Mental health outcomes of family carers after admission to aged care: A cross-sectional survey study.

OBJECTIVES: This study investigated the predictors of poor mental health outcomes among family carers of residents after transitioning into residential aged care. METHODS: Using a cross-sectional design, five groups of variables were evaluated as predictors: caregiver demographics; caregiving load; resident-related variables; loneliness and visiting frequency; and the impact of the COVID-19 context. A total of 309 primary family contacts of all residents of two residential aged care organisations in the state of Victoria (Australia) participated in the study (response rate 19%). The K-10 and the Burden Scale for Family Caregivers were used to measure the primary outcomes. We compared psychological distress and burden outcomes between carers whose relative was admitted within the last 12 months, or longer than 12 months ago. RESULTS: Time since admission (<12 months or >12 months) did not affect the level of psychological distress (t (238) = -.08, p = .94) or subjective burden (t (245) = -.89, p = .38). Being a woman, a spouse, speaking a language other than English at home, being less satisfied with the support offered by the facility, not feeling supported in the decision to admit their relative, being lonely and providing higher levels of care preadmission were predictors of poor mental health outcomes. CONCLUSIONS: Older women with low-English proficiency who were primary carers and are socially isolated, are more likely to experience poor mental health outcomes and need additional support. These findings may inform the development of screening tools and tailored interventions to support this population during and after the transition process.

Exploring emotional and social competencies in undergraduate students: Perspectives from CALD and non-CALD students.

With the internationalisation of higher education, students from culturally and linguistically diverse (CALD) backgrounds represent a significant proportion of the university student body in Australia. Research literature indicates that the unique cultural and linguistic challenges experienced by these students may adversely impact their academic performance and social integration in university settings. However, less is known about how the socio-emotional competencies of undergraduate CALD and non-CALD domestic English-speaking students compare. This cross-sectional quantitative study compares the emotional and social competencies in a cohort of CALD and non-CALD occupational therapy undergraduates. Data were collected at one Australian university from a group of 360 students enrolled in the Bachelor of Occupational Therapy (Honours) course. Participants completed the Emotional and Social Competency Inventory- University edition (ESCI-U). Multivariate regression analyses were used to compare between CALD and non-CALD students, controlling for students' year level of study, age, and gender. Key findings from the regression analysis included the observation of indicate that non-CALD students having significant higher scores than CALD students on all the ESCI-U socio-emotional subscales, especially the Emotional Self-control, Achievement Orientation, Empathy and Teamwork from western perspectives. No difference was found between CALD and non-CALD student on two cognitive competencies- systems thinking and pattern recognition. These findings should be interpreted with caution considering CALD students may interpret the questions differently and demonstrate the competencies in different ways. Specific emotional and social competencies that need to be strengthened in students are discussed and recommendations are made to inform the preparation of evidence-based curricula.

Factors contributing to the mental health outcomes of carers during the transition of their family member to residential aged care: a systematic search and narrative review.

OBJECTIVES: The transition of an older family member into a residential aged care facility (RACF) is often challenging for both the person being admitted and their family carer. This review aimed to identify the protective and contributing factors to adverse mental health outcomes among family carers following the decision to move a family member to a RACF. METHOD: A search of CINAHL, PubMed and PsycINFO was conducted for empirical papers published in English between 2004 and 2019, exploring the mental health or quality of life (QoL) of family carers of those recently admitted, or considering admission, to a RACF. Articles were reviewed by two authors for inclusion. RESULTS: Twenty-three studies met the inclusion criteria. Pre-existing depressive symptoms and poor subjective health were related to adverse mental health outcomes following admission. Information from the facility, support to change roles, and factors related to carer's health and demographics, were associated with changes in the mental health outcomes of carers during the transition of their relative to a RACF. Key protective factors of carer's mental health outcomes following the transition of their relative to a RACF are flow and transparency of information between carer and the facility staff, and staff efforts to involve carers in providing emotional support to their relative, in monitoring care, and advocating for their quality of life. CONCLUSION: There is evidence to suggest factors such lack of flow and transparency of information between carer and the facility staff may predispose carers to poor mental health and QoL following the transition of a relative to a RACF. Key protective factors of carer's mental health following admission are staff efforts to involve carers in providing emotional support to their relative, in monitoring care, and advocating for their quality of life. This review also indicates that the combination of factors that puts family carers more at risk of poor mental health and lower quality of life throughout the transition period. Policy and practice should follow recommendations that consider a combination of the above factors when addressing the needs of family carers before and after admission of an older person to RACF.

