P.0095 Outcome Associated with Suicidality in Inpatients with Symptoms of depression (OASIS-D): Design of a study assessing usual care outcomes

2021 ◽  
Vol 53 ◽  
pp. S68-S69
Author(s):  
C.U. Correll ◽  
M. Adli ◽  
C. Otte ◽  
M. Bauer ◽  
P. Falkai ◽  
...  
Keyword(s):  
Usual Care ◽  
Symptoms Of Depression ◽  
Care Outcomes

Comparative Efficacy of Seven Exercise interventions for Symptoms of depression in college students: a network of meta-analysis

2019 ◽  
Author(s):  
Shengyu Guo ◽  
Fuying Li ◽  
Yan Yang ◽  
Ling Chen
Keyword(s):  
College Students ◽  
Depressive Symptoms ◽  
Usual Care ◽  
Tai Chi ◽  
Exercise Intervention ◽  
Meta Analysis ◽  
Eligibility Criteria ◽  
Exercise Interventions ◽  
Symptoms Of Depression ◽  
Depressed College Students

Abstract Background Depression among college students is common, exercise interventions are valued as one of the most widely prescribed interventions for depressed college students, however, it is especially difficult for university administrators to determine which exercise intervention is most effective, and efficacy of exercise interventions among depressed college students have not been evaluated. Objectives To systematically review and compare the efficacy of Seven Exercise interventions for Symptoms of depression in college students. Method A network of meta-analysis was conducted to fill the objectives. PubMed, Embase databases, and two Chinese language electronic databases WANFANG and CNKI were searched for the related articles. Eligibility criteria Randomized controlled trials comparing the efficacy of Seven Exercise interventions with usual care of college students with depression were included in the review. Main outcomes The Primary outcome of the present study were standardized mean difference(SMD) and the mean change of depressive symptoms. Results 14 trials were identified, including 2010 depressed college students. The result of direct meta-analysis of this review indicated exercise interventions overall had a significantly lower mean depression scores (SMD=-1.13) when compared with usual care. The result of NMA indicated when comparing with badminton intervention, yoga(SMD=-7.7, 95%CI -14 to -0.93) and tai chi (SMD=-9.4, 95%CI -16 to -2.7) can significantly decrease depression scores of the depressed college students. The rank of seven exercise interventions with respect to efficiently decrease symptom of depressed undergraduates was Tai chi > Yoga > Volleyball > Dance > Run> Basketball> Badminton, respectively. Conclusions Tai chi exhibited the highest probability that became the most efficacy intervention among the comparions, and Yoga showed the second most effectiveness to alleviate depressive symptoms of depressed college students, and dance ranks the third, followed by run, volleyball, basketball, badminton respectively.

scholarly journals Impact of Motivational Interviewing on Self-Management in Patients With Type 2 Diabetes: Protocol for a Pilot Randomized Controlled Trial (Preprint)

2019 ◽  
Author(s):  
Man Kin Wong ◽  
Sai Yip Ronald Cheng ◽  
Tsun Kit Chu ◽  
Fung Yee Lam ◽  
Shiu Kee Lai ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Health Behaviors ◽  
Usual Care ◽  
Diabetic Control ◽  
Self Management ◽  
Randomized Controlled ◽  
Patients With Diabetes ◽  
Care Outcomes

BACKGROUND The nonpharmacological approach to diabetic control in patients with diabetes focuses on a healthy diet, physical activity, and self-management. Therefore, to help patients change their habits, it is essential to identify the most effective approach. Many efforts have been devoted to explain changes in or adherence to specific health behaviors. Such efforts have resulted in the development of theories that have been applied in prevention campaigns and include brief advice and counseling services. Within this context, motivational interviewing (MI) has proven to be effective in changing health behaviors for specific cases. However, stronger evidence is needed on the effectiveness of MI in treating chronic pathologies such as diabetes. OBJECTIVE This study will obtain preliminary data on the impact of a nurse-led MI intervention in improving glycemic control, as well as clinical, psychosocial, and self-care outcomes for individuals with type 2 diabetes mellitus when compared with usual care, with the aim of improving diabetic control in patients with diabetes. METHODS An open, two-arm, parallel, randomized controlled, pilot exploratory trial will be performed. Two government outpatient clinics in the New Territories West Cluster in Hong Kong will be involved. In total, 20 to 25 participants will be invited in each arm. Intervention participants will receive face-to-face MI interventions in addition to their usual care from the clinic. Control participants will only receive usual care. Outcomes are assessed at baseline, 6 months, and 12 months. The primary outcome measure is glycated hemoglobin levels. Secondary outcomes include blood pressure, BMI, hip and waist circumference, fasting blood, and psychosocial and self-care measures. RESULTS This study is currently underway with funding support from the Hong Kong College of Family Physician Research Seed Fund 2017. CONCLUSIONS MI skills constitute the main strategies primary care nurses use on their patients. Having economical, simple, effective, and applicable techniques is essential for primary care professionals to help their patients change their lifestyle and improve their health. This study will provide scientific evidence on the effectiveness of MI. It will be performed with strict control over the data collection, ensuring the maintenance of therapeutic integrity. CLINICALTRIAL Centre for Clinical Research and Biostatistics CUHK_CCRB00614; https://tinyurl.com/v9awzk6 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/15709

scholarly journals Do Symptoms of Depression Interact with Substance Use to Affect HIV Continuum of Care Outcomes?

