Testing the Treatment Integrity of the Managing Cancer and Living Meaningfully Psychotherapeutic Intervention for Patients With Advanced Cancer

IntroductionThe Managing Cancer and Living Meaningfully (CALM) therapy for patients with advanced cancer was tested against a supportive psycho-oncological counseling intervention (SPI) in a randomized controlled trial (RCT). We investigated whether CALM was delivered as intended (therapists’ adherence); whether CALM therapists with less experience in psycho-oncological care show higher adherence scores; and whether potential overlapping treatment elements between CALM and SPI can be identified (treatment differentiation).MethodsTwo trained and blinded raters assessed on 19 items four subscales of the Treatment Integrity Scale covering treatment domains of CALM (SC: Symptom Management and Communication with Health Care Providers; CSR: Changes in Self and Relationship with Others; SMP: Spiritual Well-being and Sense of Meaning and Purpose; FHM: Preparing for the Future, Sustaining Hope and Facing Mortality). A random sample of 150 audio recordings (75 CALM, 75 SPI) were rated on a three-point Likert scale with 1 = “adherent to some extent,” 2 = “adherent to a sufficient extent,” 3 = “very adherent.”ResultsAll 19 treatment elements were applied, but in various frequencies. CALM therapists most frequently explored symptoms and/or relationship to health care providers (SC_1: n_applied = 62; 83%) and allowed expression of sadness and anxiety about the progression of disease (FHM_2: n_applied = 62; 83%). The exploration of CALM treatment element SC_1 was most frequently implemented in a satisfactory or excellent manner (n_sufficient or very adherent = 34; 45%), whereas the treatment element SMP_4: Therapist promotes acknowledgment that some life goals may no longer be achievable (n_sufficient or very adherent = 0; 0%) was not implemented in a satisfactory manner. In terms of treatment differentiation, no treatment elements could be identified which were applied significantly more often by CALM therapists than by SPI therapists.ConclusionResults verify the application of CALM treatment domains. However, CALM therapists’ adherence scores indicated manual deviations. Furthermore, raters were not able to significantly distinguish CALM from SPI, implying that overlapping treatment elements were delivered to patients.

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Depression and Suicidality in Gay Men: Implications for Health Care Providers

American Journal of Men s Health ◽

10.1177/1557988316685492 ◽

2017 ◽

Vol 11 (4) ◽

pp. 910-919 ◽

Cited By ~ 20

Author(s):

Carrie Lee ◽

John L. Oliffe ◽

Mary T. Kelly ◽

Olivier Ferlatte

Keyword(s):

Health Care ◽

Gay Men ◽

Health Care Providers ◽

Help Seeking ◽

Adult Population ◽

Well Being ◽

Sexual Practices ◽

Care Providers ◽

Physical And Mental Health ◽

Prevalence Of Depression

Gay men are a subgroup vulnerable to depression and suicidality. The prevalence of depression among gay men is three times higher than the general adult population. Because depression is a known risk factor for suicide, gay men are also at high risk for suicidality. Despite the high prevalence of depression and suicidality, health researchers and health care providers have tended to focus on sexual health issues, most often human immunodeficiency virus in gay men. Related to this, gay men’s health has often been defined by sexual practices, and poorly understood are the intersections of gay men’s physical and mental health with social determinants of health including ethnicity, locale, education level, and socioeconomic status. In the current article summated is literature addressing risk factors for depression and suicidality among gay men including family acceptance of their sexual identities, social cohesion and belonging, internalized stigma, and victimization. Barriers to gay men’s help seeking are also discussed in detailing how health care providers might advance the well-being of this underserved subgroup by effectively addressing depression and suicidality.

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Creating Comics to Address Well-Being and Resilience During the COVID-19 Pandemic

Health Promotion Practice ◽

10.1177/15248399211065407 ◽

2021 ◽

pp. 152483992110654

Author(s):

Kathryn West ◽

Karen R. Jackson ◽

Tobias L. Spears ◽

Brian Callender

Keyword(s):

