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Background: Incarcerated trans women experience significant victimization, mistreatment, barriers to gender-affirming care, and human rights violations, conferring high risk for trauma, psychological distress, self-harm, and suicide. Across the globe, most carceral settings are segregated by sex assigned at birth and governed by housing policies that restrict gender expression—elevating ‘safety and security’ above the housing preferences of incarcerated people. Aim/methods: Drawing upon the lived experiences of 24 formerly incarcerated trans women in Australia and the United States and employing Elizabeth Freeman’s notion of chrononormativity, Rae Rosenberg’s concept of heteronormative time, and Kadji Amin’s use of queer temporality, this paper explores trans women’s carceral housing preferences and contextual experiences, including how housing preferences challenge governing chrononormative and reformist carceral housing systems. Findings: Participants freely discussed their perspectives regarding housing options which through thematic analysis generated four options for housing: 1) men’s carceral settings; 2) women’s carceral settings; 3) trans- and gay-specific housing blocks; and 4) being housed in protective custody or other settings. There appeared to be a relationship between the number of times the person had been incarcerated, the duration of their incarceration, and where they preferred to be housed. Conclusions: This analysis contributes to richer understandings regarding trans women’s experiences while incarcerated. This paper also informs the complexities and nuances surrounding housing preferences from the perspectives of trans women themselves and considers possible opportunities to enhance human rights, health and wellbeing when engaging in transformative approaches to incarceration. [ABSTRACT FROM AUTHOR]

The Covid-19 pandemic led to different ways of working for social work and human service practitioners across the globe. This paper examines the use of technology by practitioners during nationwide stay at home orders due to COVID19. This study consisted of interviews with fifteen social work and human services practitioners in Southeast Queensland, Australia. While technology is frequently used in practice, the challenges and benefits of using technology as a primary practice method whilst working from home are discussed in this paper. The findings of this study suggest that the use of technology whilst working from home may be a viable option for future practice in well-resourced organizations with technologically proficient practitioners. However, for practitioners and clients without limited access to technology or reduced digital capabilities, such arrangements risk becoming discriminatory. Considerations therefore must be made in ensuring access to technology and the appropriateness of working from home for some social work and human services practitioners. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the process of implementing an evidence-based goal-setting package into five rehabilitation services across the continuum of rehabilitation. This study used a mixed methods approach guided by Medical Research Council (MRC) recommendations for conducting process evaluations, the RE-AIM framework, and the Theoretical Domains Framework (TDF). This study will evaluate the reach, adoption, implementation, and maintenance of the goal-setting package over six months. Environmental context and resources, the clinician's social and professional role and identity, social influences and clinician beliefs about goal-setting consequences and individuals' capabilities were all identified as barriers or enablers throughout the implementation process. Community rehabilitation services faced challenges implementing paper-based resources, whilst inpatient rehabilitation sites faced challenges engaging nursing staff in the interdisciplinary approach to goal-setting. Social influences were an enabler in two sites that used the case conference format to facilitate setting common goals. Clinicians in all sites continued to express difficulties implementing shared decision-making with people who had cognitive impairments or were no longer progressing in their rehabilitation. A team-based approach to implementing the goal-setting interventions centred around the case conference format appeared to be the most successful mode for implementing interdisciplinary person-centred goal-setting. The rehabilitation case conference forum can be used to facilitate teams to set interdisciplinary common goals. Rehabilitation teams should add further consideration to how they can involve clients as a member of the rehabilitation team throughout the rehabilitation process. Embedding changes into existing process and using structured templates and tools can enhance the process of goal-setting in rehabilitation. Strong leadership, dedicated facilitation, audit and feedback can enhance team's success in implementing elements of the goal-setting implementation package. [ABSTRACT FROM AUTHOR]

Sharing personal teaching stories provides opportunities for enhanced wellbeing and learning for both experienced and pre-service teachers. This paper shares the results of a qualitative pilot study that used narrative inquiry to collect and share teacher stories. The research was conducted in two phases. The first phase collected humorous stories from experienced teachers recalled from the first years of their teaching career. Thematic data analysis investigated the wellbeing and learning impact on those teachers when sharing their stories. The second phase invited pre-service teachers to read and evaluate the impact of humorous stories when preparing for their first school placements. Thematic data analysis investigated the wellbeing and learning impact on pre-service teachers reading these stories. The analysis from both phases demonstrated recurring themes regarding the importance of teacher-student relationships for teacher wellbeing. The results also showed that the sharing and reading of stories had beneficial outcomes such as enhanced wellbeing and enhanced learning for both the teacher storytellers and the pre-service teacher readers. This study provides evidence that the inclusion of real-life stories offers a valuable addition to Initial Teacher Education programs as a way of developing professional and reflective practice. [ABSTRACT FROM AUTHOR]

Primary school educators in Australia are often uncertain about parents' perspectives when it comes to teaching about relationships and sexuality education in schools. Teachers, school leaders, parents and the broader community continue to struggle with the best way to educate children about the many topics that fall under the banner of relationships and sexuality education. This paper explores the perspectives of primary school parents in Queensland, Australia adding to the growing body of research in internationally about parents' perspectives on relationships and sexuality education in primary schools. [ABSTRACT FROM AUTHOR]

Background:Through an account of prevailing experiences of art and mental illness, this paper aims to raise awareness, open dialogue and create agency about art created by people with experience of mental illness.Methods:This paper draws on personal narrative and inquiry by an artist with mental illness and data collected as part of a larger participatory action research project that investigated understandings of identity, art and mental illness.Result:An inquiry through art raised awareness and attentiveness to the importance of choice in identity construction and exposed frequent dichotomies in art and mental illness that were negotiated to eschew prescribed social stratification. As an artist, the first author challenged values present in one idea and absent in the other, and the options and concessions available to authorise her own dialogue and agency of being an artist.Conclusion:Constructing an identity is an important part of being human, the labels that we choose or are chosen for us attribute to our identity. Reflections and recommendations are offered to consider expanded ways of thinking about art and mental illness and the functions that art play in identity construction. [ABSTRACT FROM PUBLISHER]

