Psychosocial Characteristics Of Patients Research Articles

The Potential of Percent Agreement as an Adjunctive Diagnostic Tool for Acute Temporomandibular Disorder.

Background/Objectives: It is well established that individuals with chronic temporomandibular disorder (TMD) exhibit differences in their physical and psychosocial characteristics from those with acute TMD. However, few studies have analyzed the physical and psychosocial characteristics of patients with acute TMD. The objective of this cross-sectional study is twofold: first, to ascertain whether there are differences in physical and psychosocial factors among patients with acute TMD based on the percent agreement between patient-reported pain sites and pain sites identified through standardized palpation and, second, to determine the potential of percent agreement as a diagnostic and prognostic factor. Methods: We analyzed physical and psychosocial factors in 309 patients diagnosed with acute TMD. Of these, 171 patients were selected for an analysis of their response to treatment. These patients were divided into three groups based on their percent agreement: Group A (agreement under 80%), Group B (agreement 80-89%), and Group C (agreement 90% or over) in the initial analysis and Group a (agreement under 80%), Group b (agreement 80-89%), and Group c (agreement 90% or over) in the subsequent analysis. This study was approved by the Ethics Committee of Pusan National University Dental Hospital (IRB No. 2023-05-011, 25 May 2023). Results: The lower the percent agreement, the greater the parafunctional oral habits, stress, chronicity, somatization, depression, anxiety, and number of painful sites. A lower percent agreement was associated with poorer treatment outcomes. The percent agreement demonstrated a 41.2% capacity to predict residual pain after treatment. Conclusions: Clinicians can utilize percentage agreement as an adjunctive diagnostic tool to provide more suitable treatments to patients.

DOLPHIN ASSISTED THERAPY: WELFARE OF BOTH PATIENTS WITH DEPRESSION AND PARTICIPATING DOLPHINS

The main aim of this research was to measure the effect of dolphin assisted therapy on both patients and participating dolphins. The research measured welfare of patients with depression and situational welfare of dolphins which participated in the dolphin assisted therapy programme. Patients with organic depression took part in two-week dolphin assisted therapy sessions. When measuring situational welfare of dolphins, the study sample consisted of nine individual dolphins (Tursiops truncatus ponticus, Lat.): three males and six females ranging from five to twenty years. The main research results revealed that psychosocial characteristics of patients with organic depression disorder as well as patients’ self-evaluation changed statistically significantly, the symptoms of depression decreased. The research revealed that patients were much more physically active during the period of participation in the dolphin assisted therapy process than before. The analysis of dolphin behaviour brought to the light that most of the therapy time dolphins behaved positively. There were noticed no therapy sessions where the dolphin behaviour would be evaluated as more negative than positive or just negative.

Using ambulance surveillance data to characterise blood-borne viral infection histories among patients presenting with acute alcohol and other drug-related harms.

Preventable transmission of blood-borne viruses (BBV), including human immunodeficiency virus (HIV), hepatitis C virus (HCV) and hepatitis B virus (HBV), continue in at-risk populations, including people who use alcohol and drugs (AODs). To our knowledge, no studies have explored the use of ambulance data for surveillance of AOD harms in patients with BBV infections. We used electronic patient care records from the National Ambulance Surveillance System for people who were attended by an ambulance in Victoria, Australia between July 2015 and July 2016 for AOD-related harms, and with identified history of a BBV infection. Descriptive and geospatial analyses explored the epidemiological and psychosocial characteristics of patients for these attendances. The present study included 1832 patients with a history of a BBV infection who required an ambulance for AOD-related harms. Amphetamines were reported in 24.7% of attendances where the patient identified HIV history, and heroin was reported more often for patients with viral hepatitis history (HCV: 19.2%; HBV: 12.7%). Higher proportions of attendances with a viral hepatitis history were observed in patients from the most socially disadvantaged areas. Geospatial analyses revealed higher concentrations of AOD attendances with a BBV history occurring in metropolitan Melbourne. Our study describes the utility of ambulance data to identify a sub-population of patients with a BBV history and complex medical and social characteristics. Repeat attendances of BBV history patients to paramedics could present an opportunity for ongoing surveillance using ambulance data and possible paramedic intervention, with potential linkage to appropriate BBV services.

Influence of psychosocial characteristics of patients and opinions of their relatives on indication for surgical treatment of pectus excavatum.