2018 ◽  
Vol 23 (3) ◽  
pp. 580-591 ◽  
Author(s):  
Anthony T. Fojo ◽  
Catherine R. Lesko ◽  
Keri L. Calkins ◽  
Richard D. Moore ◽  
Mary E. McCaul ◽  
...  
Keyword(s):  
Substance Use ◽  
Continuum Of Care ◽  
Symptoms Of Depression ◽  
Care Outcomes ◽  
Hiv Continuum Of Care

scholarly journals Clinical Utility of Automatable Prediction Models for Improving Palliative and End-Of-Life Care Outcomes: Towards Routine Decision Analysis Before Implementation

2021 ◽  
Author(s):  
Ryeyan Taseen ◽  
Jean-François Ethier
Keyword(s):  
Decision Analysis ◽  
Usual Care ◽  
End Of Life ◽  
Clinical Utility ◽  
Prediction Models ◽  
Patient Centered ◽  
Code Status ◽  
Temporal Validation ◽  
Care Outcomes ◽  
One Year

Objective To evaluate the clinical utility of automatable prediction models for increasing goals-of-care discussions among hospitalized patients at the end-of-life. Materials and Methods We developed three Random Forest models and updated the Modified Hospital One-year Mortality Risk model: alternative models to predict one-year mortality (proxy for EOL status) using admission-time data. Admissions from July 2011-2016 were used for training and those from July 2017-2018 were used for temporal validation. We simulated alerts for admissions in the validation cohort and modelled alternative scenarios where alerts lead to code status orders (CSOs) in the EHR. We linked actual CSOs and calculated the expected risk difference (eRD), the number needed to benefit (NNB) and the net benefit (NB) of each model for the patient-centered outcome of a CSO among EOL hospitalizations. Results Models had a C-statistic of 0.79-0.86 among unique patients. A CSO was documented during 2599 of 3773 hospitalizations at the EOL (68.9%). At a threshold that identified 10% of eligible admissions, the eRD ranged from 5.4% to 10.7% (NNB 5.4-10.9 alerts). Under usual care, a CSO had a 34% PPV for EOL status. Using this to inform the relative cost of FPs, only two models improved NB over usual care. A RF model with diagnostic predictors had the highest clinical utility by either measure, including in sensitivity analyses. Discussion Automatable prediction models with acceptable temporal validity differed meaningfully in their expected ability to improve patient-centered outcomes over usual care. Conclusion Decision-analysis should precede implementation of automated prediction models for improving palliative and EOL care outcomes.

scholarly journals Effects of Grandchildren’s Love Language Program on Depression among Thai Older Adults

2020 ◽  
Vol 17 (9) ◽  
pp. 924-932
Author(s):  
Saifon AEKWARANGKOON ◽  
Naiyana NOONIL
Keyword(s):  
Older Adults ◽  
Usual Care ◽  
Rating Scale ◽  
Treatment Effectiveness ◽  
Analysis Of Covariance ◽  
Language Program ◽  
Physical Conditions ◽  
Symptoms Of Depression ◽  
Quasi Experimental ◽  
Love Language

Depression in older adults has remained 1 of the major detrimental public health problems both worldwide and in Thailand. Among the myriad healing approaches, mental attachment on the basis of grandchildren’s love language is favorably perceived by Thai older adults with depression. The purpose of this quasi-experimental study was to evaluate the effects of grandchildren’s love language program on reducing depression among Thai older adults. Eighty Thai older adults with mild to moderate depression levels received the so-called “Love Language of Grandchildren Program” (n = 40) and usual care (n = 40). The Nine-Question Scale (9Q) and Hamilton Rating Scale for Depression (HRSD) were distributed at the pre- and post-treatment and at the 12 and 24-week of the follow-ups. The treatment effectiveness was evaluated by using Multivariate Analysis of Covariance (MANCOVA). The 9Q and HRSD scores revealed a significantly neutralized depression for those in love language of grandchildren program and, on the other hand, no decline was observed in the usual care’s participants. Love language of grandchildren program effectively reduced 9Q and HRSD symptoms of emotional, cognitive, behavioral, and physical conditions respectively. It was also more effective than the usual care in reducing mild to moderate symptoms of depression (p < 0.05). The findings provide better understanding on how grandchildren approach to prevent depression for Thai older adults in a family and community, and can be used to guide further capacity development for grandchildren who provide helping to this group.

