Caregiver Satisfaction Research Articles

18 Past and current care practices for neonates with complex medical needs: A scoping review to support clinical program evaluation

Abstract Background Neonates with complex medical needs (NCMN) are a rapidly growing patient population internationally. Although NCMN are a relatively small proportion of all Neonatal Intensive Care Unit (NICU) admissions, they are high healthcare utilizers. Since 2018, a dedicated Neonatal Complex Care Team (NCCT) has cared for NCMN at a large quaternary care center. The NCCT cares for NCMN in a dedicated, single-family room, patient area within the NICU. This model of care has yet to be evaluated for its potential impact on healthcare outcomes. Objectives The objective of the scoping review is to determine the breadth of available literature on the care practices for the management of NCMN and to collate the available evidence to define outcome measures to be used in a formal program evaluation. Design/Methods The review followed the PRISMA extension for scoping reviews and utilized resources from the Joanna Briggs Institute. The two databases that were utilized include Medline via OVID and CINAHL. The dates for included publications are January 1st 1993, until July 15th 2023. Only studies published in English and primary research were included. Two independent reviewers performed the initial title and abstract screening, and the full text review. The data extraction was completed by one independent reviewer. Results 102 articles were included in the title and abstract screen, and 12 were considered for full text review. Four articles were included. Interventions discussed in the included articles ranged from discharge conferences with patient’s caregivers, to the implementation of an entirely new model of care. Multidisciplinary health care teams appear to be integral to the in-hospital care and smooth discharge of NCMN. We identified that caregiver involvement and satisfaction are important to the discharge process as they are primarily responsible for their infant’s care after discharge, and so it is important that the specifics of care are communicated and taught effectively. The outcomes of interest identified as most useful for clinical program evaluation were length of stay and readmission rate. Additionally there was limited data reported on long-term health outcomes of this patient population. Conclusion This scoping review identified few articles that reported new models of care, a lack of consistent outcomes used in evaluating existing care models and overall a gap in research in this rapidly growing patient population. There is more work to be done to improve care of NCMN and our findings will be used in designing future studies that evaluate care models.

Mothers’ and caregivers’ experiences of COVID-19 restrictions during postpartum hospitalisation: a cross-sectional survey in France

BackgroundTransmission of SARS-CoV-2 highlighting the importance of social distancing guidelines. Following a series of lockdowns and the widespread vaccination of the European population, many countries began to lift these restrictions. During this period, while some parents yearned for emotional support and family presence, others found that the solitude facilitated by the restrictions was beneficial for bonding and breastfeeding. In France, postnatal stays are generally longer than in other countries, and the limited availability of home-based follow-up care, combined with pandemic isolation measures, further complicated perspectives on visitation restrictions. Therefore, the objective of this study was to assess the satisfaction of mothers and caregivers regarding these visit restrictions in French maternity settings during the COVID-19 pandemic.MethodsWe conducted two multicentre descriptives surveys across five French maternity wards (three in Paris and two in Lyon) from June 1st to July 15th, 2021. Participants included mothers, selected based on criteria such as French-speaking, at-term birth (≥ 37 weeks), and hospitalisation with their newborn, as well as caregivers working in the postpartum units. Satisfaction with visitation restrictions was assessed using a four-point Likert scale, which was then dichotomised into “mostly satisfied” versus “mostly dissatisfied” for the analysis. Multivariable logistic regression models were used to identify factors associated with satisfaction.ResultsWe analysed complete responses from 430 of the 2,142 mothers (20.1%) and 221 of the 385 caregivers (57.4%) who participated during the study period. The majority of mothers (68.8%, n = 296/430) and caregivers (90.5%, n = 200/221) declare themselves satisfied with the policy of restricting visits to maternity wards. The main source of mother’s satisfaction came from a quieter stay, but they regretted the absence of their other children.ConclusionsMaternity visit restriction policies were largely supported by mothers and caregivers, especially when partners and siblings were allowed. Revisiting these policies, along with the postpartum stay length, may improve care, though further evaluation in non-pandemic settings is needed.

Mindful Awareness Practices (MAPs) in Adolescents With ADHD and Cognitive Disengagement Syndrome (CDS): A Pilot Open Trial.

