Rachael Fullam - Academia.edu (original) (raw)
Papers by Rachael Fullam
International Journal of Forensic Mental Health
BMJ Supportive & Palliative Care, 2011
Psychiatry, Psychology and Law, 2016
This study examines whether Australian psychiatrists would support requests in a psychiatric adva... more This study examines whether Australian psychiatrists would support requests in a psychiatric advance directive (PAD) and the reasons underlying their decisions in response to a hypothetical vignette. An online survey was completed by 143 psychiatrists. Fewer than 3 out of 10 psychiatrists supported the patient to create a PAD which requested cessation of pharmacotherapy (27%) or remaining out of hospital and not being subject to an involuntary treatment order (24%) should their depression condition deteriorate. A thematic analysis showed that patient autonomy was the strongest theme among those who supported the patient to create a PAD, whereas the clinical profile of and risk to the patient and the professional or ethical imperative of the psychiatrist were strongest among those who were unsure about supporting the patient or who did not support the patient. These findings provide a challenge about how to fulfil obligations under the United Nations Convention on the Rights of Persons with Disabilities (2006).
BMJ Supportive & Palliative Care, 2011
BMJ Supportive & Palliative Care, 2011
BMJ Supportive & Palliative Care, 2012
Published literature suggests that advance care planning (ACP) activity in aged-care homes is inc... more Published literature suggests that advance care planning (ACP) activity in aged-care homes is inconsistent and often of poor quality. There are few published reports of the effectiveness of formal training and implementation of ACP in aged-care homes. The Respecting Patient Choices Program piloted a training and implementation model in 19 aged-care homes in Victoria, Australia in 2010-11. The model required Measurement Pre-training (%) Post-training (%) P value % of staff reporting the existence of written policies on ACP in aged-care homes. 53 100 0.008 % of aged-care homes. which discuss medical treatment options with resident/family 42 100 0.016 % of aged-care homes which discuss "things that matter most about life and living" with resident 8 9 2 0. 0 0 9 % of aged-care homes reporting that ACP information is used effectively within the facility. 33 100 0.013 % of staff reporting that ACP is carried out "well/very well" within their aged-care home.
BMJ supportive & palliative care, 2014
To develop and evaluate an interactive advance care planning (ACP) educational programme for gene... more To develop and evaluate an interactive advance care planning (ACP) educational programme for general practitioners and doctors-in-training. Development of training materials was overseen by a committee; informed by literature and previous teaching experience. The evaluation assessed participant confidence, knowledge and attitude toward ACP before and after training. Training provided to metropolitan and rural settings in Victoria, Australia. 148 doctors participated in training. The majority were aged at least 40 years with more than 10 years work experience; 63% had not trained in Australia. The programme included prereading, a DVD, interactive patient e-simulation workshop and a training manual. All educational materials followed an evidence-based stepwise approach to ACP: Introducing the topic, exploring concepts, introducing solutions and summarising the conversation. The primary outcome was the change in doctors' self-reported confidence to undertake ACP conversations. Seco...
BMJ supportive & palliative care, 2013
To assess existing advance care planning (ACP) practices in residential aged care facilities (RAC... more To assess existing advance care planning (ACP) practices in residential aged care facilities (RACFs) in Victoria, Australia before a systematic intervention; to assess RACF staff experience, understanding of and attitudes towards ACP. Surveys of participating organisations concerning ACP-related policies and procedures, review of existing ACP-related documentation, and pre-intervention survey of RACF staff covering their role, experiences and attitudes towards ACP-related procedures. 19 selected RACFs in Victoria. 12 aged care organisations (representing 19 RACFs) who provided existing ACP-related documentation for review, 12 RACFs who completed an organisational survey and 45 staff (from 19 RACFs) who completed a pre-intervention survey of knowledge, attitudes and behaviour. Findings suggested that some ACP-related practices were already occurring in RACFs; however, these activities were inconsistent and variable in quality. Six of the 12 responding RACFs had written policies and p...
