Cervical cancer is a significant public health issue, especially in the developing countries of sub-Saharan Africa. To examine knowledge adequacy on cervical cancer and screening test among African ...refugee and non-refugee women in Brisbane and further examine whether the level of knowledge vary between refugee and non-refugee women. A cross-sectional survey was conducted among 254 African-born women conveniently sampled from the Brisbane local government area. The outcome measures were knowledge on cervical cancer and Pap smear. In the multivariate logistic regression analysis non-refugees were more likely than refugees to have adequate knowledge about cervical cancer. Also, non-refugee women who were older and educated beyond secondary school, were more likely to have good knowledge about Pap smear test than refugee women. Overall, knowledge level about cervical cancer is limited among the participants and non-refugee women were more likely than refugee women to have good knowledge about cervical cancer and the screening test. These findings may inform the development of health education interventions for the targeted population to improve knowledge and awareness about cervical cancer and the screening guidelines in Australia.
While significant research has been undertaken exploring the pedagogical benefits of undertaking lengthy social work and human services field placements, there has been very little consideration ...given to the potential financial stress involved for students. This study sought to address this knowledge gap. Research was conducted in 2014 using quantitative and qualitative methods with students and academic and professional staff from six Queensland universities. The findings show a significant relationship between unpaid placements and financial hardship, creating considerable stress for students and at times a compromised placement learning experience. The limited flexibility in requirements from professional bodies and universities for how placements are undertaken has been identified as a key contributor to financial hardship. Addressing the complexities inherent in this issue requires a collaborative effort from multiple stakeholders and should not be regarded as a problem for students to endure and manage.
Hospitalisation for ambulatory care sensitive conditions (ACSHs) has become a recognised tool to measure access to primary care. Timely and effective outpatient care is highly relevant to refugee ...populations given the past exposure to torture and trauma, and poor access to adequate health care in their countries of origin and during flight. Little is known about ACSHs among resettled refugee populations. With the aim of examining the hypothesis that people from refugee backgrounds have higher ACSHs than people born in the country of hospitalisation, this study analysed a six-year state-wide hospital discharge dataset to estimate ACSH rates for residents born in refugee-source countries and compared them with the Australia-born population.
Hospital discharge data between 1 July 1998 and 30 June 2004 from the Victorian Admitted Episodes Dataset were used to assess ACSH rates among residents born in eight refugee-source countries, and compare them with the Australia-born average. Rate ratios and 95% confidence levels were used to illustrate these comparisons. Four categories of ambulatory care sensitive conditions were measured: total, acute, chronic and vaccine-preventable. Country of birth was used as a proxy indicator of refugee status.
When compared with the Australia-born population, hospitalisations for total and acute ambulatory care sensitive conditions were lower among refugee-born persons over the six-year period. Chronic and vaccine-preventable ACSHs were largely similar between the two population groups.
Contrary to our hypothesis, preventable hospitalisation rates among people born in refugee-source countries were no higher than Australia-born population averages. More research is needed to elucidate whether low rates of preventable hospitalisation indicate better health status, appropriate health habits, timely and effective care-seeking behaviour and outpatient care, or overall low levels of health care-seeking due to other more pressing needs during the initial period of resettlement. It is important to unpack dimensions of health status and health care access in refugee populations through ad-hoc surveys as the refugee population is not a homogenous group despite sharing a common experience of forced displacement and violence-related trauma.
Located at the intersection of two vulnerable groups in the contemporary labour market, young people who migrate as refugees during adolescence face a unique constellation of opportunities and ...challenges that shape their employment trajectories. Yet, the tendency for research to focus on the early years of refugee settlement means that we have an inadequate understanding of the factors that mediate their employment decisions, experiences and outcomes. Based on interviews with 51 young people, this article explores how aspirations, responsibilities, family, education and networks are understood to influence the employment trajectories of adolescent refugee migrants. While this article draws attention to the complex and dynamic range of challenges and constraints that these young people negotiate in the pursuit of satisfying and sustainable employment, what also emerges is an optimistic and determined cohort who, even as they at times unsuccessfully prepare for and navigate the labour market, maintain high hopes for a better life.
Refugee women-at-risk represent a distinct and vulnerable refugee population. We investigated the psychometric properties of the Multidimensional Loss Scale (MLS) with 104 women-at-risk, ...recently-arrived in Australia. Cross-sectional survey included: the MLS (indexing loss events and loss distress); Harvard Trauma Questionnaire (Indexing Trauma Events and Trauma Symptoms), and; Hopkins Symptom Checklist-37 (indexing anxiety, depression, and somatization symptoms). Exploratory factor analyses of MLS loss distress revealed a six-factor model (loss of symbolic self; loss of home; loss of interdependence; loss of past aspirations; interpersonal loss, and; loss of intrapersonal integrity). Cronbach alphas indicated satisfactory internal consistency for loss events (0.83) and distress (0.88). Correlations supported convergent validity of loss distress with trauma symptoms (r = 0.41) and divergent validity with anxiety (r = 0.09), Depression (r = 0.29), and somatic (r = 0.24) symptoms. Findings support MLS use in assessment of loss and associated distress with refugee women-at-risk.
