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Ralph J, Freeman LA, Ménard AD, Soucie K. Practical strategies and the need for psychological support: recommendations from nurses working in hospitals during the COVID-19 pandemic. J Health Organ Manag 2021; ahead-of-print. [PMID: 34455733 DOI: 10.1108/jhom-02-2021-0051] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE Nurses working during the coronavirus disease 2019 (COVID-19) pandemic have reported elevated levels of anxiety, burnout and sleep disruption. Hospital administrators are in a unique position to mitigate or exacerbate stressful working conditions. The goal of this study was to capture the recommendations of nurses providing frontline care during the pandemic. DESIGN/METHODOLOGY/APPROACH Semi-structured interviews were conducted during the first wave of the COVID-19 pandemic, with 36 nurses living in Canada and working in Canada or the United States. FINDINGS The following recommendations were identified from reflexive thematic analysis of interview transcripts: (1) The nurses emphasized the need for a leadership style that embodied visibility, availability and careful planning. (2) Information overload contributed to stress, and participants appealed for clear, consistent and transparent communication. (3) A more resilient healthcare supply chain was required to safeguard the distribution of equipment, supplies and medications. (4) Clear communication of policies related to sick leave, pay equity and workload was necessary. (5) Equity should be considered, particularly with regard to redeployment. (6) Nurses wanted psychological support offered by trusted providers, managers and peers. PRACTICAL IMPLICATIONS Over-reliance on employee assistance programmes and other individualized approaches to virtual care were not well-received. An integrative systems-based approach is needed to address the multifaceted mental health outcomes and reduce the deleterious impact of the COVID-19 pandemic on the nursing workforce. ORIGINALITY/VALUE Results of this study capture the recommendations made by nurses during in-depth interviews conducted early in the COVID-19 pandemic.
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527
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Tan HT, Chai BC, Lui YS. Effects of COVID-19 on Substance Use in Singapore. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2021; 15:11782218211030533. [PMID: 34456569 PMCID: PMC8392814 DOI: 10.1177/11782218211030533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 06/17/2021] [Indexed: 01/22/2023]
Abstract
This review examines the impact of COVID-19 on the substance-abuse landscape and climate with particular attention on Singapore’s. Substance-abuse has received the least attention during the COVID-19 outbreak and this pandemic has further sheared the problem’s visibility and the provision of care for this population of sufferers. The authors examine the current literature to look at the access and utility of street drugs due to border closure, the influence of the pandemic on prevailing drug behaviours as well as the effect of social distancing on drug-users. Two case studies are described. The paper serves to illuminate the ever-present problem of substance-abuse even during a viral pandemic and to remind the local government and healthcare system to continue efforts in caring for this group of patients.
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Lee J, Kim D, Lee WJ, Woo SH, Jeong S, Kim SH. Association of the COVID-19 Pandemic and Low-rescue Suicide Attempts in Patients Visiting the Emergency Department after Attempting Suicide. J Korean Med Sci 2021; 36:e243. [PMID: 34463065 PMCID: PMC8405404 DOI: 10.3346/jkms.2021.36.e243] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/17/2021] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic may increase the total number of suicide attempts and the proportion of low-rescue attempts. We investigated the factors affecting low-rescue suicide attempts using the risk-rescue rating scale (RRRS) among patients who visited the emergency department (ED) after attempting suicide before or during the COVID-19 pandemic. METHODS We retrospectively investigated suicide attempts made by patients who visited our ED from March 2019 to September 2020. Patients were classified into two groups based on whether they attempted suicide before or during the COVID-19 pandemic. Data on demographic variables, psychiatric factors, suicide risk factors and rescue factors were collected and compared. RESULTS A total of 518 patients were included in the study, 275 (53.1%) of whom attempted suicide during the COVID-19 pandemic. The proportion of patients who made low-rescue suicide attempts differed before and during the COVID-19 pandemic (37.1% vs. 28.8%) (P = 0.046). However, the proportions of patients who made high-risk suicide attempts and high-lethality suicide attempts did not significantly differ between the two periods. The independent risk factors for low-rescue suicide attempts were age and the COVID-19 pandemic (odds ratio [OR], 1.02; 95% confidence interval [CI], 1.00-1.03; P = 0.006) (OR, 1.52; 95% CI, 1.03-2.25; P = 0.034). CONCLUSION The COVID-19 pandemic was associated with low-rescue suicide attempts in patients visiting the ED after attempting suicide. Thus, we need to consider the implementation of measures to prevent low-rescue suicide attempts during similar infectious disease crises.
