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Purpose. To examine psychosocial and well-being concerns throughout the cancer experience, from prediagnosis to survivorship. Whilst most oncology research focuses on patients, the role and experiences of families and caregivers are increasingly recognised as a core component of health service delivery. Moreover, research suggests that geography is an important consideration, with evidence of rural inequities in health service provision and access. Aims. (i) To examine the unique patient and caregiver experiences of rural people in three rural cancer treatment centres in New South Wales (NSW) and (ii) to examine the barriers to rural patients and caregivers accessing psycho-oncological support in NSW. Methods. A convergent parallel mixed-method evaluation of the psychosocial experiences of rural patients and caregivers accessing cancer services through three health services in rural NSW was undertaken (N = 125). Measures of psychological distress as well as quantitative and qualitative barriers data were collected. Results. Approximately, one-third of the participants reported moderate to severe distress. Patients and caregivers reported systemic, intrapersonal, interpersonal, and pandemic-specific barriers in accessing quality psychosocial healthcare. Conclusions. These results suggest that cancer patients and caregivers in rural NSW may experience elevated levels of psychological distress and barriers in accessing psychosocial care. The combination of high psychological need for patients and caregivers with reduced availability of psychosocial support services has substantial implications for psychological wellbeing and service provision. Underdetection of psychosocial need and a lack of support services pose a significant challenge for rural people with cancer and for those who care for them; this must be an urgent priority for quality improvement and equitable healthcare provision. [ABSTRACT FROM AUTHOR]

Providing support and parenting education through home visiting is a key early intervention strategy with young parents. Less is known about what home visitors do that makes a difference. The purpose of this paper is to describe the role and experiences of professional staff working with young parents participating in a multicomponent parent support programme (home visiting and supported parenting groups) provided by a non-government organisation in a socially disadvantaged area of Sydney, Australia. This was a qualitative descriptive study. Data were collected through three focus groups conducted with the same six staff over an 18-month period. Participant descriptions of their role and experiences working with young mothers were analysed thematically. Additional data from 20 anonymised client records were analysed through content analysis. Analysis of the focus group data revealed two themes, 'Connecting' and 'Facilitating Learning'. The theme 'Connecting' reflected the development of a relationship with the young mother commencing with 'how do we engage them?', 'building trust' through to formation of a relationship described as 'they know we're not friends, they know we're workers'. The second theme, 'Facilitating Learning' was informed by the analysis of both group and client record data and comprised a number of themes around what and how mothers learnt, through to 'ending the relationship' as the mothers left the programme. The quality of a mothers' learning was dependent on the quality of the connection between herself and the staff, similarly their capacity and, or confidence to leave the programme was dependent on the relationship, 'connecting' and the learning undertaken. Role modelling through interactions with children as well as with each other was seen as the most effective way to facilitate social and parenting skill development, while formal education sessions were evaluated by the workers to be less successful than informal ones. [ABSTRACT FROM AUTHOR]

Lifeline Australia operates crisis support services through Lifeline Crisis Supporters. An integral part of their role is to conduct online suicide risk assessments with help‐seekers. However, there is limited literature regarding suicide risk assessment practices for this population. This study aimed to examine how suicide prevention training, vicarious trauma and fears impacted suicide risk assessment behaviours of Lifeline Crisis Supporters. A cross‐sectional survey design was used to recruit a volunteer convenience sample of 125 Lifeline Australia Crisis Supporters (75.2% females; Mage = 54.9) in 2018 to participate in an online survey. Findings revealed that those with more suicide‐specific training had less risk assessment‐related fears, and that fears were not related to attitudes towards suicide prevention. There was no significant relationship between vicarious trauma and amount of training or years of experience in the role. Further, participants with higher levels of vicarious trauma demonstrated significantly more negative attitudes towards suicide prevention. Overall, training appears to be a significant factor in suicide risk assessment practice behaviours of Lifeline Crisis Supporters, highlighting a need for ongoing training and support for them. This research also suggests that whilst fears exist, they do not significantly impair Lifeline Crisis Supporters' ability to undertake suicide risk assessment. [ABSTRACT FROM AUTHOR]

