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To investigate determinants of willingness to adopt telerehabilitation, willingness of technology use, core affect regarding using telerehabilitation, and digital competencies in rehabilitation professionals in Austria and Germany before and during the COVID-19 pandemic. A cross-sectional paper-based and online survey was conducted before and during COVID-19, respectively, with three cohorts of rehabilitation professionals. Outcomes were the willingness to adopt telerehabilitation evaluated using the extended Unified Theory of Acceptance and Use of Technology; willingness of technology use using the short scale for assessing the willingness of technology use; digital competencies and core affect using the Digital Competence Framework and semantic differential, respectively. Multivariate ordinal regression analysis was performed to determine predictors. Included were 603 rehabilitation professionals. Analysis revealed differences between Austria and Germany and before and during the pandemic for most outcomes. German residency, the pandemic, and a higher educational level were most important predictors of higher willingness to adopt telerehabilitation, willingness of technology use, digital competencies, and positive core affect. The pandemic increased most aspects of willingness to adopt telerehabilitation, willingness of technology use, digital competencies, and positive core affect. Results confirm that rehabilitation professionals with higher degrees are more prone to adopt innovations in healthcare.Registration: German Clinical Trials Register (DRKS00021464) The willingness to adopt telerehabilitation is associated with external factors increasing the need for alternative rehabilitation delivery, such as COVID-19, and with financial facilitators, such as reimbursement. As the willingness to adopt telerehabilitation is higher among speech and language therapists and dietitians, efforts are necessary to enhance its use in physiotherapists and occupational therapists. As a higher willingness to adopt telerehabilitation was observed in younger rehabilitation professionals and those with higher education, increasing the importance of telerehabilitation in education curricula and further knowledge transfer into practice for those already working in the field seems necessary. [ABSTRACT FROM AUTHOR]

There is little research comparatively assessing prevalence of pain between older people either with or without intellectual disability. This paper explores health and social factors associated with chronic pain in these two groups. A cross-sectional survey was undertaken in New South Wales and Queensland, Australia. Inclusion criteria were adults either with or without intellectual disability, aged 60 years and older, and currently living in community-settings. Univariate and multivariable analyses were undertaken on a sample of 391 adults with intellectual disability and 920 adults without intellectual disability. Key findings included higher prevalence of pain in the intellectual disability group, along with higher rates of osteoarthritis, falls, oral health problems, and mood disorders. Mitigating risk factors for conditions that cause chronic pain in older adults is crucial. As longevity increases, the healthcare sector needs to prioritise chronic pain management for people with intellectual disabilities through appropriate treatment strategies. [ABSTRACT FROM AUTHOR]

Little research has investigated professional identity in Australian clinical psychology postgraduate students. The current study examined potential predictors of professional identity for these students. Anonymous, self-report cross-sectional surveys for Australian postgraduate clinical psychology students were distributed via online survey links sent by their institution's Program Director. Respondents reported professional identity, motivation, engagement, satisfaction with program, resilience, burnout, demographics, and enrolment type. Data from 77 respondents were analysed. Students reported an average 4.25/5 for sense of professional identity as a psychologist. Age, work experience, and stage of program were not associated with professional identity. In multivariate analyses, higher student satisfaction, lower burnout, and lower engagement with "student" aspects of postgraduate study were associated with stronger professional identity. Levels of professional identity were relatively high and showed little influence of demographic variables. However, there is likely to be a reciprocal relationship between satisfaction with postgraduate study and professional identity for students, which would need to be evaluated in a different design to understand directions of association. Results also suggest that supporting postgraduate students in self-care and helping students to balance professional responsibilities and academic aspects of study are likely to assist in fostering postgraduates' professional identity. What is already known about this topic: Professional identity provides a sense of self in relation to membership of a specific profession. Students in health and social services professions, including psychology, have demonstrated emerging professional identities in their areas of study. In working professionals, professional identity has been found to be important for wellbeing and for relationships with colleagues and clients. What this paper adds: Professional identity amongst a sample of Australian postgraduate students in clinical psychology was independent of demographic variables such as age, gender, and previous work experience. Stronger professional identity in the current sample correlated with higher satisfaction with the program of study and lower level of burnout. In multivariate analysis, higher satisfaction with the program of study, lower burnout, and lower engagement with "academic" aspects of the program each independently predicted higher level of professional identity. From these cross-sectional findings, potential causal associations between predictors and professional identity remain to be clarified. [ABSTRACT FROM AUTHOR]

