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Perri M, Hapsari AP, Craig-Neil A, Ho J, Cattaneo J, Gaspar M, Hunter C, Rueda S, Burchell AN, Pinto AD. An evaluation of an employment assistance program focused on people living with HIV in Toronto, Canada. AIDS Care 2024; 36:500-507. [PMID: 37756653 DOI: 10.1080/09540121.2023.2253505] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/25/2023] [Indexed: 09/29/2023]
Abstract
Unemployment is more common among people living with HIV (PLWH) compared to the general population. PLWH who are employed have better physical and mental health outcomes compared to unemployed PLWH. The main objective of this mixed-methods study was to conduct a program evaluation of Employment Action (EACT), a community-based program that assists PLWH in Toronto, Ontario, Canada to maintain meaningful employment. We extracted quantitative data from two HIV services databases used by EACT, and collected qualitative data from 12 individuals who had been placed into paid employment through EACT. From 131 clients included in the analysis, 38.1% (n = 50) maintained their job for at least 6 weeks within the first year of enrollment in the EACT program. Gender, ethnicity, age, and first language did not predict employment maintenance. Our interviews highlighted the barriers and facilitators to effective service delivery. Key recommendations include implementing skills training, embedding PLWH as EACT staff, and following up with clients once they gain employment. Investment in social programs such as EACT are essential for strengthening their data collection capacity, active outreach to service users, and sufficient planning for the evaluation phase prior to program implementation.
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Affiliation(s)
- Melissa Perri
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Ayu Pinky Hapsari
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Canada
| | - Amy Craig-Neil
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Canada
| | - Julia Ho
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Canada
| | | | - Mark Gaspar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Charlotte Hunter
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Family and Community Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
| | - Sergio Rueda
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Ann N Burchell
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Family and Community Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
| | - Andrew D Pinto
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Canada
- Department of Family and Community Medicine, St. Michael's Hospital, Unity Health Toronto, Toronto, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
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Piil K, Locatelli G, Skovhus SL, Tolver A, Jarden M. A Shifting Paradigm Toward Family-Centered Care in Neuro-Oncology: A Longitudinal Quasi-Experimental Mixed-Methods Feasibility Study. J Fam Nurs 2024:10748407241236678. [PMID: 38531858 DOI: 10.1177/10748407241236678] [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] [Indexed: 03/28/2024]
Abstract
Family-centered intervention can help families facing illness-related issues. We investigated the feasibility of Family and Network Conversations (FNCs) in high-grade glioma patients and their families. Quasi-experimental feasibility study with longitudinal mixed-methods design. Patients and families were invited to three FNCs over 1 year. They completed questionnaires at four time points and expressed their perspectives on the intervention through telephone interviews. Nurses' perspectives were collected in a focus group. Twenty-one patients and 47 family members were included. On average, patients were 66 years old, mainly male, married, living with caregivers, with unifocal cancer. On average, caregivers were 47 years old, mainly female, being spouses or children of the patient. Quantitative and qualitative data did not always match and expanded each other. Nurse-delivered FNCs holistically addressed families' needs while strengthening family's dialogue and union. Nurses felt empowered, underling that advanced competencies were required. Nurse-delivered FNCs are feasible to provide family-centered care, but they should be tailored to each family's needs.
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Affiliation(s)
- Karin Piil
- Copenhagen University Hospital, Rigshospitalet, Denmark
- Roskilde University, Denmark
| | | | | | | | - Mary Jarden
- Copenhagen University Hospital, Rigshospitalet, Denmark
- University of Copenhagen, Denmark
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3
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Huang YT, Chong ESK, Lau CC, Chow LZ. Mentorship for young gay men in Hong Kong: A pilot mixed-methods randomized controlled trial. Am J Community Psychol 2024. [PMID: 38494677 DOI: 10.1002/ajcp.12749] [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: 06/30/2023] [Revised: 02/27/2024] [Accepted: 03/02/2024] [Indexed: 03/19/2024]
Abstract
This study examined whether mentorship could promote young gay men's identities and well-being, and whether a mentor's sexual orientation matters. A randomized control trial compared outcomes across three conditions: Arm A (a mentee matched with a sexual minority mentor), Arm B (a mentee matched with a heterosexual mentor), and a control arm receiving psychoeducation only. A community sample of 60 mentees aged 18-25 years was randomly allocated to the three arms and completed questionnaires at baseline, 3 months into the intervention, and at the end of the 6-month program. Fifteen mentees recounted their mentoring experiences through in-depth interviews. Linear mixed effects models showed that for both intervention and control conditions, internalized homonegativity declined while resilience, loneliness, and body acceptance improved over time. No time and group interactions were found. Meanwhile, a mentor's sexual orientation did not drive differential quality and outcomes of mentorship. Interviewees cited various benefits of mentorship, including providing companionship, enriching connection with lesbian, gay, bisexual (LGB) communities, and adding knowledge and perspectives of LGB lives and identities. Although quantitative data did not support any exclusive benefits of mentorship, most mentees recognized mentorship as a vital source of affirmation and companionship. Implications for research and mentoring programs are discussed.
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Affiliation(s)
- Yu-Te Huang
- Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, Hong Kong
- Center of Behavioral Health, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Eddie S K Chong
- Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Chi-Chung Lau
- Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, Hong Kong
- Center of Behavioral Health, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Leo Z Chow
- Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam, Hong Kong
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4
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Davis JN, Kumordzie SM, Arnold CD, Wessells KR, Nyaaba KW, Adams KP, Tan XJ, Becher E, Vosti SA, Adu-Afarwuah S, Engle-Stone R. Consumption of Discretionary Salt and Salt from Bouillon among Households, Women, and Young Children in Northern Region, Ghana: A Mixed-Methods Study with the Condiment Micronutrient Innovation Trial (CoMIT) Project. Curr Dev Nutr 2024; 8:102088. [PMID: 38419834 PMCID: PMC10897853 DOI: 10.1016/j.cdnut.2024.102088] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/11/2024] [Accepted: 01/24/2024] [Indexed: 03/02/2024] Open
Abstract
Background Information on salt consumption patterns is needed to inform the need for and design of salt reduction strategies. Objectives In northern Ghana, this study aimed to estimate household consumption of salt, including salt from bouillon, and compare (estimated) women and children's salt intake to global recommendations; to estimate the proportion of salt consumed from bouillon; and to identify factors, including knowledge, attitudes, and practices, associated with household salt consumption. Methods Employing mixed-methods methodology, we conducted a pilot survey (n = 369 households enrolled) and focus group discussions (FGDs; n = 20) in Tolon and Kumbungu districts (14 urban, 14 rural clusters) (clinicaltrials.gov registry: NCT04632771). Households reported purchases of discretionary salt (DS, "table salt") and bouillon cubes. DS and total salt (TS; DS+salt from bouillon) consumption for women (15-49 y) and children (2-5 y) were estimated using the Adult Male Equivalent method and compared with global recommendations (<5 g/d women; <3.75 g/d children). Women's salt intake was also predicted from urinary sodium excretion (INTERSALT equation). Associations between DS and TS consumption, as well as household and women's characteristics, were tested with minimally adjusted and multivariable linear mixed-effects models. Qualitative FGD themes were generated using the Framework Method. Results From household purchase data, estimated TS consumption exceeded global recommendations for 44% of children [median: 2.9 (IQR: 1.9, 5.2) g/d] and 60% of women [6.0 (4.0, 10.2) g/d]; 35% of children and 50% of women exceeded recommendations from DS alone. Bouillon contributed <25% of households' TS consumption. Few characteristics were associated with DS or TS consumption. Salient qualitative themes that shaped salt consumption behaviors included salt's ubiquity as a seasoning, key household members' influence on food procurement and preparation, and perceptions about health. Conclusions Purchase data suggest salt consumption among women and children exceeds recommendations, even when excluding salt from bouillon; food prepared outside the home likely further contributes. Salt reduction interventions may be warranted in this context.
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Affiliation(s)
- Jennie N Davis
- University of California, Department of Nutrition, Institute for Global Nutrition, Davis, CA, United States
| | - Sika M Kumordzie
- University of California, Department of Nutrition, Institute for Global Nutrition, Davis, CA, United States
| | - Charles D Arnold
- University of California, Department of Nutrition, Institute for Global Nutrition, Davis, CA, United States
| | - K Ryan Wessells
- University of California, Department of Nutrition, Institute for Global Nutrition, Davis, CA, United States
| | - Kania W Nyaaba
- University of Ghana, Department of Nutrition and Food Science, Legon, Accra, Ghana
| | - Katherine P Adams
- University of California, Department of Nutrition, Institute for Global Nutrition, Davis, CA, United States
| | - Xiuping Jenny Tan
- University of California, Department of Nutrition, Institute for Global Nutrition, Davis, CA, United States
| | - Emily Becher
- University of California, Department of Nutrition, Institute for Global Nutrition, Davis, CA, United States
| | - Stephen A Vosti
- University of California, Department of Agriculture and Resource Economics, Institute for Global Nutrition, Davis, CA, United States
| | - Seth Adu-Afarwuah
- University of Ghana, Department of Nutrition and Food Science, Legon, Accra, Ghana
| | - Reina Engle-Stone
- University of California, Department of Nutrition, Institute for Global Nutrition, Davis, CA, United States
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5
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Jørgensen CU, Løkke A, Hjorth P, Pisinger C, Farver-Vestergaard I. Barriers to implementation of smoking cessation support among healthcare professionals in the secondary healthcare sector: A qualitative and quantitative evaluation. Tob Prev Cessat 2024; 10:TPC-10-12. [PMID: 38389587 PMCID: PMC10882562 DOI: 10.18332/tpc/183775] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/31/2024] [Accepted: 02/07/2024] [Indexed: 02/24/2024]
Abstract
INTRODUCTION Smoking cessation support (SCS) in the hospital is essential; patients often struggle to maintain quit attempts, which necessitates assistance from healthcare professionals (HCPs). However, unknown barriers can obstruct the implementation of SCS in hospitals. This study aims to uncover barriers to the implementation of SCS in psychiatric, somatic, inpatient, and outpatient hospital settings. METHODS In the period from June to September 2021, HCPs in a large secondary care hospital in the Region of Southern Denmark completed an online, cross-sectional study, providing sociodemographic details and listing potential barriers to SCS. They also shared additional barriers in the form of free-text responses. Descriptive statistics and thematic analysis of free-text responses were performed. RESULTS Of 1645 HCPs surveyed, 409 elaborated their response in the free-text field assessing unlisted barriers. Top listed barriers, reported by more than one-third of participants, included: 'lack of time' (45.1%), 'lack of patient motivation' (34.3%), and 'insufficient knowledge on how to support' (32.2%). Free-text responses revealed three barrier-related, which we grouped under the themes of: 'Concerned about the patient', 'Not part of my job', and 'Inappropriate setting'. CONCLUSIONS This quantitative and qualitative study identifies barriers to SCS on multiple levels in the hospital setting, i.e. on the patient, provider, and organizational levels. These results can inform healthcare organizations and professionals in the implementation of SCS in routine hospital care.
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Affiliation(s)
| | - Anders Løkke
- Department of Medicine, Lillebaelt Hospital, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Peter Hjorth
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Psychiatric Department, Mental Health Services, University Hospital of Southern Denmark, Odense, Denmark
| | - Charlotta Pisinger
- Center of Clinical Research and Prevention, Bispebjerg-Frederiksberg University Hospital, Copenhagen, Denmark
- National Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - Ingeborg Farver-Vestergaard
- Department of Medicine, Lillebaelt Hospital, Vejle, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Ananthasubramaniam A, Jurgens D, Kahsay E, Mezuk B. Characteristics of and Variation in Suicide Mortality Related to Retirement during the Great Recession: Perspectives from the National Violent Death Reporting System. Gerontologist 2024:gnae015. [PMID: 38373097 DOI: 10.1093/geront/gnae015] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Suicide rates typically increase during recessions. However, few studies have explored how recessions impact risk among older adults nearing retirement. This study used a large suicide mortality registry to characterize and quantify suicide related to retirement during the Great Recession (GR). RESEARCH DESIGN AND METHODS Data come from the National Violent Death Reporting System (NVDRS, 2004-2017; N=53,298 suicide deaths ages ≥50). We analyzed the text narratives (i.e., descriptions of the most salient circumstances to each suicide) of these decedents using natural language processing (NLP) to identify cases that were "retirement-related" (RR, e.g., anticipating, being unable to, or recently retiring). We used time-series analysis to quantify variation in RR over the GR, and compared these trends to retirees (i.e., decedents whose occupation was "retired") and all decedents aged ≥50. We used content and network analysis to characterize themes represented in the narratives. RESULTS There were 878 RR cases (1.6% of suicides aged ≥50) identified by the NLP model; only 52% of these cases were among retirees. RR cases were younger (62 vs. 75 years) and more educated (41.5% vs 24.5% college degree) than retirees. The rate of RR suicide was positively associated with indicators of the GR (e.g., short-term unemployment R2=0.70, p=0.024), but economic indicators were not correlated with the suicide rate among retirees or older adults in general. Economic issues were more central to the narratives of RR cases during the GR compared to other periods. DISCUSSION AND IMPLICATIONS Recessions shape suicide risk related to retirement transitions.
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Affiliation(s)
| | - David Jurgens
- School of Information, University of Michigan, Ann Arbor, MI, USA
- Computer Science and Engineering Division, Department of Electrical Engineering and Computer Science, University of Michigan School of Engineering, Ann Arbor, MI, USA
| | - Eskira Kahsay
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Briana Mezuk
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Gille F, Frei A, Kaufmann M, Lehmann A, Muñoz Laguna J, Papadopoulos K, Spörri A, Stanikić M, Tušl M, Zavattaro F, Puhan MA. A guide for a student-led doctoral-level qualitative methods short course in epidemiology: faculty and student perspectives. Int J Epidemiol 2024; 53:dyae029. [PMID: 38389285 PMCID: PMC10883707 DOI: 10.1093/ije/dyae029] [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: 06/28/2023] [Accepted: 02/07/2024] [Indexed: 02/24/2024] Open
Abstract
Qualitative research and mixed methods are core competencies for epidemiologists. In response to the shortage of guidance on graduate course development, we wrote a course development guide aimed at faculty and students designing similar courses in epidemiology curricula. The guide combines established educational theory with faculty and student experiences from a recent introductory course for epidemiology and biostatistics doctoral students at the University of Zurich and Swiss Federal Institute of Technology, Zurich. We propose a student-centred course with inverse classroom teaching and practice exercises with faculty input. Integration of student input during the course development process helps align the course syllabus with student needs. The proposed course comprises six sessions that cover learning outcomes in comprehension, knowledge, application, analysis, synthesis and evaluation. Following an introductory session, the students engage in face-to-face interviews, focus group interviews, observational methods, analysis and how qualitative and quantitative methods are integrated in mixed methods. Furthermore, the course covers interviewer safety, research ethics, quality in qualitative research and a practice session focused on the use of interview hardware, including video and audio recorders. The student-led teaching characteristic of the course allows for an immersive and reflective teaching-learning environment. After implementation of the course and learning from faculty and student perspectives, we propose these additional foci: a student project to apply learned knowledge to a case study; integration in mixed-methods; and providing faculty a larger space to cover theory and field anecdotes.
