ORCID Profile
0000-0002-6732-8508
Current Organisations
Griffith University Griffith Health
,
University of Adelaide
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Publisher: Wiley
Date: 26-11-2020
DOI: 10.1111/JAN.14257
Abstract: To explore the intentions of nurses to respond to requests for legal assisted-dying. As more Western nations legalize assisted-dying, requests for access will increase across clinical domains. Understanding the intentions of nurses to respond to such requests is important for the construction of relevant policy and practice guidelines. Mixed-methods. A total of 45 Australian nurses from aged, palliative, intensive, or cancer care settings surveyed in November 2018. Q-methodology studying nurses' evaluations of 49 possible responses to a request for a hastened death. Data consisted of rank-ordered statements analysed by factor analysis with varimax rotation. Four distinct types of intentions to respond to requests for assisted-dying: a) refer and support b) object to or deflect the request c) engage and explore the request or d) assess needs and provide information. The findings underscore the complexity of intentionality in assisted-dying nursing practice and differences from other forms of end-of-life care, particularly regarding patient advocacy and conscientious objection. This study enables further research to explore determinants of these intentions. It can also assist the development of professional guidance by linking policy and clinical intentions. Identified a basic range of nurses' intentions to respond to requests for assisted-dying, as there was no evidence at present. Developed a fourfold typology of intentions to respond with most nurses intending to engage in practices that support the requestor and sometimes the request itself. A minority would object to discussing the request. The relatively low level of advocacy within the intended responses selected also is distinctly different from other end-of-life care research findings. This research could assist nursing associations in jurisdictions transitioning to legal assisted-dying to develop guidance ways nurses can frame their responses to requests.
Publisher: Wiley
Date: 03-02-2013
DOI: 10.1111/INM.12010
Abstract: The dominant model that informs clinical training for preventing violence and managing aggression posits arousal as mediated downwards from higher cortical structures. This view results in an often-misplaced reliance on verbal and cognitive techniques for de-escalation. The emergence of sensory modulation, via the Six Core Strategies, is an alternative or complementary approach that is associated with reduced rates of seclusion and restraint. Sensory-based interventions are thought to promote adaptive regulation of arousal and emotion, but this connection has had limited theoretical and empirical development. This paper presents results of a pilot trial of sensory-based interventions in four inpatient mental health units in New Zealand. Narrative analysis of interview and focus group data suggest that modifications to the environment and the use of soothing stimuli moderate or optimize arousal and promote an ability to adaptively regulate emotion. Findings are discussed in light of recent advances in the neurophysiology of emotional regulation and the General Aggression Model that posits arousal and maladaptive emotional regulation as precursors to aggression.
Publisher: JMIR Publications Inc.
Date: 11-2021
Abstract: ackground: The burgeoning mental health issues among emerging adults (ages 19 to 25) worldwide has fueled concerns about their widespread experiences of anxiety and depression. With the onset of the COVID-19 pandemic, emerging studies are being directed towards the development and deployment of digital peer emotional disclosure and support for the psychological well-being of emerging adults. However, much remains to be explored regarding implementation and clinical effectiveness, how best to conduct digital peer support intervention for emerging adults’ psychological well-being, and the associated mechanism of change. bjective: This protocol delineates a randomized controlled trial for evaluating the implementation and clinical effectiveness of Acceset, a digital peer support intervention for emerging adult mental well-being with two components. First, the digital peer support training equips befrienders (i.e., peers who provide support) in harnessing four active ingredients—Mattering, selfhood, compassion, and mindfulness—to provide effective peer support for seekers (peers who seek support). Second, the Acceset platform incorporates digital markers of psychological well-being, hinges on peer emotional disclosure process and entails community engagement. ethods: 100 participants (aged 19 to 25) from the National University of Singapore (NUS) will be recruited and randomly allocated into two arms. Arm 1 (n = 50) seekers will engage with the Acceset platform for a period of 3 weeks, together with befrienders (n = 30) and moderators (n = 30). Arm 2 (n = 50) a control group will be placed on a waitlist for Acceset intervention. Both seekers and befrienders will be monitored using a questionnaire battery at 4 time points: baseline (before the intervention), 3 weeks (the end of the intervention), 6 weeks and 9 weeks (to measure carry over effects). The implementation outcomes on the two components of the intervention will be adoption and fidelity evaluation of the digital peer support training curriculum and the feasibility and acceptability of the Acceset platform. The clinical outcomes will include Mattering, self-hood, compassion, mindfulness, perceived social support and psychological well-being scores. esults: This protocol has received approval by the Institutional Ethics Review Board of NUS in October 2021. Recruitment will commence in January 2022. We expect data collection and analyses to be completed in June 2022. The aim is to publish the preliminary results in December 2022. The size effect will be estimated using the Cohen d index with a significance level of .05 (95% reliability) and a conventional 80% power statistic. onclusions: This protocol considers a novel digital peer support intervention—Acceset—that incorporates active ingredients and digital markers of emerging adult mental well-being. Through the validation of Acceset intervention, this study defines the parameters and conditions for digital peer support intervention for emerging adults. rial Registration: ClinicalTrials.gov NCT05083676
Publisher: Elsevier BV
Date: 12-2021
Publisher: JMIR Publications Inc.
