scholarly journals General practitioners’ management of depression symptoms in Somali refugee and Norwegian patients: a film vignette experiment

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e055261
Author(s):  
Samantha Marie Harris ◽  
Per-Einar Binder ◽  
Esperanza Diaz ◽  
Vebjørn Ekroll ◽  
Gro M Sandal
Keyword(s):  
Primary Care ◽  
Sick Leave ◽  
Future Research ◽  
Depression Symptoms ◽  
Clinical Decisions ◽  
Simpson Index ◽  
Healthcare Needs ◽  
Majority Population ◽  
Somali Refugee ◽  
And Gender

ObjectivesRefugees in comparison with non-refugee patients may face higher unmet mental healthcare needs. The mechanisms underlying these disparities are still poorly understood. The general practitioner (GP) plays a vital role in refugees’ mental health (MH), managing complaints within primary care and acting as gatekeeper to specialist services. However, GPs have reported feeling uncertain about working with refugee patients. Somalis make up one of the largest refugee groups in Norway and use primary care services more than the majority population for physical health, although not for MH. The current study examines GPs’ management of MH complaints in Somali refugee versus Norwegian vignette characters and the role of GP clinical uncertainty.DesignWe distributed an online experimental survey to GPs in Norway (n=133), who were randomised to watch a simulated consultation with a female Norwegian, female Somali, male Norwegian or male Somali vignette character, presenting the same symptoms of depression. GPs indicated which diagnoses, assessments and treatments they would endorse for the patient and their level of certainty.Outcome measuresWe calculated Simpson indices to measure inter-rater reliability and 2×2 analysis of variances as well as Bayesian estimation to examine clinical certainty based on patient background and gender.ResultsGPs’ clinical decisions about Somali and Norwegian vignette characters were similar, with a few exceptions. There was less consensus regarding the first prioritised diagnosis for Somali characters (Simpson index=0.129) versus Norwegian characters (Simpson index=0.208), (p=0.011, one-tailed). Somalis more frequently received diagnoses of post-traumatic stress disorder (PTSD), while Norwegians received diagnoses of feeling depressed. GPs endorsed sick leave more often for Norwegian characters and medication for physical complaints for Somali characters. There were no substantial differences in GPs’ self-reported certainty.ConclusionsWe found few and relatively small effects of patient background and gender on GPs’ clinical decisions. Nevertheless, the validity of certain diagnoses and prescription of sick leave need to be considered by clinicians and in future research.

scholarly journals Determinants of Catalan public primary care professionals’ intention to use digital clinical consultations (eConsulta) in the post-COVID-19 context: optical illusion or permanent transformation? (Preprint)

2021 ◽  
Author(s):  
Francesc Saigí-Rubió ◽  
Josep Vidal-Alaball ◽  
Joan Torrent-Sellens ◽  
Ana Jiménez-Zarco ◽  
Francesc López Segui ◽  
...  
Keyword(s):  
Primary Care ◽  
Healthcare Professionals ◽  
Binary Logistic Regression ◽  
Bivariate Analysis ◽  
Intention To Use ◽  
Quantitative Methodology ◽  
Perceived Benefits ◽  
Environmental Pressure ◽  
Healthcare Needs ◽  
And Gender

BACKGROUND During lockdown due to COVID-19 pandemic, telemedicine has become a necessary component of clinical practice for the purpose of providing safer patient care, and it has been used to support the healthcare needs of COVID-19 patients and routine primary care patients alike. However, this change has not been fully consolidated. OBJECTIVE The objective of this study was to analyse the determinants of healthcare professionals’ intention to use the eConsulta digital clinical consultations tool in the post-COVID-19 context. METHODS A mixed qualitative and quantitative methodology was used, and a questionnaire was designed to serve as the data collection instrument. The data were analysed using univariate and bivariate analysis techniques. To confirm the theoretical model, exploratory factor analysis and binary logistic regression were applied. RESULTS The most important variables were those referring to perceived benefits (B=2.408) and the type of use that individuals habitually made of eConsulta (B=0.715). Environmental pressure (B=0.678), experience of technology (B=0.542), gender (B=0.639) and the degree of eConsulta implementation (B=0.266) were other variables influencing the intention to use the tool in the post-COVID-19 context. When replicating the previous analysis by professional group, experience of technology and gender in the physician group, and experience of the tool’s use and the centre where a professional works in the nurse group, were found to be of considerable importance. CONCLUSIONS The implementation and use of eConsulta had increased significantly as a consequence of the COVID-19 pandemic, and the majority of the healthcare professionals were satisfied with its use in practice and planned to incorporate it into their practices in the post-COVID-19 context. Perceived benefits and environmental pressure were determining factors in the attitude towards and intention to use eConsulta.

