ORCID Profile
0000-0001-9294-7872
Current Organisations
Monash University
,
Deakin University Faculty of Health
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Preventive Medicine | Health Promotion | Public Health and Health Services | Health and Community Services
Behaviour and Health | Health Education and Promotion | Health Inequalities |
Publisher: Cambridge University Press (CUP)
Date: 24-09-2018
DOI: 10.1017/S136898001800232X
Abstract: To determine the prevalence of co-morbidity of two important global health challenges, anaemia and stunting, among children aged 6–59 months in low- and middle-income countries. Secondary analysis of data from Demographic and Health Surveys (DHS) conducted 2005–2015. Child stunting and anaemia were defined using current WHO classifications. Sociodemographic characteristics of children with anaemia, stunting and co-morbidity of these conditions were compared with those of ‘healthy’ children in the s le (children who were not stunted and not anaemic) using multiple logistic models. Low- and middle-income countries. Children aged 6–59 months. Data from 193 065 children from forty-three countries were included. The pooled proportion of co-morbid anaemia and stunting was 21·5 (95 % CI 21·2, 21·9) %, ranging from the lowest in Albania (2·6 % 95 % CI 1·8, 3·7 %) to the highest in Yemen (43·3 95 % CI 40·6, 46·1 %). Compared with the healthy group, children with co-morbidity were more likely to be living in rural areas, have mothers or main carers with lower educational levels and to live in poorer households. Inequality in children who had both anaemia and stunting was apparent in all countries. Co-morbid anaemia and stunting among young children is highly prevalent in low- and middle-income countries, especially among more disadvantaged children. It is suggested that they be considered under a syndemic framework, the Childhood Anaemia and Stunting (CHAS) Syndemic, which acknowledges the interacting nature of these diseases and the social and environmental factors that promote their negative interaction.
Publisher: Elsevier BV
Date: 06-2022
Publisher: Springer Science and Business Media LLC
Date: 11-06-2009
Publisher: Informa UK Limited
Date: 04-06-2015
DOI: 10.3109/13625187.2015.1052394
Abstract: The aim of this research was to investigate awareness, perceived reliability and consideration of use of long-acting reversible contraception (LARC) among Australians of reproductive age. A s le of 18- to 50-year-old women and men (N = 2235) was randomly recruited from the Australian electoral roll in 2013. Respondents completed a self-administered, anonymous questionnaire. Data were weighted to reduce non-response bias. Factors associated with perceived reliability and consideration of use of LARC were identified in multivariable analyses. Most respondents had heard of implants (76.5%) and intrauterine contraception (63.7%). However, most did not think implants (56.3%) or IUDs (63.9%) were reliable and would not consider using implants (71.6%) or IUDs (77.5%). Those significantly more likely to perceive LARC as reliable were younger, did not regard religion as important in fertility choices, had private health insurance, had been pregnant and had had an abortion and women who had a partner. Those more likely to consider using LARC were younger and did not regard religion as important in fertility choices women who had private health insurance, lived in an area of socioeconomic advantage and had had an abortion and men without a partner, born in Australia and comfortable talking to a health care provider about contraceptive matters. Despite high awareness of LARC among Australian adults, its perceived reliability and willingness to use it remain low in certain groups. Targeted interventions that aim to increase knowledge of the benefits and reliability of LARC and allow informed use are recommended.
Publisher: Oxford University Press (OUP)
Date: 11-07-2022
Abstract: Health services implemented a range of initiatives during the COVID-19 pandemic to support employee wellbeing and assist employees to manage the professional and personal challenges they experienced. However, it is not known if such initiatives were acceptable to employees or met their needs. To evaluate the wellbeing and support initiatives implemented at an Australian health service during the COVID-19 pandemic from the perspectives of employees (both users and non-users) and key stakeholders. A mixed-methods design (survey, interviews and data audit) to investigate employees’ and key stakeholders’ perceptions, experiences and use of the wellbeing and support initiatives implemented at a large tertiary metropolitan health service in Melbourne, Australia. Ten employees participated in an interview and 907 completed a survey. The initiatives were well used and appreciated by staff. There was no significant difference in the proportion of clinical staff who had used the initiatives compared to non-clinical staff (44% versus 39% P=0.223). Survey respondents reported the initiatives improved their mental health (n = 223, 8%), ability to cope with COVID-19 related stress and anxiety (n = 206, 79%), do their work (n = 200, 77%) and relationships with colleagues (n = 174, 67%). Staff would like many of the initiatives (with some modifications) to continue after the COVID-19 pandemic. The findings suggest a high level of staff satisfaction with the implemented wellbeing and support initiatives, and confirm the need for, and importance of, developing and implementing initiatives to support health service staff during outbreaks of infectious diseases such as the COVID-19 pandemic.
Publisher: Oxford University Press (OUP)
Date: 21-01-2015
Abstract: To assess the feasibility and patient acceptance of a personalized interdisciplinary audiovisual record to facilitate effective communication with patients, family, carers and other healthcare workers at hospital discharge. Descriptive pilot study utilizing a study-specific patient feedback questionnaire conducted from October 2013 to June 2014. Twenty General Medical inpatients being discharged from an Acute General Medical Ward in a metropolitan teaching hospital. Audiovisual record of a CareTV filmed at the patient's bedside by a consultant-led interdisciplinary team, within 24 h prior to discharge from the ward, provided immediately for the patient to take home. Patient surveys were completed within 2 weeks of discharge. Technical quality, utilization, acceptability, patient satisfaction and recall of diagnosis, medication changes and post-discharge review arrangements. All patients had watched their CareTV either alone or in the presence of a variety of others: close family, their GP, a medical specialist, friends or other health personnel. Participating patients had good understanding of the video content and recall of their diagnosis, medication changes and post-discharge plans. Patient feedback was overwhelmingly positive. In the context of a General Medical Unit with extensive experience in interdisciplinary bedside rounding and teamwork, CareTV is simple to implement, inexpensive, technically feasible, requires minimal staff training and is acceptable to patients. The results of this pilot study will inform and indicate the feasibility of conducting a larger randomized control trial of the impact of CareTV on patient satisfaction, medication adherence and recall of key information, and primary healthcare provider satisfaction.
