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Paul RW, Streicher S, Wallingford M, Campbell MP, Hanna AJ, Bryan S, Tjoumakaris FP, Freedman KB. Association Between Preoperative Patient Resilience and Patient-Reported Outcomes After Rotator Cuff Repair. Orthop J Sports Med 2024; 12:23259671241255400. [PMID: 38881854 PMCID: PMC11179476 DOI: 10.1177/23259671241255400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 12/05/2023] [Indexed: 06/18/2024] Open
Abstract
Background Mental and emotional health can affect outcomes after orthopaedic surgery, and patient resilience has been found to be significantly related to postoperative functional outcomes. Purpose To evaluate the relationship between preoperative patient resilience and 2-year postoperative patient-reported outcomes after rotator cuff repair (RCR). It was hypothesized that patients with low preoperative resilience will have worse patient-reported outcomes at 2 years after RCR versus those with high resilience. Study Design Cohort study; Level of evidence, 3. Methods Patients who underwent primary arthroscopic RCR in 2020 at a single institution and completed the Brief Resilience Scale (BRS) preoperatively were identified. Other inclusion criteria were American Shoulder and Elbow Surgeons (ASES) and Single Assessment Numeric Evaluation (SANE) scores at the 2-year follow-up. Outcomes were compared in patients as divided into low resilience (BRS score >1 SD below the mean), normal resilience (BRS score ≤1 SD of the mean), and high resilience (BRS score >1 SD above the mean) groups. Results Overall, 100 patients (52 male, 48 female; mean age, 60 ± 9 years) were included in this study. Mean BRS scores did not change significantly from preoperative to 2-year follow-up (3.8 ± 0.7 vs 3.9 ± 0.8, P = .404). All patients had preoperative ASES scores. Low-resilience patients (n = 17) had significantly lower preoperative ASES scores compared with normal (n = 64) and high resilience (n = 19) patients (35 vs 42 vs 54, respectively; P = .022). There were no significant group differences in postoperative outcomes (revision rate, ASES score, ASES score improvement from preoperative to 2-year follow-up, or SANE score). Multivariate analysis indicated that preoperative resilience was not significantly associated with ASES score improvement (β estimate = -5.64, P = .150), while resilience at 2-year follow-up was significantly related to ASES score improvement (β estimate = 6.41, P = .031). Conclusion Patient-reported outcomes at 2-year follow-up did not differ based on preoperative patient resilience for arthroscopic RCR patients. Multivariate analysis also showed that preoperative resilience was not associated with improvement in ASES scores; however, resilience at 2-year follow-up was associated with ASES score improvement.
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Affiliation(s)
- Ryan W Paul
- Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, USA
- Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
| | | | | | | | - Adeeb J Hanna
- Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, USA
| | - Sean Bryan
- Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, USA
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Hayashi K, Rabu G, Cui Z, Klaire S, Homayra F, Milloy MJ, Nosyk B. Characterizing the Use of Healthcare Access Supports Among People Who Use Drugs in Vancouver, Canada, 2017 to 2020: A Cohort Study. SUBSTANCE USE & ADDICTION JOURNAL 2024:29767342241249870. [PMID: 38804580 DOI: 10.1177/29767342241249870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
BACKGROUND For structurally marginalized populations, including people who use drugs (PWUD), equitable access to healthcare can be achieved through healthcare access supports. However, few studies characterized utilization of formal (eg, outreach workers, healthcare professionals) and informal (eg, friends/family) supports. Therefore, we sought to estimate the prevalence of and factors associated with receiving each type of support among PWUD. METHODS We used data from 2 prospective cohort studies of PWUD in Vancouver, Canada, in 2017 to 2020. We constructed separate multivariable generalized linear mixed-effects models to identify factors associated with receiving each of the 3 types of supports (ie, healthcare professionals, outreach workers/peer navigators, and informal supports) compared to no supports. RESULTS Of 996 participants, 350 (35.1%) reported receiving supports in the past 6 months at baseline, through informal supports (6.2%), outreach workers (14.1%), and healthcare professionals (20.9%). In multivariable analyses, HIV positivity, chronic pain, and avoiding healthcare due to the past mistreatment were positively associated with receiving supports from each of healthcare professionals and outreach workers. Men were less likely to receive any types of the supports (all P < .05). CONCLUSIONS Utilization of healthcare access supports was relatively low in this sample. However, formal supports appeared to have reached PWUD exhibiting more comorbidities and experiencing discrimination in healthcare. Further efforts to make formal supports more available would benefit PWUD with unmet healthcare needs, particularly men.
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Affiliation(s)
- Kanna Hayashi
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Gabrielle Rabu
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
| | - Zishan Cui
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
- School of Population and Public Health, The University of British Columbia, Vancouver, BC, Canada
| | - Sukhpreet Klaire
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
- Interdepartmental Division of Addiction Medicine, Providence Health Care, Vancouver, BC, Canada
- Department of Family Practice, The University of British Columbia, Vancouver, BC, Canada
| | | | - Michael-John Milloy
- British Columbia Centre on Substance Use, Vancouver, BC, Canada
- Division of Social Medicine, Department of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - Bohdan Nosyk
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- Centre for Advancing Health Outcomes, Vancouver, BC, Canada
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Heydari A, Manzari ZS, Mohammadpourhodki R. Peer-support interventions and related outcomes in patients with myocardial infarction: A systematic review. Heliyon 2024; 10:e25314. [PMID: 38327461 PMCID: PMC10847649 DOI: 10.1016/j.heliyon.2024.e25314] [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] [Received: 08/08/2023] [Revised: 12/19/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024] Open
Abstract
Objective Myocardial infarction (MI) is one of the main causes of disability and death worldwide. Peer-support can ameliorate the psychological and physical morbidities associated with heart diseases. The aim of this study was to determine whether peer-support interventions could improve the psychological and behavioral health outcomes commonly experienced by MI patients. Methods In this systematic review, international databases (PubMed, Web of Science, and Scopus) were searched to gather related publications up to March 2023. Eligible papers were those addressing the outcomes of peer-support interventions in individuals with a history of MI. Result Twelve clinical trials published in English with a Jadad score of 3 or 4 (out of 5) were included in the final review. These studies used four approaches to deliver peer-support interventions: face-to-face, telephone-based, educational videos, and group discussion. The results showed that peer-support could have a positive effect on depression, anxiety, quality of life, sexual performance, self-care, and medication adherence. Conclusion Considering the serious impacts of MI on life, these patients need empowerment training. Peer-support can be used as a complementary supportive method to reduce MI patients' psychological complications and improve their behavioral outcomes.
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Affiliation(s)
- Abbas Heydari
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Sadat Manzari
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Mohammadpourhodki
- Student Research Committee, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
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Purcell C, Dibben G, Hilton Boon M, Matthews L, Palmer VJ, Thomson M, Smillie S, Simpson SA, Taylor RS. Social network interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease. Cochrane Database Syst Rev 2023; 6:CD013820. [PMID: 37378598 PMCID: PMC10305790 DOI: 10.1002/14651858.cd013820.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/29/2023]
Abstract
BACKGROUND Globally, cardiovascular diseases (CVD, that is, coronary heart (CHD) and circulatory diseases combined) contribute to 31% of all deaths, more than any other cause. In line with guidance in the UK and globally, cardiac rehabilitation programmes are widely offered to people with heart disease, and include psychosocial, educational, health behaviour change, and risk management components. Social support and social network interventions have potential to improve outcomes of these programmes, but whether and how these interventions work is poorly understood. OBJECTIVES: To assess the effectiveness of social network and social support interventions to support cardiac rehabilitation and secondary prevention in the management of people with heart disease. The comparator was usual care with no element of social support (i.e. secondary prevention alone or with cardiac rehabilitation). SEARCH METHODS: We undertook a systematic search of the following databases on 9 August 2022: CENTRAL, MEDLINE, Embase, and the Web of Science. We also searched ClinicalTrials.gov and the WHO ICTRP. We reviewed the reference lists of relevant systematic reviews and included primary studies, and we contacted experts to identify additional studies. SELECTION CRITERIA: We included randomised controlled trials (RCTs) of social network or social support interventions for people with heart disease. We included studies regardless of their duration of follow-up, and included those reported as full text, published as abstract only, and unpublished data. DATA COLLECTION AND ANALYSIS Using Covidence, two review authors independently screened all identified titles. We retrieved full-text study reports and publications marked 'included', and two review authors independently screened these, and conducted data extraction. Two authors independently assessed risk of bias, and assessed the certainty of the evidence using GRADE. Primary outcomes were all-cause mortality, cardiovascular-related mortality, all-cause hospital admission, cardiovascular-related hospital admission, and health-related quality of life (HRQoL) measured at > 12 months follow-up. MAIN RESULTS: We included 54 RCTs (126 publications) reporting data for a total of 11,445 people with heart disease. The median follow-up was seven months and median sample size was 96 participants. Of included study participants, 6414 (56%) were male, and the mean age ranged from 48.6 to 76.3 years. Studies included heart failure (41%), mixed cardiac disease (31%), post-myocardial infarction (13%), post-revascularisation (7%), CHD (7%), and cardiac X syndrome (1%) patients. The median intervention duration was 12 weeks. We identified notable diversity in social network and social support interventions, across what was delivered, how, and by whom. We assessed risk of bias (RoB) in primary outcomes at > 12 months follow-up as either 'low' (2/15 studies), 'some concerns' (11/15), or 'high' (2/15). 'Some concerns' or 'high' RoB resulted from insufficient detail on blinding of outcome assessors, data missingness, and absence of pre-agreed statistical analysis plans. In particular, HRQoL outcomes were at high RoB. Using the GRADE method, we assessed the certainty of evidence as low or very low across outcomes. Social network or social support interventions had no clear effect on all-cause mortality (risk ratio (RR) 0.75, 95% confidence interval (CI) 0.49 to 1.13, I2 = 40%) or cardiovascular-related mortality (RR 0.85, 95% CI 0.66 to 1.10, I2 = 0%) at > 12 months follow-up. The evidence suggests that social network or social support interventions for heart disease may result in little to no difference in all-cause hospital admission (RR 1.03, 95% CI 0.86 to 1.22, I2 = 0%), or cardiovascular-related hospital admission (RR 0.92, 95% CI 0.77 to 1.10, I2 = 16%), with a low level of certainty. The evidence was very uncertain regarding the impact of social network interventions on HRQoL at > 12 months follow-up (SF-36 physical component score: mean difference (MD) 31.53, 95% CI -28.65 to 91.71, I2 = 100%, 2 trials/comparisons, 166 participants; mental component score MD 30.62, 95% CI -33.88 to 95.13, I2 = 100%, 2 trials/comparisons, 166 participants). Regarding secondary outcomes, there may be a decrease in both systolic and diastolic blood pressure with social network or social support interventions. There was no evidence of impact found on psychological well-being, smoking, cholesterol, myocardial infarction, revascularisation, return to work/education, social isolation or connectedness, patient satisfaction, or adverse events. Results of meta-regression did not suggest that the intervention effect was related to risk of bias, intervention type, duration, setting, and delivery mode, population type, study location, participant age, or percentage of male participants. AUTHORS' CONCLUSIONS: We found no strong evidence for the effectiveness of such interventions, although modest effects were identified in relation to blood pressure. While the data presented in this review are indicative of potential for positive effects, the review also highlights the lack of sufficient evidence to conclusively support such interventions for people with heart disease. Further high-quality, well-reported RCTs are required to fully explore the potential of social support interventions in this context. Future reporting of social network and social support interventions for people with heart disease needs to be significantly clearer, and more effectively theorised, in order to ascertain causal pathways and effect on outcomes.
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Affiliation(s)
- Carrie Purcell
- Faculty of Wellbeing, Education and Language Studies, The Open University in Scotland, Edinburgh, UK
| | - Grace Dibben
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Michele Hilton Boon
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Lynsay Matthews
- School of Health and Life Sciences, University of the West of Scotland, Glasgow, UK
| | - Victoria J Palmer
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Meigan Thomson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Susie Smillie
- School of Social and Political Sciences, University of Glasgow, Glasgow, UK
| | - Sharon A Simpson
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Rod S Taylor
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, UK
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Brown M, Páez YD, Jabri A, Weiner J, Allen A, Sydnor-Campbell T, Fritz S, Creasman M, Kasturi S, Safford MM, Navarro-Millán I. Virtual training of rheumatoid arthritis peer coaches in motivational interviewing skills and concepts of cardiovascular disease. Contemp Clin Trials Commun 2023; 33:101130. [PMID: 37122490 PMCID: PMC10130077 DOI: 10.1016/j.conctc.2023.101130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/20/2023] [Accepted: 04/04/2023] [Indexed: 04/08/2023] Open
Abstract
Background Peer coaching interventions are effective in helping individuals with chronic conditions understand their disease. Most peer coach training programs occur in person, which has become an obstacle during the COVID pandemic. We describe our experiences with virtual training for future peer coach interventions. Methods Individuals with rheumatoid arthritis (RA) between 40 and 75 years of age were recruited and interviewed by the research team. We conducted seven virtual training sessions focused on four main points: Listen, Discuss, Practice, and Certify. The peer coaches provided feedback throughout the program, which was used to refine the training and intervention. A post-training focus group assessed satisfaction with the training program and intervention development process. Results Four peer coaches (3 women, 1 man) were trained, including 2 Black and 2 White individuals with advanced degrees. Their ages ranged from 52 to 57, and their RA duration ranged from 5 to 15 years. An iterative process with the coaches and researchers resulted in a nine-week training program. Peer coaches reported satisfaction, confidence, and a preference for the virtual training format. Conclusion This virtual peer coach training program was feasible and acceptable for coaches with advanced degrees during the global COVID-19 pandemic. Our approach represents an opportunity to adapt training that has been traditionally done in person. By doing so, our approach facilitates the recruitment and training of a diverse group of coaches and promotes sustainability.