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Murchland AR, Zeki Al Hazzouri A, Zhang L, Elfassy T, Grasset L, Riley AR, Wong R, Haan MN, Jones RN, Torres JM, Glymour MM. Estimating the effects of Mexico to U.S. migration on elevated depressive symptoms: evidence from pooled cross-national cohorts. Ann Epidemiol 2021; 64:53-66. [PMID: 34438024 DOI: 10.1016/j.annepidem.2021.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/16/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022]
Abstract
PURPOSE Migrating from Mexico to the U.S. is a major, stressful life event with potentially profound influences on mental health. However, estimating the health effects of migration is challenging because of differential selection into migration and time-varying confounder mediators of migration effects on health. METHODS We pooled data from the Mexican Health and Aging Study (N = 17,771) and Mexican-born U.S. Health and Retirement Study (N = 898) participants to evaluate the effects of migration to the U.S. (at any age and in models for migration in childhood or adulthood) on depressive symptom-count, measured with a modified Centers for Epidemiologic Studies-Depression scale. We modeled probability of migrating in each year of life from birth to either age at initial migration to the U.S. or enrollment and used these models to calculate inverse probability of migration weights. We applied the weights to covariate-adjusted negative binomial GEE models, estimating the ratio of average symptom-count associated with migration. RESULTS Mexico to U.S. migration was unrelated to depressive symptoms among men (ratio of average symptom-count= 0.98 [95% CI: 0.89, 1.08]) and women (ratio of average symptom-count = 1.00 [95% CI: 0.92, 1.09]). Results were similar for migration in childhood, early adulthood, or later adulthood. CONCLUSIONS In this sample of older Mexican-born adults, migration to the U.S. was unrelated to depressive symptoms.
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Torlinska J, Albani V, Brown H. Financial hardship and health in a refugee population in Australia: A longitudinal study. J Migr Health 2021; 1-2:100030. [PMID: 34405178 PMCID: PMC8352014 DOI: 10.1016/j.jmh.2020.100030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/03/2020] [Accepted: 12/03/2020] [Indexed: 11/16/2022] Open
Abstract
Refugees are at high risk for poor health and financial insecurity. We use longitudinal data from Australia of cohort of refugees. We investigate the relationship between social determinants of health, financial hardship, and health in refugees. Women, those from Northern Africa, Sub-Sahara Africa and Middle East are more likely to have poor health. Financial hardship is independently associated with poor health.
Refugees and asylum seekers are at a higher risk than the host population to poor health and financial stress. This study uses a unique longitudinal panel from Australia, the Building a New life in Australia (BNLA cohort) to understand the relationship over time between the social determinants of health, health, and financial hardship in refugees and asylum seekers. We employ a longitudinal; dynamic multivariate logistic regression to firstly estimate the relationship between the social determinants of health and poor physical and mental health. Next, we include variables related to financial hardship in our model to determine if there is an association independent of the social determinants of health. Finally, we estimate if there is a relationship between the number of financial hardships and poor physical and mental health. The results show that migrants from North Africa, the Middle East, and Sub-Sahara Africa and women are more likely to suffer from poor health. Financial hardship has an independent association with poor health. We find that going without meals had the highest odds of suffering from poor health. There was evidence of a dose response of financial hardship for those suffering from a limiting long-term health condition and post-traumatic stress syndrome. These findings suggest that refugees in Australia may need additional support past their first year to help them assimilate and contribute to economic productivity.
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531
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McHenry LK, Beasley L, Zakrajsek RA, Hardin R. Mental performance and mental health services in sport: a call for interprofessional competence and collaboration. J Interprof Care 2021; 36:520-528. [PMID: 34372750 DOI: 10.1080/13561820.2021.1963218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The provision of holistic care for athletes often involves interprofessional teams with specialists to support athletic performance and overall wellness. Yet, regarding psychological support, some have advocated for a single professional to attain both a certified mental performance consultant (CMPC) credential and any type of mental health license (e.g., Licensed Psychologist [LP], Licensed Social Worker [LSW], or Licensed Professional Counselor [LPC]) to address the mental performance and mental health needs of athletes. Unfortunately, this approach may hinder interprofessional collaboration and ignore distinctions between CMPCS and other types of mental health professionals. Alternatively, CMPCs and various types of mental health professionals may work together on interprofessional psychological support teams. The purpose of this paper is to clarify the distinct historical and theoretical foundations of mental performance consulting, clinical psychology, social work, and professional counseling in sport contexts to serve as a resource for enhancing interprofessional competence within such teams. The distinct training pathways of CMPCs, LPs, LSWs, and LPCs are outlined with attention to how each can serve a valuable role on an interprofessional support team for athletes. Applications of the World Health Organization's framework for interprofessional education and collaborative practice (IPECP) to psychological support teams in sport contexts is discussed.
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Hammett PJ, Businelle MS, Taylor BC, Erbes CR, Bastian L, Doran N, Sherman SE, Rogers ES, Burgess DJ, Fu SS. The Association Between Smoking Abstinence and Pain Trajectory Among Veterans Engaged in U.S. Department of Veterans Affairs Mental Health Care. PAIN MEDICINE 2021; 22:1793-1803. [PMID: 33502511 DOI: 10.1093/pm/pnab009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To prospectively examine associations between smoking and nicotine abstinence and pain trajectory over 12 months among smokers with low, moderate, and severe pain and to assess whether these associations differ over time. DESIGN A secondary analysis of the "Proactive Outreach for Smokers in VA Mental Health" study, a randomized controlled trial of proactive outreach for veteran smokers engaged in U.S. Department of Veterans Affairs (VA) mental health care. METHODS Participants were categorized into "low" (n = 616), "moderate" (n = 479), and "severe" pain (n = 656) groups according to baseline pain score. Associations between self-reported abstinence from smoking and nicotine at 6 and 12 months and pain trajectory, measured via the PEG scale (Pain intensity, Enjoyment of life, General activity) composite score, were assessed through the use of general linear mixed models. Interaction tests assessed whether these associations differed at 6 and 12 months. Analyses were conducted within the overall sample and within the separate pain groups. RESULTS There were significant interactions in the overall sample and the low and moderate pain groups, such that 7-day point prevalence smoking abstinence was associated with lower pain scores at 6 but not 12 months. In the severe pain group, 7-day abstinence from both smoking and nicotine was associated with lower pain scores across both time points. Six-month prolonged abstinence was not associated with pain scores. CONCLUSIONS In this prospective analysis conducted among veteran smokers engaged in mental health services, 7-day abstinence from smoking and nicotine was associated with significantly lower levels of pain. Education efforts could help better inform smokers on the relationship between smoking and pain.
