Dissertations / Theses: 'Psychiatry Australia'

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Hogg, Miranda P. "Fitness to stand trial in Australia: The investigation and comparison of clinical opinion and legal criteria." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1998. https://ro.ecu.edu.au/theses/1452.

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The extent to which Australian psychologists and psychiatrists are cognisant of the legal standard for Fitness to Stand Trial (FST) was investigated. 198 psychologists from The Australian Psychological Society (APS), and 125 psychiatrists from The Royal Australian and New Zealand College of Psychiatrists (RANZCP) responded to a survey. Psychiatrists identified a greater number of legal criteria than psychologists. This finding extended across clinicians who had experience in the evaluation of fitness to stand trial and those who did not. No difference was found between psychologists and psychiatrists for mentioning irrelevant or insufficient considerations. However, a within-group analysis revealed that the most likely condition under which psychologists and psychiatrists were found to incorporate "mental state at the time of the offence" was when they had done between 1 and 4 evaluations. Membership of both the Forensic and Clinical Colleges of the APS and the Forensic Section of RANZCP was also associated with the ability to identify more of the relevant legal criteria. The methods that psychologists and psychiatrists use to establish FST differed and were found to reflect basic training. Psychiatrists rely on the use of the clinical interview and consultation with lawyers, regardless of whether the basis of the request for assistance is intellectual disability or mental disorder. Psychologists place much greater emphasis on the use of psychometric tests, particularly when intellectual disability is implicated. The results indicate that generally both psychologists and psychiatrists have an insufficient understanding of the legal criteria for fitness to stand trial. This investigation also points to the urgent need for the APS and RANZCP to ensure membership of their forensic college or section is conditional on the completion of a formal forensic training program. Directions for future research and practical implications are discussed.

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Menaglio, Darryl Frank. "Aims, separation and attitudinal factors in mediation: An exploratory investigation." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2003. https://ro.ecu.edu.au/theses/1327.

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The general aim of this research was to explore issues regarding mediation in family law about which there appears to be uncertainty. Study I investigated: (a) what stakeholders (practitioners and separated spouses) believe the aims of mediation should be; (b) what they believe are the effects of the separation factors, that is, perceived mutuality (whether the decision to separate was made by one or both spouses), perceived status (whether spouses view themselves as Ieavers, lefts or neither), and the attribution and strength of blaming someone for the decision to separate on attitudes towards engaging in mediation; and (c) stakeholders' views of the importance of the attitudinal factors (i.e. hope, expectation and commitment) for reaching agreement. The attitudinal factors were derived from Janis and Mann's (1977) theory of decision making. Study 2 investigated the operation of the separation and attitudinal factors in separated spouses attending mediation and the influence of specific biographical variables on these factors. The biographical variables were duration of separation, duration of marriage, gender and referral type. In Study I, 67 stakeholders (42 practitioners and 25 separated spouses) were of the opinion that spouses learning techniques to be able to resolve future disagreements should be the most important aim of the four aims of mediation suggested to them. Currently, the Family Law Act 1975 does not recognise this aim, though the finding is consistent with contemporary views of what the aim of mediation should be. Stakeholders also agreed that the separation factors substantially affect attitudes towards engagement in mediation and that the attitudinal factors are very important for reaching agreement. These findings are consistent with theories that suggest the separation factors influence engagement in mediation (Brown, 1985; Emery, 1994) and that the attitudinal factors are important for reaching agreement (Weitzman & Weitzman, 2000). In Study 2, 315 separated spouses (160 females, 155 males) attending court ordered (n = 150) and voluntary (n = 135) mediation responded to a questionnaire that sampled their biographical variables and the separation and attitudinal factors. Small significant χ2 measures (p < .001) revealed that the separation factors were associated. Specifically, when separated spouses perceived the decision to separate was non- mutual, they also were likely to perceive themselves as left or leavers. Those in the non-mutual, left group were more likely to blame and the majority of these were males. Analysis of a moderate significant Kendall rank correlation coefficient (p < .001) for the association between hope and commitment and weak/negligible associations between these factors and expectation revealed that separated spouses reported high levels of hope and commitment hut did not necessarily expect to reach agreement. Separated spouses who were court ordered were more likely to blame intensely (r = .24, p < .01), were less committed (w = .14, p < .001) and less expecting (w = .43, p < .001) to reach agreement than those who attended voluntarily. Expectation of reaching agreement was highest within 6 months of the decision to separate, while strength of blame for the decision to separate was most intense in those who were court ordered and those attending mediation within 6 months of the decision to separate. Implications of the findings for policy makers, assessment of separated spouses' readiness to engage in mediation and theory to guide mediation practice are discussed.

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Fenton, Sarah-Jane Hannah. "Mental health service delivery for adolescents and young people : a comparative study between Australia and the UK." Thesis, University of Birmingham, 2016. http://etheses.bham.ac.uk//id/eprint/7111/.

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This thesis explores policy and service delivery for adolescent and young adult or ‘transition age’ mental health service users aged 16-25 across different jurisdictions in the UK and Australia. The study explores the implications that policy formulation and implementation have for service delivery in these different contextual settings; and examines how young people (who are at a vulnerable stage developmentally in terms of mental health), have their access to services affected by the existing policy framework. A policy analysis was conducted along with qualitative interviews in six case sites (three in the UK and three in Australia). The thesis adopted a critical realist approach using a laminated cross-sectional interview strategy that was developed to include interviews with national policy makers; local policy makers and service managers; staff working within services; and the young people whom were accessing services as the recipients of policy. Findings from this thesis explore how young people use risk escalation as a way of managing delays to treatment and how practitioners identify particular difficulties for young people transitioning in services when they are due to ‘step up’ into more acute services, or ‘step down’ to a less intensive service. The thesis explores the implications and unintended consequences for young people of policy including processes of ‘cost-shunting’ and ‘resource envy’ at local and national levels. Finally, the thesis offers some learning for systems working to support 16-25 year olds through demonstrating the importance of the dual role of ‘curing’ and ‘caring’ in mental health services.

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Sadkowski, Marie. "Place-identity and homelessness : The restorative nature of the home." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1993. https://ro.ecu.edu.au/theses/1456.

