ORCID Profile
0000-0002-5464-8887
Current Organisation
Flinders University
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Publisher: Computers, Materials and Continua (Tech Science Press)
Date: 23-07-2014
Publisher: SAGE Publications
Date: 30-01-2014
Abstract: The burden of caring for family members with mental illness has been researched extensively however, knowledge of spouse carers’ experiences is limited. In this article, we explore this from a carers’ perspective, with 28 spouse carers, using qualitative open-ended semistructured interviews and a grounded theory approach informed by the social interactionism tradition to collect and analyze the data. We present six interrelated themes around the central theme of this being “a real and genuine relationship.” The findings indicate that caring for a spouse with severe mental illness is a unique role compared with other caring roles. First and foremost, spouse carers strive for the relationship with their partner and accommodate mental illness into their lives to protect the relationship. Because of this, they often lead surreal lives marked by significant emotional pressure and isolation. This has implications for how mental health service providers work with and support spouse carers.
Publisher: BMJ
Date: 06-2022
DOI: 10.1136/BMJOPEN-2021-055499
Abstract: To investigate reciprocal temporal relationships between tobacco consumption and psychological disorders for youth. Design: Review Five databases (PubMed, Embase, Scopus, CINAHL and PsycINFO) on 26 September 2019 and updated on 11 May 2021, indexing tobacco, mental illness and longitudinal. Study selection: Methods used consensus and multiple reviewers. Cohort studies (n=49) examining tobacco and selected psychological disorders (depression, anxiety, bipolar, psychosis, borderline personality disorder) among youth, and systematic reviews (n=4) of these relationships met inclusion criteria. Effect of tobacco on psychological disorders and effect of psychological disorders on tobacco. Independent extraction by the first author and checked by final author. Joanna Briggs Institute Critical Appraisal Tools were used for all studies. Included studies had moderate-to-high appraisal scores. We synthesised findings using vote counting for effect direction and descriptive data. Fifty-three studies were included in the review. Thirteen of 15 studies showed a positive effect direction of tobacco on depression (p .001). Six of 12 studies showed a positive effect direction of depression on tobacco (p=0.016). Six of eight studies showed a positive effect direction of tobacco on anxiety (p=0.016). Eleven of 18 studies showed a positive effect direction of anxiety on tobacco (p=0.003). No effect between tobacco and bipolar, or tobacco and psychosis was found. No studies examined tobacco and borderline personality disorder. Reciprocal relationships existed between tobacco and both depression and anxiety for youth, though causality is unconfirmed. No positive effect direction was found between tobacco and psychosis, perhaps because nicotine has conflicting effects on psychosis. For other relationships examined, evidence was weak because of low number of studies. More research to inform prevention and early intervention is needed. CRD42020150457.
Publisher: Informa UK Limited
Date: 24-11-2017
DOI: 10.1080/09638288.2017.1407966
Abstract: This article proposes a theoretical framework to help professionals include family as active members in brain injury rehabilitation. A trend towards greater family involvement has lead to the development of family-collaboration models. However, current models appear to focus on information sharing rather than increasing the capability of family members. This article introduces a family-directed approach to brain injury model, which provides a theoretical framework for supporting family as facilitators of change. Family-collaboration models and literature regarding family experiences following brain injury and support needs are reviewed to identify the driving forces behind family engagement in rehabilitation, including effective professional-family relationships, and important factors in the delivery of education underpinned by evidence-based practices. The family-directed approach to brain injury model is based on principles of hope, family expertise, education/skill building, and family-directed intervention. The family-directed approach to brain injury model provides a theoretical framework for educating and training family members as facilitators in the management process: promoting competence rather than dependency on service systems. Guiding recommendations encourage professionals to reflect on the importance of their therapeutic relationships and their capacity to positively impact rehabilitation outcomes beyond the technical aspects of health care and treatment. Implications for Rehabilitation Training family members as facilitators in the rehabilitation process is suggested to reduce dependency on the service system, address families' unmet support needs, and to optimize rehabilitation outcomes for in iduals with brain injury. The family-directed approach to brain injury model is proposed to guide the increased involvement of family as active members in the rehabilitation team and to define potential active ingredients in this process.
Publisher: SAGE Publications
Date: 12-05-2021
Abstract: Objective: To synthesize older adults’ experiences and perceptions of goal setting and pursuit within health systems. Methods: Six databases were searched to May 2019 using a combination of MeSH and free text terms. Included papers were written in English and reported original qualitative research for participants aged 65 years and older. Participant quotes from the results sections of included studies were gathered for thematic analysis and synthesis. Results: Initial search yielded 9,845 articles, and 134 were identified for full-text review. Fifteen papers were included in the final synthesis. Two main themes were identified: enablers (intrinsic and extrinsic) and barriers (personal and system). Conclusion: Older adults’ self-belief is the strongest enabler for goal activities, enhanced by a personalized coaching approach from health staff. Conversely, inconsistent goal terminology confuses patients and reduces engagement. Likewise, fatigue has profound physical and cognitive impact on patients’ ability to engage and participate in goals.
Publisher: Wiley
Date: 13-04-2012
Publisher: Informa UK Limited
Date: 12-06-2018
Publisher: Springer Science and Business Media LLC
Date: 06-2019
Publisher: Cambridge University Press (CUP)
Date: 12-2012
DOI: 10.1017/BEC.2012.23
Abstract: This study examined whether starting with the behavioural component of cognitive behavioural therapy (CBT) decreases the drop-out rate in outpatients with comorbid anxiety and depression. Retrospective data were collected on 60 patients with anxiety and depression. Mean values of different psychosocial assessment scales during screening, mid-session and discharge session were compared between the patients receiving and not receiving any type of behavioural interventions and among the patients receiving different types of behavioural interventions. A significant relationship was found ( p .05) between behavioural interventions and retention in therapy. Patients who did not receive any sort of behavioural intervention showed a greater rate of drop-out than those who received behavioural interventions. In the group of patients receiving different types of behavioural interventions, there was significant improvement in mental health scores between the screening and discharge sessions in those who received exposure therapy. The study findings will be helpful to retain patients with comorbid anxiety and depression in an outpatient therapy setting. If patient retention is increased, CBT can be more effectively delivered and thereby achieve better health outcomes for patients, more effective use of therapy service resources, and decrease the socioeconomic burden of anxiety and depression on the community.
Publisher: Elsevier BV
Date: 02-2001
Abstract: The relation between intakes of total fat and specific types of fat and age-related macular degeneration (AMD) remains unclear. Our objective was to examine prospectively the association between fat intake and AMD. We conducted a prospective follow-up study of participants in the Nurses' Health Study and the Health Professionals Follow-up Study. At baseline (1984 for women and 1986 for men), the study included 42743 women and 29746 men aged > or = 50 y with no diagnosis of AMD who were followed until 1996. Fat intake was assessed with a food-frequency questionnaire. We accrued 567 patients with AMD with a visual loss of 20/30 or worse. The pooled multivariate relative risk (RR) for the highest compared with the lowest quintile of total fat intake was 1.54 (95% CI: 1.17, 2.01 P for trend = 0.008). Linolenic acid was positively associated with risk of AMD (top versus bottom quintile of RR: 1.49 95% CI: 1.15, 1.94 P for trend = 0.0009). Docosahexaenoic acid had a modest inverse relation with AMD (top versus bottom quintile of RR: 0.70 95% CI: 0.52, 0.93 P for trend = 0.05), and >4 servings of fish/wk was associated with a 35% lower risk of AMD compared with < or = 3 servings/mo (RR: 0.65 95% CI: 0.46, 0.91 P for trend = 0.009). Total fat intake was positively associated with risk of AMD, which may have been due to intakes of in idual fatty acids, such as linolenic acid, rather than to total fat intakes per se. A high intake of fish may reduce the risk of AMD.
Publisher: MDPI AG
Date: 05-10-2021
Abstract: Mental health issues are a severe global concern with significant personal, social, and economic consequences and costs. This paper reports results of an online survey disseminated across the Australian community investigating why people with mental health issues choose particular mental health services over others, what causes them to disengage from services, and what factors and qualities of services are important to consumers to support their continued engagement or re-engagement with mental health services. The importance of GPs was evident, given their key role in providing mental healthcare, especially to those referred to as “the missing middle”—consumers with mental health issues who fall through the gaps in care in other parts of the healthcare system. The study found that many respondents chose to engage with mental healthcare providers primarily due to accessibility and affordability, but also because of the relational qualities that they displayed as part of delivering care. These qualities fostered consumers’ sense of trust, feeling listened to, and not being stigmatized as part of help seeking and having their mental health needs met. Implications for education and practice are offered.
Publisher: Royal College of Psychiatrists
Date: 2001
DOI: 10.1192/BJP.178.1.85
Publisher: Wiley
Date: 06-2006
DOI: 10.1111/J.1447-0349.2006.00410.X
Abstract: It has been argued that psychiatric nurses are ideally placed to provide smoking cessation interventions to patients with mental illness. This assumes that psychiatric nurses actively support smoking cessation. The current paper articulates some of the reasons why this has not occurred, in particular, some of the ethical beliefs held by nurses that may prevent such activity. Such an assumption also discounts the evidence that confirms psychiatric nurses to have among the highest smoking rates in nursing and in the health professions in general. The role and impact of the institution are also considered. In-depth interviews with seven community and inpatient psychiatric nurses were thematically analysed. Extensive in idual and group discussions were also held with inpatient nurses from open and locked psychiatric settings during participant observation of the settings. The findings suggest that psychiatric nurses can be more effective in the primary care role of supporting patients' smoking cessation if they receive adequate institutional support to do so.
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/PY13103
Abstract: Health services introducing practice changes need effective implementation methods. Within the setting of a community mental health service offering recovery-oriented psychosocial support for people with mental illness, we aimed to: (i) identify a well-founded implementation model and (ii) assess its practical usefulness in introducing a new programme for recovery-oriented self-management support. We reviewed the literature to identify implementation models applicable to community mental health organisations, and that also had corresponding measurement tools. We used one of these models to inform organisational change strategies. The literature review showed few models with corresponding tools. The Promoting Action on Research Implementation in Health Services (PARIHS) model and the related Organisational Readiness to Change Assessment (ORCA) tool were used. The PARIHS proposes prerequisites for health service change and the ORCA measures the extent to which these prerequisites are present. Application of the ORCA at two time points during implementation of the new programme showed strategy-related gains for some prerequisites but not for others, reflecting observed implementation progress. Additional strategies to address target prerequisites could be drawn from the PARIHS model. The PARIHS model and ORCA tool have potential in designing and monitoring practice change strategies in community mental health organisations. Further practical use and testing of implementation models appears justified in overcoming barriers to change.
Publisher: CMA Joule Inc.
Date: 31-10-2011
DOI: 10.1503/CMAJ.110235
Publisher: Informa UK Limited
Date: 27-09-2021
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.PEC.2018.11.001
Abstract: To articulate the components of educational interventions that help children learn about managing their asthma, cystic fibrosis, or diabetes, relevant to their age/developmental status. A systematic review of chronic condition self-management (CCSM) educational interventions that included age/developmentally appropriate components, published before 27 January 2018, including evidence level and quality assessments. Teaching approaches were extracted and translated into practical components. Twenty education interventions were identified, published across 30 studies. Most studies (n = 20/30) were based on the theories of Piaget and Bandura. Similar teaching approaches were used across conditions, incorporating sequenced curriculum and a variety of active elements. Age/developmentally appropriate interventions resulted in improvements in the CCSM capabilities of children. Outcomes were improved when compared with usual care. For very young children, educational interventions were directed at parents/families. As children reached school age, interventions increasingly became child-focused, promoting autonomy. Integrated play and reinforcement were common. Adolescent interventions placed greater emphasis on communication, problem-solving, and role ision. Eight key components were identified: structured and sequenced curricula reinforcement active participation collaboration autonomy feedback multiple exposures and, problem-solving. Different components are relevant to specific life stages. Clinicians require age/developmentally appropriate practical education tools to provide effective paediatric health care.
Publisher: JMIR Publications Inc.
Date: 09-07-2015
Publisher: Elsevier BV
Date: 08-2013
Publisher: Elsevier BV
Date: 03-2020
DOI: 10.1016/J.PEC.2019.09.029
Abstract: To create a consensus list of self-management definitions, recommendations, and endpoints for children and young people (0-20 years) with chronic conditions. This study used a Delphi technique. Based on the number of relevant peer-reviewed publications, clinical academics were invited to participate in three survey rounds. Round one contained open-ended and multiple-choice questions eliciting general opinions on self-management. For round two, results were provided to the interdisciplinary expert panel as statements for rating their agreement using a 7-point Likert scale, with consensus predefined as moderately or extremely satisfied by >70% of participants. Statements not meeting consensus were re-presented in round three, with group feedback incorporated. Finalised statements informed creation of the 'Partners in Health: Self-Management Consensus List for Children and Young People'. Sixteen clinical academics participated: 12 completed round one 14 completed round two and 12 completed round three. Of 101 statements, 90 reached consensus, with statements separated into five developmentally appropriate groups. Statements covered broad self-management and self-management support domains including knowledge, involvement, monitoring/responding to symptoms, transition, impact, lifestyle, and support. Division of responsibility and autonomy were distinct themes. This research provides consensus-based guidance for clinicians providing paediatric self-management support.
