OP0264-HPR “I LITERALLY CONVINCED MYSELF I WAS GOING TO CATCH IT AND DIE”: LIVED EXPERIENCES OF THE COVID-19 PANDEMIC BY PEOPLE WITH RHEUMATIC DISEASES FROM FOUR EUROPEAN COUNTRIES

Background:The COVID-19 pandemic has resulted in unforeseen challenges for humanity, taking a significant toll, especially the immune-suppressed individuals. In this regard, the health and general well-being of people with rheumatic diseases, the great majority users of immunosuppressives, have been at stake.Objectives:To explore the impact of the COVID-19 pandemic on people with rheumatic diseases on immunosuppression during the first wave, concerning a) (self-)management of their disease; b) interaction with the health care team; c) emotional well-being and d) overall health.Methods:A qualitative study was conducted following a phenomenological approach. Adults (>18 years) with a rheumatic disease from four European countries (Cyprus, England, Greece, Portugal). Patients were recruited through patient’s associations and social media and were invited to participate in semi-structured, audio-recorded interview or focus groups, between July - August 2020. Following a pilot study the information provided was transcribed verbatim, anonymized and translated into English where necessary. An inductive approach was adopted to carry out a thematic framework analysis with the assistance of ATLAS.ti to identify key themes and subthemes. Data validation strategies were employed, and Ethical approval and informed consent were obtained.Results:Participants were 24 patients (21 women, age range 33 to 74 years) divided by 7 focus-groups and 1 individual interview. Most frequent diagnoses were rheumatoid arthritis (n=7), lupus (n=4), juvenile idiopathic arthritis (n=3).Three key themes with 3-7 subthemes were identified within the analytical framework, centred around the impact of the Covid-19 on patients’ lives (Figure 1): i) individual person (e.g. fear for myself and family, social isolation and lack of personal freedom, more time with family) ii) health settings (e.g. (un)clear information about risks of contamination, fear or risk of shortages of medication, remote consultations), and iii) work and community (e.g. persistent stress due to mass media exposure, lack of awareness by others about patients’ rheumatic disease and its disclosure, hope and suspicion about new vaccine development: “I hear that they will ask vulnerable groups to have the vaccine first (...) Why is that? we will be again the innocent victims”). Findings were similar across countries, except for spirituality (i.e. the pandemic as “the hand of God”), a coping subtheme particular to Portugal. These main themes resonated well with the social ecological model and Walsh’s Family Resilience Process [1,2].Conclusion:When experiencing a significant life-event people require some time to process the different lived experiences. This study provides insights on how patients from four countries coped with the new challenges. Such insights are invaluable for health care providers and policy makers, in guiding more meaningful support tailored to individual needs, especially at times of crisis. The study highlights the impact of COVID-19 on the lives of people with rheumatic disease. A follow-up study is currently underway to examine the effect of subsequent waves of the pandemic.References:[1]Golden SD, Earp JA. Social ecological approaches to individuals and their contexts: twenty years of health education & behavior health promotion interventions. Health Educ Behav. 2012;39(3):364-72. doi: 10.1177/1090198111418634.[2]Walsh F. Family resilience: a framework for clinical practice. Fam Process. 2003;42(1):1-18. doi: 10.1111/j.1545-5300.2003.00001.Acknowledgements:We thank the participants of this study.Disclosure of Interests:None declared

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P075 Evaluation of the impact of the COVID-19 pandemic on patients with rheumatic diseases in the UK: results from the REUMAVID study

Rheumatology ◽

10.1093/rheumatology/keab247.073 ◽

2021 ◽

Vol 60 (Supplement_1) ◽

Author(s):

Marco Garrido-Cumbrera ◽

Victoria Navarro-Compán ◽

Dale Webb ◽

Clare Jacklin ◽

Shantel Irwin ◽

...

