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Dr Michelle DiGiacomo

Biography

Dr DiGiacomo’s program of research centres on coping and adjusting in chronic conditions in vulnerable and diverse populations. She applies her background in organisational and health psychology to research on the interface of health services and vulnerable populations, particularly in respect of access and appropriateness of care. The bulk of her work, to date, has been in cardiovascular disease and secondary prevention initiatives in older women.

She is partially funded by an NHMRC Capacity Building Grant in Population Health and Health Services research in which she is investigating mental health issues associated with living with a chronic condition in Aboriginal people. She 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 undertaken consultancy work for the Cancer Council’s Aboriginal and Torres Strait Islander Sub-committee, National Heart Foundation (NSW) and TAFE (NSW), the World Health Organisation Collaborating Centre for Nursing, Midwifery and Health Development, and several NSW Area Health Services.

Image of Michelle DiGiacomo
Senior Research Fellow, Faculty of Health
Research Fellow, Centre for Cardiovascular and Chronic Care (CCCC)
Core Member, Health Services and Practice Research Strength
Associate Member, Australian Research Centre in Complementary and Integrative Medicine (ARCCIM)
Bachelor of Arts (UMASS), Master of Health Science (Hons) (USyd), PhD (USyd)
Member, Australian Psychological Society
 
Phone
+61 2 9514 4818
Room
CB10.07.234

Research Interests

Access and appropriateness of health services
Vulnerable populations living with chronic conditions
Coping and adjusting
Smoking cessation in Aboriginal people
Behaviour change
Secondary prevention
Social determinants of health
Palliative care

Can supervise: Yes
Research areas Mixed Methods Survey Methods

Epidemiology and Population Health

Chapters

Halcomb, E., Gholizadeh, L., DiGiacomo, M., Phillips, J.L. & Davidson, P.M. 2012, 'Considerations in undertaking focus group research with culturally and linguistically diverse groups in Bibliographies and Literature Reviews' in Walden, G.R. (ed), Focus Group Research, part of the SAGE Benchmarks in Social Research Methods, Sage, UK, pp. 1-17.
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

Conferences

Inglis, S., Du, H., Newton, P.J., DiGiacomo, M., Omari, A. & Davidson, P.M. 2014, 'Disease Management Interventions For Improving Self-Management In Lower-Limb Peripheral Arterial Disease: A Cochrane Review.', Global Heart Supplements, Elsevier, US, p. e262.
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.

