1
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O'Dwyer M, Porter T, Rittinghausen N, Tribuzio L, Polacsek M. Who speaks my language? Linguistic diversity among people living in Australian residential aged care facilities. Australas J Ageing 2024. [PMID: 38269639 DOI: 10.1111/ajag.13275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 11/24/2023] [Accepted: 12/03/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVES Australia's migration programs mean that an increasing number of people living in residential aged care (RAC) were born in a non-main English-speaking country (NMESC) and have a preferred language other than English (LOTE). This study describes the number of such residents in aged care facilities in Australia and discusses the implications for their care. METHODS This study presents a secondary analysis of the Australian Institute of Health and Welfare (AIHW) National Aged Care Data Clearinghouse 2020-2021 to examine the country of birth and preferred language of people living in RAC in each state and territory and the number of residents who are lone speakers of their language in their facility. RESULTS Less than half (45 per cent) of the residents born in a NMESC had a preferred LOTE. Of those, 50 per cent spoke Italian, Greek or Cantonese. At least 60 other preferred languages were recorded, the majority with very few speakers. Australia-wide, more than one in five residents with a preferred top 20 LOTE are the lone speaker of their language in their facility. The proportion of lone speakers is highest in Tasmania, the ACT and Queensland. CONCLUSIONS Understanding the extent of language diversity, location and linguistic isolation of people living in RAC is essential for planning to ensure residents with a preferred LOTE receive high-quality, individualised care. There is a need for consistent and timely data collection about the diversity of aged care residents and workers in this sector.
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Affiliation(s)
- Monica O'Dwyer
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Benetas, Hawthorn, Victoria, Australia
| | | | | | - Lisa Tribuzio
- Centre for Cultural Diversity in Ageing, Hawthorn, Victoria, Australia
| | - Meg Polacsek
- Benetas, Hawthorn, Victoria, Australia
- Australian Association of Gerontology, Melbourne, Victoria, Australia
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2
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Polacsek M, Porter T. Facilitating advance care planning in the thriving retirement village setting. Australas J Ageing 2022. [DOI: 10.1111/ajag.13168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 12/02/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
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3
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Polacsek M, Boardman GH, McCann TV. Self-Identity and Meaning in Life as Enablers for Older Adults to Self-Manage Depression. Issues Ment Health Nurs 2022; 43:409-417. [PMID: 34762554 DOI: 10.1080/01612840.2021.1998263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Depression is the most common mental illness in older adults and is a leading cause of global disability. Generally, those who have a stronger sense of self-identity and find meaning in their lives tend to manage the symptoms of depression better than those who do not. Little is known about the association between self-identity, meaning in life and self-management of depression in older adults. The aim of this grounded theory study was to explicate how older adults with depression attempted to reclaim self-identity in ways that facilitated self-management. Data collection and analysis were informed by Corbin and Strauss' approach to grounded theory. Thirty-two older adults with a formal diagnosis of moderate depression participated in in-depth, semi-structured interviews. The core problem for participants related to their sense that they were not treated as individuals as they sought to receive and adapt to a depression diagnosis. This challenge was conceptualised as Struggling to maintain personal identity as an older adult with depression. By empowering themselves and striving for a meaningful existence, participants strived to master their current circumstances in ways that strengthened their sense of personal identity. This, in turn, supported their efforts to effectively manage their symptoms of depression and employ adaptive coping strategies that optimise well-being. Our findings identify the need for recovery-oriented models of interdisciplinary practice that enhance self-identity and meaning in life in older adults, in ways that support self-management of depression.
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Affiliation(s)
- Meg Polacsek
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia.,Quality, Outcomes and Research, Benetas, Melbourne, Victoria, Australia
| | - Gayelene H Boardman
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Terence V McCann
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
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4
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Franckle RL, Boulos RJ, Thorndike AN, Moran AJ, Khandpur N, Blue D, Greene J, Block JP, Rimm EB, Polacsek M. Implementation of a 2-for-1 Price Incentive for Fruits and Vegetables in a Grocery Retail Setting. Health Promot Pract 2022:15248399221086880. [PMID: 35414293 DOI: 10.1177/15248399221086880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND AND PURPOSE There is growing interest in expanding healthy eating interventions in the retail setting. The purpose of this study was to evaluate the implementation of a successful 2-for-1 price incentive for fruits and vegetables (F&V), including frozen and canned, that took place in partnership with a large chain grocery retailer in Maine. Intervention Approach. A randomized controlled trial (RCT) pilot study was conducted in 2015-2016, followed by a larger RCT in 2016-2017, to assess whether a supermarket double-dollar F&V incentive increased purchases of these items. EVALUATION METHODS A convergent, parallel mixed-methods design was used to examine barriers and facilitators to implementing the interventions, using six implementation outcomes: acceptability, adoption, appropriateness, feasibility, implementation fidelity, and perceived cost. RESULTS The intervention was deemed highly acceptable, appropriate, and feasible by shoppers, retailers, and researchers. The F&V discount had a high rate of initial adoption. There was a moderate degree of fidelity, which improved over time based on lessons learned from the pilot and applied to the subsequent RCT. Specific costs associated with implementation from the research perspective are reported. Implications for Practice, Policy, and Research. Partnerships between academic researchers and retailers can be an effective model for improving healthful purchases among shoppers. These findings are relevant for investigators, public health advocates, and retailers interested in implementing similar grocery retail-based interventions.
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Affiliation(s)
| | - R J Boulos
- Maine Public Health Association, Augusta, ME, USA
| | - A N Thorndike
- Harvard Medical School, Boston, MA, USA
- Massachusetts General Hospital, Boston, MA, USA
| | - A J Moran
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - N Khandpur
- University of Sao Paulo, Sao Paulo, Brazil
| | - D Blue
- Hannaford Supermarkets, Scarborough, ME, USA
| | - J Greene
- Guiding Stars Licensing Company LLC, Ahold Delhaize, USA
| | - J P Block
- Harvard Medical School, Boston, MA, USA
- Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - E B Rimm
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - M Polacsek
- University of New England, Portland, ME, USA
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5
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Polacsek M, Woolford M. Strategies to support older adults' mental health during the transition into residential aged care: a qualitative study of multiple stakeholder perspectives. BMC Geriatr 2022; 22:151. [PMID: 35209848 PMCID: PMC8866554 DOI: 10.1186/s12877-022-02859-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 02/17/2022] [Indexed: 12/04/2022] Open
Abstract
Background The move from home into residential care is one of the most stressful life experiences for older adults. ‘Relocation stress’ is a significant risk factor for anxiety and/or depression in aged care residents. Whether long-term or recently diagnosed, these mood disorders are associated with a decline in overall well-being, daily functioning and independence. The mental health needs of older adults are often poorly recognised and supported, including during the transition into residential care. Despite growing interest in how to facilitate this major life transition, few studies have taken the perspective of multiple stakeholders. The aim of this study was to explore resident, relative and staff experiences of the transition into residential aged care, and to identify strategies to support the mental health of older adults at this time. The role of pastoral care practitioners to facilitate transitions and support residents’ mental health was also examined. Methods This phenomenological study involved individual interviews with 35 aged care residents, relatives and staff, between January and April 2021. Participants were selected using purposive sampling. Audio-recorded interviews were transcribed verbatim and supported by field notes. Data analysis followed Giorgi’s steps for qualitative data analysis. Results Results were distilled into three main categories related to the overall transition experience, recognising and responding to residents’ mental health needs, and tailoring support to individual needs. A novel contribution of this study relates to the need to address a broad misunderstanding of the role of pastoral care and subsequent under-utilisation of a potentially valuable resource. Conclusions By describing transition experiences and the resources to support residents’ mental health, findings of this study provide practical, ‘real world’ suggestions for reducing relocation stress. New resources developed from the findings include guides, checklists and short question-and-answer films, in which current residents and staff describe strategies to support mental health and overall quality of life. Similar resources could be used to support transitions in other care settings.
