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The Australian Community Outcomes Measurement (ACCOM) uses a standardized set of instruments to measures functional, health, and social care-related quality of life (SCRQoL) among older people receiving services at home. One of its key components is the use of modified ASCOT SCT4 survey developed by The University of Kent PSSRU. This paper presents the preliminary findings of a pilot testing of ACCOM with CALD clients in South West Sydney using face to face interviews conducted by bilingual workers as a novel approach to administering the tool. The paper will argue that some of the domains in ASCOT SCT4 survey pose unique challenges for culturally diverse groups that highlight the ethnocentric nature of some of the questions. It also discusses some of the strategies the service provider used to address these concerns and be able to utilize the tool in a culturally effective manner. [ABSTRACT FROM AUTHOR]

Motivational interviewing (MI) is a long-established evidenced-based intervention aimed at guiding people to implement change. Originally developed by William Miller from the United States and Stephen Rollnick from the United Kingdom, a strong emphasis for MI is the underlying 'spirit', rather than merely the specific techniques within the model. The 'spirit' of MI consists of four key components: acceptance, partnership, evocation and compassion. These have direct overlap with concepts within the personal recovery model recognised as a critical framework in delivery of contemporary mental health services for consumers. Despite this recognition, recovery concepts have struggled to gain consistent traction, particularly within inpatient mental health units. This paper proposes that MI presents one strategy for integrating recovery-focused principles within routine mental health nursing (MHN) practice. An overview of MI and its relationship with recovery principles is discussed in the context of contemporary MHN practice. Evaluation results of a locally developed MI workshop for MHNs within a regional area of New South Wales (NSW) in Australia are presented to highlight the emerging evidence for this potential. Following the workshop, MHN participants showed key improvements in knowledge and confidence scores, as well as in understanding of key MI processes and strategies. The consolidation of these skills through training and a supervision framework is outlined. [ABSTRACT FROM AUTHOR]

In New South Wales (NSW), legislation prioritises open adoption over long-term foster care when restoration is not possible, and suitable kin or guardians cannot be found. The adoption application includes an adoption plan that outlines the nature of a child's post-adoption contact with his or her birth family. There are efforts to include the views of the child, birth family, and prospective adoptive parents when developing this plan. This paper reports on the analysis of 89 adoption court files for 117 children from out-of-home care, finalised in 2017 by the Supreme Court of NSW. It focuses on the views of birth parents with respect to contact arrangements specified in the adoption plan. Three researchers independently coded the data, using an inductive approach based on grounded theory. The findings highlight the complexities in the changing relationship structures associated with adoption. Patterns of contact prior to adoption proceedings are highly predictive of plans for post-adoption contact. There are implications for social workers supporting positive contact experiences for children prior to an adoption order as well as the relationships between children's prospective adoptive families and birth families. Post-adoption contact decisions are informed by the views of birth family, children, and prospective adoptive parents, as well as the contact that has occurred pre-adoption. Birth parents expressed preferences for a specific amount and type of experience for contact, reflective of their relationships with the adoptive parents. Supports are needed to ensure that positive contact for children and relationships between children's birth family and adoptive family are established and maintained. [ABSTRACT FROM AUTHOR]

Children and young people in rural Australia experience disadvantage compared with metropolitan counterparts, with low educational attainment and disengagement from schooling being linked to poorer health outcomes. Schools are an existing contact point between individuals and health services. However, these health services are often overburdened and have limited scope to address broader social issues and teaching staff are focused on achieving curriculum outcomes. Embedding social workers within schools may provide an avenue for supporting students, yet social workers are rarely present in New South Wales public schools. This paper describes a study to determine teachers' understanding of the socioeconomic issues faced by school students, and the role of the social work profession in addressing such issues as part of the early stages of establishing a Social Work in Schools (SWiS) project. Eighteen semistructured interviews were undertaken with teachers across four rural Australian schools. Participants identified their awareness of potential risk factors that could lead to educational disengagement, reflected on their own limitations in dealing with these broader health presentations given their teaching focus, and provided insights into their understanding of the potential role of social workers. Rural and remote school children in Australia are at risk of reduced educational attainment and disengagement due to low socioeconomic status (SES), geographical location, parental education and employment, and family dysfunction. Social workers should advocate for the role they can play within rural school communities to assist in ameliorating the impact of socioeconomic factors on a student's capacity to engage in learning. Partnerships between schools and social work field education may facilitate the growth of social work in schools in New South Wales. [ABSTRACT FROM AUTHOR]

