An Analysis of Consumer Perspectives Following Contact with an Eating-Disorders Service

2001 ◽  
Vol 35 (1) ◽  
pp. 99-103 ◽  
Author(s):  
Nicola R. Swain-Campbell ◽  
Lois J. Surgenor ◽  
Deborah L. Snell
Keyword(s):  
Eating Disorders ◽  
Therapeutic Alliance ◽  
Consumer Satisfaction ◽  
Postal Survey ◽  
Treatment Modalities ◽  
Approval Ratings ◽  
Mental Health Consumers ◽  
Treatment Type ◽  
Consumer Perspectives ◽  
First Contact

Objective: The views of consumers following contact with treatment for eating disorders represent an underresearched aspect of service provision. The aim of this paper is to examine patterns of consumer satisfaction following contact with a specialist eatingdisorders service. Method: Using both a structured and an open-ended questionnaire format, consumer perspectives were sought routinely through postal survey 3 months after the point of first contact. Responses were analysed from 120 patients who returned their questionnaires during the 2-year period ending in December 1998. Results: Although the structured response format indicated high rates of satisfaction, the open-ended format revealed five categories describing the perceived best and worst aspects following consultation with the service. The category of therapeutic alliance drew the majority of positive comments, while the most frequently cited worst aspect of consultation was the category of treatment type. Conclusions: People with eating disorders form a unique group of mental health consumers to survey for satisfaction. While approval ratings prompted by both structured and open-ended questions were high, and centred around the theme of therapeutic alliance, the most frequent source of negative commentary was activities and structures considered essential by traditional treatment modalities. This provides important insights into the predicaments of people with eating disorders presenting for treatment, and the importance of developing satisfaction surveys to accommodate such predicaments and concerns.

scholarly journals Disparities in ADHD Diagnosis and Treatment by Race/Ethnicity in Youth Receiving Kentucky Medicaid in 2017

2021 ◽  
Vol 31 (1) ◽  
pp. 67-76
Author(s):  
Deborah Winders Davis ◽  
Kahir Jawad ◽  
Yana Feygin ◽  
Liza Creel ◽  
Maiying Kong ◽  
...  
Keyword(s):  
Population Density ◽  
Psychosocial Interventions ◽  
The United States ◽  
Diagnosis And Treatment ◽  
Treatment Modalities ◽  
Adhd Diagnosis ◽  
Stimulant Use ◽  
Treatment Type ◽  
Race Ethnicity ◽  
To Receive

Background: Kentucky has among the highest rate of attention deficit/hyperactivity disorder (ADHD) and stimulant use in the United States. Little is known about this use by race/ethnicity and geography. This article describes patterns of diagnosis of ADHD and receipt of stimulants and psychosocial interventions for children aged 6-17 years receiving Kentucky Medicaid in 2017 and identifies factors associated with diagnosis and treatment.Methods: Using Medicaid claims, children with and without ADHD (ICD-10 codes F90.0, F90.1, F90.2, F90.8, and F90.9) were compared and predictors of diag­nosis and treatment type were examined. Psychosocial interventions were defined as having at least one relevant CPT code. Chi-squared tests and logistic regression models were used for univariate and multivariable analysis, respectively.Results: The rates of ADHD, stimulant use, and psychosocial interventions in our study population exceeded the national aver­age (14% vs 9%; 75% vs 65.5%; and 51% vs 46.5%, respectively). The distributions varied by sex, race/ethnicity, sex among race/ethnicities, and population density. In general, race/ethnicity predicted ADHD diagnosis, stimulant use, and receipt of psy­chosocial interventions with non-Hispanic White children being more likely to receive diagnosis and medication, but less likely to receive psychosocial therapy than other children. Differences were also shown for rural compared with urban residence, sex, and sex within racial/ethnic groups.Conclusions: Diagnosis and treatment modalities differed for children by race/ ethnicity, population density, and sex. More data are needed to better understand whether differences are due to provider bias, child characteristics, or cultural varia­tions impacting the utilization of different treatment options.Ethn Dis. 2021;31(1):67- 76; doi:10.18865/ed.31.1.67

scholarly journals A group based smoking cessation pilot programme for community mental health clients in Sydney