Objective: Very few studies have investigated intervention approaches that may be efficacious for youth with ADHD and co-occurring cognitive disengagement syndrome (CDS) symptoms. This study examined the feasibility, acceptability, and preliminary efficacy of a mindfulness-based intervention for adolescents with ADHD and co-occurring CDS symptoms. Methods: Fourteen adolescents ages 13 to 17 years (35.71% female; 64.29% White, 7.14% Black, 28.57% Multiracial) with ADHD and elevated CDS symptoms completed the 8-week group-based Mindful Awareness Practices (MAPs) program developed for individuals with ADHD. We collected measures of CDS, ADHD, mind-wandering, mindfulness, and other difficulties and functioning at baseline, 1-month post-intervention, and 3-month post-intervention to examine preliminary efficacy. We measured participant session attendance, session engagement, at-home practice adherence, and satisfaction of adolescents and caregivers at 1-month post-intervention to examine feasibility and acceptability. We also collected qualitative feedback from adolescents and caregivers at 1-month post-intervention. Results: The intervention was overall feasible to administer, and caregivers and adolescents reported satisfaction with the intervention despite some difficulties with attendance and engagement. We observed improvements to both caregiver- and adolescent-reported CDS symptoms and ADHD-inattentive symptoms from pre-intervention to post-intervention time points, though findings across 1- and 3-month follow-up differed based on informant. We also observed improvements to some indices of adolescent-reported mind-wandering, mindfulness, brooding rumination, and academic functioning. For caregiver report, the only other noted improvement was for executive functioning. No improvements were reported by teachers. Conclusions: Findings support the initial feasibility, acceptability, and preliminary efficacy of MAPs for adolescents with ADHD and co-occurring CDS symptoms on a range of outcomes. Larger trials with a randomized design are warranted to further examine mindfulness-based interventions for adolescents with ADHD and co-occurring CDS symptoms.

Health-Related Quality of Life and Treatment Satisfaction of Patients with Malignant IDH Wild-Type Gliomas and Their Caregivers.

(1) Background: Clinical aspects like sex, age, Karnofsky Performance Scale (KPS) and psychosocial distress can affect the health-related quality of life (HR-QoL) and treatment satisfaction of patients with malignant isocitrate dehydrogenase wild-type (IDHwt) gliomas and caregivers. (2) Methods: We prospectively investigated the HR-QoL and patient/caregiver treatment satisfaction in a cross-sectional study with univariable and multiple regression analyses. Questionnaires were applied to investigate the HR-QoL (EORTC QLQ-C30, QLQ-BN20) and treatment satisfaction (EORTC PATSAT-C33). (3) Results: A cohort of 61 patients was investigated. A higher KPS was significantly associated with a better HR-QoL regarding the functional scales of the EORTC QLQ-C30 (p < 0.004) and a lower symptom burden regarding the EORTC QLQ-BN20 (p < 0.001). The patient treatment satisfaction was significantly poorer in the patients older than 60 years in the domain of family involvement (p = 0.010). None of the investigated aspects showed a significant impact on the treatment satisfaction of caregivers. (4) Conclusions: We demonstrated that in patients with IDHwt gliomas, the KPS was the most important predictor for a better HR-QoL in functional domains. Data on the HR-QoL and treatment satisfaction in patients with IDHwt gliomas and their caregivers are rare; therefore, further efforts should be made to improve supportive care in this highly distressed cohort.

Can a Digital Tool Improve the Understanding of Treatment Option for Patients With Head/Neck Cancer and Increase Providers’ Self-perceived Ability to Communicate With Patients?

A digital visual communication tool was recently developed by MyCareGorithm that incorporates explanations of treatments and procedures for cancer patients. This study evaluated if this novel tool can enhance both patient and provider satisfaction. In an IRB approved, prospective, pilot study, patients and caregivers at a single institution receiving head and neck cancer radiation underwent an initial consult using this digital tool and completed a survey of 6 questions to evaluate their understanding of their disease. Providers completed a 7-question survey to rate their satisfaction. Patients and caregivers with 4 or more “Yes” answers and providers with 5 or more “Yes” answers were defined as “Satisfied.” To obtain 90% power to detect that the proportion of “Satisfied” patients (assumed 75%) is greater than 50% with a significance level 5% using a 1-sided Z test, we planned to enroll 30 patients. Thirty patients enrolled and completed all surveys. Most patients were male (66%), White (60%), and spoke English as a primary language (93%). Patients most commonly had oropharyngeal cancer (23%). Overall, 27 of the 30 patients (90%; 1-sided 95% CI, 76.1%) were satisfied (z = 4.38, P < .05), 16 of the 17 caregivers (94%; 1-sided 95% CI, 74.8%) were satisfied, and 100% of providers were satisfied with the digital tool. Most patients (90%) and caregivers (94%) felt that the tool improved their understanding of the disease. One man answered “No” for all 6 questions, commenting that it was only marginally helpful. One woman also answered “No” for all questions, commenting that she did not find it helpful on its own without the provider's explanation. Of the 30 patients, 26 (87%) stayed at our institution to receive treatment. These findings showed high rates of patient, caregiver, and provider satisfaction with their initial consult when incorporating a digital visual tool. Its routine use in clinical practice should be strongly considered.

