Objective: This article explores chronic disease patients' personal symbolic meanings of their diseases, as emergent from their experience of Emotional Freedom Techniques (EFT) therapy. The present study is part of a larger study that explored chronic disease patients' and EFT practitioners' experiences of using EFT to support chronic disease healthcare. Design: Eight chronic disease patients who had received EFT were interviewed for this study. Semi-structured interviews were conducted face to face, or via telephone, or the online videoconferencing platform, Zoom. Interviews were transcribed verbatim and data was analysed using Interpretative Phenomenological Analysis methodology. Results: Three themes emerged, namely 'illness as an embodiment of unresolved emotional issues', 'illness as body's call for time-out and attention', and 'illness as a boundary from other people'. Conclusion: EFT offers promise as a suitable therapeutic approach to help chronic disease patients make sense of their life stories and lived experiences, and consequently, symbolic meanings of diseases. The exploration of illness symbology and meaning-making may offer therapeutic value to patients, from both an existential and a health behaviors perspective. (C) 2020 Elsevier Inc. All rights reserved.

Health literacy is a major issue for improving health outcomes of clients. In rural Victoria, Australia, the Gippsland Health Literacy Project (GHLP) educated local health services staff about health literacy and provided tools and techniques for health literacy implementation in services. This paper reports the outcomes of this project. Participants' change in knowledge was measured through pre- and post-project surveys and interviews. Descriptive analysis of survey data and analysis of interviews using qualitative description enabled exploration of individual and organisational shifts in health literacy perspectives. Healthcare professionals' knowledge of health literacy has improved as a result of the health literacy education. Health service organisations are also taking greater responsibility for health literacy responsiveness in their services. Systematic changes to policy and procedures that support health literacy are required. Although health literacy education provides more accessible health care for consumers, where projects had executive-level support the changes implemented were more likely to be successful and sustainable. What is known about this topic? Low health literacy is a strong predictor of health status and it is important for health organisations to ensure they provide health care and information in a way that can be understood, interpreted and acted on by all clients, regardless of their health literacy levels. What does this paper add? This paper presents findings on staff training and resources that can effectively support staff to improve health literacy practices. What are the implications for practitioners? Addressing health literacy issues appears to result in more accessible health care for consumers. Executive support and health literacy champions are key requirements to successfully address health literacy issues.

Background: Use of complementary medicine in Australia is increasing. Despite documented high use, however, perspectives of complementary medicine teaching inclusion within health professions education are poorly documented and understood. Aim: This paper explores medical students' perspectives of complementary medicine teaching from the curriculum of Australian medical programs. Methods: A constructivist grounded theory methodological approach was used to generate, construct, and analyse data. Thirty second-year to final-year medical students from 10 medical school education faculties in Australian universities participated in semi-structured interviews over a five-month period in 2013. Findings: Students from all represented medical schools highlighted perspectives of complementary medicine offerings in both the preclinical and clinical curriculum. Across the curriculum, a wide range of perspectives were related to both complementary medicine teaching and learning aspects incorporating social and ethical issues, evidence of clinical efficacy and safety, and evidence-based principles involving critical application and appraisal. Discussion: The findings demonstrate diverse perspectives of complementary medicine teaching not necessarily synonymous with learning. While all students highlighted some form of complementary medicine teaching and/or learning, perspectives varied between schools and across jurisdictions in terms of context and content. Clinical exposure to informal complementary medicine learning in clerkship was extensive relative to formal didactic teaching in the preclinical curriculum. Educational exposure to complementary medicine was shown to positively affect medical student attitudes towards complementary medicine. Conclusion: A coordinated policy towards integration of complementary medicine teaching in Australian medical curricula is recommended. Impetus for open debate regarding what level of complementary medicine teaching and/or learning is sufficient in medical and other health professions education is required. (C) 2017 Australian College of Nursing Ltd. Published by Elsevier Ltd.

Purpose: The objective of the present study was to explore Emotional Freedom Techniques (EFT) practitioners' experiences of using EFT to support chronic disease patients. This was part of a larger study exploring chronic disease patients' and EFT practitioners' experiences of using EFT to support chronic disease healthcare. Methods: A qualitative approach was deemed suitable for this study. Eight practitioners were interviewed using semi-structured interviews via telephone or Zoom (an online video-conferencing platform). Interviews were transcribed verbatim and data was analyzed using Interpretative Phenomenological Analysis methodology. Results and conclusion: This article presents two super-ordinate themes which explore application of EFT for addressing emotional issues faced by chronic disease patients, and for management of physical symptoms, respectively. Chronic disease patients may benefit from a holistic biopsychosocial, patient-centered healthcare approach. EFT offers potential as a technique that may be used by health practitioners to support the psychosocial aspect of chronic disease healthcare.

