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Morris L, Innes A, Williamson T, Wyatt M, Smith E, McEvoy P. Experiences of a communication-skills course for care partners of people living with dementia, empowered conversations: A qualitative framework analysis. Br J Clin Psychol 2024; 63:227-243. [PMID: 38288632 DOI: 10.1111/bjc.12447] [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: 04/03/2023] [Revised: 11/02/2023] [Accepted: 11/22/2023] [Indexed: 04/26/2024]
Abstract
OBJECTIVES Our aims were to examine whether an experiential course for care partners of people living with dementia, Empowered Conversations (EC), was acceptable to participants and to explore participants' perceptions of the impact of the course upon their communicative interactions. EC is based on an integrative model derived from psychological and linguistic theory and empirical evidence. EC is based on mentalisation theory, perceptual control theory and linguistic theory (The Communicative Impact Model). METHODS Qualitative data were collected via 28 semistructured interviews. Framework analysis was used to analyse data. RESULTS Three superordinate themes, 'improved communication', 'improved well-being' and 'support through others' were identified. Twenty-seven out of the 28 participants described feeling that they were able to better connect with the person living with dementia that they were supporting through attending EC. CONCLUSIONS The findings indicated that EC was acceptable and beneficial to care partners. Care partners developed a range of strategies and understandings that enabled them to communicate better with the person they were supporting, enhanced well-being and relationships, as well as developing social networks. This is the first qualitative study to examine a psychosocial intervention for care partners of people living with dementia using a non-CBT framework and indicates that perceived control could influence how care partners respond to stress and difficulties.
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Affiliation(s)
- Lydia Morris
- Institute of Dementia, School of Health and Society, University of Salford, Salford, UK
| | - Anthea Innes
- Institute of Dementia, School of Health and Society, University of Salford, Salford, UK
| | - Tracey Williamson
- Association for Dementia Studies, University of Worcester, Worcester, UK
| | - Megan Wyatt
- Institute of Dementia, School of Health and Society, University of Salford, Salford, UK
| | - Emma Smith
- Six Degrees Social Enterprise, Salford, UK
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Guttmann KF, Meshkati M, Frydman J, Smith CB, Dow L, Weintraub AS. NeoTalk: Communication Skills Training for Neonatal Clinicians. Am J Hosp Palliat Care 2024; 41:651-657. [PMID: 37622177 DOI: 10.1177/10499091231198507] [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: 08/26/2023] Open
Abstract
BACKGROUND Despite proven benefit, pediatric subspecialists often have not been offered formal serious illness communication skills training. We sought to: 1) develop and evaluate the impact of a communication skills course, based on the VitalTalk framework, on Neonatal Intensive Care Unit (NICU) clinicians; 2) evaluate provider comfort with key serious illness communication skills and frequency of use of those skills, before and after "NeoTalk" and; 3) explore differences and similarities between adult and pediatric serious illness communication skills courses. METHODS We developed a NICU specific communication skills course and surveyed course participants to evaluate comfort with key communication skills before and after course participation, and frequency of use of key skills before and 2 months after our course. Wilcoxon signed rank tests and Kruskal-Wallis tests were performed to compare participant responses across time points. RESULTS 34 providers completed NeoTalk training. Complete pre- and post-course data was available for 29 participants. Participants reported increased comfort with skills including 'sharing difficult news' (P = .018), and 'responding to emotion' (P = .002). Participants did not report increased frequency in using target skills 2 months after training. CONCLUSIONS A multi-disciplinary cohort of NICU providers endorsed increased confidence in key communication skills but not increased skill application 2-months post-course completion. While a single course can successfully teach skills, additional exposure may be necessary to build new communication habits. Our experience developing NeoTalk helped elucidate some of the ways in which conversations about seriously ill infants may be different from conversations about seriously ill adults.
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Affiliation(s)
- Katherine F Guttmann
- Division of Newborn Medicine, Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Malorie Meshkati
- Division of Newborn Medicine, Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julia Frydman
- Department of Geriatrics and Palliative Medicine, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cardinale B Smith
- Department of Geriatrics and Palliative Medicine, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Division of Hematology and Medical Oncology, Department of Medicine, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lindsay Dow
- Department of Geriatrics and Palliative Medicine, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrea S Weintraub
- Division of Newborn Medicine, Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Kearsey JL, West E, Vairinhos N, Constable N, Chu A, Douglas N, Charlton K. Evaluation of a Nutrition Education and Skills Training programme in vulnerable adults who are at high risk of food insecurity. J Hum Nutr Diet 2024; 37:418-429. [PMID: 37964660 DOI: 10.1111/jhn.13264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/28/2023] [Accepted: 10/31/2023] [Indexed: 11/16/2023]
Abstract
BACKGROUND In Australia, the prevalence of food insecurity increased by 1.5% between 2014 and 2016 and 2018 and 2020 due to effects of the COVID-19 pandemic. OzHarvest offers a 6-week Nutrition Education and Skills Training (NEST) programme to adults at risk of food insecurity. NEST provides 2.5-h weekly cooking workshops on simple, healthy and affordable meals. This study aimed to determine the immediate (post) and longer-term (6 months) impacts of participation in NEST. METHODS A quasi-experimental study with pre-post surveys (n = 258) and 6-month follow-up surveys (n = 20) was conducted from June 2019 to July 2022. Survey results were obtained from NEST programme participants (≥18 years) from six major Australian cities. RESULTS Participants demonstrated immediate improvement in nutrition knowledge (p < 0.001), food preparation behaviours (p < 0.001) and confidence and self-efficacy (n = 222; p < 0.001). Intake of discretionary foods decreased (p < 0.001), whereas fruit, vegetable and water intake increased (p < 0.001). Food security improved from 57% to 68% immediately after the completion of the programme (p < 0.001). Participants demonstrated longer-term improvements in nutrition knowledge (p < 0.001), cooking confidence (n = 8; p = 0.03), food preparation behaviours (p = 0.003) and increased vegetable (p = 0.03) and fruit intake (p = 0.01). CONCLUSIONS Participation in OzHarvest's NEST programme results in short-term improvements in food security levels and dietary behaviours. Over the longer term, these changes were sustained but to a lesser degree, indicating that systemic changes are required to address underlying socio-economic disadvantages.
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Affiliation(s)
- Jade L Kearsey
- School of Medical, Indigenous and Health Sciences, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Elisha West
- OzHarvest Melbourne, Port Melbourne, Victoria, Australia
| | - Nelia Vairinhos
- School of Medical, Indigenous and Health Sciences, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | | | - Angelica Chu
- OzHarvest Sydney, Alexandria, New South Wales, Australia
| | - Nigel Douglas
- OzHarvest Sydney, Alexandria, New South Wales, Australia
| | - Karen Charlton
- School of Medical, Indigenous and Health Sciences, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
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Philipp J, Franta C, Zeiler M, Truttmann S, Wittek T, Schöfbeck G, Mairhofer D, Mitterer M, Laczkovics C, Treasure J, Karwautz AFK, Wagner G. Acceptability and feasibility of SUCCEAT, an intervention for parents of adolescents with anorexia nervosa. Eur Eat Disord Rev 2024. [PMID: 38407519 DOI: 10.1002/erv.3080] [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: 08/23/2023] [Revised: 01/25/2024] [Accepted: 02/02/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE "Supporting Carers of Children and Adolescents with Eating Disorders in Austria" (SUCCEAT), a skills training for parents, delivered via workshops (WS) or online modules (ONL), has been proven to be effective in terms of parental distress, caregiver skills, and adolescents' outcome. This study examined the adherence to and the acceptability and feasibility of SUCCEAT. METHOD One-hundred parents (86% mothers) of adolescents with anorexia nervosa participated in the 8-week training. Parents were assigned to the WS (n = 50) or ONL (n = 50) format using a quasi-randomised design. Adherence, acceptability, and feasibility were assessed using self-report questionnaires. RESULTS Adherence to the sessions was high (66%-98%) for both groups. The usage of the material was comparable between the groups. However, in the WS group, participants actively approached the coaches (71.8% vs. 48.9% often/very often) or other parents (63% vs. 4.4% often/very often) more often. Perceived helpfulness was high in both groups, overall satisfaction and practicability were higher in the WS group. CONCLUSIONS Good adherence, acceptability, and feasibility were confirmed for both formats of SUCCEAT, with minimal advantages of the WS regarding satisfaction and contact with other parents and coaches. Thus, both formats can be recommended for implementation in clinical routine.
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Affiliation(s)
- Julia Philipp
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Claudia Franta
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Michael Zeiler
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Stefanie Truttmann
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Tanja Wittek
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Gabriele Schöfbeck
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Dunja Mairhofer
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Michaela Mitterer
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Clarissa Laczkovics
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Andreas F K Karwautz
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Gudrun Wagner
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
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Liu L, Yao X, Chen J, Zhang K, Liu L, Wang G, Ling Y. Virtual Reality Utilized for Safety Skills Training for Autistic Individuals: A Review. Behav Sci (Basel) 2024; 14:82. [PMID: 38392435 PMCID: PMC10885886 DOI: 10.3390/bs14020082] [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: 11/19/2023] [Revised: 01/11/2024] [Accepted: 01/19/2024] [Indexed: 02/24/2024] Open
Abstract
In recent years, virtual reality technology, which is able to simulate real-life environments, has been widely used in the field of intervention for individuals with autism and has demonstrated distinct advantages. This review aimed to evaluate the impact of virtual reality technology on safety skills intervention for individuals with autism. After searching and screening three databases, a total of 20 pertinent articles were included. There were six articles dedicated to the VR training of street-crossing skills for individuals with autism, nine articles focusing on the training of driving skills for individuals with ASD, and three studies examining the training of bus riding for individuals with ASD. Furthermore, there were two studies on the training of air travel skills for individuals with ASD. First, we found that training in some complex skills (e.g., driving skills) should be selected for older, high-functioning individuals with ASD, to determine their capacity to participate in the training using scales or questionnaires before the intervention; VR devices with higher levels of immersion are not suitable for younger individuals with ASD. Second, VR is effective in training safety skills for ASD, but there is not enough evidence to determine the relationship between the level of VR immersion and intervention effects. Although the degree of virtual reality involvement has an impact on the ability of ASD to be generalized to the real world, it is important to ensure that future virtual reality settings are realistic and lifelike. Again, adaptive models that provide personalized training to individuals with ASD in VR environments are very promising, and future research should continue in this direction. This paper also discusses the limitations of these studies, as well as potential future research directions.
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Affiliation(s)
- Lili Liu
- National Engineering Research Center of Educational Big Data, Central China Normal University, Wuhan 430079, China
- National Engineering Research Center for E-Learning, Central China Normal University, Wuhan 430079, China
- Faculty of Artificial Intelligence in Education, Central China Normal University, Wuhan 430079, China
| | - Xinyu Yao
- Faculty of Artificial Intelligence in Education, Central China Normal University, Wuhan 430079, China
| | - Jingying Chen
- National Engineering Research Center of Educational Big Data, Central China Normal University, Wuhan 430079, China
- National Engineering Research Center for E-Learning, Central China Normal University, Wuhan 430079, China
- Faculty of Artificial Intelligence in Education, Central China Normal University, Wuhan 430079, China
| | - Kun Zhang
- National Engineering Research Center of Educational Big Data, Central China Normal University, Wuhan 430079, China
- National Engineering Research Center for E-Learning, Central China Normal University, Wuhan 430079, China
- Faculty of Artificial Intelligence in Education, Central China Normal University, Wuhan 430079, China
| | - Leyuan Liu
- National Engineering Research Center of Educational Big Data, Central China Normal University, Wuhan 430079, China
- National Engineering Research Center for E-Learning, Central China Normal University, Wuhan 430079, China
- Faculty of Artificial Intelligence in Education, Central China Normal University, Wuhan 430079, China
| | - Guangshuai Wang
- National Engineering Research Center of Educational Big Data, Central China Normal University, Wuhan 430079, China
- National Engineering Research Center for E-Learning, Central China Normal University, Wuhan 430079, China
- Faculty of Artificial Intelligence in Education, Central China Normal University, Wuhan 430079, China
| | - Yutao Ling
- College of Physical Science and Technology, Central China Normal University, Wuhan 430079, China
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Manocha RHK, Best KL, Charette C, Curlock H, Sigfusson M, Faure C, Miller WC, Routhier F. Walking aid training as a clinical competence in Canadian entry-to-practice professional academic programs. Disabil Rehabil Assist Technol 2024; 19:112-119. [PMID: 35510304 DOI: 10.1080/17483107.2022.2070675] [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: 10/18/2021] [Accepted: 04/21/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Multiple healthcare professionals fit walking aids (WA) and train individuals on their use. The purpose of this investigation was to describe curricula on WA fitting and training in Canadian entry-to-practice professional programs. MATERIALS AND METHODS An online survey was administered to leads from all accredited programs (n = 199). Seventeen questions asked about the importance of WA education, instructional methods and time dedicated to WA fitting and skills training, and how the pandemic had affected WA curriculum delivery. RESULTS Responses were received from 97 programs. While most occupational therapy (OT, 8/15), physiatry (PM&R, 5/9), and physical therapy (PT, 12/19) trainees received more than 3 h of instruction on WA fitting, most nursing (29/40) and pharmacy (7/8) programs spent less than 3 h on this topic. Most OT (9/15) and PT (15/19) programs spent more than 3 h on WA skills training whereas most nursing (25/40), pharmacy (4/8), and PM&R (5/9) programs spent less than 3 h on this subject. Across all programs, 52% educated students on adapting activities of daily living for WA while 18% provided education on WA maintenance and repair. Only 19/89 programs consulted a formal WA skills training resource for curriculum development. Seventeen of 55 programs modified their WA curricula due to the pandemic. CONCLUSIONS There is a wide range in curricular approaches to WA education in Canadian professional programs. This highlights the need for a standardised WA education program to guide curricular development to ultimately improve safe WA use for clients with short- and long-term mobility impairments.IMPLICATIONS FOR REHABILITATIONCurricula on walking aids is extremely variable within and between programs.Navigating terrains, adapting activities of daily living, and maintenance are poorly taught.There is a need for a national standardized curriculum on walking aids.This curriculum should be modular and designed for practitioners, students, and patients.
