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Nicmanis M, Holmes J, Oxlad M, Chur-Hansen A. Patient Information Needs and Decision-Making Before a Cardiac Implantable Electronic Device: A Qualitative Study Utilizing Social Media Data. J Clin Psychol Med Settings 2024:10.1007/s10880-024-10024-6. [PMID: 38773048 DOI: 10.1007/s10880-024-10024-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2024] [Indexed: 05/23/2024]
Abstract
The decision to receive a cardiac implantable electronic device (CIED) represents a challenging experience for patients. However, the majority of previous research has only considered retrospective accounts of patient experiences. This study aimed to use social media data to characterize the information sought by people anticipating or considering CIED implantation and factors that influence their decision-making experiences. A Python-based script was used to collect posts made to a community intended for discussions concerning CIEDs on the social media platform Reddit. Reflexive content analysis was used to analyze the collected data. From 799 posts collected, 101 made by 86 participants were analyzed. The reported median (range) age of participants was 34 (16-67), and most were anticipating or considering a pacemaker. Three overarching categories classified the data: "Use of social media to meet informational and other needs"; "Factors influencing acceptance of the need for implantation"; and "Specific concerns considered during decision-making." Participants anticipating or considering a CIED predominantly sought experiential information. Among asymptomatic participants, doubts were prevalent, with acceptance being an influential factor in decision-making. Healthcare professionals should recognize the informational and emotional needs of prospective CIED patients and tailor support mechanisms to better facilitate their decision-making.
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Affiliation(s)
- Mitchell Nicmanis
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Level 5, Hughes Building North Terrace Campus, Adelaide, SA, 5000, Australia.
| | - Joshua Holmes
- School of Computer and Mathematical Sciences, Faculty of Sciences, Engineering and Technology, The University of Adelaide, Adelaide, SA, Australia
| | - Melissa Oxlad
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Level 5, Hughes Building North Terrace Campus, Adelaide, SA, 5000, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Level 5, Hughes Building North Terrace Campus, Adelaide, SA, 5000, Australia
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2
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Majstorovic M, Chur-Hansen A, Andrews JM, Burke ALJ. Bariatric surgeons' views on pre-operative factors associated with improved health-related quality of life following surgery. Clin Obes 2024:e12668. [PMID: 38641997 DOI: 10.1111/cob.12668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/02/2024] [Accepted: 04/10/2024] [Indexed: 04/22/2024]
Abstract
Bariatric surgery is an effective treatment for severe obesity, affording significant improvements in weight loss and health-related quality of life. However, bariatric surgeons' views on whether certain pre-operative factors predict improvements in post-operative health-related quality of life, and if so, which ones, are largely unknown. This cross-sectional survey study examined the views of 58 bariatric surgeons from Australia and New Zealand. A total of 18 factors were selected for exploration based on their mention in the literature. Participants rated the extent to which they thought these pre-operative factors would improve post-operative health-related quality of life. Responses showed that bariatric surgeons held diverse perspectives and revealed a lack of consensus regarding "predictive" factors. Generally, respondents agreed that better than average health literacy, higher socioeconomic status, good physical and psychological health, and positive social support were predictors of improved health-related quality of life following surgery. However, poor eating behaviours, smoking, and the use of alcohol or other substances were deemed negative predictors. Interestingly, aside from higher socioeconomic status, good psychological health, and positive social support, none of the aforementioned views aligned with existing literature. This study offers an initial insight into bariatric surgeons' views on the influence of different pre-operative factors on post-operative health-related quality of life. The array of views identified suggests that there may be an opportunity for medical education, but the findings warrant caution due to the sample size. Replication with a larger survey may be useful, especially as predicted health-related quality of life outcomes could guide decisions regarding surgical (non)progression.
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Affiliation(s)
- M Majstorovic
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - A Chur-Hansen
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - J M Andrews
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Surgery Program, The Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - A L J Burke
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
- Psychology Department, The Central Adelaide Local Health Network, Adelaide, South Australia, Australia
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3
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Lores T, Mikocka-Walus A, Andrews JM, Evans S, Lynch KD, Chur-Hansen A. Psychological Care for People with Inflammatory Bowel Diseases: Exploring Consumers' Perspectives to Inform Future Service Co-design. Dig Dis Sci 2024:10.1007/s10620-024-08377-x. [PMID: 38637459 DOI: 10.1007/s10620-024-08377-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 03/03/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND There is a need to improve psychological care for people with Inflammatory Bowel Diseases (IBD), noting the high psychosocial burden of disease. AIMS This study qualitatively explored the views of people living with IBD to help inform future co-design of services that better meet the psychological needs of consumers. METHODS Adults with IBD were recruited to attend virtual focus groups to discuss what they want most in an IBD-specific psychological service. The discussions were recorded and transcribed, and data were analyzed using conventional qualitative content analysis. Draft results were summarized midway and reviewed by remaining focus groups and a final expert consumer. A quantitative dataset was created of comment frequencies. RESULTS Thirty-one participants took part in the study: 10 focus groups were held with an average of three participants per group. The analysis identified 254 codes, 38 sub-categories and six categories. Five main categories were identified for an IBD-specific psychological service: People-Centered Healthcare (commented on by 90% of participants), Education and Preparation (83%), Social Connection (83%), Psychological Input (93%), and Accessible Services (97%). Results were summarized in a set of proposed clinical guidelines. CONCLUSIONS The findings of this study identify important insights from people living with IBD regarding priorities for psychological services. IBD services should focus on improving education, addressing social connection, and integrating psychological input, as well as becoming more people-centered and accessible. It is hoped that IBD services consult the proposed clinical guidelines to inform co-designed service improvements.
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Affiliation(s)
- Taryn Lores
- Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
- Royal Adelaide Hospital, Central Adelaide Local Health Network (CALHN), Port Road, Adelaide, SA, 5000, Australia.
- Department of Gastroenterology & Hepatology, Royal Adelaide Hospital, Port Road, Adelaide, SA, 5000, Australia.
| | | | - Jane M Andrews
- Royal Adelaide Hospital, Central Adelaide Local Health Network (CALHN), Port Road, Adelaide, SA, 5000, Australia
| | - Subhadra Evans
- Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Kate D Lynch
- Royal Adelaide Hospital, Central Adelaide Local Health Network (CALHN), Port Road, Adelaide, SA, 5000, Australia
| | - Anna Chur-Hansen
- Faculty of Health and Medical Sciences, The University of Adelaide, North Terrace, Adelaide, SA, 5000, Australia
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4
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Patel C, Nicmanis M, Chur-Hansen A, Crawford GB. Views of admitted palliative care patients and their clinicians on corneal donation discussions: a qualitative content analysis of semi-structured interviews. BMC Palliat Care 2024; 23:85. [PMID: 38556894 PMCID: PMC10983643 DOI: 10.1186/s12904-024-01421-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 03/26/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND There is a severe shortage of corneas for donation, globally, for transplantation and research purposes. One group of individuals who could potentially be donors are those who die within the inpatient palliative care unit. The aim of the study was to understand clinician and patient perceptions of corneal donations and discussion of donation in palliative care units. METHODS A qualitative design was utilised with data collected through semi-structured interviews and analysed using qualitative content analysis. A total of 46 interviews were undertaken involving inpatient palliative care unit patients (19) and clinicians (27) in three major inpatient palliative care units in South Australia. RESULTS Very few patient participants reported being asked about corneal donations during their time in palliative care. Most inpatient palliative care unit clinicians did not raise the topic as they felt other areas of care took precedence. Inpatient palliative care unit patients thought if inpatient palliative care unit clinicians did not raise the topic, then it was not important. There were some differences between patient and clinician views, such as preference about who raises the possibility of donation and when the discussion might occur. CONCLUSIONS Findings suggest that patients are receptive to discussing corneal donations, but clinicians are not initiating these. This is a missed opportunity for donors and potential recipients. We recommend that clinicians routinely discuss eye donation as part of palliative care.
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Affiliation(s)
- Chirag Patel
- School of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide Health, and Medical Sciences Building. Corner of North Terrace and George Street, Adelaide Health Simulation - West End Level 2, Adelaide, 5000, Australia.
- Northern Adelaide Palliative Service, Northern Adelaide Local Health Network, Adelaide, Australia.
| | - Mitchell Nicmanis
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Gregory B Crawford
- School of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide Health, and Medical Sciences Building. Corner of North Terrace and George Street, Adelaide Health Simulation - West End Level 2, Adelaide, 5000, Australia
- Northern Adelaide Palliative Service, Northern Adelaide Local Health Network, Adelaide, Australia
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5
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Tuckey N, Agteren JV, Chur-Hansen A, Ali K, Fassnacht DB, Beatty L, Bareham M, Wardill H, Iasiello M. Implementing a group-based online mental well-being program for women living with and beyond breast cancer - A mixed methods study. Asia Pac J Clin Oncol 2024. [PMID: 38558488 DOI: 10.1111/ajco.14060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/21/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
PURPOSE There is a gap in available mental well-being services in Australia for women diagnosed with breast cancer. This pilot mixed-methods uncontrolled study aimed to assess the feasibility of an online mental health and well-being intervention, the Be Well Plan (BWP), which enables participants to create a personalized, flexible well-being strategy. METHODS Women diagnosed with stages I-IV breast cancer were recruited into 4 asynchronous groups to participate in the BWP, a 5-week facilitator-led group-based mental health and well-being program. Psychological measures used at baseline and post-intervention included: the Warwick Edinburgh Mental Well-Being Scale, Brief Resilience Scale, Self-compassion Scale, 9-item Patient Health Questionnaire, 7-item General Anxiety Disorder scale, and EORC QLQ-C30. Multivariate analysis of variance and effect sizes were calculated on pre- and post-psychological measures, followed by qualitative content analysis on post-completion interviews with participants. RESULTS Nineteen women (mean age 45.7, standard deviation = 7.74) were included in the study. Large effect sizes were reported for mental well-being, depressive symptoms, and anxiety (partial ω2 = 0.28, 0.21, and 0.20, respectively). Self-compassion, resilience, and quality of life results were not statistically significant. Qualitative content analysis provided insight into experiences with Program Delivery Experience, Application of the BWP, Mental Health Improvements, Supporter Involvement, Adopted Interventions, and Recruitment. Participants reported benefits in mindfulness, grounding techniques, and physical activities. CONCLUSION The BWP has the potential to be an effective intervention to support the mental health and well-being of breast cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS This study highlights flexible interventions that accommodate the diverse needs of breast cancer survivors to improve mental well-being and alleviate psychological distress.
