ORCID Profile
0000-0003-0837-6814
Current Organisations
University of Delaware
,
University of Adelaide
,
University of South Australia
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Publisher: Informa UK Limited
Date: 17-12-2022
Publisher: Springer Science and Business Media LLC
Date: 02-05-2013
DOI: 10.1007/S00520-013-1812-9
Abstract: This study aims to identify key issues associated with the provision of psychosocial care from the perspective of rural Australian cancer patients and determine culturally appropriate methods that may reduce barriers to service use. Seventeen purposively s led adult South Australians who lived outside metropolitan Adelaide, had a diagnosis of cancer and various demographic and medical histories participated in semi-structured, face-to-face interviews. Participants also completed a demographic questionnaire. Qualitative data were analysed using thematic analysis. Five key themes were identified: (1) psychosocial support is highly valued by those who have accessed it, (2) having access to both lay and professional psychosocial support is vitally important, (3) accessing psychosocial services is made difficult by several barriers (lack of information about services, initial beliefs they are unnecessary, feeling overwhelmed and concerns about stigma and dual relationships), (4) medical staff located in metropolitan treatment centres are not sufficiently aware of the unique needs of rural patients and (5) patients require better access to psychosocial services post-treatment. Methods through which rural patients believe access to psychosocial services could be improved include: (1) providing more rural-specific information on psychosocial care, (2) improving communication between health care providers and referral to psychosocial services and (3) making psychosocial services a standard part of care. Rural cancer patients want their unique needs to be recognised and to be treated differently to their urban counterparts. There is a need for more targeted and rurally relevant information for rural cancer patients, both to inform them of, and change their attitudes towards, psychosocial services. Other practical recommendations are also discussed.
Publisher: JMIR Publications Inc.
Date: 11-01-2022
DOI: 10.2196/27631
Abstract: Farming is physically and psychologically hazardous. Farmers face many barriers to help seeking from traditional physical and mental health services however, improved internet access now provides promising avenues for offering support. This study aims to co-design with farmers the content and functionality of a website that helps them adopt transferable coping strategies and test its acceptability in the broader farming population. Research evidence and expert opinions were synthesized to inform key design principles. A total of 18 farmers detailed what they would like from this type of website. Intervention logic and relevant evidence-based strategies were mapped. Website content was drafted and reviewed by 2 independent mental health professionals. A total of 9 farmers provided detailed qualitative feedback on the face validity of the draft content. Subsequently, 9 farmers provided feedback on the website prototype. Following amendments and internal prototype testing and optimization, prototype usability (ie, completion rate) was examined with 157 registered website users who were (105/157, 66.9%) female, aged 21-73 years 95.5% (149/156) residing in inner regional to very remote Australia, and 68.2% (107/157) “sheep, cattle and/or grain farmers.” Acceptability was examined with a subset of 114 users who rated at least module 1. Interviews with 108 farmers who did not complete all 5 modules helped determine why, and detailed interviews were conducted with 18 purposively s led users. Updates were then made according to adaptive trial design methodology. This systematic co-design process resulted in a web-based resource based on acceptance and commitment therapy and designed to overcome barriers to engagement with traditional mental health and well-being strategies—ifarmwell. It was considered an accessible and confidential source of practical and relevant farmer-focused self-help strategies. These strategies were delivered via 5 interactive modules that include written, drawn, and audio- and video-based psychoeducation and exercises, as well as farming-related jokes, metaphors, ex les, and imagery. Module 1 included distress screening and information on how to speak to general practitioners about mental health–related concerns (including a personalized conversation script). Modules were completed fortnightly. SMS text messages offered personalized support and reminders. Qualitative interviews and star ratings demonstrated high module acceptability (average 4.06/5 rating) and suggested that additional reminders, higher quality audio recordings, and shorter modules would be useful. Approximately 37.1% (52/140) of users who started module 1 completed all modules, with too busy or not got to it yet being the main reason for non-completion, and previous module acceptability not predicting subsequent module completion. Sequential integration of research evidence, expert knowledge, and farmers’ preferences in the co-design process allowed for the development of a self-help intervention that focused on important intervention targets and was acceptable to this difficult-to-engage group. Australian New Zealand Clinical Trials Registry ACTRN12617000506392 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372526
Publisher: Wiley
Date: 19-06-2023
DOI: 10.1111/AJR.13008
Abstract: A growing body of research has examined the physical, psychological, social and financial impacts of living kidney donation. However, little is known about the unique experiences or additional burdens faced by living donors from regional or remote locations. To explore the experiences of living kidney donors who live outside metropolitan centres and to determine how support services could be orientated to better meet their unique needs. Seventeen living kidney donors participated in semistructured telephone interviews. Qualitative data were analysed using thematic analysis. Eight themes were identified: (1) donor's emotional well‐being is influenced by the recipient's outcome, (2) varied levels of access to medical support and other important services in rural areas, (3) travel takes a toll on time, finances and well‐being, (4) varied level of financial impact, (5) medical, emotional and social challenges, (6) both lay and health professional support is valued, (7) varied levels of knowledge and experiences accessing information and (8) a worthwhile experience overall. Despite many challenges, and travel adding to the complexity, rural living kidney donors generally consider it to be a worthwhile experience. The provision of additional emotional, practical and educational support would be welcomed by this group.
Publisher: JMIR Publications Inc.
Date: 21-12-2018
DOI: 10.2196/11724
Publisher: Wiley
Date: 25-05-2023
DOI: 10.1002/HPJA.752
Abstract: Rurality is associated with poorer health outcomes and access to health services, yet a strength of rural living includes community cohesion indicated by high rates of volunteering. While volunteerism is an effective means to target health needs in resource‐restricted contexts, research on volunteerism to address rural Australian health needs is limited. This research aimed to explore rural adults' perspectives of volunteerism in local activities and programs that had a direct health related benefit (health volunteering). Eight people from the Murray Mallee region of South Australia participated during April 2021, ranging in age from 32 to 75 years. Participants were invited to one‐on‐one interviews that occurred via a phone call or teleconference meeting, which were audio‐recorded and transcribed verbatim to facilitate thematic analysis. Seven main themes emerged. Participants identified that (1) health volunteering takes many forms, (2) health volunteering affords local ownership and accessibility, (3) health volunteers have particular skills and values, but also (4) gain social benefits and learn new skills. Rural health volunteering was also associated with (5) a variety of personal costs, and (6) there are several environmental barriers and (7) facilitators to rural health volunteering that should be considered when designing health programs. Results provide insight into how rural communities can enhance the development and application of volunteering roles to support health volunteering. Including local ch ions, reducing the financial burden and developing support networks for volunteers are practical suggestions to enhance levels of volunteering for health in rural settings.
Publisher: Wiley
Date: 23-08-2023
DOI: 10.1002/HPJA.796
Abstract: Farmers experience skin cancer and die from melanoma at significantly higher rates than the general Australian population. This study examined Australian farmers' engagement with self‐skin examinations (SSE), participation in clinical skin examinations (CSE) by a health professional, and self‐reported barriers to engagement with these important skin cancer detection practices. A cross‐sectional, mixed‐methods design was used. Australian farmers were recruited through an industry‐based organisation representing livestock farmers. Farmers ( N = 498 22–89 years 83.1% male) responded to a paper‐based survey that included closed‐ and open‐ended questions. Farmers reported engagement with self‐conducted SSE and routine CSE that was comparable to findings in the general population, but 29.4% of farmers reported that they had not sought a CSE as soon as possible after noticing changes to their skin. Farmers reported a range of barriers to SSE, including physical difficulties examining their skin, difficulties identifying changes in their skin, forgetfulness, and lack of motivation. Barriers to CSE included accessibility, cost, difficulties finding the right doctor, and avoidance and complacency. There is a need to make clinical skin cancer detection more accessible to farmers, in addition to promoting self‐skin examination and help‐seeking behaviours within this at risk population. Novel approaches are needed to address systemic barriers faced by Australian farmers. These may include the use of teledermatology or artificial intelligence to assist with CSE. Remote training delivery methods may be also utilised to teach SSE skills to farmers who may be otherwise unable to access such opportunities.
Publisher: JMIR Publications Inc.
Date: 08-02-2022
DOI: 10.2196/31018
Abstract: A large number of Australians experience mental health challenges at some point in their lives. However, in many parts of Australia, the wait times to see general practitioners and mental health professionals can be lengthy. With increasing internet use across Australia, web-based interventions may help increase access to timely mental health care. As a result, this is an area of increasing research interest, and the number of publicly available web-based interventions is growing. However, it can be confusing for clinicians and consumers to know the resources that are evidence-based and best meet their needs. This study aims to scope out the range of web-based mental health interventions that address depression, anxiety, suicidal ideation, or general mental well-being and are freely available to Australian adults, along with their impact, acceptability, therapeutic approach, and key features. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for scoping reviews (PRISMA-ScR [PRISMA extension for Scoping Reviews]) guided the review process. Keywords for the search were depression, anxiety, suicide, and well-being. The search was conducted using Google as well as the key intervention databases Beacon, Head to Health, and e-Mental Health in Practice. Interventions were deemed eligible if they targeted depression, anxiety, suicidal ideation, or general mental well-being (eg, resilience) in adults and were web-based, written in English, interactive, free, and publicly available. They also had to be guided by an evidence-based therapeutic approach. Overall, 52 eligible programs were identified, of which 9 (17%) addressed depression, 15 (29%) addressed anxiety, 13 (25%) addressed general mental well-being, and 13 (25%) addressed multiple issues. Only 4% (2/52) addressed distress in the form of suicidal ideation. The most common therapeutic approach was cognitive behavioral therapy. Half of the programs guided users through exercises in a set sequence, and most programs enabled users to log in and complete the activities on their own without professional support. Just over half of the programs had been evaluated for their effectiveness in reducing symptoms, and 11% (6/52) were being evaluated at the time of writing. Program evaluation scores ranged from 44% to 100%, with a total average score of 85%. There are numerous web-based programs for depression, anxiety, suicidal ideation, and general well-being, which are freely and publicly available in Australia. However, identified gaps include a lack of available web-based interventions for culturally and linguistically erse populations and programs that use newer therapeutic approaches such as acceptance and commitment therapy and dialectical behavior therapy. Despite most programs included in this review being of good quality, clinicians and consumers should pay careful attention when selecting which program to recommend and use, as variations in the levels of acceptability and impact of publicly available programs do exist.