There has been much talk in sociological circles of bodies as 'projects' or 'choices,' but surprisingly little examination of how these projects and choices are experienced. Consumer culture has been described as heralding a new era in body-self relations, but few have explored the experience of body-self relations. Body-self relations emerged as central to understanding in this study of the experience of the body at different ages (20-30, 45-55 and 70+ years), demonstrating the utility of empirical investigations in this area. This paper describes an orientation to the body that was common to the sample of 20 young people (aged 20-30 years) interviewed as part of this study. This orientation informed their health-related behaviours such as diet and exercise, but some participants found it to be problematic. Their voices demonstrate that bodily 'choices' may actually be experienced as irrational and even psychopathological compulsions. This experiential perspective suggests that normality may be continuous with pathology, and that differences are of degree rather than kind. The findings have implications for the treatment and prevention of eating disorders and obesity. [ABSTRACT FROM AUTHOR]

In July 2006, “welfare-to-work” policies were introduced for single parents in Australia. These policies require most single parents with school-aged children to be employed or seeking employment of 15 to 25 hours per week in return for their income support payment. The changes represented a sharp increase in the obligations applying to single parents on income support. This paper is concerned with how the wellbeing of single mothers who are combining income support and paid employment is being influenced by these stepped-up activity requirements. The paper draws on data from semistructured interviews with 21 Brisbane single mothers. The analysis explores participants’ experiences in the new policy environment, utilising the theoretical framework of “relational autonomy”. Relational approaches to autonomy emphasise the importance of relations of dependency and interdependency to the development of autonomy and wellbeing in contrast with more individualistic approaches that privilege independence and self-sufficiency. Findings indicate that in their dealings with the welfare bureaucracy, participants experienced a lack of recognition of their identities as mothers, paid workers, and competent decision makers. These experiences have negative consequences for self-worth, relational autonomy, and ultimately the wellbeing of single parent families. [ABSTRACT FROM PUBLISHER]

Measuring the impact of care delivered at home for frail older people is a complex task given many confounding variables that may impact on the ability of service providers to identify the direct impact of their programs on their clients' well-being and quality of life. The recent publication of the 2018 Wellness and Reablement Report Outcomes indicated that organizations lack formal processes to measure the impact of their programs on service users. There are therefore limited data exits on measuring outcomes and the performance of the ACCOM tool in the real world. Knowledge of a strong causal relationship between services provided and outcomes enables confidence in assuming the care provided was largely responsible for the outcome achieved. This paper will reflect on the experiences of one service provider in Brisbane, in implementing the Australian Community Care Outcomes Measurement (ACCOM) tool to measure and demonstrate the impact of their programs. [ABSTRACT FROM AUTHOR]

This paper presents the findings of a study that interviewed Aboriginal nurses to explore their experiences of the whiteness of nursing. Despite concerted efforts to improve the health of Aboriginal Australians, it still remains equivalent to third world countries. One strategy identified to address this is to increase the participation rates of Aboriginal registered nurses within the Australian healthcare workforce. Presently Aboriginal nurses account for only a small percentage of the nursing workforce. While there has been research into the recruitment and retention strategies dedicated to improving the numbers of Aboriginal registered nurses, this paper focus on the experiences of Aboriginal registered nurses within Australia's mainstream healthcare system, where they are exposed and subjected on a daily basis to the 'whiteness of nursing.' [ABSTRACT FROM AUTHOR]

There is an ongoing global shortage of mental health nurses. Within Australia, the principal strategy of offering a postgraduate education programme with various incentives to encourage nurses back to study has not been successful. This has led to the consideration of radical alternatives, including the return to pre-registration specialisation in mental health. The successful introduction of this strategy would require the full support of industry partners. To date, the voice of industry has not been heard in relation to this issue. The aim of this paper is to present the views of an Australian sample of mental health nursing directors regarding the resources and other factors required, should undergraduate specialist programmes in mental health be developed, to ensure they are relevant and likely to be successful. A qualitative exploratory research project was undertaken to explore the perspectives and opinions of industry partners. In-depth interviews were conducted with nursing directors ( n = 12) in Queensland Australia. Five main themes were identified: relationships with universities; clinical placement preparation and support; workplace culture; facilitators and preceptors; and practical student learning. Genuine collaboration between the two organisations was considered crucial for delivering a quality programme and providing the required support for students. Transformative leadership could inform this collaboration by promoting acknowledgement of and respect for differences. [ABSTRACT FROM AUTHOR]

This paper explores the feasibility of a brief Mindfulness with Metta Training Program (MMTP), targeting the enhancement of mindfulness and self-compassion in a retreat format, as a means of increasing resilience in human services professionals. In this randomised control trial, 44 human services professionals were randomly allocated either to a MMTP retreat group or to a control group. Following the MMTP intervention, no significant differences between the retreat and control groups were found on resilience, mindfulness and self-compassion variables. However, significant improvements were observed over time for the retreat group for mindfulness and self-compassion at one and four months and for resilience at four-months post MMTP intervention. The results of this pilot study show that MMTP in a retreat format is a promising method of increasing resilience, mindfulness and self-compassion in human services professionals. [ABSTRACT FROM AUTHOR]

Our understanding of the qualities and value of clinical supervision is based on uniprofessional clinical education models. There is little research regarding the role and qualities needed in the supervisor role for supporting interprofessional placements. This paper reports the views and perceptions of medical and allied heath students and supervisors on the characteristics of clinical supervision in an interprofessional, international context. A qualitative case study was used involving semi-structured interviews of eight health professional students and four clinical supervisors before and after an interprofessional, international clinical placement. Our findings suggest that supervision from educators whose profession differs from that of the students can be a beneficial and rewarding experience leading to the use of alternative learning strategies. Although all participants valued interprofessional supervision, there was agreement that profession-specific supervision was required throughout the placement. Further research is required to understand this view as interprofessional education aims to prepare graduates for collaborative practice where they may work in teams supervised by staff whose profession may differ from their own. [ABSTRACT FROM AUTHOR]

