ORCID Profile
0000-0002-8214-3704
Current Organisations
University of Adelaide
,
Flinders University
,
University of South Australia
,
University of Sydney
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Publisher: Elsevier BV
Date: 03-2009
DOI: 10.1016/J.WOMBI.2008.08.001
Abstract: Midwifery Group Practice (MGP) is a continuity of midwifery care model for women of all levels of pregnancy risk available at a tertiary metropolitan hospital in Australia. This paper presents Part II of the demonstration study exploring the effectiveness of MGP, and reports on women's satisfaction with the model of care. A Maternal Satisfaction Questionnaire was developed and sent to all women (n=120) enrolled in MGP over a three-month period. The questionnaire comprised two open-ended questions asking women to list up to three things they liked and did not like about MGP, and a structured section exploring levels of satisfaction through a five-point Likert response format. The open-ended questions were analysed using qualitative content analysis, and analysis of the structured part of the questionnaire was undertaken by comparing mean scores of satisfaction ranging from -2 (very negative attitudes) to +2 (very positive attitudes). Of the 120 women who were sent a Maternal Satisfaction Questionnaire, 84 returned their questionnaire (70% response rate). Three overarching themes were identified in the content analysis of open-ended questions, namely: Continuity of care Accessibility and Personal and professional attributes of the midwife. Analysis of the structured part of the questionnaire showed that women were satisfied with the care they received in MGP, as indicated by positive scores on all questions. Women being cared for in MGP are satisfied with their care.
Publisher: Informa UK Limited
Date: 09-07-2022
Publisher: Wiley
Date: 11-09-2014
DOI: 10.1111/JOCN.12671
Abstract: This paper reports mental health nurses' perspectives of absconding. The aims of the study were to explore nurses' perceptions of risk assessment and management practices regarding absconding from acute inpatient psychiatric settings, and their affective responses when patients absconded. Nurses are directly involved in managing the risk of patients leaving hospital while acutely unwell, as well as dealing with the implications of an absconding event. However, despite their key role, few studies have explored nurses' perceptions of absconding. An interpretive inquiry was undertaken using a systematic thematic approach. Mental health nurses (n = 11) from three acute inpatient mental health units in Australia took part in semi-structured interviews, with a focus on the nurses' experiences of working with patients who had absconded. Data were analysed using systematic thematic coding procedures. Nurses' assessment of a patient's risk of absconding involved the use of clinical judgement, focusing on markers of absconding including the patient's history and clinical presentation. The acuity of the perceived risk determined the type of risk management strategy implemented, which could include support, observation and/or the use of containment procedures. Nurses responded with a myriad of affective reactions when patients absconded depending on their assessment of the patient's risk. Support and debriefing is required for mental health nurses following an absconding event. Additional research is vital to identify alternative absconding assessment and management strategies to ensure the best possible outcome for patients and nurses. Mental health nurses play a central role in risk assessment and management for absconding, with fear of repercussions a significant consequence for them. This research highlights the importance of both clinical judgment and standardised instruments in assessing absconding risk. Further research is needed to identify alternative evidence-based absconding management strategies to support nursing practice.
Publisher: Elsevier BV
Date: 06-2016
Publisher: Wiley
Date: 25-09-2012
DOI: 10.1111/J.1447-0349.2012.00872.X
Abstract: Restraint of older persons in inpatient and residential care is used to control aggression, and prevent falls and other adverse outcomes. Initiatives to reduce these practices are being implemented worldwide. However, there has been little examination of restraint practice in psychiatric services for older persons. This paper reports a retrospective comparative analysis of restraint use in three acute and two extended care psychiatric inpatient wards in Australia. The analysis involved examination of restraint incidents and comparison of restrained and non-restrained patients. There was significant variation in restraint use between wards. On one acute ward, 12.74% of patients were restrained, although restraint use declined during the data collection period. Patients with dementia were restrained at higher rates than patients with other diagnoses, and restrained patients stayed in hospital for a longer duration. Restraint occurred early in admission, and few differences emerged between those restrained once or multiple times. Mechanical restraint was more prevalent than physical restraint, with restraint predominantly used to manage aggression and falls. Findings provide new data on restraint in older persons' psychiatric services. Greater conceptual understandings of behaviours associated with dementia and the unique needs of patients with these disorders may assist in reducing restraint use in these settings.
Publisher: Wiley
Date: 04-04-2021
DOI: 10.1111/INM.12863
Abstract: Absconding from inpatient psychiatric care is a complex problem with significant and broad ranging effects for patients, staff, family/carers, and the broader community. Absconding includes leaving the ward without permission and failing to return from leave at an agreed time. This study is a retrospective chart audit of a data set of absconding events from 11 psychiatric wards in a metropolitan Australian city. The data set included both quantitative and qualitative data. The focus of this study is analysis of the qualitative data documenting what happened during events, with quantitative data provided to contextualize the qualitative analysis. A total of 995 absconding events by 488 patients were reported between January 2016 and June 2018, representing a rate of 1.6 per 100 admissions. Two themes were identified in the qualitative analysis. ‘Having things to do’ encompassed opportunistic absconding and volitional absconding. ‘Something changed’ represented predisposing events that affected the absconding behaviour, such as being stepped down in care (moving from a more acute to a less acute psychiatric unit), receiving bad news, or interpersonal conflict either between patients or between nursing staff and patients. Results highlight the importance of harm minimization strategies to reduce the incidence of absconding.
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.APNU.2014.08.015
Abstract: There are significant issues associated with the use of restrictive measures, such as seclusion and restraint, in child and adolescent mental health care. Greater understanding of how restrictive measures are used is important for informing strategies to reduce their use. In this brief report we present a 12-month audit (1/1/2010-31/12/2011) of the use of restrictive measures (seclusion, physical restraint) in one child and adolescent acute inpatient mental health unit in Australia. The study highlights the need for continued efforts to reduce the use of restrictive measures in child and adolescent mental health services.
Publisher: Wiley
Date: 08-09-2019
DOI: 10.1111/NHS.12637
Abstract: Recovery colleges are formal learning programs that aim to support people with a lived experience of mental illness. In this study, we aimed to explore the experiences of participants in a pilot recovery college that opened in Adelaide, South Australia, in 2016. A qualitative exploratory study was conducted involving interviews with learners (n = 8) and focus groups with lived experience facilitators (course facilitators with a lived experience of mental illness, n = 5), Clinician facilitators (mental health service staff facilitators, n = 4), and care coordinators (staff providing case management support, n = 5). Three main themes (hope, identity, and the recovery college as a transition space) and two subthemes (recovery college experience and outcomes) were identified. The results showed that the recovery college provided a transition space for shifting learners' identities from patient to student, facilitated by the experiences and outcomes of the recovery college, providing hope for the future. This study highlights the importance of providing mentally healthy and non-stigmatizing learning environments to promote and cement recovery for people with a lived experience of mental illness.