Publisher: Springer Science and Business Media LLC
Date: 06-02-2023
DOI: 10.1186/S13722-022-00355-W
Abstract: Smoking and resulting health problems disproportionately impact low socioeconomic status (SES) in iduals. Building resilience presents an approach to ‘closing the gap’. Mindfulness-based interventions and setting realistic goals are preferred in low socioeconomic communities. We aim to test if these interventions, delivered online and consolidated with peer support offered via ex-smokers, are successful in promoting smoking cessation and resilience. Our conceptualisation of resilience encompasses the inner capacity/skills and external resources (e.g., social support) which smokers utilise to bounce back from adversity. We include a process evaluation of barriers/facilitators to interventions and cost-effectiveness analysis (from health system perspective). We plan a four-arm parallel 12-month RCT with a 6-month follow-up to test the efficacy of three group-based interventions each followed by peer support. Arm 1: mindfulness-integrated cognitive behavioural therapy Arm 2: mindfulness training Arm 3: setting realistic goals Arm 4: active control group directed to quit services. All interventions will be administered online. Participants are adult smokers in Australia (N = 812) who have an average weekly household income less than $457AUD or receive welfare benefits. Group-based interventions will occur over 6 months, followed by 6 months of forum-based peer support. Primary outcome: self-reported 14-day period prevalence of smoking abstinence at 6 months, with remote biochemical verification of saliva cotinine ( 30 ng/mL). Secondary outcomes include: internal resilience (Connor-Davidson Resilience Scale-25) external resilience (ENRICHD social support tool) quality adjusted life years (EQ-5D-5L) self-efficacy for smoking abstinence (Smoking-Abstinence Self-Efficacy Questionnaire) motivation to quit smoking (Biener and Abrams Contemplation Ladder) nicotine dependence (Fagerstrom Test for Nicotine Dependency) equanimity (Equanimity Scale-16) stress (Perceived Stress Scale-10) goal assessment/attainment (Problems and Goals Assessment Scale). This study is the first to compare resilience interventions for low SES smokers which have been identified by them as acceptable. Our various repeated measures and process evaluation will facilitate exploration of mechanisms of impact. We intervene within the novel framework of the Psychosocial Model of Resilience, applying a promising paradigm to address a critical and inequitable public health problem. Trial registration Australian New Zealand Clinical Trials Registry ID: ACTRN12621000445875, registered 19 April 2021 ( anzctr.org.au/Trial/Registration/TrialReview.aspx?id=381007& isReview=true ). The Universal Trial Number is U1111-1261–8951
Publisher: Springer Science and Business Media LLC
Date: 10-10-2017
Publisher: Springer Science and Business Media LLC
Date: 29-07-2014
DOI: 10.1007/S00520-014-2324-Y
Abstract: This study aimed to explore barriers to return to work (RTW) and preferences for intervention and support for cancer patients treated with curative intent from the perspectives of cancer survivors and oncology health professionals. Participants attended a focus group (N = 24) or an in idual interview (N = 14). A topic guide and a semi-structured recorded interview format were used to gather data, which were later transcribed and analysed for global themes and subthemes. With regard to barriers, the global theme 'work capacity' captured an array of barriers encompassing financial pressure, preparedness for work, lack of confidence as well as other key physical, practical and psychosocial barriers. Participants expressed a preference for RTW models that focus on objective and structured assessment whilst allowing for flexibility to address in idual needs. Cancer survivors perceive multiple barriers when attempting to RTW. These barriers were perceived to impact upon work capacity, where 'capacity' was defined broadly to include practical, physical and psychosocial concerns. RTW is an important concern for cancer survivors and structured RTW interventions should be incorporated into the care of cancer survivors.
Publisher: Elsevier BV
Date: 03-2020
DOI: 10.1016/J.PEC.2019.09.021
Abstract: To conduct a systematic review of instruments for assessing the competency of therapists in motivational interviewing (MI) for training purposes. A search of Medline, Emcare, CINAHL, Scopus, Proquest, and Web of Science databases yielded 20,313 articles, of which 105 were included in the review. Data were summarised in terms of the instruments' development, adherence to MI principles, administration characteristics, psychometric properties, advantages, and disadvantages. Twelve instruments were identified. Tools tended to be better at covering simpler MI techniques. Differences in administration burden allow users to choose between briefer but cheaper and more detailed yet costly tools. Psychometric testing was often limited, and even if more extensive, the quality was often inconsistent. Although each tool tended to have relatively unique advantages (e.g. use of client ratings), they shared common disadvantages (e.g. lack of psychometric testing). A number of tools can be used to assess MI competency, each with their own strengths but notable weaknesses that should be considered by potential users. There is a need to further test existing tools before creating new ones, due to the repetition of the same limitations. Standardised guidelines should also be created to ensure each tool meets the same quality standards.
Publisher: Springer Science and Business Media LLC
Date: 28-02-2017
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/PY13087
Abstract: Our aim was to document current communication and information-sharing practices and to identify the barriers and enablers to good practices within the context of care planning for chronic condition management. Further aims were to make recommendations about how changes to policy and practice can improve communication and information sharing in primary health care. A mixed-method approach was applied to seek the perspectives of patients and primary health-care workers across Australia. Data was collected via interviews, focus groups, non-participant observations and a national survey. Data analysis was performed using a mix of thematic, discourse and statistical approaches. Central barriers to effective communication and information sharing included fragmented communication, uncertainty around client and interagency consent, and the unacknowledged existence of overlapping care plans. To be most effective, communication and information sharing should be open, two-way and inclusive of all members of health-care teams. It must also only be undertaken with the appropriate participant consent, otherwise this has the potential to cause patients harm. Improvements in care planning as a communication and information-sharing tool may be achieved through practice initiatives that reflect the rhetoric of collaborative person-centred care, which is already supported through existing policy in Australia. General practitioners and other primary care providers should operationalise care planning, and the expectation of collaborative and effective communication of care that underpins it, within their practice with patients and all members of the care team. To assist in meeting these aims, we make several recommendations.
Publisher: Wiley
Date: 30-06-2015
DOI: 10.1111/JPM.12226
Publisher: Wiley
Date: 17-09-2013
DOI: 10.1111/JPM.12109
Abstract: It helps people with mental illnesses to recover if they are not deprived of their rights of citizenship. The right to vote is an important marker of citizenship. Ensuring citizenship through the right to vote is especially important when someone is committed under mental health legislation, yet it is unclear how and whether this occurs in practice. This paper discusses what occurs for this population in Australia and overseas and reviews the role of capacity and supported decision making in the context of the right to vote. Solutions are offered for how mental health practice can protect the interest that Australians with mental illnesses have in voting. A central feature of recovery-based practice for people with mental illness is that they are able to exercise rights and experience membership of a community. This notion of citizenship is especially important when someone has had rights removed after being committed under mental health legislation. The right to vote is a central marker of citizenship. Supporting a person's right to vote is important for recovery-based practice. In this paper, we review the issue of voting for people who have been committed under mental health legislation, why it matters for recovery, and what occurs from the Australian and international perspective. We briefly review the concepts of capacity and supported decision making in the context of the right to vote. We also consider the usefulness of the American 'Doe Standard', which has been used with the Competency Assessment Tool (CAT-V), to determine capacity to vote. Some solutions are offered that would protect the interest that Australians with mental illnesses have in voting.
Publisher: AMPCo
Date: 08-2017
DOI: 10.5694/MJA16.01425
Publisher: Informa UK Limited
Date: 05-12-2016
DOI: 10.1080/15504263.2016.1267829
Abstract: Cigarette smoking poses significant health burdens for people with mental illness. They die sooner than they should, and smoking is a major contributor to their high rates of morbid chronic physical health conditions and early mortality, compared to the general population. Family carers provide important support to people with mental illness. However, family carers' perspectives of smoking by their family members with mental illness are largely absent from the research literature and from practice, despite smoking rates remaining high and quit rates remaining low for this population. We know little about how family carers are or could be involved in supporting people with mental illness who smoke to stop smoking. This paper aims to provide a discussion of the opportunities for family carers to support their family member's smoking cessation and a discussion of our preliminary research on this topic. From the available literature, it appears that family carers are well placed to support smoking cessation for this population however, they struggled physically, philosophically, and emotionally with perceived responsibilities involving their family member's smoking and the caring role. They felt isolated and asserted that there was limited support from service providers to assist them. We concluded that family carers are important agents within the person's immediate environment who could help them to improve their smoking cessation success. This suggests also that mental health services and other health service providers could benefit from including family carers in their efforts to support smoking cessation for people with mental illness who smoke.
Publisher: Springer Science and Business Media LLC
Date: 24-09-2018
Publisher: Wiley
Date: 12-08-2021
DOI: 10.1111/HEX.13329
Abstract: In many jurisdictions worldwide, in iduals with a mental illness may be forced to receive care and treatment in the community. In Australia, legislation states that such care should be driven by a care plan that is recovery‐focussed. Key components in the care planning process include engagement and decision‐making about a person's support needs and care options, with trust being an essential component of care planning relationships. This study examines how these components were enacted during service care contacts for in iduals on community treatment orders. The study was located at two community mental health teams in South Australia. Ethnographic observations of care planning discussions between consumers, their carers and clinicians, and interviews with in iduals from these groups, were conducted over 18 months. Carspecken's critical ethnography provided a rigorous means for examining the data to identify underlying cultural themes that were informing day‐to‐day care interactions. Care planning was not occurring as it was intended, with service culture and structures impeding the development of trusting relationships. Clinicians striving to work collaboratively with consumers had to navigate a service bias and culture that emphasized a hierarchy of ‘knowing’, with consumers assumed to have less knowledge than clinicians. Services and clinicians can challenge prejudicial ethical injustice and counter this through testimonial justice and implementation of tools and approaches that support genuine shared decision‐making. This study included in iduals with lived experience of mental illness, their carers and clinicians as participants and researchers.
Publisher: Springer Science and Business Media LLC
Date: 24-09-2018
Publisher: CMA Joule Inc.
Date: 31-10-2011
DOI: 10.1503/CMAJ.111579
Publisher: American Psychological Association (APA)
Date: 2021
DOI: 10.1037/MEN0000269
Publisher: Informa UK Limited
Date: 06-03-2022
Publisher: SAGE Publications
Date: 06-2007
Publisher: Springer Science and Business Media LLC
Date: 14-12-2016
Publisher: MDPI AG
Date: 29-11-2021
Abstract: People with severe mental illness (SMI) die significantly earlier than their well counterparts, mainly due to preventable chronic conditions such as cardiovascular disease (CVD). Based on the existing research, this perspective paper summarises the key contributors to CVD in people with SMI to better target the areas that require more attention to reduce, and ultimately resolve this health inequity. We discuss five broad factors that, according to current international evidence, are believed to be implicated in the development and maintenance of CVD in people with SMI: (1) bio-psychological and lifestyle-related factors (2) socio-environmental factors (3) health system-related factors (4) service culture and practice-related factors and (5) research-related gaps on how to improve the cardiovascular health of those with SMI. This perspective paper identifies that CVD in people with SMI is a multi-faceted problem involving a range of risk factors. Furthermore, existing chronic care or clinical recovery models alone are insufficient to address this complex problem, and none of these models have identified the significant roles that family caregivers play in improving a person’s self-management behaviours. A new framework is proposed to resolve this complex health issue that warrants a collaborative approach within and between different health and social care sectors.
Publisher: Informa UK Limited
Date: 12-05-2020
Publisher: Informa UK Limited
Date: 31-03-2015
DOI: 10.3109/02699052.2015.1004751
Abstract: To examine family involvement in the management of behavioural problems following ABI in the community. Systematic literature review. Six electronic databases relevant to the field of brain injury were searched between 1980-2013. Citation indexes were used and references from articles hand searched for further literature. Studies that met the broad inclusion criteria were screened for relevance and articles selected for full-text review independently considered by two reviewers. Those found to be relevant were analysed using PEDro and McMasters critical appraisal tools. Three hundred and three studies were identified after duplicates were removed and 56 were assessed for relevance, yielding 10 studies for review. Although the majority of studies were weak in design, five revealed significant findings supportive of family involvement in the management of behavioural problems following ABI, especially where interventions consisted of both educational components and in idualized behavioural plans. Findings revealed no significant changes in family burden following behavioural interventions. There is limited research and lack of high evidence studies evaluating family involvement in behaviour management following ABI therefore, no conclusions can be drawn regarding its efficacy. More research is needed, with larger s le sizes and more rigorous design, including proper comparison groups.
Publisher: Springer Singapore
Date: 2016
Publisher: Informa UK Limited
Date: 14-09-2023
Publisher: Informa UK Limited
Date: 06-04-2017
DOI: 10.1080/02701960.2016.1165218
Abstract: An expanding aging population has placed increased demands on health care resources in many countries. Enhancing community aged care support workers' role to support greater client self-management and reablement is therefore timely. This article presents perceptions of the impact of an Australian practice change initiative designed to enhance knowledge, skills, and confidence of support workers to support behavior change in clients with complex health care needs. A comprehensive training program was delivered in 2013. Methods included thematic analysis of interviews with clients, focus groups with support workers and coordinators, and collection of case studies of client/support worker behavior change interactions. Client, support worker, and coordinator responses were highly positive, reporting improvement in the quality of interactions with clients, client health outcomes, care coordination, communication, and teamwork. Mental health literacy remained the biggest knowledge gap. This research showed that support workers are ideally placed to be more actively involved in motivating clients to achieve behavior change goals.
Publisher: Elsevier BV
Date: 08-2010
DOI: 10.1016/J.PEC.2009.10.006
Abstract: The aims of this paper are to provide a description of the principles of chronic condition self-management, common approaches to support currently used in Australian health services, and benefits and challenges associated with using these approaches. We examined literature in this field in Australia and drew also from our own practice experience of implementing these approaches and providing education and training to primary health care professionals and organizations in the field. Using common ex les of programs, advantages and disadvantages of peer-led groups (Stanford Courses), care planning (The Flinders Program), a brief primary care approach (the 5As), motivational interviewing and health coaching are explored. There are a number of common approaches used to enhance self-management. No one approach is superior to other approaches in fact, they are often complimentary. The nature and context for patients' contact with services, and patients' specific needs and preferences are what must be considered when deciding on the most appropriate support mode to effectively engage patients and promote self-management. Choice of approach will also be determined by organizational factors and service structures. Whatever self-management support approaches used, of importance is how health services work together to provide support.
Publisher: SAGE Publications
Date: 29-12-2019
Abstract: Review the evidence for the effectiveness of chronic condition self-management programs applied to Aboriginal and Torres Strait Islander Peoples. A rapid review methodology was followed to develop an evidence summary from peer-reviewed and grey literature. Only seven peer-reviewed studies were identified. The evidence indicated that group programs, particularly the Stanford Program, and structured in idual chronic condition self-management programs were of good quality for Aboriginal and Torres Strait Islander Peoples, although these need to be integrated into practice in order to see the greatest benefits. The Flinders Program showed promise as a standardised program with content designed specifically with and for these populations. Numerous grey literature sources were identified, many using strong participatory approaches developed locally within Aboriginal and Torres Strait Islander Peoples. However, few of these programs have been subject to rigorous evaluation. Despite the significant focus on chronic condition self-management programs to help address the burden of disease for Aboriginal and Torres Strait Islander Peoples, few studies exist that have been properly evaluated. The Closing the Gap Principles developed by the Australian Institute of Health and Welfare offer important guidance for how to proceed to maximise engagement, cultural appropriateness and ownership of program initiatives.
