scholarly journals The Association Between Burnout and Pediatrician Management of Adolescent Depression

2020 ◽  
Vol 11 ◽  
pp. 215013272094333
Author(s):  
Leah LaLonde ◽  
Teryn Bruni ◽  
Blake Lancaster ◽  
Alexandros Maragakis
Keyword(s):  
Primary Care ◽  
Behavioral Health ◽  
Adolescent Depression ◽  
Primary Care Providers ◽  
Personal Accomplishment ◽  
Pediatric Primary Care ◽  
Future Research ◽  
Care Providers ◽  
Academic Health ◽  
The Impact

Objective: Given the increased demand for pediatric primary care providers to manage adolescent depression, the current study examines the association between burnout and provider comfort and perception of feasibility managing adolescent depression. Method: Data were collected from 52 pediatricians at a Midwest academic health center. Results: Higher scores on depersonalization were associated with lower provider-reported comfort managing adolescent depression. Emotional exhaustion and personal accomplishment were not associated with provider-reported comfort managing adolescent depression. None of the burnout domains were associated with the provider-reported perception of the feasibility managing adolescent depression in this setting. Limitations and recommendations for future research regarding the impact of behavioral health training on burnout are discussed. Conclusions: The interpersonal stress dimension of burnout is associated with less comfort managing depression. Adding positive systematic interventions, such as behavioral health trainings that support pediatricians in the management of behavioral health may have impact on burnout.

scholarly journals Pediatric Primary Care Providers’ Use of Behavioral Health Consultation

2017 ◽  
Vol 68 (6) ◽  
pp. 531-534 ◽  
Author(s):  
Prerna G. Arora ◽  
Elizabeth H. Connors ◽  
Kelly Coble ◽  
Angela Blizzard ◽  
Larry Wissow ◽  
...  
Keyword(s):  
Primary Care ◽  
Behavioral Health ◽  
Primary Care Providers ◽  
Pediatric Primary Care ◽  
Care Providers ◽  
Health Consultation ◽  
Behavioral Health Consultation

Small Group Interactive Techniques Utilizing Videofeedback

1998 ◽  
Vol 28 (1) ◽  
pp. 97-113 ◽  
Author(s):  
Linda Gask
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
Future Research ◽  
Care Providers ◽  
Group Setting ◽  
Additional Material ◽  
Videotape Modeling ◽  
Training Approach ◽  
Evidence Of Impact ◽  
The Impact

Objective: Development and evaluation of a method of training primary care providers in psychiatric skills which utilizes videofeedback of real and roleplayed consultations in a group setting. Method: The development of the basic training approach and additional material for teaching specific skills is described. Evaluation has addressed the impact of training on 1) clinician behavior and 2) measures of outcome. Results: Research over a number of years has demonstrated an impact on clinician behavior with some evidence of impact on clinical and economic measures and patient satisfaction. Conclusions: Videofeedback training appears to be most effective when it is provided with a clear model for the professional-patient interaction. Its effectiveness can be further enhanced by delineating sets of component microskills that can be learned using a combination of videotape modeling, role-play, and feedback. Challenges for future research include investment in randomized controlled trials for outcome, developing the training approach for a range of primary care workers, training sufficient group facilitators, and achieving widespread dissemination without subsequent dilution of effectiveness.

The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care

Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 397-405 ◽  
Author(s):  
Steven Vannoy ◽  
Mijung Park ◽  
Meredith R. Maroney ◽  
Jürgen Unützer ◽  
Ester Carolina Apesoa-Varano ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Socioeconomic Status ◽  
Thematic Analysis ◽  
Older Men ◽  
Primary Care Providers ◽  
Depression Treatment ◽  
Care Providers ◽  
Low Socioeconomic ◽  
Self Image ◽  
The Impact

Abstract. Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: "What prevents men from acting on suicidal thoughts?" Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.

