Search

Background: Public policy across the world is increasingly focusing on the role of mental health promotion in whole of health strategies. There is a growing evidence-base that mental health promotion, delivered by trained facilitators, is effective in promoting self-awareness and self-care to prevent the damaging effects of ongoing stress in one's life and to promote early detection of any possible emerging mental health problems. Within Australia, however, few clinicians or school staff are confident or trained in mental health promotion. Aims: This paper reports the results of a two-day training designed for facilitators of a mental health program for secondary-school students. The goal was to develop facilitators' knowledge and understanding of best practice in youth mental health promotion and to increase their confidence in delivering the program. Design: A mixed methods evaluation assessed the impact that a solution-focused training program had on participating facilitators. Methods: A questionnaire was created and included eight quantitative items and one open ended, qualitative question. Twenty-seven nurses and guidance officers from central Queensland were recruited via convenience sampling and data were analysed using descriptive statistics and thematic analysis. Results: The evaluation revealed that participants' perception of their ability to facilitate a youth mental health program significantly improved after completing the training. Qualitative data indicated that participants found the professional development experience to be valuable, provide useful and transferable skills, and believed it to be necessary for mental health promotion work. Conclusion: By providing detailed description of the program's content and processes, other mental health professionals may be inspired to further develop effective learning experiences. [ABSTRACT FROM AUTHOR]

Remote-living and Indigenous Australians can experience menstrual health and hygiene challenges. The topic is not often openly discussed as it is considered private 'women's business'. We were invited into a remote Indigenous town and community to discuss the lived experience of menstruation with female students as well as clinical, educational and community workers. Our yarning circles and interviews collated 16 barriers in four clusters: structural living situation; knowledge, culture and behavior; discomfort and public life; and finances. Targeted efforts by relevant organizations, including schools and government agencies, were identified by participants to better support menstrual health and hygiene without associated pain, ranging moods and a sense of shame. [ABSTRACT FROM AUTHOR]

A rights perspective proposes supported decision-making as an alternative to substitute decision-making. However, evidence about supported decision-making practice is limited. Our aim was to build evidence about building the capacity of decision supporters. Eighteen parents of people with intellectual disabilities were trained in decision support using the La Trobe Support for Decision-making Practice Framework. Data from repeated semi-structured interviews and mentoring sessions were used to capture parental reflections on the value of training. The training acted as a catalyst for parent self-reflection and the Framework prompted them to adopt a more deliberative approach to supporting decision-making. Some parents perceived increased confidence of their adult offspring in expressing preferences resulting from their own changed approach. This study demonstrates the efficacy of this Framework and evidence-based training in building the capacity of parental decision supporters to be consistent with the rights paradigm. The La Trobe Support for Decision-making Practice Framework is an evidence-based approach to decision support practice with an accompanying set of free online resources which can be used by individual practitioners or programs to inform their practice and build the capacity of supporters. Parents of adults with intellectual disabilities value training in the La Trobe Support for Decision-making Practice Framework, which they consider helps to develop their decision support skills and self-reflection. Parents also value individual mentoring following training to assist them to apply the principles of the practice framework to the everyday support for decision-making they provide to their adult son or daughter. Training in support practice should be accompanied by individual mentoring or other strategies to assist parents of adults with intellectual disabilities to discuss and solve the difficult issues they confront in providing decision support more aligned to the rights paradigm. [ABSTRACT FROM AUTHOR]

To explore the decision-making processes and experiences of acute and rehabilitation clinicians, regarding referral and acceptance of patients to rehabilitation after stroke. Multi-site rapid ethnography, involving observation of multidisciplinary case conferences, interviews with acute stroke and rehabilitation clinicians, and review of key documents within five (5) acute stroke units (ASUs) in Queensland, Australia. A cyclical, inductive content analysis was performed. Seven key themes were identified, revealing the complex nature of post-stroke rehabilitation referral and acceptance decision making. Although the majority of clinicians felt that all patients could benefit from rehabilitation, they acknowledged this could not always be the case. Rehabilitation potential and goals were considered by clinicians, but decision making was impacted by ASU context and team processes, rehabilitation service availability and access procedures, and the relationships between the acute and rehabilitation clinicians. Patients and families were not actively involved in the decision-making processes. Post-stroke rehabilitation decision making in Queensland, Australia involves complex processes and compromise. Decisions are not based solely on patients' rehabilitation needs, and patients and families are not actively involved in the decision-making process. Mechanisms are required to streamline access procedures, and improve shared decision making with patients. Referral decision making for post-stroke rehabilitation is complex and not always based solely on patients' needs. Clear and straightforward access procedures and positive relationships between acute and rehabilitation clinicians have a positive impact on referral decision making. Stroke services should review their processes to ensure shared decision making is facilitated when patients require access to rehabilitation. [ABSTRACT FROM AUTHOR]

