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Aim: The purpose of this study was to empirically evaluate if children from low socio‐economic status (SES) families in regional southeast Queensland utilise acute care services for low acuity health care rather than utilising primary health services. Methods: A retrospective audit of children under the age of 5 years presented at a regional hospital emergency department (ED) over a 12‐month period. Medical records were examined for presenting problem, Australasian triage category, care outcomes, whether the child's parent/guardian held an Australian concession/health care card (AC/HCC) and accessed child health services or a general medical practitioner (GP). Results: Eight hundred and eighty‐eight children who had not reached their fifth birthday presented to ED between 1 June 2019 and 31 May 2020, with a total of 1691 presentations. Most children were bought to the ED by their parents with semi‐urgent health concerns and were discharged home following medical review. Holding an AC/HCC was a significant predictor for hospital presentation. Holding an AC/HCC was not associated with access to child health services. However, accessing child health services resulted in a small but significant increase in hospital presentations. Conclusions: The AC/HCC may be an important proxy to identify low SES individuals. These card holders tended to use acute services more frequently than those who did not qualify for an AC/HCC. Furthermore, families that engage with primary care services such as child health also accessed acute care services more frequently. The results indicate accessing primary health‐care services does not ameliorate the use of acute care services. [ABSTRACT FROM AUTHOR]

Cumulative harm refers to the effects of an accumulation of adverse experiences in a child's life. An understanding of cumulative harm and its integration into practice frameworks, legislation, policy and service delivery is hailed as an imperative of critical social concern and has been demanded by researchers, practitioners, commissioners and coroners. However, there is minimal research exploring the nature and defining qualities of cumulative harm and the implications for individuals in adulthood. The present study uses interpretive phenomenological analysis to explore the lived experiences of cumulative harm in a sample of helping professionals. The findings of this study contribute knowledge to the definitions and typologies of child abuse, neglect and adversity, and draw on empirical evidence to broaden the scope of what constitutes childhood maltreatment. Further, the findings catalyse a paradigm shift that positions accumulation as a distinct harm type and clarifies the qualities which embody cumulative harm: persistent dysfunction, dysregulation, disadvantage and disconnection. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to assess the clinical utility of a model of seven principles for effective visiting primary care services and to determine how it could be conceptualised as a tool for evaluation. Setting: The research was undertaken in the context of visiting primary care services with an agency, Outback Futures, selected as a case study. Participants: Three executive staff with Outback Futures participated in the research. Design: The case study design involved data collection by four group interviews conducted between July and November 2021. The interview data were analysed using thematic analysis. Results: This case study is additional evidence for the clinical utility of the model of seven principles. The results reinforce the importance of a community‐focussed approach to assess the impact of visiting service organisations on rural and remote communities. A comprehensive approach to evaluation is required to justify the investments made and safeguard the health and well‐being of rural and remote residents. A self‐assessment protocol has been established from the model for use by visiting services. Furthermore, three themes were drawn from the data: relationship is fundamental, the importance of co‐design, and being effective as a visiting service is challenging. Conclusion: The model is appropriate for the case study organisation, and has clinical utility and implications for other visiting services. A self‐assessment protocol has been developed. Future research should apply the model and protocol self‐assessment tool in an effort to construct a consistent and credible approach to evaluation of visiting primary care services. [ABSTRACT FROM AUTHOR]

Aims: This study ascertained nurses' perceptions about workplace violence management, strategies and support services. Background: Nurses regularly encounter verbal and physical violence in their workplace. Workplace violence has long‐term consequences on nurses' personal lives and professional work ability. However, more needs to be known about nurses' perceptions of violence management and interventions used. Methods: Ninety‐eight nurses from a regional public hospital in Queensland, Australia, completed a survey about workplace violence. Nurses worked in the Emergency Department, Intensive Care Unit or Mental Health Department. Results: Ninety‐five per cent of nurses stated that all violence should be reported, but 18% would take no action, and 22% would not complete an incident from. Perceptions and preferred responses differed for verbal and physical violence. Low‐level interventions and aggression management training were preferred by nurses. Nearly all nurses felt that they should be involved in the development of workplace violence policies. Conclusions: Nurses rate aggression management training highly, and they desire more input into violence policies. The under‐reporting of violent incidents remains an issue for future management. Implications for nursing management: Understanding nurses' perceptions of workplace violence management enables the identification of gaps when applying policy and adopting practical approaches to reduce the incidence and severity of workplace violence. [ABSTRACT FROM AUTHOR]