Journal articles

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. 1.
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Background: Indigenous Australians have poorer outcomes from cancer for a variety of reasons including poorer participation in screening programs, later diagnosis, higher rates of cancer with poor prognosis and poorer uptake and completion of treatment. Cancer prevention and support for people with cancer is part of the core business of the State and Territory Cancer Councils. To support sharing of lessons learned, this paper reports an environmental scan undertaken in 2010 in cancer councils (CCs) nationwide that aimed to support Indigenous cancer control. Methods. The methods replicated the approach used in a 2006 environmental scan of Indigenous related activity in CCs. The Chief Executive Officer of each CC nominated individuals for interview. Interviews explored staffing, projects, programs and activities to progress cancer control issues for Indigenous Australians, through phone or face-to-face interviews. Reported initiatives were tabulated using predetermined categories of activity and summaries were returned to interviewees, the Aboriginal and Torres Strait Islander Subcommittee and Chief Executive Officers for verification. Results: All CCs participated and modest increases in activity had occurred in most states since 2006 through different means. Indigenous staff numbers were low and no Indigenous person had yet been employed in smaller CCs; no CC had an Indigenous Board member and efforts at capacity building were often directed outside of the organisation. Developing partnerships with Indigenous organisations were ongoing. Acknowledgement and specific mention of Indigenous people in policy was increasing. Momentum increased following the establishment of a national subcommittee which increased the profile of Indigenous issues and provided collegial and practical support for those committed to reducing Indigenous cancer disparities. Government funding of "Closing the Gap" and research in the larger CCs have been other avenues for increasing knowledge and activity in Indigenous cancer control. Conclusions: This environmental scan measured progress, allowed sharing of information and provided critical assessment of progress across areas of importance for increasing Indigenous cancer control. Structured examination of policies, institutional support systems, programs and interventions is a useful means of highlighting opportunities for progress with minority groups relevant for many organisations. Progress has occurred with momentum likely to increase in the future and benefit from commitment to long-term monitoring and sharing of achievements. 2014 Thompson et al.; licensee BioMed Central Ltd.
Al Abed, N.A., Hickman, L., Jackson, D., 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.
Moscou-Jackson, G., Commodore-Mensah, Y., Farley, J. & DiGiacomo, M. 2014, 'Smoking-Cessation Interventions in People Living With HIV Infection: A Systematic Review', JANAC-JOURNAL OF THE ASSOCIATION OF NURSES IN AIDS CARE, vol. 25, no. 1, pp. 32-45.
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Lewis, J.M., 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. 1.
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Background: Lower socioeconomic populations live and die in contexts that render them vulnerable to poorer health and wellbeing. Contexts of care at the end of life are overwhelmingly determined by the capacity and nature of formal and informal networks and relations to support care. To date, studies exploring the nature of networks and relations of support in lower socioeconomic populations at the end of life are absent. This qualitative study sought to identify the nature of individual, community and civic networks and relations that defined the contexts of care for this group. Methods. Semi-structured qualitative interviews were conducted with 16 patients and 6 informal carers who identified that they had social and economic needs and were from a lower socioeconomic area. A social capital questionnaire identifying individual, community and civic networks and relations formed the interview guide. Interviews were audio-taped, transcribed and analysed using framework analysis. Results: Participants identified that individual and community networks and relations of support were mainly inadequate to meet care needs. Specifically, data revealed: (1) individual (informal caregivers) networks and relations were small and fragile due to the nature of conflict and crisis; (2) community trust and engagement was limited and shifted by illness and caregiving; (3) and formal care services were inconsistent and provided limited practical support. Some transitions in community relations for support were noted. Levels of civic and government engagement and support were overall positive and enabled access to welfare resources. Conclusion: Networks and relations of support are essential for ensuring quality end of life care is achieved. Lower socioeconomic groups are at a distinct disadvantage where these networks and relations are limited, as they lack the resources necessary to augment these gaps. Understanding of the nature of assets and limitations, in networks and relations of support, is necessary to inform interventions to improve end of life care for lower socioeconomic populations. 2014 Lewis et al.; licensee BioMed Central Ltd.
Deek, H., Abbott, P., Moore, L., Davison, J., Cameron, S., Digiacomo, M., McGrath, S.J., Dharmendra, T. & Davidson, P.M. 2014, 'Pneumococcus in Aboriginal and Torres Strait Islanders: the role of Aboriginal Health Workers and implications for nursing practice.', Contemp Nurse.
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Abstract 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 grey 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.
