12 results on '"Scott KM"'
Search Results
2. An Economic Evaluation of a Web-Based Management Support System for Children With Urinary Incontinence: The eADVICE Trial.
- Author
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Von Huben A, Howell M, Richards D, Hamilton S, Howard K, Teixeira-Pinto A, Craig JC, Seton C, Waters K, Deshpande A, Scott KM, and Caldwell PHY
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- Humans, Child, Female, Male, Internet-Based Intervention economics, Internet, Quality of Life, Australia, Adolescent, Cost-Benefit Analysis, Urinary Incontinence therapy, Urinary Incontinence economics
- Abstract
Purpose: Children who require specialist outpatient care typically wait substantial periods during which their condition may progress, making treatment more difficult and costly. Timely and effective therapy during this period may reduce the need for lengthy specialist care. This study evaluated the cost-effectiveness of an individualized, evidence-informed, web-based program for children with urinary incontinence awaiting a specialist appointment (Electronic Advice and Diagnosis Via the Internet following Computerized Evaluation [eADVICE]) compared to usual care. eADVICE was supervised by a primary physician and delivered by an embodied conversational agent., Materials and Methods: A trial-based cost-effectiveness analysis was performed from the perspective of the health care funder as a substudy of eADVICE, a multicenter, waitlist-controlled, randomized trial. Outcomes measures were incremental cost per incremental change in continence status and quality of life on an intention-to-treat basis. Uncertainty was examined using cost-effectiveness planes, scenarios, and 1-way sensitivity analyses. Costs were valued in 2021 Australian dollars., Results: The use of eADVICE was found to be cost saving and beneficial (dominant) over usual care, with a higher proportion of children dry over 14 days at 6 months (risk difference 0.13; 95%CI 0.02-0.23, P = .03) and mean health care costs reduced by $188 (95%CI $61-$315) per participant., Conclusions: An individualized, evidence-informed, web-based program delivered by an embodied conversational agent is likely cost saving for children with urinary incontinence awaiting a specialist appointment. The potential economic impact of such a program is favorable and substantial, and may be transferable to outpatient clinic settings for other chronic health conditions. more...
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- 2024
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3. Grace Under Pressure: a mixed methods impact assessment of a verbatim theatre intervention to improve healthcare workplace culture.
- Author
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Hooker C, Karageorge A, Scott KM, Lim R, and Nash L
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- Humans, Australia, Motivation, Delivery of Health Care, Workplace psychology, Health Personnel
- Abstract
Background: Healthcare workplace mistreatment has been documented globally. Poor workplace behaviour, ranging from incivility to bullying and harassment, is common in healthcare, and contributes significantly to adverse events in healthcare, poor mental health among healthcare workers, and to attrition in the healthcare workforce, particularly in junior years. Poor workplace behaviour is often normalised, and is difficult to address. Verbatim theatre, a form of research informed theatre in which plays are created from informants' exact words only, is particularly suited to facilitating workplace culture change by raising awareness about issues that are difficult to discuss. The objective of this study was to assess the impact of the verbatim theatre play 'Grace Under Pressure' on workplace culture in NSW hospitals., Methods: The intervention was conducted in 13 hospitals from 8 Local Health Districts (LHDs) in NSW, Australia, in October and November 2019, with aggregated impact across all sites measured by a bespoke survey ('Pam McLean Centre (PMC) survey') at the conclusion of the intervention. This study was conducted in 3 Local Health Districts (one urban, one regional, one remote), with data collection conducted in November-December 2019 and December 2020. The study design was a mixed methods assessment of the play's impact using (1) validated baseline measures of psychosocial risk, analysed descriptively, (2) overall findings from the PMC survey above, analysed descriptively, (3) interviews conducted within a month of the intervention, analysed thematically and (4) interviews conducted one year later, analysed thematically., Results: Half (51.5%) of the respondents (n = 149) to the baseline survey had scores indicating high risk of job strain and depressive symptoms. Of 478 respondents to the PMC survey (response rate 57%), 93% found the play important, 92% recommended others see the play, 89% considered that it stimulated thinking about workplace behaviour, and 85% that it made discussing these issues easier. Thematic analysis of interviews within one month (n = 21) showed that the play raised awareness about poor workplace behaviour and motivated behaviour change. Interviews conducted one year later (n = 6) attributed improved workplace culture to the intervention due to improved awareness, discussion and capacity to respond to challenging issues., Conclusions: Verbatim theatre is effective in raising awareness about difficult workplace behaviour in ways that motivate behaviour change, and hence can be effective in catalysing real improvements in healthcare workplace culture. Creative approaches are recommended for addressing similarly complex challenges in healthcare workforce retention., (© 2024. The Author(s).) more...
