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Objective/Aim: To examine the experiences of culturally safe mentoring programmes described by Aboriginal and Torres Strait Islander nurses and midwives in Australia. Design: A systematic scoping review. Data Sources: The following databases were accessed: CINAHL Plus with Full Text (EBSCO), EMCARE (Ovid), MEDLINE (Ovid), INFORMIT (Health Collection/Indigenous Collection) and SCOPUS. Support relating to key words and appropriate databases was provided by a university librarian. Review Methods: Search terms across databases were sourced from 1997–2021, identifying a total of 161 papers. Title/abstract searches were screened against the inclusion/exclusion criteria, resulting in 18 papers reaching full-text review. Of the 18 full-text papers reviewed, six were eligible for inclusion in the final review. Results/Findings: Culturally safe mentorship was a positive experience for Aboriginal and Torres Strait Islander nurses and midwives. Thematic discussion identified three key themes: Mentorship as a way forward, Culture in mentorship, and Cultural safety's role in mentorship. Discussion: Culturally safe mentoring has been a key recommendation in the nursing literature for over 20 years. There is limited knowledge on what constitutes an effective programme as mentoring programmes have not been empirically evaluated or reviewed. Conclusion: This review provides evidence that Cultural Safety and the exploration of culture impact culturally safe mentoring and can impact workforce cultural capability. Impact Statement: This review indicates that culturally safe mentoring has been a key recommendation in nursing literature for over 20 years. This review provides evidence that Cultural Safety and the exploration of culture impact culturally safe mentoring and can impact workforce cultural capability. However, there is limited knowledge of what constitutes an effective programme, as mentoring programmes have not been empirically evaluated or reviewed providing an opportunity for further research. Plain Language Summary: Little is known about Aboriginal and Torres Strait Islander nurses' and midwives' perspectives of culturally safe mentoring programmes in Australia. However, mentoring programme are seen as a key workforce retention strategy. This scoping review aims to explore and interpret Aboriginal and Torres Strait Islander nurses' and midwives' perspectives of culturally safe mentoring programmes in Australia. This review concludes that mentoring programmes require content in Cultural Safety and that programmes need to be empirically evaluated. [ABSTRACT FROM AUTHOR]

Australian research indicates that post-parental care transitions are rarely planned and primarily occur following a crisis for a primary carer. This paper examines disability staff perceptions of transitions for people with intellectual disability and their ageing carers in rural South Australia. A focus group interview model was used, with a semi-structured interview guide initiating group discussions. A thematic analysis methodological approach was selected to analyse the data. This paper reports on the theme of Service Delivery, which has three sub-themes of Availability; Distance; and Individual Access. The key findings are presented and supported by the use of exemplar quotes. This research indicates a poor intersection of general and specialist services is inhibiting post-parental transitional care for rural people. Simply allocating money to the individual does not resolve the issues, and the interface between different services needs to be better considered at government level. [ABSTRACT FROM AUTHOR]

Although health services in Australia have an aim to provide inclusive care for their patients/clients, this study highlights how barriers to care can lie at the centre of patient-provider interactions. Racial microaggression is a subtle form of racism that can occur in health settings, leading to further exclusion for First Nations Australians, immigrants and refugees. This paper is guided by Derrida's approach to deconstructionism by unpacking how language is used by health professionals – as holders of organisational power – and how they construct 'truths' or discourses about clients that historically have been marginalised by health services and system. Data comprise 21 interviews with staff from two rural health services. It identified three racial microaggressions were used to justify the challenges of providing care to people from First Nations, immigrant and refugee backgrounds: (1) Participants problematised culture(s) of service users; (2) participants implied cultural superiority in their conceptualisation of 'other' cultures; and (3) participants shared stories of inactions, discomfort and relegating of responsibility. The findings identified these discourses as forms of racial microaggression that can potentially lead to further exclusion of people seeking services and support. [ABSTRACT FROM AUTHOR]

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]

Young people with severe and complex depression experience substantial social connectedness difficulties. The aim of this qualitative study was to evaluate the role of social connectedness in a novel group therapy (Relate) for youth living with severe and complex depression from clinicians' perspectives. Semi-structured interviews were conducted with 11 clinicians practicing at Orygen's Youth Mood Clinic in Melbourne. Eight of the 11 clinicians were female, with the sample aged 30–42 years (M = 34 years, SD = 3.6 years) and having an average 4.5 years clinical experience at Orygen. Four key themes were identified by codebook thematic analysis. The first theme pertained to clients' difficulties with social engagement, which impacted their attendance of Relate, but were addressed by the intervention. In the second theme, clinicians identified Relate as providing a safe space. In the third theme, clinicians identified opportunities for positive relational experiences. In the fourth theme, clinicians observed social and clinical improvements in Relate clients, but marked recovery did not always occur after attending. Findings provide initial support for the continuation of Relate. Recommendations for future iterations of Relate include refining the intake criteria for referring clients to Relate and potentially lengthening the program's duration. What is already known about this topic: Group interpersonal therapy is an effective intervention for depression and interpersonal functioning in young people. Few studies have evaluated treatments for young people with severe and complex depression and high suicide risk. Few studies have evaluated group programs within early intervention services. What this paper adds: A relationally-focussed group therapy could improve social connectedness and interpersonal functioning for youth living with severe and complex depression. The Relate group emphasises a safe environment for sharing and social risk-taking, providing opportunities for positive relational experiences with similar others which might be particularly useful for youth with complex social difficulties. Identified issues with engagement suggest clients could benefit from an explicit rationale for how their participation in the group benefits their depression treatment. [ABSTRACT FROM AUTHOR]