BMJ supportive & palliative care, 2013
To report on the quality of advance care planning (ACP) documents in use in residential aged care... more To report on the quality of advance care planning (ACP) documents in use in residential aged care facilities (RACF) in areas of Victoria Australia prior to a systematic intervention; to report on the development and performance of an aged care specific Advance Care Plan template used during the intervention. An audit of the quality of pre-existing documentation used to record resident treatment preferences and end-of-life wishes at participating RACFs; development and pilot of an aged care specific Advance Care Plan template; an audit of the completeness and quality of Advance Care Plans completed on the new template during a systematic ACP intervention. 19 selected RACFs (managed by 12 aged care organisations) in metropolitan and regional areas of Victoria. Documentation in use at facilities prior to the ACP intervention most commonly recorded preferences regarding hospital transfer, life prolonging treatment and personal/cultural/religious wishes. However, 7 of 12 document sets fa...
BMJ Supportive & Palliative Care, 2012
BMJ Supportive & Palliative Care, 2013
BMJ Supportive & Palliative Care, 2013
BMJ Supportive & Palliative Care, 2013
Aggression and Violent Behavior
International Journal of Offender Therapy and Comparative Criminology
This study compared the efficacy of a novel group-based aggressive script rehearsal treatment pro... more This study compared the efficacy of a novel group-based aggressive script rehearsal treatment program with an emotion regulation program. Participants were 48 incarcerated adult males (28 in the script rehearsal program and 20 in the emotion regulation program). Outcomes, including the frequency of aggressive script rehearsal, aggressive behavior, and emotion regulation difficulties, were measured pre-and post-treatment and at 46 days (on average) after treatment completion, and 104 days (on average) following treatment completion. Linear Mixed Model analyses revealed no significant difference in the frequency of script rehearsal overtime for either program. There was a significant reduction in aggressive behavior associated with the script rehearsal program and a reduction in emotion regulation difficulties for both programs. Future iterations of this aggressive script rehearsal treatment program may benefit from greater intensity and incorporation of strategies that address the ma...
International Journal of Forensic Mental Health
BMJ Supportive & Palliative Care, 2011
Psychiatry, Psychology and Law, 2016
This study examines whether Australian psychiatrists would support requests in a psychiatric adva... more This study examines whether Australian psychiatrists would support requests in a psychiatric advance directive (PAD) and the reasons underlying their decisions in response to a hypothetical vignette. An online survey was completed by 143 psychiatrists. Fewer than 3 out of 10 psychiatrists supported the patient to create a PAD which requested cessation of pharmacotherapy (27%) or remaining out of hospital and not being subject to an involuntary treatment order (24%) should their depression condition deteriorate. A thematic analysis showed that patient autonomy was the strongest theme among those who supported the patient to create a PAD, whereas the clinical profile of and risk to the patient and the professional or ethical imperative of the psychiatrist were strongest among those who were unsure about supporting the patient or who did not support the patient. These findings provide a challenge about how to fulfil obligations under the United Nations Convention on the Rights of Persons with Disabilities (2006).
BMJ Supportive & Palliative Care, 2011
BMJ Supportive & Palliative Care, 2011
BMJ Supportive & Palliative Care, 2012
Published literature suggests that advance care planning (ACP) activity in aged-care homes is inc... more Published literature suggests that advance care planning (ACP) activity in aged-care homes is inconsistent and often of poor quality. There are few published reports of the effectiveness of formal training and implementation of ACP in aged-care homes. The Respecting Patient Choices Program piloted a training and implementation model in 19 aged-care homes in Victoria, Australia in 2010-11. The model required Measurement Pre-training (%) Post-training (%) P value % of staff reporting the existence of written policies on ACP in aged-care homes. 53 100 0.008 % of aged-care homes. which discuss medical treatment options with resident/family 42 100 0.016 % of aged-care homes which discuss "things that matter most about life and living" with resident 8 9 2 0. 0 0 9 % of aged-care homes reporting that ACP information is used effectively within the facility. 33 100 0.013 % of staff reporting that ACP is carried out "well/very well" within their aged-care home.
