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Dr Michelle DiGiacomo


A senior lecturer (Research) in the UTS Faculty of Health, Dr Michelle DiGiacomo leads the Reducing Health and Social Disparities stream in the University’s Centre for Cardiovascular and Chronic Care. Her research examines the contexts within which individuals, families and communities negotiate, cope, and adjust to living with chronic health conditions.

Applying her background in organisational and health psychology, she researches the interface between health and social services and vulnerable populations, particularly in respect to access and appropriateness of care. Exploring ways in which health and service initiatives can be tailored to meet diverse needs and preferences of individuals and groups is an important focus of her work.

Michelle has worked with the Chronic Care Team at the Aboriginal Medical Service Western Sydney since 2005 on a smoking cessation program and a range of other health initiatives.  She has also undertaken consultancy work for a number of institutions, including the Cancer Council and the National Heart Foundation (NSW). 


  • Deputy Editor, Journal of Smoking Cessation

Image of Michelle DiGiacomo
Senior Research Fellow, Faculty of Health
Senior Research Fellow, Centre for Cardiovascular and Chronic Care (CCCC)
Associate Member, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM)
Core Member, CHSP - Health Services and Practice
Bachelor of Arts (UMASS), Master of Health Science (Hons) (USyd), PhD (USyd)
+61 2 9514 4818

Research Interests

  • Reducing health and social disparities
  • Access and appropriateness of health services
  • Vulnerable populations living with chronic conditions
  • Qualitative research
  • Mixed methods research
  • Gendered approach to health
  • Coping and adjusting
  • Behaviour change
  • Social determinants of health
Can supervise: Yes
  • Facilitating voice, empowerment, and resilience in people from vulnerable populations
  • The interface of health services and people facing social and economic disadvantage
  • Health and wellbeing of older women
  • Culturally and linguistically diverse peoples with chronic conditions
  • Qualitative Research
  • Non-Communicable Disease 


Ivynian, S., DiGiacomo, M., Jha, S., Crossley, C. & Newton, P. 2015, 'Care-seeking decisions for worsening symptoms in heart failure: a qualitative metasynthesis', Heart Lung and Circulation, Cardiac Society of Australia and New Zealand, Elsevier, Melbourne, pp. 419-419.
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Purpose: Over 50% of heart failure (HF) patients delay seeking help for worsening symptoms until these reach acute levels and require emergency hospitalisation. This metasynthesis aimed to identify and explore factors influencing timely care-seeking in patients with HF. Methods: Electronic databases searched were Medline, EMBASE and CINAHL. Studies were included if they were peer reviewed journal articles written in English, and reported perspectives of HF patients following qualitative data collection and analysis. Forty articles underwent analysis following the approach of Thomas and Harden. Leventhal's self-regulatory model (SRM) was used to organise the literature. Results: Much of the literature fit within the SRM, however this model did not account for all factors that influence patients' care-seeking for worsening symptoms. Factors not accounted for included patients' appraisals of previous care-seeking experiences, perceived system and provider barriers to accessing care, and the influence of external appraisals. When added to factors already represented in the model, such as misattribution of symptoms, not identifying with HF diagnosis, cognitive status, lack of understanding information provided, adaptation to symptoms, and emotional responses, a more comprehensive account of patients' decision-making was revealed. Implications: This metasynthesis identified factors, as yet unaccounted for, in a prominent model, and has suggested a more comprehensive framework for addressing care-seeking in HF patients. This information can be used to tailor education, communication, and service initiatives to improve HF patients' responses to worsening symptoms.
Ivynian, S.E., Hwang, C., McDonagh, J., Digiacomo, M., Inglis, S.C. & Newton, P.J. 2015, 'Impact of multiple symptoms on quality of life and event-free survival in chronic heart failure', EUROPEAN HEART JOURNAL, pp. 128-128.
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Inglis, S., Du, H., Newton, P.J., DiGiacomo, M., Omari, A. & Davidson, P.M. 2014, 'PT453 Disease Management Interventions For Improving Self-Management In Lower-Limb Peripheral Arterial Disease: A Cochrane Review.', Global Heart Supplements, Elsevier, Melbourne, Australia, pp. e262-e262.
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Peripheral arterial disease (PAD) contributes to psychological burden, poor quality of life and an increased risk of cardiovascular events. Disease management strategies supporting behavioural change and long-term adherence may improve outcomes for people with PAD. However, to our knowledge the evidence relating to self-management interventions for people with PAD has not yet been systematically reviewed or meta-analysed
Al Abed, N., Davidson, P.M., Hickman, L., DiGiacomo, M. & Jackson, D. 2013, 'Older Arab Migrants: Between the Hammer of Prejudice and the Anvil of Social Isolation', 2nd International Conference on Ageing in a Foreign Land, Adelaide, Australia.
Cao, Y., Davidson, P.M., Digiacomo, M. & Yang, M. 2010, 'A Global Problem but of Concern in Mainland China: Pre-Hospital Delay for Acute Coronary Syndrome', CIRCULATION, pp. E125-E125.
DiGiacomo, M., Rolley, J., Smith, J. & Davidson, P.M. 2009, 'Shock, disbelief, and the process of adjusting and coping: women's experience of caring for their spouses following a percutaneous coronary intervention', JOURNAL OF WOMENS HEALTH, pp. 749-749.
DiGiacomo, M., Adamson, B. & Mahony, M.J. 2004, 'Limitations in conducting cross-cultural research: Organisational behaviour examined', INTERNATIONAL JOURNAL OF PSYCHOLOGY, pp. 441-441.

Journal articles

Maneze, D., Salamonson, Y., Poudel, C., DiGiacomo, M., Everett, B. & Davidson, P.M. 2016, 'Health-seeking behavior of Filipino migrants in Australia: The influence of persisting acculturative stress and depression', Journal of Immigrant and Minority Health.
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Background: This study examined the relationships among the constructs of acculturative stress, depression, English language usage, health literacy, and social support and the influence of these factors on health-seeking behaviors of Filipino Australians. Methods: Using a self-administered questionnaire, 552 respondents were recruited from November 2010 to June 2011. Structural equation modelling was used to examine relationships. Results: A direct and negative relationship between health-seeking behavior and depression, and an indirect relationship with acculturative stress, was observed mediated through depression. Social support had an important moderating influence on these effects. Although there was an inverse relationship between age and English language usage and depression, age was positively related to health-seeking behavior. Discussion: Despite the long duration of stay, Filipino Australian migrants continued to experience acculturative stress and depression leading to lower health-seeking behavior. This study highlights the importance of screening for acculturative stress and depression in migrants and fostering social support.
Sayers, J., Salamonson, Y., DiGiacomo, M. & Davidson, P.M. 2016, 'Validation of the Professional Practice Environment Scale in Acute Care Hospitals: A study with Australian Nurse Educators', Nurse Researcher, vol. 23, no. 4, pp. 14-18.
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Aim To report an assessment of the psychometric properties of the Professional Practice Environment (PPE) scale in a sample of Australian nurse educators in acute care hospitals. Background Although nurse educators are important in an enabling work environment, there has been no reported exploration of their satisfaction with work in acute care hospitals. Discussion The factor structure and internal consistency of the PPE scale were consistent with Erickson's eight-factor model of the items, indicating the appropriateness of the scale as an assessment tool to measure the PPE of nurse educators. Conclusion The PPE scale is useful for monitoring the work environment of nurse educators in clinical practice and the environmental effects influencing their recruitment, retention and job satisfaction. Implications for practice This work may inform the development of integrated professional practice environments where the professional practice and workplace satisfaction of nurse educators are optimised, influencing safe, quality patient care.
Deek, H., Hamilton, S., Brown, N., Inglis, S.C., DiGiacomo, M., Newton, P., Noureddine, S., Macdonald, P. & Davidson, P.M. 2016, 'Family-centred approaches to healthcare interventions in chronic diseases in adults: a quantitative systematic review.', Journal of Advanced Nursing.
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Increasingly there is a focus on self-care strategies for both malignant and non-malignant conditions. Models of self-care interventions have focussed on the individual and less on the broader context of family and society. In many societies, decision-making and health seeking behaviours, involve family members.To identify elements of effective family-centred self-care interventions that are likely to improve outcomes of adults living with chronic conditions.Review paper.MEDLINE (Ovid), CINAHL, Academic Search Complete, PsychInfo and Scopus between 2000-2014.Quantitative studies targeting patient outcomes through family-centred interventions in adults were retrieved using systematic methods in January, 2015. Search terms used were: 'family', 'spouse', 'carer', 'caregiver', 'chronic', 'chronic disease', 'self-care', 'self-management' and 'self-efficacy'. Reference lists were reviewed. Risk of bias assessment was performed using the Cochrane Collaboration's tool. Data were reported using a narrative summary approach.Ten studies were identified. Improvements were noted in readmission rates, emergency department presentations, and anxiety levels using family-centred interventions compared with controls. Elements of effective interventions used were a family-centred approach, active learning strategy and transitional care with appropriate follow-up.Involving the family in self-care has shown some positive results for patients with chronic conditions. The benefits of family-centred care may be more likely in specific socio-cultural contexts.The review has year limits and further research needs to identify support for both the patients and family caregivers.
Murray-Parahi, P., DiGiacomo, M., Jackson, D. & Davidson, P.M. 2016, 'New Graduate Registered Nurse Transition into Primary Health Care roles: An integrative literature review', Journal of Clinical Nursing.
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Maneze, D., Everett, B., Kirby, S., DiGiacomo, M., Davidson, P.M. & Salamonson, Y. 2016, ''I have only little English': language anxiety of Filipino migrants with chronic disease', Ethnicity & Health.
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OBJECTIVE: This study investigates communication challenges faced by Filipino patients with chronic diseases when engaging with healthcare professionals (HCPs). DESIGN: Nine focus groups were conducted between November 2010 and June 2011. RESULTS: Two main categories of themes were identified: patient-related and HCP-related factors. Patient-related factors included three subthemes: (1) lack of confidence in their English language abilities in clinical situations; (2) cultural attitudes; and (3) strategies used to improve communication. Older Filipinos with chronic disease were anxious about their lack of ability to explain their symptoms in English and were concerned that asking questions was conveying distrust in the HCPs. Most of the elderly simply nodded their head to indicate they understood even if they did not, for fear of being thought 'stupid'. Many participants preferred Filipino GPs or have a relative interpret for them. Two subthemes were related to HCPs including (1) not being listened to and (2) assumptions of understanding. HCPs were thought to assume English language skills in Filipino patients and therefore were not careful about ensuring understanding. CONCLUSIONS: These findings highlighted the need for HCPs to be more aware of 'grey areas' in English-language proficiency and the cultural lens through which migrants understand health.