Many countries, including Australia, have laws that enable criminal prosecution of an individual based on reckless or intentional transmission of HIV to another person. Previous research has suggested that criminalisation of HIV may serve to hamper public health efforts by inhibiting HIV status disclosure or testing. Limited research to date has sought to examine the broader impact of criminalisation on the health and wellbeing of people living with HIV, which this paper aims to address. Drawing on cross-sectional data from 895 people living with HIV in Australia, this paper describes associations between standard measures of mental health and resilience with a newly devised scale measuring anxiety about HIV criminalisation. Findings suggest that laws criminalising HIV transmission have a broadly negative impact on wellbeing of people living with HIV, a situation that is exacerbated for gay and bisexual men, and other people living with HIV who may face intersecting forms of marginalisation based on race, gender or class. There is little justification for these laws being applied in Australia and the findings add weight to advocacy seeking to overturn criminalisation across the world. [ABSTRACT FROM AUTHOR]

This paper explores the decision-making processes involved in giving physiotherapy students responsibility on clinical placement and the impact on their developing professional autonomy. The qualitative study, using semi-structured interviews, involved physiotherapy students and clinical educators (CEs) from two higher education institutions, one in Australia, and the other in the United Kingdom (UK). Findings led to the development of a heuristic framework of 'graduated supervision,' a process of progressively less direct observation and monitoring of students as clinical proficiency improved. By focusing on the measured exposure of students to increasing complexity and inverse levels of supervision, the framework captures tacit practices, and consistent, yet varied facilitation strategies adopted across specialties, and evident in clinical education settings in both countries. The framework formalizes, for the first time, assumptions and expectations previously unacknowledged. Factors identified as affecting students' progress toward autonomy include the student/CE relationship, the development of mutual trust through ongoing dialogue, and the importance of formal discussions at the commencement of a clinical placement to establish learning goals, preferred supervision styles and learner responsibilities. Insights have significance for the CE community, and students who at times have to second-guess what is required of them and how they might excel on clinical placement. [ABSTRACT FROM AUTHOR]

The landscape of cancer is changing, with earlier detection and the emergence of new treatment options signalling the potential reconfiguration of cancer (for some) as a chronic condition. Cancer is increasingly experienced in terms of chronicity, incorporating both ongoing episodes of acute treatment alongside the long-term management of disease, symptoms, and side effects. This emphasis refocuses attention toward living-with, as well as beyond, cancer. Yet, how cancer chronicity is understood and experienced by both patients and healthcare professionals remains underexplored. While sociological scholarship has critically analysed how chronic illness has been positioned as a problem of/for the person and/or the healthcare system, less attention has been paid to instances like cancer, where chronicity might be viewed as reflective of forms of success (e.g. through the deferral of mortality even in the absence of 'cure'). In this paper we draw on qualitative interview data from a large study of cancer survivorship including patients, their family carers and health professionals, across two Australian hospitals. We critically analyse the dimensions of chronicity in the cancer sphere, understanding cancer-as-chronicity as producing a particular form of subjectivity, shaped by the everyday management and experience of treatment, impairment, symptoms, and side-effects. We posit that constructions of cancer as chronic, and associated imperatives linked to longevity, commitment, and resilience, are placing new demands on patients, family carers, and professionals alike. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has caused significant disruption. This has been particularly evident within the university student population where their traditional ways of learning were abruptly reorganised and support structures removed. Objective: This paper aims to explore undergraduate student nurses' perceptions of the support required from the university during COVID-19 using the Achievement Goal Theory framework. Design: Data were collected via an online survey of undergraduate student nurses from an Australian university. This paper is reporting the data from a single open-ended item asking participants about their support needs from the University. Data were analysed using thematic analysis. Results: Of the 178 students who responded 206 individual statements were provided about the support they would like from the university. Four primary themes emerged, Support beyond academia, Academic support, Online learning readiness and Clinical practice units and clinical placement. The students identified that their needs during this pandemic include financial needs, social isolation, needs for more communication and unpreparedness for online teaching. Conclusion: Several factors were identified by participants about the additional support required from the university during COVID-19. Understanding and addressing these factors have the potential to improve student support during COVID-19 and support students in future crises. Impact statement: Understanding what support students perceive they require from the university during significant disruption will assist in future crisis management planning. [ABSTRACT FROM AUTHOR]

