'Now I Have Dreams in Place of the Nightmares': An Updated Systematic Review of Post-Traumatic Growth Among Refugee Populations.

Trauma exposure places refugees at serious risk of developing mental health difficulties. However, research also recognizes that refugees can respond to trauma with psychological development and growth, commonly referred to as post-traumatic growth (PTG). An updated systematic review was conducted to investigate PTG across different refugee populations, including the processes that mediate this phenomenon, and the use of therapy in promoting PTG. A systematic search of CINAHL Complete, Proquest 5000, PsychINFO, Scopus, and Web of Science was performed to identify studies exploring PTG in refugee populations, published between June 2013 and November 2021. In all, 26 studies met the inclusion criteria for this review. Quantitative results reveal a positive correlation between PTG and religious commitment and coping, and the effectiveness of narrative and community-based interventions in facilitating PTG. Qualitative results facilitate insight into the complex ways refugees find meaning and strength after trauma through religion, comparison-based thinking, helping others, and storytelling. Findings highlight the need for future research and interventions to recognize the distinct PTG experiences of different refugee populations.

'I no longer know that person': Experiences of families living with someone using crystal methamphetamine.

BACKGROUND: Crystal methamphetamine ('ice') use is a large and growing worldwide problem, yet few research studies have explored the impact of crystal methamphetamine use on affected friends and family members. We explored the experiences and narratives of family members and friends of people who use methamphetamine to inform the development of a Family and Friend Support Program. METHODS: This paper reports on a subset of findings from a mixed method study, which sought to better understand the experiences of family members and friends of people who use methamphetamine. Participants were recruited via Facebook advertising and asked to complete a survey outlining their experiences. At the end of the survey, participants were invited to be interviewed by a clinical psychologist on the research team, to discuss their experiences in greater depth; seventeen people agreed to be interviewed. This paper is based on a qualitative thematic analysis of these interviews using Braun and Clarke's 6-stage approach to identify key areas of concern for friends and family members of people who use methamphetamine. RESULTS: Through thematic analysis, five key themes were developed, namely: (1) loss, (2) stigma, (3) support (or lack thereof), (4) ways of coping, and (5) the value in sharing personal experiences. The results of this study revealed the profound sadness, frustration and loss friends and family members experienced when caring for a loved one who uses methamphetamine. This loss was further complicated by societal stigma surrounding the use of methamphetamine, which often extended to friends and family members themselves. Since experiences of grief and loss were interwoven across the three themes, concepts of ambiguous loss, disenfranchised grief, and narrative constructivist approaches to understanding loss, were applied to the discussion of results. CONCLUSION: This study provides a more complete picture of family and caregiver experiences when caring for a loved one using methamphetamine, which may further help inform the design of intervention programs. Implications for future research and practice with this population are considered.

The salutogenic gaze: Theorising the practitioner role in complementary and alternative medicine consultations.

Research on why people use complementary and alternative medicine (CAM) shows clients value the CAM consultation, where they feel listened to and empowered to control their own health. Such 'empowerment' through CAM use is often theorised as reflecting wider neoliberal imperatives of self-responsibility. CAM users' perspectives are well studied, but there has been little sociological analysis of interactions within the CAM consultation. Specifically, it is unclear how user empowerment/self-knowledge relates to the CAM practitioner's power and expert knowledge. We address this using audio-recorded consultations and interviews with CAM practitioners to explore knowledge use in client-practitioner interactions and its meaning for practitioners. Based on our analysis and drawing on Foucault (1973), The Birth of the Clinic: an archaeology of medical perception and Antonovsky (1979), Health, Stress and Coping, we theorise the operation of power/knowledge in the CAM practitioner-client dyad by introducing the concept of the 'salutogenic gaze'. This gaze operates in the CAM consultation with disciplining and productive effects that are oriented towards health promotion. Practitioners listen to and value clients' stories, but their gaze also incorporates surveillance and normalisation, aided by technologies that may or may not be shared with clients. Because the salutogenic gaze is ultimately transferred from practitioner to client, it empowers CAM users while simultaneously reinforcing the practitioner's power as a health expert.

