Presentation to review and define the concept of organizational context, present research on context and the relationship to healthcare associated infections, review the practice of mindfulness, discuss a role of mindfulness in patient safety.
LRI05 - Self Help for Distress in Cancer - Is It Time For An RCT [Oct 2005]Alex J Mitchell
This is an academic presentation from 2005 outlining the case for a randomized controlled trial of a self-help programme to help people deal with distress and depression following the diagnosis of cancer
Efficacy Of Meditation In The Management Of Anxietydburr
This document summarizes a research study on the efficacy of meditation for treating anxiety disorders. The study reviewed 11 research studies on meditation and anxiety. It found that mindfulness meditation was effective for preventing acute anxiety attacks and maintaining long-term management of anxiety. Meditation improved quality of life by reducing symptoms, improving relationships, and decreasing reliance on healthcare services. Regular meditation practice facilitated anxiety reduction and improved psychological outcomes.
Acceptance and Commitment Therapy as a Web-based Intervention for Depressive ...Tejas Shah
To compare the efficacy of a guided web-based intervention based on acceptance and commitment therapy (ACT) with an active control (expressive writing) and a waiting-list control
condition.
MINDFULGym: 7 Mindful Habits for Behavioral Therapists Self-CarePhang Kar
This document discusses mindfulness and mindfulness-based therapies. It begins by defining mindfulness as paying attention to the present moment with kindness, an open mind, and wisdom. It then discusses how mindfulness was introduced into medicine by Jon Kabat-Zinn in the 1970s through mindfulness-based stress reduction programs. Several mindfulness-based therapies are described, including MBCT and DBT. Research findings on the effectiveness of mindfulness-based therapy in reducing anxiety, depression, and stress are summarized. The document also provides examples of mindfulness training programs for healthcare professionals and describes habits to incorporate mindfulness into one's daily life and work.
psychosocial intervention for children and adolescents with depressionpraful kapse
Psychosocial intervention is an approach that acknowledges the psychological and social factors that influence an individual's well-being. It includes psychoeducation, cognitive and behavioral strategies, social skills training, sleep hygiene, interpersonal therapy, and group therapy. A case study describes a 12-year-old boy presenting with depression who was assessed and received cognitive behavioral therapy targeting negative thoughts, as well as social skills training and group therapy. Research shows cognitive behavioral therapy can have immediate and long-term positive effects on reducing depressive symptoms.
1) The document discusses the use of psychosocial interventions (PSI) for patients with severe mental illness, including techniques from cognitive behavioral therapy.
2) It presents a case study of a patient named Andrea who was admitted to an acute psychiatric ward and describes how staff overcame obstacles to engage Andrea and her family using PSI approaches.
3) Key aspects of the PSI used included flexible time for the nurse to build rapport with Andrea, assessing her symptoms and medication side effects, involving her family by addressing needs and devising a crisis plan, and explaining the stress vulnerability model to provide support and communication.
Cognitive behavioral therapy can help treat depression in patients with congestive heart failure. Up to 60% of heart failure patients experience some level of depression. An interdisciplinary team approach is needed to properly treat both the physical and mental health aspects of patients. This includes cardiologists, psychiatrists, psychologists, nurses, and others. Cognitive behavioral therapy focuses on changing negative thoughts and behaviors to improve coping skills and reduce depression symptoms. Studies show this therapy can be effective for heart failure patients with depression, improving quality of life and reducing hospitalizations.
Efficacy of Interpersonal Psychotherapy for Postpartum Depression. (O'hara et...Sharon
This study evaluated the efficacy of interpersonal psychotherapy (IPT) for treating postpartum depression. 120 women meeting criteria for major depression were randomly assigned to receive either 12 weeks of IPT or be in a waiting list control group. Women receiving IPT showed significantly greater reductions in depressive symptoms and higher recovery rates compared to the control group based on standardized depression scales. IPT was found to be an effective treatment for postpartum depression that could serve as an alternative to antidepressant medication.
LRI05 - Self Help for Distress in Cancer - Is It Time For An RCT [Oct 2005]Alex J Mitchell
This is an academic presentation from 2005 outlining the case for a randomized controlled trial of a self-help programme to help people deal with distress and depression following the diagnosis of cancer
Efficacy Of Meditation In The Management Of Anxietydburr
This document summarizes a research study on the efficacy of meditation for treating anxiety disorders. The study reviewed 11 research studies on meditation and anxiety. It found that mindfulness meditation was effective for preventing acute anxiety attacks and maintaining long-term management of anxiety. Meditation improved quality of life by reducing symptoms, improving relationships, and decreasing reliance on healthcare services. Regular meditation practice facilitated anxiety reduction and improved psychological outcomes.
Acceptance and Commitment Therapy as a Web-based Intervention for Depressive ...Tejas Shah
To compare the efficacy of a guided web-based intervention based on acceptance and commitment therapy (ACT) with an active control (expressive writing) and a waiting-list control
condition.
MINDFULGym: 7 Mindful Habits for Behavioral Therapists Self-CarePhang Kar
This document discusses mindfulness and mindfulness-based therapies. It begins by defining mindfulness as paying attention to the present moment with kindness, an open mind, and wisdom. It then discusses how mindfulness was introduced into medicine by Jon Kabat-Zinn in the 1970s through mindfulness-based stress reduction programs. Several mindfulness-based therapies are described, including MBCT and DBT. Research findings on the effectiveness of mindfulness-based therapy in reducing anxiety, depression, and stress are summarized. The document also provides examples of mindfulness training programs for healthcare professionals and describes habits to incorporate mindfulness into one's daily life and work.
psychosocial intervention for children and adolescents with depressionpraful kapse
Psychosocial intervention is an approach that acknowledges the psychological and social factors that influence an individual's well-being. It includes psychoeducation, cognitive and behavioral strategies, social skills training, sleep hygiene, interpersonal therapy, and group therapy. A case study describes a 12-year-old boy presenting with depression who was assessed and received cognitive behavioral therapy targeting negative thoughts, as well as social skills training and group therapy. Research shows cognitive behavioral therapy can have immediate and long-term positive effects on reducing depressive symptoms.