Publisher: Wiley
Date: 31-01-2021
DOI: 10.1111/SCS.12822
Publisher: Informa UK Limited
Date: 03-07-2023
Publisher: MDPI AG
Date: 27-09-2022
Abstract: This research aimed to explore the self-management strategies that Australian male farmers use to improve or maintain their psychological wellbeing and their views on what would assist them to overcome barriers to seeking professional mental health assistance. In idual semi-structured telephone interviews were audio-recorded with consent. Qualitative data were analysed inductively using thematic analysis. Fifteen male farmers participated, who were an average of thirty-nine years of age (23–74 years) with twenty years of farming experience (5–57 years). Seven themes relating to self-management strategies were identified: (1) interacting with a supportive network (2) involvement in groups and teams (3) physical activity (4) proactively educating themselves (5) self-prioritising and deliberately maintaining work–life balance (6) being grateful and (7) focusing on the controllable aspects of farming. Five themes were identified that related to mitigating barriers to seeking mental health assistance: (1) actively welcoming mental health professionals into the community (2) normalising help-seeking (3) making seeking mental health assistance a priority (4) offering services that are culturally appropriate and accessible for male farmers and (5) tailoring mental health information delivery to farming populations. Australian male farmers already use strategies to maintain and improve their mental health that are culturally and contextually appropriate. These proactive strategies could form the basis of interventions aiming to further promote male farmers’ wellbeing. Barriers to seeking professional mental health assistance may be overcome by implementing solutions directly suggested by male farmers. Given the elevated risk of suicide in this group, investment in trialing promotion of these strategies is warranted.
Publisher: Hindawi Limited
Date: 13-07-2017
DOI: 10.1111/ECC.12533
Abstract: Websites offer new opportunities to provide health-related information to rural communities. However, how acceptable they are to this population is unknown. This paper describes the consumer-led development of a website that provides rural-specific information on psychosocial care for rural South Australians affected by cancer, and examines its acceptability to users. The Country Cancer Support website was developed with people affected by cancer living in rural South Australia (N = 11), using a Participatory Action Research Framework and evidence-based behaviour change strategies. There were 32,389 visits in the first 3 years. An online survey (N = 111) revealed that users found the website easy to use, helpful and relevant. Most rural cancer patients and supporters (98.11%) believed it had been written by people who understood what they were going through. Patients and supporters for whom it was relevant, reported feeling more motivated and confident in accessing psychosocial support services in their rural area (66.67%) and/or capital city (67.65%) and/or in travelling for medical treatment (75.86%). Many also felt less isolated (73.33%) and/or distressed (53.57%). All health professionals reported gaining new knowledge. This study shows that carefully designed websites can successfully address rural populations' health information needs and increase intentions to access psychosocial support.
Publisher: Springer Science and Business Media LLC
Date: 21-05-2020
DOI: 10.1007/S00520-019-04822-0
Abstract: People affected by cancer who live in rural Australia experience inferior survival compared to their urban counterparts. This study determines whether self-reported physical and mental health, as well as health-promoting behaviours, also differ between rural and urban Australian adults with a history of cancer. Weighted, representative population data were collected via the South Australian Monitoring and Surveillance System between 1 January 2010 and 1 June 2015. Data for participants with a history of cancer (n = 4295) were analysed with adjustment for survey year, gender, age group, education, income, family structure, work status, country of birth and area-level relative socioeconomic disadvantage (SEIFA). Cancer risk factors and co-morbid physical and mental health issues were prevalent among cancer survivors regardless of residential location. In unadjusted analyses, rural survivors were more likely than urban survivors to be obese and be physically inactive. They were equally likely to experience other co-morbidities (diabetes, chronic obstructive pulmonary disease, cardiovascular disease, arthritis or osteoporosis). With adjustment for SEIFA, rural/urban differences in obesity and physical activity disappeared. Rural survivors were more likely to have trust in their communities, less likely to report high/very high distress, but equally likely to report a mental health condition, both with and without adjustment for SEIFA. There is a need for deeper understanding of the impact of relative socioeconomic disadvantage on health (particularly physical activity and obesity) in rural settings and the development of accessible and culturally appropriate interventions to address rural cancer survivors' specific needs and risk factors.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2020
Publisher: Wiley
Date: 15-06-2017
DOI: 10.1111/AJR.12352
Abstract: To assess the differences between farming and non-farming rural adults in perceived barriers to mental health service use. A cross-sectional survey, modified from the Barriers to Help-Seeking Scale (BHSS), was conducted using a computer-assisted telephone interview. Respondents (age 52.6 ± 11.6 years) were recruited from three rural regions of South Australia. Approximately, 78 non-farmers and 45 farmers were included in analyses. 78 retired and two unemployed participants were excluded from the analyses. Farmers and non-farmers were compared on domain scores and in idual item responses from the adapted BHSS that represent 'agrarian' attitudes to support-seeking for mental health: stoicism, self-reliance, minimisation of the problem, stigma and distrust of health professionals. In the analysis of domain scores, 'Need for Control and Self-Reliance' was a stronger barrier for farmers than non-farmers (P = 0.009) with a trend (P = 0.07) towards stronger barriers among farmers in the 'Minimising Problem and Resignation' domain. In the analysis of item-level responses, there was a difference (P = 0.03) between farmers and non-farmers in responses to 'I find it difficult to understand my doctor/health professional', with 24.4% of the farmers agreeing that this is a barrier compared with 15.3% of the non-farmers. Long-held stereotypes of stoicism and self-reliance among farmers were somewhat supported, in the context of mental health. Mental health services and professionals in rural Australia might need to adapt their practices to successfully engage this population.
Publisher: Hogrefe Publishing Group
Date: 08-11-2022
DOI: 10.1027/0227-5910/A000885
Abstract: Abstract. Background: Research suggests construction industry workers (CIWs) face increased suicide vulnerability. Aims: The current study synthesizes international evidence examining rates, risk, and drivers of CIW suicide. Method: Comprehensive searches of MEDLINE, PsycInfo, Embase, Emcare, Web of Science, Scopus, and gray literature were undertaken, identifying studies that discussed, theorized about, or demonstrated risks and/or rates and/or drivers of CIW suicide, without inclusion of other industries. Results: A number of included studies statistically analyzed suicide outcomes in a variety of CIW populations, with the majority reporting increased rate and/or risk, however significant heterogeneity limited comparisons. Twenty-five potential drivers were identified and classified as personal- or industry-related. Disentanglement highlighted the relevance of previously understood personal drivers, need for future focus on industry drivers, and potential interplay between drivers. Limitations: Exclusion of non-English articles as well as inability to extend analysis to fully understand rates and/or risk of CIW suicide and tenuous links between suggested drivers and suicide outcomes. Conclusion: Despite limitations, this paper aids understanding in relation to the suggestion that CIWs are at increased suicide vulnerability. Disentanglement of potential drivers demonstrates the importance of future research focused on industry drivers to assist in prevention strategies.
Publisher: JMIR Publications Inc.
