A/Prof DiGiacomo's research focusses on priority populations living with chronic health conditions. She examines the contexts within which individuals, families, and communities negotiate, cope, and adjust to living with chronic conditions. Through a combination of qualitative and mixed methods research, she aims to facilitate voices of Aboriginal and Torres Strait Islander people, older people, carers, and those from culturally and linguistically diverse populations to inform service design, delivery, and access and healthcare workforce capacity development. This work underscores the importance of striving for inclusive services and interactions and tailoring service initiatives to meet diverse needs and preferences to ensure safe, high quality, culturally appropriate care.
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 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
- Associate Editor, BMC Health Services Research
Can supervise: YES
- Reducing health and social disparities
- Access and appropriateness of health services
- Priority populations living with chronic conditions
- Qualitative research
- Gendered approaches to health
- Behaviour change
- Social determinants of health
- Communication and collaboration for optimal person-centred care
- Evidence-based Practice
Rao, A, DiGiacomo, M, Newton, P, Phillips, J & Hickman, L 2019, 'Meditation and secondary prevention of depression and anxiety in heart disease: A systematic review', Mindfulness, vol. 10, no. 1, pp. 1-14.View/Download from: UTS OPUS or Publisher's site
Heart disease is the leading cause of global mortality, accounting for 13.7 million deaths annually. Optimising depression and anxiety symptoms in adults with heart disease is an international priority. Heart disease secondary prevention is best achieved through implementation of sustainable pharmacological and non-pharmacological interventions, including meditation. Meditation is a means of generating self-awareness and has implications for enhanced self-management of depression and anxiety symptoms. This review aims to identify high-level quantitative evidence for meditation interventions designed to improve depression and/or anxiety symptoms among adults with heart disease and ascertain the most important elements of meditation interventions that facilitate positive depression and/or anxiety outcomes. This systematic review and narrative synthesis was completed in accordance with the PRISMA Statement and has adhered to the Cochrane Risk of Bias guideline. Six databases were searched between 1975 and 2017. Statistically significant outcomes were demonstrated in over half (5/9) of phase II meditation studies for depression and/or anxiety and involved 477 participants. Meditation interventions that generated positive outcomes for depression and/or anxiety included elements such as focused attention to body parts (or body scan) (3/4 studies) and/or group meetings (4/5 studies). Meditation is a means of reframing heart disease outpatient services towards an integrated model of care. Future adequately powered phase III studies are needed to confirm which meditation elements are associated with reductions in depression and anxiety; and the differential effects between concentrative and mindfulness-based meditation types among adults with heart disease.
Wyllie, A, Levett-Jones, T, DiGiacomo, M & Davidson, P 2019, 'Exploring the experiences of early career academic nurses as they shape their career journey: A qualitative study', NURSE EDUCATION TODAY, vol. 76, pp. 68-72.View/Download from: Publisher's site
Luckett, T, Agar, M, DiGiacomo, M, Ferguson, C, Lam, L & Phillips, J 2019, 'Health status of people who have provided informal care or support to an adult with chronic disease in the last 5 years: results from a population-based cross-sectional survey in South Australia.', Australian Health Review.View/Download from: UTS OPUS or Publisher's site
Support for Australian carers is warranted to ensure their continuing contributions to society and return to productivity after their caring role is completed.
Maneze, D, Ramjan, L, DiGiacomo, M, Everett, B, Davidson, PM & Salamonson, Y 2018, 'Negotiating health and chronic illness in Filipino-Australians: A qualitative study with implications for health promotion', Ethnicity and Health, vol. 23, no. 6, pp. 611-628.View/Download from: UTS OPUS or Publisher's site
Objective: In spite of the healthy immigrant effect, the prevalence of lifestyle-related chronic diseases among migrants is reported to approximate that of the host country with longer duration of stay. For example, higher rates of chronic diseases such as Type 2 diabetes and hypertension have been observed among Filipino migrants and these have been linked to acculturation. The aim of this study was to explore the experiences of Filipino-Australian migrants in managing their chronic health conditions in a Western host country.
Design: This paper reports on qualitative findings of a mixed methods study that used an explanatory sequential design. Nine focus group discussions were undertaken with 58 Filipino-Australian migrants with chronic disease. Thematic analysis was undertaken using a five-stage general purpose thematic framework ensuring that themes closely identified key participants' experiences.
Results: Findings revealed that health benefits provided by the health system in Australia were considered advantageous. However, a lack of social and instrumental support compounded isolation and disempowerment, limiting self-management strategies for chronic illnesses. Cultural beliefs and practices influenced their knowledge, attitude to and management of chronic disease, which health service providers overlooked because of perceived acculturation and English language skills. Overall this study has clearly identified recognition of cultural beliefs, language needs and support as three core needs of Filipino-Australian migrants with the elderly the most vulnerable.
Conclusion: This paper highlights that self-management of chronic disease among elderly Filipino immigrants may be adversely affected by host language difficulties, a lack of social support and cultural issues, impacting on access to services, health-seeking behaviours and participation in health promotion initiatives. Language, culture-specific health interventions and resources and enhancing socia...
Abbott, P, DiGiacomo, M, Magin, P & Hu, W 2018, 'A scoping review of qualitative research methods used with people in prison', International Journal of Qualitative Methods, vol. 17, no. 1.View/Download from: UTS OPUS or Publisher's site
Researchers undertaking qualitative interview and focus group research with people in prison must consider the research methods they use, given the ethical and practical complexities of prison-based research. In particular, there are explicit and implicit coercion risks and barriers to access, privacy, and confidentiality. To examine how the challenges of conducting rigorous qualitative research with prisoners were handled, we undertook a scoping review of recruitment and data collection processes
reported in qualitative research with prisoners. We searched for peer-reviewed articles of qualitative interview and focus group research with adult prisoners, published in the English language from 2005 to 2017, using MEDLINE, Embase, PsycINFO, and CINAHL databases. There were 142 articles reporting on 126 studies which met the review inclusion criteria. Challenges related to coercion risk, participant recruitment, sampling, confidentiality, privacy, and working with prison-based intermediaries should be explicitly addressed and reported. Our findings highlight key considerations and contextualized strategies for recruitment and data collection for researchers who seek to conduct rigorous and ethical qualitative research with prisoners.
Rao, A, Newton, P, DiGiacomo, M, Hickman, L, Hwang, C & Davidson, P 2018, 'Optimal gender specific strategies for the secondary prevention of cardiovascular disease in women: a systematic review', Journal of Cardiopulmonary Rehabilitation and Prevention, vol. 38, no. 5, pp. 279-285.View/Download from: UTS OPUS or Publisher's site
Wyllie, A, DiGiacomo, M, Jackson, D, Davidson, P & Phillips, J 2018, 'Corrigendum to "Acknowledging attributes that enable the career academic nurse to thrive in the tertiary education sector: A qualitative systematic review" [Nurse Educ. Today 45, October 2016, 212-218].', Nurse Education Today, vol. 62, pp. 164-164.View/Download from: UTS OPUS or Publisher's site
Hickman, L, DiGiacomo, M, Phillips, J, Rao, A, Newton, P, Jackson, D & Ferguson, C 2018, 'Improving evidence based practice in postgraduate nursing programs: Asystematic review', Nurse Education Today, vol. 63, pp. 69-75.View/Download from: UTS OPUS or Publisher's site
The nursing profession has a significant evidence to practice gap in an increasingly complex and dynamic health care environment.
