Research Projects within the School

BLliNG DM Study: Breastfeeding Length Intensity in Gestational Diabetes Mellitus (site investigators). Identification of community providers on patients’ admission to hospital

Gestational diabetes mellitus (GDM) is a condition of high blood glucose that is diagnosed in pregnancy. Gestational diabetes effects 7.5% of pregnant women in NSW, with a future risk seven–fold higher for developing type 2 diabetes, than a women who has an unaffected pregnancy. There is an increase in pregnancy complications in women with GDM including birth defects, preeclampsia, low birth weight, preterm birth, cesarean sections and macrosomia. Research has found in women who had GDM, breastfeeding is a protective factor in reducing the development of type 2 diabetes and subsequently a lower cardiovascular risk such as heart disease. At two years after birth, women who exclusively breastfeed their infants have been found to be half as likely to develop type 2 diabetes than woman who fed their infants with breast milk substitutes or infant formula. The longer the duration and intensity of breastfeeding the greater the benefit.

Aim:

The aim of our study is to investigate women who have had GDM in their first pregnancy, assess if length and intensity of breastfeeding and less interpregnancy weight gain will reduce the risk of GDM in the next pregnancy. We will also gather information on problems a women may have experienced with her breastfeeding to improve support for women with GDM and better target breastfeeding education.

Researchers:

Associate Professor Virginia Stulz, Western Sydney University

Current Status:

In Progress

Contact:

Associate Professor Virginia Stulz

Phone: 0408 427 612

Transitioning into a new graduate midwife – perspectives about a unique student-led continuity of care model – Acacia Clinic

This is a sequential mixed methods study that explores transitioning new graduate midwive’s experiences participating in a student-led midwifery model of care known as the Acacia Clinic in the workforce.This research will provide insights regarding the transitioning into new graduate midwives from a student-led midwifery group practice and greater understanding of the realities of the application of the continuity of care model in the midwifery workplace context.

Aim:

To evaluate transitioning new graduate midwives’ experiences about a student-led midwifery group practice.

Researchers:

Associate Professor Virginia Stulz
Dr Rakime Elmir
Heather Reilly
Richard Gilfillan

Current Status:

In Progress

Contact:

Associate Professor Virginia Stulz

Phone: 0408 427 612

Sterile water injections for relief of back pain in labour – a qualitative study

Only one study (Lee, Kildea & Stapleton, 2017) in Australia has investigated the qualitative aspects of using this form of pain relief during labour. This aforementioned study is different to the one we are proposing as we propose to include midwives in our study and the women are a sub set of a randomised control trial whereas this study is qualitative design and includes both women and midwives’ experiences. The National Institute for Health and Care Excellence Guidelines (NICE, 2017) suggest that there is a dearth of evidence pertaining to individual women’s experiences of using sterile water injections during labour and this project addresses this gap. Our search of the literature also revealed that there is no literature exploring midwives’ experiences and perceptions about administering sterile water injections as a form of pain relief for back pain during labour.

Aim:

The aim of this research is to obtain women’s and midwives’ views and perceptions about the experiences of using sterile water injections as a method of pain relief for back pain during labour.

Researchers:

Associate Professor Virginia Stulz
Dr Elaine Burns
Heather Reilly

Current Status:

In Progress

Contact:

Associate Professor Virginia Stulz

Phone: 0408 427 612

Evaluation of a Student-led Midwifery Group Practice: a woman’s perspective – Acacia Clinic

This is a qualitative exploratory mixed methods study that explores women’s experiences and level of satisfaction about a student-led midwifery model of care known as the Acacia Clinic. The women will be asked about the benefits and drawbacks of the student-led clinic, why this clinic is different from other models of care and the level of impact on the woman’s physical, psychosocial, emotional, intellectual, spiritual and cultural needs during pregnancy. Demographic data will be collected from the Maternity database- E-Maternity detailing birth and perinatal details.

Aim:

To evaluate women’s experiences of a student-led midwifery group practice.

Researchers:

Associate Professor Virginia Stulz
Heather Reilly
Dr Rakime Elmir
Richard Gilfillan

Current Status:

In Progress

Contact:

Associate Professor Virginia Stulz

Phone: 0408 427 612

Exploring student midwives’ experiences (ESME) in NSW using appreciative inquiry research study method.

Appreciative inquiry will be used to explore what works well, and will create an understanding of why they work well, in relation to the student midwife experience. Appreciative Inquiry is a method for uncovering the ‘positive core’ within a unit/organisation; the central premise is seeking out ‘what gives life’ to both the organisation and crucially to those within the organisation (Sharp et al., 2017; Sharp et al., 2016). From this, experimentation in action will take place to enable the identified good practices to happen more of the time. Professor Dewar has developed a model of cultural development based on appreciative inquiry which has been tested in nursing home and general nursing settings, this has yet to be tested out in the midwifery setting (Dewar & Nolan 2013; Dewar, Barrie, Sharp & Meyer, 2017; Dewar & Cook, 2014) and why this study is so important.

Aim:

To work collaboratively with key stakeholders (student midwives, midwives) to generate an experience based understanding of what is working well in relation to the student midwife experience and from this understanding, co-create ways to enhance the experience.

Researchers:

Associate Professor Virginia Stulz, Western Sydney University
Professor Belinda Dewar, University of West Scotland & Tamsin MacBride

Current Status:

In Progress

Contact:

Associate Professor Virginia Stulz

Phone: 0408 427 612

Does using a peanut ball during labour with an epidural affect birth outcomes? A pilot study

The peanut ball has only been recently used as a support for women labouring with epidurals. The peanut ball is shaped like a peanut and fits snugly between the woman’s legs so that both legs are maintained as opening the pelvic outlet to increase the progress of labour and facilitate descent of the fetal head. Using position changes during labour to enhance widening of the pelvic outlet can be beneficial but a woman who has an epidural is limited in the number of positions she can adopt. No randomised controlled trial has been implemented in Australia to establish the effectiveness of a peanut ball specifically for women using epidurals during labour and this project addresses this gap. The main aim of this pilot study is to assess the feasibility and practicality of conducting and replicating this trial to a definitive randomised controlled trial (RCT). A minimum number of 50 women will be recruited who are using an epidural in labour at two hospitals in NSW over a one year

Aim:

The primary aim of this research as a pilot study is to assess the feasibility of doing a larger study that focuses on recruitment strategies, sample size and data input by midwives and recording in progress notes in an intervention group that uses a peanut ball for pregnant women who have an epidural during labour and a control group that does not use the peanut ball. The assessment of secondary endpoints is to determine if the peanut ball makes clinically significant different outcomes by comparing the intervention group that uses the peanut ball and the control group that does not use the peanut ball.

Funding:

$10,000 Western Sydney University and Nepean Blue Mountain Local Health Distirct

Researchers:

Associate Professor Virginia Stulz
Associate Professor Kenny Lawson
Heather Reilly

Current Status:

In Progress

Contact:

Associate Professor Virginia Stulz

Phone: 0408 427 612

Aged Care Research Projects

FRailty meAsureMEnt in Heart Failure Study (FRAME-HF)

Frailty is a complex clinical syndrome associated with decline across several physiological systems and increased vulnerability to acute stressors. Frailty is strongly associated with heart failure and is a predictor of poor health outcomes including hospitalisation and death. There is high variation in the prevalence of frailty in HF ranging from 15-79%, depending on the assessment instrument used. To date, there are no validated frailty assessment instruments for use in people with heart failure; this could explain the significant heterogeneity, and hence, variability in classifications of frailty. The most commonly used instrument is the Frailty Phenotype, which defines frailty as a syndrome of increased vulnerability to acute stressors, causing age-related physical decline. Despite being frequently used to assess frailty in people with heart failure, the validity of this instrument for use in those with heart failure have yet to be determined.

Aims:

This will be achieved using data from the FRAME-HF study which consists of three discrete, though interrelated studies; 1) the comparison and validation of a number of different frailty assessment tools to ascertain the most appropriate measurement tool for use in people with heart failure; 2) the predictive validity of each frailty instrument in people with heart failure

Funding:

NSW Health PhD Scholarship in partnership with the University of Technology Sydney $45,000.

Researchers:

Professor Phillip Newton
Dr Caleb Ferguson
Professor Peter Macdonald - St Vincent's Hospital, Sydney
Victor Chang Cardiac Research Institute
Professor Patricia Davidson - Johns Hopkins University
Dr Sunita Jha - University of Technology Sydney
Ms Julee McDonagh - University of Technology Sydney
Ms Ros Prichard - University of Technology Sydney

Current Status:

In progress

Outcomes:

McDonagh J, Ferguson C, Newton PJ. Frailty assessment in heart failure: an overview of the multi-domain approach. Current Heart Failure Reports. 2018;15:17-23 McDonagh J, Martin L, Ferguson C, Jha SR, Macdonald PS, Davidson PM, Newton PJ. Frailty assessment instruments in heart failure: a systematic review. European Journal of Cardiovascular Nursing. 2017;17:23-35

Contact:

Professor Phillip Newton

Phone: 0411 057 056

Email: p.newton@westernsydney.edu.au

Chronic Care Research Projects

Cardiac and Vascular Health Research Projects

FRailty meAsureMEnt in Heart Failure Study (FRAME-HF)

Aims:

This will be achieved using data from the FRAME-HF study which consists of three discrete, though interrelated studies; 1) the comparison and validation of a number of different frailty assessment tools to ascertain the most appropriate measurement tool for use in people with heart failure; 2) the predictive validity of each frailty instrument in people with heart failure

Funding:

NSW Health PhD Scholarship in partnership with the University of Technology Sydney $45,000.

Researchers:

Professor Phillip Newton
Dr Caleb Ferguson
Professor Peter Macdonald - St Vincent's Hospital, Sydney
Victor Chang Cardiac Research Institute
Professor Patricia Davidson - Johns Hopkins University
Dr Sunita Jha - University of Technology Sydney
Ms Julee McDonagh - University of Technology Sydney
Ms Ros Prichard - University of Technology Sydney

Current Status:

In progress

Outcomes:

McDonagh J, Ferguson C, Newton PJ. Frailty assessment in heart failure: an overview of the multi-domain approach. Current Heart Failure Reports. 2018;15:17-23 McDonagh J, Martin L, Ferguson C, Jha SR, Macdonald PS, Davidson PM, Newton PJ. Frailty assessment instruments in heart failure: a systematic review. European Journal of Cardiovascular Nursing. 2017;17:23-35

Contact:

Professor Phillip Newton

Phone: 0411 057 056

Email: p.newton@westernsydney.edu.au

Chronic Conditions Research Projects

Patient-centred medical homes model of primary care for improving patient outcomes and reducing the risk of hospitalisation in high risk patients

Patients presenting with multiple chronic conditions have complex health care needs that are challenging to manage in primary care. Studies suggest that the Patient-Centred Medical Home (PCMH) model of primary care is more effective than standard care for improving clinical outcomes in patients with chronic diseases (non-communicable diseases), but the strength of the evidence base is unclear. This is a large industry-driven multicentre study investigating the effectiveness of a model of primary care based on PCMH principles for improving patient outcomes and reducing the risk of hospitalisation in high risk patients. This research is supported through a PhD scholarship of the Health Market Quality Program, Capital Markets Cooperative Research Centre (CMCRC).

Aims:

The primary aim of this research is to determine the effectiveness of a PCMH model on chronic disease management among primary health care settings. Specific aims include:

To systematically identify and review the evidence from controlled trial evaluating the effectiveness of PCMH models of primary care in chronic disease management.
To evaluate changes in the clinical outcomes of patients enrolled in the PCMH evaluation group after 12 months of intervention compared to patients under usual GP care.
To determine the effectiveness of PCMH model of care in reducing the risk of hospitalisations.
To assess changes in patients’ level of activation and health-related quality of life before and after 12-month PCMH model of care.

Funding:

CMCRC PhD Scholarship of $180,000.

Researchers:

Dr Evan Atlantis – principal supervisor
Associate Professor Federico Girosi – co-supervisor and Chief Scientist & Director of Research Digital Health Cooperative Research Centre (DHCRC)
Dr Steve Frost – co-supervisor
Professor Uma Srinivasan – DHCRC
Dr Ehsan Zare-Borzeshi – DHCRC
Dr Shima Ghassem Pour – The University of Sydney
James Rufus John – PhD

Current Status:

In progress

Outcomes:

James Rufus John, Shima Ghassempour, Federico Girosi, Evan Atlantis. The effectiveness of patient-centred medical home model versus standard primary care for chronic disease management: a systematic review protocol, Systematic Reviews, in press.

Contact:

Dr Evan Atlantis

Phone: +61 2 4620 3263

Email: e.atlantis@westernsydney.edu.au

National Association of Clinical Obesity Services (NACOS) research group

There are approximately one million Australians aged 18-65 years living with clinically severe obesity. Expert guidelines recommend that these individuals be considered for referral to specialist care where they could potentially access a range of specialist treatments such as intensive lifestyle and medical interventions including bariatric surgery. In reality, a recent study by the Clinical Obesity in Public Hospitals (COSiPH) research working group indicates that patient access to clinics, specialised services, and treatments is limited by strict entry criteria, prolonged waiting times, geographical location, as well as out-of-pocket costs. The COSiPH was established in 2017 and voted at its second annual meeting in 2018 to immediately transition into a national association. As a result, the National Association of Clinical Obesity Services (NACOS) was established on 26 October 2018. The NACOS research group members along with a range of stakeholders are working on a broad programme of activities to generate evidence based policies and practices for improving the quality of obesity care. We use a practical model of scientific inquiry to generate evidence for improving clinical obesity services.

Aims:

At the core of these activities is our vision to improve the quality of obesity care; including equitable access to specialist care clinics and intensive treatments. Specific aims include:

To describe the current state of public specialist obesity services for adults in Australia
To develop recommendations to address the current resource gaps and future needs based on consensus of expert opinion
To develop and validate a prioritisation system for obesity care
To investigate the health burdens associated with clinically severe obesity in adolescents
To determine unhealthy diet patterns and nutritional deficiencies associated with obesity and weight-loss
To investigate nutritional deficiencies associated with obesity in adults
The describe the burden of complex obesity in Australia
To develop expert recommendations for standard baseline data collections in obesity management clinics
To investigate predictors of non-completion of intensive public hospital clinical obesity services
To investigate physical capacity benefits from intensive public hospital clinical obesity services

Funding:

Clinical obesity services nationwide, Novo Nordisk Pharmaceuticals Pty. Ltd.

Researchers:

Dr Evan Atlantis – principal investigator
Associate Professor Kenny Lawson
Mr Paul Fahey
Dr Steve Frost
Dr Milan Piya
Dr Vincent Ho
Mr Ahmad Aly – Austin Hospital, University of Melbourne
Dr Amy Osborne – St. Vincent’s Melbourne
Professor Brian Oldfield – Monash University
Professor Gary Wittert – The University of Adelaide
Professor Ian Caterson – The University of Sydney
Professor John Dixon – Baker Heart and Diabetes Institute, Swinburne University of Technology
Professor Katherine Samaras – St. Vincent’s Hospital Darlinghurst, Garvan Institute of Medical Research
Dr Kathryn Williams – Nepean Hospital, The University of Sydney
Ms Kellie Fusco – The University of Adelaide
Dr Lucy Ding – Royal North Shore Hospital
Dr Nic Kormas – Campbelltown & Camden Hospitals, Concord Repatriation General Hospital
Associate Professor Paul Dugdale – Australian National University, Australian Capital Territory Health Directorate
Dr Priya Sumithran – Austin Health Weight Control Clinic, University of Melbourne
Associate Professor Samantha Hocking – Royal Prince Alfred Hospital, The University of Sydney
Dr Ramy Bishay – Blacktown Hospital, Western Sydney University
Dr Sarah Glastras – Royal North Shore Hospital
Associate Professor Tania Markovic – Royal Prince Alfred Hospital, The University of Sydney
Professor Timothy Gill – The University of Sydney
Dr Viral Chikani – The Princess Alexandra Hospital
Associate Professor Zumin Shi – Qatar University, The University of Adelaide

Current Status:

In progress.

Outcomes:

Papers:

Atlantis E; Nic Kormas; Katherine Samaras; Paul Fahey; Priya Sumithran; Sarah Glastras; Gary Wittert; Kellie Fusco3 Ramy Bishay; Tania Markovic; Lucy Ding; Kathryn Williams; Ian Caterson; Viral Chikani; Paul Dugdale; John Dixon. Clinical Obesity Services in Public Hospitals (COSiPH) in Australia: a position statement based on expert consensus (2018). Clinical Obesity, 8 (3), 203-210.
Lih A, Pereira L, Bishay R, Zang J, Omari A, Atlantis E, Kormas N. (2015) A novel multi-disciplinary intervention for long-term weight loss and glycaemic control in obese patients with diabetes. Journal of Diabetes Research, Volume 2015, Article ID 729567, 7 pages.
Cheema BS, Davies TB, Stewart M, Papalia S, Atlantis E. (2015) The feasibility and effectiveness of high-intensity boxing training versus moderate-intensity brisk walking in adults with abdominal obesity: A pilot study. BMC Sport Science, Medicine and Rehabilitation, 7 (1), 3.
Ramachandran D, Atlantis E, Hocking S, Markovic T, Gill T. Standardised baseline data collections in obesity management services in Australia: Recommendations from an expert panel, under review.
Evan Atlantis Fang Lin, Sulak Anandabaskaran, Paul Fahey, Nic Kormas. Predictors of non-completion of an intensive specialist obesity service in a public hospital: a case-control study, under review.

Conferences (invited):

1.2018, ANZOS-Breakthrough Discoveries Joint Annual Scientific Meeting 2018, 16-18 October, Melbourne, Australia. Chair – Head of the COSiPH working group, Breakfast Symposium: ‘Medical and surgical management of obesity in multidisciplinary clinics’.
2017 National Eating Disorders & Obesity Conference, 7-8 August 2017, Gold Coast, Australia. ‘Efficacy and scalability of intensive lifestyle and medical treatment for complex obesity in Australian public hospitals’.