To assess the subjective experience of patients and their parents or relatives about the existing pectus excavatum deformity and to contribute to the definition of indications for surgical treatment of this deformity. The initial sample of psychosocial characteristics consisted of self-assessments and observations of patients (and parents) regarding their health, self-image, health care, possible environmental response to their physical appearance, expectations regarding treatment. A modified version of the original Nuss questionnaire on quality of life was used in the psychological part of the examination. The study included a sample of 58 patients aged 10 to 30 years, and a sample of 58 family members of the patient (parents, relatives). The experience of poor emotional status, withdrawals, and bad self-image in patients older than 15 years than younger were significant. The tendency for female patients to have a worse experience is pronounced and significant. The largest percentage of parents have an 'indecisive' or 'weakly expressed' attitude towards surgery. Parents at a significantly higher rate show greater concern for female children. A systematic evaluation of the psychosocial perception of patients and their relatives (who will consent for the operation) may be a useful diagnostic assessment before correcting an anterior chest wall malformation.

The distribution of somatic symptom disorder and bodily distress syndrome in general hospital outpatients in China: A multicenter cross-sectional study

ObjectiveTo investigate the distribution of somatic symptom disorder (SSD) and bodily distress syndrome (BDS) and analyze the differences in psychosocial characteristics of patients with the two diagnoses. MethodsA total of 694 general hospital outpatients completed the diagnostic interviews for SSD and BDS, and a set of questionnaires evaluating their psychosocial characteristics. A secondary analysis of these data is done. ResultsSSD and BDS had a moderate overlap (kappa value = 0.43). Patients who fulfilled both SSD and BDS diagnosis showed significantly higher levels of symptom-related psychological distress (SSD-12), somatic symptom severity (PHQ-15), depression (PHQ-9), and general anxiety (GAD-7), as well as lower mental and physical quality of life (SF-12) compared to patients with neither diagnosis and patients with only one diagnosis. Patients with either diagnosis were associated with significantly higher psychosocial impairments as compared to those with neither diagnosis. Patients who only met SSD had higher SSD-12 scores, whereas those with only BDS had higher PHQ-15 scores (p<0.001). ConclusionsSSD and BDS appear to represent somewhat different psychopathologies, with SSD more associated with psychological distress and BDS associated with greater experience of somatic symptoms. Patients fulfilling both diagnosis show higher symptom severity in various psychosocial aspects.

Psychological Traits of Patients with Central Serous Chorioretinopathy (Literature Review)

Central serous chorioretinopathy (CSC) is a polyethological disease. CSC is one of the few eye diseases for which the relationship between the occurrence, course of the disease and patient psychosocial characteristics has been demonstrated including personality traits and the level of external stress factors. Excessive stimulation such as stressful living conditions, exogenous factors and personal predisposition can lead to CSH. The disease often occurs against the background of acute or chronic stress. Patients with central serous chorioretinopathy are characterized by certain personality traits i.e., type A personality, including a tendency to overachievement, competition, perfectionism, and a sthenic desire to maintain professional status. At the same time, insomnia and sleep apnea, depressive and anxiety states, post-traumatic stress disorder and alexithymia, high blood pressure, Helicobacter pylori, autoimmune diseases, psychopharmacological medication, hormone therapy are among the risk factors.

Psychosocial characteristics of patients in a cosmetology clinic: results of a non-sample study

The relevance of the study is determined by the rapid development of medical cosmetology, which, unlike plastic surgery, has not been studied at all in psychological and sociological terms, although the effect of facial skin defects on the emotional state, social success, quality of life is beyond doubt, and their elimination significantly affects psychological well-being. patients. A practicing dermatologist-cosmetologist conducted a non-selective clinical and socio-psychological study of 188 patients (mean age 39.12+0.81 years) of a cosmetology clinic. The author’s structured interview and the medico-sociological scale «Level of social frustration» were used. According to 50 parameters, women with mild, moderate and significant severity of cosmetic problems were compared. Statistical methods of analysis were used (Pearson’s χ2 and ANOVA). An analysis of clinical data showed a relationship between the severity of a facial skin defect and its nature (symptoms), age, comorbid pathology, and treatment efficacy. Social positions (educational and labor status, nature of professional activity), significant spheres of personal relations (to oneself, to persons of the opposite sex, family relations, the presence and nature of mental trauma) were studied. Among the psychological and social characteristics, the characteristics of the family sphere, the reasons for visiting the clinic, and the patient›s subjective assessment of the impact of the cosmetic problem on the quality of life have a statistical relationship with the severity of the cosmetic problem and the age of the patients. The results are compared with the data of modern world literature. The limitations of the study associated with the use of non-standardized methods, which are relevant, however, to the tasks of a screening non-selective survey, are noted. The prospects for further studies of patients of the clinic for non-surgical correction of appearance using psychometric (standardized) methods are outlined.

