ORCID Profile
0000-0001-8272-8799
Current Organisations
Flinders University
,
Central Queensland University
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Elsevier BV
Date: 06-2016
Publisher: Wiley
Date: 05-05-2010
DOI: 10.1111/J.1447-0349.2009.00660.X
Abstract: Absconding is increasingly being recognized as a problem within mental health settings with significant risks for consumers. This study examines absconding behaviours across three acute care wards within an Australian psychiatric hospital c us over a 12-month period. A descriptive statistical analysis determined the rate of absconding from 49 consumers who absconded 64 times. The absconding rate was 13.33% (absconding events), with most absconding events arising from males diagnosed with schizophrenia (57.14%) aged between 20 and 29 years, and with 62.50% of absconding events occurring whilst consumers were on their first 21-day detention order. Nearly half of all absconding events were by consumers who had absconded previously, with the highest proportion of events occurring during nursing handover. A profile of people who abscond, time of day of absconding, legal status and repeated absconding behaviours are described. The emergent profile of consumers who absconded within this study bears some similarities to that described in overseas research, although in this study consumers were slightly older and 25% of absconders were female. Of particular interest are findings that identify the timings of absconding events in relation to a consumer's legal status. Implications for practice, including assessment of risk of absconding and management, are considered.
Publisher: Wiley
Date: 11-09-2014
DOI: 10.1111/JOCN.12671
Abstract: This paper reports mental health nurses' perspectives of absconding. The aims of the study were to explore nurses' perceptions of risk assessment and management practices regarding absconding from acute inpatient psychiatric settings, and their affective responses when patients absconded. Nurses are directly involved in managing the risk of patients leaving hospital while acutely unwell, as well as dealing with the implications of an absconding event. However, despite their key role, few studies have explored nurses' perceptions of absconding. An interpretive inquiry was undertaken using a systematic thematic approach. Mental health nurses (n = 11) from three acute inpatient mental health units in Australia took part in semi-structured interviews, with a focus on the nurses' experiences of working with patients who had absconded. Data were analysed using systematic thematic coding procedures. Nurses' assessment of a patient's risk of absconding involved the use of clinical judgement, focusing on markers of absconding including the patient's history and clinical presentation. The acuity of the perceived risk determined the type of risk management strategy implemented, which could include support, observation and/or the use of containment procedures. Nurses responded with a myriad of affective reactions when patients absconded depending on their assessment of the patient's risk. Support and debriefing is required for mental health nurses following an absconding event. Additional research is vital to identify alternative absconding assessment and management strategies to ensure the best possible outcome for patients and nurses. Mental health nurses play a central role in risk assessment and management for absconding, with fear of repercussions a significant consequence for them. This research highlights the importance of both clinical judgment and standardised instruments in assessing absconding risk. Further research is needed to identify alternative evidence-based absconding management strategies to support nursing practice.
Publisher: Springer Science and Business Media LLC
Date: 22-06-2023
DOI: 10.1007/S10804-023-09455-6
Abstract: Restrictions introduced during the COVID-19 pandemic disrupted many retirees from being able to pursue their lifestyle retirement goals. This study examined the impact of lifestyle retirement goal disruption during the pandemic, sources of meaning in life, and goal setting behaviors (planfulness) on retiree wellbeing. In this quantitative study, retirees ( n = 141) in Victoria, Australia completed an online survey in mid-2021 containing measures of sources of meaning in life, planfulness, and wellbeing. Qualitative data were also collected using a series of open-ended questions regarding the nature of retirement goal disruptions. Findings revealed that greater sources of meaning in life and planfulness significantly predicted greater wellbeing in retirees, as did being in a relationship and living in an urban/city location. Age, gender, and years retired were not associated with wellbeing. Planfulness moderated the association between COVID-19 goal-disruption and wellbeing. Open-ended responses indicated that retirement goals commonly affected by COVID-19 were travel and family-time. The study revealed that older adults were able to adjust during a time of crisis, with sources of meaning in life and planfulness being useful resources for wellbeing. Planfulness was an important buffer for those experiencing goal-disruption due to COVID-19.