Objective: There is a paucity of quantitative measures of resilience specifically validated for young Aboriginal people in Australia. We undertook the first investigation of validity and reliability of the Connor-Davidson Resilience Scale (CD-RISC) in a sample of Australian Aboriginal people, with a focus on youth. Method: We conducted a cross-sectional study of resilience among a sample of 122 Aboriginal youth (15–25 years old) in New South Wales and Western Australia, featuring self-completes of the 10-item CD-RISC in online (N = 22) and face-to-face (N = 100) settings. A Rasch analysis using the 122 CD-RISC responses determined item independence, response category adequacy, differential item functioning, unidimensional measurement, person and item reliability, and item fit. Confirmatory factor analysis was also conducted, complementary to the Rasch analysis. Results: Four problematic items from the original instrument were removed, due to item dependence (items 2, 6 and 9; Q3,* > 0.30) and differential item functioning (item 4; > 0.43 logits between males and females). The final 6-item instrument exhibited improved item separation (ISI = 2.14) and reliability index values (IRI =.82) – suggesting an improved structure – however several limitations such as a prominent ceiling effect were evident (i.e., positive measure targeting coefficient of 0.99 logits). Conclusion: Findings suggest the CD-RISC instrument should be applied in Aboriginal contexts with caution. Further psychometric examination of the CD-RISC with Aboriginal youth is warranted before it can be used with confidence by researchers and clinicians. KEY POINTS What is already known about this topic: Resilience is generally thought of as positive outcomes despite exposure to risk. This can be a particularly important concept to consider in the period of youth and adolescence, when young people are experiencing wide ranging physical, emotional, and social changes and challenges. Aboriginal youth face unique circumstances that are necessary to consider when considering resilience relevant to an Aboriginal perspective. There is currently a lack in the literature in regards to defining and conceptualising resilience from an Aboriginal perspective, particularly relevant to young people. There is a dearth of instruments available that have been rigorously examined for their appropriateness and psychometric properties relating to resilience in Aboriginal youth. What this paper adds: This paper provides not only a first investigation of this version of the CD-RISC using Rasch analysis, but also the first time the CD-RISC's validity and reliability has been assessed for an Aboriginal sample in Australia. Analyses results illustrated a ceiling effect, highlighting the fact that for the instrument to be accessing the full range of resilience in the sample, new items need to be developed to tap into higher levels of resilience. With the findings of this paper as a foundation, further investigation and adaptation of the CD-RISC could potentially lead to a useful screening tool for assessing resilience and identifying Aboriginal youth who may require further support. [ABSTRACT FROM AUTHOR]

Objective: Family violence causes brain injury and trauma for many victim survivors. Neuropsychologists play a central role in helping with these issues. We aimed to evaluate rates of family violence training, knowledge and clinical skills in Australian neuropsychologists. Method: An online, brief, self-report survey of psychologists practicing clinically in the area of neuropsychology Australia wide. The survey assessed prior training, knowledge and confidence together with awareness of specific family violence clinical skills, and barriers to competent practice. Results: Responses were received from every state and territory and represented more than 10% of the total registered endorsed clinical neuropsychology workforce (N = 92). Over 90% of respondents had undertaken family violence training, however 57% reported having little or no knowledge and 67% little or no confidence working clinically in the area. Knowledge of specific family violence skills was reduced, with only 20% indicating that they knew how to respond, when clients disclosed experiencing family violence. Conclusions: Further work is needed to improve the ability of the Australian neuropsychology workforce to respond to this important health issue. Response of neuropsychologists may be sub-optimal, particularly in regard to the provision of psychological support following disclosures a central tenant of World Health Organization guidelines. KEY POINTS What is already known about this topic: Family violence is a significant public health issue in Australia. Family violence can cause both brain injuries and psychological trauma and attenuated cognitive functioning has been associated with both of these conditions. Clinical neuropsychologists commonly work with clients who experience cognitive attenuation. What this paper adds: This paper is the first, to our knowledge, to survey training, knowledge, confidence levels and specific family violence clinical skills in Australian neuropsychologists. Over 10% of the endorsed clinical neuropsychology Australian workforce participated in this self-report online survey. Results indicated that most had received some family violence training, however, self-rated knowledge, confidence and awareness of specific family violence skills were relatively low and further training and professional development in this area is required. [ABSTRACT FROM AUTHOR]

