1
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Hopper JL, Li S, MacInnis RJ, Dowty JG, Nguyen TL, Bui M, Dite GS, Esser VFC, Ye Z, Makalic E, Schmidt DF, Goudey B, Alpen K, Kapuscinski M, Win AK, Dugué PA, Milne RL, Jayasekara H, Brooks JD, Malta S, Calais-Ferreira L, Campbell AC, Young JT, Nguyen-Dumont T, Sung J, Giles GG, Buchanan D, Winship I, Terry MB, Southey MC, Jenkins MA. Breast and bowel cancers diagnosed in people 'too young to have cancer': A blueprint for research using family and twin studies. Genet Epidemiol 2024. [PMID: 38504141 DOI: 10.1002/gepi.22555] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/29/2024] [Accepted: 02/23/2024] [Indexed: 03/21/2024]
Abstract
Young breast and bowel cancers (e.g., those diagnosed before age 40 or 50 years) have far greater morbidity and mortality in terms of years of life lost, and are increasing in incidence, but have been less studied. For breast and bowel cancers, the familial relative risks, and therefore the familial variances in age-specific log(incidence), are much greater at younger ages, but little of these familial variances has been explained. Studies of families and twins can address questions not easily answered by studies of unrelated individuals alone. We describe existing and emerging family and twin data that can provide special opportunities for discovery. We present designs and statistical analyses, including novel ideas such as the VALID (Variance in Age-specific Log Incidence Decomposition) model for causes of variation in risk, the DEPTH (DEPendency of association on the number of Top Hits) and other approaches to analyse genome-wide association study data, and the within-pair, ICE FALCON (Inference about Causation from Examining FAmiliaL CONfounding) and ICE CRISTAL (Inference about Causation from Examining Changes in Regression coefficients and Innovative STatistical AnaLysis) approaches to causation and familial confounding. Example applications to breast and colorectal cancer are presented. Motivated by the availability of the resources of the Breast and Colon Cancer Family Registries, we also present some ideas for future studies that could be applied to, and compared with, cancers diagnosed at older ages and address the challenges posed by young breast and bowel cancers.
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Affiliation(s)
- John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Shuai Li
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Robert J MacInnis
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - James G Dowty
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Tuong L Nguyen
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Minh Bui
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Gillian S Dite
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Genetic Technologies Ltd., Fitzroy, Victoria, Australia
| | - Vivienne F C Esser
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Zhoufeng Ye
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Enes Makalic
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Daniel F Schmidt
- Department of Data Science and AI, Faculty of Information Technology, Monash University, Melbourne, Victoria, Australia
| | - Benjamin Goudey
- ARC Training Centre in Cognitive Computing for Medical Technologies, University of Melbourne, Carlton, Victoria, Australia
- The Florey Department of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Karen Alpen
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Miroslaw Kapuscinski
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Aung Ko Win
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
- Genetic Medicine, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Pierre-Antoine Dugué
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Roger L Milne
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Harindra Jayasekara
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Jennifer D Brooks
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Sue Malta
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Lucas Calais-Ferreira
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
| | - Alexander C Campbell
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Jesse T Young
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- Justice Health Group, Curtin School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Tu Nguyen-Dumont
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Joohon Sung
- Department of Public Health Sciences, Division of Genome and Health Big Data, Graduate School of Public Health, Seoul National University, Seoul, South Korea
- Genome Medicine Institute, Seoul National University, Seoul, South Korea
- Institute of Health and Environment, Seoul National University, Seoul, South Korea
| | - Graham G Giles
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Daniel Buchanan
- Department of Clinical Pathology, The University of Melbourne, Parkville, Victoria, Australia
| | - Ingrid Winship
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Mary Beth Terry
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Melissa C Southey
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Department of Clinical Pathology, The University of Melbourne, Parkville, Victoria, Australia
| | - Mark A Jenkins
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Victoria, Australia
- University of Melbourne Centre for Cancer Research, Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
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2
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Bourchier L, Temple-Smith M, Hocking J, Bittleston H, Malta S. Engaging older Australians in sexual health research: SHAPE2 survey recruitment and sample. Sex Health 2024; 21:NULL. [PMID: 38071758 DOI: 10.1071/sh23116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/14/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Sexual health research rarely includes older age groups and the sexual health needs of older Australians are not well understood. Older adults are online in increasing numbers; however, internet surveys involving samples of older adults and sensitive topics remain uncommon. In 2021, we developed an online survey to explore the sexual health needs of Australians aged 60+years. We describe here survey recruitment and sample obtained, comparing it with national population data (Australian Bureau of Statistics) and the sample of the similar 'Sex, Age and Me' study from 2015. METHODS We recruited 1470 people with a staggered three-phase strategy: (1) emails to organisations and community groups; (2) paid Facebook advertising; and (3) passive recruitment. Half (50.6%) found out about the study via an organisation or group and just over a third (35.7%) from Facebook. RESULTS The sample was equally balanced between men (49.9%) and women (49.7%) (0.4% other gender identities). Participants were aged 60-92years (median 69years) with all Australian States/Territories represented. Facebook recruits were younger, more likely to be working rather than retired, and more likely to live outside a major city, than those recruited by other means. CONCLUSIONS Using the recruitment methods described, we successfully obtained a diverse and fairly representative sample of older Australians within the constraints of a convenience sample and on a modest budget. This research sheds light on ways to engage an under-served demographic in sexual health research. Our experience shows that many older adults are amenable to recruitment for online sexual health surveys using the approaches outlined.
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Affiliation(s)
- Louise Bourchier
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Meredith Temple-Smith
- Department of General Practice and Primary Care, University of Melbourne, Melbourne, Vic., Australia
| | - Jane Hocking
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Helen Bittleston
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
| | - Sue Malta
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia
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Loi SM, Gaffy E, Malta S, Russell MA, Williams S, Ames D, Hill KD, Batchelor F, Cyarto EV, Haines T, Lautenschlager NT, Mackenzie L, Moore KJ, Savvas SM, Dow B. Effects of physical activity on depressive symptoms in older caregivers: The IMPACCT randomized controlled trial. Int J Geriatr Psychiatry 2024; 39:e6058. [PMID: 38279894 DOI: 10.1002/gps.6058] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 01/10/2024] [Indexed: 01/29/2024]
Abstract
OBJECTIVES Physical activity (PA) can reduce depressive symptoms but has not been tested amongst depressed older caregivers and their care-recipients. The aim of this single-blind randomized controlled trial was to investigate the effect of a 6-month tailored PA program on depressive symptoms in older caregivers. METHOD Caregivers were included if they had scores of ≥5 on the 15-item geriatric depression scale (GDS-15). Care-recipients could have any type of physical, mental or cognitive condition requiring support. The PA intervention group completed an individualized program based on the Otago-Plus Exercise Program. The primary outcome was improvement in depressive symptoms in caregivers measured at six and 12 months. RESULTS Two hundred and twelve participants (91 dyads and 30 caregivers only) were randomized using a 3:3:1 ratio to PA intervention, social-control, and usual-care control groups. There were no significant differences in depressive symptoms of the caregivers between the three groups at 6 months or 12 months. However, more than 50% of caregivers in all three groups no longer had a GDS-15 score ≥5 at 6 months. Further analysis revealed that caregivers in the PA group caring for someone with a standardised mini-mental state examination (SMMSE) score ≥24 had significantly less depressive symptoms than those caring for someone with a SMMSE score <24 compared with social-control (p < 0.02) and usual-care groups (p < 0.02). CONCLUSIONS A PA intervention may be beneficial for some caregivers in reducing symptoms of depression but may not be as beneficial to caregivers of people living with cognitive impairment.