1) The document discusses the use of psychosocial interventions (PSI) for patients with severe mental illness, including techniques from cognitive behavioral therapy.
2) It presents a case study of a patient named Andrea who was admitted to an acute psychiatric ward and describes how staff overcame obstacles to engage Andrea and her family using PSI approaches.
3) Key aspects of the PSI used included flexible time for the nurse to build rapport with Andrea, assessing her symptoms and medication side effects, involving her family by addressing needs and devising a crisis plan, and explaining the stress vulnerability model to provide support and communication.
Cognitive behavioral therapy can help treat depression in patients with congestive heart failure. Up to 60% of heart failure patients experience some level of depression. An interdisciplinary team approach is needed to properly treat both the physical and mental health aspects of patients. This includes cardiologists, psychiatrists, psychologists, nurses, and others. Cognitive behavioral therapy focuses on changing negative thoughts and behaviors to improve coping skills and reduce depression symptoms. Studies show this therapy can be effective for heart failure patients with depression, improving quality of life and reducing hospitalizations.
Efficacy of Interpersonal Psychotherapy for Postpartum Depression. (O'hara et...Sharon
This study evaluated the efficacy of interpersonal psychotherapy (IPT) for treating postpartum depression. 120 women meeting criteria for major depression were randomly assigned to receive either 12 weeks of IPT or be in a waiting list control group. Women receiving IPT showed significantly greater reductions in depressive symptoms and higher recovery rates compared to the control group based on standardized depression scales. IPT was found to be an effective treatment for postpartum depression that could serve as an alternative to antidepressant medication.
This document summarizes a bio-psycho-social assessment of Doc Wayne, a non-profit organization that uses sports to help at-risk youth. It evaluated 53 youth participants using self-reports, computerized games, and physiological measurements. Results found improvements in emotion regulation, social cognition, and stress levels compared to controls, with larger effects for multi-season participants. While some outcomes improved quickly, others emerged more slowly. The effect sizes were consistent with individual psychotherapies. The assessment concluded that sports can serve as an effective therapeutic intervention for youth.
Therapeutic Touch is a non-contact healing technique developed in the 1970s involving the channeling of healing energy through a practitioner's hands into a client's body to restore energy balance and health. The document discusses Therapeutic Touch's psychological and physiological benefits such as reduced anxiety, stress, and pain. It also explores Therapeutic Touch's value in improving patient outcomes like response to treatment, infection risk, immune function, and hospital length of stay. The document notes barriers to Therapeutic Touch's implementation include a lack of awareness in Western medicine and difficulties measuring its effects scientifically.
- The document discusses current evidence and perspectives on mind-body approaches to healing cancer and improving health outcomes. It explores how consciousness and the mind can influence physiology, stress, pain perception, and depression.
- Several mind-body interventions like cognitive therapy, meditation, biofeedback, hypnosis, and yoga have evidence for improving quality of life in cancer patients and treating other conditions. However, clinical studies have been inconsistent on whether they provide overall survival benefits.
- A comprehensive mind-body approach that addresses both conscious and subconscious aspects of healing may be needed to fully realize health benefits, though more research is still required to understand these relationships.
Overview of international challenges faced by psychiatrists through their practice
Collaborative work of:
1-Dr Yomna Gaber Senior Registrar Psychiatrist
2- Dr Hosam Kasseb Senior Registrar Psychiatrist
3-Dr Wasem Marey Consultant Psychiatrist
The document discusses recovery from mental illness, specifically schizophrenia. It provides statistics on the prevalence and outcomes of schizophrenia. Despite advances in treatment, outcomes have not significantly improved, with only 13.5% meeting recovery criteria. The recovery program described aims to facilitate personal growth and transformation beyond acute symptoms through a collaborative, strengths-based approach focused on self-directed goal setting. It emphasizes hope, well-being, social inclusion and meaning rather than just treating illness. One patient's story of improving life through the program is shared.
A level psychology and health lecture 2014.1Ben Vel
The document outlines the structure and modules of a psychology and health syllabus, including modules on the patient-practitioner relationship, adherence to medical advice, pain, stress, health promotion, and health and safety. The modules cover topics such as communication skills, diagnosis and medical style, errors in diagnosis, using and misusing medical services, and specific issues related to each health topic. Examples of relevant studies are provided for each topic area to illustrate the issues.
This document discusses work-life balance, burnout, and wellness among physicians. It begins by defining key terms like burnout, work-life balance, and wellness. It then discusses the high prevalence of burnout and work-life dissatisfaction among physicians compared to the general population. Some consequences of physician distress include medical errors, poorer patient outcomes, and reduced workforce. The document considers tensions between a culture that values productivity and the need for self-care. It provides strategies for building resilience through stress management, prioritizing wellness, developing social support, and creating a culture that supports physician well-being.
This randomized clinical trial compared the effectiveness of mindfulness-based stress reduction (MBSR), cognitive behavioral therapy (CBT), and usual care for treating chronic low back pain. 342 adults with chronic low back pain were randomly assigned to receive MBSR, CBT, or usual care. At 26 weeks, participants receiving MBSR or CBT reported significantly greater improvement in back pain and functional limitations compared to usual care. There were no significant differences in outcomes between MBSR and CBT. These findings suggest that MBSR may be an effective treatment option for chronic low back pain.
Nurses play an essential role in health assessment to identify client needs and strengths. Health assessment involves systematically collecting subjective and objective data through various methods like observation, interviews, and examinations. This data is then organized, validated, documented, and reported. Accurate assessment reflects the nurse's clinical knowledge and skills and forms the foundation for quality nursing care and intervention.