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This research aims to address deficiencies in the Place-Identity literature and establish whether the home is a central and mediating environment within this theory. An exploration of the association between homelessness and Place-Identity provides a vehicle for clarifying the psychological role of the home and in doing so an increased awareness of this social problem is promoted. Korpela's (1989) and Kaplan's (1983) theories on place, accentuating active self-regulatory mechanisms and restorative environments, act as a catalyst and provide a solid foundation for this current research. The extensive literature on the home highlights the different conceptions that abound and the lack of consensus regarding the impact of this environment. The environmental psychology paradigm promotes an understanding of the mutuality between people and their environments and in line with this belief it is Sixsmith's (1986) model of the home emphasizing the complementarity of the physical, social and emotional components that is the most influential, raising questions as to whether privacy and socialization are central adaptive functions and whether the physical environment can create a means for them to be fostered. The accent of the research is placed on a comparative analysis between homeless and non-homeless youth aged between 12-20 living in Perth's inner and outer suburbs. A random sampling procedure was used to obtain the sample (40 homeless and 40 non-homeless). An exploratory study provided some verification for the connection between Place-identity and homelessness and directed the methodology. A structured interview format was used with the instrument for the main inquiry being devised through a collaborative process with input from the researcher, administrative personnel and homeless youth. Fndings consolidate the importance of Place-Identity theory and the role places potentially have in promoting a sense of self and in maintaining self-equilibrium. An appreciation of the perceptions held of the original and current home environments by the two groups (homeless/non-homeless) suggests that it is the home that has the potential to contribute substantially to self identity. Links are made with Korpela (1989) and Kaplan (1983) demonstrating how the current home environment can reduce the impact of prior negative experiences in the original home. This finding stimulates the development and extrapolation of tentative models of Place-Identity clarifying the role of the home in creating a sense of self and maintaining self-equilibrium whilst emphasizing the importance of Promoting active self-regulation particularly pertaining to privacy and socialization. The most salient feature being the way in which these two latter qualities are stimulated by the design of homes and how they impact on self-identity. From these models an appreciation of the role of the original home as a possible causative factor for homelessness is acknowledged and importantly suggestions as to how the current home can potentially 'break' the homeless cycle proposed. The ramifications of this research extend primarily into the areas of counselling and design with the information obtained being useful for youth workers, school counsellors, parents and all concerned with youth. There are also implications for designers and architects suggesting that more conducive environments emerge from a collaborative process which encourages a shared conception of place needs. Future research is needed to broaden an understanding of the homeless group by incorporating greater numbers to include a more extensive coverage of the three types of accomodation (short, medium and long term) and those 'on the streets'. Developmental influences on Place-Identity are intimated and also warrant further investigation. This research stimulates questions about the influence of places throughout the various stages of life. It creates a foundation for determining how the physical environment can be restorative for other alienated groups in society such as those in prisons, hospitals and refuges. It also lends itself to an exploration of cultural influences such as Aboriginality and Place-Identity where such information might assist integration in a similar way as a knowledge of Place-Identity might for the homeless. It is hoped that this research might prove instrumental in impacting on policy related to accommodation services for the homeless, promote an increased understanding of this issue and lead to a continuing interest in the promotion of self-identity through the physical environment.

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Lien, Debbie A. "The prediction of antenatal and postnatal depression in a sample of Western Australian women." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2007. https://ro.ecu.edu.au/theses/1558.

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In Australia, the Edinburgh Postnatal Depression Scale (EPDS; Cox, Holden & Sagovsky, 1987) has been increasingly used to screen for antenatal depression prior to its evaluation on a sample of Australian pregnant women. Also, the identification of predictors associated with antenatal depression has been neglected relative to the research focus on postpartum depression. An aim of the study was to evaluate the antenatal screening properties of the EPDS against diagnoses of major depression with the Mini International Neuropsychiatric Interview (MINI; Sheehan eta!., 1998). The aims were also to develop predictive models of risk factors associated with antenatal depression as measured by: (a) diagnosis of major depression (MINI); (b) depressive symptoms (EPDS 2: 9); (c) depression false positive results (EPDS 2:9, but no MINI diagnosis of major depression); and (d) depression level (EPDS total score) in the antenatal and early postnatal period. The study was prospective in design, with 200 women enrolled from Western Australia's largest public maternity hospital. An EPDS 2: 12 was identified to be optimum for the clinical screening of major depression at 32 weeks of pregnancy. The results from the different regression analyses showed that the strongest predictors of antenatal depression were: depression earlier in pregnancy, anxiety, stress, daily hassles, expectations of support, personality traits, and history variables. The findings were in support of routine screening for depression and anxiety during pregnancy, the effects of stress on mood, and the lesser importance of antenatal compared to postnatal variables in accounting for postpartum depression level.

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Smith, Michelle. "The role of Lorikeet Clubhouse in psychiatric rehabilitation." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2001. https://ro.ecu.edu.au/theses/1063.

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Previous studies have suggested that participation in psychosocial support groups such as the Foundation House (Clubhouse) model have psychological benefits for patients with major mental disorders. In this research, 47 members of the Lorikeet Clubhouse in Shenton Park, WA completed the Brief Symptom Inventory, the Level of Expressed Emotion Scale and the Coping Scale for Adults to investigate whether differences existed between active and inactive Clubhouse members. Analyses of variance found no group differences on these measures, although trends in the data suggest that Clubhouse participation have a protective effect for members who report high levels of expressed emotion (EE) in their home. These conclusions are tentative due to the small sample size. Members perceived the Clubhouse to have lower levels of EE than their home environments, however these measures were correlated.

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Allcock, Martin A. "A principled and pragmatic approach to cases of negligently inflicted psychiatric injury based on corrective justice and Kantian right." Thesis, Queensland University of Technology, 2018. https://eprints.qut.edu.au/118147/1/Martin_Allcock_Thesis.pdf.

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The history of legal liability for psychiatric injury caused by negligence has been marked by judges taking different approaches, some applying general principles while others have taken a more pragmatic and arbitrary approach due to concerns including the risk of unlimited liability. This thesis applies Ernest Weinrib's and Allan Beever's corrective justice theories of negligence to such claims and suggests an approach to the duty of care which demonstrates that a choice does not need to be made between a principled but unlimited and unworkable approach on the one hand, and a clear and predictable but arbitrary and unprincipled approach, on the other. Rather, it is argued in this thesis that the approach suggested by applying Weinrib's and Beever's theories to this area of law is both principled and workable.

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Maude, Phillip M. "The development of community mental health nursing services in Western Australia : A history (1950-1995) and population profile." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1996. https://ro.ecu.edu.au/theses/935.

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This descriptive• study discusses the development of community mental health (CMH) in Western Australia (WA) and describes the current practising population of CMH nurses. The study explores literature pertaining to the emergence of the CMH movement and the deinstitutionalisation of the mentally ill. A conceptual framework was developed by adapting Lewin's change theory. CMH nurses practising in WA (n= 130), were invited to participate in the study and were asked to complete a survey questionnaire. This resulted in a 66% response rate (n = 86). Quantitative data was analysed using the Statistical Package for the Social Sciences (SPSS). Open ended questions were analysed using Colaizzis steps. The study found that mental illness has been treated according to contemporary beliefs. In the 1950s multiple forces within society led to the movement away from institutionalisation of the mentally Ill toward deinstitutionalisation. The first community clinic was established in 1956 to manage the deficit between the ever expanding population needing mental health care and the paucity of available hospital beds. The need for follow up of clients in the community resulted in the development of CMH nursing. The study also provides a profile of the current practicing population of CMH Nurses in WA, demographic details, qualifications, the work environment, educational needs, work role and job satisfaction have been described. Recommendations have been developed from the findings and are directed towards, the dissemination of information, the need for role identification/development, staff development needs, future education needs, industrial issues, clinical practice issues and areas for further nursing research

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Rankin, Timothy. "Factors associated with anxiety, depression, burnout, and PTSD in Australian paramedics." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2019. https://ro.ecu.edu.au/theses/2249.