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Affiliation(s)
- Mackenzie Brown
- Weill Cornell Medicine, Division of General Internal Medicine, New York, NY, USA
| | | | - Assem Jabri
- Weill Cornell Medicine, Division of General Internal Medicine, New York, NY, USA
| | - Joan Weiner
- Weill Cornell Medicine, Division of General Internal Medicine, New York, NY, USA
- Patient Power Research Network-ArthritisPower, USA
| | - Aberdeen Allen
- Weill Cornell Medicine, Division of General Internal Medicine, New York, NY, USA
- Patient Power Research Network-ArthritisPower, USA
| | - Tien Sydnor-Campbell
- Weill Cornell Medicine, Division of General Internal Medicine, New York, NY, USA
- Patient Power Research Network-ArthritisPower, USA
| | - Shelley Fritz
- Weill Cornell Medicine, Division of General Internal Medicine, New York, NY, USA
- Patient Power Research Network-ArthritisPower, USA
| | - Megan Creasman
- Weill Cornell Medicine, Division of General Internal Medicine, New York, NY, USA
- NewYork-Presbyterian Hospital-Weill Cornell Medicine, Division of General Internal Medicine, New York, NY, USA
| | | | - Monika M. Safford
- Weill Cornell Medicine, Division of General Internal Medicine, New York, NY, USA
| | - Iris Navarro-Millán
- Weill Cornell Medicine, Division of General Internal Medicine, New York, NY, USA
- Hospital for Special Surgery, Division of Rheumatology, New York, NY, USA
- Corresponding author. Weill Cornell Medicine, Division of General Internal Medicine Hospital for Special Surgery, Division of Rheumatology, 420 E 70th St., LH-363, New York, NY, 10021, USA.
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Manzi C, Adorni R, Giannella VA, Steca P. How to Age More Positively? Analyzing Determinants that Shape Attitudes Towards Aging. JOURNAL OF ADULT DEVELOPMENT 2023. [DOI: 10.1007/s10804-023-09447-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
AbstractA considerable amount of research has illustrated that negative attitudes toward one’s own aging can directly hinder mental and physical well-being or lead to maladjustment in later stages of life (Swift et al. in Social Issues Policy Rev 11(1):195–231, https://doi.org/10.1111/sipr.12031, 2017). Research so far has focused on the analysis of individual factors related to attitudes toward aging, often related to personality traits. Our study proposes and tests a model of positive contact with aging (PCA). It analyses both individual and social antecedents of attitudes towards one’s own aging, hypothesizing that individual health self-efficacy directly affects attitudes towards one’s own aging and that the quality and quantity of contact with older adults indirectly impacts on attitudes towards one’s own aging through attitudes towards older adults. The model was tested in a wide sample of the Italian population (N = 753) with a varied age range. The PCA model tested showed excellent fit to the data, explaining a moderate amount of variance in attitudes toward one’s own aging (12%). This model promises to offer implications for active policies that can improve attitudes towards one’s own aging, promoting educational strategies to increase intergenerational exchanges and foster health-related self-efficacy.
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Olsen DB, Pedersen PU, Noergaard MW. Prehabilitation before elective coronary artery bypass grafting surgery: a scoping review. JBI Evid Synth 2023:02174543-990000000-00142. [PMID: 36929938 DOI: 10.11124/jbies-22-00265] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
OBJECTIVE The objective of this scoping review was to identify and map existing preoperative interventions, referred to as prehabilitation, in adult patients at home awaiting elective coronary artery bypass grafting surgery. This review also sought to report feasibility and patient experiences to shape clinical practice and underpin a future systematic review. INTRODUCTION As patients age, comorbidities become more common. Strategies to improve postoperative outcomes and to accelerate recovery are required in patients undergoing coronary artery bypass grafting. Prehabilitation refers to a proactive process of increasing functional capacity before surgery to improve the patient's ability to withstand upcoming physiologic stress and, thus, avoid postoperative complications. INCLUSION CRITERIA Studies that included adult patients awaiting coronary artery bypass grafting surgery at home and that described interventions optimizing preoperative physical and psychological health in any setting were included. METHODS The JBI methodology for conducting scoping reviews was used to identify relevant studies in MEDLINE, CINAHL, Cochrane Library, Embase, Scopus, SweMed+, PsycINFO, and PEDro. Gray literature was identified searching Google Scholar, ProQuest Dissertations and Theses, MedNar, OpenGrey, NICE Evidence search, and SIGN. Studies in Danish, English, German, Norwegian, and Swedish were considered for inclusion, with no geographical or cultural limitations, or date restrictions. Two independent reviewers screened titles and abstracts, and studies meeting the inclusion criteria were imported into Covidence. Sixty-seven studies from November 1987 to September 2022 were included. The data extraction tool used for the included papers was developed in accordance with the review questions and tested for adequacy and comprehensiveness with the first 5 studies by the same 2 independent reviewers. The tool was then edited to best reflect the review questions. Extracted findings are described and supported by figures and tables. RESULTS Sixty-seven studies were eligible for inclusion, representing 28,553 participants. Analyses of extracted data identified various preoperative interventions for optimizing postoperative and psychological outcomes for adult patients awaiting elective coronary artery bypass grafting surgery. Based on similarities, interventions were grouped into 5 categories. Eighteen studies reported on multimodal interventions, 17 reported on psychological interventions, 14 on physical training interventions, 13 on education interventions, and 5 on oral health interventions. CONCLUSION This scoping review provides a comprehensive summary of strategies that can be applied when developing a prehabilitation program for patients awaiting elective coronary artery bypass surgery. Although prehabilitation has been tested extensively and appears to be feasible, available evidence is mostly based on small studies. For patients undergoing elective coronary artery bypass grafting to derive benefit from prehabilitation, methodologically robust clinical trials and knowledge synthesis are required to identify optimal strategies for patient selection, intervention design, adherence, and intervention duration. Future research should also consider the cost-effectiveness of prehabilitation interventions before surgery. Finally, there is a need for more qualitative studies examining whether individual interventions are meaningful and appropriate to patients, which is an important factor if interventions are to be effective.
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Affiliation(s)
- Dorte Baek Olsen
- Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Preben U Pedersen
- Danish Centre of Systematic Reviews: A JBI Centre of Exellence, Centre of Clinical Guidelines - Danish National Clearinghouse, Faculty of Medicine, Aalborg University, Denmark
| | - Marianne Wetendorff Noergaard
- Danish Centre of Systematic Reviews: A JBI Centre of Exellence, Centre of Clinical Guidelines - Danish National Clearinghouse, Faculty of Medicine, Aalborg University, Denmark.,Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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Batchelor R, Taylor MD. Experiences and perspectives of peer support among young adults with epilepsy. Epilepsy Behav Rep 2023; 21:100590. [PMID: 36818645 PMCID: PMC9929678 DOI: 10.1016/j.ebr.2023.100590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 01/14/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
Young adulthood is a critical developmental period which having epilepsy tends to complicate, suggesting support could be useful. This study aimed to examine the experiences and perspectives of peer support among young adults with epilepsy (YAWE). An online survey was completed by 144 YAWE. Most YAWE reported not having access to peer support but perceived several potential benefits which could support their mental health including mutual understanding, fostering friendships and reducing loneliness, and promoting self-management and coping strategies. Reported barriers to accessing peer support included practical barriers such as travel and time constraints, emotional barriers (e.g., anxiety), and peers not feeling confident or skilled enough to support others. The need for epilepsy peer support groups specifically designed for young adults, university students, and individuals with co-occurring conditions such as autism and attention deficit hyperactivity disorder were also recognised as well as online delivery to address some of the identified barriers. Appropriate training for facilitators and group moderation were noted as important. Overall, these preliminary findings support the acceptability of peer support among YAWE, indicating peer support could be a worthy focus of policy and care pathway development. However, future research is needed to evaluate the effectiveness of peer support for epilepsy populations.
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Affiliation(s)
- Rachel Batchelor
- Department of Psychology, Royal Holloway, University of London, Surrey, UK
- Corresponding author at: Department of Psychology, Royal Holloway, University of London, Egham, Surrey TW20 0EX, UK.
| | - Michelle D. Taylor
- Department of Psychology, Royal Holloway, University of London, Surrey, UK
- Health Psychology Research Limited (HPR Ltd.), 188 High Street, Egham, Surrey, UK
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Cunningham EB, Wheeler A, Hajarizadeh B, French CE, Roche R, Marshall AD, Fontaine G, Conway A, Bajis S, Valencia BM, Presseau J, Ward JW, Degenhardt L, Dore GJ, Hickman M, Vickerman P, Grebely J. Interventions to enhance testing and linkage to treatment for hepatitis C infection for people who inject drugs: A systematic review and meta-analysis. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 111:103917. [PMID: 36542883 DOI: 10.1016/j.drugpo.2022.103917] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 11/10/2022] [Accepted: 11/12/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND With the advent of direct acting antiviral (DAA) therapies for the treatment of hepatitis C virus (HCV), the World Health Organization recommended a goal to eliminate HCV as a public health threat globally by 2030. With the majority of new and existing infections in high income countries occurring among people who inject drugs, achieving this goal will require the design and implementation of interventions which address the unique barriers to HCV care faced by this population. METHODS In this systematic review and meta-analysis, we searched bibliographic databases and conference abstracts to July 21, 2020 for studies assessing interventions to improve the following study outcomes: HCV antibody testing, HCV RNA testing, linkage to care, and treatment initiation. We included both randomised and non-randomised studies which included a comparator arm. We excluded studies which enrolled only paediatric populations (<18 years old) and studies where the intervention was conducted in a different healthcare setting than the control or comparator. This analysis was restricted to studies conducted among people who inject drugs. Data were extracted from the identified records and meta-analysis was used to pool the effect of interventions on study outcomes. This study was registered in PROSPERO (CRD42020178035). FINDINGS Of 15,342 unique records, 45 studies described the implementation of an intervention to improve HCV testing, linkage to care and treatment initiation among people who inject drugs. These included 27 randomised trials and 18 non-randomised studies with the risk of bias rated as "critical" for most non-randomised studies. Patient education and patient navigation to address patient-level barriers to HCV care were shown to improve antibody testing uptake and linkage to HCV care respectively although patient education did not improve antibody testing when restricted to randomised studies. Provider care coordination to address provider level barriers to HCV care was effective at improving antibody testing uptake. Three different interventions to address systems-level barriers to HCV care were effective across different stages of HCV care: point-of-care antibody testing (linkage to care); dried blood-spot testing (antibody testing uptake); and integrated care (linkage to care and treatment initiation). INTERPRETATION Multiple interventions are available that can address the barriers to HCV care for people who inject drugs at the patient-, provider-, and systems-level. The design of models of care to improve HCV testing and treatment among people who inject drugs must consider the unique barriers to care that this population faces. Further research, including high-quality randomised controlled trials, are needed to robustly assess the impact these interventions can have in varied populations and settings.
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Affiliation(s)
| | - Alice Wheeler
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | | | - Clare E French
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1UD, UK; NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
| | - Rachel Roche
- Blood Safety, Hepatitis, Sexually Transmitted Infections (STI) and HIV Division, National Infection Service, Public Health England Colindale, London, UK; The National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at UCL, NIHR, London, UK
| | - Alison D Marshall
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia; Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
| | - Guillaume Fontaine
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Anna Conway
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia; Centre for Social Research in Health, UNSW Sydney, Sydney, NSW, Australia
| | - Sahar Bajis
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | | | - Justin Presseau
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - John W Ward
- Coalition for Global Hepatitis Elimination, The Task Force for Global Health, Decatur GA, USA
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - Gregory J Dore
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1UD, UK; NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
| | - Peter Vickerman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 1UD, UK; NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
| | - Jason Grebely
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
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Abstract
Orthopaedic trauma patients have high rates of psychiatric disorders, which put them at risk for worse outcomes after injury and surgery, including worse pain. Mental health conditions, such as depression and anxiety, can affect the perception of pain. Pain can also exacerbate or contribute to the development of mental illness after injury. Interventions to address both mental health and pain among orthopaedic trauma patients are critical. Balancing safety and comfort amid a drug overdose epidemic is challenging, and many clinicians do not feel comfortable addressing mental health or have the resources necessary. We reviewed the literature on the complex relationship between pain and mental health and presented examples of scalable and accessible interventions that can be implemented to promote the health and recovery of our patients. Interventions described include screening for depression in the orthopaedic trauma clinic and the emergency department or inpatient setting during injury and using a comprehensive and evidence-based multimodal pain management regimen that blends pharmacologic alternatives to opioids and physical and cognitive strategies to manage pain.
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Price A, de Bell S, Shaw N, Bethel A, Anderson R, Coon JT. What is the volume, diversity and nature of recent, robust evidence for the use of peer support in health and social care? An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2022; 18:e1264. [PMID: 36909883 PMCID: PMC9316011 DOI: 10.1002/cl2.1264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Background Peer support interventions involve people drawing on shared personal experience to help one another improve their physical or mental health, or reduce social isolation. If effective, they may also lessen the demand on health and social care services, reducing costs. However, the design and delivery of peer support varies greatly, from the targeted problem or need, the setting and mode of delivery, to the number and content of sessions. Robust evidence is essential for policymakers commissioning peer support and practitioners delivering services in health care and community settings. This map draws together evidence on different types of peer support to support the design and delivery of interventions. Objectives The aim of this map was to provide an overview of the volume, diversity and nature of recent, high quality evidence on the effectiveness and cost-effectiveness of the use of peer support in health and social care. Search Methods We searched MEDLINE, seven further bibliographic databases, and Epistemonikos for systematic reviews (in October 2020), randomised controlled trials (in March 2021) and economic evaluations (in May 2021) on the effectiveness of peer support interventions in health and social care. We also conducted searches of Google Scholar, two trial registers, PROSPERO, and completed citation chasing on included studies. Selection Criteria Systematic reviews, randomised controlled trials and economic evaluations were included in the map. Included studies focused on adult populations with a defined health or social care need, were conducted in high-income countries, and published since 2015. Any measure of effectiveness was included, as was any form of peer support providing the peer had shared experience with the participant and a formalised role. Data Collection and Analysis Data were extracted on the type of peer support intervention and outcomes assessed in included studies. Standardised tools were used to assess study quality for all studies: assessing the methodological quality of systematic reviews 2 for systematic reviews; Cochrane risk of bias tool for randomised controlled trials; and consensus health economic criteria list for economic evaluations. Main Results We included 91 studies: 32 systematic reviews; 52 randomised controlled trials; and 7 economic evaluations. Whilst most included systematic reviews and economic evaluations were assessed to be of low or medium quality, the majority of randomised controlled trials were of higher quality. There were concentrations of evidence relating to different types of peer support, including education, psychological support, self-care/self-management and social support. Populations with long-term health conditions were most commonly studied. The majority of studies measured health-related indicators as outcomes; few studies assessed cost-effectiveness. Studies were unevenly distributed geographically, with most being conducted in the USA. Several gaps were evident regarding the delivery of peer support, particularly the integration of peers and professionals in delivering support and interventions of longer duration. Authors' Conclusions Although there is evidence available to inform the commissioning and delivery of peer support in health and social care, there are also clear gaps that need to be addressed to further support provision, particularly regarding cost-effectiveness. The effectiveness of peer support in different countries, with varying health and social care systems, is a priority for future research, as is the integration of peers with professionals in delivering peer support.