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Affiliation(s)
- Natalie Tuckey
- Mental Health and Well-being Program, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Joep van Agteren
- Mental Health and Well-being Program, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Kathina Ali
- School of Health, University of the Sunshine Coast, Queensland, Australia
| | - Daniel B Fassnacht
- School of Health, University of the Sunshine Coast, Queensland, Australia
| | - Lisa Beatty
- Flinders University Institute of Mental Health & Well-being, College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Monique Bareham
- Patient Advocate and Cancer Survivor - SA 2022 Local Hero, Adelaide, Australia
| | - Hannah Wardill
- Supportive Oncology Research Group, Precision Medicine Theme (Cancer Program), The South Australian Health and Medical Research Institute, Adelaide, Australia
- School of Biomedicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, Australia
| | - Matthew Iasiello
- Mental Health and Well-being Program, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
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6
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Majstorovic M, Chur-Hansen A, Andrews JM, Burke A. Factors associated with progression or non-progression to bariatric surgery in adults: A systematic review. Obes Rev 2024; 25:e13698. [PMID: 38268336 DOI: 10.1111/obr.13698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Revised: 11/28/2023] [Accepted: 12/06/2023] [Indexed: 01/26/2024]
Abstract
Access to bariatric surgery is limited, and the factors related to undergoing or not undergoing the procedure are poorly understood. To this end, a systematic review of PubMed, Embase, PsycINFO, and CINAHL was conducted to deduce the factors associated with progression or non-progression to bariatric surgery. Quantitative and qualitative English-language articles ranging in date from database conception to September 2023 were included. Eligible studies employed adult participants (18 years of age or above) who had been referred for bariatric surgery. A total of 57 studies were identified. Fifteen key factors were found, alongside six less frequently studied factors: age, sex, BMI, race and ethnicity, distance to clinic, socio-economic status, insurance coverage, physical health, psychological health, eating history and habits, substance use and smoking, social influence and relationships, pre-surgery process and requirements, surgery-related concerns, choice of surgery, and others (emergency room visitation, COVID-19 virus, health literacy, appearance perceptions, time-off work, and stigma related to surgery). No factors were found to be reliably associated with progression or non-progression to bariatric surgery; however, the nature of these findings is tentative considering methodological flaws and limited research. Further studies are required to elucidate potential inequities in bariatric surgery access and educate policymakers and health professionals.
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Affiliation(s)
- Mia Majstorovic
- The School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Anna Chur-Hansen
- The School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
| | - Jane M Andrews
- Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Surgery Program, The Central Adelaide Local Health Network (CALHN), Adelaide, South Australia, Australia
| | - Anne Burke
- The School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
- Psychology Department, CALHN, Adelaide, South Australia, Australia
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7
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Hillier S, Lodge D, Nolan J, Yandell R, Chur-Hansen A, George S, Lynch E. Clinical research imperatives: principles and priorities from the perspective of Allied Health executives and managers. AUST HEALTH REV 2024; 48:207-217. [PMID: 38447201 DOI: 10.1071/ah23262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 02/20/2024] [Indexed: 03/08/2024]
Abstract
Objective It is widely understood that a key means of improving health systems and patient outcomes is through research - accessing, understanding, generating and applying research evidence-based practice. To promote more targeted and strategic research in Allied Health practice, this study sought to establish the principles, areas and priorities for clinical research as perceived by Allied Health leaders in the South Australian public health system. Methods The study used a mixed-methods design (full, sequential and equal model). Participants were recruited from theSouth Australian Department of Health and Wellbeing employment lists for Allied Health senior leaders. Consenting participants attended face-to-face focus groups; after an overview presentation, they discussed the principles for Allied Health research, followed by areas and priorities for research. Summaries of the responses were themed descriptively and circulated electronically so participants could confirm the research areas and ascribe priority ratings, clinical populations and services. Results A total of 28 people attended the stakeholder forum (5 online); 20 responded to the second-round electronic summary. Nine principles of research action were agreed. Fourteen research areas were identified and prioritised. There was a relatively consistent prioritisation of measuring Allied Health value, Allied Health workforce, hospital avoidance and closing the gap for Aboriginal health outcomes - whether the individuals were thinking about their own service or the state as a whole. Conclusions Allied Health leadership identified key principles and priorities for research to improve service delivery and patient outcomes. These priorities should generate further discussion and interest for novice and experienced researchers and leaders and can be used to inform granting and project plans.
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Affiliation(s)
- Susan Hillier
- Allied Health and Human Performance, University of South Australia, Adelaide, SA, Australia
| | - Duncan Lodge
- Department of Health and Wellbeing, SA Health and Southern Adelaide Local Health Network, SA Health, Adelaide, SA, Australia
| | - Jo Nolan
- Allied and Scientific Health Office, SA Health and Southern Adelaide Local Health Network, SA Health, Adelaide, SA, Australia
| | - Rosalie Yandell
- Department of Health and Wellbeing, SA Health and Southern Adelaide Local Health Network, SA Health, Adelaide, SA, Australia
| | | | - Stacey George
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Elizabeth Lynch
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
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8
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Urry K, Breakey GR, Scholz B, Chur-Hansen A. Approaches for improving sexuality and sexual health care in mental health settings: A qualitative study exploring clinicians' own perspectives. Int J Ment Health Nurs 2024; 33:125-133. [PMID: 37737548 DOI: 10.1111/inm.13234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 09/10/2023] [Accepted: 09/12/2023] [Indexed: 09/23/2023]
Abstract
There is an acknowledged professional practice gap regarding sexuality and sexual health related needs within mental health settings in Australia and internationally. Yet little is known about how clinicians can be best supported or enabled to improve sexuality-related practice, from their own perspective. This is important, given the sensitive and complex nature of sexuality and sexual health within the context of mental distress and service provision. This article reports a follow-up study, where mental health clinicians who participated in an initial study were invited to reflect on and discuss the (finalized) results and recommendations generated. The aim was to generate insights into the tools, strategies, and approaches participants felt would best equip and support clinicians to better incorporate sexuality and sexual health into their work. Six clinicians from three disciplines (mental health nursing, psychology, and psychiatry) participated in in-depth interviews to reflect on a plain language summary of the initial study. Three interconnected themes were generated via reflexive thematic analysis: (1) access to knowledge and information; (2) support from peers, senior colleagues, and workplaces; and (3) enacting a focus on sexuality-related care. These findings provide valuable insights into how clinicians may want to be supported in relation to (improving) their sexuality-related practice. The analysis also demonstrates the importance of a multifaceted approach to improving sexuality-related care in mental health and other health settings. This knowledge will contribute to directing future research and development of interventions, tools, strategies, or other approaches to this end.
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Affiliation(s)
- Kristi Urry
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Georgia R Breakey
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Brett Scholz
- ANU Medical School, The Australian National University, Ngunnawal Country, Canberra, Australian Capital Territory, Australia
| | - Anna Chur-Hansen
- School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
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9
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Nicmanis M, Chur-Hansen A, Oxlad M. The Psychological, Social, and Quality of Life Outcomes of People with a Cardiac Implantable Electronic Device: An Umbrella Review. Eur J Cardiovasc Nurs 2023:zvad133. [PMID: 38126134 DOI: 10.1093/eurjcn/zvad133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023]
Abstract
AIM To synthesise the psychological, social, and quality of life outcomes of people with a cardiac implantable electronic device. METHODS AND RESULTS An umbrella review of systematic reviews that reported the psychological, social, or quality of life outcomes of adults with a cardiac implantable electronic device was conducted. This umbrella review was preregistered with PROSPERO (CRD42023437078) and adhered to JBI and PRISMA guidelines. Seven databases (CINAHL, Cochrane Library, Embase, Emcare, Psycinfo, PubMed, and the Web of Science) were searched alongside citation and bibliographic searches. Methodological quality was assessed using the JBI Checklist of Systematic Reviews and Research Syntheses. Due to the heterogeneity of included reviews, findings were reported narratively. Fourteen systematic reviews met the inclusion criteria; eleven considered quality of life and three considered psychological outcomes. Little difference in quality of life was found between people with an implantable-cardioverter defibrillator and controls, however, a high prevalence of psychological disorders was present. Cardiac resynchronisation therapy devices demonstrated improvements in quality of life compared to control groups, alongside possible cognitive benefits. Quality of life did not differ between subcutaneous and transvenous implantable cardioverter-defibrillators. Pacemakers were associated with improved post-implantation quality of life. CONCLUSION Research on the psychosocial and quality of life outcomes of people with a cardiac implantable electronic device is limited and inconsistent. Given the heterogeneity of current research, conclusions are uncertain. Nevertheless, some recipients may experience adverse psychosocial complications. Further research employing rigorous methodologies is needed and healthcare practitioners should provide care that acknowledges the potential for adverse psychosocial experiences. REGISTRATIONS PROSPERO (CRD42023437078).
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Affiliation(s)
- Mitchell Nicmanis
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Australia
| | - Melissa Oxlad
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Australia
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10
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Duncanson EL, Chur-Hansen A, Le Leu RK, Macauley L, Burke AL, Donnelly FF, Collins KL, McDonald SP, Jesudason S. Dialysis Needle-Related Distress: Patient Perspectives on Identification, Prevention, and Management. Kidney Int Rep 2023; 8:2625-2634. [PMID: 38106606 PMCID: PMC10719600 DOI: 10.1016/j.ekir.2023.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 08/20/2023] [Accepted: 09/04/2023] [Indexed: 12/19/2023] Open
Abstract
Introduction Needle-related distress is common among people receiving hemodialysis and affects quality of life and treatment decisions, yet little evidence exists to guide management. This study explored patients' experiences of needle-related distress to inform the development of prevention, identification, and management strategies. Methods Semistructured interviews concerning dialysis cannulation, needle-related distress, and potential solutions were conducted with people with current or recent experience of hemodialysis (N = 15) from a tertiary hospital-based service. Interviews ceased at thematic saturation. Transcripts were analyzed thematically. Results There were 4 themes and 11 subthemes generated: (i) uncovering a hidden source of distress (dismissal and minimization by others; suffering in silence to stay alive; preparation, assessment, and education); (ii) coping with cannulation pain and trauma (interaction between physical damage, pain, and distress; operator dependency-the importance of nurse skill and technique); (iii) the environment created by dialysis nurses (emotional transference; communication during cannulation; valuing empathy and person-centered care; a psychosocially supportive dialysis unit); and (iv) supporting patient self-management of distress (accessing tools to help themselves; distraction to reduce distress). Conclusion Needle-related distress is an often-hidden element of the hemodialysis experience. Patients learn to tolerate it as an inevitable part of dialysis for survival. Nurses' technical skills and the dialysis environment they create are key determinants of the patient cannulation experience. Proposed solutions include psychological screening, education for patients to self-manage distress, and training for nurses in communication and providing relevant psychological support.
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Affiliation(s)
- Emily L. Duncanson
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Central Northern Adelaide Renal and Transplantation Services (CNARTS), Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Richard K. Le Leu
- Central Northern Adelaide Renal and Transplantation Services (CNARTS), Royal Adelaide Hospital, Adelaide, South Australia, Australia
- School of Medicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Luke Macauley
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Central Northern Adelaide Renal and Transplantation Services (CNARTS), Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Anne L.J. Burke
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Psychology Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Fiona F. Donnelly
- Central Northern Adelaide Renal and Transplantation Services (CNARTS), Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Kathryn L. Collins
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Psychology Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Stephen P. McDonald
- Central Northern Adelaide Renal and Transplantation Services (CNARTS), Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
- School of Medicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Shilpanjali Jesudason
- Central Northern Adelaide Renal and Transplantation Services (CNARTS), Royal Adelaide Hospital, Adelaide, South Australia, Australia
- School of Medicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
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11
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Duncanson E, Le Leu RK, Chur-Hansen A, Masotti T, Collins KL, Burke ALJ, Macauley LP, McDonald S, Jesudason S. Nephrology nurses' perspectives working with patients experiencing needle-related distress. J Ren Care 2023. [PMID: 37975628 DOI: 10.1111/jorc.12483] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND A key skill of nephrology nursing is cannulation of patients receiving haemodialysis. Traumatic and unsuccessful cannulation experiences, particularly in the initial weeks of haemodialysis, may contribute to the onset of needle distress for patients. OBJECTIVES To identify the key knowledge, skills and attitudes of nephrology nurses working with haemodialysis patients and the competencies relevant to nephrology nursing working with patients with needle-related distress. DESIGN A qualitative study involving semistructured interviews. Interviews were audio-recorded, transcribed and deductive, and inductive thematic analysis applied. PARTICIPANTS Nephrology nurses (n = 17) were interviewed from a tertiary kidney service in South Australia. Nurses had varying roles and years of experience (range 1-30 years) working with dialysis patients within the service. RESULTS Two overarching themes, (1) Flexibility in Practice and Care and (2) Responsibility of Nephrology Nursing, were identified as relevant across all knowledge, skills and attitudes of nephrology nurses working with patients with needle-related distress. Thirty-six knowledge, skills and attitudes were identified; 12 related to knowledge, 14 related to skills and 10 were identified as attitudes and were summarised under seven broad competencies. CONCLUSION This study identifies potential knowledge, skills and attitudes and competencies required for nephrology nurses working with patients with needle-related distress. It highlights strategies that may prevent the onset and worsening of needle-related distress, as well as reduce it. It also brings to light that nurses desire additional education regarding strategies to improve the patient experience of cannulation and nurse confidence and skill in this area.
