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Item A Contemporary Model of Stress for Understanding Family Functioning and the Psychological Distress in Relatives of People with Severe Traumatic Brain Injury(2006-01-01) Anderson, MalcolmAs documented by health and medical professionals and social and behavioral scientists, stress has a pervasive presence in our society. The effects of stress on both the individual and our culture have received much attention. The research presented in this book explores how the presence of stress has impacted society. [Book description from publisher's website]
Item A Predictive Model of Days from Infection to Discharge in Patients with Healthcare Associated Urinary Tract Infections (HAUTI): A Structural Equation Modelling Approach(2017-11-01) Ferguson, John K.; Anderson, Malcolm; Mitchell, Brett G.Background
Length of stay (LOS) in hospital is an important component of describing how costs change in relation to healthcare-associated infection and this variable underpins models used to evaluate cost. It this therefore imperative that estimations of LOS associated with infections are performed accurately.
Aim
To test the relationships between the size of hospital, age, and patient comorbidity on days from admission to infection and days from infection to discharge in patients with a healthcare-associated urinary tract infection (HAUTI), using structural equation modelling (SEM).
Methods
A non-current cohort study in eight hospitals in New South Wales, Australia. All patients admitted to the hospital for >48 h and who acquired a HAUTI were included.
Findings
From the 162,503 eligible patient admissions, 2821 (1.73%) acquired a HAUTI. SEM showed that the proposed model had acceptable fit indices for the combined sample (GFI = 1.00; AGFI = 1.00; NFI = 1.00; CFI = 1.00; RMSEA = 0.000). The main findings showed that age of patient had a direct association with days from admission to infection and with days from infection to discharge. Patient comorbidity had direct links to the variables days from admission to infection and days from infection to discharge. Multi-group analysis indicated that the age of male patients was more influential on the factor days from admission to infection when compared to female patients. Furthermore, the number of comorbidities was significantly more influential on days from admission to infection in male patients than in female patients.
Conclusion
As the first published study to use SEM to explore a healthcare-associated infection and the predictors of days from infection to discharge in hospital, we can confirm that accounting for the timing of infection during hospitalization is important and that patient comorbidity influences the timing of infection.
Item A Predictive Model of Resilience Among Family Caregivers Supporting Relatives with Traumatic Brain Injury (TBI) in Australia: A Structural Equation Modelling Approach(2017-01-01) Daher, Maysaa; Simpson, Grahame K.; Anderson, MalcolmObjectives: Developing a comprehensive understanding of resilience in family caregivers supporting relatives with TBI is important for mental health promotion, yet resilience has been vastly understudied compared to deficits and vulnerability based research. In response a paradigm shift into family research is underway in the field of rehabilitation, with a new emphasis on investigating positive adaption rather than psychological vulnerability among family caregivers of people with TBI. In the current study, a model based on previous empirical research and resilience theory was devised to examine the predictive and mediating relationships among caregiver resilience, personality, coping, self – efficacy, hope, social support and the outcome variables of caregiver burden and psychological adjustment among family members caring for relatives with TBI.
Item A Predictive Model of Resilience Among Family Caregivers Supporting Relatives with Traumatic Brain Injury (TBI): A Structural Equation Modelling Approach(2020-11-25) Simpson, Grahame K.; Daher, Maysaa; Anderson, MalcolmConstructs from positive psychology were employed to create an explicit model of caregiver resilience. Predictive and mediating relationships among resilience and related variables (personality, coping, self-efficacy, hope, social support) were then tested for their association with burden and psychological adjustment among family members caring for relatives with severe TBI. Family participants (n = 131) from six rehabilitation units from New South Wales and Queensland completed assessments which elicited explanatory (Eysenck Personality Questionnaire, Ways of Coping Questionnaire), mediating (Connor-Davidson Resilience Scale, General Self-Efficacy Scale, Herth Hope Scale, Medical Outcome Study Social Support Survey), and caregiver outcome (Caregiver Burden Scale, Mental Health sub-Scale-SF36, General Health Questionnaire, and Positive and Negative Affect Scale) variables. Structural Equation Modeling (SEM) showed that resilience had a direct effect on positive affect in caregivers. Resilience also played a protective role in relation to two variables associated with caregiver vulnerability: an indirect association with caregiver burden mediated through social support; a direct effect on hope, which, in turn, was associated with positive mental health. Positive mental health then played a buffering role in relation to psychological distress and negative affect. Resilience, in combination with other psychological attributes, was associated with reduced morbidity among family caregivers after severe TBI.
