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BACKGROUND: In an Australian randomized controlled trial (RCT), two techniques for intrapartum fetal surveillance were compared: ST analysis (STan) as an adjunct to cardiotocography (CTG), compared with CTG alone. The aim was to determine whether CTG + STan could reduce emergency cesarean birth rates while maintaining or improving neonatal outcomes. Secondary aims were to compare clinical, economic, and psychosocial outcomes. The purpose of this paper was to present psychosocial outcomes from one cohort enrolled in the trial. METHODS: The study was conducted at one tertiary referral hospital. Participants who had taken part in the trial from the outset were invited to complete a questionnaire between March 2018 and January 2020, approximately 8 weeks after giving birth. Outcomes included depression, psychological distress, health-related quality of life, and infant feeding practices. Analysis was by intention to treat. RESULTS: N = 207/527 participants completed the questionnaire (n = 113, STan; n = 94, CTG alone). Overall, no statistically significant or clinically meaningful differences were found in the two groups for symptoms of depression, psychological distress, quality of life, or infant feeding. A statistically significant difference was observed for the subscale of pain-discomfort, where scores were higher on average in the CTG alone arm relative to that in the CTG + STan arm. CONCLUSIONS: Although STan as an adjunct to CTG constitutes a different clinical technology from CTG alone, both monitoring types appeared to produce similar results in terms of postnatal psychosocial outcomes for women. Findings from this study provide service users and staff with a comprehensive assessment of STan that can be used to make evidence-informed decisions about monitoring options should STan become more widely available.
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Cardiotocografia , Qualidade de Vida , Humanos , Feminino , Gravidez , Adulto , Austrália , Cardiotocografia/métodos , Inquéritos e Questionários , Cesárea/psicologia , Monitorização Fetal/métodos , Depressão , Recém-Nascido , Angústia Psicológica , Estudos de CoortesRESUMO
BACKGROUND: Parents exposed to psychosocial adversities often experience challenges which, combined with the needs of a new-born infant, can be difficult to manage and increase the risk of poor outcomes for both parents and infants. Psychosocial adversity can disrupt the development of parental-foetal attachment to the baby during pregnancy, which can have a negative effect on parental care and quality of interaction during the postnatal period. This intervention is based on the proposition that enhanced parental capacity to mentalise and emotionally connect to unborn children during pregnancy, and better understanding about how to manage distressing infant behaviour (i.e., persistent crying and sleep problems) will: (i) promote the development of secure parent-infant attachment; (ii) improve antenatal bonding and postnatal parenting; and, (ii) reduce parental distress. METHOD: This protocol is for a pilot randomised control trial evaluating a new intervention, which makes use of innovative technologies to support parents experiencing moderate psychosocial adversity (Australian New Zealand Clinical Trials Registry: ACTRN12622000287730). The New Technology for New Parents (NTNP) intervention provides support using antenatal ultrasound scans and 'virtual home visits' during the perinatal period. Quantitative outcomes include mentalising capacity, parental-foetal/infant attachment, and parental competence. CONCLUSION: To the best of our knowledge, no study has evaluated the combined effectiveness of two novel technologies (3D/4D ultrasound scans and virtual home visits) to support parents across the antenatal and postnatal periods. This protocol, which includes the rationale for this innovative intervention, addresses a gap in services for parents experiencing moderate psychosocial adversity.
