scholarly journals Psychosocial Underpinnings of Pain and Sleep Disturbance in Safety-Net Primary Care Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Sarah Griffin ◽  
Joseph Tan ◽  
Paul B. Perrin ◽  
Allison B. Williams ◽  
Erin R. Smith ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Primary Care ◽  
Sleep Disturbance ◽  
Psychosocial Factors ◽  
Low Income ◽  
Primary Care Clinic ◽  
Safety Net ◽  
Care Clinic ◽  
Cynical Hostility

Objective. The aim of this study was to uncover possible psychosocial underpinnings of pain and sleep disturbance in a safety-net primary care sample. Methods. Patients (n = 210) awaiting care in a safety-net primary care clinic waiting room completed measures of cynical hostility, social support, mental health, sleep disturbance, and pain. This study was cross-sectional and observational. Results. A structural equation model suggested that higher cynical hostility was associated with lower social support, which in turn was associated with poorer mental health, which then corresponded with higher pain and sleep disturbance. All possible indirect (mediational) effects within this model were statistically significant, suggesting a possible route through which cynical hostility may shape pain and sleep, two common presenting problems in primary care. Conclusions. These findings illustrate the interplay of psychosocial factors with chronic pain and sleep disturbance in a sample of low-income, predominantly African-American patients seeking care at a safety-net primary care clinic. The findings support integrated primary care as a way to target not only behavioral health issues but also the psychosocial factors entangled with physical health.

Pregnant Hispanic Women: A Mental Health Study

1992 ◽  
Vol 73 (9) ◽  
pp. 515-521 ◽  
Author(s):  
Luis H. Zayas ◽  
Nancy A. Busch-Rossnagel
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Low Income ◽  
Mental Health Problems ◽  
Hispanic Women ◽  
Primary Care Clinic ◽  
Health Study ◽  
Community Based ◽  
Care Clinic ◽  
Mental Health Study

By most accounts, pregnant Hispanic women are a population at risk for perinatal health and mental health problems. In this article, the authors report on a pilot study of the mental health status of 86 low-income, pregnant Hispanics. Three cases drawn from a community-based, primary care clinic demonstrate how Hispanic women may appear in the clinical setting and how interventions can be designed.

scholarly journals Predictors of Alcohol Use in Safety-Net Primary Care: Classism, Religiosity, and Race

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Michael A. Trujillo ◽  
Erin R. Smith ◽  
Sarah Griffin ◽  
Allison B. Williams ◽  
Paul B. Perrin ◽  
...  
Keyword(s):  
Primary Care ◽  
Alcohol Use ◽  
Racial Differences ◽  
Low Income ◽  
Primary Care Clinic ◽  
Safety Net ◽  
Direct Effects ◽  
Cross Sectional ◽  
Care Clinic ◽  
Problematic Drinking

Class-based discrimination may impact problematic drinking in low-income populations, which may be buffered by personal religiosity. However, little is known how race may impact this association. The purpose of this study was to examine racial differences in the effect of class-based discrimination on problematic drinking as moderated by comfort with God and determine if there were conditional direct effects of class-based discrimination on problematic drinking by race. In this cross-sectional study, participants (N = 189) were patients of an urban, safety-net primary care clinic who completed questionnaires assessing experiences of class-based discrimination, attitudes toward God, and alcohol use. Data were collected from 2015 to 2016 and analyzed using the Hayes PROCESS macro. There was a significant main effect for class-based discrimination predicting problematic drinking. Two-way interaction analyses identified a significant comfort with God by race interaction with greater comfort with God associated with less problematic drinking among white but not black respondents. Conditional direct effects showed that experiences of class-based discrimination were associated with problematic drinking at low and moderate but not high levels of comfort with God in black participants, whereas none were observed for white participants. This study provides insight on how personal religiosity, class-based discrimination, and race may intertwine to shape problematic alcohol use in primarily low-income, urban patients. Clinicians’ awareness of risk and protective factors, as well as how race tempers the effects of such factors, is vital in providing better care for this population.

scholarly journals 140. Symptoms and Situations Predispose Patients to Use Antibiotics Without Medical Advice

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S200-S200
Author(s):  
Michael Hansen ◽  
Barbara Trautner ◽  
Roger Zoorob ◽  
George Germanos ◽  
Osvaldo Alquicira ◽  
...  
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Emergency Departments ◽  
Primary Care Clinic ◽  
Antibiotic Use ◽  
Safety Net ◽  
Care Clinic ◽  
Primary Care Clinics ◽  
Primary Care Patients ◽  
Emergency Department Patients