Health Care ◽

Health Care Providers ◽

Case Series ◽

Narrative Medicine ◽

Well Being ◽

Small Scale ◽

Care Providers ◽

Graphic Medicine ◽

Racial Injustice ◽

Pilot Implementation

In this descriptive case series, we detail the theoretical basis, methodology, and impact of a small-scale pilot implementation of graphic medicine workshops as an innovative approach to well-being and resilience in the age of COVID-19 and increasing awareness of racial injustice. The data provided in this article are anecdotal and based on participation in the workshops. Images created during the workshops are also shared as examples of the types of reflection that graphic medicine can enable. The workshops themselves were designed collaboratively and are based on the theoretical principles of graphic medicine, narrative medicine, and racial and social justice. They were conducted as part of a larger wellness initiative and were offered to health care-focused faculty at our academic medical institution. Our findings suggest that this was a beneficial activity which helped participants to reflect and reconsider their experiences with the COVID-19 pandemic and surging awareness of racial injustice. Reflections also showed that drawings were correlated with ProQOL scores and may, in larger numbers, also help to mitigate or bring attention to issues of burnout in frontline providers. Drawings shared show the tremendous impact of COVID-19 and the simultaneous chaos and emptiness of practicing during dual pandemics. Our workshops engaged about 20 frontline health care providers and other health care faculty and highlight the utility of graphic medicine as a tool for building resilience and encouraging self-reflection. Further study is necessary, as is more rigorous analysis of the relationship between the graphics created and the ability to recognize and mitigate burnout.

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Prevalence and Patterns of Health Care Use Among Poor Older People Under the Livelihood Empowerment Against Poverty Program in the Atwima Nwabiagya District of Ghana

Gerontology and Geriatric Medicine ◽

10.1177/2333721419855455 ◽

2019 ◽

Vol 5 ◽

pp. 233372141985545 ◽

Cited By ~ 5

Author(s):

Williams Agyemang-Duah ◽

Charles Peprah ◽

Francis Arthur-Holmes

Keyword(s):

Health Care ◽

Health Services ◽

Older People ◽

Health Care Providers ◽

Health Care Expenditure ◽

Well Being ◽

Health Care Use ◽

Public Health Care ◽

Care Providers ◽

Health Lifestyle

In spite of the growing literature on prevalence and patterns of health care use in later life globally, studies have generally overlooked subjective standpoints of vulnerable Ghanaian older people obstructing the achievement of the United Nations’ health-related Sustainable Development Goals. We examined the prevalence and patterns of health care use among poor older people in the Atwima Nwabiagya District of Ghana. Cross-sectional data were obtained from an Aging, Health, Lifestyle and Health Services Survey conducted between June 1 and 20, 2018 ( N = 200). Chi-square and Fisher’s exact tests were carried out to estimate the differences between gender and health care utilization with significant level of less than or equal to 0.05. Whereas, 85% of the respondents utilized health care, females were higher utilizers (88% vs. 75%) but males significantly incurred higher health care expenditure. The majority utilized health services on monthly basis (38%) and consulted public health care providers (77%). While 68% utilized services from hospitals, most sourced health information from family members (54%) and financed their health care through personal income (45%). The study found that the Livelihood Empowerment Against Poverty grant played a little role in reducing health poverty. Stakeholders should review social programs that target poor older people in order to improve their well-being and utilization of health care.

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Risk Perception and Worries among Health Care Workers in the COVID-19 Pandemic: Findings from an Italian Survey

Healthcare ◽

10.3390/healthcare8040535 ◽

2020 ◽

Vol 8 (4) ◽

pp. 535

Author(s):

Mariangela Valentina Puci ◽

Guido Nosari ◽

Federica Loi ◽

Giulia Virginia Puci ◽

Cristina Montomoli ◽

...

Keyword(s):

Health Care ◽

Risk Perception ◽

Health Care Providers ◽

Health Care Workers ◽

Health Care Professionals ◽

Sleep Disturbances ◽

Well Being ◽

Care Providers ◽

Cross Sectional ◽

Care Workers

The ongoing pandemic scenario, due to the coronavirus disease 2019 (COVID-19), has had a considerable impact on public health all over the world. Italy was one of the most affected countries, as the first European full-blown outbreak occurred there. The exposure of the Italian health care workers to COVID-19 may be an important risk factor for psychological distress. The aim of this cross-sectional study was to describe worries and risk perception of being infected among Italian Health Care Workers (HCWs) during the first wave of the pandemic. In total, 2078 HCWs participated in a web survey (78.8% were females). The highest percentage of respondents were physicians (40.75%) and nurses (32.15%), followed by medical (18.00%), health care support (4.50%) and administrative (4.60%) staff. In a score range between 0 (not worried) and 4 (very worried), our results showed that participants declared that they were worried about the Coronavirus infection with a median score of 3 (IQR 2-3) and for 59.19% the risk perception of being infected was very high. In addition, HCWs reported they suffered from sleep disturbances (63.43%). From the analysis of the psychological aspect, a possible divergence emerged between the perceived need for psychological support (83.85%) and the relative lack of this service among health care providers emerged (9.38%). Our findings highlight the importance of psychological and psychiatric support services not only during the COVID-19 pandemic, but also in other emerging infectious diseases (EIDs) scenarios. These services may be useful for health authorities and policymakers to ensure the psychological well-being of health care professionals and to promote precautionary behaviors among them.