Fathers in families raising children with disabilities are under-researched. Fathers' perspectives can be better accommodated in childhood disability services that operate on a family-centred paradigm if their perspectives are understood. This study aimed to investigate the perspectives of fathers on caring and family life, work, and health. A mixed-methods design with an online questionnaire included open-ended questions and three instruments: Depression Anxiety Stress Scales (DASS); Health Promoting Activities Scale (HPAS-M); Fathers of Children with Developmental Challenges (FCDC) Scale. Fathers (n = 33) reported high depressive (58%), anxiety (37%), and stress symptoms (61%). Fathers reported low participation in health-promoting activity with less than weekly: planning health activities (58%); solo physical activity (26%); social activity (3%); time relaxing (16%). Sixty-four percent worked full-time, although work was reported to be challenged by family responsibilities. Fathers described directly caring for their children although service interactions were low and delegated to mothers. Fathers in this study reported stress, mental health issues, and low participation in healthy activity. Fathers experienced challenges related to career progression and job choices due to family responsibilities. Providing individualised and responsive support to fathers of a child with a disability would better support the family unit. Fathers of children with a disability in this study experienced high mental health symptoms. Fathers were involved with their child's care at home but had low service interactions suggesting that service providers need to discover new ways to better engage fathers. Fathers experienced challenges to participation in paid work secondary to care responsibilities for their child with a disability and resulting needs of their family. Services that better support fathers are important to promote better health and wellbeing and support families. [ABSTRACT FROM AUTHOR]

To investigate performance of children with cerebral palsy (CP) at GMFCS Levels I-II on sports-focussed gross motor assessments; and concurrent validity of mainstream and CP-specific high-level assessment batteries and field tests. Fifty-four children (6–12 years) with CP at GMFCS I-II completed the Test of Gross Motor Development-second edition, Gross Motor Function Measure-Challenge Module, Muscle Power Sprint Test (MPST), 10 × 5 m Sprint Test (10 × 5 mST), Vertical Jump, Broad Jump, and Seated Throw. Correlations between measures, age and mobility level, and group differences between age and mobility level were examined and content analysis performed. Children at GMFCS I demonstrated significantly higher gross motor assessment battery scores than children at GMFCS II (U = 73.5–109.0, p < 0.001). Performance improved with age for children at Level I but not II. Children with higher overall motor scores scored higher on running (MPST, 10 × 5 mST, r = –0.516 to –0.816, p < 0.001), jumping (Vertical Jump, Broad Jump, r = 0.499–0.774, p < 0.001) and throwing (Seated Throw, r = 0.341–0.500, p = 0.012 < 0.001) field tests. High-level gross motor assessments were achievable and appropriately challenging for children with CP at GMFCS I-II. Scores discriminated between performance and were associated with mobility level. Concurrent validity was established between gross motor assessment batteries, and locomotor field tests. For children with cerebral palsy at GMFCS I–II, sports-focussed assessments should be used to assess high-level gross motor function. The Gross Motor Function Measure-Challenge and Test of Gross Motor Development demonstrate no ceiling for children with cerebral palsy at GMFCS I–II. Single-item running and jumping field tests provide targeted skill assessment and estimate sports skills for children with cerebral palsy. [ABSTRACT FROM AUTHOR]