Conference Papers (free):

Evan Atlantis; Nic Kormas; Katherine Samaras; Paul Fahey; Priya Sumithran; Sarah Glastras; Gary Wittert; Kellie Fusco; Ramy Bishay; Tania Markovic; Lucy Ding; Kathryn Williams; Ian Caterson; Viral Chikani; Paul Dugdale; John Dixon. Clinical Obesity Services in Public Hospitals (COSiPH) in Australia: a position statement based on expert consensus. ANZOS-Breakthrough Discoveries Joint Annual Scientific Meeting 2018, Melbourne, 16th - 18th October 2018.
Ramachandran D, Atlantis E, Hocking S, Markovic T, Gill T. Standardised baseline data collections in obesity management services in Australia: Recommendations from an expert panel. ANZOS-Breakthrough Discoveries Joint Annual Scientific Meeting 2018, Melbourne, 16th - 18th October 2018.
Anandabaskaran S, Atlantis E, Lin F, Andriani R, Fahey P, Kormas N. Predictors of non-completion of an intensive lifestyle and medical service for severe obesity in a public hospital setting. ANZOS-OSSANZ-AOCO Joint Annual Scientific Meeting 2017, Adelaide, Australia, 4th - 6th October 2017.
Atlantis E, Nundlall N, Fahey P, Kormas N. Efficacy of an intensive lifestyle and medical treatment for severe obesity in the public hospital setting: a case series. ANZOS-OSSANZ-AOCO Joint Annual Scientific Meeting 2017, Adelaide, Australia, 4th - 6th October 2017.
Cheema B, Davies TB, Stewart M, Papalia S, Atlantis E. Feasibility and Effectiveness of High-Intensity Boxing Training Versus Moderate-Intensity Brisk Walking in Obese Adults: 861 Board# 257 May 27, - Medicine & Science in Sports & Exercise, 2015. 62nd Annual Meeting of the American College of Sports Medicine, San Diego, CA, USA, 2015.

Contact:

Dr Evan Atlantis

Phone: +61 2 4620 3263

Email: e.atlantis@westernsydney.edu.au

Lung, Sleep and Heart Health Research Projects

Beyond forest plots: clinical gestalt and its influence on COPD telemonitoring studies and outcomes

Researchers:

Professor Sheree Smith, Western Sydney University
Professor Anne Holland, Deakin University
Professor Christine McDonald, University of Melbourne

Status

In progress

Contact:

Phone: +61 2 4620 3532

Improving Patient Recall in COPD Improving Patient Recall in COPD

Researchers:

Professor Sheree Smith, Western Sydney University
Joseph Descallar, Ingham Applied Medical Research Institute
Professor Guy Marks, UNSW

Current Status:

In progress

Contact:

Phone: +61 2 4620 3532

Pain measurement tools in COPD clinical practice – review of validity, reliability and responsiveness

Researchers:

Alisha Johnson, Western Sydney University
Professor Sheree Smith, Western Sydney University

Current Status:

In progress

Contact:

Phone: +61 2 4620 3532

Understanding Response Shift in COPD

Researchers:

Professor Sheree Smith, Western Sydney University
Ana Schippers, Liverpool Hospital
Professor Guy Marks, UNSW

Current Status:

In progress

Contact details:

Phone: +61 2 4620 3532

Critical Care Research Projects

Pressure injuries amongst adults admitted into Intensive Care.

Pressure injuries, represent a common but potentially preventable condition among patients admitted to hospital. Patients at the highest-risk are the elderly, those with physical impairments, and the critically ill. For this reason the prevention of pressure injuries has been identified as an important area of nursing care given to patients admitted to the intensive care unit (ICU). Importantly, preventable in many cases, pressure injuries result in a significant burden to patients and the health care system â€“ resulting in pain, increased risk of infection, morbidity and mortality, increased length of stay in hospital, and raised financial costs. Preventing pressure injuries is considered a core aim of healthcare organizations, and can be highlighted as an important task among all nurses in the intensive care setting.

Aims:

Review and describe the current risk tools used to identify patients at risk of pressure injuries in the ICU
Estimate the utility of the Waterlow and Braden tools to identifying patients at greatest risk of pressure injuries in the ICU setting
Describe the incidence and burden of pressure injuries among adults admitted to intensive care in the SWSLHD
Identify risk factors for the development of pressure injuries among adults admitted to ICU across the LHD
Develop and validate, an ICU specific risk prediction tool, that can individualize the absolute risk of pressure injury during an ICU stay
Develop interventions to prevent pressure injury, that will be specifically targeted at patients, identified at the time of admission to ICU, to be at the highest risk pressure injury.

Researchers:

Dr Stephen Frost
Joan Lynch
Dr Leanne Hunt
Prof Martin Christensen
Grant Isedale

Current Status:

In progress

Contact:

Leanne Hunt

Phone: +61 2 4570 1676

Email: l.hunt@westernsydney.edu.au

The Deli Study: Delirium in ICU

Delirium independently contributes to mortality and morbidity of patients in Intensive care and increases hospital length of stay by 10 days. Management of patients with delirium is resource intensive as they often require one-to-one nursing due to restlessness and agitation. Good evidence exists supporting the prevention and early detection as the best way to manage delirium. Nurses are the front-line health care providers to patients in the Intensive Care Unit and therefore provide the opportunity to enable an evidence-based nursing-led intervention to prevent delirium and reduce its burden. Recent studies using interventions targeting risk factors to prevent delirium in the ICU have shown significant promise of the efficacy of such programs. This study will evaluate the effectiveness of a bundle of nursing-led evidence-based interventions called the Delirium Prevention Nursing Protocol in prevention and management of delirium in Intensive Care patients.

Expected Outcomes:

The delirium-prevention nursing protocol is expected to reduce the incidence and severity of delirium. Secondary outcomes measures include a reduction in the length of stay of patients with delirium.

Dissemination of research findings will occur through the NSW Agency for Clinical Innovation who promote best practice and evidence based services models for Intensive Care across NSW. In addition, dissemination will occur through publication in peer reviewed nursing journals and presentation at national and international nursing conferences.

Researchers:

Joan Lynch
Dr Steve Frost
Leanne Hunt

Current Status:

In progress

Contact:

Leanne Hunt

Phone: +61 2 4570 1676

Email: l.hunt@westernsydney.edu.au

Assessing the feasibility of a mentoring program for young adults with intellectual disability at a community Men’s Shed (2015-2018)

People with intellectual disability face many disadvantages in their life including education, work, social relationships and health. Much of this disadvantage starts during the transition from school years to adulthood. Many young people with intellectual disability join a transition to work programme after school, but these don’t always work that well partly as they don’t involve “real-life” work settings. Many Men’s Sheds across Australia have mentoring programs and some of these involve young people with intellectual disability. The activity- and social-based context of Men’s Sheds make them a potentially ideal location for young adults with intellectual disability to learn some work skills and work behaviours. With targeted and timely support from trained mentors at Men’s Sheds, young adults with intellectual disability can potentially become more “job-ready” than from a traditional transition to work program.

Aim:

The aim of this project was to see whether a work-skills intergenerational mentoring project at Men’s Sheds for young adults with intellectual disability is feasible and appropriate.

Funding:

WA Disability Services Commission (Dr Louisa Alessandri Research Grant): $40,000.

Researchers:

Dr Nathan J Wilson
A/Prof Reinie Cordier
Prof Angus Buchanan
A/Prof Marina Ciccarelli
Dr Annette Joosten
A/Prof Judy MacCallum
Dr Sharmila Vaz

Research Partners and Affiliations

Therapy Focus (opens in a new window)
Curtin University
Murdoch University
West Australian Men’s Sheds Association
Mosman Park Men’s Shed
Kalamunda Men’s Shed

Current Status:

Completed

Outcomes:

Wilson, N.J., Buchanan, A., MacCallum, J., Ciccarelli, M., Vaz, S., Joosten, A., Milbourn, B. & Cordier, R. (2016). Supporting the transition to adulthood for youth with intellectual disabilities through intergenerational mentoring at Men’s Sheds: A pilot study. Journal of Intellectual Disability Research, 60 (7-8), 820.

Wilson, N. J., Cordier, R., Cicarrelli, M., MacCallum, J., Milbourn, B., Vaz, S., Joosten A., Buchanan, A., McAuliffe, T. & Stancliffe, R. J. (2017). Intergenerational mentoring at Men’s Sheds: A feasibility study. Journal of Applied Research in Intellectual Disabilities. doi: 10.1111/jar.12338.

Contact:

Dr Nathan J Wilson

Phone: +61 2 4570 1926

Email: n.wilson@westernsydney.edu.au

Underpinning the development of future disability nursing standards (2017-2018)

The UN Convention (Articles 25 and 26 in particular) states that people with disabilities have the right to the highest attainable standard of health and to maintain a maximum level of social and economic participation. People with intellectual and developmental disability (IDD) experience poorer health outcomes than the general population and many remain socially and economically marginalised. Nurses who work with people with IDD are central to reversing this disadvantage as they work in a multi-faceted role at the intersection of health, social and economic outcomes.

Yet, the specialised role of nurses working with people with IDD has been disregarded and has come under threat at different points in time. The advent of the National Disability Insurance Scheme (NDIS) in Australia brings about a significant and major policy change where nurses with expertise in working with people with IDD will be at the forefront of the uncharted intersection between health and social services. It is a crucial historical moment to reposition and build the capacity of nursing of people with IDD.

Aim:

This 1-year proposal will utilise an evidence-based and collaborative approach to conduct a literature review and exploratory research to underpin the future redevelopment of the PANDDA Standards.

Funding:

Professional Association of Nurses in Developmental Disability, Australia Inc.: $76,000.

Researchers:

Dr Nathan J Wilson
Dr Peter Lewis
Dr Michele Wiese
Ms Kate O'Reilly
Mr Hayden Jacques

Research Partners and Affiliations:

The Professional Association of Nurses in Developmental Disabilities, Australia (PANDDA)

Current Status:

Complete

Outcomes:

Wilson, N.J., Wiese, M., Lewis, P., Jaques, H, & O’Reilly, K. (2018). Nurses working in intellectual disability-specific settings talk about the uniqueness of their role: A qualitative study. Journal of Advanced Nursing. DOI:10.1111/jan.13898

Wilson, N.J., Lewis, P., O’Reilly, K., Wiese, M., Lin, Z., Devine, L., Booley, R., Jaques, H. & Goddard, L. (2018). Reframing the role, identity and standards for practice for registered nurses working in the specialty area of intellectual and developmental disability in Australia: The NDIS and beyond. Collegian. Doi: 10.1016/j.colegn.2018.06.002

O’Reilly, K., Lewis, P., Wiese, M., Goddard, L., Trip, H., Conder, J., Charnock, D., Lin, Z., Jaques, H. & Wilson, N.J. (2018). An exploration of the practice, policy and legislative issues of the specialist area of nursing people with intellectual disability: A scoping review. Nursing Inquiry, 25(4). e12258. doi: 10.1111/nin.12258

Jaques, H., Lewis, P., Wiese, M., O’Reilly, K. & Wilson, N.J. (2018). Understanding the contemporary role of the intellectual disability nurse: A review of the literature. Journal of Clinical Nursing, 27(21-22), 3858-3871. Doi: 10.1111/jocn.14555

Access the Final Report (opens in a new window).

Contact:

Dr Nathan J Wilson

Phone: +61 2 4570 1926

Email: n.wilson@westernsydney.edu.au

Analysis of NSW Family and Community Services client death notification (CDN) database (2017-2018)

Description:

There is a growing trend in the general community to reclaim dying and death as a collective social responsibility, reversing the medicalised or institutionalised way of death common throughout much of the 20th century. Identifying where people with intellectual disability die and the relationships between health and service variables at the time of death assists us to determine whether this trend is also common for one of society’s most vulnerable and socially marginalised groups.

Aims:

We will use a de-identified version of the FACS CDN database, that records place of death and associated factors for the period 2011 – 2015 inclusive, to determine:

The place of death of people with intellectual disability who, at the time of death, had as their principal place of residence an ADHC funded out-of-home care residential service (i.e., excluding those who died in respite care)
Summarise place-of-death patterns across the years for which there is available data.
Identify and summarise associated variables about place of death.

Funding:

NSW Family & Community Services ($21,059) and the SoSSP ($10,000)

Researchers:

Dr Michele Wiese (SoSSP)
Dr Nathan J Wilson (SoNM)
Dr Daniel Piepers (SoSSP)
Prof Roger J Stancliffe
Dr Seeta Durvasula

Partners and Affiliations:

Centre for Disability Research and Policy and the Sydney Medical School
University of Sydney.

Current Status:

Complete

Contact:

Dr Michele Wiese

Phone: +61 2 4736 0067

Email: M.Wiese@westernsydney.edu.au

Education and Workplace Research Projects

Implementing and Evaluating an Oral Health (IMPLORE) Project

In nursing practice, oral care is considered as one of the most fundamental elements of nursing activities. Yet, it is recognised that qualified nurses lack adequate knowledge to provide oral care of patients. Despite the transfer of nursing education to the tertiary education sector in recent decades across the globe, knowledge deficit among nurses regarding the health benefits, and importance of providing oral care to patients persists, and continues to be reported. A key contributing factor could be that few nursing programs embed oral health care into their curricular content, including Australian undergraduate nursing education programs. To address this issue in the nursing curriculum, in 2018, the Western Sydney University undergraduate nursing program introduced a web-based interactive oral health education module into a first year nursing unit, Primary Health Care in Action.

Aims:

This project aims to evaluate the implementation of the web-based oral health module in the 401001 unit of the undergraduate nursing program. In particular, the project aims to examine the relationships between academic engagement (indicated by hit rates) in the oral health module, performance in the oral health component in their final exam and students overall performance in the unit, taking into account the demographic characteristics of students. Insights from this evaluation will provide information to improve the embedding of specialized web-based learning content into nursing curriculum.

Researchers:

Associate Professor Ajesh George - Western Sydney University
Professor Yenna Salamonson - Western Sydney University
Ms Elizabeth Curtis - Western Sydney University
Ms Amy R. Villarosa - Western Sydney University
Dr Anna Wallace - Western Sydney University

Current Status:

In Progress

Contact:

Associate Professor Ajesh George

Phone: +61 2 8739 9356

Professor Yenna Salamonson

Examining Resilience and Grit among Students in Midwifery and Nursing Programs: The ERGATE Project

A sequential mixed method design will be used to examine the profile and experiences of commencing students in the Bachelor of Midwifery and Bachelor of Nursing programs. Quantitative data (Phases 1 & 2) will be used to identify the socio-demographic characteristics, resilience and grit levels of these participants, as well as retention and progression of these students. Qualitative data gained from semi-structured interviews targeting the 4 groups of interest (i.e. those in paid work, with dependents, international students, and over 47 years & school leavers) will be used to explore the experiences of students.

Aims:

To explore the level of resilience and grit amongst undergraduate first year midwifery and nursing students, including BMidwifery, BNursing, BNursing Advanced and Graduate Entry BNursing. In addition, this project aims to determine how individual student challenges and barriers impact on their ability to adapt to the student role in first semester of their undergraduate year.

Researchers:

Dr Holly Priddis
Prof Yenna Salamonson
A/Prof Athena Sheehan
Ms Rachel Gregory-Wilson
Ms Joan Lynch
A/Prof Lucie Ramjan
A/Prof Bronwyn Everett

Current Status:

Complete

Outcomes:

Paper:

Salamonson, Y., Priddis, H., Woodmass, J. M., Everett, B., Lynch, J., Curtis, E., & Ramjan, L. M. (Accepted 16 June 2018). The price of journeying towards the prize - Commencing nursing students’ experiences of working and studying: A qualitative study. Journal of Clinical Nursing, DOI: 10.1111/jocn.14583.

Conference:

Priddis, H., Sheehan, A., Koch, J., Lynch, J., Curtis, E., Gregory-Wilson, R., & Salamonson, Y. “Examining Resilience and Grit among Students in Midwifery & Nursing Programs: The ERGATE Project?” Poster-Oral presentation at 2016 Students Transitions Achievement Retention & Success (STARS) Conference, 29 June - 2 July 2016 | Pan Pacific Perth, Australia.

Contact:

Phone: +61 2 4620 3322

Email: y.salamonson@westernsydney.edu.au

Evaluating the impact of academic support: The Drop-In Support Centre

Despite the rapid growth of online learning formats, students continue to value face-to-face interactions, particularly the opportunities for discourse with the tutor and other students about course content and expectations.

Aim:

The primary purpose of this study was to explore nursing students’ experiences attending a drop-in support centre (DISC). In addition, this study sought to examine the academic performance of students who utilised the DISC over a 12-month period and compare this to students who did not use the centre. Recognising a need for face-to-face connectedness with students, a DISC was commenced in 2016 in a learning environment overseen by a literacy support staff member who was present each week. Individual tutors voluntarily dropped in to the sessions to assist students, particularly at peak times when assessments for their units were due, to provide academic support as required.

Researchers:

Ms Marian Martin
A/Prof Lucie Ramjan
A/Prof Bronwyn Everett
Dr Paul Glew
Ms Joan Lynch
Prof Yenna Salamonson

Current Status:

Complete

Outcomes:

Paper:

Martin, M., Ramjan, L. M. Everett, B., Glew, P., Lynch, J., & Salamonson, Y. (2018). Exploring nursing students' experiences of a drop-in support centre: A mixed-methods study. Nurse Education Today, 69: 1-7 DOI:10.1016/j.nedt.2018.06.026.

Conferences:

Martin, M., Salamonson, Y., Ramjan, L., Glew, P., Lynch, J., & Everett, B.. “The Drop-in-Support-Centre: Connecting with academic support, study buddies, and more...” Poster presentation at 2017 ‘Make Change Happen’: The Australian College of Nursing 2017 National Nursing Forum Conference, 21-23 August 2017 | The Star, Sydney, Australia.

Martin, M., Salamonson, Y., Ramjan, L., Glew, P., Lynch, J., & Everett, B.. “The Drop-in-Support-Centre: Connecting with academic support, study buddies, and more...” Poster presentation at 2017 (Reference No: 17566) Students Transitions Achievement Retention & Success (STARS) Conference, 2-5 July 2017 | Stamford Grand Adelaide, Australia.

