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D’Alessandro-Lowe AM, Ritchie K, Brown A, Xue Y, Pichtikova M, Altman M, Beech I, Millman H, Levy Y, Asma S, Hassall K, Foster F, Rodrigues S, Hosseiny F, O’Connor C, Heber A, Malain A, Schielke H, Lanius RA, McCabe RE, McKinnon MC. Characterizing the mental health and functioning of Canadian respiratory therapists during the COVID-19 pandemic. Eur J Psychotraumatol 2023; 14:2171751. [PMID: 36880459 PMCID: PMC9990694 DOI: 10.1080/20008066.2023.2171751] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 12/15/2022] [Accepted: 12/20/2022] [Indexed: 02/24/2023] Open
Abstract
Introduction: Healthcare professionals (HCPs) appear to be at increased risk for negative psychological outcomes [e.g. depression, anxiety, post-traumatic stress disorder (PTSD), moral distress] and associated impacts on functioning throughout the COVID-19 pandemic. HCPs working on designated COVID-19 units may be further impacted than their colleagues not on these units given added demands of patient care and risk of contracting COVID-19. Little is known, however, about the mental health and functioning of specific professional groups beyond nurses and physicians, including respiratory therapists (RTs), over the course of the pandemic. Accordingly, the purpose of the present study was to characterize the mental health and functioning of Canadian RTs and compare profiles between RTs working on and off designated COVID-19 units.Methods: Canadian RTs completed an online survey between February and June 2021, including demographic information (e.g. age, sex, gender,) and measures of depression, anxiety, stress, PTSD, moral distress and functional impairment. Descriptive statistics, correlation analyses and between-groups comparisons were conducted to characterize RTs and compare profiles between those on and off COVID-19 units.Results: Two hundred and eighteen (N = 218) RTs participated in this study. The estimated response rate was relatively low (6.2%) Approximately half of the sample endorsed clinically relevant symptoms of depression (52%), anxiety (51%) and stress (54%) and one in three (33%) screened positively for potential PTSD. All symptoms correlated positively with functional impairment (p's < .05). RTs working on COVID-19 units reported significantly greater patient-related moral distress compared to those not on these units (p < .05).Conclusion: Moral distress and symptoms of depression, anxiety, stress and PTSD were prevalent among Canadian RTs and were associated with functional impacts. These results must be interpreted with caution given a low response rate, yet raise concern regarding the long-term impacts of pandemic service among RTs.
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Affiliation(s)
| | - Kimberly Ritchie
- McMaster University, Hamilton, Ontario, Canada
- Homewood Research Institute, Guelph, Ontario, Canada
| | | | - Yuanxin Xue
- McMaster University, Hamilton, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Mina Pichtikova
- McMaster University, Hamilton, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
| | - Max Altman
- McMaster University, Hamilton, Ontario, Canada
| | - Isaac Beech
- McMaster University, Hamilton, Ontario, Canada
- Homewood Research Institute, Guelph, Ontario, Canada
| | | | - Yarden Levy
- McMaster University, Hamilton, Ontario, Canada
| | - Senay Asma
- McMaster University, Hamilton, Ontario, Canada
| | - Kelly Hassall
- St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Fatima Foster
- St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Sara Rodrigues
- Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada
- University of Ottawa Institute for Mental Health at the Royal, Ottawa, Ontario, Canada
| | - Fardous Hosseiny
- Atlas Institute for Veterans and Families, Ottawa, Ontario, Canada
- University of Ottawa Institute for Mental Health at the Royal, Ottawa, Ontario, Canada
| | | | - Alexandra Heber
- McMaster University, Hamilton, Ontario, Canada
- Veterans Affairs Canada
| | - Ann Malain
- Homewood Health Centre, Guelph, Ontario, Canada
| | | | - Ruth A. Lanius
- University of Western Ontario, London, Ontario, Canada
- Lawson Research Institute, London, Ontario, Canada
| | - Randi E. McCabe
- McMaster University, Hamilton, Ontario, Canada
- St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Margaret C. McKinnon
- McMaster University, Hamilton, Ontario, Canada
- Homewood Research Institute, Guelph, Ontario, Canada
- St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
