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Intersecting gender and other social inequalities are pertinent to women's mental health across the life course. Gendered violence and other forms of gender inequality in particular play a key role in the higher burden of psychological distress carried by young women. However, the context of gendered violence is often minimised or overlooked entirely when young women seek help or advice around mental health concerns. This is especially the case for young women under the age of 30 years. This paper reports on a research study exploring how young women in Australia understand their mental health, and the scope for new approaches to support that better address their needs. A qualitative survey undertaken with 52 Australian young women was used to explore the nature of their mental health experiences, sought to learn about the strategies they used when experiencing poor mental health and the scope for mental health peer support as an alternative approach to intervention. Responses from a diverse group of young women demonstrated that they understood the role that gendered violence and gender inequality played in their mental health. Findings point to the risk of slippage between young women's understandings of their lived experience and those of traditional service providers, demonstrating the risks associated with minimising or ignoring of the gendered nature of young women's mental health problems. [ABSTRACT FROM AUTHOR]

Objective: The following research paper seeks to explore how post-occupancy evaluations (POEs) are undertaken in the nine health jurisdictions across Australia and Aotearoa New Zealand and investigate if the process can be strengthened to better inform healthcare design and investment. Background: Healthcare expenditure in both nations is increasing, and the rigorous evaluation of healthcare facilities can provide evidence to improve their return on investment. A POE is a research method used to undertake this analysis, usually 12 months after a facility has been occupied. There is limited information available about how POEs are undertaken in each jurisdiction, and there has never been research conducted to understand these processes across the region. Methods: Focus groups were conducted with participants from the government health organization in each jurisdiction to collect qualitative data regarding various aspects of POE processes and barriers to undertaking POEs. Results: Only five of the nine jurisdictions undertake POEs on healthcare facilities (with varied frequencies), and there is no standardized framework in use. However, every jurisdiction does undertake a "benefits realization" process. There is limited involvement of external consultants in POEs or benefits realization processes. POE benchmarks should be established at project commencement, and POE results should then inform future projects. Top-down support is required for POEs to occur. Conclusions: The primary conclusion is that strengthening any evaluation process requires a nuanced approach in each jurisdiction to account for their unique context and challenges. Regular rigorous evaluations are required to feed results into the Australasian Health Facility Guidelines and encourage innovative facility design. [ABSTRACT FROM AUTHOR]

As incarceration rates rise worldwide, increasing numbers of parents are separated from their children. Researchers have studied the psychosocial impact on inmates and their families extensively. However, few researchers have examined how their own perspectives affect the collection and interpretation of data, specifically about parenting in correctional settings. This paper consider methodological implications of conducting research with incarcerated mothers and fathers, employing critical reflexivity to explore researchers' individual and collective experiences in a study in Australian correctional facilities. Using ourselves as informants, we examine how the context and life experiences of 'researcher' and 'researched' interact during interviews in a unique and emotionally charged environment. Correctional research requires careful adaptations to collect meaningful data from inmates and recognise their vulnerability as parents. The emotional content of interviews also has implications for analysing and interpreting research data. Our focus on interviewees as mothers and fathers, rather than as offenders, generated greater understanding of the needs of parents in custody. Recognising researchers' feelings, experiences and perspectives on parenthood can enrich research with families affected by the criminal justice and child protection systems. These insights can also inform the understanding and practice of social workers, health practitioners, educators and students who work with marginalised parents and children. [ABSTRACT FROM AUTHOR]