Contact:

Professor Yenna Salamonson

Phone: +61 2 4620 3322

Email: y.salamonson@westernsydney.edu.au

Student Engagement Using Multiple Attempt ‘Weekly Participation Task’ Quizzes (SMAQ)

This project reports on the implementation of formative weekly assessed ‘Check your understanding’ quizzes that aimed to address student preparation for weekly tutorials in a core unit in the Bachelor of Nursing. Quiz questions were designed to practice four key reading comprehension skills – finding the main idea, identifying cause and effect, finding specific details, and understanding key vocabulary. The assessment design aimed to address both the level of student preparedness for tutorial participation, as well as directing students to the most significant content areas of the curriculum. Insights from this evaluation can provide evidence about areas of success with student engagement with content and potential for improvement in curriculum and assessment design both within the School of Nursing and Midwifery and across the wider university.

Aims:

This project aims to examine the relationships between multiple attempts, and the student achievement both across the unit, the quizzes, and with each of the four types of reading comprehension questions. Specifically, the study aims to analyse the relationship to students' performances in the WPTs, the essay, the exam and students overall performance in the unit, taking into account the demographic characteristics of students.

Researchers:

Ms Lauren Metcalfe - Western Sydney University (School of Nursing & Midwifery)
Mr Mitch Hughes - Western Sydney University (School of Nursing & Midwifery)
Prof Yenna Salamonson - Western Sydney University (School of Nursing & Midwifery)

Current Status:

In progress

Outcomes:

Paper

Hughes, M., Salamonson, Y. & Metcalfe, L. (Under review, Submitted 03 November 2018, Manuscript ID: 2018_734). Student engagement using multiple-attempt ‘Weekly Participation Task’ quizzes with undergraduate nursing students. Nurse Education in Practice.

Conference presentations

Metcalfe, L., Salamonson, Y., & Hughes, M. | Using multiple-attempt ‘weekly participation task’quizzes with undergraduate nursing students.| Poster presentation, NNEC 2018: 17th National Nurse Education Conference held 1-4 May 2018 at Melbourne, Victoria, Crown Promenade, Melbourne, Australia.

Metcalfe, L., Salamonson, Y., & Hughes, M. | Student engagement using multiple-attempt ‘weekly participation task’quizzes.| Oral presentation, NNEC 2018: 17th National Nurse Education Conference held 1-4 May 2018 at Melbourne, Victoria, Crown Promenade, Melbourne, Australia.

Contact:

Ms Lauren Metcalfe

Phone: +61 2 4620 3305

Email: l.metcalfe@westernsydney.edu.au

Teaching and Learning Cultural Issues in Health Care: Experiences of teachers and Undergraduate Nursing and Midwifery students

Engendering cultural competence in nursing and midwifery students is germane to reducing disparities in contemporary health care settings, increasingly patronized by people from diverse background. Professional standards for registration in Australia require nurses and midwives to be culturally competent. Nursing and midwifery academics worldwide are responsible for preparing students for clinical practice; yet limited attention is paid to exploring how students are being prepared to care for a culturally diverse population.

Aim:

The aim of this study is to explore the experiences of teachers and undergraduate nursing and midwifery students with regards to teaching and learning cultural issues in health care.

Researchers:

Dr Olayide Ogunsiji
Dr Glenda McDonald

Current Status:

Project completed. Manuscripts being developed for Publications.

Contact:

Dr Olayide Ogunsiji

Phone: +61 2 9165 8655

Email: o.ogunsiji@westernsydney.edu.au

Nurses experiences with the new electronic medication record (eMAR)

This study aims to explore the experiences of Registered and Enrolled Nurses with the new electronic medication administration record (eMAR) recently distributed and operationalised across New South Wales acute care hospitals.

Objectives:

Key objectives of the study are to:

Identify the experiences and potential workaround practices that nurses make use of to resolve challenges that may arise during the administration of medications to patients
Explore nurses’ communication and engagement with the patient about medications being administered using the new eMAR system
Illuminate interprofessional relationships, ways of communication and strategies used by nurses, doctors, pharmacists and patients about medications that are prescribed and later administered by the nurse using the new eMAR system

Funding:

Western Sydney University - Early Career Researcher Grant $19,400.

Researchers:

Assoc. Professor Kath Peters - Western Sydney University
Ms Jennie Barrie - Director of Nursing Sydney and Sydney Eye Hospital
Dr Therese Riley - Nurse Manager Education Sydney and Sydney Eye Hospital
Ms Jan Heiler Director of Nursing Sutherland Hospital

Current Status:

In progress

Contact:

Dr Linda Gregory

Phone: +61 2 4620 3344

Email: l.gregory@westernsydney.edu.au

Mental Health Research Projects

Community Attitudes toward the Mentally Ill (CAMI) among culturally and linguistically diverse (CALD) community attitudes towards people with mental illness

Mental illness is becoming one of the top health priorities worldwide. In Australia, 4.0 million people reported having a mental or behavioural condition (ABS, 2016). However, many people do not seek professional help for their mental health issue due to the stigma and negative attitudes associated with mental illness. Mental illness is stigmatised across cultures, but it more pronounced among certain cultural groups such as among African, Chinese, and Arabic communities. Despite the significant increase of immigrant population in Australia, there is little information about the attitudes toward people with mental health problems among immigrants in Australia.

Aims:

To assess the psychometric properties of the Community Attitudes towards Mental Illness scale among 4 culturally and linguistically diverse (CALD) groups in Australia including: Chinese, Indian, African and Australian.
Compare between the above cultural groups' attitudes towards mental illness.
Compare between Chinese communities' attitudes living in country of origin as opposed to communities in Australia.

The project uses the CAMI scale developed by Taylor and Dear (1981) consisting of 40 items using a 5 point Likert scale from 1 strongly disagree to 5 strongly agree. The target sample size is 500 participants in each cultural group. The target population is Chinese, Indian, African and Australian between 18 to 75 years of age, living in Australia. The study will evaluate the cultural adaptation of the CAMI - CALD scale within the Australian context, including the above cultural groups to further establish the scale's reliability and validity.

Researchers:

Dr Gihane Endrawes, Western Sydney University
Dr Cannas Kwok, Western Sydney University
Dr Olayide Ogunsiji, Western Sydney University
Dr Bonnie Bao, Foshan University
Dr Chun Lee, Hong Kong University
Dr Abimbola Oluwatsin, Univerity of Ibadan, Nigeria

Current Status:

Complete

Contact:

Phone: +61 2 4570 1280

Validating the Community Attitudes towards the Mentally Ill (CAMI) scale to measure Arabic community attitudes towards people with mental illness

Mental illness is on the rise worldwide. It is estimated by World Health Organisation (WHO) that 1 in 4 people, that's 25% of the population has or will have a mental illness sometime throughout their lives. In Australia, 4.0 million people (17.5%) reported having a mental or behavioural condition (ABS, 2016). However, there is evidence suggesting that due to stigma and negative societal attitude towards mental illness, it prevents people from seeking professional mental health help (Ciftci, Jones & Corrigan, 2013; Dardas & Simmons, 2015; Mehta, Kassam, Leese, Butler & Thornicroft, 2009; Rayan & Jaradat, 2016). Societal attitudes towards people with mental illness can be harmful, stigmatising, rejecting, creating prejudice, discrimination, stereotyping and intolerance for individuals (SANE Australia, 2015)..

Aims:

Assess the psychometric properties of the Community Attitudes towards the Mentally Ill scale among Arabic communities in Australia.
Explore communities' attitudes towards people with mental illness.

This is a cross-sectional study using a self-reported questionnaire 'Community Attitudes towards the Mentally Ill Scale (CAMI) originally developed by Taylor and Dear (1981) in Toronto/Canada. The Scale consists of 4 subscales: Authoritarianism, Benevolence, Social restrictiveness and Community mental health ideology. It contains 40 items rated on a 5 point Likert scale from 1 strongly disagree to 5 strongly agree. The scale is translated into Arabic language using back translation and piloted to establish face validity. Demographic data is collected. The target sample (n=300) is from Arabic over 18 years old, and born overseas. Reliability and validity of scale will be determined, using confirmatory factor analysis and Cronbach alpha will determine the internal consistency of each subscale and the mean inter-item correlations and item-to-total correlations.

Funding:

Womens Research Fellowship Fund - 2017

Researchers:

Dr Gihane Endrawes, Western Sydney University
Dr Cannas Kwok, Western Sydney University
Dr Chun Lee, Hong Kong University

Current Status:

Complete

Contact:

Phone: +61 2 4570 1280

Validating the Community Attitudes towards the Mentally Ill (CAMI) scale to measure Arabic community attitudes towards people with mental illness

Aims:

To assess the psychometric properties of the Community Attitudes towards the Mentally Ill scale among Arabic communities in Australia
To explore communities' attitudes towards people with mental illness

Funding:

Womens Research Fellowship Fund - 2017.

Researchers:

Dr Gihane Endrawes, Western Sydney University
Dr Cannas Kwok, Western Sydney University
Dr Chun Lee, Hong Kong University

Current Status:

Complete

Contact:

Phone: +61 2 4570 1280

Narratives of Family Members of People Who Die as a Result of Suicide

Aim:

This study sought family members’ experiences of formal processes after the death of a loved one as a result of suicide.

The increasing prevalence of death by suicide has caused international concerns. While there has been an increasing focus on suicide prevention strategies, there has been limited research to highlight the experiences and needs of families of those who die as a result of suicide. Yet, family members may be the actual first responders to the scene of death. They are thought to experience prolonged and difficult journeys of grief. However, little was known about family members’ specific experiences of formal processes after a person’s death such as: dealing with police; health care staff; coroners or banks. The study found that families often experienced distress before the person died because of prior suicidal behaviour. This was compounded by sadness; confusion and anger after the death of their loved one. Family members reported anticipated and actual stigma after the death, resulting in isolation. Community members and people in formal services, such as police and health care services were unsure how to support families. However, support from others who had similar grief experiences was thought to be helpful.

Researchers:

Associate Professor Kath Peters (Western Sydney University)
Dr Gill Murphy (Western Sydney University)
Professor Debra Jackson (Oxford Brookes University, UK)
Colleen Cunningham (Victorian Institute of Forensic Mental Health, Australia)

Current Status:

Complete

Outcomes:

Peer reviewed publications

Peters, K., Murphy, G., & Jackson, D. (2013). Events prior to completed suicide of family members: Perspectives of family survivors. Issues in Mental Health Nursing. Doi: 10.3109/01612840.2012.751639.

Jackson, D., Peters, K., & Murphy, G. (2015). Suicide of a close family member through the eyes of a child: A narrative case study report. Journal of Child Health Care, 19(4), 495-503.

Peters, K., Cunningham, C., Murphy, G., & Jackson, D. (2016). Helpful and unhelpful responses after suicide: Experiences of bereaved family members. International Journal of Mental Health Nursing. Doi: 10.1111/inm.12224.

Peters, K., Cunningham, C., Murphy, G., & Jackson, D. (2016). ‘People look down on you when you tell them how he died’: Qualitative insights into stigma as experienced by suicide survivors. International Journal of Mental Health Nursing, 25(3), 251 -257.

Conference presentations:

Murphy. G., Peters, K., Jackson. D & Cunningham, C. (2016). Search and Rescue Services: Supporting family members of those who die as a result of suicide. Australian & New Zealand Search and Rescue Conference, Queensland.

Murphy. G., Peters, K., & Jackson. D. (2014). Experiences of stigma and blame for people bereaved by suicide. 15th International Mental Health Conference, Queensland.

Contact details:

Phone: +61 2 4570 1280

Associate Professor Lucie Ramjan

Professor Kath Peters

Phone: +61 2 4620 3567

Email: k.peters@westernsydney.edu.au

Mentoring- A Novel Approach to Support Hope for Recovery in People with Eating Disorders

Mentoring support has been found to be important in improving quality of life and hope for recovery in eating disorders. Mentorship has the potential to support resilience and the development of skills to avoid admission or relapse to hospital. Associate Professor Lucie Ramjan, Dr Sarah Fogarty, Dr Daniel Nicholls and Professor Phillipa Hay piloted a successful community mentorship program for women with anorexia nervosa in NSW in 2015. The project was innovative and the first mentorship program of its type, in that stakeholders were partners in the development and design of the program.

Funding was received from The Ian Potter Foundation in 2014 for this work and findings have been disseminated at conferences and in peer-reviewed publications. The research received media attention on ABC 702 during Mental Health Week in 2015 – http://www.abc.net.au/news/2015-10-07/anorexia-recovery-project-partners-women-with/6834140.

With further funding from a Women’s Research Fellowship in 2015, Associate Professor Ramjan, Dr Fogarty and Professor Hay extended the work to include people of any gender and with any type of Eating Disorder. Data from this research showed significant results for improving hope for mentees.

Aim:

To report preliminary outcomes on the benefits of a mentoring support program for people diagnosed with and recovered from anorexia nervosa (AN) and any eating disorder (ED).

Funding:

The Ian Potter Foundation (2014) and Western Sydney University Women’s Research Fellowship (2015).

$20,000 (The Ian Potter Foundation) and $40,000 (Western Sydney University)

Researchers:

Associate Professor Lucie Ramjan (School of Nursing and Midwifery, WSU)
Dr. Sarah Fogarty (School of Medicine, WSU)
Prof. Phillipa Hay (School of Medicine, WSU)

Current Status:

Complete

Outcomes:

Ramjan, L.M., Fogarty, S., Nicholls, D., & Hay, P. (2018). Instilling hope for a brighter future: A mixed-method mentoring support programme for individuals with and recovered from anorexia nervosa. Journal of Clinical Nursing, 27, e845-857.

Ramjan, L.M., Hay, P., & Fogarty, S. (2017). Benefits of a mentoring support program for individuals with an eating disorder: A proof of concept pilot program. BMC Research Notes, 10: 709. https://doi.org/10.1186/s13104-017-3026-6.

Fogarty, S., Ramjan, L., & Hay, P. (2016). A systematic review and meta-synthesis of the effects and experience of mentoring in eating disorders and disordered eating. Eating Behaviors, 21, 66-75.

Nicholls, D., Fogarty, S., Hay, P., & Ramjan, L. M. (2016). Participatory action research for women with anorexia nervosa. Nurse Researcher, 23(5), 26-30.

Contact details:

Phone: +61 2 9685 9032

Email: L.Ramjan@westernsydney.edu.au

Effectiveness of Mindfulness-based Stress Reduction Bibliotherapy among Young PeoplE with CanceR: The EMBER Project

Psychosocial interventions should be implemented early to facilitate positive adaptive coping skills among young people with cancer. Poor management of cancer-related mental health issues affects quality of life and increases health care expenditure. While various therapies have been shown to be effective in alleviating symptoms such as stress, anxiety, and depression in adults and children alike, many of these therapies can be costly and require experienced health professionals. In response to barriers and poor uptake in accessing psychosocial care, self-help interventions are gaining popularity. For instance, mindfulness-based self-help interventions have shown promise and effectiveness in managing stress, anxiety and depression. However much of the research on mindfulness interventions has focused on adults and while preliminary evidence is promising, very little is known about the benefits of mindfulness based intervention for young people.

Aim:

To assess the feasibility and acceptability of implementing a mindfulness intervention through web-based self-help workbook in reducing stress and depression and improving mindfulness and quality of life in young people with cancer.

Funding:

Western Sydney University-Early career researcher fellowship

Researchers:

Dr Sheeja Perumbil Pathrose
Associate Professor
Lucie Ramjan
Professor Yenna Salamonson
Associate Professor Bronwyn Everette (SNM)
Professor Jane Ussher (THRI)
Dr Pandora Patterson (CanTeen - Australian Organisation for Young People Living with Cancer 12-24 years)
Dr Fiona McDonald (CanTeen - Australian Organisation for Young People Living with Cancer 12-24 years)

Current Status:

In Progress

Contact details:

Dr Sheeja Perumbil Pathrose

Phone: 0424 998 479

Email: S.Pathrose@westernsydney.edu.au

Mother, Infant & Family Research Projects

Improving pregnancy birth experiences and outcomes

Does using a peanut ball during labour with an epidural affect birth outcomes? A pilot study

The peanut ball has only been recently used as a support for women labouring with epidurals in situ. Epidurals have been associated with higher interventions during labour, including a higher incidence of instrumental births (Anim-Somuah Smyth & Jones, 2011; Leighton & Halpern, 2002; Lieberman & O'Donoghue, 2002), especially in women having a baby for the first time (Comparative Obstetric Mobile Epidural Trial Study Group, 2001). Vacuum births have more than doubled in women experiencing epidurals (Anim-Somuah et al., 2011). The peanut ball is shaped like a peanut and fits snugly between the woman’s legs so that both legs are maintained as opening the pelvic outlet to increase the progress of labour and facilitate descent of the fetal head (Grant & Clutter, 2014). In order to mimic the desired upright position during birth, the peanut ball is used whilst the woman is in bed and the ball is supported by a pillow placed behind the woman’s hips to support her legs.

There is limited evidence on the use and effectiveness of a peanut ball for pregnant women during labour. In fact, no randomised controlled trial has been implemented in Australia to establish the effectiveness of a peanut ball for labouring women.

Aims:

The main aim of this pilot study is to assess the feasibility and practicality of conducting and replicating this trial to a definitive randomised controlled trial (RCT) in terms of the rate of willingness to be randomised, retention or attrition rate, staying in the allocated group and reasons for ceasing to use the peanut ball. Data will also be collected on the likely primary and secondary outcome measures to ensure appropriate powering of the future definitive RCT and the minimum clinically important differences between the control and intervention groups. The secondary objectives will investigate completion and acceptability of the health and satisfaction surveys by women who use the peanut ball and all women about their general level of health.

Funding:

$10,000 - Funded by Western Sydney University and Nepean Blue Mountains Local Health District – Partnership Grant

Researchers:

Associate Professor Virginia Skinner from Nepean Hospital and Western Sydney University
Heather Reilly from Nepean Hospital and Western Sydney University
Dr Robin Burr, Nepean Hospital
Justine Elliott, Nepean Hospital
Kenny Lawson, Translational Health Research Institute
Madeleine Simpson, Blue Mountains District Anzac Memorial Hospital
Heather Borradale, Qld midwife
Dr David Campbell, Nepean & Blue Mountains District Anzac Memorial hospital
Wafa Al Omari, Nepean & Blue Mountains District Anzac Memorial hospital
Dr Biing Yin, Lithgow Hospital
Deborah Gaynor, Lithgow Hospital

Current Status:

Manuscript submitted, being considered for publication, July, 2018: Using a peanut ball during labour versus not using a peanut ball during labour for women using an epidural: study protocol for a randomised controlled pilot study to Pilot & Feasibility Studies, Pubmed Open access online. Associate Professor Virginia Stulz, Dr David Campbell, Dr Biing Yin, Dr Wafa Al Omari, Dr Robin Burr, Heather Reilly, Associate Professor Kenny Lawson

Outcomes:

Anim-Somuah, M., Smyth, R. M., & Jones, L. (2011). Epidural versus non-epidural or no analgesia in labour. Cochrane Database of Systematic Reviews, (12), CD000331.

