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During the last decade there has been a conceptual shift towards viewing people with serious mental illness as consumers rather than patients and towards appreciat-ing the need to understand their views as essential to the recovery process. Represent-ing this shift, psycho-social issues associated with care and recovery are now of core sig-nificance. Responding to a need for research to inform this new paradigm, findings from research aimed at exploring factors which contribute to recovery in mental illness from the consumers’ perspective are highlighted in this article.

Consumers indicated that the process of recovery can be initiated by either a person-al crisis or a significant positive life change such as finding a life partner or having chil-dren. Taking responsibility for the process of recovery by ‘owning’ the illness is seen as essential for recovery. However, further pub-lished findings from the study indicate that this can be difficult within a mental health system that does not adequately support this healing direction.

The findings from this study indicate that self awareness, insights and self-honesty are essential attributes towards initiating and sustaining the recovery process. Important-ly, the findings indicate that recovery is seen to be an active process that requires focus and attention. Obtaining useful informa-

tion on mental illness and in particular, on how other individuals deal with recovery is noted as an important factor contributing to recovery.

The support of significant others is es-sential to recovery and the importance of connection and belonging are well known. However, the findings also indicate that a sense of safety and acceptance is essential. Therefore, it is important for individuals seeking recovery to be selective about the people included in their support circle, and cautious about sharing information on their diagnosis and personal story.

The findings point to a number of suc-cessful strategies that can be used in the re-covery process such as: focusing on aspects of the experience that can be controlled, viewing obstacles with an openness, goal setting, not dwelling on negative thoughts, engaging in self-affirming and diversional activities, maintaining a positive outlook towards the future, seeking a meaningful perspective and reflecting on progress achieved. All processes are made easier by the use of humour. The positives gained from recovery are seen to further re-enforce the continuing process of recovery.

Publication Details: McGrath, P (2009) “’I have to get really honest with me’: Find-ings on recovery from mental illness”, International Journal of Psychosocial Reha-bilitation 14(1):65-75

Psycho-SocialReview

A Quarterly Review, International Program of Psycho-Social Health Research, CQUniversity Australia

Learning from each other: Cross-Cultural Insights on Palliative Care in Indian and Australasian Regions 3

Keeping Families Connected following their Child’s Cancer Diagnosis 4

Finishing Cancer Treatment: The Positives and Negatives for Adolescents and their Families 4

Workshops in Healing: Restoring the Perspective 5

Reflections from a Haematology Social Worker 5

Remote Areas Call for Psycho-Social Support 6

Research on Survivorship Issues for Oncology Patients 7

Stroke Among Young Australians 7

Aboriginal and Torres Strait Islander Cancer Research Project 9

Editorial 2

International Perspectives 5

Global Update 9

Journal and Book Profile 10

Work-in-progress 12

R-e-search 12

‘I have to get really honest with me’: Findings on Recovery from Mental Illness

In this Issue

Regulars

Detailed Insights into Psycho-Social Health Research

See page 11

The PSR is an international review that covers issues pertaining to psycho-social aspects of health care. The PSR provides a forum and opportunity for service providers, researchers and policy makers to connect between issues on the ground and theory relevant to practice. The PSR aims to connect those interested in psycho-social health care issues.

About the Psycho-Social Review

Off the Press at IPP-SHR

Access articles online at www.ipp-shr.cqu.edu.au

July 2010 Volume 5, Issue 2

Dear Reader,

A major objective driving both our program and the quarterly review is to explore and profile innovative ways of doing research. Our motto is that we are as concerned with process as we are with product! Consequently, it is greatly satisfying to announce in this issue that IPP-SHR Podcasts are diversifying to include a complementary discussion with each podcast interviewee, titled: ‘Research Notes’. The podcasts will continue in the previous format of exploring a wide range of psycho-social research findings through discussions with leaders in the field.

The high standard of discussion with authors of recently published research articles, that explores the findings with insights for practice will continue as usual. In addition, there will be an accompanying podcast that explores the research process for the particular project being discussed. Thus, for the first time IPP-SHR will make available to our listeners useful insights on the practicalities of research. It is our sincere hope that such discussions will help those not directly involved in research to understand the many challenges researchers face, as well as assisting fellow researchers to share their problem-solving on dif ficult methodology and process issues. Click on, listen and enjoy!

While on the theme of innovation in research strategies, it is equally satisfying to report that IPP-SHRs Practitioner Researcher Program (IPR) mentioned in the last editorial, is going from strength to strength. At present, the IPR scheme is expanding to involve a range of talented practitioners doing research on topics as diverse as head and neck cancer, caring for homeless people presenting in Emergency Departments and survivorship issues. It is a privilege to work with such a talented and committed group of practitioners and to watch each of their projects develop. To repeat our motto: we are learning as much from the process as we are from the product.

As always we bring you news from researchers and practitioners working in the psycho-social enterprise around the world. It is exciting and humbling to see the impressive contributions individuals and organisations in this area are making in such a variety of ways.

Happy reading!

The findings presented in this article are the outcome of a cross-cultural research project initiated by IPP-SHR and the Regional Cancer Care Centre, Kerala, India designed to explore similarities and dif ferences between palliative care serv-ice provision in Kerala, India and South- East Queensland (SEQ), Australia, in order to inform a process of mutual learning for future service development.

