scholarly journals How to communicate with families living in complete isolation

2020 ◽  
pp. bmjspcare-2020-002633 ◽  
Author(s):  
Giovanni Mistraletti ◽  
Giuseppe Gristina ◽  
Sara Mascarin ◽  
Emanuele Iacobone ◽  
Ilaria Giubbilo ◽  
...  
Keyword(s):  
English Language ◽  
Family Members ◽  
Clinical Information ◽  
Optimal Level ◽  
Healthcare Team ◽  
Post Traumatic Stress ◽  
Clinical Communication ◽  
Consensus Statements ◽  
Consensus Procedure ◽  
Randomised Controlled

ImportanceDuring the SARS-CoV-2 pandemic, a complete physical isolation has been worldwide introduced. The impossibility of visiting their loved ones during the hospital stay causes additional distress for families: in addition to the worries about clinical recovery, they may feel exclusion and powerlessness, anxiety, depression, mistrust in the care team and post-traumatic stress disorder. The impossibility of conducting the daily meetings with families poses a challenge for healthcare professionals.ObjectiveThis paper aims to delineate and share consensus statements in order to enable healthcare team to provide by telephone or video calls an optimal level of communication with patient’s relatives under circumstances of complete isolation.Evidence reviewPubMed, Cochrane Database of Systematic Reviews, Database of Abstracts and Reviews of Effectiveness and the AHCPR Clinical Guidelines and Evidence Reports were explored from 1999 to 2019. Exclusion criteria were: poor or absent relevance regarding the aim of the consensus statements, studies prior to 1999, non-English language. Since the present pandemic context is completely new, unexpected and unexplored, there are not randomised controlled trials regarding clinical communication in a setting of complete isolation. Thus, a multiprofessional taskforce of physicians, nurses, psychologists and legal experts, together with some family members and former intensive care unit patients was established by four Italian national scientific societies. Using an e-Delphi methodology, general and specific questions were posed, relevant topics were argumented, until arriving to delineate position statements and practical checklist, which were set and evaluated through an evidence-based consensus procedure.FindingsTen statements and two practical checklists for phone or video calls were drafted and evaluated; they are related to who, when, why and how family members must be given clinical information under circumstances of complete isolation.Conclusions and relevanceThe statements and the checklists offer a structured methodology in order to ensure a good-quality communication between healthcare team and family members even in isolation, confirming that time dedicated to communication has to be intended as a time of care.

Firefighters and traumatic stress: a review

2017 ◽  
Vol 6 (1) ◽  
pp. 67-80 ◽  
Author(s):  
Alex Fraess-Phillips ◽  
Shannon Wagner ◽  
R. Luke Harris
Keyword(s):  
Traumatic Stress ◽  
English Language ◽  
Team Building ◽  
Clinical Information ◽  
Fire Service ◽  
Post Traumatic Stress ◽  
Content Type ◽  
Academic Literature ◽  
Concise Review ◽  
Post Traumatic

Purpose The purpose of this paper is to provide a review of the literature with respect to traumatic stress in a firefighting context. The goal was to provide a clear and concise review intended for use by both researchers and practitioners. Firefighters are an under-researched group in the academic literature and updated review articles are necessary to advance this body of work. Design/methodology/approach Searches of the English language literature on firefighters and traumatic stress were completed and supplemented with a review of clinical information related to post-traumatic stress disorder (PTSD). The search was comprehensive but was not guided by systematic review guidelines. Findings Research regarding firefighters and traumatic stress is limited and inconsistent in outcome. Much of the available literature supports a link between fire service work and increased post-traumatic symptomatology; however, some research has neglected to demonstrate a relationship for these factors. Some efforts such as the training of coping skills and team building may improve firefighters’ resilience to PTSD, while therapeutic and psychopharmacological treatments may be effective in reducing PTSD progression. Originality/value To the authors’ knowledge, no previous paper is available that has specifically intended to address firefighters and traumatic stress in a review format for researchers and practitioners. In the authors’ experience, fire service members are eager for literature addressing their profession and presented in a manner accessible for both non-academic and academic audiences.