The factors associated with orthorexia nervosa in type 2 diabetes and their effect on diabetes self-management scores

PurposeThis study aimed to determine the factors affecting the ORTO-R scores in individuals with T2DM and to investigate their effect on diabetes self-management.MethodsThe study included 373 individuals with type 2 diabetes between the ages of 18–65 who applied to Akdeniz University Hospital Endocrinology and Metabolic Diseases Polyclinic between January and May 2022. A questionnaire including sociodemographic data, information about diabetes, and nutritional habits, and the ORTO-R and Type 2 Diabetes Self-Management Scales were used to collect data. Linear regression analysis was performed to determine the factors affecting ORTO-R.ResultsThe linear regression analysis showed that age, gender, education level, and duration of diabetes affected ORTO-R scores in patients with type 2 diabetes. Body mass index, comorbidities (cardiovascular diseases, kidney diseases and hypertension), diabetes-related complications, diabetes treatment method and dieting had no significant contribution to the model (p > 0.05). We also found that education level, comorbidities, diabetes-related complications, diabetes treatment method, dieting, and BMI can affect diabetes self-management.ConclusionIt should be kept in mind that type 2 diabetes are at risk of orthorexia nervosa (ON) in terms of various aspects such as age, gender, education level and duration of diabetes. Since the factors affecting the risk of ON and the factors affecting diabetes self-management are intertwined, orthorexic tendencies should be kept under control while trying to increase self-management in these patients. In this respect, developing individual recommendations according to the psychosocial characteristics of patients may be an effective approach.Level of evidenceLevel V, cross-sectional study.

Psychosocial characteristics of patients undergoing cellular immunotherapies and their caregivers across time

Chimeric antigen receptor T-cells and other immunotherapies have markedly changed the paradigm of treatment for patients with relapsed or refractory hematologic malignancies. While notable in efficacy, immunotherapy is characterized by a significant possibility of life-threatening side effects. Consequently, patients are often required to have informal family caregivers present and to stay near the treating center for several weeks after cell infusion. Further, the responsibility of managing a great deal of physical care and emotional support falls to these caregivers. Given the novelty of immunotherapy treatment, there is a need to better understand the psychosocial experience of patients receiving this treatment and their caregivers. This article describes the psychosocial characteristics of patients undergoing cellular immunotherapies and their caregivers across time, including patient/caregiver distress, coping, and caregiver burden and preparedness.

Psychosocial Characteristics of Patients Evaluated for Kidney, Liver, or Heart Transplantation.

Psychosocial parameters play a pivotal role in organ recipient evaluation before wait-listing for transplantation because of their impact on organ and patient outcome. Patients in need of heart (HTx), liver (LTx), or kidney transplantation (KTx) face distinct physical and psychological challenges. This study compares the psychosocial characteristics and preferences for additional therapy for patients undergoing assessment for these three types of organ transplantation to optimize patient-tailored psychological, social, and other supportive interventions. We conducted a cross-sectional, observational study with 1110 potential transplantation candidates (LTx, n = 544; KTx, n = 330; HTx, n = 236), psychosocial status was determined for depressive symptoms (Patient Health Questionnaire Depression Scale), anxiety symptoms (seven-item Generalized Anxiety Disorder Screener), health-related quality of life (36-Item Short Form Health Survey), perceived social support (Perceived Social Support Questionnaire), sense of coherence (SoC; short form of the Sense of Coherence Scale), self-efficacy (General Self-Efficacy Short Scale), and body image (German Body Image Questionnaire-20). Preferences for additional supportive therapy were assessed dichotomously. Data were analyzed using multivariate analysis of covariance and χ2 tests. Patient groups differed significantly regarding depression ( F (2,1107) = 35.283, p < .001, partial η2 = 0.01), anxiety ( F (2,1107) = 15.027, p < .001, partial η2 = 0.03), health-related quality of life (physical: F (2,1107) = 96.772, p < .001, partial η2 = 0.15; mental: F (2,1107) = 11.442, p < .001, partial η2 = 0.02), perceived social support ( F (2,1107) = 20.813, p < .001, partial η2 = 0.04), SoC ( F (2,1107) = 12.920, p < .001, partial η2 = 0.02), self-efficacy ( F (2,1107) = 17.308, p < .001, partial η2 = 0.03), and body image (rejecting body evaluation: F (2,1107) = 5.006, p = .007, partial η2 = 0.01; vital body dynamics: F (2,1107) = 40.216, p < .001, partial η2 = 0.07). Patients evaluated for HTx showed the highest psychosocial impairment and the highest inclination regarding additional supportive therapy. Patients evaluated for HTx, LTx, and KTx have distinct psychosocial characteristics and treatment preferences. HTx patients display the highest psychosocial impairment. We suggest psychocardiological treatment structures for optimal outcome.

