Dr Sungwon Chang is a senior lecturer in the Faculty of Health who is building a national track record in biostatistics, health data linkage and justice health.
Sungwon has many years of experience in teaching biostatistics, epidemiology, population health and research methods in Bachelor of Medicine, Bachelor of Health Sciences and Master of Public Health.
With extensive experience in management, analysis and interpretation of large data sets, she has collaborated on a number of National Health and Medical Research Council-funded projects and other competitive grants. She was awarded a competitive UTS Chancellor’s Post-Doctoral Research Fellowship in 2013.
Sungwon is on the editorial board of two journals, Journal of Cardiology and Therapy, and Critical Care Journal. She is also a statistical reviewer for Journal of Clinical Nursing and provides regular peer reviews for numerous journals.
- Member of a Steering committee for Australian Chiropractic Research Network
- Member of a Data Monitoring Committee for NHMRC funded trial, C-IBS
- Member of an editorial board for Journal of Cardiology and Therapy
Can supervise: YES
- Health data linkage
- Vulnerable populations
- Justice health
- Chronic conditions
- Outcomes assessment
DiGiacomo, M, Chang, S, Luckett, T, Phillips, J, Agar, M & Lam, L 2020, 'Financial stress experienced by informal carers of adults with a chronic disease: results from an Australian population-based cross-sectional survey', Australasian Journal of Ageing.View/Download from: Publisher's site
To identify caregiving characteristics that are associated with financial stress in Australian carers of people with a chronic disease.
Data were collected via the South Australian Health Omnibus, an annual population-based, cross-sectional survey. Individuals who provided care to someone with prevalent chronic conditions were asked about financial stress and caregiving characteristics.
Of 32.4% (988/3047) who were carers, 13.4% (132/988) experienced financial stress. Adjusting for age and household income, providing more than 20 hours of care per week (AOR=2.39,95%CI=1.48-3.86), transport assistance (AOR=1.89,95%CI=1.15-3.09) and assistance with household tasks (AOR=1.92,95%CI=1.14-3.26) and caring for a person with a mental illness (AOR=2.01, 95%CI=1.24-3.28) were associated with a significant increase in odds of experiencing financial stress. Caring for a person with cancer (AOR=0.49, 95%CI=0.30-0.81) or dementia (AOR=0.40, 95%CI=0.21-0.76) was associated with a decrease in odds.
Financial stress was reported by more than 13% of carers and factors other than household income were implicated.
Currow, DC, Chang, S, Grande, ED, Ferreira, DH, Kochovska, S, Kinchin, I, Johnson, MJ & Ekstrom, M 2020, 'Quality of life changes with duration of chronic breathlessness: a random sample of community-dwelling people', Journal of Pain and Symptom Management.View/Download from: Publisher's site
Montgomery, E, Macdonald, P, Newton, P, Chang, S, Jha, S, Hannu, M, Thomson, C, Malouf, M & Havryk, A 2020, 'Frailty as a Predictor of Mortality in Patients with Interstitial Lung Disease Referred for Transplantation'.
Currow, DC, Chang, S, Reddel, HK, Kochovska, S, Ferreira, D, Kinchin, I, Johnson, M & Ekström, M 2020, 'Breathlessness, Anxiety, Depression, and Function-The BAD-F Study: A Cross-Sectional and Population Prevalence Study in Adults.', Journal of Pain and Symptom Management, vol. 59, no. 2, pp. 197-205.View/Download from: Publisher's site
CONTEXT:Breathlessness is associated with depression, but its relationship to anxiety or impaired function is less clear. OBJECTIVES:This study evaluated associations between chronic breathlessness and anxiety, depression, and functional status in the general population. METHODS:This cross-sectional study of consenting adults (18 years and older) used an online survey. Quota sampling (n = 3000) was used reflecting the 2016 national census for sex, age, and place of residence. Other data included Four-Item Patient Health Questionnaire for depression and anxiety, the modified Medical Research Council (mMRC) Breathlessness Scale, and the Australia-modified Karnofsky Performance Scale. Multinomial logistic regression assessed predictors. RESULTS:About 2977 respondents had all relevant scores (female 51.2%; median age 45.0 [range 18-92]). Prevalence of breathlessness (mMRC ≥2) was 2.4%, anxiety 6.0%, depression 2.7%, coexisting anxiety/depression 6.1%, and poorer functional status (Australia-modified Karnofsky Performance Scale ≤60) 1.6%. In multinomial regression, depression, anxiety, and coexisting anxiety/depression were predicted by younger age, longer duration of breathlessness, and poorer functional status. The highest proportions of people with breathlessness were found in the coexisting anxiety/depression group (10.6%) and depression only group (8.8%). Poorest function was in the coexisting anxiety/depression group with 11.6%. The relationship between poorer functional status and coexisting anxiety/depression was significant (odds ratio 0.90; 95% CI 0.89, 0.92). Adjusted odds ratio for breathlessness and depression only was 3.0 (95% CI 1.2, 7.8). CONCLUSION:Clinically important breathlessness (mMRC ≥2) was associated with depression, anxiety, and coexisting anxiety/depression. Poorer function that is associated with psychological morbidity in the general population requires further research.