Prevention of chronic diseases happens within systems of action across whole communities. In local communities, organisations play important roles that influence health, but many are in non-health sectors where health or 'prevention' is not their main remit. In this paper, we explore how organisations in communities perceive their role as part of a local system of chronic disease prevention. We use interview data from 'Prevention Tracker', an investigation undertaken with Australian communities that aimed to describe how local prevention systems are organised. Four communities participated – one regional, one remote, and two urban. In each, local advisory groups identified key informants for semi-structured interviews (n = 80). We applied the Ottawa Charter for Health Promotion as a sensitising framework to categorise responses; and undertook inductive thematic analysis to generate deeper insights into organisations' orientation to prevention. While some respondents clearly recognised and articulated linkages between their organisation's activities and prevention, sometimes drawing from health promotion principles to do so, many did not and were prompted by the interview to consider their contributions. A proportion explicitly distanced themselves from prevention despite their work directly addressing the social determinants that underscore health. For some, this distancing reflects a tactical decision to reduce competition and promote partnership between organisations, and to engage clients. This study demonstrates that diverse organisations make contributions to prevention – often outside of 'core business' – whether or not the organisations themselves realise, relate to and/or self-identify as playing this role. [ABSTRACT FROM AUTHOR]

Purpose: Telehealth is rapidly becoming an essential part of speech-language pathologists' core business, and yet the experiences and opinions of community-based therapists in using telehealth remain relatively unknown. This paper describes a recent study in which speech-language pathologists were provided with access to a formal language assessment within a telehealth platform and asked to provide feedback about their experiences. Method: Twenty-seven speech-language pathologists in paediatric practice were recruited via callouts on social media, community contacts and professional networks. The participants were provided access to a telehealth platform with a built-in formal language assessment and asked to use the assessment with their own caseload as clinically indicated and provide feedback after each assessment. Questionnaire data was collected via an online survey system and contained questions about each assessment including the most enjoyable and most difficult aspects of the assessment and their overall experience of the platform. Result: More than 100 assessments were completed during the 3-month trial, with clinicians reporting that on most occasions, video and audio quality was adequate or more than adequate, and that interactions with their child clients were effective. Qualitative data indicated that technical difficulties were a drawback to the assessments, but that ease of use of the assessment, the added functionality of using the assessment within the telehealth platform and factors including general benefits of telehealth, particularly that of being able to continue to provide services when face-to-face work was not possible were seen as positive elements. Conclusion: This study adds clinicians' voices to the research into telehealth, indicating that the assessment within the telehealth platform was generally easy to use, and provided an unexpected depth of insight and connection for clinicians and their clients. Future research may consider the voices of other stakeholders in telehealth interactions, including parents and child clients. [ABSTRACT FROM AUTHOR]

Young people who have grown up with perinatally acquired HIV in wealthy nations are increasingly transitioning into adult care settings which expect more independence and self-regulation than paediatric care. Drawing on the first qualitative study on growing up with HIV in Australia, this paper examines “responsibilisation” narratives in semi-structured interviews conducted with young people with HIV and their paediatric and adult care providers. Three dominant narratives were identified: responsibilisation as imperative, practice and contest. This suggests that while young people growing up with HIV in an advanced liberal setting such as Australia may value the independence of adult care, and appreciate the need to take responsibility for their health, the practices involved in becoming a responsible health citizen are shaped by individual histories and circumstances, and in some cases, can lead to serious contestation and conflict with care providers. Placing a stronger emphasis on what young people can gain from taking an active role in managing their health may more successfully foster responsibilisation, rather than focusing on what they will lose. Clinicians could benefit from greater support regarding how to engage young people with the elements of responsibilisation likely to resonate more meaningfully at different points in their lives. [ABSTRACT FROM AUTHOR]

Purpose: Healthcare staff are on the frontline during disasters despite any personal adversity and vicarious trauma they may be experiencing. Wellness Warrior training is a post-disaster intervention developed in response to the 2019-2020 Australian bushfires to support staff in a rural hospital located on the South Coast of New South Wales, Australia. Method: This study explored the experiences and perspectives of 18 healthcare staff who were trained to provide emotional and peer support to their colleagues in the aftermath of a crisis. All the Wellness Warriors participated in semi-structured interviews between March and April 2020. Data were analysed using the reflexive thematic approach. Results: Healthcare staff reported developing interpersonal skills around deep listening and connecting with others which allowed for hearing the core of their colleagues' concerns. The training also helped staff to feel differently about work and restored their faith in healthcare leadership. Conclusion: Wellness Warrior training provided staff with knowledge and skills to support their colleagues in the aftermath of a natural disaster and later during the COVID-19 pandemic. As such, these findings suggest that peer support programs such as Wellness Warriors could be one way healthcare organisations can attempt to alleviate the psychological impact of natural disasters. [ABSTRACT FROM AUTHOR]

