Search

This paper sets out the Collaborative Service Design Playbook, to guide planning, design, and implementation of co-created health services. Successful health service development and implementation is best guided by theoretically informed approaches; however, organisations often lack design and implementation know-how and have difficulty applying it. This study seeks to improve health service design and potential for scale-up by proposing a tool to guide an end-to-end process, drawing together service design, co-design, and implementation science; and exploring the tool's feasibility to establish a sustainable service solution developed with participants and experts that is scalable and sustainable. The Collaborative Service Design Playbook phases include, (1) Define the opportunity and initiatives, (2) Design the concept and prototype, (3) Deliver to scale and evaluate; and (4) Optimise to transform and sustain. This paper has implications for health marketing through providing an end-to-end approach with phased guidance for health service development, implementation, and scale up. [ABSTRACT FROM AUTHOR]

An increasing focus in aged care policy is supporting older people to age at home. However, there is little recognition of the health and independence of older private renters living in a space they do not own or control. This paper draws on in-depth interviews and assessments undertaken in the homes of 27 older tenants in the Brisbane environs aiming to understand how renting privately influenced their ability to meet their basic needs. An analysis of the findings highlights the disadvantage experienced by many older private renters. Most older private renters were unable to meet their basic needs given unaffordable rent whilst reliant on the aged pension. Further, with limited access to community aged care including home modifications, the health and independence of older private renters was found to be at risk. IMPLICATIONS Community aged care is difficult for older private renters to utilise in Australia, with unaffordable services and tenancy law limiting access to community aged care services including home modifications. It is vital social workers advocate for the community aged care needs of older private renters in practice and policy settings. [ABSTRACT FROM AUTHOR]

This two-year (2016–2018) study aimed to identify what a good life is for Aboriginal people with disability in remote Central Australia and how service providers can support them to achieve a good life. This paper presents the findings that relate to barriers to delivering services for Aboriginal people with disability. In-depth interviews and focus groups were held with Aboriginal people with disability and their carers aged at least 18 years from the Ngaanyatjarra Pitjantjatjara Yankunytjatjara (NPY) Lands and community organisations providing services there. The data were analysed using thematic analysis. There were 109 participants, of whom 47 were workers in service provider organisations and 62 were Aboriginal people. From the data, barriers to delivering services to support Aboriginal people to live a good life and solutions to overcome the barriers, were identified and described under the headings of environmental barriers and systemic issues. We discuss the policy implications of these findings with regard to addressing Indigenous disadvantage and how governments, service providers, communities, and Aboriginal people with disability and their families can work in partnership to address these barriers. Indigenous people with disability living in remote and very remote communities experience significant access and equity barriers to culturally responsive services that enable them to live a socially and culturally engaged life. Localised government and service provider disability policy approaches in Indigenous communities need to focus on both environmental and systemic issues. Greater investment in local remote communities is required to build the capacity of Indigenous families to support Aboriginal people with a disability to live a culturally and socially included life. [ABSTRACT FROM AUTHOR]

Objectives: Group singing has been reported to enhance quality of life (QoL) and mental health in older people. This paper explored whether there are differences in the effects of group singing intervention on people with Parkinson's (PwPs) in Australia, UK and South Korea. Methods: The study included PwPs (N = 95; mean age = 70.26; male 45%) who participated in a standardised 6-month weekly group singing programme. Parkinson's health-related QoL measure (PDQ39) and mental health assessment (DASS) were administered at baseline and follow-up. ANOVAs were performed with significance set as p <.05. Results: ANOVAs revealed main effects of Time on the Stigma and Social Support subscales of PDQ39; both showed a small but significant improvement over time. However, the social support reduction was moderated by country; social support was improved only in South Korean participants. The reduction in stigma was greater than previously reported minimal clinically important differences, as was the social support reduction in South Korean participants. In terms of mental health, ANOVAs revealed that the scores of Anxiety and Stress domains of DASS significantly decreased from pre-test to post-test with small effect sizes. Conclusion: This first international singing study with PwPs demonstrated that group singing can reduce stigma, anxiety and stress and enhance social support in older adults living with Parkinson's. The findings are encouraging and warrant further research using more robust designs. [ABSTRACT FROM AUTHOR]

