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Objective: The aim of this study was to evaluate the prevalence of psychiatric morbidity, alcohol use, burnout and compassion satisfaction among physician trainees in New South Wales, Australia, and examine links between personal, demographic and lifestyle factors. Methods: A total of 67 physician trainees were recruited to the study. Fifty-nine completed the online survey (88% response rate). Outcome measures included the Depression Anxiety Stress Scale, Professional Quality of Life Scale and Alcohol Use Disorders Identification Test. Results: Approximately half the respondents met screening criteria for depression (53%), stress (51%) and anxiety (46%). Secondary traumatic stress was exceptionally high across the cohort, with higher scores in females (P = 0.001). The main reasons for not seeking help for depression or anxiety were lack of time (81%), fear of lack of confidentiality or privacy (41%), embarrassment (39%) and effect on registration (27%). Eighty-eight per cent of respondents agreed that doctors feel they need to portray a healthy image, but only 54% engaged in regular exercise and 24% slept ≤6 h each day. Conclusion: The results demonstrate high levels of non-psychotic psychiatric morbidity among physician trainees and a need to improve their well-being. Workplace systems need to promote healthy work environments and support physician trainees through good mentorship and supervision. What is known about the topic?: Doctors' health and patient care can be affected when doctors experience burnout and psychiatric morbidity. What does this paper add?: This paper adds to the evidence of psychiatric morbidity, burnout, secondary trauma and increased demographic data on a cohort of junior doctors undertaking speciality training. In addition, it provides reasons for not seeking help and positive and negative coping methods used by these junior doctors. What are the implications for practitioners?: The level of distress is high and requires system changes to support both individual health measures and structural change to work and study programs. [ABSTRACT FROM AUTHOR]

With advances in medical technology, more people are surviving major trauma experiences. Those with a traumatic brain injury are one such group who may survive for several decades with significant health consequences including physical, cognitive, and psychosocial sequelae. Traumatic brain injury sufferers are typically young males with a premorbid history of risk taking. Consequently, the differential needs of female traumatic brain injury survivors are less likely to be acknowledged in the literature or by allied health workers. A large quantitative and qualitative study of people with traumatic brain injury was conducted in rural areas of New South Wales, Australia in 2004–2005. The qualitative component of the study included in-depth interviews with 11 women and 21 men. This paper focuses on the interviews with the 11 women who live in two rural areas of New South Wales. These data illustrate the psychosocial consequences of traumatic brain injury for women. They reveal that women are particularly vulnerable to isolation, disempowerment, and in extreme cases, abuse, and are less likely to have a carer. The need for gender to be a factor in ongoing social work and allied health treatment and support of traumatic brain injury sufferers and their carers is evident from this research. [ABSTRACT FROM PUBLISHER]

This study examines experiences of living with chronic illness for haemodialysis patients. In order to understand these experiences the paper takes an existential-phenomenological approach. Interviews of seven participants (five males, two females) were collected in a haemodialysis clinic. Based upon the participants experiences three core themes emerged: (1) the challenges of living with chronic renal failure; (2) body changes and embodiment; (3) their illness experience and social relationships. The findings suggest that the illness experience of chronic renal failure is an on-going struggle to attain a sense of control. We suggest that where a sense of control is limited this can create a sense of powerlessness. Further, the illness experience was not solely restricted to the individual, but also affected wider social relationships. It is only through taking into account the context of patients experience of illness that clinicians/nurses can meaningfully draw on all aspects of evidence to reach integrated clinical judgement. [ABSTRACT FROM AUTHOR]

Aim To describe women's experiences of sexuality and body image following treatment for early-stage vulvar cancer. Background There is limited information available on sexual function following treatment for early-stage vulvar cancer. A review of the literature has shown a lack of qualitative investigation into this topic. This study was undertaken to address this deficiency and to add to the existing body of knowledge describing the psychosexual outcomes for these women. Design Qualitative interview study. Methods A qualitative approach based on interpretive phenomenology was used to interview a purposive sample of 10 women (mean age 58 years) who had previously been treated for an early-stage vulvar cancer. Interviews were conducted from June-October 2009. Data were generated from verbatim transcription of the semi-structured in-depth interviews. Thematic analysis of these data revealed themes that were common to the women's experiences of sexuality and body image. Findings Four themes were identified that described the structure of the experience. Only two of these themes, sexuality and body image, will be discussed in this paper. Conclusions Findings from this study indicated that the majority of women experienced little to no long-term disruption to sexuality and body image following conservative treatment for early-stage vulvar cancer. Intimacy and relationship status were more closely linked to women's sexual satisfaction than physical arousal. Factors contributing to women experiencing negative emotions were radical vulvar excision, multiple vulvar procedures and/or the development of lymphoedema. [ABSTRACT FROM AUTHOR]