Background: Globally there are high numbers of patients with palliative care needs receiving care in hospitals. Patient reported experience measures (PREMs) provide useful data to guide improvement work. How to implement PREMs within palliative care populations is unclear. Aim: To explore the perspectives of inpatients with palliative care needs, their family members, and the clinical team regarding the use of a generic PREM as compared with a PREM designed for people with palliative care needs and related implementation factors. Design: A qualitative study was undertaken using semi-structured interviews and focus groups and integrated thematic analysis. Setting/participants: Inpatients with palliative care needs, their family members, and clinical team members were recruited from three wards in an Australian metropolitan hospital. Results: Twenty-seven interviews and three focus groups were conducted. Six themes emerged: (1) PREMs for people with palliative care needs ought to be tailored to the needs of this population; (2) PREMs should appraise whether the needs of families have been met in addition to those of patients; (3) PREMs for inpatients with palliative care needs ought to be easy to use, brief and incorporate space for free text alongside each question; (4) Implementation of PREMs for people with palliative care needs ought to consider who administers these, when and how often; (5) PREM data need to be specific enough to inform process change and/or care provision; (6) Patients and families require meaningful feedback to encourage PREM completion. Conclusions: This study provides practical guidance for PREM selection and implementation to inform improvements to care for inpatients with palliative care needs. [ABSTRACT FROM AUTHOR]

Refugee populations are widely regarded as difficult to access for research purposes, often because of specific ethical sensitivities and practical challenges. Hence, research methods must be judiciously chosen and fine-tuned to ensure they are sufficiently sensitive and culturally appropriate. Bicultural Research Assistants, who typically share language and cultural similarities with respondents, may be gainfully employed to help address these challenges. By assuming a cultural ‘brokerage’ role, they are well positioned to advise the research team, helping to ensure culturally appropriate conduct throughout the study. Despite extensive use of participatory methods in qualitative studies, the experiences of Bicultural Research Assistants in research activities in tertiary hospital environments, particularly maternity care settings, are rarely reported. This paper addresses a deficit in the literature on this topic. It describes the roles and insights of five female Bicultural Research Assistants trained in basic research methods, and employed on an evaluation of a specialist antenatal clinic for women from refugee backgrounds. Their inclusion as members of the evaluation team was essential to successfully engaging (male) gatekeepers, recruiting eligible women, administering surveys, and conducting, transcribing, and translating interviews. Following the evaluation, the Bicultural Research Assistants contributed a one-off Focus group which explored their motivations for participating in the evaluation, and their experiences of occupying multiple roles as co-researchers, interpreters and respondents. Reported benefits included the acquisition of new skills, improved interprofessional relationships and greater acknowledgement of their roles and responsibilities by hospital staff and community stakeholders. Gender-related barriers were also described. Customary socio-cultural norms, which positioned women as relatively powerless and subservient, were frequently contravened by the Bicultural Research Assistants in their research roles. [ABSTRACT FROM PUBLISHER]

Objective: To explore how stakeholders in rehabilitation conceptualise 'successful rehabilitation', to inform the development of a minimum dataset and core outcomes for sub-acute rehabilitation. Design: Qualitative consensus study using the nominal group technique. Setting: Online focus groups. Participants: Consumer representatives (n = 7), clinicians (n = 15), and health service managers (n = 9) from Australia. Intervention: Participants responded to the question, 'What does successful rehabilitation look like?'. Following item generation, they prioritised their top five responses, allocating 100 points across items to denote relative importance. Main measures: Prioritised responses were analysed across stakeholder groups using qualitative content analysis. Results: Ten themes were identified. 'Successful rehabilitation' is: (1) person and family centred; (2) effective; (3) inter-professional; (4) accessible; (5) goal oriented with meaningful outcomes; (6) connected to the continuum of care; (7) evidence-based and supportive of innovation and research; (8) appropriately funded and skilled; (9) satisfying and engaging; and (10) safe. Conclusions: Stakeholder-defined 'successful rehabilitation' aligned with principles of value-based care and evidence-based rehabilitation. Provision and receipt of person and family centred care was the most important indicator of successful rehabilitation. Measures of success should include indicators of structure, process, outcome, and experience, and be conducted at multiple time-points. [ABSTRACT FROM AUTHOR]