Keyword(s):

Mental Health ◽

At Risk ◽

Rheumatic Disease ◽

Rheumatic Diseases ◽

Well Being ◽

Research Support ◽

Patient Organisations ◽

The Uk ◽

The Impact ◽

Second Wave

Abstract Background/Aims This study presents the impact of the COVID-19 pandemic on health care, access to treatment, daily activities, well-being and mental health and the role of patient organisations from the perspective of the patient with rheumatic disease in the UK. Methods REUMAVID is an international collaboration led by HTR of the University of Seville, together with a multidisciplinary team of rheumatologists and patient organisations from 7 European countries (in the UK: NASS, NRAS and Arthritis Action). The study consists of an online survey, including the following instruments: Self-Perceived Health, WHO-5 Well-Being Index and Hospital Anxiety and Depression Scale (HADS). Data are collected in two phases: the first wave of the pandemic (from May 14th to July 18th 2020) and the second wave (to be conducted in winter 2020). Results 558 patients with rheumatic diseases participated in REUMAVID UK. The most frequently reported diagnoses were axial spondyloarthritis (44.6%), rheumatoid arthritis (44.1%) and osteoarthritis (25.6%). The mean age was 58.5±13.4 years, 78.7% women, 70.8% married or in a relationship and 54.1% having university studies. 45.8% perceived their health status being "fair to very poor" with 38.4% reporting a worsening during lockdown. 48.8% had their rheumatology appointment cancelled. Of these, 46.9% were offered either online or telephone follow-up, while the remaining 50.6% were not given any alternative. 15.6% changed their medication, of which 66.3% were indicated to do so by the medical team and 21.7% did so out of concern with COVID-19 with the major fear being that their treatment would lead to serious illness if they contracted SARS-CoV-2, while the greater hope was to be able to continue with their treatment as usual. 10.3% smoked more than before, 59.4% quit smoking and 36.3% drank more alcohol than before. 20.7% were unable to physically exercise at home and 39.2% reported weight gain. According to the WHO-5 scale, 52.5% declared poor well-being (≤50). A total of 43.6% were at risk of anxiety and 33.6% at risk of depression according to the HADS scale. During the lockdown, 54.3% were able to continue their psychological therapy. The main source of COVID-19 information was the patient organisations (reaching 63.6% of members), compared to 45.3% of non-members who did not receive any information. Conclusion The REUMAVID study has allowed us to measure and quantify the experience of British patients with rheumatic disease during an unprecedented public health crisis. A reduction in healthcare access, concern about treatment, changes in daily life habits and worsening of well-being and mental health were reported during the first wave. Patient organisations were the main source of COVID-19-related information. Further data will be gathered during the second wave. Disclosure M. Garrido-Cumbrera: None. V. Navarro-Compán: Honoraria; Abbvie, BMS, Lilly, MSD, Novartis, Pfizer, Roche, UCB. D. Webb: Grants/research support; AbbVie, Biogen, Janssen, Lilly, Novartis, UCB. C. Jacklin: Grants/research support; Abbvie, Amgen, Biogen, Eli, Lilly, Gilead, Janssen, Pfizer, Roche, Sanofi, UCB. S. Irwin: Other; Coronavirus Community Support Fund. L. Christen: Other; Novartis employee. J. Correa-Fernández: None. S. Sanz-Gómez: None. H. Marzo-Ortega: Honoraria; Abbvie, Celgene, Eli-Lilly, Janssen, Novartis, Pfizer, Takeda, UCB. Grants/research support; Janssen, Novartis.

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OP0147 RHEUMATIC? - A DIGITAL DIAGNOSTIC DECISION SUPPORT TOOL FOR INDIVIDUALS SUSPECTING RHEUMATIC DISEASES: A MULTICENTER VALIDATION STUDY

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.1118 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 87.1-88

Author(s):

R. Knevel ◽

J. Knitza ◽

A. Hensvold ◽

A. Circiumaru ◽

T. Bruce ◽

...

Keyword(s):

