Theses

Permanent URI for this community

https://hdl.handle.net/2440/14759

Included in the Research Theses collection are Masters, PHD and Professional Doctorate theses.
Masters and PHDs by coursework theses are included in the Honours and Coursework Theses collection. Some schools may choose to include Honours theses which make a significant contribution to knowledge.
If a school submits undergraduate theses or final year projects to the Digital Library, these will be included with the school's other collections.

News

For further information about the collection, please contact the Library Theses team

Browse

Browsing Theses by Advisors "Abbey, Jennifer"

Now showing 1 - 3 of 3
  • No Thumbnail Available
    ItemOpen Access
    The effects of cognitive behaviour therapy for major depression in older adults.
    (2011) Jayasekara, Rasika Sirilal; Abbey, Jennifer; Lockwood, Craig S.; The Joanna Briggs Institute
    Objectives The objective of this systematic review was to examine the effects of cognitive behavioural therapy (CBT) for older adults with depression when compared to standard care, specific medication and other therapies. Inclusion criteria This review considered only randomised controlled trials (RCTs) assessing the effectiveness of CBT as a treatment for older adult with major depression when compared to standard care, specific medication, other therapies and no intervention. The review included trials in which patients were described as elderly, geriatric, or older adults, or in which all patients were aged 55 or over. Major depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) and the World Health Organization's International Statistical Classification of Diseases and Related Health Problems (ICD-10) criteria. Search strategy The search was limited to English language papers published from 2003 to July 2011. A three-step search strategy was developed using MeSH terminology and keywords to ensure that all materials relevant to the review were captured. An initial limited search of MEDLINE and CINAHL was undertaken followed by an analysis of the text words contained in the title and abstract, and of the index terms used to describe the article. A second search using all identified keywords and index terms was then undertaken in major databases (MEDLINE; CINAHL; Cochrane Central Register of Controlled Trials; Controlled Trials; EMBASE; Current Contents; PsycINFO; Ageline). Thirdly, the reference list of all identified reports and articles were searched for additional studies. Methodological quality Each paper was assessed by two independent reviewers for methodological quality prior to inclusion in the review using The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). Meta-analyses were performed using Review Manager 5 software (2011). Results A total of seven randomised controlled trials (RCT) were included in the review. Two trials involving 159 older adults with depression compared CBT versus treatment as usual (TAU) using Beck Depression Inventory (BDI) and the pooled data of two trials found no statistically significant differences in reduction of depression after 3-4 months of the intervention (Weighted mean differences [WMD] -2.61, 95% CI -5.82 to -0.6) and 6-10 month follow-up (WMD -3.05, 95% confidence interval [CI] -6.41 to -0.32). Three trials involving 97 older adults with depression compared CBT and TAU in reduction of depression using Geriatric Depression Scale (GDS) and found a significant difference between CBT and control groups (WMD -2.83, 95% CI -4.02 to -1.64), however significant heterogeneity was observed (chi-square 10.09, df=2, I2=80% p=0.006) in both fixed and random effects models. Individually, four trials that compared the CBT with TAU found that CBT is an effective treatment for older adults with depression. Conclusion The key finding of this review is that cognitive-behavioural therapies are likely to be efficacious in older people when compared to treatment as usual. This finding is consistent with the findings of several systematic reviews and meta-analyses undertaken across a wider age range. However, the small size of included trial, the nature of the participants, and the heterogeneity of the interventions has considerable implications with regard to generalising these findings to clinical populations.
  • No Thumbnail Available
    ItemOpen Access
    Obstacles to the take-up of mental health care provision by adult males in rural and remote areas of Australia: a systematic review thesis
    (2014) Stroud, Peter Charles; Abbey, Jennifer; Attard, Melanie; Campbell, Jared; Lockwood, Craig Stuart; School of Translational Health Science