Publisher: SAGE Publications
Date: 07-03-2019
Abstract: The effectiveness of interventions for people with severe mental illness delivered by informal community care providers in low and lower middle-income countries is not known. The aim was to conduct a systematic review of the impact of community-based interventions implemented by the informal sector for people with severe mental illness in these settings. Five electronic databases (MEDLINE, EMBASE, PsycINFO, CINAHL, and Cochrane Central Register of Controlled Trials) were searched for English-language publications using both keywords and MeSH terms. All study designs were included. Five papers, reporting data from five studies conducted in four low and lower middle-income countries in 2017, met the inclusion criteria for the review. Of the five included studies, three had a before and after design, one was a randomized controlled trial, and one a qualitative investigation. Most interventions with a low-moderate quality of evidence used informal community care providers to deliver either self-help groups, traditional healing treatments, and/or a rehabilitation program. The investigators reported data about improvements in the outcomes of intervention participants (psychosocial functioning, psychotic symptoms, and social inclusion) and positive impacts on their families (family’s knowledge and skills of mental illness management, caregiving burden, social exclusion/stigma against people with severe mental illness, and financial burden). Cost-effectiveness of the intervention (in one study) found that it had a higher financial cost but greater effectiveness than the usual standard of care. Although only a small number of studies were identified, the review provides promising evidence of the professionally developed interventions for people with severe mental illness, delivered by the informal community workforce in low and lower middle-income settings. Training and supportive supervision for informal community care providers are crucial components of effective interventions.
Publisher: JMIR Publications Inc.
Date: 15-02-2016
DOI: 10.2196/IJMR.4492
Publisher: Wiley
Date: 29-03-2022
DOI: 10.1111/JAN.15236
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.WOMBI.2019.01.007
Abstract: While the physical health risks of obesity during pregnancy for women are well understood, little is known about the mental health implications. The aim of this study was to investigate the relationship between pre-pregnancy body mass index (BMI) and symptoms of antenatal depression and anxiety. Secondary analysis of cross-sectional data contributed by the younger cohort (born 1973-78) of the Australian Longitudinal Study of Women's Health who were pregnant at the time of the survey (Waves 4-6: aged 28-39years). Primary outcomes were symptoms of depression (Center for Epidemiologic Studies Depression Scale 10 score≥10) and anxiety (Goldberg Anxiety Scale score≥6). BMI was assessed using self-reported pre-pregnancy weight and height. Demographic characteristics, psychosocial factors, health behaviors and reproductive history were assessed using study-specific and standardized measures. Multivariable regression models were used to examine the associations between predictors and outcome scores. The mean pre-pregnancy BMI of the 1621 women included in the analysis was 24.9kg/m High pre-pregnancy BMI is significantly associated with an increased risk of antenatal depression and anxiety. Consistent with clinical practice guidelines, women with high pre-pregnancy BMI should be screened and assessed for depression and anxiety, and where appropriate provided with clinical referral pathways and support.
Publisher: Springer Netherlands
Date: 2014
Publisher: Informa UK Limited
Date: 16-08-2017
DOI: 10.1080/13691058.2016.1214287
Abstract: Unintended pregnancy can be difficult to identify and conceptualise. We aimed to understand how unintended pregnancies are constructed, explained and situated in a reproductive life. A total of 41 women and 7 men aged 20-50 years were interviewed in depth. Transcripts were analysed using iterative hermeneutic techniques informed by narrative theory. Of 34 participants who had been pregnant or had a partner in pregnancy, 12 women and 1 man described 23 'unintended' pregnancies, about half of which ended in abortion. Their accounts reveal that an unintended pregnancy is identified subjectively, that the same pregnancy may be identified by one partner in the pregnancy as unintended and by the other as intended, and that a researcher's supposedly objective assessment of an unintended pregnancy may be inconsistent with the assessment of the woman who experienced it. A pejorative discourse was evident, predominantly among participants who did not report having an unintended pregnancy: women use an 'unintended' pregnancy to entrap men. Accounts from five participants reporting an unintended pregnancy were selected for illustration. An appreciation of the role such a pregnancy might play in an in idual life requires a nuanced understanding of the complexity of human experience and a resistance to simple binary categorisation.
