Caroline Bulsara

University of Notre Dame Australia, Fremantle · Institute Health Research

Objective: To determine emergency department (ED) clinician’s current management for five common minor self-limiting fractures (MSLF) and evaluate practice against evidence based direct discharge pathway (DD) protocols. Methods: A survey was provided to doctors, nurse practitioners and advanced scope physiotherapists working in seven metropolitan,...

Background People with intellectual disabilities living in group homes often have complex health needs, are high health service users and need support from their service provider to access health services. In Australia, little is known about the types and amounts of these supports. Methods A case study was conducted on a large Western Australian d...

A hospital‐wide point prevalence study investigated frailty and pain in patients with a cancer‐related admission. Modifiable factors associated with frailty in people with cancer were determined through logistic regression. Forty‐eight patients (19%) with cancer‐related admissions were 2.65 times more likely to be frail and 2.12 more likely to have...

Background To investigate what factors contribute to a working age adult with a simple fracture seeking care in an Australian metropolitan Emergency Department (ED) Methods In this Qualitative Descriptive study, we interviewed ED patients with simple fractures including 5th metacarpal, 5th metatarsal, toe, radial head and clavicle fractures. Re...

Adolescence is a pivotal time for social and emotional wellbeing development, and the literature calls for psychosocial support approaches in this population. Outdoor adventure education (OAE), programs that contain activities perceived as risky by participants but undertaken in an environment of risk management and social support, provide a holist...

Issue addressed: Outdoor adventure education (OAE) (programs involving outdoor activities such as rock climbing or white-water canoeing) that participants perceive as risky, conducted in a social support setting, can be utilised by practitioners to elicit changes in educational and psychosocial outcomes to support participant adolescent wellbeing....

Objective: Dementia affects individuals older than 65 years. Currently, residential aged care facilities (RACF) use psychotropic medications to manage behavioural and neuropsychiatric symptoms of dementia (BPSD), which are recommended for short-term use and have substantial side effects, including increased mortality. Cannabinoid-based medicines (...

Background This qualitative descriptive study gauged the perceptions of adolescent focus group participants and outdoor adventure education teachers on their preferred program components to improve adolescent wellbeing during a secondary school outdoor adventure education program. Methods Five student focus groups (N = 29) and four key informant i...

Background: The aim of this study was to examine physical activity and sedentary behaviours during Western Australia's COVID-19 lockdown and their association with mental well-being. Methods: Participants completed activity related questions approximately two months after a three-month lockdown (which formed part of a larger cross-sectional stud...

The research protocol described aims to examine and establish the health outcomes of children and young people living in Out-of-Home Care (OOHC) in Perth, Western Australia (WA) from the perspective of the care recipients and service providers. A Study Advisory Panel (SAP) will be established comprised of Aboriginal Elders (because of the over-repr...

Aim: To identify, integrate, and appraise the evidence on hospitalised smokers' and staff perspectives of inpatient smoking cessation interventions and the impact on smokers' quality of life. Design: The integrative review method was used to present hospitalised smokers' and staff perspectives of inpatient smoking cessation interventions. Search...

Frailty and pain in hospitalised patients are associated with adverse clinical outcomes. However, there is limited data on the associations between frailty and pain in this group of patients. Understanding the prevalence, distribution and interaction of frailty and pain in hospitals will help to determine the magnitude of this association and assis...

Background: In 2020 and 2021, Western Australia (WA) was an early adopter of the 'COVID zero' policy, eliminating community transmission and pursuing vaccine roll out to enable a 'soft landing' once coronavirus disease 2019 (COVID-19) infiltrated the community in 2022. Optimisation and augmentation of general practice services were at the forefron...

Background: The study explored the experiences and perceptions of GPs regarding the management of chronic non-cancer pain (CNCP). Specifically, participants were asked to identify perceived enablers and barriers to CNCP care and how the care of patients with CNCP may be improved. Methods: The study utilised a qualitative descriptive methodology....

Aims: To understand nurses' perceptions of volunteer support in health care settings. Background: Increasingly, volunteers provide specialised support to health care service users, requiring volunteers and nurses to work closely together. However, little is known about nurses' perceptions of volunteer support. Methods: A scoping review was con...

Background Use of patient-reported outcome measures in clinical settings facilitate the delivery of better health care to improve patient health outcomes. Previously collected qualitative data indicated themes that could inform items for a health-related quality of life measure. This study investigated the content validity of items for inclusion in...

Background and objectives: General practitioners (GPs) are ideally placed to have a much larger role in detection and management of familial hypercholesterolaemia (FH) among their patients. The aim of this study was to seek the reflections of practice staff and newly diagnosed patients with FH on the implementation of an FH model of care in the ge...

