Julie Henderson

Older people have lived their lives': First year nursing students' attitudes towards older people

A survey was conducted with 262 commencing nursing students at a South Australian university, during a compulsory orientation week lecture prior to the first week of their nursing degree, to determine their attitudes towards older people and to working with older people. The survey provides baseline data to evaluate the efficacy of the Partnerships in Aged Care (PACE) Action Research project. The focus of which is developing aged care curriculum and placements with aged care industry partners. The survey will be replicated when this cohort completes their nursing degree. The results of this initial survey show that while commencing students generally have positive attitudes towards older people they do not aspire to work with them. The reasons cited for a lack of interest in working with older people include: poor experiences of providing care for older people; an inability to relate to or communicate with older people and a perception that the work is depressing and boring. Underpinning a negative perception of working with older people is the association of ageing with disability. Ageing for this cohort, is associated with loss of mental and physical function; loss of independence and increasing reliance on others to meet self care needs. This is viewed as evidence of a biomedical view of ageing. Contrary to previous research, many students studied in this project, who have had experience of working with older people demonstrate more positive attitudes to older people and are less likely to express stereotypical attitudes towards ageing suggesting that positive exposure to older people can challenge ageist views. The PACE project seeks to demonstrate that strategies which may promote a positive attitude to ageing such as development of educational content which promotes a quality of life rather than a biomedical approach to ageing and supported clinical placements can impact positively on nursing students perception of ageing and of working with older people.

Neoliberalism, community care and Australian mental health policy

Abstract This paper examines key documents from the Australian National Mental Health Strategy and explores the extent to which they reflect neo-liberal ideals. It argues, through discourse analysis of policy documents, that the families of the mentally ill have been reconstructed as a key source of informal care. The development of ‘community care’ and ‘informal care’ in Australian policy documents reflect a neo-liberal understanding of the individual and their family, one that views the family as an autonomous unit responsible for its own maintenance. This orientation creates a moral imperative upon the families of the mentally ill to adopt a caring role, conversely allowing for increasing regulation of the family by professional carers through the creation of formal mechanisms for carer involvement in provision of mental health services and the codification of carers’ rights and responsibilities in the Mental Health Statement of Rights and Responsibilities.

How do South Australian consumers negotiate and respond to information in the media about food and nutrition? The importance of risk, trust and uncertainty

The amount of information in the media about food and nutrition is increasing. As part of the risk society, consumers have a moral imperative to synthesize this information in order to manage their diet. This article explores how media information about food affects how consumers place trust in the food system and strategies adopted to manage conflicting nutritional information. Qualitative interviews were undertaken with 47 shoppers drawn from higher and lower socio-economic metropolitan and rural locations. There was an overriding trust in the Australian food system; however, participants talked about the impact of the large amounts of complex, confusing and often contradictory information. For some, this led to an active search for ‘truth’. For others it created uncertainty and anxiety, and for others a sense of paralysis or stasis. The findings are explored in relation to the production and consumption of risks in late modernity and the interrelationship between trust and risk.

Trust in the Australian food supply: Innocent until proven guilty

International research demonstrates diminishing trust in the food supply associated with food scares which undermine trust in expert advice. Even though Australia has not experienced major food scares, there is evidence of diminishing trust in the food supply. Interviews were conducted with 47 South Australian food shoppers from high (n = 17) and low (n = 16) socio-economic regions of Adelaide and from rural South Australia (n = 14) about food governance and trust in the Australian food supply. Participants display a high level of trust in the food supply associated with a perception that Australian food is safe; a lack of exposure to food risks; and trust in personal food safety practices. The media was the only factor which created distrust in the food system. Other participants express confidence in the food supply where confidence is understood as a lack of reflection. Contrary to concepts of reflexive modernisation which presume an increasing awareness of risk and placement of trust as a means of reducing uncertainly, participants adopt an ‘innocent until proven guilty’ approach displaying little knowledge or interest in knowing about food regulation relying instead on routine food safety practices as a means of managing uncertainty.

