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Zeitschriftenartikel zum Thema "Dementia Patients Care South Australia Adelaide"
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Paterson, Tom, Christopher Seiboth, Barbara Magin, Rajan Nagesh, Cyndy Lloyd und Helena Williams. „An initiative in primary care psychiatry in South Australia“. Australasian Psychiatry 10, Nr. 3 (September 2002): 259–64. http://dx.doi.org/10.1177/103985620201000313.
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Objective: To describe a joint mental health project involving the Adelaide Northern Division of General Practice (ANDGP) and the North West Adelaide Mental Health Service (NWAMHS). Conclusions: This project has been developed to explore alternative strategies to facilitate the identification and management of patients with mental illness in the primary care setting. The project has also endeavoured to explore alternative types of psychiatrist/general practitioner interactions other than the conventional ‘general practitioner referred psychiatrist consultation’. The development of adequate and clinically relevant evaluation methods, both quantitative and qualitative, has also been an explicit objective of the project. While the project provides an exciting stimulus for ongoing development of models of Primary Psychiatric Care, it is evident that such models can only evolve in the context of significant service and systemic change. It is hoped that the experiences in the northern suburbs of Adelaide can stimulate others to explore the ongoing collaborations between psychiatric services and general practitioners in ways that can produce better mental health outcomes in our patients.
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Smith, Judy. „The changing face of community and district nursing“. Australian Health Review 25, Nr. 3 (2002): 131. http://dx.doi.org/10.1071/ah020131.
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The Royal District Nursing Service (RDNS) of South Australia provides home- and community-based nursing care to people residing in the Adelaide Metropolitan area. The service is funded predominantly by the Home and Community Care Program. It provides community nursing services in the areas of wound management, palliative care, HIV/AIDS care, continence management, disability care, mental health and dementia care, and diabetes management. In 2000-2001, the service made 439,700 visits to people's homes or saw them in a nurse-led nursing centre. In addition, the nursing staff had 84,000 contacts other than face to face that were related to client care. These contacts include the co-ordination of care with other service providers for new and existing clients of RDNS.
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Yadav, Lalit, Tiffany K. Gill, Anita Taylor, Unyime Jasper, Jen De Young, Renuka Visvanathan und Mellick J. Chehade. „Cocreation of a digital patient health hub to enhance education and person-centred integrated care post hip fracture: a mixed-methods study protocol“. BMJ Open 9, Nr. 12 (Dezember 2019): e033128. http://dx.doi.org/10.1136/bmjopen-2019-033128.
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IntroductionOlder people with hip fractures often require long-term care and a crucial aspect is the provision of quality health information to patients and their carers to support continuity of care. If patients are well informed about their health condition and caring needs, particularly posthospital discharge into the community setting, this may support recovery and improve quality of life. As internet and mobile access reach every household, it is possible to deliver a new model of service using a digital education platform as a personal health hub where both patients and their providers of care can establish a more efficient information integration and exchange process. This protocol details proposed research, which aims to develop a ‘model of care’ by using a digital health solution that will allow delivery of high quality and patient-centred information, integrated into the existing process delivered within the community setting.Methods and analysisThis phase of the study uses a pragmatic mixed-methods design and a participatory approach through engagement of patients, their carers and healthcare providers from multiple disciplines to inform the development of a digital health platform. Quantitative methods will explore health literacy and e-health literacy among older people with hip fractures admitted to the two public tertiary care hospitals in Adelaide, South Australia. Qualitative methods will provide an understanding of aspects of content and context required for the digital health platform to be developed in order to deliver quality health information. The study will use appropriate theoretical frameworks and constructs to guide the design, analysis and overall conduct of the research study. The scope of the study intends to ultimately empower patients and their carers to improve self-management and to better use coordinated services at the community level. This could prevent further falls including associated injuries or new fractures; reduce new hospital admissions and improve confidence and engagement by limiting the psychologically restrictive ‘fear of falls’.Ethics and disseminationThe study has been approved by the Human Research Ethics Committee of the Central Adelaide Local Health Network, South Australia (SA) Health, Government of South Australia and the University of Adelaide Human Research Ethics Committee. Findings from the study will be published in suitable peer-reviewed journals and disseminated through workshops or conferences.
