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Psycho-social Update Volume 3, Issue 1 April 2008

PSU - A Quarterly Newsletter of IPP-SHR, Central Queensland University, Australia.

Palliative Care in Rural and Remote Areas: Equipment, power and travel Issues.

In This Issue Standardised questionnaire use in acute healthcare

3

Technology usage in ICU: Norway

4

Reproductive intentions for HIV Positive women: South Africa

4

Heart failure prognosis communication

6

Palliative Care integration in Brazil

7

IPP-SHR Podcast Launch

9

Regulars Editorial

2

Global Update

4

International Perspectives

6

From the Coalface

8

What’s On

7

Journal and Book Profile

10

Work-in-Progress

12

R-e-Search

12

Off The Press @ IPP-SHR

As part of a two-year National Health and Medical Research Council funded research project focusing on the delivery of palliative care services to Indigenous Australians living in the Northern Territory, IPP-SHR researchers have found that significant practical obstacles obstruct these people’s access to appropriate end-of-life care.

generators and solar sources. When power was available, it was reported as being highly unreliable. Transport problems were also identified by participants as another major obstacle inhibiting the delivery of palliative care. Whilst some organisations are able to provide transport, in most cases it was reported that patients and families had to provide their own transport. For Significant practical obstacles - including many families, the costs associated with problems with equipment, power, travel transports were problematic. and vast distances - were identified by participants as needing to be continually Underlying all of the above obstacles to overcome when working with Aboriginal palliative care was the primary problem people in the homelands of the Northern of vast distances reported by participants. Territory. Participants highlighted the With specialised medical and palliative care major obstacles imposed by the need for services being centralised in metropolitan specialised equipment, such as oxygen areas and populations in the homelands beconcentrators, both in terms of equipment ing very geographically dispersed, patients availability and its suitability to the envi- were reported as having to travel extremely ronment in which end-of-life care is deliv- long distances to access services. ered in patients’ homelands. Additionally the considerable time delays associated The findings of this research are a testawith sourcing new equipment in rural and ment to the commitment and ingenuity of remote areas and having repairs carried out those working at the front line of was found to greatly hinder health professionals’ abilities to provide palliative care. Continued Page 2... Exacerbating equipment issues, participants also highlighted their experience of problems associated with accessing power to drive equipment. It was noted that there International Program of Psycho-Social Health Research is no electricity available in most places in C E N T R A L Q U E E N S L A N D U N I V E R S I T Y, A U S T R A L I A the homeland, necessitating a reliance on-

IPP-SIIR

Practical Problems: Wheelchairs do not work well on sandy surfaces

Detailed Insights into Psycho-Social Health Research

ISSN: 18335659 Circulation: 4270+ www.ipp-shr.cqu.edu.au


Editorial Firstly, I would like to thank our many colleagues who took time to join the IPP-SHR team for our pod-cast launch at the Powerhouse. We are delighted in the interest in our pod-casting initiative and sincerely hope that it will be a user-friendly, convenient service to assist the important work of all those involved in the health industry. We believe it is of the utmost importance that all our services are easily accessible to all those who want them. For this reason we have invested considerable energy in ensuring that our website is user-friendly, publications easy to order, articles simple to request, newsletter accessible by hard copy and electronically, pod-casts not only available on the web-site but also automatically by e-mail through subscription, and feed-back and inquiries responded to immediately. As we constantly strive to improve our service we are always very pleased to hear from you - your ideas and suggestions will be gratefully received. Let us know if you are having any problems with accessing our services. In this newsletter we continue to report on the diversity of psycho-social research from around the world. From Sweden we hear of the meaning of technology in an intensive care unit; from South Africa, of insights on the reproductive intentions among HIV-positive women and men; from Canada, of the preferences of patients with heart failure for prognosis communication; and, from USA, of mental health recipients’ experiences of the therapeutic relationship. As with all other articles featured in the Global Update in this newsletter, there will be a follow-up pod-cast based on an interview with the authors on their work. As always, it is a pleasure to be able to report on the excellent work of those at the coalface of psycho-social care. From Brazil we hear of the integration of palliative care, and from Australia of the important work of the Queensland Centre for Domestic and Family Violence Research and Solaris Care at Sir Charles Gairdner Hospital in Perth. In conclusion, as this is the first newsletter for the year I would like to take the opportunity to wish our readers the very best for the rest of 2008! Many thanks for your ongoing interest and contributions! Happy reading! Dr Pam McGrath NHMRC Senior Research Fellow IPP-SHR Director

