ORCID Profile
0000-0002-7799-8177
Current Organisation
University of Adelaide
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Publisher: SAGE Publications
Date: 09-2013
Abstract: Telecounselling – the provision of counselling services by telephone, videoconferencing or Internet media – can assist with disparities in the treatment and management of depression for minority ethnic groups. We therefore reviewed the evidence examining the effectiveness of telecounselling for this population. This involved a search of electronic databases, the grey literature and two peer-reviewed journals. Study quality was examined using the Oxford Centre for Evidence Based Medicine guidelines. Cohen’s d effect sizes were additionally calculated for between-study comparisons. The final s le comprised eight independent studies, with a total of 498 adults of Asian, African-American or Spanish origin. None of the studies met the criteria for the highest methodological rating (Level 1) and there were five studies at Level 2. Significant short-term treatment effects were associated with telephone- and Internet-mediated services, including moderate to large improvements across measures of depression, anxiety, quality of life and psychosocial functioning reported. Longer-term treatment effects were also reported, although these results were based on very limited data. The results highlight the need for additional rigorous research to determine the clinical efficacy of telecounselling as a treatment option for depression among minority communities.
Publisher: Elsevier BV
Date: 06-2019
DOI: 10.1016/J.JSTROKECEREBROVASDIS.2019.03.014
Abstract: Depression and anxiety are important complications of stroke but are underdiagnosed in community settings. The current study identified which patients were at increased risk of developing either disorder more than1 year poststroke to assist in targeted screening. Crosssectional survey of 147 adults who had a stroke more than 1 year ago were recruited from stroke advocacy/support groups and an outpatient register. Participants completed the Hospital Anxiety and Depression Scale (HADS) and reported whether they had emotional problems as a stroke inpatient (single item: yes/no). Standardized self-report measures evaluated medical (physical independence, health-related quality of life), cognitive (memory, executive functioning), and psychological (social support) variables. Demographic and stroke-related (stroke type, year) information were also recorded. Between 53% and 80% of respondents (n = 117) screened positive for depressed mood and/or anxiety (HADS subscale cut-offs: ≥8 or ≥4). Logistic regression analyses indicated that stroke survivors who reported having emotional problems as inpatients (odds ratio [OR]: 0.23), were female (OR: 3.42), and had poor health-related quality of life (OR: 0.45-0.53) and cognitive problems (OR: 0.68-0.74), were more likely to screen positive for either disorder. Models based on these variables predicted screening outcomes with 91% accuracy. Community-based stroke survivors who reported experiencing emotional problems as inpatients, were female, or had poor health-related quality of life (chronic pain, disturbed sleep, communication difficulties) and/or cognitive issues were at greater risk of being depressed/anxious. Targeted screening of these patients may help to identify those who are most in need of more comprehensive clinical assessments and evidence-based interventions.
Publisher: Informa UK Limited
Date: 26-05-2021
Publisher: American Medical Association (AMA)
Date: 13-09-2021
Publisher: Springer Science and Business Media LLC
Date: 19-05-2018
DOI: 10.1007/S11136-018-1885-5
Abstract: Health-related quality of life (HRQoL) is an important outcome in coronary heart disease (CHD). However, variability in HRQoL indicators suggests a need to consider domain coverage. This review applies a globally accepted framework, the International Classification of Functioning, Disability and Health (ICF), to map HRQoL measures that are reliable and valid among people with CHD. The Embase, Pubmed and PsycInfo databases were searched, with 10 observational studies comparing HRQOL among 4786 adults with CHD to 50949 controls identified. Study reporting quality was examined (QualSyst). Hedges' g statistic (with 95% CIs and p values) was used to measure the effect size for the difference between group means (≤ 0.2 small, ≤ 0.5 medium, ≤ 0.80 large difference), and between-study heterogeneity (tau, I Adults with CHD reported lowered HRQoL (g The ICF provides a framework for evaluating and understanding the impact of CHD on HRQoL. The results demonstrate that HRQoL goes beyond physical symptoms, with activity limitations, social support and participation, and personal perceptions identified as key ICF domains in CHD assessment. Further investigations are needed to unravel the dynamic and inter-relationships between these domains, including longitudinal trends in HRQoL indicators.
Publisher: Informa UK Limited
Date: 10-04-2017
DOI: 10.3109/09638288.2016.1161847
Abstract: Media-based rehabilitation provides a powerful opportunity to examine vocational behaviors in the disability sector. However, this research is preliminary at best. This paper reports pilot data. Eighteen adults with multiple sclerosis (MS) accessed an email-delivered, resource-based package, Work and MS. Pre- and post-access vocational self-efficacy and identity (Job-Procurement Self Efficacy Scale, My Vocational Situation Scale- primary outcomes), life orientation and depressed mood (Life Orientation Test - revised and Patient Health Questionnaire-9 - secondary outcomes) were assessed. Pre- and post-change scores were examined with Wilcoxon signed ranks tests and Hedges g effect sizes with associated 95% confidence intervals. Reliable change analyses were additionally calculated to determine the clinical significance of in idual change scores. Significant and positive effects were reported for vocational self-efficacy, identity, and optimism. Reliable change scores in one or more of these key outcomes were reported by 30% of the s le. Satisfaction with the content and delivery of the email-based intervention was also noted. Preliminary evidence suggests that Work and MS can help to promote vocational goals, interests and strengths among job seekers with a disability by providing a set of tools, information and linkages relating to vocational pursuits and career development. Replication with a randomized control design is indicated. Implications for Rehabilitation Research indicates a high unemployment rate among working-age adults with MS. A combination of disease-specific, psychological, programmatic and societal variables contribute to employment instability in this group. This pilot study demonstrates that an e-mail-based resource package, Work and MS, provides an innovative and feasible option for promoting consumer engagement with vocational services and, potentially, improving vocational outcomes. Work and MS has potential applicability to other disability groups.
Publisher: SAGE Publications
Date: 08-01-2019
Abstract: Mental health interventions disseminated via, or accessed using, digital technologies are an innovative new treatment modality for managing co-morbid depression and substance use disorder. The present systematic review assessed the current state of this literature. A search of the Cochrane Library, Embase, Pubmed, PsycInfo and Scopus databases identified six eligible studies ( N participants = 862), utilising quasi-experimental or randomised controlled designs. Reporting quality was evaluated and Hedges’ g effect sizes (with 95% confidence intervals and p-values) were calculated to determine treatment effectiveness. Process outcomes (e.g. treatment satisfaction, attrition rates) were also examined. Quality ratings demonstrated high internal validity, although external validity was low. Effect size data revealed medium to large and short-term improvements in severity of depression and substance use symptoms in addition to global improvement in social, occupational and psychological functioning. Longer-term treatment effectiveness could not be established, due to the limited available data. Preliminary findings suggest that there was high client satisfaction, therapeutic alliance and client engagement. Mobile phone devices and the Internet can help to increase access to care for those with mental health co-morbidity. Large-scale and longitudinal research is, however, needed before digital mental healthcare becomes standard practice. This includes establishing critical therapeutic factors including optimum levels of assistance from clinicians.
Publisher: SAGE Publications
Date: 02-2019
Abstract: The association between employment and psychological health in adults with multiple sclerosis was examined ( N = 33 studies). Standardised mean differences (Hedges’ g) between those employed and those not in the workforce were calculated. Employed peers reported significantly greater quality of life and mood, cited fewer work and multiple sclerosis–related difficulties and were more likely to adopt problem-focused coping strategies, considered to be more effective in managing specific stressors. These data are consistent with the positive by-products of maintaining work with multiple sclerosis. Further research is needed to determine the longitudinal course of coping for those who remain employed.
Publisher: Future Medicine Ltd
Date: 10-2016
Abstract: Aims: To evaluate the safety and efficacy of cell therapies administered acutely/sub-acutely after stroke. Methods: Five databases were searched for studies examining the safety/efficacy of cell therapies administered ≤90 days post-stroke. Reporting quality and adherence to research guidelines were evaluated. Safety and efficacy were assessed using risk ratios ooled incidence rates and Hedge's g, respectively. Results: 11 therapies (N studies = 28) were trialed: reporting quality was high, but adherence to guidelines low. Serious adverse events were observed following five treatments six improved outcomes. There was a trend toward larger treatment effects in non-blinded studies, younger participants, and higher dosages. Conclusion: Although a number of therapies appear effective, many studies did not control for normal recovery (standard-care). Long-term safety also needs to be established.
Publisher: SAGE Publications
Date: 20-02-2020
Abstract: Illness severity and sociodemographic characteristics of 7,053 employees with multiple sclerosis and 11,043 peers not in the workforce were compared (Hedges’ g with 95% confidence interval and p values). Pooled findings from 25 studies confirmed the main role of a relapsing–remitting disease course and higher education to employment. To a lesser extent, disease duration, fatigue and pain symptoms and age also differentiated the two groups. Vocational interventions for persons with multiple sclerosis should focus on job retention, including mechanisms to accommodate and facilitate functional independence. Longitudinal data are needed to distinguish the characteristics of those who achieve and maintain competitive employment.