Date: 02-2021
Abstract: arming is physically and psychologically hazardous. Farmers face many barriers to help seeking from traditional physical and mental health services however, improved internet access now provides promising avenues for offering support. his study aims to co-design with farmers the content and functionality of a website that helps them adopt transferable coping strategies and test its acceptability in the broader farming population. esearch evidence and expert opinions were synthesized to inform key design principles. A total of 18 farmers detailed what they would like from this type of website. Intervention logic and relevant evidence-based strategies were mapped. Website content was drafted and reviewed by 2 independent mental health professionals. A total of 9 farmers provided detailed qualitative feedback on the face validity of the draft content. Subsequently, 9 farmers provided feedback on the website prototype. Following amendments and internal prototype testing and optimization, prototype usability (ie, completion rate) was examined with 157 registered website users who were (105/157, 66.9%) female, aged 21-73 years 95.5% (149/156) residing in inner regional to very remote Australia, and 68.2% (107/157) “sheep, cattle and/or grain farmers.” Acceptability was examined with a subset of 114 users who rated at least module 1. Interviews with 108 farmers who did not complete all 5 modules helped determine why, and detailed interviews were conducted with 18 purposively s led users. Updates were then made according to adaptive trial design methodology. his systematic co-design process resulted in a web-based resource based on acceptance and commitment therapy and designed to overcome barriers to engagement with traditional mental health and well-being strategies—ifarmwell. It was considered an accessible and confidential source of practical and relevant farmer-focused self-help strategies. These strategies were delivered via 5 interactive modules that include written, drawn, and audio- and video-based psychoeducation and exercises, as well as farming-related jokes, metaphors, ex les, and imagery. Module 1 included distress screening and information on how to speak to general practitioners about mental health–related concerns (including a personalized conversation script). Modules were completed fortnightly. SMS text messages offered personalized support and reminders. Qualitative interviews and star ratings demonstrated high module acceptability (average 4.06/5 rating) and suggested that additional reminders, higher quality audio recordings, and shorter modules would be useful. Approximately 37.1% (52/140) of users who started module 1 completed all modules, with i too busy /i or i not got to it yet /i being the main reason for non-completion, and previous module acceptability not predicting subsequent module completion. equential integration of research evidence, expert knowledge, and farmers’ preferences in the co-design process allowed for the development of a self-help intervention that focused on important intervention targets and was acceptable to this difficult-to-engage group. ustralian New Zealand Clinical Trials Registry ACTRN12617000506392 www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=372526
Publisher: Elsevier BV
Date: 03-2017
DOI: 10.1016/J.PEC.2016.10.008
Abstract: To provide an updated synthesis of the literature that investigates the self-reported information needs of people diagnosed with cancer across the cancer continuum. We conducted a scoping review of the literature published from August 2003 to June 2015 and expanded an existing typology summarizing the information needs of people diagnosed with cancer. The majority of the included studies (n=104) focused on questions relevant to the diagnosis/active treatment phase of the cancer continuum (52.9%) and thus the most frequently identified information needs related to this phase (33.4%). Information needs varied across the continuum and the results highlight the importance of recognising this fact. People diagnosed with cancer experience discrete information needs at different points from diagnosis to survival. Much of the research conducted in this area has focused on their information needs during the diagnosis and treatment of cancer, and literature relating to information needs following completion of treatment is sparse. Further research is needed to discern the specific nature of the treatment concerns and identify the information needs that survivors experience during recurrence of cancer, metastasis or changes in diagnosis, and the end of life phase of the cancer continuum.
Publisher: Informa UK Limited
Date: 13-10-2022
DOI: 10.1080/13811118.2022.2131488
Abstract: With research suggesting an increased risk of suicide for those employed in the construction industry the present review aimed to provide an updated, targeted, and rigorous estimate of the relative risk of suicide for this population. Comprehensive searches of Medline, Psycinfo, Embase, Emcare, Web of Science, and Scopus databases, as well as grey literature and reference lists, were undertaken to identify studies which reported the rate or risk of construction industry workers' suicide. Only s les that did not incorporate other industries and utilized reference groups deemed representative of the general or employed populations, were included. Eleven studies were included in the review. Primary analysis was undertaken on seven studies deemed to have wholly s les wholly representative of the construction industry. Despite a high level of heterogeneity ( Despite limitations, this paper suggests that construction industry employees may have an elevated risk of suicide. Additionally, this review highlights the need for further research, using standardized methodologies, to generate more robust understandings. Future research will benefit by accounting for locale-specific cultural and socio-political factors and attempting to quantify more specific drivers of suicide risk for this population.
Publisher: Elsevier BV
Date: 08-2021
Publisher: Wiley
Date: 19-10-2020
DOI: 10.1002/PON.5566
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2020
Publisher: Hindawi Limited
Date: 26-08-2022
DOI: 10.1111/HSC.13978
Publisher: Springer Science and Business Media LLC
Date: 14-02-2022
DOI: 10.1007/S00520-022-06857-2
Abstract: To explore the experiences of people caring for someone with cancer, while living in rural Australia, and the impact of the cancer-caring role on their well-being. Eighteen adults in regional or remote (‘rural’) Australia who cared for a person with cancer took part in semi-structured telephone interviews. Participants were aged 32–77 years and mainly female (66%). Data were analysed using thematic analysis and an essentialist approach. Eight themes were identified: (1) travel is hard, but supports are available (2) frustration with systems that do not demonstrate understanding of the rural context (3) the importance of lay and peer support (4) the impact of access to trusted, local health care services (5) the importance of access to rurally relevant information (particularly on relevant services and what to expect) (6) living with uncertainty and balancing loss with hope (7) reluctance to seek or accept psychological support and (8) the gendered nature of care. Rural cancer carers’ roles can be made easier by improving health systems and coordination to ease the burden of travel, providing information about available support and what to expect throughout cancer treatment that is relevant to the rural context, and increasing access to quality health, community, and support services, including palliative care, in rural areas. More training on the specific needs of rural patients and their carers is needed for urban health care professionals. Peer support groups may have particular value for cancer carers in rural settings, where there are known to be multiple barriers to accessing professional sources of psychosocial support.
Publisher: Wiley
Date: 10-03-2023
DOI: 10.1111/JAN.15636
Abstract: To (a) explore the experiences of early career registered nurses in rural hospitals in Australia and (b) identify strategies they believe would help increase job satisfaction and retention. Qualitative descriptive design. Thirteen registered nurses located in outer regional, remote or very remote (herein ‘rural’) Australian hospitals participated in semi‐structured interviews. Participants had graduated from a Bachelor of Nursing program in 2018–2020. Data were analyzed using thematic analysis and an essentialist, bottom‐up approach. Seven themes related to the experiences of rural early career nursing: (1) appreciate erse scope of practice (2) rewarding sense of community and opportunity to give back (3) staff support determines the quality of experience (4) feeling underprepared and the need for ongoing education (5) erse views on the optimal length of rotation and level of input into choice of clinical area (6) difficulty maintaining work/life balance due to work hours and rostering and (7) lack of staff and resources. Strategies to improve nurses' experiences included: (1) assistance with accommodation and transport (2) social gatherings to enhance connection (3) sufficient orientation and supernumerary time (4) increased frequency of contact with clinical facilitators and multiple mentors (5) prioritizing clinical education across erse topics (6) greater involvement in choice of rotations and clinical areas and (7) desire for more flexible work hours and rostering. This study highlighted the experiences of rural nurses and explored their suggestions for how to overcome challenges in their roles. Greater consideration of early career registered nurses' needs and preferences is vital to improving and maintaining a satisfied, dedicated and sustainable rural nursing workforce. Many of the strategies for improving job retention identified by nurses in this study could be actioned at a local level, with little financial or time investment. No Patient or Public Contribution.
Publisher: MDPI AG
Date: 31-01-2023
Abstract: Farms in Australia are largely family owned and managed. Complex interactions between farming history, traditions, family, business, succession, identity and place can lead to difficulties in planning for retirement for farmers. Due to the significant implications of this for farmers’ health and wellbeing, there is a clear need to determine how farmers may be best supported through the work-to-retirement transition. This scoping review summarises the literature on Australian farmers’ retirement experiences and the stressors they face during this transition. Barriers and facilitators that may hinder or help farmers were also explored. The relevant peer-reviewed literature was identified through database searching and the grey literature was collected via a web-based search. Seven studies were included in the review. Poor health and diminishing capacity to work was identified as a key stressor related to retirement. Other drivers of stress (i.e., pressure to live up to farming ideals, perceiving retirement as a threat to self-identity and financial concerns) overlapped with barriers to retirement. Farmers identified gradual transition, strong social networks, variety in interests and activities and early financial and succession planning as key facilitators of retirement. Findings will help inform the development of interventions to assist Australian farmers through this challenging stage of their lives.
Publisher: Elsevier BV
Date: 09-2015
DOI: 10.1016/J.EJCA.2015.06.129
Abstract: The aims of this analysis were to examine levels of unmet needs and depression among carers of people newly diagnosed with cancer and to identify groups who may be at higher risk, by examining relationships with demographic characteristics. One hundred and fifty dyads of people newly diagnosed with cancer and their carers, aged 18 years and older, were recruited from four Australian hospitals. People with cancer receiving adjuvant cancer treatment with curative intent, were eligible to participate. Carers completed the Supportive Care Needs Survey-Partners & Caregivers (SCNS-P&C45), and both carers and patients completed the Centre of Epidemiologic-Depression Scale (CES-D). Overall, 57% of carers reported at least one, 37% at least three, 31% at least five, and 15% at least 10 unmet needs the most commonly endorsed unmet needs were in the domains of information and health care service needs. Thirty percent of carers and 36% of patients were at risk of clinical depression. A weak to moderate positive relationship was observed between unmet needs and carer depression (r=0.30, p<0.001). Carer levels of unmet needs were significantly associated with carer age, hospital type, treatment type, cancer type, living situation, relationship status (in both uni- and multi-factor analysis) person with cancer age and carer level of education (in unifactor analysis only) but not with carer gender or patient gender (in both uni- and multi-factor analyses). Findings highlight the importance of developing tailored programmes to systematically assist carers who are supporting patients through the early stages of cancer treatment.
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.EJON.2016.12.005
Abstract: To improve understanding about (1) the validity of the Distress Thermometer (DT) as a measure of changes in distress after a cancer helpline call, (2) the impact of a helpline call on callers' distress, (3) caller and helpline nurses' comfort with use of the DT, and (4) the extent to which DT scores over the critical threshold, are associated with referral to internal support services for follow-up psychosocial care. Callers (people diagnosed with cancer and their family/friends: N = 100) completed a questionnaire that included DT ratings (three time-points), the Depression Anxiety and Stress Scale-21 (DASS-21) and measures of comfort with the DT tool. Nurses recorded referrals to internal services and their comfort in using the DT in each call. The DT correlated with the DASS-21 depression (r = 0.45, p < 0.001), anxiety (r = 0.56, p < 0.001) and stress (r = 0.64, p < 0.001) subscales demonstrating validity. Callers' self-rated distress was significantly lower after the call, regardless of gender or caller type (F(2, 97) = 63.67, p < 0.01, partial eta squared = 0.57). Over 74% of people diagnosed with cancer, 80% family/friends and 89.3% of nurses felt comfortable with DT use. Only 16% of participants were referred on to follow-up internal support services despite 90% of people with cancer and 75% of family/friends' DT scores' suggesting they required follow-up care. The DT is a valid and acceptable tool for use by cancer helplines. Improved documentation of referrals is required to better understand referral patterns.
