The Effects of Family-Centered Empowerment Model on Depression, Anxiety, and Stress of the Family Caregivers of Patients with COVID-19: A Randomized Clinical Trial

Background: Taking care of patients with Covid-19 is regarded as a challenging task for family caregivers. A family-centered empowerment model (FCEM) should help them achieve greater psychological strength in the care process.Methods: Seventy caregivers were randomized to FCEM (n= 35) or control (n= 35). The four-stage of FCEM in four online sessions through WhatsApp was provided to the intervention group from the patient's discharge until 2 weeks later. The demographic information questionnaire and Depression Anxiety Stress Scale-21 were employed both before and five days after the FCEM sessions to gather the necessary data.Results: Caregivers included 55.8% women and 44.2% men, with a mean age of 42.5 years. The results demonstrated a substantial difference in the average score of stress (p=0.023), anxiety (p=0.003), and depression (p=0.012).Conclusions: The combination of a face-to-face orientation session and online methods of FCEM is likely to lower stress, anxiety, and depression among caregivers. It can be contributed to the practicability, simplicity, and effectiveness of the intervention.Clinical Trial Registration code: This study (IRCT20180429039463N2) was registered in Iranian Registry of Clinical Trial on 10/04/2020

CEMARA: Caring and Empathy Luar Biasa untuk Meningkatkan Kompetensi Sosial Guru Sekolah Luar Biasa

School Teachers for Students with Special-Needs (STSSN) are not only required to have high cognitive abilities, they must also have a higher level of patience and energy when dealing with students with special needs. In fact, some of them have not been able to respond appropriately the uncontrolled behavior of students with various special needs. The goals of CEMARA (Extraordinary Caring and Empathy) training are enhancing the knowledge, communication skills, and social competences of special school teachers. The training process is carried out using experiential learning with four sessions. The first session is orientation session and training contract, the second session is sharing experiences and explaining knowledge about caring skills and empathy, the third session simulates how to communicate effectively in an empathetic manner, the fourth session ends with reflection and evaluation. Seven teachers of MILB YKTM Budi Asih participated as respondents. The results of this training were the emergence of increased knowledge, communication skills and social skills among teachers. They gained new knowledge about caring and empathy, then they practiced problem analysis and positive communication skills when dealing with various special need students. The improvement of teachers’ social competences is shown by the teachers’ feedback at the end of the training

Tele-U to Tele-ICU: Telehealth Nursing Education

Background The use of telehealth technology in various health care settings continues to expand. Such technology allows intensive care units to monitor patients living in remote locations and to intervene early when a patient’s condition declines or a critical event occurs. The use of telehealth can also support nurses and help meet staffing challenges, which have increased in intensive care units during the COVID-19 pandemic. Currently, however, there are no formal requirements for telehealth education in nursing education or for telehealth orientation in nursing practice. Objective To develop a telehealth curriculum based on telehealth competencies that would be broad enough to encompass all educational levels of nursing students and to support the current nursing workforce. Intervention A telehealth curriculum was designed that included an overview of telehealth, camera considerations, equipment, troubleshooting, reimbursement, legislation, and quality measures. These topics were then organized and developed into 6 online interactive video modules and simulation experiences. The curriculum topics pertinent to the tele–intensive care unit are discussed in this article. Conclusions Completion of the telehealth curriculum or a formal telehealth orientation session may provide nurses with an understanding of the principles of telehealth and the skills needed to provide high-quality patient care using telehealth best practices. As the use of telehealth continues to expand, nursing education and practice should work together to address the needs of the nursing workforce and staffing challenges, specifically in the intensive care unit setting.

