Feasibility of brief psychological distress screening by a community-based telephone helpline for cancer patients and carers

Background Up to one-third of people affected by cancer experience ongoing psychological distress and would benefit from screening followed by an appropriate level of psychological intervention. This rarely occurs in routine clinical practice due to barriers such as lack of time and experience. This study investigated the feasibility of community-based telephone helpline operators screening callers affected by cancer for their level of distress using a brief screening tool (Distress Thermometer), and triaging to the appropriate level of care using a tiered model. Methods Consecutive cancer patients and carers who contacted the helpline from September-December 2006 (n = 341) were invited to participate. Routine screening and triage was conducted by helpline operators at this time. Additional socio-demographic and psychosocial adjustment data were collected by telephone interview by research staff following the initial call. Results The Distress Thermometer had good overall accuracy in detecting general psychosocial morbidity (Hospital Anxiety and Depression Scale cut-off score ≥ 15) for cancer patients (AUC = 0.73) and carers (AUC = 0.70). We found 73% of participants met the Distress Thermometer cut-off for distress caseness according to the Hospital Anxiety and Depression Scale (a score ≥ 4), and optimal sensitivity (83%, 77%) and specificity (51%, 48%) were obtained with cut-offs of ≥ 4 and ≥ 6 in the patient and carer groups respectively. Distress was significantly associated with the Hospital Anxiety and Depression Scale scores (total, as well as anxiety and depression subscales) and level of care in cancer patients, as well as with the Hospital Anxiety and Depression Scale anxiety subscale for carers. There was a trend for more highly distressed callers to be triaged to more intensive care, with patients with distress scores ≥ 4 more likely to receive extended or specialist care. Conclusions Our data suggest that it was feasible for community-based cancer helpline operators to screen callers for distress using a brief screening tool, the Distress Thermometer, and to triage callers to an appropriate level of care using a tiered model. The Distress Thermometer is a rapid and non-invasive alternative to longer psychometric instruments, and may provide part of the solution in ensuring distressed patients and carers affected by cancer are identified and supported appropriately.

Children with special health care needs : social and learning competence in the early years

The number of children with special health care needs surviving infancy and attending school has been increasing. Due to their health status, these children may be at risk of low social-emotional and learning competencies (e.g., Lightfoot, Mukherjee, & Sloper, 2000; Zehnder, Landolt, Prchal, & Vollrath, 2006). Early social problems have been linked to low levels of academic achievement (Ladd, 2005), inappropriate behaviours at school (Shiu, 2001) and strained teacher-child relationships (Blumberg, Carle, O‘Connor, Moore, & Lippmann, 2008). Early learning difficulties have been associated with mental health problems (Maughan, Rowe, Loeber, & Stouthamer-Loeber, 2003), increased behaviour issues (Arnold, 1997), delinquency (Loeber & Dishion, 1983) and later academic failure (Epstein, 2008). Considering the importance of these areas, the limited research on special health care needs in social-emotional and learning domains is a factor driving this research. The purpose of the current research is to investigate social-emotional and learning competence in the early years for Australian children who have special health care needs. The data which informed this thesis was from Growing up in Australia: The Longitudinal Study of Australian Children. This is a national, longitudinal study being conducted by the Commonwealth Department of Families, Housing, Community Services and Indigenous Affairs. The study has a national representative sample, with data collection occurring biennially, in 2004 (Wave 1), 2006 (Wave 2) and 2008 (Wave 3). Growing up in Australia uses a cross-sequential research design involving two cohorts, an Infant Cohort (0-1 at recruitment) and a Kindergarten Cohort (4-5 at recruitment). This study uses the Kindergarten Cohort, for which there were 4,983 children at recruitment. Three studies were conducted to address the objectives of this thesis. Study 1 used Wave 1 data to identify and describe Australian children with special health care needs. Children who identified as having special health care needs through the special health care needs screener were selected. From this, descriptive analyses were run. The results indicate that boys, children with low birth weight and children from families with low levels of maternal education are likely to be in the population of children with special health care needs. Further, these children are likely to be using prescription medications, have poor general health and are likely to have specific condition diagnoses. Study 2 used Wave 1 data to examine differences between children with special health care needs and their peers in social-emotional competence and learning competence prior to school. Children identified by the special health care needs screener were chosen for the case group (n = 650). A matched case control group of peers (n = 650), matched on sex, cultural and linguistic diversity, family socioeconomic position and age, were the comparison group. Social-emotional competence was measured through Social/Emotional Domain scores taken from the Growing up in Australia Outcome Index, with learning competence measured through Learning Domain scores. Results suggest statistically significant differences in scores between the two groups. Children with special health care needs have lower levels of social-emotional and learning competence prior to school compared to their peers. Study 3 used Wave 1 and Wave 2 data to examine the relationship between special health care needs at Wave 1 and social-emotional competence and learning competence at Wave 2, as children started school. The sample for this study consisted of children in the Kindergarten Cohort who had teacher data at Wave 2. Results from multiple regression models indicate that special health care needs prior to school (Wave 1) significantly predicts social-emotional competence and learning competence in the early years of school (Wave 2). These results indicate that having special health care needs prior to school is a risk factor for the social-emotional and learning domains in the early years of school. The results from these studies give valuable insight into Australian children with special health care needs and their social-emotional and learning competence in the early years. The Australia population of children with special health care needs were primarily male children, from families with low maternal education, were likely to be of poor health and taking prescription medications. It was found that children with special health care needs were likely to have lower social-emotional competence and learning competence prior to school compared to their peers. Results indicate that special health care needs prior to school were predictive of lower social-emotional and learning competencies in the early years of school. More research is required into this unique population and their competencies over time. However, the current research provides valuable insight into an under researched 'at risk' population.