Sullivan, E, Ward, S, Zeki, R, Wayland, S, Sherwood, J, Wang, A, Worner, F, Kendall, S, Brown, J & Chang, S 2019, 'Recidivism, health and social functioning following release to the community of NSW prisoners with problematic drug use: study protocol of the population-based retrospective cohort study on the evaluation of the Connections Program.', BMJ open, vol. 9, no. 7, pp. e030546-e030546.View/Download from: Publisher's site
INTRODUCTION:The rising rate of incarceration in Australia, driven by high reoffending, is a major public health problem. Problematic drug use is associated with increasing rates of reoffending and return to custody of individuals. Throughcare provides support to individuals during imprisonment through to post-release, improving both the transition to community and health outcomes post-incarceration. The aim of this study is to evaluate the Connections Programme (CP) that utilises a throughcare approach for release planning of people in prison with a history of problematic drug use. The study protocol is described. METHODS AND ANALYSIS:Population-based retrospective cohort study. The study will use record linkage of the Connections dataset with 10 other New South Wales (NSW) population datasets on offending, health service utilisation, opioid substitution therapy, pregnancy, birth and mortality. The study includes all patients who were eligible to participate in the CP between January 2008 and December 2015 stratified by patients who were offered CP and eligible patients who were not offered the programme (non-CP (NCP)). Propensity-score matching will be used to appropriately adjust for the observable differences between CP and NCP. The differences between two groups will be examined using appropriate univariate and multivariate analyses. A generalised estimating equation approach, which can deal with repeat outcomes for individuals will be used to examine recidivism, mortality and other health outcomes, including perinatal and infant outcomes. Survival analysis techniques will be used to examine the effect of the CP by sex and Indigenous status on the 'time-to' health-related outcomes after adjusting for potential confounders. ETHICS AND DISSEMINATION:Ethical approval was received from the NSW Population and Health Services Research Ethics Committee, the Justice Health and Forensic Mental Health Network Human Research Ethics Committee, the Aboriginal Health and ...
Sullivan, EA, Kendall, S, Chang, S, Baldry, E, Zeki, R, Gilles, M, Wilson, M, Butler, T, Levy, M, Wayland, S, Cullen, P, Jones, J & Sherwood, J 2019, 'Aboriginal mothers in prison in Australia: a study of social, emotional and physical wellbeing.', Australian and New Zealand journal of public health, vol. 43, no. 3, pp. 241-247.View/Download from: Publisher's site
OBJECTIVE:To describe the social, emotional and physical wellbeing of Aboriginal mothers in prison. METHODS:Cross-sectional survey, including a Short Form Health Survey (SF-12) and Kessler Psychological Distress Scale (5-item version) administered to Aboriginal women who self-identified as mothers. RESULTS:Seventy-seven Aboriginal mothers in New South Wales (NSW) and 84 in Western Australia (WA) participated in the study. Eighty-three per cent (n=59) of mothers in NSW were in prison for drug-related offences, 64.8% (n=46) of mothers in WA were in prison for offences committed under the influence of alcohol. Sixty-eight per cent (n=52) of mothers in NSW and 35% (n=28) of mothers in WA reported mental health problems. Physical (PCS) and Mental (MCS) component scores of SF-12 varied for mothers in NSW and WA. Mothers in NSW experienced poorer health and functioning than mothers in WA (NSW: PCS 49.5, MCS 40.6; WA: PCS 54.4, MCS 48.3) and high levels of psychological distress (NSW: 13.1; WA 10.1). CONCLUSIONS:Aboriginal mothers in prison have significant health needs associated with physical and mental health, and psychological distress. Implications for public health: Adoption of social and emotional wellbeing as an explanatory framework for culturally secure healthcare in prison is essential to improving health outcomes of Aboriginal mothers in prison in Australia.
Ekstrom, M, Chang, S, Johnson, MJ, Fazekas, B, Kochovska, S, Huang, C & Currow, DC 2019, 'Low agreement between mMRC rated by patients and clinicians: implications for practice', EUROPEAN RESPIRATORY JOURNAL, vol. 54, no. 6.View/Download from: Publisher's site
Wilbourn, M, Salamonson, Y, Ramjan, L & Chang, S 2018, 'Development and psychometric testing of the Attitudes, Subjective Norms, Perceived Behavioural Control, and Intention to Pursue a Career in Mental Health Nursing scale.', International Journal of Mental Health Nursing, vol. 27, no. 1, pp. 72-81.View/Download from: Publisher's site
The aim of the present study was to develop and test the psychometric properties of the Attitudes, Subjective Norms, Perceived Behavioural Control, and Intention to Pursue a Career in Mental Health Nursing (ASPIRE) scale, an instrument to assess nursing students' intention to work in mental health nursing. Understanding the factors influencing undergraduate nursing students' career intentions might lead to improved recruitment strategies. However, there are no standardized tools to measure and assess students' intention to pursue a career in mental health nursing. The present study used a cross-sectional survey design undertaken at a large tertiary institution in Western Sydney (Australia) between May and August 2013. It comprised three distinct and sequential phases: (i) items were generated representing the four dimensions of the theory of planned behaviour; (ii) face and content validity were tested by a representative reference group and panel of experts; and (iii) survey data from 1109 first- and second-year and 619 third-year students were used in exploratory and confirmatory factor analyses to test the factorial validity of the scale. Internal consistency was measured using Cronbach's alpha. Items generated for the ASPIRE scale were subject to face and content validity testing. Results showed good factorial validity and reliability for the final 14-item scale. Principal axis factoring revealed a one-factor solution, the hypothesized model being supported by confirmatory factor analysis. The ASPIRE scale is a valid and reliable instrument for measuring intention to pursue a career in mental health nursing among Bachelor of Nursing students.
