Recommendations For Health Professionals Research Articles

Understanding the public\u2019s profile of mental health literacy in China: a nationwide study

BackgroundIn the wake of China’s massive economic development, attention has only recently turned to the enormous treatment gap that exists for mental health problems. Our study is the first comprehensive, national examination of the levels and correlates of the public’s ability to recognize mental illness in the community and suggest sources of help, setting a baseline to assess contemporary Chinese efforts.MethodsData were collected in China as part of the Stigma in Global Context – Mental Health Study (SGC-MHS) through face-to-face interviews using vignettes meeting clinical criteria for schizophrenia and major depression. Our analysis targets the Han Chinese participants (n = 1812). Differences in the recognition of mental health problems were assessed using a chi-square test and further stratified by vignette illness type and urban vs. rural residence. Adjusted regression models estimated the effects of each predictor towards the endorsement three types of help-seeking: medical doctor, psychiatrist, and mental health professional.ResultsAs expected, recognition of mental health problems is low; it is better for depression and most accurate in urban areas. Perceived severity increases endorsement of the need for care and for treatment by all provider types. Recognition of a mental health problem specifically decreases endorsement of medical doctors while increasing recommendations for psychiatrists and mental health professionals. Neurobiological attributions decrease recommendations for mental health professionals as opposed to general or specialty physicians.ConclusionsContinued efforts are needed in China to promote mental illness recognition within rural areas, and of schizophrenia specifically. Promoting recognition of mental illness, while balancing the special challenges among individuals who understand the neurobiological roots of mental illness, may constitute a key strategy to reduce the sizeable mental health treatment gap in China.

Understanding women’s postpartum sexual experiences

This study aimed to understand women’s sexual health experiences, specifically knowledge, attitudes and norms related to sexual behaviour resumption during the postpartum period. Semi-structured, reproductive health-focused interviews (N = 70) were conducted among women aged 18 years or older (range: 19–78) residing in South Carolina. Findings demonstrated that women identified clinicians as most influential concerning when they should and could resume sexual activity. Some women noted returning to sex earlier than anticipated due to personal and partner desire and indicated achieving considerable sexual satisfaction during the postpartum period. However, other participants noted difficulties resuming sexual activity, including pain and exhaustion from caring for a new baby. Findings provide practical recommendations for health professionals to further develop tailored, timely health messaging related to safe and healthy postpartum sexual behaviours. We discuss recommendations for health professionals to bring further awareness to varied postpartum sexual experiences.

Representativeness of patients enrolled in a primary care clinical trial for heavy/problem substance use

Background: The extent to which participants in randomized clinical trials (RCTs) resemble their broader target groups is of particular concern when studying stigmatized conditions such as substance use disorders (SUDs). The present study compared patients who enrolled in a 4-arm clinical trial of SBIRT (screening, brief intervention, and referral to treatment) with eligible patients who declined study participation. Methods: Participants (N = 1338) were primary care patients who anonymously completed a computer-delivered health survey and screened positive for heavy/problem alcohol or drug use. Those who consented to the RCT (n = 713) were compared with those who declined (n = 625) on a variety of demographic, substance use, and psychosocial characteristics. Variables significant at P < .20 in univariate analyses were then examined using multivariate logistic regression to determine their combined effect. Results: The sample was 60% female and 76% African American, with a mean age of 45.2 years. Patients who consented to participate differed from those who declined on 34 (60%) of the 57 variables studied. The most parsimonious model by multivariate regression found that those who consented were older, more likely to be unemployed, and more likely to endorse prescription drug misuse, problems related to drug use, family history of alcohol problems, trouble falling asleep, and a health professional recommendation to lose weight. Conclusion: Patients consenting to the RCT reported a greater number and more severe psychosocial and mental health problems than those who declined study participation. If the higher level of risk among study participants was found in other studies as well, it would raise questions regarding the generalizability of RCT results to broader clinic samples.