Publisher: Wiley
Date: 12-2014
DOI: 10.1111/INM.12100
Abstract: Absconding, where patients under an involuntary mental health order leave hospital without permission, can result in patient harm and emotional and professional implications for nursing staff. However, Australian data to drive nursing interventions remain sparse. The purpose of this retrospective study was to investigate absconding in three acute care wards from January 2006 to June 2010, in order to determine absconding rates, compare patients who did and did not abscond, and to examine incidents. The absconding rate was 17.22 incidents per 100 involuntary admissions (12.09% of patients), with no significant change over time. Being male, young, diagnosed with a schizophrenia or substance-use disorder, and having a longer hospital stay were predictive of absconding. Aboriginal and Torres Strait Islander patients had higher odds of absconding than Caucasian Australians. Over 25% of absconding patients did so multiple times. Patients absconded early in admission. More incidents occurred earlier in the year, during summer and autumn, and later in the week, and few incidents occurred early in the morning. Almost 60% of incidents lasted ≤24 hours. Formulation of prospective interventions considering population demographic factors and person-specific concerns are required for evidence-based nursing management of the risks of absconding and effective incident handling when they do occur.
Publisher: Wiley
Date: 27-08-2003
Publisher: Elsevier BV
Date: 06-2021
Publisher: SAGE Publications
Date: 05-2008
DOI: 10.1177/1329878X0812700115
Abstract: Since climate change captured global attention in the 1990s, the private in idual, addressed as a member of a concerned public, has occupied a focal position in the discourse of environmental amelioration. Recently, a range of prominent books, films and television programs — for ex le, Tim Flannery's The Weather Makers (2005), Al Gore's An Inconvenient Truth (2006) and ABC TV's Carbon Cops (2007) — have promoted the role of the in idual as the ‘starting point’ for effective environmental action. These texts assume that the provision and comprehension of sufficient information to the public about climate change will change in idual habits and practices. This accords with the ‘information-deficit model’ in environmental communication research, a concept that asserts a direct connection between in idual awareness and response, and collective action. This paper discusses the limitations of this model, pervasive in both popular and official approaches to climate change. It will interrogate the philosophical assumptions that underlie it, in which nature and culture are polarised and the human is positioned in a certain, and separate, relationship to the non-human world — an inheritance of the very logic that enables the continued exploitation of nature. Applying Bruno Latour's notion of a ‘matter of concern’ to climate change, where the gathering of a range of irreducible forces and im/materialities continually produce these phenomena, this paper proposes that, in thinking about climate change as essentially unrepresentable, a different mode of public engagement with the issue is asserted.
Publisher: University of Toronto Press Inc. (UTPress)
Date: 09-2019
Abstract: Introduction: Military service affects the health and well-being of both Veterans and their family members, with increasing recognition of the need for support to be provided to Veterans’ families. In 2017 the Australian Department of Veterans’ Affairs commissioned a rapid review of the literature to explore whether the delivery of support services to families of contemporary Veterans results in better outcomes for the Veteran. Methods: A systematic search of the peer-reviewed literature resulted in the extraction of 30 articles, reduced to 29 following quality assessment. We then produced a narrative synthesis of the articles. Results: All of the studies were undertaken in the United States (US). The majority ( n = 20) focused on couples/family therapy, in particular, to address post-traumatic stress disorder (PTSD) in Veterans. Discussion: The studies overall reported significant psychological and relational benefit for Veterans when families are supported. However, the ersity of approaches suggests that currently, no one approach suits all family situations. More work is needed to develop interventions that address the broader psychosocial needs of families, such as work commitments and childcare needs, and to evaluate how these might benefit Veterans.
Publisher: MDPI AG
Date: 23-01-2020
Abstract: There have been significant changes in the gambling landscape particularly relating to gambling in the digital age. As the gambling landscape changes, regulation of gambling also needs to change. In 2018, the Office of Responsible Gambling in New South Wales, Australia, commissioned a gap analysis to inform their research objectives and priority focus areas. This included an identification of gaps in our understanding of emerging technologies and new trends in gambling. A gap analysis of the peer-reviewed literature published since 2015 was undertaken, identifying 116 articles. The main area of focus was Internet gambling, followed by articles exploring the relationship between video gaming and gambling, the expansion of the sports betting market, Electronic Gambling Machines characteristics and articles exploring new technologies and trends in advertising and inducements. Key gaps related to the need for more research in general, as well as research focusing on subpopulations such as those using different gambling formats, those with varying levels of problem gambling, and vulnerable populations. From a methods perspective, researchers saw the need for longitudinal studies, more qualitative research and improved outcome measures. The development and testing of a public health approach to addressing the harms associated with gambling in these areas is needed.
Publisher: Hindawi Limited
Date: 30-11-2022
DOI: 10.1111/HSC.13659
Abstract: Transition to university is associated with reduced engagement in physical activity (PA), with students' PA influenced by many in idual and contextual factors. The experience of the COVID-19 pandemic is one such factor. COVID-19 has disrupted our relationships with our bodies and with others, our sense of time, and the spaces in which we live and work, resulting in reductions in PA. Based on data gathered through a phenomenological photovoice study conducted between June and December of 2020 with nine Australian university students, and informed by phenomenological writing on the uncanny, we explored how the experience of COVID-19 transformed students' lived experience of PA. PA offered students a pathway through the uncanny experience of COVID-19 by affording a way to (re)engage with others, (re)connect with spaces, make gains despite the losses, and recognise and appreciate moments of joy and reflection. This study provides novel insights that can be used to support students to meaningfully (re)engage in PA.
Publisher: SAGE Publications
Date: 28-04-2010
Abstract: The history of the relationship between complementary medicine (CM) and mainstream health care has shifted from the early days of pluralism, through hostility and exclusion, to one of grudging acceptance. The current situation is one of a tacit acknowledgement and in some cases open endorsement by biomedicine for a number of forms of CM practice, largely driven by the popularity of CM to consumers in our increasingly market driven health care system. How this relationship is ultimately worked out will impact both on the practice of CM and biomedicine, and on the health care choices available to consumers. In this article we review the research and commentary literature on the current and emerging relationship between biomedicine and CM. In particular we explore the ways in which mainstream inclusion of CM is discussed in the literature, and the biomedical and CM perspectives of mainstream CM inclusion. Finally we discuss the implications of the emerging relationship for CM, and CM practitioners and consumers.
Publisher: CSIRO Publishing
Date: 2019
DOI: 10.1071/AH18004
Abstract: Objective The aims of the present study were to establish rates of resuscitation order documentation of patients aged ≥65 years from both psychogeriatric and general medical units and to compare patients on predictors of resuscitation status, particularly examining the effect of depression. Methods A retrospective case note audit of psychogeriatric (n=162) and general medical (n=135) unit admissions within a tertiary teaching hospital was performed. Multivariate logistic regression was used to determine significant clinical and demographic predictors of resuscitation status. Results Resuscitation orders were documented in more psychogeriatric (94.4%) than general medical (48.1%) files. Depression did not significantly predict resuscitation status in either group. Having undergone competency assessment significantly predicted resuscitation status for the total s le and separately for psychogeriatric and medical patients. Older age (overall s le), poorer prognosis (overall s le), living in residential care (overall s le and medical group) and self-consenting to resuscitation status (overall s le and medical group) significantly predicted resuscitation status. Conclusions Resuscitation orders were more frequently documented on the psychogeriatric unit. Further prospective analysis is needed of how resuscitation orders are made before depression is discounted as a predictor of end-of-life decision-making. What is known about the topic? Despite increased community, media and research attention to end-of-life decision-making, resuscitation preferences of older patients are often poorly documented. Existing research into patient clinical and demographic factors that influence end-of-life decision-making have largely focused on general medical rather than psychogeriatric settings. There is a need to investigate rates of resuscitation documentation in psychogeriatric and general medical units and specific factors associated with having a ‘do not attempt resuscitation’ order in place, particularly the effect of current depression on decision-making. What does this paper add? Resuscitation orders were more frequently documented on the psychogeriatric than medical unit. Depression was not a significant predictor of resuscitation status in either group of patients. Although having undergone a competency assessment, older age and poorer prognosis predicted not being for resuscitation for the total s le, living in residential care and self-consenting to resuscitation status predicted not being for resuscitation for the overall s le and the medical group specifically. What are the implications for practitioners? This paper suggests that the need for clinicians to ensure documentation of preferences is a focus of day-to-day work with older patients. Clinicians should consider patient competency in end-of-life decision-making and how factors associated with depression, such as helplessness, may be more closely related to resuscitation decision-making in older patients.