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BACKGROUND: Many Australians experience mental health challenges, but only a third access face-to-face psychological services, due to multiple barriers including long waitlists. Additional strategies to prevent or help people de-escalate distress at an early stage are needed. Web-based mental health interventions are becoming increasingly acceptable to consumers and referring General Practitioners (GPs), but most are designed for specific disorders/populations. This study explores consumers' and health professionals' preferences and recommendations for the design of a transdiagnostic, Acceptance and Commitment Therapy (ACT)-based, online intervention for Australian adults. METHODS: Thirty-five people (consumers, carers, GPs, mental health professionals) participated in one or more co-design stages. Stage 1: semi-structured interviews to establish what is wanted from such websites (n = 22). Stage 2: feedback emailed on branding options (n = 20). Stage 3: feedback provided via Zoom or an online survey after testing a website prototype (n = 19). Data were analysed using Thematic Framework Analysis and descriptive statistics. RESULTS: Stage 1 highlighted nine key design principles (plus 25 subthemes) that participants emphasised as important to ensure the website would have broad appeal and meet their needs: (1) user choice is valued highly; (2) ACT-based content is acceptable as it is focused on helping people be proactive and 'get unstuck'; (3) non-pathologising, direct, empowering, lay language is endorsed; (4) a positive look and feel is appreciated; (5) images and videos are important to break up text and maintain engagement; (6) short text messages to aid engagement are valued; (7) provision of tailored psychoeducation for highly distressed and suicidal users is endorsed; (8) personal and proactive brand name is preferred (icanactnow); (9) diverse marketing and training activities are recommended. In Stage 2, icanactnow branding preferences were elicited (simplicity, colours to represent growth and a call to action). Stage 3 resulted in the inclusion of a safety plan template and a tailored entry portal for people referred to icanactnow by health professionals. High levels of satisfaction with the prototype were reported. CONCLUSIONS: These findings informed icanactnow and provide insights for the development of other online mental health interventions, in ways that appeal to both consumers and professionals recommending them.
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Terapia de Aceitação e Compromisso , Clínicos Gerais , Intervenção Baseada em Internet , Humanos , Adulto , Saúde Mental , AustráliaRESUMO
ISSUE ADDRESSED: Consumption of energy drinks is a public health concern, particularly in adolescents and young adults. This study explored energy drink consumers' reactions to an energy drink-specific warning label (risk of cardiac effects) and a more general sugary drink warning label (risk of obesity). METHODS: An online experimental study randomly allocated Australian energy drink consumers aged 18-39 years (N = 435) to view one of two label conditions (cardiac effects or obesity). Participants were assessed on: intention to reduce energy drink consumption, perceived health threat, perceived label effectiveness and policy support for energy drink warning labels. RESULTS: Mean intentions to reduce consumption scores were similar across the two label conditions (Mobesity = 2.5, Mcardiac = 2.6) overall; and were higher for the cardiac label (compared to obesity label) for some subgroups: females (Mobesity = 2.3, Mcardiac = 2.8; p = .037), older (25-39 years; Mobesity = 2.4, Mcardiac = 2.8; p = .016); and higher education level (Mobesity = 1.9, Mcardiac = 2.7; p = .004). While perceived health threat measures were higher for obesity than cardiac effects, perceived label effectiveness measures of 'believable' and 'relevant to me' were higher for the cardiac label than the obesity label (believable: 71.0% vs 56.1%; relevant: 42.5% vs 29.4%). Participants who viewed the cardiac label were more likely to support policy than those shown the obesity label (OR = 1.6, 95%CI [1.1, 2.3], p = .02). CONCLUSIONS: Health effect warnings labels were perceived by energy drink consumers to be impactful and are supported. Labels with energy drink-specific health effects may offer additional benefit. SO WHAT?: Policy makers can feel confident that warning labels on energy drinks will confer public health benefit.
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Bebidas Energéticas , Adolescente , Feminino , Humanos , Adulto Jovem , Austrália , Bebidas Energéticas/efeitos adversos , Rotulagem de Alimentos , Obesidade/prevenção & controle , Masculino , AdultoRESUMO
AIMS: The aim of this study is to extend understandings of the impact of surgically diagnosed endometriosis on women's social lives, work and education. METHODS: Participants (N = 200; average age: 27.1 years (±6.72)) were recruited from a range of sources, including social media and private women's health clinics. They completed an online survey comprising seven open-ended questions about how experience with endometriosis impacted (i) overall life; (ii) family relationships; (iii) friendships; (iv) attendance at social events; (v) engagement in leisure activities; (vi) work; and (vii) education. Data were analysed using inductive classical content analysis. RESULTS: The data set contained 1400 discrete codable statements, with 19% of women reporting some form of social impact. A key result was the role of family and friends, both positive and negative, as well as the positive role that the workplace/educational institution can play (noted by 50% of participants). Findings highlight the negative impact on leisure activities, reported by 86% of women. The exhaustion of sick and unpaid leave was reported by 41% of women. CONCLUSION: This study highlights the impact of endometriosis on the social and economic lives of Australian women and underscores the importance of the comprehensive response recommended in the National Action Plan for Endometriosis.