Background: Very few studies have evaluated the performance of transition to work (TTW) service providers after the TTW program was implemented in New South Wales, Australia since 2005. This paper examines employment outcomes achieved by 35 TTW service providers in Sydney. Method: Descriptive statistics and chi-square were used to analyse the TTW outcome data. Results: We found that (a) there was a constant growth in the number of TTW program entrants and an overall increase in the employment rate of TTW clients; (b) many TTW service providers in Sydney served fewer than four clients annually on average; and (c) huge differences were evident in the employment outcome performance of individual TTW service providers. Conclusion: The TTW programme in Sydney allowed more school leavers to achieve employment. However, further research is needed to examine the associations between TTW program features and different employment outcomes to build an optimal TTW program. [ABSTRACT FROM AUTHOR]

Objective: The aims of this paper were to report on the global psychosocial functioning of 5-year-old DHH children and examine the risk and protective factors that predict outcomes. Design: A cross-sectional analysis of data collected from a prospective, population-based longitudinal study. Study sample: Parents/caregivers of 356 children completed questionnaires on psychosocial development (CDI, SDQ), functional communication (PEACH) and demographic information. Children completed standardized assessments of non-verbal cognitive ability (WNV) and language (PLS-4). Results: On average, global psychosocial functioning was within the range of typically developing children; however, variability was high and 12% of children had scores that were more than 2 SDs below the norm. Non-verbal cognitive ability, presence of additional disabilities, language and functional communication significantly predicted outcomes. In contrast, type of hearing device, severity of hearing loss and age at intervention did not. Conclusion: The global psychosocial functioning of this cohort of 5-year-old DHH children fell within the range of typically developing children. The findings suggest that spoken language ability and functional communication skills are vital for healthy psychosocial development. [ABSTRACT FROM AUTHOR]

This paper describes the population of children in care in New South Wales, Australia, who were adopted by their foster families (N = 372) from 2003 to 2014. Data pertaining to 370 of these adoptees were available and obtained from administrative records accompanying adoption applications. Most of these children had been placed with their subsequent adoptive family during infancy. However, adoption orders occurred much later in their lives. According to the available information at the time of adoption, these children did not suffer the high levels of mental health problems typically identified in populations of children in foster care. Though the data do not include follow-up to determine if the contact agreed upon at the time of adoption orders translated into practice, the most frequently postadoption arrangement recorded was face-toface contact, four times a year with mother and siblings. The high levels of openness and face-to-face contact in Australian adoptions from care are a significant point of difference with other adoption models, and presents a need for research in the area. [ABSTRACT FROM AUTHOR]

Globally, heart failure (HF) is one of the major health issues faced by many older people. It causes significant symptom burden that requires ongoing management. This paper reports on a descriptive–observational study undertaken to: (1) describe the prevalence of pain and analgesic prescription usage in hospitalized older HF patients; (2) determine the degree to which these patients are provided with a pain self-management strategy prior to discharge; and (3) determine if the patients' pain self-management strategy has been detailed in the discharge summary. A total of 122 older HF patients were included in this study. Results indicated that moderate to severe pain (Numeric Rating Scale score ≥4) is experienced by a substantial number of older people hospitalized with HF. There is little documented evidence that older people are provided with adequate analgesic prescriptions and the instructions required to effectively manage their pain on discharge to the community. [ABSTRACT FROM AUTHOR]

This study examines experiences of living with chronic illness for haemodialysis patients. In order to understand these experiences the paper takes an existential-phenomenological approach. Interviews of seven participants (five males, two females) were collected in a haemodialysis clinic. Based upon the participants experiences three core themes emerged: (1) the challenges of living with chronic renal failure; (2) body changes and embodiment; (3) their illness experience and social relationships. The findings suggest that the illness experience of chronic renal failure is an on-going struggle to attain a sense of control. We suggest that where a sense of control is limited this can create a sense of powerlessness. Further, the illness experience was not solely restricted to the individual, but also affected wider social relationships. It is only through taking into account the context of patients experience of illness that clinicians/nurses can meaningfully draw on all aspects of evidence to reach integrated clinical judgement. [ABSTRACT FROM AUTHOR]