The aim of this study is to explore local health and wellbeing plans and priorities by Victorian local governments (LGs), specifically to: (1) analyse how LG priority areas are described in comparison to the State-level plan; (2) identify differences between regional and metropolitan health priorities; and (3) identify differences between LGs with high and low socioeconomic status. Content analysis of 79 LG health and wellbeing plans was undertaken. Differences in health and wellbeing priorities between LGs were examined using the t-test for two proportions. In total, 20% of the plans did not specify actions to address health priorities. One in three (34%) did not specify how evaluation will be done. Alcohol and other drugs, gambling and housing were prioritised more by metropolitan LGs, whereas disease prevention was prioritised more in regional LGs. There was no significant difference in health and wellbeing priorities of LGs with high and low socioeconomic status except for gambling. State-level health and wellbeing plans should be sensitive to differences in priorities of LGs. There is a need for local plans to commit to specific actions and evaluation. This analysis provides basis for more community-reflective, State-level planning and calls for more emphasis on identifying actions and evaluation in local level planning.

Little is known about challenges and transition that medical students from different cultural backgrounds face with regard to complementary medicine (CM). This paper explores such students’ experiences and perspectives of socio-cultural and academic difference with regard to CM and experiences of intercultural relations. Using a constructivist grounded theory approach, 30 in-depth qualitative interviews were conducted with medical students across 10 Australian medical schools. The data were rigorously analysed through a systematic process of coding, categorisation and theoretical development. The findings indicate that students adapted considerably to the host culture. Students with Western backgrounds integrated better socio-culturally and academically compared to students with non-Western backgrounds. Although nationality represented cultural identity, students’ construction of cultural difference was informed by their perception of diverging value systems within the specific educational environment. These values were, in turn, reflected in students’ reported behaviours, attitudes, and levels of engagement in socio-cultural and academic aspects of university life. Adaptation employed by students was evidenced largely due to their conflicting sense of responsibility towards familial culture regarding CM and focus on fitting in. While students’ tendency to gravitate towards cultural peers was evident, most students adapted to their host environment regarding CM to fit into normal intercultural encounters during medical school. In conclusion, students’ intercultural contact with regard to CM was both complex and problematic. At a time of significant diversification within the higher education student body, this paper highlights the role medical education institutions can play in fostering intercultural and academic guidance and support.

The aim of this study was to identify Australian medical students' complementary medicine information needs. Thirty medical students from 10 medical education faculties across Australian universities were recruited. Data were generated using in-depth semi-structured interviews and constructivist grounded theory method was used to analyze and construct data. Students sought complementary medicine information from a range of inadequate sources, such as pharmacological texts, Internet searches, peer-reviewed medical journals, and drug databases. The students identified that many complementary medicine resources may not be regarded as objective, reliable, differentiated, or comprehensive, leaving much that medical education needs to address. Most students sought succinct, easily accessible, evidence-based information to inform safe and appropriate clinical decisions about complementary medicines. A number of preferred resources were identified that can be recommended and actively promoted to medical students. Therefore, specific, evidence-based complementary medicine databases and secondary resources should be subscribed and recommended to medical schools and students, to assist meeting professional responsibilities regarding complementary medicines. These findings may help inform the development of appropriate medical information resources regarding complementary medicines.

Abstract Background Improved teamwork between conventional and complementary medicine (CM) practitioners is indicated to achieve effective healthcare. However, little is known about interprofessional collaboration and education in the context of integrative medicine (IM). Methods This paper reports the findings from a constructivist-grounded theory method study that explored and highlighted Australian medical students’ experiences and opportunities for linking interprofessional collaboration and learning in the context of IM. Following ethical approval, in-depth semi-structured interviews were conducted with 30 medical students from 10 medical education faculties across Australian universities. Results Medical students recognised the importance of interprofessional teamwork between general medical practitioners and CM professionals in patient care and described perspectives of shared responsibilities, profession-specific responsibilities, and collaborative approaches within IM. While students identified that limited interprofessional collaboration currently occurred in the medical curriculum, interprofessional education was considered a means of increasing communication and collaboration between healthcare professionals, helping coordinate effective patient care, and understanding each healthcare team members’ professional role and value. Conclusions The findings suggest that medical curricula should include opportunities for medical students to develop required skills, behaviours, and attitudes for interprofessional collaboration and interprofessional education within the context of IM. While this is a qualitative study that reflects theoretical saturation from a selected cohort of medical students, the results also point to the importance of including CM professionals within interprofessional collaboration, thus contributing to more person-centred care.