Grant, C. B. & Clutter, L. B. (2014). The peanut ball: a remarkable labor support tool. International Doula, 22(4), pp. 12 – 15.

Leighton, B. L., & Halpern, S. H. (2002). The effects of epidural analgesia on labor, maternal, and neonatal outcomes: A systematic review. American Journal of Obstetrics and Gynecology, 186(5, Suppl), S69-S77. http://dx.doi.org/10.1016/S0002-9378(02)70182-8.

Lieberman, E., &O'Donoghue, C. (2002). Unintended effects of epidural analgesia during labor: A systematic review. American Journal of Obstetrics and Gynecology, 186(5, Suppl. Nature), S31-S68.

Contact:

Associate Professor Virginia Stulz

Phone: +61 2 4734 2252

Email: V.Skinner@westernsydney.edu.au

Sterile water injections for relief of back pain in labour – a qualitative study

Sterile water injections have been used for women experiencing severe back pain during labour. Previous studies have provided evidence of significant findings from randomised controlled trials that have compared using sterile water injections with other methods of pain relief. There is a current gap in the literature regarding women’s subjective experiences of using sterile water injections for pain relief during labour. Only one study (Lee, Kildea & Stapleton, 2017) in Australia has investigated the qualitative aspects of using this form of pain relief during labour and this study is different to the one we are proposing as we propose to include midwives in our study and the women are a sub set of a randomised control trial whereas this study is qualitative design and includes both women and midwives’ experiences. The National Institute for Health and Care Excellence Guidelines (NICE, 2017) suggest that there is a dearth of evidence pertaining to individual women’s experiences of using sterile water injections during labour and this project addresses this gap. Our search of the literature also revealed that there is no literature exploring midwives’ experiences and perceptions about administering sterile water injections as a form of pain relief for back pain during labour.

Aims and Objectives:

The aim of this research is to obtain women’s and midwives’ views and perceptions about the experiences of using sterile water injections as a method of pain relief for back pain during labour.

Specific objectives of the study for women would be:

To explore the woman’s experience and expectations using sterile water injections as a form of pain relief during labour and the effect on her in the postnatal period
To identify the level of pain scale prior to receiving the sterile water injections, during administration and post administration
To explore the likelihood that the woman would use this form of pain relief in a subsequent pregnancy and whether she would recommend this form of pain relief to other women experiencing back pain in labour
To explore the women’s perceptions of sterile water injections’ effect on birth outcome and length of labour

Specific objectives of the study for midwives would be:

To explore midwives’ perceptions about introducing or suggesting sterile water injections as a form of pain relief for back pain during labour
To explore midwives’ level of confidence in administering the sterile water injections
To explore midwives’ own personal use of sterile water injections as a method of back pain relief during labour

Researchers:

Associate Professor Virginia Stulz, Nepean Hospital and Western Sydney University
Heather Reilly, Nepean Hospital and Western Sydney University
Dr Elaine Burns, Western Sydney University
Sue Downward, Nepean hospital
Lisa Cutajar, Nepean hospital
Justine Elliott, Nepean hospital

Outcomes:

Lee, N., Kildea, S. & Stapleton, H. (2017). “No pain, no gain”: The experience of women using sterile water injections, Women and Birth, Vol. 30, pp. 153 – 158, accessed at http://dx.doi.org/10.1016/j.wombi.2016.09.010

Contact:

Associate Professor Virginia Stulz

Phone: +61 2 4734 2252

Email: V.Skinner@westernsydney.edu.au

Characteristics, trends, co-admissions and service needs of women admitted to residential parenting services in the year following birth in NSW (2000-2012)

Most Australian States have day stay and Residential Parenting Services (RPS). Organisations such as Karitane and Tresillian have been providing support for parents of infants and young children since the early 20th century in NSW. In NSW around approximately 3,400 women use the residential services of Tresillian and Karitane each year, which is around 3.5% of the birthing population.

Aims and Objectives:

The aim of this study was to examine the clinical and demographic characteristics, trends, service needs and co-admissions to residential services of Tresillian and Karitane in NSW from 2000-2012. Specifically this study examined:

The clinical characteristics (pregnancy and birth complications, common obstetric interventions, postpartum physical and mental health), demographics (parity, age, residence and health insurance status) and the relationship between these of women and infants admitted to RPS in NSW in the period 2000 to 2012 and determined whether these have changed over the past decade
The pathways, including service utilisation (e.g. general practitioner (GP), universal child & family health services (CFHS), family support) and parenting experiences of women prior to admission
The relationship between use of RPS and admission to other health services in the year following birth
The skills set, training and support needs of RPS staff

This mixed methods study examined the physical (including pregnancy and obstetric interventions), psychological and demographic characteristics, trends, service needs and co-admissions to other health services, of women and infants admitted to residential parenting services (RPS) of Tresillian and Karitane in NSW (2000-2012). Analysis of linked data, clinical records and focus groups with staff provided original evidence about whether characteristics of parents admitted to the RPS reflect currently understood ‘risk’ profiles and whether complications and interventions during childbirth may impact on parenting. This will inform future service design and delivery and essential skills required by RPS staff.

Funding:

ARC Linkage grant (LP13010030)

Researchers:

Chief Investigators:

Professor Hannah Dahlen (WSU)
Professor Virginia Schmied (WSU)
Professor Cathrine Fowler (UTS)

Partner Investigators:

Mr Robert Mills (Tresillian)
Ms Jenny Smit (Tresillian)
Ms Grainne O’Laughlan (Karitane)
Ms Fefe Lawson (Karitane)
Ms Marie Dickinson (Tresillian)
Ms Jane Kookarkin (Tresillian)

Outcomes:

Women admitted to RPS experienced more intervention during the labour and birth which includes such interventions as induction, instrumental birth, caesarean section, epidural and episiotomy
The babies admitted into RPS were also more likely to have been resuscitated and go to SCN/NICU and have experienced birth trauma (particularly to the scalp). They were also much more likely (f6% of the babies admitted) to have been given a diagnosis/label of gastro oesophageal reflux (GOR)/ gastro oesophageal reflux disease (GORD)
A diagnosis/label of GOR/GORD in infants in the first year of life is strongly associated with a maternal mental health history, caesarean section and early term birth. These babies are much more likely to be admitted to RPS with crying/settling and feeding issues
There appear to be a significant number of women (10.5%) who feel traumatised by their births and this may be contributing to some of the complexity of parenting issues seen
Australian residential parenting services have a significant role in supporting mothers and their families who are experiencing parenting difficulties. It frequently provides early intervention that helps minimise later emotional, mental and physical health problems. Child and Family Health Nurses are well placed to work with and support mothers with complex histories. Acknowledgement is required that this work is stressful and frontline clinical staff such as nurses need to be adequately supported and educated to manage the complex presentations of many families. Staff all identified the need for ongoing training in perinatal maternal and infant mental health

Publications:

Dahlen, H. G., Foster, J. P., Psaila, K., Spence, K., Badawi, N., Fowler, C., . . . Thornton, C. (2018). Gastro-oesophageal reflux: a mixed methods study of infants admitted to hospital in the first 12 months following birth in NSW (2000–2011). BMC Pediatrics, 18(1), 30.

Priddis, H., Thornton, C., Fowler, C., Schmied, V., Tooher, J., Dickinson, M., & Dahlen, H. G. (2018). Characteristics and service needs of women and babies admitted to residential parenting units in New South Wales: A mixed-methods study. Journal of Clinical Nursing, 27(15-16), 2963-2973. doi:10.1111/jocn.14497

Fowler, C., Schmied, V., Dickinson, M., & Dahlen, H. G. (2016). Working with complexity: Experiences of caring for mothers seeking residential parenting services in New South Wales, Australia. Journal of Clinical Nursing. doi: 10.1111/jocn.13478

Priddis H, Thornton C, Fowler C, Schmied V, Tooher J, Dickenson M, et al. Characteristics and service needs of women and babies admitted to residential parenting units in New South Wales: A mixed‐methods study. Journal of Clinical Nursing 2018;|https://doi.org/10.1111/jocn.14497

Contact:

Phone: +61 2 9685 9118

Analysis of linked data to determine the rate of maternal and neonatal morbidity associated with commonly performed pregnancy and birth interventions

Along with Dr Charlene Thornton, Dr Lilian Peters (Netherlands) and several other national and international researchers, Professor Dahlen has been leading a team producing a series of studies using population based linked data to explores areas such as, intervention in birth, outcomes for low risk women in different settings and from different countries, domestic violence, birth before arrival, perineal outcomes and longer term maternal and newborn health following birth, pre-eclampsia and maternal death. This work has also been explicated in The Conversation and several media outlets and mediums. It has also led to international collaborations with the UK and Netherlands more recently. With additional funding the project team will now examine a range of questions using the ObstetriX database.

Funding:

Western Sydney University Partnership grant, Partner organisation NSW Health partners.

Outcomes:

Thronton, C., Hennessy, A. Dahlen, H. (2018). Short and long term maternal and child health outcomes following diagnoses of hypertension during pregnancy: A 16-year linked population data study in NSW Australia. Pregnancy Hypertension: 13, Supp 1. S32

Priddis, H., Thorton, C., Fowler, C., Schmied, V. Tooher, J., Dickinson, M., Dahlen, H.G. (2018). Characteristics and service needs of women and babies admitted to residential parenting units in New South Wales: A mixed‐methods study. Journal of Clinical Nursing. https://doi.org/10.1111/jocn.14497

Dahlen, H.G., Foster, J.P., Psaila, K., Spence, K., Badawi, N., Fowler, C., Schmied, V., Thronton, C. (2018). Gastro-oesophageal reflux: a mixed methods study of infants admitted to hospital in the first 12 months following birth in NSW (2000–2011) BMC Pediatrics 18 (1), 30. https://doi.org/10.1186/s12887-018-0999-

Dahlen, H.G., Munoz, AM., Schmied, V., Thorton, C. (2018). The relationship between intimate partner violence reported at the first antenatal booking visit and obstetric and perinatal outcomes in an ethnically diverse group of Australian pregnant women: a population-based study over 10 years. BMJ Open. https://bmjopen.bmj.com/content/8/4/e019566

Peters, L. L., Thornton, C., de Jonge, A., Khashan, A., Tracy, M., Downe, S., Feijen-de Jong, E. I. & Dahlen, H. G. 2018. The effect of medical and operative birth interventions on child health outcomes in the first 28 days and up to 5 years of age: A linked data population-based cohort study. Birth. https://doi.org/10.1111/birt.12348

Thornton, C., Dahlen, H.G. (2018). Born before arrival in NSW, Australia (2000–2011): a linked population data study of incidence, location, associated factors and maternal and neonatal outcomes. BMJ Open. https://bmjopen.bmj.com/content/8/3/e019328

Thornton, C.E., Dahlen, H.G., Hennessy, A. (2018). Does induction of labour in nulliparous hypertensive women result in vaginal birth? – A descriptive study utilising birth registry data. Pregnancy Hypertension. https://doi.org/10.1016/j.preghy.2018.01.010

Dahlen, H.G, Barnett, B., Kohlhoff, J., Drum, M.E., Munoz, AM., Thornton, C. (2015). Obstetric and psychosocial risk factors for Australian-born and non-Australian born women and associated pregnancy and birth outcomes: A population based cohort study. BMC Pregnancy and Childbirth.

Homer CSE, Thornton C, Scarf VL, Oats J, Foureur M, Sibbritt D, . . . Dahlen HG. (2014). Birthplace in New South Wales, Australia: an analysis of perinatal outcomes using routinely collected data. BMC Pregnancy and Childbirth, 14(doi:10.1186/1471-2393-14-206).

Dahlen, H. Tracy, S. Tracy, M., Bisits, A., Brown, C., Thornton, C. (2014). Rates of obstetric intervention and associated perinatal mortality and morbidity among low-risk women giving birth in private and public hospitals in NSW (2000–2008): a linked data population-based cohort study. British Medical Journal Open doi:10.1136/bmjopen-2013-004551.

Thornton C, Dahlen H.G, Korda A, & Hennessy A. (2013). The incidence of preeclampsia and eclampsia and associated maternal mortality in Australia from population-linked datasets: 2000-2008 American Journal of Obstetrics and Gynecology, 208(6), 476.e471-475. doi: 410.1016/j.ajog.2013.1002.1042. Epub 2013 Mar 1011.

Thornton, C., Schmied, V., Dennis, C_L., Barnett, B, Dahlen, H.G. (2013). Maternal deaths in NSW (2000-2006) from nonmedical causes (Suicide and Trauma) in the first year following birth. BioMed Research International. http://dx.doi.org/10.1155/2013/623743.

Dahlen HG, Schmied V, Dennis C-L, & Thornton C. (2013). Rates of obstetric intervention during birth and selected maternal and neonatal outcomes for low risk women born in Australia compared to those born overseas. BMC Pregnancy and Childbirth, doi:10.1186/1471-2393-13-100.

Dahlen HG, Priddis H, Schmied V, Sneddon A, Kettle C, Brown C, et al. (2013). Trends and risk factors for severe perineal trauma during childbirth in New South Wales between 2000 and 2008: a population-based data study. BMJ Open, 2013;3:e002824. doi:10.1136/bmjopen-2013-002824.

Priddis H, Dahlen H.G, Schmied V, Sneddon A, Kettle C, Brown C, et al. (2013). Risk of recurrence, subsequent mode of birth and morbidity for women who experienced severe perineal trauma in a first birth in New South Wales between 2000 - 2008: a population based data linkage study. BMC Pregnancy and Childbirth, 13(89), doi:10.1186/1471-2393-1113-1189.

Dahlen HG, Tracy S, Tracy M, Bisits A, Brown C, & Thornton C. (2012). Rates of obstetric intervention among low-risk women giving birth in private and public hospitals in NSW: a population-based descriptive study. BMJ Open, 2:e001723 doi:10.1136/bmjopen-2012-001723

Tracy S, Dahlen H, Caplice S, Laws P, Wang Y, Tracy M, Sullivan E, 2007, Birth centers in Australia: A national population-based study of perinatal mortality associated with giving birth in a birth center, Birth, vol 34, no. 3, pp 194-201, [Pre-UWS], [ORS ID: 214412]

Tracy, S.K., Dahlen H., Tracy M. and Sullivan E. (2006). Authors reply to correspondence 'Does size matter? A population based study of birth in lower volume maternity hospitals for low risk women.' BJOG ;113 (5):618

Conversation articles:

Dahlen, H. (May 22nd 2014). Birth intervention – and harm-more likely in private hospitals. The Conversation. https://theconversation.com/birth-intervention-and-harm-more-likely-in-private-hospitals-26801

Dahlen H. (22nd August 2013). We need to protect new mothers from trauma and suicide. The Conversation, https://theconversation.com/we-need-to-protect-new-mothers-from-trauma-and-suicide-17254.

Dahlen, H., Schmied, V. (April 26th 2018) Pregnant women are at increased risk of domestic violence in all cultural groups https://theconversation.com/pregnant-women-are-at-increased-risk-of-domestic-violence-in-all-cultural-groups-95048

Dahlen, H. Peters, L. (March 26th 2018). How birth interventions affect babies’ health in the short and long term. https://theconversation.com/how-birth-interventions-affect-babies-health-in-the-short-and-long-term-93426

Dahlen, H. Thornton, C. (March 15th 2018). What to do when the baby is born before you get to hospital. https://theconversation.com/what-to-do-when-the-baby-is-born-before-you-get-to-hospital-84281

Barclay, L., Dahlen, H., Lee, N. (August 15th 2018). Australian is breaking records for intervention in childbirth, and the costs are many. https://croakey.org/australia-is-breaking-records-for-intervention-in-childbirth-and-the-costs-are-many/

Contact:

Phone: +61 2 9685 9118

Epigenetic Influence and impact on childbirth (EPIIC) – a new international collaboration (Australia, UK and USA) dedicated to studying how common interventions and environmental factors around the time of birth may have an epigenetic impact on the mother and child

Researchers have shown epigenetic changes can occur during pregnancy and in the first few months after the birth. But to date, epigenetic influences during the actual labour and birth have rarely been studied. This is probably because researchers thought the labour and birth period was too short to lead to epigenetic changes.

To close this gap in knowledge, midwifery professors Hannah Dahlen, Soo Downe (University of Central Lancashire), Holly Powell Kennedy (Yale University) founded the international research group Epigenetic Imapact in Childbirth, or EPIIC. In January 2012 we brought together eleven researchers (midwives, scientists, epidemiologists, geneticists and epigeneticists) at the University of Hawaii and developed the EPIIC Hypothesis, which has been published in the journal Medical Hypothesis. We hypothesise that events during labour and birth – specifically the use of the synthetic hormone oxytocin, along with antibiotic use and caesarean sections - affect the epigenetic remodeling processes and the subsequent health of the mother and child.

Publications:

Dahlen HG, Kennedy HP, Anderson CM, Bell AF, Clark A, Foureur M, et al. (2013). The EPIIC hypothesis: Intrapartum effects on the neonatal epigenome and consequent health outcomes. Medical Hypothesis, 8(5), 656-662.

Dahlen, H. (2015). Why being born is good for you. Practising Midwife.

Dahlen, H.G., Downe, S., Wright, M.L., Kennedy, H.P., Taylor, J.Y. (2015 -accepted) Childbirth and consequent atopic disease: Emerging evidence on epigenetic effects based on the hygiene and EPIIC hypotheses. BMC Pregnancy and Childbirth.

Dahlen, H.G., Downe, S., Powell Kennedy, H., Foureur, M. (2014) Is society being reshaped on a microbiological and epigenetic level by the way women give birth? Midwifery. Vol 30, No.12, pp 1149-1151.