Background: The prevalence of dementia is increasing with more healthcare workers being required to care for people living with this progressive neurological disorder. The knowledge level and attitude of healthcare workers caring for those living with dementia need to be assessed and resources targeted effectively to ensure best quality care is provided. Healthcare workers for the purpose of this paper include anyone employed to care for those living with dementia. Aim: To investigate the attitudes of healthcare workers towards people living with dementia. Methods: A survey of 110 healthcare workers was undertaken between October 2016 and December 2017, using the Dementia Attitude Scale to measure attitudes towards people living with dementia. Demographic data were collected by a survey to explore whether a person's age; cultural background; qualification level; or experience level had an impact on their attitude towards people living with dementia. Results: The full survey was completed by n = 85 healthcare workers with the majority having strongly positive views about people living with dementia, with an average score of 88.31/100. However, a large number reported being afraid of people living with dementia (n = 76, 89.4%) and would avoid people with dementia who were agitated (n = 51, 61.4%). While 100% (n = 85) agreed or strongly agreed that it was possible to enjoy interacting with people living with dementia, they were more ambivalent with n = 26 (31.6%) strongly agreeing with the statement that working with people living with dementia is rewarding. A significant difference in attitude was found using one-way analysis of variance within groups due to age (p <.000) and cultural background (p <.035). Conclusions: Healthcare workers within this study had mainly positive attitudes towards people with dementia as demonstrated by the high attitude scores. However, this paper has shown that healthcare workers may require further education to improve attitude and care towards those living with dementia. [ABSTRACT FROM AUTHOR]

Current international targets aim for 90% of people diagnosed with HIV to be on antiretroviral treatment (ART). This paper aims to identify sociodemographic and attitudinal factors associated with ART non-use over time in three samples of Australian people living with HIV (PLHIV). Data for this paper were derived from an Australian cross-sectional survey of PLHIV that was repeated at three different time points: 1997, 2003, and 2012. There were approximately 1000 respondents to each survey (n = 3042 in total). The survey included approximately 250 items related broadly to health and well-being, ART use, and attitudes towards ART use. Univariate and multivariate logistic regression analyses were used. While the proportion of participants using ART increased between 1997 and 2012 (78.8–87.6%,p < .001), there was a decrease between 1997 and 2003 to 70.6% (p < .001). Factors linked to ART non-use remained steady over those 15 years. In all cohorts, people less likely to be using ART were younger and had a more recent diagnosis of HIV. In 2003 and 2012, people in full-time employment were less likely to be using ART, while those whose main source of income was a pension or social security were more likely to be using ART. Multivariate models showed that, at each time point, a belief in the health benefits of delayed ART uptake was associated with non-use. These findings suggest that there may be barriers to ART uptake that have persisted over time despite changes to clinical guidelines that now encourage early uptake. [ABSTRACT FROM PUBLISHER]