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- 2024
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4. Patterns of parental online health information-seeking behaviour.
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Yudianto B, Caldwell PH, Nanan R, Barnes EH, and Scott KM
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- Humans, Child, Adolescent, Australia, Parents, Surveys and Questionnaires, Information Seeking Behavior, Physicians
- Abstract
Aim: This study aimed to understand parents' online health information-seeking behaviour and the potential influence of this on their relationship with their child's physician., Methods: A survey regarding parental online health information-seeking behaviour was administered to parents of children aged under 18 years admitted to an Australian tertiary paediatric hospital, paediatric hospital ward and paediatric clinic, and in their social media networks. Responses were presented as frequencies and percentages. Associations between parents' trust in their child's doctor and survey responses were analysed using χ
2 tests., Results: In all, 300 surveys were completed. Most parents (89%) reported searching for online health information when their child was sick. Some (31%) followed online health information instead of going to the doctor. Parents who trusted their child's doctor were more likely to follow the doctor instead of online health information when it contained conflicting advice. Most parents (91%) wanted health-care professionals' help in searching for online health information., Conclusion: Almost all parents search for online health information, but most do not act on it. Parents' trust in their child's doctor influences how parents use online health information. Thus, clinicians could recommend trustworthy websites with information that complements their advice to ensure parents access reliable online health information., (© 2023 The Authors. Journal of Paediatrics and Child Health published by John Wiley & Sons Australia, Ltd on behalf of Paediatrics and Child Health Division (The Royal Australasian College of Physicians).) more...- Published
- 2023
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5. How paediatricians communicate with parents who access online health information.
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Karatas C, Caldwell PH, and Scott KM
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- Humans, Child, Australia, Pediatricians, Communication, Parents, Physicians
- Abstract
Aims: Recent years have seen an exponential increase in the proportion of parents searching for online health information on their child's medical condition. We investigated the experiences, attitudes and approaches of paediatricians interacting with parents who search for online health information and the impact on the doctor-parent relationship., Methods: This qualitative study was conducted utilising semi-structured interviews with 17 paediatric physicians, surgeons, anaesthetists and trainees working in an Australian children's hospital. Data were analysed through deductive and inductive thematic analysis using line-by-line coding., Results: Three key themes were identified: paediatricians' experiences with, and attitudes towards, parents using online health information; paediatricians' communication approaches; and the perceived impact on the doctor-parent relationship. These themes demonstrated that most paediatricians acknowledged the information parents found and directed parents to reliable websites. Following discussions with Internet-informed parents, a few changed their management plans and a few reported discouraging parents from further searching online., Conclusions: Our results indicate that paediatricians predominantly used patient-centred communication strategies to care for patients in partnership with parents. Paediatricians contextualising online health information can contribute to a quality partnership with parents and facilitate shared decision-making, potentially fostering better health outcomes for children. Our conclusions may inform clinicians' communication approaches when interacting with Internet-informed parents and stimulate research about more effective doctor-parent communication approaches. In a digital age, paediatricians may benefit from employing more time-efficient approaches to manage increasing workloads with their new role of digital stewardship of parents., (© 2022 The Authors. Journal of Paediatrics and Child Health published by John Wiley & Sons Australia, Ltd on behalf of Paediatrics and Child Health Division (The Royal Australasian College of Physicians).) more...
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- 2022
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6. Consensus of physician behaviours to target for early diagnosis of cerebral palsy: A Delphi study.
