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Background: Mental illness is a public health challenge disproportionately affecting rural Australians. GPs provide most of the mental health care, and they report increasing levels of burnout and unsustainable workload in the context of increased patient complexity. This may be more salient in rural settings characterised by resource constraints. In this paper, we use evaluation data from a GP psychiatry phone line established in Western Australia's Great Southern region in 2021 to describe GPs' perspectives on the service and reflect on how it may help alleviate rural GP workload. Methods: The sample was recruited among GPs practicing in the region. Data were collected through an online survey and semistructured interviews. Descriptive statistics were used to analyse the survey data. Interview data were subjected to thematic analysis; qualitative survey data were used for triangulation. Results: A total of 45 GPs completed the survey and 14 were interviewed. Interview data yielded three themes: the criticality of timeliness; the building blocks of confidence; and trust. GPs were highly satisfied with the service, and timeliness and trust were the characteristics underpinning its effectiveness. The service built GPs' confidence in managing mental health and alcohol and other drug use issues through strengthening knowledge and providing reassurance. Conclusions: Our results suggest that a telephone line operated by trusted, local psychiatrists with knowledge of the local mental health ecosystem of support can reduce rural GP workload through building confidence and strengthening personal agency, helping GPs navigate the ethical and clinical labyrinth of managing patient complexity in rural settings. GPs provide most of the mental health care and deal with an increasing number of patients with complex problems; this is more acute in rural areas where there are fewer services. This paper shows how a rural GP psychiatry phone line operated by local psychiatrists helps GPs manage their patients' mental health problems and may, in turn, reduce the workload rural GPs experience. The results add to the limited evidence and have implications for other rural locations characterised by limited resources. [ABSTRACT FROM AUTHOR]

Background: The study explored the experiences and perceptions of GPs regarding the management of chronic non-cancer pain (CNCP). Specifically, participants were asked to identify perceived enablers and barriers to CNCP care and how the care of patients with CNCP may be improved. Methods: The study utilised a qualitative descriptive methodology. General practice in Western Australia. The sample was purposive with 12 Australian GPs from predominantly metropolitan locations and with experience in managing CNCP. Semi structured interviews were conducted. Each interview was of 45–60 min duration. All interviews were audio recorded and transcribed using a secure transcription service. Thematic analysis developed themes inductively and deductively. Results: Themes emerged regarding: the importance of a holistic and personalised approach; the important role of a coordinating GP; the need for an evidence-based approach to opioid management; concerns relating to access to multidisciplinary services; the importance of clinician and patient education regarding CNCP; and an acknowledgement of the challenges for doctors and patients in managing CNCP. Conclusions: Currently, the management of CNCP in Australia is challenging. Notable challenges include: difficulties with continuity of patient care; challenges with patient expectations of treatment, in particular opioid medications; difficulty with access to the health services required to enable holistic care; and the need for improved pain education in the community. The breadth of these challenges suggests there is a need for supportive organisational and structural considerations in the healthcare system to enable optimal care of CNCP in the community. Access to specialist services for chronic non-cancer pain is problematic ins In Australia, resulting in general practitioners bearing much of the burden of care that requires a holistic and multidimensional approach. In this paper, 12 general practitioners in Western Australia described, through qualitative interviews, the challenges of caring for patients with chronic pain including fragmentation of care, difficulty with access to recommended services, mismatched patient and practitioner expectations and inadequate GP and community knowledge about chronic pain. These findings could assist in planning better services for chronic pain. [ABSTRACT FROM AUTHOR]

• This paper uses a constructivist phenomenological study with 55 in-depth interviews. • Participants include representatives from diverse Western Australian businesses. • Uses a workplace vignette to elicit cultural norms from the participants. • Thematic analysis used to classify interview text into specific concepts and phrases. • New employees, pro-active approach, and 'No-blame' culture are the key themes. Introduction: This paper uses an extensive review of the safety culture literature to identify three key themes (a) role of new employees, (b) absence of a pro-active approach, and (c) need for a 'No-blame' culture, and explores their impact on the occupational health and safety culture (OHS). Method: We use a qualitative study with a constructivist phenomenological approach consisting of 55 in-depth interviews with a diverse range of participants, including business owners, line managers and supervisors, OHS advisors, workers, and union representatives in Western Australia. A workplace vignette was used to elicit cultural norms derived from the participants' attitudes and beliefs, which were analyzed using NVivo software to conduct a thematic analysis to classify the interview text into specific concepts and phrases. Results: Findings confirm the three themes identified from our literature review and provide useful insights into the challenges faced by the participants in the implementation of safety policies. Practical Applications: Besides extending the occupational health and safety literature, these findings have important managerial implications in view of the evolving nature of work and workplaces. [ABSTRACT FROM AUTHOR]

Background: : Group singing for people with Parkinson's disease (PD) is an established intervention not only to improve voice and speech difficulties but also for emotional and social benefit. Less is known about the experiences of group singing on the couple—the person with PD and their spouse or partner together—and studies have not specifically tracked impact through time or in combination with songwriting. Aims: : To understand the impact of group singing/songwriting on couples (participants with PD and their spouses) to unpack whether this broader view might help explain why such interventions are reported as beneficial. Using a trajectory approach, a form of longitudinal research and focused ethnography, the research sought a deeper appreciation of participation through time for the couple in a singing/songwriting group. Methods & Procedures: : Four couples attending a singing/songwriting programme were observed for 10 weeks, and interviewed formally and informally weekly. Data were analysed thematically across‐case through framework analysis but also within‐case to explore the couples' experiences and narratives over time. Outcomes & Results: : The theme of 'improved relationships' between the couples was new and extended previous studies' findings of positivity, physical benefit, sense of self and social opportunity. The stories of each couple highlighted the importance of musical reminiscence and emotional respite, and demonstrated changes with time through the singing and songwriting group. Conclusions & Implications: : The benefits of offering singing/songwriting groups may be felt not only by participants with PD but also by their spouses/partners even if they choose not to attend themselves. Such benefits may include improved relationships related to the shared joy of music, musical reminiscence and emotional respite. The addition of songwriting encourages creativity and agency. A longitudinal trajectory approach is one way to appreciate how these benefits may unfold over time for participants. WHAT THIS PAPER ADDS: What is already known on the subject: Group singing for people with PD has been shown to have physical, emotional and social benefits as measured on mainly pre‐post‐assessments of vocal, speech, respiratory function and quality of life questionnaires. What this study adds to the existing knowledge: This study adds three new aspects: studying the benefits for the couple (both people with PD and their spouse/partner); taking an in‐depth focused ethnographic approach over time to collect couples' narratives and experiences; and exploring the potential for adding songwriting to the intervention. What are the potential or actual clinical implications of this work?: A qualitative trajectory approach may help clinicians understand why such interventions are experienced as beneficial. Clinicians running singing groups for people with PD should offer attendance to spouses/partners because of the potential for such groups to improve relationships and build new points of connection for the couple, as well as provide peer support for spouses. Songwriting is a useful addition for creativity, cognitive flexibility and self‐expression. [ABSTRACT FROM AUTHOR]

