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Morris R, Christianson-Barker J, Stainton T, Mills R, Rowley C, Cox J, Schroeder M, Hole R. 'They don't think I can do it': Experiences of self-advocates, employment specialists, and employers on employment of adults with intellectual disability. J Appl Res Intellect Disabil 2024; 37:e13231. [PMID: 38561915 DOI: 10.1111/jar.13231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 02/27/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND A multi-phase Canadian study was conducted as part of a large-scale community and academic research partnership focused on understanding and improving the employment experiences of people with intellectual disabilities. METHOD This multi-method study utilized a sequential approach, using findings from qualitative interviews (n = 28) to inform an online survey (n = 149). Participants were invited to share their experiences with paid employment or with persons with intellectual disabilities. RESULTS Thematic analysis of data across interview and survey findings resulted in six themes: (1) assumptions and attitudes, (2) knowledge and awareness, (3) accessibility of processes, (4) use of accommodations, (5) workplace relationships, and (6) supports and resources. CONCLUSIONS A holistic and systemic approach has the potential to improve inclusive employment experiences of people with intellectual disabilities. Action is needed mainly at the policy and employer level to reduce barriers and improve on facilitating measures reinforced by the themes shared in this study.
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Affiliation(s)
- Rae Morris
- Canadian Institute for Inclusion and Citizenship, University of British Columbia Okanagan, Kelowna, Canada
- School of Social Work, University of British Columbia, Vancouver, Canada
| | - Jennifer Christianson-Barker
- Canadian Institute for Inclusion and Citizenship, University of British Columbia Okanagan, Kelowna, Canada
- School of Graduate Studies, University of British Columbia Okanagan, Kelowna, Canada
| | - Tim Stainton
- Canadian Institute for Inclusion and Citizenship, University of British Columbia Okanagan, Kelowna, Canada
- School of Social Work, University of British Columbia, Vancouver, Canada
| | | | | | - John Cox
- People First of Canada, Winnipeg, Canada
| | | | - Rachelle Hole
- Canadian Institute for Inclusion and Citizenship, University of British Columbia Okanagan, Kelowna, Canada
- Department of Social Work, University of British Columbia Okanagan, Kelowna, Canada
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Michalak EE, Cheung IW, Willis E, Hole R, Pomeroy B, Morton E, Kanani SS, Barnes SJ. Engaging diverse patients in a diverse world: the development and preliminary evaluation of educational modules to support diversity in patient engagement research. Res Involv Engagem 2023; 9:47. [PMID: 37420307 DOI: 10.1186/s40900-023-00455-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/14/2023] [Indexed: 07/09/2023]
Abstract
BACKGROUND Current practices for engaging patients in patient-oriented research (POR) result in a narrow pool of patient perspectives being reflected in POR. This project aims to address gaps in methodological knowledge to foster diversity in POR, through the co-design and evaluation of a series of educational modules for health researchers in British Columbia, Canada. METHODS Modules were co-created by a team of academic researchers and patient partners from hardly-reached communities. The modules are presented using the Tapestry Tool, an interactive, online educational platform. Our evaluation framework focused on engagement, content quality, and predicted behavior change. The User Engagement Scale short form (UES-SF) measured participants' level of engagement with the modules. Survey evaluation items assessed the content within the modules and participants' perceptions of how the modules will impact their behavior. Evaluation items modeled on the theory of planned behavior, administered before and after viewing the modules, assessed the impact of the modules on participants' perceptions of diversity in POR. RESULTS Seventy-four health researchers evaluated the modules. Researchers' engagement and ratings of module content were high. Subjective behavioral control over fostering diversity in POR increased significantly after viewing the modules. CONCLUSIONS Our results suggest the modules may be an engaging way to provide health researchers with tools and knowledge to increase diversity in health research. Future studies are needed to investigate best practices for engaging with communities not represented in this pilot project, such as children and youth, Indigenous Peoples, and Black communities. While educational interventions represent one route to increasing diversity in POR, individual efforts must occur in tandem with high-level changes that address systemic barriers to engagement.
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Affiliation(s)
- Erin E Michalak
- Department of Psychiatry, University of British Columbia, 420-5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada.
| | - Iva W Cheung
- Department of Psychiatry, University of British Columbia, 420-5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Elsy Willis
- Department of Psychiatry, University of British Columbia, 420-5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Rachelle Hole
- School of Social Work, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Beverley Pomeroy
- Fraser Health Authority, Mental Health and Substance Use, Surrey, BC, Canada
| | - Emma Morton
- Department of Psychiatry, University of British Columbia, 420-5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Sahil S Kanani
- Department of Psychiatry, University of British Columbia, 420-5950 University Boulevard, Vancouver, BC, V6T 1Z3, Canada
| | - Steven J Barnes
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
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Hole R, Schnellert L, Cantle G. Sex: What Is the Big Deal? Exploring Individuals' with Intellectual Disabilities Experiences with Sex Education. Qual Health Res 2022; 32:453-464. [PMID: 34923868 PMCID: PMC8796054 DOI: 10.1177/10497323211057090] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
This article offers perspectives shared by self-advocates in the first phase of a community-based participatory research project untaken to address barriers that individuals with intellectual disabilities face with respect to sexual health knowledge. Using descriptive qualitative methods, we interviewed 19 individuals with intellectual disability about their experiences and knowledge related to sexual health. The research question guiding this project was: What are self-advocates' with intellectual disabilities experiences learning about sexual health and sexuality? The findings highlight that participants faced barriers and lack of access to sexual health education, and while they learned about sexual health through formal sexual health education, frequently this knowledge came through lived experience. Finally, the findings underscore that participants knew what they wanted with respect to sexual health education and offered recommendations. The importance of accessible sexual health education for self-advocates that supports their rights and desires to express their sexuality and sexual agency is highlighted.
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Affiliation(s)
- Rachelle Hole
- UBC Okanagan School of Social Work, UBC Canadian Institute for Inclusion and Citizenship, Kelowna, BC, Canada
- Rachelle Hole, UBC Canadian Institute for Inclusion and Citizenship, ARTS/FHSD 1147 Research Road, 3333 University Way, Kelowna, BC V1V 1V7, Canada.
