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Pfefferbaum B, Jacobs AK, Jones RT, Reyes G, Wyche KF. A Skill Set for Supporting Displaced Children in Psychological Recovery After Disasters. Curr Psychiatry Rep 2017; 19:60. [PMID: 28736806 DOI: 10.1007/s11920-017-0814-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Helping children, adolescents, and families displaced following a natural disaster is a daunting task made more challenging by the relatively small research base to inform services and interventions. This paper describes the current literature pertaining to intervention practices used with displaced youth. Where gaps in the literature exist, we pull from the more general research on relocation and post-disaster intervention to assist practitioners in tailoring their efforts. Specifically discussed are ways to enhance youth resilience, to help youth build new social connections and adjust to change and uncertainty while coping with trauma-related symptoms, and to meet needs through the systems in which children are embedded. The need for focused attention to cultural factors is discussed with an emphasis on collaborating with culture brokers.
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Affiliation(s)
- Betty Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, College of Medicine, Terrorism and Disaster Center, University of Oklahoma Health Sciences Center, 920 Stanton L. Young Boulevard, P.O. Box 26901, WP3217, Oklahoma City, OK, 73126-0901, USA.
| | - Anne K Jacobs
- Terrorism and Disaster Center, University of Oklahoma Health Sciences Center, 4621 N.W. 157th Terrace, Edmond, OK, 73013, USA
| | - Russell T Jones
- Virginia Polytechnic Institute and State University, Department of Psychology, 137 Williams Hall, Drill Field Drive, Blacksburg, VA, 24060, USA
| | - Gilbert Reyes
- National Child Traumatic Stress Network, 11150 W. Olympic Blvd., Suite 650, Los Angeles, CA, 90064, USA
| | - Karen F Wyche
- School of Nursing, The George Washington University, 45085 University Drive, Suite 201, Ashburn, VA, 20147, USA
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do Carmo TM, Paiva BSR, de Oliveira CZ, Nascimento MSDA, Paiva CE. The feasibility and benefit of a brief psychosocial intervention in addition to early palliative care in patients with advanced cancer to reduce depressive symptoms: a pilot randomized controlled clinical trial. BMC Cancer 2017; 17:564. [PMID: 28836960 PMCID: PMC5569457 DOI: 10.1186/s12885-017-3560-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 08/17/2017] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The aim of this study was to assess the feasibility and potential benefit of a brief psychosocial intervention based on cognitive-behavioral therapy performed in addition to early palliative care (PC) in the reduction of depressive symptoms among patients with advanced cancer. METHODS An open-label randomized phase II clinical trial with two intervention arms and one control group. Patients with advanced cancer starting palliative chemotherapy and who met the selection criteria were included. The participants were randomly allocated to three arms: arm A, five weekly sessions of psychosocial intervention combined with early PC; arm B, early PC only; and arm C, standard cancer treatment. Feasibility was investigated by calculating rates (%) of inclusion, attrition, and contamination (% of patients from Arm C that received PC). Scores of depression (primary aim), anxiety, and quality of life were measured at baseline and 45, 90, 120, and 180 days after randomization. RESULTS From the total of 613 screened patients (10.3% inclusion rate), 19, 22, and 22 patients were allocated to arms A, B, and C, respectively. Contamination and attrition rates (180 days) were 31.8% and 38.0%, respectively. No interaction between the arms and treatments were found. Regarding effect sizes, there was a moderate benefit in arm A over arms B and C in emotional functioning (-0.66 and -0.61, respectively) but a negative effect of arm A over arm C in depression (-0.74). CONCLUSIONS Future studies to be conducted with this population group need to revise the eligibility criteria and make them less restrictive. In addition, the need for arm C is questioned due to high contamination rate. The designed psychosocial intervention was not able to reduce depressive symptoms when combined with early PC. Further studies are warrant to evaluate the intervention on-demand and in subgroups of high risk of anxiety/depression. TRIAL REGISTRATION Clinical Trials identifier NCT02133274 . Registered May 6, 2014.
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Affiliation(s)
| | - Bianca Sakamoto Ribeiro Paiva
- Health-Related Quality of Life Research Group (GPQual), Barretos Cancer Hospital, Barretos, SP, Brazil.,Center for Research Support (NAP), Barretos Cancer Hospital, Barretos, SP, Brazil
| | | | | | - Carlos Eduardo Paiva
- Health-Related Quality of Life Research Group (GPQual), Barretos Cancer Hospital, Barretos, SP, Brazil. .,Center for Research Support (NAP), Barretos Cancer Hospital, Barretos, SP, Brazil. .,Department of Clinical Oncology, Barretos Cancer Hospital, Barretos, SP, Brazil. .,Departamento de Oncologia Clínica, Divisão de Mama e Ginecologia, Rua Antenor Duarte Vilella, 1331, Bairro Dr Paulo Prata, Barretos, SP, CEP: 14784-400, Brazil.