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Affiliation(s)
- Ranita H K Manocha
- Division of Physical Medicine and Rehabilitation, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Krista L Best
- Département de réadaptation, Faculté de médecine, Université Laval, Laval, Canada
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
| | - Caroline Charette
- Département de réadaptation, Faculté de médecine, Université Laval, Laval, Canada
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
| | - Hannah Curlock
- O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | - Merissa Sigfusson
- Department of Occupational Therapy, University of Alberta, Edmonton, Canada
| | - Céline Faure
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
| | - William C Miller
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
| | - François Routhier
- Département de réadaptation, Faculté de médecine, Université Laval, Laval, Canada
- Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale, Québec City, Canada
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Vijayapriya CV, Tamarana R. Effectiveness of internet-delivered dialectical behavior therapy skills training on executive functions among college students with borderline personality traits: a non-randomized controlled trial. Res Psychother 2023; 26:694. [PMID: 37905964 PMCID: PMC10690726 DOI: 10.4081/ripppo.2023.694] [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: 04/27/2023] [Accepted: 09/29/2023] [Indexed: 11/02/2023]
Abstract
Given the enormous influence of emotions on cognitive processes, individuals with borderline personality disorder (BPD) suffer from marked deficits in higher-order thinking abilities. Considering the prevalence of BPD among college students, this study aimed to investigate the changes in perceived executive functioning among college students with traits/presence of BPD undergoing internet-delivered dialectical behavior therapy skills training (DBT-ST) that included the mindfulness and emotion regulation modules. An internet-delivered version of DBT-ST was opted for, as technological advancements in the present era promote the use of online platforms for psychotherapy. This non-randomized controlled trial consisted of 36 college students with traits/presence of BPD. The intervention group attended 13 sessions of DBT-ST, and the control group attended 13 sessions of behavioral activation. Perceived executive functioning was assessed using the Behavior Rating Inventory of Executive Functions for Adults. A 2-way repeated measures analysis of variance was used to evaluate the treatment impact on the outcome variable. Results showed that the DBT-ST group had larger improvements in their abilities to initiate, plan, and organize current and future-oriented task demands and to organize their everyday environment, compared to the control group. Both, the DBT-ST group and the control group demonstrated improvements in emotional control, working memory, and their abilities to shift and task monitor. Findings suggest that the internet-delivered version of DBT-ST, consisting of the mindfulness and emotion regulation modules, can foster notable improvements in executive functions among college students with traits/presence of BPD. Improved executive functioning is one of the several multifaceted outcomes of dialectical behavior therapy.
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Gizicki E, Assaad MA, Massé É, Bélanger S, Olivier F, Moussa A. Just-In-Time Neonatal Endotracheal Intubation Simulation Training: A Randomized Controlled Trial. J Pediatr 2023; 261:113576. [PMID: 37353151 DOI: 10.1016/j.jpeds.2023.113576] [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] [Received: 02/01/2023] [Revised: 05/09/2023] [Accepted: 06/16/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE To assess if simulation-based just-in-time training (JITT, short video and simulation) is superior to video training (5-minute video) in acquiring skill in neonatal endotracheal intubation (ETI). STUDY DESIGN A Canadian multicenter randomized trial recruited junior residents who performed neonatal ETI from July 2017 to June 2021. The primary outcomes were overall and first attempt ETI success rate. Secondary outcomes included number of attempts, duration of attempts, ETI-related complications, and residents' confidence level. Statistical analysis included generalized estimating equations, mixed model analysis, Mann-Whitney test, and χ² tests. RESULTS Sixty-five residents performed 139 ETI. The overall success rate was similar for both groups (67% vs 70%, P = .71). However, the first attempt success rate was higher for the simulation-based JITT group (54% vs 41%, P = .035). The mean duration of attempts was shorter (35 [SD, 9] vs 62 [SD, 9] seconds, P = .048) and the median number of attempts had a tendency to be lower for the simulation-based JITT group (1 [IQR, 1; 1] vs 1 [IQR, 1; 2], P = .02). There were more mucosal trauma events in the simulation-based JITT group (P = .02). Residents in both groups reported similar confidence level in performing ETI. CONCLUSIONS Compared with video training, simulation-based JITT for neonatal ETI did not improve overall success rate. However, simulation-based JITT improved first attempt success rate and decreased the number and the duration of ETI attempts. With its positive clinical impact, simulation-based JITT can become an educational adjunct to neonatal ETI training for residents. TRIAL REGISTRATION ClinicalTrials.gov: NCT02809924.
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Affiliation(s)
- Ewa Gizicki
- Division of Neonatology, Department of Pediatrics, Royal Columbian Hospital, New Westminster, BC, Canada
| | - Michael-Andrew Assaad
- Division of Neonatology, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada; Centre for Applied Health Sciences Education (CPASS), Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Édith Massé
- Division of Neonatology, Department of Pediatrics, Centre Hospitalier Universitaire Sherbooke, Sherbrooke, QC, Canada
| | - Sylvie Bélanger
- Division of Neonatology, Department of Pediatrics, Centre Hospitalier Universitaire Laval, Quebec, QC, Canada
| | - François Olivier
- Division of Neonatology, Department of Pediatrics, Centre Universitaire de santé McGill, Montreal, QC, Canada
| | - Ahmed Moussa
- Division of Neonatology, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC, Canada; Centre for Applied Health Sciences Education (CPASS), Faculty of Medicine, Université de Montréal, Montreal, QC, Canada; Centre Hospitalier Universitaire Sainte-Justine Research Center, Montreal, QC, Canada.
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Jang S, Kirby RL, Hurd L, Hobson S, Emery R, Mortenson WB. Wheelchair Skills Test in simulated versus community settings: a mixed-methods crossover study of experienced motorized mobility scooter users. Disabil Rehabil Assist Technol 2023:1-8. [PMID: 37642405 DOI: 10.1080/17483107.2023.2252004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 07/07/2023] [Accepted: 08/21/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE The Wheelchair Skills Test (WST) is commonly conducted in a simulated setting. Although the WST can be done in the community setting, its usefulness in this setting has not been systematically evaluated. The purpose of this study was to compare the WST in the simulated versus community settings, and to explore participants' perceptions of performing in each environment. METHODS For this mixed-methods study, we studied 20 motorized mobility scooter users who had used their devices for ≥ 3 months. Each participant completed the WST Version 4.3 twice in random order - once in a simulated setting and once in their community within a two-week period. Semi-structured interviews were conducted after completion of the WST in both environments. A self-report version of the WST (WST-Q) was also completed that measured perceived capacity, frequency of skill performance, and confidence. RESULTS The mean (SD) total WST score in the simulated setting was 88.9% (8.6) and 92.7% (7.8) in the community setting. The two WST scores were moderately correlated (r = 0.306, p = 0.190). Community-setting WST scores were moderately correlated with WST-Q confidence scores. Simulated-setting scores were moderately correlated with WST-Q frequency scores. Although most participants preferred performing the WST in their communities due to convenience and familiarity, they perceived the simulated setting to be reflective of their community settings. CONCLUSION Despite challenges, community-based testing may provide a better reflection of everyday performance for scooter users than testing in a simulated environment.
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Affiliation(s)
- Sharon Jang
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - R Lee Kirby
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Laura Hurd
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sandra Hobson
- School of Occupational Therapy, University of Western Ontario, London, Ontario, Canada
| | - Richelle Emery
- Vancouver Coastal Health - Home and Community Care, Vancouver, British Columbia, Canada
| | - W Ben Mortenson
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
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Vasiljevic S, Isaksson M, Wolf-Arehult M, Öster C, Ramklint M, Isaksson J. Brief internet-delivered skills training based on DBT for adults with borderline personality disorder - a feasibility study. Nord J Psychiatry 2023; 77:55-64. [PMID: 35352615 DOI: 10.1080/08039488.2022.2055791] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Borderline personality disorder (BPD) is characterized by instability in emotions, relationships, and behaviors, such as self-injury and suicidal behavior. Dialectical Behavioral Therapy (DBT) is an established intervention for BPD, but there are long waiting times for treatment. This study aimed to explore if a brief internet-delivered DBT skills training program with minimal therapist support is acceptable, that it can be administered, useful, and does not do harm for patients with BPD. METHODS Acceptability was measured through data on recruitment and attrition, utilization of the intervention, reported impulses to drop out, and through ratings on self-injury and suicidality. Participants were interviewed about their experiences of the intervention; analyzed with content analysis. RESULTS Twenty patients on the waiting list for treatment at a DBT-clinic were invited and nine female patients (age 19-37 years) volunteered. The participants completed a large part of the intervention, which did not appear harmful since ratings of suicidal and self-harming behavior were similar before and after the intervention. In the interviews, participants stated that they had gained new knowledge and skills to manage situations, e.g. to stop and think before acting. Some even reported decreased levels of self-injury. The time spent on patient contact was short, and some patients reported difficulties to practice on their own and requested more support. CONCLUSIONS The intervention seems to be acceptable. Future studies should investigate in what ways some BPD patients are more susceptible to internet-delivered skills training than others, and if this intervention could be delivered within a stepped-care model.
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Affiliation(s)
- Sara Vasiljevic
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm
| | - Martina Isaksson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Martina Wolf-Arehult
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm
| | - Caisa Öster
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Mia Ramklint
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Johan Isaksson
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Stockholm, Sweden
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11
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Carroll P, Hirvikoski T, Lindholm C, Thorell LB. Group-based emotion regulation skills training for adults with ADHD: A feasibility study in an outpatient psychiatric setting. Appl Neuropsychol Adult 2023; 30:71-82. [PMID: 33905287 DOI: 10.1080/23279095.2021.1910512] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The aim of this open non-controlled clinical trial was to investigate the feasibility and preliminary treatment effects of a new group-based skills training program for adult ADHD: Group Therapy for Improving Emotional Acceptance and Regulatory Skills in Adults with ADHD (GEARS). Out of the 226 allocated patients, 213 initiated the treatment and 170 (80%) were considered treatment completers (i.e., attending at least 9 out of 14 sessions). A total of 158 of the completers also completed pre- and post-treatment assessments, and 126 provided assessments at the 3-month follow-up. Treatment credibility received high ratings, as did treatment satisfaction. Preliminary treatment effects showed significant improvements in emotion regulation with large effect sizes. Significant effects were also found for all secondary outcome variables: ADHD symptom levels, depression, anxiety, and quality of life. All significant effects remained at the 3-month follow-up. In conclusion, GEARS should be considered a feasible treatment in an outpatient psychiatric setting. The results also indicate that GEARS could be an effective treatment for adults with ADHD who are also experiencing problems with emotion regulation. However, a randomized controlled trial is needed to further evaluate the effectiveness of this new treatment.
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Affiliation(s)
- Patrick Carroll
- ADHD Outpatient Clinic, Northern Stockholm Psychiatry, Stockholm, Sweden
| | - Tatja Hirvikoski
- Department of Women's and Children's Health, Pediatric Neuropsychiatry Unit, Karolinska Institutet, Stockholm, Sweden.,Habilitation and Health, Region Stockholm, Sweden.,Center for Psychiatry Research, Region Stockholm, Sweden
| | - Charlotte Lindholm
- ADHD Outpatient Clinic, Northern Stockholm Psychiatry, Stockholm, Sweden
| | - Lisa B Thorell
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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12
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Zary N, Eysenbach G, Erasmus V, Dankbaar MEW. Teamwork Training With a Multiplayer Game in Health Care: Content Analysis of the Teamwork Principles Applied. JMIR Serious Games 2022; 10:e38009. [PMID: 36485016 PMCID: PMC9789497 DOI: 10.2196/38009] [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: 03/15/2022] [Revised: 10/11/2022] [Accepted: 10/31/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND In health care, teamwork skills are critical for patient safety; therefore, great emphasis is placed on training these skills. Given that training is increasingly designed in a blended way, serious games may offer an efficient method of preparing face-to-face simulation training of these procedural skills. OBJECTIVE This study aimed to investigate the teamwork principles that were used during gameplay by medical students and teamwork experts. Findings can improve our understanding of the potential of serious games for training these complex skills. METHODS We investigated a web-based multiplayer game designed for training students' interprofessional teamwork skills. During gameplay, 4 players in different roles (physician, nurse, medical student, and student nurse) had to share information, prioritize tasks, and decide on next steps to take in web-based patient scenarios, using one-to-one and team chats. We performed a qualitative study (content analysis) on these chats with 144 fifth-year medical students and 24 health care teamwork experts (as a benchmark study) playing the game in groups of 4. Game chat data from 2 scenarios were analyzed. For the analysis, a deductive approach was used, starting with a conceptual framework based on Crew Resource Management principles, including shared situational awareness, decision-making, communication, team management, and debriefing. RESULTS Results showed that most teamwork principles were used during gameplay: shared situational awareness, decision-making (eg, re-evaluation), communication (eg, closed loop), and team management (eg, distributing the workload). Among students, these principles were often used on a basic level. Among experts, teamwork principles were used with more open forms of speak up and more justification of decisions. Some specific Crew Resource Management principles were less observed among both groups, for example, prevention of fixation errors and use of cognitive aids. Both groups showed relatively superficial debriefing reflections. CONCLUSIONS Playing a multiplayer game for interprofessional teamwork appears to facilitate the application of teamwork principles by students in all important teamwork domains on a basic level. Expert players applied similar teamwork principles on a moderately high complexity level. Some teamwork principles were less observed among both students and expert groups, probably owing to the artifacts of the game environment (eg, chatting instead of talking). A multiplayer game for teamwork training can elicit the application of important, basic teamwork principles, both among novices and experts, and provides them with a flexible, accessible, and engaging learning environment. This may create time for exercising more complex skills during face-to-face training.
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Affiliation(s)
| | | | - Vicki Erasmus
- Implementation Research and Interprofessional Education, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Mary E W Dankbaar
- Institute of Medical Education Research Rotterdam, Erasmus University Medical Center, Rotterdam, Netherlands
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13
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Aebi M, Krause C, Barra S, Vogt G, Vertone L, Manetsch M, Imbach D, Endrass J, Rossegger A, Schmeck K, Bessler C. What Kind of Therapy Works With Juveniles Who Have Sexually Offended? A Randomized-Controlled Trial of Two Versions of a Specialized Cognitive Behavioral Outpatient Treatment Program. Sex Abuse 2022; 34:973-1002. [PMID: 35230203 DOI: 10.1177/10790632211070804] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 06/14/2023]
Abstract
There is ongoing debate about whether specialized treatment is effective to reduce sexual recidivism in juveniles who have sexually offended (JSOs). Although most treatment programs are based on cognitive behavioral therapy principles for preventing sexual offending, accordant scientific evidence is poor. Following CONSORT guidelines, the present study aimed to evaluate two versions of a short-term outpatient treatment program for JSOs in Switzerland: (a) the Therapy Program for Adequate Sexual Behaviors Version 1 (ThePaS-I), which included offending-specific skills training; (b) the ThePaS-II, which included general socioemotional skills training. Based on changes in self-reported mental health, sexual behaviors, victim empathy, and therapist-rated risk, as well as comprehensive data on sexual and general recidivism, we found some similarities regarding the effects of the two treatments. ThePaS-II showed better short-term changes in self-reported mental health than the ThePaS-I. However, JSOs in the ThePaS-I showed lower rates of sexual reoffending (but not general reoffending) after treatment than those in the ThePaS-II. Despite some methodological limitations, the current findings favor offending-specific skills-based therapy over general skills-based ones for preventing sexual reoffenses. The findings may encourage further methodologically sound studies to examine different treatment approaches for juveniles and adults who have committed criminal offenses.