Background The ageing population has led to growing numbers of older adults in hospital. Given the increased care needs of older adult patients, hospitals are facing resource challenges to ensure patient safety and quality of care. Support from trained volunteers focussed on older adults needs, such as eating, drinking, ambulation and cognitive sti...

Annual influenza vaccination of health care students and workers helps protect themselves and patients from influenza, which has a high disease burden during seasonal peaks in Australia. Health care students are an important cohort whose early attitudes and habits towards influenza vaccination may influence future behaviours. We explored the knowle...

Introduction Hospitalised older adults are prone to functional deterioration, which is more evident in frail older patients and can be further exacerbated by pain. Two interventions that have the potential to prevent progression of frailty and improve patient outcomes in hospitalised older adults but have yet to be subject to clinical trials are nu...

Our primary objective was to explore the barriers preventing clinicians from implementing what they think is ideal practice as it relates to using tools to aid diagnosis and monitor progress in mid-portion Achilles tendinopathy. Our secondary objectives were to describe the assessments employed by clinicians in their own practice to aid with (a) di...

Issue addressed: Mental health disorders (MHDs) are prevalent amongst university students with detrimental impacts on individual students, universities and the wider community. There is an urgent need for proactive and preventative strategies to address the mental health crisis in the university population. This study evaluated the efficacy of a 1...

Introduction Australian nurses have experienced higher levels of anxiety during the COVID-19 pandemic compared with the prepandemic. This may have affected their long-term mental health and intention to stay in the profession resulting in a workforce shortage, which further impacts the health of the public. Management is urgently required to improv...

Purpose The purpose of this study was to co-design a falls prevention education programme with aged care home residents and staff and evaluate its feasibility. The intention of providing the education programme was to assist residents to stay safe and mobile whilst reducing their risk of falling. Design/methodology/approach A two-phase mixed metho...

Background: A plethora of different assessment tools exist to diagnose and monitor Achilles tendinopathy, however there is little consensus within the literature and what is performed in clinical practice is unknown. The aims of this study were: 1) Describe the assessments employed by clinicians in their own practice to aid with a) diagnosis and b)...

Purpose Stroke brings about physical, cognitive, and psychosocial changes and, consequently, many stroke survivors feel underprepared for the transition from hospital to home. Nursing and allied health staff have a key role in stroke rehabilitation. Peer support programs have been found effective in supporting stroke survivors, alongside hospital s...

Objective The aim of this study was to identify barriers and enablers from the perspectives of stroke survivors, carers and staff to understand the experiences of care. Design The study used a qualitative descriptive methodology and employed semistructured interview technique. Setting A metropolitan stroke rehabilitation unit in Western Australia...

Objective: This study explored the healthcare needs and barriers to health services in older homeless women in the Perth metropolitan area, Western Australia. Methods: Twenty-two older women experiencing homelessness completed a questionnaire and semi-structured interview. Data were analysed using descriptive statistics and thematic analysis. Resul...

Background Since the beginning of the COVID-19 pandemic, the Western Australian government imposed multiple restrictions that impacted daily life activities and the social life. The aim of this study was to examine the effects of COVID-19 lockdown on the community’s physical, mental and psychosocial health. Methods Approximately 2 months after a t...

Background and objectives: A lack of public and health professional awareness about familial hypercholesterolaemia (FH) leads to an estimated 90,000 Australians remaining undiagnosed. The aim of this study was to establish the level of knowledge and awareness of FH in Australian general practices. Method: A qualitative descriptive methodology wa...

Background Parent support influences adolescent’s social-emotional well-being. One factor that may influence parent’s perception of support is their child’s level of motor competence. Aim The purpose of this study was to explore mothers’ experience of providing support for the health of adolescents with low motor competence physical and emotional...

Objective: To investigate factors contributing to the decision for a working age adult experiencing non-specific low back pain (NSLBP) to seek care at an Australian metropolitan tertiary ED. Methods: Participants triaged with NSLBP were recruited from one metropolitan tertiary Australian ED. We employed a qualitative descriptive methodology usin...

The objective of this study was to explore patients’ experiences when preparing for and undergoing general surgery at a large tertiary hospital. Findings aimed to inform the development of a prehabilitation program to empower patients to optimize their recovery and enhance their experience of general surgery. A qualitative exploratory research appr...

Introduction Frailty and pain are associated with adverse patient clinical outcomes and healthcare system costs. Frailty and pain can interact, such that symptoms of frailty can make pain assessment difficult and pain can exacerbate the progression of frailty. The prevalence of frailty and pain and their concurrence in hospital settings are not wel...

Purpose By directly engaging with women diagnosed with ovarian cancer, this study aimed to explore and identify their view of the health symptoms and outcomes that matter most to them as they traverse their disease pathway. Background Patient-reported outcome measures in ovarian cancer have tended to focus on physical symptoms rather than the more...