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Background Paramedics are at higher risk of anxiety, depression, burnout, and PTSD compared to the general population. Factors that have been associated with mental disorders include occupational stress, fatigue, sleep quality, chronic pain, physical activity, perceived social support, and overall quality of life. To date only a few of these factors have been investigated simultaneously in Australian paramedics. Aim This study aimed to investigate occupational stress, fatigue, sleep quality, chronic pain, physical activity, perceived social support, and overall quality of life, and their associations with anxiety, depression, burnout and PTSD in Australian paramedics. Methods Sixty-three paramedics, working for ambulance services in Australia, participated in this cross-sectional, self-reported study. Participants completed a questionnaire booklet composed of a demographics questionnaire, the Beck Anxiety Inventory, the Beck Depression Inventory-II, the Maslach Burnout Inventory - Human Services Survey, The Posttraumatic Stress Disorder Checklist - Civilian Version, the Emergency Medical Services Chronic Stress Questionnaire, the Chalder Fatigue Scale, the Pittsburgh Sleep Quality Index, the Orebro Musculoskeletal Pain Questionnaire, the Compendium of Physical Activities, the Multidimensional Scale of Perceived Social Support, and the Quality of Life Index. Results The prevalence of anxiety, depression, burnout and PTSD was higher in this study than what is reported in the general population of Australia. Moreover, the majority of these paramedics had one or more co-occurring mental disorders. Paramedics who reported higher levels of anxiety, depression and PTSD also reported increased occupational stress, greater levels of fatigue, poorer sleep quality, lower perceptions of social support, and significantly lower quality of life. Paramedics with burnout had significantly higher occupational stress and fatigue, and a lower quality of life when compared with paramedics without burnout. In addition, chronic pain was associated with increased levels of anxiety and depression. Conclusions Future research should be targeting interventions aimed at improving organisational and operational stress, fatigue, sleep quality, chronic pain and social support to improve anxiety, depression, burnout, and PTSD in Australian paramedics.

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Butler, D. A. "An evaluation of judicial approaches to determining tortious liability in negligence for psychiatric injury independent of physical injury in Australia and England." Thesis, Queensland University of Technology, 1996. https://eprints.qut.edu.au/35787/1/35787_Digitised%20Thesis.pdf.

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This thesis comprises an evaluation of existing and suggested approaches, and promulgation and defence of a preferred approach, to liability for psychiatric injury (or 'nervous shock') resulting from the unintentional conduct of another and occurring independently of any physical injury to the sufferer. Such a claim was first recognised a little over one hundred years ago but since that time the precise limits of liability for psychiatric injury has been an issue that has vexed courts in many jurisdictions. Even today there is no common approach to liability for psychiatric injury in Australia and England. This position is contributed to by the recent divergence in approaches to the determination of the existence of a duty of care in negligence in those countries. The thesis establishes a yardstick which is argued as being reflective of good judicial reasoning, at least as is appropriate to the subject of the enquiry, psychiatric injury. It then lays a foundation for the evaluation by an historical and analytical analysis of liability for psychiatric injury. The historical trace is set in the context of the development of the elements of the cause of action for negligence, including the recent divergence in approaches to duty, while the comparative analysis embraces decisions in Australia, England, Ireland, Scotland, New Zealand, Canada and the United States. In relation to the last mentioned, due to the lack of a federal attribute each state jurisdiction determines its own approach to the equivalent of liability for psychiatric injury, and there is no uniformly accepted response. Against this analysis, the thesis juxtaposes a medical perspective of 'nervous shock'. This perspective facilitates an evaluation of the medical legitimacy of past and current approaches and concepts and informs the promulgation of a preferred approach, including a more refined definition of the damage deemed worthy of compensation. The thesis also analyses the policy factors, or considerations of community welfare external to the interests of the parties to a particular dispute, that have shaped the limits of liability for psychiatric injury, including an assessment of the continued legitimacy of policy factors as measured against the yardstick for good judicial reasoning. It then proceeds to assess against the yardstick the continued legitimacy of individual concepts which have been promoted as being the appropriate limitations of liability. The thesis proceeds to critique the current approaches to duty of care in Australia and England, utilising psychiatric injury as a catalyst and evaluating the approaches against the yardstick. A literature review which critiques alternative approaches that have been suggested then follows. The climax of the thesis is the promulgation of a preferred approach, which draws on the analysis and evaluation throughout the thesis. This preferred approach advocates a more specific definition of the damage deemed worthy of compensation, an accommodation of an overt identification and assessment of relevant policy considerations, an incremental approach to the establishment of duty of care and greater emphasis upon the other elements of the negligence cause of action. This preferred approach is demonstrated as conforming to the yardstick and is accordingly defended as reflective of good judicial reasoning.

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Donoghue, Kathleen J. "Perceived harms and benefits of parental cannabis use, and parents’ reports regarding harm-reduction strategies." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2015. https://ro.ecu.edu.au/theses/1592.

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This research focussed on families in which at least one parent was a long-term cannabis user; I explored family members’ perceptions of the benefits and harms of cannabis use and the strategies parents used to minimise cannabis-related harm to themselves and their children. In depth, semi-structured interviews were undertaken with 43 individuals from 13 families, producing a series of family case studies that enabled examination of multiple perspectives within each family. In Study 1, I used an interpretive framework guided by Miles and Huberman’s (1994) thematic content analysis technique to analyse interview data, while study 2 yielded detailed descriptive vignettes that examined how the use of cannabis played out in particular families. Cannabis users have been portrayed as stereotypically lazy, unhealthy, deviant, and criminal. However, this was not the case with the current sample, whose lifestyles revolved around employment and family life. Parents claimed to use cannabis in a responsible way that minimised harm to self and family. Few reported personal experiences of harm and most did not believe that their children had been adversely affected by their use of cannabis. Nonetheless, children’s awareness of parental cannabis use, and access to the parent’s cannabis supply, occurred at a younger age than parents suspected. Parents reported harm reduction strategies that targeted five broad areas: (1) Dosage control; (2) Dependency; (3) Acute risk; (4) Long-term harm; and (5) Harm to children. The current study points to common-sense ways of reducing harm, such as being discreet about cannabis use; using less potent strains; prioritising family and work responsibilities; being careful about where cannabis was obtained; not mixing cannabis with tobacco; and limiting any financial outlay. The harm reduction strategies identified in this research might be helpful in the forensic evaluation, safety planning, and treatment of parental cannabis use. The validity of the current findings was enhanced by having independent data on the same topic from each family member’s point of view, including non-using partners and children, and by including both convergent and divergent data.

