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Liou KT, Garland SN, Meghani SH, Kaye NM, Thompson E, Li QS, Mao JJ. Racial differences in treatment adherence and response to acupuncture and cognitive behavioral therapy for insomnia among Black and White cancer survivors. Cancer Med 2024; 13:e7344. [PMID: 39161103 PMCID: PMC11333531 DOI: 10.1002/cam4.7344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 05/10/2024] [Accepted: 05/18/2024] [Indexed: 08/21/2024] Open
Abstract
BACKGROUND Racial disparities in sleep are well-documented. However, evidence-based options for addressing these disparities are lacking in cancer populations. To inform future research on sleep interventions, this study aims to understand racial differences in treatment responses to acupuncture and cognitive behavioral therapy for insomnia (CBT-I) among Black and White cancer survivors. METHODS We conducted a secondary analysis of a comparative effectiveness trial evaluating acupuncture versus CBT-I for insomnia in cancer survivors. We compared insomnia severity, sleep characteristics, and co-morbid symptoms, as well as treatment attitudes, adherence, and responses among Black and White participants. RESULTS Among 156 cancer survivors (28% Black), Black survivors reported poorer sleep quality, longer sleep onset latency, and higher pain at baseline, compared to White survivors (all p < 0.05). Black survivors demonstrated lower adherence to CBT-I than White survivors (61.5% vs. 88.5%, p = 0.006), but their treatment response to CBT-I was similar to white survivors. Black survivors had similar adherence to acupuncture as white survivors (82.3% vs. 93.4%, p = 0.16), but they had greater reduction in insomnia severity with acupuncture (-3.0 points, 95% CI -5.4 to 0.4, p = 0.02). CONCLUSION This study identified racial differences in sleep characteristics, as well as treatment adherence and responses to CBT-I and acupuncture. To address racial disparities in sleep health, future research should focus on improving CBT-I adherence and confirming the effectiveness of acupuncture in Black cancer survivors.
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Affiliation(s)
- Kevin T. Liou
- Department of Medicine, Integrative Medicine ServiceMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Sheila N. Garland
- Department of Psychology and OncologyMemorial University of NewfoundlandSt. John'sNewfoundland and LabradorCanada
| | - Salimah H. Meghani
- Department of Biobehavioral Health Sciences, School of NursingUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | | | | | - Q. Susan Li
- Department of Medicine, Integrative Medicine ServiceMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
| | - Jun J. Mao
- Department of Medicine, Integrative Medicine ServiceMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
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Wahl K, Orr NL, Parmar G, Zhang SXJ, MacLeod RGK, Noga H, Albert A, Flannigan R, Brotto LA, Yong PJ. Ohnut vs waitlist control for the self-management of endometriosis-associated deep dyspareunia: a pilot randomized controlled trial. Sex Med 2024; 12:qfae049. [PMID: 39220343 PMCID: PMC11365696 DOI: 10.1093/sexmed/qfae049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/18/2024] [Accepted: 07/24/2024] [Indexed: 09/04/2024] Open
Abstract
Background Deep dyspareunia affects 50% of people with endometriosis. The Ohnut is a set of interlocking rings that fit over the penis/insertive object. One or more rings can be used to limit insertion depth and reduce deep dyspareunia. Aim We conducted a pilot, parallel, open-label randomized controlled trial (RCT) to investigate the feasibility of the study design and the acceptability and preliminary efficacy of the Ohnut. Method Participants were recruited from a tertiary center for endometriosis. Eligibility criteria were surgically confirmed endometriosis, age 19-49 years, monogamous sexual relationship with a partner willing to participate in the study, and no comorbid superficial dyspareunia, anxiety, or depression. Couples were randomized into an intervention group or a waitlist control group using a 1:1 allocation ratio. All couples had sex as normal during weeks 1 to 4 (baseline period), and couples in the intervention group used the Ohnut with sex during weeks 5 to 10 (intervention period) while controls had sex as normal. Patient participants used daily diaries to record sexual activity and deep dyspareunia score (0-10) for the 10-week study. Intervention group participants completed an acceptability questionnaire at the end of the study. Outcomes The primary outcomes were feasibility of the study and acceptability of the Ohnut. We also assessed differences in deep dyspareunia scores in the participants who used the Ohnut compared to the control participants who did not. Results We recruited approximately 5 couples per month of active recruitment. Of 864 potentially eligible participants, we successfully contacted 44.7% (n = 386), of whom 8.0% (n = 31) consented, 64.8% (n = 250) were ineligible, and 27.2% (n = 105) declined. Thirty-one couples were randomly assigned to the intervention or control group, and 17 couples completed the study. Intervention group couples used the Ohnut for an average of 72.4% (32.7%) of sexual encounters during the intervention period. The mean acceptability index score for the Ohnut was 0.83 (0.078) among patients and 0.83 (0.049) among partners (index between 0 and 1). After controlling for baseline deep dyspareunia, there was a significant difference in the intervention period mean deep dyspareunia scores between the control and intervention group (4.69 (2.44) vs 2.46 (1.82), P = .012). Clinical Implications We identified preliminary evidence for the acceptability and efficacy of the Ohnut among both patients and partners, suggesting that the Ohnut may be a useful stand-alone or adjuvant management tool for endometriosis-associated deep dyspareunia. Strengths and Limitations Strengths of this study were the "real-world" use of the Ohnut and data collection from both patients and partners. Limitations of the study design included the strict eligibility criteria that affected feasibility and generalizability. Conclusion This pilot RCT indicated that the Ohnut may be an acceptable and effective intervention to reduce endometriosis-associated deep dyspareunia. We identified opportunities to improve design for a larger RCT. Clinical Trial Registration This clinical trial was registered with clinicaltrials.gov (#NCT04370444).
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Affiliation(s)
- Kate Wahl
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC V6Z 2K8, Canada
- BC Women’s Centre for Pelvic Pain and Endometriosis and UBC Endometriosis and Pelvic Pain Lab, Vancouver, BC V6H 3N1, Canada
| | - Natasha L Orr
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC V6Z 2K8, Canada
- BC Women’s Centre for Pelvic Pain and Endometriosis and UBC Endometriosis and Pelvic Pain Lab, Vancouver, BC V6H 3N1, Canada
| | - Gurkiran Parmar
- BC Women’s Centre for Pelvic Pain and Endometriosis and UBC Endometriosis and Pelvic Pain Lab, Vancouver, BC V6H 3N1, Canada
| | - Sandy X J Zhang
- BC Women’s Centre for Pelvic Pain and Endometriosis and UBC Endometriosis and Pelvic Pain Lab, Vancouver, BC V6H 3N1, Canada
| | - Rebecca G K MacLeod
- BC Women’s Centre for Pelvic Pain and Endometriosis and UBC Endometriosis and Pelvic Pain Lab, Vancouver, BC V6H 3N1, Canada
| | - Heather Noga
- BC Women’s Centre for Pelvic Pain and Endometriosis and UBC Endometriosis and Pelvic Pain Lab, Vancouver, BC V6H 3N1, Canada
- Women’s Health Research Institute, Vancouver, BC V6H 3N1, Canada
| | - Arianne Albert
- Women’s Health Research Institute, Vancouver, BC V6H 3N1, Canada
| | - Ryan Flannigan
- Department of Urologic Sciences, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | - Lori A Brotto
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC V6Z 2K8, Canada
- Women’s Health Research Institute, Vancouver, BC V6H 3N1, Canada
| | - Paul J Yong
- Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, BC V6Z 2K8, Canada
- BC Women’s Centre for Pelvic Pain and Endometriosis and UBC Endometriosis and Pelvic Pain Lab, Vancouver, BC V6H 3N1, Canada
- Women’s Health Research Institute, Vancouver, BC V6H 3N1, Canada
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Lyons GA, Zettle RD, Petts RA. Investigating Determinants of Client Psychotherapy Preference: An Analog Study. J Cogn Psychother 2024; 38:227-242. [PMID: 38991741 DOI: 10.1891/jcp-2022-0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
Increased emphasis has been placed on elucidating the contribution of client variables, such as treatment preference, to optimize evidence-based practice. This analog study sought to better understand variables associated with treatment preference using a convenience sample of college students (n = 54) who read brief descriptions of three interventions for negative thoughts-defusion, noticing, and restructuring. They rated each on acceptability and practicality and completed measures of cognitive fusion, emotional distress, and experiential avoidance as possible moderating variables. Restructuring was overwhelmingly preferred and rated as more acceptable than the two alternatives by both the overall sample and a distressed subsample. Preference for defusion or noticing was not predicted by ratings of acceptability or practicality but by elevated levels of cognitive fusion and emotional distress consistent with a compensation model. Limitations of the study and its implications for further research on psychotherapy preference and its integration within evidence-based practice are discussed.
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Affiliation(s)
- Grace A Lyons
- Department of Psychology, Wichita State University, Wichita, KS, USA
| | - Robert D Zettle
- Department of Psychology, Wichita State University, Wichita, KS, USA
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Petrov ME, Epstein DR, Krahn L, Todd M, Park JG, St. Louis EK, Morgenthaler TI, Hoffmann CM, Hasanaj K, Hollingshead K, Yu TY, Buman MP. SleepWell24, a Smartphone Application to Promote Adherence to Positive Airway Pressure Therapy: Feasibility and Acceptability in a Randomized Controlled Trial. Behav Sleep Med 2024; 22:420-432. [PMID: 38032115 PMCID: PMC11136882 DOI: 10.1080/15402002.2023.2289442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
OBJECTIVE To investigate the feasibility and acceptability of SleepWell24, a multicomponent, evidence-based smartphone application, to improve positive airway pressure therapy (PAP) adherence, among patients with obstructive sleep apnea (OSA) naive to PAP. METHODS In a single-blind randomized controlled trial, SleepWell24, with a companion activity monitor was compared to usual care plus the activity monitor and its associated app. SleepWell24 provides objective feedback on PAP usage and sleep/physical activity patterns, and chronic disease management. Patients were recruited from two sleep medicine centers and followed over the first 60 days of PAP. Feasibility and acceptability were measured by recruitment/retention rates, app usage, differences in post-trial Treatment Evaluation Questionnaire (TEQ) scores, and patient interviews. Exploratory, intent-to-treat logistic and linear mixed models estimated PAP adherence and clinical outcomes. RESULTS Of 103 eligible participants, 87 were enrolled (SleepWell24 n = 40, control n = 47; mean 57.6y [SD = 12.3], 44.8% female). Retention was ≥95% across arms. There were no significant differences in TEQ scores. SleepWell24 participants engaged with the app on 62.9% of trial days. PAP use was high across both arms (SleepWell24 vs. Control: mean hours 5.98 vs. 5.86). There were no differences in PAP adherence or clinical outcomes. CONCLUSIONS SleepWell24 was feasible and acceptable among PAP-naive patients with OSA. CLINICAL TRIAL REGISTRATION NCT03156283https://www.clinicaltrials.gov/study/NCT03156283.
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Affiliation(s)
- Megan E. Petrov
- Edson College of Nursing and Health Innovation, Arizona State University, 550 N. 3 Street Suite 301, Phoenix, AZ 85004
| | - Dana R. Epstein
- College of Health Solutions, Edson College of Nursing and Health Innovation, Arizona State University
| | - Lois Krahn
- Center for Sleep Medicine, Department of Pulmonary Medicine, Department of Psychiatry and Psychology, Mayo Clinic, Scottsdale, Arizona
| | - Michael Todd
- Edson College of Nursing and Health Innovation, Arizona State University
| | - John G. Park
- Center for Sleep Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
| | - Erik K. St. Louis
- Center for Sleep Medicine, Division of Pulmonary and Critical Care Medicine, Departments of Neurology and Medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota; and Mayo Clinic Health System Southwest Wisconsin, La Crosse, Wisconsin
| | - Timothy I. Morgenthaler
- Center for Sleep Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota
| | - Coles M. Hoffmann
- Edson College of Nursing and Health Innovation, Arizona State University
| | | | | | - Tsung-Yen Yu
- College of Health Solutions, Arizona State University
| | - Matthew P. Buman
- College of Health Solutions, Arizona State University, 550 N. 3 Street Suite 501, Phoenix, AZ 85004
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Debeaudrap P, Etoundi N, Tegbe J, Assoumou N, Dialo Z, Tanon A, Bernard C, Bonnet F, Aka H, Coffie P. The association between HIV infection, disability and lifestyle activity among middle-aged and older adults: an analytical cross-sectional study in Ivory Coast (the VIRAGE study). BMC Public Health 2024; 24:1549. [PMID: 38851706 PMCID: PMC11161960 DOI: 10.1186/s12889-024-19020-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 05/30/2024] [Indexed: 06/10/2024] Open
Abstract
INTRODUCTION People living with HIV (PLWH) live longer and face new health challenges resulting from the confluence of chronic HIV infection and the natural effect of aging and comorbidities. However, there is a dearth of information on the long-term impact of HIV infection on the health and wellbeing of PLWH in sub-Saharan Africa. This research aimed to fill this gap by reporting on physical, functional and social outcomes among PLWH treated at a referral center in Abidjan, Ivory Coast, and comparing them with those of a control group. METHODS Body composition, functional capacity, sarcopenia, limitations in daily activities and social participation were assessed among 300 PLWH (aged ≥ 30 years) and 200 uninfected adults of similar age and sex. The associations between these outcomes and participants' socioeconomic characteristics, HIV history and physical activity level were assessed using generalized additive models adjusted for age and sex. RESULTS The median age was 51 years, and the median antiretroviral therapy duration was 15 years. Compared to controls, PLWH reported higher levels of physical activity (p < 0.0001). They had a lower muscle index (adjusted p < 0.0001) and grip strength (adjusted p < 0.0001) but achieved similar performance on the 6-min walk test (6MWT, p = 0.2). Among PLWH, physical activity level was positively associated with better performance in the 6MWT (p = 0.006) and greater hand grip strength (p = 0.04). The difference in physical performance according to the level of physical activity appeared mainly after the age of 60. PLWH reported similar rates of activity limitations (p = 0.8), lower depression levels and greater scores for social functioning (p = 0.02). CONCLUSION In this study, PLWH achieved high levels of physical activity, which may explain why they maintained good physical performance and social functioning despite having a higher risk of sarcopenia. These results have important implications for resource-limited health systems and show avenues for chronic care models. TRIAL REGISTRATION This study was registered on the ClinicalTrials.gov website (NCT05199831, first registration the 20/01/2022).
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Affiliation(s)
- Pierre Debeaudrap
- Centre Population and Development (Ceped), French National Research Institute for Sustainable Development (IRD) and Paris University, Inserm ERL 1244, 45 Rue Des Saints Pères, 75006, Paris, France.
| | - Nadine Etoundi
- Infectious and Tropical Diseases Service (SMIT), Treichville Teaching Hospital, Abidjan, Côte d'Ivoire
| | - Joseph Tegbe
- Programme PAC-CI, Treichville Teaching Hospital, Abidjan, Côte d'Ivoire
| | - Nelly Assoumou
- Programme PAC-CI, Treichville Teaching Hospital, Abidjan, Côte d'Ivoire
| | - Zelica Dialo
- Infectious and Tropical Diseases Service (SMIT), Treichville Teaching Hospital, Abidjan, Côte d'Ivoire
- Department of Dermatology and Infectiology, UFR Sciences Médicales, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Aristophane Tanon
- Infectious and Tropical Diseases Service (SMIT), Treichville Teaching Hospital, Abidjan, Côte d'Ivoire
- Department of Dermatology and Infectiology, UFR Sciences Médicales, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
| | - Charlotte Bernard
- University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France
| | - Fabrice Bonnet
- University of Bordeaux, National Institute for Health and Medical Research (INSERM) UMR 1219, Research Institute for Sustainable Development (IRD) EMR 271, Bordeaux Population Health Centre, Bordeaux, France
- Service de Médecine Interne Et Maladies Infectieuses, CHU de Bordeaux, Hôpital Saint-André, Bordeaux, France
| | - Hortense Aka
- Department of Psychology, Felix Houphouet Boigny University, Abidjan, Côte d'Ivoire, Ivory Coast
| | - Patrick Coffie
- Programme PAC-CI, Treichville Teaching Hospital, Abidjan, Côte d'Ivoire
- Department of Dermatology and Infectiology, UFR Sciences Médicales, Université Félix Houphouët-Boigny, Abidjan, Côte d'Ivoire
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Pedro LMR, de Oliveira MF, Pereira MD, da Fonseca AD, Canavarro MC. Factors Associated with Prospective Acceptability and Preferences for Unified Transdiagnostic Cognitive-Behavioral Treatments and Group Therapy in the Portuguese General Population. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024:10.1007/s10488-024-01391-1. [PMID: 38839662 DOI: 10.1007/s10488-024-01391-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 06/07/2024]
Abstract
Group transdiagnostic cognitive-behavioral therapy (CBT) offers a promising solution for limited mental health access in Portugal. Understanding barriers to patient adherence is crucial for successful implementation. This study aimed to characterize the prospective acceptability and preferences for unified transdiagnostic CBT and group therapy in the Portuguese general population and explore their correlates. A sample of 243 participants (18-88 years old), recruited online, completed an online survey collecting information on sociodemographic and clinical characteristics, acceptability of transdiagnostic CBT treatments, specifically of Unified Protocol (UP), acceptability of group therapy, therapeutic format preferences, beliefs about group therapy and help-seeking attitudes. Most participants were receptive to and perceived as useful both unified transdiagnostic CBT and group therapy. Overall, participants presented significantly more favorable attitudes than unfavorable attitudes toward unified transdiagnostic CBT and group therapy (p < .001). Multivariate analyses revealed that (1) favorable attitudes toward transdiagnostic treatments were negatively associated with being employed and positively associated with living in an urban area, and higher efficacy scores; (2) unfavorable attitudes toward transdiagnostic treatments were positively associated with being married/cohabitating and negatively associated with vulnerability scores; (3) being female, living in an urban area, and higher efficacy and myth scores emerged as positive predictors of favorable attitudes toward group therapy; and (4) efficacy and vulnerability scores and help-seeking propensity emerged as negative predictors of unfavorable attitudes toward group therapy. These findings highlight the importance of delineating strategies to increase knowledge and acceptance of unified transdiagnostic CBT and group therapy in the Portuguese population, addressing specific individual characteristics.
