Thai Health-risk Transition: A National Cohort Study
Funder
National Health and Medical Research Council
Funding Amount
$1,231,214.00
Summary
Thailand's disease patterns are changing. Some changes are good but others, like emerging diabetes, heart disease and injuries, are of concern. Development-related 'health transition' can be optimised if there is information on new causes of disease - immediate risk factors, and 'upstream' economic, cultural and environmental influences. The team will study this health-risk transition in the whole Thai population - looking back 50 years, then forwards in 100,000 Sukothai Thammathirat Open Univer ....Thailand's disease patterns are changing. Some changes are good but others, like emerging diabetes, heart disease and injuries, are of concern. Development-related 'health transition' can be optimised if there is information on new causes of disease - immediate risk factors, and 'upstream' economic, cultural and environmental influences. The team will study this health-risk transition in the whole Thai population - looking back 50 years, then forwards in 100,000 Sukothai Thammathirat Open University students living all over Thailand and followed for four years. The team will map changing risks and upstream influences, produce information for Thai preventive programs, boost regional research capacity, create a regional partnership, and support PhD and postdoctoral training.Read moreRead less
Palliative Care In Aged Care Facilities For Residents With A Non-cancer Diagnosis
Funder
National Health and Medical Research Council
Funding Amount
$70,000.00
Summary
Preliminary studies have suggested there may be deficiencies in the care of residents in aged care facilities who have advanced terminal illnesses other than cancer. Aged care residents do not have access to the expertise and resources available to clients of palliative care services where cancer is the major diagnosis. This study aims to investigate the extent and nature of any deficits experienced in aged care facilities and to employ palliative care standards to develop strategies so that any ....Preliminary studies have suggested there may be deficiencies in the care of residents in aged care facilities who have advanced terminal illnesses other than cancer. Aged care residents do not have access to the expertise and resources available to clients of palliative care services where cancer is the major diagnosis. This study aims to investigate the extent and nature of any deficits experienced in aged care facilities and to employ palliative care standards to develop strategies so that any unmet needs can be addressed.Read moreRead less
The Impact Of Hospital-based Aged Care And Dementia Services On Outcomes For People With Dementia Admitted To Hospital-a
Funder
National Health and Medical Research Council
Funding Amount
$1,308,580.00
Summary
This research explores how hospital based aged care and dementia services influence outcomes for people with dementia who are admitted to hospital. Using detailed data for NSW public hospitals, it will provide information about the kinds of hospital based aged care and dementia services available to assist people with dementia, and how the level and mix of these services is associated with different patient outcomes, including lower rates of admission to hospital. There is considerable evidence ....This research explores how hospital based aged care and dementia services influence outcomes for people with dementia who are admitted to hospital. Using detailed data for NSW public hospitals, it will provide information about the kinds of hospital based aged care and dementia services available to assist people with dementia, and how the level and mix of these services is associated with different patient outcomes, including lower rates of admission to hospital. There is considerable evidence that there are many hazards for people with dementia when they are hospitalized. The project will result in recommendations about the types of services and their features which produce better outcomes for people with dementia. Every stage of the research will be guided and informed by an Expert Panel comprising representatives of dementia service consumers, aged care providers, health service planning staff and key researchers. The Panel will provide contextual information about the service environment and how it affects people with dementia. Details of the patient's complete hospital stay can be investigated by linking existing administrative datasets. Data about hospital services will be gathered through a census of NSW hospitals, supplemented with in-depth interviews with key stakeholders and small group expert discussions with experts in each Area Health Service. The research team will also visit selected hospital sites. Multilevel modelling techniques will test for statistical associations between hospital based dementia services and care outcomes including admission rates to hospital, total length of hospital stay, mortality, admission rates to hospital, and the level of patient dependency on entry to residential aged care. The model will include the influence of regional variations in the provision of community aged care packages and residential aged care and the availability of informal care. The project will include a focus on the outcomes for people with co-morbidities and for people from different culturally and linguistically diverse backgrounds.Read moreRead less
Improving Quality Of Life Of People With Dementia Living In Residential Care Facilities A Randomised Trail Of Educat Int
Funder
National Health and Medical Research Council
Funding Amount
$777,409.00
Summary
