Paper written with Centre for Primary Health Care and Equity colleagues:
The value of the PAM is about facilitating patient behaviour change and improving health outcomes. Success in achieving these aims also requires a shift in the culture, attitudes and perceptions of clinicians towards person-centred care and concepts such as patient activation and self-management.
PAM has been widely used to tailor care within a variety of patient interventions.
Enablers for the use of the PAM to tailor care include leadership and support for focusing on activation, the extent to which PAM was seen as an extension of existing patient care, and the extent to which the activation, and self care in general, was seen as extraneous or not relevant.
Further research on use of the PAM to tailor and differentiate care based on activation is needed.
The aim of this collection is to ensure immediate access to systematic reviews most directly relevant to remote health care through telehealth. The measures adopted internationally to curb the spread of COVID-19 have led to significant changes in how health care is accessed and provided. As face-to-face consultations between healthcare workers and patients pose a potential risk to both parties, remote care and telehealth offer alternatives.
Well before the impacts of the 2020 pandemic, large numbers of lower income Australian households were struggling to find affordable housing and there were long wait lists for social housing. AHURI research estimated that in 2016, there was a shortfall of around 431,000 social housing dwellings, and that this deficit would grow to 727,300 dwellings by 2036. The research concluded that 36,000 new social housing dwellings per year were required to meet this need.
With high unemployment and increased incidence of homelessness a likely outcome of the economic downturn, new social housing will be essential to ensure housing outcomes do not worsen. Industry and community organisations and peak bodies are calling for a social housing building program as part of the economic stimulus response. For example, the Australian Council of Social Service (ACOSS), in a recent report, proposes building 30,000 social housing dwellings as a way to reduce homelessness and to boost employment.
The mental health effects of COVID-19 on the general population might be profound and long-lasting, and deserve serious attention; but they cannot be the exclusive focus of conversation. Those who wish to build fairer societies and health systems after the pandemic ends must learn about and prioritise the needs of people living with severe mental illness as a matter of urgency.
The Institute for Public Policy Research in the UK has released a report based on IPPR/YouGov polling of healthcare workers called Care Fit for Carers.
It shows high degrees of dissatisfaction with the UK government’s response, and that many health care workers are considering leaving their professions .
The report also raises the prospect of the longer term-impacts on health care workers, which are likely to include physical health impacts, as well as PTSD and other mental health conditions. These impacts are not abstract and hypothetical, as shown in a BBC article on the impacts of SARS ten years after the 2003 outbreak:
Bruce England was a paramedic on duty in Toronto during the early days of the Sars outbreak and, having attended a patient with a chest infection, found himself falling ill.
For him, and many others affected by the Sars outbreak in Toronto, the effects of that experience are still being felt today. Ten years on Bruce still experiences weakness and difficulty with his breathing.
“I had Sars. It’s left a lasting impact on me and my life. So did I survive it? Maybe not, it’s still there for me,” he says.
An important from David Gunnell and colleagues in Lancet Psychiatry:
These are unprecedented times. The pandemic will cause distress and leave many people vulnerable to mental health problems and suicidal behaviour. Mental health consequences are likely to be present for longer and peak later than the actual pandemic.
Some worrying parallels between Italy and Australia’s health system challenges, as outlined in this commentary in The Lancet:
There are lessons to be learned from the current COVID-19 pandemic. First, the Italian decentralisation and fragmentation of health services seems to have restricted timely interventions and effectiveness, and stronger national coordination should be in place. Second, health-care systems capacity and financing need to be more flexible to take into account exceptional emergencies. Third, in response to emergencies, solid partnerships between the private and public sector should be institutionalised. Finally, recruitment of human resources must be planned and financed with a long-term vision.