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Affiliation(s)
- Liliana Maria Rodrigues Pedro
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, 3000-115, Portugal.
| | | | - Marco Daniel Pereira
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, 3000-115, Portugal
| | - Ana Dias da Fonseca
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, 3000-115, Portugal
| | - Maria Cristina Canavarro
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, Coimbra, 3000-115, Portugal
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Smyth E, Brennan L, Enright R, Sekhon M, Dickson J, Hussey J, Guinan E. The acceptability of exercise prehabilitation before cancer surgery among patients, family members and health professionals: a mixed methods evaluation. Support Care Cancer 2024; 32:399. [PMID: 38819477 PMCID: PMC11142941 DOI: 10.1007/s00520-024-08574-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 05/13/2024] [Indexed: 06/01/2024]
Abstract
PURPOSE Exercise prehabilitation aims to increase preoperative fitness, reduce post-operative complications, and improve health-related quality of life. For prehabilitation to work, access to an effective programme which is acceptable to stakeholders is vital. The aim was to explore acceptability of exercise prehabilitation before cancer surgery among key stakeholders specifically patients, family members and healthcare providers. METHODS A mixed-methods approach (questionnaire and semi-structured interview) underpinned by the Theoretical Framework of Acceptability was utilised. Composite acceptability score, (summation of acceptability constructs and a single-item overall acceptability construct), and median of each construct was calculated. Correlation analysis between the single-item overall acceptability and each construct was completed. Qualitative data was analysed using deductive and inductive thematic analysis. RESULTS 244 participants completed the questionnaire and n=31 completed interviews. Composite acceptability was comparable between groups (p=0.466). Four constructs positively correlated with overall acceptability: affective attitude (r=0.453), self-efficacy (r=0.399), ethicality (r=0.298) and intervention coherence (r=0.281). Qualitative data confirmed positive feelings, citing psychological benefits including a sense of control. Participants felt flexible prehabilitation program would be suitable for everyone, identifying barriers and facilitators to reduce burden. CONCLUSION Exercise prehabilitation is highly acceptable to key stakeholders. Despite some burden, it is a worthwhile and effective intervention. Stakeholders understand its purpose, are confident in patients' ability to participate, and regard it is an important intervention contributing to patients' psychological and physical wellbeing. IMPLICATIONS •Introduction should be comprehensively designed and clearly presented, providing appropriate information and opportunity for questions. •Programmes should be patient-centred, designed to overcome barriers and address patients' specific needs and goals. •Service must be appropriately resourced with a clear referral-pathway.
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Affiliation(s)
- Emily Smyth
- Department of Physiotherapy, Trinity College Dublin, Dublin, Ireland
- Trinity St James's Cancer Institute, Dublin, Ireland
| | - Louise Brennan
- Department of Physiotherapy, Trinity College Dublin, Dublin, Ireland
- Trinity St James's Cancer Institute, Dublin, Ireland
| | - Rachel Enright
- Department of Physiotherapy, Trinity College Dublin, Dublin, Ireland
- Trinity St James's Cancer Institute, Dublin, Ireland
| | - Mandeep Sekhon
- St George's, University of London, Population Health Research Institute, London, United Kingdom
| | | | - Juliette Hussey
- Department of Physiotherapy, Trinity College Dublin, Dublin, Ireland
- Trinity St James's Cancer Institute, Dublin, Ireland
| | - Emer Guinan
- Trinity St James's Cancer Institute, Dublin, Ireland.
- The Beacon Hospital, Dublin, Ireland.
- Department of Surgery, Trinity College Dublin, Dublin, Ireland.
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Graham F, Bartik W, Wayland S, Maple M. Effectiveness and Acceptability of Interventions Offered for Those Bereaved by Parental Loss to Suicide in Childhood: A Mixed Methods Systematic Review. Arch Suicide Res 2024:1-32. [PMID: 38767988 DOI: 10.1080/13811118.2024.2351101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
OBJECTIVES Identify interventions offered for children bereaved by parental suicide, investigate reported effectiveness and explore the acceptability of identified interventions. METHOD Six electronic databases were systematically searched for primary studies investigating intervention effectiveness and acceptability, (August 2011 to June 2023). Eligibility required inclusion of participants bereaved by parental suicide during childhood among sample populations. Methodological quality was evaluated applying JBI critical appraisal tools. Narrative synthesis was conducted using parallel-results convergent design. RESULTS Of the 22 eligible reports, 19 articles reported on 12 manual-based supports provided during childhood; three papers described users' experiences of various specified intervention types offered following childhood loss. Twenty-one studies reported on interventions offered for heterogeneous participant groups that included children bereaved by parental suicide. Time from loss to intervention generally included both recent (1 < 30mths) and more distant loss, with just one intervention described as solely for recently bereaved children. Eight interventions (n = 12 studies) demonstrated significant positive effects (p < 0.05), for maladaptive grief, mental health, quality of life. Only one study investigated suicide-related outcomes. Qualitative findings (n = 8 studies) facilitated development of four acceptability themes: Perceived utility, Relationships, Components and Delivery. CONCLUSIONS Heterogeneity in causes of loss/trauma and relationships with the deceased limit specific conclusions regarding effectiveness/acceptability of reviewed interventions for children bereaved by parental suicide. Few sub-group analyses of effects were reported, and qualitative evidence specifically from children bereaved by parental suicide was limited. Further research is recommended regarding mixed-user interventions, specifically for children bereaved by parental suicide.
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Hoffmann C, Avery K, Macefield R, Dvořák T, Snelgrove V, Blazeby J, Hopkins D, Hickey S, Gibbison B, Rooshenas L, Williams A, Aning J, Bekker HL, McNair AG. Usability of an Automated System for Real-Time Monitoring of Shared Decision-Making for Surgery: Mixed Methods Evaluation. JMIR Hum Factors 2024; 11:e46698. [PMID: 38598276 PMCID: PMC11043934 DOI: 10.2196/46698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 10/02/2023] [Accepted: 03/02/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Improving shared decision-making (SDM) for patients has become a health policy priority in many countries. Achieving high-quality SDM is particularly important for approximately 313 million surgical treatment decisions patients make globally every year. Large-scale monitoring of surgical patients' experience of SDM in real time is needed to identify the failings of SDM before surgery is performed. We developed a novel approach to automating real-time data collection using an electronic measurement system to address this. Examining usability will facilitate its optimization and wider implementation to inform interventions aimed at improving SDM. OBJECTIVE This study examined the usability of an electronic real-time measurement system to monitor surgical patients' experience of SDM. We aimed to evaluate the metrics and indicators relevant to system effectiveness, system efficiency, and user satisfaction. METHODS We performed a mixed methods usability evaluation using multiple participant cohorts. The measurement system was implemented in a large UK hospital to measure patients' experience of SDM electronically before surgery using 2 validated measures (CollaboRATE and SDM-Q-9). Quantitative data (collected between April 1 and December 31, 2021) provided measurement system metrics to assess system effectiveness and efficiency. We included adult patients booked for urgent and elective surgery across 7 specialties and excluded patients without the capacity to consent for medical procedures, those without access to an internet-enabled device, and those undergoing emergency or endoscopic procedures. Additional groups of service users (group 1: public members who had not engaged with the system; group 2: a subset of patients who completed the measurement system) completed user-testing sessions and semistructured interviews to assess system effectiveness and user satisfaction. We conducted quantitative data analysis using descriptive statistics and calculated the task completion rate and survey response rate (system effectiveness) as well as the task completion time, task efficiency, and relative efficiency (system efficiency). Qualitative thematic analysis identified indicators of and barriers to good usability (user satisfaction). RESULTS A total of 2254 completed surveys were returned to the measurement system. A total of 25 service users (group 1: n=9; group 2: n=16) participated in user-testing sessions and interviews. The task completion rate was high (169/171, 98.8%) and the survey response rate was good (2254/5794, 38.9%). The median task completion time was 3 (IQR 2-13) minutes, suggesting good system efficiency and effectiveness. The qualitative findings emphasized good user satisfaction. The identified themes suggested that the measurement system is acceptable, easy to use, and easy to access. Service users identified potential barriers and solutions to acceptability and ease of access. CONCLUSIONS A mixed methods evaluation of an electronic measurement system for automated, real-time monitoring of patients' experience of SDM showed that usability among patients was high. Future pilot work will optimize the system for wider implementation to ultimately inform intervention development to improve SDM. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1136/bmjopen-2023-079155.
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Affiliation(s)
- Christin Hoffmann
- National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Kerry Avery
- National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Rhiannon Macefield
- National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | - Tadeáš Dvořák
- National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | | | - Jane Blazeby
- National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | | | - Shireen Hickey
- Improvement Academy, Bradford Royal Infirmary, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, United Kingdom
| | - Ben Gibbison
- National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
- University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Leila Rooshenas
- National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
| | | | | | - Hilary L Bekker
- Leeds Unit of Complex Intervention Development (LUCID), Leeds Institute of Health Sciences, School of Medicine, University of Leeds, Leeds, United Kingdom
- The Research Centre for Patient Involvement (ResCenPI), Department of Public Health, Aarhus University, Central Denmark Region, Denmark
| | - Angus Gk McNair
- National Institute for Health and Care Research Bristol Biomedical Research Centre, Bristol Centre for Surgical Research, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, United Kingdom
- North Bristol NHS Trust, Bristol, United Kingdom
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Pfledderer CD, von Klinggraeff L, Burkart S, da Silva Bandeira A, Lubans DR, Jago R, Okely AD, van Sluijs EMF, Ioannidis JPA, Thrasher JF, Li X, Beets MW. Consolidated guidance for behavioral intervention pilot and feasibility studies. Pilot Feasibility Stud 2024; 10:57. [PMID: 38582840 PMCID: PMC10998328 DOI: 10.1186/s40814-024-01485-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 03/26/2024] [Indexed: 04/08/2024] Open
Abstract
BACKGROUND In the behavioral sciences, conducting pilot and/or feasibility studies (PFS) is a key step that provides essential information used to inform the design, conduct, and implementation of a larger-scale trial. There are more than 160 published guidelines, reporting checklists, frameworks, and recommendations related to PFS. All of these publications offer some form of guidance on PFS, but many focus on one or a few topics. This makes it difficult for researchers wanting to gain a broader understanding of all the relevant and important aspects of PFS and requires them to seek out multiple sources of information, which increases the risk of missing key considerations to incorporate into their PFS. The purpose of this study was to develop a consolidated set of considerations for the design, conduct, implementation, and reporting of PFS for interventions conducted in the behavioral sciences. METHODS To develop this consolidation, we undertook a review of the published guidance on PFS in combination with expert consensus (via a Delphi study) from the authors who wrote such guidance to inform the identified considerations. A total of 161 PFS-related guidelines, checklists, frameworks, and recommendations were identified via a review of recently published behavioral intervention PFS and backward/forward citation tracking of a well-known PFS literature (e.g., CONSORT Ext. for PFS). Authors of all 161 PFS publications were invited to complete a three-round Delphi survey, which was used to guide the creation of a consolidated list of considerations to guide the design, conduct, and reporting of PFS conducted by researchers in the behavioral sciences. RESULTS A total of 496 authors were invited to take part in the three-round Delphi survey (round 1, N = 46; round 2, N = 24; round 3, N = 22). A set of twenty considerations, broadly categorized into six themes (intervention design, study design, conduct of trial, implementation of intervention, statistical analysis, and reporting) were generated from a review of the 161 PFS-related publications as well as a synthesis of feedback from the three-round Delphi process. These 20 considerations are presented alongside a supporting narrative for each consideration as well as a crosswalk of all 161 publications aligned with each consideration for further reading. CONCLUSION We leveraged expert opinion from researchers who have published PFS-related guidelines, checklists, frameworks, and recommendations on a wide range of topics and distilled this knowledge into a valuable and universal resource for researchers conducting PFS. Researchers may use these considerations alongside the previously published literature to guide decisions about all aspects of PFS, with the hope of creating and disseminating interventions with broad public health impact.
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Affiliation(s)
- Christopher D Pfledderer
- Department of Health Promotion and Behavioral Sciences, The University of Texas Health Science Center at Houston, School of Public Health in Austin, Austin, TX, 78701, USA.
- Michael and Susan Dell Center for Healthy Living, The University of Texas Health Science Center at Houston, School of Public Health in Austin, Austin, TX, 78701, USA.
| | | | - Sarah Burkart
- Arnold School of Public Health, University of South Carolina, Columbia, SC, 29205, USA
| | | | - David R Lubans
- College of Human and Social Futures, The University of Newcastle Australia, Callaghan, NSW, 2308, Australia
| | - Russell Jago
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 1QU, UK
| | - Anthony D Okely
- Faculty of Arts, Social Sciences and Humanities, School of Health and Society, University of Wollongong, Wollongong, NSW, 2522, Australia
| | | | - John P A Ioannidis
- Department of Medicine, Stanford University, Stanford, CA, USA
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University, Stanford, CA, USA
- Department of Statistics, Stanford University, Stanford, CA, USA
- Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA
| | - James F Thrasher
- Arnold School of Public Health, University of South Carolina, Columbia, SC, 29205, USA
| | - Xiaoming Li
- Arnold School of Public Health, University of South Carolina, Columbia, SC, 29205, USA
| | - Michael W Beets
- Arnold School of Public Health, University of South Carolina, Columbia, SC, 29205, USA
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11
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Skaathun B, Salgin L, Muñoz FA, Talavera GA, Smith DM, Stockman JK, O’Bryan SE, Ramirez D, James-Price C, Servin AE. Study protocol: Project 2VIDA! SARS-CoV-2 vaccine intervention delivery for adults in Southern California. Front Public Health 2024; 12:1291332. [PMID: 38550328 PMCID: PMC10977100 DOI: 10.3389/fpubh.2024.1291332] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 02/28/2024] [Indexed: 04/02/2024] Open
Abstract
Background To date, the United States (US) leads the world in the number of infections and deaths due to the Coronavirus Disease 2019 (COVID-19). Racial and ethnic disparities in COVID-19 morbidity and mortality are staggering. Age-adjusted data show that AA and Latino individuals have had higher rates of death over most of the pandemic and during surges. Project 2VIDA! is community-based participatory research (CBPR) that was developed to address individual, social, and contextual factors related to access and acceptance of the COVID-19 vaccine among African American and Latino communities in Southern California. This paper describes the study protocol and overarching objectives. Methods and design Project 2VIDA! is a multilevel intervention that builds on the principals of CBPR and is designed to increase uptake of the COVID-19 vaccine among African American and Latino individuals (≥16 years and older) in San Diego County. The intervention was developed with a working group comprised of representatives from community and academia and centers on targeted COVID-19 individual awareness and education, linkage to medical and supportive services, COVID-19 community outreach and health promotion and offering the COVID-19 vaccine through community pop-up clinics. Discussion Findings from 2VIDA! will provide data on the impact, feasibility, and acceptability of the intervention which are all crucial for the adaptation, refinement, and improvement of vaccine outreach interventions for COVID-19 and other vaccine preventable infectious diseases that severely impact African American and Latino communities. Clinical trial registration https://clinicaltrials.gov/ct2/show/NCT05022472?term=Project+2VIDA&draw=2&rank=1, NCT05022472.