The DIRECT study aims to determine if education of General Practitioners (GPs) and Residential Care Staff can improve the quality of life (QOL) of people with dementia living in Residential Care Facilities (RCF). Our hypothesis is that a systematic educational intervention delivered to GPs and RCF staff will improve care delivery, leading to measurable improvements in the quality of life of residential care recipients. We hypothesise that education delivered to GPs will have additive effects to ....The DIRECT study aims to determine if education of General Practitioners (GPs) and Residential Care Staff can improve the quality of life (QOL) of people with dementia living in Residential Care Facilities (RCF). Our hypothesis is that a systematic educational intervention delivered to GPs and RCF staff will improve care delivery, leading to measurable improvements in the quality of life of residential care recipients. We hypothesise that education delivered to GPs will have additive effects to education delivered to RCF staff. Dementia is the leading cause of non-fatal disease burden among older Australians. Of people with dementia, nearly half live in RCF. There appears to be much scope to improve care, and thus QOL, for people with dementia living in residential facilities. However, the most effective way to translate knowledge regarding the components of high quality care into practice is uncertain and there is a paucity of Australian data to guide practice. Education of RCF staff is likely to be the cornerstone of improved care for recipients of residential care who have dementia. GPs also play a key-role in the care of older people living in RCF, including collaboration in the development of management plans, prescription of medications and initiation of health referrals. A detailed action research process with data collected from surveys, focus groups and pilots will be used to develop educational programmes for delivery to GPs and RCF staff. The primary outcome of the study will be quality of life of the people with dementia, assessed by themselves, their family carers and the staff looking after them. Several tools incorporating different sources of information will be used to assess QOL in a comprehensive fashion. Secondary outcomes will include knowledge among GPs and RCF staff regarding dementia, markers of quality care, participants’ sleep quality, and carer satisfaction. It is anticipated that the results will fill this current gap in evidence and will be of value to policy makers and stakeholders from the Residential Care Industry and Peak Community and General Practice bodies. The study results will have tangible implications for proprietors, managers and staff from the residential care sector and policy makers. The results have potential to directly benefit the quality of life of both patients and carers.Read moreRead less
Person-centred Environment And Care For Residents With Dementia: A Cost-effective Way Of Improving Quality Of Life And Q
Funder
National Health and Medical Research Council
Funding Amount
$1,548,805.00
Summary
Improving the quality of life (QOL) and quality of care for persons with dementia are important areas of Australian health research. A growing body of evidence shows that QOL in dementia can be improved by relatively simple and inexpensive modifications to nursing care practices and the physical environment. Most studies in these areas are observational, few have utilized a randomized control group design, and none has included economic evaluation. This study will address these deficiencies. Thi ....Improving the quality of life (QOL) and quality of care for persons with dementia are important areas of Australian health research. A growing body of evidence shows that QOL in dementia can be improved by relatively simple and inexpensive modifications to nursing care practices and the physical environment. Most studies in these areas are observational, few have utilized a randomized control group design, and none has included economic evaluation. This study will address these deficiencies. This is the first time that a randomized controlled trial of Person-Centred Care (PCC) and Person-Centred Environment Design (PCD) will be undertaken. The study will be conducted in 40 residential aged care services in New South Wales, to determine the efficacy and cost effectiveness of implementing PCC and PCD separately, and in combination, in improving resident quality of life and quality of care.Read moreRead less
Expectations And Barriers In The Ambulance Service And Palliative Care Interface
Funder
National Health and Medical Research Council
Funding Amount
$49,916.00
Summary
There are over 6000 paramedics in Australia. The ambulance service is faced with palliative care on a daily basis throughout the country. Their involvement in palliative care is diverse and may include response to end of life calls, response to aid home care, response to manage acute events, providing health transport and collaborating with other care givers. The nature of this involvement, and the broader policy, operational, clinical and social implications has not been researched in Australia ....There are over 6000 paramedics in Australia. The ambulance service is faced with palliative care on a daily basis throughout the country. Their involvement in palliative care is diverse and may include response to end of life calls, response to aid home care, response to manage acute events, providing health transport and collaborating with other care givers. The nature of this involvement, and the broader policy, operational, clinical and social implications has not been researched in Australia. This study will survey paramedics across two states to describe their involvement in palliative care, and the issues and challenges associated with provision of this service.Read moreRead less
