Self-compassion, but not compassion toward others, is associated with better physical health: A cross-sectional study

Compassion is a modifiable construct that is associated with better physical health outcomes but, to our knowledge, has seldom been studied in people with schizophrenia (PwS) despite its applicability to counteract widespread depression in this community that might prevent positive health behaviors. We hypothesized that, compared to non-psychiatric comparison subjects (NCs), PwS would have lower compassion toward self (CTS), lower compassion toward others (CTO), and a positive association between compassion and health outcomes, such as physical wellbeing, comorbidities, and plasma hs-CRP. This cross-sectional study examined differences in physical health, CTS, and CTO in 189 PwS and 166 NCs. We used general linear models to analyze the relationship between compassion and health. As hypothesized, PwS had lower levels of CTS and CTO, worse physical well-being, more comorbidities, and higher levels of plasma hs-CRP than NCs. In the combined sample, higher CTS was significantly associated with better physical well-being and fewer comorbidities, while higher CTO was significantly associated with more comorbidities. In PwS alone, higher CTS was significantly associated with better physical well-being and lower levels of hs-CRP. CTS seemed to have a larger positive association with physical health than CTO, with depression acting as a potential mediator for CTS. Exploring effects of CTS interventions on physical health and health behaviors could be a promising next step.

Using a qualitative co-design approach to identify recommendations for improving access to medication reviews for people from ethnic minority communities

Introduction

Reviews of medication are vital to support medicine effectiveness and optimise person-centred care outcomes. However, inequalities negatively impact ethnic minority populations when accessing medicine review services.1 It is important to identify opportunities to improve access for these communities. Previous studies have demonstrated the significance of overcoming accessibility barriers, but specific detail about how best to achieve this is lacking.2,3 Through co-design workshops, this study seeks to integrate the voices of those people from ethnic minority populations to gain better insight into improving access to medicines review services for ethnic minority communities.

Aim

This qualitative, person-centred co-design study sought to build greater knowledge and understanding by involving representatives from communities whose needs may remain unmet. When considering the value that medication reviews can offer in optimising a person’s medication, this study aimed to: (i) better understand existing barriers that may impact those from ethnic minority communities when accessing services and to (ii) identify measures that may facilitate improved service accessibility for these groups.

Methods

A series of co-design workshops, with four groups of patient-stakeholders, were conducted between September-November 2021; they took place in-person or via video call whilst adhering to COVID-19 restrictions. Existing evidence-based perceptions affecting access to medicines services were critiqued and recommendations were generated to improve access for ethnic minority patients. The workshops were audio-recorded and transcribed verbatim to enable thematic analysis. QSR NVivo (Version 12) facilitated data analysis. The Health Research Authority granted ethical approval (ref: 21/HRA/1426).

Results

Twelve participants were recruited: including 8 UK citizens, 2 asylum seekers and 2 participants in receipt of residency visas. In total, 4 different ethnic minority groups were represented. Each participant took part in a first and second workshop to share and co-create recommendations. Three recommendations were developed and centred on: (i) delivering culturally competent medicines review services; (ii) building awareness of medicines review services and how to access them; and (iii) enabling better discussions with patients from ethnic minority communities.

Discussion/Conclusion

The results have important implications for overcoming ethnic inequalities in access to medicines reviews. The data highlighted the significance of raising awareness of the medicine review services and understanding each person’s lived experiences in order to address barriers that currently affect access. Delivering medication review services with cultural competency is vital; steps should be taken to address potential language barriers and build patient-provider relationships through in-person medication reviews. Collaborative co-production approaches could enable better design, implementation and delivery of medication services that are accessible and culturally competent, in order to best meet the needs of ethnic minority communities. Steps should be taken to address knowledge gaps around cultural competence training to enable the creation of pharmacies as inclusive, person-centred healthcare settings. Methods for improving person-centred communication within pharmacies should be further explored. Close, collaborative working with individual populations could enable specific tailoring of medicines review services that best meet the needs of the community. The National Institute for Health Research Applied Research Collaboration (NIHR ARC) and Newcastle University Patient and Public Involvement and Engagement group had extensive input in the study design and conceptualisation. Seven patient champions were appointed to the steering group to ensure that the research was conducted, and the findings were reported, with cultural competence and sensitivity.

References

1. Robinson A, et al. A qualitative exploration of the barriers and facilitators affecting ethnic minority patient groups when accessing medicine review services: perspectives of healthcare professionals. Health Expectations, 2021. DOI: 10.1111/hex.13410.

2. Robinson A, et al. “He or she maybe doesn’t know there is such a thing as a review”: a qualitative investigation exploring barriers and facilitators to accessing medication reviews from the perspective of people from ethnic minority communities. Health Expectations, 2022. DOI: 10.1111/hex.13482.

3. Latif A, et al. A qualitative exploration to understand access to pharmacy medication reviews: views from marginalized patient groups. Pharmacy, 2020. DOI: 10.3390/pharmacy8020073.

American Psychiatric Association's Leadership Fellowship Program: Short-term and Longer-term Outcomes

OBJECTIVE

This study assessed the impact of a Leadership Fellowship, sponsored by the American Psychiatric Association (APA) and APA Foundation, on the careers of psychiatry residents and examined the influence of gender and year of Fellowship completion. This 2-year program for residents offered multiple opportunities to interact with professional leaders at various levels.

METHODS

A retrospective online survey of alumni of the APA Leadership Fellowship, who had completed this Fellowship between 2003 and 2019, was conducted.

RESULTS

Out of the 93 psychiatrists who were sent the survey, 59 alumni responded (60.8% response rate). Most respondents had remained involved with organized psychiatry groups and 80% held leadership positions. Respondents reported high levels of satisfaction with the APA Fellowship experience, noting the importance of peer networking. Overall, male and female respondents were similar in their subsequent leadership positions and satisfaction with the survey. Similarly, Fellows who completed the Fellowship in 2003-2015 had responses about the experience that were largely similar to those in the 2016-2019 cohort that had not yet completed their residency.

CONCLUSION

A vast majority of alumni of the APA Leadership Fellowship had become leaders in their workplace or organized psychiatry groups. The leadership-focused career development programs for psychiatry trainees are important avenues to develop a diverse cohort of future leaders in psychiatry.