Objective: To explore the experiences of close family members when another family member is using methamphetamine and how the family member responds over time. Background: Methamphetamine use has widespread implications and harms for both people who use the drug and those that live with them. While there is a significant representation in the literature relating to family members of people who use drugs or alcohol, there are limited studies specifically considering family members experiences of methamphetamine use. Families have been shown to have both positive and negative impacts on people using drugs, but less is known on the impact on the family members themselves. Study design and methods: Multiple semi- structured qualitative interviews were conducted with 11 families (17 individual participants) from regional and metropolitan Western Australia over a 12-month period. Interpretative Phenomenological Analysis was used in data collection and analysis. Results: Four main themes were identified: 1. the New Lifeguard describes family members' unplanned insertion into a new role and their rapidly changing experience of the person using methamphetamine. 2. Hit by the Wave demonstrates participants' experience of repeated and unpredictable impacts on their lives. 3. Life in the Ocean describes the groundlessness associated with changes to goals and family structure. 4. Learning to Surf illuminates the changing strategies employed over time, moving away from trying to fix the person, to participants managing their own wellbeing. Discussion: This study identified common aspects within the lived experience of close family members of people using methamphetamine and ascertained a commonality in the process of this experience. Significant impacts to all areas of life were reported, and distress was fluctuating and unpredictable in line with the cyclical nature of the drug use. Participant responses to these changes varied over time between resentment and trying to fix things, and acceptance and resilience, while gaining or maintaining like-minded supports. Conclusion: Understanding the issues faced by families around this unique drug is vital in providing informed interventions for this group. Family members experience a broad range of financial, social and health impacts and harms over a protracted length of time. They are often not the focus of available support and in adapting to these issues, will themselves seek support away from treatment services for the person using methamphetamine. Implications for practice Understanding the complex journey of families has a broad range of implications (and opportunities) for a variety of areas such as criminal justice, family support and child protection. There is an opportunity for these areas to consider broader and more specific supports and approaches, and to develop more appropriate, bespoke, and inclusive treatment for families of people using methamphetamine. What is already known about the topic? • Methamphetamine is recognised worldwide as a harmful drug with few effective treatments for methamphetamine dependence. • Few studies exist exploring the specific impact of methamphetamine on family members. • Fewer studies explore the experiences over time. What this paper adds: • Family members with a relative who is using methamphetamine experience a range of harms in many areas of their lives. • The impact of methamphetamine use is unpredictable and takes place over long periods of time, affecting both individual family members and impacting on the overall structure of the family unit. • Families and family members adapt their approach over time, from attempting to fix the situation, to stepping back and seeking support from others who they perceive to be in similar circumstances. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? The rate of mental illness in the general population is ever increasing, Mental health nurses are ageing, and this is not a preferred career for new graduates; thus, recruitment and retention of mental health nurses is declining, Stigma is attached to the view of mental illness and the role of a mental health nurse. If this stigma can be reduced, it may provide an opportunity for the profession to become more popular and assist recruitment in this area, What the paper adds to existing knowledge? Previous research has focused on why mental health nurses leave the profession which has not provided successful results, This study adopts a new way of working whereby we gathered opinions from current mental health nurses focusing on why they originally wanted to work in mental health, What are the implications for practice? New findings presented in this paper will guide improvements in nurse training, policy development for mental health services and improve recruitment of the next generation of mental health nurses, The findings provide a strong message that in order to entice others to work in mental health, we need to first address breaking down the stigma related to mental health nursing, Abstract Introduction A lack of understanding surrounding the role of mental health nursing is associated with recruitment and retention challenges. Additional complexities include stigma related to the role, an ageing workforce and dearth of graduates keen to pursue this career. Scientific Rational Previous research has focused on why nurses leave the profession which has not provided necessary solutions. There is a need to instead explore why nurses originally chose a career in mental health. Aim of study This qualitative study focused on opinions and experiences of existing mental health nurses to determine what could be performed to entice nurses to choose mental health. Methods A cross-sectional design involving a brief interview was conducted with 192 Western Australian nurses from one public mental health service. Results Thematic analysis revealed an overarching theme 'breaking down stigma' and additional themes of: 'visibility of mental health nursing' and 'growing mental health nursing.' Subthemes under 'visibility' included 'self-promotion' plus 'industry and university promotion,' whereas subthemes related to 'growing' focused upon 'improving the student experience.' Finally, 'recognizing the mental health specialty' was identified for an attractive career pathway. Discussion This study adds to international evidence and showcases unique insights from mental health nurses into why they chose a career in mental health whilst previously replicated research focused on why nurses chose to leave. Implications for practice Findings suggest that before we can entice nurses to choose mental health, there is urgency to reduce stigma related to the role. 'Breaking down stigma' will allow the role to become more visible and be represented in a more positive authentic manner. New findings in this paper will drive improvements of future nurse education, policy planning and recruitment design for the next generation of mental health nurses. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to explore Western Australian cancer patients' experiences of out-of-pocket expenses (OOPE) during diagnosis and cancer treatment using a phenomenological approach. Methods: Semi-structured interviews were conducted with a purposive convenience sample of 40 Western Australian cancer patients diagnosed with breast, lung, prostate or colorectal cancer. Participants were asked about the impact of their diagnosis, the associated costs and their experience within the health system. Data were analysed using thematic content analysis. Results: Three key themes influencing participant OOPE experiences were identified: (1) personal circumstances; (2) communication with health providers; and (3) coping strategies. Despite Australia's public healthcare system, several participants found the costs affected their financial security and resorted to coping strategies including medication rationing and restrictive household budgeting. The key themes had a complex and interrelated effect on patient OOPE experiences and were used to adapt Carrera et al. 's model of economic consequences of cancer treatment on the patient and patient coping to describe these relationships in a mixed healthcare system. Conclusion: Organised efforts must be implemented to mitigate maladaptive coping strategies being used by cancer patients: (1) health providers should seek informed financial consent from patients before commencing treatment; and (2) financial aid and support schemes for cancer patients should be reviewed to ensure they are delivered equitably. What is known on this topic?: The financial cost of cancer can have significant adverse effects on cancer patients. Although financial transparency is desired by cancer patients, its implementation in practice is not clear. What does this paper add?: This study adapts a conceptual model for the economic consequences of a cancer diagnosis and repurposes it for a mixed public–private health system, providing a framework for understanding downstream consequences of cancer costs and highlighting opportunities for intervention. What are the implications for health practitioners?: Health practitioners need to initiate discussions concerning treatment costs earlier with cancer patients. There are several resources and guides available to assist and facilitate financial transparency. Without urgent attention to the financial consequences of cancer treatment and related expenses, we continue to leave patients at risk of resorting to maladaptive coping strategies, such as medication rationing and restrictive household budgeting. [ABSTRACT FROM AUTHOR]

Sexual health promotion and Relationships and Sexuality Education (RSE) are influenced by interrelated social and cultural factors, particularly in a rural setting. This paper reports on findings from interviews with young people when asked about experiences and perspectives accessing RSE and sexual health services in a small rural Australian town. Fifteen young people (16–24 years) participated in semi-structured focus groups and interviews. Data was analysed and coded with four key themes emerging: relevant and credible sexual health education; make it easy; GP accessibility; and discreet condom supply. The findings of this study have practical implications when addressing community level sexual health and RSE needs. [ABSTRACT FROM AUTHOR]

Aim: To explore the health beliefs and health behaviours of older Vietnam‐born people living with chronic disease in Western Australia. Design: This study was designed as a focused ethnography guided by the interpretative research paradigm and Leininger's Theory of Culture Care. Methods: Data were collected through participant observation and interviews undertaken at participants' homes in Western Australia over 7 months in 2019. Data were analysed using Wolcott's approach for transferring qualitative data, comprising three phases: description, thematic analysis and interpretation. Results: This study included 12 participants. The health perspectives and practices of older Vietnam‐born Australians significantly reflected the traditional Vietnamese values. These included the stigma towards chronic disease as an inevitable consequence of ageing; self‐blame thoughts about chronic disease causations and maintained traditional dietary practices. However, some aspects of their health behaviours such as beliefs and practices in traditional medicine, Western medicine and physical exercise reflected a blended approach combining both Vietnamese‐oriented and Westernized‐orientated practices. Individual factors were also identified as contributing to chronic disease self‐care among participants. Conclusion: This study emphasizes culture played a significant role in shaping the way that older Vietnam‐born Australians believed and behaved while living with chronic conditions. However, it also indicates that culture is not a stationary concept, it evolves gradually and is socially constructed. Implications: A better understanding of the health beliefs and practices of older Vietnam‐born Australians is expected to contribute to the delivery of culturally safe and effective support for this population. The achievement of culturally safe care requires a systemic approach and collaboration of strategies across sectors. Patient and public contribution: This study encompassed the contribution of 12 older Vietnam‐born Australians who offered the researcher the privilege to enter their world and the staff of social care organization who opened the gate for the researcher to approach participants. [ABSTRACT FROM AUTHOR]