IPP-SHR

WE WOULD LIKE TO HEAR FROM YOU! ‘Psycho-Social Update’ (PSU) is a newsletter from the International Program of Psycho-Social Health Research (IPP-SHR), Central Queensland University, circulated quarterly to an international audience of over 4500 service providers, policy makers and academics with an interest in the human experience of serious physical and mental illness. If you have news to share or wish to contribute an article please contact us - we will help pass the message on! www.ipp-shr.cqu.edu. au/contact

Palliative Care in Rural and Remote Areas ... From Page 1 palliative care service provision to Indigenous people in rural and remote areas. The information about the many obstacles faced by patients, carers and health professionals provide important insights to inform the development of health policy planning and funding. Publication Details: McGrath P., Holewa H., McGrath Z., (2007) “Practical problems for Aboriginal Palliative Care service provision in rural and remote areas: Equipment, power and travel issues”, Collegian, 14; 3: 21-26.

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Making Them More Vulnerable: The Irony of Using Questionnaires Off the Press @ IPP-SHR Empathy and caring are repeatedly noted as the core needs of dying patients and their families. Consequently, the ability of hospice and palliative care nurses to understand and respond sensitively to the emotions expressed by their patients and families is central to holistic and compassionate palliative care service delivery.

and the question of whether these instruments help or hinder holistic, compassionate hospice practice. In response to this, IPP-SHR researchers have explored the impact of the use of standardised questionnaires with clients from a holistic, community-based hospice service, Cittamani, located in the Sunshine Coast Hinterland, Queensland.

Maintaining this focus in the face Hospice staff interviewed provided a of the increasing demands of bu- strong indication that the use of quesreaucratisation represents a tionnaires undermined their ability to engage in holistic and compassionate

share their feelings. These findings have important implications when viewed in the context of the emotionally challenging time associated with the end-of-life experience for both patients and carers. The essential irony in the findings is that questionnaires, which prior to the study were seen by hospice staff as effective instruments for assessing vulnerability, actually work to make the vulnerable more vulnerable. Furthermore, participants indicated that equivalent information could be obtained from clients through means sensitive to clients’ emotionally vulnerable state, such as utilisation of intuitive skills and talking.

Overall, these findings provide a sober reminder of the importance of health care professionals constantly reflecting on the taken for granted notions that underpin their practice. In relation to nursing professionals, Questionnaire Usage - Not always an unqualified good these findings affirm the importance hospice care, by inhibiting the devel- of nurses being confident to honour key challenge being faced by pro- opment of trusting and supportive the instinct for compassion that unfessionals working in this area. In relationships. Participants reported derpins their caring profession. particular, the increasing utilisation that the experience of using Quesof standardised assessment tools, tionnaires was invasive, confronting, such as questionnaires, is an impor- and at times overwhelming for the Findings from this study specifically tant contributor to this mounting hospice client for whom they were focusing upon hospice clients’ expepressure. caring. Questionnaire use was also riences of standardised questionnaire reported to compromise workers’ use are published in separate articles, Up until now there has existed a ability to sensitively engage with and downloadable from ‘loud silence’ in the research litera- question clients and was reported to ture relating to the impact of using inhibit clients’ abilities to honestly www.ipp-shr.cqu.edu.au. questionnaires with hospice clients

OA OA

OPEN ACCESS

Publication Details: McGrath P., Phillips E (2007) “Making them more vulnerable: The Irony of Using Questionnaires”, Nursing Forum, 42; 2: 65-72.

What is Open Access? IPP-SHR is committed to providing ease of access to all publications. If you see this symbol in the PSU it signifies that you can view the full text version online.

