Lost in translation?

The vast majority of research in the psychology of reproduction and infancy ultimately aims to improve the health and well-being of individuals in meaningful ways. Despite diversity in topics of study, research in our field can support improved planning of health and social services and the development and implementation of policy, practice guidelines and programmes to enhance the experiences of women, men and children. Research published in the current issue demonstrates this practical utility. In this issue of the journal Chin, Hall and Daiches’ meta-synthesis of fathers’ experiences of the transition to parenthood and Bradley and Slade’s review of fathers’ mental health problems following the birth of a child legitimate men’s role in the maternity care system and provide a robust basis for the development of health policies and programmes that can address their needs. Together, their findings highlight the importance of improved tailoring of antenatal education (practical accessibility and content relevance) for fathers, and opportunities for postnatal reflection, debriefing, and support...

The effects of a woman-focused, woman-held resource on preventive health behaviors during pregnancy : the pregnancy pocketbook

We evaluated the effectiveness of a woman-held pregnancy record ('The Pregnancy Pocketbook') on improving health behaviors important for maternal and infant health. The Pregnancy Pocketbook was developed as a woman-focused preventive approach to pregnancy health based on antenatal management guidelines, behavior-change evidence, and formative research with the target population and health service providers. The Pregnancy Pocketbook was evaluated using a quasi-experimental, two-group design; one clinic cohort received the Pregnancy Pocketbook (n = 163); the other received Usual Care (n = 141). Smoking, fruit and vegetable intake, and physical activity were assessed at baseline (service-entry) and 12-weeks. Approximately two-thirds of women in the Pregnancy Pocketbook clinic recalled receiving the resource. A small, but significantly greater proportion of women at the Pregnancy Pocketbook site (7.6%) than the UC site (2.1%) quit smoking. No significant effect was observed of the Pregnancy Pocketbook on fruit and vegetable intake or physical activity. Few women completed sections that required health professional assistance. The Pregnancy Pocketbook produced small, but significant effects on smoking cessation, despite findings that indicate minimal interaction about the resource between health staff and the women in their care. A refocus of antenatal care toward primary prevention is required to provide essential health information and behavior change tools more consistently for improved maternal and infant health outcomes.

Prevalence of health behaviours in pregnancy at service entry in a Queensland health service district

Objective: Limited prevalence data for unhealthy pregnancy health behaviours make it difficult to prioritise primary prevention efforts for maternal and infant health. This study's objective was to establish the prevalence of cigarette smoking, sufficient fruit and vegetable intake and sufficient physical activity among women accessing antenatal clinics in a Queensland (Australia) health service district. Method: Cross-sectional self-reported smoking status, daily fruit and vegetable intake, weekly physical activity and a range of socio-demographic variables were obtained from women recruited at their initial antenatal clinic visit, over a three-month recruitment phase during 2007. Results: Analyses were based on 262 pregnant women. The study sample was broadly representative of women giving birth in the district and state, with higher representation of women with low levels of education and high income. More than one quarter of women were smoking. Few women met the guidelines for sufficient fruit (9.2%), vegetables (2.7%) or physical activity (32.8%) during pregnancy. Conclusions: There were low levels of adherence to health behaviour recommendations for pregnancy in this sample. Implications: There is a clear need to develop and evaluate effective pregnancy behaviour interventions to improve primary prevention in maternal and infant health. Brief minimal contact interventions that can be delivered through primary care to create a greater primary prevention focus for maternal and infant health would be worth exploring.

Investigating well-being and mental health in Queensland fire-fighters

This thesis used survey and interview methods to examine how organisational and interpersonal factors impact on the mental health of fire and rescue workers. It was the first published research to assess and predict multiple indicators of mental health; psychological distress, well-being, posttraumatic growth and posttraumatic stress disorder symptoms. The results provide valuable information for supporting fire and rescue workers through psychoeducation and proactive intervention programs.