2013 ◽  
Vol 9 (1) ◽  
pp. 26-30 ◽  
Author(s):  
Erin Devine ◽  
Raquiba Jahan Khan ◽  
Karen Bedford ◽  
Wei Zhuang Jiang ◽  
Henry Lim
Keyword(s):  
Mental Health ◽  
Smoking Cessation ◽  
Community Mental Health ◽  
Community Mental Health Services ◽  
Physical Symptoms ◽  
Postal Survey ◽  
Motivating Factors ◽  
Community Based Interventions ◽  
Mental Health Consumers ◽  
Mental Health Clients

Introduction: This article describes the process and evaluation of a smoking cessation support programme for mental health clients in Sydney.Aim: The objective of the study was to assess a group-based smoking cessation support model for community mental health clients.Methods: Two community mental health services participated; 29 clients received free NRT products and weekly education for 12 weeks on: effects of smoking, nicotine dependence, NRT use, withdrawal process and the benefits of quitting. Evaluation included face-to-face interviews, telephone or postal survey using a semi-structured questionnaire.Results: The baseline (n = 29) and follow-up (n = 14) surveys showed reduction in the number of cigarettes (30 to 21) smoked a day (55% vs. 36%). At one month 47% (n = 19) were confident about stopping smoking permanently whereas 19% (n = 14) reported the same after six months. Participants reported concerns of health effects, illness, physical symptoms (77% n = 27) and financial cost (93% n = 27) were the motivating factors in quitting. None of the findings was statistically significant.Conclusions: Community based interventions to address the rate of smoking in this group is needed. Financial and health benefits can be used as motivating factors, and integration of smoking cessation assistance in treatment and rehabilitation of mental health consumers would be useful.

scholarly journals Balancing risk requires a balanced approach: Commentary on… severe and enduring eating disorders: recognition and management

2014 ◽  
Vol 20 (6) ◽  
pp. 402-404
Author(s):  
William Rhys Jones ◽  
John F. Morgan
Keyword(s):  
Eating Disorders ◽  
Therapeutic Alliance ◽  
Robust Approach ◽  
Balanced Approach ◽  
Complex Group ◽  
Tailored Approach

SummaryPaul Robinson's article provides an excellent summary of some of the challenges faced by clinicians working with patients with severe and enduring eating disorders (SEED) and outlines a robust approach to the recognition and management of this complex group of patients. This commentary expands on some of the points raised, adds some further views and suggests a tailored approach to establishing a therapeutic alliance with patients and carers.

Clinical presentation of breast cancer: Age, stage, and treatment modalities in a contemporary cohort of Michigan women.

2011 ◽  
Vol 29 (27_suppl) ◽  
pp. 1-1 ◽  
Author(s):  
D. R. Smith ◽  
J. Caughran ◽  
J. L. Kreinbrink ◽  
G. K. Parish ◽  
S. M. Silver ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Task Force ◽  
Breast Conservation ◽  
Screening Mammography ◽  
Breast Conservation Surgery ◽  
Treatment Modalities ◽  
Breast Cancers ◽  
Screening Guidelines ◽  
Treatment Type ◽  
The Impact

1 Background: The U.S. Preventative Services Task Force (USPSTF) revised their breast cancer screening recommendations in 2009 changing their stance on age and frequency of mammography screening to biannual exams starting at age 50. The purpose of this study is to analyze data from a statewide breast cancer registry managed by the Michigan Breast Oncology Quality Initiative (MiBOQI) to determine the impact of these new recommendations on diagnosing and treating breast cancer. Methods: De-identified data were collected on women participating in the MiBOQI registry at seventeen statewide institutions from 2006-2009. Data included method of detection, cancer stage, age at detection, treatment type, and patient demographics. Participants were stratified based on age, and data analyzed using NCSS software (chi-square and t-tests). Results:5903 women with breast cancer with an average age at diagnosis of 59.4 years were included. 65.5% of breast cancers were detected via mammography, 29.8% by palpation, and 4.7% by other methods. In women under 50 years of age, cancers were detected by mammography in 48.3% (69.3% >50yr) and by palpation in 46.1% (24.1% >50yr). Patients with palpable presentations were younger (55.8 yr vs. 61.2 yr; p <0.001). Cancers with a palpable presentation were diagnosed at higher stages (50.0% stage II) than with mammography (52.5% stage I; p<0.001). Breast conservation surgery occurred more frequently than mastectomy (palpation 54.2%; mammography 72.9%, p<0.001) but cancers detected through palpation were more likely to undergo mastectomy procedures. Conclusions: Results of this study validate the importance of annual screening mammography in women older than 50 years, and women aged 40 to 49 years recently omitted from screening guidelines. There was an increased prevalence of palpation for the method of detection in women less than 50 years of age. If screening mammography is omitted in this group, cancers when detected may be of a more advanced stage and result in more mastectomies. This study also supports the use of palpation as a method of detection despite recent recommendations against teaching self breast exams by USPSTF.

