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Objectives: To compare women with men presenting with HIV to a public health HIV clinic, to identify the special characteristics and health care needs of women living with HIV in the Barwon South West region in Victoria. Methods: A retrospective cohort study of 35 women and 135 men living with HIV who attended the clinic between 2009 and 2020. Gender differences were assessed using nonparametric analyses. Results: The women were diagnosed with HIV younger than the men (mean 29.5 years vs. 36.7 years) and more were born in Africa (28.6% vs. 5.2%). More men than women presented with sexually transmittable infections (38.5% vs. 14.3%) at the time of diagnosis, and were diagnosed through a sexual health screen (37% vs. 17%). The proportions of men and women who used alcohol and other drugs (recent to their diagnosis) were similar (68.1% vs. 48.6%), and there was no difference in proportions presenting with AIDS-defining illnesses (p = 0.425), or CD4 cell count (advanced: £200 cells, relatively well: ‡201 cells, p = 0.241), but the women had a lower viral load (p < 0.001). Conclusions: In this study of 170 people living with HIV, nearly one-half of the men with known HIV history were diagnosed through sexual health screens, but women’s HIV was mostly detected through targeted screening. Results highlight gender disparity in access to sexual health screening and assessment, including low awareness of sexual health risks for women, and endorse the view that HIV is a heterosexual sexually transmittable infection in women.

The caring self-efficacy of direct care workers in residential aged care has been explored in the literature mostly as a predictor rather than the focus of interest. This scoping review aimed to provide an overview of the existing literature on aged care workers’ caring self-efficacy and factors that influence it. A systematic search was performed in six electronic databases. All primary studies were included. A total of 41 studies met the inclusion criteria. Caring self-efficacy was most often described by aged care workers as their capacity to deal with difficult situations. The self-efficacy scores of direct care workers were high across studies. Self-efficacy was positively influenced by access to resources, relationships with residents and their families, the support of supervisors and co-workers, job satisfaction, and training opportunities, and negatively affected by work pressure and burnout. Findings indicate possible avenues for intervention to improve direct care workers’ self-efficacy in aged care.

IntroductionDetection of mild cognitive impairment (MCI) is essential in slowing progression to dementia. Primary care plays a vital role in detecting and managing MCI. The chronic care model (CCM) provides effective methods to manage chronic diseases.ObjectiveThis study aimed to explore how MCI services are delivered in primary care in China.MethodsFocus group interviews were conducted face to face among MCI stakeholders from six community health centres (CHCs) involved in the ‘friendly community programme’ in Shanghai, China. A total of 124 MCI stakeholders were interviewed, consisting of 6 groups (n=42) of general practitioners (GPs), 3 groups (n=18) of CHC managers, 4 groups (n=32) of people with MCI and 4 groups (n=32) of informal caregivers. Content and thematic analyses were performed using a combination of induction and deduction approaches.ResultsThree major themes emerged from the data corresponding to the CCM framework: hesitant patients, unprepared providers and misaligned environments. While the public are hesitant to seek medical attention for MCI problems, due to misunderstanding, social stigma and a lack of perceived benefits, GPs and CHCs are not well prepared either, due to lack of knowledge and a shortage of GPs, and a lack of policy, funding and information support. None of these issues can be addressed separately without tackling the others.ConclusionThis study combined the diverse perceptions of all the main stakeholders to detect and manage MCI in primary care settings in China. A vicious circle was found among the three interconnected CCM domains, creating a gridlock that should be addressed through a system’s approach targeting all of the above-mentioned aspects.