This study attempts to understand the factors that influence clinician resistance to the implementation of health information technology in a mandatory setting. A survey study was conducted with 202 clinicians regarding their perceptions of the implementation of electronic medication management systems (eMMS) in an Australian hospital. The data was collected during the initial roll-out of eMMS for model validation and quantitative analysis. The overall results indicated that performance expectancy, switching costs, and facilitating conditions are direct predictors of clinician resistance, whereas effort expectancy and social influence showed indirect effects on clinician resistance through performance expectancy or switching costs. The study is among the first study that investigates passive clinician resistance to the implementation of health information technology in a health organisation. This study also focused on opposition behaviour among under-examined degrees of resistance. This study provides some insights to the hospital management on how to mitigate clinician resistance in the implementation of health information technology. Other types of clinician resistance, such as postponement and rejection, are not examined in this study. Future research on postponement behaviour and rejection behaviour is needed to have a more comprehensive view of clinician resistance. [ABSTRACT FROM AUTHOR]

It is well documented parents of children who have a disability are at an increased risk of poor mental health and wellbeing. A capacity building program designed to build key worker self-efficacy to support the mental health of parents accessing early childhood intervention services (ECIS) for their child was trialled. A stepped-wedge cluster randomised trial design was utilised to deliver and evaluate a 12-month intervention program, comprising tailored professional development, resource development and sustainability measures. The repeated measurements on individuals in six clusters over three follow-up periods were analysed using linear mixed models. Comparison of the control and new program statistical means (adjusted for period effects) were assessed with an F test. Key workers reported increased confidence to talk to parents about their own wellbeing (d = 0.51, F(1, 51.8) = 4.28, p = 0.044) and knowledge of parental mental wellbeing improved (p = 0.006). A reduction in staff sick leave partially offset the cost of the intervention. A multi-pronged intervention targeted at key workers was found to be an effective way to ensure parental wellbeing is supported at an ECIS in Australia. ACTRN12617001530314 There are implications for the development of children whose parents are experiencing high stress and poor mental health, whereby parents of children with disability or developmental delays are at increased risk. Findings from this study support the recommendation that a key worker is provided to holistically support families who access Early Childhood Intervention Services to aid in reducing poor parental wellbeing and child outcomes. Improved confidence to support and initiate conversations regarding parental wellbeing by key workers, in combination with support from management and the organisation to undertake this as part of their role, is a positive finding from this intervention study. [ABSTRACT FROM AUTHOR]

Healthy eating (HE) and physical activity (PA) are essential for children's health and well-being. Innovative approaches, informed by formative research, are crucial to promoting these behaviors. Experiential learning, involving active, hands-on approaches, may be an effective way to encourage healthy behaviors in children. Children's museums could contribute to health education by providing a variety of educational opportunities. To inform the design of an experiential learning Healthy Living program for children at an Australian children's museum. A qualitative study involving focus group discussions with 23 caregivers and in-depth interviews with 6 staff were conducted to explore perceptions of caregivers and staff working in an Australian children's museum (Discovery Space) relating to potentially effective experiential learning strategies for promoting children's healthy behaviors. Data were transcribed verbatim and thematically analyzed in NVivo 12. Key considerations for promoting HE and PA children through experiential learning activities include involving caregivers, engaging children through processes such as providing choice and stimulating curiosity, and selecting appropriate activity types such as simple, engaging, fun, hands-on, sensory play, and music-based activities. Experiential learning activities that address these key considerations can promote HE and PA in children and should be studied in future studies. Competencies and sub-competencies in two areas of responsibility, (I) Assessment of Needs and Capacity and (V) Advocacy, were addressed. [ABSTRACT FROM AUTHOR]

There is building evidence that oesophageal screening (OS) should be considered a critical component of videofluoroscopic swallow studies (VFSS). This study surveyed Australian speech-language pathologists (SLPs) regarding current practices and perceptions of OS in VFSS. A 16–24 item online survey was distributed to Australian SLPs via relevant email forums. One response per site was requested. Survey questions explored experience and training in VFSS, skill and confidence with OS, OS protocol use, and pathways following OS. One hundred and one SLPs across all Australian states and territories responded, with 70% (n = 69/99) from metropolitan hospitals and 74% (n = 75/101) having more than five years' VFSS experience. While 69% (n = 70/101) of SLPs conducted OS, only half (n = 35/70) conducted OS routinely, and only 4% (n = 3/70) always used published OS protocols. Barriers to OS, for some participants, were concerns about scope of practice and confidence. This study confirms higher levels of OS in Australia compared to similar international surveys and provides rich data on the Australian context. Prescriptive clinical guidelines for OS, consensus regarding a preferred OS protocol, and specific OS training may clarify SLP scope of practice and improve SLP confidence and standardisation in OS. [ABSTRACT FROM AUTHOR]