Dahlen, H., Downe, S., Wright, M., Kennedy, H. and Taylor, J. (2016), 'Childbirth and consequent atopic disease : emerging evidence on epigenetic effects based on the hygiene and EPIIC hypotheses', BMC Pregnancy and Childbirth, vol 16, no 1.

Peters, L. L., Thornton, C., De Jonge, A., Khashan, A., Tracy, M., Downe, S., Feijen-De Jong, E. I. & Dahlen, H. G. 2018. The effect of medical and operative birth interventions on child health outcomes in the first 28 days and up to 5 years of age: A linked data population-based cohort study. Birth.

Conversation articles:

Dahlen H. (26th March 2013). Can caesarean sections increase susceptibility to disease? The Conversation https://theconversation.com/can-caesarean-sections-increase-susceptibility-to-disease-12334.

Contact:

Phone: +61 2 9685 9118

Midwives’ perspectives and experiences of obstetric emergencies

Some health professionals often face traumatic situations when caring for patients. Midwives are among the health professionals that witness adverse labour and birth events. The aim of the study was to explore midwives’ experiences and perspectives of obstetric emergencies. A qualitative research design guided the study. Fifteen Australian midwives participated in telephone interviews. While all midwives in the study received mandatory obstetric emergency training, most of them were unprepared for the ‘drama’ and unfolding of the obstetric emergency event. Some midwives demonstrated resilience and were able to process the situation, reconcile their feelings and return to work. Other midwives were unable to return to work immediately after the event and experienced symptoms of Secondary Traumatic Stress Disorder. Organisational and Collegial support and opportunities to debrief and talk of the experience was imperative to their ability to cope and return to work unscathed.

Funding:

WSU ECR return to work grant

Researchers:

Dr Rakime Elmir
Professor Virginia Schmied
Professor Hannah Dahlen
Ms Jackie Pangas

Outcomes:

Elmir, R., Pangas, J., Dahlen, H., & Schmied, V. (2017). A meta-ethnographic synthesis of midwives’ and nurses’ experiences of adverse labour and birth events. Journal of Clinical Nursing, 26(23-24), 4184-4200. doi:10.1111/jocn.13965

Father’s experience of birth trauma

Being present at the birth can impact on men’s sense of self, his identity as a father, his relationship with his infant, partner and may alter family dynamics. A qualitative methodological framework was used. Seventeen fathers from Australia and New Zealand participated in face-to-face, email and telephone interviews.

Aim:

The aim of the study was to explore men’s experiences of birth when their partners had encountered birth complications or adverse birth events.

Funding:

WSU and seed grant

Researchers:

Dr Rakime Elmir
Professor Virginia Schmied

Current Status:

Meta-ethnographic study published; study publication in process

Findings and Outcomes:

These men described the birth as the worst experience of their lives and they feared for the lives of their infants and partners. Many of the men expected and wanted to be involved in birth and the maternity care journey, instead they found they were pushed to the side and excluded from the labour and birth during times of emergency. Being excluded for part or all of the birth perpetuated feelings of anxiety and vulnerability, and at times fathers were left not knowing anything about what was happening to their partners. The support of midwives and other health professionals’ was crucial to how fathers adjusted and processed the complications of the labour and birth event.

Publication

Elmir R, Schmied V. (2016) A meta-ethnographic synthesis of fathers' experiences of complicated births that are potentially traumatic. Midwifery, 32(1), 66-74.

Contact:

Dr Rakime Elmir

Phone: +61 2 4620 3372

Email: R.Elmir@westernsydney.edu.au

The Perinatal Journey: the process and impact of psychosocial assessment

The aim of this study was to describe the process and impact of the psychosocial assessment undertaken by midwives in the antenatal booking visit and by child and family health nurses (CFHN) in the postnatal universal home visit. In particular the study captured the dynamics of the interaction between women and professionals during psychosocial assessment, describing the actions of midwives / CFHNs and the reactions of women and their subsequent engagement in ongoing services.

Funding:

ARC Linkage LP0991327

Researchers:

Chief Investigators:

Prof Virginia Schmied
Associate Professor Lynn Kemp
Dr Tanya Meade (Covic)

Partner Investigators:

Professor Bryanne Barnett
Mr R Mills
Ms D. Nemeth
Ms M. Hughes

Current Status:

Completed

Contact:

Professor Virginia Schmied

Phone: +61 2 9685 9505

Characteristics, trends, co-admissions and service needs of women admitted to residential parenting services in the year following birth in NSW (2000-2012)

Aims and Objectives:

The clinical characteristics (pregnancy and birth complications, common obstetric interventions, postpartum physical and mental health), demographics (parity, age, residence and health insurance status) and the relationship between these of women and infants admitted to RPS in NSW in the period 2000 to 2012 and determined whether these have changed over the past decade
The pathways, including service utilisation (e.g. general practitioner (GP), universal child & family health services (CFHS), family support) and parenting experiences of women prior to admission
The relationship between use of RPS and admission to other health services in the year following birth
The skills set, training and support needs of RPS staff

Funding:

ARC Linkage grant (LP13010030)

Researchers:

Chief Investigators:

Professor Hannah Dahlen (WSU)
Professor Virginia Schmied (WSU)
Professor Cathrine Fowler (UTS)

Partner Investigators:

Mr Robert Mills (Tresillian)
Ms Jenny Smit (Tresillian)
Ms Grainne O’Laughlan (Karitane)
Ms Fefe Lawson (Karitane)
Ms Marie Dickinson (Tresillian)
Ms Jane Kookarkin (Tresillian)

Outcomes:

Women admitted to RPS experienced more intervention during the labour and birth which includes such interventions as induction, instrumental birth, caesarean section, epidural and episiotomy
The babies admitted into RPS were also more likely to have been resuscitated and go to SCN/NICU and have experienced birth trauma (particularly to the scalp). They were also much more likely (f6% of the babies admitted) to have been given a diagnosis/label of gastro oesophageal reflux (GOR)/ gastro oesophageal reflux disease (GORD)
A diagnosis/label of GOR/GORD in infants in the first year of life is strongly associated with a maternal mental health history, caesarean section and early term birth. These babies are much more likely to be admitted to RPS with crying/settling and feeding issues
There appear to be a significant number of women (10.5%) who feel traumatised by their births and this may be contributing to some of the complexity of parenting issues seen
Australian residential parenting services have a significant role in supporting mothers and their families who are experiencing parenting difficulties. It frequently provides early intervention that helps minimise later emotional, mental and physical health problems. Child and Family Health Nurses are well placed to work with and support mothers with complex histories. Acknowledgement is required that this work is stressful and frontline clinical staff such as nurses need to be adequately supported and educated to manage the complex presentations of many families. Staff all identified the need for ongoing training in perinatal maternal and infant mental health

Publications:

Contact:

Phone: +61 2 9685 9118

Tackling maternal anxiety: reconceptualising the mothering narrative

Anxiety in the perinatal period (i.e. in pregnancy or up to one year following birth) is a major mental health issue affecting 1 in 5 mothers in Australia. This is distressing for individual women and families; and can impact the health and development of children. Our research is investigating the role the ‘good mother’ narrative may play in raising anxiety.

Aim:

Our ultimate goal is to transform the narrative from one that pathologises mothers, and those who support them, to one that normalises, embraces and celebrates the diverse, natural concerns about parenting. We are doing this through diverse initiatives including arts-based projects such as the Mother’s Day Letters campaign and the Mockingbird project.

Funding:

$5,000 - Health & Well-being Theme WSU

Researchers:

Professor Virginia Schmied and colleagues

Current Status:

In Progress

Contact:

Professor Virginia Schmied

Phone: +61 2 9685 9505

Mockingbird

Postnatal (postpartum or puerperal) psychosis is an under recognised condition that affects 1 to 2 women in every 1000 after childbirth and increases the woman’s risk of suicide and, on occasions, infanticide. This paper reports on a play, Mockingbird, that portrays women’s lived experience over four generations.

Aim:

The aim of the performance was to increase awareness about postnatal psychosis and to start conversation between healthcare professionals and the community about how we can redesign services to improve health outcomes for mothers and their babies.

Funding:

$6,000 - The Australian Research Council Centre for Excellence for the History of Emotions

Researchers:

Dr Diana Jefferies
Dr Margaret Duff
Professor Virginia Schmied
Lisa Brickell
Ruth Dudding
Siri Embla

Current Status:

In Progress

Contact:

Dr Diana Jefferies

Email: d.jefferies@westernsydney.edu.au

The Lived Experience of Postnatal Psychosis: An historical comparison with current experience

This project turns to history and the present to explore how women experience psychosis after childbirth. Using a unique archival collection of historical healthcare records, we are able to compare a woman's experience from 1885 to 1955 as they were admitted to Callan Park and Gladesville Hospitals in Sydney with a diagnosis of psychosis or mania following childbirth. From this analysis, we can then interview women who experience psychosis following birth in the last ten years to explore the similairities and differences in their care. We ask the question: Has treatment and care improved?

Aim:

The aim of this project is to raise awareness and to explore how services can be improved for women experiencing psychosis after childbirth. This is important because there are no publicly funded specialist mother and baby beds in NSW at the present time. This means that women are often care for in general mental health facilities where staff do not have a good understanding of the issues facing a new mother. It also means that mothers are separated from their newborns. Postnatal psychosis also increases a mother's risk of suicide if it is not recognised as soon as symptoms begin.

Researchers:

Dr Diana Jefferies
Professor Virginia Schmied
Dr Margaret Duff
Mrs Deborah Vickers - Consumer representative

Current Status:

In Progress

Contact:

Diana Jefferies

Email: d.jefferies@westernsydney.edu.au

Promoting healthy infant feeding and parenting practices

Mother Infant Caring Communities

Aims:

The aim of this study is to design, in collaboration with a broad range of Australian communities, a set of community-based principles and strategies to support new mothers to breastfeed their infants and to enhance the early parenting experience. The objectives of the study are to:

Examine the role of local communities in the promotion and support of breastfeeding and early parenting
Explore with diverse community members (including: new parents, grandparents, peer support groups such as Australian Breastfeeding Association (ABA), children’s services (playgroups, preschools), teachers, local government, local business representatives, members of church groups, community clubs (Rotary, Leagues), neighbourhood centres) the contribution that they or their organisation or group can make to the promotion and support of breastfeeding
Articulate a set of core principles that reflect the value Australian communities place on the importance of the early years and on supporting mothers to breastfeed
Design strategies that can be adapted locally to implement the community-based principles

Researchers:

Virginia Schmied
Elaine Burns
Athena Sheehan

Current Status:

The porject is ongoing as we work with additional local council areas.

Outcomes

Participants are identifying the positive characteristics of the community and services that foster health and well-being for mothers and infants including, facilities, “lots of parks, walking tracks, open spaces and playgrounds, safe community centres”. Shopping centres were described as the ‘village’. However in both workshops, participants talked about what was not working to support breastfeeding stating that breastfeeding was rarely observed in public and that bottle feeding was more evident. There are insufficient facilities for breastfeeding and parenting rooms are limited or inappropriate.

Contact:

Virginia Schmied

Phone: +61 2 9685 9505

WECDI - A collaborative approach to optimise child development in western Sydney: a study of community perspectives and needs.

Early childhood development is arguably the strongest predictor of adult health, education and social outcomes. There are effective interventions that can improve outcomes for children but we know that the best solutions are those that are locally designed and implemented by the people who experience them and that real change comes from place-based solutions and collective impact (Harwood).

This study we will use Appreciative Inquiry to explore with diverse community members their perceptions of the needs of children and families. Data will be collected through ‘community conversations’ where groups within the community come together to discuss key issues in a similar way to a focus group. To add to data collected through community conversations, we will also conduct a brief online survey of community members as well as mapping the relationship between time, place and emotion using the novel “invisiblecity” web-based mobile phone app developed by WSU researchers.

Collectively we will design and implement innovative strategies and approaches that will ensure optimum development for children 0 to 8 years as well as support women in pregnancy.

Aim:

The overall goal of the Wentworthville Early Childhood Development Initiative (WECDI) is to significantly decrease early childhood developmental vulnerability in Wentworthville and Constitution Hill by supporting and empowering families and community to ensure children thrive and are happy, healthy and school ready by the time they start school.

Funding:

$20,000 from SONM Partnership grant with Parramatta City Council

Researchers:

Professor Virginia Schmied
Dr Cathy Kaplun
Dr Kim Psaila
Prof Lynn Kemp
Mr Phil Scott

Current Status:

In progress.

Contact:

Virginia Schmied

Phone: +61 2 9685 9505

Parenting experiences of refugee mothers and fathers in New South Wales, Australia

Every year, around 13,750 people of refugee background are resettled in Australia (Milosevic, Cheng, & Smith, 2012). Many of these new arrivals are of child-bearing age and either come with small children or will become first-time parents within the first three to five years of resettlement. In Australia and internationally, there is growing recognition of the need to understand the experiences and service needs of women and men who are either humanitarian or economic migrants and are becoming parents for the first time or are now raising their children in a new country. It is important to fill this gap in the literature not only to inform health and social service development but to challenge current representations of motherhood and fatherhood in Australia which offer an inadequate reflection of the experiences of non-Western mothers and fathers. This proposed study will be an important starting point to fill this gap.

Aims:

This study aims to:

Examine the meanings and experiences of new parenthood for refugee women and men with a particular focus on participants’ feelings about becoming or being a mother or father.
Identify the diverse pregnancy, birth, postpartum and parenting practices in which study participants choose to participate (or not) and examine how these practices are maintained or modified by women and men.
Explore refugee women’s and men’s perceptions of and experiences with health and other services to identify the facilitators or barriers to service use.

Funding:

$37,366 from Western Sydney University Women’s Fellowship Research Development Fund.

Researchers:

Dr Olayide Ogunsiji
Professor Virginia Schmied

Current Status:

Research completed, manuscripts are being developed for Publication

Contact:

Olayide Ogunsiji

Phone: +61 2 9165 8655

Email: o.ogunsiji@westernsdney.edu.au

Volunteering in infant and young child feeding in emergencies (IYCF-E) in the European Refugee Crisis

Infants and young children are vulnerable in emergencies and their mothers and caregivers require infant feeding support to protect their health and wellbeing. Expertise in IYCF-E can be difficult locate when an emergency occurs. However, many health professionals and volunteer breastfeeding counsellors hold expertise in supporting infant feeding in non-emergency settings. Many such individuals volunteered to provide IYCF-E support to mothers and caregivers in the recent European Refugee crisis. This study considers the experiences of such volunteers in IYCF-E.

Aims:

Understand the motivations, challenges and rewards for volunteers in IYCF-E
Consider the benefits and pitfalls for organisations working with volunteers in IYCF-E
Consider how volunteers adjust (or do not adjust) their practice to the emergency context
Determine how volunteers might be better supported to support mothers and caregivers in IYCF-E

Researchers:

Adjunct Associate Professor Karleen Gribble
Dr Aunchalee Palmquist, University of North Carolina

Current Status:

In progress

Contact:

Adjunct Associate Professor Karleen Gribble

Phone: 0431 118 485

Email: k.gribble@westernsydney.edu.au

Australia experiences a high incidence of natural emergencies and Australian governments have committed significant investment into emergency preparedness and response. Amongst the population groups most vulnerable to emergencies, are infants and young children with their vulnerability centering around their specific food and fluid needs. As a result, the World Health Assembly has urged all member states to develop and implement infant and young child feeding in emergency (IYCF-E) plans in line with international guidance. This study aimed to determine the degree to which Australia has complied with this direction by conducting an audit of Australian emergency plans and guidance.

Aims:

Identify the any content in Australian Federal, State/Territory and Local Government Area plans or guidance related to IYCF-E
Determine how emergency preparedness for the needs of infants and young children might be improved in Australia

Researchers:

Adjunct Associate Professor Karleen Gribble
Mary Peterson- World Breastfeeding Trends Initiative, Australian Breastfeeding Association
Decalie Brown- World Breastfeeding Trends Initiative, NSW Health

Current Status:

In progress

Contact:

Adjunct Associate Professor Karleen Gribble

Phone: 0431 118 485

Email: k.gribble@westernsydney.edu.au

Infant feeding in foster care

International and national recommendations are that infants be exclusively breastfed for the first six months of life and continue breastfeeding into their second year. However, large numbers of infants in Australia are removed from maternal care because of child protection concerns. In such circumstances, it is possible for infants to continue to receive breastmilk via breastfeeding at contact visits or through the provision of breastmilk. Where expressed breastmilk is provided, agencies, agencies workers and foster carers have a role in whether, and how, it is provided. In addition, where expressed breastmilk is not provided, foster carers formula feed infants. However, because foster carers have not given birth to these infants they are not provided with the infant feeding support that birthing women are given. It is unknown the degree to which foster carers are provided with assistance and training regarding infant feeding by agencies. This study considered the experiences and views of Australian foster carers of breastfeeding and formula feeding in foster care.

Aims:

Identify the experiences of Australian foster carers of breastfeeding during contact visits, provision of expressed breastmilk and formula feeding regarding their foster infants.
Determine what sort of support and education around infant feeding would be beneficial to foster carers.

Researchers:

Adjunct Associate Professor Karleen Gribble
Dr Elaine Burns
Associate Professor Kath Peters

Current Status:

In progress

Contact:

Dr Stacy Blythe

Phone: +61 2 4620 3762

Email: S.Blythe@westernsydney.edu.au

Belonging in two families: exploring permanence options for children in out-of-home care

There are large numbers of children in long term out of home care in Australia. Most of these children are on finalised orders meaning that a decision has been made that they cannot be returned to the care of their parents. Long-term foster care has been found to provide poor health and developmental outcomes for these children because such placements often lack physical permanence and emotional belonging. However, it has been suggested that guardianship and plenary adoption, which are the other options available, also have significant drawbacks that may contribute to poor mental health. Other countries have a further option, called simple adoption, which may ameliorate some of these drawbacks. This study aimed to explore the strengths and weaknesses of long-term foster care, guardianship, plenary adoption, and simple adoption from the viewpoints of those who have personal or professional experience with foster care or adoption.