BackgroundUrinary and fecal incontinence are disabling impairments after stroke that can be clinically managed with electrical stimulation.AimThe purpose of this systematic review was to determine the effectiveness of non-implanted electrical stimulation to reduce the severity of post-stroke incontinence.Summary of reviewClinical trials of non-implanted electrical stimulation applied for the purposes of treating post-stroke incontinence were searched in MEDLINE, EMBASE, CINAHL, PEDro, and CENTRAL. From a total of 5043 manuscripts, 10 trials met the eligibility criteria ( n = 894 subjects). Nine trials reported urinary incontinence severity outcomes enabling meta-analysis of transcutaneous electrical nerve stimulation (TENS; five trials) and electroacupuncture (four trials). Studies provide good-to-fair quality evidence that TENS commenced 3 months after stroke ( SMD = −0.67, 95% CI −1.09 to −0.26). Electroacupuncture has a large effect when administered >5 times a week ( SMD = −2.32, 95% CI −2.96 to −1.68) and a small effect when administered five times a week ( SMD = −0.44, 95% CI −0.69 to −0.18). Only one trial reported the effect of non-implanted electrical stimulation on post-stroke fecal incontinence.ConclusionsPublished trials evaluating the effect of non-implanted electrical stimulation on post-stroke incontinence are few and heterogenous. Synthesized trials suggest that early and frequent treatment using electrical stimulation is probably more effective than sham or no treatment. Further trials measuring incontinence in an objective manner are required.

Objectives This study explored whether consumer experience report (CER) data from residential aged care services (RACSs) could be combined into a general factor and determined whether poor experience in RACSs could be predicted by known resident or home characteristics or sampling procedures. Methods CER data collected by structured interviews in 2018 and early 2019 were analysed using structural equation modelling and linear regression analysis. Results Data were available from 17 194 interviews undertaken at 1159 RACSs. The 10 CER items loaded onto two independent factors. Bifactorial modelling indicated that items could be combined into a general factor. Controlling for state or territory, consumer experience was best predicted by home size: those in large facilities reported poorer experience than those in smaller facilities. Other significant negative predictors with small effect sizes included not being independently mobile, being male and not being randomly selected. Dementia did not predict total CER score. Conclusions The results of this study support the inclusion of people with dementia and exclusion of volunteer participants from published CERs. Further research is needed to explore why a relatively poor consumer experience is reported by people in larger homes, men and those with mobility issues. What is known about the topic? Poor experience in aged care is a persistent concern for government, individuals and aged care services. The recent Royal Commission into Aged Care Quality and Safety has identified systemic failure. Although many organisational features and processes have previously been identified as important in determining the quality of care, few studies have explored the characteristics that predict the consumer experience of residents in aged care. What does this paper add? This paper provides empirical evidence that several variables influence consumer experience in aged care, including facility size and resident sex and mobility. There is evidence that smaller facilities provide care that is perceived better by residents, and that men and people with mobility issues have worse experiences in aged care. There is a lack of clarity as to what other influences, such as facility ethos, facility location and staffing levels, may contribute to resident experience. Such clarity is important, because Australian aged care is currently facing comprehensive scrutiny, and governments are looking to ensure the safety and quality of aged care services. What are the implications for practitioners? Identifying and addressing inequities in aged care services and mitigating risks must be a priority in Australia to ensure aged care services provide safe and high-quality care. The results of this study challenge current funding structures that encourage the development of larger aged care homes, and instead suggest that better funding for smaller-sized facilities may be able to improve the experience of residents in aged care. The results also suggest that facilities and governments should attend to the experiences of specific groups, such as men and people with mobility issues.

Objectives: To evaluate The Little Things training program, designed to assist personal care assistants (PCAs) from culturally and linguistically diverse (CALD) backgrounds to communicate more effectively with aged care residents. Methods: This project included PCAs from residential aged care facilities (RACFs) and Certificate III students from registered training organisations (RTOs) in Melbourne, Australia. A control group (n = 18) was also included. Measures included the following: pre- and posttraining confidence to communicate and rankings of task importance; posttraining perceived change in confidence; and posttraining impacts on practice. Results: Altogether, 75 PCAs and 30 RTO students participated in Intake I of the training and 31 PCAs and 34 RTO students in Intake 2. Confidence increased in The Little Things participants relative to those in the control group (β = 0.11, T = 1.99, p = 0.05). Change did not vary by Intake or whether someone was in the RACF or RTO group, F (2, 147) = 0.58, p = 0.5; nor by sociodemographic characteristics. Most training participants (84%) thought their ability to communicate with older people would ‘improve a lot’ as a result of the training. Training participants also ranked the importance of duties such as ‘Speaking in a friendly and informal way to older people’ more highly after than before the training (p = 0.01), while little change was observed in the control group. Conclusions: The Little Things program increased training participants' confidence to communicate and shifted perceived priorities towards interacting with residents in a way that enhanced resident well-being.

