Victoria Team

• MD, MPH, DrPH
• Senior Research Fellow at Monash University (Australia)

We investigated nurses' experiences of hospital‐acquired pressure injury (PI) prevention in acute care services to better understand how PI prevention may be optimised. We used the Theoretical Domains Framework to systematically identify barriers and enablers to evidence‐based preventive practices as required by the International Guideline. This st...

To systematically search and synthesise available literature on barriers and enablers to evidence‐based care for patients with laparotomy wounds reported by acute care nurses. Specifically, we focused on wound assessment, infection control techniques, wound products used, escalation of care, dressing application, documentation and holistic care. Th...

Aim To explore the relationship between physical activity levels and wound healing and recurrence in people with venous leg ulcers. Methods Questionnaires and medical records were used to collect data, with responses used to group participants into different physical activity groups. The differences in healing and recurrence outcomes of ulcers amo...

Aim(s) To: (1) explore current best practices for hospital‐acquired pressure injury prevention in high BMI patients; (2) summarize nurses' experiences in preventing and managing them; (3) explore the association between a high BMI and occurrence and severity of pressure injury. Design Exploratory. Methods Scoping review. Data Sources Ovid MEDLIN...

The need to improve career development and training for residential aged care workers in Australia to achieve required essential competencies, including infection prevention and control competencies, has been repeatedly highlighted. In Australia long-term care settings for older adults are known as residential aged care facilities (RACFs). The COVI...

Background Healthcare organisations provide policies and guidelines to direct the nursing staff’s decision-making surrounding care in patients with surgical wounds to reflect the best current evidence. Nonetheless, nurses face multiple challenges in providing evidence-based care (EBC), leading to inconsistent surgical wound care. In addition, the r...

Objective: To explore clinicians' perspectives regarding strategies to support exercise interventions for people with venous leg ulcers. Design: 1:1 interview was guided by the Behaviour Change Wheel (BCW) to collect thoughts from clinicians with experiences in managing venous leg ulcers. Settings: Clinical nurses in metropolitan/regional Vict...

Background The level of personal health literacy of patients with venous leg ulcers is likely to affect their ability to self-manage their condition impacting on their adherence to treatment and influences healing and recovery outcomes. Objectives To scope existing research that examined the level of health literacy in venous leg ulcer patients, t...

Background: Hospital-acquired pressure injuries are a significant healthcare burden and an international safety and quality care issue. Managing and preventing pressure injuries in high body mass index patients (30 or higher) requires a multifactorial approach and additional resources.Objective: This scoping review explores current best practices f...

Background Venous leg ulceration is caused by chronic venous insufficiency and affects millions of adults worldwide who suffer prolonged healing episodes and due to underlying pathophysiology ulcer recurrence is common after healing. Compression therapy is the current best practice for managing venous leg ulcer since it provides constant pressure,...

Pressure injuries (PIs) substantively impact quality of care during hospital stays, although only when they are severe or acquired as a result of the hospital stay are they reported as quality indicators. Globally, researchers have repeatedly highlighted the need to invest more in quality improvement, risk assessment, prevention, early detection, a...

The primary objective of this systematic review was to identify which quality of life instruments have been applied in published studies of patients with active venous leg ulcers. Our secondary objective was to map the measurement properties of each identified quality of life instrument and to inform future recommendations for clinical practice and...

Healing time is protracted and ulcer recurrence is common in patients with venous leg ulcers. Although compression is the mainstay treatment, many patients do not heal timely. Physical activity may be a clinically effective adjunct treatment to compression to improve healing outcomes. This scoping review provides a broad overview of the effect of p...

When faced with adverse circumstances, there may be a tendency for individuals, agencies, and governments to search for a target to assign blame. Our focus will be on the novel coronavirus (COVID-19) outbreak, where racial groups, political parties, countries, and minorities have been blamed for spreading, producing or creating the virus. Blame—her...

A hospital-acquired pressure injury (HAPI) is a common complication across the globe. The severity of HAPI ranges from skin redness and no skin breakdown to full skin and tissue loss, exposing the tendons and bones. HAPI can significantly impact the quality of life. In addition to the human cost, this injury carries a high economic burden with the...

