Bridget Hamilton | University of Melbourne (original) (raw)

Papers by Bridget Hamilton

International Journal of Mental Health Nursing, 2019

As involvement of consumers/survivors in planning, delivery, and evaluation of services has incre... more As involvement of consumers/survivors in planning, delivery, and evaluation of services has increased, expectations of authentic and effective engagement, versus tokenism, have also risen. Different factors contribute to, or detract from, authentic engagement. Writing from mental health consumer/survivor and nursing positioning, respectively, we aim to redress the common problem of including only a narrow range of views and voices. This paper introduces a conceptual model that supports leaders in research, clinical, service, and policy roles to understand the necessity of engaging with a broader spectrum of consumer/survivor views and voices. The model draws on published consumer/survivor materials, making explicit diverse experiences of treatment and care and identifying the subsequent rich consumer/survivor advocacy agendas. We propose that strong co‐production is made possible by recognizing and welcoming consumer/survivor activist, facilitator, transformer, and humanizer contrib...

This review examined research on physical design features in mental health facilities that reduce... more This review examined research on physical design features in mental health facilities that reduce the use of seclusion and restraint. Overall, the review found evidence that the physical environment can have a role in supporting better outcomes for consumers of inpatient mental health services, including reduction in the use of seclusion and restraint. Improvements to the physical environment are likely to be achieved through good design features; these include adequate space and privacy, no overcrowding, exposure to daylight and other appropriate lighting, reduced levels of unpleasant noise, access to gardens and a home-like environment.

Early Intervention in Psychiatry, 2018

AimEarly intervention services (EISs) for first‐episode psychosis (FEP) have been established int... more AimEarly intervention services (EISs) for first‐episode psychosis (FEP) have been established internationally, however, service disengagement is a recurrent concern resulting in unplanned treatment cessation. The implications of this are far‐reaching due to the financial and personal costs associated with untreated symptoms. The aim of this meta‐synthesis was to collect, interpret and synthesize qualitative research about how engagement is experienced within EISs for FEP.MethodsA systematic search was conducted in PsycINFO, Ovid MEDLINE and Ovid Emcare from date of conception to November 2016. Following initial screening, 91 abstracts and 13 full texts were reviewed for eligibility. Nine studies were then critically appraised using the CASP tool for qualitative studies, data were systematically extracted and results were synthesized using constant comparison and reciprocal translational analysis.ResultsNine qualitative studies explored engagement with EISs, from the perspectives of ...

Data collected at St Vincent's Public Hospital (STV) (Melbourne) cardiac wards over 3 years, ... more Data collected at St Vincent's Public Hospital (STV) (Melbourne) cardiac wards over 3 years, 2008-2010 (212 patients). This study was aimed at improving the screening of depression and anxiety in patients with coronary heart disease (CHD), through implementation of a model of care including examining the effectiveness of a clinical pathway in patients following admission for an acute cardiac event. Based on a collaboration with "Beyond Blue", Professor Patricia Davidson (Curtin University) and Dr Steve Bunker (Medibank Private).

Psychosis, 2018

Early intervention services play a crucial role in providing treatment for young people experienc... more Early intervention services play a crucial role in providing treatment for young people experiencing a first episode psychosis. However, on average, 30 per cent of young people disengage from treatment, which may result in untreated symptoms, difficulty returning to school or work and relationship breakdowns. This qualitative study aimed to understand the help-seeking experiences and initial engagement with an early intervention service. Semi-structured interviews were conducted with nine young people and five caregivers, focussing on engagement in the first eight weeks of treatment. Themes were identified using thematic analysis. Key findings were that participants entered the early intervention service after a time of intense distress and confusion. This was related to symptoms, difficulties working or studying, and initial experiences of help-seeking and treatment. Commonly there was relief on meeting a caring person who would be their support going forward. However, trust was influenced by previous positive and negative experiences. Establishing a therapeutic relationship and building trust are dynamic and relational concepts, and as such, they warrant reflection by all key stakeholders. Awareness and understanding of these concepts may guide changes to individual practice and service development.

Archives of Psychiatric Nursing, 2010

Background: Seclusion is widely used internationally to manage disturbed behavior by psychiatric ... more Background: Seclusion is widely used internationally to manage disturbed behavior by psychiatric patients, although many countries are seeking to reduce or eliminate this practice. Time-out has been little described and almost completely unstudied. Aim and Method: To assess the relationship of seclusion and time-out to conflict behaviors, the use of containment methods, service environment, physical environment, patient routines, staff characteristics, and staff group variables. Data from a multivariate cross-sectional study of 136 acute psychiatric wards in England were used to conduct this analysis. Results: Seclusion is used infrequently on English acute psychiatric wards (0.05 incidents per day), whereas time-out use was more frequent (0.31 incidents per day). Usage of seclusion was strongly associated with the availability of a seclusion room. Seclusion was associated with aggression, alcohol use, absconding, and medication refusal, whereas time-out was associated with these and other more minor conflict behaviors. Both were associated with the giving of as required medication, coerced intramuscular medication, and manual restraint. Relationships with exit security for the ward were also found. Conclusions: Given its low usage rate, the scope for seclusion reduction in English acute psychiatry may be small. Seclusion reduction initiatives need to take a wider range of factors into account. Some substitution of seclusion with time-out may be possible, but a rigorous trial is required to establish this. The safety of intoxicated patients in seclusion requires more attention.