This mixed methods study explored challenges faced by pastoral care workers. A development phase preceded an on-line survey completed by chaplains and pastoral practitioners (n = 40) employed by a major Australian aged care provider. The survey covered the purpose of pastoral care, key tasks and resources, current and future challenges, and participants' responses to challenges. The biggest issue was heavy demand on participants' time, due to insufficient staff and demanding organisational procedures. A commonly mentioned challenge with future implications was increasing resident acuity. Respondents were dedicated and enthusiastic, despite heavy workloads and occasional difficulty working with care staff or management.

Understanding the role of organisational policies in improving work–life interaction is important, as such policies may provide a legitimate means to extend working life, potentially leading to imp...

Nursing students rate geriatric nursing poorly in career preferences, but aging populations mean more older people require access to health care. Negative attitudes held by nursing students can lead to ageism affecting the quality of care provided. The purpose of this scoping review is to summarize research findings in the published literature relating to factors associated with nursing students’ attitudes toward older people, and the tools used to measure these attitudes. The Joanna Briggs Institute guide for conducting a scoping review was used. Eleven databases and search engines were searched for international peer reviewed research articles published in English between January 2000 and February 2021. Sixteen articles were included in the review. This review highlights areas for affirmative action to improve undergraduate nursing students’ attitudes toward older people to prepare them to work effectively in future health care systems. Positive attitudes were associated with: senior years of study; professional values (caring, professionalism, trust); education regarding care of older adults; knowledge about aging; contact with older family members; comfort communicating with older people; and willingness to work with older people following graduation. It also identified the need for a current, nursing-specific measure of attitudes toward older people.

As consumer-directed care programmes become increasingly common in aged care provision, there is a heightened requirement for literature summarising the experience and perspectives of recipients. We conducted rapid evidence reviews on two components of consumer experience of home- and community-based aged care: (a) drivers of choice when looking for a service (Question 1 (Q1)); and (b) perceptions of quality of services (Question 2 (Q2)). We systematically searched MEDLINE and EMBASE databases, and conducted manual (non-systematic) searches of primary and grey literature (e.g. government reports) across CINAHL, Scopus, PsychINFO, and Web of Science, Trove and OpenGrey databases. Articles deemed eligible after abstract/full-text screening subsequently underwent risk-of-bias assessment to ensure their quality. The final included studies (Q1: N = 21; Q2: N = 19) comprised both quantitative and qualitative articles, which highlighted that consumer choices of services are driven by a combination of: desire for flexibility in service provision; optimising mobility; need for personal assistance, security and safety, interaction, and social/leisure activities; and to target and address previously unmet needs. Similarly, consumer perspectives of quality include control and autonomy, interpersonal interactions, flexibility of choice, and safety and affordability. Our reviews suggest that future model development should take into account consumers’ freedom to choose services in a flexible manner, and the value they place on interpersonal relationships and social interaction.

Objectives: Cognitive behavioral therapy (CBT) for depression and anxiety for older adults living in residential aged care facilities (RACFs) needs to accommodate the care needs of residents and the circumstances of RACFs. This systematic review examines the delivery and content characteristics of these interventions, in relation to participant satisfaction, staff appraisal, uptake rate, attrition rate, and treatment effectiveness. Such a review could provide important information for the development of future CBT-based interventions. Method: Studies that examined the application of CBT for depression or anxiety in RACFs were identified by systematically searching a number of relevant databases. Reference lists of all included studies were examined, and citation searches on the Web of Science were conducted. Two independent reviewers were involved in screening articles and in extracting data and assessing methodological quality of the selected studies. Results: Across the 18 studies included in this review, the most common therapeutic strategy was pleasant activities scheduling. Studies varied on treatment duration (2–24 weeks), number of sessions (6–24), and length of sessions (10–120 min). Residents and staff members were satisfied with the CBT interventions. The average uptake rate was 72.9%. The average attrition rate was 19.9%. Statistically significant results were reported in 8 of the 12 randomized controlled trials (RCTs). In these eight RCTs, CBT was characterized by psychoeducation, behavioral activation, and problem-solving techniques; further, the therapists in six of these studies had training in psychology. Conclusion: CBT interventions for depression and anxiety are acceptable to RACF residents and judged positively by staff members. Effective studies differed from non-effective studies on content and training characteristics, but not on other delivery features.