To evaluate effectiveness of teaching and learning strategies related to a capstone project within a Masters of Nursing program that encourage the development of evidence based practice capabilities.
Systematic review that conforms to the PRISMA statement. Sample: Master's Nursing programs that include elements of a capstone project within a university setting.
Data Sources/Review Methods
MEDLINE, CINAHL, Cochrane Database of Systematic Reviews, ERIC and PsycInfo were used to search for RCT's or quasi experimental studies conducted between 1979 and 9 June 2017, published in a peer reviewed journal in English.
Of 1592 studies, no RCT's specifically addressed the development of evidence based practice capabilities within the university teaching environment. Five quasi-experimental studies integrated blended learning, guided design processes, small group work, role play and structured debate into Masters of Nursing research courses. All five studies demonstrated some improvements in evidence based practice skills and/or research knowledge translation, with three out of five studies demonstrating significant improvements.
There is a paucity of empirical evidence supporting the best strategies to use in developing evidence based practice skills and/or research knowledge translation skills for Master's Nursing students. As a profession, nursing requires methodologically robust studies that are discipline specific to identify the best approaches for developing evidence-based practice skills and/or research knowledge translation skills within the university teaching environment. Provision of these strategies will enable the nursing profession to integrate the best empirical evidence into nursing practice.
Green, A, Abbott, P, Davidson, P, Delaney, P, Delaney, J, Patradoon-Ho, P & DiGiacomo, M 2018, 'Interacting with providers: an intersectional exploration of the experiences of carers of Aboriginal children with a disability', Qualitative Health Research, vol. 28, no. 12, pp. 1923-1932.View/Download from: UTS OPUS or Publisher's site
Intersectionality has potential to create new ways to describe disparities and craft meaningful solutions. This study aimed to explore Aboriginal carers' experiences of interactions with health, social, and education providers in accessing services and support for their child. Carers of Aboriginal children with a disability were recruited from an Australian metropolitan Aboriginal community-controlled health service. In-depth, semi-structured interviews were conducted with nineteen female carers. Transcripts underwent interpretative phenomenological analysis. Intersectionality was applied as an analytical framework due to the inherent power differentials for Aboriginal Australians and carers for people with a disability. Marginalisation and a lack of empowerment was evident in the experiences of interactions with providers due to cultural stereotypes and racism, lack of cultural awareness and sensitivity, and poverty and homelessness. Community-led models of care can help overcome the intersectional effects of these identities and forms of oppression in carers' interactions with providers and enhance access to care.
Brown, N, Luckett, T, Davidson, PM & DiGiacomo, M 2017, 'Family-focussed interventions to reduce harm from smoking in primary school-aged children: A systematic review of evaluative studies.', Preventive Medicine, vol. 101, pp. 117-125.View/Download from: UTS OPUS or Publisher's site
Children living in families where adults smoke are exposed to harmful effects of tobacco smoke and risk a predisposition to smoking initiation. Interventions to support families to reduce risk of harm from smoking have been developed and tested. The purpose of this review is to identify effective family-based interventions used to promote smoke-free home environments in families with primary school age children (aged 5-12years). A systematic search of MEDLINE, Cochrane and CINAHL electronic databases was conducted. Narrative synthesis of included articles was completed. Guidelines for reporting behaviour change interventions were used to summarise and compare intervention timing, content, intensity and delivery. Quality of included studies was critiqued using United States Preventative Services Taskforce (USPST) procedures for internal and external validity. Narrative synthesis was based on methods described by Popay and colleagues. Nineteen articles that evaluated 14 intervention studies focussed on child smoking prevention (n=5), parent smoking cessation (n=4) and environmental tobacco smoke reduction (n=6). Interventions and outcomes were heterogeneous, and were rarely informed by theoretical frameworks relating to family, parenting or child development. Family based interventions may be an important strategy to reduce the effects of smoking for children. There is a need for interventions to be informed by theory relevant to children, parenting and families.
DiGiacomo, M, Hatano, Y, Phillips, J, Lewis, J, Abernathy, A & Currow, D 2017, 'Caregiver characteristics and bereavement needs: findings from a population study', Palliative Medicine, vol. 31, no. 5, pp. 465-474.View/Download from: UTS OPUS or Publisher's site
Background: Globally, the majority of care for people with life-limiting illnesses is provided by informal caregivers. Identifying characteristics of caregivers that may have unmet needs and negative outcomes can enable provision of better support to facilitate their adjustment.
Aim: We compared characteristics, expressed unmet needs, and outcomes for spousal caregivers, with other caregivers at the end of life, by gender and age.
Design: The South Australian Health Omnibus is an annual, random, face-to-face, cross-sectional survey wherein respondents are asked about end-of-life care.
Setting/Participants: Participants were aged over 15, resided in households in South Australia, and had someone close to them die from a terminal illness in the last five years.
Results: Of the 1,540 respondents who provided hands-on care for someone close at the end of life, 155 were widows/widowers. Bereaved spousal caregivers were more likely to: be older, female, better educated, have lower incomes, less full-time work, English as second language, sought help with grief, and provided more day-to-day care for longer periods. Spousal caregivers were less likely to be willing to take on caregiving again, less able to 'move on' with life, and needed greater emotional support and more information about the illness and services. The only difference between widows and widowers was older age of spouse in women. Younger spousal caregivers perceived greater unmet emotional needs and were significantly less likely to be able to 'move on'.
Conclusions: Spousal caregivers are different from other caregivers, with more intense needs that are not fully met. These have implications for bereavement, health, and social services.
Rihari-Thomas, J, DiGiacomo, M, Phillips, J, Newton, P & Davidson, PM 2017, 'Clinician Perspectives of Barriers to Effective Implementation of a Rapid Response System in an Academic Health Centre: A Focus Group Study', International Journal of Health Policy and Management, vol. 6, no. 8, pp. 447-456.View/Download from: UTS OPUS or Publisher's site
Background: Systemic and structural issues of rapid response system (RRS) models can hinder implementation. This study sought to understand the ways in which acute care clinicians (physicians and nurses) experience and negotiate care for deteriorating patients within the RRS.
Methods: Physicians and nurses working within an Australian academic health centre within a jurisdictional-based model of clinical governance participated in focus group interviews. Verbatim transcripts were analysed using thematic content analysis.
Results: Thirty-four participants (21 physicians and 13 registered nurses [RNs]) participated in six focus groups over five weeks in 2014. Implementing the RRS in daily practice was a process of informal communication and negotiation in spite of standardised protocols. Themes highlighted several systems or organisational-level barriers to an effective RRS, including (1) responsibility is inversely proportional to clinical experience; (2) actions around system flexibility contribute to deviation from protocol; (3) misdistribution of resources leads to perceptions of inadequate staffing levels inhibiting full optimisation of the RRS; and (4) poor communication and documentation of RRS increases clinician workloads.
Conclusion: Implementing a RRS is complex and multifactorial, influenced by various inter- and intra-professional factors, staffing models and organisational culture. The RRS is not a static model; it is both reflexive and iterative, perpetually transforming to meet healthcare consumer and provider demands and local unit contexts and needs. Requiring more than just a strong initial implementation phase, new models of care such as a RRS demand good governance processes, ongoing support and regular evaluation and refinement. Cultural, organizational and professional factors, as well as systems-based processes, require consideration if RRSs are to achieve their intended outcomes in dynamic healthcare settings.