Another implementation science is possible: engaging an 'intelligent public' in knowledge translation.

As the world contends with the COVID-19 pandemic, scientific expertise has permeated political discourse and the phrase 'following the science' is being used to build trust and justify government decision-making. This phrase reflects a problematic assumption that there is one objective science to follow and that the use of scientific knowledge in decision-making is inherently neutral. In this article, we examine more closely the dense and intricate relationships, values, politics, and interests that determine whose knowledge counts, who gets to speak, who is spoken for, and with what consequences, in the translation of scientific knowledge. Drawing key insights from Stengers' Manifesto for Slow Science, we argue that implementation science has a central role to play in problematising the historic dominance of certain voices and institutional structures that have come to symbolise trust, rigour, and knowledge. Yet to date, implementation science has tended to overlook these economic, social, historical, and political forces. Fraser's conception of social justice and Jasanoff's 'technologies of humility' are introduced as useful frameworks to extend the capacity of implementation science to engage the broader public as an 'intelligent public' in the translation of knowledge, during and beyond the pandemic.

"Another tool in our toolbox": a scoping review of the use of eHealth technologies in health social work practice.

There is increasing recognition of the salience of eHealth technologies in enhancing health service capacity. Yet social work remains "behind the curve" in progressing digital practices. As the demand for digital health care increases, particularly following COVID-19, it is becoming increasingly urgent to understand how social workers engage with eHealth technologies, and how technological engagement impacts on social work practice. In this scoping review, we sought to examine eHealth use in health social work practice. Our findings suggest that, while social workers recognize the strengths and opportunities to broaden the scope of their practice, they remain concerned that eHealth may not be congruent with the values and approaches of the profession. This review provides a broad overview of health social workers' engagement with eHealth technologies and considers implications for future research that examines the nuanced and complex nature of professional values, risk, and assessment in the digital space.

Classifying knowledge used in complementary medicine consultations: a qualitative systematic review.

BACKGROUND: Complementary Medicine (CM) is widely used internationally but there is limited understanding of the forms of knowledge CM practitioners use in their clinical practice and how they use this knowledge in interactions with patients. This review aims to synthesise the existing evidence on the forms of knowledge that are mobilised, and the role of this knowledge in the interactions between practitioners and patients during CM consultations. It considered a diverse range of CM practice areas to develop a classification of CM practitioners' knowledge use in consultations. METHODS: Systematic searches of health and sociology databases were conducted using core concepts, including complementary and alternative medicine, practitioners, and knowledge. Articles were included where they reported on data from recorded CM practitioner and patient consultations and offered insights into the types and applications of knowledge used in these consultations. 16 unique studies were included in the review. Data were extracted, coded and analysed thematically. RESULTS: Results demonstrate that diverse sources of knowledge were mobilised by practitioners, predominantly derived from the patients themselves -their bodies and their narratives. This reflected principles of patient-centredness. The use of discipline specific forms of knowledge and references to biomedical sources illustrated ongoing efforts towards legitimacy for CM practice. CONCLUSION: CM practitioners are navigating tensions between what some might see as competing, others as complementary, forms of knowledge. The classification system provides a useful tool for promoting critically reflective practice by CM practitioners, particularly in relation to self-assessment of knowledge translation and patient interactions.

A systematic literature review and narrative synthesis of effective interventions for family and caregivers of people who use methamphetamine.