Objective: This study aims to explore psychologists' attitudes towards the use of video conferencing technology (VCT) to deliver therapy. Method: Participants (N = 12) were recruited via opportunistic sampling either via the Australian Psychological Society website or social media. Participants (three males and nine females) were located in Queensland. They were aged between 23 and 50 years of age (mean age = 32.91, SD = 9.36), held varying levels of experience in psychology (<1 year to 12 years) and types of endorsement (e.g. provisional, general, clinical and health). A semistructured interview schedule was applied in‐person (n = 7) or via telephone (n = 5). Data were analysed using Braun and Clarke's (2006) five‐step method for assessing qualitative data in psychology. Results: Results indicated that psychologists' attitudes towards VCT to deliver therapy paralleled the tri‐component definition of attitudes proposed by Breckler (1984) and Rajecki (1982). Subthemes reflecting these components included perceived limitations or benefits of VCT (i.e. a cognitive component), a sense of comfort when using VCT (i.e. an affective component), and a general tendency to resist or embrace VCT (i.e. a behavioural disposition). Conclusions: Key barriers and facilitators identified underscore the need for training to improve knowledge and awareness of VCT, including its evidence base. Specifically, the assistance of 'embracers' to provide training in VCT (e.g. adapting microskills to a different medium and using technology flexibly) may also dispel negative views held by psychologists regarding VCT and its effectiveness and consequently facilitate a wider adoption of VCT throughout Australia. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to understand parent engagement and disengagement in the delivery of occupational therapy to their children. Methods: This study used a qualitative interpretive description methodology. Focus groups and individual interviews were employed. Thirty-two occupational therapists participated in focusgroups or one-on-one interviews. Thematic analysis was used to analyse the data. Results: Thematic analysis of the data revealed two overarching themes which influenced parent engagement and disengagement in therapy: (1) Parent-therapist relationship and; (2) Therapist responsiveness. Within these two themes: parent feelings; time and timing of therapy; levels of engagement and factors influencing parent engagement were evident. Conclusions: Findings contribute to understanding parent engagement and disengagement in therapy. The findings extend current models of therapeutic engagement in occupational therapy informed by self-determination theory (SDT). Autonomy-, relatedness- and competence-supportive SDT strategies to enhance parent engagement in therapy are described. Occupational therapists reported that parents experience a range of feelings when engaged and disengaged in therapy. These feelings related to hopelessness, having confidence in the therapist and feeling supported, validated and empowered. Parent engagement and disengagement in therapy was described by occupational therapists as occurring at different levels: when it works well (engaged); engaged in the idea of therapy but not engaged in the doing of therapy (middle ground engagement); and when it doesn't work well (disengagement). Occupational therapists reported the importance of being aware of how the factor of time and family, service and therapist characteristics can variously impact parent engagement in therapy. Occupational therapists focus on the parent-therapist relationship and being responsive to parent needs and feelings when engaging parents in therapy. Occupational therapists can draw on principles from self-determination theory to guide them regarding the selection of strategies to engage parents in therapy. [ABSTRACT FROM AUTHOR]

Objective: The current study sought to explore audiologists' use of the Ida Institute Motivation Tools to help them identify clients' readiness for change within initial assessment appointments. Design: The study involved a mixed methods intervention design. Data were collected pre- and post-training audiologists to use the Ida Motivation tools in their appointments. Appointments were video-recorded and analysed using conversation analysis. Clients and audiologists also completed questionnaires within each appointment to measure clients' readiness-for-change. Study sample: Participants included 5 audiologists and 22 adult clients from two Audiology clinics. Results: Audiologists incorporated the Ida Motivation tools into the post-training appointments without a significant increase in appointment time. The Ida tools solicited responses from clients that displayed their ambivalence regarding hearing rehabilitation/aids within their talk. Post‐training, audiologists' perceptions of clients' stage of readiness were not significantly more likely to match clients' self-reported stage on the URICA. Conclusions: The Ida Motivation tools may be useful to solicit clients' ambivalent feelings towards hearing rehabilitation/aids, however, it is important for audiologists to actively listen for ambivalence within clients' interactional responses to the tools in order judge clients' readiness. [ABSTRACT FROM AUTHOR]

Clear links have been established between low health literacy (HL) levels and poor health outcomes. One means of improvement may be found in the rapidly growing paid home care workforce, whose direct and frequent contact with aged/disabled care recipients positions them to provide HL support. This study examines Australian homecare worker (HCW) experiences in HL when providing assistance to their care recipients. A self-reported cross-sectional survey collected data from 75 HCWs. They reported concerns about their clients' HL, yet were cautious about providing support in this area. HL levels of the HCWs themselves were unconvincing, and the majority requested targeted education and training. Further research is needed into HL levels of both HCWs and care recipients, client demographics, the types of HL support being requested of HCWs, a more detailed scoping of the HCW role, and the curriculum and pedagogies which may comprise a HL education and training program for HCWs. [ABSTRACT FROM AUTHOR]

Objective: The present study aimed to explore the nature of parental involvement in the intervention of children with hearing loss, as experienced by parents. Design: A qualitative descriptive methodology was adopted to conduct semi-structured in-depth interviews with a purposive sample of parents who have a child with hearing loss. Study sample: Seventeen parents of 11 children aged 6-9 years participated in this study. Results: The overarching theme of parents taking the central role was identified using thematic analysis. This overarching theme connected five themes which described the nature of parental involvement: (1) parents work behind the scenes; (2) parents act as ‘case managers’; (3) parents always have their child’s language development in mind; (4) parents’ role extends to advocacy for all children with hearing loss; and (5) parents serve a number of roles, but at the end of the day, they are parents. Conclusions: The results indicate that parental involvement in the intervention of children with hearing loss is multifaceted in nature and incorporates a broad range of behaviours and practices. These findings have important implications for the provision of family-centred practices. [ABSTRACT FROM AUTHOR]