Item A Study of Whether Individual and Dyadic Relations Between Spirituality and Resilience Contribute to Psychological Adjustment Among Individuals with Spinal Cord Injuries and their Family Members(2019-09-01) Anderson, Malcolm; Dorsett, Pat; Briggs, Lynne; Simpson, Grahame K.; Jones, Kate FionaObjective:
To test a model of spiritual well-being and resilience among individuals with spinal cord injuries and their family members.
Design:
Prospective cross-sectional observational data were analyzed by structural equation modelling.
Setting:
Inpatient and community services at one rehabilitation hospital.
Subjects:
Individual with spinal cord injury (n = 50) and family member (n = 50) dyads.
Interventions:
Standard rehabilitation, both inpatient and community.
Main measure(s):
Functional assessment of chronic illness therapy – spiritual well-being scale – expanded, Connor–Davidson resilience scale, positive and negative affect scale, depression anxiety and stress scale–21, satisfaction with life scale.
Results:
Median time post-injury was 8.95 months (IQR (interquartile range) = 14.15). Individuals with spinal cord injury and family members reported high scores for both spiritual well-being (66.06 ± 14.89; 68.42 ± 13.75) and resilience (76.68 ± 13.88; 76.64 ± 11.75), respectively. Analysis found the model had acceptable fit (e.g. chi-square goodness of fit statistic = 38.789; P = .263). For individuals with spinal cord injury, spiritual well-being was positively associated with resilience which, in turn, was associated with increasing positive affect and satisfaction with life. Among family members, spiritual well-being was positively associated with resilience. Resilience was then associated with lowered levels of depression and mediated the impact of depression on satisfaction with life. Limited evidence was found for mutual dyadic links, with the only significant pathway finding that resilience in the individual with spinal cord injury was associated with increased satisfaction with life among family members.
Conclusion:
Increased spirituality and resilience make a significant contribution (both independently and in combination) to positive psychological outcomes for both individuals with spinal cord injury and their family members.
Item Answers Linked to Mitchell BG, Dancer SJ, Anderson A, Dehn E. Risk of Organism Acquisition from Prior Room Occupants: A Systematic Review and Meta-analysis(2016-04-01) Dehn, Emily; Anderson, Malcolm; Dancer, Stephanie; Mitchell, Brett G.Item Designing an Innovative System to Evaluate a Postgraduate Supervision Support and Development Framework(2016-04-01) Carton, Janet; Williams, Anthony; Northcote, Maria T.; Mitchell, Brett G.; de Waal, Kayle; Anderson, Malcolm; Petrie, KevinThe supervision of a doctoral student engages the supervisor/s and the candidate in a professional learning and teaching relationship, described by some as the pedagogy of supervision (Grant, 2005; Nulty, Kiley, & Meyer, 2009). In the past few decades, many universities have developed ‘supervisor training’ programs and other innovations to support supervisors. These programs are designed to cultivate the necessary knowledge and skills to support academic and research staff to supervise postgraduate student(s) (Carton & Kelly, 2014; Carton, O’Farrell, & Kelly, 2013; Luca et al., 2013). As part of a project that was funded by an Office for Learning and Teaching (OLT) Extension Grant, such a Framework was recently designed and implemented at Avondale College of Higher Education, a small higher education institution in the early phases of postgraduate program development (Petrie et al., 2015). The effectiveness of such initiatives is often difficult to measure in small institutions such as Avondale; the relatively small number of students and supervisors does not always provide the breadth of feedback necessary to evaluate success using traditionally employed evaluation methods. This paper reports on the innovative evaluation system developed as part of this project, using the pedagogy of supervision as a frame of reference to evaluate the Framework. This evaluation process is being undertaken using a design-based research methodology (Anderson & Shattuck, 2012) which has guided the construction of evaluation criteria and metrics to evaluate the effectiveness of Avondale's Research Training Support Framework. The developed evaluation method and its initial findings will be reported in this paper.