Improving routine mental health screening for depression and anxiety in a paediatric lupus clinic: a quality improvement initiative for enhanced mental healthcare

BackgroundMental health (MH) conditions are prevalent in adolescents with childhood-onset SLE (cSLE). Early identification is crucial in preventing poor patient outcomes; however, MH screening rates remain low.Local problemFrom July 2021–January...

Caregiver Wellness after Traumatic Brain Injury (CG-Well): Protocol for a randomized clinical trial

IntroductionAfter injury, survivors of moderate to severe traumatic brain injury (msTBI) depend on informal family caregivers. Upwards of 77% of family caregivers experience poor outcomes, such as adverse life changes, poor health-related quality of life, and increased depressive symptoms. Caregivers frequently report minimal support or training to prepare them for their new role. The majority of previously developed caregiver and caregiver/survivor dyad interventions after msTBI focus on providing information to either survivors only, or to long-term caregivers, rather than to the new caregiver. This manuscript describes the protocol of an ongoing randomized control trial, Caregiver Wellness after TBI (CG-Well), developed to provide education, support, and skill-building to caregivers of adults with msTBI, beginning when the survivor is early in the clinical course. MethodsWithin two weeks of admission to the ICU, participants are randomized to CG-Well online modules (intervention group, n = 50 dyads) or information, support, and referral (ISR) e-bulletins that exist in the public domain (control group, n = 50 dyads) over the first six months after their family member’s msTBI. Both groups receive regular phone calls. The primary outcome is intervention satisfaction at six months. ResultsEnrollment began in March, 2022 and is projected to complete October 2024. We have enrolled approximately 70% of participants at this time. Primary analysis completion is anticipated April, 2025. DiscussionThis RCT is designed to evaluate caregiver satisfaction by addressing the need for tailored supportive care for caregivers of msTBI beginning during the ICU admission. Trial RegistrationClinicaltrials.gov Registration Number: NCT05307640

Factors associated with life satisfaction among family caregivers of persons living with dementia

Purpose: Because family caregivers provide a considerable amount of daily care to persons living with dementia, they are at risk of experiencing poor life satisfaction. Therefore, this study aimed to examine factors associated with the life satisfaction of family caregivers of persons living with dementia. Methods: Data were collected through surveys from family caregivers (N=183), and a multiple linear regression analysis was conducted to examine the factors associated with their life satisfaction. Results: The final model indicated that perceiving support from intimate others as helpful (β=.22, p&lt;.001) was associated with greater life satisfaction, whereas a negative relationship with the care recipients (β=−.15, p=.046) and greater psychological burden (β=−.40, p&lt;.001) were associated with poorer life satisfaction (Adjusted R2=0.49, F=20.42, p&lt;.001). Conclusion: Public policy should focus on providing greater support to family caregivers. Furthermore, healthcare professionals should implement intervention programs for family caregivers that focus on lowering their psychological burden.

Effect of internet usage on the life satisfaction of the elderly spousal caregivers of disabled elderly

This empirical study examines the impact of internet usage on the life satisfaction of spousal caregivers responsible for elderly individuals with disabilities. Utilizing data from the China Health and Retirement Longitudinal Study (CHARLS), released in November 2023, we analyzed the health status and life satisfaction of these caregivers in the context of the recent rapid development of the internet. A stratified Proportionate to Size Sampling (PPS) approach was employed in this investigation. We assessed whether the life satisfaction of spousal caregivers is associated with internet use and whether internet adoption can moderate intergenerational relationships, interpersonal interactions, and political engagement among these caregivers. The study analyzed a sample of 760 individuals, with an average age of 60.31 years, and rural households comprising 77.14% of the sample. Our findings indicate a positive correlation between internet usage and the life satisfaction of spousal caregivers. This result enhances our understanding of the relationship between internet usage and life satisfaction in this context. Furthermore, this study supports the advancement of internet access for the aging population, assists elderly individuals in bridging the digital divide, and provides a theoretical foundation for the development of targeted, elderly-friendly internet policies by the government.