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Affiliation(s)
- Felix Gille
- Institute for Implementation Science in Health Care (IfIS), University of Zurich, Zurich, Switzerland
- Digital Society Initiative (DSI), University of Zurich, Zurich, Switzerland
| | - Anja Frei
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Marco Kaufmann
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Anja Lehmann
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Javier Muñoz Laguna
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
- EBPI-UWZH Musculoskeletal Epidemiology Research Group, University of Zurich and Balgrist University Hospital, Zurich, Switzerland
- University Spine Centre Zurich (UWZH), Balgrist University Hospital and University of Zurich, Zurich, Switzerland
| | - Kimon Papadopoulos
- Institute for Implementation Science in Health Care (IfIS), University of Zurich, Zurich, Switzerland
- Digital Society Initiative (DSI), University of Zurich, Zurich, Switzerland
| | - Angela Spörri
- Central Informatics, Multimedia an E-Learning Services, University of Zurich, Zurich, Switzerland
| | - Mina Stanikić
- Institute for Implementation Science in Health Care (IfIS), University of Zurich, Zurich, Switzerland
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Martin Tušl
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Federica Zavattaro
- Institute for Implementation Science in Health Care (IfIS), University of Zurich, Zurich, Switzerland
- Digital Society Initiative (DSI), University of Zurich, Zurich, Switzerland
| | - Milo Alan Puhan
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
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Bollig G, Gräf K, Gruna H, Drexler D, Pothmann R. "We Want to Talk about Death, Dying and Grief and to Learn about End-of-Life Care"-Lessons Learned from a Multi-Center Mixed-Methods Study on Last Aid Courses for Kids and Teens. Children (Basel) 2024; 11:224. [PMID: 38397336 PMCID: PMC10887051 DOI: 10.3390/children11020224] [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: 12/27/2023] [Revised: 02/01/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024]
Abstract
BACKGROUND Last Aid Courses (LAC) for adults have been established in 21 countries in Europe, Australia and America to improve the public discussion about death and dying and to empower people to participate in end-of-life care provision. In 2018, the first Last Aid Courses for kids and teens (LAC-KT) were introduced. The aim of the study was to explore the views and experiences of the course participants and Last Aid Course instructors on the LAC-KT. METHODS A mixed-methods approach was used. The views of the LAC-KT participants, aged 7 to 17 years, on the LAC-KT were collected using a questionnaire. In addition, the experiences of the Last Aid Course instructors were explored in focus group interviews. RESULTS The results show that 84% of the participants had experiences with death and dying and 91% found the LAC-KT helpful for everyone. The majority of the participants appreciate the opportunity to talk and learn about death, dying, grief and palliative care. CONCLUSIONS The LAC-KT is feasible, very well accepted and a welcome opportunity for exchanging and obtaining information about dying, grief and palliative care. The findings of the study indicate that the LAC-KT should be offered to all interested children and teenagers and included in the school curriculum.
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Affiliation(s)
- Georg Bollig
- Department of Anesthesiology, Intensive Care, Palliative Medicine and Pain Therapy, Helios Klinikum, 24837 Schleswig, Germany
- Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, 50924 Cologne, Germany
- Last Aid Research Group International (LARGI), 24837 Schleswig, Germany
- Letzte Hilfe Deutschland gGmbH, 24837 Schleswig, Germany (H.G.); (D.D.); (R.P.)
| | - Kirsti Gräf
- Letzte Hilfe Deutschland gGmbH, 24837 Schleswig, Germany (H.G.); (D.D.); (R.P.)
- Pfeiffersche Stiftungen, 39114 Magdeburg, Germany
| | - Harry Gruna
- Letzte Hilfe Deutschland gGmbH, 24837 Schleswig, Germany (H.G.); (D.D.); (R.P.)
| | - Daniel Drexler
- Letzte Hilfe Deutschland gGmbH, 24837 Schleswig, Germany (H.G.); (D.D.); (R.P.)
- Department of Palliative Medicine, RoMed Klinikum, 83022 Rosenheim, Germany
| | - Raymund Pothmann
- Letzte Hilfe Deutschland gGmbH, 24837 Schleswig, Germany (H.G.); (D.D.); (R.P.)
- Kinder PACT, 22297 Hamburg, Germany
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Chen P, Yu H, Lin CF, Guo J, Elliott J, Bleakney A, Jan YK. Effect of adaptive sports on quality of life in individuals with disabilities who use wheelchairs: a mixed-methods systematic review. Disabil Rehabil Assist Technol 2024:1-17. [PMID: 38330244 DOI: 10.1080/17483107.2024.2313110] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 01/26/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE Adaptive sports participation has been shown to improve quality of life (QoL) in individual with disabilities. However, inconsistent results in various domains of QoL exist in the literature. The objective of this mixed-methods systematic review is to identify and synthesize evidence from quantitative and qualitative studies on the effect of adaptive sports on QoL in individuals with disabilities who use wheelchairs for mobility. METHODS A systematic literature review of quantitative, qualitative, and mixed-methods research on the effect of adaptive sports on QoL was conducted on five databases (Scopus, Web of Science, PsycINFO, Medline, and PubMed). Quality appraisal was conducted by two authors by using the Mixed Methods Appraisal Tool. RESULTS This review identified 4 key findings from 41 studies, including 31 quantitative and 10 qualitative studies. First, individuals with disabilities using wheelchairs for mobility who actively engaged in adaptive sports tend to report higher QoL scores compared with those who were inactive or did not participate. Second, the relationship between the duration of regular participation in adaptive sports and QoL scores exhibited inconsistent results. Third, a multi-component adaptive sports program demonstrates the potential to further improve QoL scores. Last, qualitative investigations reveal that participation in adaptive sports positively influences various domains of well-being in wheelchair users, including encompassing physical and emotional well-being, interpersonal relationships, material well-being, personal development, self-determination, and social inclusion. CONCLUSION This review provides a comprehensive relationship between adaptive sports participation and QoL of wheelchair users. This study identifies the value of multi-component interventions and demonstrates the diverse positive influences of adaptive sports on well-being.
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Affiliation(s)
- Panpan Chen
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Physical Education, Tsinghua University, Beijing, China
| | - Hongjun Yu
- Department of Physical Education, Tsinghua University, Beijing, China
| | - Cheng-Feng Lin
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Physical Therapy, National Cheng Kung University, Tainan, Taiwan
| | - Jiaqi Guo
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Jeannette Elliott
- Disability Resources and Educational Services, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Adam Bleakney
- Disability Resources and Educational Services, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Yih-Kuen Jan
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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10
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Slotegraaf AI, de Kruif AJTCM, Agasi-Idenburg CS, van Oers SMD, Ronteltap A, Veenhof C, Gerards MHG, Verburg AC, Hoogeboom TJ, de van der Schueren MAE. Understanding recovery of people recovering from COVID-19 receiving treatment from primary care allied health professionals: a mixed-methods study. Disabil Rehabil 2024:1-10. [PMID: 38318773 DOI: 10.1080/09638288.2024.2311330] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024]
Abstract
PURPOSE To quantitatively assess changes in recovery of people recovering from COVID-19 treated by a primary care allied health professional, and to qualitatively describe how they dealt with persistent complaints. MATERIALS AND METHODS This mixed-methods study is part of a Dutch prospective cohort study, from which thirty participants were selected through purposive sampling. Quantitative data on recovery were collected at start of treatment and 6 months. Additionally, by use of semi-structured interviews participants were asked on how persistent complaints influenced their lives, and how they experienced received primary care allied health treatment. RESULTS Despite reported improvements, most participants still experienced limitations at 6 months. Hospital participants reported a higher severity of complaints, but home participants reported more diverse complaints and a longer recovery. Most participants were satisfied with the primary care allied healthcare. Tender loving care and a listening ear, learning to manage limits, and support and acceptance of building up in small steps were perceived as contributing most to participants' recovery. CONCLUSION Although improvements were reported on almost all outcomes, most participants suffered from persistent complaints. Despite these persistent complaints, many participants reported being better able to cope with persistent complaints because they had decreased substantially in their intensity. TRIAL REGISTRATION Clinicaltrials.gov registry (NCT04735744).
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Affiliation(s)
- Anne I Slotegraaf
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
| | - Anja J Th C M de Kruif
- Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - Carla S Agasi-Idenburg
- Research Group Innovation of Movement Care, University of Applied Sciences Utrecht, Utrecht, the Netherlands
| | - Sonja M D van Oers
- Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - Amber Ronteltap
- Research Group Innovation of Movement Care, University of Applied Sciences Utrecht, Utrecht, the Netherlands
| | - Cindy Veenhof
- Research Group Innovation of Movement Care, University of Applied Sciences Utrecht, Utrecht, the Netherlands
- Department of Rehabilitation, Physical Therapy Science and Sport, Brain Center, University Medical Center Utrecht, Utrecht University, the Netherlands
| | - Marissa H G Gerards
- Department of Epidemiology, Care and Public Health Institute (CAPHRI), Faculty of Health, Medicine and Life sciences, Maastricht University, Maastricht, the Netherlands
- Department of Physiotherapy, Maastricht university medical centre, Maastricht, the Netherlands
| | - Arie C Verburg
- IQ Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Thomas J Hoogeboom
- IQ Healthcare, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Marian A E de van der Schueren
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, the Netherlands
- Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, Nijmegen, the Netherlands
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Chen D, Su Z, Gu Z. Two cities, two stages in transforming society-a mixed methods study comparing doctors' adoption of mobile apps for communication with patients in Hangzhou and Yancheng, China. Front Public Health 2024; 12:1320949. [PMID: 38375337 PMCID: PMC10875126 DOI: 10.3389/fpubh.2024.1320949] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/15/2024] [Indexed: 02/21/2024] Open
Abstract
Objectives Mobile apps have become commonplace in doctor-patient communication over the last 20 years. Doctors mainly use two kinds of app, social networking apps (i.e., WeChat) and medical platform apps (i.e., Haodf). The purpose of this study was to investigate whether the attributes of social interaction in local society impact doctors' choice of mobile apps to communicate with patients. This article addresses two research questions: (a) To what degree do doctors' adoption patterns in different societies differ? (b) Why do doctors choose certain mobile apps to communicate with patients? Methods This study employed a mixed methods research design to analyze doctor's adoption behavior patterns in two cities, Hangzhou (HZ) and Yancheng (YC), which represent two stages in transforming society. Various patterns, measured as the percentage of doctors who utilize the medical platform app of Haodf among all doctors and the average service counts per doctor, were compared in three groups of tertiary hospitals: the top ones in HZ, the average ones in HZ, and the average ones in YC. We also conducted thematic content analysis of qualitative data from semi-structured interviews with 20 purposely selected doctors in the two cities. Results The percentages of doctors who have adopted the app of Haodf from the three groups of tertiary hospitals were 49.97%, 41.00%, and 32.03%, with an average service counts per doctor of 261, 182 and 39, respectively. According to the interviewees, doctors from YC are more likely to use social networking apps to communicate with patients than their HZ counterparts to maintain social connections with their relatives, friends, colleagues, and others. Conclusion This study demonstrates that doctors' choices of mobile apps are dependent upon social context. In traditional society, where people have close ties, the logic of using social networking apps lies in doctors' need to maximize the utility of their knowledge by maintaining social connections with others. In modern society, where the close ties between people have gradually weakened, the logic of using medical platform apps lies in doctors' needs for reputation marketing, either for themselves or for institutions, their affiliated departments or hospitals.
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Affiliation(s)
- Dongjin Chen
- Institute for Social Governance and Communication Innovation of Zhejiang, Communication University of Zhejiang, Hangzhou, China
| | - Zhenhua Su
- College of Media and International Culture, Zhejiang University, Hangzhou, China
| | - Zheng Gu
- School of Public Affairs, Zhejiang University, Hangzhou, China
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Posner JE, Tagoe H, Casella A, Madevu-Matson C, Duffy M, Sharer M, Nagai H. Staff perspectives on the feasibility of the person-centered care assessment tool (PCC-at) in HIV treatment settings in Ghana: a mixed-methods study. HIV Res Clin Pract 2024; 25:2312319. [PMID: 38348872] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
Person-centered care (PCC) aims to improve client's experiences in HIV care while advancing outcomes. This study team developed the PCC assessment tool (PCC-AT) to assess PCC service performance in HIV treatment settings in Ghana. Study objectives aimed to describe the range of PCC-AT scores within and across study facilities and examine the feasibility of PCC-AT implementation in diverse HIV treatment settings. The PCC-AT was piloted at five health facilities providing HIV services among 37 staff. Immediately following each pilot, focus group discussions (FGDs) were conducted to gather feasibility data. Thematic qualitative analysis was conducted on translated FGD transcripts. Across facilities, providers scored highest in the staffing domain, followed by service provision, and direct client support. Time required to implement the PCC-AT averaged 62 minutes. Providers described the tool as well-structured, user-friendly, relevant, reflective of the core PCC delivery elements, and useful in elucidating actions to improve PCC service delivery across domains. The PCC-AT holds potential to strengthen activities that support clients' broader clinical, mental and psychosocial wellbeing by offering friendly services that attend to each client's holistic needs while contributing progress towards epidemic control.
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Affiliation(s)
| | | | | | | | - Malia Duffy
- Health Across Humanity, LLC, Boston, MA, USA
| | - Melissa Sharer
- John Snow, Inc, Boston, MA, USA
- Saint Ambrose University, Davenport, IL, USA
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13
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DeAlmeida K, Blanco K, Metz K, Bohr NL. Inpatient pediatric nursing staff experiences treating psychiatric patients: A mixed methods study. J Child Adolesc Psychiatr Nurs 2024; 37:e12441. [PMID: 37747199 DOI: 10.1111/jcap.12441] [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: 05/09/2023] [Revised: 08/21/2023] [Accepted: 09/14/2023] [Indexed: 09/26/2023]
Abstract
PROBLEM A gap in the literature exists attempting to understand the impact that the influx of pediatric psychiatric patients has had on inpatient general medicine pediatric nursing staff. METHODS A mixed-method research study was conducted among full- and part-time pediatric nurses and nursing assistants working on general pediatric units. Quantitative data was collected via an anonymous survey using the Professional Quality of Life Scale version 5 and Support Appraisal for Work Stressors scale. Surveys were followed by semistructured interviews. FINDINGS Of the 158 staff eligible, 47 (29.7%) participated in the quantitative portion. [Correction added on 29 September 2023, after the first online publication: In the preceding sentence, the participation rate was revised from 23.5% to 29.7% in this version.] Significant differences were found between roles, with nurses experiencing lower levels of compassion satisfaction and higher levels of burnout. Role differences were seen in supervisor support and nonwork support, with nurses reporting less support from both. Supervisor support showed a significant correlational relationship with compassion satisfaction and burnout. Nonwork support showed similar correlations with compassion satisfaction and burnout. Themes that emerged from the interviews were Barriers to Care, Emotional Impact, and "Help Me Help You." CONCLUSION Nurses may be at greater risk for compassion fatigue due to perceived inadequate support from leadership, unclear role expectations, and lack of resources.