Publisher: BMJ
Date: 02-2020
DOI: 10.1136/BMJOPEN-2019-033080
Abstract: Motivating behavioural change during client consultations is of crucial importance across all health professions to address the growing burden of chronic conditions. Yet health professionals often lack the skills and confidence to use evidence-based counselling interventions to support clients’ behavioural change and mobilise clients’ resources and self-efficacy for change to address their long-term needs. This pre–post pilot study will develop a motivational interviewing (MI) virtual client training tool for health professionals and test the effectiveness of the educational content and usability of the virtual client interaction. Postgraduate students across a range of health disciplines will be recruited. Data assessing attitudes towards preventive healthcare will be collected using a modified version of the Preventive Medicine Attitudes and Activities Questionnaire. Conversations with the virtual client will be analysed using the Motivational Interviewing Treatment Integrity code to assess changes in MI skills. The System Usability Scale will be used to assess the usability of the virtual client training tool. This protocol was approved by the Flinders University Social and Behavioural Research Ethics Committee in May 2019. The results of the pilot study will inform the development of an avatar-based mobile application consisting of MI teaching and interactions with a generic virtual client that can be easily adapted to multiple scenarios.
Publisher: Hindawi Limited
Date: 18-06-2010
DOI: 10.1111/J.1365-2524.2010.00935.X
Abstract: Despite the love that exists between children with disabilities and their parents and the positive contribution that children with a disability make to families and communities, caring for a child with a disability can be difficult and demanding for parents, carers and the family. Their interaction with the many and varied health professionals they encounter can serve to either ameliorate or exacerbate these difficulties. In this paper we report on a qualitative needs analysis undertaken as part of a project to develop disability awareness resources for generic health professionals (GHP). Data were collected through focus groups (n = 5) and in idual interviews (n = 7) with 34 parents/carers and was analysed using a process of thematic analysis. 'Partnership' was identified as the overarching theme that answers the question 'What do parents/carers want from a GHP?' Three further themes were identified that together tell the partnership 'story'. These are: 'The GHP-parent partnership', 'Qualities of a GHP', and 'The role of advocacy in the GHP-parent partnership'. Implications are presented that highlight the importance of advocacy in GHP-parent partnerships and suggest improvements in GHP education and preparation.
Publisher: Wiley
Date: 10-01-2020
DOI: 10.1111/JPM.12585
Abstract: WHAT IS KNOWN ON THE SUBJECT?: The use of chemical restraint in emergency situations is to control aggression or violence to protect consumers and staff and is to be used as a last resort when all other behavioural control alternatives have been exhausted. Chemical restraint involves the use of medication. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first paper to systematically review the prevalence of the use of chemical restraint. The use of chemical restraint is common across emergency departments and acute psychiatric inpatient units worldwide. Consumers who are restrained are also likely to receive chemical restraint. The studies reviewed demonstrate that there is a need for more standardized data collection so that clearer comparisons can be made between healthcare settings and countries. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Implications of practice include the need to report adverse events post-chemical restraint as these can deleteriously affect a person's physical health. Identification of and staff education about first-line management techniques before chemical restraint is administered are significant to reduce its use. ABSTRACT: Introduction Chemical restraint is used to manage uncontrolled aggression, agitation or violent behaviours of consumers with mental health disorders admitted to acute psychiatric or emergency settings. Aim This systematic review aimed to synthesize the international prevalence of chemical restraint for non-consenting adults. Method PsycINFO, CINAHL, MEDLINE/PubMed and Google Scholar databases were searched for peer-reviewed literature published between January 1996 and July 2018. This paper reports on data extracted from retrospective audits of chemical restraint practice. Results Forty-eight papers were included. The median prevalence of use of any restraint was 21.2% (25th% 8.0 to 75th% 36.3). Median prevalence of people who were chemically restrained, of all people restrained in any manner, was 43.1% (25th% 22.9% to 75th% 70.7%). Of all people admitted to facility(ies), the median prevalence of chemical restraint was 7.4% (25th% 2.7 to 75th% 17.6). There was no statistically significant difference in any prevalence measure considering healthcare setting or country. There was a significant decrease over the review period in the use of any restraint, including chemical restraint. Discussion and implications for practice This is the first known comprehensive meta-view of chemical restraint use worldwide, highlighting the need for standardized data collection to enable comparisons between healthcare settings and countries. Relevance statement There is an international imperative to reduce or eliminate the use of coercive practices, such as physical and chemical restraint, in mental health care. This study provides important information for mental health nursing by synthesizing the international prevalence of chemical restraint for non-consenting adults. This meta-view of the worldwide use of chemical restraint can inform ongoing efforts to reduce its use.
Publisher: Springer Science and Business Media LLC
Date: 12-2017
Publisher: Wiley
Date: 13-04-2006
DOI: 10.1111/J.1365-2702.2006.01510.X
Abstract: The aims of this paper were to review and critique existing research literature on children's and young people's experiences of chronic renal disease and to propose alternative approaches that may be more fruitful in addressing existing research shortcomings. Chronic renal disease, which results in approximately 1.6-4 new cases per year per million population in the 0-15 years age group, is a serious illness that causes severe and irreversible reduction in kidney function. Despite modern medical advances, its significance and implications for the lives of the children and young people concerned are profound. Salient literature for this review was obtained using the major health and social science electronic databases such as Medline, CINAHL, Psyclit and Sociofile. Manual searching of relevant books, journals and 'grey literature', combined with the genealogy approach, extended and strengthened the search. Research in this area focuses mainly on two areas, namely psychological adjustment and adaptation to end-stage renal disease. This research is grounded within a framework of empirical psychology that values objectivity, measurement and quantification. This predominantly psychometric approach is critiqued for simplifying the complex experience of end-stage renal disease and for pathologizing children and young people with this disease. We identify a significant gap in the research literature, namely the lack of research that takes into account these children's and young peoples'own perspectives of their experiences. Chronic renal disease has a significant impact on children's and young people's lives. Understanding the experiences of these children is important for the provision of effective healthcare. Conducting child-centred qualitative research in this area would allow us to explore vital questions of meaning, perception and understanding. If health and social care organizations claim to provide 'consumer-focused' services, it behoves us to develop first a clearer understanding of the lives and experiences of children and families who seek our help and to use this knowledge and understanding to plan and provide more grounded and responsive services.