The impact of nurse-led atrial fibrillation clinics on patient and healthcare outcomes: a systematic mixed studies review

2019 ◽  
Vol 18 (7) ◽  
pp. 526-533 ◽  
Author(s):  
Kathy L Rush ◽  
Lindsay Burton ◽  
Kira Schaab ◽  
Alexandra Lukey
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Usual Care ◽  
Healthcare Utilisation ◽  
Emergency Department Visits ◽  
Mixed Studies Review ◽  
Care Outcomes ◽  
The Impact ◽  
Systematic Mixed Studies Review

Background: Atrial fibrillation, the most common arrhythmia worldwide, continues to increase as the population ages. Patients with atrial fibrillation, particularly those newly diagnosed or who have multiple comorbidities, have high healthcare utilisation rates. Nurse-led atrial fibrillation clinics have developed to improve care and guidance for atrial fibrillation patients, with the potential to reduce hospital presentations and healthcare utilisation. Atrial fibrillation clinics that provide specialised and patient-centred care have improved patient symptom management, quality of life and reduced healthcare utilisation and costs. Aims: The aim of this study was to provide the first synthesis of evidence for the impact of nurse-led atrial fibrillation clinics on patient, healthcare utilisation, and quality of care outcomes. Methods: This systematic mixed studies review examined citations from three databases: Medline, CINAHL and Embase, using the search terms ‘atrial fibrillation’ and ‘clinic’, and related concepts. Seventeen moderate to high quality articles were selected. Results: Overall, atrial fibrillation clinics were more cost effective, had shorter wait times and reduced hospitalisation and emergency department visits. Symptoms and sinus rhythm restoration were comparable in the nurse-led compared to physician-led cardioversion clinics. Findings related to patient knowledge and patient satisfaction were mixed, while mortality rates were lower, and patient medication adherence was higher in nurse-led atrial fibrillation compared to usual care. Quality of life and guideline adherence was increased in patients receiving nurse-led atrial fibrillation care compared to usual care. Conclusion: Nurse-led clinics improved healthcare, patient and quality care outcomes. Future research might examine the role of technology in delivery of nurse-led clinics in rural/remote areas as well as patient experiences with nurse-led clinics.

scholarly journals Impact of Self-Acupressure on Co-Occurring Symptoms in Cancer Survivors

2018 ◽  
Vol 2 (4) ◽  
Author(s):  
Suzanna Maria Zick ◽  
Ananda Sen ◽  
Afton Luevano Hassett ◽  
Andrew Schrepf ◽  
Gwen Karilyn Wyatt ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Sleep Quality ◽  
Cancer Survivors ◽  
Usual Care ◽  
Mixed Models ◽  
Breast Cancer Survivors ◽  
Symptoms Of Depression ◽  
Treatment Action ◽  
The Relationship ◽  
Trial Participants

AbstractBackgroundCancer survivors with fatigue often experience depressive symptoms, anxiety, and pain. Previously, we reported that self-acupressure improved fatigue; however, its impact on other co-occurring symptoms and their involvement in treatment action has not been explored.MethodsChanges in depressive symptoms, anxiety, and pain were examined prior to and following two formulas of self-acupressure and usual care using linear mixed models in 288 women from a previously reported clinical trial. Participants were categorized by random assignment into one of three groups: 1) relaxing acupressure, 2) stimulating acupressure, or 3) usual care. Moderators investigated were body mass index, age, depressive symptoms, anxiety, sleep and pain, and mediators were change in these symptoms.ResultsFollowing treatment, depressive symptoms improved statistically significantly for the relaxing acupressure group (41.5%) compared with stimulating acupressure (25%) and usual care (7.7%). Both acupressure groups were associated with greater improvements in anxiety than usual care, but only relaxing acupressure was associated with greater reductions in pain severity, and only stimulating acupressure was associated with greater reductions in pain interference. There were no statistically significant moderators of sleep quality, anxiety, or depressive symptoms. Fatigue statistically significantly moderated pain, and age statistically significantly modified fatigue. Changes in depressive symptoms and sleep quality statistically significantly mediated the relationship between relaxing acupressure and usual care on fatigue; however, the effect was small.ConclusionsAcupressure was associated with greater improvements than usual care in anxiety, pain, and symptoms of depression in breast cancer survivors with troublesome fatigue. These findings warrant further evaluation in suitably controlled randomized trials.

scholarly journals Impact of Motivational Interviewing on Self-Management in Patients With Type 2 Diabetes: Protocol for a Pilot Randomized Controlled Trial