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Affiliation(s)
- Katelyn DeAlmeida
- Nursing Research Department, UChicago Medicine, Chicago, Illinois, USA
| | - Keli Blanco
- Nursing Research Department, UChicago Medicine, Chicago, Illinois, USA
| | - Katherine Metz
- Nursing Research Department, UChicago Medicine, Chicago, Illinois, USA
| | - Nicole L Bohr
- Nursing Research Department, UChicago Medicine, Chicago, Illinois, USA
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Mehrabi S, Drisdelle S, Dutt HR, Middleton LE. "If I want to be able to keep going, I must be active." Exploring older adults' perspectives of remote physical activity supports: a mixed-methods study. Front Public Health 2024; 12:1328492. [PMID: 38327585 PMCID: PMC10847274 DOI: 10.3389/fpubh.2024.1328492] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 01/02/2024] [Indexed: 02/09/2024] Open
Abstract
Introduction Pandemic-related public health restrictions limited older adults' physical activity programs and opportunities. Physical activity supports shifted to remote options, however, information on their adoption and effectiveness is limited. This study aims to describe the remote supports received by older adults and their perceived effectiveness. Additionally, it aims to describe facilitators and barriers to remote supports for physical activity among older adults, particularly those reliant on technology. Methods This study used an explanatory, sequential, mixed-methods design. Community-dwelling older adults (≥ 60 years) were recruited to partake in a web-based survey and an optional semi-structured follow-up interview informed by the COM-B model. Participant characteristics, perceived effectiveness of remote supports, and the presence and severity of barriers were described. Changes in physical activity levels before and during the pandemic were analyzed using the Wilcoxon signed-rank test. Qualitative data underwent inductive thematic analysis. Results Fifty seven older adults (68.3 ± 7.1 years, 43 Female) completed the survey, of which 15 participants (67.4 ± 5.8 years, 12 Female) participated in interviews. The majority were Caucasian, highly educated, and resided in Canada. Total physical activity levels showed no statistically significant change from before to during the pandemic (p = 0.74); however, at-home exercise participation and technology usage increased. Pre-recorded and real-time virtual exercise supports were perceived as most effective. Main barriers included limited contact with exercise professionals, limited access to exercise equipment or space, and decreased mental wellness. Thematic analysis identified five main themes: (i) Enabled by knowledge and resources; (ii) Diverse motivations for physical activity; (iii) Fostering participation through social connection; (iv) Supervision and safety: enabling adherence; and (v) Virtual exercise: a sustainable option with technological considerations. Conclusion Virtual platforms show promise in supporting older adults' physical activity at home, especially for those with limited in-person access. Our study suggests that both real-time and pre-recorded virtual exercise supports are feasible, depending on technological capacity and support. While interactive real-time virtual programs allow interaction with professionals and peers, pre-recorded programs provide timing flexibility. Further research is needed to establish best practices for safe and effective virtual exercise programming, promoting its long-term adoption for supporting a wider range of older adults.
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Affiliation(s)
- Samira Mehrabi
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Sara Drisdelle
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Hanna R Dutt
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Laura E Middleton
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Research Institute for Aging, Waterloo, ON, Canada
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Santos AJ, Kislaya I, Matias-Dias C, Machado A. Health beliefs and attitudes toward Influenza and COVID-19 vaccination in Portugal: a study using a mixed-method approach. Front Public Health 2024; 11:1331136. [PMID: 38312138 PMCID: PMC10834706 DOI: 10.3389/fpubh.2023.1331136] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 12/21/2023] [Indexed: 02/06/2024] Open
Abstract
Introduction Vaccination is one of the most effective population strategies to prevent infectious diseases and mitigate pandemics, and it is important to understand vaccine uptake determinants since vaccine hesitancy has been increasing for the past few decades. The Health Belief Model (HBM) has been widely used for understanding vaccination behavior. The current study aimed to assess influenza vaccine (IV) non-uptake and attitudes toward COVID-19 vaccination, two important respiratory diseases with similar symptoms, and routes of transmission in the Portuguese population. Methods We conducted a cross-sectional study using a panel sample of randomly chosen Portuguese households. A total of 1,050 individuals aged 18 years and over responded to a telephone or online questionnaire. Through a mixed-method approach, we employed thematic content analysis to describe reasons for not taking the IV, considering the HBM dimensions, and quantitative statistical analysis to estimate IV and COVID-19 vaccine coverage. Results The IV uptake for the overall population was 30.7% (CI 95%: 26.5, 35.2). Susceptibility was found to be a main factor for IV non-uptake, followed by barriers, such as stock availability and fear of adverse effects. The uptake of the COVID-19 vaccine was very high in the study population (83.1%, CI 95%: 13.6%-20.9%). There was a high perception of COVID-19-associated severity and fear of the consequences. Individuals who reported IV uptake seemed to perceive a higher severity of COVID-19 and a higher benefit of taking the COVID-19 vaccine for severe complications. Discussion Thus, the population does not seem to consider influenza to be a health risk, as opposed to COVID-19, which is considered to be a possibly severe disease. The association between IV uptake and COVID-19 perceptions highlights that an overall attitude toward vaccination in general may be an important individual determinant.
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Affiliation(s)
- Ana João Santos
- CINTESIS@RISE, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Irina Kislaya
- Department of Infectious Diseases Epidemiology, Bernhard Nocht Institute for Tropical Medicine (BNITM), Hamburg, Germany
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisboa, Portugal
- Comprehensive Health Research Center (CHRC), NOVA University of Lisbon, Lisbon, Portugal
| | - Carlos Matias-Dias
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisboa, Portugal
- Comprehensive Health Research Center (CHRC), NOVA University of Lisbon, Lisbon, Portugal
- Public Health Research Centre, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
| | - Ausenda Machado
- Epidemiology Department, National Institute of Health Doctor Ricardo Jorge, Lisboa, Portugal
- Comprehensive Health Research Center (CHRC), NOVA University of Lisbon, Lisbon, Portugal
- Public Health Research Centre, National School of Public Health, NOVA University of Lisbon, Lisbon, Portugal
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Kåks P, Stansert Katzen L, Målqvist M, Bergström A, Herzig van Wees S. Implementing a social innovation for community-based peer support for immigrant mothers in Sweden: a mixed-methods process evaluation. Front Public Health 2024; 11:1332738. [PMID: 38283291 PMCID: PMC10821792 DOI: 10.3389/fpubh.2023.1332738] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 12/27/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction A South African social innovation based on peer support for mothers was contextualized in southern Sweden. The objective of the project was to support expectant women and mothers of young children in immigrant communities to access public services that would benefit maternal and child health. This study aimed to assess how the intervention was implemented, what the contextual barriers and facilitators were, and how the implementation was perceived by those who delivered and received it. Methods The study used mixed methods with a convergent parallel design and followed the Medical Research Council guidance on process evaluations of complex interventions. Semi-structured interviews (n = 19) were conducted with peer supporters, client mothers, and key stakeholders involved in the intervention. The qualitative data were analyzed using content analysis. Quantitative data on peer supporters' activities were collected during contacts with client mothers and were presented descriptively. Results The five peer supporters had 1,294 contacts with client mothers, of which 507 were first-time contacts. The reach was perceived as wide, and the dose of the intervention was tailored to individual needs. Barriers to implementation included community mistrust of social services, norms on gender roles and parenting, and funding challenges. The implementation was facilitated by the organization's reputation, network, experience, and third-sector affiliation. Peer supporters tended to prioritize linking clients to other services over the educational components of the intervention, sometimes doing more than what was originally planned. Implementation strategies used included building trust, using multiple outreach venues, using internal support structures, and providing practical assistance as an entry point to comprehensive psychosocial support. The personal connection between peer supporters and clients was highly valued, and the building of relationships enabled them to address sensitive topics. Peer supporters sometimes experienced a blurred line between professional and personal roles. Conclusions Peer supporters used a variety of strategies to navigate identified barriers and facilitators. Trust was central both as a contextual factor and a strategy for implementation. It is valuable to maintain a balance between flexibility and adherence to the function of peer supporters. Further research is needed to evaluate the effects of the intervention.
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Affiliation(s)
- Per Kåks
- SWEDESD, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Linnea Stansert Katzen
- SWEDESD, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Mats Målqvist
- SWEDESD, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Anna Bergström
- SWEDESD, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Sibylle Herzig van Wees
- SWEDESD, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
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Brockie T, Kahn-John M, Mata Lopez L, Bell E, Brockie T, Brockie T, Decker E, Glass N, Has Eagle H, Helgeson K, Main NJ, Kazemi M, Perez-Monteau R, Myrick A, Nelson KE, Ricker A, Rider T, Roberts T, Wilson DH, Yazzie K, Perrin N. A mixed-methods study protocol on factors contributing to suicide clusters among Native American youth in a northern plains reservation. Front Public Health 2024; 11:1281109. [PMID: 38259800 PMCID: PMC10800579 DOI: 10.3389/fpubh.2023.1281109] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 12/12/2023] [Indexed: 01/24/2024] Open
Abstract
Introduction Suicide and suicide clusters within Native American Reservation communities are devastating to the entire community and increase individuals' risk for suicide over the lifespan. The objective of this paper is to describe the Indigenous community-based participatory research protocol implemented in partnership with the Fort Belknap Indian Community in Montana, United States. The study protocol was developed to understand suicide risk and protective factors, and community-derived solutions, in a reservation community with history of a suicide cluster and high rates of youth suicide. Methods In this mixed-methods study, qualitative data from youth, adults, and service providers and quantitative data from 200 adolescents and young adults (aged 14-24 years) were collected in Fort Belknap, Montana from May - December of 2022. Qualitative data were collected first via in-depth interviews and focus groups. Survey questions included validated and pre-tested measures of factors youth experience across socio-ecological levels. Thematic analysis was applied to the qualitative data; and logistic regression models were used to examine relationships within the quantitative data. Discussion This study will add a multi-dimensional perspective to our current understanding of (1) risk and protective factors for suicide, community-derived postvention solutions, and insights on community assets, and (2) the current health and psychosocial status of youth in the Fort Belknap community. This study may serve as an exemplar of co-created, culturally safe solutions designed to address mental health resource gaps. Next steps include development of a suicide crisis response tool kit and a culturally aligned postvention intervention that will enhance individual, family, and community survivance.
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Affiliation(s)
- Teresa Brockie
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | | | | | - Eleesha Bell
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Fort Belknap Reservation Community, Agency, MT, United States
| | - Truth Brockie
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Fort Belknap Reservation Community, Agency, MT, United States
| | - Terry Brockie
- Fort Belknap Reservation Community, Agency, MT, United States
| | - Ellie Decker
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Nancy Glass
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | | | | | - Nona J. Main
- Montana Family Planning, Bozeman, MT, United States
| | - Mina Kazemi
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | | | - Alicia Myrick
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Fort Belknap Reservation Community, Agency, MT, United States
| | - Katie E. Nelson
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Adriann Ricker
- Johns Hopkins School of Nursing, Baltimore, MD, United States
| | - Tammy Rider
- Fort Belknap Tribal Health Department, Harlem, MT, United States
| | - Teeah Roberts
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Fort Belknap Reservation Community, Agency, MT, United States
| | - Deborah H. Wilson
- Johns Hopkins School of Nursing, Baltimore, MD, United States
- Auckland University of Technology, Auckland, New Zealand
| | - Karen Yazzie
- Fort Belknap Tribal Health Department, Harlem, MT, United States
| | - Nancy Perrin
- Johns Hopkins School of Nursing, Baltimore, MD, United States
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Frances SM, Murray L, Nicklin E, Velikova G, Boele F. Long-term health-related quality of life in meningioma survivors: A mixed-methods systematic review. Neurooncol Adv 2024; 6:vdae007. [PMID: 38375359 PMCID: PMC10876080 DOI: 10.1093/noajnl/vdae007] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024] Open
Abstract
Background Meningiomas account for ~25% of all primary brain tumors. These tumors have a relatively favorable prognosis with ~92% of meningioma patients surviving >5 years after diagnosis. Yet, patients can report high disease burden and survivorship issues even years after treatment, affecting health-related quality of life (HRQOL). We aimed to systematically review the literature and synthesize evidence on HRQOL in meningioma patients across long-term survival, defined as ≥2 years post-diagnosis. Methods Systematic literature searches were carried out using Medline, EMBASE, CINAHL, PsycINFO, and Web of Science Core Collection. Any published, peer-reviewed articles with primary quantitative, qualitative, or mixed-methods data covering the physical, mental, and/or social aspects of HRQOL of meningioma survivors were included. A narrative synthesis method was used to interpret the findings. Results Searches returned 2253 unique publications, of which 21 were included. Of these, N = 15 involved quantitative methodology, N = 4 mixed methods, and N = 2 were qualitative reports. Patient sample survival ranged from 2.75 to 13 years. HRQOL impairment was seen across all domains. Physical issues included persevering symptoms (eg, headaches, fatigue, vision problems); mental issues comprised emotional burden (eg, high prevalence of depressive symptoms and anxiety) and cognitive complaints; social issues included role limitations, social isolation, and affected work productivity. Due to study heterogeneity, the impact of treatment on long-term HRQOL remains unclear. Conclusions The findings from this review highlight the areas of HRQOL that can be impacted in long-term survivorship for patients with meningioma. These findings could help raise awareness among clinicians and patients, facilitating support provision.
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Affiliation(s)
- Sé Maria Frances
- Patient-Centred Outcomes Research, Leeds Institute of Medical Research at St James’s, St James’s University Hospital, University of Leeds, Leeds, UK
| | - Louise Murray
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UK
| | - Emma Nicklin
- Patient-Centred Outcomes Research, Leeds Institute of Medical Research at St James’s, St James’s University Hospital, University of Leeds, Leeds, UK
| | - Galina Velikova
- Patient-Centred Outcomes Research, Leeds Institute of Medical Research at St James’s, St James’s University Hospital, University of Leeds, Leeds, UK
- Department of Clinical Oncology, Leeds Cancer Centre, Leeds Institute of Medical Research at St James’s, University of Leeds, Leeds, UK
| | - Florien Boele
- Patient-Centred Outcomes Research, Leeds Institute of Medical Research at St James’s, St James’s University Hospital, University of Leeds, Leeds, UK
- Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Gooden TE, Wang J, Carvalho Goulart A, Varella AC, Tai M, Sheron VA, Wang H, Zhang H, Zhong J, Kumarendran B, Nirantharakumar K, Surenthirakumaran R, Bensenor IM, Guo Y, Lip GYH, Thomas GN, Manaseki-Holland S. Generalisability of and lessons learned from a mixed-methods study conducted in three low- and middle-income countries to identify care pathways for atrial fibrillation. Glob Health Action 2023; 16:2231763. [PMID: 37466418 PMCID: PMC10360996 DOI: 10.1080/16549716.2023.2231763] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/27/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND Identifying existing care pathways is the first step for understanding how services can be improved to enable early diagnosis and effective follow-up care for non-communicable diseases (NCDs); however, evidence on how care pathways can and should be identified in low- and middle-income countries (LMICs) is lacking. OBJECTIVE To describe generalisability and lessons learned from recruitment and data collection for the quantitative component of a mixed methods study designed to determine the care pathway for atrial fibrillation (AF) in Brazil, China and Sri Lanka. METHODS Adults (≥18 years) that spoke the local language and with an AF diagnosis were eligible. We excluded anyone with a hearing or cognitive impairment or ineligible address. Eligible participants were identified using electronic records in Brazil and China; in Sri Lanka, researchers attended the outpatient clinics to identify eligible participants. Data were collected using two quantitative questionnaires administered at least 2-months apart. A minimum sample size of 238 was required for each country. RESULTS The required sample size was met in Brazil (n = 267) and China (n = 298), but a large proportion of AF patients could not be contacted (47% and 27%, respectively) or refused to participate (36% and 38%, respectively). In Sri Lanka, recruitment was challenging, resulting in a reduced sample (n = 151). Mean age of participants from Brazil, China and Sri Lanka was 69 (SD = 11.3), 65 (SD = 12.8) and 58 (SD = 11.7), respectively. Females accounted for 49% of the Brazil sample, 62% in China and 70% in Sri Lanka. CONCLUSIONS Generalisability was an issue in Brazil and China, as was selection bias. Recruitment bias was highlighted in Sri Lanka. Additional or alternative recruitment methods may be required to ensure generalisability and reduce bias in future studies aimed at identifying NCD care pathways in LMICs.