Background: Lack of access, late engagement and limited referral for palliative care remain critical issues in supporting Indigenous Australians with life limiting illness. Aim: To explore the experiences and perspectives of Indigenous and non-Indigenous health professionals regarding the provision of palliative care for Indigenous people with advanced disease. Design: Qualitative study involving semi-structured focus groups/interviews with analysis following an inductive thematic approach. Setting/participants: A purposive sample (n = 54) of medical, nursing, allied health and Indigenous Hospital Liaison Officers engaged in caring for Indigenous patients at a metropolitan teaching hospital in Australia. Results: Four overarching themes were identified regarding provision of palliative care for Indigenous patients. These were (1) the intersection of cultures – Indigenous peoples, health and palliative care, (2) bridging the cultural divide: the integral role of Indigenous Hospital Liaison Officers, (3) health professionals devolve their responsibility to provide culturally appropriate care and (4) building towards a more holistic, culturally aware provision of palliative care. Conclusions: For many Indigenous people, the health system may be experienced as inflexible, narrowly focused and even prejudiced and traumatising. For Indigenous patients at the end of life, these challenges are heightened. The Indigenous Hospital Liaison Officers, working at the intersections of these two cultures, are key to negotiating such challenges as they seek opportunities to facilitate communication and understanding between firmly held cultural needs. [ABSTRACT FROM AUTHOR]

The connection between intimate partner violence (IPV) perpetration and problematic alcohol and/ or other drug (AOD) use has been well established in public health, social work and criminology research. Despite the overwhelming evidence of the correlation between these two problem behaviors, service systems addressing these issues have historically done so in siloed approaches to practice. AOD interventions have frequently been criticized for a lack of IPV focused assessment and practice. Similarly, specialist IPV interventions generally do not address clients' underlying risk factors, including problematic AOD use, through holistic intervention approaches. Suggestions to combine IPV and AOD focused interventions for men who use violence are often met with skepticism, raising questions around which sector could deliver a combined intervention approach and how different ideological standpoints in client work can and should be integrated into a combined framework. In this article, we examine the views of key stakeholders (n = 10) involved in the funding, development and/ or delivery of different service responses to men who use IPV in an Australian jurisdiction. Drawing on qualitative interview and focus group data, we explore their views around combined, group-based interventions, including the perceived need for such intervention models along with sector readiness and key considerations critical in informing the combining of IPV and AOD focused perpetrator interventions. Stakeholder findings identify the need for holistic responses to perpetrators of IPV with comorbid problematic AOD use. Further, findings provide guidance for funding bodies and community service providers considering combined, group-based interventions for perpetrators of IPV with comorbid problematic AOD use. [ABSTRACT FROM AUTHOR]

Communicating about medications across transitions of care is a challenging process for older patients. In this article, we examined communication processes between older patients, family members, and health professionals about managing medications across transitions of care, focusing on older patients' experiences. A focused ethnographic design was employed across two metropolitan hospitals. Data collection methods included interviews, observations, and focus groups. Following thematic analysis, data were analyzed using Fairclough's Critical Discourse Analysis and Medication Communication Model. Older patients' medication knowledge and family members' advocacy challenged unequal power relations between clinicians and patients and families. Doctors' use of authoritative discourse impeded older patients' participation in the medication communication. Older patients perceived that nurses' involvement in medication communication was limited due to their task-related routines. To reduce the unequal power relations, health professionals should be more proactive in sharing information about medications with older patients across transitions of care. [ABSTRACT FROM AUTHOR]

Women with disabilities experiencing violence can face challenges accessing domestic and family violence (DFV) services. Our research explored how these services understood and operationalized access for women with disabilities. In this article, we use Levesque, Harris, and Russell's access framework to show how to be accessible to women with disabilities, and DFV services can widen the lens of access and accessibility to respond to women's own priorities. These centered around appropriateness, approachability, and acceptability. Addressing these broader issues of access in policy and practice alongside disability-specific needs can better align what services offer and what women need. [ABSTRACT FROM AUTHOR]

Introduction: The purpose of this study was to explore perceived barriers to managing medications and potential solutions to such barriers among Bhutanese former refugees and service providers in Tasmania, Australia. Method: Thirty Bhutanese former refugees and service providers recruited through community health programs participated in a community-based participatory research design. Data were elicited through a structured focus group process and analyzed using content analysis. Results: Perceived barriers to managing medications included language barriers, low health literacy, and culturally unresponsive interactions with services. Themes identifying potential solutions to barriers referred to the functional health literacy of individuals (providing reassurance, checking understanding, and involving support networks) and creating supportive health care environments (consistent service providers, culturally responsive care, assistance navigating services, using trained interpreters). Discussion: Creating environments conducive to interactive and critical health literacy about medications is as important for culturally congruent care as supporting the functional health literacy of individuals. [ABSTRACT FROM AUTHOR]