    Introduction/background: Research and practice have suggested that mental health care, and mental health care practices and practitioners, along with mental health care systems, seem to be confronted with obstacles in the take-up and delivery of mental health-care services to adult males living in rural and remote areas of Australia. The aim of this systematic review thesis is to appraise and synthesise research evidence about these obstacles. These obstacles may influence the interaction between adult rural and remote dwelling males, and mental health care providers and mental health care systems. This thesis reviews and analyses health data from health systems, provider and recipient view points, through a critical analysis of the research literature published from 1995. This field of research has warranted further exploration and understanding in both qualitative and quantitative domains. Methodology The qualitative and quantitative components of this systematic review thesis have considered studies which included adult males of all racial and cultural backgrounds residing in rural and remote areas of Australia. The quantitative component has considered studies which evaluated the nature, significance, causes of and remedies to obstacles to mental health care, and the nature and significance of such obstacles from both the provider and recipient points of view. The qualitative component has considered studies which explored the meaning and experience of obstacles from similar viewpoints. Results: The outcomes of this systematic review thesis have led to the identification and description of four categories of obstacles which impact on adult males seeking mental health care in rural and remote communities of Australia. These categories are population characteristics, environment, health behaviour and health outcomes. Conclusion Quantitative and qualitative data has revealed a constellation of statistical data and themes from men’s perceptions and experiences that clarify the everyday nature of obstacles to the take-up of mental health care by rural and remote dwelling Australian adult males. Provider (supply side) and recipient (demand side) obstacles contribute to the factors involved in the demand for and supply of services and the under-use of mental health care services by adult rural and remote males in Australia. This analysis opens a fertile ground for future research in this field.
  • No Thumbnail Available
    ItemOpen Access
    A systematic review of appropriateness and effectiveness of management strategies used for the behavioural and psychological symptoms of dementia in the residential care setting.
    (2013) Kowald, Matthew Stuart; Abbey, Jennifer; White, Sarahlouise; McArthur, Alexandra Lee; School of Translational Health Science
    Background The incidence of dementia is increasing throughout the world. People with dementia often require residential care. The management of behaviours in residential care is a significant and stressful part of caring for people with dementia. The ability to apply appropriate and effective management strategies to these behaviours is vital to maintain the safety of the person with dementia and the people who live with them and care for them. Objectives The aim of this review is to identify and synthesise the best available evidence of the appropriateness and effectiveness of different strategies used to manage the behavioural and psychological symptoms of dementia in the residential care setting. Inclusion criteria Types of participants Adults aged 65 years and older regardless of gender, ethnicity, co-morbidities who reside in a residential care facility. The subjects must have a diagnosis of dementia and exhibit behaviours which require a degree of modification or management so that they can be safely managed in a residential care facility. Types of interventions/Phenomenon of Interest Interventions types examined in this review were: Standard behavioural therapies, Alternative therapies, Complementary therapies, Psychotherapies, Environmental factors, Pharmacological interventions. Types of studies This comprehensive review considered both qualitative and quantitative studies. Included quantitative studies were randomized control trials, case control and cohort studies. The qualitative studies focused on the experiences of the people with dementia and the people who care for them. Types of Outcome Measures There was a wide range of outcome measures in the selected studies. The outcome strategies focused on both prevalence and severity of behaviours to illustrate effectiveness of interventions. Search Strategy Both published and unpublished English language studies were considered, from inception of the eight databases searched up to March 2012. A three-step search strategy was utilized in each component of this review. Methodological quality 20 papers were assessed for methodological quality by two independent reviewers, using standardised Joanna Briggs Institute instruments. Of these papers, two were qualitative and the remaining 18 were quantitative through this process studies were considered to be of moderate to high quality as assessed against the Joanna Briggs critical appraisal tools. No studies were excluded based on methodological quality. Data Collection and Data Synthesis Data was extracted using standardized data extraction tools. Meta-analysis of quantitative data was appropriate for two of the studies, it was not attempted on the others due to lack of clinical and statistical heterogeneity; therefore findings are presented as a narrative. Meta-aggregation of qualitative findings was conducted in order to generate synthesised findings. Results 20 papers were identified for this systematic review. 18 of these papers were quantitative and two were qualitative. These papers described effective and appropriate management of the behavioural and psychological symptoms using a variety of methods, pharmacological and non-pharmacological. Conclusion Effectiveness in management of behavioural and psychological symptoms of dementia is dependent on correct diagnosis of the behaviour and the detection of underlying pathology organic or psychiatric. Interventions need to be targeted at the resident and based on the residents lived experiences.