Ferguson, C, DiGiacomo, M, Gholizadeh, L, Ferguson, LE & Hickman, LD 2017, 'The integration and evaluation of a social-media facilitated journal club to enhance the student learning experience of evidence based practice', Nurse Education Today, vol. 48, pp. 123-128.View/Download from: UTS OPUS or Publisher's site
DiGiacomo, M, Green, A, Delaney, P, Delaney, J, Patradoon-Ho, P, Davidson, P & Abbott, P 2017, 'Experiences and needs of carers of Aboriginal children with a disability: a qualitative study', BMC Family Practice, vol. 18, pp. 1-11.View/Download from: UTS OPUS or Publisher's site
Background: Australian parents/carers of a person with a disability experience higher rates of depression, more financial stress, and are twice as likely to be in poor physical health than the general population. Aboriginal and Torres Strait Islander peoples experience worse health, social and economic outcomes than other Australians, and those with a disability face 'double disadvantage'. This study aimed to better understand the experiences and needs of parents/carers/families of Aboriginal children with a disability.
Methods: Semi-structured in-depth interviews were conducted with parents or primary carers of Aboriginal children aged zero-eight with disability. Interviews were analysed using thematic analysis.
Results: Nineteen women (sixteen mothers and three grandmothers) were interviewed. More than half were lone carers (without a partner or spouse). Participants described their experiences, including challenges and facilitators, to providing and accessing care, impacts on their health and wellbeing, and associated economic and non-economic costs of caregiving. Financial strain and social isolation was particularly prominent for lone carers.
Conclusions: Tailoring services to the needs of carers of Aboriginal children with a disability means supporting kinship caregiving, facilitating engagement with other Aboriginal families, and streamlining services and systems to mitigate costs. The experiences described by our participants depict an intersection of race, socio-economic status, gender, disability, and caregiving. Services and funding initiatives should incorporate such intersecting determinants in planning and delivery of holistic care.
Green, A, Luckett, T, Abbott, P, DiGiacomo, M, Delaney, P, Delaney, J & Davidson, PM 2017, 'A framework for an asset-informed approach to service mapping', Nurse Researcher, vol. 25, no. 3, pp. 19-25.View/Download from: UTS OPUS or Publisher's site
Background Asset-informed approaches are increasingly emphasised in public health, but
transferring this approach to planning health services requires prospective systematic methods.
Asset-informed approaches to service-mapping have started to develop, but there are no
standardised guidelines. These methods are becoming of particular interest, as nurses engage in
population health activities.
Aim To identify methods of asset-informed mapping for addressing health problems and develop a
framework to support the methodological rigour of service-mapping.
Discussion The authors undertook an integrative literature review using a systematic approach
and narrative synthesis. Ten articles met the inclusion criteria. Reported methods included the
formation of a core team to drive the process, as well as varying detail about methods of collecting
data and forming maps. Challenges and solutions included the effectiveness of the core team
depending on having a designated leader, frequent meetings and previous partnerships, using
community 'cultural brokers', and determining aims and scope.
Conclusion Results of the review can be used to modify existing generic resources for assetinformed
mapping to their application in health services. Four main stages seem especially
applicable and important: defining the parameters of the service-mapping process; identifying
services; mapping services; and consultation and implementation.
Implications for practice The shift towards asset-informed approaches in community and public
health is an important step in realising the potential of existing assets in communities to influence
health outcomes. The framework offered in this paper is intended to assist in developing an
evidence base, by promoting the systematic and rigorous reporting of methods used in assetinformed
approaches to service-mapping.
Shishehgar, S, Gholizadeh, L, DiGiacomo, M, Green, A & Davidson, PM 2017, 'Health and socio-cultural experiences of refugee women: An integrative review', The Journal of Immigrant and Minority Health, vol. 19, no. 4, pp. 959-973.View/Download from: UTS OPUS or Publisher's site
Maneze, D, Everett, B, DiGiacomo, M, Davidson, PM & Salamonson, Y 2016, 'An examination of responses to surveys among Filipino-Australian migrants', Nurse Researcher, vol. 24, no. 2, pp. 30-33.View/Download from: UTS OPUS or Publisher's site
Davidson, PM, Glass, N & DiGiacomo, M 2016, 'Global Women's Health Issues: Sex and Gender Matter', Medical Journal of Australia, vol. 205, no. 8, pp. 346-348.View/Download from: UTS OPUS or Publisher's site
Although the terms 'sex' and 'gender' are commonly used as synonyms, they refer to two distinct concepts. Sex refers to the biological differences between men and women, whereas gender refers to socially defined roles, behaviours and expectations. Being clear about the distinction between the two terms is important, as the contribution to women's health of sex and gender are likely to be different, and therefore also our solutions for reducing disparities. Sex differences are increasingly recognised as being important for conditions such as cardiovascular disease,1 for example, and while physiological differences in coronary vasculature can contribute to different presentations and manifestations of disease, gender influences health behaviours, risks, and access to health services.2 We argue that taking gender into account, as well as sex, is critical to improving health outcomes.
Maneze, D, Salamonson, Y, Poudel, C, DiGiacomo, M, Everett, B & Davidson, PM 2016, 'Health-seeking behavior of Filipino migrants in Australia: The influence of persisting acculturative stress and depression', Journal of Immigrant and Minority Health, vol. 18, no. 4, pp. 779-786.View/Download from: UTS OPUS or Publisher's site
This study examined the relationships among the constructs of acculturative stress, depression, English language use, health literacy, and social support and the influence of these factors on health-seeking behaviors of Filipino Australians. Using a self-administered questionnaire, 552 respondents were recruited from November 2010 to June 2011. Structural equation modelling was used to examine relationships. A direct and negative relationship between health-seeking behaviors 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. Despite their long duration of stay, Filipino Australian migrants continue to experience acculturative stress and depression leading to lower health-seeking behaviors. This study highlights the importance of screening for acculturative stress and depression in migrants and fostering social support.
Sayers, JM, Salamonson, Y, DiGiacomo, M & Davidson, PM 2016, 'Validation of the professional practice environment scale in nurse educators in hospitals', Nurse Researcher, vol. 23, no. 4, pp. 14-18.View/Download from: UTS OPUS or Publisher's site
© 2016 RCNi Ltd. 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, SC, DiGiacomo, M, Newton, P, Noureddine, S, Macdonald, P, Davidson, PM & FAMILY Project Investigators 2016, 'Family-centred approaches to healthcare interventions in chronic diseases in adults: a quantitative systematic review.', Journal of Advanced Nursing, vol. 72, no. 5, pp. 968-979.View/Download from: UTS OPUS or Publisher's site
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.
Maneze, D, Everett, B, Kirby, S, DiGiacomo, M, Davidson, PM & Salamonson, Y 2016, ''I have only little English': language anxiety of Filipino migrants with chronic disease', Ethnicity and Health, vol. 21, no. 6, pp. 596-608.View/Download from: UTS OPUS or Publisher's site
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.