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Affiliation(s)
- Samantha M Loi
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
- Neuropsychiatry Centre, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Ellen Gaffy
- National Ageing Research Institute, Parkville, Victoria, Australia
| | - Sue Malta
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
| | - Melissa A Russell
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
| | - Susan Williams
- National Ageing Research Institute, Parkville, Victoria, Australia
| | - David Ames
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
- National Ageing Research Institute, Parkville, Victoria, Australia
- St Georges Hospital, Kew, Victoria, Australia
| | - Keith D Hill
- Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Frances Batchelor
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
- National Ageing Research Institute, Parkville, Victoria, Australia
| | | | - Terence Haines
- Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Nicola T Lautenschlager
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
- Royal Melbourne Hospital Mental Health Services, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | | | - Kirsten J Moore
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
- National Ageing Research Institute, Parkville, Victoria, Australia
| | - Steven M Savvas
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
- National Ageing Research Institute, Parkville, Victoria, Australia
| | - Briony Dow
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
- National Ageing Research Institute, Parkville, Victoria, Australia
- Deakin University, Waurn Ponds, Victoria, Australia
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4
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Hinchliff S, Mawson RL, Malta S, Cliff G. How to support the sexual wellbeing of older patients. BMJ 2023; 380:e072388. [PMID: 36972919 DOI: 10.1136/bmj-2022-072388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Affiliation(s)
- Sharron Hinchliff
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, UK
| | - Rebecca L Mawson
- The Academic Unit of Primary Medical Care, University of Sheffield, Sheffield
- GPwER SRH, Valley Medical Centre, Stocksbridge, Sheffield
| | - Sue Malta
- Sexual Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Gilli Cliff
- South Yorkshire Housing Association Limited, Sheffield
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5
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Goller JL, Bittleston H, Kong FYS, Bourchier L, Williams H, Malta S, Vaisey A, Lau A, Hocking JS, Coombe J. Sexual behaviour during COVID-19: a repeated cross-sectional survey in Victoria, Australia. Sex Health 2022; 19:92-100. [PMID: 35484839 DOI: 10.1071/sh21235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/21/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND During 2020, the State of Victoria (Australia) experienced two COVID-19 waves. Both resulted in community lockdowns followed by eased restrictions. We examined variation of sexual behaviour in Victorians over time during COVID-19. METHODS We conducted a repeated online survey at four timepoints corresponding with two lockdown (LD1, LD2) and two reduced restriction (RR1, RR2) periods in Victoria. A convenience sample of participants aged ≥18years was recruited via social media and asked about their recent (past 4weeks) sexual behaviour. Using multivariable logistic regression, we investigated variation in sexual behaviour between surveys. RESULTS A total of 1828 surveys were completed; 72% identified as female, 69% were aged 18-29years, 90% were metropolitan residents. The proportion reporting recent partnered sex ranged from 54.9% (LD2) to 70.2% (RR1). Across all timepoints, the most common sexual partners were regular (81.5%, n=842) and 10.8% (n=111) reported casual partners (e.g. hook-ups). Compared with LD1, respondents were >2-fold more likely to report casual partner(s) during reduced restrictions (RR1: aOR 2.0; 95% CI 1.1-3.7; RR2: aOR 2.8; 95% CI 1.3-5.9). Across all timepoints, 26.6% (n=486) reported using dating apps. Compared with LD1, dating app use for face-to-face activities (e.g. dates, hook-ups) was >4-fold higher during reduced restrictions (RR1: aOR 4.3; 95% CI 2.3-8.0; RR2: aOR 4.1; 95% CI 1.9-8.8). App use for distanced activities (e.g. sexting, virtual dates) was highest during LD1 (48.8%) than other periods. CONCLUSIONS In this convenience sample, self-reported sexual behaviours fluctuated between lockdowns and reduced restrictions. While dating apps may provide a mechanism for virtual connections, this may be temporary until physical connections are possible.
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Affiliation(s)
- Jane L Goller
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Vic. 3053, Australia
| | - Helen Bittleston
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Vic. 3053, Australia
| | - Fabian Yuh Shiong Kong
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Vic. 3053, Australia
| | - Louise Bourchier
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Vic. 3053, Australia
| | - Henrietta Williams
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Vic. 3053, Australia; and Melbourne Sexual Health Centre, Alfred Health, Carlton, Vic. 3053, Australia
| | - Sue Malta
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Vic. 3053, Australia; and National Ageing Research Institute Inc., Parkville, Vic. 3052, Australia
| | - Alaina Vaisey
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Vic. 3053, Australia
| | - Andrew Lau
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Vic. 3053, Australia
| | - Jane S Hocking
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Vic. 3053, Australia
| | - Jacqueline Coombe
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Carlton, Vic. 3053, 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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7
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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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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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9
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Coombe J, Kong FYS, Bittleston H, Williams H, Tomnay J, Vaisey A, Malta S, Goller JL, Temple-Smith M, Bourchier L, Lau A, Chow EPF, Hocking JS. Love during lockdown: findings from an online survey examining the impact of COVID-19 on the sexual health of people living in Australia. Sex Transm Infect 2021; 97:357-362. [PMID: 33203737 PMCID: PMC7670557 DOI: 10.1136/sextrans-2020-054688] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 09/22/2020] [Accepted: 10/03/2020] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Australia recorded its first case of COVID-19 in late January 2020. On 22P March 2020, amid increasing daily case numbers, the Australian Government implemented lockdown restrictions to help 'flatten the curve'. Our study aimed to understand the impact of lockdown restrictions on sexual and reproductive health. Here we focus on sexual practices. METHODS An online survey was open from the 23PP April 2020 to 11P May 2020. Participants were recruited online via social media and other networks and were asked to report on their sexual practices in 2019 and during lockdown. Logistic regression was used to calculate the difference (diff) (including 95% CIs) in the proportion of sex practices between time periods. RESULTS Of the 1187 who commenced the survey, 965 (81.3%) completed it. Overall, 70% were female and 66.3% were aged 18-29 years. Most (53.5%) reported less sex during lockdown than in 2019. Compared with 2019, participants were more likely to report sex with a spouse (35.3% vs 41.7%; diff=6.4%; 95% CI 3.6 to 9.2) and less likely to report sex with a girl/boyfriend (45.1% vs 41.8%; diff=-3.3%; 95% CI -7.0 to -0.4) or with casual hook-up (31.4% vs 7.8%; 95% CI -26.9 to -19.8). Solo sex activities increased; 14.6% (123/840) reported using sex toys more often and 26.0% (218/838) reported masturbating more often. Dating app use decreased during lockdown compared with 2019 (42.1% vs 27.3%; diff= -14.8%; 95% CI -17.6 to -11.9). Using dating apps for chatting/texting (89.8% vs 94.5%; diff=4.7%; 95% CI 1.0 to 8.5) and for setting up virtual dates (2.6% vs 17.2%; diff=14.6%; 95% CI 10.1 to 19.2) increased during lockdown. CONCLUSION Although significant declines in sexual activity during lockdown were reported, people did not completely stop engaging in sexual activities, highlighting the importance of ensuring availability of normal sexual and reproductive health services during global emergencies.
