Search

There is no literature to guide mental health nursing in bushfire‐affected communities. Using autoethnographic methods, the author reflects on his experience of mental health nursing during the Australian bushfires of 2019–20 and the challenges of identifying existing practice guidance. Applying an existing nursing model and insights from gestalt, he analyses his field notes to identify and describe practices which he found important and useful for working with bushfire‐affected persons and communities. Eight suggestions are provided to assist mental health nurses to practise in an informed way and promote recovery. This paper makes a contribution to a small body of existing mental health nursing research using autoethnographic methods, and it is the first contribution to the mental health nursing literature about working with bushfire‐affected persons and communities. [ABSTRACT FROM AUTHOR]

The large number of international medical graduates (IMGs) working in Australia, and many other countries around the world, has received significant attention from the media, governments and academia. These institutions utilise a number of classificatory schemes in order to categorise IMGs. Such classification is often stigmatising, yet goes largely unquestioned. In this paper I show that the 'official naming' of IMGs in Australia, as well as the naming of IMGs by staff in hospitals, is historically, politically and socially produced. Following Bourdieu's call to also study how the classified classify, the paper goes on to examine ways in which IMGs name and categorise each other, drawing on ethnographic research. I argue that IMGs use classification themselves, strategically, in order to modify their marginalised position within the 'social space' of the hospital. The article questions taken-for-granted assumptions about classified groups such as IMGs and leaves an opening for change. [ABSTRACT FROM AUTHOR]

In the past decades, public health has increasingly addressed what has been called the children's obesity 'epidemic', most notably through large-scale initiatives promoting physical activity. Through a discourse analysis the current paper critically examines such efforts in Canadian and Australian public health. Public health websites in Canada and Australia were examined for information concerning children's health, physical activity and obesity and explored for how these issues were represented in the discourse. Bacchi's (2009) 'What's the problem represented to be?' approach to discourse analysis guided our interrogation of the taken-for-granted assumptions underlying Canadian and Australian public health discourse, the ideological and political influences involved in its construction, and the knowledge base upon which it rests. The article calls for critical reflection on how children's physical and leisure activities are being advanced. [ABSTRACT FROM AUTHOR]

Despite heightened concerns about levels of obesity and overweight in Western societies, there is a relative absence of sociological research into the subjective experience of dieting, especially for men. This paper focuses on findings related to the male participants from a qualitative study of fourteen volunteers (six female and eight male) drawn from a larger clinical trial comparing two diet conditions. Semi-structured interviews were conducted in two stages to gain an in-depth understanding of the experience of dieting, and found that these men understood and practiced their dieting in different ways from the women, but also from each other, depending on their notions of masculinity. Some were eager to reframe their dieting in 'more manly' terms. The social support or sabotage received from friends and family is significant to these experiences of dieting. This paper discusses how men understand and practice dieting within the framework of gendered discourses and gendered relations that can make healthy eating hard to sustain. [ABSTRACT FROM AUTHOR]

Foster care systems across Australia are widely recognised as being 'in crisis'. Problems of both supply (a lack of appropriate placements for children) and demand (increasing numbers of child protection notifications) are central to this crisis. Addressing these problems requires an approach to social work practice that encourages greater support for existing foster carers, and that in so doing, helps to attract new carers to the system. One of the ways in which this may be achieved is through an emphasis on foster care as a form of family based care that holds the potential to meet the needs not only of children, but of adults seeking to engage in familial relationships with children. Drawing upon a psychoanalytically-informed approach to social work, this paper presents and analyses data from a national research project examining existing Australian foster carers' experiences of care provision. The results demonstrate that despite considerable adversity (which often takes the shape of foster families not being recognised as such), foster carers continue to form unique, supportive families with children. Implications are drawn from this for a social work practice that acknowledges diversity in family forms and which validates the identifications and desires that circulate within foster families. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapists routinely report low levels of confidence in addressing needs related to sexuality and intimacy. These issues are compounded when supporting clients with intellectual disability, due to prevailing assumptions about capacity and few practical support resources. At a disciplinary level, there is ongoing discourse around how to best conceptualise and support sexual and gender identities generally, within models of human occupation. Leveraging interdisciplinarity, where sexuality overlaps as a sphere of interest, can aid the development of practical support resources. Engagement with sociology (focussed on relationality) and disability studies (focussed on embodiment) offers a generative path forward. Methods: The deliberative dialogues framework was used to develop a co‐designed resource by occupational therapists for occupational therapists. Six Australian occupational therapists with experience working with clients with intellectual disability and/or sexuality were purposively recruited to participate in co‐design groups. Using the eight features of deliberative dialogue, data was collected and analysed by an interdisciplinary research team to collaboratively produce a practical support resource. Results: Participants agreed the greatest need was to develop a resource for clinicians, to support conversations with clients about sexuality. Five key themes emerged: (1) Theoretical explanations addressing why sexuality is important must be paired with practical advice; (2) make a conversational call to action from 'OTs' for 'OTs' by locating sexuality within the domain of occupational therapy; (3) make explicit that people with intellectual disability are sexual beings; (4) need for self‐reflection; and (5) demonstrate how existing understandings of occupation apply to sexuality. Conclusion: A resource in the form of a brochure was developed, intended to be used as a conversation primer. The process used to develop the resource demonstrated the value of interdisciplinary collaboration and the utility of deliberative dialogue as a co‐design method. [ABSTRACT FROM AUTHOR]

