Development of mental health first aid guidelines on how a member of the public can support a person affected by a traumatic event: a Delphi study

BACKGROUND: People who experience traumatic events have an increased risk of developing a range of mental disorders. Appropriate early support from a member of the public, whether a friend, family member, co-worker or volunteer, may help to prevent the onset of a mental disorder or may minimise its severity. However, few people have the knowledge and skills required to assist. Simple guidelines may help members of the public to offer appropriate support when it is needed.

METHODS: Guidelines were developed using the Delphi method to reach consensus in a panel of experts. Experts recruited to the panels included 37 professionals writing, planning or working clinically in the trauma area, and 17 consumer or carer advocates who had been affected by traumatic events. As input for the panels to consider, statements about how to assist someone who has experienced a traumatic event were sourced through a systematic search of both professional and lay literature. These statements were used to develop separate questionnaires about possible ways to assist adults and to assist children, and panel members answered either one questionnaire or both, depending on experience and expertise. The guidelines were written using the items most consistently endorsed by the panels across the three Delphi rounds.

RESULTS: There were 180 items relating to helping adults, of which 65 were accepted, and 155 items relating to helping children, of which 71 were accepted. These statements were used to develop the two sets of guidelines appended to this paper.

CONCLUSIONS: There are a number of actions which may be useful for members of the public when they encounter someone who has experienced a traumatic event, and it is possible that these actions may help prevent the development of some mental health problems in the future. Positive social support, a strong theme in these guidelines, has some evidence for effectiveness in developing mental health problems in people who have experienced traumatic events, but the degree to which it helps has not yet been adequately demonstrated. An evaluation of the effectiveness of these guidelines would be useful in determining their value. These guidelines may be useful to organisations who wish to develop or revise curricula of mental health first aid and trauma intervention training programs and policies. They may also be useful for members of the public who want immediate information about how to assist someone who has experienced a potentially traumatic event.

Development of mental health first aid guidelines for suicidal ideation and behaviour: a Delphi study

BACKGROUND: Suicide is a statistically rare event, but devastating to those left behind and one of the worst possible outcomes associated with mental illness. Although a friend, family member or co-worker may be the first person to notice that a person is highly distressed, few have the knowledge and skills required to assist. Simple guidelines may help such a person to encourage a suicidal individual to seek professional help or decide against suicide.

METHODS: This research was conducted using the Delphi methodology, a method of reaching consensus in a panel of experts. Experts recruited to the panels included 22 professionals, 10 people who had been suicidal in the past and 6 carers of people who had been suicidal in the past. Statements about how to assist someone who is thinking about suicide were sourced through a systematic search of both professional and lay literature. The guidelines were written using the items most consistently endorsed by all three panels.

RESULTS: Of 114 statements presented to the panels, 30 were accepted. These statements were used to develop the guidelines appended to this paper.

CONCLUSION: There are a number of actions which are considered to be useful for members of the public when they encounter someone who is experiencing suicidal thoughts or engaging in suicidal behaviour. These guidelines will be useful in revision of curricula of mental health first aid and suicide intervention training programs. They can also be used by members of the public who want immediate information about how to assist a suicidal person.

Cancer Treatment Survey (CaTS): development and validation of a new instrument to measure patients' preparation for chemotherapy and radiotherapy

Objective: Cancer patients experience high levels of pre-treatment anxiety. Chemotherapy and radiotherapy are threatening medical procedures. Preparation for these procedures should include the provision of sensory and procedural information, and addressing fears. The aim of this study was to develop a cancer treatment survey (CaTS) to assess the preparation for chemotherapy and radiotherapy in cancer patients.

Methods: Drawing on evidence for how to prepare patients for threatening procedures, items were generated by psychosocial/clinical experts and pilot tested with cancer patients. The 36-item draft CaTS was administered to 192 cancer patients commencing chemotherapy for lymphoma, breast or colon cancer. Participants also completed the Hospital Anxiety and Depression Scale (HADS) and basic medical and demographic information was recorded.

