Chi-Wai Lui

What makes a community age-friendly: A review of international literature

This paper undertakes a comprehensive review of the growing international literature on age‐friendly communities. It examines a range of approaches and identifies the key attributes associated with creating a sustainable environment for seniors. The authors critically evaluate emerging policy trends and models and suggest directions for future research attention. The discussion provides important information and insights for the development of ageing policy and planning in Australia.

Veiled entrapment: A study of social isolation of older Chinese migrants in Brisbane, Queensland

ABSTRACT This paper presents the findings of a study of the support and service needs of older Chinese people in Brisbane, the capital city of Queensland, Australia. There were two specific objectives: to ascertain the problems encountered by older Chinese-Australians in their daily lives and social activities; and to develop policy and service development recommendations, with a view to mitigating their problems, meeting their unmet needs, improving their quality of life, and enhancing their participation in Australian society. The study used multiple methods, including a literature review, focus group meetings, and a community survey. The findings indicate that older Chinese people, and particularly women, experience significant restrictions in their activity patterns, social isolation and loneliness. Their lack of proficiency in the English language, and the difficulties they have in accessing language-support and interpretation services, limit their autonomous mobility and make them heavily dependent on their adult children, not least for transport. Their physical and psychological wellbeing is affected further by strained relations with their adult children, and these are compounded by financial concerns. The implications of the findings for welfare policy and practice are discussed at the end of the paper.

Contextualizing integration: a critical social science approach to integrative health care.

This article argues for the importance of examining the phenomenon of integrative health care in broader social and historical contexts. The authors examine mainstream approaches to identify patterns of integrative medicine and criticize them for their neglect of clashes among different philosophical paradigms and the wider social contexts that govern health care in practice. The authors outline a framework and highlight the values of a critical social science perspective in deepening our understanding of recent transformations in health care practice and issues surrounding biomedicine and complementary/alternative medicine (including chiropractic, naturopathy, massage, acupuncture/oriental medicine, etc) and traditional medicine. A critical social science perspective pays special attention to complex power relations, inclusionary/exclusionary strategies, and interprofessional dynamics in medicine. Drawing upon recent research findings, the authors illustrate how such a perspective reveals the intricacies and tensions that surround the integration of different paradigms of health care practice. The authors summarize the importance of situating integrative health care in structural contexts and affirm their commitment to a critical social science approach.

A comparison of complementary and alternative medicine users and use across geographical areas: A national survey of 1,427 women

BackgroundEvidence indicates that people who reside in non-urban areas have a higher use of complementary and alternative medicine (CAM) than people who reside in urban areas. However, there is sparse research on the reasons for such differences. This paper investigates the reasons for geographical differences in CAM use by comparing CAM users from four geographical areas (major cities, inner regional, outer region, rural/remote) across a range of health status, healthcare satisfaction, neighbourhood and community factors.MethodsA cross-sectional survey of 1,427 participants from the Australian Longitudinal Study on Womens Health (ALSWH) conducted in 2009.ResultsThe average total cost of consultations with CAM practitioners was

The Use of Complementary and Alternative Medicine During Pregnancy: A Longitudinal Study of Australian Women

416 per annum and was highest for women in the major cities, declining with increasing distance from capital cities/remoteness (p < 0.001). The average total cost of self-prescribed CAM was

The urban-rural divide in complementary and alternative medicine use: a longitudinal study of 10,638 women

349 per annum, but this did not significantly differ across geographical areas. The increased use of CAM in rural and remote areas appears to be influenced by poorer access to conventional medical care (p < 0.05) and a greater sense of community (p < 0.05) amongst these rural and remote residents. In contrast to the findings of previous research this study found that health status was not associated with the differences in CAM use between urban and non-urban areas.ConclusionIt appears that a number of factors influence the different levels of CAM use across the urban/non-urban divide. Further research is needed to help tease out and understand these factors. Such research will help support health care policy and practice with regards to this topic.

