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Drawing on findings from a study of two social generations of gender and sexuality diverse Australians, this paper offers a critical analysis of expectations and experiences of inclusive health care for LGBTQ+ youth. Data were collected by means of individual and focus group interviews with people from two different social generations who grew up in regional or urban Australia: those born in the 1970s (n = 50) and those born in the 1990s (n = 71). Data were analysed inductively to develop insights into what inclusive health care meant, and what this revealed about the potential for fostering belonging in healthcare settings. Findings raise critical questions about how inclusiveness of care might best be understood in encounters between gender and sexual minorities and health professionals. In particular, forms of 'inclusivity labour' were observed across the social generations, both in terms of the work involved in seeking to locate supportive services, and in assessing the performance of clinicians in healthcare settings, with implications for the continued engagement of LGBTQ+ young people with essential forms of care. Mobilising contemporary forms of inclusivity labour, including attention to the affective dimensions of healthcare engagement, has the potential to promote both better health and more meaningful experiences of belonging for gender and sexual minorities. [ABSTRACT FROM AUTHOR]

This paper examines the mediating effects of social identification on the relationship between high performance work systems (HPWS) and psychological empowerment and the direct relationship between psychological empowerment and clinician perceptions of quality of patient care. We use structural equation modelling on a sample of 254 health professionals from a large regional hospital in Australia. Results demonstrate, first, a strong effect of HPWS on social identification. Second, social identification mediates the relationship between HPWS and psychological empowerment and, third, psychological empowerment has a strong effect on clinician perceptions of quality of patient care. Implications are drawn for management theory and hospital managers. [ABSTRACT FROM PUBLISHER]

Nurse practitioners were introduced into Australia in 1990 to improve access to health care in isolated communities where medical doctors are scarce. The slow uptake of nurse practitioners in these areas has largely been the result of legislation not affording them access to provider numbers through the Medicare Australia Act 1973. This has denied nurse practitioners the opportunity to become primary care providers because they cannot prescribe medications and order diagnostic tests at rebated costs. Recently this Act changed, making provision for nurse practitioners. Ironically the enactment of the new legislation still prevents nurse practitioners from practicing effectively. This paper describes the discursive practices in legislation, driven by traditional power brokers, which perpetuate the traditional role of nurses as care givers and fails to support the evolution of nurse practitioners as care providers. These continued practices effectively prevent nurse practitioners from working to their potential, despite government reassurance under recent health care reform in Australia. [ABSTRACT FROM AUTHOR]

The term ‘workforce development’ is increasingly popular in the health-care field. It appears to encompass a range of human and organizational development activity. However, there has been limited explication of the concept of workforce development in Australian health care at area health service levels. It is timely to develop a framework for workforce development and processes to guide any evaluation of the implementation of workforce development strategies. This paper presents a framework that has been developed through consultative processes in an area health service and an associated review of literature. [ABSTRACT FROM AUTHOR]

In 2020 Coronavirus disease (COVID-19) was identified in Australia. During the pandemic, as essential workers, hospital-based social workers have been on the frontline. This cross-sectional study examines the resilience of social workers during the COVID-19 pandemic, how the pandemic impacted on social work and lessons learnt. Hospital social workers working in three states, namely Victoria, Queensland, and New South Wales were invited to participate in an online web-based survey, providing non-identifiable demographic details and information a) relating to their proximity to COVID-19, b) their degree of resilience (CD-RISC-2), c) professional quality of life, d) perceived social support, e) physical health, f) professional and personal growth during the pandemic, and g) impacts of COVID-19 on their practice. Basic descriptive statistics were computed for variables of interest. Within group, comparisons were made using paired t-tests or one-way ANOVAs for continuous variables as appropriate to investigate possible interstate differences. Regression analyses were conducted to determine which factors contribute to resilience. Social workers, during the pandemic, whether working under the constraints of lockdown or not, demonstrated high levels of resilience. These levels were similar across the three states, unaffected by the degree of infection in the community, indicating that as a group, social workers have high innate levels of resilience. This study provides an in-depth understanding of the impact of COVID-19 on hospital social workers, the long-term impact of the pandemic on social work practice, and potentially useful lessons learnt for the future. [ABSTRACT FROM AUTHOR]