Purpose:This paper explains and demonstrates the pilot application of Triangulated Proxy Reporting (TPR); a practical technique for enhancing communication around people who have severe cognitive impairment (SCI). Methods and results:An introduction explains SCI and how this impacts on communication; and consequently on quality of care and quality of life. This is followed by an explanation of TPR and its origins in triangulation research techniques. An illustrative vignette explicates its utility and value in a group home for a resident with profound multiple disabilities. The Discussion and Conclusion sections propose the wider application of TPR for different cohorts of people with SCIs, their communication partners and service providers. Conclusions:TPR presents as a practical technique for enhancing communication interactions with people who have SCI. The paper demonstrates the potential of the technique for improving engagement amongst those with profound multiple disabilities, severe acquired brain injury and advanced dementia and their partners in and across different care settings.Implications for RehabilitationTriangulated Proxy Reporting (TPR) shows potential to improve communications between people with severe cognitive impairments and their communication partners.TPR can lead to improved quality of care and quality of life for people with profound multiple disabilities, very advanced dementia and severe acquired brain injury, who otherwise are very difficult to support.TPR is a relatively simple and inexpensive technique that service providers can incorporate into practice to improving communications between clients with severe cognitive impairments, their carers and other support professionals. [ABSTRACT FROM PUBLISHER]

Our choice for care at the end of our lives is constrained by many factors, including the options available to us, our capacity to choose and the social structures that constrain our options and therefore our choices. Working with the interaction between personal agency and social constraints is a core public health activity. An intentional public health approach to palliative and end-of-life care can elucidate the direct relationship between our social circumstances and the quality of our end of life and uncover the implications of structural inequity for end-of-life choice. The approach reorients systems and settings to achieve accessible and equitable palliative and end of-life care for all, and identifies contributions that all jurisdictions, settings, organisations, sectors and communities can make to improving end-of-life care outcomes. Frameworks that support this shift in practice and policy are however in their infancy. Implementation frameworks that can structure and guide 'how' to translate public health palliative care concepts into sustainable practice are needed. This paper reports on an evidence-based Australian public health palliative care framework designed to achieve this. [ABSTRACT FROM AUTHOR]

All papers in this special edition ofMental Health, Religion & Cultureutilise data sets from the 2011 round of the Australian National Church Life Survey (NCLS). This paper presents a methodological overview of the NCLS, including data collection methods, survey instruments and demographic descriptions of church attender and leader data sets. The data sets have good national coverage and denominational diversity, although Pentecostals are under-represented. The data sets may be further affected by self-selection by participating churches; however, the content of the surveys is unlikely to have triggered self-selection biases at the level of individuals. The paper also provides details concerning the measurement of quality of life in the present collection, concentrating on the Personal Wellbeing Index (PWI) which is featured in four of the five empirical papers. Mean PWI scores for churchgoers and leaders were similar to the Australian populace at large, although there was greater variability among churchgoers. The domain of spirituality/religion makes a significant contribution to well-being in these Australian Christian sub-populations. [ABSTRACT FROM AUTHOR]

