Rehabilitation From Addiction and Chronic Illnesses: A Comparative Analysis of the Narratives of Hungarian Patients

2020 ◽  
Vol 34 (1) ◽  
pp. 65-80
Author(s):  
Asztrik Kovács ◽  
Virág Mezőfi ◽  
V. Anna Gyarmathy ◽  
József Rácz
Keyword(s):  
Chronic Illness ◽  
Recovery Process ◽  
Active Role ◽  
Healthcare Services ◽  
Chronic Illnesses ◽  
Psychological Services ◽  
Structured Interviews ◽  
Rehabilitation Process ◽  
Psychological Phenomena ◽  
Patient Groups

BackgroundIn Hungary the psychological care provided during the rehabilitation of patients with chronic illnesses is insufficient. Patients with addiction, on the other hand, appear to make more use of psychological services. Narratives of patients recovering from addiction and patients with various chronic illnesses were examined in order to gain a better understanding of psychological phenomena during rehabilitation.MethodsSemi-structured interviews were carried out. Narrative and thematic analysis was used in order to determine the structure and characteristics of patients' narratives.ResultsThe narratives of patients recovering from addiction were found to be more structured and uniform; they identified with their illness and played an active role in their recovery. Patients with a chronic illness mainly recounted passive events and physical difficulties. Stigmatization was mentioned by both groups.Implications for practiceThe level of stigmatization experienced by patients with a chronic illness may be one of the reasons why they use healthcare services more frequently than patients with an addiction. The authors believe that teaching patients to provide good narratives about suffering from and recovering from chronic illnesses may aid them in the rehabilitation process. An adaptive mixture of different illnesses and addiction narratives might be beneficial in the recovery process of various patient groups.

scholarly journals Parent-child collaboration in health care decision making: perspectives of young people with chronic illness

2021 ◽  
Author(s):  
Elana Jackson
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Chronic Illness ◽  
Young People ◽  
Organ Transplant ◽  
Chronic Illnesses ◽  
Structured Interviews ◽  
Health Care Decision ◽  
Role Of Parents ◽  
Care Decision

This study explores the perspectives of young people with chronic illness on their participation in health care discussions and decision making, with a specific focus on the role of parents in facilitating participation. Semi-structured interviews were conducted with 26 participants between the ages of 5 and 18. Participants were recruited from inpatient units at a pediatric hospital. A range of chronic illnesses were represented among members of the sample, including kidney failure, Crohn’s disease, organ transplant, and sickle cell anemia. Following data collection, a focused analysis was conducted of participants’ statements related to parent involvement in the health care decision making process. Salient themes that emerged from analysis of the data reveal a complex and bidirectional process in which young people and parents negotiate children’s participation in making decisions related to their health care. Based on the findings, a collaborative-contextual model of decision making is proposed.

Designing an mHealth Roadmap for the Journey to Self-Management: A Qualitative Study with Adolescents and Young Adults Living with Chronic Illness

2021 ◽  
pp. 174239532110674
Author(s):  
Caitlin S. Sayegh ◽  
Ellen Iverson ◽  
Clarissa Newman ◽  
Diane Tanaka ◽  
Ellen F. Olshansky ◽  
...  
Keyword(s):  
Young Adults ◽  
Chronic Illness ◽  
Los Angeles ◽  
Chronic Illnesses ◽  
Adolescents And Young Adults ◽  
Self Management ◽  
Management Skills ◽  
Structured Interviews ◽  
Mhealth Intervention ◽  
The Right