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Hudmon KS, Vitale FM, Elkhadragy N, Corelli RL, Strickland SL, Varekojis SM, Heeg MO. Evaluation of an Interprofessional Tobacco Cessation Train-the-Trainer Program for Respiratory Therapy Faculty. Respir Care 2021; 66:475-481. [PMID: 32900914 PMCID: PMC9994066 DOI: 10.4187/respcare.07791] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Although tobacco use is the leading cause of numerous preventable diseases, including respiratory illnesses, respiratory therapy students historically have received inadequate education for treating tobacco use and dependence. To address this gap, a respiratory-specific tobacco cessation training program was created and disseminated via a train-the-trainer approach for faculty in respiratory therapy and respiratory care programs across the United States. The purpose of this study was to estimate the impact of the live, web-based, train-the-trainer programs on participating faculty, and to assess changes in the extent of adoption of tobacco cessation content in respiratory therapy curricula across institutions in the United States. METHODS Five live, 2.5-h web-based train-the-trainer programs for respiratory therapy faculty were conducted. To characterize impact of this national initiative, surveys were administered at baseline, immediately after training, and then at the end of the subsequent academic year. RESULTS A total of 270 respiratory therapy faculty members participated in a live webinar training, representing 248 of the 402 (61.7%) respiratory therapy schools in the United States. At the end of the subsequent academic year, faculty reported significant improvement in their overall ability to teach tobacco cessation (P < .001). Nearly all (97.4%) agreed that the webinar train-the-trainer format was conducive to learning, and high self-ratings were reported for skills to teach the tobacco cessation content. During the 2016-2017 academic year, 1,248 respiratory therapy students received training. Faculty anticipated teaching a median of 3 h of tobacco cessation in the subsequent academic year. CONCLUSIONS Training respiratory therapy faculty using a train-the-trainer approach had a positive impact on faculty's perceived confidence and ability to teach tobacco cessation at their institutions.
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Affiliation(s)
- Karen Suchanek Hudmon
- Department of Pharmacy Practice, Purdue University, College of Pharmacy, West Lafayette, Indiana.
- Department of Clinical Pharmacy, School of Pharmacy, University of California San Francisco, San Francisco, California
| | - Francis M Vitale
- Department of Pharmacy Practice, Purdue University, College of Pharmacy, West Lafayette, Indiana
| | - Nervana Elkhadragy
- Department of Pharmacy Practice, Purdue University, College of Pharmacy, West Lafayette, Indiana
| | - Robin L Corelli
- Department of Clinical Pharmacy, School of Pharmacy, University of California San Francisco, San Francisco, California
| | | | - Sarah M Varekojis
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio
| | - Marlene O Heeg
- Office of Continuing Education and Professional Development, Purdue University, West Lafayette, Indiana
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Abstract
Many women who quit smoking after learning they are pregnant revert back to smoking after birth of their baby. The high rate of recidivism suggests that women need education about risk of relapse and effective strategies to remain smoke free even before they are discharged from the hospital. Despite evidence that smoking cessation and relapse prevention counseling is effective during early postpartum, many nurses do not provide their patients with this important information, perhaps because they feel inadequately prepared to do so. Helping Women Stop Smoking in Pregnancy and Beyond is an education program designed to help perinatal nurses inform women of negative risks of smoking and offer women strategies to avoid the high probability of resuming smoking after birth. It includes evidence-based interventions that can be used by nurses to provide effective smoking relapse prevention counseling to women during postpartum.
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Development of a Tobacco Cessation Clinical Decision Support System for Pediatric Emergency Nurses. Comput Inform Nurs 2017; 34:560-569. [PMID: 27379524 DOI: 10.1097/cin.0000000000000267] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Almost 50% of children who visit the pediatric emergency department are exposed to tobacco smoke. However, pediatric emergency nurses do not routinely address this issue. The incorporation of a clinical decision support system into the electronic health record may improve the rates of tobacco exposure screening and interventions. We used a mixed-methods design to develop, refine, and implement an evidence-based clinical decision support system to help nurses screen, educate, and assist caregivers to quit smoking. We included an advisory panel of emergency department experts and leaders and focus and user groups of nurses. The prompts include the following: (1) "Ask" about child smoke exposure and caregiver smoking; (2) "Advise" caregivers to reduce their child's smoke exposure by quitting smoking; (3) "Assess" interest; and (4) "Assist" caregivers to quit. The clinical decision support system was created to reflect nurses' suggestions and was implemented in five busy urgent care settings with 38 nurses. The nurses reported that the system was easy to use and helped them to address caregiver smoking. The use of this innovative tool may create a sustainable and disseminable model for prompting nurses to provide evidence-based tobacco cessation treatment.
