Nursing - Research Publications
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ItemConnecting and Healing: The Role of Existential Isolation in Mediating the Impact of the Therapeutic Relationship on Canadian Men's Mental Health Outcomes(SAGE PUBLICATIONS INC, 2022-11)The therapeutic relationship has emerged as one of the most important components of successful treatment outcomes, regardless of the specific form of therapy. Research has now turned its attention to better understanding how the therapeutic relationship contributes to patient improvement. Extant literature contends that a strong therapeutic relationship may help reduce a patient's sense of existential isolation (i.e., a sense of not feeling understood by others). Research indicates that existential isolation might be especially problematic for men, potentially increasing their risk for suicidality. This study investigated the association between strength of the therapeutic relationship and psychological distress and suicidality among men who received psychotherapy, and whether existential isolation mediated this association. A total of 204 Canadian men who had previously attended psychotherapy participated in a cross-sectional survey, completing measures of the quality of their most recent therapeutic relationship, existential isolation, depression and anxiety symptoms, and suicidality. Regression with mediation analysis was conducted. Two models were tested; one with depression/anxiety symptoms as the dependent variable and the other with suicidality as the dependent variable. Both mediation models emerged as significant, indicating an indirect effect for quality of the therapeutic relationship on symptoms of anxiety/depression and suicidality through existential isolation. The findings suggest that a positive therapeutic relationship can contribute to men feeling less isolated in their experiences in life (i.e., less existentially isolated), thereby helping mitigate psychological distress and suicidality.
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Item"I could hang up if the practitioner was a prat": Australian men's feedback on telemental healthcare during COVID-19(PUBLIC LIBRARY SCIENCE, 2022-12-14)The COVID-19 pandemic restrictions, uncertainties and management inconsistencies have been implicated in men's rising distress levels, which in turn have somewhat normed the uptake of telemental healthcare services (i.e., phone and/or video-conference-based therapy). Given past evidence of poor engagement with telemental health among men, this mixed-methods study examined Australian men's use of, and experiences with telemental health services relative to face-to-face care during the pandemic. A community sample of Australian-based men (N = 387; age M = 47.5 years, SD = 15.0 years) were recruited via Facebook advertising, and completed an online survey comprising quantitative items and open-response qualitative questions with the aim of better understanding men's experiences with telemental healthcare services. In total, 62.3% (n = 241) of participants reported experience with telemental health, and regression analyses revealed those who engaged with telemental health were on average younger, more likely to be gay and university educated. Men who had used telemental health were, on average, more satisfied with their therapy experience than those who had face-to-face therapy. Among those who had telemental healthcare, marginally lower satisfaction was observed among regional/rural based relative to urban men, and those who had to wait longer than 2 months to commence therapy. Qualitative findings highlighted positive aspects of telemental healthcare including comfort with accessing therapy from familiar home environments and the convenience and accessibility of telemental health alongside competing commitments and COVID-19 restrictions. Conversely, drawbacks included technical limitations such as crosstalk impeding therapeutic progress, disconnects and audio-visual lag-times and the 'impersonal' nature of telemental healthcare services. Findings broadly signal COVID-19 induced shifts norming of the use of virtual therapy services, with clear scope for improvement in the delivery of therapeutic practice using digital modalities, especially among help-seeking men.
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ItemMen, relationships and partner-initiated break-ups: A narrative analysis(SAGE PUBLICATIONS LTD, 2022-07)For men, significant risks associated with partner-initiated break-ups include domestic violence, mental health challenges and difficultly with life transition. This narrative analysis study shares three storylines drawn from interviews with 25 men who experienced a partner-initiated break-up. Ill equipped to stay or to initiate leaving narratives positioned participants as conflict averse, lacking agency and withdrawing emotionally from the partnership and its demise. Victims of circumstance narratives included men who engaged in cyclic arguments and ongoing power struggles with partners, a pattern that often amplified conflict after the break-up. Transitioning these two impasse narratives were some participants whose Accountability and growth storylines highlighted their introspective self-work, aided by resources including professional help to deconstruct, understand, and adjust their behaviours. Making connections to masculinities theory, these findings suggest that tailored interventions, including narrative therapy, might usefully interrupt impasse narratives to aid men's development and healthful transitions through partner-initiated break-ups.