Deek, H, Chang, S, Newton, PJ, Noureddine, S, Inglis, SC, Arab, GA, Kabbani, S, Chalak, W, Timani, N, Macdonald, PS & Davidson, PM 2017, 'An evaluation of involving family caregivers in the self-care of heart failure patients on hospital readmission: Randomised controlled trial (the FAMILY study).', International Journal of Nursing Studies, vol. 75, pp. 101-111.View/Download from: Publisher's site
BACKGROUND: The prevalence of heart failure is increasing in Lebanon but to date there is no systematic evaluation of a disease management intervention. OBJECTIVE: The aim of this study was to evaluate the effect of involving family caregivers in the self-care of patients with heart failure on the risk of hospital readmission. DESIGN: A multi-site, block randomised controlled trial. SETTINGS: The study was conducted over a 13-month period in three tertiary medical centres in Beirut and Mount Lebanon, Lebanon. PARTICIPANTS: Adult patients presenting for an exacerbation of heart failure to one of the study centres were included. Patients with limited life expectancy or physical functionality, planned cardiac bypass or valve replacement surgery, living alone or in nursing homes, or aged less than 18 years were excluded. METHODS: Patients allocated to the intervention group and their family caregivers were provided with a comprehensive, culturally appropriate, educational session on self-care maintenance and symptom management along with self-care resources. The usual care group received the self-care resources only. Follow-up phone calls were conducted 30days following discharge by a research assistant blinded to treatment assignment. The primary outcome was hospital readmission and the secondary outcomes were self-care, quality of life, major vascular events and healthcare utilization. RESULTS: The final sample included 256 patients hospitalized for heart failure randomised into control (130 patients) and intervention (126 patients) groups. The mean age was 67 (SD=8)years, and the majority (55%) were male. Readmission at 30days was significantly lower in the intervention group compared to the control group (n=10, 9% vs. n=20, 19% respectively, OR=0.40, 95% CI=0.02, 0.10, p=0.02). Self-care scores improved in both groups at 30days, with a significantly larger improvement in the intervention group than the control group in the maintenance and confidence sub-scales, b...
Frawley, J, Sibbritt, D, Steel, A, Chang, S & Adams, J 2017, 'Complementary and Conventional Health-care Utilization Among Young Australian Women With Urinary Incontinence.', Urology, vol. 99, pp. 92-99.View/Download from: Publisher's site
OBJECTIVE: To examine the relationship between health status and health service utilization (including conventional and complementary and alternative medicine [CAM]) accessed by women experiencing urinary incontinence (UI). Although a high number of younger women report symptoms of UI, such as leaking urine, only a small proportion seek help for these symptoms. MATERIALS AND METHODS: The Australian Longitudinal Study on Women's Health is a large nationally representative study that investigates the health and well-being of women. The 2 most recent surveys (2006 and 2009) of the young cohort (women aged 28-33 and 31-36 respectively) were analyzed. RESULTS: The presence of UI was 8.5% in 2006 (n = 859) and 23.3% in 2009 (n = 1878), whereas the percentage of women who sought help for their UI was 18.6% (n = 160) and 2.2% (n = 182) respectively. Women with UI had poorer health compared with women without UI (P < .005), and women who sought help for their symptoms had poorer physical functioning than women who did not (P < .005). Women who sought help were greater users of conventional and CAM health services (P < .005), including a general practitioner, specialist, hospital doctor, physiotherapist, and naturopath. CONCLUSION: UI is relatively common in younger women. However, many do not seek help. Of the women who do seek care, a large number visit CAM professionals as well as conventional medical professionals, despite a lack of research evaluating the efficacy of CAM treatment. Research is needed to explore CAM practitioner approaches to the treatment of UI and to evaluate the efficacy of these treatments.
Suswardany, DL, Sibbritt, DW, Supardi, S, Pardosi, JF, Chang, S & Adams, J 2017, 'A cross-sectional analysis of traditional medicine use for malaria alongside free antimalarial drugs treatment amongst adults in high-risk malaria endemic provinces of Indonesia', PLOS ONE, vol. 12, no. 3.View/Download from: Publisher's site
Sibbritt, D, Leach, M, Chang, S, Sundberg, T, Cramer, H, Lauche, R & Adams, J 2017, 'Health care utilization among young Australian women with severe tiredness: Results from the Australian Longitudinal Study on Women's Health (ALSWH)', Health Care for Women International, vol. 38, no. 9, pp. 983-995.View/Download from: Publisher's site
In this article we explore the use of health services and self-prescribed treatments amongst 8,088 young Australian women with severe tiredness. Data were obtained from the Australian Longitudinal Study on Women's Health. The prevalence of severe tiredness was 49.2%. The frequency of visits to healthcare practitioners was greater among women who sought help for their severe tiredness, compared with women who did not seek help for their severe tiredness or who did not report severe tiredness. Given the impact of this health problem on Australian women, we call for further research on the optimal treatment for severe tiredness.