Objectives Adolescents and young adults (AYA) with chronic illnesses often struggle with illness self-management. The objective of this study is to understand how AYA with various chronic illnesses develop self-management skills and which mobile health (mHealth) strategies they believe could be helpful. Methods Semi-structured interviews were conducted with patients, between 16 to 20 years old, living with at least one chronic illness (N = 19), between 2018 and 2019 in Los Angeles, CA. Three coders completed thematic coding to understand how AYA develop and maintain self-management skills, to inform the development of mHealth interventions appropriate across a variety of chronic conditions. Results Results suggest that AYA develop self-management skills through several strategies, including (1) getting organized, (2) making it work for me and (3) keeping the right mentality. AYA described developing these strategies through: (1) receiving social support, (2) accessing helpful tools and technologies, and (3) going through a maturation process. They provided recommendations for mHealth intervention developers. Discussion The results suggest that an appealing mHealth intervention could support AYA patients in proactively acquiring self-management skills and prevent having to rely on trial and error or uneven access to guidance and support. Interventions should be responsive to individual technology preferences and practices.

scholarly journals Parent-child collaboration in health care decision making: perspectives of young people with chronic illness

2021 ◽  
Author(s):  
Elana Jackson
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Chronic Illness ◽  
Young People ◽  
Organ Transplant ◽  
Chronic Illnesses ◽  
Structured Interviews ◽  
Health Care Decision ◽  
Role Of Parents ◽  
Care Decision

This study explores the perspectives of young people with chronic illness on their participation in health care discussions and decision making, with a specific focus on the role of parents in facilitating participation. Semi-structured interviews were conducted with 26 participants between the ages of 5 and 18. Participants were recruited from inpatient units at a pediatric hospital. A range of chronic illnesses were represented among members of the sample, including kidney failure, Crohn’s disease, organ transplant, and sickle cell anemia. Following data collection, a focused analysis was conducted of participants’ statements related to parent involvement in the health care decision making process. Salient themes that emerged from analysis of the data reveal a complex and bidirectional process in which young people and parents negotiate children’s participation in making decisions related to their health care. Based on the findings, a collaborative-contextual model of decision making is proposed.

Toward establishing telepsychology guideline: Turning the challenges of COVID-19 into opportunity (Preprint)

2020 ◽  
Author(s):  
Mohammed M. J. Alqahtani
Keyword(s):  
Mental Health ◽  
Health Care Services ◽  
Task Force ◽  
Healthcare Services ◽  
Psychological Services ◽  
Face To Face ◽  
Care Services ◽  
Governance Model ◽  
Provision Of Services ◽  
Temporary Response

BACKGROUND The COVID-19 pandemic has obstructed the classical practices of psychological assessment and intervention via face-to-face interaction. Patients and all health professionals have been forced to isolate and become innovative to continue receiving and providing exceptional healthcare services while minimizing the risk of exposure to, or transmission of, COVID-19. OBJECTIVE This document is proposed initially as a guide to the extraordinary implementation of telepsychology in the context of the COVID-19 pandemic and to extend its implementation to use fundamentally as the main guideline for telepsychology services in Saudi Arabia and other Arabic communities. METHODS A professional task force representing different areas of professional psychology reviewed, summarized, and documented methods, policies, procedures, and other resources to ensure that the recommendations and evidence reviews were valid and consistent with best practices. RESULTS The practice of telepsychology involves the consideration of legal and professional requirements. This paper provides a guideline and recommendations for procedural changes that are necessary to address psychological services as we transition to telepsychology, as well as elucidates and demonstrates practical telepsychology frameworks, procedures, and proper recommendations for the provision of services during COVID-19. It adds a focused examination and discussion related to factors that could influence the telemedicine guideline, such as culture, religion, legal matters, and how clinical psychologists could expand their telepsychology practice during COVID-19 and after, seeking to produce broadly applicable guidelines for the practice of telepsychology. Professional steps in practical telemedicine were illustrated in tables and examples. CONCLUSIONS Telepsychology is not a luxury or a temporary response. Rather, it should be considered part of a proactive governance model to secure a continuity of mental health care services. Arabic communities could benefit from this guideline to telepsychology as an essential protocol for providing mental health services during and after the COVID-19 pandemic.