Despite evidence that stroke education is important and effective, low rates of stroke education are reported worldwide. Many stroke survivors and carers report that current stroke information does not meet their needs. The aim of the current study was to explore the perceptions of stroke survivors and carers towards stroke education in an Australian health context. A qualitative descriptive approach using focus groups was used to explore education received and preferred content, format and timing of education. Data were analysed inductively using qualitative content analysis to identify key categories, sub‐categories and an overarching theme. Fifteen stroke survivors and four carers participated. Four categories emerged: the timing of stroke education, the content of stroke education, the format of stroke education, and reactions to stroke education. Each category contained a number of sub‐categories. One overarching theme was woven through the transcripts: everyone is different and has different needs. Overall, participants generally expressed positive attitudes towards stroke education. Participants reported that education should occur at multiple timepoints and in a mixed format. All participants reported receiving stroke education in hospital, but not in the community. Stroke survivors preferred group education, while carers did not share this preference. Both stroke survivors and carers desired information about post‐stroke physical changes and computer use; however, stroke survivors desired additional information spanning a variety of areas such as motivation and driving. Tailoring of stroke education for each individual is critical to ensure that education meets the needs of stroke survivors and carers from the hospital to the community. [ABSTRACT FROM AUTHOR]

Growth in e‐mental health services in the past decade has been significant, corresponding with rising rates of mental health concerns and amplified by social isolation strategies imposed by the COVID‐19 global pandemic. Governments, mental health services and practitioners have identified this as a significant area for investment and highlight its capacity for widespread reach, prevention and early intervention. At a time of growth and investment, it is critical to evaluate the extent to which online mental health platforms are effective in reaching the diverse populations they aim to serve. The current study used content analysis to evaluate 33 Australian mental health websites receiving government funding for the availability of translated materials and resources for culturally and linguistically diverse people. The websites analysed covered a range of mental health topics and overall had limited translated materials available. Only four websites (12.12%) provided a translation tool and none of the interactive tools offered, such as web chat services, were available in languages other than English. From a total of 1100 subsections across all websites, eight subsections (0.73%) were specifically targeting populations identifying as culturally and linguistically diverse. Strategic reconsideration and investment are required to enhance the capacity of current mental health platforms to engage and support the mental health needs of the diverse communities they intend to serve. The research and its findings can provide a basis for research and reflection within other health and social services as online platforms proliferate. [ABSTRACT FROM AUTHOR]

Complex traumatic experiences, such as childhood sexual and physical abuse, occur in approximately 13% of the Australian population and are more common in women. Despite the prevalence of complex trauma and the need for evidence‐based services for survivors, no studies have explored treatment‐related experiences of women with complex trauma in Australia. The aim of the current study was to identify barriers and facilitators to treatment seeking and engagement amongst women who have experienced complex trauma in Australia. Semi‐structured interviews were conducted with 11 women with complex trauma histories who presented to a university outpatient psychology clinic. Content analysis was used to identify common barriers and facilitators to mental health treatment seeking and engagement amongst these women. Participants faced three key barriers when seeking treatment and engaging in mental health services: systemic issues, dissatisfaction with treatment and intrapersonal barriers (e.g. fear of the healthcare system). Appropriate support from supportive, committed health care workers was a facilitator to engagement and access. Findings from this study suggest that the mental health system in Australia may not be meeting the needs of women with complex trauma histories. Increasing access to affordable, trauma‐informed care and bolstering providers' knowledge of complex trauma, may enable some of the barriers identified by participants to be overcome. [ABSTRACT FROM AUTHOR]

Gait aid provision is a standard approach to improve mobility and balance for older people. This research aims to understand and compare community care staff practice (health vs. non‐health professionals) for gait aid use by people with and without dementia. A cross‐sectional survey was conducted with Australian community care staff between October 2020 and February 2021. Survey items consisted of closed/open‐ended questions to explore staff practice for people with/without dementia, and assessments/procedures health professionals used for people with dementia. Likert‐scale items gauged staff agreement on factors that influenced their decisions regarding gait aid use for people with dementia. Univariate logistic regression analyses were used to examine staff practice for people with/without dementia and their interaction effects, and factors that influenced decision‐making regarding gait aid use for people with dementia. Content analyses were used to collate responses on assessments/procedures used for people with dementia. Health (n = 109) and non‐health professionals (n = 138) completed the survey. Compared with non‐health professionals, health professionals were more likely to (1) refer the person without dementia [odds ratio, 95% CI: 23.9 (12.1, 47.3), p <.01] and person with dementia [27.8 (12.5, 61.7), p <.01] to a physiotherapist for gait aid assessment, (2) agree with gait aid use if the person with dementia: (a) lives with someone who can monitor gait aid safety [coefficient, 95% CI: −0.75 (−1.29, −0.21), p =.01], (b) performs well on a cognitive functional screen [−0.68 (−1.20, −0.16), p =.01] and (c) gives feedback about gait aid use [−0.64 (−1.15, −0.12), p =.02]. No interaction effects existed between health/non‐health professionals and whether the person had dementia/no dementia on the practice options examined. Health professionals infrequently reported using single/dual task, simple/complex gait or motor sequence testing to assess people with dementia for gait aid use. Strategies such as developing decision aid tool(s) may guide mobility practice for community care staff. [ABSTRACT FROM AUTHOR]

