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McLeay SG, Mathews T, Leeza Struwe. Psychoeducation group facilitation training for nurses: A quality improvement project. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2024; 37:e12476. [PMID: 39039576 DOI: 10.1111/jcap.12476] [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: 05/23/2023] [Revised: 07/03/2024] [Accepted: 07/06/2024] [Indexed: 07/24/2024]
Abstract
BACKGROUND According to the 2020-2021 National Survey of Children's Health, 23.3% of children and adolescents met criteria for one or more mental, emotional, developmental, or behavioral problems. However, the prevalence of depression, anxiety, and post traumatic stress disorder have risen dramatically since the COVID-19 pandemic, leading to an increase in suicidal ideations, completed suicides, and pediatric psychiatric hospitalizations. There is a critical need for high quality mental healthcare treatments, including psychoeducation. Inpatient psychiatric nurses are well positioned to lead psychoeducation groups, but few receive training. LOCAL PROBLEM Nurses at a designated inpatient pediatric psychiatric unit expressed discomfort in facilitating psychoeducation groups. METHODS This is a one-group prepost and follow-up quality improvement study designed to improve the quality of psychoeducation group facilitation skills provided by nurses at a child and adolescent inpatient psychiatric unit. A convenience sample of nurses (N = 16) participated. Baseline (T1), post-test (T2), and follow-up (T3) data were collected regarding nurses' self-efficacy, evidence based-practice attitudes, and knowledge of psychoeducation group facilitation. INTERVENTIONS Nurses received 45 min of psychoeducation group facilitation education and 15 min of skills simulation. RESULTS The nurses' knowledge, self-efficacy, and attitudes toward evidence-based practice when facilitating psychoeducation groups increased significantly from the baseline to the post-test, which was sustained from the post-test to the follow-up period. CONCLUSION Study findings indicate the importance of supporting nurses in their role of psychoeducation group facilitation through education and program structure. Further research is needed to assess longer term sustainability and efficacy in leading psychoeducation groups.
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Affiliation(s)
- Shanon G McLeay
- College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Therese Mathews
- College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Leeza Struwe
- College of Nursing, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Feinberg A, Gessner KH, Deal AM, Heiling HM, Myers S, Raynor MC, Milowsky MI, Wobker SE, Commander CW, Lazard AJ, Bjurlin MA, Smith AB, Johnson DC, Wallen EM, Kim WY, Tan HJ. Decisional Conflict Among Patients Newly Diagnosed With Clinical T1 Renal Masses: A Prospective Study. J Urol 2024; 212:320-330. [PMID: 38717916 PMCID: PMC11233232 DOI: 10.1097/ju.0000000000004023] [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: 08/23/2023] [Accepted: 04/25/2024] [Indexed: 05/21/2024]
Abstract
PURPOSE Because multiple management options exist for clinical T1 renal masses, patients may experience a state of uncertainty about the course of action to pursue (ie, decisional conflict). To better support patients, we examined patient, clinical, and decision-making factors associated with decisional conflict among patients newly diagnosed with clinical T1 renal masses suspicious for kidney cancer. MATERIALS AND METHODS From a prospective clinical trial, participants completed the Decisional Conflict Scale (DCS), scored 0 to 100 with < 25 associated with implementing decisions, at 2 time points during the initial decision-making period. The trial further characterized patient demographics, health status, tumor burden, and patient-centered communication, while a subcohort completed additional questionnaires on decision-making. Associations of patient, clinical, and decision-making factors with DCS scores were evaluated using generalized estimating equations to account for repeated measures per patient. RESULTS Of 274 enrollees, 250 completed a DCS survey; 74% had masses ≤ 4 cm in size, while 11% had high-complexity tumors. Model-based estimated mean DCS score across both time points was 17.6 (95% CI 16.0-19.3), though 50% reported a DCS score ≥ 25 at least once. On multivariable analysis, DCS scores increased with age (+2.64, 95% CI 1.04-4.23), high- vs low-complexity tumors (+6.50, 95% CI 0.35-12.65), and cystic vs solid masses (+9.78, 95% CI 5.27-14.28). Among decision-making factors, DCS scores decreased with higher self-efficacy (-3.31, 95% CI -5.77 to -0.86]) and information-seeking behavior (-4.44, 95% CI -7.32 to -1.56). DCS scores decreased with higher patient-centered communication scores (-8.89, 95% CI -11.85 to -5.94). CONCLUSIONS In addition to patient and clinical factors, decision-making factors and patient-centered communication relate with decisional conflict, highlighting potential avenues to better support patient decision-making for clinical T1 renal masses.
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Affiliation(s)
- Amir Feinberg
- Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kathryn H Gessner
- Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Allison M Deal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Hillary M Heiling
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Shannon Myers
- Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Mathew C Raynor
- Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Matthew I Milowsky
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Sara E Wobker
- Department of Pathology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Clayton W Commander
- Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Allison J Lazard
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Marc A Bjurlin
- Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Angela B Smith
- Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - David C Johnson
- Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Eric M Wallen
- Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - William Y Kim
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Division of Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Hung-Jui Tan
- Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Baier AL, Nugent S, Horton DM, Salameh H, Kehle-Forbes SM. Rates and reasons for veteran mental health service utilization following completion of evidence-based trauma-focused treatment for PTSD. Psychol Serv 2024; 21:560-568. [PMID: 37917477 PMCID: PMC11063117 DOI: 10.1037/ser0000815] [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] [Indexed: 11/04/2023]
Abstract
Despite the effectiveness of prolonged exposure (PE) and cognitive processing therapy (CPT) for posttraumatic stress disorder (PTSD) in reducing symptoms of PTSD and co-occurring symptoms, emerging research suggests continued mental health service utilization (MHSU) following the completion of these interventions. Reasons for continued MHSU remain unknown despite its relevance to PE/CPT outcomes and implementation. The present study employed a mixed methods approach to explore rates and reasons for VA MHSU post PE/CPT. A national sample of 5,634 U.S. veterans who completed either PE or CPT were identified to quantitatively determine the frequency, type, and location of MHSU in the 12 months following PE/CPT completion. A random subsample of 60 veterans completed semistructured qualitative interviews to explore reasons for MHSU post PE/CPT. Findings suggest high MHSU; 98.4% of veterans attended at least one mental health appointment in the year following completion of PE/CPT, with an average attending 27.64 appointments in the year following treatment completion. Qualitatively, veterans, particularly those with low-to-moderate residual symptoms, described a preference for additional treatment to continue practicing and applying skills learned in treatment. Veterans expressed low self-efficacy to maintain treatment gains without support and accountability from their therapists and viewed ongoing treatment as a safety net until they felt more confident in their skills and stability of gains. Veterans with high residual symptoms indicated needing additional PTSD-specific treatment or treatment for a co-occurring condition. Notably, some veterans reported no additional treatment needs, despite continued engagement in care. Evidence-based strategies for facilitating self-efficacy and ongoing application of PE/CPT principles posttreatment are needed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Allison L. Baier
- National Center for PTSD Women's Health Sciences Division at VA Boston Healthcare System, Boston, MA, USA
- Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA
| | - Sean Nugent
- Center for Care Delivery & Outcomes Research, Minneapolis VA Healthcare System, Minneapolis, MN, USA
| | - David M. Horton
- Center for Care Delivery & Outcomes Research, Minneapolis VA Healthcare System, Minneapolis, MN, USA
| | - Hope Salameh
- Center for Care Delivery & Outcomes Research, Minneapolis VA Healthcare System, Minneapolis, MN, USA
| | - Shannon M. Kehle-Forbes
- National Center for PTSD Women's Health Sciences Division at VA Boston Healthcare System, Boston, MA, USA
- Center for Care Delivery & Outcomes Research, Minneapolis VA Healthcare System, Minneapolis, MN, USA
- University of Minnesota, Department of Medicine, Minneapolis, MN, USA
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Ojeda VD, Groneman A, Hiller-Venegas S, Moreno M, Schuler B, Barksdale J, Berliant E, Romero N, Edwards TM, Lister Z, Gilmer T, Gaines T, Bazzi A. A randomized clinical trial testing a health literacy intervention to reduce disparities in access to care among Justice-Impacted Adults (JIA). HEALTH & JUSTICE 2024; 12:34. [PMID: 39083138 PMCID: PMC11290280 DOI: 10.1186/s40352-024-00284-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 06/20/2024] [Indexed: 08/03/2024]
Abstract
BACKGROUND Low health literacy is costly and observed among justice-impacted adults (JIA), a group that often faces numerous barriers in accessing healthcare and a disproportionate burden of illness. Health literacy interventions for JIA are critically needed to improve healthcare access and related outcomes. METHODS This manuscript describes the protocol for a longitudinal mixed-methods randomized clinical trial that assesses the effectiveness of a coach-guided health literacy intervention on JIA's healthcare access. The intervention was previously piloted with justice impacted adults. We will recruit 300 JIA ages 18 + in San Diego, California. Participants will be randomized 1:1 to the Treatment Group (i.e., coach-guided intervention providing 12 sessions of individualized health coaching and service navigation over 6 months) or the Control Group (i.e., self-study of the health coaching program, and brief service navigation support). We will quantitatively assess JIA's healthcare access defined as: use of healthcare, health insurance status, and regular source of care at 6-months as the primary outcomes. Participants will also be surveyed at 12-months. Statistical analyses will incorporate the intent-to-treat (ITT) principle and we will estimate mixed-effects logistic regression for the primary outcomes. We will also conduct qualitative interviews at 6 and 12-months with 40 purposively sampled participants, stratified by study arm, who reported healthcare access barriers at baseline. Interviews will explore participants' satisfaction with the intervention, healthcare attitudes, self-efficacy for and barriers to healthcare access over time, perceived contribution of the intervention to health and well-being, and diffusion of intervention-related information within participants' social networks. We will conduct deductive thematic analyses of qualitative data. DISCUSSION Low health literacy among JIA is a foundational challenge requiring tailored intervention strategies. Findings from this trial may inform policies and the structure of service delivery models to build health literacy among JIA in institutional and community settings throughout the United States and elsewhere. TRIAL REGISTRATION This study is registered with the United States' ClinicalTrials.gov registry under protocol # 161,903.
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Affiliation(s)
- Victoria D Ojeda
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA.
| | - Arthur Groneman
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Sarah Hiller-Venegas
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Melissa Moreno
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Briana Schuler
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Jerrica Barksdale
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Emily Berliant
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Natalie Romero
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Todd M Edwards
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Zephon Lister
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Todd Gilmer
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Tommi Gaines
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
| | - Angela Bazzi
- Herbert Wertheim School of Public Health, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0725, USA
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Reynolds K, Mueller S, Horn M. Predicting performance in a doctor of physical therapy gross anatomy course based on an exploratory factor analysis of the anatomical self-efficacy instrument. ANATOMICAL SCIENCES EDUCATION 2024. [PMID: 38984713 DOI: 10.1002/ase.2488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 06/23/2024] [Accepted: 06/24/2024] [Indexed: 07/11/2024]
Abstract
Measuring self-efficacy can be a valuable means for instructors to predict student performance. However, it is crucial to measure self-efficacy within specific contexts to effectively gauge students' perceptions of their capabilities. This study evaluated the factors comprising the Anatomical Self-Efficacy Instrument (ASEI) and determined whether these factors could predict performance in gross anatomy. Three cohorts of Doctor Physical Therapy (DPT) students completed the ASEI at the start of gross anatomy. An exploratory factor analysis (EFA) analyzed the ASEI's dimensionality, and Cronbach's alpha evaluated the internal consistency of the extracted factors. Linear regression was used to determine whether ASEI's total or subdomain scores predicted final anatomy course performance scores. In total, 142 of 287 (49.5%) DPT students completed the ASEI. EFA revealed three distinct factors, including "cognitive," "psychomotor," and "clinical anatomy self-efficacy", and explained 44.9%, 13.7%, and 5.2% of the total variance, respectively. Only cognitive self-efficacy predicted final gross anatomy course performance (β = 0.34; R2 = 0.071; F(3,138) = 3.51; p < 0.05). Overall, the ASEI's 3-factor solution implies its multidimensionality, a finding that could inform the development of more comprehensive self-efficacy measures. Notably, "cognitive self-efficacy" was the only subdomain that predicted DPT student performance in anatomy, suggesting its potential as a tool for identifying students in need of additional learning support. The ASEI's practical usability should be further explored through additional psychometric testing.