Terminology around the use of complementary medicines (CM) within medical discourse is ambiguous. Clear collective discourse within the medical context is required. This study reports the findings of a Constructivist Grounded Theory Method study used to explore medical students’ conceptualisation of terminology and associated value components around CMs as evidenced within their discourse community. The results show that terminology surrounding CMs within medicine is politically charged and fraught with value judgements. Terms used to describe CMs were considered, many of which were deemed problematic. Categorisation of specific medicines was also deemed inappropriate in certain contexts. Conceptualisation of CM terminology, categorisation and value implications, discriminated between levels of evidence for CMs and provided insights into the social change of medicine towards emergence of an evidence-based integrative approach. The results show that terminology surrounding CM is a social construct consistent with fluid conceptualisation and operationalisation in different social contexts.

Formal medical education about complementary medicine (CM) that comprises medicinal products/treatments is required due to possible CM interactions with conventional medicines; however, few guidelines exist on design and implementation of such education. This paper reports findings of a constructivist grounded theory method study that identified key strategies for integrating CM literacy education into medical curricula. Analysis of data from interviews with 30 medical students showed that students supported a longitudinal integrative and pluralistic approach to medicine. Awareness of common patient use, evidence, and information relevant to future clinical practice were identified as focus points needed for CM literacy education. Students advocated for interactive case-based, experiential and dialogical didactic techniques that are multiprofessional and student-centred. Suggested strategies provide key elements of CM literacy within research, field-based practice, and didactic teaching over the entirety of the curriculum. CM educational strategies should address CM knowledge deficits and ultimately respond to patients' needs.

Objective: Across the Western world, including Australia, growing popularity of complementary medicines (CMs) mandates their implementation into medical education (ME). Medical students in international contexts have expressed a need to learn about CMs. In Australia, little is known about the student-specific need for CM education. The objective of this paper was to assess the self-reported need for CM education among Australian medical students.Design: Thirty second-year to final-year medical students participated in semi-structured interviews. A constructivist grounded theory methodological approach was used to generate, construct and analyse data.Setting: Medical school education faculties in Australian universities.Results: Medical students generally held favourable attitudes toward CMs but had knowledge deficits and did not feel adept at counselling patients about CMs. All students were supportive of CM education in ME, noting its importance in relation to the doctor patient encounter, specifically with regard to interactions with medical management. As future practitioners, students recognised the need to be able to effectively communicate about CMs and advise patients regarding safe and effective CM use.Conclusions: Australian medical students expressed interest in, and the need for, CM education in ME regardless of their opinion of it, and were supportive of evidence-based CMs being part of their armamentarium. However, current levels of CM education in medical schools do not adequately enable this. This level of receptivity suggests the need for CM education with firm recommendations and competencies to assist CM education development required. Identifying this need may help medical educators to respond more effectively. (C) 2015 Elsevier Ltd. All rights reserved.

INTRODUCTION:This study investigated whether increased numbers of primary healthcare clinical consultations in Indigenous communities in some remote areas of Australia are associated with the reduced need for urgent medical evacuations and remote telephone consultations.METHODS:A retrospective comparison study of routinely collected data utilising correlation analysis was conducted. Statistical associations have been measured using Pearson product-moment correlation coefficients. The setting was 20 primary healthcare centres in the Northern Territory servicing ≥5900 residents between July 2008 and June 2010; data were collected from Central Australia Remote Health and the Royal Flying Doctor Service-Central Operations, Alice Springs base. Main outcome measures included number of acute medical evacuations and number of remote telephone consultations relative to number of face-to-face consultations with Aboriginal health workers, remote area nurses and general practitioners.RESULTS:Statistically significant positive correlations were found between numbers of acute medical evacuations and numbers of face-to-face consultations (r = 0.659; 95% confidence interval (CI): 0.305-0.855), remote area nurse consultations (r = 0.481; 95% CI: 0.055-0.765) and general practitioner consultations (r = 0.798; 95% CI: 0.555-0.920). Significant positive correlations were also found between numbers of remote telephone consultations and numbers of face-to-face consultations (r = 0.546; 95% CI: 0.135-0.795) and general practitioner consultations (r = 0.563; 95% CI: 0.163-0.805).CONCLUSIONS:The provision of more frequent healthcare centre face-to-face consultations, including general practitioner consultations, is associated with an increased burden of acute medical evacuations and remote telephone consultation services in this remote setting.

