Publications by authors named "Linda Isherwood"

6 Publications

  • Page 1 of 1

Care workers' perspectives of factors affecting a sustainable aged care workforce.

Int Nurs Rev 2020 Oct 14. Epub 2020 Oct 14.

College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia.

Aims: To identify the reasons why workers decide to enter, stay or leave the aged care workforce; and the factors influencing them to transition between community and residential sectors in Australia.

Background: Factors affecting the recruitment and retention of suitable care workers in aged care are complex and influenced by personal, institutional and societal factors.

Methods: A qualitative description study design.

Results: In total, 32 staff participated in the study. Five main themes were identified: entering aged care with a passion for the job; entering aged care as it is the only employment option; factors attracting care workers to stay in aged care; factors influencing care workers to leave the job; and preferring to work in residential aged care rather than community aged care.

Conclusion: Issues relating to the attraction and retention of aged care workers are influenced by personal, institutional and societal factors. Critical shortages in the aged care workforce make the industry more susceptible to crises such as COVID-19 outbreaks.

Implication For Nursing Practice: Aged care organizations need to create a positive psychosocial work environment for staff to improve the attraction and retention of skilled care workers. They also need to develop staff recruitment guidelines to ensure care workers with the appropriate skills and training and a passion for working with older adults are selected. Staff development programmes need to focus on learning activities that enable staff to build peers support in the work environment.

Implications For Health Policy: There is a need to mandate curriculum to enable nursing students to receive more gerontological education and exposure to aged care throughout their education. Aged care quality standards need to mandate transition support for new graduate nurses.
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October 2020

Why do older people with multi-morbidity experience unplanned hospital admissions from the community: a root cause analysis.

BMC Health Serv Res 2015 Nov 27;15:525. Epub 2015 Nov 27.

Discipline of General Practice, Flinders University, GPO Box 2100, Adelaide, 5001, South Australia.

Background: Increasing demand for hospital services by older people is a major concern for Australian health care providers. To date there has been little in-depth research that encompasses contextual and systems factors contributing to hospital admissions. The objective of this study was to determine the reasons why older patients experienced unplanned hospital admissions to a major public hospital.

Methods: A retrospective qualitative study using a Root Cause Analysis (RCA) methodology was conducted in a major public hospital in Adelaide, South Australia and surrounding community. Community dwelling older people admitted to the hospital who were well enough to give informed consent and be interviewed were invited to take part in the study. With patients consent, family members, general practitioners (GPs) and specialists were also interviewed and patient hospital records reviewed. Using a purposive sampling technique to obtain maximum variability, thirty-six older people (aged 70 years and older) participated in the study. GPs (n = 17), family members (n = 14), and other healthcare providers (n = 12) involved in their care were also interviewed. Cases were then analysed according to a standardized protocol to determine the root cause of admission. Root causes were then assigned to broader categories using thematic analysis.

Results: The root causes of unplanned admissions were identified and categorised into six causal groups: a consequence of minimal care, progression of disease, home care accessibility, high complexity, clinical error, and delayed care-seeking by the patient.

Conclusions: RCA can be effectively applied to determine the causes of unplanned hospital admissions although the process is time consuming. Four categories of admission (minimal care, clinical error, home care access, delayed care-seeking) were deemed potentially preventable. This methodology and classification approach may assist in designing interventions to prevent future hospitalisations in this high-risk population.
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November 2015

Family histories of school bullying: implications for parent-child psychotherapy.

Australas Psychiatry 2014 Apr 10;22(2):149-53. Epub 2014 Feb 10.

Associate Professor, Department of Psychiatry, Flinders University of South Australia, Bedford Park, SA, Australia.

Objective: The purpose of this study was to determine whether a parent's past history of peer victimisation predicted their children's risk of being bullied at school.

Method: In face-to-face interviews, a representative community sample of 1895 mothers and fathers were asked about exposure to traumatic bullying during their schooling. Parents completed the Medical Outcomes Study Short-Form Health Survey (SF-36) to measure possible links with health-related quality of life. The interviews also inquired whether their children were victims of traumatic bullying at school.

Results: Parental victimisation was associated with an increased risk for their children being bullied (55% with a positive parental history compared with 25% with no parental history: relative risk=2.17). In a multivariate logistic model controlling for the parents' age, gender, socioeconomic status and health-related quality of life (physical and emotional components), parental victimisation remained a strong predictor for the children's victimisation at school (relative risk=2.00). In 9.3% of the sample, both parent and child experienced bullying during their schooling.