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Affiliation(s)
- Emily Duncanson
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Australia and New Zealand Dialysis and Transplant Registry, Adelaide, South Australia, Australia
| | - Richard K Le Leu
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Tahlia Masotti
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Kathryn L Collins
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Psychology Department, Central Adelaide Local Health Network, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Anne L J Burke
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Psychology Department, Central Adelaide Local Health Network, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Luke P Macauley
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
| | - Stephen McDonald
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
- Australia and New Zealand Dialysis and Transplant Registry, Adelaide, South Australia, Australia
| | - Shilpanjali Jesudason
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
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12
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Nicmanis M, Chur-Hansen A, Linehan K. The Information Needs and Experiences of People Living With Cardiac Implantable Electronic Devices: Qualitative Content Analysis of Reddit Posts. JMIR Cardio 2023; 7:e46296. [PMID: 37766632 PMCID: PMC10652197 DOI: 10.2196/46296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 09/06/2023] [Accepted: 09/27/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Cardiac implantable electronic devices (CIEDs) are used to treat a range of cardiovascular diseases and can lead to substantial clinical improvements. However, studies evaluating patients' experiences of living with these devices are sparse and have focused mainly on implantable cardioverter defibrillators. In addition, there has been limited evaluation of how people living with a CIED use social media to gain insight into their condition. OBJECTIVE This study aims to analyze posts from web-based communities called subreddits on the website Reddit, intended for people living with a CIED, to characterize the informational needs and experiences of patients. METHODS Reddit was systematically searched for appropriate subreddits, and we found 1 subreddit that could be included in the analysis. A Python-based web scraping script using the Reddit application programming interface was used to extract posts from this subreddit. Each post was individually screened for relevancy, and a register of participants' demographic information was created. Conventional qualitative content analysis was used to inductively classify the qualitative data collected into codes, subcategories, and overarching categories. RESULTS Of the 484 posts collected using the script, 186 were excluded, resulting in 298 posts from 196 participants being included in the analysis. The median age of the participants who reported this was 33 (IQR 22.0-39.5; range 17-72) years, and the majority had a permanent pacemaker. The content analysis yielded 5 overarching categories: use of the subreddit by participants, questions and experiences related to the daily challenges of living with a CIED, physical sequelae of CIED implantation, psychological experiences of living with a CIED, and questions and experiences related to health care while living with a CIED. These categories provided insight into the diverse experiences and informational needs of participants living with a CIED. The data predominantly represented the experiences of younger and more physically active participants. CONCLUSIONS Social media provides a platform through which people living with a CIED can share information and provide support to their peers. Participants generally sought information about the experiences of others living with a CIED. This was often done to help overcome a range of challenges faced by participants, including the need to adapt to living with a CIED, difficulties with navigating health care, psychological difficulties, and various aversive physical sequelae. These challenges may be particularly difficult for younger and physically active people. Health care professionals may leverage peer support and other aid to help people overcome the challenges they face while living with a CIED.
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Affiliation(s)
- Mitchell Nicmanis
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Karen Linehan
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
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13
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Lores T, Evans S, Chur-Hansen A, Andrews JM, Goess C, Smith L, Skvarc D, Mikocka-Walus AA. Virtual adjunctive gut-directed hypnotherapy for people with Crohn's disease: A randomized controlled pilot and feasibility trial. Complement Ther Clin Pract 2023; 53:101791. [PMID: 37531719 DOI: 10.1016/j.ctcp.2023.101791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 07/20/2023] [Accepted: 07/28/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Gut-directed hypnotherapy appears to be a promising adjunctive treatment for people with Crohn's disease. The primary objective of this pilot trial was to evaluate feasibility and acceptability of virtually delivered hypnotherapy to determine the parameters for a future definitive trial. METHODS This prospective, single-site, randomized controlled pilot and feasibility trial compared a 7-week course of virtually delivered adjunctive gut-directed hypnotherapy to standard medical treatment only for adults with Crohn's disease. Primary outcomes were study feasibility and intervention acceptability. Secondary outcomes were objective disease activity and patient-reported outcomes. Assessments took place at five time-points: baseline, post-intervention, and follow-up three-, six-, and 12-months post-intervention. KEY RESULTS Recruitment took place between July 2020 and August 2021 at a tertiary hospital. Recruitment was initially slow and subsequently expanded to community settings. Thirty-seven participants were enrolled in the trial: 95% were retained at post-intervention and 76% at 12-months. Completion of online assessments was high (97-100% across all time-points) whilst objective data collection was low (34-44%). Most intervention participants completed all hypnotherapy sessions (88%) and reported being extremely satisfied (73%), despite 60% experiencing technical issues. CONCLUSION & INFERENCES Virtually delivered hypnotherapy was acceptable to participants. Certain aspects of the trial including online assessment were feasible, while recruitment and objective data collection were challenges. Undertaking a future definitive trial will require broader recruitment scope and significant funding for widespread objective data collection. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry ANZCTR#1260000348954.
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Affiliation(s)
- Taryn Lores
- Deakin University, Melbourne, Australia; Central Adelaide Local Health Network (CALHN), Adelaide, Australia.
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14
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Radisic G, Leu RL, Donnelly F, Duncanson E, Collins KL, Burke ALJ, Chur-Hansen A, McDonald S, Hill K, Macauley L, Jesudason S. How Can Nurses Support Patients on Hemodialysis Who Experience Needle Fear? An Online Educational Intervention for Nephrology Nurses. Nephrol Nurs J 2023; 50:423-428. [PMID: 37983551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Nephrology nurses struggle to support patients on hemodialysis who experience needle fear due to absence of adequate programs or guidelines. Therefore, we have designed an educational intervention for nurses to learn techniques and strategies to support patients with needle fear and review best cannulation practices with minimal trauma to improve patients' experience of dialysis. A pre-post design measured self-reported confidence in nurses' ability to support patients on dialysis who have a fear of needles. We found nurses can benefit from targeted educational interventions that provide information and strategies regarding needle fear management. Findings from this study have a potential to be transferred to other chronic disease settings with frequent needle use.
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Affiliation(s)
- Gorjana Radisic
- Project Manager/Research Officer, Royal Adelaide Hospital, Adelaide, South Australia
| | - Richard Le Leu
- Clinical Research Coordinator for the Central Northern Adelaide Renal and Transplantation Service (CNARTS) Clinical Research Group, South Australia Health, Adelaide, South Australia
| | - Fiona Donnelly
- Nurse Practitioner, Royal Adelaide Hospital, Adelaide, South Australia
| | - Emily Duncanson
- Research Officer, Royal Adelaide Hospital, Adelaide, South Australia
| | - Kathryn Louise Collins
- Co-Director of Psychology, Central Adelaide Local Health Network, Adelaide, South Australia
| | - Anne Louise Jane Burke
- Co-Director of Psychology, Central Adelaide Local Health Network, Adelaide, South Australia
| | | | - Stephen McDonald
- Director of Dialysis, Central Adelaide Local Health Network, Adelaide, South Australia
| | - Kathy Hill
- Lecturer and Academic Integrity Officer, University of South Australia, Adelaide, South Australia
| | - Luke Macauley
- Consumer Partner, Kidney Health Australia, Adelaide, South Australia
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15
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Brook E, Chur-Hansen A, Chan L, Crawford G. Psychological service provision in Australian Palliative Care Services. Palliat Support Care 2023:1-7. [PMID: 37427578 DOI: 10.1017/s1478951523000925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
OBJECTIVES Psychological distress is common among palliative care patients. Despite this, little is known about the availability of psychological services to support palliative care patients within Australia. This study aimed to determine the level of psychological support services available within Australian Palliative Care Services. The study was based on a similar study in Australia by Crawford in 1999, allowing differences over time to be examined. METHODS A 12-item online survey was distributed to adult Palliative Care Services throughout Australia from November 2021 to January 2022. Quantitative and qualitative analysis of responses was conducted, with comparisons made with the 1999 study using a 2-proportions z-test. RESULTS Social workers were the most available professionals delivering psychological care (prevalence of 94.1%), followed by spiritual care workers (62.5%), creative therapists (43.8%), counselors (36.4%), psychiatrists (31.3%), complementary therapists (28.1%), and psychologists (25.0%). Nearly 60% of services had no access to a psychiatrist or a psychologist. The proportion of Palliative Care Services that had access to a psychiatrist, psychologist, or counselor was significantly less in 2021/22 compared to 1999, with differences of 29.4% (p = 0.002), 23.4% (p = 0.015), and 26.1% (p = 0.006), respectively. SIGNIFICANCE OF RESULTS Lack of access to psychiatrists, psychologists, and counselors in Australian Palliative Care Services remains a significant issue and has become more prevalent since 1999. Ongoing advocacy and increased government funding to enable psychological health professionals to be readily employed in Palliative Care Services is vital.
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Affiliation(s)
- Emma Brook
- School of Medicine, Faculty of Health and Medical Sciences, Univeristy of Adelaide, Adelaide, Australia
- Northern Adelaide Palliative Service, Northern Adelaide Local Health Network, Adelaide, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Lily Chan
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Gregory Crawford
- School of Medicine, Faculty of Health and Medical Sciences, Univeristy of Adelaide, Adelaide, Australia
- Northern Adelaide Palliative Service, Northern Adelaide Local Health Network, Adelaide, Australia
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16
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Le Leu R, Bennett PN, Dansie K, Shanahan L, Chur-Hansen A, Collins KL, Burke ALJ, Donnelly F, Duncanson E, Meade A, McDonald S, Jesudason S. Changes in symptom burden in the first 6 months after dialysis commencement: a prospective longitudinal observational cohort study. J Nephrol 2023; 36:1485-1488. [PMID: 37000370 DOI: 10.1007/s40620-023-01603-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/12/2023] [Indexed: 04/01/2023]
Affiliation(s)
- Richard Le Leu
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, 1 Port Rd, Adelaide, SA, 5000, Australia.