Results: A systematic process of item selection removed 11 items. Factor analysis indicated a two-factor solution, with 11 items representing sensory/psychological concerns and 14 items representing procedural concerns. The two subscales demonstrated excellent internal reliability with Cronbach's alpha both over 0.90 and the average inter-item correlation for each scale exceeded 0.30. Divergent validity was established for both CaTS subscales with the HADS-A and-T (all r<0.30). Younger participants (under 65 years of age) had significantly greater procedural concerns (p = 0.001; medium effect).

Conclusions: The CaTS is a two factor, 25-item measure that assesses sensory/psychological concerns and procedural concerns relating to cancer treatment. The instrument provides a reliable and valid outcome measure for interventions to prepare cancer patients for chemotherapy and radiotherapy.

The development of a conceptual model and self-reported measure of occupational health and safety vulnerability

Injuries at work have a substantial economic and societal burden. Often groups of labour market participants, such as young workers, recent immigrants or temporary workers are labelled as being "vulnerable" to work injury. However, defining groups in this way does little to enable a better understanding of the broader factors that place workers at increased risk of injury. In this paper we describe the development of a new measure of occupational health and safety (OH&S) vulnerability. The purpose of this measure was to allow the identification of workers at increased risk of injury, and to enable the monitoring and surveillance of OH&S vulnerability in the labour market. The development included a systematic literature search, and conducting focus groups with a variety of stakeholder groups, to generate a pool of potential items, followed by a series of steps to reduce these items to a more manageable pool. The final measure is 29-item instrument that captures information on four related, but distinct dimensions, thought to be associated with increased risk of injury. These dimensions are: hazard exposure; occupational health and safety policies and procedures; OH&S awareness; and empowerment to participate in injury prevention. In a large sample of employees in Ontario and British Columbia the final measure displayed minimal missing responses, reasonably good distributions across response categories, and strong factorial validity. This new measure of OH&S vulnerability can identify workers who are at risk of injury and provide information on the dimensions of work that may increase this risk. This measurement could be undertaken at one point in time to compare vulnerability across groups, or be undertaken at multiple time points to examine changes in dimensions of OH&S vulnerability, for example, in response to a primary prevention intervention.

Longitudinal predictors of domestic violence perpetration and victimization: a systematic review

Domestic violence (DV) is a serious and complex social issue which is associated with significant costs to both those individuals who are directly affected and the wider community. Preventative approaches with vulnerable population groups represent an important component of any integrated response to DV and should be informed by an understanding of those factors that influence violence developmentally. This paper reports the findings of a systematic review of longitudinal studies that have prospectively investigated childhood and/or adolescent predictors of DV perpetration and/or victimization among adult men and women in intimate relationships. We identified 25 original studies that met the inclusion criteria, all of which investigated predictors of domestic physical abuse. Few studies prospectively examined psychological, sexual and verbal abuse. Child and adolescent abuse, family of origin risks, child and adolescent behavioral problems, adolescent peer risks, and sociodemographic risks were all identified as significant predictors of DV perpetration and victimization. It is concluded that early childhood and adolescent factors are consistent predictors in the development of DV perpetration and victimization and that prevention and early intervention approaches targeting these factors are likely to prove the most effective.