Deek, H, Chang, S, Noureddine, S, Newton, PJ, Inglis, SC, Macdonald, PS, Al Arab, G & Davidson, PM 2016, 'Translation and validation of the Arabic version of the Self-care of Heart Failure Index', NURSE RESEARCHER, vol. 24, no. 2, pp. 34-40.View/Download from: Publisher's site
Hussein, R, Everett, B, Hu, W, Smith, A, Thornton, A, Chang, S & Salamonson, Y 2016, 'Predictors of new graduate nurses' satisfaction with their transitional support programme.', Journal of Nursing Management, vol. 24, no. 3, pp. 319-326-319-326.View/Download from: Publisher's site
To examine the influence of new graduate nurses' (NGNs) personal and situational factors on their satisfaction with the practice environment.Transitional support programmes are widely used to provide professional support for NGNs' transitioning-to-practice. However, little is known about whether personal characteristics and situational factors influence NGNs' satisfaction with the practice environment.This was a cross-sectional survey. NGNs were surveyed approximately 8 weeks after commencement of the support programme. In addition to socio-demographic and situational data, two validated, standardised instruments were administered: the Manchester Clinical Supervision Scale (MCSS-26) and the Practice Environment Scale Australia (PES-AUS).A total of 109 NGNs completed the survey. Three independent and significant predictors of NGNs' satisfaction were: (1) unit satisfaction (standardised beta, β = 0.41); (2) satisfaction with the clinical supervision (β = 0.31); and (3) assigned unit: critical-care areas (β = -0.17), explaining 32.5% of the variance. Conclusion This study demonstrates the importance of clinical supervision and unit level support on satisfaction, and the need for additional support for NGNs assigned to critical-care areas.The findings of this study suggest there are modifiable situational factors that influence NGNs' satisfaction with the practice environment, and allocating NGNs to critical-care areas on their first rotation should be avoided.
Jha, SR, Hannu, MK, Chang, S, Montgomery, E, Harkess, M, Wilhelm, K, Hayward, CS, Jabbour, A, Spratt, PM, Newton, P, Davidson, PM & Macdonald, PS 2016, 'The Prevalence and Prognostic Significance of Frailty in Patients With Advanced Heart Failure Referred for Heart Transplantation.', Transplantation, vol. 100, no. 2, pp. 429-436.View/Download from: Publisher's site
Frailty is a clinically recognized syndrome of decreased physiological reserve. The heightened state of vulnerability in these patients confers a greater risk of adverse outcomes after even minor stressors. Our aim was to assess the prevalence and prognostic significance of the frailty phenotype in patients referred for heart transplantation.Consecutive patients referred or on the waiting list for heart transplantation from March 2013 underwent frailty assessment. Frailty was defined as a positive response to 3 or more of the following 5 components: weak grip strength, slowed walking speed, poor appetite, physical inactivity, and exhaustion. In addition, markers of disease severity were obtained, and all patients underwent cognitive (Montreal Cognitive Assessment) and depression (Depression in Medical Illness-10) screening.One hundred twenty patients (83 men:37 women; age, 53 ± 12 years, range, 16-73 years; left ventricular ejection fraction, 27 ± 14%) underwent frailty assessment. Thirty-nine of 120 patients (33%) were assessed as frail. Frailty was associated with New York Heart Association class IV heart failure, lower body mass index, elevated intracardiac filling pressures, lower cardiac index, anemia, hypoalbuminemia, hyperbilirubinemia, cognitive impairment, and depression (all ρ < 0.05). Frailty was independent of age, sex, heart failure duration, left ventricular ejection fraction, or renal function. Frailty was an independent predictor of increased all-cause mortality: 1 year actuarial survival was 79 ± 5% in the nonfrail group compared with only 54 ± 9% for the frail group (P < 0.005).Frailty is prevalent among patients with advanced symptomatic heart failure referred for heart transplantation and is associated with increased mortality.
Jha, SR, Hannu, MK, Gore, K, Chang, S, Newton, P, Wilhelm, K, Hayward, CS, Jabbour, A, Kotlyar, E, Keogh, A, Dhital, K, Granger, E, Jansz, P, Spratt, PM, Montgomery, E, Harkess, M, Tunicliff, P, Davidson, PM & Macdonald, PS 2016, 'Cognitive impairment improves the predictive validity of physical frailty for mortality in patients with advanced heart failure referred for heart transplantation', JOURNAL OF HEART AND LUNG TRANSPLANTATION, vol. 35, no. 9, pp. 1092-1100.View/Download from: Publisher's site
Salamonson, Y, Ramjan, LM, van den Nieuwenhuizen, S, Metcalfe, L, Chang, S & Everett, B 2016, 'Sense of coherence, self-regulated learning and academic performance in first year nursing students: A cluster analysis approach.', Nurse Education in Practice, vol. 17, pp. 208-213.View/Download from: Publisher's site
This paper examines the relationship between nursing students' sense of coherence, self-regulated learning and academic performance in bioscience. While there is increasing recognition of a need to foster students' self-regulated learning, little is known about the relationship of psychological strengths, particularly sense of coherence and academic performance. Using a prospective, correlational design, 563 first year nursing students completed the three dimensions of sense of coherence scale - comprehensibility, manageability and meaningfulness, and five components of self-regulated learning strategy - elaboration, organisation, rehearsal, self-efficacy and task value. Cluster analysis was used to group respondents into three clusters, based on their sense of coherence subscale scores. Although there were no sociodemographic differences in sense of coherence subscale scores, those with higher sense of coherence were more likely to adopt self-regulated learning strategies. Furthermore, academic grades collected at the end of semester revealed that higher sense of coherence was consistently related to achieving higher academic grades across all four units of study. Students with higher sense of coherence were more self-regulated in their learning approach. More importantly, the study suggests that sense of coherence may be an explanatory factor for students' successful adaptation and transition in higher education, as indicated by the positive relationship of sense of coherence to academic performance.