Publisher: Springer Science and Business Media LLC
Date: 21-05-2013
DOI: 10.1038/SC.2013.25
Abstract: Cross-sectional survey. To examine factors that contribute to the process of positive adjustment, or resilience, in an adult community s le with spinal cord injury (SCI). South Australian Spinal Cord Injury Service, H stead Rehabilitation Centre, South Australia, Australia A postal survey comprising standardised measures of resilience (Connor-Davidson Resilience Scale-10 item), self-efficacy (Moorong Self-Efficacy Scale), locus of control (Locus of Control of Behaviour Scale) and psychological distress (Depression Anxiety Stress Scale--21 item). Of 60 respondents, 58% reported moderate to high levels of resilience. Resilience correlated significantly with high self-efficacy (r=0.68, P<0.01), internal locus of control (r=-0.52, P<0.01) and low psychological distress (depression r=-0.68, P<0.01 anxiety r=-0.55, P<0.01 stress r=-0.67, P 0.05), time since injury (r=-0.14, P>0.05), gender (t(58)=-0.92, P>0.05), lesion completeness (t(57)=-0.86, P>0.05), or SCI diagnosis (t(58)=-1.21, P>0.05). A multiple regression indicated that psychological distress and self-efficacy were the only two variables that uniquely contributed to resilient behaviour. Resilience is an important psychological process in the longer-term management of SCI which can be promoted by targeting rehabilitation interventions towards mood management in addition to self efficacy beliefs. Larger-scale research will help to validate these results.
Publisher: Springer Science and Business Media LLC
Date: 08-03-2016
DOI: 10.1038/SC.2016.15
Abstract: Meta-analysis. Prevalence estimates indicate that anxiety following spinal cord injury (SCI) is a common problem. However, methodological differences between studies may impact the clinical interpretation of these data. Data from 18 independent studies (Nparticipants=3158), which reported the prevalence of an anxiety disorder or associated symptoms, were identified from the Embase, PubMed and PsycInfo databases. Proportions were the primary effect size estimate. Confidence intervals, fail-safe Ns and the I(2) statistic were additionally calculated to identify the extent to which findings were robust and consistent across studies. Five per cent of participants met the criteria for either GAD or panic disorder, with Agoraphobia identified in 2.5%. These diagnostic data were, however, limited to two studies. Higher rates were noted for self-reported 'caseness' of anxiety, with 27% reporting clinically significant symptoms. Anxiety prevalence estimates varied across the in idual self-report measures (range: 15-32%). Method of administration (range: 26-32%) did not impact significantly on these estimates nor did recruitment source, with similarly high anxiety levels reported by hospital (27%) and community (29%) s les. Early identification and treatment of anxiety are important in SCI rehabilitation, with a subgroup of in iduals experiencing chronic symptoms. Further research is needed to establish guidelines for the interpretation of self-report data, including the use of clinical cutoffs.
Publisher: SAGE Publications
Date: 26-11-2023
Publisher: Springer Science and Business Media LLC
Date: 16-08-2015
Publisher: Elsevier BV
Date: 08-2022
Publisher: Informa UK Limited
Date: 14-06-2022
DOI: 10.1080/10401334.2021.1919519
Abstract: High levels of burnout have been widely reported among postgraduate medical trainees, however relatively little literature has examined what 'wellbeing' means for this group. Moreover, the literature that does exist has generally overlooked the potential role of specialty factors in influencing such conceptualizations. This is particularly true for family medicine and general practice trainees - a specialty considered to be unique due, in part, to its focus on community-based care. The present review sought to explore conceptualizations of wellbeing specifically within the context of family medicine and general practice training. The Embase, Ovid Medline, and PsycINFO databases were searched from inception to November 2019 for literature examining wellbeing in family medicine and general practice trainees. Literature was iteratively thematically analyzed through the process of a hermeneutic cycle. In total, 36 articles were reviewed over seven rounds, at which point saturation was reached. The findings confirm the complex and multifaceted nature of wellbeing as experienced by family medicine and general practice trainees. An emphasis on psychological factors - including emotional intelligence, positive mental health, self-confidence and resilience - alongside positive interpersonal relationships, rewards, and balanced interactions between trainees' personal and professional demands were deemed critical elements. A model of wellbeing that emphasizes rich connections between trainees' personal and professional life domains is proposed. Further qualitative research will help to extend current understanding of wellbeing among medical trainees, including the in iduality of each specialty's experiences, with the potential to enhance interventional efforts.
Publisher: Cambridge University Press (CUP)
Date: 18-11-2021
DOI: 10.1017/JRC.2021.7
Abstract: Physical activity (PA) is a known benefit to older adults with diabetes however, the determinants of PA are less well studied in this population. Applying the World Health Organization’s International Classification of Functioning, Disability and Health (ICF), a well-established biopsychosocial framework, we explored PA participation among older adult with type 2 diabetes. Using data from the Health and Retirement Study and the RAND Center for the Study of Aging (N = 2,016 mean age = 73.19 SD = 6.16), we conducted hierarchical stepwise regression analysis to evaluate the relative contribution of different biopsychosocial predictors to PA – namely, body functions and structure, activity and participation, personal, and environmental factors. Altogether, biopsychosocial factors accounted for 20% of the variance in PA participation. Of the personal factors, high extraversion and low neuroticism explained approximately 54% of the variance in PA among the older adults – beyond sociodemographics. Low body mass index, reduced pain, reduced depression, and higher cognitive functioning also had good explanatory power (25% of explained variance), whereas activity participation and environment did not (10% each). Aligning care with components of the ICF will help to ensure a focus on person-centric practices and, in turn, optimize participation outcomes such as PA.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 31-03-2020
DOI: 10.1097/ACM.0000000000003379
Abstract: Postgraduate medical trainees experience high rates of burnout however, inconsistencies in definitions of burnout characterize this literature. The authors conducted a systematic review and meta-analysis examining burnout levels and patterns in postgraduate medical trainees, using a continuous conceptualization of burnout, consistent with the Maslach Burnout Inventory (MBI) framework. The authors searched 5 electronic databases (Cochrane Library, Embase, ERIC, Ovid MEDLINE, Ovid PsycINFO) between January 1981 and July 2019 for studies reporting postgraduate medical trainees’ burnout levels using the MBI-Human Services Survey. They examined study reporting quality using the QualSyst quality appraisal tool and calculated standardized mean differences (Hedges’ g ), comparing trainees’ data with MBI norms for medicine and the overall population using a random effects model. They explored between-study heterogeneity using subgroup analyses (i.e., by training level and specialty). Finally, they studied the combined contribution of these 2 variables (and year of study publication) to burnout levels, using meta-regression. The authors identified 2,978 citations and included 89 independent studies in their review. They pooled the data for the 18,509 postgraduate trainees included in these studies for the meta-analyses. Reporting quality was generally high across the included studies. The meta-analyses revealed higher burnout levels among trainees compared with medicine and overall population norms, particularly for the depersonalization subscale. The authors also identified statistically significant differences between nonsurgical and surgical registrars (specialty trainees), with trainees from 12 in idual specialties exhibiting unique burnout patterns. There is a need to reduce and prevent burnout early in medical training. Given the differences in burnout levels and patterns across specialties, interventions must focus on the unique patterns exhibited by each specialty in the target population using a multidimensional approach. Standardizing the definition of burnout in accordance with the MBI framework will facilitate progression of this work.
Publisher: Informa UK Limited
Date: 02-09-2015
DOI: 10.3109/02699052.2014.948067
Abstract: Community-based rehabilitation can help to maximize function following acquired brain injury (ABI) however, data on treatment outcome is limited in quantity. To describe and evaluate client outcomes of an outpatient programme for adults with moderate-to-severe traumatic and non-traumatic ABI. Two phase design involving retrospective and longitudinal study of programme completers with ABI (n = 47). Changes in functioning were measured with the Mayo-Portland Inventory (MPAI-4), administered pre- and immediately post-rehabilitation and at 3 years follow-up. Self-ratings were supplemented with MPAI-4 data from significant others (n = 32) and staff (n = 32). Injured in iduals and informants reported improved physical and psychosocial functioning immediately following the completion of community rehabilitation, with medium-to-large and significant treatment gains noted on the MPAI-4 ability, adjustment and participation sub-scales (Cohen's d range = 0.31-1.10). A deterioration in in iduals' adjustment was further reported at follow-up, although this was based on limited data. Issues with longer-term rehabilitation service provision were additionally noted. The data support the need for continuity of care, including ongoing emotional support, to cater to the complex and dynamic needs of the ABI population. However, these results need to be considered in the context of a small s le size and quasi-experimental design.