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Affiliation(s)
- Britt Skaathun
- School of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA, United States
| | - Linda Salgin
- San Ysidro Health Center, San Diego, CA, United States
| | | | | | - Davey M. Smith
- School of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA, United States
| | - Jamila K. Stockman
- School of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA, United States
| | - Sophie E. O’Bryan
- School of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA, United States
| | | | | | - Argentina E. Servin
- School of Medicine, Division of Infectious Diseases and Global Public Health, University of California, San Diego, La Jolla, CA, United States
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12
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Pfledderer CD, von Klinggraeff L, Burkart S, da Silva Bandeira A, Lubans DR, Jago R, Okely AD, van Sluijs EM, Ioannidis JP, Thrasher JF, Li X, Beets MW. Expert Perspectives on Pilot and Feasibility Studies: A Delphi Study and Consolidation of Considerations for Behavioral Interventions. RESEARCH SQUARE 2023:rs.3.rs-3370077. [PMID: 38168263 PMCID: PMC10760234 DOI: 10.21203/rs.3.rs-3370077/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Background In the behavioral sciences, conducting pilot and/or feasibility studies (PFS) is a key step that provides essential information used to inform the design, conduct, and implementation of a larger-scale trial. There are more than 160 published guidelines, reporting checklists, frameworks, and recommendations related to PFS. All of these publications offer some form of guidance on PFS, but many focus on one or a few topics. This makes it difficult for researchers wanting to gain a broader understanding of all the relevant and important aspects of PFS and requires them to seek out multiple sources of information, which increases the risk of missing key considerations to incorporate into their PFS. The purpose of this study was to develop a consolidated set of considerations for the design, conduct, implementation, and reporting of PFS for interventions conducted in the behavioral sciences. Methods To develop this consolidation, we undertook a review of the published guidance on PFS in combination with expert consensus (via a Delphi study) from the authors who wrote such guidance to inform the identified considerations. A total of 161 PFS-related guidelines, checklists, frameworks, and recommendations were identified via a review of recently published behavioral intervention PFS and backward/forward citation tracking of well-know PFS literature (e.g., CONSORT Ext. for PFS). Authors of all 161 PFS publications were invited to complete a three-round Delphi survey, which was used to guide the creation of a consolidated list of considerations to guide the design, conduct, and reporting of PFS conducted by researchers in the behavioral sciences. Results A total of 496 authors were invited to take part in the Delphi survey, 50 (10.1%) of which completed all three rounds, representing 60 (37.3%) of the 161 identified PFS-related guidelines, checklists, frameworks, and recommendations. A set of twenty considerations, broadly categorized into six themes (Intervention Design, Study Design, Conduct of Trial, Implementation of Intervention, Statistical Analysis and Reporting) were generated from a review of the 161 PFS-related publications as well as a synthesis of feedback from the three-round Delphi process. These 20 considerations are presented alongside a supporting narrative for each consideration as well as a crosswalk of all 161 publications aligned with each consideration for further reading. Conclusion We leveraged expert opinion from researchers who have published PFS-related guidelines, checklists, frameworks, and recommendations on a wide range of topics and distilled this knowledge into a valuable and universal resource for researchers conducting PFS. Researchers may use these considerations alongside the previously published literature to guide decisions about all aspects of PFS, with the hope of creating and disseminating interventions with broad public health impact.
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Affiliation(s)
| | | | - Sarah Burkart
- University of South Carolina Arnold School of Public Health
| | | | | | - Russ Jago
- University of Bristol Population Health Sciences
| | | | | | | | | | - Xiaoming Li
- University of South Carolina Arnold School of Public Health
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13
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Krassikova A, Wills A, Vellani S, Sidani S, Keatings M, Boscart VM, Bethell J, McGilton KS. Development and Evaluation of a Nurse Practitioner Huddles Toolkit for Long Term Care Homes. Can J Aging 2023:1-9. [PMID: 38044629 DOI: 10.1017/s0714980823000740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
Long-term care homes (LTCHs) were disproportionately affected by the coronavirus disease (COVID-19) pandemic, creating stressful circumstances for LTCH employees, residents, and their care partners. Team huddles may improve staff outcomes and enable a supportive climate. Nurse practitioners (NPs) have a multifaceted role in LTCHs, including facilitating implementation of new practices. Informed by a community-based participatory approach to research, this mixed-methods study aimed to develop and evaluate a toolkit for implementing NP-led huddles in an LTCH. The toolkit consists of two sections. Section one describes the huddles' purpose and implementation strategies. Section two contains six scripts to guide huddle discussions. Acceptability of the intervention was evaluated using a quantitative measure (Treatment Acceptability Questionnaire) and through qualitative interviews with huddle participants. Descriptive statistics and manifest content analysis were used to analyse quantitative and qualitative data. The project team rated the toolkit as acceptable. Qualitative findings provided evidence on design quality, limitations, and recommendations for future huddles.
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Affiliation(s)
- Alexandra Krassikova
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Aria Wills
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Shirin Vellani
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Souraya Sidani
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, ON, Canada
| | - Margaret Keatings
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Veronique M Boscart
- School of Health and Life Sciences, Conestoga College, Kitchener, ON, Canada
| | - Jennifer Bethell
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Katherine S McGilton
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
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14
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Moreira H, Góis AC, Pereira AM, Pereira B, Caiado B, Nepomuceno MI, Pereira AI. Parents' acceptability of blended psychological interventions for children with emotional disorders. Internet Interv 2023; 34:100687. [PMID: 38023966 PMCID: PMC10654020 DOI: 10.1016/j.invent.2023.100687] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Objectives This study aims to (1) describe parents' knowledge and use of online resources to address children's mental health issues and the family's general internet and technology usage patterns; (2) examine parents' acceptance of blended interventions for children with emotional disorders (ED); and (3) analyse the predictors of parents' intention to use a blended intervention if their children experienced an ED. Method The sample included 164 Portuguese parents (95.7 % mothers) of children between the ages of 6 and 13 years who completed an online survey. The study was disseminated through social networks, personal contacts of the researchers, and among parents participating in a randomized controlled trial investigating the efficacy of a psychological intervention for children with ED. Results Only 4.3 % of parents knew about online psychological interventions for children, and only 1.2 % had used them before. Most parents (73.2 %) reported that they would choose face-to-face individual therapy as their first option if their child had any ED, followed by blended therapy (14.8 %). Regression analyses showed that higher levels of parents' intention to use a blended intervention were predicted by their perceptions of the utility or efficacy of this type of delivery format. Discussion/conclusion These results suggest that although most parents show unfamiliarity with blended psychological interventions for children, they consider it a treatment modality to which they would resort if their children had emotional difficulties. Their intention to use such an intervention seems to be more likely if they perceive it as useful and effective.
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Affiliation(s)
- Helena Moreira
- University of Coimbra, Center for Research in Neuropsychology and Cognitive-Behavioral Interventions, Faculty of Psychology and Educational Sciences, Portugal
| | - Ana Carolina Góis
- University of Coimbra, Center for Research in Neuropsychology and Cognitive-Behavioral Interventions, Faculty of Psychology and Educational Sciences, Portugal
| | - Ana Maria Pereira
- University of Coimbra, Faculty of Psychology and Educational Sciences, Portugal
| | - Bárbara Pereira
- University of Coimbra, Center for Research in Neuropsychology and Cognitive-Behavioral Interventions, Faculty of Psychology and Educational Sciences, Portugal
| | - Brígida Caiado
- University of Coimbra, Center for Research in Neuropsychology and Cognitive-Behavioral Interventions, Faculty of Psychology and Educational Sciences, Portugal
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Ndambo MK, Pickersgill M, Bunn C, Stewart RC, Umar E, Nyasulu M, McIntosh AM, Manda-Taylor L. Maternal mental health research in Malawi: Community and healthcare provider perspectives on acceptability and ethicality. SSM - MENTAL HEALTH 2023; 3:100213. [PMID: 38045108 PMCID: PMC10311285 DOI: 10.1016/j.ssmmh.2023.100213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 12/05/2023] Open
Abstract
Maternal mental health (MMH) is recognised as globally significant. The prevalence of depression and factors associated with its onset among perinatal women in Malawi has been previously reported, and the need for further research in this domain is underscored. Yet, there is little published scholarship regarding the acceptability and ethicality of MMH research to women and community representatives. The study reported here sought to address this in Malawi by engaging with communities and healthcare providers in the districts where MMH research was being planned. Qualitative data was collected in Lilongwe and Karonga districts through 20 focus group discussions and 40 in-depth interviews with community representatives and healthcare providers from January through April 2021. All focus groups and interviews were audio recorded, transcribed verbatim (in local languages Chichewa and Tumbuka), translated into English, and examined through thematic content analysis. Participants' accounts suggest that biopsychosocial MMH research could be broadly acceptable within the communities sampled, with acceptability framed in part through prior encounters with biomedical and public health research and care in these regions, alongside broader understandings of the import of MMH. Willingness and consent to participate do not depend on specifically biomedical understandings of MMH, but rather on familiarity with individuals regarded as living with mental ill-health. However, the data further suggest some 'therapeutic misconceptions' about MMH research, with implications for how investigations in this area are presented by researchers when recruiting and working with participants. Further studies are needed to explore whether accounts of the acceptability and ethicality of MMH research shift and change during and following research encounters. Such studies will enhance the production of granular recommendations for further augmenting the ethicality of biomedical and public health research and researchers' responsibilities to participants and communities.
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Affiliation(s)
| | - Martyn Pickersgill
- Centre for Biomedicine, Self and Society, Usher Institute, University of Edinburgh, Scotland, United Kingdom
| | - Christopher Bunn
- Malawi Epidemiology Intervention Research Unit, Malawi
- School of Social and Political Sciences, Institute of Health and Wellbeing, University of Glasgow, Scotland, United Kingdom
| | - Robert C. Stewart
- Malawi Epidemiology Intervention Research Unit, Malawi
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Scotland, United Kingdom
| | - Eric Umar
- School of Global and Public Health, Kamuzu University of Health Sciences, Malawi
| | | | - Andrew M. McIntosh
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Scotland, United Kingdom
| | - Lucinda Manda-Taylor
- School of Global and Public Health, Kamuzu University of Health Sciences, Malawi
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16
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Fahey MC, Krukowski RA, Anderson RT, Cohn WF, Porter KJ, Reid T, Wiseman KP, You W, Wood CH, Rucker TW, Little MA. Reaching adults who smoke cigarettes in rural Appalachia: Rationale, design & analysis plan for a mixed-methods study disseminating pharmacy-delivered cessation treatment. Contemp Clin Trials 2023; 134:107335. [PMID: 37730197 PMCID: PMC10841546 DOI: 10.1016/j.cct.2023.107335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 08/25/2023] [Accepted: 09/15/2023] [Indexed: 09/22/2023]
Abstract
INTRODUCTION Unlike other U.S. geographical regions, cigarette smoking prevalence remains stagnant in rural Appalachia. One avenue for reaching rural residents with evidence-based smoking cessation treatments could be utilizing community pharmacists. This paper describes the design, rationale, and analysis plan for a mixed-method study that will determine combinations of cessation treatment components that can be integrated within community pharmacies in rural Appalachia. The aim is to quantify the individual and synergistic effects of five highly disseminable and sustainable cessation components in a factorial experiment. METHODS This sequential, mixed-method research design, based on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework, will use a randomized controlled trial with a 25 fully crossed factorial design (32 treatment combinations) to test, alone and in combination, the most effective evidence-based cessation components: (1) QuitAid (yes vs. no) (2) tobacco quit line (yes vs. no) (3) SmokefreeTXT (yes vs. no) (4) combination NRT lozenge + NRT patch (vs. NRT patch alone), and (5) eight weeks of NRT (vs. standard four weeks). RESULTS Logistic regression will model abstinence at six-months, including indicators for the five treatment factors and all two-way interactions between the treatment factors. Demographic and smoking history variables will be considered to assess potential effect modification. Poisson regression will model quit attempts and percent of adherence to treatment components as secondary outcomes. CONCLUSION This study will provide foundational evidence on how community pharmacies in medically underserved, rural regions can be leveraged to increase utilization of existing evidence-based tobacco cessation resources for treating tobacco dependence. CLINICAL TRIALS NCT05660525.
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Affiliation(s)
- M C Fahey
- Medical University of South Carolina, Charleston, SC, USA
| | - R A Krukowski
- University of Virginia, Department of Public Health Sciences, Charlottesville, VA, USA
| | - R T Anderson
- University of Virginia, School of Medicine, Charlottesville, VA, USA
| | - W F Cohn
- University of Virginia, Department of Public Health Sciences, Charlottesville, VA, USA
| | - K J Porter
- University of Virginia, Department of Public Health Sciences, Charlottesville, VA, USA
| | - T Reid
- University of Virginia, Department of Public Health Sciences, Charlottesville, VA, USA
| | - K P Wiseman
- University of Virginia, Department of Public Health Sciences, Charlottesville, VA, USA
| | - W You
- University of Virginia, Department of Public Health Sciences, Charlottesville, VA, USA
| | - C H Wood
- My Pharmacy, Greensboro, NC, USA
| | - T W Rucker
- University of Virginia, Health Systems, Nellysford, VA, USA
| | - M A Little
- University of Virginia, Department of Public Health Sciences, Charlottesville, VA, USA.
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17
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Santos GC, Liljeroos M, Tschann K, Denhaerynck K, Wicht J, Jurgens CY, Hullin R, Schäfer-Keller P. Feasibility, acceptability, and outcome responsiveness of the SYMPERHEART intervention to support symptom perception in persons with heart failure and their informal caregivers: a feasibility quasi-experimental study. Pilot Feasibility Stud 2023; 9:168. [PMID: 37794511 PMCID: PMC10548691 DOI: 10.1186/s40814-023-01390-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 08/29/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Symptom perception is an important process of heart failure (HF) self-care that persons with HF need in order to master self-care management. It also leads to better patient outcomes. Symptom perception consists of body observation and analysis, which are both challenging. We aimed to test the feasibility, acceptability, and outcome responsiveness of a novel intervention (SYMPERHEART) delivered to persons with HF with their informal caregiver. METHODS We designed SYMPERHEART as a complex evidence-informed education and support intervention targeting body observation and analysis. We conducted a feasibility quasi-experimental study with a single group pre-post-test design. We included three subsamples: persons with HF receiving home-based care, their informal caregivers exposed to SYMPERHEART, and home-care nurses who delivered SYMPERHEART during 1 month. We assessed feasibility by recruitment time, time to deliver SYMPERHEART, eligibility rate, and intervention fidelity. We assessed acceptability by consent rate, retention rate, persons with HF engagement in body observation, and treatment acceptability. Outcome responsiveness was informed by patient-reported (PRO) and clinical outcomes: HF self-care and the informal caregivers' contribution to HF self-care, perception of HF symptom burden, health status, caregivers' burden, and HF events. We performed descriptive analyses for quantitative data and calculated Cohen's d for PROs. A power analysis estimated the sample size for a future full-scale effectiveness study. RESULTS We included 18 persons with HF, 7 informal caregivers, and 9 nurses. Recruitment time was 112.6 h. The median time to deliver SYMPERHEART for each participant was 177.5 min. Eligibility rate was 55% in persons with HF. Intervention fidelity revealed that 16 persons with HF were exposed to body observation and analysis. Consent and retention rates in persons with HF were 37.5% and 100%, respectively. Participants engaged actively in symptom and weight monitoring. Treatment acceptability scores were high. Symptom perception and informal caregivers' contribution to symptom perception were found to be responsive to SYMPERHEART. We estimate that a sample size of 50 persons with HF would be needed for a full-scale effectiveness study. CONCLUSIONS SYMPERHEART was found to be feasible and acceptable. This feasibility study provides information for a subsequent effectiveness study. TRIAL REGISTRATION ISRCTN. ISRCTN18151041 , retrospectively registered on 4 February 2021, ICTRP Search Portal.
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Affiliation(s)
- Gabrielle Cécile Santos
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne, Lausanne University Hospital, Lausanne, Switzerland
| | - Maria Liljeroos
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - Kelly Tschann
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | - Kris Denhaerynck
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland
| | - Justine Wicht
- Service d'Aide et de Soins à Domicile de La Sarine, Fribourg, Switzerland
| | - Corrine Y Jurgens
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Roger Hullin
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Petra Schäfer-Keller
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland.