Areas in which dif ferences were noted were found through discussions about death and in-patient palliative care ward experiences. When talking about death in Kerala, as in SEQ, the pal-liative care professionals are providing leadership by ensuring that patients and their families are provided with honest information and afforded the opportuni-ty and support to talk openly about the challenges of dying. In Kerala, there is a cultural imperative that patients are not

told that they are dying and carers will actively block any attempts by health professionals to provide prognostic information to patients. In Trivandrum, patients may be referred to the palliative care ward without being told that their condition is terminal.

The situation in SEQ is only dif fer-ent by degree. There is a strong ethical imperative that patients and their carers are provided with honest information about prognosis—it is a prerequisite of admission to palliative care services that patients are informed of their terminal condition. However, there is often a discord between open communication regarding death and dying, with many oncology patients still dying within the curative system.

There are some resource dif ferences between SEQ and Kerala. A social worker is not specific to the palliative care ward but rather, has the responsibility of a

hospital-wide caseload, of which pallia-tive care work dominates. In SEQ, the pal-liative care team is multidisciplinary and can include a social worker or counsellor.

From the perspective of both pro-grams, the most important learning came from the major similarities in the pallia-tive care programs of such geographi-cally diverse locations. Reaching across the cultural divide was not a lesson in dealing with dif ferences but rather, an affirmation of our similarities.

Publication details: McGrath, P, Holewa, H, Koilparampil, T, Koshy, C & George, S (2009) “Learning from each other: cross-cultural insights on palliative care in Indian and Australian regions”, International Journal of Palliative Nursing 15(10):499-509

Book Launch – Eight Seasons by Sandra EvansIPP-SHR has recently celebrated the release of Sandra Evan’s book, ‘Eight Seasons – Our family’s journey with childhood leukaemia’, with a launch at the

Leukaemia Foundation of Queensland, Clem Jones Village. Eight Seasons is a firsthand account of a mother’s experience

after the diagnosis and treatment of childhood leukaemia. Special pricing is available for Psycho-Social Review subscribers – http://www.ipp-shr.cqu.edu.au/bookshop/

Find Us On Facebook and Twitter

See us on Facebook or Twitter! IPP-SHR hopes to provide an informal method communicating with you and to provide greater interaction with IPP-SHR. Pose questions, comment or receive IPP-SHR updates through social media.

IPP-SHR Helps Research Childhood Cancer in Bangladesh IPP-SHR has recently teamed with an international panel organised by the British Columbia Cancer Control Agency, Canada to tackle the problem of un-met need in Bangladesh.

New Podcast Series: ‘Research Notes’‘Research Notes’ adds another staple to the IPP-SHR Podcast line up. This complementary podcast explores the ‘how to’ of research, including issues, methodologies and practicalities. Find the podcast at www.ipp-shr.cqu.edu.au/podcasts.

Homelessness and the Emergency DepartmentIPP-SHR welcomes Vivian Houston from the Princess Alexandra Hospital, to the team as an IPP-SHR Practitioner Researcher (IPR). Vivian will explore homeless presentation to the emergency department. More details are available on the back page.

IPP-SHR and Cure Our KidsIPP-SHR recently joined with Cure Our Kids to present research insights on Post- Traumatic Stress and Childhood Cancer at two Parent Gathering dinners. Insights highlight the need to normalise the experience and for health care providers to use pro-active strategies during treatment to minimise potential future issues.

Bereavement Research Out!IPP-SHR has completed data analysis and write up for the Bereavement Research Project, which explores mortality following a significant bereavement episode. Full details and a written report will be available at www.ipp-shr.cqu.edu.au/projects.

HIV/ AIDS Research in IndiaCollaborating with the St Johns Community Care Centre and Amrita Community Care Centre in Kerala, India, Dr Sue Rice, IPP-SHR has recently completed data collection on a collaborative project exploring HIV/AIDS and stigma issues.

Dr Pam McGrath

IPP-SHR Director, NHMRC Senior Research Fellow

Editorial

What’s Happening at IPP-SHR?

Sandra Evans and her family at the launch.

Prof Charles Larson, Dr Stuart Peacock,

Prof O.B. Tim Eden, Mr Hamish Holewa,

Dr Paul Rogers, Dr Shameul Alam

Members of the HIV/AIDS Research team.A/Prof Thomas Koilparampil, Mr Hamish Holewa,

Major Archbishop Cleemis Catholicos,

Dr Sue Rice, Fr Jose Kizhakkedath

Learning from each other: Cross-Cultural Insights on Palliative Care in Indian and Australasian Regions

Off the Press at IPP-SHR

• 3IPP-SHR, CQUniversity Australia • www.ipp-shr.cqu.edu.au

We would like to hear from you!IPP-SHR is keen to hear your thoughts on the Psycho-Social Review. If you are interested in any particular topics or would like to see any new sections introduced please let us know.

Letters to the editor, news or articles that you wish to share can be sent to ipp-shr@cqu.edu.au or www.ipp-shr.cqu.edu.au. Articles or news items can be either a full version or abridged. We look forward to hearing from you.

Email: ipp-shr@cqu.edu.au

Research that ConnectsIPP-SHR’s Collaborative Research

IPP-SHR offers a variety of initiatives to allow integrated and collaborate research relevant to your professional practice and in your organization.