| | | | - Gloria Cantle
- UBC Okanagan School of Social Work, UBC Canadian Institute for Inclusion and Citizenship, Kelowna, BC, Canada
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Michalak EE, Barnes SJ, Morton E, O'Brien HL, Murray G, Hole R, Meyer D. Supporting Self-Management and Quality of Life in Bipolar Disorder with the PolarUs App (Alpha): Protocol for a Mixed-Methods Study (Preprint). JMIR Res Protoc 2022; 11:e36213. [PMID: 35925666 PMCID: PMC9389375 DOI: 10.2196/36213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 04/13/2022] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Erin E Michalak
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Steven J Barnes
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Emma Morton
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Heather L O'Brien
- School of Information, University of British Columbia, Vancouver, BC, Canada
| | - Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Melbourne, BC, Canada
| | - Rachelle Hole
- Canadian Institute for Inclusion and Citizenship, University of British Columbia, Kelowna, BC, Canada
| | - Denny Meyer
- Centre for Mental Health, Swinburne University of Technology, Melbourne, BC, Canada
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Cook S, Hole R. Trauma, intellectual and/or developmental disability, and multiple, complex needs: A scoping review of the literature. Res Dev Disabil 2021; 115:103939. [PMID: 33934926 DOI: 10.1016/j.ridd.2021.103939] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/25/2021] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Trauma is a significant underlying factor in the multimorbidity of people with Intellectual and/or Development Disabilities (IDD). This relationship is further complicated by a growing recognition of a subset of multiply stigmatized individuals with an IDD and complex, intersecting health and social needs. AIM The aim of this review was to examine what is known about trauma and people with an IDD and complex needs, as defined by Community Living British Columbia's (CLBC) Multiple, Complex Needs (MCN) framework, through a broad review of relevant literature. METHOD AND PROCEDURES We conducted a scoping review of the peer-reviewed (9 disability journals; 7 academic databases) and grey (2 grey literature databases) on IDD and trauma through an inclusive approach that used search criteria drawn from the defining features of CLBC's MCN Framework. OUTCOMES AND RESULTS Apart from there being a limited amount of research on trauma and IDD, two key findings emerged. Through differing approaches that get at issues of trauma in different ways (i.e., through adverse life events or experiences of abuse), the first finding is that the research related to trauma and IDD is not cleanly linked together. The second is the focus on treatment services or interventions and not on what's happening at the organizational or system level. CONCLUSION AND IMPLICATIONS There is limited research on trauma and IDD making it even more important to unify the evidence that exists. However, the literature is not integrated across different theoretical and disciplinary perspectives. In addition, the focus of trauma-related research that is occurring is interventions at the individual versus system level. Also needed are studies that explore trauma-informed practice from an organizational or top-down perspective.
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Affiliation(s)
- Shelley Cook
- UBC Canadian Institute for Inclusion and Citizenship ARTS/FHSD, 1147 Research Road, Kelowna, BC, V1V 1V7, Canada.
| | - Rachelle Hole
- UBC Canadian Institute for Inclusion and Citizenship ARTS/FHSD, 1147 Research Road, Kelowna, BC, V1V 1V7, Canada.
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Shannon CA, Olsen LL, Hole R, Rush KL. "There's nothing here": Perspectives from rural parents promoting safe active recreation for children living with autism spectrum disorders. Res Dev Disabil 2021; 115:103998. [PMID: 34111755 DOI: 10.1016/j.ridd.2021.103998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/02/2021] [Accepted: 05/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Children with autism spectrum disorder (ASD) and their families experience challenges and barriers at multiple levels that influence their activity participation. The purpose of this study was to develop understanding about factors influencing how families can promote safe, active recreation for their children 3-12 years living with ASD across rural settings and how supports for these families can be enhanced. METHODS This qualitative study used an interpretive descriptive approach. Twelve in-depth, semi-structured interviews with parents of children with ASD were conducted. Data was analyzed thematically. RESULTS Four main themes emerged: 1) ASD specific child vulnerabilities impeding safe recreation. 2) Importance of safe outdoor spaces in rural settings for children with ASD. 3) Diverse parent strategies to address risks and needs. 4) Perceived needs for training of recreation providers. CONCLUSION Findings highlight family-centred priority issues including parental safety concerns related to elopement and risk of injury linked to environmental and outdoor hazards prominent in rural settings. Autism awareness and recreational training is needed and could incorporate collaborative development of child specific safety plans to foster inclusive opportunities. Program planners can use this information to encourage policy making to aid families' safe activity participation.
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Affiliation(s)
- Crystal A Shannon
- University of British Columbia, Okanagan, 3333 University Way, Kelowna, BC, V1V 1V7, Canada; School of Nursing, University of British Columbia, Okanagan, Canada.
| | - Lise L Olsen
- University of British Columbia, Okanagan, 3333 University Way, Kelowna, BC, V1V 1V7, Canada; Canadian Institute for Inclusion and Citizenship, 1147 Research Road, Kelowna, BC, V1V 1V7, Canada; School of Nursing, University of British Columbia, Okanagan, Canada
| | - Rachelle Hole
- University of British Columbia, Okanagan, 3333 University Way, Kelowna, BC, V1V 1V7, Canada; Canadian Institute for Inclusion and Citizenship, 1147 Research Road, Kelowna, BC, V1V 1V7, Canada; School of Social Work, University of British Columbia, Okanagan, Canada
| | - Kathy L Rush
- University of British Columbia, Okanagan, 3333 University Way, Kelowna, BC, V1V 1V7, Canada; School of Nursing, University of British Columbia, Okanagan, Canada
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Battalova A, Bulk L, Nimmon L, Hole R, Krupa T, Lee M, Mayer Y, Jarus T. "I Can Understand Where They're Coming From": How Clinicians' Disability Experiences Shape Their Interaction With Clients. Qual Health Res 2020; 30:2064-2076. [PMID: 32449447 DOI: 10.1177/1049732320922193] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Students and clinicians with disabilities are underrepresented in the academic health programs and professional clinical settings. Disability studies foregrounds the unique ways of knowing and being that clinicians with disabilities can offer. Based on a larger grounded theory study of the experiences of students and clinicians with disabilities, this article examines the role that clinicians' abilities to draw on their personal experiences of living with a disability have on their interactions with clients. The analysis of semistructured interviews with 55 students and clinicians with disabilities from different fields contributes to the development of a theory of epistemic connection. The theory is informed by the following three themes: (a) building rapport through understanding, (b) from understanding to advocacy and creative approaches, and (c) between professionalism and disability. The findings emphasize not only the importance of diversifying the health care workforce but also incorporating disability epistemology into the health care culture.