Multilingual interactions in clinical dental education: A focus on mediated interpreting

2012 ◽  
Vol 8 (3) ◽  
pp. 197-210
Author(s):  
Susan M. Bridges ◽  
Cynthia K.Y. Yiu ◽  
Colman P. McGrath
Keyword(s):  
Staff Development ◽  
Healthcare Team ◽  
Clinical Settings ◽  
Clinical Communication ◽  
Dental Surgery ◽  
Language And Culture ◽  
Medical Interpreting ◽  
Essential Resource ◽  
Intercultural Mediators

In clinical dental consultations in multilingual contexts, medical interpreting is often performed by the supporting staff as part of routine triadic formulations. As academic dentistry becomes increasingly internationalised, issues of language and culture add to the interactional complexity of clinical communication and education. A multivariate approach was adopted to investigate one case of multilingualism in dentistry in Asia. Collection of both survey (n=86) and interactional data provided empirical evidence regarding language use and language demands across integrated Polyclinics. Descriptive statistics of Dental Surgery Assistant (DSA) perception data and conversation analysis (CA) of mediated interpretation indicate that, as members of the oral healthcare team, DSAs in Hong Kong are an essential resource in their role of intercultural mediators between patients and clinicians, both staff and students. Discussion of sociolinguistic notions of place-as-location and place-as-meaning supports a wider conceptualisation of the role of support staff as interpreters in clinical settings. Implications are drawn for policy, curriculum and staff development.

Effectiveness of Child to Parent Communication Using Information Package on Food Hygiene

2018 ◽  
Vol 3 (07) ◽  
Author(s):  
Ms. Sonam Yangchen Bhutia ◽  
Dr. Sushma Kumari Saini ◽  
Dr. Manmeet Kaur ◽  
Dr. Sandhya Ghai
Keyword(s):  
School Children ◽  
Home Visit ◽  
Controlled Trial ◽  
Family Members ◽  
Sampling Technique ◽  
Control Group ◽  
Food Hygiene ◽  
Parent Communication ◽  
Post Test ◽  
Randomised Controlled

School children can act as change agent not only for families but for community. The study aimed to assess effectiveness of information package on knowledge and practices of parents/family members of school children studying in Govt. Sr. Sec. School on food hygiene in Dhanas and Daddu Majra Colony, UT, Chandigarh. A non-randomised controlled trial was conducted on 201 school children studying in VIIth standard and their parents/family members. Purposive sampling technique was utilised to enrol 101 in case and 100 participants in control group. Interview schedule for knowledge assessment and observation checklist for assessing the practices of parents/ family members was used. Pre assessment of both the groups was done by a home visit. Experimental group school children were educated on food hygiene as per the protocol. Pre and post-test knowledge of school children on food hygiene was assessed and were asked to disseminate the information to their parents/family members.  After 15 days, second time home visit was done to the parents/family members of both the groups for the post assessment of knowledge and practices. Significant improvement in knowledge and practices of parents/family members related to food hygiene was observed. Hence, school children can be an effective tool in health related knowledge dissemination which can further promote healthy practices.

scholarly journals DECRYPT trial: study protocol for a phase II randomised controlled trial of cognitive therapy for post-traumatic stress disorder (PTSD) in youth exposed to multiple traumatic stressors

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e047600
Author(s):  
Leila Allen ◽  
Polly-Anna Ashford ◽  
Ella Beeson ◽  
Sarah Byford ◽  
Jessica Chow ◽  
...  
Keyword(s):  
Young People ◽  
Cognitive Therapy ◽  
Multiple Trauma ◽  
Traumatic Stress ◽  
Controlled Trial ◽  
Post Traumatic Stress ◽  
Children And Young People ◽  
Post Traumatic ◽  
Randomised Controlled ◽  
Post Randomisation

BackgroundPost-traumatic stress disorder (PTSD) is a distressing and disabling condition that affects significant numbers of children and adolescents. Youth exposed to multiple traumas (eg, abuse, domestic violence) are at particular risk of developing PTSD. Cognitive therapy for PTSD (CT-PTSD), derived from adult work, is a theoretically informed, disorder-specific form of trauma-focused cognitive–behavioural therapy. While efficacious for child and adolescent single-event trauma samples, its effectiveness in routine settings with more complex, multiple trauma-exposed youth has not been established. The Delivery of Cognitive Therapy for Young People after Trauma randomised controlled trial (RCT) examines the effectiveness of CT-PTSD for treating PTSD following multiple trauma exposure in children and young people in comparison with treatment as usual (TAU).Methods/designThis protocol describes a two-arm, patient-level, single blind, superiority RCT comparing CT-PTSD (n=60) with TAU (n=60) in children and young people aged 8–17 years with a diagnosis of PTSD following multiple trauma exposure. The primary outcome is PTSD severity assessed using the Children’s Revised Impact of Event Scale (8-item version) at post-treatment (ie, approximately 5 months post-randomisation). Secondary outcomes include structured interview assessment for PTSD, complex PTSD symptoms, depression and anxiety, overall functioning and parent-rated mental health. Mid-treatment and 11-month and 29-month post-randomisation assessments will also be completed. Process–outcome evaluation will consider which mechanisms underpin or moderate recovery. Qualitative interviews with the young people, their families and their therapists will be undertaken. Cost-effectiveness of CT-PTSD relative to TAU will be also be assessed.Ethics and disseminationThis trial protocol has been approved by a UK Health Research Authority Research Ethics Committee (East of England–Cambridge South, 16/EE/0233). Findings will be disseminated broadly via peer-reviewed empirical journal articles, conference presentations and clinical workshops.Trial registrationISRCTN12077707. Registered 24 October 2016 (http://www.isrctn.com/ISRCTN12077707). Trial recruitment commenced on 1 February 2017. It is anticipated that recruitment will continue until June 2021, with 11-month assessments being concluded in May 2022.