Comparison of three different dressings for partial thickness burns in children : study protocol for a randomised controlled trial

BACKGROUND: In the paediatric population, pain and distress associated with burn injuries during wound care procedures remain a constant challenge. Although silver dressings are the gold standard for burn care in Australasia, very few high-level trials have been conducted that compare silver dressings to determine which will provide the best level of care clinically. Therefore, for paediatric patients in particular, identifying silver dressings that are associated with lower levels of pain and rapid wound re-epithelialisation is imperative. This study will determine whether there is a difference in time to re-epithelialisation and pain and distress experienced during wound care procedures among Acticoat, Acticoat combined with Mepitel and Mepilex Ag dressings for acute, paediatric partial thickness burns. METHODS/DESIGN: Children aged 0 to 15 years with an acute partial thickness (superficial partial to deep partial thickness inclusive) burn injury and a burn total body surface area of distress and healing will be repeated at each dressing change until complete wound re-epithelialisation occurs or skin grafting is required. Additional data collected will include infection status at each dressing change, physical function, scar outcome and scar management requirements, cost effectiveness of each dressing and staff perspectives of the dressings. DISCUSSION: The results of this study will determine the effects of three commonly used silver and silicone burn dressing combinations on the rate of wound re-epithelialisation and pain experienced during dressing procedures in acute, paediatric partial thickness burn injuries. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12613000105741.

Improving dental and medical students’ psychological health using a self-development coaching program : a pilot study

Introduction: Dental and medical students worldwide, including in Saudi Arabia, have been reported to have a high incidence of poor psychological health, such as depression, stress, anxiety, and lowlife satisfaction. Self-development coaching programs have become an increasingly popular way to improve individuals’ lives. However, few studies have evaluated the psychological effects of such programs among dental and medical students. Moreover, no studies have been conducted on self-development coaching programs in Saudi Arabia. Aims: The aim of this study was to assess the feasibility of a larger study via a pilot study and to acquire preliminary findings about the effectiveness of a self-development coaching program on psychological health among dental and medical students in Saudi Arabia. Methods: A pre-post interventional study design was used to test a self-development coaching program (How to be an Ultra-Super Student) with a sample of medical students (n=17) at Umm Al-Qura University at Saudi Arabia. The outcome measures were students’ psychological distress (depression, anxiety, and stress), life satisfaction, self-efficacy, the coach, and coaching program characteristics. Results: The study showed that there was a significant improvement in depression (p=0.04), self-efficacy (p=0.02), and satisfaction with life (p=0.04), which supported the feasibility of a large study in the future. Conclusions: The study’s findings encourage the implementation of a randomized, controlled trial study with a larger sample to further test the effectiveness of using self-development coaching programs with medical and dental students in Saudi Arabia to improve their psychological health.

A little learning is a dangerous thing? The ethics of teaching accidental tourists in higher education

This paper raises questions about the ethical issues that arise for academics and universities when under-graduate students enrol in classes outside of their discipline - classes that are not designed to be multi-disciplinary or introductory. We term these students ‘accidental tourists'. Differences between disciplines in terms of pedagogy, norms, language and understanding may pose challenges for accidental tourists in achieving desired learning outcomes. This paper begins a discussion about whether lecturers and universities have any ethical obligations towards supporting the learning of these students. Recognising that engaging with only one ethical theory leads to a fragmented moral vision, this paper employs a variety of ethical theories to examine any possible moral obligations that may fall upon lecturers and/or universities. In regards to lecturers, the paper critically engages with the ethical theories of utilitarianism, Kantianism and virtue ethics (Aristotle) to determine the extent of any academic duty to accidental tourists. In relation to universities, this paper employs the emerging ethical theory of organisational ethics as a lens through which to critically examine any possible obligations. Organisational ethics stems from the recognition that moral demands also exist for organisations so organisations must be reconceptualised as ethical actors and their policies and practices subject to ethical scrutiny. The analysis in this paper illustrates the challenges faced by lecturers some of whom, we theorise, may experience a form of moral distress facing a conflict between personal beliefs and organisational requirements. It also critically examines the role and responsibilities of universities towards students and towards their staff and the inherent moral tensions between a market model and demands for ‘good' learning experiences. This paper highlights the tensions for academics, between academics and universities and within university policy and indicates the need for greater reflection about this issue, especially given the many constraints facing lecturers and universities.