For more information, please visit www.ipp-shr.cqu.edu.au/collaborate

Access articles online at www.ipp-shr.cqu.edu.au

In 2007, Redkite launched its first pilot Telegroup program in response to a call from families for greater cancer specific support in their local community. Since then, nearly 60 parents have participated in this telephone-based, professionally facilitated group support.

Redkite Telegroup brings together six parents in a conference call for one hour a week, for eight weeks. A range of issues are selected by group mem-bers and discussed in detail throughout the eight weeks. Participants have the opportunity to share contact details on completion of the group and remain connected beyond the eight week program.

The Telegroup model encourages parents to share and normalise the many challenges of their experience whatever stage they are at during the dif ficult can-

cer journey. As one parent reflected:

“It is like I have a filing cabinet in my head to hold all my thoughts, feelings and emotions in order, but since my son’s diagnosis it ’s like someone has pulled open all the draws of the filing cabinet and scattered all the files. I felt like I was standing in that room trying to sort out all the files but getting nowhere. Now I feel that with the Telegroup and your [Redkite Telegroup facilitators] help and support, we have been sorting through all those files [emotions, thoughts & feel-ings] together and slowly putting them back in order. Instead of trying to deal with everything at onc, and just getting overwhelmed, I know that I can deal with one thing at a time, calmly and productively.”

Since the launch of Redkite in 2007 we have run ten telegroups, with a mix

of groups specifically for parents of pae-diatric patients, parents of adolescents and young adults and groups of mums and dads.

In 2010, Redkite is expanding the Tel-egroup program to reach grandparents and bereaved parents.

For further information about the Telegroup program contact Redkite on 1300 722 644 or support@redkite.org.au.

Leigh KurthSenior Project and Services CoordinatorRedkitewww.redkite.org.au

Completing treatment is often celebrated as a milestone in the cancer journey for patients and their families. However, while this time may signify the end of de-

manding or debilitating treatments, the risk of relapse and long-term side effects of treatment remains.

A research team from the Children’s Centre for Cancer and Blood Disorders, Sydney Children’s Hospital, is currently exploring the psycho-social impact of completing cancer treatment on ado-lescents and their families. Our team is conducting semi-structured telephone interviews with adolescents (aged 12-18) who have completed cancer treatment in the last 36 months, their parents and

their siblings. Currently, we have inter-viewed 11 adolescents, 13 mothers, nine fathers and ten siblings (with a target of 64 interviews in total).

In the study so far, all participants have reported positive emotions at can-cer treatment completion, particularly relief and joy. Post-treatment growth themes have included: a greater appre-ciation for life, a stronger sense of self and personal maturity. Adolescents have also reported post-treatment dif ficulties, describing their fears of relapse, con-cerns for the future, reduced educational achievement (particularly maths) and their dif ficulties coping with fatigue and unexpected medical complications.

Many parents have described a period of exhaustion after their child’s

treatment completion, with mothers reporting a greater tendency to worry about all their children and about ap-propriate parenting than fathers. Siblings so far have tended to report worries concerning their parents’ coping ability in lieu of their own needs.

Preliminary results demonstrate that many adolescents are surprisingly resil-ient and most families cope well with the transition to survivorship. However, while finishing treatment is another step on the journey back to normal life, many adolescents and their families believe that life will never be ‘normal’ again.

For further information about this project, contact Dr. Claire Wakefield at c.wakefield@unsw.edu.au.

Redkite Telegroups: Keeping Families Connected following their Child’s Cancer Diagnosis

Finishing Cancer Treatment: The Positives and Negatives for Adolescents and their Families.

Programs & Practit ioners

• 5

Programs & Practit ioners

IPP-SHR, CQUniversity Australia • www.ipp-shr.cqu.edu.au

Programs & Practit ioners

Although the practice of medicine is widely regarded as both an art and a science and also regarded as a ‘healing profession’, medical students are

rarely taught about healing. Indeed, it has been said that doctors have become ‘curers of disease’ rather than ‘healers of the sick’. Workshops in Healing 1 and 2, is an elective, interactive, pilot workshop provided to senior medical students in the pre-intern stage of their undergradu-ate curriculum at the University of NSW, immediately prior to graduation. Eight to twelve self-selected students partici-pate in a small group format over four hours, in two hour sessions. Extensive published material is provided for each session which are held within two days of each other. The content and interac-tions which occur within each session

are deemed confidential in order to encourage openness. Written, open-ended assessment is requested from each participant within a week or two from the final session. The sessions use paintings, poetry, song and classic/con-temporary literature to illustrate points of discussion related to healing. A highly reflective environment is encouraged.

In the first session, students reflect on themselves, their motivation to learn medicine and their positive and negative experiences within the medi-cal curriculum. This can be a powerful time of personal reflection and insight into the student’s journey to date and what being a doctor will mean for each participant. Students are also taught about therapeutic use of self and the important ways in which they can be therapeutic instruments.

The second two hour session focuses

on the illness of the patient—the impact of illness on the whole person, the nature of suffering, meaning, and the ways in which suffering of others may be addressed and relieved. The importance of storytelling and the development of healing connections with other entities, is particularly emphasised.

To have a significant therapeutic impact on patients as a doctor, not only requires technical skills, mastery and knowledge but requires a reflective stance and an ability to connect with patients on an existential level. Profes-sional and personal benefits of this integration are discussed.