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533
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Naqvi SSB, Davis J, Pickles RW, Loewenthal MR. "Concerns and Psychological Wellbeing of Health Care Workers During the COVID-19 Pandemic in a Tertiary Care Hospital in NSW". Intern Med J 2021; 51:1407-1413. [PMID: 34346147 PMCID: PMC8447026 DOI: 10.1111/imj.15465] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 07/12/2021] [Accepted: 07/24/2021] [Indexed: 11/28/2022]
Abstract
Background In early 2020, the impending COVID‐19 pandemic placed a once‐in‐a‐generation professional and personal challenge on healthcare workers. Publications on direct physical disease abound. The authors wanted to focus on doctors' psychological well‐being. Aims To assess the impact of the COVID‐19 pandemic on doctors' well‐being and evaluate their concerns as the pandemic progressed. Methods A mixed‐methods, hospital‐based survey was sent to doctors at the 650‐bed tertiary referral hospital in NSW at two different periods (late‐March and early May 2020). A validated mental well‐being tool (Short Warwick Edinburgh Mental Well‐being Scale (SWEMWBS)) was combined with COVID‐19‐specific questions. Results Two hundred and thirty‐five responses were obtained from 450 doctors, with a response rate of 32% in the first survey and 20% in the second. The majority (35%) of respondents were doctors‐in‐training, followed by staff‐specialists (23%). The highest response was from frontline workers in both surveys, including the intensive care unit (27%), anaesthesia (21%) and emergency department (13%). ‘Extreme concern’ regarding personal protective equipment (PPE) shortage dropped from 22.6% to 2.2% and ‘extreme concern’ of contracting COVID‐19 fell from 22.6% to 3.4% in the second survey. The proportion of respondents with a ‘low’ psychological well‐being score improved from 38% to 27% between the two surveys. The resulting mean improvement in the SWEMWBS was 3.49 (95% confidence interval = 3.06–3.91, P < 0.001). Conclusion Both COVID‐19 specific concerns and psychological well‐being improved greatly in the second survey. Possible explanations are the fall in COVID‐19 cases in the district, improvements in PPE supply and supportive measures communicated to doctors during this period.
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Hawkins EJ, Lott AM, Danner AN, Malte CA, Hagedorn HJ, Berger D, Donovan LM, Sayre GG, Mariano AJ, Saxon AJ. Primary Care and Mental Health Prescribers, Key Clinical Leaders, and Clinical Pharmacist Specialists' Perspectives on Opioids and Benzodiazepines. PAIN MEDICINE 2021; 22:1559-1569. [PMID: 33661287 DOI: 10.1093/pm/pnaa435] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Due to increased risks of overdose fatalities and injuries associated with coprescription of opioids and benzodiazepines, healthcare systems have prioritized deprescribing this combination. Although prior work has examined providers' perspectives on deprescribing each medication separately, perspectives on deprescribing patients with combined use is unclear. We examined providers' perspectives on coprescribed opioids and benzodiazepines and identified barriers and facilitators to deprescribing. DESIGN Qualitative study using semistructured interviews. SETTING One multisite Veterans Affairs (VA) healthcare system in the United States of America. SUBJECTS Primary care and mental health prescribers, key clinical leaders, clinical pharmacist specialists (N = 39). METHODS Interviews were audio-recorded, transcribed, and analyzed using thematic analysis. Themes were identified iteratively, through a multidisciplinary team-based process. RESULTS Analyses identified four themes related to barriers and facilitators to deprescribing: inertia, prescriber self-efficacy, feasibility of deprescribing/tapering, and promoting deprescribing, as well as a fifth theme, consequences of deprescribing. Results highlighted the complexity of deprescribing when multiple prescribers are involved, a need for additional support and time, and concerns about patients' reluctance to discontinue these medications. Facilitators included agreement with the goal of deprescribing and fear of negative consequences if medications are continued. Providers spoke to how deprescribing efforts impaired patient-provider relationships and informed their decisions not to start patients on these medications. CONCLUSIONS Although providers agree with the goal, prescribers' belief in a limited deprescribing role, challenges with coordination among prescribers, concerns about insufficient time and patients' resistance to discontinuing these medications need to be addressed for efforts to be successful.