Item Develop and Implement an Institutional Framework to Support and Improve Supervision of Honours and Higher Degree Research Students(2014-12-01) Mitchell, Brett; Anderson, Malcolm; de Waal, Kayle; Petrie, Kevin; Williams, Anthony; Northcote, MariaItem Develop and Implement an Institutional Framework to Support and Improve Supervision of Honours and Higher Degree Research Students(2016-04-01) Lemke, Gina; Mitchell, Brett G.; Anderson, Malcolm; de Waal, Kayle; Petrie, Kevin; Williams, Anthony; Northcote, Maria T.The purpose of this project is to develop and implement an institutional supervision support framework to improve and enhance the capacity of Avondale's academic staff to supervise honours and higher degree students.
Item Develop and Implement an Institutional Framework to Support and Improve Supervision of Honours and Higher Degree Research Students(2016-01-01) Lemke, Gina; Mitchell, Brett G.; Anderson, Malcolm; de Waal, Kayle; Petrie, Kevin; Williams, Anthony; Northcote, Maria T.Develop and Implement an Institutional Framework to Support and Improve Supervision of Honours and Higher Degree Research Students" (2016). Education Conference Papers. Paper 33. http://research.avondale.edu.au/edu_conferences/33
Item Developing a Model for Suicide Ideation after Severe Traumatic Brain Injury Using Structural Equation Modelling(2016-05-19) Morey, Peter; Anderson, Malcolm; Tate, Robyn; Simpson, Grahame K.Objectives: The risk of suicide ideation (SI) after severe traumatic brain injury (TBI) is double the level within the general population. Little is known about the mechanisms underlying this elevated risk. This study aimed to develop an explanatory model of SI after severe TBI, based on the interaction among distal (predisposing) and proximal (precipitating) risk factors, protective factors and SI.
Methods: Participants (n = 90) with very severe TBI (Post Traumatic Amnesia > 7 days) were recruited from the Liverpool Brain Injury Rehabilitation Unit in Sydney Australia. Participants completed a battery of neuropsychological tests targeting executive functions as well as self-report measures of SI, positive and negative mood states, stress, self-awareness, self-esteem and problem-solving. Treating clinicians rated participants on measures of aggression, frontal systems dysfunction and participation. Data were analysed using structural equation modelling.
Results: The final model demonstrated good fit indices (NFI = 0.924, IFI = 0.994, TLI = 0.986, CFI = 0.993, RMSEA = 0.03). The model accounted for 34% of the variance in SI. One distal risk factor, poor problem-solving, had a direct relationship to SI. Other distal risk factors including post-injury aggression and disinhibition had direct and indirect links to depression (a proximal risk factor), which in turn mediated their relationship to hopelessness and SI. The protective factors (social support, hope, community participation, self-esteem) mediated the relationship between distal/proximal risk factors, hopelessness and SI. The protective effect of social support and community participation was mediated through their association with increased levels of hope and self-esteem.
Conclusions: The current model demonstrates the direct and indirect effects of risk factors and protective factors associated with SI after severe TBI. The model provides several suggested targets for clinical intervention to build positive mental health and reduce suicide risk. The model can now be tested prospectively to evaluate its predictive validity.
Item Development of an Evidence-based Professional Learning Program Informed by Online Teachers' Self-efficacy and Threshold Concepts(2016-09-01) Boddey, Chris; Anderson, Malcolm; Kilgour, Peter W.; Reynaud, Daniel; Northcote, Maria T.; Gosselin, Kevin P.As online education continues to expand across varied educational sectors, so does the demand for professional development programs to guide academic teaching staff through the processes of developing their capacities to design and teach online courses. To meet these challenges at one higher education institution, a mixed methods research study was implemented to identify the professional learning needs of academic teaching staff for the purposes of developing a tailor-made professional development program. The principles of self-efficacy and threshold concepts were used to inform the design of the study. Data were systematically gathered from the participants to determine self-efficacy, concerns, and questions and experiences of academic teaching staff with online teaching. Findings revealed that academic staff held threshold concepts, skills and attitudes about online teaching. Three groups of staff were identified, all with varying forms of professional development requirements. This case study account demonstrates how an evidence-based project provided the basis for a research-informed institutional professional development program that is currently guiding academic staff through their development as online course designers and teachers.
