Improving Outcomes For People With Cancer: Consultation Skills Training With Oncologists
Funder
National Health and Medical Research Council
Funding Amount
$499,070.00
Summary
Each year approximately 30,000 Australians die from cancer and 65,000 new cancers are diagnosed. Despite much research for a cure for cancer, the incidence and mortality from cancer has not changed. New treatments now cause people with cancer to live longer with the disease, so we now need to focus on efforts to optimise the quality of life of these people. Although the emotional burden on patients and families is recognized, there is a sense that this is an inevitable by-product of the disease ....Each year approximately 30,000 Australians die from cancer and 65,000 new cancers are diagnosed. Despite much research for a cure for cancer, the incidence and mortality from cancer has not changed. New treatments now cause people with cancer to live longer with the disease, so we now need to focus on efforts to optimise the quality of life of these people. Although the emotional burden on patients and families is recognized, there is a sense that this is an inevitable by-product of the disease and its management in existing clinical systems. However, this does not need to be the case. There is now ample evidence that the way that doctors interact with their patients can effect the accuracy of diagnosis and prognosis, as well as patients' satisfaction, adherence with treatment instructions and quality of life after being diagnosed with cancer. Both patient advocate groups and clinicians have called for further training for doctors to effectively manage psychosocial aspects of cancer care, however, despite this support, there have been few opportunities for such training in Australia. We have developed an innovative consultation-skills program for oncologists. So that the effectiveness of the project can be evaluated, it will be implemented as a randomised controlled trial with oncologists from major Australian cancer clinics being randomly allocated to an intervention or control group. The training program will be delivered by videoconferencing, to overcome many of the barriers that have impeded busy clinicians from participating in previous training programs. This is the first international study to use videoconferencing between remote locations for this type of consultation skills training. A variety of measures will be used to evaluate the impact of the training, including patients' quality of life, anxiety, depression and perceived needs, and oncologists' burn-out.Read moreRead less
Competence To Give Informed Consent For Research Participation In Schizophrenia And Related Psychoses.
Funder
National Health and Medical Research Council
Funding Amount
$300,000.00
Summary
There is current controversy surrounding the ethics of allowing people with mental illness to participate in research. By trying to safe guard what is considered a vulnerable group, we may also be denying these people their rights to make decisions for themselves. The potential benefits of clinical research in an area where treatments are often ineffective and cause serious side effects may also be denied to these people. This study aims to measure the capacities of patients with psychoses to gi ....There is current controversy surrounding the ethics of allowing people with mental illness to participate in research. By trying to safe guard what is considered a vulnerable group, we may also be denying these people their rights to make decisions for themselves. The potential benefits of clinical research in an area where treatments are often ineffective and cause serious side effects may also be denied to these people. This study aims to measure the capacities of patients with psychoses to give informed consent to participate in clinical research. The uniqueness of this project is that subjects will be rated as either competent or incompetent according to legal definitions applicable in Australia by utilising predetermined thresholds. We will also determine whether performance of patients in tests of competence can be improved through an established educational program. Additionally we plan to re-evaluate patients after a period of 6 months in order to test the reliability of competence performance.Read moreRead less
Evaluation Of Cognitive-behaviour Therapy For Alcohol And Other Drug Problems Among People With A Psychotic Illness
Funder
National Health and Medical Research Council
Funding Amount
$217,465.00
Summary
Abuse of alcohol and other drugs among people with a major psychiatric illness is a serious public health problem and cost-effective treatments need to be developed and assessed. The aim of this project is to evaluate the effectiveness of a counselling intervention. 180 individuals with a psychotic illness and concurrent alcohol and other drug (AOD) problems will be randomly assigned to counselling or usual treatment and followed up for a period of 12 months. The indicators of interest include: ....Abuse of alcohol and other drugs among people with a major psychiatric illness is a serious public health problem and cost-effective treatments need to be developed and assessed. The aim of this project is to evaluate the effectiveness of a counselling intervention. 180 individuals with a psychotic illness and concurrent alcohol and other drug (AOD) problems will be randomly assigned to counselling or usual treatment and followed up for a period of 12 months. The indicators of interest include: current drug use; psychiatric symptoms; self-harm; social functioning; and use of health services. Findings from the proposed study will assist in the selection of particular treatment strategies and will aid the overall development of services for people with both major mental illness and substance abuse.Read moreRead less
An Ethical Analysis Of The Disclosure Of Surgeons' Performance Data To Patients Within The Informed Consent Process
Funder
National Health and Medical Research Council
Funding Amount
$148,937.00
Summary
For over a decade, hospitals in the American state of New York have been collecting information about the mortality rates of surgeons conducting Coronary Artery Bypass Grafts, and making this information available to patients. The United Kingdom is set to make these and other performance indicators on the ability of surgeons ('report cards') available from 2004. There are good reasons to think a similar system may be introduced in Australia in the near future. Patients can use the information co ....For over a decade, hospitals in the American state of New York have been collecting information about the mortality rates of surgeons conducting Coronary Artery Bypass Grafts, and making this information available to patients. The United Kingdom is set to make these and other performance indicators on the ability of surgeons ('report cards') available from 2004. There are good reasons to think a similar system may be introduced in Australia in the near future. Patients can use the information contained in report cards when deciding whether or not to consent to have a particular surgeon conduct an operation on them. Contemporary bioethicists stress the importance of a proper informed consent process in medicine. This is a process in which a doctor advises a patient of relevant information and ensures that the patient comprehends that information, before the patient consents to an operation. Currently report cards in America are publicly disseminated on the internet, however there is no systematic attempt to incorporate the information contained in report cards into the informed consent process. We do not know if patients understand the information they are given, or if they incorporate it into their decision making procedures appropriately. In our study we will consider how information that is contained in report cards could best be used in the informed consent process. We will keep in mind the importance of helping patients to make their own informed decisions to consent to operations, the importance of respecting the professional integrity of surgeons and the importance of providing the best possible standard of care for patients. The result of our study will be a revised model of the informed consent process that incorporates report cards in an ethically acceptable way.Read moreRead less