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, 5000, Australia.
| | - Paul N Bennett
- University of South Australia, Clinical and Health Sciences, Adelaide, SA, Australia
| | - Kathryn Dansie
- Australia and New Zealand Dialysis and Transplant Registry, Adelaide, SA, Australia
| | - Lisa Shanahan
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, 1 Port Rd, Adelaide, SA, 5000, Australia
| | - Anna Chur-Hansen
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, 5000, Australia
| | - Kathryn L Collins
- Psychology Department, Central Adelaide Local Health Network, Royal Adelaide Hospital, Adelaide, SA, 5000, Australia
| | - Anne L J Burke
- Psychology Department, Central Adelaide Local Health Network, Royal Adelaide Hospital, Adelaide, SA, 5000, Australia
| | - Fiona Donnelly
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, 1 Port Rd, Adelaide, SA, 5000, Australia
| | - Emily Duncanson
- Australia and New Zealand Dialysis and Transplant Registry, Adelaide, SA, Australia
| | - Anthony Meade
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, 1 Port Rd, Adelaide, SA, 5000, Australia
| | - Stephen McDonald
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, 1 Port Rd, Adelaide, SA, 5000, Australia
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, 5000, Australia
- Australia and New Zealand Dialysis and Transplant Registry, Adelaide, SA, Australia
| | - Shilpanjali Jesudason
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, 1 Port Rd, Adelaide, SA, 5000, Australia
- Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, 5000, Australia
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17
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Dorstyn D, Oxlad M, Whitburn S, Fedoric B, Roberts R, Chur-Hansen A. Client and staff perspectives regarding effective work injury rehabilitation. AUST HEALTH REV 2023:AH22256. [PMID: 36921621 DOI: 10.1071/ah22256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/01/2023] [Indexed: 03/17/2023]
Abstract
ObjectiveEarly, targeted treatment is critical to recovery and overall health following a work-related illness or injury. Limited research has explored the important dimensions of work-specific injury rehabilitation from both client and staff perspectives.MethodsA total of 17 participants (13 clients with work-related injuries, 3 physiotherapists, 1 project manager) involved in a unique program providing allied health treatment in combination with return-to-work services, were interviewed. Data were analysed using reflexive thematic analysis.ResultsFour themes were generated: (1) a biopsychosocial approach to rehabilitation; (2) a self-paced environment where client outcomes are optimised through transparent and collaborative team processes; (3) comprehensive care aids client recovery and return to work; and (4) a desire for service expansion is hampered by systemic barriers.ConclusionsInjured workers and staff provided very positive feedback about the biopsychosocial supports needed for successful return to work, particularly the use of in-house work-specific simulation tasks as gradual in-vivo exposure and collaboration with scheme stakeholders. How to best provide this holistic care within current legislative requirements remains a challenge.
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18
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Dorstyn DS, Chur-Hansen A, Mansell E, Murphy G, Roberts RM, Stewart P, Potter E, Kneebone I, Craig A. Facilitators and barriers to employment for persons with chronic spinal cord injury or disorder: A qualitative study framed by the person-environment-occupation model. J Spinal Cord Med 2023; 46:246-255. [PMID: 34038332 PMCID: PMC9987752 DOI: 10.1080/10790268.2021.1922231] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
CONTEXT/OBJECTIVE Prolonged unemployment is common for people living with a spinal cord injury or disorder (SCI/D) and can impact negatively on quality of life. The present study examines stakeholder perspectives and experiences with the job search process in order to identify service gaps and return-to-work solutions. DESIGN In-depth semi-structured interviews were thematically analysed, with questions focused on factors that can help or hinder efforts to gain employment. Generated themes were then applied to the Person-Environment-Occupation (PEO) systems model of participation. SETTING Community-based disability service provider in South Australia. PARTICIPANTS Purposive sample of persons with SCI/D (n = 8) and rehabilitation professionals (n = 4). RESULTS Person-centred themes were strongly endorsed by both groups and focused on incentives of, and motivation for, employment. Equally important to the job search process were individual expectations and attitudes, particularly job readiness. Environmental facilitators included employers' positive attitude, although workplace discrimination remained a concern. Occupation-based barriers, rather than opportunities, were identified - namely, difficulties in SCI/D self-management, the need for timely functional assessments, and more opportunities for education, upskilling and retraining. CONCLUSIONS The PEO model provides a broad framework to better understand the complex return-to-work process for people with a SCI/D and, potentially, uncover tangible solutions. The suggestion is that vocational rehabilitation should go beyond skills training and include motivational support to enhance job readiness. This must be done on a case-by-case basis. There is also a need for active and covert discrimination to be addressed through employment policies. The findings will be used to develop intervention targets for a newly established vocational rehabilitation service.
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Affiliation(s)
- Diana S Dorstyn
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Ella Mansell
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Gregory Murphy
- School of Psychology and Public Health, La Trobe University, Bundoora, Australia
| | - Rachel M Roberts
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Peter Stewart
- The Paraplegic and Quadriplegic Association of South Australia, Adelaide, Australia
| | - Elizabeth Potter
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, Australia
| | - Ian Kneebone
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, Australia
| | - Ashley Craig
- Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Kolling Institute of Medical Research, RNSH, St Leonards, Australia
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19
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Macauley L, Chur-Hansen A. Human Health Benefits of Non-Conventional Companion Animals: A Narrative Review. Animals (Basel) 2022; 13:ani13010028. [PMID: 36611636 PMCID: PMC9817996 DOI: 10.3390/ani13010028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 12/24/2022] Open
Abstract
Research investigating health benefits from household human-animal bonds has focused mostly on bonds with companion dogs, cats, and horses. Wellbeing benefits associated with other companion animal species such as birds, fish, and reptiles are described and anecdotally reported, but there is little empirical literature supporting this. The literature suggests that health benefits of companion animals are predicated on human perceptions of the animal rather than the animal's species. Therefore, relationships with non-conventional companion animals of diverse species may benefit the health of their human guardians as do dogs, cats, and horses. This narrative review summarizes the current literature exploring perceived health benefits gained from non-conventional companion animals. Searches were conducted for published literature and grey literature up to October 2022 across PsycINFO and PubMed databases, and Newsbank media database for commercial media publications. Nineteen studies and 10 media articles were included in the review. Gaps in the literature include a lack of rigorous research to investigate the health benefits of non-conventional companion animals. Non-conventional companion animals may benefit their guardians by providing social support through acting as attachment figures, facilitating social opportunities and daily routines, fulfilling cognitive needs, and recreating restorative capacities of mindfully observing natural landscapes. Further high-quality research into the human-non-conventional companion animal bond is warranted.
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20
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Fratini A, Hemer SR, Chur-Hansen A. Peeking Behind the Curtains. Anthropology in Action 2022. [DOI: 10.3167/aia.2022.290301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Abstract
Patchwork ethnography is a viable methodological and theoretical approach. Fieldwork can be accessible, achievable and accommodating of both personal and professional circumstances and responsibilities of the researcher, and external factors such as living within a COVID-19 world. In this article, we explain patchwork ethnography and showcase how the methodology was implemented during the first author's PhD fieldwork conducted in 2020–2021 relating to peeking behind the physical and metaphorical curtains of the death industry to understand the handling, management and conceptualisation of the dead human body in Adelaide, South Australia. We demonstrate how field sites were constructed and discuss the methodological tools utilised to produce an ethnographic experience. We also question the ongoing viability of notions of ‘traditional’ fieldwork practices.
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21
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Feeney M, Chur-Hansen A, Mikocka-Walus A. People Living with Inflammatory Bowel Disease Want Multidisciplinary Healthcare: A Qualitative Content Analysis. J Clin Psychol Med Settings 2022; 29:570-577. [PMID: 34185254 DOI: 10.1007/s10880-021-09801-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 12/20/2022]
Abstract
This study reports on the preferences of people with inflammatory bowel disease (IBD) for their healthcare. Overall, 477 people with IBD responded to an open-ended survey question within a larger study. We qualitatively content-analysed these responses with open coding using NVivo. Respondents expressed a desire for (1) better communication, (2) multidisciplinary care, (3) better treatment, services and specialist care, (4) whole person care, (5) health promotion, (6) proactive healthcare, (7) fewer administrative issues and (8) improved hospital experience. Patients with IBD want patient-centred, multidisciplinary care. Healthcare professionals should facilitate patients' access to proactive care.
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Affiliation(s)
- Meg Feeney
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, North Tce, SA, 5005, Australia
| | - Anna Chur-Hansen
- School of Psychology, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia
| | - Antonina Mikocka-Walus
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, North Tce, SA, 5005, Australia.
- School of Psychology, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
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22
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Page SM, Chur-Hansen A, Delfabbro PH. Hairdressers as a source of social support: A qualitative study on client disclosures from Australian hairdressers' perspectives. Health Soc Care Community 2022; 30:1735-1742. [PMID: 34423509 DOI: 10.1111/hsc.13553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 07/12/2021] [Accepted: 08/09/2021] [Indexed: 06/13/2023]
Abstract
Hairdressing is one of the few non-health professional occupations where workers physically interact with clients, who are often comfortable in confiding private information to them. Despite this, relatively little is known about how hairdressers understand and experience this role as informal confidants. This study aimed to address this using an in-depth qualitative approach to capture what hairdressers are hearing from clients, and how hairdressers respond and feel about supporting clients. Participant led interviews with prompt questions were conducted in South Australia in 2019, transcribed and analysed using Thematic Analysis. Results indicate clients disclose information about family, health, identity, mental health and women's health. Important themes generated in relation to the role of hairdressers included: their need to have a client focus; blurring role boundaries; behaving like a therapist and, providing a place of safety and advice, while also maintaining confidentiality. Hairdressers reported feeling undervalued, emotionally drained, and in need of support in their role, but conversely, also reported having good job satisfaction. Further research is needed to examine whether hairdresser-client interactions may promote better mental and physical health outcomes for clients due to psychological buffering arising from the social support provided by hairdressers, as well as the impact on hairdressers and implications for their training.
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Affiliation(s)
- Stacey M Page
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Paul H Delfabbro
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
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23
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Cafarella P, Effing T, Chur-Hansen A. Interventions targeting psychological well-being for motor neuron disease carers: A systematic review. Palliat Support Care 2022; 21:1-17. [PMID: 35287783 DOI: 10.1017/s1478951522000311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES This systematic review considers interventions designed to improve the psychological well-being (PWB) of carers of people with motor neuron disease (MND) using quantitative, qualitative, or mixed-methods studies, and aimed to (1) summarize current research, (2) assess the quality of evidence, and (3) evaluate the effectiveness of interventions. METHOD Mixed-methods systematic review (MMSR) was conducted based on Joanna Briggs Institute methodology for quantitative, qualitative, and mixed-methods reviews and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Thirteen papers met the inclusion criteria, including 12 studies (six mixed-methods, four quantitative, and two qualitative). Four studies described randomized controlled trials, seven detailed uncontrolled longitudinal studies with a single treatment group and a pre-post design, and one was an observational survey. Critical appraisal of the studies revealed a wide range of weaknesses in the quantitative and/or qualitative methodologies. Due to the heterogeneity of interventions, outcomes, and measurements, a narrative and convergent approach to data synthesis was employed. While a minority of studies demonstrated some benefits to hedonic and eudaimonic aspects of PWB, the interpretability of these data was limited by methodological problems. SIGNIFICANCE OF RESULTS This MMSR highlighted a paucity of quality research regarding interventions for the PWB of MND carers. Although some benefits to PWB were demonstrated, most studies suffered from substantial methodological problems, rendering the overall evidence base low. High-quality and carefully designed studies are a priority to enable effective development and testing of much-needed interventions targeting the PWB for MND carers.