Survivorship is an under-recognized period in the care of women with breast cancer. This paper aimed to determine if supports provided by health services were adequate in meeting the expressed needs of women and partners during survivorship. A mixed-method study consisted of: (1) in-depth interviews with women (n = 18) and partners (n = 8) (completed June 2014–November 2014) and (2) a questionnaire with health providers (n = 34) (completed April 2015) regarding services offered, needs addressed, and barriers to service delivery. Both were completed in Perth, Western Australia. Findings were determined using thematic analysis and descriptive statistics. Many unmet needs were identified by women and partners, including: pain, fatigue, fear of recurrence, employment, leisure, and social and intimacy difficulties. Participants did not receive a formal plan to assist them. Health providers reported a range of supports, including cancer surveillance and management of physical, psychological, emotional, and relationship concerns. However, many barriers concerning service delivery were identified. Despite services reporting that they provided various supports, interview participants did not appear to use and benefit from these. Coordination of service delivery was identified as requiring improvement. The use of survivorship care plans also needs refinement to determine suitability for use during survivorship. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study was positioned within a larger action research study relating to a peer-led Aboriginal home visiting parent support program in an urban Western Australian setting. The aims for this study component were to identify program elements, exploring participants’ perceptions of the program’s suitability, feasibility, acceptability and effectiveness to inform program model recommendations and add to the body of knowledge on effective Aboriginal peer led program models. Background: The ability of Aboriginal parents to develop positive family environments is crucial, with parent support needing to be reflexive to local needs and sociocultural influences. Culturally appropriate service provision needs meaningful and acceptable strategies. Design: This study was situated within a critical paradigm supporting Participatory Action Research methodology, using Action Learning Sets as the participant engagement and data collection setting. Methods: Within ten Action Learning Sets, focus group interviews were carried out with Aboriginal peer support workers, a non-Aboriginal parent support worker, an Aboriginal program coordinator, an Aboriginal education support officer and non- Aboriginal program managers (n = 8), and individual interviews with parents (n = 2) and community agencies (n = 4). Data were analysed using thematic analysis. Results: Five themes were derived from peer support worker and community agency cohorts: peer support worker home visiting skills; responding to impacts of social determinants of health; client support and engagement; interagency collaboration; and issues addressing program sustainability. Parent responses augmented these themes. Conclusions: Participants identified five key elements relating to peer-led home visiting support for Aboriginal parents. These are uniquely placed to inform ongoing program development as there is little additional evidence in wider national and international contexts. Relevance to clinical practice: Engagement with communities and peer support workers to develop culturally relevant partnerships with Aboriginal families is integral to contemporary child health practice. Ongoing nurse support is needed for peer support worker role development. Indigenous Australian peoples are people who identify as Aboriginal or Torres Strait Islander. Respectfully, throughout this paper, they will be described as Aboriginal. [ABSTRACT FROM AUTHOR]

This paper explores the engagement in physical activity as a potential coping strategy for asylum seekers living in the Australian community without the right to work and with prolonged uncertainty, and benefits or barriers to undertaking such activity. Semi-structured in-depth interviews were held with 29 asylum seekers who had arrived to Australia by boat and were living in the community in the cities of Perth, Sydney or Melbourne in July-October 2013 after their release from immigration detention. The ratio of the numbers of men and women interviewed (23 men and 6 women) was comparable to the ratio of men and women who came by boat to Australia seeking asylum in 2012-2013. Nine participants reported that they participated in physical activity as a coping strategy. Seven other participants were so worried about their future and their families that they did not have the mental or physical energy to engage in physical activity. A further six wanted to participate in physical activity but faced a number of barriers to doing so. The seven remaining participants were either not asked about their physical activity engagement because they focused their discussion on other challenges or did not elaborate on why they were not engaging in physical activity. The findings suggest that physical activity, coupled with other coping strategies, are important for some asylum seekers in trying to manage the distress of being denied the right to work and living with prolonged uncertainty. In addition, these findings highlight the critical barrier that government policy plays in disabling engagement in physical activity, which further compounds social exclusion. This includes the lack of welfare support provided, which hinders people's financial ability to access activities and support in the community. [ABSTRACT FROM AUTHOR]

Background Heuristic inquiry is a research approach that improves understanding of the essence of an experience. This qualitative method relies on researchers' ability to discover and interpret their own experience while exploring those of others. Aim To present a discussion of heuristic inquiry's methodology and its application to the experience of nurse migration. Discussion The researcher's commitment to the research is central to heuristic inquiry. It is immersive, reflective, reiterative and a personally-affecting method of gathering knowledge. Researchers are acknowledged as the only people who can validate the findings of the research by exploring their own experiences while also examining those of others with the same experiences to truly understand the phenomena being researched. This paper presents the ways in which the heuristic process guides this discovery in relation to traditional research steps. Conclusion Heuristic inquiry is an appropriate method for exploring nurses' experiences of migration because nurse researchers can tell their own stories and it brings understanding of themselves and the phenomenon as experienced by others. Implications for practice Although not a popular method in nursing research, heuristic inquiry offers a depth of exploration and understanding that may not be revealed by other methods. [ABSTRACT FROM AUTHOR]

Aim: To explore residential aged care nurses working in interim, rehabilitation and residential aged care perceptions of resilience. Design: Qualitative Portraiture methodology. Inclusion criteria were that all participants were English speaking, registered with the Australian Health Practitioners Registration Authority and had more than five years' experience working in an aged care environment. Three participants were interviewed and employed within a metropolitan interim, rehabilitation and aged care setting. Results: Eight themes were identified: valuing social support; leadership, managing 'self'; 'paying it forward'; passion for the profession; focusing on the positive and the taking on of challenge. Conclusions: This paper focuses on the impact of aged care nursing work on nurses and in particular how the nurses remain resilient in their work environment. Resilience can be developed through education and can sustain professional longevity. Workload stress can be alleviated through the provision of resilience training. [ABSTRACT FROM AUTHOR]

Aboriginal Australians are at higher risk of developing certain types of cancer and, once diagnosed, they have poorer outcomes than their non-Aboriginal counterparts. Lower access to cancer screening programmes, deficiencies in treatment and cultural barriers contribute to poor outcomes. Additional logistical factors affecting those living in rural areas compound these barriers. Cancer support groups have positive effects on people affected by cancer; however, there is limited evidence on peer-support programmes for Aboriginal cancer patients in Australia. This paper explores the roles played by an Aboriginal women's cancer support network operating in a regional town in Western Australia. Data were collected through semi-structured interviews with 24 participants including Aboriginal and mainstream healthcare service providers, and network members and clients. Interviews were audiotaped and transcribed verbatim. Transcripts were subjected to inductive thematic analysis. Connecting and linking people and services was perceived as the main role of the network. This role had four distinct domains: (i) facilitating access to cancer services; (ii) fostering social interaction; (iii) providing a culturally safe space; and (iv) building relationships with other agencies. Other network roles included providing emotional and practical support, delivering health education and facilitating engagement in cancer screening initiatives. Despite the network's achievements, unresolved tensions around role definition negatively impacted on the working relationship between the network and mainstream service providers, and posed a threat to the network's sustainability. Different perspectives need to be acknowledged and addressed in order to build strong, effective partnerships between service providers and Aboriginal communities. Valuing and honouring the Aboriginal approaches and expertise, and adopting an intercultural approach are suggested as necessary to the way forward. [ABSTRACT FROM AUTHOR]

Background: Research has highlighted a need to improve the quality of clinical documentation and data within aged care and disability services in Australia to support improved regulatory reporting and ensure quality and safety of services. However, the specific causes of data quality issues within aged care and disability services and solutions for optimisation are not well understood. Objectives: This study explored aged care and disability workforce (referred to as 'data-users') experiences and perceived root causes of clinical data quality issues at a large aged care and disability services provider in Western Australia, to inform optimisation solutions. Methods: A purposive sample of n = 135 aged care and disability staff (including community-based and residential-based) in clinical, care, administrative and/or management roles participated in semi-structured interviews and web-based surveys. Data were analysed using an inductive thematic analysis method, where themes and subthemes were derived. Results: Eight overarching causes of data and documentation quality issues were identified: (1) staff-related challenges, (2) education and training, (3) external barriers, (4) operational guidelines and procedures, (5) organisational practices and culture, (6) technological infrastructure, (7) systems design limitations, and (8) systems configuration-related challenges. Conclusion: The quality of clinical data and documentation within aged care and disability services is influenced by a complex interplay of internal and external factors. Coordinated and collaborative effort is required between service providers and the wider sector to identify behavioural and technical optimisation solutions to support safe and high-quality care and improved regulatory reporting. [ABSTRACT FROM AUTHOR]