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Connell, Mong L. "A study of the cultural appropriateness of service delivery models in the Australian mental health system." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2002. https://ro.ecu.edu.au/theses/714.

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This study is an attempt to examine the cultural appropriateness of the mental health system in relation to the Vietnamese refugee community in Australia. Culture and mental health, as widely acknowledged in the field of transcultural psychiatry, are closely linked. No aspect of the diagnosis or treatment methods can be justified without reference to the cultural traditions of the mental health system and the client. In a country like Australia, where multiculturalism is a dominant feature of the society, the need is even greater in incorporating culture into every aspect of the mental health system, if it desires to provide a culturally appropriate service to all immigrant groups. Every immigrant group brings with them different cultural values and attitudes. Included in these are viewpoints about mental health/illness that can diverge distinctly from those belonging to the more prevalent Anglo-Saxon cultural norms. How the illness is perceived as to its cause, treatment to healing are different in most cultures. According to the Australian Bureau of Statistics (1996), Vietnamese immigrants form one of the largest displaced people ever to be accepted into Australia as refugees. Their history of escape from the communist regime in Vietnam have sparked worldwide concerns about the state of their mental health. Their journey of escape is not without torture and trauma. Once settled into a country like Australia, they face many settlement obstacles. The cultural and social adjustments that they have to undergo have made them one of the most vulnerable and disadvantaged immigrant groups in Australia. Faced with such a group that have a high predisposition to mental stress and anxiety, the question lies in whether the Australian mental health system is sufficiently informed and prepared to provide a service which has relevance and meaning to these people. I argue that the system has not adequately provided a service to such a purpose. Although much progress and research has been done, it still operates very much within a Western philosophy. Its traditions, values and attitudes reflect a worldview that make little cultural sense to these people. Its racist assumptions and attitudes which promote cultural superiority of the West has resulted in a system labelled as culturally inefficient. Racism has been socially constructed and entrenched within the system for many years and it's origins are lost in the history of Western culture. Its mental health system is essentially monocultural. Culturally inappropriate diagnostic and treatment programmes and a shortage of professionals with the necessary linguistic, cultural and clinical competencies are just some of the deficiencies that exist within the system. Many training programmes have failed to evoke practitioners into questioning the effectiveness and cultural appropriateness of these fundamental structures supporting existing models of service delivery. This study is done through a discussion of the history of racism, certain important concepts, for example, culture and mental health/illness and the social, historical and political experience of the Vietnamese. The rest of the research focuses on certain specific barriers of accessibility and concludes with how these barriers can be addressed. In doing so, it advocates for a totally non-racist approach from an international to a personal level of service. Only through this approach can the mental health system claim to provide a service that is culturally sensitive and meaningful.

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Ku, Tan Kan. "Culture and stigma towards mental illness : a comparison of general and psychiatric nurses of Chinese and Anglo-Australian backgrounds /." Connect to thesis, 2007. http://repository.unimelb.edu.au/10187/8400.

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A sample of 208 nurses (a response rate of 63%) participated in a study by responding to a questionnaire comprising of 170 items which examined nurses’ attitudes towards mental illness, and the association between contact, cultural values, general and practice stigma. General stigma refers to attitudes towards the mentally ill while practice stigma is informed from differential clinical practice approaches towards the care of two case vignettes describing a patient with mental illness and one with diabetes. Subjects were recruited using the snowballing technique and comprised of nurses (83 Anglo Psychiatric, 41 Anglo General, 49 Chinese Psychiatric and 35 Chinese General) currently practising in Victoria. Age ranged from 21 to 65 years. Principal components analyses were conducted on items to develop subscales related to individualism and collectivism, contact types, general and practice stigma. Analyses of variance and covariance were conducted to examine differences between nurse type and ethnicity and respectively, to account for possible differences in background, contact and in the case of practice stigma, general stigma.
The key findings revealed differences according to nurse type and ethnicity in several of the subscales. Psychiatric nurses endorsed a higher level of contact than general nurses with mentally ill people on the variables ‘Contact Through Work Situation’, ‘Patient Help Nurses’ and ‘External Socialisation with Patient’, but not on the variable ‘Relative With Mental Illness’. By virtue of more contact, psychiatric nurses also endorsed less general stigma than general nurses, assessed by results from analysing social distancing, but not by negative stereotyping of people with mental illness. With respect to practice stigma, while care and satisfaction did not differ according to patient type and nurse type, psychiatric nurses expressed less authoritarianism and negativity than general nurses towards the mental illness case than general nurses while lesser differences between nurse types were evident for the diabetes case. Chinese nurses when compared with Anglo-Australian nurses, endorsed more highly collectivist values measured by the variables ‘Ingroup Interdependence’ and ‘Ingroup Role Concern’ but there was no difference in individualist values. This may reflect acculturation towards Western values but also retention of Chinese values, interpreted in the light of other results on cultural affiliation, as a bicultural position. Chinese nurses endorsed more highly general stigma towards the mentally ill than Anglo nurses when statistically controlling for differences in background demographics and contact factors.
Nursing satisfaction did not differ in ethnicity and patient type. Chinese nurses endorsed more highly care and authoritarianism in their clinical practice approaches than Anglo-Australian nurses, although there was no significant interaction effect between ethnicity and patient type on care and authoritarianism. Chinese nurses endorsed more highly negativity than Anglo-Australian nurses for the mental illness case than the diabetes case, an effect later shown to be mediated by differences in general stigma between the two ethnic groups. Within the Chinese sample, higher contact was associated with lower differential negativity for the mental illness than the diabetes case. Several path analyses suggested Chinese values influenced differential negativity, mediated by general stigma and prior diversified contact with people having a mental illness.
It may be concluded from these results that practice stigma is related to cultural values but the relationship is mediated by general stigma and contact. What aspect of the Chinese values specifically correlates with general stigma remains a question for further research, but several possibilities are discussed.

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Soar, Rod. ""Drugs on the mind" : dual diagnosis : the experience of mental health professionals." University of Ballarat, 2003. http://archimedes.ballarat.edu.au:8080/vital/access/HandleResolver/1959.17/15384.