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Affiliation(s)
- Marcel Aebi
- Department of Justice and Home Affairs, Research & Development, Corrections and Rehabilitation, Canton of Zurich, Zurich, Switzerland
- Department of Forensic Psychiatry, Child and Adolescent Forensic Psychiatry, 363320University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Chiara Krause
- Department of Forensic Psychiatry, Child and Adolescent Forensic Psychiatry, 363320University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Steffen Barra
- Institute for Forensic Psychology and Psychiatry, Neurocenter - Saarland University Medical Center, Homburg/Saar, Homburg/Saar, Germany
| | - Gunnar Vogt
- Department of Justice and Home Affairs, Psychiatric-Psychological Services, Corrections and Rehabilitation, Canton of Zurich, Zurich, Switzerland
| | - Leonardo Vertone
- Department of Forensic Psychiatry, Child and Adolescent Forensic Psychiatry, 363320University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Madleina Manetsch
- Department of Forensic Child and Adolescent Psychiatry, Forensic Psychiatric Clinic, University Psychiatric Hospitals, University of Basel, Basel, Switzerland
| | | | - Jérôme Endrass
- Department of Justice and Home Affairs, Research & Development, Corrections and Rehabilitation, Canton of Zurich, Zurich, Switzerland
- Department of Forensic Psychology, University of Konstanz, Konstanz, Germany
| | - Astrid Rossegger
- Department of Justice and Home Affairs, Research & Development, Corrections and Rehabilitation, Canton of Zurich, Zurich, Switzerland
- Department of Forensic Psychology, University of Konstanz, Konstanz, Germany
| | - Klaus Schmeck
- Child and Adolescent Psychiatric Research Department, Psychiatric University Hospitals, University of Basel, Basel, Switzerland
| | - Cornelia Bessler
- Department of Justice and Home Affairs, Research & Development, Corrections and Rehabilitation, Canton of Zurich, Zurich, Switzerland
- Department of Forensic Psychiatry, Child and Adolescent Forensic Psychiatry, 363320University Hospital of Psychiatry Zurich, Zurich, Switzerland
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14
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White A, Dunn N, Matsunaga E, Dimeff L. Innovations in Practice: Feasibility and provision of dialectical behavior therapy skills training for adolescents and their families. Child Adolesc Ment Health 2022. [PMID: 36373508 DOI: 10.1111/camh.12605] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/24/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Suicide is a leading cause of death for adolescents in the United States. Widespread implementation of evidence-based practices for this population remains challenging due to resource shortages and system barriers. Dialectical Behavior Therapy for Adolescents (DBT-A) has robust research support, with positive clinical outcomes when implemented with fidelity. At the same time, implementation requires individual therapy with trained clinicians, a resource which may not be available at the level required in some communities. The current study uses theoretical frameworks from adult implementations of Dialectical Behavior Therapy (DBT) where treatment was provided in a DBT Skills Training format without weekly individual therapy to examine skills training for adolescent clients with suicidal behaviors and is the first published study regarding feasibility of skills training for this population. METHODS Adolescents and their families were offered DBT Skills Training while on the waitlist for DBT-A. Of the 125 families referred, 48 chose DBT Skills Training and 77 opted to wait for DBT-A, creating a natural quasi-experimental design useful in exploring differences between DBT-Skills Training and DBT-A. RESULTS There were no significant differences between the two groups at baseline. Rates of treatment completion were similar between the two groups. CONCLUSIONS Results from the current study demonstrate similar rates of treatment drop-out and treatment completion between DBT Skills Training and DBT-A, suggesting DBT Skills Training without individual therapy for adolescents is feasible and warrants additional research.
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Affiliation(s)
| | | | | | - Linda Dimeff
- Portland DBT Institute, Portland, OR, USA.,Evidence Based Practice Institute, Seattle, WA, USA
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15
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Jogerst KM, Cassidy DJ, Coe TM, Monette D, Sell N, Eurboonyanum C, Hamdi I, Petrusa E, Stearns D, Gee DW, Chyn A, Saillant N, Takayesu JK. Interprofessional Trauma Team Training: Leveraging Each Specialties' Expertise to Teach Procedural-Based Skills. J Surg Educ 2022; 79:e273-e284. [PMID: 36283921 DOI: 10.1016/j.jsurg.2022.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 07/16/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The goal of this study was to utilize interprofessional trauma team training to teach procedural-based skills, teamwork, and assess the impact on the procedural comfort and interprofessional collaboration. DESIGN Interdisciplinary skills sessions were created to focus on chest tube placement and advanced ultrasound techniques. Chest tube sessions were taught by senior general surgery (GS) residents and faculty. Ultrasound sessions were taught by emergency medicine (EM) fellows and faculty. Mock trauma simulations for EM and GS residents and EM nurses, were developed to also focus on improving interprofessional trauma-bay collaboration. Sessions were held throughout the year for 2 consecutive academic years. After completing skills sessions and trauma scenarios, participants were surveyed on skill comfort, session utility, and willingness to collaborate with the other specialty. Likert scale responses were analyzed by specialty cohort and in aggregate. Free-text feedback responses were analyzed for common themes. SETTING Large, tertiary, urban academic medical center PARTICIPANTS: Forty seven EM residents and 32 GS residents completed instructional chest tube and ultrasound simulations, respectively. Twenty two EM residents, 24 GS residents, and 29 EM nurses participated in interprofessional trauma simulations. RESULTS For chest tube placement: 71% of EM residents reported feeling uncomfortable with the procedure prior to the session, with 100% reporting improved confidence afterwards. Seventy percent stated the model was realistic. One hundred percent thought it improved their procedural skills. All participants thought it was worthwhile, should be offered again in future years, and planned to incorporate what they learned in their future practice. For the ultrasound sessions: 61% of GS residents felt uncomfortable with the Focused Assessment with Sonography in Trauma prior to the simulation. Ninety four percent reported the improved skill and confidence, and felt the model was realistic. All participants felt sessions were worthwhile, should be offered again, and planned to incorporate what they learned in their future practice. For trauma simulations: 97% of participants felt scenarios were realistic and clinically relevant and planned to incorporate lessons learned in their future clinical practice. All participants thought participation was worthwhile. Ninety seven percent thought it improved their confidence with trauma clinical management and 56% reported it improved their skills. Many participants reported they appreciated learning from the other specialty's perspective, with greater than 95% of all participants reporting improved comfort and willingness to collaborate across disciplines when caring for future trauma patients. All participants requested the simulation sessions continue in future academic years. CONCLUSION Interprofessional trauma simulation sessions can harness the unique skill sets of different disciplines to teach procedural-based skills and improve interprofessional collaboration within the trauma bay.
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Affiliation(s)
- Kristen M Jogerst
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts; Department of Surgery, Mayo Clinic Hospital, Phoenix, Arizona.
| | - Douglas J Cassidy
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Taylor M Coe
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Derek Monette
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Naomi Sell
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | | | - Isra Hamdi
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Emil Petrusa
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Dana Stearns
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Denise W Gee
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Angela Chyn
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Noelle Saillant
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - James K Takayesu
- Department of Emergency Medicine, Massachusetts General Hospital, Boston, Massachusetts
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16
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Berking M, Eichler E, Naumann E, Svaldi J. The efficacy of a transdiagnostic emotion regulation skills training in the treatment of binge-eating disorder-Results from a randomized controlled trial. Br J Clin Psychol 2022; 61:998-1018. [PMID: 35567309 DOI: 10.1111/bjc.12371] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 12/23/2021] [Accepted: 03/29/2022] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Deficits in emotion regulation (ER) have been shown to be associated with binge-eating disorder (BED). To further clarify the causal nature of this association, we tested whether systematically enhancing ER skills would reduce symptoms of BED. METHODS We randomly allocated N = 101 individuals meeting the criteria for BED to a transdiagnostic ER skills training or to a waitlist control condition (WLC). Primary outcome was the reduction in binges during the treatment-vs.-waiting period as assessed with the Eating Disorder Examination (EDE) interview. RESULTS Mixed-model ANOVAs indicated that the average pre-to-post decrease in binges assessed with the EDE was significantly greater in the ER skills training condition than in the WLC (d = 0.66). These effects were stable over the 6-month follow-up period (d = 0.72). Remission rates at post/follow-up were 34.4/45.0% in the skills training and 7.5/20.0% in the WLC. Additionally, we found a greater reduction in general eating disorder psychopathology, of food consumption in a bogus taste test and of depression in the ER skills training condition. Moreover, the greater reduction in binge-eating episodes in the training condition was (partially) mediated by a greater increase in ER skills. CONCLUSIONS The findings provide further support for the assumed importance of deficits in ER as a maintaining factor and, hence, as a target in the treatment of BED. As ER skills trainings have been shown to also reduce other kinds of psychopathology, they might be considered a promising transdiagnostic add-on component to disorder-specific interventions.
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Affiliation(s)
| | - Eva Eichler
- University of Erlangen-Nuremberg, Erlangen, Germany
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17
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Gates JR, Wilson-Menzfeld G. What Role Does Geragogy Play in the Delivery of Digital Skills Programs for Middle and Older Age Adults? A Systematic Narrative Review. J Appl Gerontol 2022; 41:1971-1980. [PMID: 35543169 PMCID: PMC9364233 DOI: 10.1177/07334648221091236] [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: 11/22/2022] Open
Abstract
This systematic narrative review aimed to explore the implementation and delivery of
digital skills programs for middle and older age adults; and understand the presence of
adult learning theory (namely, geragogy/critical geragogy) in their delivery. A database
search was undertaken to examine international literature, published between 2010 and
2020. From 1,713 papers identified during the database searches, 17 papers were included.
Thematic synthesis was used to analyze the papers in this review. Themes were generated
relating to the implementation and delivery of digital skills programs: negative
perceptions of aging; the learning environment; and value of technology. The role of
geragogy/critical geragogy is not explicit in the delivery of digital skills programs in
this review but has an underlying thread of empowerment and embodies the ethos of these
learning theories to some extent. The findings of this review have been used to develop
recommendations for delivering digital skills to older adults.
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Affiliation(s)
- Jessica R Gates
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Gemma Wilson-Menzfeld
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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18
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Heinen J, Bäuerle A, Schug C, Krakowczyk JB, Strunk SE, Wieser A, Beckord J, Jansen C, Dries S, Pantförder M, Erim Y, Zipfel S, Mehnert-Theuerkauf A, Wiltink J, Wünsch A, Dinkel A, Stengel A, Kruse J, Teufel M, Graf J. Mindfulness and skills-based eHealth intervention to reduce distress in cancer-affected patients in the Reduct trial: Intervention protocol of the make it training optimized. Front Psychiatry 2022; 13:1037158. [PMID: 36387004 PMCID: PMC9650647 DOI: 10.3389/fpsyt.2022.1037158] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/12/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Cancer-affected patients experience high distress due to various burdens. One way to expand psycho-oncological support is through digital interventions. This protocol describes the development and structure of a web-based psycho-oncological intervention, the Make It Training optimized. This intervention is currently evaluated in the Reduct trial, a multicenter randomized controlled trial. METHODS The Make It Training optimized was developed in six steps: A patient need and demand assessment, development and acceptability analysis of a prototype, the formation of a patient advisory council, the revision of the training, implementation into a web app, and the development of a motivation and evaluation plan. RESULTS Through a process of establishing cancer-affected patients' needs, prototype testing, and patient involvement, the Make It Training optimized was developed by a multidisciplinary team and implemented in a web app. It consists of 16 interactive self-guided modules which can be completed within 16 weeks. DISCUSSION Intervention protocols can increase transparency and increase the likelihood of developing effective web-based interventions. This protocol describes the process and results of developing a patient-oriented intervention. Future research should focus on the further personalization of web-based psycho-oncological interventions and the potential benefits of combining multiple psychotherapeutic approaches.
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Affiliation(s)
- Jana Heinen
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University, Tübingen, Germany.,Comprehensive Cancer Center (CCC-TS), University Hospital Tübingen, Tübingen, Germany
| | - Alexander Bäuerle
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany.,Comprehensive Cancer Center, University Hospital Essen, Essen, Germany
| | - Caterina Schug
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Julia Barbara Krakowczyk
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany.,Comprehensive Cancer Center, University Hospital Essen, Essen, Germany
| | - Sven Erik Strunk
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Alexandra Wieser
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University, Tübingen, Germany.,Comprehensive Cancer Center (CCC-TS), University Hospital Tübingen, Tübingen, Germany
| | - Jil Beckord
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany.,Comprehensive Cancer Center, University Hospital Essen, Essen, Germany
| | - Christoph Jansen
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany.,Comprehensive Cancer Center, University Hospital Essen, Essen, Germany
| | - Sebastian Dries
- Fraunhofer Institute for Software and Systems Engineering (ISST), Dortmund, Germany
| | - Michael Pantförder
- Fraunhofer Institute for Software and Systems Engineering (ISST), Dortmund, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University, Tübingen, Germany.,Comprehensive Cancer Center (CCC-TS), University Hospital Tübingen, Tübingen, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Alexander Wünsch
- Clinic for Psychosomatic Medicine and Psychotherapy, Freiburg Medical Center, Albert-Ludwigs-Universität Freiburg, Freiburg, Germany.,Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Andreas Dinkel
- Department of Psychosomatic Medicine and Psychotherapy, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University, Tübingen, Germany.,Comprehensive Cancer Center (CCC-TS), University Hospital Tübingen, Tübingen, Germany.,Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Johannes Kruse
- Department of Psychotherapy and Psychosomatics, Justus Liebig University Giessen, Giessen, Germany.,Department of Psychotherapy and Psychosomatics, Philipps University Marburg, Marburg, Germany
| | - Martin Teufel
- Clinic for Psychosomatic Medicine and Psychotherapy, LVR-University Hospital Essen, University of Duisburg-Essen, Essen, Germany.,Center for Translational Neuro- and Behavioral Sciences (C-TNBS), University of Duisburg-Essen, Essen, Germany.,Comprehensive Cancer Center, University Hospital Essen, Essen, Germany
| | - Johanna Graf
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Eberhard Karls University, Tübingen, Germany.,Comprehensive Cancer Center (CCC-TS), University Hospital Tübingen, Tübingen, Germany
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19
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Abstract
BACKGROUND Autism spectrum disorder (ASD) is a common and lifelong neurodevelopmental disorder with the hallmark features of social impairment and restricted and repetitive patterns of behaviour. Individuals with ASD often experience co-occurring mental health difficulties, some of which may obfuscate the ASD features themselves. Although there is a high need for mental health services for autistic adults, there are surprisingly few evidence-based treatments (EBTs) available; moreover, many mental health practitioners who are well-trained in EBTs shy away from treating autistic individuals due to lack of training in ASD. AIMS The aim of the current study was to evaluate the feasibility and acceptability of dialectical behaviour therapy skills training (DBT-ST) in a sample of autistic adults without intellectual disability. METHOD Sixteen adults with ASD were recruited from a treatment waiting list to enrol in this study, which included 24 weeks of DBT-ST delivered in a group setting. Feasibility and acceptability were assessed using retention and attendance data and a participant satisfaction questionnaire. RESULTS Retention (81.3%) and attendance data (mean 87.5%) provided support for the feasibility of this intervention. Overall satisfaction ratings were high (mean 4.5 out of 5), and participants reported that they felt that DBT-ST would probably be helpful for others with ASD (mean 4.5 out of 5). CONCLUSIONS The study findings provide preliminary evidence of (1) the feasibility of providing DBT-ST for autistic adults in community-based clinics, and (2) the perceived benefit of DBT-ST for this under-served population. Recommended modifications to the standard DBT-ST materials are discussed.
