Mary T. Hawkins

Scale matters: the need for a Bipolar Depression Rating Scale (BDRS)

Objective:  To briefly review the clinical and biological distinctions between unipolar and bipolar depression critiquing in particular currently available depression rating scales and discuss the need for a new observer‐rated scale tailored to bipolar depression.

Positive development in emerging adulthood

Positive functioning in the developmental period of emerging adulthood has received little investigation. The current study investigated components of positive development using confirmatory factor analysis of Australian Temperament Project data collected from 1,158 young adults aged 19–20 years. Positive development constructs that have been theoretically conceptualised were examined to test core concepts. Five first-order constructs were identified in this sample: Civic Action and Engagement, Social Competence, Life Satisfaction, Trust and Tolerance of Others, and Trust in Authorities and Organisations. A second-order positive development factor defined by these constructs provided good fit for the data. This model of positive development in emerging adulthood can provide an outcome measure that can then be used to investigate the developmental processes and pathways involved.

Carers' perspectives of respite care in Australia: an evaluative study.

Caring for someone with dementia is burdensome and challenging. In Australia, respite services help carers to cope with these demands. In this descriptive study, 62 carers of people with dementia provided information on their use of respite care, its effectiveness and their satisfaction with services provided during the preceding 12 months. Results indicated that carers used day centre, in-home, residential, regular outings and cottage care. The main reasons for use were to assist with managing care, take a break, or attend to health problems. Although 78% of carers rated respite as beneficial to their care recipients, most suggested areas that required attention. Improvements included the need for more time and flexibility, better quality and more permanent staff, improved communication, bureaucracy, administration and affordability. Respite providers need to recognize these limitations and develop strategies to improve the delivery of diverse respite care for carers of people with dementia.

Cognitive vulnerability and resilience to depressed mood

This study evaluated positive and negative attributional styles, sociotropy, autonomy and optimism as contributors to positive affect and negative affect. The two affect measures respectively separated depression from general psychological distress. Model fit for 168 adult women indicated that each attributional style contributed indirectly to depression via optimism. Further, negative attributional style directly contributed to psychological distress as did sociotropy and autonomy. Results also confirmed an interrelatedness between negative attributional style, sociotropy and autonomy. Discussion addresses interpretation of the model and implications for research.

Referrals to hospital emergency departments from residential aged care facilities: stuck in a time warp

Abstract This research aimed to describe the number and type of residents admitted to emergency departments (EDs) over 2 years; and to explore nurses’ perceptions of the reasons why residential aged care facility (RACF) residents are referred to EDs. The research objective was addressed in a retrospective exploratory study using data on admissions to EDs from RACFs (N = 3,094) at the participating organisation over a 2-year period, and interview data on seven RACF and four ED nurses’ perceptions of the issues involved. Most residents presenting at EDs required urgent medical attention. Major themes identified by RACF and ED nurses included issues related to staff competency, availability of general practitioners, lack of equipment in RACFs, residents and family members requesting referrals, communication difficulties, and poor attitudes towards RACF staff. There is a need to use strategies to detect residents whose conditions are deteriorating and treat them promptly in RACFs.

Differentiating three conceptualisations of the relationship between positive development and psychopathology during the transition to adulthood

The transition to adulthood is characterised by both great potential for positive change and a relatively high incidence of problem outcomes. A multidimensional model of positive development during the transition to adulthood (at 19-20 years) has recently been proposed. However, an unresolved question regarding the nature of positive development during this time is how best to conceptualise its relationship to psychopathology. We drew on data from 1158 participants in the Australian Temperament Project, a large longitudinal community-based study that has followed young peoples psychosocial adjustment from infancy to early adulthood. Using structural equation modelling, we compared three models reflecting different conceptualisations of the relationship between positive development and psychopathology. The results suggest that positive development and psychopathology are best modelled as separate but correlated constructs. Hence, development in one domain is likely to influence the other, although separate and specific developmental pathways are also likely to be operating.

Construct validity and reliability of the Handover Evaluation Scale.