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18
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Sorkpor SK, Miao H, Moore C, Johnson CM, Maria DMS, Pollonini L, Ahn H. Listening to Remotely Monitored Home-based Preferred Music for Pain in Older Black Adults with Low Back Pain: A Pilot Study of Feasibility and Acceptability. Pain Manag Nurs 2023; 24:e102-e108. [PMID: 37482453 DOI: 10.1016/j.pmn.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 06/23/2023] [Accepted: 07/02/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Low back pain (LBP) is a complex condition that is widespread among older Black adults. Nonpharmacologic interventions are recommended as first-line therapy, but their use in practice is limited, possibly due to misunderstanding of their analgesic characteristics. AIM To determine the feasibility and acceptability of listening to preferred music at home to relieve pain in older Black adults aged 65 years or older with LBP. METHOD We recruited 20 community-dwelling older adults (≥65 years) with LBP to use noise-isolating headphones to listen to their preferred music for 20 minutes twice daily for four days via the MUSIC CARE® app. Feasibility was determined using enrollment, adherence, and attrition rates, and acceptability was determined using the Treatment Acceptance and Preference (TAP) scale. Average pain scores were self-reported using the Numeric Rating Scale (NRS) after the second intervention of the day. Pain scores were evaluated using paired sample t test and repeated-measures ANOVA. RESULTS Enrollment, adherence, and attrition rates were 95.25%, 100.00%, and 0.00%, respectively. Most participants rated the TAP scale at ≥3, indicating acceptance. Pain scores decreased significantly from baseline (M = 46.90, SD = 21.47) to post-intervention (M = 35.70, SD = 16.57), t (19) = 2.29, p = .03. Repeated measures ANOVA showed a significant decrease in mean pain scores over time [F (2.36, 44.88) = 5.61, p = .004, η2 = .23]. CONCLUSIONS Listening to preferred music for 20 minutes twice a day is a feasible and acceptable intervention that can considerably reduce pain in older Black adults with LBP.
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Affiliation(s)
- Setor K Sorkpor
- College of Nursing, Florida State University, Tallahassee, Florida.
| | - Hongyu Miao
- College of Nursing, Florida State University, Tallahassee, Florida
| | - Carolyn Moore
- School of Music, Sam Houston State University, Huntsville, Texas
| | - Constance M Johnson
- Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas
| | - Diane M Santa Maria
- Cizik School of Nursing, University of Texas Health Science Center Houston, Houston, Texas
| | - Luca Pollonini
- Departments of Engineering Technology, University of Houston, Texas
| | - Hyochol Ahn
- University of Arizona College of Nursing, Tucson, Arizona
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Van Orden KA, Bower E, Lutz J, Silva C. Engage coaching for caregivers: a pilot trial to reduce loneliness in dementia caregivers. Aging Ment Health 2023; 27:2019-2026. [PMID: 36898849 PMCID: PMC10492891 DOI: 10.1080/13607863.2023.2187345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/27/2023] [Indexed: 03/12/2023]
Abstract
OBJECTIVES There are no evidence-based interventions for reducing loneliness in family caregivers of people with dementia (ADRD caregivers), despite heightened risk. We examined feasibility, acceptability, and potential efficacy of a brief behavioral intervention, Engage Coaching for Caregivers, to reduce loneliness and increase social connection for older ADRD caregivers experiencing stress and loneliness. METHODS A single-arm clinical trial of 8 individual sessions of Engage Coaching delivered remotely. Outcomes assessed 3-months post-intervention included loneliness and relationship satisfaction (co-primary) and perceived social isolation (secondary). RESULTS Engage Coaching was feasible to deliver, with n = 25 of 30 enrolled completing at least 80% of sessions. 83% indicated the program met expectations and 100% reported the program was suitable and convenient. Improvements were observed in loneliness (standardized response mean [SRM] = 0.63), relationship satisfaction (SRM = 0.56), and perceived social isolation (SRM = 0.70). CONCLUSION Engage Coaching is a promising behavioral intervention to enhance social connection for older ADRD caregivers.
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Affiliation(s)
- Kimberly A. Van Orden
- Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, 14642, United States
| | - Emily Bower
- Pacific University, School of Graduate Psychology, Hillsboro, OR
| | - Julie Lutz
- Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, 14642, United States
| | - Caroline Silva
- Department of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, 14642, United States
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Harris K, Gooding PA, Awenat Y, Haddock G, Cook L, Huggett C, Jones S, Lobban F, Peeney E, Pratt D, Peters S. Acceptability of a novel suicide prevention psychological therapy for people who experience non-affective psychosis. Psychol Psychother 2023; 96:560-576. [PMID: 36856293 PMCID: PMC10953419 DOI: 10.1111/papt.12456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/01/2023] [Indexed: 03/02/2023]
Abstract
OBJECTIVES Suicide is a leading cause of death worldwide. People experiencing psychosis are at increased risk of death by suicide. Talking therapies can alleviate suicidal thoughts, plans, and attempts. Therapies need to also be acceptable to recipients. The aim of this study was to investigate the views on psychological therapy for people experiencing psychosis and suicidality using the Theoretical Framework of Acceptability. DESIGN Qualitative interview study. METHODS Participants were recruited from a randomised controlled trial comparing suicide prevention psychological therapy with treatment as usual. Individuals had a diagnosis of non-affective psychosis and experience of suicidal thoughts, plans and/or attempts. To assess the acceptability of the therapy, semi-structured interviews were conducted with 20 participants randomised to receive therapy. Data were deductively analysed using an adaptation of the Theoretical Framework of Acceptability. RESULTS Interviews (Mean = 45 min) were conducted and audio recorded with 21 participants. Data were organised into six themes: 1. Affective attitude, 2. Burden, 3. Alliance, 4. Intervention coherence, 5. Perceived effectiveness, and 6. Self-efficacy. There was no evidence of issues relating to domains of ethicality and opportunity costs associated with receiving therapy. CONCLUSIONS Talking about suicide was difficult and, at times, distressing, but it was perceived to be useful for understanding experiences. To be acceptable, it is important for therapists to ensure that clients' understanding of therapy aligns with expectations of effectiveness and to invest in building strong therapeutic alliances. Future research will benefit from examining therapists' experiences of delivering therapy through different modes (e.g. online, telephone).
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Affiliation(s)
- Kamelia Harris
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Manchester Academic Health Sciences Centre (MAHSC)ManchesterUK
- Greater Manchester Mental Health NHS Foundation TrustManchesterUK
| | - Patricia A. Gooding
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Manchester Academic Health Sciences Centre (MAHSC)ManchesterUK
- Greater Manchester Mental Health NHS Foundation TrustManchesterUK
| | - Yvonne Awenat
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Manchester Academic Health Sciences Centre (MAHSC)ManchesterUK
- Greater Manchester Mental Health NHS Foundation TrustManchesterUK
| | - Gillian Haddock
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Manchester Academic Health Sciences Centre (MAHSC)ManchesterUK
- Greater Manchester Mental Health NHS Foundation TrustManchesterUK
| | - Leanne Cook
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Manchester Academic Health Sciences Centre (MAHSC)ManchesterUK
- Greater Manchester Mental Health NHS Foundation TrustManchesterUK
| | - Charlotte Huggett
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Manchester Academic Health Sciences Centre (MAHSC)ManchesterUK
- Greater Manchester Mental Health NHS Foundation TrustManchesterUK
| | - Steven Jones
- Lancashire and South Cumbria NHS Foundation TrustLancashireUK
- Department of Health ResearchLancaster UniversityLancasterUK
| | - Fiona Lobban
- Lancashire and South Cumbria NHS Foundation TrustLancashireUK
- Department of Health ResearchLancaster UniversityLancasterUK
| | - Ellen Peeney
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Manchester Academic Health Sciences Centre (MAHSC)ManchesterUK
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Manchester Academic Health Sciences Centre (MAHSC)ManchesterUK
- Greater Manchester Mental Health NHS Foundation TrustManchesterUK
| | - Sarah Peters
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and HealthUniversity of ManchesterManchesterUK
- Manchester Academic Health Sciences Centre (MAHSC)ManchesterUK
- Manchester Centre for Health Psychology, Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biological, Medical and Health SciencesUniversity of ManchesterManchesterUK
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21
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Quint EE, Haanstra AJ, van der Veen Y, Maring H, Berger SP, Ranchor A, Bakker SJL, Finnema E, Pol RA, Annema C. PREhabilitation of CAndidates for REnal Transplantation (PreCareTx) study: protocol for a hybrid type I, mixed method, randomised controlled trial. BMJ Open 2023; 13:e072805. [PMID: 37500274 PMCID: PMC10387712 DOI: 10.1136/bmjopen-2023-072805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Abstract
INTRODUCTION Kidney transplant candidates (KTCs) need to be in optimal physical and psychological condition prior to surgery. However, KTCs often experience compromised functional capacity which can be characterised as frailty. Prehabilitation, the enhancement of a person's functional capacity, may be an effective intervention to improve the health status of KTCs. The PREhabilitation of CAndidates for REnal Transplantation (PreCareTx) study aims to examine the effectiveness of a multimodal prehabilitation programme on the health status of KTCs, and to explore the potential of implementation of prehabilitation in daily clinical practice. METHODS AND ANALYSIS This study uses a single centre, effectiveness-implementation hybrid type I study design, comprised of a randomised controlled trial and a mixed-methods study. Adult patients who are currently on the transplant waiting list or are waitlisted during the study period, at a university medical centre in The Netherlands, will be randomly assigned to either prehabilitation (n=64) or care as usual (n=64) groups. The prehabilitation group will undergo a 12-week home-based, tailored prehabilitation programme consisting of physical and/or nutritional and/or psychosocial interventions depending on the participant's deficits. This programme will be followed by a 12-week maintenance programme in order to enhance the incorporation of the interventions into daily life. The primary endpoint of this study is a change in frailty status as a proxy for health status. Secondary endpoints include changes in physical fitness, nutritional status, psychological well-being, quality of life and clinical outcomes. Tertiary endpoints include the safety, feasibility and acceptability of the prehabilitation programme, and the barriers and facilitators for further implementation. ETHICS AND DISSEMINATION Medical ethical approval was granted by the Medical Ethics Committee Groningen, Netherlands (M22.421). Written informed consent will be obtained from all participants. The results will be disseminated at international conferences and in peer-reviewed journals. TRIAL REGISTRATION NUMBER ClinicalTrials.gov, NCT05489432.
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Affiliation(s)
- Evelien E Quint
- Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Avril J Haanstra
- Department of Health Sciences, Section of Nursing Science, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Yvonne van der Veen
- Department of Health Sciences, Section of Nursing Science, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Internal Medicine, Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Heleen Maring
- Department of Health Sciences, Section of Nursing Science, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Physical Therapy, University Medical Center Groningen, Groningen, The Netherlands
| | - Stefan P Berger
- Internal Medicine, Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Adelita Ranchor
- Department of Health Sciences, Section of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Stephan J L Bakker
- Internal Medicine, Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Evelyn Finnema
- Department of Health Sciences, Section of Nursing Science, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Robert A Pol
- Department of Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Coby Annema
- Department of Health Sciences, Section of Nursing Science, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Lanier VM, Lohse KR, Hooker QL, Francois SJ, van Dillen LR. Treatment preference changes after exposure to treatment in adults with chronic low back pain. PM R 2023; 15:817-827. [PMID: 36106673 PMCID: PMC10014477 DOI: 10.1002/pmrj.12897] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 05/17/2022] [Accepted: 08/19/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Patients' pretreatment preferences can influence outcomes of nonpharmacologic treatments for musculoskeletal pain. Less is known about how patients' treatment preferences change following exposure to treatment. OBJECTIVE To examine the effect of exposure to treatment and change in disability and pain on treatment preference ratings of two exercise-based treatments for people with chronic low back pain (LBP). DESIGN Secondary analysis of a subsample of participants from a randomized clinical trial. SETTING Academic research setting. PARTICIPANTS Individuals with chronic LBP (n = 83). INTERVENTIONS 6 weekly sessions of motor skill training (MST) or strength and flexibility exercise (SFE). MAIN OUTCOME MEASURES Prior to treatment, participants completed a treatment preference assessment measure (TPA) describing MST and SFE. Participants rated four attributes (effectiveness, acceptability/logicality, suitability/appropriateness, convenience) of each treatment on a 5-point Likert scale (0-4) with higher scores indicating higher ratings. An overall preference rating was calculated as the mean of the attribute ratings. The TPA was administered 12 months post treatment to reassess participants' ratings of the treatment they received. RESULTS Participants who received MST rated their preference for MST higher 12 months post treatment and participants who received SFE rated their preference for SFE lower. Smaller improvements (to worsening) in pain were associated with a reduction in preference ratings in the SFE group, whereas the MST group generally increased their ratings regardless of pain. Changes in disability were not related to changes in preference ratings. CONCLUSIONS Participants changed their preference ratings of two exercise-based treatments for LBP after exposure to the treatment. Participants who received the less familiar MST viewed this treatment more favorably 12 months post treatment, and this change was less contingent on changes in disability/pain than for participants in the SFE group. Assessing preference ratings at various times during treatment is crucial to understand a person's preference for and perceptions of a treatment.
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Affiliation(s)
- Vanessa M Lanier
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Keith R Lohse
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Quenten L Hooker
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sara J Francois
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Linda R van Dillen
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
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23
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Schäfer-Keller P, Graf D, Denhaerynck K, Santos GC, Girard J, Verga ME, Tschann K, Menoud G, Kaufmann AL, Leventhal M, Richards DA, Strömberg A. A multicomponent complex intervention for supportive follow-up of persons with chronic heart failure: a randomized controlled pilot study (the UTILE project). Pilot Feasibility Stud 2023; 9:106. [PMID: 37370176 DOI: 10.1186/s40814-023-01338-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 06/07/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Heart failure (HF) is a progressive disease associated with a high burden of symptoms, high morbidity and mortality, and low quality of life (QoL). This study aimed to evaluate the feasibility and potential outcomes of a novel multicomponent complex intervention, to inform a future full-scale randomized controlled trial (RCT) in Switzerland. METHODS We conducted a pilot RCT at a secondary care hospital for people with HF hospitalized due to decompensated HF or with a history of HF decompensation over the past 6 months. We randomized 1:1; usual care for the control (CG) and intervention group (IG) who received the intervention as well as usual care. Feasibility measures included patient recruitment rate, study nurse time, study attrition, the number and duration of consultations, intervention acceptability and intervention fidelity. Patient-reported outcomes included HF-specific self-care and HF-related health status (KCCQ-12) at 3 months follow-up. Clinical outcomes were all-cause mortality, hospitalization and days spent in hospital. RESULTS We recruited 60 persons with HF (age mean = 75.7 years, ± 8.9) over a 62-week period, requiring 1011 h of study nurse time. Recruitment rate was 46.15%; study attrition rate was 31.7%. Follow-up included 2.14 (mean, ± 0.97) visits per patient lasting a total of 166.96 min (mean, ± 72.55), and 3.1 (mean, ± 1.7) additional telephone contacts. Intervention acceptability was high. Mean intervention fidelity was 0.71. We found a 20-point difference in mean self-care management change from baseline to 3 months in favour of the IG (Cohens' d = 0.59). Small effect sizes for KCCQ-12 variables; less IG participants worsened in health status compared to CG participants. Five deaths occurred (IG = 3, CG = 2). There were 13 (IG) and 18 (CG) all-cause hospital admissions; participants spent 8.90 (median, IQR = 9.70, IG) and 15.38 (median, IQR = 18.41, CG) days in hospital. A subsequent full-scale effectiveness trial would require 304 (for a mono-centric trial) and 751 participants (for a ten-centre trial) for HF-related QoL (effect size = 0.3; power = 0.80, alpha = 0.05). CONCLUSION We found the intervention, research methods and outcomes were feasible and acceptable. We propose increasing intervention fidelity strategies for a full-scale trial. TRIAL REGISTRATION ISRCTN10151805 , retrospectively registered 04/10/2019.
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Affiliation(s)
- Petra Schäfer-Keller
- Institute of Applied Research in Health, School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland.