Background and aims The alcohol industry produces 'responsible drinking' advertising campaigns. There is concern that these may promote drinking while persuading governments and the general public that the industry is acting responsibly. This paper examined young people's thoughts and feelings in response to one of these campaigns in Australia. Design A qualitative analysis of introspection data provided by young drinkers after exposure to a responsible drinking advertisement produced by DrinkWise called 'How to Drink Properly'. Setting Perth, Western Australia. Participants Forty-eight 18-21-year-old drinkers. Measurements The qualitative data were imported into NVivo10 and coded according to the various stages of advertising effects frameworks. A thematic analysis approach was used to identify patterns in the data relating to (i) perceptions of the source and purpose of the advertisement and (ii) any resulting attitudinal or behavioural outcomes. Findings Despite the sample comprising mainly high-risk drinkers, participants were generally unable to relate to the heavy drinkers depicted in the DrinkWise advertisement. This disassociation resulted in a perceived lack of need to modify their own drinking behaviours. Instead, the study participants found the advertisement to be entertaining and supportive of existing social norms relating to heavy drinking among members of this age group. Conclusions The 'How to Drink Properly' advertisement by Drinkwise in Australia may reinforce existing drinking attitudes and behaviours among young drinkers. [ABSTRACT FROM AUTHOR]

Background: The use of stimulant medication for Attention Deficit Hyperactivity Disorder (ADHD) to improve classroom behaviour and sustained concentration is well known. Achieving a better academic grade has been reported as the prime motivation for stimulant use and is an increasingly discussed topic. The proliferation of stimulant use for ADHD has been a cause for public, medical and policy concern in Australia. This paper explores individuals' perceptions of ADHD, the meaning that the diagnosis carries for them and their attitudes to stimulant medication treatment.Methods: This qualitative study was underpinned by a social constructivist approach and involved semi-structured interviews with eight participants. The participants were parents of children with ADHD or were adults who themselves had been diagnosed with ADHD. Interviews were audiotaped, transcribed verbatim and thematically analysed.Results: There were three interrelated yet contradictory overarching themes: (i) An impairment to achieving success, which can be a double-edged sword, but has to be fixed; (ii) Diagnosis as a relief that alleviates fault and acknowledges familial inheritance; (iii) Responsibility to be normal and to fit in with societal expectations. Collectively, these perceptions and meanings were powerful drivers of stimulant use.Conclusions: Paying attention to perceptions of ADHD and reasons for seeking or not seeking stimulant treatment is important when planning appropriate interventions for this condition. [ABSTRACT FROM AUTHOR]

This paper describes an evaluation of postgraduate midwifery students' experiences of a model of blended learning, following completion of a newly accredited Master of Midwifery Practice (MMP) course in a Western Australian university. Successful completion of the course leads to registration as a midwife with a Master's degree. This is the first midwifery degree at Master's level offered in Western Australia, which offers another route into the midwifery profession alongside existing options for postgraduate and undergraduate students. Midwifery students enrolled on the 2-year MMP course are registered nurses, who are offered flexible learning options involving on-campus and online learning, as opposed to traditional on-campus lectures and tutorials. The evaluation consisted of a 10-part questionnaire given to 25 midwifery students, of which 17 were completed and returned. Responses were analysed by the authors and a consensus on the final interpretation was reached. Four main themes were identified from the evaluation: variety of teaching methods, feeling overwhelmed, contextualising midwifery, and support. [ABSTRACT FROM AUTHOR]

Mental health nursing has an ageing workforce with a critical shortage of nurses in Western Australia. Additionally, mental health is not the preferred career for many graduate nurses. Current challenges with recruitment and retention suggest that strategies are needed to address this issue. This research project adopted a novel approach that focused on exploring the positive aspects of why mental health nurses remain, rather than why they leave. A cross-sectional design was employed comprising a brief interview survey, and nurses working within one public mental health service in Western Australia were invited to participate. A total of 192 nurses participated across 5 months, from adult, older adult, forensic, and education/research programmes. Thematic analysis was conducted from five key questions, and responses from questions one and two are discussed in this paper: 'Why did you choose mental health nursing?' and 'Why do you remain in mental health nursing?'. The main themes extracted in response to choosing mental health nursing were wanting to make a difference, mental health captured my interest, encouraged by others, and opportunities. Subsequent themes extracted from responses to remaining in mental health nursing were facing reality, passion for mental health nursing, patient-centred caring, and workplace conditions. Findings will be utilized to inform strategies for recruitment and retention of graduate nurses; further development of support systems, such as preceptorship training and improving student clinical experiences; as well as improving professional development opportunities for existing mental health nurses. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic and subsequent social isolation measures had a profound impact on communities worldwide. In regional and remote Western Australia, the use of online platforms has become increasingly important for maintaining social and emotional well-being. This article examines the role of 'The Isolation Tour 2020' Facebook page in providing a lifeline for its mostly Aboriginal audience to stay connected with culture, Country, and one another during the 2020 COVID-19 lockdown in Western Australia. The authors conducted an in-depth interview with one of the administrators of the page and supplemented this with a thematic analysis of publicly available Facebook data. Data were analysed using NVivo qualitative analysis software and common themes were identified. The findings show that 'The Isolation Tour 2020' provided an effective virtual platform for people to interact with loved ones and feel a sense of belonging and comfort in the uncertainty of the pandemic. This research highlights the importance of online spaces for supporting social and emotional well-being during extended periods of social isolation and offers insights into how similar initiatives can be supported in future. [ABSTRACT FROM AUTHOR]

The provision of community‐based space for people experiencing a mental health crisis is regarded as a favourable alternative to the emergency department. However, the only non‐emergency department safe spaces in Western Australia are located within hospitals or hospital grounds. This qualitative study asked mental health consumers in Western Australia with experience of presentation at the emergency department during a mental health crisis to describe what a safe space would look and feel like. Data were collected through focus groups and thematically analysed. The findings present the voices of mental health consumers through the framework of health geography and the therapeutic landscape. These participants articulated important physical and social features of a therapeutic safe space and their symbolism as inclusive, accessible places where they would experience a sense of agency and belonging. Participants also expressed a need for trained peer support within the space to complement the skilled professional mental health team. Participants' experiences of the emergency department during mental health crises were described as contrary to their recovery needs. The research reinforces the need for an alternative to the emergency department for adults who experience mental health crises and provides consumer‐led evidence to inform the design and development of a recovery‐focused safe space. [ABSTRACT FROM AUTHOR]

Introduction: This study describes the experiences of eight mothers from the Wheatbelt region of Western Australia who shared their stories of travelling and/or temporarily relocating for birth. Objective: The aim of this study was to describe rural and remote Western Australian mothers' experiences of travelling long distances and/or relocating to give birth. Design: This study was based on Crotty's four elements of qualitative research. This study was underpinned by a constructivist epistemology, a feminist theoretical lens and a narrative approach using semistructured, story‐based interviews. Participants narrated their stories of birthing away from home by telephone interview. Findings: Five major themes were identified utilising thematic analysis. These were (1) feeling forgotten in the system, (2) accessibility and choice, (3) compounded social isolation, (4) doing it hard: financial and logistical challenges and (5) building strength: advocating for myself and baby. Discussion: Mothers' stories were reflective of current and historical failures of rural maternal health policy, including widespread closures of rural birthing hospitals. Mothers described the logistical barriers they faced with little support and suggested multiple solutions that would improve their experiences. Conclusion: Mothers faced significant obstacles which impeded their access to equitable maternal healthcare. This study highlights the complexities of birthing as a rural mother and the need to address maternal health inequities between rural and metropolitan women. [ABSTRACT FROM AUTHOR]