Developing a Life Story Intervention for Older Adults With Dementia or at Risk of Delirium Who Were Hospitalized: Multistage, Stakeholder-Engaged Co-Design Study.

Older adults with chronic or acute cognitive impairment, such as dementia or delirium, who are hospitalized face unique barriers to person-centered care and a higher risk for negative outcomes stemming from hospitalizations. There is a need for co-designed interventions adapted for these patients to the hospital setting to improve care and outcomes. Patient life storytelling interventions have demonstrated promise in enhancing person-centered care by improving patient-care team relationships and providing information to enable care tailored to individual needs and values. This study aims to engage patients, care partners, and clinical stakeholders in a co-design process to adapt an existing life storytelling model for use with older adults with dementia and at risk of delirium in the acute care hospital setting. We recruited patients with dementia or at risk of delirium who were hospitalized, their care partners, clinicians, and informaticists. A 3-stage co-design process that used a mixed methods data collection approach including in-depth interviews and surveys was completed. We used content analysis to analyze qualitative data and descriptive statistics to summarize quantitative data. In total, 27 stakeholder informants (ie, patients, care partners, and interdisciplinary care team [IDT] members) participated. Stakeholders were unanimously interested in using patient life stories as a tool for hospital care through electronic health record (EHR) integration. Stakeholders shared potential topics for life stories to cover, including social support, information on patients' key life events, and favorite activities. Participants provided insights into the logistics of integrating life stories into acute care, including interview arrangement, story-sharing methods, and barriers and facilitators. IDT members shared preferences on EHR integration, resulting in 3 co-designed mock-ups of EHR integration options. Stakeholders shared ways to optimize future acceptability and uptake, including engaging with the care team and promoting awareness of life stories, ensuring suitability to the acute environment (eg, distilling information in an easily digestible way), and addressing concerns for patient capacity and privacy (eg, engaging care partners when appropriate). Thoughts on potential impacts of life stories were also elicited, including improving patient- and care partner-IDT member relationships; humanizing patients; increasing clinical team, patient, and caregiver satisfaction; and enabling more specific, tailored care for patients with dementia and at risk of delirium. This study resulted in a co-designed life storytelling intervention for patients with dementia and at risk for delirium in an acute care hospital setting. Stakeholders provided valuable information to ensure future intervention acceptability and uptake, including potential benefits, facilitators, and challenges in the acute care setting.

The Association between Healthcare Satisfaction and Social Support and Stress, Depression, and Life Satisfaction in Female Caregivers: The Moderating Role of Dependence of a Sick Child.

A cross-sectional study was conducted among 185 female caregivers of children with rare diseases. The data were analysed by using hierarchical regression analysis to examine the moderating effect of the child's dependence. Lower dependence of the child moderated the association between a higher level of healthcare satisfaction and reduced stress and a higher level of life satisfaction. Furthermore, lower child dependence moderated the association between a higher level of social support and a reduction in depression. In contrast, this association was absent in female caregivers with highly dependent children. On the other hand, the research confirmed that a higher level of social support led to stress reduction and increased life satisfaction in all respondents, regardless of the child's dependence. Furthermore, the research confirmed that higher levels of healthcare satisfaction are associated with a reduction in depression in caregivers, regardless of the child's dependence level. This research highlights the importance of providing adequate social support and high-quality healthcare in order to improve the psychosocial well-being of caregivers of children with rare diseases. Interventions to increase this support can reduce stress and depression and increase caregivers' life satisfaction. Thus, future research should focus on the development and evaluation of specific interventions that support these factors.