Professionalism, Resilience and Reflective Thinking: How Do These Influence Occupational Therapy Student Fieldwork Outcomes?

The relationship between entry-level, undergraduate occupational therapy students' fieldwork performance and measures of professionalism, reflective thinking and resilience was examined. A group of 135 undergraduates (86% female) completed a self-report questionnaire containing the standardized instruments measuring professionalism, resilience and reflective thinking. The Australian Student Practice Evaluation Form-Revised (SPEF-R) measured fieldwork performance. Linear regression analyses identified Staying Healthy and Relationships with Others as significant predictors of students' fieldwork performance in Professional Behaviors, Self-Management and Information Gathering. The findings highlight the importance of interpersonal skills and engagement in healthy lifestyles in key fieldwork performance areas.

Baccalaureate occupational therapy students' development of social and emotional competencies.

BACKGROUND: Academic life requiring students to meet academic and professional practice expectations can be stressful. Effective emotional and social competence can assist students in managing feelings, stressful situations and fostering relationships with educators, peers, and clients. Hence this is a helpful professional competence for health students to possess. OBJECTIVE: To compare the emotional and social competence among the baccalaureate occupational therapy students across four academic year levels. METHOD: A quantitative cross-sectional design was used. A total of 360 baccalaureate occupational therapy students completed the Emotional and Social Competency Inventory- University Edition. Regression analysis followed by contrast analysis examined the differences among first-, second-, third- and fourth-year levels. RESULTS: Students demonstrated "satisfactory" or above social and emotional competencies. For all students, the average Emotional and Social Competency Inventory subscale scores on teamwork, empathy and achievement orientation were the highest three competencies. The lowest average scores were systems thinking, inspirational leadership and coach and monitor skills. Fourth year students' emotional self-control (p = 0.03), positive outlook (p = 0.02), and influence (p = 0.02) were significantly lower than first-year students. No other significant differences were found between year levels on the other subscales. CONCLUSION: Overall, students demonstrated good social and emotional competencies, with strengths in teamwork, empathy and achievement orientation competencies, which are fundamental in health service practice. However, fourth-year students demonstrated lower scores in emotional self-control, positive outlook, and influence competencies compared to their first-year peers. This indicates that fourth-year students have developed better self-awareness, can be more reflective and have a better perception of reality. It is recommended that targeted learning opportunities to develop students' emotional and social competencies to nurture final-year students' abilities and confidence be incorporated into the curriculum. Academic and practice education staff working with final year occupational therapy students need to consider the associated stress during this time when providing learning opportunities.

Women's experiences of birth trauma: A scoping review.

BACKGROUND: A high number of Australian women report experiencing traumatic birth events. Despite high incidence and potential wide spread and long-lasting effects, birth trauma is poorly recognised and insufficiently treated. Birth trauma can trigger ongoing psychosocial symptoms for women, including anxiety, tokophobia, bonding difficulties, relationship issues and PTSD. Additionally, women's future fertility choices can be inhibited by birth trauma. AIM: To summarize the existing literature to provide insight into women's experiences of birth trauma unrelated to a specific pre-existing obstetric or contextual factor. METHODS: The review follows 5 stages of Arksey and O'Malley's framework. 7 databases were searched using indexed terms and boolen operators. Data searching identified 1354 records, 5 studies met inclusion criteria. FINDINGS: Three key themes emerged; (1) health care providers and the maternity care system. (2) Women's sense of knowing and control. (3) Support. DISCUSSION: Continuity of carer creates the foundations for facilitative interactions between care provider and woman which increases the likelihood of a positive birth experience. Women are able to gain a sense of feeling informed and being in control when empowering and individualized care is offered. Functional social supports and forms of debriefing promotes psychological processing and can enable post traumatic growth. CONCLUSION: Existing literature highlights how birth trauma is strongly influenced by negative health care provider interactions and dysfunctional operation of the maternity care system. A lack of education and support limited informed decision-making, resulting in feelings of losing control and powerlessness which contributes to women's trauma. Insufficient support further compounds women's experiences.