Publisher: Wiley
Date: 21-05-2023
DOI: 10.1111/JRH.12768
Abstract: The aim of this research was to develop a contextually and culturally appropriate scale to assess farmers’ barriers to health‐related help‐seeking. An initial pool of items was developed from the academic literature and input from an expert panel of farmers, rural academics, and rural clinicians. A draft 32‐item questionnaire was then developed and sent to farmers registered with FARMbase, which is an Australian national farmer database. Two hundred and seventy‐four farmers completed the draft questionnaire (93.7% male, 73.7% aged 56‐75 years). An exploratory factor analysis identified 6 factors “Health Issues are a Low Priority,” “Concerns about Stigma,” “Structural Health System Barriers,” “Minimization and Normalization,” “Communication Barriers,” and “Continuity of Care.”. Test‐retest reliability was examined with a further 10 farmers (90% male, Mean age = 57, SD = 5.91), who completed the questionnaire twice (at 2‐ to 3‐week intervals). Results indicated moderate‐good test‐retest reliability. The resulting 24‐item Farmer Help‐Seeking Scale provides a measure of help‐seeking that is specifically designed to capture the unique context, culture, and attitudes that can interfere with farmers’ help‐seeking, and inform the development of strategies to increase health‐service utilization in this at‐risk group.
Publisher: Springer Science and Business Media LLC
Date: 14-09-2023
Publisher: MDPI AG
Date: 11-11-2022
DOI: 10.3390/NU14224776
Abstract: Poorer mental health is common in undergraduate students due to academic stress. An interplay between stress and diet exists, with stress influencing food choices. Nutritional interventions may be effective in preventing mental health decline due to complex bidirectional interactions between the brain, the gut and the gut microbiota. Previous studies have shown walnut consumption has a positive effect on mental health. Here, using a randomized clinical trial (Australian New Zealand Clinical Trials Registry, #ACTRN12619000972123), we aimed to investigate the effects of academic stress and daily walnut consumption in university students on mental health, biochemical markers of general health, and the gut microbiota. We found academic stress had a negative impact on self-reported mood and mental health status, while daily walnut consumption improved mental health indicators and protected against some of the negative effects of academic stress on metabolic and stress biomarkers. Academic stress was associated with lower gut microbial ersity in females, which was improved by walnut consumption. The effects of academic stress or walnut consumption in male participants could not be established due to small numbers of participants. Thus, walnut consumption may have a protective effect against some of the negative impacts of academic stress, however sex-dependent mechanisms require further study.
Publisher: MDPI AG
Date: 14-04-2021
Abstract: Primary producers face considerable risks for poor mental health. While this population can be difficult to engage in programs to prevent poor mental health, approaches tailored to reflect the context of primary producers’ life and work have been successful. This paper reports on the co-design phase of a project designed to prevent poor mental health for primary producers—specifically, the advantages, challenges and considerations of translating face-to-face co-design methods to an online environment in response to COVID-19 restrictions. The co-design phase drew upon the existing seven-step co-design framework developed by Trischler and colleagues. Online methods were adopted for all steps of the process. This paper models how this co-design approach can work in an online, primary producer context and details key considerations for future initiatives of this type. The development of online co-design methods is an important additional research method for use not only during a pandemic but also when operating with limited resources or geographic constraints. Results demonstrate the following: (i) co-designing online is possible given adequate preparation, training and resource allocation (ii) “hard to reach” populations can be engaged using online methods providing there is adequate early-stage relationship building (iii) co-design quality need not be compromised and may be improved when translating to online and (iv) saved costs and resources associated with online methods can be realigned towards intervention/service creation, promotion and user engagement. Suggestions for extending Trischler and colleagues’ model are incorporated.
Publisher: Springer Science and Business Media LLC
Date: 07-01-2022
DOI: 10.1007/S00520-021-06710-Y
Abstract: Not monitoring adherence to oral anticancer therapies (OAT) can lead to poor clinical outcomes, including premature death as reported by Foulon et al. (Acta Clin Belg 66(2):85-96, 2011) and Greer et al. (Oncologist 21(3):354-76, 2016). Barriers to the implementation of supportive cancer care interventions in medication adherence occur with multiple hospital sites, cancer diagnoses, and numerous healthcare professionals. This commentary describes challenges and strategies from two OAT adherence trials in Australia and Switzerland to assist researchers in the design and implementation of future interprofessional trials.
Publisher: Rural and Remote Health
Date: 15-02-2018
DOI: 10.22605/RRH4155
Publisher: Springer Science and Business Media LLC
Date: 24-07-2022
DOI: 10.1007/S00520-021-06430-3
Abstract: To investigate the successful strategies of health workers who support and regularly communicate with Aboriginal and Torres Strait Islander people about cancer and its treatment. Semi-structured interviews were conducted face-to face or via telephone and audio-recorded with twenty-three health professionals (medical and radiation oncologists, oncology nurses and Aboriginal Health Workers), 5 identifying as Aboriginal or Torres Strait Islander in the Northern Territory and South Australia. When data saturation was reached, thematic analysis using a bottom up, essentialist/realist approach was used. Six themes emerged. (1) Create a safe environment, engender trust and build rapport. This involves considering the physical environment and allowing time in interviews to establish a relationship. (2) Employ specific communication strategies to explain cancer, treatment and its side effects through language choices and employing visual aids such as drawings, metaphors and relatable analogies. (3) Obtain support from Aboriginal and Torres Strait Islander staff and patient escorts who can assist in communication. (4) Consider culture which involves collective decision making, strong connection to country and community, with cultural obligations and a unique understanding of cancer. (5) Anticipate the contextual complexities of conflicts between Western medicine and Aboriginal culture, practitioner bias and difficulty maintaining contact with patients. (6) Develop personal qualities of good communicators, including being patient-centred, showing respect, patience, empathy and honesty. These insights will help foster more positive interactions with the health system and promote optimal outcomes for Aboriginal and Torres Strait Islander people with cancer.
Publisher: MDPI AG
Date: 26-11-2022
Abstract: Background: Suicide in the Australian Construction Industry (ACI) is a significant issue, however minimal understanding of suicidal ideation prevalence, as well as the potential role psychosocial job adversity and increased adherence to traditional masculine norms may play in its presence, is apparent. Method: A representative s le of Australian men (n = 11,132) were used to create initial understandings of prevalence of suicidal ideation (past two weeks), psychosocial job adversities and level of adherence to traditional masculine norms for the ACI (n = 1721) in comparison to a general population comprised of the remaining employed males from Other Industries (n = 9411). Additionally, due to their reported increased suicide vulnerability investigation of associations between suicidal ideation, psychosocial job adversities and adherence to traditional masculine norms for the ACI were undertaken. Results: No difference in suicidal ideation prevalence was reported between the ACI and those employed in Other Industries (p 0.05), however, increased prevalence of psychosocial job adversities (p ≤ 0.001) and adherence to traditional masculine norms (p ≤ 0.001) for the ACI was seen. Significant multivariate associations between suicidal ideation, psychosocial job adversities (OR = 1.79, 95%CI [1.12–2.85]) and two domains of traditional masculine norms, self-reliance (OR = 1.29, 95%CI [1.09–1.51]) and risk-taking (OR = 1.20, 95%CI [1.01–1.41]), were reported. Conclusion: Results suggest need for increased understanding of later stage suicidal trajectory drivers in the ACI. Findings indicate need for prevention group/industry concentration on mitigation of psychosocial job adversities, as well as a more nuanced and increased discussion of the negative role of self-reliance and risk-taking domains of traditional masculine norms may play in ACI suicidal ideation, as opposed to the construct as a whole.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 18-09-2023
Publisher: Springer Science and Business Media LLC
Date: 11-11-2022
DOI: 10.1007/S13187-020-01908-W
Abstract: Rural cancer patients have inferior cancer outcomes and unique unmet information needs. This paper explores the value of rural people affected by cancer delivering cancer-related education and support to their peers via 3-5 min online YouTube films. In part 1, 14 rural Australians affected by cancer (10 survivors, 4 carers), 50% (7/14) female, 55-79 years, "storytellers", were purposively invited to be filmed sharing their cancer-related experience and advice for others facing similar challenges. They then reflected on their storytelling experience during semi-structured interviews with an independent researcher. In part 2, 11 rural South Australians affected by cancer (8 survivors, 3 carers), 82% (9/11) female, 32-75 years, "viewers", who had watched at least three of the videos, were interviewed. When data saturation was reached, thematic analysis was employed. Storytellers were found to be highly satisfied with the film-making process and product. They valued rapport building prior to filming and the opportunity to help others. They also found storytelling cathartic and the films useful in communicating their cancer experience to family and friends. Rural viewers appreciated the honesty, authenticity, relatability and believability of the storytellers, the practical advice on rural-specific psychosocial issues, acknowledgment of the impact of isolation and the opportunity to understand others' cancer experiences. The film's short duration and professional film-making added appeal. Inclusion of younger storytellers and methods of delivery other than YouTube were suggested. This study highlights the value of this approach for storytellers and viewers. It may be particularly beneficial for isolated rural cancer survivors who feel that their unique challenges are not adequately addressed by mainstream cancer education resources However, further quantitative research to test acceptability and impact in representative rural s les is required.