Publisher: Elsevier BV
Date: 03-2020
DOI: 10.1016/J.PEC.2019.09.021
Abstract: To conduct a systematic review of instruments for assessing the competency of therapists in motivational interviewing (MI) for training purposes. A search of Medline, Emcare, CINAHL, Scopus, Proquest, and Web of Science databases yielded 20,313 articles, of which 105 were included in the review. Data were summarised in terms of the instruments' development, adherence to MI principles, administration characteristics, psychometric properties, advantages, and disadvantages. Twelve instruments were identified. Tools tended to be better at covering simpler MI techniques. Differences in administration burden allow users to choose between briefer but cheaper and more detailed yet costly tools. Psychometric testing was often limited, and even if more extensive, the quality was often inconsistent. Although each tool tended to have relatively unique advantages (e.g. use of client ratings), they shared common disadvantages (e.g. lack of psychometric testing). A number of tools can be used to assess MI competency, each with their own strengths but notable weaknesses that should be considered by potential users. There is a need to further test existing tools before creating new ones, due to the repetition of the same limitations. Standardised guidelines should also be created to ensure each tool meets the same quality standards.
Publisher: Wiley
Date: 25-03-2013
DOI: 10.1111/BIRT.12035
Abstract: Induction of labor, an increasingly common intervention, is often preceded by the application of an agent to "prime" or "ripen" the cervix. We conducted a randomized controlled trial to compare clinical, economic, and psychosocial outcomes of inpatient and outpatient cervical priming before induction of labor. In this paper we present the psychosocial outcomes. Women participating in a randomized controlled trial in two Australian metropolitan teaching hospitals completed questionnaires to measure anxiety and depression at enrollment, and to examine satisfaction, experiences, depression, and infant feeding 7 weeks after giving birth. Data analysis was by intention to treat and by having received the intervention as intended (approximately 50% in each group). Of 1,004 eligible women, 85 percent consented (n = 407, outpatient n = 414 inpatient). No statistically significant or clinically relevant differences were found in immediate anxiety, depression, or infant feeding. Small, statistically significant differences favoring outpatient priming were found in seven of the nine subscales in the 7-week postpartum questionnaire. The direction of the effect was maintained, mostly with a larger effect size in women who received the intervention. Women allocated to outpatient priming were more satisfied with their priming experience than women allocated to inpatient priming. Being informed that they could go home after cervical priming did not increase women's anxiety.
Publisher: Informa UK Limited
Date: 11-11-2011
DOI: 10.3109/01612840.2011.603880
Abstract: Risk assessment and management is a major component of contemporary mental health practice. Risk assessment in health care exists within contemporary perspectives of management and risk aversive practices in health care. This has led to much discussion about the best approach to assessing possible risks posed by people with mental health problems. In addition, researchers and commentators have expressed concern that clinical practice is being dominated by managerial models of risk management at the expense of meeting the patient's health and social care needs. The purpose of the present study is to investigate the risk assessment practices of a multidisciplinary mental health service. Findings indicate that mental health professionals draw on both managerial and therapeutic approaches to risk management, integrating these approaches into their clinical practice. Rather than being dominated by managerial concerns regarding risk, the participants demonstrate professional autonomy and concern for the needs of their clients.
Publisher: Informa UK Limited
Date: 02-2012
Publisher: Wiley
Date: 07-01-2022
DOI: 10.1111/INM.12971
Abstract: Implementing psychosocial approaches into mental health inpatient settings continues to be challenging. This is despite mental health policies prioritizing trauma‐informed and recovery‐orientated care approaches. This study reports on an interdisciplinary project that implemented and examined the uptake of weighted modalities in a psychiatric inpatient rehabilitation setting. While over‐reliance on pro re nata (PRN) medication in these settings has been reported, weighted modalities are a sensory approach that can be self‐initiated by consumers as an alternative to use of PRN to manage distress and agitation. A mixed‐methods realist approach was used to determine what works, for whom, and in what circumstances weighted modalities were offered by clinicians and used by consumers. Additionally, we were interested in determining whether there was an associated change in PRN use during the trial. Data included in‐depth interviews with consumers ( n = 12) and clinicians ( n = 11), and extraction of PRN medication use preceding, throughout, and following implementation. Statistical analysis revealed a significant increase in PRN rates in the first 3 months of implementation (mean difference from baseline = 29.5, P = 0.047) but a significant decrease in the second three‐month period following implementation (mean difference from baseline = −30.7, P = 0.036). Qualitative findings highlighted the key components of successful implementation as being environmental restructuring (availability/accessibility and visibility of weighted modalities) and social influences. Strategies to enhance these components are discussed.
Publisher: SAGE Publications
Date: 07-2010
Abstract: This Australian study sought to understand how practitioners of the traditional systems of what is now termed complementary and alternative medicine (CAM) are responding to the adoption of their traditional medicine therapies by the mainstream health care system, and the practice of these therapies by mainstream health care practitioners. A grounded theory approach was used for this study. In-depth interviews were conducted with 19 participants who were non-mainstream practitioners from five traditional systems of medicine — Traditional Chinese Medicine,Ayurveda, Naturopathy, Homeopathy and Western Herbal Medicine. Four main conceptual categories were identified: Losing Control of the CAM Occupational Domain (the participants’ main concern) Personal Positioning Professional Positioning (the core category) and Legitimacy.These categories formed the elements of the substantive theory of ‘ becoming accepted’ as a legitimate health care provider in the mainstream health system, which explained the basic social process that the study’s participants were using to resolve their main concern.
Publisher: Wiley
Date: 09-09-2019
DOI: 10.1111/INM.12654
Abstract: One approach to manage people with behaviours of concern including agitated or aggressive behaviours in health care settings is through the use of fast-acting medication, called chemical restraint. Such management often needs to be delivered in crisis situations to patients who are at risk of harm to themselves or others. This paper summarizes the available evidence on the effectiveness and safety of chemical restraint from 21 randomized controlled trials (RCTs) involving 3788 patients. The RCTs were of moderate to high quality and were conducted in pre-hospital, hospital emergency department, or ward settings. Drugs used in chemical restraint included olanzapine, haloperidol, droperidol, risperidol, flunitrazepam, midazolam, promethazine, ziprasidone, sodium valproate, or lorazepam. There was limited comparability between studies in drug choice, combination, dose, method of administration (oral, intramuscular, or intravenous drip), or timing of repeat administrations. There were 31 outcome measures, which were inconsistently reported. They included subjective measures of behaviours, direct measures of treatment effect (time to calm time to sleep), indirect measures of agitation (staff or patient injuries, duration of agitative or aggressive episodes, subsequent violent episodes), and adverse events. The most common were time to calm and adverse events. There was little clarity about the superiority of any chemical method of managing behaviours of concern exhibited by patients in Emergency Departments or acute mental health settings. Not only is more targeted research essential, but best practice recommendations for such situations requires integrating expert input into the current evidence base.