Education is state-run in Australia, and within each of the eight states and territories there are both government and independent schooling systems. This paper details the position of gay, lesbian, bisexual, transgender, intersex and queer (GLBTIQ) students within Australian education policy documents nationally, focusing on the three largest states and educational sectors in Australia. Survey data are used to report on the schooling experiences of over 3000 Australian GLBTIQ young people aged 14–21 years. Data from interviews with key policy informants identify both the obstacles to implementing policies, and how such obstacles have been overcome. Much official policy sees sexuality education as promoting inclusive, protective and affirming messages around GLBTIQ students. There exist significant correlations between policy and a variety of well-being and psycho-social outcomes for GLBTIQ students, including lowered incidence of homophobic abuse and suicide, and the creation of supportive school environments. Ideal policy visions are outlined, along with practical recommendations of relevance to a variety of stakeholders. [ABSTRACT FROM PUBLISHER]

This paper presents a sub-set of findings from the first interview (T1) of an Australian longitudinal study that documents the living donor's experience with renal transplant. There has been limited Australian research on this topic to date. A qualitative methodological approach was used, involving open-ended interviews with prospective living kidney donors (n = 20) from the Renal Transplantation Unit at the Princess Alexandra Hospital in Brisbane, Queensland, Australia. The interviews were analysed using qualitative research methods of coding and thematic analysis. A significant majority of participants reported that the decision to become a living kidney donor was a positive, easy and spontaneous decision. It was driven by their natural instincts and they offered to be a donor at the earlier opportunity, rather than waiting to be asked. The offer was based on their desire to relieve the recipient's suffering and possible death associated with dialysis and kidney failure. While concerns associated with the medical operation for donation (nephrectomy) were a consideration, this was significantly overshadowed by their desire to improve the recipient's quality of life and avoid their possible death. In the face of such suffering and death, the donation of a kidney was considered ‘no big deal’. Such findings can be used to inform the assessment process for live donor screening. [ABSTRACT FROM PUBLISHER]

This paper examines commercial gambling by Indigenous Australians in three regions of north Queensland. Semi-structured interviews conducted with 60 Indigenous Australians revealed numerous themes that influence Indigenous gambling activities. Themes were synthesized into a conceptual model for understanding Indigenous commercial gambling by developing several gambler profiles. These profiles were analysed as being positioned along a public health continuum model of gambling, from healthy to unhealthy commercial gambling. The four emerging profiles were labelled social, binge, exploited and committed gambler, respectively. The continuum model explains gambler profiles, including behaviours, motivations and outcomes as moving from healthy gambling in low-risk situations to unhealthy gambling in high-risk situations. The model contributes to a deeper understanding of influences involved in controlling or stimulating gambling by Indigenous gamblers in these regions. [ABSTRACT FROM AUTHOR]

Children placed in out-of-home care are a particularly disadvantaged group in society, who have often been exposed to trauma and socioeconomic disadvantage. As a result, they experience poorer health outcomes than children in the general population, especially mental health outcomes. One health outcome that has yet to be researched thoroughly is overweight and obesity of children placed in out-of-home care. Hence, the overall goal of this paper was to review the extant literature over the last decade on weight-related issues for children in out-of-home care, with particular emphasis on overweight and obesity. The findings of the review revealed that there is a lack of rigorous Australian research in relation to prevalence rates of overweight and obesity in children in out-of-home care; there is a lack of strategies or interventions designed specifically to combat overweight and obesity in children in out-of-home care; and one of the major limitations of Australian research to date is the use of self-report measures to assess the weight status of children in out-of-home care. It was concluded that prevention and intervention strategies are needed that target children as they enter out-of-home care. [ABSTRACT FROM PUBLISHER]

Aims and objectives: This paper reports a study aimed at exploring the nursing practices associated with the administration of pro re nata (PRN) postoperative analgesia to children, and at gaining a preliminary understanding of the decisions that nurses make about this important intervention. Background: Nurses are responsible for assessing and administering the appropriate medication at the appropriate time to the child in pain. There was scant published research about the administration of postoperative PRN analgesia to children, or about the decision-making processes inherent in this aspect of clinical nursing care. Design: A sequential mixed methods explanatory study with two data collection phases -- quantitative followed by qualitative -- was conducted. Results: Nurses used multiple strategies to ascertain children's need for postoperative PRN analgesia, including reference to pain assessment tools, focussing on the behavioural cues of children, involving parents and children, and drawing upon personal and professional backgrounds and experience. Evaluation of the effectiveness of PRN postoperative analgesia was poorly communicated. Conclusions: Decision-making associated with the selection and administration of appropriate analgesia to children is complex. In-service education should be developed and offered to nurses working with children postoperatively to ensure the appropriate use of PRN pain relief. Relevance to clinical practice: Documentation surrounding this task is poor and needs to be addressed as a matter of urgency to ensure quality patient outcomes. [ABSTRACT FROM AUTHOR]

Nurses represent the largest occupational group of health care professionals in Australia. The ratio of nurses to population is relatively consistent, unlike other health care professional groups (including medical doctors and allied health staff) whose numbers decline as population density and distance from metropolitan areas increases. Nurses working in areas where other health care professionals are limited or absent have expanded scopes of practice with their work being more generalist than specialist. The role of nurses in remote and isolated areas of Queensland, Australia was the focus of a commissioned multi-case research project. Findings reported in this paper relate to the position of registered nurses as part of an interprofessional team. These findings indicated that, in some instances, local health care teams were limited to a single nurse and Indigenous health care worker/s, while in others the teams were more diverse. In all cases collegial support was available either locally or via telecommunication technology. Understanding the role of each team member, having useful strategies to enhance communication and work collaboratively were identified as essential criteria for “good practice”. [ABSTRACT FROM AUTHOR]