Self-Compassion and Quality of Life in Adults Who Stutter

2020 ◽  
Vol 29 (4) ◽  
pp. 2097-2108
Author(s):  
Robyn L. Croft ◽  
Courtney T. Byrd
Keyword(s):  
Quality Of Life ◽  
Social Connectedness ◽  
The Self ◽  
Future Research ◽  
Self Compassion ◽  
Adults Who Stutter ◽  
And Gender ◽  
Relationship Of ◽  
The Impact

Purpose The purpose of this study was to identify levels of self-compassion in adults who do and do not stutter and to determine whether self-compassion predicts the impact of stuttering on quality of life in adults who stutter. Method Participants included 140 adults who do and do not stutter matched for age and gender. All participants completed the Self-Compassion Scale. Adults who stutter also completed the Overall Assessment of the Speaker's Experience of Stuttering. Data were analyzed for self-compassion differences between and within adults who do and do not stutter and to predict self-compassion on quality of life in adults who stutter. Results Adults who do and do not stutter exhibited no significant differences in total self-compassion, regardless of participant gender. A simple linear regression of the total self-compassion score and total Overall Assessment of the Speaker's Experience of Stuttering score showed a significant, negative linear relationship of self-compassion predicting the impact of stuttering on quality of life. Conclusions Data suggest that higher levels of self-kindness, mindfulness, and social connectedness (i.e., self-compassion) are related to reduced negative reactions to stuttering, an increased participation in daily communication situations, and an improved overall quality of life. Future research should replicate current findings and identify moderators of the self-compassion–quality of life relationship.

The use of ICT by SMMEs in a Digital Economy: A case study in Buffalo City Metropolitan in South Africa [Abstract]

10.28945/4314 ◽  
2019 ◽  
Keyword(s):  
South Africa ◽  
Technology Acceptance ◽  
21St Century ◽  
Common Knowledge ◽  
Digital Economy ◽  
Future Research ◽  
Wealth Creation ◽  
Underdeveloped Areas ◽  
And Gender ◽  
Set Up

Aim/Purpose: The goal of this study is to advance understanding of ICT utilization by SMMEs by checking access, ability (in terms of technological skills) and usage of ICT among some SMMEs entrepreneurs operating their businesses in an underdeveloped areas to enhance their business activities in order to utilizes the digital opportunities 21st century digital economies present. Background: In today’s world no nation or region is untouched by the forces of globalization and digital economy. One of the key pioneering forces of globalization is the advances of ICT like internet, social networks, etc. In the sphere of business, this pioneering force has also altered the way businesses and organizations communicate and interact with customers and society at large. Such alternation presents obvious opportunities for wealth creation and growth for businesses and organizations that are well-equipped to take advantages of them. But for those that are less-equipped, particularly SMMEs, globalization can easily lead to fore-closures and marginalization. It is a common knowledge that SMMEs entrepreneurs mostly rely on ICT gadgets like mobile phone, Laptops, Tablets to conduct their business activities as many of them don’t have enough capital to set up offices with necessary equipment. Therefore, using various ICT functions/programs on these ICT devices to enhance their business activities are critical to their businesses in the 21st century digital economies. Methodology: Purposeful sampling was used to approach fifty-four SMMEs entrepreneurs operating their businesses in underdeveloped areas locally called Townships in Buffalo City Metropolitan. Microsoft excel was used in the descriptive statistics. Contribution: This research will add to the growing knowledge ICT usage in SMMEs in the 21st century digital economies. Findings: The results indicate that the participating SMMEs entrepreneurs need to be educated, trained and supported in the use of the ICT applicable to enhance their business activities in order for them to take advantages of 21st century digital economies present. Recommendations for Practitioners: The agencies tasked with looking after SMMEs in South Africa needs to consider the lacked of utilisation of ICTs by SMMEs entrepreneurs operating their businesses in underdeveloped areas as one of the barrier to growing of their businesses and take necessary steps to address it. Recommendation for Researchers: Since age and gender have been proven to be key-moderating variables in many technology acceptance models. There is a need to explore in depth whether the factors of gender and age also act as barriers. Impact on Society: The research will assist stakeholders, policy makers and agencies tasked with looking after SMMEs to identify the barriers hindering SMMEs to grow and address them accordingly. Future Research: More work needs to be done to check whether gender, age of the SMMEs entrepreneurs have some effects on their attitude towards the integration of ICT into their business activities.