The Mindfulness Based Program for Infertility (MBPI) aims to reduce depression in infertile women. The study found that after completing the 10-week MBPI, which included mindfulness training, women reported significant increases in self-efficacy in dealing with infertility and significant decreases in depressive symptoms. A mediation analysis showed that increased self-efficacy mediated the effect of the MBPI in reducing depressive symptoms. The MBPI helps reduce depression by improving women's confidence in their cognitive, emotional, and behavioral skills for managing infertility.
Deterioration in Psychotherapy: A Summary of Research by Jorgen FlorScott Miller
This study explored how 10 Norwegian psychologists think about patient deterioration in psychotherapy. The psychologists showed a lack of common terminology around deterioration and underestimated its occurrence. They received little education on deterioration and felt uncomfortable discussing it. The study highlights the lack of awareness around negative outcomes in education and practice. It aims to provide a better basis for quantitative research on how deterioration is interpreted.
Recent studies demonstrate the effectiveness of understanding how and why pain is generated, and why it sometimes persists long after it protective effect has passed. We have combined an educational program with mindfulness exercises and skills training to help individuals develop their own recovery plan
This study examined characteristics of cancer patients interested in bibliotherapy and their motivation and adherence to a self-help program. The majority of participants were female, over 50 years old, and had education beyond high school. Participants had various cancer types and stages. They reported high autonomous motivation to engage in the program and over half had clinically significant psychological distress. Participants completed on average 80% of the workbook and spent 57 minutes weekly engaging with it. Those with more depressive symptoms spent less time reading. Motivation was unrelated to adherence measures but wanting responsibility for well-being related to seeking social support. The findings support bibliotherapy as an intervention option for a broad range of cancer patients.
This document discusses stress, its causes and effects. It defines stress as a state of imbalance resulting from a disparity between situational demands and an individual's ability to meet those demands. Stress can be caused by external factors like the environment or internal factors like lifestyle choices. The general adaptation syndrome describes the body's three stage response to stress. When a person experiences stress, they may exhibit physical or emotional symptoms. Managing stress involves identifying stressors, selecting coping strategies like exercise, nutrition, and social support. The document also examines stress among students and nurses, finding that academic factors are a primary stressor for students while long hours and lack of support contribute to stress in nurses.
This document discusses the nursing diagnosis process. It begins by introducing nursing diagnosis as the second phase of the nursing process and a pivotal step. It then discusses NANDA's role in developing standardized nursing diagnoses and taxonomy. The document outlines the 13 domains of nursing diagnosis and characteristics such as being clear, evidence-based, and amenable to nursing intervention. It describes different types of diagnoses and provides examples. Finally, it discusses formulating diagnostic statements, including one, two and three part statements, and qualities of accurate diagnostic statements.
Clinical reasoning and patient centered care in physiotherapyzualias
This document discusses clinical reasoning and patient-centered care in physiotherapy. It defines clinical reasoning as the process physiotherapists use to collect and evaluate patient data to make judgments about diagnosis and treatment. Patient-centered care actively involves patients in decisions about their care. The document also outlines the components of documentation for patient care, including subjective assessment, objective assessment, analysis, plan, intervention, evaluation and review. Thorough documentation is important for legal protection, communication between healthcare providers, and ensuring quality patient care.
This document summarizes and critiques research on psychoneuroimmunology (PNI) and claims that psychological factors can influence cancer outcomes. It finds that PNI research often relies on weak study designs, ignores negative findings, and overstates small or insignificant positive results. Better designed studies find little evidence that stress influences cancer or that psychosocial interventions impact survival time. The document cautions against overinterpreting immune system changes without considering the system's complexity.
Assessing and reporting outcomes that are important to patients in trials and...cmaverga
The document discusses the importance of including patient-reported outcomes (PROs) in clinical trials and Cochrane reviews. PROs are any reports coming directly from patients about how they function or feel in relation to their health condition or treatment, without interpretation by clinicians. It is important to include PROs because they capture effects only known to patients, like symptoms, function, and feelings. The document provides examples of PROs being incorporated into Cochrane reviews and identifies some of the methodological challenges in doing so.
This document summarizes a bio-psycho-social assessment of Doc Wayne, a non-profit organization that uses sports to help at-risk youth. It evaluated 53 youth participants using self-reports, computerized games, and physiological measurements. Results found improvements in emotion regulation, social cognition, and stress levels compared to controls, with larger effects for multi-season participants. While some outcomes improved quickly, others emerged more slowly. The effect sizes were consistent with individual psychotherapies. The assessment concluded that sports can serve as an effective therapeutic intervention for youth.
Therapeutic Touch is a non-contact healing technique developed in the 1970s involving the channeling of healing energy through a practitioner's hands into a client's body to restore energy balance and health. The document discusses Therapeutic Touch's psychological and physiological benefits such as reduced anxiety, stress, and pain. It also explores Therapeutic Touch's value in improving patient outcomes like response to treatment, infection risk, immune function, and hospital length of stay. The document notes barriers to Therapeutic Touch's implementation include a lack of awareness in Western medicine and difficulties measuring its effects scientifically.
- The document discusses current evidence and perspectives on mind-body approaches to healing cancer and improving health outcomes. It explores how consciousness and the mind can influence physiology, stress, pain perception, and depression.
- Several mind-body interventions like cognitive therapy, meditation, biofeedback, hypnosis, and yoga have evidence for improving quality of life in cancer patients and treating other conditions. However, clinical studies have been inconsistent on whether they provide overall survival benefits.
- A comprehensive mind-body approach that addresses both conscious and subconscious aspects of healing may be needed to fully realize health benefits, though more research is still required to understand these relationships.
Overview of international challenges faced by psychiatrists through their practice
Collaborative work of:
1-Dr Yomna Gaber Senior Registrar Psychiatrist
2- Dr Hosam Kasseb Senior Registrar Psychiatrist
3-Dr Wasem Marey Consultant Psychiatrist
The document discusses recovery from mental illness, specifically schizophrenia. It provides statistics on the prevalence and outcomes of schizophrenia. Despite advances in treatment, outcomes have not significantly improved, with only 13.5% meeting recovery criteria. The recovery program described aims to facilitate personal growth and transformation beyond acute symptoms through a collaborative, strengths-based approach focused on self-directed goal setting. It emphasizes hope, well-being, social inclusion and meaning rather than just treating illness. One patient's story of improving life through the program is shared.
