Facilitators' teaching and social presence in online asynchronous interprofessional education discussion.

Asynchronous discussion boards have been increasingly used to engage teams of interprofessional learners in interactive and reflective discourse. Facilitation of this interprofessional discourse is critical, yet largely unexplored. The Community of Inquiry (CoI) framework provides a lens through which facilitators' contributions on asynchronous discussion boards can be explored. The aim of this study was to apply the CoI framework teaching and social presence indicators to an online asynchronous IPE facilitation environment to determine if they comprehensively describe the kind of contributions made by IPE facilitators in two types of interprofessional team discussions. Directed content analysis based on the teaching and social presence indicators from the CoI framework was used to analyse seven facilitators' contributions to four asynchronous team discussion points (two key dimensions and two case study discussions). Sixteen of the 31 teaching and social presence indicators, along with a new indicator (feedback on assessment tasks), comprehensively described the facilitators' contributions. Many of the teaching presence indicators were used in a greater proportion of the key dimension discussions than in the case study discussions. This study demonstrates that the teaching and social presence indicators of the CoI framework are a valuable way to describe the contributions made by facilitators to asynchronous interprofessional team discussions.

Interprofessional education and practice guide No. 10: Developing, supporting and sustaining a team of facilitators in online interprofessional education.

Whilst we have seen a growth in the use of information and communication technologies to deliver interprofessional education (IPE) in the last decade, little has been written about facilitating IPE in the online environment. For the last 10 years, the Faculty of Health at Deakin University has offered a fully online IPE course that has consistently employed facilitators to guide interprofessional teams in both asynchronous and synchronous (real-time) online interprofessional learning experiences. This Interprofessional Education and Practice Guide draws on the Deakin University leadership experience in supporting teams of online IPE facilitators over the last decade, underpinned by prior research and key literature. The key lessons provided in this guide aim to assist others in developing, supporting and sustaining a team of online IPE facilitators to guide asynchronous and synchronous online interprofessional learning experiences.

Experiences and health care preferences of women with ovarian cancer during the diagnosis phase.

OBJECTIVE: An ovarian cancer diagnosis presents physical and psychological challenges. Usually identified at an advanced stage, the disease involves invasive treatment and has a high mortality rate. The diagnosis phase is generally a time of heightened distress. Accordingly, the aim of this qualitative study was to explore the health care experiences and preferences of women with ovarian cancer during this phase, and identify opportunities to enhance women's experiences and outcomes. METHODS: Thirty-four women diagnosed with ovarian cancer were recruited from across Australia (median age = 60.5 years, range = 31-74 years). Semistructured interviews explored participants' experience of health care services and preferences during the diagnosis phase. Thematic analysis of interview transcripts followed. RESULTS: Five themes were identified including "navigating uncertainty" which summarized women's general experiences throughout the diagnosis phase and provided a context for concomitant health care preferences. Four other themes highlighted significant areas where health care may be better aligned with women's preferences. These included "responsiveness in health care," "relational communication," "person-centered information," and "preparation for living beyond cancer treatment." CONCLUSIONS: Responsive and prompt health care services that employ relational communication, provide patient-centered information, and prepare women for survivorship could improve the health care experiences of women diagnosed with ovarian cancer.

A Multi-Family Group Intervention for Adolescent Depression: The BEST MOOD Program.

Depression is the most common mental disorder for young people, and it is associated with educational underachievement, self-harm, and suicidality. Current psychological therapies for adolescent depression are usually focused only on individual-level change and often neglect family or contextual influences. The efficacy of interventions may be enhanced with a broader therapeutic focus on family factors such as communication, conflict, support, and cohesion. This article describes a structured multi-family group approach to the treatment of adolescent depression: Behaviour Exchange Systems Therapy for adolescent depression (BEST MOOD). BEST MOOD is a manualized intervention that is designed to address both individual and family factors in the treatment of adolescent depression. BEST MOOD adopts a family systems approach that also incorporates psychoeducation and elements of attachment theories. The program consists of eight multifamily group therapy sessions delivered over 2 hours per week, where parents attend the first four sessions and young people and siblings join from week 5. The program design is specifically aimed to engage youth who are initially resistant to treatment and to optimize youth and family mental health outcomes. This article presents an overview of the theoretical model, session content, and evaluations to date, and provides a case study to illustrate the approach.

The intergenerational continuity of breastfeeding intention, initiation, and duration: a systematic review.