A growing body of research provides evidence of the link between nurse-to-patient ratios (NTPRs) and skill mix with adverse patient outcomes. This paper reports an investigation into nurse staffing patterns, skill mix and patient movement in critical care units in NSW, Australia. A 'snapshot' of staffing patterns and patient movement over 1 week in October 2012 was obtained by use of a cross-sectional design using retrospective survey and administrative data. A wide variation was found in NTPRs, skill mix and the number of nursing staff vacancies in coronary care and high dependency units. These variations suggest that the quality of patient care may vary between facilities in New South Wales. [ABSTRACT FROM AUTHOR]

Aim: To assess the feasibility and the effects of a multi-component education toolkit that used the Aged Care Funding Instrument behaviour (ACFI-BEH) scores to trigger care planning for older people experiencing behavioural and psychological symptoms of dementia (BPSD). Method: Forty-six older people and 209 staff and managers from five Sydney metropolitan residential aged care (RAC) facilities participated in this pre-post intervention pilot study. Results: The face validity and accessibility/acceptability of the toolkit was established, but potential utility of the ACFI-BEH in informing care planning was proven to be negligible. The ACFI-informed education toolkit did not lead to statistically significant improvements in care planning practice or reduce the severity/frequency of the targetted BPSD. Care plan quality remained low post intervention, with between 31% (N = 12/39) and 65% (N = 13/20) of care plans not addressing the persons' BPSD, nor utilising the ACFI information in relation to BPSD. Conclusion: This study has underscored the problems associated with current care planning practice in RAC settings and the need for developing strategies to ensure quality and safe care through individualised care planning practices. Our study processes, results and lessons discussed in this paper could assist future research on this type of research in RAC settings. [ABSTRACT FROM AUTHOR]

Early parenting residential units provide a child and family health support and education service for parents experiencing parenting difficulties. An ongoing concern of nursing staff and management is whether the parenting knowledge and skills gained are translated into sustainable parenting practices after discharge. This paper explores the response to a post discharge telephone interview about parents' experience of nursing care during their residential stay and their parenting experience since discharge. A descriptive qualitative approach identified four themes in the parents' responses: greater confidence, greater knowledge about their babies, changing expectations of parenting and their infants, and sustainability of parenting skills. [ABSTRACT FROM AUTHOR]

This paper reports on an evaluation of an educational initiative that seeks to improve the diabetes health outcomes of a vulnerable group, Indigenous Australians residing in remote and rural New South Wales. In this context seven Aboriginal Health Workers (AHWs) and ten registered nurses (RNs) undertook an accredited Australian Diabetes Educators Association (ADEA) course. The aims of this study were to identify the beliefs, attitudes and experiences of this group concerning specialist diabetes training, strategies already used by managers and those that could be used to help consolidate the diabetes expertise of AHWs and RNs. The fi ndings indicate specialist diabetes training and constructive support is required if AHWs and RNs are to develop from a novice to an expert. We concluded that the ADEA diabetes course is highly relevant to the needs of Indigenous Australians an [ABSTRACT FROM AUTHOR]

This paper explores how the structuring of places and time influence Aboriginal and Torres Strait Islander patient and carer experiences of health services. Face-to-face in-depth interviews were conducted with urban Aboriginal and Torres Strait Islander people with diabetes, chronic heart failure or chronic obstructive pulmonary disease as well as family carers (N = 19). Content analysis was undertaken. Participants report that each element of the time spent in Aboriginal Medical Services is seen as more valuable and worthwhile than in mainstream health services, from social and health sharing experiences in the waiting room to health care in clinical places; and that users feel they can rely on sufficient time and respectful care in their clinical consultation. Purposeful design of both physical and temporal aspects of health services is called for. We suggest re-introducing opportunities for spatiotemporal design in health care that have been limited by the segmented 'person as illness' design features of Australia's current mainstream health system. [ABSTRACT FROM AUTHOR]