Shishehgar, S., Gholizadeh, L., DiGiacomo, M. & Davidson, P.M. 2016, 'Health and socio-cultural experiences of refugee women: An integrative review', The Journal of Immigrant and Minority Health.
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Sowole, O., Power, T., Jackson, D., Davidson, P.M. & DiGiacomo, M. 2016, 'Resilience of African migrant women: an integrative review', Health Care for Women International.
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Sayers, J., Salamonson, Y., DiGiacomo, M. & Davidson, P.M. 2015, 'Nurse educators in Australia: High job satisfaction despite role ambiguity', Journal of Nurse Education and Practice, vol. 5, no. 4, pp. 41-51.
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Purpose: The purpose of this study was to describe the nurse educator role in Australian hospitals, including their practice and performance standards. Methods: A cross-sectional, online survey of nurse educators employed in acute care hospitals in Australia was administered over a three-month period. The survey comprised established and researcher-developed scales, and a single open-ended question. Quantitative data was analysed using descriptive statistics. Qualitative data was analysed using a general inductive approach. Results: Nurse educators who were more likely to fulfill nurse educator competency practice domains had master's degrees in education, defined professional development needs, and met regularly with their managers. These educators also had higher levels of job satisfaction. Participants identified that role ambiguity and role confusion adversely impacted nurse educator role expectations, responsibilities, and job satisfaction. Despite this, the majority of educators intended to stay in their role for the foreseeable future. Conclusions: Role ambiguity influenced professional identity and job satisfaction, highlighting the need for clarification of nurse educator roles. These findings suggest the need for review of the nurse educator role and incorporation of professional and educational requirements and practice competencies. Ongoing role monitoring is recommended to identify the effects of role change.
Brown, N., Luckett, T., Davidson, P.M. & DiGiacomo, M. 2015, 'Interventions to Reduce Harm from Smoking with Families in Infancy and Early Childhood: A Systematic Review', International Journal of Environmental Research and Public Health, vol. 12, no. 3, pp. 3091-3119.
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Exposure to adult smoking can have deleterious effects on children. Interventions that assist families with smoking cessation/reduction and environmental tobacco smoke (ETS) avoidance can improve child health outcomes and reduce the risk of smoking initiation. The purpose of this review was to describe the state of the science of interventions with families to promote smoke-free home environments for infants and young children, including parent smoking reduction and cessation interventions, ETS reduction, and anti-smoking socialisation interventions, using the socio-ecological framework as a guide. A systematic review of peer-reviewed articles identified from journal databases from 2000 to 2014 was undertaken. Of 921 articles identified, 28 were included in the review. Considerable heterogeneity characterised target populations, intervention types, complexity and intensity, precluding meta-analysis. Few studies used socio-ecological approaches, such as family theories or concepts. Studies in early parenthood (child age newborn to one year) tended to focus on parent smoking cessation, where studies of families with children aged 1–5 years were more likely to target household SHSe reduction. results suggest that interventions for reduction in ETS may be more successful than for smoking cessation and relapse prevention in families of children aged less than 5 years. There is a need for a range of interventions to support families in creating a smoke free home environment that are both tailored and targeted to specific populations. Interventions that target the social and psychodynamics of the family should be considered further, particularly in reaching vulnerable populations. Consideration is also required for approaches to interventions that may further stigmatise families containing smokers. Further research is required to identify successful elements of interventions and the contexts in which they are most effective.
Davidson, P.M. & DiGiacomo, M. 2015, 'Family Caregiving: Benefits and Burdens', Circulation: Cardiovascular Quality and Outcomes, vol. 8, pp. 133-134.
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Sibbritt, D., Davidson, P., DiGiacomo, M., Newton, P. & Adams, J. 2015, 'Use of Complementary and Alternative Medicine in Women With Heart Disease, Hypertension and Diabetes (from the Australian Longitudinal Study on Women's Health)', AMERICAN JOURNAL OF CARDIOLOGY, vol. 115, no. 12, pp. 1691-1695.
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Perera, H. & DiGiacomo, M. 2015, 'The Role of Trait Emotional Intelligence in Achievement during a Stressful Educational Transition: An Integrative Model of Mediation via Social Support, Coping and Adjustment', Personality and Individual Differences, vol. 83, pp. 208-213.
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The authors propose conceptual models linking trait emotional intelligence (TEI) with achievement both directly and indirectly via perceived social support (PSS), engagement coping (EC), and adjustment, in the context of the university transition. The models were tested in a multiwave design with a sample of incoming Australian undergraduates (N = 470). In structural equation analyses, TEI was found to be a direct predictor of higher PSS and the greater use of EC strategies. Further, mediation analyses revealed that TEI was indirectly associated with academic adjustment via EC and psychological adjustment via EC and PSS operating in parallel. TEI was also found to be indirectly associated with achievement via EC and academic adjustment linked serially in a three-path mediated sequence. These direct and indirect relations were robust when controlling for known confounding influences. The empirically supported mediating processes extend the literature by elucidating some of the pathways through which TEI is linked with better adjustment and achievement.
DiGiacomo, M., Lewis, J., Phillips, J., Nolan, M. & Davidson, P.M. 2015, 'The business of death: a qualitative study of financial concerns of widowed older women', BMC Women's Health, vol. 15, pp. 36-36.
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Background The feminisation of ageing and increasing number of widowed women in contemporary society has significant implications. Older women are at risk of poor health, social, and economic outcomes upon widowhood. The aim of the study was to describe women's experiences in the period soon after their husbands' death, including their financial issues and concerns, and the ways in which these experiences impacted on the transition to widowhood late in life. Methods This was a longitudinal study using serial in-depth semi-structured interviews with 21 community-dwelling women over the age of 65 in Australia. Verbatim transcripts underwent Interpretive Phenomenological Analysis. Results Thematic analysis revealed: 1) administrative burden increases vulnerability; 2) gender roles impact on transitions; and 3) financial adjustments render housing insecurity and health risk. High administrative burden within the context of significant grief and mourning was a defining feature of the early bereavement period. Complicated protracted administrative processes, insensitive interactions, and reminders of loss contributed to distress, anxiety and feelings of demoralisation. Several women identified assumption of household financial management as the most difficult aspect of coping with their husband's death. Conclusions Older women may have unmet needs for assistance with administrative, financial, and legal issues immediately following spousal death and potentially for years afterward. Lack of familiarity and absence of instrumental support with financial and legal issues signal the need for policy reform, resources to improve financial literacy in women throughout the life course, increased advocacy, and consideration of different support and service models.
Shishehgar, S., Gholizadeh, L., DiGiacomo, M. & Davidson, P.M. 2015, 'The impact of migration on the health status of Iranians: An integrative literature review', BMC International Health and Human Rights, vol. 15, no. 20.
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Forber, J., DiGiacomo, M., Davidson, P.M., Carter, B. & Jackson, D. 2015, 'The context, influences and challenges for undergraduate nurse clinical education: Continuing the dialogue', Nurse Education Today, vol. 35, no. 11, pp. 1114-1118.
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Introduction Approaches to clinical education are highly diverse and becoming increasingly complex to sustain in complex milieu Objective To identify the influences and challenges of providing nurse clinical education in the undergraduate setting and to illustrate emerging solutions. Method A discursive exploration into the broad and varied body of evidence including peer reviewed and grey literature. Discussion Internationally, enabling undergraduate clinical learning opportunities faces a range of challenges. These can be illustrated under two broad themes: (1) legacies from the past and the inherent features of nurse education and (2) challenges of the present, including, population changes, workforce changes, and the disconnection between the health and education sectors. Responses to these challenges are triggering the emergence of novel approaches, such as collaborative models.
Cao, Y., DiGiacomo, M., Salamonson, Y., Li, Y., Huai, B. & Davidson, P.M. 2015, 'Nurses' perceptions of their professional practice environment: a cross-sectional study.', Journal of Clinical Nursing, vol. 24, no. 23-24, pp. 3441-3448.
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AIMS AND OBJECTIVES: To describe nurses' perceptions concerning their professional practice environment in mainland China and identify factors associated with these views. BACKGROUND: Globally, the environments in which nurses work influence the quality of nursing practice and health care. DESIGN: A cross-sectional descriptive survey using both paper- and online-based delivery modes was used. METHOD: A convenience sampling method was used. The survey questionnaire was composed of sociodemographic items and the 38-item Chinese version of Professional Practice Environment survey. The content of the paper-based questionnaire was identical to the online survey. Pearson's chi-square test was conducted to compare the demographic characteristics of these two data sets. Descriptive statistics analysis included frequency, percentage, mean and standard deviation. Multiple linear regression analysis using the Backwards method was applied to identify independent predictors of each subscale of the 38-item Chinese version of Professional Practice Environment. RESULTS: A total of 573 questionnaires were analysed. The mean score of each subscale of the 38-item Chinese version of Professional Practice Environment in this study ranged from 266-305. All subscales except work motivation (305, standard deviation: 044) scored less than 30. Areas rated as most in need of improvement included control over practice, interpersonal interaction, supportive leadership and handling conflict, and staff relationships with physicians and autonomy. CONCLUSION: This study has identified nurses' perspectives regarding their workplaces in contemporary China. These data have provided an important baseline for developing and implementing culturally appropriate strategies to improve the working environment of Chinese nurses. RELEVANCE TO CLINICAL PRACTICE: A supportive and enabling work environment promotes professional development and the safety and quality of health care. Addressing these factor...
Ivynian, S., DiGiacomo, M. & Newton, P. 2015, 'Care-seeking decisions for worsening symptoms in heart failure: a qualitative metasynthesis', Heart Failure Reviews, vol. 20, no. 6, pp. 655-671.
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Over 50% of heart failure (HF) patients delay seeking help for worsening symptoms until these reach acute levels and require emergency hospitalisation. This metasynthesis aimed to identify and explore factors influencing timely care-seeking in patients with HF.
Maneze, D., DiGiacomo, M., Salamonson, Y., Descallar, J. & Davidson, P.M. 2015, 'Facilitators and Barriers to Health-Seeking Behaviours among Filipino Migrants: Inductive Analysis to Inform Health Promotion', BioMed Research International.