BACKGROUND: In studies investigating predictors of breastfeeding behaviors, it is not uncommon for researchers to adjust for participants' having been breastfed as an infant. This assumes an intergenerational effect of breastfeeding continuity. Our aim was to investigate the veracity of that assumption. Specifically, we sought to summarize and evaluate evidence of associations between breastfeeding in one generation and breastfeeding intentions and behaviors in the second generation. METHODS: A systematic search of psychological, nursing, and medical databases was conducted for studies examining "having been breastfed" as a factor in breastfeeding intention, initiation, or duration. Quality indicators were assessed and limitations reported. Effects were explored according to outcomes of intention, initiation, and duration. RESULTS: Fifteen papers were found to be eligible for the review. Having been breastfed as an infant was consistently correlated with breastfeeding intention, initiation, and duration. Effect sizes differed depending on methodology. Men's infant-feeding status was also related to later intentions to support or encourage a partner to breastfeed. CONCLUSIONS: Robust evidence for intergenerational breastfeeding continuity is present; however, mechanisms that explain this association were not considered in the studies reviewed and would best be explored within longitudinal cohort studies.

Development of the Health Literacy of Caregivers Scale - Cancer (HLCS-C): item generation and content validity testing.

BACKGROUND: Health literacy refers to an individual's ability to engage with health information and services. Cancer caregivers play a vital role in the care of people with cancer, and their capacity to find, understand, appraise and use health information and services influences how effectively they are able to undertake this role. The aim of this study was to develop an instrument to measure health literacy of cancer caregivers. METHOD: Content areas for the new instrument were identified from a conceptual model of cancer caregiver health literacy. Item content was guided by statements provided by key stakeholders during consultation activities and selected to be representative across the range of cancer caregiver experiences. Content validity of items was assessed through expert review (n = 7) and cognitive interviews with caregivers (n = 16). RESULTS: An initial pool of 82 items was generated across 10 domains. Two categories of response options were developed for these items: agreement with statements, and difficulty undertaking presented tasks. Expert review revealed that the majority of items were relevant and clear (Content Validity Index > 0.78). Cognitive interviews with caregivers suggested that all except three items were well understood. CONCLUSION: A resultant 88 item questionnaire was developed to assess cancer caregiver health literacy. Further work is required to assess the construct validity and reliability of the new measure, and to remove poorly performing and redundant items, which will result in a shorter, final measure. The new measure has the potential to inform the development and evaluation of interventions and the improvement of health service delivery to cancer caregivers.

Facilitators' experience of delivering asynchronous and synchronous online interprofessional education.

INTRODUCTION: Online delivery of interprofessional education (IPE) is an emerging area with very little research to date focusing on the experience of the facilitator in this process. The purpose of this article was to explore the facilitator experience of online asynchronous and synchronous IPE facilitation of pre-licensure students. METHODS: Nineteen online facilitators participated in semi-structured telephone interviews to explore this experience. RESULTS: Findings from Interpretative Phenomenological Analysis indicated that the facilitators found positives of the experience including perceiving that the students were learning, their own development as a facilitator, the flexibility of the role and feeling supported as a facilitator. Challenges of the experience were also noted including technological problems in the synchronous environment and engaging some students or teams in both the synchronous and asynchronous environments. DISCUSSION: While this study identified positive aspects of the facilitation experience it also highlighted some key topics which need to be addressed in training for online IPE facilitators to further enhance their experience, and subsequently the experience and interprofessional learning of their students.

Experiences of parenting for autistic children in Australia and Italy: a qualitative cross-cultural comparison.

Introduction: Parents vary in their gradual adaptation to the demands of caring for an autistic child. Their experiences can be positive, negative, or a combination of both, depending on the severity of the cases and various personal and social factors. Cross-cultural comparisons can aid in understanding how contextual factors, such as the availability of social and health services, and cultural factors, such as family relationships and the distribution of care burden, may influence the caregiving experience. However, there is a limited amount of cross-cultural research on this topic, which is almost exclusively quantitative. Aims and methods: From an ecocultural perspective, our interview-based study aimed to explore the experiences of Australian (15) and Italian (11) parents of autistic children living in their respective countries. Results: The analysis identified three main themes. Life through autism, autism through life: coexisting with an unexpected life partner, Parenting autistic children: reorganization of parents' subjectivity and familiar dynamics, and The unseen side of disability: autism communities between inclusion and segregation. Discussion: Our comparative approach reveals both commonalities and differences between the two groups of participants. The similarities support features previously identified in the literature: the emotional and physical burden on parents and the positive impact on parental identity. The differences relate to the diagnostic process, interactions with health professionals, the impact of autism on family dynamics and parental perspectives, and the role assigned to siblings. Despite facing similar challenges, these differences reveal how Italian and Australian parents articulate different understandings linked to social and cultural differences.