This paper contributes to the advancement of quality-of-life research in tourism by examining complex relationships involving direct, mediated, moderated and moderated mediation relationships among the antecedents to quality-of-life. Using a sample of 222 repeat visitors in an Australian national park, the findings indicate positive significant effects of (1) place satisfaction on quality-of-life; (2) place satisfaction on place attachment; (3) place attachment on quality-of-life; (4) park citizenship on place attachment. The findings further support that (5) place attachment mediates the relationship between place satisfaction and quality-of-life; (6) social involvement moderates the relationship between place satisfaction and place attachment; (7) park citizenship moderates the relationship between place satisfaction and place attachment; (8) social involvement moderates the relationship between place attachment and quality-of-life; (9) social involvement moderates the indirect effect of place satisfaction on quality-of-life. Theoretical and practical implications are discussed. Park managers, for example, need to promote on-site marketing and post-visit communication/interpretation, encouraging repeat visits and behavioural change. Message delivery needs to promote a sense of belonging to the park with personal meaning, creating place distinctiveness. Personal actions to promote include signing petitions supporting the park's biodiversity, and other resources, and volunteering to participate in meetings and other direct actions. [ABSTRACT FROM AUTHOR]

This paper explored the psychological mechanisms by which leisure enhances well-being by using sentence-by-sentence coding of the best-possible-selves text produced by 112 participants. Of the 1097 sentences, 41% were coded as leisure indicating that leisure is an important component of optimal well-being. The data showed that Australians have significantly less leisure in their daily lives than our sample desired; older and wealthier individuals placed a greater emphasis on leisure but there were no significant differences based on gender. Application of the Detachment-Recovery, Autonomy, Mastery, Meaning, Affiliation (DRAMMA) framework showed the following allocation of sentences to psychological mechanisms: Detachment-Recovery-21%, Autonomy-23%, Mastery-12%, Meaning-11% and Affiliation-33%. In their ideal future, participants imagined that they have the time and money to do what they want, particularly, to travel. We showed leisure is not solely associated with ‘having fun’; 59% of participants wanted to use their leisure time to learn, improve, or contribute to society. [ABSTRACT FROM PUBLISHER]

Beginning in 2013, the Australian Royal Commission into Institutional Responses to Child Sexual Abuse (referred to as the Royal Commission) bought to public consciousness a history of child sexual exploitation that contradicts dearly held values of the preciousness and innocence of childhood and the trust of public organizations. The Royal Commission has publically validated the trauma that victims have experienced across institutions. It has also identified and raised the issue of a symptomatology ofcultural traumaat work in community and public life. Using the work of contemporary trauma theorists and applying it to one hearing held in Victoria in May 2015, this paper suggests that collective trauma can shape cultural identity and influence the quality of communal life. [ABSTRACT FROM PUBLISHER]

Aims: The current study assesses the impact of youth drug treatment on substance use, offending and wellbeing in a sample of young people recruited from specialist youth alcohol and drug treatment. The paper examines the impact of treatment engagement on the size and substance use profile of the young person's social network and hypothesises that the best treatment outcomes are associated with maintaining the size of the young person's social network but changing its composition to reduce the representation of substance use in social networks. Methods: A cohort study of 112 young people (aged 16–21) engaged in specialist youth alcohol and drug treatment services in Victoria, Australia, were recruited at the beginning of treatment and re-interviewed six months later using a structured questionnaire. Findings: There were improvements in substance use, social functioning, mental health and life satisfaction from baseline to follow-up. While network size was associated with mental health and quality of life markers, only having a lower proportion of substance users in the social network was associated with lower substance use and offending at follow-up. Conclusions: Social networks are a key component of wellbeing in adolescence. This study suggests that through independent analysis of network size and network composition, both the size and the composition of social networks have an important role to play in developing interventions for adolescent substance users that will sustain behaviour changes achieved in specialist treatment. [ABSTRACT FROM AUTHOR]

This paper examines the transformation of open space and how it compares to older residential development. A study has been conducted at the residential level because neighbourhoods have been a basic unit of city design throughout the recent history of urban settlements. Furthermore, the neighbourhood is a more humanly relevant scale of urban development. The method adopted for this research was a comparative urbanism by comparing old and new residential areas. This study found that incremental redevelopment of old residential areas through both re-subdivision and intensification of development on existing allotments has resulted in a progressive loss of open space. However, the study also confirmed that the current supplies of open space across all the study areas (old and new residential areas) are relatively similar. The main difference between the open space supply in older and newer residential areas comes down to the ownership of land (i.e. the proportion of public versus private open space). The study demonstrated that older residential areas with large allotments have experienced a significant loss of private open space – originally from 50%, to current levels of 23–30%. The paper concludes that there is a need for a holistic approach to the provision of public and private open spaces to improve the quality of life at a residential level. [ABSTRACT FROM PUBLISHER]