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Affiliation(s)
- Paul Cafarella
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, South Australia, Australia
- Department of Respiratory Medicine, Flinders Medical Centre, Southern Adelaide Local Health Network, South Australia, Australia
- College of Nursing and Health Sciences, Flinders University of South Australia, Adelaide, Australia
- College of Medicine and Public Health, Flinders University of South Australia, Adelaide, Australia
| | - Tanja Effing
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, South Australia, Australia
- College of Medicine and Public Health, Flinders University of South Australia, Adelaide, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, South Australia, Australia
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Radisic G, Duncanson E, Le Leu R, Collins KL, Burke ALJ, Turner JK, Chur-Hansen A, Donnelly F, Hill K, McDonald S, Macauley L, Jesudason S. Improving management of needle distress during the journey to dialysis through psychological education and training-the INJECT study feasibility pilot protocol. Pilot Feasibility Stud 2022; 8:28. [PMID: 35120560 PMCID: PMC8815234 DOI: 10.1186/s40814-022-00989-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 01/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Needle-related distress is a common yet poorly recognised and managed problem among haemodialysis (HD) patients. The aim of this pilot study is to test the feasibility and acceptability of the INJECT Intervention-an innovative psychology-based intervention to empower patients to self-manage needle distress with the support of dialysis nurses. METHODS This investigator-initiated, single-arm, non-randomised feasibility study will take place in a large dialysis service in Adelaide, Australia. Participants will include patients aged ≥ 18 years, commencing or already receiving maintenance HD, recruited through dialysis physicians and nursing staff as individuals believed to be at risk of needle distress. They will be screened for inclusion using the Dialysis Fear of Injection Questionnaire (DFIQ) and enrolled into the study if the score is ≥ 2. The multi-pronged intervention encompasses (i) psychologist review, (ii) patient self-management program and (iii) nursing education program. The primary aim is to evaluate feasibility and acceptability of the intervention from patient and dialysis nurse perspectives, including recruitment, retention, engagement with the intervention and completion. Secondary exploratory outcomes will assess suitability of various tools for measuring needle distress, evaluate acceptability of the nursing education program and measure cannulation-related trauma and vascular access outcomes. CONCLUSION The results will inform the protocol for larger trials addressing needle distress in HD patients. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12621000229875, approved 4 April 2021, https://www.anzctr.org.au/ .
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Affiliation(s)
- G Radisic
- Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia.
| | - E Duncanson
- Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia.,School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, 5000, Australia
| | - R Le Leu
- Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia.,School of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, 5000, Australia
| | - K L Collins
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, 5000, Australia.,Psychology Department, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia
| | - A L J Burke
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, 5000, Australia.,Psychology Department, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia
| | - J K Turner
- Psychology Department, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia
| | - A Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, 5000, Australia
| | - F Donnelly
- Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia
| | - K Hill
- University of South Australia, South Australia, 5000, Adelaide, Australia
| | - S McDonald
- Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia.,School of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, 5000, Australia
| | - L Macauley
- Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia.,School of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, 5000, Australia
| | - S Jesudason
- Central Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, 5000, Australia.,School of Medicine, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, 5000, Australia
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Urry K, Chur-Hansen A, Khaw C. 'It's Not Really a Part of Standard Practice': Institutional Silencing of Sexuality Within Australian Mental Health Settings. Qual Health Res 2022; 32:543-555. [PMID: 34904865 DOI: 10.1177/10497323211061340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Research seeking to understand and improve sexuality-related practice in mental health settings has paid little attention to the institutional context in which clinicians' practice is embedded. Through a social constructionist lens, we used thematic analysis to examine how 22 Australian mental health clinicians implicated the wider institutional context when discussing and making sense of sexuality-related silence within their work. Interviews were part of a study exploring participants' perceptions of sexuality and sexual health in their work more generally. Broader silences that shaped and reinforced participants' perceptions and practice choices were situated in professional education; workplace cultures; and the tools, procedures and policies that directed clinical practice. We argue that sexuality-related silence in mental health settings is located in the institutional context in which clinicians learn and work, and discuss how orienting to this broader context will benefit research and interventions to improve sexuality-related practice across health settings.
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Affiliation(s)
- Kristi Urry
- School of Psychology, Faculty of Health and Medical Sciences, 1066University of Adelaide, Adelaide, SA, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, 1066University of Adelaide, Adelaide, SA, Australia
| | - Carole Khaw
- School of Medicine, Faculty of Health and Medical Sciences, 1066University of Adelaide, Adelaide, SA, Australia
- Adelaide Sexual Health Centre, Infectious Disease UnitRoyal Adelaide Hospital, Adelaide, SA, Australia
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Jackson T, Chur-Hansen A, Duncanson E, Jesudason S. A qualitative content analysis of an online forum for people with kidney disease: Exploring the role of companion and non-companion animals. J Ren Care 2021; 48:220-229. [PMID: 34797030 DOI: 10.1111/jorc.12406] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 10/05/2021] [Accepted: 10/22/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Companion and other animals have been known to promote wellbeing of people living with chronic disease by assisting in emotional regulation, social interaction and enhancing self-identity. However, little is known about the impact of animals on people with kidney disease, who often live with treatment burden, as well as compromised immune systems making them vulnerable to zoonotic diseases. OBJECTIVES To explore the impact companion and non-companion animals have on the lives of people living with kidney disease. DESIGN Qualitative Content Analysis of 518 posts from an online forum. PARTICIPANTS One hundred seventy-two people (109 female, 41 male and 22 unknown) posting to an online forum for people undergoing kidney dialysis. RESULTS Benefits of bonds with animals included reciprocal love and affection, emotional support, stress reduction, aiding relaxation, assisting social interaction, animals' intuitive comfort when unwell, feelings of loyalty, and motivation to live, concerns relating to zoonotic disease risk, and patients' impressions of health professionals' opinions on animals. CONCLUSIONS This study reinforces the existence of strong bonds between humans and animals, as well as demonstrating the importance of and concerns regarding interacting with non-companion animals for people with chronic kidney disease (CKD). There is a mismatch between patients' perception of infection risk and the advice and opinions of some healthcare professionals. Recognition and support for the role of animals as social supports are warranted in history taking, patient education of risk, and the biopsychosocial benefits of animals.
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Affiliation(s)
- Tara Jackson
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia, Australia
| | - Emily Duncanson
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia, Australia.,Central Northern Adelaide Renal and Transplantation Service (CNARTS) Clinical Research Group, Royal Adelaide Hospital, South Australia, Australia
| | - Shilpanjali Jesudason
- Central Northern Adelaide Renal and Transplantation Service (CNARTS) Clinical Research Group, Royal Adelaide Hospital, South Australia, Australia.,Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia, Australia
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Duncanson E, Chur-Hansen A, Jesudason S. Patient perspectives of coping with automated peritoneal dialysis. Perit Dial Int 2021; 42:344-352. [PMID: 34498514 DOI: 10.1177/08968608211043411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Patients receiving peritoneal dialysis (PD) experience poor quality of life, depression, anxiety and lifestyle changes. Insights into how patients adjust to and cope with PD from a psychological perspective will aid care. METHODS Participants were recruited purposively through the Central Northern Adelaide Renal and Transplantation Service in South Australia. Ten patients receiving automated PD (APD) (5 females and 5 males) aged 31 to 77 years (M = 59.3) participated in a semi-structured interview. Interview transcripts were analysed thematically through inductive and deductive methods. RESULTS Five main themes representing participants' experiences and perspectives of adjusting to and coping with APD were identified: (1) Resigned Acceptance, (2) A Bridge to Transplant, (3) Navigating Emotions at Milestones and Transitions, (4) Professional Support (Sub-themes: Psychological Support and Education and Information Delivery and (5) Social Enablers (Sub-theme: Hidden from View and Hiding Illness). CONCLUSIONS Patients employ cognitive, emotional and behavioural strategies and rely strongly on social supports to cope with APD. PD at home aids preservation of pre-illness identity, however, also results in feelings of isolation and being misunderstood. Psychological distress and poor coping may be heightened at key disease milestones and transition periods when professional psychological support should be offered. We provide suggestions to address patients' psychosocial needs and coping in treatment decision-making and dialysis care.
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Affiliation(s)
- Emily Duncanson
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia, Australia.,Central Northern Adelaide Renal and Transplantation Service (CNARTS), Royal Adelaide Hospital, South Australia, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia, Australia
| | - Shilpanjali Jesudason
- Central Northern Adelaide Renal and Transplantation Service (CNARTS), Royal Adelaide Hospital, South Australia, Australia.,Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia, Australia
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Thomas J, Kumar K, Chur-Hansen A. How pharmacy and medicine students experience the power differential between professions: "Even if the pharmacist knows better, the doctor's decision goes". PLoS One 2021; 16:e0256776. [PMID: 34437641 PMCID: PMC8389418 DOI: 10.1371/journal.pone.0256776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/15/2021] [Indexed: 11/26/2022] Open
Abstract
Interprofessional Education (IPE) is one approach to improving communication and collaborative practice between professions, which are essential for the optimal delivery of healthcare. Common barriers include negative attitudes, professional stereotypes, professional cultures and power differentials between professional groups. The aim of this qualitative study was to explore how professional hierarchies and power differentials shape interprofessional interactions between preregistration pharmacy and medicine students. Data were gathered via semi-structured interviews and subject to thematic analysis. Four main themes were identified: Reproducing traditional hierarchies; Social norms around respect; Hierarchies in care values and goals; and Challenging the narrative is possible. Students' interactions with and views of the other profession largely reflected traditional stereotypes and power differentials. Hierarchy was evident in how respect was accorded and in how care values and goals were managed. Despite this, students overwhelmingly perceived and reported a sense of agency in changing the status quo. Emerging professional identity and conceptualisation of future roles is heavily influenced by the hierarchical relationship between the professions and can pose a significant barrier to collaborative practice. Greater support for collaborative interprofessional practice is needed at the level of policy and accreditation in health education and healthcare to ensure greater commitment to change.
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Affiliation(s)
- Josephine Thomas
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Koshila Kumar
- Prideaux Centre for Research in Health Professions Education, Flinders University, Bedford Park, South Australia, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
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Duncanson E, Le Leu RK, Shanahan L, Macauley L, Bennett PN, Weichula R, McDonald S, Burke ALJ, Collins KL, Chur-Hansen A, Jesudason S. The prevalence and evidence-based management of needle fear in adults with chronic disease: A scoping review. PLoS One 2021; 16:e0253048. [PMID: 34111207 PMCID: PMC8192004 DOI: 10.1371/journal.pone.0253048] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 05/27/2021] [Indexed: 11/27/2022] Open
Abstract
Background Little is known about the prevalence and best management of needle fear in adults with chronic disease, who may experience frequent and long-term exposure to needles for lifesaving therapies such as renal dialysis and cancer treatment. Identifying interventions that assist in management of needle fear and associated distress is essential to support these patients with repeated needle and cannula exposure. Method We followed the PRISMA methodology for scoping reviews and systematically searched PsychINFO, PubMed (MEDLINE), ProQuest, Embase and grey literature and reference lists between 1989 and October 2020 for articles related to needle discomfort, distress, anxiety, fear or phobia. The following chronic diseases were included: arthritis, asthma, chronic back pain, cancer, cardiovascular disease, chronic obstructive pulmonary disease, diabetes, and mental illness, or kidney failure. Literature concerning dentistry, vaccination, intravenous drug users and paediatric populations were excluded. Results We identified 32 papers reporting prevalence (n = 24), management (n = 5) or both (n = 3). Needle fear prevalence varied in disease cohorts: 17–52% (cancer), 25–47% (chronic kidney disease) and 0.2–80% (diabetes). Assessment methods varied across studies. Management strategies had poor evidence-base, but included needle-specific education, decorated devices, cognitive-behavioural stress management techniques, distraction, and changing the therapy environment or modality. Conclusion Although needle fear is common there is a paucity of evidence regarding interventions to address it among adults living with chronic disease. This scoping review has highlighted the need for improved identification of needle fear in adults and development of interventions are required for these cohorts.