Occupational therapy competency standards provide an evidence-base to inform clinical best practice, however it is not known whether education about competency standards will increase occupational therapists' adherence to their use. To investigate if education about the 'Australian Competency Standards for Occupational Therapy Driver Assessors' leads to increased adherence to the competency standards in the clinical practice of occupational therapy driver assessors. A mixed methods multiple case study design was used to evaluate 5 occupational therapy driver assessors' adherence to the competency standards. An audit of 25 client files and interviews were conducted to evaluate practice against the competency standards prior to an education session, followed by an audit of a further 25 files, interview and feedback after education. Qualitative and quantitative analyses suggest that education about the 'Australian Competency Standards for Occupational Therapy Driver Assessors' was associated with increased adherence to the competency standards in clinical practice. The results also support the use of competency standards in clinical practice. Competency standards can be used to inform and guide clinical practice, and individualised education and feedback of practice against the competency standards can increase occupational therapists' adherence to these standards. [ABSTRACT FROM AUTHOR]

In recognition of the broader relational aspects of viral infections, family support is considered important when someone is diagnosed with a blood-borne virus (BBV), such as HIV, hepatitis C (HCV) and hepatitis B (HBV). However, families' own support needs are often not a priority in service provision within the BBV sector. In this article, we draw on qualitative interviews with 20 key informants working in various professional capacities in health, social policy, care and advocacy sectors in Australia, and explore their experiences and perspectives on family inclusivity in their services. Overall, key informants acknowledged the diversity of what constitutes family, and consistently viewed family engagement as beneficial to both diagnosed individuals and the wider familial networks affected by a diagnosis. However, prioritising individual care in support services presented barriers to engaging families, which are further complicated by the role of stigma in shaping the social realities of living with a BBV. Increasing understanding in service provision settings that serodiscordance can be a family experience has the potential to widen this analytic lens to consider the support needs of families in their own right. [ABSTRACT FROM AUTHOR]

Health funding provisions supported by governments are pivotal for families accessing independent speech-language pathology services in Australia. Little is known of the facilitators and barriers that exist for accessing public funding for speech-language pathology services through independent providers. This study aimed to investigate and describe the perceptions of speech-language pathologists in accessing public funding models (PFMs) for children and young persons with communication and swallowing needs within Australian independent practice. Semi-structured qualitative interviews were conducted with twenty independent speech-language pathologists who had experience of PFMs in Australia. Digitally recorded interviews were transcribed verbatim and subjected to thematic analysis. Data analysis revealed five superordinate and eighteen subordinate themes. The five superordinate themes were: (a) accessibility in securing funding provisions; (b) time as a commodity; (c) incongruence between funding provisions and speech-language pathology evidence; (d) trust as a multifaceted quality; and (e) consequences of PFMs. This original and timely research offers perceptive descriptions of the multifaceted facilitators and barriers for families seeking to access public funding for independent speech-language pathology services in Australia. Research findings illuminate challenges for the speech-language pathology profession. Accessibility to funding was identified as a major issue. Research findings suggest that current funding provisions do not align with the dosage required for evidence-based speech-language pathology management. Further, this research has highlighted the need for funding to be equitable, acceptable to stakeholders, and for services to be delivered in an efficient and sustainable manner. Future research is recommended to understand which Australian PFMs: (a) facilitate consumer access to speech-language pathology services; (b) enrich consumer experiences; and (c) align with scientific evidence to promote optimal outcomes. [ABSTRACT FROM AUTHOR]

Healthcare models have incorporated self-management approaches to facilitate increased patient responsibility for chronic condition management. As aphasia is a chronic condition, self-management may be beneficial for people with aphasia; however, the possible impacts of the language disorder on self-management must be acknowledged and addressed. Speech-language pathologists would likely be principal providers of self-management support; therefore, their perspectives should be sought when considering development of aphasia self-management approaches. This study aims to explore speech-language pathologist perspectives of aphasia self-management. In-depth, semi-structured interviews conducted with 15 speech-language pathologists in Australia. Interview data analysed using qualitative content analysis. Aphasia self-management was viewed as a person- and family-centred approach enabling comprehensive long-term care for people with aphasia and promoting control, responsibility, and independence. Speech-language pathologists were seen to have a substantial role providing self-management support and consultation, and training was required to expand this role. Communication partners and peer support were highly valued. Personal and environmental factors may influence successful aphasia self-management. Differences between aphasia self-management and chronic condition self-management were considered. Self-management could facilitate long-term sustainable aphasia management. Aphasia self-management approaches should factor in how to maximise communication partner and peer support. Aphasia-friendly self-management resources are necessary. [ABSTRACT FROM AUTHOR]

To report on implementing a workforce education and development initiative to enhance LGBTIQA+ literacy and responsiveness. An instrument of 7 questions was administered to staff who attended a 1-hour introductory training session on LGBTIQA+ literacy and responsiveness held across an Australian inner metropolitan clinical mental health service. In total, 113 questionnaires were received. Overall 68% of staff agreed, or strongly agreed that they had adequate knowledge and attitudes to meet the support needs of LGBTIQA+ people. There were 75% who felt confident working with LGBTIQA+ people. A strong 91% reported the training to be useful to their clinical practice. Overall, 45% neither agreed nor disagreed their service was set up clinically and culturally for LGBTIQA+ persons, with 18% disagreeing or strongly disagreeing. Organizational commitment in the form of training and education supports staff to become equipped with knowledge and skills in providing inclusive and responsive practice to LGBTIQA+ people. Training and education are reported to contribute to service improvement and staff capacity to better respond to community needs. [ABSTRACT FROM AUTHOR]