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Affiliation(s)
- Tiffany E Gooden
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Jingya Wang
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Alessandra Carvalho Goulart
- Faculdade de Medicina, Universidade, Sao Paulo, São Paulo, Brazil
- Center for Clinical and Epidemiologic Research and Division of Internal Medicine, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Ana C Varella
- Faculdade de Medicina, Universidade, Sao Paulo, São Paulo, Brazil
| | - Meihui Tai
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Vethanayagan Antony Sheron
- Department of Community and Family Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
| | - Hao Wang
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Hui Zhang
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Jiaoyue Zhong
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Balachandran Kumarendran
- Department of Community and Family Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
| | | | - Rajendra Surenthirakumaran
- Department of Community and Family Medicine, Faculty of Medicine, University of Jaffna, Jaffna, Sri Lanka
| | - Isabela M Bensenor
- Faculdade de Medicina, Universidade, Sao Paulo, São Paulo, Brazil
- Center for Clinical and Epidemiologic Research and Division of Internal Medicine, University Hospital, University of São Paulo, São Paulo, Brazil
| | - Yutao Guo
- Department of Cardiology, Chinese PLA General Hospital, Beijing, China
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Reddy AR, Doshi AK, Mak A, Shea JA, Fardad JT, Moon J, Hu P, Garcia-Marcinkiewicz AG. Assessing the health literacy of caregivers in the pediatric intensive care unit: a mixed-methods study. Front Pediatr 2023; 11:1308673. [PMID: 38188919 PMCID: PMC10771288 DOI: 10.3389/fped.2023.1308673] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/01/2023] [Indexed: 01/09/2024] Open
Abstract
Background Limited health literacy is associated with increased hospitalizations, emergency visits, health care costs, and mortality. The health literacy levels of caregivers of critically ill children are unknown. This mixed-methods study aims to quantitatively assess the health literacy of caregivers of children admitted to the pediatric intensive care unit (PICU) and qualitatively describe facilitators and barriers to implementing health literacy screening from the provider perspective. Methods Caregivers of patients admitted to our large, academic PICU (between August 12, 2022 and March 31, 2023) were approached to complete a survey with the Newest Vital Sign (NVS), which is a validated health literacy screener offered in English and Spanish. We additionally conducted focus groups of interdisciplinary PICU providers to identify factors which may influence implementation of health literacy screening using the Consolidated Framework for Implementation Research (CFIR) framework. Results Among 48 surveyed caregivers, 79% demonstrated adequate health literacy using the Newest Vital Sign screener. The majority of caregivers spoke English (96%), were mothers (85%), and identified as White (75%). 83% of caregivers were able to attend rounds at least once and 98% believed attending rounds was helpful. Within the PICU provider focus groups, there were 11 participants (3 attendings, 3 fellows, 2 nurse practitioners, 1 hospitalist, 2 research assistants). Focus group participants described facilitators and barriers to implementation, which were mapped to CFIR domains. Timing of screening and person administering screening were identified as modifiable factors to improve future implementation. Conclusion We found the health literacy levels of PICU caregivers in our setting is similar to prior assessments of parental health literacy. Participation in morning rounds was helpful for developing understanding of their child's illness, regardless of health literacy status. Qualitative feedback from providers identified barriers across all CFIR domains, with timing of screening and person administering screening as modifiable factors to improve future implementation.
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Affiliation(s)
- Anireddy R. Reddy
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Department of Anesthesiology and Critical Care, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States
| | - Anushree K. Doshi
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Department of Anesthesiology and Critical Care, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Allison Mak
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States
- Department of General Surgery, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Judy A. Shea
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States
- Department of Medicine, Perelman School of Medicine and University of Pennsylvania, Philadelphia, PA, United States
| | - Joana T. Fardad
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Jiwon Moon
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Paula Hu
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
| | - Annery G. Garcia-Marcinkiewicz
- Department of Anesthesiology and Critical Care Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA, United States
- Department of Anesthesiology and Critical Care, The University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
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Brunt MW, Haley DB, LeBlanc SJ, Kelton DF. Perceived role of the veterinarian in promoting dairy cattle welfare. Front Vet Sci 2023; 10:1325087. [PMID: 38164396 PMCID: PMC10757964 DOI: 10.3389/fvets.2023.1325087] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/04/2023] [Indexed: 01/03/2024] Open
Abstract
Improving the lives of animals in agricultural systems has primarily focused on minimizing negative experiences. Research is needed on the promotion of positive experiences (pleasure, enjoyment, play, choice, happiness) for animals and the role of veterinarians in their promotion. Our aims were to describe how Canadian bovine veterinarians and veterinary students perceive the role of a veterinarian in positive vs. negative experiences for dairy cows and to analyze the rationale provided to explain their answers. Canadian veterinary practitioners (n = 78) and veterinary students (n = 148) responded to an online cross-sectional survey and were asked, on a 7-point scale, how important the role of a veterinarian is to promote practices that influence the experience of dairy cows. We used qualitative description to analyse participants' open-ended text responses. Practices to minimize negative experiences were most important (mean ± SE; 6.8 ± 0.03), a balance of positive and negative experiences was less important (6.4 ± 0.05), and encouragement of positive experiences scored lowest (6.0 ± 0.06), although all scored highly. Four themes were identified to explain participants' reasoning regarding their perceived role of a veterinarian in the promotion of dairy cattle welfare, centered on: the animal, the producer, the veterinarian, and society. Participants indicated that promoting positive experiences was less important than decreasing negative experiences (5.9 ± 0.09). There were four themes identified to explain participants' reasoning regarding the relative importance of promotion of positive experiences versus decreasing negative experiences which centered on: frameworks to compare positive and negative experiences, impacts on the animal, the participant's view of their role, and the practicality of implementation. These results indicate modest differences in valuing avoidance of negative vs. promotion of positive welfare. There were no differences in the quantitative analyses between veterinarians and veterinary students. We conclude that veterinarians are favorably disposed to positive aspects of welfare for dairy cows but may be more focussed on avoidance of negative aspects of welfare.
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Affiliation(s)
- Michael W. Brunt
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
- Campbell Centre for the Study of Animal Welfare, University of Guelph, Guelph, ON, Canada
- Dairy at Guelph, University of Guelph, Guelph, ON, Canada
| | - Derek B. Haley
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
- Campbell Centre for the Study of Animal Welfare, University of Guelph, Guelph, ON, Canada
- Dairy at Guelph, University of Guelph, Guelph, ON, Canada
| | - Stephen J. LeBlanc
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
- Campbell Centre for the Study of Animal Welfare, University of Guelph, Guelph, ON, Canada
- Dairy at Guelph, University of Guelph, Guelph, ON, Canada
| | - David F. Kelton
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
- Campbell Centre for the Study of Animal Welfare, University of Guelph, Guelph, ON, Canada
- Dairy at Guelph, University of Guelph, Guelph, ON, Canada
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Fins IS, Singleton DA, Radford AD, Sánchez-Vizcaíno F, Pinchbeck GL. A mixed-methods approach utilising electronic health records to examine antimicrobial prescription surrounding gastrointestinal clinical presentations in dogs and cats. Front Vet Sci 2023; 10:1166114. [PMID: 38149298 PMCID: PMC10749927 DOI: 10.3389/fvets.2023.1166114] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 11/16/2023] [Indexed: 12/28/2023] Open
Abstract
Introduction Systemically-administered antimicrobials are often prescribed in canine and feline gastrointestinal clinical presentations. Responsible use of antimicrobials, particularly those considered Highest Priority Critically Important Antimicrobials (HPCIAs) is vital to tackle antimicrobial resistance. Although practice-level prescription guidance is available, further strategies based on a greater understanding of antimicrobial prescription at the population-level are needed. Here, we used a mixed-methods approach, harnessing veterinary electronic health records (EHRs) to characterise the use of antimicrobials in canine and feline gastrointestinal presentations, and to explore justification and reasoning around antimicrobial prescribing, particularly of HPCIAs. Methods This observational study used 23,337 EHRs complemented with veterinary practitioner-completed questionnaires, from canine and feline gastrointestinal consultations from 225 volunteer UK veterinary practices between April 2014 and September 2018. Results A total of 83.4% (95% confidence interval (CI) 82.6-84.3) gastrointestinal presentations were reported as mild, with non-haemorrhagic diarrhoea and vomiting the most frequently reported clinical signs. Systemically-administered antimicrobials occurred in 28.6% of canine (95% CI 26.9-30.3) and 22.4% of feline (95% CI 20.4-24.4) gastrointestinal consultations, with HPCIA prescription occurring more frequently in cats. Results of multivariable analysis showed the presence of non-haemorrhagic diarrhoea (canine Odds Ratio (OR) 2.1, 95% CI 1.9-2.3; feline OR 1.8, 95% CI 1.5-2.1), haemorrhagic diarrhoea (canine OR 4.2, 95% CI 3.8-4.7; feline OR 3.1, 95% CI 2.4-3.8), and moderate/severe presentations (canine OR 1.9, 95% CI 1.7-2.8; feline OR 2.0, 95% CI 1.7-2.5) were positively associated with receiving a systemically-administered antimicrobial. Thematic analysis of clinical narrative content of 516 gastrointestinal consultations where HPCIAs were prescribed allowed the identification of ten factors underpinning reasoning or decision-making for HPCIA prescription: perceived animal/owner compliance; owner's expectations; perceived risk of infection; clinical signs; recent clinical history; perceived positive previous response to antimicrobial therapy; geriatric patients and euthanasia; concomitant conditions; diagnostic testing and the behavioral trend to trial antimicrobial therapy empirically in gastrointestinal cases. No explicit justification for HPCIA prescription was recorded in 77% of cases. Discussion Improving recorded justification represents a clear target for stewardship programmes. By utilising a complementary mixed-methods approach to EHRs, this study unlocks previously untapped data recorded within EHRs. These results can help inform targeted interventions, contributing towards enhanced antimicrobial stewardship.
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Affiliation(s)
- Ivo S. Fins
- Institute of Infection, Veterinary and Ecological Sciences, Department of Livestock and One Health, University of Liverpool, Neston, United Kingdom
| | - David A. Singleton
- Institute of Infection, Veterinary and Ecological Sciences, Department of Livestock and One Health, University of Liverpool, Neston, United Kingdom
| | - Alan D. Radford
- Institute of Infection, Veterinary and Ecological Sciences, Department of Infection Biology and Microbiomes, University of Liverpool, Neston, United Kingdom
| | | | - Gina L. Pinchbeck
- Institute of Infection, Veterinary and Ecological Sciences, Department of Livestock and One Health, University of Liverpool, Neston, United Kingdom
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Vaughn VM, Krein SL, Hersh A, Buckel WR, White AT, Horowitz J, Patel PK, Gandhi TN, Petty LA, Spivak ES, Bernstein SJ, Malani AM, Johnson LB, Neetz RA, Flanders SA, Galyean P, Kimball E, Bloomquist K, Zickmund T, Zickmund SL, Szymczak JE. Excellence in Antibiotic Stewardship: A mixed methods study comparing High, Medium, and Low Performing Hospitals. Clin Infect Dis 2023:ciad743. [PMID: 38059532 DOI: 10.1093/cid/ciad743] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/13/2023] [Accepted: 12/01/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND Despite antibiotic stewardship programs existing in most acute care hospitals, there continues to be variation in appropriate antibiotic use. While existing research examines individual prescriber behavior, contextual reasons for variation are poorly understood. METHODS We conducted an explanatory, sequential mixed methods study of a purposeful sample of 7 hospitals with varying discharge antibiotic overuse. For each hospital, we conducted surveys, document analysis, and semi-structured interviews with antibiotic stewardship and clinical stakeholders. Data were analyzed separately and mixed during the interpretation phase, where each hospital was examined as a case, with findings organized across cases using a strengths, weaknesses, opportunities, and threats framework to identify factors accounting for differences in antibiotic overuse across hospitals. RESULTS Surveys included 85 respondents. Interviews included 90 respondents (31 hospitalists, 33 clinical pharmacists, 14 stewardship leaders, 12 hospital leaders). On surveys, clinical pharmacists at hospitals with lower antibiotic overuse were more likely to report feeling: respected by hospitalist colleagues (p=0.001), considered valuable team members (p=0.001), comfortable recommending antibiotic changes (p=0.02). Based on mixed-methods analysis, hospitals with low antibiotic overuse had four distinguishing characteristics: a) robust knowledge of and access to antibiotic stewardship guidance, b) high quality clinical pharmacist-physician relationships, c) tools and infrastructure to support stewardship, and d) highly engaged Infectious Diseases physicians who advocated stewardship principles. CONCLUSION This mixed-method study demonstrates the importance of organizational context for high performance in stewardship and suggests improving antimicrobial stewardship requires attention to knowledge, interactions, and relationships between clinical teams and infrastructure that supports stewardship and team interactions.
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Affiliation(s)
- Valerie M Vaughn
- Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Division of Health System Innovation & Research, Department of Population Health Science, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Division of Hospital Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Sarah L Krein
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Division of General Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Adam Hersh
- Division of Infectious Diseases, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Whitney R Buckel
- Intermountain Healthcare Pharmacy Services, Taylorsville, UT, USA
| | - Andrea T White
- Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Jennifer Horowitz
- Division of Hospital Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Payal K Patel
- Division of Infectious Diseases, Department of Medicine, Intermountain Health, Salt Lake City, Utah, USA
| | - Tejal N Gandhi
- Division of Infectious Diseases, Department of Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Lindsay A Petty
- Division of Infectious Diseases, Department of Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Emily S Spivak
- Division of Infectious Diseases, Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Steven J Bernstein
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Division of General Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Anurag M Malani
- Division of Infectious Diseases, Department of Internal Medicine, Trinity Health Michigan, Ann Arbor, Michigan, USA
| | - Leonard B Johnson
- Division of Infectious Diseases, Department of Internal Medicine, Ascension St. John Hospital, Detroit, Michigan, USA
| | - Robert A Neetz
- Department of Pharmacy, MyMichigan Health, Midland, Michigan, USA
| | - Scott A Flanders
- Division of Hospital Medicine, Department of Internal Medicine, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Patrick Galyean
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Elisabeth Kimball
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Kennedi Bloomquist
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Tobias Zickmund
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Susan L Zickmund
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
- Informatics, Decision-Enhancement & Analytic Sciences Center, VA Salt Lake City Healthcare System, Salt Lake City, Utah, USA
| | - Julia E Szymczak
- Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
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Gonzalo JD, Graaf D, Wolpaw DR, Lehman E, Thompson BM. Non-physician and physician preceptors in Landscapes of Practice: a mixed-methods study exploring learning for 1 st-year medical students in clinical experiences. Med Educ Online 2023; 28:2166386. [PMID: 36642918 PMCID: PMC9848231 DOI: 10.1080/10872981.2023.2166386] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 02/22/2022] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Medical education has traditionally relied on physician educators. With expanding Health Systems Science competencies, non-physician healthcare providers are required. To investigate preceptor-role types, communication frequency, and importance of preceptors in value-added patient navigator roles (PN) and clinical preceptorships (CP). Using a mixed-methods approach, medical students participating in PN and CP during the first year of medical school (n=191) identified individuals with whom they communicated and communication frequency (1=never, 7=frequently), and importance of preceptors to work/education (1=not important, 7=extremely important; open-ended responses). Quantitative data were analyzed via repeated measures using a mixed-effects model and McNemar's test; effect size was calculated via Cohen's d or Cohen's h; qualitative data was analyzed using thematic analysis. Comparing ratings for non-physicians to physician healthcare professionals in PN, communication frequency (5.54 vs 3.65; p<0.001, d=1.18), importance to work (5.77 vs 4.28, p<0.001, d=0.89) and education (5.02 vs 4.12, p<0.001; d=0.49) were higher for non-physician educators. Comparing ratings for non-physicians to physician healthcare professionals in CP, communication frequency (4.93 vs. 6.48, p<0.001, d=1.33), importance to work (5.12 vs 6.61 vs, p<0.001, d=1.29) and education (4.32 vs 6.55, p<0.001, d=1.89) were higher for physician educators. Qualitative analysis indicated that non-physician healthcare providers in PN focused on Health Systems Science concepts, including social determinants of health and healthcare delivery. In PN, students observed collaboration from the perspective of multiple providers. In CP, healthcare providers, mainly physicians, focused on physician-centric clinical skills and interprofessional collaboration from the physician's perspective. Educational benefits of non-physician healthcare professionals related to Health Systems Science in work-based clinical settings - or Landscapes of Practice - can help students understand systems-based concepts such as social determinants of health, healthcare delivery systems, and interprofessional collaboration. Differences in the educational value of non-physician healthcare educators perceived by students should be further explored.