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McNamara L, Scott KM, Boyd RN, and Novak I
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- Australia, Consensus, Delphi Technique, Early Diagnosis, Humans, Surveys and Questionnaires, Cerebral Palsy diagnosis, Physicians
- Abstract
Aims: Historically, the diagnosis of cerebral palsy has been made after 12 months of age, delaying access to crucial early intervention that optimises functional outcomes. This study aimed to identify and specify priority physician diagnostic behaviours to target in implementation interventions to increase the rate of diagnosis of cerebral palsy under 6 months of age in Australia., Methods: We conducted a two-round online Delphi study with a multi-professional expert panel of cerebral palsy researchers and clinicians. A reference group identified a six-item list of potential diagnostic behaviours, which were modifiable at the individual level, that could lead to an early cerebral palsy diagnosis. In the first survey, participants rated the importance of each item on a 10-point Likert scale and supplied their reasoning for this, and were able to suggest new behaviours. In the second survey, participants ranked items in order of priority., Results: All six items reached consensus for inclusion (100%). No new items were added to the list. Ranking identified the top three priorities for online physician implementation interventions: (i) refer for or conduct the General Movements Assessment; (ii) refer for or conduct the Hammersmith Infant Neurological Examination; and (iii) communication of the diagnosis., Conclusion: An online Delphi method can effectively inform tailored implementation intervention development. A consensus was achieved on the priority physician diagnostic behaviours to target in interventions to lower the age of cerebral palsy diagnosis in Australia., (© 2021 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).) more...
- Published
- 2021
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7. Australian community health practitioners' knowledge and experience with managing urinary incontinence that begins in childhood.
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Caldwell PH, Manocha R, Hamilton S, Scott KM, and Barnes EH
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- Adolescent, Adult, Australia epidemiology, Child, Child, Preschool, Community Health Workers statistics & numerical data, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Urinary Incontinence epidemiology, Urinary Incontinence physiopathology, Clinical Competence standards, Community Health Workers standards, Urinary Incontinence therapy
- Abstract
Background and Objectives: General practitioners (GPs) often see children with enuresis and daytime urinary incontinence, and adults with persistent enuresis. The aim of this study was to assess Australian community health practitioners' knowledge and experiences with managing these conditions., Method: Health practitioners were surveyed about their knowledge and experience managing urinary incontinence that begins in childhood. Associations between participant characteristics and knowledge/experience were examined using chi-square tests., Results: The 1495 participants were mostly female, experienced, GPs who worked in a metropolitan area and/or saw patients with incontinence infrequently, but felt knowledgeable and confident about management of incontinence. Correct survey answers were given by 93% of participants for managing enuresis, 81% for daytime urinary incontinence (with 18% choosing inappropriate and potentially dangerous responses), and 61% for managing enuresis that has persisted into adulthood., Discussion: Better education is needed for GPs regarding management of urinary incontinence that begins in childhood, particularly for daytime incontinence in children and enuresis that persists into adulthood. more...
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- 2019
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8. A review of the hours dedicated to oral health education in medical programmes across Australia.
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Abbott B, Zybutz C, Scott KM, Eberhard J, and Widmer R
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- Australia, Humans, Program Evaluation, Surveys and Questionnaires, Time Factors, Curriculum statistics & numerical data, Oral Health education, Schools, Medical statistics & numerical data, Teaching statistics & numerical data
- Abstract
Background: Oral health is an important predictor for general health, and poor oral health is interrelated with the manifestations of systemic disease., Aim: To determine the extent of oral health education in medical schools across Australia., Methods: A survey of Australian medical schools was conducted (September 2013 to June 2014). Participants were administrators and curricula coordinators of medical programmes. The main outcome measures were teaching hours of specific areas of oral health education. Data were descriptively analysed., Results: Participants from 8 of 18 universities responded to the questionnaire. The total hours dedicated to oral health in the medical programmes were: zero in one school; less than 2 h in three schools, 6-10 h in three schools and 30 h in one school. Only four schools taught the correlation between oral health and overall health, two schools taught about dental diseases (caries and periodontal disease), three schools taught dental trauma management and six schools taught oral anatomy. Only five schools taught about oral cancer: two of these taught about cancer for 10-15 min. No school reported hands-on training in an oral health setting., Conclusions: The results indicate that Australian medical school graduates have little, if any, foundational knowledge of oral health (dental caries, bidirectional relationship between diabetes and periodontal disease, oral cancer and dental emergencies). The recognition of poor oral health plays a significant part in the early detection and care of chronic diseases. The teaching of fundamental oral health to medical students is crucial and should be integrated into medical school curricula., (© 2018 Royal Australasian College of Physicians.) more...