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Recent publicity has focused on the problems created by the usage of illicit drugs in the community. The growing use of illicit drugs throughout the Grampians region and the lack of resources and professional services available to regional and rural areas raise many questions as to treatment options and the accessibility and appropriateness of drug and alcohol and mental health services. Despite the fact that mental health professionals in rural/regional areas are expected to deliver the most appropriate care to individuals with a comorbid drug and alcohol and psychiatric disorder, a number of these rural/regional mental health professionals have limited preparation and experience in dealing with dual diagnosis issues. This phenomenological study focuses on the area of dual diagnosis, specifically the experiences of health professionals who care for clients diagnosed with a serious mental illness and a coexisting drug and alcohol disorder. Results are described in the form of four themes, which emerged from data collected during in-depth interviews with 13 mental health professionals who care for clients with a dual diagnosis. The themes captured in this research will be described using metaphors as headings. The first theme Sink or swim represents mental health professionals’ initial preparation to care for this group of complex clientele. Treading water symbolises mental health professionals’ endeavours to keep their head above water and reflects on their feelings while endeavouring to do so. Rowing against the tide describes mental health professionals’ understanding of clients’ drug misuse, which impacts greatly on the level of care.
Master of Nursing

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Steel, Zachary Psychiatry Faculty of Medicine UNSW. "Mental disorder amongst people of Vietnamese background: prevalence, trauma and culture." Publisher:University of New South Wales. Psychiatry, 2008. http://handle.unsw.edu.au/1959.4/40888.

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The role that culture and trauma plays in shaping mental health outcomes continues to dominate debate in the field of transcultural and post-conflict mental health. The broad aim of this thesis is to investigate key issues relevant to these two factors in relation to the Vietnamese. A meta-analysis of international epidemiological research indicated that countries of North and South East Asia appear to manifest low rates of mental disorder compared to English-speaking countries. A meta-regression analysis of research undertaken specifically with refugee and conflict-affected populations, confirmed a robust association between torture and general trauma and risk to mental disorder. The thesis then examines data from three population-based mental health surveys: 1,161 Vietnamese-Australian residents in the state of New South Wales; 3,039 Vietnamese resident in the Mekong Delta region of Vietnam; and 7,961 Australian-born persons drawn from a national survey. All surveys applied the Composite International Diagnostic Interview, with the Vietnamese surveys also applying the Phan Vietnamese Psychiatric Rating Scale, an indigenously-derived measure of mental disorder. The ICD-10 classification system yielded lowest rates amongst Vietnamese in the Mekong Delta, intermediate amongst Vietnamese in NSW; and highest rates amongst the Australian-born population. The Phan Vietnamese Psychiatric Rating Scale added a substantial number of cases in both Vietnamese samples. The findings suggest that sole reliance on a western-derived measure of mental disorder may fail to identify a cases of mental disorder across cultures. Trauma remained a substantial risk factor for mental disorder amongst Australian Vietnamese accounting for a substantial portion of the total burden of mental disorder in that population. The implications of these findings in developing a more refined model for understanding the mental health consequences of mass trauma across cultures are discussed.

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Finn, Michael P. "Perceptions of discharge planning needs : A study of discharge planning in the mental health setting." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 1995. https://ro.ecu.edu.au/theses/1158.

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Major mental disorder, with prolonged periods of dysfunction that require long term care, is an issue of concern amongst mental health professionals. Although substantial effort and resources are devoted towards returning mentally ill individuals to the community, one of the most distinctive and consistent features of the persistently mentally ill (PMI) is their high rate of readmission to hospital. Existing studies into discharge planning revealed that no research had been undertaken to determine if this is the case in Western Australia. This study sought to investigate perceptions of discharge planning held by patients, carers, nurses and allied health workers involved in discharge preparation in a major metropolitan psychiatric hospital operated by the Health Department of Western Australia. Eighty one subjects were selected from the four principal groups involved in care in this mental health setting, consisting of patients ( n = 21 ), carers ( n = 20 ), nurses ( n = 22 ) and allied health workers ( n = 18 ). Perceptions of discharge planning of these subjects were evaluated and compared using the Discharge Priorities Rating Scale. Farran, Carr & Maxson's model of goal congruence in discharge planning was used to guide this study. Significant differences were found to exist in the perceptions of discharge planning between patients, carers, nurses and allied health workers. Differences in perceptions are seen to have a detrimental effect on the discharge planning process, resu1ting in unnecessary and frequent readmission to hospital and the perpetuation of institutional dependency. Whilst the results of this study can only be applied to similar institutions, the findings are relevant for the persistently mentally ill who have patterns of frequent readmissions across the public and private mental health service settings. The results obtained indicate that nurses can facilitate effective discharge planning practices by adopting a more assertive role in the hea1th care team, in communicating patients' and their carers' concerns and promoting a more collaborative approach to care.

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Barrelle, Kate. "Referrals to clinical psychologists : effects of the perceived identity of the referral source." Master's thesis, 1996. http://hdl.handle.net/1885/143950.

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18

Banfield, Michelle A. "Scope for research : study of consumer priorities for research on depression and bipolar disorder in Australia." Phd thesis, 2010. http://hdl.handle.net/1885/151093.

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There is growing acceptance of the importance of the consumer viewpoint in mental health research. Previous studies have identified differences in research priorities for researchers and mental health consumers in Australia defined broadly (e.g., Jorm, Griffiths, Christensen & Medway, 2002a). However, little is known about the research priorities of consumers with specific mental health conditions. The aim of the SCOPE for Research project was to inform future directions for research on depression and bipolar disorder in Australia. This was achieved through the qualitative and quantitative exploration of consumer priorities and a comparison of these priorities with published Australian research. Phase 1 comprised focus groups with consumers and individual telephone interviews with consumer advocates. Participants were asked to discuss topics, groups and settings they believed were priorities for depression or bipolar disorder research. They were also asked to describe the factors that influenced their priority-setting and to identify their sources of information on mental health research. A qualitative analysis was conducted to identify major themes and construct a survey for the second phase of the project. In Phase 2, participants were asked to rate the importance of each topic, group or setting on a 5-point scale. Phase 3 of the project consisted of a thematic analysis of Australian published research on depression and bipolar disorder from 1997-2006 and comparison of the consumer survey results with published research. The most frequently cited themes in Phase 1 included the need for research on medication, and lifestyle and psychosocial influences on depression and bipolar disorder. Participants expressed reluctance to prioritise particular subpopulation groups and favoured community-wide research in community settings. They cited personal experience as the strongest influence on their priority-setting and most commonly sourced their information on depression and bipolar disorder research from the Internet. In Phase 2, participants rated research into the topic areas management and treatment as the top priorities. The highest rated target groups for research focused on people most at risk and Phase 2 participants prioritised research conducted in outpatient health settings such as community mental health services. As in Phase 1, the majority of participants were influenced by their own personal experience when setting priorities. The most common sources of information were mental health organisations and the Internet. Most published research identified in Phase 3 concerned lifestyle and psychosocial influences, causes, and description & characteristics of depression and bipolar disorder. Many studies targeted groups based on age and research was primarily conducted in the community. The comparison of the results of the Phase 2 consumer survey with the Phase 3 literature survey revealed more differences than similarities between the priorities of consumers and the current research output. This project represents an important contribution to the process of actively involving consumers in mental health research in Australia. It provides insight into the areas of most concern to the people who are the ultimate beneficiaries of research, the mental health consumers, and the findings can be used as a guide to ensure relevant research.