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Affiliation(s)
- Jed D. Gonzalo
- Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Deanna Graaf
- Penn State College of Medicine, Hershey, Pennsylvania, USA
| | - Daniel R. Wolpaw
- Department of Medicine, Penn State College of Medicine in Hershey, Pennsylvania, USA
| | - Erik Lehman
- Penn State College of Medicine, Hershey, Pennsylvania, USA
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Pavlovic N, Brady B, Boland R, Harris IA, Flood VM, Genel F, Gao M, Naylor JM. A mixed methods approach to investigating physical activity in people with obesity participating in a chronic care programme awaiting total knee or hip arthroplasty. Musculoskeletal Care 2023; 21:1447-1462. [PMID: 37772968 DOI: 10.1002/msc.1825] [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: 09/03/2023] [Revised: 09/09/2023] [Accepted: 09/14/2023] [Indexed: 09/30/2023]
Abstract
AIMS To describe patient-reported physical activity and step count trajectory and explore perceived barriers and enablers to physical activity amongst people with obesity participating in a chronic care programme whilst awaiting arthroplasty. DESIGN Convergent parallel mixed-method study. METHOD A patient cohort derived from a longitudinal sample of adults with end-stage osteoarthritis and obesity from a chronic care programme whilst awaiting primary total knee or hip arthroplasty (n = 97) was studied. Physical activity was measured at baseline (entry to the wait list) and before surgery (9-12 months waiting time) using the Lower Extremity Activity Scale (LEAS) and activity monitors (activPAL™). A subset of participants completed in-depth semi-structured interviews 6 months after being waitlisted to explore perceived barriers and enablers to physical activity. Themes were inductively derived and then interpreted through the COM-B model. RESULTS Baseline LEAS and activPAL™ data were available from 97 and 63 participants, respectively. The proportion of community ambulant individuals reduced from 43% (95% CI 33%-53%) at baseline to 17% (95% CI 9%-28%) pre-surgery. Paired activPAL™ data (n = 31) for step count, upright time, and stepping time remained unchanged. Twenty-five participants were interviewed. Five themes underpinning physical activity were mapped to the COM-B model components of capability (physical capability), opportunity (accessibility and social norms), and motivation (self-efficacy and beliefs and physical activity). CONCLUSIONS Participation in a chronic care programme did not improve physical activity levels for people with obesity awaiting arthroplasty. Programs cognisant of the COM-B model components may be required to address the natural trajectory of declining physical activity levels while awaiting arthroplasty.
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Affiliation(s)
- Natalie Pavlovic
- South Western Sydney Clinical School, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- Fairfield Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
| | - Bernadette Brady
- Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
- School of Health Sciences, Western Sydney University, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Robert Boland
- Fairfield Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Ian A Harris
- Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
- School of Clinical Medicine, UNSW Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Victoria M Flood
- University Centre for Rural Health, Northern Rivers, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Furkan Genel
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
- St George and Sutherland Clinical School, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Manxin Gao
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Justine M Naylor
- South Western Sydney Clinical School, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
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Bradford C, Martin D, J Loughran K, Robertson N, Carne A, Skidmore N, L Harrison S. The impact of sport on the physical, psychological and social wellbeing of people with chronic breathlessness: A mixed-methods systematic review. Clin Rehabil 2023; 37:1611-1636. [PMID: 37518887 PMCID: PMC10580676 DOI: 10.1177/02692155231190770] [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: 11/07/2022] [Accepted: 07/12/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE Sport participation may have quality-of-life benefits for people with chronic breathlessness; however, its feasibility and impact on health are unknown. We aimed to synthesise the scientific literature concerning the impact of sport for people with chronic breathlessness. DATA SOURCES Searches of MEDLINE, CINAHL, PsycINFO, Embase, SPORTDiscus and Google Scholar were conducted (May 2023). REVIEW METHODS Studies were included if they assessed the impact of sport with participants who were likely to suffer from chronic breathlessness due to an underlying condition (e.g. severe asthma, heart failure). A convergent-segregated approach to synthesis in accordance with the JBI methodology for mixed-methods reviews was utilised, including meta-analytic and meta-aggregation analyses. RESULTS A total of 22 studies met the inclusion criteria. Studies sampled 1017 participants from 13 different countries, with sample sizes ranging from 5 to 185. Causes of breathlessness consisted of chronic respiratory diseases (9 studies) and coronary heart disease (13 studies). Design-wise, 18 reported quantitative methods, 3 qualitative, and 1 mixed-methods. CONCLUSIONS Sports were well-adhered to with only minor/unrelated adverse events reported. Improvements in exercise capacity were observed although there was no impact on health-related quality of life. Other quantitative outcomes extracted varied widely across studies, making it difficult to draw firm conclusions. Participation in sports was reliably recorded at intensity consistent with moderate-to-vigorous activity despite being self-paced. Qualitative themes emphasised the positive elements of sport participation, namely, social cohesion, the capacity to incorporate culture, and the idea that participation is enjoyable rather than a necessary chore to maintain one's health.
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Affiliation(s)
- Callum Bradford
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Denis Martin
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Kirsti J Loughran
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Noelle Robertson
- School of Psychology and Vision Sciences, University of Leicester, Leicester, UK
| | - Alexandra Carne
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Nathan Skidmore
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
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Emery LT, Evans CM, Dimitrova J, O'Keefe C, Simms LJ. Understanding the association between normal and maladaptive personality traits: Replication and extension of Morey et al. (2020). J Pers 2023. [PMID: 38014708 DOI: 10.1111/jopy.12904] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/08/2023] [Accepted: 11/05/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND/OBJECTIVE The Alternative Model for Personality Disorders (AMPD) within the DSM-5 includes separable components representing general personality dysfunction (Criterion A) and maladaptive personality traits (Criterion B). Some critique Criterion A for accounting for little incremental variance in PD beyond Criterion B. However, Morey et al. (2020) hypothesized that personality dysfunction is a key mechanism through which normal-range traits account for the maladaptive component of personality traits, justifying its inclusion. We sought to replicate and extend this work in a psychiatric sample with mixed methods. METHOD In total, 152 participants recruited from mental health clinics completed multiple measures of personality dysfunction and normal-range and maladaptive traits. RESULTS Replication was only partially achieved. The degree of incremental prediction of maladaptive traits and the extent to which personality dysfunction explained the relations between normal-range and maladaptive traits varied significantly across traits, and those effects that reached significance were small in magnitude. Removing variance due to personality dysfunction reduced intercorrelations among maladaptive traits by only a small amount. CONCLUSION Counter to Morey et al. (2020), our results failed to support maladaptive traits as composites of normal-range traits and personality dysfunction, suggesting that other methods of distinguishing personality pathology severity and style are needed.
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Affiliation(s)
- Leah T Emery
- Department of Psychology, University at Buffalo, Buffalo, New York, USA
| | - Chloe M Evans
- Department of Psychology, University at Buffalo, Buffalo, New York, USA
| | - Julia Dimitrova
- Department of Psychology, University at Buffalo, Buffalo, New York, USA
| | - Courtney O'Keefe
- Department of Psychology, University at Buffalo, Buffalo, New York, USA
| | - Leonard J Simms
- Department of Psychology, University at Buffalo, Buffalo, New York, USA
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Gruber R, Häfner M, Kachel S. Dressing up social psychology: Empirically investigating the psychological functions of clothing using the example of symbolic protection. Br J Soc Psychol 2023. [PMID: 38010875 DOI: 10.1111/bjso.12700] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/29/2023]
Abstract
Clothing behaviour remains an understudied research area within social psychology. Through the present research, we aim to anchor attire as an empirical research subject by investigating the psychological properties of one of its functionalities, namely, to provide protection. We argue that attire's undisputed role in shielding humans from environmental hazards may extend to the psychological level and protect them from the incorporeal consequences of existential threats symbolically. In this Registered Report, a mixed-methods approach links an ecologically valid field study of self-presentation in social media posts during Russia's war on Ukraine (Study 1; N = 248) with supraliminal priming of mortality salience in an online experiment (Study 2; N = 248). Across both studies, we expect that mortality concerns let people accentuate the physically protective attributes of clothing (e.g. more layers of clothing) and resort to more in-group prototypical dress styles (i.e. more gender-stereotypical). Findings show that people adjust their clothing preferences in response to existential threats, favouring in-group prototypical clothing (more gender-typical for both women and men in Study 1) and physically protective attire (higher in women and lower in men in Study 2) during high (vs. low) levels of existential threat. By positioning clothing as a research area within social psychology, our goal is to stimulate a wave of research on its profound role for humankind. Furthermore, we provide a dynamic and robust methodological approach to researching terror management theory.
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Affiliation(s)
- Robert Gruber
- Institute for Theory and Practice of Communication, Berlin University of the Arts, Berlin, Germany
- Department of Social, Environmental, and Economic Psychology, University of Kaiserslautern-Landau, Landau, Germany
| | - Michael Häfner
- Institute for Theory and Practice of Communication, Berlin University of the Arts, Berlin, Germany
| | - Sven Kachel
- Department of Social, Environmental, and Economic Psychology, University of Kaiserslautern-Landau, Landau, Germany
- Department of Languages, University of Helsinki, Helsinki, Finland
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He J, Hu K, Wang B, Wang H. Effects of women with gestational diabetes mellitus related weight gain on pregnancy outcomes and its experiences in weight management programs: a mixed-methods systematic review. Front Endocrinol (Lausanne) 2023; 14:1247604. [PMID: 38075066 PMCID: PMC10699134 DOI: 10.3389/fendo.2023.1247604] [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] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/10/2023] [Indexed: 12/18/2023] Open
Abstract
Introduction Proper controlling gestational diabetes mellitus (GDM)-related gestational weight gain (GWG) during pregnancy can optimize pregnancy outcomes and improve postpartum glucose homeostasis. This study aimed to explore the existing intervention programs, the effects on pregnancy outcomes, and the experiences of weight management for GDM-related GWG in women with GDM. Methods This mixed-methods systematic review was retrieved from nine databases. The retrieval time was from the database construction to September 20, 2023, and all studies were published in English and Chinese. The included records used quantitative, qualitative, or mixed methods and reported original studies of weight-related intervention regimens, effects on pregnancy outcomes, and women's experiences and perceptions. This review used a convergent segregated approach to synthesize and integrate research findings from Joanna Briggs Institute (JBI) mixed-methods systematic reviews. Results There were 16 articles that met the inclusion criteria, and the articles came from seven different countries and included 23,997 women with GDM. The meta-analysis pooled outcomes for the incidence of weight gain exceeding the Institute of Medicine (IOM) recommendations after GDM diagnosis to delivery was 0.31% (95% CI 0.21-0.42). The effectiveness of GDM-related weight interventions in reducing weight gain after GDM diagnosis was supported by quantitative evidence. The GDM-related GWG below the IOM recommendations is a protective factor (OR=0.68, 95%CI 0.48-0.97) for large for gestational Age (LGA), and above the IOM recommendations is a risk factor (OR=1.62, 95%CI 1.15-2.27) for LGA. In addition, no significant statistical significance was found in the pooled outcomes of small for gestational age (SGA). Avoiding excessive weight gain helps to optimize neonatal birth weight, pregnancy outcomes, and maternal blood glucose levels. According to qualitative survey results, some women with GDM experienced weight stigma, and a positive relationship between healthcare providers and GDM women helped in weight management. Conclusion Following a diagnosis of GDM, weight management interventions positively affected GWG and pregnancy outcomes. In order to improve compliance and safety of weight management in women with GDM, criteria and interventions for weight gain associated with GDM need to be further explored and improved. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=404492, identifier CRD42023404492.
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Affiliation(s)
- Jing He
- Nursing Department, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- School of Nursing, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Kaili Hu
- Nursing Department, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Binghua Wang
- Nursing Department, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Hui Wang
- Nursing Department, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
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Griebler U, Dobrescu A, Ledinger D, Klingenstein P, Sommer I, Emprechtinger R, Persad E, Gadinger A, Trivella M, Klerings I, Nussbaumer-Streit B. Evaluation of the interim Cochrane rapid review methods guidance-A mixed-methods study on the understanding of and adherence to the guidance. Res Synth Methods 2023; 14:824-846. [PMID: 37483013 DOI: 10.1002/jrsm.1656] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/11/2023] [Accepted: 07/02/2023] [Indexed: 07/25/2023]
Abstract
The Cochrane Rapid Review Methods Group (RRMG) first released interim guidance in March 2020 to support authors in conducting rapid reviews (RRs). The objective of this mixed-methods study was to assess the adherence and investigate authors' understanding of the RRMG guidance. We identified all documents citing the Interim Cochrane RRMG guidance up to February 17, 2022 and performed an exploratory adherence analysis. We interviewed 20 RR authors to assess the recommendations' comprehensibility and reasons for any deviations. Further, we surveyed nine authors of COVID-19-related Cochrane reviews for their reasons for not conducting a RR. We analyzed 128 RRs (111 non-Cochrane, 17 Cochrane) that cited the RRMG guidance. Several recommendations were not followed by a large proportion of RR authors such as stepwise approach to study design inclusion or peer review of search strategies, whereas others were exceeded, for example, dual independent screening of abstracts/full texts. The most reported reasons for deviating from the guidance were time constraints, unclarities in the recommended approach, or inapplicability to the specific RR. Overall, the guidance was viewed as user-friendly; however, without pre-existing knowledge of systematic review (SR) conduct, the application was perceived as difficult. The main reasons for conducting a full SR over a RR were late availability of the guidance, preset mandate to conduct a SR, uncertainty regarding methodological distinctions between SR and RR, and inapplicability to the evidence base. Clarifications are warranted throughout the Interim Cochrane RRMG guidance to ensure that users with various experience levels can understand and apply its recommendations accordingly.