Health Care ◽

Decision Support ◽

Rheumatic Disease ◽

Rheumatic Diseases ◽

Receiver Operating Curve ◽

Musculoskeletal Complaints ◽

Immune Mediated ◽

Diagnostic Decision ◽

Ocean Observations ◽

Receiver Operating

Background:Digital diagnostic decision support tools promise to accelerate diagnosis and increase health care efficiency in rheumatology. Rheumatic? is an online tool developed by specialists in rheumatology and general medicine together with patients and patient organizations for individuals suspecting a rheumatic disease.1,2 The tool can be used by people suspicious for rheumatic diseases resulting in individual advise on eventually seeking further health care.Objectives:We tested Rheumatic? for its ability to differentiate symptoms from immune-mediated diseases from other rheumatic and musculoskeletal complaints and disorders in patients visiting rheumatology clinics.Methods:The performance of Rheumatic? was tested using data from 175 patients from three university rheumatology centers covering two different settings:A.Risk-RA phase setting. Here, we tested whether Rheumatic? could predict the development of arthritis in 50 at risk-individuals with musculoskeletal complaints and anti-citrullinated protein antibody positivity from the KI (Karolinska Institutet)B.Early arthritis setting. Here, we tested whether Rheumatic? could predict the development of an immune-mediated rheumatic disease in i) EUMC (Erlangen) n=52 patients and ii) LUMC (Leiden) n=73 patients.In each setting, we examined the discriminative power of the total score with the Wilcoxon rank test and the area-under-the-receiver-operating-characteristic curve (AUC-ROC).Results:In setting A, the total test score clearly differentiated between individuals developing arthritis or not, median 245 versus 163, P < 0.0001, AUC-ROC = 75.3 (Figure 1). Also within patients with arthritis the Rheumatic? total score was significantly higher in patients developing an immune-mediated arthritic disease versus those who did not: median score EUMC 191 versus 107, P < 0.0001, AUC-ROC = 79.0, and LUMC 262 versus 212, P < 0.0001, AUC-ROC = 53.6.Figure 1.(Area under) the receiver operating curve for the total Rheumatic? scoreConclusion:Rheumatic? is a web-based patient-centered multilingual diagnostic tool capable of differentiating immune-mediated rheumatic conditions from other musculoskeletal problems. A following subject of research is how the tool performs in a population-wide setting.References:[1]Knitza J. et al. Mobile Health in Rheumatology: A Patient Survey Study Exploring Usage, Preferences, Barriers and eHealth Literacy. JMIR mHealth and uHealth. 2020.[2]https://rheumatic.elsa.science/en/Acknowledgements:This project has received funding from EIT Health. EIT Health is supported by the European Institute of Innovation and Technology (EIT), a body of the European Union that receives support from the European Union’s Horizon 2020 Research and Innovation program.This project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 777357, RTCure.Disclosure of Interests:Rachel Knevel: None declared, Johannes Knitza: None declared, Aase Hensvold: None declared, Alexandra Circiumaru: None declared, Tor Bruce Employee of: Ocean Observations, Sebastian Evans Employee of: Elsa Science, Tjardo Maarseveen: None declared, Marc Maurits: None declared, Liesbeth Beaart- van de Voorde: None declared, David Simon: None declared, Arnd Kleyer: None declared, Martina Johannesson: None declared, Georg Schett: None declared, Thomas Huizinga: None declared, Sofia Svanteson Employee of: Elsa Science, Alexandra Lindfors Employee of: Ocean Observations, Lars Klareskog: None declared, Anca Catrina: None declared

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The Quality Mental Health Care Network: A roadmap to improving quality mental healthcare in Canada

Healthcare Management Forum ◽

10.1177/0840470420974713 ◽

2021 ◽

Vol 34 (2) ◽

pp. 100-106

Author(s):

Emily J. Follwell ◽

Siri Chunduri ◽

Claire Samuelson-Kiraly ◽

Nicholas Watters ◽

Jonathan I. Mitchell

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Focus Groups ◽

Lived Experiences ◽

Mental Healthcare ◽

Care Network ◽

Key Informant ◽

Health Care Network

Although there are numerous quality of care frameworks, little attention has been given to the essential concepts that encompass quality mental healthcare. HealthCare CAN and the Mental Health Commission of Canada co-lead the Quality Mental Health Care Network (QMHCN), which has developed a quality mental healthcare framework, building on existing provincial, national, and international frameworks. HealthCare CAN conducted an environmental scan, key informant interviews, and focus groups with individuals with lived experiences to develop the framework. This article outlines the findings from this scan, interviews and focus groups.

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OP0082-PARE THE EFFECT COVID-19 HAS ON THE MENTAL HEALTH OF PEOPLE LIVING WITH RHEUMATIC DISEASES. FROM DATA TO INTERVENTIONS.