Publisher: Wiley
Date: 25-09-2012
DOI: 10.1111/J.1447-0349.2012.00872.X
Abstract: Restraint of older persons in inpatient and residential care is used to control aggression, and prevent falls and other adverse outcomes. Initiatives to reduce these practices are being implemented worldwide. However, there has been little examination of restraint practice in psychiatric services for older persons. This paper reports a retrospective comparative analysis of restraint use in three acute and two extended care psychiatric inpatient wards in Australia. The analysis involved examination of restraint incidents and comparison of restrained and non-restrained patients. There was significant variation in restraint use between wards. On one acute ward, 12.74% of patients were restrained, although restraint use declined during the data collection period. Patients with dementia were restrained at higher rates than patients with other diagnoses, and restrained patients stayed in hospital for a longer duration. Restraint occurred early in admission, and few differences emerged between those restrained once or multiple times. Mechanical restraint was more prevalent than physical restraint, with restraint predominantly used to manage aggression and falls. Findings provide new data on restraint in older persons' psychiatric services. Greater conceptual understandings of behaviours associated with dementia and the unique needs of patients with these disorders may assist in reducing restraint use in these settings.
Publisher: SAGE Publications
Date: 25-10-2021
DOI: 10.1177/13684302211038062
Abstract: While considering the role of group-level factors as predictors of collective action, research has overlooked the role of group prototypes in determining willingness to engage in collective action. To begin to investigate this area, we conducted two correlational studies ( Ns = 141 and 98) in high schools examining the association between prototypical ingroup members’ desire to engage in collective action and participants’ collective action on behalf of a disadvantaged group (immigrants). Results showed a positive association between these two variables. We also investigated boundaries of this effect, finding that the association emerged when participants lacked personal experiences with the disadvantaged group (cross-group friendships Study 1) or identified more with their ingroup, an effect also found when including a behavioral measure of collective action (Study 2). Intentions to follow the prototypical ingroup member emerged as the mediator (Study 2). It is worth noting that our methodology allowed us to assess prototypicality in a naturalistic context by calculating a metacontrast ratio for each group member, in line with self-categorization theory’s conceptualization of prototypicality. We discuss the theoretical and practical implications, with reference to the role of prototypicality as a means of social influence and to developing social norms in the context of collective action.
Publisher: Springer Science and Business Media LLC
Date: 23-12-2020
DOI: 10.1038/S41594-019-0353-4
Abstract: The human leukocyte antigen (HLA) locus is strongly associated with T cell-mediated autoimmune disorders. HLA-DQ2.5-mediated celiac disease (CeD) is triggered by the ingestion of gluten, although the relative roles of genetic and environmental risk factors in CeD is unclear. Here we identify microbially derived mimics of gliadin epitopes and a parental bacterial protein that is naturally processed by antigen-presenting cells and activated gliadin reactive HLA-DQ2.5-restricted T cells derived from CeD patients. Crystal structures of T cell receptors in complex with HLA-DQ2.5 bound to two distinct bacterial peptides demonstrate that molecular mimicry underpins cross-reactivity toward the gliadin epitopes. Accordingly, gliadin reactive T cells involved in CeD pathogenesis cross-react with ubiquitous bacterial peptides, thereby suggesting microbial exposure as a potential environmental factor in CeD.
Publisher: Elsevier BV
Date: 05-2010
Publisher: Informa UK Limited
Date: 09-04-2022
Publisher: Elsevier BV
Date: 12-2014
DOI: 10.1016/J.APNU.2014.08.015
Abstract: There are significant issues associated with the use of restrictive measures, such as seclusion and restraint, in child and adolescent mental health care. Greater understanding of how restrictive measures are used is important for informing strategies to reduce their use. In this brief report we present a 12-month audit (1/1/2010-31/12/2011) of the use of restrictive measures (seclusion, physical restraint) in one child and adolescent acute inpatient mental health unit in Australia. The study highlights the need for continued efforts to reduce the use of restrictive measures in child and adolescent mental health services.
Publisher: Springer International Publishing
Date: 21-12-2017
Publisher: Wiley
Date: 12-2014
DOI: 10.1111/INM.12100
Abstract: Absconding, where patients under an involuntary mental health order leave hospital without permission, can result in patient harm and emotional and professional implications for nursing staff. However, Australian data to drive nursing interventions remain sparse. The purpose of this retrospective study was to investigate absconding in three acute care wards from January 2006 to June 2010, in order to determine absconding rates, compare patients who did and did not abscond, and to examine incidents. The absconding rate was 17.22 incidents per 100 involuntary admissions (12.09% of patients), with no significant change over time. Being male, young, diagnosed with a schizophrenia or substance-use disorder, and having a longer hospital stay were predictive of absconding. Aboriginal and Torres Strait Islander patients had higher odds of absconding than Caucasian Australians. Over 25% of absconding patients did so multiple times. Patients absconded early in admission. More incidents occurred earlier in the year, during summer and autumn, and later in the week, and few incidents occurred early in the morning. Almost 60% of incidents lasted ≤24 hours. Formulation of prospective interventions considering population demographic factors and person-specific concerns are required for evidence-based nursing management of the risks of absconding and effective incident handling when they do occur.
