Health and well-being in higher education : student perception of an Australian university

The health and well-being of university students is a priority agenda, given the need to advance health in the university system and the United Nations Sustainability Development Goal regarding quality and inclusive education. However, current literature lacks adequate insights regarding health and well-being considerations. This study investigated students’ perceptions concerning how university students experience health and well-being. The study is underpinned using the biopsychosocial model of health and was conducted via a cross-sectional student survey with quantitative and open-ended questions at an Australian university in 2021. A hierarchical regression model with 625 respondents indicated health and well-being are significantly influenced by mental (t-value = 15.7, p < 0.001), physical (t-value = 9.48, p < 0.001), university learning (t-value = 5.16, p < 0.001), and economic (t-value = 4.78, p < 0.001) domains regardless of the demographic and study characteristics of students. Students’ perception of their health and well-being varied according to student age, the college of study, and whether they were an international student. Both the quantitative and qualitative findings supported that the mental, physical, university learning, and economic domains of students’ health and well-being are interdependent. There is a case for a proactive, continuous, inclusive, and holistic health and well-being approach to support student success in higher education

Discharge delay from the post anaesthesia care unit : a nursing perspective

Background: The Post Anaesthesia Care Unit (PACU) is a critical junction between the operating theatre and the wards. It is essential for the close monitoring of patients before they are discharged to their destination wards for recovery. Many clinical and non-clinical factors influence the flow of patient discharge from the PACU to the wards. This study explores PACU nurses’ perceptions of non-clinical factors causing discharge delays and how these impact the work of nurses. Method: In this study, a descriptive qualitative methodology was implemented. This methodology is widely used in nursing and health care research as it provides a descriptive analysis of a phenomenon with straightforward descriptions of experience and perceptions. Data were collected from ten PACU nurses via in-depth, semi-structured, recorded, individual interviews. Thematic analysis using the work of Braun and Clarke was applied to gain rich insight into PACU nurses’ views, values and experiences concerning discharge delay influenced by non-clinical factors. Findings: Four themes related to discharge delay were identified: ‘accepted as part of the day’, ‘wards are never ready’, ‘feeling frustrated, powerless and stressed’ and ‘empathy for patients’. The analysis of interview transcripts demonstrated that PACU nurses constantly experienced discharge delays because ward beds or ward nurses were not readily available for admitting post-operative patients from the PACU. The findings also revealed PACU nurses’ perceptions of non-clinical discharge delay and how this event may induce stress, frustration and feelings of hopelessness at work. Participants expressed that discharge delay caused them stress and negative emotions or ‘bad feelings’ and challenged their ability to show compassion for patients. Conclusion: PACU nurses perceive discharge delays due to non-clinical factors as compromising their work. Their perspective on discharge delay indicates the need to improve relevant non-clinical factors to minimise PACU nurses’ work stress and to help facilitate the discharge experience of patients and nurses

Staff experiences of a reablement approach to care for older people in a regional Australian community : a qualitative study

Reablement is described as a person-centred, goal-directed intervention with a view to regain, maintain or improve the independence of older clients. Although evidence to support the use of reablement as a multidisciplinary, home-based intervention for community-dwelling older adults is increasing, there is limited knowledge about what it means for care staff who provide client-based services. This study, which was nested in a larger program evaluation, used a descriptive qualitative approach to explore direct care staff and care coordinator experiences of translating a reablement training program into practice for older people in a regional Australian community. Two months after the training program four focus groups were conducted with 13 care coordinators to assimilate staff experiences with development of care plans, systems, processes and practices of reablement. In addition, four direct care staff took part in individual interviews, which centred on eliciting their experience using the reablement approach with clients. Results from the care coordinator focus groups and the direct care staff interviews highlight the importance of reablement staff training and the involvement of staff in the development and delivery of a reablement approach to client-centred care. A number of organisational and client-centred challenges such as communication, functional partnerships, staff education and resourcing are also uncovered in this research into the development of a reablement-focused care service in a regional setting. Overall there is support for the dominating discourse around healthy ageing and the policy approach of ageing in place to support wellness