Date: 20-09-2022
DOI: 10.2196/34602
Abstract: Mental health issues among emerging adults (aged 19-25 years) on a global scale have underscored the need to address their widespread experiences of depression and anxiety. As a result of the COVID-19 pandemic, emerging studies are being directed toward the development and deployment of digital peer emotional disclosure and support for the psychological well-being of emerging adults. However, it is important to explore the implementation and clinical effectiveness, as well as associated mechanisms of change, for optimal approaches in conducting digital peer support interventions for emerging adults’ psychological well-being. We describe a randomized controlled trial to evaluate the implementation and clinical effectiveness of Acceset, a digital peer support intervention to address emerging adult mental well-being. The intervention has 2 components. First, the digital peer support training equips befrienders (ie, peers who provide support) to harness 4 components of psychological well-being—mattering, selfhood, compassion, and mindfulness—to provide effective peer support for seekers (ie, peers who seek support). Second, Acceset incorporates psychological well-being digital markers and harnesses community engagement to drive emotional disclosure among peers. A total of 100 participants (aged 19-25 years) from the National University of Singapore will be recruited and randomized into 2 arms. In arm 1 (n=50), the seekers will use Acceset with befrienders (n=30) as well as moderators (n=30) for 3 weeks. Arm 2 comprises a wait-listed control group (n=50). A questionnaire battery will be used to monitor seekers and befrienders at 4 time points. These include baseline (before the intervention), 3 weeks (end of the intervention), and 6 and 9 weeks (carryover effect measurement). Implementation outcomes of the intervention will involve evaluation of the training curriculum with respect to adoption and fidelity as well as user acceptability of the Acceset platform and its feasibility for broader deployment. Clinical outcomes will include mattering, selfhood, compassion, mindfulness, perceived social support, and psychological well-being scores. This protocol received National University of Singapore Institutional Ethics Review Board approval in October 2021. Recruitment will commence in January 2022. We expect data collection and analyses to be completed in June 2022. Preliminary findings are expected to be published in December 2022. The Cohen d index will be used for effect size estimation with a .05 (95% reliability) significance level and 80% power. This protocol considers a novel digital peer support intervention—Acceset—that incorporates components and digital markers of emerging adult mental well-being. Through the validation of the Acceset intervention, this study defines the parameters and conditions for digital peer support interventions for emerging adults. ClinicalTrials.gov NCT05083676 t2/show/NCT05083676 PRR1-10.2196/34602
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.IJNURSTU.2018.03.012
Abstract: This study investigated New Zealand nurses' views on legalising assisted dying across a range of clinical conditions, nurses' willingness to engage in legal assisted dying, potential deterrents and enablers to such engagement, and nurses' perceptions of the proper role of their professional bodies in relation to legalising assisted dying. A Bill for legalising assisted dying is currently before the New Zealand parliament. Of the 16 jurisdictions where assisted dying has been specifically legislated, only the Canadian federal statute provides nurses with explicit legal protection for their performance of assisted dying-related tasks. An absence of policy development and planning for safe nursing practice prior to legalisation of assisted dying results in a gap in professional support and guidance. Exploratory cross-sectional survey. A self-selected s le of 475 New Zealand nurses responded to an anonymous online survey disseminated through the newsletters and websites of relevant medical and nursing professional bodies. A sub-s le of nurses who expressed support for or ambivalence about legalisation (n = 356): rated their level of support for legalising assisted dying in New Zealand across a range of medical conditions, and their willingness to participate in a range of assisted dying tasks identified barriers and facilitators to potential participation and assessed the responsibility of the professional bodies to provide practice supports. Mixed-method approach using descriptive analysis of quantitative data qualitative data were analysed thematically. Nurses supported legalisation at a rate (67%) significantly greater than that of doctors (37%) and for a erse range of medical conditions. Most supporting nurses were willing to engage in the full range of relevant assisted dying roles. They identified several practical and ethical supports as essential to safe engagement, in particular practice guidelines, specific training, legal protections, clinical supervision and mentoring, and independent review of assisted dying service provision. They saw the facilitation of these supports as primarily the responsibility of their professional bodies. Nursing bodies should proactively facilitate workforce awareness and development of assisted dying policy and practice supports in anticipation of legalisation. This can be done through information c aigns and by adapting assisted dying policy, practice materials and systems already developed internationally. Nursing bodies need to engage in formulating legislation to ensure inclusion of explicit protections for participating nurses and to delegate relevant responsibilities to regulatory bodies.
