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Heffernan S, O'Malley M, Curtin M, Hawkins A, Murphy R, Goodwin J, Barry K, Taylor A, Happell B, O' Donovan Á. An evaluation of a trauma-informed educational intervention to enhance therapeutic engagement and reduce coercive practices in a child and adolescent inpatient mental health unit. Int J Ment Health Nurs 2024; 33:978-991. [PMID: 38291645 DOI: 10.1111/inm.13299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/10/2024] [Accepted: 01/15/2024] [Indexed: 02/01/2024]
Abstract
High-risk behaviours are sometimes encountered in Child and Adolescent inpatient mental health units and can prompt the use of coercive practices to maintain safety. Coercive practices may lead to re-traumatisation of young people and deteriorating therapeutic relationships. Trauma-informed practice (TIP) has successfully reduced coercive practices. While education is identified as foundational to implementation, evaluations of programmes remain minimal. The aim of this study was to explore mental health professionals' views and experiences of a trauma-informed education programme and its likely impact on their approach to practice. Five mental health professionals agreed to participate, four contributed in a focus group and one in an individual interview. Data were analysed thematically using the Braun and Clarke Framework. Three main themes were identified. Firstly, shifting attitudes and perceptions of trauma-informed practice. Participants believed they had developed more compassion towards clients and these attitudes were reflected in their clinical practice. Secondly, challenges associated with trauma-informed practice educational intervention. Staffing issues and shift work made it difficult for participants to attend education sessions regularly. Participants identified barriers to practicing in a trauma-informed manner in the current clinical environment. Finally, the need for interdisciplinary communication and support was identified. Participants saw the need for all professionals, not only nurses, to take responsibility for changing practice, and for stronger support at the organisational level. Trauma-informed practice is crucial to recovery-focused mental health nursing practice. These findings highlight the importance of TIP education and suggest areas for further improvement to enhance positive mental health outcomes for young people.
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Affiliation(s)
- Sinéad Heffernan
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, County Cork, Ireland
| | - Maria O'Malley
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, County Cork, Ireland
| | - Margaret Curtin
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, County Cork, Ireland
| | - Andrew Hawkins
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, County Cork, Ireland
| | - Rachel Murphy
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, County Cork, Ireland
| | - John Goodwin
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, County Cork, Ireland
| | - Karen Barry
- Eist Linn, Child and Adolescent Mental Health Services, Cork and Kerry Healthcare, Health Service Executive, Cork, Ireland
| | - Alice Taylor
- Eist Linn, Child and Adolescent Mental Health Services, Cork and Kerry Healthcare, Health Service Executive, Cork, Ireland
| | - Brenda Happell
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, County Cork, Ireland
- Faculty of Health, Southern Cross University, East Lismore, New South Wales, Australia
| | - Áine O' Donovan
- School of Nursing and Midwifery, Brookfield Health Sciences Complex, University College Cork, Cork, County Cork, Ireland
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Fitts M, Soldatic K. Temporalities of emergency: the experiences of Indigenous women with traumatic brain injury from violence waiting for healthcare and service support in Australia. HEALTH SOCIOLOGY REVIEW : THE JOURNAL OF THE HEALTH SECTION OF THE AUSTRALIAN SOCIOLOGICAL ASSOCIATION 2024; 33:160-174. [PMID: 38770642 DOI: 10.1080/14461242.2024.2345596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 04/07/2024] [Indexed: 05/22/2024]
Abstract
Globally, traumatic brain injury (TBI) has been recognised as a serious health issue not only because of the immediate impacts at the time the injury occurs but even more so due to the longstanding impacts. Even though TBI is a globally recognised condition, the research is disproportionately focused on its incidence in, and immediate and long-term effects on men. A growing body of research suggests that generally, women who experience family violence are at high risk of TBI and suffer its impacts in ways that reflect gendered differences in the patterns and frequency of violence. In Australia, the social and physical costs of TBI are multiplied for Indigenous women, whose experience of disability and access to healthcare lies at the intersection of gender and race in the historical context of settler colonialism. The present study addresses the need for research into the sociodemographic inequalities that affect access to culturally appropriate hospital care, timely response systems, and flexible, safe and engaged social services. This paper draws on data from interviews and focus groups with Indigenous women, hospital staff and community-based service providers and suggests potential pathways for further research in settler-colonial settings elsewhere in the world.