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Affiliation(s)
- Meg Polacsek
- Benetas, Level 1, 789 Toorak Road, Melbourne, Vic, 3123, Australia.
| | - Marta Woolford
- Benetas, Level 1, 789 Toorak Road, Melbourne, Vic, 3123, Australia
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Goh AM, Doyle C, Gaffy E, Batchelor F, Polacsek M, Savvas S, Malta S, Ames D, Winbolt M, Panayiotou A, Loi SM, Cooper C, Livingston G, Low LF, Fairhall A, Burton J, Dow B. Co-designing a dementia-specific education and training program for home care workers: The 'Promoting Independence Through quality dementia Care at Home' project. Dementia (London) 2022; 21:899-917. [PMID: 35135380 DOI: 10.1177/14713012211065377] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Undertaking co-design with the end users of services has rapidly evolved as the best-practice approach to program design, development and implementation. Increased interest in using participatory co-design in dementia care has drawn attention to the need for evidence-informed methods for facilitating the meaningful involvement of people with dementia and their family carers in co-design activities. The aim of this paper is to describe the co-design framework used in the co-design of a dementia specialist training program for home care workers. The Promoting Independence Through quality dementia Care at Home program is a successful example of co-design methodology used across multiple project stages and with various stakeholder groups, including people living with dementia, family carers, home care workers, managers and researchers. Co-design methods were tailored to each stage, purpose, and stakeholder group, and to facilitate the involvement of people living with dementia. Findings provide unique insights into optimising input from co-design partners, including people living with dementia; the methodology, conditions and requirements for participants to co-design and implement ideas; and perspectives on the enablers and challenges of using co-design in this population. In this paper, we present a comprehensive approach for involving people living with dementia as active and equal contributors in inclusive and meaningful participatory co-design.
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Affiliation(s)
- Anita My Goh
- 110764National Ageing Research Institute, Parkville, VIC, Australia.,2281The University of Melbourne, Parkville, VIC, Australia.,548265Melbourne Neuropsychiatry Centre, Parkville, VIC, Australia
| | - Colleen Doyle
- 110764National Ageing Research Institute, Parkville, VIC, Australia
| | - Ellen Gaffy
- 110764National Ageing Research Institute, Parkville, VICAustralia.,2080University, Bundoora, VIC, Australia
| | | | - Meg Polacsek
- 10764National Ageing Research Institute, Parkville, VIC, Australia.,292325Benetas, Melbourne, VIC, Australia
| | - Steven Savvas
- 110764National Ageing Research Institute, Parkville, VIC, Australia
| | - Sue Malta
- 110764National Ageing Research Institute, Parkville, VIC, Australia.,2281The University of Melbourne, Parkville, VIC, Australia
| | - David Ames
- 110764National Ageing Research Institute, Parkville, VIC, Australia.,2281The University of Melbourne, Parkville, VIC, Australia
| | | | - Anita Panayiotou
- 110764National Ageing Research Institute, Parkville, VIC, Australia
| | - Samantha M Loi
- 548265Melbourne Neuropsychiatry Centre, Parkville, VIC, Australia
| | - Claudia Cooper
- Division of Psychiatry, 4919University College London, London, UK
| | - Gill Livingston
- Division of Psychiatry, 4919University College London, London, UK
| | - Lee-Fay Low
- 4538University of Sydney, Sydney, NSW, Australia
| | | | | | - Briony Dow
- 110764National Ageing Research Institute, Parkville, VIC, Australia.,2281The University of Melbourne, Parkville, VIC, Australia
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Goh AMY, Polacsek M, Malta S, Doyle C, Hallam B, Gahan L, Low LF, Cooper C, Livingston G, Panayiotou A, Loi SM, Omori M, Savvas S, Burton J, Ames D, Scherer SC, Chau N, Roberts S, Winbolt M, Batchelor F, Dow B. What constitutes 'good' home care for people with dementia? An investigation of the views of home care service recipients and providers. BMC Geriatr 2022; 22:42. [PMID: 35016640 PMCID: PMC8751242 DOI: 10.1186/s12877-021-02727-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 12/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Our objective was to explore what people receiving and providing care consider to be 'good' in-home care for people living with dementia. METHODS We conducted 36 in-depth interviews and two focus groups with key stakeholders in Australia in the first quarter of 2018. Participants included those receiving care (4 people living with dementia, 15 family carers) or providing care (9 case managers, 5 service managers, 10 home care workers). Qualitative thematic analysis was guided by Braun and Clarke's six-step approach. RESULTS Consensus was reached across all groups on five themes considered as important for good in-home dementia care: 1) Home care workers' understanding of dementia and its impact; 2) Home care workers' demonstrating person-centred care and empathy in their care relationship with their client; 3) Good relationships and communication between care worker, person with dementia and family carers; 4) Home care workers' knowing positive practical strategies for changed behaviours; 5) Effective workplace policies and workforce culture. The results contributed to the co-design of a dementia specific training program for home care workers. CONCLUSIONS It is crucial to consider the views and opinions of each stakeholder group involved in providing/receiving dementia care from home care workers, to inform workforce training, education program design and service design. Results can be used to inform and empower home care providers, policy, and related decision makers to guide the delivery of improved home care services. TRIAL REGISTRATION ACTRN 12619000251123 .
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Affiliation(s)
- Anita M Y Goh
- National Ageing Research Institute, Parkville, VIC, Australia. .,The University of Melbourne, Parkville, VIC, Australia. .,Melbourne Neuropsychiatry Centre, Parkville, VIC, Australia. .,Royal Melbourne Hospital, PO Box 2127, Melbourne, VIC, 3050, Australia.
| | | | - Sue Malta
- The University of Melbourne, Parkville, VIC, Australia
| | - Colleen Doyle
- National Ageing Research Institute, Parkville, VIC, Australia
| | - Brendan Hallam
- Institute of Epidemiology & Health Care, University College London, London, UK
| | - Luke Gahan
- National Ageing Research Institute, Parkville, VIC, Australia.,LaTrobe University, Melbourne, VIC, Australia
| | - Lee Fay Low
- University of Sydney, Sydney, NSW, Australia
| | - Claudia Cooper
- Division of Psychiatry, University College London, London, United Kingdom
| | - Gill Livingston
- Division of Psychiatry, University College London, London, United Kingdom
| | - Anita Panayiotou
- National Ageing Research Institute, Parkville, VIC, Australia.,Safer Care, Melbourne, VIC, Australia
| | - Samantha M Loi
- The University of Melbourne, Parkville, VIC, Australia.,Melbourne Neuropsychiatry Centre, Parkville, VIC, Australia.,Royal Melbourne Hospital, PO Box 2127, Melbourne, VIC, 3050, Australia
| | - Maho Omori
- Monash University, Clayton, VIC, Australia
| | - Steven Savvas
- National Ageing Research Institute, Parkville, VIC, Australia
| | - Jason Burton
- dementia360, Perth, Western Australia, Australia
| | - David Ames
- National Ageing Research Institute, Parkville, VIC, Australia.,Academic Unit for Psychiatry of Old Age, Kew, VIC, Australia
| | | | - Nadia Chau
- National Ageing Research Institute, Parkville, VIC, Australia
| | - Stefanie Roberts
- The University of Melbourne, Parkville, VIC, Australia.,Royal Melbourne Hospital, PO Box 2127, Melbourne, VIC, 3050, Australia
| | | | | | - Briony Dow
- National Ageing Research Institute, Parkville, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
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8
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Woolford M, Joyce C, Polacsek M. Strategies to optimize aged care volunteer recruitment and retention: A systematic review. J Gerontol Soc Work 2022; 65:45-62. [PMID: 33971797 DOI: 10.1080/01634372.2021.1923605] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 06/12/2023]
Abstract
Population aging and resource constraints in aged care indicate an ever increasing need for volunteers in this growing sector. Volunteers in aged care have different expectations and experiences, as they typically form longer and closer relationships with residents, and perform important social support functions that may otherwise not be delivered. Tailored strategies to recruit and retain these volunteers are needed. The aims of this review were to identify the motivations and expectations of aged care volunteers, and to examine strategies that foster their recruitment, retention and role satisfaction. A systematic review of MEDLINE, PsycINFO, CINAHL, Embase and Cochrane Library was conducted. Selection criteria included qualitative and quantitative studies published in English, with no date restrictions. Volunteering roles were restricted to residential aged care services. The 18 studies eligible for review presented consistently strong themes across volunteer motivation, recruitment/retention, and satisfaction/involvement. Implications for policy and practice relate to the importance of setting clear role expectations, matching volunteers' skills with roles, ongoing training and support, and the need for operational frameworks that support volunteers with administrative processes, communication and complaint resolution. Improved volunteer management that enables the consistent provision of social support in this setting stands to improve residents' quality of life.