Objective: Visiting health care services were developed to improve access to essential health care in rural and remote areas. Evaluating these services requires a robust framework. The objective of this study was to assess the confirmability and credibility of a model of 7 principles for effective visiting health care services. Setting: Three iterative online survey rounds administered between July and December 2020. Participants: A heterogeneous panel of 13 experts in rural and remote health care participated, including managers of health care services, senior clinical staff in rural and remote regions and research academics specialising in rural infrastructure. Design: The model was appraised using the Delphi method involving iterative online survey rounds to facilitate anonymous and structured discussion between panel members. Results: Findings indicate consensus between panel members and support for a revised model. The revised model includes 4 modifications: (a) proposal of a new principle titled Feasibility, (b) restructure of 2 existing principles, (c) refined shape of the model to more accurately reflect the nature of service delivery and (d) detailed definitions of each principle. Conclusion: This study presents a credible, revised version of the model of 7 principles for effective visiting services. This will enhance the quality of the health workforce across geographically large countries, like Australia, enabling organisations to more effectively and consistently evaluate the impact of their service on rural and remote communities. [ABSTRACT FROM AUTHOR]

Aims and objectives: To examine nurses' perceptions of physical and verbal violence perpetrated by patients and visitors and to investigate themes surrounding gender and the incidence of violence. Background: The prevalence of violence towards nurses is a concern for nurses and hospital administrators. However, nurses who work in acute care and mental healthcare settings are particularly at high risk. This study examines the occurrence, type of violence and gender issues in a regional public hospital of Queensland Australia. Design: An exploratory, qualitative design. Methods: Focus group interviews with 23 nurses from Emergency Department (ED), Intensive Care Unit (ICU) and Psychiatry Department (PD) working in Queensland regional public hospital, Australia. Qualitative data were transcribed and thematically analysed manually and by NVivo. COREQ research reporting checklist followed. Results: Participants reported frequent incidents of verbal and physical violence on a daily basis. Severe incidence included punching, kicking, biting and scratching, as well as threats of using weapons, such as knives. Patients were more likely to exhibit physical violence, especially towards male nurses, while hospital visitors including patient's family were more likely to exhibit verbal violence. Allocating male nurses in volatile areas and to care for violent patients raises concerns that the male nurses may be seen by their patients as "bodyguards" and not as a professional nurse. Conclusion: Findings indicate that staff believe that violence is increasing, feel the burden to accept that violence as part of the job and that the bureaucratic processes of the organisation make it difficult to address violence or get support. Organisations need to be vigilant in ensuring assistance is accessible and simplified. Relevant to clinical practice: This study contributes new knowledge to the discussion concerning of gender issues. Identifying gender issues could assist in developing the necessary interventions to reduce workplace violence. [ABSTRACT FROM AUTHOR]

The pervasive effects of cumulative harm resulting from adverse childhood experiences influence all aspects of an individual's life course. Research highlights a relationship between early trauma and career choice; however, there is a dearth of research pertaining specifically to cumulative harm and the influence on career choice in the helping professions. A systematic literature review was conducted to explore the associations of cumulative harm and childhood trauma on career decision making in people in the helping professions. A search was conducted across databases between February 1990 and February 2019 relevant to searches combining three areas of interest: (a) "childhood trauma," (b) "career choice," and (c) "helping professionals." Database searches and further manual searches yielded a total of 208 articles, and 28 studies satisfied all inclusion criteria. Only studies that were peer-reviewed and published between February 1990 and February 2019 were included. The evidence from the review indicated that family of origin dysfunction, parentification, individual characteristics, and traits developed through adversity, and experiential motivations were associated with the career choice in the helping professions. Further research is required to explore different professional cohorts and the utility of life themes as both a source of data for research and reflexive practice in helping professionals. [ABSTRACT FROM AUTHOR]

Critical care healthcare professionals are at high risk in developing burnout and mental health disorders including depression, anxiety, and post-traumatic stress disorder. High demands and the lack of resources lead to decreased job performance and organizational commitment, low work engagement, and increases emotional exhaustion and feelings of loneliness. Peer support and problem-solving approaches demonstrate promising evidence as it targets workplace loneliness, emotional exhaustion, promotes work engagement, and supports adaptive coping behaviors. Tailoring of interventions have also shown to be effective in influencing attitudes and behavior changes, attending to the individual experience and specific needs of end-users. The purpose of this study is to assess the feasibility and user-perceived acceptability of a combined intervention (Individualized Management Plan (IMP) and Professional Problem-Solving Peer (PPSP) debrief) in critical care healthcare professionals. This protocol was registered in the Australian and New Zealand Clinical Trials Registry (ACTRN12622000749707p). A two-arm randomized controlled trial, with pre-post-follow-up repeated measures intergroup design with 1:1 allocation ratio to either 1) treatment group–IMP and PPSP debrief, or 2) active control group–informal peer debrief. The primary outcomes will be conducted by assessing the recruitment process enrolment, intervention delivery, data collection, completion of assessment measures, user engagement and satisfaction. The secondary outcomes will explore preliminary effectiveness of the intervention using self-reported questionnaire instruments from baseline to 3-months. This study will provide the interventions' feasibility and acceptability data for critical care healthcare professionals and will be used to inform a future, large-scale trial testing efficacy. [ABSTRACT FROM AUTHOR]