10.2196/15709 ◽  
2020 ◽  
Vol 9 (3) ◽  
pp. e15709
Author(s):  
Man Kin Wong ◽  
Sai Yip Ronald Cheng ◽  
Tsun Kit Chu ◽  
Fung Yee Lam ◽  
Shiu Kee Lai ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Primary Care ◽  
Health Behaviors ◽  
Usual Care ◽  
Diabetic Control ◽  
Self Management ◽  
Randomized Controlled ◽  
Patients With Diabetes ◽  
Care Outcomes

Background The nonpharmacological approach to diabetic control in patients with diabetes focuses on a healthy diet, physical activity, and self-management. Therefore, to help patients change their habits, it is essential to identify the most effective approach. Many efforts have been devoted to explain changes in or adherence to specific health behaviors. Such efforts have resulted in the development of theories that have been applied in prevention campaigns and include brief advice and counseling services. Within this context, motivational interviewing (MI) has proven to be effective in changing health behaviors for specific cases. However, stronger evidence is needed on the effectiveness of MI in treating chronic pathologies such as diabetes. Objective This study will obtain preliminary data on the impact of a nurse-led MI intervention in improving glycemic control, as well as clinical, psychosocial, and self-care outcomes for individuals with type 2 diabetes mellitus when compared with usual care, with the aim of improving diabetic control in patients with diabetes. Methods An open, two-arm, parallel, randomized controlled, pilot exploratory trial will be performed. Two government outpatient clinics in the New Territories West Cluster in Hong Kong will be involved. In total, 20 to 25 participants will be invited in each arm. Intervention participants will receive face-to-face MI interventions in addition to their usual care from the clinic. Control participants will only receive usual care. Outcomes are assessed at baseline, 6 months, and 12 months. The primary outcome measure is glycated hemoglobin levels. Secondary outcomes include blood pressure, BMI, hip and waist circumference, fasting blood, and psychosocial and self-care measures. Results This study is currently underway with funding support from the Hong Kong College of Family Physician Research Seed Fund 2017. Conclusions MI skills constitute the main strategies primary care nurses use on their patients. Having economical, simple, effective, and applicable techniques is essential for primary care professionals to help their patients change their lifestyle and improve their health. This study will provide scientific evidence on the effectiveness of MI. It will be performed with strict control over the data collection, ensuring the maintenance of therapeutic integrity. Trial Registration Centre for Clinical Research and Biostatistics CUHK_CCRB00614; https://tinyurl.com/v9awzk6 International Registered Report Identifier (IRRID) DERR1-10.2196/15709

scholarly journals Randomized trial examining the effect of exercise and wellness interventions on preventing postpartum depression and perceived stress

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Beth A. Lewis ◽  
Katie Schuver ◽  
Shira Dunsiger ◽  
Lauren Samson ◽  
Amanda L. Frayeh ◽  
...  
Keyword(s):  
At Risk ◽  
Postpartum Depression ◽  
Usual Care ◽  
Perceived Stress ◽  
Exercise Intervention ◽  
Low Cost ◽  
Postpartum Women ◽  
Exercise Interventions ◽  
Symptoms Of Depression ◽  
Wellness Intervention

Abstract Background Approximately 13–19% of postpartum women experience postpartum depression and a majority report at least some stress during the postpartum phase. Traditional interventions such as psychotherapy and antidepressant medications are often not feasible or desirable. The purpose of this study was to examine two low cost, brief, accessible interventions designed to prevent postpartum depression and perceived stress among women at high risk. Methods Participants (n = 450) who were on average four weeks postpartum, had a history of depression before pregnancy, and exercised less than 60 min per week were randomly assigned to one of the following three conditions: (1) 6-month telephone-based exercise intervention; (2) 6-month telephone-based wellness/support intervention (e.g., healthy eating, sleep, and perceived stress); or (3) usual care. Results Overall, 2.4% of participants met criteria for depression at 6 months and 3.6% at 9 months with no differences between groups. At 6 months following randomization, median symptoms of depression were significantly lower among wellness participants compared to usual care participants (b = − 1.00, SE = 0.46, p = .03). Perceived stress at 6 months post-randomization was significantly lower among exercise vs. usual care participants (b = − 2.00, SE = .98, p = .04) and exercise vs. wellness participants (b = − 2.20, SE = 1.11, p = .04). Conclusions The wellness intervention was efficacious for preventing symptoms of depression; however, postpartum depression that met the diagnostic criteria was surprisingly low in all conditions among this at risk sample of postpartum women. Exercise interventions may have a protective effect on perceived stress among women at risk for postpartum depression. Practitioners should consider integrating exercise and wellness interventions into postpartum care. Trial registration Clinical Trials Number: NCT01883479 (06/21/2013).

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