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DiGiacomo, M., Green, A., Rodrigues, E., Mulligan, K. & Davidson, P.M. 2015, 'Developing a gender-based approach to chronic conditions and women's health: a qualitative investigation of community-dwelling women and service provider perspectives', BMC Women's Health, vol. 15, pp. 15-15.
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Background Chronic conditions contribute to over 70 % of Australia's total disease burden, and this is set to increase to 80 % by 2020. Women's greater longevity means that they are more likely than men to live with disability and have unique health concerns related to their gender based roles in society. Cultural and social issues can impact on women's health and are important to consider in health services planning and research. In this study, we aimed to identify barriers and facilitators to providing a gender-based approach to chronic conditions and women's health in an eastern metropolitan region of Australia. Methods Focus groups were used to engage both community-dwelling women who had chronic conditions and relevant professional stakeholders in the target area. Recorded proceedings underwent thematic analysis. Results Five focus groups were conducted with professional stakeholders and women community members in February and March 2014. Resultant themes included: women's disempowerment through interactions with health systems; social and economic constraints and caregiving roles act to exclude women from participating in self-care and society; and empowerment can be achieved through integrated models of care that facilitate voice and enable communication and engagement. Conclusions This study underscores the importance of including perspectives of sex and gender in health care services planning. Tailoring services to socio-demographic and cultural groups is critical in promoting access to health care services. Unique epidemiological trends, particularly the ageing of women and new migrant groups, require particular attention.
Thompson, S.C., Shahid, S., DiGiacomo, M., Pilkington, L. & Davidson, P.M. 2014, 'Making progress: the role of Cancer Councils in Australia in Indigenous cancer control', BMC Public Health, vol. 14, no. 347.
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Al Abed, N.A., Hickman, L., Jackson, D.E., DiGiacomo, M. & Davidson, P.M. 2014, 'Older Arab migrants in Australia: Between the hammer of prejudice and the anvil of social isolation', Contemporary Nurse, vol. 46, no. 2, pp. 259-262.
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Moscou-Jackson, G., Commodore-Mensah, Y., Farley, J. & DiGiacomo, M. 2014, 'Smoking Cessation Interventions in Persons Living with HIV or AIDS: A systematic review', Journal of the Association of Nurses in AIDS Care, vol. 25, no. 1, pp. 32-45.
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Tobacco smoking remains a prevalent behavior in people living with HIV infection (PLWH) and is associated with impaired immune functioning, increased cardiovascular risk, and decreased response to antiretroviral therapy. This review presents a critique and synthesis of evidence on effective smoking cessation interventions for PLWH. A comprehensive search identified 9 peer-reviewed intervention studies, published between 1989 and 2012. The highest odds of smoking cessation (OR 4.33-5.6) were in 2 randomized controlled trial interventions using cell phone technology. Clinically significant reductions in systolic blood pressure, weight gain, and increased CD4+ T cell count were reported for participants who ceased smoking in 3 of the 9 studies. Overall, multi-strategy smoking cessation interventions, delivered over multiple sessions, were effective. However, the most effective interventions were tailored to the unique individual needs of PLWH, including assessment and intervention of poly-substance abuse and mental health issues as well as the inclusion of access-promoting elements.
Deek, H.A., Abbott, P., Moore, L., Davison, J., Cameron, S., DiGiacomo, M., McGrath, S., Dharmendra, T. & Davidson, P.M. 2014, 'Pneumococcus in Aboriginal and Torres Strait Islanders: the role of Aboriginal Health Workers and implications for nursing practice', Contemporary Nurse, vol. 46, no. 1, pp. 54-58.
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Background: Pneumonia is a common cause of hospitalization in Aboriginal and Torres Strait Islander men and women. Aim: This article seeks to describe the importance of immunizing against pneumonia in Aboriginal Australians and suggest strategies for screening and follow-up. Method: An integrative literature review, using both published and gray literature was undertaken to identify methods of screening and surveillance strategies for pneumococcus. Results: The literature was summarized under the following themes: Pneumococcal disease; prevention strategies; access to care; improving access to vaccinations; culturally competent interventions and the role of Aboriginal health professionals. Conclusion: Community controlled conditions and the role of the Aboriginal Health Workers are seen as critical to reducing health disparities. Nurses can play a critical role in bridging the gap between mainstream and community controlled organizations. Working to increase the numbers of Aboriginal health professionals is a critical step in improving health outcomes for Aboriginal and Torres Strait Islander peoples.
Lewis, J., DiGiacomo, M., Currow, D.C. & Davidson, P.M. 2014, 'Social capital in a lower socioeconomic palliative care population: a qualitative investigation of individual, community and civic networks and relations', BMC Palliative Care, vol. 13, no. 30.
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The article reports findings from a qualitative investigation of the needs and experiences of palliative care patients and caregivers who are experiencing financial hardship or disadvantage. This article highlights the individual, community and civic networks and relations relevant to these experiences.
Green, A., DiGiacomo, M., Luckett, T., Abbott, P., Davidson, P.M., Delaney, J. & Delaney, P. 2014, 'Cross-sector collaborations in Aboriginal and Torres Strait Islander childhood disability: a systematic integrative review and theory-based synthesis', International Journal of Equity in Health, vol. 13, pp. 126-126.
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Introduction Aboriginal and Torres Strait Islander children in Australia experience a higher prevalence of disability and socio-economic disadvantage than other Australian children. Early intervention is vital for improved health outcomes, but complex and fragmented service provision impedes access. There have been international and national policy shifts towards inter-sector collaborative responses to disability, but more needs to be known about how collaboration works in practice. Methods A systematic integrative literature review using a narrative synthesis of peer-reviewed and grey literature was undertaken to describe components of inter- and intra-sector collaborations among services to Aboriginal and Torres Strait Islander children with a disability and their families. The findings were synthesized using the conceptual model of the ecological framework. Results Thirteen articles published in a peer-reviewed journal and 18 articles from the grey literature met inclusion criteria. Important factors in inter- and intra-sector collaborations identified included: structure of government departments and agencies, and policies at the macro- (government) system level; communication, financial and human resources, and service delivery setting at the exo- (organizational) system level; and relationships and inter- and intra-professional learning at the meso- (provider) system level. Conclusions The policy shift towards inter-sector collaborative approaches represents an opportunity for the health, education and social service sectors and their providers to work collaboratively in innovative ways to improve service access for Aboriginal and Torres Strait Islander children with a disability and their families. The findings of this review depict a national snapshot of collaboration, but as each community is unique, further research into collaboration within local contexts is required to ensure collaborative solutions to improve service access are responsive to local n...
DiGiacomo, M. 2014, 'Making the most of your research sabbatical: opportunities for productivity and serendipity', Advances in Nursing Doctoral Education and Research, vol. 2, no. 3, pp. 20-24.
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Davidson, P.M., DiGiacomo, M. & Jackson, D.E. 2013, 'Enriching doctoral education with student diversity', Advances in Nursing Doctoral Education and Research, vol. 1, no. 1, pp. 10-16.
This article seeks to identify factors to be considered in embracing perspectives of diversity in doctoral programs from the perspective of the extant literature and personal reflec-tion of experienced supervisors
Lewis, J., Davidson, P.M., DiGiacomo, M., Luckett, T. & Currow, D. 2013, 'A Social Capital Framework for Palliative Care: Supporting Health and Well-Being for People With Life-Limiting Illness and Their Carers Through Social Relations and Networks', Journal of Pain and Symptom Management, vol. 45, no. 1, pp. 92-103.
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This paper summarizes the literature on social capital, well-being, and quality of life for key outcomes to inform a model of social capital in palliative care.
Perera, H. & DiGiacomo, M. 2013, 'The relationship of trait emotional intelligence with academic performance: A meta-analytic review', Learning and Individual Differences, vol. 28, pp. 20-33.
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In the past decade, there has been considerable debate among scholars over whether trait emotional intelligence (trait EI) predicts academic performance (AP). This meta-analysis aimed to assess the validity of trait EI for predicting AP and test moderators of the relation between the constructs.
DiGiacomo, M., Davidson, P.M., Byles, J.E. & Nolan, M. 2013, 'An integrative and socio-cultural perspective of health, wealth, and adjustment in widowhood', Health Care for Women International, vol. 34, no. 12, pp. 1067-1083.
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Women comprise a larger proportion of the ageing population, often outlive their spouses, and face a variety of challenges upon widowhood. Discrete aspects of the health impact of widowhood have been described in the literature; however, the expanse of sociocontextual issues that impact on older women's adjustment is less prominent. We undertook a literature review to synthesize recent research and interventions and identify current trends and gaps in knowledge and services. Although many health, social, cultural, and economic factors impact on recently widowed older women throughout the world, we found few interventions targeting this population incorporating these factors.
DiGiacomo, M., Davidson, P.M., Abbott, P.A., Delaney, P., Dharmendra, T., McGrath, S., Delaney, J. & Vincent, F. 2013, 'Childhood disability in Aboriginal and Torres Strait Islander peoples: a literature review', International Journal for Equity in Health, vol. 12, no. 7.
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Aboriginal and Torres Strait Islander children have higher rates of disability than non-Indigenous children and are considered doubly disadvantaged, yet there is very little data reflecting prevalence and service access to inform design and delivery of services. Failing to address physical, social, and psychological factors can have life-long consequences and perpetuate longstanding health disparities. Methods A narrative literature review was undertaken to identify peer reviewed literature describing factors impacting on the prevention, recognition, and access to support and management of disability in Indigenous Australian children. Results Twenty-seven peer-reviewed journal articles met inclusion criteria. The majority of articles focused on the hearing loss and learning disabilities consequent of otitis media. Few articles reported data on urban or metropolitan Indigenous populations or described interventions. Individual/community-, provider-, and systems level factors were identified as impacting on recognition and management of disability in young Indigenous children. Conclusions Given the burden of childhood disability, the limited literature retrieved is concerning as this is a barometer of activity and investment. Solutions addressing childhood disability will require collaboration between health, social and educational disciplines as well as an increased investment in prevention, identification and promotion of access.
DiGiacomo, M., Delaney, P., Abbott, P., Davidson, P.M., Delaney, J. & Vincent, F. 2013, ''Doing the hard yards': carer and provider focus group perspectives of accessing Aboriginal childhood disability services', BMC Health Services Research, vol. 13, no. 326.