A culture of trust : engaging Muslim women in community sport organizations

This article examines the impetus for, and process of, engaging Muslim women in community sport. The research focuses on how and why a community sport organization, located in a large Australian city, embraced cultural change and developed a more inclusive community sport environment through social capital facilitation. The operation of the three types of social capital (bonding, bridging and linking) is considered alongside social capital attributes (networks, trust, reciprocity, volunteering and community building). The theoretical framework employed is derived from Lin's framework of social capital. The research findings are analysed through an examination of the stages of investment, development, mobilization and reproduction of social capital. This research illustrates the potential for the development of trust, cooperation and community networks, leading to cultural awareness, and changes to the cultural profile and practices of community sport organizations

Reablement training and practice : challenging ageism, ableism, and dependency in the care of older Australians

How can formal care arrangements and procedures using reablement practices of ‘working with’ older people, challenge the stigma of ‘dependency’ in the care of older adults? This project, focused on education of care workers in reablement practice, challenges attitudes in the care of older Australians in both the short and long term. When sustaining these new practices it was discovered that existing social norms around ableism and ageism were contested and innovative behaviours developed. An Australian University and a community care organisation collaborated to co-design and implement a strategy for ensuring a reablement-based model of care was embedded as part of the organisation’s core values (Prior, 2020). This strategy involved the development of bespoke educational training material around reablement and its benefits for community care. It also included an evaluation of staff understanding and skill development following their training and how these staff incorporated new knowledge and values in working to empower older people (Maxwell, 2021). Staff emphasised the successes and challenges associated with the adoption of a formal reablement structure into their current model of care, as well as the alignment of reablement in challenging discourses of ‘dependency’. Staff provided in-depth discussion of how reablement had become a routine part of their daily activities in the direct care of clients and indirectly through organisational based activities such as training, formal and informal feedback, and policy development. Discussion focused on appropriate reablement needs, governance and organisational strategy, reablement as an empowering practice, and strong organisational culture supporting reablement practices

An Australian interpretive description of Contact Precautions through a bioethical lens : recommendations for ethically improved practice

Background: Contact Precautions (CP) were developed to control multi-resistant organisms (MROs) in hospitals. However, MROs persist and harms are associated with CP. Research objectives were to understand the bioethical impact of CP on patients and health-professionals, and make recommendations for ethically-improved management of MRO-colonized patients. Methods: Interpretive description methodology scaffolded upon bioethical principles framed this qualitative study. Findings were explored alongside contemporary published reports to make recommendations for practice and research. Results: Nine patients and 24 health professionals participated. Four themes were found: Powerlessness moving to acceptance; You feel a bit of a pariah; Others need protection, but I need looking after too; Doing Contact Precautions is not easy. Discussion: CP conflict with the principle of respect for autonomy due to non-adherence to informed consent, and sub-optimal communication. Patients experience health care inequality, and discriminatory practices breaching the principle of justice. CP elicit stigma for patients, and moral distress and inter-personal conflict for staff, breaching the principle of non-maleficence. Under the principle of beneficence, pluralistic cost–benefit assessment situates CP as low-value practice. Conclusions: CP challenge organizational culture, professional well-being, and person-centered ethical care. Ethical costs of CP outweigh benefits, obliging policy-makers to reconsider CP in managing MRO-colonized patients

When laughter and physical activity opens the door to the kingdom of freedom : Danish seniors on the move towards improved health