Publisher: Elsevier BV
Date: 02-2016
Abstract: To identify subgroups of Australian adults likely to receive physical activity advice from their general practitioner and to evaluate the content of the advice provided. Participants (n=1,799), recruited from the Australian Health and Social Science panel, completed an online survey. Signal Detection Analysis was used to identify subgroups that were more/less likely to have received physical activity recommendations. Overall, 18% of participants received a physical activity recommendation from their general practitioner in the past 12 months and eight unique subgroups were identified. The subgroup with the highest proportion (54%) of participants reporting that they received a physical activity recommendation was those with poor physical and mental health-related quality of life and an average daily sitting time of <11 hours. Other subgroups with high proportions of in iduals receiving recommendations were characterised by higher weight and/or the presence of co-morbidities. The most commonly prescribed physical activity type was aerobic activity. Few participants received specific physical activity advice. General practitioners are incorporating physical activity promotion into their practice, but primarily as a disease management tool and with limited specificity. Strategies to assist Australian general practitioners to effectively promote physical activity are needed.
Publisher: JMIR Publications Inc.
Date: 29-07-2018
Abstract: dherence to oral chemotherapy is crucial to maximize treatment outcomes and avoid health complications in cancer patients. Mobile phones are widely available worldwide, and evidence that this technology can be successfully employed to increase medication adherence for the treatment of other chronic diseases (eg, diabetes) is well established. However, the extent to which there is evidence that mobile phone–based interventions improve adherence to oral chemotherapy is unknown. his scoping review aims to explore what is known about mobile phone–delivered interventions designed to enhance adherence to oral chemotherapy, to examine the reported findings on the utility of these interventions in increasing oral chemotherapy adherence, and to identify opportunities for development of future interventions. his study followed Arksey and O’Malley’s scoping review methodological framework. he review search yielded 5 studies reporting on 4 interventions with adults (aged years) diagnosed with erse cancer types. All interventions were considered acceptable, useful, and feasible. The following themes were evident: text messages and mobile apps were the main methods of delivering these interventions, the 2 most commonly employed oral chemotherapy adherence–enhancing strategies were management and reporting of drug-related symptoms and reminders to take medication, the importance of stakeholders’ engagement in intervention design, and the overall positive perceptions of delivery features. Areas for future research identified by this review include the need for further studies to evaluate the impact of mobile phone–delivered interventions on adherence to oral chemotherapy as well as the relevance for future studies to incorporate design frameworks and economic evaluations and to explore the moderator effect of high anxiety, poor baseline adherence, and longer time taking prescribed drug on adherence to oral chemotherapy. espite the increasing body of evidence on the use of mobile phones to deliver medication adherence–enhancing interventions in chronic diseases, literature on the oral chemotherapy context is lacking. This review showed that existing interventions are highly acceptable and useful to cancer patients. The engagement of stakeholders as well as the use of a design framework are important elements in the development of mobile phone–delivered interventions that can be translated into oncology settings.
Publisher: MDPI AG
Date: 04-09-2022
Abstract: This study aimed to explore barriers and facilitators that impact on farmers’ help-seeking behaviours for health and mental health concerns. Fifteen semi-structured interviews were conducted with farmers (12 male age 51.7 ± 12.6 years) from three rural regions in South Australia. Interviews explored demographic and farm-related characteristics, perceptions of in idual (and where relevant family) health and mental health concerns and experiences, and perceived barriers of health support-seeking. Thematic analysis was used to identify key themes. Four key themes were identified relating to help-seeking personal attitudes and beliefs, farm-related barriers, health system barriers and the provision of support from family and friends. Dominant personal attitudes included valuing independence, strength and privacy. Farm related barriers included the ‘farm comes first’ and the fact that ‘farm work is never done’. Health system barriers included issues relating to availability of choice and access, professionals (lack of) understanding of farm life, and time and financial costs of accessing care. Provision of support from family and friends involved informal help and advice, including facilitating access to professional support. Multiple attitudinal, structural, and farm-related issues affect farmers’ help-seeking. Professionals who understand farm work practices and routines are valued by farmers and this is likely to facilitate access to care. Workforce development programs and community programs that involve farmers’ perspectives as consumers and co-designers, using evidence-based strategies, may assist in strengthening these relationships.
Publisher: Mary Ann Liebert Inc
Date: 10-2019
Abstract: Pain is an understudied and undertreated consequence of cancer survival. Pain education is now a recommended treatment approach for persistent non-cancer pain, yet it has not been well applied to the context of adolescent and young adult (AYA) cancer survival. In March 2018, an interdisciplinary meeting was held in Adelaide, South Australia to set a research agenda for pain education in AYA cancer survivors. We identified that AYAs with persistent pain and those with heightened pain-related fear have the potential to benefit from pain education. We identified a number of unique challenges of engaging AYA survivors in pain education, and point towards future research directions.
Publisher: BMJ
Date: 06-2023
DOI: 10.1136/BMJOPEN-2022-071080
Abstract: Patient education is a critical component of healthcare delivery. However, medical information and knowledge are complex and can be difficult for patients and families to comprehend when delivered verbally. The use of virtual reality (VR) to convey medical information to patients may bridge this communication gap and lead to more effective patient education. It may be of increased value to those with low health literacy and levels of patient activation, in rural and regional settings. The objective of this randomised, single-centre pilot study is to examine the feasibility and preliminary effectiveness of VR as an education tool for people with cancer. The results will provide data to inform the feasibility of a future randomised controlled trial, including s le size calculations. Patients with cancer undergoing immunotherapy will be recruited. A total of 36 patients will be recruited and randomised to one of three trial arms. Participants will be randomised 1:1:1 to receive VR, a two-dimensional video or standard care (ie, verbal communication and information leaflets). Feasibility will be assessed by recruitment rate, practicality, acceptability, usability and related adverse events. The potential impact of VR on patient-reported outcomes (ie, perceived information provision quality, knowledge about immunotherapy and patient activation) will be assessed and stratified by information coping style (ie, monitors vs blunters) whenever statistical analyses are significant. The patient-reported outcomes will be measured at baseline, post-intervention and 2 weeks post-intervention. In addition, semistructured interviews will be conducted with health professionals and participants randomised to the VR trial arm, to further explore acceptability and feasibility. Ethics approval was obtained from the Greater Western Human Research Ethics Committee, New South Wales Local Health District (2022/ETH01760). Informed consent will be obtained from all participants. Findings will be disseminated via relevant conference presentations and publications in peer-reviewed journals. ACTRN12622001473752.
Publisher: Wiley
Date: 17-10-2022
DOI: 10.1111/AJR.12930
Abstract: Investigating how co‐designed knowledge can be translated to co‐produce a public health capacity‐building solution for difficult‐to‐engage population groups drawing on the co‐production experience of a prevention‐focused, capacity‐building mental health solution targeting primary producers. A qualitative study undertaken in rural and regional Victoria involving members of the design working group including project team (7px), digital design team (5px), marketing team (3px), and funding partner representatives. The study design involved reflective practice to collect data to identify the phases of co‐production and assess the design working group members' experiences. The analysis involved inductive coding using Braun and Clarke's thematic analysis. Identifying major points of ergence and/or convergence enablers and/or constraints and ways to better navigate and strengthen the co‐production process. Given members of the design working group, erse skills sets ergence was experienced in all co‐production phases. Divergence was also experienced between the project team and the funding partner given the uniqueness of working conditions and requirements of workers in the primary production industry. The project team applied an iterative development process to project management encouraging iterative cycles to create/test/revise among the teams, and with the funding partner, until each was satisfied with the end result (convergence). When developing a co‐created public health prevention c aign it is critical that the project team focuses on relationship building among the members of the design working group and ensures adequate resourcing, development of shared understanding of project goals and target audience, ongoing communication, and a commitment to working iteratively.
Publisher: Springer Science and Business Media LLC
Date: 08-01-2018
Publisher: Wiley
Date: 19-11-2022
DOI: 10.1111/AJR.12815
Abstract: To explore rural financial counsellors' experiences interacting with psychologically distressed farmers and identify contextually appropriate methods to maintain their own well‐being and link farmers to psychological supports, within their existing roles. Rural, regional and remote Australia. Fifty rural financial counsellors participated. They worked across 6 Australian states/territories. In idual semi‐structured telephone interviews were audio‐recorded with consent. Qualitative data were analysed using thematic analysis. Themes were identified using an essentialist, bottom‐up approach. Forty‐six themes emerged relating to the 5 topics explored: (a) how to recognise distress in farmers (eg inability to focus/make decisions, deterioration in presentation/organisation, anger, blaming) (b) impact of farmers' psychological distress on the financial case management process (eg slows, disrupts or stops it, negatively impacts counsellor well‐being) (c) strategies for working effectively with distressed farmers (eg flexibility, open‐ended questions, listening to story, simplicity, instilling hope) (d) referral of distressed farmers to psychological support (eg willing if tried themselves ositive reports, lack of local rural face‐to‐face services, stigma and lack of understanding of importance challenging, a farming focus and support from family/ community assists) and (e) strategies to maintain their own well‐being (eg compartmentalising, exercise, supervision). Rural financial counsellors play an important role by recognising signs of distress in farmers and referring them to appropriate psychological supports. However, this is a demanding role and ensuring counsellors have appropriate services to refer farmers to, and support with their own well‐being, is imperative.
