ORCID Profile
0000-0002-6641-5888
Current Organisations
University of Tasmania
,
Eternal Women's Health
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Publisher: Frontiers Media SA
Date: 03-08-2023
DOI: 10.3389/FPSYG.2023.1189840
Abstract: The aim of this study was to explore the experiences of voluntary reunification from the perspectives of adult alienated children and targeted parents Nine adult alienated children and 12 targeted parents participated in semi-structured interviews which were transcribed verbatim and analyzed thematically Six themes emerged in the data from the adult alienated children including catalysts for reunification, factors influencing reunification, adult alienated child relationships, the role of communication in reunification, adult alienated child understandings of alienation post reunification, and the role of therapy in reunification. Three themes emerged from the targeted parents including what is reunification, factors impacting reunification, and life after reunification. Findings from the present study offer novel insights into the experience of voluntary reunification from the perspectives of both adult alienated children and targeted parents. They illustrate that voluntary reunification is a process that takes time. This process can span decades and can include periods of connection and rejection.
Publisher: Wiley
Date: 04-11-2022
DOI: 10.1111/APHW.12415
Abstract: Psychological factors of emotional distress and cognition have an important role in the understanding and management of endometriosis however, their temporal relationship with key pain variables is not fully understood. This exploratory study sought to establish the temporal relationship between psychological and pain‐related factors in a 12‐month prospective study of 208 Australian women with endometriosis. Participants, aged 18–50 years and living in Australia, were recruited via social media and completed baseline (May 2019) and 12‐month follow‐up (June 2020) surveys. Participants who reported a diagnosis of endometriosis and menses in the past 12 months were included in the study. Structural equation modelling was used to determine the temporal effects of psychological and pain‐related factors in endometriosis. In a covariate‐adjusted model, baseline emotional distress was the only variable to predict pain catastrophizing ( β = .24, p .01), functional pain disability ( β = .16, p .05) and concomitant emotional distress ( β = .55, p .001) 12 months later, adjusting for age and chronic illness. Women who exhibit symptoms of distress may be at risk of poorer psychological and physical function at 12 months. Further research is required to understand the impact of psychological management early in the disease course.
Publisher: Elsevier BV
Date: 04-2023
Publisher: Bioscientifica
Date: 07-2022
DOI: 10.1530/RAF-22-0003
Abstract: Endometriosis is a common yet under-recognised chronic disease with one in nine (more than 830,000) women and those assigned female at birth diagnosed with endometriosis by the age of 44 years in Australia. In 2018, Australia was the first country to develop a roadmap and blueprint to tackle endometriosis in a nationwide, coordinated manner. This blueprint is outlined in the National Action Plan for Endometriosis (NAPE), created from a partnership between government, endometriosis experts and advocacy groups. The NAPE aims to improve patient outcomes in the areas of awareness and education, clinical management and care and research. As researchers and clinicians are working to improve the lives of those with endometriosis, we discuss our experiences since the launch of the plan to highlight areas of consideration by other countries when developing research priorities and clinical plans. Historically, major barriers for those with endometriosis have been twofold first, obtaining a diagnosis and secondly, effective symptom management post-diagnosis. In recent years, there have been calls to move away from the historically accepted ‘gold-standard’ surgical diagnosis and single-provider specialist care. As there are currently no reliable biomarkers for endometriosis diagnosis, specialist endometriosis scans and MRI incorporating artificial intelligence offer a novel method of visualisation and promising affordable non-invasive diagnostic tool incorporating well-established technologies. The recognised challenges of ongoing pain and symptom management, a holistic interdisciplinary care approach and access to a chronic disease management plan, could lead to improved patient outcomes while reducing healthcare costs. Endometriosis is a chronic disease where tissue like the lining of the uterus is found in other locations around the body. For the 830,000 people living with endometriosis in Australia, this often results in an immense burden on all aspects of daily life. In 2018, Australia was the first country to introduce a roadmap and blueprint to tackle endometriosis in a nationwide coordinated manner with the National Action Plan for Endometriosis. This plan was created as a partnership between government, endometriosis experts and advocacy groups. There are several other countries who are now considering similar plans to address the burden of endometriosis. As researchers and clinicians are working to improve the lives of those with endometriosis, we share our experiences and discuss areas that should be considered when developing these national plans, including diagnostic pathways without the need for surgery, and building new centres of expertise in Endometriosis and Pelvic Pain.
