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Background: Relatively little is understood about real-world provision of oncology care in ambulatory outpatient clinics (OPCs). This study aimed to: 1) develop an understanding of behaviours and practices inherent in the delivery of cancer services in OPC common areas by characterising the organisation and implementation of this care; and 2) identify barriers to, and facilitators of, the delivery of this care in OPC common areas.Methods: A purpose-designed ethnographic study was employed in four public hospital OPCs. Informal field scoping activities were followed by in-situ observations, key informant interviews and document review. A view of OPCs as complex adaptive systems was used as a scaffold for the data collection and interpretation, with the intent of understanding 'work as done'. Data were analysed using an adapted "Qualitative Rapid Appraisal, Rigorous Analysis" approach.Results: Field observations were conducted over 135 h, interviews over 6.5 h and documents were reviewed. Analysis found six themes. Staff working in OPCs see themselves as part of small local teams and as part of a broader multidisciplinary care team. Professional role boundaries could be unclear in practice, as duties expanded to meet demand or to stop patients "falling through the cracks." Formal care processes in OPCs were supported by relationships, social capital and informal, but invaluable, institutional expertise. Features of the clinic layout, such as the proximity of departments, affected professional interactions. Staff were aware of inter- and intra-service communication difficulties and employed strategies to minimise negative impacts on patients. We found that complexity, coordination, culture and capacity underpin the themes that characterise this care provision.Conclusions: The study advances understanding of how multidisciplinary care is delivered in ambulatory settings and the factors which promote or inhibit effective care practice. Time pressures, communication challenges and competing priorities can pose barriers to care delivery. OPC care is facilitated by: self-organisation of participants; professional acumen; institutional knowledge; social ties and relationships between and within professional groups; and commitment to patient-centred care. An understanding of the realities of 'work-as-done' may help OPCs to sustain high-quality care in the face of escalating service demand. [ABSTRACT FROM AUTHOR]

This study explores and identifies the different challenges for both antenatal and postnatal fathers that might act as precursors for poor paternal perinatal emotional well-being. Twelve fathers living in Sydney, aged over 18 years, identified as either an antenatal or postnatal father were interviewed concerning their experiences. Interview data were thematically analysed to identify challenges faced by expectant and new fathers. Five main challenges were identified – father–mother relationship, father–child relationship, life changes, lack of support and birth event. The results of this study indicate possible differences between antenatal and postnatal challenges, with postnatal fathers being confronted by additional challenges. These findings provide valuable insight for health professionals to better target treatment interventions by considering the actual precursors for poor emotional well-being in fathers. [ABSTRACT FROM AUTHOR]

Objective: There have been few descriptions of how outpatient cancer care is provided to patients from culturally and linguistically diverse (CALD) communities. As populations who experience disparities in cancer care access and outcomes, deeper understanding is needed to help identify those factors which can shape the receipt of multidisciplinary care in ambulatory settings. This paper reports on data collected and analysed as part of a multicentre characterisation of care in Australian public hospital cancer outpatient clinics (OPCs). Results: Analysis of data from our ethnographic study of four OPCs identified three themes: "Identifying CALD patient language-related needs"; "Capacity and resources to meet CALD patient needs", and "Making it work for CALD communities." The care team comprises not only clinicians but also families and non-clinical staff; OPCs serve as "touchpoints" facilitating access to a range of therapeutic services. The findings highlight the potential challenges oncology professionals negotiate in providing care to CALD communities and the ways in which clinicians adapt their practices, formulate strategies and use available resources to support care delivery. [ABSTRACT FROM AUTHOR]

This article describes the experiences of teaching undergraduate psychology students in an Australian context. The degree course the students take has no community or critical units, but it is one of very few in Australia that has a compulsory standalone unit in qualitative methods. While qualitative methods are by no means necessarily inherently critical or community focused, it has presented an opportunity to the teachers of the unit (the authors of this paper). The authors of this paper, who employ community critical methodologies in their research, aim to design teaching which is also grounded in such theory, wherever possible and despite significant limitations. Such teaching is informed by: challenging taken for granted assumptions; deconstruction and problem posing; making things uncomfortable; and relating differently. The paper describes a design of teaching where all the students undertake research projects exploring the research question: "what does psychology offer community?" Following a description of the methodologies and teaching practices, the authors reflect subjectively on their experiences working with the students, on opportunities which arose and on structural boundaries which appear to make community critical methodologies in university teaching very difficult. [ABSTRACT FROM AUTHOR]