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Greaves, Danielle, Peter J. Psaltis, Amit Lampit, Daniel H. J. Davis, Ashleigh E. Smith, Alice Bourke, Michael G. Worthington, Michael J. Valenzuela und Hannah A. D. Keage. „Computerised cognitive training to improve cognition including delirium following coronary artery bypass grafting surgery: protocol for a blinded randomised controlled trial“. BMJ Open 10, Nr. 2 (Februar 2020): e034551. http://dx.doi.org/10.1136/bmjopen-2019-034551.
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IntroductionCoronary artery bypass grafting (CABG) surgery is known to improve vascular function and cardiac-related mortality rates; however, it is associated with high rates of postoperative cognitive decline and delirium. Previous attempts to prevent post-CABG cognitive decline using pharmacological and surgical approaches have been largely unsuccessful. Cognitive prehabilitation and rehabilitation are a viable yet untested option for CABG patients. We aim to investigate the effects of preoperative cognitive training on delirium incidence, and preoperative and postoperative cognitive training on cognitive decline at 4 months post-CABG.Methods and analysisThis study is a randomised, single-blinded, controlled trial investigating the use of computerised cognitive training (CCT) both pre-CABG and post-CABG (intervention group) compared with usual care (control group) in older adults undergoing CABG in Adelaide, South Australia. Those in the intervention group will complete 1–2 weeks of CCT preoperatively (45–60 min sessions, 3.5 sessions/week) and 12 weeks of CCT postoperatively (commencing 1 month following surgery, 45–60 min sessions, 3 sessions/week). All participants will undergo cognitive testing preoperatively, over their hospital stay including delirium, and postoperatively for up to 1 year. The primary delirium outcome variable will be delirium incidence (presence vs absence); the primary cognitive decline variable will be at 4 months (significant decline vs no significant decline/improvement from baseline). Logistic regression modelling will be used, with age and gender as covariates. Secondary outcomes include cognitive decline from baseline to discharge, and at 6 months and 1 year post-CABG.Ethics and disseminationEthics approval was obtained from the Central Adelaide Local Health Network Human Research Ethics Committee (South Australia, Australia) and the University of South Australia Human Ethics Committee, with original approval obtained on 13 December 2017. It is anticipated that approximately two to four publications and multiple conference presentations (national and international) will result from this research.Trial registration numberThis clinical trial is registered with the Australian New Zealand Clinical Trials Registry and relates to the pre-results stage. Registration number: ACTRN12618000799257.
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Boord, Monique S., Daniel H. J. Davis, Peter J. Psaltis, Scott W. Coussens, Daniel Feuerriegel, Marta I. Garrido, Alice Bourke und Hannah A. D. Keage. „DelIrium VULnerability in GEriatrics (DIVULGE) study: a protocol for a prospective observational study of electroencephalogram associations with incident postoperative delirium“. BMJ Neurology Open 3, Nr. 2 (Dezember 2021): e000199. http://dx.doi.org/10.1136/bmjno-2021-000199.
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IntroductionDelirium is a neurocognitive disorder common in older adults in acute care settings. Those who develop delirium are at an increased risk of dementia, cognitive decline and death. Electroencephalography (EEG) during delirium in older adults is characterised by slowing and reduced functional connectivity, but markers of vulnerability are poorly described. We aim to identify EEG spectral power and event-related potential (ERP) markers of incident delirium in older adults to understand neural mechanisms of delirium vulnerability. Characterising delirium vulnerability will provide substantial theoretical advances and outcomes have the potential to be translated into delirium risk assessment tools.Methods and analysisWe will record EEG in 90 participants over 65 years of age prior to elective coronary artery bypass grafting (CABG) or transcatheter aortic valve implantation (TAVI). We will record 4-minutes of resting state (eyes open and eyes closed) and a 5-minute frequency auditory oddball paradigm. Outcome measures will include frequency band power, 1/f offset and slope, and ERP amplitude measures. Participants will undergo cognitive and EEG testing before their elective procedures and daily postoperative delirium assessments. Group allocation will be done retrospectively by linking preoperative EEG data according to postoperative delirium status (presence, severity, duration and subtype).Ethics and disseminationThis study is approved by the Human Research Ethics Committee of the Royal Adelaide Hospital, Central Adelaide Local Health Network and the University of South Australia Human Ethics Committee. Findings will be disseminated through peer-reviewed journal articles and presentations at national and international conferences.Trial registration numberACTRN12618001114235 and ACTRN12618000799257.