- Cardiology, HFR Fribourg - Hôpital Cantonal, Fribourg, Switzerland.
| | - Denis Graf
- Cardiology, HFR Fribourg - Hôpital Cantonal, Fribourg, Switzerland
| | - Kris Denhaerynck
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland
| | - Gabrielle Cécile Santos
- Institute of Applied Research in Health, School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | - Josepha Girard
- Institute of Applied Research in Health, School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | - Marie-Elise Verga
- Institute of Applied Research in Health, School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | - Kelly Tschann
- Institute of Applied Research in Health, School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | - Grégoire Menoud
- Institute of Applied Research in Health, School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | - Anne-Laure Kaufmann
- Data Acquisition Unit, HES-SO Valais-Wallis, University of Applied Sciences and Arts Western Switzerland, Sion, Switzerland
| | | | - David A Richards
- Faculty of Health and Life Sciences, University of Exeter, Exeter, UK
- Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Anna Strömberg
- Department of Health, Medicine and Caring Sciences and Department of Cardiology, Linköping University, Linköping, Sweden
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24
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Hellberg SN, Lundegard L, Hopkins TA, Thompson KA, Kang M, Morris T, Schiller CE. Psychological distress and treatment preferences among parents amidst the COVID-19 pandemic. PSYCHIATRY RESEARCH COMMUNICATIONS 2023; 3:100109. [PMID: 36942154 PMCID: PMC9997051 DOI: 10.1016/j.psycom.2023.100109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 02/21/2023] [Accepted: 03/08/2023] [Indexed: 03/11/2023]
Abstract
The COVID-19 pandemic has presented many stressors for parents. This study was conducted to examine treatment preferences and barriers to care amidst COVID-19. Parents (N = 95) completed self-report measures. Education was provided on interventions (e.g., individual therapy, medication), and acceptability assessed. Elevated stress and distress were observed. Parents indicated interest in services for parenting concerns, stress, anxiety, and depression. Individual therapy and telehealth were highly acceptable, while medication and group therapy were less accepted. Findings highlight the need for specific supports among parents amidst the pandemic. Factors that influence treatment preference warrant further attention. Implications for healthcare service delivery are discussed.
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Affiliation(s)
| | | | | | | | - Michelle Kang
- Department of Psychiatry, UNC School of Medicine, USA
| | - Terrique Morris
- Department of Psychology & Neuroscience, UNC Chapel Hill, USA
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25
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Edward JS, McLouth LE, Rayens MK, Eisele LP, Davis TS, Hildebrandt G. Coverage and Cost-of-Care Links: Addressing Financial Toxicity Among Patients With Hematologic Cancer and Their Caregivers. JCO Oncol Pract 2023; 19:e696-e705. [PMID: 36888937 PMCID: PMC10414719 DOI: 10.1200/op.22.00665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/31/2023] [Indexed: 03/10/2023] Open
Abstract
PURPOSE This study examined the feasibility, acceptability, and preliminary effectiveness of an oncology financial navigation (OFN) intervention, Coverage and Cost-of-Care Links (CC Links), among patients with hematologic cancer and their caregivers who are at increased risk of experiencing financial toxicity (FT). METHODS All patients who presented to the Division of Hematology and Bone and Marrow Transplant (BMT) at an National Cancer Institute-designated cancer center between April 2021 and January 2022 were screened for FT during inpatient and outpatient visits. Patients who screened positive for FT and met the inclusion criteria were recruited to participate in CC Links that provided financial navigation and assistance via a financial navigator. Caregivers of patients undergoing BMTs were also recruited to participate. Primary outcomes were defined as improvements in FT, distress, and physical and mental quality of life. RESULTS Fifty-four patients and 32 caregivers completed the intervention and pre-/postintervention surveys. CC Links resulted in statistically significant decreases in the Comprehensive Score for FT for both patients (|t| = 2.42, P = .019) and caregivers (|t| = 2.43, P = .021) and total FT (|t| = 2.13, P = .041) and material conditions scores (|t| = 2.25, P = .031) for caregivers only. Only 27% of eligible patients participated in the study, whereas 100% of eligible caregivers participated. The majority of participants rated the intervention highly for acceptability (89%) and appropriateness (88%). An average of $2,500 (USD) in financial benefits was secured per participant via CC Links. CONCLUSION CC Links was effective in decreasing FT among patients with hematologic cancer and their caregivers while demonstrating high acceptability and appropriateness ratings.
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Affiliation(s)
- Jean S. Edward
- College of Nursing, University of Kentucky, Lexington, KY
| | - Laurie E. McLouth
- Department of Behavioral Health, College of Medicine, University of Kentucky, Lexington, KY
| | | | - Lori P. Eisele
- Patient Financial Experience, University of Kentucky HealthCare, Lexington, KY
| | - Tani S. Davis
- Markey Cancer Center, Division of Hematology and Blood and Marrow Transplants, Lexington, KY
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Lapointe T, Houle J, Sia YT, Payette M, Trudeau F. Addition of high-intensity interval training to a moderate intensity continuous training cardiovascular rehabilitation program after ischemic cerebrovascular disease: A randomized controlled trial. Front Neurol 2023; 13:963950. [PMID: 36686521 PMCID: PMC9846748 DOI: 10.3389/fneur.2022.963950] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 12/01/2022] [Indexed: 01/06/2023] Open
Abstract
Introduction Moderate intensity continuous training (MICT) is usually recommended for stroke or transient ischemic attack (TIA) patients. High intensity interval training (HIIT) has emerged as a potentially effective method for increasing cardiorespiratory fitness (CRF) among clinical populations. Its effectiveness remains to be demonstrated after stroke. A combined program of HIIT and MICT was designed to create a realistic exercise program implemented for a clinical setting to help patients become more active. Purpose This study aimed to compare the effects of a 6-month exercise program with either MICT only or a combination of HIIT and MICT and a control group in terms of CRF, cardiovascular risk factors, functionality, cognitive function (Montreal Cognitive Assessment) and depression markers (Hospital Anxiety and Depression Scale). Methods This randomized controlled trial started with 52 participants (33 men and 19 women, mean age: 69.2 ± 10.7) divided into three groups: HIIT + MICT combined, MICT, and control. Both exercise groups consisted of 4 weekly sessions including supervised and at-home exercise. Outcomes were assessed at T0 (baseline measure), T6 (end of exercise protocols), and T12 (follow-up), 40 participants having completed the 12-month follow-up. Results At T6, both HIIT+MICT and MICT programs provided a similar increase of CRF (3 ml·min-1·kg-1) from baseline (p < 0.01), while the control group showed a global slight decrease. Despite some decrease of CRF at T12 compared to T6, improvement persisted 6 months post-intervention (HIIT + MICT: p < 0.01 and MICT: p < 0.05). The control group decreased compared with baseline (p < 0.05). The two exercise programs induced a comparable increase in self-reported physical activity and a decrease in anxiety and depression markers. Participants in HIIT + MICT and MICT programs declared a good degree of acceptability assessed by the Acceptability and Preferences Questionnaire. Conclusion A 6-month HIIT + MICT combined program and a standard MICT program induced similar improvements in CRF, self-reported physical activity and anxiety and depression markers among patients with prior ischemic stroke or TIA compared with a control group. These effects appear to persist over time. Addition of HIIT was safe and considered acceptable by participants. Our results do not support any superiority of the combination HIIT + MICT nor disadvantage vs. MICT in this population.
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Affiliation(s)
- Thalia Lapointe
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Julie Houle
- Department of Nursing, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Ying-Tung Sia
- Integrated University Center for Health and Social Services Mauricie- and Centre-du-Québec, Trois-Rivières, QC, Canada
| | - Marika Payette
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - François Trudeau
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada,*Correspondence: François Trudeau ✉
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Alexopoulos AS, Soliman D, Lewinski AA, Strawbridge E, Steinhauser K, Edelman D, Crowley MJ. Simplifying therapy to assure glycemic control and engagement (STAGE) in poorly-controlled diabetes: A pilot study. J Diabetes Complications 2023; 37:108364. [PMID: 36525906 PMCID: PMC9839589 DOI: 10.1016/j.jdiacomp.2022.108364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/08/2022] [Accepted: 11/25/2022] [Indexed: 12/12/2022]
Abstract
In this single-arm pilot study, we demonstrated feasibility and acceptability of an insulin simplification intervention in patients with persistent, poorly-controlled type 2 diabetes on complex insulin regimens. While not powered to assess clinical outcomes, we observed neither worsened glycemic control nor increased hypoglycemia.
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Affiliation(s)
- Anastasia-Stefania Alexopoulos
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC 27710, United States; Department of Medicine, Division of Endocrinology, Duke University Medical Center, Rd, Durham, NC 27710, United States.
| | - Diana Soliman
- Department of Medicine, Division of Endocrinology, Duke University Medical Center, Rd, Durham, NC 27710, United States
| | - Allison A Lewinski
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC 27710, United States; School of Nursing, Duke University, Durham, NC 27710, United States
| | - Elizabeth Strawbridge
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC 27710, United States
| | - Karen Steinhauser
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC 27710, United States; Department of Population Health Sciences, Duke University, Durham, NC 27710, United States
| | - David Edelman
- Department of Population Health Sciences, Duke University, Durham, NC 27710, United States; Department of Medicine, Division of General Internal Medicine, Duke University Medical Center, 2301 Erwin Rd, Durham, NC 27710, United States
| | - Matthew J Crowley
- Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Medical Center, Durham, NC 27710, United States; Department of Medicine, Division of Endocrinology, Duke University Medical Center, Rd, Durham, NC 27710, United States
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Collette K, Feeley N, Galipeau R, Lebel V. Acceptability and feasibility of a digital educational intervention designed to improve the psychological well-being of parents with a preterm infant at the neonatal intensive care unit: A pilot project. Early Hum Dev 2023; 176:105717. [PMID: 36724661 DOI: 10.1016/j.earlhumdev.2023.105717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/21/2023] [Accepted: 01/22/2023] [Indexed: 01/28/2023]
Abstract
BACKGROUND Families experience psychological distress when their preterm infant is in the Neonatal Intensive Care Unit. A tailored educational intervention may be beneficial for their psychological well-being. Unfortunately, existing websites have moderate to low information quality and there is no educational website for French-speaking parents. AIM To measure the acceptability and feasibility of a digital educational intervention designed to improve the psychological well-being of parents with a preterm infant, as well as the acceptability and feasibility of the study methods used. METHODS A pilot randomized controlled trial was conducted. Participants were randomized to have access to either an educational website or information pamphlet. They were invited to complete an online questionnaire about stress and depressive symptoms 2 and 4 weeks after recruitment. An online questionnaire regarding the acceptability of the intervention and the data collection process was completed 5 weeks after recruitment. RESULTS Twenty parents participated. All participants with access to the website considered it was acceptable in terms of the appropriateness, convenience, and efficiency to meet their informational needs. 85 % of participants assigned to the website viewed it 1 to 3 times per day during the data collection period and 69.4 % consulted the website for 5 to 20 min each time. The data collection process was acceptable for 85 % to 95 % of participants. DISCUSSION The educational website was an acceptable and feasible intervention and the data collection process used was acceptable according to participants.
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Affiliation(s)
- Kimberley Collette
- Université du Québec en Outaouais, Nursing Department, 5 rue St-Joseph, St-Jérôme, Québec J7Z 0B7, Canada.
| | - Nancy Feeley
- Ingram School of Nursing at McGill University, Montreal, Québec, Canada; Jewish General Hospital Centre for Nursing Research, Lady Davis Institute, Montreal, Québec, Canada
| | - Roseline Galipeau
- Université du Québec en Outaouais, Nursing Department, 5 rue St-Joseph, St-Jérôme, Québec J7Z 0B7, Canada
| | - Valérie Lebel
- Université du Québec en Outaouais, Nursing Department, 5 rue St-Joseph, St-Jérôme, Québec J7Z 0B7, Canada.
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Fox MT, Butler JI, Sidani S, Alzghoul MM, Skinner M, Amell T, Ferguson-Paré M. Family caregivers' perspectives on the acceptability of four interventions proposed for rural transitional care: A multi-method study. PLoS One 2022; 17:e0279187. [PMID: 36534678 PMCID: PMC9762580 DOI: 10.1371/journal.pone.0279187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND There is a critical need for hospital-to-home transitional care interventions to prepare family caregivers for patients' post-discharge care in rural communities. Four evidence-based interventions (named discharge planning, treatments, warning signs, and physical activity) have the potential to meet this need but family caregivers' perspectives on the acceptability of the interventions have not been examined. This gap is significant because unacceptable interventions are unlikely to be used or used as designed, thereby undermining outcome achievement. Accordingly, this study examined the perceived acceptability of the four interventions to rural family caregivers. MATERIALS AND METHODS A multi-method descriptive design was used. The quantitative method entailed the administration of an established scale to assess the interventions' perceived acceptability to family caregivers. The qualitative method involved semi-structured interviews to explore family caregivers' perceived acceptability of the interventions in greater depth, including acceptable and unacceptable aspects, in the context of their own transitional care experience. Participants were the family caregivers of a relative who had been discharged home in a rural community from an acute care hospital in Ontario, Canada. RESULTS The purposive sample included 16 participants who were mostly middle-aged women (n = 14; 87.5%) caring for a parent (n = 9; 56.3%) at high risk for hospital readmission. The mean scores on the acceptability measure were 3 or higher for all interventions, indicating that, on average, the four interventions were perceived as acceptable. In terms of acceptable aspects, four themes were identified: the interventions: 1) involve family caregivers and proactively prepare them for discharge, 2) provide clear, written, and detailed guidance, 3) place the onus on healthcare providers to initiate communication, and 4) ensure post-discharge follow-up. In terms of unacceptable aspects, one theme was identified: the physical activity intervention would be challenging to implement. DISCUSSION The findings support implementing the four interventions in practice throughout the hospital-to-home transition. Healthcare providers should assess family caregivers' comfort in participating in the physical activity intervention and tailor their role accordingly.
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Affiliation(s)
- Mary T. Fox
- School of Nursing, York University, Toronto, Ontario, Canada
- York University Centre for Aging Research and Education, Toronto, Ontario, Canada
| | - Jeffrey I. Butler
- School of Nursing, York University, Toronto, Ontario, Canada
- York University Centre for Aging Research and Education, Toronto, Ontario, Canada
| | - Souraya Sidani
- Faculty of Community Services, Ryerson University, Toronto, Ontario, Canada
| | - Manal M. Alzghoul
- School of Nursing, Lakehead University, Thunder Bay, Ontario, Canada
| | - Mark Skinner
- Trent School of the Environment, Peterborough, Ontario, Canada
- Trent Centre for Aging & Society, Peterborough, Ontario, Canada
| | - Travis Amell
- School of Nursing, York University, Toronto, Ontario, Canada
- Hospice of Waterloo Region, Waterloo, Ontario, Canada
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Richard-Lalonde M, Feeley N, Cossette S, Chlan LL, Gélinas C. Acceptability and Feasibility of a Patient-Oriented Music Intervention to Reduce Pain in the Intensive Care: Protocol for a Randomized Crossover Pilot Trial (Preprint). JMIR Res Protoc 2022; 12:e40760. [PMID: 37163350 DOI: 10.2196/40760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 02/20/2023] [Accepted: 03/09/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Many patients experience pain in the intensive care unit (ICU) despite receiving pain medication. Research has shown that music can help reduce pain. Music interventions studied so far have not used music streaming to generate playlists based on patient preferences while incorporating recommended tempo and duration. Previous research has focused on postoperative ICU patients able to self-report, which is underrepresentative of the ICU population that might benefit from a music intervention for pain management. We developed a new patient-oriented music intervention (POMI) that incorporates features based on theoretical, empirical, and experiential data intended to be used in the ICU. Such a music intervention should consider the expertise of ICU patients, family members, and nursing staff, as well as the practicality of the intervention when used in practice. OBJECTIVE The primary objectives of this study are to (1) evaluate the acceptability and feasibility of the POMI to reduce pain in ICU patients and (2) evaluate the feasibility of conducting a crossover pilot randomized controlled trial (RCT) for intervention testing in the ICU. A secondary objective is to examine the preliminary efficacy of the POMI to reduce pain in ICU patients. METHODS A single-blind 2×2 crossover pilot RCT will be conducted. Patients will undergo 1 sequence of 2 interventions: the POMI which delivers music based on patients' preferences via headphones or music pillow for 20-30 minutes and the control intervention (headphones or pillow without music). The sequence of the interventions will be inverted with a 4-hour washout period. Timing of the interventions will be before a planned bed turning procedure. Each patient will undergo 1 session of music. Twenty-four patients will be recruited. Patients able to self-report (n=12), family members of patients unable to self-report (n=12), and nursing staff (n=12) involved in the bed turning procedure will be invited to complete a short questionnaire on the POMI acceptability. Data will be collected on the feasibility of the intervention delivery (ie, time spent creating a playlist, any issue related to headphones/pillow or music delivery, environmental noises, and intervention interruptions) and research methods (ie, number of patients screened, recruited, randomized, and included in the analysis). Pain scores will be obtained before and after intervention delivery. RESULTS Recruitment and data collection began in March 2022. As of July 5, 2022, in total, 22 patients, 12 family members, and 11 nurses were recruited. CONCLUSIONS Methodological limitations and strengths are discussed. Study limitations include the lack of blinding for patients able to self-report. Strengths include collecting data from various sources, getting a comprehensive evaluation of the intervention, and using a crossover pilot RCT design, where participants act as their own control, thus reducing confounding factors. TRIAL REGISTRATION ClinicalTrials.gov NCT05320224; https://clinicaltrials.gov/ct2/show/NCT05320224. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/40760.
