Carers NSW 2014 carer survey: main report

Executive Summary The biennial Carers NSW Carer Survey collects information about carers in NSW to inform the organisation・s direction, support and systemic advocacy for all carers across NSW. The 2014 survey collected more extensive and detailed data than any previous Carer Survey and has established a framework to guide future surveys. This report provides an overview of the main findings from the survey data, with future publications to investigate specific issues in greater depth. The survey was completed by 1,684 carers - 84% of whom were female, and over half were aged between 45 and 64 years. A significant majority were the main provider of care for those they supported. Approximately one in three had experienced a long-‐term illness or disability themselves within the previous year. While the demographic profile of survey respondents indicated a wide range of caring relationships and experiences, comparisons with population-‐based statistics highlight that this sample is not representative of the broader NSW carer population. This limits the generalisability of survey findings, however, it also allows for more detailed data analysis to be conducted within the more highly represented sub-‐groups of carers, and also suggests areas for improved data collection in future surveys. Carers generally framed their reasons for caring in a positive way, with more than twice as many wanting to take on their caring roles than felt they had no choice. Nevertheless, a significant proportion indicated that no one else assisted them or that they would not be able to find help if they needed a break. Significantly, over one quarter of respondents reported providing more than 70 hours of care per week. This finding is particularly important, since associations were found between the hours of care provided per week, the length of caring roles, and the prevalence of carers\u27 long‐term illness or disability. In line with a great deal of previous literature, the wellbeing of carers in this survey was low compared to the general Australian population. Despite this, carers consistently emphasised the positive value of caring as being greater than the negative impacts. This report highlights those carers who are at greater risk of experiencing low wellbeing, including those with more intensive caring demands and those with long-‐term illnesses or disabilities. At the same time, male carers and older carers tended to report higher levels of wellbeing. Amongst carers who were not in paid employment, more than one in two had stopped working because of their caring responsibilities. Notably, these carers reported poorer wellbeing than those who had stopped working for other reasons. A large majority of working carers indicated that their employers knew about their caring responsibilities, but one in four did not feel supported to balance work and care. Survey responses also indicated that many carers experience some degree of conflict in balancing their caring responsibilities, finances and career progression. Carers reported using local doctors and family/friends for support more than any other source, as well as being restricted from accessing services by the cost, not knowing what was available, and their caring responsibilities taking priority. A majority of carers were not currently accessing supportive services for themselves and interestingly, most did not want to. When carers were satisfied with the services received by the person(s) they cared for and felt more included by service providers, they were more likely to report better wellbeing outcomes. Carers of people with a disability were invited to share their expectations of the impact of person centred approaches and individualised funding to the disability service sector. Awareness of these concepts had increased since the Carers NSW 2012 Carer Survey, with expectations being more positive than negative. Notably, carers who had practical experience of individualised funding packages were much more positive about their introduction than those yet to experience them. Former carers were also invited to complete the survey, with 146 responses being received. Their previous caring roles had usually ended through the death of the person they cared for or the care recipient\u27s admission into residential care facilities. Very few indicated that they had stopped caring because they could no longer cope, highlighting carers\u27 resilience and dedication to their caring roles. The data collected in this survey will inform a range of advocacy and research work. Importantly, the Carers NSW 2014 Carer Survey makes a significant contribution to the evidence base regarding carers in NSW, with the main findings indicating implications for the recognition and support of carers by service providers, governments, and the wider community. &nbsp

Taking Responsibility: Psychological and Attitudinal Change through a Domestic Violence Intervention Program in New South Wales, Australia

Literature widely reports the negative impacts of domestic violence at individual, family, and societal levels. Intervention programs that effectively assist violent men to develop alternate ways of relating, and thus enhance the safety of women and children, are of significant value to governments and the community. This study evaluates the effectiveness of one such program in promoting change in relevant attitudes and psychological constructs. Program participants completed pre- and post-group surveys containing validated scales that measured their gender equity beliefs, self-esteem, mastery, and psychological distress. Over the duration of program attendance, positive changes were evident regarding men’s self-esteem, mastery, and psychological distress, however, no significant change in gender equity beliefs was apparent. The positive changes evident amongst participants indicate beneficial outcomes from group work participation in areas that have been identified as risk factors for violent behaviour.  The results also suggest that intervention programs would benefit from an increased focus on gender equity beliefs, and that further research is necessary on the extent to which this focus could improve attitudes, and consequently promote safety for women and children