A randomized controlled trial of a correspondence-based intervention for carers of relatives with psychosis

Background Family members play a crucial role in supporting the recovery of loved ones with psychosis. The journey of recovery is not only traversed by the person experiencing the mental illness but also by their family. Interventions to support these families have traditionally either focused on psychoeducation or addressed problematic interactions or expressed emotion. Family programmes have far less frequently emphasized supporting family members' adjustment to the challenges posed by their relative's disorder or their recovery from associated distress. The study compared a control condition that received only a psychoeducational booklet (Information) and a condition also receiving a correspondence-based interactive recovery-oriented intervention (Connections). The Connections group was expected to show greater improvements in recovery knowledge, well-being, experiences of caregiving, hopefulness and distress. Method A randomized controlled trial was conducted to evaluate the effectiveness of two correspondence-based family interventions delivered to 81 carers of relatives with psychosis. Results Intent-to-treat analyses showed no differential outcomes between conditions, but an analysis of participants who substantially completed their allocated treatment showed that carers receiving Connections had significantly more improvements in well-being, positive experiences of caregiving and distress. Conclusions Correspondence interventions that support carer's recovery may result in more positive mental health for those who complete key elements of the programme compared with information alone. However, many carers do not complete a correspondence programme and this may limit its impact.

Developing an acculturation and resilience scale for use with culturally and linguistically diverse populations

Australian multicultural society consists of culturally and linguistically diverse (CALD) migrants, refugees and international students from different parts of the world. Despite hardships, these individuals show resilience and adapt successfully. However, there is a dearth of scales measuring these positive developments and personal strengths. The study describes the development and evaluation of a scale measuring resilience and acculturation of CALD people. Items were generated for the Acculturation and Resilience Scale (AARS).The AARS and other acculturation and psychological distress scales were administered to 225 CALD community members. Exploratory factor analyses resulted in a 27-item AARS with three subscales: Acculturation, Resilience, and Spirituality. The three-factor structure was subjected to a confirmatory factor analysis on a sample of 515 international students. The factor structure stability was upheld by the second sample. The psychometric properties were investigated using the two samples and demonstrated satisfactory internal consistency, test-retest reliability, and divergent validity. The scale addresses a major gap in the literature and can be used to measure the positive acculturation and resilience of the newly arrived and relocated individuals. Further research is warranted to examine the scale’s psychometric properties with migrants and refugees from a range of ethnic communities.

Development and validation of a pregnancy symptoms inventory

Background Physical symptoms are common in pregnancy and are predominantly associated with normal physiological changes. These symptoms have a social and economic cost, leading to absenteeism from work and additional medical interventions. There is currently no simple method for identifying common pregnancy related problems in the antenatal period. A validated tool, for use by pregnancy care providers would be useful. The aim of this study was to develop and validate a Pregnancy Symptoms Inventory for use by health professionals. Methods A list of symptoms was generated via expert consultation with health professionals. Focus groups were conducted with pregnant women. The inventory was tested for face validity and piloted for readability and comprehension. For test-re-test reliability, the tool was administered to the same women 2 to 3 days apart. Finally, midwives trialled the inventory for 1 month and rated its usefulness on a 10cm visual analogue scale (VAS). Results A 41-item Likert inventory assessing how often symptoms occurred and what effect they had, was developed. Individual item test re-test reliability was between .51 to 1, the majority (34 items) scoring ≥0.70. The top four “often” reported symptoms were urinary frequency (52.2%), tiredness (45.5%), poor sleep (27.5%) and back pain (19.5%). Among the women surveyed, 16.2% claimed to sometimes or often be incontinent. Referrals to the incontinence nurse increased > 8 fold during the study period. Conclusions The PSI provides a comprehensive inventory of pregnancy related symptoms, with a mechanism for assessing their effect on function. It was robustly developed, with good test re-test reliability, face validity, comprehension and readability. This provides a validated tool for assessing the impact of interventions in pregnancy.