Publisher: Frontiers Media SA
Date: 18-12-2018
Publisher: SAGE Publications
Date: 09-2010
DOI: 10.3109/00048674.2010.488637
Abstract: The aims of this study were to assess mental health workers' attitudes to addressing tobacco dependence with patients, to identify barriers that may prevent people with mental illness from receiving support, and determine workers' recommendations for tobacco policy and practice change. Questionnaires were sent to government and non-government mental health services in Adelaide, South Australia. The questionnaires asked workers to rate on a Likert rating scale their attitudes to addressing tobacco use with patients and to respond to qualitative questions about managing tobacco use within mental health services. Quantitative data were analysed using SPSS version 15.0 and qualitative data was coded by three researchers into categories or themes and then analysed. Questionnaires (324) were received from staff across 45 organizations providing clinical and psychosocial services. More than two thirds of the participants felt it was important for mental health services to be involved in assisting patients to quit smoking however, only 26% said they raised the issue of tobacco use with patients, often or as part of the assessment. Respondents on average felt approximately one third of their patients could quit or reduce tobacco use if they received nicotine replacement therapy, information and support. Most workers suggested changes to policy and practice within mental health services including smoke free areas and the provision of information and support. The rate of tobacco use amongst people with mental illness is still very high with serious social and health consequences. Mental health workers are uniquely placed to assist patients to quit or reduce tobacco use. This study has shown many workers believe that it is important to address tobacco use with their patients as part of routine care and that mental health services should implement significant tobacco policy and practice change.
Publisher: Informa UK Limited
Date: 04-08-2016
DOI: 10.1080/09638288.2022.2127932
Abstract: Psychoeducational interventions are commonly used to improve mental health among the general population however, their application among people with complex communication needs is under explored. This scoping review aims to identify the psychoeducational interventions utilised with people with complex communication needs, any adaptations to improve communication access, and outcomes for this population. The scoping review was conducted using the Arksey and O'Malley guidelines and included stakeholder consultations. A systematic search of the literature was conducted. Stakeholder consultations were conducted via semi-structured interviews with informants from three populations: people with complex communication needs, everyday communication partners and mental health workers. The search yielded 2112 articles. Twenty-four articles were retained for data extraction. Numerical analysis provided an overview of the existing literature. Thematic analysis highlighted the range of communication access strategies applied within psychoeducational interventions. Common aims and outcomes of interventions occurred across three interrelated themes: education, symptom reduction, and improved coping and wellbeing. Stakeholder consultations enabled contextualisation of literature. People with complex communication needs may benefit from psychoeducational interventions when effective, personalised communication access strategies are employed. Future research should include lived-experience perspectives to ensure the relevance of communication access strategies in mental health support.Implications for rehabilitationThis scoping review adds to the evidence base supporting equitable access to mental health support for people with complex communication needs.A range of specific strategies are presented for mental health workers to consider when working with people with complex communication needs.Positive behaviour support (PBS) practitioners must be equipped to address the psychoeducational and mental health support requirements of people with complex communication needs.
Publisher: JMIR Publications Inc.
Date: 14-03-2019
Abstract: moking rates of Australians with severe mental illness (SMI) are disproportionately higher than the general population. Despite the rapid growth in mobile health (mHealth) apps, limited evidence exists to inform their design for SMI populations. his study aimed to explore the feasibility, acceptability, and utility of adapting a novel smoking cessation app (Kick.it) to assist smokers with SMI to prevent smoking relapse and quit. sing co-design, two in-depth interviews with 12 adult smokers and ex-smokers with SMI were conducted in this qualitative study. Stage 1 interviews explored participants’ smoking-related experiences and perceptions of social support for smoking cessation, informed the development of the stage 2 interview schedule, and provided context for participants’ responses to the second interview. Stage 2 interviews explored participants’ perceptions of the feasibility, utility, and acceptability of the app features for SMI populations. eople with SMI perceived mHealth interventions to support their quit smoking attempts as feasible, acceptable, and useful. Key emerging themes included personalization of the app to users’ psychosocial needs, a caring app to mediate self-esteem and self-efficacy, an app that normalizes smoking relapse and multiple quit attempts, a strong focus on user experience to improve usability, and a social network to enhance social support for smoking cessation. his study gained an in-depth understanding of the lived experiences of smoking and quitting among people with SMI and their perception of the Kick.it app features to help inform the tailoring of the app. Specific program tailoring is required to assist them in navigating the complex interactions between mental illness and smoking in relation to their psychosocial well-being and capacity to quit. This study describes the adaptations required for the Kick.it app to meet the specific needs and preferences of people with SMI. Results of this study will guide the tailoring of the Kick.it app for SMI populations. The study findings can also inform a co-design process for the future development and design of smoking cessation apps for SMI populations.
Publisher: SAGE Publications
Date: 02-10-2017
Abstract: This paper reports outcomes of a clinical audit of smoke-free policy implementation within an Australian inpatient psychiatric setting. It aimed to evaluate assessment of smoking status and subsequent management of nicotine withdrawal, and investigate any patient factors influencing these processes. A total of 67 medical case notes were retrospectively analysed for inpatients admitted to psychiatric units of a general hospital in South Australia, from July to September 2015. Patient demographic variables and information from the hospital’s Smoking Assessment and Management Form (SAMF) were recorded. Data analysis involved descriptive statistics and Chi-square tests of association between dependent variables (how the SAMF was completed) and independent variables (sex, voluntary status, diagnosis). The SAMF was implemented for most patients (76.1%), with 64.71% completed within 24 hours of admission though, many were incomplete. Nicotine dependence was not properly assessed for 42.3% of smokers 69.23% were prescribed nicotine replacement therapy (NRT), despite most scoring moderate to high nicotine dependence. No statistically significant relationships were found between patient factors and form completion. SAMF completion was timely for most patients however, sections important for determining support actions remained largely incomplete, suggesting patients’ nicotine withdrawal is not being adequately addressed. More work is needed to improve inpatient staff’s assessment to ensure optimal care.
Publisher: Springer Science and Business Media LLC
Date: 22-05-2019
Publisher: Wiley
Date: 30-11-2020
DOI: 10.1111/JPM.12714
Abstract: Internationally, stigma towards people with mental illness has reduced due to greater understanding, education and advocacy in the community, and more focus on recovery‐oriented care within practice guidelines. However, many people with a diagnosis of BPD continue to experience stigma and difficulty accessing health services. Contributing factors include lack of understanding of BPD and effective management by health professionals, stigma from the general population and within healthcare services, and financial and geographical barriers. Mental health nurses comprise a large part of the healthcare workforce responsible for the day‐to‐day care of people diagnosed with BPD. This paper investigates how Australian consumer perspectives on BPD management have changed over time. Comments from a large survey, delivered to consumers in 2011 ( N = 153) and 2017 ( N = 424), were analysed for common themes. Themes were broadly related to NHMRC BPD Guidelines sections released in 2013. These data sets therefore present an opportunity to evaluate changes in consumer perspectives pre‐ and post‐Guideline release. Although no direct causal relationship can be drawn, analysing these changes can potentially assist with understanding the impact of the Guidelines in practice. No such analysis of the Australian Guidelines has been conducted to date in the existing literature. Many people diagnosed with BPD continue to experience stigma, barriers to treatment and difficulty accessing appropriate services. Widespread practical implementation of the Guidelines was not apparent however, improved general awareness and understanding of BPD from consumers and health professionals were evident. Improved education and practice across each and all aspects of the Guidelines are indicated. The Guidelines need review to ensure they are in‐line with current evidence‐based practice, as well as effective health professional education, support and funding to embed the revised Guidelines into practice. Internationally, many in iduals diagnosed with BPD continue to experience stigma within health care and are more likely to be viewed as manipulative and evoke negative responses from clinicians, compared with other mental health consumers. To understand Australian consumer perspectives regarding BPD management, and how these have changed between 2011 and 2017. To comment on how NHMRC BPD Guidelines, released 2013, are faring in practice. In iduals who identified a BPD diagnosis completed a 75‐question survey, delivered online Australia‐wide, in 2011 ( N = 153) and 2017 ( N = 424), providing comparative data sets to evaluate changes in consumer perspective on BPD management. Many people diagnosed with BPD experience difficulties when seeking help, stigma within health services and barriers to treatment. Improved general awareness, communication and understanding of BPD from consumers and health professionals were evident. Consumers demonstrated increased BPD‐literacy and help‐seeking behaviours in 2017, providing opportunity for health professionals to build stronger therapeutic relationships. Widespread practical implementation of the Guidelines does not appear to have been achieved. More health professional education, updated Guidelines, funding and strategies to embed these Guidelines into practice are needed. Mental health nurses regularly provide care to people diagnosed with BPD with practical education and support, they and other health professionals can improve their confidence in practice and provide better quality care to consumers.
Publisher: Elsevier BV
Date: 08-2011
DOI: 10.1016/J.NEDT.2010.09.008
Abstract: Nurses and other health professionals are required to demonstrate broad levels of expertise and service to ensure quality patient-centred health care. Interprofessional practice aligned with interprofessional education (IPE) has been promoted as a vehicle to promote broad levels of expertise. However, challenges remain for universities and other higher education institutions to successfully provide IPE opportunities for students. This paper presents perceptions of academic staff towards IPE from one Australian multi-c us health faculty. Perceptions were collected using interviews and two workshops. Findings are themed under the categories of faculty barriers, industry challenges and future opportunities. The perceptions of one health faculty regarding the fundamental factors required for IPE success were executive leadership of IPE, a supportive funding framework and an IPE based curricula. Nursing education can play a key role in embracing and leading future IPE approaches given that nurses are the numerically dominant health professional group and work collaboratively with other professionals to deliver patient-centred care.
Publisher: Springer Science and Business Media LLC
Date: 03-01-2019
Publisher: InTech
Date: 16-01-2013
DOI: 10.5772/46217
Publisher: MDPI AG
Date: 10-09-2013
Publisher: CSIRO Publishing
Date: 2010
DOI: 10.1071/PY09070
Abstract: Organisational change aimed at service improvement continues to be a challenging process for many health services, managers and teams. Current imperatives to develop service models responsive to the growing demands of chronic conditions on health systems suggest that reflection on core change principles is warranted. Dominant themes for progress in embedding chronic condition self-management (CCSM) support into practice settings arose from content analyses of case studies from health professionals who have attempted to implement CCSM support into their health services after undertaking specific training (The Flinders Program of CCSM). This included in-depth interviews with 10 trainers accredited to deliver training in this CCSM care planning approach to the workforce, formal reflections from 47 postgraduate students (currently in the health workforce) enrolled in a dedicated CCSM program at Flinders University and a consensus forum with accredited trainers. Emergent themes were then considered in the context of existing organisational change and CCSM literature. Long understood principles of effective change management continue to be important, including leadership support, clear vision, team cohesion, effective people management and shared values. However, interdependence of these and other factors seems to be most important. Organisational change that builds capacity for CCSM support is possible, given a clearer understanding of where efforts will have the most positive impact on change.
Publisher: MDPI AG
Date: 03-02-2018
Publisher: MDPI AG
Date: 10-08-2019
Abstract: Background: Our understanding of gambling relapse is limited despite the damaging consequences affecting many aspects of the gambler’s life. Paradoxically, regardless of these negative consequences problem gamblers (PGs) continue to relapse, seemingly unable to stop this cycle of harm. This paper addresses the phenomenon of repeated gambling relapse shedding some insights into why gamblers continue to relapse. Methods: The study comprised of (n = 54) participants purposefully selected who participated in either 1 of 5 focus groups (n = 35) or in-depth interviews (n = 19). The new knowledge obtained was from PGs, significant others, and workers with direct experience of gambling relapse. Interview recordings were analysed using thematic, textual analysis. Results: The avoidance of negative emotions from the consequences of the destructive behaviour associated with repeated relapse leads to a hopeless “merry-go-round”. Once on this “merry go round”, relapse becomes a habitual way of life where behaviour change and learning from the devastation of a gambling relapse is challenging. Exiting this cycle means PGs must face the consequences of their gambling which for many is overwhelming, and relapse is a way to avoid despair. Conclusions: These findings provide insights into relapse which has implications for gamblers seeking treatment, assessment and treatment “drop-outs”.
Publisher: Springer Science and Business Media LLC
Date: 18-07-2017
DOI: 10.1007/S11136-016-1368-5
Abstract: To evaluate the factor structure of the revised Partners in Health (PIH) scale for measuring chronic condition self-management in a representative s le from the Australian community. A series of consultations between clinical groups underpinned the revision of the PIH. The factors in the revised instrument were proposed to be: knowledge of illness and treatment, patient-health professional partnership, recognition and management of symptoms and coping with chronic illness. Participants (N = 904) reporting having a chronic illness completed the revised 12-item scale. Two a priori models, the 4-factor and bi-factor models were then evaluated using Bayesian confirmatory factor analysis (BCFA). Final model selection was established on model complexity, posterior predictive p values and deviance information criterion. Both 4-factor and bi-factor BCFA models with small informative priors for cross-loadings provided an acceptable fit with the data. The 4-factor model was shown to provide a better and more parsimonious fit with the observed data in terms of substantive theory. McDonald's omega coefficients indicated that the reliability of subscale raw scores was mostly in the acceptable range. The findings showed that the PIH scale is a relevant and structurally valid instrument for measuring chronic condition self-management in an Australian community. The PIH scale may help health professionals to introduce the concept of self-management to their patients and provide assessment of areas of self-management. A limitation is the narrow range of validated PIH measurement properties to date. Further research is needed to evaluate other important properties such as test-retest reliability, responsiveness over time and content validity.