Publisher: Wiley
Date: 11-03-2021
DOI: 10.1111/NHS.12822
Abstract: With an imperative to reduce or eliminate the use of coercive practices in mental health care it is important to understand the experience of service users and staff. This review aimed to synthesize qualitative studies, published between 1996 and 2020, reporting on mental health service users' and staff's experiences of chemical restraint. The databases PsycINFO, CINAHL, MEDLINE, Embase, Emcare, Web of Science, and Scopus were searched. Three analytic themes were identified from 17 included articles, synthesizing the experiences of service users and staff. These were “Unjustified versusjustified,” “Violence versus necessity,” and “Reflecting back: Positives and negatives.” Service users viewed chemical restraint as an unjustified response to “behaviors of concern” and experienced it as a violent act with negative outcomes, although some saw it as necessary in retrospect and preferred it to other forms of coercion. Staff generally viewed it as a justified response to “behaviors of concern” and experienced it as appropriate within the constraints of staff numbers and limited alternatives. These findings identify nuances not apparent in the literature, which has generally conflated all forms of coercive practices.
Publisher: Informa UK Limited
Date: 11-09-2018
Publisher: Wiley
Date: 09-03-2018
DOI: 10.1111/INM.12451
Abstract: Restrictive practices continue to be used in mental health care despite increasing recognition of their harms and an international effort to reduce and ultimately eliminate their use. The aim of this qualitative study was to explore mental health nurses' views of the potential elimination of these practices. Nine focus groups were conducted with 44 mental health nurses across Australia, and the data analysed using thematic analysis. Overall, the nurses expressed significant fear about the potential elimination of restrictive practices and saw themselves as being blamed for both the use of these practices and the consequences should they be eliminated. Findings detail the conflicts facing staff in balancing the need for ward safety for everyone present while at the same time providing person-centred care. Nurses described the changing role of the mental health nurse in acute settings, being more focussed on risk assessment and medication while at the same time attempting to practise in trauma-informed person-centred ways. The impact on ward safety with increasing acuity of consumers plus the presence of forensic consumers and those affected by meth hetamine was emphasized. Change initiatives need to take into account nurses' deep concerns about the consequences of eliminating all forms of control measures in hospitals and respond to the symptoms and behaviours consumers present with and associated unpredictable and concerning behaviours. Attempts to eliminate restrictive practices should, therefore, be carefully considered and come with a clear articulation of alternatives to ensure the safety of consumers, visitors, and staff.
Publisher: Wiley
Date: 26-12-2016
DOI: 10.1111/INM.12298
Abstract: Empathy is a central component of nurse-consumer relationships. In the present study, we investigated how empathy is developed and maintained when there is conflict between nurses and consumers, and the ways in which empathy can be used to achieve positive outcomes. Through semistructured interviews, mental health nurses (n = 13) and consumers in recovery (n = 7) reflected on a specific conflict situation where they had experienced empathy, as well as how empathy contributed more generally to working with nurses/consumers. Thematic analysis was used to analyse the data, utilizing a framework that conceptualizes empathy experiences as involving antecedents, processes, and outcomes. The central theme identified was 'my role as a nurse - the role of my nurse'. Within this theme, nurses focussed on how their role in managing risk and safety determined empathy experienced towards consumers consumers saw the importance of nurse empathy both in conflict situations and for their general hospitalization experience. Empathy involved nurses trying to understand the consumer's perspective and feeling for the consumer, and was perceived by consumers to involve nurses 'being there'. Empathic relationships built on trust and rapport could withstand a conflict situation, with empathy a core component in consumer satisfaction regarding conflict resolution and care. Empathy allows the maintenance of therapeutic relationships during conflict, and influences the satisfaction of nurses and consumers, even in problematic situations. Nurse education and mentoring should focus on nurse self-reflection and building empathy skills in managing conflict.
Publisher: Springer Science and Business Media LLC
Date: 24-09-2018
Publisher: Informa UK Limited
Date: 06-03-2022
Publisher: American Psychological Association (APA)
Date: 07-2015
DOI: 10.1037/A0038154
Publisher: Elsevier BV
Date: 09-2013
DOI: 10.1016/J.WOMBI.2013.03.001
Abstract: Induction of labour often begins with the application of a priming agent to soften the cervix, generally requiring women to stay in hospital overnight (inpatient priming). An alternative is outpatient priming by a midwife, where women are allowed to go home following priming. This approach has the potential to impact, either positively or negatively, on the midwives involved. To what extent did the introduction of outpatient priming influence midwives' work demands, work autonomy, stress and job satisfaction. A before-after study (with two separate cross-sectional s les) was conducted alongside a randomized controlled trial of outpatient versus inpatient priming, conducted at two metropolitan teaching hospitals in Australia. Midwives completed a questionnaire before the introduction of outpatient priming and again approximately two years later. 208 midwives participated (response rates-time 1:81% (87/108) time 2:78% (121/156)). A mixed model analysis test of pre-post intervention differences found no changes in work demand, work autonomy and satisfaction. At time 2, over 80% of midwives reported that the introduction of the practice had reduced or made no difference to their work stress and workload, and 93% reported that outpatient priming had increased or had no impact on their job satisfaction. Furthermore, 97% of respondents were of the opinion that the option of outpatient priming should continue to be offered. Results suggest that outpatient priming for induction of labour is viable from a midwifery practice perspective, although more research is needed.
Publisher: Elsevier BV
Date: 08-2010
DOI: 10.1016/J.MIDW.2008.09.004
Abstract: to examine changes in midwives' attitudes to their professional role following the introduction of midwifery group practice (MGP) (a caseload model of midwifery continuity of care provided to women of all risk levels) and to explore aspects of the model that were working well and those that were not working well. the questionnaire 'Attitudes to Professional Role' was used to measure midwives' satisfaction in terms of professional satisfaction, professional support, client interaction, and professional development. Open-ended questions were also included to offer an opportunity for midwives to expand on their experiences of working in the MGP model. The questionnaire was administered at five time points over the 18-month evaluation period. Round 1 was prior to the implementation of MGP, Rounds 2-4 were at three-month intervals, with Round 5 six months later. Analysis of the structured part of the questionnaire was undertaken by comparing mean scores of satisfaction ranging from -2 (very negative attitudes) to +2 (very positive attitudes), and the open-ended questions were analysed using qualitative content analysis. the Women's and Children's Hospital, Adelaide, South Australia. questionnaires were distributed to all midwives (n=15) working in MGP in Rounds 1, 2 and 3, and to the 12 midwives remaining from the original s le in Rounds 4 and 5. Fourteen questionnaires were returned in Round 1, 12 in Round 2, 10 in Round 3, nine in Round 4, and 10 in Round 5. overall, a positive change in attitudes to professional role was reflected in all sub-scales in the period between start-up and 18 months later a reduction in scores occurred in Round 3. The mean increases were significant for all sub-scales apart from professional development. Five main themes were identified across the rounds in the content analysis: 'continuity of care', 'working pattern', 'working environment', 'collegiality' and 'issues relating to midwifery practice'. Midwives gained particular satisfaction from providing continuity of care and building relationships with women and their families, and through practising autonomously as a midwife. While there was a struggle to manage the hours worked and being on call, high levels of professional satisfaction were maintained. while there were aspects of MGP that midwives were not satisfied with and wanted to change, overall they were satisfied with the model. there is a need for ongoing evaluation in order to monitor the short- and long-term impact on midwives of working in a caseload model of continuity of midwifery care.