Publisher: Informa UK Limited
Date: 12-2018
DOI: 10.1111/AP.12372
Publisher: Walter de Gruyter GmbH
Date: 16-05-2023
Abstract: Chronic prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a complex condition which causes a significant burden on the diagnosed in iduals. Assessment and management are perplexing, often resulting in unsatisfactory outcomes. Existing research has only focused on patients’ perspectives of pain experiences, but scant evidence is available to understand the barriers that undermine effective pain management. Using an exploratory approach, this study examined these barriers from practitioners’ perspectives. Twelve semi-structured interviews were conducted with practitioners across disciplines who have experience in chronic pelvic pain management in males. Practitioners expressed their views and experiences in supporting men with CP/CPPS and what barriers they perceived when providing treatment for patients. Data were analysed using reflexive thematic analysis supported by NVivo software. Five broad and interrelated themes were identified: (1) Where to Start, (2) Insufficient Resources, (3) Prioritisation, (4) Training and Confident Practice and (5) Constraints in Help-Seeking. Practitioners value multimodal management using a biopsychosocial approach however, practical challenges prevent practitioners from choosing and applying this approach in clinical practice. The findings also identified some unique challenges faced by men with CP/CPPS consistent with previous evidence from patient perspective. Refining terminology, developing specific resources, and increasing psychosocial treatment options are urgently needed.
Publisher: Elsevier BV
Date: 10-2022
DOI: 10.1016/J.JPSYCHORES.2022.110993
Abstract: The understanding as to how people with endometriosis view and relate to their bodies is limited but important given the physical and psychological symptoms associated with the condition. The current study explored the differences in HRQoL (general, physical, emotional) and body image in an endometriosis and control s le. The current study also examined the influence of disease status (+Endo, -Endo), psychological wellbeing, and body image on HRQoL. Data was collected via an international online cross-sectional survey examining HRQoL, body image factors (negative appreciation of body size, lack of body familiarity, general body dissatisfaction), and psychological wellbeing (depression, anxiety, somatic concern) in adults. Participants were grouped by disease status (endometriosis: +Endo n = 318 control: -Endo n = 420). As hypothesised, the +Endo group reported significantly lower HRQoL and poorer body image than those in the -Endo group. Hierarchical multiple regression analyses (MRA) indicated that disease status and somatic concern are significant correlates of general HRQoL, and that disease status and lack of body familiarity are significant correlates of physical and emotional HRQoL. Endometriosis has a negative impact on HRQoL and body familiarity, with those diagnosed with the condition reporting significantly lower levels of HRQoL. Assessment and treatment of poor body familiarity in people diagnosed with endometriosis is recommended as part of psychological treatment pathways.
Publisher: Walter de Gruyter GmbH
Date: 09-08-2023
Abstract: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex condition. Despite recommendations for the inclusion of non-pharmacological treatment in the management of CP/CPPS, the focus has predominantly been on the inclusion of physical therapies with minimal discussion of psychological interventions. Therefore, this systematic review aimed to evaluate peer-reviewed studies of psychological interventions for men with CP/CPPS to determine their therapeutic efficacy and quality of intervention. The review was registered in PROSPERO and based on PRISMA 2020 protocol. The systematic literature search was conducted in six databases. Quantitative studies of psychological intervention for adult men with CP/CPPS that provided outcome measures of pain, quality of life and/or psychological symptoms were reviewed. The Oxford level of evidence and Quality Assessment Tool for Quantitative Studies developed by the Effective Public Health Practice were employed. A total of 4,503 studies were reviewed seven met the inclusion criteria. The included studies were randomised controlled trials, cohort, repeated measures, and case-series studies, with most including combined treatment for CP/CPPS. Cognitive therapy, cognitive behavioural therapy, or paradoxical relaxation training were found to be effective. However, high risks of bias were found in all included studies, limiting the generalisability and reliability of findings. Evidence is preliminary but shows promise for psychological treatment either as a combined or standalone treatment for CP/CPPS. However, there is a need to develop research with a more rigorous methodology to evaluate psychological treatments for men with CP/CPPS.