Professor J H KearsleyDirectorDepartment of Radiation Oncology St George Hospital

Workshops in Healing: Restoring the Perspective

Participant’s Comments“With regards to the course, I thought it was insightful and gratifying. It was nice to know that I was not the only one who felt that the current medical system was lacking a human touch. I recall your photograph of robots and I agree that in many aspects, we have become like robots with the current medical system.

It was also useful to discuss the issue of patient suffering openly, I felt it ’s good to be exposed to such topics as: showing compassion and find-ing meaning to suffering at such an early point in our medical career. However, I think it would take time (a long time) and loads of experience for me to put meaning to those concepts.” Robot sculptures courtesy of www.ClaytonBailey.com

My name is Andrea Bowness and I am one of two Registered Social Workers who work within the Regional

Cancer Treatment Service at Palmerston North Hospital in New Zealand.

The region covers a population of

555 000 people, over a catchment area which spans four District Health Boards and includes, Manawatu, Gisborne, Hawkes Bay, Taranaki, Wanganui and Wairarapa. Haematology is my special-ity; my practice stems from a strength- based and narrative approach.

In this role I meet with patients newly

diagnosed with acute leukaemia. I also see those undergoing an autologous stem cell transplant to address any psychosocial risk factors that may impact on their experience of the transplant process.

There is often a fine balance in knowing when and where to engage

Reflections from a Haematology Social WorkerChat Back

cont’d on next page

In 1992, the Mater Hospi-tal established the Nurs-ing Research Centre with the goals to provide sup-port for nurses to con-duct research to establish

priorities for clinical nursing research and to integrate these objectives into the daily delivery of nursing care. In reference to the Psycho-Social Review, Volume 5 Issue 1, of a collaboration between IPP-SHR and the Leukaemia Foundation of Queensland, Shannyn Pike, a Registered Nurse in the Oncology Department at Mater hospital, writes about her experiences and research concerning survivorship issues for oncol-ogy patients.

My interest in survivorship care for people with a history of cancer began in about 2006. This interest was piqued by my day-to-day contact with these patients in my job as an oncology nurse. In 2006, roughly two-thirds of people diagnosed with cancer were expected to be long-term cancer survivors (that is to

survive five or more years past their di-agnosis). This translates to more than 22 million people worldwide. In Australia, there are an estimated 340 000 long-term cancer survivors. Their population is growing at a rate of about 2 per cent a year.

I have seen patients who look for-ward to the end of active treatment (like chemo- or radiotherapy) who are often surprised by the feelings they experi-ence when they actually finish. As the President’s Cancer Panel puts it, ‘The end of cancer treatment is not necessarily the end of the cancer experience. For some patients, the period following the end of treatment may be as stressful, if not more so, as undergoing treatment itself.’

It is at the end of active treatment for their cancer that patients also lose the structure and support provided by regular contact with the oncology health care team. Less contact with this team may make the patient feel aban-doned, leaving them looking for support

but unsure of where to find it. Patients describe losing their ‘safety net’ when transitioning from active treatment and they are faced with the responsibility of self-monitoring for adverse outcomes like recurrence.

At the moment, survivorship care for people who have had cancer is a grow-ing and exciting area of research. I hope to add to this research through my work at the Mater Hospital’s Nursing Research Centre and I am planning to study the concept of uncertainty within people who have finished treatment for color-ectal cancer. I hope that this research will eventually lead to a program to ad-dress the psycho-social needs of cancer survivors and lead to improvements in the cancer survivorship experience for patients of the Mater Health Services.

Shannon PikeRegistered NurseMater Nursing Research Centre Brisbane Australia

Research on Survivorship Issues for Oncology Patients

Chat Back

• 7IPP-SHR, CQUniversity Australia • www.ipp-shr.cqu.edu.au

Stroke is one of the most costly diseases for the Australian population and surpris-

ingly, one quarter of all strokes occur in adults under 65 years of age. Each year, approximately 12 000 Australians of working age survive a stroke. Younger stroke survivors have less physical impairment and are more likely to survive a stroke compared with older people—however, the psycho-social disability and economic hardship they experience is substantial. Most of these younger stroke survivors are responsible for generating an income or providing family care and their primary objective is to return to work. However, many young Australians are at risk of experiencing loss of employment, productivity and experienc-ing depression.

A new study underway at The George Institute, is investigat-ing the psycho-social outcomes in stroke and is designed to provide information on potentially modifiable psycho-social pre-dictors of returning to work after stroke for younger (<65 years) stroke survivors. This information is vital for providing a basis and targets for effective vocational rehabilitation strategies.

The study is underway across New South Wales, Australia and will assess younger stroke survivors who have experienced a re-cent (within 28 days) stroke and were taken to hospital. Patients aged between 18-65 years will be followed for a period of 12 months. Researchers will conduct three interviews with patients after their stroke to determine what support young stroke survi-vors need to help them return to work. They are also looking at acceptability and other psycho-social factors in the work place. In addition, the economic impact of not returning to work for younger stroke survivors and their families will be explored.

The George Institute is a Sydney-based, world renowned health and medical research institute, focused on the prevention and management of chronic disease and injury.

Emma Orpilla, Public Relations Manager The George Institute Email: info@george.org.auwww.thegeorgeinstitute.org

Anecdotal and research evidence has indicated there is a need to provide psycho-social support for remote area practitioners and this has resulted in the development and implementation of a telephone counselling support service for those working in remote areas of Australia.

