AITHM Double Seminar - Lem Pelentsov and Andrea Fielder
Mr Lem Pelentsov – Scoping reviews: An overview and the research application
Andrea Fielder – An improved Model of Care for Substance Using Pregnant and Parenting Women
Friday 15 July - 10:30am - 12:00pm
**New rooms! Cairns D3.063 video linked to Townsville 39.252A
Mr Lemuel Pelentsov
Lecturer, School of Nursing and Midwifery, University of South Australia
Presentation: Scoping reviews: An overview and the research application
Introduction: Lemuel Pelentsov is a lecturer in the School of Nursing and Midwifery, University of South Australia. The aim of his doctoral research was to develop a scale designed to measure the supportive care needs of parents caring for children with rare diseases. This mixed methods study involved four phases: Scoping review (Phase 1), Focus groups (Phase 2), International web-based survey (phase 3), and Structural equation modelling and scale development (Phase 4).
Background: Rare diseases are a large diverse group of life-threatening or chronically debilitating illnesses, the majority of which are genetic-based, originate during foetal development, are associated with significant disability, and have no cure, pre-existing pathways of care or personalized medical intervention strategies. Individuals and families affected by rare diseases have traditionally received meagre attention from political, scientific and medical communities, with parents needs especially having received very little attention. Many parents caring for a child with a rare disease will face a life-time of challenges and personal sacrifice, often with limited access to health services and support, and a lack of experienced health professionals to aid them., many of which have no formal title and are difficult to diagnose. Rare diseases are now considered a global public health issue.
Objectives: The purpose of this presentation is to provide an overview of scoping reviews – a five stage process – and demonstrate its application with published results of a scoping review which investigated the supportive care needs of parents of children with rare diseases.
Methods: Scoping reviews are one of the many different types of systematic reviews that can be undertaken. The five critical stages of a scoping review outlined by Arksey and O'Malley (2005) will be discussed here.
Results: A total of 29 papers were included in a scoping review of supportive care needs of parents with children with rare diseases. Four studies used quantitative methods, 18 used qualitative, three used a mixed methods approach, and four were literature reviews. From the results of this review, a preliminary framework was proposed outlining parental supportive care needs for rare diseases.
Conclusions: A reason why a scoping review is ideal for critically reviewing the literature is that it is much quicker to undertake than a systematic review, yet, it still has sufficient rigour in terms of critical analysis.
Andrea fielder – An improved Model of Care for Substance Using Pregnant and Parenting Women
Illicit opioid dependence, such as heroin and prescription analgesics, during pregnancy has risen world–wide, with United States (US) figures showing almost a 5-fold increase since 2000. Consequently, associated adverse event health care costs for the mother, fetus and newborn have also risen. In Australia, 4.2% of pregnant women report using any illicit substance, and 2.4% report using any pharmaceutical for non-medical purposes. In the US and Europe, substance using pregnant women and their infants can receive care during and after pregnancy through multidisciplinary comprehensive treatment facilities, where their pregnancy, substance use and other physical and psychological health issues are managed in the same onsite treatment setting. This program model is absent in Australia and can result in significant gaps, shortfalls in service delivery and standards of practice of care of pregnant substance using women and their exposed infants. Assistance and support services for all substance using women during pregnancy are pivotal for primary proactive prevention, and may reduce the demand for secondary reactive interventions. Models of care treating pregnancy and substance abuse issues in the same setting not only clinically proven in their ability to improve maternal and infant outcomes they are also economically proven by reductions in health care costs through breaking the intergenerational substance use cycle. This presentation will show case an example of a comprehensive trauma informed care program for substance using pregnant and parenting women, with the view to implement this type of program in the future.
Dr Fielder is a pharmacologist specialising in the area of substance use and pregnancy, with particular interests in opioid maintenance pharmacotherapies. She received her PhD from the University of Adelaide investigating the use of buprenorphine and methadone in pregnancy and their effects on the mother, fetus and neonate. In 2014 she undertook her Fulbright Scholarship at the University of North Carolina Horizons Program in Chapel Hill North Carolina, where she was able to observe the logistics of a comprehensive treatment program to improve outcomes for substance using pregnant and parenting women and their families. She has published over 30 peer reviewed publications, presented at 11 international and national conferences, has provided peer review for 15 journals, is an Associate Editor for BMC Pregnancy and Childbirth, is a member of the Women’s and Children’s Hospital foundation grant review panel and has provided external peer review for NHMRC. Dr Fielder has also significantly contributed to clinical guidelines in the area of substance use and mental health in pregnant and non-pregnant populations, including guidelines for the World Health Organisation, the Colombo Plan and the United States International Narcotics and Law Enforcement.