Waitlist management in a pediatric weight management clinic: implementing an orientation session

Background This study evaluates implementation of an orientation session to address a waitlist of more than 2000 referrals to a pediatric weight management clinic in the Mid-South United States. Methods An hour-long group-based orientation to the pediatric weight management clinic was implemented to provide information about the structure and expectations of the clinic as well as education on healthy lifestyle recommendations. Families were contacted from the waitlist by telephone and invited to attend an orientation session prior to scheduling a clinic appointment. Results Of 2251 patients contacted from the waitlist, 768 scheduled an orientation session, of which 264 (34 %) attended. Of the 264 orientation participants, 246 (93 %) scheduled a clinic appointment. Of those, 193 (79 %) completed a clinic visit. Waitlist times decreased from 297.8 ± 219.4 days prior to implementation of orientation sessions to 104.1 ± 219.4 days after. Conclusions Orientation has been an effective and efficient way to triage patient referrals while maximizing attendance in limited clinic slots for patients and families demonstrating interest and motivation. Elements of this approach are likely generalizable to other pediatric clinical settings that must strategically manage a large volume of patient referrals.

Leveraging Orientation and Learning Transfer to Launch Capstone Consulting Projects

This orientation session was designed to prepare students for their final MBA Capstone project, leverage lessons learned from graduates, transfer prior learning about teams and project management, and launch consulting projects with actual clients. Companies have used orientation sessions to onboard new employees for many years to improve productivity and innovation. Comparatively, the use of student orientation sessions is an understudied area. Our exploratory survey of 68 Capstone students on the completion of their course indicates that they benefit from this session, and subsequently have demonstrated marked improvement in teamwork and client deliverables according to their professors. This article addresses the elements of the orientation session that can be replicated and implemented by other professors teaching similar courses. We recommend that future research continue to examine this pedagogy.

A Novel Approach to Training Monotony and Acute-Chronic Workload Index: A Comparative Study in Soccer

Load is a multifactorial construct, but usually reduced to parameters of volume and intensity. In the last decades, other constructs have been proposed for assessing load, but also relying on relationships between volume and intensity. For example, Foster's Training Monotony has been used in athletes' load management simply by computing mean weekly load divided by its standard deviation, often multiplied by session rate of perceived exertion. Meanwhile, the Acute to Chronic Workload Ratio (ACWR) has been debated by the sport scientists as a useful monitoring metric and related to so-called injury prevention. None of these models includes parameters that are representative of training specificity, namely load orientation. The aim of this study is to present broader conceptual approaches translated by new indices for assessing Intraweek Training Monotony (ITM) and Acute to Chronic Workload Index (ACWI) while incorporating load orientation, session duration and weekly density (frequency normalized) in addition to parameters related to proxies of external and/or internal load. Our ITM and Foster's Training Monotony were similar in terms of average values, but very different for individualized analysis, illustrating how average values may be deceiving. While Foster's model provided clusters of values, ITM provided more scattered, individualized data. ACWI and ACWR provided very distinct qualitative information, and the two models were uncorrelated. Therefore, the models incorporating training load orientation presented in this study provide distinct and not redundant information when compared to previous models. More importantly, ITM and ACWI are metrics that are compatible to each other and might fit to coaches' monitoring targets in the short and medium terms, respectively. Because our models include several parameters, including load orientation, we contend that might provide a more complete monitoring tool. However, we suggest they are used for intraindividual comparisons and not so strongly for interindividual comparisons.

Taking Responsibility for the Future

Although K–12 online education is becoming more common in the United States, there is still much we do not know about how K–12 online teachers are being prepared. Given that few teacher education programs include online pedagogy in their teacher training efforts, it becomes incumbent on states to find alternative ways to prepare teachers for virtual instruction. This chapter analyzes a nine-week orientation session that is part of an established, state-run induction program for prospective K–12 online instructors. Although the findings are specific to the program being studied, the authors believe they can serve as a model for educators in other states wishing to develop similar types of induction programs to meet the rising demand for K–12 online instruction in the United States.

Student Veterans: Does How We Welcome Them Matter?