This paper draws upon literature from economics, and the human capital and equity fields in order to present a theoretical framework for a new multidimensional measure of poverty for Australia. Poverty is about having low living standards; but its measurement has traditionally focused only on an individual's income or on other dimensions of living standards that are not appropriate for contemporary Australian society, such as calorie intake. There are two additional capabilities individuals require for adequate living standards: health and education. Each of these is required for basic functioning within modern society, but have traditionally been ignored by measures of poverty. This paper argues that health is a basic capability people need for a fulfilling life, allowing individuals to participate in activities essential in modern society, and that education can also be seen in this light. As such it is vital that health and education be included in measures of poverty. In order to move Australian poverty measurement forward and build upon the work of the past, poverty measurement must move its focus away from only looking at low income, and take a holistic focus on the living standards of individuals by incorporating assessments of health and education. [ABSTRACT FROM AUTHOR]

In modern times when we speak of a mobile lifestyle we think of backpackers, fruit pickers, tourists, bikies or people living in caravans. Some people, of course, deliberately choose such a lifestyle. In the context of the historical past, of the people who moved in and out of this place - Kalgoorlie (our conference venue) - one group in particular had a very mobile lifestyle, though not by choice. I refer to the Afghan camel drivers who came to Australia for economic reasons. They mostly arrived as single men and assisted the explorers in their expeditions, and contributed to the development of the infrastructure of the Australian outback. The camel drivers steered the camels, 'the ships of the desert', that carried water tanks out to the mining areas such as Kalgoorlie and Coolgardie and other areas where water was scarce. The camels also carried wool bales and boxes of merchandize from one part of Australia to another. And they carted sleepers for the construction of railway lines from Perth to Coolgardie, and materials for the development of the Overland Telegraph Line in South Australia back in 1870-1872. The mobile nature of the lives of the Afghan camel drivers never permitted them to stay in one place for long. The Afghans were predominantly Muslims. They retained their culture and religion in such a harsh lifestyle. In this paper I examine the pattern of their mobile lifestyle from 1860 to 1930 and discuss their identity when they were with other ethnic groups, conflict when they faced resistance and their outspoken nature when they were regarded as the 'other'. Finally, I consider their loyalty to their Australian employers (and explorers). This paper relies on both primary and secondary sources, including oral testimonies. [ABSTRACT FROM AUTHOR]

In Australia we have become preoccupied with the potential adverse impact of our ageing population on our health and social systems. The projected cost of having increasing proportions of our population in the over 70s, retired, chronically ill category of the demographic profile is emerging as a major challenge for governments and private insurers: so much so in fact that the government is now urging older people to stay at work longer. In America, new approaches to the management and self-management of chronic diseases have been invoked to encourage and support older people to improve their quality of life and reduce their recourse to and dependence upon health care technologies, clinical interventions and health care management systems. Unless this is achieved, it is argued, the cost of looking after this emerging ‘bubble’ of elderly people will become increasingly unsustainable as fewer and fewer (proportionately) younger people work to pay the taxes that support ageing, retired, sick and dependent populations. This paper argues that we are at real risk of having our economic wealth and productivity impeded and truncated by the financial burden of looking after high demand and high cost dependants at the aged end of the social demographic. This paper offers an alternative view of our ageing population, as well as highlighting some of the assets we have in our elderly populations, and providing suggestions as to an alternative view of the phenomenon of ageing that incorporates elements such as flexible working arrangements and the application of new, enabling technologies. This approach to our ageing population dilemma is predicated on a concept of lifelong learning and social participation along with better preventive and early intervention systems of health care. [ABSTRACT FROM AUTHOR]