Nothing to lose: a phenomenological study of upper limb nerve transfer surgery for individuals with tetraplegia.

PURPOSE: For individuals with tetraplegia, regaining upper limb function forms the highest priority for improving quality of life. Use of nerve transfers to reconstruct upper limb function is increasing, however little is known about individual's decision to have and experience of the surgery and associated rehabilitation outcomes. This qualitative study aimed to understand the experience of surgery on the lives of individuals with tetraplegia 18 months post-surgery. METHOD: In-depth, semi-structured interviews were conducted with five purposively selected individuals who have undergone upper limb nerve transfers at a metropolitan health service, Melbourne, Australia, specializing in spinal cord injury rehabilitation. Collaizi's phenomenological framework guided data analysis, resulting in an essence statement describing the individuals' experience. RESULTS: An essence statement comprising three themes; Deciding on Surgery, Facing Challenges: Surgery to Recovery and Evaluating Surgical Outcomes, was developed. CONCLUSION: The study suggests that for individuals with tetraplegia, hope to regain lost upper limb function forms a core consideration in the decision to have surgery. For clinicians supporting patient's decision, balancing hope with the realities of surgery is important. Even small changes in upper limb function had an important influence on participant's confidence in social situations through enhanced participation in a range of everyday activities.IMPLICATIONS FOR REHABILITATIONIn making a decision to have surgery, individuals with tetraplegia benefit from two way discussions with the healthcare team and others who have already undergone surgery.Healthcare teams need to help prepare individuals for the challenges of surgery including: expectations of pain, hospital stay, initial loss of independence and the time it may take to see re-innervation of target muscles and subsequent functional changes.Surgery should be routinely considered as individuals' report that even small changes in upper limb function positively increases participation in everyday tasks and confidence in social situations.When evaluating changes in upper limb function, patient-centered measures should be used.

Professionalism as a Predictor of Fieldwork Performance in Undergraduate Occupational Therapy Students: An Exploratory Study.

This study investigated the relationship between professionalism factors and undergraduate occupational therapy students' fieldwork performance as measured by the Student Practice Education Form-Revised Edition (SPEF-R). 135 undergraduate occupational therapy students (86% 20-24 years old; 87% female) completed the Penn State College of Medicine Professionalism Questionnaire (PSCOPQ). Student fieldwork performance was measured using the Student Practice Evaluation Form-Revised Edition (SPEF-R). Multi-linear regression with bootstrapping was completed on the midway and final SPEF-R scores. Regression analysis demonstrated a range of professionalism variables to be significant predictors of fieldwork performance at the midway assessment of their fieldwork placement: Equity was a significant predictor of Self-management Skills; Enrichment and Altruism were significant predictors of Coworker Communication; and Altruism was a strong predictor of Communication Skills. No PSCOPQ variable was found to be a significant predictor of final SPEF-R performance. The findings reflect the dynamic and complex nature of professionalism in occupational therapy fieldwork settings.

Exploring the relationship between resilience and practice education placement success in occupational therapy students.

INTRODUCTION: Practice education is a fundamental component of health professional students' education and many personal, social and professional factors impact on students' performance. This study investigated the relationship between measures of resilience and practice education performance in occupational therapy students. METHODS: A quantitative cross-sectional study was used to collect the data. In all, 149 occupational therapy students completed a self-report questionnaire comprised of demographic questions and two standardised scales: Resilience at University (RAU) and Resilience Scale for Adults (RSA). Students' practice education performance was measured by the Student Practice Evaluation Form-Revised (SPEF-R). Multi-linear regression analyses with bootstrapping were completed to identify resilience factors that were predictive of occupational therapy students' practice performance. RESULTS: Overall, occupational therapy students reported high levels of resilience based on the RAU and RSA subscale scores. "Managing Stress," "Find Your Calling" and "Living Authentically" were strong predictors of a range of key fieldwork performance SPEF-R factors, including "Professional Behaviours," "Self-management Skills," "Co-worker Communication" and "Communication Skills." CONCLUSION: The resilience factors identified as being significant predictors of practice education performance outcomes in occupational therapy students represent notable findings. They suggest that students' capabilities in managing their stress levels, finding meaning in their chosen profession, and engaging self-care daily activities outside of the work environment that are meaningful, authentic and fit with one's personal values and beliefs can act as buffers against the challenges experienced by students who are completing practice education placements. The findings will assist academic and practice educators in identifying and targeting vulnerable students and strengthening resilience strategies through proactive pre-practice placement initiatives. Qualitative studies are recommended to further explore the relationship between resilience and practice education performance in occupational therapy students.