Background: Methamphetamine is a highly addictive central nervous stimulant associated with numerous adverse health, psychological, and social impacts. Family and friends of people who use methamphetamine often take on a crucial caregiving role in supporting their loved one. Consequently, they can experience a range of psychosocial challenges themselves. This review aimed to identify and assess the effectiveness of interventions designed to support caregivers of people who use methamphetamine. Methods: A systematic search of relevant literature published in the English language was conducted. Of 2257 records identified, only 2 evaluation studies examined interventions specifically designed for caregivers of people who use methamphetamine. Additionally, four qualitative accounts described experiences of caring for people who use methamphetamine. These accounts were summarized narratively to provide a more complete picture of family and caregiver experiences and coping strategies. Results: Effective treatment components included tending to caregiver concerns and providing training to enhance informational support and problem-solving skills. Qualitative accounts uncovered a range of challenges experienced by caregivers, such as emotional distress, concern for the person using methamphetamine, disrupted family structures, and financial difficulties. Coping strategies included attempts at managing and supporting the person using methamphetamine while protecting the overall cohesion and wellbeing of the family unit. Conclusions: This review highlighted a lack of evidence-based interventions for caregivers of people who use methamphetamine. More research is needed to clarify concerns that may be particularly relevant for those in a caregiving role.

Mental health care needs in cystic fibrosis: A scoping review.

People with cystic fibrosis experience rates of anxiety and depression that are considerably higher than those of the general population. Research suggests low mental health functioning can lead to poor health outcomes and quality of life for this population. Consequently, recognition of the need for routine mental health screening and referral in cystic fibrosis care is increasing. Yet to date, less is known about the actual mental health care needs of people with cystic fibrosis. This scoping review sought to address this gap by examining the mental health care needs of adults and adolescents living with cystic fibrosis, and how are these needs are (or are not) being met. Findings suggest current efforts at mental health care provision do not adequately meet the needs of people with cystic fibrosis, highlighting the urgency of conducting high quality intervention research to support effective mental health care for this population.

Placing equity at the heart of eHealth implementation: a qualitative pilot study.

BACKGROUND: There is a growing urgency to tackle issues of equity and justice in the implementation of eHealth technologies. METHODS: Qualitative interviews were conducted with 19 multidisciplinary health professionals to explore the implementation and uptake of eHealth technologies in practice. The aim of this article was to examine in more detail issues of equity and justice in the implementation and uptake of eHealth technologies in practice. Results were analysed using Braun and Clarke's six-step reflexive thematic analysis approach. RESULTS: Nancy Fraser's concept of social justice is introduced as a novel framework for inquiry into the implementation of digital health services. Health professionals reported that eHealth offered their clients a greater sense of safety, convenience, and flexibility, allowing them to determine the nature and pace of their healthcare, and giving them more control over their treatment and recovery. However, they also expressed concerns about the use of eHealth with clients whose home environment is unsafe. Application of Fraser's framework revealed that eHealth technologies may not always provide a secure clinical space in which the voices of vulnerable clients can be recognised and heard. It also highlighted critical systemic and cultural barriers that hinder the representation of clients' voices in the decision to use eHealth technologies and perpetuate inequalities in the distribution of eHealth services. CONCLUSIONS: To facilitate broad participation, eHealth tools need to be adaptable to the needs and circumstances of diverse groups. Future implementation science efforts must also be directed at identifying and addressing the underlying structures that hinder equitable recognition, representation, and distribution in the implementation of eHealth resources.

"It's Hard, but We Could Kind of Laugh About It": Exploring the Role of Humor in Brain Cancer Caregiving.

Research exploring the benefits of humor for caregivers is limited and, to date, no qualitative studies have explored the role of humor in brain cancer caregiving. To address this gap, we analyzed transcripts from twenty-one in-depth telephone interviews conducted with brain cancer caregivers from a strengths perspective. Thematic analysis using Braun and Clarke's method revealed that humor functions as (1) an innate element of the self and relationship, (2) an expression of mutual connection and understanding, (3) a way of managing difficult or awkward moments, (4) a form of avoidance or a welcome distraction, and may be (5) helpful, or unhelpful, depending on where someone is in the brain cancer trajectory. Findings suggest that humor represents an important yet complex individual and family strength for health service providers to identify and build upon.

Understanding motivation for Australian adolescents and young adults with cystic fibrosis: Modifiable factors to support self-management.

