BackgroundRheumatic fever (RF) and rheumatic heart disease (RHD) cause considerable morbidity and mortality amongst Australian Aboriginal and Torres Strait Islander populations. Secondary antibiotic prophylaxis in the form of 4-weekly benzathine penicillin injections is the mainstay of control programs. Evidence suggests, however, that delivery rates of such prophylaxis are poor.MethodsThis qualitative study used semi-structured interviews with patients, parents/care givers and health professionals, to explore the enablers of and barriers to the uptake of secondary prophylaxis. Data from participant interviews (with 11 patients/carers and 11 health practitioners) conducted in four far north Queensland sites were analyzed using the method of constant comparative analysis.ResultsDeficits in registration and recall systems and pain attributed to injections were identified as barriers to secondary prophylaxis uptake. There were also varying perceptions regarding responsibility for ensuring injection delivery. Enablers of secondary prophylaxis uptake included positive patient-healthcare provider relationships, supporting patient autonomy, education of patients, care givers and healthcare providers, and community-based service delivery.ConclusionThe study findings provide insights that may facilitate enhancement of secondary prophylaxis delivery systems and thereby improve uptake of secondary prophylaxis for RF/RHD.

PurposeHealth systems around the world are struggling to meet the needs of aging populations and increasing numbers of clients with complex health conditions. Faced with multiple health system challenges, governments are advocating for team-based approaches to health care. Key descriptors used to describe health care teams include “interprofessional,” “multiprofessional,” “interdisciplinary,” and “multidisciplinary.” Until now there has been no review of the use of terminology relating to health care teams. The purpose of this integrative review is to provide a descriptive analysis of terminology used to describe health care teams.MethodsAn integrative review of the literature was conducted because it allows for the inclusion of literature related to studies using diverse methodologies. The authors searched the literature using the terms interprofessional, multiprofessional, interdisciplinary, and multidisciplinary combined with “health teams” and “health care teams.” Refining strategies included a requirement that journal articles define the term used to describe health care teams and include a list of health care team members. The literature selection process resulted in the inclusion of 17 journal articles in this review.Results:Multidisciplinary is more frequently used than other terminology to describe health care teams. The findings in this review relate to frequency of terminology usage, justifications for use of specific terminology, commonalities and patterns related to country of origin of research studies and health care areas, ways in which terminology is used, structure of team membership, and perspectives of definitions used.Conclusion:Stakeholders across the health care continuum share responsibility for developing and consistently using terminology that is both common and meaningful. Notwithstanding some congruence in terminology usage, this review highlights inconsistencies in the literature and suggests that broad debate among policy makers, clinicians, educators, researchers, and consumers is still required to reach useful consensus.

This article focuses on Corbin and Strauss’ evolved version of grounded theory. In the third edition of their seminal text, Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory, the authors present 16 assumptions that underpin their conception of grounded theory methodology. The assumptions stem from a symbolic interactionism perspective of social life, including the themes of meaning, action and interaction, self and perspectives. As research design incorporates both methodology and methods, the authors aim to expose the linkages between the 16 assumptions and essential grounded theory methods, highlighting the application of the latter in light of the former. Analyzing the links between symbolic interactionism and essential grounded theory methods provides novice researchers and researchers new to grounded theory with a foundation from which to design an evolved grounded theory research study.

Health care systems depend on viable health professional workforces. Nurse workforce projections for Australia indicate that by 2030 the demand for nurses will exceed supply. Retaining nurses is an ongoing problem both in Australia and globally. This study investigates nurse self-concept, practice environment and resilience, and how these three factors influence the retention of early career registered nurses (ECRNs). ECRNs are defined as RNs in the first 5 years of practice post-graduation. The researchers used a cross-sectional design for the study. Survey responses were elicited from 161 ECRNs in one Australian hospital and health service using four survey instruments: The Nurse Self-Concept Questionnaire, the Practice Environment Scale of the Nursing Work Index, the Connor–Davidson Resilience Scale and the Nurse Retention Index. Study findings demonstrate correlations between ECRN retention intentions and nurse self-concept, practice environment and resilience. The significance of these factors at different points during the first five years of practice emphasises the need for judicious and well-timed use of strategies to positively influence nurse retention. Longitudinal research investigating the significance of influencing factors over time would further contribute to our understanding of ECRN retention intentions.

BackgroundThe role of Australian general practice nurses (PNs) has developed exponentially since the introduction of service based funding in 2005. In particular, their role has expanded to include cervical screening and well women’s health care services provided under the supervision of a general practitioner (GP). While previous research identifies barriers to the provision of these services, this study sought to investigate enablers for nurse led care in this area.MethodsA number of grounded theory methods including constantly comparing data, concurrent data collection and analysis and theoretical sampling are utilised in this qualitative, exploratory study. A purposive sample of PNs who completed the required program of education in order to provide cervical screening and well women’s health care services was recruited to the study. Data is presented in categories, however a limitation of the study is that a fully integrated grounded theory was unable to be produced due to sampling constraints.ResultsFour enablers for the implementation of a change in the PN role to include cervical screening and well women’s health checks are identified in this study. These enablers are: GPs being willing to relinquish the role of cervical screener and well women’s health service provider; PNs being willing to expand their role to include cervical screening and well women’s health services; clients preferring a female practice nurse to meet their cervical screening and well women’s health needs; and the presence of a culture that fosters interprofessional teamwork. Seven strategies for successfully implementing change from the perspective of PNs are also constructed from the data. This study additionally highlights the lack of feedback on smear quality provided to PNs cervical screeners and well women’s health service providers.ConclusionsThe influence of consumers on the landscape of primary care service delivery in Australia is of particular note in this study. Developing interprofessional teams that maximise each health care provider’s role will be fundamental to comprehensive service delivery in the future.