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.910 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 44-45

Author(s):

S. Mingolla ◽

A. Celano ◽

M. Santopietro

Keyword(s):

Mental Health ◽

Rheumatic Diseases ◽

Rare Diseases ◽

Psychological Impact ◽

Well Being ◽

Total Sample ◽

Support Service ◽

Health Condition ◽

National Association ◽

The Impact

Background:Covid-19 has had an important impact on the mental health conditions of over 5 million Italians suffering from one of the over 150 rheumatic diseases. In order to understand the psychological impact of the Covid-19 emergency and the restrictions imposed to counter it, the Italian National Association of People with Rheumatic and Rare Diseases – APMARR APS launched the research “Living with a rheumatic pathology”.Objectives:Gather data directly from Italian patients about the impact of the COVID-19 and consequent restrictions on their mental health and feelings; evaluate the most effective intervention to be implemented to face the pandemic by Patients organization.Methods:A qualitative-quantitative survey was carried out through a questionnaire administered throughout the national territory to a sample of N = 1,001 people. The people invited to complete the questionnaire were women (55,9%) and men (44,1%), aged 18-85 years (age 18-41=26,7%; age 42-65=64%; age >65=9,3%) with at least one rheumatic pathology. The questionnaire was made up of 39 questions, of which 29 were closed and 10 were open. For the administration of the questionnaires, the CAWI (Computer Aided Web Interview) methodology of on-line survey was used. The 1,001 interviews were carried out from 7 to 14 August 2020.Results:More than 4 out of 10 people (total sample 44.2%; male 60%, female 35,7%; age 18-41=39,1%; age 42-65=45,9%; age >65 = 50%) declared that the emergency period has somehow caused a worsening of their health condition. People declared that the deterioration of their health is due to the emergency period for the following reasons: 1) Psychological: such as stress and anxiety: “Too much stress and anxiety made the symptoms worse.”; “The stress of the quarantine affected my problem”; “Insomnia. Nervousness. General ailments. Depression. Strong stress” 2) Inability to perform physiotherapy and motor activities due to the lockdown 3) Postponement of examinations, visits and checks 4) remote working, in some cases described as harmful for people’s mental and physical health: “Due to Covid19 I had to do remote working and I worked even 12 hours a day including holidays to the detriment of my family life”.Furthermore, from January 31, 2020 a significant increase emerged in communication problems with rheumatology specialist compared to the period before the emergency due to Covid-19. The sharp increase may be due to the situation of severe psychological stress to which also the doctors were subjected in the emergency phase: people could not find the comfort of being empathically listened to.Conclusion:The research shows that the most frequent symptoms among people with rheumatic diseases were depression and high levels of anxiety due to strong emotional stress. Psychological malaise caused direct effects in worsening the symptoms of rheumatic disease as well as other related effects, for example, insomnia. The forced isolation due to the lockdown has made people lack the social support that is fundamental for the psychological well-being especially for those suffering from some chronic pathology. Starting from the data collected, APMARR promptly activated a completely free psychological support service with 6 professional psychologists, two of them specialized in emergency psychology. The service is accessible online and is still going on for all who are not able to overcome the anxiety and fear related to the pandemic and its evolution. Thousands of accesses to the service have been measured to date.References:S Mingolla1, A Celano1, M Santopietro2[1]NATIONAL ASSOCIATION OF PEOPLE WITH RHEUMATIC AND RARE DISEASES - APMARR APS[2]WeResearch. Ricerche di marketingDisclosure of Interests:None declared

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Family Physicians’ Standpoint and Mental Health Assessment in the Light of COVID-19 Pandemic—A Nationwide Survey Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18042093 ◽

2021 ◽

Vol 18 (4) ◽

pp. 2093

Author(s):

Tina Vilovic ◽

Josko Bozic ◽

Marino Vilovic ◽

Doris Rusic ◽

Sanja Zuzic Furlan ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Perceived Stress ◽