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20
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Oberoi KPS, Caine AD, Schwartzman J, Livingston DH, Merchant AM, Kunac A. Surgical Skills Olympiad: A 4-Year Experience in a General Surgery Residency Program. Surg J (N Y) 2021; 7:e222-e225. [PMID: 34466660 PMCID: PMC8390299 DOI: 10.1055/s-0041-1733991] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 06/29/2021] [Indexed: 11/29/2022] Open
Abstract
Background
The acquisition of operative skills is the critical defining component of general surgery training. Performing simulated tasks has been shown to increase a resident's technical skills. As such, we devised the Surgical Skills Olympiad, an annual simulation-based skills competition. We examined our 4-year experience with the Olympiad at a large academic general surgery residency program.
Objective
This study aimed to use competition to motivate trainees to increase the time they spent practicing basic surgical skills, resulting in improved performance over time.
Methods
Teams were formed from members of each postgraduate year (PGY) class. Competition tasks were level specific: knot tying for PGY-1, basic laparoscopy for PGY-2, handsewn bowel anastomosis for PGY-3, vascular anastomosis for PGY-4, and advanced laparoscopy for PGY-5. Task scores over a 4-year period (2014–2017) were analyzed and a survey of participating teaching faculty was conducted.
Results
Ten faculty members responded to the survey, for a response rate of 63%. A total of 50% respondents felt that the caliber of surgical skills increased since the Olympiad was implemented. Ninety percent agreed that the Olympiad was beneficial for residents to assess their skills against their peers. Over 4 years, there was an improvement in scores for suturing task, advanced laparoscopy, and bowel anastomosis (
p
< 0.05 for all three).
Conclusion
A residency-wide surgical skills competition can improve resident performance in technical tasks and promote faculty engagement in resident skills training.
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Affiliation(s)
- Kurun P S Oberoi
- Division of General/Minimally Invasive Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Akia D Caine
- Division of General/Minimally Invasive Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Jacob Schwartzman
- Division of General/Minimally Invasive Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - David H Livingston
- Division of Trauma and Surgical Critical Care, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Aziz M Merchant
- Division of General/Minimally Invasive Surgery, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
| | - Anastasia Kunac
- Division of Trauma and Surgical Critical Care, Department of Surgery, Rutgers New Jersey Medical School, Newark, New Jersey
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21
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Swaminathan G, Parulekar SV. Does Simulation Training Improve the Accuracy of Vaginal Assessment of Labour Progress? Cureus 2021; 13:e16089. [PMID: 34367747 PMCID: PMC8330498 DOI: 10.7759/cureus.16089] [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] [Accepted: 07/01/2021] [Indexed: 11/05/2022] Open
Abstract
Aim To measure the utility of the Simulation training model for training purposes over and above conventional methods of training for vaginal assessment during labour. Methods The study group included undergraduate trainees, and the control group included postgraduate trainees and qualified personnel, i.e. senior registrars and consultants. Participants from the study group were trained for vaginal assessment on the simulation training model. Then both the groups were tested on the model for accuracy in estimating each value of cervical dilatation and fetal station. Mean cervical dilatation and station accuracy scores were noted, and comparative analysis was done between the study and control groups. Results A total of 150 participants were included. The overall mean dilatation and station accuracy scores of a model trained study group participants were better than subjectively trained control group participants. Study group participants showed greater accuracy for smaller dilatations, i.e. 1, 2, 3, 4cm and middle dilatation, i.e. 5cm and 6cm (p value=<0.05). In contrast, comparing the two groups for higher dilatations from 6 to 10 cm did not show any statistical significance. Study group participants also showed greater accuracy for all the fetal stations except stations 0 and +1. Conclusions The simulation training model can be considered an in vitro training device to improve the trainees' understanding of cervical dilatation and fetal station and can be made a part of a routine obstetric teaching program.
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Affiliation(s)
- Girija Swaminathan
- Obstetrics and Gynaecology, King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Mumbai, IND
| | - Shashank V Parulekar
- Obstetrics and Gynaecology, King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Mumbai, IND
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22
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Higgins M, Madan CR, Patel R. Deliberate Practice in Simulation-Based Surgical Skills Training: A Scoping Review. J Surg Educ 2021; 78:1328-1339. [PMID: 33257298 DOI: 10.1016/j.jsurg.2020.11.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/10/2020] [Accepted: 11/11/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND In recent years there has been a shift from traditional Halstedian methods toward more simulation-based medical education (SBME) for developing surgical skills. Questions remain about the role and value of SBME, although feedback and engagement in repetitive practice have been associated with positive learning outcomes. Regardless of approach, the principles of deliberate practice align with both the Halstedian traditions and ways of implementing SBME. Whilst deliberate practice is well described in the wider literature, the extent to which it is an effective instructional approach in surgical training remains unknown. OBJECTIVE To explore the effectiveness of deliberate practice as an instructional design for developing surgical skills through SBME interventions, as assessed by improvements in trainee performance and/or patient outcomes. METHODS A combined search was conducted in PUBMED, CINAHL, EMBASE, MEDLINE, PSYCHINFO, and Google Scholar. Three hundred one articles were screened and 17 met the inclusion criteria for analysis. RESULTS There was heterogeneity of study methods with 6 randomized control trials, 7 pretest/post-test design, 2 nonrandomized comparisons and 2 observational studies. All articles demonstrated positive learner outcomes following SBME with deliberate practice, although there was no direct comparison to another instructional method. Two studies demonstrated skill transfer to the clinical environment and 1 demonstrated improved patient outcomes. CONCLUSION Deliberate practice informed SBME interventions appeared effective for developing surgical skills among trainee surgeons, however the reliability of these conclusions was limited by the modest quality of the research studies and the design elements of deliberate practice were inconsistently applied. There was little evidence that deliberate practice led to skills retention beyond 30 days, although participant numbers were low and the quality of studies was modest.
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Affiliation(s)
- Mark Higgins
- University of Nottingham, Nottingham, United Kingdom.
| | | | - Rakesh Patel
- University of Nottingham, Nottingham, United Kingdom
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23
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Philipp J, Franta C, Zeiler M, Truttmann S, Wittek T, Imgart H, Zanko A, Auer-Welsbach E, Mairhofer D, Mitterer M, Laczkovics C, Schöfbeck G, Jilka E, Egermann WB, Treasure J, Karwautz AFK, Wagner G. Does a Skills Intervention for Parents Have a Positive Impact on Adolescents' Anorexia Nervosa Outcome? Answers from a Quasi-Randomised Feasibility Trial of SUCCEAT. Int J Environ Res Public Health 2021; 18:ijerph18094656. [PMID: 33925694 PMCID: PMC8124826 DOI: 10.3390/ijerph18094656] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/17/2021] [Accepted: 04/23/2021] [Indexed: 12/14/2022]
Abstract
Skills trainings for caregivers of patients with anorexia nervosa (AN) have been proven to be effective in improving caregiver skills and reducing caregivers’ psychopathology. The effects on patients, especially adolescents, are largely unknown. The aim of this study was to evaluate the effectiveness of a caregivers’ skills training program (Supporting Carers of Children and Adolescents with Eating Disorders in Austria, SUCCEAT, workshop or online version) on adolescents with AN delivered as workshops (WS) or online (ONL). Outcomes are Body-Mass-Index (BMI) percentile, eating psychopathology (Eating Disorder Examination, EDE), attitudinal and behavioural dimensions of eating disorders (Eating Disorder Inventory-2), motivation to change (AN Stages of Change Questionnaire), emotional and behavioural problems (Youth Self-Report) and quality of life (KINDL). All outcome variables significantly improved across both SUCCEAT groups (WS and ONL) and were sustained at 12-month follow-up. The online and workshop delivery of SUCCEAT were equally effective. Most effect sizes were in the medium-to-high range. Full or partial remission was observed in 72% (WS) and 87% (ONL) of patients. Caregiver skills trainings, either delivered as workshops or online modules, are highly recommended to complement treatment as usual.
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Affiliation(s)
- Julia Philipp
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (C.F.); (M.Z.); (S.T.); (T.W.); (D.M.); (M.M.); (C.L.); (G.S.); (E.J.); (W.B.E.); (A.F.K.K.)
| | - Claudia Franta
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (C.F.); (M.Z.); (S.T.); (T.W.); (D.M.); (M.M.); (C.L.); (G.S.); (E.J.); (W.B.E.); (A.F.K.K.)
| | - Michael Zeiler
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (C.F.); (M.Z.); (S.T.); (T.W.); (D.M.); (M.M.); (C.L.); (G.S.); (E.J.); (W.B.E.); (A.F.K.K.)
| | - Stefanie Truttmann
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (C.F.); (M.Z.); (S.T.); (T.W.); (D.M.); (M.M.); (C.L.); (G.S.); (E.J.); (W.B.E.); (A.F.K.K.)
| | - Tanja Wittek
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (C.F.); (M.Z.); (S.T.); (T.W.); (D.M.); (M.M.); (C.L.); (G.S.); (E.J.); (W.B.E.); (A.F.K.K.)
| | - Hartmut Imgart
- Parkland Clinic, Clinic for Psychosomatic Medicine and Psychotherapy, 34537 Bad Wildungen, Germany; (H.I.); (A.Z.)
| | - Annika Zanko
- Parkland Clinic, Clinic for Psychosomatic Medicine and Psychotherapy, 34537 Bad Wildungen, Germany; (H.I.); (A.Z.)
| | - Ellen Auer-Welsbach
- Department for Neurology and child and adolescents Psychiatry, 9020 Klagenfurt am Wörthersee, Austria;
| | - Dunja Mairhofer
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (C.F.); (M.Z.); (S.T.); (T.W.); (D.M.); (M.M.); (C.L.); (G.S.); (E.J.); (W.B.E.); (A.F.K.K.)
| | - Michaela Mitterer
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (C.F.); (M.Z.); (S.T.); (T.W.); (D.M.); (M.M.); (C.L.); (G.S.); (E.J.); (W.B.E.); (A.F.K.K.)
| | - Clarissa Laczkovics
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (C.F.); (M.Z.); (S.T.); (T.W.); (D.M.); (M.M.); (C.L.); (G.S.); (E.J.); (W.B.E.); (A.F.K.K.)
| | - Gabriele Schöfbeck
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (C.F.); (M.Z.); (S.T.); (T.W.); (D.M.); (M.M.); (C.L.); (G.S.); (E.J.); (W.B.E.); (A.F.K.K.)
| | - Elisabeth Jilka
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (C.F.); (M.Z.); (S.T.); (T.W.); (D.M.); (M.M.); (C.L.); (G.S.); (E.J.); (W.B.E.); (A.F.K.K.)
| | - Wolfgang B. Egermann
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (C.F.); (M.Z.); (S.T.); (T.W.); (D.M.); (M.M.); (C.L.); (G.S.); (E.J.); (W.B.E.); (A.F.K.K.)
| | - Janet Treasure
- Section of Eating Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London WC2R 2LS, UK;
| | - Andreas F. K. Karwautz
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (C.F.); (M.Z.); (S.T.); (T.W.); (D.M.); (M.M.); (C.L.); (G.S.); (E.J.); (W.B.E.); (A.F.K.K.)
| | - Gudrun Wagner
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria; (J.P.); (C.F.); (M.Z.); (S.T.); (T.W.); (D.M.); (M.M.); (C.L.); (G.S.); (E.J.); (W.B.E.); (A.F.K.K.)
- Correspondence: ; Tel.: +43-140-400-3-0170
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Álvarez ML, Waissbluth S, González C, Napolitano C, Torrente M, Délano PH, Alarcón R, Fernández F, Bitrán R. How the COVID-19 pandemic affects specialty training: An analysis of a nationwide survey among otolaryngology residents in Chile. Medwave 2021; 21:e8098. [PMID: 33617520 DOI: 10.5867/medwave.2021.01.8097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 08/29/2020] [Accepted: 10/20/2020] [Indexed: 11/27/2022] Open
Abstract
Introduction Coronavirus disease 2019, or COVID-19, has become a global pandemic. Given that the highest viral load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is found in the airway, otolaryngologists are at high risk of infection. As a result, multiple recommendations have emerged regarding protective measures for surgical teams, including suspending non-urgent procedures and surgeries. Objectives To evaluate the impact of the COVID-19 pandemic on otolaryngology residency training programs nationwide. Methods A cross-sectional survey-based study was completed in April 2020. The participants were recruited through an online survey, sent by email to all Chilean otolaryngology residents. Demographics, clinical activities, on-call shifts, COVID-19 infection status, exposure to COVID-19 patients, deployment to other specialties, diagnostic/therapeutic procedures, and surgeries performed were analyzed. Self-reported surgical data logs from previous years were used to compare results. Results Forty-seven residents completed the survey (84% response rate); 64% of residents refer seeing patients ten days or less during April 2020. Commonly performed procedures such as flexible nasolaryngoscopy, rigid nasal endoscopy, and peritonsillar abscess drainage were not performed by over 40% of the residents in that month. Only 38% participated in surgeries, with an average of 0.6 surgeries as a first surgeon, a dramatic decrease in surgical exposure when comparing the data logs from previous years. Most residents refer the following measures taken by their residency program to improve residency training: bibliographic videoconferences (87%), online clinical case seminars (60%), weekly journal clubs (38%), among others. Conclusions Clinical and surgical opportunities decreased dramatically during April 2020. Adjustments to the regular academic curricula should be considered to decrease the negative impact of this pandemic on residency training.