Abstract Background Use of antibiotics without a prescription (non-prescription use) contributes to antimicrobial resistance. Non-prescription use includes obtaining and taking antibiotics without a prescription, taking another person’s antibiotics, or taking one’s own stored antibiotics. We conducted a quantitative survey focusing on the factors that impact patients’ decisions to use non-prescription antibiotics. Methods We surveyed patients visiting public safety net primary care clinics and private emergency departments in a racially/ethnically diverse urban area. Surveys were read aloud to patients in Spanish and English. Survey domains included patients’ perspectives on which syndromes require antibiotic treatment, their perceptions of health care, and their access to antibiotics without a prescription. Results We interviewed 190 patients, 122 from emergency departments (64%), and 68 from primary care clinics (36%). Overall, 44% reported non-prescription antibiotic use within the past 12 months. Non-prescription use was higher among primary care clinic patients (63%) than the emergency department patients (39%, p = 0.002). The majority felt that antibiotics would be needed for bronchitis (78%) while few felt antibiotics would be needed for diarrhea (30%) (Figure 1). The most common situation identified “in which respondents would consider taking antibiotics without contacting a healthcare provider was “got better by taking this antibiotic before” (Figure 2). Primary care patients were more likely to obtain antibiotics without prescription from another country than emergency department patients (27% vs. 13%, P=0.03). Also, primary care patients were more likely to report obstacles to seeking a doctor’s care, such as the inability to take time off from work or transportation difficulties, but these comparisons were not statistically significant. Figure 1. Patients’ agreement that antibiotics would be needed varied by symptom/syndrome. Figure 2. Situations that lead to non-prescription antibiotic use impacted the two clinical populations differently Conclusion Non-prescription antibiotic use is a widespread problem in the two very different healthcare systems we included in this study, although factors underlying this practice differ by patient population. Better understanding of the factors driving non-prescription antibiotic use is essential to designing patient-focused interventions to decrease this unsafe practice. Disclosures All Authors: No reported disclosures

scholarly journals Mental Health Trauma Center Integrated with a Primary Care Clinic

2010 ◽  
Vol 25 (S1) ◽  
pp. S49-S49
Author(s):  
N. Laor ◽  
A. Louden ◽  
S. Shachar ◽  
Z. Wiener
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Trauma Center ◽  
Primary Care Clinic ◽  
Care Clinic

Using Touch-Screen Technology to Assess Smoking in a Low-Income Primary Care Clinic: A Pilot Study

2011 ◽  
Vol 46 (14) ◽  
pp. 1750-1754 ◽  
Author(s):  
Philip H. Smith ◽  
Gregory G. Homish ◽  
Christopher Barrick ◽  
Nancy L. Grier
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Low Income ◽  
Primary Care Clinic ◽  
Touch Screen ◽  
Care Clinic

Primary Care Patients' Reactions to Mental Health Screening

1996 ◽  
Vol 26 (4) ◽  
pp. 431-441 ◽  
Author(s):  
Mark Zimmerman ◽  
David T. Lush ◽  
Neil J. Farber ◽  
Jon Hartung ◽  
Gary Plescia ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Psychiatric Treatment ◽  
Primary Care Clinic ◽  
Empirical Support ◽  
Medical Patients ◽  
Care Clinic ◽  
History Of ◽  
Primary Care Patients ◽  
High Level

Objective: The authors examined whether there is empirical support for the notion that medical patients are upset by being asked questions about psychiatric disorders. Method: Six hundred and one patients attending a primary care clinic completed the SCREENER—a newly developed, brief self-administered questionnaire that surveys a broad range of psychopathology. In addition, they completed a second questionnaire that assessed their attitudes toward the SCREENER. Results: We found a high level of acceptance by patients. The questions were judged easy to answer, and they rarely aroused significant negative affect. Fewer than 2 percent of the patients judged the questions difficult to answer, and fewer than 3 percent were “very much” embarrassed, upset, annoyed, or uncomfortable with the questions. Individuals with a history of psychiatric treatment and poorer current mental health reacted more unfavorably to the questionnaire. Conclusions: From the patient's perspective, it is feasible and acceptable to use self-administered questionnaires for routine screening of psychiatric problems in primary care settings.

scholarly journals Food security is related to adult type 2 diabetes control over time in a United States safety net primary care clinic population

2017 ◽  
Vol 7 (5) ◽  
pp. e277-e277 ◽  
Author(s):  
M U Shalowitz ◽  
J S Eng ◽  
C O McKinney ◽  
J Krohn ◽  
B Lapin ◽  
...  
Keyword(s):  
United States ◽  
Type 2 Diabetes ◽  
Primary Care ◽  
Primary Care Clinic ◽  
Safety Net ◽  
Adult Type ◽  
Care Clinic ◽  
Clinic Population ◽  
Over Time
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