Publisher: CSIRO Publishing
Date: 30-08-2021
DOI: 10.1071/AH21118
Abstract: Objective The aim of this study was to describe nurses’ and midwives’ experiences following the first phase of the implementation of an electronic medical record (EMR) system at a large public health service in metropolitan Melbourne, Australia. Methods Four focus groups were held 8–10 months after implementation of the EMR. Transcripts were analysed using thematic analysis. Results Of 39 participants, 25 were nurses (64%), 12 were midwives (31%) and two did not provide this information. The mean (±s.d.) duration of clinical experience was 15.6 ± 12.2 years (range 2–40 years). Three main themes were identified: (1) effects on workflow: although some participants reported that EMR facilitated easier access to real-time patient data, others indicated that workflow was disrupted by the EMR being slow and difficult to navigate, system outages and lack of interoperability between the EMR and other systems (2) effects on patient care and communication: some participants reported that the EMR improved their communication with patients and reduced medication errors, whereas others reported a negative effect on patient care and communication and (3) negative effects of the EMR on nurses’ and midwives’ personal well-being, including frustration, stress and exhaustion. These experiences were often reported in the context of cognitive workload due to having to use multiple systems simultaneously or extra work associated with EMR outages. Conclusion Nurses’ and midwives’ experiences of the EMR were complex and mixed. Nurses and midwives require significant training and ongoing technical support in the first 12 months after implementation of an EMR system. Including nurses and midwives in the design and refinement of the EMR will ensure that the EMR aligns with their workflow. What is known about the topic? Studies reporting nurses’ and midwives’ experiences of using EMR are scarce and mostly based in countries where whole-of-service implementations are carried out, funded by governments. What does this paper add? Nurses and midwives perceive benefits of using an EMR relatively soon after implementation in terms of their workflow and patient care. However, in the first year after EMR implementation, nurses and midwives experience some negative effects on workflow, patient care and their own well-being. The effects on clinical workflow are further compounded by EMR downtime (scheduled and unscheduled) and hybrid systems that require users to access other technology systems alongside the EMR. What are the implications for practitioners? In countries like Australia, whole-of-service, simultaneous implementation of EMR systems using best-available server technology may not be possible due to funding constraints. In these circumstances, nurses and midwives may initially experience increased workload and frustration. Ongoing training and technical support should be provided to nurses and midwives for several months following implementation. Including nurses and midwives in the design of the EMR will result in better alignment with their specific workflow, thus maximising benefits of EMR implementation.
Publisher: Elsevier BV
Date: 06-2022
Publisher: Springer Science and Business Media LLC
Date: 11-10-2017
Publisher: Oxford University Press (OUP)
Date: 19-03-2022
Abstract: Hospital clinicians report poor psychosocial well-being during the COVID-19 pandemic. Few studies have reported data at more than one time point. To compare psychosocial well-being among hospital clinicians at two different time points during the COVID-19 pandemic in 2020. Participants included doctors, nurses, midwives and allied health clinicians at a multi-site, public health service in Melbourne, Australia. Data were collected via two cross-sectional, online surveys: May to June (wave 1 n = 638) and October to December 2020 (wave 2 n = 358). The Depression, Anxiety and Stress Scale (DASS-21) assessed psychological well-being in the past week. Investigator-devised questions assessed COVID-19 concerns and perceived work impacts. General linear models were used to assess impact of wave on psychological distress. There were no significant demographic differences between the two groups. Both positive (e.g. learning experience) and negative (e.g. risk of getting COVID-19) impacts were reported. In both waves, staff were most concerned about health risks to family members. Wave 2 respondents were significantly more likely than wave 1 respondents to indicate concerns about colleagues having COVID-19, increased workloads, leave cancellation and increased conflict at work (all P & 0.001). Adjusting for sex, age, self-rated health and discipline group, depression, anxiety and stress scores were significantly higher for respondents in the second than the first wave (all P & 0.001). Psychological well-being of hospital clinicians was significantly worse during the second wave of the COVID-19 pandemic than the first. Sustained occupational and psychosocial support is recommended even when immediate COVID-19 concerns and impacts resolve.
Publisher: WHO Press
Date: 24-11-2011
Publisher: Springer Science and Business Media LLC
Date: 06-02-2018
DOI: 10.1007/S10995-018-2454-9
Abstract: Introduction Despite the considerable and increasing proportion of women of reproductive age with a chronic non-communicable disease (NCD) and the potential adverse implications of many NCDs for childbearing, little is known about the fertility management experiences of women with an NCD, including their contraceptive use, pregnancy experiences and outcomes, and reproductive health care utilisation. The aim of this study was to investigate the fertility management experiences of women with an NCD and draw comparisons with women without an NCD. Method A s le of 18-50 year-old women (n = 1543) was randomly recruited from the Australian electoral roll in 2013. Of these women, 172 women reported a physical, chronic non-communicable disease: diabetes, arthritis, asthma, hypertension, heart disease, thyroid disorders, and cystic fibrosis. Respondents completed an anonymous, self-administered questionnaire. Factors associated with fertility management were identified in multivariable analyses. Results Women who reported having an NCD were significantly more likely than women who did not report an NCD to have ever been pregnant (75.9 vs. 67.5%, p = 0.034), have had an unintended pregnancy (33.47 vs. 25.5%, p = 0.026), and have had an abortion (20.3 vs. 14.2%, p = 0.044) they were less likely to consult a healthcare provider about fertility management (45.0 vs. 54.4%, p = 0.024). Similar proportions were using contraception (48.8 vs. 54.5%, p = 0.138). Conclusion The findings have implications for healthcare providers and women with an NCD and highlight the importance of addressing possible assumptions about the inability of women with an NCD to become pregnant, and ensuring women receive information about suitable methods of contraception and pre-pregnancy care.
Publisher: Oxford University Press (OUP)
Date: 07-09-2017
Abstract: To systematically review the available evidence about hospital discharge communication practices and identify which practices were preferred by patients and healthcare providers, improved patient and provider satisfaction, and increased patients' understanding of their medical condition. OVID Medline, Web of Science, ProQuest, PubMed and CINAHL plus. Databases were searched for peer-reviewed, English-language papers, published to August 2016, of empirical research using quantitative or qualitative methods. Reference lists in the papers meeting inclusion criteria were searched to identify further papers. Of the 3489 articles identified, 30 met inclusion criteria and were reviewed. Much research to date has focused on the use of printed material and person-based discharge communication methods including verbal instructions (either in person or via telephone calls). Several studies have examined the use of information technology (IT) such as computer-generated and video-based discharge communication practices. Utilizing technology to deliver discharge information is preferred by healthcare providers and patients, and improves patients' understanding of their medical condition and discharge instructions. Well-designed IT solutions may improve communication, coordination and retention of information, and lead to improved outcomes for patients, their families, caregivers and primary healthcare providers as well as expediting the task for hospital staff.