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Background: Despite a high prevalence of disability, Aboriginal Australians access disability services in Australia less than non-Aboriginal Australians with a disability. The needs of Aboriginal children with disability are particularly poorly understood. They can endure long delays in treatment which can impact adversely on development. This study sought to ascertain the factors involved in accessing services and support for Aboriginal children with a disability. Methods: Using the focus group method, two community forums, one for health and service providers and one for carers of Aboriginal children with a disability, were held at an Aboriginal Community Controlled Health Service (ACCHS) in the Sydney, metropolitan area of New South Wales, Australia. Framework analysis was applied to qualitative data to elucidate key issues relevant to the dimensions of access framework. Independent coding consistency checks were performed and consensus of analysis verified by the entire research team, several of whom represented the local Aboriginal community. Results: Seventeen health and social service providers representing local area government and non-governmentfunded health and social service organisations and five carers participated in two separate forums between September and October 2011. Lack of awareness of services and inadequate availability were prominent concerns in both groups despite geographic proximity to a major metropolitan area with significant health infrastructure. Carers noted racism, insufficient or non-existent services, and the need for an enhanced role of ACCHSs and AHWs in disability support services. Providers highlighted logistical barriers and cultural and historical issues that impacted on the effectiveness of mainstream services for Aboriginal people. Conclusions: Despite dedicated disability services in an urban community, geographic proximity does not mitigate lack of awareness and availability of support. This paper has enumerated a numb...
DiGiacomo, M., Lewis, J., Nolan, M., Phillips, J.L. & Davidson, P.M. 2013, 'Transitioning From Caregiving to Widowhood', Journal of Pain and Symptom Management, vol. 46, no. 6, pp. 817-825.
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Older women commonly assume a caregiving role for their husbands at the end of life and are more vulnerable to poorer health, well-being, and social and economic challenges. The aim of this study was to ascertain older women's experiences of spousal caregiving at the end of life and the ways in which this experience impacts on the transition to widowhood.
Lam, S., Davidson, P.M., Leslie, G., DiGiacomo, M. & Soh, K. 2013, 'Nurses' Perceptions Of Standardised Assessment And Prevention Of Complications In An ICU', Journal Of Clinical Nursing, vol. 22, no. 5-6, pp. 856-865.
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Aims and objectives To describe nurses' perceptions of evidence-based recommendations to prevent complications in a Malaysian intensive care unit. Background Ventilator-associated pneumonia, catheter-related blood stream infection and pressure ulcer are
DiGiacomo, M., Lewis, J., Nolan, M.T., Phillips, J. & Davidson, P.M. 2013, 'Health transitions in recently widowed older women: a mixed methods study', BMC Health Services Research, vol. 13, no. 143.
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Lam, S.K., Davidson, P., DiGiacomo, M. & Leslie, G. 2013, 'Nurses' perceptions of standardised assessment and prevention of complications in a Malaysian intensive care unit', Journal of Clinical Nursing, vol. 22, no. 5-6, pp. 856-865.
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DiGiacomo, M., Klein, G., Horvath, L. & Bittoun, R. 2013, 'Introduction to special conference edition of Journal of Smoking Cessation', Journal of Smoking Cessation.
DiGiacomo, M. & Delaney, P. 2013, 'Community-led resilience in Aboriginal childhood disability', Council of Children's Nurses Newsletter, vol. 8.
Davidson, P.M., Mitchell, J., DiGiacomo, M., Inglis, S., Newton, P.J., Harman, J. & Daly, J. 2012, 'Cardiovascular disease in women: implications for improving health outcomes', Collegian, vol. 19, no. 1, pp. 5-13.
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This literature review collated data on women and cardiovascular disease in Australia and globally to inform public health campaigns and health care interventions. If found that women with acute coronary syndromes show consistently poorer outcomes than men, independent of comorbidity and management, despite less anatomical obstruction of coronary arteries and relatively preserved left ventricular function. Higher mortality and complication rates are best documented amongst younger women and those with STsegment-elevation myocardial infarction. Sex differences in atherogenesis and cardiovascular adaptation have been hypothesised, but not proven. Atrial fibrillation carries a relatively greater risk of stroke in women than in men, and anticoagulation therapy is associated with higher risk of bleeding complications. The degree of risk conferred by single cardiovascular risk factors and combinations of risk factors may differ between the sexes, and marked postmenopausal changes are seen in some risk factors. Sociocultural factors, delays in seeking care and differences in self-management behaviours may contribute to poorer outcomes in women. Differences in clinical management for women, including higher rates of misdiagnosis and less aggressive treatment, have been reported, but there is a lack of evidence to determine their effects on outcomes, especially in angina. Although enrolment of women in randomised clinical trials has increased since the 1970s, women remain underrepresented in cardiovascular clinical trials. Improvement in the prevention and management of CVD in women will require a deeper understanding of womenâs needs by the community, health care professionals, researchers and government.
Jiwa, M., Davidson, P.M., Newton, P.J., DiGiacomo, M., McGrath, S. & Lotriet, C. 2012, 'Patient, Provider and System Factors Impacting on the Diagnosis and Management of Lung Cancer Care in Australia', Journal of Cancer Therapy, vol. 3, pp. 406-411.
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Background: Lung cancer is the leading cause of cancer death in Australia, with only modest improvements in survival. This study aims to identify factors impacting on diagnosis and management of lung cancer with particular reference to Australian primary care. Methods: A sequential mixed method modified approach employing interview and a two- phased survey technique. Following telephonic interviews with 31 health professionals (individuals representing general practitioners, specialized physicians, nurses and allied health practitioners), interview data was analysed using qualita-tive thematic analysis, and surveys using descriptive statistics. Emergent themes were organised under patient, provider and system factors. Interviews ceased upon saturation of data. Results: Multiple patient, provider and systems issues were seen to contribute to adverse health outcomes. There is a strong relationship between smoking and outcomes, and factors related to higher smoking rates such as a lower socioeconomic status. For smokers, guilt and/or denial was con-sidered a reason for delay in the decision to seek medical care for cough or shortness of breath. Aboriginal people un-der-report morbidity related to smoking and chronic obstructive pulmonary disease; other patients fail to recognise the significance of their symptoms. Discussion: Despite the poor prognosis of lung cancer diagnosis, increased awareness of presentation and treatment options can address disparities in health outcomes.
Davidson, P.M., Meleis, A., McGrath, S., DiGiacomo, M., Dharmendra, T., Puzantian, H.V., Song, M. & Riegel, B.J. 2012, 'Improving Womens Cardiovascular Health: Position Statement From the International Council on Womens Health Issues', Health Care for Women International, vol. 33, no. 10, pp. 943-955.
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The International Council on Women's Health Issues is an international nonprofit association dedicated to the goals of promoting the health, health care, and the well-being of women. Presented in this article are key recommendations discussed at its 18th biannual meeting where delegates aimed to raise awareness about the potent influence of gender-specific factors on the development, progression, and outcomes of CVD. Key recommendations for decreasing the burden of CVD are are discussed.
Cao, X., Cao, Y., Salamonson, Y., DiGiacomo, M., Chen, Y., Chang, S., Riegel, B. & Davidson, P.M. 2012, 'Translation and validation of the Chinese version of the Acute Coronary Syndrome Response Index (C-ACSRI)', International Journal of Nursing Studies, vol. 49, no. 10, pp. 1277-1290.
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The study aims to translate and validate a Chinese version of the Acute Coronary Syndrome Response Index and to assess the knowledge, attitudes, and beliefs of individuals in mainland China with a history of coronary heart disease.
Davidson, P.M., Jiwa, M., DiGiacomo, M., McGrath, S., Newton, P.J., Durey, A., Bessarab, D. & Thompson, S.C. 2012, 'The experience of lung cancer in Aboriginal and Torres Strait Islander peoples and what it means for policy, service planning and delivery', Australian Health Review, vol. 37, no. 1, pp. 70-78.
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Background. Aboriginal and Torres Strait Islander peoples experience inferior outcomes following diagnosis of lung cancer. Aim. To examine the experience of lung cancer in this population and identify reasons for poorer outcomes and lower levels of treatment compared with non-Aboriginal and Torres Strait Islander peoples, and opportunities for early intervention.
Inglis, S., Du, H., Newton, P.J., DiGiacomo, M., Omari, A. & Davidson, P.M. 2012, 'Disease management interventions for improving self-management in lower-limb peripheral arterial disease (Protocol)', Cochrane Database of Systematic Reviews, no. 3.
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Evidence supports the use of chronic disease management interventions to improve self-management in chronic diseases other than PAD, however it is unclear what benefits these interventions offer for people with PAD. To our knowledge, there are no other systematic reviews of the evidence for chronic disease management interventions to improve self-management for lower-limb PAD. The objective of this review is to systematically review, synthesise and quantify the effects of non-pharmacological and non-surgical chronic disease management interventions targeting self-management for people with lower-limb PAD.
Everett, B., DiGiacomo, M., Rolley, J.X., Salamonson, Y. & Davidson, P.M. 2011, 'You won't know if you don't ask: discrepancy and ambivalence in attitudes toward behavior change', Journal of Cardiovascular Nursing, vol. 26, no. 6, pp. 460-465.
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Background: Behavior change is challenging following an acute cardiac event, and commonly, individuals are ambivalent. Aim: The objective of this study was to describe the experience of behavior change of survivors of an acute cardiac event. Method: Semistructured interviews were undertaken with 25 participants attending 3 cardiac rehabilitation programs. An inductive process of qualitative thematic analysis was used to analyze the transcripts. Results: Analysis revealed ambivalence to change, misconceptions, and confusion about terminology. Discrepancies between what participants felt they should be doing and what they actually were doing reflected their ambivalence. Further inconsistencies were reflected in participants' misunderstandings and confusion regarding disease processes and management of heart disease. Conclusions: These findings reflect the misconception and ambivalence regarding behavior change that individuals experience. Clinicians may require greater skills in detecting conflicting or ambivalent discourse to support patients through sustainable health behavior change.
Davidson, P.M., DiGiacomo, M. & McGrath, S. 2011, 'The Feminization of Aging: How Will This Impact on Health Outcomes and Services?', Health Care for Women International, vol. 32, no. 12, pp. 1031-1045.
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We conducted an integrative review to identify issues and challenges that face aging women and to distinguish areas for future research. We found that many older women continue to face inequities related to health and often are invisible within the discourse of aging policy. In this article we argue for a greater focus on the unique needs of women, a gendered approach to policy and intervention development, and promotion of the health of women across the life span. Policymakers, health care workers, and researchers need to consider the perspective of gender as well as age when implementing and evaluating effective interventions.