The impact of carer status on participation in healthy activity and self-reported health among Australian women over 50 years.

BACKGROUND/AIM: Occupational therapists frequently work with carers and their family member who requires direct services. In Australia, women provide the majority of informal care. Carer status is determined by the provision of informal help or supervision to an older person, or a person with a disability or long-term health condition. Caregiving responsibilities can impact mental and physical health and reduce women's participation in leisure activities and the labour force. The aim of the study was to examine differences in the participation of Australian women, aged 50 years and over, with and without caregiving responsibilities, in self-selected health promoting activities, self-reported mental health and participation in physical activity. METHODS: This cross-sectional study investigated Australian women (N = 157) who completed a survey comprising demographic questions, the Depression Anxiety Stress Scales-21 (DASS-21), International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Health Promoting Activities Scale (HPAS). Differences between carers and non-carers in participation in health promoting activities, mental health, physical activity and labour force participation were investigated using Mann-Whitney U and Kruskal-Wallis tests. RESULTS: Carers reported significantly lower participation in health promoting activities (P < 0.001), vigorous physical activity (P = 0.001) and moderate physical activity (P = 0.009). Carers also reported significantly higher responses than non-carers, in symptoms of depression, anxiety and stress (P < 0.001). Carers were significantly more likely than non-carers to be engaged in part-time employment, with 37% of carers employed part-time and 44% of carers not working. CONCLUSION: These findings indicate significant differences between women with and without caregiving responsibilities and their participation in health promoting activities, self-reported mental health, participation in physical activity and the labour force. Carers may benefit from occupational therapy that recognises the important role of carers in the life of their family member and supports carer's health and participation in health promoting activities.

Intrarater Reliability and Other Psychometrics of the Health Promoting Activities Scale (HPAS).

OBJECTIVE: The Health Promoting Activities Scale (HPAS) measures the self-rated frequency with which adults participate in activities that promote health. We evaluated the internal consistency, construct validity, and intrarater reliability of the HPAS with a cohort of mothers (N = 56) of school-age children. METHOD: We used an online survey that included the HPAS and measures of mental and physical health. Statistical analysis included intraclass correlation coefficients (ICCs), measurement error, error range, limits of agreement, and minimum detectable change (MDC). RESULTS: The HPAS showed good internal consistency (Cronbach's α = .73). Construct validity was supported by a significant difference in HPAS scores among participants grouped by physical activity level; no other differences were significant. Results included a high aggregate ICC of .90 and an MDC of 5 points. CONCLUSION: Our evaluation of the HPAS revealed good reliability and stability, suggesting suitability for ongoing evaluation as an outcome measure.

Retirement: What will you do? A narrative inquiry of occupation-based planning for retirement: Implications for practice.

AIM: To examine, using a retrospective narrative study, the factors influencing four older people's decision to plan for the activities they would undertake once retired, the planning process undertaken and their subsequent experience of retirement. METHOD: Semi-structured interviews were conducted to examine the factors influencing older people's decision to commence pre-retirement planning, the planning process undertaken and their experience of retirement. In keeping with narrative inquiry, paradigmatic-type narrative analysis led to the development of categories and subsequent themes to reveal the participants' experiences of these issues. RESULTS: Three themes: environmental influences, the planning process and retirement experiences: the outcome of planning, were derived from the participants' narratives. Overall, retirement activities that were continued or initiated led to a positive experience even when these planned activities were temporarily interrupted or altered. Planning for future years in retirement and older age also continued. CONCLUSION: Occupational therapists have a unique understanding of the centrality of occupation to health and wellbeing. Thus occupational therapists are well-positioned to assist people identify, plan and engage in meaningful occupations outside work in retirement.