Publisher: Wiley
Date: 21-07-2019
DOI: 10.1111/JAN.14124
Abstract: To determine if the Partners in Health scale, pertinent to assessing patient chronic condition self-management, operates equivalently for men and women. There are distinct gender-based differences in self-management behaviours and health perceptions. This may introduce non-invariance in self-report measures. Testing of measurement invariance is a recommended practice in nursing science to ensure robust metrics. A representative cross-sectional population survey in South Australian. In 2014, 940 people responded to the South Australian Health Omnibus Survey, a battery of health-related questions. MI and estimation of heterogeneity was tested using Bayesian confirmatory factor analysis. Findings showed self-management constructs were interpreted equivalently between men and women. Observed population heterogeneity associated lower education levels with poorer illness and treatment knowledge, smokers with poorer treatment partnerships and mental health problems with lower coping capacity. Approximate measurement invariance was achieved between men and women for Partners in Health scale. There is a lack of well-validated generic instruments, including investigation into gender variability, for measuring chronic condition self-management behaviours. Lower education levels were found to connect with poorer knowledge of health condition and treatment. Mental health problems attenuated ability to cope with the effect of the condition. Findings can facilitate the development of better tailored interventions for self-management of patients' chronic condition/s.
Publisher: SAGE Publications
Date: 2008
DOI: 10.1080/10398560701851976
Abstract: Objective: The aim of this paper is to describe the introduction, trial and termination of a smoke-free policy in an acute mental health unit of a regional hospital, and to consider factors that may contribute to the success of such policies in other settings. Methods: This analysis is based on key informant interviews and review of correspondence related to the trial, and examination of the relevant incident-reporting database. Results: Planning for implementation is described. The trial itself was terminated after 6 weeks due to perceived increases in aggression by patients towards staff working in the high dependency unit. Staff perceived that these episodes were directly related to these patients not being allowed to smoke. While there was an increase in events during the trial relating to two seriously ill in iduals, examination of formal incident reports over a period of 2 years suggests little change in the overall number of incidents. Conclusions: Despite clear public health benefits, implementation of a smoke-free policy may have untoward behavioural effects in institutional mental health settings. In addition, staff expectations and perceptions are critical. Salient factors appear to be preparation of staff and patients, appropriate training, avoidance of exceptions and inconsistency, considering alternatives to smoking to fill the gap created by the policy, and a culture of critical evaluation in practice. Such processes will facilitate understanding and cooperation so that mental health services are able to participate in important policy processes with implications for the health of patients and staff.
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/AH17099
Abstract: Objective The study aimed to determine the impact of the Flinders Chronic Condition Management Program for chronic condition self-management care planning and how to improve its use with Bendigo Health’s Hospital Admission Risk Program (HARP). Methods A retrospective analysis of hospital admission data collected by Bendigo Health from July 2012 to September 2013 was undertaken. Length of stay during admission and total contacts post-discharge by hospital staff for 253 patients with 644 admissions were considered as outcome variables. For statistical modelling we used the generalised linear model. Results The combination of the HARP and Flinders Program was able to achieve significant reductions in hospital admissions and non-significant reduction in emergency department presentations and length of stay. The generalised linear model predicted that vulnerable patient groups such as those with heart disease (P = 0.037) and complex needs (P 0.001) received more post-discharge contacts by HARP staff than those suffering from diabetes, renal conditions and psychosocial needs when they lived alone. Similarly, respiratory (P 0.001), heart disease (P = 0.015) and complex needs (P = 0.050) patients had more contacts, with an increased number of episodes than those suffering from diabetes, renal conditions and psychosocial needs. Conclusion The Flinders Program appeared to have significant positive impacts on HARP patients that could be more effective if high-risk groups, such as respiratory patients with no carers and respiratory and heart disease patients aged 0–65, had received more targeted care. What is known about the topic? Chronic conditions are common causes of premature death and disability in Australia. Besides mental and physical impacts at the in idual level, chronic conditions are strongly linked to high costs and health service utilisation. Hospital avoidance programs such as HARP can better manage chronic conditions through a greater focus on coordination and integration of care across primary care and hospital systems. In support of HARP, self-management interventions such as the Flinders Program aim to help in iduals better manage their medical treatment and cope with the impact of the condition on their physical and mental wellbeing and thus reduce health services utilisation. What does this paper add? This paper sheds light on which patients might be more or less likely to benefit from the combination of the HARP and Flinders Program, with regard to their impact on reductions in hospital admissions, emergency department presentations and length of stay. This study also sheds light on how the Flinders Program could be better targeted towards and implemented among high-need and high-cost patients to lessen chronic disease burden on Australia’s health system. What are the implications for practitioners? Programs targeting vulnerable populations and applying evidence-based chronic condition management and self-management support achieve significant reductions in potentially avoidable hospitalisation and emergency department presentation rates, though sex, type of chronic condition and living situation appear to matter. Benefits might also accrue from the combination of contextual factors (such as the Flinders Program, supportive service management, clinical ch ions in the team) that work synergistically.
Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/AH19156
Abstract: ObjectiveThe aim of this study was to describe the current state of carer engagement and partnership in two mental health (MH) services in South Australia and the implementation of the six partnership standards in A Practical Guide to Working with Carers of People with a Mental Illness. MethodsAnonymous surveys of carer experiences and clinician self-ratings of their own practice against the six partnership standards were completed by 94 staff and 58 carers within public and private MH in-patient units before and after exposure of clinicians to education about the partnership standards. Descriptive statistical analysis was performed and, where applicable, a comparative analysis used the two-s le Z-test of proportions. Qualitative data was analysed thematically. ResultsConsiderable gaps were evident between carer experiences and clinician self-ratings of their own practice. Overall, the surveys point to the lack of a consistent approach by both public and private services, and suggest potential barriers to fostering carer participation and engagement. Confidentiality was a particularly noted barrier to partnership with carers. ConclusionSignificant improvement is needed to meet the partnership standards. Brief exposure to the Guide is not, in itself, sufficient to effect change in the overall attitudes, skills and knowledge of clinical staff about engaging carers. Significantly more focus on staff education, clinical discussions and supervision is needed to meet the MH carer partnership standards. What is known about the topic?Partnership with MH consumers and carers is an established key principle within national MH policies and accreditation standards. Family carers play an important role in supporting consumers’ recovery, yet many carers continue to report being excluded, particularly by in-patient clinical staff. What does this paper add?This is the first study to investigate the partnership standards in practice by comparing the perspectives of carers and in-patient MH clinical staff. What are the implications for practitioners?Improving partnership with carers of people with mental illness will require significant MH service leadership support shifts in current practice and culture. In addition, a more nuanced understanding of confidentiality is required to overcome the barriers to involving family carers more meaningfully in care.
Publisher: Wiley
Date: 25-02-2021
DOI: 10.1111/JAN.14801
Abstract: To assess what is known about the effectiveness of face‐to‐face self‐management programmes designed specifically for adolescents (10–19 years) with a chronic illness. A systematic review and synthesis without meta‐analysis (SWiM). Six international web‐based reference libraries were searched with a date range of 1946 to July 2020. The PRISMA statement and SWiM guideline were used for reporting the methods and results. The PICO format was used to develop a focused clinical question and the eligibility criteria of our review. Quality assessment of the included studies was performed using the Cochrane Effective Practice Organisation of Care criteria. Eight studies (four randomized controlled trials and four descriptive designs) met the inclusion criteria and were published between 2003 and 2017. Results of the review: Three studies demonstrated measures of illness control which showed initial improvements in adherence as a result of the interventions but failed to demonstrate sustained adherence over time. Booster sessions were identified as an effective strategy to improve adherence, but were often omitted. There is a limited body of evidence on the effectiveness of self‐management programmes specifically developed for adolescents with a chronic illness, an important but under researched area. Future research lies in the development of more rigorous studies that focus on quantitative outcome measures for evaluating the effectiveness of self‐management programmes to guide the development of future programmes. It is crucial for adolescents with a chronic illness to develop independence and the self‐management skills required to effectively manage their chronic condition as they transition to adulthood. On current evidence, in planning future self‐management interventions should include booster sessions. Nurses with additional training and experience have a key role in supporting adolescents with a chronic illness to develop self‐management skills as they assume responsibility for their own healthcare.
Publisher: Springer Science and Business Media LLC
Date: 30-01-2014
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/PY15089
Abstract: Involving consumers in research enhances its quality and appropriateness, and is required within many research funding schemes. While the rationale for consumer involvement is understood, its implementation is unclear. The researcher investigated views of a group of Australia’s leading researchers (n=38) about the role of consumers in their research using a brief survey administered at the Australia National Health and Medical Research (NHMRC) Translation Conference in 2014. Interpretive content analysis was used for data analysis. Respondents noted the importance of consumer involvement in the planning and design of research, to ensure its relevance to the community as end-users of research outcomes. Therefore, consumers were seen as central to research translation by the respondents. Many respondents perceived empathy for the experiences of others as a fundamental researcher skill. Despite strong acknowledgement of the benefits of consumer involvement in research, gaps exist between the rhetoric and practice of consumer involvement beyond consultative roles. Power over decisions made about research processes and ownership of research are continuing barriers to greater consumer involvement in research. Structural changes to how research is funded, evaluated and reported provide a means of addressing these gaps. NHMRC leadership is needed to promote these changes.
Publisher: Springer Science and Business Media LLC
Date: 05-10-2022
DOI: 10.1186/S13063-022-06740-9
Abstract: Self-management support is increasingly viewed as an integral part of chronic condition management in adolescence. It is well recognized that markers of chronic illness control deteriorate during adolescence. Due to the increasing prevalence of long-term chronic health conditions in childhood and improved survival rates of previously life-limiting conditions in children and adolescents, significant numbers of adolescents are having to manage their chronic condition effectively as they transition to adult health care. Therapy adherence has been identified as a major challenge for young people living with a chronic condition such as cystic fibrosis, diabetes, or asthma requiring long-term pharmacological therapy and/or lifestyle modifications. Most systematic reviews on self-management interventions address adult populations. Very few intervention studies are directed at adolescents with a chronic condition who are transitioning to adult health services. This protocol describes a prospective randomized controlled trial of a standardized self-management intervention program delivered to adolescents aged 15–18 years prior to their transfer to adult care. This study has been designed to provide evidence regarding self-management programs for adolescents and is the first study to use the Flinders Program with this important, under-researched age group. A randomized controlled trial is used to investigate the effectiveness of a modified adolescent-friendly version of an adult self-management program. This program is directed at improving self-management in an adolescent cohort 15–18 years of age with a chronic condition being treated in a specialist pediatric hospital. Participants will be randomized to either usual care or the modified Flinders Program plus usual care. Data collection will include measures of specific illness control, unscheduled hospital admissions, and questionnaires to record self-management competencies, quality of life, self-efficacy, and outcome measures specific to the chronic condition at baseline, 3 months, 6 months, and 12 months after delivery. This study will provide a better understanding of the elements required for effective self-management programs in adolescents with a chronic condition and address some important knowledge gaps in current literature. The study will be carried out in collaboration with the Discipline of Behavioural Health at Flinders University, Adelaide, Australia, in order to inform the development of an adolescent version of the successful and validated Flinders Program™. Australian and New Zealand Clinical Trials Registry (ACTRN12621000390886). Registered on April 8, 2021.
Publisher: Copernicus GmbH
Date: 22-08-2019
Abstract: Abstract. The penultimate deglaciation (PDG, ∼138–128 thousand years before present, hereafter ka) is the transition from the penultimate glacial maximum (PGM) to the Last Interglacial (LIG, ∼129–116 ka). The LIG stands out as one of the warmest interglacials of the last 800 000 years (hereafter kyr), with high-latitude temperature warmer than today and global sea level likely higher by at least 6 m. Considering the transient nature of the Earth system, the LIG climate and ice-sheet evolution were certainly influenced by the changes occurring during the penultimate deglaciation. It is thus important to investigate, with coupled atmosphere–ocean general circulation models (AOGCMs), the climate and environmental response to the large changes in boundary conditions (i.e. orbital configuration, atmospheric greenhouse gas concentrations, ice-sheet geometry and associated meltwater fluxes) occurring during the penultimate deglaciation. A deglaciation working group has recently been set up as part of the Paleoclimate Modelling Intercomparison Project (PMIP) phase 4, with a protocol to perform transient simulations of the last deglaciation (19–11 ka although the protocol covers 26–0 ka). Similar to the last deglaciation, the disintegration of continental ice sheets during the penultimate deglaciation led to significant changes in the oceanic circulation during Heinrich Stadial 11 (∼136–129 ka). However, the two deglaciations bear significant differences in magnitude and temporal evolution of climate and environmental changes. Here, as part of the Past Global Changes (PAGES)-PMIP working group on Quaternary interglacials (QUIGS), we propose a protocol to perform transient simulations of the penultimate deglaciation under the auspices of PMIP4. This design includes time-varying changes in orbital forcing, greenhouse gas concentrations, continental ice sheets as well as freshwater input from the disintegration of continental ice sheets. This experiment is designed for AOGCMs to assess the coupled response of the climate system to all forcings. Additional sensitivity experiments are proposed to evaluate the response to each forcing. Finally, a selection of paleo-records representing different parts of the climate system is presented, providing an appropriate benchmark for upcoming model–data comparisons across the penultimate deglaciation.
Publisher: Elsevier BV
Date: 04-2023
Publisher: University of Toronto Press Inc. (UTPress)
Date: 08-2020
Abstract: Introduction: Social support, particularly support from an intimate partner, is both a significant protective factor for trauma-exposed Veterans and critical for recovery in mental health, yet we know little about the experiences and support needs of their partners, particularly in the Australian context. This study examined the multidimensional nature of experiences of being an intimate partner of a contemporary Veteran with posttraumatic stress disorder (PTSD). Methods: The authors used a qualitative phenomenological approach to conduct an inductive thematic analysis of data collected through in idual interviews with a purposive s le of 10 partners of contemporary Veterans living in Australia. Interviewees were recruited through a range of community support organizations. Results: Analysis revealed intimate partners are crucial participants in supporting the recovery journey for traumatized Veterans, effectively managing day-to-day care, encouraging autonomy and instilling hope. However, descriptions highlighted that lack of understanding of partners’ daily lives, and particularly their commitment to maintaining their intimate relationship, by health care providers and government results in a sense of invisibility and is the key barrier to receiving the support they need in order to support recovery in their Veteran partners. Discussion: The findings underscore the importance of recognizing the role of intimate relationships in trauma recovery and of responding to the support needs of intimate partners. In particular, the findings have clear implications for improving the engagement by health care providers of partners of Veterans with PTSD in Veteran clinical treatment. More formal recognition of the indirect impact of PTSD on partners of Veterans is also needed within organizational policies and procedures. Finally, there is clearly a need for continuing education of health care providers, government staff and the general community about the nature of PTSD and its impacts on relationships, particularly the intimate type.
