Nurses' experiences of practice and political reform in long-term aged care in Australia : implications for the retention of nursing personnel

Keywords gerontological nursing;health care reform;health policy;long-term care;recruitment and retention Aim  The aim of the study was to explore registered nurses’ experiences in long-term aged care in light of the political reform of aged care services in Australia. Background  In Australia, the aged care industry has undergone a lengthy period of political and structural reform. Despite reviews into various aspects of these reforms, there has been little consideration of the effect these are having on the practice experiences and retention of nursing staff in long-term care. Methods  In this critical hermeneutic study, 14 nurses from long-term care facilities in Australia were interviewed about their experiences during the reform period. Results  The data revealed a sense of tension and conflict between nurses’ traditional values, roles and responsibilities and those supported by the reforms. Nurses struggled to renegotiate both their practice roles and values as the reforms were implemented and the system evolved. Nursing management support was an important aspect in mediating the effect of reforms on nursing staff. Conclusion  This research highlights both the tensions experienced by nurses in long-term aged care in Australia and the need to renegotiate nursing roles, responsibilities and values within an evolving care system. This research supports a role for sensitive and proactive nursing management during periods of industry reform as a retention strategy for qualified nursing personnel.

Children's exposure to domestic violence in Australia

Children's 'witnessing' or exposure to domestic violence has been increasingly recognised as a form of child abuse, both in Australia and internationally. Although it is difficult to accurately assess the scope of the problem, research has demonstrated that a substantial amount of domestic violence is witnessed by children. As this paper outlines, witnessing domestic violence can involve a range of incidents, ranging from the child 'only' hearing the violence, to the child being forced to participate in the violence or being used as part of a violent incident. In this paper, current knowledge about the extent of children's exposure to domestic violence in Australia is described, along with the documented impacts that this exposure can have on children. This includes psychological and behavioural impacts, health and socioeconomic impacts, and its link to the intergenerational transmission of violence and re-victimisation. Current legislative and policy initiatives are then described and some community-based programs that have been introduced in Australia to address the problem of children's exposure to domestic violence are highlighted. The paper concludes that initiatives focused on early intervention and holistic approaches to preventing and responding to children's exposure to domestic violence should be considered as part of strategies developed to address this problem.

Aboriginality and the Northern Territory intervention

This thesis examines the construction of Aboriginality in recent public policy reasoning through identifying representations deployed by architects and supporters of the Commonwealth’s 2007 Northern Territory Emergency Response (the intervention). Debate about the Northern Territory intervention was explicitly situated in relation to a range of ideas about appropriate Government policy towards Indigenous people, and particularly about the nature, role, status, value and future of Aboriginality and of Aboriginal people and Torres Strait Islanders. This project involves analysis of constructions of Aboriginality deployed in texts created and circulated to explain and justify the policy program. The aim of the project is to identify the ideas about Aboriginality deployed by the intervention’s architects and supporters, and to examine the effects and implications of these discourses for political relationships between Indigenous people and settlers in Australia. This thesis will argue that advocates of the Northern Territory intervention construct Aboriginality in a range of important ways that reassert and reinforce the legitimacy of the settler colonial order and the project of Australian nationhood, and operate to limit Aboriginal claims. Specifically, it is argued that in linking Aboriginality to the abuse of Aboriginal children, the intervention’s advocates and supporters establish a political debate about the nature and future of Aboriginality within a discursive terrain in which the authority and perspectives of Indigenous people are problematised. Aboriginality is constructed in this process as both temporally and spatially separated from settler society, and in need of coercive integration into mainstream economic and political arrangements. Aboriginality is depicted by settler advocates of intervention as an anachronism, with Aboriginal people and cultures understood as primitive and/or savage precursors to settlers who are represented as modern and civilised. As such, the communities seen as the authentic home or location of Aboriginality represent a threat to Aboriginal children as well as to settlers. These constructions function to obscure the violence of the settler order, provide justification or moral rehabilitation for the colonising project, and reassert the sovereignty of the settler state. The resolution offered by the intervention’s advocates is a performance or enactment of settler sovereignty, representing a claim over and through both the territory of Aboriginal people and the discursive terrain of nationhood.

Community health workers' response to violence against women

This paper reports on a qualitative study of community health workers from a predominantly rural based region in Queensland. The purpose of this study was to determine the community health worker barriers to identification, assessment and intervention on the issue of violence against women. The qualitative research method comprised five structured focus group interviews with 28 community health workers using open-ended questions to explore their perceptions. Analysis of the focus group data revealed that community health workers expressed reluctance to become involved in cases of violence against women. The reasons they provided are grouped under three main themes: barriers to identification; barriers to assessment; and barriers to intervention. Training programs offered to rural community health workers need to be aware of the barriers to identifying, assessing and intervening in cases of violence against women that are highlighted by this study. Further studies are needed to assess the wider relevance of these findings to other groups of community health workers in rural and non-rural settings.