Internationally Trafficked Men in the USA: Experiences and Recommendations for Mental Health Professionals

Internationally Trafficked Men in the USA: Experiences and Recommendations for Mental Health Professionals

Exercise and pregnancy in recreational and elite athletes: 2016/2017 evidence summary from the IOC expert group meeting, Lausanne. Part 5. Recommendations for health professionals and active women

Exercise and pregnancy in recreational and elite athletes : 2016/2017 evidence summary from the IOC expert group meeting, Lausanne. Part 5. Recommendations for health professionals and active women

Trauma-informed practice in intellectual disability services: Recommendations for mental health professionals in the UK

This paper reports on the thinking of a multi-professional national group promoting trauma-informed working in Intellectual Disability services, in which the Faculty is collaborating. The paper explains the need to take account of trauma and attachment difficulties in clinical and social care services, and the need to promote trauma-informed approaches. A simple acronym, SECURED, is proposed as an aide-memoire for professionals to apply in their work.

Black Male Mental Health and the Black Church: Advancing a Collaborative Partnership and Research Agenda.

This article explores the role the Black Church could play in facilitating spiritually sensitive, culturally relevant and gender-specific services to address the mental health and well-being of Black males. The help-seeking behaviors of Black men are examined as the authors offer two theories: the body, mind, spirit, environment, social, transcendent, and health, illness, men, and masculinities that may assist the Black Church in functioning as an effective support networks for healthy Black male mental health. Next, the authors discuss implications for practice, research, and education, and lastly, eight recommendations for Black Church leadership, social workers, and mental health professionals are also discussed.

Exercise and pregnancy in recreational and elite athletes: 2016/2017 evidence summary from the IOC expert group meeting, Lausanne. Part 5. Recommendations for health professionals and active women

Exercise and pregnancy in recreational and elite athletes: 2016/2017 evidence summary from the IOC expert group meeting, Lausanne. Part 5. Recommendations for health professionals and active women

Factors influencing women's decisions about having the pertussis-containing vaccine during pregnancy.

INTRODUCTION New Zealand experienced a major epidemic of pertussis from September 2011 to January 2014. In response to this epidemic, a pertussis-containing tetanus, diphtheria and acellular pertussis (Tdap) vaccine was funded for pregnant women of 28-38 weeks' gestation. AIM To investigate the factors influencing women's decisions regarding having the Tdap vaccine during pregnancy. METHODS A retrospective, self-reported postal survey of early postpartum women in Canterbury that assessed participant knowledge, beliefs, attitudes and influencing factors about the Tdap vaccine was conducted from June to October 2013. RESULTS Of the 1883 surveys distributed, 596 women completed the survey. The main factors influencing women's decisions to accept the Tdap vaccine during pregnancy were: the desire to protect their baby, a health professional's recommendation, the threat of pertussis in the community and the fact that the vaccine was administered at no cost. Conversely, for women who did not receive the Tdap vaccine, the main factors that influenced their decisions were: they did not know the vaccine was available, fear of side-effects and doubt regarding vaccine effectiveness. CONCLUSION A clear health professional recommendation for maternal Tdap immunisation was a significant factor influencing pregnant women and would most likely improve the uptake of the vaccine.

Parental involvement in adolescent depression interventions: A systematic review of randomized clinical trials.

Despite the widespread research recommendations for psychiatric nurses and other mental health professionals to include parents in adolescent depression treatment, no systematic reviews have yet synthesized the findings from intervention studies that included parents in the treatment and/or prevention of adolescent depression. Therefore, this systematic review was conducted to (i) identify and describe clinical trials that included parents as an integral component of adolescent depression interventions, (ii) examine the effectiveness of these trials in reducing depressive symptoms, and (iii) evaluate their methodological quality. We systematically searched the databases PubMed and PsycINFO. The search strategy adhered to the PRISMA statement to guide identification and selection of articles. Further, a structured evaluation form was adapted from the CONSORT statement and methodological literature to evaluate the elicited clinical trials. A total of 288 unique articles met criteria for abstract level screening, 45 articles were selected for full-text review, and 16 articles were included in the final analysis. We found that (i) available approaches to include parents in adolescent depression interventions vary in their theoretical stance, purpose, sample characteristics, and measured outcomes, (ii) the health outcomes of these approaches seemed to be contingent upon the nature of parental involvement, and (iii) effective translation of these approaches into practice needs to be considered in the light of their methodological rigour. Our review revealed a variety of promising approaches to utilize the parental and family contexts as a means of preventing or treating adolescent depression. However, more research is needed to determine which interventions, within what contexts, and using what resources will facilitate the best health outcomes for adolescents with depression and their parents.