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Feasibility, satisfaction, acceptability and safety of telehealth for First Nations and culturally and linguistically diverse people: a scoping review. Public Health 2022; 207:119-126. [DOI: 10.1016/j.puhe.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/28/2022] [Accepted: 04/20/2022] [Indexed: 11/18/2022]
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Gentile C, Starnino L, Dupuis G, D'Antono B. Mindfulness-Based Stress Reduction in Older Adults at Risk for Coronary Artery Disease: A Pilot Randomized Trial. Clin Gerontol 2022; 45:272-286. [PMID: 33719899 DOI: 10.1080/07317115.2021.1887421] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Stress influences metabolic activity and increases risk for cardiovascular disease (CVD). We sought to a) examine feasibility and acceptability of mindfulness-based stress reduction (MBSR) in older adults at risk for CVD, and b) obtain preliminary data on its metabolic impact. METHODS A pilot RCT was conducted using a pre-post, 2-month follow-up design. Eighty-one individuals with metabolic syndrome and non-normative responses to stress in a previous investigation were invited. Participants were randomized (by sex and stress response) to a 9-week MBSR or a wait-list control group. Feasibility and acceptability were assessed and blood assayed. Between-subjects (MBSR vs waitlist control) ANOVAs on metabolic parameter change scores, and one-way repeated measures ANOVAs (pre-, post-, follow-up) were performed. RESULTS Thirty-three individuals (41%) responded to invitations, 26 were interested, of whom 19 were randomized (Mage = 67 years, SD = 7.70). Completion rate of MBSR was 72% and overall attendance was 96%. Reported benefits included increased relaxation, greater interpersonal connection, and increased body awareness. MBSR led to a decrease of 15% in LDL cholesterol and 10% in total cholesterol versus 4.5% and 1%, respectively, in the waitlist. Within group analyses showed notable decreases in LDL, triglycerides, and waist circumference post-MBSR and 2 months later. CONCLUSIONS A RCT was largely feasible and MBSR acceptable to participants. MBSR may lead to sustained decreases in cholesterol levels, warranting development of large-scale research on this topic. CLINICAL IMPLICATIONS Given the role of stress in CVD, addition of stress management interventions may serve as a useful complement to risk management among older individuals.
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Affiliation(s)
| | - Louisia Starnino
- Research Centre, Montreal Heart Institute, Montreal, Quebec, Canada.,Psychology Department, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Gilles Dupuis
- Psychology Department, Université du Québec à Montréal, Montreal, Quebec, Canada
| | - Bianca D'Antono
- Research Centre, Montreal Heart Institute, Montreal, Quebec, Canada.,Psychology, Université du Québec à Montréal, Montreal, Quebec, Canada
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Sanıl M, Eminer F. An integrative model of patients' perceived value of healthcare service quality in North Cyprus. Arch Public Health 2021; 79:227. [PMID: 34930446 PMCID: PMC8685307 DOI: 10.1186/s13690-021-00738-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 11/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background Improving healthcare quality has become an essential objective for all health institutions worldwide to address the need to improve services, manage costs and satisfy patient expectations about the quality of care. As health is one of the leading service sectors of the North Cyprus economy, analysing patients’ perceived value of healthcare service quality is crucial. In this research, a comparative analysis of existing models revealed affordability, acceptability and accessibility as the leading modern service quality indicators affecting patients’ perceived value of healthcare service quality. The quality of services is a leading factor impacting business competition and retention dictated by the current market. This study aimed to investigate the factors that influence patient perceptions of healthcare service quality in North Cyprus. Methods A self-administered questionnaire was carried out among 388 patients of public and private hospitals in North Cyprus, and the data were analysed using partial least squares-structural equation modelling. Results Empirical results highlight that the acceptability of healthcare services is a prerequisite for perceiving a high value of service quality. The affordability and accessibility of services, respectively, were less effective. Results concerning mediating effects confirm that acceptability could fully mediate the relationship between affordability and perceived value and could partially mediate the impact of accessibility on the perceived quality of healthcare services. Conclusion This study contributes to healthcare theory and practice by developing a conceptual framework to provide policymakers and managers with a practical understanding of factors that affect healthcare service quality.
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Affiliation(s)
- Mert Sanıl
- Faculty of Health Sciences, European University of Lefke, Gemikonagı-Lefke, North Cyprus, TR-10, Mersin, Turkey.
| | - Fehiman Eminer
- Faculty of Economics and Administrative Sciences, European University of Lefke, Gemikonagı-Lefke, North Cyprus, TR-10, Mersin, Turkey
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Tice LC, Eagle DE, Rash JA, Larkins JS, Labrecque SM, Platt A, Yao J, Proeschold-Bell RJ. The Selah study protocol of three interventions to manage stress among clergy: a preference-based randomized waitlist control trial. Trials 2021; 22:892. [PMID: 34886896 PMCID: PMC8655493 DOI: 10.1186/s13063-021-05845-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Like many helping professionals in emotional labor occupations, clergy experience high rates of mental and physical comorbidities. Regular stress management practices may reduce stress-related symptoms and morbidity, but more research is needed into what practices can be reliably included in busy lifestyles and practiced at a high enough level to meaningfully reduce stress symptoms. METHODS AND ANALYSIS The overall design is a preference-based randomized waitlist control trial. United Methodist clergy in North Carolina will be eligible to participate. The intervention and waitlist control groups will be recruited by email. The interventions offered are specifically targeted to clergy preference and include mindfulness-based stress reduction, Daily Examen, and stress inoculation training. Surveys will be conducted at 0, 12, and 24 weeks with heart rate data collected at 0 and 12 weeks. The primary outcomes for this study are self-reported symptoms of stress and heart rate at week 12 for each intervention compared to waitlist control; the secondary outcome is symptoms of anxiety comparing each intervention vs waitlist control. ETHICS AND DISSEMINATION Ethical approval was obtained from the Duke University Campus IRB (2019-0238). The results will be made available to researchers, funders, and members of the clergy community. STRENGTHS AND LIMITATIONS OF THIS STUDY While evidence-based stress reduction practices such as mindfulness-based stress reduction (MBSR) exist, a wider variety of practices should be tested to appeal to different individuals. Clergy in particular may prefer, and consequently enact, spiritual practices like the Daily Examen, and individuals such as clergy who spend most of their time thinking and feeling may prefer experiential-based practices like stress inoculation training. If efficacious, the Daily Examen and stress inoculation training practices have high feasibility in that they require few minutes per day. This study is limited by the inclusion of Christian clergy of only one denomination. TRIAL REGISTRATION ClinicalTrials.gov NCT04625777 . November 12, 2020.
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Affiliation(s)
- Logan C. Tice
- Duke Global Health Institute, Duke Center for Health Policy & Inequalities Research, Duke University, 310 Trent Drive, Durham, NC 27710 USA
| | - David E. Eagle
- Duke Global Health Institute, Duke Center for Health Policy & Inequalities Research, Duke University, 310 Trent Drive, Durham, NC 27710 USA
| | - Joshua A. Rash
- Department of Psychology, Memorial University of Newfoundland, St. John’s, Canada
| | - Jessie S. Larkins
- Duke Global Health Institute, Duke Center for Health Policy & Inequalities Research, Duke University, 310 Trent Drive, Durham, NC 27710 USA
| | - Sofia M. Labrecque
- Duke Global Health Institute, Duke Center for Health Policy & Inequalities Research, Duke University, 310 Trent Drive, Durham, NC 27710 USA
| | - Alyssa Platt
- Duke Global Health Institute, Duke Center for Health Policy & Inequalities Research, Duke University, 310 Trent Drive, Durham, NC 27710 USA
| | - Jia Yao
- Duke Global Health Institute, Duke Center for Health Policy & Inequalities Research, Duke University, 310 Trent Drive, Durham, NC 27710 USA
| | - Rae Jean Proeschold-Bell
- Duke Global Health Institute, Duke Center for Health Policy & Inequalities Research, Duke University, 310 Trent Drive, Durham, NC 27710 USA
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Shepardson RL, Buckheit KA, Funderburk JS. Anxiety treatment preferences among veteran primary care patients: Demographic, mental health, and treatment-related correlates. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2021; 39:563-575. [PMID: 34472956 PMCID: PMC9358443 DOI: 10.1037/fsh0000628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Anxiety symptoms are common, yet undertreated, among primary care patients. Accommodating patient treatment preferences improves engagement and retention. In contrast to depression, little is known about primary care patients' preferences for anxiety treatment. METHOD Participants were 144 veterans experiencing anxiety symptoms but not receiving psychotherapy who were recruited from primary care. Preferences for 11 anxiety treatment attributes (method; location; type; format; provider; frequency, length, and number of appointments; psychotherapy orientation; symptom focus; and topic/skill) and demographic, mental health (e.g., anxiety symptom severity), and treatment-related (e.g., psychotherapy history) variables were assessed via mailed survey. We used chi-square goodness of fit tests to identify patient preferences for each attribute and multivariate multinomial logistic regression models to explore demographic, mental health, and treatment-related correlates of treatment preferences. RESULTS Patient preferences were largely consistent with integrated primary care models, particularly Primary Care Behavioral Health, with a few exceptions. Patients preferred longer appointments (e.g., 45-60 minutes) and a longer duration of treatment (e.g., ≥13 appointments) than is typically offered in primary care. Several variables, particularly education level, perceived need for help, anxiety symptom severity, and attitudes toward psychotherapy, were repeatedly associated with preferences for various anxiety treatment attributes. DISCUSSION Results from this study suggest that patients tend to have distinct preferences for anxiety treatment in primary care that are largely consistent with common integrated primary care models. Results also identify several variables that may be associated with specific preferences, which may help match patients to their preferred type of care. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Sasaki N, Obikane E, Vedanthan R, Imamura K, Cuijpers P, Shimazu T, Kamada M, Kawakami N, Nishi D. Implementation Outcome Scales for Digital Mental Health (iOSDMH): Scale Development and Cross-sectional Study. JMIR Form Res 2021; 5:e24332. [PMID: 34817391 PMCID: PMC8663479 DOI: 10.2196/24332] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/15/2021] [Accepted: 10/06/2021] [Indexed: 11/30/2022] Open
Abstract
Background Digital mental health interventions are being used more than ever for the prevention and treatment of psychological problems. Optimizing the implementation aspects of digital mental health is essential to deliver the program to populations in need, but there is a lack of validated implementation outcome measures for digital mental health interventions. Objective The primary aim of this study is to develop implementation outcome scales of digital mental health for different levels of stakeholders involved in the implementation process: users, providers, and managers or policy makers. The secondary aim is to validate the developed scale for users. Methods We developed English and Japanese versions of the implementation outcome scales for digital mental health (iOSDMH) based on the literature review and panel discussions with experts in implementation research and web-based psychotherapy. The study developed acceptability, appropriateness, feasibility, satisfaction, and harm as the outcome measures for users, providers, and managers or policy makers. We conducted evidence-based interventions via the internet using UTSMeD, a website for mental health information (N=200). Exploratory factor analysis (EFA) was conducted to assess the structural validity of the iOSDMH for users. Satisfaction, which consisted of a single item, was not included in the EFA. Results The iOSDMH was developed for users, providers, and managers or policy makers. The iOSDMH contains 19 items for users, 11 items for providers, and 14 items for managers or policy makers. Cronbach α coefficients indicated intermediate internal consistency for acceptability (α=.665) but high consistency for appropriateness (α=.776), feasibility (α=.832), and harm (α=.777) of the iOSDMH for users. EFA revealed 3-factor structures, indicating acceptability and appropriateness as close concepts. Despite the similarity between these 2 concepts, we inferred that acceptability and appropriateness should be used as different factors, following previous studies. Conclusions We developed iOSDMH for users, providers, and managers. Psychometric assessment of the scales for users demonstrated acceptable reliability and validity. Evaluating the components of digital mental health implementation is a major step forward in implementation science.
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Affiliation(s)
- Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Erika Obikane
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Rajesh Vedanthan
- Department of Population Health, Grossman School of Medicine, New York University, New York, NY, United States
| | - Kotaro Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Taichi Shimazu
- Behavioral Science Division, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Masamitsu Kamada
- Department of Health and Social Behavior, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Norito Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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d’Arma A, Valle A, Di Tella S, Massaro D, Rovaris M, Baglio F, Marchetti A. A theory of mind training for people with multiple sclerosis: Development of a scale to assess the treatment acceptability. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02457-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Staats P, Deer T, Ottestad E, Erdek M, Spinner D, Gulati A. Understanding the role of patient preference in the treatment algorithm for chronic low back pain: results from a survey-based study. Pain Manag 2021; 12:371-382. [PMID: 34470473 DOI: 10.2217/pmt-2021-0011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Aims: Interventional pain treatments range from injections to established radiofrequency ablation techniques and finally neuromodulation. In addition to safety, efficacy and cost dominance, patient preference for type of treatment is important. Methods: Chronic pain patients (n = 129) completed a preference scale to determine which interventional pain management procedures they would prefer from among radiofrequency ablation, temporary (60-day) peripheral nerve stimulation (PNS), conventional PNS and spinal cord stimulation/dorsal root ganglion stimulation. A second survey (n = 347) specific to assessing the preference for radiofrequency ablation or temporary PNS treatment was completed by patients with low back pain. Results: On the basis of mean rank, temporary PNS percutaneously implanted for up to 60 days was the most preferred treatment compared with the other options presented (p = 0.002). Conclusions: Patient preference should be unbiased and considered as an independent variable for physician discussion in treatment options and future research.
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Affiliation(s)
| | - Timothy Deer
- West Virginia School of Medicine, Morgantown, WV 26506, USA
| | - Einar Ottestad
- Stanford University School of Medicine, Palo Alto, CA 94304, USA
| | - Michael Erdek
- Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - David Spinner
- Mount Sinai School of Medicine, New York, NY 10029, USA
| | - Amitabh Gulati
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
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Bérubé M, Dupuis S, Leduc S, Roy I, Côté C, Grzelak S, Clairoux S, Panic S, Lauzier F. Tapering Opioid Prescription Program for High-Risk Trauma Patients: A Pilot Randomized Controlled Trial. Pain Manag Nurs 2021; 23:142-150. [PMID: 34479822 DOI: 10.1016/j.pmn.2021.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 08/02/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Chronic opioid use has been documented in up to 20% of patients with traumatic injuries. Hence, we developed the Tapering Opioids Prescription Program for high-risk Trauma (TOPP-Trauma) patients. AIMS To assess the feasibility and acceptability of TOPP-Trauma, examine the feasibility of the research methods, and describe its potential efficacy in reducing long-term opioid use. DESIGN A two-arm pilot randomized controlled trial. METHODS Fifty participants discharged home were assigned to TOPP-Trauma or an educational pamphlet. Feasibility was assessed based on ability to provide the program components. The acceptability was assessed with the Treatment Acceptability and Preference Questionnaire. The feasibility of the research methods was evaluated according to standard parameters. Self-reported morphine equivalent dose (MED) and MEDs supplied by pharmacies were measured at 6 and 12 weeks. RESULTS Eighty percent or more of TOPP-Trauma components were delivered as planned, and the program was deemed highly acceptable. Approximately 10% of screened patients were eligible. Eighty-five percent of eligible patients agreed to participate with 20% attrition rates. TOPP-Trauma participants used less MED/day compared to the control group at 6 and 12 weeks (1.2. vs. 12.2 mg; 0.4. vs 4.0 mg), and pharmacies supplied less than half of cumulative MEDs to those who received the program at 12 weeks, but the differences were not statistically significant. CONCLUSIONS Some challenges need to be addressed before testing TOPP-Trauma. These include creating strategies to decrease attrition, offering the program throughout the care continuum to higher risk patients, and evaluating the impacts of reduced opioid use.
