Perception of Home Demands, Social Support, and Marital Adjustment Among Women During Covid-19

The COVID-19 pandemic continues to bring colossal impact on families, particularly on marital adjustments. This paper reports findings of a study that examined perceptions of home demands, social support, and marital adjustment among women during COVID-19. A sample of 252 women was taken. Participants were administered a Demographic information sheet, Home Demands Questionnaire, Multidimensional Scale of Perceived Social Support, and Enrich Marital Satisfaction Scale. The data was analysed using Pearson Product Moment Correlation Coefficient and Multiple Linear Regression analysis. Results revealed a significant negative relationship between perceptions of home demands and social support, and marital adjustment, and also a significant positive relation between social support and marital adjustment among women. Findings showed that women are likely to face additional problems because of limited sources of social support due to COVID-19 which is an imperative aspect for marital adjustment. Findings have implications for marriage counsellors, therapists, and clinical practitioners.

Opioid Medication Disposal Among Patients Following Hand Surgery

Background: Despite increased public awareness to dispose of unused narcotics, opioids prescribed postoperatively are retained, which may lead to drug diversion and abuse. This study assessed retention of unused opioids among hand surgery patients and describes disposal methods and barriers. Methods: Participants undergoing hand surgery were given an opioid disposal information sheet preoperatively (N = 222) and surveyed postoperatively to assess disposal or retention of unused opioids, disposal methods, and barriers to disposal. A binomial logistic regression was conducted to assess whether age, sex, pain intensity, and/or the type of procedure were predictors of opioid disposal. Results: There were 171 patients included in the analysis (n = 51 excluded; finished prescription or continued opioid use for pain control). Unused opioids were retained by 134 patients (78%) and disposal was reported by 37 patients (22%). Common disposal methods included returning opioids to a pharmacy (49%) or mixing them with an unwanted substance (24%). Reasons for retention included potential future use (54%), inconvenient disposal methods (21%), or keeping an unfilled prescription (9%). None of the patient factors analyzed (age, sex, type of procedure performed, or pain score) were predictors of disposal of unused narcotics ( P > .05). Conclusions: Most patients undergoing hand surgery retained prescribed opioids for future use or due to impractical disposal methods. The most common disposal methods included returning narcotics to a pharmacy or mixing opioids with unwanted substances. Identifying predictors of disposal may provide important information when developing strategies to increase opioid disposal.

How to make study documents clear and relevant: the impact of patient involvement

Background Patient and public involvement can improve study outcomes, but little data have been collected on why this might be. We investigated the impact of the Feasibility and Support to Timely Recruitment for Research (FAST-R) service, made up of trained patients and carers who review research documents at the beginning of the research pipeline. Aims To investigate the impact of the FAST-R service, and to provide researchers with guidelines to improve study documents. Method A mixed-methods design assessing changes and suggestions in documents submitted to the FAST-R service from 2011 to 2020. Quantitative measures were readability, word count, jargon words before and after review, the effects over time and if changes were implemented. We also asked eight reviewers to blindly select a pre- or post-review participant information sheet as their preferred version. Reviewers’ comments were analysed qualitatively via thematic analysis. Results After review, documents were longer and contained less jargon, but did not improve readability. Jargon and the number of suggested changes increased over time. Participant information sheets had the most suggested changes. Reviewers wanted clarity, better presentation and felt that documents lacked key information such as remuneration, risks involved and data management. Six out of eight reviewers preferred the post-review participant information sheet. FAST-R reviewers provided jargon words and phrases with alternatives for researchers to use. Conclusions Longer documents are acceptable if they are clear, with jargon explained or substituted. The highlighted barriers to true informed consent are not decreasing, although this study has suggestions for improving research document accessibility.

1197. Development and Implementation of Innovative Syringe Service Programs for Veterans in Rural and Urban Settings

Background Syringe Services Programs (SSPs) is one aspect of a comprehensive Harm Reduction approach necessary to reduce the transmission of blood borne infections including Hepatitis B, Hepatitis C, and HIV. Substance Abuse and Mental Health Services Administration (SAMHSA) estimates that in 2019 that 595,000 veterans engage in opioid misuse with at least 57,000 veterans engaging in heroin. Stigmas to SSP are pervasive in the community and within the government system. Federal law prohibited the use of federal funds to purchase sterile needles or syringes for the purposes of illegal use of drugs by injection. It was officially clarified in May 24, 2021 that the prohibition to purchase syringes does not apply to Veterans Health Administration (VHA). While awaiting approximately 2 years to secure this clarification, syringes were obtained through a community donation. We aim to describe our process including difficulties encountered and data collected for SSP at two locations. Difficulties included developing an anonymous process to track quality, motivating providers to refer, educating highest risk veterans, providing face to face engagement during COVID-19 pandemic and ability to mail Harm Reduction kits containing sterile syringes. Illiana VA Program Information Sheet Orlando VA Program Information Sheet Methods Of the 140 facilities within VHA, there are currently only two SSPs established, Illiana VA and Orlando VA. A retrospective analysis of Harm Reduction benefits was performed among veterans who engaged with the two SSPs between 2018 to 2021. Orlando VA SSP Intake Process Map Process that veteran undergo when they engage with Orlando VA SSP Contents of Standard SSP Kit Distributed to Veterans at Orlando VA Results Approximately 3000 syringes were dispensed. Of the 17 veterans, 65% received syringes, 82% received naloxone, 100% engagement in mental health and 94% engagement in substance use disorder clinics. In total, 65% were screened for HIV, 82% for HCV and 29% for sexually transmitted infections. Conclusion These numbers, while modest, are notable, especially given the financial and organizational barriers that were in place. Furthermore, the COVID-19 pandemic impacted full implementation and outreach. With the recent, official clarification on syringe purchase and support for SSPs, the number of SSPs in the VA will grow, along with opportunity for more robust data collection. The experience of both facilities is a model for programs currently in development and moves us closer to ending the HIV epidemic by 2030. Disclosures All Authors: No reported disclosures