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Affiliation(s)
- Jacqueline Coombe
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Fabian Yuh Shiong Kong
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Helen Bittleston
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Henrietta Williams
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
| | - Jane Tomnay
- Centre for Excellence in Rural Sexual Health, Department of Rural Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Alaina Vaisey
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sue Malta
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- National Ageing Research Institute Inc, Parkville, Victoria, Australia
| | - Jane L Goller
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Meredith Temple-Smith
- Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
| | - Louise Bourchier
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Andrew Lau
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Eric P F Chow
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Jane S Hocking
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
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10
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Hinchliff S, Fileborn B, Alba B, Lyons A, Minichiello V, Barrett C, Brown G, Malta S, Dow B. Talking about sex with friends: perspectives of older adults from the Sex, Age & Me study in Australia. Cult Health Sex 2021; 23:367-382. [PMID: 32609066 DOI: 10.1080/13691058.2019.1710568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/22/2019] [Accepted: 12/27/2019] [Indexed: 06/11/2023]
Abstract
This qualitative study explored the barriers and facilitators to sexual communication between older adults and friends. Fifty-three women and men aged 58 and older were interviewed about their intimate relationships and sexual behaviours and attitudes. Findings indicated that talking about sex with friends played an important role in providing support and sharing information. The privacy of the topic meant that trust and confidentiality had to be in place before sexual conversations occurred, and that discretion was required for those married or in a relationship due to potential breaches of privacy. Stereotypes associated with older age made talking about sex 'risky' as participants were vulnerable to scrutiny. Growing-up during a time when sex was taboo influenced willingness and comfort in talking about sex today. Among those who did talk with friends, women tended to talk to women and men to men. These findings are significant in the context of an increasing global population of older adults and silence around sex and ageing. By exploring sexual communication outside of the healthcare context, where previous research has focused, the findings indicate novel ways to support the sexual health and well-being of older adults.
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Affiliation(s)
- Sharron Hinchliff
- School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
| | - Bianca Fileborn
- School of Political and Social Sciences, University of Melbourne, Melbourne, Australia
| | - Beatrice Alba
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - Anthony Lyons
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - Victor Minichiello
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
- School of Justice, Faculty of Law, Queensland University of Technology, Brisbane, Australia
| | | | - Graham Brown
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - Sue Malta
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Briony Dow
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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11
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Coombe J, Kong F, Bittleston H, Williams H, Tomnay J, Vaisey A, Malta S, Goller J, Temple-Smith M, Bourchier L, Lau A, Hocking JS. Contraceptive use and pregnancy plans among women of reproductive age during the first Australian COVID-19 lockdown: findings from an online survey. EUR J CONTRACEP REPR 2021; 26:265-271. [PMID: 33615946 DOI: 10.1080/13625187.2021.1884221] [Citation(s) in RCA: 6] [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: 10/22/2022]
Abstract
PURPOSE Australia introduced 'lockdown' measures to control COVID-19 on 22 March 2020 which continued for a period of two months. We aimed to investigate the impact this had on sexual and reproductive health (SRH). MATERIALS AND METHODS Australians aged 18+ were eligible to participate in an online survey from 23 April to 11 May 2020. We report on the experiences of 518 female participants aged <50 years. Pregnancy intentions and contraceptive use were analysed using descriptive statistics. Odds ratios and 95% confidence intervals were calculated to investigate difficulty accessing SRH products and services. Qualitative data were analysed using conventional content analysis. RESULTS Most participants were aged 18-24 years, and indicated they were trying to avoid pregnancy. The oral contraceptive pill was the most common single method used however nearly 20% reported they were not using contraception. Women who were employed had less trouble accessing contraception during lockdown. Participants reported delaying childbearing or deciding to remain childfree due to COVID-19. CONCLUSION COVID-19 lockdown impacted the SRH of Australian women. Findings highlight the importance of continued access to SRH services and products during global emergencies.
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Affiliation(s)
- Jacqueline Coombe
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Fabian Kong
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Helen Bittleston
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Hennie Williams
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia.,Melbourne Sexual Health Centre, Alfred Health, Carlton, Australia
| | - Jane Tomnay
- Centre for Excellence in Rural Sexual Health, Department of Rural Health, University of Melbourne, Australia
| | - Alaina Vaisey
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Sue Malta
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia.,National Ageing Research Institute, Parkville, Australia
| | - Jane Goller
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | | | - Louise Bourchier
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Andrew Lau
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
| | - Jane S Hocking
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Australia
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12
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Bourchier L, Malta S, Temple-Smith M, Hocking J. Do we need to worry about sexually transmissible infections (STIs) in older women in Australia? An investigation of STI trends between 2000 and 2018. Sex Health 2020; 17:517-524. [PMID: 33334416 DOI: 10.1071/sh20130] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 11/05/2020] [Indexed: 11/23/2022]
Abstract
Background This study examined trends in chlamydia, gonorrhoea and syphilis diagnosis, and chlamydia testing and positivity, among older women in Australia between 2000 and 2018. METHODS Using national notifiable disease data and Medicare data, diagnosis rates were calculated for each sexually transmissible infection (STI), as well as testing and positivity rates for chlamydia. Data were compared between two older groups (55-64 and 65-74 years) and two younger groups (15-24 and 25-34 years). Poisson regression examined trends for 2000-18 and 2014-18 separately. RESULTS Rates for all STIs increased across all age groups and were highest in the two youngest age groups. From 2014 to 2018, chlamydia rates increased the most among those aged 55-64 years [incidence rate ratio (IRR) = 1.06; 95%CI: 1.02-1.10] and declined in those aged 15-24 years (IRR = 0.99; 95%CI: 0.99-0.99). Gonorrhoea rates increased the most among those aged 65-74 years (IRR = 1.47; 95%CI: 1.23-1.77) and least in those aged 15-24 years (IRR = 1.12; 95%CI: 1.10-1.13). Syphilis rates increased the most among those aged 55-64 years (IRR = 1.58; 95%CI: 1.25-1.99) and least in those aged 15-24 years (IRR = 1.29; 95%CI: 1.23-1.35). Chlamydia test positivity declined among younger women but remained stable in older women. CONCLUSIONS In general, STIs are increasing among older women in Australia at a faster rate than among younger women. Although the greatest burden is among younger women, STIs need to be considered and monitored among older women.