Objective It has been acknowledged that the mental health of Aboriginal and Torres Strait Islander people has been 'bedeviled' by the inappropriate application of non-Indigenous models of mental health. To enhance Indigenous health and well-being it is necessary for non-Indigenous practitioners to find a culturally safe way to enter the negotiated space of cross-cultural mental health. This will be facilitated through understanding both the points of similarity and divergence in perspectives of mental health across cultures. The current study aimed to explore urban Aboriginal and Torres Strait Islander's understandings of mental health using a social emotional well-being and cognitive behavioural framework. Method A qualitative research project was conducted with a sample of 19 Australian Aboriginal and Torres Strait Islander people. Data were collected via individual semi-structured interviews and focus groups. Thematic analysis was conducted to identify themes within the data. Results Qualitative: Four themes emerged as reflecting health and well-being-coping skills, knowledge, social support, and connectedness. The theme of connectedness to country, family and kinship, cultural knowledge, and social networks emerged as reflecting a unique contribution to Indigenous health and well-being. However, the themes of coping skills, knowledge, and social support shared cross-cultural meaning. In particular, coping skills identified in the behavioural, emotional, and cognitive domains shared many cross-culturally applicable avenues for intervention. Conclusions Therapeutic interventions in these domains are already well established within cognitive behaviour therapies. Cross-cultural understandings within these themes offer clinicians a culturally safe avenue for supporting Aboriginal and Torres Strait Islander health and well-being. [ABSTRACT FROM AUTHOR]

Purpose:While research has begun to explore the management of aphasia across the continuum of care, to date there is little in-depth, context specific knowledge relating to the speech pathology aphasia management pathway. This research aimed to provide an in-depth understanding of the current aphasia management pathway in the acute hospital setting, from the perspective of speech pathologists. Method:Underpinned by a social constructivist paradigm, the researchers implemented an interpretive phenomenological method when conducting in-depth interviews with 14 Australian speech pathologists working in the acute hospital setting. Interview transcripts and interviewer field notes were subjected to a qualitative content analysis. Results:Analysis identified a single guiding construct and five main categories to describe the management of aphasia in the acute hospital setting. The guiding construct,First contact with the profession,informed the entire management pathway. Five additional main categories were identified:Referral processes;Screening and assessment;Therapeutic intervention;Educational and affective counselling; andAdvocacy. Conclusions:Findings suggest significant diversity in the pathways of care for people with aphasia and their families in the acute hospital setting. Additional support mechanisms are required in order to support speech pathologists to minimise the evidence-practice gap.Implications for RehabilitationSignificant diversity exists in the current aphasia management pathway for people with acute post-stroke aphasia and their families in the acute hospital setting.Mechanisms that support speech pathologists to minimise the evidence-practice gap, and consequently reduce their sense of professional dissonance, are required. [ABSTRACT FROM AUTHOR]

Objective: To determine test–re-test reproducibility of the Timed Up & Go (TUG) test, 30-second repetition maximum (repmax) of functional exercises, 6-Minute Walk Test (6MWT) and High-level Mobility Assessment Tool (HiMAT) in children with Acquired Brain Injury (ABI). Secondarily, to assess the accuracy between hand-timed and video-timed scores for the TUG test and HiMAT. Methods: Thirty children at least 1 year post-ABI (mean age at assessment = 11 years 11 months, SD = 2 years 4 months; 14 males; Gross Motor Function Classification Scale I = 17, II = 13) were assessed twice. Intra-class correlation coefficients (ICC), standard error of measurement and minimum detectable change (MDC) were determined. The Bland-Altman method and 95% limits of agreement (LOA) were used to assess the agreement between hand and video-timed TUG test and HiMAT scores. Results: Test–re-test reproducibility was acceptable for the TUG test (ICC = 0.92; MDC = 1.2s); repmax of functional exercises (ICC = 0.84–0.98; MDC = 4–8 reps); 6MWT (ICC = 0.90; MDC = 69.38 m) and HiMAT (ICC = 0.98; MDC = 6). Comparison of hand and video scores for the TUG test and HiMAT demonstrated a mean difference of 0.23 (LOA = –0.3–0.7) and –0.07 (LOA = –1.99–1.85), respectively. Conclusions Test–re-test reproducibility of lower limb activity capacity measures in children with ABI are acceptable. The MDC scores provide a useful reference to interpret treatment effectiveness. Video timing was more accurate than hand-timing for the TUG test. [ABSTRACT FROM AUTHOR]