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Affiliation(s)
- Alfiya Battalova
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - Laura Bulk
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - Laura Nimmon
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - Rachelle Hole
- The University of British Columbia, Kelowna, British Columbia, Canada
| | - Terry Krupa
- Queens University, Kingston, Ontario, Canada
| | - Michael Lee
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - Yael Mayer
- The University of British Columbia, Vancouver, British Columbia, Canada
| | - Tal Jarus
- The University of British Columbia, Vancouver, British Columbia, Canada
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Morton E, Hole R, Murray G, Buzwell S, Michalak E. Experiences of a Web-Based Quality of Life Self-Monitoring Tool for Individuals With Bipolar Disorder: A Qualitative Exploration. JMIR Ment Health 2019; 6:e16121. [PMID: 31799936 PMCID: PMC6920912 DOI: 10.2196/16121] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/02/2019] [Accepted: 10/14/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Self-monitoring of symptoms is a cornerstone of psychological interventions in bipolar disorder (BD), but individuals with lived experience also value tracking holistic outcomes, such as quality of life (QoL). Importantly, self-monitoring is not always experienced positively by people with BD and may have lower than expected rates of engagement. Therefore, before progressing into QoL tracking tools, it is important to explore user perspectives to identify possible risks and benefits, optimal methods to support engagement, and possible avenues to integrate QoL self-monitoring practices into clinical work. OBJECTIVE This study aimed to conduct a qualitative exploration of how individuals with BD engaged with a Web-based version of a BD-specific QoL self-monitoring instrument, the QoL tool. METHODS A total of 43 individuals with BD engaged with a self-management intervention with an optional Web-based QoL self-assessment tool as part of an overarching mixed method study. Individuals were later interviewed about personal experiences of engagement with the intervention, including experiences of gauging their own QoL. A thematic analysis was used to identify salient aspects of the experience of QoL self-monitoring in BD. RESULTS In total, 4 categories describing people's experiences of QoL self-monitoring were identified: (1) breadth of QoL monitoring, (2) highlighting the positive, (3) connecting self-monitoring to action, and (4) self-directed patterns of use. CONCLUSIONS The findings of this research generate novel insights into ways in which individuals with BD experience the Web-based QoL self-assessment tool. The value of tracking the breadth of domains was an overarching aspect, facilitating the identification of both areas of strength and life domains in need of intervention. Importantly, monitoring QoL appeared to have an inherently therapeutic quality, through validating flourishing areas and reinforcing self-management efforts. This contrasts the evidence suggesting that symptom tracking may be distressing because of its focus on negative experiences and positions QoL as a valuable adjunctive target of observation in BD. Flexibility and personalization of use of the QoL tool were key to engagement, informing considerations for health care providers wishing to support self-monitoring and future research into Web- or mobile phone-based apps.
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Affiliation(s)
- Emma Morton
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Rachelle Hole
- School of Social Work, University of British Columbia, Okanagan, BC, Canada
| | - Greg Murray
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Simone Buzwell
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Erin Michalak
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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Jones KE, Ben-David S, Hole R. Are individuals with intellectual and developmental disabilities included in research? A review of the literature. ACTA ACUST UNITED AC 2019. [DOI: 10.1080/23297018.2019.1627571] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Katherine Elisabeth Jones
- Canadian Institute for Inclusion and Citizenship, School of Social Work, University of British Columbia, Kelowna, British Columbia, Canada
| | - Shelly Ben-David
- Canadian Institute for Inclusion and Citizenship, School of Social Work, University of British Columbia, Kelowna, British Columbia, Canada
| | - Rachelle Hole
- Canadian Institute for Inclusion and Citizenship, School of Social Work, University of British Columbia, Kelowna, British Columbia, Canada
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Moeini S, Rasmussen JV, Salomonsson B, Domeij-Arverud E, Fenstad AM, Hole R, Jensen SL, Brorson S. Reverse shoulder arthroplasty has a higher risk of revision due to infection than anatomical shoulder arthroplasty. Bone Joint J 2019; 101-B:702-707. [DOI: 10.1302/0301-620x.101b6.bjj-2018-1348.r1] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Aims The aim of this study was to use national registry database information to estimate cumulative rates and relative risk of revision due to infection after reverse shoulder arthroplasty. Patients and Methods We included 17 730 primary shoulder arthroplasties recorded between 2004 and 2013 in The Nordic Arthroplasty Register Association (NARA) data set. With the Kaplan–Meier method, we illustrated the ten-year cumulative rates of revision due to infection and with the Cox regression model, we reported the hazard ratios as a measure of the relative risk of revision due to infection. Results In all, 188 revisions were reported due to infection during a mean follow-up of three years and nine months. The ten-year cumulative rate of revision due to infection was 1.4% overall, but 3.1% for reverse shoulder arthroplasties and 8.0% for reverse shoulder arthroplasties in men. Reverse shoulder arthroplasties were associated with an increased risk of revision due to infection also when adjusted for sex, age, primary diagnosis, and year of surgery (relative risk 2.41 (95% confidence interval 1.26 to 5.59); p = 0.001). Conclusion The overall incidence of revision due to infection was low. The increased risk in reverse shoulder arthroplasty must be borne in mind, especially when offering it to men. Cite this article: Bone Joint J 2019;101-B:702–707.
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Affiliation(s)
- S. Moeini
- Department of Orthopaedic Surgery, Zealand University Hospital, Department of Clinical Medicine, University of Copenhagen, Koege, Denmark
| | - J. V. Rasmussen
- Department of Orthopaedic Surgery, Herlev and Gentofte University Hospital, Department of Clinical Medicine, University of Copenhagen, Herlev, Denmark
| | - B. Salomonsson
- Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden
| | - E. Domeij-Arverud
- Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden
| | - A. M. Fenstad
- Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway
| | - R. Hole
- Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway
| | - S. L. Jensen
- Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark
| | - S. Brorson
- Department of Orthopaedic Surgery, Zealand University Hospital, Department of Clinical Medicine, University of Copenhagen, Koege, Denmark
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Schnellert L, Richardson P, Roberts E, McDonald S, MacHardy C, Rosal A, Smith J, Rader M, Frisque J, Hole R. Enacting Equity in Higher Education through Critical Disability Studies: A Critical Community Self-Study. DSQ 2019. [DOI: 10.18061/dsq.v39i2.6150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
In this critical community self-study, we describe the development of the Interdisciplinary Disability and Inclusion Research Collaborative (IDIRC) at the University of British Columbia Okanagan. IDIRC is a self-organizing collective involving eleven faculty, students and staff devoted to Critical Disability Studies (CDS) and the relationships between CDS, practice and social change. We ask: What are the social relations, commitments, activities, and research needs of this university's researchers, students and staff in relation to disability and inclusion? Through a constant comparative analysis of interview data we surfaced themes related to the social relations, commitments, activities and research needs of our members. Our findings and discussion illustrate how similar cross-disciplinary groups might build inclusive spaces, which unite staff, graduate students and faculty towards disrupting normativity, interdisciplinarity, and praxis within and beyond academia. IDIRC attends to the embodiment of values and theoretical perspectives that are relational, diversity-positive, intersectional and advocacy-oriented.
