Sink or swim- ageing in Australia

As the number of people under the age of 65 declines, the number over 65 will double in the next half century. By 2031, it is estimated those over 65 will account for more than a quarter of the Australian population. The fastest rate of growth will be in the over-85-years category, projected to double over the next 20 years and to triple over 50 years to include 2.3 million people. Health care providers cannot afford to wait for the inevitable crises this vast demographic shift will provoke. To meet these future demands, educational and health care institutes should consider establishing interdisciplinary think-tanks for multidisciplinary research, policy development and innovations in aged care and health service delivery.Aust Health Rev 2005: 29(2): 146-150<br /

Diabetes Capabilities for the Healthcare Workforce Identified via a 3-Staged Modified Delphi Technique.

Consumers access health professionals with varying levels of diabetes-specific knowledge and training, often resulting in conflicting advice. Conflicting health messages lead to consumer disengagement. The study aimed to identify capabilities required by health professionals to deliver diabetes education and care to develop a national consensus capability-based framework to guide their training. A 3-staged modified Delphi technique was used to gain agreement from a purposefully recruited panel of Australian diabetes experts from various disciplines and work settings. The Delphi technique consisted of (Stage I) a semi-structured consultation group and pre-Delphi pilot, (Stage II) a 2-phased online Delphi survey, and (Stage III) a semi-structured focus group and appraisal by health professional regulatory and training organisations. Descriptive statistics and central tendency measures calculated determined quantitative data characteristics and consensus. Content analysis using emergent coding was used for qualitative content. Eighty-four diabetes experts were recruited from nursing and midwifery (n = 60 [71%]), allied health (n = 17 [20%]), and pharmacy (n = 7 [9%]) disciplines. Participant responses identified 7 health professional practice levels requiring differences in diabetes training, 9 capability areas to support care, and 2 to 16 statements attained consensus for each capability-259 in total. Additionally, workforce solutions were identified to expand capacity for diabetes care. The rigorous consultation process led to the design and validation of a Capability Framework for Diabetes Care that addresses workforce enablers identified by the Australian National Diabetes Strategy. It recognises diversity, creating shared understandings of diabetes across health professional disciplines. The findings will inform diabetes policy, practice, education, and research

Providing continence care in residential aged care facilities: a grounded theory study

This thesis resulted in a grounded theory that described and explained how Australian residential aged care residents&rsquo; continence care needs were determined, delivered, and communicated. The researcher identified a basic social problem that influenced overall care, and a basic social process staff used to deal with the problem

The challenge of managing continence care in residential aged care settings : recommendations for research and practice

Incontinence-related problems are a major reason for placement in residential aged care facilities. Data from the Residential Classification Scale indicates that 86% of people in residential aged care facilities in Australia are dependent on others for bladder management, 77% require some support with bowel management and 78% require some support with toileting. In this paper, we present an overview of the literature on the issues that need to be considered for the management of incontinence in residential aged care settings. Based on this literature, we make recommendations for research and practice. Although residential care facilities are mandated to provide continence care, there is little research evidence on which to base care or to evaluate the effectiveness of current practices. Further research is required to address this gap in information to ensure delivery of residential aged care that meets the requirements of the Aged Care Act 1997.<br /

Treatment of urinary incontinence after stroke in adults

Background: Urinary incontinence can affect 40-60% of people admitted to hospital after a stroke, with 25% still having problems on hospital discharge and 15% remaining incontinent at one year. Objectives: To determine the optimal methods for treatment of urinary incontinence after stroke in adults. Search methods: We searched the Cochrane Incontinence and Stroke Groups specialised registers (searched 15 March 2007 and 5 March 2007 respectively), CINAHL (January 1982 to January 2007), national and international trial databases for unpublished data, and the reference lists of relevant articles. Selection criteria: Randomised or quasi-randomised controlled trials evaluating the effects of interventions designed to promote continence in people after stroke. Data collection and analysis: Data extraction and quality assessment were undertaken by two reviewers working independently. Disagreements were resolved by a third reviewer. Main results: Twelve trials with a total of 724 participants were included in the review. Participants were from a mixture of settings, age groups and phases of stroke recovery. Behavioural interventions Three trials assessed behavioural interventions, such as timed voiding and pelvic floor muscle training. All had small sample sizes and confidence intervals were wide

Exploring Diabetes Competencies: Engaging with Colleagues using the Delphi Method

Background: A 20% increase in adult diabetes is anticipated by 2030 when 58% of the CDE workforce will have reached retirement age. Fundamental to increasing equity in safe diabetes healthcare access across the health spectrum is a competent, flexible and adaptive workforce. Higher demand for healthcare professionals with both diabetes and non-medical prescribing competencies warrants a more efficient means of developing the workforce. Aim: To develop a Capability Framework by accessing the opinion of a diverse range of diabetes expert healthcare professionals and academics, of different disciplines and work settings. Method: The qualitative research used an online Delphi method informed by consultation and focus groups to gain consensus. A Consultation Group was engaged to inform the Delphi survey development phase. A pilot Delphi survey was administered via Qualtrics, an online platform, to six diabetes experts to test Qualtrics features and confirm questions captured the intended information. An expert panel from across Australia commenced the final Delphi survey. Analysed data obtained from the Delphi survey formed a list of competencies under nine capabilities. An Expert Advisory Group was engaged to review the positioning of competencies, wording and omissions. Further, ‘member checking’ will ensure the trustworthiness of results. The Delphi expert panel ranks the importance of the identified competencies for each of the capability areas until consensus achieved. Results: Fifty-seven diabetes experts from nursing, dietetics, podiatry, pharmacy, exercise physiology and academic backgrounds were recruited to the project and administered the Delphi survey. The Delphi method captured demographic data and comprehensive lists of skills, knowledge and attributes required by health professionals working at basic to expert levels in diabetes care. Discussion: Using Delphi as a method enables ease of access and reach to the breadth of diabetes healthcare professionals across the nation. Also, it allows for re-examining the understanding of valuable information