The extant literature on Jewish Holocaust survivors’ experiences of receiving aged care services typically focuses on the risk that formal care settings may reactivate traumatic memories. Absent from previous research have been the viewpoints of older survivors themselves regarding their aged care experiences. An interpretive phenomenological approach was used to investigate Jewish Holocaust survivors’ lived experience of using community aged care services. Thirteen in-depth interviews were conducted and analysed using thematic analysis. The credibility of the findings was ensured by methodological triangulation and peer debriefing. Four major themes emerged from the analysis: wanting carers to do their job well; being supported to maintain autonomy; having a good relationship with the carer; and being understood as an individual. Although Holocaust survivors described the lived experience of using community aged care services in terms of universal themes similar to those identified with other groups of care recipients, the data revealed that this experience is intertwined with individual earlier-life traumatic experiences. This study has implications for training age care staff who work with Holocaust survivors and older trauma survivors from other refugee backgrounds.

Purpose The purpose of this paper is to explore job satisfaction, and how the work-life interface might affect job satisfaction, among residential aged care staff. The statistical package PROCESS was used to analyse the impacts of workplace stressors (poor safety climate, poor relationships with colleagues and poor relationships with management) and potential mediating variables that measured aspects of the work-life interface, specifically work-family conflict (WFC) and work-life balance. Design/methodology/approach This survey research was carried out through distribution of a paper-based questionnaire to approximately 800 permanent, fixed term and casual employees working in residential aged care. All job roles, including both direct care and support staff, were represented in the sample. Findings WFC and work-life balance act serially to mediate the relationships between workplace stressors and job satisfaction. Research limitations/implications Study participants were restricted to residential aged care facilities in the metropolitan Melbourne area, Australia, limiting generalisability of the findings. Practical implications The work-life interface is a legitimate concern for human resources managers. Implications include need for greater understanding of the contribution of work-life fit to job satisfaction. Interventions to improve job satisfaction should take into account how workplace stressors affect the work-life interface, as well as job-related outcomes. Enhanced work-life fit should improve job-related outcomes. Originality/value This paper explores the potential mediating roles of WFC and work-life balance on job satisfaction and demonstrates a pathway through which the work-life interface affects job satisfaction for workers in residential aged care.

OBJECTIVE To develop and pilot a short interview tool to be implemented by the Australian Aged Care Quality Agency (AACQA) in residential aged care, to inform prospective consumers about the quality of care and services received-the consumer experience report (CER). METHODS Twenty-four questions addressing the four Aged Care Quality Standards were piloted with 140 residents and 48 representatives (including 27 resident-representative pairs). A method for approximating random selection was also trialled. Fifty-two residents were interviewed twice, one week apart, and each question's usability was rated by 11 surveyors and two interpreters. Selection criteria for questions included consumer preference, test-retest reliability, resident-representative agreement, usability and low missing data. RESULTS Nineteen questions performed well on missing data, 16 on test-retest, 17 on resident-representative agreement and 12 on usability. Ten quantitative and two open-ended questions were selected. CONCLUSIONS The CER questions proved suitable to collect data systematically on consumer experience in residential aged care. AACQA (now the Aged Care Quality and Safety Commission) uses the CER interview to support their audit process, and aggregated results are published online.