Note: We respectfully refer to Aboriginal and Torres Strait Islander people as Indigenous in this study. Objective: To design and develop an Indigenous specific suicide intervention skills program that focuses on education and intervention training as an effective suicide prevention strategy. Method: Using a co‐designed wrap‐around framework, we developed a program in collaboration with >90 communities, stakeholders and service providers across Australia to understand knowledge, awareness and sense of connectedness between at‐risk groups and health services or support groups. Results: The I‐ASIST training provides participants with the necessary skills and knowledge to apply a suicide intervention model. The framework behind the intervention model provides caregivers the awareness to recognise when someone may be at risk of suicide. It then gives them the skills to connect with a person at risk of suicide and to understand and clarify that risk, steps to keep that person safe for a specific period and then provide them with the resources or links required for further help. The program enables the development of knowledge through interactive strategies through cultural recognition and empowerment of participants. Based on a social‐enterprise model, I‐ASIST has been translated into a certified program supported by LivingWorks Australia. Conclusion: Based on a strengths‐based and self‐determination model of co‐design, this grass roots innovative framework creates suicide safer communities. [ABSTRACT FROM AUTHOR]

Aim: We aim to investigate nurses' perceptions of support after incidences of Workplace Violence. Background: Nurses experience workplace violence daily. Adequate support following incidents of violence can reduce adverse impacts. Current support systems for coping with workplace violence are lacking. Methods: Focus group interviews were conducted with 23 nurses working in a regional Queensland Hospital. Qualitative data was transcribed and thematically analyzed to determine themes. The consolidated criteria for reporting qualitative research checklist was followed. Results: The primary source of support after a violent incident was from other nurses. Support was needed immediately to empower nurses to be able to continue their caring role. Often the support was not provided nor were nurses aware of the support services available. Although personal family and friends were a valuable support, most nurses were reluctant to disclose their experiences to protect them. Conclusions: This paper discusses nurses' experience of support following violence incidents at work as part of findings from a more extensive study that explored the perceptions of nurses regarding violence, strategies and support in a regional Queensland Hospital. Hospital support following a violent incident was perceived as inadequate and nurses felt unsupported immediately following an incident. Implications for Nursing Management: After an incidence of workplace violence, appropriate effective support may mitigate the enduring impacts of experiencing violence. There is the need for hospital management to provide effective support services and improve staff awareness of available support services. [ABSTRACT FROM AUTHOR]

Background: The primary goal of chronic obstructive pulmonary disease (COPD) management is to optimise a patient's functional status and quality of life. By encouraging effective patient self‐management within primary healthcare, unplanned and potentially avoidable COPD admissions to the emergency department (ED) can be avoided. Aim: The aim of this study is to examine whether distance to hospital influences the rate of ED presentation, hospital admission and hospital length of stay for COPD patients. Methods: The 2016 to 2018 resulted in a total of 5253 patient presentations with a primary medical diagnosis code of J44 (COPD). These were at the main hospitals of three Queensland Hospital and Health Services: Toowoomba, Ipswich and Gold Coast. To examine the variations in patient characteristics based on distance, a one‐way ANOVA (analysis of variance) test was conducted. The Kruskal‐Wallis test indicated that there were group differences. Results: This study identified significant variation in COPD‐related hospital length of stay and distance to hospital among COPD patients within three hospitals in South East Queensland, Australia. These results confirm that distance plays an important role in determining duration of hospital stay (in number of days) among COPD patients, with clear evidence of the distance 'decay phenomenon'. It appears from the findings of the current study that distance to the hospital is not associated with the greater likelihood of ED presentation but may influence length of stay. Conclusions: Several distance‐specific studies have concluded that lower utilisation of hospital care is associated with distance to hospital. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To report patient and family intensive care experiences using the Measuring the Intensive Care Experience (MICE) tool across two intensive care units (ICU). Background: The patient and family experience of care is an important indicator for quality improvement of ICUs, yet few studies evaluate both patient and family experiences in relation to overall care quality as well as specifically measuring quality of medical care, nursing care and organisational care as well as overall experience of the quality of intensive care. Design: A cross‐sectional survey. Methods: A 23 item survey was administered to ICU patients and their family members across two ICUs, a regional 189‐bed hospital and a metropolitan 227‐bed hospital in Queensland, Australia. The response rate was 272 of 394 ICU patients (36.4%). STROBE guidelines were used in reporting this study. Results: Findings indicate a highly positive overall experience of ICU care among patients and families. However, patients reported areas of unmet needs following their stay in ICU broadly related to (1) symptom management, education and information support, and (2) improving the incorporation of patient and family care ICU‐related shared decision‐making. Conclusions: Supportive interventions are needed that target improve symptom management and inform and education ICU patients. Relevance to clinical practice: The MICE survey facilitated the identification of a range of areas requiring quality improvement. Improving the integration of patients and families into shared decision‐making and support is a key aspect for quality improvement. [ABSTRACT FROM AUTHOR]