• Examining adolescent perceptions of their parents influence on their access and use of mental health services. • Use qualitative face to face interviews. • Parents were highlighted by adolescents as prominent influences in adolescent mental health journeys, however this influence could be positive and negative for the adolescent. • Highlights the complexity of the involvement of parents in their child's mental health service use. To explore adolescent experiences of accessing and utilising mental health service in Perth, Western Australia. This paper focusses on the adolescent identified influence of parents in accessing and using mental health services. Qualitative semi-structured face-to-face interviews with 22 adolescents aged 14–18 years old in Perth, Western Australia. Interviews were transcribed verbatim and analysed thematically. The influence of parents on adolescents' experiences within the mental health system were grouped under three themes: parental involvement in accessing and continued use of mental health services for their children; parental understanding and awareness of child's mental health problems; parent–child relationship. It was common for adolescents to report that the influence and involvement of their parents could create facilitators and barriers to mental health care. This research highlighted the complexities in how parents can be both supportive and hindering influences in their child's mental health care. Adolescent experiences highlight the need for parents to be a key area of focus for mental health services and future reforms to support and improve adolescent mental health service use. Additional research is needed to explore how to effectively increase parental mental health literacy in the community and what factors are needed to create trusted parent-adolescent relationships. [ABSTRACT FROM AUTHOR]

Aim: The aims of the study were to investigate family and hospital staff views about the use of spring‐infusor devices for administration of intravenous antibiotic medications, to examine if the device is acceptable and feasible and to map a process for implementation. Design: A qualitative study with a pragmatist approach, within a larger, mixed methods knowledge translation study. Methods: Data were collected by semi‐structured interviews with patients who have cystic fibrosis and their parents and focus groups and interviews with hospital staff. Interviews were concluded when no new themes were identified. Thematic analysis and process mapping was undertaken. Results: Six parents, nine children and 30 staff were interviewed. Families preferred spring‐infusors. Staff knowledge, experience and attitudes toward spring‐infusor use was varied. All staff acknowledged that their role is to support patient‐centred care. Spring‐infusors are preferred by families and clinicians above other IV administration devices but misconceptions about spring‐infusor use and numerous procedural challenges reduced their use. [ABSTRACT FROM AUTHOR]

This study explores the concept of social connectedness for adults with Cystic Fibrosis (CF), generally and during the onset of the COVID-19 pandemic, to help inform contemporary CF healthcare. Social connectedness is an essential component of belonging and refers to an individual's sense of closeness with the social world. Unique disease factors make exploration of social connectedness pertinent, added to by COVID-19, with the CF population potentially facing increased risk for severe illness. Seventeen adults with CF in Western Australia undertook interviews, with findings categorized as overarching themes. In a general sense, participants described social connectedness challenges caused by CF, despite which they reported meaningful connections that benefits their mental and physical health. Within a COVID-19 specific context, participants demonstrated resilience in the face of adversity, highlighted the importance of empathy in relation to the pandemic, and described how social support is both an outcome and enhancer of social connectedness. This study contributes to limited social connectedness literature within CF and chronic illness in general, highlighting the importance of social connectedness awareness raising, assessments and interventions in CF healthcare inside and outside the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Culturally and Linguistically Diverse (CALD) groups within high‐income countries are at risk of being left behind by the COVID‐19 vaccination rollout. They face both access and attitudinal barriers, including low trust in government and health authorities. Objective: To explore perceptions and attitudes towards COVID‐19 vaccination, as well as facilitators, barriers and strategies to promote uptake among CALD residents of Western Australia (WA), where there were almost no COVID‐19 cases for 2 years. Design and Participants: Perth, WA's capital, was chosen as the state's study site because most of the state's CALD population lives there. Eleven semistructured in‐depth interviews and three focus groups (with 37 participants) were conducted with CALD residents between August and October 2021. Thematic analysis was conducted, informed by the 'Capability', 'Opportunity', 'Motivation', 'Behaviour' model. Results: CALD participants faced barriers including a lack of knowledge about COVID‐19 and the vaccines, low self‐rated English proficiency and education levels, misinformation, passive government communication strategies and limited access to vaccine clinics/providers. They were, however, motivated to vaccinate by the imminent opening of state and international borders, trust in government and healthcare authorities, travel intentions and the desire to protect themselves and others. Conclusions: Despite high levels of trust and significant desire for vaccines among CALD communities in Perth, current strategies were not meeting their needs and the community remains at risk from COVID‐19. Tailored intervention strategies are required to provide knowledge, address misinformation and facilitate access to ensure uptake of COVID‐19 vaccines—including for additional doses—amongst CALD communities. Governments should work with trusted CALD community members to disseminate tailored COVID‐19 vaccine information and adequately translated resources. Patient or Public Contribution: The Wesfarmers Centre of Vaccines and Infectious Diseases Community Reference Group at Telethon Kids Institute consulted on this project in September 2020; Ishar Multicultural Women's Health Services consulted on and facilitated the focus groups. [ABSTRACT FROM AUTHOR]

In the context of pressures faced by the nursing profession including increasing patient acuity and global nursing shortages, the importance of nurse resilience has gained attention in research and practice. Resilience is viewed as a protective factor that enables individuals to avoid psychological harm and continue in their work. There is limited evidence on the impact of external factors such as work conditions on nurse resilience. This study aimed to explore how external factors influence nurse resilience and to incorporate this knowledge into an updated definition of nurse resilience. As part of a two‐phase mixed methods study, focus groups were conducted to obtain qualitative data to explore nurse's perceptions of resilience and factors they felt affected their resilience. Data analysis identified three main themes derived from 10 subthemes: Perceptions of Resilience, Pressures and Challenges, and Support and Strategies contributed to understanding how external factors can affect nurse resilience. A range of factors emerged including the impact of workplace conditions, organizational philosophy, the performance of managers, and the teams nurses work within, which were not reflected in an earlier definition of nurse resilience derived through a concept analysis. These factors were incorporated in an updated definition of nurse resilience. Understanding resilience in the nursing profession and the external factors that affect it is critical to the development of effective research, policies, interventions, and work environments to protect nurse well‐being, promote nurse retention, and ensure the provision of quality patient care. [ABSTRACT FROM AUTHOR]

This research investigates resettlement stress among African migrants in Australia and how migrants manage stress. The research used 30 semi-structured interviews with African migrants in Western Australia. Participants used various strategies, including reliance on family as a community and on God – usually constructed by alliance rather than kinship – to manage stress. The article's key contribution highlights the multilayered approach for social work to integration strategies for migrants. The study identifies three significant issues emerging: the importance of 'families' as community networks, the experience of discrimination and the significance of faith in God as crucial migrant support factors. [ABSTRACT FROM AUTHOR]

The objective of the study was to identify whether creating a responsive, respectful and trustworthy environment that provides free dental care for clients who are homeless using volunteer dental professionals was effective in meeting their oral health needs in Fremantle, Western Australia. Qualitative research conducted between October 2018 and August 2019 was guided by a social constructivist paradigm to gather and analyse data. Semi‐structured interviews were conducted with adults experiencing homelessness accessing a community dental clinic and health providers and other stakeholders involved in its establishment, management and service delivery. An inductive approach to analysis was used to organise themes under the categories of 'establishing the oral health clinic' (OHC) and 'responses to the implementation of the clinic' Thirty‐nine semi‐structured interviews were conducted across eight participant groups: clients, executive management, the oral health clinical reference group, volunteer dentists, employed staff, nursing students, volunteer staff and other stakeholders. Key findings across all groups included positive responses to the establishment and implementation of the OHC, the quality of care and the safe and respectful environment in which services were delivered. Challenges related to sustainability include uncertainty around ongoing funding and recruitment of dental professionals. Whilst volunteer dental services fill a gap in meeting the complex needs of this population group, mainstream services must consider and address issues of equity in this context. Findings can be used to guide this process that includes creating environments of respect and trust where adults who are homeless or at risk of homelessness feel safe, welcomed and more likely to return to the service. [ABSTRACT FROM AUTHOR]