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.M., Digiacomo, M., Luckett, T., Davidson, P.M. & Currow, D.C. 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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Context: Social relations and networks are vital for sustaining and enhancing end-of-life care. The social capital concept supports a framework to understand the association between social relations and well-being; yet, to date, there has been very limited investigation of social capital in the palliative care literature. A framework for understanding social contexts in end-of-life care is necessary. Objectives: To summarize the literature on social capital, well-being, and quality of life for key outcomes to inform a model of social capital in palliative care. Methods: The electronic databases MEDLINE (1997 to March 2011), Embase (1997 to March 2011), CINAHL (1997 to March 2011), and PsycINFO (1997 to March 2011) were searched using key/MeSH search terms of "social capital," "palliative care," and "well-being" and/or "quality of life." The literature was reviewed to identify key concepts to develop and inform a palliative care social capital framework. Results: A total of 93 articles were included in the literature review, with only two articles identifying discourse on social capital and palliative care. Four key areas integrating the social capital outcomes informed a framework for palliative care. Conclusion: The social capital concept provides a structure for understanding how the organization and meaning of social contexts can potentially enhance or hinder end-of-life care. Research that identifies specificity in application of social capital concepts is fundamental to issues of access to services, sustaining levels of care, quality of life, and well-being. The importance of "bridged" social capital relations and networks for improved resource acquisition and information flow was identified in the literature and outlined within the palliative care social capital framework. Differential access to social capital by disadvantaged groups provides further impetus to engage a model of social capital for palliative care. 2013 Published by Elsevier Inc. on behalf of U.S. Cancer Pain Relief Committee.
Perera, H.N. & 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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DiGiacomo, M., Davidson, P.M., Byles, J. & Nolan, M.T. 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 than men, 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 that few interventions targeting this population incorporate these factors. 2013 Copyright Taylor and Francis Group, LLC.
Digiacomo, M., Davidson, P.M., Abbott, P., Delaney, P., Dharmendra, T., McGrath, S.J., 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. 1.
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Introduction. 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. 2013 DiGiacomo et al.; licensee BioMed Central Ltd.
Davidson, P.M., Jiwa, M., DiGiacomo, M.L., McGrath, S.J., Newton, P.J., Durey, A.J., Bessarab, D.C. & Thompson, S.C. 2013, '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. Method. Literature was sought via electronic database searches and journal hand-searching for the period from January 1995 to July 2010. Databases used included Indigenous HealthInfoNet, SCOPUS, PsycInfo, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, HealthInsite and Google Scholar. Findings. Exposure to risk factors, cultural and spiritual values, remoteness and geographic characteristics, entrenched socioeconomic inequalities and racism contribute to reduced service access and poor outcomes. The review highlighted a complex interplay of individual, social, health system and environmental factors that impact on optimal lung cancer care and lung cancer outcomes. Considering the burden of lung cancer within a framework of social determinants of health is necessary for policy-making and service planning and delivery. Conclusions. It is imperative that the disproportionate burden of lung cancer in Aboriginal and Torres Strait Islander peoples is addressed immediately. Whilst strategic interventions in lung cancer prevention and care are needed, service providers and policy makers must acknowledge the entrenched inequality that exists and consider the broad range of factors at the patient, provider and system level. Primary care strategies and health promotion activities to reduce risk factors, such as smoking, must also be implemented, with Aboriginal and Torres Strait Islander peoples' engagement and control at the core of any strategy. This review has indicated that multifaceted interventions, supported by enabling policies that target individuals, communities and health professionals, are necessary to improve lung cancer outcomes and disparities. What is known about the topic? Aboriginal Australians suffer a disproportionate burden of ill health including poor outcomes from lung cancer. What does this paper add? This paper reports the outcomes of an integrative literature review. The paper identifies potential barriers to optimal lung cancer care and management for Aboriginal Australians. This paper describes barriers within the context of individual beliefs and behaviours, healthcare systems issues and environmental issues. The authors conclude that acknowledging entrenched inequality and addressing factors at the patient, provider and system level are needed to reduce the lung cancer burden in Aboriginal Australians. What are the implications for practitioners? This paper highlights the need for a greater focus on lung cancer care, awareness and diagnosis within the Aboriginal Australian population. Addressing culturally appropriate smoking-cessation initiatives is of particular importance. Primary care practitioners are key to reducing the burden of lung cancer in Aboriginal Australians. AHHA 2013.
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. 1.
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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-government-funded 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 number of considerations to address provision of disability services in an urban Australian Aboriginal community including building expertise and specialist capacity within Aboriginal Health Worker positions and services. Increasing awareness of services, facilitating linkages and referrals, eliminating complexities to accessing support, and working with families and Aboriginal community organisations within a framework of resilience and empowerment to ensure a relevant and acceptable model are necessary steps to improving support and care for Aboriginal children with a disability. 2013 DiGiacomo et al.; licensee BioMed Central Ltd.