Improved job quality will make longer working lives in the aged care sector more sustainable. We interviewed 20 older aged care workers to identify which job characteristics are significant for health and to identify policy remedies. Workers take pleasure and pride in responding autonomously to a care recipient's situation, developing understanding, maintaining morale and performing intimate bodily care with dignity. However, a shortage of staff time requires workers to take a task-oriented approach. This causes worker stress and diminishes their desire and capacity to delay retirement. In the Australian context, regulating minimum staffing is the most suitable policy response. [ABSTRACT FROM AUTHOR]

Available evidence affirms the effectiveness- of crisis helpline services in providing appropriate short-term intervention for many groups, but the unique needs of sexual minority adult callers may prevent them from deriving similar therapeutic benefit. Two hundred and forty-eight sexual minority adults from across Australia were asked about a previous personal crisis where they had accessed, or had considered accessing, a crisis helpline service. While most responses indicated some familiarity with available services, only 30% (n=75) of participants had accessed a helpline service during a time of crisis. Despite a low rate of service uptake, many of those who had used a service evaluated it positively. The low rate of overall engagement was attributed to a fear of being discriminated against by helpline workers or arose from a concern that they would have insufficient understanding of LGBT-specific concerns to be able to render meaningful support. For helpline services to increase service uptake among sexual minority adults, it is recommended that outreach efforts be undertaken to dispel the negative perceptions about such services by sexual minority persons. [ABSTRACT FROM AUTHOR]

Purpose: The role of allied health practitioners providing physical rehabilitation of central facial palsy (CFP) is minimally reported in the literature. This study explores current practice and the roles, attitudes and perceptions of allied health professionals (AHPs) working with people with CFP. Method: An electronic survey was distributed to speech-language pathologists (SLPs), occupational therapists and physiotherapists. Responses (n = 78) were analysed using qualitative and quantitative methods. Result: SLPs often lead management of CFP; however, their role is not clearly defined nor well recognised. Several barriers were identified which prevent AHPs from providing consistent specialist rehabilitation to people with CFP. These included a lack of training, no clear delegation of role, limited evidence and lack of resources. Conclusion: Survey respondents viewed CFP to be within SLP scope of practice; although, ownership of management varies between countries and professions. Most SLPs recognise the negative impact of CFP and feel a sense of responsibility to provide assessment and treatment of this impairment, but many barriers to doing so have been identified. Suggestions to improve access to rehabilitation for people with CFP included increased access to training for SLPs, more evidence, clinical practice guidelines and more clinical resources. Further research is required to ensure people suffering from CFP can access services that provide skilled management of their impairment. [ABSTRACT FROM AUTHOR]

Occupational therapists have skills to work with people considering or experiencing the transition from paid work to retirement. The aims were to explore: (1) occupational therapists' experiences and perceptions in working with people transitioning to retirement; (2) current scope of practice of occupational therapy in the work-to-retirement transition; and (3) factors influencing current scope of practice of occupational therapy in the work-to-retirement transition. Qualitative semi-structured interviews with Australian occupational therapists were thematically analysed. Fourteen Australian occupational therapists were interviewed. Three overarching themes (12 sub themes) emerged: (1) occupational therapists' application of a contemporary occupational paradigm; (2) current approaches adopted by occupational therapists are add on, stylistic and talk based; and (3) contextual challenges and opportunities encountered by occupational therapists. Occupational therapists use enablement skills (e.g. coach; collaborate) and consider various professional reasons (e.g. engagement in meaningful occupation; health responsibility) when addressing the transition from work to retirement. Overcoming barriers to service provision (e.g. funding; lack of role clarity) will facilitate a more comprehensive service provision to enable health and well-being of older adults. [ABSTRACT FROM AUTHOR]

Early recognition of stroke signs and symptoms is critical to ensure people receive the right treatment at the right time. Communication impairment associated with left-hemisphere stroke is easily identifiable due to the recognisable signs of aphasia, whereas signs of cognitive-communication disorder (CCD) after right hemisphere (RH) stroke are often subtler. In contrast to aphasia, no sensitive screening tools exist to allow for early identification of CCD after RH stroke. To prioritise test items required for a screening tool to identify CCD after RH stroke from the perspective of expert speech-language pathologists. The nominal group technique (NGT) was used with expert speech-language pathologists to determine the most important test items required for a screening tool to identify RH CCD. Results were analysed using a quantitative measure of item ranking and inductive content analysis. Five expert speech pathologists located across Australia and the USA, representing a mix of clinicians and researchers participated in the nominal group. The highest ranked test items across the four cognitive-communication domains (lexical semantics, discourse, pragmatics and prosody) were interpretation of sarcasm or humour, rating conversational discourse, a conversational skills checklist, and expressive prosody. Content analysis revealed three themes: Assessment Domains, Considerations in Item Design and Knowledge Gap. The NGT revealed that multiple considerations exist in developing a screening tool for CCD after RH stroke. [ABSTRACT FROM AUTHOR]