Complementary and alternative medicine use for headache and migraine: a critical review of the literature

BACKGROUND The use of complementary and alternative medicine is increasingly prevalent in contemporary Western societies. The objective of this study was to explore trends and patterns in complementary and alternative medicine practitioner consultations and the use of complementary and alternative medicine consumption before, during, and after pregnancy and between pregnancies. METHODS Analysis focused on data from 13,961 women from the younger cohort of the Australian Longitudinal Study on Womens Health collected between 1996 and 2006. Chi-square tests were employed for the cross-sectional analysis of categorical variables and t tests for continuous variables. Generalized estimating equations were used to conduct multivariate longitudinal analysis. RESULTS Complementary and alternative medicine use among pregnant and nonpregnant women continued to increase over the 10-year period. Although pregnancy status was not predictive of the use of alternative treatments, pregnant women employed these therapies or modalities for the relief of pregnancy-related complaints and symptoms. Analysis also revealed that women used complementary and alternative treatments selectively during pregnancy. CONCLUSIONS This study highlights the need for further research that is sensitive to the consumption of specific complementary and alternative therapies or modalities and to the wider contexts within which women perceive risk associated with their use of complementary and alternative treatments.

Current challenges and future directions for naturopathic medicine in Australia: a qualitative examination of perceptions and experiences from grassroots practice

BackgroundResearch has identified women in rural and remote areas as higher users of complementary and alternative medicine (CAM) practitioners than their urban counterparts. However, we currently know little about what influences womens CAM consumption across the urban/rural divide. This paper analyses 10,638 womens CAM use across urban and rural Australia.MethodsData for this research comes from Survey 5 of the Australian Longitudinal Study on Womens Health conducted in 2007. The participants were aged 56-61years. The health status and health service use of CAM users and non-users were compared using chi-square tests for categorical variables and t-tests for continuous variables.ResultsWomen who consulted a CAM practitioner varied significantly by place of residence: 28%, 32% and 30% for urban, rural and remote areas respectively (P < .005). CAM users tended to be more dissatisfied with conventional care than CAM non-users, but this was consistent across the 3 areas of residence. CAM users have higher percentages of most symptoms but the only rural/urban differences were for severe tiredness, night sweats, depression and anxiety. For diagnosed diseases, CAM users have higher percentages of most diagnoses but only hypertension and skin cancer were statistically significantly higher for rural and remote but not urban women (P < .005).ConclusionsIn contrast to some recent claims, our analysis suggests the lack of access to and/or patient dissatisfaction with conventional health practitioners may not play a central role in explaining higher use of CAM by women in rural and remote areas when compared to women in urban areas.

A qualitative study of naturopathy in rural practice: A focus upon naturopaths' experiences and perceptions of rural patients and demands for their services

Contexts.— An evidence base for complementary and alternative medicine (CAM) consumption within general populations is emerging. However, research data on CAM use for headache disorders remain poorly documented. This paper, constituting the first critical review of literature on this topic, provides a synopsis and evaluation of the research findings on CAM use among patients with headache and migraine.

Preventing social isolation in later life: findings and insights from a pilot Queensland intervention study

BackgroundNaturopaths are an increasingly significant part of the healthcare sector in Australia, yet despite their significant role there has been little research on this practitioner group. Currently the naturopathic profession in Australia is undergoing a period of rapid professional growth and change. However, to date most research exploring the perceptions of naturopaths has been descriptive in nature and has focused on those in leadership positions rather than grassroots practitioners. This article explores the perceptions and experiences of practising naturopaths on the challenges and future directions of their profession.MethodsSemi-structured interviews were conducted with 20 naturopaths practising in the Darling Downs region of South-east Queensland, Australia to explore current perceived challenges in the naturopathic profession in Australia.ResultsParticipants perceived a number of internal and external challenges relating to the profession of naturopathic medicine. These included a public misconception of the role of naturopathic medicine; the co-option of naturopathic medicine by untrained or unqualified practitioners; the devaluation of naturopathic philosophy as a core component of naturopathic practice; a pressure to move towards an evidence-based medicine model focused on product prescription; the increasing commercial interest infiltrating complementary medicine, and; division and fragmentation within the naturopathic profession. Naturopaths generally perceived government regulation as a solution for many of these challenges, though this may be representative of deeper frustrations and disconnections between the views of grassroots naturopaths and those in professional leadership positions.ConclusionsGrassroots naturopaths identify a number of challenges that may have significant impacts on the quality, effectiveness and safety of naturopathic care. Given the significant role naturopaths play in healthcare in Australia the practice and policy implications of these challenges require further research attention.