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Affiliation(s)
- Matías L Álvarez
- Departamento Otorrinolaringología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0002-7199-3033
| | - Sofia Waissbluth
- Departamento Otorrinolaringología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. Adress: Diagonal Paraguay 362, 7º piso, Santiago, Chile. . ORCID: 0000-0002-6884-968X
| | - Claudia González
- Departamento Otorrinolaringología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0002-4110-6763
| | - Carla Napolitano
- Departamento Otorrinolaringología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile. ORCID: 0000-0002-9459-7957
| | - Mariela Torrente
- Departamento Otorrinolaringología, Facultad de Medicina, Universidad de Chile, Santiago, Chile. ORCID: 0000-0002-3151-9142
| | - Paul H Délano
- Centro Avanzado de Ingeniería Eléctrica y Electrónica, AC3E, Universidad Técnica Federico Santa María, Valparaíso, Chile. ORCID: 0000-0003-2588-4757
| | - Ricardo Alarcón
- Departamento Otorrinolaringología, Facultad de Medicina, Universidad de Concepción, Concepción, Chile. ORCID: 0000-0002-8260-7441
| | - Francisca Fernández
- Departamento Otorrinolaringología, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile. ORCID: 0000-0002-8068-4136
| | - Roger Bitrán
- Departamento Otorrinolaringología, Facultad de Medicina, Universidad de Católica del Norte, Coquimbo, Chile. ORCID: 000-0002-1775-0057
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25
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Smith AM, Stewart K, Baul T, Valentine SE. Peer delivery of a brief cognitive-behavioral treatment for posttraumatic stress disorder: A hybrid effectiveness-implementation pilot study. J Clin Psychol 2020; 76:2133-2154. [PMID: 32632945 PMCID: PMC7665989 DOI: 10.1002/jclp.23020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 12/18/2019] [Revised: 04/02/2020] [Accepted: 06/04/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) treatment delivery by peer specialist providers could increase access to and engagement with PTSD treatment in low resource settings. The current pilot study tested the feasibility, acceptability, and initial effectiveness of a peer-delivered, brief cognitive-behavioral therapy for PTSD. METHOD Four certified peer specialists delivered the intervention to 18 participants with probable PTSD. We assessed PTSD symptoms weekly and administered surveys and interviews at baseline and posttreatment. RESULTS Our mixed-methods approach suggests that the intervention was feasible and acceptable, demonstrating high client satisfaction. We also found significant improvements in PTSD, depressive, anxiety, and general stress symptoms. CONCLUSIONS Peer-delivered interventions may be a good fit for addressing posttraumatic stress symptoms for people accessing care in low resource settings. Future research should evaluate peer-delivered PTSD treatment as a strategy for both reducing symptoms and improving access and engagement in professional care.
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Affiliation(s)
- Ashley M. Smith
- Department of Psychiatry, Boston Medical Center, 720 Harrison Avenue, Suite 1150, Boston, MA, 02118, U.S
| | - Kaylee Stewart
- Department of Psychiatry, Boston Medical Center, 720 Harrison Avenue, Suite 1150, Boston, MA, 02118, U.S
| | - Tithi Baul
- Department of Psychiatry, Boston Medical Center, 720 Harrison Avenue, Suite 1150, Boston, MA, 02118, U.S
| | - Sarah E. Valentine
- Department of Psychiatry, Boston Medical Center, 720 Harrison Avenue, Suite 1150, Boston, MA, 02118, U.S
- Department of Psychiatry, Boston University School of Medicine, 720 Harrison Avenue, Suite 1150, Boston, MA, 02118, U.S
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26
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Oberoi G, Eberspächer-Schweda MC, Hatamikia S, Königshofer M, Baumgartner D, Kramer AM, Schaffarich P, Agis H, Moscato F, Unger E. 3D Printed Biomimetic Rabbit Airway Simulation Model for Nasotracheal Intubation Training. Front Vet Sci 2020; 7:587524. [PMID: 33330714 PMCID: PMC7728614 DOI: 10.3389/fvets.2020.587524] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 08/12/2020] [Accepted: 10/22/2020] [Indexed: 11/29/2022] Open
Abstract
Rabbit inhalation anesthesia by endotracheal intubation involves a higher risk among small animals owing to several anatomical and physiological features, which is pathognomonic to this species of lagomorphs. Rabbit-specific airway devices have been designed to prevent misguided intubation attempts. However, it is believed that expert anesthetic training could be a boon in limiting the aftermaths of this procedure. Our research is aimed to develop a novel biomimetic 3D printed rabbit airway model with representative biomechanical material behavior and radiodensity. Imaging data were collected for two sacrificed rabbit heads using micro-computed tomography (μCT) and micro-magnetic resonance imaging for the first head and cone beam computed tomography (CBCT) for the second head. Imaging-based life-size musculoskeletal airway models were printed using polyjet technology with a combination of hard and soft materials in replicates of three. The models were evaluated quantitatively for dimensional accuracy and radiodensity and qualitatively using digital microscopy and endoscopy for technical, tactic, and visual realism. The results displayed that simulation models printed with polyjet technology have an overall surface representation of 93% for μCT-based images and 97% for CBCT-based images within a range of 0.0-2.5 mm, with μCT showing a more detailed reproduction of the nasotracheal anatomy. Dimensional discrepancies can be caused due to inadequate support material removal and due to the limited reconstruction of microstructures from the imaging on the 3D printed model. The model showed a significant difference in radiodensities in hard and soft tissue regions. Endoscopic evaluation provided good visual and tactile feedback, comparable to the real animal. Overall, the model, being a practical low-cost simulator, comprehensively accelerates the learning curve of veterinary nasotracheal intubation and paves the way for 3D simulation-based image-guided interventional procedures.
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Affiliation(s)
- Gunpreet Oberoi
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - M. C. Eberspächer-Schweda
- Department/Hospital for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Sepideh Hatamikia
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
- Austrian Center for Medical Innovation and Technology, Wiener Neustadt, Austria
| | - Markus Königshofer
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Doris Baumgartner
- Department/Hospital for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | | | - Peter Schaffarich
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Hermann Agis
- Department of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Francesco Moscato
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Vienna, Austria
- Austrian Cluster for Tissue Regeneration, Vienna, Austria
| | - Ewald Unger
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
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27
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Watanabe M, Yoneyama Y, Hamada H, Kohno M, Hasegawa O, Takahashi H, Kawase-Koga Y, Matsuo A, Chikazu D, Kawata S, Itoh M. The Usefulness of Saturated Salt Solution Embalming Method for Oral Surgical Skills Training: A New Cadaveric Training Model for Bone Harvesting. Anat Sci Educ 2020; 13:628-635. [PMID: 31608585 DOI: 10.1002/ase.1925] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 07/29/2018] [Revised: 07/24/2019] [Accepted: 10/09/2019] [Indexed: 06/10/2023]
Abstract
The purpose of this study was to assess the usefulness of saturated salt solution-embalmed cadavers for oral surgical skills training related to bone graft harvesting. Two half-day surgical skills training workshops were held at the Tokyo Medical University utilizing eight cadavers embalmed with the saturated salt solution. A total of 22 participants including oral surgeons, residents, and dentists attended the workshop. Surgical training consisted of six procedures related to intraoral and extraoral bone harvesting. The participants were surveyed to assess self-confidence levels for each surgical procedure before and after completion of each workshop. The Wilcoxon signed-rank test was used to compare the differences between each median score before and after the workshop. There were statistically significant increases in the self-assessed confidence scores in bone harvesting procedures for the zygomatic bone (P = 0.003), maxillary tuberosity (P = 0.002), and other sites (P < 0.001). The anatomical features of saturated salt solution-embalmed cadavers were also examined. The textures of the oral mucosa and skin were similar to those of living individuals. The structure of bone tissues was well-preserved and the hardness was realistic. Consequently, all procedures were performed with sufficient realism. The saturated salt solution method has a relatively low cost of preparation and storage, and almost no odor. The authors suggest that saturated salt solution-embalmed cadavers could provide a new model for oral surgical skills training in bone harvesting.
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Affiliation(s)
- Masato Watanabe
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | - Yuya Yoneyama
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | - Hayato Hamada
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan
| | - Michihide Kohno
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | - On Hasegawa
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | - Hidetoshi Takahashi
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | - Yoko Kawase-Koga
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | - Akira Matsuo
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University Ibaraki Medical Center, Ibaraki, Japan
| | - Daichi Chikazu
- Department of Oral and Maxillofacial Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | - Shinichi Kawata
- Department of Anatomy, Tokyo Medical University, Tokyo, Japan
| | - Masahiro Itoh
- Department of Anatomy, Tokyo Medical University, Tokyo, Japan
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Pattojoshi A, Tikka SK. School-based substance use disorder prevention in India: A brief appraisal. Indian J Psychiatry 2020; 62:427-430. [PMID: 33165333 PMCID: PMC7597725 DOI: 10.4103/psychiatry.indianjpsychiatry_43_19] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 05/22/2019] [Accepted: 06/04/2020] [Indexed: 11/23/2022] Open
Abstract
Substance use among Indian school children is a rising concern. Awareness across Indian schools and mental health professions regarding school-based prevention programs for substance use is limited. Describing the globally recommended evidence-based school-based prevention programs, this commentary highlights their need, availability, feasibility, and cultural relevance in Indian context.
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Affiliation(s)
- Amrit Pattojoshi
- Department of Psychiatry, Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, India
| | - Sai Krishna Tikka
- Department of Psychiatry, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
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Kullberg MLJ, Mouthaan J, Schoorl M, de Beurs D, Kenter RMF, Kerkhof AJ. E-Learning to Improve Suicide Prevention Practice Skills Among Undergraduate Psychology Students: Randomized Controlled Trial. JMIR Ment Health 2020; 7:e14623. [PMID: 32012076 PMCID: PMC7003118 DOI: 10.2196/14623] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 09/02/2019] [Accepted: 10/07/2019] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Despite increasing evidence of the effectiveness of digital learning solutions in higher vocational education, including the training of allied health professionals, the impact of Web-based training on the development of practical skills in psychiatry and psychology, in general, and in suicide prevention, specifically, remains largely understudied. OBJECTIVE This study aimed to determine the effectiveness of an electronic learning (e-learning) module on the adherence to suicide prevention guidelines, knowledge of practical skills, and provider's confidence to have a conversation about suicidal behavior with undergraduate psychology students. METHODS The e-learning module, comprising video recordings of therapist-patient interactions, was designed with the aim of transferring knowledge about suicide prevention guideline recommendations. The program's effects on guideline adherence, self-evaluated knowledge, and provider's confidence were assessed using online questionnaires before the program (baseline and at 1 month [T1] and 3 months after baseline). The eligible third- and fourth-year undergraduate psychology students were randomly allocated to the e-learning (n=211) or to a waitlist control condition (n=187), with access to the intervention after T1. RESULTS Overall, the students evaluated e-learning in a fairly positive manner. The intention-to-treat analysis showed that the students in the intervention condition (n=211) reported higher levels of self-evaluated knowledge, provider's confidence, and guideline adherence than those in the waitlist control condition (n=187) after receiving the e-learning module (all P values<.001). When comparing the scores at the 1- and 3-month follow-up, after both groups had received access to the e-learning module, the completers-only analysis showed that the levels of knowledge, guideline adherence, and confidence remained constant (all P values>.05) within the intervention group, whereas a significant improvement was observed in the waitlist control group (all P values<.05). CONCLUSIONS An e-learning intervention on suicide prevention could be an effective first step toward improved knowledge of clinical skills. The learning outcomes of a stand-alone module were found to be similar to those of a training that combined e-learning with a face-to-face training, with the advantages of flexibility and low costs.
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Affiliation(s)
| | - Joanne Mouthaan
- Department of Clinical Psychology, Leiden University, Leiden, Netherlands
| | - Maartje Schoorl
- Department of Clinical Psychology, Leiden University, Leiden, Netherlands
| | - Derek de Beurs
- Netherlands Institute for Health Services Research, Utrecht, Netherlands
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Holmqvist Larsson K, Andersson G, Stern H, Zetterqvist M. Emotion regulation group skills training for adolescents and parents: A pilot study of an add-on treatment in a clinical setting. Clin Child Psychol Psychiatry 2020; 25:141-155. [PMID: 31419914 DOI: 10.1177/1359104519869782] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Difficulties with emotion regulation have been identified as an underlying mechanism in mental health. This pilot study aimed at examining whether group skills training in emotion regulation for adolescents and parents as an add-on intervention was feasible in an outpatient child and adolescent psychiatric clinic. We also investigated if the treatment increased knowledge and awareness of emotions and their functions, increased emotion regulation skills and decreased self-reported symptoms of anxiety and depression. Six skills training groups were piloted with a total of 20 adolescents and 21 adults. The treatment consisted of five sessions dealing with psychoeducation about emotions and emotion regulation skills training. Paired-samples t test was used to compare differences between before-and-after measures for adolescents and parents separately. The primary outcome measure, Difficulties in Emotion Regulation Scale, showed significant improvement after treatment for both adolescents and parents. For adolescents, measures of alexithymia were significantly reduced. Also, emotional awareness was significantly increased. Measures of depression and anxiety did not change. In conclusion, group skills training as an add-on treatment can be feasible and effective but further studies are needed.
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Affiliation(s)
- Kristina Holmqvist Larsson
- Department of Child and Adolescent Psychiatry and Department of Clinical and Experimental Medicine, Linköping University, Sweden
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Sweden.,Department of Clinical Neuroscience, Karolinska Institute, Sweden
| | | | - Maria Zetterqvist
- Department of Child and Adolescent Psychiatry and Department of Clinical and Experimental Medicine, Linköping University, Sweden
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Sullivan A, Elshenawy S, Ades A, Sawyer T. Acquiring and Maintaining Technical Skills Using Simulation: Initial, Maintenance, Booster, and Refresher Training. Cureus 2019; 11:e5729. [PMID: 31723493 PMCID: PMC6825451 DOI: 10.7759/cureus.5729] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 11/09/2022] Open
Abstract
Simulation-based education has been shown to be an effective tool to mitigate skill decay. However, many of the strategies reported in the literature have overlapping terminology with little consensus on the timing of the strategy to prevent skill decay. In this review, we propose and provide a standardized nomenclature and framework for simulation strategies used to obtain, maintain, or regain skills that are decaying. This framework delineates four types of training: initial, maintenance, booster, and refresher. The framework differentiates these training types based on the learner competency at the time of the training, as well as the frequency and intensity of the training. Initial training is aimed at “novice” learners with the goal to achieve competency. Once competency is achieved, maintenance training prevents skill deterioration through low-dose high-frequency (LDHF) training. Booster training is used when the learner is still proficient, but competency begins to wane. Booster training occurs less frequently than maintenance training but with greater intensity to overcome the skill decay that occurs over time. Refresher training is aimed at re-establishing skill levels after competency has reached unsatisfactory levels. Refresher training is higher intensity than booster and maintenance training. We describe simulation-based strategies reported in the literature that can be used for each type of training. We conclude that there should be an increased emphasis in medical education towards maintenance and booster training in order to preserve skills before competency is lost.