Publisher: Elsevier BV
Date: 06-2021
Publisher: BMJ
Date: 08-04-2014
Publisher: CSIRO Publishing
Date: 2019
DOI: 10.1071/AH18004
Abstract: Objective The aims of the present study were to establish rates of resuscitation order documentation of patients aged ≥65 years from both psychogeriatric and general medical units and to compare patients on predictors of resuscitation status, particularly examining the effect of depression. Methods A retrospective case note audit of psychogeriatric (n=162) and general medical (n=135) unit admissions within a tertiary teaching hospital was performed. Multivariate logistic regression was used to determine significant clinical and demographic predictors of resuscitation status. Results Resuscitation orders were documented in more psychogeriatric (94.4%) than general medical (48.1%) files. Depression did not significantly predict resuscitation status in either group. Having undergone competency assessment significantly predicted resuscitation status for the total s le and separately for psychogeriatric and medical patients. Older age (overall s le), poorer prognosis (overall s le), living in residential care (overall s le and medical group) and self-consenting to resuscitation status (overall s le and medical group) significantly predicted resuscitation status. Conclusions Resuscitation orders were more frequently documented on the psychogeriatric unit. Further prospective analysis is needed of how resuscitation orders are made before depression is discounted as a predictor of end-of-life decision-making. What is known about the topic? Despite increased community, media and research attention to end-of-life decision-making, resuscitation preferences of older patients are often poorly documented. Existing research into patient clinical and demographic factors that influence end-of-life decision-making have largely focused on general medical rather than psychogeriatric settings. There is a need to investigate rates of resuscitation documentation in psychogeriatric and general medical units and specific factors associated with having a ‘do not attempt resuscitation’ order in place, particularly the effect of current depression on decision-making. What does this paper add? Resuscitation orders were more frequently documented on the psychogeriatric than medical unit. Depression was not a significant predictor of resuscitation status in either group of patients. Although having undergone a competency assessment, older age and poorer prognosis predicted not being for resuscitation for the total s le, living in residential care and self-consenting to resuscitation status predicted not being for resuscitation for the overall s le and the medical group specifically. What are the implications for practitioners? This paper suggests that the need for clinicians to ensure documentation of preferences is a focus of day-to-day work with older patients. Clinicians should consider patient competency in end-of-life decision-making and how factors associated with depression, such as helplessness, may be more closely related to resuscitation decision-making in older patients.
Publisher: Wiley
Date: 10-01-2020
DOI: 10.1111/JPM.12585
Abstract: WHAT IS KNOWN ON THE SUBJECT?: The use of chemical restraint in emergency situations is to control aggression or violence to protect consumers and staff and is to be used as a last resort when all other behavioural control alternatives have been exhausted. Chemical restraint involves the use of medication. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: This is the first paper to systematically review the prevalence of the use of chemical restraint. The use of chemical restraint is common across emergency departments and acute psychiatric inpatient units worldwide. Consumers who are restrained are also likely to receive chemical restraint. The studies reviewed demonstrate that there is a need for more standardized data collection so that clearer comparisons can be made between healthcare settings and countries. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Implications of practice include the need to report adverse events post-chemical restraint as these can deleteriously affect a person's physical health. Identification of and staff education about first-line management techniques before chemical restraint is administered are significant to reduce its use. ABSTRACT: Introduction Chemical restraint is used to manage uncontrolled aggression, agitation or violent behaviours of consumers with mental health disorders admitted to acute psychiatric or emergency settings. Aim This systematic review aimed to synthesize the international prevalence of chemical restraint for non-consenting adults. Method PsycINFO, CINAHL, MEDLINE/PubMed and Google Scholar databases were searched for peer-reviewed literature published between January 1996 and July 2018. This paper reports on data extracted from retrospective audits of chemical restraint practice. Results Forty-eight papers were included. The median prevalence of use of any restraint was 21.2% (25th% 8.0 to 75th% 36.3). Median prevalence of people who were chemically restrained, of all people restrained in any manner, was 43.1% (25th% 22.9% to 75th% 70.7%). Of all people admitted to facility(ies), the median prevalence of chemical restraint was 7.4% (25th% 2.7 to 75th% 17.6). There was no statistically significant difference in any prevalence measure considering healthcare setting or country. There was a significant decrease over the review period in the use of any restraint, including chemical restraint. Discussion and implications for practice This is the first known comprehensive meta-view of chemical restraint use worldwide, highlighting the need for standardized data collection to enable comparisons between healthcare settings and countries. Relevance statement There is an international imperative to reduce or eliminate the use of coercive practices, such as physical and chemical restraint, in mental health care. This study provides important information for mental health nursing by synthesizing the international prevalence of chemical restraint for non-consenting adults. This meta-view of the worldwide use of chemical restraint can inform ongoing efforts to reduce its use.