Aims:

Identify the perceived strengths and weaknesses of long-term foster care, guardianship, plenary adoption, and simple adoption as considered by individuals with personal or professional experience with foster care or adoption
Identify the views of people with experiences of adoption and foster care on post-guardianship and post adoption support and on birth certificates for adopted people
Determine how the permanence options available for children in long-term foster care might be improved

Funding:

$20 000 SONM Partnership Grant and Adopt Change

Researchers:

Dr Stacy Blythe
Associate Professor Kath Peters
Adjunct Associate Professor Karleen Gribble

Current Status:

In progress

Contact:

Dr Stacy Blythe

Phone: +61 2 4620 3762

Email: S.Blythe@westernsydney.edu.au

Content analysis of foster carer recruitment materials in NSW

Large numbers of children reside in out-of-home care in Australia. These children have almost always experienced maltreatment. This leaves them vulnerable to poor mental and physical health throughout childhood and the rest of their lives. Particularly for the very young, foster carers are needed who can love and attached to them and provide them with sensitive, responsive care. This analysis of foster carer recruitment material considered what agencies are informing potential foster carers is involved in foster caring, with a particular emphasis on the emotional aspects of foster care.

Aim:

Identify what foster care agencies are informing potential foster carers is involved in foster caring with particular emphasis on considering how instrumental care and emotional care are presented

Researchers:

Adjunct Associate Professor Karleen Gribble
Dr Stacy Blythe

Current Status:

In progress

Contact:

Adjunct Associate Professor Karleen Gribble

Phone: 0431 118 485

Email: k.gribble@westernsydney.edu.au

Breastfeeding Peer and Professional support: a review of a drop-in service

The Australian Breastfeeding Association, amongst other activities, offers a 24 breastfeeding helpline, local peer support group meetings and training for breastfeeding peer counsellors and educators. In 2011, a Breastfeeding Lounge was developed to fill a perceived gap in service provision for women with ongoing breastfeeding problems who required face-to-face support from a dedicated, and free, breastfeeding service. This service was exclusively focussed on breastfeeding support and was located at the NSW ABA branch office in Castle Hill. The ‘ABA Breastfeeding Lounge’ drop-in service was available to all mothers, without an appointment, one day per week. Confidential records were kept after every consultation detailing; the reason for presentation, the support offered and the suggested actions. Mothers were encouraged to return to the service as often as necessary for ongoing face-to-face peer support. Women were also linked into their local ABA peer support group. The breastfeeding lounge was not advertised externally and referrals came from ABA volunteers, other mothers and a variety of health professionals.

This study was conducted in two phases:

Phase 1: Participant observation was used to observe, and audio record, individual interactions between breastfeeding women and an ABA peer breastfeeding counsellor at the Breastfeeding Lounge.

Phase 2: A retrospective file audit and an online survey was conducted to capture women’s reasons for accessing the service, the service provided and the outcomes over a two-year period.

Aims:

This study aimed to explore women’s experiences of attending an Australian Breastfeeding Association drop-in service for breastfeeding support. The study captured the reasons for presentation to the service, the support provided, and the breastfeeding outcomes following engagement with the service.

Researchers:

Zoi Triandifilidis
Louise Duursma

Current Status:

Complete

Outcomes:

Burns, E. Duursma, L. Triandafilidis, Z. (in progress). “They were lifesavers”: a qualitative review of an ABA drop-in service, for submission
Duursma, L. Burns, E. (in progress). Accessible drop-in support enables ongoing breastfeeding: a mixed methods review

Contact:

Elaine Burns

Phone: +61 2 9685 9818

Best Beginnings: Improving Breastfeeding Support for Women in Western

The Australian National Infant Feeding survey results in 2011 revealed the most cited reason for not breastfeeding was ‘previously unsuccessful experience’ (38%). This project sought to design a model of care for women who have had negative experiences to improve breastfeeding rates in this group. Phase one of the project included individual interviews with women who have had previous negative experiences with breastfeeding, as well as interviews with peer support counsellors and midwives. One month later a collaborative workshop was conducted with three key stakeholder groups: women, Health professional and peer supporters. Using the four phases of Appreciative Inquiry (discovery, dream, design, destiny) the group designed a model of support which combined professional support from continuity of care midwives and peer support from breastfeeding volunteers.

Aim:

The aim of this project was to design a model of breastfeeding support, in collaboration with key stakeholders, targeting women who have had a previously negative experience of breastfeeding.

Funding:

$10,000 - WSU Early Career Researcher grant

Researchers:

Zoi Trianfadildis
Virginia Schmied

Current Status:

Complete

Contact:

Elaine Burns

Phone: +61 2 9685 9818

Organisational support for return to work whilst breastfeeding: an appreciative inquiry exploration

Workplace gender equality and anti-discrimination legislation currently protects the rights of women with regard to breastfeeding and return to work (Australian Government, 1984, 2012). There is limited available research on the return to work experiences of Australian women who are breastfeeding. Only one Australian study has explored health staff perceptions of organisational support for breastfeeding. This cross sectional survey revealed that ‘return to work’ was the most common reason women gave for ceasing breastfeeding (Weber et al., 2011).

This funded study will utilise an Appreciative Inquiry (AI) approach to ‘discover, understand and foster innovations’ (Cooperrider & Srivastva, 1987) in organisations that employ women. This study will include the experiences of breastfeeding women returning to work in two female dominated professions. The focus on female dominated professions is strategic in this study, and it forms an integral part of the appreciative process. It acknowledges the difficulties associated with integrating exclusively female requirements into gender neutral workplaces. This is particularly difficult in workplaces where the numbers of women are small (Ayre, Mills, & Gill, 2013; Powell & Sang, 2015; Smith, 2013). This project will progress towards a collaborative workshop which will bring together women from female and male dominated workplaces to co-create strategies to make all workplaces conducive to enabling return to work after childbirth and maintaining breastfeeding. Identifying the facilitators and barriers, to maintaining breastfeeding after return to work, will contribute to the development of enabling workplace cultures and environments, which genuinely support women to meet the WHO and NHMRC recommendations for breastfeeding duration.

Aims:

This project aims to explore organisational support for women who plan to maintain breastfeeding after returning to work, following the birth of a baby. The objectives of the study are to:

Explore the infant feeding decisions that breastfeeding women make when returning to work with an infant aged 1 month to 11 months
Identify the organisational culture and workplace provisions for women who are combining return to work with breastfeeding
Describe women’s experience of maintaining breastmilk supply whilst working
Identify the facilitators and barriers to combining breastfeeding with return to work
Identify strategies which enable women to maintain breastmilk supply following return to work

Funding:

$40,000 - WSU Women’s Fellowship Grant

Researchers:

Associate Professor Susanne Gannon
Dr Sky Hugman

Current Status:

In progress

Contact:

Elaine Burns

Phone: +61 2 9685 9818

A known midwife or another mother: a study of professional and peer support provided to breastfeeding women during the first month after birth

Breastfeeding initiation rates in Australia are high with 9 out of 10 women commencing breastfeeding however less than 2 out of 10 women reach the WHO recommendations for exclusive breastfeeding until 6 months after birth. Additional support has been shown to increase breastfeeding duration however little is known about the components of facilitative support. This project builds on doctoral work which explored the components of breastfeeding support provided by hospital based midwives during the first week after birth. The study included: observations and audio recording of interactions between midwives or peer supporters and breastfeeding women (n=20), followed by interviews with women several weeks after the interactions had been observed.

Aim:

The aim of this study was to explore the similarities and differences in the breastfeeding support provided by midwives working in a continuity of care model (Midwifery Group Practice) and trained peer-supporters (Australian Breastfeeding Association (ABA) counsellors) in the first month after birth.

Funding:

$7,500 - Western Sydney University SEED Grant

Researchers:

Virginia Schmied

Current Status:

Complete

Outcomes:

Burns E, Schmied V, 2017, 'The right help at the right time': positive constructions of peer and professional support for breastfeeding, Women and Birth, vol 30, no 5, pp 389-397. http://dx.doi.org/10.1016/j.wombi.2017.03.002

Contact:

Elaine Burns

Phone: +61 2 9685 9818

Breastfeeding Friendly Communities at WSU

World Health Organisation global breastfeeding data reveals that cultures which accept breastfeeding as the norm, experience high uptake of breastfeeding, and continued breastfeeding for the recommended durations. Breastfeeding “makes the world healthier, smarter, and more equal”. The benefits of breastfeeding include fewer infections in children, less dental malocclusion, improved cognitive functioning and reduction in diabetes and obesity, and these advantages have been shown to continue later into life. For women breastfeeding decreases the risk of breast cancer, and has been linked to decreases in ovarian cancer and type 2 diabetes. In Australia, two of the key inhibitors for breastfeeding, are return to work and breastfeeding in public.

This study provided data on the experiences of staff and students at Western Sydney University who have combined return to work or study with breastfeeding. Survey data revealed how women experienced WSU campuses in terms of access to breastfeeding spaces and facilities to store expressed breastmilk. This study also benchmarked WSU breastfeeding policy and provisions, against those in other universities and also compared the WSU policy and provisions against the ABA Breastfeeding Friendly Workplace standards.

Aims:

This study aimed to describe the provision of breastfeeding friendly spaces at Western Sydney University campuses. The study questions were:

Do existing WSU policies, and facilities, meet the needs of staff and students who are breastfeeding?
How do existing WSU breastfeeding policies compare with other Tertiary Institutions in NSW?
What are the barriers and facilitators to accessing the breastfeeding friendly spaces at WSU?
Does WSU meet the ABA standards for a Breastfeeding Friendly Workplace?

Funding:

$5,000 - Western Sydney University Vice Chancellor's Gender Equity Fund

Current Status:

Complete

Outcomes:

Burns, E. Triandafilidis, Z. (under review) Taking the path of least resistance: A qualitative analysis of return to work or study while breastfeeding, International Breastfeeding Journal.

Contact:

Elaine Burns

Phone: +61 2 9685 9818

Current practices of intragastric tube placement confirmation and gastric residual aspiration in Australian neonatal care Units- A cross sectional survey

Providing adequate nutrition is vital to the survival and development of sick neonates. Enteral feeding is the routinely adopted alternative feeding method in the neonatal unit. Anecdotal evidence reports that there is wide variation in practice in relation to intragastric tube placement, confirmation and gastric residual (GR) aspiration practices. Consequently, access to evidence-based guidelines in this domain is a priority.

Aims:

To explore the current practices of intragastric tube placement and gastric residual aspiration practices of neonatal clinicians in Australia.

Researchers:

Dr Jann Foster
Dr Virginia Schmied
Dr Hannah Dahlen
Dr Kim Psalia
Dr. Christine Taylor (SoNM)
Kaye Spence, Children's Hospital at Westmead and Adjunct Associate Professor School of Nursing and Midwifery, Western Sydney University
Dr Nadia Badawi, Children's Hospital at Westmead
Shusannah Morris
Karen Peters Life's Little Treasures Foundation
Dr Katherine Gregory Brigham and Women's Hospital, Boston College, Boston

Current Status:

Complete

Outcomes:

The survey result demonstrated variability in practice of nasogastric tube placement, confirmation and GR aspiration and there is the needed to develop for an evidence-based guideline to support the practices related to enteral feeding to ensure optimum care to the neonates.

Contact:

Sheeja Perumbil Pathrose

Phone: 0424 998 479

Email: S.Pathrose@westernsydney.edu.au

Improving care and outcomes for premature or sick infants and their families

Experiences of parents feeding infants in the NICU, SCN and following hospital discharge: An online survey

Optimal nutrition is one of the fundamental components for infants to reach their full growth and neurodevelopmental potential. However, preterm infants often display difficulty establishing oral feeding following birth. Little is known about parental experiences in feeding preterm infants post hospital discharge. It is important to understand the kinds of feeding problems faced by families.

Aims:

To identify:

problems/issues faced by parents in relation to feeding
facilitators and barriers that influence infant feeding
resources and support related to feeding accessed by the parents post hospital discharge

Funding:

Western Sydney University Women’s scholarship 2016

Researchers:

Jann Foster
Kaye Spence
Prof. Nadia Badawi
Virginia Schmied
Hannah Dahlen
Kim Psaila
Christine Taylor
Karen Peters
Shusannah Morris
Roslyn Coles

Current Status:

Publication in progress

Outcomes:

Study presented at the 21st Annual International Congress of the Perinatal Society of Australia and New Zealand April 2 – April 5, 2017.

Contact:

Virginia Schmied

Phone: +61 2 9685 9505

Tube feeding and feed transition practice in special care nurseries (SCNs)

Parents and clinicians have reported that inconsistencies in practices, for transitioning infants from tube to sucking feeds in preparation for home, are a major cause for concern.

Aims:

To identify current practice for the transition from intra-gastric tube feeding to breastfeeding and/or bottle in preterm infants in Australian special care units including:

extent of variation in tube feeding practices
criteria for commencing suck feeds
methods to determine suck feeding competence in infants
methods to transition from intra-gastric tube to suck feeds

Funding:

Western Sydney University Women’s scholarship 2016

Researchers:

Jann Foster
Kaye Spence
Nadia Badawi
Adam Buckmaster
Ian Wright
Christine Taylor
Lynn Sinclair
Sylvia Lees
Shusannah Morris
Karen Peters
Roslyn Coles

Current Status:

Publication in progress

Outcomes:

Study presented at the 21st Annual International Congress of the Perinatal Society of Australia and New Zealand April 2 – April 5, 2017.

Contact:

Virginia Schmied

Phone: +61 2 9685 9505

A qualitative exploration of the experiences of feeding infants in the NICU, SCN and following hospital discharge

Very little is known about parental experiences in feeding previously sick term and preterm infants in the NICU/SCN and post hospital discharge, yet feeding these infants after discharge remains a primary concern for families. Developing an in-depth understanding of the experiences of parents feeding their infants in the NICU, SCN and post hospital discharge is essential for targeted knowledge translation interventions, and if applicable, the need for further research to assist in providing appropriate post-discharge services.

Aims:

To gain an in-depth understanding of the feeding experiences of parents of preterm infants in relation to:

transition from intra-gastric tube feeding to bottle or breast feeding
transition from bottle or breast feeding to solid feeding
facilitators and barriers that influence infant feeding
need to targeted knowledge translation interventions
identify need for further research

Funding:

Western Sydney University Women’s scholarship 2016

Researchers:

Jann Foster
Kaye Spence
Prof. Nadia Badawi
Virginia Schmied
Hannah Dahlen
Kim Psaila
Christine Taylor
Karen Peters
Shusannah Morris
Roslyn Coles

Current Status:

Data in progress

Contact:

Virginia Schmied

Phone: +61 2 9685 9505

Continuity of care (CoCo) for parents whose infants require admission to neonatal intensive care (NICU) for a congenital anomaly: perceptions of families and health professionals.

The diagnosis and birth of a baby with a congenital abnormality requiring surgery is a stressful situation for families. High level support from midwifery and neonatal services and continuity of care is central to their experience and outcomes. The high risk maternity team at Westmead Hospital in partnership with staff from the Grace Centre for Newborn Care at the Children’s Hospital Westmead have been working together to develop a model of care which endeavours to support families who have received a diagnosis of a congenital anomaly in the antenatal period through to admission to the Grace NICU. This study used a mixed methods design to map the current care pathways and processes for families and their newborn infants from the point of diagnosis on antenatal ultrasound of a congenital anomaly, through to discharge from the NICU and ongoing care up to six weeks following discharge.

Aim:

Map the current care pathway and service processes for pregnant women following a diagnosis made antenatally of a congenital anomaly requiring their newborn baby’s admission into a surgical neonatal intensive care unit (NICU), from the point of the mother's admission to the antenatal high risk clinic through to 3 months following discharge of the baby from the NICU Examine the facilitators and barriers to the delivery of effective family centred care. Identify opportunities and strategies for service redesign to improve continuity of care for parents whose infants require admission to neonatal intensive care (NICU) for a congenital abnormality

Researchers:

Dr Kim Psaila
Dr Virginia Schmied
Dr Jann Foster
Ms Susan Heath Westmead Hospital
Ms Kaye Spence
Mrs Christine Jorgenson Children’s Hospital Westmead

Current Status:

Complete

Contact:

Dr Kim Psaila

Phone: +61 2 9865 9819

Email: Kim.Psaila@westernsydney.edu.au

Migrant and refugee families’ perceptions and experiences of care provided in a neonatal intensive care unit

The birth of an infant requiring neonatal care is a stressful experience for both parents and the neonate. The technological NICU environment can limit mother-infant contact, and can be perceived as frightening. Mothers may observe events (e.g. resuscitation) and procedures that cause psychological distress. Their infant’s appearance and responses can also be disturbing. They may also be concerned about the survival or medical status of their infant. Parents express a strong desire to participate in care of their infant yet, they struggle to understand their role in the NICU. Studies constantly report lack of information, unclear instructions and poor role negotiation hinder parents ability to participate in care resulting in parents feeling out of control and under surveillance. Feelings of guilt, worries about infant health and uncertainty about the future are common and persist after discharge (7, 8) and higher levels of depression are reported. The experience of having an infant admitted to NICU is potentially more difficult for parents from migrant and refugee backgrounds for whom the health system is foreign and poor communication with health professionals may hinder understanding of their infant’s condition. Yet internationally research addressing this is almost non-existent.

Aim:

In this project we aim to strengthen cultural competency and quality of care provided to migrants/refugee families experiencing neonatal intensive care services in South Western Sydney.

Examine the experiences of migrant and refugee women and men / families who have an infant in the NICU
Explore staff perceptions of supporting migrant/refugee women and men who have an infant in the NICU
Using the NHMRC framework for cultural competence provide strategies to strengthen the cultural competence in NICU

Researchers:

Dr Suza Trajkovski
Professor Virginia Schmied
Dr Shanti Raman
Dr Kim Psaila
Ms Margaret Longman
Niccoletta Giannoutsos

Current Status:

In progress

Contact:

Dr Suza Trajkovski

Phone: +61 2 4620 3363

Email: S.Trajkovski@westernsydney.edu.au

An exploration of caregivers' feeding experiences of children with Cerebral Palsy (The CareFed-CP Study)

This study investigated the feeding experiences of caregivers of children with CP, including barriers and enablers to feeding, and the support systems utilised by caregivers. An exploratory, descriptive research design was undertaken in two phases: 1) a qualitative approach using semi-structured individual telephone interviews; 2) a survey design using an online survey. Ethics approval was granted by Western Sydney University HREC and The Cerebral Palsy (CP) Alliance HREC. Participants were from invitations via the CP Alliance Facebook page and from the CP Alliance NSW/ACT register.