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Michalak EE, Morton E, Barnes SJ, Hole R, Murray G. Supporting Self-Management in Bipolar Disorder: Mixed-Methods Knowledge Translation Study. JMIR Ment Health 2019; 6:e13493. [PMID: 30985287 PMCID: PMC6487350 DOI: 10.2196/13493] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 02/19/2019] [Accepted: 02/22/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Self-management is increasingly recognized as an important method through which individuals with bipolar disorder (BD) may cope with symptoms and improve quality of life. Digital health technologies have strong potential as a method to support the application of evidence-informed self-management strategies in BD. Little is known, however, about how to most effectively maximize user engagement with digital platforms. OBJECTIVE The aims of this study were (1) to create an innovative Web-based Bipolar Wellness Centre, (2) to conduct a mixed-methods (ie, quantitative and qualitative) evaluation to assess the impact of different sorts of engagement (ie, knowledge translation [KT]), and (3) to support engagement with the self-management information in the Bipolar Wellness Centre. METHODS The project was implemented in 2 phases. In phase 1, community-based participatory research and user-centered design methods were used to develop a website (Bipolar Wellness Centre) housing evidence-informed tools and strategies for self-management of BD. In phase 2, a mixed-methods evaluation was conducted to explore the potential impact of 4 KT strategies (Web-based webinars, Web-based videos, Web-based one-to-one Living Library peer support, and in-person workshops). Quantitative assessments occurred at 2 time points-preintervention and 3 weeks postintervention. Purposive sampling was used to recruit a subsample of participants for the qualitative interviews, ensuring each KT modality was represented, and interviews occurred approximately 3 weeks postintervention. RESULTS A total of 94 participants were included in the quantitative analysis. Responses to evaluative questions about engagement were broadly positive. When averaged across the 4 KT strategies, significant improvements were observed on the Bipolar Recovery Questionnaire (F1,77=5.887; P=.02) and Quality of Life in Bipolar Disorder (F1,77=8.212; P=.005). Nonsignificant improvements in positive affect and negative affect were also observed. The sole difference that emerged between KT strategies related to the Chronic Disease Self-Efficacy measure, which decreased after participation in the webinar and video arms but increased after the Living Library and workshop arms. A subsample of 43 participants was included in the qualitative analyses, with the majority of participants describing positive experiences with the 4 KT strategies; peer contact was emphasized as a benefit across all strategies. Infrequent negative experiences were reported in relation to the webinar and video strategies, and included technical difficulties, the academic tone of webinars, and feeling unable to relate to the actor in the videos. CONCLUSIONS This study adds incremental evidence to a growing literature that suggests digital health technologies can provide effective support for self-management for people with BD. The finding that KT strategies could differentially impact chronic disease self-efficacy (hypothesized as being a product of differences in degree of peer contact) warrants further exploration. Implications of the findings for the development of evidence-informed apps for BD are discussed in this paper.
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Affiliation(s)
- Erin E Michalak
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Emma Morton
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Steven J Barnes
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Rachelle Hole
- School of Social Work, University of British Columbia, Okanagan, BC, Canada
| | | | - Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
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Baumbusch J, Moody E, Hole R, Jokinen N, Stainton T. Using Healthcare Services: Perspectives of Community-Dwelling Aging Adults With Intellectual Disabilities and Family Members. Journal of Policy and Practice in Intellectual Disabilities 2018. [DOI: 10.1111/jppi.12264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Elaine Moody
- Schools of Nursing and Occupational Therapy; Dalhousie University; Halifax Nova Scotia Canada
| | - Rachelle Hole
- UBC School of Social Work; Kelowna British Columbia Canada
| | - Nancy Jokinen
- UBC School of Social Work; Kelowna British Columbia Canada
- University of Northern British Columbia; Prince George British Columbia Canada
| | - Tim Stainton
- UBC School of Social Work; Kelowna British Columbia Canada
- University of British Columbia; Vancouver British Columbia Canada
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Rasmussen JV, Hole R, Metlie T, Brorson S, Äärimaa V, Demir Y, Salomonsson B, Jensen SL. Anatomical total shoulder arthroplasty used for glenohumeral osteoarthritis has higher survival rates than hemiarthroplasty: a Nordic registry-based study. Osteoarthritis Cartilage 2018; 26:659-665. [PMID: 29474992 DOI: 10.1016/j.joca.2018.02.896] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 02/07/2018] [Accepted: 02/12/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To report the10-year survival rates of different shoulder arthroplasty types used for glenohumeral osteoarthritis. DESIGN Data from 2004 to 2013 was prospectively collected by the national shoulder arthroplasty registers in Denmark, Norway and Sweden and merged into a harmonized dataset under the umbrella of the Nordic Arthroplasty Register Association. The common dataset included data that all three registers could deliver and where consensus regarding definitions could be made. Revision was defined as removal or exchange of any component or the addition of a glenoid component. RESULTS The cumulative survival rates at 10 years after resurfacing hemiarthroplasty (RHA) (n = 1,923), stemmed hemiarthroplasty (SHA) (n = 1,587) and anatomical total shoulder arthroplasty (TSA) (n = 2,340) were 0.85, 0.93 and 0.96 respectively (P < 0.001, Log rank test). RHA (HR: 2.5; CI 1.9-3.4, P < 0.001) and SHA (HR: 1.4; CI 1.0-2.0, P < 0.04) had an increased risk of revision compared to TSA. Gender, age and period of surgery were included in the Cox regression model. For patients below 55 years, the 10-year cumulative survival rates were 0.75 (RHA, n = 354), 0.81 (SHA, n = 146), and 0.87 (TSA, n = 201). CONCLUSIONS Anatomical TSA had the highest implant-survival rate. Young patients had, independently of the arthroplasty type, lower implant-survival rates. The treatment of young patients with end-stage osteoarthritis remains a challenge.
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Affiliation(s)
- J V Rasmussen
- Department of Orthopaedic Surgery, Herlev Hospital, Department of Clinical Medicine, University of Copenhagen, Denmark.
| | - R Hole
- Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway.
| | - T Metlie
- Norwegian Arthroplasty Register, Department of Orthopaedic Surgery, Haukeland University Hospital, Bergen, Norway.
| | - S Brorson
- Department of Orthopaedic Surgery, Zealand University Hospital, Department of Clinical Medicine, University of Copenhagen, Denmark.
| | - V Äärimaa
- Departments of Orthopaedics and Traumatology, Turku University and University Hospital, Turku, Finland.
| | - Y Demir
- Department of Orthopedics, Karolinska Institutet, Danderyds Sjukhus AB, Danderyd, Stockholm, Sweden.
| | - B Salomonsson
- Department of Orthopedics, Karolinska Institutet, Danderyds Sjukhus AB, Danderyd, Stockholm, Sweden.
| | - S L Jensen
- Department of Orthopaedic Surgery, Aalborg University Hospital, Aalborg, Denmark.
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Morton E, Michalak EE, Hole R, Buzwell S, Murray G. 'Taking back the reins' - A qualitative study of the meaning and experience of self-management in bipolar disorder. J Affect Disord 2018; 228:160-165. [PMID: 29248822 DOI: 10.1016/j.jad.2017.12.018] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 11/12/2017] [Accepted: 12/06/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Self-management (SM) is increasingly emphasised as a key aspect of bipolar disorder (BD) treatment. However, little is known about the subjective experience of SM, which might have both positive and negative impacts. The present study aimed to advance this literature through qualitative investigation of the experiences of people with BD who participated in an SM intervention targeting quality of life (QoL). METHODS Forty-three individuals with BD engaged with an SM intervention and were later questioned about personal experiences of engagement with the intervention, including attempts to enact self-management strategies. Thematic analysis was used to identify important aspects of the experience of SM in BD. RESULTS Four themes describing people's experiences of SM were identified: 1) SM for BD is empowering, 2) individual responsibility to self-manage BD, 3) SM strategies lack power to control BD, and 4) the relationship of SM to the healthcare system. LIMITATIONS Potential limitations to generalisability may occur from self-selection bias in favour of SM and the QoL-focused nature of the present intervention. CONCLUSIONS The findings of this research generate novel insights into ways in which individuals with BD engage with SM interventions. For most people with BD, SM invokes a sense of empowerment and responsibility, although some feel symptoms remain beyond their control. A sense of partnership between consumers and clinicians may emerge from attention to SM, but traditional medical approaches were perceived as neglecting this aspect of care. Considerations from consumer perspectives are presented to assist clinicians and researchers utilising SM interventions in BD.