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Affiliation(s)
- Michelle Fitts
- Institute for Culture and Society, Western Sydney University, Parramatta, Australia
- Menzies School of Health Research, Charles Darwin University, Alice Springs, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Townsville, Australia
| | - Karen Soldatic
- Canada Excellence Research Chair Health Equity and Community Wellbeing, Toronto Metropolitan University, Toronto, Canada
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Klein LB, Melnik J, Curran K, Luebke J, Moore KM, Ruiz AM, Brown C, Parker D, Hernandez-White I, Walsh K. Trauma- and Violence-Informed Empowering Care for Sexual Assault Survivors. JOURNAL OF FORENSIC NURSING 2024; 20:166-173. [PMID: 38509039 PMCID: PMC11333187 DOI: 10.1097/jfn.0000000000000483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
BACKGROUND Forensic nurse examiners, including sexual assault nurse examiners, provide care for survivors holistically through healthcare, emotional support, connection to follow-up care, safety planning, and, if desired, evidence collection to aid in the prosecution of sexual assault. There is increasing recognition that trauma-informed care must also include an understanding of the impacts of structural violence on minoritized patients to ensure health equity. AIM To help address this guidance gap, we expanded Campbell and colleagues' empowering care model using a trauma- and violence-informed care (TVIC) lens. METHODS We used an iterative discussion-based process that included five joint meetings between a seven-member transdisciplinary research team and a five-member nurse advisory board. RESULTS In a TVIC-informed empowering care model, we propose behavioral examples for forensic nurses for each of Campbell et al.'s five key domains of empowering care for forensic nurse examinations (i.e., build rapport and establish trust, show compassion, provide patient-directed care, convey professionalism, and provide resource referral and follow-up). CONCLUSIONS These behavioral examples for nurses can help guide forensic nurse training and practice to reduce disparities in treatment and follow-up support. Structures and systems are needed that enable forensic nurses to provide trauma- and violence-informed empowering care to survivors of sexual assault and, over time, increase the accessibility of forensic nurse examinations and improve patient outcomes.
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Affiliation(s)
- L B Klein
- Author Affiliations: Sandra Rosenbaum School of Social Work
| | - Jessica Melnik
- Department of Psychology, University of Wisconsin-Madison
| | | | | | | | - Ashley M Ruiz
- Edson College of Nursing and Health Innovation, Arizona State University
| | | | | | | | - Kate Walsh
- Departments of Psychology and Gender and Women's Studies, University of Wisconsin-Madison
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Moodie S, Jones J, Chenhall R, Williams R, Garlett C, Gibberd A, O’Donnell M, McAullay D, McNamara B, Eades S. Intersectoral collaboration for supporting the health and wellbeing of Aboriginal families and children in out-of-home care: perspectives from Western Australian Aboriginal Community Controlled Health Organisations. Front Public Health 2024; 12:1392208. [PMID: 38983266 PMCID: PMC11231078 DOI: 10.3389/fpubh.2024.1392208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/05/2024] [Indexed: 07/11/2024] Open
Abstract
Introduction Western Australia has one of the highest rates of Aboriginal children entering out-of-home care in Australia. Kinship care is the preferred culturally safe out-of-home care option for Aboriginal children, yet all jurisdictions, including Western Australia, are far from meeting best-practice national standards. Intersectoral collaboration is a key primary healthcare principle and internationally recognized for improving health systems and outcomes. This paper presents findings from a qualitative research project investigating Aboriginal primary healthcare workers' experiences of intersectoral collaboration challenges and strengthening opportunities. Methods Constructivist grounded theory guided this research involving 55 semi-structured interviews and four focus group discussions with Aboriginal primary healthcare workers. The research was guided by Indigenous methodologies and led by Indigenous researchers Participants were recruited from seven Aboriginal Community Controlled Health Organisations located across Perth metro, Pilbara, Midwest/Gascoyne and Southwest regions in Western Australia. Results Key themes identified around intersectoral collaboration challenges were communication, including information sharing and interagency meetings, and the relationship with the government sector, including trust and the importance of the perception of Aboriginal health service independence. Key themes around strengthening areas to improve intersectoral collaboration included strengthening service resourcing and coverage, including the availability of services, and addressing high program turnover. The need for a shift in approach, including more emphasis on Aboriginal-led care and aligning approaches between sectors, was another area for strengthening. Discussion This study addresses a significant research gap concerning out-of-home care, kinship care, and intersectoral collaboration in an Australian Aboriginal context. Findings highlighted the need to review the out-of-home and kinship models of care to strengthen the system, including creating more formal and structured modes of collaborating and better resourcing family support and kinship care.