To examine whether the work-life interface (through work-family conflict and overall work-life balance) moderates the relationship between work ability and workplace demands and resources.This study used a cross-sectional survey design to collect data from 426 employees working in residential aged care.A paper-based questionnaire was distributed to all permanent and casual employees at eight aged care facilities in Melbourne, Australia, between June - September 2013. Moderation analyses were conducted using PROCESS v. 2.13 in SPSS v. 22.As expected, workplace demands and resources directly influenced workers' work ability. In addition, moderate-to-high levels of work-family conflict and low-to-moderate levels of satisfaction with work-life balance combined interactively with particular workplace demands and resources (relationships with management, physical demands, and safety climate) to reduce work ability.This study advances understanding of how work-life balance and work-life conflict can influence work ability levels and shows that addressing the work-life interface may be a legitimate means to improve work ability, potentially leading to continued workforce participation.Staff retention in the residential aged care sector needs to be addressed. One possible means of achieving this is through improving work ability. This study expanded knowledge of how the work-life interface may influence work ability. The research demonstrated that relationships between work ability and particular workplace demands and resources were moderated by the work-life interface. This finding has implications for how human resources managers of residential aged care facilities may improve workforce retention-through facilitating employees to manage the work-life interface better.目的: 研究工作-生活界面(通过工作-家庭冲突和整体工作-生活平衡)是否调节工作能力与工作场所需求和资源之间的关系。 设计: 本研究采用横断面调查设计,收集了426名在养老院工作的员工数据。 方法: 2013年6月至9月,我们向澳大利亚墨尔本8家老年护理机构的所有长期员工和临时工发放了一份纸质问卷。采用SPSS第22节第2.13节的过程进行适度分析。 结果/发现: 正如所料,工作场所的需求和资源直接影响着员工的工作能力。此外,中等至高水平的工作-家庭冲突和较低至中等水平的工作-生活平衡满意度与特定的工作场所需求和资源(与管理、物质需求和安全氛围的关系)相互作用,以降低工作能力。 结论: 本研究增进了对工作-生活平衡和工作-生活冲突如何影响工作能力水平的理解,并表明处理工作-生活界面可能是提高工作能力的一种合理方法,潜在地引起持续的劳动力参与。 影响: 需要解决居住养老部门的工作人员留用问题。实现这一目标的一个可能途径是提高工作能力。本研究扩展了工作-生活界面如何影响工作能力的知识。研究表明,工作能力与特定工作场所需求和资源之间的关系受工作-生活界面的调节。这一发现对老年护理机构的人力资源管理人员如何通过促进员工更好地管理工作-生活界面来提高员工保留率具有启示意义。.

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Objectives: Cognitive Rehabilitation interventions have the potential to improve quality of life for people with MCI. We recently developed, trialled, and evaluated the use of the MAXCOG (Maximisin...

Conflicted parental separation is associated with escalating risks to wellbeing and safety for all family members. The Family Law DOORS (FL-DOORS, Detection Of Overall Risk Screen) is a three-part framework designed to assist frontline workers to identify, evaluate, and respond to these risks in separated families. The FL-DOORS system includes a 10-domain parent self-report screening measure, covering child and parent wellbeing, cultural and social risks, and safety risks experienced by and initiated by each parent. A first validation study of this screen was conducted with the first 660 separated parents to complete the measure at a frontline community agency, and found robust psychometric properties (McIntosh, Wells, & Lee, 2016). This paper presents a revalidation study of FL-DOORS screening measure with a new cohort of 5,429 separated parents, including 1,642 pairs. Our aim was to evaluate whether FL-DOORS was fit for the purpose of indicating a range of safety and wellbeing risks in separated families. We repeated internal scale reliability and concurrent and external criterion validity analyses. Original subscales were largely confirmed, and validity analyses were extended through a Multi-Trait Multi-Method (MTMM) approach. In this second larger cohort, the FL-DOORS screen was again found fit-for-purpose as an indicator of domestic violence and wellbeing risks in separated families. (PsycINFO Database Record

Objective: Rates of depression and anxiety are high among older adults in residential aged care facilities (RACFs). This study examined the extent to which psychological services are made available to facility residents in Australia, and investigated barriers to accessing such services. Method: The sample consisted of 90 senior staff from a random sample of RACFs. Participants completed self-report questionnaires regarding their perspectives on the availability of psychological services and potential barriers to access psychological services. Results: Access to psychological services was poor. Psychologists were employed at a rate only one third that of other providers of mental health services. Residents were rarely referred to psychologists or to psychological treatments. The most important barriers to access, as perceived by participants, were the low availability of psychologists specialising in treating older adults, lack of government funding for such access, and limited staff training in detecting depression and anxiety. Conclusion: Access to psychologists and psychological services remains poor in Australian residential aged care settings. Such access may be improved by developing a workforce of clinical geropsychologists, improving funding mechanisms for residents to access psychological services, and addressing staff knowledge about depression and anxiety.