Social barriers to Type 2 diabetes self‐management: the role of capital

Approaches to self-management traditionally focus upon individual capacity to make behavioural change. In this paper, we use Bourdieus concepts of habitus and capital to demonstrate the impact of structural inequalities upon chronic illness self-management through exploring findings from 28 semi-structured interviews conducted with people from a lower socioeconomic region of Adelaide, South Australia who have type 2 diabetes. The data suggests that access to capital is a significant barrier to type 2 diabetes self-management. While many participants described having sufficient cultural capital to access and assess health information, they often lacked economic capital and social capital in the form of support networks who promote health. Participants were often involved in social networks in which activities which are contrary to self-management have symbolic value. As a consequence, they entered relationships with health professionals at a disadvantage. We conclude that structural barriers to self-management arising from habitus resulting in the performance of health behaviours rooted in cultural and class background and limited access to capital in the form of economic resources, social networks, health knowledge and prestige may have a negative impact on capacity for type 2 diabetes self-management.

Gerontological Education in Undergraduate Nursing Programs: An Australian Perspective

Literature reveals difficulties in preparing nurses to care for older people. This article reports a study that aimed to facilitate positive changes in gerontological education in an undergraduate nursing program by identifying barriers and effective actions. A critical research approach was applied to the study. Data were mainly collected through focus groups. A total of five barriers were identified in gerontological education in an undergraduate nursing program. Actions which may address these barriers were explored. Critical reflection on educational practice based on partnerships between education and service sectors has the potential of leading an educational reform in gerontological nursing.

Farmers are the most trusted part of the Australian food chain: results from a national survey of consumers

Objective : Trust is a crucial component of food safety and governance. This research surveyed a random selection of the population to examine its level of trust in a variety of ‘actors’ and organisations in the food chain.

Mental health and barriers to the achievement of the ‘right to health’

This paper explores issues relating to access to physical and mental health care for people with mental health problems in light of Australias endorsement in 2008 of the Convention of the Rights of Persons with Disabilities, which established the right to health and to health care. Interviews were conducted with 10 key stakeholders with legal, policy, clinical and advocacy roles within South Australia and at a national and international level. Participants identified several barriers to the achievement of the right to health for people with mental illness, with discussion highlighting the legal definition of rights, governance of health and mental health, and structural barriers to receipt of care as the primary barriers. The data are explored in relation to social models of disability.

Trust makers, breakers and brokers: building trust in the Australian food system.

BackgroundThe importance of consumer trust in the food supply has previously been identified, and dimensions of consumer trust in food—who they trust and the type of trust that they exhibit—has been explored. However, there is a lack of research about the mechanisms through which consumer trust in the food supply is developed, maintained, broken and repaired. This study seeks to address this gap by exploring if, and how, consumer trust in the food supply is considered by the media, food industry and governments when responding to food scares. The aim of the research is to develop models of trust building that can be implemented following food scares.MethodsSemi-structured interviews will be undertaken with media, public relations officials and policy makers in Australia, New Zealand and the United Kingdom. Participants will be recruited through purposive sampling and will be asked to discuss a hypothetical case study outlining a food incident, and any experiences of specific food scares. Models of trust development, maintenance and repair will be developed from interview data. Comment on these models will be sought from experts in food-related organizations through a Delphi study, where participants will be asked to consider the usefulness of the models. Participants’ comments will be used to revise the models until consensus is reached on the suitability and usability of the models.DiscussionThis study will contribute to the literature about systems-based trust, and explore trust as a social and regulatory process. The protocol and results will be of interest and use to the food industry, food regulators, consumer advocate groups, media seeking to report food-related issues and policy makers concerned with public health and consumer health and well-being. This research represents an important contribution to the translation of the theoretical conceptualizations of trust into practical use in the context of food.

What should primary health care practitioners know about factors influencing young people's food choices?

Background To identify factors that determine the nature and extent of young consumers trust in food; sources of information which influence young consumer food choices; and how trust impacts on young people’s food choices. Method In-depth qualitative research interviews were conducted with young women and men, who are the primary food purchasers in their household ( n=8) Results Food choices of young adults were generally determined by cost and convenience. The overall perception was that Australian food regulation was effective and therefore, food safety need not be questioned. Health including long term health, although considered, was not central in food choice behaviour. Trustworthy nutrition information sources included family and friends. While food labels were used they were considered scientific and complex. The media and the food industry were deemed to be untrustworthy information sources.