A systematic review of reliable and valid tools for the measurement of patient participation in healthcare

INTRODUCTION: Patient participation in healthcare is recognised internationally as essential for consumer-centric, high-quality healthcare delivery. Its measurement as part of continuous quality improvement requires development of agreed standards and measurable indicators. AIM: This systematic review sought to identify strategies to measure patient participation in healthcare and to report their reliability and validity. In the context of this review, patient participation was constructed as shared decision-making, acknowledging the patient as having critical knowledge regarding their own health and care needs and promoting self-care/autonomy. METHODS: Following a comprehensive search, studies reporting reliability or validity of an instrument used in a healthcare setting to measure patient participation, published in English between January 2004 and March 2014 were eligible for inclusion. RESULTS: From an initial search, which identified 1582 studies, 156 studies were retrieved and screened against inclusion criteria. Thirty-three studies reporting 24 patient participation measurement tools met inclusion criteria, and were critically appraised. The majority of studies were descriptive psychometric studies using prospective, cross-sectional designs. Almost all the tools completed by patients, family caregivers, observers or more than one stakeholder focused on aspects of patient-professional communication. Few tools designed for completion by patients or family caregivers provided valid and reliable measures of patient participation. There was low correlation between many of the tools and other measures of patient satisfaction. CONCLUSION: Few reliable and valid tools for measurement of patient participation in healthcare have been recently developed. Of those reported in this review, the dyadic Observing Patient Involvement in Decision Making (dyadic-OPTION) tool presents the most promise for measuring core components of patient participation. There remains a need for further study into valid, reliable and feasible strategies for measuring patient participation as part of continuous quality improvement.

Systematic reviews: a social work perspective

Systematic reviews are gaining prominence and recognition as being an important methodological approach to dealing with ever growing amounts of research data, and recent years have seen the development of guidelines for both the conduct and reporting of systematic reviews. Initially systematic reviews came to prominence as a method for synthesising data emerging from Randomised Control Trials (RCTs) but increasingly the term “systematic review” is being used in regards to reviews of studies of a wide range of research designs. However, among Australian social workers, utilisation and conduct of systematic reviews has been limited. This paper will explore the question of what a systematic review is, introduce some of the key issues in undertaking such a review, and explore the implications of the emergence of systematic reviews from a social work perspective.

The Maltreatment-Offending Association: a systematic review of the methodological features of prospective and longitudinal studies

Although the association between childhood maltreatment and the subsequent development of offending behavior is well documented, the association does not necessarily reflect a causal relationship. This paper provides a systematic review of prospective and longitudinal studies using official records of maltreatment to gain insights into the extent to which methodological variations are likely to influence the conclusions drawn about the likely relationship between maltreatment and offending. Sixty-two original studies met the inclusion criteria. These studies were assessed according to a set of seven methodological criteria: (1) inclusion of comparison groups, (2) the use of statistical controls, (3) valid outcome measures, (4) operationalization of maltreatment, (5) proper temporal order of associations, (6) data relating to unsubstantiated maltreatment, and (7) consideration of mediating and moderating factors. The strength of evidence in support of the maltreatment-offending association was influenced by a number of methodological factors. Despite the increasing sophistication of studies, there is a need to be mindful of how these factors are taken into account in future research in order to gain a deeper understanding of the adverse consequences of maltreatment and how this might influence outcomes and inform interventions.

Self-practice and self-reflection in training of psychological interventions and therapist skills development: A qualitative meta-synthesis review

© 2015 Australian Psychological Society. Objective: The use of self-practice and self-reflection has been proposed as an efficacious strategy in the training of therapists. It has been argued to enhance therapist skills, and a key factor in the development of expertise. This systematic literature review investigated the effect of self-practice and self-reflection on therapist skills development. Method: Studies were identified through Medline, Academic Search Complete, PsychINFO, PsycARTICLES, Proquest, ISI, CINAHL, Cochrane, and Scopus databases. Additional studies were identified through lateral searches of relevant papers' reference lists and direct correspondence with authors of unpublished material. The selection criteria were studies that investigated the effect of self-practice and/or self-reflection on therapist skill development. There was no restriction on sample sizes, design of studies, dates of publication, or peer-reviewed papers. All studies were published in English. Results: Ten studies were included in this review. A thematic analysis was undertaken to analyse qualitative data. Due to inconsistency in the variables investigated across the quantitative studies, quantitative results were not subject to a meta-analysis but simply reported. Finally, qualitative and quantitative data were juxtaposed in a meta-synthesis. Conclusion: The meta-synthesis revealed inconsistencies between the qualitative and quantitative literature and a gap in relation to declarative knowledge. Methodological limitations across studies are discussed and recommendations for future research provided.

