Experiences of regional and rural people with cancer being treated with radiotherapy in a metropolitan centre

This paper explores the issues related to rural people with cancer whose choice of radiotherapy treatment necessitated travel and accommodation in a metropolitan centre. Semi-structured interviews with 46 participants, from the Toowoomba and Darling Downs region of Queensland, Australia, were conducted and the data thematically analysed. The specific themes identified were: being away from loved ones, maintaining responsibilities whilst undergoing treatment, emotional stress, burden on significant others, choice about radiotherapy as a treatment, travel and accommodation, and financial burden. This study supports the need for a radiotherapy centre in the location of Toowoomba as a way of providing some equity and access to such treatment for the rural people of Queensland.

Where in the world is room N101? Engaging with first year education students' experiences of transition

National reports on students’ experiences in their first year of tertiary study suggest that many students, particularly those coming directly from  secondary schools, find the transition into university life particularly difficult. These reports suggest that while many students find the experience to be a challenging hurdle others feel disengaged and unconnected to academic life. Reports also note that many students enter university with the expectation that their university experience should 'fit into their lives' rather than vice-versa.

Additionally, research indicates that successful transitional experiences for undergraduate students are critical in promoting effective learning habits, positive attitudes and openness to new knowledge. Establishing positive practices in the early days of the undergraduate course can enable students to utilise these experiences and knowledge as a part of their life-long professional habits. However, in order for this to occur, connections must be made, and relationships built, between students and their new peer groups and with the wider academic community. Connections must also be made between students' prior experiences and their new knowledge.

In light of the findings of recent research and reports, Deakin University has instituted a First Year Initiative to assist students in their transitions. Alongside and complementary to this, the Faculty of Education has developed a new three year Education Studies Major program which began this year.

In this paper, we discuss the ways in which the first two units of this new educational program aim to address some of the issues that students face when making the transition into university life. We see the implementation of the first two units as a 'pilot study' and while at this stage, evaluation of these units is only beginning, here we will consider some of the pedagogical strategies, resources, organisational structures and 'grounded' experiences that are being trialled as means to help students make the connections and take the first successful steps in their journey to becoming professional educators. Ways in which these new approaches aim to build important relationships between students, with staff and, as well, help them connect their prior experiences with new knowledge, will be considered in light of the literature on first year student transitions.

Discharge planning: from the acute sector for people over the age of 65

This paper reports the findings relating to discharge planning from a larger study (Hegney et al 2001) that aimed to investigate options to improve care co-ordination between the aged, community, acute and primary care sectors for the elderly residents of a large provincial town. The data, which were collected from a wide variety of aged care stakeholders in the region, are consistent with previous Australian studies. First, it appears that inappropriate discharge from acute hospitals occurs in Toowoomba because there is a perceived lack of information regarding the available community care options and a lack of suitable models to support people's care needs within their own homes. Second, inappropriate discharge practices from acute hospitals occur due to a lack of knowledge and communication on the part of health professionals employed in these settings with regard to the on- going health care needs of elderly people. Third, there is little discharge planning occurring that includes the general practitioner in post-discharge care. Finally, inappropriate discharge can also be attributed to the lack of sub-acute/step-down/rehabilitation options and long waiting lists for community home care services in the region.

Close, but still too far: the experience of Australian people with cancer commuting from a regional to a capital city for radiotherapy treatment

This paper reports the findings of a study undertaken in November 2001 on the experiences of 17 rural people from the regional city of Toowoomba who had been diagnosed with cancer and were required to travel to the capital city of Queensland (Brisbane) for radiotherapy. The interviews were tape recorded; the recordings were transcribed verbatim and analysed for emergent themes and subthemes, following verification by the participants that the transcription was a true record of their experience. The major themes that arose from the study were (1) the burden of travel; (2) the difficulties of living in accommodation that is not one's own home; (3) the financial burden caused by the need to relocate or travel to and from Brisbane; (4) the lack of closeness to family and friends; (5) and feelings of being a burden on others. The findings suggest that at a time of stress, an increasing burden is placed on cancer clients and their families if they are required to travel for radiotherapy. Health professionals who read the results of this study should be aware of the isolation of rural people who have to live in an unfamiliar environment at a time of great stress. Support mechanisms should be put into place in these referral centres to deal with these stressors.

The interface of acute and aged care: the role of the nurse in provincial area

Objective: This study was to investigate issues that arose from pre-admission to post-discharge, for people in Toowoomba, Queensland over the age of 65 admitted to an acute facility. This paper concentrates on a significant concern that emerged from the latge amount of data collected during this project, that is, the role of the nurse in the continuum of health care involving elderly people.

Method: The study involved a multi-site, multi-agency and multi-method (qualitative and quantitative) approach. Data was collected from regional service providers, the Department of Health and Aged Care (DHAC), the Australian Bureau of Statistics (ABS), Home and Community Care (HACC), the Aged Care Assessment Team (ACAT), elderly people who had been discharged from regional hospitals and their carers, residents of regional aged care facilities, area health professionals and elderly regional hospital inpatients.

Results: The data indicated that nurses in this provincial area currently play a limited role in preadmission planning, being mostly concerned with elective surgery, especially joint replacements. While nurses deliver the majority of care during hospitalisation, they do not appear to be cognizant of the needs of the elderly regarding post-acute discharge.

Conclusion: The recent introduction of the model of nurse case management in the acute sector appears to be a positive development that will streamline and optimise the health care of the elderly across the continuum in the Toowoomba area. The paper recommends some strategies, such as discharge liaison nurses based in Emergency Departments and the expansion of the nurse case management role, which would optimise care for the elderly person at the interface of care.