Digiacomo, M., Lewis, J., Nolan, M.T., Phillips, J. & 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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Context: 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. Objectives: 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. Methods: Longitudinal, in-depth, semistructured interviews were conducted with older women three times over a one-year period after the death of their husbands. This report focuses on the initial interviews that examined the transition from caregiving to widowhood. Transcripts were analyzed using interpretive phenomenological analysis methods. Participants were community-dwelling women older than 65 years who had recently been caregivers for their husbands who died within the past two years. Results: Older women caregivers described their caregiver role as taxing, particularly in light of their own chronic conditions that they failed to prioritize and address. They did not ask for help in managing their roles and health problems, but quietly endured. Hence, they did not communicate their needs or strains explicitly. The degree of perceived adequacy of communication and interaction with health professionals were important factors impacting on their bereavement. Conclusion: It is imperative for health professionals to appreciate that older women caregivers may need more supportive interaction and information during the end-of-life caregiving, they may have expectations of communication, and they may deny or fail to focus on their own health issues. A patient/family/carer- centered approach could negate this oversight and improve the outcomes for these women as they transition into widowhood. 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Soh, K.L., Davidson, P.M., Leslie, G., Digiacomo, M. & Soh, K.G. 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 three frequent adverse events in the intensive care unit. Implementing evidenced-based practice is critical in prevention of these complications. Design: A qualitative focus group study. Methods: Focus groups were conducted with nurses in the intensive care unit of a regional hospital in Malaysia following evidence-based interventions. Focus group transcripts were analysed using the method of thematic analyses. Results: Thirty-four nurses participated in eight focus groups. The main themes derived from the interviews: (1) nurses' knowledge impacts on the change process; (2) initial resistance, ambivalence and movement to acceptance; and (3) hierarchical organisational structure can hinder the change process. Conclusion: Enhancing nurses' knowledge and attitudes of evidence-based practice, providing them with tools to monitor their clinical practice, and empowering them to change practice are likely to be important in influencing clinical outcomes. Increasing the emphasis on evidence-based practice in nursing curricula and engaging in cultural change processes in the workplace are necessary to improve clinical outcomes. Relevance to clinical practice: These findings provide valuable information for implementing clinical practice improvement interventions. 2012 Blackwell Publishing Ltd.
Deek, H., Abbott, P., Moore, L., Davison, J., Cameron, S., Digiacomo, M., McGrath, S.J., Dharmendra, T. & Davidson, P.M. 2013, 'Pneumococcus in Aboriginal and Torres Strait Islander peoples: the role of Aboriginal health workers and implications for nursing practice.', Contemporary nurse, vol. 46, no. 1, pp. 54-58.
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Pneumonia is a common cause of hospitalization in Aboriginal and Torres Strait Islander men and women. This article seeks to describe the importance of immunizing against pneumonia in Aboriginal Australians and suggest strategies for screening and follow-up. An integrative literature review, using both published and gray literature was undertaken to identify methods of screening and surveillance strategies for pneumococcus. 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. 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.
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. 1.
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Background: Older recently widowed women are faced with increased health risks and chronic conditions associated not only with bereavement, but also, older age. Loss and grief, adjusting to living alone, decreased income, and managing multiple chronic conditions can impact on older women's ability to transition following recent spousal bereavement. Providing appropriate, timely, and effective services to foster this life transition is of critical importance, yet few services directed towards these women exist in Australia, and there is little data describing the experiences of women and their support needs at this time. Methods. We conducted a longitudinal mixed method study using in-depth semi-structured interviews and questionnaires that were administered three times over a twelve month period to understand the experiences and needs of older women in the period following their husbands' deaths. Descriptive statistics and Interpretive Phenomenological Analysis were used to analyse quantitative and qualitative data, respectively, prior to data integration. Results: Participants were twenty-one community-dwelling recently widowed older women who were an average age of 71 (SD 6.13) years. The majority of participants scored within normal ranges of depression, anxiety, and stress, yet a subset of participants had elevated levels of each of these constructs (37%, 27%, and 19%, respectively) throughout the study period. Positive self-reports of general health predominated, yet 86% of participants were living with one or more chronic condition and taking an average of 4 medications per day. The majority (76%) experienced exacerbations of existing conditions or were diagnosed with a new illness in the early bereavement period, leading to planned and unplanned hospitalisations and other health service use. Qualitative data provided insight into these experiences, the meanings women ascribed to them, and their reasons for enacting certain health risk behaviours. Conclusions: The combination of co-morbidities, polypharmacy, and risk behaviors impacted on medication management and appeared associated with health events. The feminization of ageing and an increasing number of older women living alone with multiple chronic conditions represent significant challenges to health services and societal support systems. Older women's transition to widowhood signals concomitant health transitions and multidimensional support needs. 2013 DiGiacomo et al.; licensee BioMed Central Ltd.
