Conectar
To examine practice nurse knowledge, attitudes, and practices about medication abortion in Australia.
Cross-sectional survey.
A national online survey was conducted from July to December 2021. Nurses working in general practice were recruited using convenience sampling. Data collected included demographics, knowledge, attitudes, and practices in abortion care. Analyses used included descriptive statistics and Poisson regression.
From 489 responses, knowledge about medication abortion, its provision, and efficacy was low. Although many respondents felt it was acceptable to assist in medication abortion, few indicated involvement. Those with advanced qualifications had greater perceived knowledge of abortion counselling. Respondent involvement in medication abortion was more likely if they had worked in general practice for a long time, their primary place of work was outside of general practice, or had advanced nursing qualifications.
Given their role in the community, there is an opportunity to better utilise practice nurses for abortion care. Incorporation of abortion into the nursing curriculum and routine practice, including supportive funding mechanisms for care, is needed.
Low knowledge and a lack of practice nurses providing abortion services adversely impact patient access.
Practice nurse provision of medication abortion has not yet been optimised. While practice nurses reported acceptability to provide abortion care, this could be enhanced with funding, education, and service normalisation. These results will inform policy makers, educators, patients, general practices, and nurses to support patient access to abortion care. Incorporating abortion care into nursing curriculum and practice will support women's access to these services.
CHERRIES guideline.
Professional groups, family planning organisations, industry, and government grant partners supported the study's recruitment.
ACTRN12622000655741
To describe practice nurse long-acting reversible contraception (LARC) knowledge and practices.
Cross-sectional survey.
Between July and December 2021, we conducted an online survey using convenience sampling to recruit Australian nurses who work in primary care, known as practice nurses. We collected data about demographics and knowledge and practices relating to LARC. Analysis used descriptive statistics and Poisson regression.
From 489 eligible responses, most respondents were women and the majority worked in metropolitan practices. Most (90.4%) believed that their advice could influence women's contraceptive choices. Few inserted/removed intrauterine devices (IUDs) (11.2%) or implants (15.9%). Of those that did insert LARC, most did so one to five times in the last month (IUDs 72.2%; implants 73.6%). General practice as a primary place of work was negatively associated with implant provision. Respondents with more general practice experience (≥ 15 years) and/or higher qualifications were more likely to respond correctly to knowledge questions and provide IUDs or implants. Most (62.8%) correctly identified IUD suitability for nulliparous women.
Practice nurses have knowledge gaps and limited practice opportunities for LARC provision.
Practice nurses need supportive funding policies and ongoing education and skills development to enhance patient access to LARC and their choice of provider.
CHERRIES guideline.
Partner organisations assisted with the study's recruitment.
ACTRN12622000655741
The COVID-19 pandemic accelerated telehealth adoption, offering remote consultations via phone and video. Allied health services are one part of the healthcare system where telehealth, in specific teleconsultations, has been applied and has shown promising results in improving healthcare access by breaking down financial, logistical and geographic barriers. However, more insight is needed into the consumer’s perspective. A consumer is anyone who has used, currently uses or will use telehealth for allied health services. Therefore, this study explores consumer experiences and preferences, identifying barriers and facilitators to telehealth for allied health services.
This qualitative study used focus group discussions to evaluate consumers’ experiences with telehealth for allied health services. Allied health was defined as healthcare professionals distinct from medical, dental and nursing fields. Eight focus groups with 57 participants were conducted. The participants were recruited from the general public as well as seldom represented communities such as a support service focused on improving and maintaining members’ mental health, the deaf and hard-of-hearing community, young disabled people and the Pacific Islander community. An inductive thematic analysis was used to analyse the data.
Five main themes were identified. First, the consumer with their individual characteristics and context played a major role in the suitability of telehealth. Second, the allied health practitioner and their skills influenced the quality and therefore the success of remote consultations. Further, the relationship between consumer and practitioner contributed to the success of telehealth. The appointment itself was equally often discussed. While telehealth improved access to care, remote appointments were seen as more suitable for questions and verbal exchanges. Lastly, the technology was an important factor with the availability of necessary technology and the accessibility of it playing a central role.
The findings reinforce existing research while highlighting new insights from often under-represented groups, emphasising the importance of telehealth choice, accessible technology and quality standards.
Opioid analgesic medications play a critical role in pain management but are associated with significant risks, including addiction. General practitioners in primary care account for a substantial proportion of opioid prescriptions, and prescribing practices may not always fully align with clinical guidelines. Given the limited evidence supporting long-term opioid use for chronic non-cancer pain, there is a pressing need for interventions that promote safer, guideline-concordant prescribing. The Smarta Val (Smart Choices) trial will evaluate whether a new multicomponent intervention, comprising an educational seminar, written materials and feedback on prescribing over 12 months, can improve opioid prescribing practices in primary care.