A group psychological intervention to enhance the coping and acculturation of international students

There is a shortage of psychological interventions to aid the acculturation of international students. To address this issue, the present study developed and trialled a brief group psychological intervention, the STAR program: Strengths, Transitions, Adjustments, and Resilience. This program was developed using suggestions from international students and university professional and academic staff that had significant dealings and designated roles to guide support international students. It comprises of four weekly two-hour sessions, and is experiential and cognitive-behavioural in nature. The STAR program aims to enhance coping, which is predicted to subsequently improve psychological adaptation (an acculturation outcome). Sixteen international students participated in the pilot trial of the STAR program. The participants completed measures on coping self-efficacy, social self-efficacy, psychological adaptation, and psychological distress pre-intervention, post-intervention, and one-month follow-up. Results showed that participants’ psychological adaptation and coping self-efficacy significantly increased from pre to post, with the treatment gain maintained at the one-month follow-up for psychological adaptation. Increases in social self-efficacy were evident, but these did not reach significance, possibly due to a lack of power. The STAR program did not have an impact on psychological distress; however, participants were only minimally distressed at the commencement of the program. The qualitative feedback gathered from the participants, provided suggestions for further refinement, as well as information about the clinical utility of the STAR program.

Raising Children in Single-Parent Families

Children from single-parent families fare more poorly on multiple outcomes than those in two-parent families. Most explanations for these differences assume that compromised parenting and parent mental health play a central role. This chapter explores the contribution of a range of factors to the parenting and mental health of single mothers using data from approximately 1000 Australian single mothers with a child aged 4–5 or 8–9 years. The findings show that single mothers are more likely than couple mothers to experience parenting and mental health difficulties; however, they also face heightened adversity in their home and extra-familial environments. Importantly, this comparison of single and couple mothers facing similar levels of adversity shows no difference in poor parenting practices, although single mothers remain more vulnerable to psychological distress. These findings have policy implications since they challenge the prevailing view that single-parent families inherently provide sub-optimal environments for raising children.

Psychosocial and communication variables involved in mediating the individual experience of older adults following a severe weather event

The recent floods in south-east Queensland have focused policy, academic and community attention on the challenges associated with severe weather events (SWE), specifically pre-disaster preparation, disaster-response and post-disaster community resilience. Financially, the cost of SWE was $9 billion in the 2011 Australian Federal Budget (Swan 2011); psychologically and emotionally, the impact on individual mental health and community wellbeing is also significant but more difficult to quantify. However, recent estimates suggest that as many as one in five will subsequently experience major emotional distress (Bonanno et al. 2010). With climate change predicted to increase the frequency and intensity of a wide range of SWE in Australia (Garnaut 2011; The Climate Institute 2011), there is an urgent and critical need to ensure that the unique psychological and social needs of more vulnerable community members - such as older residents - are better understood and integrated into disaster preparedness and response policy, planning and protocols. Navigating the complex dynamics of SWE can be particularly challenging for older adults and their disaster experience is frequently magnified by a wide array of cumulative and interactive stressors, which intertwine to make them uniquely vulnerable to significant short and long-term adverse effects. This current article provides a brief introduction to the current literature in this area and highlights a gap in the research relating to communication tools during and after severe weather events.

Partial mediation role of self-efficacy between positive social interaction and mental health in family caregivers for dementia patients in Shanghai

We explored the mediation effect of caregiver self-efficacy on the influences of behavioral and psychological symptoms (BPSD) of dementia care recipients (CRs) or family caregivers’ (CGs) social supports (informational, tangible and affectionate support and positive social interaction) on CGs’ mental health. We interviewed 196 CGs, using a battery of measures including demographic data of the dyads, CRs’ dementia-related impairments, and CGs’ social support, self-efficacy and the Medical Outcome Study (MOS) Short-Form (SF-36) Health Survey. Multiple regression analyses showed that gathering information on self-efficacy and managing CG distress self-efficacy were the partial mediators of the relationship between positive social interaction and CG mental health. Managing caregiving distress self-efficacy also partial mediated the impact of BPSD on CG mental health. We discuss implications of the results for improving mental health of the target population in mainland China.

The power of naming : the multifaceted value of learning students’ names

The modern day Australian law school is expected to educate and engage law students. Ideally law school will instil a sense of passion (or at least appreciation) for the law, promote a positive professional identity, foster a sense of community, and provide general support to law students. Collectively, the Australian legal academy is struggling with these goals. Significant numbers of students feel isolated, disconnected and unengaged throughout their tertiary legal education. Teaching students from increasingly diverse backgrounds, who spend less time on campus and less face-to-face time in class, many law academics feel ill-equipped to respond to the challenge of engaging law students in time and cost efficient ways. Intentionally learning and using student names has potential to humanise the law school experience, build community, and positively impact upon the wellbeing of students and staff.