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

Thesis (PhD(Nursing))--University of South Australia, 2018. Includes bibliographical references (pages 250-276) Focusing on what it means to move from wanting to die to wanting to live, this research is based on a qualitative in-depth multiple-case study research design, which was used because of its methodological ability to explore the meaning of protective factors that give older people reasons to live. Because the study of meaning in suicide involves two levels of analysis – the individual (within) and the cultural group (between) – multiple-case study facilitated exploration of protective factors within each case and between cases. To generate descriptive categories and sub-categories of protective factors, qualitative content analysis of seven cases was employed to seek out what was particular about each case (within) and what was common across the cases (between).

In conceptualizing vulnerability, it is common for researchers to assume that some participants are more vulnerable on the basis of their membership of a particular group or because they exhibit particular characteristics. Older people are often viewed as inherently more vulnerable by ethics committees and the ethical guidelines committees construct. Because age alone does not confer or cause vulnerability, risk of harm to older research participants is not purely associated with their intrinsic connection to a vulnerable group, and classifying older research participants as vulnerable may not necessarily protect them from harm. Drawing on the preliminary findings of a qualitative study of older people who had survived a suicide attempt, we reflect on how the specific context of our study had the potential of framing older people as vulnerable, and describe ways in which these were managed and resolved. Specifically, we discuss potential for harm through the ethical principles of coercion and distress.

Older adults are at higher risk of dying by suicide than younger age groups, particularly where a previous attempt has been made. The aim of this study was to identify and review quantitative and qualitative research studies of attempted suicide in older people published between 2005 and 2014. Of the 128 relevant studies identified 23 were included for review. Content analysis was employed to extend conceptually the interaction between biological, psychological and social factors in the context of the suicidal process. The perspectives of older people who have survived a suicide attempt are critically needed to inform future prevention and intervention strategies, specific to the sociocultural frameworks within which they operate. Refereed/Peer-reviewed

Background: Pharmacotherapy is commonly a frontline treatment for depression in the long-term care of older adults, however some people continue to experience adverse effects after therapy has ceased. A growing body of evidence suggests alternative forms of treatment for depression are warranted, though little attention has been given to clinician and consumers' views and perspectives of treatment. Aim: The purpose of this study was to explore clinician and consumers' views and perspectives of CBT treatment for older people with depression. Method Focus groups (n=l) and individual interviews (n=4) were conducted with mental health professionals (n=6) and older consumers (n=2). Results Thematic analysis revealed a range of insights embedded within three major themes: (i) Understanding and experience of CBT; (ii) Challenges and barriers to CBT uptake, and (iii) Delivering CBT - when and by whom? Discussion Older people can positively influence their depressive symptoms by changing their behaviour and thought processes through engagement with CBT interventions. CBT is flexible and has the potential to offer longer-term relief of depressive symptoms experienced by older people. Mental health nurses may be uniquely situated to incorporate elements of CBT into their treatment and care of older people with depressive illness. Refereed/Peer-reviewed

Effective risk assessment and risk management is an important component of clinical mental health practice and is vital to people in crisis and at risk of an adverse outcome. This discussion paper reflects on key findings from a symposium addressing clinical risk assessment and risk management processes and methods. The focus of the symposium centred on the importance of shared learning in clinical practice to enable practitioners to reflect and learn from one another in relation to the complexities of modern-day mental health practice and the implications of the various mental health reform agendas to the provision of clinical care and treatment. The symposium provided an opportunity for clinicians to critically present and discuss risk assessment and risk management practices in an endeavour to develop a systematic approach to the effective assessment and management of suicide, aggression and violence in a range of mental health settings. Key findings from the symposium are discussed against a backdrop of contemporary literature in the field and form a practical framework for the assessment and management of risk regarding suicide, aggression and violence. Refereed/Peer-reviewed

Summary Introduction Evaluating and improving a model of nursing care is a fundamental part of clinical practice improvement. While Australian nurses are showing increasing interest in improving models of care delivery, more research is needed that addresses and articulates the processes attendant upon evaluating, re-designing and implementing improvements to the provision of nursing care. Providing nurses with an open opportunity to plan, act, observe and reflect on their practice promotes successful partnerships between academics and clinicians. Aim The aim of this study was to evaluate and improve the model of nursing care delivery to patients in a general surgical ward using participatory action research. Method Researchers conducted non-participant observations ( n = 9) of two hours duration across the 24 h period. Focus groups ( n = 3) were used to share non-participant observation data with staff, providing them with an opportunity to reflect on their practice and explore possible solutions. Data was collected in 2008–2009. Results Two main problem areas were identified as impeding the nurses’ ability to provide care to patients: (i) practices and behaviours of nurses and (ii) infrastructure and physical layout of the ward. An overview of issues within each problem area is presented. Conclusion Shifting the focus of task-centred care towards a more patient-centred care approach, results directly in improvements in resource utilisation, improved cost-effectiveness and job satisfaction for nursing staff. New ways of thinking about nursing processes and systems, workflow design and skill allocation will guide hospital administrators and managers in the effective and efficient allocation of nursing work in similar settings.