Publisher: American Psychological Association (APA)
Date: 2011
DOI: 10.1037/A0022249
Abstract: The delivery of mental health services by telephone, referred to as telecounseling, has the potential to improve the health outcomes of adults with an acquired physical disability in a cost-effective way. However, the efficacy of this form of treatment requires further evaluation before it is used on a larger scale. This meta-analysis provides a critical and quantitative evaluation of the impact of telephone-administered psychological interventions on the psychosocial functioning of adults with an acquired physical disability caused by spinal cord injury, limb utation, severe burn injury, stroke, or multiple sclerosis. A comprehensive search of eight electronic databases identified eight studies (N = 658 participants) that compared treatment efficacy to that of matched control groups. Differences in the psychosocial outcomes of treatment and control participants were examined using Cohen's d effect sizes. Fail-safe Ns and 95% confidence intervals were used to evaluate the significance of these results. Significant improvements in coping skills and strategies (overall d = 0.57), community integration (overall d = 0.45), and depression (overall d = 0.44) were observed immediately after telecounseling, with modest improvements in quality of life maintained at 12 months post-intervention (overall d = 0.37). The results suggest that telecounseling is an effective treatment modality for adults adjusting to a physical disability however, further trials are needed to establish the long term psychosocial benefits.
Publisher: Springer Science and Business Media LLC
Date: 06-06-2018
DOI: 10.1007/S11136-018-1892-6
Abstract: In the original publication of the article, the surname of one of the co-authors was misspelled as 'Mpfou'. This has been updated in this correction.
Publisher: Elsevier BV
Date: 09-2021
Publisher: Informa UK Limited
Date: 18-02-2015
Publisher: Elsevier BV
Date: 11-2021
DOI: 10.1016/J.GERINURSE.2021.08.006
Abstract: The number of nursing assistants (NAs) in the long-term care industry is on the rise, helping to service the needs of an increasingly aging population. Understanding influences on NAs service qualities and resident satisfaction is important to sustainable long-term care services. To date, the research evidence about NAs factors and resident satisfaction has not been synthesized. We aimed to address this gap in the evidence. Utilizing a mixed-methods systematic review, we searched PubMed, PsycINFO, AgeLine, MEDLINE, Scopus, and Google Scholar databases for journal articles with primary data published from database inception to March 2021. Both qualitative and quantitative literature were considered and a narrative summary provided. Study reporting quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklists and Critical Appraisal Skills Programme Checklist. A total of 25 articles, spanning 9 countries and regions, were included in the review. Study reporting quality was good. A positive relationship between aged-care resident satisfaction and NAs job satisfaction (n = 8) was identified. Resident satisfaction was enhanced through NA training programs (n = 7), quality of daily interaction with NAs (n = 6), and the overall contribution of NAs in promoting residents` experiences (n = 4) DISCUSSION: The current findings highlight the important role of NAs in improving resident care in long-term care settings. Nursing home administrators need to better understand the value of NAs and to provide supports for growth and development in their work. Continuing the professional development of NAs can not only improve their skills but also benefit resident satisfaction and organizational sustainability.
Publisher: Oxford University Press (OUP)
Date: 07-11-2020
Abstract: Cognitive training delivered in conjunction with physical activity, may help to optimize aging and delay or prevent dementia in in iduals with mild cognitive impairment (MCI). However, their efficacy is less well studied compared to pharmaceutical treatments. This systematic review synthesizes the emerging evidence on combined cognitive-physical interventions for enhancing functioning in older adults with MCI, with implications for practice and research. We searched the PubMed, PsycINFO, Ageline, Medline, Web of Science and ProQuest databases, and hand-searched articles published between July 2013 and November 2018. Only randomized controlled trials which incorporated cognitive and physical components targeted to in iduals with MCI over the age of 50 were eligible. Our search yielded 10 eligible, independent articles. Intervention participants with MCI self-reported, or demonstrated, improved functioning across a range of cognitive (global cognitive function, executive function, processing speed, memory, attention, mood, emotion, motivation, brain cortex, orientation), and physical (gait, balance, mobility) outcomes. Interventions which combined cognitive-physical training were comparable to those which isolated these same elements, in terms of their effects on executive function, processing speed, attention, mood, and cardiorespiratory fitness. There is preliminary evidence to support the positive effects of multicomponent interventions to improve cognitive-motor abilities in older adults at risk of developing dementia. The strength of this research evidence is, however, limited. Longitudinal studies are needed to determine whether these effects are maintained over time. The optimal intervention intensity and length also need to be established.
Publisher: Informa UK Limited
Date: 03-2018
DOI: 10.1111/AJPY.12157
Publisher: Springer Science and Business Media LLC
Date: 02-07-2020
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/AH15054
Abstract: Objective The aim of the present study was to develop and pilot a measure of patient satisfaction that encompasses themes, activities, settings and interactions specific to the neuropsychological assessment process. Methods A focus group of out-patients (n = 15) was surveyed to identify the factors commonly associated with a satisfactory neuropsychological experience. Responses informed a purposely designed 14-item patient satisfaction scale (α = 0.88) that was completed by 66 hospital out-patients with mild to moderate cognitive impairment. Results Satisfaction with the neuropsychological assessment process was generally reported, with the testing phase (85%) rated significantly more favourably than the pre-assessment (79%) and feedback (70%) phases. Commentaries provided by 32 respondents identified interpersonal facilitators to a satisfactory neuropsychological assessment experience, but also dissatisfaction with physical aspects of the testing environment in addition to service availability. Conclusions The patient satisfaction scale can be used as a quality assurance tool to evaluate neuropsychological service delivery. Large-scale research is needed to confirm the scale’s psychometric properties. Further research may also include a broader perspective on the consumers’ experience of neuropsychological services.
Publisher: Informa UK Limited
Date: 03-05-2017
Publisher: SAGE Publications
Date: 05-2016
Abstract: Hypnotherapy can address the biopsychosocial aspects of disability-related pain, although the available evidence is limited in quality and quantity. Meta-analytic techniques were utilised to evaluate 10 controlled studies. Hypnotherapy produced significant short-term improvements in fatigue, pain experience and affect. However, a lack of significance was noted at 3- to 6-month follow-up. A beneficial effect size ( d w = 0.53 confidence interval = 0.28–0.84) in comparison to control conditions was reported, although comparability with other cognitive-behavioural treatments could not be confirmed across the few studies reporting this data ( d w = 0.06 confidence interval = −0.33 to 0.45). The findings highlight the need for further controlled and longitudinal research in this area.
Publisher: Elsevier BV
Date: 09-2022
DOI: 10.1016/J.YEBEH.2022.108766
Abstract: Research on third-wave cognitive behavioral therapies has burgeoned over the last ten years. However, questions remain about the effectiveness of these therapies for people with epilepsy. This article provides an up-to-date review of the current evidence-base. Following protocol registration (PROSPERO CRD42021269882), two reviewers searched six databases (from inception until 1 March 2022) for mindfulness and acceptance interventions targeted at mental health in adults with epilepsy. The reporting quality of included studies was rated (QualSyst tool) and standardized mean group differences (Hedges' g) with 95% confidence intervals and p values calculated. Results were narratively synthesized based on therapy characteristics and mental health outcome. Eleven randomized controlled trials, involving 941 adults with chronic epilepsy, were included. All studies were of sound methodological quality. Third-wave therapies were typically delivered in a group format although varied in their face-to-face, telephone, and online learning options. Programs evaluating Acceptance and Commitment Therapy, Mindfulness-Based Cognitive Therapy, or elements of both, outperformed wait-listed controls or usual care, although in idual variability in treatment response was evident (g Acceptance techniques and mindfulness practice may bring mental health benefits for some people living with epilepsy, but do not have consistent results for everyone. Patient ersity and preferences need to be factored into effective third-wave approaches for this cohort.
Publisher: Informa UK Limited
Date: 02-2019
Publisher: Elsevier BV
Date: 02-2018
DOI: 10.1016/J.APMR.2017.08.475
Abstract: To provide a preliminary evaluation of the effectiveness of an online resource for job seekers with multiple sclerosis (MS). Randomized controlled design. Community-dwelling cohort. Adults (N = 95) with relapsing-remitting or progressive MS were randomly assigned to one of two groups. Forty-five accessed an email delivered, 7 module resource, Work and MS, over a 4 week period. Waitlist control participants (n=50) were offered the opportunity to access Work and MS 4 weeks postenrollment. Primary outcomes focused on vocational interests (My Vocational Situation Scale) and self-efficacy in job-seeking activities (Job-Procurement Self Efficacy Scale). Secondary outcomes focused on perceived workplace difficulties (Multiple Sclerosis Work Difficulties Questionnaire [MSWDQ]), optimism (Life Orientation Test - Revised), and mood (Patient Health Questionnaire-9). Intention-to-treat analyses revealed pre-post gains: participants who accessed Work and MS reported improved confidence in their career goals (My Vocational Situation Scale g=.55 95% confidence interval [CI], .14-.96 P=.008) and positively reappraised potential workplace difficulties (MSWDQ g range, .42-.47 P range, .023-.042). The effect on job self-efficacy was not significant, but changed in the expected direction (g=.17 95% CI, -.23 to .57 P=.409). Completer data revealed larger, significant effect estimates (g range, .52-.64 P range, .009-.035). Findings provide preliminary support for the utility of a job information resource, Work and MS, to augment existing employment services. The results also suggest the need to test employment-ready interventions in a larger study population. This might include the addition of online peer support to increase intervention compliance.
Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/AH19095
Abstract: ObjectiveYoung adults aged 18–24 years often delay or avoid seeking help for their mental health concerns. eMental health, the use of the Internet to deliver mental health information, services and care, offers a low-cost, easy-access option. However the factors that influence online help-seeking among this cohort remain unclear. MethodsAndersen’s healthcare utilisation model was adapted to examine correlates of eMental health use among Australian youth. In all, 161 young adults completed an online survey comprising sociodemographic questions, online feature preferences, the Actual and General Help-seeking Questionnaires, Berkman–Syme Social Network Index, General Self-Efficacy Scale, Service Obstacles Scale and Depression, Anxiety and Stress Scales. ResultsAlmost 70% of young people reported having previously accessed some form of online support for their personal or emotional problems. This included informal information via social media and formalised counselling services. Notably, perception of service satisfaction was low. Hierarchical logistical regression identified two significant predisposing factors to subsequent online help-seeking: prior face-to-face service use and living or cohabitating with others. ConclusionseMental health is accessed by young people in Australia, yet more needs to be done to better integrate this service model into the healthcare system. This includes training and education for consumers and professionals about existing, effective programs. What is known about this topic?eMental health platforms can bridge the gap between technology and conventional mental health care. Despite its rapidly expanding evidence base, the implementation of eMental health into the Australian healthcare system remains slow. More work needs to be done to elucidate the factors underlying preferences for online help-seeking. What does this paper add?Young adult perspectives on the delivery of mental health information, services and care via the Internet are examined in accordance with a major conceptual model, namely Andersen’s behavioural model of health services use. The majority of those surveyed reported having accessed some form of online support for an emotional issue, although dissatisfaction with the quality of this support was expressed. Andersen’s model can guide future research in this area and potentially help target eMental health initiatives to in idual service users’ needs. What are the implications for practitioners?eMental health interventions offer an alternative for young adults who have difficulty accessing traditional mental health care services, but are also an adjunct to those experiencing mild to moderate symptoms of mental illness. Practitioners can introduce young adults to eMental health by discussing the benefits and limitations and by providing information about available and secure online programs delivered by trusted service providers.
Publisher: Informa UK Limited
Date: 05-03-2020
DOI: 10.1080/07481187.2019.1578305
Abstract: Mental health research highlights the need to focus on suicide risk in college students. However, evidence for associated risk and protective factors in this cohort is mixed. This review synthesizes data from 29 independent studies (
Publisher: Springer Science and Business Media LLC
Date: 11-12-2008
Abstract: Comparison of two self-report instruments with a structured diagnostic interview. To investigate the properties of the Depression Anxiety Stress Scales-21 (DASS-21) in patients with spinal cord injuries. South Australian Spinal Cord Injuries Service, H stead Rehabilitation Centre, Northfield, South Australia. Forty paraplegic or tetraplegic patients participated. Two self-report measures, DASS-21 and Brief Symptom Inventory (BSI), assessed Depression, Anxiety and Stress. These measures were compared with each other and with diagnoses based on the Mini International Neuropsychiatric Interview. Mean scores on both self-report measures were below clinical threshold levels. Prevalence rates of anxiety and depression were higher on DASS-21 than on BSI. DASS-21 was as sensitive as BSI, but had lower specificity to detect anxiety and depression. DASS-21 is a promising screening measure for patients with spinal cord injury in a rehabilitation setting. It has greater sensitivity for identifying those with possible anxiety disorders than it does for those with depressive disorders.
Publisher: Informa UK Limited
Date: 25-05-2022
DOI: 10.1080/09638288.2021.1921859
Abstract: Third-wave psychological therapies can benefit in iduals and families living with autism spectrum disorder (ASD). To date, little is known about in iduals' perceptions and experiences of therapy. This meta-synthesis aimed to capture participants' own reflections of mindfulness and acceptance-based therapies, including potential barriers and facilitators to therapy engagement. Database searches identified 10 independent studies targeting caregivers ( Caregivers highlighted a need to adapt the length and frequency of daily mindfulness practice around busy lifestyles. Adults with ASD also identified therapy barriers, although these data were less robust. Children with ASD focused on therapy benefits. All three participant groups commented on the importance of mindfulness as a method to enhance self-awareness, self-regulation and self-care. Peer support provided in group-based therapy was also seen as beneficial. Future research should examine the application of mindfulness therapies to adults with ASD, with little currently known about this cohort's therapy experiences. Whether traditional mindfulness approaches can be effectively modified to accommodate ongoing, cumulative daily demands these families experience also requires investigation.Implications for rehabilitationIn iduals with autism spectrum disorders (ASD) and their caregivers often experience high levels of anxiety and stress.Mindfulness and acceptance-based therapies can enhance an in idual's self-awareness and self-regulation, thereby reducing distress - with benefits extending to familiesGroup-based therapy is an important adjunct to the support of caregivers developing mindfulness-awareness.
Publisher: SAGE Publications
Date: 12-07-2019
Abstract: Stress management interventions can help to improve mental health for adults living with multiple sclerosis. However, uncontrolled study designs may overestimate intervention effects. A systematic search of the Embase, PsycINFO, PubMed, and Scopus databases identified eight randomized controlled trials evaluating cognitive behavioral approaches for a pooled s le of 568 adults with multiple sclerosis. Both group and in idual-based stress management interventions appear to be effective in promoting self-management of stress. Further research is needed to confirm the optimal timing of stress management interventions across the MS spectrum and strategies to maintain intervention effects.
Publisher: Springer Science and Business Media LLC
Date: 10-05-2016
DOI: 10.1038/SC.2016.66
Abstract: Meta-analysis. Although the association between modifiable psychosocial factors and spinal cord injury (SCI) pain has been identified, the full range of psychological and social difficulties for those who experience acute and/or persistent pain remains unclear. This meta-analysis consolidates the available evidence, using the International Classification of Functioning, Disability and Health (ICF) as a reference framework. Nineteen studies that examined persistent neuropathic, nociceptive or mixed pain subtypes in adults with a SCI (newly acquired and chronic Nparticipants=2934) were identified from electronic database searches. Standardised mean differences between SCI pain and no-pain groups on self-reported psychosocial outcomes were calculated, along with 95% confidence intervals, fail-safe Ns and heterogeneity statistics. Twenty in idual outcomes were grouped into nine ICF-related categories. Emotional functions were the most frequent (100%) psychosocial outcomes assessed, with pain contributing to heightened stress (d=-0.85), depression (d=-2.49) anxiety (d range=-0.85 to -1.45), poor self-efficacy (d=-0.77), lowered wellbeing (d range=-0.67 to -1.02) and decreased use of adaptive coping, such as illness acceptance (d=-0.85). Activity limitations and participation restriction were examined by seven studies (43%), although these findings were largely characterised by single studies. Multicomponent treatments that target mood disturbance and foster community connections are important in SCI pain management. However, to improve the comparability of future studies, SCI pain research must adopt definitions of pain consistent with the International Spinal Cord Injury Pain Classification along with validated outcomes that map onto the ICF framework.
Publisher: Elsevier BV
Date: 07-2020
Publisher: Informa UK Limited
Date: 10-06-2021
DOI: 10.1080/09638288.2019.1623852
Abstract: Cerebral palsy has been linked to decreased quality of life. However use of self- versus proxy-perspectives and norm-s le comparisons to examine quality of life impact may produce different results. To compare quality of life ratings in children and adolescents with cerebral palsy relative to typically developing peers in consideration of s le and methodological moderators on estimated effects. Eleven independent studies, comprising a pooled s le of 1475 families living with cerebral palsy and 42119 peers, were identified. Study reporting quality was evaluated with the QualSyst tool and standardised mean group differences (Hedges' All studies provided good to excellent methodological and statistical detail. Physical quality of life was significantly impaired among those with cerebral palsy ( Physical quality of life is, invariably, more affected in those with cerebral palsy. The connection between cerebral palsy and psychosocial quality of life is less clear. Noted parent-child discrepancies highlight the value of a multi-informant approach to child quality of life assessment. Implications for rehabilitation Quality of life is an important health-related outcome in cerebral palsy research and practice. Collecting both self-report and proxy data can help to highlight quality of life issues that are salient to the parent and to the child or adolescent with cerebral palsy. Selection of the appropriate quality of life instrument depends on the assessment purpose, with available measures varying in their focus on functionality, subjectivity and illness-specific items. Quality of life assessment of children with cerebral palsy should extend beyond functional abilities to include less obvious, but critical, psychological and social issues.