El cáncer a la mesa. Experiencias, sentidos y emociones de pacientes con cáncer de laringe (España)

For a little over three decades, the relationship between diet and cancer has been thoroughly researched through quantitative studies, by medical experts in nutrition and cancer. However, the narratives and experiences of cancer patients with respect to food and the emotional climates that surround the nutritional process – understood as an entirely social fact – are understudied. The subordination of this perspective reflects short-sightedness towards these narratives. This paper proposes an ethnographic approach to the dietary experience of a group of patients suffering from laryngeal cancer in Spain. Herein we will analyze the senses and meanings they give to the loss of “normality” in dietary practices, the feelings and emotions they assign to these practices, the importance placed on nutrition, the recommendations of health professionals, or the process of resistance. Notions such as shame, stigma or identity reinforce the thesis that we must pay close attention to these worlds of experience, which have traditionally been subordinated to physiological needs.

La formation en soins palliatifs en Europe

Education and training in palliative care are a challenging issue needing to be addressed to meet the need of patients and families, across a range of clinical setting as home, hospital, nursing home. Since 1992 the EAPC has been aware of the importance of education for the development of palliative care and suggested some recommendations for health professionals in order for them to give the best palliative care. Three levels of education are required, from basic to specialist level, for skill, knowledge and attitudes. The training should provide competencies in the field of symptoms management but also in psychosocial suffering, decision making and legal aspects of palliative care, with attention to the patient and families beliefs and experience during the disease. This global approach needs to have the multi-disciplinary aspects and team working included in the training regardless of the student’s profession. This specific approaches benefit to the health care professional and give an ability to provide better care for all patients, in palliative situation or not.

Comparing two schizophrenia-specific quality of life instruments in institutionalized people with schizophrenia

Clinical health professionals may have difficulties to select appropriate schizophrenia-specific Quality of life (QoL) instruments because of the limited information regarding their psychometric properties. Two widely used schizophrenia-specific QoL instruments (Schizophrenia Quality of Life Scale Revision 4 [SQLS-R4] and Lancashire Quality of Life Profile [LQOLP]) were compared in institutionalized people with schizophrenia, and useful recommendations for clinical health professionals were provided. Participants (n = 100) filled out the two instruments twice. Test-retest reliability, internal consistency, and confirmatory factor analyses (CFAs) were conducted. Both SQLS-R4 domains (r = 0.573–0.731) and LQOLP domains (r = 0.303–0.778) had good test-retest reliability. However, the objective QoL domains in the LQOLP showed lower internal consistency (α = 0.219–0.617) than its subjective QoL domains (α = 0.532–0.947) and the SQLS-R4 domains (α = 0.768–0.939). The CFAs with two correlated underlying instruments constructs and two correlated underlying QoL traits (viz., Physical and Psychosocial QoL) performed the best data-model fit (CFI = 0.990, RMSEA = 0.039, SRMR = 0.039), which supported the validity of both instruments. Although both SQLS-R4 and LQOLP were valid and reliable, using SQLS-R4 on institutionalized people seemed to be more psychometrically solid than using the LQOLP.

Belonging to Multiple Nationalities: A Phenomenological Study

The purpose of this qualitative study was to explore the lived experiences of individuals who identify with multiple nationalities. As the world becomes increasingly global and more individuals migrate, it is becoming commonplace for individuals to identify with more than one nationality. Psychologists and mental health professionals need to be aware of the impact of having multiple nationalities integrated into one’s identity in order to gain a deeper understanding and provide more effective treatment to these individuals. A phenomenological research design was utilized in this study. Ten participants identifying with more than one nationality (age range = 25 to 46, = 30.1) were interviewed. Several themes emerged within a context of intersectionality including: (a) process of constructing a multiple nationality identity; (b) intentionality about identifying with multiple nationalities; (c) reactions of others; (d) cultural intelligence—openness, appreciation, and acceptance of diversity; (e) similarities between cultures, language, religions, and spiritualties across nationalities; (f) feeling connected or disconnected through language; (g) where is home, and where do I belong?; (h) professional identities; and (i) importance of food. Participants provided recommendations for mental health professionals. Theoretical, research, and clinical implications are discussed.