Abshire, M, Prichard, R, DiGiacomo, M, Cajita, M & Dennison Himmelfarb, C 2016, 'Adaptation and Coping in patients living with an LVAD: a metasynthesis', Heart and Lung: the journal of acute and critical care, vol. 45, no. 5, pp. 397-405.View/Download from: UTS OPUS or Publisher's site
To synthesize information supporting coping and adaptation of LVAD patients and to identify opportunities for future interventions.
Left Ventricular Assist Device (LVAD) patients demonstrate improvements in quality of life and functional status, but qualitative research has not been meaningfully integrated.
Qualitative meta-synthesis using Lazarus and Folkmans' Transactional Model of stress and coping.
Four distinct stages of adaptation were identified: Pre-LVAD, Implant Hospitalization, Early Home Adaptation and Late Home Adaptation. Each stage includes tasks in physical, psychological and social domains. Two themes emerged: 1) Primary Appraisal: Every stage is a new challenge and 2) Secondary Appraisal: Routines are achievable, emotions are more difficult.
Emotional challenges including fear and anxiety related to life-limiting illness and changed social roles need to be honestly addressed. Individuals living with LVAD achieve a sense of independence, enjoy social interactions and meaningful activities through addressing practical and emotional problems to facilitate coping.
Forber, J, DiGiacomo, M, Carter, B, Davidson, P, Phillips, J & Jackson, D 2016, 'In pursuit of an optimal model of undergraduate nurse clinical education: An integrative review', Nurse Education in Practice, vol. 21, pp. 83-92.View/Download from: UTS OPUS or Publisher's site
Clinical learning experiences are an essential part of nurse education programs. Numerous approaches to clinical education and student supervision exist. The aim of this integrative review was to explore how studies have compared or contrasted different models of undergraduate nurse clinical education. A search of eight databases was undertaken to identify peer-reviewed literature published between 2006 and 2015. Eighteen studies met the inclusion criteria. A diverse range of methodologies and data collection methods were represented, which primarily explored student experiences or perceptions. The main models of undergraduate nurse clinical education identified were: traditional or clinical facilitator model; the preceptorship or mentoring model; and the collaborative education unit model in addition to several novel alternatives. Various limitations and strengths were identified for each model with no single optimal model evident. Thematic synthesis identified four common elements across the models: the centrality of relationships; the need for consistency and continuity; the potential for variety of models; and the viability/sustainability of the model. The results indicate that effective implementation and key elements within a model may be more important than the overarching concept of any given model. Further research is warranted to achieve an agreed taxonomy and relate model elements to professional competence.
Wyllie, A, DiGiacomo, M, Phillips, J, Davidson, PM & Jackson, D 2016, 'Acknowledging attributes that enable the career academic nurse to thrive in the tertiary education sector: a qualitative systematic review', Nurse Education Today, vol. 45, pp. 212-218.View/Download from: UTS OPUS or Publisher's site
Murray-Parahi, P, DiGiacomo, M, Jackson, D & Davidson, PM 2016, 'New Graduate Registered Nurse Transition into Primary Health Care roles: An integrative literature review', Journal of Clinical Nursing, vol. 25, pp. 3084-3101.View/Download from: UTS OPUS or Publisher's site
Aims and objectives. To summarise the literature describing new graduate nursetransition to professional practice within the primary health care (PHC) setting.Background. There is a plethora of research literature spanning several decadesabout new graduate nurse transition in the acute care setting. Yet, the experiencesof new graduate nurse in the PHC setting is unremarkable particularly consider-ing the increasing demand for skilled health care workers and focus of healthreform to provide care where people work and live.Design. Electronic data bases, Academic Search Complete, EBSCO, Medline, Psy-cINFO, CINHAL, and ERIC were searched using a combination of terms andsynonyms arising from three key concepts which identify the phenomenon; 'tran-sition', 'new graduate registered nurse' and 'primary health care. An inclusivesearch strategy placed no limits on language or publication date.Results. Of the 50 articles located and examined for relevance; 40 were sourcedthrough databases and 10 from Google Scholar/Alerts and hand-searching refer-ences. None of the 19 articles retained for analysis addressed all key concepts.Conclusions. Some challenges of researching the professional transition of gradu-ate nurses in PHC settings included, an absence of deﬁnitive transition models, adearth of literature and deference to acute care research.Relevance to clinical practice. Nursing in PHC settings, particularly the client'shome is notably different to hospital settings because of higher levels of isolationand autonomy. Societal changes, health reform and subsequent demand for skilledworkers in PHC settings has caused health care providers to question the logicthat such roles are only for experienced nurses. Implications arise for educationand health service providers who desire to close the theory practice gap and miti-gate risk for all stakeholders when next generation nurses have limited opportuni-ties to experience PHC roles as undergraduates and newly graduated registered...
Sowole, O, Power, T, Jackson, D, Davidson, PM & DiGiacomo, M 2016, 'Resilience of African migrant women: an integrative review', Health Care for Women International, vol. 37, no. 9, pp. 946-963.View/Download from: UTS OPUS or Publisher's site
African migrant women represent a rapidly growing cohort of new arrivals in many countries. Many of these women demonstrate strength and resilience throughout the stressful migration process. In this integrative review, we explore the literature on African migrants' resilience using an ecological framework. Nine peer-reviewed journal articles and six grey literature documents were reviewed. Key internal and external factors in achieving resilience were identified, discussed, and diagrammatically represented using Bronfenbrenner's Ecological Framework under micro-, meso-, exo-, and macro-levels. Our findings show that the capacity for resilience demonstrated during migration could have implications for policy and practice.
Ferguson, C, DiGiacomo, M, Saliba, B, Green, J, Moorley, C, Wyllie, A & Jackson, D 2016, 'First year nursing students' experiences of social media during the transition to university: a focus group study.', Contemporary Nurse, vol. 52, no. 5, pp. 625-635.View/Download from: UTS OPUS or Publisher's site
Social media platforms such as Facebook allow users to connect with each other online. They are also used as tools for creating communities, which can then be utilised as a mean for supportive, professional and social learning.
This study aimed to explore first year Bachelor of Nursing student experiences with social media in supporting student transition and engagement into higher education.
Qualitative focus groups Methods: First year Bachelor of Nursing students were conveniently sampled for inclusion in this study. Ten students were included in three face-to-face focus groups which lasted between 45 minutes and one hour each. When it became apparent that no new information was emerging from focus groups, recruitment stopped. Sessions were audio-recorded and transcribed verbatim. Data were analysed using qualitative thematic content analysis.
Three key themes emerged from the data that illustrates the experiences of transition and engagement of first year student nurses using social media at university. These were; 1) Facilitating familiarity and collaboration at a safe distance; 2) Promoting independent learning by facilitating access to resources; and 3) Mitigating hazards of social media.
This study has demonstrated the importance of social media applications such as Facebook in supporting informal peer-peer learning and support, augmenting online and offline relationships, and building professional identity as a nurse. Students reported active increased use when assessments were due and while on clinical placement. Students found Facebook useful as an avenue to debrief and reflect, whilst on clinical placement, and as a tool to meet new friends and strengthen existing relationships. There is need for future research and evaluation of interventions that bridge the divide between traditional learning platforms such as Blackboard and social media platforms.