Sibbritt, D, Peng, W, Chang, S, Liang, H & Adams, J 2016, 'The use of conventional and complementary health services and self-prescribed treatments amongst young women with constipation: A national cohort study.', Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver, vol. 48, no. 11, pp. 1308-1313.View/Download from: Publisher's site
Little research has been conducted regarding the comprehensive health service utilisation in constipation care. This study investigates the comprehensive health service utilisation amongst Australian women with constipation.This study draws upon data from the Australian Longitudinal Study on Women's Health. A total of 8074 young women were asked about their frequency of constipation, measures of quality of life, and use of a range of health services and self-prescribed treatments via two postal surveys conducted in 2006 and 2009, respectively.The prevalence of constipation was 18.5% amongst women in 2009. Constipated women had poorer quality of health than women without constipation. Women who sought help for constipation were more likely to visit multiple groups of conventional and complementary health practitioners compared to women who did not experience constipation (p<0.005). However, women were less likely to visit a specialist for the management of constipation over time (2006 to 2009). There was an increase in the proportion of women with constipation who self-prescribed vitamins/minerals over time (p<0.001).Although only 4.5% of women sought help for their constipation, given the increasing use of multiple health services across time, more studies are required regarding the optimal treatment in constipation care.
Wardle, JL & Chang, S 2015, 'Cross-promotional alcohol discounting in Australia's grocery sector: a barrier to initiatives to curb excessive alcohol consumption?', Australian and New Zealand Journal of Public Health, vol. 39, no. 2, pp. 124-128.View/Download from: Publisher's site
Adams, J, Steel, A, Chang, S & Sibbritt, D 2015, 'Helping address the national research and research capacity needs of Australian chiropractic: introducing the Australian Chiropractic Research Network (ACORN) project.', Chiropractic and Manual Therapies, vol. 23, no. 12.View/Download from: Publisher's site
Chiropractic is a popular health care choice in Australia and yet major gaps in our empirical understanding of this area of practice remain. Furthermore, while some research excellence exists, a largely uncoordinated approach to research activity and development has in effect led to silos of interest and a lack of strategic 'big-picture' planning essential to producing a sustainable research culture and capacity for the profession. This commentary identifies the significance of a number of key features - including a national, coordinated focus, and a rich engagement with the practitioner and patient base amongst others - arguably important to the future development of research and research capacity within Australian chiropractic. The design features and phases of the Australian Chiropractic Research Network (ACORN) project are also outlined. ACORN is one contemporary initiative specifically developed to address chiropractic's research and research capacity building needs and help grow a broad evidence-base to inform safe, effective patient care.
Chang, S, Davidson, PM, Newton, PJ, Macdonald, P, Carrington, MJ, Marwick, TH, Horowitz, JD, Krum, H, Reid, CM, Chan, YK, Scuffham, PA, Sibbritt, D & Stewart, S 2015, 'Composite outcome measures in a pragmatic clinical trial of chronic heart failure management: A comparative assessment', International Journal of Cardiology, vol. 185, pp. 62-68.View/Download from: Publisher's site
Suswardany, DL, Sibbritt, DW, Supardi, S, Chang, S & Adams, J 2015, 'A critical review of traditional medicine and traditional healer use for malaria and among people in malaria-endemic areas: contemporary research in low to middle-income Asia-Pacific countries', Malaria Journal, vol. 14, no. 98.View/Download from: Publisher's site
Chang, S, Newton, PJ, Inglis, S, Luckett, T, Krum, H, MacDonald, PS & Davidson, PM 2014, 'Are all outcomes in chronic heart failure rated equally? An argument for a patient-centred approach to outcome assessment', Heart Failure Reviews, vol. 19, no. 2, pp. 153-162.View/Download from: Publisher's site
Chronic heart failure (CHF) is a multi-dimensional and complex syndrome. Outcome measures are important for determining both the efficacy and quality of care and capturing the patient's perspective in evaluating the outcomes of health care delivery. Capturing the patient's perspective via patient-reported outcomes is increasingly important; however, including objective measures such as mortality would provide more complete account of outcomes important to patients. Currently, no single measure for CHF outcomes captures all dimensions of the quality of care from the patient's perspective.
Chang, S, Davidson, PM, Newton, PJ, Krum, H, Salamonson, Y & MacDonald, PS 2013, 'What is the methodological and reporting quality of health related quality of life in chronic heart failure clinical trials?', International Journal of Cardiology, vol. 164, no. 2, pp. 133-140.View/Download from: Publisher's site
Background: Although the number of clinical trials assessing health related quality of life (HRQoL) in chronic heart failure (CHF) has increased exponentially over the last decade, little is known about the quality of reporting. The purpose of this review was to assess the methodological and reporting rigor of HRQoL in RCTs of pharmacological therapy in CHF.