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Affiliation(s)
- Emma Morton
- Department of Psychological Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
| | - Erin E Michalak
- Division of Mood Disorders, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Rachelle Hole
- School of Social Work, University of British Columbia, Okanagan, BC, Canada
| | - Simone Buzwell
- Department of Psychological Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
| | - Greg Murray
- Department of Psychological Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia.
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Morton E, Michalak E, Hole R, Buzwell S, Murray G. The ‘new normal’: relativity of quality of life judgments in individuals with bipolar disorder—a qualitative study. Qual Life Res 2018; 27:1493-1500. [DOI: 10.1007/s11136-018-1811-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2018] [Indexed: 10/18/2022]
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Cornelissen E, Mitton C, Davidson A, Reid C, Hole R, Visockas AM, Smith N. Fit for purpose? Introducing a rational priority setting approach into a community care setting. J Health Organ Manag 2017; 30:690-710. [PMID: 27296887 DOI: 10.1108/jhom-05-2013-0103] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose - Program budgeting and marginal analysis (PBMA) is a priority setting approach that assists decision makers with allocating resources. Previous PBMA work establishes its efficacy and indicates that contextual factors complicate priority setting, which can hamper PBMA effectiveness. The purpose of this paper is to gain qualitative insight into PBMA effectiveness. Design/methodology/approach - A Canadian case study of PBMA implementation. Data consist of decision-maker interviews pre (n=20), post year-1 (n=12) and post year-2 (n=9) of PBMA to examine perceptions of baseline priority setting practice vis-à-vis desired practice, and perceptions of PBMA usability and acceptability. Findings - Fit emerged as a key theme in determining PBMA effectiveness. Fit herein refers to being of suitable quality and form to meet the intended purposes and needs of the end-users, and includes desirability, acceptability, and usability dimensions. Results confirm decision-maker desire for rational approaches like PBMA. However, most participants indicated that the timing of the exercise and the form in which PBMA was applied were not well-suited for this case study. Participant acceptance of and buy-in to PBMA changed during the study: a leadership change, limited organizational commitment, and concerns with organizational capacity were key barriers to PBMA adoption and thereby effectiveness. Practical implications - These findings suggest that a potential way-forward includes adding a contextual readiness/capacity assessment stage to PBMA, recognizing organizational complexity, and considering incremental adoption of PBMA's approach. Originality/value - These insights help us to better understand and work with priority setting conditions to advance evidence-informed decision making.
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Affiliation(s)
- Evelyn Cornelissen
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, Canada AND Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, Canada
| | - Craig Mitton
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, Canada and School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Alan Davidson
- Faculty of Health and Social Development, University of British Columbia - Okanagan, Kelowna, Canada
| | - Colin Reid
- Faculty of Health and Social Development, University of British Columbia - Okanagan, Kelowna, Canada
| | - Rachelle Hole
- Faculty of Health and Social Development, University of British Columbia - Okanagan, Kelowna, Canada
| | | | - Neale Smith
- Centre for Clinical Epidemiology & Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, Vancouver, Canada
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Abstract
Bipolar disorder (BD) has been related to heightened creativity, yet core questions remain unaddressed about this association. We used qualitative methods to investigate how highly creative individuals with BD understand the role of symptoms and treatment in their creativity, and possible mechanisms underpinning this link. Twenty-two individuals self-identified as highly creative and living with BD took part in focus groups and completed quantitative measures of symptoms, quality of life (QoL), and creativity. Using thematic analysis, five themes emerged: the pros and cons of mania for creativity, benefits of altered thinking, the relationship between creativity and medication, creativity as central to one's identity, and creativity's importance in stigma reduction and treatment. Despite reliance on a small sample who self-identified as having BD, findings shed light on previously mixed results regarding the influence of mania and treatment and suggest new directions for the study of mechanisms driving the creative advantage in BD.
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Affiliation(s)
| | | | - Greg Murray
- Swinburne University of Technology, Hawthorn, Australia
| | - Rachelle Hole
- University of British Columbia, Okanagan, British Columbia, Canada
| | - Steven J Barnes
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Erin E Michalak
- University of British Columbia, Vancouver, British Columbia, Canada
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Hole R, Robinson CA, Stainton T, Lige S, Crawford C. Home Sharing and People With Intellectual Disabilities: A Qualitative Exploration. Journal of Policy and Practice in Intellectual Disabilities 2015. [DOI: 10.1111/jppi.12138] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Tim Stainton
- University of British Columbia; Vancouver BC Canada
| | - Sara Lige
- University of British Columbia; Kelowna BC Canada
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Romyn A, Rush KL, Hole R. Vascular Access Transition: Experiences of Patients on Hemodialysis. Nephrol Nurs J 2015; 42:445-454. [PMID: 26591269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
An interpretive descriptive design was used to explore the experiences of patients on hemodialysis who had utilized and transitioned from a central venous catheter (CVC) to an arteriovenous fistula (AVF). Eleven patients participated in semi-structured interviews that were analyzed using constant comparison. Within the larger context of living with end stage renal disease, participants described their vascular access experiences according to three main themes: impact, coping, and influencing factors. Accesses had physical, psychosocial, and lifestyle-related impacts that participants coped with primarily by exercising control and gradually accepting, and were influenced by education, trust in healthcare providers, and family. Findings revealed a cumulative burden for many participants with AVF and the need to improve the patient experience of vascular accesses especially for those living in rural communities.