Conclusions: Parent and child dyads can be exposed sequentially to school bullying. In some instances, they may share familial characteristics that are exploited by bullies. These experiences can be explored in parent-child psychotherapy.
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April 2014

Recruitment for a clinical trial of chronic disease self-management for older adults with multimorbidity: a successful approach within general practice.

BMC Fam Pract 2013 Aug 28;14:125. Epub 2013 Aug 28.

Discipline of General Practice, Flinders Prevention Promotion and Primary Health Care Cluster, Flinders University, Health Sciences Building, Level 3, Registry Road, Bedford Park, South Australia, Australia.

Background: A robust research base is required in General Practice. The research output for General Practice is much less than those of other clinical disciplines. A major impediment to more research in this sector is difficulty with recruitment. Much of the research in this area focuses on barriers to effective recruitment and many projects have great difficulty with this process. This paper seeks to describe a systematic approach to recruitment for a randomized controlled trial that allowed the study team to recruit a substantial number of subjects from General Practice over a brief time period.

Methods: A systematic approach to recruitment in this setting based on prior literature and the experience of the investigator team was incorporated into the design and implementation of the study. Five strategies were used to facilitate this process. These included designing the study to minimize the impact of the research on the day-to-day operations of the clinics, engagement of general practitioners in the research, making the research attractive to subjects, minimizing attrition and ensuring recruitment was a major focus of the management of the study. Outcomes of the recruitment process were measured as the proportion of practices that agreed to participate, the proportion of potentially eligible subjects who consented to take part in the trial and the attrition rate of subjects. Qualitative interviews with a subset of successfully recruited participants were done to determine why they chose to participate in the study; data were analyzed using thematic analysis.

Results: Five out of the six general practices contacted agreed to take part in the study. Thirty-eight per cent of the 1663 subjects who received a letter of invitation contacted the university study personnel regarding their interest in the project. Recruitment of the required number of eligible participants (n = 256) was accomplished in seven months. Thematic analysis of interviews with 30 participants regarding key factors in their study participation identified a personalised letter of endorsement from their general practitioner, expectation of personal benefit and altruism as important factors in their decision to participate.

Conclusion: Recruitment can be successfully achieved in General Practice through design of the research project to facilitate recruitment, minimize the impact on general practice operations and ensure special care in enrolling and maintaining subjects in the project.
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August 2013

Marital satisfaction among older couples: the role of satisfaction with social networks and psychological well-being.

Int J Aging Hum Dev 2013 ;76(2):123-39

Flinders University, Adelaide, Australia.

Marital satisfaction is important for health and well-being, although determinants of satisfaction among older couples are unclear. Much of the marital literature has focused on the role of the spouse, in isolation from satisfaction with broader social relationships. We conducted separate semi-structured interviews with both members of n = 40 couples (mean age 76 years) to measure satisfaction with particular types of social networks (confidant, friend, children, other relatives) as well as levels of physical and psychological well-being. In order to account for the likely interdependence among observations within married couples, a series of multi-level models, culminating in a full actor-partner interdependence model, were fitted. Results indicate that an individual's own depressive symptoms were related to their levels of marital satisfaction, whereby higher scores on the depression scale predicted lower marital satisfaction scores for the individual. None of the individual's other variables (physical well-being, sociodemographic, or social network satisfaction), nor any of the spouse variables, were related to individual levels of marital satisfaction. These findings reinforce the importance of psychological well-being as influencing the quality of older couple relationships.
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June 2013

A longitudinal analysis of social engagement in late-life widowhood.

Int J Aging Hum Dev 2012 ;74(3):211-29

National Institute of Labour Studies, Faculty of Social and Behavioural Sciences, Flinders University, Australia.

Very little is known of the longitudinal changes that occur in contact with children and participation in social activities during late-life widowhood. Using data on social networks and activities drawn from the Australian Longitudinal Study of Ageing, trajectories of change in social engagement were modeled for 1266 participants (mean age 76.7 years) over a 16-year period. Levels of social engagement were found to remain high during older age and rose following the transition to widowhood. Frequency of phone contact with children and participation in social activities were higher for widowed than married participants. However, the very-old, males, those in lower socio-economic groups, in poorer health, or without a child living nearby were found to have lower levels of social engagement in widowhood, and may be at increased risk of social isolation. High levels of social engagement during widowhood may assist individuals in successfully overcoming the challenges of spousal bereavement.
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August 2012