Salamonson, Y, Weaver, R, Chang, S, Koch, J, Bhathal, R, Khoo, C & Wilson, I 2013, 'Learning approaches as predictors of academic performance in first year health and science students', Nurse Education Today, vol. 33, no. 7, pp. 729-733.View/Download from: Publisher's site
Aims: To compare health and science students' demographic characteristics and learning approaches across different disciplines, and to examine the relationship between learning approaches and academic performance. Background: While there is increasing recognition of a need to foster learning approaches that improve the quality of student learning, little is known about students' learning approaches across different disciplines, and their relationships with academic performance. Design: Prospective, correlational design. Methods: Using a survey design, a total of 919 first year health and science students studying in a university located in the western region of Sydney from the following disciplines were recruited to participate in the study - i) Nursing: n = 476, ii) Engineering: n = 75, iii) Medicine: n = 77, iv) Health Sciences: n = 204, and v) Medicinal Chemistry: n = 87. Results: Although there was no statistically significant difference in the use of surface learning among the five discipline groups, there were wide variations in the use of deep learning approach. Furthermore, older students and those with English as an additional language were more likely to use deep learning approach. Controlling for hours spent in paid work during term-time and English language usage, both surface learning approach (beta = -0.13, p = 0.001) and deep learning approach (beta = 0.11, p = 0.009) emerged as independent and significant predictors of academic performance. Conclusions: Findings from this study provide further empirical evidence that underscore the importance for faculty to use teaching methods that foster deep instead of surface learning approaches, to improve the quality of student learning and academic performance
Cao, X, Cao, Y, Salamonson, Y, DiGiacomo, M, Chen, Y, Chang, S, Riegel, B & Davidson, PM 2012, 'Translation and validation of the Chinese version of the Acute Coronary Syndrome Response Index (C-ACSRI)', International Journal of Nursing Studies, vol. 49, no. 10, pp. 1277-1290.View/Download from: Publisher's site
The study aims to translate and validate a Chinese version of the Acute Coronary Syndrome Response Index and to assess the knowledge, attitudes, and beliefs of individuals in mainland China with a history of coronary heart disease.
Chang, S, Gholizadeh, L, Salamonson, Y, DiGiacomo, M, Betihavas, V & Davidson, PM 2011, 'Health span or life span: the role of patient reported outcomes in informing health policy', Health Policy, vol. 100, no. 1, pp. 96-104.View/Download from: Publisher's site
OBJECTIVES: Population ageing and the increasing burden of chronic conditions challenge traditional metrics of assessing the efficacy of health care interventions and as a consequence policy and planning. Using chronic heart failure (CHF) as an exemplar this manuscript seeks to describe the importance of patient-reported outcomes to inform policy decisions. METHODS: The method of an integrative review has been used to identify patient-reported outcomes (PROs) in assessing CHF outcomes. Using the Innovative Care for Chronic Conditions the case for developing a metric to incorporate PROs in policy planning, implementation and evaluation is made. RESULTS: In spite of the increasing use of PROs in assessing CHF outcomes, their incorporation in the policy domain is limited. CONCLUSIONS: Effective policy and planning is of health care services is dependent on the impact on the individual and their families. Epidemiological transitions and evolving treatment paradigms challenge traditional metrics of morbidity and mortality underscoring the importance of assessing PROs.
Juntasopeepun, P, Davidson, PM, Chang, S, Suwan, N, Phianmongkhol, Y & Srisomboon, J 2011, 'Development and psychometric evaluation of the Thai Human Papillomavirus Beliefs Scale', Nursing and Health Sciences, vol. 13, no. 4, pp. 475-480.View/Download from: Publisher's site
In this study, we developed and evaluated the psychometric properties of the Thai Human Papillomavirus Beliefs Scale. The Scale was tested on 386 young women aged 18â24 years in Chiang Mai, Thailand. Content validity of the Scale was evaluated by a panel of experts, construct validity was determined using exploratory factor analysis, and reliability was assessed for stability and internal consistency. Factor analysis provided empirical support for the existence of four factors, which accounted for 67.7% of the total variance: perceived susceptibility, perceived seriousness, perceived benefits, and perceived barriers. Cronbach's a reliability coefficients for the four subscales ranged from 0.59 to 0.86. Factors predicting intention to receive the papillomavirus vaccine were perceived susceptibility, perceived benefits, and perceived barriers. The Thai Human Papillomavirus Beliefs Scale demonstrated promising psychometric properties, indicating that it might be a useful instrument for assessing young women's human papillomavirus and cervical cancer-associated beliefs, and for predicting human papillomavirus vaccination intention.
Gholizadeh, L, Salamonson, Y, Davidson, PM, Parvan, K, Frost, S, Chang, S & Hare, D 2010, 'Cross-cultural validation of the Cardiac Depression Scale in Iran', British Journal of Clinical Psychology, vol. 49, no. 4, pp. 517-528.View/Download from: Publisher's site
Background: The Cardiac Depression Scale (CDS) is a disease-specific instrument for measuring depression in cardiac patients. This study was designed to validate the CDS in an Iranian population. Methods: Translation and back translation of the 26- Item CDS scale was performed using recommended procedures. The Iranian translation of the CDS (I-CDS) was administered to 261 individuals in Iran, concurrently with the Beck Depression Inventory. The factor structure of the I-CDS was examined using exploratory factor analysis procedures to enable comparison with previous psychometric evaluation of the CDS. Receiver operating characteristic (ROC) curves were used to examine the ability of the I-CDS to discriminate between categories of depression. Results: First-order exploratory factor analysis uncovered two robust factors, consistent with the second-order dimensions originally reported by the developers of this instrument. Cronbachâs alpha was 0.88 for the total 26-item I-CDS, indicating satisfactory internal consistency of the I-CDS. Intercorrelation between the total scores for the I-CDS and BDI was 0 .62 (P< .001). For the I-CDS cut off of 90, the sensitivity was 85%, and specificity was 61% with a computed area under the curve (AUC) of .81 (95% CI, .76- .87). For the I-CDS cut off of 100, the sensitivity was 81% and specificity was 63% with a computed AUC of .81 (95% CI, .76- .87). Conclusion: This validation study of the Iranian version of the CDS proved that it is an acceptable, a reliable and valid measure of depression in cardiac patients.