Introduction: Following 2016 legislation permitting limited access to cannabis for research and medicinal purposes, the number of randomized clinical trials (RCTs) investigating the effectiveness of medicinal cannabis (MC) on symptom burden relief in cancer contexts has increased in Australia. This study aimed to understand the perceptions, hopes and concerns of people with advanced cancer regarding the future availability and regulation of MC in Australia. Methods: This qualitative study draws on semistructured interviews conducted between February 2019 and October 2020 in Brisbane, Australia, as part of an MC RCT substudy. Interviews were undertaken on 48 patients with advanced cancer in palliative care eligible to participate in an MC trial (n = 26 participated in an RCT; n = 2 participated in a pilot study; n = 20 declined). Interviews included a discussion of patients' decision‐making regarding trial participation, concerns about MC and perceptions of future availability, including cost. Transcribed interviews were analysed inductively and abductively, informed by constructivist thematic analysis conventions. Results: Overall, participants supported making MC legally accessible as a prescription‐only medication. Fear of financial toxicity, however, compromised this pathway. Steep posttrial costs of accessing MC prompted several people to decline trial participation, and others to predict—if found effective—that many would either access MC through alternative pathways or reduce their prescribed dosage to enable affordable access. Conclusions: These findings suggest that—despite a relatively robust universal healthcare system—Australians are potentially vulnerable to and fearful of financial toxicity. Prevalent in the United States, financial toxicity occurs when disadvantaged cancer patients access necessary but expensive medications with lasting consequences: bankruptcy, ongoing anxiety and cancer worry. Interview transcripts indicate that financial fears—and the systems sustaining them—may pose a threat to RCT completion and to equitable access to legal MC. Such findings support calls for embedding qualitative substudies and community partnerships within RCTs, while also suggesting the importance of subsidisation to overcoming injustices. Patient or Public Contribution: A patient advisory committee informed RCT design. This qualitative substudy foregrounds patients' decision‐making, perceptions and experiences. [ABSTRACT FROM AUTHOR]

Sociological health research on the concept of trust has been bedevilled by its multivocalities. This article extends Luhmann's attempts to clarify a sociology of trust. Luhmann argued a semantic distinction between trust and confidence. In this article, we use empirical data on patient ‘trust’ in doctors to argue that there is also a semantic distinction between trust and dependence. We conducted 37 semi-structured interviews with patients with coronary heart disease in Adelaide, Australia in 2008 and 2009. Our findings indicate that risk, familiarity and time were critical to understand the distinction between trust and dependence. We argue that patients in situations of emergency (heightened risk) ‘depended’ on, rather than trusted, doctors, given the patients lack of familiarity with their doctors. Time was a mediating factor, as the more ‘urgent’ the situation, the more likely it was that dependence came into play, since the situation was ‘unfamiliar’. Rather than juxtaposing trust and dependence, in this article we show how dependence may coexist with trust in the health care system in times of emergency. [ABSTRACT FROM PUBLISHER]

: Strong evidence exists for the role of physical activity in preventing and managing a range of chronic health conditions. A particular challenge in promoting physical activity as a health strategy exists in culturally and linguistically diverse (CALD) groups, as such groups demonstrate high risk for a range of non-communicable diseases. The aim of this research was to examine the perspective of multicultural health service providers for CALD groups with respect to the physical activity services/initiatives on offer, access barriers to these services, and ideas for future service delivery in this area. Semi-structured interviews were conducted with 15 multicultural health service providers across the capital cities of the three most populous states in Australia (New South Wales, Queensland, and Victoria), and thematic content analysis was used to examine the data. Findings indicated that the majority of physical activity initiatives were associated with organizations offering other social services for CALD communities but were greatly restrained by resources. As well, it was found that most services were not designed by taking into account specific cultural requirements for CALD communities or their cultural expectations. Common barriers identified to service uptake were classified as socio-cultural (e.g., gender, language, context of health) and environmental (e.g., transportation) in nature. These findings should be utilized when planning future physical activity and health promotion initiatives for increasing CALD participation. In particular, programs need to be culturally tailored to the specific expectations of CALD groups, addressing cultural safety and sensitivity, and should be in partnership with other organizations to extend the reach and capacity. [ABSTRACT FROM AUTHOR]

Australia leads the world in the mass adoption of Human Papillomavirus (HPV) vaccines, a new frontier in mass vaccination programmes. This article reports on participatory workshops with the first generation of young Australian women to participate in the HPV mass vaccination programme. In particular, it addresses the themes of trust and confidence. A substantial literature highlights the growing realm of active trust at the expense of habitual confidence in 'risk society'. Another line of inquiry highlights the preference of governments for policies designed to enhance confidence rather than trust. This study finds that participants were guided by confidence in their adoption of the HPV vaccine, at the expense of trust. Participants readily transferred their confidence in the existing vaccination regime to the HPV mass vaccination programme, notwithstanding its novel features. Yet participants expressed growing misgivings about their informed consent and the 'marketing' of the vaccine in the course of workshops, reflecting failure to achieve their active trust. [ABSTRACT FROM AUTHOR]

Limited qualitative studies have been conducted with former members of charismatic groups, especially in Australia. The majority of studies with former members have been conducted by psychologists through quantitative methodologies and clinical case studies. Qualitative studies that explore the phenomenon of charismatic group involvement have predominantly been carried out by sociologists, and these focus on current members of such groups. Sociologists and psychologists have drawn seemingly contradictory conclusions from their study. This study aims to narrow the gap by investigating adjustment to life after involvement with a charismatic group as experienced by former members of such groups through the use of qualitative methods. Seven participants from four different groups were recruited via purposive sampling and modified snowball sampling. A qualitative methodology informed by phenomenology was chosen. In-depth interviews were used to explore the participants’ accounts of adjusting to life after involvement. The findings of this study suggest that the experiences of former members of charismatic groups may be comparable to others who have experienced extreme transitions and adjustments or relationships where significant power differentials exist. [ABSTRACT FROM AUTHOR]