Inciting the social imagination to realising the dream : An unfolding story of reform in a low-socioeconomic school

This paper presentation addresses design-based research that became a catalyst for social change among a disadvantaged school community. The aim of the longitudinal research was to protoype an evidence-based model for whole school digital and print literacy pedagogy renewal among students from low socioeconomic, Indigenous, and migrant backgrounds. Applying Anthony Gidden’s principle of the “duality of structure”, the paper presentation interprets how the collective agency of researchers and the school community began to transform the structural properties of the institution in a two-way dynamism, so that the structural properties of the school were not outside of individual action, but were implicated in its reproduction and transformation.

Applying social technology to Business Process Lifecycle Management

In recent years social technologies such as wikis, blogs or microblogging have seen an exponential growth in the uptake of their user base making this type of technology one of the most significant networking and knowledge sharing platforms for potentially hundreds of millions of users. However, the adoption of these technologies has been so far mostly for private purposes. First attempts have been made to embed features of social technologies in the corporate IT landscape, and Business Process Management is no exception. This paper aims to consolidate the opportunities for integrating social technologies into the different stages of the business process lifecycle. Thus, it contributes to a conceptualization of this fast growing domain, and can help to categorize academic and corporate development activities.

Diversity in action : minority group media and social change (text-only version)

This magazine, written by Melissa Giles, features three Brisbane-based media organisations: Radio 4RPH, Queensland Pride and 98.9FM. The PDF file on this website contains a text-only version of the magazine. Contact the author if you would like a copy of the text-only EPUB file or a copy of the full digital magazine with images. An audio version of the magazine is available at http://eprints.qut.edu.au/41729/

Widening the context for interdisciplinary social research : SFL as a method for sociology, anthropology, and communication research

In this paper, I show clear links between the theoretical underpinnings of SFL and those of specific sociological, anthropological, and communication research traditions. My purpose in doing so is to argue that SFL is an excellent interdisciplinary research method for the social sciences, especially considering the emergent form of political economy being touted by new media enthusiasts: the so called knowledge (or information) economy. To demonstrate the flexibility and salience of SFL in diverse traditions of social research, and as evidence of its ability to be deployed as a flexible research method across formerly impermeable disciplinary and social boundaries, I use analyses from my doctoral research, relating these - theoretically speaking - to specific research traditions in sociology, communication, and anthropology.

Social network and aesthetic reflexivity in the creative industries

This article reviews some key critical writing about the commodification or exploitation of networked social relations in the creative industries. Through a comparative case study of networks in fashion and new media industries in the city of Manchester, UK, the article draws attention to the social, cultural and aesthetic aspects of the networks among creative practitioners. It argues that within the increasing commercialisation in the creative industries there are networked spaces within which non-instrumental values are created. The building of social networks reflects on the issue of how creatives perceive their work in these industries both economically and socially/culturally.

Start playing with your food : fun food experiences with mobile social media

Healthy and sustainable food is gaining more attention from consumers, industry, and researchers. Yet many approaches to date are limited to information dissemination, advertisement or education. We have embarked on a three year collaborative research project (2011 – 2013) to explore urban food practices – eating, cooking, growing food – to support the well-being of people and the environment. Our overall goal is to employ a user-centred interaction design research approach to inform the development of entertaining, real-time, mobile and networked applications, engaging playful feedback to build motivation. Our aspiration for this study is to deliver usable and useful mobile and situated interaction prototypes that employ individual and group strategies to foster food cultures that provide new pathways to produce, share and enjoy food that is green, healthy, and fun.