van der Sluijs, C, Bensoussan, A & Chang, S 2009, 'A randomized placebo-controlled trial on the effectiveness of an herbal formula to alleviate menopausal vasomotor symptoms', Menopause, vol. 16, no. 2, pp. 336-344.View/Download from: Publisher's site
Johnson, M, Chang, S, Murphy, B & Payne, S 2008, 'A survey of the risk-management behaviours of Australian general practitioners', Quality in Primary Care, vol. 16, no. 1, pp. 7-15.
Background Toassistgeneralpractitioners(GPs)in minimising their risk of medical error, the edu- cation unit of a medical insurer developed a survey that assessed the risk-management behaviours of GPs. Objective This study describes the risk-manage- ment behaviours of Australian GPs and how they vary by age, sex and workload intensity. Method A cross-sectional survey of 572 practising GPs, from a random selection of 1657 insured GPs, formed the data for analysis. GPs self-reported their behaviour using the valid and reliable Know your Risk GP-Non-procedural Scale. Results GPs reported performing risk-management behaviours frequently in six key areas: practitioner communication, facilitating patient responses, man- aging adverse outcomes, practice setting, diagnosis, and prescribing/treatment. Risk-management be- haviours varied little by age, sex or workload, with `facilitating patient responses being a key domain in age, sex and workload differences (older GPs and women self-reported higher performance) later found to be not significant when the interaction of age, sex and workload was examined. Conclusion Most GPs were actively engaged in general risk-management behaviours. This self- assessment tool and education strategy identified areas for improvement for individual GPs. The initiative prompted GPs to seek additional educa- tion including practice reviews. This risk-manage- ment strategy would be applicable to sole practices, group practices and divisions of general practice. Workload intensity may be a major consideration in the focus and extent of participation in risk- management behaviours, and research using varying levels of workload intensity is recommended.
Johnson, M, Murphy, B, Payne, S & Chang, S 2008, 'Self-assessment of medico-legal risk by doctors: the Know Your Risk Version 1 - Short form', Australian Health Review, vol. 32, no. 2, pp. 339-348.View/Download from: Publisher's site
An instrument to measure medicolegal risk management behaviours among medical practitioners was developed and tested. A cross sectional survey was posted to 962 UNITED Medical Protection members receiving premium support. A final sample of 757 currently working medical practitioners responded, including general practitioners (21.9%), surgeons (29.9%), obstetricians and gynaecologists (12.7%), and others (35.5%). The Know Your Risk Version 1 - Short Form and other tools developed by this team are available for use by group practices, hospital administrators and practitioners. These tools have the potential to assist regulators and insurers to identify, monitor or screen individual medicolegal risk behaviours.
Bensoussan, A, Chang, S, Menzies, RG & Talley, N 2001, 'Application of the general health status questionnaire SF36 to patients with gastrointestinal dysfunction: Initial validation and validation as a measure of change', Australian and New Zealand Journal of Public Health, vol. 25, no. 1, pp. 71-77.View/Download from: Publisher's site
Johnson, M, Marsden, J, Day, E & Chang, S 2001, 'Nursing skill assessment within populations: scale development and testing', Contemporary Nurse, vol. 10, pp. 46-57.
Cook, C, Burgess-Limerick, R & Chang, S 2000, 'The prevalence of neck and upper extremity musculoskeletal symptoms in computer mouse users', International Journal of Industrial Ergonomics, vol. 26, no. 3, pp. 347-356.View/Download from: Publisher's site
Computer pointing devices such as the mouse are widely used. Despite this, the relationship between musculoskeletal symptoms and mouse use has not been established. The aim of this cross-sectional study was to determine whether a relationship existed between computer mouse use and musculoskeletal symptoms in a sample of 270 computer mouse users. Factors demonstrating a significant association with symptoms were entered into a step-wise multiple logistic regression, adjusting for age and sex and controlling for potential interdependence between variables. No relationship was found between hours of mouse use per day and reported symptoms. A relationship was found between the variable of arm abduction which is specific to mouse use and symptoms in the neck. Relationships were found between non-mouse-specific risk factors such as stress, screen height and shoulder elevation. The findings of this study support the hypothesis that mouse use may contribute to musculoskeletal injury of the neck and upper extremity. Mouse users are exposed to the same recognized risk factors associated with keyboard use as well as the additional risk factor of arm abduction during mouse use.