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Affiliation(s)
- Marta Woolford
- Quality, Outcomes and Research, Benetas, Melbourne, Victoria, Australia
- School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Catherine Joyce
- Quality, Outcomes and Research, Benetas, Melbourne, Victoria, Australia
- School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Meg Polacsek
- Quality, Outcomes and Research, Benetas, Melbourne, Victoria, Australia
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Savvas S, Goh AMY, Batchelor F, Doyle C, Wise E, Tan E, Panayiotou A, Malta S, Winbolt M, Clarke P, Burton J, Low LF, Loi SM, Fairhall A, Polacsek M, Stiles J, Muliadi F, Chau N, Scherer S, Ames D, Sousa TV, Dow B. Promoting Independence Through quality dementia Care at Home (PITCH): a research protocol for a stepped-wedge cluster-randomised controlled trial. Trials 2021; 22:949. [PMID: 34930422 PMCID: PMC8687633 DOI: 10.1186/s13063-021-05906-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/03/2021] [Indexed: 11/28/2022] Open
Abstract
Background Home care service providers are increasingly supporting clients living with dementia. Targeted and comprehensive dementia-specific training for home care staff is necessary to meet this need. This study evaluates a training programme delivered to care staff (paid personal carers) of clients living with dementia at home. Methods This study is a pragmatic stepped-wedge cluster-randomised controlled trial (SW-CRT). Home care workers (HCWs) from seven home care service providers are grouped into 18 geographical clusters. Clusters are randomly assigned to intervention or control groups. The intervention group receives 7 h of a dementia education and upskilling programme (Promoting Independence Through quality dementia Care at Home [PITCH]) after baseline measures. The control group receives PITCH training 6 months after baseline measures. This approach will ensure that all participants are offered the program. Home care clients living with dementia are also invited to participate, as well as their family carers. The primary outcome measure is HCWs’ sense of competence in dementia care provision. Discussion Upskilling home care staff is needed to support the increasing numbers of people living with dementia who choose to remain at home. This study uses a stepped-wedge cluster-randomised trial to evaluate a training programme (PITCH) for dementia care that is delivered to front-line HCWs. Trial registration anzctr.org.au; ACTRN12619000251123. Registered on 20 February 2019.
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Affiliation(s)
- Steven Savvas
- The National Ageing Research Institute, Parkville, VIC, Australia.
| | - Anita M Y Goh
- The National Ageing Research Institute, Parkville, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia.,Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia
| | | | - Colleen Doyle
- The National Ageing Research Institute, Parkville, VIC, Australia
| | - Erica Wise
- The National Ageing Research Institute, Parkville, VIC, Australia
| | - Esther Tan
- The National Ageing Research Institute, Parkville, VIC, Australia
| | - Anita Panayiotou
- The National Ageing Research Institute, Parkville, VIC, Australia
| | - Sue Malta
- The National Ageing Research Institute, Parkville, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | | | | | | | - Lee-Fay Low
- University of Sydney, Sydney, NSW, Australia
| | - Samantha M Loi
- The University of Melbourne, Parkville, VIC, Australia.,Neuropsychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia
| | | | - Meg Polacsek
- The National Ageing Research Institute, Parkville, VIC, Australia.,Benetas, Melbourne, VIC, Australia
| | - Jay Stiles
- The National Ageing Research Institute, Parkville, VIC, Australia
| | - Fenny Muliadi
- The National Ageing Research Institute, Parkville, VIC, Australia
| | - Nadia Chau
- The National Ageing Research Institute, Parkville, VIC, Australia
| | | | - David Ames
- The National Ageing Research Institute, Parkville, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
| | | | - Briony Dow
- The National Ageing Research Institute, Parkville, VIC, Australia.,The University of Melbourne, Parkville, VIC, Australia
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Abstract
Depression is the most prevalent mental illness in older adults and is expected to increase with population aging. Health care policy in higher income countries increasingly promotes the self-management of long-term conditions, including depression. Scant research has considered how older adults understand and practice self-management. In this article, we present the findings of a grounded theory study which sought to explain how older community-based adults experience and self-manage depression. Interviews and observations were conducted with 32 older adults with a formal diagnosis of moderate depression. Participants responded to a diagnosis of depression by Taking stock, Accessing support, and Reclaiming self-identity. Their efforts were influenced by perspectives on age and depression, access to the health care system, and individual capacity for self-management. Improved understanding of how to facilitate self-management strategies may enable older adults to remain independent and healthier for longer, while moderating the risk of a chronic condition worsening.
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Affiliation(s)
- Meg Polacsek
- Victoria University, Melbourne, Victoria, Australia
- Benetas, Melbourne, Victoria, Australia
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11
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Bryant C, Brown L, Polacsek M, Batchelor F, Capon H, Dow B. Volunteer-led behavioural activation to reduce depression in residential care: a feasibility study. Pilot Feasibility Stud 2020; 6:95. [PMID: 32670597 PMCID: PMC7341647 DOI: 10.1186/s40814-020-00640-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 06/29/2020] [Indexed: 11/18/2022] Open
Abstract
Objectives Symptoms of depression are highly prevalent and under-treated in residential aged care facilities. Behavioural activation is a simple, cost-effective psychosocial intervention that might be appropriate to help reduce depression and improve well-being in this setting. The purpose of this study was to investigate the feasibility and efficacy of an 8-week, volunteer-led behavioural activation intervention designed for depressed aged care residents. Method This feasibility study employed a single-arm design, where outcomes were measured at baseline, post-intervention and 3-month follow-up. Aged care residents with depressive symptoms were invited to participate, and healthy volunteers were trained to deliver the intervention. Intervention feasibility was assessed on six a priori-determined domains. Depression, anxiety and flourishing were included as outcomes using intention-to-treat analysis. Result Seventeen aged care residents with depressive symptoms and 13 volunteers were successfully recruited within the expected 6-month timeframe. Both residents and volunteers were satisfied with the intervention (7/8), and there was a high (87%) completion rate. The intervention was associated with a large and statistically significant reduction in resident depressive symptoms, d = − 1.14, with the effect increasing to d = 2.82 when comparing baseline to 3-month follow-up. Anxiety reduced from mild symptoms at baseline mean = 6.17 (5.12) to the subclinical range post-intervention, mean = 3.53 (4.29) (g = 0.61, p = 0.03). Conclusion This 8-week volunteer-led behavioural activation intervention was found to be feasible and acceptable to depressed aged care residents. The intervention was effective in ameliorating depression. A larger randomized controlled trial is warranted.