Feeling Threatened by Immigrants: The Role of Ideology and Subjective Societal Status

2020 ◽  
Author(s):  
Michael Bollwerk ◽  
Bernd Schlipphak ◽  
Joscha Stecker ◽  
Jens Hellmann ◽  
Gerald Echterhoff ◽  
...  
Keyword(s):  
Online Survey ◽  
Middle Eastern ◽  
Social Dominance Orientation ◽  
Survey Study ◽  
Future Research ◽  
Right Wing Authoritarianism ◽  
Threat Perceptions ◽  
Contextual Determinants ◽  
Intergroup Conflicts ◽  
And Gender

Threat perceptions towards immigrants continue to gain importance in the context of growing international migration. To reduce associated intergroup conflicts, it is crucial to understand the personal and contextual determinants of perceived threat. In a large online survey study (N = 1,184), we investigated the effects of ideology (i.e., Right-Wing Authoritarianism and Social Dominance Orientation), subjective societal status (SSS) and their interaction effects in predicting symbolic and realistic threat perceptions towards Middle Eastern immigrants. Results showed that ideology (higher RWA and SDO) and lower SSS significantly predicted both symbolic and realistic threat, even after controlling for income, education, age, and gender. Furthermore, ideology and SSS interacted significantly in predicting realistic threat, with higher levels of SDO and RWA enhancing the effect of SSS. In the discussion, we focus on the implications of our findings with respect to understanding societal conflicts, discuss methodological limitations, and provide directions for future research.

The Role of Resilience in Sexual and Gender Minority Mental Health

2020 ◽  
pp. 428-442
Author(s):  
Dawn M. Szymanski ◽  
Kirsten A. Gonzalez
Keyword(s):  
Mental Health ◽  
Minority Stress ◽  
Quantitative Research ◽  
Social Stigma ◽  
Therapeutic Interventions ◽  
Future Research ◽  
Minority Mental Health ◽  
And Gender ◽  
Structural Levels

Many lesbian, gay, bisexual, transgender, and queer (LGBTQ) persons are able to persevere and flourish despite pervasive social stigma and minority stress based on their sexual orientation and gender identity. This chapter reviews the research on LGBTQ resilience that can occur at individual, interpersonal/family, community, and contextual/structural levels. The authors describe qualitative research that has examined pathways to resilience and positive LGBTQ identity. The authors also review quantitative research on LGBTQ resilience via mediator, moderator, and moderated mediation models. Variables are described that have been found to explain or buffer the links between external and internalized minority stressors and mental health outcomes. The authors review the small but growing body of research that has begun to examine the efficacy of therapeutic interventions aimed at promoting LGBTQ resilience. Limitations are discussed and directions for future research are suggested.

The Interplay of Developing Morality and Gender Attitudes

2020 ◽  
pp. 724-745
Author(s):  
Rebecca S. Bigler ◽  
Lynn S. Liben
Keyword(s):  
Psychological Theory ◽  
The United States ◽  
Gender Nonconformity ◽  
Gender Attitudes ◽  
Future Research ◽  
Policy And Practice ◽  
Ethical Policy ◽  
History Of ◽  
And Gender ◽  
And Behavior

Morality and gender are intersecting realms of human thought and behavior. Reasoning and action at their intersection (e.g., views of women’s rights legislation) carry important consequences for societies, communities, and individual lives. In this chapter, the authors argue that children’s developing views of morality and gender reciprocally shape one another in important and underexplored ways. The chapter begins with a brief history of psychological theory and research at the intersection of morality and gender and suggests reasons for the historical failure to view gender attitudes through moral lenses. The authors then describe reasons for expecting morality to play an important role in shaping children’s developing gender attitudes and, reciprocally, for gender attitudes to play an important role in shaping children’s developing moral values. The authors next illustrate the importance and relevance of these ideas by discussing two topics at the center of contentious debate in the United States concerning ethical policy and practice: treatment of gender nonconformity and gender-segregated schooling. The chapter concludes with suggestions for future research.

scholarly journals Occasional and persistent frequent attenders and sickness absences in occupational health primary care: a longitudinal study in Finland

BMJ Open ◽  
2019 ◽  
Vol 9 (2) ◽  
pp. e024980 ◽  
Author(s):  
Tiia T M Reho ◽  
Salla A Atkins ◽  
Nina Talola ◽  
Markku P T Sumanen ◽  
Mervi Viljamaa ◽  
...  
Keyword(s):  
Primary Care ◽  
Longitudinal Study ◽  
Occupational Health ◽  
Sick Leave ◽  
Diagnostic Codes ◽  
Frequent Attenders ◽  
Frequent Attendance ◽  
Increased Risk ◽  
Working Age