Publisher: Informa UK Limited
Date: 25-06-2018
DOI: 10.1080/13625187.2018.1483020
Abstract: Women with polycystic ovary syndrome (PCOS) are usually told that the condition is associated with fertility difficulties. However, little is known about their fertility management including contraceptive use, childbearing desires, and pregnancy outcomes. To compare the fertility management experiences and outcomes of Australian women with and without PCOS. The 2013 Australian electoral roll was used to identify a random s le of 18- to 50-year-old women who were sent the Understanding Fertility Management in Australia survey to be completed anonymously. Factors associated with fertility management and outcomes were identified in multivariable analyses. Among the 1543 women who completed and returned the survey, 113 (7.3%) reported having PCOS. Women with PCOS reported a similar rate of current contraceptive use as women without PCOS (50.4% vs. 52.6%, p = .66). However, they were significantly younger at first pregnancy (24.9 vs. 26.8 years, p = .015), more likely to have consulted a health professional about fertility management (OR: 3.86, 95% CI: 2.50-5.96, p < .001), and perceive that it would be difficult to conceive (OR: 2.31, 95% CI: 1.41-3.79, p = .001) than women without PCOS. There were no significant differences in the number of desired children, unintended pregnancies, live births, abortions or miscarriages between women with and without PCOS. These findings indicate that women with PCOS need more nuanced information about their fertility potential. While they may experience fertility difficulties because of their condition, they should also be informed that they can conceive spontaneously and need reliable contraception to avoid pregnancy when it is not wanted.
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.AUCC.2021.09.006
Abstract: Rounding by the Rapid Response team (RRT) is an integral part of safety and quality care of the deteriorating patient. Rounding enables Intensive Care Units (ICU) liaison nurses to proactively identify deteriorating patients in the general wards and minimize the time spent by general nursing staff to call for assistance. The study examined nurses' and midwives' experiences of proactive rounding by a RRT/ICU Liaison service, including the impact on workflow and patient care as well as enablers and barriers to utilization of the service. A mixed method approach was used: an online survey and semi-structured interviews with nurses and midwives in an acute care setting. 52 respondents completed the online survey and 6 participated in a semi-structured interviews. The majority of survey respondents found the service useful and indicated that rounding by the ICU Liaison service improves patient care. Participants also believed that pro-active rounding increases staff confidence and builds rapport when utilizing the ICU Liaison service. Barriers to use of the service included the lack of out of normal business hours support and obtaining prompt support. Proactive rounding was perceived by nurses and midwives to be beneficial for both themselves and patients, and ensured that deteriorating patients were identified.
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/SH17004
Abstract: Background There are few reliable Australian abortion data. The aim was to investigate prevalence, sexual experiences and socioeconomic characteristics of women and men who report having had or being a partner in an abortion. Methods: A cross-sectional survey of women and men aged 18–50 years randomly selected from the Australian Electoral Roll was used. Weighted multivariable analyses were conducted. Results: Data from 2235 returned (of 15 480) mailed surveys were analysed. One in six women and one in 10 men had experienced or been a partner in an abortion. In adjusted analyses, for women, experience of sexual coercion [adjusted odds ratio (AOR) 2.18, 95% confidence interval (CI) 1.46, 3.24] was associated with significantly increased odds of abortion, and socioeconomic advantage (AOR = 0.57 95% CI 0.39, 0.84), being comfortable negotiating contraceptive use (AOR 0.26 95% CI 0.09, 0.73) and importance of religion in fertility choices (AOR = 0.55 95% CI 0.35, 0.87) were associated with significantly reduced odds. For men, sexual coercion (AOR = 3.05 95% CI 1.51, 6.18) and metropolitan residence (AOR = 1.70 95% CI 1.06, 2.75) significantly increased the odds of reporting being a partner in an abortion. Conclusions: The findings contribute to scarce information about abortion in Australia. The high prevalence of abortion suggests that effective contraceptive counselling and accessible contraception services are not sufficient, and that there is a continuing need for universal pregnancy advice and abortion services. The association between sexual coercion and abortion warrants further investigation.
Publisher: Informa UK Limited
Date: 02-11-2018
DOI: 10.1080/13625187.2018.1539163
Abstract: To examine the fertility experiences of women reporting and not reporting endometriosis in a population-based survey. A cross-sectional survey among a community s le of 1543 women in Australia. Data were analysed to compare fertility management between women who did and did not report endometriosis. Factors associated with unintended pregnancy, infertility diagnosis, time to conception and live birth were identified through multivariable analyses. While in idual contraceptive use did not differ by endometriosis status, avoiding pregnancy was less important to women reporting endometriosis (50.5%) than to others (68.7% p < .001). Women reporting endometriosis were approximately three times more likely to report an infertility diagnosis-the majority (39.7%) of which were 'unexplained female or male infertility'-(p < .001) and six times more likely to report taking longer than 12 months to conceive than those who did not report endometriosis (p < .001). Although more women reporting a diagnosis of endometriosis also reported never having been pregnant (11.9%) than those who did not report a diagnosis (6.0%), this difference was not statistically significant (p = .060). There were also no endometriosis-associated differences in women's reports of unintended pregnancy, abortion, having been pregnant, or having had a live birth. Our findings counter the common assertion that women with endometriosis are unlikely to conceive, and support the need for health care and information that addresses all aspects of fertility management (not just infertility) for women with endometriosis.