Publisher: SAGE Publications
Date: 29-12-2019
Abstract: Review the evidence for the effectiveness of chronic condition self-management programs applied to Aboriginal and Torres Strait Islander Peoples. A rapid review methodology was followed to develop an evidence summary from peer-reviewed and grey literature. Only seven peer-reviewed studies were identified. The evidence indicated that group programs, particularly the Stanford Program, and structured in idual chronic condition self-management programs were of good quality for Aboriginal and Torres Strait Islander Peoples, although these need to be integrated into practice in order to see the greatest benefits. The Flinders Program showed promise as a standardised program with content designed specifically with and for these populations. Numerous grey literature sources were identified, many using strong participatory approaches developed locally within Aboriginal and Torres Strait Islander Peoples. However, few of these programs have been subject to rigorous evaluation. Despite the significant focus on chronic condition self-management programs to help address the burden of disease for Aboriginal and Torres Strait Islander Peoples, few studies exist that have been properly evaluated. The Closing the Gap Principles developed by the Australian Institute of Health and Welfare offer important guidance for how to proceed to maximise engagement, cultural appropriateness and ownership of program initiatives.
Publisher: Informa UK Limited
Date: 08-09-2020
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 14-12-2020
Publisher: Wiley
Date: 25-09-2012
DOI: 10.1111/J.1447-0349.2012.00873.X
Abstract: Absconding from acute psychiatric inpatient units is a significant issue with serious social, economic, and emotional costs. A qualitative study was undertaken to explore the experiences of people (n = 12) who had been held involuntarily under the local mental health act in an Australian inpatient psychiatric unit, and who had absconded (or attempted to abscond) during this time. The aim of the study was to explore why people abscond from psychiatric inpatient units, drawing on published work from health geography on the significance of the person-place encounter, and in particular the concept of 'therapeutic landscapes'. The findings show that the inpatient unit is perceived as a safe or unsafe place, dependent on the dialectical relationship between the physical, in idual, social, and symbolic aspects of the unit. Consumers absconded when the unit was perceived as unsafe. Forming a therapeutic relationship with staff, familiarity with the unit, a comfortable environment, and positive experiences with other consumers all supported perceptions that the unit was safe, decreasing the likelihood of absconding. Findings extend existing work on the person-place encounter within psychiatric inpatient units, and bring new knowledge about the reasons why consumers abscond. Implications for practice are discussed.
Publisher: Elsevier BV
Date: 2011
DOI: 10.1016/J.HEALTHPLACE.2010.12.001
Abstract: A qualitative study was conducted in Australia to explore women's preferences for inpatient or outpatient settings for cervical priming for induction of labour. The concept of therapeutic landscapes was used to explore the different aspects of the home and hospital that make them therapeutic to women. The therapeutic value of the home and hospital landscapes was defined by their ability to provide women with 'comfort' and 'safety', and women were found to draw on a range of contextual factors to negotiate between the comfort of home and the perceived safety of the hospital. The study provides important information for health professionals to enable them to enhance women's wellbeing should they be offered the choice of inpatient or outpatient priming.
Publisher: SAGE Publications
Date: 04-2008
Abstract: Genital herpes is a prevalent sexually transmitted viral infection. While genital herpes is not life-threatening, it can cause physical discomfort and psychosocial difficulties, and may increase the risk of contracting HIV. Given that genital herpes cannot be cured, both the condition itself, and the possibility of passing it on to others, becomes a part of the everyday reality of those in iduals diagnosed with genital herpes. In this article we explore the ways in which people with genital herpes attending the Sexually Transmitted Infections (STI) clinic govern their `contagious bodies'. The discussion draws on the Foucauldian concept of governmentality, and uses Foucault's idea of ethics as a framework to identify the technologies of the self by which in iduals with genital herpes govern their own thoughts and behaviours in relation to the contagiousness of the condition. Implications for practice and other ways of thinking about what happens in the STI clinic context are suggested.
Publisher: Springer Science and Business Media LLC
Date: 2001
Abstract: Gambling research has contributed much to our understanding of the effects of gambling on families, yet we have only the most cursory understanding of the child's perspective on what it is like to grow up in such a family. The aim of this qualitative study was to gain a deeper understanding of the experiences of Australian children who live in families where a parent or caregiver has a serious gambling problem by exploring the perspectives and understandings of the children and young people themselves. This paper reports a central finding, the experience of 'Pervasive Loss,' from our interviews with 15 young people, 11 males and 4 females, aged between 7 and 18 years. Their sense of loss encompassed both physical and existential aspects of the child's life, including their parent(s), relationships, trust, security, sense of home, and material goods. The dimensions of this experience of pervasive loss are explored from the child's perspective. Children living in families where gambling is a problem experience threats to their overall well-being to the extent that parental problem gambling must now considered to be a significant child health as well as social problem.
Publisher: Hindawi Limited
Date: 23-01-2019
DOI: 10.1111/ECC.12996
Abstract: Oesophagectomy for cancer is associated with significant morbidity and mortality, and reduced quality of life. Structured rehabilitation potentially offers improved physical and psychological outcomes. We aimed to explore patient, carer and healthcare provider attitudes and preferences towards the role of rehabilitation. We interviewed 15 patients who had undergone an oesophagectomy, 10 carers and 13 healthcare providers about perceived impacts of treatment preferred components of a rehabilitation program barriers/enablers of support provision and participation in rehabilitation programs. Data were analysed using framework analysis. The overarching theme was "Getting back to normal." Diagnosis of disease signified a disruption to the normal trajectory of patients' lives and the post-treatment period was characterised as striving to return to normal. Patients and carers focused on rehabilitation needs post-treatment including dietary support, physiotherapy and healthcare provider support. Healthcare providers described rehabilitation as potentially beneficial from the pre-treatment phase and, along with carers, highlighted the importance of psychological support. Barriers included access to services, cost of service provision and appointment burden. A need for rehabilitation services was identified by healthcare providers from the point of diagnosis, rather than only after surgery. Implications include improved service provision by healthcare institutions for patients undergoing oesophagectomy.
Publisher: Oxford University Press (OUP)
Date: 21-03-2022
Abstract: Social determinants of health have a significant effect on health and wellbeing. There is increasing recognition of the need for health professionals to measure and address the social determinants affecting the health and wellbeing of their clients, yet efforts to do so are h ered by the lack of a validated, brief self-report measure that covers a range of determinants in a single measure. This study aimed to develop and conduct initial validation of a measure of social determinants of health, the Steps to Better Health Questionnaire (STBH-Q). Construct validity was assessed via factorial validity using exploratory factor analysis and second order confirmatory factor analysis (CFA), followed by convergent validity against the EQ-5D-5L quality of life measure. Reliability was assessed by exploring internal consistency. A convenience s ling approach was used, and 330 Australian adults aged 18 and over completed the survey. This initial validation suggests an underlying structure of STBH-Q consisting of Access Employment, Finances & Education Safety Physical & Mental Health and Family & Childhood, confirmed by second-order CFA. Results of convergent validity testing with the EQ-5D-5L demonstrated significant correlations of modest to moderate strength with the instrument as a whole and with the sub-scales in the expected direction. Cronbach’s alpha for the five scales ranged from 0.561 to 0.827. Further development and validation of the STBH-Q is needed to explore alternative questions regarding social connection and habits/addictions and add additional items to factors with only two items.