Performance analysis for object-oriented software: a systematic mapping

Performance is a crucial attribute for most software, making performance analysis an important software engineering task. The difficulty is that modern applications are challenging to analyse for performance. Many profiling techniques used in real-world software development struggle to provide useful results when applied to large-scale object-oriented applications. There is a substantial body of research into software performance generally but currently there exists no survey of this research that would help identify approaches useful for object-oriented software. To provide such a review we performed a systematic mapping study of empirical performance analysis approaches that are applicable to object-oriented software. Using keyword searches against leading software engineering research databases and manual searches of relevant venues we identified over 5,000 related articles published since January 2000. From these we systematically selected 253 applicable articles and categorised them according to ten facets that capture the intent, implementation and evaluation of the approaches. Our mapping study results allow us to highlight the main contributions of the existing literature and identify areas where there are interesting opportunities. We also find that, despite the research including approaches specifically aimed at object-oriented software, there are significant challenges in providing actionable feedback on the performance of large-scale object-oriented applications.

Development and interrater reliability of the UK Mental Health Triage Scale

Mental health triage scales are clinical tools used at point of entry to specialist mental health service to provide a systematic way of categorizing the urgency of clinical presentations, and determining an appropriate service response and an optimal timeframe for intervention. The aim of the present study was to test the interrater reliability of a mental health triage scale developed for use in UK mental health triage and crisis services. An interrater reliability study was undertaken. Triage clinicians from England and Wales (n = 66) used the UK Mental Health Triage Scale (UK MHTS) to rate the urgency of 21 validated mental health triage scenarios derived from real occasions of triage. Interrater reliability was calculated using Kendall's coefficient of concordance (w) and intraclass correlation coefficient (ICC) statistics. The average ICC was 0.997 (95% confidence interval (CI): 0.996-0.999 (F (20, 1300) = 394.762, P < 0.001). The single measure ICC was 0.856 (95% CI: 0.776-0.926 (F (20, 1300) = 394.762, P < 0.001). The overall Kendall's w was 0.88 (P < 0.001). The UK MHTS shows substantial levels of interrater reliability. Reliable mental health triage scales employed within effective mental health triage systems offer possibilities for not only improved patient outcomes and experiences, but also for efficient use of finite specialist mental health services.

Systematic examination of publicly-available information reveals the diverse and extensive corporate political activity of the food industry in Australia

BACKGROUND: The political influence of the food industry, referred to as corporate political activity (CPA), represents a potential barrier to the development and implementation of effective public health policies for non-communicable diseases prevention. This paper reports on the feasibility and limitations of using publicly-available information to identify and monitor the CPA of the food industry in Australia. METHODS: A systematic search was conducted for information from food industry, government and other publicly-available data sources in Australia. Data was collected in relation to five key food industry actors: the Australian Food and Grocery Council; Coca Cola; McDonald's; Nestle; and Woolworths, for the period January 2012 to February 2015. Data analysis was guided by an existing framework for classifying CPA strategies of the food industry. RESULTS: The selected food industry actors used multiple CPA strategies, with 'information and messaging' and 'constituency building' strategies most prominent. CONCLUSIONS: The systematic analysis of publicly-available information over a limited period was able to identify diverse and extensive CPA strategies of the food industry in Australia. This approach can contribute to accountability mechanisms for NCD prevention.

Development of mental health first aid guidelines for panic attacks: a Delphi study

BACKGROUND: Panic attacks are common, and while they are not life-threatening events, they can lead to the development of panic disorder and agoraphobia. Appropriate help at the time that a panic attack occurs may decrease the fear associated with the attack and reduce the risk of developing an anxiety disorder. However, few people have the knowledge and skills required to assist. Simple first aid guidelines may help members of the public to offer help to people who experience panic attacks.