Informed consent is critical in research with children. Although much has been written about the need to see consent as an ongoing process, less has considered how to do it in practice. This article reflects on the authors’ experiences of conducting a piece of research focusing on children’s experiences of safety from abuse within institutional contexts. It draws on feedback provided by participants and the guidance of three Children’s Reference Groups. The importance of presenting information in accessible and appropriate ways, of providing opportunities for participants to negotiate their participation and for in-the-moment challenges be dealt with collaboratively and reflexively are stressed. To illustrate our approach, we provide a number of consent tools and describe how they were utilised. [ABSTRACT FROM AUTHOR]

This qualitative inquiry explored the processes and practices of collaboration as experienced by a group of Australian multidisciplinary Aboriginal and non-Aboriginal health workers. Each worker had participated, for a period of 2 to 5 years, in an Australian Government–funded project in which a range of health initiatives led to improved access to cancer services by Aboriginal communities in a rural region of South Eastern Australia. Initiatives which addressed high rates of mortality from cancer, poor access to cancer screening, and engagement with cancer treatment were developed through the formation of close working relationships between Aboriginal and non-Aboriginal health workers. These relationships were regarded as personally and professionally transformative. Through the sharing of knowledge, skills, and experiences, new ways of knowing, being, and doing emerged. Developing a deeper understanding of cross-cultural collaboration is one way of addressing complex health problems and building the capacity of the health workforce. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate perceptions of health and health behaviors among Indigenous Australian men. Using a participatory action research (PAR) framework, we conducted two focus groups and 40 individual semi-structured interviews with men between the ages of 18 and 35 years in each of three locations across Australia. We used the health beliefs model to provide a framework for the analyses. Participants recognized that their Indigenous status placed them in a vulnerable position with regard to health, and that there might be serious consequences of failing to follow a good diet and engage in appropriate exercise. However, they delineated a number of barriers to engaging in such health behaviors. These perceived barriers require addressing at a range of policy levels within government, with a focus on social structures and institutionalized discrimination, as well as unemployment, poverty, dispossession, and cultural oppression. [ABSTRACT FROM AUTHOR]

Background: To effectively care for people who are terminally ill, including those without decision-making capacity, palliative care physicians must know and understand the legal standing of Advance Care Planning in their jurisdiction of practice. This includes the use of advance directives/living wills and substitute decision-makers who can legally consent to or refuse treatment if there is no valid advance directive. Aim: This study aimed to investigate the knowledge, attitudes and practices of medical specialists most often involved in end-of-life care in relation to the law on withholding/withdrawing life-sustaining treatment from adults without decision-making capacity. Design/participants: A pre-piloted survey was posted to specialists in palliative, emergency, geriatric, renal and respiratory medicine; intensive care; and medical oncology in three Australian States. Surveys were analysed using SPSS 20 and SAS 9.3. Results: The overall response rate was 32% (867/2702) – 52% from palliative care specialists. Palliative care specialists and geriatricians had significantly more positive attitudes towards the law ( χ 42 2 = 94 . 352 ; p < 0.001) and higher levels of knowledge about the withholding/withdrawing life-sustaining treatment law ( χ 7 2 = 30 . 033 ; p < 0.001) than did the other specialists, while still having critical gaps in their knowledge. Conclusion: A high level of knowledge of the law is essential to ensure that patients’ wishes and decisions, expressed through Advance Care Planning, are respected to the maximum extent possible within the law, thereby according with the principles and philosophy of palliative care. It is also essential to protect health professionals from legal action resulting from unauthorised provision or cessation of treatment. [ABSTRACT FROM AUTHOR]

The article discusses a study conducted to explore the understanding of palliative care by healthcare professionals caring for patients with advanced cancer. Topics discussed include understanding related to palliative care, implications for optimal patient care in all areas of health provision, understandings related to palliative care services.