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ItemProtocol for a randomized controlled trial of the Men in Mind training for mental health practitioners to enhance their clinical competencies for working with male clients(SPRINGERNATURE, 2022-07-15)BACKGROUND: Although the proportion of men seeking professional mental health care has risen over the past two decades, on average, men continue to attend fewer sessions of psychotherapy and are more likely to drop out of treatment prematurely compared to women. Men account for three-quarters of suicide deaths; furthermore, over half of the males who die by suicide have engaged with mental health care in the 12 months prior to their death. These findings highlight a need to equip mental health practitioners with skills to improve male clients' engagement and mental health outcomes. This article reports the protocol for a randomized controlled trial of Men in Mind, a self-paced online training program purpose-built to advance the clinical competencies of practitioners who provide psychotherapy to male clients. METHODS: A randomized controlled trial with two parallel groups will be conducted. Participating practitioners will be randomly allocated, on a 1:1 basis, to the intervention group (Men in Mind training) or a waitlist control group. The primary outcome, efficacy of the training, will be evaluated by pre- to post-training (T1 to T2) changes in scores on the Engaging Men in Therapy Scale (EMITS) in the intervention group, relative to the control group. DISCUSSION: This trial will provide evidence of the efficacy of Men in Mind training, as an interim step towards adjusting content and delivery of the intervention to maximize the potential for sustaining and scaling. TRIAL REGISTRATION: The trial was registered prospectively with the Australian New Zealand Clinical Trials Registry on 3rd December 2021 (ACTRN12621001669886).
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ItemMapping Men's Mental Health Help-Seeking After an Intimate Partner Relationship Break-Up(SAGE PUBLICATIONS INC, 2022-08)Deleterious effects of separation and divorce on men's mental health are well-documented; however, little is known about their help-seeking when adjusting to these all-too-common life transitions. Employing interpretive descriptive methods, interviews with 47 men exploring their mental health help-seeking after a relationship break-up were analyzed in deriving three themes: (1) Solitary work and tapping established connections, (2) Reaching out to make new connections, and (3) Engaging professional mental health care. Men relying on solitary work and established connections accessed relationship-focused self-help books, online resources, and confided in friends and/or family. Some participants supplemented solitary work by reaching out to make new connections including peer-based men's groups and education and social activities. Comprising first-time, returning, and continuing users, many men responded to relationship break-up crises by engaging professional mental health care. The findings challenge longstanding commentaries that men actively avoid mental health promotion by illuminating wide-ranging help resources.
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ItemExploring Teacher and Parent Perspectives on School-Based Masculinities in Relation to Mental Health Promotion(FRONTIERS MEDIA SA, 2022-06-13)The capacity for boys' and young men's mental health promotion to act via shifting masculine norms that are linked to poor mental health outcomes, highlights the need to improve the extent to which school-based programs can promote mental health through leveraging more positive embodiments of masculinity. To-date, the perspectives of parents and teachers on such processes are understudied. This qualitative study presents teacher and parent views regarding adolescent masculinities and avenues for school-based developmental programming for boys and young men. In this study, 16 individual qualitative interviews were undertaken with 10 parents (six females, four males), and six teachers (three females, three males), recruited from an independent all-boys' grammar school in Melbourne, Australia. Thematic analysis of parents' and teachers' perspectives indicated their perception of the role of context-dependent "public" and "private" masculinities, the influence of Australian masculinity norms, and the role of private boys' school cultures in the development of adolescent masculinities. Additionally, strategies for development encompassed participants' appetite for boys' exposure to positive role models, in addition to consistent and relevant developmental programming to support positive masculinity development. Findings have implications for efforts to support prosocial masculine identity development via school-based initiatives, as an avenue to promoting mental health of boys and young men.