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Endometriose , Adulto , Austrália , Escolaridade , Emprego , Endometriose/diagnóstico , Endometriose/cirurgia , Feminino , Humanos , Inquéritos e QuestionáriosRESUMO
Throughout the COVID-19 pandemic, concerns have been raised about an 'infodemic', with information and misinformation being spread across multiple channels and mediums. Information consumption has also been associated with increased anxiety throughout the pandemic. Thus, the present study investigates the mediating role of state anxiety on the relationship between information consumption (defined as mean frequency of information consumption multiplied by number of information sources) and COVID-19 protective behaviours. We compare results across Australian and United States samples and account for personal risk perception and belief in misinformation about COVID-19. Cross-sectional data collected between 28 and 30 April 2020 were analysed using Bayesian structural equation modelling among participants from Australia (N = 201), and the United States (N = 306). State anxiety scores were above the conventional clinical cut-off. Information consumption was positively associated with state anxiety, personal risk perception, and COVID-19 protective behaviours in the Australian and the United States samples. Additionally, the relationship between information consumption and COVID-19 protective behaviours was positively mediated by state anxiety in both nations, suggesting some functional benefits of anxiety. Differences in risk perception and belief in misinformation existed between the Australian and United States sample. Findings provide support for current guidance from organisations such as the WHO, APA, and APS on limiting information consumption to reduce anxiety. To effectively communicate critical public health messaging while minimising potential burdens on mental health, there is a need to develop and test interventions that assist people in calibrating the extent and nature of their information consumption.
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COVID-19 , Ansiedade/epidemiologia , Austrália/epidemiologia , Teorema de Bayes , COVID-19/epidemiologia , Estudos Transversais , Humanos , Pandemias , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: This study used retrospective linked population data to investigate the impact of early childhood cancer on developmental outcomes. METHODS: Children aged <9 years with a recorded malignant neoplasm were identified in the South Australian Cancer Registry. They were then linked to developmental data recorded in the Australian Early Development Census (AEDC) for the 2009, 2012, and 2015 data collection periods; and assigned five matched controls from the same AEDC year. RESULTS: Between 2000 and 2015, 43 children had a malignant cancer diagnosis and also participated in the AEDC. Compared to controls, childhood cancer survivors exhibited greater developmental vulnerability in their physical health and wellbeing. Between survivors and controls, no significant developmental differences were observed in social, emotional, language and cognitive, and communication and general knowledge domains. Rural or remote location had a significant positive effect on developmental outcomes for childhood cancer survivors relative to controls, suggesting this was a protective factor in terms of physical health and wellbeing, social competence, communication, and general knowledge. Among all children, socioeconomic advantage was linked to better developmental outcomes on all domains except physical health and wellbeing. CONCLUSION: Following an early cancer diagnosis, children may require targeted care to support their physical health and wellbeing. Geographic variation in developmental outcomes indicates remoteness was a protective factor and requires further investigation. This study highlights the feasibility of using administrative whole-population data to investigate cancer outcomes.