METHODS: The Delphi method was used to reach consensus in a panel of experts. Experts included 50 professionals and 6 people who had experience of panic attacks and were active in mental health advocacy. Statements about how to assist someone who is having a panic attack were sourced through a systematic search of both professional and lay literature. These statements were rated for importance as first aid guidelines by the expert and consumer panels and guidelines were written using the items most consistently endorsed.

RESULTS: Of 144 statements presented to the panels, 27 were accepted. These statements were used to develop the guidelines appended to this paper.

CONCLUSION: There are a number of actions which are considered to be useful for members of the public to do if they encounter someone who is having a panic attack. These guidelines will be useful in revision of curricula of mental health first aid programs. They can also be used by members of the public who want immediate information about how to assist someone who is experiencing panic attacks.

The development and validation of a golf swing and putt skill assessment for children

The aim was to describe development of a process-oriented instrument designed to assess the golf swing and putt stroke, and to assess the instrument’s discriminative validity in terms of age and reliability (intra-rater and re-test). A Delphi consultation (with golf industry professionals and researchers in movement skill assessment) was used to develop an assessment for each skill based on existing skill assessment protocols. Each skill had six components to be marked as present/absent. Individual scores were based on the number of performance components successfully demonstrated over two trials for each skill (poten-tial score range 0 to 24). Children (n = 43) aged 6-10 years (M = 7.8 years, SD = 1.3) were assessed in both skills live in the field by one rater at Time 1(T1). A subset of children (n = 28) had consent for assessments to be videoed. Six weeks later 19 chil-dren were reassessed, five days apart (T2, T3). An ANOVA assessed discriminative validity i.e. whether skill competence at T1 differed by age (6 years, 7/8 years and 9/10 years). Intraclass correlations (ICC) assessed intra-rater reliability between the live and video assessment at T1 and test-retest reliability (be-tween T2 and T3). Paired t-tests assessed any systematic differ-ences between live and video assessments (T1) and between T2 and T3. Older children were more skilled (F (2, 40) = 11.18, p < 0.001). The live assessment reflected the video assessment (ICC = 0.79, 95% CI 0.59, 0.90) and scores did not differ between live and video assessments. Test retest reliability was acceptable (ICC = 0.60, 95% CI 0.23, 0.82), although the mean score was slightly higher at retest. This instrument could be used reliably by golf coaches and physical education teachers as part of sys-tematic early player assessment and feedback.

A classification of healthcare facilities: toward the development of energy performance benchmarks for day surgery centers in Australia

OBJECTIVE: In the literature, there is no consistent classification of healthcare facilities. In order to benchmark, assess, and compare the environmental performance of these buildings, it is important to clearly identify the typology within the scope of a particular research. This article identifies the different typologies within the healthcare sector, particularly in Australia, with the aim of the development of energy performance benchmarks for day surgery/procedure centers. BACKGROUND: Healthcare buildings encompass a wide range of facilities. They all share the same purpose of healing and offering a health service for patients. However, they vary significantly in terms of patient type and service provided. These buildings consume a considerable amount of energy, and as a result of the different designs and sizes, their pattern of energy consumption varies. METHODS: The research used a systematic review of the literature to determine how the term "healthcare facility" has been employed in different contexts. In order to better understand the differences in healthcare facilities, definitions and the origin of hospitals and healthcare facilities are introduced and a framework for the classification of healthcare facilities and hospitals is proposed. RESULTS: Healthcare facilities are classified into the following six categories: patient type, care provided, management and ownership, level of care, facility size, and location. Based on these classifications, a categorization for the studies of energy performance in healthcare is introduced. CONCLUSIONS: This study provides a basis for assessment and comparison for a particular healthcare building typology that will assist researchers working in the field of design and energy assessment of healthcare facilities.