Rolley, J.X., Smith, J., DiGiacomo, M., Salamonson, Y. & Davidson, P.M. 2011, 'The caregiving role following percutaneous coronary intervention', Journal Of Clinical Nursing, vol. 20, no. 1-2, pp. 227-235.
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Aim. The aim of this study is to describe the experience of caregivers of individuals who have had a percutaneous coronary intervention (PCI). Background. Decreased lengths of hospital stay and an increased emphasis on chronic disease self-management inc
Gholizadeh, L., DiGiacomo, M., Salamonson, Y. & Davidson, P.M. 2011, 'Stressors influencing Middle Eastern womens perceptions of the risk of cardiovascular disease: a focus group study', Health Care for Women International, vol. 32, no. 8, pp. 723-745.
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To better understand Australia-dwelling Middle Eastern womens lack of service utilization in cardiovascular health, we undertook a study to investigate their understandings and meanings of cardiovascular disease (CVD) and its risk factors. Eight focus groups were conducted in community settings with Turkish, Persian, and Arab women. We found that the women understated their risk of CVD, faced many barriers in reducing their risks, and perceived stress as the most significant contributor to CVD. Women described their stress as primarily emanating from issues surrounding migration and acculturation. Implications for development and delivery of tailored health interventions for Middle Eastern women are discussed.
Davidson, P.M., Jiwa, M., Goldsmith, A.J., McGrath, S., DiGiacomo, M., Phillips, J.L., Agar, M., Newton, P.J. & Currow, D. 2011, 'Decisions for lung cancer chemotherapy: the influence of physician and patient factors', Supportive Care in Cancer, vol. 19, no. 8, pp. 1261-1266.
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Purpose The purpose of this study is to review the literature examining how the beliefs and behaviours of physicians and patients influence clinical communication, doctor-patient interaction and treatment decisions for lung cancer treatment. Methods Literature was obtained via electronic database searches and hand searching of journals from 1990 to 2011. Results Wide variability in perceptions of the value of chemotherapy in lung cancer is present among both physicians and patients. There is a mismatch in the degree patients and physicians weigh survival, such that patients value survival benefits highly whilst physicians strongly emphasize toxicity and associated symptoms. This lack of congruence between patients and clinicians is influenced by a range of factors and has implications for treatment decisions, long-term survival and quality of life in people affected by lung cancer. Conclusion The divergence of treatment priorities indicates a need for improved communication strategies addressing the needs and concerns of both patients and clinicians. Patients should understand the benefits and risks of treatment options, while clinicians can gain a greater awareness of factors influencing patients' decisions on treatments. Reflecting these perspectives and patient preferences for lung cancer treatment in clinical guidelines may improve clinician awareness.
Chang, S., Gholizadeh, L., Salamonson, Y., DiGiacomo, M., Betihavas, V. & Davidson, P.M. 2011, 'Health span or life span: the role of patient reported outcomes in informing health policy', Health Policy, vol. 100, no. 1, pp. 96-104.
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OBJECTIVES: Population ageing and the increasing burden of chronic conditions challenge traditional metrics of assessing the efficacy of health care interventions and as a consequence policy and planning. Using chronic heart failure (CHF) as an exemplar this manuscript seeks to describe the importance of patient-reported outcomes to inform policy decisions. METHODS: The method of an integrative review has been used to identify patient-reported outcomes (PROs) in assessing CHF outcomes. Using the Innovative Care for Chronic Conditions the case for developing a metric to incorporate PROs in policy planning, implementation and evaluation is made. RESULTS: In spite of the increasing use of PROs in assessing CHF outcomes, their incorporation in the policy domain is limited. CONCLUSIONS: Effective policy and planning is of health care services is dependent on the impact on the individual and their families. Epidemiological transitions and evolving treatment paradigms challenge traditional metrics of morbidity and mortality underscoring the importance of assessing PROs.
Davidson, P.M., Daly, J., Leung, D., Ang, E., Paull, G., DiGiacomo, M., Hancock, K., Cao, Y., Du, H. & Thompson, D.R. 2011, 'Health-seeking beliefs of cardiovascular patients: A qualitative study', International Journal of Nursing Studies, vol. 48, no. 11, pp. 1367-1375.
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The study aims were to (a) describe the experiences of Chinese Australians with heart disease following discharge from hospital for an acute cardiac event; (b) identify patterns and cultural differences of Chinese Australians following discharge from hospital; and (c) illustrate the illness/health seeking behaviors and health beliefs of Chinese Australians. Design Qualitative study Methods Interview data were obtained from the following sources: (a) focus groups of Chinese community participants without heart disease; (b) interviews with patients recently discharged from hospital following an admission for an acute cardiac event; and (c) interviews with Chinese-born health professionals working in Australia. Qualitative thematic analysis was undertaken. Results Study themes generated from the data were: (1) linking traditional values and beliefs with Western medicine; (2) reverence for health professionals and family; and (3) juxtaposing traditional beliefs and self-management. Conclusions Considering the influence of cultural values in developing health care plans and clinical decision making is important.
DiGiacomo, M., Davidson, P.M., Zecchin, R.P., Lamb, K. & Daly, J. 2011, 'Caring for others, but not themselves: implications for health care interventions in women with cardiovascular disease', Nursing Research and Practice, vol. 2011.
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Cardiovascular disease is the largest killer of women internationally and women often suffer inferior outcomes following an acute cardiac event as compared to men. A gendered approach to investigating cardiovascular disease in women incorporates the unique social, cultural, and economic circumstances that being a woman brings to the health encounter. The multiple roles enacted by many women may be important factors in this health discrepancy. In order to more fully understand the impact of the roles of women on health, a questionnaire was administered to participants of the Heart Awareness for Women group cardiac rehabilitation program which assessed womenâs role perceptions followed by discussions. We found that caregiving can be both positive and negative. It gives a sense of purpose, meaning, and community connection as well as burden and conflict. Emphasis must be placed on promoting strategies in women to achieve a balance between caregiving responsibilities and prioritisation of cardiovascular health.
Lewis, J., DiGiacomo, M., Currow, D. & Davidson, P.M. 2011, 'Dying in the margins: understanding palliative care and socioeconomic deprivation in the developed world', Journal of Pain and Symptom Management, vol. 42, no. 1, pp. 105-118.
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Individuals from low socioeconomic (SE) groups have less resources and poorer health outcomes. Understanding the nature of access to appropriate end-of-life care services for this group is important. This article evaluated the literature in the developed world for barriers to access for low SE groups. Electronic databases searched in the review included MEDLINE (1996â2010), CINAHL (1996â2010), PsychINFO (2000â2010), Cochrane Library (2010), and EMBASE (1996â2010). Publications were searched for key terms âsocioeconomic disadvantage,â âsocioeconomic,â âpoverty,â âpoorâ paired with âend-of-life care,â âpalliative care,â âdying,â and âterminal Illness.â Articles were analyzed using existing descriptions for dimensions of access to health services, which include availability, affordability, acceptability, and geographical access. A total of 67 articles were identified for the literature review. Literature describing end-of-life care and low SE status was limited. Findings from the review were summarized under the headings for dimensions of access. Low SE groups experience barriers to access in palliative care services. Identification and evaluation of interventions aimed at reducing this disparity is required.
Davidson, P.M., McGrath, S., Meleis, A., Stern, P., DiGiacomo, M., Dharmendra, T., Correa-De-Araujo, R., Campbell, J., Hochleitner, M., Messias, D., Brown, H., Teitelman, A., Sindhu, S., Reesman, A., Richter, S., Sommers, M., Schaeffer, D., Stringer, M., Sampselle, C., Anderson, D., Tuazon, J., Cao, Y. & Covan, E.K. 2011, 'The health of women and girls determines the health and well-being of our modern world: A white paper from the International Council on Women's Health Issues', Health Care for Women International, vol. 32, no. 8, pp. 870-886.
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The International Council on Women's Health Issues (ICOWHI) is an international nonprofit association dedicated to the goal of promoting health, health care, and well-being of women and girls throughout the world through participation, empowerment, advocacy, education, and research. We are a multidisciplinary network of women's health providers, planners, and advocates from all over the globe. We constitute an international professional and lay network of those committed to improving women and girl's health and quality of life. This document provides a description of our organization mission, vision, and commitment to improving the health and well-being of women and girls globally.
Davidson, P.M., DiGiacomo, M., Thompson, S.C., Abbott, P.A., Davison, J., Moore, L., Daly, J., McGrath, S., Taylor, K. & Usherwood, T. 2011, 'Health workforce issues and how these impact on Indigenous Australians', Journal of Australian Indigenous Issues, vol. 14, no. 4, pp. 69-84.
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Indigenous Australians suffer a disproportionate burden of iII health estimated to be 2.5 times higher than other Australians. A number of complex and multifaceted factors impact not only on health inequity but also imbalance in the health workforce. Addressing workforce issues for both Indigenous and non-Indigenous health workers is vital in decreasing the gap in health and social outcomes for Indigenous Australians. It is widely recognised that the capacity of the lndigenous health workforce is a crucial factor in responding effectively to Indigenous health needs. Using the typology of workforce imbalances proposed by Zurn and colleagues, this paper critically analyses issues within Australia impacting on the health workforce, arguing that it is impossible to consider workforce issues for Indigenous health without regard for global, sociodemographic, cultural, geographic and economic factors.
Sayers, J., DiGiacomo, M. & Davidson, P.M. 2011, 'The nurse educator role in the acute care setting in Australia: important but poorly described', Australian Journal of Advanced Nursing, vol. 28, no. 4, pp. 44-52.
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Objective The purpose of this paper is to describe the nurse educator role in the acute care setting in Australia. Method A literature review using Ganongâs (1987) method of analysis was undertaken. Computerised databases were searched for articles published in English between 2000 and 2008 using the key words: âeducationâ, ânursingâ, ânurseâ`educatorâ, âteachingmethodsâ, âclinicalâ, âoutcomes health careâ and âAustraliaâ. Information was summarised to identify issues impacting on the nurse educator role using a standardised data extraction tool. Results The search strategies generated 152 articles and reports. The review identified that the nurse educator role is fundamental in supporting clinical practice and integral to developing a skilled and competent health workforce. Conclusion Confusion in nursing roles and role ambiguity contribute to the challenges for nurse educators in acute care. The absence of a national, standardised approach to role description and scope of practice in Australia may adversely impact role enactment. Further discussion and debate of the nurse educator role in Australia is warranted.
