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Abstract Background While participatory social network analysis can help health service partnerships to solve problems, little is known about its acceptability in cross-cultural settings. We conducted two case studies of chronic illness service partnerships in 2007 and 2008 to determine whether participatory research incorporating social network analysis is acceptable for problem-solving in Australian Aboriginal health service delivery. Methods Local research groups comprising 13–19 partnership staff, policy officers and community members were established at each of two sites to guide the research and to reflect and act on the findings. Network and work practice surveys were conducted with 42 staff, and the results were fed back to the research groups. At the end of the project, 19 informants at the two sites were interviewed, and the researchers conducted critical reflection. The effectiveness and acceptability of the participatory social network method were determined quantitatively and qualitatively. Results Participants in both local research groups considered that the network survey had accurately described the links between workers related to the exchange of clinical and cultural information, team care relationships, involvement in service management and planning and involvement in policy development. This revealed the function of the teams and the roles of workers in each partnership. Aboriginal workers had a high number of direct links in the exchange of cultural information, illustrating their role as the cultural resource, whereas they had fewer direct links with other network members on clinical information exchange and team care. The problem of their current and future roles was discussed inside and outside the local research groups. According to the interview informants the participatory network analysis had opened the way for problem-solving by “putting issues on the table”. While there were confronting and ethically challenging aspects, these informants considered that with flexibility of data collection to account for the preferences of Aboriginal members, then the method was appropriate in cross-cultural contexts for the difficult discussions that are needed to improve partnerships. Conclusion Critical reflection showed that the preconditions for difficult discussions are, first, that partners have the capacity to engage in such discussions, second, that partners assess whether the effort required for these discussions is balanced by the benefits they gain from the partnership, and, third, that “boundary spanning” staff can facilitate commitment to partnership goals.

Competencies by nurses in information technology (IT) are essential to health care in Australia yet data suggest deficiencies in access and use. A study commissioned by the Australian Government aimed to determine the extent of access and use and the barriers to the use of IT among nurses across Australia. A survey was distributed to 10,000 members of the Australian Nursing Federation with a 43% overall response rate. Fewer than 15% of nurses did not use computers as part of their work. The greatest use was for client records, patient pathology and radiology results and professional development. IT uptake in health is supported by nurses who are, however frustrated by limitations to access and software that is not fit for purpose. A lack of confidence in using IT was noted by many nurses. Fewer than 20% had received pre-registration training in any aspect of IT and only 30% post registration. In addition to training, high work load, numbers of computers and inadequate technical support were the major barriers to computer use. [ABSTRACT FROM AUTHOR]

Increasing chronic disease rates in regional Australian communities necessitates innovative models of healthcare. We evaluated the efficacy of an interprofessional chronic disease program, delivered within a regional student-led nursing and allied health clinic in Southern Queensland, Australia. Changes to anthropometric, aerobic fitness and strength, and quality of life outcomes were examined at four time points spanning 16 months: intake, program transition (4 months), 6 and 12 months (post-transition). Our primary aim was to investigate whether the health improvements achieved during the program were sustained at 12 months in a subset of participants who provided complete data. Significant improvements were found in 6 of 11 measures, including the 6-minute walk test, grip strength, and self-reported quality of life across physical and psychosocial dimensions, with these improvements maintained to final review. No significant changes were found in body mass index (BMI), waist circumference, fat mass, or muscle mass. This is the first health clinic in regional Australia to deliver a student-led model of interprofessional and collaborative service to tackle the increasing burden of chronic disease in the community. The cost-effectiveness of this service and other potential clinical and social benefits remain to be investigated. [ABSTRACT FROM AUTHOR]

Aims: The purpose of this paper is to present the findings of two qualitative studies which identified strategies used by breastfeeding women to assist them to continue breastfeeding., Background: While breastfeeding initiation rates are high in Australia, the majority of women wean before the recommended time. The identification of interventions which may increase breastfeeding duration is therefore a research priority., Design: The Against All Odds study used a case-controlled design to investigate the characteristics of women who continued to breastfeed in the face of extraordinary difficulties. Phase One of the I Think I Can study employed the Nominal Group Technique to investigate the views of subject matter experts regarding which psychological factors may influence the duration of breastfeeding., Method: Against All Odds study participants (n = 40) undertook a one- to two-hour interview and the transcribed data were analysed using thematic analysis. Stratified purposeful sampling was employed in the I Think I Can study (n = 21), with participants assigned group membership according to their most recent breastfeeding experience. A fourth group was composed of experienced breastfeeding clinicians. The nominal group technique was used to generate group data and segments of the discussion were audiotaped and transcribed for thematic analysis., Results: Participants in both the studies raised strategies used to assist them in their efforts to cope with the challenges of breastfeeding and early motherhood. These strategies included increasing breastfeeding knowledge, staying relaxed and 'looking after yourself', the use of positive self-talk, challenging unhelpful beliefs, problem solving, goal setting and the practice of mindfulness., Conclusions: Employment of these simple behavioural and cognitive strategies may assist women to cope with the pressures inherent in the experience of early mothering, thereby increasing the duration of breastfeeding., Relevance to Clinical Practice: These results may represent a 'tool box' of coping strategies which can be provided to women for use in the postnatal period.

This article reports on the views of Australian nurses as to their use of computers in the workplace. Data were collected by questionnaires mailed to 10,000 members of the 150,000-member Australian Nursing Federation, which represents 60% of the Australian nursing workforce. The response rate was 43.3%. Computer use was 20% by assistants in nursing, rising to 75% by enrolled nurses and to more than 95% by RNs. Principal uses for the computers by the nurses were for access to patients' records and for internal communication. Most respondents (79%) agreed that the use of computers had improved information access. Only 9.4% considered that adoption of a national electronic health record would not be useful to healthcare. Fewer than 5% stated that they have no interest in computers, and 87% considered that their age was never or rarely a barrier to their use of the technology. However, not all aspects of computer introduction to nursing were positive. The proportions of respondents who considered that the use of computers had made their work easier, reduced duplication of data entry, and reduced errors in handing patient data were only 42%, 32%, and 31%, respectively. Results demonstrate a positive attitude toward information technology by Australian nurses but identify issues that must be addressed to support continued interest and engagement.

Competencies by nurses in information technology (IT) are essential to health care in Australia yet data suggest deficiencies in access and use. A study commissioned by the Australian Government aimed to determine the extent of access and use and the barriers to the use of IT among nurses across Australia. A survey was distributed to 10,000 members of the Australian Nursing Federation with a 43% overall response rate. Fewer than 15% of nurses did not use computers as part of their work. The greatest use was for client records, patient pathology and radiology results and professional development. IT uptake in health is supported by nurses who are, however frustrated by limitations to access and software that is not fit for purpose. A lack of confidence in using IT was noted by many nurses. Fewer than 20% had received pre-registration training in any aspect of IT and only 30% post registration. In addition to training, high work load, numbers of computers and inadequate technical support were the major barriers to computer use.