A longitudinal study of the health and wellbeing of culturally and linguistically diverse caregivers of people with psychosis in Australia.

Despite Australia being an ethnically diverse country, there are limited longitudinal studies of the health and wellbeing of culturally and linguistically diverse (CALD) carers of people with psychosis. An Australian population-based survey found that 22.7% of carers of people with mental disorders were born overseas. This study aimed to explore the demographic profile, social connectedness, psychological health, quality of life, grief and caregiving consequences of CALD carers of people with psychosis over 12 months. This longitudinal study utilised a prevalence survey design and recruited 52 CALD carers who were born in 24 countries outside Australia. A series of validated instruments were administered to assess carer health and wellbeing. Descriptive and inferential analysis of the results suggested that CALD carers experienced social isolation (34.7%), psychological distress (28.9%), moderate grief and caregiving consequences and poorer quality of life than the general population. Younger CALD carers and spouse carers experienced greater negative caregiving consequences than other kinship or friend carers. There were no significant changes in these outcomes over the 12-month period of the study. Ethnic-sensitive interventions are needed to better support CALD carers experiencing negative caregiving consequences, especially younger carers or spouses, within the current level of service provision.

Poon WC ，Joubert L ，Harvey C 《-》

A longitudinal population-based study of carers of people with psychosis.

Poon AWC ，Harvey C ，Mackinnon A ，Joubert L ... -  《-》

Perceived needs of carers of people with psychosis: An Australian longitudinal population-based study of caregivers of people with psychotic disorders.

Studies have documented the perceived needs of carers of people with psychosis but most recruitment has utilised convenience sampling resulting in limited understanding of carers' needs. This longitudinal study was conducted within the second Australian prevalence study of psychosis, aiming to obtain generalisable findings regarding perceived needs of carers of people with psychosis. Semi-structured interviews were conducted with 98 carers of people with psychosis recruited in the Australian prevalence study of psychosis. Seventy-eight of the carers were reinterviewed 1 year later to measure changes in their perceived needs. Correlational and paired T tests were conducted to identify relationships between perceived needs and carer's health and well-being, and changes in levels of perceived needs over time. Qualitative responses were structurally coded by segmentation according to the Carers' and Users' Expectations of Services-Carer version. Thematic analysis of common words and phrases was undertaken to identify key themes concerning carers' perceived needs. There was minimal improvement in carers' perceived needs over time and their needs were closely related to their perception of their own social connectedness, psychological health and quality of life. Five themes were identified: Greater involvement of carers in the treatment plan, provision of relevant information to carers, multiple biopsychosocial support for carers, well-being and independence interventions for people with psychosis, and choice to care and alternate caring arrangements. Although policy recognises the need to support carers, findings show that focused interventions are required to address carers' perceived needs more holistically in current mental health services. To support carers' recovery, services need to include carers in treatment planning, and consider ways to address their needs and improve their own health and well-being.

Poon AWC ，Joubert L ，Harvey C 《-》

A qualitative study into the use of formal services for dementia by carers from culturally and linguistically diverse (CALD) communities.

Shanley C ，Boughtwood D ，Adams J ，Santalucia Y ，Kyriazopoulos H ，Pond D ，Rowland J ... -  《BMC HEALTH SERVICES RESEARCH》

Development of a model of dementia support and pathway for culturally and linguistically diverse communities using co-creation and participatory action research.

To develop an inclusive model of culturally sensitive support, using a specialist dementia nurse (SDN), to assist people with dementia from culturally and linguistically diverse (CALD) communities and their carers to overcome barriers to accessing health and social care services. Co-creation and participatory action research, based on reflection, data collection, interaction and feedback from participants and stakeholders. An SDN support model embedded within a home nursing service in Melbourne, Australia was implemented between October 2013 and October 2015. People experiencing memory loss or with a diagnosis of dementia from CALD backgrounds and their carers and family living in the community setting and expert stakeholders. Reflections from the SDN on interactions with participants and expert stakeholder opinion informed the CALD dementia support model and pathway. Interaction with 62 people living with memory loss or dementia from CALD backgrounds, carers or family members receiving support from the SDN and feedback from 13 expert stakeholders from community aged-care services, consumer advocacy organisations and ethnic community group representatives informed the development and refinement of the CALD dementia model of care and pathway. We delineate the three components of the 'SDN' model: the organisational support; a description of the role; and the competencies needed. Additionally, we provide an accompanying pathway for use by health professionals delivering care to consumers with dementia from CALD backgrounds. Our culturally sensitive model of dementia care and accompanying pathway allows for the tailoring of health and social support to assist people from CALD backgrounds, their carers and families to adjust to living with memory loss and remain living in the community as long as possible. The model and accompanying pathway also have the potential to be rolled out nationally for use by health professionals across a variety of health services.

Goeman D ，King J ，Koch S 《BMJ Open》