DiGiacomo, M., Davidson, P.M., Abbott, P.A., Davidson, J., Moore, L. & Thompson, S.C. 2011, 'Smoking Cessation in Indigenous Populations of Australia, New Zealand, Canada, and the United States: Elements of Effective Interventions', International Journal of Environmental Research and Public Health, vol. 8, no. NA, pp. 388-410.
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Indigenous people throughout the world suffer a higher burden of disease than their non-indigenous counterparts contributing to disproportionate rates of disability. A significant proportion of this disability can be attributed to the adverse effects of smoking. In this paper, we aimed to identify and discuss the key elements of individual-level smoking cessation interventions in indigenous people worldwide. An integrative review of published peer-reviewed literature was conducted. Literature on smoking cessation interventions in indigenous people was identified via search of electronic databases.
Soh, K.L., Davidson, P.M., Leslie, G., DiGiacomo, M., Rolley, J.X., Soh, K. & Rahman, A. 2011, 'Factors to drive clinical practice improvement in a Malaysian intensive care unit: assessment of organizational readiness using a mixed method approach', International Journal of Multiple Research Approaches, vol. 5, no. 1, pp. 104-121.
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This study assessed organisational readiness and factors to drive clinical practice improvement for VAP, CRBSI and PU in a Malaysian intensive care unit (ICU). A mixed method study approach was undertaken in a 16-bed ICU in regional Malaysia using an environmental scan, key informant interviews, staff surveys, and patient audit to elucidate factors contributing to planning for clinical practice improvement. Measurements of sustainability of practice and regard for the practice environment were assessed using validated measures. An environmental scan demonstrated high patient occupancy and case load. Nineteen percent of ICU patients developed complications according to validated measures. Survey results indicated that the majority of nurses had a good knowledge of strategies to prevent ICU complications and a positive attitude toward change processes. Engaging executive leadership was identifi ed as crucial in priming the clinical site for practice change. Providing nurses with tools to monitor their clinical practice and empowering them to change practices are important in improving clinical outcomes.
DiGiacomo, M., Davidson, P.M., Abbott, P.A., Davison, J., Moore, L. & Thompson, S.C. 2011, 'Smoking cessation in indigenous populations of Australia, New Zealand, Canada, and the United States: elements of effective interventions.', International journal of environmental research and public health, vol. 8, no. 2, pp. 388-410.
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Indigenous people throughout the world suffer a higher burden of disease than their non-indigenous counterparts contributing to disproportionate rates of disability. A significant proportion of this disability can be attributed to the adverse effects of smoking. In this paper, we aimed to identify and discuss the key elements of individual-level smoking cessation interventions in indigenous people worldwide. An integrative review of published peer-reviewed literature was conducted. Literature on smoking cessation interventions in indigenous people was identified via search of electronic databases. Documents were selected for review if they were published in a peer-reviewed journal, written in English, published from 1990-2010, and documented an individual-level intervention to assist indigenous people to quit smoking. Studies that met inclusion criteria were limited to Australia, New Zealand, Canada, and the USA, despite seeking representation from other indigenous populations. Few interventions tailored for indigenous populations were identified and the level of detail included in evaluation reports was variable. Features associated with successful interventions were integrated, flexible, community-based approaches that addressed known barriers and facilitators to quitting smoking. More tailored and targeted approaches to smoking cessation interventions for indigenous populations are required. The complexity of achieving smoking cessation is underscored as is the need to collaboratively develop interventions that are acceptable and appropriate to local populations.
Davidson, P.M., Gholizadeh, L., Haghshenas, A., Rotem, A., DiGiacomo, M., Eisenbruch, M. & Salamonson, Y. 2010, 'A review of the cultural competence view of cardiac rehabilitation', Journal of Clinical Nursing, vol. 19, no. 9-10, pp. 1335-1342.
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Aims and objectives. This paper describes cultural competence issues within the scientific and scholarly discourse surrounding cardiac rehabilitation (CR). Background. CR is an important secondary prevention strategy, improving health-related outcomes and reducing the risks of subsequent cardiovascular events. Internationally, it is widely accepted as a discrete health service model and is endorsed by government and professional bodies. Over past decades, low participation rates in CR remain a concern, particularly among minority groups and culturally and linguistically diverse populations. Design. Systematic review. Methods. Search of electronic databases. Conclusions. Few studies to date have described cultural competence in CR service design and as a consequence, there are minimal data to assist CR professionals and policy makers in tailoring health service delivery models. The limited scholarly debate and discussion regarding cultural competence in the CR literature limits the development and evaluation of culturally appropriate interventions. Relevance to clinical practice. There needs to be greater attention to the concept of cultural competence, both in practice and research settings, to ensure access to CR for people from culturally and linguistically diverse backgrounds.
DiGiacomo, M., Thompson, S., Smith, J.V., Taylor, K., Dimer, L., Ali, M., Wood, M., Leahy, T.G. & Davidson, P.M. 2010, ''I Don't Know Why They Don't Come': Barriers To Participation In Cardiac Rehabilitation', Australian Health Review, vol. 34, no. 4, pp. 452-457.
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Objectives. To describe health professionals' perceptions of Aboriginal people's access to cardiac rehabilitation (CR) services and the role of institutional barriers in implementing the National Health and Medical Research Council (NHMRC) guidelines. Strengthening Cardiac Rehabilitation and Secondary Prevention for Aboriginal and Torres Strait Islander peoples. Design. Qualitative study.
DiGiacomo, M., Lam, P., Roberts, B., Lau, T.C., Song, R. & Davidson, P.M. 2010, 'Exploring the Reasons for Adherence to Tai Chi Practice', Journal of Alternative & Complementary Medicine, vol. 16, no. 12, pp. 1245-1246.
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The bene?ts of physical activity are indisputable, but engaging individuals to take part in sustained activity is challenging. 1 Although of particular consideration in older adults, adherence to physical activity is a challenge across the lifespan and is dependent on personality characteristics
DiGiacomo, M., Davidson, P.M., Taylor, K., Smith, J., Dimer, L., Ali, M., Wood, M., Leahy, T. & Thompson, S. 2010, 'Health information system linkage and coordination are critical for increasing access to secondary prevention in Aboriginal health: a qualitative study', Quality in Primary Care, vol. 18, no. 1, pp. 17-26.
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Background: Aboriginal Australians have low rates of participation in cardiac rehabilitation (CR), despite having high rates of cardiovascular disease. Barriers to CR participation reflect multiple patientrelated issues. However, an examination of the broader context of health service delivery design and implementation is needed. Aims: To identify health professionalsâ perspectives of systems related barriers to implementation of the National Health and Medical Research Council (NHMRC) Guidelines Strengthening Cardiac Rehabilitation and Secondary Prevention for Aboriginal and Torres Strait Islander Peoples.
DiGiacomo, M., Abbott, P., Davison, J., Moore, L. & Davidson, P.M. 2010, 'Facilitating uptake of Aboriginal adult health checks through community engagement and health promotion', Quality in Primary Care, vol. 18, no. 1, pp. 57-64.
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Background Adult Health Checks (AHCs) for Aboriginal and Torres Strait Islander people (MBS Item 710) promote comprehensive physical and psychosocial health assessments. Despite the poor uptake of health assessments in Aboriginal and Torres Strait Islander people, a small number of successful implementation initiatives have been reported. In order to ensure uptake of these screening initiatives, there remains a need to demonstrate the feasibility of models of implementing AHCs.
Davidson, P.M., Abbott, P., Davison, J. & DiGiacomo, M. 2010, 'Improving Medication Uptake in Aboriginal and Torres Strait Islander Peoples', Heart, Lung and Circulation, vol. 19, no. 5-6, pp. 372-377.
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Background: Poor medication adherence is associated with adverse health outcomes. Improving access and adherence to pharmacological therapy is important in achieving optimal health outcomes for Indigenous populations. In spite of the impressive evidence base for cardiovascular pharmacotherapy, strategies for promoting adherence and evidence based practice are less well refined and the challenges for Indigenous populations are more pronounced. Aim:To identify factors impacting on medication adherence in Aboriginal Australians and identify solutions to improve the quality use of medicines.
Sayers, J. & DiGiacomo, M. 2010, 'The nurse educator role in Australian hospitals: implications for health policy', Collegian, vol. 17, no. 2, pp. 77-84.
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To date, the nurse educator role in the Australian hospital setting has been poorly described. Current pressures for health care reform have prompted reviews of nursing roles. This paper discusses the literature pertaining to the nurse educator role within the context of the Australian health care environment and current health care policy. Building on this synthesis, barriers and facilitators impacting on the nurse educator role are identified and strategic directions for policy, role clarification and advanced practice role development are highlighted. Further research identifying the impact of the hospital-based nurse educator on patient outcomes and professional nursing practice are proposed.
Cao, Y., Davidson, P.M., DiGiacomo, M. & Yang, M. 2010, 'Pre-hospital delay for acute coronary syndrome in China', Journal of Cardiovascular Nursing, vol. 25, no. 6, pp. 487-496.
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Background: Despite the effectiveness of timely reperfusion therapy for acute coronary syndrome, prehospital delay remains a global concern. Objective: This article assesses the state-of-the-science regarding prehospital delay for acute coronary syndrome in China. Method: Electronic databases and hand searching were undertaken using key words such as prehospital delay, care-seeking delay, coronary heart disease, heart disease, acute coronary syndrome, unstable angina pain, acute myocardial infarction, cardiovascular disease, chest pain, and Chin (China/Chinese). The Chinese search was supervised by a Chinese health librarian. Results: Based on the search criteria, 28 studies were identified and reviewed using a standardized data extraction tool. Older age, attribution of symptoms to noncardiac causes, lack of health insurance coverage, poor access to transportation, and female sex were identified as contributing to prehospital delay. Conclusion: Health system reforms in China are necessary, particularly with regard to addressing the needs of older people, women, and other vulnerable populations in the context of the rising number of people with coronary heart disease. Developing targeted strategies, learned from both national and international experience, are required to develop targeted interventions
Thompson, S., DiGiacomo, M., Smith, J., Taylor, K., Dimer, L., Ali, M., Wood, M., Leahy, T. & Davidson, P.M. 2009, 'Are the processes recommended by the NHMRC for improving Cardiac Rehabilitation (CR) for Aboriginal and Torres Strait Islander people being implemented?: an assessment of CR Services across Western Australia', Australia and New Zealand Health Policy, vol. 6, no. 29.