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Bannister, Justine. "Abuse, attachment, mentalising and mental disorders in youth refuge residents." Thesis, 2006. http://hdl.handle.net/1885/150133.

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Kelly, Claire. "The mental health literacy of Australian adolescents." Phd thesis, 2005. http://hdl.handle.net/1885/150294.

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21

McFarlane, Alexander Cowell. "The psychiatric sequelae of a natural disaster : the 1983 Ash Wednesday bushfires / Alexander Cowell McFarlane." 1990. http://hdl.handle.net/2440/38364.

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Typescript (Photocopy)
Includes bibliographies
3 v. ;
Title page, contents and abstract only. The complete thesis in print form is available from the University Library.
Thesis (M.D.)--Dept. of Psychiatry, University of Adelaide, 1990

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Dunlop, Robyn. "‘Psychiatry at the Coal Face’: patients and the development of community mental health services in New South Wales, Australia, 1960–1980." Thesis, 2021. http://hdl.handle.net/1959.13/1432897.

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Research Doctorate - Doctor of Philosophy (PhD)
The second half of the twentieth century was a period of major reform in the administration of mental health in Western democracies, when the orientation of state mental health services turned from legally certified to voluntary patients and psychiatric treatment moved from hospital to community settings. This thesis tells the story of reform of the administration of mental health during the development of community mental health services from 1960 to 1980. It positions the changing role of the patient as crucial to these reforms. I argue that Newcastle and the surrounding Hunter Valley region in New South Wales, Australia, was a site of particular importance in genealogies of patients. Newcastle, an industrial, regional city, was undergoing shifts representative of wider demographic and economic trends in the West during this period, and was the location for experimentation in the administration of mental health. These developments were linked to the emergence of patient rights and obligations, and developments influenced psychiatry and medical education. While the changing authority of patients in the administration of mental health has received little scholarly attention, in this study I argue that it has a central place in mental health histories. I demonstrate this by reconstructing the rollout of voluntary patient and community mental health services for implied patients in New South Wales in 1960-1980, with particular reference to Newcastle. I read source material against the grain to bring social and cultural perspectives to developments that shaped, and were negotiated by, patients. I draw on material from academic, health administration and community sectors, held in the David Maddison Collection in the University of Newcastle Archives, New South Wales, Australia; oral history interviews with former mental health staff and family members of patients; government reports; and interviews and published material by patients available in the public domain. In doing so I expose the lineage of twenty-first century mental health patient roles. I argue that changes in patients and services reflected an expansion in what mental health services were seen to address, and that approaches trialled in the administration of mental health have had a powerful influence on public health policy over time.

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23

Kordes, Doris. "The arts of care in an asylum and a community 1925-2004: Kenmore Hospital, New South Wales and Canberra, the Australian Capital Territory." Phd thesis, 2009. http://hdl.handle.net/1885/155196.

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This thesis examines the arts of care in an asylum in New South Wales (NSW) and a mental health community in the Australian Capital Territory in twentieth-century Australia, and describes and compares a range of governmental responses for responding to persons deemed to be in need of care. The thesis explores similarities between twentieth-century Australian care techniques and the key principles underpinning a ‘care system’ that was developed over 200 years ago. It proposes three twentieth-century care regimes, each one characteristic of a certain period: Herd Care, set in an asylum era that emphasised custodialism and confinement (1925-1958); Therapeutic Community, a period during which the asylum was reconfigured into a facilitative community (1959-1983); and Community Care, beginning around 1983, when NSW asylums were ‘rationalised’, their care techniques fragmented and outsourced in diverse settings generally referred to collectively as the mental health community. Some of the dynamics, continuities and ruptures in twentieth-century care regimes are analysed. Chapters describe the landscapes of care. They explore how environmental settings have been designed to reinforce the care regimes in which they are mobilised and how they ‘make up’ the possibilities for action of the subject of care. The dynamics of care between care providers and their recipients are examined. Some of the continuities and discontinuities of meanings associated with ‘family’ and ‘community’ in each of the care regimes are observed. Fieldwork findings are combined with the cultural narrative of psychiatric primitivism to consider why subjects have been deemed in need of care, at times in need of protection and training and at other times in need of discipline and restraint. The new possibilities for action that have emerged in Australian twentieth-century mental health governance are considered, when subjects of care have been encouraged to learn how to be free

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Warelow, Philip John. "The significance of gender to Australian psychiatric nursing." Thesis, 2003. https://researchonline.jcu.edu.au/1257/1/01front.pdf.

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This research has critically examined, using a historical method and discourse analysis, some of the many issues related to gender in Australian psychiatric nursing. More specifically, it has explored how gender and gender differences amongst Australian psychiatric nurses evolved, their significance, how they are maintained, and some of their continuing influences and effects in respect to the nature and role of the psychiatric nursing profession. A major focus of the research has been the explication of the published discourse since 1788 in the context of Australia's social and cultural development, including more recent changes in professional and health service organisations and education. These have also been interpreted within the context of international developments, and have contained lines of inquiry relating to gender, the sexual division of labour, role stereotypes, patriarchy, feminism and the history of psychiatry. Using a discourse analysis and historical criticism, the principal aim of the research is a recovery of the past, which seeks to understand more clearly the meaning of associated discourses and texts so they can be used as a knowledge base and a resource. This will enable the current nursing workforce to use these understandings productively and by adding meaning, to benefit from the wisdom of the past. Recommendations of this thesis include the need for health services and human resources to be more pro-active in adopting gender-neutral recruitment strategies and in constructing nursing as a job for men, and in embracing a less gendered conception of nursing. It is suggested that recruitment should be targeting people who are suited to the work, emphasising the role function and taking a more egalitarian approach. Whilst gender is important, it is argued that if we continue to assume that only females can care we are taking a shortsighted view, and that many males provide high quality care. The thesis recommends that the comprehensive nurse education programmes offered by universities and other educational institutions need to increase the psychiatric nursing components of their undergraduate degrees. This extended curriculum should include the topic of gender, as well as the history of psychiatric nursing. The range of skills that particular genders bring to nursing and the crossover of gender markers might be a useful starting point for this. This research argues that the comprehensive nurse education programmes in Australia do not adequately prepare nurses to work in mental health settings, and that separate training programmes for nurses working in mental health are to be preferred. Psychiatric nursing is conceived as a specialty, which needs to be treated as such.

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Coxon, Robert Andrew. "Battlefield trauma (exposure, psychiatric diagnosis and outcomes)." 2008. http://hdl.handle.net/2440/50423.