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Cancer as a multifactorial disorder develops due to the complex interaction between gene and envi... more Cancer as a multifactorial disorder develops due to the complex interaction between gene and environment. A person may be susceptible to cancer due to his individual genetic makeup. Cancer causes maximum death worldwide as per data given by the World Health Organization. Some cases are reported with particular genetic makeup. Hence, the proper understanding of eco-genomics of cancer is necessary to interpret the underlying cause and risk factor for cancer. Combining huge gene expression date available in cyberspace and advanced machine learning technique may bring out the strongest candidate genes, which individually or as a part of the complex system, have more accurate prognostic value to determine someone's susceptibility toward cancer. In this paper, we have analyzed gene expression data for the lung cancer available in the Kent Ridge Bio-Medical Dataset Repository. The microarray gene expression data are analyzed to select and predict the optimal subset of genes, which are the most probable causing agent of lung cancer. INDEX TERMS Gene expression analysis, machine learning technique, eco-genomics, multilayer perceptron, information gain attribute ranking.

International Journal of Mental Health Nursing, 2021

Suicide by hanging is increasing in many countries around the world and whilst efforts are being ... more Suicide by hanging is increasing in many countries around the world and whilst efforts are being made to influence the prevention agenda to reduce the incidence, little is known regarding the contributing factors for choosing this method. The purpose of this scoping review is to summate understandings about how the epidemiology and prevention of suicide by hanging is recognised, described, and discussed in the literature, and critically appraise the extent to which the lived-experiences of survivors of suicide attempts are included. A scoping review was conducted implementing the appropriate framework and in accord with the PRIMSA-ScR extension. Three databases (CINAHL, PubMed, and PsycINFO) were searched along with the reference lists of eligible sources in January and February 2021. Thirty-six articles with a primary focus on hanging as a method of suicide and/or its prevention are included in this review, with brief thematic analysis used to summarise the featured studies. Three distinct themes emerging from the literature include: (i) Hanging suicide deaths in the community environment or person's usual place of residence, (ii) Hanging suicide deaths in controlled environments (including police cells, prisons, and inpatient units), and (iii) Medical management of near-lethal hangings. This review highlights the necessity for improving education and policy regarding the controlled environments frequently associated with hanging suicides and the medical management of near-lethal hangings, as well as the ongoing need for policy to guide and govern the responsible media portrayal of known suicides as well as fictional hangings. Finally, this review highlights the necessity for including those with lived-experiences of a suicide attempt by hanging to advance the current prevention agenda.

Realistic three-dimensional (3-D) shake table tests using E-Defense were conducted for full-scale... more Realistic three-dimensional (3-D) shake table tests using E-Defense were conducted for full-scale 5-story steel building specimens with/without dampers. As the first step of co-relative analysis, a detailed 3-D analysis model consisting of practical line and spring elements is formulated by closely reflecting the actual properties of the frame portion without dampers. Analytical results agree well with the experimental results, and are utilized to understand and/or clarify both global and local behavior of the frame. The model is also used for hypothetical analysis of the frame under a larger table motion not applied in the test due to the safety reason.

Background Safewards is a program that consists of a conceptual model and a set of 10 interventio... more Background Safewards is a program that consists of a conceptual model and a set of 10 interventions, developed in the UK for use in acute psychiatric wards (Bowers 2014). The Safewards model explains the relationship between conflict and containment in this setting, highlighting opportunities for nurses to intervene, both to prevent conflict and to respond in least restrictive ways. A package of 10 interventions was implemented in 2013 in a large cluster randomised controlled trial in 31 adult acute wards in England (Bowers et al 2015). The experimental trial in England showed that Safewards was associated with both reduced conflict and reduced use of seclusion. The Victorian Safewards Trial seeks to: apply the Safewards model; implement the same 10 Safewards interventions in Victorian public mental healthcare settings; and extend the interventions to aged persons' and adolescent mental health wards and to secure extended care (SECU) settings. It was a collaborative effort between the Department of Health and Human Services and seven public mental health services.

BMJ Open, 2021

Increasing efforts are being made to prevent and/or eliminate the use of seclusion and restraint ... more Increasing efforts are being made to prevent and/or eliminate the use of seclusion and restraint in mental health facilities. Recent literature recognises the importance of the physical environment in supporting better outcomes in mental health services. This rapid review scoped the existing literature studying what physical design features of mental health facilities can reduce the use of seclusion and physical restraint.DesignA rapid review of peer-reviewed literature.MethodsPeer-reviewed literature was searched for studies on architectural design and the use of restraint and seclusion in mental health facilities. The following academic databases were searched: Cochrane Library, Medline, PsycINFO, Scopus and Avery for English language literature published between January 2010 and August 2019. The Joanna Briggs Institute’s critical appraisal tool was used to assess the quality of included studies.ResultsWe identified 35 peer-reviewed studies. The findings revealed several overarchi...