Publisher: Elsevier BV
Date: 06-2008
Publisher: SAGE Publications
Date: 12-12-2011
Abstract: A lack of empathic responsiveness toward others has been consistently identified as an important antecedent to aggressive behavior and violent crime, with many rehabilitation programs for violent offenders incorporating treatment modules that are specifically designed to increase offender empathy. This study examined the extent to which cognitive (perspective taking) and affective (empathic concern, personal distress) empathy predicted anger in a clinical (male prisoners convicted of a violent offense) and a nonclinical (student) s le. Perspective taking emerged as the strongest predictor of self-reported anger in response to an interpersonal provocation, as well as being most consistently related to scores on measures of general trait anger and methods of anger control. While the relationship between perspective taking and anger was apparent for offenders as well as students, the results did not support the idea that an inability to perspective take is a particular characteristic of violent offenders.
Publisher: Springer Science and Business Media LLC
Date: 21-05-2018
Publisher: Wiley
Date: 14-05-2020
DOI: 10.1111/INM.12734
Publisher: Elsevier BV
Date: 08-2007
Publisher: Informa UK Limited
Date: 11-11-2011
DOI: 10.3109/01612840.2011.603880
Abstract: Risk assessment and management is a major component of contemporary mental health practice. Risk assessment in health care exists within contemporary perspectives of management and risk aversive practices in health care. This has led to much discussion about the best approach to assessing possible risks posed by people with mental health problems. In addition, researchers and commentators have expressed concern that clinical practice is being dominated by managerial models of risk management at the expense of meeting the patient's health and social care needs. The purpose of the present study is to investigate the risk assessment practices of a multidisciplinary mental health service. Findings indicate that mental health professionals draw on both managerial and therapeutic approaches to risk management, integrating these approaches into their clinical practice. Rather than being dominated by managerial concerns regarding risk, the participants demonstrate professional autonomy and concern for the needs of their clients.
Publisher: Wiley
Date: 27-09-2022
DOI: 10.1111/INM.12934
Publisher: Wiley
Date: 10-12-2012
DOI: 10.1111/JPM.12026
Publisher: Wiley
Date: 09-09-2019
DOI: 10.1111/INM.12654
Abstract: One approach to manage people with behaviours of concern including agitated or aggressive behaviours in health care settings is through the use of fast-acting medication, called chemical restraint. Such management often needs to be delivered in crisis situations to patients who are at risk of harm to themselves or others. This paper summarizes the available evidence on the effectiveness and safety of chemical restraint from 21 randomized controlled trials (RCTs) involving 3788 patients. The RCTs were of moderate to high quality and were conducted in pre-hospital, hospital emergency department, or ward settings. Drugs used in chemical restraint included olanzapine, haloperidol, droperidol, risperidol, flunitrazepam, midazolam, promethazine, ziprasidone, sodium valproate, or lorazepam. There was limited comparability between studies in drug choice, combination, dose, method of administration (oral, intramuscular, or intravenous drip), or timing of repeat administrations. There were 31 outcome measures, which were inconsistently reported. They included subjective measures of behaviours, direct measures of treatment effect (time to calm time to sleep), indirect measures of agitation (staff or patient injuries, duration of agitative or aggressive episodes, subsequent violent episodes), and adverse events. The most common were time to calm and adverse events. There was little clarity about the superiority of any chemical method of managing behaviours of concern exhibited by patients in Emergency Departments or acute mental health settings. Not only is more targeted research essential, but best practice recommendations for such situations requires integrating expert input into the current evidence base.