The purpose of this study was to test the international transferability and structural validity of the Career Futures Inventory (CFI) in a sample of Australian university students (N = 1,566). Exploratory factor analysis of the data from a random half-split of the sample supported a three-factor solution equivalent to the original CFI subscales, Career Optimism, Career Adaptability, and Perceived Knowledge. Confirmatory factor analysis of the data from the remaining random half-split supported the structural validity of a short form, the CFI-9. The subscales of the CFI-9 had acceptable internal consistencies and correlations with measures of academic major satisfaction, career choice satisfaction, and generalized self-efficacy. It was concluded that the properties of the CFI and the CFI-9 were sufficient to explore their application as measures of perceptions of employability. It was suggested that the CFI-9 has potential as a diagnostic screening tool for counseling and educational interventions. [ABSTRACT FROM PUBLISHER]

Objective: Chronic obstructive pulmonary disease (COPD) patients commonly have frequent visits to the ED. Consequently, COPD has a significant effect on total healthcare expenditure. The objective was to measure the frequency of ED presentation and hospitalisation among COPD patients and to estimate the costs resulting from such care utilisation. Methods: This was a causal‐comparative non‐experimental research design conducted in three regional hospitals between 2016 and 2018. Two different original data sets were used: an automated hospital data set and an audit of patient charts. Secondary cost data were also used. Data were analysed using Pearson's χ2 test to estimate the relationship between several patient and treatment‐related characteristics. Results: There were 5253 patient presentations at ED and hospital length of stay data were available for 5079 COPD patients. The total cost of hospital stays was $42.14 million for the time period and the mean average cost was $8297 for ED patients who were admitted to hospital. Factors significantly associated with hospital length of stay were age and time spent in the ED. Noticeably, one (51.7%) in two COPD patients were discharged from ED (all destinations) within 4 h irrespective of their triage category. Conclusions: COPD patient presentation to ED and admission to hospital is an expensive method of providing healthcare to manage this chronic condition. Clinical practitioners and policy makers need to develop and implement optimal integrated care management systems to reduce this hospitalisation rate and reduce the societal costs associated with COPD patient management. The objective was to measure the frequency of ED presentation and hospitalisation among COPD patients and to estimate the costs resulting from such care utilisation. COPD patient presentation to ED and admission to hospital is an expensive method of providing health care to manage this chronic condition. [ABSTRACT FROM AUTHOR]

Objective: This study determined the cultural appropriateness of the Structured Clinical Interview for the DSM-IV Axis I Disorders (SCID-I) as an acceptable tool for diagnosing mental illness among Indigenous people.Methods: De-identified qualitative feedback from participants and psychologists regarding the cultural appropriateness of the SCID-I for Indigenous people using open-ended anonymous questionnaires was gathered. Aboriginal Medial Service staff and Indigenous Support Workers participated in a focus group.Results: A total of 95.6% of participants felt comfortable during the 498 questionnaires completed. Psychologists also provided qualitative feedback for 502 (92.3%) interviews, of whom 40.4% established a good rapport with participants. Of the participants, 77.7% understood the SCID-I questions well, while 72.5% did not require any cultural allowances to reach a clinical diagnosis.Conclusion: When administered by a culturally safe trained psychologist, SCID-I is well tolerated in this group. [ABSTRACT FROM AUTHOR]

University students are likely to experience high rates of stress, which has the potential to negatively affect academic performance and their experience of study. Research with on-campus students has found positive benefits of health-promoting behaviours such as stress reduction and academic achievement; yet no research has examined these relationships with distance education students (and in comparison with on-campus students). Distance education students are a growing cohort in Australia higher education and elsewhere. This paper aims to redress this imbalance by comparing the relationships between stress, strain and coping, academic outcomes, and health-promoting behaviours in tertiary students (on-campus and distance education students). The study involved 242 on-campus and 399 distance education students at a regional Australian university. A path model was developed comparing both cohorts, and relationships were found to be similar, indicating no significant difference. Online interventions for distance education students which could be used to enhance coping are discussed. [ABSTRACT FROM PUBLISHER]