A level psychology and health lecture 2014.1Ben Vel
The document outlines the structure and modules of a psychology and health syllabus, including modules on the patient-practitioner relationship, adherence to medical advice, pain, stress, health promotion, and health and safety. The modules cover topics such as communication skills, diagnosis and medical style, errors in diagnosis, using and misusing medical services, and specific issues related to each health topic. Examples of relevant studies are provided for each topic area to illustrate the issues.
This document discusses work-life balance, burnout, and wellness among physicians. It begins by defining key terms like burnout, work-life balance, and wellness. It then discusses the high prevalence of burnout and work-life dissatisfaction among physicians compared to the general population. Some consequences of physician distress include medical errors, poorer patient outcomes, and reduced workforce. The document considers tensions between a culture that values productivity and the need for self-care. It provides strategies for building resilience through stress management, prioritizing wellness, developing social support, and creating a culture that supports physician well-being.
This randomized clinical trial compared the effectiveness of mindfulness-based stress reduction (MBSR), cognitive behavioral therapy (CBT), and usual care for treating chronic low back pain. 342 adults with chronic low back pain were randomly assigned to receive MBSR, CBT, or usual care. At 26 weeks, participants receiving MBSR or CBT reported significantly greater improvement in back pain and functional limitations compared to usual care. There were no significant differences in outcomes between MBSR and CBT. These findings suggest that MBSR may be an effective treatment option for chronic low back pain.
Nurses play an essential role in health assessment to identify client needs and strengths. Health assessment involves systematically collecting subjective and objective data through various methods like observation, interviews, and examinations. This data is then organized, validated, documented, and reported. Accurate assessment reflects the nurse's clinical knowledge and skills and forms the foundation for quality nursing care and intervention.
The Mindfulness Based Program for Infertility (MBPI) aims to reduce depression in infertile women. The study found that after completing the 10-week MBPI, which included mindfulness training, women reported significant increases in self-efficacy in dealing with infertility and significant decreases in depressive symptoms. A mediation analysis showed that increased self-efficacy mediated the effect of the MBPI in reducing depressive symptoms. The MBPI helps reduce depression by improving women's confidence in their cognitive, emotional, and behavioral skills for managing infertility.
Deterioration in Psychotherapy: A Summary of Research by Jorgen FlorScott Miller
This study explored how 10 Norwegian psychologists think about patient deterioration in psychotherapy. The psychologists showed a lack of common terminology around deterioration and underestimated its occurrence. They received little education on deterioration and felt uncomfortable discussing it. The study highlights the lack of awareness around negative outcomes in education and practice. It aims to provide a better basis for quantitative research on how deterioration is interpreted.
Recent studies demonstrate the effectiveness of understanding how and why pain is generated, and why it sometimes persists long after it protective effect has passed. We have combined an educational program with mindfulness exercises and skills training to help individuals develop their own recovery plan
This study examined characteristics of cancer patients interested in bibliotherapy and their motivation and adherence to a self-help program. The majority of participants were female, over 50 years old, and had education beyond high school. Participants had various cancer types and stages. They reported high autonomous motivation to engage in the program and over half had clinically significant psychological distress. Participants completed on average 80% of the workbook and spent 57 minutes weekly engaging with it. Those with more depressive symptoms spent less time reading. Motivation was unrelated to adherence measures but wanting responsibility for well-being related to seeking social support. The findings support bibliotherapy as an intervention option for a broad range of cancer patients.
This document discusses stress, its causes and effects. It defines stress as a state of imbalance resulting from a disparity between situational demands and an individual's ability to meet those demands. Stress can be caused by external factors like the environment or internal factors like lifestyle choices. The general adaptation syndrome describes the body's three stage response to stress. When a person experiences stress, they may exhibit physical or emotional symptoms. Managing stress involves identifying stressors, selecting coping strategies like exercise, nutrition, and social support. The document also examines stress among students and nurses, finding that academic factors are a primary stressor for students while long hours and lack of support contribute to stress in nurses.
This document discusses the nursing diagnosis process. It begins by introducing nursing diagnosis as the second phase of the nursing process and a pivotal step. It then discusses NANDA's role in developing standardized nursing diagnoses and taxonomy. The document outlines the 13 domains of nursing diagnosis and characteristics such as being clear, evidence-based, and amenable to nursing intervention. It describes different types of diagnoses and provides examples. Finally, it discusses formulating diagnostic statements, including one, two and three part statements, and qualities of accurate diagnostic statements.
Clinical reasoning and patient centered care in physiotherapyzualias
This document discusses clinical reasoning and patient-centered care in physiotherapy. It defines clinical reasoning as the process physiotherapists use to collect and evaluate patient data to make judgments about diagnosis and treatment. Patient-centered care actively involves patients in decisions about their care. The document also outlines the components of documentation for patient care, including subjective assessment, objective assessment, analysis, plan, intervention, evaluation and review. Thorough documentation is important for legal protection, communication between healthcare providers, and ensuring quality patient care.
This document summarizes and critiques research on psychoneuroimmunology (PNI) and claims that psychological factors can influence cancer outcomes. It finds that PNI research often relies on weak study designs, ignores negative findings, and overstates small or insignificant positive results. Better designed studies find little evidence that stress influences cancer or that psychosocial interventions impact survival time. The document cautions against overinterpreting immune system changes without considering the system's complexity.
Assessing and reporting outcomes that are important to patients in trials and...cmaverga
The document discusses the importance of including patient-reported outcomes (PROs) in clinical trials and Cochrane reviews. PROs are any reports coming directly from patients about how they function or feel in relation to their health condition or treatment, without interpretation by clinicians. It is important to include PROs because they capture effects only known to patients, like symptoms, function, and feelings. The document provides examples of PROs being incorporated into Cochrane reviews and identifies some of the methodological challenges in doing so.