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Affiliation(s)
- Louise Bourchier
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Vic. 3053, Australia; and Corresponding author.
| | - Sue Malta
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Vic. 3053, Australia; and National Ageing Research Institute, Poplar Road, Parkville, Vic. 3052, Australia
| | - Meredith Temple-Smith
- Department of General Practice, The University of Melbourne, 780 Elizabeth Street, Melbourne, Vic. 3004, Australia
| | - Jane Hocking
- Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Carlton, Vic. 3053, Australia
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13
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Segbedzi T, South SH, Hughes M, Malta S. Australian Association of Gerontology Position Paper Summary: LGBTI Ageing Research in Australia. Australas J Ageing 2020; 39:158-160. [PMID: 32686904 DOI: 10.1111/ajag.12814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 04/26/2020] [Accepted: 04/27/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Tonye Segbedzi
- Australian Association of Gerontology, Melbourne, Victoria, Australia
| | | | - Mark Hughes
- Australian Association of Gerontology, Melbourne, Victoria, Australia
| | - Sue Malta
- Australian Association of Gerontology, Melbourne, Victoria, Australia
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14
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Freak-Poli R, Malta S. An overview of sexual behaviour research in later life-Quantitative and qualitative findings. Australas J Ageing 2020; 39 Suppl 1:16-21. [PMID: 32567181 DOI: 10.1111/ajag.12773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 12/19/2022]
Abstract
AIM This article provides an overview of current sexual behaviour research in later life by describing associated factors, including the physical and psychological benefits. METHODS Recent systematic reviews were interrogated for findings on sexual behaviour research in adults aged 60+. RESULTS Regardless of research methods employed, all studies showed that there were a range of physical and psychological benefits to remaining sexually active in later life. While quantitative studies placed an emphasis on measuring penile-vaginal intercourse, they provided no definitive conclusion about the benefits due to 'inconsistent results' across studies. Qualitative studies described the myriad ways in which older adults redefine what constitutes sexual activity despite the onset of dysfunction and disability. CONCLUSION While the different research methods show that engaging in sexual behaviour has physical and psychological benefits at all adult ages, there is limited conclusive evidence about what the overall benefits might be in later life.
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Affiliation(s)
- Rosanne Freak-Poli
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., Australia.,Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Sue Malta
- Sexual Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.,National Ageing Research Institute, Parkville, Vic., Australia
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15
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Freak-Poli R, Malta S. Sex and intimacy in later life: From understanding and acceptance to policy. Australas J Ageing 2020; 39 Suppl 1:3-5. [PMID: 32567183 DOI: 10.1111/ajag.12799] [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: 11/29/2022]
Affiliation(s)
- Rosanne Freak-Poli
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Vic., Australia.,Department of Epidemiology, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Sue Malta
- Sexual Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Vic., Australia.,National Ageing Research Institute, Parkville, Vic., Australia
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16
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Malta S, Wallach I. Sexuality and ageing in palliative care environments? Breaking the (triple) taboo. Australas J Ageing 2020; 39 Suppl 1:71-73. [DOI: 10.1111/ajag.12744] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 09/18/2019] [Accepted: 09/22/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Sue Malta
- Melbourne School of Population and Global Health University of Melbourne Carlton Victoria Australia
- National Ageing Research Institute Parkville Victoria Australia
| | - Isabelle Wallach
- Département de Sexologie Université du Québec à Montréal Montreal Quebec Canada
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17
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Malta S, Temple‐Smith M, Bickerstaffe A, Bourchier L, Hocking J. ‘That might be a bit sexy for somebody your age’: Older adult sexual health conversations in primary care. Australas J Ageing 2020; 39 Suppl 1:40-48. [DOI: 10.1111/ajag.12762] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Sue Malta
- Melbourne School of Population and Global Health University of Melbourne Melbourne Vic Australia
- National Ageing Research Institute Parkville Vic Australia
| | | | - Adrian Bickerstaffe
- Melbourne School of Population and Global Health University of Melbourne Melbourne Vic Australia
| | - Louise Bourchier
- Melbourne School of Population and Global Health University of Melbourne Melbourne Vic Australia
| | - Jane Hocking
- Melbourne School of Population and Global Health University of Melbourne Melbourne Vic Australia
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18
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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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19
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Heywood W, Lyons A, Fileborn B, Minichiello V, Barrett C, Brown G, Hinchliff S, Malta S, Crameri P. Self-reported testing and treatment histories among older Australian men and women who may be at risk of a sexually transmissible infection. Sex Health 2019; 14:139-146. [PMID: 27914483 DOI: 10.1071/sh16075] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 10/27/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Rates of sexually transmissible infections (STIs) are increasing among older adults in many countries. Little is known about the testing and treatment histories of these populations. Correlates of testing in the past 5 years among older adults who may be at risk of a STI were examined. METHODS A cross-sectional survey of 2137 Australians aged 60+ years that involved questions on STIs and STI testing was conducted in 2015. To help inform potential education campaigns, analyses focused on those who may have been at risk of a STI (n=805, 38%). RESULTS Less than one in three reported a STI test in the past 5 years (n=241, 30%) while 6% (n=51) reported a STI diagnosis. Those diagnosed typically received treatment from a family doctor or general practitioner. Among men, lower testing rates were associated with older age, identifying as heterosexual, lower educational attainment, not using online dating and reporting one partner in the past 5 years. For women, lower rates of testing were found among those who did not use a condom at their most recent sexual encounter and those with one partner in the past 5 years. CONCLUSIONS STI testing rates were low. This study indicates that consideration should be given to the way targeted education campaigns are formulated, such as emphasising the importance of STI testing to older people who are at risk, as well as encouraging healthcare professionals to discuss sexual health with their older patients.