ObjectivesFrequent attenders (FAs) create a substantial portion of primary care workload but little is known about FAs’ sickness absences. The aim of the study is to investigate how occasional and persistent frequent attendance is associated with sickness absences among the working population in occupational health (OH) primary care.Setting and participantsThis is a longitudinal study using medical record data (2014–2016) from an OH care provider in Finland. In total, 59 676 patients were included and categorised into occasional and persistent FAs or non-FAs. Sick-leave episodes and their lengths were collected along with associated diagnostic codes. Logistic regression was used to analyse associations between FA status and sick leaves of different lengths (1–3, 4–14 and ≥15 days).ResultsBoth occasional and persistent FA had more and longer duration of sick leave than non-FA through the study years. Persistent FAs had consistently high absence rates. Occasional FAs had elevated absence rates even 2 years after their frequent attendance period. Persistent FAs (OR=11 95% CI 7.54 to 16.06 in 2016) and occasional FAs (OR=2.95 95% CI 2.50 to 3.49 in 2016) were associated with long (≥15 days) sickness absence when compared with non-FAs. Both groups of FAs had an increased risk of long-term sick leaves indicating a risk of disability pension.ConclusionBoth occasional and persistent FAs should be identified in primary care units caring for working-age patients. As frequent attendance is associated with long sickness absences and possibly disability pensions, rehabilitation should be directed at this group to prevent work disability.

754 Insomnia and Depression Symptoms in Primary Care Patients Referred for Mental Health Care

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A294-A294
Author(s):  
Ivan Vargas ◽  
Alexandria Muench ◽  
Mark Seewald ◽  
Cecilia Livesey ◽  
Matthew Press ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Primary Care Providers ◽  
Depression Symptoms ◽  
Care Providers ◽  
Mild Depression ◽  
Significant Depression ◽  
Clinically Significant

Abstract Introduction Past epidemiological research indicates that insomnia and depression are both highly prevalent and tend to co-occur in the general population. The present study further assesses this association by estimating: (1) the concurrence rates of insomnia and depression in outpatients referred by their primary care providers for mental health care; and (2) whether the association between depression and insomnia varies by insomnia subtype (initial, middle, and late). Methods Data were collected from 3,174 patients (mean age=42.7; 74% women; 50% Black) who were referred to the integrated care program for assessment of mental health symptoms (2018–2020). All patients completed an Insomnia Severity Index (ISI) and a Patient Health Questionnaire (PHQ-9) during their evaluations. Total scores for the ISI and PHQ-9 were computed. These scores were used to categorize patients into diagnostic groups for insomnia (no-insomnia [ISI < 8], subthreshold-insomnia [ISI 8–14], and clinically-significant-insomnia [ISI>14]) and depression (no-depression [PHQ-914]). Items 1–3 of the ISI were also used to assess the association between depression and subtypes of insomnia. Results Rates of insomnia were as follows: 34.6% for subthreshold-insomnia, 35.5% for clinically-significant insomnia, and 28.9% for mild-depression and 26.9% for clinically-significant-depression. 92% of patients with clinically significant depression reported at least subthreshold levels of insomnia. While the majority of patients with clinical depression reported having insomnia, the proportion of patients that endorsed these symptoms were comparable across insomnia subtypes (percent by subtype: initial insomnia 63%; middle insomnia 61%; late insomnia 59%). Conclusion According to these data, the proportion of outpatients referred for mental health evaluations that endorse treatable levels of insomnia is very high (approximately 70%). This naturally gives rise to at least two questions: how will such symptomatology be addressed (within primary or specialty care) and what affect might targeted treatment for insomnia have on health were it a focus of treatment in general? Support (if any) Vargas: K23HL141581; Perlis: K24AG055602

Military Background and Gender Identity in Psychological Assessment Among College Students: Factorial Invariance of the Counseling Center Assessment of Psychological Symptoms–62 (CCAPS-62)

Assessment ◽  
2021 ◽  
pp. 107319112199876
Author(s):  
Arpita Ghosh ◽  
Christopher R. Niileksela ◽  
Rebecca Janis
Keyword(s):  
Gender Identity ◽  
Structural Equation ◽  
Psychological Symptoms ◽  
College Counseling ◽  
Counseling Center ◽  
Factorial Invariance ◽  
Equation Modeling ◽  
Future Research ◽  
Military Background ◽  
And Gender

The purpose of this study was to examine the factorial invariance of the Counseling Center Assessment of Psychological Symptoms–62 (CCAPS-62) across military background and gender identity. A sample of 2,208 military students and 2,208 nonmilitary students were chosen from a large database of university and college counseling centers. Using exploratory structural equation modeling, findings suggested the CCAPS-62 is mostly invariant across military background and gender identity. Only three item thresholds appeared to be noninvariant across groups. These results suggest comparisons of scores across military background and gender can be made. Latent mean differences across groups were also examined. After controlling for several background variables, there were some differences between males and females on subscales measuring depression, eating concerns, and generalized anxiety, but no differences between military and nonmilitary students. Implications for practice and future research are discussed.

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