Publisher: Informa UK Limited
Date: 11-09-2018
Publisher: Wiley
Date: 26-12-2016
DOI: 10.1111/INM.12298
Abstract: Empathy is a central component of nurse-consumer relationships. In the present study, we investigated how empathy is developed and maintained when there is conflict between nurses and consumers, and the ways in which empathy can be used to achieve positive outcomes. Through semistructured interviews, mental health nurses (n = 13) and consumers in recovery (n = 7) reflected on a specific conflict situation where they had experienced empathy, as well as how empathy contributed more generally to working with nurses/consumers. Thematic analysis was used to analyse the data, utilizing a framework that conceptualizes empathy experiences as involving antecedents, processes, and outcomes. The central theme identified was 'my role as a nurse - the role of my nurse'. Within this theme, nurses focussed on how their role in managing risk and safety determined empathy experienced towards consumers consumers saw the importance of nurse empathy both in conflict situations and for their general hospitalization experience. Empathy involved nurses trying to understand the consumer's perspective and feeling for the consumer, and was perceived by consumers to involve nurses 'being there'. Empathic relationships built on trust and rapport could withstand a conflict situation, with empathy a core component in consumer satisfaction regarding conflict resolution and care. Empathy allows the maintenance of therapeutic relationships during conflict, and influences the satisfaction of nurses and consumers, even in problematic situations. Nurse education and mentoring should focus on nurse self-reflection and building empathy skills in managing conflict.
Publisher: American Association for the Advancement of Science (AAAS)
Date: 11-2019
DOI: 10.1126/SCIIMMUNOL.AAY6039
Abstract: Characterizing MAIT cell development led to the identification of key regulators that specify MAIT cell fate in the thymus.
Publisher: Cambridge University Press (CUP)
Date: 2014
DOI: 10.1017/JRR.2014.1
Abstract: This study aimed to investigate the influence of sex and gender role identity on anger experience at varying levels of provocation in a s le of 585 Australian students. Participants viewed videotaped vignettes of a potentially anger-triggering event where the intent of another person was either ambiguous or unambiguous. Measures of self-predicted anger, trait anger, and gender role identity were then completed. Results supported the hypothesis that it is gender role identity rather than sex that is more closely related to angry emotion. There was, however, no support for the hypothesis that anger arousal would be greater in circumstances in which the intention behind a provoking event is ambiguous when the respondent identifies with a masculine gender role. The implications of these findings for the development of anger management programs are discussed.
Publisher: Springer Science and Business Media LLC
Date: 13-11-2017
Publisher: Springer Science and Business Media LLC
Date: 21-05-2019
DOI: 10.1038/S41467-019-10198-W
Abstract: Mucosal-associated invariant T (MAIT) cells express an invariant TRAV1/TRAJ33 TCR-α chain and are restricted to the MHC-I-like molecule, MR1. Whether MAIT cell development depends on this invariant TCR-α chain is unclear. Here we generate Traj33 -deficient mice and show that they are highly depleted of MAIT cells however, a residual population remains and can respond to exogenous antigen in vitro or pulmonary Legionella challenge in vivo. These residual cells include some that express Trav1 + TCRs with conservative Traj -gene substitutions, and others that express Trav1 - TCRs with a broad range of Traj genes. We further report that human TRAV1-2 - MR1-restricted T cells contain both MAIT-like and non-MAIT-like cells, as judged by their TCR repertoire, antigen reactivity and phenotypic features. These include a MAIT-like population that expresses a public, canonical TRAV36 + TRBV28 + TCR. Our findings highlight the TCR ersity and the resulting potential impact on antigen recognition by MR1-restricted T cells.
Publisher: Cambridge University Press (CUP)
Date: 05-2008
Publisher: Informa UK Limited
Date: 08-01-2023
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2014
Publisher: Wiley
Date: 25-09-2012
DOI: 10.1111/J.1447-0349.2012.00873.X
Abstract: Absconding from acute psychiatric inpatient units is a significant issue with serious social, economic, and emotional costs. A qualitative study was undertaken to explore the experiences of people (n = 12) who had been held involuntarily under the local mental health act in an Australian inpatient psychiatric unit, and who had absconded (or attempted to abscond) during this time. The aim of the study was to explore why people abscond from psychiatric inpatient units, drawing on published work from health geography on the significance of the person-place encounter, and in particular the concept of 'therapeutic landscapes'. The findings show that the inpatient unit is perceived as a safe or unsafe place, dependent on the dialectical relationship between the physical, in idual, social, and symbolic aspects of the unit. Consumers absconded when the unit was perceived as unsafe. Forming a therapeutic relationship with staff, familiarity with the unit, a comfortable environment, and positive experiences with other consumers all supported perceptions that the unit was safe, decreasing the likelihood of absconding. Findings extend existing work on the person-place encounter within psychiatric inpatient units, and bring new knowledge about the reasons why consumers abscond. Implications for practice are discussed.
Publisher: Ubiquity Press, Ltd.