HXR 2016: FAST TRACK: Prove It: The role of Evidence and Insights in Health I...HxRefactored
Using evidence and insights during the post-intervention phase allows for:
1) Evaluating the impact of the intervention by measuring changes in determinants, behaviors, and health outcomes.
2) Iteratively improving the intervention design based on lessons learned.
3) Determining if the intervention worked as intended and should be continued, modified, or discontinued.
The document summarizes a study that investigated the quality of life, spirituality, and social support among 25 caregivers of cancer patients compared to a control group of 25 individuals. Key findings included:
- Caregivers reported significantly lower psychological well-being and environmental quality of life than the control group.
- Caregivers reported significantly higher levels of spirituality and perceived social support compared to the control group.
- There was no significant difference between caregivers and the control group in terms of physical well-being.
Quality Of Life, Spirituality and Social Support among Caregivers of Cancer P...iosrjce
Caregiving can be both rewarding and challenging. Literature suggests that family caregivers may
experience increased symptoms of psychological and social malfunctioning. However, it may also provide one
with opportunities to renew relationships or feel connected to a higher power. The current study is an attempt to
investigate how caregiving influences a person’s general wellbeing. The sample consisted of 25 caregivers of
cancer patients and 25 appropriately matched control.World Health Organization- QOL (1991),
Multidimensional Scale of Perceived Social Support by Zimet, et al (1988) and Spiritual Perspective Scale by
Reed (1986) were used to asses QOL, Social support and spirituality respectively. The obtained data was
analyzed in SPSS using independent sample t-test. Results indicated a significant difference between Caregivers
and the control group on QOL, spirituality and social support.
This document summarizes research on strategies for integrating mental health care into primary care practices. It finds that screening patients for mental health issues alone is not effective and does not change outcomes. The most effective strategy found is collaborative care, which involves primary care providers, case managers with mental health backgrounds, and supervision from mental health professionals. However, more research is still needed to identify best practices and overcome financial barriers to fully integrating services.
Individuals have significant power over their own health and well-being, more so than doctors, hospitals, or medications. According to the US Department of Health, Education, and Welfare, lifestyle choices like diet, exercise, and avoiding risky behaviors can substantially reduce the leading causes of death in a country. Individual health is influenced at least as much by personal decisions and behaviors as by clinical care.
Running head PROJECT MILESTONE TWO 1.PROJECT MILESTONE.docxtodd581
Running head: PROJECT MILESTONE TWO
1.
PROJECT MILESTONE TWO
6.
Running head: FINAL PROJECT MILESTONE
3.
Southern New Hampshire University
January 6th, 2019
Research question: “Does self-disclosure of the therapist improve eating disorder treatment.”
Hypothesis: Self-disclosure of the therapist improves eating disorder treatment.
Information On Research
The key variables for this research are self-disclosure of the therapist and eating disorder treatment. This research will focus on online research whereby participants will be recruited from an eating disorder charity database. The participants will be asked about the status of their condition and how they feel about having the disorder. The neutral condition will be that the therapists will disclose their sexuality and their feelings towards the patients’ conditions and personality (Marziliano, Pessin, Rosenfeld, & Breitbart, 2018).
Process of Study
The study will continue for two months with the therapists making contact with the participants once every week. These conditions will form the independent variables. The dependent variable would be participants continued to receive positive self-disclosures from the therapist leading to a greater level of patient self-disclosure, which lowered their shame, and encouraged the participants to continue with the treatment process. The participants will also be asked if they have been involved in any treatment before, and how they could describe their therapeutic alliance (Fuertes, Moore, & Ganley, 2018).
A longitudinal study and the rate of drop-out will be used to gather more information about the participants. The collected data will then be analyzed in relation to the independent variables by the end of the study. One of the ethical issues, which will be looked into while conducting the study, is informed consent. Participants will be informed about the purpose of the research and will have the right to participate or not participate in it. Secondly, the research will ensure the privacy and confidentiality of every participant.
Annotated Bibliography:
Secrecy and concealment are typical behaviors in individuals with eating problems. In the article titled “ Self-Disclosure in eating disorders,” researchers examined women with greater related eating issues and determined whether or not, these women would be willing to disclose information. In this study, different types of disclosure were calculated considering the body appearance of the individual and to restrained eating. This article would benefit my research because it provides great information that will confirm my theory and test my hypothesis.
Abstract 1.
Those who suffer from eating disorders are very emotional beings. Often times, some may not feel a need to express their need to not eat foods. Many women become self-conscious about their weight and find it hard to share th.
This document provides information on chronic illness in adolescents including:
- Chronic illnesses are long-lasting health conditions that impact physical, mental, and social well-being. Examples include asthma, cancer, diabetes, and heart disease.
- Approximately 20-30% of adolescents in the US have a chronic illness, with 10-13% reporting substantial limitations. Depression and non-adherence to treatment plans are common issues.
- Several assessment tools are recommended to evaluate an adolescent's medical history, illness impact, depression, anxiety, quality of life, and treatment adherence.
- Suggested intervention strategies include cognitive behavioral therapy to challenge irrational thoughts and beliefs, develop coping skills, and improve treatment adherence.
The lecture I gave for the Indiana University Health Joint Transplant Education and Research Lecture Series on palliative care. That's right, palliative care in transplant patients NOT at the end-of-life.
Anna Ratzliff, MD, PhD, Associate Director for Education, Division of Integrated Care & Public Health Department of Psychiatry & Behavioral Sciences, University of Washington
Latino Health Forum 2014
Anna Ratzliff, MD, PhD, Associate Director for Education, Division of Integrated Care & Public Health Department of Psychiatry & Behavioral Sciences, University of Washington
This document summarizes a study that explored the experiential process of Healing Touch therapy for people with moderate depression. The study used grounded theory and case study methodology. Through grounded theory analysis, the study uncovered four stages in the process of emerging from depression: 1) believing in the practitioner, self, and future self; 2) integrating all aspects of self; 3) accessing inner strength and resources; and 4) engaging with life. Case studies of individual participants supported these stages and showed trajectories of each person's experience over time. The study provides insight into how Healing Touch may help people emerge from a state of disconnection associated with depression.