Publisher: Elsevier BV
Date: 08-2016
Publisher: BMJ
Date: 06-2022
DOI: 10.1136/BMJOPEN-2021-056404
Abstract: Behavioural activation (BA) is an effective treatment for depression however, it is unclear if it can be used to manage pain. To conduct a scoping review of primary research that reported using BA to support people living with chronic pain to understand how BA had been used in relation to pain. In addition, we wanted to understand whether there were any reported changes in that pain, and how and who delivered BA. Primary research published in English. We searched seven databases MEDLINE, Ovid Embase, Ovid Emcare, PsycINFO, CINAHL, Scopus and Web of Science, for primary research. No initial date limit was used with the date the searches were conducted used as the end date limit (1 July 2021). A customised data extraction table was developed, piloted and used. 551 papers were screened for inclusion, with 15 papers included in our review. Studies were conducted in North America and in Canada. These included three case studies, nine uncontrolled trials and three randomised controlled trials. Only two studies reported pain as the primary outcome. BA was applied across a range of pain related conditions. The dose of BA ranged from 3 to 16 sessions. Duration of treatment was 3 weeks to 12 months. Most studies reported reductions in pain following exposure to BA. BA has the potential to reduce pain. Caution needs to be exercised in the interpretation of these findings as a high risk of bias was observed in most studies. High-quality research is required to test if BA is an effective intervention for chronic pain.
Publisher: Wiley
Date: 19-05-2023
DOI: 10.1002/PON.6168
Abstract: To evaluate the psychometric properties of the Perceptions of Parental Illness Questionnaire for Cancer (PPIQ‐C) among adolescents and young adults (AYAs). A s le of 372 AYAs (aged 12–24 years) who had a parent diagnosed with cancer completed the PPIQ‐C and the Kessler Psychological Distress Scale (K10). Exploratory factor analyses were conducted to examine the dimensional structure of the PPIQ‐C. Scale reliability was evaluated using Cronbach's alpha (α) and McDonald's omega (ω). Pearson correlation analyses were conducted to assess construct validity by examining correlations between PPIQ‐C subscale scores and K10 total scores. The PPIQ‐C is organised into three sections, each with a separate factor structure for items representing identity , core ( emotional representations , coherence , timeline , consequences , and controllability ), and cause dimensions of the Common‐Sense Model of Self‐Regulation. Exploratory factor analyses determined the structure of each section: identity items comprised two subscales (12 items), core items comprised 10 subscales (38 items), and cause items comprised three subscales (11 items). Scale reliability was acceptable for all subscales, except the cause subscale chance or luck attributions ( α = 0.665). Correlations between PPIQ‐C subscale scores and K10 total scores provided support for construct validity. Preliminary evidence suggests that the PPIQ‐C is a reliable, valid, and useful tool for assessing illness perceptions among AYAs with a parent with cancer. The PPIQ‐C may be a useful addition to both clinical practice and future research, however further evaluation work is needed to confirm its structure and robustness prior to use.
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.PEC.2022.02.005
Abstract: To explore what is currently known about the use of virtual reality (VR) as a patient education tool in healthcare. Arksey and O'Malley's scoping review method and the PRISMA-ScR Checklist were employed. Four peer-reviewed databases were searched (Medline, Embase, PsychINFO, the Cochrane library). Pre-defined selection criteria identified 18 studies for inclusion. Results were synthesized using a narrative approach. VR as an educational tool in healthcare is feasible and acceptable, and may improve patient's knowledge about their illness and satisfaction with treatment. Most studies used the Oculus VR glasses or headset, educated patients though the use of 3D 360° VR anatomical models, and were conducted with people affected with cancer. Opportunities exist for exploring unintended consequences, and the role of VR in educating populations with lower health literacy. VR could assist in communicating medical information and knowledge to patients, but more research is needed, particularly to identify for whom and in what situations this method is most useful and to improve understanding about the potential unintended consequences. Health professionals should consider using VR to educate their patients, and researchers can use this as a road map on how to address knowledge gaps in this field.
Publisher: Wiley
Date: 30-01-2022
DOI: 10.1111/AJCO.13656
Abstract: Nonadherence to oral chemotherapy (OC) can lead to health complications, including premature death. Mobile phones are increasingly used to deliver medication adherence interventions. However, there is limited evidence about mobile phone-based interventions to increase adherence to OC, specifically. This study explores the proof-of-concept of a smartphone program to support adherence to OC in people with cancer. This was a 10-week, nonrandomized, multisite trial. The outcomes assessed were acceptability, satisfaction with the intervention, adherence to OC, knowledge about OC, and side-effects presence and severity. The program consisted of short message service (SMS) reminders to take OC, as well as information about OC, including the management of side-effects. Twenty-two participants (17-74 y/o, median age 60 y/o) were recruited at six hospitals. The s le included 10 different cancer diagnoses (predominance of breast cancer) and 11 OC medications. Acceptability of the intervention was high, with 95% of the enrolled participants completing postintervention measures, and 81% reporting high satisfaction with the program. The intervention was found to have no effect on supporting adherence to OC (assessed by self-report and medication event monitoring system) in this s le. An increase in knowledge about OC was observed at postintervention (p = 0.010). This study demonstrated proof-of-concept of the smartphone program and highlighted the need for intervention and trial design-related refinements. Future work should evaluate the effect of the program on adherence to OC with nonadherent patients.
Publisher: Springer Science and Business Media LLC
Date: 03-06-2019
DOI: 10.1007/S12529-019-09793-4
Abstract: In iduals construct beliefs about an illness based on their own perceptions, interpretation, and understanding of the illness and its treatment. These beliefs (collectively referred to as "illness cognitions" or "representations") can have implications for psychological outcomes in family members and carers of an in idual with an illness. The aim of this study was to explore young people's perceptions of their parent's cancer using the Common-Sense Model of Self-Regulation as a theoretical framework. Semi-structured, one-on-one interviews were conducted with young people who had a parent diagnosed with cancer. Interview transcripts were analysed using deductive thematic analysis techniques. Eleven young people aged 15-24 years participated in the study. Major themes aligned with the dimensions of the Common-Sense Model of Self-Regulation. Young people described their experiences with parental cancer with reference to cognitive representations (beliefs about the illness identity, their understanding or coherence of the illness, and consequences, curability or controllability, timeline, and cause of the illness) and emotional representations (emotional beliefs and subjective feelings about the illness). Findings indicate that young people's perceptions of their parent's cancer can be usefully described within the framework of the Common-Sense Model of Self-Regulation. Future research should investigate the relationships between young people's illness cognitions, coping strategies, and psychological adjustment following their parent's cancer diagnosis. This will provide valuable insights for the development of interventions that target specific types of illness cognitions associated with maladaptive coping strategies and poor adjustment.
Publisher: Springer Science and Business Media LLC
Date: 06-01-2014
Publisher: Elsevier BV
Date: 06-2017
DOI: 10.1016/J.EJON.2017.03.007
Abstract: Community-based cancer organizations provide telephone-based information and support services to assist people diagnosed with cancer and their family/friends. We investigated the demographic characteristics and psychosocial support needs of family/friends who contacted Australian Cancer Council 13 11 20 information and support helplines. Data collected on 42,892 family/friends who contacted a 13 11 20 service across Australia from January 2010 to December 2012 were analyzed. Chi-square analysis was used to examine associations between caller groups and reasons for calling, logistic regression to examine age and gender interaction effects. The majority of calls received were from women (81%) of middle- (40%) and high-socio-economic backgrounds (41%), aged 40-59 years (46%) 52% phoned for information on cancer diagnosis (including early detection, risk factors), 22% on treatment/disease management, and 26% phoned seeking psychological/emotional support. Information on a diagnosis was significantly more often the reason older males called, compared to female callers of any age. Overall, 32% found out about the service through Cancer Council resources or events, 20% from the media, 18% from the internet 11% from health professionals. Family/friends of persons diagnosed with cancer have specific information and support needs. This study identifies groups of family/friends to whom the promotion of this service could be targeted. Within Australia and internationally, clinicians and oncology nurses as well as allied health professionals can provide an important role in increasing access to cancer telephone support services to ensure the needs of the family and friends of people affected by cancer are being met.
Publisher: BMJ
Date: 06-2021
DOI: 10.1136/BMJOPEN-2020-041036
Abstract: Chronic pain is a distressing condition and often poorly treated and managed. Psychological therapies are considered first-line intervention for people with chronic pain. Common psychological therapies require extensive clinician training and specialist qualifications. One approach that does not need lengthy training nor specialist qualification, but has empirical support in other health domains, is behavioural activation (BA). BA seeks to increase engagement in behaviours that are valued by the person and progress through behaviours that can increase mood and develop skills that build satisfying routines. BA can help people to manage their condition through scheduling behaviours, promoting routine and mastery over their condition. The extent to which BA has been used to support people living with chronic pain is not clear. This scoping review aims to identify published studies describing the application of BA to support people living with chronic pain. To map the evidence regarding BA and chronic pain, including the study type and the associated evidence, a scoping review was adopted. The search will be conducted in bibliographic databases, clinical trial registries and grey literature. No date limits will be applied to the search strategy. Screening of titles and abstracts, and full-text screening, will be independently undertaken by two investigators using Covidence software. Any disagreement between investigators will be resolved by a third investigator. Data from included publications will be extracted using a customised data extraction tool. The scoping review is an analysis of existing data and therefore ethics approval is not required. The findings of this scoping review will further our understanding of how BA has been used to support people living with chronic pain and inform future training and education programmes in this area.