Our study utilizes Australian survey evidence to estimate the heath and justice costs of a cohort of young homeless people. Health and justice costs for young homeless people are highly skewed with median costs well below mean costs. This is particularly true of justice costs resulting from a relatively high proportion of young homeless people having no interaction with the justice system. Having a diagnosed mental health condition is a primary driver of both health and justice costs. Having been homeless or sleeping rough in the previous year is associated with approximately four times mean health and justice costs compared with not having experienced homelessness. High justice costs are associated not only with having a diagnosed mental health condition homelessness and rough sleeping, but also a high-risk of dependence on one or more drugs or alcohol, identifying as Indigenous and a history of out-of-home care before the age of 18. [ABSTRACT FROM AUTHOR]

Health services internationally are reconsidering whether current service delivery models are inclusive and responsive to lesbian, gay, bisexual, trans* and gender diverse, intersex, and/or queer (LGBTIQ+) identifying individuals. A survey was conducted to establish a baseline needs analysis, as part of an LGBTIQ+ workforce development program, on perceived staff knowledge and confidence in a multi-site public mental health service in Melbourne, Australia. The survey comprising multiple choice, 5-point Likert scale ratings, and short answer sections was administered to mental health staff attending training at their place of work. Workplaces included: community clinics, residential services, acute inpatient services, service development, and research departments. Perceptions of self-confidence and knowledge, and further support needs expressed, were examined through analyzing quantitative and qualitative responses in feedback following the education sessions. The sample comprised 85 respondents; the majority female (66%), with a good representation of staff across age brackets. While the majority of staff identified as heterosexual (68%), LGBTIQ+ individuals were represented. Though 64% of staff surveyed noted that opportunities exist in the workplace to discuss LGBTIQ+ issues, a desire to increase knowledge was expressed by 94% of staff. Staff attitudes, knowledge, confidence, and support needs should be carefully considered at organizational and leadership levels, to ensure health services foster LGBTIQ+ responsive service delivery models and practices. [ABSTRACT FROM AUTHOR]

The rapidly expanding Australian home care workforce represents an untapped resource for improving health literacy (HL) and health outcomes of their clients. Nine home care workers (HCWs) were interviewed for this study to gain data around their experiences of providing HL support to their clients, key HL needs and priorities, and training that would best these needs. Findings indicate that HCWs are providing HL support, and identify a number of enablers and barriers to providing this support. Core inclusions for a HL training checklist are suggested. Implications for future research are considered. [ABSTRACT FROM AUTHOR]

Caregiving at the end-of-life has been associated with a range of physical, spiritual, social, and psychological outcomes, and influenced by encounters with providers of specialist palliative care. The purpose of this qualitative study was to explore experiences of bereaved carers of people with a life-limiting illness, in the context of care provided through a Western Sydney supportive and palliative care service. Thirteen bereaved caregivers participated in semi-structured, in-depth interviews. Transcripts were analyzed using a thematic approach, informed by thematic networks. Four domains appeared to mediate carer experiences: confrontations with trauma, suffering, and death; navigating transitions and boundaries and the caregiving role as liminal space; encountering connection in formal care contexts; and negotiating system issues. This study is one of the first to explore caregiver experiences within a low socioeconomic population in Western Sydney and provides a nuanced understanding of factors which may shape experiences of palliative care. Findings suggest that ongoing attention to the cultivation of skilful practitioners is warranted; able to companion caregivers in a manner attuned to the potential for trauma in the context of expected death. Additionally, findings call for investment in specialist sites of care alongside greater attention to public health approaches to palliative care. [ABSTRACT FROM AUTHOR]