Transition to Adult Health Care Services for Young Adults with Chronic Medical Illness and Psychiatric Comorbidity.

This article provides national data on the lack of transition preparation among youth with special health care needs, including those with emotional, behavioral, and developmental conditions. Consumer and provider transition barriers pertaining to inadequate transition support are summarized. In addition, current US transition goals are presented along with health professional recommendations on transition. The Six Core Elements of Health Care Transition, which are aligned with professional recommendations, are reviewed with practice-based lessons learned from quality improvement efforts. The article concludes with a discussion of transition evaluation needs and opportunities.

How rural and urban patients in Australia with colorectal or breast cancer experience choice of treatment provider: A qualitative study

Modern healthcare systems promote patient choice of cancer treatment provider, but little is known about how place of residence influences decision-making. This research explored how rural and urban patients with breast or colorectal cancer experience choice of cancer treatment provider in Victoria, Australia. Realist thematic analysis of 43 semi-structured telephone interviews identified little active participation in decision-making regardless of area of residence or cancer diagnosis. Perceptions of choice were impacted by urgency for treatment, insurance status and access to providers, a key issue for rural patients. All patients wanted high quality care, but needed to trust health professional's recommendations. Rural patients experienced more complex decision-making, balancing a range of social factors with perceptions about quality of accessible care. Further research into variation in quality of care and complex cancer pathways for rural and urban cancer patients is warranted to inform choices and enhance patient-centred care.

ED03.02 The Australian Tobacco Control Strategy: Lessons Learned

This presentation will outline the developments that have led the international tobacco industry to describe Australia as “the darkest market in the world.” This will be presented in the context of international developments, with implications and recommendations for other countries, and researchers, clinicians, health professionals, health organizations and governments There will be discussion of the origins and early history of tobacco control in Australia; the components of comprehensive tobacco control programs; policy-relevant research; successes, failures and distractions; and the roles of key organizations and individuals. This will be followed by an outline of major developments, including the establishment of a consensus approach; national and local approaches; activity by key groups; progress across a range of key areas including public education, advocacy, tobacco advertising bans, taxation, health warnings, smoke-free, exposing tobacco industry activities, cessation supports; and other measures. There will be discussion of the Australian world-leading tobacco plain packaging legislation, which is now being replicated in many other countries, and the very encouraging resultant trends. The Australian experience and successes will be presented in a global context, with recognition that the tobacco industry will always oppose any measures that might reduce smoking and is constantly looking for new ways to resist action and promote its products. From this conclusions will be drawn and recommendations made for all concerned to reduce smoking, with consideration of next possible developments. Plain packaging, the world's darkest market, Tobacco Control, advocacy

Time to question diabetes self-management support for Arabic-speaking migrants: exploring a new model of care.

The objective of this study was to explore a new model for diabetes self-management support in Arabic-speaking migrants. Two qualitative methods were used: face-to-face semi-structured individual interviews and focus groups. Interviews were audio-taped, transcribed verbatim and coded thematically. Arabic-speaking migrants with Type 2 diabetes were recruited from several primary, secondary and tertiary healthcare settings in metropolitan Melbourne, Australia. These settings were purposefully selected to obtain a diverse group of participants. Data collection continued until saturation was reached. This is the first study that involved members of Arabic-speaking communities in Australia in a formal process of consumer and public involvement to inform research design and recruitment in order to provide evidence for a new model of diabetes self-management for Arabic-speaking migrants. No self-management support was offered to Arabic-speaking migrants beyond the initial diagnosis period. Significant knowledge gaps and skills deficits in all self-management domains were evident. The provision of tailored self-management support was considered crucial. When asked about preferred structure and delivery modalities, a strong preference was reported for face-to-face storytelling interactions over telephone- or internet-based interventions. Gender-specific group education and self-management support sessions delivered by Arabic-speaking diabetes health professionals, lay peers or social workers trained in diabetes self-management were highly regarded. A patient and public involvement approach allows genuine engagement with Arabic-speaking migrants with diabetes. There is urgent need for a new model for self-management support among Arabic-speaking migrants. Findings yielded new recommendations for diabetes health professionals working with these migrant communities to support behaviour change.