Lessons learnt : complementing good clinical renal questions with an appropriate research strategy

The purpose of this article is to present lessons learnt by nurses when conducting research to encourage colleagues to ask good clinical research questions. This is accomplished by presenting a study designed to challenge current practice which included research flaws. The longstanding practice of weighing renal patients at 0600 hours and then again prior to receiving haemodialysis was examined. Nurses believed that performing the assessment twice, often within a few hours, was unnecessary and that patients were angry when woken to be weighed. An observational study with convenience sampling collected data from 46 individuals requiring haemodialysis, who were repeatedly sampled to provide 139 episodes of data. Although the research hypotheses were rejected, invaluable experience was gained, with research and clinical practice lessons learnt, along with surprising findings.

Tea ceremony and Sukiya : negating social hierarchy

There is a widely held view that architecture is very strongly and even primarily determined by the society and culture rather than geographical, technical, economic or cli-matic factors. This is especially evident in societies where rituals, customs and tradition play a significant role in the design of built forms. One such society was that of Feudal Japan under the rule of samurai warriors. The strictly controlled hierarchical society of Feudal Japan, isolated from the rest of the world for over 250 years, was able to develop the art and architecture borrowed from neighboring older cultures of China and Korea into what is now considered uniquely Japanese. One such architecture is the Sukiya style tea houses where the ritual of tea ceremony took place. This ritual was developed by the tea masters who were Zen monks or the merchants who belonged to the lowest class in the hierarchical feudal society. The Sukiya style developed from 14th to 16th century and became an architectural space that negated all the rules imposed on commoners by the samurai rulers. The tea culture had a major influence on Japanese architecture, the concept of space and aesthetics. It extended into the design of Japanese gardens, clothes, presentation of food, and their manners in day to day life. The focus of this paper is the Japanese ritual of tea ceremony, the architecture of the tea house it inspired, the society responsible for its creation and the culture that promoted its popularity and its continuation into the 21st century.

Schooling and refugees : engaging with the complex trajectories of globalisation

This paper examines the complexities associated with educating a mobile and politically marginalised population, refugee students, in the state of Queensland, Australia. Historically, schools have been national institutions concerned with social reproduction and citizenship formation with a focus on spatially fixed populations. While education authorities in much of the developed world now acknowledge the need to prepare students for a more interconnected world of work and opportunity, they have largely failed to provide systemic support for one category of children on the move - refugees. We begin this paper with a discussion of forced migration and its links with ‘globalisation’. We then present our research findings about the educational challenges confronting individual refugee youth and schools in Queensland. This is followed with a summary of good practice in refugee education. The paper concludes with a discussion of how nation-states might play a more active role in facilitating transitions to citizenship for refugee youth.

Shouting from the rooftops : Queer digital storytelling for social impact

This chapter explores some of the practical and theoretical obstacles and opportunities for self-expression experienced by a group of Queer Dig- ital Storytellers who primarily make and distribute their stories online. “Queer” in this chapter encompasses a diverse range of gender and sexual identities and perspectives on same, including the heterosexual children of queer parents and heterosexual parents of queer children. As such it is also used as a unifying moniker by participants in the Rainbow Family Tree case study that is examined in this chapter. The Digital Storytellers in this case study are largely motivated by a desire to have an impact on social attitudes towards gender and sexuality, both in their personal province of friends and family, and in public domains constituted of unknown or invisible audiences. The privacy and publicity dilemmas that will be considered arise out of positioning personal stories in the public domain and the quandaries that emerge from an activist desire to speak truth to power that is located across a wide cross section of audiences.