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The meaning of technology in an intensive care unit - an interview study Location: Trollhättan, Sweden Existing research suggests that technology can both dehumanise patient care and restrict nurses’ freedom of action. These findings raise questions about the relationship between technology, care and medicine in units where patients’ need for treatment exists within an emergency context. In response, a study by Swedish researchers has aimed to explore how staff members in an intensive care unit (ICU) make sense of technology in their everyday practice. Following interviews with staff members from one ICU about their understanding of technology in their everyday practice, three main findings emerged. Staff members appeared to consider technology to be vitally important in directing and controlling medical treatment and ensuring patients’ well being. Linked with this, technology was seen as facilitating everyday practice by making treatment more secure and decreasing workloads. Conversely, technology was perceived by staff members to be not completely trustworthy and not easy to handle: factors that were reported to complicate everyday practice and form the basis of ethical dilemmas. Overall, the findings of this study demonstrate that, contrary to previous findings, technology seems to be embedded in care and medical treatment. Furthermore, the meaning of technology shifts depending on differing staff members’ perceptions. Publication Details: Wikström, A., Cederborg, A. & Johanson, M. (2007) “The meaning of technology in an intensive care unit - an interview study”, Intensive & Critical Care Nursing. 23; 4: 187-195.

GLOBAL ‘Life is still going on’: Reproductive intentions among HIV-positive women and men in South Africa Location: Cape Town, South Africa A qualitative study conducted in Cape Town, South Africa, has found that the experience of being HIV positive modifies, rather than removes individuals’ reproductive desires. These findings emerged from in-depth interviews conducted with 61 HIV positive men and women, half of whom at time of interview were receiving antiretroviral treatment (ART). Within the interviews, participants discussed their reproductive intentions with the researchers and talked about the factors that influenced these. The research indicates that a diversity of reproductive intentions exist within the HIV positive population, with some individuals wishing to avoid pregnancy and others holding a strong desire to experience parenthood. Fears of partner and infant infection and having a previously infected baby were important factors deterring some individuals from considering having children. There was also strongly perceived community disapproval associated with HIV and reproduction. Contrasting with this, some participants expressed a powerful desire to become parents, mediated by prevailing social and cultural norms that encouraged childbearing in society more broadly. Motherhood was reported as constituting an important component of married women’s identity and important for women’s social status. Family, husbands’ and societal expectations for childbearing were also important influences on women’s reproductive intentions, for some counterbalancing HIV as a factor discouraging reproduction. The findings highlight the need for explicit policies recognising reproductive rights and choice. They support the need for health counselling and service interventions that advance safer and healthier reproductive options for HIV positive individuals in this region of the world which is experiencing a generalised and advanced HIV/AIDS pandemic. Publication Details: Cooper, D., Harries, J., Myer, L., Orner, P. & Bracken, H. (2007) “‘Life is still going on’: reproductive intentions among HIV-positive women and men in South Africa”, Social Science & Medicine. 65; 2: 274-283.

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Preferences of patients with heart failure for prognosis communication Location: ontario, Canada

Communication about prognosis is fundamental to discussions and planning for end-of-life (EOL) care for patients with advanced heart failure (HF). In spite of this, little is known about the preferences of patients that could guide communication about prognosis. In response to this gap in knowledge, Canadian researchers have undertaken a qualitative study to identify the preferences of patients with advanced HF regarding communication about their prognosis and its implications. Using grounded theory methodology, the researchers recruited twenty patients from the Heart Function Clinic at the McMaster University Medical Centre in Hamilton, Ontario to participate in one-to-one interviews. Four main themes emerged from that data relating to patient communication preferences. Firstly, patients indicated a desire to learn about their level of wellness, their prognosis and the implications of this whilst they retained optimal cognitive function; rather than further along the dying trajectory when their capacity for EOL decision making might be diminished. Secondly, patients preferred physicians to initiate discussions about prognosis at the time of diagnosis. Thirdly, patients expressed a strong preference for physicians to disclose the prognostic possibilities, treatments and outcomes associated with HF, including the possibilities of deterioration and death. Finally, patients identified a need for truth to be balanced with hope. Aspects of hope identified as important by patients included hope for quality of life, symptom control and control over EOL decisions. These findings suggest that communication about prognosis between patients and physicians can be difficult and in practice is sometimes deferred. It is anticipated that the preferences shared by patients in this study will offer guidance to physicians in planning and initiating dialogue about prognosis. Publication Details: Caldwell, P., Arthur, H. & Demers, C. (2007) “Preferences of patients with heart failure for prognosis communication”, The Canadian Journal of Cardiology. 23; 10: 791-796.