Patients with mental health conditions commonly present in General Practice. Mental health curricula are broad. We do not know that trainees are exposed to the learning they require. This study aimed to establish the prevalence, characteristics and associations of GP trainees' management of mental health problems. This paper presents a cross-sectional analysis of the Registrar Clinical Encounters in Training (ReCEnT) study, an ongoing multisite cohort study of Australian GP trainees (registrars) documenting their clinical experiences over 60 consecutive consultations. Univariate and multivariable logistic regression analyses were conducted with outcome of the problem/diagnosis being a mental health condition. 1659 trainees provided data on 218,325 consultations and 340,453 problems/diagnoses. Mental health conditions were associated with patients being male, of Aboriginal or Torres Strait Islander or English-speaking background. Trainee characteristics were being more senior and having trained in Australia. Practice characteristics included being in low socioeconomic areas. Trainees sought less help for mental health concerns than they did for other problems. While early-career GPs see a broad range of mental health conditions, they may benefit from training to manage patients from cross-cultural contexts. They may also need support to generate appropriate learning goals and seek assistance if they are to continue to deepen competence. [ABSTRACT FROM AUTHOR]

In respect of professional nursing, the term scope of practice is regularly used, yet is often poorly defined both in Australia and internationally. This study explores the determinants of scope of practice from a national sample of Australian registered nurses using an online survey (Scope-QAu). This paper reports on two parts of a large cross-sectional survey wherein 1231 registered nurses in Australia provided data on how they determined their scope of practice. Scope of practice in the Australian nursing context is influenced by a range of professional publications, guidelines and standards, as well as professional peers and one's own judgement. Findings reveal that few demographic characteristics predicted the way nurses determined their own scope of practice. Nurses commonly relied upon three professional publications, peers and line managers, to establish their individual scope of practice. Impact statement: Registered nurses do not rely solely on professional guidelines or regulatory frameworks when determining their scope of practice. [ABSTRACT FROM AUTHOR]

As the population ages, so does the number of older patients encountered by paramedics. It is vital that paramedics are adequately prepared to meet the unique and growing needs of these patients. Experience and education play key roles in the formation of attitudes that impact behavior, and ultimately patient care. The aim of this study was to determine the level of student paramedic experience with knowledge of, and attitudes toward, older adults and to examine the relationship between these factors. This was a cross-sectional study utilizing three paper-based questionnaires; Experience with Older Adults Questionnaire, Australian Facts on Aging Quiz 2 (FAQ2), and Aging Semantic Differential (ASD). Of the 871 paramedic student participants, 79% had an oldest living grandparent 65 years old or above, and 63% had encountered older adults on clinical placement. The mean (SD) score for the FAQ2 was 12.7 (3.0) out of a possible 25, indicating a low level of knowledge about older people. The mean (SD) score for the ASD was 120.3 (17.77), indicating slightly positive attitudes toward older adults. Knowledge (β = −0.06;p = .058) and experience (β = −0.06;p = .058) had weak associations with attitudes. Student paramedics have some prior experience with older adults, relatively low knowledge and generally positive attitudes. There is some association between these factors; however, the impact on patient care requires further investigation. Paramedic educators should strive to provide students with broad quality experiences and education that increases awareness and understanding of older people. [ABSTRACT FROM AUTHOR]

Objective:This paper presents a summary of otoacoustic emission (OAE) data collected as part of an Australian hearing health survey (Carter, 2011; Williams et al, 2014) designed to: (1) examine the relationship between audiological indicators and participant characteristics, and (2) extract audiological data suitable for reference use.Design:Cross-sectional cohort study. Distortion product (DP) OAE and transient evoked (TE) OAE measures.Study sample:Age range 11–35 years;N =1386 participants (2672 test ears).Results:Descriptive statistics for amplitude and signal-to-noise ratio (SNR) were calculated for 327 participants (589 test ears; age 13 to 32 years). DPOAE amplitudes down to the 25th percentile were > 0 dB SPL for test frequencies up to 6 kHz. TEOAE SNRs down to the 25th percentile were > 6 dB SPL up to 4 kHz.Summary:This dataset can be used as a clinical reference for similar populations, providing that the same test parameters are used.Conclusions:The clinical significance of OAE testing would be greater if agreed criteria were available. These data could be pooled with other datasets to build a substantial OAE database, similar to the existing international standards for pure-tone hearing threshold levels (HTLs) (ISO, 2000). [ABSTRACT FROM PUBLISHER]