Remote-living and Indigenous Australians can experience menstrual health and hygiene challenges. The topic is not often openly discussed as it is considered private 'women's business'. We were invited into a remote Indigenous town and community to discuss the lived experience of menstruation with female students as well as clinical, educational and community workers. Our yarning circles and interviews collated 16 barriers in four clusters: structural living situation; knowledge, culture and behavior; discomfort and public life; and finances. Targeted efforts by relevant organizations, including schools and government agencies, were identified by participants to better support menstrual health and hygiene without associated pain, ranging moods and a sense of shame. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) has a detrimental impact on women and children's emotional, physical and social well-being and has been identified as one of the most common contributors to women's experiences of housing instabilities and homelessness. Women affected by IPV often experience a great level of uncertainty around housing solutions when trying to leave an abusive partner. This study explores women's responses to IPV and the related risk of homelessness through women's narratives (n= 22) in Queensland, Australia. Of particular interest are women's decisions and actions to minimise the impact of IPV as well as homelessness on their and their children's safety and well-being. Findings reveal that women's agency in relation to harm minimisation can take various forms, including the decision to stay with, leave or return to an abusive partner. The data offer insights into women's strategic attempts to manage IPV and the related risk of homeless while trying to minimise the harm associated with one and the other. Implications for understanding women's agency in managing IPV and the related risk of homelessness and providing adequate support mechanisms to improve women and children's social, emotional and physical well-being are discussed. [ABSTRACT FROM AUTHOR]

A rights perspective proposes supported decision-making as an alternative to substitute decision-making. However, evidence about supported decision-making practice is limited. Our aim was to build evidence about building the capacity of decision supporters. Eighteen parents of people with intellectual disabilities were trained in decision support using the La Trobe Support for Decision-making Practice Framework. Data from repeated semi-structured interviews and mentoring sessions were used to capture parental reflections on the value of training. The training acted as a catalyst for parent self-reflection and the Framework prompted them to adopt a more deliberative approach to supporting decision-making. Some parents perceived increased confidence of their adult offspring in expressing preferences resulting from their own changed approach. This study demonstrates the efficacy of this Framework and evidence-based training in building the capacity of parental decision supporters to be consistent with the rights paradigm. The La Trobe Support for Decision-making Practice Framework is an evidence-based approach to decision support practice with an accompanying set of free online resources which can be used by individual practitioners or programs to inform their practice and build the capacity of supporters. Parents of adults with intellectual disabilities value training in the La Trobe Support for Decision-making Practice Framework, which they consider helps to develop their decision support skills and self-reflection. Parents also value individual mentoring following training to assist them to apply the principles of the practice framework to the everyday support for decision-making they provide to their adult son or daughter. Training in support practice should be accompanied by individual mentoring or other strategies to assist parents of adults with intellectual disabilities to discuss and solve the difficult issues they confront in providing decision support more aligned to the rights paradigm. [ABSTRACT FROM AUTHOR]

A number of innovative models of student practice placements are emerging due to pressures on universities to provide quality practice placements and on health services to deliver rehabilitation efficiently, safely and cost-effectively. The student-resourced service delivery (SRSD) group program is one such model in occupational therapy. There is a paucity of research evidence to guide services in planning, implementing and evaluating the SRSD model. The study aimed to explore and identify the factors that key stakeholders perceived as contributing to the successful development and implementation of the occupational therapy student-resourced service delivery group programs. Participants in this multi-site study were rehabilitation inpatients, clinicians, Clinical Education Liaison Managers and students completing practice placement in the student-resourced service delivery group program. Data were collected using face-to-face semi-structured interviews and focus groups. A total of 83 participants consented to the study. Four themes emerged from the data. Planning needs to be an iterative process that commences before and continues during the program. Support processes need to be established for students and clinicians during and across placements. The creation of an engaging, client-relevant and graded group dynamic is critical for success. Establishing a culture whereby groups are valued by the clients, therapy and multidisciplinary teams is important. The above-mentioned factors were perceived as contributing to successful operationalisation of a student-resourced service delivery group program, and may be helpful when developing student-resourced service delivery professional practice placements in other settings. Student-resourced service delivery of groups are one way to achieve additional professional practice placements for students and delivery of therapy services for patients. Ongoing investment for planning and preparation, provision of continual support for students, a culture of valuing groups and students, and creating a group dynamic that engages group participants were perceived by stakeholders as key ingredients for successful implementation of the student-resourced service delivery group model. Clinicians and educators are encouraged to use the perceived success factors identified in this study as a resource for future student-resourced service delivery program development. [ABSTRACT FROM AUTHOR]

To explore the decision-making processes and experiences of acute and rehabilitation clinicians, regarding referral and acceptance of patients to rehabilitation after stroke. Multi-site rapid ethnography, involving observation of multidisciplinary case conferences, interviews with acute stroke and rehabilitation clinicians, and review of key documents within five (5) acute stroke units (ASUs) in Queensland, Australia. A cyclical, inductive content analysis was performed. Seven key themes were identified, revealing the complex nature of post-stroke rehabilitation referral and acceptance decision making. Although the majority of clinicians felt that all patients could benefit from rehabilitation, they acknowledged this could not always be the case. Rehabilitation potential and goals were considered by clinicians, but decision making was impacted by ASU context and team processes, rehabilitation service availability and access procedures, and the relationships between the acute and rehabilitation clinicians. Patients and families were not actively involved in the decision-making processes. Post-stroke rehabilitation decision making in Queensland, Australia involves complex processes and compromise. Decisions are not based solely on patients' rehabilitation needs, and patients and families are not actively involved in the decision-making process. Mechanisms are required to streamline access procedures, and improve shared decision making with patients. Referral decision making for post-stroke rehabilitation is complex and not always based solely on patients' needs. Clear and straightforward access procedures and positive relationships between acute and rehabilitation clinicians have a positive impact on referral decision making. Stroke services should review their processes to ensure shared decision making is facilitated when patients require access to rehabilitation. [ABSTRACT FROM AUTHOR]