Publisher: Informa UK Limited
Date: 02-2023
DOI: 10.2147/PPA.S391340
Publisher: CSIRO Publishing
Date: 2023
DOI: 10.1071/AH23120
Publisher: Elsevier BV
Date: 04-2016
Abstract: Mistimed, unexpected or unwanted pregnancies occur in Australia, despite widespread contraception use. The objective was to estimate prevalence and ascertain modifiable social factors for prevention of unintended pregnancy. National population-based survey of women and men aged 18-51 years recruited from a random s le of electors on the Australian Electoral Roll in 2013. Data were weighted to reduce non-response bias. Factors associated with unintended pregnancy were identified in multivariable analyses. Data from 2,235 completed questionnaires were analysed (Women: 69% Men: 31%). Of those ever pregnant or partner in pregnancy (59%), 40% had experienced an unintended pregnancy. Adjusting for other risks, ever having experienced sexual coercion (AOR, 95%CI=Women 1.948 1.458-2.601 Men 1.657, 1.014-2.708) socioeconomic disadvantage (AOR, 95%CI=Women 1.808, 1.373, 2.381 Men 1.360, 1.004-1.841), living in a rural area (AOR, 95%CI=Women 1.403, 1.056-1.864 Men 1.583, 1.161-2.159), and for men being born overseas (AOR, 95%CI 1.989, 1.317-3.002) were significantly associated with unintended pregnancy. Experiences of sexual coercion, social disadvantage, rural residence and overseas birth are independently associated with unintended pregnancy in Australia. Public health policy and health service initiatives should prioritise prevention of sexual coercion, reduction of social inequality and reduction of geographic inequality for those in rural areas.
Publisher: CSIRO Publishing
Date: 30-09-2022
DOI: 10.1071/AH22110
Abstract: Objective To describe self-reported general and psychological health for allied health practitioners at an Australian acute public health service over three time points within the coronavirus disease 2019 (COVID-19) pandemic. Methods This study collected data from cross-sectional online surveys at three time points: May–June 2020 (T1), October–November 2020 (T2) and November–December 2021 (T3). The self-report questionnaire consisted of demographic questions, a general health question and the 21-item version of the Depression Anxiety Stress Scales (DASS-21). Results A total of 308 responses were received (T1 n = 135, T2 n = 78, T3 n = 95) from representatives of eight allied health professions. The proportion of allied health practitioners reporting poor general health significantly increased over time, as did mean scores on all DASS-21 sub-scales. General health status was also significantly associated with DASS-21 subscale scores. Anxiety scores increased significantly between T1 and T2, while depression scores increased significantly between T2 and T3. Significant increases in stress scores were recorded across all time intervals. Between T1 and T3, the proportion of allied health practitioners reporting moderate, severe, or extremely severe symptoms increased for depression (10.3–30.9%), anxiety (5.2–18.2%) and stress (13.3–36.3%). Conclusion The general and psychological health of allied health practitioners appears to be worsening as the COVID-19 pandemic continues. Organisational strategies to support the health of the allied health workforce in acute care settings must address the cumulative effects of prolonged pressure on their general and psychosocial health. Support strategies need to be responsive to changes in psychological wellbeing at different phases of the pandemic.
Publisher: SAGE Publications
Date: 26-07-2016
Abstract: Most of the world’s children and adolescents live in low- and lower-middle-income countries (LALMIC), but there is limited evidence about polyvictimization (experiences of multiple forms of victimization) among them. The aims of this article were to systematically review the evidence from LALMIC about the overall prevalence of polyvictimization and to identify the associations between polyvictimization and health and well-being among children and adolescents. A systematic search of the English-language peer-reviewed literature to identify empirical, quantitative studies conducted in LALMIC between 2005 and 2015, assessing at least four forms of victimization among young people aged up to 19 years. Where prevalence of any victimization and of polyvictimization were reported, meta-analyses were performed. A total of 30/8,496 articles were included in the review. Evidence was available from 16/84 LALMIC and methodology and quality varied. Pooled prevalence of experiences of any victimization was 76.8% (95% confidence interval (CI) [64.8%, 88.9%]). Prevalence of polyvictimization ranged from 0.3% to 74.7% with an overall estimate of 38.1% (95% CI [18.3%, 57.8%]). None of the studies examined the associations between polyvictimization and physical or reproductive health or quality of life. Polyvictimization was associated with increased likelihood of mental health problems and involvement in health risk behaviors. Experiences of polyvictimization among children and adolescents in LALMIC are more prevalent than in high- and upper-middle-income countries and contribute to the burden of poor health among children and adolescents. Most LALMIC lack local data, and research is required to address this knowledge gap.
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.SRHC.2019.100457
Abstract: The Postnatal Wellbeing in Transition (PostTrans) Questionnaire assesses psychosocial wellbeing among women transitioning to motherhood while managing pre-existing diabetes. Face and content validity have been previously reported however the PostTrans questionnaire has 51 items which imposes a substantial burden on respondents. The aim of this study was exploratory analysis of the PostTrans questionnaire to investigate whether a reduction in the number of items was statistically supported, and whether clinically meaningful subscales could be derived. A prospective cohort of women with type 1 or type 2 diabetes was recruited from three metropolitan hospitals in Melbourne, Australia. Women completed surveys across three postnatal time points. Data were pooled for the analysis. Suitability for factor analysis was confirmed and exploratory Principal Components Analysis with oblique rotation was conducted. The number of responses in the pooled dataset was 117. The reduced PostTrans scale has 27 items and six factors, which together explain 68.7% of the variance. The subscales assess: feeling as if one is coping with diabetes and the infant feeling anxious and guilty about diabetes feeling supported by family sensitivity to the opinions of others prioritising self-care and health professional support. The number of items in the PostTrans Questionnaire was reduced from 51 to 27 items. Six meaningful subscales emerged, which can help health professionals identify and address areas in which women with diabetes are experiencing psychosocial difficulties. The revised scale provides a feasible instrument to be tested for psychometric properties in a larger s le.