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Affiliation(s)
- Anna Price
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Siân de Bell
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Naomi Shaw
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Alison Bethel
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Rob Anderson
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
| | - Jo Thompson Coon
- Exeter HS&DR Evidence Synthesis CentreUniversity of Exeter Medical School, University of ExeterExeterUK
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12
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Amonoo HL, Harnedy LE, Staton SC, Longley RM, Daskalakis E, El-Jawahri A, Huffman JC. Peer support in patients with hematologic malignancies: a systematic review. Bone Marrow Transplant 2022; 57:1240-1249. [PMID: 35597891 DOI: 10.1038/s41409-022-01709-3] [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: 02/25/2022] [Revised: 04/29/2022] [Accepted: 05/06/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Peer support has been utilized and associated with clinical outcomes (e.g., improved mood) in patients with solid malignancies. However, to date, there is minimal literature examining peer support among patients with hematologic malignancies and/or patients who have undergone hematopoietic stem cell transplantation (HSCT). METHODS In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we completed a systematic review using five databases to assess the relationship between peer support and clinical outcomes (e.g., distress, physical symptoms) among patients with hematologic malignancies or HSCT recipients. RESULTS The eight included studies examined peer support in a total of 574 patients. Four intervention studies highlighted the potential benefits of peer support, such as improved physical symptoms. Two studies, one interventional and one cross-sectional, highlighted the need for more empirically based peer support interventions in the HSCT population. CONCLUSION Among patients with hematologic malignancies and/or HSCT recipients, there is a dearth of literature examining the association between peer support and outcomes, although few studies have described a positive association between peer support and better health outcomes. More randomized controlled studies are needed to better understand the role of peer support and peer support interventions on outcomes in these vulnerable populations.
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Affiliation(s)
- Hermioni L Amonoo
- Department of Psychosocial Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. .,Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
| | - Lauren E Harnedy
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Sophie C Staton
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Areej El-Jawahri
- Harvard Medical School, Boston, MA, USA.,Mass General Cancer Center, Massachusetts General Hospital, Boston, MA, USA
| | - Jeff C Huffman
- Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
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13
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Comparing Self-management Programs with and without Peer Support Among Patients with Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc 2022; 19:1687-1696. [PMID: 35442179 DOI: 10.1513/annalsats.202108-932oc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
RATIONALE Self-management support (SMS) is an essential component of care for patients who have chronic obstructive pulmonary disease (COPD), but there is little evidence on how to provide SMS most effectively to these patients. Peer support (i.e. support provided by a person with a similar medical condition) has been successfully used to promote self-management among patients with various chronic conditions, yet no randomized studies have focused on testing its effects for patients with COPD. OBJECTIVES To assess whether adding peer support to healthcare professional support to help patients with COPD self-management results in better health-related quality of life (HRQOL) and less acute care use. METHODS A 2-arm randomized controlled trial (RCT) was performed at one academic and one community hospital, and their affiliate clinics. Study population included patients aged ≥40 years who had been diagnosed with COPD by a physician and were currently receiving daily treatment for it. Two SMS strategies were compared over six-months. One strategy relied on the healthcare professional (HCP) for COPD self-management (HCP Support); the other used a dual approach involving both healthcare professionals and peer supporters (HCP Plus Peer Support). The primary outcome was change in HRQoL measured by the St George's Respiratory Questionnaire (SGRQ) at 6 months (range 0-100, lower is better; 4-point meaningful difference). Secondary outcomes included the COPD-related and all-cause hospitalizations and ED visits. Analysis was conducted under intention to treat. RESULTS The number of enrolled participants was 292. Mean age was 67.7 (SD 9.4) years; 70.9% white and 61.3% female . SGRQ scores were not significantly different between the study arms. HCP Plus Peer arm participants had fewer COPD-related acute care events at 3 months ( incidence rate ratio (IRR) 0.68 ; 95% CI 0.50 - 0.93), and 6 months ( IRR 0.84 ; 95% CI 0.71 - 0.99). CONCLUSIONS Adding peer support to HCP support to help patients self-manage COPD, did not further improve HRQoL in this study. However, it did result in fewer COPD-related acute care events during the 6-month intervention period. Clinical trial registered with ClinicalTrials.gov (NCT02891200).
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Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Crit Care Med 2021; 49:e1063-e1143. [PMID: 34605781 DOI: 10.1097/ccm.0000000000005337] [Citation(s) in RCA: 852] [Impact Index Per Article: 284.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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15
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Gray E, Smith C, Bunton R, Skinner M. Perceptions and experiences of engaging in physical activity following coronary artery bypass graft surgery. Physiother Theory Pract 2021; 38:2841-2855. [PMID: 34666600 DOI: 10.1080/09593985.2021.1989733] [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: 10/20/2022]
Abstract
BACKGROUND Engagement in physical activity (PA) during the recovery period following coronary artery bypass graft (CABG) surgery improves physical and health-related quality-of-life outcomes. OBJECTIVE To explore people's perceptions and experiences of engaging in PA during the first three months following CABG surgery. METHODS A mixed methods study design was utilized. Quantitative data were collected via accelerometer activity capture and standardized questionnaires. Qualitative data were collected via semi-structured interviews at weeks 1, 3, 6 and 12 post-hospital discharge. Interviews were analyzed using inductive thematic analysis. RESULTS Two overarching themes described the overall experience of engaging in PA: 1) "Navigating a difficult and unfamiliar road to recovery" and 2) "Still cautious but becoming more confident and able." These themes described the impact over time that various physical (i.e., fatigue, pain, medical complications, and physical deconditioning), psychological (i.e., fear, confidence, uncertainty, and motivation), and environmental (support) factors had on PA engagement, as well as the relationships between these factors. CONCLUSION The findings provided insight into the physical, psychological, and environmental factors that impacted participants' PA engagement following CABG surgery. This knowledge may benefit health professionals to optimize preparation and support for adults to engage in PA post-hospital discharge following CABG surgery.
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Affiliation(s)
- Emily Gray
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Cath Smith
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Richard Bunton
- Department of Surgical Sciences, Otago Medical School, Division of Health Sciences, University of Otago, Dunedin, New Zealand
| | - Margot Skinner
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, Division of Health Sciences, University of Otago, Dunedin, New Zealand
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16
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Summers C, Wu P, Taylor AJG. Supporting Mental Health During the COVID-19 Pandemic Using a Digital Behavior Change Intervention: An Open-Label, Single-Arm, Pre-Post Intervention Study. JMIR Form Res 2021; 5:e31273. [PMID: 34459740 PMCID: PMC8496681 DOI: 10.2196/31273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 08/12/2021] [Accepted: 08/24/2021] [Indexed: 01/26/2023] Open
Abstract
Background The COVID-19 pandemic is taking a toll on people’s mental health, particularly as people are advised to adhere to social distancing, self-isolation measures, and government-imposed national lockdowns. Digital health technologies have an important role to play in keeping people connected and in supporting their mental health and well-being. Even before the COVID-19 pandemic, mental health and social services were already strained. Objective Our objective was to evaluate the 12-week outcomes of the digitally delivered Gro Health intervention, a holistic digital behavior change app designed for self-management of mental well-being, sleep, activity, and nutrition. Methods The study used a quasi-experimental research design consisting of an open-label, single-arm, pre-post intervention engagement using a convenience sample. Adults who had joined the Gro Health app (intervention) and had a complete baseline dataset (ie, 7-item Generalized Anxiety Disorder scale, Perceived Stress Scale, and 9-item Patient Health Questionnaire) were followed up at 12 weeks (n=273), including 33 (12.1%) app users who reported a positive COVID-19 diagnosis during the study period. User engagement with the Gro Health platform was tracked by measuring total minutes of app engagement. Paired t tests were used to compare pre-post intervention scores. Linear regression analysis was performed to assess the relationship between minutes of active engagement with the Gro Health app and changes in scores across the different mental health measures. Results Of the 347 study participants, 273 (78.67%) completed both the baseline and follow-up surveys. Changes in scores for anxiety, perceived stress, and depression were predicted by app engagement, with the strongest effect observed for changes in perceived stress score (F1,271=251.397; R2=0.479; P<.001). Conclusions A digital behavior change platform that provides remote mental well-being support can be effective in managing depression, anxiety, and perceived stress during times of crisis such as the current COVID-19 pandemic. The outcomes of this study may also support the implementation of remote digital health apps supporting behavior change and providing support for low levels of mental health within the community.
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Affiliation(s)
| | - Philip Wu
- School of Management, Royal Holloway, University of London, Egham, United Kingdom
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17
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Evans L, Rhodes A, Alhazzani W, Antonelli M, Coopersmith CM, French C, Machado FR, Mcintyre L, Ostermann M, Prescott HC, Schorr C, Simpson S, Wiersinga WJ, Alshamsi F, Angus DC, Arabi Y, Azevedo L, Beale R, Beilman G, Belley-Cote E, Burry L, Cecconi M, Centofanti J, Coz Yataco A, De Waele J, Dellinger RP, Doi K, Du B, Estenssoro E, Ferrer R, Gomersall C, Hodgson C, Møller MH, Iwashyna T, Jacob S, Kleinpell R, Klompas M, Koh Y, Kumar A, Kwizera A, Lobo S, Masur H, McGloughlin S, Mehta S, Mehta Y, Mer M, Nunnally M, Oczkowski S, Osborn T, Papathanassoglou E, Perner A, Puskarich M, Roberts J, Schweickert W, Seckel M, Sevransky J, Sprung CL, Welte T, Zimmerman J, Levy M. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med 2021; 47:1181-1247. [PMID: 34599691 PMCID: PMC8486643 DOI: 10.1007/s00134-021-06506-y] [Citation(s) in RCA: 1360] [Impact Index Per Article: 453.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 08/05/2021] [Indexed: 02/07/2023]
Affiliation(s)
- Laura Evans
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Washington, Seattle, WA, USA.
| | - Andrew Rhodes
- Adult Critical Care, St George's University Hospitals NHS Foundation Trust & St George's University of London, London, UK
| | - Waleed Alhazzani
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Massimo Antonelli
- Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione, Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | | | - Flávia R Machado
- Anesthesiology, Pain and Intensive Care Department, Federal University of São Paulo, Hospital of São Paulo, São Paulo, Brazil
| | | | | | - Hallie C Prescott
- University of Michigan and VA Center for Clinical Management Research, Ann Arbor, MI, USA
| | | | - Steven Simpson
- University of Kansas Medical Center, Kansas City, KS, USA
| | - W Joost Wiersinga
- ESCMID Study Group for Bloodstream Infections, Endocarditis and Sepsis, Division of Infectious Diseases, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Fayez Alshamsi
- Department of Internal Medicine, College of Medicine and Health Sciences, Emirates University, Al Ain, United Arab Emirates
| | - Derek C Angus
- University of Pittsburgh Critical Care Medicine CRISMA Laboratory, Pittsburgh, PA, USA
| | - Yaseen Arabi
- Intensive Care Department, Ministry of National Guard Health Affairs, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Luciano Azevedo
- School of Medicine, University of Sao Paulo, São Paulo, Brazil
| | | | | | | | - Lisa Burry
- Mount Sinai Hospital & University of Toronto (Leslie Dan Faculty of Pharmacy), Toronto, ON, Canada
| | - Maurizio Cecconi
- Department of Biomedical Sciences, Humanitas University Pieve Emanuele, Milan, Italy.,Department of Anaesthesia and Intensive Care, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
| | - John Centofanti
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
| | - Angel Coz Yataco
- Lexington Veterans Affairs Medical Center/University of Kentucky College of Medicine, Lexington, KY, USA
| | | | | | - Kent Doi
- The University of Tokyo, Tokyo, Japan
| | - Bin Du
- Medical ICU, Peking Union Medical College Hospital, Beijing, China
| | - Elisa Estenssoro
- Hospital Interzonal de Agudos San Martin de La Plata, Buenos Aires, Argentina
| | - Ricard Ferrer
- Intensive Care Department, Vall d'Hebron University Hospital, Vall d'Hebron Institut de Recerca, Barcelona, Spain
| | | | - Carol Hodgson
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia
| | - Morten Hylander Møller
- Department of Intensive Care 4131, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | | | - Shevin Jacob
- Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Michael Klompas
- Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Department of Population Medicine, Harvard Medical School, and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Younsuck Koh
- ASAN Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Anand Kumar
- University of Manitoba, Winnipeg, MB, Canada
| | - Arthur Kwizera
- Makerere University College of Health Sciences, Kampala, Uganda
| | - Suzana Lobo
- Intensive Care Division, Faculdade de Medicina de São José do Rio Preto, São Paulo, Brazil
| | - Henry Masur
- Critical Care Medicine Department, NIH Clinical Center, Bethesda, MD, USA
| | | | | | - Yatin Mehta
- Medanta the Medicity, Gurugram, Haryana, India
| | - Mervyn Mer
- Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Mark Nunnally
- New York University School of Medicine, New York, NY, USA
| | - Simon Oczkowski
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Tiffany Osborn
- Washington University School of Medicine, St. Louis, MO, USA
| | | | | | - Michael Puskarich
- University of Minnesota/Hennepin County Medical Center, Minneapolis, MN, USA
| | - Jason Roberts
- Faculty of Medicine, University of Queensland Centre for Clinical Research, The University of Queensland, Brisbane, Australia.,Department of Pharmacy, Royal Brisbane and Women's Hospital, Brisbane, Australia.,Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Brisbane, Australia.,Division of Anaesthesiology Critical Care Emergency and Pain Medicine, Nîmes University Hospital, University of Montpellier, Nîmes, France
| | | | | | | | - Charles L Sprung
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.,Department of Anesthesiology, Critical Care and Pain Medicine, Hadassah Medical Center, Jerusalem, Israel
| | - Tobias Welte
- Medizinische Hochschule Hannover and German Center of Lung Research (DZL), Hannover, Germany
| | - Janice Zimmerman
- World Federation of Intensive and Critical Care, Brussels, Belgium
| | - Mitchell Levy
- Warren Alpert School of Medicine at Brown University, Providence, Rhode Island & Rhode Island Hospital, Providence, RI, USA
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Fatehi Hassanabad A, Bahrami N, Novick RJ, Ali IS. Delirium and depression in cardiac surgery: A comprehensive review of risk factors, pathophysiology, and management. J Card Surg 2021; 36:2876-2889. [PMID: 34120376 DOI: 10.1111/jocs.15610] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/17/2021] [Accepted: 04/19/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Mental health and wellbeing continue to gain more attention as they are inextricably associated with clinical outcomes, particularly quality of life. Many medical ailments and major surgeries affect patients' mental health, including depression and delirium. AIMS The objective of this manuscript was to comprehensively review and critically examine the literature pertaining to cardiac surgery, depression, and delirium. METHODS This is a narrative review article. We performed our search analysis by using the following key words: "Cardiac Surgery", "Depression", "Delirium", "Clinical outcomes", and "Mental Health". Search analysis was done on MedLine PubMed, accessing indexed peer-reviewed publications. RESULTS Cardiac Surgery is a life-altering intervention indicated to improve morbidity and mortality in patients with cardiovascular diseases. Psychiatric conditions before and after cardiac surgery worsen patient prognosis and increase mortality rate. Specifically, preoperative depression increases postoperative depression and is associated with impaired functional status, slow physical recovery, and an increased readmission rate. DISCUSSION Although the exact pathophysiology between depression and cardiovascular disease (CVD) is unknown, several pathways have been implicated. Unmanaged depression can also lead to other psychological conditions such as delirium. Like depression, the exact association between delirium and CVD is not well understood, but believed to be multifactorial. CONCLUSION Herein, we provide a comprehensive review of the links between depression, delirium, and cardiovascular surgery. We critically examine the current data that pertains to the pathophysiology of these debilitating mental health issues in the context of cardiac surgery. Finally, we summarize the various treatment options available for managing depression and delirium in the cardiac surgery patient population.