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Affiliation(s)
- Christina Bryant
- Melbourne School of Psychological Sciences, University of Melbourne, 12th Floor, Redmond Barry Building, Parkville, VIC Australia
| | - Lydia Brown
- Melbourne School of Psychological Sciences, University of Melbourne, 12th Floor, Redmond Barry Building, Parkville, VIC Australia.,North Eastern Rehabilitation Centre, Healthscope Hospitals, Melbourne, VIC Australia
| | - Meg Polacsek
- National Ageing Research Institute, Parkville, VIC Australia
| | - Frances Batchelor
- National Ageing Research Institute, Parkville, VIC Australia.,School of Physiotherapy, University of Melbourne, Parkville, VIC Australia
| | - Hannah Capon
- National Ageing Research Institute, Parkville, VIC Australia
| | - Briony Dow
- National Ageing Research Institute, Parkville, VIC Australia.,School of Population and Global Health, University of Melbourne, Parkville, VIC Australia
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12
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Abstract
Objectives: A considerable body of work addresses prevalence and treatment options for depression in older adults. However, less is known about their capacity to self-manage their depression. Effective self-management of depression has the potential to improve individuals' quality of life through information, empowerment and perceived control, while enabling more efficient health service utilisation. The aim of this paper was to identify the barriers and facilitators to self-management of depression in older adults.Method: A qualitative study comprising in-depth, semi-structured interviews with 32 older adults with a diagnosis of moderate depression.Results: Three over-arching themes captured the barriers and facilitators to participants' capacity to self-manage their depression. Perspectives on age and depression represented how views of older age and mental health influenced the approach to self-management. Ability to access the health care system concerned the ability to identify and engage with different services and support. Individual capacity for self-management reflected participants' views on and the resources required for effective self-management.Conclusion: This study offers a better understanding of the factors that positively or negatively influence older adults' ability to self-manage their depression. Strategies to improve self-management should address misconceptions about age and depression, and older adults' interest in and capacity to embrace self-management practices.
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Affiliation(s)
- Meg Polacsek
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia.,National Ageing Research Institute, Parkville, Victoria, Australia
| | - Gayelene H Boardman
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Terence V McCann
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
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13
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Polacsek M, Goh A, Malta S, Hallam B, Gahan L, Cooper C, Low LF, Livingston G, Panayiotou A, Loi S, Omori M, Savvas S, Batchelor F, Ames D, Doyle C, Scherer S, Dow B. 'I know they are not trained in dementia': Addressing the need for specialist dementia training for home care workers. Health Soc Care Community 2020; 28:475-484. [PMID: 31646701 DOI: 10.1111/hsc.12880] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 08/12/2019] [Accepted: 09/27/2019] [Indexed: 05/22/2023]
Abstract
Global population ageing has meant a rapid increase in the numbers of older people with dementia, most of whom live in their own homes. Staying at home is an important determinant of health and well-being. As care needs increase, the quality of community support which older people receive directly influences their capacity to remain in their own homes. While many are supported informally by family carers, formal support provided by home care workers often enables them to remain at home for longer period. However, providing community-based care for people with dementia can be challenging. Workers often lack training in dementia-specific care for clients with increasingly complex needs, and typically work without direct supervision. As the demand for person-centred home care for people with dementia increases, specialist dementia training for home care workers is urgently needed. In this qualitative study, we used in-depth interviews of a purposive sample, comprising 15 family carers and four older people with dementia, to understand the experience of receiving community care. Data analysis was guided by Braun and Clarke's approach to thematic analysis and revealed the following five overlapping themes, relating to home care workers' understanding of dementia, person-centred care, communication and rapport, mutual collaboration, and the influence of organisational constraints on continuity of care. Although participants acknowledged that service providers operated under challenging circumstances, they were frustrated with home care workers' lack of dementia knowledge and inconsistent staff rostering. Conversely, an understanding of the lived experience of dementia, effective communication and rapport, and continuity of care contributed significantly to a positive experience of receiving care. The findings of this study will be used to inform the essential elements of a training program aimed at enabling and empowering a skilled, specialist home care workforce to support older people with dementia to live well at home for as long as possible.
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Affiliation(s)
- Meg Polacsek
- National Ageing Research Institute, Parkville, Vic., Australia
- Institute for Health and Sport, Victoria University, Melbourne, Vic., Australia
| | - Anita Goh
- National Ageing Research Institute, Parkville, Vic., Australia
- The University of Melbourne, Parkville, Vic., Australia
- NorthWestern Mental Health, Parkville, Vic., Australia
| | - Sue Malta
- The University of Melbourne, Melbourne, Vic., Australia
| | | | - Luke Gahan
- The Australian Red Cross Blood Service, Melbourne, Vic., Australia
- La Trobe University, Melbourne, Vic., Australia
| | - Claudia Cooper
- Division of Psychiatry, University College London, London, UK
| | - Lee-Fay Low
- Dementia Collaborative Research Centre, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Gill Livingston
- Division of Psychiatry, University College London, London, UK
| | | | - Samantha Loi
- Department of Psychiatry, University of Melbourne and NorthWestern Mental Health, Parkville, Vic., Australia
| | - Maho Omori
- National Ageing Research Institute, Parkville, Vic., Australia
| | - Steven Savvas
- National Ageing Research Institute, Parkville, Vic., Australia
- Royal Freemasons, Melbourne, Vic., Australia
| | | | - David Ames
- National Ageing Research Institute, Parkville, Vic., Australia
- The University of Melbourne, Parkville, Vic., Australia
- Florey Institute of Neuroscience and Mental Health, Parkville, Vic., Australia
| | - Colleen Doyle
- National Ageing Research Institute, Parkville, Vic., Australia
| | - Sam Scherer
- Royal Freemasons, Melbourne, Vic., Australia
| | - Briony Dow
- National Ageing Research Institute, Parkville, Vic., Australia
- The University of Melbourne, Parkville, Vic., Australia
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Abstract
This paper identifies the components of a successful wellness-illness transition on the experience and management of depression. Data collection and analysis were informed by Corbin and Strauss' approach to grounded theory. Exemplars and case studies are used to illustrate the findings. Three themes reflected participants' experiences of a wellness-illness transition relating to depression in older adults: Accepting a change in wellness-illness status, Adapting to the changeable nature of depression, and Creating new meaning. A change in wellness-illness status is interpreted through personal beliefs about depression, and the knowledge, skills and resources required to optimise well-being. Successful transitions were associated with improved experience and management of depression. The findings have implications for how older adults recognise and respond to symptoms of depression. Judicious advice and support from health professionals can facilitate wellness-illness transitions, thereby enhancing health and well-being outcomes for older adults with depression.