scholarly journals Whole School SEND (WSS) Review: study protocol for a two-arm pragmatic parallel cluster randomised controlled trial in 160 English secondary schools

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Stephen Morris ◽  
Andrew Smith ◽  
Cathy Lewin ◽  
Peter Hick ◽  
Jordan Harrison
Keyword(s):  
School Change ◽  
English Language ◽  
Controlled Trial ◽  
Cluster Randomised Controlled Trial ◽  
Educational Needs ◽  
Special Educational Needs ◽  
Whole School ◽  
Cluster Randomised ◽  
Educational Need ◽  
Randomised Controlled

Abstract Background The trial will study the effects of the Whole School SEND Review on secondary school pupils in English mainstream education, to understand the impact of the intervention on academic attainment, wellbeing, and school attendance. The Review is designed to facilitate whole-school change through providing enhanced, intensive and sustained support and training in inclusive education for school special educational needs coordinators and leadership teams. The trial will have a specific focus on pupils designated as having special educational needs or disabilities. Methods We recruited 160 English secondary schools (approx. 58,000 pupils across two cohorts) to a two-arm pragmatic parallel cluster randomised controlled trial, with allocation at the school level. Randomisation will be stratified by school region. The primary outcome is attainment in English language (using standardised national test results at 16 years) for pupils designated as having a special educational need (approx. 4000 pupils). Secondary outcomes will be measured for pupils both with and without a special educational need designation and include pupil wellbeing (measured using the Strengths and Difficulties Questionnaire), absences and exclusions, and attainment in Mathematics and English language at 16 years. The intervention will be implemented from July 2021 and analysis of outcomes (for the year 9 cohort) will take place in September 2023, with further analysis (for the year 8 cohort) in September 2024 if the evaluation shows that acceptable implementation fidelity has been achieved. Discussion Pupils with special educational needs represent a significant and often vulnerable part of the secondary school population, are disproportionately likely to be excluded from school, eligible for free school meals, or supported by children’s social care. Despite these multiple important areas of need, school leaders report substantial challenges in making additional provision for this group. Previous research has highlighted the development of inclusive school cultures (rather focusing primarily on targeted individualised approaches) as being important. This trial will investigate how an intervention designed to drive whole school change may lead to outcomes for pupils with and without a special educational needs designation. As such, this trial is expected to make an important contribution to research evidence and to UK educational policy. Trial registration ISRCTN registry ISRCTN11339306. Registered on 12 March 2020 (retrospectively registered).

scholarly journals The effect of flexible cognitive–behavioural therapy and medical treatment, including antidepressants on post-traumatic stress disorder and depression in traumatised refugees: pragmatic randomised controlled clinical trial

2016 ◽  
Vol 208 (3) ◽  
pp. 252-259 ◽  
Author(s):  
Caecilie Böck Buhmann ◽  
Merete Nordentoft ◽  
Morten Ekstroem ◽  
Jessica Carlsson ◽  
Erik Lykke Mortensen
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Behavioural Therapy ◽  
Controlled Clinical Trial ◽  
Post Traumatic Stress ◽  
Cognitive Behavioural ◽  
Randomised Controlled Clinical Trial ◽  
Post Traumatic ◽  
Randomised Controlled

