Medicine & Health

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  • (2007) Chan, Bibiana Chi Wing
    Report
    Under-utilisation of mental health services is widespread globally and within Australia, especially among culturally and linguistically diverse (CALD) communities. Improving service access is a priority, as is the need to deliver culturally competent services to the CALD communities. Having migrated to Australia in waves for approximately 150 years from China and South East Asia for various social, political and economic reasons, the Chinese population in Sydney is now the fastest growing non-English speaking ethnic group. There is a need to better understand the impact of culture on the emotional experiences of these Chinese in Australia. How do Chinese make sense of their depressive episodes? To address this question, this study explored the ways participants reach out for medical and/or non-medical help. Lay concepts of illness underpin these decisions and were thus unveiled. Mixed-method research design provided the opportunity to bring together multiple vantage points of investigation: population mental health, transcultural psychiatry and medical anthropology. A study combining quantitative survey and qualitative focus groups was undertaken in metropolitan Sydney. Narratives on symptoms, explanatory models and help-seeking strategies were articulated by focus group informants. Surveys covered demographics, symptom-recognition, previous depressive experiences and professional help sought. Depression measurement tools were cross-culturally validated. Self-ratings of ethnic identities and the Suinn-Lew Self-Identity Acculturation Scale were used to quantify Chinese participants’ acculturation level. This allowed comparisons between ‘low-acculturated’ Chinese’, ‘highly-acculturated’ Chinese and Australians. Survey results showed comparable levels of symptom-recognition in all subgroups. Focus group discussions provided rich data on informants’ help-seeking strategies. Highly acculturated Chinese closely resembled the Australians in many study variables, yet qualitative data suggested cultural gaps beyond language barriers in influencing service use. Participants believed that trustful relationships could work as the bridge to link services with those in need. The implications for Australia’s mental health policy include recognising the importance of rapport-building and the existence of cultural gaps. The study indicated professionals can benefit from acquiring information about the mental health beliefs both of individual clients and the wider ethnic communities in which they belong, and respecting the cultural differences between helper and helped as the first step towards cultural competency.

  • (2008) Chan, Bibiana Chi Wing
    Report
    心理衛生服務不被廣泛採用﹐不單是澳洲也是全球性的現象﹐尤其是那些多元文化和語言背景 (Cultural and Linguistically Diverse)的社區。改善接觸服務的各種 門徑自然是當前急務﹐還需要考慮到服務範疇對多元文化的社區是否適切。華裔人士早於一百五十年前從中國及東南亞地區移民到澳洲﹐他們包括來自不同社會﹑政治﹑經濟背景的人士。悉尼的華人人口是澳洲近年增長最迅速的少了民族! 有見及此, 我們需要了解一下文化對情緒表現的影響. 華裔人士怎樣解釋他們的 抑鬱經歷呢? 要回答以上的問題﹐這個研究主要探討參加者怎樣尋求醫療和非醫療的服務。一般華人做這些決定時所持的病理概念就得以揭示出來! 混合式的研究設計 正好提供一個 機會去從一個垮躍多個學術領域 (公共衛生﹑ 跨文化心理學和 醫護人類學)的角度 來進行研究。這個在悉尼市區進行的研究,融合了‘數量’的問卷調查和‘質量’的社區座談會。取得的資料包括 病癥﹑病人的詮釋方法﹐求助途徑等. 問卷搜集到背 景資料, 病癥識辨﹐以往的抑鬱經歷和 曾向那些專業服務求助, 抑鬱症的量表和其 他跨文化的工具都經過嚴格測試覆核﹐其中用來量度華裔參加者的文化適應能力的量表 Suinn-Lew Self-Identity Acculturation Scale, 把參加者客觀地分成較傳統 和較澳洲化兩個組別﹑ 和澳洲人的一組作比較。 問卷調查顯示兩組華人和一組澳洲人對抑鬱症的病癥識辨能力相約﹔社區座談會的討論則引出了有關求助途徑的豐富資料。較澳洲化的華人跟澳洲人組別在很多個研究指標 (或稱變數﹐variables) 上都很接近。不過座談會資料卻指出文化上的差異對選 擇甚麼樣的服務有一定影響,很明顯這是超越語言上的障礙!參加者認為對專業人士或服務機構的信任是連接服務與病者的重要一環。研究結果呼籲澳洲心理衛生的策劃者必須正視‘建立良好關係的重要’。專業人士必需增強了解個別病者和少數民族對精神或心理病的詮釋。尊重求助者和施予援助者之間的文化差異’是踏出推動多元民化心理衛生服務的第一步.