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Affiliation(s)
- Ursula Griebler
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
| | - Andreea Dobrescu
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
| | - Dominic Ledinger
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
| | - Pauline Klingenstein
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
| | - Isolde Sommer
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
| | - Robert Emprechtinger
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
- Faculty of Health and Medicine, University of Krems, Krems an der Donau, Austria
| | - Emma Persad
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Arianna Gadinger
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
| | - Marialena Trivella
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
- Department of Cardiovascular Medicine, John Radcliffe Hospital, Oxford, UK
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Irma Klerings
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
| | - Barbara Nussbaumer-Streit
- Department for Evidence-based Medicine and Evaluation, University of Krems, Krems an der Donau, Austria
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Williams AJ, Freed M, Theofanopoulou N, Daudén Roquet C, Klasnja P, Gross J, Schleider J, Slovak P. Feasibility, Perceived Impact, and Acceptability of a Socially Assistive Robot to Support Emotion Regulation With Highly Anxious University Students: Mixed Methods Open Trial. JMIR Ment Health 2023; 10:e46826. [PMID: 37906230 PMCID: PMC10646679 DOI: 10.2196/46826] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Mental health difficulties among university students have been rising rapidly over the last decade, and the demand for university mental health services commonly far exceeds available resources. Digital interventions are seen as one potential solution to these challenges. However, as in other mental health contexts, digital programs often face low engagement and uptake, and the field lacks usable, engaging, evidence-supported mental health interventions that may be used flexibly when students need them most. OBJECTIVE The aim of this study is to investigate the feasibility and acceptability of a new, in situ intervention tool (Purrble) among university students experiencing anxiety. As an intervention, Purrble was designed to provide in situ support for emotion regulation (ER)-a well-known transdiagnostic construct-directly in the moments when individuals are facing emotionally challenging situations. A secondary aim is to consider the perceived impact of Purrble on youth mental health, as reported by students over a 7-week deployment. METHODS A mixed methods open trial was conducted with 78 under- and postgraduate students at Oxford University. Participants were recruited based on moderate to high levels of anxiety measured by Generalized Anxiety Disorder-7 at baseline (mean 16.09, SD 3.03). All participants had access to Purrble for 7 weeks during the spring term with data on their perceived anxiety, emotion dysregulation, ER self-efficacy, and engagement with the intervention collected at baseline (pre), week 4 (mid), and week 8 (postintervention). Qualitative responses were also collected at the mid- and postintervention points. RESULTS The findings demonstrated a sustained engagement with Purrble over the 7-week period, with the acceptability further supported by the qualitative data indicating that students accepted Purrble and that Purrble was well-integrated into their daily routines. Exploratory quantitative data analysis indicated that Purrble was associated with reductions in student anxiety (dz=0.96, 95% CI 0.62-1.29) and emotion dysregulation (dz=0.69, 95% CI 0.38-0.99), and with an increase in ER self-efficacy (dz=-0.56, 95% CI -0.86 to -0.26). CONCLUSIONS This is the first trial of a simple physical intervention that aims to provide ongoing ER support to university students. Both quantitative and qualitative data suggest that Purrble is an acceptable and feasible intervention among students, the engagement with which can be sustained at a stable level across a 7-week period while retaining a perceived benefit for those who use it (n=32, 61% of our sample). The consistency of use is particularly promising given that there was no clinician engagement or further support provided beyond Purrble being delivered to the students. These results show promise for an innovative intervention model, which could be complementary to the existing interventions.
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Affiliation(s)
- A Jess Williams
- Department of Informatics, King's College London, London, United Kingdom
| | - Maureen Freed
- Psychodynamic Studies, University of Oxford, Oxford, United Kingdom
| | | | | | - Predrag Klasnja
- School of Information, University of Michigan, Ann Arbor, MI, United States
| | - James Gross
- Psychophysiology Laboratory, University of Stanford, Stanford, CA, United States
| | - Jessica Schleider
- Department of Psychology, Stony Brook University, New York, NY, United States
| | - Petr Slovak
- Department of Informatics, King's College London, London, United Kingdom
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Finn S, Wright LHV, Mak HW, Åström E, Nicholls L, Dingle GA, Warran K. Expanding the social cure: a mixed-methods approach exploring the role of online group dance as support for young people (aged 16-24) living with anxiety. Front Psychol 2023; 14:1258967. [PMID: 37915522 PMCID: PMC10616254 DOI: 10.3389/fpsyg.2023.1258967] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 09/11/2023] [Indexed: 11/03/2023] Open
Abstract
There is an increased interest in whether online arts interventions support mental health and social connections. This study explored eight weeks of online group dance as support for young people (aged 16-24) living with anxiety. The applicability of the 'social cure' theoretical framework to the novel context of an online dance class was sought. The study utilised an embedded QUAL+quan design, incorporating participatory focus group discussions (n = 3 groups; n = 11 participants) and one-on-one interviews (n = 2 participants), creative reflections (n = 16 participants) and ethnographic fieldnotes, and a repeated measures design with surveys at three timepoints (week 1, n = 27; week 4, n = 18; week 8, n = 14). Thematic analysis identified two overarching themes demonstrating how the dance classes (i) provided the opportunity to co-construct a meaningful shared identity and (ii) supported holistic wellbeing. The quantitative findings supported this, suggesting lower anxiety, depression, and loneliness and higher wellbeing, self-esteem, self-efficacy, and group closeness. This study expands the social cure to its application to an online dance context for the first time.
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Affiliation(s)
- Saoirse Finn
- WHO Collaborating Centre for Arts & Health, Social Biobehavioural Research Group, Department of Behavioural Science & Health, Institute of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Laura H. V. Wright
- Childhood and Youth Studies Research Group, Institute for Community, Education, and Society, Moray House School of Education and Sport, The University of Edinburgh, Edinburgh, United Kingdom
| | - Hei Wan Mak
- WHO Collaborating Centre for Arts & Health, Social Biobehavioural Research Group, Department of Behavioural Science & Health, Institute of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Emili Åström
- Dance Base, Scotland’s National Centre for Dance, Edinburgh, United Kingdom
| | - Lucy Nicholls
- WHO Collaborating Centre for Arts & Health, Social Biobehavioural Research Group, Department of Behavioural Science & Health, Institute of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Genevieve A. Dingle
- Music, Dance and Health Research Group, School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - Katey Warran
- WHO Collaborating Centre for Arts & Health, Social Biobehavioural Research Group, Department of Behavioural Science & Health, Institute of Epidemiology and Public Health, University College London, London, United Kingdom
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Hanlon CA, Chopra J, Boland J, McIlroy D, Poole H, Saini P. A mixed-methods evaluation of the acceptability and fidelity of the James' Place model for men experiencing suicidal crisis. Health Psychol Behav Med 2023; 11:2265142. [PMID: 37842012 PMCID: PMC10572045 DOI: 10.1080/21642850.2023.2265142] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 09/25/2023] [Indexed: 10/17/2023] Open
Abstract
Background Research supports development of informal, community-based suicide prevention interventions that can be tailored to suit men's unmet needs. The James' Place model (JPM) is a community-based, clinical suicide prevention intervention for men experiencing suicidal crisis. Evidence supports the efficacy of the JPM and there are plans to expand to additional sites across the UK. This study evaluates therapists perceived acceptability of the JPM, and if fidelity to the planned delivery of the model is maintained within therapeutic practice. Method A mixed-methods design was used. Descriptive analyses of 30 completed intervention cases were examined to review fidelity of the model against the intervention delivery plan. Eight therapists took part in semi-structured interviews between November 2021 and March 2022 exploring the perceived acceptability, and barriers and facilitators to delivering the JPM. Results Descriptive analyses of James' Place audit notes revealed high levels of adherence to the JPM amongst therapists, but highlighted components of the model needed to be tailored according to individual men's needs. Thematic analysis led to the development of five themes. The first theme, therapeutic environment highlighted importance of the therapy setting. The second theme identified was specialised suicide prevention training in the JPM that facilitated therapists understanding and expertise. The third theme identified was therapy engagement which discusses men's engagement in therapy. The fourth theme, person-centred care related to adaptation of delivery of JPM components. The final theme, adapting the JPM to individual needs describes tailoring of the JPM by therapists to be responsive to individual men's needs. Conclusion The findings evidence therapist's acceptability and their moderate adherence to the JPM. Flexibility in delivery of the JPM enables adaptation of the model and co-production of therapy to meet men's needs. Implications for clinical practice are discussed.
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Affiliation(s)
- Claire Anne Hanlon
- Department of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Jennifer Chopra
- Department of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Jane Boland
- MSc Leadership in Healthcare, James’ Place, Liverpool, UK
| | - David McIlroy
- Department of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Helen Poole
- Department of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Pooja Saini
- Department of Psychology, Liverpool John Moores University, Liverpool, UK
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Leo DG, Lane DA, Riley M, Lotto AA, Lotto RR. Facilitators and barriers of physical activity participation in children with a single ventricle physiology: a mixed-methods study. Cardiol Young 2023; 33:1992-1999. [PMID: 36484131 DOI: 10.1017/s1047951122003754] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The present study focuses on assessing the physical activity level of children with Fontan circulation for Hypoplastic Left Heart Syndrome and identifying potential barriers and facilitators toward their participation in physical activity. PATIENTS AND METHODS Seven children aged 5-16 years (mean (SD) 8.8 (3.7) years) with a Fontan procedure for hypoplastic left heart syndrome, their parents (n = 7), and siblings (n = 1) were recruited. Data were collected using a mixed-methods approach: (i) children wore an activity monitor for 7 days to record physical activity, with sedentary time and level of activity calculated from accelerometer data; (ii) children completed a bespoke questionnaire recording limitations in physical activity; (iii) parents completed a semi-structured interview discussing perceptions about their child's physical activity participation. Qualitative data were analysed using thematic analysis. RESULTS Activity monitors data recorded highly active children with a mean (SD) of 153(36) minutes/day spent in moderate-to-vigorous physical activity. Time spent in sedentary behaviour was also high (57.5% of total accelerometer wearing-time). Four key themes relating to parental perceptions of physical activity were identified: (i) A new lease of life -post-Fontan; (ii) Setting limits - managing limitations; (iii) The wider world - how others set limits; and (iv) "I fear the future" - parental concerns. CONCLUSION Following completion of the Fontan circulation, children engaged in higher levels of physical activity in comparison to the national average. However, more than half their time was spent in sedentary behaviour. Fears and anxiety from parents and teachers may act as a barrier toward physical activity participation.
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Affiliation(s)
- Donato Giuseppe Leo
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest, Liverpool, UK
| | - Deirdre A Lane
- Department of Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest, Liverpool, UK
| | - Marlene Riley
- Department of Paediatric Cardiac Surgery, Alder Hey Children's Hospital, Liverpool, UK
| | - Attilio A Lotto
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest, Liverpool, UK
- Department of Paediatric Cardiac Surgery, Alder Hey Children's Hospital, Liverpool, UK
- School of Nursing and Allied Health, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Robyn R Lotto
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest, Liverpool, UK
- School of Nursing and Allied Health, Faculty of Health, Liverpool John Moores University, Liverpool, UK
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Avila A, Cordero J, Ibilah O, Frietze G, Moya EM. Hispanic Survivors and Caregivers of Human Papillomavirus-Associated Cancers: Lived Experiences in a U.S.-Mexico Border Community. Health Educ Behav 2023; 50:595-603. [PMID: 36511085 PMCID: PMC10468152 DOI: 10.1177/10901981221139179] [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] [Indexed: 08/24/2023]
Abstract
Although human papillomavirus (HPV)-associated cancers are preventable and treatable at early stages, health disparities in HPV-associated cancer outcomes continue to exist among Hispanic populations. Hispanics residing along the U.S.-Mexico border face barriers distinct from other geographically dispersed populations within the United States. The current research aimed to explore perspectives and lived experiences of survivors and caregivers of HPV-associated cancers in El Paso, Texas, to inform intervention development and health practices to increase preventive services among populations residing on the U.S.-Mexico border region. A mixed-method approach was employed using a semi-structured interview guide with Quality of Life (QOL) scales with (N = 29) survivors and caregivers of HPV-associated cancers. Content analysis was used to extract themes and descriptive statistics were reported for quality of life. Five major themes were identified: (1) barriers to preventive services and treatment; (2) role of health care providers in diagnosis and care; (3) treatment challenges, support systems, and challenges associated with caregiving; and (4) HPV prevention and health recommendations from survivors and caregivers. Finally, given the context of the COVID-19 pandemic, an additional theme was explored on accessibility to health and human services. QOL scales suggested better overall physical health and spiritual well-being in survivors and fear of reoccurrence among caregivers and survivors. The current research highlights the role of health care providers and human service professionals in the promotion of health practices of at-risk populations by increasing health literacy among cancer patients and caregivers, and exploring experiences, challenges, and messages caregivers and survivors had regarding HPV prevention.
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Affiliation(s)
- Alondra Avila
- Border Biomedical Research Center (BBRC), The University of Texas at El Paso, El Paso, TX, USA
| | - Jacquelin Cordero
- Border Biomedical Research Center (BBRC), The University of Texas at El Paso, El Paso, TX, USA
- The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Osinachi Ibilah
- Border Biomedical Research Center (BBRC), The University of Texas at El Paso, El Paso, TX, USA
| | - Gabriel Frietze
- Border Biomedical Research Center (BBRC), The University of Texas at El Paso, El Paso, TX, USA
| | - Eva M. Moya
- Border Biomedical Research Center (BBRC), The University of Texas at El Paso, El Paso, TX, USA
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Chua WL, Wee LPC, Lim JYG, Yeo MLK, Jones D, Tan CK, Khan FA, Liaw SY. Automated rapid response system activation-Impact on nurses' attitudes and perceptions towards recognising and responding to clinical deterioration: Mixed-methods study. J Clin Nurs 2023; 32:6322-6338. [PMID: 37087695 DOI: 10.1111/jocn.16734] [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: 09/27/2022] [Revised: 02/12/2023] [Accepted: 04/05/2023] [Indexed: 04/24/2023]
Abstract
AIM To explore general ward nurses' attitudes and perceptions towards recognising and responding to clinical deterioration in a hospital with automated rapid response system activation. BACKGROUND There is growing interest in deploying automated clinical deterioration notification systems to reduce delayed or failed recognition and response to clinical deterioration of ward patients. However, little is known about its impact on ward nurses' perspectives and work patterns. DESIGN A mixed-methods study. METHODS Online survey of 168 registered nurses and individual interviews with 10 registered nurses in one acute hospital in Singapore. The study adhered to the STROBE checklist for cross-sectional studies and the COREQ guidelines for qualitative studies. RESULTS Many nurses (38.1%) rarely performed patient assessments or observations other than vital signs assessment to assess for early signs of clinical deterioration. About 30% were worried about being criticised for calling the primary team doctors. Four themes emerged from the qualitative analysis: automated rapid response system activation as a safety net, being more cautious with vital signs monitoring, the NEWS2 alone is inadequate, and ward nurses as the 'middleman' between the intensive care unit outreach nurse and primary team doctors. CONCLUSIONS Although nurses value the automated rapid response system activation as a safety net to minimise delays in accessing urgent critical care resources, it does not address the sociocultural barriers inherent in escalation of care. Although the automated system led nurses to be more cautious with vital signs monitoring, it does not encourage them to perform comprehensive patient assessments to detect early signs of deterioration. RELEVANCE TO CLINICAL PRACTICE Nurse education on assessing for clinical deterioration should focus on the use of broader patient assessment skills other than vital signs. Sociocultural barriers to escalation of care remain a key issue that needs to be addressed by hospital management. NO PATIENT OR PUBLIC CONTRIBUTION No patients, service users, care-givers or members of the public were involved in the study.
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Affiliation(s)
- Wei Ling Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Li-Phing Clarice Wee
- Department of Nursing Administration, Ng Teng Fong General Hospital, National University Health System, Singapore
| | - Jia Ying Germaine Lim
- Department of Nursing, Ng Teng Fong General Hospital, National University Health System, Singapore
| | - Min Li Kimberly Yeo
- Department of Nursing, Ng Teng Fong General Hospital, National University Health System, Singapore
| | - Daryl Jones
- Intensive Care Unit, Austin Health, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
- Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia
| | - Chee Keat Tan
- Department of Intensive Care Medicine, Ng Teng Fong General Hospital, National University Health System, Singapore
| | - Faheem Ahmed Khan
- Department of Intensive Care Medicine, Ng Teng Fong General Hospital, National University Health System, Singapore
| | - Sok Ying Liaw
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Hood P, Turner CJ, Beggs B, Owens L, Chapman AL. Making Lemonade out of Lemons: Dialectical Behavior Therapy via Telehealth During a Pandemic. Behav Ther 2023; 54:876-891. [PMID: 37597964 PMCID: PMC10065055 DOI: 10.1016/j.beth.2023.03.007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/03/2023] [Accepted: 03/23/2023] [Indexed: 04/03/2023]
Abstract
The COVID-19 pandemic has created a burden on healthcare systems and increased demand for mental healthcare at a time when in-person services are limited. Many programs offering dialectical behavior therapy (DBT) for complex clients have pivoted to telehealth in order to increase access to critical mental healthcare. There is, however, limited research on the provision of telehealth treatment for clients with complex psychopathology more broadly, or the telehealth implementation of DBT more specifically. The aim of this study was to examine the use of telehealth services and related clinician attitudes and experiences in the context of DBT. We examined the degree of telehealth platform adoption among DBT clinicians, as well as changes in stress and self-care strategies. A supplemental aim was to gather clinicians' recommendations for providing DBT via telehealth. Participants included N = 99 DBT practitioners (79.8% female; 20.2% male). Qualitative and quantitative methods were used for data analysis. Findings show that telehealth DBT has been widely adopted among DBT clinicians, and that clinicians' attitudes to telehealth DBT are cautiously optimistic. Participants described three main areas of stress associated with DBT via telehealth provision, as well as lost and novel self-care strategies.
