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Guo S, Deng W, Wang H, Liu J, Liu X, Yang X, He C, Zhang Q, Liu B, Dong X, Yang Z, Li Z, Li X. The efficacy of internet‐based cognitive behavioural therapy for social anxiety disorder: A systematic review and meta‐analysis. Clin Psychol Psychother 2020; 28:656-668. [DOI: 10.1002/cpp.2528] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 10/22/2020] [Accepted: 10/23/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Shangyu Guo
- Department of Medical Psychology, Chaohu Clinical Medical College Anhui Medical University Hefei China
- Department of Pediatrics, Second Clinical Medical College Anhui Medical University Hefei China
| | - Wenrui Deng
- Department of Medical Psychology, Chaohu Clinical Medical College Anhui Medical University Hefei China
| | - Hongtao Wang
- Department of Pediatrics, Second Clinical Medical College Anhui Medical University Hefei China
| | - Jiayuan Liu
- Department of Medical Anesthesia, First Clinical Medical College Anhui Medical University Hefei China
| | - Xiaoyu Liu
- Department of Medical Psychology, Chaohu Clinical Medical College Anhui Medical University Hefei China
| | - Xinxin Yang
- Department of Medical Psychology, Chaohu Clinical Medical College Anhui Medical University Hefei China
| | - Cengceng He
- Department of Medical Psychology, Chaohu Clinical Medical College Anhui Medical University Hefei China
| | - Qiqi Zhang
- Department of Clinical Medical, First Clinical Medical College Anhui Medical University Hefei China
| | - Boya Liu
- Department of Clinical Medical, First Clinical Medical College Anhui Medical University Hefei China
| | - Xinghua Dong
- Department of Clinical Medical, First Clinical Medical College Anhui Medical University Hefei China
| | - Zifan Yang
- Department of Clinical Medical, First Clinical Medical College Anhui Medical University Hefei China
| | - Ziqi Li
- Department of Clinical Medical, First Clinical Medical College Anhui Medical University Hefei China
| | - Xiaoming Li
- Department of Medical Psychology, Chaohu Clinical Medical College Anhui Medical University Hefei China
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Boulazreg S, Rokach A. The Lonely, Isolating, and Alienating Implications of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. Healthcare (Basel) 2020; 8:E413. [PMID: 33092097 PMCID: PMC7711762 DOI: 10.3390/healthcare8040413] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/27/2020] [Accepted: 10/11/2020] [Indexed: 12/26/2022] Open
Abstract
This article provides a narrative review on myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) through a psychosocial lens and examines how this impairment affects its sufferers during adolescence and adulthood, as well as how it impacts family caregivers and healthcare professionals' mental health. Since there has been a lack of investigation in the literature, the primary psychosocial stressor that this review focuses on is loneliness. As such, and in an attempt to help establish a theoretical framework regarding how loneliness may impact ME/CFS, loneliness is comprehensively reviewed, and its relation to chronic illness is described. We conclude by discussing a variety of coping strategies that may be employed by ME/CFS individuals to address their loneliness. Future directions and ways with which the literature may investigate loneliness and ME/CFS are discussed.
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Affiliation(s)
- Samir Boulazreg
- Faculty of Education, University of Western Ontario, London, ON N6A 3K7, Canada
| | - Ami Rokach
- Department of Psychology, York University, Toronto, ON M3J 1P3, Canada;
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Bunn C, Harwood E, Akhter K, Simmons D. Integrating care: the work of diabetes care technicians in an integrated care initiative. BMC Health Serv Res 2020; 20:235. [PMID: 32192474 PMCID: PMC7082957 DOI: 10.1186/s12913-020-05109-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 03/13/2020] [Indexed: 11/24/2022] Open
Abstract
Background As diabetes prevalence rises world-wide, the arrangement of clinics and care packages is increasingly debated by health care professionals (HCPs), health service researchers, patient groups and policy makers. ‘Integrated care’, while representing a range of approaches, has been positioned as a promising solution with potential to benefit patients and health systems. This is particularly the case in rural populations which are often removed from centres of specialist care. The social arrangements within diabetes integrated care initiatives are understudied but are of particular importance to those implementing such initiatives. In this paper we explore the ‘work’ of integration through an analysis of the role played by Health Care Assistants (HCAs) who were specially trained in aspects of diabetes care and given the title ‘Diabetes Care Technician’ (DCT). Methods Using thematic analysis of interview (n = 55) and observation data (n = 40), we look at: how the role of DCTs was understood by patients and other HCPs, as well as the DCTs; and explore what DCTs did within the integrated care initiative. Results Our findings suggested that the DCTs saw their role as part of a hierarchy, providing links between members of the integrated team, and explaining and validating clinical decisions. Patients characterised DCTs as friends and advisors who provided continuity. Other HCPs perceived the DCTs as supportive, providing long-term monitoring and doing a different job to conventional HCAs. We found that DCTs had to navigate local terrain (social, ethical and physical), engage in significant conversation and negotiate treatment plans created through integrated care. The analysis suggests that relationships between patients and the DCTs were strong, had the quality of friendship and mitigated loneliness. Conclusions DCTs played multidimensional roles in the integrated care initiative that required great social and emotional skill. Building friendships with patients was central to their work, which mitigated loneliness and facilitated the care they provided.
