise on multiple fronts: improved access, timeliness, continuity of care, and culturally sensitive health care, enabling improved self-management of chronic conditions, and provide crucial support from local Indigenous healthcare providers within the community. Future research on the sustainability and impact of personalised, consumer-centric digital health services in Indigenous populations is essential.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11671847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}