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Neoplasias , Web Semântica , Austrália/epidemiologia , Criança , Desenvolvimento Infantil , Pré-Escolar , Humanos , Neoplasias/epidemiologia , Estudos RetrospectivosRESUMO
AIMS AND OBJECTIVES: The current study aimed to qualitatively explore men's help-seeking behaviours by analysing male callers' talk on an Australian health helpline. Analysis focused on identifying the ways in which men positioned themselves as help-seekers and the extent to which help-seeking behaviours deviated or conformed to the narrative commonly reported on in men's health literature which, generally speaking, positions men as reluctant help-seekers and health service users. METHODS: The present study utilised naturally occurring instances of men's help-seeking during 196 calls to the helpline, Healthdirect Australia. Thematic analysis was used to explore recurrent themes in help-seeking interactions. FINDINGS: The analysis yielded three broad themes, which were formulated as caller archetypes. These themes included the 'reluctant caller', the 'unwell patient' and the 'concerned carer', as well as a number of associated sub-themes within these broad categories. CONCLUSIONS: The findings demonstrated that male callers sought help in a variety of different ways, rather than prescribing to a homogenous pattern of help-seeking. However, it was acknowledged that some data did align with help-seeking behaviour which indicated men's reluctance to engage with their own health. SO WHAT?: The present study contributes to men's health promotion by identifying the various social devices used by men to facilitate help-seeking. The findings highlight the changing and flexible landscape of contemporary masculinity and its impact on health engagement. Recognising the versatility in men's health behaviour is important for ensuring that men have positive experiences during healthcare encounters which, in turn, may facilitate future health service uptake and engagement.
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Masculinidade , Homens , Austrália , Serviços de Saúde , Humanos , Masculino , Saúde do HomemRESUMO
OBJECTIVE: To identify the modifiable psychological and behavioural coping strategies associated with low levels of psychological distress, independent of more stable personality and demographic factors, in a sample of farmers who reported being exposed to a recent stressful event during an extended drought. DESIGN/SETTING/PARTICIPANTS: Three hundred and nine South Australian, drought-affected grain, sheep and/or cattle farmers completed printed or online questionnaires. Only those who reported experiencing a stressful event in the past month that they rated ≥7 on a scale ranging from 1 (not stressful at all) to 10 (extremely stressful) were included in the analyses (n = 175, 65.06%). Participants ranged in age from 24 to 85 years and 40% were female. MAIN OUTCOME MEASURES: Psychological distress was measured using the Kessler Psychological Distress Scale, and coping strategies were measured using a situational version of the COPE inventory. Five personality factors (extraversion, neuroticism, openness, conscientiousness and agreeableness) were assessed using the Quickscales-R. RESULTS: In the final multivariable model, distress was elevated among individuals reporting higher neuroticism and behavioural disengagement, and lower in individuals reporting greater use of acceptance. These 3 variables explained 44% of the variance in distress. CONCLUSION: Farmers recently exposed to a significant stressor, who used acceptance as a coping strategy, did not engage in behavioural disengagement and scored low on neuroticism, were least likely to experience distress. Given the stability of personality factors, interventions that foster farmers' use of acceptance and prevent behavioural disengagement as coping strategies might assist them with the management of future stressors, particularly in times of drought.
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Adaptação Psicológica , Secas , Fazendeiros/psicologia , Neuroticismo , Angústia Psicológica , População Rural/estatística & dados numéricos , Estresse Psicológico/etiologia , Adulto , Animais , Austrália , Bovinos , Fazendeiros/estatística & dados numéricos , Feminino , Humanos , Saúde Mental , Pessoa de Meia-Idade , OvinosRESUMO
INTRODUCTION: This study explored the extent to which disaggregated support from family, peers, close friendships, teachers, and schools predicted membership into identified, sex-specific trajectories of depressed mood in 3210 Australian adolescents (49% females) based on self-report data collected at four annual time points from school Grade 6 to 9 (ages 10-16). METHODS: The sample was initially split by sex. Group-Based Trajectory Modelling was used to identify the trajectory groups using a Censored Normal model, starting with a two-group model and increasing group size in increments of one, up to a six-group model. Overall model-fit and specific model-fit criteria were examined, and participants were allocated to best-fit groups. Multinomial Logistic Regression examined the associations between baseline social supports and allocated trajectory group membership. RESULTS: For boys, four trajectory groups were identified which were given the qualitative labels; Low Stable, Moderate Stable, Moderate Decreasing, and High Stable. Regression analysis showed that higher rates of peer belonging were associated with membership in the low and moderate groups compared to the High Stable group. For girls, four trajectory groups were identified and labelled as Low Stable, Moderate Decreasing, Moderate Increasing and High Increasing. Regression analysis showed that higher rates of family support, school climate, and peer belonging were associated with membership in the low and moderate groups compared to the High Increasing group. CONCLUSIONS: Implications included the need for school-based early intervention programs to consider disaggregated supports and vary their interventions by sex. Limitations and directions for future research are discussed.