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Affiliation(s)
- Anne Sullivan
- Pediatrics: Neonatology, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - Summer Elshenawy
- Pediatrics: Neonatology, The Children's Hospital of Philadelphia, Philadelphia, USA
| | - Anne Ades
- Pediatrics, Children's Hospital of Philadelphia, Philadelphia, USA
| | - Taylor Sawyer
- Pediatrics, University of Washington School of Medicine, Seattle, USA
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Dures E, Rooke C, Hammond A, Hewlett S. Training and delivery of a novel fatigue intervention: a qualitative study of rheumatology health-care professionals' experiences. Rheumatol Adv Pract 2019; 3:rkz032. [PMID: 31559382 PMCID: PMC6755488 DOI: 10.1093/rap/rkz032] [Citation(s) in RCA: 5] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/01/2019] [Indexed: 01/16/2023] Open
Abstract
Objectives Successful, non-pharmacological research interventions are challenging to implement in clinical practice. The aim of the study was to understand the experiences of rheumatology nurses and occupational therapists (tutors) delivering a novel fatigue intervention in a trial setting, and their views on requirements for clinical implementation. After training, tutors delivered courses of a manualized group cognitive-behavioural intervention to patients with RA in a seven-centre randomized controlled trial [Reducing Arthritis Fatigue by clinical Teams using cognitive-behavioural approaches (RAFT)], which demonstrated reduced fatigue impact at 2 years. Methods Fourteen tutors participated in interviews, and eight tutors also participated in a focus group. Data were audio-recorded, transcribed and analysed using inductive thematic analysis. Results The following five main themes were identified: 'exciting but daunting' reflected the mixture of excitement and anxiety in intervention training and delivery; 'skills practice and demonstrations were essential' captured the value of learning and practising together, even though the process could be uncomfortable; 'an individual approach to a standardized intervention' showed how tutors negotiated adherence to the manual with delivery using their own words; 'becoming a better practitioner' described how participation enhanced tutors' wider clinical practice; and 'pragmatic and flexible' highlighted practical adaptations to facilitate training and intervention roll out. Conclusion These insights inform strategies for clinical implementation of an evidence-based intervention that addresses a patient priority, with implications for other successful research interventions. Tutors believed that the skills acquired during RAFT enhanced their wider clinical practice, which highlights the benefits of upskilling members of clinical teams to provide self-management support to patients.
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Affiliation(s)
- Emma Dures
- Department of Nursing and Midwifery, University of the West of England.,Academic Rheumatology, Bristol Royal Infirmary, Bristol
| | - Clive Rooke
- Academic Rheumatology, Bristol Royal Infirmary, Bristol
| | - Alison Hammond
- Centre for Health Sciences Research, School of Health and Society, University of Salford, Manchester, UK
| | - Sarah Hewlett
- Department of Nursing and Midwifery, University of the West of England.,Academic Rheumatology, Bristol Royal Infirmary, Bristol
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Schwid M, Harris O, Landry A, Eyre A, Henwood P, Kimberly H. Use of a Refresher Course Increases Confidence in Point-of-Care Ultrasound Skills in Emergency Medicine Faculty. Cureus 2019; 11:e5413. [PMID: 31632866 PMCID: PMC6795372 DOI: 10.7759/cureus.5413] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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: 11/05/2022] Open
Abstract
Introduction All practicing emergency medicine (EM) physicians need to maintain a skillset in emergency ultrasound (US) after their initial training. EM physicians in academic practice may be supervising trainees performing ultrasound applications that they aren't comfortable with. This study investigates the effectiveness of a US refresher course. The hypothesis was that a series of short courses would increase confidence in performing and supervising US applications. Methods Nine basic emergency ultrasound applications were taught over the course of one year by ultrasound fellowship-trained EM faculty in a simulation center at a single academic institution. Each session included 30-minutes of didactics/image review and 30-minutes of hands-on practice on normal volunteers and was followed by an anonymous questionnaire evaluating comfort level performing and supervising the ultrasound application before and after the course using a Likert scale from 1 "not at all confident" to 5 "very confident". Results Thirty-six of 60 EM physicians participated in at least 1 of the 9 sessions (median 3, interquartile range 2-4). Faculty who attended had a median of 10 (interquartile range 7-15) years in practice and 61% work at both academic and community sites. For all sessions combined, confidence in performing US increased from a mean score on the Likert scale of 3.3 to 4.4 (difference 1.1, confidence interval (CI) (0.94, 1.29), p < 0.001) and confidence in supervising trainees increased from a mean of 3.4 to 4.5 (difference 1.1, CI (0.88, 1.23), p < 0.001). The largest increases were seen in musculoskeletal (MSK), nerve, and pelvic applications and the least increase was seen with the session focused on intravenous access, but confidence was increased in all sessions. Physicians in practice ≥10 years increased in confidence in performing and supervising the applications by 1.4 (CI (1.11, 1.60), p < 0.001) and 1.3, (CI (1.01, 1.49), p < 0.001), respectively. Physicians in practice <10 years increased 0.8 (CI (0.57, 1.03), p < 0.001) and 0.8 (CI (0.55, 1.05), p < 0.001), respectively. Conclusion An emergency ultrasound refresher course for EM physicians at a single institution improved self-reported confidence in both performing and supervising trainees in all applications reviewed. Those in practice ≥10 years showed the largest increases.
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Affiliation(s)
- Madeline Schwid
- Emergency Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, USA
| | - Owen Harris
- Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Adaira Landry
- Emergency Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, USA
| | - Andrew Eyre
- Emergency Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, USA
| | - Patricia Henwood
- Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Heidi Kimberly
- Emergency Medicine, Brigham & Women's Hospital, Harvard Medical School, Boston, USA
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Lenti G, Norenberg A, Farnan JM, Weissman A, Cook M, Shah N, Moriates C, Wallingford S, Lynch S, Stebbins M, Millard S, Samarth A, Zhang JX, Thaver A, Meltzer DO, Oguntimein M, Frost M, Arora VM. Development and testing of a web module to IMPROVE generic prescribing of oral contraceptives among primary care physicians. J Clin Pharm Ther 2019; 44:579-587. [PMID: 31152684 DOI: 10.1111/jcpt.12853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 04/12/2019] [Accepted: 04/30/2019] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE The use of generic oral contraceptives (OCPs) can improve adherence and reduce healthcare costs, yet scepticism of generic drugs remains a barrier to generic OCP discussion and prescription. An educational web module was developed to reduce generic scepticism related to OCPs, improve knowledge of generic drugs and increase physician willingness to discuss and prescribe generic OCPs. METHODS A needs assessment was completed using in-person focus groups at American College of Physicians (ACP) Annual Meeting and a survey targeting baseline generic scepticism. Insights gained were used to build an educational web module detailing barriers and benefits of generic OCP prescription. The module was disseminated via email to an ACP research panel who completed our baseline survey. Post-module evaluation measured learner reaction, knowledge and intention to change behaviour along with generic scepticism. RESULTS AND DISCUSSION The module had a response rate of 56% (n = 208/369). Individuals defined as generic sceptics at baseline were significantly less likely to complete our module compared to non-sceptics (responders 9.6% vs non-responders 16.8%, P = 0.04). The majority (85%, n = 17/20) of baseline sceptics were converted to non-sceptics (P < 0.01) following completion of the module. Compared to non-sceptics, post-module generic sceptics reported less willingness to discuss (sceptic 33.3% vs non-sceptic 71.5%, P < 0.01), but not less willingness to prescribe generic OCPs (sceptic 53.3% vs non-sceptic 67.9%, P = 0.25). Non-white physicians and international medical graduates (IMG) were more likely to be generic sceptics at baseline (non-white 86.9% vs white 69.9%, P = 0.01, IMG 13.0% vs USMG 5.0% vs unknown 18.2%, P = 0.03) but were also more likely to report intention to prescribe generic OCPs as a result of the module (non-white 78.7% vs white 57.3%, P < 0.01, IMG 76.1% vs USMG 50.3% vs unknown 77.3%, P = 0.03). WHAT IS NEW AND CONCLUSION A brief educational web module can be used to promote prescribing of generic OCPs and reduce generic scepticism.
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Affiliation(s)
- Gena Lenti
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | | | - Jeanne M Farnan
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois.,Department of Medicine, University of Chicago, Chicago, Illinois
| | | | - Michelle Cook
- American Association of Nurse Practitioners, Austin, Texas
| | - Neel Shah
- Harvard Medical School, Boston, Massachusetts.,Costs of Care, Boston, Massachusetts
| | - Christopher Moriates
- Costs of Care, Boston, Massachusetts.,Dell Medical School, University of Texas, Austin, Texas
| | | | - Shalini Lynch
- School of Pharmacy, University of California San Francisco, San Francisco, California
| | - Marilyn Stebbins
- School of Pharmacy, University of California San Francisco, San Francisco, California
| | - Steven Millard
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois
| | - Anita Samarth
- Clinovations Government + Health, Washington, District of Columbia
| | - James X Zhang
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Ali Thaver
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - David O Meltzer
- Department of Medicine, University of Chicago, Chicago, Illinois
| | - Murewa Oguntimein
- Office of Generic Drugs, Food and Drug Administration, Silver Spring, Maryland
| | - Mitchell Frost
- Office of Generic Drugs, Food and Drug Administration, Silver Spring, Maryland
| | - Vineet M Arora
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois.,Department of Medicine, University of Chicago, Chicago, Illinois.,Costs of Care, Boston, Massachusetts
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de la Fuente R, Altermatt FR. Cognitive load theory as a framework for simulation-based, ultrasound-guided internal jugular catheterization training: Once is not enough, but we must measure it first. CAN J EMERG MED 2019; 21:E3. [PMID: 31113506 DOI: 10.1017/cem.2019.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Decker SE, Adams L, Watkins LE, Sippel LM, Presnall-Shvorin J, Sofuoglu M, Martino S. Feasibility and preliminary efficacy of dialectical behaviour therapy skills groups for Veterans with suicidal ideation: pilot. Behav Cogn Psychother 2019; 47:616-21. [PMID: 30894240 DOI: 10.1017/S1352465819000122] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Veterans are at high risk for suicide; emotion dysregulation may confer additional risk. Dialectical behaviour therapy (DBT) is a well-supported intervention for suicide attempt reduction in individuals with emotion dysregulation, but is complex and multi-component. The skills group component of DBT (DBT-SG) has been associated with reduced suicidal ideation and emotion dysregulation. DBT-SG for Veterans at risk for suicide has not been studied. AIMS This study sought to evaluate the feasibility and acceptability of DBT-SG in Veterans and to gather preliminary evidence for its efficacy in reducing suicidal ideation and emotion dysregulation and increasing coping skills. METHOD Veterans with suicidal ideation and emotion dysregulation (N = 17) enrolled in an uncontrolled pilot study of a 26-week DBT-SG as an adjunct to mental health care-as-usual. RESULTS Veterans attended an average 66% of DBT-SG sessions. Both Veterans and their primary mental health providers believed DBT-SG promoted Veterans' use of coping skills to reduce suicide risk, and they were satisfied with the treatment. Paired sample t-tests comparing baseline scores with later scores indicated suicidal ideation and emotion dysregulation decreased at post-treatment (d = 1.88, 2.75, respectively) and stayed reduced at 3-month follow-up (d = 2.08, 2.59, respectively). Likewise, skillful coping increased at post-treatment (d = 0.85) and was maintained at follow-up (d = 0.91). CONCLUSIONS An uncontrolled pilot study indicated DBT-SG was feasible, acceptable, and demonstrated potential efficacy in reducing suicidal ideation and emotion dysregulation among Veterans. A randomized controlled study of DBT-SG with Veterans at risk for suicide is warranted.
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Essig S, Steiner C, Kühne T, Kremens B, Langewitz W, Kiss A. Communication Skills Training for Professionals Working with Adolescent Patients with Cancer Based on Participants' Needs: A Pilot. J Adolesc Young Adult Oncol 2019; 8:354-362. [PMID: 30648933 DOI: 10.1089/jayao.2018.0078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: We aimed to pilot and evaluate communication skills training (CST) for health care professionals (HCPs) interacting with adolescent patients with cancer and their parents based on participants' needs. Methods: We developed and piloted a 2-day CST with physicians and nurses in adolescent oncology. The CST's agenda was determined by the critical incidents reported by the participants. Training consisted of experiential learning based on role-play between HCPs and simulated patients and parents. Whenever suited, short lectures were given on specific communication techniques. Skills were self-assessed by questionnaires before, immediately after, and 6 months after training. We compared the proportion of participants who felt confident in 19 predefined areas of difficult communication before and 6 months after training. Responses to open-ended questions were analyzed qualitatively by thematic analysis. Results: Twenty-six physicians and 24 nurses participated in 6 CSTs. The proportion of participants who felt confident increased significantly in 6 of 19 communication items (p < 0.05). Positive feedback outweighed negative in quantity and quality. Predominant themes immediately after training were the training's practical orientation and intensity, and 6 months later, increased self-confidence and applied communication techniques. Participants noted that the effect diminishes with time, and expressed their need for booster trainings. Conclusion: The results of CST tailored to the specific needs of HCPs in adolescent oncology were promising. We suggest that similar training opportunities are implemented elsewhere.