The recent influx of veterans into higher education has caused an increase of dedicated services and programs. Educational success is contingent upon student involvement in their educational communities, and orientation plays an important role in facilitating this engagement. Using quasi-experimental research design, and Schlossberg’s constructs of mattering and marginality in higher education as a lens, this study sought to discover if student veterans experienced differing levels of mattering to their schools when categorized by the type of orientation they attended. Five hundred eighty-nine student veterans at 13 public universities within one Midwestern state completed the Unified Measure of University Mattering Instrument (France, 2011), and provided limited demographic information. Findings demonstrate that student veterans who experienced an orientation session which included a session designed exclusively for veterans demonstrated statistically significant higher scores in their perceived mattering to their school than student veterans who did not attend orientation. However, student veterans who attended standard orientation without veteran-specific content did not demonstrate statistically significant higher scores that those who did not attend orientation at all. Results indicate how small changes in traditional programs can have a significant impact on student veterans’ sense of mattering to their university.

The development and efficacy of an interdisciplinary chronic pelvic pain program

Introduction: Chronic pelvic pain (CPP) is a significant issue, and approximately 14% of women experience CPP once in their lifetime. While interdisciplinary pain management is considered the gold standard of treatment, few programs offer this type of treatment in Canada. The aims of this paper were to: 1) describe the development of an interdisciplinary CPP program; and 2) demonstrate changes in patient-related outcomes after attending an interdisciplinary CPP program. Methods: Referrals were received from community urologists and obstetricians/gynecologists, and pain physicians at the Michael G. DeGroote Pain Clinic. Patients attended an orientation session, completed an interdisciplinary assessment, and if appropriate attended an eight-day interdisciplinary CPP program. Each day consisted of group-based pelvic floor physiotherapy, psycho-education, goal-setting, cognitive behavioral therapy, and mindfulness. Psychometric questionnaires were completed pre- and post-program by patients, and paired sample t-tests were used to evaluate the changes in patient-related outcomes after attending the program. Results: Thirty-seven female patients completed the program, and results demonstrate that the CPP program was associated with significant improvements in impact of pelvic pain on quality of life, readiness for change, and pain-related self-efficacy, as well as decreases in pain catastrophizing and fear of pain/re-injury. Conclusions: CPP is a complex condition that requires interdisciplinary management and care. The results of this study demonstrate the short-term benefits of an interdisciplinary CPP program and highlight the unique needs of women with CPP and implicate multiple factors for programming and treatment.

Abstract 15660: Impact of Telemedicine on Pediatric Cardiac Center’s Ambulatory Response to the 2019 Novel Coronavirus Disease (covid-19) Pandemic

Background: The 2019 novel coronavirus disease (COVID-19) pandemic puts cardiology patients at high risk for worsening of their underlying disease due to a decrease in non-emergent outpatient visits and social distancing concerns. Our aim was to assess the impact of telemedicine on ambulatory cardiology. Our hypothesis was that telemedicine would bridge the drop in ambulatory visits thus allowing surveillance visits to continue. Methods: Retrospective study from 3/2 to 6/12/2020 utilizing an administrative ambulatory database. Weekly telemedicine and in-person visits were extracted from EMR schedules. A telemedicine orientation session and individualized in-service sessions were provided to all cardiology staff by an expert in telemedicine. Logistics of scheduling, consenting, conducting the visit, documenting and billing were reviewed. To maximize physical distancing, in-person visits were relocated to regional outpatient centers. Prior to COVID-19, 37 cardiologists and 2 nurse practitioners conducted an average of 350 ambulatory visits/week. Results: The number of providers conducting telemedicine visits increased from 3 (8%) pre-COVID-19 to 31 (79%) during the pandemic. Compared to pre-COVID average, the median (IQR) weekly total ambulatory visits during the pandemic was 62% (57-90%). During the COVID-19 pandemic, the median frequency of telemedicine visits was 18% (11-32%). (Figure 1) Conclusion: Ambulatory in-person cardiology visits decreased during the COVID-19 pandemic; however telemedicine visits partially compensated for this drop. At the height of stay-at-home orders, cardiology in-person outpatient visits decreased to 25%, but rapidly increased back up to 88% the usual in-person visit volume. Future study is needed to assess the impact on patient outcomes, family satisfaction, cost-effectiveness and revenue of telemedicine visits during the COVID-19 pandemic.