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Jiménez-López A JL, Pérez-García MI, Miranda-Delgado M. [Need of mental health teams for patients hospitalized due to SARS-CoV-2 and front-line health personnel]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2021; 59:339-346. [PMID: 35015471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 05/11/2021] [Indexed: 06/14/2023]
Abstract
People vulnerable to mental health problems during the COVID-19 outbreak include hospitalized patients and frontline health professionals; mostly reported discomforts include: insomnia, anxiety and depression. Under strict infection measures, non-essential personnel such as clinical psychiatrists and psychologists are strongly discouraged from entering isolation wards; therefore, frontline health-care workers become the main personnel providing psychological interventions to patients in hospitals without knowing how to mitigate patient distress. Health personnel do not receive adequate care for due to lack of time, stigma associated with using mental health services and fear of unwanted intervention. Remote care tools such as tele-psychiatry and online psychological intervention have disadvantages for conditions requiring physical examination. The National Health Commission of China released guiding principles to reduce the psychosocial effects of the COVID-19 outbreak recommending the creation of mental health teams. In this article we present the data obtained by a mental health team in a COVID-19 hospital of the Mexican Institute of Social Security, showing differences in emotional discomfort and diagnoses of mental disorders in patients in isolation and in frontline health personnel, suggesting the need for teams made up of psychiatry and psychology staff with face-to-face on-site assessments.
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536
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Hobbs Knutson K, Wennberg D, Rajkumar R. Driving Access and Quality: A Shift to Value-Based Behavioral Health Care. Psychiatr Serv 2021; 72:943-950. [PMID: 33957765 DOI: 10.1176/appi.ps.202000386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Multiple barriers exist to accessing behavioral health care, and several are related to payment. The national shortage of behavioral health providers is exacerbated by their not joining health insurance networks, often shifting the cost of treatment to patients. In the face of high out-of-network expenses, deductibles, and copays, many insured patients forgo behavioral health treatment altogether. However, even when patients access care, health outcomes are not routinely measured, and there is reason to suspect that the quality of care is poor. To address these issues, value-based reimbursement for behavioral health care offers a sustainable pathway to increase payment for providers in return for improved population health outcomes and costs. This article describes a comprehensive collaborative effort between a payer and a health care technology and services organization to support behavioral health providers to enter into value-based care. This approach changes financial incentives to drive improvements in behavioral health care access and quality.
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Delanerolle G, Phiri P, Zeng Y, Marston K, Tempest N, Busuulwa P, Shetty A, Goodison W, Muniraman H, Duffy G, Elliot K, Maclean A, Majumder K, Hirsch M, Rathod S, Raymont V, Shi JQ, Hapangama DK. A systematic review and meta-analysis of gestational diabetes mellitus and mental health among BAME populations. EClinicalMedicine 2021; 38:101016. [PMID: 34308317 PMCID: PMC8283332 DOI: 10.1016/j.eclinm.2021.101016] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/02/2021] [Accepted: 06/21/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is a common complication of pregnancy and is associated with an increased risk of mental health (MH) disorders including antenatal and postnatal depression (PND), anxiety and post-traumatic-stress-disorder (PTSD). We hypothesized GDM and MH disorders will disproportionately affect individuals from Black, Asian and Minority Ethnic backgrounds. METHODS A systematic methodology was developed, and a protocol was published in PROSPERO (CRD42020210863) and a systematic review of publications between 1st January 1990 and 30th January 2021 was conducted. Multiple electronic databases were explored using keywords and MeSH terms. The finalised dataset was analysed using statistical methods such as random-effect models, subgroup analysis and sensitivity analysis. These were used to determine odds ratio (OR) and 95% confidence intervals (CI) to establish prevalence using variables of PND, anxiety, PTSD and stress to name a few. FINDINGS Sixty studies were finalised from the 20,040 data pool. Forty-six studies were included systematically with 14 used to meta-analyze GDM and MH outcomes. A second meta-analysis was conducted using 7 studies to determine GDM risk among Black, Asian and Minority Ethnic women with pre-existing MH disorders. The results indicate an increased risk with pooled adjusted OR for both reflected at 1.23, 95% CI of 1.00-1.50 and 1.29, 95% CI of 1.11-1.50 respectively. INTERPRETATION The available studies suggest a MH sequalae with GDM as well as a sequalae of GDM with MH among Black, Asian and Minority Ethnic populations. Our findings warrant further future exploration to better manage these patients. FUNDING Not applicable.
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Paudel J. Home Alone: Implications of COVID-19 for Mental Health. Soc Sci Med 2021; 285:114259. [PMID: 34388621 PMCID: PMC8479491 DOI: 10.1016/j.socscimed.2021.114259] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 07/06/2021] [Accepted: 07/21/2021] [Indexed: 11/29/2022]
Abstract
Rationale The outbreak of the 2019 novel coronavirus disease (COVID-19) has induced a considerable degree of fear, emotional stress and anxiety among individuals around the world. Objective The objective of this study is to evaluate the relationship between COVID-19 virus cases per 1000 residents and mental health outcomes of individuals across the globe. Methods Using plausibly exogenous variation in daily country-level reports of new COVID-19 cases across the world, this study employs an individual-by-day global data set to assess the association between virus outbreak intensity and short-term measures of mental health outcomes. Results Results indicate that females are 20.02% (95 % CI [6.65 %, 33.39 %]) more likely than males to find life depressing, suggesting that they may bear a much larger mental health burden than males during the COVID-19 pandemic. The association between the pandemic and mental health is more pronounced among individuals staying at home for the past week, who are 14.81 % (95 % CI [3.46 %, 26.16 %]) more likely to feel anxious and 11.17 % (95 % CI [2.13 %, 20.21 %]) more likely to experience emotional instability than their counterparts. The association between virus outbreak intensity and the likelihood of anxiety among individuals staying at home increases with household size, ranging from 11.73 % (95 % CI [-4.65 %, 28.11 %]) among individuals with 0–1 members in the household to 21.02 % (95 % CI [5.73 %, 36.31 %]) among those with 4–8 members in the household. Conclusion These short-run estimates of mental health damages associated with COVID-19 imply that welfare losses from pandemics among individuals are enormous across the globe.