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Background: Cardiovascular disease is the major cause of premature death of Indigenous Australians, and despite evidence that cardiac rehabilitation (CR) and secondary prevention can reduce recurrent disease and deaths, CR uptake is suboptimal. The National Health and Medical Research Council (NHMRC) guidelines Strengthening Cardiac Rehabilitation and Secondary Prevention for Aboriginal and Torres Strait Islander peoples, published in 2005, provide checklists for services to assist them to reduce the service gap for Indigenous people. This study describes health professionals' awareness, implementation, and perspectives of barriers to implementation of these guidelines based on semi-structured interviews conducted between November 2007 and June 2008 with health professionals involved in CR within mainstream health services in Western Australia (WA). Twenty-four health professionals from 17 services (10 rural, 7 metropolitan) listed in the WA Directory of CR services were interviewed.
Gholizadeh, L., Salamonson, Y., Worrall-Carter, L., DiGiacomo, M. & Davidson, P.M. 2009, 'Awareness and Causal Attributions of Risk Factors for Heart Disease among Immigrant Women Living in Australia', Journal of Women's Health, vol. 18, no. 9, pp. 1385-1393.
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Abstract Objective: Coronary heart disease (CHD) is a major cause of morbidity and mortality globally, and risk factors for CHD are associated with social and cultural attribution as well as individual psychological factors. The aims of this study were to explore the causal attributions of risk factors for CHD and to describe the relationship between their physiological status and causal attributions among immigrant Arabic, Turkish, and Iranian women living in Australia. Methods: Fifty-five women of Turkish, Iranian, and Persian backgrounds were recruited from community groups in metropolitan Sydney using snowball sampling and the assistance of bilingual health care workers. Body weight and blood pressure were assessed, and a questionnaire, including investigator-developed instruments and the Depression, Anxiety and Stress Scale, was administered. Health interpreters assisted with study procedures and translation of study instruments. Results: There was a low level of awareness of the risk of heart disease among women, although participants had knowledge of risk factors for heart disease broadly. The most highly attributed risk factors for CHD among participants were obesity, physical inactivity, and psychological distress. Women who rated highly on psychological distress scores were more likely to attribute negative emotions as causative factors for heart disease. Conclusions: Strategies to promote the awareness of the association between heart disease and women are required among migrant women. Further investigation is required to overcome the barriers to engaging in effective risk minimizing behaviors for heart disease.
Cao, Y., Davidson, P.M. & DiGiacomo, M. 2009, 'Cardiovascular disease in China: an urgent need to enhance the nursing role to improve health outcomes', Journal Of Clinical Nursing, vol. 18, no. 5, pp. 687-693.
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Aims. This paper reviews the role of cardiac nursing in China and the potential of this professional group to take an important role in secondary and tertiary prevention initiatives. Background. China is undergoing unprecedented economic growth, yet globalisation of Chinese society has caused an increase in the prevalence of chronic conditions, particularly cardiovascular disease. studies recognise that health providers and members of the public are not fully aware of the risks associated with cardiovascular disease and consequently are not equipped to deal with this looming epidemic.
Cao, Y., Digiacomo, M., Du, H.Y. & Davidson, P.M. 2009, 'Chinese nurses' perceptions of heart health issues facing women in China: a focus group study.', The Journal of cardiovascular nursing, vol. 24, no. 6, pp. E23-E29.
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BACKGROUND: China is in a state of rapid economic growth and epidemiological transition. Morbidity and mortality relating to heart disease in women have increased dramatically. OBJECTIVES: The aim of this study was to obtain the views of nurses regarding heart health issues for women in contemporary China. DESIGN: : This study used focus group interviews. SETTINGS: Convenience sampling was used to recruit nurses working in acute care hospitals in metropolitan China. METHODS: Five focus groups containing 28 female participants were conducted. Focus groups were moderated by 2 bilingual Chinese nurses, audiotaped, and analyzed using thematic analysis. RESULTS: Four themes emerged from the focus group data: (1) mixed perceptions of disease burden in women, (2) modern life impacts upon women's health, (3) need for focus on prevention and coordination, and (4) education and support are keys to driving healthcare improvements. CONCLUSIONS: Heart disease, as a significant health issue for women in China, is underappreciated among Chinese nurses.
Davidson, P.M., DiGiacomo, M., Zecchin, R., Clarke, M., Paul, G., Lamb, K., Hancock, K., Chang, E. & Daly, J. 2008, 'A cardiac rehabilitation program to improve psychosocial outcomes of women with heart disease', Journal of Women's Health, vol. 17, no. 1, pp. 123-134.
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Background and aims: Heart disease in women is characterised by greater disability and a higher rate of morbidity and early death after an acute coronary event compared with men. Women also have lower participation rates than men in cardiac rehabilitation. This study sought to describe development of a nurse-directed cardiac rehabilitation program tailored to the needs of women following an acute cardiac event to address their psychological and social needs. Methods: The Heart Awareness for Women program (HAFW) commenced in 2003 with phase I involving development of program elements and seeking validation through consumers and clinical experts. The program was then trialed in an 8-week program in a convenience sample of 6 women. Phase II applied the revised program using action research principles focusing on enabling clinical staff to implement the ongoing program. A total of 54 women participated in this phase, 48 of whom completed baseline questionnaires. A mixed-method evaluation, using questionnaires, interviews, and observation, assessed the impact of the intervention on psychological and social aspects of womens recovery following an acute coronary event. Results: Women welcomed the opportunity to discuss their individual stories, fears, and challenges and to derive support from contact with other women. Via health professional facilitation, women were able to develop strategies collectively to address risk factor modification and achieve optimal cardiovascular health. No statistically significant changes in depression, anxiety, stress, cardiac control, role integration, or perceived social support were found; however, descriptive and qualitative findings revealed decreases in anxiety and an increased sense of social support.
Phillips, J.L., Davidson, P.M., Newton, P.J. & DiGiacomo, M. 2008, 'Supporting patients and their caregivers after-hours at the end of life: the role of telephone support', Journal of Pain and Symptom Management, vol. 36, no. 1, pp. 11-21.
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Twenty-four hour access is accepted as a gold standard for palliative care service delivery, yet minimal data exist to justify the cost of this initiative to health care planners and policy makers. Further, there is scant information concerning optimal and efficient methods for delivering after-hours palliative care advice and support, particularly in regional and rural settings. This article reports on an evaluation of a local after-hours telephone support service in regional Australia. A centralized after-hours telephone support service was provided by generalist nurses at a Multipurpose Service in a rural community. A mixed-method evaluation, including semistructured interviews, was undertaken after 20 months of operation. During the period March 31, 2005 until November 15, 2006, 357 patients were registered as part of the Mid North Coast Rural Palliative Care Program. Ten percent of patients or their caregivers accessed the After-Hours Telephone Support Service, representing 55 occasions of service.
Everett, B., Davidson, P.M., Sheerin, N., Salamonson, Y. & DiGiacomo, M. 2008, 'Pragmatic insights into a nurse-delivered motivational interviewing intervention in the outpatient cardiac rehabilitation setting', Journal of Cardiopulmonary Rehabilitation and Prevention, vol. 28, no. 1, pp. 61-64.
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Despite an increasing interest in motivational interviewing as a strategy to facilitate behavior change in people with cardiovascular disease, its use in cardiac rehabilitation (CR) appears minimal. Therefore, it is unclear whether the clinical method of motivational interviewing requires modification for the CR population, in which it could be argued that people are motivated and engaged. The purposes of this report are to describe processes in incorporating motivational interviewing in the CR setting and to discuss insights gained regarding the use of this intervention. METHODS: As part of a randomized controlled trial currently recruiting in the CR setting, patients allocated to the intervention group participate in 2 motivational interviewing sessions with a motivational interviewing-trained nurse. To ascertain treatment fidelity, this process review comprised 3 sources: (1) the extant literature on motivational interviewing, (2) reflections of the project team, and (3) data derived from audiotaped interviews.
DiGiacomo, M., Davidson, P.M., Davison, J., Moore, L. & Abbott, P. 2008, 'Butting out at AMSWS', Australian Nursing Journal, vol. 15, no. 10, pp. 35-35.
he high rate (50%) of smoking among Aboriginal people (ABS 2005) coupled with limited culturally appropriate smoking cessation interventions makes addressing this important public health issue a challenge. The Aboriginal Medical Service of Western Sydney (AMSWS) offers a high intensity smoking cessation program which provides support, counselling, and subsidised nicotine replacement therapy to its clients through theleadership and community advocacy of Aboriginal Health Workers. The Butt Busters program arose from significant community consultation in 2005 and has now screened over 120 clients, several of whom have quit smoking and many others who are making positive steps toward this behavioural change.
Davidson, P.M., DiGiacomo, M., Abbott, P., Sheerin, N., Heal, P., Mieni, L., Bradbery, B., Zecchin, R., Smith, J., Mark, A. & Davison, J. 2008, 'A partnership model in the development and implementation of a collaborative, cardiovascular education program for Aboriginal health workers', Australian Health Review, vol. 32, no. 1, pp. 139-146.
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A partnership model was established among key education providers, policy makers, non-government organisations, the local area health service and Aboriginal community controlled organisations aimed at increasing collaboration, skill development, cultural competence and increasing access to mentorship and expertise for Aboriginal Health Workers (AHWs). A group of 21 AHWs, within two cohorts, undertook the program between October 2005 and June 2006. A mixed-method evaluation using quantitative and qualitative data collection methods was undertaken prospectively.
Davidson, P.M., Salamonson, Y., Webster, J., Andrew, S., DiGiacomo, M., Gholizadeh, L., Newton, P.J. & Moser, D. 2008, 'Changes in depression in the immediate post-discharge phase in a cardiac rehabilitation population assessed by the Cardiac Depression Scale.', Journal of Cardiopulmonary Rehabilitation and Prevention, vol. 28, no. 5, pp. 312-315.