AIMS AND OBJECTIVES To examine the psychometric properties of the Handover Evaluation Scale using exploratory and confirmatory factor analysis. BACKGROUND Handover is a fundamental component of clinical practice and is essential to ensure safe patient care. Research indicates a number of problems with this process, with high variability in the type of information provided. Despite the reported deficits with handover practices internationally, guidelines and standardised tools for its conduct and evaluation are scarce. Further work is required to develop an instrument that measures the effectiveness of handover in a valid and reliable way. DESIGN Secondary analysis of data collected between 2006-2008 from nurses working on 24 wards across a large Australian healthcare service. METHODS A sample of 299 nurses completed the survey that included 20 self-report items which evaluated the effectiveness of handover. Data were analysed using exploratory factor analysis and confirmatory factor analysis supported by structural equation modelling. RESULTS Analyses resulted in a 14-item Handover Evaluation Scale with three subscales: (1) quality of information (six items), (2) interaction and support (five items) and (3) efficiency (three items). A fourth subscale, patient involvement (three items), was removed from the scale as it was not a good measure of handover. CONCLUSIONS The scale is a self-report, valid and reliable measure of the handover process. It provides a useful tool for monitoring and evaluating handover processes in health organisations, and it is recommended for use and further development. RELEVANCE TO CLINICAL PRACTICE Monitoring handover is an important quality assurance process that is required to meet healthcare standards. This reliable and valid scale can be used in practice to monitor the quality of handover and provide information that can form the basis of education and training packages and guidelines to improve handover policies and processes.

The longitudinal prediction of alcohol consumption-related harms among young adults

This study explores the longitudinal pathways by which risk and protective factors influence the development of alcohol-related harms in a representative community sample of 941 young adults (19–20 years) from Victoria, Australia, focusing on the role of concurrent risky drinking. Impulsivity at 15–16 years, alcohol-related harms at 15–16 years and 17–18 years, frequency of intoxication at 17–18 years, and antisocial behavior, friends’ drinking and living arrangements at 19–20 years were directly related to alcohol-related harms, as well as indirectly related to harms through increased risky drinking. Paternal drinking at 17–18 years was directly related to alcohol-related harms. Friends’ drinking at 19–20 years and alcohol-related harms at age 17–18 interacted with risky drinking to increase the likelihood of alcohol-related harms. Implications for intervention efforts are discussed.

The relationship between positive development and psychopathology during the transition to adulthood: A person-centred approach

The transition to adulthood is characterised by potential for both positive development and problem outcomes such as psychopathology, yet little is known about relationships between the two. Given the diversity of pathways observed during this transition period, there is likely to be significant heterogeneity in young peoples experiences of these outcomes. Drawing on data from 1158 19-20 year olds in the Australian Temperament Project and using latent profile analysis, we identified six subgroups. For most, higher positive development was associated with lower psychopathology and vice versa. One group (33.6%) was high across all positive development measures and low on psychopathology, and another (47.7%) average in both areas. The remaining four groups were low on positive development but differentiated by average psychopathology (4.7%), high internalising (5.5%), and moderate (7.2%) and severe (1.3%) externalising problems. Tailored intervention strategies that address both the promotion of competence and prevention of problem outcomes are needed.

The structural stability of positive development across young adulthood: longitudinal findings from the Australian temperament project

The purpose of this study was to examine the structural stability of positive development across the 20s using data from one of Australia’s oldest population-based studies of social–emotional development. Positive development was indicated by civic action and engagement, trust and tolerance of others, trust in authorities and organizations, social competence, and life satisfaction. Results extend an earlier published model spanning 19–20 and 23–24 years by incorporating a new wave of data collected at 27–28 years. The age 27–28 latent model was gender invariant and a robust replication of our earlier model. Associations between the latent constructs in the mid- to late 20s were stronger than those in emerging adulthood. This work provides evidence of a cohesive higher order construct of positive development from late adolescence to the late 20s and has the potential to inform measurement of strength-based research and prevention programs in the emerging and young adult periods.