Objectives The Health Workforce Australia Clinical Supervision Support Program Discussion Paper (2010) highlighted the education deficits of health professionals responsible for the clinical supervision of students. This research aimed to develop, implement and evaluate a new education program for nurses to assist in the development of knowledge and attitude to supervise students whilst on clinical practicum. Design The impact of the ACS program was determined using a descriptive methodology involving the collection and analysis of quantitative and qualitative data using a triangulation approach. This included the use of surveys, online reflections and interviews. Settings The ACS program was presented in both the metropolitan and regional areas of Western Australia. Subjects Participants (n=199) were from both the public and private health care sector working in a variety of nursing specialties within both the inpatient and community setting. Results Analysis of the data determined that participants improved their knowledge and attitude towards students and clinical supervision. Conclusions The ACS was confirmed as a strategy for providing effective education for nurses. [ABSTRACT FROM AUTHOR]

This paper examines the supportive care in place to meet the needs of patients receiving radiotherapy at a regional oncology service in Bunbury, Western Australia. Semi‐structured in‐depth interviews with 21 service providers and 17 adults diagnosed with cancer who underwent radiotherapy at the Service were recorded, transcribed and analysed thematically. Key themes relevant were co‐operation and collaboration of interdisciplinary team members; support from organisations to assist with accommodation, transport, emotional support and provision of practical assistance, as well as barriers to accessing support. Most participants were positive about the support available, recognising the needs of rural radiotherapy patients for assistance with travel, accommodation and psychosocial support to help deal with the stressors they face. Collaboration between the various service providers maximised the support available to patients but the drop off in psychosocial support once the intensity of treatment was completed was identified as a weakness in the support available. The support system, established around a regional radiotherapy service, was enhanced by the collaborative professional relationships developed among service providers. The service extends beyond clinical service delivery by recognising financial, logistical and psychosocial support needs, factors to be considered to ensure rural radiotherapy patients are provided with holistic care. [ABSTRACT FROM AUTHOR]

Patients in hospital following stroke express a desire to continue therapy tasks outside of treatment activities. However, they commonly describe experiences of boredom and inactivity. An enriched environment aims to provide opportunities for physical, cognitive and social activity and informed the development of a Communication Enhanced Environment (CEE) model to promote patient engagement in language activities. Explore patient perceptions of a CEE model, and barriers and facilitators to engagement in the model. A qualitative description study from a larger project that implemented a CEE model into acute and rehabilitation private hospital wards in Western Australia. Semi-structured interviews were conducted with seven patients, including four with aphasia, within 22 days post-stroke who had access to the CEE model. Patients described variable experiences accessing different elements of the CEE model which were influenced by individual patient factors, staff factors, hospital features as well as staff time pressures. Those who were able to access elements of the CEE model described positive opportunities for engagement in language activities. While findings are encouraging, further exploration of the feasibility of a CEE model in this complex setting is indicated to inform the development of this intervention. Patient access to a CEE model is challenging in a hospital setting. Patients who were able to access elements of the CEE model described positive opportunities for engagement in language activities. Patients' access to the CEE model was influenced by patient factors, staff factors, hospital features as well as staff time pressures. [ABSTRACT FROM AUTHOR]

Aims: This feasibility study aimed to systematically identify and address the support needs of parents of children with life-limiting illnesses and to assess whether the systematic approach was acceptable and relevant to parents. Methods: The CSNAT (Paediatric) intervention consisted of two assessment visits with the paediatric palliative care team, 2–8 weeks apart, comprising conversations about sources for support in a tertiary children hospital in Western Australia (2018–2019). Audio-recorded telephone interviews were conducted with parents, and inductive thematic analysis was undertaken. Results: All 28 parents who were involved in the intervention agreed to be interviewed. Five themes summarised their experience: caregiving challenges, perceived gaps and feelings of isolation; the usefulness and practicality of the systematic assessment; emotional responses to self-reflection; feelings of validation and empowerment; and received supports responsive to their needs. Conclusions: Parents appreciated the value of this systematic approach in engaging them in conversations about their needs and solutions to address them. While clinical service support was affirmed by parents, they were left wanting in other areas of practical, psychosocial, and emotional support. Palliative care services need to build stronger partnerships with supportive community networks through compassionate communities volunteer models of care to address the non-clinical needs of these families. [ABSTRACT FROM AUTHOR]

Aims and objectives: To determine whether the current rural graduate programmes in Western Australia adequately support new graduate nurses transitioning into practice. Background: Graduate nurse's transition to employment is a time of significant change and challenge, often resulting in periods of transition shock. These challenges are magnified in rural areas where graduates have to relocate to commence their career with limited rural nursing experience. Graduate programmes were developed to smooth the transition for university trained bachelor's degree registered nurses into the workforce. Supportive graduate nursing programmes are essential for enabling transition to practice and reduce attrition rates. Design: Longitudinal convergent mixed method parallel design was informed by Duchscher's transition stage model. Method: Thematic analysis was applied to all interviews. COREQ checklist was completed. Descriptive statistics and content analysis were used to analyse the survey responses. Results: New graduates cycled through both transition shock and honeymoon periods on commencement of employment, reporting high levels of satisfaction in simultaneity with signs of transition shock. Satisfaction dropped within 7 months indicating a transition crisis before an adjustment period occurred at the end of their graduate year. Limited resources were highlighted as obstacles to providing adequate support to rural graduate nurses. Conclusion: The honeymoon stage of transition co‐existed with transition shock at the commencement of graduate programmes, which may obscure the need for continuing adequate support. Inadequate and/or a lack of preceptorship was evident throughout the Western Australian rural graduate programmes. Graduate programmes need to be structured but flexible to allow for individual differences in graduates' and clinical contexts. Relevance to clinical practice: Structured but flexible graduate programmes allow for individual differences in graduates and clinical situations. New graduate nurses would benefit from a break midway through their graduate year to assist and overcome the transition crisis stage. Education of nurses undertaking the preceptor role is required to deliver adequate support to graduate nurses and decrease transition shock. [ABSTRACT FROM AUTHOR]

We report findings of a mixed-method evaluation of Local Area Coordination (LAC) in one English Local Authority—an approach that draws on principles of earlier intervention, and place-, asset- and strengths-based activity. We drew on documentary materials, unstructured observation and qualitative interviews. In total, fifty-five qualitative interviews were conducted with professional stakeholders (including Coordinators, statutory agencies and community organisations), and a purposive sample of individuals supported by LAC. Positively, LAC is operating as intended. It is a flexible and agile approach, and one that is less constrained by the expectations and methods associated with traditional service delivery. Reported impacts include: tackling isolation and loneliness; building a positive vision of the future; identifying non-service solutions and being heard. We discuss the ongoing conceptual and methodological challenges to building the LAC evidence base, fostering professional support and understanding, and managing expectations of individuals and communities in furthering development. Resolving these would allow LAC to move beyond being a promising, local and small-scale transformative development for individuals and families. Its future trajectory is enmeshed in the implications of COVID-19 for individuals, families and communities: rising poverty and widening inequality, a fragile Third Sector, and concerns about community fatigue and erosion of trust. [ABSTRACT FROM AUTHOR]

This article describes the processes and outcomes of a research project exploring children's motivation to write, undertaken by four pre-primary teachers in Western Australia. The teachers adopted a sociocultural theoretical framework using child centred participatory methodology, in which 109 children aged between five and six years shared their views of writing in conversation with their teacher. Thematic analysis in conjunction with statistical analysis indicated that the majority of children were motivated to write. They had a positive attitude towards writing, evidenced by their self-efficacy and were developing aspects of self-determination evidenced by their sense of ownership and control of the codes of writing. They had some understanding of the value of writing as a means of supporting reading and securing a positive future, thus enhancing their motivation to write. However, a small group of children indicated that they did not like writing, found writing hard, and did not know how or what to write. In addition, few children mentioned writing as a means of communication. The absence of purpose and audience in the children's responses, was partly explained by the teachers' focus on the codes of writing, potentially impacting on children's motivation. This prompted the teachers to re-conceptualise their writing program in ways that engaged children in authentic writing tasks, while continuing to scaffold their understanding of the codes of writing. This collaborative approach to research, in ways that privilege children's voices, has implications for informing pedagogy across a range of early childhood contexts and curriculum areas. [ABSTRACT FROM AUTHOR]