Publisher: Elsevier BV
Date: 11-2012
DOI: 10.1016/J.WHI.2012.08.001
Abstract: Certain chronic health conditions and their treatments may compromise women's fertility some chronic conditions are more likely to affect women of reproductive age than others, and some are heritable. All have implications for women's future childbearing and fertility management. The aim of this systematic review was to identify the concerns about childbearing and related information needs and preferences of women with a chronic, noncommunicable health condition. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedure. Relevant social science and medical science databases (Ovid MEDLINE, ProQuest, and CINAHL plus) were searched for peer-reviewed, English-language papers published from 1995 to August 2012 of empirical research using quantitative or qualitative methods. Of the 5,350 articles identified, 29 met inclusion criteria and were reviewed. Despite variation in methods, the studies demonstrated consistently that women with a chronic health condition are concerned about childbearing and have questions about the reproductive implications of their condition. The evidence suggests that there is less consistency about women's preferences for the mode and timing of information about the effect of the condition and its treatment on childbearing. Most research to date has focused on the needs and experiences of women with cancer there is almost none about other noncommunicable conditions. There are serious evidence gaps about the childbearing concerns and related information needs and preferences of women with chronic, noncommunicable health conditions. Research is required to address these gaps and to inform the development of appropriate tools to assist women in this situation with their childbearing decisions.
Publisher: Springer Science and Business Media LLC
Date: 08-08-2019
Publisher: Informa UK Limited
Date: 29-06-2015
Publisher: Elsevier BV
Date: 09-2021
Publisher: Informa UK Limited
Date: 17-06-2019
Publisher: Public Library of Science (PLoS)
Date: 19-07-2017
Publisher: Elsevier BV
Date: 06-2017
Publisher: Springer Science and Business Media LLC
Date: 10-10-2016
Publisher: Elsevier BV
Date: 05-2021
Publisher: Informa UK Limited
Date: 16-06-2010
Publisher: Elsevier BV
Date: 04-2019
DOI: 10.1016/J.MATURITAS.2019.01.011
Abstract: To describe the mental and physical self-reported health of community-based women in Australia aged 50 years and over, and ascertain factors associated with better physical and emotional health. A national, anonymous, online survey of women aged 18 years and above living in Australia. Factors associated with better physical and mental health among women aged ≥50 years. Of the 10,620 women who completed the survey, 4947 (46.6%) were aged 50 years or over. More than half (60.1%) reported being in "excellent" or "very good" overall health. While almost 40% had been diagnosed with depression or anxiety by a medical doctor or a psychologist at some time in their life, almost all (89.4%) had low levels of current anxiety. Factors significantly associated with good overall health were being in paid employment, partnered, "about the right weight", and doing at least 2.5 h of physical activity per week. Better lifelong (never been diagnosed with depression or anxiety) and current mental health were both associated with older age, being in paid employment, being partnered, being in good overall health, doing at least 2.5 h of physical activity per week, and using less health care (<5 visits to the doctor in the previous year). The findings that regular exercise and workforce participation were associated with better physical and mental health in this growing population can inform future targeted interventions to increase physical activity levels and support the retention of older women in the workforce.
Publisher: CSIRO Publishing
Date: 13-02-2023
DOI: 10.1071/PY22111
Publisher: CSIRO Publishing
Date: 19-07-2021
DOI: 10.1071/AH21014
Abstract: Objective This study investigated the short-term psychosocial effects of the COVID-19 pandemic on hospital clinical staff, specifically their self-reported concerns and perceived impact on their work and personal lives. Methods Nurses, midwives, doctors and allied health staff at a large metropolitan tertiary health service in Melbourne, Australia, completed an anonymous online cross-sectional survey between 15 May and 10 June 2020. The survey assessed respondents’ COVID-19 contact status, concerns related to COVID-19 and other effects of COVID-19. Space was provided for free-text comments. Results Respondents were mostly concerned about contracting COVID-19, infecting family members and caring for patients with COVID-19. Concerns about accessing and using personal protective equipment, redeployment and their ability to provide high-quality patient care during the pandemic were also reported. Pregnant staff expressed uncertainty about the possible impact of COVID-19 on their pregnancy. Despite their concerns, few staff had considered resigning, and positive aspects of the pandemic were also described. Conclusion The COVID-19 pandemic has had a considerable impact on the work and personal lives of hospital clinical staff. Staff, particularly those who are pregnant, would benefit from targeted well-being and support initiatives that address their concerns and help them manage their work and personal lives. What is known about the topic? The COVID-19 pandemic is having an impact on healthcare workers’ psychological well-being. Little is known about their COVID-19-related concerns and the perceived impact of the pandemic on their work and personal lives, particularly hospital clinical staff during the ‘first wave’ of the pandemic in Australia. What does this paper add? This paper contributes to a small but emerging evidence base about the impact of the COVID-19 pandemic on the work and personal lives of hospital clinical staff. Most staff were concerned about their own health and the risk to their families, friends and colleagues. Despite their concerns, few had considered resigning. Uncertainty about the possible impact of COVID-19 on pregnancy was also reported. What are the implications for practitioners? During the current and future pandemics, staff, especially those who are pregnant, would benefit from targeted well-being and support initiatives that address their concerns and help them manage the impact on their health, work and personal lives.