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Affiliation(s)
- Meg Polacsek
- National Ageing Research Institute, Parkville, Victoria, Australia.,Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Gayelene H Boardman
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Terence V McCann
- Institute for Health and Sport, Victoria University, Melbourne, Victoria, Australia
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Goh AM, Dow B, Polacsek M, Doyle C, Ames D, Winbolt M, Savvas S, Malta S, Low LF, Clarke P, Cooper C, Panayiotou A, Livingston G, Lyketsos C, Gahan L, Batchelor F, Loi SM, Burton J, Hallam B, Scherer S, Gaffy E. F3-04-03: STAKEHOLDER PERSPECTIVES ON HOW THE HOME CARE SECTOR CAN SUPPORT PEOPLE TO LIVE WELL WITH DEMENTIA. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Anita M.Y. Goh
- National Ageing Research Institute; Parkville Australia
- University of Melbourne; Parkville Australia
- Melbourne Health; Parkville Australia
| | - Briony Dow
- University of Melbourne; Parkville Australia
- National Ageing Research Institute; Parkville Australia
| | - Meg Polacsek
- National Ageing Research Institute; Parkville Australia
| | - Colleen Doyle
- National Ageing Research Institute; Parkville Australia
| | - David Ames
- National Ageing Research Institute; Parkville Australia
- The University of Melbourne; Parkville Australia
- AIBL Research Group; Perth and Melbourne Australia
- The University of Melbourne; Parkville Australia
| | | | - Steven Savvas
- National Ageing Research Institute; Parkville Australia
| | - Susan Malta
- University of Melbourne; Parkville Australia
| | - Lee-Fay Low
- The University of Sydney; Lidcombe Australia
| | - Philip Clarke
- University of Melbourne; Parkville Australia
- Oxford University; Oxford United Kingdom
| | | | | | - Gill Livingston
- University College London; London United Kingdom
- Camden and Islington NHS Foundation Trust; London United Kingdom
| | | | - Luke Gahan
- National Ageing Research Institute; Parkville Australia
| | | | - Samantha M. Loi
- University of Melbourne; Parkville Australia
- Melbourne Health; Parkville Australia
| | | | | | | | - Ellen Gaffy
- National Ageing Research Institute; Parkville Australia
- La Trobe University; Melbourne Australia
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McCann TV, Polacsek M, Lubman DI. Experiences of family members supporting a relative with substance use problems: a qualitative study. Scand J Caring Sci 2019; 33:902-911. [DOI: 10.1111/scs.12688] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Accepted: 03/12/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Terence V. McCann
- Institute of Health and Sport Victoria University Melbourne Vic. Australia
| | - Meg Polacsek
- National Ageing Research Institute Melbourne Vic. Australia
| | - Dan I. Lubman
- Turning Point Eastern Health Clinical School Monash University Melbourne Vic. Australia
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Boardman G, Lawrence K, Polacsek M. Undergraduate student nurses' perspectives of an integrated clinical learning model in the mental health environment. Int J Ment Health Nurs 2019; 28:96-104. [PMID: 29897671 DOI: 10.1111/inm.12496] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/15/2018] [Indexed: 11/30/2022]
Abstract
Providing nursing students with appropriate clinical practice during their undergraduate programme is critical to ensuring that graduates meet the competency requirements to gain registration as a nurse. In response to the predicted nursing workforce shortage, universities have been significantly increasing the enrolment of undergraduate nurses into Bachelor of Nursing courses. This has placed a demand on the availability of clinical placements and often universities struggle to find appropriate places. In this study, a Bachelor of Nursing course incorporated an Integrated Clinical Learning Model (ICLM) for the first time during a mental health placement. The model offered students the flexibility of attending their clinical placement over a 16-week period instead of a traditional block of 4 weeks. The aim of this study was to evaluate the student perspective of this model and whether it prepared them for the nursing workforce. Focus groups were conducted with undergraduate nursing students following their mental health clinical placement at an acute and extended care inpatient unit. Data were analysed using thematic analysis. Main themes included preparedness for practice, maintaining a work-life balance, and perceiving they were part of a team. The ICLM deepened students' knowledge and had a positive impact on their overall clinical learning.
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Affiliation(s)
- Gayelene Boardman
- College of Health and Biomedicine (Discipline of Nursing), Victoria University, Melbourne, Vic., Australia
| | - Karen Lawrence
- College of Health and Biomedicine (Discipline of Nursing), Victoria University, Melbourne, Vic., Australia
| | - Meg Polacsek
- College of Health and Biomedicine (Discipline of Nursing), Victoria University, Melbourne, Vic., Australia
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Abstract
Depression is the most prevalent mental illness among older adults. However, help-seeking by older adults is frequently delayed, resulting in longer duration of untreated symptoms, poorer health outcomes, and consequent higher healthcare use. Early help-seeking and access to appropriate support benefits individuals, while providing better outcomes from health systems constrained by limited resources. The aim of this study, which is abstracted from a larger study, was to identify the factors that inhibited and enabled formal help-seeking in older adults with a diagnosis of moderate depression. Corbin and Strauss' approach to grounded theory informed data collection and analysis. Two themes and related subthemes concerning help-seeking barriers and facilitators were abstracted from the data. Help-seeking barriers were attributable to stigma, self-motivation, accessing formal support, ageism, and difficulty obtaining an initial diagnosis. Help-seeking facilitators were accepting personal responsibility, mental health literacy, therapeutic alliances, and informal support. Findings have implications for the role of mental health nurses, who are well-placed to provide support to community-based older adults with depression. More broadly, mental health nurses and other clinicians should seek to reduce help-seeking barriers and implement ways to facilitate help-seeking in this cohort.
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Affiliation(s)
- Meg Polacsek
- Institute for Health and SportVictoria UniversityMelbourneVic.Australia
| | | | - Terence V. McCann
- Institute for Health and SportVictoria UniversityMelbourneVic.Australia
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Abstract
BACKGROUND Grounded theory is one of the most widely used qualitative research methodologies. However, it is complex and frequently misinterpreted and misapplied. AIM To provide a critical overview of grounded theory, to support neophyte researchers' understanding of a methodology for systematically generating theory from data. DISCUSSION The uniqueness of grounded theory is evident in the way researchers explicate concepts from the data during research, rather than entering the field with a list of predefined concepts. Adherence to its rigorous standards enables researchers to contribute to knowledge and practice. CONCLUSION Grounded theory is particularly useful in nursing and midwifery research, where it can be applied to a broad range of topics. Neophyte researchers should not be deterred by its rigorous standards, although time and effort are required to appreciate the similarities and differences between grounded theory approaches. IMPLICATIONS FOR PRACTICE A clear understanding of its philosophical foundations and attention to its main features should underpin researchers' efforts to conduct a high-quality grounded theory study.
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Affiliation(s)
- Meg Polacsek
- Department of Nursing and Midwifery, Victoria University, Melbourne, Australia
| | - Gayelene Boardman
- Nursing College of Health and Biomedicine, Victoria University, Melbourne, Australia
| | - Terence McCann
- Department of Nursing & Midwifery, College of Health and Biomedicine, Victoria University, Melbourne, Australia
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Abstract
BACKGROUND A fundamental decision when planning a study is the selection of the most appropriate approach to the research. Researchers choosing grounded theory must consider which approach is best suited to for collecting and analysing data. AIM To enable nurse researchers to choose and apply a grounded theory methodology, using a worked example to illustrate the main elements and considerations. DISCUSSION Grounded theory provides a helpful framework to guide data collection and analysis, and to generate theory from the data. It can also be used to modify or advance existing theories. CONCLUSION Neophyte researchers need to understand the jargon, technical language and specific requirements of grounded theory to use it to its capacity. This supports the correct application of their preferred approach to grounded theory, and continuity between the study's question, aims and methods. IMPLICATIONS FOR PRACTICE It takes time and effort to understand the different approaches of grounded theory, and to learn its rigorous standards. This paper offers guidance to nurse researchers by explaining fundamental decisions to be made when choosing and adopting a grounded theory methodology.