Publisher: MDPI AG
Date: 19-07-2020
Abstract: (1) Background: Financial harms associated with problem gambling are substantial and result in suicidal ideation, depression, anxiety and relationship damage, causing distress for problem gamblers and their families. This paper examines Electronic Gaming Machine gamblers’ frantic use of credit during episodes of gambling as a substantial public health burden. (2) Methods: This qualitative study comprised 29 participants purposefully selected who participated in either focus groups or in-depth interviews, which were analysed using thematic, textual analysis. (3) Results: Ready access to credit in the gambling venues enabled problem gamblers to engage in desperate credit transactions to continue to gamble. Many showed frantic, repeated patterns of e-credit withdrawal, which may be typical of gambling while “in the zone”, when it is highly likely that the gamblers are not able to make informed decisions about the use of credit. This pattern of the electronic withdrawal of cash may well be recognisable electronically by financial institutions in real-time, as part of a duty of care potentially owed by banks to their customers. It would provide an opportunity for the identification of people at financial risk due to gambling and systemic intervention to limit the financial harm at a time when financial decision-making is impaired. (4) Conclusions: Although this finding needs further confirmation, there are significant implications for harm minimisation and early intervention for affected PGs. It also raises the issue of the ‘duty of care’ owed to PG customers by financial institutions.
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/AH13200
Abstract: Objective To evaluate the impact of implementing a smoke-free policy in an Australian high-security forensic psychiatry in-patient hospital. Methods Focus groups (n = 21) and surveys with both patients (n = 45) and staff (n = 111 53.2% nurses) elicited participants’ experience of and attitudes towards an introduced smoke-free policy. A follow-up survey elicited the impact of the policy on 15 patients’ smoking practice after discharge. Results Eighty-five per cent of patients stated it was easier to quit smoking when no one else smoked. Over half the discharged patients surveyed (58%) continued to not smoke after discharge, despite almost half the staff (41%) perceiving that patients were unlikely to quit long-term. Smoking staff were significantly more pessimistic than non-smoking staff. Many patients (69%) perceived that their health had improved as a result of not smoking. Most staff (80%) viewed nicotine dependence treatment as important, but fewer (66%) felt confident to support patients to stop smoking. Increased patient violence and management difficulties expected by staff were not realised. Conclusions A smoke-free policy can be successfully implemented in forensic psychiatry in-patient units. Nursing staff are a large and important group who need particular support to implement a smoke-free policy into practice effectively, particularly those who are smokers. Continuity of care as part of a coordinated policy and service response is needed. What is known about the topic? Healthcare settings are increasingly going totally smoke free, with mental health facilities the slowest to implement these policy changes. This is due, in part, to the fear of possible increases in violence and aggression among a patient population who have a high prevalence of smoking. What does this paper add? This paper adds to the evidence base that implementing a smoke-free policy in mental health in-patient hospitals is not only feasible, but also has substantial benefits for both staff and patients. In particular, it highlights the policy and practice implications that can assist mental health facilities to go smoke free. What are the implications for practitioners? A smoke-free policy can be successfully implemented in forensic psychiatry in-patient units however, more support and education for staff is needed to increase their confidence and capacity to implement the policy consistently across service domains.
Publisher: Public Library of Science (PLoS)
Date: 23-10-2019
Publisher: Informa UK Limited
Date: 12-03-2019
DOI: 10.1080/09638237.2019.1581337
Abstract: People with borderline personality disorder (BPD) experience significant stigma, particularly at the interface of care delivery. To compare and contrast what stigma looks like within mental health care contexts, from the perspective of patients and mental health professionals (MHPs) and how it is perpetuated at the interface of care. A review of the literature was undertaken to compare the experiences of stigma towards BPD from the patient and MHP perspective by thematically analysing the results from empirical studies exploring their experiences. Thirty studies were found 12 on patients perspectives and 18 on clinicians perspectives. Six themes arose from the thematic synthesis: (1) stigma related to diagnosis and disclosure (2) perceived un-treatability (3) stigma as a response to feeling powerless (4) stigma due to preconceptions of patients (5) low BPD health literacy and (6) overcoming stigma through enhanced empathy. A conceptual framework for explaining the perpetuation of stigma and BPD is proposed. Stigma towards people with BPD is perpetuated through poor BPD health literacy by patients and MHPs that stalls effective treatment and engagement, and disempowers all concerned, deferring responsibility to others. Addressing this stigma requires multiple strategies that include more targeted education, advocacy and leadership.
Publisher: Informa UK Limited
Date: 06-10-2022
DOI: 10.1080/15622975.2022.2112074
Abstract: The primary objectives of these international guidelines were to provide a global audience of clinicians with (a) a series of evidence-based recommendations for the provision of lifestyle-based mental health care in clinical practice for adults with Major Depressive Disorder (MDD) and (b) a series of implementation considerations that may be applicable across a range of settings. Recommendations and associated evidence-based gradings were based on a series of systematic literature searches of published research as well as the clinical expertise of taskforce members. The focus of the guidelines was eight lifestyle domains: physical activity and exercise, smoking cessation, work-directed interventions, mindfulness-based and stress management therapies, diet, sleep, loneliness and social support, and green space interaction. The following electronic bibliographic databases were searched for articles published prior to June 2020: PubMed, EMBASE, The Cochrane Library (Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Methodology Register), CINAHL, PsycINFO. Evidence grading was based on the level of evidence specific to MDD and risk of bias, in accordance with the World Federation of Societies for Biological Psychiatry criteria. Nine recommendations were formed. The recommendations with the highest ratings to improve MDD were the use of physical activity and exercise, relaxation techniques, work-directed interventions, sleep, and mindfulness-based therapies (Grade 2). Interventions related to diet and green space were recommended, but with a lower strength of evidence (Grade 3). Recommendations regarding smoking cessation and loneliness and social support were based on expert opinion. Key implementation considerations included the need for input from allied health professionals and support networks to implement this type of approach, the importance of partnering such recommendations with behaviour change support, and the need to deliver interventions using a biopsychosocial-cultural framework. Lifestyle-based interventions are recommended as a foundational component of mental health care in clinical practice for adults with Major Depressive Disorder, where other evidence-based therapies can be added or used in combination. The findings and recommendations of these guidelines support the need for further research to address existing gaps in efficacy and implementation research, especially for emerging lifestyle-based approaches (e.g. green space, loneliness and social support interventions) where data are limited. Further work is also needed to develop innovative approaches for delivery and models of care, and to support the training of health professionals regarding lifestyle-based mental health care.
Publisher: SAGE Publications
Date: 2007
Abstract: Background: Less than optimal outcomes and escalating costs for chronic conditions including mental illness have prompted calls for innovative approaches to chronic illness management. Aims: This study aimed to test the feasibility and utility of combining a generic, clinician administered and peer-led self-management group approach for people with serious mental illness. Method: General practitioners and mental health case managers used a patient centred care model (the Flinders model) to assist 38 patients with serious mental illness to identify their self-management needs, and match these with interventions including Stanford peer-led, self-management groups and one-to-one peer support. Self-management and quality of life outcomes were measured and qualitative evaluation elicited feedback from all participants. Results: Collaborative care planning, combined with a problems and goals focused approach, resulted in improved self-management and mental functioning at 3 to 6 months follow-up. The Stanford self-management course was applicable and acceptable to patients with serious mental illnesses. Qualitative feedback was highly supportive of this approach. Conclusions: Generic, structured assessment and care planning approaches, resulting in self-management education targeted to the in idual, improved self-management and quality of life. Patients and service providers reported considerable gains despite the challenges associated with introducing a generic model within the mental health and general practice sector.
Publisher: Informa UK Limited
Date: 07-03-2021
Publisher: SAGE Publications
Date: 08-2019
Abstract: Although the negative effects of problem gambling (PG) are well-documented in respect of gamblers themselves, less research has focused on the experiences of their partners, particularly in situations where the gambler is not help-seeking. Data were drawn from 15 in-depth interviews of partners living with a non-help-seeking problem gambler. Through a hermeneutical-phenomenological analysis, nine central themes emerged: social activity, realization, role conflict, stigma, denial, health issues, disconnectedness, hypervigilance, and security. Findings indicated that living with a non-help-seeking PG partner was characterized by chronic worry, exhaustion, relationship conflict, and an overwhelming sense of isolation. Partners found it exceedingly difficult to reliably detect their partners’ gambling behavior, resulting in chronic hypervigilance, and were reluctant to seek help due to stigma. There is a need for programs that provide both guidance for partners to help protect their well-being and evidence-based strategies to help motivate non-help-seeking problem gamblers to acknowledge their problem and seek help.
Publisher: CSIRO Publishing
Date: 2013
DOI: 10.1071/PY13033
Abstract: Practice nurses in Australia are now funded to facilitate chronic condition management, including self-management support. Chronic disease management requires an established rapport, support and proactivity between general practitioners, patients and the practice nurses. To achieve this, training in shared decision making is needed. e-Learning supports delivery and achievement of such policy outcomes, service improvements and skill development. However, e-learning effectiveness for health care professionals’ is determined by several organisational, economic, pedagogical and in idual factors, with positive e-learning experience linked closely to various supports. This paper reinforces previous studies showing nurses’ expanding role across general practice teams and reports on some of the challenges of e-learning. Merely providing practice nurses with necessary information via web-based learning systems does not ensure successful learning or progress toward improving health outcomes for patients.
Publisher: SAGE Publications
Date: 20-02-2018
Abstract: The aim of this study was to report on a half-day multi-stakeholder symposium on community treatment orders (CTOs) hosted by the Melbourne Social Equity Institute (MSEI), which identified research gaps and opportunities, and produced an agreed agenda for future CTO research. The MSEI convened a symposium for 22 experts in CTO research to discuss research priorities in this field in Australasia. An independent moderator elicited views and recommendations and produced a report detailing possible research projects. Research on CTOs is contentious and there is a need to gather and examine information regarding both their use and utility. Due to the complexities involved, it was agreed that research should be undertaken in partnership with persons with had lived experience of mental health problems, clinicians, policymakers and other interdisciplinary stakeholders. Five key areas for future investigation were identified. The issues and recommendations arising from the symposium should shape the scope, nature and conduct of future research directions in the field.
Publisher: Springer Science and Business Media LLC
Date: 10-10-2016
Publisher: Springer Science and Business Media LLC
Date: 11-12-2019
DOI: 10.1007/S00520-019-05218-W
Abstract: Comorbidity in breast cancer patients impacts treatment choice, toxicity, and outcomes. While comorbidity measurement tools are frequently used by researchers, little is known about their use in clinical practice. The aim of this review was to examine the use of comorbidity measurement tools in clinical practice and their role in treatment decision-making in breast cancer. Six electronic databases were searched from inception to 21 March 2019. Quantitative or mixed methods studies addressing primary treatment of breast cancer and identifying a comorbidity measurement tool used in clinical practice treatment decision-making were included. Data was extracted on tool utilized, impact on treatment decisions or outcomes, pattern of use, and psychometric properties. A systematic search of literature yielded 752 studies. Of the four studies that met inclusion criteria, each utilized a comprehensive geriatric assessment tool, though only in a subset of patients. No studies found direct comorbidity measurement tools utilized independently of geriatric assessment. Assessment results had variable impact on treatment decisions. Impacts on patient mortality and treatment toxicity, cost-effectiveness, and psychometric characteristics of the tools were not identified. There is little evidence on use of specific comorbidity tools in clinical decision-making in breast cancer outside of comorbidity assessment as part of geriatric assessment tools. There was limited impact on decision-making or patient outcomes when these were utilized. Further research is needed to identify barriers to comorbidity assessment in clinical practice and identify comorbidity tools that have the potential to improve patient outcomes.
Publisher: Frontiers Media SA
Date: 20-05-2019
Publisher: MDPI AG
Date: 07-03-2022
Abstract: Preventive care to address chronic disease risk behaviours is infrequently provided by community mental health services. In this cluster-randomised controlled trial, 12 community mental health services in 3 Local Health Districts in New South Wales, Australia, will be randomised to either an intervention group (implementing a new model of providing preventive care) or a control group (usual care). The model of care comprises three components: (1) a dedicated ‘healthy choices’ consultation offered by a ‘healthy choices’ clinician (2) embedding information regarding risk factors into clients’ care plans and (3) the continuation of preventive care by mental health clinicians in ongoing consultations. Evidence-based implementation strategies will support the model implementation, which will be tailored by being co-developed with service managers and clinicians. The primary outcomes are client-reported receipt of: (1) an assessment of chronic disease risks (tobacco smoking, inadequate fruit and vegetable consumption, harmful alcohol use and physical inactivity) (2) brief advice regarding relevant risk behaviours and (3) referral to at least one behaviour change support. Resources to develop and implement the intervention will be captured to enable an assessment of cost effectiveness and affordability. The findings will inform the development of future service delivery initiatives to achieve guideline- and policy-concordant preventive care delivery.
Publisher: Oxford University Press (OUP)
Date: 23-08-2020
Publisher: Springer Science and Business Media LLC
Date: 19-09-2020
Publisher: Informa UK Limited
Date: 02-2011
DOI: 10.2147/PPA.S17822
Publisher: Wiley
Date: 08-09-2019
DOI: 10.1111/NHS.12637
Abstract: Recovery colleges are formal learning programs that aim to support people with a lived experience of mental illness. In this study, we aimed to explore the experiences of participants in a pilot recovery college that opened in Adelaide, South Australia, in 2016. A qualitative exploratory study was conducted involving interviews with learners (n = 8) and focus groups with lived experience facilitators (course facilitators with a lived experience of mental illness, n = 5), Clinician facilitators (mental health service staff facilitators, n = 4), and care coordinators (staff providing case management support, n = 5). Three main themes (hope, identity, and the recovery college as a transition space) and two subthemes (recovery college experience and outcomes) were identified. The results showed that the recovery college provided a transition space for shifting learners' identities from patient to student, facilitated by the experiences and outcomes of the recovery college, providing hope for the future. This study highlights the importance of providing mentally healthy and non-stigmatizing learning environments to promote and cement recovery for people with a lived experience of mental illness.