In search of Kipling's six honest serving men in upper limb rehabilitation after stroke, we sought to investigate clinicians' perspective of when and where to begin therapy, how much and what therapy to provide, and who and why (or not) to provide therapy. Materials & methods: Within-participant case cross-over experiments were nested within an anonymous web-based questionnaire (21 questions, three cases). Graph theory-based voting to produce ranked ordered lists and mixed-effect logistic regression were performed. In total, 225 Australian stroke clinicians responded: 53% occupational therapists, 61% working in acute/inpatient stroke setting. Most respondents indicated they did not have a protocol/expectation regarding when (62%), how much (84%) or what (60%) therapy to provide in their setting. Respondents ranked 24-h to 7-days post-stroke as the optimal time to commence therapy, and 30- to 60-min per day as the optimal dose to provide. Within-participant experiments demonstrated that greater motor recovery as time progressed increased the odds of offering therapy, while lack of motor recovery, shoulder pain, neurological decline and sole therapist reduced the odds. We need to develop an evidence base concerning Kipling's six honest serving men and equip clinicians with clinical decision-making skills aligned with this focus. Most clinicians did not have access to a protocol / clinical pathway which defines when, how much and what upper limb therapy to provide after stroke, which may be improved by providing individual clinicians with organisational support to make therapy decisions. To improve the personalisation of upper limb rehabilitation in clinical practice, we need to understand when and where after stroke to begin therapy, how much and what therapy to provide, as well as who and why (clinical decision-making) to provide therapy. Clinicians perceive clinical trials as successful if the therapy can demonstrate recovery that is greater than a minimal clinical important difference (MCID). [ABSTRACT FROM AUTHOR]

Occupational therapists are experts in determining domestic assistance levels. It is a complex multi-dimensional process resulting in different opinion regarding care hours. Therapists providing medicolegal reports on domestic care for the courts within Australia were surveyed. 58 occupational therapists responded with most aged between 41 to 50 years of age. There was a strong correlation between years of clinical and medicolegal experience (r = 0.730, n = 58, p = 0.000) as well as between years and numbers of medicolegal assessments conducted in 2017 (r = 0.264, n = 58, p = 0.420). Assessment based on occupational analysis interview combined observation of the claimant performing tasks in their home, medical information, and contextual factors such as family expectations. Translation of data to hours of care was based on therapist's clinical experience of medical diagnosis (x2 6.89, p = 0.009) and claimant's statements of performance combined with therapist's clinical experience (x2 = 5.58, p = 0.18). Therapists providing defendant only reports often use their own time to perform housework as a guide. Triangulation data combined confirmation of the person's statements through observation of performance, the environment in which they lived, and the occupational therapists own clinical reasoning skill. Documenting all the factors influencing the occupational therapist's decision is the key to understanding clinical reasoning. When estimating domestic care occupational therapists should: •Provide written documentation that clearly explains the assessment methods used, the results and conclusion made regarding domestic care. •Triangulate data including claimant's statements of performance, confirmation by observation on tasks, medical report information in the context of the claimant's environmental and contextual factors. •Be aware their own years of experience do not equate to level of expertise. [ABSTRACT FROM AUTHOR]

Sport psychologists provide their services in complex settings, with numerous competing demands, resource constraints, and aims/goals for the psychology support service. Research in sport psychology often struggles to characterize the unique challenges of applied practice as it occurs in context. This research examined the delivery of a year-round sport psychology support service in a relatively small state sports academy, which serviced approximately 100 talented and high-potential athletes across multiple sports and levels. A qualitative process evaluation was undertaken. Eight semi-structured interviews were conducted with key stakeholders, including: two current psychologists, one former psychologist, two senior managers, one full time coach and three athletes. After deductively coding content into six higher-order themes, based on process-evaluation approaches, quotes were inductively analyzed using thematic content analysis. Dense and rich category clusters were identified within each higher-order theme: (a) aims and objectives; (b) context and environment; (c) implementation (i.e., what is done by the sport psychologists?); (d) attributes of the sport psychologists; (e) mechanisms of impact; and (f) outcomes generated. The themes extended beyond what is articulated in many current models of service delivery. Analysis suggested that not only are there numerous concepts "in play" when delivering sport psychology services, but that they are deeply interdependent and interconnected. There were notable discrepancies between the assumed aims of the service and the outcomes that were most valued by participants. The study identifies several key strengths and threats for the sport psychology service, and insights that can be applied in diverse service delivery settings. We explored the psychological service delivery of a multi-sport talent development academy, which prepares talented athletes for elite level. We characterized the service's: aims; delivery context; delivery activities; attributes of the deliverer; how outcomes were generated; and outcomes. The analysis emphasized the importance of the competencies, reflexivity and collaboration of practitioner-in-role. A practitioner in this role requires not only core competencies, but substantial contextual-awareness to tailor service-delivery and manage the expectations of service-users. Many valued outcomes were generated through interdisciplinary collaboration, and not exclusively one-to-one or workshop delivery Protecting the "bandwidth" of such a practitioner—delivering to many service-users largely alone—may facilitate improved outcomes and unexpected opportunities by enabling reflection, planning and collaboration. [ABSTRACT FROM AUTHOR]