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Affiliation(s)
- Ali Fatehi Hassanabad
- Section of Cardiac Surgery, Department of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, Calgary, Alberta, Canada
| | - Nabila Bahrami
- Department of Medicine, Department of Medicine, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Richard J Novick
- Section of Cardiac Surgery, Department of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, Calgary, Alberta, Canada
| | - Imtiaz S Ali
- Section of Cardiac Surgery, Department of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, Calgary, Alberta, Canada
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Haldar S, Mishra SR, Kim Y, Hartzler A, Pollack AH, Pratt W. Use and impact of an online community for hospital patients. J Am Med Inform Assoc 2021; 27:549-557. [PMID: 31986197 PMCID: PMC7075532 DOI: 10.1093/jamia/ocz212] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 11/08/2019] [Accepted: 12/04/2019] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Although patient-peer support technologies have demonstrated effectiveness in a variety of health contexts-including diabetes, weight loss, and cancer-less is known about how hospitalized patients can benefit from this support. We investigated the nature of peer support in the hospital and the impact this support had on patients' hospital stays. MATERIALS AND METHODS We created a technology, resembling an online health community, in which patients could exchange advice about their hospitalization. We deployed it at 1 pediatric hospital and 1 adult hospital. With 30 participants, we conducted bedside interviews, observed how they used the technology during their hospitalization, and completed follow-up phone interviews. RESULTS Participants shared advice about several topics, including adjusting to the hospital and building relationships with providers. Contrary to concerns that such a system would primarily serve as a place for patients to "complain," sentiment analysis showed that 23 of 36 (64%) of the shared advice reflected positive sentiment. Patients also reported positive impacts to their quality, safety, and hospital experience due to the inpatient peer support community. DISCUSSION Participants benefited from peer support that transcended diagnoses and individual health conditions. The shared experience of being in the hospital was sufficient to yield valuable and practical peer support. Participants who did not contribute their own advice still experienced benefits from reading their peers' advice. CONCLUSIONS Our study demonstrated the positive nature of peer advice exchanged, and the benefits of this advice on patients' hospital stays. Inpatient peer support technologies could be an additional resource for patients to engage in their care.
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Affiliation(s)
- Shefali Haldar
- Division of Biomedical and Health Informatics, University of Washington, Seattle, Washington, USA
| | - Sonali R Mishra
- Information School, University of Washington, Seattle, Washington, USA
| | - Yoojung Kim
- Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
| | - Andrea Hartzler
- Division of Biomedical and Health Informatics, University of Washington, Seattle, Washington, USA
| | - Ari H Pollack
- Division of Nephrology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Wanda Pratt
- Information School, University of Washington, Seattle, Washington, USA
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20
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Leman MA, Claramita M, Rahayu GR. Factors influencing healthy role models in medical school to conduct healthy behavior: a qualitative study. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2021; 12:1-11. [PMID: 33491661 PMCID: PMC7883803 DOI: 10.5116/ijme.5ff9.9a88] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 01/09/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES This study aimed to identify the factors that support or inhibit medical teachers as healthy role models in medical school to conduct healthy behavior. METHODS This qualitative study involved semi-structured in-depth interviews with medical teachers categorized as healthy role models in a medical school from a previous survey. Ten medical teachers were selected using purposive sampling. Three medical teachers were interviewed by direct meetings, and the remaining were phone interviewed, with one interview facilitated by chat using WhatsApp. Transcribed interviews were coded openly. Themes were finalized through discussion and debate to reach a consensus. RESULTS Two themes were identified: perceived facilitators and perceived barriers, which were classified into four categories and 13 subcategories: intrinsic facilitators (motivation, conscious awareness, having physical limitations, knowledge, and economic reasons); extrinsic facilitators (the impact on doing a particular job, feedback, time, and environment); intrinsic barriers (the lack of self-motivation and having physical limitations); and extrinsic barriers (the burden of responsibilities for being medical teachers and environment). CONCLUSIONS Factors that support and inhibit medical teachers as healthy role models in medical school are influenced by intrinsic and extrinsic factors. This result could be used by medical schools to design appropriate interventions to help medical teachers as healthy role models in conducting healthy behavior. More studies are needed to explore other factors that influence medical teachers to conduct healthy behavior. During the COVID-19 pandemic, healthy role models in medical schools are vitally important and significantly contribute to the overall health of a nation.
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Affiliation(s)
- Michael A. Leman
- School of Dentistry, Faculty of Medicine, Universitas Sam Ratulangi, Manado, Indonesia
| | - Mora Claramita
- Department of Medical, Health Professions Education and Bioethics, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Gandes R. Rahayu
- Department of Medical, Health Professions Education and Bioethics, Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
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21
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Ebrahimi H, Abbasi A, Bagheri H, Basirinezhad MH, Shakeri S, Mohammadpourhodki R. The role of peer support education model on the quality of life and self-care behaviors of patients with myocardial infarction. PATIENT EDUCATION AND COUNSELING 2021; 104:130-135. [PMID: 32826102 DOI: 10.1016/j.pec.2020.08.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/27/2020] [Accepted: 08/02/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE This study aimed to assess the effect of peer education on the quality of life and self-care behaviors of patients with myocardial infarction. METHODS In this clinical trial, 70 patients with myocardial infarction meeting the inclusion criteria were assigned to experimental (n = 35) or control (n = 35) groups using block randomization. Patients in the intervention group received two one-hour training sessions on the third day after myocardial infarction during the CCU stay along with routine care. Education intervention was performed by peers. The control group will follow routine care. All patients selected were assessed using McNews' quality of life questionnaire and Miller self-care questionnaire, respectively before the intervention and also one month after discharge. Chi-square and t-test were used to analyze the data. RESULTS After the intervention, the mean of quality of life and the mean score of self-care behaviors in the experimental group were significantly higher compared to the control group. CONCLUSIONS According to the results, to improve the quality of life and promote the self-care behaviors in such patients, using peer education along with healthcare professionals is recommended. PRACTICE IMPLICATION This patient education approach had a significant impact on quality of life and self-care behavior.
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Affiliation(s)
- Hossein Ebrahimi
- Randomized Controlled Trial Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ali Abbasi
- Department of Nursing, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Hossein Bagheri
- Department of Nursing, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohammad Hasan Basirinezhad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Shakeri
- Department of Nursing, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Reza Mohammadpourhodki
- Department of Nursing, Kashmar Center of Higher Health Education, Mashhad University of Medical Sciences, Mashhad, Iran.
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Lee S, Collins EG. Factors influencing physical activity after cardiac surgery: An integrative review. Heart Lung 2021; 50:136-145. [DOI: 10.1016/j.hrtlng.2020.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/18/2020] [Accepted: 10/06/2020] [Indexed: 10/23/2022]
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Leahey TM, Huedo-Medina TB, Grenga A, Gay L, Fernandes D, Denmat Z, Doyle C, Areny-Joval R, Wing RR. Patient-provided e-support in reduced intensity obesity treatment: The INSPIRE randomized controlled trial. Health Psychol 2020; 39:1037-1047. [PMID: 33252929 DOI: 10.1037/hea0000996] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE There are two types of patient supporters, peers (two individuals initiating health behavior change who support one another) and mentors (a previously successful patient who supports incoming patients). Social comparison theory suggests that peers and mentors may elicit social comparison processes (patients may compare their progress to that of their peer/mentor), and these social comparisons could impact treatment outcomes. This randomized controlled trial is the first to examine the differential impact of peers and mentors on obesity treatment outcomes and social comparison processes when added to reduced intensity treatment. METHOD Participants (N = 278) were randomly assigned to reduced intensity behavioral weight loss treatment alone (rBWL), rBWL plus peer e-support (rBWL + Peer), or rBWL plus mentor e-support (rBWL + Mentor). rBWL involved periodic group sessions that decreased over time; when group sessions decreased, intensity of peer/mentor e-support increased. Weight and social comparison processes were assessed throughout the 12-month intervention. RESULTS There was a significant treatment effect; when group sessions became less frequent and peer/mentor e-support became more frequent, rBWL + Peer had significantly greater weight loss than rBWL alone, and rBWL + Mentor was not significantly different from the other two. Social comparison processes differed by treatment arm; rBWL + Peer participants tended to report more lateral social comparisons ("my weight loss progress is 'similar' to my peer's"), whereas rBWL + Mentor participants reported more upward comparisons ("my weight loss progress is 'worse than' my mentor's"). Upward comparisons were associated with poorer weight loss outcomes. CONCLUSIONS Peer e-support may be an effective, low-cost, sustainable method for improving longer-term weight loss outcomes in reduced intensity obesity treatment. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Linda Gay
- Weight Control and Diabetes Research Center
| | | | - Zeely Denmat
- Institute for Collaboration on Health, Intervention and Policy
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Draper O, Goh I, Huang C, Kibblewhite T, Le Quesne P, Smith K, Gray E, Skinner M. Psychosocial interventions to optimize recovery of physical function and facilitate engagement in physical activity during the first three months following CABG surgery: a systematic review. PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1832714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Owen Draper
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Isaiah Goh
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Cong Huang
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | | | - Poppy Le Quesne
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Kate Smith
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Emily Gray
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Margot Skinner
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Aboumatar H, Naqibuddin M, Neiman J, Saunders J, Kim S, Chaudhry H, Garcia-Morales E, Robinson N, McBurney M, Jager L, Ajayi T, Bone L, Chung S, Farrell B, Joo Jin H, Linnell J, Pirfo M, Rand C, Riley P, Salvaterra C, Shea K, Singh J, Wise R. Methodology and baseline characteristics of a randomized controlled trial testing a health care professional and peer-support program for patients with chronic obstructive pulmonary disease: The BREATHE2 study. Contemp Clin Trials 2020; 94:106023. [PMID: 32360887 DOI: 10.1016/j.cct.2020.106023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/23/2020] [Accepted: 04/26/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Self-management support (SMS) for patients with COPD can improve health-related quality of life (HRQOL). However, it remains unclear what SMS strategies are most effective. Using peer support to advance self-management is promising, as peer supporters possess credibility and can serve as role models. METHODS We conducted a single-blinded RCT comparing the effectiveness of two strategies to support patients with COPD. The strategies were 'Health Care Professional (HCP)' and 'HCP Plus Peer' support. Peer support was provided by patients with COPD who have stopped smoking, completed an acute pulmonary rehabilitation program, and met the requirements for becoming a peer supporter. We enrolled patients receiving treatment at inpatient and outpatient settings. Patients were encouraged to invite one family-caregiver to enroll with them. The primary outcome measure was the change in HRQOL at 6 months post enrollment. Secondary outcomes included COPD-related and all-cause hospitalizations and ED visits. Caregiver outcomes included preparedness for caregiving, caregiver stress, and coping. RESULTS A total of 292 patients as well as 50 family-caregivers were enrolled. The average patient age was 67.3 yrs. (SD 9.4), 61% were female and 26% were African-Americans. The majority of caregivers were females (68%) and were a spouse/partner (58%). DISCUSSION This study tested a dual strategy for providing support to patients with COPD that incorporates peer and health care professional support. The study had minimal exclusion criteria. If shown effective, the study offers a program of peer support that can be readily implemented in health care settings.