Publisher: Wiley
Date: 28-12-2015
DOI: 10.1111/HEX.12327
Publisher: Computers, Materials and Continua (Tech Science Press)
Date: 20-10-2015
Publisher: SAGE Publications
Date: 23-09-2020
Abstract: To determine whether evidence-based practice guidelines promote developmentally appropriate chronic condition self-management for children with asthma, type 1 diabetes mellitus, and cystic fibrosis. Systematic review of clinical guidelines current as at 22 September 2017, including assessment of quality of each guideline using the iCAHE ‘Guideline Quality Checklist’, and mapping of the supporting evidence. Fifteen guidelines were identified: asthma ( n=7) and type 1 diabetes mellitus ( n=7), CF ( n=1). Guideline quality was variable, and 11 different grading systems were used. In total, there were 28 recommendations promoting age/developmental considerations. Recommendations focused on: collaboration ( n=15), chronic condition self-management education ( n= 17), clinicians’ skills ( n= 4) personalized action plans ( n=3), problem-solving ( n=2) and the assessment of children’s chronic condition self-management needs ( n=3). Developmental transitions are highlighted as important time points in some guidelines: preschool ( n=2), and adolescence ( n=3). All guidelines encouraged triadic partnerships between children, adult caregivers and clinicians. Evidence supporting the developmental aspects of the guidelines’ recommendations was poor only 14 out of 57 journals listed as evidence were concordant. Current guidelines articulate that developmentally appropriate chronic condition self-management is important however, more work needs to be done to translate the concept into practical clinical tools.
Publisher: MDPI AG
Date: 23-01-2020
Abstract: There have been significant changes in the gambling landscape particularly relating to gambling in the digital age. As the gambling landscape changes, regulation of gambling also needs to change. In 2018, the Office of Responsible Gambling in New South Wales, Australia, commissioned a gap analysis to inform their research objectives and priority focus areas. This included an identification of gaps in our understanding of emerging technologies and new trends in gambling. A gap analysis of the peer-reviewed literature published since 2015 was undertaken, identifying 116 articles. The main area of focus was Internet gambling, followed by articles exploring the relationship between video gaming and gambling, the expansion of the sports betting market, Electronic Gambling Machines characteristics and articles exploring new technologies and trends in advertising and inducements. Key gaps related to the need for more research in general, as well as research focusing on subpopulations such as those using different gambling formats, those with varying levels of problem gambling, and vulnerable populations. From a methods perspective, researchers saw the need for longitudinal studies, more qualitative research and improved outcome measures. The development and testing of a public health approach to addressing the harms associated with gambling in these areas is needed.
Publisher: University of Toronto Press Inc. (UTPress)
Date: 09-2019
Abstract: Introduction: Military service affects the health and well-being of both Veterans and their family members, with increasing recognition of the need for support to be provided to Veterans’ families. In 2017 the Australian Department of Veterans’ Affairs commissioned a rapid review of the literature to explore whether the delivery of support services to families of contemporary Veterans results in better outcomes for the Veteran. Methods: A systematic search of the peer-reviewed literature resulted in the extraction of 30 articles, reduced to 29 following quality assessment. We then produced a narrative synthesis of the articles. Results: All of the studies were undertaken in the United States (US). The majority ( n = 20) focused on couples/family therapy, in particular, to address post-traumatic stress disorder (PTSD) in Veterans. Discussion: The studies overall reported significant psychological and relational benefit for Veterans when families are supported. However, the ersity of approaches suggests that currently, no one approach suits all family situations. More work is needed to develop interventions that address the broader psychosocial needs of families, such as work commitments and childcare needs, and to evaluate how these might benefit Veterans.
Publisher: Cambridge University Press (CUP)
Date: 12-2011
Abstract: Introduction: Anxiety and depression in adolescence is prevalent but often unrecognised and untreated. This can lead to serious disorders in later life. This study explored how teachers recognise anxiety and depression in secondary school students and act on their concerns. Method: Twenty teachers from four secondary colleges in regional Victoria, Australia were interviewed regarding their experiences. In-depth interviews were analysed using descriptive thematic analysis in order to understand how teachers respond to this issue. Results: Teachers' recognition of mental health problems in students and the threshold for reporting their concerns was subjective and not based on any formal knowledge of how to identify anxiety or depression risk factors in students. Years of teaching experience was not associated with increased knowledge of mental health problems in students. Time pressures and lack of resources in student wellbeing teams were barriers to teachers reporting their concerns about students. Conclusion: Education bodies and teaching universities responsible for training teachers and providing ongoing professional learning need to ensure that mental health training is part of every teacher's core skill set, so that teachers can confidently promote mental wellbeing, identify emerging mental health problems, know how to facilitate access to more specialist intervention where required and contribute effectively to follow-up support.
Publisher: Informa UK Limited
Date: 12-10-2016
Publisher: Hindawi Limited
Date: 05-06-2022
DOI: 10.1111/HSC.13856
Abstract: The objective of this phenomenological study was to describe families' experiences of supporting veterans and emergency service first responders (ESFRs) (known also as public safety personnel) to seek help for a mental health problem. In-depth semi-structured open-ended interviews were undertaken with 25 family members of Australian veterans and ESFRs. Fourteen participants were family members of police officers. Data were analysed thematically. Participants described a long and difficult journey of supporting the person's help-seeking across six themes. Traumatic exposures, bullying in the workplace and lack of organisational support experienced by veterans/ESFRs caused significant family distress. Families played a vital role in help-seeking but were largely ignored by veteran/ESFR organisations. The research provides a rich understanding of distress and moral injury that is experienced not only by the service members but is transferred vicariously to their family within the mental health help-seeking journey. Veteran and ESFR organisations and mental health services need to shift from a predominant view of distress as located within an in idual (intrapsychic) towards a life-course view of distress as impacting families and which is more relational, systemic, cultural and contextual.
Publisher: Elsevier BV
Date: 10-2001
Publisher: Springer Science and Business Media LLC
Date: 27-11-2019
DOI: 10.1186/S12889-019-7939-Y
Abstract: Smoking prevalence remains inequitably high for lower SES (socioeconomic status) populations. The psychosocial interactive model of resilience theorises that resilience might be ‘switched on’ in order to support and/or maintain smoking cessation for these populations. This study aimed to develop a Resilience Intervention for Smoking Cessation (RISC) through reviewing the extant literature around efficacious interventions for smoking cessation. Deliberative democracy principles were then used to understand lay perspectives regarding this potential smoking cessation program. Public health databases were searched to find efficacious psycho-social resilience interventions in the peer-reviewed literature for smoking cessation amongst lower SES populations. Potential components for RISC were selected based on evidence within the literature for their effectiveness. We then employed the Nominal Group Technique (NGT) to create discussion and consensus on the most socially appropriate and feasible components from the perspective of smokers from low SES areas. The NGT included 16 people from a lower SES population in southern metropolitan Adelaide who indicated they were seriously contemplating quitting smoking or had recently quit. Data were collected from multiple Likert ratings and rankings of the interventions during the NGT workshop and analysed descriptively. The Wilcoxon signed-ranked test was used where appropriate. Qualitative data were collected from participant reflections and group discussion, and analysed thematically. Six smoking cessation interventions, likely to enhance resilience, were selected as potential constituents for RISC: mindfulness training setting realistic goals support groups smoke free environments mobile phone apps and motivational interviewing. Consensus indicated that mindfulness training and setting realistic goals were the most acceptable resilience enhancing interventions, based on perceived usefulness and feasibility. This research applied principles from deliberative democracy in order to illuminate lay knowledge regarding an appropriate and acceptable smoking cessation resilience program for a lower SES population. This process of collaborative and complex knowledge-generation is critically important to confront inequities as an ongoing challenge in public health, such as smoking cessation for disadvantaged groups. Further research should involve development and trial of this resilience program.
Publisher: Wiley
Date: 03-07-2014
DOI: 10.1111/JAN.12203
Abstract: To examine health worker-client interactions during care planning to understand processes that foster client empowerment and disempowerment. It is unclear how health worker-client exchanges and information sharing through chronic condition care planning currently operate in primary health care. Moreover, it is unclear how control in these exchanges either enhances collaborative decision-making, partnership and client empowerment, or works to create client disempowerment and dependency on workers and health services. Critical discourse analysis of qualitative data from ethnographic observations and audio-taped worker-client consultations. Multidisciplinary teams in two Australian community-based primary healthcare sites participated. This included nurses, general practitioners and allied health workers and their clients who had a chronic condition care plan. Nineteen worker-client consultations were observed/recorded in 2011. Control was expressed through multiple processes inherent in the worker role and in their interactions with clients. When workers exercised disproportionate control and clients relinquished their own control, client disempowerment and dependency were evident. Clients' attempts to gain control and workers' attempts to relinquish control alleviated clients' disempowerment and dependency. However, structural features of information sharing systems and workers' care planning behaviours diminished such efforts. Worker awareness of their communication style and the power of their role must improve for client chronic condition self-care management to be achieved. Training on the impacts of control in worker communication and systems where they work must be provided if unbeneficial forms of client dependency are to be overcome and true self-care management is to be realized.
Publisher: Springer Science and Business Media LLC
Date: 14-03-2023
DOI: 10.1007/S00520-023-07678-7
Abstract: Breast cancer survivors experience significant burden from comorbid chronic conditions, but little is known about how well these conditions are managed. We conducted a national survey of Australian breast cancer survivors to examine the burden of chronic conditions, their impact and care alignment with the principles of chronic condition management. A study-specific survey incorporated questions about chronic conditions using the Charlson Comorbidity Index (CCI), functional status using the Vulnerable Elders Survey (VES) and perceived quality of care for cancer and non-cancer conditions using the Patient Assessment of Care for Chronic Conditions Survey (PACIC). Members of Breast Cancer Network Australia (BCNA) were invited via email to complete the survey either online or through direct mail. The survey was sent to 2198 BCNA members and 177 responses were received (8.1%). Respondents were women aged 32–88 years (median 60.1 years). The majority were married (116 67.7%) and had private insurance (137 80.0%) and reported good to excellent health (119 73.5%). Other health conditions were reported by 157 (88.7%), the most common being chronic pain (27.1%) and fatigue (22.0%). When asked about management of comorbidities or cancer, less than 20% were routinely asked about management goals, helped to set goals or asked about health habits. In this population of survivors with good health status and high rates of private insurance, comorbidities were common and their management, as well as management of breast cancer, was poorly aligned with chronic condition management principles.
Publisher: BMJ
Date: 02-2020
DOI: 10.1136/BMJOPEN-2019-033080
Abstract: Motivating behavioural change during client consultations is of crucial importance across all health professions to address the growing burden of chronic conditions. Yet health professionals often lack the skills and confidence to use evidence-based counselling interventions to support clients’ behavioural change and mobilise clients’ resources and self-efficacy for change to address their long-term needs. This pre–post pilot study will develop a motivational interviewing (MI) virtual client training tool for health professionals and test the effectiveness of the educational content and usability of the virtual client interaction. Postgraduate students across a range of health disciplines will be recruited. Data assessing attitudes towards preventive healthcare will be collected using a modified version of the Preventive Medicine Attitudes and Activities Questionnaire. Conversations with the virtual client will be analysed using the Motivational Interviewing Treatment Integrity code to assess changes in MI skills. The System Usability Scale will be used to assess the usability of the virtual client training tool. This protocol was approved by the Flinders University Social and Behavioural Research Ethics Committee in May 2019. The results of the pilot study will inform the development of an avatar-based mobile application consisting of MI teaching and interactions with a generic virtual client that can be easily adapted to multiple scenarios.
Publisher: MDPI AG
Date: 06-12-2018
Abstract: The prevalence of people seeking care for Borderline Personality Disorder (BPD) in primary care is four to five times higher than in the general population. Therefore, general practitioners (GPs) are important sources of assessment, diagnosis, treatment, and care for these patients, as well as important providers of early intervention and long-term management for mental health and associated comorbidities. A thematic analysis of two focus groups with 12 GPs in South Australia (in discussion with 10 academic, clinical, and lived experience stakeholders) highlighted many challenges faced by GPs providing care to patients with BPD. Major themes were: (1) Challenges Surrounding Diagnosis of BPD (2) Comorbidities and Clinical Complexity (3) Difficulties with Patient Behaviour and the GP–Patient Relationship and (4) Finding and Navigating Systems for Support. Health service pathways for this high-risk/high-need patient group are dependent on the quality of care that GPs provide, which is dependent on GPs’ capacity to identify and understand BPD. GPs also need to be supported sufficiently in order to develop the skills that are necessary to provide effective care for BPD patients. Systemic barriers and healthcare policy, to the extent that they dictate the organisation of primary care, are prominent structural factors obstructing GPs’ attempts to address multiple comorbidities for patients with BPD. Several strategies are suggested to support GPs supporting patients with BPD.
Publisher: Springer Science and Business Media LLC
Date: 29-03-2014
Publisher: Springer Science and Business Media LLC
Date: 12-2017
Publisher: Cambridge University Press (CUP)
Date: 02-02-2017
Abstract: Objectives: To consider the strategies currently used by family care givers to manage challenging behaviour in the community following ABI, and to identify what supports are available that support family care givers in addressing this issue. Research design: Delphi study. Methods: Service providers (n = 8) and family care givers (n = 3) completed a three-round Delphi process with the aim of reaching consensus (75% agreement) regarding research objectives. Round 1 consisted of an open-ended questionnaire in which items were identified these items were then rated in Round 2 and 3 using a Likert scale. Statistical aggregation then allowed for quantitative analysis. Results: The findings suggest a number of behaviour management approaches are being used by family care givers, including basic antecedent strategies, agreeing with the person's demands, and medication. Consensus was reached that only two services in SA provide specific support to family care givers regarding behaviour management in the community: Families4Families Inc. (a peer support network) and Private Specialists (e.g., [neuro]psychologists and [neuro]psychiatrists). Conclusions: Findings emphasise the need for more specialised services specific to educating and supporting family care givers in the management of challenging behaviours following ABI. These services should be accessible, centralised, and easy for family care givers to navigate.
Publisher: JMIR Publications Inc.