This document summarizes a study that explored the experiential process of Healing Touch therapy for people with moderate depression. The study used grounded theory and case study methodology. Through grounded theory analysis, the study uncovered four stages in the process of emerging from depression: 1) believing in the practitioner, self, and future self; 2) integrating all aspects of self; 3) accessing inner strength and resources; and 4) engaging with life. Case studies of individual participants supported these stages and showed trajectories of each person's experience over time. The study provides insight into how Healing Touch may help people emerge from a state of disconnection associated with depression.
This document summarizes a study that explored the experiential process of Healing Touch therapy for people with moderate depression. The study used grounded theory and case study methodology. Through grounded theory analysis, the study uncovered four stages in the process of emerging from depression: 1) believing in the practitioner, self, and future self; 2) integrating all aspects of self; 3) accessing inner strength and resources; and 4) engaging with life. Case studies of individual participants supported these stages and showed reductions in depression scores after Healing Touch therapy. The study provides insight into how energy-based therapies like Healing Touch may help treat depression.
Protection of human subjects,Phenomenon ,Methodology,Study design,Theoretical model,Significance of the study,Research problem,
WHAT IS THE IMPACT OF COMFORT CARE VERSES ALTERNATIVE CARE FOR THE CHRONIC DYING PATIENT FAMILY AND THE HEALTH CARE TEAM
A Problem Solving Intervention for hospice caregivers a pilot study.pdfSabrina Ball
This pilot study tested a Problem Solving Intervention (PSI) with 29 informal caregivers of hospice patients to improve their coping and problem-solving skills. PSI is a structured, cognitive-behavioral intervention that teaches problem definition, alternative generation, decision making, and solution implementation. After completing three PSI sessions, caregivers reported lower anxiety, better problem solving skills, and feeling less negatively impacted by caregiving. They also perceived PSI as helpful for discussing challenges and developing plans to address them. The study provides preliminary evidence that a problem-solving approach may benefit hospice caregivers and warrants further research.
This document describes collaborative therapeutic neuropsychological assessment (CTNA), a method for providing client-centered feedback on neuropsychological test results. CTNA was developed based on therapeutic assessment and individualized assessment approaches. It uses a framework based on motivational interviewing principles. The basic CTNA process involves an initial interview, neuropsychological testing, and a feedback session where test results are discussed collaboratively. Interpersonal skills like empathy, open-ended questions, affirmations and summaries are emphasized. Outcome studies have looked at the psychological and clinical benefits of CTNA feedback. The document discusses applications of CTNA and lessons learned from using this approach in clinical practice.
The document discusses best practices for effective family meetings in medical ethics situations. It provides an overview of ethics and preventive ethics, reviews literature on the benefits of family meetings, and outlines a 10-step approach to structuring an effective family meeting based on lessons from the literature. The 10 steps include preparation, introducing participants and purpose, assessing family understanding, summarizing and educating the family, discussing prognosis and goals of care, addressing emotions, making a plan, follow up, and closure.
Similar to Organizational Contex and Patient Safety: Is there a Role for Mindfulness? (20)
Unlocking the Secrets to Safe Patient Handling.pdfLift Ability
Furthermore, the time constraints and workload in healthcare settings can make it challenging for caregivers to prioritise safe patient handling Australia practices, leading to shortcuts and increased risks.
R3 Stem Cell Therapy: A New Hope for Women with Ovarian FailureR3 Stem Cell
Discover the groundbreaking advancements in stem cell therapy by R3 Stem Cell, offering new hope for women with ovarian failure. This innovative treatment aims to restore ovarian function, improve fertility, and enhance overall well-being, revolutionizing reproductive health for women worldwide.
Comprehensive Rainy Season Advisory: Safety and Preparedness Tips.pdfDr Rachana Gujar
The "Comprehensive Rainy Season Advisory: Safety and Preparedness Tips" offers essential guidance for navigating rainy weather conditions. It covers strategies for staying safe during storms, flood prevention measures, and advice on preparing for inclement weather. This advisory aims to ensure individuals are equipped with the knowledge and resources to handle the challenges of the rainy season effectively, emphasizing safety, preparedness, and resilience.
Letter to MREC - application to conduct studyAzreen Aj
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Organizational Contex and Patient Safety: Is there a Role for Mindfulness?
1. Organizational Context and
Patient Safety:
Is There a Role for Mindfulness
Heather M. Gilmartin, PhD, NP
Post-doctoral Nurse Fellow
Denver-Seattle Center of Innovation
Department of Veterans Affairs
October 9, 2015
1
2. Disclaimer & Conflicts of
Interest
Disclaimer:
The contents of this presentation do not represent
the views of the Department of Veterans Affairs or
the United States Government.
Conflicts of Interest:
None
2
3. Goals
• Review and define the concept of organizational
context
• Present research on context and the relationship
to healthcare-associated infections
• Review the practice of mindfulness
• Discuss a role for mindfulness in patient safety
3
6. Does a proven patient safety
program vary in its’ effectiveness
in different contexts?
If so, how and why?
Shekelle PG, Pronovost PJ, Wachter RM, et al. Assessing the evidence for context-sensitive
effectiveness and safety of patient safety practices: Developing criteria. Rockville, MD: Agency
for Healthcare Research and Quality; 2010. Prepared under Contract No. HHSA-290-2009-
10001C.