Factors influencing health professionals' response to victims of domestic violence

This thesis examined factors influencing health professional's response to victims of domestic violence in Vietnam. As this is the first time that this type of research has been conducted in Vietnam, it was expected that the results would contribute significantly to local knowledge and should add to global perspectives. Since it is the first questionnaire about this topic to be developed in Vietnam, the psychometric property of the questionnaire was primarily established, resulting in the questionnaire being recommended to use for further study. By explaining the factors that affect the intentions to respond of health workers, this project provides key data for authorities to design intervention strategies to improve the responses of health professionals to victims of domestic violence in Vietnam.

Redistribution and technology adoption under uncertainty : a political economy perspective

We examine the role of politico-economic influences on macroeconomic performance within the framework of an endogenous growth model with costly technology adoption and uncertainty. The model is aimed at understanding the diversity in growth and inequality experiences across countries. Agents adopt either of two risky technologies, one of which is only available through financial intermediaries, who are able to alleviate some of this risk. The entry cost of financial intermediation depends on the proportion of government revenue that is allocated towards cost-reducing financial development expenditure, and agents vote on this proportion. The results show that agents at the top and bottom ends of the distribution prefer alternative means of re-distribution, thereby effectively blocking the allocation of resources towards cost-reducing financial development expenditure. Thus political factors have a role in delaying financial and capital deepening and economic development. Furthermore, the model provides a political-economy perspective on the Kuznets curve; uncertainty interacts with the political economy mechanism to produce transitional inequality patterns that, depending on initial conditions, can unearth the Kuznets-curve experience. Finally, the political outcomes are inefficient relative to policies aimed at maximizing the collective welfare of agents in the economy.

Intimate relationship status variations in violence against women : urban, suburban, and rural differences

Woman abuse varies across intimate relationship categories (e.g., marriage, divorce, separation). However, it is unclear whether relationship status variations in violence against women differ across urban, suburban, and rural areas. We test the hypothesis that rural females, regardless of their intimate partner relationship status, are at higher risk of intimate violence than their urban and suburban counterparts. Results indicate that marital status is an important aspect of the relationship between intimate victimization and geographic area and that rural divorced and separated females are victimized at rates exceeding their urban counterparts.

Domestic violence and family law : recognition and appropriation

The battered women’s movement in the United States contributed to a sweeping change in the recognition of men’s violence against female intimate partners. Naming the problem and arguing in favour of its identification as a serious problem meriting a collective response were key aspects of this effort. Criminal and civil laws have been written and revised in an effort to answer calls to take such violence seriously. Scholars have devoted significant attention to the consequences of this reframing of violence, especially around the unintended outcomes of the incorporation of domestic violence into criminal justice regimes. Family law, however, has remained largely unexamined by criminologists. This paper calls for criminological attention to family law responses to domestic violence and provides directions for future research.

Intimate perceptions : exploring justice from the perspective of Australian survivors of Clergy Sexual Violence

The issue of child sexual abuse in Christian institutions has been persistent and politicalised across the world. Images and stories of abusive clergy, and their superiors who protect them, are common fodder for commercial and public media. In November 2012 the Australian Prime Minister announced a Royal Commission into child sexual abuse in Australian institutions. This came on the back of multiple calls such an inquiry. At this same time in Victoria, Australia, a Parliamentary Inquiry in the same issue was completing its process and preparing a report. This study draws on submissions made to the Victorian Parliamentary Inquiry and data from 15 ethnographic interviews with survivors of child sexual abuse in Christian institutions of Australia. The common themes of these sources are of betrayal, grief, a persistent search for justice and for recognition of the trauma rendered, not only to the lives of survivors but also to their families and communities. These are not new themes in the literature of child sexual abuse in Christian Institutions, however the perceptions of victimisation in the Australian context has only been explored in limited ways.

Rural masculinities and the internalisation of violence in agricultural communities

This article is based on research we conducted in two agricultural communities as part of a broader study that included mining communities in rural Australia. The data from the agricultural locations tell a different story to that of the mining communities. In the latter, alcohol-fuelled, male-on-male assaults in public places caused considerable anxiety among informants. By contrast, people in the agricultural communities seemed more troubled by hidden violent harms which were largely privatised and individualised, including self-harm, suicide, isolation and threats to men’s general wellbeing and mental health; domestic violence; and other forms of violence largely unreported and thus unacknowledged within the wider community (including sexual assault and bullying linked to homophobia). We argue one reason for the different pattern in the agricultural communities is the decline of pub(lic) masculinity, and with this, the increasing isolation of rural men and the increasing propensity to internalise violence. We argue that the relatively high rates of suicide in agricultural communities experiencing rural decline are symptomatic of the internalisation of violence.