Aims:

To explore caregivers’ feeding experiences in caring for their child with Cerebral Palsy (CP)
To explore the caregivers’ experiences around feeding support for their child with CP, including identifying current support systems
To identify strategies for targeted knowledge translation interventions

Funding:

Western Sydney University Women’s Fellowship Research Grant $25,720.

Researchers:

Dr Jann Foster
Prof Nadia Badawi AM, Medical Director, Grace Centre of Newborn care, The Children's Hospital at Westmead
University of Sydney Prof Iona Novak, head of Research, Cerebral Palsy Alliance Research Institute

Current Status:
- Complete
Outcomes:
- Conference presentations: Australian College of Children and Young People's Nurses (ACCYPN) 2018 Conference, 24-26 Oct., Perth, WA PSANZ 2019 (Perinatal Society of Australia and New Zealand) Annual Congress, 17-20 March, Gold Coast, QLD. Journal articles systematic review.
Contact:

Dr Christine Taylor

Phone: +61 2 9685 9029

Email: ch.taylor@westernsydney.edu.au

Investigating service system design, models of care and professional education

Mothers and Postnatal Care at Blacktown (MAP Care)

The provision of safe, high-quality, and satisfying postnatal care for women and their babies in hospital and the community is an ongoing challenge in New South Wales and nationally. Postnatal care, particularly in hospital, is consistently reported by women as the least satisfying aspect of their maternity care; it is also the least satisfying area of midwives’ practice. Change is urgently needed.

Aims:

The redevelopment of Blacktown Hospital, with the new maternity unit opening in 2019, offers a unique opportunity to:

Co-design the model(s) of postnatal care to optimise maternal and newborn physical and psychosocial health – this includes: planning the effective use of single rooms with carer space to engage carers in postnatal care and education; and determining the cost-benefit of the new model(s)
Improve workplace culture and work satisfaction for midwives
Determine the impact of hospital postnatal environments, including noise levels, on the delivery and experience of postnatal care

Funding:

$15,000 from SONM MIFam Research Network; WSLHD internal support and WSLHD kickstarter grant

Researchers:

Prof Virginia Schmied
Dr Elaine Burns
Dr Ann Dadich
Associate Professor Kenny Lawson
Ms Lisa White – CMC - Blacktown and Mount Hospitals (BMDH)
Ms Judith Calvert – Midwifery Unit Manager - BMDH

Status:

In progress.

Contact:

Professor Virginia Schmied

Phone: +61 2 9685 9505

Child Health: Researching Universal Services (CHoRUS): A study to investigate the feasibility of implementing a national approach to child and family health services (ARC linkage)

This study investigated the feasibility of implementing a national approach to child and family health services. Consultative forums with consumers and professional leaders, a national survey of and focus groups with midwives, nurses, general practitioners and practice nurses will provide a comprehensive understanding of the essential components of a universal service. Findings will identify organisational, service and professional characteristics that are enablers and barriers to implementation.

Researchers:

Chief Investigators: Prof Virginia Schmied; Prof Sue Kruske (UQ), Prof Caroline Homer (UTS); Prof Lesley Barclay (USyd); Prof Ian Wilson (UOW); Prof Cathrine Fowler (UTS), A/Prof Lynn Kemp (UNSW).

Partner Investigators Dr Sharon Goldfeld, Dr Michael Fasher. Vic Dept of Education & Early Child Development, NT Department of Health & Families; WA Dept of Health; Qld Dept of Health; NSW Dept of Family & Community Services; AAMCFHN, RACGP, AGPN, APNA, ACM

PhD student (completed): Dr Kim Psiala (WSU)

Current Status:

Complete

Outcomes:

Rossiter, C., Fowler, C., Hesson, A., Kruske, S., Homer, C. S. E., Kemp, L., & Schmied, V. (2018). Australian parents’ experiences with universal child and family health services. Collegian. doi:10.1016/j.Collegian.2018.09.002
Rossiter, C., Fowler, C., Hesson, A., Kruske, S., Homer, C. S. E., & Schmied, V. Australian parents’ use of universal child and family health services: A consumer survey. Health & Social Care in the Community, 0(0). doi10.1111/hsc.1266
Hesson, A., Fowler, C., Rossiter, C. and Schmied, V. (in press) Lost and ocnfused: Parent representative groups’ perspectives on child and fmaily health services in Australia. Australian Journal of Primary Health Care.
Olley, H., Psaila, K., Fowler, C., Kruske, S., Homer, C., & Schmied, V. (2017). ‘Being the bridge and the beacon’: a qualitative study of the characteristics and functions of the liaison role in child and family health services in Australia. Journal of Clinical Nursing, 26(1-2), 91-102. doi: 10.1111/jocn.13373
Rossiter, C., Schmied, V., Kemp, L., Fowler, C., Kruske, S., & Homer, C. S. E. (2017). Responding to families with complex needs: a national survey of child and family health nurses. Journal of Advanced Nursing, 73(2), 386-398. doi: 10.1111/jan.13146
Schmied V, Homer C, Fowler C, .Psaila, K., Barclay, L., Wilson, I., Kemp, L., Fasher, M. & Kruske, S. (2015) Implementing a national approach to universal child and family health services in Australia: Professionals' views of the challenges and opportunities. Health and Social Care in the Community 23(2): 159-70.
Psaila K, Schmied V, Fowler C, Kruske S. (2015) Interprofessional collaboration at transition of care: Perspectives of child and family health nurses and midwives. Journal of Clinical Nursing; 24(1-2): 160-72.
Fowler C, Schmied V, Psaila K, Kruske S, Rossiter C. (2015) Ready for practice: What child and family health nurses say about education. Nurse Education Today; 35(2): e67-e72.
Psaila K, Fowler C, Kruske S, Schmied V. (2014) A qualitative study of innovations implemented to improve transition of care from maternity to child and family health (CFH) services in Australia. Women and Birth; 27(4): e51-e60.
Schmied V, Fowler C, Rossiter C, et al. (2014) Nature and frequency of services provided by child and family health nurses in Australia: Results of a national survey. Australian Health Review; 38(2): 177-85.
Psaila, K., Kruske, S., Fowler, C. & Schmied, V. (2014) Smoothing out the transition of care between maternity and child and family health services: Perspectives of child and family health nurses and midwives. MC Pregnancy and Birth 14:151.
Psaila, K., Schmied, V., Fowler, C. & Kruske, S. (2014) Discontinuities between maternity and child and family health services: health professional's perceptions, BMC Health Services Research 14:4.
Jeyendra, A., Rajadurai, J., Chanmugam, J., Trieu, A., Nair, S., Baskaran R. & Schmied, V. (2013) A Qualitative Study of Australian General Practitioners' Perspectives of their Role in Well-Child Health Care, BMC Family Practice 14 Art No 2.

Contact:

Professor Virginia Schmied

Phone: +61 2 9685 9505

POstnatal Pathways and Processes (POPPY) Study

For over a decade, researchers in Australia and in other wealthy countries have reported on the high level of physical and mental health problems and concerns of women in the first year after birth and the limitations of current postnatal hospital and community-based services in addressing these needs. National surveys indicate that there is a dramatic drop in breastfeeding in the first six weeks after birth and only 15% of infants are exclusively breastfed to six months as recommended by the World Health Organisation. Previous research demonstrates that women do not get the support they need to establish breastfeeding and high numbers of infants receive infant formula prior to hospital discharge.

Aims:

Too map the current postnatal processes, pathways and care from birth to 12 weeks postpartum for women and their infants who are well that is, with no or few physical health complications following birth and are at low risk of developing mental health problems.
Identify the gaps in processes and care and to analyse opportunities and design system and care innovations to improve the ‘patient/woman journey’.

Funding:

WSU partnership grant with NSW Kids and Families, NSW Health

Researchers:

Research team: Prof Virginia Schmied; Dr Elaine Burns; Dr Karen Myors; Prof Hannah Dahlen; Dr Joanne Curry
Study Partners: The study was conducted in partnership with researchers, policy makers, service managers and clinicians with a view to informing the redesign of postnatal services in one Sydney metropolitan maternity service and the related community child and family health services.

Current Status:

Publications in progress.

Contact:

Professor Virginia Schmied

Phone: +61 2 9685 9505

Psychosocial InterProfessional Education (PIPE)

Significant poor maternal and child outcomes result from complex psychosocial issues and it is critical that students have the knowledge and skills to work effectively with women and their families in collaboration with diverse health and social care professionals. Our interprofessional teaching team, digital technology specialists and clinicians came together in November 2017 to ensure midwifery, psychology, social work and medical students were well-prepared to work in multidisciplinary teams to address the significant and increasing perinatal mental health and social problems experienced by Australian women and families. The team developed and scripted high quality video footage scenes from case studies to provide students a visual component to their learning that culminated in a realistic case scenario workshop identifying appropriate interdisciplinary pathways of care. The result was two one day collaborative workshops held in May, 2018 with 40 and 35 students respectively in each workshop.

Aim:

The aim of the Psychosocial InterProfessional Education (PIPE) project was to increase health professional students’ awareness and skills in interprofessional collaboration in the perinatal period.

Funding:

In kind support Rich Media

Researchers:

Hazel Keedle, School of Nursing & Midwifery
Virginia Stulz, School of Nursing & Midwifery
Rachel Bentley, Rich Media Digital Futures
Holly Kaye-Smith, Rich Media Digital Futures
Tanya Meade, School of Social Science and Psychology
Rosemary Qummouh, School of Social Science and Psychology
Phillipa Hay, School of Medicine
Janet Conti, School of Social Science and Psychology

Current Status:

Completed for 2018, publication in progress
Received a WSU teaching and learning innovation award December 2018

Contact:

Professor Virginia Schmied

Phone: +61 2 9685 9505

Evaluation of a Student-led Midwifery Group Practice: a woman’s perspective – Acacia Clinic

The introduction of student caseloading is a timely initiative for our midwifery profession, directing us towards the vision of the profession. This continuity of care initiative encompasses the forming of a unique and nuanced relationship between the woman and the student midwife to enhance better outcomes for both the woman, her baby and significant others including family and community members. The concept of woman-centred care is an integral component to this relationship as the midwife focuses on each woman’s individual needs encompassing her physical, psychosocial, emotional, spiritual and cultural needs.

Currently at Nepean Hospital, the Women’s and Children’s Health Network has a high quota of midwifery students and it became increasingly difficult to place all students at a given time into the antenatal clinic to achieve the university mandatory clinical requirements of Continuity of Care Experiences. The Bachelor of Midwifery students are allocated to spend time in a caseload midwifery antenatal clinic that has evolved into a Midwifery Student-Led Midwifery Group Practice known as the Acacia Clinic. This alternative was posed to support midwifery students and also provides another opportunity to provide care for low risk women and their families and this project is being evaluated from the woman’s perspective.

Aims and Objectives:

To evaluate women’s experiences of a student-led midwifery group practice.

Specific objectives of the study include:

To evaluate whether interaction with midwifery students as leading the antenatal care is beneficial or deleterious for pregnant women
What are the facilitators and barriers unique to the student-led model of care compared to other standard midwifery led models of care, (if the woman has been exposed to other models of care)?
Whether women request to return to the student-led model of care
To evaluate women’s experiences about levels of satisfaction of student-led midwifery care
To assess whether the student midwife and the woman’s relationship impacts on her physical, psychosocial, emotional, intellectual, spiritual and cultural needs during pregnancy
To assess and evaluate why continuity of care is / or is not important for the woman during her pregnancy, birth and postnatal period
To evaluate women’s levels of anxiety

Researchers:

Associate Professor Virginia Stulz
Heather Reilly, Western Sydney University and Nepean hospital
Richard Gilfillan, Nepean Hospital
Dr Rakime Elmir, Western Sydney University

Contact:

Professor Virginia Schmied

Phone: +61 2 9685 9505

Appreciative Inquiry Research study for Exploring Student Midwives’ Experiences (The ESME project)

NSW is facing a severe shortage of midwives and nurses, and that by 2030, there will be a gap of 8,000 workers that will affect client care as those midwives exit and retire from the system (Calderwood & Miskelly, 2018). This study is a collaborative initiative with NSW Health (Nursing and Midwifery Office), University of the West of Scotland, School of Nursing and Midwifery, Centre for Nursing and Midwifery Research, Nepean Hospital and three other local health districts including South Eastern Sydney (St George hospital), Western Sydney (Blacktown) and Hunter New England Health (John Hunter). The researchers work in each of the local health districts to generate an experience based understanding of being a student midwife and from this understanding, co-create ways to enhance the experience with student midwives and midwives. The student learning experience is crucial to both attracting potential students to this field of work and in retention and future leaders and transformers of care into the future. Therefore, a study that explores what a good experience would look like from the perspectives of those who have had the experience – student midwives and midwives is timely.

Aims and Objectives:

To work collaboratively with key stakeholders (student midwives, midwives) to generate an experience based understanding of what is working well in relation to the student midwife experience and from this understanding, co-create ways to enhance the experience.

Objectives

To discover what matters and works well at present in the student midwife experience from the perspective of student midwives and midwives.
To explore the views of participants on what could make the student midwife experience even better.
To co-create ideas to enhance the experience of being a student midwife, and to use an improvisational approach when testing out these ideas in practice.
To consider measures that need to be taken in order to encourage the new learning generated to be taken forward, and facilitate continued enhancement of the student midwife experience.
To evaluate the experience of essential of care coordinators in relation to their experience of becoming appreciative inquirers.
To celebrate the learning generated within the collaborative inquiry groups and share this learning locally, nationally and internationally.

Researchers:

Professor Belinda Dewar - University of West of Scotland
Associate Professor of Midwifery Virginia Stulz – Coordinating Investigator – Centre for Nursing & Midwifery Research, Nepean Blue Mountains Health District
Nicola Drayton – Researcher – Nepean Blue Mountains Health District
Tamsin MacBride – University of West of Scotland
Jacqui Cross – Nursing and Midwifery Office – Chief Nursing and Midwifery Officer
Michael Peregrina - Nursing and Midwifery Office - Principal Advisor Nursing Leadership and Culture

Outcomes:

Sharp C., Dewar B., & Barrie K. (2016). Forming new futures through appreciative Inquiry. IRISS insight number 33.
Sharp C., Dewar B., Barrie K. & Meyer J. (2017). How being appreciative creates change – theory in practice from health and social care in Scotland. Action Research Journal, May, 1-21, http://journals.sagepub.com/eprint/Z44dS4EGxivjtYnnfiWN/full.

Contact:

Professor Virginia Schmied

Phone: +61 2 9685 9505

South West Innovative Mentoring Midwives Study (SWIMMS)

Improving the midwifery student experience is a critical issue for SWSLHD. The clinical placement experiences of midwifery students in Australia and internationally demonstrate, that while some placements offer optimal learning experiences supported by experienced and compassionate midwives, other placements are stressful and unsupportive, offering limited learning opportunities. There is promising evidence that well-designed and supported midwife-midwifery student mentorship programs can make a positive difference to student experience and retention. However, there has been little evaluation of the impact on the midwife mentors, their work satisfaction and on workplace culture.

Aims:

Improve the experience and confidence and increase retention of midwifery students in SWSLHD
Increase the number of students who take-up a position in SWSLHD on graduation
Build capacity in midwives to mentor midwifery students and to provide effective point of care clinical teaching
Increase the job satisfaction and retention in the workplace of the Midwife Mentors
Facilitate a positive workplace culture for midwives and students

Researchers:

Karen Sorenson (SWSLHD)
Prof Virginia Schmied
Fiona Arundell
Prof Hannah Dahlen
JA/Prof Athena Sheehan
Dr Elaine Burns
Dr Holly Priddis
Hazel Keedle

This project is partnership between SWSLHD and the School of Nursing and Midwifery, Western Sydney University (WSU).

Status:

In progress.

Outcomes:

Evaluation of the mentorship program

Pre and post-implementation data have been collected from Midwife Mentors and midwifery students including demographic data, training and experience and their perceptions, expectations and experience of the mentoring relationship using validated measures of mentorship potential and competency, the mentor-mentee relationship, workplace satisfaction, perceptions of workplace culture and career intentions. Midwives Mentors were surveyed at the start and the end of the program to ascertain their perceptions of working with midwifery students and to identify aspects of workplace culture that facilitate or hinder student support and engagement. Focus group discussions will be held with the mentors and mentees at the start to determine their aspirations for the mentorship relationship; again in mid-2018 to determine what is working well and address challenges, and at the end of the program to gather information about benefits and challenges of the mentoring program. During the 12 month period students and mentors will keep an online reflective journal. To determine the impact that the mentorship program has on maternity unit culture we will also survey midwifery staff across the LHD pre and post program.

Contact:

Professor Virginia Schmied

Phone: +61 2 9685 9505

Evaluation of a Student-led Midwifery Group Practice: a woman’s perspective – Acacia Clinic

Aims:

To evaluate women’s experiences of a student-led midwifery group practice. Specific objectives of the study include:

To evaluate whether interaction with midwifery students as leading the antenatal care is beneficial or deleterious for pregnant women
What are the facilitators and barriers unique to the student-led model of care compared to other standard midwifery led models of care, (if the woman has been exposed to other models of care)?
Whether women request to return to the student-led model of care
To evaluate women’s experiences about levels of satisfaction of student-led midwifery care
To assess whether the student midwife and the woman’s relationship impacts on her physical, psychosocial, emotional, intellectual, spiritual and cultural needs during pregnancy
To assess and evaluate why continuity of care is / or is not important for the woman during her pregnancy, birth and postnatal period
To evaluate women’s levels of anxiety
Researchers:
- Associate Professor Virginia Stulz, Western Sydney University & Nepean hospital
- Heather Reilly, Western Sydney University & Nepean hospital
- Richard Gilfillan from Nepean hospital
- Dr Rakime Elmir from Western Sydney University
Contact:

Professor Virginia Stulz

Phone: +61 2 4734 2252

Email: V.Skinner@westernsydney.edu.au

WECDI - A collaborative approach to optimise child development in western Sydney: a study of community perspectives and needs.