Objectives Patient contributions (co-payments) for one months’ supply of a publicly-subsidized medicine in Australia were increased by 21% in January 2005 (US$2.73-$3.31 for social security recipients and $17.05-$20.58 for others). This study investigates the relationship between patients’ use of statin medication and hospitalization for acute coro...

This pilot study aimed to examine EVOLVE UK extra care housing tool in an Australian residential aged care minor refurbishment context. The tool’s content validity was established with 34 subcategories (I-CVI ≥0.75) and 612 statements (n = 509 I-CVI ≥0.75) relevant. A subsequent audit indicated high concordance (Rho-C = 0.750 to 0.997) within four...

Introduction In January 2005, the Australian Government increased the consumer medication co-payment by 21%. Previous research found that this affected population-level utilisation of statins, which fell by 5% following the co-payment increase. The subsequent health impact on individuals reducing or ceasing use of statins is unknown. Objectives an...

Objective This study examined the association between statin usage (discontinued, reduced or continued) and two-year death following a 21% increase in the Pharmaceutical Benefits Scheme (PBS) consumer co-payment in Western Australia. Methods A retrospective observational study in Western Australia using linked administrative Commonwealth PBS data...

Aim To describe a tailored qualitative research methodology for exploring the complex interaction of factors driving non‐urgent care seeking in the emergency department. Design Qualitative descriptive design with a literature informed semi‐structured interview and analysis structure. Triangulation with the State‐Trait Anxiety Inventory allows expe...

Aim: To evaluate the connection between residential aged care architecture, the residents' ability to find home and Quality of Life themes. Design: This study uses convergent qualitative mixed methods approach across the three phases of the research project to explore the lived experience of residential aged care residents, their family members,...

Background: Approximately 20% of women with gynecologic cancers are under age 40 and with delayed childbearing, women may be diagnosed before their first pregnancy. Although fertility preservation is a priority for many women, attitudes to conception have not previously been investigated in these patients or their partners. We explored attitudes t...

PurposeThe aim of this study was to develop and ensure the content validity of a new patient-reported outcome measure, the Cancer Patient Empowerment Questionnaire (CPEQ), to measure the level of, desire for, and enablement of empowerment among cancer patients in follow-up.Methods An iterative process based on: (i) empowerment theories by Zimmerman...

Objective This study assessed the effect of the frequency of general practitioner (GP) visitation in the 12 months before a 21% consumer copayment increase in the Pharmaceutical Benefits Scheme (PBS; January 2005) on the reduction or discontinuation of statin dispensing for tertiary prevention.Methods The study used routinely collected, whole-popul...

Background: Dementia is a neurological condition that affects the cognitive and functional ability of the brain and is the leading cause of disability among those aged 65 years and above. More effective ways to manage dementia symptoms are needed because current treatment options (antidepressants and antipsychotics) can be ineffective and are asso...

Background: Adults with intellectual disability experience high rates of falls making falls prevention an important health need. The purpose of the study was to seek perspectives of older adults with intellectual disability and their caregivers to (a) explore the experiences of older adults with intellectual disability when seeking healthcare serv...

Background: Dementia is a neurological condition that affects the cognitive and functional ability of the brain and is the leading cause of disability among those aged 65-years and above. More effective ways to manage dementia symptoms are needed as current treatment options (anti-depressant and antipsychotic) can be ineffective and associated with...

Background: Dementia is a neurological condition that affects the cognitive and functional ability of the brain and is the leading cause of disability among those aged 65-years and above. More effective ways to manage dementia symptoms are needed as current treatment options (anti-depressant and antipsychotic) can be ineffective and associated with...

Background: People with intellectual disability (ID) experience age-related changes earlier in life, and as such, falls among people with ID are of serious concern. Falls can cause injury and consequently reduce quality of life. Limited studies have investigated the incidence of falls among people with ID and the associated risk factors. The purpo...

Our identity develops with age, and many impacting factors will determine whether it is healthy or unhealthy. A particularly fragile phase of identity development occurs during adolescence when level of motor competence may be influential, yet is rarely considered. Purpose: The purpose of this study was to examine male and female adolescent’s perce...

Background: Dementia is a neurological condition that affects the cognitive and functional ability of the brain and is the leading cause of disability among those aged 65-years and above. More effective ways to manage dementia symptoms is needed as current treatment options (anti-depressant and antipsychotic) can be ineffective and associated with...

The objective of this study is to identify elements pertaining to minor refurbishments of residential aged care facilities. A narrative review of relevant publications was conducted. Inductive content analysis was used to categorize coded data into major or minor refurbishment or staff practices. Further analysis identified minor refurbishment doma...

Objective: The objective of the review was too synthesize the best available evidence on the incidence and prevalence of falls among adults with intellectual disability (ID). Introduction: Falls among adults with ID frequently cause physical injury and may negatively impact on their quality of life. Studies investigating falls among people with...