Date: 08-12-2014
DOI: 10.5334/IJIC.1885
Publisher: Wiley
Date: 18-07-2018
DOI: 10.1111/INM.12522
Publisher: Informa UK Limited
Date: 12-2010
Publisher: Informa UK Limited
Date: 02-05-2017
DOI: 10.1080/13607863.2017.1320702
Abstract: Integrated care has been identified as means of managing the demands on the healthcare budget while improving access to and quality of services. It is particularly pertinent to rural health services, which face limited access to specialist and support services. This paper explores the capacity of three rural communities in South Australia to deliver integrated mental health support for older people. Thirty-one interviews were conducted with local health and social service providers from mental health, community health, general practice, residential aged care, private practice, NGOs and local government as part of a larger action research project on service integration. Participants highlighted differences in service delivery between the communities related to size of the community and access to services. Three structural barriers to delivery of integrated care were identified. These are as follows: fragmentation of governmental responsibility, the current funding climate, and centralisation and standardisation of service delivery. We conclude that despite a focus upon integrated care in mental health policy, many features of current service delivery undermine the flexibility and informal relationships that typically underpin integration in rural communities.
Publisher: SAGE Publications
Date: 08-02-2018
Abstract: This paper reports a pilot study exploring the benefits of offering sensory modulation within a mental health emergency setting for consumers experiencing distress during a psychiatric presentation. Seventy-four consumers with a mental health presentation reported on their sensory modulation use experiences during their stay in a South Australian tertiary teaching hospital emergency department. An evaluation form was used to document use of items, self-reported distress pre and post sensory modulation use, and other consumer experiences. Consumers used between one and six sensory items for a median duration of 45 min. There was a statistically significant reduction ( t(73) = 15.83, p .001) in self-reported distress post sensory modulation use, and consumers also reported that use was helpful, distracting, calming and assisted in managing negative emotions and thoughts. The results demonstrate the potential value of sensory-based interventions in reducing behavioural and emotional dysregulation in an emergency setting whilst also promoting consumer self-management strategies.
Publisher: Public Library of Science (PLoS)
Date: 23-02-2022
DOI: 10.1371/JOURNAL.PONE.0263128
Abstract: Despite rising cases of COVID-19 in the United States of America, several states are easing restrictions (e.g., relaxing physical distancing requirements, reopening businesses) that were imposed to limit community transmission of the virus. In iduals hold differing opinions regarding whether restrictions should continue to be imposed or lifted, evidenced, for ex le, by debate and protests regarding reopening of businesses and venues. Health and social psychological research suggest that perceptions of COVID-19related risk, experiences of the virus, and in idual difference factors can help explain in iduals’ attitudes towards health initiatives and their tendency to be persuaded towards a specific course of action. The purpose of this study was to investigate what factors influence support or opposition to easing COVID-19-related restrictions. A s le of 350 United States citizens, responding to an anonymous survey, were asked about the extent to which they support/oppose easing of COVID-19-related restrictions, both generally and in relation to specific restrictions. Respondents completed measures of their experiences of COVID-19, in idual difference factors, and demographic variables, including political affiliation and degree of social and economic conservatism. In a series of regression analyses, significant demographic predictors of support or opposition for easing restrictions were gender, age, ethnicity, and education, with political affiliation and degree of social and economic conservatism also predicting attitudes. Experiences related to COVID-19 that predicted attitudes were concerns for self and family, perceptions of threat posed by the virus, perceived ability to adhere to restrictions, willingness to take government direction, and belief in COVID-19-related conspiracy theories. At an in idual differences level, uncertainty avoidance, collectivism, long-term orientation, masculinity, empathic concern, personal distress, reactance, and general conspiracy theory beliefs all significantly precited attitudes to easing restrictions. Understanding the factors that help explain attitudes towards COVID-19 restrictions can inform how best to position health messaging and initiatives going forward, particularly as states or countries open borders.
Publisher: SAGE Publications
Date: 12-05-2014
Abstract: The purpose of this study was to investigate restraint use in Australian emergency departments (EDs). A retrospective audit of restraint incidents in four EDs (from 1 January 2010 to 31 December 2011). The restraint rate was 0.04% of total ED presentations. Males and females were involved in similar numbers of incidents. Over 90% of restrained patients had a mental illness diagnosis and were compulsorily hospitalised. Mechanical restraint with the use of soft shackles was the main method used. Restraint was enacted to prevent harm to self and/or others. Median incident duration was 2 hours 5 minutes. In order to better integrate the needs of mental health clients, consideration is needed as to what improvements to procedures and the ED environment can be made. EDs should particularly focus on reducing restraint duration and the use of hard shackles.