This Bush Support Line aims to con-tribute psychological support for health practitioners and their families adjusting to life in a remote context. The service targets the needs of multi-disciplinary remote and rural health practitioners, including, General Practitioners medical specialists, nurses, allied health practi-tioners, and Aboriginal health workers. The program also aims to prevent new incidences of psychological harm among remote health practitioners as a result of exposure to job related traumatic events, such as, medical emergencies, natural disasters, motor vehicle accidents, homi-cides, suicides, family violence, physical and sexual assaults and vehicle breakdown

in remote areas. In many instances, the Bush Support Line is the only support service available to help the remote and rural health workforce to deal with personal and job related stress, burn-out or trauma. Counsellors are contacted by ringing a free call number: 1800 805391.

The service is staffed by registered psychologists with remote work experi-ence and they are available throughout a 24-hour roster. Callers do not have to be in a crisis to call this service. Use of the Bush Support Line is encouraged at the early stage development of a problem or dif ficult situation. Counsellors are available to provide strategies to help practitioners in their remote work and for discussion and support. All infor-mation is confidential and callers may remain anonymous.

A global approach is adopted where the Bush Support Line is strengthened by a raft of dif ferent services, all aimed at providing timely support for remote practitioners.

Strategies used include:• The 24-hour Bush Support Line—a

confidential telephone support and de-

briefing service (toll free from anywhere in Australia);

• Stress management courses and other workshops;

• Publications, including self care booklets;

• Informational products to increase awareness of BSS;

• Best Practice Guidelines to support practitioners following a job related trauma.

It has been reported that remote area practitioners have a sense that they should only call in an emergency, which is clearly not the most effective problem solving strategy. Perhaps the great-est barrier to the use of the service is a practitioner’s own sense of invulnerabil-ity— ‘I should be able to cope without outside help.’ The service has worked on developing an education and awareness program to counteract these misper-ceptions and there is evidence that this approach is paying dividends.

Colleen NiedermeyerNational Program Managerwww.crana.org.au Bush Support Line: 1800 805 391

therapeutically with the patient. Symp-toms from treatment often impact on a person’s ability to participate and engage and these f luctuations can occur daily. Likewise, finding the uninterrupted privacy and space they and their families need can be a challenge. I am often sur-prised that the existential conversations happen at opportune times and can start from an informal corridor catch up.

Patients receiving treatment for acute leukaemia can be away from home for a number of months and in this time they develop very close relationships with the Haematology team and ward staff. We have found the transition back home for

patients and their family can be a chal-lenging time, particularly if relationships and rapport have not been fostered with their local hospital and community services.

Two key initiatives are helping us make this transition better for patients and families:

1. As a team we have developed resource folders (which have been kindly donated by the Leukaemia & Blood Foundation) that include support serv-ice information pertinent to both the patient’s home and treatment areas. The folders also include general information

including, financial and medico-legal matters.

2. A regional oncology and pallia-tive care social work network has been formed and meets bi-annually. This network supports the patient’s transition home and promotes continuity of care in practice. It also promotes understanding of how each contributing District Health Board operates.

These initiatives have been invaluable in preparing patients to navigate their way through two health systems and to develop wider support networks on their return home.

Stroke Among Young Australians

Remote Areas Call for Psycho-Social Support

Reflections from a Haematology Social Worker (cont’d from previous page)

Chat Back

Chat Back

Programs & Practit ioners

Global Update: Newfoundland, Canada

Qualitative Bereavement Research: Incongruity between the Perspectives of Par ticipants and Research Ethics BoardsThe use of qualitative research methodologies to document the experience of bereavement is on the increase. The interactive, open-ended nature of qualitative interviews with this cohort oftentimes results in members of Research Ethics Boards (REBs) flagging the interview process as a potential risk for participants, which runs counter to the reported experience of participants, who frequently state that the interview was a positive experience that allowed them to share their journey with an engaged and interested researcher. This particular study aimed to explore this apparent gap between REBs and research participants.

The REBs reported ethical concerns which involved weighing the risks versus the benefits to the potential participant. The REBs noted that the open-ended interactive nature of the interview complicated the informed consent process as no definitive structure is imposed during the interview, so neither party knows exactly what will be shared throughout the session. In addition, REBs were concerned whether an individual in the midst of be-reavement is actually able to give informed consent due to their

vulnerable state.

In contrast, the participants stated that they appreciated the therapeutic process of talking with an interested person willing to sit with them in their pain. Participants commented that the interview did not cause pain but rather, allowed them a positive space in which to express their pain. One participant stated that it ‘provided an opportunity to explore’ in a focussed and private manner. Participants noted that the therapeutic nature of the interview was most evident when the interviewers approach included, compassion, empathy, authentic interest, warmth, kind-ness, a non-judgmental stance, and the ability to contend with powerful emotions.

Publication Details: Buckle, J., Dwyer, S., & Jackson, M. (2010) Qualitative Bereavement Research: Incongruity between the Perspectives of Participants and Pesearch Ethics Boards, Interna-tional Journal of Social Research Methodology, 13 (2): 111-25. Précis by IPP-SHR

Global Update: Rhode Island, USA

Fulfilling the Mission of Academic Medicine: Training Residents in the Health Needs of PrisonersApproximately 12 million Americans rotate through correctional facilities on an annual basis. This vulnerable population is pre-dominately black and have a high rate of diseases, such as, hepa-titis C, HIV, and tuberculosis. With increasing lengths of prison sentences, there is now a growing need to meet the chronic medical needs of an aging incarcerated population who are ex-periencing diseases such as asthma, diabetes and hypertension.