An ecological momentary assessment of OCD-relevant intrusions: Frequency, feared self, and concealment.

This study provides the first examination of the frequency, characteristics, and dynamics surrounding daily experiences of OCD-relevant intrusions among non-clinical participants (N = 54, Nobs = 2314) using ecological momentary assessment. It also examines the extent to which self-related constructs-participants' feared-self beliefs and their tendency to conceal aspects of self-relate to such intrusive phenomena. Participants completed a baseline questionnaire before reporting state depressed mood and intrusions up to five times per day (at semi-random intervals) for 14 days. Results suggest that questionnaire measures may result in underreporting of the frequency of intrusions, with most participants (80%) reporting at least one intrusion across the momentary observations, and 20% of observations indicating intrusive phenomena experienced since the previous momentary report. Baseline factors including OCD-related beliefs and feared self were related to the proportion of intrusions experienced, whereas self-concealment was not. Within the moment, state feared-self predicted intrusion-related distress, duration, perceived importance, the urge to act, and the need to control thoughts. The urge to conceal within the moment was significant but negatively related to perceived importance and the urge to act. Overall, this study provides evidence for the relevance of momentary measures of intrusions, and adds to evidence for self-beliefs in the dynamics of the disorder.

The interplay between ovarian cancer and social relationships: an analysis of patients' metaphors.

OBJECTIVE: Research showed that ovarian cancer poses unique challenges to patients' care experiences and that patients' social networks could affect their care path significantly. The present study aimed to analyse the metaphors that patients used to signify the impact of the illness on their social relationships and the role of relationships in dealing with cancer. DESIGN: Following a qualitative description approach we conducted 38 semi-structured interviews with Australian (14) and Italian (24) women diagnosed at different stages of ovarian cancer. RESULTS: The analysis identified four themes bringing together the meanings expressed by participants' metaphors: Lack of comprehension and communication; Isolation, marginalisation, and self-isolation; Discrepancy between the private and public self; and Social relationships as empowerment resources. CONCLUSION: The polysemic nature of patients' metaphors captures both the empowering and especially disempowering role of social relationships in dealing with ovarian cancer. Results also show that metaphors are used to make sense of the impact of ovarian cancer on social relationships and to express different strategies for managing patients' networks.

Father trait anger: Associations with father-infant bonding and subsequent parenting stress.

Introduction: Parent anger presents a risk to family safety and child development. Father trait anger may also compromise the early relational context of fathers and offspring, yet evidence is lacking. The aim of this study is to examine effects of father trait anger on parenting stress in the toddler years, and the mediational role of father-infant bonding. Method: Data were from 177 Australian fathers of 205 children. Trait anger (total, angry temperament, and angry reaction), father-infant bonding subscales (patience and tolerance, affection and pride, and pleasure in interaction), and subsequent parenting stress (parental distress, difficult child, and parent-child dysfunctional interaction) were assessed. At each of the subscale levels, mediational path models examined whether father-infant bonding explained the relationship between trait anger and parenting stress. Models were presented where there was at least a small association between the mediator and both the predictor and outcome. Results: Patience and tolerance was the only domain of father-infant bonding correlated with both trait anger and all parenting stress outcomes. Patience and tolerance partially mediated the effect of total trait anger on parental distress and fully mediated effects on difficult child and parent-child dysfunctional interaction. Patience and tolerance fully mediated relationships between angry temperament and all domains of parenting stress. Angry reactions only had a direct effect on parental distress. Discussion: Father trait anger both directly and indirectly (through patience and tolerance in the father-infant bond) impacts their experiences of parenting stress in the toddler years. Early interventions to manage father trait anger and improve father-infant bonding may benefit fathers and children.

Associations between unintended fatherhood and paternal mental health problems: A systematic review and meta-analysis.