Publisher: Wiley
Date: 15-05-2018
DOI: 10.1111/INM.12477
Abstract: Nursing students, regardless of setting, require skills in working with people with mental health issues. One way to provide students with learning opportunities within the context of limited undergraduate mental health content and lack of mental health placements is through employment as assistants in nursing (AIN). The purpose of the study was to investigate the use of AINs employed in an emergency department in South Australia to supervise (continuous observation) mental health consumers on inpatient treatment orders. Twenty-four participants took part in the study, with AINs (n = 8, all studying in an undergraduate nursing programme), nurse managers (n = 5), and nurses (n = 11) participating in semi-structured interviews. Data were analysed using thematic analysis. Themes focused on (i) the AIN role, their practice, boundaries or restrictions of their role, and the image consumers have of AINs (ii) learning through experience, where the AIN role was a practical opportunity to learn and apply knowledge obtained through university studies and (iii) support, which focused on how AINs worked with nursing staff as part of the healthcare team. Overall, participants believed that AINs played an important role in the ED in supervising consumers on involuntary mental health treatment orders, where their unique role was seen to facilitate more positive consumer experiences. The AIN role is one way for nursing students to develop skills in working with people with mental health issues.
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: Cambridge University Press (CUP)
Date: 2017
DOI: 10.1017/JRR.2017.8
Abstract: This article reviews current knowledge about how the tendency to reflect on personal experience is related to the tendency to take another's perspective. While it is well established that self-reflection leads to a greater understanding of one's own emotions, cognitions, and behaviours, the extent to which it is associated with understanding others is less well understood, despite the implications of this for the development of more effective interventions to improve empathy. The types of self-reflection that are used in clinical and psychotherapeutic interventions are used to illustrate the possibilities here, and ways in which clinicians may increase their own self-reflection are also considered.
Publisher: Cambridge University Press (CUP)
Date: 2015
DOI: 10.1017/JRR.2015.6
Abstract: This study tested the hypothesis that it is easier to take the perspective of another person when one has similar past experience. Volunteer participants ( N = 154) were asked to take the perspective of a protagonist in one of four problematic interpersonal situations and then to rate the ease with which they felt able to perspective take and the extent of their personal past experience of similar situations. Similar past experience predicted ease of perspective taking, with the relationship influenced by reflection on past experience. Ease of perspective taking mediated the relationship between similar past experience and participant perceptions of their accuracy in understanding the other person, but ease was not associated with emotional arousal. The findings have potential therapeutic applications for attempts to increase empathy and understanding in people for whom perspective taking may be difficult.
Publisher: Cambridge University Press (CUP)
Date: 2013
DOI: 10.1017/JRR.2013.6
Abstract: The ability to take the perspectives of others is considered a prerequisite for effective interpersonal interaction. Despite extensive investigation into the correlates of perspective taking, there have been few previous attempts to understand the process by which people take another's psychological point of view. The purpose of this exploratory study was to identify the strategies used by in iduals when attempting to take the perspective of another person. Twelve participants discussed a time they engaged in perspective taking. The analysis revealed that perspective taking was used in situations in which significant negative emotions could arise, and that participants shifted between the use of self-information (e.g., switching places, past experience) and other-information (e.g., target's personal characteristics) during the process of perspective taking. Different emotions and cognitions were associated with taking one's own perspective and taking that of the other person. The study provides a direct consideration of an under-investigated component of social and personal relationships.
Publisher: Wiley
Date: 31-03-2019
DOI: 10.1111/INM.12591
Abstract: Reducing and/or eliminating the use of coercive measures in psychiatric services is a priority worldwide. Chemical restraint is one such measure, yet to date has been poorly defined and poorly investigated. The aim of this study was to examine chemical restraint use in 12 adult acute inpatient psychiatric units in Adelaide, South Australia. Methods involved the analysis of all reported chemical restraint events occurring over a 12-month period analysed using a descriptive quantitative design. There were 166 chemical restraint events involving 110 consumers. The highest prevalence rate in an in idual unit was 28.78 events per 1000 occupied bed days, with the lowest being 0.12 events per 1000 occupied bed days. More males (n = 69, 57.5%) were involved in chemical restraint than females. Schizophrenia, schizotypal, and delusional disorders were the predominant diagnoses among consumers who were chemically restrained. The most events occurred during three time blocks: 14.00-14.59 pm, 16.00-16.59 pm, and 21.00-21.59 pm. The two most common medications used were olanzapine and clonazepam. The study presents a general picture of the practice of chemical restraint in Adelaide and identifies areas of concern in relation to the need for monitoring of side effects and completion of systematic processes of documentation regarding chemical restraint events. Findings highlight the need for sustained focus on reducing the need for chemical restraint and exploring less restrictive measures with those most likely to receive medication against their will.