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Affiliation(s)
- Christopher Bunn
- Institute of Health and Wellbeing, College of Social Sciences, University of Glasgow, Glasgow, G12 8RS, UK
| | - Elissa Harwood
- Faculty of Health, Education, Medicine & Social Care, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Kalsoom Akhter
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB2 0SR, UK
| | - David Simmons
- Wolfson Diabetes and Endocrinology Clinic, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge, CB2 0QQ, UK. .,School of Medicine, Western Sydney University, Campbelltown, NSW, 2560, Australia.
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Tran MW, Weiland TJ, Phillips GA. Psychosocial and nonclinical factors predicting hospital utilization in patients of a chronic disease management program: a prospective observational study. J Ambul Care Manage 2016; 38:77-86. [PMID: 25469581 DOI: 10.1097/jac.0b013e31829d9e81] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Psychosocial factors such as marital status (odds ratio, 3.52; 95% confidence interval, 1.43-8.69; P = .006) and nonclinical factors such as outpatient nonattendances (odds ratio, 2.52; 95% confidence interval, 1.22-5.23; P = .013) and referrals made (odds ratio, 1.20; 95% confidence interval, 1.06-1.35; P = .003) predict hospital utilization for patients in a chronic disease management program. Along with optimizing patients' clinical condition by prescribed medical guidelines and supporting patient self-management, addressing psychosocial and nonclinical issues are important in attempting to avoid hospital utilization for people with chronic illnesses.
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Affiliation(s)
- Mark W Tran
- St Vincent's Hospital Melbourne, Fitzroy (Mr Tran, Dr Weiland, and Ms Phillips), and University of Melbourne, Parkville (Dr Weiland and Ms Phillips), Victoria, Australia
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Morgan HM, Entwistle VA, Cribb A, Christmas S, Owens J, Skea ZC, Watt IS. We need to talk about purpose: a critical interpretive synthesis of health and social care professionals' approaches to self-management support for people with long-term conditions. Health Expect 2016; 20:243-259. [PMID: 27075246 PMCID: PMC5354019 DOI: 10.1111/hex.12453] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2016] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND Health policies internationally advocate 'support for self-management', but it is not clear how the promise of the concept can be fulfilled. OBJECTIVE To synthesize research into professional practitioners' perspectives, practices and experiences to help inform a reconceptualization of support for self-management. DESIGN Critical interpretive synthesis using systematic searches of literature published 2000-2014. FINDINGS We summarized key insights from 164 relevant papers in an annotated bibliography. The literature illustrates striking variations in approaches to support for self-management and interpretations of associated concepts. We focused particularly on the somewhat neglected question of the purpose of support. We suggest that this can illuminate and explain important differences between narrower and broader approaches. Narrower approaches support people to manage their condition(s) well in terms of disease control. This purpose can underpin more hierarchical practitioner-patient communication and more limited views of patient empowerment. It is often associated with experiences of failure and frustration. Broader approaches support people to manage well with their condition(s). They can keep work on disease control in perspective as attention focuses on what matters to people and how they can be supported to shape their own lives. Broader approaches are currently less evident in practice. DISCUSSION AND CONCLUSION Broader approaches seem necessary to fulfil the promise of support for self-management, especially for patient empowerment. A commitment to enable people to live well with long-term conditions could provide a coherent basis for the forms and outcomes of support that policies aspire to. The implications of such a commitment need further attention.