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Affiliation(s)
- Stefan Essig
- 1 Institute of Primary and Community Care, Lucerne, Switzerland.,2 Swiss Paraplegic Research, Nottwil, Switzerland
| | - Claudia Steiner
- 3 Department of Psychosomatic Medicine, Division of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Thomas Kühne
- 4 Division of Oncology/Hematology, University Children's Hospital, Basel, Switzerland
| | - Bernhard Kremens
- 5 Department of Pediatrics II, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Wolf Langewitz
- 3 Department of Psychosomatic Medicine, Division of Internal Medicine, University Hospital Basel, Basel, Switzerland
| | - Alexander Kiss
- 3 Department of Psychosomatic Medicine, Division of Internal Medicine, University Hospital Basel, Basel, Switzerland
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Nieuwboer MS, van der Sande R, van der Marck MA, Olde Rikkert MGM, Perry M. Clinical leadership and integrated primary care: A systematic literature review. Eur J Gen Pract 2019; 25:7-18. [PMID: 30474447 PMCID: PMC6394325 DOI: 10.1080/13814788.2018.1515907] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 07/18/2018] [Accepted: 08/15/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Leaders are needed to address healthcare changes essential for implementation of integrated primary care. What kind of leadership this needs, which professionals should fulfil this role and how these leaders can be supported remains unclear. OBJECTIVES To review the literature on the effectiveness of programmes to support leadership, the relationship between clinical leadership and integrated primary care, and important leadership skills for integrated primary care practice. METHODS We systematically searched PubMed, CINAHL, Embase, PsycINFO until June 2018 for empirical studies situated in an integrated primarycare setting, regarding clinical leadership, leadership skills, support programmes and integrated-care models. Two researchers independently selected relevant studies and critically appraised studies on methodological quality, summarized data and mapped qualitative data on leadership skills. RESULTS Of the 3207 articles identified, 56 were selected based on abstract and title, from which 20 met the inclusion criteria. Selected papers were of mediocre quality. Two non-controlled studies suggested that leadership support programmes helped prepare and guide leaders and positively contributed to implementation of integrated primary care. There was little support that leaders positively influence implementation of integrated care. Leaders' relational and organizational skills as well as process-management and change-management skills were considered important to improve care integration. Physicians seemed to be the most adequate leaders. CONCLUSION Good quality research on clinical leadership in integrated primary care is scarce. More profound knowledge is needed about leadership skills, required for integrated-care implementation, and leadership support aimed at developing these skills.
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Affiliation(s)
- Minke S. Nieuwboer
- Department of Geriatric Medicine, Radboud University Medical Center, Radboud UMC Alzheimer Centre, Nijmegen, The Netherlands
| | - Rob van der Sande
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
- Faculty of Health, Behaviour and Society, HAN University of Applied Sciences, Nijmegen, The Netherlands
| | - Marjolein A. van der Marck
- Department of Geriatric Medicine, Radboud University Medical Center, Radboud UMC Alzheimer Centre, Nijmegen, The Netherlands
- Radboud University Medical Center, Department of Geriatric Medicine, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Marcel G. M. Olde Rikkert
- Department of Geriatric Medicine, Radboud University Medical Center, Donders Institute for Brain Cognition and Behaviour, Nijmegen, The Netherlands
- Radboud University Medical Center, Department of Geriatric Medicine, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Marieke Perry
- Department of Geriatric Medicine, Radboud University Medical Center, Radboud UMC Alzheimer Centre, Nijmegen, The Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
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Cooperman NA, Rizvi SL, Hughes CD, Williams JM. Field Test of a Dialectical Behavior Therapy Skills Training-Based Intervention for Smoking Cessation and Opioid Relapse Prevention in Methadone Treatment. J Dual Diagn 2019; 15:67-73. [PMID: 30646819 DOI: 10.1080/15504263.2018.1548719] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Objective: Almost all individuals in methadone treatment for opioid dependence smoke cigarettes, and half of people in methadone treatment have an opioid relapse within six months. Dialectical behavior therapy (DBT) skills training has shown promise for addressing substance use and a variety of health behaviors and conditions; however, it has never been evaluated for smoking cessation in any population. The objective of this study was to field test a DBT skills training-based intervention for tobacco dependence and opioid relapse prevention (DBT-Quit) among people in methadone treatment. Methods: We recruited seven individuals in methadone treatment to participate in a field test of DBT-Quit. Participants attended 12 weekly 90-minute DBT skills training groups, focusing on mindfulness, emotion regulation, and distress tolerance skills. Participants received nicotine patches for eight weeks and completed assessments at baseline, 6 weeks (mid-treatment), and 12 weeks (post-treatment). Results: All but one participant (86%, n = 6) attended at least 50% of intervention sessions. Participants were "very" or "mostly" satisfied with the intervention. At 12 weeks, all but one (86%, n = 6) had made a quit attempt, and one (14%) had seven-day point prevalence abstinence. Participants were smoke-free for 24 hours (14%, n = 1), 7 to 14 days (43%, n = 3), and 30 to 59 days (29%, n = 2). Participants smoked significantly fewer cigarettes per day at 6 weeks and 12 weeks as compared to baseline. No participants used illicit drugs. As compared to baseline, at follow-up there were no significant differences in difficulties with emotion regulation, distress tolerance, or mindfulness. Conclusions: A DBT skills training-based intervention for individuals who smoke and have an opioid use disorder is feasible and acceptable in methadone treatment and may help this population prevent drug relapse, attempt to quit smoking, experience smoke-free days, and cut down on their smoking. More research is needed to determine the optimal structure and components of a DBT skills-based intervention for drug relapse prevention and smoking cessation. Further, a randomized controlled trial of DBT-Quit is needed to determine the efficacy of DBT skills training for smoking cessation and drug relapse prevention in this population.
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Affiliation(s)
- Nina A Cooperman
- a Rutgers Robert Wood Johnson Medical School , Piscataway, NJ.,b Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
| | - Shireen L Rizvi
- c Rutgers Graduate School of Applied and Professional Psychology, Piscataway, NJ
| | - Christopher D Hughes
- c Rutgers Graduate School of Applied and Professional Psychology, Piscataway, NJ
| | - Jill M Williams
- a Rutgers Robert Wood Johnson Medical School , Piscataway, NJ.,b Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
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Dedmon MM, Xie DX, O Connell BP, Dillon NP, Wellborn PS, Bennett ML, Haynes DS, Labadie RF, Rivas A. Endoscopic Ear Surgery Skills Training Improves Medical Student Performance. J Surg Educ 2018; 75:1480-1485. [PMID: 29753685 DOI: 10.1016/j.jsurg.2018.04.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 04/19/2018] [Indexed: 05/16/2023]
Abstract
OBJECTIVE Analyze medical student performance using an endoscopic ear surgery (EES) skills trainer over time. DESIGN Simulation experience. SETTING Surgical skills lab. PARTICIPANTS Five medical students and 1 expert surgeon completed 3 training sessions using an EES trainer to practice specific tasks designed to improve instrument control. During each session, participants performed 3 tasks, such as placing beads onto wires, 5 times per session for a total of 15 trials per task. Exercises were scored based on completion time. Results were compared before and after training. Pre- and post-task surveys were administered. RESULTS Prior to skills training, 0% of medical students reported feeling comfortable holding an endoscope or ear instruments. For students, overall mean completion times decreased significantly for each exercise by the conclusion of the training experience: placing beads on wires improved from 152 to 44 seconds (p < 0.001), placing simulated prostheses from 264 to 93 seconds (p < 0.001), and navigating a pattern from 193 to 66 seconds (p = 0.002). Individual analysis showed varying learning curves among participants and between exercises, with some students exhibiting rapid improvement. At the conclusion of training, 80% of students felt comfortable holding the endoscope and using otologic instruments, and 100% were satisfied with the experience. CONCLUSIONS Novice surgeons can exhibit significant skill improvement with repetitive practice on an EES trainer. Variable baseline skill and improvement rates highlight the individual characteristics of skill acquisition, which may be important factors during otolaryngology and endoscopic ear surgery training.
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Affiliation(s)
- Matthew M Dedmon
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
| | - Deborah X Xie
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Brendan P O Connell
- Department of Otolaryngology-Head & Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Neal P Dillon
- Department of Mechanical Engineering, Vanderbilt University, Nashville, Tennessee
| | - Patrick S Wellborn
- Department of Mechanical Engineering, Vanderbilt University, Nashville, Tennessee
| | - Marc L Bennett
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - David S Haynes
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Robert F Labadie
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Alejandro Rivas
- Department of Otolaryngology-Head & Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
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Morris L, Mansell W, Williamson T, Wray A, McEvoy P. Communication Empowerment Framework: An integrative framework to support effective communication and interaction between carers and people living with dementia. Dementia (London) 2018; 19:1739-1757. [PMID: 30370794 PMCID: PMC7576889 DOI: 10.1177/1471301218805329] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [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: 01/16/2023]
Abstract
Objectives To demonstrate the power of integrating three theoretical perspectives (Mentalization
Theory, Perceptual Control Theory and the Communicative Impact model), which jointly
illuminate the communication challenges and opportunities faced by family carers of
people with dementia. To point the way to how this framework informs the design and
delivery of carer communication and interaction training. Method Conceptual synthesis based on a narrative review of relevant literature, supported by
examples of family carers. Results We use the conceptual models to show how the capacity to mentalize (“holding mind in
mind”) offers a greater sense of control over internal and external conflicts, with the
result that they can be deescalated in pursuit of mutual goals. Conclusions The integrative conceptual framework presented here highlights specific psychological
and relational mechanisms that can be targeted through carer training to enhance
communication with a person living with dementia.
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Affiliation(s)
- Lydia Morris
- Institute of Dementia, School of Health and Society, University of Salford, Salford, UK
| | - Warren Mansell
- School of Health Sciences, University of Manchester, Manchester, UK
| | | | - Alison Wray
- School of English, Communication & Philosophy, Cardiff University, Cardiff, UK
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Franta C, Philipp J, Waldherr K, Truttmann S, Merl E, Schöfbeck G, Koubek D, Laczkovics C, Imgart H, Zanko A, Zeiler M, Treasure J, Karwautz A, Wagner G. Supporting Carers of Children and Adolescents with Eating Disorders in Austria (SUCCEAT): Study protocol for a randomised controlled trial. Eur Eat Disord Rev 2018; 26:447-461. [PMID: 29732651 PMCID: PMC6175075 DOI: 10.1002/erv.2600] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 10/10/2017] [Revised: 02/20/2018] [Accepted: 03/30/2018] [Indexed: 12/12/2022]
Abstract
Supporting Carers of Children and Adolescents with Eating Disorders in Austria (SUCCEAT) is an intervention for carers of children and adolescents with anorexia nervosa and atypical anorexia nervosa. This paper describes the study protocol for a randomised controlled trial including the process and economic evaluation. Carers are randomly allocated to one of the 2 SUCCEAT intervention formats, either 8 weekly 2‐hr workshop sessions (n = 48) or web‐based modules (n = 48), and compared with a nonrandomised control group (n = 48). SUCCEAT includes the cognitive‐interpersonal model, cognitive behavioural elements, and motivational interviewing. The goal is to provide support for carers to improve their own well‐being and to support their children. Outcome measures include carers' distress, anxiety, depression, expressed emotions, needs, motivation to change, experiences of caregiving, and skills. Further outcome measures are the patients' eating disorder symptoms, emotional problems, behavioural problems, quality of life, motivation to change, and perceived expressed emotions. These are measured before and after the intervention, and 1‐year follow‐up.
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Affiliation(s)
- Claudia Franta
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Julia Philipp
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Karin Waldherr
- Ferdinand Porsche Distance Learning University for Applied Sciences, Vienna, Austria
| | - Stefanie Truttmann
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Elisabeth Merl
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Gabriele Schöfbeck
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Doris Koubek
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Clarissa Laczkovics
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Hartmut Imgart
- Parkland-Clinic, Clinic for Psychosomatic Medicine and Psychotherapy, Bad Wildungen-Reinhardshausen, Germany
| | - Annika Zanko
- Parkland-Clinic, Clinic for Psychosomatic Medicine and Psychotherapy, Bad Wildungen-Reinhardshausen, Germany
| | - Michael Zeiler
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Janet Treasure
- Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Andreas Karwautz
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Gudrun Wagner
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
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Tunpattu S, Newey V, Sigera C, De Silva P, Goonarathna A, Aluthge I, Thambavita P, Perera R, Meegahawatte A, Isaam I, Dondorp AM, Haniffa R. A short, structured skills training course for critical care physiotherapists in a lower-middle income country. Physiother Theory Pract 2018; 34:714-722. [PMID: 29319380 DOI: 10.1080/09593985.2018.1423593] [Citation(s) in RCA: 6] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The aim of this article is to describe the delivery and acceptability of a short, structured training course for critical care physiotherapy and its effects on the knowledge and skills of the participants in Sri Lanka, a lower-middle income country. METHODS The two-day program combining short didactic sessions with small group workshops and skills stations was developed and delivered by local facilitators in partnership with an overseas specialist physiotherapist trainer. The impact was assessed using pre/post-course self-assessment, pre/post-course multiple-choice-question (MCQ) papers, and an end-of-course feedback questionnaire. RESULTS Fifty-six physiotherapists (26% of critical care physiotherapists in Sri Lanka) participated. Overall confidence in common critical care physiotherapy skills improved from 11.6% to 59.2% in pre/post-training self-assessments, respectively. Post-course MCQ scores (mean score = 63.2) and percentage of passes (87.5%) were higher than pre-course scores (mean score = 36.6; percentage of passes = 12.5%). Overall feedback was very positive as 75% of the participants were highly satisfied with the course's contribution to improved critical care knowledge. CONCLUSIONS This short, structured, critical care focused physiotherapy training has potential benefit to participating physiotherapists. Further, it provides an evidence that collaborative program can be planned and conducted successfully in a resource poor setting. This sustainable short course model may be adaptable to other resource-limited settings.