UPDATE

A Look At ‘Take my hand, help me out’: mental Psychohealth service recipients’ experience of the therapeutic relationship Social Health Research Location: North Carolina, USA In order to discover what is ‘therapeutic about therapeutic relationships’ Around The in the context of mental health service provision, researchers from the United States of America have set out to explore mental health service users’ experiences of Globe therapeutic relationships. This study consisted of a secondary analysis of qualitative interviews conducted with persons with mental illness as part of a study of the experience of being understood. This secondary analysis used data from 20 interviews with community-dwelling adults with mental illness, who were asked to talk about the experience of being understood by a health care provider. The findings indicate that individuals experienced therapeutic relationships against a backdrop of challenges, including mental illness, domestic violence, substance abuse, and homelessness. They had therapeutic relationships with nurses (psychiatric/ mental health nurses and dialysis nurses), physicians (psychiatrists and general practitioners), psychologists, social workers, and counsellors. Experiences of the therapeutic relationship were expressed in three figural themes, titled using participants’ own words: ‘relate to me’, ‘know me as a person’, and ‘get to the solution’. The ways in which these participants described therapeutic relationships challenge some long-held beliefs, such the use of touch, self-disclosure, and blunt feedback. The findings indicate that, for people working with those experiencing mental illness, the establishment of a therapeutic relationship requires in-depth personal knowledge, which is acquired only through time, understanding, and skill. This study highlights the centrality of knowing the whole person, rather than knowing the person only as a service recipient, for those wishing to establish and enhance the therapeutic potential of relationships. Publication Details: Shattell, M., Starr, S. & Thomas, S. (2007) ‘Take my hand, help me out’: mental health service recipients’ experience of the therapeutic relationship”, International Journal Of Mental Health Nursing. 16; 4: 274-84.

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Brazil

International How Psycho-Social Research is used around the world

Palliative Care Integration in Brazil: Perspectives From the CoalFace Dr Fabio Ikedo is a physician (rheumatologist) and the Chief of Palliative Care and Pain Department at the Universidade Sao Francisco medical School in Braganca Paulista, Brazil. His research interests include end-of-life issues, spirituality and health. Dr Ikedo shared his unique insights into Brazil’s palliative care situation with PSU: Brazil has around 185 million people and is the fifth most populous country in the world. Whilst Brazil has the 9th largest economy in the world by purchasing power, we have 19.31% of the population living below the poverty line. It is a land of contrasts. Considering just breast cancer, the incidence in 2006 was 48 930 new cases. Of those diagnosed, a large number of patients eventually need palliative care. Although the interest for palliative care has been growing in Brazil, there are few palliative care services in our country (probably less than 60). As of November 2002, not a single medical school in Brazil could be found that included palliative care as part of the curriculum. Responding to this dearth of palliative care education, the university where I teach, Universidade Sao Francisco, has included palliative care in the medical school curriculum since February 2006. Mentoring and teaching the new generation of medical students will be the key to improve the quality of end-of-life issues in our country.

From Favela to Skyscrapers: Palliative care provision represents a significant challenge for Brazil .

Image: Etic Schockmel Creative Commons Attribution Sharealkike 2.5 License

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Perspectives International Perspective aims to give an insight into all aspects of psycho-social issues around the globe. Whether it is recent advances in innovative programs addressing psycho-social issues, musings about psycho- social practices, or an update on the relevance of psycho-social issues within your town, country or region, we are keen to hear from you. If you have anything you wish to share, give us a buzz, drop a line or flick us an email.