This paper reports our experiences with the application of a number of alternative approaches to a study of women's economic circumstances and quality of life in a typical western city. The important work of, especially, Martha Nussbaum on the capabilities approach to evaluations of “quality of life” has highlighted pitfalls associated with the use of a narrow informational base in studies of women's lives and has emphasized the value of qualitative methods in these evaluations. However, to date, most discussions of the relevance of plural approaches to studies of women's lives have been conducted in the context of developing countries. This paper contributes a practical, current example of the relevance of such approaches to assessments of the lives of women in western countries as well. The research findings reported in the paper also cast further light on the importance of several, related themes in the literature on the capabilities approach, namely the importance of understanding how women's aspirations and expectations change with their economic and social experiences; and the importance of appreciating the social uses of language and how this affects the way in which women describe their lives. [ABSTRACT FROM AUTHOR]

This paper describes one aspect of a study that investigated how Advance Care Planning (ACP) was implemented in residential care facilities (RACFs) in Australia and the role of a Clinical Nurse Consultant (CNC) for ACP.Three RACFs were included in the study.This paper focuses on the implementation process of ACP by the CNC in the RACFs.The preliminary findings highlight the need to dispel the myths about ACP and Advanced Care Directives (ACDs), and how the CNC acted as a broker for ACP.The CNC's role is represented by a Nursing Brokerage Model. By revealing how ACP is implemented the research contributes to the limited existing knowledge of options that are currently available to older adults and their families in order to help them make care choices about the end of their lives. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to identify groups of cardiac patients who share similar perceptions about their illness and to examine the relationships between these schemata and psychosocial outcomes such as quality of life and depression. A total of 190 cardiac patients with diagnoses of myocardial infarction, stable angina pectoris or chronic heart failure, completed a battery of psychosocial questionnaires within four weeks of their admission to hospital. These included the Brief Illness Perceptions Questionnaire (BIPQ), Beck Depression Inventory II (BDI II) and The MacNew Health-related Quality of Life instrument (MacNew). BIPQ items were subjected to latent class analysis (LCA) and the resulting groups were compared according to their BDI II and MacNew scores. LCA identified a five-class model of illness perception which comprised the following: (1) Consequence focused and mild emotional impact, n = 55, 29%; (2) Low illness perceptions and low emotional impact, n = 45, 24%; (3) Control focused and mild emotional impact, n = 10, 5%; (4) Consequence focused and high emotional impact, n = 60, 32%; and (5) Consequence focused and severe emotional impact, n = 20, 10%. Gender and diagnosis did not appear to reflect class membership except that class 2 had a significantly higher proportion of AMI patients than did class 5. There were numerous significant differences between classes in regards to depression and health-related quality of life. Notably, classes 4 and 5 are distinguished by relatively high BDI II scores and low MacNew scores. Identifying classes of cardiac patients based on their illness perception schemata, in hospital or shortly afterwards, may identify those at risk of developing depressive symptoms and poor quality of life. [ABSTRACT FROM PUBLISHER]

Australians are getting older, faster. This paper presents the statistical picture and describes the implications and opportunities for public library services. The author argues that federal funding for high speed broadband, Internet training, health information services, and for fostering partnerships with other community service agencies would make a major difference to quality of life for ageing Australians. [ABSTRACT FROM AUTHOR]

In Australia there is widespread community concern about the wellbeing of adolescents, particularly at the important time of approaching the transition from school to post-school life. However, few studies have focused on the wellbeing of Australian Year 12 students. This paper reports on a study investigating wellbeing among 377 Year 12 students in three public high schools in eastern Australia. The study explored wellbeing in terms of environmental and personality variables and investigated whether the school setting provided environmental elements that enhance adolescent wellbeing in ways similar to those provided by employment for adult wellbeing. The results indicated that school contributed significantly to adolescent wellbeing by providing time structure, access to the wider society, and social contact. Personality variables were found to be significant predictors of life satisfaction and affective wellbeing. The findings have implications for the enhancement of environmental features that may optimise the wellbeing of adolescents at school. [ABSTRACT FROM AUTHOR]