Publisher: Elsevier BV
Date: 03-2019
DOI: 10.1016/J.SRHC.2018.11.004
Abstract: The life expectancy of women with cystic fibrosis (CF) has increased, enabling many to reach reproductive age. However, little is known about the childbearing concerns and information needs of women with CF or their preferences for information about the effect of their condition and its treatment on childbearing. The aim of this study was to identify the childbearing concerns and related information needs and preferences of women with CF. To ensure access to a erse group of women with CF throughout Australia and to minimise the risk of cross infection, an online group was advertised and convened on Facebook from October through December 2017. In a closed-group moderated discussion, participants responded to questions about childbearing concerns and the related information needs and preferences of women with CF. Non-identifiable demographic information was sought via an online anonymous survey. The discussion transcript was analysed thematically. Participants (n = 11) identified a number of concerns about childbearing including uncertainty about whether to have children achieving or maintaining a pregnancy and giving birth treatment and treatment adherence during pregnancy, breastfeeding and motherhood and the impact of pregnancy and childbirth on future health. Women wanted information about childbearing as it related to their CF but reported difficulties accessing up-to-date accurate relevant information. Women with CF want to be better informed about childbearing, and identified a need for personalised information as well as regular reviews with their CF treating team so that they can make informed decisions about having children.
Publisher: CSIRO Publishing
Date: 09-10-2020
DOI: 10.1071/AH20203
Abstract: Objective This study assessed the psychological well-being of Australian hospital clinical staff during the COVID-19 pandemic. Methods An anonymous online cross-sectional survey was conducted in a large metropolitan tertiary health service located in Melbourne, Australia. The survey was completed by nurses, midwives, doctors and allied health (AH) staff between 15 May and 10 June 2020. The Depression, Anxiety and Stress Scale – 21 items (DASS-21) assessed the psychological well-being of respondents in the previous week. Results In all, 668 people responded to the survey (nurses/midwives, n = 391 doctors, n = 138 AH staff, n = 139). Of these, 108 (16.2%) had direct contact with people with a COVID-19 diagnosis. Approximately one-quarter of respondents reported symptoms of psychological distress. Between 11% (AH staff) and 29% (nurses/midwives) had anxiety scores in the mild to extremely severe ranges. Nurses and midwives had significantly higher anxiety scores than doctors (P 0.001) and AH staff (P 0.001). Direct contact with people with a COVID-19 diagnosis (P 0.001) and being a nurse or midwife (P 0.001) were associated with higher anxiety scores. Higher ratings of the health service’s pandemic response and staff support strategies were protective against depression (P 0.001), anxiety (P 0.05) and stress (P 0.001). Conclusions The COVID-19 pandemic had a significant effect on the psychological well-being of hospital clinical staff, particularly nurses and midwives. Staff would benefit from (additional) targeted supportive interventions during the current and future outbreaks of infectious diseases. What is known about the topic? The outbreak of COVID-19 is having, and will have, a considerable effect on health services. No Australian data about the effect of COVID-19 on the psychological well-being of hospital clinical staff are available. What does this paper add? Australia healthcare providers have experienced considerable emotional distress during the COVID-19 pandemic, particularly nurses and midwives and clinical staff who have had direct contact with people with a COVID-19 diagnosis. In this study, nurses and midwives had significantly higher levels of anxiety, depression and stress during the pandemic than general Australian adult population norms, and significantly more severe anxiety symptoms than medical and AH staff. Despite a lower number of COVID-19 cases and a lower death rate than in other countries, the proportion of Australian hospital clinical staff experiencing distress is similar to that found in other countries. What are the implications for practitioners? Targeted well-being interventions are required to support hospital clinical staff during the current and future outbreaks of infectious diseases and other ‘crises’ or adverse events.
Publisher: Elsevier BV
Date: 05-2020
DOI: 10.1016/J.WOMBI.2019.06.008
Abstract: Breastfeeding has significant health benefits for maternal and infant health, yet women with pre-pregnancy diabetes (type 1 or type 2 diabetes mellitus) are often less likely to breastfeed compared with other childbearing women. Intention to breastfeed and making the decision to breastfeed during pregnancy are significant predictors of breastfeeding in the general population, but intention to breastfeed has not been assessed during pregnancy among women with pre-pregnancy diabetes. To investigate factors associated with breastfeeding to three months postpartum, including demographic, health and reproductive characteristics, perceived support and pre-birth intention to breastfeed, among women with pre-pregnancy diabetes. A prospective cohort of women with pre-pregnancy diabetes was recruited at three metropolitan hospitals in Melbourne, Australia. Women completed surveys during the third trimester of pregnancy (including intention to breastfeed) and at approximately 3 months postpartum (including current breastfeeding). Factors associated with any breastfeeding at 3 months postpartum were investigated using logistic regression. Pregnancy surveys were completed by 79 women three-month postpartum data were available for 47 women. Of these, more than two-thirds (n=32, 68%) indicated that they were breastfeeding. Controlling for other relevant variables, only pre-birth intention to breastfeed was significantly associated with any breastfeeding at three months (Adjusted Odds Ratio (95% confidence intervals, p)=20.49 (20.18-20.80, 0.017)). Pre-birth intention to breastfeed was the only significant predictor of continued breastfeeding to 3 months postpartum. Pregnancy provides an important opportunity for health professionals to educate and support women with pre-pregnancy diabetes about their breastfeeding intentions.