Cystic fibrosis (CF) is Australia's most common life limiting genetic condition, characterised by declining health and quality of life (QoL) over time. Despite improvements in treatment, there remains no cure. Adolescents and young adults (AYAs) with CF experience broad impacts to psychosocial functioning and QoL, as well as major transitions in care, all at a time of significant developmental change. The importance of developmentally tailored approaches to youth health care and self-management for young people with CF are well understood. However, to date, models of youth specific self-management have been lacking and motivation for young people with CF has not been well explored. This qualitative study, based on a social constructionist epistemological framework, addresses this gap. A total of 21 AYAs aged 15-30 years were recruited through one paediatric and one adult Australian CF centre. Demographic, clinical and distress data were captured to describe health complexity. Semi-structured interviews were audio-recorded, transcribed and analysed using thematic analysis. Participants were representative of Australian AYAs with CF by demography and clinical status. Alarmingly, over a third reported clinically significant distress. Two themes emerged. The first Identified impacts to motivation and self-management resulting from the challenges of managing CF, life and care. These included time and competing priorities, changing health statis, mental health, social factors, unmet needs and health system complexity. The second identified factors that support motivation including: achievement, meaning and purpose; consequence avoidance; and accountability. These results illustrate the importance of AYA specific, theoretically founded, holistic self-management models which extend beyond current theoretical approaches that aim to understand behaviour change or address barriers, in isolation from motivation. Improved approaches to care based on these findings are essential to foster positive behavioural change, support self-management and foster the best health outcomes for young people living with CF.

Supporting friends and family of adults with a primary brain tumour: A systematic review.

Expanding on the limited work in supportive care for friends and family caregivers of adults with a primary brain tumour, this review sought to examine all available evidence since 2010 on the efficacy and feasibility of supportive interventions for this population including non-controlled studies. A systematic review of the literature was conducted on the feasibility and effectiveness/efficacy of supportive interventions for brain cancer caregivers in line with PRISMA guidelines. 13 studies met the eligibility criteria and were identified for inclusion. Most interventions employed tailored psychoeducation, and expert involvement via psychotherapy or care coordination. Only two interventions demonstrated clinically significant improvements. Findings indicate that dyadic yoga programs, and programs that enhance caregiver mastery to manage patient behavioural problems, may lead to improvements in some clinical outcomes. Results highlight the diverse nature of supportive interventions and indicate that support for primary brain tumour caregivers is currently suboptimal. Our findings illustrate an overall low certainty of evidence, with a need for more adequately powered randomised controlled trials. As the complexities of brain cancer care-giving are an obstacle to standardised interventions, this review underscores the need for future trials to incorporate complimentary qualitative research methodologies.

Barriers and facilitators to the use of e-health by older adults: a scoping review.

BACKGROUND: Limited attention has been paid to how and why older adults choose to engage with technology-facilitated health care (e-health), and the factors that impact on this. This scoping review sought to address this gap. METHODS: Databases were searched for papers reporting on the use of e-health services by older adults, defined as being aged 60 years or older, with specific reference to barriers and facilitators to e-health use. RESULT: 14 papers were included and synthesised into five thematic categories and related subthemes. Results are discussed with reference to the Unified Theory of Acceptance and Use of Technology2. The most prevalent barriers to e-health engagement were a lack of self-efficacy, knowledge, support, functionality, and information provision about the benefits of e-health for older adults. Key facilitators were active engagement of the target end users in the design and delivery of e-health programs, support for overcoming concerns privacy and enhancing self-efficacy in the use of technology, and integration of e-health programs across health services to accommodate the multi-morbidity with which older adults typically present. CONCLUSION: E-health offers a potential solution to overcome the barriers faced by older adults to access timely, effective, and acceptable health care for physical and mental health. However, unless the barriers and facilitators identified in this review are addressed, this potential will not be realised.