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Affiliation(s)
- Emily Duncanson
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, South Australia, Australia
| | - Richard K. Le Leu
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Lisa Shanahan
- Paramount Health Service, Adelaide, South Australia, Australia
| | - Luke Macauley
- Patient Partner for Central and Northern Adelaide Renal and Transplantation Service Clinical Research Group, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Paul N. Bennett
- Clinical and Health Services, University of South Australia, Adelaide, Australia
| | - Rick Weichula
- Centre for Evidence-based Practices, South Australia, Faculty of Health and Medical Sciences, University of Adelaide, South Australia, Australia
| | - Stephen McDonald
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Anne L. J. Burke
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, South Australia, Australia
- Psychology Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Kathryn L. Collins
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, South Australia, Australia
- Psychology Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, South Australia, Australia
| | - Shilpanjali Jesudason
- Central and Northern Adelaide Renal and Transplantation Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Department of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- * E-mail:
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Newell SJ, Chur-Hansen A, Strelan P. A construct validity analysis of the concept of psychological literacy. Australian Journal of Psychology 2021. [DOI: 10.1080/00049530.2021.1922069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Affiliation(s)
| | - Anna Chur-Hansen
- School of Psychology, University of Adelaide, Adelaide, Australia
| | - Peter Strelan
- School of Psychology, University of Adelaide, Adelaide, Australia
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Lores T, Goess C, Mikocka-Walus A, Collins KL, Burke ALJ, Chur-Hansen A, Delfabbro P, Andrews JM. Integrated Psychological Care Reduces Health Care Costs at a Hospital-Based Inflammatory Bowel Disease Service. Clin Gastroenterol Hepatol 2021; 19:96-103.e3. [PMID: 32007538 DOI: 10.1016/j.cgh.2020.01.030] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 01/18/2020] [Accepted: 01/24/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Inflammatory bowel diseases (IBD) are associated with high psychosocial burden and economic cost. Integrating psychological care into routine management might lead to savings. We performed a 2-year investigation of the effects of integrated psychological care in reducing healthcare use and costs. METHODS We performed a prospective study of 335 adult patients treated at a hospital-based IBD service in Australia. Participants were recruited between September 2015 and August 2016 and completed screening instruments to evaluate mental health and quality of life. Data on healthcare use and costs for the previous 12 months were also collected. Patients found to be at risk for mental health issues were offered psychological intervention. Patients were followed up 12 months after screening (between September 2016 and August 2017). RESULTS A significantly higher proportion of subjects at risk for mental health issues had presented to an emergency department in the 12 months before screening (51/182; 28%) compared to psychologically healthy subjects (28/152; 18%; X2(1) = 4.23; P = .040). Higher levels of depression and general distress (but not anxiety) were related to increased odds of hospital admission (adjusted odds ratios, 1.07 and 1.05, respectively). Among the patients who accepted psychological intervention, the number who presented to emergency departments was reduced significantly in the 12 months after screening (follow-up) compared to the 12 months before screening (P = .047), resulting in a cost saving of AU$30,140 ($20,816 USD). A cost-benefit analysis of the integrated psychological care model revealed a net saving of AU$84,905 ($58,647 USD) over a 2-year period. CONCLUSIONS Risk for mental health issues is associated with higher healthcare costs in people with IBD. Providing integrated psychological care to individuals at risk for mental health issues can reduce costs, particularly by decreasing visits to emergency departments. Further studies are required to determine the best care to provide to reduce costs.
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Affiliation(s)
- Taryn Lores
- Inflammatory Bowel Disease Service, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia; School of Psychology, Faculty of Health, Deakin University, Melbourne, Victoria, Australia; School of Psychology, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.
| | - Charlotte Goess
- Inflammatory Bowel Disease Service, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Antonina Mikocka-Walus
- School of Psychology, Faculty of Health, Deakin University, Melbourne, Victoria, Australia
| | - Kathryn L Collins
- School of Psychology, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia; Department of Psychology, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Anne L J Burke
- School of Psychology, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia; Department of Psychology, Central Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Paul Delfabbro
- School of Psychology, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
| | - Jane M Andrews
- Inflammatory Bowel Disease Service, Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia; School of Medicine, Faculty of Health & Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
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Oxlad M, Roberts R, Chur-Hansen A, Proeve M, Auton J, Sarris A, Tabe A. Employing Multiple Mini Interviews in Selection Processes for Psychology Professional Training Programs: Ten Tips for Effective Implementation. MedEdPublish (2016) 2020; 9:192. [PMID: 38073773 PMCID: PMC10699392 DOI: 10.15694/mep.2020.000192.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023] Open
Abstract
This article was migrated. The article was marked as recommended. In Australia and internationally, entry into many professional psychology training programs is highly competitive, and as a duty of care to the public, training institutions must seek to offer places to those best-suited to training to become a psychologist. Typically, part of this selection process involves an interview. While panel interviews have been widely utilised, recently, in a range of health disciplines, these have been substituted for multiple mini interviews (MMIs) with evidence for their acceptability, validity and reliability. There is limited research on the use of MMIs in psychology professional training selection processes. We have used this approach for three years to select approximately 100 trainees for Clinical, Health and Organisational and Human Factors postgraduate psychology training programs. Based on our experience and feedback from applicants, we provide information that suggests this selection method is well-received by applicants. We also provide ten tips on how to effectively implement this approach to determine those most suitable for further training.
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Abstract
Diagnosing deafness is a culturally situated practice generating considerable research in health sciences but limited work in anthropology. Diagnosis fast-tracks parents into a medical and education pathway but can also create tension for parents and professionals. Drawing on ethnographic fieldwork, we argue that in this biomedical context, emotions are often understood by professionals as impairing for parents, and hence problematic for the treatment process. In contrast emotions are characterized by parents as motivational and tools for decision making on a pathway that is experienced as a source of stress.
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Affiliation(s)
- Claire Harris
- Anthropology and Development Studies, University of Adelaide, Adelaide, Australia
| | - Susan Hemer
- Anthropology and Development Studies, University of Adelaide, Adelaide, Australia
| | - Anna Chur-Hansen
- School of Psychology, University of Adelaide, Adelaide, Australia
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Dowsett E, Delfabbro P, Chur-Hansen A. Adult separation anxiety disorder: The human-animal bond. J Affect Disord 2020; 270:90-96. [PMID: 32339110 DOI: 10.1016/j.jad.2020.03.147] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/14/2020] [Accepted: 03/29/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The introduction of an adult onset Separation Anxiety Disorder in the DSM-V recognises that separation anxiety can occur at any stage across the lifespan. In this paper, we examine whether adult separation anxiety, which is known to occur when people are apart from other people close to them, can also develop when people are separated from animal companions. The social and individual psychological correlates of this reported phenomenon are examined. METHODS Participants (N = 313, aged 18-76, M = 41.89 years), completed demographic information and questionnaires measuring separation anxiety from companion animals and humans, attachment towards companion animals and humans, and social support. RESULTS Significant positive relationships were observed between separation anxiety from humans, people substitution and separation anxiety from animals. Participants with greater separation anxiety from animals also reported less social support and greater attachment anxiety involving humans. People substitution was also positively related to greater animal-related separation anxiety. Associations were generally weaker when cats were identified as the principal companion animal. Participants without children reported significantly less attachment-related avoidance (human); less perceived social support; greater people substitution; and, greater separation anxiety towards companion animals. Separation anxiety from humans, attachment avoidance, and attachment anxiety accounted for 41% of variance in separation anxiety from animals. LIMITATIONS The correlational design does not allow the investigation of causal associations. CONCLUSIONS A strong, positive relationship was observed between human-related separation anxiety and animal-related separation anxiety, which was significantly stronger for people with lower levels of social support.
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Affiliation(s)
- Elisha Dowsett
- School of Psychology, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Paul Delfabbro
- School of Psychology, University of Adelaide, Adelaide, SA, 5005, Australia.
| | - Anna Chur-Hansen
- School of Psychology, University of Adelaide, Adelaide, SA, 5005, Australia
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Abstract
Research indicates social support is imperative for postpartum well-being. The types of social support and access to preferred supports are less understood. This article considers first-time mothers' perceptions of the effectiveness of social supports and perceived barriers to accessing support and provides recommendations for best practice. A search of the literature for terms related to postpartum social support was conducted. Major themes were identified and synthesised. A critique and analysis of the literature is presented with recommendations for best practice. Much of the research around postnatal support fails to distinguish the specific type of support, meaning creating support solutions for the postpartum period may not be effectively targeted. Recommendations for individualised support are made.
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Urry K, Chur-Hansen A, Khaw C. 'It's just a peripheral issue': A qualitative analysis of mental health clinicians' accounts of (not) addressing sexuality in their work. Int J Ment Health Nurs 2019; 28:1278-1287. [PMID: 31353790 DOI: 10.1111/inm.12633] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2019] [Indexed: 02/05/2023]
Abstract
Sexuality, relationships, and intimacy are integral parts of many peoples' lives, not negated by mental distress and illness. Yet typically, these needs are not addressed adequately in mental health settings. In-depth interviews were conducted with mental health clinicians with an aim of exploring their perceptions and understandings of sexuality and sexual concerns within mental health settings. Participants were 22 mental health nurses, psychologists, and psychiatrists working with people across a range of settings in four Australian cities. Sexuality or aspects of this were often not addressed in clinical practice, and this was common across participants' accounts. A critical thematic analysis was conducted to explore how participants made sense of or explained this silence in relation to sexuality. Two key themes were 'Sexuality is hard to talk about' and 'Sexuality is a "peripheral issue"'. In positioning sexuality as a peripheral issue, participants drew on three key explanations (sub-themes): that sexuality rarely 'comes up', that it is not pragmatic to address sexuality, and that addressing sexuality is not part of participants' roles or skill sets. A third theme captured the contrasting perception that 'Sexuality could be better addressed' in mental health settings. This analysis indicates that, beyond anticipated embarrassment, mental health clinicians from three disciplines account for omissions of sexuality from clinical practice in similar ways. Moreover, these accounts serve to peripheralize sexuality in mental health settings. We consider these results within the context of espoused holistic and recovery-oriented principles in mental health settings.
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Affiliation(s)
- Kristi Urry
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Anna Chur-Hansen
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, South Australia, Australia
| | - Carole Khaw
- Adelaide Sexual Health Centre, Infectious Diseases Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
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Dow MQ, Chur-Hansen A, Hamood W, Edwards S. Impact of dealing with bereaved clients on the psychological wellbeing of veterinarians. Aust Vet J 2019; 97:382-389. [PMID: 31364771 DOI: 10.1111/avj.12842] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 04/09/2019] [Accepted: 05/08/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Research has identified that members of the veterinary profession are at high risk of occupational stress, burnout, poor psychological wellbeing and an elevated rate of suicide. Although scholarly interest in veterinarians has increased in recent years, relatively few studies have specifically examined the emotional work in veterinary interactions and what effect dealing with companion animal owners' grief has on the wellbeing of veterinarians. The purpose of this study was to determine if dealing with bereaved clients affected the psychological wellbeing of veterinarians. The concept of compassion fatigue was explored, including whether veterinarians believed that their training had equipped them for communicating with grieving clients. METHODS Veterinary surgeons registered in South Australia in 2015 were invited to complete an online survey, with 105 participants responding. RESULTS Many participants, particularly female and younger veterinarians, were experiencing mild to severe psychological distress and nearly half of the sample was experiencing high to very high levels of compassion fatigue. No participants reported seeking psychological or other professional mental health support and the majority had not referred a grieving client to a psychologist or other mental health professional. A significant proportion of veterinarians felt their own mental health was affected by dealing with clients grieving the loss of a companion animal. DISCUSSION The findings are discussed in terms of increasing the wellbeing of veterinarians through improved curriculum training and workplace health promotion, particularly considering the high suicide rate reported for the profession.