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Affiliation(s)
- Mélanie Bérubé
- Research Center of the CHU de Québec-Université Laval, Population Health and Optimal Practices Research Unit (Trauma-Emergency-Critical Care Medicine), Quebec City, Canada; Faculty of Nursing, Université Laval, Quebec City, Canada.
| | - Sébastien Dupuis
- Pharmacy Department, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal, Montreal, Canada
| | - Stéphane Leduc
- Orthopaedic Department, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal, Montreal, Canada
| | - Isabel Roy
- Trauma Program, Hôpital du Sacré-Cœur de Montréal, 5400 Boulevard Gouin, Monteal, Canada
| | - Caroline Côté
- Research Center of the CHU de Québec-Université Laval, Population Health and Optimal Practices Research Unit (Trauma-Emergency-Critical Care Medicine), Quebec City, Canada; Faculty of Nursing, Université Laval, Quebec City, Canada
| | - Sonia Grzelak
- Research Center of the CHU de Québec-Université Laval, Population Health and Optimal Practices Research Unit (Trauma-Emergency-Critical Care Medicine), Quebec City, Canada; Faculty of Nursing, Université Laval, Quebec City, Canada
| | - Sarah Clairoux
- Pharmacy Department, Centre Intégré Universitaire de Santé et de Services Sociaux du Nord-de-l'Île-de-Montréal, Montreal, Canada
| | - Stéphane Panic
- Trauma Program, Hôpital du Sacré-Cœur de Montréal, 5400 Boulevard Gouin, Monteal, Canada
| | - François Lauzier
- Research Center of the CHU de Québec-Université Laval, Population Health and Optimal Practices Research Unit (Trauma-Emergency-Critical Care Medicine), Quebec City, Canada
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Martorella G, Hanley AW, Pickett SM, Gelinas C. Web- and Mindfulness-Based Intervention to Prevent Chronic Pain After Cardiac Surgery: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e30951. [PMID: 34459749 PMCID: PMC8438614 DOI: 10.2196/30951] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 07/05/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cardiac surgery is a frequently performed procedure. However, pain after cardiac surgery may become chronic (lasting >3 months) in adults. Once discharged from the hospital, patients are at greater risk of developing chronic postsurgical pain (CPSP) and of prolonged opioid use, as they need to self-manage their pain. Psychological risk and protective factors such as pain-related catastrophic thoughts and pain acceptance determine their ability to cope and their use of opioids, which is crucial for self-management of pain. Studies on mindfulness-based cognitive therapy (MBCT) have multiplied their potential effects on pain acceptance and catastrophic thoughts. However, web-based MBCT for the prevention of CPSP has not yet been examined. OBJECTIVE The aim of this study is to pilot test a 4-week-long web-based MBCT intervention for adults following discharge from the hospital by assessing the acceptability or feasibility of the intervention and examining preliminary effects on pain intensity, pain interference with activities and opioid use, and pain acceptance and catastrophic thoughts in the 6 months following surgery. METHODS A double-blinded pilot randomized controlled trial will be used to assess a web-based MBCT intervention. Patients will be selected according to the following criteria: age ≥18 years; first-time elective cardiac surgery via a median sternotomy; worst pain in the past week score ≥4/10; ability to understand and complete questionnaires in English; and ability to use an electronic device such as a smartphone, computer, or tablet. After baseline measures, 32 participants will be randomized into two groups: one receiving both the brief, 4-week-long web-based MBCT intervention and usual care (experimental group) and the other receiving only one standardized, web-based educational session with weekly reminders and usual care (attention control group). Peer-reviewed competitive funding was received from Florida State University's Council on Research & Creativity in January 2021, as well as research ethics approval from Florida State University's institutional review board. RESULTS Recruitment began in June 2021. Unfortunately, because of the current COVID-19 pandemic, recruitment is not progressing as expected. Recruitment strategies are constantly monitored and updated according to latest data and restrictions surrounding the pandemic. CONCLUSIONS This research is significant because it targets the trajectory of CPSP, a leading cause of disability and opioid misuse. This is the first study to assess MBCT for the prevention of CPSP after cardiac surgery in the recovery phase. This approach is innovative because it promotes self-management of pain through the modulation of individual factors. If successful, the intervention could be expanded to numerous populations at risk of chronic pain. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/30951.
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Affiliation(s)
- Geraldine Martorella
- Tallahassee Memorial Healthcare Center for Research and Evidence-Based Practice, College of Nursing, Florida State University, Tallahassee, FL, United States
| | - Adam W Hanley
- Center on Mindfulness and Integrative Health Intervention Development, College of Social Work, University of Utah, Salt Lake City, UT, United States
| | - Scott M Pickett
- Department of Behavioral Sciences and Social Medicine, Center for Translational Behavioral Science, College of Medicine, Florida State University, Tallahassee, FL, United States
| | - Céline Gelinas
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
- Centre for Nursing Research, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada
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Chen JO, Chang SC, Lin CC. The development and pilot testing of an ACP simulation-based communication-training program: Feasibility and acceptability. PLoS One 2021; 16:e0254982. [PMID: 34428209 PMCID: PMC8384223 DOI: 10.1371/journal.pone.0254982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 07/07/2021] [Indexed: 11/19/2022] Open
Abstract
The lack of knowledge of advance care planning and training of communication skills among nurses in Taiwan is one of the main reasons for the low rate of advance directive signing. However, there is no specific and effective solution to this problem. The purposes of this study were (1) to develop and pilot testing of an advance care planning simulation-based communication training program and (2) to evaluate the feasibility and acceptability of the program. This study was conducted in three phases. Phase 1: Developing an advance care planning simulation-based communication training program; Phase 2: Conducting a pilot test; Phase 3: Evaluating the feasibility and acceptability of the program. Twelve convenient participants from a medical center in central Taiwan were selected. The participants believed that team-based learning was beneficial for several reasons. First, it helped to clarify the participants’ understanding of advance care planning and improve their communication skills. Second, role-playing, as one of the components, was helpful for discovering their own shortcomings in communication skills while debriefing enabled them to identify their blind spots in the communication process. Finally, the reflection log documented their weekly performance so they were able to reflect upon their weekly performance, improve their performance, and become more confident. All twelve participants signed the consent form and completed the whole training program. The participants were satisfied with the program, affirming that the timing and content of the program were appropriate and that the expected learning outcomes could be achieved. According to participant feedback, the program was beneficial in improving their knowledge of advance care planning and confidence in communication. Thus, it is feasible and acceptable to introduce communication of advance care planning programs into the staff training protocols of healthcare organizations. Clinical trial registration:NCT04312295.
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Affiliation(s)
- Jui-O Chen
- Department of Nursing, Tajen University, Pingtung County, Kaohsiung, Taiwan
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Chen Chang
- Department of Nursing, Changhua Christian Hospital, Changhua, Taiwan
- College of Nursing and Health Sciences, Dayeh University, Changhua, Taiwan
| | - Chiu-Chu Lin
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Renal Care, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
- * E-mail:
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Santos GC, Liljeroos M, Hullin R, Denhaerynck K, Wicht J, Jurgens CY, Schäfer-Keller P. SYMPERHEART: an intervention to support symptom perception in persons with heart failure and their informal caregiver: a feasibility quasi-experimental study protocol. BMJ Open 2021; 11:e052208. [PMID: 34315799 PMCID: PMC8317123 DOI: 10.1136/bmjopen-2021-052208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Symptom perception in heart failure (HF) has been identified as crucial for effective self-care, and is related to patient and health system outcomes. There is uncertainty regarding the feasibility and acceptability of symptom perception support and doubts regarding how to include informal caregivers. This study aims to test the feasibility, acceptability and outcome responsiveness of an intervention supporting symptom perception in persons with HF and their informal caregiver. METHODS AND ANALYSIS A feasibility study with a quasi-experimental pretest and post-test single group design is conducted. The convenience sample consists of 30 persons with HF, their informal caregivers and six nurses. SYMPERHEART is an evidence-informed intervention that targets symptom perception by educational and support components. Feasibility is measured by time-to-recruit; time-to-deliver; eligibility rate; intervention delivery fidelity rate. Acceptability is measured by rate of consent, retention rate, treatment acceptability and the engagement in the intervention components. Outcome responsiveness includes: HF self-care (via the Self-care of Heart Failure Index V.7.2); perception of HF symptom burden (via the Heart Failure Somatic Perception Scale V.3); health status (via the Kansas City Cardiomyopathy Questionnaire-12); caregivers' contribution to HF self-care (via the Caregiver Contribution to Self-Care of Heart Failure Index 2); caregivers' burden (via the Zarit Burden Interview). Clinical outcomes include HF events, hospitalisation reason and length of hospital stay. Descriptive statistics will be used to report feasibility, acceptability, patient-reported outcomes (PRO) and clinical outcomes. PRO and caregiver-reported outcome responsiveness will be reported with mean absolute change and effect sizes. ETHICS AND DISSEMINATION The study is conducted according to the Declaration of Helsinki. The Human Research Ethics Committee of the Canton of Vaud, Switzerland, has approved the study. Written informed consent from persons with HF and informal caregivers are obtained. Results will be published via peer reviewed and professional journals, and further disseminated via congresses. TRIAL REGISTRATION NUMBER ISRCTN18151041.
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Affiliation(s)
- Gabrielle Cécile Santos
- School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
- Institute of Higher Education and Research in Healthcare, University of Lausanne Faculty of Biology and Medicine, Lausanne, Switzerland
| | - Maria Liljeroos
- Department of Health, Medicine and Caring Sciences, Linköping University, Linkoping, Sweden
- Centre for Clinical Research Sörmland, Uppsala University, Eskilstuna, Sweden
| | - Roger Hullin
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
- Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Kris Denhaerynck
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland
| | - Justine Wicht
- Service d'Aide et de Soins à Domicile de la Sarine, Fribourg, Switzerland
| | - Corrine Y Jurgens
- William F. Connell School of Nursing, Boston College, Chestnut Hill, Massachusetts, USA
| | - Petra Schäfer-Keller
- School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
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Fox MT, Sidani S, Butler JI, Skinner MW, Macdonald M, Durocher E, Hunter KF, Wagg A, Weeks LE, MacLeod A, Dahlke S. Optimizing hospital-to-home transitions for older persons in rural communities: a participatory, multimethod study protocol. Implement Sci Commun 2021; 2:81. [PMID: 34294145 PMCID: PMC8295643 DOI: 10.1186/s43058-021-00179-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/27/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Transitional care involves time-limited interventions focusing on the continuity of care from hospital to home, to optimize patient functioning and management. Providing interventions, as part of transitional care, that optimize the functioning of older people with dementia is critical due to the small window of opportunity in which they can return to their baseline levels of functioning. Yet prior research on transitional care has not included interventions focused on functioning and did not target older people with dementia in rural communities, limiting the applicability of transitional care to this population. Accordingly, the goal of this study is to align hospital-to-home transitional care with the function-related needs of older people with dementia and their family-caregivers in rural communities. METHODS In this multimethod study, two phases of activities are planned in rural Ontario and Nova Scotia. In phase I, a purposive sample of 15-20 people with dementia and 15-20 family-caregivers in each province will rate the acceptability of six evidence-based interventions and participate in semi-structured interviews to explore the interventions' acceptability and, where relevant, how to improve their acceptability. Acceptable interventions will be further examined in phase II, in which a purposive sample of healthcare providers, stratified by employment location (hospital vs. homecare) and role (clinician vs. decision-maker), will (1) rate the acceptability of the interventions and (2) participate in semi-structured focus group discussions on the facilitators and barriers to delivering the interventions, and suggestions to enable their incorporation into rural transitional care. Two to three focus groups per stratum (8-10 healthcare providers per focus group) will be held for a total of 8-12 focus groups per province. Data analysis will involve qualitative content analysis of interview and focus group discussions and descriptive statistics of intervention acceptability ratings. DISCUSSION Findings will (1) include a set of acceptable interventions for rural transitional care that promote older patients' functioning and family-caregivers' ability to support patients' functioning, (2) identify resources needed to incorporate the interventions into rural transitional care, and (3) provide high-quality evidence to inform new transitional care practices and policies and guide future research.
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Affiliation(s)
- Mary T. Fox
- School of Nursing, Faculty of Health, York University Centre for Aging Research and Education, York University, HNES suite 343, 4700 Keele St, Toronto, Ontario M3J 1P3 Canada
| | - Souraya Sidani
- School of Nursing, Faculty of Community Services, Ryerson University, 350 Victoria Street, Toronto, Ontario M5B 2K3 Canada
| | - Jeffrey I. Butler
- School of Nursing, York University Centre for Aging Research and Education, Faculty of Health, York University, HNES suite 343, 4700 Keele Street, Toronto, Ontario M3J 1P3 Canada
| | - Mark W. Skinner
- Trent School of the Environment, Trent University, 1600 West Bank Drive, Peterborough, Ontario K9L 0G2 Canada
| | - Marilyn Macdonald
- School of Nursing, Dalhousie University, Room 130, Forrest Bldg., PO Box 15000, 5869 University Avenue, Halifax, Nova Scotia B3H 4R2 Canada
| | - Evelyne Durocher
- School of Rehabilitation Science, Institute of Applied Health Sciences, Faculty of Health Sciences, McMaster University, Room 428, 1400 Main St. W, Hamilton, Ontario L8S 1C7 Canada
| | - Kathleen F. Hunter
- Faculty of Nursing, University of Alberta, 5-293 Edmonton Clinic Health Academy 11405-87 Ave NW, Edmonton, Alberta T6G 1C9 Canada
| | - Adrian Wagg
- Department of Geriatric Medicine, University of Alberta, 1-198 Clinical Sciences Building, Edmonton, Canada
| | - Lori E. Weeks
- School of Nursing, Dalhousie University, Room G30, Forrest Bldg. PO Box 15000, Halifax, Nova Scotia B3H 4R2 Canada
| | - Ann MacLeod
- Trent/Fleming School of Nursing, Trent University, 1600 West Bank Drive, Peterborough, Ontario K9L 0G2 Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy 11405-87 Ave NW, Edmonton, Alberta T6G 1C9 Canada
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Munro N, Baker E, Masso S, Carson L, Lee T, Wong AMY, Stokes SF. Vocabulary Acquisition and Usage for Late Talkers Treatment: Effect on Expressive Vocabulary and Phonology. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:2682-2697. [PMID: 34098725 DOI: 10.1044/2021_jslhr-20-00680] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose This study examined the effect of Vocabulary Acquisition and Usage for Late Talkers (VAULT) treatment on toddlers' expressive vocabulary and phonology. Parent acceptability of VAULT treatment was also considered. Method We used a nonconcurrent multiple baseline single case experimental design with three late talking toddlers aged 21-25 months. The treatment was delivered twice weekly in 30-min sessions for 8 weeks by a rotating team of four speech-language pathologists. Toddlers heard three of their 10 strategically selected target words a minimum of 64 times in play activities each session. Expressive vocabulary and phonology was assessed pre-post, with parent interviews conducted posttreatment. Results All toddlers increased production of target words and expressive vocabulary. Ambient expressive vocabulary size increased by an average of 16 words per week (range of 73-169 words learned over the treatment period). On a 20-item, single-word speech assessment, the toddlers' phonetic inventories increased on average from three to seven consonants, and five to eight vowels. Two toddlers used protowords pretreatment, which were replaced by recognizable attempts at words posttreatment. Parents reported the treatment was acceptable for the child and their family with future consideration of parent-based delivery of the treatment in the home. Conclusions The results of this treatment provide further evidence of a model of intervention informed by the principles of implicit learning, and the interconnectedness of phonological and lexical learning. Investigation is required to establish the efficacy and feasibility of VAULT in clinical contexts. Supplemental Material https://doi.org/10.23641/asha.14714733.