Publisher: Elsevier BV
Date: 11-2019
DOI: 10.1016/J.IENJ.2019.100789
Abstract: The number of people dying in emergency departments (EDs) is increasing. However, EDs are not well designed or resourced for safe and effective End-Of-Life (EOL) care encounters, and there is little evidence regarding clinicians' perceptions and experiences of providing such care when the death is sudden and unexpected. This study explored nurses' perceptions and experiences of caring for patients who die suddenly and unexpectedly in the ED. Open-end responses were collected as part of a larger descriptive survey design. The qualitative data were analysed thematically. 211 ED nurse completed the online survey. Within the qualitative data, five themes were identified during analysis: 1) key elements of EOL care, 2) systemic and environmental barriers, 3) educational deficits, 4) role ambiguity, and 5) emotional impact. Participants identified communication, a standardised approach, and better educational preparedness as the most important elements of EOL care when the death was sudden and unexpected. ED nurses want to provide high quality care to dying patients and their families. However, their efforts are h ered by systemic and environmental barriers outside their control. There is a need for a culture shift to overcome the barriers that currently obstruct ED nurses from providing meaningful and effective EOL care in the ED.
Publisher: Wiley
Date: 20-08-2017
DOI: 10.1111/INM.12350
Abstract: Australia is a country rich in cultural ersity, with Indigenous Australians having specific cultural values and a variety of spoken languages. In addition, the increasing number of people from migrant and refugee backgrounds requires that health professionals be able to communicate effectively with people from a wide range of cultural backgrounds. This is particularly relevant when undertaking a mental health assessment, because members of erse communities often face the dual vulnerability of marginalization and stigmatization. This paper reports on the development and evaluation of a virtual teaching and learning resource that prepares health students to be culturally competent in mental health assessment. Four online interprofessional learning journeys were developed. Evaluation of the learning resources was conducted across three participating Australian universities. Quantitative evaluation involved pre- and post-testing using an empathy scale, the Mental Health Nursing Clinical Confidence Scale, and the Cultural Competence Questionnaire informed by the theory of planned behaviour. Qualitative data from focus group interviews explored participants' experiences of using the guided learning journey. Participants reported changes from pretest to post-test in their empathy and attitudes towards culturally and linguistically erse consumers with significant positive changes in cultural competence, empathy, and attitudes. There was strong satisfaction with the learning materials, indicating that participants valued this 'real world' learning experience. Results require cautious interpretation, given recruitment difficulties in the evaluation phase. However, these learning journeys appear to have potential to be an effective way to challenge attitudes and perceptions, as well as increase cultural competence towards culturally and linguistically erse consumers.
Publisher: Wiley
Date: 15-02-2011
DOI: 10.1111/J.1365-2702.2010.03553.X
Abstract: Aims and objectives. The purpose of this study was to examine absconding behaviour (a patient leaving the hospital without permission) in acute and rehabilitation wards of one Australian psychiatric institution to describe the characteristics of the absconding patient and these events. Background. Absconding is a significant issue in psychiatric inpatient settings, with risks that include patient harm, aggression and violence. In spite of this, limited research has been conducted in Australia on patients who abscond while receiving psychiatric care. Design. The study was a retrospective descriptive analysis. Method. Absconding events from three acute and seven rehabilitation wards over a 12‐month period were studied. Results. The rate of absconding events by detained patients was 20·82%. Gender was not significantly associated with absconding, although 61·19% of those who absconded were men diagnosed with schizophrenic disorders. Over half of acute care patients who absconded left during their first 21‐day detention order. More than half of absconding events were by patients that absconded more than once. There was limited support for the efficacy of locking ward doors. Age and diagnosis emerged as particularly important factors to consider. Discussion. The study revealed that men are not more likely to abscond than women, that locking ward doors does not deter the determined absconders and that once a person has absconded, they are more likely to do so again. Younger patients and those with a schizophrenic disorder may be particularly likely to abscond. There also appears to be a link between continuing detention orders and an absconding event. Conclusions. Findings provide new data about the profile of absconding patients in Australia. Exploration of the reasons why patients abscond and why many do so repeatedly warrants further investigation. Relevance to clinical practice. Risk management approaches taking into account factors associated with absconding could be trialled to reduce the incidence of absconding in psychiatric inpatient settings.
No related grants have been discovered for Adam Gerace.