Spence, SA, Fraser, GC & Chang, S 1996, 'Responses in milk production to the control of gastrointestinal nematode and paramphistome parasites in dairy cattle', Australian Veterinary Journal, vol. 74, no. 6, pp. 456-459.View/Download from: Publisher's site
Objective: To determine the effect of treating naturally acquired gastrointestinal nematode and paramphistome infections on milk production in dairy cattle. Design: A field trial. Animals: One thousand two hundred and thirty nine dairy cows. Procedure: Cows were either not treated or treated with 4.5 mg/kg oxfendazole, 16.6 mg/kg oxyclozanide or 4.5 mg/kg oxfendazole and 16.6 mg/kg oxyclozanide in March, May and August. Results: A significant increase in milk production, averaging 0.4 L (SE 0.2) per day, was seen when dairy cows infected with gastrointestinal nematodes and paramphistomes were treated with oxfendazole or oxfendazole and oxyclozanide in March, May and August. Cows treated with oxyclozanide alone at these times produced no more milk than untreated cows. Faecal egg counts confirmed that oxyclozanide treatment reduced paramphistome populations and oxfendazole treatment reduced nematode populations in cows over the 7-month monitoring period. Conclusion: When dairy cows infested with gastrointestinal nematodes and paramphistomes were treated with oxfendazole alone or oxfendazole and oxyclozanide in March, May and August milk production increased.
Johnson, M & Chang, S 2014, 'Sampling in Quantitative Research' in Jironjwong, S, Johnson, M & Welch, A (eds), Research Methods in Nursing and Midwifery Pathways to Evidence-based Practice, Oxford University Press, Sydney, pp. 163-181.
Chang, S 2011, 'Populations and Sampling' in Jirojwong, S, Johnson, M & Welch, A (eds), Research Methods in Nursing and Midwifery: Pathways to evidence-based practice, Oxford University Press, Sydney.
DiGiacomo, M, Lewis, J, Parker, D, Chang, S, Koirala, B & Phillips, J 2018, 'Healthy Ageing, Yet Unmet Need in Australian War Widows: A Sequential Mixed Methods Study', International Council of Women's Health Issues Congress, Hong Kong.
Jha, SR, Hannu, MK, Wilhelm, K, Newton, PJ, Chang, S, Chang, S, Montgomery, E, Harkess, M, Tunnicliff, P, Smith, A, Hayward, C, Jabbour, A, Keogh, A, Kotlyar, E, Dhital, K, Granger, E, Jansz, P, Spratt, P & Macdonald, PS 2016, 'Frailty Measures in Advanced Heart Failure Patients Listed for Transplantation', JOURNAL OF HEART AND LUNG TRANSPLANTATION, Elsevier, USA, pp. S27-S27.View/Download from: Publisher's site
To identify if the addition of cognitive impairment, depression, or both, to the physical assessment of frailty provides better outcome prediction in advanced heart failure (AHF) patients listed for heart transplantation.
Beginning in 2013, all patients with AHF referred to our Transplant Unit have undergone assessment of physical frailty using the Fried Phenotype (FP), cognition (Montreal Cognitive Assessment, MoCA) and depression (Depression in Medical Illness, DMI). We assessed the value of four composite frailty measures: physical frailty (PF ≥ 3/5 = frailty), 'cognitive frailty' (FP+MoCA ≥ 3/6 = frail), depressive frailty (FP+DMI ≥ 3/6 = frail) and cognitive-depressive frailty (FP+MoCA+DMI ≥ 3/7 = frail) in predicting outcomes.
145 patients (99M: 46F; age 53±13 years, range 16-73; LVEF 27±14%) underwent assessment of frailty. Of the four measures, 'cognitive frailty' provided the strongest predictor of survival. When categorised by PF, 96 (66%) were identified as non- or pre-frail (NPF) and 49 (34%) were identified as frail. The prevalence of 'cognitive frailty' was higher with 85 NPF (59%) and 60 (41%) frail. Frailty (either physical or cognitive) was associated with higher NYHA, lower cardiac index, anemia, hypoalbuminemia and lower BMI. Frailty was independent of LVEF, LV diameter, renal function (serum creatinine and eGFR), sex and age. Actuarial survival curves are shown in Figure 1 for both physical (a) and cognitive (b) frailty. Survival curves adjust for bridge-to-transplant ventricular assist device (BTT-VAD) implantation and/or transplantation are also shown in figure 1 (c)/(d). Frailty was associated with higher mortality, with cognitive frailty better capturing early mortality: physical frailty (20 NF; 20F) and cognitive frailty (17 NF; 25F).
Cognitive frailty was highly prevalent in this cohort. The addition of cognition to the physical assessment of frailty strengthened the capacity to identify those at risk of early...
Jha, SR, Hannu, MK, Wilhelm, K, Newton, PJ, Chang, S, Montgomery, E, Harkess, M, Tunnicliff, P, Smith, A, Hayward, C, Jabbour, A, Keogh, A, Kotlyar, E, Dhital, K, Granger, E, Jansz, P, Spratt, P & Macdonald, P 2016, 'Reversibility of Frailty in Advanced Heart Failure Patients Listed for Transplantation', JOURNAL OF HEART AND LUNG TRANSPLANTATION, 36th Annual Meeting and Scientific Sessions of the International-Society-for-Heart-and-Lung-Transplantation (ISHLT), ELSEVIER SCIENCE INC, Washington, DC, pp. S29-S29.View/Download from: Publisher's site
Chang, S, Newton, PJ, Salamonson, Y, MacDonald, PS & Davidson, PM 2010, 'Health Related Quality of Life Assessment in Pharmacological Clinical Trials: Rigor of Measurement and Reporting', JOURNAL OF CARDIAC FAILURE, 14th Annual Scientific Meeting of the Heart-Failure-Society-of-America, CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS, San Diego, CA, pp. S88-S88.View/Download from: Publisher's site