- Published
- 2018
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9. Acknowledging medical students' reports of intimidation and humiliation by their teachers in hospitals.
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Barrett J and Scott KM
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- Australia, Bullying psychology, Cross-Sectional Studies, Female, Humans, Incidence, Interprofessional Relations, Male, Needs Assessment, Shame, Students, Medical statistics & numerical data, Young Adult, Bullying statistics & numerical data, Education, Medical, Undergraduate methods, Medical Staff, Hospital psychology, Pediatrics education, Students, Medical psychology
- Abstract
Aim: The continuing existence of 'teaching by humiliation' of medical students and junior doctors in Australia has recently been highlighted in a number of research publications and media reports. This study investigates medical students' experiences of being intimidated or humiliated during their clinical rotations in Australian hospitals in paediatrics and adult medicine., Methods: From factors identified in earlier research, a two-page survey was developed for administration at two Australian medical schools. Administered in Semester 2 of 2014, students were invited to add their own free-text comments at the conclusion of 17 closed questions. Using thematic analysis of the qualitative data, the researchers identified the common themes in the students' free-text comments, which are reported in this paper., Results: We found five main themes in the qualitative data: a spectrum of interpretations of and responses to 'teaching by humiliation', an accepted means of enculturating the young, teachers' techniques for asking questions, the victims and perpetrators of mistreatment and the variance of prevalence in different contexts., Conclusion: Research shows the persistence of 'teaching by humiliation', even in paediatrics, particularly when doctors are questioning students in ways that shame them for their lack of knowledge. Given the many personal and professional costs of these practices, this cycle of mistreatment needs to be brought to an end. There is a need for students' reports of intimidation and humiliation to be acknowledged; the offending practices need to be interrupted, and more effective and respectful approaches to teaching need to be adopted., (© 2017 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).) more...
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- 2018
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10. Grace Under Pressure: a drama-based approach to tackling mistreatment of medical students.
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Scott KM, Berlec Š, Nash L, Hooker C, Dwyer P, Macneill P, River J, and Ivory K
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- Attitude, Australia, Curriculum, Drama, Female, Humans, Interpersonal Relations, Male, Organizational Culture, Pilot Projects, Qualitative Research, Social Skills, Universities, Bullying, Education, Medical, Undergraduate, Health Personnel ethics, Learning, Professionalism education, Students, Medical, Teaching
- Abstract
A positive and respectful learning environment is fundamental to the development of professional identities in healthcare. Yet medical students report poor behaviour from healthcare professionals that contradict professionalism teaching. An interdisciplinary group designed and implemented a drama-based workshop series, based on applied theatre techniques, to help students develop positive professional qualities and interpersonal skills to deal with challenges in the healthcare setting. We piloted the workshops at the University of Sydney in 2015. Attendees completed evaluation questionnaires and participated in a focus group or interview. Of 30 workshop attendances, there were 29 completed questionnaires and three participants attended a focus group or interview. Workshop activities were rated as 'very good' or 'good' by 21/22 (95.5%). Thematic analysis of qualitative data highlighted the rationale for participation (to deal with bullying, prevent becoming a bully, learn social skills), workshop benefits (express emotions, learn about status dynamics and deconstructing personalities, empathy, fun), challenges (meeting participants' expectations, participants' need for further practice) and implications for medical education (need to develop awareness of others' perspectives). Our research has shown that there is momentum to challenge mistreatment in medical education. While a multipronged approach is needed to generate systemic change, this pilot offers a positive and creative innovation. It helps students improve their interpersonal skills and sense of self to deal with challenges in the healthcare setting, including mistreatment., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.) more...
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- 2017
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11. "Teaching by humiliation" and mistreatment of medical students in clinical rotations: a pilot study.