Depression Scale ◽

Family Physicians ◽

Knowledge Score ◽

Well Being ◽

Anxiety And Depression ◽

Event Scale ◽

The Impact

During the coronavirus disease 2019 (COVID-19) outbreak, family physicians (FPs) are the backbone of the healthcare system with considerable impact on the general population, and their well-being is of great importance. The aim of this investigation was to assess FPs mental health, as well as knowledge, attitudes and practices (KAPs) regarding the pandemic, and opinions on non-communicable disease (NCD) health care provided to patients. A cross-sectional study was carried out with a sample of 613 FPs. Anxiety and depression levels were estimated with the Hospital Anxiety and Depression Scale, subjective perceived stress with the Perceived Stress Scale, while trauma-related symptoms were assessed using the Impact on Event Scale-COVID19. KAPs toward the pandemic and opinions regarding NCD patients were evaluated with questionnaires accordingly. Results have shown that age (β = −0.02, p = 0.013) and personal risk of COVID‑19 (β = 1.05, p < 0.001) were significant independent correlates of the knowledge score. A total of 87.7% FPs expressed moderate/high perceived stress, 45.2% moderate/severe trauma-related symptoms, 60.4% borderline/abnormal anxiety levels, and 52.4% borderline/abnormal depression levels. Knowledge score was an independent predictor of perceived stress (β = −0.33, p = 0.023) and anxiety (β = −0.31, p = 0.006) levels. Limited accessibility to healthcare services and decreased number of newly-diagnosed NCD cases were mostly agreed on. The pandemic puts a considerable strain on FPs mental health, as well as on public health measures, due to the decreased overall quality of NCD patient health care. Educational programs may bridge the gaps between FPs’ knowledge. Thus lowering anxiety and improving patient care.

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‘You don’t look autistic’: A qualitative exploration of women’s experiences of being the ‘autistic other’

Autism ◽

10.1177/1362361321993722 ◽

2021 ◽

pp. 136236132199372

Author(s):

Kate Seers ◽

Rachel C Hogg

Keyword(s):

Lived Experiences ◽

Well Being ◽

Autism Spectrum ◽

Social Expectations ◽

Autism Spectrum Condition ◽

Women’S Experiences ◽

Women's Experiences ◽

Spectrum Condition ◽

The Impact ◽

Experiences Of Women

There is currently a paucity of literature exploring the experiences of women on the autism spectrum. It is imperative research is conducted to capture the experiences of women on the autism spectrum and ensure appropriate support is provided to this cohort. Drawing upon a social constructionist framework, this qualitative research study sought to understand how psychological and socio-cultural constructions of autism spectrum condition and gender influence the well-being of women on the autism spectrum. Eight participants engaged in a semi-structured interview, with thematic analysis conducted to demonstrate the impact of gender roles and social expectations on the women’s identity and autism spectrum condition expression. The research highlighted the changing understandings of autism spectrum condition across a woman’s lifespan and the process and impact of resisting hegemonic autism spectrum condition categorisation. The findings demonstrate that social constructions of gender and stereotypical understandings of autism spectrum condition, which prioritise a deficit, medical model, have significant consequences for women’s well-being and subjectivity. The women experienced challenging formative years, but with diagnosis and the evolution and acceptance of their identities, they were able to resist negative narratives of autism spectrum condition, embrace their strengths and develop adaptive coping strategies. It is hoped this article generates insights for societal and clinical recognition to better support women on the autism spectrum. Lay abstract Most autism spectrum condition research addresses the neurological and biological causes of autism spectrum condition, focusing upon deficits associated with autism spectrum condition and behavioural interventions designed to minimise these deficits. Little is known about the lived experiences of adult women on the autism spectrum and how they navigate social expectations around gender, autism spectrum condition and gendered understandings of autism spectrum condition. The lived experiences of eight women on the AS will be shared here, with attention to how gendered expectations influence women’s experiences of autism spectrum condition, their sense of self and well-being. Findings showed these women struggled to reconcile the expectations of others, particularly early in life. The women had difficultly conforming to stereotypical ideals of femininity, yet as they aged, they felt less need to conform, valuing their unique style and behaviours. The women also rejected deficit-oriented descriptions of autism spectrum condition generated by the medical community, preferring to focus on their strengths and unique characteristics. It is hoped this article helps psychologists and the wider community to understand and meet the needs of women on the AS.