Publisher: Informa UK Limited
Date: 10-2010
DOI: 10.5172/JAMH.9.2.138
Publisher: Wiley
Date: 18-07-2020
DOI: 10.1111/JEP.13232
Abstract: Chemical restraint (CR) (also known as rapid tranquilisation) is the forced (non-consenting) administration of medications to manage uncontrolled aggression, anxiety, or violence in people who are likely to cause harm to themselves or others. Our population of interest was adults with mental health disorders (with/without substance abuse). There has been a growing international movement over the past 22 years towards reducing/eliminating restrictive practices such as CR. It is appropriate to summarise the research that has been published over this time, identify trends and gaps in knowledge, and highlight areas for new research to inform practice. To undertake a comprehensive systematic search to identify, and describe, the volume and nature of primary international research into CR published since 1995. This paper reports the processes and overall findings of a systematic search for all available primary research on CR published between 1 January 1996 and 31 July 2018. It describes the current evidence base by hierarchy of evidence, country (ies) producing the research, CR definitions, study purpose, and outcome measures. This review identified 311 relevant primary studies (21 RCTs 46 non-controlled experimental or prospective observational studies 77 cross-sectional studies 69 retrospective studies 67 opinion pieces, position or policy statements and 31 qualitative studies). The USA, UK, and Australia contributed over half the research, whilst cross-country collaborations comprised 6% of it. The most common research settings comprised acute psychiatric wards (23.3%), general psychiatric wards (21.6%), and general hospital emergency departments (19.0%). A key lesson learnt whilst compiling this database of research into CR was to ensure that all papers described non-consenting administration of medications to manage adults with uncontrolled aggression, anxiety, or violence. There were tensions in the literature between using effective CR without producing adverse events, and how to decide when CR was needed (compared with choosing non-chemical intervention for behavioural emergencies), respecting patients' dignity whilst safeguarding their safety, and preserving safe workplaces for staff, and care environments for other patients. The range of outcome measures suggests opportunities to standardise future research.
Publisher: Hindawi Limited
Date: 07-2001
DOI: 10.1046/J.0966-0410.2001.00302.X
Abstract: Problem gambling is becoming an increasingly widespread and damaging social and health problem. As opportunities for gambling become more accessible, especially through lotteries and electronic gaming machines, it is likely that more people will develop serious gambling problems. Given the worldwide increasing spending on gambling activities and the increasing number of problem gamblers, it is unfortunate but likely that the children who grow up in problem gambling families will become an important area of concern for child health and social workers. Considerable research has been undertaken into problem gambling and the adult problem gambler, but within the gambling and child health literature there is almost no recognition of the experiences of children who live in problem-gambling families. Drawing on the findings of the landmark Productivity Commission Report, this review explores the marked increase in gambling and its social effects, especially from the Australian perspective. The damaging social effects of problem gambling on families and children are reviewed and the comparative invisibility of children and young people in such research is discussed. The pervasive influence of developmentalism is critiqued and highlighted in relation to the exclusion of children's perspectives from our research understandings. The review concludes by proposing that adoption of some of the emerging 'new paradigm' approaches to childhood and children's experiences could markedly enhance our understandings of the lives and experiences of this significant group of children and young people.
Publisher: Informa UK Limited
Date: 02-05-2017
DOI: 10.1080/13607863.2017.1320702
Abstract: Integrated care has been identified as means of managing the demands on the healthcare budget while improving access to and quality of services. It is particularly pertinent to rural health services, which face limited access to specialist and support services. This paper explores the capacity of three rural communities in South Australia to deliver integrated mental health support for older people. Thirty-one interviews were conducted with local health and social service providers from mental health, community health, general practice, residential aged care, private practice, NGOs and local government as part of a larger action research project on service integration. Participants highlighted differences in service delivery between the communities related to size of the community and access to services. Three structural barriers to delivery of integrated care were identified. These are as follows: fragmentation of governmental responsibility, the current funding climate, and centralisation and standardisation of service delivery. We conclude that despite a focus upon integrated care in mental health policy, many features of current service delivery undermine the flexibility and informal relationships that typically underpin integration in rural communities.
Publisher: SAGE Publications
Date: 12-05-2014
Abstract: The purpose of this study was to investigate restraint use in Australian emergency departments (EDs). A retrospective audit of restraint incidents in four EDs (from 1 January 2010 to 31 December 2011). The restraint rate was 0.04% of total ED presentations. Males and females were involved in similar numbers of incidents. Over 90% of restrained patients had a mental illness diagnosis and were compulsorily hospitalised. Mechanical restraint with the use of soft shackles was the main method used. Restraint was enacted to prevent harm to self and/or others. Median incident duration was 2 hours 5 minutes. In order to better integrate the needs of mental health clients, consideration is needed as to what improvements to procedures and the ED environment can be made. EDs should particularly focus on reducing restraint duration and the use of hard shackles.
Publisher: Oxford University Press (OUP)
Date: 10-2023
Publisher: Wiley
Date: 19-10-2017
DOI: 10.1016/J.JALZ.2017.09.007
Abstract: Progress in understanding and management of vascular cognitive impairment (VCI) has been h ered by lack of consensus on diagnosis, reflecting the use of multiple different assessment protocols. A large multinational group of clinicians and researchers participated in a two-phase Vascular Impairment of Cognition Classification Consensus Study (VICCCS) to agree on principles (VICCCS-1) and protocols (VICCCS-2) for diagnosis of VCI. We present VICCCS-2. We used VICCCS-1 principles and published diagnostic guidelines as points of reference for an online Delphi survey aimed at achieving consensus on clinical diagnosis of VCI. Six survey rounds comprising 65-79 participants agreed guidelines for diagnosis of VICCCS-revised mild and major forms of VCI and endorsed the National Institute of Neurological Disorders-Canadian Stroke Network neuropsychological assessment protocols and recommendations for imaging. The VICCCS-2 suggests standardized use of the National Institute of Neurological Disorders-Canadian Stroke Network recommendations on neuropsychological and imaging assessment for diagnosis of VCI so as to promote research collaboration.