Item Differential Pathways of Psychological Distress in Spouses Versus Parents of People with Severe Traumatic Brain Injury (TBI): Multigroup Analysis(2009-10-15) Gillett, Lauren; Gosling, Tamera; Mok, Magdalena; Morey, Peter; Simpson, Grahame K.; Anderson, MalcolmPrimary objective: A contemporary model of psychological stress based on an amalgamation of Conservation of Resources theory and the McMaster Model of Family Functioning was devised to compare the effects of neurobehavioural impairments on family functioning and psychological distress in spouses and parents caring for relatives with TBI.
Method: Participants were 64 spouses and 58 parents. They completed the Neurobehavioral Problem Checklist, Family Assessment Device and the Brief Symptom Inventory. Structural equation modelling (SEM) was used to test the model for the combined (spouses and parents) sample. Multi-group analysis was then employed for examining differences in structural weights for spouses and parents.
Main results: SEM supported the model for the combined sample. Multi-group analysis showed for spouses cognitive and behavioural impairments significantly disrupted family functioning, which in turn increased psychological distress. In contrast, cognitive and behavioural impairments did not significantly disrupt family functioning in parents. For parents, however, cognitive impairments increased psychological distress. Furthermore, parents who reported disrupted family functioning also experienced higher levels of psychological distress. The effect of cognitive impairments was statistically more influential on the level of distress in parents when compared to spouses.
Conclusions: Understanding these differences can assist in better targeting family support interventions.
Read More: http://informahealthcare.com/doi/abs/10.3109/02699050903302336Item Do Spirituality, Resilience and Hope Mediate Outcomes among Family Caregivers After Traumatic Brain Injury or Spinal Cord Injury? A Structural Equation Modelling Approach(2020-02-26) Gopinath, Bamini; Genders, Michelle; Jones, Kate Fiona; Anderson, Malcolm; Simpson, Grahame K.BACKGROUND: A deficits approach to understanding psychological adjustment in family caregivers of individuals with a neurological disability is extensive, but further research in the field of positive psychology (spirituality, resilience, hope) may provide a potential avenue for broadening knowledge of the family caregiver experience after traumatic brain injury (TBI) or spinal cord injury (SCI). OBJECTIVE: To test a proposed model of spirituality among family caregivers of individuals with TBI or SCI, using structural equation modelling (SEM). METHODS: A cross-sectional design was employed to survey ninety-nine family participants (TBI = 76, SCI = 23) from six rehabilitation units from NSW and Queensland. Assessments comprised Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale-Expanded, Connor –Davidson Resilience Scale, Herth Hope Index, and three measures of psychological adjustment including Caregiver Burden Scale, Positive and Negative Affect Scale, and Depression Anxiety Stress Scale. RESULTS: SEM showed the proposed model was a good fit. The main findings indicated spirituality had a direct negative link with burden. Spirituality had a direct positive association with hope which, in succession, had a positive link with resilience. Spirituality influenced positive affect indirectly, being mediated by resilience. Positive affect, in turn, had a negative association with depression in caregivers. CONCLUSIONS: This study contributes to better targeting strength-based family interventions.
Item Does Resilience Influence Ways of Coping among Families Supporting Relatives With Severe Traumatic Brain Injury or Spinal Cord Injury?(2016-06-01) Daher, Maysaa; Anderson, Malcolm; Simpson, Grahame K.Resilience contributes to the individual adjustment of family members providing support to relatives with a traumatic brain injury (TBI) or spinal cord injury (SCI).
Item Here for Good: Resilience in Caregivers of those with Traumatic Brain Injury (TBI)(2019-06-14) Simpson, Grahame; Anderson, MalcolmHere For Good is a podcast series from leading researchers at Avondale University College. This episode features School of Nursing Graduate Studies Convenor Associate Professor Malcolm Anderson and Griffith University’s Professor Grahame Simpson in conversation with Associate Dean (Research) Associate Professor Carolyn Rickett.