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Affiliation(s)
- Sasha Moodie
- National Drug Research Institute, Curtin University, Perth, WA, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Jocelyn Jones
- National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Richard Chenhall
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Robyn Williams
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
| | - Cathy Garlett
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Alison Gibberd
- National Drug Research Institute, Curtin University, Perth, WA, Australia
- Hunter Research Medical Institute, Newcastle, NSW, Australia
| | - Melissa O’Donnell
- Australian Centre for Child Protection, University of South Australia, Adelaide, SA, Australia
| | - Dan McAullay
- Kurongkurl Katitjin, Edith Cowan University, Perth, WA, Australia
| | - Bridgette McNamara
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Barwon South West Public Health Unit, Barwon Health, Geelong, VIC, Australia
| | - Sandra Eades
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
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Baker S, Gallegos D, Rebuli MA, Taylor AJ, Mahoney R. Food Insecurity Screening in High-Income Countries, Tool Validity, and Implementation: A Scoping Review. Nutrients 2024; 16:1684. [PMID: 38892619 PMCID: PMC11174716 DOI: 10.3390/nu16111684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 05/17/2024] [Accepted: 05/25/2024] [Indexed: 06/21/2024] Open
Abstract
Household food insecurity has significant negative implications across the lifespan. While routine screening is recommended, particularly in healthcare, guidelines are lacking on selection of screening tools and best-practice implementation across different contexts in non-stigmatizing ways. The objective of this scoping review was to synthesize evidence on household food insecurity screening tools, including psychometrics, implementation in a range of settings, and experiences of carrying out screening or being screened. Four electronic databases were searched for studies in English published from 1990 until June 2023. A total of 58 papers were included, 21 of which focused on tool development and validation, and 37 papers described implementation and perceptions of screening. Most papers were from the USA and described screening in healthcare settings. There was a lack of evidence regarding screening in settings utilized by Indigenous people. The two-item Hunger Vital Sign emerged as the most used and most valid tool across settings. While there is minimal discomfort associated with screening, screening rates in practice are still low. Barriers and facilitators of screening were identified at the setting, system, provider, and recipient level and were mapped onto the COM-B model of behavior change. This review identifies practical strategies to optimize screening and disclosure.
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Affiliation(s)
- Sabine Baker
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, South Brisbane, QLD 4101, Australia; (D.G.); (A.J.T.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
| | - Danielle Gallegos
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, South Brisbane, QLD 4101, Australia; (D.G.); (A.J.T.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
| | | | - Amanda J. Taylor
- Centre for Childhood Nutrition Research, Faculty of Health, Queensland University of Technology, South Brisbane, QLD 4101, Australia; (D.G.); (A.J.T.)
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD 4059, Australia
| | - Ray Mahoney
- Australian e-Health Research Centre, CSIRO Health and Biosecurity, Herston, QLD 4029, Australia;
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McTavish JR, McHolm A, Niec A, Pietrantonio AM, McKee C, MacMillan HL. Case conceptualization in child welfare: an underused resource to improve child, family, and provider outcomes. Front Psychiatry 2024; 14:1292690. [PMID: 38274420 PMCID: PMC10808490 DOI: 10.3389/fpsyt.2023.1292690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/22/2023] [Indexed: 01/27/2024] Open
Abstract
Case conceptualization, formally known as case formulation, is one tool that assists in determining the best course of action for children and families experiencing family violence that has been under-utilized in child welfare. In this article we present a step-by-step case conceptualization process that considers the child welfare context. We then present a hypothetical case example of a 10-year-old child referred by a child welfare worker to evidence-based treatment for mental health and behavioural concerns. Mental health services are not helpful for the child and further consultation is enlisted. To more effectively guide intervention and treatment planning and ultimately improve outcomes for the child, we present case conceptualization as a process that incorporates relevant aspects of the child and family's history and circumstance. We conclude with a succinct case conceptualization and treatment plan to show how the prognosis of the child can be improved when case conceptualization is employed.