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Alisic E, Tyler MP, Giummarra MJ, Kassam-Adams R, Gouweloos J, Landolt MA, Kassam-Adams N. Trauma-informed care for children in the ambulance: international survey among pre-hospital providers. Eur J Psychotraumatol 2017; 8:1273587. [PMID: 28326162 PMCID: PMC5328382 DOI: 10.1080/20008198.2016.1273587] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 12/05/2016] [Accepted: 12/12/2016] [Indexed: 11/20/2022] Open
Abstract
Background: Pre-hospital providers, such as paramedics and emergency medical technicians, are in a position to provide key emotional support to injured children and their families. Objective: Our goal was to examine (a) pre-hospital providers' knowledge of traumatic stress in children, attitudes towards psychosocial aspects of care, and confidence in providing psychosocial care, (b) variations in knowledge, attitudes, and confidence according to demographic and professional characteristics, and (c) training preferences of pre-hospital providers regarding psychosocial care to support paediatric patients and their families. Method: We conducted a cross-sectional, online survey among an international sample of 812 pre-hospital providers from high-income countries. The questionnaire was adapted from a measure for a similar study among Emergency Department staff, and involved 62 items in 7 main categories (e.g. personal and work characteristics, knowledge of paediatric traumatic stress, and confidence regarding 18 elements of psychosocial care). The main analyses comprised descriptive statistics and multiple regression analyses. Results: On average, respondents answered 2.7 (SD = 1.59) out of seven knowledge questions correctly. Respondents with higher knowledge scores were more often female, parent of a child under 17, and reported that at least 10% of their patients were children. A majority of participants (83.5%) saw all 18 aspects of psychosocial care as part of their job. Providers felt moderately confident (M = 3.2, SD = 0.45) regarding their skills in psychosocial care, which was predicted by gender (female), having more experience, having a larger proportion of child patients, and having received training in psychosocial care in the past five years. Most respondents (89.7%) wanted to gain more knowledge and skills regarding psychosocial care for injured children. In terms of training format, they preferred an interactive website or a one-off group training. Conclusions: There appears to be both a need and an opportunity for education initiatives regarding paediatric traumatic stress in the pre-hospital context.
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Affiliation(s)
- Eva Alisic
- Monash University Accident Research Centre, Monash University, Clayton, Australia; Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland
| | - Mark P Tyler
- School of Psychological Science and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Australia; School of Psychology and Public Health, Department of Psychology and Counselling, La Trobe University, Melbourne, Australia
| | - Melita J Giummarra
- Institute of Safety, Compensation & Recovery Research, Melbourne, Australia; Caulfield Pain Management & Research Centre, Caulfield Hospital, Caulfield, Australia; Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia
| | - Rahim Kassam-Adams
- College of Science and Technology, Temple University , Philadelphia , PA , USA
| | - Juul Gouweloos
- Impact, National Knowledge and Advice Centre for Psychosocial Care Concerning Critical Incidents, Partner in Arq Psychotrauma Expert Group, Diemen, The Netherlands; Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands
| | - Markus A Landolt
- Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland; Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Nancy Kassam-Adams
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA; School of Medicine, University of Pennsylvania Perelman, Philadelphia, PA, USA
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Lee MS, Hwang JW, Lee CS, Kim JY, Lee JH, Kim E, Chang HY, Bae SM, Park JH, Bhang SY. Psychosocial Interventions for Children and Adolescents after a Disaster: A Systematic Literature Review (1991–2015). Soa Chongsonyon Chongsin Uihak 2016. [DOI: 10.5765/jkacap.2016.27.4.278] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Mi-Sun Lee
- Department of Psychiatry, Eulji University Hospital, Seoul, Korea
| | - Jun-Won Hwang
- Department of Psychiatry, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Cheol-Soon Lee
- Department of Psychiatry, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea
| | | | | | - Eunji Kim
- Todak Psychiatry Clinic, Ansan, Korea
| | - Hyoung Yoon Chang
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Korea
- Sunflower Center of Southern Gyeonggi for Women and Children Victims of Violence, Suwon, Korea
| | - Seung-Min Bae
- Department of Psychiatry, Gachon University Gil Medical Center, Incheon, Korea
| | - Jang-Ho Park
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Soo-Young Bhang
- Department of Psychiatry, Eulji University School of Medicine, Eulji University Hospital, Seoul, Korea
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Child Disaster Mental Health Services: a Review of the System of Care, Assessment Approaches, and Evidence Base for Intervention. Curr Psychiatry Rep 2016; 18:5. [PMID: 26719308 DOI: 10.1007/s11920-015-0647-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Several decades of research have informed our knowledge of children's reactions to disasters and the factors that influence their reactions. This article describes the system of care for child disaster mental health services using population risk to determine needed services and a stepped care approach built on assessment and monitoring to advance children to appropriate services. To assess the evidence base for disaster interventions, recent reviews of numerous child disaster mental health interventions are summarized.
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