scholarly journals Formative process evaluation of a guideline-driven process for improving the cultural responsiveness of alcohol and drug treatment services

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sara Farnbach ◽  
Julaine Allan ◽  
Raechel Wallace ◽  
Alexandra Aiken ◽  
Anthony Shakeshaft
Keyword(s):  
Culturally Responsive ◽  
Implementation Fidelity ◽  
Healthcare Services ◽  
Cultural Responsiveness ◽  
Free Text ◽  
Structured Interviews ◽  
Culturally Responsive Practice ◽  
Step Process ◽  
Treatment Services ◽  
Service Staff

Abstract Background To improve Australian Aboriginal and Torres Strait Islander people’s access to, and experience of, healthcare services, including Alcohol and other Drug (AoD) treatment services, principles and frameworks have been developed to optimise cultural responsiveness. Implementing those principles in practice, however, can be difficult to achieve. This study has five aims: i) to describe a five-step process developed to operationalise improvements in culturally responsive practice in AoD services; ii) to evaluate the fidelity of implementation for this five-step process; iii) to identify barriers and enablers to implementation; iv) to assess the feasibility and acceptability of this approach; and v) to describe iterative adaptation of implementation processes based on participant feedback. Methods Participating services were 15 non-Aboriginal AoD services in New South Wales, Australia. Implementation records were used to assess the implementation fidelity of the project. Structured interviews with chief executive officers or senior management were conducted, and interview data were thematically analysed to identify project acceptability, and the key enablers of, and barriers to, project implementation. Quantitative descriptive analyses were performed on the post-implementation workshop survey data, and responses to the free text questions were thematically analysed. Results A high level of implementation fidelity was achieved. Key enablers to improving culturally responsive practice were the timing of the introduction of the five-step process, the active interest of staff across a range of seniority and the availability of resources and staff time to identify and implement activities. Key barriers included addressing the unique needs of a range of treatment sub-groups, difficulty adapting activities to different service delivery models, limited time to implement change in this evaluation (three months) and the varied skill level across staff. The project was rated as being highly acceptable and relevant to service CEOs/managers and direct service staff, with planned changes perceived to be achievable and important. Based on CEO/management feedback after the project was implemented at the initial services, several improvements to processes were made. Conclusion The operationalisation of the five-step process developed to improve cultural responsiveness was feasible and acceptable and may be readily applicable to improving the cultural responsiveness of a wide variety of health and human services.

scholarly journals Birds of a Feather Flock Together: Disadvantageous Decision Making in Augmented Restless Legs Syndrome Patients with and without Impulse Control Disorders

2021 ◽  
Vol 11 (3) ◽  
pp. 383
Author(s):  
Beatrice Heim ◽  
Philipp Ellmerer ◽  
Ambra Stefani ◽  
Anna Heidbreder ◽  
Elisabeth Brandauer ◽  
...  
Keyword(s):  
Decision Making ◽  
Restless Legs Syndrome ◽  
Impulse Control ◽  
Compulsive Sexual Behavior ◽  
Structured Interviews ◽  
Restless Legs ◽  
Information Sampling ◽  
Patient Groups ◽  
Post Hoc ◽  
Beads Task

Background: Augmentation (AUG) in patients with restless legs syndrome (RLS) can be associated with impulse control disorder (ICD) symptoms, such as compulsive sexual behavior, gambling disorder or compulsive shopping. In this study, we wanted to assess whether RLS patients with AUG differ in decision making from those patients who have augmentation and in addition ICD symptoms (AUG + ICD) in a post hoc analysis of a patient cohort assessed in a previous study. Methods: In total, 40 RLS patients with augmentation (19 AUG + ICD, 21 AUG without ICDs) were included. RLS diagnosis, severity, and diagnosis of augmentation were made by sleep disorder specialists. ICD symptoms were assessed using semi-structured interviews. All patients performed the beads task, which is an information sampling task where participants must decide from which of the two cups colored beads were drawn. Results were compared to 21 healthy controls (HC). Results: There was no difference in information sampling or irrational decision making between AUG and AUG + ICD patients (p = 0.67 and p = 1.00, respectively). Both patient groups drew less beads and made more irrational decisions than HC (all p-values < 0.03, respectively). Conclusions: Our results suggest that augmentation itself is associated with poorer decision making even in the absence of ICD symptoms. Further studies are necessary to explore whether rapid and hasty decision making are a harbinger of augmentation in RLS.