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Affiliation(s)
| | | | - Alan Cribb
- Centre for Public Policy Research, King's College London, London, UK
| | - Simon Christmas
- Centre for Public Policy Research, King's College London, London, UK
| | - John Owens
- Centre for Public Policy Research, King's College London, London, UK
| | - Zoë C Skea
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Ian S Watt
- Department of Health Sciences/Hull York Medical School, Faculty of Science, University of York, Heslington, York, UK
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Hannum SM, Rubinstein RL. The meaningfulness of time; Narratives of cancer among chronically ill older adults. J Aging Stud 2016; 36:17-25. [PMID: 26880601 PMCID: PMC4757851 DOI: 10.1016/j.jaging.2015.12.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 10/20/2015] [Accepted: 12/01/2015] [Indexed: 11/30/2022]
Abstract
This study, using ethnographically-based interviews, sought to describe how chronically ill older adults experience a new cancer diagnosis and the effects of this on their interpretations of personal health, aging, and the future. Three semi-structured interviews were conducted with each of the fifteen informants. We asked questions that explored each individual's life history, chronic illness occurrence, and direct experiences with cancer. Interviews were structured to provide social and historical contexts to enhance our understanding of the informants' illness narratives. Interview transcripts were analyzed thematically to describe how individuals described the cancer experience, its meaning, and its consequences. One of the major findings of our study was the role of cancer in disrupting individual biography, an interruption that fragmented time into three distinct segments: the Recalled Past, the Existent Present, and the Imagined Future. We highlight three main themes around the experience of illness-related time: (1) disruption found in individual biographical accounts as a result of fragmented time dimensions; (2) altered projections of a continuous sense of self into the future; and (3) modified treatment decisions resulting from a perceived altered life course and the finitude of advancing age. We further introduce the concept of Anomalous Time as a permutation of time central to individual experiences of cancer. Implications for how older adults understood their cancer and individual reactions relevant to seeking care are discussed.
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Affiliation(s)
- Susan M Hannum
- Cancer Epidemiology, Prevention, and Control Training Fellowship, Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Rm. 263, Baltimore, MD 21205, United States.
| | - Robert L Rubinstein
- Department of Sociology and Anthropology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Baltimore, MD 21250, United States.
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Johannessen A, Bruvik FK, Hauge S. Family carers' experiences of attending a multicomponent psychosocial intervention program for carers and persons with dementia. J Multidiscip Healthc 2015; 8:91-9. [PMID: 25709469 PMCID: PMC4334330 DOI: 10.2147/jmdh.s76093] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Psychosocial interventions for persons with dementia and their primary family carers are promising approaches to reducing the challenges associated with care, but, obtaining significant outcomes may be difficult. Even though carers in general are satisfied with such interventions, few studies have evaluated the interventions by means of qualitative methods. Aim The objective of the study reported here was to investigate family carers’ experiences of a multicomponent psychosocial intervention program, and also to offer advice on how to develop the intervention program. Methods Content analyses were taken from individual qualitative interviews conducted in 2012 with 20 carers (aged 50–82 years) who participated in a psychosocial intervention program that included education, individual and family counseling, and parallel group sessions for carers and persons with dementia. Results Two main categories emerged: 1) benefits of the intervention program, which sets out the informants’ experiences for the benefits of participation, described in the subcategories “importance of content and group organization” and “importance of social support”; and 2) missing content in the intervention program, which details the informants’ suggestions for future interventions, contained in the subcategories “need for extended content” and “need for new group organization”. Conclusion The carers found the interventions useful. The importance of even earlier and more flexible interventions for the family carers, the extended family, and the persons with dementia was underscored.
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Affiliation(s)
- Aud Johannessen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Frøydis Kristine Bruvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway ; Kavli Centre, Haraldsplass Deaconess Hospital, Bergen, Norway ; Haraldsplass Deaconess University College, Bergen, Norway
| | - Solveig Hauge
- Norway Faculty of Health and Social Studies and Centre of Caring Research - Southern Norway, Telemark University College, Porsgrunn, Norway
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Nowrangi MA, Kortte KB, Rao VA. A Perspectives Approach to Suicide After Traumatic Brain Injury: Case and Review. PSYCHOSOMATICS 2014; 55:430-7. [DOI: 10.1016/j.psym.2013.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Revised: 11/19/2013] [Accepted: 11/21/2013] [Indexed: 10/26/2022]
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Getting on with living life: experiences of older adults after home care. ACTA ACUST UNITED AC 2014; 31:493-501; quiz 501-3. [PMID: 24081131 DOI: 10.1097/nhh.0b013e3182a87654] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Providers in all settings are increasingly aware of the need to focus on transitional care needs and services across healthcare settings to improve quality of life, maintain optimal health, and prevent unnecessary hospitalizations. Home care is an essential piece of the transitional care puzzle, especially in providing services to support older adults with chronic comorbid conditions to remain at home safely with optimal health and psychosocial well-being. Home care is essential in bridging the gap from acute hospital care to home; however, little is known about the needs of older adults after discharge from home care. Our study investigated the perceptions of older adults with chronic health conditions after discharge from home care regarding their daily activities and healthcare needs and identified how these needs were met.