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Depressão/psicologia , Relações Familiares/psicologia , Grupo Associado , Apoio Social , Adolescente , Austrália , Criança , Feminino , Humanos , Estudos Longitudinais , Masculino , Instituições Acadêmicas , Autorrelato , Inquéritos e QuestionáriosRESUMO
Purpose: This study investigated how coping impacts offspring's adaption to parental cancer in terms of post-traumatic growth, resilience, and emotion; and how coping differs between offspring.Methods: Participants (18-34 years; n = 244) completed an online survey. Data were analyzed using generalized linear modeling and multinomial regression.Findings: Higher levels of adaptive coping was associated with higher post-traumatic growth, resiliency, and positive affect; whereas maladaptive coping was associated with lower resiliency and higher negative affect. Females and offspring who did not access support for their parent's cancer reported higher adaptive coping. Offspring bereaved by parental cancer reported higher levels of maladaptive coping. Offspring whose parents' cancer was of shorter duration and those who lived with their ill parent had lower adaptive and maladaptive coping.Conclusions/Implications: Adaptive coping appeared beneficial to offspring. Supportive interventions may benefit from focusing on increasing adaptive coping, particularly among bereaved offspring.
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Adaptação Psicológica , Filho de Pais com Deficiência/psicologia , Neoplasias , Adolescente , Adulto , Filho de Pais com Deficiência/estatística & dados numéricos , Emoções , Feminino , Humanos , Masculino , Crescimento Psicológico Pós-Traumático , Resiliência Psicológica , Inquéritos e Questionários , Adulto JovemRESUMO
Non-adherence to antipsychotic medication is common among people with schizophrenia, and is associated with an increased risk of relapse. It is important to develop strategies to enhance medication adherence. Few qualitative studies have been undertaken to understand the consumer's perspective. The voice of people who are prescribed these medications is therefore missing from the research literature. Reasons for non-adherence were investigated by directly engaging with consumers and exploring their attitudes, beliefs and experiences concerning antipsychotic medications. Qualitative, semi- structured, one-to-one interviews were conducted with 25 community-dwelling people with schizophrenia from metropolitan Adelaide, Australia. Interviews were audio-recorded, transcribed and analysed, guided by a grounded theory approach. Codes identified in open coding were grouped into categories, reflective of the different aspects of consumers' attitudes and experiences with medication. Interviews continued until there was saturation of themes. Consumer-related factors, medication-related factors and service-related factors were reported to influence adherence behavior. These included poor insight, unpleasant medication side effects, inadequate efficacy and poor therapeutic alliance. Lessons gained during periods of non-adherence were the motivator for future adherence; such as worsening of symptoms if medication was not taken. Potential implications of future adherence described by Interviewees include greater involvement of peer workers, as they were considered to work more effectively with consumers to encourage adherence. Peer workers had more credibility than other service providers due to their lived experience. Multiple factors were identified that impact on antipsychotic medication adherence, providing opportunities for interventions and improvements in services that would enhance adherence.