Factors Predicting Trial Engagement, Treatment Satisfaction, and Health-Related Quality of Life During a Web-Based Treatment and Social Networking Trial for Binge Drinking and Depression in Young Adults: Secondary Analysis of a Randomized Controlled Trial.

BACKGROUND: Mental health and alcohol use problems are among the most common causes of disease burden in young Australians, frequently co-occur (comorbidity), and lead to significant lifetime burden. However, comorbidities remain significantly underdetected and undertreated in health settings. Digital mental health tools designed to identify at-risk individuals, encourage help-seeking, or deliver treatment for comorbidity have the potential to address this service gap. However, despite a strong body of evidence that digital mental health programs provide an effective treatment option for a range of mental health and alcohol use problems in young adults, research shows that uptake rates can be low. Thus, it is important to understand the factors that influence treatment satisfaction and quality-of-life outcomes for young adults who access e-mental health interventions for comorbidity. OBJECTIVE: In this study, we seek to understand the factors that influence treatment satisfaction and quality-of-life outcomes for young adults who access e-mental health interventions for comorbid alcohol and mood disorders. The aim is to determine the importance of personality (ie, Big Five personality traits and intervention attitudes), affective factors (ie, depression, anxiety, and stress levels), and baseline alcohol consumption in predicting intervention trial engagement at sign-up, satisfaction with the online tool, and quality of life at the end of the iTreAD (Internet Treatment for Alcohol and Depression) trial. METHODS: Australian adults (N=411) aged between 18 and 30 years who screened positive for depression and alcohol use problems signed up for the iTreAD project between August 2014 and October 2015. During registration, participants provided information about their personality, current affective state, alcohol use, treatment expectations, and basic demographic information. Subsequent follow-up surveys were used to gauge the ongoing trial engagement. The last follow-up questionnaire, completed at 64 weeks, assessed participants' satisfaction with web-based treatment and quality-of-life outcomes. RESULTS: Multiple linear regression analyses were used to assess the relative influence of predictor variables on trial engagement, treatment satisfaction, and quality-of-life outcomes. The analyses revealed that the overall predictive effects of personality and affective factors were 20% or lower. Neuroticism constituted a unique predictor of engagement with the iTreAD study in that neuroticism facilitated the return of web-based self-assessments during the study. The return of incentivized follow-up assessments predicted treatment satisfaction, and state-based depression predicted variance in quality-of-life reports at study completion. CONCLUSIONS: Our findings suggest that traditional predictors of engagement observed in face-to-face research may not be easily transferable to digital health interventions, particularly those aimed at comorbid mental health concerns and alcohol misuse among young adults. More research is needed to identify what determines engagement in this population to optimally design and execute digital intervention studies with multiple treatment aims. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ACTRN): 12614000310662; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=365137&isReview=true. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s12889-015-2365-2.

Theories Informing eHealth Implementation: Systematic Review and Typology Classification.

BACKGROUND: Theory-guided approaches to implementation science have informed translation efforts and the acceptance of eHealth (digital health) interventions in clinical care. However, there is scarce evidence on which theories are best suited to addressing the inherent complexity of eHealth implementation. OBJECTIVE: The objectives of this systematic review are to identify theories that inform and explain eHealth implementation and to classify these theories using the typology by Sovacool and Hess for theories of sociotechnical change. METHODS: An electronic search was conducted in the PsycINFO, MEDLINE, Embase, CINAHL, Scopus, Sociological Source Ultimate, Web of Science, ABI/INFORM, EBSCO, and ProQuest databases in June 2019. Studies were included if they were published between 2009 and June 2019; were written in English; reported on empirical research, regardless of study or publication type; reported on one or more theories in the context of eHealth implementation; and were published in a peer-reviewed journal. A total of 2 reviewers independently assessed the titles, abstracts, and full texts. Theories identified were classified using a typology for theories of sociotechnical change, which was considered a useful tool for ordering and analyzing the diverse theoretical approaches as a basis for future theory building. RESULTS: Of the 13,101 potentially relevant titles, 119 studies were included. The review identified 36 theories used to explain implementation approaches in eHealth. The most commonly used approaches were the Technology Acceptance Model (TAM) (n=33) and the Unified Theory of Acceptance and Use of Technology (UTAUT) (n=32). These theories were primarily concerned with individual and interpersonal elements of eHealth acceptance. Less common were theories that reflect the various disorderly social processes and structural dimensions of implementation, such as the normalization process theory (n=17) and the structuration theory (n=6). CONCLUSIONS: Theories currently informing the implementation of eHealth interventions predominantly focus on predicting or explaining end-user acceptance. Theoretical perspectives that capture the dense and intricate relationships and structures required to enact sustainable change are less well represented in the eHealth literature. Given the growing acknowledgment of the inherent complexity of eHealth implementation, future research should develop and test models that recognize and reflect the multidimensional, dynamic, and relational nature of this process.