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Affiliation(s)
- Wendy Heywood
- Australian Research Centre in Sex, Health and Society; School of Psychology and Public Health; La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia
| | - Anthony Lyons
- Australian Research Centre in Sex, Health and Society; School of Psychology and Public Health; La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia
| | - Bianca Fileborn
- Australian Research Centre in Sex, Health and Society; School of Psychology and Public Health; La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia
| | - Victor Minichiello
- Australian Research Centre in Sex, Health and Society; School of Psychology and Public Health; La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia
| | - Catherine Barrett
- Australian Research Centre in Sex, Health and Society; School of Psychology and Public Health; La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia
| | - Graham Brown
- Australian Research Centre in Sex, Health and Society; School of Psychology and Public Health; La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia
| | - Sharron Hinchliff
- School of Nursing and Midwifery, University of Sheffield, Barber House Annexe, 3a Clarkehouse Road, Sheffield, S10 2LA, UK
| | - Sue Malta
- National Ageing Research Institute, University of Melbourne, PO Box 2127, Royal Melbourne Hospital, Vic. 3050, Australia
| | - Pauline Crameri
- Australian Research Centre in Sex, Health and Society; School of Psychology and Public Health; La Trobe University, 215 Franklin Street, Melbourne, Vic. 3000, Australia
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Malta S, Temple-Smith M, Hunter J, McGavin D, Lyne J, Bickerstaffe A, Hocking J. Could an online or digital aid facilitate
discussions about sexual health with
older Australians in general practice? Aust J Gen Pract 2019; 47:870-875. [PMID: 31212407 DOI: 10.31128/ajgp-04-18-4557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Background and objectives Older patients want to discuss sexual
health with general practitioners (GPs)
but feel uncomfortable doing so, as
do their GPs. Online and digital aids
(ODAs) are used in other clinical
contexts and could provide an effective
tool to overcome this discomfort. The
aim of this study was to explore health
practitioners’ views on the type of ODA
that could be used to facilitate sexual
health discussions between older
patients (aged ≥60 years) and health
practitioners. Methods Thirty-seven interviews were conducted
in Victoria, Australia, between March
and June 2017. Participants comprised
15 GPs, 12 practice nurses or practice
managers and 10 key informants (five
in sexual health, five in ODAs). Results Most ODAs currently available target
younger populations. Checklists or
self‑service kiosks may provide
effective means to facilitate sexual
health discussions with older patients
in primary care. Discussion ODAs are acceptable and feasible to
implement in younger populations but
need testing with older patients. Health
professionals need training to deal with
sexual health matters arising from using
such aids.
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Affiliation(s)
- Sue Malta
- PhD, Research Fellow, Melbourne School
of Population and Global Health, University of
Melbourne and Social Gerontology Division, National
Ageing Research Institute, Vic. susan.malta@
unimelb.edu.au
| | - Meredith Temple-Smith
- PhD, Director of Research
Training, Department of General Practice, University
of Melbourne, Vic
| | - Jesse Hunter
- MD, Melbourne Medical School, University of Melbourne, Vic
| | - Declan McGavin
- MD, Melbourne Medical School, University of Melbourne, Vic
| | - Jenni Lyne
- MD, Melbourne Medical School, University of Melbourne, Vic
| | - Adrian Bickerstaffe
- PhD, Melbourne School
of Population and Global Health, University of
Melbourne, Vic
| | - Jane Hocking
- PhD, Head, Sexual Health Unit,
Melbourne School of Population and Global Health,
University of Melbourne, Vic
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21
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Malta S, Hocking J, Lyne J, McGavin D, Hunter J, Bickerstaffe A, Temple-Smith M. Do you talk to your older patients about sexual health? Health practitioners’ knowledge of, and attitudes towards, management of sexual health among older Australians. Aust J Gen Pract 2019; 47:807-811. [PMID: 31207681 DOI: 10.31128/ajgp-04-18-4556] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Research suggests that older patients want to talk about sexual health, but are reluctant to initiate these discussions with health practitioners. Little is known of the practitioners’ perspectives. The objective of this study was to explore health practitioners’ knowledge of and attitudes towards management of sexual health among older patients. METHOD Semi-structured interviews were conducted with 15 general practitioners (GPs) and six practice nurses in rural/metropolitan general practices in March to June 2017 in Victoria, Australia. RESULTS Most GPs believed it was appropriate to discuss sexual health with older patients but did not routinely do so. Common barriers included age and gender discordance between GP and patient, complexity of patient comorbidities and patient–doctor relationships. Practice nurses identified the limitations of their role as a barrier, although some nurses initiated discussions during health assessments. DISCUSSION Health practitioners generally believed the responsibility for initiation of sexual health discussions rested with patients, but understood patients’ reluctance. They saw the need for an intervention to assist in such discussions.
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Affiliation(s)
- Sue Malta
- PhD, Research Fellow, Melbourne School of Population and Global Health, University of Melbourne and Social Gerontology Division, National Ageing Research Institute, Vic.
| | - Jane Hocking
- PhD, Head, Sexual Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Vic
| | - Jenni Lyne
- MD, Melbourne Medical School, University of Melbourne, Vic
| | - Declan McGavin
- MD, Melbourne Medical School, University of Melbourne, Vic
| | - Jesse Hunter
- MD, Melbourne Medical School, University of Melbourne, Vic
| | - Adrian Bickerstaffe
- PhD, Melbourne School of Population and Global Health, University of Melbourne, Vic
| | - Meredith Temple-Smith
- PhD, Director of Research Training, Department of General Practice, University of Melbourne, Vic
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22
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Abstract
OBJECTIVES This article examines relationships between experiences of ageism and four specific mental health outcomes among older Australian adults, including whether these relationships vary depending on age, gender, and sexual orientation. METHODS A survey was conducted nationwide involving 2137 participants aged 60 years and older. Mental health variables included depressive symptoms, anxious symptoms, general stress, and positive mental health or flourishing. RESULTS Recent experiences of ageism were found to be strongly related to poorer mental health on all four mental health variables. However, experiences of ageism appeared to have a greater effect on the mental health of those who were younger in age (specifically depression), of men more so than women (specifically depression), and of those who identified as heterosexual as opposed to other sexual orientations (specifically general stress). CONCLUSION These findings suggest that experiences of ageism may be an important factor in the health and well-being of older adults, especially for those who are younger, male, and heterosexual, and may need to be taken into account when devising strategies for supporting healthier and happier ageing.
