A narrative synthesis of the impact of primary health care delivery models for refugees in resettlement countries on access, quality and coordination.

Introduction: Refugees have many complex health care needs which should be addressed by the primary health care services, both on their arrival in resettlement countries and in their transition to long-term care. The aim of this narrative synthesis is to identify the components of primary health care service delivery models for such populations which have been effective in improving access, quality and coordination of care.

Methods: A systematic review of the literature, including published systematic reviews, was undertaken.

Exploring culture-specific differences in beliefs about causes, kinship and the heritability of major depressive disorder: the views of Anglo-Celtic and Chinese-Australians.

The aim of this study was to explore cultural differences in causal attributions and beliefs about heritability of major depressive disorder (MDD). Face-to-face interviews with Anglo-Celtic- and Chinese-Australians community members with a family history of MDD were conducted and subjected to a rigorous qualitative analysis, using the computer software NVivo. Sixteen Anglo-Celtic-Australians and 16 Chinese-Australians were interviewed.

The impact of a brief lifestyle intervention delivered by generalist community nurses (CN SNAP trial).

Background: The risk factors for chronic disease, smoking, poor nutrition, hazardous alcohol consumption, physical inactivity and weight (SNAPW) are common in primary health care (PHC) affording opportunity for preventive interventions. Community nurses are an important component of PHC in Australia. However there has been little research evaluating the effectiveness of lifestyle interventions in routine community nursing practice.

The impact of a team-based intervention on the lifestyle risk factor management practices of community nurses: outcomes of the community nursing SNAP trial.

Background: Lifestyle risk factors like smoking, nutrition, alcohol consumption, and physical inactivity (SNAP) are the main behavioural risk factors for chronic disease. Primary health care is an appropriate setting to address these risk factors in individuals. Generalist community health nurses (GCHNs) are uniquely placed to provide lifestyle interventions as they see clients in their homes over a period of time.

Clients' experience of brief lifestyle interventions by community nurses.

Lifestyle modification interventions in primary health care settings are an important means of addressing lifestyle risk factors. An essential factor for the success of lifestyle advice is the client's acceptance. Lifestyle interventions offered in general practice are well accepted by clients.

Is there scope for community health nurses to address lifestyle risk factors? the community nursing SNAP trial.

Background: This paper examines the opportunity and need for lifestyle interventions for patients attending generalist community nursing services in Australia. This will help determine the scope for risk factor management within community health care by generalist community nurses (GCNs).

Methods: This was a quasi-experimental study conducted in four generalist community nursing services in NSW, Australia.

Satisfaction with referral relationships between general practice and allied health professionals in Australian primary health care.

Chronic diseases require a multidisciplinary approach to provide patients with optimal care in general practice. This often involves general practitioners (GPs) referring their patients to allied health professionals (AHPs). The Team-link study explored the impact of an intervention to enhance working relationships between GPs and AHPs in general practice regarding the management of two chronic diseases: diabetes and ischaemic heart disease (IHD) or hypertension.

Patient and practice characteristics predict the frequency of general practice multidisciplinary referrals of patients with chronic diseases: a multilevel study.

Objectives: Chronic diseases require a multidisciplinary approach to provide optimal patient care in general practice. In Australian general practice, this usually involves referral to an allied health provider outside the practice. This study explored the patient and practice factors associated with referral of patients with diabetes, ischaemic heart disease (IHD) or hypertension to external allied health providers (AHPs).

Finding common ground? Evaluating an intervention to improve teamwork among primary health-care professionals.

Objective: Multidisciplinary care has been shown as the most effective option for chronic disease. The aim of the Team-link study was to assess the effectiveness of an intervention to improve teamwork among general practitioners (GPs), practice staff and allied health professionals (AHPs). This paper describes changes to teamwork using qualitative data collected in the study.

Development and early experience from an intervention to facilitate teamwork between general practices and allied health providers: the Team-link study.

Background: This paper describes the development and implementation of an intervention to facilitate teamwork between general practice and outside allied and community health services and providers.

Methods: A review of organizational theory and a qualitative study of 9 practices was used to design an intervention which was applied in four Divisions of General Practice and 26 urban practices. Clinical record review and qualitative interviews with participants were used to determine the key lessons from its implementation.

An efficacy trial of brief lifestyle intervention delivered by generalist community nurses (CN SNAP trial).

Background: Lifestyle risk factors, in particular smoking, nutrition, alcohol consumption and physical inactivity (SNAP) are the main behavioural risk factors for chronic disease. Primary health care (PHC) has been shown to be an effective setting to address lifestyle risk factors at the individual level. However much of the focus of research to date has been in general practice.

Lower rates of depression in westernised Chinese in the US.

Background: Low reported rates of depression in Chinese populations could reflect real or artefactual factors, and might be clarified by studying acculturated Chinese in western regions. We therefore sought to determine whether reported rates of depressive disorders differ in resident Chinese and matched non-Chinese controls in a large US community survey.

Method: We accessed data from the US National Epidemiological Survey of Alcoholism and Related Conditions, involving 306 Chinese subjects and 306 matched non-Chinese subjects.

Cross-cultural validation of the DMI-10 measure of state depression: the development of a Chinese language version.

Depression measurement tools in cross-cultural research require careful design and thorough validation to ensure that cognitive concepts in one culture can be appropriately translated and applied to a differing culture. The aim of this study was to validate the Chinese version of a screening measure of state depression, the 10-item Depression in Medically Ill (DMI-10), and we report three interdependent studies. An initial bilingual test-retest study identified four (of the 10) items as having poor cross-cultural validity.

Depression and help-seeking in a western sample of 'highly acculturated' Chinese and controls.

Background: It is commonly reported that "the Chinese" have low rates of depression, partially reflecting a greater tendency to somatize and to be less likely to seek help.

Objective: To examine the impact of acculturation on depression reporting and help-seeking patterns.

Method: We compared 50 highly acculturated Chinese with age and gender-matched non-Chinese control subjects in a western region on measures of state and lifetime depression, attributional interpretation of somatic cues and help-seeking.

Recognition of depressive symptoms by Chinese subjects: the influence of acculturation and depressive experience.

Background: We have previously found that the level of acculturation in Chinese subjects influences reporting of depression. It is not clear to what extent such differences in reporting are a consequence of differences in the recognition of depressive symptoms. This study examined the influence of acculturation and personal depressive experience on recognition of depressive symptoms in a sample of Chinese subjects and controls in a western region.

Depression in the Chinese: the impact of acculturation.

Background: Studies of depression in the Chinese have long identified low rates and a greater likelihood of somatization, findings which could reflect cultural influences or real differences. We report a study from a western region examining the impact of acculturation on depression to clarify the role of cultural factors.

Method: In a Sydney-based study, Chinese subjects (n = 385) and a matched control group of 143 non-Chinese subjects completed either a Chinese or English questionnaire assessing state and lifetime depression, attributional style, depression recognition and help-seeking.

Some recommendations to assess depression in Chinese people in Australasia.

Objective: To provide some general recommendations for psychiatric assessment of depression among Chinese patients within a predominately Western society.

Method: A literature review is provided with interpretive comments.

Results: The prevalence of depression reported in community studies undertaken in Chinese communities is very low.