The transition to the workforce can be stressful for psychology registrars. Supervision can be a protective factor during this transition. However, the incremental benefit of adding structured group supervision to individual supervision remains unclear. We aimed to explore the impact of registrars' participation in structured group supervision offered within Australian Health services. We surveyed Australian psychology registrars who had and had not participated in a structured group supervision programmes about their experiences and satisfaction with supervision, and its impact on development of foundational competencies and transition to professional work roles. Participants were 63 psychology registrars (95% in clinical psychology and clinical neuropsychology). Group comparisons using independent-samples t-tests revealed that registrars who had participated in structured group supervision (n = 32) were more confident in the key foundational competencies of "communication and interpersonal relationships" (d =.53) and "intervention strategies" (d =.57), and felt more supported by their workplace (d =.73), than participants with no structured group supervision (n = 31). Structured group supervision appears to offer additional work role adjustment benefits for psychology registrars. Further studies are needed on the structured group supervision experience for Australian early-career psychologists to guide future implementation of these programme across health services. KEY POINTS What is already known about this topic: (1) The transition to the workforce is a stressful time for graduates. (2) Supervision is an essential part of psychology training that helps to develop skills and confidence in practitioners. (3) There are a range of benefits of group supervision including peer feedback and enhanced public speaking skills.What this topic adds: (1) Specific additional benefits of structured group supervision include feeling more supported by the workplace and being better able to meet registrar program requirements. (2) Structured group supervision programs may enhance perceived development of foundational competencies, including communication and interpersonal relationships and intervention strategies. (3) Provision of structured group supervision programs by Australian health services could help attract and retain a loyal early-career psychology workforce who feel valued and more confident. [ABSTRACT FROM AUTHOR]

We investigated the effects of increasing physical activity (PA) and reducing sedentary behaviour (SB) of mental health professionals on their attitudes towards and practices in recommending more PA and less SB to their clients. A 4-week pre-post intervention trial was conducted involving 17 mental health professionals. The participants who increased their own physical activity during the intervention increased the frequency of recommending more PA (p = 0.009) and less SB (p = 0.005) to their clients. A relatively simple, low-cost intervention, consisting of group behaviour change counselling, goal setting and positive feedback, may improve the practices of mental health professionals. Supplemental data for this article is available online at https://doi.org/10.1080/01612840.2021.1972189. [ABSTRACT FROM AUTHOR]

Purpose: The current landscape of speech-language pathology (SLP) services for 12- to 16-year olds in Australia remains largely unchartered. Implementing the Speech Pathology 2030 vision necessitates mapping current services, and gaps in services, provided by speech-language pathologists (SLPs). However, the last survey of Australian SLPs' practices with young people was conducted in 2005. The aim of this study was to bridge the service delivery information gap. Method: Ninety-six SLPs working with 12- to 16-year olds in Australia completed an anonymous online survey consisting of binary choice, multiple choice, and Likert scale questions. A theoretical approach to service delivery based on response to intervention models underpinned question design. Result: SLP clinical practices remain traditional, following an impairment/diagnostic model. Additionally, there is an inequitable provision of SLP services across states/territories of Australia, according to whether or not there is government provision for SLP services in public schools. Conclusion: The results suggest a need for standard government provision of SLP services across Australia to ensure equity of access. These findings inform our understanding of contemporary assessment and intervention practices of SLPs working with 12- to 16-year olds in Australia. [ABSTRACT FROM AUTHOR]

Purpose: To explore the perceptions, use and interest to use telepractice by speech-language pathologists (SLPs) to deliver services to people with Parkinson's disease (PwPD). Method: A cross-sectional, mixed-methods online survey was conducted. Recruitment of SLPs with an active caseload of PwPD was conducted through non-probability, purposive sampling. Data were analysed using frequency distribution and thematic analysis. Result: A total of 63 SLPs responded. The majority (82.5%) were interested in telepractice, but only 23.1% provided services to PwPD online. Monitoring of motor speech function, and therapy were the primary services delivered online. Of those who did not currently offer online services to PwPD, 77.5% expressed interest to use telepractice. The development of telepractice guidelines and a comprehensive list of available software were the resources most requested to assist clinicians in offering such services. Most perceived telepractice as an appropriate delivery method for speech-language pathology services. However, views regarding the preference for face-to-face delivery were divided. Conclusion: SLPs view telepractice as a viable service delivery model for PwPD, but uptake of the model is variable. Several key barriers and resource limitations must be addressed to facilitate the implementation and sustainability of telepractice in clinical services. [ABSTRACT FROM AUTHOR]

To investigate current speech pathology practice regarding working with friends. An online survey was conducted with 68 speech pathologists who worked with TBI across metropolitan and rural settings in Australia. The survey investigated the reasons speech pathologists work with friends, barriers to working with friends and perceptions of successful friendships post TBI. Descriptive statistics and content analysis of open ended responses were used to analyze the data. There were more speech pathologists (40%) who did not include friends compared to those who did. Friends were most commonly included in the rehabilitation process, through the provision of education programs. The primary rationale for working with friends was to prevent negative psychosocial outcomes for the person with TBI. There were numerous barriers to working with friends, most commonly the inability to access friends. Making and keeping friends are a significant part of most people's lives. Therefore, it is important to consider their role in contributing to improved outcomes for people with TBI. With communication partner training being an integral component to recovery and maintenance of relationships post TBI, the development of targeted education and training materials is warranted, to enable the inclusion of friends in the rehabilitation process. [ABSTRACT FROM AUTHOR]