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Affiliation(s)
- Anthony Lyons
- a Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health , La Trobe University , Melbourne , Australia
| | - Beatrice Alba
- a Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health , La Trobe University , Melbourne , Australia
| | - Wendy Heywood
- a Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health , La Trobe University , Melbourne , Australia
| | | | - Victor Minichiello
- a Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health , La Trobe University , Melbourne , Australia.,c School of Medicine and Public Health , University of Newcastle , Callaghan , Australia.,d Faculty of Law, School of Justice , Queensland University of Technology , Brisbane , Australia
| | | | - Sharron Hinchliff
- f School of Nursing and Midwifery , University of Sheffield , Sheffield , United Kingdom
| | - Sue Malta
- g National Ageing Research Institute , Parkville , Australia.,h School of Global and Population Health , University of Melbourne , Carlton , Australia
| | - Briony Dow
- g National Ageing Research Institute , Parkville , Australia.,h School of Global and Population Health , University of Melbourne , Carlton , Australia
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23
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Malta S, Williams SB, Batchelor FA. 'An ant against an elephant': Retirement village residents' experiences of disputes and dispute resolution. Australas J Ageing 2018; 37:202-209. [PMID: 29614204 DOI: 10.1111/ajag.12524] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 11/30/2022]
Abstract
OBJECTIVE To record Victorian retirement village residents' experiences of dispute management and satisfaction levels related to dispute resolution processes. METHODS Survey distributed to 6500 retirement village residents. RESULTS Surveys returned from 1876 residents (29% return rate). Most residents rated life in retirement villages as positive (mean 7.9/10), with an association between life satisfaction and management's ability to resolve disputes (rs = 0.44, P < 0.01). Almost 70% of respondents reported issues of concern to management were resolved satisfactorily; 38% were not resolved to residents' satisfaction. One-fifth reported contacting regional managers or higher personnel regarding issues affecting them, with two-thirds of these respondents reporting a negative outcome. Over 30% did not know if their village had dispute resolution processes in place. CONCLUSION Despite finding retirement village life positive, residents of retirement villages found disputes and dispute resolution processes unsatisfactory and desired change to address these concerns.
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Affiliation(s)
- Sue Malta
- Social Gerontology Division, National Ageing Research Institute, Melbourne, Victoria, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia.,Faculty of Health, Arts and Design, Swinburne University, Melbourne, Victoria, Australia
| | - Susan B Williams
- Clinical Gerontology Division, National Ageing Research Institute, Melbourne, Victoria, Australia
| | - Frances A Batchelor
- Clinical Gerontology Division, National Ageing Research Institute, Melbourne, Victoria, Australia
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24
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Heywood W, Lyons A, Fileborn B, Hinchliff S, Minichiello V, Malta S, Barrett C, Dow B. Sexual Satisfaction Among Older Australian Heterosexual Men and Women: Findings from the Sex, Age & Me Study. J Sex Marital Ther 2018; 44:295-307. [PMID: 28812450 DOI: 10.1080/0092623x.2017.1366959] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study explored sexual satisfaction in older heterosexual Australians using data from a national sample of 1,583 men and women aged 60+ who hoped or planned to have sex in the future. Data collection took place in 2015; participants were recruited using a variety of online and offline advertisements. Less than half the sample (46%) reported they were very or extremely satisfied with their sexual lives. Those who had sex more often and were more interested in sex were more likely to be satisfied, while those who wanted sex more often in the future were less likely to be satisfied, as were men who had experienced sexual difficulties. Sexual satisfaction was also associated with life satisfaction in men and positive mental health in women. Factors associated with satisfaction in this study will help guide strategies to support older people in realizing the sexual lives they desire.
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Affiliation(s)
- Wendy Heywood
- a Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health , La Trobe University , Melbourne , Australia
| | - Anthony Lyons
- a Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health , La Trobe University , Melbourne , Australia
| | | | - Sharron Hinchliff
- c School of Nursing and Midwifery , University of Sheffield , Sheffield , UK
| | - Victor Minichiello
- a Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health , La Trobe University , Melbourne , Australia
- d School of Medicine and Public Health , University of Newcastle , Newcastle , Australia
- e School of Justice, Faculty of Law , Queensland University of Technology , Brisbane , Australia
| | - Sue Malta
- f National Ageing Research Institute , Melbourne , Australia
- g School of Population and Global Health , University of Melbourne , Melbourne , Australia
- h Faculty of Health, Arts & Design , Swinburne University of Technology , Melbourne , Australia
| | | | - Briony Dow
- f National Ageing Research Institute , Melbourne , Australia
- g School of Population and Global Health , University of Melbourne , Melbourne , Australia
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25
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Fileborn B, Brown G, Lyons A, Hinchliff S, Heywood W, Minichiello V, Malta S, Barrett C, Crameri P. Safer Sex in Later Life: Qualitative Interviews With Older Australians on Their Understandings and Practices of Safer Sex. J Sex Res 2018; 55:164-177. [PMID: 28276933 DOI: 10.1080/00224499.2017.1280121] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Rates of sexually transmitted infections (STIs) are increasing in older cohorts in Western countries such as Australia, the United Kingdom, and the United States, suggesting a need to examine the safer sex knowledge and practices of older people. This article presents findings from 53 qualitative interviews from the study Sex, Age, and Me: A National Study of Sex and Relationships Among Australians Aged 60+. Participants were recruited through an online national survey. We consider how participants understood "safer sex," the importance of safer sex to them, the safer sex practices they used (and the contexts in which they used them), and the barriers to using safer sex. Older adults had diverse understandings, knowledge, and use of safer sex practices, although participants tended to focus most strongly on condom use. Having safer sex was strongly mediated by relationship context, trust, perceived risk of contracting an STI, concern for personal health, and stigma. Common barriers to safer sex included erectile difficulties, embarrassment, stigma, reduced pleasure, and the lack of a safer sex culture among older people. The data presented have important implications for sexual health policy, practice, and education and health promotion campaigns aimed at improving the sexual health and well-being of older cohorts.