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Affiliation(s)
- Kelly Reynolds
- Doctor of Physical Therapy Division, Duke University School of Medicine, Durham, North Carolina, USA
| | - Shani Mueller
- Doctor of Physical Therapy Division, Duke University School of Medicine, Durham, North Carolina, USA
| | - Maggie Horn
- Doctor of Physical Therapy Division, Duke University School of Medicine, Durham, North Carolina, USA
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Mundt JM, Zee PC, Schuiling MD, Hakenjos AJ, Victorson DE, Fox RS, Dawson SC, Rogers AE, Ong JC. Development of a Mindfulness-Based Intervention for Narcolepsy: A Feasibility Study. Sleep 2024:zsae137. [PMID: 38895897 DOI: 10.1093/sleep/zsae137] [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: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
STUDY OBJECTIVES Mindfulness-based interventions (MBI) have been shown to improve psychosocial functioning in medical populations but have not been studied in narcolepsy. This study examined the feasibility and acceptability of an MBI that was adapted for narcolepsy, including three variations in program length. METHODS Adults with narcolepsy (N = 60) were randomized to MBI groups of varying durations: brief (4 weeks), standard (8 weeks), or extended (12 weeks). Participants completed assessments at baseline, 4 weeks, 8 weeks, and 12 weeks. To assess feasibility and acceptability, primary outcomes included attendance, meditation practice, and data completeness. Additionally, participants completed measures of mindfulness, self-compassion, mood, sleep, psychosocial functioning, and cognition. An effect size of Cohen's d ≥ 0.5 was used as the pre-specified benchmark for a minimal clinically important difference (MCID). RESULTS The attendance, meditation, and data completeness benchmarks were met by 71.7%, 61.7%, and 78.3% of participants, respectively. Higher proportions of the brief and extended groups met these benchmarks compared to the standard group. All groups met the MCID for mindfulness, self-compassion, self-efficacy for managing emotions, positive psychosocial impact, global mental health, and fatigue. Standard and extended groups met the MCID for anxiety and depression, and extended group met the MCID for additional measures including social and cognitive functioning, daytime sleepiness, hypersomnia symptoms, and hypersomnia-related functioning. CONCLUSION Results suggest that the remote delivery and data collection methods are feasible to employ in future clinical trials, and it appears that the extended MBI provides the most favorable clinical impact while maintaining attendance and engagement in meditation practice.
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Affiliation(s)
- Jennifer M Mundt
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Phyllis C Zee
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Matthew D Schuiling
- Department of Psychology, Indiana University Indianapolis, Indianapolis, IN, USA
| | - Alec J Hakenjos
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David E Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Rina S Fox
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Division of Advanced Nursing Practice and Science, University of Arizona College of Nursing, Tucson, AZ, USA
| | - Spencer C Dawson
- Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, IN, USA
| | - Ann E Rogers
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Jason C Ong
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Circadian and Sleep Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Nox Health, Inc., Alpharetta, GA, USA
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Li G, Su Q. Exploring the role of personal quantification in alleviating generalized anxiety disorder among Chinese PhD students: A cross-sectional study. Medicine (Baltimore) 2024; 103:e38449. [PMID: 38847731 PMCID: PMC11155607 DOI: 10.1097/md.0000000000038449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/10/2024] [Indexed: 06/10/2024] Open
Abstract
Personal quantification plays a crucial role in preserving individual mental health. However, in previous research, its effectiveness in alleviating generalized anxiety disorder (GAD) has not been conclusively established. This study explores the impact of personal quantification on GAD among PhD students. The research data was obtained through questionnaires distributed to 308 PhD students across universities in China. Among these students, 118 anxiety-free participants were excluded, yielding valuable data from 190 students with GADs. We employed Python programming language and SPSS software for the empirical analysis. The results illustrated that personal quantification significantly and negatively impacted GAD (β = -0.148, P = .002), concurrently producing a significantly positive effect on self-efficacy (β = 0.359, P < .001). Further analysis showed that through 5000 sampling iterations and a 95% confidence level, self-efficacy significantly reduced certain symptoms of GAD (β = -0.1183; P = .026; 95% Cl: -0.2222 to -0.0144). Moreover, when the coefficient of self-efficacy was significantly negative, the impact of personal quantification on GAD remained statistically significant (β = -0.1056; P = .033; 95% Cl: -0.2025 to -0.0087). The findings indicated that personal quantification has a significant role in alleviating GAD among PhD students, which is partly mediated through self-efficacy. This study contributes valuable insights to the nonpharmacological alleviation of GAD in Chinese PhD students.
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Affiliation(s)
- Guilong Li
- Business School, Central University of Finance and Economics, Beijing, China
- School of Business Administration, Xinjiang University of Finance & Economics, Urumqi, Xinjiang, China
| | - Qiulan Su
- Business School, Central University of Finance and Economics, Beijing, China
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Lally RM, Schmidt R, Kupzyk K, Wengel SP, Cordts KP, Mills AC, Richards SE. Implementing Longitudinal Wellbeing Interventions and Evaluation Among Midwestern Healthcare Workers During COVID-19. West J Nurs Res 2024; 46:296-306. [PMID: 38465618 DOI: 10.1177/01939459241237663] [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: 03/12/2024]
Abstract
BACKGROUND The impact of the COVID-19 pandemic on the mental health of healthcare workers throughout the world has been reported, but most studies have been cross-sectional and excluded the Midwestern U.S. healthcare workforce. OBJECTIVE This study aimed to longitudinally assess the psychological wellbeing and wellness strategies used by a Midwestern academic health system's workforce at multiple points throughout waves of the COVID-19 pandemic to inform ongoing implementation of appropriate wellness activities. METHODS An anonymous REDCap survey linked within our team-developed wellness education was posted in the employee online newsletter in April (T1), July (T2), October 2020 (T3), and May 2021 (T4). Surveys were open to all employees (approx. 9000) for approximately 12 days at each time point. Anxiety, depressive symptoms, stress, self-efficacy, and self-care activities were assessed. Following each data collection, team members discussed findings and planned wellness education implementation. RESULTS Response ranged from n = 731 (T1) to n = 172 (T4). Moderate to severe stress was reported by 29.5% (n = 203) of respondents at T1 and 34.0% (n = 108) at T2. At T3, all psychological symptoms significantly increased (p < .001) as COVID-19 surged, with 48.5% (n = 141) of respondents reporting moderate to severe stress. At T4, stress significantly declined (p < .001). Exercise was the most frequently reported coping strategy. CONCLUSIONS Mental health symptoms reported by a Midwestern healthcare workforce increased during surges of COVID-19 hospitalizations. Individuals in non-patient contact roles experienced symptom levels similar to and at times with greater severity than healthcare personnel with patient contact roles.
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Affiliation(s)
- Robin M Lally
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Rachael Schmidt
- Fred & Pamela Buffett Cancer Center, Nebraska Medicine, Omaha, NE, USA
| | - Kevin Kupzyk
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - Steven P Wengel
- Department of Psychiatry, University of Nebraska Medical Center, Omaha, NE, USA
| | | | - Adam C Mills
- Department of Psychology, Nebraska Medicine, Omaha, NE, USA
| | - Sarah E Richards
- Nebraska Medicine, Omaha, NE, USA
- Division of Hospital Medicine, University of Nebraska Medical Center, Omaha, NE, USA
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Martin Ginis KA, Sinden AR, Bonaccio S, Labbé D, Guertin C, Gellatly IR, Koch L, Ben Mortenson W, Routhier F, Basham CA, Jetha A, Miller WC. Experiential Aspects of Participation in Employment and Mobility for Adults With Physical Disabilities: Testing Cross-Sectional Models of Contextual Influences and Well-Being Outcomes. Arch Phys Med Rehabil 2024; 105:303-313. [PMID: 37607656 DOI: 10.1016/j.apmr.2023.08.004] [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: 03/29/2023] [Revised: 07/18/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVE To use structural equation modeling to test research- and theory-informed models of potential predictors and outcomes of subjective experiences of employment and mobility participation in a national sample of people with physical disabilities. DESIGN Cross-sectional survey. SETTING Canada. PARTICIPANTS English or French-speaking adults with a physical impairment affecting mobility and restricting activities or participation, and who participated in employment (n=457) or mobility (n=711) life domains. INTERVENTIONS N/A. MAIN OUTCOME MEASURES Participants completed standardized measures of perceived health, and employment-specific and/or mobility-specific measures of perceived abilities, social support, accessibility and policies (predictor variables); the Measure of Experiential Aspects of Participation (MeEAP) in employment and/or mobility; and standardized measures of emotional well-being, social well-being and life satisfaction (outcome variables). RESULTS Analyses using structural equation modeling showed that in both employment and mobility domains, perceived health, abilities, social support, and accessibility were positively related to experiential aspects of participation. Participation experiences were positively related to social well-being, emotional well-being, and life satisfaction. CONCLUSIONS Results support and extend current theorizing on participation experiences among adults with physical disabilities. Intrapersonal and environmental factors may play a role in optimizing participation experiences in employment and mobility which, in turn, may lead to better well-being and life satisfaction. These results emphasize the importance of conceptualizing participation from an experiential perspective and provide a basis for advancing theory and practice to understand and improve the participation experiences and well-being of adults living with physical disabilities.
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Affiliation(s)
- Kathleen A Martin Ginis
- Department of Medicine, Division of Physical Medicine & Rehabilitation, University of British Columbia, Vancouver, Canada; Centre for Chronic Disease Prevention and Management, Kelowna, Canada; School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada.
| | - Adrienne R Sinden
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
| | - Silvia Bonaccio
- Telfer School of Management, University of Ottawa, Ottawa, Canada; Institute for Work & Health, Toronto, Canada
| | - Delphine Labbé
- Disability and Human Development Department, College of Applied Health Sciences, University of Illinois, Chicago, IL
| | - Camille Guertin
- School of Health and Exercise Sciences, University of British Columbia, Kelowna, Canada
| | - Ian R Gellatly
- Department of Strategy, Entrepreneurship, and Management, Alberta School of Business, University of Alberta, Edmonton, Canada
| | - Laura Koch
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - W Ben Mortenson
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada; Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada; Rehabilitation Research Program, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - François Routhier
- Center for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec, Canada; Department of Rehabilitation, Faculty of Medicine, Université Laval, Quebec, Canada
| | - C Andrew Basham
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Arif Jetha
- Institute for Work & Health, Toronto, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - William C Miller
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, Canada; Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada
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Salsman JM, McLouth LE, Tooze JA, Little-Greene D, Cohn M, Kehoe MS, Moskowitz JT. An eHealth, Positive Emotion Skills Intervention for Enhancing Psychological Well-Being in Young Adult Cancer Survivors: Results from a Multi-Site, Pilot Feasibility Trial. Int J Behav Med 2023; 30:639-650. [PMID: 36890329 PMCID: PMC10485177 DOI: 10.1007/s12529-023-10162-5] [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] [Accepted: 02/01/2023] [Indexed: 03/10/2023]
Abstract
BACKGROUND Young adult (YA) cancer survivors experience clinically significant distress and have limited access to psychosocial support. Given growing evidence for unique adaptive benefits of positive emotion in the context of health-related and other life stress, we developed an eHealth positive emotion skills intervention for post-treatment survivors called EMPOWER (Enhancing Management of Psychological Outcomes With Emotion Regulation) and evaluated feasibility and proof of concept for reducing distress and enhancing well-being. METHOD In this single-arm pilot feasibility trial, post-treatment YA cancer survivors (ages 18-39) participated in the EMPOWER intervention which included 8 skills (e.g., gratitude, mindfulness, acts of kindness). Participants completed surveys at baseline (pre-intervention), 8 weeks (post-intervention), and 12 weeks (1-month follow-up). Primary outcomes included feasibility (assessed by participation percentage) and acceptability (would recommend EMPOWER skills to a friend). Secondary outcomes included psychological well-being (mental health, positive affect, life satisfaction, meaning/purpose, general self-efficacy) and distress (depression, anxiety, anger). RESULTS We assessed 220 YAs for eligibility; 77% declined. Of those screened, 44 (88%) were eligible and consented, 33 began the intervention, and 26 (79%) completed the intervention. Overall retention was 61% at 12 weeks. Average acceptability ratings were high (8.8/10). Participants (M = 30.8 years, SD = 6.6) were 77% women, 18% racial/ethnic minorities, and 34% breast cancer survivors. At 12 weeks, EMPOWER was associated with improved mental health, positive affect, life satisfaction, meaning/purpose, and general self-efficacy (ps < .05, ds = .45 to .63) and decreased anger (p < .05, d = - 0.41). CONCLUSION EMPOWER demonstrated evidence of feasibility and acceptability as well as proof of concept for enhancing well-being and reducing distress. Self-guided, eHealth interventions show promise for addressing YA cancer survivors' needs and warrant additional research to optimize survivorship care. TRIAL REGISTRATION ClinicalTrials .gov NCT02832154, https://clinicaltrials.gov/ct2/show/NCT02832154.