Publisher: Wiley
Date: 31-08-2022
DOI: 10.1111/MEDU.14931
Abstract: Although research has explored burnout risk factors among medical trainees, there has been little exploration of the personal experiences and perceptions of this phenomenon. Similarly, there has been little theoretical consideration of trainee wellbeing and how this relates to burnout. Our study aimed to conceptualise both constructs. We situated this study within a post‐positivist epistemology using grounded theory to guide the research process. Participants were recruited from one Australian General Practice training organisation. Fourteen trainees completed interviews, while a further five focus groups explored the views of 33 supervisors, educators and training coordinators. Data collection and analysis occurred concurrently, drawing upon constant comparison and triangulation. Template analysis, using an iterative process of coding, was employed to generate conceptual models of the phenomena of interest. Participants described burnout as an insidious syndrome lying on a spectrum, with descriptions coalescing under seven themes: altered emotion, compromised performance, disengagement, dissatisfaction, exhaustion, overexertion and feeling overwhelmed. Wellbeing was perceived to comprise personal and professional domains that interacted and were fuelled by an underlying ‘reservoir’. Both constructs were linked by the degree of a trainee's value fulfilment, with burnout occurring when a trainee's wellbeing reservoir was depleted. Participants in this study characterised burnout and wellbeing as multifaceted, connected constructs. Given the complexity of these constructs, preventive interventions should target both person and workplace‐focused factors, with value fulfilment proposed as the basic change mechanism. A novel model that synthesises and advances previous research is offered based on these findings.
Publisher: Informa UK Limited
Date: 10-2020
DOI: 10.1111/AP.12457
Publisher: Springer Science and Business Media LLC
Date: 17-02-2017
Publisher: Cambridge University Press (CUP)
Date: 04-05-2015
DOI: 10.1017/JRC.2015.1
Abstract: Post-injury return to work (RTW) is an important rehabilitation outcome regardless of injury type. With Spinal Cord Injury (SCI), the odds of successful RTW are lower than for the general population of work-injured. Australians living with a SCI have a higher RTW rate than many other developed countries, including the United States. Important influences on relatively higher post-injury RTW rates in the Australian context include its universal disability care policy, Australia's suite of no-fault accident insurance systems that allow for multi-faceted rehabilitation services to be provided to eligible in iduals in addition to appropriate rewards for rehabilitation service providers. A combination of these systemic factors is important when delivering comprehensive rehabilitation services to those with catastrophic injuries, such as SCI. The empirical evidence on drivers of successful RTW post SCI is, however, limited in comparison to the evidence on interventions for enhanced coping following SCI. Future studies could consider the relative merits of specific RTW interventions with SCI contrasting policy and capitation systems as well as utilising study designs that take into account pre-morbid work participation and secondary health conditions.
Publisher: Cambridge University Press (CUP)
Date: 04-2020
DOI: 10.1017/JRC.2020.3
Abstract: Anecdotally, there are frequent reports that peer-facilitated initiatives can be successfully used in employment services. However, in Australia, there is little information about how to effectively deliver peer support. In this paper, we discuss how peer-based interventions might be used to supplement formal return-to-work services and contribute to positive job-seeking outcomes. We illustrate the potential of vocational peer support using a real situation involving a young adult who successfully returned to work soon after sustaining a traumatic injury. Future research should explore the inclusion of various peer support structures and formats as a component of other employment services, to help people with long-term conditions and disabilities achieve a range of vocational outcomes and to guide practice in this area.
Publisher: SAGE Publications
Date: 03-07-2013
Abstract: To investigate the short- and medium-term efficacy of counselling services provided remotely by telephone, video or internet, in managing mental health outcomes following spinal cord injury. A search of electronic databases, critical reviews and published meta-analyses was conducted. Seven independent studies ( N = 272 participants) met the inclusion criteria. The majority of these studies utilized telephone-based counselling, with limited research examining psychological interventions delivered by videoconferencing ( N study = 1) or online ( N study = 1). There is some evidence that telecounselling can significantly improve an in idual’s management of common comorbidities following spinal cord injury, including pain and sleep difficulties ( d = 0.45). Medium-term treatment effects were difficult to evaluate, with very few studies providing these data, although participants have reported gains in quality of life 12 months after treatment ( d = 0.88). The main clinical advantages are time efficiency and consumer satisfaction. The results highlight the need for further evidence, particularly randomized controlled trials, to establish the benefits and clinical viability of telecounselling.
Publisher: Wiley
Date: 04-08-2019
DOI: 10.1111/AJAG.12703
Abstract: To systematically assess the relationship between computer-mediated communication and social function in older adults aged 55 or older. Embase, PsycINFO and PubMed were searched (database inception to December 2018). Where available, effect sizes (correlation r) with 95% confidence intervals and P values were calculated for in idual studies. Of 4,139 eligible articles retrieved, 17 studies involving a pooled s le of 17,640 participants were included. Frequent computer-mediated communication was significantly, albeit weakly, associated with higher levels of social support and connectedness (r range = 0.08 to 0.33, P < 0.05). One discrepant negative relationship was noted (r = -0.16, 95% CI [-0.30, -0.02], P = 0.03), involving a distinct s le of gamers. Computer-mediated communication is related to amount of social functioning in older adults, although the causal nature of this relationship requires further longitudinal investigation. S le confounds (eg socio-economic status and successful ageing) may limit the interpretation of these findings.
Publisher: Informa UK Limited
Date: 25-08-2022
Publisher: Future Medicine Ltd
Date: 2017
Abstract: Aim: To assess the safety and efficacy of cell therapies for chronic stroke. Methodology: Five databases were searched for treatments administered days post-stroke. Reporting quality, adherence to research guidelines, treatment safety (risk ratios ooled incidence rates) and neurological/functional efficacy (Hedge’s g) were all evaluated. Results: Twenty-three studies examined 17 treatments. Reporting quality scores were medium to high, but adherence to recommended guidelines was lower. Three treatments resulted in serious adverse events four improved outcomes more than standard care. However, many studies were under-powered and in idual patients varied in their response to some treatments. Conclusion: Preliminary findings suggest that some cell therapies may be relatively safe and effective, but larger double-blinded placebo-controlled studies are needed to establish the long-term risks and benefits.
Publisher: Springer Science and Business Media LLC
Date: 15-10-2018
Publisher: SAGE Publications
Date: 22-02-2015
Abstract: Summary The effectiveness of psychological services provided remotely, telepsychology, for the management of Posttraumatic Stress Disorder (PTSD) was evaluated. Eleven studies ( n = 472 participants) were identified from electronic database searches. Study quality was assessed, with studies characterised by small and underpowered s les. Effect sizes and associated confidence intervals (CIs) were calculated to determine the direction and magnitude of treatment change. Short-term treatment gains were reported for internet and video-based interventions. This included significant medium to large improvements ( d range = 0.66–3.22) in cognitive and behavioural symptoms of depression, generalised anxiety and posttraumatic stress. However, the equivalence of telepsychology and face-to-face psychotherapy could not be determined, with few comparative studies available. Both treatment gains and deterioration were noted 1 to 6 months following treatment cessation, although this was based on limited follow-up data. Further larger scale and longitudinal research will help to ascertain the minimum requirements for the management and treatment of PTSD in a technology-supported environment.
Publisher: SAGE Publications
Date: 07-10-2021
Abstract: Gaming disorder was included in the latest revision of the International Classification of Diseases (11th ed.). Worldwide, prevalence estimates of gaming disorder are considerably heterogeneous and often appear to be exceedingly high. However, few studies have examined the methodological, cultural and/or demographic factors that might explain this phenomenon. This review employed meta-analytic techniques to compute the worldwide-pooled prevalence of gaming disorder and evaluate the potential contributing factors for varied prevalence estimates. Prevalence estimates were extracted from 53 studies conducted between 2009 and 2019, which included 226,247 participants across 17 different countries. Study findings were meta-analyzed using a random-effects model. Subgroup and moderator analyses examined potential sources of heterogeneity, including assessment tool and cut-off, participant age and gender, s le size and type, study region, and year of data collection. The worldwide prevalence of gaming disorder was 3.05% (confidence interval: [2.38, 3.91]) this figure was adjusted to 1.96% [0.19, 17.12] when considering only studies that met more stringent s ling criteria (e.g. stratified random s ling). However, these estimates were associated with significant variability. The choice of screening tool accounted for 77% of the variance, with the Lemmens Internet gaming disorder-9, Gaming Addiction Identification Test and Problematic Videogame Playing scales associated with the highest estimates. Adolescent s les, lower cut-off scores and smaller s le size were significant predictors of higher prevalence. Gaming disorder rates were approximately 2.5:1 in favor of males compared to females. The worldwide prevalence of gaming disorder appears to be comparable to obsessive-compulsive disorder and some substance-related addictions, but lower than compulsive buying and higher than problem gambling. Gaming disorder prevalence rates appear to be inflated by methodological characteristics, particularly measurement and s ling issues.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-01-2016
Abstract: Research links blood pressure variability ( BPV ) with stroke however, the association with cerebral small‐vessel disease ( CSVD ) remains unclear. As BPV and mean blood pressure are interrelated, it remains uncertain whether BPV adds additional information to understanding cerebrovascular morphological characteristics. A systematic review was performed from inception until March 3, 2019. Eligibility criteria included population, adults without stroke ( weeks) exposure, BPV quantified by any metric over any duration comparison, (1) low versus high or mean BPV and (2) people with versus without CSVD and outcomes, (1) CSVD as subcortical infarct, lacunae, white matter hyperintensities, cerebral microbleeds, or enlarged perivascular spaces and (2) standardized mean difference in BPV . A total of 27 articles were meta‐analyzed, comprising 12 309 unique brain scans. A total of 31 odds ratios ( OR s) were pooled, indicating that higher systolic BPV was associated with higher odds for CSVD ( OR, 1.27 95% CI, 1.14–1.42 I 2 =85%) independent of mean systolic pressure. Likewise, higher diastolic BPV was associated with higher odds for CSVD ( OR, 1.30 95% CI, 1.14–1.48 I 2 =53%) independent of mean diastolic pressure. There was no evidence of a pairwise interaction between systolic/diastolic and BPV /mean OR s ( P =0.47), nor a difference between BPV versus mean pressure OR s ( P =0.58). Fifty‐four standardized mean differences were pooled and provided similar results for pairwise interaction ( P =0.38) and difference between standardized mean differences ( P =0.70). On the basis of the available studies, BPV was associated with CSVD independent of mean blood pressure. However, more high‐quality longitudinal data are required to elucidate whether BPV contributes unique variance to CSVD morphological characteristics.