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Affiliation(s)
- Jill R. McTavish
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Angela McHolm
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Anne Niec
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Anna Marie Pietrantonio
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Christine McKee
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Harriet L. MacMillan
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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Collier AF, Schaefer KR, Uddin A, Noonan C, Dillard DA, Son-Stone L, Manson SM, Buchwald D, MacLehose R. COVID-19 vaccination in urban American Indian and Alaska Native children: Parental characteristics, beliefs and attitudes associated with vaccine acceptance. Vaccine X 2023; 15:100406. [PMID: 38058791 PMCID: PMC10696120 DOI: 10.1016/j.jvacx.2023.100406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 11/07/2023] [Accepted: 11/12/2023] [Indexed: 12/08/2023] Open
Abstract
Background Little is known about vaccination rates for American Indian and Alaska Native (AI/AN) parents and their children, or parental decisions in this regard. Improving vaccination rates is a serious concern due to the disproportionate incidence and morbidity of COVID-19 in AI/AN people. Purpose Our goal was to describe urban AI/AN parental attributes associated with COVID-19 vaccination of their children. Methods Survey participants (n = 572) were ≥18 years of age, had children ≥5 years of age, AI/AN, and seen at one of six urban health organizations serving primarily AI/AN people within the prior year. They were asked about gender, age, education, marital status, perceived stress, trauma history, whether they had received the COVID-19 vaccine, tested positive for COVID-19 in the past, and if their child was vaccinated. They were also asked about 16 vaccine hesitancy reasons. Results Parental vaccination rate was 82%, with 59% of their children vaccinated. Parents who vaccinated their children were older, had higher education, lower stress and trauma, and were more likely to be vaccinated compared to parents who did not vaccinate their children. Forty-two percent of parents indicated they would likely vaccinate their unvaccinated child in the future. Sixteen vaccine hesitancy reasons revealed four factors: distrust, inconvenience, lack of concern about the pandemic, and AI/AN concerns. Parents who had no plans to vaccinate their children had the highest vaccine distrust and lack of concern about the pandemic. Parents with greater vaccine distrust and AI/AN specific concern reported significantly greater trauma history and higher levels of education. Conclusion Even though vaccination rates for AI/AN parents and children are high, the consequences of COVID-19 for AI/AN people are more severe than for other US populations. Providers should use trauma-informed, trust-building and culturally competent communication when discussing choices about vaccination with AI/AN parents.
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Affiliation(s)
| | | | - Azhar Uddin
- Institute for Research and Education to Advance Community Health, Elson S Floyd College of Medicine, Washington State University, United States
| | - Carolyn Noonan
- Institute for Research and Education to Advance Community Health, Elson S Floyd College of Medicine, Washington State University, United States
| | | | - Linda Son-Stone
- First Nations Community Healthsource, Albuquerque, NM, United States
| | - Spero M. Manson
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, United States
| | - Dedra Buchwald
- Institute for Research and Education to Advance Community Health, Elson S Floyd College of Medicine, Washington State University, United States
| | - Richard MacLehose
- Department of Epidemiology and Community Health, University of Minnesota, School of Public Health, United States
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Allice I, Acai A, Ferdossifard A, Wekerle C, Kimber M. Indigenous Cultural Safety in Recognizing and Responding to Family Violence: A Systematic Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16967. [PMID: 36554846 PMCID: PMC9779508 DOI: 10.3390/ijerph192416967] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/09/2022] [Accepted: 12/15/2022] [Indexed: 06/17/2023]
Abstract
This systematic scoping review synthesizes the recommended approaches for providing culturally safe family violence interventions to Indigenous peoples in health care and social service settings. A total of 3783 sources were identified through our electronic database searches, hand-searching of Indigenous-focused journals, and backward and forward citation chaining. After screening those sources in duplicate, 28 papers were included for synthesis in June 2020. Forward citation chaining of these 28 included articles in June 2022 identified an additional 304 possible articles for inclusion; following the screening of those 304 articles, an additional 6 were retained in the review. Thus, a total of 34 articles were included for data extraction and narrative synthesis. Initial results were presented to members of the Six Nations of the Grand River Youth Mental Wellness Committee, and their feedback was incorporated into our inductive organization of findings. Our findings represent three thematic areas that reflect key recommendations for health care and social service provision to Indigenous families for whom family violence is a concern: (1) creating the conditions for cultural safety; (2) healing at the individual and community level; and (3) system-level change. These findings demonstrate the need to center Indigenous peoples and perspectives in the development and implementation of cultural safety approaches, to acknowledge and address historically contingent causes of past and present family violence including colonization and related state policies, and to transform knowledge and power relationships at the provider, organization, and government level.