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Affiliation(s)
- John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine & Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
| | - Laurie E McLouth
- Department of Behavioral Science and Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Janet A Tooze
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine & Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, USA
| | - Denisha Little-Greene
- Health Care Education, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | | | - Mia Sorkin Kehoe
- Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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11
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Joo PY, Lee W, Hoffman S, Baumhauer J, Oh I. Utilization of PROMIS Neuropathic Pain Quality for Detection and Monitoring Neuropathic Pain in Heel Pain Patients. FOOT & ANKLE ORTHOPAEDICS 2023; 8:24730114231213620. [PMID: 38058978 PMCID: PMC10697051 DOI: 10.1177/24730114231213620] [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] [Indexed: 12/08/2023] Open
Abstract
Background Diagnosis and management of neuropathic pain (NP) in foot and ankle patients remain challenging. We investigated the plausibility of using Patient-Reported Outcomes Measurement Information System (PROMIS) Neuropathic Pain Quality (PQ-Neuro) as an initial screening tool to detect NP and track the treatment effects. Methods Patients with heel pain were prospectively recruited and grouped to no-NP, mild-NP, and severe-NP based on the initial PROMIS PQ-Neuro t scores. Pain Interference (PI), Physical Function (PF), and Self-Efficacy (SE) scores were evaluated at baseline, 30-day, and 90-day follow-up. Other factors such as age, smoking, body mass index (BMI), low back/neck pain, anxiety/depression, and medications were analyzed. Linear mixed modeling was used to assess the main effects of time and NP on PROMIS t scores, comparing minimal clinically important difference (MCID). Results Forty-eight patients with mean age of 52.4 years were recruited. Using the PROMIS PQ-Neuro as the assessment tool, 33 patients (69%) were detected to have NP at baseline-23 (48%) mild and 10 (21%) severe. BMI was the only independent factor associated with NP (P = .011). Higher baseline PQ-Neuro t score was significantly associated with higher follow-up PQ-Neuro (P < .001), PI (P = .005), and lower SE (P = .04) across time points. Patients with NP showed lower PF at baseline with significantly less improvement in PF (3 vs 9.9, P = .035) and did not meet MCID. Conclusion Baseline PROMIS PQ-Neuro ≥46 was significantly associated with worse PI and SE across all time points, with less clinically significant improvements in PF. Prevalence of NP in heel pain patients was high. The PROMIS PQ-Neuro may serve as a valuable tool for detection of NP and guiding clinical treatment decision pathways for heel pain patients. Level of Evidence Level III, prospective cohort study.
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Affiliation(s)
- Peter Y Joo
- Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, NY, USA
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA
| | - Wonyong Lee
- Department of Orthopaedic Surgery, Guthrie Clinic, Sayre, PA, USA
| | - Samantha Hoffman
- Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, NY, USA
| | - Judith Baumhauer
- Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, NY, USA
| | - Irvin Oh
- Department of Orthopaedics and Rehabilitation, University of Rochester Medical Center, Rochester, NY, USA
- Department of Orthopaedics and Rehabilitation, Yale School of Medicine, New Haven, CT, USA
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12
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Cella D, Garcia SF, Cahue S, Smith JD, Yanez B, Scholtens D, Lancki N, Bass M, Kircher S, Flores AM, Jensen RE, Smith AW, Penedo FJ. Implementation and evaluation of an expanded electronic health record-integrated bilingual electronic symptom management program across a multi-site Comprehensive Cancer Center: The NU IMPACT protocol. Contemp Clin Trials 2023; 128:107171. [PMID: 36990275 PMCID: PMC10164083 DOI: 10.1016/j.cct.2023.107171] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 03/25/2023] [Accepted: 03/25/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND People with cancer experience symptoms that adversely affect quality of life. Despite existing interventions and clinical guidelines, timely symptom management remains uneven in oncology care. We describe a study to implement and evaluate an electronic health record (EHR)-integrated symptom monitoring and management program in adult outpatient cancer care. METHODS Our cancer patient-reported outcomes (cPRO) symptom monitoring and management program is a customized EHR-integrated installation. We will implement cPRO across all Northwestern Memorial HealthCare (NMHC) hematology/oncology clinics. We will conduct a cluster randomized modified stepped-wedge trial to evaluate patient and clinician engagement with cPRO. Further, we will embed a patient-level randomized clinical trial to evaluate the impact of an additional enhanced care (EC; cPRO plus web-based symptom self-management intervention) relative to usual care (UC; cPRO alone). The project uses a Type 2 hybrid effectiveness-implementation approach. The intervention will be implemented across seven regional clusters within the healthcare system comprising 32 clinic sites. A 6-month prospective pre-implementation enrollment period will be followed by a post-implementation enrollment period, during which newly enrolled, consenting patients will be randomly assigned (1:1) to EC or UC. We will follow patients for 12 months post-enrollment. Patients randomized to EC will receive evidence-based symptom-management content on cancer-related concerns and approaches to enhance quality of life, using a web-based tool ("MyNM Care Corner"). This design allows for within- and between-site evaluation of implementation plus a group-based comparison to demonstrate effectiveness on patient-level outcomes. DISCUSSION The project has potential to guide implementation of future healthcare system-level cancer symptom management programs. http://ClinicalTrials.gov # NCT03988543.
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Affiliation(s)
- David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America; Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, United States of America.
| | - Sofia F Garcia
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America; Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, United States of America.
| | - September Cahue
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
| | - Justin D Smith
- Department of Population Health Sciences, University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, UT, United States of America.
| | - Betina Yanez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
| | - Denise Scholtens
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
| | - Nicola Lancki
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
| | - Michael Bass
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
| | - Sheetal Kircher
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
| | - Ann Marie Flores
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America; Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, United States of America; Department of Physical Therapy and Human Movement Science, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
| | - Roxanne E Jensen
- Outcomes Research Branch Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, United States of America.
| | - Ashley Wilder Smith
- Outcomes Research Branch Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, United States of America
| | - Frank J Penedo
- Departments of Psychology and Medicine, University of Miami, Coral Gables, FL, United States of America; Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, FL, United States of America.
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13
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Riggs KR, Cherrington AL, Kertesz SG, Richman JS, DeRussy AJ, Varley AL, Becker WC, Morris MS, Singh JA, Markland AD, Goodin BR. Higher Pain Catastrophizing and Preoperative Pain is Associated with Increased Risk for Prolonged Postoperative Opioid Use. Pain Physician 2023; 26:E73-E82. [PMID: 36988368 PMCID: PMC10337451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
BACKGROUND Prolonged postoperative opioid use (PPOU) is considered an unfavorable post-surgical outcome. Demographic, clinical, and psychosocial factors have been associated with PPOU, but methods to prospectively identify patients at increased risk are lacking. OBJECTIVES Our objective was to determine whether an individual or a combination of several psychological factors could identify a subset of patients at increased risk for PPOU. STUDY DESIGN Observational cohort study with prospective baseline data collection and passive outcomes data collection. SETTING A single VA medical center in the United States. METHODS Patients were recruited from a preoperative anesthesia clinic where they were undergoing evaluation prior to elective surgery, and they completed a survey before surgery. The primary outcome was PPOU, defined as outpatient receipt of a prescribed opioid 31 to 90 days after surgery as determined from pharmacy records. Primary covariates of interest were pain catastrophizing, self-efficacy, and optimism. Additional covariates included social and demographic factors, pain severity, medication use, depression, anxiety, and surgical fear. RESULTS Of 123 patients included in the final analyses, 30 (24.4%) had PPOU. In bivariate analyses, preoperative opioid use and preoperative nonsteroidal anti-inflammatory drug use were significantly associated with PPOU. The combination of high pain catastrophizing and high preoperative pain (OR 3.32, 95% CI 1.41 - 7.79) was associated with higher odds of PPOU than either alone, and the association remained significant after adjusting for preoperative opioid use (OR 2.56, 95% CI 1.04 - 6.29). LIMITATIONS Patients were recruited from a single site, and the sample was not large enough to include potentially important variables such as procedure type. CONCLUSIONS A combination of high pain catastrophizing and high preoperative pain has the potential to be a clinically useful means of identifying patients at elevated risk of PPOU.
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Affiliation(s)
- Kevin R. Riggs
- Birmingham VA Medical Center, Birmingham, Alabama, United States
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
- Geriatric Research, Education, and Clinical Center, Birmingham VA Medical Center, Birmingham, Alabama, United States
| | - Andrea L. Cherrington
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Stefan G. Kertesz
- Birmingham VA Medical Center, Birmingham, Alabama, United States
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Joshua S. Richman
- Birmingham VA Medical Center, Birmingham, Alabama, United States
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Aerin J. DeRussy
- Birmingham VA Medical Center, Birmingham, Alabama, United States
| | | | - William C. Becker
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
- Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Melanie S. Morris
- Birmingham VA Medical Center, Birmingham, Alabama, United States
- Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Jasvinder A. Singh
- Birmingham VA Medical Center, Birmingham, Alabama, United States
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
| | - Alayne D. Markland
- Birmingham VA Medical Center, Birmingham, Alabama, United States
- Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
- Geriatric Research, Education, and Clinical Center, Birmingham VA Medical Center, Birmingham, Alabama, United States
| | - Burel R. Goodin
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, United States
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14
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Ugarte-Gil MF, Gamboa-Cardenas RV, Reátegui-Sokolova C, Pimentel-Quiroz VR, Medina M, Elera-Fitzcarrald C, Rodriguez-Bellido Z, Pastor-Asurza CA, Perich-Campos RA, Alarcón GS. A better self-efficacy is predictive of better health-related quality of life (HRQoL) in patients with systemic lupus erythematosus: data from the Almenara Lupus Cohort. Lupus Sci Med 2023; 10:10/1/e000874. [PMID: 36787922 PMCID: PMC9930544 DOI: 10.1136/lupus-2022-000874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 01/27/2023] [Indexed: 02/16/2023]
Abstract
OBJECTIVE To determine the possible predictive value of self-efficacy on health-related quality of life (HRQoL) in patients with SLE. METHODS Patients with SLE from the Almenara Lupus Cohort were included. Self-efficacy was ascertained with the six domains from the Patient-Reported Outcomes Measurement Information System (PROMIS) self-efficacy for managing chronic conditions. For PROMIS domains, a score of 50 is the average for a clinical population (people with a chronic condition), a higher score indicates that the respondent has greater self-efficacy. HRQoL was ascertained with the physical and mental component summary (PCS and MCS) measures of the Short-Form 36 (SF-36). Generalised estimating equations were performed, using as outcome the PCS or MCS in the subsequent visit, and the self-efficacy domain in the previous visit; multivariable models were adjusted for possible confounders. The confounders were measured in the same visit as the self-efficacy domain. RESULTS Two-hundred and nine patients for a total of 564 visits were included; 194 (92.8%) patients were women and mean age at diagnosis was 36.4 (14.0) years. In the multivariable models, a better PCS was predicted by a better self-efficacy for managing symptoms, managing medications and treatments and managing social interactions and general self-efficacy; a better MCS was predicted by a better self-efficacy for managing daily activities, managing symptoms, managing medications and treatments and managing social interactions. CONCLUSION A better self-efficacy is predictive of subsequent better HRQoL, even after adjustment for possible confounders. These results should encourage clinicians to develop strategies to improve self-efficacy in patients with SLE.