Publisher: SAGE Publications
Date: 16-03-2023
DOI: 10.1177/13591053231160922
Abstract: Body compassion bridges together the constructs of body image and self-compassion and refers to the relationship people have with their bodies, encompassing defusion, common humanity and acceptance. The purpose of the current study was to validate the 23-item Body Compassion Scale (BCS), in a female s le, and to determine the distinctiveness of body compassion from the similar construct of self-compassion. A total of 513 females completed an online cross-sectional survey examining body compassion, self-compassion, body image, and psychological health. Results supported the validation of the three-factor structure of the BCS, with the subscales of defusion and acceptance being more strongly associated with measures of body image than self-compassion. The BCS subscale of common humanity revealed lower associations with body image compared to self-compassion. The findings suggest that body compassion is a body-specific construct relating to body image concerns and while related, is distinct, from the construct of self-compassion.
Publisher: Wiley
Date: 26-07-2023
DOI: 10.1111/AJO.13741
Abstract: Lesbian, gay, bisexual, transgender, queer, asexual/aromantic (LGBTQA+) people, assigned female at birth (AFAB), experience disproportionately poorer gynaecological healthcare outcomes compared to their cisgender, heterosexual peers. The barriers to gynaecological care remain poorly understood. In a step toward bridging this gap, the current study explored the lived gynaecological healthcare experiences of Australian LGBTQA+ AFAB people and the barriers they experience in accessing care. Semi‐structured interviews were conducted with 22 LGBTQA+ AFAB people. An inductive thematic qualitative design was used to explore the lived experiences and identify themes associated with the reported experiences. Thematic analysis identified seven themes related to experiences in accessing gynaecological healthcare, including discrimination, fear, perceived provider or cultural incompetency, accessibility, and gender identity. Several sub‐themes were also identified such as refusal of care, microaggression, misgendering, and patient as educator. Participants suggested that barriers to care could be alleviated by the integration of LGBTQA+ specific healthcare training into the university‐level medical curriculum and professional development programs that address cultural competency and inclusive healthcare. These preliminary findings inform the necessity for the development of evidence‐based practice guidelines that specifically address the unique and erse needs of the LGBTQA+ AFAB population.
Publisher: Oxford University Press (OUP)
Date: 22-11-2021
Abstract: What is the relationship between self-compassion, endometriosis-related symptoms and psychological health in women with symptomatic endometriosis? Decreased self-compassion is associated with increased psychological distress, extended diagnostic delay and varies according to in idual endometriosis-symptom profile. Existing research indicates that endometriosis is associated with reduced psychological health and varied endometriosis-related symptom profiles. Examining the level of self-compassion reported by women with endometriosis is important as greater self-compassion has been found to improve psychological well-being in several chronic health populations. This study utilized a cross-sectional survey design to explore the relationship between self-compassion, psychological health and endometriosis-related symptoms (n = 318). Women with a self-reported diagnosis of endometriosis were recruited via online advertising through social media platforms. Demographic and endometriosis-specific information (e.g. disease stage, diagnostic delay, symptom experience) was collected in addition to psychological health and self-compassion. Psychological health was measured by the PROMIS Emotional Distress and Anxiety short forms and the Patient Health Questionnaire (PHQ-15). Self-compassion was measured by the Self-Compassion Scale (26-item). Independent t-tests, bivariate correlations and linear regression analyses explored the relationship between specific endometriosis-related symptoms, psychological health and self-compassion. Hierarchical multiple regression indicated that psychological symptoms accounted for the greatest variance in levels of self-compassion in the current s le. Depression and anxiety were found to be significant negative predictors of self-compassion. Notable symptoms that were significant in the final model were the presence of dysmenorrhea, lower back pain, dyspareunia, pain after sexual intercourse, fatigue and nausea. The cross-sectional nature of the findings prevents direct findings of causality. The information pertaining to endometriosis was self-report in nature and was not medically verified. These preliminary findings indicate the importance of clinical interventions aimed at enhancing self-compassion and the importance of in idual case conceptualization and treatment planning based on endometriosis-related symptomatic profiles. The study was not associated with research funding. Author L.V.N. is a member of the Endometriosis Australia Clinical Advisory Committee. N/A.