BMJ supportive & palliative care, 2014
To develop and evaluate an interactive advance care planning (ACP) educational programme for gene... more To develop and evaluate an interactive advance care planning (ACP) educational programme for general practitioners and doctors-in-training. Development of training materials was overseen by a committee; informed by literature and previous teaching experience. The evaluation assessed participant confidence, knowledge and attitude toward ACP before and after training. Training provided to metropolitan and rural settings in Victoria, Australia. 148 doctors participated in training. The majority were aged at least 40 years with more than 10 years work experience; 63% had not trained in Australia. The programme included prereading, a DVD, interactive patient e-simulation workshop and a training manual. All educational materials followed an evidence-based stepwise approach to ACP: Introducing the topic, exploring concepts, introducing solutions and summarising the conversation. The primary outcome was the change in doctors' self-reported confidence to undertake ACP conversations. Seco...
BMJ supportive & palliative care, 2013
To assess existing advance care planning (ACP) practices in residential aged care facilities (RAC... more To assess existing advance care planning (ACP) practices in residential aged care facilities (RACFs) in Victoria, Australia before a systematic intervention; to assess RACF staff experience, understanding of and attitudes towards ACP. Surveys of participating organisations concerning ACP-related policies and procedures, review of existing ACP-related documentation, and pre-intervention survey of RACF staff covering their role, experiences and attitudes towards ACP-related procedures. 19 selected RACFs in Victoria. 12 aged care organisations (representing 19 RACFs) who provided existing ACP-related documentation for review, 12 RACFs who completed an organisational survey and 45 staff (from 19 RACFs) who completed a pre-intervention survey of knowledge, attitudes and behaviour. Findings suggested that some ACP-related practices were already occurring in RACFs; however, these activities were inconsistent and variable in quality. Six of the 12 responding RACFs had written policies and p...
BMJ supportive & palliative care, 2013
To report on the quality of advance care planning (ACP) documents in use in residential aged care... more To report on the quality of advance care planning (ACP) documents in use in residential aged care facilities (RACF) in areas of Victoria Australia prior to a systematic intervention; to report on the development and performance of an aged care specific Advance Care Plan template used during the intervention. An audit of the quality of pre-existing documentation used to record resident treatment preferences and end-of-life wishes at participating RACFs; development and pilot of an aged care specific Advance Care Plan template; an audit of the completeness and quality of Advance Care Plans completed on the new template during a systematic ACP intervention. 19 selected RACFs (managed by 12 aged care organisations) in metropolitan and regional areas of Victoria. Documentation in use at facilities prior to the ACP intervention most commonly recorded preferences regarding hospital transfer, life prolonging treatment and personal/cultural/religious wishes. However, 7 of 12 document sets fa...
BMJ Supportive & Palliative Care, 2012
BMJ Supportive & Palliative Care, 2013
BMJ Supportive & Palliative Care, 2013
BMJ Supportive & Palliative Care, 2013
Aggression and Violent Behavior
International Journal of Offender Therapy and Comparative Criminology
This study compared the efficacy of a novel group-based aggressive script rehearsal treatment pro... more This study compared the efficacy of a novel group-based aggressive script rehearsal treatment program with an emotion regulation program. Participants were 48 incarcerated adult males (28 in the script rehearsal program and 20 in the emotion regulation program). Outcomes, including the frequency of aggressive script rehearsal, aggressive behavior, and emotion regulation difficulties, were measured pre-and post-treatment and at 46 days (on average) after treatment completion, and 104 days (on average) following treatment completion. Linear Mixed Model analyses revealed no significant difference in the frequency of script rehearsal overtime for either program. There was a significant reduction in aggressive behavior associated with the script rehearsal program and a reduction in emotion regulation difficulties for both programs. Future iterations of this aggressive script rehearsal treatment program may benefit from greater intensity and incorporation of strategies that address the ma...