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Scott KM, Caldwell PH, Barnes EH, and Barrett J
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- Australia, Data Collection, Humans, Pilot Projects, Teaching, Bullying psychology, Education, Medical statistics & numerical data, Students, Medical psychology
- Abstract
Objective: To generate a contemporary understanding of "teaching by humiliation" as experienced by medical students in Australia., Design, Setting and Participants: In this pilot study, we surveyed final-stage medical students from two Australian medical schools about their experiences of teaching by humiliation during their adult and paediatric clinical rotations. The students were invited to complete the anonymous survey at the end of their paediatric rotation in Semester 2 of 2013. We used descriptive statistics to analyse quantitative data, and a grounded theory approach to analyse qualitative data., Main Outcome Measures: Student reports of experiencing or witnessing teaching by humiliation during their adult and paediatric clinical rotations., Results: Of 151 students invited to participate, 146 (96.7%) completed the survey. Most students reported experiencing (108; 74.0%) or witnessing (118; 83.1%) teaching by humiliation during adult clinical rotations. Smaller but still sizeable proportions had experienced (42; 28.8%) or witnessed (64; 45.1%) it during their paediatric clinical rotation. The humiliating and intimidating behaviours students experienced were mostly more subtle than overt and included aggressive and abusive questioning techniques. The students' responses to these practices ranged from disgust and regret about entering the medical profession to endorsement of teachers' public exposure of a student's poor knowledge., Conclusions: Practices associated with humiliating medical students persist in contemporary medical education. These practices need to be eradicated, given the evidence that they affect students' learning and mental health and are dissonant with formal professionalism curricula. Interventions are needed to interrupt the transgenerational legacy and culture in which teaching by humiliation is perpetuated. more...
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- 2015
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12. Te Rau Hinengaro: the New Zealand Mental Health Survey: overview of methods and findings.
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Wells JE, Oakley Browne MA, Scott KM, McGee MA, Baxter J, and Kokaua J
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- Algorithms, Australia epidemiology, Cost of Illness, Cross-Sectional Studies, Demography, Diagnosis, Computer-Assisted, Diagnostic and Statistical Manual of Mental Disorders, Humans, Incidence, International Classification of Diseases, Mental Disorders ethnology, Mental Health Services statistics & numerical data, New Zealand epidemiology, Prevalence, Public Policy, Social Support, Health Care Surveys methods, Health Surveys, Interview, Psychological, Mental Disorders diagnosis, Mental Disorders epidemiology
- Abstract
Objective: To estimate the prevalence and severity of anxiety, mood, substance and eating disorders in New Zealand, and associated disability and treatment., Method: A nationwide face-to-face household survey of residents aged 16 years and over was undertaken between 2003 and 2004. Lay interviewers administered a computerized fully structured diagnostic interview, the World Health Organization World Mental Health Survey Initiative version of the Composite International Diagnostic Interview. Oversampling doubled the number of Māori and quadrupled the number of Pacific people. The outcomes reported are demographics, period prevalences, 12 month severity and correlates of disorder, and contact with the health sector, within the past 12 months., Results: The response rate was 73.3%. There were 12,992 participants (2,595 Māori and 2,236 Pacific people). Period prevalences were as follows: 39.5% had met criteria for a DSM-IV mental disorder at any time in their life before interview, 20.7% had experienced disorder within the past 12 months and 11.6% within the past month. In the past 12 months, 4.7% of the population experienced serious disorder, 9.4% moderate disorder and 6.6% mild disorder. A visit for mental health problems was made to the health-care sector in the past 12 months by 58.0% of those with serious disorder, 36.5% with moderate disorder, 18.5% with mild disorder and 5.7% of those not diagnosed with a disorder. The prevalence of disorder and of serious disorder was higher for younger people and people with less education or lower household income. In contrast, these correlates had little relationship to treatment contact, after adjustment for severity. Compared with the composite Others group, Māori and Pacific people had higher prevalences of disorder, unadjusted for sociodemographic correlates, and were less likely to make treatment contact, in relation to need., Conclusions: Mental disorder is common in New Zealand. Many people with current disorder are not receiving treatment, even among those with serious disorder. more...
- Published
- 2006
- Full Text
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