Background: Chronic venous leg ulceration is a common and costly clinical issue across the world, affecting up to 3 in 1,000 people. Compression therapy is recommended as the gold standard treatment in clinical practice, although a large number of venous leg ulcers remain unhealed after several years. Physical activity may improve healing although...

Objective: The objective of this review is to synthesize available qualitative evidence to an overview of the barriers and enablers that influence physical activity participation in patients with venous leg ulcers. Introduction: Management of venous leg ulcers is a costly and time-consuming process in clinical settings, due to the protracted hea...

The aim of this study was to understand which factors influence patients’ adherence to venous leg ulcer treatment recommendations in primary care. We adopted a qualitative study design, conducting phone interviews with 31 people with venous leg ulcers in Melbourne, Australia. We conducted 31 semi-structured phone interviews between October and Dece...

Introduction Chronic venous leg ulcer (VLU) healing is a complex clinical problem. It requires intervention from skilled, costly, multidisciplinary wound-care teams, working with patients to manage their care. Compression therapy has been shown to help heal venous ulcers and to reduce recurrence, with some evidence suggesting the value of exercise...

Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in China in December 2019 and became a pandemic in a short period of time. While most infected people might have mild symptoms, older people and people with chronic illnesses may develop acute respiratory distress syn...

Pressure injury is a common hospital acquired complication across the globe. The severity of hospital acquired pressure injury ranges from skin redness and no skin breakdown to full skin and tissue loss, exposing tendons and bones. Pressure injury can significantly impact on quality of life. In addition to the human cost, hospital acquired pressure...

In Western countries, thinness remains the most privileged type of body and the one most people aspire towards (Grogan). Conversely, fatness is considered ugly, unappealing, and unhealthy (LeBesco). However, in other geographic locations, this culture is different; for example, in Mauritania (Guerrero), rural Jamaica (Sobo), and Ukraine (Bilukha an...

As coronavirus infection spread across Europe and north America to much poorer parts of the world, calls for personal protection – hand washing, physical distancing, and masks – highlighted the structural challenges of implementation. These personal measures were complemented by public health directives, worldwide, for populations to stay home, or...

Background Venous leg ulcers are the most common chronic wound seen in Australian primary care. Healing outcomes are protracted due to suboptimal use of clinical practice guideline recommendations. A better understanding of the differences between patients and clinicians may optimise management in primary care and improve healing and health outcome...

Abstract Background Venous leg ulcers (VLUs) are a common and costly problem. Due to a cycle of healing and recurrence, they are challenging to treat. Adults with VLUs are less likely to be physically active and show greater sleep disturbances than the general population; limited evidence suggests these issues contribute to VLU healing delays. Fur...

As coronavirus infection spread across Europe and north America to much poorer parts of the world, calls for personal protection – hand washing, physical distancing, and masks – highlighted the structural challenges of implementation. Australians took to panic buying, physically fighting over toilet rolls in supermarkets, precipitating a national s...

Recruitment to wound care clinical trials is challenging and a better understanding of patient decisions to participate has the potential to influence recruitment success. We conducted 31 semi-structured telephone interviews of patients who participated in the Aspirin in Venous Leg Ulcer (ASPiVLU) randomised controlled trail (RCT) or ASPiVLU cohort...

The study objective was to explore the characteristics of rural general practice which exemplify optimal end‐of‐life (EOL) care from the perspective of people diagnosed with cancer, their informal carers and general practitioners (GPs); and the extent to which consumers perceived that actual EOL care addressed these characteristics. Semi‐structured...

There is a global health professional knowledge deficit on pressure injury (PI) prevention and early detection and standard preventive interventions recommended by the clinical practice guidelines may not be fully implemented, which is applicable to the COVID-19 situation. Health professionals may lack awareness of pressure points typical for patie...

The aim of this study was to gain a better understanding of the venous leg ulcer (VLU) management in primary health care settings located in Melbourne metropolitan and rural Victoria, Australia. We explored health professionals' perspective on the use of the Australian and New Zealand Venous Leg Ulcer Clinical Practice Guideline (VLU CPG) to identi...

Wound management is a significant and growing issue worldwide. Knowledge of dressing products and clinical expertise in dressing selection are two major components in holistic wound management to ensure evidence-based wound care. With expanding global market of dressing products, there is need to update clinician knowledge of dressing properties in...