Understanding ambivalence in help-seeking for suicidal people with comorbid depression and alcohol misuse.

Help-seeking prior to a suicide attempt is poorly understood. Participants were recruited from a previous research trial who reported a history of suicidal behaviours upon follow-up. Qualitative interviews were conducted with six adults to understand their lived experience of a suicide attempt and the issues affecting help-seeking prior to that attempt. Participants described being aware of personal and professional supports available; however, were ambivalent about accessing them for multiple reasons. This paper employs an ecological systems framework to better understand the complex and multi-layered interpersonal, societal and cultural challenges to help-seeking that people with suicidal ideation can experience.

Integrating psychosocial approaches into the management of childhood functional gastrointestinal disorders: a role for social work.

FGID is one of the most common pain conditions in children and adversely affects their functioning and quality of life. Recent approaches to the management of paediatric FGID recognise the importance of an integrated biopsychosocial approach. Unfortunately, research findings show that psychosocial factors are often not adequately addressed in the management of FGID in children. We recently conducted a survey of 327 paediatric doctors in Australia to investigate their approaches to managing two of the most common childhood FGID - functional abdominal pain (FAP) and irritable bowel syndrome (IBS). Findings provide important insights into paediatricians' perceptions of the role of psychosocial issues and interventions in these conditions. Implications for social work are discussed.

Functional gastrointestinal disorders in children and adolescents: Knowledge, practice and attitudes of Australian paediatricians.

AIM: To investigate paediatricians' understanding of, and approaches to, the diagnosis and treatment of functional abdominal pain (FAP) and irritable bowel syndrome (IBS) in children. METHODS: This study used an electronic survey of doctors subscribing to a popular Australian-based paediatrics email forum. Responses about investigation and management in two clinical vignettes were correlated with respondent demographic data, practice setting, attitudes and knowledge. RESULTS: The 327 respondents were mostly female (60.3%), aged <45 years (54.5%), general paediatricians (53.5%), working in public outpatient clinics (50.5%). Awareness of Rome III diagnostic criteria was low (37.2%) but associated with confidence in diagnosing FAP/IBS in the vignettes. Respondents who lacked confidence in diagnosing FAP/IBS requested more investigations (P < 0.05), although most acknowledged they would not be helpful. Most (70.5%) believed that families are unlikely to accept an FAP diagnosis without investigations requested. Fewer than 1 of 3 were aware of clear evidence for the effective therapy of FAP or IBS, although awareness did not influence management options selected. Two-thirds of respondents believe that FAP is a psychological rather than a medical problem, while few (8.8%) believe the same about IBS (P < 0.001). Parental pressure to find an immediate cure was cited as the most frequent challenge to successful management in both FAP (86.6%) and IBS (75.9%). CONCLUSIONS: Awareness of the Rome criteria was associated with greater confidence in diagnosing FAP and IBS. Attitudes to FAP and IBS being diagnoses of exclusion are prevalent among paediatricians and associated with more investigations requested. There is a lack of awareness of evidence-based therapies for FAP and IBS.