Date: 28-01-2016
Publisher: SAGE Publications
Date: 2020
DOI: 10.33151/AJP.17.801
Abstract: Over the past decade there has been significant focus on the mental health and wellbeing of emergency service workers in Australia, evidenced by the 2018 Senate Inquiry into the role of Commonwealth, state and territory Governments in addressing the high rates of mental health conditions experienced by first responders, emergency service workers and volunteers. Call-takers as an occupational group within this domain are at risk of cumulative and vicarious trauma, yet there is little research on their work-related mental illness. This systematic thematic narative literature review of qualitative articles reports on the mental health and wellbeing of emergency call-takers. Both published peer review (2000–2018) and grey literature (2009–2018) that examined the impact of emergency work on call-takers was retrieved. Papers that focussed on call-takers’ psychological and psychosocial health were selected. Databases included Ovid Medline, CINAHL, Ovid EMcare, PsychInfo, Scopus as well as Google Scholar. Fourteen articles met the eligibility criteria five peer review and nine grey literature studies. Thematic analysis identified issues around surveillance versus lack of supervision role denial versus advocacy and failure to acknowledge vicarious trauma. Suggestions for improvement required recognition of the stressful nature of the work, improvements in workplace culture and the provision of support and counselling services. Workplace stressors for call-takers arise from their work in dealing with trauma related communication with the public as well workplace culture, particularly the response of management to issues such as shift work, poorly managed rosters and long hours of work with little time for recovery. Compounding these issues is the invisibility of call-taker work.
Publisher: Elsevier BV
Date: 2002
DOI: 10.1016/S0277-9536(01)00008-9
Abstract: This paper reports the findings of a study investigating the smoking behaviours of a community-based psychiatric population. Using a qualitative, grounded theory approach, the four diagnostic categories of schizophrenia, bi-polar affective disorder, depression, and personality disorder were studied (24 interviews in total) in order to identify similarities and differences in smoking behaviours and perceptions of links between illness and cigarette smoking. A number of theoretical constructs emerged from the data, many of which confirm and enhance current understandings of issues, such as the role of cigarettes in managing the symptoms of illness. However, several themes not found in the existing literature also emerged. Smoking was found to play a significant existential role in the lives of participants: alleviating the effects of stigma, promoting positive and negative freedoms, and providing core needs as part of quality of life decisions. Perceptions of the nature and degree of interaction between psychiatric symptoms and the 'need' to smoke were also found to be significant. Variations in smoking between the different diagnostic groups were also found, in particular in the process of smoking itself the nature of the nicotine dependence as predominantly physical or psychological, attitudes towards the quitting process and sense of control, and the degree of significance of existential factors. The research findings suggest that we may be able to add new methods to our current ways of intervening to assist people with a mental illness who want to quit smoking. Differences in perceptions and patterns of use suggest that intervention may be more effective if psychiatric diagnosis is also taken into consideration. Because the paper is descriptive and hypothesis generating, its findings need to be tested using a larger s le.
Publisher: Mark Allen Group
Date: 02-10-2018
DOI: 10.12968/IJTR.2018.25.10.538
Abstract: Families require more specialised support to manage behaviours of concern following acquired brain injury within community settings. Evidence supports the involvement of family caregivers in behaviour interventions, however there are no validated behaviour support approaches for in iduals with acquired brain injury emphasising family involvement. This research aims to (1) gain insight from rehabilitation professionals and family caregivers on best practice in behaviour support following acquired brain injury in community settings, and (2) obtain feedback on the proposed Family-directed Positive Behaviour Support Programme, which aims to enhance the capability of family caregivers in supporting behavioural changes in an in idual following acquired brain injury. Rehabilitation professionals (n=8) and family caregivers (n=3) completed a three-round Delphi study with the aim of reaching consensus (75% agreement) regarding research objectives. All items presented regarding best practice in supporting family caregivers with behaviour support reached consensus. Results were used to refine the content and format of delivery of the Family-directed Positive Behaviour Support programme. Findings suggest an agreement regarding what support is needed, yet this is still not being provided. The Delphi process has made significant contribution to the Family-directed Positive Behaviour Support programme, which aims to inform a family-directed approach to behaviour support following acquired brain injury in community settings.
Publisher: Cambridge University Press (CUP)
Date: 28-05-2013
DOI: 10.1017/JRC.2013.4
Abstract: This review aims to highlight how the chronic condition self-management support (CCSMS) field might inform and enhance the skills of the disability employment services (DES) workforce, particularly in its interactions with clients with complex disability needs. The approach we have taken involves a consideration of current education and training, recruitment of staff into DES and issues of concern arising from these processes. The main findings of our review are that the current DES workforce may not have the required skills to fully meet the needs of the populations they serve given the growing burden of chronic conditions, generally. We conclude by calling for greater consideration of CCSMS education and training as core required skills for the DES workforce, so that they might integrate their practice more collaboratively alongside other support providers.
Publisher: American Psychiatric Association Publishing
Date: 03-2010
Abstract: Smoking is the largest cause of preventable illness in the United States, the United Kingdom, Canada, Australia, and many other countries. Smokers with mental illness smoke significantly more than those without mental illness and therefore experience even greater smoke-related harm. Internationally, there is increasing pressure on psychiatric inpatient settings to adopt smoke-free policies. This study examined smoke-free policies across psychiatric inpatient settings in Australia and thereby identified factors that may contribute to the success or failure of smoke-free initiatives in order to better inform best practice in this important area. Semistructured in-depth telephone interviews were conducted with 60 senior administrators and clinical staff with direct day-to-day experience with smoking activities in 99 adult psychiatric inpatient settings across Australia. Quantitative data were analyzed using descriptive statistical analysis and Pearson's chi square correlations measure of association. Factors associated with greater success of smoke-free initiatives were clear, consistent, and visible leadership cohesive teamwork extensive training opportunities for clinical staff fewer staff smokers adequate planning time effective use of nicotine replacement therapies and consistent enforcement of a smoke-free policy. A smoke-free policy is possible within psychiatric inpatient settings, but a number of core interlinking features are important for success and ongoing sustainability.
Publisher: Wiley
Date: 08-04-2015
DOI: 10.1111/JPM.12193
Abstract: There is limited understanding of the experience of family carers of people diagnosed with borderline personality disorder (BPD). This study aimed to explore their experiences of being carers, their attempts to seek help for the person diagnosed with BPD and their own carer needs. An invitation to participate in an online survey was distributed to carers across multiple consumer and carer organizations and mental health services, by the Private Mental Health Consumer Carer Network (Australia) in 2011. Responses from 121 carers showed that they experience significant challenges and discrimination when attempting to engage with and seek support from health services. Comparison with consumers' experiences (reported elsewhere) showed that these carers have a clear understanding of the discrimination faced by people with this diagnosis, largely because they also experience exclusion and discrimination. Community carer support services were perceived as inadequate. General practitioners were an important source of support however, they and other service providers need more education and training to support attitudinal change to address discrimination, recognize carers' needs and provide more effective support. This study provides the first detailed account of BPD carers' experiences across a broad range of support needs and interactions with community support and health services.
Publisher: Informa UK Limited
Date: 13-05-2016
DOI: 10.1080/01635581.2016.1170169
Abstract: Exercise and a healthy diet are beneficial after cancer, but are not uniformly adopted by cancer survivors. This study reports on the feasibility, acceptability, and effectiveness of a self-management-based nutrition and exercise intervention for Australian cancer survivors. Adult survivors (n = 25) during curative chemotherapy (stratum 1[S1] n = 11) or post-treatment (stratum 2 [S2] n = 14) were recruited prospectively from a single center. The Flinders Living Well Self-Management Program™ (FLW Program) was utilized to establish patient-led nutrition and exercise goals and develop a tailored 12-wk intervention plan. Fortnightly reviews occurred with assessments at baseline, 6 and 12 wk. A recruitment and retention rate of 38% and 84% were observed. Both strata maintained total skeletal muscle mass. Small reductions in body mass index, hip circumference, and percentage body fat, and small increases in hand grip strength and exercise capacity among subjects in both strata were observed. No significant differences were observed between strata however, significant increases in exercise capacity and global health status for S2 were observed from baseline to 12 wk. FLW Program is a feasible mode of delivering nutrition and exercise intervention to cancer survivors and it appears that there are no barriers to implementing this program early during chemotherapy. Hence, the additive effect of gains achieved over a longer duration is promising and this should be explored in randomized controlled trials adequately powered to observe clinically and statistically significant improvements in relevant outcomes.
Publisher: Computers, Materials and Continua (Tech Science Press)
Date: 12-03-2015
Publisher: SAGE Publications
Date: 09-2004
Abstract: Background: This article reports the findings from a comparative study investigating smoking behaviours among institutionalised psychiatric populations from a sociological perspective. Method: The study involved participant observation of two separate Australian sites between 1999 and 2002, the second site serving to generalise the findings from the first site. Discussion and conclusions: Systemic barriers to quitting were identified, emanating from the mental health system in general. Cigarettes were identified as the currency by which economic, social and political exchange took place between participants who described an enculturation process that involved complex processes of reinforcement to smoke. Once entered into, escape from the smoking culture of the settings appeared to be extremely difficult for clients and staff.
Publisher: Wiley
Date: 22-04-2018
DOI: 10.1111/AJR.12413
Abstract: Chronic conditions are major health problems for Australian Aboriginal people. Self-management programs can improve health outcomes. However, few health workers are skilled in self-management support and existing programs are not always appropriate in Australian Aboriginal contexts. The goal was to increase the capacity of the Australian health workforce to support Australian Aboriginal people to self-manage their chronic conditions by adapting the Flinders Program of chronic condition self-management support for Australian Aboriginal clients and develop and deliver training for health professionals to implement the program. Feedback from health professionals highlighted that the Flinders Program assessment and care planning tools needed to be adapted to suit Australian Aboriginal contexts. Through consultation with Australian Aboriginal Elders and other experts, the tools were condensed into an illustrated booklet called 'My Health Story'. Associated training courses and resources focusing on cultural safety and effective engagement were developed. A total of 825 health professionals across Australia was trained and 61 people qualified as accredited trainers in the program, ensuring sustainability. The capacity and skills of the Australian health workforce to engage with and support Australian Aboriginal people to self-manage their chronic health problems significantly increased as a result of this project. The adapted tools and training were popular and appreciated by the health care organisations, health professionals and clients involved. The adapted tools have widespread appeal for cultures that do not have Western models of health care and where there are health literacy challenges. My Health Story has already been used internationally.
Publisher: Springer Science and Business Media LLC
Date: 03-07-2020
Publisher: MDPI AG
Date: 16-08-2022
Abstract: This research aimed to map evidence about system supports and gaps for Australians with psychosocial disabilities and life-limiting diagnoses. A scoping review of available policy documents, academic, and grey literature was completed to discover key characteristics of this concept and provide context around the phenomenon. Our focus was on Australia’s National Disability Insurance Scheme (NDIS), a key reform providing support to the disability population nationally. No peer-reviewed or grey literature was retrieved on the phenomena. Therefore, three lines of enquiry were developed: experiences of NDIS participants living with psychosocial disabilities the death, dying, and palliative care supports and experiences of NDIS participants of any disability type and the experiences for people living with severe and persistent mental illness (SPMI) and life-limiting diagnoses. Five themes were identified: (1) the person (2) advocacy (3) informal supports (4) formal supports and (5) existing research. NDIS participants living with SPMI and their informal and formal support systems are still struggling to navigate the NDIS. While there are no specific publications about their end-of-life experiences, people with SPMI often experience poor end-of-life outcomes. Rigorous research into their death, dying, and palliative care experiences is needed to inform improved support to them, including their end-of-life care.
Publisher: SAGE Publications
Date: 02-03-2023
Publisher: Wiley
Date: 03-05-2017
DOI: 10.1111/HEX.12551
Publisher: Springer Science and Business Media LLC
Date: 10-11-2016
Publisher: Springer Science and Business Media LLC
Date: 21-06-2023
DOI: 10.1007/S10899-023-10226-X
Abstract: Over the past decade, greater emphasis has been placed on the role of the land-based gambling industry to respond to problem gambling behaviour in their venues. Despite this, there is a lack of clear information advising best practice responses by gambling venue employees. This article reviews strategies, practices, and policies employed by land-based gambling venues concerning their employees’ role in preventing gambling-related harm and responding to problem gambling behaviours. A systematic search strategy was applied to source peer-reviewed literature which identified 49 articles. The synthesised results were arranged and presented across five categories: (1) the identification of gamblers with potential problems in the venue (2) gambling venue staff responses to gamblers with potential problems (3) gamblers’ perspectives around venue responsibilities and interactions with gamblers with potential problems (4) corporate social responsibility programs and the identification of gamblers with problems in the venue and (5) gambling venue staff needs. The results suggest that most activity performed by venue staff concerning their response to problem gambling is limited to observing and documenting risky behaviours and then discussing this internally with other venue staff. Action which moves beyond this, such as approaching and interacting with identified gamblers of concern, rarely occurs. The results of this review suggest that a focus on the identification and intervention specifically with identified gamblers of concern is a particularly unhelpful aspect of the role of venue staff. The results also indicate that a re-thinking of the role frontline staff play in addressing problem gambling is necessary.
Publisher: Springer Science and Business Media LLC
Date: 18-06-2016
Publisher: Springer Science and Business Media LLC
Date: 12-2015
Publisher: BMJ
Date: 20-03-2009
Publisher: SAGE Publications
Date: 12-2011
DOI: 10.3109/00048674.2011.619961
Abstract: Objective: The aim of this paper was to estimate the degree to which smoke-free facilities may facilitate smoking cessation in smokers with mental illness by estimating the proportion of smokers with mental illness who receive inpatient treatment, their smoking rates and average durations of stay. Method: Smoking and hospitalization rates were estimated from the Australian National Survey of Mental Health and Wellbeing. Information on duration of inpatient treatment was calculated from the Western Australian Mental Health Information System. Results: Of Australia's estimated 3 567 000 current adult smokers, 32.4% had a mental illness in the past 12 months, and 66.6% had a lifetime mental illness. However, only 1.4% of smokers were hospitalized for a mental health problem in the past 12 months, and 6.3% had ever been hospitalized for a mental health problem. Of those hospitalized for mental health treatment in the past 12 months, 61.2% were current smokers. In 2007 median duration of inpatient mental health admissions was 1 day, and 57% of admissions had duration of 2 days or less. Conclusions: The majority of smokers with mental illness are not treated in inpatient facilities, and where inpatient admissions occur they are generally of short duration. While smoking cessation is an important goal in treatment of smokers with mental illness, support after discharge from inpatient care is important for longer term cessation. Other strategies will be required to support smoking cessation efforts for the majority of smokers with mental illness not in contact with mental health services.