Objective To evaluate a new information resource developed for clients with mild cognitive impairment (MCI) or early dementia and their family supporters. Methods A controlled group trial was undertaken comparing 40 clients and family supporters who received ‘service as usual’ followed by 40 clients and family supporters who received ‘service as usual’ plus the new information resource. Telephone interviews comprising open questions, ratings and a quality-of-life questionnaire were undertaken two to four weeks after the client's final feedback session. Results The two groups (equivalent on sex, age and cognition) showed a similar pattern of responses regarding handout use and evaluation. However, family supporters in the group who received and read the new resource were better able to describe their use of cognitive management strategies. Conclusion Some family supporters appeared to benefit from using the new resource but people with MCI may require further face-to-face support to learn new strategies.

Objectives To review the efficacy of a home-based four-session individualized face-to-face cognitive rehabilitation (MAXCOG) intervention for clients with mild cognitive impairment (MCI) or early dementia and their close supporters. Design Randomized controlled trial comparing the intervention group (MAXCOG) with treatment as usual (control). Participants A total of 55 client–supporter dyads were enrolled in the study and 40 completed; 25 client–supporter dyads completed MAXCOG and 15 completed treatment as usual. Both MAXCOG and control groups included more MCI cases than dementia (22 versus 3 and 12 versus 3, respectively). Intervention Four weekly individual sessions of MAXCOG consisting of personalized interventions to address individually relevant goals, supported by the provision of the MAXCOG information resource. Measures The primary outcomes were goal performance and satisfaction, assessed using the Canadian Occupational Performance Measure (COPM). Questionnaires assessing mood, illness adjustment, quality of life, and carer burden were also administered. Results The intervention group displayed significantly higher performance and satisfaction with primary goals on the COPM post-intervention than the control group, using a per-protocol analysis. Conclusions The MAXCOG intervention is effective in improving goal performance and satisfaction in clients with MCI and early dementia.

Objective To review studies published in the Australasian Journal on Ageing (AJA) about the aged care workforce, and to identify influences on quality of care and potential policy directions. Methods Articles in the AJA on the aged care workforce published from 2009 to 2018 were identified, grouped into themes and rated for quality. Results Twenty-eight articles were identified. Articles fell into four themes: (i) staff knowledge, skills and attitudes; (ii) staff well-being and workforce stability; (iii) environmental factors that influence staff capacity; and (iv) interventions to improve staff capacity. Studies reinforced the importance of staff-consumer, staff-relatives and staff-staff relationships and a supportive workplace culture for staff work ability and capacity to provide high quality care. Conclusions It is possible to improve practice in community and residential aged care, given: (i) enough staff; (ii) better training in person-centred practice; and (iii) a supportive staff culture that encourages staff to put their training into practice.

Ensuring sufficient staff numbers to accommodate an increasing need for aged-care services is one challenge facing the residential aged-care sector. Human resources management (HRM) policy and practice need to explore ways flexible working arrangements can be utilised to improve recruitment and retention. This study applied a person–environment (P–E) fit model to understanding the role of flexible working arrangements in contributing to the successful operation of residential aged-care facilities in Victoria, Australia. A sample of 108 residential aged-care workers participated in semi-structured interviews to discuss flexible working arrangements, facilitators and barriers affecting their use and uptake, and individual and organisation outcomes resulting from their use. HRM should encourage the development and implementation of policies and practices related to flexible working arrangements in residential aged care, and their uptake by staff, to enhance P–E fit, thus supporting people to remain in their jobs.

When former spouses experience distress and dispute following separation, risks to well-being and to safety are heightened for all family members. Reliable family-wide risk screening is essential. The Family Law DOORS (Detection of Overall Risk Screen) is a 3-part screening framework to assist identification, evaluation, and response to safety and well-being risks in separated families. Uniquely, the Family Law DOORS screens for victimization and perpetration risks and appraises infant and child developmental risk. The Family Law DOORS self-report screening tool is the subject of this report. Internal scale reliability and concurrent and external criterion validity for the Family Law DOORS were estimated with a community sample of 660 separated parents, including 181 mother-father pairs. Overall psychometric properties are strong and demonstrate good potential for the Family Law DOORS to support early risk detection for separating families. (PsycINFO Database Record

Lack of awareness among paid carers of the possible late-life consequences of early-life periods of extreme and prolonged traumatization may have negative impacts on the experiences of trauma survivors in receiving care. An interpretive phenomenological approach was used to investigate the lived experience of paid carers in providing care for Jewish Holocaust survivors. In total, 70 carers participated in 10 focus group discussions. Credibility of the findings was ensured by methodological triangulation and peer debriefing. Three major themes emerged: (a) knowing about survivors’ past helps me make sense of who they are, (b) the trauma adds an extra dimension to caregiving, and (c) caring for survivors has an emotional impact. Specific knowledge, attitudes, and skills for building positive care relationships with Holocaust survivors were identified. The findings offer a starting point for advancing knowledge about the care of older survivors from other refugee backgrounds.