Collectively we will design and implement innovative strategies and approaches that will ensure optimum development for children 0 to 8 years as well as support women in pregnancy.

Aim:

The overall goal of the Wentworthville Early Childhood Development Initiative (WECDI) is to significantly decrease early childhood developmental vulnerability in Wentworthville and Constitution Hill by supporting and empowering families and community to ensure children thrive and are happy, healthy and school ready by the time they start school.

Funding:

$20,000 from SONM Partnership grant with Parramatta City Council

Researchers:

Professor Virginia Schmied
Dr Cathy Kaplun
Dr Kim Psaila
Prof Lynn Kemp
Mr Phil Scott

Current Status:

In progress.

Contact:

Virginia Schmied

Phone: +61 2 9685 9505

Oral Health Research Projects

Oral Health in Pregnancy

Implementing and evaluating an oral health module for the WSU Bachelor of Midwifery program (BMIOH)

Oral diseases are among the most common health problems experienced by Australians, with pregnant women being particularly at risk. As poor oral health during pregnancy can have a significant impact on the health and wellbeing of the mother and the child, guidelines recommend that antenatal care providers play an active role in promoting maternal oral health to pregnant women. Midwives are in an ideal position to fill this role, as they see and advise the majority of pregnant women in Australia. However there is currently no formal education or training regarding maternal oral health available to undergraduate midwifery students in Australia.

To address this, we plan to implement and evaluate Australia’s first oral health education program for undergraduate Bachelor of Midwifery students at the Western Sydney University. Having this initial education will help equip graduating midwives with the necessary knowledge and confidence to promote maternal oral health and will complement the existing MIOH CPD program.

Project Team:

Associate Professor Ajesh George, Western Sydney University, SWSLHD, University of Sydney, Ingham Institute
Dr Margaret Duff
Professor Hannah Dahlen, Western Sydney University
Professor Virginia Schmeid, Western Sydney University
Dr Elaine Burns
Dr Holly Priddis

Contact:

Phone: 02 8738 9356

Developing perinatal oral health guidelines for Dentists and prenatal care providers (PERIOH)

Despite the importance of oral health care during pregnancy, pregnant women rarely seek dental care during pregnancy. This low uptake of dental services has mainly been attributed to various barriers experienced by pregnant women such as cost, lack of awareness and misconceptions. Yet, new research reveals that there are significant provider barriers that further exacerbate this problem, including a lack of clear consensus among dentists and antenatal care providers regarding perinatal oral health care, and a lack of emphasis being placed on oral health within maternity care in Australia. It is therefore vital that practice guidelines in perinatal oral health be developed for all dental and prenatal care providers in Australia. Such guidelines will help alleviate any concerns health professionals may have and ensure pregnant women receive a consistent message about the importance or oral health.

The program has been developed over the following six (6) phases:

Forming a multidisciplinary advisory committee for the development of the guidelines
Conducting pilot work for developing the guidelines
Developing the guidelines
Achieving consensus through consultation
Dissemination and implementation
Evaluation and revision

Aim:

To develop, implement and evaluate perinatal oral health (PERIOH) guidelines for antenatal (midwives/general practitioners/obstetricians) and dental care providers in Australia

Funding:

Funding is gratefully acknowledged from:

Western Sydney University
NSW Centre for Oral Health Strategy
Australian Dental Association
Phillips Australia

Project Team:

Associate Professor Ajesh George, Western Sydney University, SWSLHD, University of Sydney, Ingham Institute
Professor Maree Johnson, Australian Catholic University, Ingham Institute
Professor Hannah Dahlen, Western Sydney University
Dr Shilpi Ajwani, SLHD Oral health services, Sydney Dental Hospital, University of Sydney
Clinical Associate Prof Sameer Bhole, SLHD Oral health services, Sydney Dental Hospital, University of Sydney
Professor Jenny Reath, Western Sydney University
Professor Andrew Korda, Western Sydney University

Contact:

Phone: 02 8738 9356

Paediatric Oral health

Reducing dental decay in young children through an antenatal intervention: A longitudinal cohort study of MIOH kids (MIOH kids)

Almost half of Australian preschool aged children experience tooth decay. Tooth decay can impact on a child’s ability to eat, sleep, learn and grow. Australian interventions to reduce childhood decay have focused mainly on the postnatal period, despite international evidence showing antenatal interventions can positively impact a child’s oral health.

Aim:

To examine how creative writing can promote healthy ageing

Funding

Funding is gratefully acknowledged from: * The Foundation for Children

Project Team:

Assoc Prof. Ajesh George – Western Sydney University, SWSLHD, University of Sydney, Ingham Institute
Prof Maree Johnson – Australian Catholic University, Ingham Institute
Prof Hannah Dahlen – Western Sydney University
Dr Shilpi Ajwani – SLHD Oral health services, Sydney Dental Hospital, University of Sydney
Clinical Associate Prof Sameer Bhole – SLHD Oral health services, Sydney Dental Hospital, University of Sydney
Adjunct Assoc Prof Ravi Srinivas – SWSLHD Oral Health Services, Western Sydney University
Sharon Ellis – Campbelltown Hospital SWSLHD
Dr Albert Yaacoub – NBMLHD Oral Health Services

Contact:

Phone: 02 8738 9356

Designing, implementing and evaluating an online early childhood oral health module (ECOH-M) for the Masters of Family Health at Western Sydney University

Early Childhood Caries (ECC) is the most common chronic disease among young children globally despite it being a preventable condition. Almost half of Australian children aged 5 years’experience childhood caries, with rates highest among families from socioeconomically disadvantaged backgrounds. ECC can lead to pain, swelling and hospitalization among children and can also negatively impact their functioning in terms of learning, speech and growth development. To address ECC, there has been a lot of emphasis internationally on involving child health professionals such as child and family health nurses (CFHNs) in this area as they are in optimal positions to provide screening and oral health education to parents, carers and children. In Australia this led to the launch of the Early Childhood Oral Health (ECOH) program in 2007 using a model of shared responsibility facilitated through the use of the NSW Personal Health Record.

This program provided parents and health professionals with increased access to health information to enable early identification of the disease and referral of affected children to appropriate oral health treatment services. The evaluation of the ECOH program showed that parents, as a consequence, had increased access to oral health information and also that CFHNs were incorporating the screening and referral of children to dental services into their practice. Currently training is provided to CFHNs by ECOH co-coordinators through face-face workshops post registration. However, there is no comprehensive education being provided in this area to nursing students undertaking their child and family health training. This study aims to address this by developing, implementing and evaluation Australia’s first oral health module for postgraduate CFHNs students at Western Sydney University. Having this initial education will help equip graduating CFHN’s with the necessary knowledge and confidence to promote infant oral health and support the ECOH

Funding:

Funding is gratefully acknowledged from:

NSW Centre for Oral Health Strategy

Project Team:

Dr Cathy Dixon – Western Sydney University, Ingham Institute
Sharlene Vlahos – Western Sydney University
Tanya Schinkewitsch – Western Sydney University
Assoc Prof. Ajesh George – Western Sydney University, SWSLHD, University of Sydney, Ingham Institute

Contact:

Phone: 02 8738 9356

Developing a Dietitian Initiated program for oral health and eating disorders

The prevalence of eating disorders has increased globally in the last 30 years. In Australia, more than 1,000,000 people have an eating disorder (9% of the general population) with prevalence rates increasing in children and adolescents. The adolescent phase (ages 13-18 years) has been identified as the peak period of onset for eating disorders. Compromised nutritional intake as a result of restrictive and obsessive dieting and purgative behaviours can have a damaging and irreversible impact on oral health. Individuals with eating disorders are at an increased risk of tooth sensitivity, demineralisation and caries which may impede dietary intervention and treatment. These individuals are also five times more at risk of developing dental erosion than those without an eating disorder. These dental problems can lead to a decline in self-esteem, quality of life and social psychology, all of which can be detrimental during the adolescence period where there is a focus on aesthetic appearance and development of self-concept and identity.

It is now recognised internationally and by the Dietitians Association of Australia (DAA) that eating disorders is an oral health risk in the adolescent population, and dietitians should encourage good dental hygiene and provide oral health care advice to this population. Dietitians form part of the multidisciplinary primary care team and are therefore in an ideal position to provide education, conduct oral health assessments, identify complications and recommend nutritional interventions during inpatient consultations. Despite these recommendations, currently there is no evidence of interventions that assist in early identification, screening or oral health education of adolescents and young adults with eating disorders. While previous research has identified dentists to be in an ideal position for identifying and addressing the oral health issues of individuals with eating disorders, other studies have shown that some adolescents are more likely to be less trusting and hostile towards dentists due to dental anxiety.

Aims:

The overall aim of this study is to develop a program inclusive of a screening tool and education guide focused on capacity building dietitians to provide oral health risk assessments, education and dental referrals to Australian adolescents and young adults (AYA) with eating disorders. This will be implemented in the following phases:

Systematic review
Current perceptions of dietitians towards oral health and eating disorders
Perceptions of adolescents and young adults with eating disorders towards oral health
Development of an oral health screening tool and education guide

Project Team:

Tiffany Patterson Norrie – Western Sydney University, SWSLHD, Ingham Institute
Assoc Prof. Ajesh George – Western Sydney University, SWSLHD, University of Sydney, Ingham Institute
Dr Lucie Ramjan – Western Sydney University, Ingham Institute
Dr Mariana S. Sousa – Western Sydney University, SWSLHD, Ingham Institute

Contact:

Phone: 02 8738 9356

Oral Health of Aboriginal People

Oral Health & Cardiovascular Health & Stroke

Developing a cardiovascular oral health program: a mixed methods study (CARDIOH)

Cardiovascular disease (CVD) is the leading cause of death in Australia, and as such is a national health priority. A recent systematic review and meta-analysis has found periodontal disease to be independently associated with CHD. In view of current evidence, general consensus internationally is that cardiac care providers should provide oral health promotion, assessments and dental referrals for a comprehensive periodontal therapy. However, in Australia, cardiac clinicians do not provide oral health education, assessments and referrals to consumers during rehabilitation.

Aims:

The aim of the study is to develop a Cardiovascular Oral Health (CARDIOH) program for a cardiac setting in the Sydney. This program will incorporate oral health guidelines into cardiac care practice and will involve educating and training cardiac clinicians (medical, nursing and allied health staff) to provide oral health education, assessment and referrals to their patients.

Scoping review and development of the CARDIOH program framework
Perceptions of the program from consumers & cardiac rehabilitation clinicians
Designing and pilot testing the CARDIOH education program with cardiac clinicians
Trial of the CARDIOH program

Funding:

The Commonwealth Government of Australia (Australian Postgraduate Award)

Project Team:

Paula Sanchez – Western Sydney University, SWSLHD, Ingham Institute
Assoc Prof. Ajesh George – Western Sydney University, SWSLHD, University of Sydney, Ingham Institute
Assoc Prof. Bronwyn Everett – Western Sydney University, SWSLHD, University of Sydney, Ingham Institute
Prof Yenna Salamonson – Western Sydney University, Ingham Institute
Adjunct Assoc Prof Ravi Srinivas – SWSLHD Oral Health Services, Western Sydney University
Dr Shilpi Ajwani – SLHD Oral health services, Sydney Dental Hospital, University of Sydney
Clinical Associate Prof Sameer Bhole – SLHD Oral health services, Sydney Dental Hospital, University of Sydney
Assoc Prof. Rohan Rajaratnam – Western Sydney University
Assoc Prof. Julie Redfern – George Institute, University of Sydney

Contact:

Phone: 02 8738 9356

Integrated dental care after stroke (IDeaS)

Stroke causes damaging oral health effects such as difficulty swallowing and an impaired brushing action. These both result in a greater amount of bacteria in the mouth and this increases the risk of pneumonia, a significant complication post-stroke. The National Clinical Guidelines for Stroke show the need for oral care following stroke and suggest how nurses and allied health staff, such as speech pathologists, occupational therapists and dietitians, can be important in oral assessment and management. However, current evidence suggests that nurses are often not involved in oral care of stroke patients and do not have adequate knowledge about it.

Aims:

The purpose of this project is to explore patients and acute stroke nursing professionals’ perceptions regarding the practicability, acceptability and feasibility of the IDEAS program.

Scoping review of evidence for the potential role of nurses and other non-dental professionals in the oral care of stroke patients.
Explore attitudes, knowledge and practices of stroke patients and non-dental professionals
Designing the online IDEAS program
Education, training and assessment of health professionals
Pilot testing the IDEAS program

Funding:

In-kind support is gratefully acknowledged from:

Sydney Local Health District

Project Team:

Dr Shilpi Ajwani – SLHD Oral health services, Sydney Dental Hospital, University of Sydney
Nadia Burkolter – Royal Prince Alfred Hospital, SLHD
Prof Craig Anderson – University of Sydney
Clinical Associate Prof Sameer Bhole – SLHD Oral health services, Sydney Dental Hospital, University of Sydney
Assoc Prof. Ajesh George – Western Sydney University, SWSLHD, University of Sydney, Ingham Institute

Contact:

Phone: 02 8738 9356

Oral Health & Cancer

Assessing the oral cancer risk behaviours of Indian immigrants in Australia

Oral cancer is one of the most prevalent cancer’s worldwide affecting over 200,000 people annually. In India, oral cancer has become a pandemic while in Australia approximately 2,500 new cases are registered each year, representing a significant disease burden to the population.

In recent decades, oral cancer is showing a disturbing rise with increasing immigration from south Asian countries like India. In Australia, Indians are one of the fastest growing communities, forming around 2.8% of the total population (4,68,800). Social and cultural habits like tobacco and areca nut chewing are predisposing factors to oral cancer and remains prevalent among Indians following migration, and as a result, Australia is likely to see a considerable increase of this disease in future.

Increasing oral cancer rates in Australia over the past few years coupled with easy access to tobacco and areca products and difficulties in accessing public dental services, suggests that a comprehensive approach to oral cancer assessment and prevention is imperative among Indian migrants. Hence, exploring the oral cancer risk behaviours of Indian communities in Australia is important to develop culturally relevant, preventive and educational interventions. It is hoped that the findings from this study will help develop risk profiles of Indian migrants in Australia, which will be useful for medical, nursing and dental professionals in delivering early risk assessment strategies to this population and eventually decrease the rate of oral cancer in Australia.

Contact:

Phone: 02 8738 9356

Oral Health & Diabetes

Developing a diabetes oral health program: A mixed methods study (DIOH)

The interrelationship between oral health and diabetes mellitus (DM) is a growing concern. It is now established that poor oral health and DM have a bidirectional relationship: DN increases the risk of developing periodontal disease which in turn negatively affects glycaemic control which can lead to further diabetic complications. International and Australian guidelines recommend that diabetes care providers assess the oral health of people with diabetes. Currently, there is limited research being undertaken in this area and the potential role of Diabetes Care Providers in promoting oral health has not been fully explored in Australia.

Aims:

The overall aim of this 4-phase project is to develop a Diabetes Oral Health (DIOH) program initiated by Diabetes Educators (DE’s) for patients. This program will incorporate oral health guidelines into diabetic care practice and will involve educating and training DNEs to provide oral health education, assessment and referrals to their patients.

Scoping review and designing the Diabetes Oral Health Program
Patients, GPs and DE’s perceptions regarding oral health and the Program
Developing Diabetic Oral Health program with an expert panel
Pilot testing the Diabetic Oral Health program

Funding:

In-kind support is gratefully acknowledged from:

Sydney Local Health District and South Western Sydney Local Health District

Project Team:

Prakash Poudel – Western Sydney University, SWSLHD, Ingham Institute
Assoc Prof. Ajesh George – Western Sydney University, SWSLHD, University of Sydney, Ingham Institute
Prof Rhonda Griffiths – Western Sydney University
Dr Vincent Wing-Ming Wong – University of New South Wales
Dr Amit Arora – Western Sydney University, Ingham Institute

Contact:

Phone: 02 8738 9356

Oral Health, Ageing & Palliative Care

Improving oral health outcomes for people living with disability and in residential care facilities (ACOH)

In recent years, there has been an increasing interest in research on how to best service the needs of Australia’s ageing population. Research has indicated that many of the oral diseases associated with ageing can be easily prevented by good daily oral hygiene practices and timely access to dental care. In response to this, the Better Oral Health in Residential Aged Care program was developed to train nursing staff to provide oral care to aged care residents. However, recent survey of Directors of Nursing (DoNs) in Residential Aged Care Facilities (RACFs) reported that even following this program, less than half (48%) of residents had dental assessment on admission and 74.2% of facilities did not have regular visits by dentists.

Aim:

The overall aim of this quality assurance project is to evaluate current practices and develop strategies to improve the oral health outcomes of people living in residential aged care

Funding:

Funding is gratefully acknowledged from:

South Western Sydney Local Health District Innovation Committee

Project Team:

Dr Sally Clark – SWSLHD
Amy Villarosa – Western Sydney University, SWSLHD, Ingham Institute
Tiffany Patterson Norrie – Western Sydney University, SWSLHD, Ingham Institute
Cynthia Valderrama – SWSLHD, Ingham Institute
Jennifer Anlezark – SWSLHD
Kylie Smidt – SWSLHD, Ingham Institute
Diana Wiskich – SWSLHD
Susan MacDonald – HarbisonCare
Assoc Prof. Ajesh George – Western Sydney University, SWSLHD, University of Sydney, Ingham Institute

Contact:

Phone: 02 8738 9356

Oral Health & Disability

Improving oral health outcomes of people with intellectual and developmental disabilities

People with disabilities can experience many challenges that could affect oral health status, including the need for assistance with core activities, additional barriers to accessing quality health care, and a higher likelihood of having lower incomes and education levels when compared to the general population (Kavanagh and Kelly 2012). As such, research has shown that people with disabilities are at higher risk of experiencing poor oral health outcomes when compared to the general population.

Aim:

To examine how creative writing can promote healthy ageing

Funding:

Funding is gratefully acknowledged from:

Western Sydney University

Project Team:

Dr Nathan Wilson – Western Sydney University, Ingham Institute
Zhen Lin – Western Sydney University
Amy Villarosa – Western Sydney University, SWSLHD, Ingham Institute
Assoc Prof. Ajesh George – Western Sydney University, SWSLHD, University of Sydney, Ingham Institute

Contact:

Phone: 02 8738 9356