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Wilson, Annabelle, Tamara Mackean, Liz Withall, Eileen Willis, Odette Pearson, Colleen Hayes, Kim O'Donnell et al. „Protocols for an Aboriginal-led, Multi-methods Study of the Role of Aboriginal and Torres Strait Islander Health Workers, Practitioners and Liaison Officers in Quality Acute Health Care“. Journal of the Australian Indigenous HealthInfoNet 3, Nr. 1 (2022): 1–13. http://dx.doi.org/10.14221/aihjournal.v3n1.2.
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Objectives Aboriginal and Torres Strait Islander Health Workers/Practitioners and Liaison Officers play an important, often critical role providing advocacy and cultural and emotional support for Aboriginal and Torres Strait Islander patients. The main goals of this research are to explore i) how Aboriginal and Torres Strait Islander Health Workers/Practitioners and Liaison Officers are integrated in the routine delivery of care for Aboriginal and Torres Strait Islander peoples in hospital, and ii) how the role of Aboriginal and Torres Strait Islander Health Workers/Practitioners and Liaison Officers facilitates quality health outcomes. Methods This study is being conducted in three different hospitals using a multi-method approach including: yarning and Dadirri, patient journey mapping, survey and semi-structured interviews. Ethics approval has been provided from four ethics committees covering the three project sites in Australia (Adelaide, South Australia; Sydney, New South Wales and Alice Springs, Northern Territory). Significance This study uses innovative methodology founded on the privileging of Aboriginal and Torres Strait Islander knowledges to collect Aboriginal and Torres Strait Islander perspectives and understand patient journeys within acute health care systems. This project is led by Aboriginal and Torres Strait Islander researchers and guided by the Project Steering Committee comprised of stakeholders. Implications There is limited research that explores quality acute care processes and the integration of Aboriginal and Torres Strait Islander Health Workers/Practitioners work within health care teams. This research will make a valuable contribution to understanding how hospital services can achieve quality acute health care experiences for Aboriginal and Torres Strait Islander People.
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Horwood, C. M., P. Hakendorf und C. H. Thompson. „Comparison of specialist and generalist care“. Australian Health Review 42, Nr. 5 (2018): 579. http://dx.doi.org/10.1071/ah17197.
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Objective The choice of whether to admit under a specialist or a generalist unit is often made with neither clear rationale nor understanding of its consequences. The present study compared the characteristics and outcomes of patients admitted with community-acquired pneumonia to either a general medicine or respiratory unit. Methods This study was a retrospective cross-sectional study using data from public hospitals in Adelaide, South Australia. Over 5 years there were 9775 overnight, unplanned appropriate adult admissions. Patient length of hospital stay, in-patient mortality rate and 30-day unplanned readmission rate were calculated, with and without adjustment for patient age and comorbidity burden. Results Over 80% of these patients were cared for by a general medicine unit rather than a specialist unit. Patients admitted to a general medicine unit were, on average, 4 years older than those admitted to a respiratory unit. Comorbidity burdens were similar between units at the same hospital. Length of in-patient stay was >1 day shorter for those admitted to a general medicine unit, without significant compromise in mortality or readmission rates. Between each hospital, general medicine units showed a range of mortality rates and length of hospital stay, for which there was no obvious explanation. Conclusions Compared with speciality care, general medicine units can safely and efficiently care for patients presenting to hospital with community-acquired pneumonia. What is known about the topic? Within the narrow range of any specific disease, generalist medical services are often cited as inferior in performance compared with a speciality service. This has implications for hospital resourcing, including both staffing and ward allocation. What does this paper add? This paper demonstrates that most patients admitted with a principal diagnosis of community-acquired pneumonia were admitted to a generalist unit and did not apparently fare worse than patients admitted to a specialist service; patients admitted to a generalist unit spent less time in hospital and there was no difference in mortality or readmission rate compared with patients admitted to a specialist service. What are the implications for practitioners? The provision of generalist services at urban hospitals in Australia provides a safe alternative admission option for patients presenting with pneumonia, and possibly for other common acute medical conditions.