Improving Access to Integrated Behavioral Health in a Nurse-Led Federally Qualified Health Center

2021 ◽  
pp. 107839032199416
Author(s):  
Sarah Stalder ◽  
Aimee Techau ◽  
Jenny Hamilton ◽  
Carlo Caballero ◽  
Mary Weber ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Behavioral Health ◽  
Behavioral Health Care ◽  
Primary Care Providers ◽  
Care Team ◽  
Psychiatric Nurse ◽  
Care Providers ◽  
Team Members ◽  
Task Forces

BACKGROUND: The specific aims of this project were to create a fully integrated, nurse-led model of a psychiatric nurse practitioner and behavioral health care team within primary care to facilitate (1) patients receiving an appropriate level of care and (2) care team members performing at the top of their scope of practice. METHOD: The guiding model for process implementation was Rapid Cycle Quality Improvement. Three task forces were established to develop interventions in the areas of Roles and Responsibilities, Training and Implementation, and the electronic health record. INTERVENTION: The four interventions that emerged from these task forces were (1) the establishment of patient tiers based on diagnosis, medications, and risk assessment; (2) the creation of process maps to engage care team members; (3) just-in-time education regarding psychiatric medication management for primary care providers; and (4) use of a registry to track patients. RESULTS: The process measures of referrals to the psychiatric care team and psychiatric assessment intakes performed as expected. Both measures were higher at the onset of the project and lower 1 year later. The outcome indicator, number of case reviews, increased dramatically over time. CONCLUSIONS: For psychiatric nurse practitioners, this quality improvement effort provides evidence that a consultative role can be effective in supporting primary care providers. Through providing education, establishing patient tiers, and establishing an effective workflow, more patients may have access to psychiatric services.

Educational Initiative to Standardize Concussion Management in Pediatric Primary Care

2017 ◽  
Vol 57 (7) ◽  
pp. 806-814 ◽  
Author(s):  
Alex M. Taylor ◽  
Lise E. Nigrovic ◽  
Meredith L. Saillant ◽  
Emily K. Trudell ◽  
Jonathan R. Modest ◽  
...  
Keyword(s):  
Primary Care ◽  
Learning Community ◽  
Rating Scales ◽  
Community Intervention ◽  
Treatment Algorithm ◽  
Primary Care Providers ◽  
Pediatric Primary Care ◽  
Care Providers ◽  
Effect Change ◽  
Concussion Management

Pediatric primary care providers report limited training and tools to manage concussion. We developed a learning community intervention for a large independent pediatric practice association affiliated with a university hospital to standardize concussion management and improve the use of consensus-based guidelines. The learning community included in-person and online didactics, followed by a web-based reinforcement platform to educate and train clinicians on our treatment algorithm and decision support tools. Chart reviews before and after the intervention demonstrated significant increases in the use of standardized symptom rating scales (19.6% to 69.3%; P < .001), balance assessment (2.3% to 37.6%; P < .001), and scheduled follow-up (41.8% to 61.2%; P < .001), with an increase in delivery of our entire best practice bundle from 3.5% to 28.1% ( P < .001). A multimodal educational intervention can effect change among pediatric primary care providers and help align their management practices with consensus-based guidelines.

The Impact of Primary Care Providers’ Bias on Depression Screening for Lesbian Women

2021 ◽  
pp. 152483992110660
Author(s):  
Shuying Sha ◽  
Mollie Aleshire
Keyword(s):  
Primary Care ◽  
Statistical Tests ◽  
Secondary Analysis ◽  
Primary Care Providers ◽  
Depression Screening ◽  
Lesbian Women ◽  
Care Providers ◽  
Explicit Bias ◽  
Implicit And Explicit ◽  
The Impact

Primary care providers’ (PCPs) implicit and explicit bias can adversely affect health outcomes of lesbian women including their mental health. Practice guidelines recommend universal screening for depression in primary care settings, yet the guidelines often are not followed. The intersection of PCPs’ implicit and explicit bias toward lesbian women may lead to even lower screening and diagnosis of depression in the lesbian population than in the general population. The purpose of this secondary analysis was to examine the relationship between PCPs’ implicit and explicit bias toward lesbian women and their recommendations for depression screening in this population. PCPs ( n = 195) in Kentucky completed a survey that included bias measures and screening recommendations for a simulated lesbian patient. Bivariate inferential statistical tests were conducted to compare the implicit and explicit bias scores of PCPs who recommended depression screening and those who did not. PCPs who recommended depression screening demonstrated more positive explicit attitudes toward lesbian women ( p < .05) and their implicit bias scores were marginally lower than the providers who did not recommend depression screening (p = .068). Implications for practice: Depression screening rates may be even lower for lesbian women due to implicit and explicit bias toward this population. Training to increase providers’ awareness of bias and its harm is the first step to improve primary care for lesbian women. Policies must protect against discrimination based on sexual orientation or gender identity.

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