6
7. Translating Infection Prevention Evidence to Enhance
Patient Safety
Sarah L. Krein, PhD, RN et al. (2004-2008)
• Examined how complex organizational and contextual
factors either facilitated or hindered the adoption and
effective implementation of evidence-based practices
• Results:
o Prevalence rates for prevention practices:
• Central line-associated bloodstream infections (CLABSI) (Krein et al., 2007)
• Catheter-related urinary tract infections (Saint et al.,2008)
• Ventilator-associated pneumonia infections (Krein, et al., 2008)
o Benefit of “champions” and financial incentives (Damschroder et al., 2009)
o Role of collaborative programs (Krein et al., 2008)
o Priority of interventions in organization (Saint et al., 2008)
o Debate about evidence supporting interventions (Saint et al., 2008)
o Role of leadership (Saint et al., 2010)
o Role of organizational context (Krein et al, 2010)
7
8. The Quality Health Outcomes Model
Client
Context
Intervention Outcome
Mitchell, P. H., Ferketich, S., & Jennings, B. M. (1998). Quality health
outcomes model. Image - the Journal of Nursing Scholarship, 30(1), 43-46.
(with permission)
8
9. Organizational Context and HAIs:
Testing the Quality Health Outcomes Model
Heather Gilmartin, PhD, NP, CIC et al. (2014)
• Data Source:
o Prevention of Nosocomial Infection and Cost-Effectiveness Refined
(PNICER) Study (Stone et al., 2014)
• Objective:
o Test a middle-range theoretical model to explain the relationships
between:
• Adherence to central line bundle interventions
• Organizational context
• CLABSI outcomes
• Methods:
o Secondary data analysis
o Exploratory/confirmatory factor analysis
o Structural equation modeling
o 614 U.S. hospitals in 2011
9
11. The Role of Organizational Context on Adherence
to HAI Bundle Practices and HAI Outcomes
Post-doctoral Project
• Data Source:
o VHA All-employee Survey and Inpatient Evaluation Center data
• Objectives:
o Explore the relationships between:
• Aspects of organizational context
• Adherence to central line bundle interventions
• CLABSI outcomes
o Adjusted for patient severity
• Methods:
o Secondary data analysis
o Exploratory/confirmatory factor analysis
o Mediation models
o 120 ICUs per year - 2008-2011
11
12. Patient Weighted
Case Severity Index
(ICU level)
Organizational
Context
CL Bundle
Intervention
CLABSI Outcomes
Hand Hygiene
2% CHG
Max Barrier
Optimal Site
Organizational
Climate
Organizational
Culture
Work
Environment
Structural
Characteristics
AES Culture
Survey
AES Job
Satisfaction
AES OAI Facility
Complexity Level
30-day Standard
Mortality Ratio
AES: All Employee Survey
CHG: Chlorhexidine Gluconate
The Quality Health Outcomes Model Applied to
Infection Prevention in the VA
12
16. Paying attention in a particular way, on
purpose, in the present moment, and
non-judgmentally.
Kabat-Zinn J. Full catastrophe living: Using the wisdom of your body and mind to
face stress, pain, and illness. New York: Random House; 1991.
16
17. A mindful practitioner attends, in a
nonjudgmental way, to his or her own
physical and mental processes during
ordinary everyday tasks to act with
clarity and insight.
Epstein RM. Mindful practice. JAMA. 1999;282(9):833-839
17
18. Mindfulness is attending to the
ordinary, the obvious, and the present.
Epstein RM. Mindful practice. JAMA. 1999;282(9):833-839
18
19. Mindfulness is the opposite of
multitasking.
Epstein RM. Mindful practice. JAMA. 1999;282(9):833-839
19
20. An aim of mindfulness practice is to
take greater responsibility for one’s life
choices.
Ludwig DS, Kabat-Zinn J. Mindfulness in medicine. JAMA.
2008;300(11):1350-1352
20
21. Somatic and Psychological
Disorders
Work/Caregiving Related
Issues
21
• Pain
• Depression
• Anxiety
• Addiction
• Insomnia
• PTSD
• Burnout
• Stress
• Compassion fatigue
• Recovery from work
Mindfulness as an Intervention
Irving, J.A., Dobkin, P.L., & Park, J. (2009). Cultivating mindfulness in health care professionals: A
review of empirical studies of mindfulness-based stress reduction. Complementary Therapies in Clinical
Practice, 15, 61-66.
22. Mindfulness-Based Stress
Reduction Program
• 8-week intensive introduction to mindfulness practice
o 2.5 hour class 1x/week
o 30-45 minutes of meditation per day
o 7-hour retreat(day of silence) after week 6
• Began at U Mass Medical Center in 1979
• >700 hospitals have programs for patients and staff
• Instructors receive extensive training and must be
committed practitioners themselves
22
Kabat-Zinn J. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness.
New York: Random House; 1991.
23. Mindfulness Techniques
• Meditation
o Sitting
o Walking
o Eating
o Everyday activities
o Loving kindness
• Mindful movement (yoga)
• Attitudinal Foundations
o Non-judging
o Patience
o Trust
o Non-striving
o Beginner’s mind
o Acceptance
o Letting go
23
Kabat-Zinn J. Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness.
New York: Random House; 1991.
24. Stress and Burnout in
Healthcare Professionals
• Burnout:
o Over 40% of nurses report general occupational burnout
o 28% of physicians endorse 2 out of 3 aspects of burnout
o Up to 60% of psychologists admit to having practiced at times when
they viewed themselves as distressed to the point of clinical
ineffectiveness
• Physical Health Problems:
• Fatigue, insomnia, heart disease, depression, obesity, hypertension,
infection, carcinogenesis, diabetes, and premature aging
• Stress:
• Significantly reduces clinicians’ attention and concentration
• Detracts from decision-making skills
• Diminishes the ability to communicate effectively, to convey empathy,
and to establish meaningful relationships with patients
24
Sharma, M., & Rush, S.E. (2014). Mindfulness-based stress reduction as a stress management intervention for healthy individuals: A
systematic review. Journal of Evidence-based Complementary & Alternative Medicine, 19(4), 271-286.
25. Mindful critical self-reflection enables
physicians to listen attentively to
patients’ distress, recognize their own
errors, refine their technical skills, make
evidence-based decisions, and clarify their
value so they can act with compassion,
technical competence, presence, and
insight.