BACKGROUND: Unintended pregnancies are linked to adverse parental mental health, yet little attention has been given to this relationship in fathers specifically. We aimed to meta-analyse associations between unintended pregnancies and mental health problems in fathers with children aged ≤36 months. METHODS: We conducted keyword searches of Medline, CINAHL, Academic Search Complete, PsycInfo and Embase to February 2, 2022, and hand searched included reference lists. RESULTS: Of 2826 records identified, 23 studies (N = 8085 fathers), reporting 29 effects, were eligible for meta-analysis. Included studies assessed depression, anxiety, stress, parenting stress, post-traumatic stress disorder (PTSD), alcohol misuse and psychological distress. Pooled estimates, from random effects meta-analyses, for all mental health outcomes (k = 29; OR = 2.28) and depression only (k = 19; OR = 2.36), showed that the odds of reporting mental health difficulties were >2-fold higher in men reporting unintended births compared with those reporting intended births. However, there was no evidence of association with anxiety (k = 2) or stress (k = 2). Overall, mental health problems were greater in low-income countries. No differences were found across parity, timepoint of mental health assessment, or instruments used to measure mental health symptoms. LIMITATIONS: Analyses were limited by the use of retrospective assessment of pregnancy intention, and heterogeneity of measures used. Further, assessment of fathers' mental health was restricted to the first year postpartum. This review was limited to English language studies. CONCLUSIONS: Unintended pregnancies present an identifiable risk for postpartum mental health problems in fathers.

The notion of self in the journey back from addiction.

In this study we explored how those recovering from addiction negotiated self, and the role supported accommodation played in the journey back from addiction. Transcripts from 11 in-depth interviews were analyzed by 2 coders who identified the most salient themes relevant to the self in recovery within the personal contexts of participants. The participants noted that reclaiming the self that had been lost to addiction was of primary importance to them. The recovery journey exposed a self that had reached the lowest point in life; one that was hardly recognizable; one that was undesirable. Engaging with supported accommodation provided participants with a sanctuary within which to reclaim the self, and was seen as central to their recovery.

Through the lens of hetero-normative assumptions: re-thinking attitudes towards gay parenting.

In this study we explored the attitudes and beliefs of nine heterosexual adults towards gay male and female couples parenting children. We conceptualised participants' perceptions as one primary lens through which gay parenting is viewed. Based on the narratives provided, this lens comprised hetero-normative, homophobic or heterosexist assumptions and coloured the way in which participants perceived aspects of the concept of gay couples parenting children. At times, participants attempted to adjust their primary lens and adopt different views that initially suggested ambivalence and sometimes contradictory positions. Despite the range of attitudes and assumptions about same-sex parenting, consensus over the potential negative developmental impact on children raised by same-sex parents remained evident. Evidence suggests that same-sex parenting is already a reality in Westernised nations and has little or no bearing on the sexual orientation of children. However, concern that children be brought up with every opportunity to 'become' heterosexual, whether they are the product of same-sex or opposite-sex parents, remains evident.

Body image and self-esteem among Asian, Pacific Islander, and White college students in Hawaii and Australia.

Body image and its relationship to self-esteem was examined among Asian, Pacific Islander, and White women and men from Hawaii and Australia (n = 172). Although Pacific Islander and White participants had higher body mass indices than Asians, Pacific Islanders were more satisfied than Asians with their health and more satisfied than Asians and Whites with their appearance. Thus, higher body weight and greater body satisfaction may co-occur among Pacific Islanders, whereas lower weight and lower body satisfaction may co-occur among Asians. The findings suggest different levels of risk for body image dissatisfaction, and its associated psychological consequences, across ethnic groups.

The things that make us: self and object attachment in hoarding and compulsive buying-shopping disorder.

Excessive or maladaptive object attachment is the defining feature of Hoarding Disorder (HD) and the acquisition process within Compulsive Buying-Shopping Disorder (CBSD). In recent years, the relationship of object attachment within HD and CBSD to individual's self-concept has become the focus of direct research. On the basis of this literature, it seems that an underdeveloped, ambivalent, or discrepant self-concept could be a vulnerability for dysfunctional object attachment behavior. Further, the importance of objects in buttressing and extending self-concept, both individually and in relationship to others, appears to be a central function underlying pathological object attachment. An important future direction of research is whether directly addressing self-concept can serve as the next advancement for psychological treatments for these debilitating disorders.

Breastfeeding and emerging motherhood identity: An interpretative phenomenological analysis of first time Chinese Australian mothers' breastfeeding experiences.