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Affiliation(s)
- Manuel Francisco Ugarte-Gil
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, Peru .,Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistémicas, Universidad Científica del Sur, Lima, Peru
| | - Rocio Violeta Gamboa-Cardenas
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, Peru,Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistémicas, Universidad Científica del Sur, Lima, Peru
| | - Cristina Reátegui-Sokolova
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, Peru,Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
| | - Victor Román Pimentel-Quiroz
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, Peru,Grupo Peruano de Estudio de Enfermedades Autoinmunes Sistémicas, Universidad Científica del Sur, Lima, Peru
| | - Mariela Medina
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, Peru
| | - Claudia Elera-Fitzcarrald
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, Peru,Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Ica, Peru
| | - Zoila Rodriguez-Bellido
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, Peru,Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Cesar Augusto Pastor-Asurza
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, Peru,Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Risto Alfredo Perich-Campos
- Rheumatology Department, Hospital Nacional Guillermo Almenara Irigoyen, EsSaalud, Lima, Peru,Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Graciela S Alarcón
- Max E. Heersink School of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA,School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
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15
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Foster CC, Blackwell CK, Kan K, Morales L, Cella D, Shaunfield S. Parental self-efficacy managing a child's medications and treatments: adaptation of a PROMIS measure. J Patient Rep Outcomes 2023; 7:10. [PMID: 36735145 PMCID: PMC9898482 DOI: 10.1186/s41687-023-00549-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 01/16/2023] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Self-efficacy is important for managing chronic conditions; however, its measurement in pediatric healthcare settings remains rare. The goal of this project was to adapt an existing disease-agnostic adult self-efficacy patient reported outcome (PRO) measure to enhance suitability of items for measuring the self-efficacy of parents that manage their children's health conditions. METHODS We adapted the existing Patient-Reported Outcomes Measurement Information System® (PROMIS®) adult self-efficacy healthcare measure to parental voice. First, a targeted literature review informed rephrasing of the adult items and identification of new pediatric-specific content. The initial item pool was revised based on input from 12 multidisciplinary experts. Next cognitive interviews of adapted items were simultaneously conducted with English and Spanish-speaking parents of pediatric patients with a range of chronic and/or disabling conditions recruited from a Midwestern children's hospital to finalize the measure. RESULTS Findings resulted in an initial item pool of 33 pediatric-specific items which were narrowed to 31 draft items based on expert input. Parent cognitive interview findings (N = 26) informed further item reduction resulting in a final measure consisting of 30 items representing nine domains. Fourteen items are relevant to children regardless of condition severity (e.g., health care information/decision making; symptom identification/management) and 16 items are relevant to children with specific health care needs (e.g., medication usage, equipment). CONCLUSION We conducted a first step in developing a condition-agnostic, PRO measure of parental self-efficacy managing their children's chronic and/or disabling conditions that is acceptable and understandable to English and Spanish-speaking parents.
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Affiliation(s)
- Carolyn C Foster
- Division of Advanced General Pediatrics and Primary Care, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
- Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 162, Chicago, IL, 60611, USA.
| | - Courtney K Blackwell
- Depatment of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kristin Kan
- Division of Advanced General Pediatrics and Primary Care, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 162, Chicago, IL, 60611, USA
| | - Luis Morales
- Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Box 162, Chicago, IL, 60611, USA
| | - David Cella
- Depatment of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sara Shaunfield
- Depatment of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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16
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Serpentini S, Silvestri G, Catarinella A, Cristaldi G, Borgese C, Deledda G, Sommacal S, Iannopollo L, Calvo V, Ronconi L, Merluzzi TV. Assessment of socio-relational self-efficacy in breast cancer patients: Italian validation of the social relationship coping efficacy scale (SRCE-I). BMC Psychol 2022; 10:248. [PMID: 36329538 PMCID: PMC9632030 DOI: 10.1186/s40359-022-00966-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 10/27/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Social relationship coping efficacy (SRCE) represents the ability to maintain or enhance social relationships in the context of serious illness. The purpose of the current study was to confirm the factor structure, psychometric properties, and utility of the Italian version of the SRCE scale. METHODS 181 breast cancer patients completed the SRCE-Italian (SRCE-I), the Cancer Behavior Inventory-Brief/Italian (CBI-B/I), quality of life (QOL) measures (EORTC QLQ-C30; EORTC QLQ-BR23), and the Hospital Anxiety and Depression Scale (HADS). RESULTS The SRCE-I was internally consistent (Cronbach alpha = .95) and factor analysis confirmed that the SRCE-I was a unidimensional construct. In terms of validity, the SRCE-I was correlated with QOL (EORTC QLQ-30, Social Functioning, r = .33, Emotional Functioning, r = .57, and Global Health/Quality of Life; r = .54) and scales of the EORTC QLQ-BR23 (e.g., Future Perspective, r = .38; Breast Symptoms, -.31). SRCE-I was also correlated negatively with the HADS (r = -.72) and positively with the CBI-B/I (r = .79), a measure of coping efficacy (all ps < .001). Mediation analyses confirmed the utility of the SRCE-I scale as a mediating mechanism in enhancing social functioning and QOL. CONCLUSIONS The SRCE-I is a structurally sound, reliable, and valid measure that assesses the ability to maintain or enhance social support and mitigate the loss of social support. The SRCE-I can be used as a screening measure to assess low efficacy for maintaining social support or as a measure to detect the change in efficacy for enhancing social support in interventions to improve the QOL of patients.
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Affiliation(s)
- Samantha Serpentini
- grid.419546.b0000 0004 1808 1697Psychological Service of the Breast Cancer Unit, UOC Medical Oncology 2, UOSD Hospital Psychology, Veneto Institute of Oncology (IOV) – IRCCS, Via Gattamelata, 64, 35100 Padua, Italy
| | - Giulia Silvestri
- grid.419546.b0000 0004 1808 1697Psychological Service of the Breast Cancer Unit, UOC Medical Oncology 2, UOSD Hospital Psychology, Veneto Institute of Oncology (IOV) – IRCCS, Via Gattamelata, 64, 35100 Padua, Italy
| | - Antonio Catarinella
- grid.15496.3f0000 0001 0439 0892Vita-Salute San Raffaele University, Milan, Italy
| | - Grazia Cristaldi
- grid.419546.b0000 0004 1808 1697Psychological Service of the Breast Cancer Unit, UOC Medical Oncology 2, UOSD Hospital Psychology, Veneto Institute of Oncology (IOV) – IRCCS, Via Gattamelata, 64, 35100 Padua, Italy
| | - Caterina Borgese
- grid.419546.b0000 0004 1808 1697Psychological Service of the Breast Cancer Unit, UOC Medical Oncology 2, UOSD Hospital Psychology, Veneto Institute of Oncology (IOV) – IRCCS, Via Gattamelata, 64, 35100 Padua, Italy
| | - Giuseppe Deledda
- grid.416422.70000 0004 1760 2489Sacro Cuore Hospital- Don Calabria-IRCCS of Negrar (VR), Negrar, Italy
| | | | - Letizia Iannopollo
- grid.419546.b0000 0004 1808 1697Psychological Service of the Breast Cancer Unit, UOC Medical Oncology 2, UOSD Hospital Psychology, Veneto Institute of Oncology (IOV) – IRCCS, Via Gattamelata, 64, 35100 Padua, Italy
| | - Vincenzo Calvo
- grid.5608.b0000 0004 1757 3470Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padua, Padua, Italy
| | - Lucia Ronconi
- grid.5608.b0000 0004 1757 3470Department of Philosophy, Sociology, Pedagogy and Applied Psychology (FISPPA), University of Padua, Padua, Italy
| | - Thomas V. Merluzzi
- grid.131063.60000 0001 2168 0066Department of Psychology, University of Notre Dame, Notre Dame, IN USA
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Lin SY, Tan JH, Tay BXH, Koh JPCS, Siew L, Teo MCH, Tan JYC, Hilal S. Exploring the Socio-Demographic and Psychosocial Factors That Enhance Resilience in the COVID-19 Crisis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12580. [PMID: 36231880 PMCID: PMC9565082 DOI: 10.3390/ijerph191912580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
The Coronavirus disease 2019 (COVID-19) has greatly affected mental health worldwide. This study aimed to identify sociodemographic and psychosocial factors that influence the level of resilience among Singaporeans amidst the pandemic. An online questionnaire was administered to Singaporeans and permanent residents aged 21 and above. The online questionnaire collected information on sociodemographics, infection, and contact with COVID-19. Psychosocial variables-specifically optimism, self-efficacy, hope, and resilience-were also assessed through validated questionnaires. A total of 404 responses were collected in this study. Men were reported to have higher resilience compared to women (28.13 vs. 25.54, p-value < 0.001). Married individuals were observed to have higher resilience compared to their single counterparts (27.92 vs. 25.77, p-value < 0.001). Interestingly, participants who knew of family members/friends who had contracted COVID-19 were reported to be more resilient than those who did not (28.09 vs. 26.19, p-value = 0.013). Optimism, self-efficacy, and hope were also found to be associated with higher resilience (p-value < 0.001). In conclusion, one's sex, marital status, contact with COVID-19, level of optimism, self-efficacy, and hope were shown to significantly affect resilience. Given the long-drawn nature of the COVID-19 pandemic, interventions should aim to improve optimism, self-efficacy, and hopefulness in the community.
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Affiliation(s)
- Snow Yunni Lin
- MBBS Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Jian Han Tan
- MBBS Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Brenda Xian Hui Tay
- MBBS Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - John Paul Chern Shwen Koh
- MBBS Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Lei Siew
- MBBS Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Marcus Cher Hean Teo
- MBBS Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Jeremy Yen Chin Tan
- MBBS Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
| | - Saima Hilal
- MBBS Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore 117549, Singapore
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18
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Capin JJ, Jolley SE, Morrow M, Connors M, Hare K, MaWhinney S, Nordon-Craft A, Rauzi M, Flynn S, Stevens-Lapsley JE, Erlandson KM. Safety, feasibility and initial efficacy of an app-facilitated telerehabilitation (AFTER) programme for COVID-19 survivors: a pilot randomised study. BMJ Open 2022; 12:e061285. [PMID: 35882451 PMCID: PMC9329728 DOI: 10.1136/bmjopen-2022-061285] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/14/2022] [Indexed: 01/31/2023] Open
Abstract
OBJECTIVES Determine the safety, feasibility and initial efficacy of a multicomponent telerehabilitation programme for COVID-19 survivors. DESIGN Pilot randomised feasibility study. SETTING In-home telerehabilitation. PARTICIPANTS 44 participants (21 female, mean age 52 years) discharged home following hospitalisation with COVID-19 (with and without intensive care unit (ICU) stay). INTERVENTIONS Participants were block randomised 2:1 to receive 12 individual biobehaviourally informed, app-facilitated, multicomponent telerehabilitation sessions with a licenced physical therapist (n=29) or to a control group (n=15) consisting of education on exercise and COVID-19 recovery trajectory, physical activity and vitals monitoring, and weekly check-ins with study staff. Interventions were 100% remote and occurred over 12 weeks. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome was feasibility, including safety and session adherence. Secondary outcomes included preliminary efficacy outcomes including tests of function and balance; patient-reported outcome measures; a cognitive assessment; and average daily step count. The 30 s chair stand test was the main secondary (efficacy) outcome. RESULTS No adverse events (AEs) occurred during testing or in telerehabilitation sessions; 38% (11/29) of the intervention group compared with 60% (9/15) of the control group experienced an AE (p=0.21), most of which were minor, over the course of the 12-week study. 27 of 29 participants (93%; 95% CI 77% to 99%) receiving the intervention attended ≥75% of sessions. Both groups demonstrated clinically meaningful improvement in secondary outcomes with no statistically significant differences between groups. CONCLUSION Fully remote telerehabilitation was safe, feasible, had high adherence for COVID-19 recovery, and may apply to other medically complex patients including those with barriers to access care. This pilot study was designed to evaluate feasibility; further efficacy evaluation is needed. TRIAL REGISTRATION NUMBER NCT04663945.