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539
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Azizpour I, Mehri S, Moghaddam HR, Mirzaei A, Soola AH. The impact of psychological factors on bereavement among frontline nurses fighting Covid-19. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2021; 15:100341. [PMID: 34367916 PMCID: PMC8325519 DOI: 10.1016/j.ijans.2021.100341] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 07/17/2021] [Accepted: 07/24/2021] [Indexed: 02/08/2023] Open
Abstract
The COVID-19 pandemic has considerably changed the workplace and social relationships of nurses. As potential factors, uncertainty, stigma, and exposure of nurses' families to risk have disturbed the process of providing healthcare services for patients infected by COVID-19. Accordingly, this study aimed at determining the impact of psychological factors on stigma among frontline nurses fighting COVID-19. The extant paper was carried out based on the descriptive-analytical method for April-June 2020. A total of 312 nurses working in educational-medical centers in Ardabil, Iran, were selected using the census method to participate in this research. To collect data, demographic features, stigma, mental health, perceived stress, and hardiness questionnaires were used. The collected data were analyzed using statistical correlation tests, multivariate regression, and descriptive tests through SPSS v.22 Software. The mean score of stigma in nurses equaled 28.36 ± 10.55. Results of the correlation coefficient showed a positive relationship between the mean score of stigma and stress (P ≤ 0.01) as well as the negative relationship between mental health and hardiness (P ≤ 0.01). Multivariate regression analysis indicated that mental health could be the predictor of stigma. Therefore, these factors should be identified and controlled to mitigate stigma under such critical circumstances.
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Kim DM, Bang YR, Kim JH, Park JH. The Prevalence of Depression, Anxiety and Associated Factors among the General Public during COVID-19 Pandemic: a Cross-sectional Study in Korea. J Korean Med Sci 2021; 36:e214. [PMID: 34313037 PMCID: PMC8313395 DOI: 10.3346/jkms.2021.36.e214] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/19/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Since its first case confirmed on January 20, 2020, Korea has been through three waves of the COVID-19 pandemic. Fears of the fourth wave persist as new cases continue to emerge. In such unpredictable times, the mental well-being of people is of crucial importance. This study examined the levels of depression and anxiety and their predictors among the Korean general public in Busan, Korea, during the COVID-19 pandemic. METHODS We conducted a cross-sectional study via a self-reported questionnaire administered to 2,288 adult residents (aged 19-60 years) of Busan, Korea. Participants' depression and anxiety were assessed using the Korean version of the Patient Health Questionnaire-4 (PHQ-4), which consists of PHQ-2 and Generalized Anxiety Disorder-2 (GAD-2), with the cutoff score of 3. RESULTS The mean age of the participants was 39.71 years. COVID-19 had several psychosocial impacts on people. It was revealed that 80.3% had restrictions in outside activities, 47.3% reported financial difficulties, and 53.6% had a fear of death or fatal outcome when infected with COVID-19. We performed logistic regression analysis to identify the factors associated with depression and anxiety. A total of 30.7% participants were classified as at risk of depression based on cutoff score of 3 on PHQ-2. Logistic regression analysis revealed that changes in sleep pattern due to COVID-19 were most strongly associated with depression, followed by restrictions in outside activities due to social distancing and increased family conflicts due to COVID-19. Also, 22.6% participants were classified as at risk of anxiety based on a cutoff score of 3 on GAD-2. Analysis revealed that changes in sleep pattern due to COVID-19 were most strongly associated with anxiety, followed by spending a lot of time searching for COVID-19-related information and having a fear of death or fatal outcome when infected with COVID-19. CONCLUSION The results are alarming; 30.7% had a PHQ-2 score of 3 or higher, indicating depression, and 22.6% had a GAD-2 score of 3 or higher, indicating anxiety. Changes in sleep pattern had the strongest association with both depression and anxiety. Our results can be used to formulate mental health policies tailored to the context of the city. Our findings suggest the high prevalence of depression and anxiety in the society during the COVID-19 pandemic, which places growing importance on early intervention for mental health problems during these times.