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Armin J, Johnson T, Hingle M, Giacobbi P, Gordon JS. Development of a Multi-Behavioral mHealth App for Women Smokers. JOURNAL OF HEALTH COMMUNICATION 2017; 22:153-162. [PMID: 28121240 PMCID: PMC5485903 DOI: 10.1080/10810730.2016.1256454] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
This article describes the development of the See Me Smoke-Free™ (SMSF) mobile health application, which uses guided imagery to support women in smoking cessation, eating a healthy diet, and increasing physical activity. Focus group discussions, with member checks, were conducted to refine the intervention content and app user interface. Data related to the context of app deployment were collected via user testing sessions and internal quality control testing, which identified and addressed functionality issues, content problems, and bugs. Interactive app features include playback of guided imagery audio files, notification pop-ups, award-sharing on social media, a tracking calendar, content resources, and direct call to the local tobacco quitline. Focus groups helped design the user interface and identified several themes for incorporation into app content, including positivity, the rewards of smoking cessation, and the integrated benefits of maintaining a healthy lifestyle. User testing improved app functionality and usability on many Android phone models. Changes to the app content and function were made iteratively by the development team as a result of focus group and user testing. Despite extensive internal and user testing, unanticipated data collection and reporting issues emerged during deployment due not only to the variety of Android software and hardware but also to individual phone settings and use.
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Affiliation(s)
- Julie Armin
- a Department of Family & Community Medicine , University of Arizona , Tucson , Arizona , USA
| | - Thienne Johnson
- b Department of Computer Science , University of Arizona , Tucson , Arizona , USA
| | - Melanie Hingle
- c Department of Nutritional Sciences , University of Arizona , Tucson , Arizona , USA
| | - Peter Giacobbi
- d Department of Sports Sciences , West Virginia University , Morgantown , West Virginia , USA
| | - Judith S Gordon
- a Department of Family & Community Medicine , University of Arizona , Tucson , Arizona , USA
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Hudmon KS, Mark M, Livin AL, Corelli RL, Schroeder SA. Tobacco education in U.S. respiratory care programs. Nicotine Tob Res 2014; 16:1394-8. [PMID: 25031314 DOI: 10.1093/ntr/ntu113] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Exposure to tobacco smoke impacts the onset or exacerbation of most respiratory disorders, and respiratory therapists are well positioned to identify tobacco use and provide cessation assistance. The purpose of this study was to characterize the level of tobacco cessation education provided to students in U.S. respiratory care training programs. METHODS A national survey of 387 respiratory care programs assessed the extent to which tobacco is addressed in required coursework, methods of instruction, perceived importance, and adequacy of current levels of tobacco education in curricula and perceived barriers to enhancing the tobacco-related education. RESULTS A total of 244 surveys (63.0% response) revealed a median of 165 min (IQR, 88-283) of tobacco education throughout the degree program. Pathophysiology of tobacco-related disease (median, 45 min) is the most extensively covered content area followed by aids for cessation (median, 20 min), assisting patients with quitting (median, 15 min), and nicotine pharmacology and principles of addiction (median, 15 min). More than 40% of respondents believed that latter 3 content areas are inadequately covered in the curriculum. Key barriers to enhancing tobacco training are lack of available curriculum time, lack of faculty expertise, and lack of access to comprehensive evidence-based resources. Nearly three-fourths of the respondents expressed interest in participating in a nationwide effort to enhance tobacco cessation training. CONCLUSIONS Similar to other disciplines, enhanced tobacco cessation education is needed in respiratory care programs to equip graduates with the knowledge and the skills necessary to treat tobacco use and dependence.