Publisher: Oxford University Press (OUP)
Date: 21-07-2023
DOI: 10.1093/IBD/IZAD122
Abstract: The bidirectional relationship between inflammatory bowel disease (IBD) flare-ups and depression/anxiety symptoms has prompted investigations into psychotherapy to improve health-related quality of life (HRQoL) by targeting depression and anxiety. Acceptance commitment therapy (ACT) is effective in improving symptoms of depression and anxiety in people with chronic diseases, yet minimal research has examined ACT’s effectiveness for IBD. This study examines the feasibility, acceptability, and preliminary efficacy of the ACTforIBD program, an online program codesigned with consumers to deliver ACT to those with IBD. Adults with IBD and symptoms of mild-moderate distress were randomized to ACTforIBD or an active control (psychoeducation) condition. Participants completed 8 weekly, 1-hour sessions, 4 of which were therapist facilitated. Feasibility was based on recruitment and retention and acceptability was derived from postprogram satisfaction measures. Preliminary efficacy was determined by group differences in rate of change in study outcomes from baseline to postprogram. Of 62 participants (89% women, 11% men mean age 33 years), 55 completed the program (ACTforIBD: n = 26 [83.9%] active control: n = 29 [93.5%]). Adherence and acceptability were high in the ACTforIBD group, with 80% of participants completing all self-directed modules and 78% of participants expressing satisfaction with the program. Significant and marginally significant group × time interactions were found for anxiety symptoms (b = -1.89 95% confidence interval, -3.38 to -0.42) and psychological HRQoL (b = -0.04 95% confidence interval, -0.07 to 0.01), showing decreased anxiety and increased psychological HRQoL in the intervention group. ACTforIBD is feasible, acceptable, and improved anxiety symptoms, and psychological HRQoL. This highlights the need for a full-scale randomized controlled trial to further examine the program’s efficacy.
Publisher: Wiley
Date: 24-05-2023
DOI: 10.1111/AJO.13699
Abstract: In Australia, endometriosis affects one in nine women and those assigned female at birth. Although endometriosis is more common than conditions such as diabetes, research funding for endometriosis research has historically been low in comparison. The National Action Plan for Endometriosis is an Australian Federal Government initiative designed to redress this imbalance, with a focus on research funding. Identification of research priorities, and subsequent funding allocation that is determined by consumer input is vital. An online survey focusing on Australia and New Zealand found that the highest general priorities were the treatment and management of endometriosis and its cause(s).
Publisher: BMJ
Date: 06-2022
DOI: 10.1136/BMJOPEN-2021-060272
Abstract: Inflammatory bowel disease (IBD) involves an abnormal immune response to healthy gut bacteria. When a person develops IBD, their susceptibility to anxiety and/or depression increases. The ACTforIBD programme, specifically designed for people with IBD and comorbid psychological distress, draws on acceptance and commitment therapy (ACT), which promotes acceptance of situations that cannot be solved such as persistent physical symptoms. There are no ACT trials for IBD using an active control group or a telemedicine approach, which is important to improve accessibility, particularly in the context of the ongoing COVID-19 pandemic. The ACTforIBD programme is administered online with a 4-hour therapist involvement per participant only if successful it can be widely implemented to improve the well-being of many in iduals with IBD. Our team have codesigned with consumers the ACTforIBD programme, an 8-week intervention of 1-hour sessions, with the first three sessions and the last session delivered one-to-one by a psychologist, and the other sessions self-directed online. This study aims to evaluate the feasibility and preliminary efficacy of ACTforIBD to reduce psychological distress in patients with IBD. Using a randomised controlled trial, 25 participants will be randomised to ACTforIBD, and 25 patients to an active control condition. This protocol has been approved by Deakin University Research Ethics Committee in September 2021 (Ref. 2021-263) and the New Zealand Central Health and Disability Ethics Committee in December 2021 (Ref. 2021 EXP 11384). The results of this research will be published in peer-reviewed journals and shared with various stakeholders, including community members, policy-makers and researchers, through local and international conferences. ACTRN12621001316897.