scholarly journals Older African Americans’ Perspectives on Exposure to Structural Discrimination Across Contexts and the Life Course

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 689-689
Author(s):  
Sarah LaFave ◽  
Sarah Szanton ◽  
Roland Thorpe
Keyword(s):  
African Americans ◽  
Life Course ◽  
Healthcare Services ◽  
Community Dwelling ◽  
Structured Interviews ◽  
Older African Americans ◽  
Environmental Toxin ◽  
Development Of Instrument ◽  
The Life Course ◽  
Interpersonal Level

Abstract This presentation reports on findings from the first phase of a mixed methods study aimed at developing an instrument to assess older African Americans’ exposure to structural racial discrimination. We conducted semi-structured interviews with older African Americans about their perspectives on and exposure to structural discrimination. Participants (n=20) were community-dwelling African Americans aged fifty and older in Baltimore, MD. Participants described exposure to structural discrimination that had accumulated across the life course and across the contexts of education, employment, healthcare services, criminal justice system, neighborhood factors, media and marketing of unhealthy products, environmental toxin exposures, and income, credit and wealth. In the next phase of the study, we will incorporate these findings into the development of instrument items. Developing and testing a tool to assess exposure to discrimination beyond the interpersonal level is an important step in identifying solutions to mitigate the contribute of discrimination to racial health disparities.

scholarly journals Views and experiences of family physicians about Syrian refugee patients in Turkey: a qualitative research

2021 ◽  
Vol 22 ◽  
Author(s):  
Duygu Ayhan Baser ◽  
Özge Mıhcı ◽  
Meltem Tugce Direk ◽  
Mustafa Cankurtaran
Keyword(s):  
Primary Healthcare ◽  
Asylum Seekers ◽  
Health Care Services ◽  
Qualitative Methodology ◽  
Healthcare Delivery ◽  
Family Physicians ◽  
Healthcare Services ◽  
Free Access ◽  
Structured Interviews ◽  
Syrian Refugee

Abstract Aim: The aim of this study was to describe the attitudes, views and solution proposals of family physicians (FPs) about primary healthcare problems of Syrian refugee patients. This study would be the very first study for Turkey that evaluates the attitudes, views and solution proposals of FPs about primary healthcare problems of Syrian refugee patients. Background: Following the anti-regime demonstrations that started in March 2011, the developments in Syria created one of the biggest humanitarian crises in the world and the largest number of asylum seekers continue to be hosted in Turkey. There are some studies evaluating asylum seekers’ access to healthcare services in Europe, and the common result is that refugees have free access to primary healthcare services in most countries; however, they face many obstacles when accessing primary healthcare services. While there are studies in the literature evaluating the situation of access to primary healthcare services from the perspective of asylum seekers; there are few studies evaluating the opinions/views of FPs. Methods: A qualitative methodology informed by the grounded theory was used to guide the research. A total of 20 FPs were interviewed face to face through semi-structured interviews, using 12 questions about their lived experience and views caring of refugee population. Interviews were analysed thematically. Finding: The following themes were revealed: Benefiting from Primary Health Care Services, Benefiting from Rights, Differences Between the Approach/Attitudes of Turkish Citizens and Refugees, Barriers to Healthcare Delivery, Training Needs of Physicians, Solution proposals. FPs reported that there is a need for support in primary care and a need for training them and refugees in this regard and they specified refugee healthcare centres are the best healthcare centres for refugees; however, the number of these and provided services should be increased.