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These original data for this research were documented in the clinical diary records of an army psychiatrist on deployment in Vietnam during 1969–70. This study is unique due to the original battlefield diagnosis data used for foundation comparison analysis and longitudinal retrospective case control paired measurement. In battlefield psychiatric assessment diagnostic data recorded in Vietnam during 1969–70 of 119 Australian military servicemen (Experimental group) who presented battlefield trauma exposure reactions were examined. The research case controls (Control group) are 275 Australian Vietnam veterans selected from data at the Australian War Memorial Research Centre. Case control identified participants did not present with medical symptoms in 1969-70 and presented the same demographic profile as the Experimental group population. This research examined whether initial psychiatric illnesses initiated by battlefield trauma exposure in 1969-70 by a cohort of Vietnam veterans would have long term pernicious effects on their physical and psychological health, relationships and employment status. This research compared, PTSD, delayed onset PTSD, severity of combat exposure and depressive symptoms, quality of dyads, general health and quality of life. The analysis of specific demographic variables determined the means, standard deviations, and medians for those continuous variables for both groups from 1969-70 (n=394) and 2006-07 (n=97). The 2006-07 Experimental group (n=21) represents 17.65% and the Control group (n=76) represents 28.15% of the original groups selected and matched from 1969-70 data. These participants completed a battery of psychometric questionnaires and a follow up telephone interview. Demographic variables were evaluated for inclusion as covariates. These demographic variables were correlated with combat exposure and the presentation of PTSD in 1969-70 and 2006-07. PTSD identified in 2006-07 was modelled as a latent variable with three manifest indicators (re-experiencing, hyper-arousal and avoidance). Categorical variables were determined by frequency tables for respective group participants. Group differences in continuous variables were analysed by t-test or the Wilcoxon signed rank sum test accounting for non-normal distributions. Categorical variables, chi-square tests or Fisher's Exact Tests were performed when assumptions of chi-square tests were violated. Research participants from 1969-70 and 2006-07 did not indicate a significant difference in demographic, categorical or continuous variables. Initial 1969-70 battlefield psychiatric diagnosis TSD did indicate of a causal link to delayed onset PTSD in research participants in 2006-07. The PTSD (2006-07 diagnosis) indicated a descriptive difference, 64 of the 76 Control met the diagnostic criteria, while 19 of the 21 Experimental met the criteria. A significant difference was identified in the 2006-07 presence and severity of depression, two symptoms (intrusion and avoidance) of PTSD and the reported combat exposure. The prevalence of delayed onset PTSD was also highlighted. Obtaining original battlefield psychiatric diagnoses is rare. Comparison with an identifiable Control group after 35 years informs knowledge of how military personnel cope with battlefield exposure. Specifically concluding that; battlefield exposures during 1969-70 for the majority of the research participants have impacted detrimentally on their psychological and physical health, relationships, employment and ongoing overall wellbeing to this day. Delayed onset PTSD is the principal indicator of this current state for these veterans.
Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2008

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26

Coxon, Robert Andrew. "Battlefield trauma (exposure, psychiatric diagnosis and outcomes)." Thesis, 2008. http://hdl.handle.net/2440/50423.

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These original data for this research were documented in the clinical diary records of an army psychiatrist on deployment in Vietnam during 1969–70. This study is unique due to the original battlefield diagnosis data used for foundation comparison analysis and longitudinal retrospective case control paired measurement. In battlefield psychiatric assessment diagnostic data recorded in Vietnam during 1969–70 of 119 Australian military servicemen (Experimental group) who presented battlefield trauma exposure reactions were examined. The research case controls (Control group) are 275 Australian Vietnam veterans selected from data at the Australian War Memorial Research Centre. Case control identified participants did not present with medical symptoms in 1969-70 and presented the same demographic profile as the Experimental group population. This research examined whether initial psychiatric illnesses initiated by battlefield trauma exposure in 1969-70 by a cohort of Vietnam veterans would have long term pernicious effects on their physical and psychological health, relationships and employment status. This research compared, PTSD, delayed onset PTSD, severity of combat exposure and depressive symptoms, quality of dyads, general health and quality of life. The analysis of specific demographic variables determined the means, standard deviations, and medians for those continuous variables for both groups from 1969-70 (n=394) and 2006-07 (n=97). The 2006-07 Experimental group (n=21) represents 17.65% and the Control group (n=76) represents 28.15% of the original groups selected and matched from 1969-70 data. These participants completed a battery of psychometric questionnaires and a follow up telephone interview. Demographic variables were evaluated for inclusion as covariates. These demographic variables were correlated with combat exposure and the presentation of PTSD in 1969-70 and 2006-07. PTSD identified in 2006-07 was modelled as a latent variable with three manifest indicators (re-experiencing, hyper-arousal and avoidance). Categorical variables were determined by frequency tables for respective group participants. Group differences in continuous variables were analysed by t-test or the Wilcoxon signed rank sum test accounting for non-normal distributions. Categorical variables, chi-square tests or Fisher's Exact Tests were performed when assumptions of chi-square tests were violated. Research participants from 1969-70 and 2006-07 did not indicate a significant difference in demographic, categorical or continuous variables. Initial 1969-70 battlefield psychiatric diagnosis TSD did indicate of a causal link to delayed onset PTSD in research participants in 2006-07. The PTSD (2006-07 diagnosis) indicated a descriptive difference, 64 of the 76 Control met the diagnostic criteria, while 19 of the 21 Experimental met the criteria. A significant difference was identified in the 2006-07 presence and severity of depression, two symptoms (intrusion and avoidance) of PTSD and the reported combat exposure. The prevalence of delayed onset PTSD was also highlighted. Obtaining original battlefield psychiatric diagnoses is rare. Comparison with an identifiable Control group after 35 years informs knowledge of how military personnel cope with battlefield exposure. Specifically concluding that; battlefield exposures during 1969-70 for the majority of the research participants have impacted detrimentally on their psychological and physical health, relationships, employment and ongoing overall wellbeing to this day. Delayed onset PTSD is the principal indicator of this current state for these veterans.
Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2008

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27

Smith, Terrence Gordon, University of Western Sydney, of Arts Education and Social Sciences College, and School of Humanities. "'With tact, intelligence and a special acquaintance with the insane' : a history of the development of mental health care(nursing) in New South Wales, Australia, Colonisation to Federation 1788 - 1901." 2005. http://handle.uws.edu.au:8081/1959.7/31368.