Incidence of reduced penis size among men with recurrent prostate cancer previously treated with surgery, radiation plus androgen deprivation, or radiation alone.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 38-38
Author(s):  
Arti Parekh ◽  
Ming-Hui Chen ◽  
Karen Elizabeth Hoffman ◽  
Toni K. Choueiri ◽  
Jim C. Hu ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Sexual Function ◽  
Odds Ratio ◽  
Multivariable Analysis ◽  
Androgen Deprivation ◽  
Treatment Modalities ◽  
Treatment Type ◽  
Psa Failure ◽  
Penis Size ◽  
Previously Treated

38 Background: The relative incidence of reduced penis size across prostate cancer treatment modalities is not well-known. Methods: The incidence of physician-reported patient complaints about reduced penis size was calculated for 948 men in the COMPARE registry who experienced PSA failure and were assessed a median of 5.45 (2.6-8.9 IQ range) years after prostatectomy or radiation (RT) consisting of either external beam or brachytherapy. Multivariable logistic regression was used to determine factors associated with poorer sexual function and incontinence. Results: Of 948 men, 25 (2.63%) complained of a reduced penis size. The incidence of reduced penis size by treatment was: surgery (19/510=3.73%), RT plus androgen deprivation therapy (ADT) (6/225=2.67%), RT without ADT (0/213=0%). Surgery (p=0.004) and RT+ADT (p=0.016) had significantly more short penis complaints than RT alone. Rates of shortened penis for surgery and for RT+ADT were similar (p=0.47). On multivariable analysis adjusting for age and treatment type, short penis was associated with poorer sexual function (Odds ratio: 2.430, 95% CI: 1.046-5.643) (p=0.0389) and more incontinence (Odds ratio: 4.671, 95% CI: 1.985-10.994) (p=0.0004). Conclusions: Complaints about reduced penis size were more common with RT+ADT or surgery than with RT alone, and were associated with poorer sexual function and incontinence issues.

Comparative effectiveness of combination TACE/ablation vs. monotherapy in hepatocellular carcinoma.

2016 ◽  
Vol 34 (4_suppl) ◽  
pp. 350-350
Author(s):  
Arthur Winer ◽  
Yohei Rosen ◽  
Frederick Lu ◽  
Russell S. Berman ◽  
Marcovalerio Melis ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Therapy Group ◽  
Dual Therapy ◽  
Treatment Modalities ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
Treatment Type ◽  
Significant Difference ◽  
Arterial Chemoembolization

350 Background: Hepatocellular Carcinoma (HCC) is a leading cause of cancer-related death worldwide. Loco-regional treatment modalities for HCC include Trans-Arterial Chemoembolization (TACE) and Radiofrequency/Microwave Ablation (RFA/MWA). Studies have shown that dual therapy with both TACE and ablation is beneficial, though data is limited. We retrospectively studied all HCC patients treated with either TACE, ablation, or dual therapy at a tertiary referral public hospital to determine differences in survival. Methods: Following IRB approval, all patients diagnosed with HCC (1998-2013) at our institution were retrospectively analyzed for date of diagnosis, treatment-type, length of follow-up, and survival. Patients were excluded if they did not undergo TACE or RFA/MWA, or underwent other treatments, such as surgery. The primary outcome was all-cause mortality 5 years after diagnosis. Kaplan Meier curves were created and statistics with Log-rank testing and hazard ratios (HR) were performed. Results: Of 509 patients diagnosed with HCC, 109 (21.4%) met inclusion criteria. 60 were treated with TACE alone, 30 with ablation alone, and 19 were treated with both, either concomitantly or in sequence. Median follow-up and overall median survival was 15.5, 19, and 52 months for TACE, ablation, and dual therapy, respectively. Survival at 5 years was 11.9%, 13.3% and 42.1% for TACE, ablation, and combination groups respectively. Kaplan Meier analysis revealed a significant increase in survival in the combination therapy group vs. RFA or TACE alone at 5 years (p = 0.0006). However, there was no significant difference in survival when comparing TACE vs. RFA/MWA at 5 years (HR = 1.18, p = 0.48). Conclusions: Our study suggests a greater survival benefit for patients treated with TACE and RFA/MWA versus either modality alone.