Urinary Incontinence - the accidental leaking of urine - is a major problem in Australia and has a significant impact on quality of life, affecting the social, psychological, physical and financial aspects of life. The prevalence of urinary incontinence is significantly higher in women than in men. While urine loss itself is a devastating symptom, older women are also likely to suffer lower urinary tract symptoms associated with the overactive bladder syndrome such as urgency, frequency, mixed incontinence and nocturia which are reported more frequently in older women. These symptoms disrupt activities of daily living as well as seriously disturbing sleep and general health status. Conservative nurse interventions have been shown to be effective in the management of these symptoms. Simple assessment tools suitable for use by primary level clinicians and conservative management strategies are discussed within the paper. [ABSTRACT FROM AUTHOR]

This paper prospectively documents the health-related quality of life (HRQoL) and social participation benefits of adult patients receiving cochlear implants in Australia and New Zealand. Thirty-four consecutively implanted patients completed the Assessment of Quality of Life (AQoL) and Hearing Participation Scale (HPS) instruments before implantation, and at 3- and 6-month follow-ups. Implantation resulted in significant improvements in AQoL and HPS scores. The effect size was 1.09 for both measures. Those in the top socio-economic tertile obtained the greatest gains. The HRQoL and social participation benefits were slightly larger than those reported elsewhere. This may be because participants used more recent technology (Nucleus 24 rather than Nucleus 22) and received auditory and self-efficacy training as part of their rehabilitation. The results suggest that cochlear implants have a large beneficial effect. They show that social and HRQoL outcomes can be parsimoniously measured using the HPS and AQoL instruments. [ABSTRACT FROM AUTHOR]

For patients with metastatic, incurable cancer the prognosis itself and its acceptance may influence their subjective well-being. This paper addresses the issue of what patients with incurable cancer should be told about their disease. It considers whether the patients' will to live and perceptions of the information their doctor provides may have consequences for well-being. The analysis is of a subset of data from a study of patients diagnosed with metastatic, incurable cancer who were recruited prospectively from one of several treatment centres in south-east Queensland, Australia. The sample is restricted to 46 patients with evaluable data at three points in time: within two weeks of diagnosis of metastatic, incurable cancer (T1); approximately three months after enrolment in the study (T2); and within eight weeks of death (T3). The results examine the impact of the patients' will to live and beliefs about curability of their disease on their quality of life. The will to live leads to an optimistic assessment of curability, which in turn enhances assessments of subjective well-being or quality of life as patients near death. [ABSTRACT FROM AUTHOR]

Recent research in Australian sociology and political science has debated the extent to which postmaterialist values and economic self-interest shape voting in federal elections. Some researchers have argued that postmaterialist values have partly displaced materialist concerns with physical security and economic well-being in Australian public life. This displacement, coupled with the adoption by major political parties of postmaterialist 'quality of life' issues such as the environment, has meant that voting in Australia has come to be more dependent on postmaterialist values than on perceptions of economic interest. Other research, however, has found no relationship between postmaterialist values and voting behaviour, while economic evaluations remain a strong determinant of voting behaviour. Part of the disagreement reflects methodological differences in the research. But different methodological problems compromise each of the previous studies. In this paper we use data from the 1990, 1993, 1996 and 1998 Australian Election Studies to investigate postmaterialist and economic voting in the Commonwealth House of Representatives and the Senate. Using various statistical methods, we first explore bivariate relationships between key variables and then use multivariate models of postmaterialist and economic voting to adjudicate between the contending positions. [ABSTRACT FROM AUTHOR]