Effect Of A Weight Management Program For Overweight And Obese Children: A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$430,000.00
Summary
Children who are obese have a higher risk of numerous health problems, including high blood pressure, high cholesterol and joint problems. They also experience reduced self-esteem and discrimination as well as an increased risk of premature death or poor health due to heart disease and Type 2 diabetes in adulthood. Approximately 25% of Australian children are overweight or obese. This prevalence has doubled since the 1980's and is still increasing. Child obesity is a major public health problem ....Children who are obese have a higher risk of numerous health problems, including high blood pressure, high cholesterol and joint problems. They also experience reduced self-esteem and discrimination as well as an increased risk of premature death or poor health due to heart disease and Type 2 diabetes in adulthood. Approximately 25% of Australian children are overweight or obese. This prevalence has doubled since the 1980's and is still increasing. Child obesity is a major public health problem and innovative approaches to solving this problem are urgently needed. A range of factors has been postulated as contributing to the global childhood obesity epidemic, including environmental, psychosocial, physical, nutrition, metabolic and lifestyle factors. However, the major determinants involve a shift away from energy balance through reduced energy expenditure or physical activity and increased energy intake. Conventional weight-management strategies have incorporated restricting energy intake or diet, increasing energy expenditure or physical activity, decreasing sedentary activities, parental involvement, and behaviour modification. However, these strategies have only shown moderate success among children in the medium to long term and very few can be translated into community settings. The purpose of this study, and its original contribution to research, is to determine the impact of a physical activity skill development and parent-centred family weight management program on the weight, cardiovascular health, physical activity, dietary intake, and sedentary behaviours of overweight and obese children.Read moreRead less
A Parent Education And Skills Training Early Intervention For Children With Autism
Funder
National Health and Medical Research Council
Funding Amount
$305,674.00
Summary
Autism is a severely handicapping disorder adversely affecting social interaction, communication, and behaviour, interests and activities. Over the past 9 years our team has conducted a follow-up study of a large group of 111 Australian children and adolescents with autism. The young people have continued to have very high levels of emotional and behavioural disturbance and generally do not improve. Parents of children with autism are under significant amounts of stress; reporting high levels of ....Autism is a severely handicapping disorder adversely affecting social interaction, communication, and behaviour, interests and activities. Over the past 9 years our team has conducted a follow-up study of a large group of 111 Australian children and adolescents with autism. The young people have continued to have very high levels of emotional and behavioural disturbance and generally do not improve. Parents of children with autism are under significant amounts of stress; reporting high levels of disturbed family functioning and mental health problems. Although there is no cure, children benefit most when early help is provided (under 5 years). There are several promising interventions based on intensive behaviour and educational management, for example requiring 40 hours per week of therapist contact over 2 years. Such programs are costly and impractical as widely available treatment options. Training parents to understand and manage their child also shows promise. This study will evaluate the effectiveness of a parent skills training and education treatment program compared to supportive therapy, and to generally available community services. The therapists will follow a treatment manual that will ensure a consistent and replicable approach. The progress of the children with autism and their families will be reassessed immediately after treatment, and at 1 and 2 years post-treatment in order to ascertain immediate and long-term effects of the treatment. If treatment proves to be of use, we will have established a defined, cost efficient, practical and effective model of early treatment that can be easily taught to professionals and widely disseminated throughout early childhood services.Read moreRead less
Evaluation Of Family Well Being Empowerment Program: A Participatory Action Research Initiative
Funder
National Health and Medical Research Council
Funding Amount
$487,920.00
Summary
We have shown that family well being empowerment training in Indigenous communities can significantly enhance program participants' sense of control and responsibility for the conditions affecting their health and well being (Tsey and Every, 2000a;Tsey and Every, 2000b). Following this, there has been a great deal of interest and demand for the family well being program not only in Indigenous Australia, but also among Maori people in New Zealand. Presently, we are involved in four collaborative ....We have shown that family well being empowerment training in Indigenous communities can significantly enhance program participants' sense of control and responsibility for the conditions affecting their health and well being (Tsey and Every, 2000a;Tsey and Every, 2000b). Following this, there has been a great deal of interest and demand for the family well being program not only in Indigenous Australia, but also among Maori people in New Zealand. Presently, we are involved in four collaborative initiatives with indigenous communities in response to growing interest and demand for the program. The current proposal is a joint initiative between University of Queensland, Apunipima Cape York Health Council and Gurriny Yealamucka Health Services which aims to: a. Consolidate and extend the existing family well being initiatives in Hopevale and Yarrabah to two other north Queensland communities (yet to be selected from several that have expressed an interest), using a participatory action research process b. Undertake a meta evaluation of outcomes across all four sites This proposal aims to increase our understanding about ways in which individuals and groups of people can be better supported in their efforts to bring about changes in personal and social life.Read moreRead less