Haem atology and Palliative An International Concern

C are

This research-based publication addresses well documented concerns that palliative care is still not appropriately integrated into haematology. It presents a trilogy of models, Functional, Evolving and Refractory, which outline factors influencing the integration of palliative care and haematology. This booklet shares the wisdom of those who have successfully identified problems and found solutions in this challenging area of health care and aims to inform health professionals wishing to work towards giving haematology patients and their families the benefits of compassionate, best practice palliative care. The global relevance of this booklet has been demonstrated in its first year of publication by the distribution of over 7000 copies to healthcare providers, consumer groups, teaching institutions and policy makers around the globe. This publication has also been used as a teaching tool by educators working in the UK, Germany, France, China, India and Japan and the insights contained in this booklet have been presented to international conference audiences in the USA and New Zealand. Free copies of this publication can be downloaded electronically or ordered in hard copy format online from IPP-SHR’s website, http://www.ipp-shr.cqu.edu.au/bookshop/?hpc.

What ’s

On

The Eighth International Review of Bipolar Disorders (IRBD). The Bella Centre, Copenhagen, Denmark, 14-16 April 2008, http://www.irbd.org 13th National Conference: Management of Drug Users in Primary Care - Meeting the Needs of Diverse Populations: Hard to Reach or Easy to Ignore? The Brighton Centre, Brighton, UK, 24 -25 April 2008, http://www. smmgp.org.uk 10th Paediatric & Child Health Nursing Conference. Darwin Entertainment Centre, Darwin, Australia, 30 April - 2 May 2008. http://www.ipchnconference.com.au 2008 GP & PH Research Conference, Health For All? Hobart, Tasmania, 4-6 June 2008,

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http://www.phcris.orgau/conference/2008 2nd Qualitative Research on Mental Health Conference. Tampere, Finland, 9 - 11 June 2008, http://www.uta.fi/ laitokset/sospol/qrmh2/ 10th World Congress of Psycho-Oncology. Madrid, Spain, 9 -13 June 2008, http://www.ipos-society.org 15th International Conference on Cancer Nursing. Vancouver, Canada, 17 - 21 August 2008, http://www. isncc.org/meeting/announcement/ 14th Annual Qualitative Health Research Conference, Edmonton, Alberta, Canada, 3 - 6 October 2008, http:// www.uofaweb.ualberta.ca/iiqm/Conferences.cfm

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Queensland Centre for Domestic and Family Violence Research (CDFVR) Leading Australia in accredited training for domestic and family violence

The Queensland Centre for Domestic and Family Violence Research (CDFVR) has recently achieved a major milestone in the development of responses to domestic and family violence in Queensland, in the form of an accredited Course in Responding to Domestic and Family Violence (Course Code: 30629QLD). This is the only accredited Course of its kind in Australia and will provide a benchmark for prospective employers recruiting appropriately skilled staff in community-based domestic violence support services, and government agencies that may be a first point of contact for women subjected to domestic and family violence. Jointly funded by the Queensland Office for Women and the Department of Communities, the Course was developed through extensive consultation and collaboration with government and non-government stakeholders, in response to a long-held need for quality and consistent training to support inter-agency collaboration and co-ordination when responding to domestic and family violence. The Course also aims to focus on working effectively with Aboriginal, Torres Strait Islander, and culturally and linguistically diverse families and communities; and addressing gaps in service delivery for rural and remote communities. The Course is comprised of three units of competency, namely Recognise and Respond to Domestic and Family Violence (CHCDFV1B); Referring Appropriately and Effectively in Response to Domestic and Family Violence (DFVR1A); and Reflecting on Work Practice when Responding to Domestic and Family Violence (DFVR2A). Successful completion of the Course (through a Registered Training Organisation) will result in a nationally recognised qualification, a Statement of Attainment, issued under the Australian Qualifications Framework. Training materials have also been produced to support the delivery of these units and these are available for trainers to purchase from the Department of Employment and Training’s Centre for Training Materials. Further details about the Course, including answers to frequently asked questions and links to the Centre for Training Materials can be found in the “Accredited Training” section of the homepage menu on CDFVR’s website at:

www.noviolence.com.au

F r o m T h e C o a l - F a c e Programs and Practitioners SolarisCare

Integrated Care for Cancer Since 2001, the SolarisCare Foundation has been making a difference in the lives of people affected by cancer. SolarisCare aims to improve the quality of life of cancer patients and carers by giving them the support they require to cope with the emotional and physical side effects of cancer diagnosis, treatment and recovery. SolarisCare runs a purpose built drop-in centre located within a major hospital designed to provide a safe place for patients and carers to reflect and have time-out. Visitors are welcome anytime and are met by Meet and Greet volunteers who talk about what the Centre has to offer and listen to any concerns arising from their cancer diagnosis and treatment. The Centre provides access to: • Touch based complementary therapies in a safe, supervised setting. • A place to ‘switch off’ and relax while visiting the hospital. • Information from a variety of resources including internet, books, brochures, handouts, DVD and video. • Information about local and national support groups. • Information about our research trials. • A ‘listening ear’ provided by the trained volunteers. The Centre is accessible free of charge to all people with cancer, their family and carers in Western Australia. For more information on SolarisCare visit their website, http://www.solariscare.com.au, email info@solariscare. com.au or telephone (08) 9346 7630.

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Podcast Launch IPP-SHR has celebrated the initiation of its podcasting program with an official launch held at Brisbane Powerhouse. A capacity crowd of over fifty practitioners, academics and invited guests joined with IPP-SHR staff for this occasion to celebrate IPP-SHR’s podcasting program and to learn more about this exciting initiative. IPP-SHR Director, Dr Pam McGrath opened the launch and was followed by speeches by IPP-SHR Program Manager, Mr Hamish Holewa and invited speaker, Associate Professor David Henderson, Medical Director of Redland Hospital. Funded by the National Health and Medical Research Council (NHMRC) and Central Queensland University, IPP-SHR is breaking new ground with its development of a podcasting program. IPP-SHR Podcasts explore the latest happenings in the world of psycho-social health research through interviews with eminent researchers and practitioners around the globe. These podcasts enable interested listeners to keep abreast of happenings in their field of research and connect in an entertaining way with findings of importance to them. IPP-SHR podcasts are dedicated to translating the latest in psycho-social health research findings into entertaining and informative format.

www.ipp-shr.cqu.edu.au/podcasts Clockwise From Right: Dr Graheme Vaughan & Mr Michael Bouwman ----Audience----- Mr Hamish Holewa, Mr Michael Bouwman, Dr Pam McGrath & Ms Stasia Kail-Buckley----- A/Prof David Henderson

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Journal and Book Profile Austral-Asian Journal of Cancer - OPEN ACCESS Austral-Asian Journal of Cancer (ISSN-0972-2556) is the first international cancer journal published within Asia and Australia. This journal is a multidisciplinary oncology journal covering all aspects of cancer treatment and research including scientific, clinical and psycho-social. Free online access to the community of researchers and full text articles are available at: www.ajcancer.org

The International Journal of Nursing Practice The International Journal of Nursing Practice aims to promote and develop nursing both in its professional and academic context on an international level. All articles are peer reviewed and are grounded in scientific, theoretical and philosophical research. www.blackwellpublishing.com

Living with Leukaemia, Lymphoma and Myeloma: A Guide to Patients and Families. Living with Leukaemia, Lymphoma and Myeloma is a book designed to guide and provide a source of information for anyone diagnosed with a blood cancer. It provides an easy read that explores, with rich information and insights, the experience from the perspective of the patient and their family.

www.ipp-shr.cqu.edu.au

Book Review Goggin and Newell are to be congratulated for this scholarly, insightful, well argued, and challenging book. The authors provide profound insights on social justice in Australia through the detailed and compassionate telling of the lived experience of disability. The discussion is rich and detailed, embracing a diversity of disability issues related to health, welfare, sport, biotechnology, deinstitutionalization, political life and the treatment of refugees. The book is suitable for a wide audience as it combines a well referenced academic discussion with clear, practical case studies. Disability in Australia: Exposing a Social Apartheid, by Gerard Goggin & Christopher Newell, 2005, UNSW Press.

Do You Have A Book To Review?

If you have a book or journal that you would like to display in this profile please send a copy to PSU REVIEWS, PO BOX 796 TOOWONG Q 4066 AUSTRALIA


IPP-SHR Podcasts Detailed insights into psycho-social health research

Listen, read and participate. IPP-SHR provides full online access to podcasts, transcripts and related links. Users can listen to the podcast and read any additional accompanying information, including articles, powerpoints, author or institution information. IPP-SHR has made it easy to listen to the podcast and users without subscription systems can automatically receive podcasts delivered to your email. Podcasting is easy - just read below.