Item Impact of Resilience on the Longer-term Well-being of Family Caregivers, Service Utilisation and Client Community Participation(2016-01-01) Cameron, Ian; Gopinath, Bamini; Anderson, Malcolm; Simpson, Grahame K.Item Length of Stay and Mortality Associated with Healthcare-Associated Urinary Tract Infections: A Multi-State Model(2016-05-01) Barnett, Adrian G.; Sear, Jacqueline; Anderson, Malcolm; Ferguson, John K.; Mitchell, Brett G.Background: The emergence of antimicrobial resistance is of particular concern with respect to urinary tract infections, since the majority of causative agents are Gram negative bacteria. Healthcare-associated urinary tract infections (HAUTIs) are frequently associated with instrumentation of the urinary tract, specifically within dwelling catheters.
Aim: To evaluate the current incidence, mortality, and length of hospital stay associated with HAUTIs.
Methods: A non-concurrent cohort study design was used, conducted between January 1st, 2010 and June 30th, 2014. All patients admitted to one of the eight participating Australian hospitals and who were hospitalized for more than two days were included. The primary outcome measures were the incidence, mortality, and excess length of stay associated with HAUTIs.
Findings: From 162,503 patient admissions, 1.73% [95% confidence interval (CI): 1.67 e1.80] of admitted patients acquired a HAUTI. Using a multi-state model, the expected extra length of stay due to HAUTI was four days (95% CI: 3.1e5.0 days). Using a Cox regression model, infection significantly reduced the rate of discharge (hazard ratio: 0.78; 95% CI: 0.73e0.83). Women were less likely to die (0.71; 0.66e0.75), whereas older patients were more likely to die (1.40; 1.38e1.43). Death was rarer in a tertiary referral hospital compared to other hospitals, after adjusting for age and sex (0.74; 0.69e0.78).
Conclusion: This study is the first to explore the burden of HAUTIs in hospitals using appropriate statistical methods in a developed country. Our study indicates that the incidence of HAUTI, in addition to its associated extra length of stay in hospital, presents a burden to the hospital system. With increasing incidence of UTI due to antimicrobial-resistant organisms, surveillance and interventions to reduce the incidence of HAUTI are required.
Item Length of Stay and Mortality Associated with Healthcare-Associated Urinary Tract Infections: A Multistate Model(2016-04-01) Barnett, Adrian G.; Sear, Jacqueline; Anderson, Malcolm; Ferguson, John K.; Mitchell, Brett G.Background: To evaluate the current incidence, mortality and length of stay associated with healthcare associated urinary tract infections (HAUTIs). Material/methods: A non-concurrent cohort study design is used, conducted between 1 January 2010 and 30 June 2014. All patients admitted to one of the eight participating Australian hospitals and who were hospitalised more than two days were included. The primary outcomes measures were the incidence, mortality and excess length of stay associated with healthcare associated urinary tract infections. Results: From 162,503 patient admissions, 1.73% (95% CI 1.67–1.80) of admitted patients acquired a HAUTI. Using a multi-state model, the expected extra length of stay due to HAUTI was 4 days, 95% CI 3.1–5.0 days. Using a Cox regression model, infection significantly reduced the rate of discharge (HR 0.78, 95%CI, 0.73-0.83. Women were less likely to die (HR 0.71, 95%CI 0.66-0.75), whereas older patients were more likely to die (HR 1.40, 95%CI 1.38-1.43). Death was rarer in a tertiary referral hospital compared to other hospitals, after adjusting for age and sex (HR 0.74, 95%CI, 0.69-0.78). Conclusions: This study is the first study to explore the burden of HAUTIs in hospitals using appropriate statistical methods in a developed country. Our study indicates that the incidence of HAUTI in addition to its associated extra length of stay in hospital, present a burden to the hospital system. With increasing incidence of UTI due to antimicrobial resistant organisms, surveillance and interventions to reduce the incidence of HAUTI are required.
Item Management of Patients with Neurologic Infections, Autoimmune Disorders, and Neuropathies(2005-01-01) Anderson, MalcolmPresents the key material requirements for medical-surgical nursing courses. Set within the context of the Australian and New Zealand health care systems, the text explores the impact of the economic, political and cultural environments of Australia and New Zealand on the delivery of quality nursing care. [Book summary]