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Evaluating the Interactive Effect of COVID-19 Worry and Loneliness on Mental Health Among Young Adults. COGNITIVE THERAPY AND RESEARCH 2021; 46:11-19. [PMID: 34334844 PMCID: PMC8310460 DOI: 10.1007/s10608-021-10252-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 11/01/2022]
Abstract
Background Young adults are overrepresented in terms of adverse mental health problems related to COVID-19. Emerging work has identified worry about the consequences and trajectory of COVID-19 and loneliness as important factors in mental health during the pandemic. However, the main and interactive effects of worry about COVID-19 and loneliness have not been explored in one overarching model in relation to mental health problems among young adults. Methods The present study therefore evaluated loneliness and COVID-19 related worry in terms of anxiety, stress, and depression among young adults (209 college students, 76.1% female, M age = 22.99 years, SD = 5.25) recruited to participate in an online survey study. Results Results indicated a significant interaction between COVID-19 worry and loneliness for each criterion variable (depression: b = .01, SE = .003, t = 2.86, p = .01; anxiety: b = .01, SE = .002, t = 2.36, p = .02; stress: b = .01, SE = .003, t = 2.54, p = .01), such that worry was more strongly related to each mental health outcome among those that endorsed higher levels of loneliness. Conclusion The current findings suggest loneliness is related to negative mental health symptoms among young adults experiencing COVID-19 related worry. The current findings provide initial empirical evidence for the impact of COVID-19 worry on mental health among young adults experiencing loneliness. Future research may benefit from exploring how COVID-19 worry and loneliness interplay over time.
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Chernet A, Probst-Hensch N, Sydow V, Paris DH, Labhardt ND. Mental health and resilience among Eritrean refugees at arrival and one-year post-registration in Switzerland: a cohort study. BMC Res Notes 2021; 14:281. [PMID: 34294120 PMCID: PMC8299667 DOI: 10.1186/s13104-021-05695-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 07/14/2021] [Indexed: 11/24/2022] Open
Abstract
Objective Eritrea is the most frequent country of origin among asylum seekers in Switzerland. On their journey through the desert and across the Mediterranean Sea, Eritrea refugees are often exposed to traumatizing experiences. The aim of this study is to assess the mental health status and resilience of Eritrean migrants in Switzerland upon arrival and one-year post-arrival, using standardized mental health screening and resilience assessment tools. Results At baseline, 107 refugees (11.2% female, median age 25) were interviewed: 52 (48.6%) screened positive for Post-Traumatic Stress Disorder (score ≥ 30), 10.3% for anxiety (≥ 10) and 15.0% for depression (≥ 10); 17.8% scored as risk/hazardous drinkers (≥ 8). The majority (94.4%) had a high resilience score (≥ 65). For one-year follow-up, 48 asylum seekers could be reached. In interviews 18 (38%) of these reported imprisonment in a transit country and 28 (58%) that they had witnessed the death of a close person along the migration route. At the one year assessment, rates of risky/hazardous alcohol use remained unchanged, rates of positive PTSD screening tended to be lower (50.0% (24/48) at baseline vs 25.0% (12/48) at follow-up), as were rates of positive screening for anxiety (8.3% vs 4.2%) and depression (14.6 vs 6.3%). Supplementary Information The online version contains supplementary material available at 10.1186/s13104-021-05695-5.
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543
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Wetmore JB, Chernov C, Perlman SE, Borrell LN. Associations of Health Conditions and Health-Related Determinants with Disability among New York City Adult Residents. Ethn Dis 2021; 31:445-452. [PMID: 34295132 DOI: 10.18865/ed.31.3.445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introduction Population-based disability prevalence estimates are limited for New York City (NYC). We examined the association of several health and health-related measures with disability among NYC residents aged 20-64 years. Methods We used information from 1,314 adults who participated in the 2013-2014 NYC Health and Nutrition Examination Survey (HANES). We categorized survey participants as having a disability if they reported a physical, mental, and/or emotional problem preventing work or if they reported difficulty walking without special equipment because of a health problem. We used log-binomial regression to quantify the association of each exposure with disability before and after adjustment for select covariates. Results Overall, 12.4% of the study's NYC residents aged 20-64 years had a disability. After adjustment, disability prevalence was significantly greater among those who reported having unmet health care needs (prevalence ratio [PR] = 1.75, 95% CI: 1.18-2.57) and those who reported fair/poor general health (PR = 2.33, 95% CI: 1.68-3.24). The probability of disability was greater among NYC residents with arthritis (PR = 2.66, 95% CI: 1.85-3.98) and hypertension (PR = 1.48, 95% CI: 1.04-2.11) when compared with those without these conditions. Disability was also associated with depression (PR = 2.96, 95% CI: 2.06-4.25), anxiety (PR = 2.89, 95% CI: 2.15-3.88), and post-traumatic stress disorder (PR = 2.55, 95% CI: 1.66-3.91). Disability, however, was not associated with diabetes. Conclusion Disability is more prevalent among those with unmet health care needs, fair/poor general health, arthritis, hypertension, depression, anxiety, and PTSD in these NYC residents, aged 20-64 years. These findings have implications for NYC's strategic planning initiatives, which can be better targeted to groups disproportionately affected by disability.