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Affiliation(s)
- Jacob John Capin
- Department of Physical Medicine & Rehabilitation, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, USA
- Department of Physical Therapy, Marquette University, Milwaukee, Wisconsin, USA
- Geriatric Research Education and Clinical Center (GRECC), Eastern Colorado Veterans Affairs, Aurora, Colorado, USA
| | - Sarah E Jolley
- Division of Pulmonary and Critical Care Medicine, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, USA
| | - Mary Morrow
- Department of Biostatistics and Informatics, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, USA
| | - Meghan Connors
- Department of Physical Medicine & Rehabilitation, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, USA
| | - Kristine Hare
- Department of Physical Medicine & Rehabilitation, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, USA
| | - Samantha MaWhinney
- Department of Biostatistics and Informatics, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, USA
| | - Amy Nordon-Craft
- Department of Physical Medicine & Rehabilitation, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, USA
| | - Michelle Rauzi
- Department of Physical Medicine & Rehabilitation, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, USA
| | | | - Jennifer E Stevens-Lapsley
- Department of Physical Medicine & Rehabilitation, University of Colorado Denver - Anschutz Medical Campus, Aurora, Colorado, USA
- Geriatric Research Education and Clinical Center (GRECC), Eastern Colorado Veterans Affairs, Aurora, Colorado, USA
| | - Kristine M Erlandson
- Division of Infectious Diseases, University of Colorado - Anschutz Medical Campus, Aurora, Colorado, USA
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Knauer J, Terhorst Y, Philippi P, Kallinger S, Eiler S, Kilian R, Waldmann T, Moshagen M, Bader M, Baumeister H. Effectiveness and cost-effectiveness of a web-based routine assessment with integrated recommendations for action for depression and anxiety (RehaCAT+): protocol for a cluster randomised controlled trial for patients with elevated depressive symptoms in rehabilitation facilities. BMJ Open 2022; 12:e061259. [PMID: 35738644 PMCID: PMC9226881 DOI: 10.1136/bmjopen-2022-061259] [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] [Received: 01/20/2022] [Accepted: 06/06/2022] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION The integration of a web-based computer-adaptive patient-reported outcome test (CAT) platform with persuasive design optimised features including recommendations for action into routine healthcare could provide a promising way to translate reliable diagnostic results into action. This study aims to evaluate the effectiveness and cost-effectiveness of such a platform for depression and anxiety (RehaCAT+) compared with the standard diagnostic system (RehaCAT) in cardiological and orthopaedic health clinics in routine care. METHODS AND ANALYSIS A two-arm, pragmatic, cluster-randomised controlled trial will be conducted. Twelve participating rehabilitation clinics in Germany will be randomly assigned to a control (RehaCAT) or experimental group (RehaCAT+) in a 1:1 design. A total sample of 1848 participants will be recruited across all clinics. The primary outcome, depression severity at 12 months follow-up (T3), will be assessed using the CAT Patient-Reported Outcome Measurement Information System Emotional Distress-Depression Item set. Secondary outcomes are depression at discharge (T1) and 6 months follow-up (T2) as well as anxiety, satisfaction with participation in social roles and activities, pain impairment, fatigue, sleep, health-related quality of life, self-efficacy, physical functioning, alcohol, personality and health economic-specific general quality of life and socioeconomic cost and benefits at T1-3. User behaviour, acceptance, facilitating and hindering factors will be assessed with semistructured qualitative interviews. Additionally, a smart sensing substudy will be conducted, with daily ecological momentary assessments and passive collection of smartphone usage variables. Data analysis will follow the intention-to-treat principle with additional per-protocol analyses. Cost-effectiveness analyses will be conducted from a societal perspective and the perspective of the statutory pension insurance. ETHICS AND DISSEMINATION The study will be conducted according to the Declaration of Helsinki. The Ethics Committee of Ulm University, has approved the study (on 24 February 2021 ref. 509/20). Written informed consent will be obtained for all participants. Results will be published via peer-reviewed journals. TRIAL REGISTRATION NUMBER DRKS00027447.
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Affiliation(s)
- Johannes Knauer
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Yannik Terhorst
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Paula Philippi
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Selina Kallinger
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Sandro Eiler
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Reinhold Kilian
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Tamara Waldmann
- Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
| | - Morten Moshagen
- Department of Psychological Research Methods, Ulm University, Ulm, Germany
| | - Martina Bader
- Department of Psychological Research Methods, Ulm University, Ulm, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
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Yang YX, Zhang L, Zhao YY, Hao N, Wang BB, Lin YP. Self-efficacy of patients with inflammatory bowel disease: A review. Shijie Huaren Xiaohua Zazhi 2022; 30:425-430. [DOI: 10.11569/wcjd.v30.i10.425] [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: 02/06/2023] Open
Abstract
Inflammatory bowel disease (IBD) is a chronic, recurrent, and incurable intestinal disease, which is easy to bring heavy physical and mental damage to patients, and self-efficacy is an important factor affecting physical and mental health. This article reviews the self-efficacy of patients with IBD, focusing on the measurement tools, influencing factors, influence on patients, and improvement measures, in order to provide reference for related research in the future.
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Affiliation(s)
- Ya-Xin Yang
- Nursing Department, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, Henan Province, China
| | - Li Zhang
- Nursing Department, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, Henan Province, China
| | - Yue-Yue Zhao
- Nursing Department, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, Henan Province, China
| | - Na Hao
- Department of Gastroenterology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, Henan Province, China
| | - Bin-Bin Wang
- Department of Gastroenterology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, Henan Province, China
| | - Yu-Peng Lin
- Nursing Department, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450014, Henan Province, China
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21
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Hurst C, Rakkapao N, Malacova E, Mongkolsomlit S, Pongsachareonnont P, Rangsin R, Promsiripaiboon Y, Hartel G. Psychometric properties of the general self-efficacy scale among Thais with type 2 diabetes: a multicenter study. PeerJ 2022; 10:e13398. [PMID: 35646480 PMCID: PMC9135036 DOI: 10.7717/peerj.13398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/17/2022] [Indexed: 01/14/2023] Open
Abstract
Background Type 2 diabetes (T2D) is one of the most common chronic diseases in the world. In recent decades the prevalence of this disease has increased alarmingly in lower to middle income countries, where their resource-limited health care systems have struggled to meet this increased burden. Improving patient self-care by improving diabetes knowledge and diabetes management self-efficacy represents a feasible way of ameliorating the impact of T2D on the patient, and the health care system. Unfortunately, the relationships between self-efficacy, diabetes self-management, and thereafter, patient outcomes, are still far from well understood. Although a domain-specific measure of diabetes management self-efficacy, the Diabetes Management Self-Efficacy Scale (DMSES), has been validated in the Thai T2D population, more general measures of self-efficacy, such as the General Self-Efficacy scale (GSE) have not been validated in this population. In this paper we translate and examine the psychometric properties of the GSE in Thais living with T2D. Methods In this nation-wide study we examined the psychometric properties of the GSE in 749 Thais diagnosed with T2D within the last five years, and evaluated its relationship with the DMSES along with other patient characteristics. Reliability of GSE was assessed using Cronbach's alpha, and the construct validity was examined using confirmatory factor analysis, along with GSE's convergence and discrimination from DMSES. Results The Thai version of the GSE was shown to have good psychometric properties in Thais living with T2D. Cronbach's alpha was shown to be 0.87 (95% CI [0.86, 0.88]). We also demonstrated the structural validity of the GSE (Tucker-Lewis Index = 0.994, Cumulative Fit Index = 0.995, Adjusted Goodness of Fit Index = 0.998, Root Mean Square Error of Approximations = 0.025, 95% CI [0.06-0.039]), and that this instrument has a similar structure in Thais as in other populations. GSE was also shown to have some overlap with the DMSES with correlations among GSE and the DMSES domains ranging from 0.18 to 0.26, but also the GSE has substantial discrimination from DMSES (Disattenuated correlation coefficient = 0.283, 95% CI [0.214-0.352], p < 0.001). This suggests that while general and diabetes management self-efficacy are somewhat associated, there are aspects of diabetes management self-efficacy not captured by the more stable general self-efficacy. Conclusions We demonstrate that the Thai GSE is a reliable and valid measure. We believe the GSE may represent a useful tool to examine the efficacy of proposed and existing diabetes self-management, and management self-efficacy interventions.
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Affiliation(s)
- Cameron Hurst
- Biostatistics Group, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- Faculty of Public Health, Thammasat University, Rangsit, Prathumthani, Thailand
- Molly Wardaguga Research Centre, Charles Darwin University, Brisbane, Queensland, Australia
| | - Nitchamon Rakkapao
- Faculty of Public Health, Thammasat University, Rangsit, Prathumthani, Thailand
| | - Eva Malacova
- Biostatistics Group, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | | | | | - Ram Rangsin
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Din Daeng, Bangkok, Thailand
| | - Yindee Promsiripaiboon
- Department of Public Health, Surat Thani Rajabhat University, Mueng, Surat Thani, Thailand
| | - Gunter Hartel
- Biostatistics Group, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
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22
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Sood E, Gramszlo C, Perez Ramirez A, Braley K, Butler SC, Davis JA, Divanovic AA, Edwards LA, Kasparian N, Kelly SL, Neely T, Ortinau CM, Riegel E, Shillingford AJ, Kazak AE. Partnering With Stakeholders to Inform the Co-Design of a Psychosocial Intervention for Prenatally Diagnosed Congenital Heart Disease. J Patient Exp 2022; 9:23743735221092488. [PMID: 35493441 PMCID: PMC9039438 DOI: 10.1177/23743735221092488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Input from diverse stakeholders is critical to the process of designing healthcare interventions. This study applied a novel mixed-methods, stakeholder-engaged approach to co-design a psychosocial intervention for mothers expecting a baby with congenital heart disease (CHD) and their partners to promote family wellbeing. The research team included parents and clinicians from 8 health systems. Participants were 41 diverse parents of children with prenatally diagnosed CHD across the 8 health systems. Qualitative data were collected through online crowdsourcing and quantitative data were collected through electronic surveys to inform intervention co-design. Phases of intervention co-design were: (I) Engage stakeholders in selection of intervention goals/outcomes; (II) Engage stakeholders in selection of intervention elements; (III) Obtain stakeholder input to increase intervention uptake/utility; (IV) Obtain stakeholder input on aspects of intervention design; and (V) Obtain stakeholder input on selection of outcome measures. Parent participants anticipated the resulting intervention, HEARTPrep, would be acceptable, useful, and feasible for parents expecting a baby with CHD. This model of intervention co-design could be used for the development of healthcare interventions across chronic diseases.
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Affiliation(s)
- Erica Sood
- Nemours Cardiac Center, Nemours Children’s Hospital Delaware, Wilmington, DE, USA
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Hospital Delaware, Wilmington, DE, USA
- Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Colette Gramszlo
- Nemours Cardiac Center, Nemours Children’s Hospital Delaware, Wilmington, DE, USA
| | - Alejandra Perez Ramirez
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Hospital Delaware, Wilmington, DE, USA
| | - Katherine Braley
- Nemours Cardiac Center, Nemours Children’s Hospital Florida, Orlando, FL, USA
| | | | - Jo Ann Davis
- Department of Pediatrics, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Allison A Divanovic
- Department of Pediatrics, Cincinnati Children’s Hospital, Cincinnati, OH, USA
| | | | - Nadine Kasparian
- Center for Heart Disease and Mental Health, Department of Pediatrics, Cincinnati Children’s Hospital, Cincinnati, OH, USA
| | - Sarah L Kelly
- Departments of Pediatrics and Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Cynthia M Ortinau
- Department of Pediatrics, Washington University in St. Louis, St. Louis, MO, USA
| | - Erin Riegel
- Parent Research Partner, Wilmington, DE, USA
| | | | - Anne E Kazak
- Nemours Center for Healthcare Delivery Science, Nemours Children’s Hospital Delaware, Wilmington, DE, USA
- Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
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23
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Davis S, Antonio M, Smith M, Burgener P, Lavallee DC, Price M, Fletcher SC, Lau F. Paving the Way for Electronic Patient-Centered Measurement in Team-Based Primary Care: Integrated Knowledge Translation Approach. JMIR Form Res 2022; 6:e33584. [PMID: 35302508 PMCID: PMC8976252 DOI: 10.2196/33584] [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: 09/24/2021] [Revised: 12/21/2021] [Accepted: 12/30/2021] [Indexed: 11/23/2022] Open
Abstract
Background Patient-centered measurement (PCM) aims to improve the overall quality of care through the collection and sharing of patient values, outcomes, and perspectives. However, the use of PCM in care team decisions remains limited. Integrated knowledge translation (IKT) offers a collaborative, adaptive approach to explore best practices for incorporating PCM into primary care practices by involving knowledge users, including patients and providers, in the exploratory process. Objective This study aims to test the feasibility of using patient-generated data in team-based care; describe the use of these data for team-based mental health care; and summarize patient and provider care experiences with PCM. Methods We conducted a multi-method exploratory study in a rural team-based primary care clinic using IKT to co-design, implement, and evaluate the use of PCM in team-based mental health care. Care pathways, workflows, and quality improvement activities were adjusted iteratively to improve integration efforts. Patient and provider experiences were evaluated using individual interviews relating to the use of PCM and patient portals in practice. All meeting notes, interview summaries, and emails were analyzed to create a narrative evaluation. Results During co-design, a care workflow was developed to incorporate electronically collected patient-generated data from the patient portal into the electronic medical record, and customized educational tools and resources were added. During implementation, care pathways and patient workflows for PCM were developed. Patients found portal use easy, educational, and validating, but data entries were not used during care visits. Providers saw the portal as extra work, and the lack of portal and electronic medical record integration was a major barrier. The IKT approach was invaluable for addressing workflow changes and understanding the ongoing barriers to PCM use and quality improvement. Conclusions Although the culture toward using PCM is changing, the use of PCM during care has not been successful. Patients felt validated and supported through portal use and could be empowered to bring these data to their visits. Training, modeling, and adaptable PCM methods are required before PCM can be integrated into routine care.
