Latest Australian research

O'Connor M.

Abstract: This paper is a personal reflection on involvement in the development of the first voluntary assisted dying legislation in Australia. Points of contention are discussed, where plural values were evident, as the legislation progressed towards implementation. Finally, ongoing areas of difficulty with the legislation are listed, where further thought is required to ensure ease of access for those in need.

Phan H, Ngu B, Hsu CS, Chen SC.

Abstract: Life and death education is a distinct field of study that has potential life relevance for consideration (e.g., self-awareness and subsequent improvement of one's own health well-being). Existing research development, situating in different learning-sociocultural contexts, has provided consistent evidence that showcases the differing viewpoints of life functioning (e.g., what is the true meaning of life?) and the intricate nature of death and dying (e.g., a death ritual that closely associates with a particular cultural group). Some of the research studies undertaken indicate the effective use of 'philosophization' or the discourse of philosophical analysis, enabling individuals to philosophize, contemplate, and seek transpersonal understanding of the subject matters of life and death (e.g., can a state of 'spiritual transcendence' help to alleviate a person's fear of death?). Such discourse, interestingly, has offered some informative yields for enriching and meaningful life purposes - for example, the seeking to attain transpersonal understanding of life (e.g., what does a state of self-transcendence actually mean?) and/or transpersonal life experience may assist a senior citizen to cope with his mental health during a temporary health crisis. Our teaching and research interest of life and death education over the past decade has led us to consider one important line of inquiry for development: namely, the proposition of a 'universal' blueprint or framework of life and death education for curriculum development, teaching, and research purposes. We are cognizant of the fact that, to date, there is no clear consensus or agreement as to what one is expected (e.g., specific learning outcome) to teach students who wish to study and learn about life and death education. On this basis, the present theoretical article introduces a theoretical framework, termed as 'The Life + Death Education Framework' (e.g., for universities), to assist educators for their quality teaching and/or research inquiries of life and death education. We firmly believe that the Life + Death Education Framework can be universal and, in this case, apply to different learning-sociocultural contexts.

Lamba GT, LaBrooy C, Lewis S, Olver I, Holmes A, Stewart C, et al.

Objective: The introduction and implementation of voluntary assisted dying (VAD) legislation represents a major shift in Australian health policy. Given potential repercussions for health professionals, understanding how they are being affected by this legislation is important to guide future policy and legislative changes. This study aims to explore the perspectives and experiences of Australian health professionals on VAD and compare impacts on those working under different state legislation in Victoria and WA.

Methods: Data were collected using a cross-sectional survey design, targeting health professionals nationally, primarily doctors and nurses. The survey had closed and open-ended response options, was informed by previous publications and was piloted prior to further roll-out. Recruitment was via professional networks and social media. Quantitative data were descriptively analysed and qualitative data were coded using NVivo and thematically analysed. 

Results: There was a final sample size of 223. Impacts on clinicians identified include inadequate remuneration, a need for ongoing support and the recognition of barriers to mandatory training.

Conclusions: Impacts on health practitioners, if not addressed, have future implications for workforce sustainability. Increasing numbers of trained VAD practitioners may enable distribution of clinical load and prevent burnout. VAD practitioners are not being appropriately remunerated, which could be addressed by introducing dedicated Medicare Benefits Schedule items for VAD. Attention should also be given to incentivising training, including continuing professional development accreditation and appropriate funding. Strategies to support staff could include debriefing, mentoring, peer support and psychological consultations.

McGill K, Bhullar N, Pearce T, Batterham PJ, Wayland S, Maple M.

Abstract: Brief contact interventions are an efficient and cost-effective way of providing support to individuals. Whether they are an effective bereavement intervention is not clear. This systematic review included articles from 2014 to 2021.711 studies were identified, with 15 meeting inclusion criteria. The brief contact interventions included informational and emotional supports. Narrative synthesis identified that participants valued brief contact interventions, however some did not find them helpful. Exposure to a brief contact intervention was typically associated with improvements in wellbeing. Studies with comparison groups typically found significant but modest improvements in grief, depression symptoms and wellbeing associated with the intervention. However, one intervention was associated with significant deterioration of depression symptoms. Existing brief contact interventions for bereavement appear feasible, generally acceptable to the target population and are associated with improvements in wellbeing. Further development and evaluation to account for why improvements occur, and to identify any unintended impacts, is required.

Austin PD, Lee W, Keall R, Lovell MR.

Background: Spiritual care is increasingly recognised as an essential component of care in palliative settings. Given this growing body of literature on spiritual interventions, there is a need to systematically evaluate and synthesis findings from previous systematic reviews.

Aim: To systematically synthesise the available evidence from systematic reviews concerning (a) the efficacy of spiritual care interventions and (b) the extent and nature of spiritual care interventions used in specialist palliative care settings.

Methods: An umbrella review of systematic reviews was conducted in accordance with PROSPERO (CRD42024455147) and followed the Joanna Briggs Institute methodology for umbrella reviews.

Data sources: Electronic databases (Ovid Medline, Embase, APA PsycINFO, Cochrane Database of Systematic Reviews, CINAHL and Web of Science) and references of accepted systematic reviews were searched for systematic reviews from inception to 2024. The AMSTAR-2 criteria was used to assess risk of bias within systematic reviews.

Results: A toal of 27 reviews met the eligibility criteria and reported the effects of 14 different spiritual care interventions across 431 studies including 55,759 participants. Findings show that spiritual care interventions especially dignity therapy and life-review may be effective for improving outcomes including spiritual wellbeing, emotional symptoms, quality-of-life and physical symptoms in people receiving specialist palliative care. Under half of included reviews report follow-up data where only emotional symptoms and quality-of-life are reported in more than one review.

Conclusion: Overall, spiritual care interventions have positive effects on spiritual wellbeing, quality of life and mood, compared to control conditions. Increased methodological rigour is needed to capture effect and duration of effect with spiritual care interventions at different phases of palliative care.