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Does mhGAP training of primary health care providers improve the identification of child- and adolescent mental, neurological or substance use disorders? Results from a randomized controlled trial in Uganda

Global Mental Health ◽

10.1017/gmh.2018.18 ◽

2018 ◽

Vol 5 ◽

Cited By ~ 3

Author(s):

A. Akol ◽

F. Makumbi ◽

J. N. Babirye ◽

J. S. Nalugya ◽

S. Nshemereirwe ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Randomized Controlled Trial ◽

Primary Health Care ◽

Health Care Providers ◽

Controlled Trial ◽

Child And Adolescent ◽

Care Providers ◽

Randomized Controlled ◽

Primary Health

Background.Integrating child and adolescent mental health (CAMH) into primary health care (PHC) using the WHO mental health gap action program (mhGAP) is recommended for closing a mental health treatment gap in low- and middle-income countries, but PHC providers have limited ability to detect CAMH disorders. We aimed to evaluate the effect of PHC provider mhGAP training on CAMH disorder identification in Eastern Uganda.Methods.Thirty-six PHC clinics participated in a randomized controlled trial which compared the proportion of intervention (n= 18) to control (n= 18) clinics with a non-epilepsy CAMH diagnosis over 3 consecutive months following mhGAP-oriented CAMH training. Fisher's exact test and logistic regression based on intention to treat principles were applied. (clinicaltrials.gov registration NCT02552056).Results.Nearly two thirds (63.8%, 23/36) of all clinics identified and recorded at least one non-epilepsy CAMH diagnosis from 40 692 clinic visits of patients aged 1–18 recorded over 4 months. The proportion of clinics with a non-epilepsy CAMH diagnosis prior to training was 27.7% (10/36, similar between study arms). Training did not significantly improve intervention clinics’ non-epilepsy CAMH diagnosis (13/18, 72.2%) relative to the control (7/18, 38.9%) arm,p= 0.092. The odds of identifying and recording a non-epilepsy CAMH diagnosis were 2.5 times higher in the intervention than control arms at the end of 3 months of follow-up [adj.OR 2.48; 95% CI (1.31–4.68);p= 0.005].Conclusion.In this setting, mhGAP CAMH training of PHC providers increases PHC clinics’ identification and reporting of non-epilepsy CAMH cases but this increase did not reach statistical significance.

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A Qualitative Study of a Compassion, Presence, and Resilience Training for Oncology Interprofessional Teams

Journal of Holistic Nursing ◽

10.1177/0898010118765016 ◽

2018 ◽

Vol 37 (1) ◽

pp. 30-44 ◽

Cited By ~ 5

Author(s):

Rinat Nissim ◽

Carmine Malfitano ◽

Mark Coleman ◽

Gary Rodin ◽

Mary Elliott

Keyword(s):

Health Care ◽

Health Care Providers ◽

Subjective Experience ◽

Well Being ◽

Holistic Health ◽

Cancer Center ◽

Care Practice ◽

Care Providers ◽

Interprofessional Teams ◽

Resilience Training

The well-being of health care providers may be challenged by their work, with evidence that oncology health care providers are a high-risk group for burnout. The present qualitative pilot study evaluated a mindfulness-based group intervention, referred to as Compassion, Presence, and Resilience Training (CPR-T), for oncology interprofessional teams. The purpose of this study was to elucidate the subjective experience of oncology health care providers receiving CPR-T and their perceptions of its benefits, risks, or challenges. The CPR-T was delivered to providers from two oncology teams in a large cancer center in Canada. Ten of these providers participated in semistructured interviews 1 to 5 months after completing the CPR-T. The interview transcripts were coded using a thematic analysis strategy. Five benefits of the CPR-T were identified: learning to pause, acquiring a working definition of stress and self-care, becoming fully present, building self-compassion, and receiving organizational acknowledgment and recognition of stress. In addition, two participant-identified challenges were recognized: sharing vulnerability within interprofessional teams and committing to a sitting meditation practice. These findings demonstrate positive transformations as a result of the CPR-T, as well as important challenges, and have important implications for holistic health care practice in oncology. Further research is necessary to validate the findings of this explorative study.