People with serious mental illness (SMI) have increased risk of cardiovascular disease and premature death, yet research on nurse-provided health promotion in mental health services remains under-developed. This paper informs efforts to improve the nursing role in physical health of consumers with SMI by establishing what nurse perceptions and background influence their care. Members of the Australian College of Mental Health Nursing were invited to participate in an online survey on their views on physical health care in mental health services. Survey questions included: (a) nurse-consumer collaboration in preventative care and (b) sub-sections of the Robson and Haddad Physical Health Attitude Scale to measure nurse perceived barriers to encouraging lifestyle change of consumers with SMI and frequency of nurse physical healthcare practices. Structural equation modelling was applied to investigate antecedents to physical health care, as well as relationships between antecedents. A national sample of 643 nurses reported regular engagement in health promotion (e.g. advice on diet). There was statistical support for a model depicting perceived consumer-nurse collaboration as a dual-determinant of nurse perceived barriers and self-reported health promotion to consumers with SMI. Perceived barriers to consumer lifestyle change did not predict health promotion. The effects of nurse-consumer collaboration were significant, but small. Perceived consumer-nurse collaboration in preventative care may positively influence the amount of health promotion by nurses in mental health. Perceived barriers to consumer adherence with a healthy lifestyle did not have an impact on nurse-delivered health promotion. [ABSTRACT FROM AUTHOR]

Background: Alcohol disproportionately affects socially disadvantaged groups including Aboriginal and Torres Strait Islander Australians. Methods to assess alcohol intake for disadvantaged communities need to be able to capture variable or episodic drinking. The ability of a seven-day diary to capture typical consumption for a predominantly Aboriginal sample has not been assessed. Objective: One aim of this paper was to examine agreement between a seven-day retrospective diary and 'usual' drinking assessed by a modified version of the Alcohol Use Disorders Identification Test question 3 (AUDIT-3m; two questions). Other aims were to describe drinking patterns as reported in the seven-day diary. Method: In 2012, consecutive adults attending an Aboriginal Community Controlled Health Service completed a cross-sectional health risk survey on a touch screen laptop ( n = 188). Alcohol consumption questions included the retrospective diary and AUDIT-3m. Agreement was assessed using weighted kappa analysis. Results: There was good agreement between the two measures of consumption; however, the AUDIT-3m questions identified more current drinkers. Respondents who were drinkers (54%) tended to consume large amounts per drinking occasion: almost half (46%) of diary completers reported nine or more standard drinks on at least one occasion in the last week. Conclusions: The seven-day diary did not adequately capture variability in alcohol consumption common among this sample. Although the AUDIT-3m appeared acceptable, alternative approaches to assess usual or risky alcohol consumption, such as asking about specific drinking occasions, or allowing participants to respond in non-standard drink sizes, also need to be considered for indigenous and other disadvantaged communities. [ABSTRACT FROM AUTHOR]

People with serious mental illness experience premature death due to higher rates of cardiometabolic conditions (e.g. cardiovascular disease, diabetes) than the general population. Mental health services often do not provide sufficient cardiometabolic clinical care to address these risks. The cardiometabolic health nurse (CHN) role has been suggested as a strategy for ensuring integrated care is provided and sustained. The views of nurses in mental health would be essential in informing the viability and development for this initiative. This paper presents the findings of open-ended comments from a cross-sectional online survey of nurses working in mental health in Australia ( n  =  643) eliciting views about the possible introduction of the cardiometabolic nurse. Thematic analysis was undertaken, of 133 open comments on this topic. The findings suggest that nurses see the specialist role as suitable and valuable for mental health services. Some nurses voiced concern about specialisation leading to fragmentation (e.g. in responsibilities for physical health, division of mental and physical health care, and less emphasis on equipping all nurses with comprehensive care skills), especially for settings where generalist nursing was seen as already available. The findings suggest this role is viewed favourably by nurses, provided that it is consistent with holistic and comprehensive care. Empirical research is needed to see whether this role increases holism (as valued by consumers and nurses) and cardiometabolic outcomes. [ABSTRACT FROM AUTHOR]