Cohort study comparison of Mental Health and Wellbeing Services delivered by The Royal Flying Doctor Service, across Far North and Central West Queensland

Culturally appropriate psychotherapy and its retention: An example from Far North Queensland (Australia)

BACKGROUND

Culturally appropriate mental health care is essential in remote Australia. However, while associated with the development of an effective therapeutic alliance, current literature insufficiently reports the retention and psychotherapy outcomes of Indigenous adults. We aimed to describe the characteristics and retention of clients attending the Far North Mental Health and Wellbeing Service (FNS).

METHODS

We conducted a retrospective cross-sectional study on clients who received one or more psychotherapy consultations between 1st July 2019 and 31st December 2020. Population, entrance, and treatment characteristics were described, with retention compared between the major cultural groups. Entrance characteristics comprised referral pathway and reason for presentation and were investigated as alternative predictors of client retention.

FINDINGS

There were 186 non-Indigenous (68.3 % female) and 174 Indigenous (62.6 % female) clients, with a median number of 3.0 consultations (IQR 2.0-5.3). Indigenous status did not significantly predict retention. Referral pathway significantly predicted the number of consultations (Wald X2(6) = 17.67, p = .0071) and immediate discontinuation (Wald X2(6) = 12.94, p = .044), with self-referred clients having the highest retention. Initial presentation reason significantly predicted the number of consultations (Wald X2(5) = 13.83, p = .017), with clients with potential health hazards related to socioeconomic and psychosocial circumstances having the lowest retention. Significantly more Indigenous clients presented for this reason (20.1 % vs 4.3 %).

INTERPRETATION

Comparable retention of Indigenous clients suggests cultural appropriateness of the psychotherapy being delivered by the FNS. Services might use the described therapeutic approach as a guide for culturally appropriate care.

Understanding the determinants of ePharmacy services: the moderating effect of technology discomfort

Purpose

The purpose of this study is to understand the determinants affecting behavioral intention (BI) to use ePharmacy services. The moderating role of technology discomfort in the relationship between BI and the actual use of ePharmacies in the context of Bangladesh is also examined.

Design/methodology/approach

A descriptive, quantitative approach was used to consider the UTAUT-2 model. Using the convenience sampling method, 255 responses were collected. The data were analyzed using Smart-PLS 3.2 software to investigate the hypothesized relationships.

Findings

The findings reveal that website information, doctors’ services, performance expectancy, return policy, social influence, perceived reliability and facilitating conditions are significantly related to the BI to use ePharmacy services. Interestingly, the structural equation modeling results also confirmed that technology discomfort has no moderating effect on the relationship between BI and actual usage behavior.

Research limitations/implications

This research provides theoretical contribution by extending the practical knowledge focusing on the relationship of ePharmacy, BI and actual usage behavior by using UTAUT-2 model – a relevant and unexplored issue in the easting literature, offering several research opportunities as the future avenue.

Practical implications

The result highlights the economic and social relevance from the perspective of a developing country. As people are showing their intention toward ePharmacy, managers and decision-makers need to take strategic decision to overcome any difficulties. Policymakers need to improve their services for the expansion of ePharmacy through different development projects.

Originality/value

This study advances past studies on the use of ecommerce in the pharmaceutical industry and provides a general understanding of customers in developing countries.