Attitudes and management of alcohol problems in general practice: Descriptive analysis based on findings of a world health organization international collaborative survey

Aims: To determine if general practitioners' (GPs) experience of education on alcohol, support in their working environment for intervening with alcohol problems, and their attitudes have an impact on the number of patients they manage with alcohol problems. Methods: 1300 GPs from nine countries were surveyed with a postal questionnaire as part of a World Health Organization (WHO) collaborative study. Results: GPs who received more education on alcohol (OR = 1.5; 95% CI, 1.3-1.7), who perceived that they were working in a supportive environment (OR = 1.6; 95% CI, 1.4-1.9), who expressed higher role security in working with alcohol problems (OR = 2.0; 95% CI, 1.5-2.5) and who reported greater therapeutic commitment to working with alcohol problems (OR = 1.4: 95% CI, 1.1-1.7) were more likely to manage patients with alcohol-related harm. Conclusion: Both education and support in the working environment need to be provided to enhance the involvement of GPs in the management of alcohol problems.

Professional status, employee attitudes and multiple identifications at work

We conducted two studies exploring the influence of professional status on three targets of organisational identification. In the first study, 180 employees from a large metropolitan hospital completed an organisation-wide survey. As predicted, employees belonging to high-status professional groups reported higher levels of identification with their profession, followed by their work unit and the organisation. In contrast, employees belonging to low-status professional groups reported higher levels of identification with their work unit and the organisation, compared to their profession. Identification with the various targets was also associated with higher levels of job satisfaction and organisational commitment, and lower levels of uncertainty and emotional exhaustion. In the second study, 60 employees from the same hospital took part in semi-structured interviews to further explore issues relating to professional identification. In line with the results of the first study, the professional group was viewed as a central target of identification at work, particularly for those employees belonging to high status professional groups. Professional identification was also identified as a conduit for social meaning and a signifier of intergroup boundaries. Implications for the management of multiple identifications and heterogeneous teams are discussed.

Attitudes and beliefs of oral health professionals regarding their role in health promotion

Issues addressed: The study was designed to gain an understanding of health promotion from the perspective of oral health professionals employed in the public sector during a transition in the focus of services. Methods: A cross sectional survey of oral health professionals employed by Queensland Health was conducted between March and April 2001. Staff were randomly sampled from employment records. A proportionate random sample, stratified across professional groups and geographical zones, was selected. Results: While the majority of the health professionals surveyed perceived oral health promotion to be part of their role, they felt ill equipped to adopt it. Professional groups differed in their confidence and perception of how to promote health in their clinical setting, existing barriers they encountered and their participation in health promotion programs. Conclusions: Strategies to improve the adoption of the oral health promotion role within Queensland public oral health services include: regular in- service and education for all staff regarding health promotion issues; increased cohesion of the oral health team; intersectorial collaboration; supportive district management; and a refocus to primary health care and public health concepts

Impact of an intensive nursing education course on nurses' knowledge, confidence, attitudes, and perceived skills in the care of patients with cancer

Purpose/Objectives: To evaluate the impact of a cancer nursing education course on RNs. Design: Quasi-experimental, longitudinal, pretest/post-test design, with a follow-up assessment six weeks after the completion of the nursing education course. Setting: Urban, nongovernment, cancer control agency in Australia. Sample: 53 RNs, of whom 93% were female, with a mean age of 44.6 years and a mean of 16.8 years of experience in nursing; 86% of the nurses resided and worked in regional areas outside of the state capital. Methods: Scales included the Intervention With Psychosocial Needs: Perceived Importance and Skill Level Scale, Palliative Care Quiz for Nurses, Breast Cancer Knowledge, Preparedness for Cancer Nursing, and Satisfaction With Learning. Data were analyzed using multiple analysis of variance and paired t tests. Main Research Variables: Cancer nursing-related knowledge, preparedness for cancer nursing, and attitudes toward and perceived skills in the psychosocial care of patients with cancer and their families. Findings: Compared to nurses in the control group, nurses who attended the nursing education course improved in their cancer nursing-related knowledge, preparedness for cancer nursing, and attitudes toward and perceived skills in the psychosocial care of patients with cancer and their families. Improvements were evident at course completion and were maintained at the six-week follow-up assessment. Conclusions: The nursing education course was effective in improving nurses' scores on all outcome variables. Implications for Nursing: Continuing nursing education courses that use intensive mode timetabling, small group learning, and a mix of teaching methods, including didactic and interactive approaches and clinical placements, are effective and have the potential to improve nursing practice in oncology.

Interagency collaboration between child protection and mental health services: Practices, attitudes and barriers

Objective: The aim of this paper is to examine some of the factors that facilitate and hinder interagency collaboration between child protection services and mental health services in cases where there is a parent with a mental illness and there are protection concerns for the child(ren). The paper reports on agency practices, worker attitudes and experiences, and barriers to effective collaboration. Method: A self-administered, cross-sectional survey was developed and distributed via direct mail or via line supervisors to workers in statutory child protection services, adult mental health services, child and youth mental health services, and Suspected Child Abuse and Neglect (SCAN) Teams. There were 232 completed questionnaires returned, with an overall response rate of 21%. Thirty-eight percent of respondents were statutory child protection workers. 39% were adult mental health workers, 16% were child and youth mental health workers, and 4% were SCAN Team medical officers (with 3% missing data). Results: Analysis revealed that workers were engaging in a moderate amount of interagency contact, but that they were unhappy with the support provided by their agency. Principle components analysis and multivariate analysis of variance (MANOVA) on items assessing attitudes toward other workers identified four factors, which differed in rates of endorsement: inadequate training, positive regard for child protection workers, positive regard for mental health workers, and mutual mistrust (from highest to lowest level of endorsement). The same procedure identified the relative endorsement of five factors extracted from items about potential barriers: inadequate resources, confidentiality, gaps in interagency processes, unrealistic expectations, and professional knowledge domains and boundaries. Conclusions: Mental health and child protection professionals believe that collaborative practice is necessary; however, their efforts are hindered by a lack of supportive structures and practices at the organizational level. (c) 2005 Published by Elsevier Ltd.

Eating disorder attitudes and psychopathology in Caucasian Australian, Asian Australian and Thai university students

Objective: To examine eating disorder attitudes and psychopathology among female university students in Australia and Thailand. Method: Participants were 110 Caucasian Australians, 130 Asian Australians and 101 Thais in Thailand. The instruments included the Eating Attitudes Test (EAT) and the Eating Disorders Inventory (EDI). Results: Eating disorder attitudes and psychopathology scores in the Thai group were found to be highest. The Asian Australian group did not have significantly higher scores on the EAT-26 than the Caucasian Australian group, but had higher scores in some subscales of the EDI-2. That the Thai group had the highest scores in susceptibility to developing an eating disorder and eating disorder psychopathology may be partially explained in sociocultural terms, with pressure to be thin more extreme in Thailand than in Australia. The evidence suggested that unhealthy eating disorder psychopathology is not limited to Western societies but is already present in Thai and other Asian societies.