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Antipsicóticos , Vida Independente , Adesão à Medicação , Relações Médico-Paciente , Esquizofrenia/tratamento farmacológico , Adulto , Antipsicóticos/efeitos adversos , Antipsicóticos/uso terapêutico , Austrália , Feminino , Teoria Fundamentada , Humanos , Entrevistas como Assunto , Masculino , Pesquisa Qualitativa , RecidivaRESUMO
[Purpose] The foundations of the scoliosis specific and evidence-based physiotherapy program according to Schroth is the original the Lehnert-Schroth (LS) classification which is still in use today. The purpose of this paper is to test the reliability of the LS classification system, using clinical and radiological images of scoliosis patients as classified by specialist experienced clinicians. [Participants and Methods] A list of 40 pictures of X-Rays and a list of 40 clinical pictures (all posterior trunk images) of patients with idiopathic scoliosis were provided by the second author. Three specialist professional physiotherapists or orthotists rated all clinical and radiological pictures according to these two patterns of the LS classification. [Results] The intra-observer Kappa value was 0.90 (clinical) and 1.00 (x-rays). The inter-observer Kappa values at average was 0.65 (clinical) and 0.71 (x-rays). [Conclusion] For the application of classifying the patients when prescribing postural advice and exercises from the Schroth program the LS-classification seems an easy to use and highly reliable tool. This test demonstrated sufficient reliability with respect to the x-rays, but the tests of the clinical pictures alone, demonstrated fair levels of reliability, which indicates that it is an appropriate tool for physiotherapists when an x-ray is not available.
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BACKGROUND: Given the sudden and unexpected nature of an emergency caesarean section (EmCS) coupled with an increased risk of psychological distress, it is particularly important to understand the psychosocial outcomes for women. The aim of this systematic literature review was to identify, collate and examine the evidence surrounding women's psychosocial outcomes of EmCS worldwide. METHODS: The electronic databases of EMBASE, PubMed, Scopus, and PsycINFO were searched between November 2017 and March 2018. To ensure articles were reflective of original and recently published research, the search criteria included peer-reviewed research articles published within the last 20 years (1998 to 2018). All study designs were included if they incorporated an examination of women's psychosocial outcomes after EmCS. Due to inherent heterogeneity of study data, extraction and synthesis of both qualitative and quantitative data pertaining to key psychosocial outcomes were organised into coherent themes and analysis was attempted. RESULTS: In total 17,189 articles were identified. Of these, 208 full text articles were assessed for eligibility. One hundred forty-nine articles were further excluded, resulting in the inclusion of 66 articles in the current systematic literature review. While meta-analyses were not possible due to the nature of the heterogeneity, key psychosocial outcomes identified that were negatively impacted by EmCS included post-traumatic stress, health-related quality of life, experiences, infant-feeding, satisfaction, and self-esteem. Post-traumatic stress was one of the most commonly examined psychosocial outcomes, with a strong consensus that EmCS contributes to both symptoms and diagnosis. CONCLUSIONS: EmCS was found to negatively impact several psychosocial outcomes for women in particular post-traumatic stress. While investment in technologies and clinical practice to minimise the number of EmCSs is crucial, further investigations are needed to develop effective strategies to prepare and support women who experience this type of birth.
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Cesárea/psicologia , Tratamento de Emergência/psicologia , Complicações Pós-Operatórias/psicologia , Período Pós-Parto/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Feminino , Humanos , Período Pós-Operatório , Gravidez , Qualidade de Vida , Autoimagem , Adulto JovemRESUMO
[Purpose] Although there is evidence that non-specific chronic pain can be influenced by physical therapy, some patients with scoliosis and chronic pain may benefit from additional brace treatment. The purpose of this review is to answer the question whether there are studies on the use of brace treatment in patients with scoliosis and pain and to investigate whether brace treatment does positively influence chronic pain. [Methods] A PubMed review has been undertaken using the key words (1) scoliosis and pain and brace treatment and (2) scoliosis and pain and orthotics. From both searches the studies were extracted that included a patient group with the diagnosis of a scoliosis and with additional chronic non-specific low back pain, treated with a brace. [Results] One hundred forty two items have been found for search (1) and 111 for search (2). The total number of relevant items found in both searches was 10. According to the studies found, bracing seems an effective treatment for this condition. [Conclusion] Brace treatment in patients with scoliosis and chronic non-specific low back pain has demonstrated to be effective. It should be used when exercise treatment is not effective. A clinical test is demonstrated to predict the most beneficial approach in brace treatment.