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Michalak EE, Lane K, Hole R, Barnes SJ, Khatri N, Lapsley S, Maxwell V, Milev R, Parikh SV, Berk L, Berk M, Tse S, Murray G, Algorta GP, Lobban F, Jones S, Johnson SL. Towards a Better Future for Canadians with Bipolar Disorder: Principles and Implementation of a Community-Based Participatory Research Model. ACTA ACUST UNITED AC 2015. [DOI: 10.15402/esj.2015.1.a08] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Michalak EE, Lane K, Hole R, Barnes SJ, Khatri N, Lapsley S, Maxwell V, Milev R, Parikh SV, Berk L, Berk M, Tse S, Murray G, Algorta GP, Lobban F, Jones S, Johnson SL. Towards a Better Future for Canadians with Bipolar Disorder: Principles and Implementation of a Community-Based Participatory Research Model. ACTA ACUST UNITED AC 2015. [DOI: 10.15402/esj.v1i1.41] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The Collaborative RESearch Team to study psychosocial factors in bipolar disorder (CREST.BD) is a multidisciplinary network dedicated to advancing science and practice around psychosocial issues associated with bipolar disorder (BD), improving the care and wellness of people living with bipolar disorder, and strengthening services and supports for these individuals. CREST.BD specializes in community-based participatory research, in which research is conducted as a partnership between researchers and community members. This article describes the evolution of the CREST.BD network and CREST.BD’s commitment to community-based participatory research in bipolar disorder research. Examples of CREST.BD projects using community-based participatory research to study stigma, quality of life, psychosocial interventions, and creativity in bipolar disorder are highlighted, and opportunities and challenges of engaging in community-based participatory research in bipolar disorder specifically and the mental health field more broadly are discussed. This article demonstrates how CBPR can be used to enhance the relevance of research practices and products through community engagement, and how community-based participatory research can enrich knowledge exchange and mobilization.Â
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23
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Rush KL, Kjorven M, Hole R. Older Adults’ Risk Practices From Hospital to Home: A Discourse Analysis. GERONT 2014; 56:494-503. [DOI: 10.1093/geront/gnu092] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 08/30/2014] [Indexed: 11/12/2022] Open
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Cornelissen E, Mitton C, Davidson A, Reid C, Hole R, Visockas AM, Smith N. Determining and broadening the definition of impact from implementing a rational priority setting approach in a healthcare organization. Soc Sci Med 2014; 114:1-9. [PMID: 24887012 DOI: 10.1016/j.socscimed.2014.05.027] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 04/09/2014] [Accepted: 05/19/2014] [Indexed: 11/16/2022]
Abstract
Techniques to manage scarce healthcare resources continue to evolve in response to changing, growing and competing demands. Yet there is no standard definition in the priority setting literature of what might constitute the desired impact or success of resource management activities. In this 2006-09 study, using action research methodology, we determined the impact of implementing a formal priority setting model, Program Budgeting and Marginal Analysis (PBMA), in a Canadian health authority. Qualitative data were collected through post year-1 (n = 12) and year-2 (n = 9) participant interviews, meeting observation and document review. Interviews were analyzed using a constant comparison technique to identify major themes. Impact can be defined as effects at three levels: system, group, and individual. System-level impact can be seen in the actual selection of priorities and resource re-allocation. In this case, participants prioritized a list of $760,000 worth of investment proposals and $38,000 of disinvestment proposals; however, there was no clear evidence as to whether financial resources were reallocated as a result. Group and individual impacts, less frequently reported in the literature, included changes in priority setting knowledge, attitudes and practice. PBMA impacts at these three levels were found to be interrelated. This work argues in favor of attempts to expand the definition of priority setting success by including both desired system-level outcomes like resource re-allocation and individual or group level impacts like changes to priority setting knowledge, attitudes and practice. These latter impacts are worth pursuing as they appear to be intrinsic to successful system-wide priority setting. A broader definition of PBMA impact may also suggest conceptualizing PBMA as both a priority setting approach and as a tool to develop individual and group priority setting knowledge and practice. These results should be of interest to researchers and decision makers using or considering a formal priority setting approach to manage scarce healthcare resources.
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Affiliation(s)
- Evelyn Cornelissen
- Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, 7th Floor, 828 West 10th Ave., Research Pavilion, Vancouver, British Columbia, Canada V5Z 1M9.
| | - Craig Mitton
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, 7th Floor, 828 West 10th Ave., Research Pavilion, Vancouver, British Columbia, Canada V5Z 1M9; School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Alan Davidson
- Faculty of Health and Social Development, University of British Columbia - Okanagan, 3333 University Way, Kelowna, British Columbia, Canada V1V 1V7.
| | - Colin Reid
- Faculty of Health and Social Development, University of British Columbia - Okanagan, 3333 University Way, Kelowna, British Columbia, Canada V1V 1V7.
| | - Rachelle Hole
- Faculty of Health and Social Development, University of British Columbia - Okanagan, 3333 University Way, Kelowna, British Columbia, Canada V1V 1V7.
| | - Anne-Marie Visockas
- Alberta Health Services, #2523, 10101 Southport Road SW, Calgary, Alberta, Canada T2W 3N2.
| | - Neale Smith
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, University of British Columbia, 7th Floor, 828 West 10th Ave., Research Pavilion, Vancouver, British Columbia, Canada V5Z 1M9.
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Michalak EE, Livingston JD, Maxwell V, Hole R, Hawke LD, Parikh SV. Using theatre to address mental illness stigma: a knowledge translation study in bipolar disorder. Int J Bipolar Disord 2014; 2:1. [PMID: 25505692 PMCID: PMC4215813 DOI: 10.1186/2194-7511-2-1] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Accepted: 12/12/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Reduction of the stigma of mental illness is an international priority; arts- and contact-based approaches represent a promising mode of intervention. This project was designed to explore the impact of a one-woman theatrical performance on attitudes towards bipolar disorder (BD) on people with BD and healthcare providers. METHODS A playwright and actress who lives with BD developed a stage performance - 'That's Just Crazy Talk' - targeting stigmatizing attitudes towards BD. Prospective, longitudinal and sequential mixed methods were used to assess the impact of the performance on people with BD (n = 80) and healthcare providers (n = 84). Qualitative interviews were conducted with 33 participants (14 people with BD and 19 healthcare providers). RESULTS AND DISCUSSION Quantitatively, healthcare providers showed significantly improved attitudes immediately post-performance, but this change was not maintained over time; people with BD showed little quantitative change. Qualitatively, both people with BD and BD healthcare providers showed enduring and broadly positive changes. A theatrical presentation designed to reduce stigma produced immediate impact on healthcare providers quantitatively and significant qualitative impact on people with BD and healthcare providers. Additionally, the utility of using mixed-method approaches in mental health research was demonstrated.
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Affiliation(s)
- Erin E Michalak
- Division of Mood Disorders, Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, V6T 2A1 Canada
| | - James D Livingston
- Saint Mary's University, 923 Robie St, Halifax, Nova Scotia B3H 3C3 Canada
| | - Victoria Maxwell
- Crazy for Life Co., P.O. Box 1354, Sechelt, British Columbia V0N 3A0 Canada
| | - Rachelle Hole
- School of Social Work, University of British Columbia, ARTS Bldg, 3333 University Way, Kelowna, British Columbia V1V 1V7 Canada
| | - Lisa D Hawke
- Université de Saint-Boniface, 200 Avenue de la Cathedrale, Winnipeg, MB R2H 0H7 Canada
| | - Sagar V Parikh
- University of Toronto, 399 Bathurst Street, Toronto, Ontario M5T 2S8 Canada ; University Health Network, 190 Elizabeth Street, Toronto, Ontario M5G 2C4 Canada
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Wallace BB, MacEntee MI, Harrison R, Hole R, Mitton C. Community dental clinics: providers' perspectives. Community Dent Oral Epidemiol 2012; 41:193-203. [DOI: 10.1111/cdoe.12012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Accepted: 09/06/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Bruce B. Wallace
- Faculty of Dentistry; University of British Columbia; Vancouver; BC; Canada
| | | | - Rosamund Harrison
- Faculty of Dentistry; University of British Columbia; Vancouver; BC; Canada
| | - Rachelle Hole
- School of Social Work; University of British Columbia - Okanagan; Kelowna, BC; Canada
| | - Craig Mitton
- Centre for Clinical Epidemiology and Evaluation; Vancouver Coastal Health; Research Institute School of Population and Public Health; University of British Columbia; Vancouver; BC; Canada
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Michalak EE, Hole R, Livingston JD, Murray G, Parikh SV, Lapsley S, McBride S. Improving care and wellness in bipolar disorder: origins, evolution and future directions of a collaborative knowledge exchange network. Int J Ment Health Syst 2012; 6:16. [PMID: 22963889 PMCID: PMC3549769 DOI: 10.1186/1752-4458-6-16] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Accepted: 08/04/2012] [Indexed: 12/22/2022] Open
Abstract
The Collaborative RESearch team to study psychosocial factors in bipolar disorder (CREST.BD) is a multidisciplinary, cross-sectoral network dedicated to both fundamental research and knowledge exchange on bipolar disorder (BD). The core mission of the network is to advance the science and understanding of psychological and social issues associated with BD, improve the care and wellness of people living with BD, and strengthen services and supports for these individuals. CREST.BD bridges traditional and newer research approaches, particularly embracing community-based participatory research (CBPR) methods. Membership of CREST is broad, including academic researchers, people with BD, their family members and supports, and a variety of health care providers. Here, we describe the origins, evolution, approach to planning and evaluation and future vision for our network within the landscape of CBPR and integrated knowledge translation (KT), and explore the keys and challenges to success we have encountered working within this framework.