Green, A, Abbott, P, Delaney, P, Patradoon-Ho, P, Delaney, J, Davidson, PM & DiGiacomo, M 2016, 'Navigating the journey of Aboriginal childhood disability: a qualitative study of carers' interface with services', BMC health services research, vol. 16, no. 1, p. 680.View/Download from: UTS OPUS
BACKGROUND: The disadvantage experienced by Aboriginal and Torres Strait Islander children with a disability is well recognized. The long term consequences of failing to address disability on health, education and employment underlies the importance of early intervention. Caregivers experience a disproportionate burden and have challenges accessing services. The aim of this study was to describe the carer journey of accessing support and services.METHODS: We conducted in-depth semi-structured interviews with nineteen parents and carers of Aboriginal children aged 0-8 years. The children were patients at a child developmental clinic at a metropolitan area Aboriginal health service in Eastern Australia. Interpretive phenomenological analysis was applied to transcribed verbatim accounts.RESULTS: Four themes were developed using the 'journey' metaphor to describe the carer pathway of accessing support and services at the community, service and policy levels. Themes included 1) the need for increased signage within communities via community education, information and awareness, 2) wrong way signs, roundabouts and roadblocks encountered when accessing services, 3) alternate routes can facilitate the journey, and 4) incompatibility of inflexible bureaucratic road rules and lived realities.CONCLUSIONS: The challenges of caring for a child with a disability are indisputable and these can be compounded for people experiencing socio-economic disadvantage and marginalisation. Overcoming challenges to service access faced by carers of Aboriginal children with a disability will require investment in community, services and policy to tailor culturally appropriate models of care.
Green, A, Abbott, P, Delaney, P, Patradoon-Ho, P, Delaney, J, Davidson, PM & DiGiacomo, M 2016, 'Navigating the journey of Aboriginal childhood disability: a qualitative study of carers' interface with services', BMC Health Services Research, vol. 16, no. 1, pp. 1-11.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: The disadvantage experienced by Aboriginal and Torres Strait Islander children with a disability is well recognized. The long term consequences of failing to address disability on health, education and employment underlies the importance of early intervention. Caregivers experience a disproportionate burden and have challenges accessing services. The aim of this study was to describe the carer journey of accessing support and services. METHODS: We conducted in-depth semi-structured interviews with nineteen parents and carers of Aboriginal children aged 0-8 years. The children were patients at a child developmental clinic at a metropolitan area Aboriginal health service in Eastern Australia. Interpretive phenomenological analysis was applied to transcribed verbatim accounts. RESULTS: Four themes were developed using the 'journey' metaphor to describe the carer pathway of accessing support and services at the community, service and policy levels. Themes included 1) the need for increased signage within communities via community education, information and awareness, 2) wrong way signs, roundabouts and roadblocks encountered when accessing services, 3) alternate routes can facilitate the journey, and 4) incompatibility of inflexible bureaucratic road rules and lived realities. CONCLUSIONS: The challenges of caring for a child with a disability are indisputable and these can be compounded for people experiencing socio-economic disadvantage and marginalisation. Overcoming challenges to service access faced by carers of Aboriginal children with a disability will require investment in community, services and policy to tailor culturally appropriate models of care.
Sayers, J, Salamonson, Y, DiGiacomo, M & Davidson, PM 2015, 'Nurse educators in Australia: High job satisfaction despite role ambiguity', Journal of Nurse Education and Practice, vol. 5, no. 4, pp. 41-51.View/Download from: UTS OPUS or Publisher's site
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.
Maneze, D, DiGiacomo, M, Salamonson, Y, Descallar, J & Davidson, PM 2015, 'Facilitators and Barriers to Health-Seeking Behaviours among Filipino Migrants: Inductive Analysis to Inform Health Promotion', BioMed Research International.View/Download from: UTS OPUS or Publisher's site
Brown, N, Luckett, T, Davidson, PM & 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.View/Download from: UTS OPUS or Publisher's site
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.
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.View/Download from: UTS OPUS or Publisher's site
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.View/Download from: UTS OPUS or Publisher's site
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.
Cao, Y, DiGiacomo, M, Salamonson, Y, Li, Y, Huai, B & Davidson, PM 2015, 'Nurses' perceptions of their professional practice environment: a cross-sectional study.', Journal of Clinical Nursing, vol. 24, no. 23-24, pp. 3441-3448.View/Download from: UTS OPUS or Publisher's site
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 2·66-3·05. All subscales except work motivation (3·05, standard deviation: 0·44) scored less than 3·0. 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...
Shishehgar, S, Gholizadeh, L, DiGiacomo, M & Davidson, PM 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.View/Download from: UTS OPUS or Publisher's site
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.View/Download from: UTS OPUS or Publisher's site
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.
DiGiacomo, M, Lewis, J, Phillips, J, Nolan, M & Davidson, PM 2015, 'The business of death: a qualitative study of financial concerns of widowed older women', BMC Women's Health, vol. 15, pp. 1-10.View/Download from: UTS OPUS or Publisher's site
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.
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.
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.
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.
Forber, J, DiGiacomo, M, Davidson, PM, 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.View/Download from: UTS OPUS or Publisher's site
Approaches to clinical education are highly diverse and becoming increasingly complex to sustain in complex milieu
To identify the influences and challenges of providing nurse clinical education in the undergraduate setting and to illustrate emerging solutions.
A discursive exploration into the broad and varied body of evidence including peer reviewed and grey literature.
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.
DiGiacomo, M, Green, A, Rodrigues, E, Mulligan, K & Davidson, PM 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.View/Download from: UTS OPUS or Publisher's site
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.
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.
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.
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.
Inglis, SC, Du, H, Newton, PJ, DiGiacomo, M, Omari, A & Davidson, PM 2014, 'PT453 Disease Management Interventions For Improving Self-Management In Lower-Limb Peripheral Arterial Disease: A Cochrane Review', Global Heart, vol. 9, no. 1, pp. e262-e262.View/Download from: Publisher's site
Thompson, SC, Shahid, S, DiGiacomo, M, Pilkington, L & Davidson, PM 2014, 'Making progress: the role of Cancer Councils in Australia in Indigenous cancer control', BMC Public Health, vol. 14, no. 347, pp. 1-13.View/Download from: UTS OPUS or Publisher's site
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.
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.
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 knowled...
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.View/Download from: UTS OPUS or Publisher's site
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.
Lewis, J, DiGiacomo, M, Currow, DC & Davidson, PM 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, pp. 1-9.View/Download from: UTS OPUS or Publisher's site
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.
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.View/Download from: UTS OPUS
Al Abed, NA, Hickman, L, Jackson, DE, DiGiacomo, M & Davidson, PM 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.View/Download from: UTS OPUS
Green, A, DiGiacomo, M, Luckett, T, Abbott, P, Davidson, PM, 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.View/Download from: UTS OPUS or Publisher's site
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.
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.
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.
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...
Lewis, J, DiGiacomo, M, Luckett, T, Davidson, PM & 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.View/Download from: UTS OPUS or Publisher's site
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.View/Download from: UTS OPUS or Publisher's site
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, PM, Byles, JE & 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.View/Download from: UTS OPUS or Publisher's site
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, PM, Abbott, PA, 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.View/Download from: UTS OPUS or Publisher's site
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.
Davidson, PM, Jiwa, M, DiGiacomo, M, McGrath, S, Newton, PJ, Durey, A, Bessarab, D & Thompson, SC 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.View/Download from: UTS OPUS or Publisher's site
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.
DiGiacomo, M, Delaney, P, Abbott, P, Davidson, PM, 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.View/Download from: UTS OPUS or Publisher's site
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...
