Paradoxes, contradictions, and dilemmas: Reflections on the contours of a pandemic and its implications for social work education.

Summary: This is a reflective and theoretical article that discusses the impact of COVID-19 on social work practice. The pandemic, which made its presence felt globally from early 2020, continues to have ongoing and significant consequences for lives, livelihoods, public health, and personal freedoms. We argue that, while its specific contours are yet to be comprehensively researched, let alone the final outcomes understood, the pandemic has presented opportunities to develop new ways of thinking about social work and social work education.

Guardianship patient characteristics and outcomes in geriatric social work practice: Australian context.

This study explored the patient characteristics and outcomes in relation to guardianship in a large-scale sub-acute Australian hospital. Fifteen patients who appointed a guardian at The Kingston Center, Monash Health, participated through exploratory data collection and analysis utilizing a de-identifiable template. The findings revealed both diverse and complex patient characteristics, and ethical dilemmas in patient outcomes for social workers.

Discordance between the perceptions of clinicians and families about end-of-life trajectories in hospitalized dementia patients.

Background: Due to the unpredictable dementia trajectory, it is challenging to recognize illness progression and the appropriateness of a palliative approach. Further confusion occurs during hospitalization where the presence of comorbid conditions complicates prognostication. This research examined clinicians and families' perceptions of dementia as a terminal condition in relation to end-of-life admissions.

Bereaved families' experiences of end-of-life decision making for general medicine patients.

Background: Family involvement in decision making for hospitalised patients is associated with improved end-of-life care. Yet, these discussions can be challenging for physicians and families and associated with distress, confusion and conflict. There is a need to understand how best to support families involved in decisions regarding the transition from active to palliative treatment in hospital settings.

Housing and Support Narratives of People Experiencing Mental Health Issues: Making My Place, My Home.

Choice, control, privacy, and security are widely reported housing preferences of mental health consumers, are associated with improved well-being and greater housing satisfaction, and are important for recovery. This paper describes housing and neighborhood experiences from a larger qualitative study that sought to learn with people experiencing mental health issues about their everyday lives in an Australian urban community. A participatory approach to health research informed this study.

Sitting with silence: hospital social work interventions for dying patients and their Families.

The recent controversy around the hospital end of life care has highlighted the vulnerability of dying patients and their families. However, little is known about how social workers provide support and intervention around the end of life in the hospital. Eight hospital social workers provided qualitative descriptions of their clinical practice for adult patients and their families.

Does the Theory of Planned Behaviour Explain Allied Health Professionals' Evidence-Based Practice Behaviours? A Focus Group Study.

Background: Research suggests that allied health professionals agree with evidence-based practice (EBP); however, implementation of research findings into clinical practice is poor. Interventions aimed at improving EBP have been largely unsuccessful. Implementation science research suggests that a theory-driven approach is critical when attempting to modify behaviour of healthcare professionals.

The relationship between discharge medications and falls in post-hospitalised older adults: A 6-month follow-up.

Objective: To identify discharge medications, especially psychotropic medications that are associated with falls, amongst older adults within 6 months following hospitalisation.

Methods: Negative binomial regression was used to examine relationships between discharge medications and falls in older post-hospitalised adults. Multiple regression that considered falls risk factors at discharge was performed.

How soon do allied health professionals lose confidence to perform EBP activities? A cross-sectional study.

Objective: To explore if there is a relationship between allied health professionals' confidence to perform a range of evidence-based practice (EBP) activities and the time since they graduated from their entry-level degree and the presence of postgraduate qualifications.

Design: Cross-sectional survey.

Setting: Allied health professionals from two Australian public metropolitan health services, including acute, subacute, and community settings.

Being pragmatic about healthcare complexity: our experiences applying complexity theory and pragmatism to health services research.

Background: The healthcare system has proved a challenging environment for innovation, especially in the area of health services management and research. This is often attributed to the complexity of the healthcare sector, characterized by intersecting biological, social and political systems spread across geographically disparate areas. To help make sense of this complexity, researchers are turning towards new methods and frameworks, including simulation modeling and complexity theory.

Systematic Review for the Quality of End-of-Life Care for Patients With Dementia in the Hospital Setting.

Background:: Patients with dementia may receive suboptimal end-of-life care in hospital settings reflecting broader debate around the palliative status of dementia syndromes.

Objectives:: To synthesize literature describing the quality of end-of-life care for patients with dementia dying in hospital.

Methods:: An integrative review assessed the quality of 26 articles concerning medical, nursing, and psychosocial care of patients with dementia dying in hospital settings.

Impact of disinvestment from weekend allied health services across acute medical and surgical wards: 2 stepped-wedge cluster randomised controlled trials.

Background: Disinvestment (removal, reduction, or reallocation) of routinely provided health services can be difficult when there is little published evidence examining whether the services are effective or not. Evidence is required to understand if removing these services produces outcomes that are inferior to keeping such services in place. However, organisational imperatives, such as budget cuts, may force healthcare providers to disinvest from these services before the required evidence becomes available.

New ways of seeing: Health social work leadership and research capacity building.

Building research capacity amongst social work practitioners is critically important for leaders in the social work profession. To reverse an apparent reluctance to use evidence and engage in research, strong social work leadership in practice organisations is needed. The literature on leadership in health social work is relatively silent regarding research capacity building as a leadership attribute but it is argued in this paper that leadership is crucial.