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Affiliation(s)
- Erin E Michalak
- Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada.
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Michalak EE, Hole R, Holmes C, Velyvis V, Austin J, Pesut B, Hou S. Implications for Psychiatric Care of the Word ‘Recovery’ in People with Bipolar Disorder. Psychiatr Ann 2012. [DOI: 10.3928/00485713-20120507-04] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Michalak E, Livingston JD, Hole R, Suto M, Hale S, Haddock C. 'It's something that I manage but it is not who I am': reflections on internalized stigma in individuals with bipolar disorder. Chronic Illn 2011; 7:209-24. [PMID: 21357643 DOI: 10.1177/1742395310395959] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Bipolar disorder (BD) is a complex chronic condition associated with substantial costs, both at a personal and societal level. Growing research indicates that experiences with stigma may play a significant role in contributing to the distress, disability, and poor quality of life (QoL) often experienced in people with BD. Here, we present a sub-set of findings from a qualitative study of self-management strategies utilized by high functioning Canadian individuals with BD. Specifically, we describe a theme relating to participants' experiences and understandings of internalized stigma. Descriptive qualitative methods were used including purposeful sampling and thematic analysis. High functioning individuals with BD type I or II (N = 32) completed quantitative scales to assess symptoms, functioning and QoL, and participated in an individual interview or focus group to discuss the self-management strategies that they use to maintain or regain wellness. Thematic analysis identified several themes, including one relating to internalized stigma. Within this, four additional themes were identified: stigma expectations and experiences, sense of self/identity, judicious disclosure, and moving beyond internalised stigma. One of the more unique aspects of the study is that it involves a participant sample that is managing well with their illness, which differs from the norm in biomedical research that typically focuses on pathology, problems and dysfunction.
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Affiliation(s)
- Erin Michalak
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
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Stainton T, Brown J, Crawford C, Hole R, Charles G. Comparison of community residential supports on measures of information & planning; access to & delivery of supports; choice & control; community connections; satisfaction; and, overall perception of outcomes. J Intellect Disabil Res 2011; 55:732-745. [PMID: 21241396 DOI: 10.1111/j.1365-2788.2010.01378.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND This paper reports on some of the findings of a large-scale survey (n = 852) of family members and support staff of adults with intellectual disabilities receiving community living services in British Columbia, Canada, concentrating on comparison of outcomes across four types of community residential settings: group homes, family model homes, independent home or apartment, and family home. METHOD Comparisons were conducted on six domains: information and planning; access to and delivery of supports; choice and control; community connections; satisfaction; and, overall perception of outcomes. Where applicable, further multivariate analyses were undertaken to determine the effect of the degree of help required by the residents and the respondent type. RESULTS Findings indicate that on all measures other than choice and control, group homes and family model homes showed better outcomes than either independent settings or family homes. CONCLUSION The findings may indicate that the move to more independent living settings is not being accompanied by appropriate supports.
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Affiliation(s)
- T Stainton
- Centre for Inclusion and Citizenship, University of British Columbia, Vancouver, BC, Canada.
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Abstract
A discursive exploration of the practices that shape and discipline nurses' responses to postoperative delirium Although delirium is classified as a medical emergency, it is often not treated as such by health care providers. The aim of this study was to critically examine, through a poststructural, Foucauldian concept of discourse, the language practices and discourses that shape and discipline nurses' care of older adults with postoperative delirium (POD) with a purpose to question accepted nursing practice. The study was based on data collected from face-to-face, in-depth, personal interviews with six nurses who work on an acute postoperative patient care unit. Five analytic readings of the data identified two prominent discourses at work in nursing practice which influenced the care of patients with POD. These were identified as discourses of legitimacy/illegitimacy and discourses of nursing work. Through the process of poststructural analysis it became evident that one overriding discourse - the biomedical/scientific discourse - served to direct, legitimize and govern all other discourses. The findings of this study have implications for nursing knowledge and practice, length of hospital stay and improved patient outcomes. This study builds on previous work and is the first study to conduct a discourse analysis illuminating nurses' responses to POD through comparison with other acute medical emergencies from a poststructural perspective.
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Affiliation(s)
- Mary Kjorven
- Interior Health, Kelowna, British Columbia University of British Columbia, Okanagan, Canada.
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Murray G, Suto M, Hole R, Hale S, Amari E, Michalak EE. Self-management strategies used by 'high functioning' individuals with bipolar disorder: from research to clinical practice. Clin Psychol Psychother 2010; 18:95-109. [PMID: 20572206 DOI: 10.1002/cpp.710] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Bipolar disorder (BD) is a complex mental illness that results in substantial costs, both at a personal and societal level. Research into BD has been driven by a strongly medical model conception, with a focus upon pathology and dysfunction. Little research to date has focused upon strategies used to maintain or regain wellness in BD. Here, we present results from a qualitative study of self-management strategies used by a Canadian sample of 'high-functioning' individuals with BD. The aims of the present paper are two-fold: (1) To provide a description of the self-management strategies identified as effective by this sample of high functioning individuals and 2) to explore these results from a clinical perspective. METHODS High functioning (determined as a score of either 1 or 2 on the objectively-rated Multidimensional Scale of Independent Functioning) individuals with BD type I or II (N = 33) completed quantitative scales to assess depression, mania, psychosocial functioning and quality of life, and underwent either an individual interview or focus group about the self-management strategies they used to maintain or regain wellness. RESULTS The specific self-management strategies that individuals enacted are contained within the following categories: (1) sleep, diet, rest and exercise; (2) ongoing monitoring; (3) reflective and meditative practices; (4) understanding BD and educating others; (5) connecting to others and (6) enacting a plan. These strategies are discussed in the context of current treatment interventions and research findings, offering clinicians a broad range of potential techniques or tools to assist with their efforts to support individuals with BD in maintaining or regaining wellness. CONCLUSIONS The strategies adopted by a sample of people coping well with their BD show remarkable overlap with the targets of existing adjunctive psychosocial interventions for BD. The clinician can use this information to motivate clients to engage with such strategies. The present findings also serve to remind the clinician of significant individual differences in the personal meaning and concrete application of superficially similar strategies.