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OP0097 LISTERIA MONOCYTOGENES. DESCRIPTION AND ANALYSIS OF CASES IN AN IMMUNODEPRESSED POPULATION BY RHEUMATIC DISEASES

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.4282 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 53.2-54

Author(s):

M. Lisbona Muñoz ◽

P. León ◽

G. Lopez Antequera ◽

E. Rubio-Romero

Keyword(s):

Listeria Monocytogenes ◽

Rheumatic Disease ◽

Pregnant Women ◽

Rheumatic Diseases ◽

Case Series ◽

Similar Proportion ◽

Neurological Manifestations ◽

Biological Dmards ◽

Parametric Data ◽

The Impact

Background:Listeria monocytogenes is a gram-positive bacteria that cause the invasive disease listeriosis. Human clinical syndromes are infrequent, mostly appearing in immunosuppressed individuals, newborns, the elderly, pregnant women, and occasionally healthy patients.Objectives:We describe and analyze Listeria-related demographics and clinical features to determine the predisposing conditions for severe infections in an immunodepressed population by rheumatic diseases.Methods:Descriptive Observational Study. A retrospective analysis of 143 patients were performed affected by listeriosis, with positive isolation of Listeria monocytogenes from blood, treated in the H.U. Virgen del Rocío (Seville- Spain) between 2003-2019. Of them 9 were rheumatic patients. The type of clinical manifestation was analyzed, paying special attention to the characteristics associated with patients with neurological complications or unfavorable outcome (death and / or abortion in pregnant women), immunosuppression (associated with cancer or rheumatic disease) was assessed as independent variables, chronic diseases (Hypertension, Diabetes Mellitus, dyslipidemia, COPD, Renal Insufficiency and Ischemic Heart Disease) as well as other baseline characteristics of the patient. (age, sex, pregnancy) and their toxic habits (tobacco and alcohol).Results:The sample includes a similar proportion of men (70 cases) and women (73 cases), of all ages. Of the total patients, most (85%) required hospital admission, with a duration median (non-parametric data) of 11 days. 78% of the cases admitted showed a favorable evolution. However, 15.4% resulted in death and 5.6% in abortion. This percentage of abortions represented 29% of the total pregnant women admitted Of all the patients admitted, a third (33%) were immunocompromised, including patiets with cancer (79%) and rheumatic diseases (21%). Include lupus (33%), RA (22%), APs (11%), polymyalgia rheumatica (11%), panuveitis (11%) and ANCA vasculitis MPO specificity (11%). All of them required admission although the majority showed a favorable evolution, except one of the patient. which resulted in death, in which case in addition to lupus he presented with prostate cancer. Regarding the baseline treatment of these patients, 7 underwent treatment with synthetic DMARDs and three with biological DMARDs (1 Adalimumab, 1 Infliximab and 1 Rituximab) As a result of the listeria infection, most of them had fever or digestive symptoms and two of they experienced neurological manifestations (meningoencephalitis) None of these last two (with lupus and RA) had biological DMARDs.Conclusion:Listeriosis is an uncommon but potentially serious infection usually in older people, pregnant women and immunocompromised patients. In our sample, 33% of the patients were immunocompromised. Of the 9 patients. affected by listeria with rheumatic disease we find a death for meningoencephalitis. Given the impact of this infection in immunosuppressed patients should pay attention in our patients with fever and neurological manifestations.Reference:[1]Eleftherios Mylonakis et al. A Case Series and Review of 222 Cases. Medicine 2002; 81: 260-269.[2]Alcoba Lez M et al.Meningitis por Listeria monocytogenes en el adulto en España. Presentación de 10 casos y revisión de la literatura. Rev Clin Esp 2002; 202 (12): 638-643.[3]Eleftherios Mylonakis et al. Central Nervous Sistem Infection with Listeria monocytogenes. 33 Years’ Experience at a General Hospital and Review of 776 Episodes from tha Literature. Medicine 1998; 77: 313-336.Disclosure of Interests:None declared

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Primary care teams’ experiences of delivering mental health care during the COVID-19 pandemic: a qualitative study

BMC Family Practice ◽

10.1186/s12875-021-01496-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Rachelle Ashcroft ◽

Catherine Donnelly ◽

Maya Dancey ◽

Sandeep Gill ◽

Simon Lam ◽

...