BACKGROUND: Chinese Australian mothers are more likely than the general Australian mothers to introduce formula in the first month of age. A better understanding of the context of formula introduction in the early weeks of birth can provide a deeper insight into how Chinese Australian mothers can be supported to continue exclusive breastfeeding. METHODS: An interpretative phenomenological analysis approach was used to examine the lived breastfeeding experiences of 11 first time Chinese mothers in Australia. The experiences of those who breastfed exclusively were compared to those who introduced formula in the first month after birth. FINDINGS: An overarching theme across all participants' narratives was the meaning ascribed to breastfeeding in their emerging motherhood identity. Breastfeeding could be a pragmatic and a socially desirable method to nourish an infant but lacking personal identification to the mother. These mothers were more vulnerable to the early introduction of formula, especially when the support environment was lacking. Maternal identity conflict was common and negatively impacted exclusive breastfeeding and mothers' mental health. In contrast, mothers who identified closely with breastfeeding showed greater persistence and enjoyment in breastfeeding and were more likely to continue breastfeeding exclusively. Health professionals were perceived to have an important influence in strengthening maternal breastfeeding motivation and self-efficacy. CONCLUSION: Breastfeeding support to Chinese Australian mothers needs to consider how breastfeeding can be better integrated with their motherhood identity. Health professionals are well-positioned to facilitate this process through a better understanding of mothers' cultural and social contexts around breastfeeding.

Cohort profile: the Men and Parenting Pathways (MAPP) Study: a longitudinal Australian cohort study of men's mental health and well-being at the normative age for first-time fatherhood.

PURPOSE: The Men and Parenting Pathways (MAPP) Study is a prospective investigation of men's mental health and well-being across the normative age for transitioning to fatherhood. This includes trajectories and outcomes for men who do and do not become fathers across five annual waves of the study. PARTICIPANTS: Australian resident, English-speaking men aged 28-32 years at baseline were eligible. Recruitment was over a 2-year period (2015-2017) via social and traditional media and through engagement with study partners. Eight hundred and eighteen eligible men consented to participate. Of these, 664 men completed the first online survey of whom 608 consented to ongoing participation. Of the ongoing sample, 83% have participated in at least two of the first three annual online surveys. FINDINGS TO DATE: Three waves of data collection are complete. The first longitudinal analysis of MAPP data, published in 2020, identified five profiles that characterise men's patterns of depressive symptom severity and presentations of anger. Profiles indicating pronounced anger and depressive symptoms were associated with fathers' lack of perceived social support, and problems with coparenting and bonding with infants. In a second study, MAPP data were combined with three other Australian cohorts in a meta-analysis of associations between fathers' self-reported sleep problems up to 3 years postpartum and symptoms of depression, anxiety and stress. Adjusted meta-analytic associations between paternal sleep and mental health risk ranged from 0.25 to 0.37. FUTURE PLANS: MAPP is an ongoing cohort study. Waves 4 and 5 data will be ready for analyses at the end of 2021. Future investigations will include crossed-lagged and trajectory analyses that assess inter-relatedness and changing social networks, mental health, work and family life. A nested study of COVID-19 pandemic-related mental health and coping will add two further waves of data collection in a subsample of MAPP participants.

Tolerance of larger body sizes by young adults living in Australia and Hawaii.

Identifying the barriers to achieving an appropriate body size is important for health. This study investigated young adults' tolerance of excess weight in other adults. Participants were 172 students (65 male, 107 female) with a mean age of 22.24 years (SD = 1.61). Half the participants resided in Australia, and half in Hawaii. Students from both countries were found to be tolerant of body sizes larger than those recommended for good health. These results help inform our understanding of the factors that may influence weight gain, and have important implications for the worldwide obesity problem and related health issues.

Using photo-elicitation and interpretative phenomenological analysis to explore possessions as links to self-concept and the identities of others in hoarding disorder.

OBJECTIVES: The aim of this study was to explore the importance of possessions as extensions of self-concept and connections to significant others for people that hoard. DESIGN: A total of 10 participants were recruited through hoarding group treatment programmes. Participants photographed significant possessions in their home and discussed these in semi-structured interviews. RESULTS: Analysis of transcripts using interpretative phenomenological analysis revealed three interrelated superordinate themes: (1) time travels with you; (2) possessions are me, they're a reflection of my life; and (3) they're linked: I look at them and I think of people. Challenging early life factors were the source of significant self-uncertainty. Possessions were often touchstones of self-confidence and reminders of both positive and negative relationships. CONCLUSIONS: The results highlight the many dimensions of possessions' links to both self-concept and the identities of others, providing a distinct contribution to the hoarding literature. Implications for future research and treatment are discussed. PRACTITIONER POINTS: Problematic attachments to items may be formed as a compensatory response to challenging early life experiences. Possessions may reflect self-confidence, uniqueness, and be perceived to be physical extensions of who people that hoard are. Belongings can be reminders of interpersonal relationships for people that hoard.