OBJECTIVE:The purpose of this study was to review the literature for cases of adverse events in infants and children treated by chiropractors or other manual therapists, identifying treatment type and if a preexisting pathology was present. METHOD:English language, peer-reviewed journals and non-peer-reviewed case reports discussing adverse events (ranging from minor to serious) were systematically searched from inception of the relevant searchable bibliographic databases through March 2014. Articles not referring to infants or children were excluded. RESULTS:Thirty-one articles met the selection criteria. A total of 12 articles reporting 15 serious adverse events were found. Three deaths occurred under the care of various providers (1 physical therapist, 1 unknown practitioner, and 1 craniosacral therapist) and 12 serious injuries were reported (7 chiropractors/doctors of chiropractic, 1 medical practitioner, 1 osteopath, 2 physical therapists, and 1 unknown practitioner). High-velocity, extension, and rotational spinal manipulation was reported in most cases, with 1 case involving forcibly applied craniosacral dural tension and another involving use of an adjusting instrument. Underlying preexisting pathology was identified in a majority of the cases. CONCLUSION:Published cases of serious adverse events in infants and children receiving chiropractic, osteopathic, physiotherapy, or manual medical therapy are rare. The 3 deaths that have been reported were associated with various manual therapists; however, no deaths associated with chiropractic care were found in the literature to date. Because underlying preexisting pathology was associated in a majority of reported cases, performing a thorough history and examination to exclude anatomical or neurologic anomalies before applying any manual therapy may further reduce adverse events across all manual therapy professions.

Aim: Infantile colic is a prevalent and distressing condition for which there is no proven standard therapy. The aim of this paper is to review medical and conventional treatments for infantile colic.Methods: A systematic literature review was undertaken of studies on medical and conventional interventions for infantile colic from 1980 to March 2009. The results and methodological rigour of included studies were analysed using the CONSORT (Consolidated Standards Of Reporting Trials) 2001 statement checklist and Centre for Evidence Based Medicine critical appraisal tools.Results: Nineteen studies and two literature reviews were included for review. Pharmacological studies on Simethicone gave conflicting results and with Dicyclomine hydrochloride and Cimetropium bromide results were favourable but side effects were noted along with issues in study methodology. Some nutritional studies reported favourable results for the use of hydrolysed formulas in bottle-fed infants or low-allergen maternal diets in breastfed infants but not for the use of additional fibre or lactase. There were several issues in regards to methodological rigour. Behavioural studies on the use of increased stimulation gave unfavourable results, whereas results from the use of decreased stimulation and contingent music were favourable. These studies demonstrated poor methodological rigour.Conclusion: There is some scientific evidence to support the use of a casein hydrolysate formula in formula-fed infants or a low-allergen maternal diet in breastfed infants with infantile colic. However, there is little scientific evidence to support the use of Simethicone, Dicyclomine hydrochloride, Cimetropium bromide, lactase, additional fibre or behavioural interventions. Further research of good methodological quality on low-allergenic formulas and maternal diets is indicated.

Objective: To determine what models of integrative medicine (IM) are being employed in contemporary health care settings, and how and which factors affect and facilitate the success of IM in terms of the integration of complementary and alternative medicine (CAM) and conventional medicine in primary health care (PHC).Design: Literature review.Setting: Australian and international PHC settings, and hospitals.Measures: Australian and international peer-reviewed literature identified from database searches, reference lists, desktop searches, texts, and relevant website searches (e.g., government and health-related departments and agencies). Focus was literature with the keywords 'integrative' or 'integrated' in conjunction with 'medicine' or 'health care'. Articles were analysed for descriptions of continuous and integrative services involving contemporary IM practices, their background, characteristics, and implementation.Findings and discussion: Classifications of IM in the literature present various ways that IM can be implemented, and it appears that strategies have been successfully developed to facilitate integration. Although few of the barriers to the integration of CAM and conventional medicine have been resolved, concerns over the legitimacy of CAM in health care (e.g., safety, biomedical evidence, and efficacy) are being overcome by the use of evidence-based practice in IM delivery. There are two dominant models of IM that have been developed. One is the selective combination of both biomedical evidence and experience-based evidence of both CAM and conventional medicine. The other is the selective incorporation of exclusively evidence-based CAMS into conventional medicine. The two model types signify different levels of equity between CAM and conventional medicine in regard to the power, autonomy, and control held by each. However, the factors common to all IM models, whether describing CAM as supplementary (and subordinate) or complementary (and partnered) to conventional medicine, is the concept of a health care model that aspires to be client-centred and holistic, with focus on health rather than disease as well as mutual respect among peer practitioners.Conclusions: The growth and viability of IM will depend on evidence-based practices, non-hierarchal IM practices, and identifying the successful influences on the integration of CAM and conventional medicine for recognition of its inherent value in PHC. (C) 2011 Elsevier Ltd. All rights reserved.