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Care ◽

Qualitative Study ◽

Mental Health Care ◽

Focus Groups ◽

Care Delivery ◽

Virtual Care ◽

Primary Care Teams ◽

The Impact

Abstract Background Integrated primary care teams are ideally positioned to support the mental health care needs arising during the COVID-19 pandemic. Understanding how COVID-19 has affected mental health care delivery within primary care settings will be critical to inform future policy and practice decisions during the later phases of the pandemic and beyond. The objective of our study was to describe the impact of the COVID-19 pandemic on primary care teams’ delivery of mental health care. Methods A qualitative study using focus groups conducted with primary care teams in Ontario, Canada. Focus group data was analysed using thematic analysis. Results We conducted 11 focus groups with 10 primary care teams and a total of 48 participants. With respect to the impact of the COVID-19 pandemic on mental health care in primary care teams, we identified three key themes: i) the high demand for mental health care, ii) the rapid transformation to virtual care, and iii) the impact on providers. Conclusions From the outset of the COVID-19 pandemic, primary care quickly responded to the rising mental health care demands of their patients. Despite the numerous challenges they faced with the rapid transition to virtual care, primary care teams have persevered. It is essential that policy and decision-makers take note of the toll that these demands have placed on providers. There is an immediate need to enhance primary care’s capacity for mental health care for the duration of the pandemic and beyond.

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Development of an Equity, Diversity, Inclusion, and Anti-racism Pledge as the Foundation for Action in an Academic Department of Neurology

Neurology ◽

10.1212/wnl.0000000000012674 ◽

2021 ◽

Vol 97 (15) ◽

pp. 729-736 ◽

Cited By ~ 1

Author(s):

Gillian L. Gordon Perue ◽

Susan E. Fox-Rosellini ◽

Nicole B. Sur ◽

Erika Marulanda-Londono ◽

Jason Margolesky ◽

...

Keyword(s):

Law Enforcement ◽

Lived Experiences ◽

Personal Development ◽

Socioeconomic Inequality ◽

Well Being ◽

Faculty Members ◽

Systemic Racism ◽

National Conversation ◽

The Impact ◽

Grand Rounds

Recent racial inequities as illustrated by the health disparities in COVID-19 infections and deaths, the recent killings of Black men and women by law enforcement, and the widening socioeconomic inequality and have brought systemic racism into a national conversation. These unprecedented times may have deleterious consequences, increasing stress, and trauma for many members of the neurology workforce. The Equity, Diversity, Inclusion and Anti-Racism Committee within our Department of Neurology provides infrastructure and guidance to foster a culture of belonging and addresses the well-being of faculty, staff, and trainees. Here, we present the creation and implementation of our Equity, Diversity, Inclusion, and Anti-Racism (EDIA) Pledge, which was central to our committee's response to these unprecedented times. We outline the process of developing this unique EDIA Pledge and provide a roadmap for approaching these important topics through a Continuing Medical Education Neurology Grand Rounds aimed at fostering a diverse, inclusive, equitable, and antiracist work environment. Through the lived experiences of 4 faculty members, we identify the impact of bias and microaggressions and encourage allyship and personal development for cultural intelligence. We hope that these efforts will inspire neurology departments and other academic institutions across the globe to make a similar pledge.

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“Women Are Cancer, You Shouldn’t Be Working in Sport”: Sport Psychologists’ Lived Experiences of Sexism in Sport

The Sport Psychologist ◽

10.1123/tsp.2020-0029 ◽

2020 ◽

pp. 1-12

Author(s):

Aura Goldman ◽

Misia Gervis

Keyword(s):

United Kingdom ◽

Focus Groups ◽

Sport Psychology ◽

Thematic Analysis ◽

Lived Experiences ◽

The United Kingdom ◽

Power Differentials ◽

The Feminine ◽

Gendered Power ◽

The Impact

Though sexism has been recognized as problematic in sport, its impact on female sport psychologists in the United Kingdom has not yet been investigated. The purpose of this research was to explore the impact of sexism and its influence on practice. Four semistructured focus groups were conducted, comprising 11 sport psychologists who worked in the United Kingdom. Thematic analysis revealed four general themes: the environment, privileging masculinity, acts of sexism, and the feminine. Participants’ discourse suggests that female sport psychologists are impacted by sexism in their workplaces. Gendered power differentials, coupled with the low status of sport psychology within sport, exacerbated the challenges faced by female sport psychologists. This study contributes to making up for the dearth of research on the impact of sexism on sport psychologists. Suggestions are made with regard to implications for practice.

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