Objectives To explore the views of clients, supporters and counsellors about their experiences of the maximising cognition (MAXCOG) intervention. Methods The most significant change (MSC) method of analysis was used. Twenty-three narrative accounts of the MAXCOG intervention and the ‘MSC’ that occurred were obtained. A panel, including experts from Alzheimer's Australia, the MAXCOG research team and clinicians from memory clinics, conducted a workshop to discuss and categorise the accounts. Results Two subcategories of stories were identified: (i) An ‘acceptance group’ that focused on adjustment issues; and (ii) A ‘goal achievement’ group with a focus on goals and improvement in ability and confidence. These subcategories mapped closely to the original goals outlined for the MAXCOG intervention. Conclusion The MAXCOG intervention was successful in assisting people to work towards goals and adjust psychologically to difficulties.

The aim of this study was to examine older adults' experiences of change following a group memory intervention, the La Trobe and Caulfield Hospital (LaTCH) Memory Group programme. Semi-structured qualitative interviews were conducted with 30 individuals. Participants were healthy older adults and older adults with amnestic mild cognitive impairment (MCI) who had participated in the memory group five years previously. Transcripts were analysed for emergent themes in a workshop, using the Most Significant Change technique. The focus group derived four major themes relating to participants' experiences of change. Particularly noteworthy were themes describing a process of acceptance and normalising of memory difficulties in older age, as well as enhancement of coping and self-efficacy. The results highlight the importance of group support for older adults with and without objective memory impairment. Memory groups may use the group format to full advantage by (a) enhancing participants' experiences of universality to alleviate distress and promote coping, and (b) developing group norms to promote positive ageing, encompassing enhanced acceptance and self-efficacy.

© 2019 National Rural Health Alliance Ltd. Objective: To assess the quality of life of older Australians living in rural and urban communities over time. Design: Panel survey conducted in 2012-2013 and 2014-2015. Setting: Participants lived in metropolitan Melbourne (urban sample, N = 279), rural Victoria (N = 98) or Tasmania (N = 47). Participants: All participants (N = 424) were clients of aged care providers or residents in retirement housing or residential care. Main outcome measures: Quality of life. Result: A repeated-measures analysis of variance showed a decrease in quality of life over time. There was no difference in change in quality of life over time by location of participants (urban vs rural). Multiple regression analysis showed that resilience predicted baseline quality of life in all three locations. Conclusion: These findings generally did not support significant differences between geographic locations in trajectories of older adults' quality of life over time. Instead, individuals' resilience appears to be the strongest predictor of quality of life.

Aim To assess the internal reliability and validity (content and criterion) of the Older Patients in Acute Care Survey (OPACS) as a measure of nurses’ knowledge, attitudes and practices regarding care of older hospitalized patients in Australia. Design Cross‐sectional survey. Method A convenience sample of final year nursing students at an Australian university in October 2014 completed the OPACS (N = 191). Internal reliability was assessed using Cronbach's alpha, content validity using exploratory factor analysis and criterion validity using correlations between the OPACS and Palmore's Facts on Aging Quiz and the Caring Efficacy Scale. Results Despite good internal reliability on both OPACS subscales, exploratory factor analysis of the 36 items representing behaviours and the 50 items on knowledge and attitudes failed to load strongly on their corresponding factors. Analyses of criterion validity suggested the OPACS scales are measures of attitude.