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Affiliation(s)
- Meg Polacsek
- Department of Nursing and Midwifery, Victoria University, Melbourne, Australia
| | - Gayelene Boardman
- Nursing College of Health and Biomedicine, Victoria University, Melbourne, Australia
| | - Terence McCann
- Department of Nursing & Midwifery, College of Health and Biomedicine, Victoria University, Melbourne, Australia
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Boardman G, Lawrence K, Polacsek M. Preceptors' perspectives of an integrated clinical learning model in a mental health environment. Int J Ment Health Nurs 2018; 27:1420-1429. [PMID: 29441663 DOI: 10.1111/inm.12441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/10/2018] [Indexed: 11/29/2022]
Abstract
Supervised clinical practice is an essential component of undergraduate nursing students' learning and development. In the mental health setting, nursing students traditionally undertake four-week block placements. An integrated clinical learning model, where preceptors mentor students on an individual basis, has been used successfully in the clinical learning environment. This flexible model provides the opportunity for students to work across morning, afternoon, night and weekend shifts. There is a need to improve the evidence base for a flexible model for students undertaking a mental health placement. The aim of this study was to understand preceptors' experience of, and satisfaction with, a mental health integrated clinical learning model. Focus groups were used to elicit the views of preceptors from a mental health service. Findings highlight the advantages and disadvantages of an integrated clinical learning model in the mental health setting. Participants suggested that students may benefit from flexible work arrangements, a variety of experiences and a more realistic experience of working in a mental health service. However, they found it challenging to mentor and evaluate students under this model. Most also agreed that the model impeded students' ability to engage with consumers and develop rapport with staff. The findings indicate the need to develop a placement model that meets the unique needs of the mental health setting.
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Affiliation(s)
- Gayelene Boardman
- College of Health and Biomedicine (Nursing & Midwifery), Victoria University, Melbourne, Victoria, Australia
| | - Karen Lawrence
- College of Health and Biomedicine (Nursing & Midwifery), Victoria University, Melbourne, Victoria, Australia
| | - Meg Polacsek
- College of Health and Biomedicine (Nursing & Midwifery), Victoria University, Melbourne, Victoria, Australia
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22
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McCann TV, Polacsek M. Addressing the vexed issue of authorship and author order: A discussion paper. J Adv Nurs 2018; 74:2064-2074. [PMID: 29791017 DOI: 10.1111/jan.13720] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 03/13/2018] [Accepted: 03/15/2018] [Indexed: 11/28/2022]
Abstract
AIMS To review and discuss authorship and author order in the context of nursing and midwifery publications and to present a set of principles to guide and justify author order. BACKGROUND Variation in author order trends is evident across different authors, disciplines and countries. Confusion and conflict between authors give rise to important issues concerning ethics and collaboration and may delay publication. Lack of transparency in authorship practices also impedes judgements when individual contributions are used in support of employment, promotion, tenure and/or research funding applications. DESIGN Discussion paper. DATA SOURCES A literature search of BioMed Central, Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE with Full Text and PubMed for original peer-reviewed papers published in English between 2007 - 2017, in the disciplines of nursing and midwifery. IMPLICATIONS FOR NURSING Much is written about authorship practices across disciplines and countries. Despite existing authorship guidelines, author order remains an area of confusion and contention. Disputes about authorship and author order have the potential to cause distrust and breakdowns in research relationships, thereby disrupting nursing and midwifery scholarship and research. The main issues concern honorary and ghost authorship, authorship versus acknowledgement, confusion about collaboration, author order, research students as co-authors, equal author credit and the need for explicit guidelines. CONCLUSION Good communication and mutual respect are crucial to the authorship process. However, clear instructions are needed to guide decisions on authorship and author order. It is recommended that the "first-last-author-emphasis" be adopted uniformly internationally across nursing and midwifery research.
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Affiliation(s)
- Terence V McCann
- Department of Nursing and Midwifery, Institute of Health and Sport, Victoria University, Melbourne, Victoria, Australia
| | - Meg Polacsek
- Department of Nursing and Midwifery, Institute of Health and Sport, Victoria University, Melbourne, Victoria, Australia
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McCann TV, Polacsek M. False gold: Safely navigating open access publishing to avoid predatory publishers and journals. J Adv Nurs 2017; 74:809-817. [PMID: 29047152 DOI: 10.1111/jan.13483] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2017] [Indexed: 01/13/2023]
Abstract
AIM The aim of this study was to review and discuss predatory open access publishing in the context of nursing and midwifery and develop a set of guidelines that serve as a framework to help clinicians, educators and researchers avoid predatory publishers. BACKGROUND Open access publishing is increasingly common across all academic disciplines. However, this publishing model is vulnerable to exploitation by predatory publishers, posing a threat to nursing and midwifery scholarship and practice. Guidelines are needed to help researchers recognize predatory journals and publishers and understand the negative consequences of publishing in them. DESIGN Discussion paper. DATA SOURCES A literature search of BioMed Central, CINAHL, MEDLINE with Full Text and PubMed for terms related to predatory publishing, published in the period 2007-2017. IMPLICATIONS FOR NURSING Lack of awareness of the risks and pressure to publish in international journals, may result in nursing and midwifery researchers publishing their work in dubious open access journals. Caution should be taken prior to writing and submitting a paper, to avoid predatory publishers. FINDINGS The advantage of open access publishing is that it provides readers with access to peer-reviewed research as soon as it is published online. However, predatory publishers use deceptive methods to exploit open access publishing for their own profit. Clear guidelines are needed to help researchers navigate safely open access publishing. CONCLUSION A deeper understanding of the risks of predatory publishing is needed. Clear guidelines should be followed by nursing and midwifery researchers seeking to publish their work in open access journals.
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Affiliation(s)
- Terence V McCann
- Department of Nursing and Midwifery, College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia
| | - Meg Polacsek
- Department of Nursing and Midwifery, College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia
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Cranwell K, Polacsek M, McCann TV. Improving care planning and coordination for service users with medical co-morbidity transitioning between tertiary medical and primary care services. J Psychiatr Ment Health Nurs 2017; 24:337-347. [PMID: 27500593 DOI: 10.1111/jpm.12322] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/15/2016] [Indexed: 11/30/2022]
Abstract
UNLABELLED WHAT IS KNOWN ON THE SUBJECT?: Mental health service users with medical co-morbidity frequently experience difficulties accessing and receiving appropriate treatment in emergency departments. Service users frequently experience fragmented care planning and coordinating between tertiary medical and primary care services. Little is known about mental health nurses' perspectives about how to address these problems. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Emergency department clinicians' poor communication and negative attitudes have adverse effects on service users and the quality of care they receive. The findings contribute to the international evidence about mental health nurses' perspectives of service users feeling confused and frustrated in this situation, and improving coordination and continuity of care, facilitating transitions and increasing family and caregiver participation. Intervention studies are needed to evaluate if adoption of these measures leads to sustainable improvements in care planning and coordination, and how service users with medical co-morbidity are treated in emergency departments in particular. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Effective planning and coordination of care are essential to enable smooth transitions between tertiary medical (emergency departments in particular) and primary care services for service users with medical co-morbidity. Ongoing professional development education and support is needed for emergency department clinicians. There is also a need to develop an organized and systemic approach to improving service users' experience in emergency departments. ABSTRACT Introduction Mental health service users with medical co-morbidity frequently experience difficulties accessing appropriate treatment in medical hospitals, and often there is poor collaboration within and between services. Little is known about mental health nurses' perspectives on how to address these problems. Aim To explore mental health nurses' perspectives of the experience of service users with medical co-morbidity in tertiary medical services, and to identify how to improve care planning and coordination for service users transitioning between tertiary medical and primary care services. Method Embedded within an experience-based co-design study, focus group discussions were conducted with 17 emergency department nurses and other clinicians, in Melbourne, Australia. Results Three main themes were abstracted from the data: feeling confused and frustrated, enhancing service users' transition and experience and involving families and caregivers. Participants perceived the service user experience to be characterized by fear, confusion and a sense of not being listened to. They highlighted that service users' transition and experience could be enhanced by facilitating transitions and improving coordination and continuity of care. They also emphasized the need to increase family and caregiver participation. Conclusion Our findings contribute to knowledge about improving the way service users are treated in emergency departments and improving care planning and coordination; in particular, facilitating transitions, improving coordination and continuity of care and increasing family and caregiver participation.