Design of a prototype of clothing for older persons with neurocognitive diseases with behavioural troubles interfering with the management of sphincter disorders

Introduction: The evolution of neurocognitive diseases is marked by increasingly disruptive behavioural disorders as well as sphincter troubles. To avoid being forced to use physical restraints or therapies that promote drowsiness to prevent older patients from removing their diapers, caregivers can use a onesie. However, this solution does not respect the dignity of these persons. Objectives: To design a prototype of onesie that will be aesthetically pleasing as daytime clothing, with features that simplify its use by professional caregivers and respect the dignity of older adults with neurocognitive diseases. Methodology: A randomized open trial was conducted comparing the prototype of onesie that was developed to a classic onesie. The degree of respect for the dignity of these older adults was rated as well acceptability and reliability of the two onesies and a satisfaction survey among caregivers was carried out using a derived questionnaire from the ITHACA project. Results: The final version of the prototype was a onesie resembling to a clothing adapted for day wear and allowing caregivers to quickly change persons with restricted participation. Forty subjects were included. No difference was found in the dignity ratings assigned by their relatives. The caregiver satisfaction survey showed that they thought the prototype respected the dignity of the subjects but that the use of the classic onesie made the work easier. Conclusion: Our prototype of onesie allowed a better usability by caregivers, was better accepted than a classic model of onesie while respecting the dignity of older adults with neurocognitive diseases.

A Study of the Effectiveness of Camp Baker, an Adapted Summer Treatment Program for Children with ADHD

ABSTRACT Background Although the Summer Treatment Program (STP) is a well-established treatment for ADHD, STPs are only offered at a few sites in the United States, suggesting opportunities for improved implementation. Objective This study aimed to evaluate the effectiveness and caregiver satisfaction of Camp Baker, an adapted STP for children with ADHD designed to address implementation barriers. Methods Adaptations included condensing the length of treatment and augmenting the STP to cover additional skills (e.g. educational opportunities, therapeutic skills training, enhanced parent training). Children (N = 159; 84.3% male; 65.4% White; 5–12 years old) with ADHD participated in Camp Baker throughout 2019, 2021, and 2022. Families who participated in Camp Baker in 2019 were asked to complete an anonymous survey that contained choice-select (e.g. “My child is better at handling daily life”) and open-ended questions (e.g. “From your perspective, how did Camp Baker most help your child?”) to assess their perceptions of and satisfaction with Camp Baker. Qualitative survey responses (n = 30) were double-coded using an inductive content analysis approach. Results Commonly endorsed themes included positive feelings about the program (e.g. “fun camp experience at Camp Baker”), positive feelings about parent training (e.g. “the training is amazing”), and positive child outcomes (e.g. “gave him newfound confidence”). Caregivers reported significant improvement in child behavioral, attentional, and emotional problems from pre- to post-camp. Conclusion With intentional adaptations made, Camp Baker was easily implementable while demonstrating promise for the retainment of effectiveness and satisfaction.

Telehealth vs In-Person Early Palliative Care for Patients With Advanced Lung Cancer

Numerous studies show that early palliative care improves quality of life and other key outcomes in patients with advanced cancer and their caregivers, although most lack access to this evidence-based model of care. To evaluate whether delivering early palliative care via secure video vs in-person visits has an equivalent effect on quality of life in patients with advanced non-small cell lung cancer (NSCLC). Randomized, multisite, comparative effectiveness trial from June 14, 2018, to May 4, 2023, at 22 US cancer centers among 1250 patients within 12 weeks of diagnosis of advanced NSCLC and 548 caregivers. Participants were randomized to meet with a specialty-trained palliative care clinician every 4 weeks either via video visit or in person in the outpatient clinic from the time of enrollment and throughout the course of disease. The video visit group had an initial in-person visit to establish rapport, followed by subsequent virtual visits. Equivalence of the effect of video visit vs in-person early palliative care on quality of life at week 24 per the Functional Assessment of Cancer Therapy-Lung questionnaire (equivalence margin of ±4 points; score range: 0-136, with higher scores indicating better quality of life). Participants completed study questionnaires at enrollment and at weeks 12, 24, 36, and 48. By 24 weeks, participants (mean age, 65.5 years; 54.0% women; 82.7% White) had a mean of 4.7 (video) and 4.9 (in-person) early palliative care encounters. Patient-reported quality-of-life scores were equivalent between groups (video mean, 99.7 vs in-person mean, 97.7; difference, 2.0 [90% CI, 0.1-3.9]; P = .04 for equivalence). Rate of caregiver participation in visits was lower for video vs in-person early palliative care (36.6% vs 49.7%; P < .001). Study groups did not differ in caregiver quality of life, patient coping, or patient and caregiver satisfaction with care, mood symptoms, or prognostic perceptions. The delivery of early palliative care virtually vs in person demonstrated equivalent effects on quality of life in patients with advanced NSCLC, underscoring the considerable potential for improving access to this evidence-based care model through telehealth delivery. ClinicalTrials.gov Identifier: NCT03375489.