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Johannessen A, Povlsen L, Bruvik F, Ulstein I. Implementation of a multicomponent psychosocial programme for persons with dementia and their families in Norwegian municipalities: experiences from the perspective of healthcare professionals who performed the intervention. Scand J Caring Sci 2013; 28:749-56. [PMID: 24350617 DOI: 10.1111/scs.12107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2013] [Accepted: 11/20/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND A randomised controlled intervention study was conducted in 17 Norwegian municipalities to provide home-dwelling people with dementia and their families with knowledge and skills to cope with the emerging problems and stresses of everyday life. It included training health professionals to carry out the intervention. Since little is known about possible benefits for health professionals of participating in such a study in terms of knowledge and change of practice as well as their views on whether the intervention is useful, we carried out this study. AIM To investigate the outcome of the study from the perspective of the healthcare professionals who participated in the intervention. METHOD Interviews with 19 health professionals were performed during 2012, using three focus groups and six individual interviews. The sample was purposive and included informants aged 34-61 years from 13 municipalities. RESULTS Three main categories emerged: challenges, new knowledge and service development. The category challenges details the challenges connected with professionals' participation in the intervention and how they dealt with them and is described in three subcategories. The category new knowledge demonstrates the knowledge the professionals achieved while conducting the intervention and is described through three subcategories. Service development presented how the informants' experiences could contribute to improve the provision of care and details in one subcategory. CONCLUSION The results revealed a need for more knowledge among health professionals about the situation of home-dwelling persons with dementia and their families. The study indicated that health professionals must be more aware of these persons' abilities to find their own solutions to their problems. Structured individual interventions as well as group-based interventions in the early stages of dementia and throughout the course of the disorder seem beneficial. There is a need for better collaboration between the specialist health services, GPs and health workers in the municipalities.
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Affiliation(s)
- Aud Johannessen
- Ageing and Health, Norwegian Centre for Research, Education and Service Development, Vestfold Hospital Trust, Tønsberg, Norway
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Lunney M, McGuire M, Endozo N, McIntosh-Waddy D. Consensus-validation study identifies relevant nursing diagnoses, nursing interventions, and health outcomes for people with traumatic brain injuries. Rehabil Nurs 2010; 35:161-6. [PMID: 20681391 DOI: 10.1002/j.2048-7940.2010.tb00042.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
A consensus-validation study used action research methods to identify relevant nursing diagnoses, nursing interventions, and patient outcomes for a population of adults with traumatic brain injury (TBI) in long-term care. In meetings totaling 159 hours to reach 100% consensus through group discussions, the three classifications of NANDA International's (NANDA-I's) approved nursing diagnoses, the Nursing Interventions Classification (NIC), and the Nursing Outcomes Classification (NOC) were used as the basis for three nurses experienced in working with adults with TBI to select the elements of nursing care. Among almost 200 NANDA-I nursing diagnoses, 29 were identified as relevant for comprehensive nursing care of this population. Each nursing diagnosis was associated with 3-11 of the more than 500 NIC interventions and 1-13 of more than 300 NOC outcomes. The nurses became aware of the complexity and the need for critical thinking. The findings were used to refine the facility's nursing standards of care, which were to be combined with the interdisciplinary plan of care and included in future electronic health records.
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Affiliation(s)
- Margaret Lunney
- College of Staten Island, City University of New York, Staten Island, NY, USA.
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Wasserman L, Shaw T, Vu M, Ko C, Bollegala D, Bhalerao S. An overview of traumatic brain injury and suicide. Brain Inj 2009; 22:811-9. [DOI: 10.1080/02699050802372166] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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