Publisher: Springer Science and Business Media LLC
Date: 25-04-2020
Publisher: Springer Science and Business Media LLC
Date: 07-01-2021
Publisher: Wiley
Date: 02-2021
DOI: 10.1111/AJR.12693
Publisher: Hindawi Limited
Date: 30-06-2022
DOI: 10.1111/HSC.13894
Abstract: Accessibility of health services outside metropolitan centres in Australia is sub-optimal. Recognising the barriers and enablers of healthcare access in rural, remote and regional settings is necessary to improving health service access in these disadvantaged populations. Accordingly, this study aimed to examine the determinants of healthcare use in rural, remote and regional South Australia. Cross-sectional survey data were collected from adults living outside metropolitan Adelaide in South Australia between April 2017 and March 2018. Using a multi-modal recruitment c aign, eligible adults were invited to complete the 44-item consumer utilisation, expectations and experiences of healthcare instrument. Independent predictors of health service utilisation (dependent variable) were determined using negative binomial regression. The questionnaire was completed by 3926 predominantly female (52.5%) adults aged ≥50 years (56.7%), residing in regional South Australia (84.5%). Fifteen independent variables were significantly associated with health service utilisation using univariate analyses. Using negative binomial regression analysis, two predisposing factors (sex, remoteness), three enabling factors (income, health literacy, employment), two need factors (health rating, multimorbidity) and two personal health practices (alcohol, diet) were independently and significantly associated with healthcare use. Female sex (OR = 1.436, p < 0.001), good/excellent health rating (OR = 0.589, p < 0.001) and high multimorbidity (OR = 1.408, p < 0.001) were the strongest predictors of health service use. These findings will help inform the development of targeted health promotion and service engagement strategies for regional populations, which in addition to addressing workforce shortages, may help address inequity in health outcomes, particularly for groups engaging with regional healthcare services infrequently.
Development of a Smartphone Program to Support Adherence to Oral Chemotherapy in People with Cancer
Publisher: Informa UK Limited
Date: 12-2019
DOI: 10.2147/PPA.S225175
Publisher: University of South Australia
Date: 2022
DOI: 10.25954/X9S9-8592
Publisher: Oxford University Press (OUP)
Date: 28-06-2019
DOI: 10.1093/TBM/IBY055
Abstract: Rates of referral of patients to psychosocial services are low in most cancer treatment centers, while rates of distress are high. The purpose of this study is to identify clinicians' barriers to referring cancer patients to psychosocial services and strategies that could increase rates of referral. A purposive s ling method ensured data were gathered in two large public teaching hospitals from seven oncologists and five hematologists with varying levels of experience, of whom five were female. Data were collected using semistructured interviews guided by the Capability, Opportunity, Motivation and Behavior model (Michie S, Atkins L, West R. The Behaviour Change Wheel: A Guide to Designing Interventions. United Kingdom: Silverback Publishing 2014.). This helped us to identify modifiable variables associated with referral likelihood and associated evidence-based strategies using the Behavior Change Wheel. Data were analyzed using Thematic Analysis. Barriers relating to capability, opportunity, and motivation to refer to psychosocial services were identified, including lack of knowledge of available services, how to refer to them, and the types of patients who would benefit. Other barriers included the following: lack of time to discuss and refer, convoluted referral pathways, long waiting times, and fear of patient reluctance due to stigma. Respondents identified numerous strategies for overcoming barriers, including training on referral best practice, role-plays, the provision of lists of services with referral and contact details, and increasing service capacity via additional funding. Findings inform the development of acceptable, evidence-based strategies, to improve rates of referral to psychosocial services by oncologists and hematologists. Without implementation, a substantial number of people affected by cancer will continue to suffer from potentially treatable distress.
Publisher: Wiley
Date: 02-2021
DOI: 10.1111/AJR.12695
Publisher: MDPI AG
Date: 30-03-2021
Abstract: The transition from urban centres back to rural and remote communities can be challenging for rural cancer survivors after treatment. This study aimed to (a) provide deeper understanding of the experiences of rural survivors who have completed active cancer treatment and returned to their rural communities, and (b) determine strategies to re-orient existing services or develop new interventions to more appropriately meet rural survivors’ service preferences and needs. Semi-structured interviews were conducted with 22 adults (64% female) who lived outside of a metropolitan area and had completed active cancer treatment (n = 13), were the carer for a rural/remote cancer survivor (n = 6), or were both a survivor and carer (n = 3). Thematic analysis was conducted to identify dominant themes in the qualitative data. A range of physical, psychological and practical challenges that impact quality of life among rural survivors post-treatment were found. These challenges appeared to be compounded by a lack of trust in local rural healthcare services and a lack of clear post-treatment pathways to quality of life-enhancing support services. Acceptable strategies to overcome barriers included nurse-led, telephone-based, or face-to-face interventions, initiated and continued by the same service provider, and that included support to manage emotional challenges associated with post-treatment survivorship. The findings will inform the design of interventions to better meet rural cancer survivors’ post-treatment support needs.
Publisher: MDPI AG
Date: 09-12-2021
Abstract: This research aims to identify the factors that influence caregivers’ decisions about the aged care providers they select for their elder relatives when caring from a distance and what they value once they have engaged a service. Adult long-distance carers for older relatives living within Australia were purposively s led and they participated in audio-recorded interviews. A thematic analysis was employed to investigate the data. A s le of 13 participants enabled data saturation with no new major themes identified in the final three interviews. Participants were 50 to 65 years (Mean = 59.8) and mostly (77%) female. Four themes emerged relating to selection of care providers: (1) availability of care, (2) financial arrangements, (3) proximity and location, and (4) reputation of care provider. Five themes detailed valued qualities of care: (1) vigilant monitoring and responsivity, (2) communication with family, (3) flexibility and proactiveness of care, (4) staffing, and (5) access to appropriate and holistic care to maintain wellbeing. Long-distance caregivers face barriers in selecting and managing aged care services from afar within a complex Australian aged care system. They strongly value regular, proactive communication about the wellbeing of their relatives and may be particular beneficiaries of communication and assistive monitoring technologies.
Publisher: Springer Science and Business Media LLC
Date: 21-11-2018
Publisher: Wiley
Date: 15-01-2019
DOI: 10.1002/PON.4970
Publisher: Elsevier BV
Date: 11-2022
Publisher: Springer Science and Business Media LLC
Date: 15-05-2018
Publisher: Springer Science and Business Media LLC
Date: 08-04-2021
Publisher: Springer Science and Business Media LLC
Date: 14-08-2022
Publisher: Frontiers Media SA
Date: 12-05-2023
DOI: 10.3389/FPSYT.2023.1144314
Abstract: This research was designed to generate understandings of drivers and experiences of suicidal ideation and distress among Australian Construction Industry (ACI) workers, as well as what helped during these experiences. Fifteen participants, from a variety of ACI or closely associated roles, with an average age of 45 years (29–66), engaged in in idual, semi-structured interviews. Interviews were audio-recorded with consent and analyzed using descriptive thematic analysis. Eight themes relating to what may drive the presence of suicidal ideation and distress were identified 1) challenges of working within the ACI, 2) relationship and family issues, 3) social disconnection, 4) personal financial hardship, 5) perceived lack of support, 6) alcohol and drug use, 7) child custody/access and legal issues, and 8) experience of mental health challenges, trauma, or a significant adverse life event. Four themes relating to experience and expression of suicidal ideation and distress were identified: 1) suicidal thoughts, 2) impaired thinking, 3) observable expressions of suicidal distress, and 4) lack of observable expressions of suicidal distress. Six themes relating to what helped during experiences and well as what can be done by the ACI to help mitigate experiences, were identified: 1) presence of colleague and managerial support, 2) MATES in Construction, 3) engagement with non-work activities and social support, 4) personal skills and knowledge relating to suicide and mental health, 5) high level industry integration and engagement with support programs, and 6) work hours and expectations changes. Findings highlight several industry and personal related challenges that may drive experiences, with many potentially mitigatable by ACI changes and focused prevention strategies. Participant suicidal thought descriptions align with previously identified constructs deemed central in suicidal trajectories. While findings highlight several observable expressions of suicidal ideation and distress, challenges associated with identifying and assisting in iduals in the ACI who may be struggling were also reported. Several factors that helped ACI workers during their experiences, as well as what the ACI can do to mitigate future experiences, were identified. Recommendations are made based on these findings, encouraging a more supportive work environment, as well as continued development and increased awareness of support and education systems.
Publisher: MDPI AG
Date: 13-02-2017
DOI: 10.3390/JCM6020019
Publisher: MDPI AG
Date: 03-03-2022
Abstract: This study examined Australian farmers’ engagement with skin cancer prevention behaviours and explored what made it hard for them to be ‘SunSmart’ (barriers), and what could be done to make prevention easier (facilitators). In total, 498 farmers (83.1% male, 22–89 years, 50.8% grain, sheep, or cattle farmers) participated. The least frequently performed SunSmart behaviours (reported as never practiced during summer) were using SPF 30+ sunscreen (16.6%), wearing protective sunglasses (10.5%), and wearing protective clothing (8.6%). Greater engagement (i.e., higher scores on scale from Never to Always) with SunSmart behaviours was explained by gender (female), educational attainment (trade or technical college certificate vs. high school), personal skin cancer history, and skin sun sensitivity. Barriers reported by farmers related to personal preferences (e.g., short-sleeved rather than long-sleeved clothing), comfort, and perceived impracticality of sun protection. Farmers’ solutions included making protective clothing and sunscreen more appropriate for farm work (e.g., by making clothing more breathable). A personal health scare was the most reported motivation for skin cancer prevention. Findings highlight the need for increased access to sun-protective clothing and sunscreen that is suitable for wearing when working on farms, complemented by culturally appropriate health education messaging, to encourage more farmers to perform SunSmart behaviours.