Incidence of Pressure Injuries in Patients at Risk Using a Powered Alternating Pressure Air Mattress: A Noninterventional Study in a Real-World Setting.

The aim of the study was to determine the clinical value of using a powered alternating pressure air mattress (P-APAM) in the prevention of pressure injury (PI) in patients at medium to high risk. Noncomparative, observational study. The sample comprised 86 patients who were >18years old, were classified as having medium to high risk of PI, had no PI at baseline, and were lying more than 15hours a day on a specific P-APAM. Data were collected between September 2018 and July 2019, in 4 nursing homes, and 1 long-term care geriatrics hospital department in France. In addition to guideline-based care for PI prevention, patients were followed up for 35days following placement on the P-APAM. The main outcome was the percentage of patients who developed between day 0 and day 35 at least 1 PI of at least stage 2 on the sacrum, spine, or heel. Secondary outcomes were patient assessments of comfort, caregiver satisfaction, mattress noise level, and mattress safety. No patients experienced a PI (incidence=0%; 95% confidence interval, 0.00%-4.28%). Patients were satisfied or very satisfied with the mattress in most cases in terms of comfort (77.9%) and stability (73.0%). Patients also rated the noise level of the mattress as satisfactory or very satisfactory in all cases (100%). When combined with guideline-based PI prevention measures, use of the P-APAM was associated with a low incidence of PI.

Using Existing Resources to Create a Successful End-of-Life Doula Program

The end-of-life doula role has emerged as an integral part of the interdisciplinary team caring for patients. The doulas provide an extra layer of support from a non-clinical lens to prevent crises, follow-up with families, and guide them through their journey. This manuscript describes how a hospice agency developed a performance improvement project to train volunteers to become end-of-life doulas through a rigorous training program, based on the Doula Model of Care. The implementation of the program was evaluated based on caregiver and staff satisfaction, and volunteer knowledge competency. The results from the pilot program showed mixed outcomes for patient and staff satisfaction, but created a rigorous training program for hospice volunteers. The COVID-19 pandemic disrupted data gathering and implementation of the program, so outcomes were varied. However, the program remains successful with ongoing training of the end-of-life doulas and an increase in new volunteers to support the program.

Analysis of the intensity of engagement with CuidaTEXT, a text message intervention for dementia caregiver support among Latinos/as

ABSTRACT Objectives To examine the associations between participant intensity of engagement with a text message intervention, CuidaTEXT, and socio-demographic factors, acceptability measures, and clinical outcomes among Latino/a caregivers of individuals with dementia. Methods CuidaTEXT is a six-month, bilingual, and bidirectional intervention. We enrolled 24 Latino/a caregivers in a one-arm feasibility trial. Participants received approximately one automatic daily text message and could engage with the intervention by texting specific keywords (e.g. STRESS to receive messages about stress-coping), and by chat-texting with a live coach. We used metrics and psychometric scales to quantify variables. Results Participants sent a total of 1847 messages to CuidaTEXT. Higher intensity of engagement was associated with higher intervention satisfaction (r = 0.6, p = 0.007), as were several other acceptability outcomes. We found no associations between intensity of engagement with CuidaTEXT and sociodemographic or clinical outcomes (p > 0.05). Conclusion Encouraging more intense engagement with CuidaTEXT might lead to higher levels of satisfaction with the intervention. However, it is possible that those who are highly satisfied, engage more intensely with CuidaTEXT. Future research should determine the directionality of these associations to optimize text message interventions. Clinical Implications Creating more opportunities to increase the intensity of text message engagement with caregiver support interventions may improve caregiver satisfaction with them.