Davidson, P, DiGiacomo, M, Leslie, G, Soh, KL & Soh, KG 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.View/Download from: UTS OPUS or Publisher's site
Deek, HA, Abbott, P, Moore, L, Davison, J, Cameron, S, DiGiacomo, M, McGrath, S, Dharmendra, T & Davidson, PM 2013, '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.View/Download from: UTS OPUS or Publisher's site
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.
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.
DiGiacomo, M, Lewis, J, Nolan, MT, Phillips, J & Davidson, PM 2013, 'Health transitions in recently widowed older women: a mixed methods study', BMC Health Services Research, vol. 13, no. 143.View/Download from: UTS OPUS or Publisher's site
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
DiGiacomo, M, Lewis, J, Nolan, M, Phillips, JL & Davidson, PM 2013, 'Transitioning From Caregiving to Widowhood', Journal of Pain and Symptom Management, vol. 46, no. 6, pp. 817-825.View/Download from: UTS OPUS or Publisher's site
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.
Inglis, S, Du, H, Newton, P, DiGiacomo, M, Omari, A & Davidson, PM 2012, 'Disease management interventions for improving self-management in lower-limb peripheral arterial disease', Cochrane Database of Systematic Reviews, no. 3.View/Download from: UTS OPUS or Publisher's site
Davidson, PM, Mitchell, J, DiGiacomo, M, Inglis, S, Newton, PJ, Harman, J & Daly, J 2012, 'Cardiovascular disease in women: implications for improving health outcomes', Collegian, vol. 19, no. 1, pp. 5-13.View/Download from: UTS OPUS or Publisher's site
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, PM, Newton, PJ, 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.View/Download from: UTS OPUS or Publisher's site
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, PM, Meleis, A, McGrath, S, DiGiacomo, M, Dharmendra, T, Puzantian, HV, Song, M & Riegel, BJ 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.View/Download from: UTS OPUS or Publisher's site
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, PM 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.View/Download from: UTS OPUS or Publisher's site
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.
Everett, B, DiGiacomo, M, Rolley, JX, Salamonson, Y & Davidson, PM 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.View/Download from: UTS OPUS or Publisher's site
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, PM, 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.View/Download from: UTS OPUS or Publisher's site
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, JX, Smith, J, DiGiacomo, M, Salamonson, Y & Davidson, PM 2011, 'The caregiving role following percutaneous coronary intervention', Journal Of Clinical Nursing, vol. 20, no. 1-2, pp. 227-235.View/Download from: UTS OPUS or Publisher's site
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, PM 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.View/Download from: UTS OPUS or Publisher's site
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.
Chang, S, Gholizadeh, L, Salamonson, Y, DiGiacomo, M, Betihavas, V & Davidson, PM 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.View/Download from: UTS OPUS or Publisher's site
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, PM, Daly, J, Leung, D, Ang, E, Paull, G, DiGiacomo, M, Hancock, K, Cao, Y, Du, H & Thompson, DR 2011, 'Health-seeking beliefs of cardiovascular patients: A qualitative study', International Journal of Nursing Studies, vol. 48, no. 11, pp. 1367-1375.View/Download from: UTS OPUS or Publisher's site
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, PM, Zecchin, RP, 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.View/Download from: UTS OPUS or Publisher's site
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, PM 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.View/Download from: UTS OPUS or Publisher's site
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, PM, 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, EK 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.View/Download from: Publisher's site
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, PM, DiGiacomo, M, Thompson, SC, Abbott, PA, 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.View/Download from: UTS OPUS
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, PM 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.View/Download from: UTS OPUS
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, PM, Abbott, PA, Davison, J, Moore, L & Thompson, SC 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.View/Download from: UTS OPUS or Publisher's site
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.
Soh, KL, Davidson, PM, Leslie, G, DiGiacomo, M, Rolley, JX, 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.View/Download from: UTS OPUS or Publisher's site
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.
Davidson, PM, Jiwa, M, Goldsmith, AJ, McGrath, S, DiGiacomo, M, Phillips, JL, Agar, M, Newton, PJ & 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.View/Download from: UTS OPUS or Publisher's site
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.
Davidson, PM, 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.View/Download from: UTS OPUS or Publisher's site
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, JV, Taylor, K, Dimer, L, Ali, M, Wood, M, Leahy, TG & Davidson, PM 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.View/Download from: UTS OPUS or Publisher's site
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, TC, Song, R & Davidson, PM 2010, 'Exploring the Reasons for Adherence to Tai Chi Practice', Journal of Alternative & Complementary Medicine, vol. 16, no. 12, pp. 1245-1246.View/Download from: UTS OPUS or Publisher's site
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, PM, 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.View/Download from: UTS OPUS
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, PM 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.View/Download from: UTS OPUS
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, PM, 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.View/Download from: UTS OPUS or Publisher's site
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.
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, PM, 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.View/Download from: UTS OPUS or Publisher's site
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
Davidson, PM, Cao, Y, Digiacomo, M & Du, HY 2009, 'Chinese nurses' perceptions of heart health issues facing women in China: A focus group study', Journal of Cardiovascular Nursing, vol. 24, no. 6.View/Download from: Publisher's site
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. 2009 Lippincott Williams & Wilkins.
Thompson, S, DiGiacomo, M, Smith, J, Taylor, K, Dimer, L, Ali, M, Wood, M, Leahy, T & Davidson, PM 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.View/Download from: UTS OPUS
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, PM 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.View/Download from: UTS OPUS or Publisher's site
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, PM & 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.View/Download from: UTS OPUS or Publisher's site
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.
Davidson, PM, 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.View/Download from: UTS OPUS or Publisher's site
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.
Everett, B, Davidson, PM, 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.View/Download from: UTS OPUS or Publisher's site
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.
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, PM, 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.View/Download from: UTS OPUS or Publisher's site
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, PM, Salamonson, Y, Webster, J, Andrew, S, DiGiacomo, M, Gholizadeh, L, Newton, PJ & 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.View/Download from: UTS OPUS
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, PM 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.View/Download from: UTS OPUS or Publisher's site
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
Phillips, JL, Davidson, PM, Newton, PJ & 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.View/Download from: UTS OPUS or Publisher's site
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.
Parry, A, Worrall-Carter, L, Page, K, Kuhn, L, DiGiacomo, M & Davidson, PM 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.View/Download from: UTS OPUS
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, PM & 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.View/Download from: UTS OPUS or Publisher's site
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.
DiGiacomo, M, Davidson, PM, 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.View/Download from: UTS OPUS
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, PM, 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.View/Download from: UTS OPUS or Publisher's site
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, JL & Davidson, PM 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
Halcomb, E, Gholizadeh, L, DiGiacomo, M, Phillips, JL & Davidson, PM 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.View/Download from: UTS OPUS or Publisher's site
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.
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
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, BJ 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.