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Affiliation(s)
- Bianca Fileborn
- a Australian Research Centre in Sex, Health, and Society
- b School of Psychology and Public Health, La Trobe University
- c School of Social Sciences , University of New South Wales
| | - Graham Brown
- a Australian Research Centre in Sex, Health, and Society
- b School of Psychology and Public Health, La Trobe University
| | - Anthony Lyons
- a Australian Research Centre in Sex, Health, and Society
- b School of Psychology and Public Health, La Trobe University
| | | | - Wendy Heywood
- a Australian Research Centre in Sex, Health, and Society
- b School of Psychology and Public Health, La Trobe University
| | - Victor Minichiello
- a Australian Research Centre in Sex, Health, and Society
- b School of Psychology and Public Health, La Trobe University
- e School of Medicine Public Health , University of Newcastle and School of Justice
- f Faculty of Law , Queensland University of Technology
| | - Sue Malta
- g National Ageing Research Institute, University of Melbourne
- h Swinburne Institute of Social Research , Swinburne University of Technology
| | - Catherine Barrett
- a Australian Research Centre in Sex, Health, and Society
- b School of Psychology and Public Health, La Trobe University
| | - Pauline Crameri
- a Australian Research Centre in Sex, Health, and Society
- b School of Psychology and Public Health, La Trobe University
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26
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Fileborn B, Hinchliff S, Lyons A, Heywood W, Minichiello V, Brown G, Malta S, Barrett C, Crameri P. The Importance of Sex and the Meaning of Sex and Sexual Pleasure for Men Aged 60 and Older Who Engage in Heterosexual Relationships: Findings from a Qualitative Interview Study. Arch Sex Behav 2017; 46:2097-2110. [PMID: 28299563 DOI: 10.1007/s10508-016-0918-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 06/30/2016] [Revised: 10/04/2016] [Accepted: 12/07/2016] [Indexed: 05/12/2023]
Abstract
That many older individuals continue to engage in various forms of sexual expression well into later life is now well established in the literature. To date, however, only a small body of qualitative research has examined older men's experiences and understandings of sex in later life. Likewise, the ways in which older men's discussions on sex may be used as an avenue for "doing" masculinity remain underexplored. Older men are particularly interesting in this regard, as they inhabit an increasingly subordinated position in relation to hegemonic masculine ideals because of their age. To what extent might this limit or, alternatively, open up the possibilities for sexual expression and subjectivity in later life? Drawing on a subset of findings from Sex, Age, and Me: A National Study with Australian Women and Men Aged 60 and Older, data from qualitative interviews with 27 Australian men were explored in this article. The first Australian study of its kind, we argue that older men who engage in heterosexual relationships draw on a diverse and complex array of discursive positions regarding sex, relationships, and masculinity in making sense of their experiences of sex in later life. Older men are a heterogeneous group, and their experiences and understandings of sex do not simplistically follow "decline" or "success" narratives of aging. The findings of this research build upon and extend emerging research illustrating the centrality of intimacy to older men's sexual lives, while simultaneously highlighting the ways in which the body and discursive constructions of sex intersect to shape older men's sexual subjectivities.
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Affiliation(s)
- Bianca Fileborn
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia.
| | - Sharron Hinchliff
- School of Nursing and Midwifery, University of Sheffield, Sheffield, UK
| | - Anthony Lyons
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia
| | - Wendy Heywood
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia
| | - Victor Minichiello
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia
- School of Justice, Faculty of Law, Queensland University of Technology, Brisbane, Australia
| | - Graham Brown
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia
| | - Sue Malta
- National Ageing Research Institute, University of Melbourne, Parkville, Australia
- Swinburne Institute of Social Research, Swinburne University of Technology, Melbourne, Australia
| | - Catherine Barrett
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia
| | - Pauline Crameri
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, 215 Franklin Street, Melbourne, VIC, 3000, Australia
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27
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Lyons A, Heywood W, Fileborn B, Minichiello V, Barrett C, Brown G, Hinchliff S, Malta S, Crameri P. The Sex, Age, and Me study: recruitment and sampling for a large mixed-methods study of sexual health and relationships in an older Australian population. Cult Health Sex 2017; 19:1038-1052. [PMID: 28276921 DOI: 10.1080/13691058.2017.1288268] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 08/09/2016] [Accepted: 01/25/2017] [Indexed: 06/06/2023]
Abstract
Older people are often excluded from large studies of sexual health, as it is assumed that they are not having sex or are reluctant to talk about sensitive topics and are therefore difficult to recruit. We outline the sampling and recruitment strategies from a recent study on sexual health and relationships among older people. Sex, Age and Me was a nationwide Australian study that examined sexual health, relationship patterns, safer-sex practices and STI knowledge of Australians aged 60 years and over. The study used a mixed-methods approach to establish baseline levels of knowledge and to develop deeper insights into older adult's understandings and practices relating to sexual health. Data collection took place in 2015, with 2137 participants completing a quantitative survey and 53 participating in one-on-one semi-structured interviews. As the feasibility of this type of study has been largely untested until now, we provide detailed information on the study's recruitment strategies and methods. We also compare key characteristics of our sample with national estimates to assess its degree of representativeness. This study provides evidence to challenge the assumptions that older people will not take part in sexual health-related research and details a novel and successful way to recruit participants in this area.
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Affiliation(s)
- Anthony Lyons
- a Australian Research Centre in Sex, Health and Society , La Trobe University , Melbourne , Australia
| | - Wendy Heywood
- a Australian Research Centre in Sex, Health and Society , La Trobe University , Melbourne , Australia
| | - Bianca Fileborn
- a Australian Research Centre in Sex, Health and Society , La Trobe University , Melbourne , Australia
| | - Victor Minichiello
- a Australian Research Centre in Sex, Health and Society , La Trobe University , Melbourne , Australia
| | - Catherine Barrett
- a Australian Research Centre in Sex, Health and Society , La Trobe University , Melbourne , Australia
| | - Graham Brown
- a Australian Research Centre in Sex, Health and Society , La Trobe University , Melbourne , Australia
| | - Sharron Hinchliff
- b School of Nursery and Midwifery , University of Sheffield , Sheffield , UK
| | - Sue Malta
- c National Ageing Research Institute , Melbourne , Australia
- d Swinburne Institute of Social Research , Swinburne University of Technology , Hawthorn , Australia
| | - Pauline Crameri
- a Australian Research Centre in Sex, Health and Society , La Trobe University , Melbourne , Australia
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28
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Fileborn B, Lyons A, Heywood W, Hinchliff S, Malta S, Dow B, Brown G, Barrett C, Minichiello V. Talking to healthcare providers about sex in later life: Findings from a qualitative study with older Australian men and women. Australas J Ageing 2017. [DOI: 10.1111/ajag.12450] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Bianca Fileborn
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health La Trobe University Melbourne Victoria Australia
- School of Social Sciences, Faculty of Arts and Social Sciences University of New South Wales Sydney New South Wales Australia
| | - Anthony Lyons
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health La Trobe University Melbourne Victoria Australia
| | - Wendy Heywood
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health La Trobe University Melbourne Victoria Australia
| | - Sharron Hinchliff
- School of Nursing and Midwifery University of Sheffield Sheffield UK
| | - Sue Malta
- National Ageing Research Institute University of Melbourne Melbourne Victoria Australia
- Swinburne Institute of Social Research Swinburne University of Technology Melbourne Victoria Australia
| | - Briony Dow
