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Objective: To explore the perceptions of rural health professionals who use telehealth services for cardiovascular health care, including the potential role of telehealth in enhancing services for this patient group. Methods: Semi-structured interviews were conducted with ten rural health professionals across a range of disciplines, including medicine, nursing and allied health. All study participants were based in the same rural region in New South Wales, Australia. Results: Participant responses emphasised the importance of including rural communities in ongoing dialogue to enhance telehealth services for cardiovascular care. Divergent expectations about the purpose of telehealth and unresolved technology issues were identified as factors to be addressed. Rural health professionals highlighted the importance of all stakeholders coming together to overcome barriers and enhance telehealth services in a collaborative manner. Conclusion: This study contributes to an evolving understanding of how health professionals based in regional Australia experience telehealth services. Future telehealth research should proceed in collaboration with rural communities, supported by policy that actively facilitates the meaningful inclusion of rural stakeholders in telehealth dialogue. What is known about the topic?: Telehealth is frequently discussed as a potential solution to overcome aspects of rural health, such as poor outcomes and limited access to services compared with metropolitan areas. In the context of telehealth and cardiovascular disease (CVD), research that focuses on rural communities is limited, particularly regarding the experiences of these communities with telehealth. What does this paper add?: This paper offers insight into how telehealth is experienced by rural health professionals. The paper highlights divergent expectations of telehealth's purpose and unresolved technological issues as barriers to telehealth service delivery. It suggests telehealth services may be enhanced by collaborative approaches that engage multiple stakeholder groups. What are the implications for practitioners?: The use and development of telehealth in rural communities requires a collaborative approach that considers the views of rural stakeholders in their specific contexts. To improve telehealth services for people living with CVD in rural communities, it is important that rural stakeholders have opportunities to engage with non-rural clinicians, telehealth developers and policy makers. [ABSTRACT FROM AUTHOR]

Aim The hospital environment as a workplace has undergone rapid changes over the last 50 years. Despite this, there has been very little research exploring how dietitians working in hospitals perceive their workplace. Moreover, previous studies in this area have focused predominantly on examining the North American experience of dietitians. Only a handful of previous studies have investigated the experiences of Australian dietitians at different stages of their careers. Therefore this study, in part, addresses a gap in the extant literature by examining how New South Wales ( NSW) public-hospital dietitians perceive their workplace and its influence on their ability to function as healthcare professionals. Methods In 2011, 32 in-depth interviews were conducted with dietitians from 11 NSW public hospitals. Participants were selected from four career stages: new graduates, mid-career, specialists and managers. Data from the interviews were analysed through a grounded theory approach. Results Data analysis revealed that dietitians sought validation of their work experience from five sources within the workplace. In this paper, these five sources have been depicted as a conceptual model labelled the ' Five Sources of Value'. The five sources identified were: acquisition of knowledge; relationships with others; work culture; role clarity; and personal attributes. This study also found the relative importance of these values changed according to the career stage of the individual dietitian. Conclusions The retention and engagement of staff within a hospital environment is an ongoing issue for dietetic managers. The ' Five Sources of Value' identified through this study and their relative influence at different career stages may assist managers in developing workplace strategies that addresses the major areas of concern for many staff. As a result of the qualitative nature of this exploratory study, the generalisability of the findings are limited. To address this limitation, future research may follow a more quantitative approach. [ABSTRACT FROM AUTHOR]

The grandparent-as-parent role is a growing social issue both within Australia and internationally. This paper explores the experience of grief as reported by grandparents who are raising their grandchildren. The data presented are part of a larger qualitative study that investigated the lived experience of 34 grandparents who have taken on the full-time care of grandchildren when their own children have been unable to parent them. In-depth interviews conducted with the grandparent participants and analysed through a three-layer narrative analysis reveal the paradoxical dimension of grandparents' experience as they navigate the complex issues that characterise their predominantly unanticipated role. While all of the grandparents referred to the benefits, satisfaction, and joy of taking on the parenting of grandchildren, their narratives were deeply imbued with experiences of loss and grief. The discussion analyses this experience in relation to grief theory and posits that the complex and disenfranchised nature of grandparents' grief means it often goes unacknowledged, including in the policies, programs, and services developed to support grandparents-as-parents. [ABSTRACT FROM AUTHOR]

The concept and definition of pastoral care in aged care remains ambiguous. This paper reports on the defining characteristics and meaning of pastoral care from the perspective of older recipients, their family members and pastoral care workers. Using a qualitative descriptive approach semistructured in-depth interviews were conducted with 18 pastoral care workers and 11 older people. Transcribed data were analysed using NVivo software and coded for emerging themes. The defining characteristics of pastoral care that emerged from analysis of transcribed interviews were: a trusting relationship, spiritual support, emotional support and practical support. Findings also portray the role of the pastoral care worker as spiritual guide, confidante, and emotional and practical supporter acting within a trusting relationship. Future studies should confirm these results by exploring the perceptions of experts in the field of pastoral care. [ABSTRACT FROM AUTHOR]

Staff members in residential aged care facilities (RACFs) make prioritization decisions to determine which aspects of care are most important and thus should be attended to first. Prioritization can potentially result in substandard care if lower priority tasks are delayed or left undone, known as "missed care." This study investigated the contexts in which prioritization dilemmas arise in RACFs and the influences on prioritization decision-making. Thirty-two staff members participated in a think-aloud task during a prioritization activity, a demographic questionnaire, a post-sorting interview, and a semi-structured interview. Data were analyzed using inductive content analysis. Prioritization dilemmas occurred in response to high workloads, inadequate staffing, unexpected events, and conflicting demands. Seven influences on prioritization decision-making were identified. In some instances, these influences were seen to be in conflict, making prioritization decision-making challenging. Efforts to prevent missed care should consider the influences on staff members' decision-making and aim to reduce prioritization dilemmas. [ABSTRACT FROM AUTHOR]