Although 'refugees' are frequently represented in visual media, it is predominantly as the central subject matter and rarely are they positioned as the photographers of their own journeys. In this ...article, we present photographic images that have been taken by refugee background youth portraying their experiences of the first years of settlement in Australia. We consider how, in our longitudinal research conducted with 120 refugee background youth, visual materials can provide equally important yet different insights in comparison to written or spoken narratives on the experiences of refugee settlement. Through an examination of the photograph's visual content, we explore the ways in which they portrayed their early experiences of external suburban settlement environments and their depictions of interior spaces and home-making practices. We discuss how these visual insights capture an alternative way of seeing the experiences of becoming at home as the youth become emplaced post-resettlement in Australia. We argue that the photographs taken by these refugee background youth illustrate how visual methods and materials can provide equally important but often overlooked insights into early settlement experiences. Importantly, the photographic images offer a way of portraying the people, places and sentiments that are central to the everyday lives of refugee background youths in ways that oral and written narratives cannot.
In response to an identified need, a specialist antenatal clinic for women from refugee backgrounds was introduced in 2008, with an evaluation planned and completed in 2010.
Can maternity care ...experiences for women from refugee backgrounds, attending a specialist antenatal clinic in a tertiary Australian public hospital, be improved?
The evaluation employed mixed methods, generating qualitative and quantitative data from two hospital databases, a chart audit, surveys and interviews with service users, providers and stakeholders. Contributions were received from 202 participants.
The clinic was highly regarded by all participants. Continuity of care throughout the antenatal period was particularly valued by newly arrived women as it afforded them security and support to negotiate an unfamiliar Western maternity system. Positive experiences decreased however; as women transitioned from the clinic to labour and postnatal wards where they reported that their traditional birthing and recuperative practices were often interrupted by the imposition of Western biomedical notions of appropriate care. The centrally located clinic was problematic, frequently requiring complex travel arrangements. Appointment schedules often impacted negatively on traditional spousal and family obligations.
Providing comprehensive and culturally responsive maternity care for women from refugee backgrounds is achievable, however it is also resource intensive. The production of translated information which is high quality in terms of production and content, whilst also taking account of languages which are only rarely encountered, is problematic. Cultural competency programmes for staff, ideally online, require regular updating in light of new knowledge and changing political sensitivities.
Objective: To investigate risk and protective factors for medically serious suicide attempts among young Australian adults.
Method: The study used a case–control design. A clinical sample of 18–24 ...year olds was recruited via the emergency department of a large public hospital following a suicide attempt (n=95) and was compared to a sample of 18–24 year olds who participated in a population-based survey (n=380).
Results: Risk factors for medically serious suicide attempts included early school leaving, parental divorce (males only), distress due to problems with parents (females only), distress due to problems with friends, distress due to the break-up of a romantic relationship, tobacco use, high alcohol use, current depressive symptomatology and a previous diagnosis of depression. Protective factors included social connectedness, problem-solving confidence and locus of control. There was a trend for social connectedness to be more protective among those with high rather than low levels of depressive symptomatology, and among smokers rather than non-smokers.
Conclusions: Results are discussed in terms of designing evidence-based suicide prevention activities for young adults.
This research examined contributions of loss events to loss distress and trauma symptoms (accounting for trauma events) for refugee women at risk. Participants (N = 104) responded to the ...Multidimensional Loss Scale (loss events and distress) and Harvard Trauma Questionnaire (trauma events and symptoms). Loss events contributed uniquely to loss distress (explaining additional 50.8% variance), and made a unique contribution to trauma symptoms (explaining additional 5.2% variance) approximately equal to trauma events. Appropriate response to psychic distress in refugee women at risk requires assessment of both loss and trauma and consideration of cultural differences in ways loss is expressed and meaning ascribed to symptoms.
Patients with advanced cancer commonly use complementary and alternative medicine (CAM), however, little research has been undertaken on their reasons for doing so.
This study sought to identify in ...detail the reasons for using CAM among patients with advanced cancer.
Qualitative study using semistructured interviews.
Interviews conducted with 39 patients who were participating in a longitudinal study exploring the levels of palliative care received by patients with cancer in Brisbane, Australia. All participants were receiving or had received conventional cancer treatments. Sampling was based on the potential richness of the information provided by the participants and the variability in terms of the regularity of CAM use.
Most participants self-treated with CAM and perceived CAM modalities as complementary rather than alternative to conventional cancer treatments. Within this context, this group of people used CAM to prolong their survival, palliate their symptoms or alleviate the side effects of conventional cancer treatments, detoxify their bodies, boost immunity and enhance their overall quality of life.
When facing an incurable life-threatening illness such as advanced cancer, the decision to use CAM is a pragmatic one. Clinicians need to be aware of what their patients are doing and their rationale for doing so. Screening for physical, emotional, and spiritual discomfort associated not only with the disease but with some of the cancer treatments needs to be given a prominent place in the clinical encounter. Patients with cancer want to know more about how to maintain or improve their quality of life during and after surgery, radiation, or chemotherapy. Fostering an open non-judgmental communication with patients is part of good clinical practice.
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