Relationships between racial/ethnic minority status, therapeutic alliance, and treatment expectancies among veterans with PTSD.

ObjectiveLittle is known about the prevalence of continued opioid use following aneurysmal subarachnoid hemorrhage (aSAH) despite guidelines recommending their use during the acute phase of disease. We sought to determine prevalence of opioid use following aSAH and test the hypothesis that acute pain and higher inpatient opioid dose increased outpatient opioid use.MethodsWe reviewed consecutively admitted aSAH patients from November 2015 through September 2019. We retrospectively collected pain scores and daily doses of analgesics. Pain burden was calculated as area under the pain-time curve. Univariate and multivariable regression models determined risk factors for continued opioid use at discharge and outpatient follow-up.ResultsWe identified 234 aSAH patients with outpatient follow-up. Continued opioid use was common at discharge (55% of patients) and follow-up (47% of patients, median 63 (IQR 49–96) days from admission). Pain burden, craniotomy, and racial-ethnic minority status were associated with discharge opioid prescription in multivariable analysis. At outpatient follow-up, pain burden (OR 1.88, 95% CI 1.5–2.4), depression (OR 3.1, 95% CI 1.1–8.8), and racial-ethnic minority status (OR 2.1, 95% CI 1.1–4.0) were independently associated with continued opioid use while inpatient opioid dose was not.ConclusionContinued opioid use following aSAH is prevalent and related to refractory pain during acute illness, but not inpatient opioid dose. More efficacious analgesic strategies are needed to reduce continued opioid use in patients following aSAH.Classification of evidenceThis study provides Class II evidence that continued opioid use following aSAH is associated with refractory pain during acute illness but not hospital opioid exposure.

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Social Support and Attachment to Pets Moderate the Association between Sexual and Gender Minority Status and the Likelihood of Delaying or Avoiding COVID-19 Testing

Social Sciences ◽

10.3390/socsci10080301 ◽

2021 ◽

Vol 10 (8) ◽

pp. 301

Author(s):

Angela Matijczak ◽

Jennifer W. Applebaum ◽

Shanna K. Kattari ◽

Shelby E. McDonald

Keyword(s):

Social Support ◽

Ethnic Minority ◽

Moderating Effect ◽

Minority Status ◽

Gender Minority ◽

Treatment Services ◽

Sexual And Gender Minority ◽

Additional Barrier ◽

And Gender ◽

Racial Ethnic

Sexual and gender minority individuals (SGM) face barriers to accessing COVID-19 testing and treatment services. Living with pets may pose an additional barrier due to concerns about pet welfare. This study investigates whether the relation between SGM status and the likelihood of delaying or avoiding testing and treatment for COVID-19 varies as a function of attachment to pets and social support. Our sample consisted of 1453 adults (Mage = 39.4 years, 12.6% racial/ethnic minority; 21.8% SGM). We conducted simple and additive multiple moderation analyses to investigate the moderating effect of attachment to pets and social support on the relation between SGM status and the likelihood of delaying or avoiding COVID-19 testing or treatment. Attachment to pets moderated the association between SGM status and the likelihood of delaying or avoiding COVID-19 testing in the simple (β = 0.82, Z = 2.09, p = 0.04) and additive multiple moderation analyses (β = 0.82, Z = 2.05, p = 0.04). SGM participants were more likely than non-SGM participants to report that they would delay or avoid testing when they reported high attachment to their pet (β = 0.75, OR = 2.11, Z = 2.51, p = 0.01) and low (β = 0.75, OR = 2.12, Z = 2.48, p = 0.01) or moderate (β = 0.73, OR = 2.08, Z = 2.14, p = 0.03) levels of social support.

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