Davidson, P.M., Mitchell, J.A., DiGiacomo, M., Inglis, S.C., 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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Objective: To collate data on women and cardiovascular disease in Australia and globally to inform public health campaigns and health care interventions. Design: Literature review. Results: 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 ST-segment-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. Conclusions: Improvement in the prevention and management of CVD in women will require a deeper understanding of women's needs by the community, health care professionals, researchers and government. 2011 Royal College of Nursing, Australia.
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, no. 4A, pp. 1-6.
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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.
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)', The Cochrane Database of Systematic Reviews, vol. 3, pp. 1-11.
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.
Davidson, P.M., Meleis, A.I., McGrath, S.J., Digiacomo, M., Dharmendra, T., Puzantian, H.V., Song, M. & Riegel, B. 2012, 'Improving Women's Cardiovascular Health: A Position Statement From the International Council on Women's Health Issues', HEALTH CARE FOR WOMEN INTERNATIONAL, vol. 33, no. 10, pp. 943-955.
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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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Background: Patients' knowledge, attitudes, and beliefs toward acute coronary syndrome are important predictors of delay in seeking medical attention. Currently, there is no instrument in China to measure these factors. Without such an instrument, there is limited understanding of the knowledge, attitudes and beliefs of Chinese patients. The Acute Coronary Syndrome Response Index is a validated instrument to measure patients' knowledge, attitudes, and beliefs about the symptoms and responses to acute coronary syndrome. Objectives: 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. Design: Cross-sectional study. Setting: Two tertiary teaching general hospitals and community in Shandong province, Eastern China. Participants: Individuals with a history of coronary heart disease. Method: The Acute Coronary Syndrome Response Index was professionally translated and piloting was undertaken to ensure equivalence of meaning and cultural appropriateness. Two means were used for participant recruitment: (1) direct approach in hospital and (2) advertisement in a popular health magazine in Shandong province. Principal component analysis was performed to examine the construct validity, and internal consistency was assessed using Cronbach's alpha values. Results: 224 participants with coronary heart disease were recruited, including 158 in-patients and 66 individuals living in the community. Participants' mean age was 64.3 13.8 years. The majority of participants (61.7%) were male. Cronbach's coefficient for total scores of the Chinese version of Acute Coronary Syndrome Response Index was 0.81, 0.79 for knowledge, 0.87 for attitudes, and 0.71 for the beliefs scale. Pearson's method of bivariate correlation test demonstrated convergent validity. Conclusion: The Chinese version of Acute Coronary Syndrome Response Index can be considered as a reliable and valid instrument. Further testing of the instrument which is needed to assess the acceptability and to ensure the utility of the instrument is warranted. 2012 Elsevier Ltd.
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. Copyright 2011 Lippincott Williams & Wilkins.
Davidson, P.M., DiGiacomo, M. & McGrath, S.J. 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. Taylor & Francis Group, LLC.
Rolley, J., Smith, J., DiGiacomo, M., Salamonson, Y. & Davidson, P. 2011, 'The caregiving role following percutaneous coronary intervention', JOURNAL OF CLINICAL NURSING, vol. 20, no. 1-2, pp. 227-235.
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Gholizadeh, L., Digiacomo, M., Salamonson, Y. & Davidson, P.M. 2011, 'Stressors influencing middle eastern women's 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 women's 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. Taylor & Francis Group, LLC.
Davidson, P.M., Jiwa, M., Goldsmith, A.J., McGrath, S.J., Digiacomo, M., Phillips, J.L., Agar, M., Newton, P.J. & Currow, D.C. 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. 2011 Springer-Verlag.
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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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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Objectives: 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. 2011 Elsevier Ltd.
Digiacomo, M., Davidson, P.M., Zecchin, R., Lamb, K. & Daly, J. 2011, 'Caring for others, but not themselves: implications for health care interventions in women with cardiovascular disease.', Nurs Res Pract, vol. 2011, p. 376020.
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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 women's 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.M., Digiacomo, M., Currow, D.C. & 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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Context: 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. Objectives: To evaluate the literature in the developed world for barriers to access for low SE groups. Methods: Electronic databases searched in the review included MEDLINE (1996-2010), CINAHL (1996-2010), PsychINFO (2000-2010), Cochrane Library (2010), and EMBASE (1996-2010). Publications were searched for key terms "socioeconomic disadvantage," "socioeconomic," "poverty," "poor" paired with "end-of-life care," "palliative care," "dying," and "terminal Illness." Articles were analyzed using existing descriptions for dimensions of access to health services, which include availability, affordability, acceptability, and geographical access. Results: 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. Conclusion: Low SE groups experience barriers to access in palliative care services. Identification and evaluation of interventions aimed at reducing this disparity is required. 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Davidson, P.M., McGrath, S.J., Meleis, A.I., Stern, P., DiGiacomo, M., Dharmendra, T., Correa-De-Araujo, R., Campbell, J.C., Hochleitner, M., Messias, D.K.H., Brown, H., Teitelman, A., Sindhu, S., Reesman, K., Richter, S., Sommers, M.S., Schaeffer, D., Stringer, M., Sampselle, C., Anderson, D., Tuazon, J.A., 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. 10, 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. Taylor & Francis Group, LLC.
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.M., 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.