Therapeutic Alliance in Web-based Treatment for Eating Disorders: Patient and Therapist perspectives (Preprint)

2021 ◽  
Author(s):  
Claudia Stoeten
Keyword(s):  
Eating Disorders ◽  
Eating Disorder ◽  
Therapeutic Alliance ◽  
Secondary Analysis ◽  
Positive Association ◽  
Treatment Completion ◽  
Post Treatment ◽  
Symptom Reduction ◽  
Total Patient ◽  
Therapist Perspectives

BACKGROUND In face-to-face therapy for eating disorders, the therapeutic alliance (TA) is an important predictor of symptom reduction and treatment completion. Current, however, not much is known about the TA during web-CBT and its associations with symptom reduction, treatment completion and the perspectives of patients versus therapists. OBJECTIVE The present study aimed to investigate (1) differences between TA-ratings measured at interim and post-treatment, separately for patients and therapists, (2) the degree of agreement between therapists and patients (treatment completers and non-completers) for TA-ratings, and (3) associations between patient and therapist TA-ratings and both eating disorder pathology and treatment completion. METHODS A secondary analysis was performed on the RCT data of a web-CBT intervention for eating disorders. TA-ratings (HAQ) were measured at interim and post-treatment, focusing on treatment completers, non-completers and therapists. Paired t-tests were conducted to assess the change from interim to post-treatment. Intraclass correlations were calculated to determine cross-informant agreement with regards to HAQ-scores between patients and therapists. Through two stepwise regressive procedures (at interim and post-treatment), it was examined which HAQ-scores predicted (1) eating disorder pathology and (2) therapy completion. RESULTS Participants were 170 females with BN (n=33), BED (n=68), or EDNOS (n=69); mean age 39.6 (SD=11.5) years. For completers, HAQ-total scores and HAQ-Helpfulness scores improved significantly from interim to post-treatment. For non-completers, all HAQ-scores decreased significantly. For all HAQ-scales, agreement between patients and therapists was poor. However, agreement was slightly better post-treatment than at interim. The helpfulness subscale of the HAQ was negatively associated with eating disorder psychopathology at interim and post-treatment. A positive association was found between HAQ-total patient scores at interim and treatment completion. Lastly, post-treatment HAQ-total patient scores and post-treatment HAQ-Helpfulness scores of therapists were positively associated with treatment completion. CONCLUSIONS The results showed that for web-CBT for eating disorders, in particular the confidence to improve one’s situation (HAQ-Helpfulness) is important for predicting eating disorder pathology and treatment completion. Furthermore, in the current web-CBT, the TA increased for completers and decreased for non-completers, according to both patients and therapists.

scholarly journals Stages of Recovery Instrument: Development of a Measure of Recovery from Serious Mental Illness

2006 ◽  
Vol 40 (11-12) ◽  
pp. 972-980 ◽  
Author(s):  
Retta Andresen ◽  
Peter Caputi ◽  
Lindsay Oades
Keyword(s):  
Mental Health ◽  
Instrument Development ◽  
Psychological Health ◽  
Postal Survey ◽  
Stage Model ◽  
Longitudinal Methods ◽  
Research Register ◽  
Mental Health Consumers ◽  
Health Consumers ◽  
Definition Of

Objective: In order to realize the vision of recovery-orientated mental health services, there is a need for a model and a method of measuring recovery as the concept is described by mental health consumers. A preliminary five-stage model based on consumer accounts was developed in an earlier study by the authors. This next stage of the research program describes the development and initial testing of a stage measure which, when validated, can be used in testing that model. Method: Existing measures of recovery were reviewed to assess their concordance with the model, and a new measure, the Stages of Recovery Instrument (STORI) was subsequently developed. A postal survey was conducted of 94 volunteers from the NISAD Schizophrenia Research Register. Participants completed the STORI and measures of mental health, psychological wellbeing, hope, resilience and recovery. Results: The STORI correlated with all of the psychological health variables, and the five stage subscales were found to be internally consistent. An ordinal relationship between the stage subscales was demonstrated by the intercorrelations of the subscale scores and the pattern of correlations between the subscales and the other measures. However, a cluster analysis of items revealed an overlap in measurement of adjacent stages, with only three clear clusters emerging. Conclusions: The results provide preliminary empirical validation of the STORI as a measure of the consumer definition of recovery. However, refinement of the measure is needed to improve its capacity to discriminate between the stages of the model. The model could then be comprehensively tested using longitudinal methods and the inclusion of objective measures.

Sign in / Sign up

Export Citation Format

Share Document