Parent decisions regarding paid work and care of the child

Australia has witnessed a continual increase in maternal employment over the past two decades, which has placed focus on child care- its effects on the child and on early childhood education and care policy and provision. The engagement of women in the paid workforce contributes to national economic development, and is recognised in government policy incentives such as cash subsidies and tax relief for child care fees. These incentives are targeted towards mothers, to encourage them to engage in paid work. Making a contribution to the family’s economy and to a mother’s economic self sufficiency are two key drivers for women’s engagement in satisfying paid work. Many women also seek to maintain a personal investment in the development of their career, simultaneously ensuring that the child is experiencing suitable care. Policies that support women’s choices for satisfying workforce engagement and care arrangements are prudent for ensuring productivity of the economy as well as for enhancing the wellbeing of parents and children (OECD, 2007). Policies that provide family friendly employment arrangements, paid parental leave, and child care support, directly affect maternal employment decisions. Availability of family friendly employment policies is viewed as one way to not only promote gender equity in employment opportunities but also support the wellbeing of children and families (OECD, 2007). Yet there are not comprehensive and coherent policies on work and family in Australia. Australia is due to implement its first paid parental leave scheme in January, 2011. At the time of the data collection of this research, June 2007 to December 2008, Australia had no statutory provision for paid parental leave. To date, most research has focused on the consequences of paid work and care decisions made by women. Far less is known about the processes of decision-making and reasons underlying women’s choices. Investigation of what is most salient for women as they make decisions regarding engagement in paid work, and care for their child is important in order to inform policy and practices related to parental leave, family friendly employment and care for the child. This prospective longitudinal research was of 124 Australian expectant first-time mothers who completed questionnaires in their third trimester of pregnancy, and again at six and twelve months postpartum. First-time expectant mothers' decisions regarding engaging in paid work and selecting care for their child represent those of a group who are invested in motherhood and have usually had direct experience of engaging in paid work. They therefore provide an important insight into society’s idealised views about motherhood and the emotional and social uncertainty of making personal decisions where the consequences of such decisions are unknown. These decisions reflect public beliefs about the role of women in contributing to the country’s productivity and decisions about providing for the economic and emotional care needs of their family. As so little is known about the reasoning and processes of decision-making of women’s choices regarding paid work and care of the child this research was designed to capture expectant first-time mother’s preferred options for engaging in paid work and the care of their child, and investigate their actual decisions made at six and 12 months postpartum. To capture preferred options, decisions and outcomes of decisions regarding paid work and care of the child a prospective longitudinal research design was utilised. This design had three important components that addressed key limitations in the extant literature. First the research commenced in pregnancy in order to investigate preferences and beliefs about paid work and care and to examine baseline data that may influence decisions made as the women returned to paid work. Second the research involved longitudinal tracking from the antenatal time point to six and 12 months postpartum in order to identify the influences on decisions made. Third the research measured outcomes of the decisions made at each time point. This research examined the intentions, preferences, beliefs, influences, and outcomes of the decisions about engagement in paid work and choice of care. The analyses examined factors predicting return to paid work, the timing of return and extent of engagement in paid work; the care for the child; satisfaction with paid work; satisfaction with care for the child, motherhood and fulfilment; and maternal wellbeing at six and 12 months postpartum. The factors of interest were both rational/economic (availability and extent of paid and unpaid maternity leave; flexible work patterns) and emotional/affective (career satisfaction, investment in motherhood, and concern with quality of care for the child). Results indicated a group preference, and realisation for, return to paid work within the first year after the birth of a child but with reduction in hours to part-time. Most women saw paid work not only as a source of income but also as source of personal satisfaction. There were four key themes arising from this research. First, the women strived to feel emotionally secure when deciding about engaging in paid work and care of the child. To achieve emotional security women made their decisions for paid work and care of the child differently. A woman’s decision for maternal employment is a function of her personal beliefs, preferences and context regarding paid work and care of the child. She adjusts her established work identity with her new identity as a mother. The second key theme from this research is that the women made their decisions for maternal employment in response to their personal context and there were different levels of opportunities between the women’s choices. There is inequity of entitlement regarding work conditions associated with a woman’s education level. This has implications for the woman’s engagement in paid work, and her child’s health and wellbeing. The third key theme is that the quality of the child’s care mattered to the women in the research. They preferred care provided by parents and/or relatives more than any other types of care. The fourth key theme identified that satisfaction and wellbeing outcomes experienced as a result of maternal employment decisions were a complex interaction between multiple factors that change across time with the ongoing development of the mother’s identity, and the development of the child. The implications for policy within Australia are that the employment of mothers in the workforce necessitates that non-parental care becomes a public concern, where there is universal access to good quality affordable care for every child, not just for those who can afford it. This is equitable and represents real choice while supporting the rights of the child (Thorpe, Cloney & Tayler, 2010), protecting and promoting the public interest (Cleveland & Krashinsky, 2010). Children’s health and wellbeing will be supported (Moore & Oberklaid, 2010) while children are in non-parental care, and they will be exposed to environments and experiences that support their learning and development. The significant design of the research enabled the trajectories of first-time expectant women to be tracked from the antenatal point to 12 months postpartum. But there were limitations: the small sample size, the over-representation of the sample being highly educated and the nature of a longitudinal research that is set within the economic, social and political context at that time. These limitations are discussed in relation to suggestions for future research.