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Affiliation(s)
- K Cranwell
- Department of Community Services, Western Health, Melbourne, VIC, Australia
| | - M Polacsek
- Department of Community Services, Western Health, Melbourne, VIC, Australia
| | - T V McCann
- Centre for Chronic Disease, College of Health and Biomedicine (Discipline of Nursing), Victoria University, Melbourne, VIC, Australia
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Polacsek M, Boardman G, McCann TV. Paying patient and caregiver research participants: putting theory into practice. J Adv Nurs 2016; 73:847-856. [PMID: 27878859 DOI: 10.1111/jan.13222] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2016] [Indexed: 11/29/2022]
Abstract
AIM To review and discuss the ethical and practical considerations about paying patient and caregiver participants in nursing research and, based on this review, to develop a set of guiding principles about payment of participants. BACKGROUND To increase recruitment and retention, it is becoming increasingly common in nursing research to provide some form of payment to participants. The risk is that the promise of a payment may influence a patient or caregiver's decision to participate in research. However, research ethics protocols seldom provide explicit guidance about paying participants. Even where formal policies or fee schedules exist, there is little consistency in determining how payments should be calculated or administered. This has resulted in highly variable payment practices between locations, disciplines and institutions. DESIGN Discussion paper. DATA SOURCES PubMed, MEDLINE with Full Text, CINAHL and Health Source (Nursing/Academic Edition) were searched for terms related to paying research participants published between 2000 - August 2016. IMPLICATIONS FOR NURSING Nurse researchers must comply with international, national and institutional ethical standards. Important ethical and practical considerations should guide the decision-making process about whether to pay research participants and how to determine the nature or value of the payment. Guiding principles can support researchers by highlighting key factors that may direct their decision-making in this regard. CONCLUSION A deeper understanding of the fundamental ethical and practical considerations is needed to support researchers in their deliberations about paying participants in nursing research.
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Affiliation(s)
- Meg Polacsek
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia
| | - Gayelene Boardman
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia
| | - Terence V McCann
- Centre for Chronic Disease, College of Health and Biomedicine, Victoria University, Melbourne, Victoria, Australia
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26
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Cranwell K, Polacsek M, McCann TV. Improving mental health service users' with medical co-morbidity transition between tertiary medical hospital and primary care services: a qualitative study. BMC Health Serv Res 2016; 16:302. [PMID: 27456864 PMCID: PMC4960840 DOI: 10.1186/s12913-016-1567-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 07/20/2016] [Indexed: 11/10/2022] Open
Abstract
Background Mental health service users have high rates of medical co-morbidity but frequently experience problems accessing and transitioning between tertiary medical and primary care services. The aim of this study was to identify ways to improve service users’ with medical co-morbidity care and experience during their transition between tertiary medical hospitals and primary care services. Method Experience-based co-design (EBCD) qualitative study incorporating a focus group discussion. The study took place in a large tertiary medical service, incorporating three medical hospitals, and primary care services, in Melbourne, Australia. A purposive sample of service users and their caregivers and tertiary medical and primary care clinicians participated in the focus group discussion, in August 2014. A semi-structured interview guide was used to inform data collection. A thematic analysis of the data was undertaken. Results Thirteen participants took part in the focus group interview, comprising 5 service users, 2 caregivers and 6 clinicians. Five themes were abstracted from the data, illustrating participants’ perspectives about factors that facilitated (clinicians’ expertise, engagement and accessibility enhancing transition) and presented as barriers (improving access pathways; enhancing communication and continuity of care; improving clinicians’ attitudes; and increasing caregiver participation) to service users’ progress through tertiary medical and primary care services. A sixth theme, enhancing service users’ transition, incorporated three strategies to enhance their transition through tertiary medical and primary care services. Conclusion EBCD is a useful approach to collaboratively develop strategies to improve service users’ with medical co-morbidity and their caregivers’ transition between tertiary medical and primary care services. A whole-of-service approach, incorporating policy development and implementation, change of practice philosophy, professional development education and support for clinicians, and acceptance of the need for caregiver participation, is required to improve service users’ transition.
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Affiliation(s)
- Kate Cranwell
- Community Services, Western Health, Melbourne, VIC, Australia
| | - Meg Polacsek
- Community Services, Western Health, Melbourne, VIC, Australia.,Centre for Chronic Disease, College of Health and Biomedicine, Discipline of Nursing, Victoria University, PO Box 14428, Melbourne, VIC, 8001, Australia
| | - Terence V McCann
- Centre for Chronic Disease, College of Health and Biomedicine, Discipline of Nursing, Victoria University, PO Box 14428, Melbourne, VIC, 8001, Australia.
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Cranwell K, Polacsek M, McCann TV. Mental health consumers' with medical co-morbidity experience of the transition through tertiary medical services to primary care. Int J Ment Health Nurs 2016; 25:127-35. [PMID: 26735771 PMCID: PMC4834798 DOI: 10.1111/inm.12174] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 08/18/2015] [Accepted: 08/25/2015] [Indexed: 10/25/2022]
Abstract
Medical comorbidity in people with long-term mental illness is common and often undetected; however, these consumers frequently experience problems accessing and receiving appropriate treatment in public health-care services. The aim of the present study was to understand the lived experience of mental health consumers with medical comorbidity and their carers transitioning through tertiary medical to primary care services. An interpretative, phenomenological analysis approach was used, and semistructured, video-recorded, qualitative interviews were used with 12 consumers and four primary caregivers. Four main themes and related subthemes were abstracted from the data, highlighting consumer's and carers' experience of transition through tertiary medical to primary care services: (i) accessing tertiary services is difficult and time consuming; (ii) contrasting experiences of clinician engagement and support; (iii) lack of continuity between tertiary medical and primary care services; and (iv) Mental Health Hospital Admission Reduction Programme (MH HARP) clinicians facilitating transition. Our findings have implications for organisational change, expanding the role of MH HARP clinicians (whose primary role is to provide consumers with intensive support and care coordination to prevent avoidable tertiary medical hospital use), and the employment of consumer and carer consultants in tertiary medical settings, especially emergency departments.
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Affiliation(s)
| | - Meg Polacsek
- Community Services, Western Health, Australia.,Centre for Chronic Disease, College of Health and Biomedicine, Discipline of Nursing, Victoria University, Melbourne, Victoria, Australia
| | - Terence V McCann
- Centre for Chronic Disease, College of Health and Biomedicine, Discipline of Nursing, Victoria University, Melbourne, Victoria, Australia
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Abstract
AIM This paper explores the experiences of older German Australians, with a focus on their support needs and preferences in later life. METHODS Data were collected through qualitative semi-structured interviews. Data analysis incorporated a systematic concept matrix approach to content analysis. RESULTS The findings of the study indicate that older German Australians have adapted well to the Australian way of life. Their high English language proficiency allowed them to source services without the barrier of language often reported in studies of older migrants. They did not show high interest in ethno-specific services. CONCLUSION Few studies have been conducted on older German Australians, and none focuses specifically on their experience of ageing in Australia. This study contributes to the body of knowledge on older migrants and, specifically, on those for whom language is not necessarily a major obstacle to obtaining aged care information or services.