  • (2008) Zablotska, Iryna; Prestage, Garrett; Frankland, Andrew; Chong, Stanley; Sutherland, Rob; Corrigan, Nick; Honnor, Geoff; Kippax, Susan
    Report
    Gay Community Periodic Surveys surveys are regularly conducted in Sydney, Melbourne, Brisbane, Cairns, Canberra, Adelaide and Perth to monitor changes in sexual and other risk practices over time among Australian gay men who are gay community attached, recruited from gay sex-on-premises venues, social sites and clinics.

  • (2002) Mao, Limin; Van de Ven, Paul; Prestage, Garrett; Jin, Fengyi; Grulich, Andrew; Crawford, June; Kippax, Susan; Murphy, Dean; Allan, Brent
    Report
    The Health in Men (HIM) cohort is a longitudinal (5-year) study of HIV-negative gay men in Sydney which started in June 2001. It has two arms: a socio-behavioural arm consisting of regular interviews about the impact of HIV on the sexual and social lives of men in the study; and a clinical arm consisting of serological testing for HIV and other sexually transmissible infections. The data collected allow socio-behavioural data to be directly compared with clinical data. Participants are interviewed annually and tested for HIV and other STIs. Up to 500 new men are recruited to the study each year.

  • (2003) Fogarty, Andrea; Rawstorne, Patrick; Prestage, Garrett; Grierson, Jeffrey; Grulich, Andrew; Kippax, Susan; Worth, Heather; Murphy, Dean
    Report
    Positive Health is a longitudinal cohort study of HIV-positive men and women living in NSW and Victoria. A major focus is the impact of HIV and associated treatments on health, and more generally, on the lived experience of People Living with HIV and AIDS (PLWHA) over time.

  • (2004) Baker, Amanda; Kay-Lambkin, Frances; Bucci, Sandra; Haile, Melanie; Richmond, Robyn; Carr, Vaughan
    Report
    The prevalence of smoking among people with a psychiatric illness, especially schizophrenia, is much higher than in the general population (Goff et al., 1992). Smoking is associated with adverse mental and physical consequences among people with psychotic disorders. In terms of adverse physical consequences, smoking related diseases are the greatest contributor to early mortality among people with a psychotic illness (Lawrence, Holma & Jablensky, 2001). Despite the high prevalence of smoking, smoking cessation programs have not typically been part of treatment regimens available to people with psychiatric illness. This manual describes an intervention delivered over six weekly sessions, followed by two fortnightly booster sessions, and conducted on an individual basis. It includes some of the theoretical and contextual background information relevant to the treatment program, and its evaluation in the randomised controlled trial conducted over 2000-2003. Outcomes for the randomised controlled trial are briefly summarised. Each subsequent section contains a detailed session-by-session guide to the content of the tobacco reduction intervention evaluated in the randomised controlled trial. Many handouts, homework activities and therapist and client resources are additionally provided.

  • (2005) Persson, Asha; Fogarty, Andrea; Rawstorne, Patrick; Prestage, Garrett
    Report
    Part 1: The cultural context of HIV and body shape change: a report on the Northern Rivers regional arm of the Side Effects and Lipodystrophy project 2002-2004 Part 2: Positive health in the Northern Rivers: an analysis of northern rivers data from the Positive Health study

  • (2007) Zablotska, Iryna; Brown, Graham; Frankland, Andrew; Prestage, Garrett; Kippax, Susan; Langdon, Trish
    Report
    Gay Community Periodic Surveys surveys are regularly conducted in Sydney, Melbourne, Brisbane, Cairns, Canberra, Adelaide and Perth to monitor changes in sexual and other risk practices over time among Australian gay men who are gay community attached, recruited from gay sex-on-premises venues, social sites and clinics.

  • (2004) Holt, Martin; Jin, Fengyi; Grulich, Andrew; Murphy, Dean; Smith, Gary
    Report
    This report includes findings from a crosssectional study of social and behavioural risk factors for syphilis infection and transmission among MSM in Sydney (Part 1), as well as qualitative material on gay men's understandings and experiences of syphilis and other STIs (Part 2). The cross-sectional study recruited men diagnosed with syphilis from inner Sydney sexual health clinics, inviting them to complete a questionnaire about how they believed they contracted syphilis, their disease knowledge, sexual behaviour and risk practices for onward transmission. The qualitative material on syphilis, STIs and the perception and management of risk is taken from interviews with gay men in Sydney who engage in sexually adventurous sex practices. The results from the study provides useful information in guiding educational and public health responses to the increase in syphilis among MSM in Sydney.

  • (2007) Zablotska, Iryna; Prestage, Garrett; Chong, Shanley; Schamburg, Kevin; Mills, David; Blattman, Tony; Kippax, Susan
    Report
    Gay Community Periodic Surveys surveys are regularly conducted in Sydney, Melbourne, Brisbane, Cairns, Canberra, Adelaide and Perth to monitor changes in sexual and other risk practices over time among Australian gay men who are gay community attached, recruited from gay sex-on-premises venues, social sites and clinics.