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Affiliation(s)
- M Q Dow
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, North Terrace, Adelaide, South Australia, 5005, Australia
| | - A Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, University of Adelaide, North Terrace, Adelaide, South Australia, 5005, Australia
| | - W Hamood
- School of Animal and Veterinary Science, Faculty of Science, University of Adelaide, SA, Australia
| | - S Edwards
- Adelaide Health Technology Assessment, School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, SA, Australia
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Lores T, Goess C, Mikocka-Walus A, Collins KL, Burke ALJ, Chur-Hansen A, Delfabbro P, Andrews JM. Integrated Psychological Care is Needed, Welcomed and Effective in Ambulatory Inflammatory Bowel Disease Management: Evaluation of a New Initiative. J Crohns Colitis 2019; 13:819-827. [PMID: 30721977 DOI: 10.1093/ecco-jcc/jjz026] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 12/12/2018] [Accepted: 01/31/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS Inflammatory bowel disease is associated with psychosocial issues which reduce quality of life and impair medical management. However, these issues are rarely addressed in routine care. A model of integrated psychological screening and intervention was trialled to measure prevalence, patient participation, and potential benefits to mental health and/or quality of life. METHODS During a 12-month period, 490 adult patients at an established hospital-based service were approached to complete screening instruments for anxiety, depression, general distress, quality of life and medication adherence. Disease-specific and demographic data were also collected. Patients who scored highly on screening questionnaires were offered psychological intervention (in-service or externally referred). Participants were reassessed after 12 months. RESULTS Psychological screening was well accepted with 68% (N = 335) participating. Psychological care was 'needed', with 55% (N = 183) scoring highly for anxiety, depression and/or general distress. Half of those 'in need' (N = 91) accepted intervention. In those who accepted, levels of anxiety (mean at intake [M1] = 12.11 vs mean at follow-up [M2] = 9.59, p < 0.001), depression (M1 = 8.38 vs M2 = 6.42, p < 0.001), general distress (M1 = 17.99 vs M2 = 13.96, p < 0.001), mental health quality of life (M1 = 54.64 vs M2 = 59.70, p < 0.001) and overall quality of life (M1 = 57.60 vs M2 = 64.10, p < 0.001) each improved between intake and follow-up. Engagement in psychological intervention was six times greater for those treated in-service vs externally referred (χ2[1] = 13.06, p < 0.001, odds ratio = 6.47). CONCLUSIONS Mental health issues are highly prevalent in people with inflammatory bowel disease. Patients are open to psychological screening and treatment. Psychological care can improve patient mental health and quality of life, and works best when integrated into routine management.
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Affiliation(s)
- Taryn Lores
- IBD Service, Department of Gastroenterology & Hepatology, Royal Adelaide Hospital, Adelaide, Australia
| | - Charlotte Goess
- IBD Service, Department of Gastroenterology & Hepatology, Royal Adelaide Hospital, Adelaide, Australia
| | | | - Kathryn L Collins
- Psychology Department, Central Adelaide Local Health Network, Adelaide, Australia
| | - Anne L J Burke
- Psychology Department, Central Adelaide Local Health Network, Adelaide, Australia
| | - Anna Chur-Hansen
- School of Psychology, University of Adelaide, Adelaide, Australia
| | - Paul Delfabbro
- School of Psychology, University of Adelaide, Adelaide, Australia
| | - Jane M Andrews
- IBD Service, Department of Gastroenterology & Hepatology, Royal Adelaide Hospital, Adelaide, Australia
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Abstract
PURPOSE Psychologists working with persons with vision impairment face unique challenges in providing psychological services, including mental health care and cognitive assessments. While existing competency guidelines for general disability and rehabilitation psychology are relevant to working with persons with vision impairment in many ways, specific competencies are needed. Previous psychological research into the provision of therapy for persons with vision impairment has focused mainly on communication and intervention strategies and lacks input from the vision-impaired community. MATERIALS AND METHODS This qualitative study, grounded in disability, rehabilitation psychology, and competency frameworks aimed to identify the knowledge, skills, and attitudes necessary for psychologists working with persons with vision impairment. RESULTS Through triangulating responses from both registered psychologists (N = 10) and persons with vision impairment (N = 5), a thematic analysis identified 29 competencies under six major themes, including: Expertise, Impact, Approach, Collaboration, Assessment, and Flexibility. Competencies were discretely categorized as knowledge, skills, or attitudes. CONCLUSIONS This study provides data that may be used as the basis for more rigorous research into identifying areas for vision impaired-specific competency-based training in undergraduate, postgraduate, and professional psychology curricula.Implications for rehabilitationWhilst competencies for disability and rehabilitation psychology already exist, the competencies for psychologists working with persons with vision impairment require updating, informed by both practitioners and clients with vision impairment.These competencies include: knowledge of eye conditions and pathologies; knowledge of the variation in impact of vision loss; general knowledge about vision loss and normal lifespan development; and, the ability to assess the specific impact of vision loss on the individual.Other skills and attitudes, such as oral communication skills and relaying hope and optimism, whilst necessary for all therapeutic encounters, may require particular modification when working with vision-impaired persons.Educators responsible for professional postgraduate courses in psychology should ensure that training incorporates an understanding of the need to modify approaches for particular groups of clients, such as those with vision impairment.
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Affiliation(s)
| | - Anna Chur-Hansen
- School of Psychology, University of Adelaide, Adelaide, Australia
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Zambrano SC, Chur-Hansen A, Crawford GB. Beyond Right or Wrong: Attitudes and Practices of Physicians, Nurses, Psychologists, and Social Workers Regarding Attendance at Patient Funerals. J Palliat Med 2019; 22:400-407. [DOI: 10.1089/jpm.2018.0234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sofia C. Zambrano
- Universitäres Zentrum für Palliative Care, Inselspital, Bern University Hospital, Bern, Switzerland
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Anna Chur-Hansen
- School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Gregory B. Crawford
- Northern Adelaide Palliative Service, Northern Adelaide Local Health Network, Adelaide, Australia
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Dorstyn D, Roberts R, Murphy G, Kneebone I, Craig A, Chur-Hansen A, Migliorini C, Potter E, Marshall R, Clark J, Neeson S, Stewart P. Can targeted job-information for adults with spinal cord dysfunction be effectively delivered online? A pilot study. J Spinal Cord Med 2019; 42:94-101. [PMID: 28466761 PMCID: PMC6340270 DOI: 10.1080/10790268.2017.1321821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE To pilot a novel email-based information package (Work and SCI) for job-seekers with an acquired spinal cord injury (SCI) or spinal cord dysfunction (SCI/D). STUDY DESIGN Prospective, non-randomized, repeated measures trial. SETTING Community dwelling cohort in Australia. PARTICIPANTS Five people with SCI (mean age 46.4 years, SD = 10.2; 4 female) initially reviewed Work and SCI. Twenty-four with SCI/D subsequently enrolled, of whom 16 (mean age 46.4 years, SD = 11.1; 7 female), completed the intervention. INTERVENTION Intervention participants accessed Work and SCI over a 4-week period. OUTCOME MEASURES Individual changes in pre-post scores for the My Vocational Situation Scale, Job Procurement Self-Efficacy Scale, Patient Health Questionnaire-9 and Life Orientation Test-Revised were examined. RESULTS Reliable change in pre-post scores across outcomes were reported by 38% (n = 6) of participants. Favorable comments on the Work and SCI resource were provided in addition to suggestions for improvement. CONCLUSIONS Preliminary data suggest that Work and SCI may help to establish vocational interests among job-seekers with a SCI/D, however further work is needed to enhance participant compliance. This might include moderator support to promote and maintain participation. A controlled design will also help to identify factors that influence engagement with the Work and SCI resource.
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Affiliation(s)
- Diana Dorstyn
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, South Australia, Australia,Correspondence to: Dr. Diana Dorstyn, School of Psychology, University of Adelaide, North Terrace campus, Adelaide, South Australia, Australia 5005; Ph: 61 08 8313 0649.
| | - Rachel Roberts
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, South Australia, Australia
| | - Gregory Murphy
- School of Public Health, LaTrobe University, Victoria, Australia
| | - Ian Kneebone
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, New South Wales, Australia
| | - Ashley Craig
- Sydney Medical School-Northern, Kolling Institute of Medical Research, The University of Sydney, New South Wales, Australia
| | - Anna Chur-Hansen
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, South Australia, Australia
| | - Christine Migliorini
- Department of Occupational Therapy, School of Primary Health Care, Monash University, Victoria, Australia
| | - Elizabeth Potter
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, South Australia, Australia,South Australian Spinal Cord Injury Research Centre, South Australia, Australia
| | - Ruth Marshall
- South Australian Spinal Cord Injury Research Centre, South Australia, Australia
| | - Jillian Clark
- South Australian Spinal Cord Injury Research Centre, South Australia, Australia
| | - Sharron Neeson
- Paraplegic and Quadriplegic Association of South Australia (PQSA), South Australia, Australia
| | - Peter Stewart
- Paraplegic and Quadriplegic Association of South Australia (PQSA), South Australia, Australia
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Duncanson E, Chur-Hansen A, Jesudason S. Psychosocial consequences of gastrointestinal symptoms and dietary changes in people receiving automated peritoneal dialysis. J Ren Care 2018; 45:41-50. [PMID: 30585418 DOI: 10.1111/jorc.12265] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Gastrointestinal (GI) symptoms are associated with poor psychosocial wellbeing among people receiving peritoneal dialysis (PD). The mind-gut axis represents one possible explanatory mechanism for this relationship. Despite existing evidence, the individual's experience of GI symptoms and their potential psychosocial consequences have not been explored. OBJECTIVE To understand the experiences of people receiving peritoneal dialysis regarding their gastrointestinal health and psychosocial wellbeing. METHOD Ten people undergoing automated PD (five females, five males) aged 31-77 years (Mean = 59.3, SD = 15.67) participated in a single one-on-one qualitative interview. Interviews ceased at thematic saturation. Transcripts were analysed using the framework approach. RESULTS A central theme of Autonomy emerged from the data representing participants' experiences of the psychosocial consequences of dialysis, GI symptoms, and dietary changes. This overarched two main themes: 1) Loss of Autonomy [Sub-themes: Interference to Daily Life (Dialysis process and sleep, Impacts on relationships), Powerlessness, Frustration, Food Aversion, and Restriction (Friendships and social life, Impacts on partner)] and 2) Attempts to Gain Autonomy (Sub-themes: Coping Well, Pragmatism, and Maintaining Normality). A related sub-theme of Partner as a Carer emerged as part of Loss of Autonomy. CONCLUSION GI symptoms and diet and fluid restrictions have psychosocial consequences resulting in multiple losses of autonomy for people receiving PD, who employ strategies to attempt to regain autonomy in the face of these issues. Dietary and GI symptom management advice should aim to enhance patient autonomy within the confines of PD therapy and thus reduce its psychosocial impacts.