Abstract P076: Increased Burden Of Chronic Illness Among Insured Compared To Uninsured Sudden Death Victims

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Reaves Houston ◽  
Susan Keen ◽  
Chelsea Deitelzweig ◽  
Hannah Jones ◽  
Sarah Laible ◽  
...  
Keyword(s):  
Health Insurance ◽  
Chronic Illness ◽  
Sudden Death ◽  
Private Insurance ◽  
Chronic Illnesses ◽  
Categorical Variables ◽  
Insurance Status ◽  
Public Insurance ◽  
Status Data ◽  
Lower Frequencies

Introduction: Lack of health insurance is associated with reduced access to medical care and increased mortality. Chronic illness is associated with sudden death, a major cause of natural death. Insurance status of sudden death victims has not been characterized. Hypothesis: Uninsured compared to insured sudden death victims will have more chronic illnesses. Methods: From 2013-2015, emergency medical services-attended out of hospital deaths among ages 18-64 in Wake County, NC were screened to adjudicate sudden deaths. Medical records were reviewed for demographic, clinical, and health insurance status data. Insurance status was characterized as private, public, or no insurance. Cases were excluded from the analysis if no information on insurance was available. Comparisons of demographic and clinical characteristics were made between the three insurance status groups using Student’s t-test and ANOVA for continuous and categorical variables, respectively. Results: Of 399 cases of sudden death, insurance status data was available for 130: 25 (19.2%) had no insurance, 62 (47.7%) had public insurance, 31 (23.8%) had private insurance, and 12 (9.2%) had insurance of unknown type. Uninsured victims had lower frequencies of hypertension, hyperlipidemia, and chronic respiratory disease than those with private or public insurance, and lower frequencies of diabetes mellitus, mental illness, and substance abuse than those publicly insured (Table 1). No significant differences were found in coronary artery disease, age, gender, race, marital status, or years of education. Conclusion: Uninsured sudden death victims have less chronic illnesses than those insured. This counterintuitive finding suggests that uninsured sudden death victims have undiagnosed chronic illnesses that are treatable and preventable and contribute to their death. Our results suggest that expanding health insurance among working age adults may reduce the incidence of sudden death.

ADAPTATION OF QUESTIONNAIRE "SECONDARY BENEFIT FROM THE DISEASE"

2021 ◽  
pp. 130-151
Author(s):  
Irina V. Vets ◽  
Keyword(s):  
Recovery Process ◽  
Well Being ◽  
Psychological Phenomena ◽  
Multi Scale ◽  
Russian Version ◽  
Recovery Cost ◽  
Confirmatory Analysis ◽  
Recovery Resources ◽  
Recovery Pathways ◽  
Gains And Losses

An adaptation of the Russian version of the questionnaire «Secondary benefit from the disease» based on the questionnaire Will Joel Friedman «The Benefits of Suffering and the Costs of Well Being: Secondary Gains and Losses» (1994) is presented in the article. Our questionnaire consists of two parts and includes 40 questions, with 4-5 statements on each scale. The first part describes how a person becomes ill, includes scales: regression, somatization triggers, conformism, simulation. The second part of the questionnaire consists of scales: recovery resources, recovery cost, recovery pathways, autonomy, and reflects the recovery process. The standardization of the questionnaire (n=392) indicates that the methodology has good psychometric indicators of the internal consistency of the scales and retest reliability. However, we cannot say that the scales are completely independent, requiring additional research. The confirmatory analysis allowed us to see a good consistency of the questionnaire items. When studying the discriminative power of points, it turned out that this technique is suitable for studying the secondary benefit of the disease for people from 18 to 60 years old. The multi-scale method allows evaluating the psychological phenomena that hinder and contribute to a speedy recovery. The article contains the text of the questionnaire with instructions and keys.

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