Miranda Stephens

Evaluating the effects of mindfulness-based interventions for informal palliative caregivers: A systematic literature review.

Background: There is a need to identify proactive, evidence-based interventions to support informal palliative caregivers. Mindfulness-based interventions, evidenced in the literature as providing physical and mental health benefits for diverse populations, may have application in the setting of palliative caregiving. Aim: To describe, evaluate and synthesise the peer-reviewed literature on the effects of mindfulness-based interventions for informal palliative caregivers. Design: A Systematic Literature Review according to the Preferred Reporting Items for Systematic Review and Meta Analyses guidelines and a Narrative synthesis. Data sources: The Cochrane Library, CINAHL, MEDLINE, PsycINFO and EMBASE databases, searched from inception to February 2014 and references of included studies. Results: A total of 13 articles, reporting 10 studies (n = 432 participants) were included. All studies were conducted in the last 5 years. Dementia caregivers were the most frequently researched population (n = 7). Results suggest that mindfulness-based interventions are feasible and acceptable to offer to informal palliative caregivers and may provide benefit, particularly in terms of reducing depression and caregiver burden and increasing quality of life. However, effects were not as robust as findings in the wider mindfulness intervention literature. Conclusion: This is the first systematic literature review on this topic. Results suggest both feasibility and potential benefit. Further qualitative research is required to explore the outcomes identified by informal caregivers themselves as the reduced magnitude of effect may suggest that we are not measuring the right outcomes in this context. This would inform more sensitive outcome measures for future intervention studies and guide the development and application of mindfulness-based models in this area.

Utilisation of evidence-based practices by ASD early intervention service providers

A number of autism intervention practices have been demonstrated to be effective. However, the use of unsupported practices persists in community early intervention settings. Recent research has suggested that personal, professional and workplace factors may influence intervention choices. The aim of this research was to investigate knowledge and use of strategies, organisational culture, individual attitudes, sources of information and considerations informing intervention choices by early intervention providers. An online survey was completed by 72 early intervention providers from four organisations across Australia. Providers reported high levels of trust and access of information from internal professional development, therapists and external professional development. A range of considerations including child factors, family values and research were rated as important in informing intervention choices. Participants reported greater knowledge and use of evidence-based and emerging practices than unsupported. Levels of use were linked to levels of knowledge, as well as some organisational and attitudinal factors. Areas for future research and implications are discussed.

Early intervention for children with autism: An Australian rural hub and spokes model

The North West Tasmania Autism Specific Early Learning and Care Centre offers early intervention to children with autism symptoms in an extended hours Child Care Centre. In this regional and rural area it operates as a hub and spokes model with children from outlying areas receiving intervention from educators at their local mainstream childcare centre supported by specialist staff at the North West Tasmania Autism Specific Early Learning and Care Centre. We analysed clinical assessments of all children over the period 2009–2014 at entry and follow-up and found children in the spokes centres were achieving similar outcomes to those in the hub centres. The outcomes appeared to be moderated by the limited attendance of children with a smaller effect sizes on the majority of measures compared to best practice. However, larger effect sizes on the measure of socialisation could reflect the emphasis of the program on the social skills needed for participation in mainstream school environments.

A pilot study of social inclusion and quality of life for parents of children with autism spectrum disorder

ABSTRACT Background Access to both childcare and early intervention for pre-school children with autism spectrum disorder (ASD) can be difficult for parents or carers and may impact on parental social inclusion and wellbeing. There is limited research investigating how specialist centres offering both services may impact on parental outcomes. Method Parents whose children were attending such a specialised childcare setting in two states in Australia (Tasmania and South Australia) were invited to participate in a mixed-methods study investigating quality of life (Qol), social inclusion and perceptions of the centres. Results Parents had typically low levels of QoL but reported a range of benefits from receiving services, including increased levels of community participation and increased competence and confidence in themselves as parents. Conclusions Childcare centres offering specialist multi-disciplinary early intervention and parental support are valued by parents and assist with social inclusion.