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544
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Yang W, Hu B. Catastrophic health expenditure and mental health in the older Chinese population: The moderating role of social health insurance. J Gerontol B Psychol Sci Soc Sci 2021; 77:160-169. [PMID: 34255044 PMCID: PMC8755894 DOI: 10.1093/geronb/gbab130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Catastrophic health expenditure (CHE) has considerable effects on household living standards, but little is known regarding the relationships between CHE and people's mental health. Using China as an example, this study examines the association between CHE and mental health and investigates whether the association differs between those with and without social health insurance (SHI). METHODS The data came from three waves of the China Health and Retirement Longitudinal Study (CHARLS 2011, 2013, and 2015, N = 13,166). We focused on older people aged 60 and above. We built panel data regression and quantile regression models to analyse the data. RESULTS Incurring CHE is significantly associated with poor mental health. The association is weakened among older people receiving SHI, which indicates that SHI has a protective effect. Moreover, the association between CHE and mental health and the protective effect of SHI are stronger among those with mild or moderate mental health problems. DISCUSSION Our findings provide empirical evidence that encourages the integration of psychologically informed approaches in health services. We also urge governments in low- and middle-income countries to consider more generous health financing mechanisms for older people with greater healthcare needs.
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545
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Hisle-Gorman E, Schvey NA, Adirim TA, Rayne AK, Susi A, Roberts TA, Klein DA. Mental Healthcare Utilization of Transgender Youth Before and After Affirming Treatment. J Sex Med 2021; 18:1444-1454. [PMID: 37057453 DOI: 10.1016/j.jsxm.2021.05.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 04/12/2021] [Accepted: 05/14/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Transgender and gender-diverse (TGD) adolescents experience increased mental health risk compared to cisgender peers. Limited research suggests improved outcomes following gender-affirmation. This study examined mental healthcare and psychotropic medication utilization among TGD youth compared to their siblings without gender-related diagnoses and explored utilization patterns following gender-affirming care. METHOD This retrospective cohort study used military healthcare data from 2010-2018 to identify mental healthcare diagnoses and visits, and psychotropic medication prescriptions among TGD youth who received care for gender dysphoria before age 18, and their siblings. Logistic and Poisson regression analyses compared mental health diagnosis, visits, and psychotropic prescriptions of TGD youth to their siblings, and compared healthcare utilization pre- and post-initiation of gender-affirming pharmaceuticals among TGD adolescents. RESULTS 3,754 TGD adolescents and 6,603 cisgender siblings were included. TGD adolescents were more likely to have a mental health diagnosis (OR 5.45, 95% CI [4.77-6.24]), use more mental healthcare services (IRR 2.22; 95% CI [2.00-2.46]), and be prescribed more psychotropic medications (IRR = 2.57; 95% CI [2.36-2.80]) compared to siblings. The most pronounced increases in mental healthcare were for adjustment, anxiety, mood, personality, psychotic disorders, and suicidal ideation/attempted suicide. The most pronounced increased in psychotropic medication were in SNRIs, sleep medications, anti-psychotics and lithium. Among 963 TGD youth (Mage: 18.2) using gender-affirming pharmaceuticals, mental healthcare did not significantly change (IRR = 1.09, 95% CI [0.95-1.25]) and psychotropic medications increased (IRR = 1.67, 95% CI [1.46-1.91]) following gender-affirming pharmaceutical initiation; older age was associated with decreased care and prescriptions. CONCLUSION Results support clinical mental health screening recommendations for TGD youth. Further research is needed to elucidate the longer-term impact of medical affirmation on mental health, including family and social factors associated with the persistence and discontinuation of mental healthcare needs among TGD youth. Hisle-Gorman E, Schvey NA, Adirim TA, et al. Mental Healthcare Utilization of Transgender Youth Before and After Affirming Treatment. J Sex Med 2021;18:1444-1454.
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546
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Roblee C, Horen SR, Hamidian Jahromi A. Commentary: Physical, Mental and Sexual Health Among Transgender Women. A Comparative Study Among Operated Transgender and Cisgender Women in a National Tertiary Referral Network. J Sex Med 2021; 18:1473-1474. [PMID: 37057452 DOI: 10.1016/j.jsxm.2021.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 06/04/2021] [Indexed: 10/20/2022]
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547
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Park JI, Baek H, Kim SW, Jeong JY, Song KH, Yu JH, Nam-Goong IS, Cho EH. Questionnaire-based Survey of Demographic and Clinical Characteristics, Health Behaviors, and Mental Health of Young Korean Adults with Early-onset Diabetes. J Korean Med Sci 2021; 36:e182. [PMID: 34227263 PMCID: PMC8258240 DOI: 10.3346/jkms.2021.36.e182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 06/03/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The incidence of early-onset diabetes is increasing among young adults. However, there are limited data on the characteristics and management of young Korean adults with diabetes. This study assessed the clinical and demographic characteristics, health behaviors, and mental health among young Korean adults with diabetes mellitus. METHODS This cross-sectional study included young Korean adults with diabetes (n = 225) with an onset age of 20-39 years from four university hospitals. Demographic characteristics, management of diabetes, and mental health were assessed using a questionnaire survey. RESULTS Type 2 diabetes was the most common type (73.3%), and 13.8% of participants were classified as other types or unknown. Approximately, 64.7% of participants had a strong family history of diabetes, and 76% had treatment within three months of diagnosis. Approximately, 11.1% of participants had diabetic complications; 39.1% of participants received insulin injections, including oral anti-diabetic medications. Additionally, 30.4% were smokers, and only 28% had active physical activity; 26.5% of participants had >3 hours of screen time. One third of participants never had breakfast, and 60.5% went out to eat at least three times a week. Half of the participants showed moderate to severe stress perception, and 21.4% of patients had moderate to severe levels of depression based on the Korean version of Beck Depression Inventory score. CONCLUSION Early-onset diabetes was associated with a strong family history and early insulin treatment. Young adults with diabetes had poor health behaviors and frequent mental depression. These findings suggest the necessity of health policies for improving health behaviors and mental distress.