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Towers AM, Rand S, Collins G, Smith N, Palmer S, Cassell J. Measuring quality of life in care homes when self-report is challenging: the construct validity, structural characteristics and internal consistency of the mixed-methods adult social care outcomes toolkit. Age Ageing 2023; 52:afad168. [PMID: 37659095 PMCID: PMC10474903 DOI: 10.1093/ageing/afad168] [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: 10/26/2022] [Indexed: 09/04/2023] Open
Abstract
INTRODUCTION The adult social care outcomes toolkit (ASCOT) measures social care-related quality of life (SCRQoL) using self-completion questionnaires and interviews. Many care home residents find such methods inaccessible, leading to a reliance on proxy-reporting. This study aimed to establish the psychometric properties of the mixed-methods toolkit [ASCOT-Care Homes, 4 outcome (CH4)] for measuring SCRQoL when residents cannot self-report. METHODS Two cross-sectional, mixed-methods studies were undertaken in care homes for older people in England between 2015 and 2020. We used the ASCOT-CH4 (observation, and interviews with residents and proxies) to collect information about SCRQoL and collected additional data on residents' needs and characteristics, and variables hypothesised to be related to SCRQoL.Hypothesis testing was applied to establish construct validity, Cronbach's alpha for internal consistency and exploratory factor analysis for structural validity. RESULTS The combined dataset included 475 residents from 54 care homes (34 nursing, 20 residential). Half had a diagnosis of dementia. Less than a third of residents were able to complete an ASCOT interview. Observations and proxy interviews informed researcher ratings, meaning there were no missing ASCOT-CH4 scores. ASCOT-CH4 was found to be a weak unidimensional scale, consistent with other ASCOT measures, with acceptable internal consistency (α = 0.77, 8 items). Construct validity was supported by the findings. CONCLUSIONS The ASCOT-CH4 is an alternative to conventional proxy-questionnaires for measuring the SCRQoL of care home residents, with good psychometric properties. A limitation is that users need a range of data collection skills. Future research should explore whether findings are replicable when data are collected by other researchers.
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Affiliation(s)
- Ann-Marie Towers
- Centre for Health Services Studies (CHSS), University of Kent, Kent, UK
| | - Stacey Rand
- Personal Social Services Research Unit (PSSRU), University of Kent, Kent, UK
| | - Grace Collins
- Personal Social Services Research Unit (PSSRU), University of Kent, Kent, UK
| | - Nick Smith
- Personal Social Services Research Unit (PSSRU), University of Kent, Kent, UK
| | - Sinead Palmer
- Personal Social Services Research Unit (PSSRU), University of Kent, Kent, UK
| | - Jackie Cassell
- Primary Care and Public Health, Brighton and Sussex Medical School (BSMS), Brighton, UK
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Watts T, Sydor A, Whybrow D, Temeng E, Hewitt R, Pattinson R, Bundy C, Kyle RG, Jones B. Registered Nurses' and nursing students' perspectives on moral distress and its effects: A mixed-methods systematic review and thematic synthesis. Nurs Open 2023; 10:6014-6032. [PMID: 37458290 PMCID: PMC10416007 DOI: 10.1002/nop2.1913] [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: 09/14/2022] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 08/12/2023] Open
Abstract
AIM To examine Registered Nurses (RNs') and nursing students' perspectives on factors contributing to moral distress and the effects on their health, well-being and professional and career intentions. DESIGN Joanna Briggs Institute mixed-methods systematic review and thematic synthesis. Registered in Prospero (Redacted). METHODS Five databases were searched on 5 May 2021 for studies published in English since January 2010. Methodological quality assessment was conducted in parallel with data extraction. RESULTS Searches yielded 2343 hits. Seventy-seven articles were included. Most were correlational design and used convenience sampling. Studies were mainly from North America and Asia and situated in intensive and critical care settings. There were common, consistent sources of moral distress across continents, specialities and settings. Factors related to perceived inability or failure to enact moral agency and responsibility in moral events at individual, team and structural levels generated distress. Moral distress had a negative effect on RNs health and psychological well-being. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution to this systematic review.
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Affiliation(s)
- Tessa Watts
- School of Healthcare SciencesCardiff UniversityCardiffUK
| | - Anna Sydor
- School of Healthcare SciencesCardiff UniversityCardiffUK
| | - Dean Whybrow
- School of Healthcare SciencesCardiff UniversityCardiffUK
| | - Eunice Temeng
- School of Healthcare SciencesCardiff UniversityCardiffUK
| | - Rachael Hewitt
- School of Healthcare SciencesCardiff UniversityCardiffUK
| | | | | | - Richard G. Kyle
- Public Health WalesCardiffUK
- Academy of NursingUniversity of ExeterExeterUK
| | - Bethan Jones
- School of Healthcare SciencesCardiff UniversityCardiffUK
- School of Health and Social WellbeingUniversity of West of EnglandBristolUK
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Farrer Mackie J, Gray HL, Marshall J, Himmelgreen D, Alkon A, Kirby RS. "I Wear a Mask. I Wear It All the Time. The Kids Don't Wear Masks": Early Childhood Education Mask-Wearing During COVID-19 in Florida. Health Promot Pract 2023; 24:944-949. [PMID: 35574594 DOI: 10.1177/15248399221093972] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND New federal health guidance was issued for early childhood education (ECE) programs to reduce the risk of COVID-19 in March 2020. The Centers for Disease Control and Prevention recommended mask-wearing for adults and children aged 2 years and older. Wearing masks was a new practice for teachers and children, and this study investigated when and how masks were worn in ECE centers in Florida. METHODS This study was part of a larger assessment of the impact of COVID-19 on mealtime routines in ECE centers. Two statewide surveys based on the Trust Model were sent to directors and teachers via Florida Department of Children and Families. Only teachers were interviewed. Data were collected from August to October 2020. The analysis included survey results and interview responses related to mask-wearing. RESULTS Surveys were completed by 759 directors and 431 teachers, and 29 teachers were interviewed. Survey results indicated that more teachers than children wore masks during pre- and postmeal activities. Interviews revealed three models that explain mask-wearing: (1) teachers only, in which teachers were required to wear a mask, but children were not; (2) teachers and children, in which teachers and children were required to wear a mask; and (3) masks optional, in which teachers and children could choose to wear a mask. CONCLUSION Understanding how decisions about mask-wearing were made at the center level can inform training and support health and safety in ECE. Use of personal protective equipment (such as masks) is effective for reducing risk of pathogen transmission for children and adults in ECE settings.
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Affiliation(s)
- Joanna Farrer Mackie
- University of California, Merced, Merced, CA, USA
- University of South Florida, Tampa, FL, USA
| | | | | | | | - Abbey Alkon
- University of California San Francisco School of Nursing, San Francisco, CA, USA
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Han K, Hou Z, Tu S, Wang Q, Hu S, Xing Y, Du J, Zang S, Chantler T, Larson H. Caregivers' understanding of childhood influenza vaccination during the epidemic in China. A mixed-methods study. Front Public Health 2023; 11:1196019. [PMID: 37637809 PMCID: PMC10447896 DOI: 10.3389/fpubh.2023.1196019] [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: 03/29/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023] Open
Abstract
Introduction Influenza vaccination uptake among young children has been poor in China, but it is unclear how it changed during the COVID-19. This study aimed to investigate the uptake status and reasons of childhood influenza vaccination during the pandemic in China. Methods A mixed-methods study combining a questionnaire survey and semi-structured interviews was conducted in Anhui, Shaanxi, and Guangdong provinces between September and November 2021. 2081 caregivers completed the valid questionnaire. 38 caregivers participated in interviews, and data were analyzed thematically, using deductive and inductive coding. Results A total of 2081 caregivers completed the valid questionnaire, and 38 caregivers participated in interviews. Among the caregivers, a total of 1796 were in the age group for high-risk groups in the 2019-2020 flu season, and 46.10% reported that their children received influenza vaccination in the 2019-2020 flu season; 43.63% said that they vaccinated their children against influenza in the 2020-2021 flu season. Many caregivers indicated that the adoption of nonpharmacologic interventions (NPIs) during COVID-19 reduced the risk of influenza infection for children. Most caregivers consider the severity of influenza to be low, and some confused the common cold with influenza. Meanwhile, some caregivers lack confidence in the vaccine's effectiveness and importance. They thought that vaccines are not effective in preventing the constantly mutating virus. Despite clear perceptions about the severity of influenza and the effectiveness of the vaccine, we found that most caregivers did not receive any relevant medical information, and the communication about vaccines between caregivers and professional information sources, such as healthcare workers, is inadequate. Hence, caregivers have no scientific evidence to back up their perceptions. In terms of access to vaccination service, caregivers reported conflicts between time of vaccination service and their schedule, and the need for vaccine prices to be reduced. Discussion Targeted interventions are needed to address caregivers' lack of risk perception on influenza during COVID-19 and promote communication between caregivers and professional information sources. Extending vaccination service hours and increasing the number of vaccine clinics close to residential areas and expansion of financing sources for self-paid vaccination could facilitate the access to influenza vaccination service.
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Affiliation(s)
- Kaiyi Han
- School of Public and Health, Fudan University, Shanghai, China
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Zhiyuan Hou
- School of Public and Health, Fudan University, Shanghai, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Shiyi Tu
- School of Public and Health, Fudan University, Shanghai, China
- NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Qian Wang
- School of Public and Health, Fudan University, Shanghai, China
| | - Simeng Hu
- School of Public and Health, Fudan University, Shanghai, China
| | - Yuting Xing
- School of Public and Health, Fudan University, Shanghai, China
| | - Jing Du
- School of Public and Health, Fudan University, Shanghai, China
| | - Shujie Zang
- School of Public and Health, Fudan University, Shanghai, China
| | - Tracey Chantler
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Heidi Larson
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Department of Health Metrics Sciences, University of Washington, Seattle, WA, United States
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Vithlani J, Hawksworth C, Elvidge J, Ayiku L, Dawoud D. Economic evaluations of artificial intelligence-based healthcare interventions: a systematic literature review of best practices in their conduct and reporting. Front Pharmacol 2023; 14:1220950. [PMID: 37693892 PMCID: PMC10486896 DOI: 10.3389/fphar.2023.1220950] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 07/25/2023] [Indexed: 09/12/2023] Open
Abstract
Objectives: Health economic evaluations (HEEs) help healthcare decision makers understand the value of new technologies. Artificial intelligence (AI) is increasingly being used in healthcare interventions. We sought to review the conduct and reporting of published HEEs for AI-based health interventions. Methods: We conducted a systematic literature review with a 15-month search window (April 2021 to June 2022) on 17th June 2022 to identify HEEs of AI health interventions and update a previous review. Records were identified from 3 databases (Medline, Embase, and Cochrane Central). Two reviewers screened papers against predefined study selection criteria. Data were extracted from included studies using prespecified data extraction tables. Included studies were quality assessed using the National Institute for Health and Care Excellence (NICE) checklist. Results were synthesized narratively. Results: A total of 21 studies were included. The most common type of AI intervention was automated image analysis (9/21, 43%) mainly used for screening or diagnosis in general medicine and oncology. Nearly all were cost-utility (10/21, 48%) or cost-effectiveness analyses (8/21, 38%) that took a healthcare system or payer perspective. Decision-analytic models were used in 16/21 (76%) studies, mostly Markov models and decision trees. Three (3/16, 19%) used a short-term decision tree followed by a longer-term Markov component. Thirteen studies (13/21, 62%) reported the AI intervention to be cost effective or dominant. Limitations tended to result from the input data, authorship conflicts of interest, and a lack of transparent reporting, especially regarding the AI nature of the intervention. Conclusion: Published HEEs of AI-based health interventions are rapidly increasing in number. Despite the potentially innovative nature of AI, most have used traditional methods like Markov models or decision trees. Most attempted to assess the impact on quality of life to present the cost per QALY gained. However, studies have not been comprehensively reported. Specific reporting standards for the economic evaluation of AI interventions would help improve transparency and promote their usefulness for decision making. This is fundamental for reimbursement decisions, which in turn will generate the necessary data to develop flexible models better suited to capturing the potentially dynamic nature of AI interventions.
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Affiliation(s)
- Jai Vithlani
- National Institute for Health and Care Excellence, London, United Kingdom
| | - Claire Hawksworth
- National Institute for Health and Care Excellence, Manchester, United Kingdom
| | - Jamie Elvidge
- National Institute for Health and Care Excellence, Manchester, United Kingdom
| | - Lynda Ayiku
- National Institute for Health and Care Excellence, Manchester, United Kingdom
| | - Dalia Dawoud
- National Institute for Health and Care Excellence, London, United Kingdom
- Faculty of Pharmacy, Cairo University, Cairo, Egypt
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Whisenant M, Jones M, Ann-Yi S, Necroto V, Skrljac A, Bruera E, Milbury K. Living With an Advanced Cancer While Parenting Minor Children: A Needs Assessment Study. J Pain Symptom Manage 2023; 66:160-167.e3. [PMID: 37148983 DOI: 10.1016/j.jpainsymman.2023.04.027] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 04/21/2023] [Accepted: 04/30/2023] [Indexed: 05/08/2023]
Abstract
BACKGROUND Evidence-based interventions addressing the needs of couples co-parenting young children while facing an advanced cancer diagnosis are lacking. Thus, this study seeks to identify parenting-related intervention needs and delivery preferences of advanced cancer patients and their spouses/co-parents. METHODS Twenty-one couples completed quantitative measures of cancer-related parenting concerns, relationship and family functioning, and service needs along with individual semi-structured interviews. RESULTS Patients (mean age=44 years, 48% female, 91% White) and spouses (mean age=45 years, 52% female, 91% White) reported family distress (62% of couples) and marital distress (29% of couples). Parenting concerns were generally high with patients revealing concerns particularly regarding the practical impact of the cancer on the child(ren). Spouses rated concerns about the co-parent significantly higher (P<.001) than patients. Parenting concerns were inversely associated with relationship (P<.001 for patients; P=.03 for spouses) and family functioning (P<.001 for patients). Themes identified through qualitative interviews include needs related to maintenance of family routines and traditions, childcare, transportation, meals, home maintenance, and finances. Couples who endorsed marital distress also indicated a need for conflict resolution skills. All patients and 89% of spouses would like to receive parenting-related education/services; up to 50% of couples preferred targeted, self-led readings without therapist support; and up to 50% desired counseling sessions indicating a preference towards dyadic and video conferenced intervention delivery. CONCLUSIONS The delivery of optimal supportive care involves a family-focused perspective such as screening for parenting status and referrals to social work services to address the need of tangible resources and manage parenting-related distress.
