Jo Wainer

Indigenous women's expectations of clinical care during treatment for a gynaecological cancer: rural and remote differences in expectations

OBJECTIVES To report on differences in Indigenous womens expectations of clinical care during treatment for a gynaecological cancer in rural and remote regions. DESIGN Qualitative interviews were conducted in New South Wales, Victoria, South Australia and the Northern Territory in 2008 with 37 clinicians working in gynaecological cancer and 24 women with a gynaecological cancer. Three of the participants were Indigenous women living in large rural towns (others were non-Indigenous), whereas six of the 37 clinicians interviewed worked closely with Indigenous women in remote settings. Indigenous women were contacted through an Indigenous researcher. Interviews were analysed for emerging themes, then compared with each other and with the research literature for similarities and differences. RESULTS There is considerable variation between clinician observations of the expectations of Indigenous women in remote regions, and the views of Aboriginal women in rural settings. CONCLUSION Indigenous women in rural settings have specific views about quality medical care. These include expectations of timely and culturally appropriate care, and strong ties to family and kin, but do not accord with other research findings that suggest Aboriginal women must receive care from same sex clinicians or that care is often delayed. The paper alerts practitioners to the fact that culturally appropriate care will vary from group to group, particularly between remote, rural and urban populations.

GP registrar well-being: a cross-sectional survey.

ObjectivesTo investigate the major stressors affecting GP registrars, how those at risk can be best identified and the most useful methods of managing or reducing their stress.Design, setting and participantsCross-sectional postal questionnaire of all GP registrars in one large regional training providers catchment area.Main outcome measuresThe Depression, Anxiety and Stress Scale (DASS), a specifically developed Registrar Stressor Scale consisting of five subscales of potential stressors, plus closed questions on how to identify and manage stress in GP registrars.ResultsSurvey response rate of 51% (102/199). Rural difficulties followed by achieving a work/life balance were the principal stressors. Ten percent of registrars were mildly or moderately depressed or anxious (DASS) and 7% mild to moderately anxious (DASS). Registrars preferred informal means of identifying those under stress (a buddy system and talks with their supervisors); similarly, they preferred to manage stress by discussions with family and friends, debriefing with peers and colleagues, or undertaking sport and leisure activities.ConclusionsThis study supports research which confirms that poor psychological well-being is an important issue for a significant minority of GP trainees. Regional training providers should ensure that they facilitate formal and informal strategies to identify those at risk and assist them to cope with their stress.

By women for women: Australia's national women's health policy

Australia is now in the sixth year of its National Womens Health Policy and Programme. It started when the womens movement broke the silence on womens experience and fuelled womens determination to do things for themselves as society was not providing what was needed. The knowledge base on womens health and the demands for change developed by womens health activists, taken up by a government with a strong social justice policy, led to a national consultation with Australian women in 1988 which lasted nearly two years. Groups and individuals representing more than a million women defined what they considered to be priority womens health issues: violence against women, reproductive health, mental health, occupational health, the health effects of sex role stereotyping, the health of carers, and the health of older women. A wide variety of services for women are now funded, including centres against sexual assault, health information, education and training programmes, and research and clinical services.