Aim: To investigate the cumulative effect of multiple self-reported concussions and the enduring effect of concussion on drivers' hazard perception ability. It was hypothesized: (1) that individuals reporting multiple previous concussions would be slower to anticipate traffic hazards than individuals reporting either one previous concussion or none; and (2) that individuals reporting a concussion within the past 3 months would be slower to anticipate traffic hazards than individuals reporting either an earlier concussion or no prior concussion. Method: Two hundred and eighty-two predominantly young drivers (nconcussed = 68, Mage = 21.57 years, SDage = 6.99 years, 66% female) completed a validated hazard perception test (HPT) and measures of emotional, cognitive, health and driving status. Results: A one-way analysis of variance showed that there was no significant effect of concussion number on HPT response times. Similarly, pairwise comparisons showed no significant differences between the HPT response times of individuals reporting a concussion within the previous 3 months, individuals reporting an earlier concussion and the never concussed group. Conclusion: The findings suggest that previous concussions do not adversely affect young drivers' ability to anticipate traffic hazards; however, due to reliance on self-reports of concussion history, further prospective longitudinal research is needed. [ABSTRACT FROM AUTHOR]

Background: Communication impairments following traumatic brain injury (TBI) can represent a significant barrier to successful community reintegration. Previous research has typically focused on linguistic competence to identify communication difficulties experienced by people with TBI living in the community, rather than participation in everyday communication activities. Objective: To describe communication activities and communication partners of people with traumatic brain injury (TBI) over a 24-hour period compared to matched controls. Research design: A cross-sectional study using a customized, mixed-methods survey with time-use data collected from people with TBI and a demographically matched control group. Methods: Twenty people with TBI living within the community and 20 matched non-injured controls were interviewed about their involvement in communication activities over the previous 24 hours using a time-use diary.Activities were compared between the groups using Mann-Whitney U-tests and Chi-squared tests. Results: The TBI group spent significantly less time engaged in communication activities and less time engaged in conversation and reported significantly fewer numbers of communication partners compared to the control group. Conclusion: The results highlight discrepancies in participation in communication activities between people with TBI and people without TBI, suggesting the need for intervention studies to enhance communication participation in daily life following TBI. [ABSTRACT FROM PUBLISHER]

Purpose: The purpose of the current study was to explore infrastructure issues that may be barriers to the establishment and improvement of dysphagia services in Malaysia compared to settings with established dysphagia management services (i.e. Queensland, Australia). Method: A mixed method design incorporating quantitative and qualitative data was used to increase credibility, validity and comprehensiveness of the results. Thirty-eight hospitals (Malaysia = 21, Queensland = 17) participated in Phase 1 (quantitative component) of the study involving completion of an infrastructure checklist by a speech-language pathologist from each hospital regarding availability of networking and communication, staffing and financial support, facilities and documentation of guidelines for dysphagia management. Subsequently, eight sub-samples from each cohort were then involved in Phase 2 (qualitative component) of the study involving a semi-structured interview on issues related to the impact of infrastructure availability or constraints on service provision. Result: The current study reveals that multiple challenges exist with regard to dysphagia services in Malaysian government hospitals compared to Queensland public hospitals. Conclusion: Overall, it was identified that service improvement in Malaysia requires change at a systems and structures level, but also, more importantly, at the individual/personal level, particularly focusing on the culture, behaviour and attitudes among the staff regarding dysphagia services. [ABSTRACT FROM AUTHOR]

Purpose. Head and neck cancer (HNC) survivors may experience functional changes to their voice, speech and hearing following curative chemoradiotherapy. However, few studies have explored the impact of living with such changes from the perspective of the HNC survivor and their carer. The current study employed a person-centred approach to explore the lived experience of communication changes following chemoradiotherapy treatment for HNC from the perspective of survivors and carers. Method. Participants included 14 survivors with non-glottic HNC and nine carers. All participants took part in in-depth interviews where they were encouraged to describe their experiences of living with and adjusting to communication changes following treatment. Interviews were analysed as a single data set. Result. Four themes emerged including: (1) impairments in communication sub-systems; (2) the challenges of communicating in everyday life; (3) broad ranging effects of communication changes; and (4) adaptations as a result of communication changes. Conclusion. These data confirm that communication changes following chemoradiotherapy have potentially negative psychosocial impacts on both the HNC survivor and their carer. Clinicians should consider the impact of communication changes on the life of the HNC survivor and their carer and provide adequate and timely education and management to address the needs of this population. [ABSTRACT FROM AUTHOR]