2265 Patient experience and outcome measures in virtual wards at Swansea Bay university health board.

Abstract Introduction Swansea Bay Health Board is covered by eight community clusters (240 virtual beds), each with their own Virtual Ward (VW) MDT which provides community based Comprehensive Geriatric Assessment and reablement. The VW governance structure includes the routine collection of person-centred metrics. There is no recognised PROM or PREM specifically designed for needs of frail older people and PROMsand PREMsare rarely used to inform quality and continuity in services at transitions of care (e.g. at discharge from hospital). Methods VW data from June 2023 to February 2024 was analysed. Patient-reported outcomes and experiences (PROMS and PREMS) were collected by the VW team at set timepoints in the patient journey. Data was collected using the PRO-MAPP digital interface ensuring inter-user consistency. Results 1858 VW patients, 1094 (58.9%) female, median age 86 years. The majority, 1044 (56.2%) were referred from secondary care, primarily from acute frailty services, with the remainder identified by primary care. In total, 418 PROMS and 344 PREMS were collected. PROMS—Reported improvements in mobility, self-care, usual activities, pain and anxiety &amp; depression (p &amp;lt; 0.001) after VW input. PREMS—The majority of patients found the VW had been explained well prior to referral (84.0%), were contacted promptly (95.6%), staff were professional and friendly (100%), provided patient-centred care (94.2%), staff were contactable (92.4%), were glad they avoided or reduced the length of hospital admission (95.3%). When speaking with 72 care-givers, they were happy the patients’ needs were met (100%) and the VW positively impacted their lives as carers (90.1%). Discussion There was high patient and care-giver satisfaction with the VW service. PROM data suggested a significant positive impact on patient outcomes. Not all the patients referred to the VW have been sampled which is a missed opportunity and there was a variability between data collection between clusters.

Utilizing the Summer Treatment Program Model to Promote School Readiness in Young Children Living in Urban Poverty: An Initial Effectiveness Open Trial

ABSTRACT Access to, and engagement in, quality mental health care for young children with externalizing behavior problems (EBPs) who are living in urban poverty is limited. Innovative efforts to engage families in early intervention are needed to ensure school success. The goals of the current study were to transport the Summer Treatment Program for Prekindergartners (STP-PreK, an adaptation of the Children’s Summer Treatment Program and evaluate the implementation and initial program promise for children living in urban poverty via an open trial. Participants were 115 preschool children (68.7% male; 84.3% Black) with EBPs and their caregivers. Nearly all the participating families were living with low to extremely low incomes. Participants received a 7-week STP-PreK, including a daily school readiness program and weekly behavioral parenting training. Implementation outcomes were measured via attendance records, satisfaction ratings, and fidelity measures. Program promise was measured via caregiver ratings and child assessments, collected pre-, post-, and at 6 months following the intervention. On average, results demonstrate strong feasibility and acceptability with high child attendance (90.56%) and caregiver satisfaction with services. Intervention effects across domains of child functioning reveal medium-to-large effects on academics (d’s = 0.46–1.95), overall impairment (d = 0.79), behavioral functioning (d’s = 0.38 – 0.84), and executive functioning (d = 0.58). Effects were largely maintained at 6-month follow-up (d’s = 0.13–1.86). Overall, the results support the promise of the STP-PreK model in enhancing school readiness outcomes for young children at-risk. Directions for continued adaptation and future research are discussed.

Personalized Video-Based Educational Platform to Improve Stroke Knowledge: A Randomized Clinical Trial.

Stroke knowledge is critical to treatment adherence and poststroke outcomes. Here, we aimed to quantify the impact of a personalized video-based educational platform to test the hypothesis that it improves patient satisfaction and stroke knowledge. In a single-center pilot randomized trial, all patients with stroke and caregivers received standard stroke education during the hospitalization, but half were randomized to receive access to MyStroke, a personalized educational platform that provided brief videos about their stroke, risk factors, medications, and poststroke lifestyle. Satisfaction, stroke knowledge, and quality of life were assessed 7, 30, and 90 days after discharge. A total of 120 subjects (96 patients and 24 caregivers) were randomized to standard education (n=59) or MyStroke. At 90 days post-stroke, those who received MyStroke were more likely to be satisfied with the stroke education the received (90% versus 73%, P=0.05) and more likely to correctly identify their stroke cause (67% versus 32%, P=0.003). However, MyStroke was not associated with a difference in self-reported quality of life (EuroQol Visual Analogue Scale: 80 versus 75, P=0.06) or general stroke knowledge (total Stroke Patient Education Retention: 5 versus 5, P=0.47). With respect to secondary end points, MyStroke increased risk factor awareness 7 and 30 days poststroke, but this difference was not significant at 90 days. The MyStroke personalized video-based education platform improved patient and caregiver satisfaction while improving some aspects of personalized stroke knowledge without improving general stroke knowledge. A multicenter trial is needed to confirm these results, clarify generalizability, and target clinically relevant metrics such as stroke recurrence or adherence. URL: https://www.clinicaltrials.gov; Unique identifier: NCT05118503.