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Affiliation(s)
- Selena Davis
- School of Health Information Science, University of Victoria, Victoria, BC, Canada
| | - Marcy Antonio
- School of Information, University of Michigan, Ann Arbor, MI, United States
| | - Mindy Smith
- College of Human Medicine, Michigan State University, Grand Rapids, MI, United States.,Patient Advisory Committee, Kootenay Boundary Collaborative Services Committee, Castlegar, BC, Canada
| | - Paul Burgener
- Patient Voices Network, BC Patient Safety & Quality Council, Vancouver, BC, Canada
| | | | - Morgan Price
- Innovation and Support Unit, Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Sarah C Fletcher
- Innovation and Support Unit, Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Francis Lau
- School of Health Information Science, University of Victoria, Victoria, BC, Canada
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24
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Park IH, Sya'bandari Y, Liu Y. Item bias on the geriatric depression scale (GDS): investigating the quality and generalizability of GDS on Chinese and Korean community-dwelling elderly population. BMC Geriatr 2021; 21:637. [PMID: 34753445 PMCID: PMC8577178 DOI: 10.1186/s12877-021-02516-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 08/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although some previous studies have reported the impact of cultural factors on individuals' cognition and decision making, a shortage of research has led to this comparison study for Chinese and Korean elderly, a growing population with depression. This study aimed to explore depression levels in Chinese and South Korean elderly individuals by focusing on testing the generalizability of the Geriatric Depression Scale (GDS). METHODS The data of 493 community-dwelling Chinese and Korean elderly individuals over the age of 60 years were used to examine GDS. To test the dimensionality, item quality, and reliability of the GDS, the item response theory, Rasch analysis was performed. The detection of differential item functioning (DIF) of the GDS between the two countries was determined by performing a hybrid ordinal logistic regression. RESULTS The four-dimensional framework of the GDS, categorized into agitation, cognitive concerns, dysphoria, and vigor/withdrawal was fit for measuring depression levels in Chinese and Korean elderly individuals. In addition, good item quality and reliability of the GDS indicate that almost all items in this scale contribute to measuring the intended trait. Meanwhile, 18 out of 28 items of the GDS were detected as country-related DIF with five items having a large effect size. CONCLUSIONS Although China and Korea are close geographically and culturally, the item bias shown by severe country-related DIF implies that different cultural backgrounds impact how the elderly interpret GDS items. The cultural issues related to the specific DIF items, the implication to accuracy of individual scores estimation, and the optimal decision to treat individuals were discussed.
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Affiliation(s)
- In Hye Park
- School of Nursing, University of Washington-Seattle, Seattle, USA
| | | | - Yang Liu
- Nursing Department, School of medicine, Xiamen University, Xiamen, China.
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25
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Teo I, Chay J, Cheung YB, Sung SC, Tewani KG, Yeo LF, Yang GM, Pan FT, Ng JY, Abu Bakar Aloweni F, Ang HG, Ayre TC, Chai-Lim C, Chen RC, Heng AL, Nadarajan GD, Ong MEH, See B, Soh CR, Tan BKK, Tan BS, Tay KXK, Wijaya L, Tan HK. Healthcare worker stress, anxiety and burnout during the COVID-19 pandemic in Singapore: A 6-month multi-centre prospective study. PLoS One 2021; 16:e0258866. [PMID: 34679110 PMCID: PMC8535445 DOI: 10.1371/journal.pone.0258866] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/06/2021] [Indexed: 11/19/2022] Open
Abstract
Aim The long-term stress, anxiety and job burnout experienced by healthcare workers (HCWs) are important to consider as the novel coronavirus disease (COVID-19) pandemic stresses healthcare systems globally. The primary objective was to examine the changes in the proportion of HCWs reporting stress, anxiety, and job burnout over six months during the peak of the pandemic in Singapore. The secondary objective was to examine the extent that objective job characteristics, HCW-perceived job factors, and HCW personal resources were associated with stress, anxiety, and job burnout. Method A sample of HCWs (doctors, nurses, allied health professionals, administrative and operations staff; N = 2744) was recruited via invitation to participate in an online survey from four tertiary hospitals. Data were gathered between March-August 2020, which included a 2-month lockdown period. HCWs completed monthly web-based self-reported assessments of stress (Perceived Stress Scale-4), anxiety (Generalized Anxiety Disorder-7), and job burnout (Physician Work Life Scale). Results The majority of the sample consisted of female HCWs (81%) and nurses (60%). Using random-intercept logistic regression models, elevated perceived stress, anxiety and job burnout were reported by 33%, 13%, and 24% of the overall sample at baseline respectively. The proportion of HCWs reporting stress and job burnout increased by approximately 1·0% and 1·2% respectively per month. Anxiety did not significantly increase. Working long hours was associated with higher odds, while teamwork and feeling appreciated at work were associated with lower odds, of stress, anxiety, and job burnout. Conclusions Perceived stress and job burnout showed a mild increase over six months, even after exiting the lockdown. Teamwork and feeling appreciated at work were protective and are targets for developing organizational interventions to mitigate expected poor outcomes among frontline HCWs.
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Affiliation(s)
- Irene Teo
- Programme in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
- Department of Psychosocial Oncology, National Cancer Centre Singapore, Singapore, Singapore
- * E-mail:
| | - Junxing Chay
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Yin Bun Cheung
- Programme in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
- Centre for Child Health Research, Tampere University, Tampere, Finland
| | - Sharon C. Sung
- Programme in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Department of Developmental Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Komal G. Tewani
- Department of Gynaecological Oncology, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Li Fang Yeo
- Department of Internal Medicine, Changi General Hospital, Singapore, Singapore
| | - Grace Meijuan Yang
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
| | - Fang Ting Pan
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Jin Ying Ng
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | | | - Hui Gek Ang
- Division of Allied Health, Singapore General Hospital, Singapore, Singapore
| | - Tracy Carol Ayre
- Division of Nursing, Singapore General Hospital, Singapore, Singapore
| | - Crystal Chai-Lim
- Medical Social Services, Singapore General Hospital, Singapore, Singapore
| | - Robert Chun Chen
- Division of Radiological Sciences, Singapore General Hospital, Singapore, Singapore
| | - Ai Ling Heng
- Division of Radiological Sciences, Singapore General Hospital, Singapore, Singapore
| | | | - Marcus Eng Hock Ong
- Programme in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Department of Emergency Medicine, Singapore General Hospital, Singapore, Singapore
| | - Brian See
- Occupational Health Service, Changi General Hospital, Singapore, Singapore
| | - Chai Rick Soh
- Department of Anaesthesiology, Singapore General Hospital, Singapore, Singapore
| | | | - Bien Soo Tan
- Division of Radiological Sciences, Singapore General Hospital, Singapore, Singapore
| | - Kenny Xian Khing Tay
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore
| | - Limin Wijaya
- Department of Infectious Disease, Singapore General Hospital, Singapore, Singapore
| | - Hiang Khoon Tan
- Division of Surgery and Surgical Oncology, Singapore General Hospital and National Cancer Centre Singapore, Singapore, Singapore
- SingHealth Duke-NUS Global Health Institute, Singapore, Singapore
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Norcott A, Chan CL, Nyquist L, Bynum JP, Min L, Fetters MD, DeJonckheere M. Behaviours of older adults and caregivers preparing for elective surgery: a virtually conducted mixed-methods research protocol to improve surgical outcomes. BMJ Open 2021; 11:e048299. [PMID: 34663655 PMCID: PMC8524274 DOI: 10.1136/bmjopen-2020-048299] [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: 01/21/2023] Open
Abstract
INTRODUCTION Older adults (age ≥65 years) are pursuing increasingly complex, elective surgeries; and, are at higher risk for intraoperative and postoperative complications. Patients and their caregivers frequently struggle with the postoperative recovery process at home, which may contribute to complications. We aim to identify opportunities to intervene during the preoperative period to improve postoperative outcomes by understanding the preparatory behaviours of older adults and their caregivers before a complex, elective surgery. METHODS AND ANALYSIS As a result of the COVID-19 pandemic, we will conduct this study via telephone and videoconferencing. Using a multiphase mixed-methods research design, we will collect data on 10-15 patient-caregiver dyads from a pool of older adults (across a spectrum of cognitive abilities) scheduled for an elective colorectal surgery between 1 July 2020 and 30 May 2021. We will collect quantitative and qualitative data before (T1, T2) and after (T3, T4) surgery. Preoperatively, participants will each complete a cognitive assessment and a semi-structured qualitative interview that focuses on their preparatory behaviours (T1). They will then answer questionnaires about mood, self-efficacy and home environment (T2). Three weeks following hospital discharge, participants will complete another qualitative interview focusing on a comparison of preoperative and postoperative preparedness (T3). Researchers will also collect information about the patient's medical conditions, the postoperative complications and healthcare utilisation from the patient's chart 30 days following discharge (T4). We will code and conduct thematic analysis of the qualitative data to identify salient themes. Quantitative data will be analysed using basic descriptive statistics to characterise the participants. We will integrate the qualitative and quantitative findings using results from the quantitative scales to group participants and with use of joint display analysis. ETHICS AND DISSEMINATION Ethics approval was obtained from the University of Michigan IRB. Study findings will be disseminated through peer-reviewed journals and presentations at conferences.
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Affiliation(s)
- Alexandra Norcott
- Geriatric Research, Education, and Clinical Center (GRECC), VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Chiao-Li Chan
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Linda Nyquist
- Institute of Gerontology, University of Michigan, Ann Arbor, Michigan, USA
| | - Julie P Bynum
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy & Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Lillian Min
- Geriatric Research, Education, and Clinical Center (GRECC), VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Michael D Fetters
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Melissa DeJonckheere
- Institute for Healthcare Policy & Innovation, University of Michigan, Ann Arbor, MI, USA
- Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA
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Kunzler BR, Foy AJ, Levi BH, Van Scoy LJ, Lehman EB, Smith TJ, Green MJ. Does Caregiver Participation in Advance Care Planning Using a Decision Support Tool Together With Patients Reduce Caregiver Strain, Burden and Anxiety Over Time? A Post-Hoc Analysis of a Randomized Controlled Trial. Am J Hosp Palliat Care 2021; 39:757-761. [PMID: 34414808 DOI: 10.1177/10499091211040233] [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: 11/17/2022] Open
Abstract
CONTEXT Surrogate decision makers experience significant amounts of anxiety, burden, and strain in their role as caregivers and decision makers for loved ones. OBJECTIVES To investigate longitudinally whether surrogate decision makers engaging in ACP together with their loved one reduces perceived anxiety, burden, and strain felt by surrogate decision makers. METHODS Post-hoc analysis of a randomized controlled trial evaluating caregivers' perceived self-efficacy to serve as surrogate decision makers. The trial employed a 2×2 study design of patient/caregiver dyads who engaged in advance care planning (ACP) using a standard living will form vs "Making Your Wishes Known" (MYWK), and having the patient engage in ACP alone vs together with the family caregiver. Surrogates completed validated survey instruments surveys longitudinally to compare levels of anxiety, burden, and strain. RESULTS 246 of 285 dyads completed the measures. No significant reductions in anxiety, burden, or strain were found longitudinally in surrogate decision makers using MYWK together with loved one's vs other control groups. Increases in strain and anxiety were seen across all study groups and increases in burden across 2/4 study groups. Strain and burden increased most in the MYWK Together arm (▴ = +2.22 and ▴ = +1.91 respectively). CONCLUSION Family caregivers who engaged in ACP together with patients using the decision support tool MYWK did not experience less strain, burden, or anxiety longitudinally compared to other study arms. These results may help inform the design of future studies and interventions that promote caregivers' involvement in ACP interventions.