Publisher: Informa UK Limited
Date: 02-01-2023
Publisher: Springer Science and Business Media LLC
Date: 09-08-2023
DOI: 10.1186/S13047-023-00645-9
Abstract: Diabetes-related foot disease (DFD) accounts for up to 75% of lower-extremity utations globally. Rural and remote communities are disproportionately affected by DFD. Telehealth has been advocated as a strategy to improve equity of access to health care in rural and remote communities. Current literature suggests that successful implementation of telehealth requires access to adequate reliable equipment, staff training, and support. A real-time video-based telehealth foot service (TFS) for delivering DFD management has recently been established in a Vascular Surgery and Podiatry clinic within a large South Australian metropolitan hospital. The purpose of this study was to gain insights into the experiences of rural and remote health professionals utilising the TFS, as this could be invaluable in optimising the uptake of telehealth use in DFD. This exploratory, descriptive qualitative study employed one-on-one, semi-structured interviews with health professionals who utilised the service. Thematic analysis using an essentialist inductive approach was employed. Participants included 14 rural and remote health professionals 2 general practitioners, 2 nurses, 1 Aboriginal Health Practitioner, and 9 podiatrists. In addition, 2 metropolitan-based TFS staff were interviewed. Five key themes were identified. ‘Patients have reduced travel burden’ included that telehealth enabled Indigenous patients to stay on country. ‘Patients had increased psychosocial support’ covered the benefits of having health professionals who knew the patient present in consults. ‘Improved access’ incorporated how telehealth improved interprofessional relationship building and communication. ‘Technological and equipment challenges’ highlighted that poor network connectivity and poor access to equipment to conduct telehealth consults in rural areas were barriers. The last theme,’Lack of service communication to rural health professionals’, highlighted the need for communication around service details. Telehealth is a valuable tool that can improve access to treatment for rural and remote Indigenous DFD patients. While this has the potential to improve DFD outcomes, empirical data is required to confirm outcomes. Considering the advantages of telehealth and rural staff shortages, there is an urgent need for investment in improved equipment and processes and an understanding of the training needs of the health care workforce to support the use of telehealth in DFD management.
Publisher: JMIR Publications Inc.
Date: 07-06-2021
Abstract: large number of Australians experience mental health challenges at some point in their lives. However, in many parts of Australia, the wait times to see general practitioners and mental health professionals can be lengthy. With increasing internet use across Australia, web-based interventions may help increase access to timely mental health care. As a result, this is an area of increasing research interest, and the number of publicly available web-based interventions is growing. However, it can be confusing for clinicians and consumers to know the resources that are evidence-based and best meet their needs. his study aims to scope out the range of web-based mental health interventions that address depression, anxiety, suicidal ideation, or general mental well-being and are freely available to Australian adults, along with their impact, acceptability, therapeutic approach, and key features. he PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for scoping reviews (PRISMA-ScR [PRISMA extension for Scoping Reviews]) guided the review process. Keywords for the search were depression, anxiety, suicide, and well-being. The search was conducted using Google as well as the key intervention databases Beacon, Head to Health, and e-Mental Health in Practice. Interventions were deemed eligible if they targeted depression, anxiety, suicidal ideation, or general mental well-being (eg, resilience) in adults and were web-based, written in English, interactive, free, and publicly available. They also had to be guided by an evidence-based therapeutic approach. verall, 52 eligible programs were identified, of which 9 (17%) addressed depression, 15 (29%) addressed anxiety, 13 (25%) addressed general mental well-being, and 13 (25%) addressed multiple issues. Only 4% (2/52) addressed distress in the form of suicidal ideation. The most common therapeutic approach was cognitive behavioral therapy. Half of the programs guided users through exercises in a set sequence, and most programs enabled users to log in and complete the activities on their own without professional support. Just over half of the programs had been evaluated for their effectiveness in reducing symptoms, and 11% (6/52) were being evaluated at the time of writing. Program evaluation scores ranged from 44% to 100%, with a total average score of 85%. here are numerous web-based programs for depression, anxiety, suicidal ideation, and general well-being, which are freely and publicly available in Australia. However, identified gaps include a lack of available web-based interventions for culturally and linguistically erse populations and programs that use newer therapeutic approaches such as acceptance and commitment therapy and dialectical behavior therapy. Despite most programs included in this review being of good quality, clinicians and consumers should pay careful attention when selecting which program to recommend and use, as variations in the levels of acceptability and impact of publicly available programs do exist.
Publisher: Springer Science and Business Media LLC
Date: 29-01-2021
Publisher: Springer Science and Business Media LLC
Date: 04-01-2016
DOI: 10.1007/S00520-015-3069-Y
Abstract: The purpose of this study is to determine how people diagnosed with cancer who call the Cancer Council Helpline in South Australia differ from carers/family/friends (caregivers) who call. Descriptive, retrospective audit of calls from people who contacted Cancer Council Helpline in South Australia between 16 April 2009 and 16 April 2013 who were diagnosed with cancer (n = 5766) or were the caregivers (n = 5174) of a person with cancer. Caregivers were more likely to be female (p < 0.001) younger in age (p < 0.001) call regarding cancer that was metastasised/widespread/advanced, terminal or at an unknown stage (p < 0.001) and phone requesting general cancer information or emotional support (p < 0.001). This group was more distressed (p < 0.001) but less likely (p = 0.02) to be offered and/or accept referrals to counselling than people diagnosed with cancer who called. Follow-up care was required by 63.5 % of caregivers and 73.1 % of people with cancer according to distress management guidelines 8.5 and 15.3 %, respectively, accepted referrals to internal services. The most frequently discussed topic for both groups was emotional sychological concerns. There were no differences in remoteness of residence or call length between groups. Caregivers represented different demographic groups than people diagnosed with cancer who called this helpline. The two groups phoned for different issues, at different stages of disease progression, displayed different levels of distress and, therefore, may benefit from services being tailored to meet their unique needs. These results also demonstrate the capacity of helplines to complement other health services and confirm that callers to cancer helplines exhibit high levels of distress.
Publisher: Springer Science and Business Media LLC
Date: 21-06-2017
DOI: 10.1007/S00520-017-3785-6
Abstract: The purpose of this study was to explore rural families' functioning following a parental cancer diagnosis. Ten families in which a parent of dependent children had received a cancer diagnosis were purposively s led using two questionnaires based upon the Resiliency Model of Family Adjustment and Adaptation (RMFAA): the Family Crisis Oriented Personal Evaluation Scales (F-COPES) and the Family Attachment Changeability Index 8 (FACI8). The total participant number was 34, which comprised the involvement of 17 parents and 17 children. The use of questionnaires ensured representation from both high and low functioning families. Qualitative data were gathered via semi-structured family interviews, and thematic analysis was used. Families identified three key challenges that are not accounted for by the RMFAA and may be unique to the rural cancer patient experience: frequent travel, increased work/financial demands and family separation. Families also described a number of protective factors that enabled them to cope with the demands of the cancer diagnosis, some of which were specific to rural families, while others may apply to Australian families more broadly. Many of these protective factors aligned with the RMFAA framework. The findings suggest that rural families' ability and willingness to access external resources, including informal community support and formal support services, are influenced by the strength of their internal protective factors. This result has practical implications for the development of interventions that accommodate the specific supportive care needs of rural families affected by cancer.
Publisher: Wiley
Date: 07-04-2023
DOI: 10.1111/AJR.12982
Abstract: Farmers face a range of factors that negatively influence their mental health and suicide risk, yet have limited access to appropriate support. Behavioural activation (BA) is an evidence‐based therapy that can be effectively delivered by nonclinical workers. Working with members of farming communities to deliver BA to their peers has the potential to overcome many well‐established barriers to mental health help‐seeking and improve outcomes for this at‐risk group. This paper describes the findings of a co‐design phase informing the development of a peer (farmer)‐led approach for delivering BA for farmers living with depression or low mood. This qualitative study used a co‐design approach involving members of the target community. Focus groups were transcribed and analysed using Thematic Analysis and the Framework approach. Ten online focus groups with 22 participants were held over 3 months. Four overarching, interlinked themes were identified: (i) filling the gap in rural mental health support (ii) alignment with the farming context—tailoring how, where and when we engage about mental health (iii) the ‘messenger’ is as important as the message and (iv) sustainability, governance and support. Findings suggest BA could be a contextually appropriate model of support for the farming community—given its practical and solution‐focused approach—and could help improve access to support. Having peer workers deliver the intervention was viewed as appropriate. Ensuring governance structures are developed to support peers to deliver the intervention will be essential to facilitate effectiveness, safety and sustainability. Insights gained through co‐design have been critical to the success of developing this new model of support for members of farming communities experiencing depression or low mood.
Publisher: Springer Science and Business Media LLC
Date: 12-03-2021
Location: Iran (Islamic Republic of)
No related grants have been discovered for Kate Gunn.