Residential aged care facilities (RACFs) face severe challenges in the provision of high-quality end of life care. A pilot of a nurse-led end-of-life palliative care consultative service (CiMaS) supporting RACFs was conducted in three RACFs in the West Moreton Region of Queensland, Australia, from May 2018. We conducted a mixed method evaluation comprising: a chart audit of deaths in the 12 months before and after the intervention; focus groups with RACF staff; and interviews with facility directors, primary family members and GPs. Quantitative and Qualitative data were assessed separately with statistical and thematic analyses respectively. The RACFs cared for 277 residents. There were 24 pre-intervention deaths and 44 in the intervention period (28 (64%) referred to CiMaS). There was widespread support for the service. Families felt supported and knowledgeable about what was happening. Care plans were almost always recorded in health records. Patients' symptoms appeared to be better recognised and managed. Staff and Facility managers felt more support than previously, with more responsive and reliable out of hours support. There were significant care improvements in patients not referred to CiMaS, suggesting a learning effect. GPs observed improvements in nursing staff confidence and support to families. Transfers to hospitals fell by two-thirds for both referred and non-referred patients compared with the year before implementation. The program was both efficient and effective. [ABSTRACT FROM AUTHOR]

Increasingly, people live longer with advanced cancer, despite having no prospect of full recovery. Ongoing survival is owed to early detection and effective disease management, yet experienced as highly precarious. In this article we explore how cancer chronicity brings into effect a pre-occupation with time, what time is to people with advanced cancer, and what socio-cultural norms inflect everyday practices. We analyse 20 interviews conducted in Queensland, Australia with 11 participants with advanced cancer, to trace the intersections of what time means, what people do with time, and what time feels like. Drawing on scholarship on the moralities around ill health, we discuss how awareness of time emerges in cancer chronicity and raises moral questions on how to live well. Here, imperatives of optimisation (urging people with advanced cancer to make the most of limited time) intersect with imperatives of authenticity (marked by emphasis on how to live one's own best life). These dynamics reveal expressions of living with advanced cancer in morally viable ways. Such ontological processes have implications for the lived experience of people with advanced cancer, their families and oncological care. [ABSTRACT FROM AUTHOR]

Conducting and interpreting videofluoroscopic swallow studies (VFSS) is a complex, multi-dimensional task, requiring post-qualification training to develop knowledge, skill and competence. Speech-language pathology (SLP) managers must continually ensure staffs are adequately trained to deliver safe and effective VFSS services. However, VFSS training is resource intensive, variable in content and not consistently accessed universally. This study examined managers' perceptions of a new VFSS eLearning programme and its impact on VFSS training and service delivery. The eLearning programme incorporated theoretical and procedural aspects of VFSS, accessed free of charge by speech-language pathologists working in a large public health service in Queensland, Australia. Twenty-two SLP managers participated in semi-structured interviews, which were evaluated using inductive content analysis. Four themes were identified relating to eLearning benefits: (1) design and content facilitated widespread uptake, (2) enhanced training opportunities, (3) increased clinical skill and workforce capacity and (4) benefits and efficiencies for SLP services. A fifth theme described contextual considerations for using the programme. This study contributes information about the benefits of eLearning for delivering consistent, accessible VFSS training, in a resource-efficient manner. Managers perceived the eLearning programme as a valuable resource to supplement practical VFSS training, to ultimately support VFSS service provision. [ABSTRACT FROM AUTHOR]

Objective: This study aims to explore psychologists' attitudes towards the use of video conferencing technology (VCT) to deliver therapy. Method: Participants (N = 12) were recruited via opportunistic sampling either via the Australian Psychological Society website or social media. Participants (three males and nine females) were located in Queensland. They were aged between 23 and 50 years of age (mean age = 32.91, SD = 9.36), held varying levels of experience in psychology (<1 year to 12 years) and types of endorsement (e.g. provisional, general, clinical and health). A semistructured interview schedule was applied in‐person (n = 7) or via telephone (n = 5). Data were analysed using Braun and Clarke's (2006) five‐step method for assessing qualitative data in psychology. Results: Results indicated that psychologists' attitudes towards VCT to deliver therapy paralleled the tri‐component definition of attitudes proposed by Breckler (1984) and Rajecki (1982). Subthemes reflecting these components included perceived limitations or benefits of VCT (i.e. a cognitive component), a sense of comfort when using VCT (i.e. an affective component), and a general tendency to resist or embrace VCT (i.e. a behavioural disposition). Conclusions: Key barriers and facilitators identified underscore the need for training to improve knowledge and awareness of VCT, including its evidence base. Specifically, the assistance of 'embracers' to provide training in VCT (e.g. adapting microskills to a different medium and using technology flexibly) may also dispel negative views held by psychologists regarding VCT and its effectiveness and consequently facilitate a wider adoption of VCT throughout Australia. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to understand parent engagement and disengagement in the delivery of occupational therapy to their children. Methods: This study used a qualitative interpretive description methodology. Focus groups and individual interviews were employed. Thirty-two occupational therapists participated in focusgroups or one-on-one interviews. Thematic analysis was used to analyse the data. Results: Thematic analysis of the data revealed two overarching themes which influenced parent engagement and disengagement in therapy: (1) Parent-therapist relationship and; (2) Therapist responsiveness. Within these two themes: parent feelings; time and timing of therapy; levels of engagement and factors influencing parent engagement were evident. Conclusions: Findings contribute to understanding parent engagement and disengagement in therapy. The findings extend current models of therapeutic engagement in occupational therapy informed by self-determination theory (SDT). Autonomy-, relatedness- and competence-supportive SDT strategies to enhance parent engagement in therapy are described. Occupational therapists reported that parents experience a range of feelings when engaged and disengaged in therapy. These feelings related to hopelessness, having confidence in the therapist and feeling supported, validated and empowered. Parent engagement and disengagement in therapy was described by occupational therapists as occurring at different levels: when it works well (engaged); engaged in the idea of therapy but not engaged in the doing of therapy (middle ground engagement); and when it doesn't work well (disengagement). Occupational therapists reported the importance of being aware of how the factor of time and family, service and therapist characteristics can variously impact parent engagement in therapy. Occupational therapists focus on the parent-therapist relationship and being responsive to parent needs and feelings when engaging parents in therapy. Occupational therapists can draw on principles from self-determination theory to guide them regarding the selection of strategies to engage parents in therapy. [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]