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Affiliation(s)
| | - Andrew J Foy
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.,Heart and Vascular Institute, Penn State College of Medicine, Hershey, PA, USA
| | - Benjamin H Levi
- Department of Humanities, Penn State College of Medicine, Hershey, PA, USA.,Department of Pediatrics, Penn State College of Medicine, Hershey, PA, USA
| | - Lauren J Van Scoy
- Department of Humanities, Penn State College of Medicine, Hershey, PA, USA.,Department of Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Erik B Lehman
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Theresa J Smith
- Department of Humanities, Penn State College of Medicine, Hershey, PA, USA
| | - Michael J Green
- Department of Humanities, Penn State College of Medicine, Hershey, PA, USA.,Department of Medicine, Penn State College of Medicine, Hershey, PA, USA
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Yuan L, Yuan L. Effectiveness of nursing Intervention on anxiety, psychology and self-efficacy among elderly patients with acute coronary syndrome after percutaneous coronary intervention: An observational cohort study. Medicine (Baltimore) 2021; 100:e26899. [PMID: 34414946 PMCID: PMC8376368 DOI: 10.1097/md.0000000000026899] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/16/2021] [Indexed: 01/04/2023] Open
Abstract
The aim of the present study is to investigate effect nursing intervention on anxiety, psychology and self-efficacy among elderly patients with acute coronary syndrome after percutaneous coronary intervention, and the correlation between patients' anxiety, psychology and self-efficacy and nursing intervention.One hundred thirty six patients with acute coronary intervention were randomly divided into the experimental group (n = 68) and the control group (n = 68). The experimental group received nursing intervention measures, and control group received routine nursing. We measured the depression, anxiety score of the 2 groups before and after nursing and multiple regressions was to analysis the correlation between patients' anxiety, psychology and self-efficacy and nursing intervention.The nursing intervention effect of the 2 groups after intervention were improved before intervention (P < .05), and the Hospital Anxiety and depression scale (HADS) in the was decreased than that of the control group after psychological intervention. The general self-efficacy scale scores of experimental group were obviously improved after receiving the intervention, and the scores in the experimental group were much higher than the control group after receiving the intervention, namely (P < .05). Furthermore, Single regression analysis showed that single (Marital status) (r = 0.367, P < .001), divorced or separated (Marital status) (r = 0.338, P < .001), Widowed (Marital status) (r = 0.458, P < .001), nursing intervention (r = 0.431, P < .001) and Length of hospital stay (r = 0.276, P = .003) showed a significant correlation with patients' anxiety, psychology and self-efficacy. Multiple regression analysis showed that Length of hospital stay (P = .001) and nursing intervention (P < .001) were significantly correlated with patients' anxiety, psychology and self-efficacy.Nursing intervention maybe significantly improve patients' anxiety, psychology and self-efficacy, and nursing intervention was significantly correlated with patients' anxiety, psychology and self-efficacy. Considering the limited number of studies analyzed, large sample-size clinical trials are necessary to verify the effect nursing intervention on anxiety, psychology and self-efficacy among elderly patients with acute coronary syndrome after percutaneous coronary intervention.
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Affiliation(s)
- Leifang Yuan
- Department of Physical examination, Laizhou Municipal People's Hospital, Laizhou, China
| | - Leihua Yuan
- Department of Paediatrics, Laizhou Municipal People's Hospital, Laizhou, China
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29
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Xu Y, Song W, Wang Q, Li H, Peng C, Liu J, Liu R. The effect of a psychological nursing intervention program based on the "Timing it Right" (TIR) framework on elderly patients' anxiety, psychology, and self-efficacy. Am J Transl Res 2021; 13:9600-9606. [PMID: 34540084 PMCID: PMC8430053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/20/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the occurrence of anxiety and depression in elderly patients and to explore the effect of a psychological nursing intervention program based on the "Timing it Right" framework on the anxiety, depression, and self-efficacy among elderly patients. METHODS 135 elderly patients admitted to our hospital were divided into two groups. The 69 patients in the experimental group underwent systematic psychological intervention, and the 66 patients in the control group were given only general psychological support. The Hospital Anxiety and Depression Scale (HADS) and the General Self Efficacy Scale (GSEs) scores were used to assess the effect of the psychological intervention program on the elderly patients. RESULTS The psychological nursing intervention effect of the two groups after the intervention was improved compared with before the intervention (P < 0.05), and the Hospital Anxiety and Depression Scale (HADS) scores were lower in the experimental group than they were in the control group after the psychological intervention. The general self-efficacy scale scores of the experimental group were significantly improved after the intervention, and the scores in the experimental group were much higher than the scores in the control group after the intervention (P < 0.05). CONCLUSION The incidences of anxiety and depression were higher in the elderly patients, and a psychological intervention program based on the "Timing it Right" framework can effectively reduce the negative emotions of anxiety and depression, and enhance the sense of self-efficacy.
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Affiliation(s)
- Yanqiong Xu
- Department of Geratology, The Second People’s Hospital of KunmingKunming 650000, Yunnan, China
| | - Wenhong Song
- Department of Geratology, First Affiliated Hospital of Kunming Medical UniversityKunming 650000, Yunnan, China
| | - Qi Wang
- Department of Traumatic Orthopedic, Kunming Municipal Hospital of Traditional Chinese MedicineKunming 650000, Yunnan, China
| | - Hua Li
- Department of Geratology, The Second People’s Hospital of KunmingKunming 650000, Yunnan, China
| | - Cen Peng
- Department of Geratology, First Affiliated Hospital of Kunming Medical UniversityKunming 650000, Yunnan, China
| | - Jingxian Liu
- Department of Geratology, First Affiliated Hospital of Kunming Medical UniversityKunming 650000, Yunnan, China
| | - Rui Liu
- Department of Traditional Chinese Medicine, The First People’s Hospital of KunmingKunming 650000, Yunnan, China
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Bates CR, Nicholson LM, Rea EM, Hagy HA, Bohnert AM. Life Interrupted: Family Routines Buffer Stress during the COVID-19 Pandemic. JOURNAL OF CHILD AND FAMILY STUDIES 2021; 30:2641-2651. [PMID: 34404970 PMCID: PMC8360776 DOI: 10.1007/s10826-021-02063-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/25/2021] [Indexed: 05/28/2023]
Abstract
Adoption of certain behavioral and social routines that organize and structure the home environment may help families navigate the challenges presented by the COVID-19 pandemic. The current cross-sectional study aimed to assess family routines prior to and during the COVID-19 pandemic and examine associations with individual and family well-being. Using a national sample, 300 caregivers of children ages 6-18 were surveyed using Amazon Mechanical Turk platform during the first three months of COVID-19 pandemic in the United States. Caregivers reported on family demographics, COVID-19-related stress, engagement in family routines (prior to and during the COVID-19 pandemic), stress mindset, self-efficacy, and family resiliency. Overall, families reported engaging in fewer routines during the COVID-19 pandemic compared to prior to the pandemic. COVID-19-related stress was highest in low-income families, families of healthcare workers, and among caregivers who had experienced the COVID-19 virus. Moreover, COVID-19-related stress was negatively related to self-efficacy, positively related to an enhancing stress mindset, and negatively related to family resilience. Engagement in family routines buffered relations between COVID-19-related stress and family resilience, such that COVID-19-related stress was not associated with lower family resilience among families that engaged in high levels of family routines. Results suggest that family routines were challenging to maintain in the context of the COVID-19 pandemic, but were associated with better individual and family well-being during this period of acute health, economic, and social stress.
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Affiliation(s)
- Carolyn R. Bates
- Division of Developmental and Behavioral Health, Department of Pediatrics, Children’s Mercy Kansas City, Kansas City, MO USA
| | | | - Elizabeth M. Rea
- Department of Psychology, Loyola University Chicago, Chicago, IL USA
| | - Hannah A. Hagy
- Department of Psychology, Loyola University Chicago, Chicago, IL USA
| | - Amy M. Bohnert
- Department of Psychology, Loyola University Chicago, Chicago, IL USA
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Racine S, Miller A, Mehak A, Trolio V. Examining risk and protective factors for psychological health during the COVID-19 pandemic. ANXIETY STRESS AND COPING 2021; 35:124-140. [PMID: 34314272 DOI: 10.1080/10615806.2021.1958789] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND OBJECTIVES The coronavirus disease 2019 (COVID-19) pandemic has profoundly impacted people's lives, with significant mental health consequences emerging. In addition to sociodemographic and COVID-19 specific factors, psychological risk and protective mechanisms likely influence individual differences in mental health during the COVID-19 pandemic. We examined associations between a broad set of risk and protective factors with depression, anxiety, alcohol problems, and eating pathology, and investigated interactions between objective stress due to COVID-19 and risk/protective variables in predicting psychopathology. METHODS Participants were 877 adults (73.7% female) recruited via internet sources from around the globe, but primarily residing in North America (87.4%). RESULTS Structural equation modelling revealed that certain risk and protective factors (e.g., loneliness, mindfulness) were broadly related to psychopathology, whereas others showed unique relations with specific symptoms (e.g., greater repetitive thinking and anxiety; low meaning and purpose and depression). COVID-19 objective stress interacted with risk factors, but not protective factors, to predict greater anxiety symptoms, but not other forms of psychopathology. CONCLUSIONS Findings contribute to our understanding of psychological mechanisms underlying individual differences in psychopathology in the context of a global stressor. Strategies that reduce loneliness and increase mindfulness will likely impact the greatest number of mental health symptoms.
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Affiliation(s)
- Sarah Racine
- Department of Psychology, McGill University, Montréal, Canada
| | - Alexia Miller
- Department of Psychology, McGill University, Montréal, Canada
| | - Adrienne Mehak
- Department of Psychology, McGill University, Montréal, Canada
| | - Vittoria Trolio
- Department of Psychology, McGill University, Montréal, Canada
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Wei H, Duan X. Application of KTH-integrated nursing model in care of patients with multi-drug resistant tuberculosis. Am J Transl Res 2021; 13:6855-6863. [PMID: 34306436 PMCID: PMC8290726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 02/19/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To evaluate the effect of the KTH-integrated nursing model of the knowledge-attitude-belief-practice model (KABP)-transtheoretical model (TTM)-as a health belief model (HBM) in nursing care of patients with multi-drug resistant tuberculosis (MDR-TB). METHODS Using a prospective study method, 102 patients with MDR-TB were randomly divided into two groups according to a random number table. The control group (n=51) received conventional nursing care, and the study group (n=51) received a KTH-integrated nursing model. The sputum negative conversion rate, effective rate of lesion absorption, level of disease cognition, compliance, self-efficacy (general self-efficacy scale, GSES score), healthy behavior (health-promoting lifestyle profile, HPLP), and quality of life (GQOL-74 scale score) were compared between the two groups. RESULTS Six months after enrollment, the sputum-negative conversion rate, total effective rate of lesion absorption, and total compliance rate of the study group were significantly higher than those of the control group (80.39% vs. 62.75%, 84.31% vs. 66.67%, 96.08% vs. 78.43%, P<0.05). 6 months after enrollment, the treatment plan, etiopathogenesis and harm, precautions, importance of treatment compliance, observation and follow-up, and total score of the study were all significantly higher than those of the control group (P<0.05). Six months after enrollment, the scores of GSES, HPLP and GQOL-74 in the study group were significantly higher than those of the control group (P<0.05). CONCLUSION The implementation of a KTH integrated nursing model for patients with MDR-TB was beneficial to promote sputum-negative conversion and lesion absorption, and improved disease awareness, medication compliance, self-efficacy, healthy behavior, and quality of life.
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Affiliation(s)
- Hanfen Wei
- The Five Tuberculosis Endemic Areas, The Public Health Clinical Center of ChengduChengdu, Sichuan Province, China
| | - Xiaoqian Duan
- Department of Psychosomatic Medicine, Xijing Hospital, Air Force Military Medical UniversityXi’an, Shaanxi Province, China
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33
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Brett BL, Walton SR, Kerr ZY, Nelson LD, Chandran A, Defreese JD, Echemendia RJ, Guskiewicz KM, Meehan Iii WP, McCrea MA. Distinct latent profiles based on neurobehavioural, physical and psychosocial functioning of former National Football League (NFL) players: an NFL-LONG Study. J Neurol Neurosurg Psychiatry 2021; 92:282-290. [PMID: 33483350 DOI: 10.1136/jnnp-2020-324244] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/30/2020] [Accepted: 09/22/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To identify subgroups of former National Football League (NFL) players using latent profile analysis (LPA) and examine their associations with total years of participation (TYP) and self-reported lifetime sport-related concussion history (SR-CHx). METHODS Former NFL players (N=686) aged 50-70 years, with an average 18.0 TYP (±4.5) completed a questionnaire. SR-CHx distributions included: low (0-3; n=221); intermediate (4-8; n=209) and high (9+; n=256). LPA measures included: Quality of Life in Neurological Disorders Emotional-Behavioral Dyscontrol, Patient Reported Outcomes Measurement Information System Cognitive Function, Emotional Support, Self-Efficacy, Meaning and Purpose, Physical Function, Pain Interference, Participation in Social Roles and Activities, Anxiety, Depression, Fatigue, and Sleep Disturbance. Demographic, medical/psychiatric history, current psychosocial stressors, TYP and SR-CHx were compared across latent profiles (LPs). RESULTS A five profile solution emerged: (LP1) global higher functioning (GHF; 26.5%); (LP2) average functioning (10.2%); (LP3) mild somatic (pain and physical functioning) concerns (22.0%); (LP4) somatic and cognitive difficulties with mild anxiety (SCA; 27.5%); LP5) global impaired functioning (GIF; 13.8%). The GIF and SCA groups reported the largest number ofe- medical/psychiatric conditions and higher psychosocial stressor levels. SR-CHx was associated with profile group (χ2(8)=100.38, p<0.001); with a higher proportion of GIF (72.6%) and SCA (43.1%) groups reporting being in the high SR-CHx category, compared with GHF (23.1%), average (31.4%) and somatic (27.8%) groups. TYP was not significantly associated with group (p=0.06), with greater TYP reported by the GHF group. CONCLUSIONS Five distinct profiles of self-reported functioning were identified among former NFL players. Several comorbid factors (ie, medical/psychiatric diagnoses and psychosocial stressors) and SR-CHx were associated with greater neurobehavioural and psychosocial dysfunction.