Objective Mindfulness-integrated cognitive behaviour therapy (MiCBT) is a transdiagnostic psychological intervention for the alleviation of chronic mental health conditions. Although health workers utilise the approach in Australasia, Europe, and North America, the modality has been overlooked in the literature. Furthermore, few qualitative studies have investigated mindfulness training for experienced healthcare professionals. This study addresses these gaps and is the first investigation of an Australian sample in this field of study. Method The design comprises a two-stage qualitative analysis of the recorded experiences of six health professionals during introductory MiCBT training in Australia, using course workbooks and semi-structured interviews conducted at between 3 and 21 months' follow-up. Results Results show a high level of agreement with the extant literature on other mindfulness-based approaches. Themes involve harnessing of personal challenges during training to one's advantage, gaining equanimity through exposure, and personal benefits linked to home practice. However, notable themes from the literature relating to group cohesion and professional self-care are absent. Novel findings include the reported ability of participants to regard personal difficulties as opportunities, rather than threats, to practice; and differences in how mindfulness training is implemented professionally by psychologists and social workers working with dissimilar client groups. Conclusions Results suggest that specifics of the training delivery, occupation of professionals, and level of client functioning could all play a part in determining perceived outcomes of mindfulness training for participants. The findings will be of interest to anyone who designs, implements, or participates in mindfulness-based training programmes. [ABSTRACT FROM AUTHOR]

Meeting the medical, nutritional, and psychosocial mealtime needs of aged care residents requires a holistic, multidisciplinary approach. To date the perspectives of this multidisciplinary team have not been adequately explored. The aim of this study was to explore the perspectives of a range of service providers involved in mealtime management in residential aged care. In-depth semistructured interviews were conducted with 61 participants from five service disciplines. Four themes emerged: (1) mealtimes are highly valued; (2) service providers face common barriers to mealtime management; (3) communication among service providers is challenging; and (4) education in mealtime management is limited. Data indicated service providers acknowledge the importance of mealtimes but recognize numerous shortfalls in current care. The need for interdisciplinary training and increased communication and collaboration among providers was emphasized, including the need for clarification of provider roles. Limited consideration of mealtimes in policy and funding documents was identified as a primary barrier in further prioritizing mealtime management and advancing mealtime care. [ABSTRACT FROM PUBLISHER]

This article investigates whether patients who used a mixture of private and public hospital care have higher total hospital utilization than those who exclusively used either public or private hospital care. Using Australian hospital administrative data of heart disease patients, we found that those who used a mixture of private and public care had the highest total hospital utilization. Our findings are robust to how utilization is measured and endogeneity between utilization and hospital type choice. [ABSTRACT FROM AUTHOR]

Background: Australians seeking health care from any public hospital have the right to non-discriminatory safe medical assessment, treatment and nursing care. The literature clearly indicates that people presenting to public hospitals with acute alcohol- or drug-related conditions are at risk of dying by being denied medical and nursing treatment. This denial of treatment is on the basis that their presumed condition is solely drug- and alcohol-related. There is often even a greater risk for Aboriginal people who present for treatment. This literature comprises reports from coronial inquiries, police incidents, safety audits, and critical incidents in health services, and anecdotal information from specialist drug and alcohol nurses. Such violation of this vulnerable population's right to safe health care has often resulted in suicide and other preventable deaths, disability and exacerbation of physical and mental illness. Method: A critique was conducted of recent available Australian 'grey' literature comprising coronial and police reports, local critical incident alert systems in hospital reports and anecdotal information from specialist drug and alcohol nurses associated with three case studies. Findings: The reports revealed that some of the people seeking treatment for alcohol-, drug-and mental health-related crises, who were denied treatment, subsequently died in police custody, shelters, home, public places or elsewhere. The evidence showed that many who died did so because medical and nursing staff presumed they were just 'alcoholic' or 'drunk' and therefore were not seriously injured or ill. Commonly, stereotyping and racism were found to influence a health professional's decision to refuse treatment, and their unethical practice was directly linked to deaths because of missed or wrong diagnoses and poor standards of nursing assessment. Several cases, all occurring recently in South Australian country areas, were identified through a critical incident alert system and re-confirmed by local specialist drug and alcohol nurses who were aware of each case. One case was an Aboriginal man and two others were non-Aboriginal men. All were relatively young. Each man was denied proper medical assessment, treatment and safe nursing care by staff in the hospitals in which they sought help. As a consequence, the Aboriginal man developed delirium tremens requiring medical retrieval by air to a major teaching hospital for intensive care. The other two men required extensive support and intervention due to acute mental illnesses that co-existed with their drug use. Discussion: This review offers important information from which to build strategies to remediate poor policies, practices, and attitudes. Hopefully, these strategies may assist to prevent similar situations occurring in the future. [ABSTRACT FROM AUTHOR]