BackgroundLittle evidence exists on the treatment of traumatised refugees.AimsTo estimate treatment effects of flexible cognitive–behavioural therapy (CBT) and antidepressants (sertraline and mianserin) in traumatised refugees.MethodRandomised controlled clinical trial with 2×2 factorial design (registered with Clinicaltrials.gov, NCT00917397, EUDRACT no. 2008-006714-15). Participants were refugees with war-related traumatic experiences, post-traumatic stress disorder (PTSD) and without psychotic disorder. Treatment was weekly sessions with a physician and/or psychologist over 6 months.ResultsA total of 217 of 280 patients completed treatment (78%). There was no effect on PTSD symptoms, no effect of psychotherapy and no interaction between psychotherapy and medicine. A small but significant effect of treatment with antidepressants was found on depression.ConclusionsIn a pragmatic clinical setting, there was no effect of flexible CBT and antidepressants on PTSD, and there was a small-to-moderate effect of antidepressants and psychoeducation on depression in traumatised refugees.

scholarly journals Evaluating the effectiveness of a group-based resilience intervention versus psychoeducation for emergency responders in England: A randomised controlled trial

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0241704
Author(s):  
Jennifer Wild ◽  
Shama El-Salahi ◽  
Michelle Degli Esposti ◽  
Graham R. Thew
Keyword(s):  
Mental Health ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Self Report ◽  
Post Traumatic Stress ◽  
Emergency Responders ◽  
Significant Difference ◽  
Randomised Controlled ◽  
Resilience Intervention

Background Emergency responders are routinely exposed to traumatic critical incidents and other occupational stressors that place them at higher risk of mental ill health compared to the general population. There is some evidence to suggest that resilience training may improve emergency responders’ wellbeing and related health outcomes. The aim of this study was to evaluate the effectiveness of a tertiary service resilience intervention compared to psychoeducation for improving psychological outcomes among emergency workers. Methods We conducted a multicentre, parallel-group, randomised controlled trial. Minim software was used to randomly allocate police, ambulance, fire, and search and rescue services personnel, who were not suffering from depression or post-traumatic stress disorder, to Mind’s group intervention or to online psychoeducation on a 3:1 basis. The resilience intervention was group-based and included stress management and mindfulness tools for reducing stress. It was delivered by trained staff at nine centres across England in six sessions, one per week for six weeks. The comparison intervention was psychoeducation about stress and mental health delivered online, one module per week for six weeks. Primary outcomes were assessed by self-report and included wellbeing, resilience, self-efficacy, problem-solving, social capital, confidence in managing mental health, and number of days off work due to illness. Follow-up was conducted at three months. Blinding of participants, researchers and outcome assessment was not possible due to the type of interventions. Results A total of 430 participants (resilience intervention N = 317; psychoeducation N = 113) were randomised and included in intent-to-treat analyses. Linear Mixed-Effects Models did not show a significant difference between the interventions, at either the post-intervention or follow-up time points, on any outcome measure. Conclusions The limited success of this intervention is consistent with the wider literature. Future refinements to the intervention may benefit from targeting predictors of resilience and mental ill health. Trial registration ISRCTN registry, ISRCTN79407277.

scholarly journals What works to promote walking at the population level? A systematic review

2018 ◽  
Vol 52 (12) ◽  
pp. 807-812 ◽  
Author(s):  
Charlie Foster ◽  
Paul Kelly ◽  
Hamish A B Reid ◽  
Nia Roberts ◽  
Elaine M Murtagh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mass Media ◽  
English Language ◽  
Environmental Changes ◽  
Controlled Trial ◽  
Population Level ◽  
Eligibility Criteria ◽  
Community Initiatives ◽  
School Based ◽  
Randomised Controlled

ObjectiveInterventions to promote walking have focused on individual or group-based approaches, often via the randomised controlled trial design. Walking can also be promoted using population health approaches. We systematically reviewed the effectiveness of population approaches to promote walking among individuals and populations.DesignA systematic review.Data sources10 electronic databases searched from January 1990 to March 2017.Eligibility criteriaEligibility criteria include pre-experimental and postexperimental studies of the effects of population interventions to change walking, and the effects must have been compared with a ‘no intervention’, or comparison group/area/population, or variation in exposure; duration of ≥12 months of follow up; participants in free-living populations; and English-language articles.Results12 studies were identified from mostly urban high-income countries (one focusing on using tax, incentivising the loss of parking spaces; and one using policy only, permitting off-leash dogs in city parks). Five studies used mass media with either environment (n=2) or community (n=3) approaches. Four studies used environmental changes that were combined with policies. One study had scaled up school-based approaches to promote safe routes to schools. We found mass media, community initiatives and environmental change approaches increased walking (range from 9 to 75 min/week).

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