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Introduction: Depression is increasingly a focus of attention in the management of heart disease. Clinicians in cardiac rehabilitation (CR) are well placed to assess and facilitate management of symptoms of depression, yet the timing and interpretation of measurements remain unclear. Metods: We administered the Hare-Davis Cardiac Depression Scale (CDS) in a usual care, outpatient CR program in a metropolitan setting. As part of routine assessment and monitoring of outcomes in a 6-week outpatient CR program, we administered the CDS at entry, at completion of the 6-week program, and at 12 months. Results: Data were available on 151 patients for the 3 measurement points. At baseline, the mean CDS score was 76.07 (22.38), which dropped at 6 weeks to 64.85 (21.69) but increased slightly at 12 months to 69.79 (24.36). The changes in these scores were statistically significant for all measurement points (P <.03). The trend of change for the CDS was reflected in the subscale scores, which dropped at 6 weeks but increased slightly at 12 months. Discussion: Findings demonstrate a positive impact of CR on CDS scores at 6 weeks and 12 months, although there was a trend for increased scores at 1 year. This observation requires further investigation and underscores the importance of longitudinal studies.
Cao, Y., DiGiacomo, M., Du, H., Ollerton, E. & Davidson, P.M. 2008, 'Cardiovascular disease in Chinese women - An emerging high-risk population and implications for nursing practice', Journal of Cardiovascular Nursing, vol. 23, no. 5, pp. 386-394.
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Background: Globally, cardiovascular disease (CVD) is the leading cause of death among women. In China, the burden of CVD is increasing at an alarming rate, yet, it is underestimated and has important primary, secondary, and tertiary prevention issues. A
Parry, A., Worrall-Carter, L., Page, K., Kuhn, L., DiGiacomo, M. & Davidson, P.M. 2007, 'Returning to work: Exploring the experiences of women with acute coronary syndromes', British Journal of Cardiac Nursing, vol. 2, no. 6, pp. 292-301.
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Aims: The aim of this study was to explore the transition experiences of Australian women in resuming paid employment after an acute coronary syndrome (ACS) event. Background: Until recently cardiovascular research has focused predominantly on men but this is changing and research exploring womens experiences of ACS has increased. Despite knowing that many women do not resume paid employment following an ACS event, little is known about the experience of those women who do, even though it is understood that returning to the previous level of employment after an ACS event is a positive outcome. Design: An exploratory qualitative approach underpinned by naturalistic inquiry was undertaken. Methods: A purposive sample of seven women who had experienced their first ACS event 12 months ago was selected. Each woman was interviewed using a semistructured format and their interviews were transcribed verbatim. Thematic analysis of the transcript set and conceptual mapping were employed to formulate key themes. Findings: All women (mean age 52.6 years) resumed paid employment at various stages during their recovery, but reported similar transition processes. Three key themes representing this process were identified: primary motivation; influence through guidance and support; and resuming paid employment. Conclusions: Study findings revealed that these women required substantial support from family, friends and employers, with ongoing guidance from health professionals to return to paid work. The timeframes for their return varied and some modified their roles within the workforce to enable them to return to paid work. However, formal cardiac rehabilitation did not appear to have a significant impact on these participants decisions to return to work. They felt that more information about this decision may have been helpful if given at the time of cardiac rehabilitation.
Urlic, K., Davidson, P.M. & DiGiacomo, M. 2007, 'Illness perceptions influence involvement in rehabilitation programs and adoption of lifestyle changes following acute myocardial infarction', Australian Occupational Therapy Journal, vol. 54, no. 4, pp. 318-319.
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Research objective: To explore illness perceptions of women following acute myocardial infarction. Design: Qualitative. Setting: Three district general hospitals in south-east England. Participants: Purposive sample of 10 women who had been admitted and since discharged from one of the three hospitals in the study with acute myocardial infarction (AMI). They participated in the study 3 months after their AMI. Their ages ranged from 30 to 80 years with a mean of 72.
Halcomb, E., Gholizadeh, L., DiGiacomo, M., Phillips, J.L. & Davidson, P.M. 2007, 'Literature review: considerations in undertaking focus group research with culturally and linguistically diverse groups', Journal Of Clinical Nursing, vol. 16, no. 6, pp. 1000-1011.
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Aims. This integrated literature review seeks to identify the key considerations in conducting focus groups and discusses the specific considerations for focus group research with culturally and linguistically diverse groups. Background. The focus group method is a technique of group interview that generates data through the opinions expressed by participants. Focus groups have become an increasingly popular method of data collection in health care research. Although focus groups have been used extensively with Western populations, they are a particularly useful tool for engaging culturally and linguistically diverse populations. The success of focus groups in this context is dependent upon the cultural competence of the research team and the research questions.
DiGiacomo, M., Davidson, P.M., Vanderpluym, A., Snell, R. & Worrall-Carter, L. 2007, 'Depression, anxiety and stress in women following acute coronary syndrome: implications for secondary prevention', Australian Critical Care, vol. 20, no. 2, pp. 69-76.
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Objective To document incidence of depression, anxiety, and stress in women more than 6 months following an acute coronary syndrome. Design Participants were identified from a coronary care unit database. The Depression Anxiety Stress Scales 21 (DASS 21) was sent to potential participants via postal survey. Setting A metropolitan teaching hospital in Melbourne, Australia. Participants The cohort of women was aged between 55 and 70 years. They had been admitted to hospital with a diagnosis of acute coronary syndrome (ACS) between 6 and 14 months prior to participating in this study. Main outcome measures Scores on Depression, Anxiety, and Stress Scale (DASS 21). Results Of the 117 posted questionnaires, 39 women with a mean age of 63 (S.D. 4.97) responded to the survey, representing a response rate of 33.3%. Most participants scored within normal levels of depression (66.7%), anxiety (60.5%), and stress (70.3%), however, mild to extremely severe levels of each construct (33.4%, 39.6%, and 29.7%, respectively) were found. Conclusions The reporting of elevated levels of depression, anxiety and stress in a subset of women more than 6 months following an ACS event underscores the importance of ongoing screening for risk factors impacting on psychological well-being and the inclusion of this information in education and counseling strategies in both the inpatient and outpatient settings. Based on these pilot data, consideration of a screening system in the immediate post discharge period for women at risk and an education or support service are recommended.
DiGiacomo, M., Davidson, P.M., Davison, J., Moore, L. & Abbott, P. 2007, 'Stressful life events, resources, and access: key considerations in quitting smoking at an Aboriginal Medical Service', Australian & New Zealand Journal of Public Health, vol. 31, no. 2, pp. 174-176.
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Objective: Aboriginal and Torres Strait Islander people experience adverse health outcomes and have high rates of smoking and related illnesses. This brief report describes stress as a barrier to quitting smoking derived from reflections within an Aboriginal Medical Service and makes recommendations for intervention development.
Halcomb, E., Gholizadeh, L., DiGiacomo, M., Phillips, J.L. & Davidson, P.M. 2007, 'Considerations in undertaking focus group research with culturally and linguistically diverse groups in Bibliographies and Literature Reviews', Journal of Clinical Nursing, pp. 1000-1011.
Focus groups are a popular, widely accepted, and legitimate research method to determine attitudes, experiences, perceptions, and knowledge on a wide range of topics in many fields of endeavor. Focus groups lead to the voicing of attitudes and insights not readily attainable from other qualitative forms of data collection. The spectrum of interest in focus groups covers virtually all disciplines, and the variety of the applications for this technique is extraordinary. As part of the SAGE Benchmarks in Social Research Methods series, Graham Walden explores what a focus group is, how they are best used, the strengths and weaknesses of focus groups and the ethical issues surrounding focus groups, amongst other things. Volume 2, Part 2, 'Bibliographies and Literature Reviews' contains Halcomb et al.'s "Considerations in undertaking focus group research with culturally and linguistically diverse groups". URL: http://www.sagepub.com/books/Book235672/toc
Davison, J., Moore, L., DiGiacomo, M. & Davidson, P.M. 2006, 'Partnerships improve cardiovascular health', Australian Nurses Journal, vol. 14, no. 2, pp. 31-31.
Cardiovascular disease (CVD) is the leading cause of death in the AiLstralian Indigenous population (ABS and AIHW 2001). Unfortunately, Australian Aboriginals have not benefited from the reductions in CVD seen in other sectors of the population
Davidson, P.M. & DiGiacomo, M. 2006, 'Improving cardiovascular health: a collaborative education program for AHWs', Australian Nurses Journal, vol. 14, no. 2, pp. 26-26.
The high rate of cardiovascular morbidity and mortality among Indigenous Australians is of k ^ concern and demands novel aiid innovative strategies (Brown et al 2005). Aboriguial Healtli Workers (AHW) play a vital role in accessing communities in order to address cardiovascular risk factor modification
DiGiacomo, M. & Adamson, B.J. 2001, 'Coping with stress in the workplace: Implications for new health professionals', Journal of Allied Health, vol. 30, no. 2, pp. 106-111.
Because health care professionals must provide high-quality care while simultaneously adjusting to the new demands of a rapidly changing health care system, work stress and possibly even burnout are prevalent issues for both senior professionals and recent health science graduates upon entry into the workforce. This article examines the experience of stress and the importance of coping abilities, particularly focusing on students enrolled in health professional courses and those who have recently entered the workforce. It also presents research pertaining to whether newly graduated health professionals are coping effectively with the demands of work. Suggestions for improving stress-coping abilities are given.


DiGiacomo, M. & Davidson, P.M. 2013, 'Australian women outlive men then struggle with disadvantage', The Conversation Media Trust.
This article refers to the recent Council of Australian Government (COAG) Reform Council's report, Tracking equity: Comparing outcomes for women and girls across Australia, which charts Australia's gender disparities over a lifetime. It contains discussion of older women's experiences of ageing in Australia, where some find themselves isolated, poor, and ill-equipped to meet the challenges of living alone with multiple chronic conditions. It The article highlights the need for innovative strategies to identify women at higher risk of poor outcomes and the imperative to deliver cross-sector strategies.
Ferguson, C., DiGiacomo, M. & Davidson, P.M. 2012, 'Ladykiller: the hidden danger to women's health', The Conversation.
Cardiovascular disease is the biggest killer of women in Australia. It accounts for more than 40% of all female deaths, which means it kills more Australian women than breast cancer and lung cancer combined. But few women are aware of their risk and many wouldn't necessarily be able to recognise warning signs. Part of the difficulty stems from the fact that heart disease is often not obvious and, sometimes, it has no symptoms. High blood pressure (hypertension), for instance, is a major risk factor in cardiovascular disease and can easily go undetected for years. So many women remain unaware that heart disease and stroke are major health issues for them.
DiGiacomo, M. 2012, 'Ladykiller: the hidden danger to women's health', The Converstaion.
  • Aboriginal Medical Service Western Sydney
  • University of Western Sydney
  • Johns Hopkins University