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Affiliation(s)
- Greg Murray
- Faculty of Life and Social Sciences, Swinburne University of Technology, Melbourne, Australia
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Abstract
Social relations to therapists and other patients in treatment are important for positive and negative experiences among patients with substance addiction. * Improvements in mental health and substance use were considered as the more important areas of recovery among these patients. * One of the core reasons for premature dropout could be a failure to establish positive social relations and temptations to relapse to substance use. Abstract Research concerning patients with substance addiction and how they perceive their treatment remains scant. The objective of this study was therefore to examine positive and negative perceptions of treatment and recovery from the perspectives of these patients. Data were collected with semi-structured interviews among seven patients who completed treatment and six patients who prematurely dropped out from their programme (n= 13). Patients were strategically sampled from five inpatient facilities and one outpatient opioid maintenance treatment clinic located in two Norwegian counties. All interviews were transcribed and thereafter analysed with contextual content analysis aided by the qsr nvivo 8.0 software. This was carried out to obtain information about the manifest positive and negative content in the interviews. The results showed that the therapeutic alliance and mutual influences among patients were important for perceptions of treatment. Frequent staff turnover also related to these perceptions. The more important domains of recovery were psychosocial functioning and substance use. The implications of the results were discussed in relation to clinical practice and further research.
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Affiliation(s)
- T Nordfjaern
- Research Scientist, The Drug and Alcohol Treatment in Central Norway, Strandveien 1, Stjørdalen, Norway.
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Hole R. Requests for vasectomy: counselling and consent. J R Soc Med 2001; 94:657. [PMID: 11733606 PMCID: PMC1282320 DOI: 10.1177/014107680109401227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Waal H, Krook AL, Welle-Strand G, Espegren O, Hole R, Lazaridis KB, Sandvold M, Moen S, Høiseth T. [A national model for drug-supported rehabilitation of opiate addicts]. Tidsskr Nor Laegeforen 2001; 121:2301-5. [PMID: 11571885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Affiliation(s)
- H Waal
- Senter for medikamentassistert rehabilitering i Oslo Seksjon for kliniske rusmiddelproblemer Kirkeveien 166 0407 Oslo.
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Hole R. Advance directives. Three questions should be asked. BMJ 2000; 321:705. [PMID: 11202939 PMCID: PMC1118573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
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Hole R. Euthanasia in the Netherlands. J R Soc Med 1999; 92:546. [PMID: 10692915 PMCID: PMC1297410 DOI: 10.1177/014107689909201026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Hole R. The aftermath of the Bristol case. Series of operations with low mortality may exhibit high average mortality by chance. BMJ 1998; 317:812-3. [PMID: 9786665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
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Willis JAR, McKinstry B, Tomlin PJ, Dawson R, Gray AJ, Hole R, Egan J, Lee D, Fisher P, Geller RJ, Gardiner K, Pemberton PJ, Ramsay J, Briley D, Nicholson R, Banerjee AK, Webb B, Gainsborough N, Kerrison S, Lloyd-Mostyn RH, Ashley-Miller M, Elwyn GJ, Lewis M. The aftermath of the Bristol case. BMJ 1998. [DOI: 10.1136/bmj.317.7161.811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
Information on the significance of the mouth in old age has been obtained from structured interviews with older subjects focused largely on the significance and impact of oral dysfunction. There is, however, a growing sense that inventories of dysfunction do not explain the full significance of aging and that structured interviews offer little opportunity to explore feelings and concerns. This study adopted a qualitative approach to collect and analyse data from unrestricted responses to the question: "What is the significance of oral health in the lives of older adults?" The data were collected by interviewing 24 elders, and major themes in transcripts of the interviews were identified by the research team using inductive analytical techniques. Our findings indicate that the significance of oral health in this age group was considered largely within the context of three interacting themes--comfort, hygiene and health--that can be illustrated within a theoretical framework that corresponds with more general theories of aging to offer guidance for health promotion and further research. Overall, the participants offered a positive perspective on the mouth, and they emphasized the need to adapt as an integral part of successful aging and a means of coping with the impact of oral disorders.
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Szilágyi A, Hole R, Keckstein J, Rossmanith WG. Effects of ovarian surgery on the dopaminergic and opioidergic control of gonadotropin and prolactin secretion in women with polycystic ovarian disease. Gynecol Endocrinol 1993; 7:159-66. [PMID: 8291452 DOI: 10.3109/09513599309152497] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Ovarian surgery has been demonstrated as an effective means to establish regular menstrual cycles and resumption of ovulation in patients with polycystic ovarian disease (PCO). We questioned whether such reinstitution of menstrual cyclicity may be associated with changes in the opioidergic and dopaminergic activity known to be aberrant in these women. Opioidergic and dopaminergic tone was therefore assessed in patients with PCO before and after ovarian laser vaporization (n = 4) or classical ovarian wedge resection (n = 4). Blood samples for the determination of luteinizing hormone (LH), follicle stimulating hormone (FSH) and prolactin were frequently obtained following opioidergic and/or dopaminergic antagonism affected by naloxone (4 mg i.v.) or metoclopramide (10 mg i.v.). In response to either surgical approach, circulating LH levels decreased (p < 0.01), while FSH concentrations remained unaltered. Further, LH and FSH concentrations did not noticeably change following challenges with naloxone or metoclopramide: this applied to conditions before and after ovarian surgery. Prolactin release in response to metoclopramide was markedly (p < 0.01) higher following ovarian surgery than before. Thus, both ovarian laser surgery and classical wedge resection can effectively restore normal menstrual cyclicity in PCO patients, although they failed to alter opioidergic and dopaminergic activity. Dopaminergic inhibition of prolactin secretion was further enhanced after ovarian surgery. These observations suggest that different modes of ovarian surgery are effective in influencing central gonadal control, but that the central opioidergic and dopaminergic control of gonadotropin and prolactin secretion remains unaffected by ovarian surgery in PCO women, even when menstrual cyclicity is resumed.
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Affiliation(s)
- A Szilágyi
- Department of Obstetrics and Gynecology, University of Pécs, Hungary
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Hole R. Re: Chronic testicular pain following vasectomy. Br J Urol 1992; 70:338-9. [PMID: 1422702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Hole R, Haywood JK. Auditing perioperative mortality. Ann R Coll Surg Engl 1988; 70:184-5. [PMID: 3408178 PMCID: PMC2498756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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O'Boyle PJ, Lumb GN, Vesey S, Maskell R, Hole R. Points: Urinary frequency and urgency. West J Med 1987. [DOI: 10.1136/bmj.294.6565.182-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hole R. Orchidectomy versus oestrogen for prostatic cancer. Br Med J (Clin Res Ed) 1986; 293:1100-1. [PMID: 3094792 PMCID: PMC1341947 DOI: 10.1136/bmj.293.6554.1100-c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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