Publisher: Elsevier BV
Date: 03-2003
DOI: 10.1053/JPMN.2003.4
Publisher: Elsevier BV
Date: 09-2002
Abstract: The aims of the current investigation were (1) to examine the ethical and professional conflicts experienced by Tasmanian registered nurses in attempting to provide optimal pain management, and (2) to examine nurse satisfaction with their professional relationship with physicians and with their level of involvement in pain management. A total of 1,015 registered nurses completed a 21-item survey examining ethical and professional conflicts encountered during patient pain management. Data also were gathered investigating nurse satisfaction with their involvement in and professional relationship with physicians during pain management. The respondents who felt adequately consulted by physicians were significantly more likely to instigate the consultation process than the respondents who felt that they were not adequately consulted by physicians about their patient's pain status. This was marked in relation to the need for increased pain relief medications. Nurses who did not feel adequately consulted by physicians were significantly more likely to experience ethical conflicts such as concerns about undermedication and patient reluctance to report pain. Nurses' concerns related to ethical conflicts concerning effective pain management are affected by their relationship with physicians. Education, for both nurses and physicians, concerning the role of the nurse in the workplace will help to ensure that these conflicts do not arise. Guidelines concerning the level of patient care at which consultation is necessary will ensure fewer conflicts and greater nurse satisfaction in the workplace.
Publisher: Springer Science and Business Media LLC
Date: 22-11-2022
Publisher: SAGE Publications
Date: 06-12-2022
DOI: 10.1177/13591053211059390
Abstract: This international cross-sectional study examined the level and potential correlates of self and body compassion in women ( n = 227) with polycystic ovary syndrome (PCOS). Participants completed an online survey examining quality of life, psychological health, body image and self and body compassion. Low levels of self and body compassion were found, with depression and body image concern identified as negative correlates of self and body compassion. Physical health was identified as a positive correlate of body compassion. The findings identify the important relationship between body image, psychological health and self and body compassion in women with PCOS.
Publisher: SAGE Publications
Date: 27-03-2022
DOI: 10.1177/13591053221085051
Abstract: This international cross-sectional study examined the relationships between endometriosis-related symptom experience and health-related quality of life (HRQoL) in 318 women with endometriosis. Measures of symptom burden and distress, pain, psychological wellbeing, and HRQoL were collected via an online survey. Age, symptom duration, burden, and distress were associated with lower psychological wellbeing and HRQoL, with small to medium effect sizes. Somatic concern, depression, pain, dysmenorrhea, clitoral pain, dyspareunia, and bloating were found to be significant correlates of HRQoL. The findings highlight the importance of considering a broader range of endometriosis-related symptoms than pain alone and the ongoing need to reduce diagnostic delay in endometriosis.
Publisher: Informa UK Limited
Date: 12-06-2020
Publisher: Springer Science and Business Media LLC
Date: 12-05-2019
DOI: 10.1007/S00737-019-00972-6
Abstract: Endometriosis impacts the physical, psychological and quality of life domains of women. Despite the medical and/or surgical management of endometriosis, the presence of persistent pelvic pain and psychological distress often continues, suggesting a role for psychological interventions in treatment planning. The present study aimed to conduct the first systematic review, with narrative data synthesis, on psychological interventions for endometriosis-related symptoms. The study also aimed to determine the effectiveness of current interventions in resolving psychological and pain-related loss of function associated with endometriosis and to identify gaps in the literature requiring further research. A total of 15,816 studies were retrieved through database searching and handsearching, with two researchers identifying 11 full-text studies that met inclusion criteria. Three studies of 'moderate' quality were identified, although the overall quality of studies was found to be 'weak', with a 'high' risk of bias. The findings regarding the effectiveness of psychological interventions for endometriosis-related symptoms remain inconclusive. Further research into psychological interventions for women with endometriosis that employ evidence-based protocols with high intervention integrity is recommended.
Publisher: Elsevier BV
Date: 04-2001
DOI: 10.1016/S0020-7489(00)00053-5
Abstract: The aim of this research was to obtain information concerning knowledge of the pain management practices of Tasmanian nurses. We examined the knowledge of Tasmanian Registered Nurses in relation to pain management issues such as addiction, use of analgesics and the assessment of pain. In addition, we queried them about their satisfaction with information they had received about how to manage pain in both workplace programs and in their initial education. A total of 2768 registered nurses were mailed a 29-item survey examining knowledge of pain management practices. One thousand and fifteen valid surveys were returned. Mean scores on the knowledge questions (72% correct) of the survey revealed deficits in knowledge. Nurses specifically lacked up-to-date knowledge concerning the pharmacological management of pain, but displayed a more up-to-date knowledge concerning the effect of patient variables on pain perception. Nurses also rated the information they received about pain management during workplace programs as poor, feeling that they acquired significantly more in-depth information during their initial education. The results of this study have implications for institutions involved in both patient pain management and pain management education.
No related grants have been discovered for Leesa Van Niekerk.