Objective: Little research has investigated variables affecting the relationship between weight‐ or shape‐related bullying (WSB) and specific forms of disordered eating in adolescence. This study aimed to examine the relationship between WSB and eating disorder behaviors in Australian adolescents, and whether this relationship was moderated by body image attitudes. Method: Data were used from the first wave of the EveryBODY study, a survey of body image concerns and eating disorders in a large representative sample of Australian adolescents (N = 573), aged 11–19 years. Participants completed an online survey with measures of WSB frequency, body image attitudes (drives for thinness, leanness, and muscularity), and disordered eating behaviors. Results: Results indicated that frequency of WSB was positively associated with purging and muscularity‐oriented behavior (MOB), but not dietary restriction, binge eating, or compulsive exercise. The relationship between WSB and MOB was moderated by drive for muscularity, such that victimization frequency was positively associated with MOB for those with high, but not low, desire to attain a muscular physique. Discussion: Findings indicate that WSB is positively associated with purging and MOB but not other eating disorder behaviors, and that drive for muscularity moderates its effect on some behaviors. Understanding these relationships will be important in implementing tailored interventions for adolescents based on screening for victimization experiences and specific body image attitudes. [ABSTRACT FROM AUTHOR]

Purpose:The purpose of this study was to explore the impact of stroke on female sexuality from the perspective of women who have had a stroke. Method:A descriptive qualitative study. Nine female stroke survivors living in metropolitan and surrounding districts of Sydney, Australia took part in semi-structured conversational interviews. The mean length of time from stroke onset to interview was around 6 years and 2 months (range 1 year, 2 months to 15 years, 9 months). The interviews were digitally recorded and transcribed. The transcripts were systematically analysed using inductive thematic analysis. Results:The women experienced many and varied bodily alterations as a consequence of stroke which impacted negatively on their sexuality. These bodily alterations impacted on female sexuality in two ways: one was as an assault on the female sense of self and the other was by limiting possibilities for enacting female sexuality. Conclusion:Stroke impacts on female sexuality through bodily alterations and their consequences and because sexuality is important to female stroke survivors, it should be addressed as part of person-centred rehabilitation.Implications for RehabilitationSexuality is about much more than just “having sex” and is important to female stroke survivors.Stroke impacts on female sexuality through bodily alterations and their consequences.Understanding the impact of stroke on female sexuality is a step towards more person-centred rehabilitation. [ABSTRACT FROM PUBLISHER]

Studies of women's experiences of being overweight and pregnant are limited in the literature. Given the increasing rates of obesity in pregnant women, and the impact of being overweight on the health of the mother and the child, this qualitative descriptive study aimed to explore the perceptions and experiences of overweight pregnant women attending two maternity units in Sydney, Australia. Fourteen women aged between 25 and 42 years with a body mass index greater than 30 kg/m2 participated in a face-to-face interview in their third trimester of pregnancy or in the early post-natal period. All interviews were recorded and transcribed. Field notes were also recorded following each interview. Data were analysed using thematic analysis. Four themes were identified in the data: 'being overweight and pregnant', 'being on a continuum of change', 'get alongside us' and finally 'wanting the same treatment as everyone else'. Most women recognised their weight as an issue both for their own health and well-being and for its impact on the baby. Women believed health professionals should address the issue of obesity with them but do so in a supportive and positive way that recognised their individual needs and expectations. Health professionals need to consider new approaches or models of care for overweight women that give them support and enable individual needs and expectations to be met. Culturally specific programs may also need to be developed. [ABSTRACT FROM AUTHOR]

Aims and objective. To describe the effects sacrococcygeal pilonidal sinus wounds had on participants' activities of living. Background. A sacrococcygeal pilonidal sinus commonly occurs in healthy young people and is associated with considerable morbidity and discomfort. Surgery is frequently required, and patients are often discharged home with large open wounds. Most research has addressed the technical aspects of surgery and treatment. Design. An interpretive descriptive approach guided by The Model of Living framework. Methods. Purposive sampling was used to recruit four women and seven men, age range 17-39 years, from a metropolitan hospital in NSW, Australia. Data were collected through semi-structured interviews that were audio-taped, transcribed verbatim and analysed using thematic analysis. Results. Three themes and eight subthemes emerged from the analysis: (1) 'Adaption' included subthemes, learning to live with the wound, difficulty living with the wound and living life despite the wound; (2) 'Perception' embraced subthemes, embarrassment, lack of understanding and changed body image; and (3) 'Control' included subthemes, loss of control and gaining control. Participants whose pain was not managed, who were unprepared for the postoperative recovery at home or experienced delayed wound healing had most difficulty with activities of living. Conclusions. This research gives some insight into the pilonidal wound experience from the person's perspective. All activities of living were affected by the pilonidal sinus wound. The effect was variable and influenced by pain, embarrassment and a general lack of understanding about the condition and the care of the wound. The specific wound location was an underlying factor causing problems for participants. Relevance to clinical practice. Individualised care will help in reducing discomfort and improving life experiences following surgery. Patients who are prepared for the postoperative recovery at home, have adequate analgesia and do not experience delayed wound healing are more likely to manage activities of living. [ABSTRACT FROM AUTHOR]