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Affiliation(s)
- Ilana Allice
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Anita Acai
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Ayda Ferdossifard
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Christine Wekerle
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4L8, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4L8, Canada
- Optentia Research Unit, North-West University, Potchefstroom 2520, South Africa
| | - Melissa Kimber
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON L8S 4L8, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, ON L8S 4L8, Canada
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Hegarty KL, Andrews S, Tarzia L. Transforming health settings to address gender‐based violence in Australia. Med J Aust 2022; 217:159-166. [PMID: 35796723 PMCID: PMC9546247 DOI: 10.5694/mja2.51638] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/09/2022] [Accepted: 06/16/2022] [Indexed: 12/02/2022]
Abstract
Gender‐based violence includes intimate partner violence, sexual violence and other harmful acts directed at people based on their gender. It is common in Australia and causes great ill health, especially for women victims/survivors, with Indigenous women particularly affected. Health services are an opportune place for early intervention for victims/survivors of gender‐based violence as they attend frequently. Interventions that are evidence‐based and respond to consensus from victim/survivor voices include universal education, screening in antenatal care, first line supportive care, and referral for advocacy and psychological interventions, including mother–child work. Health care staff require training, protocols, scripts, referral pathways, understanding of cultural safety and antiracist practice in service delivery, and leadership support to undertake this sensitive work, including support, if needed, for their own experiences of gender‐based violence. Using a trauma‐, violence‐ and gender‐informed approach across health systems, taking into account structural inequities, is essential to sustain the gender‐based violence work in health services. Gender‐based violence experienced by Indigenous women is distinct and of urgent concern as rates rapidly increase. Inequities across the health system are pronounced for Indigenous women.
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Affiliation(s)
- Kelsey L Hegarty
- Safer Families Centre University of Melbourne Melbourne VIC
- Centre for Family Violence Prevention, Royal Women’s Hospital Melbourne VIC
| | - Shawana Andrews
- Safer Families Centre University of Melbourne Melbourne VIC
- Melbourne Poche Centre for Indigenous Health University of Melbourne Melbourne VIC
| | - Laura Tarzia
- Safer Families Centre University of Melbourne Melbourne VIC
- Centre for Family Violence Prevention, Royal Women’s Hospital Melbourne VIC
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Carlin E, Cox Z, Orazi K, Derry KL, Dudgeon P. Exploring Mental Health Presentations in Remote Aboriginal Community Controlled Health Services in the Kimberley Region of Western Australia Using an Audit and File Reviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1743. [PMID: 35162765 PMCID: PMC8835535 DOI: 10.3390/ijerph19031743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/25/2022] [Accepted: 01/29/2022] [Indexed: 02/04/2023]
Abstract
The study aims to explore the role of mental health care in remote Aboriginal health services in the Kimberley region of Western Australia and provide a more nuanced understanding of the patients presenting for care, their needs, and the clinical response. Little is currently known about primary health care presentations for mental health, suicide, and self-harm for remote dwelling Aboriginal residents of the Kimberley region, despite high rates of psychological distress, self-harm, and suicide across the area. This study was progressed through a retrospective, cross-sectional audit of the electronic medical records system used by three remote clinics to explore the interactions recorded by the clinics about a patient's mental health. In addition, an in-depth file review was conducted on a stratified purposive sample of 30 patients identified through the audit. Mental ill-health and psychological distress were found to be prominent within clinical presentations. Psychosocial factors were frequently identified in relation to a patient's mental health presentation. Optimizing patients' recovery and wellness through service improvements, including an enhanced mental health model of care, is an important next step.