Publisher: Cambridge University Press (CUP)
Date: 2018
DOI: 10.1017/GMH.2017.34
Abstract: The experiences of and reflections on interpersonal violence and victimisation among adolescents living in low- and middle-income countries are poorly understood. The aim was to describe Vietnamese adolescents’ reflections on their experiences of victimisation. A self-completed, cross-sectional survey investigating exposure to violence among high school students in Hanoi, Vietnam was conducted during 2013–2014. The last section invited participants to write about any of the matters covered in the questionnaire. Thematic analysis was conducted on these free-text comments. A total of 73/76 eligible students participated in the pilot and 1616/1745 in the main survey. Of these, a total of 239 records with free-text comments were analysed. Students described experiences of violence occurring at home, at school and in the community. Experiences of violence led to sadness, loneliness, having extremely negative thoughts about the value of life, and suicidal ideas. Adolescents’ experiences occurred in the context of poor parent–adolescent and teacher–student relationships, particularly concerning dissatisfaction with academic performance. Adolescents wanted to be trusted, to be given more autonomy, and to improve their relationships with parents and teachers. Vietnamese adolescents experience various forms of victimisation, which are detrimental to their health and wellbeing. Understanding of their experiences of and perceptions of violence and its impact on their health and wellbeing is important in the prevention of violence against young people in Vietnam.
Publisher: Informa UK Limited
Date: 04-05-2017
DOI: 10.1080/13625187.2017.1304534
Abstract: Unintended pregnancy and abortion may, in part, result from suboptimal use of effective contraception. This study aimed to identify sociodemographic factors associated with the use of effective and less effective methods among women and men of reproductive age living in Australia. In a cross-sectional national survey, 1544 women and men aged 18-51 were identified as being at risk of pregnancy. Chi-square and logistic regression analyses were used to assess the sociodemographic factors related to contraceptive use. Most respondents (n = 1307, 84.7%) reported using a method of contraception. Use of any contraceptive was associated with being born in Australia (Odds Ratio [OR] 1.89 95% Confidence Interval [CI]1.186, 3.01 p = .008), having English as a first language (OR 1.81 95% CI: 1.07, 3.04 p = .026), having private health insurance (OR 2.25 95% CI 1.66, 3.04 p < .001), and not considering religion important to fertility choices (OR 0.43 95%CI 0.31, 0.60 p < .001). A third used effective contraceptive methods (n = 534, 34.6% permanent methods: 23.1%, and long-acting reversible contraception (LARC): 11.4%). Permanent methods were more likely to be used in rural areas (OR 0.62 95%CI 0.46, 0.84 p = .002). Use of the least effective, short-term methods was reported by nearly half (condoms: 25.6%, withdrawal: 12.5%, and fertility-awareness-based methods: 2.8%). Those who relied on withdrawal were more likely to live in a metropolitan area (OR 2.85 95% CI 1.95, 4.18 p < .001), and not have private health insurance (OR 0.52 95% CI 0.38, 0.71 p < .001). Targeted promotion of the broad range of available contraceptives may raise awareness and uptake of more effective methods and improve reproductive autonomy in certain population groups.
Publisher: Springer Science and Business Media LLC
Date: 25-08-2011
Publisher: CSIRO Publishing
Date: 2013
DOI: 10.1071/PY11117
Abstract: Australian health policy emphasises prevention, early intervention and improved pathways to treatment for perinatal mental disorders. Primary care is vital to achieving these aims. The aim of this study was to understand the anticipated needs and preferred sources of mental health information and support of men and women expecting their first baby. Nulliparous English-speaking expectant parents attending childbirth education programs in public and private hospitals participated in single sex small group discussions in late pregnancy. Discussions were audio-recorded, transcribed and analysed thematically using the group as the unit of analysis. Eight groups (22 women 16 men) encompassing erse socioeconomic circumstances were conducted. Analyses showed idealised fantasies consistently tempered with realistic expectations about adjustment to life with a baby. However, there were erse and gendered views about whether primary care providers should discuss mental health with parents of infants and willingness to complete written questionnaires or be referred for specialist mental health care. Men regard primary family care as mother not father inclusive. Expectant parents readily anticipate realistic postnatal adjustment and need for emotional support. Increased provision of services that meet men’s needs and public understanding and acceptance of Australian integrated models of primary postnatal mental health care are needed.
Publisher: Elsevier BV
Date: 09-2011
DOI: 10.1016/J.WHI.2011.02.006
Abstract: Financial and employment concerns are commonly regarded as the most important factors determining Australian women's childbearing. However, little is known about the relationship between women's health and their childbearing. We investigated the relationship between health and childbearing expectations and outcomes in a population-based s le of women living in Victoria, one Australian state (n = 569), recruited from the Australian Electoral Roll in 2005. Participants completed a self-administered, anonymous questionnaire. Health problems were identified by many participants as a salient factor in their childbearing, and were often an obstacle that prevented them from achieving their ideal childbearing outcomes. The results challenge the prevailing view that women's childbearing is mostly voluntary, and primarily based on financial considerations or career ambitions. To assist women in achieving their childbearing preferences, appropriate health care and policies are required.
Publisher: Oxford University Press
Date: 07-2014
DOI: 10.1093/OXFORDHB/9780199778072.013.014
Abstract: Maternity presents major adaptive challenges for women. It is common for pregnant women and women who have recently given birth to access nonprofessional resources, including those developed by interested in iduals, members of community groups, or peer-support initiatives, to understand their emotional experiences and needs. This chapter investigates the nature and content of nonprofessional resources, defined as those developed by people without health-related qualifications, for pregnant and postpartum women experiencing emotional distress or mental health problems and the evidence about them generated in systematic evaluations. Although nonprofessional resources provide information and support in privacy and anonymity without fees and therefore are potentially more accessible than professional care, many are limited to personal narratives and do not refer to scientific evidence, and few have been formally evaluated. Overall, the highest quality nonprofessional resources and approaches are those generated in collaborations between consumers and professionals and for which some evaluation of acceptability, comprehensibility, and effectiveness is available.
Publisher: Springer Science and Business Media LLC
Date: 04-11-2016
Publisher: Oxford University Press (OUP)
Date: 2018
Start Date: 12-2011
End Date: 06-2015
Amount: $210,000.00
Funder: Australian Research Council
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