The carer persona: Masking individual identities

According to Jungian theory, ‘persona’ is a concept reflecting a compromise between the individual and society. In mediating between a person’s subjective inner world and the external social world, the persona represents a generalised idea of the self which builds up from experiences of interacting with society. Such reflections of self-identity can therefore develop across multiple domains of a person’s life, culminating in understandings of self in a variety of specific roles. The existence of multiple personas can be clearly demonstrated in the context of people providing unpaid care for a family member or friend who has a disability, mental illness, chronic condition, or who is frail. Carers are likely to possess multiple roles as an individual, existing across various social and personal domains. This paper argues that in caring for loved one, a compromise takes place between individual selves and the social caring role. That is, the ‘carer persona’ can mask a carer’s individual identities and their associated needs. The potential complexity of caring roles is therefore explored, with an emphasis on acknowledging the personal needs and identities of carers beyond their caring roles. This acknowledgment has implications for service delivery and policy development regarding carers and those for whom they care

Poor Reporting: The Political Unconscious in Journalistic Responses to Poverty and Protest During the Cotton Crisis.

The poor do not represent themselves in the Press; despite being the first victims of economic crises, they are instead presented by journalistic mediators. This thesis utilises the methodology outlined in Fredric Jameson’s seminal text The Political Unconscious Narrative as a Socially Symbolic Act (1981) to unearth that mediation. The thesis posits that, by examining journalistic responses to poverty and protest, during a time of recognised and short-term economic crisis, it is possible to unearth the political unconscious, and strategies of containment employed which are intended to conceal the relationship between labour and value, in order to defend the status quo. It is further posited that an investigation of three politically and commercially competitive newspapers will reveal a broad strategy of containment beyond the political binary of left and right. As such, the study considers the liberal Manchester Guardian, the conservative Manchester Courier and the radical Manchester Examiner and Times. The analysis focuses on the reporting of political agitation in Stevenson Square, Manchester, during the Lancashire Cotton Crisis and the American Civil War and around the subject of legislation employed to manage poverty. The Cotton Crisis between 1861 and 1865, saw destitution among unemployed cotton workers, who faced the Labour Test when seeking ‘famine relief’ in order to survive. This economic crisis is of recognised international political and historical significance and is well-researched, but there has not been a broad study of the journalistic response in its representation of poverty and protest in Manchester. The British response to the American Civil War, spanning the same time period, is the focus of much debate, with a focus on Manchester, as is the responses to relief payments to the unemployed, with reference to the city, but analysis of political protest in Manchester in reaction to poverty legislation is scant. Further, available research, while extensive in regard to the history of the Victorian press, is less developed into the ideology of mid nineteenth-century journalism as specifically contributing to an understanding and presentation of poverty. The response of the unemployed workers is researched with regard to the experience of poverty, particularly in terms of poetry and dialect, but the journalistically reported words of their political protests during the Cotton Crisis has not, until now, been thoroughly analysed. This thesis, in considering journalistic copy totalling 43,000 words from late 1862 to early 1863, argues that the political unconscious masked the horror of poverty and mediated the collective experience of working class existence to defend the status quo

NUJ Reporting Poverty Campaign: introducing a trade union challenge to journalistic representations of the unemployed and the working poor

The National Union of Journalists (NUJ) has reporting poverty guidelines for its 25k+ members to use alongside its Code of Conduct. These were introduced following a campaign from trade union activists and are now available to media workers in the industry including, among others, staff at the BBC, the tabloid and broadsheet press. These guidelines were created to challenge the demonising and stereotyping of the working poor and people in receipt of benefits found in British journalism. In this paper they are contextualised, within the ideology of austerity, a British media dominated by the middle and upper class, and the resulting demonising of the poor during economic crises. This article posits that the campaigning work can provide a theoretical and practical challenge to encourage and enable workers to join forces in rejecting the scapegoating of low paid, unemployed and under employed workers as seen in the media. In so doing, it considers that, while the guidelines may have limited influence in some sections of the media, they are nonetheless a significant tool, and position of solidarity, in challenging the depoliticising individualising apparent in reporting poverty, the ‘skivers versus strivers’ discourse, and in providing a critique of the journalistic use of sources. This paper, written by a contributor to those guidelines and leader of the NUJ campaign, serves as an introduction to this unique British trade union approach, informed and led by collaboration with people who have experienced of poverty

Variations in HIV Prevention Coverage in Subpopulations of Australian Gay and Bisexual Men, 2017–2021: Implications for Reducing Inequities in the Combination Prevention Era