Clear links have been established between low health literacy (HL) levels and poor health outcomes. One means of improvement may be found in the rapidly growing paid home care workforce, whose direct and frequent contact with aged/disabled care recipients positions them to provide HL support. This study examines Australian homecare worker (HCW) experiences in HL when providing assistance to their care recipients. A self-reported cross-sectional survey collected data from 75 HCWs. They reported concerns about their clients' HL, yet were cautious about providing support in this area. HL levels of the HCWs themselves were unconvincing, and the majority requested targeted education and training. Further research is needed into HL levels of both HCWs and care recipients, client demographics, the types of HL support being requested of HCWs, a more detailed scoping of the HCW role, and the curriculum and pedagogies which may comprise a HL education and training program for HCWs. [ABSTRACT FROM AUTHOR]

Background: Healthcare encounters are important in ensuring safe access to medical or surgical care for transgender people. Previous literature suggests many transgender people have had negative encounters with healthcare professionals. In Australia, there is limited research about this population and their healthcare, and less from regional locations. Aims: This study primarily aimed to explore both transgender client and clinician perspectives and experiences of healthcare interactions. A secondary aim was to investigate increased presentations to sexual health clinics in North Queensland by people wishing to transition. Methods: Semi-structured, in-depth interviews were used to gather data from 23 participants. Interview transcripts were inductively analyzed and themes developed. Results: Four themes emerged relating to healthcare encounters and the regional setting of North Queensland. These showed that support from family and peers is important for transgender mental health and wellbeing, and that person-centered clinicians who acknowledge a holistic approach to transgender care also form part of the support network for transgender individuals particularly in the regional setting. The internet was found to play a significant role in this study's findings. Discussion: A collaborative holistic approach to transgender healthcare should be taken by client and clinician to best support the transgender individual during transition. The establishment of Australian guidelines and online peer support groups would facilitate this approach, particularly in rural or regional areas where specialist services are limited. [ABSTRACT FROM AUTHOR]

Objective: To establish the point prevalence of cognitive impairment among a representative group of homeless people in Cairns. The sample included a large number of Aboriginal and/or Torres Strait Islander people. Method: This research was conducted among an opportunistic sample of participants residing in a homeless shelter. An interview administered cross‐sectional survey was conducted with 60 participants over 12 weeks. The Kimberly Indigenous Cognitive Assessment (KICA‐Cog) and a clinical diagnosis by a psychiatrist (using DSM‐V criteria) were used to establish cognitive impairment. The 36‐item version of the World Health Organisation Disability Assessment Survey 2.0 (WHODAS 2.0) was employed to ascertain limitations in daily living activities. Results: Seventy‐five percent of participants were Aboriginal and/or Torres Strait Islander people. Thirty‐five percent of the sample had a cognitive impairment based on the KICA‐cog while over 70% of the sample had a cognitive impairment based on clinical criteria. Being screened for dementia or global cognitive impairment according to the KICA‐Cog was significantly correlated with having greater difficulty across the following WHODAS domains: understanding or communicating, self‐care, and life activities. Conclusions: Many people who are homeless have a cognitive impairment and this impairment impacts their ability to participate in society. A shift in practice is necessary to support homeless populations with a high proportion of Aboriginal and/or Torres Strait Islander people. It is important that culturally appropriate methods—focusing on cognitive health—are employed to support Aboriginal and/or Torres Strait Islander people who are homeless. [ABSTRACT FROM AUTHOR]

Background: Heavy cannabis use in remote Indigenous Australian communities potentially contributes to existing health disparities. Community members' perceptions of cannabis harms will support harm-minimization in these settings. Objective: To describe perceived cannabis harms reported by a cohort of Indigenous Australians living in small, isolated communities as an indication of their existing resources for change. Method: Inductive thematic analysis of 407 semi-structured interviews with participants in a cohort study in three remote communities in Cape York in far north Queensland (Australia) revealed major areas of concern about cannabis. Three attitudinal categories were defined according to reported cannabis impacts and urgency for change: 1- "LOW CONCERN" said cannabis was a low priority community issue; 2- "SOME CONCERN" tolerated cannabis use but identified personal or community-level concerns; and 3- "HIGH CONCERN" expressed strong aversion to cannabis and identified serious personal or community-level harms. The characteristics and the patterns of concerns were summarized across the groups. Results: "Category 1- LOW CONCERN" (n = 107), mostly current users, emphasized personal "financial impacts" and "stress." "Category 2 – SOME CONCERN" (n = 141) perceived community level impacts warranting systematic action, particularly on "employment"; and "Category 3 – HIGH CONCERN" (n = 159), most of the never users, emphasized concerns for families and youth. Irrespective of use history, the cohort reported financial and abstinence-related stress, overlapping alcohol issues and generally endorsed alleviating impacts on children and youth. Conclusion: Nearly ubiquitous experience with cannabis harms and impacts in this cohort suggests resources for harm reduction including family and cultural obligation, stress relief, financial management, and engagement are available across all community members, not just users. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore the perspectives of caregivers regarding the information and support they received following diagnosis of their child’s hearing loss. Design: A mixed methods explanatory sequential design was conducted. Study sample: A total of 445 caregivers of children completed a written survey, and five parents participated in qualitative in-depth interviews. Results: The most common sources of information for caregivers were discussion with an audiologist, written information, and discussion with a medical professional. Approximately 85% of caregivers reported they were satisfied with the personal/emotional support and information received from service providers. Additional comments from 91 caregivers indicated that 11% experienced a breakdown in information transfer with health professionals. Interviews conducted with five parents from three families revealed two themes which described the diagnostic period as a difficult and emotional experience for parents: (1) support and information provided during diagnosis: what happens first? and (2) accessing early intervention services following a diagnosis of hearing loss: navigating the maze. Conclusions: The findings of this study give insight into the perspectives of caregivers who have a child diagnosed with hearing loss. The importance of providing timely information and personal/emotional support to caregivers cannot be underestimated. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to explore the nature of parental involvement in the intervention of children with hearing loss, as experienced by parents. Design: A qualitative descriptive methodology was adopted to conduct semi-structured in-depth interviews with a purposive sample of parents who have a child with hearing loss. Study sample: Seventeen parents of 11 children aged 6-9 years participated in this study. Results: The overarching theme of parents taking the central role was identified using thematic analysis. This overarching theme connected five themes which described the nature of parental involvement: (1) parents work behind the scenes; (2) parents act as ‘case managers’; (3) parents always have their child’s language development in mind; (4) parents’ role extends to advocacy for all children with hearing loss; and (5) parents serve a number of roles, but at the end of the day, they are parents. Conclusions: The results indicate that parental involvement in the intervention of children with hearing loss is multifaceted in nature and incorporates a broad range of behaviours and practices. These findings have important implications for the provision of family-centred practices. [ABSTRACT FROM AUTHOR]