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Chu AL, Hickman M, Steel N, Jones PB, Davey Smith G, Khandaker GM. Inflammation and Depression: A Public Health Perspective. Brain Behav Immun 2021; 95:1-3. [PMID: 33882327 DOI: 10.1016/j.bbi.2021.04.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/16/2021] [Accepted: 04/16/2021] [Indexed: 12/27/2022] Open
Abstract
The multifaceted role of low-grade systemic inflammation in depression and physical illnesses like cardiovascular disease highlights complex interactions between the body, brain and mind. While current research on inflammation and depression has largely focused on exploring possible disease mechanisms and therapeutic potential, we seek to broaden the current discussion by introducing a public health perspective. In this Viewpoint, we propose that inflammation and its contributing sources could represent important targets for public health strategies aimed at improving both mental and physical health. We discuss potential universal, selective and indicated primary prevention strategies for inflammation-related depression. We consider potential approaches to secondary prevention, including scope for anti-inflammatory treatment and CRP testing for guiding treatment allocation and prognosis. Preventive strategies discussed here could also be relevant for other inflammation-mediated mental health conditions.
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Sarikhani Y, Bastani P, Rafiee M, Kavosi Z, Ravangard R. Key Barriers to the Provision and Utilization of Mental Health Services in Low-and Middle-Income Countries: A Scope Study. Community Ment Health J 2021; 57:836-852. [PMID: 32285371 DOI: 10.1007/s10597-020-00619-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 04/06/2020] [Indexed: 01/28/2023]
Abstract
Inadequate attention has been given to the provision of mental health (MH) services especially in low-and middle-income countries (LMICs). This study was aimed to identify key barriers to provide and utilize MH services in LMICs. A comprehensive search on7 important online databases was conducted for key barriers to the provision and utilization MH services in LMICs from Jan 2000 to Nov 2019. Five-step Arksey and O'Malley guideline was used for scope study. The extracted data were synthesized using a qualitative content analysis and thematic network. Three main themes identified as barriers to the provision of MH services in LMICs, namely resource and administrative barriers, information and knowledge barriers, as well as policy and legislation barriers. Also attitudinal barriers, structural barriers, knowledge barriers, and treatment-related barriers were four main themes emerged regarding the challenges of utilization of MH services. Equitable access to MH services in LMICs is influenced by many barriers in both provision and utilization sides. In order to alleviate these problems, health systems could adopt some strategies including integration of MH into the general health policy, improvement of public MH awareness, developing anti-stigma programs, reallocation of health resources toward high-priority MH needs, developing community-based insurance, as well as integration of MH services into all levels of health-care systems. The success of intervention strategies depends on the weight of these barriers in different socio-economic contexts.
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550
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Evaluating a Web-Based Adult ADHD Toolkit for Primary Care Clinicians. J Am Board Fam Med 2021; 34:741-752. [PMID: 34312267 DOI: 10.3122/jabfm.2021.04.200606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/03/2021] [Accepted: 02/10/2021] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Approximately 5% of the US adult population has Attention Deficient Hyperactivity Disorder (ADHD) that can negatively impact quality of life. Health care professionals report a need to increase their knowledge of and confidence in treating adult ADHD. The American Academy of Family Physicians National Research Network (AAFP NRN) collaborated with a panel of experts to create a web-based AAFP Adult ADHD Toolkit composed of resources to aid in the diagnosis, management, and treatment of adults with ADHD. OBJECTIVES Assess the impact of using an AAFP Adult ADHD Toolkit in a practice setting. METHODS Ninety-seven primary and behavioral health care professionals from AAFP NRN practices (n=6) used the Toolkit for 17 weeks. Data on Toolkit use, usefulness, implementation, impact, and changes in knowledge and confidence were collected via pre-post and weekly surveys. Mixed methods, regression analyses, t-tests, and mixed ANOVA were used to assess change over time. RESULTS Use of the Toolkit improved health care providers' knowledge by midpoint relative to baseline in areas related to treatment effects, side effects, and outcomes (3.6 vs 3.0; P = .004); existing ADHD resources (3.3 vs 2.9; P = .03); and management of ADHD in patients with comorbid conditions (3.2 vs 2.7; P = .01). By the end of the study, Toolkit use was associated with increased confidence in mental health and life history interview techniques (3.5 vs 3.0; P = .03); treatment options for ADHD with comorbid mental health disorders (3.2 vs 2.3; P ≤ .001); and treatment options for ADHD with coexisting substance use disorders (3.0 vs 2.3; P = .003). By the end of the study, most participants (n=47, 87%) reported the Toolkit addressed most of their needs related to diagnosis, treatment, and management of adult ADHD. CONCLUSION Availability and adoption of the Toolkit into the routine care of adults with ADHD measurably increased health care professionals' knowledge especially in those providers who regularly see adult patients with ADHD.
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