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Shin, Hee-Young, Svetla Gadzhanova, Elizabeth E. Roughead, Michael B. Ward und Lisa G. Pont. „The use of antipsychotics among people treated with medications for dementia in residential aged care facilities“. International Psychogeriatrics 28, Nr. 6 (18.01.2016): 977–82. http://dx.doi.org/10.1017/s1041610215002434.
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ABSTRACTBackground:Antipsychotic agents have limited efficacy for Behavioral and Psychological Symptoms of Dementia (BPSD) and there are concerns about their safety. Despite this, they are frequently used for the management of BPSD. This study aimed to assess the use of antipsychotics among people on anti-dementia medicines in Australian residential aged care facilities.Methods:Data were obtained from an individual patient unit dose packaging database covering 40 residential aged care facilities in New South Wales, Australia. Residents supplied an anti-dementia medicine between July 2008 and June 2013 were included. Prevalence of concurrent antipsychotic use was established. Incident antipsychotic users between January 2009 and December 2011 were identified. We examined initial antipsychotic dose, maximum titrated doses, type and duration of antipsychotic use, and compared use with Australian guidelines.Results:There were 291 residents treated with anti-dementia medicines, 129 (44%) of whom received antipsychotics concomitantly with an anti-dementia medicine. Among the 59 incident antipsychotic users, risperidone (73%) was the most commonly used antipsychotic agent. Amongst the risperidone initiators, 43% of patients had initial doses greater than 0.5 mg/day and 6% of patients exceeded 2.0 mg/day for their maximum dose. 53% of concomitant users received daily treatment for greater than six months.Conclusions:Our study using records of individual patient unit dose supply, which represents the intended medication consumption schedule, shows high rates of concurrent use of antipsychotics and anti-dementia medicines and long durations of use. The use of antipsychotics in patients with dementia needs to be carefully monitored to improve patient outcomes.
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Powell, Kathryn, Nigel Stocks und Caroline Laurence. „A new venture in interdisciplinary student learning in a co-located health service“. Australian Health Review 40, Nr. 2 (2016): 205. http://dx.doi.org/10.1071/ah14241.
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Learning about interdisciplinary health approaches is important for students of health professions. Yet, interdisciplinary learning programs are sparse within primary health clinics. Larger health care complexes, such as superclinics in Australia, offer interdisciplinary learning opportunities for health, but also pose difficulties. This case study describes the introduction of an interdisciplinary student learning program in Adelaide, South Australia, over a 1-year period. The objectives of the program were for students to: (1) understand the range of patient needs in primary healthcare (PHC); (2) identify circumstances in which the involvement of another professional may benefit patients; and (3) learn more about team work. Despite barriers, the practice environment was found to be suitable for student learning. Program modifications were made in response to the need for scheduled time for clinic staff to work with students, non-simultaneous student placements, a need for a coordinator, the availability of discipline-specific supervision and the need to provide incentives for students to participate, particularly giving course credits or recognition. Embedding interdisciplinary programs in a clinic setting requires time and resources. The present case study demonstrates that larger PHC clinics have the potential to implement interdisciplinary learning programs based on an authentic learning approach.
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Harvey, Peter W., John Petkov, Inge Kowanko, Yvonne Helps und Malcolm Battersby. „Chronic condition management and self-management in Aboriginal communities in South Australia: outcomes of a longitudinal study“. Australian Health Review 37, Nr. 2 (2013): 246. http://dx.doi.org/10.1071/ah12165.