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Affiliation(s)
- Meagan Whisenant
- Department of Behavioral Science (M.J., V.N., K.M.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Morgan Jones
- Department of Behavioral Science (M.J., V.N., K.M.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sujin Ann-Yi
- Department of Palliative, Rehabilitation & Integrative Medicine (S.A.-Y., E.B.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Victoria Necroto
- Department of Behavioral Science (M.J., V.N., K.M.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ashley Skrljac
- Department of Research (M.W., A.S.), The University of Texas Health Science Center at Houston, Cizik School of Nursing, Houston, Texas, USA
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation & Integrative Medicine (S.A.-Y., E.B.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Kathrin Milbury
- Department of Behavioral Science (M.J., V.N., K.M.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
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Queroue M, Pouymayou A, Pereira E, Tzourio C, González-Caballero JL, Montagni I. An interactive video increasing French students' mental health literacy: a mixed-methods randomized controlled pilot study. Health Promot Int 2023; 38:daab202. [PMID: 34897453 DOI: 10.1093/heapro/daab202] [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] [Indexed: 11/12/2022] Open
Abstract
Mental health literacy (MHL) is a determinant of psychological well-being in young people. A randomized controlled design was used to evaluate the appreciation and effectiveness of an interactive video on French University students' MHL (knowledge about depression and suicidal behavior, mental health help-seeking behaviors, stigma and misconceptions about mental health). At the baseline, all participants (n = 101) completed a questionnaire including several scales on MHL. One month after, participants were randomly assigned to two homogeneous groups (intervention, n = 50 or control, n = 51) and again completed the questionnaire on MHL. Through a mixed-methods approach, semi-structured interviews were also conducted with the intervention group to collect information on the appreciation of the interactive video. Quantitative data indicated that MHL scores increased or remained stable in the intervention group. Comparison with the control group and multivariate logistic regression models did not show statistically significant differences, due to the small sample of the study. According to qualitative data, users appreciated the content and the format of the intervention. It was suggested that the video could be disseminated in other University campuses in France and internationally to promote MHL among students.
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Affiliation(s)
- Marine Queroue
- Bordeaux Population Health Research Center (UMR 1219), Team HEALTHY, University of Bordeaux, 146 rue Léo Saignat, 33000 Bordeaux, France
| | - Aude Pouymayou
- Bordeaux Population Health Research Center (UMR 1219), Team HEALTHY, University of Bordeaux, 146 rue Léo Saignat, 33000 Bordeaux, France
| | - Edwige Pereira
- Bordeaux Population Health Research Center (UMR 1219), Team HEALTHY, University of Bordeaux, 146 rue Léo Saignat, 33000 Bordeaux, France
| | - Christophe Tzourio
- Bordeaux Population Health Research Center (UMR 1219), Team HEALTHY, University of Bordeaux, 146 rue Léo Saignat, 33000 Bordeaux, France
| | | | - Ilaria Montagni
- Bordeaux Population Health Research Center (UMR 1219), Team HEALTHY, University of Bordeaux, 146 rue Léo Saignat, 33000 Bordeaux, France
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Reims N, Rauch A, Nivorozhkin A. [Challenges and Adaptation Strategies of Service Providers in Vocational Rehabilitation - A Mixed-Methods Analysis]. Rehabilitation (Stuttg) 2023; 62:207-215. [PMID: 37023766 PMCID: PMC10425206 DOI: 10.1055/a-2053-6763] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
AIM OF THE STUDY The aim of this study was to identify current challenges faced by service providers (SPs) as well as those likely to arise in the future and the coping strategies to deal with them. Challenges are requirements externally imposed on the SPs and perceived by them as central to their work. We focus on SPs that offered disability-specific programs financed by the Federal Employment Agency in December 2016. METHOD The study is based on a mixed-methods design. In summer 2017, a quantitative online survey of SPs (n=266) was conducted, as well as in-depth qualitative guided interviews (44 representatives at 32 SPs) until mid 2019. Factor analysis (STATA) and analyses in the sense of Grounded Theory (MaxQDA) were carried out. RESULTS The experts at the SPs addressed three main challenge contexts or types: 1. competitive framework conditions (such as decreasing numbers of participants, increasing price competition or rising cost pressure), 2. changes in the structure of participants (such as decreasing educational competencies, more participants with behavioral problems, mental illnesses or multiple disabilities) and 3. changing demands of the labor market (such as increasing importance of computer-based activities, higher demands on qualifications or decrease in simple tasks). For the first two types, SPs had clear and overarching strategies. For example, SPs responded to the first type by changing their facility portfolio or opening up to target groups. Concerning the second type, SPs responded - according to their specific contexts of action - with further training of the staff, arrangement of permanent positions or hiring of new staff (especially psychologically trained staff) as well as negotiations with the financers of vocational rehabilitation. The third type, however, presented a very broad picture with few clear, tangible, overarching strategies. In general, SPs also looked upon financers as having an obligation to further optimize the rehabilitation process, in particular, to adequate allocation of programs and the provision of more flexible and individualized program concepts. CONCLUSIONS There is no one-size-fits-all response to current and future challenges. However, the COVID-19 pandemic has shown that strategies for expected developments - such as the need to further develop digitization - must not be put on the back burner.
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Affiliation(s)
- Nancy Reims
- Forschungsbereich Erwerbslosigkeit und Teilhabe (FBET), Institut
für Arbeitsmarkt- und Berufsforschung, Nürnberg
| | - Angela Rauch
- Forschungsbereich Erwerbslosigkeit und Teilhabe (FBET), Institut
für Arbeitsmarkt- und Berufsforschung, Nürnberg
| | - Anton Nivorozhkin
- Forschungsbereich Erwerbslosigkeit und Teilhabe (FBET), Institut
für Arbeitsmarkt- und Berufsforschung, Nürnberg
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Lahiri A, Jha SS, Chakraborty A, Dey A, Dobe M. Home-Isolation Care in Newly COVID-19-Positive Elderly Patients: A Caregiver-Centric Explanatory Framework. Int J Public Health 2023; 68:1606060. [PMID: 37538233 PMCID: PMC10394230 DOI: 10.3389/ijph.2023.1606060] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/29/2023] [Indexed: 08/05/2023] Open
Abstract
Objectives: This community-based study aimed to identify the effect of different behavioral factors of family caregivers on the decision for home-isolation-based treatment of a new COVID-19-diagnosed elderly individual. It also explored the facilitators and barriers contributing to the decision-making process. Methods: A mixed-methods design was adopted to study the role of behavioral constructs such as risk tolerance, risk aversion, regret aversion, loss aversion, self-efficacy, and risk perception in healthcare-seeking decisions. By integrating the findings from the quantitative and qualitative parts, a framework was developed. Results: Self-efficacy, risk perception, and risk tolerance related to different issues were crucial factors behind the healthcare decision. However, regarding the various issues under consideration, risk perception followed by risk tolerance were the significant predictors for decision-making. Conclusion: To enhance appropriateness and equity in emergency healthcare-seeking, interventions should target risk tolerance and risk perception, taking into account the awareness levels of caregivers and the target population's risk and regret aversion. Such integrated approaches can improve the quality of care for elderly patients in home-based settings.
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Affiliation(s)
- Arista Lahiri
- Dr. B. C. Roy Multi-Speciality Medical Research Centre, Indian Institute of Technology Kharagpur, Kharagpur, West Bengal, India
| | - Sweety Suman Jha
- Dr. B. C. Roy Multi-Speciality Medical Research Centre, Indian Institute of Technology Kharagpur, Kharagpur, West Bengal, India
| | - Arup Chakraborty
- Department of Community Medicine, Medical College and Hospital, Kolkata, West Bengal, India
| | - Abhijit Dey
- WHO-NTEP Technical Support Network, Swasthya Bhawan, Kolkata, West Bengal, India
| | - Madhumita Dobe
- Foundation for Actions and Innovations Towards Health Promotion (FAITH), Kolkata, West Bengal, India
- All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
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Zhang X, Reynolds BL. A Mixed-Methods Investigation of the Effectiveness and Perceptions of Learning English Collocations Using the Keyword Method and the Rote Learning Method. Behav Sci (Basel) 2023; 13:591. [PMID: 37504038 PMCID: PMC10375987 DOI: 10.3390/bs13070591] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/01/2023] [Accepted: 07/11/2023] [Indexed: 07/29/2023] Open
Abstract
This study investigated the effectiveness, as well as EFL learners' perceptions, of the keyword method (KWM) in comparison to the rote learning method (RLM) for the learning of English collocations. A controlled laboratory-like setting was adopted for randomly assigning participants to the KWM group (n = 15) or the RLM group (n = 15). After receiving training on the use of the respective strategy, the two participant groups applied the respective strategy to the learning of collocations. Collocations were assessed at three different time periods, and additional data regarding perceptions of the two strategies were elicited through one-on-one post hoc interviews. The quantitative data revealed that the KWM was superior to the RLM in terms of the long-term retention of productive collocation knowledge; knowledge of adjective-noun collocations was retained better than verb-noun collocations. The qualitative data revealed that participants deemed that the KWM was unfamiliar but effective. Additionally, participants claimed that the RLM was facile but may result in a high rate of forgetting. The pedagogical implications are that foreign language teachers should encourage language learners to use the KWM for learning English collocations. Although the KWM has been recommend by many researchers, it is still rarely advocated for by foreign language instructors. Therefore, it is important that both EFL learners and teachers should be aware of the KWM's long-term retention effects on the learning of English collocations and apply this vocabulary learning strategy (VLS) in their actual learning and teaching context.
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Affiliation(s)
- Xiaofang Zhang
- Faculty of Education, University of Macau, Room 1014, E33, Av. da Universidade, Taipa, Macau SAR, China
| | - Barry Lee Reynolds
- Faculty of Education, University of Macau, Room 1014, E33, Av. da Universidade, Taipa, Macau SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Av. da Universidade, Taipa, Macau SAR, China
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48
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Pierce SK, Reynolds KA, Jakobson LS, Ricci MF, Roos LE. Unmet Parental Mental Health Service Needs in Neonatal Follow-Up Programs: Parent and Service Provider Perspectives. Children (Basel) 2023; 10:1174. [PMID: 37508670 PMCID: PMC10378703 DOI: 10.3390/children10071174] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/23/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023]
Abstract
Parental mental health services in neonatal follow-up programs (NFUPs) are lacking though needed. This study aimed to determine (1) the unmet mental health needs of parents and (2) the parent and provider perspectives on barriers and opportunities to increase mental health service access. Study 1: Parents in a central Canadian NFUP (N = 49) completed a mixed-method online survey (analyzed descriptively and by content analysis) to elucidate their mental health, related service use, barriers to service use, and service preferences. Study 2: Virtual focus groups with NFUP service providers (N = 5) were run to inform service improvements (analyzed by reflexive thematic analysis). The results show that parents endorsed a 2-4 times higher prevalence of clinically significant depression (59.2%), anxiety (51.0%), and PTSD (26.5%) than the general postpartum population. Most parents were not using mental health services (55.1%) due to resource insecurity among parents (e.g., time, cost) and the organization (e.g., staffing, training, referrals). Consolidating parents' and service providers' perspectives revealed four opportunities for service improvements: bridging services, mental health screening, online psychoeducation, and peer support. Findings clarify how a central Canadian NFUP can address parental mental health in ways that are desired by parents and feasible for service providers.
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Affiliation(s)
- Shayna K Pierce
- Department of Psychology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - Kristin A Reynolds
- Department of Psychology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg, MB R3E 3N4, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada
| | - Lorna S Jakobson
- Department of Psychology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
| | - M Florencia Ricci
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB R3A 1S1, Canada
- Manitoba Neonatal Follow-Up Program, Winnipeg, MB R3E 3G1, Canada
| | - Leslie E Roos
- Department of Psychology, University of Manitoba, Winnipeg, MB R3T 2N2, Canada
- Children's Hospital Research Institute of Manitoba, Winnipeg, MB R3E 3P4, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB R3A 1S1, Canada
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49
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Ye W, Liu J. Exploring and modeling the reading-writing connection in EFL integrated writing. Front Psychol 2023; 14:1161272. [PMID: 37476091 PMCID: PMC10355151 DOI: 10.3389/fpsyg.2023.1161272] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 06/09/2023] [Indexed: 07/22/2023] Open
Abstract
Reading-to-write tasks have increasingly been used in high-stakes language tests worldwide; however, the nature of the reading-writing connection is not well understood. This study utilized a mixed-methods approach to ground descriptions of EFL cognitive processes and identify process interaction patterns to determine how reading and writing were connected. Grounded theory analysis of fourteen EFL learners' writing think-aloud protocols showed that students engaged in an interactive composing process involving source reading, comprehension monitoring, planning, language monitoring, narration monitoring, and continuity evaluation. We also conducted a confirmatory factor model study on 486 EFL learners' responses to a self-developed writing questionnaire, which covered five factors, including reading monitoring, narration monitoring, ideational planning, continuity evaluation, and skill integration. The findings showed that reading monitoring was the only factor that had a direct and significant impact on skill integration, a composite factor covering discourse synthesizing and source using processes. Based on the discussion of the theoretical, empirical, and pedagogical implications of the current findings, we called for more studies to explore the use of three pillar skills-reading, writing, and language use-to support EFL integrated writing. We also suggested that test designers include explicit rating descriptor(s) for source using to evaluate reading comprehension, and instructors enhance reading instruction to improve task performance.
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Affiliation(s)
- Wei Ye
- School of Foregin Languages, Guangdong Polytechnic Normal University, Guangzhou, China
| | - Jianda Liu
- Center for Linguistics and Applied Linguistics, Guangdong University of Foreign Studies, Guangzhou, China
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Martin LAL, Melchert D, Knack M, Fuchs T. Relating movement markers of schizophrenia to self-experience-a mixed-methods study. Front Psychiatry 2023; 14:1212508. [PMID: 37415694 PMCID: PMC10319999 DOI: 10.3389/fpsyt.2023.1212508] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 05/29/2023] [Indexed: 07/08/2023] Open
Abstract
Introduction Basic self-disorders on the one hand and motor symptoms on the other hand are discussed as endophenotypes of schizophrenia psychopathology. However, the systematic interaction between motor symptoms and the self-experience of patients is rarely studied. Methods In a previous study we defined motor markers of schizophrenia via a data-driven analysis of patients' gait patterns. In this study, we related the movement markers to measures of basic self-disorder obtained with EASE interviews. We substantiated the correlations with a qualitative content analysis of the interviews of a subset of four patients. We related qualitative and quantitative data on an intra- and interpersonal level. Results Our results suggest an association between the previously defined, theory-independent movement markers and basic self-disorders, specifically in the domain of cognition, self-experience and bodily experiences. While movement marker manifestation was not precisely reflected in the individuals' descriptions of anomalous self- and body experience, we found clear trends of more and more intense descriptions with increasing movement marker scores, when looking at specific experiences, such as hyper reflexivity. Discussion These results foster an integrated view of the patient and could stimulate therapeutic approaches aiming at an improvement of self- and body-experience of patients with schizophrenia.
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Affiliation(s)
- Lily A. L. Martin
- Department of Psychology, Faculty of Behavioral and Cultural Studies, University of Heidelberg, Heidelberg, Germany
- Department of General Psychiatry, Centre for Psychosocial Medicine, Academic Medical Center, University of Heidelberg, Heidelberg, Germany
- Research Institute for Creative Arts Therapies (RIArT), Department of Therapy Sciences, Alanus University of Arts and Social Sciences, Alfter, Germany
| | - David Melchert
- Department of Educational Science and Psychology, Free University Berlin, Berlin, Germany
| | - Monika Knack
- Department of Philosophy, Faculty of Philosophy, University of Heidelberg, Heidelberg, Germany
| | - Thomas Fuchs
- Department of General Psychiatry, Centre for Psychosocial Medicine, Academic Medical Center, University of Heidelberg, Heidelberg, Germany
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