The mandate of academic medicine is the pursuit of health for all. In 2001, a survey involving 1209 residency directors showed only 14 per cent offered courses on the health needs of prison-ers and 22 per cent made available a clinical experience in a correctional facility. To achieve the objectives of this mandate, academic medicine needs to increase training for medical train-ees in this population.

This would result in a mutually beneficial partnership in which medical care would be provided to the incarcerated individuals whilst training residents in their unique health care needs.

Moreover, physicians in training would be given the opportu-nity to experience the ability to foster a sense of social respon-sibility, which is oftentimes overlooked within their education. This mutually beneficial partnership would result in academic medicine becoming a leader in raising training opportunities and awareness within this marginalised cohort in the American culture.

Publication Details: Wakeman, S & Rich, J. (2010) Fulfilling the Mission of Academic Medicine: Training Residents in the Health Needs of Prisoners, Journal of General Internal Medicine, 25 (2): 186-8. Précis by IPP-SHR

A look at Psycho-Social Health Research from around the Globe

Find more Global Updates online at www.ipp-shr.cqu.edu.au/enews

BackgroundWhile for most Australians cancer mortality rates are in decline, a marked excess in cancer mortality remains for Aboriginal Australians.

Cancer Australia has contracted Cancer Council SA (CCSA) to review research and initiatives aimed at improving all areas of cancer control for Aboriginal Australians from primary preven-tion through to support and palliative care.

The overall objective of this research project is to improve the effectiveness of Aboriginal and Torres Strait Islander cancer control by determining successful and culturally appropriate cancer control services and measures. Results will be used to plan initiatives to reduce disparities many Aboriginal and Torres

Strait Islanders experience, across all aspects of their cancer journey.

AimsSpecifically, this research project seeks to:• Identify, consolidate and assess existing projects and both quantitative and qualitative research surrounding Aboriginal and Torres Strait Islander cancer control.• Identify and recommend solutions to the barriers and gaps in Aboriginal and Torres Strait Islander cancer control.• Identify existing or proposed practical evidence-based activi-ties that should continue and be supported.• Identify practical research opportunities to further develop effective evidence-based Aboriginal and Torres Strait Islander cancer control.• Identify any other options that may be available to improve Aboriginal and Torres Strait Islander cancer control.

Carmel MCNamaraCoordinator Aboriginal Cancer Control Programs

Aboriginal Cancer Research Project

IPP-SHR, CQUniversity Australia • www.ipp-shr.cqu.edu.au • 9

Assistance NeededIt is likely that some research and/or activities may not be published or easily accessible in report form including:

1. Copies of unpublished reports involving cancer control activities in Aboriginal and Torres Strait Islander communities across the cancer trajectory (e.g. screening, prevention, support, diagnosis, treatment, survival, palliative care). 2. Contact details for key agencies/contacts that would be aware of further cancer control literature and/or activities occurring in Aboriginal or Torres Strait Islander communities 3. Contact details for key stakeholders who the Investigators could potentially consult with to gain overviews of research not currently available in the academic or grey literatures

If you are able to assist please direct copies of reports, details of key contacts or cancer related programs and initiatives to Joseph Miller at CCSA (jmiller@cancersa.org.au), or call Joe on (08 8291 4144).

Responding to the needs of the Pallia-tive Care community an online network, a “community of practice”, in Cancer and Palliative Care has been created. The aim of the network is to enable research-ers and clinicians to make connections, exchange ideas and information, ask and answer questions, share resources and media online. The online network ena-bles communication across national and international boundaries about practice

and research in cancer and palliative care, through discussion forums, social networking, resource sharing and links. There’s a ‘common room’ for informal socialising and friendly networking.

The primary aim for the network is for people to make links between their personal learning contexts and their professional life and activities. Members include nurses, clinicians, allied health professionals and postgraduate students in the UK, Europe, the Far East and Africa.

For further information about the online network visit http://copcunis.ning.com

Dr Anne ArberLecturer in Cancer and Palliative CareUniversity of SurreyGuildford, United Kingdom

Online Community of PracticePrograms & Practit ioners

Global Update

IPP-SHR Podcasts - Bringing you the latest in psycho-social health research from around the world. Listen online at www.ipp-shr.cqu.edu.au/podcasts

Podcast PicksJournal & Book Profile

Men in Canada and Australia tend to moni-tor their own symptoms and self-medicate, rather than consulting family physicians and GPs. This is largely due to the belief that to be masculine, they must be stoic, autonomous and self-reliant. How then are leaders of prostate cancer support groups able to create an environment where men feel comfortable discussing sensitive topics such as impotence, incontinence and digital rectal examinations? This week, Michael Bouwman talks with Dr John Oliffe, who studied prostate cancer sup-port groups in Canada and found that group leaders ‘disarm stoicism’ through humour, which allows participants to engage at a level

they are comfortable with This means that newly diagnosed men experiencing anxiety are able to gain valuable information. He says humorous accounts from group members about their own experiences with treatment side effects such as incontinence, often lead to discussions about coping strategies and help to normalise the experiences for the entire group. John stresses that humour can still be used inappropriately, he recommends that prostate cancer support groups develop their own group rules for the use of humour.