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Objectives. This paper describes the longitudinal component of a larger mixed methods study into the processes and outcomes of chronic condition management and self-management strategies implemented in three Aboriginal communities in South Australia. The study was designed to document the connection between the application of structured systems of care for Aboriginal people and their longer-term health status. Methods. The study concentrated on three diverse Aboriginal communities in South Australia; the Port Lincoln Aboriginal Health Service, the Riverland community, and Nunkuwarrin Yunti Aboriginal Health Service in the Adelaide metropolitan area. Repeated-measure clinical data were collected for individual participants using a range of clinical indicators for diabetes (type 1 and 2) and related chronic conditions. Clinical data were analysed using random effects modelling techniques with changes in key clinical indicators being modelled at both the individual and group levels. Results. Where care planning has been in place longer than in other sites overall improvements were noted in BMI, cholesterol (high density and low density lipids) and HbA1c. These results indicate that for Aboriginal patients with complex chronic conditions, participation in and adherence to structured care planning and self-management strategies can contribute to improved overall health status and health outcomes. Conclusions. The outcomes reported here represent an initial and important step in quantifying the health benefits that can accrue for Aboriginal people living with complex chronic conditions such as diabetes, heart disease and respiratory disease. The study highlights the benefits of developing long-term working relationships with Aboriginal communities as a basis for conducting effective collaborative health research programs. What is known about the topic? Chronic condition management and self-management programs have been available to Aboriginal people in a range of forms for some time. We know that some groups of patients are keen to engage with care planning and self-management protocols and we have anecdotal evidence of this engagement leading to improved quality of life and health outcomes for Aboriginal people. What does this paper add? This paper provides early evidence of sustained improvement over time for a cohort of Aboriginal people who are learning to deal with a range of chronic illnesses through accessing structured systems of support and care. What are the implications for practitioners? This longitudinal evidence of improved outcomes for Aboriginal people is encouraging and should lead on to more definitive studies of outcomes accruing for people engaged in structured systems of care. Not only does this finding have implications for the overall management of chronic illness in Aboriginal communities, but it points the way to how health services might best invest their resources and efforts to improve the health status of people with chronic conditions and, in the process, close the gap between the life expectancy of Aboriginal people and that of other community groups in Australia.
Dissertationen zum Thema "Dementia Patients Care South Australia Adelaide"
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Chalmers, Jane. „The oral health of older adults with dementia“. Title page, contents and abstract only, 2001. http://web4.library.adelaide.edu.au/theses/09PH/09phc438.pdf.
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Bibliography: leaves 347-361. Presents results of 2 longitudinal studies investigating the oral health of older adults with dementia, using questionnaires and clinical inspections at baseline and one year. Groups studied were nursing home residents and those living in the community, with moderate to severe dementia or no dementia diagnosis. Caries experience was related to dementias severity and not to specific dementia diagnoses. Coronal and root caries experience was higher in dementia participants with moderate-severe dementia, the socio-economically disadvantaged, more functionally dependent, taking neuroleptic medications with high anticholinergic adverse effects, with eating and swallowing problems, were not attending the dentist, who needed assistance and were behaviourally difficult during oral hygiene care and whose carers were burdened.
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Chalmers, Jane. „The oral health of older adults with dementia / Jane Chalmers“. Thesis, 2001. http://hdl.handle.net/2440/21695.
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Bibliography: leaves 347-361.403 leaves ; 30 cm.
Presents results of 2 longitudinal studies investigating the oral health of older adults with dementia, using questionnaires and clinical inspections at baseline and one year. Groups studied were nursing home residents and those living in the community, with moderate to severe dementia or no dementia diagnosis. Caries experience was related to dementias severity and not to specific dementia diagnoses. Coronal and root caries experience was higher in dementia participants with moderate-severe dementia, the socio-economically disadvantaged, more functionally dependent, taking neuroleptic medications with high anticholinergic adverse effects, with eating and swallowing problems, were not attending the dentist, who needed assistance and were behaviourally difficult during oral hygiene care and whose carers were burdened.
Thesis (Ph.D.)--University of Adelaide, Dept. of Dentistry, 2001