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Affiliation(s)
- Hanan Aboumatar
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA; Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21218, USA; Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, 601 North Caroline Street, Suite 2080, Baltimore, MD 21205, USA; Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, 2024 East Monument Street, Baltimore, MD 21287, USA.
| | - Mohammad Naqibuddin
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA
| | - Joseph Neiman
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA; Department of Internal Medicine, Hackensack University Medical Center, 30 Prospect Avenue, Hackensack, NJ 07601, USA
| | - Jamia Saunders
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA
| | - Samuel Kim
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA
| | - Hina Chaudhry
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA
| | - Emmanuel Garcia-Morales
- Armstrong Institute for Patient Safety and Quality, The Johns Hopkins School of Medicine, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA; Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - Nancy Robinson
- Johns Hopkins Bayview Medical Center, 4940 Eastern Ave, Baltimore, MD 21224, USA
| | - Marjorie McBurney
- Johns Hopkins Bayview Medical Center, 4940 Eastern Ave, Baltimore, MD 21224, USA
| | - Leah Jager
- Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA
| | - Tokunbo Ajayi
- Howard County General Hospital, 5755 Cedar Lane, Columbia, MD 21044, USA
| | - Lee Bone
- Department of Health, Behavior, and Society, Bloomberg School of Public Health, Johns Hopkins University, 601 North Caroline Street, Suite 2080, Baltimore, MD 21205, USA
| | - Suna Chung
- Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, 2024 East Monument Street, Baltimore, MD 21287, USA
| | - Bernard Farrell
- Howard County General Hospital, 5755 Cedar Lane, Columbia, MD 21044, USA
| | - Hui Joo Jin
- Department of Psychiatry, Johns Hopkins School of Medicine, 600 North Wolfe Street, Baltimore, MD 21287, USA
| | - John Linnell
- BREATHE2 Study, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA
| | - Marlene Pirfo
- Johns Hopkins Bayview Medical Center, 4940 Eastern Ave, Baltimore, MD 21224, USA
| | - Cynthia Rand
- Pulmonary and Critical Care Medicine, The Johns Hopkins School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA
| | - Peggy Riley
- BREATHE2 Study, 750 East Pratt Street, 15th floor, Baltimore, MD 21202, USA
| | - Carmen Salvaterra
- Pulmonary Disease & Critical Care Medicine, Johns Hopkins Community Physicians, 11085 Little Patuxent Parkway, Columbia, MD 21044, USA
| | - Kai Shea
- Johns Hopkins Bayview Medical Center, 4940 Eastern Ave, Baltimore, MD 21224, USA
| | - Jorawar Singh
- Howard County General Hospital, 5755 Cedar Lane, Columbia, MD 21044, USA
| | - Robert Wise
- Pulmonary and Critical Care Medicine, The Johns Hopkins School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA
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Aliche JC, Ifeagwazi CM, Chukwuorji JC, Eze JE. Roles of Religious Commitment, Emotion Regulation and Social Support in Preoperative Anxiety. JOURNAL OF RELIGION AND HEALTH 2020; 59:905-919. [PMID: 30145628 DOI: 10.1007/s10943-018-0693-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Surgery is a relatively commonplace medical procedure in healthcare settings. The mental health status of the person undergoing surgery is vital, but there is dearth of empirical studies on the mental health status of surgery patients, particularly with regard to the factors associated with anxiety in surgical conditions. This study investigated the roles of religious commitment, emotion regulation (cognitive reappraisal and expressive suppression) and social support in preoperative anxiety in a sample of 210 surgical inpatients from a Nigerian tertiary healthcare institution. A cross-sectional design was adopted. Before the surgery, respondents completed the state anxiety subscale of State-Trait Anxiety Inventory, Religious Commitment Inventory, Emotion Regulation Questionnaire and Multidimensional Scale of Perceived Social Support. After controlling for relevant demographic factors, regression results showed that cognitive reappraisal, social support and interpersonal religious commitment were negatively associated with preoperative anxiety, while expressive suppression was positively associated with preoperative anxiety. The emotion regulation strategies made robust and significant explanation of variance in preoperative anxiety. Appropriate interventions to promote interpersonal religious commitment, encourage cognitive reappraisal and enhance social support quality may improve mental health outcomes in surgery.
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Affiliation(s)
| | - Chuka Mike Ifeagwazi
- Department of Psychology, University of Nigeria, Nsukka, 41000, Enugu state, Nigeria
| | | | - John E Eze
- Department of Psychology, University of Nigeria, Nsukka, 41000, Enugu state, Nigeria
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Abstract
OBJECTIVES Identifying solutions to improve recovery after critical illness is a pressing problem. We systematically evaluated studies of peer support as a potential intervention to improve recovery in critical care populations and synthesized elements important to peer support model design. DATA SOURCES A systematic search of Medical Literature Analysis and Retrieval System Online, Cumulative Index to Nursing and Allied Health Literature, PsychINFO, and Excertpa Medica Database was undertaken May 2017. Prospective Register of Systematic Reviews identification number: CRD42017070174. STUDY SELECTION Two independent reviewers assessed titles and abstracts against study eligibility criteria. Studies were included where 1) patients and families had experienced critical illness and 2) patients and families had participated in a peer support intervention. Discrepancies were resolved by consensus and a third independent reviewer adjudicated as necessary. DATA EXTRACTION Two independent reviewers assessed study quality with the Newcastle-Ottawa Scale and the Cochrane Risk of Bias Tool, and data were synthesized according to the Preferred Reporting Items for Systematic Reviews guidelines and interventions summarized using the Template for Intervention Description and Replication Checklist. DATA SYNTHESIS Two-thousand nine-hundred thirty-two studies were screened. Eight were included, comprising 192 family members and 92 patients including adults (with cardiac surgery, acute myocardial infarction, trauma), pediatrics, and neonates. The most common peer support model of the eight studies was an in-person, facilitated group for families that occurred during the patients' ICU admission. Peer support reduced psychologic morbidity and improved social support and self-efficacy in two studies; in both cases, peer support was via an individual peer-to-peer model. In the remaining studies, it was difficult to determine the outcomes of peer support as the reporting and quality of studies was low. CONCLUSIONS Peer support appeared to reduce psychologic morbidity and increase social support. The evidence for peer support in critically ill populations is limited. There is a need for well-designed and rigorously reported research into this complex intervention.
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Açıkel MET. Evaluation of Depression and Anxiety in Coronary Artery Bypass Surgery Patients: A Prospective Clinical Study. Braz J Cardiovasc Surg 2019; 34:389-395. [PMID: 31364347 PMCID: PMC6713374 DOI: 10.21470/1678-9741-2018-0426] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The aim of this clinical study is to determine the depression and anxiety levels in coronary artery bypass graft (CABG) surgery patients in the pre and postoperative periods. METHODS This clinical prospective study was done with 65 patients. Beck's Depression Inventory (BDI) and Beck's Anxiety Inventory (BAI) tests were performed in patients who had a diagnosis of coronary artery disease and were awaiting CABG surgery. These patients presented characteristic symptoms of anxiety and depression and BDI and BAI tests are important to assess these symptoms. RESULTS We found out that depression and anxiety levels were higher in the postoperative than in the preoperative period (P<0.001). Both anxiety and depression levels were increased significantly following CABG operation when compared with preoperative levels in all patients. Statistical correlation of depression and anxiety in different ages, genders, and professions were evaluated too, but we did not found a correlation between them (P>0.05). CONCLUSION We suggest that good management of the psychological condition of cardiac surgery candidates, as well as post-bypass patients, will improve quality of life and cardiovascular outcomes in these patients.
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Affiliation(s)
- Melike Elif Teker Açıkel
- S.B.Ü. Haseki Education and Research Hospital Department of Cardiovascular Surgery İstanbul Turkey Department of Cardiovascular Surgery, S.B.Ü. Haseki Education and Research Hospital, İstanbul, Turkey
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Mohammadpourhodki R, Bagheri H, Basirinezhad MH, Ramzani H, Keramati M. Evaluating the effect of lifestyle education based on peer model on anxiety in patients with acute myocardial infarction. ACTA ACUST UNITED AC 2019; 16:/j/jcim.ahead-of-print/jcim-2018-0132/jcim-2018-0132.xml. [DOI: 10.1515/jcim-2018-0132] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 10/26/2018] [Indexed: 11/15/2022]
Abstract
Abstract
Background
Anxiety in patients with myocardial infarction (MI) which has a very negative effect on the prognosis of their disease and their physical and mental health. We performed this study in order to find the impact of a peer based education (PE) on anxiety in patients with MI.
Methods
This was a randomized clinical trial study. The study participants included 60 patient with MI, who were randomly divided into two groups. The first group received routine education and the other one received PE. We assessed anxiety before and 30 days after the intervention through a valid questionnaires. Data were analyzed by independent sample t-test, two-way ANOVA and the Bonferroni test.
Results
The majority of samples were male, married, self-employer, and living in city. After 30 days intervention the anxiety score was significantly lower in the PE group compare to the control group.
Conclusion
Our findings indicated that the implication of PE as an educational element in decreasing anxiety score and can be considered as a method for continuing of care, and could as well as be a good approach for other patients.
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Marks B, Sisirak J, Magallanes R, Krok K, Donohue-Chase D. Effectiveness of a HealthMessages Peer-to-Peer Program for People With Intellectual and Developmental Disabilities. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2019; 57:242-258. [PMID: 31120402 PMCID: PMC8118146 DOI: 10.1352/1934-9556-57.3.242] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Effective strategies to improve health education, food choices, and physical activity are vital for people with intellectual and developmental disabilities (IDD), as their sedentary lifestyles and high fat diets are contributing to poor health, such as cardiovascular disease, osteoporosis, hypertension, Type II diabetes, and obesity. This study examined the effectiveness of a peer-led health promotion program for people with IDD. One group pre/post-test design was used to test the feasibility and effectiveness of the 12-week HealthMessages Program for three groups: peer health coaches (PHCs), mentors, and peer participants. A total of 379 volunteers participated including PHCs people with IDD (n = 33), mentors-staff from community organizations (n = 35), and peer participants-peers with IDD (n = 311). Following the intervention and 12-week HealthMessages Program, PHCs had significant changes in physical activity and hydration knowledge, mentors had significant changes in self-efficacy scores, and peer participants had significant changes in physical activity and hydration knowledge, social supports, and total health behaviors. A dyad approach supported PHCs and mentors to implement a successful HealthMessages Program with their peers.
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Affiliation(s)
- Beth Marks
- Beth Marks, Jasmina Sisirak, and Rubia Magallanes, University of Illinois at Chicago, Department of Disability & Human Development, Rehabilitation Research Training Center on Developmental Disabilities and Health; Kristin Krok and Dina Donohue-Chase, NorthPointe Resources, Inc., Zion, IL
| | - Jasmina Sisirak
- Beth Marks, Jasmina Sisirak, and Rubia Magallanes, University of Illinois at Chicago, Department of Disability & Human Development, Rehabilitation Research Training Center on Developmental Disabilities and Health; Kristin Krok and Dina Donohue-Chase, NorthPointe Resources, Inc., Zion, IL
| | - Rubia Magallanes
- Beth Marks, Jasmina Sisirak, and Rubia Magallanes, University of Illinois at Chicago, Department of Disability & Human Development, Rehabilitation Research Training Center on Developmental Disabilities and Health; Kristin Krok and Dina Donohue-Chase, NorthPointe Resources, Inc., Zion, IL
| | - Kristin Krok
- Beth Marks, Jasmina Sisirak, and Rubia Magallanes, University of Illinois at Chicago, Department of Disability & Human Development, Rehabilitation Research Training Center on Developmental Disabilities and Health; Kristin Krok and Dina Donohue-Chase, NorthPointe Resources, Inc., Zion, IL
| | - Dina Donohue-Chase
- Beth Marks, Jasmina Sisirak, and Rubia Magallanes, University of Illinois at Chicago, Department of Disability & Human Development, Rehabilitation Research Training Center on Developmental Disabilities and Health; Kristin Krok and Dina Donohue-Chase, NorthPointe Resources, Inc., Zion, IL
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Tully MA, Cunningham C, Wright A, McMullan I, Doherty J, Collins D, Tudor-Locke C, Morgan J, Phair G, Laventure B, Simpson EEA, McDonough SM, Gardner E, Kee F, Murphy MH, Agus A, Hunter RF, Hardeman W, Cupples ME. Peer-led walking programme to increase physical activity in inactive 60- to 70-year-olds: Walk with Me pilot RCT. PUBLIC HEALTH RESEARCH 2019. [DOI: 10.3310/phr07100] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background
Levels of physical activity decline with age. Some of the most disadvantaged individuals in society, such as those with a lower rather than a higher socioeconomic position, are also the most inactive. Peer-led physical activity interventions may offer a model to increase physical activity in these older adults and thus help reduce associated health inequalities. This study aims to develop and test the feasibility of a peer-led, multicomponent physical activity intervention in socioeconomically disadvantaged community-dwelling older adults.
Objectives
The study aimed to develop a peer-led intervention through a rapid review of previous peer-led interventions and interviews with members of the target population. A proposed protocol to evaluate its effectiveness was tested in a pilot randomised controlled trial (RCT).
Design
A rapid review of the literature and the pilot study informed the intervention design; a pilot RCT included a process evaluation of intervention delivery.
Setting
Socioeconomically disadvantaged communities in the South Eastern Health and Social Care Trust and the Northern Health and Social Care Trust in Northern Ireland.
Participants
Fifty adults aged 60–70 years, with low levels of physical activity, living in socioeconomically disadvantaged communities, recruited though community organisations and general practices.
Interventions
‘Walk with Me’ is a 12-week peer-led walking intervention based on social cognitive theory. Participants met weekly with peer mentors. During the initial period (weeks 1–4), each intervention group participant wore a pedometer and set weekly step goals with their mentor’s support. During weeks 5–8 participants and mentors met regularly to walk and discuss step goals and barriers to increasing physical activity. In the final phase (weeks 9–12), participants and mentors continued to set step goals and planned activities to maintain their activity levels beyond the intervention period. The control group received only an information booklet on active ageing.
Main outcome measures
Rates of recruitment, retention of participants and completeness of the primary outcome [moderate- and vigorous-intensity physical activity measured using an ActiGraph GT3X+ accelerometer (ActiGraph, LLC, Pensacola, FL, USA) at baseline, 12 weeks (post intervention) and 6 months]; acceptability assessed through interviews with participants and mentors.
Results
The study planned to recruit 60 participants. In fact, 50 eligible individuals participated, of whom 66% (33/50) were female and 80% (40/50) were recruited from general practices. At 6 months, 86% (43/50) attended for review, 93% (40/43) of whom returned valid accelerometer data. Intervention fidelity was assessed by using weekly step diaries, which were completed by both mentors and participants for all 12 weeks, and checklists for the level of delivery of intervention components, which was high for the first 3 weeks (range 49–83%). However, the rate of return of checklists by both mentors and participants diminished thereafter. Outcome data indicate that a sample size of 214 is required for a definitive trial.
Limitations
The sample was predominantly female and somewhat active.
Conclusions
The ‘Walk with Me’ intervention is acceptable to a socioeconomically disadvantaged community of older adults and a definitive RCT to evaluate its effectiveness is feasible. Some modifications are required to ensure fidelity of intervention delivery is optimised. Future research needs to identify methods to recruit males and less active older adults into physical activity interventions.
Trial registration
Current Controlled Trials ISRCTN23051918.
Funding
This project was funded by the National Institute for Health Research (NIHR) Public Health Research programme and will be published in full in Public Health Research; Vol. 7, No. 10. See the NIHR Journals Library website for further project information. Funding for the intervention was gratefully received from the Health Improvement Division of the Public Health Agency.