Published 23 April 2010Interview with Dr John Oliffe

First published in 1994 and now in its 3rd Edition, ‘The Sage Handbook of Qualitative Research’ represents the definitive tome of qualitative enquiry. Edited by Denzin and Lincoln, the book brings together an international board of qualitative experts and comprehensively presents most aspects of qualitative research, from philosophical and theoretical underpinnings to practice methods. Whilst there may be other texts that cover the practicalities of ‘doing’ qualitative research, particularly for beginners, there is little else that covers the breadth and scope of this book

Bringing Indigenous peoples’ voices to end-of-life research was the impetus for a recently published thematic issue by the Journal of Palliative Care. Commonalities amongst Indigenous peoples’ experiences of dealing with an end-of-life experience were highlighted within this collective body of 11 manuscripts. This international body of research represented a diversity of geographical locations such as Australia, New Zealand, the United States and Canada.

The authors identified several commonalities amongst the Indigenous peoples’ journey through an end-of-life experience. One of the major issues was that they often lived in remote or rural communities and consequently would have limited or no access to palliative care. And secondly, when they leave home for hospital, they often encounter a healthcare system that offers treatment in a way that is inconsistent with their beliefs and cultural backgrounds.

A challenge experienced by all the authors was the necessity of having a foothold in the community they researched. Only by taking the time to know – and to be known – could the information flow freely. Oftentimes this trust would be built slowly over several years and would be based upon a mutual sense of respect between community members and the researchers. With this Indigenous peoples’ issue, a family of far-flung researchers have been drawn together in a temporary home at the Journal.

For any questions, contact Alison Ramsey at alison.ramsey@criugm.qc.cq

The Journal of Palliative Care is a peer reviewed journal that seeks to provide a forum for professionals engaged in palliative care and palliative medicine. The Journal features opinion papers, reviews, case reports, book reviews and reports on international activities.

IPP-SHRs affiliated journal, the Austral-Asian Journal of Cancer (AJC), provides a scientific and academic forum for knowledge transfer, discussion and research for countries within the Austral-Asian region. The Austral-Asian Journal of Cancer is an Open- Access journal and does not charge publication fees. The AJC operates an English translation program aimed at ensuring that important academic and scientific research is available to its readers in English.

Ambulance workers witness death and injury on a daily basis and have a much greater risk of developing post-traumatic stress disorder (PTSD) than people in the general community. But what gives some incidents and not others, the power to evoke traumatic emotions and how can we support paramedics? This week Hamish Holewa talks to Dr Janice Halpern, who says the results of her study surprised her, as well as the paramedics in her study, by showing that poignant incidents arousing intense compassion such as the death of a baby, children being harmed by their parents, or deaths of an innocent are particularly pow-

erful. She says we think of traumatic incidents as very intense and demanding. However, it’s often the very quiet motionless incidents where there is often nothing to do that result in overwhelming feelings. Janice says we need to educate ambulance workers and their su-pervisors to recognise and tolerate vulnerable feelings, as many dismiss their own emotions and avoid seeking support, believing what they have witnessed is not severe enough to be ‘critical’.

Published 19 February 2010Interview with Dr Janice Halpern

Whilst medical schools are increasingly rec-ognising the importance of empathy training, the hidden curriculum—the reality of clinic care—often overrides empathy training when medical students begin work in the wards. This week, Hamish Holewa talks with Dr Re-becca Garden, who believes this is a concern given the strong evidence that patients do better medically and are more likely to col-laborate in their treatment programs when they are working with empathic doctors. She says we need to teach health professionals to be as conscious of emotions as possible and to

respond to emotions in themselves and their patients in order to deliver effective patient- centred care. Rebecca stresses that the critical point in building a collaborative relationship with a patient is reached when doctors check back with patients to make sure they’ve ‘got it right’, as it gives doctors an opportunity to learn more about the factors influencing their patient’s health and allows the patients to be the authority on their own story of illness.

Published 5 February 2010Interview with Dr Rebecca Garden

IPP-SHR podcasts explore the latest in the world of psycho-social health research.

Latest Podcasts

Tourette’s Syndrome: Understanding the impact of diagnosis on children, families and caregiversPublished 18 June, 2010

‘Everyday Ethics’: Tailoring Ethics Education To Meet The Needs Of Doctors In Paediatric Outpatient ClinicsPublished 4 June, 2010

Detecting Cancer Earlier: The Need For New Strategies And Interventions For GPs And Primary CarersPublished 21 May, 2010

Post-Natal Cultural Practices In Ethiopia: Protective Or Destructive To Mental Health?Published 7 May, 2010

Children Living With Grandparents: An Under- Recognised and Under-Resourced PhenomenonPublished 26 March, 2010

‘Research Notes’

IPP-SHR has released a new podcast series - ‘Research Notes’

Released every Friday fortnight, “Research Notes” is a complementary podcast which explores the practicalities, issues and methodology associated with conducting psycho-social health research.