Development Of A Palliative Care Service For Rural And Remote Communities
Funder
National Health and Medical Research Council
Funding Amount
$150,000.00
Summary
This project will develop, implement and evaluate a new model of providing palliative care to individuals in rural and remote communities that will utilise existing health and community resources to provide palliative care. As the number of patients requiring palliation in rural and remote communities is small, the service may not function at all times but come together (pop-up) as required. Evaluation of the model in three different types of rural communities will be undertaken in three states ....This project will develop, implement and evaluate a new model of providing palliative care to individuals in rural and remote communities that will utilise existing health and community resources to provide palliative care. As the number of patients requiring palliation in rural and remote communities is small, the service may not function at all times but come together (pop-up) as required. Evaluation of the model in three different types of rural communities will be undertaken in three states (New South Wales, Queensland and West Australia). Phase I will develop a framework to assist rural communities undertake a critical palliative care service review. Phase II will implement and evaluate the model, leading to recommendations for provision of best practice palliative care more generally in rural communities.Read moreRead less
Palliative Care Constituency, Utilisation & Impact On Health Care: A Western Australia Based Epidemiology & Sociological
Funder
National Health and Medical Research Council
Funding Amount
$150,000.00
Summary
Using the Western Australian linked database and in consultation with palliative care service providers, the study will: 1. Study patterns of palliative care delivery during the last 12 months of life, comparing utilisation between different socio-demographic groups and cause of death. 2. Study the relationships between the services provided and the terminally ill. 3. Develop a definition of those who utilise designated palliative care programs and apply it to ....Using the Western Australian linked database and in consultation with palliative care service providers, the study will: 1. Study patterns of palliative care delivery during the last 12 months of life, comparing utilisation between different socio-demographic groups and cause of death. 2. Study the relationships between the services provided and the terminally ill. 3. Develop a definition of those who utilise designated palliative care programs and apply it to the population of Western Australia in 1994-1999. 4. Develop a forecasting model to optimise the planning and delivery of palliative care service in Australia.Read moreRead less
Palliative Care For Aboriginal And Torres Strait Islander People With End-stage Renal Disease: An Action Research Initiati
Funder
National Health and Medical Research Council
Funding Amount
$295,554.00
Summary
There are significant gaps in current knowledge for providing culturally appropriate and effective palliative care for Aboriginal and Torres Strait Islander people with kidney failure. This project will consider these issues in partnership with the Kowanyama Community and the associated key Aboriginal and Torres Strait Islander and other agencies. Echoing the recommendations by the �National Indigenous Palliative Care Needs Study� this study will address the absence of a culturally appropriate m ....There are significant gaps in current knowledge for providing culturally appropriate and effective palliative care for Aboriginal and Torres Strait Islander people with kidney failure. This project will consider these issues in partnership with the Kowanyama Community and the associated key Aboriginal and Torres Strait Islander and other agencies. Echoing the recommendations by the �National Indigenous Palliative Care Needs Study� this study will address the absence of a culturally appropriate model of care pathway for Aboriginal and Torres Strait Islander people with advanced kidney failure to make effective informed choices for palliative care. Through the use of action research methodology this study will engage with Aboriginal and Torres Strait Islander people to consider these issues, taking into consideration their cultural, spiritual and social needs, those of their family, carers, healthcare personnel and the wider community. Subject to discussions and input from the Aboriginal and Torres Strait Islander people and other key stakeholders it is anticipated that the key areas of interest will focus on spirituality, quality of life, role of the family, carer and community, understandings and experience of kidney failure, treatment options, patient advocacy systems, the need for relocation, and the potential role of advanced care planning. Intervention strategies will also be conducted and evaluated. Subject to discussions and input from the Aboriginal and Torres Strait Islander participants and other key stakeholders it is anticipated that these will focus on a community based education program, development of a culturally appropriate quality of life questionnaire, development and piloting of a culturally appropriate mechanism for people to consider advanced care planning and development and piloting of a patient advocacy process for those from remote areas visiting metropolitan renal - palliative care health services.Read moreRead less