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[Purpose] Specific exercises and brace treatment are the two evidence-based modes of treatment for patients with scoliosis. The purpose of this paper is to present the first end-results from a prospective cohort that commenced treatment in 2011 with a CAD based Chêneau derivate and is then compared to the published results achieved with the Boston Brace. [Participants and Methods] Inclusion criteria for the study, refers to the SRS inclusion criteria on bracing, except the range of Cobb angles which was extended to curvatures of up to 45°. Twenty-eight patients were weaned from their CAD Chêneau style brace. The results of this cohort have been compared with the BRAIST study by Weinstein et al. with the help of the Z-test. [Results] A success rate of 92.9% has been achieved. This was compared to the success rate of 72% in the BRAIST study. The differences were highly significant in the Z-test. [Conclusion] The results achieved with the GBW are significantly and better than the results achieved with the Boston brace. Therefore, the standards for bracing should be reviewed with the results that symmetric compression with Boston bracing is not as successful, when compared to asymmetric high correction bracing results, which allow a standardized classification-based corrective approach.
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BACKGROUND: Redesigning primary health services may enhance timely and effective uptake by men. The primary aim of this study was to assess the likelihood of Australian men attending a dedicated men's health service (DMHS). The further aims were to better understand the reasons for their preferences and determine how health behaviours influence likelihood. METHODS: A survey on health service use and preferences, health help-seeking behaviours, and the likelihood of attending a DMHS was administered by telephone to 1506 randomly selected men (median age 56 years, range 19-95). Likelihood of attending a DMHS was rated using a single item Likert scale where 0 was not at all likely and 10 highly likely. Respondents were classified by age (< or > = 65 years) and health status. Principal component analyses were used to define health behaviours, specifically help-seeking and delay/avoidance regarding visiting a doctor. Multivariable linear and logistic regression analyses were used to examine predictors of likelihood of attending a DMHS. RESULTS: The mean likelihood of attending a DMHS was 5.8 (SD 3.3, median 6, moderate likelihood) and 21%, 26% and 23% of men rated likelihood as moderate, high and very high respectively. Being happy with their existing doctor was the most common reason (52%) for being less likely to attend a DMHS. In unadjusted analyses, younger men reported being more likely to attend a DMHS (p < 0.001) with older-sick men reporting being least likely (p < 0.001). Younger men were more likely than older men to score higher on delay/avoidance and were more likely to self-monitor. In the full model, men with current health concerns (p ≤ 0.01), who scored higher on delay/avoidance (p ≤ 0.0006), who were more likely to be information-seekers (p < 0.0001) and/or were motivated to change their health (p ≤ 0.0001) reported a higher likelihood of attending a DMHS irrespective of age and health status. CONCLUSIONS: Seventy percent of men reported a moderate or higher likelihood of attending a DMHS. As young healthy men are more likely than older men to display health behaviours that are associated with a higher likelihood of attending a DHMS, such as delay/avoidance, marketing a DMHS to such men may be of value.