Hospital‐acquired pressure injuries (HAPIs) represent a serious clinical and economic problem. The cost of treating HAPIs in Australian public hospitals was recently reported at AUS$983 million per annum. There are three main sources of data for documenting pressure injury (PI) occurrence in Australian hospitals: incident reporting, medical record...

Venous leg ulcers (VLUs) are a common chronic often undertreated condition, which affects individual's health related quality of life (HRQoL). Numerous patient‐reported outcome measures (PROMs) have been validated to capture HRQoL in patients with VLUs. However, available instruments contain many items, are hard to use in clinical practice, and pre...

Background: Venous leg ulcers represent the most common chronic wound problem managed in Australian primary care. Despite the prevalence of the condition, there is an evidence-practice gap in both diagnosis and management of venous leg ulcers. Objective: We used the Theoretical Domains Framework to identify barriers and enablers perceived by pri...

Pressure injuries (PIs) are a common quality indicator for hospital care, and preventing PIs often requires patient engagement; as such, Australian consensus research has recommended that high‐quality education materials be made to patients for PIs via hospital networks. The purpose of the present study was to assess the availability and accuracy o...

Aim: In this article, we focus on primary health clinicians' experiences of vascular assessment in venous leg ulcer (VLU) diagnostics and management, including ankle brachial pressure index (ABPI) measurements using Doppler ultrasonography. Methods: We conducted semi-structured face-to-face and telephone interviews with general practitioners [15...

Chronic venous leg ulcers are challenging to heal and have a high rate of recurrence. This has a significant impact on older individual health and is a financial burden on health care resources. This study aimed to identify factors associated with the healing of venous leg ulcers via secondary examination of data from a previously published prospec...

Background Medication non‐adherence is prevalent among patients with rheumatoid arthritis (RA). Rheumatologists are specialists in medication prescribing and counselling for RA, but their insights regarding medication adherence have not been studied. Objective To explore rheumatologists' insights into medication adherence in patients with RA. Met...

Venous leg ulcers (VLUs) are increasing in the community due to a rise in the number of people with chronic venous insufficiency, diabetes and obesity. General practitioners (GPs) and practice nurses (PNs) play an important role in diagnosing and managing people with VLUs, although there are gaps between recommended and current practice. The aim of...

Venous leg ulcers (VLUs) are a significant complication amongst persons with chronic venous sufficiency (CVI) that frequently follow a cycle of healing and recurrence. Current clinical practice guidelines (CPGs) recommend applying below knee compression to improve VLU healing. Compression could be applied if the Ankle Brachial Pressure Index (ABPI)...

Pressure Injuries [PIs] are a significant health issue worldwide, and contribute substantially toward the economic burden in healthcare systems. This is primarily because PIs increase the length of hospital stays; and longer hospital stays also predict PI development. PIs are also used to measure the performance of health staff and facilities in a...

Compression therapy is the current evidence-based approach to manage venous leg ulcers (VLU), however adherence is a major barrier to successful treatment. Combination approaches may relieve the burden of treatment by shortening the time to ulcer healing. This scoping review conducted by Australian researchers aimed to establish the evidence of eff...

Evidence translation in wound care relies on the need for evidence generation. Clinical practice may become evidence-generating only if evidence generating research projects, such as randomized controlled trials, became routinized in clinical settings. The aim of this study was to identify optimal trial-related practices to routinize trial-related...

Pressure injury (PI) rates are a commonly used indicator of performance of health care facilities, both in acute and subacute settings. However, measuring PI rates in an accurate and reproducible fashion has been challenging. The consequences of poor measurement may include failure to identify poorly performing institutions or incorrect accusations...

Methodology: 15 General Practitioners (GPs) and 20 Practice Nurses (PNs) from primary healthcare settings located in metropolitan Melbourne and Regional Victoria participated in this study. Participants were recruited through personal and professional networks and were interviewed face-to-face or by telephone. Identifying drivers of behaviour The T...

Clinical practice guidelines (CPGs) for venous leg ulcer (VLU) management recommend below knee compression to improve healing outcomes after calculating the ankle brachial pressure index (ABPI) to rule out significant arterial disease. This systematic scoping review aimed to complete a qualitative and quantitative content analysis of international...