International Journal of Environmental Research and Public Health, 2021

Mental health presentations to the emergency department (ED) have increased, and the emergency de... more Mental health presentations to the emergency department (ED) have increased, and the emergency department has become the initial contact point for people in a mental health crisis. However, there is mounting evidence that the ED is not appropriate nor effective in responding to people in mental health crises. Insufficient attention has been paid to the subjective experience of people seeking support during a mental health crisis. This review aims to describe the qualitative literature involving the subjective experiences of people presenting to the ED during a mental health crisis. The method was guided by Arksey and O’Malley’s framework for scoping studies and included keyword searches of PsycINFO, CINAHL, Medline and Embase. A narrative analysis, drawing on the visual tool of journey mapping, was applied to summarise the findings. Twenty-three studies were included. The findings represent the experience of accessing EDs, through to the impact of treatment. The review found points ...

Frontiers in Psychiatry, 2019

Aim: To describe the impact of Safewards on consumer experiences of inpatient mental health servi... more Aim: To describe the impact of Safewards on consumer experiences of inpatient mental health services. Method: A postintervention survey was conducted with 72 consumers in 10 inpatient mental health wards 9-12 months after Safewards was implemented. Results: Quantitative data showed that participants felt more positive about their experience of an inpatient unit, safer, and more connected with nursing staff. Participants reported that the impact of verbal and physical aggression had reduced because of Safewards. Qualitatively, participants reported increased respect, hope, sense of community, and safety and reduced feelings of isolation. Some participants raised concerns about the language and intention of some interventions being condescending. Discussion: Consumers' responses to Safewards were positive, highlighting numerous improvements of importance to consumers since its implementation across a range of ward types. The findings suggest that Safewards offers a pathway to reducing restrictive interventions and enables a move toward recovery-oriented practice.

Journal of Nursing Scholarship, 2019

This is the author manuscript accepted for publication and has undergone full peer review but has... more This is the author manuscript accepted for publication and has undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as

European Journal of Cancer Care, 2018

Identifying essential information to support patient decision-making regarding participation in c... more Identifying essential information to support patient decision-making regarding participation in cancer clinical trials: a Delphi study

International Journal of Mental Health Nursing, 2017

Restrictive practices are used in response to conflict and aggression in psychiatric inpatient se... more Restrictive practices are used in response to conflict and aggression in psychiatric inpatient settings. Reducing such practices is the focus internationally of policy and legislative change, many initiatives, and a growing body of research. Safewards is a model and a set of 10 interventions designed to reduce conflict and containment in inpatient services. In the current study, we aimed to assess the impact of implementing Safewards on seclusion in Victorian inpatient mental health services in Australia. The study used a before-and-after design, with a comparison group matched for service type. Thirteen wards opted into a 12week trial to implement Safewards and 1-year follow up. The comparison group was all other wards (n = 31) with seclusion facilities in the jurisdiction, matched to service type. Mandatorily-reported seclusion event data for all 44 wards over a 15-month period were analysed using negative binomial regression. Adherence to Safewards was measured via fidelity checklists at four time points: twice during the trial, post-trial, and at 1-year follow up. Seclusion rates were reduced by 36% in Safewards trial wards by the 12-month follow-up period (incidence rate ratios (IRR) = 0.64,) but in the comparison wards seclusion rates did not differ from baseline to post-trial (IRR = 1.17) or to follow-up period (IRR = 1.35). Fidelity analysis revealed a trajectory of increased use of Safewards interventions after the trial phase to follow up. The findings suggest that Safewards is appropriate for practice change in Victorian inpatient mental health services more broadly than adult acute wards, and is effective in reducing the use of seclusion.

Epidemiology and psychiatric sciences, Jan 12, 2016

There are growing calls to reduce, and where possible eliminate, the use of seclusion and restrai... more There are growing calls to reduce, and where possible eliminate, the use of seclusion and restraint in mental health settings, but the attitudes and beliefs of consumers, carers and mental health professionals towards these practices are not well understood. The aim of this study was to compare the attitudes of mental health service consumers, carers and mental health professionals towards seclusion and restraint in mental health settings. In particular, it aimed to explore beliefs regarding whether elimination of seclusion and restraint was desirable and possible. In 2014, an online survey was developed and widely advertised in Australia via the National Mental Health Commission and through mental health networks. The survey adopted a mixed-methods design, including both quantitative and qualitative questions concerning participants' demographic details, the use of seclusion and restraint in practice and their views on strategies for reducing and eliminating these practices. In...