The regulation of pain and other emotions is a developmental process that takes place in the context of attachment relationships. Children with chronic, medically unexplained pain struggle to accurately identify, communicate and regulate negative body states, and to connect these body states to their day-to-day experience. This article describes an individual intervention – one component of a multimodal treatment programme – whose aim is to help children find skills to manage their pain. The intervention incorporates ideas and practices from several theoretical models – the dynamic-maturational model of attachment, cognitive-behavioural theories, narrative therapy, art therapy, sensorimotor approaches –pragmatically selected and adapted to help children presenting to our Chronic Pain Service achieve good clinical outcomes. At the outset we assess the child’s capacity to identify, regulate and communicate positive and negative body states, and tailor our individual intervention so as to extend each child’s proximal level of development. We initially focus on the body in an effort to equip the child with a non-verbal, image-based language for identifying and communicating pain and other negative body states. Once the child has developed a non-verbal way of knowing her body, a range of cognitive-behavioural, narrative and other strategies are introduced. The intervention aims to increase the child’s emotional functioning: her skill in identifying, symbolically representing, communicating and managing pain and other negative body states. [ABSTRACT FROM PUBLISHER]

This qualitative study into Australian manhood featured 63 men discussing 'acceptable' masculinity. Homophobic humour emerged as central to the formation of Australian male identity, but it had the potential to induce violence and emotional damage when the 'humour' moved along a malleable continuum from good-natured banter to abuse. Significantly, it was men of all sexualities who were targeted, indicating that it was non-conformity to gender norms as well as sexuality being policed, as boys and men used humour to control and humiliate each other. Recollections of these instances ranged from 'it was just a joke' for some perpetrators, to 'orchestrated cruelty' for men who had been victimised. Some of the latter group reported depression extending into their adult lives based on their youthful experiences. Understanding the impact when humour goes 'beyond a joke' is important for policy makers, educators and healthcare workers, as a potential for emotional damage and physical violence is highlighted. The study highlights the importance of understanding masculinity as an influence on men's health and wellness. [ABSTRACT FROM AUTHOR]

Aim: To determine the attitudes of rural men to matters of health and body image. Methods: Focus group discussions were used to examine the attitudes of a sample of Australian rural men to matters of health and body image in the context of their eating and exercise behaviours. Forty-two rural men, aged 25–64 years, took part in four focus groups, one exclusively for farmers, in south-western New South Wales (NSW). Results: Results from these focus groups reveal that many of the masculine myths surrounding male behaviour in relation to health and ideas on body image persist among rural men in south-western NSW. Talking about health is not considered a male past-time; visiting health professionals is still seen as a last resort; being a ‘big bloke’ is perceived to be advantageous and heavy drinking is still considered an Australian male domain, especially among the younger men in the groups. Conclusion: The present study provides a deeper understanding of rural men's attitudes to body image issues and lifestyle behaviours, which is critical to helping change health outcomes for this hard-to-reach group. [ABSTRACT FROM AUTHOR]

This study aimed to determine the characteristics of anabolic-androgenic steroid (AAS) users to determine their motivations for use, and to examine the patterns and correlates of AAS use, with particular attention to homo/bi-sexual men. A personal interview was conducted with 100 current AAS users in New South Wales, Australia using a structured questionnaire divided into ten separate sections: demographics; patterns of AAS use; reasons for AAS use; opinions and attitudes concerning AAS; training activity; sources of steroids; AAS information sources; effects of AAS; lifestyle issues including legal and illegal drug use; and deterrents to AAS use. This predominantly male sample (94%) included 27% homo/bi-sexual men. Homo/bi-sexual users reported a different pattern of AAS use from the heterosexual users. They started using at a later age and used smaller quantities less frequently. Homo/bi-sexual users were also more likely to identify as body image users and indicate that their motivation to use AAS on their first and most recent occasion was to improve appearance, although there were no significant differences between homo/bi-sexuals and heterosexuals in relationship to perceptions of body shape. The homo/bi-sexual men in this sample were also far more likely to have used a wide range of illicit drugs. [ABSTRACT FROM AUTHOR]

Current trends suggest that adolescent obesity is an on-going and recurrent decimal that is still on the rise in Australia and the social burden associated with it can significantly cause low self-esteem and lack of confidence in personal body image in adulthood. Nonetheless, evidence-based prevention programs are not widely implemented in schools, even though they are commonplace for easy access to adolescents. The primary objective of this systematic review was to assess the scope and efficacy of adolescent obesity intervention strategies in Australian schools, to guide future research. Seven electronic databases were searched for peer-reviewed school-based intervention articles written in the English language and targeting 12–18-year-old adolescents. Intervention characteristics were extracted, and quality, efficacy and outcome measures were assessed utilizing thirteen studies that met the inclusion criteria for this review. Most of the Australian adolescent obesity research emanated from the State of New South Wales and none were nationwide. Five studies successfully met all the requirements in all measured outcomes, four met at least one measured outcome and the remaining four were unsuccessful. Despite the weak evidence of intervention efficacy for most of the reviewed studies, school-based interventions with multi-component combinations of physical activity, nutrition and alignment to a theory yielded promising results. Our findings point to the need for future research to assess the perceptions of school stakeholders in relation to the barriers and enablers to establishing school-based prevention and intervention programs for adolescents. [ABSTRACT FROM AUTHOR]