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Affiliation(s)
- Sanjeewa Tunpattu
- a Cardiothoracic Intensive Care Unit , National Hospital of Sri Lanka , Colombo , Sri Lanka
| | - Victoria Newey
- b Barts Health NHS Trust , St. Bartholomew's Hospital , London , UK
| | - Chathurani Sigera
- c National Intensive Care Surveillance , Ministry of Health , Colombo , Sri Lanka.,d Network for Intensive Care Skills Training , Colombo , Sri Lanka
| | - Pubudu De Silva
- c National Intensive Care Surveillance , Ministry of Health , Colombo , Sri Lanka.,d Network for Intensive Care Skills Training , Colombo , Sri Lanka.,e Intensive Care National Audit and Research Center , London , UK
| | - Amal Goonarathna
- f School of Physiotherapy and Occupational Therapy , Ministry of Health , Colombo , Sri Lanka
| | - Iranga Aluthge
- f School of Physiotherapy and Occupational Therapy , Ministry of Health , Colombo , Sri Lanka
| | - Pasan Thambavita
- g Neuro Trauma Centre , National Hospital of Sri Lanka , Colombo , Sri Lanka
| | - Rohan Perera
- f School of Physiotherapy and Occupational Therapy , Ministry of Health , Colombo , Sri Lanka
| | - Amila Meegahawatte
- c National Intensive Care Surveillance , Ministry of Health , Colombo , Sri Lanka
| | - Ilhaam Isaam
- d Network for Intensive Care Skills Training , Colombo , Sri Lanka
| | - Arjen M Dondorp
- h Mahidol Oxford Tropical Medicine Research Unit , Bangkok , Thailand
| | - Rashan Haniffa
- c National Intensive Care Surveillance , Ministry of Health , Colombo , Sri Lanka.,d Network for Intensive Care Skills Training , Colombo , Sri Lanka.,h Mahidol Oxford Tropical Medicine Research Unit , Bangkok , Thailand.,i Department of Clinical Medicine, Faculty of Medicine , University of Colombo , Colombo , Sri Lanka
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Abstract
OBJECTIVES This article describes a pilot test of an individually tailored program to improve community living and health self-management skills in older adults with serious mental illness. METHOD This study provided the Helping Older People Experience Success-Individually Tailored (HOPES-I) intervention, an adaptation of an empirically supported, manualized, group-based skills training program shown to improve community functioning, psychiatric symptoms, self-efficacy, and receipt of preventive health. HOPES-I targets 5 skill areas: leisure time, communication, independent living, friendships, and health self-management. We enrolled 47 adults age 50 and older (mean age = 62) with serious mental illness (38% schizophrenia spectrum, 62% mood disorders). Trained HOPES-I coaches evaluated participants' skills and functioning and engaged them in shared decision-making to select which curricular areas to receive. Participants received 1 HOPES-I session per week for 9-12 months, with assessments of overall psychosocial functioning and the 5 skill areas targeted by the program at baseline, postintervention, and at 3 and 6 months. RESULTS Participants with baseline impairments in overall functioning and in each of the skill areas targeted by the program demonstrated significant improvements on related outcome measures. Selection of specific HOPES-I curriculum was not associated with level of impairment in associated skill areas at baseline, but participants with more impairment overall chose and completed more curriculum modules. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The results of this study support the feasibility and potential benefits of an individually tailored skills training program for the rapidly growing and vulnerable group of older people with serious mental illness. (PsycINFO Database Record
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Affiliation(s)
- Sarah I Pratt
- Department of Psychiatry, The Geisel School of Medicine at Dartmouth
| | - Kim T Mueser
- Department of Psychiatry, The Geisel School of Medicine at Dartmouth
| | - Rosemarie Wolfe
- Department of Community and Family Medicine, The Geisel School of Medicine at Dartmouth
| | - Meghan M Santos
- Department of Community and Family Medicine, The Geisel School of Medicine at Dartmouth
| | - Stephen J Bartels
- Department of Psychiatry, The Geisel School of Medicine at Dartmouth
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Cloitre M, Garvert DW, Weiss BJ. Depression as a moderator of STAIR Narrative Therapy for women with post-traumatic stress disorder related to childhood abuse. Eur J Psychotraumatol 2017; 8:1377028. [PMID: 29038682 PMCID: PMC5639421 DOI: 10.1080/20008198.2017.1377028] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 08/23/2017] [Indexed: 11/10/2022] Open
Abstract
Background: Depression among those who have experienced childhood abuse is associated with earlier onset, more persistent and severe symptoms, more frequent relapse, and poorer treatment outcomes across a variety of psychiatric disorders. In addition, individuals with a history of childhood abuse are more likely to develop post-traumatic stress disorder (PTSD) co-occurring with depression. Objective: This study evaluated whether severity of depression moderated the outcome in a PTSD treatment for childhood abuse survivors. Specifically, we assessed whether individuals with significant depression obtained better outcomes when provided with a two-module treatment which included a skills training component with behavioral activation interventions, Skills Training in Affective and Interpersonal Regulation (STAIR) followed by a trauma-focused component, Narrative Therapy, as compared to two control conditions where one component (STAIR or Narrative Therapy) was replaced with Supportive Counseling. Method: Participants were 104 women with PTSD related to childhood abuse. Participants were randomized into three conditions: (1) STAIR plus Narrative Therapy (SNT), (2) STAIR plus Supportive Counseling (SSC), and (3) Supportive Counseling plus Narrative Therapy (SCNT). Clinician-Administered PTSD Scale for DSM-IV (CAPS-IV) PTSD symptom severity was assessed at pre-treatment, post-treatment, and 3 and 6 month follow-up. Results: Participants with severe depression showed superior PTSD symptom reduction following SNT, while those in the other two conditions experienced a loss of improvement after treatment ended. A similar finding was obtained among those with moderate depression, while among those with low levels of depression, outcomes did not differ across the three treatment conditions. Conclusions: Childhood abuse survivors with severe depression obtained superior outcomes in a treatment that combined skills training with trauma-focused work. Skills packages which contain behavioral activation interventions in combination with trauma-focused work may be particularly beneficial for patients with childhood abuse and severe depression.
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Affiliation(s)
- Marylene Cloitre
- National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Donn W. Garvert
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Brandon J. Weiss
- National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
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Hodsoll J, Rhind C, Micali N, Hibbs R, Goddard E, Nazar BP, Schmidt U, Gowers S, Macdonald P, Todd G, Landau S, Treasure J. A Pilot, Multicentre Pragmatic Randomised Trial to Explore the Impact of Carer Skills Training on Carer and Patient Behaviours: Testing the Cognitive Interpersonal Model in Adolescent Anorexia Nervosa. Eur Eat Disord Rev 2017; 25:551-561. [PMID: 28948663 DOI: 10.1002/erv.2540] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 07/14/2017] [Indexed: 12/11/2022]
Abstract
AIM The aim of the study is to establish the acceptability, feasibility and approximate size of the effect of adding a carer intervention [Experienced Caregivers Helping Others (ECHO)] to treatment as usual (TAU) for adolescents with anorexia nervosa. METHODS The study is a pilot randomised trial comparing TAU (n = 50) alone or TAU plus ECHO with (n = 50) or without (n = 49) telephone guidance. Effect sizes (ESs) were regression coefficients standardised by baseline standard deviations of measure. RESULTS Although engagement with ECHO was poor (only 36% of carers in the ECHO group read over 50% of the book), there were markers of intervention fidelity, in that caregivers in the ECHO group showed a moderate increase in carer skills (ES = 0.4) at 12 months and a reduction in accommodating and enabling behaviour at 6 months (ES = 0.17). In terms of efficacy, in the ECHO group, carers spent less time care giving (ES = 0.40, p = 0.04) at 1 year, and patients had a minor advantage in body mass index (ES = 0.17), fewer admissions, decreased peer problems (ES = -0.36) and more pro-social behaviours (ES = 0.53). The addition of telephone guidance to ECHO produced little additional benefit. CONCLUSIONS The provision of self-management materials for carers to standard treatment for adolescent anorexia nervosa shows benefits for both carers and patients. This could be integrated as a form of early intervention in primary care. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- John Hodsoll
- Department of Biostatistics, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Charlotte Rhind
- Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Nadia Micali
- Behavioural and Brain Sciences Unit, University College London, Institute of Child Health, London, UK.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rebecca Hibbs
- Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Elizabeth Goddard
- Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Bruno Palazzo Nazar
- Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK.,Institute of Psychiatry, Federal University of Rio de Janeiro (IPUB-UFRJ), Rio de Janeiro, Brazil
| | - Ulrike Schmidt
- Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Simon Gowers
- Adolescent Psychiatry, University of Liverpool, Chester, UK
| | - Pamela Macdonald
- Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Gillian Todd
- Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Sabine Landau
- Department of Biostatistics, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Janet Treasure
- Department of Psychological Medicine, Section of Eating Disorders, King's College London, Institute of Psychiatry, Psychology & Neuroscience, London, UK
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Ballou J, Wiseman C, Jackson L, Godfrey R, Cagle D. Lactation Skills Workshop: A Collaboration of the City of Dallas WIC and Local Hospitals. J Nutr Educ Behav 2017; 49:S202-S206.e1. [PMID: 28689559 DOI: 10.1016/j.jneb.2017.05.347] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 01/10/2017] [Revised: 05/07/2017] [Accepted: 05/10/2017] [Indexed: 06/07/2023]
Abstract
The Baby-Friendly Hospital Initiative, a global endeavor of the World Health Organization and the United Nations Children's Fund, is an evidence-based program identifying 10 interventions that when hospitals implement them, breastfeeding (BF) rates improve. It recognizes the powerful role that health care workers have in successful BF and the need for competent hands-on skills to support lactation. The City of Dallas, TX, Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program collaborated with 3 urban hospitals and developed a training of practical techniques and information for staff to use while working with BF patients. Since implementation, 1,600 workers were trained, 1 hospital achieved Baby-Friendly designation, and all have increased BF rates by 10%.
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Affiliation(s)
| | - Christine Wiseman
- City of Dallas Special Supplemental Nutrition Program for Women, Infants, and Children, Lactation Care Center, Dallas, TX
| | | | | | - Dani Cagle
- Methodist Dallas Medical Center, Dallas, TX
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Abstract
OBJECTIVE To compare a novel "third wave" mindfulness-based training program with an established skills training derived from dialectical behavior therapy, to reduce ADHD symptoms and improve mindfulness and self-efficacy. METHOD Ninety-one adults with ADHD (combined and inattentive type, mainly medicated) were non-randomly assigned to and treated within a mindfulness-based training group (MBTG, n = 39) or a skills training group (STG, n = 52), each performed in 13 weekly 2-hr sessions. RESULTS General linear models with repeated measures revealed that both programs resulted in a similar reduction of ADHD symptoms, and improvement of mindfulness and self-efficacy. However, the effect sizes were in the small-to-medium range. A decrease in ADHD symptoms ≥30% was observed in 30.8% of the MBTG participants and 11.5% of the STG participants. CONCLUSION The comparatively weak results may be due to limitations such as the absence of randomization, the lack of a control group without intervention, and the lack of matching groups for borderline, depression, and anxiety status. Moreover, audio instructions for home exercises and more stringent monitoring of participants' progress and eventual absence from sessions might have improved the outcome.
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Herrmann-Werner A, Gramer R, Erschens R, Nikendei C, Wosnik A, Griewatz J, Zipfel S, Junne F. Peer-assisted learning (PAL) in undergraduate medical education: An overview. Z Evid Fortbild Qual Gesundhwes 2017; 121:74-81. [PMID: 28545616 DOI: 10.1016/j.zefq.2017.01.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 11/29/2016] [Accepted: 01/14/2017] [Indexed: 11/26/2022]
Abstract
Peer-assisted learning (PAL) has a long tradition and is nowadays implemented in the curricula of most medical faculties. Besides traditional areas of application like problem-based learning, anatomy, or CPR, more and more departments and institutes have established PAL as part of their everyday teaching. This narrative review provides some background information and basic definitions of PAL. It offers an overview on features and determinants as well as underlying learning theories and developments in PAL. In addition, motives for implementation are highlighted followed by a comparison of advantages and disadvantages. After outlining aspects of quality management including the training of tutors and the evaluation and acceptance of PAL formats, this review concludes with an outlook on how PAL can proceed into the future and where further research is necessary.
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Affiliation(s)
- Anne Herrmann-Werner
- University Hospital Tuebingen, Department of Psychosomatic Medicine and Psychotherapy, Tuebingen, Germany; Medical Faculty Tuebingen, Interdisciplinary Training and Simulation Centre DocLab, Tuebingen, Germany.
| | - Regina Gramer
- Medical Faculty Tuebingen, Interdisciplinary Training and Simulation Centre DocLab, Tuebingen, Germany
| | - Rebecca Erschens
- University Hospital Tuebingen, Department of Psychosomatic Medicine and Psychotherapy, Tuebingen, Germany
| | - Christoph Nikendei
- University of Heidelberg, Department for General Internal Medicine and Psychosomatics, Heidelberg, Germany
| | - Annette Wosnik
- Medical Faculty Tuebingen, Dean's Office for student affairs, Tuebingen, Germany
| | - Jan Griewatz
- University of Tuebingen, Competence Centre for University Teaching in Medicine Baden-Wuerttemberg, Tuebingen, Germany
| | - Stephan Zipfel
- University Hospital Tuebingen, Department of Psychosomatic Medicine and Psychotherapy, Tuebingen, Germany; Medical Faculty Tuebingen, Dean's Office for student affairs, Tuebingen, Germany
| | - Florian Junne
- University Hospital Tuebingen, Department of Psychosomatic Medicine and Psychotherapy, Tuebingen, Germany
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Kordahl HL, Fougner M. Facilitating awareness of philosophy of science, ethics and communication through manual skills training in undergraduate education. Physiother Theory Pract 2017; 33:206-217. [PMID: 28095097 DOI: 10.1080/09593985.2016.1277289] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Professional health science education includes a common theoretical basis concerning the theory of science, ethics and communication. Former evaluations by first-year students of the bachelor physiotherapy program at Oslo and Akershus University College of Applied Sciences (HiOA) show that they find it hard to understand the relation between these particular topics and future professional practice. This challenge is the starting point for a pedagogical development project that aims to develop learning contexts that highlight the relevance of these theoretical concepts. AIM The aim of the study is to explore and present findings on the value of using Sykegrep manual skills classes as an arena in which students can be encouraged to think about, reflect on and appreciate the role and value of the philosophical perspectives that inform their practice and contributes to practise knowledge. METHOD A qualitative study with data collection through focus groups was performed and analyzed using thematic content analysis. Eighteen first-year undergraduate students, who had completed the manual skills course, participated in the study. FINDINGS Analysis of the data yielded three categories of findings that can be associated with aspects of philosophy of science, ethics and communication. These are as follows: 1) preconceived understanding of physiotherapy; 2) body knowledge perspectives; and 3) relational aspects of interactions. Undergraduate students' understanding and experience of philosophy of science, ethics and communication may be facilitated by peer collaboration, reflection on intimacy and touch and the ethical aspects of interaction during manual skills training. CONCLUSION Practical classes in Sykegrep provide a basis for students' discussions about the body as well as their experiences with the body in the collaborative learning context. The students' reflections on their expectations of manual skills in physiotherapy and experiences of touch and being touched can facilitate an awareness of philosophy of science, ethics and communication. IMPLICATIONS Our study will be an incitement to further develop a manual skills teaching program that incorporates philosophy of science, ethics and communication in undergraduate education.
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Affiliation(s)
- Hilde Lund Kordahl
- a Faculty of Health Sciences , Oslo and Akershus University College of Applied Sciences , Oslo , Norway
| | - Marit Fougner
- a Faculty of Health Sciences , Oslo and Akershus University College of Applied Sciences , Oslo , Norway
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