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During the earliest days of the penal colony in New South Wales in 1788, the plight of the mentally ill was given little consideration by the governing authorities, particularly the convict insane, who lived (and died) by their wits and suffered cruel punishment if their behaviour was seen as recalcitrant. This thesis traces a history of mental health carers (nursing) from the foundation of the penal colony until the Federation of the Australian colonies to form a nation in 1901. The research makes a contribution to the profession of mental health nursing by providing an understanding of the origins and development of that profession in New South Wales. The thesis also examines ways in which the historic development of mental health nursing has influenced the work of mental health nurses and nursing in the present, and exposes recurrent dominant issues of the past which will, if they remain unaddressed, continue to influence that profession in the future.
Doctor of Philosophy (PhD)

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28

Petrie, Eileen Margaret. "Action research in preventing workplace burnout in rural remote community mental health nursing." 2008. http://hdl.handle.net/2440/51601.

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The social phenomenon of stress and workplace burnout has spanned over five decades. Despite a plethora of literature that exists, there still remain problematic issues that neither scientific investigation or government legislation have been able to resolve. The literature examined throughout this research is extensive and does reflect this 50-year period. It demonstrates that studies into this phenomenon have attempted to define stress, identify causal factors of workplace stress, workplace burnout and environmental congruence; and discusses strategies (focused on both the individual and organizational levels) that have been implemented to effect beneficial outcomes for individuals affected by any one of these. As this thesis continues, the more recent literature gives a greater recognition to violence in the workplace and legislative enactments as preventative measures to reduce the heavy burden of costs, both physical and financial, to organizations. This extensive literature review indicates no answer to the problem has been identified to date and that this phenomenon remains, giving a clear indication that further scientific investigation is required to find a solution to what was described as the most serious health issue of the 20th century. Based on the literature examined this health issue has now gone well beyond the 20th century, giving relevance to the research study described in this thesis. The investigation is validated as vital and should be used as a basis for further research. This study undertook a collaborative social process, action research, empowering participants to identify and change stressful factors identified within their practice indicative to rural remote community mental health teams. A critical social theory arose out of the problems within the context of the research setting, based on the ideal that the significant issues for this group of individuals within this organization could be solved through the action research process. The group ‘existed’ within the issues indicative to this rural remote area, however these issues were outside their control. Through the implementation of the action research process courses of actions were undertaken that provided enlightenment in self-knowledge with dialogue heightening collective empowerment to effect change within their practice. The action research process, being a holistic process, facilitated this change in practice, developed and refined theory as it proceeded in a cyclic fashion within this local setting. It concerned actual not abstract practices in the social world in which these participants practice. This methodology facilitated examining the significant stressors identified by the Community Mental Health Support Team (CMHST) that caused distress, allowing them to implement changes in their practice. The forum provided an avenue that could reduce stressors significantly and prevent ongoing occupational stress that contributes to workplace burnout. It offered an opportunity to work with a group of participants in a nonhierarchical and non-exploitative manner and enabled members of this group to identify their roles as effective practitioners, empowering them to effect the changes they deemed as essential criteria to reduce the stress they were experiencing indicative to their remoteness. Critical reviewing throughout the data collection attempted to understand and redefine these significant issues. It aimed to acknowledge the way things were relative to how things could be improved from organizational, personal and wider community perspectives. Simple principles and guidelines of action research were followed potentiating acceptance as a rigorous research approach from a positivist perspective whilst retaining the attributes that characterise action research. There are solutions to the dilemma of the employee overcoming the debilitating effects of stress leading to workplace burnout. This includes the cooperation of managers, policy makers, academic researchers and government officials working collaboratively to reduce the impact of occupational stress. Through this collaborative process, changes can be effected to ensure the health of the nation improves and that relevant recognition is given to the fact that there is a significant threat to a healthy workforce. Examining the nursing profession from a social perspective provides alternatives to medicalising workplace injuries and illnesses.
Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2008

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29

Petrie, Eileen Margaret. "Action research in preventing workplace burnout in rural remote community mental health nursing." Thesis, 2008. http://hdl.handle.net/2440/51601.

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Abstract:

The social phenomenon of stress and workplace burnout has spanned over five decades. Despite a plethora of literature that exists, there still remain problematic issues that neither scientific investigation or government legislation have been able to resolve. The literature examined throughout this research is extensive and does reflect this 50-year period. It demonstrates that studies into this phenomenon have attempted to define stress, identify causal factors of workplace stress, workplace burnout and environmental congruence; and discusses strategies (focused on both the individual and organizational levels) that have been implemented to effect beneficial outcomes for individuals affected by any one of these. As this thesis continues, the more recent literature gives a greater recognition to violence in the workplace and legislative enactments as preventative measures to reduce the heavy burden of costs, both physical and financial, to organizations. This extensive literature review indicates no answer to the problem has been identified to date and that this phenomenon remains, giving a clear indication that further scientific investigation is required to find a solution to what was described as the most serious health issue of the 20th century. Based on the literature examined this health issue has now gone well beyond the 20th century, giving relevance to the research study described in this thesis. The investigation is validated as vital and should be used as a basis for further research. This study undertook a collaborative social process, action research, empowering participants to identify and change stressful factors identified within their practice indicative to rural remote community mental health teams. A critical social theory arose out of the problems within the context of the research setting, based on the ideal that the significant issues for this group of individuals within this organization could be solved through the action research process. The group ‘existed’ within the issues indicative to this rural remote area, however these issues were outside their control. Through the implementation of the action research process courses of actions were undertaken that provided enlightenment in self-knowledge with dialogue heightening collective empowerment to effect change within their practice. The action research process, being a holistic process, facilitated this change in practice, developed and refined theory as it proceeded in a cyclic fashion within this local setting. It concerned actual not abstract practices in the social world in which these participants practice. This methodology facilitated examining the significant stressors identified by the Community Mental Health Support Team (CMHST) that caused distress, allowing them to implement changes in their practice. The forum provided an avenue that could reduce stressors significantly and prevent ongoing occupational stress that contributes to workplace burnout. It offered an opportunity to work with a group of participants in a nonhierarchical and non-exploitative manner and enabled members of this group to identify their roles as effective practitioners, empowering them to effect the changes they deemed as essential criteria to reduce the stress they were experiencing indicative to their remoteness. Critical reviewing throughout the data collection attempted to understand and redefine these significant issues. It aimed to acknowledge the way things were relative to how things could be improved from organizational, personal and wider community perspectives. Simple principles and guidelines of action research were followed potentiating acceptance as a rigorous research approach from a positivist perspective whilst retaining the attributes that characterise action research. There are solutions to the dilemma of the employee overcoming the debilitating effects of stress leading to workplace burnout. This includes the cooperation of managers, policy makers, academic researchers and government officials working collaboratively to reduce the impact of occupational stress. Through this collaborative process, changes can be effected to ensure the health of the nation improves and that relevant recognition is given to the fact that there is a significant threat to a healthy workforce. Examining the nursing profession from a social perspective provides alternatives to medicalising workplace injuries and illnesses.
Thesis (Ph.D.) - University of Adelaide, School of Population Health and Clinical Practice, 2008

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Dissertations / Theses on the topic 'Psychiatry Australia'

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