My Kite Will Fly: Improving Communication and Understanding in Young Children When a Mother Is Diagnosed with Life-Threatening Gynecological Cancer.

Study Aims: The My Kite Will Fly (MKWF) research program is built on the well-documented need for effective clinical communication tools and therapeutic interventions where a child's mother is diagnosed with life-threatening gynecological cancer.

Methods: The Dignity Model and Child-Centered approach were two key study foundations in this pilot cohort. Quantitative survey and qualitative semistructured methods were employed to gather data from patient families at three distinct phases: Diagnosis, Treatment, and Palliative care.

Health social workers sources of knowledge for decision making in practice.

This article presents findings from research examining knowledge social workers in a health network in Victoria, Australia identified as informing their decision-making. Data for 13 patients, and in-depth interviews with six social workers who worked with these patients, were studied. A thematic analysis of interviews revealed that participants identified reliance on past experience and contextual/situational information as underpinning their decisions, demonstrating their commitment to person-in-environment perspectives.

Social Isolation, Physical Capacity, and Physical Activity in Older Community-Dwelling Adults Post-Hospitalization.

This paper investigated the potential relationships between physical capacity and physical activity (recreational and household) with social isolation amongst older adults. Data for hospitalized Victorians (n = 311) were analyzed in univariable, multivariable and latent growth curve analyses over six months. Measures included items from the Friendship Scale, Lubben Social Network Scale (LSNS-6), Australian Survey of Disability, Ageing and Carers Household (SDAC), and Phone-FITT.

Understanding temporal relationships between depression, falls, and physical activity in a cohort of post-hospitalized older adults - a breakthrough or a conundrum?

Background: Clinical depression affects approximately 15% of community-dwelling older adults, of which half of these cases present in later life. Falls and depressive symptoms are thought to co-exist, while physical activity may protect an older adult from developing depressive symptoms. This study investigates the temporal relationships between depressive symptoms, falls, and participation in physical activities amongst older adults recently discharged following extended hospitalization.

What makes weekend allied health services effective and cost-effective (or not) in acute medical and surgical wards? Perceptions of medical, nursing, and allied health workers.

Background: There is strong public support for acute hospital services to move to genuine 7-day models, including access to multidisciplinary team assessment. This study aimed to identify factors that might enable an effective and cost-effective weekend allied health services on acute hospital wards.

Methods: This qualitative study included 22 focus groups within acute wards with a weekend allied health service and 11 telephone interviews with weekend service providers.

Music's Relevance for People Affected by Cancer: A Meta-Ethnography and Implications for Music Therapists.

Background: Evidence supports music-based oncologic support interventions including music therapy. By comparison, little is understood about music-based self-care. This meta-ethnography examined five published qualitative studies to extend understanding of music's relevance, including helpfulness, for people affected by cancer; including children, adolescents, and adults with cancer, carers, and the bereaved.

Study protocol for two randomized controlled trials examining the effectiveness and safety of current weekend allied health services and a new stakeholder-driven model for acute medical/surgical patients versus no weekend allied health services.

Background: Disinvestment from inefficient or ineffective health services is a growing priority for health care systems. Provision of allied health services over the weekend is now commonplace despite a relative paucity of evidence supporting their provision. The relatively high cost of providing this service combined with the paucity of evidence supporting its provision makes this a potential candidate for disinvestment so that resources consumed can be used in other areas.

Anxiety and Depression during Transition from Hospital to Community in Older Adults: Concepts of a Study to Explain Late Age Onset Depression.

The transition between extended hospitalization and discharge home to community-living contexts for older adults is a critical time period. This transition can have an impact on the health outcomes of older adults such as increasing the risk for health outcomes like falls, functional decline and depression and anxiety. The aim of this work is to identify and understand why older adults experience symptoms of depression and anxiety post-discharge and what factors are associated with this.

Investigation of older adults' participation in exercises following completion of a state-wide survey targeting evidence-based falls prevention strategies.

This paper examines whether involvement in an observational study may prompt participants to change their exercise behaviors. Data were collected from 394 older community dwellers in Victoria, Australia using a baseline survey, and 245 of these participated in a follow-up survey one year later. Survey domains were drawn from constructs of relevant health behavior models.

Sound continuing bonds with the deceased: the relevance of music, including preloss music therapy, for eight bereaved caregivers.

This study examines music's relevance, including preloss music therapy, for 8 informal caregivers of people who died from cancer. The design was informed by constructivist grounded theory and included semistructured interviews. Bereaved caregivers were supported or occasionally challenged as their musical lives enabled a connection with the deceased.

"A quiet still voice that just touches": music's relevance for adults living with life-threatening cancer diagnoses.

Purpose: Music has historically aided health and loss-adaptation, however, cancer patients' experience of music for self-care is not well understood. This study examines adult cancer patients' views about music's role before and after diagnosis.

Methods: Constructivist approach, with grounded theory informed design using convenience, snowball and theoretical sampling.

A novel research design can aid disinvestment from existing health technologies with uncertain effectiveness, cost-effectiveness, and/or safety.

Objectives: Disinvestment is critical for ensuring the long-term sustainability of health-care services. Key barriers to disinvestment are heterogeneity between research and clinical settings, absence of evidence of effectiveness of some health technologies, and exposure of patients and organizations to risks and poor outcomes. We aimed to develop a feasible research design that can evaluate disinvestment in health technologies of uncertain effectiveness or cost-effectiveness.