In this chapter, we have reviewed the technological advances in the development of interactive wound dressings. Since the time when the value of a moist wound environment in wound healing process was recognised, the primary purpose of dressings has changed from reducing moisture to maintaining moisture. The balance of moisture is critical to healin...

Low recruitment rate for randomized controlled trials (RCTs) is a common issue. Information on barriers and facilitators to recruitment for RCTs may inform researchers on how to improve the recruitment rate. The aim of this qualitative project was to identify barriers and facilitators to participant recruitment for a randomized double-blinded place...

Purpose of study Randomised controlled trials represent the gold standard in intervention efficacy evaluation. However, suboptimal recruitment affects completion and power of a therapeutic trial in detecting treatment differences. We conducted a systematic review to examine the barriers and enablers to patient recruitment for randomised controlled...

Standard best practice for the treatment of venous leg ulcers (VLUs) is compression bandaging of the lower leg to reduce hydrostatic pressure. There is considerable variation in reported healing rates when using this gold-standard approach; therefore, a systematic and robust evaluation of other interventions is required. Exercise interventions, in...

Increasing levels of physical activity among people with venous leg ulcers (VLUs) can potentially reduce the health cost burden, improve functional aspects of patients’ lives and increase ulcer healing rates. The aim of this study was to investigate factors associated with physical activity levels in patients with VLUs. Data from 2016 to 2017 Aspir...

Objective: In this paper, we apply psychological agency theory to women's interviews of their breastfeeding experiences to understand the role of agency in relation to breastfeeding initiation, maintenance and duration. Design: Qualitative, video interviews were collected from 49 women in the UK from a wide range of ethnic, religious, educationa...

The Twinning in Africa urn is dedicated to one of my patients, an Ethiopian woman who had two twin sets and came to the clinic that I worked in for an antenatal check-up. She suspected she had a twin pregnancy and this was later confirmed by the ultrasound findings. The central image of the urn depicts an African woman who is pregnant with twins, b...

Exclusive breastfeeding for at least six months is the recommended method of infant feeding (World Health Organization [WHO] and United Nations Children’s Fund [UNICEF], 2003). Breastfeeding is being promoted as the social norm in the US, UK, and Australasia in an attempt to replace formula feeding (American Academy of Pediatrics, 2012; Australian...

Breast milk expression has been promoted as liberating for women and as offering them more choices, but there has been little research on women's experiences of it and even less critical commentary on the consequences of its incorporation into mainstream behavior. Drawing on narratives of women in the United Kingdom about breastfeeding, we explore...

The social participation of people with disabilities is limited by the combined effects of their impairments and socio-environmental factors. Current policies in Australia and other industrialised countries have focused on developing skills and promoting independence, as ways of supporting social inclusion and improving the quality of life of peopl...

In this article, we report on a small qualitative scale study with immigrant Russian-speaking Australian women, carers of dependent family members. Drawing on in-depth interviews, we explore women's health-related behaviours, in particular their participation in breast and cervical cancer screening. Differences in preventive health care policies in...

This work provides an overview of the literature on the current and projected social and health effects of climate change in countries affected by sub-Antarctic atmospheric circulation, including Argentina, Australia, Chile, New Zealand, and South Africa. These countries, which for convenience we gloss as ‘40 South’, are already experiencing consid...

The growing evidence on the benefits and risks of complementary and alternative medicine (CAM) and its high rate of use (69% of Australians) - particularly for chronic or recurrent conditions - means increasing attention on CAM. However, few people disclose CAM use to their GP, and health professionals tend to inadequately discuss CAM-related issue...

This chapter on the cultural dimensions of pregnancy, birth and post-natal care has been produced for Queensland Health by Victoria Team, Katie Vasey and Lenore Manderson, Social Science and Health Research Unit, School of Psychology, Psychiatry and Psychological Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University. It deri...

In Australia, rapid population ageing, and government efforts to support people who are chronically ill, elderly or with disabilities to live in their own homes, has led to the primary responsibility of care being undertaken by families. Through its social policies, the Australian government provides income and other types of support to informal ca...

Artificial tanning, defined as deliberate exposure to ultraviolet rays produced by artificial tanning devices, is a new and emerging public health issue in Australia and globally. Epidemiological research suggests that artificial tanning may contribute to the incidence of melanoma, nonmelanoma skin cancer as well as other health problems. Given tha...