Mothers’ experiences of the NICU and a NICU support group programme

Objective: to understand both the maternal experience of the NICU and mothers’ views of a NICU Parent Support Group. Background: mothers of babies who are born prematurely have their first experiences of parenting while their infant is in the neonatal intensive care unit (NICU). This presents multiple challenges and a range of stresses related to their role as a mother and concerns about their baby’s survival and growth. Thus, various supportive interventions have been trialled with this NICU parent population. However, the focus of this support and how it should be delivered lacks research as an evidence base for practice. Mothers’ experiences of the NICU and a professionally facilitated NICU support group at a city hospital were explored in this qualitative research study. Method: nine mothers were interviewed in 2010 while their babies were NICU inpatients. Interviews were recorded, transcribed and analysed thematically. Results: the NICU admission resulted in participant mothers facing challenges in getting to know their baby, forming their parenting role while in the NICU, and a reliance upon, but resentment toward, nursing staff. Positive feelings about their baby’s strengths were also apparent. The parent support group was an important part of managing the experience of the NICU and was reported to meet the emotional support needs of these NICU parents. Conclusion: the implications and recommendations for NICU-based emotional support are discussed. In particular, modifications to support group structures to ensure professional staff involvement and a balance between education and emotional care are reviewed.     

Returning home to work: Malaysian students who studied medicine overseas

International students' medical training often includes an elective placement in their home country to prepare them for practice on graduation. Seven Malaysian students in their final year of medicine were interviewed pre- and post-graduation and asked to reflect on whether they felt adequately prepared for working in Malaysia. These seven international students, who studied medicine in Australia, all returned to Malaysia for six weeks for their elective, and the interviews canvassed their perceptions of this experience, along with their thoughts on how well their training in Australia had prepared them for working in their country of origin. The interview data were qualitatively analysed, and case studies were constructed. Main themes were identified and tabulated. Students voiced similar concerns about how ready they were for working at home. These included a lack of practical skills relative to their Malaysian-trained counterparts, language difficulties, medical communication skill incompatibilities across cultures, expectations to perform complex or unfamiliar tasks with minimal supervision and substantial burdens of responsibility with long working hours. These students did not feel greatly prepared for their return home to practise medicine. The elective placement was not well utilized by the majority of students in this study.     

Gaps in the evidence about companion animals and human health: some suggestions for progress

A number of researchers have explored the relationship between companion animal ownership and human physical and psychological health. Results have been inconclusive, with positive, neutral and negative effects variously reported in the literature. Furthermore, the possible mechanisms of any influence are frustratingly unclear. A number of conceptual and methodological weaknesses have hampered progress in our understanding of how companion animals may impact upon human health. The two evidence gaps discussed in this paper, with suggestions for needed next steps, are: (i) a preponderance of anecdotal reports and cross-sectional research designs; and (ii) failure to control for a host of other known influences on human health including health habits, level of attachment to the companion animal and human social supports. Finally, an example of these gaps is provided in relation to the literature on the effects of animals on elderly nursing home residents.     

Health effects of ownership of and attachment to companion animals in an older population

Background: Two reasons for the inconclusiveness of the literature on the health effects of pet ownership are (1) failure to control for other known influences on health, and (2) inadequate consideration of the nature of the emotional relationship between owners and their companion animals.Purpose: The main aims were to develop a measure of pet attachment that reflects psychologists’ use of the attachment concept, and to see if pet ownership or attachment added to the health variance explained by known predictors.Method: Community-living older adults (n = 314) gave information by interview using structured questions and standardized scales. Multiple regressions were then conducted to examine the possible predictive role of health habits, human social supports, pet ownership, and owners’ attachment to the pet, on health and well-being.Results: The pet attachment measure showed good internal reliability. After controlling for other variables, neither pet ownership nor pet attachment added significantly to explained variance in health and well-being.Conclusions: The health of elderly people is related to their health habits and social supports but not to their ownership of, or attachment to, a companion animal.     

Can targeted job-information for adults with spinal cord dysfunction be effectively delivered online? A pilot study

Objective: To pilot a novel email-based information package (Work and SCI) for job-seekers with an acquired spinal cord injury (SCI) or spinal cord dysfunction (SCI/D).

Study design: Prospective, non-randomized, repeated measures trial.

Setting: Community dwelling cohort in Australia.

Participants: Five people with SCI (mean age 46.4 years, SD?=?10.2; 4 female) initially reviewed Work and SCI. Twenty-four with SCI/D subsequently enrolled, of whom 16 (mean age 46.4 years, SD?=?11.1; 7 female), completed the intervention.

Intervention: Intervention participants accessed Work and SCI over a 4-week period.

Outcome measures: Individual changes in pre-post scores for the My Vocational Situation Scale, Job Procurement Self-Efficacy Scale, Patient Health Questionnaire-9 and Life Orientation Test-Revised were examined.

Results: Reliable change in pre-post scores across outcomes were reported by 38% (n?=?6) of participants. Favorable comments on the Work and SCI resource were provided in addition to suggestions for improvement.

Conclusions: Preliminary data suggest that Work and SCI may help to establish vocational interests among job-seekers with a SCI/D, however further work is needed to enhance participant compliance. This might include moderator support to promote and maintain participation. A controlled design will also help to identify factors that influence engagement with the Work and SCI resource.     

The evaluation of undergraduate students' written English language skills

CONTEXT: Writing is an important skill for practitioners and students, yet this is a skill rarely taught in a formal capacity at medical school. At the University of Adelaide many students are from non-English speaking backgrounds and have varying proficiencies in English. We wished to devise a method and instrument which could identify students who may benefit from formative feedback and tuition in writing. OBJECTIVES AND METHOD: Students' written account of a short clinical interview with a standardized patient was assessed using a new instrument (the Written Language Rating Scale) designed especially for this study. The assessment of writing was made by one rater with qualifications in teaching English as a second language. SUBJECTS: 127 second-year medical students enrolled at the University of Adelaide, Australia. INSTRUMENTS AND RESULTS: The scale appeared to have good internal consistency, face and construct validity, and test security was not an issue. However, it had questionable concurrent validity with a standardized language test, although this may be partly due to the period of time which had elapsed between administration of the two tests. CONCLUSIONS: This study was useful in providing a means to objectively rate students' written English language skills and to target students in need of formative feedback and tuition. However, further research is necessary for both evaluation of medical writing and interventions for its improvement.