This cluster randomised pragmatic trial will assess changes in opioid prescribing across primary healthcare centres (PHCCs) in Stockholm, Sweden. Consenting PHCCs will be randomised 1:1 to either the intervention group, receiving the multicomponent intervention, or the active control group, receiving a leaflet on prescribing recommendations. A sample size of 24 PHCCs per group is required to detect differences in opioid prescribing between groups. A third group of non-randomised observational reference PHCCs will be included to provide contextual information on prescribing practices during the study period. Data sources include regional healthcare databases, baseline and 12-month follow-up questionnaires, and an intervention delivery form. The primary outcome is the change in prescription of opioids at 12 months. Secondary outcomes are the change in prescription of opioids at 24 months and the change in the specific opioid substances prescribed at 12 months.
The study has been approved by the Swedish Ethical Review Authority (Dnr 2021-06739-01). Participation in the study requires informed consent from PHCC managers in the intervention and active control groups. Results will be disseminated through international peer-reviewed journals and conference presentations.
Hearing loss is highly prevalent and impacts many aspects of a person’s life, including communication, social engagement, employment, general health and well-being. Yet, many people do not access hearing healthcare and are unaware of the range of hearing healthcare options available. Barriers to hearing healthcare include poor understanding of hearing loss and its impact; poor knowledge of help-seeking for hearing healthcare options; minimal support to help decide which option is best; and stigma related to hearing loss. These barriers lead to many people not receiving the hearing healthcare they need. Guided by theories of behaviour change and implementation science, HearChoice, an online tailored decision support intervention, has been co-developed to empower adults with hearing difficulties by offering them choice and control over their own hearing healthcare. HearChoice aims to facilitate informed decisions, accessibility and uptake of hearing healthcare, including a wide range of interventions, for adults with hearing difficulties. The objectives of the trial are to evaluate the effectiveness, health economics and feasibility of HearChoice.
This online randomised controlled trial will recruit participants with hearing difficulties across Australia, with an anticipated sample size of 640. Participants will be randomised to either HearChoice (treatment) or an Australia-specific Hearing Option Grid (active control), both delivered online. Outcomes will be assessed at baseline when the interventions will be offered, at 7 days post-intervention (primary endpoint) and at 3 months post-intervention. An email reminder will be sent at 1-month post-intervention. The primary outcome is decisional conflict. Secondary outcomes include measures of readiness and self-efficacy to take action, hearing-related quality of life and empowerment, assessment of the value and impact of HearChoice, work performance and health, and feasibility measures. Primary analysis will compare outcomes between HearChoice and the active control at the primary endpoint.
The study was approved by the Curtin University Human Ethics Committee (HRE2023-0024). All participants will provide written informed consent prior to participation. A broad dissemination plan of the study findings includes peer-reviewed publications, scientific conference presentations, articles and presentations for the wider community and public written in lay and accessible language, and social media.
Australian New Zealand Clinical Trials Registry (ACTRN12624001139561).
Individuals living with severe mental illness (SMI) are at a significantly higher risk of mortality. This mixed-methods systematic review identifies and explores factors, including access inequalities to annual health checks (AHCs), for people living with SMI sharing protected characteristics in the UK, as identified in Core20PLUS5.
Mixed-methods systematic review.
MEDLINE, EMBASE, PsycINFO, CINAHL, ASSIA, Google Scholar and the grey literature were searched from 1 January 2004 to 30 January 2025.
Inclusion criteria were adults >18 years of age living with SMI. We included studies of AHCs, short health screening interventions, health promotion interventions, considering or aiming to improve uptake and/or access to screening for people living with SMI. We included mixed-methods and quantitative studies: randomised controlled trials, non-randomised controlled studies, cohort studies, cross-sectional studies and process evaluations. We also included qualitative studies.
Two reviewers independently assessed the evidence for inclusion using the eligibility criteria at title, abstract and at full-text screening. Quality Assessment with Diverse Studies was used for methodological quality. Analysis used Levesque’s Conceptual Framework of Access as an a priori framework and dimensions of equality from Core20PLUS5 and PROGRESS PLUS. Separate and independent quantitative and qualitative narrative syntheses and integration of the evidence from both occurred.
36 studies were included. Five studies applied reasonable adjustments to increase access to AHCs but lacked evaluation, controls and comparisons. 26 studies failed to discuss deprivation or ethnicity and only 6 studies discussed barriers and facilitators of access to AHCs for people of different ethnic, linguistic or cultural backgrounds. There was no evidence for interventions improving access to AHCs. Access focused primarily on dimensions of services, over abilities to access AHCs for people living with SMI.
There are access inequalities to AHCs for people living with SMI sharing protected characteristics. Robust research is urgently needed to identify, modify and ameliorate barriers to the policy recommended AHCs.
CRD42023437905.
FreshRSS 