Publisher: SAGE Publications
Date: 22-02-2015
Abstract: Summary Web-based interventions offer potential benefits for managing and treating depression in the context of chronic physical illness, however their use with this population has yet to be quantitatively assessed. The present systematic review examined the biopsychosocial data from 11 independent studies ( N = 1348 participants), including randomised controlled and quasi-experimental designs most commonly performed with diabetes and multiple sclerosis. Study quality was evaluated using the Downs and Black (1998) index, with most studies being statistically underpowered although internal validity was demonstrated. Treatment outcomes were quantified using Cohen’s d effect sizes. Results indicated significant short-term improvements in depression severity ( d w = 0.36, CI = 0.20-0.52, p 0.01), in addition to quality of life, problem-solving skills, functional ability, anxiety and pain-related cognitions ( d range = 0.23 to 1.10). Longer-term outcomes could not be determined based on the limited data. Further robust studies are required before wider adoption of web techniques takes place.
Publisher: SAGE Publications
Date: 23-12-2020
Abstract: To examine the evidence for motivational interviewing when used to assist in iduals with multiple sclerosis manage their healthcare. The Cochrane, Embase, PsycINFO and PubMed databases were searched for studies published between 1983 and December 2019. The reference lists of included studies were additionally examined and Scopus citation searches conducted. Study screening and data extraction were independently completed by two reviewers. Randomised controlled trials comparing motivational interviewing interventions for multiple sclerosis to usual care, wait-list or other active intervention controls were examined. Studies were assessed using the Cochrane Risk of Bias tool. Standardised mean differences (Hedges’ g), 95% confidence intervals and P values were calculated for all health and behavioural outcomes. Ten randomised controlled trials, involving a pooled s le of 987 adults with relapsing–remitting or progressive multiple sclerosis and mild to moderate impairment, were identified. Most trials had a low or unclear risk of methodological bias. Motivational interviewing, when used in conjunction with other counselling or rehabilitation techniques, resulted in significant immediate medium-to-very large improvements in multiple physical, psychological, social and behavioural outcomes (range: g = .34–2.68). Maintenance effects were promising (range: g = .41–1.11), although less frequently assessed ( N studies = 5) and of limited duration (1–7 months). In idual and group-based interventions, delivered in-person or by telephone, were all effective. Motivational interviewing is a flexible counselling technique that may improve rehabilitation care for multiple sclerosis. However, evidence for persisting benefits to health outcomes and behaviour is currently limited.
Publisher: American Psychological Association (APA)
Date: 06-2014
DOI: 10.1037/A0037118
Publisher: SAGE Publications
Date: 12-04-2022
DOI: 10.1177/02692155221091509
Abstract: To establish the effectiveness of relaxation and related therapies in treating Multiple Sclerosis related symptoms and sequelae. PsycINFO, PubMed, Embase, CINAHL, ProQuest Dissertations and Theses Global databases were searched. We included studies from database inception until 31 December 2021 involving adult participants diagnosed with multiple sclerosis or disseminated sclerosis, which featured quantitative data regarding the impact of relaxation interventions on multiple sclerosis-related symptoms and sequelae. Studies which examined multi-modal therapies - relaxation delivered in combination with non-relaxation interventions - were excluded. Risk of bias was assessed using the Revised Risk of Bias tool for randomised trials - ROB2, Risk of Bias in Non-Randomised Studies of Interventions ROBINS-I), and within and between-group effects were calculated (Hedges' Twenty-eight studies met inclusion criteria. Twenty-three of these were randomised controlled trials, with 1246 total participants. This review reports on this data, with non-randomised study data reported in supplemental material. Post -intervention relaxation was associated with medium to large effect-size improvement for depression, anxiety, stress and fatigue. The effects of relaxation were superior to wait-list or no treatment control conditions however, comparisons with established psychological or physical therapies were mixed. In idual studies reported sustained effects (≤ 6 months) with relaxation for stress, pain and quality of life. Most studies were rated as having a high/serious risk of bias. There is emerging evidence that relaxation therapies can improve outcomes for persons with multiple sclerosis. Given the high risk of bias found for included studies, stronger conclusions cannot be drawn.
Publisher: Informa UK Limited
Date: 2014
DOI: 10.1310/TSR2101-40
Abstract: Evidence suggests that the incorporation of leisure activities in adult stroke rehabilitation can contribute to improved physical, cognitive, and psychological outcomes. However, differences in study design and treatment delivery may affect these findings. Furthermore, the magnitude of therapeutic change associated with leisure therapy is unclear, with few quantitative reviews available. To synthesize and evaluate the empirical evidence examining leisure therapy in stroke rehabilitation. Eight independent studies (N = 615 participants) were identified from a comprehensive database search. Study quality was evaluated using the Oxford Levels of Evidence. Pre- and posttreatment data for participants who received leisure therapy, in comparison with peers who received standard care or no treatment, were evaluated by calculating Cohen's d effect sizes and 95% confidence intervals. No studies met the criteria for the highest level of methodological rigor, although all used randomization procedures. Leisure therapy contributed to significant short-term improvements in psychological outcomes, namely quality of life and mood (d range, 2.10 to 0.54), in addition to leisure-specific outcomes, including increased participation in and satisfaction with leisure activities (d range, 0.81 to 1.23). Longer term effects of treatment could not be determined, with one study providing data and reporting nonsignificant effects (d range, -0.07 to 0.17). There is some evidence that leisure therapy offers an opportunity to enhance short-term treatment gains in community-based stroke rehabilitation. Further controlled research is needed to establish its longer term effects and assist the development of evidence-based guidelines for this treatment.
Publisher: Springer Science and Business Media LLC
Date: 15-06-2016
Publisher: American Psychiatric Association Publishing
Date: 09-2016
DOI: 10.1176/APPI.PS.201500280
Abstract: The purpose of this review was to systematically evaluate the available heterogeneous research examining determinants of mental health service use among young adults. Nine electronic databases were searched to identify quantitative studies examining sociodemographic and psychological variables predictive of or associated with mental health service use. Included studies were examined against the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Effect size estimates in the form of odds ratios were calculated and classified according to predisposing, enabling, and need factors, consistent with Andersen's behavioral model of health care. Eighteen studies met all of the inclusion criteria (N=96,297 participants). Studies generally followed the STROBE recommendations for external validity, although limitations in internal validity were noted. Prior service contact and being homosexual or bisexual, female, or Caucasian were predisposing factors significantly associated with mental health service use. Social support was the single enabling factor identified, although this finding was based on limited data. In relation to need, young adults who reported higher perceived need for professional help or more mental health difficulties were more likely to have utilized services. This review identified subgroups of young adults who are less likely to access mental health support. Future research should focus on developing psychoeducational interventions targeted at young men and racial-ethnic minority groups, in addition to informing young adults of the success of mental health counseling in the absence of a diagnosis.