Comprehensive primary health care is integral to meaningful client-centred care, with nurses and midwives central to partnership approaches with individuals, families and communities. A primary health model of antenatal care is needed for Aboriginal and Torres Strait Islander women in rural and remote areas, where complex social determinants of health impact on pregnancy outcomes, early years and lifelong health. Staff experiences from a community midwifery-led antenatal program in a remote Western Australian setting were explored, with the aim of investigating program impacts from health service providers' perspectives. Interviews with 19 providers, including community midwives, child health nurses, program managers, a liaison officer, doctors and community agency staff, examined elements comprising a culturally safe community antenatal program for Aboriginal and Torres Strait Islander women, exploring program benefits and challenges. Thematic analysis derived five themes: Organisational and Accessibility Factors; Culturally Appropriate Support; Staff Availability and Competencies; Collaboration; and Sustainability. The ability of program staff to work in culturally safe partnerships with clients in collaboration with community agencies was essential to building meaningful and sustainable antenatal strategies. Midwifery primary health care competencies were viewed as a strong enabling factor, with potential to reduce health disparities in accordance with Australian Government and research recommendations. Investigating community-based primary health care models of antenatal care is important for Aboriginal and Torres Strait Islander women in rural and remote areas. This study evaluated the impact of a community midwifery-led antenatal program in a remote Western Australian setting, with findings highlighting factors enabling program staff and community agencies to work in culturally safe partnerships with clients. These qualities help build meaningful and sustainable antenatal strategies, with midwifery primary health care competencies viewed as a strong enabling factor. [ABSTRACT FROM AUTHOR]

The study objective was to explore the characteristics of rural general practice which exemplify optimal end‐of‐life (EOL) care from the perspective of people diagnosed with cancer, their informal carers and general practitioners (GPs); and the extent to which consumers perceived that actual EOL care addressed these characteristics. Semi‐structured telephone interviews were conducted with six people diagnosed with cancer, three informal carers and four GPs in rural and regional Australia. Using a social constructionist approach, thematic analysis was undertaken. Seven characteristics were perceived to be essential for optimal EOL care: (1) commitment and availability, (2) building of therapeutic relationships, (3) effective communication, (4) psychosocial support, (5) proficient symptom management, (6) care coordination and (7) recognition of the needs of carers. Most GPs consistently addressed these characteristics. Comprehensive EOL care that meets the needs of people dying with cancer is not beyond the resources of rural and regional GPs and communities. [ABSTRACT FROM AUTHOR]

Purpose: Previous studies have pointed the need for more research, which explores how peer provision brings about change associated with recovery. This study aims to test Leamy's framework, which consists of five recovery processes: connectedness, hope, identity, meaning and empowerment (also known as the CHIME framework) within the peer provision context. Design/methodology/approach: This mixed-methods study was completed in two stages. A total of 13 face-to-face interviews were conducted with peers and the transcripts were analysed thematically. A short online questionnaire was completed by 12 peers and analysed with both descriptive statistics and thematic analysis. Findings: The participants spoke about the value of peer providers (PPs) in building connectedness, fostering hope and optimism, growing identity, enhancing meaning and empowerment (CHIME). However, their connectedness was hindered by external circumstances and the intrapersonal capacities of their PP. Practical implications: The CHIME framework was useful in highlighting stages in which peers moved through their recovery and its corresponding PP involvement. PPs were also found to promote motivation, which was a key driver in their peers' recoveries. Further research is needed to test frameworks that account for wider systemic issues and the role PPs play in enhancing motivation. Originality/value: This study has identified the usefulness of the CHIME framework in describing peer provision. It contributes to our understanding of how peer provision can promote recovery in persons with mental health challenges. It lays the groundwork for future research into examining the role of peer provision in recovery and its distinctiveness from other forms of mental health support. [ABSTRACT FROM AUTHOR]

Purpose: Approximately 40–50% of people with multiple sclerosis (MS) have dysarthria impacting confidence in communication. This study explored how people with MS experienced a novel therapeutic approach combining dysarthria therapy with poetry in a group format. Method: Participants were recruited through MSWA (formerly known as the Multiple Sclerosis Society of Western Australia), a leading service provider for people living with all neurological conditions in Western Australia. They attended eight weekly sessions led by a speech pathologist and a professional poet. The study was co-designed and qualitative, using observational field notes recorded during sessions and semi-structured in-depth interviews with participants after programme completion. The results from an informal, unstandardised rating scale of communication confidence, along with standardised voice and speech measures, were used to facilitate discussion about confidence in the interviews. Result: Nine participants with MS completed the group programme. Analysis of the qualitative data revealed participants' positive views regarding the pairing of speech pathology and poetry. Thematic analysis identified four core themes: living with MS and its "series of griefs"; belonging to a group – "meeting with a purpose"; the power of poetry; and poetry as a medium for speech pathology. Conclusion: Poetry in combination with dysarthria therapy represents a novel, interprofessional approach for improving communication confidence in individuals with MS. [ABSTRACT FROM AUTHOR]

Aim and objectives: To gain insight into the supportive care needs of Western Australian women experiencing gynaecological cancer. Background: Meeting the supportive care needs of people living with cancer is becoming increasingly important as advances in cancer treatment contribute to growing numbers of survivors. International evidence suggests between 24%–56% of women with gynaecological cancer have unmet supportive care needs and that psychological challenges, information provision and holistic care are priorities. No qualitative investigation has previously explored women's journey of gynaecological cancer within the Australian setting. Design: A qualitative descriptive design was used. Methods: Women treated for gynaecological cancer were recruited from a tertiary public women's hospital in Western Australia. Thematic analysis was conducted on qualitative data collected from 190 women over 12 months through written open‐ended survey responses and telephone interviews. The COnsolidated criteria for REporting Qualitative research (COREQ) guided presentation of results. Results: Analysis yielded five themes and four subthemes: (a) Communication style directs the experience (subthemes: feeling supported; absence of empathy); (b) It's not just about the disease (subthemes: life has changed; holistic care); (c) A desire for information; (d) Drawing upon resilience; and (e) Navigating the system. Discussion: Exploration of the women's needs leads to the discussion of three concepts. Communication styles, harnessing women's resilience and alternative models of care are evaluated for their capacity to improve care and women's quality of life into survivorship. Recommendations are made for further research and possible interventions that can be translated into the clinical setting. Conclusion: Women with gynaecological cancer described complex often unmet supportive care needs and interactions with the healthcare system. Insight gained directs suggestions for improved service provision. Relevance to clinical practice: Improved patient‐centred communication, harnessing resilience as a resource and alternative models of care for follow‐up are encouraged as areas of improvement for clinicians and care services. [ABSTRACT FROM AUTHOR]

Aims and objectives: To understand why Western Australian (WA) midwives choose to remain in the profession. Background: Midwifery shortages and the inability to retain midwives in the midwifery profession is a global problem. The need for effective midwifery staff retention strategies to be implemented is therefore urgent, as is the need for evidence to inform those strategies. Design: Glaserian grounded theory (GT) methodology was used with constant comparative analysis. Methods: Fourteen midwives currently working clinically area were interviewed about why they remain in the profession. The GT process of constant comparative analysis resulted in an overarching core category emerging. The study is reported in accordance with Tong and associates' (2007) Consolidated Criteria for Reporting Qualitative Research (COREQ). Results: The core category derived from the data was labelled—"I love being a midwife; it's who I am." The three major categories that underpin the core category are labelled as follows: "The people I work with make all the difference"; "I want to be 'with woman' so I can make a difference"; and "I feel a responsibility to pass on my skills, knowledge and wisdom to the next generation." Conclusion: It emerged from the data that midwives' ability to be "with woman" and the difference they feel they make to them, the people they work with and the opportunity to "grow" the next generation together underpin a compelling new middle‐range theory of the phenomenon of interest. Relevance to clinical practice: The theory that emerged and the insights it provides will be of interest to healthcare leaders, who may wish to use it to help develop midwifery workforce policy and practice, and by extension to optimise midwives' job satisfaction, and facilitate the retention of midwives both locally and across Australia. [ABSTRACT FROM AUTHOR]

