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MPRU History
The
Medical Psychology Unit was formed in 1984 by Dr Stewart Dunn
(psychologist) and Prof John Turtle, Professor of Medicine and Head of
the Department of Endocrinology at the University of Sydney, to conduct
research combining the principles of Psychology and Medicine in
diabetes. In 1988, Dr Dunn began working with Prof Martin Tattersall
(medical oncologist) and expanded the work of the Unit into cancer. The
Unit was based in the Faculty of Medicine, Central Clinical School at
the University of Sydney, and was co-directed by Dr Dunn and Prof
Tattersall. Early research included developing measures of
psychological adjustment to diabetes and cancer, exploring
psychological predictors of outcome in melanoma and breast cancer
patients, and developing an interaction analysis system to code
audio-taped oncology consultations.
Beginning with a staff of three, the
Unit rapidly expanded, and by 1994 had a staff of 12, funded entirely
by peer reviewed grants. Dr Phyllis Butow joined the staff in 1989 and
became Deputy Director in 1992. In 1996, Professor Dunn moved to the
Northern Clinical School and founded the Pam McLean Cancer
Communications Centre. Dr Butow became co-Director of the Unit, based
half time at the Northern and half-time at the Central Clinical
Schools. The Unit changed its name to the Medical Psychology Research
Unit (MPRU) in 1997 to better capture its focus.
In 2002, Prof Butow was awarded an
NHMRC Research Fellowship and returned full-time to the Central
Clinical School. With increasing responsibilities in teaching and
administration, Prof Dunn resigned as Co-Director but has maintained an
affiliation with the Unit, particularly in the application of
communication research to communication skills training for health
professionals.
In 2003, Prof Butow accepted an
appointment to a Chair in Psychology at the University of Sydney and
the MPRU became a cross-Faculty Unit in the Faculty of Medicine and the
School of Psychology. Dr Melanie Price joined the MPRU in 2004 and
became Deputy Director in 2006.
Currently the MPRU has (including the
Directors) 28 staff including 10 post-doctoral senior researchers. The
MPRU has built an international reputation in the area of
Psycho-Oncology and doctor-patient communication. It has been extremely
successful, demonstrating its capacity to bring in funds and personnel
to the University. Professors Butow and Tattersall are currently Chief
Investigators on projects which have received competitive funding for
over $8,000,000. Since 1995, the group has won 63 peer reviewed grants,
attracted over $16,000,000 in research funds and published over 170
articles in high impact factor journals.
Recently, the MPRU has joined forces
with the Sydney Health Decision Making Group in the School of Public
Health to form a Centre for Medical Psychology and Evidence-based
Decision Making within the University.
Research Interests
The MPRU has research interests in
a wide arena, falling under the discipline of Health Psychology. These
include: psychosocial predictors of the development and outcome of
disease, the psychological impact of disease, factors influencing
coping and adjustment to disease, development and evaluation of
interventions to enhance health professional-patient communication,
psychometric measurement and test development. These are described in
more detail below.
1.
Doctor-patient communication
2. Cultural
aspects of cancer care
3.
Psychosocial predictors of the development and outcome of disease
4.
Psychological adjustment to illness and improving quality of life
5. Genetic
counseling and testing
6. End of life
issues
1.
Doctor-patient communication
See Current Research
Projects
Patients with cancer grapple with many difficult issues. They need to
cope with bad news, take in complex and new information, make difficult
decisions about treatment, and deal with the impact of disease on
themselves, their partners and their family. Doctors and other health
professionals can assist patients throughout this journey; research is
needed to facilitate this process. Recognition of the importance of
this area is reflected in the increasing attendance at communication
skills training courses. Specific areas we have been researching
include:
- Interaction analysis (coding) of doctor-patient
communication
- Development and evaluation of strategies to
improve doctor-patient communication and promote shared
decision-making, including the provision of question prompt lists,
letters summarising the consultation, audiotapes of the consultation
and decision aids
- Auditing and improving the process of informed
consent to standard treatments and clinical trials
- Evaluation of the impact of communication
skills training on doctor and patient outcomes
- Development of guidelines in communicating risk
and prognosis These strategies are now being applied in other areas,
for example, provision of tapes to parents of babies in neonatal
intensive care units; information needs re screening in healthy
populations.
2.
Cultural aspects of cancer care
See Current Research
Projects
Australia is a multi-cultural society, and principles of care developed
in Western societies do not always transfer to other cultures. Specific
areas we have been researching include:
- Preferences for communication of the diagnosis
and prognosis in the Greek and Chinese communities
3.
Psychosocial predictors of the development and outcome of disease
See Current Research
Projects
There has been a long-term interest in the role of psychosocial factors
in promoting disease, or affecting its outcome. Most of the work in
this area has been flawed by methodological shortcomings. Specific
areas we have been researching include:
- Exploring the role of stress, personality,
social support and coping style in the outcome of primary and secondary
cancer
- Development and evaluation of an intervention
to increase optimism and minimisation of the impact of cancer to
promote longer survival
- Exploration of the role of stress, coping and
social support in promoting breast cancer development in women from
high risk breast cancer families.
4.
Psychological adjustment to illness and improving quality of life
See Current Research
Projects
Research has been conducted on the psychosocial outcomes of cancer
across time, including rates of anxiety and depression, sexual and
relationship outcomes and quality of life. Interventions to improve
adjustment are needed. Specific areas we have been researching include:
- Documenting unmet needs and quality of life
outcomes over time in different diseases and different stages,
including the survival phase
- Impact of informal and formal support networks
on quality of life
- Documenting psychosexual outcomes following
treatment for gynaecological cancer and developing interventions to
improve these
- Evaluation of the effectiveness of different
types of cancer support groups
- Development of interventions to assist carers
of cancer patients
- Development of strategies to support leaders of
cancer support groups
5.
Genetic counseling and testing
See Current Research
Projects
With the growth of technological advances in screening for genetic
disorders and the identification of increasing numbers of genetic
mutations predisposing to illness, interest has grown in the impact of
genetic counseling and testing, and optimal ways to communicate genetic
information to individuals and families. Specific areas we have been
researching include:
- The psychological impact of being informed one
is at low, moderate or high risk, and of receiving a genetic test
result (positive or negative)
- Impact of variations in the content and process
of genetic counseling on patient outcomes.
- Development of a communication tool to
facilitate discussions of risk
6. End of
life issues
See Current Research
Projects
Many issues arise at the end of life, including communicating
prognosis, referral to palliative care, and making decisions about
treatment. Specific areas we have been researching include:
- Optimal methods to communicate about prognosis
and end-of life issues, including timing, content and process issues
- Timing of referral to palliative care
- Methods to reduce pain and other symptoms at
the end of life.
- Communicating with bereaved relatives
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