Davidson, PM, Beaman, A & DiGiacomo, M 2018, 'Case Study: A Chinese Immigrant Seeks Health Care in Australia' in Douglas, M, Pacquiao, D & Purnell, L (eds), Global Applications of Culturally Competent Health Care: Guidelines for Practice, Springer International Publishing, Germany, pp. 381-386.View/Download from: UTS OPUS or Publisher's site
The forces of globalization and migration have enriched diversity across the globe as well as intensified certain migration corridors (Czaika and Haas 2014). Australia is a diverse and culturally pluralistic society with people from a range of cultural, ethnic, linguistic, and religious backgrounds (Radermacher and Feldman 2017). Aboriginal and Torres Strait Islander people have inhabited Australia for tens of thousands of years and are the traditional owners of the land (Brown 2009). Most Australians are immigrants or the descendants of immigrants who arrived over the last two centuries from more than 200 countries. Mainland China continues to remain the biggest country from which immigrants come to Australia, and in recent years, it has overtaken the United Kingdom to become its largest source of immigrants.
DiGiacomo, M, Kochovska, S, Cahill, P, Virdun, C & Phillips, J 2018, 'Family-focused care span' in MacLeod, R & Van den Block, L (eds), Textbook of Palliative Care, Springer International Publishing AG, part of Springer Nature 2018.View/Download from: Publisher's site
A family-focused care approach in palliative
care recognizes the fundamental role of families
in contributing to the care of people with
life-limiting conditions. It is essential that
healthcare providers develop understanding
of families' needs and the skills to collaborate
effectively with families caring for people at
the end of their lives. This chapter introduces
the concept and components of family-focused
palliative care. It continues with a discussion
of what patients and families perceive to be
the most important aspects of end-of-life care.
This chapter provides information to assist
healthcare providers who work with people
with life-limiting conditions and their families
in providing family-focused care and to
identify gaps and challenges to providing
Ivynian, S, Newton, P & DiGiacomo, M 2018, 'Care-seeking decisions in patients with heart failure: a matter of identity and previous healthcare experience', European Society of Cardiology: Heart Failure 2018, Vienna.
Ivynian, S, Newton, P & DiGiacomo, M 2018, 'Patient preferences for HF information delivery and perceptions of patient-provider communication', European Society of Cardiology Heart Failure 2018, Vienna.
DiGiacomo, M, Lewis, J, Parker, D, Chang, S, Koirala, B & Phillips, J 2018, 'Healthy Ageing, Yet Unmet Need in Australian War Widows: A Sequential Mixed Methods Study', International Council of Women's Health Issues Congress, Hong Kong.
Wyllie, A, Levett-Jones, T, DiGiacomo, M & Davidson, P 2018, 'A REAL orientation: a program designed to give early career academic nurses career confidence', National Nurse Education Conference, Melbourne.
Murray-Parahi, P, DiGiacomo, M, Phillips, J, Jackson, D & Davidson, P 2018, 'Preparing next generation nurses for primary health care roles: the barriers and enablers of new graduate registered nurse professional transition', 7th International Nurse Education Conference, Banff, Canada.
Wyllie, A, Levett-Jones, T, Davidson, P & DiGiacomo, M 2018, 'P-ECAN - Designing a program to maximise career planning for early career academic nurses', 7th International Nurse Education Conference, Banff, Canada.
Ferguson, C, DiGiacomo, M, Saliba, B, Green, J, Moorley, C, Wyllie, A & Jackson, D 2018, 'First year nursing students' experiences of social media during the transition to university: a focus group study', 7th International Nurse Education Conference.
Rihari-Thomas, J, DiGiacomo, M, Phillips, J, Newton, P & Davidson, PM 2017, 'Physicians' and Nurses' Perspectives of a Rapid Response System in an Academic Health Centre: A Focus Group Study', 13th International Conference on Rapid Response Systems and Medical Emergency Teams, International Society for Rapid Response Systems (iSSRS), Chicago.
Luckett, T, Agar, M, DiGiacomo, M, Ferguson, C, Lam, L, Newton, P & Phillips, J 2017, 'Predictors of Health Status in South Australians Caring for People With Cancer: A Population-Based Study', ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, WILEY, pp. 163-163.
Green, A, Henry, V, Abbott, P, Delaney, P, Delaney, J, Patradoon-Ho, P, Davidson, PM & DiGiacomo, M 2017, 'Re-imagining the service landscape for Aboriginal children with a disability', 6th Annual NHMRC and Lowitja Institute Symposium on Research Translation, Brisbane.
Abbott, P, DiGiacomo, M, Magin, P, Davison, J, Watt, K & Hu, W 2016, 'Engaging Women in Prison in Qualitative Research', INTERNATIONAL JOURNAL OF QUALITATIVE METHODS, SAGE PUBLICATIONS INC.
Maneze, D, Ramjan, L, DiGiacomo, M & et al. 2016, 'Negotiating health and chronic illness in Filipino-Australians: A qualitative study with implications for health promotion', 15th World Congress on Public Health, Melbourne, Australia.
Shisheghar, S, Gholizadeh, L, Davidson, PM & DiGiacomo, M 2016, 'Coping strategies applied by Iranian asylum seeker women living in Sydney, Australia', 21st International Council on Women's Health Issues (ICOWHI) Congress, International Council on Women's Health Issues (ICOWHI) Congress, Baltimore, Maryland, USA.
Rao, A, DiGiacomo, M, Newton, P, Phillips, J, Davidson, PM & Hickman, L 2016, 'Meditation as a secondary prevention strategy for heart disease: a systematic review', Australian Cardiac Rehabilitation Association Conference, Adelaide.
Rao, A, Newton, P, DiGiacomo, M, Hickman, LD, Hwang, C & Davidson, PM 2016, 'Which gender specific cardiac rehabilitation models best reduce cardiovascular risk in women?', 21st International Council on Women's Health Issues (ICOWHI) Cogress. Scale and Sustainability: Moving Women's Health Issues Forward, Baltimore, Maryland, USA.View/Download from: UTS OPUS
Sowole, T, Power, T, Jackson, D, Davidson, PM & DiGiacomo, M 2016, 'West African women migrants in Australia: Implications for health care', African Studies Association of Australasia and the Pacific (AFSAAP) 2016 Conference, Perth, Australia.
Sowole, O, Power, T, Jackson, D, Davidson, P & DiGiacomo, M 2016, 'Overcoming trauma: West African migrant women's experiences of healing in Australia', 21st International Council on Women's Health Issues (ICOWHI) Congress, International Council on Women's Health Issues (ICOWHI) Congress, Baltimore, Maryland, USA.
Ferguson, C, DiGiacomo, M, Gholizadeh, L, Ferguson, L & Hickman, L 2016, 'The integration and evaluation of a social-media facilitated journal club to enhance the student learning experience of evidence-based practice: a case study', UTS Teaching and Learning Forum, Sydney.
DiGiacomo, M, Green, A & Abbott, P 2016, 'Mothers and grandmothers navigating caregiving in Aboriginal childhood disability', 21st International Council on Women's Health Issues (ICOWHI) Congress, International Council on Women's Health Issues (ICOWHI) Congress, Baltimore, Maryland, USA.
Green, A, DiGiacomo, M & Davidson, PM 2016, '"Just see what her needs are...get a picture of her world': the need for a gender-based approach to care of women with chronic conditions', 21st International Council on Women's Health Issues (ICOWHI) Congress, International Council on Women's Health Issues (ICOWHI) Congress, Baltimore, Maryland, USA.
Green, A, DiGiacomo, M & Davidson, PM 2016, 'Facilitating Women's Transitions in Later Life and Chronic Conditions', International Council on Women's Health Issues (ICOWHI) Congress, Baltimore, Maryland, USA.