Publisher: Elsevier BV
Date: 09-2011
Publisher: MDPI AG
Date: 10-10-2016
Publisher: Informa UK Limited
Date: 07-03-2023
Publisher: Informa UK Limited
Date: 23-02-2016
DOI: 10.1080/02701960.2015.1116070
Abstract: Enhancing support workers' (SW) role is timely given increasing demands on human and financial health care resources. This article presents outcomes of a program, delivered to 140 participants from five community aged care providers in Australia, designed to enhance knowledge, skills, and confidence of community aged care SWs, building their practical skills in understanding, recognizing, and responding to complexity. Evaluation training modules on communication, complexity, behavior change, and chronic condition self-management support involved pre ost surveys with SWs and their supervisors. SWs reported greater awareness, skills, and confidence in working with complexity, reinforcing the value of their existing practices and skills. Coordinators reported greater appreciation of SWs' skills, and greater awareness of gaps in SWs' support and supervision needs. Educators, policy makers, and services should account for these contributions, given growing fiscal restraint and focus on reablement and consumer-directed care.
Publisher: SAGE Publications
Date: 24-11-2019
Abstract: The Partners in Health scale is a structurally valid measure of chronic condition self-management behaviours. This report describes a study that further evaluated construct validity of Partners in Health scale by assessing its relationship with a single-item measure of general self-rated health. The concurrent validity of the scale was demonstrated by a statistically significant association with general self-rated health in a population representative s le of people with chronic conditions.
Publisher: Wiley
Date: 07-05-2021
DOI: 10.1111/INM.12877
Abstract: Community treatment orders (CTOs) require in iduals with a mental illness to accept treatment from mental health services. CTO legislation in South Australia states that treatment and care should be recovery‐focused, although justification for use is predominantly risk‐based, and care often coercive. Although CTOs are contested, in iduals, families, and clinicians frequently engage in care planning within this context. This paper examines how the concepts of risk and risk management impact care planning from the perspectives of in iduals on CTOs, their families, and clinicians. Ethnographic methods of observation and interview provided a detailed account of the perspectives of each group over an 18‐month period from two community mental health teams in South Australia. Findings show that care planning occurred within a culture of practice dominated by risk. Risk, however, was understood differently by each participant group, with the dominant narrative informed by biogenetic understandings of mental illness. This dominance impacted on the positioning of participant groups in care planning, focus of care contacts, and care options available. To improve care experiences and outcomes for in iduals on CTOs, narrow conceptualizations of risk and recovery need to broaden to include an understanding of personal and social adversities in iduals face. A broader understanding should reposition participants in the care planning context and rebalance care discussions, from a focus on clinical recovery to recovering citizenship.
Publisher: Oxford University Press (OUP)
Date: 13-02-2018
DOI: 10.1093/TBM/IBX031
Abstract: Currently, the evidence for mobile health (mHealth) smoking cessation interventions is limited and heterogeneous, warranting the need for innovative rigorously developed solutions. The aim of this study was to describe the development of a smoking cessation smartphone application (app) developed using evidence-based principles. The app (Kick.it) was designed using the Intervention Mapping framework, incorporating an extensive literature review and qualitative study, in combination with the Behavioural Change Taxonomy v1, the Theoretical Domains Framework, and the Persuasive System Design framework. Kick.it provides quit smoking education, skills training, motivational content and self-regulation functionality for smokers, as well as their social support network. By logging cravings and cigarettes smoked, users will create their own smoking profile, which will be used to provide tailored interventions. It hosts a social network to allow 24/7 social support and provides in-app tools to help with urges to smoke. The app aims to motivate smokers to retry if they slip-up or relapse, allowing them to learn from previous smoking cessation attempts. Rather than basing the app on a singular behavioral change approach, Kick.it will use elements stemming from a variety of behavioral approaches by combining methods of multiple psychological theories. The use of best-practice intervention development frameworks in conjunction with evidence-based behavioral change techniques is expected to result in a smartphone app that has an optimal chance of helping people to quit smoking.
Publisher: Informa UK Limited
Date: 25-08-2015
DOI: 10.1080/13607863.2015.1078283
Abstract: Mental health care for older people is primarily delivered in the community and is largely dependent on informal carers. Mental health policy encourages partnerships between carers and service providers to facilitate service access, coordination and positive experience of care. However, carers often lack information and support from services, with the potential for carer burden, and negative impacts on their own health and capacity to fulfil caring tasks. This paper explores rural carers' experiences of accessing care from a range of services for older people with mental health problems. The Pathways Interview Schedule was used to facilitate 9 in-depth care journey interviews with 11 carers of older people with a mental health problem. Interviews explored their journeys to and through mental health, aged care, primary care and social care services. Framework analysis was used to explore carers' experiences and perceptions of care with a focus on access enablers and barriers. Carers had a significant role in navigating services and operationalising care for their relative. Enablers to accessing care included carer knowledge and workers actively involving carers in planning. Barriers included carer mental health literacy, consumer and carer readiness for services, and worker misinterpretation of confidentiality and privacy laws. Carers should be considered key partners in mental health care planning that crosses service sectors. For this to occur, changes are required at the worker level, including increased communication between mental health workers and carers, and the service level, involving training for staff in interpreting confidentiality and privacy policy.
Publisher: Springer Science and Business Media LLC
Date: 12-2020
DOI: 10.1186/S13033-020-00424-0
Abstract: Pasung is the term used in Indonesia and a number of other countries for seclusion and restraint of people with mental illness in the community, usually at home by their family. While pasung has been banned because it is contrary to human rights, its practice continues to exist within the community, particularly where community mental health services are limited, and in the absence of adequate social support, and pervasive negatives beliefs about mental illness. It is essential to understand the reasons for the ongoing use of pasung and to examine potential solutions. A systematic review and narrative synthesis of peer-reviewed international literature was conducted to identify the socio-cultural contexts for pasung use, and interventions to address it. The analysis draws on the socio-ecological framework, which focused on relationships between the in idual and their environment. Fifty published articles were included in the review all studies were conducted in Asia and Africa, with 32 undertaken in Indonesia. Most studies were qualitative (n = 21). Others included one case–control study, one cross-sectional study, and seven surveys only four studies examined the application of an intervention, and each used a pre and post methodology. Of these, two studies tested psychoeducational interventions which aimed to overcome family burden due to pasung, and each suggested a community mental health approach. The remaining two studies evaluated the intervention of ‘unlocking’ one study used a community-based culturally sensitive approach, and the other used a community-based rehabilitation program. Reasons for pasung given by family appear to be as a last resort and in the absence of other supports to help them care for the person with severe mental illness. The findings highlight that a mixture of in idual, interpersonal, community and policy interventions are needed to reduce the use of pasung. While consumer and carer involvement as part of a socio-ecological approach is understood to be effective in reducing pasung, an understanding of how to elaborate this in the management of pasung remains elusive. Review Registration CRD42020157543: CRD
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/AH15028
Abstract: Objective The aims of the present study were to explore the beliefs of Australian experts in tobacco control and change ch ions working in mental health and tobacco cessation, and to identify measures for addressing the problem of high smoking rates for people with mental illness. Methods Qualitative interviews were undertaken to explore participants’ views, and the Delphi technique was used to achieve consensus on ways in which the problem would be best addressed. Results This consensus centred on the need for leadership within the mental health system. The problem was reconceptualised from being solely the responsibility of the mental health sector into an issue that requires the combined resources of a partnership and shared leadership between government and non-government services, public health leaders, policy makers and people with mental illness and their families. Conclusions Collaboration would raise the priority of the issue, reduce the debilitating effect of stigma and discrimination within the mental health sector and would place smoking reduction firmly on the political and public agenda. A recovery-orientated focus would increase the skill base and be inclusive of workers, families and carers of people with mental illness who face smoking issues on a daily basis. Reconceptualising this as an issue that would benefit from cooperation and partnerships would disrupt the notion that the problem is solely the responsibility of the mental health sector. What is known about the topic? Rates of smoking have remained high for people with mental illness despite population-wide public health strategies successfully reducing smoking rates in the general population. For people with mental illness, the benefits of quitting smoking for both their mental and physical health are overshadowed by concerns about the complexity of their needs. There is a lack of knowledge about how smoking cessation support can be improved to increase success rates in smokers with mental illness. What does this paper add? The present study is the first to bring a cross-sector lens of public health and mental health ‘experts’ together to discuss the reasons for the high rates of smoking among people with mental illness and to obtain their shared agreement on solutions. This Australian-specific study analyses participants’ responses to the problem representation and reveals what the issue is considered to be, where action should occur and how the problem should be resolved. What are the implications for practitioners? For the Australian context, there is a need for leadership and a consistent smoke-free message about the benefits of not smoking. Staff working in mental health require training in providing brief interventions, motivational interviewing and pharmacological support. Joining together as a partnership of government and non-government services, including public health leaders and policy makers, and involving people with mental illness and their families, would benefit all concerned.
Publisher: Wiley
Date: 24-05-2018
DOI: 10.1111/INM.12479
Abstract: People with severe mental illness (SMI) are widely reported to be at an increased risk of morbidity and premature death due to physical health conditions. Mental health nurses are ideally placed to address physical and mental health comorbidity as part of their day-to-day practice. This study involved an audit of hardcopy and electronic clinical case-notes of a random s le of 100 people with SMI case managed by community mental health service in metropolitan South Australia, to determine how well physical health conditions and risk factors, screening, and follow-up are recorded within their service records. Every contact between 1 July 2015 and 30 June 2016 was read. One-way ANOVA, Scheffe's test, and Fisher's exact test determined any significant associations across audit variables, which included gender, age, income, living arrangement, diagnosis, lifestyle factors, recording of physical health measures, and carer status. A focus on physical health care was evident from everyday case-note records however, because this information was 'buried' within the plethora of entries and not brought to the fore with other key information about the person's psychiatric needs, it remained difficult to gain a full picture of potential gaps in physical health care for this population. Under-reporting, gaps and inconsistencies in the systematic recording of physical health information for this population are likely to undermine the quality of care they receive from mental health services, the ability of mental health service providers to respond in a timely way to their physical healthcare needs, and their communication with other healthcare providers.
Publisher: JMIR Publications Inc.
Date: 03-09-2019
DOI: 10.2196/14023
Abstract: Smoking rates of Australians with severe mental illness (SMI) are disproportionately higher than the general population. Despite the rapid growth in mobile health (mHealth) apps, limited evidence exists to inform their design for SMI populations. This study aimed to explore the feasibility, acceptability, and utility of adapting a novel smoking cessation app (Kick.it) to assist smokers with SMI to prevent smoking relapse and quit. Using co-design, two in-depth interviews with 12 adult smokers and ex-smokers with SMI were conducted in this qualitative study. Stage 1 interviews explored participants’ smoking-related experiences and perceptions of social support for smoking cessation, informed the development of the stage 2 interview schedule, and provided context for participants’ responses to the second interview. Stage 2 interviews explored participants’ perceptions of the feasibility, utility, and acceptability of the app features for SMI populations. People with SMI perceived mHealth interventions to support their quit smoking attempts as feasible, acceptable, and useful. Key emerging themes included personalization of the app to users’ psychosocial needs, a caring app to mediate self-esteem and self-efficacy, an app that normalizes smoking relapse and multiple quit attempts, a strong focus on user experience to improve usability, and a social network to enhance social support for smoking cessation. This study gained an in-depth understanding of the lived experiences of smoking and quitting among people with SMI and their perception of the Kick.it app features to help inform the tailoring of the app. Specific program tailoring is required to assist them in navigating the complex interactions between mental illness and smoking in relation to their psychosocial well-being and capacity to quit. This study describes the adaptations required for the Kick.it app to meet the specific needs and preferences of people with SMI. Results of this study will guide the tailoring of the Kick.it app for SMI populations. The study findings can also inform a co-design process for the future development and design of smoking cessation apps for SMI populations.
Publisher: SAGE Publications
Date: 2008
Publisher: Elsevier BV
Date: 04-2018
DOI: 10.1016/J.APNU.2017.11.016
Abstract: The Work and Social Adjustment Scale (WSAS) is used by psychiatric nurses for screening and evaluating patients' treatment outcomes for a variety of mental health problems. This study investigated longitudinal and gender measurement invariance of WSAS using structural equation modeling within a help-seeking problem gambling s le (n=445), and an intervention program for depression and anxiety s le (n=444). The concept of functional impairment was defined by all WSAS items in males and females at pre- and post-treatment assessments. These findings confirm that the WSAS is a robust and efficacious instrument for evaluating treatment outcomes in two differing populations.
Publisher: Informa UK Limited
Date: 17-01-2020
Publisher: SAGE Publications
Date: 2012
Publisher: MDPI AG
Date: 22-01-2021
Abstract: Gambling is occurring in a rapidly changing landscape, with new trends and technologies affecting gambling behaviour and problem gambling across a range of populations. Gambling activity among adolescents and young people has received considerable research attention due to a high prevalence of gambling reported among these groups in recent years. Despite legislation worldwide to constrain gambling among adolescents and young people, modern technology, such as online gaming apps and online gambling venues, has significantly increased their exposure to the risks of problem gambling. It is important, therefore, to have up to date information about what is currently known about gambling and to explore gaps in our knowledge. This gap analysis presents the results of a systematic approach to reviewing the current literature on gambling behaviour, attitudes, and associated risk factors for gambling and problem gambling among adolescents and young adults (aged 10–25 years). The review included studies published between January 2015 and August 2020 and included 85 studies for final synthesis. Findings reveal further research is needed on the implications for young people of emerging technologies and new trends in gambling in the digital age. The current gap analysis reveals that this should include more research on the development and impact of both treatment and intervention strategies, and policy and regulatory frameworks from a public health perspective.
Publisher: Wiley
Date: 14-11-2011
Publisher: Informa UK Limited
Date: 2008
Publisher: Hindawi Limited
Date: 15-04-2020
DOI: 10.1111/HSC.12998
Publisher: Springer Science and Business Media LLC
Date: 11-07-2018
Start Date: 09-2023
End Date: 09-2026
Amount: $490,170.00
Funder: Australian Research Council
View Funded ActivityStart Date: 2023
End Date: 12-2025
Amount: $648,164.00
Funder: Australian Research Council
View Funded Activity