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Affiliation(s)
- Benjamin L Brett
- Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA .,Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Samuel R Walton
- Exercise and Sports Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Zachery Y Kerr
- Exercise and Sports Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Lindsay D Nelson
- Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Avinash Chandran
- NCAA Injury Surveillance Program, Datalys Center for Sports Injury Research and Prevention, Indianapolis, Indiana, USA
| | - J D Defreese
- Exercise and Sports Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Ruben J Echemendia
- Psychological and Neurobehavioral Associates, State College, Pennsylvania, USA
| | - Kevin M Guskiewicz
- Exercise and Sports Science, University of North Carolina, Chapel Hill, North Carolina, USA
| | | | - Michael A McCrea
- Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.,Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Carlozzi NE, Kallen MA, Brickell TA, Lange RT, Boileau NR, Tulsky D, Hanks RA, Massengale JP, Nakase-Richardson R, Ianni PA, Miner JA, French LM, Sander AM. Measuring emotional suppression in caregivers of adults with traumatic brain injury. Rehabil Psychol 2020; 65:455-470. [PMID: 31580109 PMCID: PMC7117989 DOI: 10.1037/rep0000291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Caregivers of individuals with traumatic brain injury (TBI) often feel pressure to maintain the appearance that they are emotionally well adjusted, despite feelings to the contrary. Because there are currently no measures examining this construct, this article focuses on the development of a new measure that is specific to caregivers of people with TBI. DESIGN A total of 533 caregivers of civilians with TBI (n = 218) or service members/veterans (SMVs) with TBI (n = 315) completed 43 emotional suppression items, as well as other patient-reported outcomes and an estimate of the functional ability of the person with TBI. RESULTS Exploratory and confirmatory factor analyses supported the retention of 25 items. Graded response model (GRM) analyses and differential item functioning (DIF) studies supported the retention of 21 items in the final measure. Expert review and GRM calibration data were used to develop a 6-item static short form (SF) and program a computer adaptive test (CAT). Internal consistency was excellent for both the CAT and SF (reliabilities ≥ 0.91); 3-week test-retest stability was good (all intraclass correlations ≥ 0.89). Convergent validity was supported by moderate associations between TBI-CareQOL Emotional Suppression and related measures (rs from 0.47 to 0.59); discriminant validity was supported by small correlations between Emotional Suppression and positive aspects of caregiving and physical health (rs from 0.14 to 0.28). Known-groups validity was also supported. CONCLUSIONS The new TBI-CareQOL Emotional Suppression CAT and 6-item short form is the first self-report measure of this construct in this population. Our findings suggest this new measure has strong psychometric properties. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Noelle E. Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Michael A. Kallen
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Tracey A. Brickell
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD
- Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Rael T. Lange
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Nicholas R. Boileau
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - David Tulsky
- Center for Health Assessment Research and Translation, and Departments of Physical Therapy and Psychological Brain Sciences, University of Delaware, Newark, DE
| | - Robin A. Hanks
- Department of Psychology and Neuropsychology, Rehabilitation Institute of Michigan, Detroit, MI
- Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, MI
| | | | - Risa Nakase-Richardson
- MHBS, James A. Haley Veterans’ Hospital, Tampa, FL
- Defense and Veterans Brain Injury Center, James A. Haley Veterans’ Hospital, Tampa, FL
- Department of Internal Medicine, Morsani College of Medicine, University of South Florida, Tampa, FL
| | - Phillip A. Ianni
- Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, MI
| | - Jennifer A. Miner
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Louis M. French
- Defense and Veterans Brain Injury Center, Walter Reed National Military Medical Center, Bethesda, MD
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD
- Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Angelle M. Sander
- H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine/Harris Health System, Houston, TX
- Brain Injury Research Center, TIRR Memorial Hermann, Houston, TX
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Hamilton CB, Li LC. Measures of Patient Activation and Self-Efficacy. Arthritis Care Res (Hoboken) 2020; 72 Suppl 10:645-659. [PMID: 33091240 DOI: 10.1002/acr.24350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/05/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Clayon B Hamilton
- The University of British Columbia, Vancouver, British Columbia, Canada, and Arthritis Research Canada, Richmond, British Columbia, Canada
| | - Linda C Li
- The University of British Columbia, Vancouver, British Columbia, Canada, and Arthritis Research Canada, Richmond, British Columbia, Canada
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Campbell M, Ramirez-Zohfeld V, Seltzer A, Lindquist LA. Training Hospitalists in Negotiations to Address Conflicts with Older Adults around Their Social Needs. Geriatrics (Basel) 2020; 5:E50. [PMID: 32937771 PMCID: PMC7555776 DOI: 10.3390/geriatrics5030050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/04/2020] [Accepted: 09/09/2020] [Indexed: 11/23/2022] Open
Abstract
Hospitalists care for a growing population of older patients with unique social needs that can often be addressed by providing caregiver help in the home. The importance of addressing social needs is well-recognized, yet older patients sometimes refuse these services. This refusal of services may result in rehospitalization and increased morbidity for patients. We aimed to overcome this refusal of social support through an innovative workshop training hospitalists in negotiation and dispute resolution. Hospitalists at a tertiary care, urban academic medical center completed a one-hour interactive workshop on negotiation and dispute resolution focused on addressing older patients' refusal of social services. One month post workshop, participants reported increased confidence in engaging patients and families in conflicts and felt empowered to negotiate in both their clinical practice and personal lives. Training hospitalists to negotiate with older adults needing social services is feasible and positively impacts the ability to provide geriatric care.
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Affiliation(s)
- Mobola Campbell
- Department of Medicine, Mayo Clinic, Jacksonville, FL 32224, USA;
| | - Vanessa Ramirez-Zohfeld
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA; (V.R.-Z.); (A.S.)
| | - Anne Seltzer
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA; (V.R.-Z.); (A.S.)
| | - Lee A. Lindquist
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA; (V.R.-Z.); (A.S.)
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Salsman JM, McLouth LE, Cohn M, Tooze JA, Sorkin M, Moskowitz JT. A Web-Based, Positive Emotion Skills Intervention for Enhancing Posttreatment Psychological Well-Being in Young Adult Cancer Survivors (EMPOWER): Protocol for a Single-Arm Feasibility Trial. JMIR Res Protoc 2020; 9:e17078. [PMID: 32463014 PMCID: PMC7290453 DOI: 10.2196/17078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/10/2020] [Accepted: 02/27/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Adolescent and young adult cancer survivors (AYAs) experience clinically significant distress and have limited access to supportive care services. Interventions to enhance psychological well-being have improved positive affect and reduced depression in clinical and healthy populations but have not been routinely tested in AYAs. OBJECTIVE The aim of this protocol is to (1) test the feasibility and acceptability of a Web-based positive emotion skills intervention for posttreatment AYAs called Enhancing Management of Psychological Outcomes With Emotion Regulation (EMPOWER) and (2) examine proof of concept for reducing psychological distress and enhancing psychological well-being. METHODS The intervention development and testing are taking place in 3 phases. In phase 1, we adapted the content of an existing, Web-based positive emotion intervention so that it would be suitable for AYAs. EMPOWER targets 8 skills (noticing positive events, capitalizing, gratitude, mindfulness, positive reappraisal, goal setting, personal strengths, and acts of kindness) and is delivered remotely as a 5-week, Web-based intervention. Phase 2 consisted of a pilot test of EMPOWER in a single-arm trial to evaluate feasibility, acceptability, retention, and adherence and to collect data on psychosocial outcomes for proof of concept. In phase 3, we are refining study procedures and conducting a second pilot test. RESULTS The project was part of a career development award. Pilot work began in June 2015, and data collection was completed in March 2019. The analysis is ongoing, and results will be submitted for publication by May 2020. CONCLUSIONS If this intervention proves feasible and acceptable, EMPOWER will be primed for a subsequent large, multisite randomized controlled trial. As a scalable intervention, it will be ideally suited for AYA survivors who would otherwise not have access to supportive care interventions to help manage posttreatment distress and enhance well-being. TRIAL REGISTRATION ClinicalTrials.gov NCT02832154, https://clinicaltrials.gov/ct2/show/NCT02832154. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/17078.
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Affiliation(s)
- John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest School of Medicine, Winston Salem, NC, United States
| | - Laurie E McLouth
- Department of Behavioral Science, Markey Cancer Center, University of Kentucky College of Medicine, Lexington, KY, United States
| | - Michael Cohn
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Janet A Tooze
- Department of Biostatistics and Data Science, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest School of Medicine, Winston Salem, NC, United States
| | - Mia Sorkin
- Department of Obstetrics & Gynecology, University of Chicago, Chicago, IL, United States
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Benedict C, Ford JS, Schapira L, Simon P, Spiegel D, Diefenbach M. Family-building decision aid and planning tool for young adult women after cancer treatment: protocol for preliminary testing of a web-based decision support intervention in a single-arm pilot study. BMJ Open 2019; 9:e033630. [PMID: 31888941 PMCID: PMC6937115 DOI: 10.1136/bmjopen-2019-033630] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Many young adult female (YA-F) cancer survivors who received gonadotoxic therapy will experience fertility problems. After cancer, having a child will often require assisted reproductive technology (ART), surrogacy or adoption. However, there are significant informational, psychosocial, financial and logistical barriers to pursuing these options. Survivors report high rates of decision uncertainty and distress related to family-building decisions. The aim of this study is to pilot test a web-based decision aid and planning tool for family-building after cancer. METHODS AND ANALYSIS The pilot study will use a single-arm trial design to test the feasibility and acceptability (aim 1) and obtain effect size estimates of the decision support intervention (aim 2). The target sample size is 100. Participants will include YA-F survivors (aged 18-45 years) who are post-treatment and have not completed desired family-building. A longitudinal prepost design will be conducted. Participants will complete three psychosocial assessment surveys over a 3-month time period to track decisional conflict (primary outcome) and cognitive, emotional, and behavioural functioning (secondary outcomes). After completing the baseline survey (T1; pre-intervention), participants will have access to the decision aid website. Postintervention surveys will be administered at 1-month (T2) and 3-month (T3) follow-up time points. Feasibility and acceptability metrics will be analysed. Pairwise t-tests will test mean scores of outcome variables from T1 to T2. Effect size estimates (Cohen's d) will be calculated. Google analytics will evaluate user engagement with the website over the study period. Baseline and follow-up data will examine measures of feasibility, acceptability and intervention effect size. ETHICS AND DISSEMINATION This will be the first test of a supportive intervention to guide YA-F cancer survivors in family-building decisions and early planning. Study findings will inform intervention development. Future directions will include a randomised controlled trial to test intervention efficacy over a longer time period. TRIAL REGISTRATION NUMBER NCT04059237; Pre-results.
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Affiliation(s)
- Catherine Benedict
- Stanford University School of Medicine, Stanford, California, USA
- Stanford Cancer Institute, Palo Alto, California, USA
| | - Jennifer S Ford
- Hunter College and The Graduate Center, City University of New York (CUNY), New York City, New York, USA
| | - Lidia Schapira
- Stanford University School of Medicine, Stanford, California, USA
- Stanford Cancer Institute, Palo Alto, California, USA
| | - Pamela Simon
- Lucile Packard Children's Hospital Stanford, Palo Alto, California, USA
| | - David Spiegel
- Stanford University School of Medicine, Stanford, California, USA
- Stanford Cancer Institute, Palo Alto, California, USA
| | - Michael Diefenbach
- Center for Health Innovation and Outcomes Research, Feinstein Institute for Medical Research, Northwell Health, Manhasset, New York, USA
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