Publisher: Springer Science and Business Media LLC
Date: 12-2020
DOI: 10.1186/S13033-020-00424-0
Abstract: Pasung is the term used in Indonesia and a number of other countries for seclusion and restraint of people with mental illness in the community, usually at home by their family. While pasung has been banned because it is contrary to human rights, its practice continues to exist within the community, particularly where community mental health services are limited, and in the absence of adequate social support, and pervasive negatives beliefs about mental illness. It is essential to understand the reasons for the ongoing use of pasung and to examine potential solutions. A systematic review and narrative synthesis of peer-reviewed international literature was conducted to identify the socio-cultural contexts for pasung use, and interventions to address it. The analysis draws on the socio-ecological framework, which focused on relationships between the in idual and their environment. Fifty published articles were included in the review all studies were conducted in Asia and Africa, with 32 undertaken in Indonesia. Most studies were qualitative (n = 21). Others included one case–control study, one cross-sectional study, and seven surveys only four studies examined the application of an intervention, and each used a pre and post methodology. Of these, two studies tested psychoeducational interventions which aimed to overcome family burden due to pasung, and each suggested a community mental health approach. The remaining two studies evaluated the intervention of ‘unlocking’ one study used a community-based culturally sensitive approach, and the other used a community-based rehabilitation program. Reasons for pasung given by family appear to be as a last resort and in the absence of other supports to help them care for the person with severe mental illness. The findings highlight that a mixture of in idual, interpersonal, community and policy interventions are needed to reduce the use of pasung. While consumer and carer involvement as part of a socio-ecological approach is understood to be effective in reducing pasung, an understanding of how to elaborate this in the management of pasung remains elusive. Review Registration CRD42020157543: CRD
Publisher: Wiley
Date: 26-05-2018
DOI: 10.1111/INM.12351
Publisher: Wiley
Date: 28-05-2020
DOI: 10.1111/NHS.12725
Publisher: Informa UK Limited
Date: 05-02-2014
DOI: 10.1080/13607863.2013.878307
Abstract: Unmet mental health care needs of older people (aged 65 and over) have been identified as a serious problem internationally, particularly in rural areas. In this study we explored the views of health and social care providers of the barriers to effective mental health care for older people in a rural region in Australia. Semi-structured interviews were conducted with 19 participants from 13 organisations providing care and support to older people in a rural region of Australia. A framework analysis approach was used to thematically analyse the data. Two main themes were identified: 'Recognising the Problem' and 'Service Availability and Access'. In particular the participants identified the impact of the attitudes of older people and health professionals, as well as service inadequacies and gaps in services, on the provision of mental health care to older people in a rural region. This study supports previous work on intrinsic and extrinsic barriers to older people with mental health problems accessing mental health services. The study also offers new insight into the difficulties that arise from the separation of physical and mental health systems for older people with multiple needs, and the impact of living in a rural region on unmet mental health care needs of older people.
Publisher: Springer Science and Business Media LLC
Date: 17-12-2019
Publisher: MDPI AG
Date: 22-01-2021
Abstract: Gambling is occurring in a rapidly changing landscape, with new trends and technologies affecting gambling behaviour and problem gambling across a range of populations. Gambling activity among adolescents and young people has received considerable research attention due to a high prevalence of gambling reported among these groups in recent years. Despite legislation worldwide to constrain gambling among adolescents and young people, modern technology, such as online gaming apps and online gambling venues, has significantly increased their exposure to the risks of problem gambling. It is important, therefore, to have up to date information about what is currently known about gambling and to explore gaps in our knowledge. This gap analysis presents the results of a systematic approach to reviewing the current literature on gambling behaviour, attitudes, and associated risk factors for gambling and problem gambling among adolescents and young adults (aged 10–25 years). The review included studies published between January 2015 and August 2020 and included 85 studies for final synthesis. Findings reveal further research is needed on the implications for young people of emerging technologies and new trends in gambling in the digital age. The current gap analysis reveals that this should include more research on the development and impact of both treatment and intervention strategies, and policy and regulatory frameworks from a public health perspective.
Publisher: SAGE Publications
Date: 05-08-2013
Abstract: Colorectal cancer (CRC) is one of the most prevalent cancers worldwide, and an ideal target for early detection and prevention through cancer screening. Unfortunately, rates of participation in screening are less than adequate. In this article we explore why people who were offered a fecal immunochemical test for CRC decided to participate or not, and for those who did participate, what influenced them to take action and complete the test. We conducted four focus groups and 30 telephone interviews with 63 people. The main reason people decided to screen was “wanting to know” their CRC status, which operated on a continuum ranging from wanting to know, through varying degrees of ambivalence, to not wanting to know. The majority of participants expressed ambivalence about CRC screening, and the main cue to action was the opportunity to screen without being too inconvenienced.
Publisher: Elsevier BV
Date: 06-2010
DOI: 10.1016/J.MIDW.2008.06.004
Abstract: To explore how a group of midwives achieved a work-life balance working within a caseload model of care with flexible work hours and on-call work. in-depth interviews were conducted and the data were analysed using a data-driven thematic analysis technique. Children, Youth and Women's Health Service (CYWHS) (previously Women's and Children's Hospital), Adelaide, where a midwifery service known as Midwifery Group Practice (MGP) offers a caseload model of care to women within a midwife-managed unit. 17 midwives who were currently working, or had previously worked, in MGP. analysis of the midwives' in idual experiences provided insight into how midwives managed the flexible hours and on-call work to achieve a sustainable work-life balance within a caseload model of care. it is important for midwives working in MGP to actively manage the flexibility of their role with time on call. Organisational, team and in idual structure influenced how flexibility of hours was managed however, a period of adjustment was required to achieve this balance. the study findings offer a description of effective, sustainable strategies to manage flexible hours and on-call work that may assist other midwives working in a similar role or considering this type of work setting.
Publisher: Wiley
Date: 31-03-2019
DOI: 10.1111/INM.12591
Abstract: Reducing and/or eliminating the use of coercive measures in psychiatric services is a priority worldwide. Chemical restraint is one such measure, yet to date has been poorly defined and poorly investigated. The aim of this study was to examine chemical restraint use in 12 adult acute inpatient psychiatric units in Adelaide, South Australia. Methods involved the analysis of all reported chemical restraint events occurring over a 12-month period analysed using a descriptive quantitative design. There were 166 chemical restraint events involving 110 consumers. The highest prevalence rate in an in idual unit was 28.78 events per 1000 occupied bed days, with the lowest being 0.12 events per 1000 occupied bed days. More males (n = 69, 57.5%) were involved in chemical restraint than females. Schizophrenia, schizotypal, and delusional disorders were the predominant diagnoses among consumers who were chemically restrained. The most events occurred during three time blocks: 14.00-14.59 pm, 16.00-16.59 pm, and 21.00-21.59 pm. The two most common medications used were olanzapine and clonazepam. The study presents a general picture of the practice of chemical restraint in Adelaide and identifies areas of concern in relation to the need for monitoring of side effects and completion of systematic processes of documentation regarding chemical restraint events. Findings highlight the need for sustained focus on reducing the need for chemical restraint and exploring less restrictive measures with those most likely to receive medication against their will.
Publisher: Wiley
Date: 10-12-2016
DOI: 10.1016/J.JALZ.2016.10.007
Abstract: Numerous diagnostic criteria have tried to tackle the variability in clinical manifestations and problematic diagnosis of vascular cognitive impairment (VCI) but none have been universally accepted. These criteria have not been readily comparable, impacting on clinical diagnosis rates and in turn prevalence estimates, research, and treatment. The Vascular Impairment of Cognition Classification Consensus Study (VICCCS) involved participants (81% academic researchers) from 27 countries in an online Delphi consensus study. Participants reviewed previously proposed concepts to develop new guidelines. VICCCS had a mean of 122 (98-153) respondents across the study and a 67% threshold to represent consensus. VICCCS redefined VCI including classification of mild and major forms of VCI and subtypes. It proposes new standardized VCI-associated terminology and future research priorities to address gaps in current knowledge. VICCCS proposes a consensus-based updated conceptualization of VCI intended to facilitate standardization in research.
Publisher: Wiley
Date: 14-02-2020
DOI: 10.1111/JEP.13363
Publisher: American Psychological Association (APA)
Date: 07-2019
DOI: 10.1037/MEN0000169
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Candice Oster.