Publisher: SAGE Publications
Date: 03-12-2021
Abstract: Legal assisted dying is a rare event, but as legalisation expands, requests for it will likely increase, and the nurse most often receives the informal, initial request. To assess the effects of attitude in interaction with normative and control beliefs on an intention to respond to a request for legal assisted dying. The study had the lead author’s institutional ethics approval, and participants were informed that participation was both anonymous and voluntary. This was a cross-sectional correlational study of 377 Australian registered nurses who completed an online survey. Generalised linear modelling assessed the effects of independent variables against intended responses to requests for legal assisted dying. Compared to nurses who did not support legal assisted dying, nurses who did had stronger beliefs in patient rights, perceived social expectations to refer the request and stronger control in that intention. Nurses who did not support legal assisted dying had stronger beliefs in ethics of duty to the patient and often held dual intentions to discuss the request with the patient but also held an intention to deflect the request to consideration of alternatives. This study advances the international literature by developing quantified models explaining the complexity of nurses’ experiences with requests for an assisted death. Attitude was operationalised in interaction with other beliefs and was identified as the strongest influence on intentions, but significantly moderated by ethical norms. The complex of determinants of those intentions to respond to requests for an assisted death suggests they are not isolated from each other. Nurses might have distinct intentions, but they can also hold multiple intentions even when they prioritise one. These findings present opportunities to prepare nurses in a way that enhances moral resilience in the face of complex moral encounters.
Publisher: Wiley
Date: 16-11-2012
DOI: 10.1111/J.1447-0349.2011.00771.X
Abstract: The study aimed to evaluate the impact of introducing designated care coordinators into an acute mental health inpatient unit in terms of service delivery, clinical outcomes, and service user and significant other perceptions. A pre-post-controlled design was implemented with a consecutive s le of 292 service users admitted and staying more than 5 days in two wards, with care coordinators introduced in one ward. Data were obtained from clinical records, standard measures, and service user and significant other surveys. Care coordinator input was associated with significant improvements in service delivery and stronger involvement of significant others and community resources. Care-coordinated clients showed significantly better clinical outcomes, including the Health of Nations Outcome Scales behaviour subscale, less time in the intensive care subunit, less community crisis team input in the week following discharge, and lower rates of readmission in the month following discharge. Care-coordinated service users and their significant others gave higher ratings of service delivery, outcome, and satisfaction. The results indicate that designated care coordinators significantly improve care processes, outcomes, and service user experience in acute inpatient mental health settings.
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/AH13208
Abstract: Objective Non-government organisations make a substantial contribution to the provision of mental health services despite this, there has been little research and evaluation targeted at understanding the role played by these services within the community mental health sector. The aim of the present study was to examine the depth and breadth of services offered by these organisations in south-east Queensland, Australia, across five key aspects of reach and delivery. Methods Representatives from 52 purposively targeted non-government organisations providing mental health services to in iduals with significant mental health challenges were interviewed regarding their approach to mental health service provision. Results The findings indicated a erse pattern of service frameworks across the sector. The results also suggested a positive approach to the inclusion of consumer participation within the organisations, with most services reporting, at the very least, some form of consumer advocacy within their processes and as part of their services. Conclusions This paper offers an important first look at the nature of non-government service provision within the mental health sector and highlights the importance of these organisations within the community sector. What is known about the topic? Non-government organisations make a substantial contribution to the multisectorial provision of services to mental health consumers in community settings. Non-government organisations in Australia are well established, with 79.9% of them being in operation for over 10 years. There is an increasing expectation that consumers influence the development, delivery and evaluation of mental health services, especially in the community sector. What does this paper add? This paper provides a profile of non-government organisations in one state in Australia with respect to the services they provide, the consumers they target, the practice frameworks they use, the use of peer workers and consumer participation, the success they have had with obtaining funding and the extent to which they collaborate with other services. What are the implications for practitioners? This paper provides readers with an understanding of the non-government organisations and the services they provide to people with mental health conditions. In addition, the findings provide an opportunity to learn from the experience of non-government organisations in implementing consumer participation initiatives.
Publisher: SAGE Publications
Date: 22-04-2022
DOI: 10.1177/00302228221089120
Abstract: Background & objectives: Identifying the impacts of COVID-19 on patients’ and practitioners’ access to legal assisted dying and euthanasia (AD& E) services is vital to informing service continuity in an ongoing pandemic. Methods: An anonymous online survey collected qualitative and quantitative data from health practitioners and agencies providing legal AD& E services ( n = 89), complemented by semi-structured interviews with 18 survey respondents who volunteered. Results: Following governments’ responses to the dynamic pandemic context, rates of AD& E inquiries and requests fluctuated across and within jurisdictions, based on a complex interaction of factors affecting patient access to AD& E agencies and assessors as services were disrupted. Service flexibility and nimbleness became key elements in continuing service availability and included calculated ‘rule-breaking’ considered justifiable to adhere to established bioethics. Making innovative adjustments to usual practice led to reviewing the effectiveness of AD& E services and laws, resulting in providers now improving services and lobbying for legislative change.
No related grants have been discovered for Michael Wilson.