Publisher: Springer Science and Business Media LLC
Date: 27-09-2018
DOI: 10.1038/S41393-018-0200-1
Abstract: A prospective, parallel randomized controlled trial (RCT). To test the preliminary effects of an online resource targeted to job-seekers with spinal cord injury or disorder (SCI/D), and to determine the feasibility of proceeding to a full-scale RCT. A community cohort in Australia. Forty-eight adults (M = 42 years, SD = 10.95, 27 males) were randomized to receive 4-weeks access to the Work and SCI resource (n = 25) or to a wait-list control group (n = 23). The Work and SCI intervention involved six stand-alone learning modules which provided job-searching and career-planning information through text, videos, and interactive activities. Self-report measures were administered at baseline and after 4 weeks: Job Procurement Self-Efficacy Scale (JSES), Life Orientation Test-Revised (LOT-R), and Patient Health Questionnaire-9 (PHQ-9). Online usage data identified high uptake of the Work and SCI resource, although study attrition was problematic. Intention-to-treat analyses failed to reach statistical significance, whereas complete data revealed a significant interaction effect for optimism (LOT-R). Further research to develop and enhance Work and SCI is indicated. Remediable strategies to optimize recruitment and statistical power in a future definitive RCT are discussed. This project was funded by the auDA Foundation (project 16019).
Publisher: Springer Science and Business Media LLC
Date: 09-05-2017
DOI: 10.1038/SC.2017.45
Abstract: To summarise quantitatively the available evidence relating to pretraumatic, peritraumatic and posttraumatic characteristics that may increase or decrease the risk of developing posttraumatic stress disorder (PTSD) following spinal cord injury (SCI). Systematic review. Seventeen studies were identified from the PubMed, PsycInfo, Embase, Scopus, CINAHL, Web of Science and PILOTS databases. Effect size estimates (r) with associated 95% confidence intervals (CIs), P-values and fail-safe Ns were calculated. In idual studies reported medium-to-large associations between factors that occurred before (psychiatric history r=0.48 (95% CI, 0.23-0.79) P=0.01) or at the time of injury (tetraplegia r=-0.36 (95% CI, -0.50 to -0.19) P<0.01). Postinjury factors had the strongest pooled effects: depressed mood (r Combinations of peri- and post-injury factors appear to be influential in the development of PTSD among persons with SCI. Further studies are needed to extrapolate these findings to the broader spinal cord-injured population. More longitudinal research, driven by multicausal models of causation such as the diathesis-stress model, is also needed to determine the temporality of PTSD risk factors.
Publisher: Springer Science and Business Media LLC
Date: 10-12-2014
DOI: 10.1038/SC.2013.152
Abstract: Cross-sectional survey. To examine factors that may enhance and promote resilience in adults with spina bifida. Community-based disability organisations within Australia. Ninety-seven adults with a diagnosis of spina bifida (SB) completed a survey comprising of demographic questions in addition to standardised self-report measures of physical functioning (Craig Handicap Assessment and Reporting Technique), resilience (Connor-Davidson Resilience Scale, 10 item), self-esteem (Rosenberg Self-esteem Scale), self-compassion (Self-compassion Scale) and psychological distress (Depression Anxiety Stress Scales, 21 item). The majority (66%) of respondents reported moderate to high resilience. Physical disability impacted on coping, with greater CD-RISC 10 scores reported by in iduals who were functionally independent in addition to those who experienced less medical co-morbidities. Significant correlations between resilience and psychological traits (self-esteem r=0.36, P<0.01 self-compassion r=0.40, P<0.01) were also noted. However, the combined contribution of these variables only accounted for 23% of the total variance in resilience scores (R(2)=0.227, F(5,94)=5.23, P<0.01). These findings extend current understanding of the concept of resilience in adults with a congenital physical disability. The suggestion is that resilience involves a complex interplay between physical determinants of health and psychological characteristics, such as self-esteem and self-compassion. It follows that cognitive behavioural strategies with a focus on self-management may, in part, contribute to the process of resilience in this group. Further large-scale and longitudinal research will help to confirm these findings.
Publisher: Springer Science and Business Media LLC
Date: 24-07-2019
DOI: 10.1007/S10803-019-04145-3
Abstract: Mindfulness-based therapies are rising in popularity. However, evidence for their effectiveness in reducing psychological distress and enhancing wellbeing for families living with autism spectrum disorder (ASD) is limited. A systematic search identified 10 independent studies, involving a pooled s le of 233 children and adults with ASD and 241 caregivers. Hedges' g effect sizes with associated 95% confidence intervals, in addition to heterogeneity, were calculated using a random-effects model. Caregivers, children and adults who received mindfulness all reported significant gains in subjective wellbeing immediately post-intervention. Available data indicated intervention effects were maintained at 3-month follow-up. Mindfulness presents a promising intervention strategy in ASD populations, however more controlled research is required to determine its precise efficacy for affected families and subgroups.
Publisher: SAGE Publications
Date: 26-10-2011
Abstract: This meta-analysis evaluated the impact of cognitive behavior therapy (CBT) on the psychological adjustment of adults with spinal cord injury (SCI). A comprehensive search of six electronic databases identified 10 studies (424 participants) that met the inclusion criteria. Pre- and post-data for participants who received CBT were pooled and analyzed. Large and significant group differences were noted for measures of assertiveness, coping, self-efficacy, depression and quality of life. These data suggest that CBT has a significant positive impact on short-term psychological outcomes following SCI. However, further research is needed to establish the long-term benefits.
Publisher: Springer Science and Business Media LLC
Date: 05-08-2014
DOI: 10.1038/SC.2014.92
Abstract: Spinal cord injury (SCI) research has highlighted links between psychological variables and employment outcome however, there remains a need to consolidate the available heterogenous data. Meta-analytic techniques were used to examine and quantify differences in psychological functioning and employment status among adults with an acquired SCI. Fourteen observational studies (N = 9, 868 participants) were identified from an electronic database search. Standardised mean difference scores between employed and unemployed groups were calculated using Cohen's d effect sizes. Additionally, 95% confidence intervals, fail-safe Ns, percentage overlap scores and heterogeneity statistics were used to determine the significance of d . Moderate to large and positive weighted effects were noted across three broad psychological constructs: affective experience or feelings (dw = 3.16), quality of life (dw = 1.06) and life satisfaction (dw = 0.70). However, the most compelling non-heterogeneous finding was associated with life satisfaction, a finding that was also not subject to publication bias. Inconsistent and weak associations between employment and in idual measures of vocational attitude, self-efficacy, locus of control, adjustment and personality were also noted. Psychological factors and attributes are linked to employment post-SCI however, the available data are limited in quantity. Longitudinal research is also needed to determine whether these variables can help to preserve employment over time.
Publisher: Springer Science and Business Media LLC
Date: 18-07-2021
Publisher: Elsevier BV
Date: 08-2021
Publisher: American Psychological Association (APA)
Date: 02-2017
DOI: 10.1037/TEP0000129
Publisher: Informa UK Limited
Date: 05-09-2018
DOI: 10.1080/13607863.2017.1370689
Abstract: To quantitatively review the literature comparing depressed mood, anxiety and psychological distress in caregivers (CGs) of older adults with Alzheimer's disease (AD) with non-caregivers (NCGs) Methods: Eighteen independent studies comparing AD CGs (N = 2378) with NCGs (N = 70,035) were evaluated in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Standardised mean differences (Hedges' g) with associated 95% confidence intervals and p-values were calculated using a random-effects model. Studies generally conformed to STROBE criteria in terms of their methodological and procedural detail, although data management issues that may contribute to methodological bias were identified. Pooled effect estimates revealed medium to large group differences in depression (g Caregivers of patients with AD experience poor mental health in comparison to the general population, with female caregivers being disproportionately affected. Further exploration of the psychosocial variables that contribute to these group differences is needed to inform effective support services and, in turn, help caregivers manage the emotional demands of AD.
Publisher: Springer Science and Business Media LLC
Date: 24-02-2018
Publisher: Informa UK Limited
Date: 23-04-2023
DOI: 10.1080/10401334.2022.2048833
Abstract: Efforts to promote wellbeing and reduce burnout amongst postgraduate medical trainees have been h ered by little consideration of interventions' underlying mechanisms, as well as how interventions are delivered. The critical role of trainee specialty has also been overlooked, despite the unique personal and work-based stressors faced among subgroups - such as those completing Family Medicine/General Practice. A consolidation of intervention research can help to guide the design, implementation and evaluation of future targeted programs and potentially enhance their effectiveness. The present hermeneutic literature review addresses this gap. The Embase, Ovid Medline, and Ovid PsycINFO databases were searched for articles exploring wellbeing and related concepts of burnout and stress amongst Family Medicine/General Practice trainees. Thirty-one studies were identified through seven iterative rounds, with articles that offered novel insights and/or addressed knowledge gaps identified in each round and analyzed, followed by refinement of the overarching coding structure. Thematic analysis was conducted by two researchers. Proposed and enacted wellbeing interventions typically involved a combination of in idualistic (e.g., self-awareness), organizational (e.g., increasing policy flexibility), and cultural (e.g., leadership) strategies. Change mechanisms were interpersonal (e.g., comradery) and, to a greater extent, intrapersonal (e.g., normalizing and accepting feelings of insecurity). Key delivery methods included the need to ingrain trainee wellness into daily work life and the importance of contextualizing interventions to increase their relevance, acceptance, and effectiveness. The present review identifies and consolidates key mechanisms of change intrinsic to wellbeing-promotion interventions, alongside delivery methods. These findings provide guidance for practice and research to identify these attributes of interventions in the design and evaluation stages. This, in turn, will enhance the clarity of what is being evaluated, facilitating more informed comparisons between evaluations.