Purpose: High demand for speech-language pathology services is reflected in long waiting lists. Waiting can be active or passive and has implications for stakeholders, including consumers, professionals, and organisations. The present study explored experiences and perspectives regarding waiting for speech-language pathology services through analysis of stakeholders' written submissions to an Australian Government Senate Inquiry. Method: Written submissions (n = 337) were screened for terms related to waiting. Included submissions (n = 133) were written by organisations (36.8%), speech-language pathologists (29.3%), parents (27.8%), individuals with communication and/or swallowing difficulties (5.3%), and others. Result: Inductive thematic analysis identified three themes. (1) Duration. Consistently described as long. (2) Consequences. Consumers' consequences included: burden on physical health, finances, time, emotional wellbeing, and relationships, reduced continuity of care, and increased intervention needs. Professional consequences included: stress and burnout impacting job satisfaction, and reduced effectiveness. Societal consequences included: social and ethical burden, and a drain on health and legal systems. (3) Actions. Consumers advocated and sought alternatives (e.g. threats to harm their child, relocation to a capital city), professionals implemented service delivery and policy actions, and organisations lacked effective system-wide strategies. Conclusion: Existing services did not appear to meet stakeholders' needs. Action is needed to improve speech-language pathology waiting lists and access to services, and minimise possible consequences for stakeholders. [ABSTRACT FROM AUTHOR]

Purpose: To determine the clinical practices of Australian speech-language pathologists in the management of communication disorders in people with Parkinson's disease (PwPD) and their perspectives on service provision. Method: A cross-sectional, mix-methods online survey was conducted. Nonprobability, purposive sampling was utilised to recruit speech-language pathologists who currently work with PwPD. Descriptive statistics and thematic analysis were employed. Result: Ninety-nine clinicians responded. Most offered services for both motor speech and cognitive-communication disorders, but a greater focus on the motor speech disorder was evident. A range of impairment and functional assessments and interventions were reported. Therapy was most commonly delivered one session a week over 4 or 6 weeks. Service, client and evidence barriers in the management of both communication disorders were identified. Most clinicians felt PwPD accessed communication services at stages later than optimal, they recognised a need to improve their services in varying degrees (92.3%), and believed not enough services exist for PwPD in Australia (78%). Cognitive-communication management was the highest requested area for further research evidence. Conclusion: This study captured the current practices of Australian speech-language pathologists in the management of communication disorders in PwPD. Findings may inform future service planning, research on service effectiveness and new management targets. [ABSTRACT FROM AUTHOR]

Despite the benefits of augmentative and alternative communication (AAC) systems for children with complex communication needs, these systems are not consistently accepted by parents. This study aimed to explore factors that contribute to the acceptance, rejection, or abandonment of AAC systems. Semi-structured interviews were conducted with 16 speech-language pathologists (SLPs) who had introduced at least one AAC system that was rejected or abandoned by the parent of a young child, as well as one that had been accepted. Thematic analysis revealed six themes that describe influences on parent acceptance of AAC systems: (a) The Way Parents View their Child, (b) Parents' Views on AAC Intervention, (c) Support Networks Around Parents, (d) The Capacity of and Demands on Parents, (e) Services Provided by SLPs, and (f) Specific Features of AAC Systems. Themes were largely consistent with the existing literature; however, SLPs raised the novel concept of parent grief and loss as a potential contributor to AAC abandonment. To increase AAC acceptance, SLPs should consider not only the child with complex communication needs, but also the child's parents, the AAC systems available, and their own clinical limitations. [ABSTRACT FROM AUTHOR]

Purpose: Aboriginal Australians are under-represented in stroke rehabilitation services and rehabilitation practices that are sensitive to the needs of Aboriginal people are not currently available. This project tested the feasibility and acceptability of a rehabilitation model and approach to therapy with Aboriginal people with acquired communication disorders post-stroke. Method: Eight Aboriginal people with acquired communication disorders post-stroke were recruited to this study. Sixteen treatment sessions were provided twice weekly at the person's place of residence by a speech-language pathologist and Aboriginal co-worker. Feasibility was measured by analysing the number of sessions conducted jointly by the speech-language pathologist and Aboriginal co-worker and participant attendance. Participant acceptability was measured through the analysis of a post-therapy questionnaire. The Aboriginal co-worker's and speech-language pathologists' perceptions of the acceptability were collected through semi structured interviews. Result: Across all sessions 84.2% were attended by the Aboriginal co-worker and speech-language pathologist and seven of the eight participants completed all prescribed sessions. Positive feedback was provided by participants, the Aboriginal co-worker and speech-language pathologist on the key components of the programme. Conclusion: The rehabilitation model used within Wangi appears to be feasible and acceptable to participants and therapists. It provides direction to improve the quality of care for Aboriginal stroke survivors. [ABSTRACT FROM AUTHOR]