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ItemSexual abuse and mental ill health in boys and men: what we do and don't know(CAMBRIDGE UNIV PRESS, 2022-06-09)The spectrum of adverse mental health trajectories caused by sexual abuse, broadly defined as exposure to rape and unwanted physical sexual contact, is well-known. Few studies have systematically appraised the epidemiology and impact of sexual abuse among boys and men. New meta-analytic insights (k = 44; n = 45 172) reported by Zarchev and colleagues challenge assumptions that men experiencing mental ill health rarely report sexual abuse exposure. Adult-onset sexual abuse rates of 1-7% are observed in the general population, but for men experiencing mental ill health, adult lifetime prevalence was 14.1% (95% CI 7.3-22.4%), with past-year exposure 5.3% (95% CI 1.6-12.8%). We note that these rates are certainly underestimates, as childhood sexual abuse exposures were excluded. Boys and men with a sexual abuse history experience substantial disclosure and treatment barriers. We draw attention to population health gains that could be achieved via implementation of gender-sensitive assessment and intervention approaches for this at-risk population.
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Item"Appreciate the Little Things": A Qualitative Survey of Men's Coping Strategies and Mental Health Impacts During the COVID-19 Pandemic(SAGE PUBLICATIONS INC, 2022-05)The COVID-19 pandemic has presented a suite of circumstances that will simultaneously affect mental health and mobilize coping strategies in response. Building on a lack of research specifically exploring men's mental health impacts during the COVID-19 pandemic, this study presents the results of a qualitative survey exploring men's self-reported aspects of the pandemic giving rise to mental health challenges, alongside their diverse coping strategies applied during this time. The sample comprised 555 men from North America (age M = 38.8 years; SD = 13.5 years), who participated via an online survey with two open-ended qualitative questions assessing, respectively, the aspects of the pandemic affecting their mental health, and the strategies used to manage these challenges. Free-text responses were coded using inductive content analysis. Results pertaining to the mental health impacts of COVID-19 were categorized into two overarching themes: far-reaching ramifications of COVID-19 encompassing consequences for lifestyle, work, and functioning, alongside novel anxieties related to health risks and daily uncertainty. In addition, coping strategies reported were categorized into two broad themes: efforts to avoid, dull or distract oneself from distress, alongside adapting and doing things differently, which encompassed largely approach-oriented efforts to flexibly ameliorate distress. Results signal the far-reaching impacts of COVID-19, alongside profound flexibility and diverse enactments of resilience among men in adapting to unprecedented challenges. Findings have implications for mental health promotion that should aim to leverage men's adaptive coping to encourage opportunities for social connectedness in response to the mental health impacts of the various psychosocial challenges of the COVID-19 pandemic.
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ItemNo Preview AvailableAn evaluation of the psychometric properties of the Fear of COVID-19 Scale in a sample of help-seeking men(POLSKIE TOWARZYSTWO PSYCHIATRYCZNE-POLISH SOC PSYCHIATRY, 2022-03)Aim of the study The Fear of COVID-19 Scale is a widely used measurement tool for related anxieties, however previous studies validating the scale report varying fit indices, often below accepted cut-off points. This suggests re-specification of the scale may be required. The present study aimed to examine the psychometric properties of the English-version of the Fear of COVID-19 Scale in a population of help-seeking males using exploratory (EFA) and confirmatory factor analysis (CFA). Subject or material and methods Data from 621 males aged 18-80 years (mean=38.23, SD=13.59) was collected via a cross-sectional open online survey. Along with the 7-item Fear of COVID-19 Scale, the PHQ-4 and PROMIS Anger Short Form were used to measure probable anxiety, depression and anger. Data were randomly partitioned into two subsamples and separate factor analyses were conducted with robust CFA corrections applied for non-normality. Results A 4-item single-factor version of the scale was identified reporting excellent model fit (R-RMSEA=.033, R-CFI=.998, R-TFI=.997, SRMR=.012) and good internal consistency (α=.86). Age and probable anxiety effects were observed. Discussion Relative to existing validation studies of the Fear of COVID-19 Scale, the present study provides improved psychometrics of the 4-item version of the scale, while scale means observed were comparable to other studies. Conclusions This study validates a 4-item version of the Fear of COVID-19 Scale to assess related anxieties in a help seeking male population. Future research should seek to validate the 4-item version in other subpopulations.
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ItemNo Preview AvailableMasculinity and mental illness in and after men's intimate partner relationships(ELSEVIER, 2022-12)