Your hosts, Stasia Kail- Buckley & Michael Bouwman

L atest Podcasts A Qualitative Study on Health Providers’ Illness Narratives

Dr Robert Kempainen talks about his qualitative study of health providers’ illness narratives, including the findings of this research; the unique issues this study raises for the health professionals and consumers; and how these findings can be used for educational purposes. Click Here to Listen

Publication details: Kempainen R., Bartels D. & Veach P. (2007) Life on the receiving end: A qualitative analysis of health providers illness narratives. Academic Medicine. 82; 2: 207 -213.

Patients’ Expectations of Blood Testing in General Practice

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Dr Marloes van Bokhoven’s work explores why patients want to have their blood tested. Marloes discusses her motivation for conducting research into patients’ expectations of blood testing; her findings that patients often hold high expectations of blood testing; and the fundamental tension between maintaining the magic of testing and handling the misunderstood disadvantages associated with screening. Publication details: Bokhoven, M., Pleunis-van Empel, M., Kock, H., Grol, R., Dinant, G., & Weijden, T.(2006) Why do patients want to have their blood tested? A qualitative study of patient expectations in general practice. BMC Family Practice. 7: 75-83.

Mental Health Nurses’ Experiences of Schizophrenia in China and India

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Professor Louise Higgins’ research explores mental health nurses’ experiences of schizophrenia care in China and India. Louise discusses the issues relating to care within these cultures and the similarities and differences between the western model of care and the Chinese and Indian approaches. The interview concludes with a discussion of the potential for these findings to be incorporated into western mental health systems to improve outcomes for individuals with schizophrenia. Publication details: Higgins, H., Dey-Ghatak, P., & Davey,G. (2007) Mental health nurses’ experiences of schizophrenia rehabilitation in China and India: A preliminary study. International Journal of Mental Health Nursing. 16: 22- 27.

What is Podcasting?

or another subscription program. You can use these programs when you see the icon to the right.

Podcasts are digital audio files that you can listen to on your computer or portable music device (IPod, Mobile phone, I-River). Podcasting gives you the flexibility to listen to your favourite programs at a time, method and place which is convenient to you.

3. Email Updates - Subscribe to the email update. When a new podcast is released an email will be automatically sent to your nominated address with a link to the podcast.

IPP-SHR provides four methods of listening to our podcast. 1. Audio-on-Demand - Listen online or download from the IPP-SHR website. Just click on the Podcast Icon, www.ipp-shr.cqu.edu.au/podcasts 2. Subscribe to the podcast using programs such as I-tunes, Juice

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4. Listen Through the PSU - Click on the podcast icon of the electronic version of the PSU and it will automatically play on your computer! These icons relate to an RSS (Real Simple Syndication) feed. It is used as a convenient method of subscribing to content that is regularly changing. Once subscribed, you do not need to visit the website to view updated content as the RSS reader will automatically download it to your computer. When you see this icon you can use it to subscribe to a podcast.

w w w. i p p - s h r . c q u . e d u . a u / p od c a s t s

IPP-SHR podcasts explore the latest in the world of psycho-social health research. With thorough commentary, convenience of access and global coverage, catch up on the latest in psycho-social health news.


De c i si on M a k i n g i n R en a l T r a n s p l a n t D on or s W or k

i n

P ro gr ess

The decision to donate a kidney is potentially life altering, involving major nontherapeutic surgery and the loss of a significant body part. Whilst the benefits linked to the recipient of a kidney donation have been well documented in research literature, the risks experienced by live kidney donors are less well understood. The research that does exist indicates that both physical and emotional costs are associated with kidney donation. Thus, to ensure positive outcomes for donors, it is essential that the decision to donate is appropriately explored and assessed and that adequate information is available about both the immediate and long term outcomes for donors. Although outcomes for the live kidney recipients are better understood, there is little work exploring the outcomes for donors.