Sexual Harassment in the Egyptian Streets: Feminist Theory Revisited

This study examined the act of sexual harassment, as perceived by Egyptian male harassers. Participants’ justifications of their harassing acts were explained using feminist theory, which postulated that sexual harassment occurs due to men’s tendency to blame women for this act, their failure to empathize with its victims, and their attempt to punish their competitive efforts. In-depth interviews were conducted with nine self-professed harassers. Thematic analysis of these interviews produced theory-driven themes that reflected the above mentioned assertions of feminist theory. Moreover, thematic analysis added cultural depth to this theory’s explanation of sexual harassment by producing emerging themes that highlighted the roles of participants’ strict interpretations of religious texts and experiences of societal oppression in justifying this act. Recommendations for mental health professionals and policy makers who design intervention and prevention programs for sexual harassment will be presented.

Fitness to stand trial evaluations in immigration proceedings.

In Canada, criminal defendants have the right to participate in their legal defense. Although this right is often interpreted as relating to defendants' physical presence, it also relates to their mental abilities. Fitness to stand trial (FST) refers to defendants' capacity to complete procedural duties and follow court proceedings. The criteria for FST (also known as competency to stand trial) were defined in 1992 in the revision of the Canadian Criminal Code (CCC). Although the ultimate decision regarding competency lies with the court, the decision is traditionally based on the recommendations of mental health professionals (although in Canada, the report must be written by a physician; CCC, s.672.1). FST evaluations are the most commonly conducted forensic mental health assessment (O'Shaughnessy, 2007; van der Wolf et al., 2010). Between 1992 and 2004, approximately 1,860 defendants were found unfit to proceed with their criminal cases (Latimer & Lawrence, 2006). Moreover, Latimer and Lawrence (2006) noted that requests for competency evaluations and the number of persons found unfit have been increasing since the standard's development in 1992.FST, as described by the CCC, is limited to criminal settings and does not directly apply in immigration proceedings. However, a similar criterion exists for those in this type of setting. The Immigration and Refugee Board (IRB) of Canada requires that those members who are responsible for hearing the case and making a decision designate a representative for examinees or detainees who are unable to appreciate the nature of the immigration proceedings (IRB, 2005). Despite the existence of this standard, there are few details and little empirical research to assist in its implementation. The lack of clear guidelines is juxtaposed with an increased burden on the part of the claimants in immigration proceedings, as they often complete these proceedings without legally trained representatives (Rehaag, 2011).Although understudied, the role of FST is especially important in immigration settings (e.g., asylum hearings), where the outcome of the trial may involve a risk of persecution or death. The amount of individuals in Canada who could potentially be impacted by policies relating to immigration proceedings is substantial. Between 2006 and 2011, approximately 1,162,900 foreign-born individuals immigrated to Canada, representing 3.5% of Canada's total population (Statistics Canada, 2013). There were 539,036 refugee claimants from 1995 to 2014 (Citizenship & Immigration Canada, 2014). Although the largest recent immigrant group originated from Asia, individuals from Africa, the Caribbean, Central America, and South America are also immigrating at high rates (Statistics Canada, 2013).Although the standard for fitness in immigration settings does not specify the existence of a mental disorder, the responsibilities associated with fitness are particularly precarious for those with mental health problems. Psychological symptoms could impact individuals' abilities to understand and work effectively on their cases. This is problematic as individuals involved in immigration proceedings are likely to be suffering from symptoms of mental illness (Gros & van Groll, 2015). Cultural factors associated with migration may contribute to the risk of mental disorders, particularly psychotic disorders (Anderson, Cheng, Susser, McKenzie, & Kurdyak, 2015). For example, Anderson and colleagues (2015) found that in Canada, immigrants from the Caribbean and Bermuda and refugees from East Africa and South Asia had high rates of schizophrenia. Even when treatment is available, these individuals might remain untreated. This would likely impact the rates of fitness. As a point of comparison, although the presence of mental illness is not sufficient cause in and of itself, in criminal settings, defendants with psychotic disorders or symptomatology are more likely to be found unfit to stand trial at the time of the evaluations (Cooper & Zapf, 2003; Latimer & Lawrence, 2006; Viljoen, Zapf, & Roesch, 2003). …