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Affiliation(s)
- Emily Duncanson
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia, 5005, Australia.,Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, South Australian Health and Medical Research Institute (SAHMRI), South Australia, 5001, Australia
| | - Anna Chur-Hansen
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia, 5005, Australia
| | - Shilpanjali Jesudason
- Central and Northern Adelaide Renal and Transplantation Service (CNARTS), Royal Adelaide Hospital, South Australia, 5000, Australia.,Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia, 5005, Australia.,Kidney Health Australia, South Australia, 5000, Australia
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Opozda M, Wittert G, Chur-Hansen A. Patients' expectations and experiences of eating behaviour change after bariatric procedures. Clin Obes 2018; 8:355-365. [PMID: 30117282 DOI: 10.1111/cob.12273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Revised: 05/29/2018] [Accepted: 06/09/2018] [Indexed: 12/14/2022]
Abstract
Patients' pre-surgical expectations and post-surgical experiences of eating-related behaviour change after bariatric surgery may vary by procedure and time since surgery. To investigate this, data were coded from 206 Australian adults ≥2 months post-Roux-en-Y gastric bypass (RYGB; 17%), adjustable gastric band (AGB; 23%) or vertical sleeve gastrectomy (VSG; 60%) who completed an online questionnaire including open-ended questions about pre-surgical eating-related expectations and post-surgical experiences. Participants were 94% female, and mean age was 45.9 (SD = 10.0). Average time since surgery varied (AGB: 69.6 months; RYGB: 22.8; and VSG: 17.8). The proportions reporting any one or more 'positive' (healthy, helpful or desired; RYGB 82%; AGB 76%; and VSG 84%) or any one or more 'negative' (unhealthy, unhelpful or unwanted; RYGB 46%; AGB 46%; and VSG 42%) post-surgical eating-related experience did not differ by procedure. Negative experiences were more often reported at ≥18 months than 2 to <18 months (P = 0.035). After both VSG and AGB, but not RYGB, reporting any one or more positive eating-related experience was related to better outcomes (VSG: in mental health; AGB: in weight loss, physical health, satisfaction) and negative experiences were linked to poorer outcomes (VSG: in mental health, satisfaction; AGB: in mental and physical health, satisfaction). Reporting any one or more positive experience was related to better mental health improvement at 2 to <18 months and greater satisfaction at 18+ months post-surgery. The findings highlight the necessity of long-term, multidisciplinary patient care and further investigation into impacts of eating-related experiences on outcomes, with attention to procedure-based and temporal effects.
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Affiliation(s)
- M Opozda
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
- Discipline of Medicine, Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
- Adelaide Medical School, The University of Adelaide, Freemasons Foundation Centre for Men's Health, Adelaide, South Australia, Australia
- Centre for Nutrition and Gastrointestinal Diseases, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - G Wittert
- Adelaide Medical School, The University of Adelaide, Freemasons Foundation Centre for Men's Health, Adelaide, South Australia, Australia
- Centre for Nutrition and Gastrointestinal Diseases, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - A Chur-Hansen
- School of Psychology, The University of Adelaide, Adelaide, South Australia, Australia
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Dorstyn D, Roberts R, Murphy G, Craig A, Kneebone I, Stewart P, Chur-Hansen A, Marshall R, Clark J, Migliorini C. Work and SCI: a pilot randomized controlled study of an online resource for job-seekers with spinal cord dysfunction. Spinal Cord 2018; 57:221-228. [PMID: 30262878 DOI: 10.1038/s41393-018-0200-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/22/2018] [Accepted: 08/22/2018] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN A prospective, parallel randomized controlled trial (RCT). OBJECTIVES To test the preliminary effects of an online resource targeted to job-seekers with spinal cord injury or disorder (SCI/D), and to determine the feasibility of proceeding to a full-scale RCT. SETTING A community cohort in Australia. METHODS Forty-eight adults (M = 42 years, SD = 10.95, 27 males) were randomized to receive 4-weeks access to the Work and SCI resource (n = 25) or to a wait-list control group (n = 23). The Work and SCI intervention involved six stand-alone learning modules which provided job-searching and career-planning information through text, videos, and interactive activities. Self-report measures were administered at baseline and after 4 weeks: Job Procurement Self-Efficacy Scale (JSES), Life Orientation Test-Revised (LOT-R), and Patient Health Questionnaire-9 (PHQ-9). RESULTS Online usage data identified high uptake of the Work and SCI resource, although study attrition was problematic. Intention-to-treat analyses failed to reach statistical significance, whereas complete data revealed a significant interaction effect for optimism (LOT-R). CONCLUSION Further research to develop and enhance Work and SCI is indicated. Remediable strategies to optimize recruitment and statistical power in a future definitive RCT are discussed. SPONSORSHIP This project was funded by the auDA Foundation (project 16019).
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Affiliation(s)
- Diana Dorstyn
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, SA, Australia.
| | - Rachel Roberts
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Gregory Murphy
- School of Psychology and Public Health, La Trobe University, Bundoora, VIC, Australia
| | - Ashley Craig
- Northern Clinical School, Faculty of Medicine and Health, Kolling Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Ian Kneebone
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Ultimo, NSW, Australia
| | - Peter Stewart
- PQSA - The Paraplegic and Quadriplegic Association of South Australia, Dulwich, SA, Australia
| | - Anna Chur-Hansen
- Faculty of Health and Medical Sciences, School of Psychology, University of Adelaide, Adelaide, SA, Australia
| | - Ruth Marshall
- South Australian Spinal Cord Injury Research Centre, Hampstead Rehabilitation Centre, Northfield, SA, Australia.,Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Jillian Clark
- South Australian Spinal Cord Injury Research Centre, Hampstead Rehabilitation Centre, Northfield, SA, Australia.,Faculty of Health and Medical Sciences, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Christine Migliorini
- Department of Occupational Therapy, School of Primary Health Care, Monash University, Frankston, VIC, Australia
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Urry K, Chur-Hansen A. Who decides when people can have sex? Australian mental health clinicians' perceptions of sexuality and autonomy. J Health Psychol 2018; 25:2188-2199. [PMID: 30035634 DOI: 10.1177/1359105318790026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Sexuality is a central aspect of human experience but there is evidence that this is largely constrained, pathologised or ignored in mental health settings. We conducted in-depth interviews with 22 psychologists, psychiatrists and mental health nurses working across a variety of settings in four Australian cities. Sexuality was most often perceived as relevant in the mental health setting when it was simultaneously constructed as dangerous. Participants located this danger in sexual expression itself or within individuals who, because of mental illness, lacked the autonomy required to successfully engage in 'safe' sex. We discuss these findings and their implications for research and professional practice.
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Abstract
This article was migrated. The article was marked as recommended. Healthcare students from different professional backgrounds are often brought together under the banner of Interprofessional Education (IPE) in an effort to improve collaborative practice. Despite the demonstrated positive impact of IPE on students' knowledge, skills and attitudes, it is not clear what students think about learning with students from another health profession. The aim of this study was to explore pharmacy and medicine students' views and experiences of learning together. Participants were Year 3 Pharmacy and Year 4 Medicine students, with qualitative data gathered via a written reflection. Three main themes were identified. Students were accepting of learning with the other professional group. Learning about was evident, particularly in relation to each other's roles and contributions to patient care. Learning from another professional group was the most problematic as students tended to view and treat knowledge as a commodity to be acquired from another rather than something that could be jointly developed. While medicine and pharmacy students' valued learning with and about each other, they were less likely to engage in co-constructing and sharing new meanings and thus learn from one another. To provide a basis for meaningful collaborative practice, IPE needs to challenge students' fundamental assumptions, beliefs and values about learning with, from and about other professions.
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Abstract
This paper is an ethnographic exploration of how attachment theory underpins therapeutic practices in an Australian institutional context where mothers of infants have been diagnosed and are undergoing treatment for mental illness. We argue that attachment theory in this particular context rests on a series of principles or assumptions: that attachment theory is universally applicable; that attachment is dyadic and gendered; that there is an attachment template formed which can be transferred across generations and shapes future social interactions; that there is understood to be a mental health risk to the infant when attachment is characterised as problematic; and that this risk can be mitigated through the therapeutic practices advocated by the institution. Through an in-depth case study, this paper demonstrates how these assumptions cohere in practice and are used to assess mothering as deficient, to choose therapeutic options, to shape women's behaviour, and to formulate decisions about child placement.
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Affiliation(s)
- Sonia Masciantonio
- Department of Anthropology & Development Studies, University of Adelaide, Adelaide, SA, 5005, Australia.,School of Psychology, University of Adelaide, Adelaide, SA, 5005, Australia
| | - Susan R Hemer
- Department of Anthropology & Development Studies, University of Adelaide, Adelaide, SA, 5005, Australia.
| | - Anna Chur-Hansen
- School of Psychology, University of Adelaide, Adelaide, SA, 5005, Australia
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Opozda M, Wittert G, Chur-Hansen A. Patients’ reasons for and against undergoing Roux-en-Y gastric bypass, adjustable gastric banding, and vertical sleeve gastrectomy. Surg Obes Relat Dis 2017; 13:1887-1896. [DOI: 10.1016/j.soard.2017.07.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 07/05/2017] [Accepted: 07/06/2017] [Indexed: 10/19/2022]
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Abstract
The appropriateness of attending a patient's funeral is a medical dilemma. This article focuses on 437 doctors who participated in an online survey. Seventy-one percent of general practitioners, 67% of oncologists, 67% of psychiatrists, 63% of palliative medicine specialists, 52% of surgeons, and 22% of intensive care specialists had attended patient funerals. Significant differences in demographics and between specialties were identified in terms of barriers and benefits associated with attendance. Although attendance is a personal decision, there is a need for open discussions in medical education and professional development concerning death and the role of doctors after a patient dies.
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Affiliation(s)
- Sofía C Zambrano
- a School of Psychology , The University of Adelaide , Adelaide , Australia
| | - Anna Chur-Hansen
- a School of Psychology , The University of Adelaide , Adelaide , Australia
| | - Gregory B Crawford
- b School of Medicine , The University of Adelaide , Adelaide , Australia
- c Northern Adelaide Palliative Service , Northern Adelaide Local Health Network, Adelaide , Australia
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Abstract
OBJECTIVES Old age psychiatrists work with end-of-life (EOL) issues and encounter patient deaths, but death and dying have received limited focus in old age psychiatry training and research. This qualitative study explores old age psychiatrists' experience of and approach to working with patients at the EOL. METHOD Australian old age psychiatrists were purposively sampled and interviewed in-depth. Data saturation was achieved after nine participant interviews. Verbatim transcripts were analysed for themes, which were independently verified. RESULTS Two dichotomous overarching themes were identified. Death is not our business reflected participants' experience of working in a mental health framework and incorporated four themes: death should not occur in psychiatry; working in a psychiatric treatment model; keeping a distance from death and unexpected death is a negative experience. Death is our business reflected participants' experience of working in an aged care context and incorporated four themes: death is part of life; encountering the EOL through dementia care; doing EOL work and expected death is a positive experience. CONCLUSION Participants reported conflict because of the contradictory domains in which they work. They were comfortable working with patients at the EOL when death was expected, particularly in dementia. By contrast, they struggled with death as an adverse outcome in circumstances influenced by mental health culture, which was characterised by risk management, suicide prevention and a focus on recovery. This study has implications for models of care underpinning old age psychiatry. An integrated person-centred model of care may provide a contextually appropriate approach for practice.
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Affiliation(s)
- Duncan McKellar
- a Eastern Community Mental Health , Central Adelaide Local Health Network , Tranmere , South Australia
| | - Felicity Ng
- b Lyell McEwin Health Service , Northern Adelaide Local Health Network , Elizabeth Vale , South Australia
| | - Anna Chur-Hansen
- c School of Psychology , The University of Adelaide , Adelaide , South Australia
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