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Comportamentos Relacionados com a Saúde , Serviços de Saúde/estatística & dados numéricos , Comportamento de Busca de Ajuda , Saúde do Homem , Adulto , Idoso , Idoso de 80 Anos ou mais , Austrália , Pesquisas sobre Atenção à Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Probabilidade , Adulto JovemRESUMO
This study reviewed the literature regarding the psychological, social, and behavioural impact of parental cancer on offspring aged 10-24 years, at the time of the parent's first diagnosis. A systematic literature review was conducted following 2015 PRISMA guidelines. Seven studies met inclusion criteria. Offspring were impacted by their parent's cancer and experienced psychological and behavioural problems. Daughters and offspring who experienced more problems at their parent's diagnosis appeared to be most impacted. Offspring refrained from communicating their disease-related concerns, but expected their parents to communicate openly. Turning to oneself and peer-support were coping strategies used by offspring. The majority of offspring were significantly impacted by their parent's cancer. The paucity of literature focusing on offspring aged 10-24â¯yearsâ¯at the time of their parent's incident cancer diagnosis indicates that research has overlooked offspring age at their parent's cancer onset as a factor that may influence their future outcomes.
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Acontecimentos que Mudam a Vida , Neoplasias/psicologia , Relações Pais-Filho , Pais , Adolescente , Criança , Humanos , Adulto JovemRESUMO
BACKGROUND: Women's views are critical for informing the planning and delivery of maternity care services. ST segment analysis (STan) is a promising method to more accurately detect when unborn babies are at risk of brain damage or death during labour that is being trialled for the first time in Australia. This is the first study to examine women's views about STan monitoring in this context. METHODS: Semi-structured interviews were conducted with pregnant women recruited across a range of clinical locations at the study hospital. The interviews included hypothetical scenarios to assess women's prospective views about STan monitoring (as an adjunct to cardiotocography, (CTG)) compared to the existing fetal monitoring method of CTG alone. This article describes findings from an inductive and descriptive thematic analysis. RESULTS: Most women preferred the existing fetal monitoring method compared to STan monitoring; women's decision-making was multifaceted. Analysis yielded four themes relating to women's views towards fetal monitoring in labour: a) risk and labour b) mobility in labour c) autonomy and choice in labour d) trust in maternity care providers. CONCLUSIONS: Findings suggest that women's views towards CTG and STan monitoring are multifaceted, and appear to be influenced by individual labour preferences and the information being received and understood. This underlies the importance of clear communication between maternity care providers and women about technology use in intrapartum care. This research is now being used to inform the implementation of the first properly powered Australian randomised trial comparing STan and CTG monitoring.
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Cardiotocografia/psicologia , Monitorização Fetal/psicologia , Trabalho de Parto/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Gestantes/psicologia , Adulto , Austrália , Cardiotocografia/métodos , Feminino , Monitorização Fetal/métodos , Humanos , Projetos Piloto , Gravidez , Estudos Prospectivos , Pesquisa QualitativaRESUMO
BACKGROUND: Participation at the recommended intervals is critical for screening to be effective in reducing colorectal cancer (CRC) incidence. This study describes patterns of screening participation over four rounds of fecal immunochemical testing (FIT) to identify whether demographic variables and prior screening satisfaction are significantly associated with patterns of re-participation. METHODS: Baseline surveys were mailed to 4000 South Australians randomly selected from the electoral-roll. Respondents (n = 1928/48.2%) were offered four annual FIT rounds. Screening participation and satisfaction at each round were recorded. RESULTS: Study participation was 58.5, 66.9, 73.1 and 71.4% respectively over four rounds. Three participation patterns were described: consistent participation (43.1%), consistent non-participation (26.4%) and inconsistent participation (changeable; 30.5%), including intermittent and sustained change patterns. Sustained change described those who changed participatory behavior and then maintained for at least two rounds (n = 375/19.5%). Older people, and those not working were most likely to sustain participation. Younger invitees, especially men, were more likely to change participatory behavior and sustain the change. People with higher disadvantage, less education, not working and with no prior (pre-trial) screening experience were more likely to start participating and drop out. People dissatisfied with a prior screening test, including finding aspects embarrassing or unpleasant, were also more likely not to participate in annual screening or to drop out. CONCLUSIONS: The findings identify those at risk of non- or inconsistent participation in rescreening. They should aid targeting of interventions for demographic groups at risk and ensuring screening experiences are not perceived as unpleasant or difficult.