Abbott, P, Magin, P, Davison, J, DiGiacomo, M, Watt, K & Hu, W 2015, 'Recruitment of people in prison to interview or focus group research', Qualitative Health Research (QHR) Conference, Toronto, Canada.
DiGiacomo, M, Shishehgar, S, Gholizadeh, L & Davidson, PM 2015, 'A review of health and socio-cultural experiences of displaced women', International Conference on Fostering Human Resilience, Las Vegas, Nevada, USA.View/Download from: UTS OPUS
DiGiacomo, M, Shishehgar, S, Gholizadeh, L & Davidson, PM 2015, 'Health and Socio-cultural Experiences of Refugee Women: An Integrative Review', Inaugural International Conference on Migration, Social disadvantage and Health, Melbourne.View/Download from: UTS OPUS
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.View/Download from: UTS OPUS or Publisher's site
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, SE, Hwang, C, McDonagh, J, Digiacomo, M, Inglis, SC & Newton, PJ 2015, 'Impact of multiple symptoms on quality of life and event-free survival in chronic heart failure', EUROPEAN HEART JOURNAL, Congress of the European-Society-of-Cardiology (ESC), OXFORD UNIV PRESS, London, ENGLAND, pp. 128-128.View/Download from: UTS OPUS
Forber, J, DiGiacomo, Davidson, PM, Carter, B & Jackson, D 2015, 'Undergraduate nurse clinical education: Visioning the future.', NET2015 – 26th International Networking for Healthcare Education Conference, Cambridge, UK.
DiGiacomo, M, Lewis, J, Phillips, J, Davidson, PM & Nolan, M 2015, 'The role of gender, administrative burden, and financial concerns in the transition to widowhood; a qualitative study', Australian Association of Gerontology, Alice Springs.
Green, A, DiGiacomo, M, Luckett, T, Abbott, P, Davidson, PM, Delaney, J & Delaney, P 2015, 'Cross-sector collaborations in Aboriginal and Torres Strait Islander childhood disability: a systematic integrative review', 2015 Primary Health Care Research Conference, Adelaide.
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.View/Download from: UTS OPUS or Publisher's site
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
DiGiacomo, M & Davidson, P 2013, 'Engagement, trust, and collaboration: critical elements in engaging Aboriginal communities', Building Mental Wealth: Improving mental health for better health outcomes among Indigenous Australians, NHMRC Capacity Building Grant in Population Health and Health Services Research Symposium, Perth, Australia.
Al Abed, N, Davidson, PM, 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.
DiGiacomo, M 2012, 'Improving women's cardiovascular health', International Council on Women's Health Issues (ICOWHI) Congress, Bangkok, Thailand.
Zecchin, R, Chai, Y, Lindsay, G, Hungerford, J, Baihn, J, Owen, M, Thelander, J, DiGiacomo, M, Davidson, P & Denniss, R 2012, 'What She Said – What We Said! One Woman's Misperceptions of Her Risk Factors for Heart Disease', Australian Cardiac Rehabilitation Association, Brisbane, Australia.
DiGiacomo, M, Davidson, PM, Lewis, J, Phillips, J & Nolan, M 2012, 'Early Widowhood in Older Women: A Time of Vulnerability and Health Stress', International Council on Women's Health Issues (ICOWHI) Congress, Bangkok.
DiGiacomo, M 2011, 'Building Mental Wealth: Improving mental health for better health outcomes among Indigenous Australians', NHMRC Capacity Building Grant in Population Health and Health Services Research Symposium, Perth, Australia.
DiGiacomo, M, Davison, J, Moore, L & et al. 2010, 'Partnerships improve smoking cessation and cardiovascular health', Cardiac Society of Australia and New Zealand, Adelaide, Australia.
Goldston, K, Davidson, P, Ferry, C, Keogh, L, Newton, P, DiGiacomo, M, Rolley, J & Hickie, I 2010, 'The collaborative methodology can assist in developing capacity for depression screening and management in cardiac rehabilitation', Australian Cardiac Rehabilitation Association, Canberra, Australia.
Goldston, K, Davidson, P, Ferry, C, Keogh, L, Newton, P, DiGiacomo, M, Rolley, J & Hickie, I 2010, 'Teams working together to improve screening for depression in cardiac rehabilitation', Australian Cardiac Rehabilitation Association, Canberra, Australia.
Cao, Y, Davidson, PM, 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, Davidson, P & Ingham, J 2009, 'Older women's experiences of widowhood in the first twelve months following bereavement', St. Vincent's and Mater Health Service 2009 Nursing Research Symposium, Sydney, Australia.
Lewis, J, DiGiacomo, M, Davidson, P & Currow, D 2009, 'Dying in the margins: access to palliative care services for people living in extreme poverty', Together! Cultural Connections for Quality Care at the End of Life, Palliative Care Australia, Perth, Australia.
Thompson, S, Smith, J, DiGiacomo, M & et al. 2009, 'Lessons from a West Australian statewide assessment of the implementation of the NHMRC recommendations for Strengthening Cardiac Rehabilitation and Secondary Prevention of Aboriginal and Torres Strait Islander People', Cardiac Society of Australia and New Zealand, Sydney, Australia.
Thompson, S, Smith, J, DiGiacomo, M & et al. 2009, 'Are the processes recommended by the NHMRC for improving cardiac rehabilitation for Aboriginal and Torres Strait Islander people being implemented? An assessment of CR services across Western Australia', National Heart Foundation Australia Conference, Brisbane, Australia.
DiGiacomo, M, Davison, J, Abbott, P & et al. 2009, 'Smoking Cessation at the Aboriginal Medical Service Western Sydney', Pacific Nursing Research Conference, Honolulu, Hawaii, USA.
DiGiacomo, M, Rolley, J, Smith, J & Davidson, PM 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.
Rolley, J, Smith, J, DiGiacomo, M & Davidson, P 1970, 'Carers tell their story: The experience following percutaneous coronary intervention', Australian Cardiac Rehabilitation Association, Alice Springs, Australia.
Davison, J, Abbott, P, DiGiacomo, M & et al. 1970, 'Stress Management and Smoking Cessation: the Aboriginal Medical Service Western Sydney Experience', Kimberley Aboriginal Medical Service Health Summit, Broome, Australia.
Daly, J, Davidson, P & DiGiacomo, M 1970, 'The Heart Awareness for Women Program: a strategy to decrease depression, anxiety and stress in women following an acute cardiac event', 20th Annual Pacific Nursing Research Conference, Honolulu, Hawaii, USA.
DiGiacomo, M, Adamson, B & Mahony, MJ 2004, 'Limitations in conducting cross-cultural research: Organisational behaviour examined', INTERNATIONAL JOURNAL OF PSYCHOLOGY, pp. 441-441.
DiGiacomo, M 2016, 'Think: Health, Women's Health Week Panel interview, The health needs of women throughout the life', 2SER.
DiGiacomo, M 2015, 'Think: Health, bereaved-women-shouldering-financial-burden', 2SER.
DiGiacomo, M 2015, 'Think: Health, smoking-rates-high-among-disadvantaged-communities', 2SER.
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.
DiGiacomo, M 2012, 'Ladykiller: the hidden danger to women's health', The Converstaion.
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.
- Aboriginal Medical Service Western Sydney
- Western Sydney University
- Johns Hopkins University