In the last 20 years, there have been many developments in health promoting hospitals and health services (HPH), particularly in Europe. In Australia, health promotion (HP) programs are being conducted in the hospital setting; however, developments related to the HPH concept have been slower. To identify the effects and benefits of a health service working under the HPH banner, and to assist HP practitioners in advocacy and planning for their health service to become an HPH, we conducted a literature review. Eight studies met the criteria of research on HPH or evaluation of HP programs within an HPH framework. Seven key themes were identified in these studies. Enablers and barriers to HPH development were analyzed and discussed within these themes. This review found a dearth of high-level research on HPH. In particular, there were few Australian studies. There is limited evidence, therefore, of the efficacy of HPH. Much more high-level research and dissemination of the findings are needed in order to encourage policy-makers and health service administrators to invest resources in HPH and to support the work of HP practitioners interested in developing their health service into an HPH.

A dominant discourse constructs Indigenous secondary school students as likely to leave school early and unlikely to take up a health career. We believe that this failure discourse shapes the school and tertiary transition experience for the majority of Indigenous students, regardless of their capabilities and aspirations. Career development practitioners have the potential to change the experiences of Indigenous school students and play a part in closing the gap between Indigenous and non-Indigenous health outcomes. However, only 18% or 26 out of 144 Victorian secondary school career advisers or guidance counsellors who responded to our survey demonstrated the knowledge, skills and understanding to effectively advise and support an Indigenous student who expressed an interest in a health career.

This article explores whether complementary and alternative medicine (CAM) users view CAM as a unified concept or individualize the modalities. A survey about the beliefs and concerns surrounding the use of 22 CAM modalities was posted to a random sample of 1,308 people in five rural and two metropolitan localities in Victoria, Australia. The response rate was 40% (n = 459). Overall, 91% of respondents were found to either have used one CAM modality (85%, n = 386) or be open to future use (6%, n = 33). Respondents did not view CAM as a unified concept. Each modality was used by people with different characteristics and beliefs about health care. However, it was practical to divide the 22 CAM modalities into four categories that we have named natural remedy, wellness, accepted, and established modalities. The four categories lie along a set of continua extending from natural remedy modalities and ‘‘holistic health care’’ beliefs at one end to established modalities and a belief in the tenets of conventional medicine at the other. We were able to develop a model to show this diagrammatically.

The numbers of Indigenous students studying in health career courses at the tertiary level is low. This paper describes a forum conducted as part of a project of national significance which examines the solutions and barriers for Indigenous student entry to medical and other health science education. Small group discussions and observations were used to determine how a group of Indigenous students, school age and mature, became interested in a health career, what influenced them, their expectations and where they sourced information. The initial design of the forum, based on other successful non-Indigenous health career events, was deemed inappropriate. When an Indigenous educator intervened, and used a more culturally appropriate approach, the engagement of the Indigenous students increased. The importance of culturally relevant health career promotion is a vital part of a complex series of actions needed to increase the recruitment and retention of Indigenous students into health science careers.

Australian and American studies have found higher annual rural complementary and alternative medicine (CAM) use than predominantly metropolitan studies. Little has been written about variations in CAM use between rural places. The Perspectives on the Use in Communities of Complementary and Alternative Medicine (PUC-CAM) study explored CAM use in rural places through a survey of five rural and two metropolitan localities in Victoria, Australia. The survey was posted to 1308 people with a response rate of 40% (n = 459). Metropolitan respondents' current CAM use was 47% (n = 46) and the rural respondents' 54% (n = 195), while lifetime use was 81%, (n = 80) for the metropolitan respondents and 86%, (n = 310) for the rural respondents. The respondents in agriculturally based rural places stayed with 'established' modalities such as chiropractic and massage therapy while in the sea change and peri-metropolitan places a wider range of modalities were used.