Falls rates in older people continue to rise despite concerted efforts to manage falls risks. As more effective strategies to reduce falls in older people may arise from better understanding their perspectives on falls risk, this study aimed to explore perceptions and behavioural decisions that may affect risk of falling among older people living in regional Australia. this qualitative research, informed by hermeneutics, explored older people’s perspectives on decisions they made that could affect their falls risk. The study involved 26 participants (21 females) aged 65–84 years, residing in regional Australia. In total, 13 participated in semi-structured focus groups and 13 in semi-structured, in-depth interviews. six key themes illuminated the challenges older people faced in relation to falls risk. These were: the role that independence played in decision making regarding risk; the influence of previous falls experience; older people’s level of understanding of risks; ability and willingness to engage with support; the need or desire to cover up a fall history; and the influence of finances in managing risk. Older people’s accounts demonstrated they experienced competing influences that impacted upon decisions they made with respect to falls risks. Most significantly, the complex interplay of these influences drove the decisions older people made, sometimes placing them at greater risk of falling. consideration of the multifaceted issues older people face when managing falls risk, and the influence these factors have on their behaviours, is vital to successfully reducing rates of fall related injuries in this population.
There is emerging evidence on the value of interprofessional education (IPE) for health professional students; however, there is less focus on assessing students on IPE experiences in clinical placement contexts. Researchers have focused on student attitudes to, or readiness for, IPE. Multiple other elements need to be assessed, including formative student assessment, profession-specific competency standards, and students’ interprofessional (IP) capabilities. Effective and authentic IP-assessment models are needed that can both demonstrate student learning, and facilitate successful sharing of assessment amongst professionals. Supervisor’s perspectives on successful sharing of assessment amongst professions have not been addressed to date in the literature. This article describes one approach for IP-Assessment, using a complex theory framework and based on an iterative cycle of developing, implementing, and evaluating a student assessment tool within an international IP placement, which could be utilized in a range of settings. A qualitative research approach explores the strengths, challenges, and outcomes of IP-Assessment from the perspective of the supervisors. Three overarching themes were identified: acknowledging the student journey, interprofessional authenticity, and collective and collaborative learning. The process of developing and implementing IP-Assessment enabled the articulation of placement and assessment priorities and provided learning opportunities for both supervisors and students.
7 July 2023 in Focus on Health Professional Education: A Multi-Professional Journal
Introduction: Allied health professionals require skills in interprofessional collaboration to work effectively to achieve person-centred health outcomes. Simulated interprofessional experiences provide students with unique opportunities in a supported environment to develop the necessary skills required for future practice. Methods: An exploratory cross-sectional study using a qualitative survey design was employed to understand the attitudes and perceptions of allied health students after completing a university based, cross-campus, interprofessional simulation experience. Results: Over 200 students from four disciplines across three campuses of a regional Australian university were involved in a simulated experience that included a range of different interprofessional activities. Post-experience survey data from approximately 40% of students suggested that students perceived the experience had several positive learnings, including a better understanding of their own and other professions and the value of interprofessional collaboration and teamwork in client care; increased confidence, particularly in communicating with other healthcare professionals; and a broader understanding of healthcare, including eHealth. The results also highlighted the challenges of implementing a project across multiple disciplines and campuses and provided useful suggestions to further improve the experience. Conclusion: The findings of this research suggest that carefully developed and authentic interprofessional experiences through simulation can provide allied health students with the opportunity to develop valuable skills in communication and teamwork as well as an emerging appreciation of the benefits of a coordinated team approach to person-centred healthcare.
The use of telehealth has proliferated to the point of being a common and accepted method of healthcare service delivery. Due to the rapidity of telehealth implementation, the evidence underpinning this approach to healthcare delivery is lagging, particularly when considering the uniqueness of some service users, such as those in rural areas. This research aimed to address the current gap in knowledge related to the factors critical for the successful delivery of telehealth to rural populations. This research used a qualitative descriptive design to explore telehealth service provision in rural areas from the perspective of clinicians and describe factors critical to the effective delivery of telehealth in rural contexts. Semi-structured interviews were conducted with clinicians from allied health and nursing backgrounds working in child and family nursing, allied health services, and mental health services. A manifest content analysis was undertaken using the Framework approach. Sixteen health professionals from nursing, clinical psychology, and social work were interviewed. Participants mostly identified as female (88%) and ranged in age from 26 to 65 years with a mean age of 47 years. Three overarching themes were identified: (1) Navigating the role of telehealth to support rural healthcare; (2) Preparing clinicians to engage in telehealth service delivery; and (3) Appreciating the complexities of telehealth implementation across services and environments. This research suggests that successful delivery of telehealth to rural populations requires consideration of the context in which telehealth services are being delivered, particularly in rural and remote communities where there are challenges with resourcing and training to support health professionals. Rural populations, like all communities, need choice in healthcare service delivery and models to increase accessibility. Preparation and specific, intentional training for health professionals on how to transition to and maintain telehealth services is a critical factor for delivery of telehealth to rural populations. Future research should further investigate the training and supports required for telehealth service provision, including who, when and what training will equip health professionals with the appropriate skill set to deliver rural telehealth services.
Damage to the articular cartilage resulting in an acute tear can lead to functional changes within the joint and increase the risk of osteoarthritis developing. There is limited understanding of the association between occupational risk factors and sustaining an acute articular cartilage tear in the military and other physically demanding occupations. Therefore, the aim of this systematic review was to identify and evaluate original research reporting on occupational risk factors associated with sustaining acute articular cartilage tears. Methods: A systematic review following the Preferred Reporting Items for Systematic review and Meta-Analysis—Protocols was conducted and registered with the Open Science Framework. Key academic databases were searched using terms from the following concepts: risk or cause, paid occupations, and acute articular cartilage tears. Results: Of an initial 941 studies, 2 studies met the eligibility criteria, both reporting data from military contexts; only one evaluated acute articular cartilage tears in both males and females. One paper focused on articular cartilage injury within the knee and the other within the ankle joint with incidence rates being 0.2 and 0.3 per 1000 person-years, respectively. People in more physically active occupations and individuals with an above-normal body mass index were reported as being at higher risk of sustaining an acute articular cartilage tear. Conclusion: Physically demanding occupations, such as the military, may increase the risk for acute tears of the articular cartilage. However, the findings of this review indicate there is a paucity of research to underpin understanding of the injury mechanisms and occupational risk factors for acute articular cartilage tears.
28 June 2019 in Australian Journal of Rural Health