Data from this article are derived from responses to questionnaires provided by 232 frontline workers and team leaders from a range of organizations across four Australian states who participated in The Invisible Practices Project: Engaging With Fathers Who Use Violence. This project was designed to explore the practices of workers who see perpetrators of domestic violence outside the relative safety of group-work programs. Thematic analysis was employed to examine the research question: What is the organizational context that contributes to, or constrains, the practices of frontline workers intervening with fathers who use violence? This article reports the ways that agencies increase the visibility of, and practices with, fathers who use violence. Increasing the visibility of fathers who use violence is posited as a crucial driver of policy and practice reform aligned with feminist goals of eliminating sexist institutional practices. It is argued that such practices render fathers who use violence invisible, reinforce patriarchal views of family roles and responsibilities, intensify the scrutiny on the mothering of women survivors, and compound the impact of domestic violence. This article documents emerging practices that seek to redress practices that support patriarchal views of family roles and responsibilities and has implications for understanding the capacity of social workers and other professionals to intervene with fathers who use violence. [ABSTRACT FROM AUTHOR]

Purpose: This study trialled a play-based, peer-to-peer intervention with children with autism spectrum disorder (ASD) to identify suitable instruments for measuring changes in pragmatic language following the intervention, and evaluate preliminary effectiveness. It also aimed to investigate the appropriateness of the intervention for participants. Method: Ten children with ASD, their typically developing peers, and parents participated. The Pragmatics Observational Measure (POM), Social Emotional Evaluation (SEE) and Profiling Elements of Prosody in Speech Communication (PEPS-C) measured the participant's social communication skills before, after, and 2-months following the intervention. Parent interviews were conducted two months after the intervention and responses were analysed using a thematic approach. Result: Children demonstrated gains in pragmatic language on the POM (χ2(3) = 11.160, p = 0.011) and related higher-level language on the SEE (χ2(2) = 6.686, p = 0.035). The PEPS-C did not produce any significant results. Parent interview responses indicated the intervention was appropriate for the children and families involved. Conclusion: The intervention warrants further investigation of effectiveness with a more robust research design. Consideration should be given to using observational measures of pragmatic language away from the clinic environment to evaluate generalisation, and future development of the intervention might consider variations in playmates and group size. [ABSTRACT FROM AUTHOR]

Aims: To explore the transition experiences of newly graduated registered nurses with particular attention to patient safety. Background: New graduate registered nurses' transition is accompanied by a degree of shock which may be in tune with the described theory–practice gap. The limited exposure to clinical settings and experiences leaves these nurses at risk of making errors and not recognising deterioration, prioritising time management and task completion over patient safety and care. Design: Qualitative descriptive approach using semi‐structured interviews. Methods: Data were collected during 2017–18 from 11 participants consenting to face‐to‐face or telephone semi‐structured interviews. Interviews were transcribed verbatim, and data were analysed using thematic analysis techniques assisted by Nvivo coding software. The study follows the COREQ guidelines for qualitative studies (see Supplementary File 1). Results: Key themes isolated from the interview transcripts were as follows: patient safety and insights; time management; making a mistake; experiential learning; and transition. Medication administration was a significant cause of stress that adds to time management anguish. Although the new graduate registered nurses' clinical acumen was improving, they still felt they were moving two steps forward, one step back with regards to their understanding of patient care and safety. Conclusion: Transition shock leaves new graduate registered nurses' focused on time management and task completion over patient safety and holistic care. Encouragement and support needed to foster a safety culture that foster safe practices in our new nurses. Relevance to practice: Having an understanding of the new graduate registered nurses' experiences and understanding of practice will assist Graduate Nurse Program coordinators, and senior nurses, to plan and provide the relevant information and education during these initial months of transition to help mitigate the risk of errors occurring during this time. [ABSTRACT FROM AUTHOR]

The number of falls and fall‐associated injury rates among older people continues to rise worldwide. Increased efforts to influence older people's falls prevention behaviour are needed. A two‐phase exploratory community‐based participatory study was conducted in Western Australia. First, three prototype audio‐visual (AV) falls prevention messages were designed collaboratively with six older people. Second, the messages' effect on community‐dwelling older people's knowledge, awareness and motivation to take action regarding falls prevention was explored using focus groups. Data were analysed using thematic analysis to explore participants' responses to the messages. The participants' (n = 54) perspectives on the AV messages varied widely and stereotypes of ageing appeared to influence these. The presented falls facts (including falls epidemiology statistics) increased some participants' falls risk awareness and falls prevention knowledge. Other participants felt ready‐to‐use falls prevention information was lacking. Some expressed positive emotions or a personal connection to the messages and suggested the messages helped reduce ageing‐related stigma. Strongly opposing viewpoints suggested that other participants identified implicit negative messages about ageing, which reduced their motivation with the messages. Suggestions to improve the message persuasiveness included adding more drama and tailoring messages to appeal to multiple age groups. Overall, the AV falls prevention messages designed in collaboration with older people elicited a divergent range of positive and negative perspectives from their peers, which was conceptualised by the overarching theme 'we all look at things different ways'. Opinions differed regarding whether the messages would appeal to older people. Public campaigns targeting falls prevention should be designed and tailored towards older peoples' differing perspectives about ageing. [ABSTRACT FROM AUTHOR]

Objective: Child sexual abuse in remote Indigenous communities is prevalent and damaging, and finding solutions has been challenging. This study is an evaluation of Indigenous stakeholders' experiences of an intervention aimed at addressing child sexual abuse in remote Indigenous communities in Western Australia. Method: Nine interviews were analysed using a thematic analysis methodology. Interviewees included family members of children who had been sexually abused, and Indigenous service providers who lived in the communities. Results: Three broad themes emerged from the analysis: communication, action and presence, and working together to address child sexual abuse. Stakeholders described how the engagement with the team was respectful and collaborative, communication and service provision were excellent and stakeholders felt that they had a strong part to play in the process. Engagement, trust, warm relationships, and excellent outcomes were strong features of this initiative. Conclusions: The operation was seen as a new way of working together, and was strongly endorsed by the Indigenous participants interviewed in this study. [ABSTRACT FROM AUTHOR]

Objective: While prior experience, favourable location and anticipation of high quality care are known to influence patient choice to attend a private ED, it is likely that decision‐making is also influenced by other persons. In particular, patients arriving by ambulance are under the care of paramedics, whose values towards healthcare and rationale for choosing one ED over another have not been studied. This study aimed to describe reasons why paramedics choose to bring patients to a private ED. Methods: Exploratory, qualitative study using semi‐structured, face‐to‐face interviews with paramedics bringing patients to a private ED from the community. Two primary questions reinforced by structured prompts were asked: 'Why did you choose to come to this emergency department?' and 'What are your general expectations of this emergency department visit?' Interviews were audio recorded, transcribed verbatim and analysed thematically. Results: Fifty paramedics were interviewed with 48 interviews able to be transcribed and used in analysis. Four factors were identified to increase the likelihood of a private ED destination: specific direction, institutional allegiance, hospital logistics and systems and receiving hospital service ethos. Conclusions: Paramedics take into consideration when possible patient's wishes and are more likely to bring a patient to a private ED if they have specific direction from the patient or the patient's family or GP. The likelihood of presenting to a private ED is increased if the patient has an allegiance with the facility and the paramedics perceive favourably the hospital logistics and systems as well as service ethos. [ABSTRACT FROM AUTHOR]

Purpose: To determine the impact of the Graduate Diploma of Perioperative Nursing on student learning and career progression. Participants and setting: A validated mixed methods descriptive survey was sent to participants (n=67). Findings were analysed using descriptive statistics and results were further investigated using a focus groups of 12 individuals. Methods: Overall 96 per cent of graduates were satisfied with the program and agreed that the program had improved their delivery of patient care and enhanced their application of theoretical knowledge to clinical skills. Three themes were identified from data from the focus groups: 'learning', 'empowerment' and 'opportunity'. Qualitative findings confirmed program satisfaction among participants who valued the learning experience. Conclusion: The Graduate Diploma of Perioperative Nursing provides a unique opportunity for nurses in Western Australia to engage in a workplacesupported program to consolidate their specialised practice. With significant cutbacks occurring in nursing education across both the private and public health care sectors, the profession should advocate for the role of work integrated learning as a strategy to support nurses' development in a complex and changing health workplace. [ABSTRACT FROM AUTHOR]