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Clinical Research With Pregnant Women: Perspectives of Pregnant Women, Health Care Providers, and Researchers

Qualitative Health Research ◽

10.1177/1049732318773724 ◽

2018 ◽

Vol 28 (13) ◽

pp. 2033-2047 ◽

Cited By ~ 3

Author(s):

Kyoko Wada ◽

Marilyn K. Evans ◽

Barbra de Vrijer ◽

Jeff Nisker

Keyword(s):

Health Care ◽

Prenatal Care ◽

Clinical Research ◽

Pregnant Women ◽

Health Care Providers ◽

Research Participation ◽

Well Being ◽

Constructivist Grounded Theory ◽

Care Providers ◽

Women Health

Limited clinical research with pregnant women has resulted in insufficient data to promote evidence-informed prenatal care. Charmaz’s constructivist grounded theory methodology was used to explore how research with pregnant women would be determined ethically acceptable from the perspectives of pregnant women, health care providers, and researchers in reproductive sciences. Semistructured interviews were conducted with a purposive sample of 12 pregnant women, 10 health care providers, and nine reproductive science researchers. All three groups suggested the importance of informed consent and that permissible risk would be very limited and complex, being dependent on the personal benefits and risks of each particular study. Pregnant women, clinicians, and researchers shared concerns about the well-being of the woman and her fetus, and expressed a dilemma between promoting research for evidence-informed prenatal care while securing the safety in the course of research participation.

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Senior healt-hcare fraud under investigation

Journal of Financial Crime ◽

10.1108/jfc-04-2020-0071 ◽

2020 ◽

Vol ahead-of-print (ahead-of-print) ◽

Author(s):

Nicole F. Stowell ◽

Carl Pacini ◽

Martina K. Schmidt ◽

Nathan Wadlinger

Keyword(s):

Health Care ◽

Health Care Providers ◽

Well Being ◽

Care Providers ◽

Prevention Strategies ◽

Effective Prevention ◽

Content Type ◽

Health Care Fraud ◽

Increased Risk ◽

The Usa

Purpose This study aims to increase awareness and educate the reader about health-care fraud targeting seniors in the USA to help stakeholders better understand, recognize and prevent this type of fraud. Design/methodology/approach This paper collects statistics on the current state of health care frauds committed against seniors, and examines related cases and laws. Findings The authors find this type of fraud is highly prevalent and expected to increase. Current laws preventing this fraud from occurring are multifold and complex. While prevention strategies through law enforcement have been somewhat successful, a reduction in resources may put seniors at an increased risk in the years to come. Research limitations/implications Without additional prevention strategies, the problem will likely escalate with a growing population of older adults. This study encourages further research into effective prevention strategies and methods to fight health-care fraud against seniors. Practical implications Health-care fraud and its associated costs pose a significant threat to the society and economy of the USA. Reducing this fraud will not only reduce the costs to the US economy but also improve the physical and mental well-being of senior victims, reduce their mortality and hospitalization rates and improve the public trust placed to health-care providers. Originality/value This study highlights how health-care fraud is committed against seniors. With the projected trend of an aging US population, educating stakeholders, increasing awareness and applying tools to protect seniors will be important to reduce the absolute scope of this problem in the future.

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Struggling and Overcoming Daily Life Barriers Among Children With Congenital Heart Disease and Their Parents in the West Bank, Palestine

Journal of Family Nursing ◽

10.1177/1074840718809710 ◽

2018 ◽

Vol 24 (4) ◽

pp. 585-611 ◽

Cited By ~ 4

Author(s):

Kawther Elissa ◽

Carina Sparud-Lundin ◽

Åsa B. Axelsson ◽

Salam Khatib ◽

Ewa-Lena Bratt

Keyword(s):

Health Care ◽

Congenital Heart Disease ◽

Heart Disease ◽

Health Care Providers ◽

Congenital Heart ◽

Daily Life ◽

West Bank ◽

Well Being ◽

Negative Consequences ◽

Care Providers

Advances in early diagnosis, treatment, and postoperative care have resulted in increased survival rates among children with congenital heart disease (CHD). Research focus has shifted from survival to long-term follow-up, well-being, daily life experiences, and psychosocial consequences. This study explored the everyday experiences of children with CHD and of their parents living in the Palestinian West Bank. Interviews with nine children aged 8 to 18 years with CHD and nine parents were analyzed using content analysis. The overall theme that emerged was facing and managing challenges, consisting of four themes: sociocultural burden and finding comfort, physical and external limitations, self-perception and concerns about not standing out, and limitations in access to health care due to the political situation. To provide optimum care for children with CHD and their parents, health care providers and policy makers must understand the negative consequences associated with sociocultural conditions and beliefs about chronic illness.

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