Publisher: School of Human Services and Social Work, Griffith University
Date: 12-11-2021
DOI: 10.36251/JOSI.218
Publisher: Springer Science and Business Media LLC
Date: 13-10-2023
Publisher: American Psychological Association (APA)
Date: 05-2017
DOI: 10.1037/REP0000125
Abstract: Acceptance of the International Classification of Functioning, Disability and Health (ICF) in research and clinical practice has been delayed, despite its multiperspective approach to health measurement. This review utilized the ICF to examine evidence on the associations between depressive symptoms and psychosocial functioning in a patient cohort: multiple sclerosis (MS). Forty-nine studies, involving 7,548 adults with relapsing or progressive forms of MS, were quantitatively evaluated. Data were categorized according to ICF domains: activities of in iduals along with their participation in life areas and influential environmental and personal factors. Effect size estimates, in the form of Pearson's r, 95% confidence intervals and Fail-safe Ns were calculated. Depression severity was linked to reduced social activities and participation levels (29%, n = 14 studies). Limited quality and/or frequency of informal support from family and friends was also identified as an environmental barrier to participation (29%, n = 14 studies). Intrapersonal markers of depressive symptomatology (e.g., low self-efficacy, anxiety, poor coping, illness attitudes and beliefs) were routinely reported (53%, n = 29 studies). The ICF can help guide the selection of clinical measures to assess psychosocial functioning in adults with MS and highlight areas necessitating further research and/or intervention. For those reporting depressed mood, this might include interventions premised on supporting activity and participation in addition to reinforcing interpersonal strengths. To enhance the utility of the ICF in MS care, further research is needed to operationalize its domains and to map this framework onto existing measurement tools. (PsycINFO Database Record
Publisher: SAGE Publications
Date: 09-12-2015
Abstract: The concept of resilience remains under-researched in the multiple sclerosis literature. Consequently, current understanding of the unique and joint contribution of disability-specific variables, cognitive-behavioural skills and social resources to this dynamic process is limited. A holistic model of resilience was therefore developed and tested. Results of an online survey completed by 196 adults with multiple sclerosis revealed both direct and indirect pathways to resilience, with positive affect and self-efficacy being the strongest predictors. The findings lend support to psychological interventions which focus on promoting the personal resources and assets needed to cope effectively with multiple sclerosis.
Publisher: Elsevier BV
Date: 11-2012
DOI: 10.1016/J.APMR.2012.06.002
Abstract: To determine whether an in idualized counseling intervention delivered by telephone-telecounseling-feasibly improves the emotional adjustment of adults with a newly acquired spinal cord injury (SCI). Randomized controlled trial. Spinal injuries unit of a rehabilitation center. Adults (N=40) aged 18 or older, who were recently discharged home from inpatient spinal rehabilitation, were randomly assigned to a telecounseling treatment or standard-care control group. All participants had recently received psychological treatment as inpatients in order to help assist them in adjusting to their disability. Referral to the inpatient psychology service was therefore a key indicator of participants' baseline distress levels and, consequently, their need for counseling support postdischarge. Seven telecounseling sessions were delivered over a 12-week period by a single psychologist (D.D.). Pre- and postintervention data, plus a 3-month follow-up assessment, were compared with that of an SCI control group who received standard care. Psychosocial outcome was measured using the following: Depression Anxiety Stress Scale-21 Mini International Neuropsychiatric Interview Spinal Cord Lesion Emotional Wellbeing and Coping Strategies Questionnaires and the Multidimensional Measure of Social Support. Cost-effectiveness and clinical feasibility were also evaluated. Telecounseling participants reported clinical improvements in depression and anxiety and aspects of SCI coping immediately postintervention. However, these treatment gains were not statistically significant. Additionally, treatment effects were minimal at 3-month follow-up. Delivery related outcomes, including participation rate and cost analyses, were all positive. The results suggest that continued psychological services for in iduals reporting distress during their inpatient rehabilitation is important and that such services can be delivered by telephone cost-effectively and efficiently. However, the long-term benefits of telecounseling, once ceased, were not demonstrated.
Publisher: Springer Science and Business Media LLC
Date: 28-09-2015
Publisher: Springer Science and Business Media LLC
Date: 22-12-2010
DOI: 10.1038/SC.2009.161
Abstract: A repeated measures, non-randomised controlled trial. To examine the effectiveness of in idualised cognitive behaviour therapy (CBT) on the psychological adjustment of patients undergoing rehabilitation for newly acquired spinal cord injury. South Australian Spinal Cord Injury Service, H stead Rehabilitation Centre, South Australia, Australia. Eleven participants received in idual CBT as part of their spinal rehabilitation. Self-reported levels of depression, anxiety and stress were assessed before the intervention, at week 12 of rehabilitation and at 3 months post-discharge, using the depression, anxiety and stress scales (DASS-21). Functional independence was also assessed, using the Functional Independence Measure (FIM). Responses were compared with 13 participants, closely matched on demographic and injury variables, who received standard psychological care (that is, assessment and monitoring only). Depression scores for treatment participants showed a significant time effect, with worsening symptoms reported at three-month follow-up, after CBT was discontinued. In contrast, the DASS-21 scores of standard care participants remained at subclinical levels throughout the study. Clinical improvements in symptoms of anxiety and stress were also reported by the treatment group as inpatient therapy progressed. Targeted, in idualised psychological treatment contributed to short-term, meaningful improvements in emotional outcomes for in iduals reporting psychological morbidity after recent spinal injury. The results also highlight the need for ongoing access to specialised, psychological services post-discharge. Replication of these results with a larger s le is required before definitive conclusions can be drawn.
Publisher: Wiley
Date: 13-11-2019
DOI: 10.1002/CPP.2341
Abstract: Although there is sufficient research and clinical evidence to support the inclusion of gaming disorder in the latest revision of the International Classification of Diseases, relatively little is known about the effectiveness of first-line psychological treatment for gaming disorder or internet gaming disorder (IGD) as it is listed in the Diagnostic and Statistical Manual. This systematic review employed meta-analytic techniques to determine the effectiveness of cognitive-behavioural therapy (CBT) for IGD on four key outcomes: IGD symptoms, anxiety, depression, and time spent gaming. A database search identified 12 independent CBT studies. Effect size estimates (Hedges' g) with associated confidence intervals, prediction intervals, and p values for each pre-post treatment outcome, were calculated. Study reporting quality was evaluated in accordance with the Consolidated Standards of Reporting Trials guidelines. Subgroup and moderator analyses were undertaken to investigate potential sources of heterogeneity. CBT demonstrated high efficacy in reducing IGD symptoms (g = 0.92 [0.50, 1.34]) and depression (g = 0.80, [0.21, 1.38]), and showed moderate efficacy in reducing anxiety (g = 0.55, [0.17, 0.93]) at post-test. There was insufficient power to determine whether CBT was capable of reducing time spent gaming. Treatment gains at follow-up were nonsignificant across the four treatment outcomes. The pooled findings suggest that CBT for IGD is an effective short-term intervention for reducing IGD and depressive symptoms. However, the effectiveness of CBT for reducing actual time spent gaming was unclear. Given the limitations of this evidence base, there is a need for more rigorous studies to determine the potential long-term benefits of CBT for IGD. Given the rise in treatment demand for internet gaming disorder (IGD) and problematic gaming, it is necessary to determine which treatments are most effective for whom and under which conditions. This review shows that cognitive-behavioural therapy for IGD, which is often considered the first-line therapy, can improve IGD symptoms and comorbid depression. However, treatment gains tend to be short-term and their effect in reducing time spent gaming is unclear. Programs that target problematic gaming may be improved by additional support beyond the standard program of therapy sessions. More funding and resources are needed to support the development of a more rigorous evidence base on IGD and its treatment.
Publisher: Cambridge University Press (CUP)
Date: 10-06-2014
DOI: 10.1017/JRC.2014.3
Abstract: An online survey of adult women living in Australia with an acquired or congenital disability was conducted to explore the needs and challenges experienced by this population. Data for 116 respondents with a primary mobility ( n = 92), sensory-related ( n = 12), psychiatric ( n = 6), or neurocognitive impairment ( n = 6) were collected. Word clouds and content analysis were utilised to examine the data. Barriers to achieving vocational, health and relationship goals were identified, including systemic (e.g. financial resources, accessibility issues, societal attitudes), physical (e.g. medical sequalae), and psychological (e.g. self-concept, assertiveness) issues. Strategies to overcome these barriers included increased availability of peer support networks and opportunities for personal development. It follows that disability services require a multi-faceted approach, with a focus on biopsychosocial factors that include, but are not limited to, mobility, self-care and communication needs.
No related grants have been discovered for Diana Dorstyn.