In Australia, the PANDA—Perinatal Anxiety & Depression Australia National Helpline (the Helpline) offers support to callers impacted by emotional health challenges in the perinatal period. Callers receive counselling from professional staff and peer support from volunteers. An understanding of factors that contribute to callers' experiences of emotional distress, as well as potential barriers and facilitators to help‐seeking, can be used to inform future service design and delivery. A caller intake form is completed by Helpline staff when an individual contacts the service for the first time, or re‐engages after a period of non‐contact. We analysed all intake forms of individuals calling about their own emotional wellbeing from the middle month of each season in 2014: January, April, July, and October. Content analysis was undertaken, focusing on caller profile, patterns of help‐seeking, and reasons for caller engagement. Of the 365 calls, the majority were from women (n = 358, 98%) who were pregnant (n = 59, 16%) or had a child ≤12 months of age (n = 241, 75%). Many were seeking support regarding depression (n = 186, 51%) or anxiety (n = 162, 44%), with a number seeking help for both (n = 71, 20%). Almost a third were identified as being 'at risk', including a number who were experiencing thoughts of suicide or self‐harm. Complex interrelating factors contributed to callers' emotional distress, including: stressful life events; pregnancy, birthing and parenting experiences; social isolation; and histories of mental health difficulties. Significant numbers of parents experience emotional health challenges in the perinatal period, but many do not receive adequate treatment. Complex factors contribute to callers' distress, highlighting the need for health professionals to undertake thorough psychosocial assessments during the perinatal period so those that need additional support are identified, and appropriate care provided. Telephone Helplines like PANDAs assist overcoming barriers to care and provide specialised perinatal mental health support to families. [ABSTRACT FROM AUTHOR]

Abstract: Rich social relationships contribute to improved well‐being and health outcomes, yet aged care client assessments tend to focus almost exclusively on physical issues. We aim to explore the experiences of aged care staff following their use of social engagement and well‐being instruments as part of routine assessments for home‐care clients. The social engagement (Australian Community Participation Questionnaire, ACPQ) and well‐being (ICEpop CAPability Measure for Older Adults, ICECAP‐O) instruments were embedded into the centralised information system of an Australian aged care provider. Staff administered these instruments during routine client assessments across a 9‐month period involving 289 assessments. Semistructured interviews with 12 staff members were conducted and themes explored using qualitative content analysis. Key factors related to the acceptability of instrument adoption were found. Staff reported the instruments were convenient to use and were valuable in eliciting information for care plan development. Staff found that the instruments complemented their standard assessment procedures and did not disrupt their routine workload. They emphasised that the information gained greatly assisted their discussions with clients, identified social needs, and enhanced client involvement in decisions about desired services. There were also some challenging elements, including staff concerns regarding their ability to deal with emotional responses from clients evoked by the survey questions. ACPQ and ICECAP‐O are useful tools for identifying psychosocial client needs, are feasible for use by large‐scale aged care organisations and provide valuable information to guide decision‐making about services. Future research should identify the long‐term effects on improving social participation and client outcomes. [ABSTRACT FROM AUTHOR]

This project implemented and evaluated two models of care for terminally ill people living alone at home: installing personal alarms (PA) and providing extra care aide (CA) support. The primary aim was to assess the feasibility of using a randomised controlled trial (RCT) approach with this group. A secondary aim was to assess the potential impact of the models of care on the participants' quality of life, symptom distress, anxiety and depression, and perceived benefits and barriers to their use. The two models of care were piloted in collaboration with Silver Chain Hospice Care Service (SCHCS) in Western Australia during 2009-2010. Using a pilot RCT design, equal numbers of participants were randomised to receive extra CA time, PAs or standard care. Attrition reduced the sample size from 20 in each group to 12, 14 and 17 respectively. The intervention period was between 6 and 12 weeks depending on prognosis. The participants were functionally and psychologically well and the majority lived alone by choice. There were physical and psychological benefits associated with provision of the two models of care, particularly for the group supported by CAs in terms of improved sleeping and appetite. However, the impact was mostly not statistically significant due to small sample sizes. The study has highlighted two methodological challenges: the wide variation in the degree of living alone at home leading to complex inclusion criteria, and an RCT approach with attrition differing across groups and patients not wanting to be included in the assigned group. The RCT approach is not considered appropriate for the 'home alone' palliative care population that would have been better supported by providing each participant with a personalised model of care according to needs. However, the outcomes of the project have prompted changes in SCHCS practice when providing care to these patients. [ABSTRACT FROM AUTHOR]