In medieval and early modern times in Europe, popular games were an important element of social life (Elias and Dunning, 1986; Eichberg, 2012, 2013). Popular games had strong social elements of playfulness and laughter as well as violence and disorderliness (Eichberg, 2016), which disappeared with the civilizing process (Elias and Dunning, 1986). Even though the words ‘games’ and ‘play’ are still in use, they have come to represent the rule-based and orderly organization of modern sport – the Olympic Games and ‘playing’ football as the most well-known examples (Eichberg, 2013). Hand in hand with the hygienic turn and its dominant view of physical activity as health enhancement, playfulness became eradicated from physical activity (Eichberg, 2013; Winther, 2014). Research into physical activity to date has not fully considered the importance of the social-bodily processes of joy and laughter. Laughter as a social phenomenon has been exiled, along with the scientific questioning of the social meaning of laughing. Laughter has often been recognized as a causality of humour (Parvulescu, 2010) or in health research as a means to achieve a health goal (Hybholt and Friis Thing, 2019)

Considering the precautionary principle and its application to MRSA and SARS-CoV-2 as emerging novel pathogens of their time

In the 1980s Contact Precautions were introduced as a precautionary measure to control the emerging threat of antimicrobial resistance in hospitals, particularly methicillin resistant Staphylococcus aureus (MRSA). Today, antimicrobial resistance remains a concerning global public health threat, and a focus for hospital patient safety priorities. In late 2019 a novel respiratory virus described as SARS-CoV-2, was reported. Just as MRSA had prompted control measures developed in the context of limited information and understanding of the pathogen, public health control measures against SARS-CoV-2 were promptly and strictly implemented. Whilst SARS-CoV-2 control measures were successful at containing the virus, numerous detrimental socio-economic and health impacts have led to a rebalancing of harms versus benefits and loosening of restrictions. Conversely, evidence collated over the past 50 years, suggests that Contact Precautions are not superior to well-applied standard infection prevention and control precautions in controlling MRSA acquisition in hospitals. Several harms associated with Contact Precautions, affecting patient safety, financial costs, and organisational culture, are described. However, rebalancing of hospital MRSA control policies has been slow to materialise. This commentary invites infection prevention and control policy makers to reflect and revise policies for the control of MRSA in hospitals so that harms do not outweigh benefits

Leisure as an agent of social change : special issue introduction

Having mounted a case for leisure as a human right in 2015 (McGrath, Young and Adams 2017), the organizers of the 13th Biennial (2017) Australian and New Zealand Association for Leisure Studies (ANZALS) Conference in Hobart, Tasmania asked delegates to take this notion a step further by reviewing leisure as a social change agent at individual, community and societal levels. A key focus was the capacity of leisure to improve the human condition (especially in the context of a rapidly changing world), and the role leisure plays in challenging social norms, biases, discrimination and stereotypes, thus enabling social justice outcomes. Of interest was how leisure enhances the quality of life and empowers groups, such as migrants, people living with a disability, older people, women and girls, those of lower socioeconomic status, lesbian, gay, bisexual, transsexual, intersex and queer (LGBTIQ) and indigenous peoples. The transition of leisure activities through an individual’s different stages of life organically emerged as a sub-theme of the conference and this special issue, especially around active participation and volunteerism

The health needs of regionally based individuals who experience homelessness : perspectives of service providers

The bidirectional relationship between homelessness and poor health and the barriers that individuals who experience homelessness face when trying to access healthcare are well documented. There is, however, little Australian research exploring the situation of individuals who experience homelessness in regional contexts and, moreover, from the perspective of service providers. A qualitative descriptive methodology underpinned this study, with in-depth semi-structured interviews being conducted with 11 service providers to identify barriers to care faced by people who experience homelessness and barriers that service providers themselves experience in supporting this population. The key barriers identified were client-level barriers: living day-by-day, financial, health literacy, mental health conditions, behaviour, safety and stigma; provider-level barriers: few bulk-billing doctors, fragmented services, limited resources, negative past experiences with healthcare; and system level barriers: transportation, over-stretched healthcare services. The combined impact of these barriers has significantly contributed to the desperate situation of people experiencing homelessness in Launceston. This situation is likely replicated in other regional populations in Australia. Given that individuals experiencing homelessness have higher rates of every measure in health inequality, steps need to be taken to reduce barriers, and a standardised approach to health care urgently needs to be implemented by governments at the state and national level to improve the health of regionally based individuals experiencing homelessness