In light of this, IPP-SHR researchers have set out to explore the factors that contribute to ethically and emotionally sound decision-making by donors that can be predictive of positive donor outcomes posttransplant. This three year longitudinal study will be conducted via in-depth interviews with kidney donors focussing on their predonation decision making and their post transplantation experiences It is anticipated that this research will produce important insights into the psycho-social impacts that live kidney donation has upon donors and assist health care professionals in their development of more effective screening processes. For more information please visit www.ipp-shr.cqu.edu.au and follow the Project Section

R-e-Search

Highlighting innovative use of information technology products for Psycho-Social Health Research

Hamish Holewa IPP-SHR Program Manager

A warm welcome to r-E-search for 2008. This year celebrates the 40th anniversary of the “X Y position indicator for a display system” designed in 1968 by Douglas Engelbart. More commonly known as the mouse, this computer interface device is still a primary device for computer interaction. Although, change in interface devices over the last 40 years has been minimal, 2008 holds much promise with an exciting paradigm shift occurring in the way humans interact with computers. For this issue of r-E-search we will look into three devices (two of which are not computers) which are providing leadership in new methods of human –computer interaction.

The Nintendo Wii – This device is primarily a games console and is more likely to found in the lounge room as an entertainment device than in an office. Whilst Nintendo’s competitors, namely Sony and Microsoft, have gone after this lucrative market with the age old mantra of better graphics, faster processing and more power, Nintendo opted for a different angle and revolutionised the way that people interact with the games, primarily through the console’s remote. The remote features accelerators and infrared detectors which allows software to interpret motion in full 3D space and to responds to speed and acceleration forces. In the gaming world, this enables a player to realistically control and maintain the subtleties of on-screen items such as a tennis racquet, baseball bat or a sword. Although, the incorporation of additional sensors monitoring velocity and 3D space, has not be incorporated into desktop computing, the features provide an interesting glimpse of future devices and a shift in thinking on how to visualise and manipulate objects on the desktop. The Tablet PC – This is a laptop computer, with the ability to swivel the screen around and set it back onto the computer, thus making an electronic tablet. Although it can be used as a normal laptop, when in tablet mode users interact directly with the screen through an electronic pen, called a ‘stylus.’ The stylus doubles as a mouse but also enables users to write, mark and draw on the screen with accuracy and dexterity that far surpasses the mouse. For example, users can easily write cursive text on the screen, an action which is almost impossible using a mouse. In practical terms, users can write on their PowerPoint screens during presentation, mark a students PDF assignment as in hard copy or jot down notes in a meeting. Furthermore, apart from accuracy of tracking, the use of a stylus pen also adds further input options such as pressure and tapping. Such interfaces could be used to easily facilitate options such as document zoom. The Apple I-Touch – Younger cousin of the famous I-Pod and brother to the I-Phone, you may be wondering why a music player is included in a list of human interactions devices. Apple has a well deserved reputation for ease of use and innovation in human computer interfaces. Just as the I-pod revolutionised complex and often cumbersome tasks such as scrolling through play lists with the advent of the scroll wheel, the I-touch continues along this innovative path by replacing the scroll wheel with a touch screen as the central interface with the device. Whilst not revolutionary in itself, the way the user controls features and complex tasks is. One feature that highlights such interface is the use of pinch, swipe and expand. Photos can be expanded or contracted by moving two fingers together or apart whilst touching the screen. The above devices show an expansion of interface options to be used while interacting with the computer and provide a likely environment for a shift in thinking on how computer interaction is achieved. Although, the mouse and keyboard combination provide a robust and proven method and will remain so for many more years, expect 2008 to be the beginning of an exciting I-pod Touch, Wii, Tablet PC: Three examples of future human computer interaction methods. paradigm shift in how we interact with our computers.

IPP-SIIR

International Program of Psycho-Social Health Research CENTRAL QUEENSLAND UNIVERSITY

Images: Aidan C Siegel; Jecowa Creative Commons 3.0

Contact Details: IPP-SHR, Central Qld University, Brisbane Office, PO BOX 796 TOOWONG Q 4066 AUSTRALIA + 61 7 3374 1792 or +61 7 3025 3377 ipp-shr@cqu.edu.au

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