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Affiliation(s)
- Mark A Tully
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
- UK Clinical Research Collaboration, Centre of Excellence for Public Health Northern Ireland, Belfast, UK
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, UK
- Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health, School of Health Sciences, Ulster University, Newtownabbey, UK
| | - Conor Cunningham
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
- UK Clinical Research Collaboration, Centre of Excellence for Public Health Northern Ireland, Belfast, UK
| | - Ashlene Wright
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
- UK Clinical Research Collaboration, Centre of Excellence for Public Health Northern Ireland, Belfast, UK
| | - Ilona McMullan
- UK Clinical Research Collaboration, Centre of Excellence for Public Health Northern Ireland, Belfast, UK
- Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health, School of Health Sciences, Ulster University, Newtownabbey, UK
| | - Julie Doherty
- Psychology Research Institute, Ulster University, Coleraine, UK
| | - Debbie Collins
- Department of General Practice, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - Catrine Tudor-Locke
- Department of Kinesiology, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA
| | - Joanne Morgan
- UK Clinical Research Collaboration, Centre of Excellence for Public Health Northern Ireland, Belfast, UK
- Community Development and Health Network, Newry, UK
| | - Glenn Phair
- Northern Ireland Clinical Trials Unit, The Royal Hospitals, Belfast, UK
| | | | | | - Suzanne M McDonough
- UK Clinical Research Collaboration, Centre of Excellence for Public Health Northern Ireland, Belfast, UK
- Centre for Health and Rehabilitation Technologies, Institute of Nursing and Health, School of Health Sciences, Ulster University, Newtownabbey, UK
- School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Evie Gardner
- Northern Ireland Clinical Trials Unit, The Royal Hospitals, Belfast, UK
| | - Frank Kee
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
- UK Clinical Research Collaboration, Centre of Excellence for Public Health Northern Ireland, Belfast, UK
| | - Marie H Murphy
- Centre for Physical Activity and Health Research, Ulster University, Newtownabbey, UK
| | - Ashley Agus
- Northern Ireland Clinical Trials Unit, The Royal Hospitals, Belfast, UK
| | - Ruth F Hunter
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
- UK Clinical Research Collaboration, Centre of Excellence for Public Health Northern Ireland, Belfast, UK
| | - Wendy Hardeman
- Health Promotion Research Group, School of Health Sciences, University of East Anglia, Norwich, UK
| | - Margaret E Cupples
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
- UK Clinical Research Collaboration, Centre of Excellence for Public Health Northern Ireland, Belfast, UK
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Anthony SJ, Robertson T, Selkirk E, Dix D, Klaassen RJ, Sung L, Klassen AF. The social impact of early psychological maturity in adolescents with cancer. Psychooncology 2019; 28:586-592. [PMID: 30646430 DOI: 10.1002/pon.4982] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/12/2018] [Accepted: 01/01/2019] [Indexed: 11/05/2022]
Abstract
OBJECTIVE There is a growing need to assess the long-term quality of life (QOL) of pediatric oncology patients since many children now survive their disease. This paper highlights the subjective perspectives of pediatric cancer patients and specifically explores how experiencing cancer at a young age impacts adolescents in the areas of social functioning, peer relationships, and QOL. The findings emerged from a qualitative research study that explored how pediatric oncology patients ascribe meaning to their illness. METHODS Study participants were recruited from four Canadian academic pediatric hospitals. In this study, we used an interpretative description approach. Semistructured interviews were completed, transcribed verbatim, and coded through the method of constant comparison. RESULTS A total of 37 children and adolescents (n = 19 female; 51%) participated. The majority of participants were diagnosed with leukemia (n = 16; 43%) or lymphoma (n = 9; 24%). Sixty-two percent of participants were adolescents between the ages of 13 and 18 years (n = 23). Data illustrated a unique adolescent experience, which has been reported as a subset of the original population. Adolescent participants noted an accelerated experience of maturation, which invited reflections of gratitude as well as feelings of isolation and disconnect from peers. Participants were saddened to have "missed out" on normative parts of childhood. CONCLUSION Findings highlighted experiences of accelerated maturity that prompted adverse social outcomes for adolescent participants, which impacted their QOL. Future research is needed to explore the intersection of accelerated maturity attributed to illness, social functioning, and QOL. Peer support through technology engagement is suggested for this population.
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Affiliation(s)
- Samantha J Anthony
- Child Health Evaluative Sciences, The Hospital for Sick Children/Peter Gilgan Centre for Research and Learning, Toronto, ON, Canada.,Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | - Taylor Robertson
- Child Health Evaluative Sciences, The Hospital for Sick Children/Peter Gilgan Centre for Research and Learning, Toronto, ON, Canada
| | - Enid Selkirk
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
| | - David Dix
- Department of Pediatrics Hem/Onc/BMT, BC Children's Hospital, Vancouver, BC, Canada
| | - Robert J Klaassen
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Lillian Sung
- Division of Haematology-Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Anne F Klassen
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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Grunberg PH, Dennis CL, Da Costa D, Zelkowitz P. Infertility patients' need and preferences for online peer support. REPRODUCTIVE BIOMEDICINE & SOCIETY ONLINE 2018; 6:80-89. [PMID: 30547107 PMCID: PMC6282097 DOI: 10.1016/j.rbms.2018.10.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 07/10/2018] [Accepted: 10/16/2018] [Indexed: 05/09/2023]
Abstract
This study sought to determine the level of interest in online peer support among infertility patients, factors associated with such interest, and preferences for features of an online peer support network. A sample of 236 men and 283 women (n = 519) seeking fertility treatment were recruited from four clinics in Ontario and Quebec, Canada. Participants completed an anonymous online questionnaire assessing demographics, perceived stress and fertility characteristics, in addition to interest in and preferences for online infertility peer support. Most men (80.1%) and women (89.8%) expressed interest in online peer support, with perceived stress being related to interest among both men and women. Non-White ethnicity and lower income were related to greater interest among men. Patients reported a preference for mobile accessibility, monitored peer-to-peer communication, and links to information. Men and women, particularly those with high levels of perceived stress, expressed interest in online peer support and shared similar preferences for features irrespective of fertility characteristics. Demographic characteristics and perceived stress were related to a desire for more personalized support options.
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Affiliation(s)
- Paul H. Grunberg
- McGill University, Department of Psychology, Montreal, Quebec, Canada
- Jewish General Hospital, Department of Psychiatry, Montreal, Quebec, Canada
| | - Cindy-Lee Dennis
- University of Toronto, Lawrence S. Bloomberg Faculty of Nursing, Toronto, Ontario, Canada
| | - Deborah Da Costa
- McGill University, Department of Medicine, Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Phyllis Zelkowitz
- Jewish General Hospital, Department of Psychiatry, Montreal, Quebec, Canada
- McGill University, Department of Psychiatry, Montreal, Quebec, Canada
- Jewish General Hospital, Lady Davis Institute for Medical Research, Montreal, Quebec, Canada
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Breakey VR, Bouskill V, Nguyen C, Luca S, Stinson JN, Ahola Kohut S. Online Peer-to-Peer Mentoring Support for Youth with Hemophilia: Qualitative Needs Assessment. JMIR Pediatr Parent 2018; 1:e10958. [PMID: 31518296 PMCID: PMC6715049 DOI: 10.2196/10958] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 06/15/2018] [Accepted: 06/15/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND To support adolescents through transition from pediatrics to adult care, health care providers and families help teens gain knowledge and develop self-management skills. Peer mentoring can provide meaningful support and has been associated with improved health outcomes in patients with other chronic conditions. Peer mentoring is an appealing way to provide support, but it is imperative to consider the unique needs of adolescents to ensure its success. OBJECTIVE The objective of our study was to identify the peer mentoring wants and needs of youth with hemophilia in order to guide the development of a new program. METHODS In this qualitative study, we interviewed a convenience sample of youth with hemophilia from 2 Canadian hemophilia treatment centers. Two iterative cycles of audiorecorded, semistructured individual interviews were conducted. Descriptive statistics and content analyses were used to organize data into categories that reflected emerging themes. RESULTS In total, we recruited 23 participants aged 12-20 years, with a mean age of 14.91 (2.57) years. When asked about program design, participants weighed the importance of flexibility in delivery (eg, Web-based, in person, text messaging [short message service]), content (eg, structured vs unstructured), frequency of sessions, and length of the program. Participants identified some potential challenges such as scheduling issues, comfort level for disease discussion, and discordant mentor-mentee personality types. The program was viewed as a positive medium for connecting peers with hemophilia. CONCLUSIONS Adolescents with hemophilia expressed interest in a peer mentoring program and provided valuable insight that will be applied in the development of a peer mentoring program for youth with hemophilia.
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Affiliation(s)
- Vicky R Breakey
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, McMaster Children's Hospital, Hamilton, ON, Canada.,Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Vanessa Bouskill
- Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada.,Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Cynthia Nguyen
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
| | - Stephanie Luca
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jennifer N Stinson
- Lawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Sara Ahola Kohut
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, ON, Canada.,Department of Psychiatry, The Hospital for Sick Children, Toronto, ON, Canada
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Farquhar JM, Stonerock GL, Blumenthal JA. Treatment of Anxiety in Patients With Coronary Heart Disease: A Systematic Review. PSYCHOSOMATICS 2018; 59:318-332. [PMID: 29735242 PMCID: PMC6015539 DOI: 10.1016/j.psym.2018.03.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 03/14/2018] [Accepted: 03/19/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Anxiety is common in patients with coronary heart disease (CHD) and is associated with an increased risk for adverse outcomes. There has been a relative paucity of studies concerning treatment of anxiety in patients with CHD. OBJECTIVE We conducted a systematic review to organize and assess research into the treatment of anxiety in patients with CHD. METHODS We searched CCTR/CENTRAL, MEDLINE, EMBASE, PsycINFO, and CINAHL for randomized clinical trials conducted before October 2016 that measured anxiety before and after an intervention for patients with CHD. RESULTS A total of 475 articles were subjected to full text review, yielding 112 publications that met inclusion criteria plus an additional 7 studies from reference lists and published reviews, yielding 119 studies. Sample size, country of origin, study quality, and demographics varied widely among studies. Most studies were conducted with nonanxious patients. The Hospital Anxiety and Depression Scale and State-Trait Anxiety Inventory were the most frequently used instruments to assess anxiety. Interventions included pharmacological, counseling, relaxation-based, educational, or "alternative" therapies. Forty (33% of total) studies reported that the interventions reduced anxiety; treatment efficacy varied by study and type of intervention. Elevated anxiety was an inclusion criterion in only 4 studies, with inconsistent results. CONCLUSION Although there have been a number of randomized clinical trials of patients with CHD that assessed anxiety, in most cases anxiety was a secondary outcome, and only one-third found that symptoms of anxiety were reduced with treatment. Future studies need to target anxious patients and evaluate the effects of treatment on anxiety and relevant clinical endpoints.
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Affiliation(s)
- Julia M Farquhar
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Gregory L Stonerock
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - James A Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
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Thomet C, Moons P, Schwerzmann M, Apers S, Luyckx K, Oechslin EN, Kovacs AH. Self-efficacy as a predictor of patient-reported outcomes in adults with congenital heart disease. Eur J Cardiovasc Nurs 2018; 17:619-626. [DOI: 10.1177/1474515118771017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective: Self-efficacy is a known predictor of patient-reported outcomes in individuals with acquired diseases. With an overall objective of better understanding patient-reported outcomes in adults with congenital heart disease, this study aimed to: (i) assess self-efficacy in adults with congenital heart disease, (ii) explore potential demographic and medical correlates of self-efficacy and (iii) determine whether self-efficacy explains additional variance in patient-reported outcomes above and beyond known predictors. Methods: As part of a large cross-sectional international multi-site study (APPROACH-IS), we enrolled 454 adults (median age 32 years, range: 18–81) with congenital heart disease in two tertiary care centres in Canada and Switzerland. Self-efficacy was measured using the General Self-Efficacy (GSE) scale, which produces a total score ranging from 10 to 40. Variance in the following patient-reported outcomes was assessed: perceived health status, psychological functioning, health behaviours and quality of life. Hierarchical multivariable linear regression analysis was performed. Results: Patients’ mean GSE score was 30.1 ± 3.3 (range: 10–40). Lower GSE was associated with female sex ( p = 0.025), not having a job ( p = 0.001) and poorer functional class ( p = 0.048). GSE positively predicted health status and quality of life, and negatively predicted symptoms of anxiety and depression, with an additional explained variance up to 13.6%. No associations between self-efficacy and health behaviours were found. Conclusions: GSE adds considerably to our understanding of patient-reported outcomes in adults with congenital heart disease. Given that self-efficacy is a modifiable psychosocial factor, it may be an important focus for interventions targeting congenital heart disease patients’ well-being.