Epstein RM. Mindful practice. JAMA. 1999;282(9):833-839
25
26. Challenges: Method and Process
• Lack of a standardized approach to the method and its
interventions
• Lack of a universally accepted definition
o Example: John Kabat-Zinn versus Ellen Langer
• Lack of consensus on approach to measurement:
o Technique
o General method
o Psychological process that can produce outcomes
o Outcome all on its own
• Mindfulness may be best represented as a latent
variable
26
Mars, T.S., & Abbey, H. (2010). Mindfulness meditation practice as a healthcare intervention: A systematic review. International Journal
of Osteopathic Medicine, 13, 56-66.
27. Measuring Mindfulness
• Self-report scales that assess the general tendency to be
mindful in daily life
• Psychometric validation
• Instruments assess different content due to issues with
conceptualization of the concept:
o Frieburg Mindfulness Inventory
o Mindfulness Attention and Awareness Scale
o The Kentucky Inventory of Mindfulness Skills
o The Cognitive and Affective Mindfulness Scale
o The Mindfulness Questionnaire
o Toronto Mindfulness Scale
o The Philadelphia Mindfulness Scale
o Five Facet Mindfulness Questionnaire
27
Mars, T.S., & Abbey, H. (2010). Mindfulness meditation practice as a healthcare intervention: A systematic review. International Journal
of Osteopathic Medicine, 13, 56-66.
28. Measuring the Impact of
Mindfulness
• Maslach Burnout Inventory
• Professional Quality of Life (ProQOL) IV
• Impact of Event Scale – Revised (IES-R)
• Nursing Job Satisfaction Scale
• Short Form 12 Health Survey (SF-12)
• Jefferson Scale of Physician Empathy
• Profile of Mood States
• Recovery Experience Questionnaire
• Pittsburgh Sleep Quality Index
28
Mars, T.S., & Abbey, H. (2010). Mindfulness meditation practice as a healthcare intervention: A systematic review. International Journal
of Osteopathic Medicine, 13, 56-66.
30. Applying mindfulness at the bedside:
A mind-hand connection
(Gilmartin & Saint, In Review)
• Frenzied environment of clinical practice
• Hand hygiene as a prompt for a moment of mindfulness
o Awareness back to the present
o Allow for a moment of clarity, insight, and reflection
o Move hand hygiene from passive compliance to act of self-care
and self-compassion
• We provided an mindful guide to hand hygiene
30
31. Clean Hands Save Lives
• Wet your hands with clean, running water (warm or
cold), turn off the tap, and apply soap.
• Lather your hands by rubbing them together with the
soap. Be sure to lather the backs of your hands,
between your fingers, and under your nails.
• Scrub your hands for at least 20 seconds. Need a timer?
Hum the "Happy Birthday" song from beginning to end
twice.
• Rinse your hands well under clean, running water.
• Dry your hands using a clean towel or air dry them.
31http://www.cdc.gov/handwashing/when-how-handwashing.html
32. Mindful Hand Hygiene
• Pause, take a breath, notice that you are turning on the
faucet and regard the feeling of water flowing from your
wrists to your fingers.
• Be present in the moment and experience the sensation
of rubbing soap into your wrists, hands, and fingers, then
washing it all down the drain.
• Focus your attention on your thoughts and emotions.
Stay present and accept whatever arises, just as it is,
without reacting.
• Set an intention, be it listening with intent, choosing your
words mindfully, or to act with compassion in your next
encounter.
• Smile, to acknowledge this act of kindness to yourself and
to your patient.
32
33. Does a mindful guide to hand
hygiene improve the self-reported
experience of hand hygiene for
healthcare providers versus standard
hand hygiene instructions?
33
34. Surgical Scrub Guide
• Start the water taps and get a comfortably warm and
adequate flow of water.
• During washing, use your elbows to release the soap and turn
the taps off, because your hands must remain decontaminated.
• Scrubbing begins at the fingernails, and a nail file and brush
from a sterile pack can be used. Scrubbing then occurs in three
washing cycles:
o Hands and arms extending to two inches above the elbow;
o Hands and half way up the forearms; and
o Hands only
• Your hands should always be held above the level of your
elbows at all times in order to prevent dirty water from dripping
from the upper arm onto lower sterile areas.
34
35. Conclusion
• Mindfulness is an inherently human quality
• Mindfulness can be developed with training
• Mindfulness is being applied to self-treat a variety of
conditions with reported positive effects
• There are challenges in measuring mindfulness
o What is mindfulness?
o How is mindfulness expressed?
o How is it measured?
• How does mindfulness operate to produce positive outcomes?
• There is a role for mindfulness in patient safety
35
36. Acknowledgments
• Thank you:
o Dr. Pat Stone, Columbia University
o Dr. Karen Sousa, University of Colorado
o Dr. Cathy Battaglia, University of Colorado &
Denver VA
o Dr. Sarah Krein, University of Michigan &
Ann Arbor VA
o Dr. Sanjay Saint, University of Michigan &
Ann Arbor VA
36
37. Contact Information
Heather M. Gilmartin
Post-doctoral Nurse Fellow
U.S. Department of Veterans Affairs
Denver/Seattle Center of Innovation
1055 Clermont St.
Denver, CO 80220
Heather.gilmartin@va.gov
720-857-5097
37
38. Thanks to the VA for
thinking outside the box
for our Veterans and their
caregivers.
Go Blue!!!
Thank You
38
39. References
Bate, P. (2014). Context is everything. In J. R. Bamber (Ed.), Perspectives on context: A selection of essays considering the role of context in successful
quality improvement (pp. 1-30). London, England: Health Foundation.
Damschroder, L. J., Banaszak-Holl, J., Kowalski, C. P., Forman, J., Saint, S., & Krein, S. L. (2009). The role of the "champion" in infection prevention: Results
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Editor's Notes
Shorter programs are being created – 1 hour weekly meetings and 5-15 mindfulness sessions.