Translating facilitated multimodal online learning into effective person-centred practice for the person living with dementia among health care staff in Australia: an observational study.

BACKGROUND: This paper aims to identify whether health care staff perceive a 12-week online facilitated, multimodal, person-centred care, dementia education program influences their knowledge, skills, behaviour and practice improvement activities in dementia care. In particular it will examine a dementia education program 'Positive Approach to Care of the Older Person with Dementia' (The Program). METHODS: Three clusters of online questions were developed. Participants completed the first cluster at course completion (N = 1455;2013-2016). The second cluster was added into the 2015-2016 exit-surveys to measure clinical practice improvement (CPI) activities implementation (N = 520). Thirdly, all participants were invited to a 2018 follow-up survey (N = 343). The Program was also matched with key factors that are likely to result in effective online dementia education programs. RESULTS: The Program had a 78% completion rate. At course completion (2013-2016, N = 1455), 62% felt that the online forums generated useful discussion and 92% thought their work would support implementing their new knowledge and skills. In 2015-16, participants (N = 520) reported that The Program had influenced their practice in terms of new knowledge (87%), understanding (87%), awareness (88%), and new ideas about delivering dementia care (80%). Almost all (95%) participants indicated they had changed 'an aspect of their own professional practice'. Sixty-three percent had planned to develop a CPI activity. Of those (N = 310), 40% developed a new or improved tool and 21% planned to deliver education or create new resources. The most common CPI activities reported in the 2018 follow-up survey (N = 343) included education (49%) and role modelling of new behaviour (47%). Additionally, 75% indicated their CPI influenced their practice and had influenced patients (53%) and colleagues (53%). Fifty-seven percent reported their projects were sustained for 12 months or more. CONCLUSION: The Positive Approach to Care of the Older Person with Dementia education program can potentially improve training the dementia workforce. Participants perceived that a multimodal online platform facilitated by clinical champions influences knowledge transfer, skills and behaviour, encourages workplace CPI activities. Further effort could be directed towards empowering and supporting care staff on system, procedure and practice change and engaging management to translate training activities into practice.

Publish or perish: strategies to help rural early career researchers increase publication output.

INTRODUCTION: Researchers are challenged to publish or perish. A range of barriers to writing can result in sub-optimal productivity, particularly for early career researchers. Researchers in rural areas may face additional challenges of distance and limited access to colleagues. Implementing strategies to address some of these obstacles was identified as a priority for a group of early career, rural researchers. METHODS: In late 2010, the Wiljo-Piri Writing Group was established, embarking on fortnightly lunch-time meetings for support, networking and the public setting of writing goals; and arranging pairing of 'writing buddies' committed to writing daily, with contact before and/or after each writing session to provide motivation and accountability. Key measures for improvement were publication output (publications per person per year (PPY)) and perceptions of effectiveness of strategies. RESULTS: Publication output varied between individuals and over time; overall PPY rates improved from 0.5 to 1.25. 'Buddy writing' helped facilitate adherence to routine writing sessions and was associated with perceptions of increased creativity, efficiency, confidence and ability to focus. CONCLUSIONS: Structured peer support can be a powerful tool to create and maintain regular writing practices and increase publication output. 'Buddy writing' is applicable to any research or academic setting, and helps maintain commitment to daily writing sessions. Furthermore, such interventions can provide peer support for those working in rural settings, helping to address issues such as geographical and professional isolation. Suggested key steps in establishing structured peer support are provided.

Factors influencing early retirement intentions in Australian rural general practitioners.

BACKGROUND: The Australian general practice workforce is ageing. This and a trend towards higher exit intentions and earlier retirement make it increasingly important to identify those work and personal factors affecting intention to leave, which are amenable to change. AIMS: To assess the various work, occupational and individual health factors associated with early retirement intentions among Australian rural general practitioners (GPs) that may be amenable to intervention. METHODS: A cross-sectional study of GPs practising in rural Australia. Odds ratios of early retirement intentions across work, occupational and individual health factors were calculated. RESULTS: There were 92 participants (response rate 56%), and 47% of responders intended to retire before 65. GPs with medium to high burnout levels had higher odds of intending to retire. Increased job satisfaction and work ability scores were associated with decreased retirement intentions, whereas increased physical and mental work ability demands were associated with an increase in retirement intentions. Absenteeism was not related to retirement intentions but presenteeism was. GPs reporting any work-related sleep problems were found to have a 3-fold increase in the odds of early retirement intentions. The odds of early retirement intentions also increased with higher psychological distress, worsening general health and longer working hours. CONCLUSIONS: From a health policy reform perspective, the greatest impact on reducing early retirement intentions among ageing GPs could potentially be made by intervening in areas of working hours, burnout and work-related sleep issues, followed by job satisfaction, psychological distress, health, general workability and mental and physical work ability.

Partial and complete retirement due to ill-health among mature age Australians.

OBJECTIVES: An ageing population requires governments to keep older people working longer and delay early retirement. This paper investigates the extent to which common health problems and geographical location are associated with full and partial early retirement among mature-age Australians. STUDY DESIGN: Cross sectional. METHODS: Multinomial logistic regression analysis of self-reported data of 21,719 women and 16,393 men from the 45 and Up Study. OUTCOME MEASURE: retirement status. RESULTS: Women who reported ever having been told by a doctor that they had a stroke, cancer (except melanoma and skin and breast cancer), osteoarthritis, depression, osteoporosis, thrombosis, or anxiety were more likely to be fully retired due to ill-health compared to those without these health problems. Those who reported ever having been told by a doctor that they had depression, breast cancer or osteoarthritis were more likely to be partially retired due to ill-health than those without these health problems. Men who reported ever having been told by a doctor that they had cancer, heart disease, anxiety or depression were more likely to be fullyorpartially retired due to ill-health than those without these health problems. Men who reported having had a stroke, diabetes, thyroid problems, osteoarthritis or osteoporosis were more likely to be fully retired due to ill-health compared to those without these health problems. Men and women living outside major cities were more likely to be fully retired due to ill-health. Men from outer regional areas were also more likely to be partially retired due to ill-health. CONCLUSIONS: To reduce early retirement due to ill-health, health practitioners, governments and employers should address targeted health problems, particularly in areas outside capital cities.