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. 2011 by the authors; licensee MDPI, Basel, Switzerland.
Lam, S., 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. NA, pp. 104-121.
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.', Int J Environ Res 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. 2010 Blackwell Publishing Ltd.
DiGiacomo, M.L., Thompson, S.C., Smith, J.S., Taylor, K.P., Dimer, L.A., Ali, M.A., Wood, M.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. Setting. Metropolitan and rural tertiary and community-based public CR services and Aboriginal health services in WA. Participants. Thirty-eight health professionals working in the CR setting. Method. Semistructured interviews were undertaken with 28 health professionals at public CR services and 10 health professionals from Aboriginal Medical Services in WA. The participants represented 17 services (10 rural, 7 metropolitan) listed in the WA Directory of CR services. Results. Emergent themes included (1) a lack of awareness of Aboriginal CR patients' needs; (2) needs related to cultural awareness training for health professionals; and (3) Aboriginal health staff facilitate access for Aboriginal patients. Conclusions. Understanding the institutional barriers to Aboriginal participation in CR is necessary to recommend viable solutions. Promoting cultural awareness training, recruiting Aboriginal health workers and monitoring participation rates are important in improving health outcomes. AHHA 2010.
DiGiacomo, M., Lam, P., Roberts, B.L., Lau, T.C., Song, R. & Davidson, P.M. 2010, 'Exploring the Reasons for Adherence to T'ai Chi Practice', JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE, vol. 16, no. 12, pp. 1245-1246.
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Digiacomo, M., Davidson, P.M., Taylor, K.P., Smith, J.S., Dimer, L., Ali, M., Wood, M.M., Leahy, T.G. & Thompson, S.C. 2010, 'Health information system linkage and coordination are critical for increasing access to secondary prevention in Aboriginal health: a qualitative study.', Qual Prim Care, vol. 18, no. 1, pp. 17-26.
Aboriginal Australians have low rates of participation in cardiac rehabilitation (CR), despite having high rates of cardiovascular disease. Barriers to CR participation reflect multiple patient-related issues. However, an examination of the broader context of health service delivery design and implementation is needed.
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.', Qual Prim Care, vol. 18, no. 1, pp. 57-64.
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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Sayers, J.M. & 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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Cao, Y., Davidson, P.M., DiGiacomo, M. & Yang, M. 2010, 'Prehospital Delay for Acute Coronary Syndrome in China', JOURNAL OF CARDIOVASCULAR NURSING, vol. 25, no. 6, pp. 487-496.
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Thompson, S.C., Digiacomo, M.L., Smith, J.S., Taylor, K.P., Dimer, L., Ali, M., Wood, M.M., Leahy, T.G. & 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.', Aust New Zealand Health Policy, vol. 6, p. 29.
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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 WOMENS HEALTH, vol. 18, no. 9, pp. 1385-1393.
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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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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, vol. 18, no. 5, pp. 749-749.
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.', J Cardiovasc Nurs, vol. 24, no. 6, pp. E23-E29.
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China is in a state of rapid economic growth and epidemiological transition. Morbidity and mortality relating to heart disease in women have increased dramatically.
Davidson, P., Digiacomo, M., Zecchin, R., Clarke, M., Paul, G., Lamb, K., Hancock, K., Chang, E., Daly, J. & Invest, H.A.W.P. 2008, 'A cardiac rehabilitation program to improve psychosocial outcomes of women with heart disease', JOURNAL OF WOMENS HEALTH, vol. 17, no. 1, pp. 123-134.
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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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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.
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., Zecchin, R., Heal, P.E., Mieni, L., Sheerin, N., Smith, J., Mark, A., Bradbery, B. & 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.
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.
Davidson, P.M., Salamonson, Y., Webster, J., Andrew, S., DiGiacomo, M., Gholizadeh, L., Newton, P. & Moser, D. 2008, 'Changes in depression in the immediate postdischarge 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.
Cao, Y., DiGiacomo, M., Du, H.Y., Ollerton, E. & Davidson, P. 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.
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.
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.J., Gholizadeh, L., DiGiacomo, M., Phillips, J. & 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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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.', Aust Crit Care, vol. 20, no. 2, pp. 69-76.
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To document incidence of depression, anxiety, and stress in women more than 6 months following an acute coronary syndrome.
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 AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, vol. 31, no. 2, pp. 174-176.
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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. & Mahony, M.J. 2004, 'Limitations in conducting cross-cultural research: Organisational behaviour examined', INTERNATIONAL JOURNAL OF PSYCHOLOGY, vol. 39, no. 5-6, pp. 441-441.
DiGiacomo, M. & Adamson, B. 2001, 'Coping with stress in the workplace: implications for new health professionals.', J 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.

Non traditional outputs

DiGiacomo, M. & Davidson, P.M. 2013, 'Australian women outlive men then struggle with disadvantage', The Conversation, The Conversation Media Trust, Melbourne.
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 Australias 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, 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 wouldnt 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.