Using repeated behavioural surveillance data collected from gay and bisexual men (GBM) across Australia, we assessed trends in HIV prevention coverage (the level of ‘safe sex’ achieved in the population by the use of effective prevention methods, including condoms, pre-exposure prophylaxis [PrEP] and having an undetectable viral load). We stratified these trends by age, country of birth/recency of arrival, sexual identity, and the proportion of gay residents in the participant’s suburb. Among 25,865 participants with casual male partners, HIV prevention coverage increased from 69.8% in 2017 to 75.2% in 2021, lower than the UNAIDS target of 95%. Higher levels of coverage were achieved among older GBM (≥ 45 years), non-recently-arrived migrants, and in suburbs with ≥ 10% gay residents. The lowest levels of prevention coverage (and highest levels of HIV risk) were recorded among younger GBM (< 25 years) and bisexual and other-identified participants. Younger, recently-arrived, and bisexual GBM were the most likely to use condoms, while PrEP use was concentrated among gay men, 25–44-year-olds, and in suburbs with more gay residents. The use of undetectable viral load was most common among participants aged ≥ 45 years. Our analysis shows that high HIV prevention coverage can be achieved through a mixture of condom use, PrEP use, and undetectable viral load, or by emphasising PrEP use. In the Australian context, younger, bisexual and other-identified GBM should be prioritised for enhanced access to effective HIV prevention methods. We encourage other jurisdictions to assess the level of coverage achieved by combination prevention, and variations in uptake

Adjusting Behavioural Surveillance and Assessing Disparities in the Impact of COVID-19 on Gay and Bisexual Men’s HIV-Related Behaviour in Australia

COVID-19 has disrupted sexual behaviour and access to health systems. We adapted regular HIV behavioural surveillance of gay and bisexual men (GBM) in Australia in response to COVID-19, assessed the impact on the profile of the sample, the participants’ HIV-related behaviour, and whether COVID-19 may have accentuated existing disparities in the Australian HIV epidemic. Data collected from five states during July 2017–June 2021 were included (N = 31,460). The emphasis on online recruitment after COVID-19 led to smaller sample sizes, greater geographic reach, and a higher proportion of bisexual-identifying participants. Most participants (88.1%) reported physical distancing and 52.1% had fewer sex partners due to COVID-19. In the COVID-19-affected rounds (July 2020–June 2021), the number of male partners, recent HIV testing and pre-exposure prophylaxis (PrEP) use all fell, and HIV risk among the smaller group of participants who reported casual sex increased. COVID-related changes were generally more pronounced among GBM aged under 25 years, participants from suburbs with fewer gay residents, and bisexual men. These groups should be prioritised when encouraging GBM to reengage with HIV testing services and effective prevention methods, like condoms and PrEP

Finding a way: long-term care homes to support dementia

An ageing demographic has increased the number of people with dementia. Although dementia is commonly associated with memory loss, other early symptoms include difficulty with wayfinding. Dementia alters visuo-spatial perception and the processes used to interpret the physical environment. The role of the design of the physical environment for people with dementia has gained increased recognition. Despite this, design for dementia is often overlooked, focusing on issues relating to physical impairment. This paper presents the results of a PhD study and aims to examine the role of the design of the physical environment in supporting wayfinding for people with dementia living in long-term care settings in Northern Ireland. Mixed methods combined the observation of wayfinding walks and conversational style interviews to elicit perspectives and experiences of residents with dementia. The findings aim to promote well-being for those with dementia living in long-term care settings

Changing Attitudes Towards Condoms Among Australian Gay and Bisexual Men in the PrEP Era: An Analysis of Repeated National Online Surveys 2011-2019

Condoms have been the primary form of HIV prevention for gay and bisexual men (GBM) for most of the HIV epidemic. The introduction of biomedical HIV prevention may have changed attitudes towards condoms. Data from repeated national online surveys of GBM in Australia were used to examine how attitudes towards condoms and confidence discussing condoms with partners changed in the period 2011-2019. The proportion of all participants who reported a positive experience in using condoms remained low and unchanged (9.6% in 2011 to 6.0% in 2019). Confidence in discussing condoms with partners decreased over time (from 72.2% in 2011 to 56.6% in 2019). Confidence in discussing condoms was associated with concern about sexually transmitted infections, and more consistent condom use. Sustaining confidence in using condoms may be more challenging as biomedical prevention methods become more commonly used

POSIWID and determinism in design for behaviour change

Copyright @ 2012 Social Services Research GroupWhen designing to influence behaviour for social or environmental benefit, does designers' intent matter? Or are the effects on behaviour more important, regardless of the intent involved? This brief paper explores -- in the context of design for behaviour change -- some treatments of design, intentionality, purpose and responsibility from a variety of fields, including Stafford Beer's "The purpose of a system is what it does" and Maurice Broady's perspective on determinism. The paper attempts to extract useful implications for designers working on behaviour-related problems, in terms of analytical or reflective questions to ask during the design process