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Affiliation(s)
- Karen Suchanek Hudmon
- Department of Pharmacy Practice, Purdue University College of Pharmacy, Indianapolis, IN; Department of Clinical Pharmacy, University of California San Francisco School of Pharmacy, San Francisco, CA;
| | | | - Adam L Livin
- Department of Pharmacy Practice, Purdue University College of Pharmacy, Indianapolis, IN
| | - Robin L Corelli
- Department of Clinical Pharmacy, University of California San Francisco School of Pharmacy, San Francisco, CA
| | - Steven A Schroeder
- Department of Medicine, University of California San Francisco School of Medicine, San Francisco, CA
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Hamm E, Muramoto ML, Howerter A, Floden L, Govindarajan L. Use of provider-based complementary and alternative medicine by adult smokers in the United States: Comparison from the 2002 and 2007 NHIS survey. Am J Health Promot 2014; 29:127-31. [PMID: 24359177 DOI: 10.4278/ajhp.121116-quan-559] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To provide a snapshot of provider-based complementary and alternative medicine (pbCAM) use among adult smokers and assess the opportunity for these providers to deliver tobacco cessation interventions. DESIGN Cross-sectional analysis of data from the 2002 and 2007 National Health Interview Surveys. SETTING Nationally representative sample. SUBJECTS A total of 54,437 (31,044 from 2002; 23,393 from 2007) adults 18 years and older. MEASURES The analysis focuses on 10 types of pbCAM, including acupuncture, Ayurveda, biofeedback, chelation therapy, chiropractic care, energy therapy, folk medicine, hypnosis, massage, and naturopathy. ANALYSIS The proportions of current smokers using any pbCAM as well as specific types of pbCAM in 2002 and 2007 are compared using SAS SURVEYLOGISTIC. RESULTS Between 2002 and 2007, the percentage of recent users of any pbCAM therapy increased from 12.5% to 15.4% (p = .001). The largest increases occurred in massage, chiropractic, and acupuncture. Despite a decrease in the national average of current smokers (22.0% to 19.4%; p = .001), proportions of smokers within specific pbCAM disciplines remained consistent. CONCLUSION Complementary and alternative medicine (CAM) practitioners, particularly those in chiropractic, acupuncture, and massage, represent new cohorts in the health care community to promote tobacco cessation. There is an opportunity to provide brief tobacco intervention training to CAM practitioners and engage them in public health efforts to reduce the burden of tobacco use in the United States.
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Gordon JS, Mahabee-Gittens EM, Andrews JA, Christiansen SM, Byron DJ. A randomized clinical trial of a web-based tobacco cessation education program. Pediatrics 2013; 131:e455-62. [PMID: 23319529 PMCID: PMC3557402 DOI: 10.1542/peds.2012-0611] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/16/2012] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES We report the results of a randomized clinical trial of a 3-hour, web-based, tobacco cessation education program, the Web-Based Respiratory Education About Tobacco and Health (WeBREATHe) program, for practicing pediatric respiratory therapists (RTs), registered nurses (RNs), and nurse practitioners (NPs). METHODS Two hundred fifteen RTs (n = 40), RNs (n = 163), and NPs (n = 12) employed at the Children's Hospital of Philadelphia and the Children's Hospital, University of Colorado at Denver, participated in this study. All study activities were completed online. After consenting, participants were randomly assigned to either the training (intervention) or delayed training (control) condition. The training condition consisted of a 3-hour continuing education unit course plus ongoing online resources. Participants were assessed at baseline, 1 week, and 3 months after enrollment. RESULTS Participants in the training condition were more likely to increase their tobacco cessation intervention behaviors than their delayed training counterparts (F[1, 213] = 32.03, P < .001). Training participants showed significantly greater levels of advise (F[1, 213] = 7.22, P < .001); assess (F[1, 213] = 19.56, P < .001); and particularly assist/arrange (F[1213] = 35.52, P < .001). In addition, training condition participants rated the program highly on measures of consumer satisfaction. CONCLUSIONS The WeBREATHe program is the first evidence-based education program in tobacco cessation designed specifically for pediatric RTs, RNs, and NPs. Engagement in WeBREATHe increased participants' tobacco cessation-related behaviors.
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Affiliation(s)
- Judith S Gordon
- Department of Family and Community Medicine, University of Arizona, 1450 E. Cherry Ave, Tucson, AZ 85719, USA.
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