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Affiliation(s)
- Natalie Munro
- The University of Sydney, New South Wales, Australia
| | - Elise Baker
- The University of Sydney, New South Wales, Australia
- Western Sydney University, Penrith, New South Wales, Australia
- South Western Sydney Local Health District Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Sarah Masso
- The University of Sydney, New South Wales, Australia
- Charles Sturt University, Bathurst, New South Wales, Australia
| | - Lynn Carson
- The University of Sydney, New South Wales, Australia
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Peterson BS, West AE, Weisz JR, Mack WJ, Kipke MD, Findling RL, Mittman BS, Bansal R, Piantadosi S, Takata G, Koebnick C, Ashen C, Snowdy C, Poulsen M, Arora BK, Allem CM, Perez M, Marcy SN, Hudson BO, Chan SH, Weersing R. A Sequential Multiple Assignment Randomized Trial (SMART) study of medication and CBT sequencing in the treatment of pediatric anxiety disorders. BMC Psychiatry 2021; 21:323. [PMID: 34193105 PMCID: PMC8243307 DOI: 10.1186/s12888-021-03314-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/04/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Treatment of a child who has an anxiety disorder usually begins with the question of which treatment to start first, medication or psychotherapy. Both have strong empirical support, but few studies have compared their effectiveness head-to-head, and none has investigated what to do if the treatment tried first isn't working well-whether to optimize the treatment already begun or to add the other treatment. METHODS This is a single-blind Sequential Multiple Assignment Randomized Trial (SMART) of 24 weeks duration with two levels of randomization, one in each of two 12-week stages. In Stage 1, children will be randomized to fluoxetine or Coping Cat Cognitive Behavioral Therapy (CBT). In Stage 2, remitters will continue maintenance-level therapy with the single-modality treatment received in Stage 1. Non-remitters during the first 12 weeks of treatment will be randomized to either [1] optimization of their Stage 1 treatment, or [2] optimization of Stage 1 treatment and addition of the other intervention. After the 24-week trial, we will follow participants during open, naturalistic treatment to assess the durability of study treatment effects. Patients, 8-17 years of age who are diagnosed with an anxiety disorder, will be recruited and treated within 9 large clinical sites throughout greater Los Angeles. They will be predominantly underserved, ethnic minorities. The primary outcome measure will be the self-report score on the 41-item youth SCARED (Screen for Child Anxiety Related Disorders). An intent-to-treat analysis will compare youth randomized to fluoxetine first versus those randomized to CBT first ("Main Effect 1"). Then, among Stage 1 non-remitters, we will compare non-remitters randomized to optimization of their Stage 1 monotherapy versus non-remitters randomized to combination treatment ("Main Effect 2"). The interaction of these main effects will assess whether one of the 4 treatment sequences (CBT➔CBT; CBT➔med; med➔med; med➔CBT) in non-remitters is significantly better or worse than predicted from main effects alone. DISCUSSION Findings from this SMART study will identify treatment sequences that optimize outcomes in ethnically diverse pediatric patients from underserved low- and middle-income households who have anxiety disorders. TRIAL REGISTRATION This protocol, version 1.0, was registered in ClinicalTrials.gov on February 17, 2021 with Identifier: NCT04760275 .
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Affiliation(s)
- Bradley S. Peterson
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Psychiatry, Keck School of Medicine at The University of Southern California, Los Angeles, USA
| | - Amy E. West
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - John R. Weisz
- grid.38142.3c000000041936754XDepartment of Psychology, Harvard University, Cambridge, USA
| | - Wendy J. Mack
- grid.42505.360000 0001 2156 6853Department of Preventive Medicine, Keck School of Medicine at The University of Southern California, Los Angeles, USA
| | - Michele D. Kipke
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA ,grid.42505.360000 0001 2156 6853Department of Preventive Medicine, Keck School of Medicine at The University of Southern California, Los Angeles, USA
| | - Robert L. Findling
- grid.224260.00000 0004 0458 8737Virginia Commonwealth University, Richmond, USA
| | - Brian S. Mittman
- grid.414895.50000 0004 0445 1191Department of Research & Evaluation, Kaiser Permanente, Los Angeles, USA
| | - Ravi Bansal
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - Steven Piantadosi
- grid.38142.3c000000041936754XBrigham And Women’s Hospital, Harvard Medical School, Boston, USA
| | - Glenn Takata
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - Corinna Koebnick
- grid.414895.50000 0004 0445 1191Department of Research & Evaluation, Kaiser Permanente, Los Angeles, USA
| | - Ceth Ashen
- Children’s Bureau of Southern California, Los Angeles, USA
| | - Christopher Snowdy
- grid.42505.360000 0001 2156 6853Department of Psychiatry, Keck School of Medicine at The University of Southern California, Los Angeles, USA
| | - Marie Poulsen
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - Bhavana Kumar Arora
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - Courtney M. Allem
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA
| | - Marisa Perez
- Hathaway-Sycamores Child and Family Services, Altadena, USA
| | - Stephanie N. Marcy
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | - Bradley O. Hudson
- grid.239546.f0000 0001 2153 6013Children’s Hospital Los Angeles, Los Angeles, CA USA ,grid.42505.360000 0001 2156 6853Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, USA
| | | | - Robin Weersing
- grid.263081.e0000 0001 0790 1491SDSU-UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University, San Diego, USA
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Oberoi D, McLennan A, Piedalue KA, Wayne PM, Jones JM, Carlson LE. Factors Influencing Preference for Intervention in a Comparative Effectiveness Trial of Mindfulness-Based Cancer Recovery and Tai Chi/ Qigong in Cancer Survivors. J Altern Complement Med 2021; 27:423-433. [PMID: 33902334 DOI: 10.1089/acm.2020.0400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2022] Open
Abstract
Introduction: An important gap between randomized efficacy research and real-world implementation of complementary therapies is the role of patient preferences in influencing engagement and outcome. Several studies have highlighted the benefits of patient preference on health outcomes, but few have investigated the factors associated with preference for interventions, which may be critical to assure the success of program implementation. The current study sought to explore the factors associated with patient preference in an ongoing randomized preference-based trial of Mindfulness-Based Cancer Recovery (MBCR) versus Tai Chi/qigong (TCQ) (the Mindfulness and Tai Chi/qigong in Cancer Health [MATCH] study). Materials and Methods: A multi-method study design was used. A subsample of participants were purposely selected from the ongoing MATCH study to have representation from both intervention arms and from both men and women across different age groups. Open-ended, semi-structured qualitative interviews were conducted to explore the factors influencing initial patient preference. Interviews were transcribed verbatim and analyzed by using inductive thematic analysis. The treatment acceptability and preference measure was administered to determine patients' ratings of acceptability and credibility of both preferred and nonpreferred interventions. Results: A total of 13 participants were interviewed prior to program attendance, with 8 (62%) preferring TCQ and 5 (38%) choosing MBCR. Major themes related to patients' preference for intervention included: (1) expectations about the preferred intervention; (2) knowledge of the intervention; (3) past experiences with the intervention; and (4) self-efficacy. Participants' mean treatment acceptability scores were higher for their preferred program than their nonpreferred program. Conclusion: Understanding the factors that influence cancer survivors' preference for mind-body interventions can augment health care providers' knowledge of the barriers and facilitators for successful implementation of interventions in clinical settings, as well as help patients make informed treatment decisions and improve satisfaction and outcomes. Clinical trial registration no.: NCT03641222.
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Affiliation(s)
- Devesh Oberoi
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Andrew McLennan
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Katherine-Ann Piedalue
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Peter M Wayne
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA
| | - Jennifer M Jones
- Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer Centre, Toronto, Canada
| | - Linda E Carlson
- Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
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den Hertog R, Niessen T. Taking into account patient preferences in personalised care: Blending types of nursing knowledge in evidence-based practice. J Clin Nurs 2021; 30:1904-1915. [PMID: 33763940 DOI: 10.1111/jocn.15743] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 12/11/2020] [Accepted: 03/01/2021] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To explore how excellent nurses in hospitals take into account patient preferences in nursing decision-making in the evidence-based practice towards personalised care. BACKGROUND In evidence-based practice, nursing decision-making is based on scientific evidence, evidence of best practice and individual patient preferences. Little is known about how nurses in hospitals take into account patient preferences in nursing decision-making. DESIGN Qualitative grounded theory. METHODS Data collection entailed 27 semi-structured interviews with nurses designated by their colleagues as excellent caregivers, followed by 57 hours of participant observation. Data analysis was conducted using three-level coding with constant comparison and theoretical sampling. The COREQ checklist for qualitative research was followed. RESULTS A main finding was that participants used three implicit tools to discover patient preferences: establishing a connection, using antennae and asking empathic questions, thus instantly reassuring patients from the very first contact. Their starting point in care was the patient's perception of quality of life wherein they shifted towards their patient's perspective: "Teach me to provide the best care for you in this situation." During the observations, it was confirmed that the excellent nurses behaved as they had described before. CONCLUSION Excellent nurses actively turn towards patients' expectations and experienced quality of life by carefully blending individual sensitive and situation specific patient preferences with scientific evidence and evidence of best practice. In doing so, they are able to balancing more equally patient preferences in to the equation called evidence-based practice, thus leading to wise decision-making in personalised nursing care. RELEVANCE TO CLINICAL PRACTICE Patient preferences become a fully fledged part of nursing decision-making in EBP when in education and practice, the implicit knowledge of excellent nurses about how to take into account patient preferences to provide personalised care is more valued and taught.
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Affiliation(s)
- Ria den Hertog
- Department of Healthcare/nursing, Christian University of Applied Sciences, Ede, The Netherlands
| | - Theo Niessen
- Department of Healthcare/nursing, Fontys University of Applied Sciences, Eindhoven, The Netherlands
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Bernard S, Frenette AG, McLean L, Noël P, Froment MA, Hébert LJ, Moffet H. Reliability of ultrasound imaging of pelvic floor morphology and function among females who have undergone pelvic radiotherapy. Neurourol Urodyn 2021; 40:1001-1010. [PMID: 33739537 DOI: 10.1002/nau.24656] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/03/2021] [Accepted: 03/02/2021] [Indexed: 12/27/2022]
Abstract
AIMS To investigate the intra- and inter-rater reliability of two-dimensional (2D) transperineal ultrasound imaging (USI) measures of bladder wall thickness (BWT), urethral length (UL), and parameters related to levator plate length (LP) and transient changes in LP during pelvic floor muscle (PFM) contraction, and on Valsalva in women who received radiation therapy (RT) for treatment of pelvic cancer. METHODS Twenty women with a history of RT for the treatment of pelvic cancer were assessed independently by two raters on the same day. Five outcomes were assessed for reliability: BWT, UL, and LP at rest (LP-R), during a maximal voluntary contraction of the PFMs (LP-MVC), and during a maximal-effort Valsalva maneuver (LP-MVM). Reliability was determined using intra-class correlation coefficients (ICC) and Bland-Altman analyses. Measurement error was determined using standard error of the measurement (SEM) and minimal detectable difference. RESULTS Intra-rater reliability was very good for LP-R, LP-MVC, LP-MVM, and UL (ICC: 0.97 [0.93-0.99], 0.95 [0.88-0.98], 0.84 [0.59-0.94], and 0.96 [0.89-0.98], respectively). Inter-rater reliability was very good for LP-R (ICC: 0.82 [0.55-0.93]), and good for LP-MVC, LP-MVM, and UL (ICC: 0.79 [0.46-0.92], 0.79 [0.49-0.92], and 0.75 [0.36-0.90], respectively). BWT had poor intra- and inter-rater reliability. The variability between measurements was the smallest for LP-R, LP-MVC, and UL for intra-rater assessments, and for LP-R and UL for inter-rater assessments. SEM values for intra-rater assessments were LP-R: 1.5 mm, LP-MVC: 1.84 mm, LP-MVM: 4.33 mm, and UL: 1.16 mm. CONCLUSIONS Although these results support the reliability of 2D-transperineal USI for the evaluation of UL and PFM parameters, they do not support its use for the assessment of BWT.
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Affiliation(s)
- Stéphanie Bernard
- Department of Rehabilitation, Faculté de Médecine, Université Laval, Québec, Québec, Canada
| | - Anne-Gabrielle Frenette
- Departments of Radiology and Radiation Oncology, Centre Hospitalier Université de Québec, Hôtel-Dieu de Québec, Université Laval, Québec, Québec, Canada
| | - Linda McLean
- Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Patricia Noël
- Departments of Radiology and Radiation Oncology, Centre Hospitalier Université de Québec, Hôtel-Dieu de Québec, Université Laval, Québec, Québec, Canada
| | - Marie-Anne Froment
- Departments of Radiology and Radiation Oncology, Centre Hospitalier Université de Québec, Hôtel-Dieu de Québec, Université Laval, Québec, Québec, Canada
| | - Luc J Hébert
- Department of Rehabilitation, Faculté de Médecine, Université Laval, Québec, Québec, Canada
| | - Hélène Moffet
- Department of Rehabilitation, Faculté de Médecine, Université Laval, Québec, Québec, Canada
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Martorella G, McDougall GJ. Barriers and Facilitators to the Prevention of Chronic Pain in the Subacute Phase After Cardiac Surgery. Pain Manag Nurs 2021; 22:28-35. [PMID: 33189543 PMCID: PMC10673644 DOI: 10.1016/j.pmn.2020.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/01/2020] [Accepted: 09/09/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND Although a transitional approach promoting continuity of care is warranted to prevent chronic post-surgical pain (CPSP) and opioid misuse, there is limited research examining interventions targeting the subacute phase after cardiac surgery. Contextual multi-level factors may explain this scarcity. AIMS The purpose of this study was to explore the potential implementation of a nursing intervention to prevent CPSP in the subacute phase by describing nurses' viewpoints of current barriers and facilitators. DESIGN A descriptive qualitative study was conducted using secondary data analysis. SETTINGS A Web-based survey was used along with in-person interviews. PARTICIPANTS 75 perioperative nurses. METHODS Qualitative data from individual interviews (n=10) and open-ended responses to a survey (n=65) regarding the intervention's acceptability were used. Content analysis was conducted using a deductive approach. RESULTS The introduction of nurses from various clinical settings to a new intervention allowed reflection on current practice and represented a shift toward a preventive approach. The main barrier expressed was the lack of communication and continuity of care between clinical settings. Several policy implications were outlined such as increasing the involvement of rehabilitation programs and strengthening collaboration between pain specialists and primary care providers. CONCLUSIONS Based on perceptions of nurses involved at different stages of the continuum, the findings provide a preliminary picture of clinical challenges and potential avenues for the prevention of CPSP in the subacute phase after cardiac surgery. An expanded pain management nursing role in primary care would allow earlier interventions and contribute to the prevention of CPSP for a tremendous number of patients undergoing surgeries.
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50
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Kourouma KR, Yaméogo WME, Doukouré D, Agbré Yacé ML, Tano Kamelan A, Coulibaly-Koné SA, Millogo T, Kouanda S. Feasibility study on the adoption of the WHO safe childbirth checklist by front-line healthcare providers and managers in Burkina Faso and Côte d'Ivoire. Pilot Feasibility Stud 2020; 6:150. [PMID: 33042570 PMCID: PMC7541264 DOI: 10.1186/s40814-020-00691-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 09/21/2020] [Indexed: 01/26/2023] Open
Abstract
Background The World Health Organization Safe Childbirth Checklist tool was specifically designed for developing countries such as sub-Saharan African countries, to ensure safety and security of the couple mother and newborn around the time of childbirth. However, the implementation of the Safe Childbirth Checklist tool requires a good knowledge of the context setting to face challenges. Our study objectives were (1) to assess the acceptability of the WHO SCC tool and (2) to identify conditions and strategies for a better introduction and use of the WHO SSC tool. Methods This was a pilot multi-country study conducted from January to March 2019 in Burkina Faso and Côte d’Ivoire, respectively, in the health regions of central-North and Agnéby-Tiassa-Mé. In each health region, 5 health facilities of different levels within the health system pyramid were selected through a purposive sampling. The study was conducted in 2 phases: 38 healthcare providers and 15 managers were first trained to use the Safe Childbirth Checklist tool; secondly, the trained providers were allowed to use the tool in real-life conditions for 2 weeks. Then, semi-structured interviews were conducted among healthcare providers and managers. The topics covered by the interview guides were acceptability of the tool, barriers and facilitators to its use, as well as strategies for better introduction and use within the healthcare system. Analysis was carried out using the Nvivo 12 software. Results Respondents reported an overall good acceptance of using the tool. However, they suggested minor content adaptation. The design of the tool and increased workload were the main barriers to its use. Potential facilitators to its introduction were managers’ commitment, healthcare providers’ motivation, and the availability of supplies. The best strategies for optimal use were its attachment to existing tool such as partograph or/and its display in the maternity ward. Conclusions The findings showed that the implementation of the Safe Childbirth Checklist tool is acceptable in Burkina Faso and Côte d’Ivoire. These findings are important and will help to design a trial aiming at assessing the effectiveness of the tool WHO SCC tool in these two countries.
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Affiliation(s)
- Kadidiatou Raissa Kourouma
- Institut National de Santé Publique/Cellule de Recherche en Santé de la Reproduction, Abidjan, Côte d'Ivoire
| | | | - Daouda Doukouré
- Institut National de Santé Publique/Cellule de Recherche en Santé de la Reproduction, Abidjan, Côte d'Ivoire
| | - Marie Laurette Agbré Yacé
- Institut National de Santé Publique/Cellule de Recherche en Santé de la Reproduction, Abidjan, Côte d'Ivoire
| | - Akoua Tano Kamelan
- Institut National de Santé Publique/Cellule de Recherche en Santé de la Reproduction, Abidjan, Côte d'Ivoire
| | | | - Tiéba Millogo
- Institut Africain de Santé Publique/Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
| | - Séni Kouanda
- Institut Africain de Santé Publique/Institut de Recherche en Sciences de la Santé, Ouagadougou, Burkina Faso
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