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Affiliation(s)
- Corina Thomet
- Center for Congenital Heart Disease, Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
- Department of Public Health and Primary Care, KU Leuven – University of Leuven, Belgium
| | - Philip Moons
- Department of Public Health and Primary Care, KU Leuven – University of Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Sweden
| | - Markus Schwerzmann
- Center for Congenital Heart Disease, Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Silke Apers
- Department of Public Health and Primary Care, KU Leuven – University of Leuven, Belgium
| | - Koen Luyckx
- School Psychology and Development in Context, KU Leuven – University of Leuven, Belgium
| | - Erwin N Oechslin
- Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network and University of Toronto, Canada
| | - Adrienne H Kovacs
- Toronto Congenital Cardiac Centre for Adults, Peter Munk Cardiac Centre, University Health Network and University of Toronto, Canada
- The Knight Cardiovascular Institute, Oregon Health & Science University, Portland, USA
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Colón-Semenza C, Latham NK, Quintiliani LM, Ellis TD. Peer Coaching Through mHealth Targeting Physical Activity in People With Parkinson Disease: Feasibility Study. JMIR Mhealth Uhealth 2018; 6:e42. [PMID: 29449201 PMCID: PMC5832905 DOI: 10.2196/mhealth.8074] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 10/30/2017] [Accepted: 12/14/2017] [Indexed: 01/06/2023] Open
Abstract
Background Long-term engagement in exercise and physical activity mitigates the progression of disability and increases quality of life in people with Parkinson disease (PD). Despite this, the vast majority of individuals with PD are sedentary. There is a critical need for a feasible, safe, acceptable, and effective method to assist those with PD to engage in active lifestyles. Peer coaching through mobile health (mHealth) may be a viable approach. Objective The purpose of this study was to develop a PD-specific peer coach training program and a remote peer-mentored walking program using mHealth technology with the goal of increasing physical activity in persons with PD. We set out to examine the feasibility, safety, and acceptability of the programs along with preliminary evidence of individual-level changes in walking activity, self-efficacy, and disability in the peer mentees. Methods A peer coach training program and a remote peer-mentored walking program using mHealth was developed and tested in 10 individuals with PD. We matched physically active persons with PD (peer coaches) with sedentary persons with PD (peer mentees), resulting in 5 dyads. Using both Web-based and in-person delivery methods, we trained the peer coaches in basic knowledge of PD, exercise, active listening, and motivational interviewing. Peer coaches and mentees wore FitBit Zip activity trackers and participated in daily walking over 8 weeks. Peer dyads interacted daily via the FitBit friends mobile app and weekly via telephone calls. Feasibility was determined by examining recruitment, participation, and retention rates. Safety was assessed by monitoring adverse events during the study period. Acceptability was assessed via satisfaction surveys. Individual-level changes in physical activity were examined relative to clinically important differences. Results Four out of the 5 peer pairs used the FitBit activity tracker and friends function without difficulty. A total of 4 of the 5 pairs completed the 8 weekly phone conversations. There were no adverse events over the course of the study. All peer coaches were “satisfied” or “very satisfied” with the training program, and all participants were “satisfied” or “very satisfied” with the peer-mentored walking program. All participants would recommend this program to others with PD. Increases in average steps per day exceeding the clinically important difference occurred in 4 out of the 5 mentees. Conclusions Remote peer coaching using mHealth is feasible, safe, and acceptable for persons with PD. Peer coaching using mHealth technology may be a viable method to increase physical activity in individuals with PD. Larger controlled trials are necessary to examine the effectiveness of this approach.
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Affiliation(s)
- Cristina Colón-Semenza
- Center for Neurorehabilitation, Department of Physical Therapy & Athletic Training, College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Nancy K Latham
- Boston Claude D Pepper Older Americans Independence Center, Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
| | - Lisa M Quintiliani
- School of Medicine, Department of Medicine, Section of General Internal Medicine, Boston University, Boston, MA, United States
| | - Terry D Ellis
- Center for Neurorehabilitation, Department of Physical Therapy & Athletic Training, College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
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Comparison of effect of Nursing Education and Peer Education Methods on Self-Efficacy in Patients with Myocardial Infarction. ACTA ACUST UNITED AC 2018. [DOI: 10.5812/modernc.56012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Baker DM, Lee MJ, Jones GL, Brown SR, Lobo AJ. The Informational Needs and Preferences of Patients Considering Surgery for Ulcerative Colitis: Results of a Qualitative Study. Inflamm Bowel Dis 2017; 24:179-190. [PMID: 29272489 DOI: 10.1093/ibd/izx026] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Patients considering surgery for ulcerative colitis (UC) face a difficult decision as surgery may or may not improve quality of life. National Institute for Health and Care Excellence guidelines for UC emphasize the importance of providing quality preoperative information to patients but note no quality studies for the desired content of this information. Our aim was to explore patient information preferences prior to undergoing surgery for ulcerative colitis. METHODS Semistructured interviews with patients who underwent an operation and patients who considered but declined an operation were conducted. Interviews explored informational preferences, with emphasis on preoperative information given, preoperative information desired but not received, and retrospective informational desires. Interviews were transcribed and coded using an inductive thematic analysis using NVivo software. Data saturation was assessed after 12 interviews, with interviews continuing until saturation was achieved. Ethical approval was gained prior to interviews commencing (16/NW/0639). RESULTS A total of 16 interviews were conducted before data saturation was achieved (male n = 7, female n = 9). Eight patients declined surgery, and 8 opted for subtotal colectomy with permanent end ileostomy (n = 5) or ileoanal pouch (n = 3). A total of 4 themes and 14 subthemes were identified. Three dominant subthemes of informational shortcomings emerged: "long-term effects of surgery," "practicalities of daily living," and "long-term support." Peer support was desired by patients but was infrequently supported by health care professionals. CONCLUSIONS Current preoperative information does not address patient informational needs. Surgical consultations should be adapted to suit patient preferences. Clinical practice may need to be altered to ensure that patients are better supported following surgery.
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Affiliation(s)
- Daniel Mark Baker
- University of Sheffield Medical School, Sheffield, UK.,Department of General Surgery, Sheffield Teaching Hospitals, Sheffield, UK
| | - Matthew James Lee
- University of Sheffield Medical School, Sheffield, UK.,Department of General Surgery, Sheffield Teaching Hospitals, Sheffield, UK
| | | | - Steven Ross Brown
- Department of General Surgery, Sheffield Teaching Hospitals, Sheffield, UK
| | - Alan Joseph Lobo
- Academic Unit of Gastroenterology, Sheffield Teaching Hospitals, Sheffield, UK
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Colella TJ, King-Shier K. The effect of a peer support intervention on early recovery outcomes in men recovering from coronary bypass surgery: A randomized controlled trial. Eur J Cardiovasc Nurs 2017; 17:408-417. [PMID: 28805455 DOI: 10.1177/1474515117725521] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND AIM Examine the effect of a professionally-guided telephone peer support intervention on recovery outcomes including depression, perceived social support, and health services utilization after coronary artery bypass graft surgery (CABG). METHODS A randomized controlled trial was conducted with post-coronary artery bypass graft surgery men ( N=185) who were randomized before hospital discharge. The intervention arm received telephone-based peer support through weekly telephone calls from a peer volunteer over six weeks, initiated within 3-4 days of discharge. RESULTS Although a significant difference was detected in pre-intervention depression scores at discharge, there were no differences between groups in changes in depression scores at six weeks ( p=0.08), 12 weeks (0.49) or over time ( p=0.51); and no significant differences in perceived social support scores over time ( p=0.94). At 12 weeks, the intervention group had significantly lower incidence of health services utilization (family physician ( p=0.02) and emergency room ( p=0.04)). CONCLUSIONS Healthcare providers need to continue to investigate novel interventions to enhance social support and reduce depression in cardiac patients.
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Affiliation(s)
- Tracey Jf Colella
- 1 University Health Network/Toronto Rehab Cardiovascular Prevention & Rehabilitation Program, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Kathryn King-Shier
- 2 Faculty of Nursing, Department of Community Health Sciences, University of Calgary, Alberta, Canada
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Ziehm S, Rosendahl J, Barth J, Strauss BM, Mehnert A, Koranyi S. Psychological interventions for acute pain after open heart surgery. Cochrane Database Syst Rev 2017; 7:CD009984. [PMID: 28701028 PMCID: PMC6432747 DOI: 10.1002/14651858.cd009984.pub3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND This is an update of a Cochrane review previously published in 2014. Acute postoperative pain is one of the most disturbing complaints in open heart surgery, and is associated with a risk of negative consequences. Several trials investigated the effects of psychological interventions to reduce acute postoperative pain and improve the course of physical and psychological recovery of participants undergoing open heart surgery. OBJECTIVES To compare the efficacy of psychological interventions as an adjunct to standard care versus standard care alone or standard care plus attention control in adults undergoing open heart surgery for pain, pain medication, psychological distress, mobility, and time to extubation. SEARCH METHODS For this update, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Web of Science, and PsycINFO for eligible studies up to February 2017. We used the 'related articles' and 'cited by' options of eligible studies to identify additional relevant studies. We checked lists of references of relevant articles and previous reviews. We searched the ProQuest Dissertations and Theses Full Text Database, ClinicalTrials and the WHO International Clinical Trials Registry Platform to identify any unpublished material or ongoing trials. We also contacted the authors of primary studies to identify any unpublished material. In addition, we wrote to all leading heart centres in Germany, Switzerland, and Austria to check whether they were aware of any ongoing trials. SELECTION CRITERIA Randomised controlled trials comparing psychological interventions as an adjunct to standard care versus standard care alone or standard care plus attention in adults undergoing open heart surgery. DATA COLLECTION AND ANALYSIS Two review authors (SZ and SK) independently assessed trials for eligibility, estimated the risk of bias and extracted all data. We calculated effect sizes for each comparison (Hedges' g) and meta-analysed data using a random-effects model. We assessed the evidence using GRADE and created 'Summary of findings' tables. MAIN RESULTS We added six studies to this update. Overall, we included 23 studies (2669 participants).For the majority of outcomes (two-thirds), we could not perform a meta-analysis since outcomes were not measured, or data were provided by one trial only.No study reported data on the number of participants with pain intensity reduction of at least 50% from baseline. Only one study reported data on the number of participants below 30/100 mm on the Visual Analogue Scale (VAS) in pain intensity (very low-quality evidence). Psychological interventions did not reduce pain intensity in the short-term interval (g 0.39, 95% CI -0.18 to 0.96, 2 studies, 104 participants, low-quality evidence), medium-term interval (g -0.02, 95% CI -0.24 to 0.20, 4 studies, 413 participants, moderate-quality evidence) or in the long-term interval (g 0.05, 95% CI -0.20 to 0.30, 2 studies, 200 participants, moderate-quality evidence).No study reported data on median time to re-medication or on number of participants re-medicated. Only two studies provided data on postoperative analgesic use in the short-term interval, showing that psychological interventions did not reduce the use of analgesic medication (g 1.18, 95% CI -2.03 to 4.39, 2 studies, 104 participants, low-quality evidence). Studies revealed that psychological interventions reduced mental distress in the medium-term (g 0.37, 95% CI 0.13 to 0.60, 13 studies, 1388 participants, moderate-quality evidence) and likewise in the long-term interval (g 0.32, 95% CI 0.10 to 0.53, 14 studies, 1586 participants, moderate-quality evidence). Psychological interventions did not improve mobility in the medium-term interval (g 0.23, 95% CI -0.22 to 0.67, 3 studies, 444 participants, low-quality evidence), nor in the long-term interval (g 0.09, 95% CI -0.10 to 0.28, 4 studies, 458 participants, moderate-quality evidence). Only two studies reported data on time to extubation, indicating that psychological interventions reduced the time to extubation (g 0.56, 95% CI 0.08 to 1.03, 2 studies, 154 participants, low-quality evidence).Overall, the very low to moderate quality of the body of evidence on the efficacy of psychological interventions for acute pain after open heart surgery cannot be regarded as sufficient to draw robust conclusions.Most 'Risk of bias' assessments were low or unclear. We judged selection bias (random sequence generation) and attrition bias to be mostly low risk for included studies. However, we judged the risk of selection bias (allocation concealment), performance bias, detection bias and reporting bias to be mostly unclear. AUTHORS' CONCLUSIONS In line with the conclusions of our previous review, there is a lack of evidence to support or refute psychological interventions in order to reduce postoperative pain in participants undergoing open heart surgery. We found moderate-quality evidence that psychological interventions reduced mental distress in participants undergoing open heart surgery. Given the small numbers of studies, it is not possible to draw robust conclusions on the efficacy of psychological interventions on outcomes such as analgesic use, mobility, and time to extubation respectively on adverse events or harms of psychological interventions.
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Affiliation(s)
- Susanne Ziehm
- University Hospital of LeipzigInstitute of Medical Psychology and Medical SoziologyPhilipp‐Rosenthal‐Straße 55LeipzigSaxonyGermany4103
| | - Jenny Rosendahl
- University Hospital of JenaInstitute of Psychosocial Medicine and PsychotherapyStoystrasse 3JenaThuringiaGermany07743
| | - Jürgen Barth
- UniversityHospital and University of ZurichInstitute for Complementary and Integrative MedicineSonneggstrasse 6ZurichSwitzerlandCH‐8091
| | - Bernhard M Strauss
- University Hospital of JenaInstitute of Psychosocial Medicine and PsychotherapyStoystrasse 3JenaThuringiaGermany07743
| | - Anja Mehnert
- University Hospital of LeipzigInstitute of Medical Psychology and Medical SoziologyPhilipp‐Rosenthal‐Straße 55LeipzigSaxonyGermany4103
| | - Susan Koranyi
- University Hospital of LeipzigInstitute of Medical Psychology and Medical SoziologyPhilipp‐Rosenthal‐Straße 55LeipzigSaxonyGermany4103
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Richards SH, Anderson L, Jenkinson CE, Whalley B, Rees K, Davies P, Bennett P, Liu Z, West R, Thompson DR, Taylor RS. Psychological interventions for coronary heart disease. Cochrane Database Syst Rev 2017; 4:CD002902. [PMID: 28452408 PMCID: PMC6478177 DOI: 10.1002/14651858.cd002902.pub4] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Coronary heart disease (CHD) is the most common cause of death globally, although mortality rates are falling. Psychological symptoms are prevalent for people with CHD, and many psychological treatments are offered following cardiac events or procedures with the aim of improving health and outcomes. This is an update of a Cochrane systematic review previously published in 2011. OBJECTIVES To assess the effectiveness of psychological interventions (alone or with cardiac rehabilitation) compared with usual care (including cardiac rehabilitation where available) for people with CHD on total mortality and cardiac mortality; cardiac morbidity; and participant-reported psychological outcomes of levels of depression, anxiety, and stress; and to explore potential study-level predictors of the effectiveness of psychological interventions in this population. SEARCH METHODS We updated the previous Cochrane Review searches by searching the following databases on 27 April 2016: CENTRAL in the Cochrane Library, MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid), and CINAHL (EBSCO). SELECTION CRITERIA We included randomised controlled trials (RCTs) of psychological interventions compared to usual care, administered by trained staff, and delivered to adults with a specific diagnosis of CHD. We selected only studies estimating the independent effect of the psychological component, and with a minimum follow-up of six months. The study population comprised of adults after: a myocardial infarction (MI), a revascularisation procedure (coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI)), and adults with angina or angiographically defined coronary artery disease (CAD). RCTs had to report at least one of the following outcomes: mortality (total- or cardiac-related); cardiac morbidity (MI, revascularisation procedures); or participant-reported levels of depression, anxiety, or stress. DATA COLLECTION AND ANALYSIS Two review authors independently screened titles and abstracts of all references for eligibility. A lead review author extracted study data, which a second review author checked. We contacted study authors to obtain missing information. MAIN RESULTS This review included 35 studies which randomised 10,703 people with CHD (14 trials and 2577 participants added to this update). The population included mainly men (median 77.0%) and people post-MI (mean 65.7%) or after undergoing a revascularisation procedure (mean 27.4%). The mean age of participants within trials ranged from 53 to 67 years. Overall trial reporting was poor, with around a half omitting descriptions of randomisation sequence generation, allocation concealment procedures, or the blinding of outcome assessments. The length of follow-up ranged from six months to 10.7 years (median 12 months). Most studies (23/35) evaluated multifactorial interventions, which included therapies with multiple therapeutic components. Ten studies examined psychological interventions targeted at people with a confirmed psychopathology at baseline and two trials recruited people with a psychopathology or another selecting criterion (or both). Of the remaining 23 trials, nine studies recruited unselected participants from cardiac populations reporting some level of psychopathology (3.8% to 53% with depressive symptoms, 32% to 53% with anxiety), 10 studies did not report these characteristics, and only three studies excluded people with psychopathology.Moderate quality evidence showed no risk reduction for total mortality (risk ratio (RR) 0.90, 95% confidence interval (CI) 0.77 to 1.05; participants = 7776; studies = 23) or revascularisation procedures (RR 0.94, 95% CI 0.81 to 1.11) with psychological therapies compared to usual care. Low quality evidence found no risk reduction for non-fatal MI (RR 0.82, 95% CI 0.64 to 1.05), although there was a 21% reduction in cardiac mortality (RR 0.79, 95% CI 0.63 to 0.98). There was also low or very low quality evidence that psychological interventions improved participant-reported levels of depressive symptoms (standardised mean difference (SMD) -0.27, 95% CI -0.39 to -0.15; GRADE = low), anxiety (SMD -0.24, 95% CI -0.38 to -0.09; GRADE = low), and stress (SMD -0.56, 95% CI -0.88 to -0.24; GRADE = very low).There was substantial statistical heterogeneity for all psychological outcomes but not clinical outcomes, and there was evidence of small-study bias for one clinical outcome (cardiac mortality: Egger test P = 0.04) and one psychological outcome (anxiety: Egger test P = 0.012). Meta-regression exploring a limited number of intervention characteristics found no significant predictors of intervention effects for total mortality and cardiac mortality. For depression, psychological interventions combined with adjunct pharmacology (where deemed appropriate) for an underlying psychological disorder appeared to be more effective than interventions that did not (β = -0.51, P = 0.003). For anxiety, interventions recruiting participants with an underlying psychological disorder appeared more effective than those delivered to unselected populations (β = -0.28, P = 0.03). AUTHORS' CONCLUSIONS This updated Cochrane Review found that for people with CHD, there was no evidence that psychological treatments had an effect on total mortality, the risk of revascularisation procedures, or on the rate of non-fatal MI, although the rate of cardiac mortality was reduced and psychological symptoms (depression, anxiety, or stress) were alleviated; however, the GRADE assessments suggest considerable uncertainty surrounding these effects. Considerable uncertainty also remains regarding the people who would benefit most from treatment (i.e. people with or without psychological disorders at baseline) and the specific components of successful interventions. Future large-scale trials testing the effectiveness of psychological therapies are required due to the uncertainty within the evidence. Future trials would benefit from testing the impact of specific (rather than multifactorial) psychological interventions for participants with CHD, and testing the targeting of interventions on different populations (i.e. people with CHD, with or without psychopathologies).