Purpose: Post-treatment follow-up for lymphoma potentially fails to address the supportive care needs of survivors. A nurse-led lymphoma survivorship model of care was developed and tested in a phase II pilot pragmatic randomised controlled trial (RCT). The intervention comprised three face-to-face appointments, delivery of tailored resources and...

Objectives: Previous Australian research has shown that following the 21% increase in patient copayments for medications on the Pharmaceutical Benefits Scheme (PBS) in 2005, the use of lipid-lowering therapy declined by 5%. This study aimed to determine the demographic and clinical characteristics of individuals who continued, reduced or ceased th...

Background: Falls among older adults with intellectual disability (ID) are recognised as a serious health problem potentially resulting in reduced health-related quality of life and premature placement in residential care. However there are limited studies that have investigated this problem and thus falls rates among older adults with ID remain u...

Background Health services in Tasmania, Victoria and now Western Australia are changing to goals‐of‐care (GOC) advance‐care‐planning (ACP) documentation strategies. Aim To compare the clinical impact of two different health department sanctioned ACP documentation strategies. Methods An unblinded, pre‐and‐post, controlled study over two correspond...

Purpose: To explore and describe lymphoma survivors’ thoughts and perceptions of the components of a nurse- led lymphoma survivorship clinic intervention. Methods: An exploratory, qualitative descriptive study using interviews from 10 participants who had transi- tioned post-treatment into the survivorship phase via a nurse-led lymphoma survivorshi...

Objective To determine patient satisfaction and experience after Robot‐Assisted Radical Prostatectomy (RARP) for prostate cancer, using a convergent mixed‐method qualitative analysis approach. Patients and Methods 412 patients who underwent RARP between January 2014 and June 2016 were mailed questionnaires and invited to participate in focus group...

This paper reports on experiences of dealing with practical matters after death. Semi structured interviews with bereaved individuals were thematically analyzed. Within the theme of coping, dealing with practical matters was a significant stressor and was found to be extremely challenging, time consuming, and to negatively impact on mental and emot...

Accessible Summary People with intellectual disability do not often take part in research. When people with intellectual disability are thinking about taking part in research, it is important that they are given support to participate in the decision‐making. This study describes how an informed consent process was developed for people with intellec...

Objectives: To determine if medical graduates from an Australian university are educated and skilled in health advocacy for their future practice with patients and the wider community. Methods: The authors used an exploratory mixed methodology starting with curriculum mapping of the medical curriculum, followed by key informant interviews with t...

Appendix 1. Interview Guide questions used in Phase Two of the key informant interviews

This paper reports on experiences of dealing with practical matters after death. Semi structured interviews with bereaved individuals were thematically analyzed. Within the theme of coping, dealing with practical matters was a significant stressor and was found to be extremely challenging, time consuming, and to negatively impact on mental and emot...

Objective Although the needs of the bereaved have been identified widely in the literature, how these needs translate into meaningful, appropriate, and client-centered programs needs further exploration. The application of receptivity to support is a critical factor in participation by the bereaved in palliative care bereavement programs. Receptivi...

Abstract Background Falls are a major socio-economic problem among residential aged care (RAC) populations resulting in high rates of injury including hip fracture. Guidelines recommend that multifactorial prevention strategies are implemented but these require translation into clinical practice. A community of practice (CoP) was selected as a suit...

Objective: The aim of the current study was to explore barriers to genetic counseling and testing in women with gynecological cancers deemed at significant risk of carrying a germline mutation. Methods: A qualitative study using semi-structured interviews and inductively analysed thematically. Eight patients with ovarian or endometrial cancer pa...

Introduction Familial hypercholesterolaemia (FH), an autosomal dominant disorder of lipid metabolism, results in accelerated onset of atherosclerosis if left untreated. Lifelong treatment with diet, lifestyle modifications and statins enable a normal lifespan for most patients. Early diagnosis is critical. This protocol trials a primary care-based...

Purpose: To describe the unmet informational, psychological, emotional, social, practical, and physical needs and preferences for posttreatment survivorship care of individuals living with multiple myeloma to inform the development of relevant, person-centered, survivorship services. Methods: An exploratory, descriptive study using 2 focus group...

Objectives This study explores how medical graduates and their workplace supervisors perceive the value of a structured clinical audit program (CAP) undertaken during medical school. Methods Medical students at the University of Notre Dame Fremantle complete a structured clinical audit program in their final year of medical school. Semi-structured...

Investigating older peoples’ preferences for receiving information about falls prevention could enhance communication and increase the uptake of relevant messages. The aim of the study was to examine the views and preferences of community-dwelling older adults about seeking and receiving falls prevention information. A community forum using a modif...

Review question/objective:: The objective of this review is to synthesize the best available evidence to determine the incidence and prevalence of falls in adults with intellectual disability living in the community.