- National Ageing Research Institute University of Melbourne Melbourne Victoria Australia
| | - Graham Brown
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health La Trobe University Melbourne Victoria Australia
| | - Catherine Barrett
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health La Trobe University Melbourne Victoria Australia
| | - Victor Minichiello
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health La Trobe University Melbourne Victoria Australia
- School of Medicine and Public Health University of Newcastle Newcastle New South Wales Australia
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29
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Fileborn B, Lyons A, Hinchliff S, Brown G, Heywood W, Dow B, Malta S, Minichiello V. Improving the sexual lives of older Australians: Perspectives from a qualitative study. Australas J Ageing 2017; 36:E36-E42. [DOI: 10.1111/ajag.12405] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Bianca Fileborn
- Australian Research Centre in Sex, Health and Society School of Psychology and Public Health La Trobe University Melbourne Victoria Australia
- School of Social Sciences Faculty of Arts and Social Sciences University of New South Wales Sydney New South Wales Australia
| | - Anthony Lyons
- Australian Research Centre in Sex, Health and Society School of Psychology and Public Health La Trobe University Melbourne Victoria Australia
| | - Sharron Hinchliff
- School of Nursing and Midwifery University of Sheffield Sheffield UK
| | - Graham Brown
- Australian Research Centre in Sex, Health and Society School of Psychology and Public Health La Trobe University Melbourne Victoria Australia
| | - Wendy Heywood
- Australian Research Centre in Sex, Health and Society School of Psychology and Public Health La Trobe University Melbourne Victoria Australia
| | - Briony Dow
- National Ageing Research Institute University of Melbourne Melbourne Victoria Australia
| | - Sue Malta
- National Ageing Research Institute University of Melbourne Melbourne Victoria Australia
- Swinburne Institute of Social Research Swinburne University of Technology Melbourne Victoria Australia
| | - Victor Minichiello
- Australian Research Centre in Sex, Health and Society School of Psychology and Public Health La Trobe University Melbourne Victoria Australia
- School of Medicine and Public Health University of Newcastle Newcastle New South Wales Australia
- Faculty of Law School of Justice Queensland University of Technology Brisbane Queensland Australia
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30
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Lyons A, Heywood W, Fileborn B, Minichiello V, Barrett C, Brown G, Hinchliff S, Malta S, Crameri P. Sexually active older Australian's knowledge of sexually transmitted infections and safer sexual practices. Aust N Z J Public Health 2017; 41:259-261. [PMID: 28245525 DOI: 10.1111/1753-6405.12655] [Citation(s) in RCA: 14] [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] [Received: 04/01/2016] [Revised: 10/01/2016] [Accepted: 11/01/2016] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Rates of sexually transmitted infections (STIs) are rising among older Australians. We conducted a large survey of older people's knowledge of STIs and safer sexual practices. METHODS A total of 2,137 Australians aged 60 years and older completed the survey, which included 15 questions assessing knowledge of STIs and safer sexual practices. We examined both levels of knowledge and factors associated with an overall knowledge score. RESULTS In total, 1,652 respondents reported having sex in the past five years and answered all knowledge questions. This group had good general knowledge but poorer knowledge in areas such as the protection offered by condoms and potential transmission modes for specific STIs. Women had better knowledge than men. Men in their 60s, men with higher education levels, and men who thought they were at risk of STIs reported better knowledge than other men. Knowledge was also better among men and women who had been tested for STIs or reported 'other' sources of knowledge on STIs. CONCLUSIONS Many older Australians lack knowledge of STIs and safer sexual practices. Implications for public health: To reverse current trends toward increasing STI diagnoses in this population, policies and education campaigns aimed at improving knowledge levels may need to be considered.
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Affiliation(s)
- Anthony Lyons
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Victoria
| | - Wendy Heywood
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Victoria
| | - Bianca Fileborn
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Victoria
| | - Victor Minichiello
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Victoria.,School of Medicine and Public Health, University of Newcastle, New South Wales.,School of Justice, Faculty of Law, Queensland University of Technology
| | - Catherine Barrett
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Victoria
| | - Graham Brown
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Victoria
| | - Sharron Hinchliff
- School of Nursing and Midwifery, University of Sheffield, United Kingdom
| | - Sue Malta
- National Ageing Research Institute, University of Melbourne, Victoria.,Swinburne Institute of Social Research, Swinburne University of Technology, Victoria
| | - Pauline Crameri
- Australian Research Centre in Sex, Health and Society, School of Psychology and Public Health, La Trobe University, Victoria
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Affiliation(s)
- Sue Malta
- National Ageing Research Institute; The University of Melbourne; Melbourne Victoria Australia
- School of Population and Global Health; The University of Melbourne; Melbourne Victoria Australia
| | - Colleen Doyle
- National Ageing Research Institute; The University of Melbourne; Melbourne Victoria Australia
- Australian Catholic University and Villa Maria Catholic Homes; Melbourne Victoria Australia
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32
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Loi SM, Dow B, Moore K, Hill K, Russell M, Cyarto E, Malta S, Ames D, Lautenschlager N. Factors associated with depression in older carers. Int J Geriatr Psychiatry 2016; 31:294-301. [PMID: 26153792 DOI: 10.1002/gps.4323] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [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] [Received: 02/10/2015] [Revised: 05/10/2015] [Accepted: 06/10/2015] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Depression is an adverse outcome frequently seen in carers. With the increasing ageing population and reliance on informal carers, this study aims to identify factors associated with depression in carers in the older age group, using factors that have not been previously investigated. METHODS We conducted a cross-sectional analysis of 202 older carers using the Geriatric Depression scale, demographics, personality traits, attitudes to ageing and other carer characteristics. RESULTS Increased hours spent caring and higher levels of neuroticism were all factors associated with depression. The care-recipient diagnosis, other personality traits, attitudes to ageing, leisure-physical activity (PA) and domestic-PA were not significantly associated with depression. CONCLUSIONS These findings have important implications for interventions to target at-risk carers.
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Affiliation(s)
- Samantha M Loi
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Kew, Victoria, Australia.,National Ageing Research Institute, Parkville, Victoria, Australia.,Melbourne Neuropsychiatry Unit, Melbourne Health, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Briony Dow
- National Ageing Research Institute, Parkville, Victoria, Australia
| | - Kirsten Moore
- National Ageing Research Institute, Parkville, Victoria, Australia
| | - Keith Hill
- School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Melissa Russell
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Elizabeth Cyarto
- National Ageing Research Institute, Parkville, Victoria, Australia
| | - Sue Malta
- National Ageing Research Institute, Parkville, Victoria, Australia.,Swinburne Institute for Social Research, Swinburne University, Hawthorn, Victoria, Australia
| | - David Ames
- National Ageing Research Institute, Parkville, Victoria, Australia
| | - Nicola Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Kew, Victoria, Australia.,School of Psychiatry and Clinical Neurosciences and the Western Australia Centre for Health and Aging, University of Western Australia, Perth, Victoria, Australia
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Roberts G, Morley C, Walters W, Malta S, Doyle C. Caring for people with dementia in residential aged care: Successes with a composite person-centered care model featuring Montessori-based activities. Geriatr Nurs 2015; 36:106-10. [DOI: 10.1016/j.gerinurse.2014.11.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 11/11/2014] [Accepted: 11/12/2014] [Indexed: 11/25/2022]
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