Social Work - Theses
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ItemAn exploratory study into the experience of healthcare professionals caring for adolescent and young adults (AYA) with cancer when cure is no longer the goal of care.( 2015)Adolescents and young adults (AYA) with cancer are a unique subgroup within oncology due to specific medical and psychosocial needs. Palliative care in AYA oncology is largely an under researched area. Much of the research to date in palliative care has focussed on the paediatric and older adult populations. However, recent research illustrates that clinicians caring for young people with incurable disease identify this work to be challenging, although the reasons for this, and whether there are differences across professional disciplines, remains unknown. This study aimed to provide an understanding of the experience, degree of knowledge, attitudes and practices of healthcare professionals caring for AYA patients with incurable cancer. The study was based at Peter MacCallum Cancer Centre, a specialist cancer centre in Melbourne. A practice based, qualitative research methodology was employed comprising two phases. Phase I involved focus groups. Phase II involved semi structured in-depth interviews. Results are described by professional discipline. They highlight the challenges and enablers to practice, reported by professionals. The main challenges faced were: a lack of age-appropriate knowledge, experience and communication skills and insufficient organisational prioritisation of appropriate care for AYAs. The main enablers of good clinical care for AYAs were: a multidisciplinary approach to practice; age-appropriate education and skills and; support for staff. Recommendations arising from this research include a multipronged approach to improving service delivery comprising three areas. First, targeted professional development, education and training in age-appropriate care and communication. Second, greater organisational commitment to clinician skill development, increasing multidisciplinary forums for care planning, formalising staff support and improving hospital wide age-appropriate resources. Third, the development of policies, procedures and guidelines for these key areas.
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ItemAn exploratory study into the understanding health professionals have about the impact of culture on the experience of Vietnamese patients diagnosed with cancer.( 2013)Primary research focused on health professional understanding of the impact of culture on the cancer experience of Vietnamese patients does not exist in Australia. Australia’s population continues to grow in diversity with more cultures merging and emerging through waves of migration and the birth of new generations. The Vietnamese population represents one of the most recent waves of migration to Australia, with the Vietnamese population in Australia more than tripling over the past 30 years. However, there remains no published research about how this population gives meaning to their experience of cancer; a disease which has significant impacts on health, wellbeing and quality of life. This exploratory study was based at Peter MacCallum Cancer Centre, Australia’s only tertiary public hospital dedicated to cancer treatment, research and education. It aimed to describe demographic characteristics of Vietnamese patients and explore the understanding of health professionals about the impact of culture on the cancer experience of Vietnamese patients and their family. This study employed a Practice-Based Research (PBR) methodology across three Phases including Clinical Data Mining (CDM), health professional focus groups and clinical case studies. Results from this research describe the demographic detail of the Vietnamese patient population attending the specialist cancer centre and reveal that there is an absence of comprehensive psychosocial assessment by health professionals and therefore limited referral for support services such as social work. Outcomes from the focus groups illustrate the complex awareness that health professionals have of culture and the challenges this presents in providing cancer care for this population. Recommendations from this study suggest a model of targeted education for health professionals and interpreters to increase cultural and psychosocial competence in providing cancer care for this population. It is recommended that an evidence-informed model of care, integrating a Vietnamese Cultural Advocate into the cancer system, as cultural interface between health professionals, health system and patient and family would be of benefit to the care received by Vietnamese patients and their families.