Copyright of Australian Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Australian Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Despite the fact that Aboriginal and Torres Strait Islander communities typically experience a high prevalence of sexual and family violence, service responses have mostly been culturally inappropriate and ineffective. This article reports on a collaborative, participatory research project aimed at exploring barriers to service access by Aboriginal and Torres Strait Islander clients when they have been affected by sexual and family violence. The findings reveal multiple barriers to service access, including justice system deterrents, social taboo, shame, and a lack of culturally appropriate services. The article highlights the importance of recognising and addressing the complex interplay of historic, social, and cultural factors influencing service access. [ABSTRACT FROM PUBLISHER]

Objective It has been acknowledged that the mental health of Aboriginal and Torres Strait Islander people has been 'bedeviled' by the inappropriate application of non-Indigenous models of mental health. To enhance Indigenous health and well-being it is necessary for non-Indigenous practitioners to find a culturally safe way to enter the negotiated space of cross-cultural mental health. This will be facilitated through understanding both the points of similarity and divergence in perspectives of mental health across cultures. The current study aimed to explore urban Aboriginal and Torres Strait Islander's understandings of mental health using a social emotional well-being and cognitive behavioural framework. Method A qualitative research project was conducted with a sample of 19 Australian Aboriginal and Torres Strait Islander people. Data were collected via individual semi-structured interviews and focus groups. Thematic analysis was conducted to identify themes within the data. Results Qualitative: Four themes emerged as reflecting health and well-being-coping skills, knowledge, social support, and connectedness. The theme of connectedness to country, family and kinship, cultural knowledge, and social networks emerged as reflecting a unique contribution to Indigenous health and well-being. However, the themes of coping skills, knowledge, and social support shared cross-cultural meaning. In particular, coping skills identified in the behavioural, emotional, and cognitive domains shared many cross-culturally applicable avenues for intervention. Conclusions Therapeutic interventions in these domains are already well established within cognitive behaviour therapies. Cross-cultural understandings within these themes offer clinicians a culturally safe avenue for supporting Aboriginal and Torres Strait Islander health and well-being. [ABSTRACT FROM AUTHOR]

This article reports on the findings of qualitative, semistructured interviews conducted with 40 older Australian participants and 39 participants in Hong Kong who either did or did not engage in organized learning in the last 6 months. Phenomenology was used to guide the interviews and analysis to explore the experiences and perspectives of these older people. The meaning older people attribute to aging and learning and their possible relationship in their lives in both societies is described and compared. [ABSTRACT FROM AUTHOR]

Copyright of Australian Social Work is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose:While research has begun to explore the management of aphasia across the continuum of care, to date there is little in-depth, context specific knowledge relating to the speech pathology aphasia management pathway. This research aimed to provide an in-depth understanding of the current aphasia management pathway in the acute hospital setting, from the perspective of speech pathologists. Method:Underpinned by a social constructivist paradigm, the researchers implemented an interpretive phenomenological method when conducting in-depth interviews with 14 Australian speech pathologists working in the acute hospital setting. Interview transcripts and interviewer field notes were subjected to a qualitative content analysis. Results:Analysis identified a single guiding construct and five main categories to describe the management of aphasia in the acute hospital setting. The guiding construct,First contact with the profession,informed the entire management pathway. Five additional main categories were identified:Referral processes;Screening and assessment;Therapeutic intervention;Educational and affective counselling; andAdvocacy. Conclusions:Findings suggest significant diversity in the pathways of care for people with aphasia and their families in the acute hospital setting. Additional support mechanisms are required in order to support speech pathologists to minimise the evidence-practice gap.Implications for RehabilitationSignificant diversity exists in the current aphasia management pathway for people with acute post-stroke aphasia and their families in the acute hospital setting.Mechanisms that support speech pathologists to minimise the evidence-practice gap, and consequently reduce their sense of professional dissonance, are required. [ABSTRACT FROM AUTHOR]

Background: Communication impairments following traumatic brain injury (TBI) can represent a significant barrier to successful community reintegration. Previous research has typically focused on linguistic competence to identify communication difficulties experienced by people with TBI living in the community, rather than participation in everyday communication activities. Objective: To describe communication activities and communication partners of people with traumatic brain injury (TBI) over a 24-hour period compared to matched controls. Research design: A cross-sectional study using a customized, mixed-methods survey with time-use data collected from people with TBI and a demographically matched control group. Methods: Twenty people with TBI living within the community and 20 matched non-injured controls were interviewed about their involvement in communication activities over the previous 24 hours using a time-use diary.Activities were compared between the groups using Mann-Whitney U-tests and Chi-squared tests. Results: The TBI group spent significantly less time engaged in communication activities and less time engaged in conversation and reported significantly fewer numbers of communication partners compared to the control group. Conclusion: The results highlight discrepancies in participation in communication activities between people with TBI and people without TBI, suggesting the need for intervention studies to enhance communication participation in daily life following TBI. [ABSTRACT FROM PUBLISHER]