Working with individuals with dual disabilities can be a complex process in the presence of limited evidence base to guide clinical practice. The aims of this qualitative study were to investigate perceptions of best practices of Australian psychologists who work with this specialist population. Thirty-eight Australian psychologists working in the intellectual disability field participated in eight semistructured focus groups. Perceptions of evidence-based practice for individuals with intellectual disabilities and in relation to mental health assessment were explored. Psychologists demonstrated resourcefulness in adapting to limits in available evidence-based practice and in modifying mainstream practice to suit the needs of individuals with dual disabilities. Findings suggest the necessity of practice-based evidence in contributing to the evidence base, and person-centered approaches in relation to best practice for people with intellectual disabilities. Implications for strengthening psychologists' clinical competency and bridging the research and practice gap are discussed. [ABSTRACT FROM AUTHOR]

Background While legitimate practice tools have been the subject of debate within the profession, little attention has been paid to psychological frames of reference ( PFs OR). Hence, this article explores the ways psychological theories and therapies shape occupation-based practice in mental health settings. Methodology Narrative inquiry methods and thematic analysis were used to explore the career stories of nine occupational therapists who had worked in mental health practice for more than five years. Findings Respondents found it difficult to hold onto their occupational focus in the psychology-dominated world of mental health practice. The main themes to emerge were (i) tension between occupation and psychology; (ii) overwhelming pressures to adopt PFs OR; (iii) resistance to PFs OR; and (iv) using PFs OR to enhance professional repertoires. Findings pointed to the need to ensure PFs OR include occupational considerations for occupation-based practice in mental health. Conclusion A occupation-based perspective means balancing PFs OR with occupation-based considerations, so service-user issues are holistically addressed. There is a need to critically review occupational therapists' use of PFs OR lest their most visible practical actions appear psychologically based rather than occupation based. [ABSTRACT FROM AUTHOR]

Aims To explore nursing students' perceptions of how their profession is portrayed on medical television programmes. Background Recruitment and retention in nursing have been linked to the image of the profession in society. Images of nursing in popular media frequently draw on stereotypes that may damage the appeal of nursing for potential students and denigrate the value and status of the profession. A growing body of work analyses how nursing is portrayed in popular media, but less research asks nursing students themselves to reflect on this area. Design Convergent parallel mixed methods. Methods Data were collected in 2011 from surveys of 484 undergraduate nursing students at a large university in New South Wales, Australia, that included demographic data, their viewing habits of medical television programmes and their opinions of how the shows handled nursing ethics and professionalism and the image of nursing on television and nursing role models. Results Most students watch medical television programmes. Students who do not speak English at home watched fewer programmes but were more positive about the depictions of professionalism. The qualitative data showed students were concerned that television can have a negative influence on the image of nursing, but they also recognized some educational and recruitment value in television programmes. Conclusions It is important for nurses, educators and students to be critically engaged with the image of their profession in society. There is value in engaging more closely with contemporary media portrayals of nursing for students and educators alike. [ABSTRACT FROM AUTHOR]

In this article I analyse maternal narratives of informal school exclusion at the point of transition into primary school in Sydney, Australia. The common thread that connects these narratives is the experience of stigma. Some scholars have argued that the link between stigma and disability is weakening. The material presented here, drawn from interviews with 22 mothers of children with autism, gives a picture of the continuing pervasive stigmatisation of children with autism and their mothers, as well as a systemic failure of all sectors of the education system in Australia to meet the promises of policies of school inclusion. [ABSTRACT FROM PUBLISHER]

ABSTRACT The purpose of this qualitative study was to better understand the experience of grandparents who are raising their grandchildren in New South Wales, Australia. In-depth interviews were conducted with 34 grandparents and their narratives transcribed and studied using paradigmatic analysis to reveal common themes among the stories told. Identity theory further informed the discussion of these findings. Woven throughout the grandparent narratives is a story of paradox - of experience simultaneously made up of pain/pleasure, myth/reality, inclusion/exclusion, being deserving/undeserving, visible/invisible and voiced/silenced. The findings signal a significant role-identity conflict for grandparents who are parenting grandchildren. This study points to the need for policy and practice that more closely reflects the complexity of experience associated with the grandparent-as-parent role. [ABSTRACT FROM AUTHOR]

Male prison rape and sexual assaults remains a serious and sensitive issue in many countries. Human rights groups claim that sexual assaults among male prisoners have reached pandemic proportions and need to be stopped. Researchers for many years have studied the causes of male sexual assault in prison and offered numerous recommendations on its prevention. Few, however, have presented evidence for a decline in male prisoner sexual assaults and investigated the reasons for the decline. This article provides evidence from population-based surveys of a steady decrease in male prisoner sexual assaults in New South Wales (NSW) between 1996 and 2009. The authors conducted in-depth interviews with former and current inmates, and using a “systems” approach they discuss the complexity of sexual assaults in prison, incorporating a multiplicity of perspectives. In particular, they bring together different sources of data and discuss this in relation to changes in power structures and control in a modern prison, the attitudes of older and younger prisoners, the concept of “duty of care,” introduction of prison drug programs, and prisoner attitudes toward gender and sexuality. In anthropology, the term “system” is used widely for describing sociocultural phenomena of a given society in a holistic manner without reducing the complexity of a given community. [ABSTRACT FROM AUTHOR]