Deta i led Ins ights in to

Psycho-Soc ia l Hea l th Resea rch

‘Welcome to the club nobody wanted to join’: Humour and Masculinity in Prostate Cancer Suppor t Groups

The Sage Handbook of Qualitative Research

The Journal Of Palliative Care: Featured Review

Austral-Asian Journal of Cancer (AJC)

‘Nothing I could do’: Accepting Distress and Vulnerability in Ambulance Workers

‘I really would like to hear your story’: Incorporating Clinical Empathy into the Ward

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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 PSR REVIEWS, PO BOX 796 TOOWONG Q 4066 AUSTRALIA

IPP-SHR, CQUniversity Australia • www.ipp-shr.cqu.edu.au

As network speeds, con-nection options and devices that are able to connect to the internet increase, more computing will move to ‘the cloud’—a term that refers primarily to the avail-ability of on-demand computer software, processing and data storage over the internet. It corresponds to a paradigm shift in the delivery of computing resources, so instead of buying a software package—say a popular office productivity application which may include a word-processing, spreadsheet and database application—within ‘cloud’ computing, you only pay for what you actually use. For example, if you only ever use a database application once a year, you only ever pay for its use once a year. Similarly, this concept can be used for other computing services such as processing power and storage. If you need a lot of processing power to edit a video or complete some graphic design, this can be dialled in from ‘the cloud’. In essence, cloud computing refers to the ability to access computing services, data and processing power over the Internet but only when you need it—you don’t need to have a highly specified desktop machine that only uses 20 per cent of its capability most of the time.

Potential cost advantages aside, cloud computing has the potential to offer increased avenues for collaboration and greater access to wider subsets of data. However, in relation to research software, development is still in its infancy. A no-table example of cloud-based qualitative research software is Saturate — www.saturateapp.com. Although still in production, this application allows you to code and thematically analyse text-based sources within a web-browser and easily share and collaborate coding and analysis. It provides a glimpse into the future of on-line data analysis. Additionally, spreadsheet services such as Google Spreadsheets or Zoho Sheet are available for limited quantitative analysis. Indications are that major statistical software providers are considering cloud-based services but cur-rently there are no commercial offerings. Other collaboration and cloud services for general office-based applications exist and are quite advanced—indeed, this column has been written using a cloud service - Zoho Writer.

But a paradigm shift requires a shift in thinking. It’s about having access to your data all the time in a collaborative

manner and being constantly connected. Development still needs to be completed and robust ethical, policy and governance frameworks need to be implemented. The physical location of data may not be read-ily transparent, nor who has access to the data. This is a legitimate concern consider-ing the sensitivity of some data and restric-tions that some funding imposes on data handling and storage.

Cloud computing has been made pos-sible by advances in browser technology, internet connection speeds and to a web-site programming paradigm, collectively called AJAX. Such advances allow websites to be more fluid and interactive, mimick-ing a user experience similar to normal desktop software. However, what you do need is consistent, fast and reliable access to the ‘cloud.’ Also, you do not want to be replicating files and services between your desktop and information stored on the internet. This poses numerous challenges, particularly when you want to work on data which is stored in the cloud but you are having connectivity issueslike if you are on a plane for example.. These are still issues that are being worked out, however in the future most of your computing will be done in the air!

If you received this letter in error or do not wish to receive any subsequent editions, please visit “Contact us” at www.ipp-shr.cqu.edu.au. The material contained in “Psycho-Social Review” is intended only to provide a summary and general overview on matters of interest. It is not intended to be comprehensive. The views and information expressed within “Psycho-Social Review” are not necessarily the views or opinions of IPP-SHR or its affiliates. IPP-SHR takes no responsibility for the accuracy or otherwise of the content of “Psycho-Social Review” and recipients are advised not to rely upon any representations, statements, content or information without independent verification. For your convenience and information, “Psycho-Social Review” contains links to other sites. IPP-SHR makes no representation or warranty as to the accuracy or any other aspect of the information on those linked sites. No link to another site should be construed as an endorsement or recommendation of any information, goods or services referred to. Attribution: In order of Appearance - ©iStockphoto.com/asiseeit; ©iStockphoto.com/stockcam; ©iStockphoto.com/AndrewJohnson; ©iStockphoto.com/sodafish; ©iStockphoto.com/RypeArts; ©iStockphoto.com/lushik. Design & Layout: Black pen® – www.blackpen.com.au

Up in the Cloud

Homelessness in the Emergency Department

Hamish Holewa

IPP-SHR Program Manager

Contact Details:IPP-SHR, CQUniversity, Brisbane Office, PO BOX 796 TOOWONG Q 4066 AUSTRALIA Telephone: + 61 7 3025 3377 Email: ipp-shr@cqu.edu.au

IPP-SHR, in conjunction with the Princess Alexandra Hospital, Social Work Depart-ment and under the shared auspices of the IPP-SHR Practitioner Researcher Scheme have embarked on a year long project exploring homelessness in the Emergency Department.

Supported by a Queensland Health Initiative under the National Partnership Agreement on Homelessness (NPAH),

the project aims to facilitate better care for people identified as homeless within the Emergency Department and increase onward referrals to appropriate service providers and agencies. The project also aims to better understand the needs and experiences of homeless people and the response of the Emergency Department in care provision.

The study will consist of three arms: the first will explore homeless people’s perspectives of the emergency depart-

ment; the second will focus on the understanding and response of Emer-gency Department health professionals in their perception of homelessness and their health care approach. Lastly, the study will explore the wider context of referrals and community support by mapping community services provid-ers and detailing service provider’s responses and needs when consulting with the Emergency Department within the context of homelessness

Work-in-Progress at IPP-SHR