Background: The prevalence rates of depressive and anxiety disorders are high in residential aged care settings. Older adults in such settings might be prone to these disorders because of losses associated with transitioning to residential care, uncertainty about the future, as well as a decline in personal autonomy, health, and cognition. Cognitive behavioral therapy (CBT) is efficacious in treating late-life depression and anxiety. However, there remains a dearth of studies examining CBT in residential settings compared with community settings. Typically, older adults living in residential settings have higher care needs than those living in the community. To date, no systematic reviews have been conducted on the content and the delivery characteristics of CBT for older adults living in residential aged care settings. Objective: The objective of this paper is to describe the systematic review protocol on the characteristics of CBT for depression and/or anxiety for older adults living in residential aged care settings. Methods: This protocol was developed in compliance with the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Studies that fulfill the inclusion criteria will be identified by systematically searching relevant electronic databases, reference lists, and citation indexes. In addition, the PRISMA flowchart will be used to record the selection process. A pilot-tested data collection form will be used to extract and record data from the included studies. Two reviewers will be involved in screening the titles and abstracts of retrieved records, screening the full text of potentially relevant reports, and extracting data. Then, the delivery and content characteristics of different CBT programs of the included studies, where available, will be summarized in a table. Furthermore, the Downs and Black checklist will be used to assess the methodological quality of the included studies. Results: Systematic searches will commence in May 2018, and data extraction is expected to commence in July 2018. Data analyses and writing will happen in October 2018. Conclusions: In this section, the limitations of the systematic review will be outlined. Clinical implications for treating late-life depression and/or anxiety, and implications for residential care facilities will be discussed. Trial Registration: PROSPERO 42017080113; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=80113 (Archived by WebCite at http://www.webcitation.org/70dV4Qf54) Registered Report Identifier: RR1-10.2196/9902

This paper examines the role of person-environment (P-E) fit in encouraging longer working lives in a sample of Australian public servants. Study results are of interest to those involved in the development of effective HRM policy aimed at retention of older workers. A sample of 332 workers aged 40 and over, completed a questionnaire. Multivariate regression analyses were used to identify the most important predictors of intention to retire. Focus group interviews (n = 42) were also undertaken. Age and duration of service were strong, negative predictors of time to intended retirement. Work ability and Job satisfaction, two key elements in a P-E fit model, were important in identifying people who intended to retire within the next five years. HRM policy needs to take into account the complexity of retirement decisions and recognise that decision points exist and a one-size-fits-all approach is unlike to be successful. © 2016 Australian Human Resources Institute.

BACKGROUND The prevalence rates of depressive and anxiety disorders are high in residential aged care settings. Older adults in such settings might be prone to these disorders because of losses associated with transitioning to residential care, uncertainty about the future, as well as a decline in personal autonomy, health, and cognition. Cognitive behavioral therapy (CBT) is efficacious in treating late-life depression and anxiety. However, there remains a dearth of studies examining CBT in residential settings compared with community settings. Typically, older adults living in residential settings have higher care needs than those living in the community. To date, no systematic reviews have been conducted on the content and the delivery characteristics of CBT for older adults living in residential aged care settings. OBJECTIVE The objective of this paper is to describe the systematic review protocol on the characteristics of CBT for depression and/or anxiety for older adults living in residential aged care settings. METHODS This protocol was developed in compliance with the recommendations of the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). Studies that fulfill the inclusion criteria will be identified by systematically searching relevant electronic databases, reference lists, and citation indexes. In addition, the PRISMA flowchart will be used to record the selection process. A pilot-tested data collection form will be used to extract and record data from the included studies. Two reviewers will be involved in screening the titles and abstracts of retrieved records, screening the full text of potentially relevant reports, and extracting data. Then, the delivery and content characteristics of different CBT programs of the included studies, where available, will be summarized in a table. Furthermore, the Downs and Black checklist will be used to assess the methodological quality of the included studies. RESULTS Systematic searches will commence in May 2018, and data extraction is expected to commence in July 2018. Data analyses and writing will happen in October 2018. CONCLUSIONS In this section, the limitations of the systematic review will be outlined. Clinical implications for treating late-life depression and/or anxiety, and implications for residential care facilities will be discussed. CLINICALTRIAL PROSPERO 42017080113; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=80113 (Archived by WebCite at http://www.webcitation.org/70dV4Qf54) REGISTERED REPORT IDENTIFIER RR1-10.2196/9902

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of psychological therapies in comparison with treatment as usual, waiting list, attentional control, other psychological therapies, or cointervention for depression in older people living in long‐term care (LTC) settings.