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Affiliation(s)
- Suzanne H Richards
- Leeds Institute of Health Sciences, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Leeds, UK, LS2 9LJ
- Primary Care, University of Exeter Medical School, St Luke's Campus, Magdalen Road, Exeter, Devon, UK, EX1 2LU
| | - Lindsey Anderson
- Institute of Health Research, University of Exeter Medical School, Veysey Building, Salmon Pool Lane, Exeter, UK, EX2 4SG
| | - Caroline E Jenkinson
- Primary Care, University of Exeter Medical School, St Luke's Campus, Magdalen Road, Exeter, Devon, UK, EX1 2LU
| | - Ben Whalley
- School of Psychology, University of Plymouth, Plymouth, UK
| | - Karen Rees
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK, CV4 7AL
| | - Philippa Davies
- School of Social and Community Medicine, University of Bristol, Canynge Hall, Bristol, UK, BS8 2PS
| | - Paul Bennett
- Department of Psychology, University of Swansea, Singleton Park, Swansea, UK, SA2 8PP
| | - Zulian Liu
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Robert West
- Wales Heart Research Institute, Cardiff University, Heath Park, Cardiff, UK, CF14 4XN
| | - David R Thompson
- Department of Psychiatry, University of Melbourne, St Vincent's Hospital, Melbourne, Victoria, Australia, VIC 3000
| | - Rod S Taylor
- Institute of Health Research, University of Exeter Medical School, Veysey Building, Salmon Pool Lane, Exeter, UK, EX2 4SG
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Abstract
Introducción. Después de un infarto agudo de miocardio, los pacientes experimentan altos niveles de estrés emocional y ansiedad. Estas percepciones limitan sus comportamientos saludables.Objetivo. Determinar el nivel de autoeficacia general en pacientes post-infarto agudo de miocardio según la edad, género, estado de rehabilitación y atención en una unidad de cardiología en Girardot.Materiales y métodos. Investigación descriptiva, evaluada a través de la Escala general de autoeficacia versión ll, en una población de 149 personas entre los 35 y 65 años. Para el análisis estadístico de los resultados se utilizaron medidas estadísticas descriptivas y pruebas de correlación.Resultados. La edad de los participantes tuvo una media de 52 años. El análisis de la autoeficacia por grupo de edad evidenció incidencia mínima de la autoeficacia en el grupo de edad. Según el género, los hombres se percibieron más autoeficaces que las mujeres. Además, los pacientes que no asistieron a la rehabilitación cardíaca tuvieron un nivel de autoeficacia general ligeramente mayor en comparación con los rehabilitados.Conclusiones. No hubo relación entre la edad, el género y la rehabilitación frente al nivel de autoeficacia. Estas variables dependieron de otras diferentes a las del estudio.
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Abstract
Adolescents with chronic pain are often socially isolated, having never met others with chronic pain, and often feel misunderstood by healthy peers. Adolescence is a sensitive period for developing one's sense of self and autonomy, which often occurs in the context of peer relationships. This developmental process is disrupted in adolescents when their chronic pain interferes with their social interactions. Peer mentoring is proposed as a developmentally timely intervention. The aim of this study is to develop and test the feasibility, acceptability, and impact of the iPeer2Peer program. The iPeer2Peer program is a tailored peer mentorship program that provides modeling and reinforcement by peers (trained young adults with chronic pain aged 18-25 years who have learned to successfully manage their pain). This program aimed to enhance self-management of chronic pain in adolescents through 10 Skype video calls over the course of 8 weeks. A pilot randomized controlled trial design using waitlist controls was used in an adolescent chronic pain sample. Twenty-eight adolescents aged 14.8 ± 1.6 years (93% female) completed the trial (intervention: n = 12; control n = 16). Three adolescents completed the intervention after completing their participation in the control arm. The iPeer2Peer program was feasible and acceptable, provided the adolescents were given more time to complete all 10 calls. When compared with controls, adolescents who completed the iPeer2Peer program had significant improvement in self-management skills and their coping efforts were more successful. The iPeer2Peer program is a promising peer mentoring intervention that complements standard care for adolescents with chronic pain.
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Ahola Kohut S, Stinson J, Forgeron P, van Wyk M, Harris L, Luca S. A qualitative content analysis of peer mentoring video calls in adolescents with chronic illness. J Health Psychol 2016; 23:788-799. [PMID: 27682341 DOI: 10.1177/1359105316669877] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This article endeavored to determine the topics of discussion during open-ended peer mentoring between adolescents and young adults living with chronic illness. This study occurred alongside a study of the iPeer2Peer Program. Fifty-two calls (7 mentor-mentee pairings) were audio recorded, transcribed verbatim, and analyzed using inductive coding with an additional 30 calls (21 mentor-mentee pairings) coded to ensure representativeness of the data. Three categories emerged: (1) illness impact (e.g., relationships, school/work, self-identity, personal stories), (2) self-management (e.g., treatment adherence, transition to adult care, coping strategies), and (3) non-illness-related adolescent issues (e.g., post-secondary goals, hobbies, social environments). Differences in discussed topics were noted between sexes and by diagnosis. Peer mentors provided informational, appraisal, and emotional support to adolescents.
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Affiliation(s)
- Sara Ahola Kohut
- 1 The Hospital for Sick Children, Canada.,2 University of Toronto, Canada
| | - Jennifer Stinson
- 1 The Hospital for Sick Children, Canada.,2 University of Toronto, Canada
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Dowd SM, Artistico D. Type and strength of self-construal interact with the influence of anchoring heuristics in appraisals of self-efficacy. LEARNING AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.lindif.2016.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Carroll DL, Rankin SH. Comparing Interventions in Older Unpartnered Adults after Myocardial Infarction. Eur J Cardiovasc Nurs 2016; 5:83-9. [PMID: 16256442 DOI: 10.1016/j.ejcnurse.2005.09.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2005] [Revised: 08/29/2005] [Accepted: 09/27/2005] [Indexed: 11/16/2022]
Abstract
BACKGROUND Older adults after myocardial infarction (MI) are a vulnerable group who may benefit from interventions to improve health outcomes. The use of a peer advisor or an advanced practice nurse (APN) to provide a self-efficacy intervention is a promising method of improving health outcomes after MI. AIMS The purpose of this paper was to compare the effect of two self-efficacy interventions, a peer advisor and an APN, to a group who received standard care after MI. METHODS The study was a three-group randomized clinical trial with a peer advisor intervention group, an APN intervention group, and a standard care group. Outcome data were collected in the hospital after MI and by telephone at 12 weeks after hospital discharge, after the interventions were completed. RESULTS At 12 weeks after MI, there were no significant differences between the 3 groups in health outcomes. There were similar changes in self-efficacy for performing recovery behaviors, the actual performance of recovery behavior, physical and mental health across both intervention groups and the standard care group. CONCLUSIONS Although the data did not validate the benefits of these self-efficacy interventions, future efforts at identifying changes in health outcomes may need to use more discrete measurements that are more sensitive to changes in the older unpartnered adult after an MI.
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Affiliation(s)
- Diane L Carroll
- Department of Nursing, GRB 1034, Massachusetts General Hospital, Boston, MA 02114, USA.
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Gardner G, Elliott D, Gill J, Griffin M, Crawford M. Patient Experiences Following Cardiothoracic Surgery: An Interview Study. Eur J Cardiovasc Nurs 2016; 4:242-50. [PMID: 15923146 DOI: 10.1016/j.ejcnurse.2005.04.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2004] [Revised: 04/09/2005] [Accepted: 04/20/2005] [Indexed: 11/24/2022]
Abstract
Background: Numerous studies have investigated patient outcomes of cardiac surgery, including some examining health-related quality of life. While these studies have provided some insight into patients' physical function, social abilities and perceived quality of life, studies examining the experiences of individuals recovering from cardiac surgery have received only limited investigation. Aims: This paper presents a thematic analysis of interviews conducted with patients recovering from cardiothoracic surgery, about their memories and experiences of hospital and recovery post-hospital discharge. Methods: Using an exploratory qualitative approach, eight participants were interviewed 6 months following their surgery. Transcripts of interviews were examined using a content analysis approach, with open coding of text and categorising of similar concepts into themes. Findings: Participants reported varying degrees of pain and physical dysfunction during their recovery from surgery and some had still not returned to optimal function. Seven themes emerged from the data: impressions of ICU; comfort/discomfort; being sick/getting better; companionship/isolation; hope/hopelessness; acceptance/apprehension; and life changes. A number of the themes were constructed as a continuum, with participants often demonstrating a range of views or experiences. Many had little or no memory of their stay in the intensive care unit, although others had vivid recollections. Their impressions of hospital were mostly positive, although many experienced fear, apprehension, and mood disturbances at some time during their recovery. Most participants recalled being sick, reaching a turning point, and then getting better. Many participants reported a change in life view since their recovery from surgery. Conclusions: Attention to specific areas of patient orientation, education and support was identified to facilitate realistic expectations of recovery. In addition, some form of systematic follow-up that focuses on patient recovery in terms of both physical and psychological function is important.
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How Well Do You Expect to Recover, and What Does Recovery Mean, Anyway? Qualitative Study of Expectations After a Musculoskeletal Injury. Phys Ther 2016; 96:797-807. [PMID: 26586855 DOI: 10.2522/ptj.20150229] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 11/10/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Expecting to recover from a musculoskeletal injury is associated with actual recovery. Expectations are potentially modifiable, although it is not well understood how injured people formulate expectations. A better understanding of how expectations are formulated may lead to better knowledge about how interventions might be implemented, what to intervene on, and when to intervene. OBJECTIVES The objective of this study was to explore what "recovery" meant to participants, whether they expected to "recover," and how they formed these expectations. METHODS This qualitative study used interpretive phenomenological analysis. Eighteen semistructured interviews were conducted with people seeking treatment for recent musculoskeletal injuries. RESULTS Recovery was conceptualized as either (1) complete cessation of symptoms or pain-free return to function or (2) return to function despite residual symptoms. Expectations were driven by desire for a clear diagnosis, belief (or disbelief) in the clinician's prognosis, prior experiences, other people's experiences and attitudes, information from other sources such as the Internet, and a sense of self as resilient. CONCLUSIONS Expectations appear to be embedded in both hopes and fears, suggesting that clinicians should address both when negotiating realistic goals and educating patients. This approach is particularly relevant for cases of nonspecific musculoskeletal pain, where diagnoses are unclear and treatment may not completely alleviate pain.
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Enggaard H, Uhrenfeldt L. Experiences of peer support in self-management interventions among people with ischemic heart disease: a systematic review protocol. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2016; 14:10-16. [PMID: 27532134 DOI: 10.11124/jbisrir-2016-2372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The objective of this review is to identify, appraise and synthesize the best available evidence regarding people with ischemic heart disease and their experiences with peer support in self-management interventions.More specifically, the review question is: How do people with ischemic heart disease experience peer support in structured self-management interventions led or co-led by peers?
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Affiliation(s)
- Helle Enggaard
- 1Department of Nursing, University College Northern Denmark 2Department of Health Science and Technology, Aalborg University 3Danish Center of Systematic Reviews: an Affiliate Center of the Joanna Briggs Institute, the Center of Clinical Guidelines-Clearing House, Aalborg University, Aalborg, Denmark
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