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Affiliation(s)
- Emma Carlin
- Kimberley Aboriginal Medical Services, Broome, WA 6725, Australia;
- The Rural Clinical School of Western Australia, The University of Western Australia, Broome, WA 6725, Australia;
| | - Zaccariah Cox
- Kimberley Aboriginal Medical Services, Broome, WA 6725, Australia;
| | - Kristen Orazi
- The Rural Clinical School of Western Australia, The University of Western Australia, Broome, WA 6725, Australia;
| | - Kate L. Derry
- School of Indigenous Studies, University of Western Australia, Perth, WA 6009, Australia; (K.L.D.); (P.D.)
| | - Pat Dudgeon
- School of Indigenous Studies, University of Western Australia, Perth, WA 6009, Australia; (K.L.D.); (P.D.)
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Toccalino D, Haag HL, Estrella MJ, Cowle S, Fuselli P, Ellis MJ, Gargaro J, Colantonio A. The Intersection of Intimate Partner Violence and Traumatic Brain Injury: Findings From an Emergency Summit Addressing System-Level Changes to Better Support Women Survivors. J Head Trauma Rehabil 2022; 37:E20-E29. [PMID: 34985037 DOI: 10.1097/htr.0000000000000743] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) occurring during intimate partner violence (IPV) is a largely unrecognized but significant public health crisis. One in 3 women will experience IPV in their lifetime, up to 75% of whom will sustain a TBI as a result. This article reports on the systems-level findings from a national summit to address barriers, needs, and priorities related to healthcare and support services for women survivors of IPV-TBI. OBJECTIVES (1) To identify key needs, facilitators, and barriers to care for women survivors of IPV presenting with TBI; and (2) to cocreate ideas for resources and principles for identification, clinical care, and support for healthcare practitioners who treat women exposed to IPV and TBI. METHODS Using a community-based participatory research approach, we engaged 30 stakeholders-drawn from a national IPV-TBI Knowledge-to-Practice (K2P) Network including diverse women survivors, service providers, researchers, and decision makers-in 2 half-day virtual meetings. Data were gathered through small group breakout sessions using semistructured discussion guides. Sessions were recorded, transcribed verbatim, and analyzed using thematic analysis techniques. Stakeholders contributed to the analysis and knowledge translation through member-checking activities. Ethics approval was obtained through the University of Toronto. FINDINGS Three main systems-level themes arose during these discussions: (1) the need for trauma-informed, anti-racist, and equitable health and social care systems; (2) the need for cross-pollination of knowledge between disciplines; and (3) the need for systems-level support for integrated and coordinated care. This article explores these needs and provides recommendations and suggestions for paths forward. CONCLUSIONS The findings of this project enhance understanding of system-level needs among women survivors and provide a template for a national agenda for IPV-TBI research and practice.
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Affiliation(s)
- Danielle Toccalino
- Institute of Health Policy, Management and Evaluation (Ms Toccalino and Dr Colantonio), Rehabilitation Sciences Institute (Ms Estrella and Dr Colantonio), Department of Occupational Science & Occupational Therapy (Dr Colantonio), and Dalla Lana School of Public Health (Dr Colantonio), University of Toronto, Toronto, Ontario, Canada; Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada (Ms Haag and Dr Colantonio); KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada (Mss Haag and Gargaro and Dr Colantonio); Parachute, Toronto, Ontario, Canada (Mss Cowle and Fuselli); Pan Am Concussion Program, Section of Neurosurgery, Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada (Dr Ellis); and Ontario Neurotrauma Foundation, Toronto, Ontario, Canada (Ms Gargaro)
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