Background: Aged care services and nursing roles are evolving in response to policy reform and increasing consumer expectations, however the nursing workforce is declining in numbers. Aims: To examine registered nurses' perceptions and experiences of working in aged care. Methods: Descriptive, exploratory study involving thematic analysis of individual interviews. Results: Key issues related to: professional role strain; workforce challenges; managing expectations, relationships and communication; balancing rights and risk in decision-making; changing models of care and impacts of policy and regulation. Conclusion: Expectations and perceptions of aged care nursing are unclear and conflicted. Nurses face significant challenges in meeting consumer, profession, organisational, and policy expectations amidst workforce instability and resource constraints. Structural barriers and aged care policy environments represent significant threats to sustaining nursing in aged care. [ABSTRACT FROM AUTHOR]

Background: Person-centred care is a policy priority for health services seeking to assure the public they provide safe, high-quality care, in keeping with rising consumer expectations. However, study of person-centred care rarely includes acute-care patients' perspectives. Methodology: In 2013, semi-structured interviews were held with 10 former patients of an Australian regional health service and examined via thematic analysis to understand patients' experiences of nursing care, interpret findings in the context of person-centred care principles and identify ways to enhance and support compassionate, person-centred care in everyday nursing practice. Results: Clinically competent care, delivered compassionately through a positive nurse–patient relationship, resulted in personal, emotional or spiritual responses that were the catalyst for patient empowerment and participation in care, and a positive outlook toward recovery. Implications for practice: Nurses wishing to implement person-centred care need to recognise the importance of prioritising human connection and compassion in conjunction with clinical competence. [ABSTRACT FROM AUTHOR]

Quality of life is shown to be lower in people diagnosed with mental illness in comparison to the general population. The aim of this study is to examine the Quality of life in a subset of people accessing mental health services in a regional Queensland Centre. Thirty-seven people accessing mental health services completed the SF36 Health Survey on three occasions. Differences and relationships between Physical Composite Scores and Mental Composite Scores, comparisons with Australian population norms, and temporal change in Quality of Life were examined. Physical Composite Scores were significantly different to, but significantly correlated with, Mental Composite Scores on each occasion. Physical Composite Scores and Mental Composite Scores were significantly different to population norms, and did not vary significantly across time. The poor Quality of life of people with mental illness remains a significant challenge for the mental health workforce. [ABSTRACT FROM PUBLISHER]

Purpose: The purpose of the current study was to explore infrastructure issues that may be barriers to the establishment and improvement of dysphagia services in Malaysia compared to settings with established dysphagia management services (i.e. Queensland, Australia). Method: A mixed method design incorporating quantitative and qualitative data was used to increase credibility, validity and comprehensiveness of the results. Thirty-eight hospitals (Malaysia = 21, Queensland = 17) participated in Phase 1 (quantitative component) of the study involving completion of an infrastructure checklist by a speech-language pathologist from each hospital regarding availability of networking and communication, staffing and financial support, facilities and documentation of guidelines for dysphagia management. Subsequently, eight sub-samples from each cohort were then involved in Phase 2 (qualitative component) of the study involving a semi-structured interview on issues related to the impact of infrastructure availability or constraints on service provision. Result: The current study reveals that multiple challenges exist with regard to dysphagia services in Malaysian government hospitals compared to Queensland public hospitals. Conclusion: Overall, it was identified that service improvement in Malaysia requires change at a systems and structures level, but also, more importantly, at the individual/personal level, particularly focusing on the culture, behaviour and attitudes among the staff regarding dysphagia services. [ABSTRACT FROM AUTHOR]

Primary objective: To explore experiences of pathways, outcomes and choice after motor vehicle accident (MVA) acquired severe traumatic brain injury (sTBI) under fault-based vs no-fault motor accident insurance (MAI). Methods: In-depth qualitative interviews with 10 adults with sTBI and 17 family members examined experiences of pathways, outcomes and choice and how these were shaped by both compensable status and interactions with service providers and service funders under a no-fault and a fault-based MAI scheme. Participants were sampled to provide variation in compensable status, injury severity, time post-injury and metropolitan vs regional residency. Interviews were recorded, transcribed and thematically analysed to identify dominant themes under each scheme. Results: Dominant themes emerging under the no-fault scheme included: (a) rehabilitation-focused pathways; (b) a sense of security; and (c) bounded choices. Dominant themes under the fault-based scheme included: (a) resource-rationed pathways; (b) pressured lives; and (c) unknown choices. Participants under the no-fault scheme experienced superior access to specialist rehabilitation services, greater surety of support and more choice over how rehabilitation and life-time care needs were met. Conclusions: This study provides valuable insights into individual experiences under fault-based vs no-fault MAI. Implications for an injury insurance scheme design to optimize pathways, outcomes and choice after sTBI are discussed. [ABSTRACT FROM PUBLISHER]

Purpose. Head and neck cancer (HNC) survivors may experience functional changes to their voice, speech and hearing following curative chemoradiotherapy. However, few studies have explored the impact of living with such changes from the perspective of the HNC survivor and their carer. The current study employed a person-centred approach to explore the lived experience of communication changes following chemoradiotherapy treatment for HNC from the perspective of survivors and carers. Method. Participants included 14 survivors with non-glottic HNC and nine carers. All participants took part in in-depth interviews where they were encouraged to describe their experiences of living with and adjusting to communication changes following treatment. Interviews were analysed as a single data set. Result. Four themes emerged including: (1) impairments in communication sub-systems; (2) the challenges of communicating in everyday life; (3) broad ranging effects of communication changes; and (4) adaptations as a result of communication changes. Conclusion. These data confirm that communication changes following chemoradiotherapy have potentially negative psychosocial impacts on both the HNC survivor and their carer. Clinicians should consider the impact of communication changes on the life of the HNC survivor and their carer and provide adequate and timely education and management to address the needs of this population. [ABSTRACT FROM AUTHOR]