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Affiliation(s)
- Meg Polacsek
- Victoria University, Melbourne, Victoria, Australia.
| | - Jocelyn Angus
- Victoria University, Melbourne, Victoria, Australia.
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Polacsek M, Rogers EM, Woodall WG, Delaney H, Wheeler D, Rao N. MADD victim impact panels and stages-of-change in drunk-driving prevention. J Stud Alcohol 2001; 62:344-50. [PMID: 11414344 DOI: 10.15288/jsa.2001.62.344] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To assess the additional effects of Mothers Against Drunk Driving (MADD) Victim Impact Panels (VIPs) over the effects of a DWI (driving while intoxicated) school, on (1) moving individuals through the stages-of-change toward not drinking while driving and (2) drunk-driving recidivism. METHOD A randomized experiment with 813 (75% male) DWI offenders in New Mexico measured progress through the stages-of-change at pretest, posttest, 1-year follow-up and 2-year follow-up. In addition, drunk-driving recidivism over 2 years was measured from state driving records. Individuals were randomly assigned to a DWI school or a DWI school plus a MADD VIP. RESULTS No significant difference in movement through the stages-of-change, or in recidivism, occurred between respondents in the DWI-school-only treatment, and those in the DWI school plus VIP treatment. CONCLUSIONS There was no additional effect of the MADD VIP, a relatively emotional intervention, over that of the DWI school, a relatively informational approach, on DWI behavior (whether measured by stages-of-change or by DWI rearrest data) over the 2-year period following the two interventions.
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Affiliation(s)
- M Polacsek
- Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, USA
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Polacsek M, Celentano DD, O'Campo P, Santelli J. Correlates of condom use stage of change: implications for intervention. AIDS Educ Prev 1999; 11:38-52. [PMID: 10070588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
A telephone survey was used to collect data on attitudes, beliefs, and practices concerning condom use among 812 African Americans with regular sex partners and of reproductive age in Baltimore. Condom use was "staged" according to Prochaska's model of stage of behavioral change. Characteristics of the respondents' sexual relationships, peer characteristics, and demographic and psychosocial characteristics were examined for their association with the stage of condom use. Multiple logistic regression analysis revealed that a partner's reaction to condom use, condom use self-efficacy with the partner, condom use outcome expectancy with the partner, perceived partner risk, length of relationship, sterility, cohabitation, perceived vulnerability to HIV infection and perceived peer norms about condom use were each independently related to staged condom use. Gender differences in the relationship of these independent variables with stages of change were found. Implications for intervention include differential treatment by gender and stage of change. Couples should also be considered for intervention.
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Affiliation(s)
- M Polacsek
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, USA
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Santelli JS, Kouzis AC, Hoover DR, Polacsek M, Burwell LG, Celentano DD. Stage of behavior change for condom use: the influence of partner type, relationship and pregnancy factors. Fam Plann Perspect 1996; 28:101-7. [PMID: 8827145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A theoretical model was used to examine the influence of relationship factors, pregnancy intentions, contraceptive behavior and other psychosocial characteristics on stages of behavior change in condom use among heterosexual black women of reproductive age. Data from an inner-city street survey compared women who were not contemplating condom use, women who were attempting to use condoms or had used them consistently for short periods of time, and those who had achieved long-term consistent use. Women's relationship with their main partner appears to be an important factor in understanding their use of condoms both with main partners and with other partners. For condom use with the main partner, factors such as emotional closeness and partner support were significant predictors of the likelihood that women would be attempting to use condoms rather than not contemplating use. Cohabitation and the belief that condom use builds trust were significant predictors of long-term consistent condom use. Having a regular or main partner was strongly associated with intentions to use condoms with other partners. Women who wanted to become pregnant were much less likely to intend to use condoms with their main partner, and women using oral contraceptives were less likely to be long-term consistent condom users.
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Affiliation(s)
- J S Santelli
- Department of Maternal and Child Health, Johns Hopkins School of Hygiene and Public Health, Baltimore, USA
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Santelli JS, Celentano DD, Rozsenich C, Crump AD, Davis MV, Polacsek M, Augustyn M, Rolf J, McAlister AL, Burwell L. Interim outcomes for a community-based program to prevent perinatal HIV transmission. AIDS Educ Prev 1995; 7:210-220. [PMID: 7646945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
The AIDS Prevention for Pediatric Life Enrichment (APPLE) project is a community-based program to prevent perinatal HIV infection by preventing infection in women. One project component tested a primary prevention model developed from principles of cognitive social learning theory which used street outreach and community-targeted small media materials to increase the use of condoms. Formative research was used to explore community perceptions about HIV/AIDS and to design media materials. Program evaluation employed a two-community, time series, quasi-experimental design. Annual street surveys samples individuals in areas where they were likely to encounter outreach workers. Baseline surveys found substantial pre-programmatic behavior change. After two years considerable APPLE name recognition (40%), contact with media materials (63%), and contact with outreach workers (36%) were found and norms reflecting social acceptability of condoms were more positive among women in the intervention community. Condom use at last sexual encounter rose in both communities but was significantly higher in the intervention community. Condom use also was higher among women who reported exposure to either small media or small media plus street outreach. Other self-reported HIV-prevention behaviors did not show change in the initial period.
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Affiliation(s)
- J S Santelli
- Division of Adolescent and School Health, CDC, Atlanta, GA 30333, USA
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Nebot M, Celentano DD, Burwell L, Davis A, Davis M, Polacsek M, Santelli J. AIDS and behavioural risk factors in women in inner city Baltimore: a comparison of telephone and face to face surveys. J Epidemiol Community Health 1994; 48:412-8. [PMID: 7964343 PMCID: PMC1059993 DOI: 10.1136/jech.48.4.412] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
STUDY OBJECTIVE The study aimed to investigate the influence the mode of administration of a questionnaire (telephone or face to face) on reports of sexual behaviour and attitudes of HIV risk among woman of reproductive age. DESIGN Two cross sectional surveys--one, a modified random digit dialing telephone survey, the second, a face to face street sample--were carried out by the same interviewers using similar questionnaires in the same neighbourhoods. SETTING AND PARTICIPANTS Two socially deprived, inner city neighbourhoods of Baltimore City were assessed in early 1990 before a community health intervention was carried out in one of them. Women between 17 and 35 years were surveyed. MAIN RESULTS Altogether 775 and 416 women in the target age group were interviewed by telephone and face to face methods: the response rates were 66.4% and 77% respectively. Telephone respondents tended to be older, had more education, were more often married, were less likely to live in subsidised housing, and were more likely to report HIV testing. The proportions of respondents who reported a previous abortion and had had a surgical sterilisation were higher among the telephone respondents (34.7% v 24.1% and 26.4% v 20.6%, respectively). With regard to sexual risk behaviour, the only statistically significant differences were found in the proportion who reported having used drugs (10.6% of the face to face v 2.4% of the telephone sample) or alcohol (30.5% v 16.3%) at last sexual intercourse. The observed method effect on these variables remained unchanged after adjusting for age, education, employment, and marital status. This effect was even stronger for a subgroup of face to face respondents who reported not having a telephone at home. The adjusted odds ratios for reporting alcohol consumption and use of drugs at the last sexual encounter in this group compared with the telephone respondents were 3.7 (2.1, 6.6) and 14.1 (5.7, 34.5) respectively. CONCLUSIONS Despite the socioeconomic bias associated with the mode of data collection, there are only a few differences between the telephone and personal survey methods in reports of sexual behaviour. These differences are mostly concentrated in young women (under 20 years), and in a particularly socioeconomically deprived subgroup identified through telephone ownership.
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Affiliation(s)
- M Nebot
- Division of Behavioural Sciences and Health Education, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD
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