Effectiveness of Psychosocial Rehabilitation: Innovative Method of Results Assessment

Background: The main problem of evaluating the effectiveness of psychosocial rehabilitation (PSR) is incorrect methods of processing psychometric data obtained with the help of appropriate tools (scales and questionnaires), which are standard used to measure the effectiveness of interventions within the framework of the implementation of PSR procedures. The purpose of the study: 1) а systematic analysis of the problems of assessing the severity of mental disorders and the effectiveness of subsequent PSR; 2) development of cardinal algorithms for processing the initial expert information in order to obtain appropriate numerical criteria for the effectiveness of the PSR. Material and methods: a systematic analysis of domestic and foreign publications, based on the results of their own research on the problems of assessing patients’ conditions, as well as evaluating the effectiveness of a comprehensive long-term PSR program for people with schizophrenia and schizophrenic spectrum disorders in various forms of care (public organization, day hospital, hospital). As methods of information processing, clinical-psychopathological, psychometric, as well as methods of system analysis and the analytic hierarchy process (AHP) were used. Results: an innovative methodology and algorithms for processing expert clinical, psychopathological and psychometric information based on the AHP apparatus have been developed to develop criteria for the effectiveness of PSR. The cardinal difference between the proposed approach and the rank methods of processing initial information is that the results of processing initial expert information are obtained in the fundamental scale of AHP (numerical scale), which ensures the correct integration of psychometric and psychosocial characteristics of patients when considering diagnostic procedures, psychosocial therapy and rehabilitation. Conclusions: the calculations are based on expert assessments of the weight of areas of impaired functioning of patients and the corresponding changes in psychosocial characteristics. This ensures the universality of the methodology and algorithms for evaluating the effectiveness of any rehabilitation interventions: from psychosocial to physiotherapy.

Factors influencing the duration of hospitalization of patients with schizophrenia.

IntroductionSevere mental disorders represent an important and large proportion of healthcare resource utilization and are associated with increased hospitalization rates and costs. Given the high percentage of total hospital days and costs associated with caring for people with psychotic disorders, a better understanding of the factors that determine the duration of hospitalization of patients with such disorders is imperative.PurposeThe aim of the present study was to investigate socio-demographic, clinical and psychosocial characteristics of patients with schizophrenia, admitted to a Greek public psychiatric hospital, and the relationship between these characteristics and duration of hospitalization among these patients.MethodsThis is a cross-sectional study. The study sample consisted of 103 patients diagnosed with schizophrenia (F-20). The collection of data was performed by using the NEO-Five Factor Inventory, the Connor-Davidson Resilience Scale (CD-RISC25), Multidimensional Scale of Perceived Social Support, (MSPSS), Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning scale (GAF) for assessing key personality factors, psychological resilience, social support, symptom severity and the severity of the disease, respectively. Descriptive analyses and inferential statistic methods were applied. Correlation between socio-demographic, psychosocial or clinical characteristics with the length of stay were explored. In addition, linear regression analysis was performed in order to examine predicting factors for the duration of hospitalization. All statistical analysis was performed using SPSS v.25.ResultsThe mean age of the sample was 43.9 (SD = ±11.4) years, 67% of patients were men, and the mean length of hospitalization was 40.7 days. Factors found to be significantly associated with length of stay in the overall sample include the previous admissions (p=0.010), the type of admission (compulsory or voluntary) (p=0.017), bed rest (p=0.043) and duration of bed rest (p=0.002), and the existence of social support networks especially from friends (p=0.018).ConclusionsOur findings indicate that basic psychosocial and clinical factors were associated with the duration of hospital stay. Duration of hospitalization results from a complex interface between characteristics and activities of the health system, patient, and clinician’s influence on discharge timing, which requires additional study. Our findings further warrant the need for policymakers to consider socio-demographic status, psychosocial and clinical factors when allocating resources to hospitals caring for patients with severe mental disorders.

Non-suicidal and Suicidal Self-harm at a Psychiatric Centre: A review of cases

Background&#x0D; Previous self-harm has been reported as an important risk factor for future attempts and death by suicide, therefore understanding the psychosocial characteristics of people with a history of self-harm may help in developing models for reduction of suicide. The objective of this study was to present the psychosocial characteristics of patients who presented with self-harm and recorded them in our suicidality register.&#x0D; Method&#x0D; This is a review of the suicidality register of patients who presented with deliberate self-harm and were referred and reviewed by the psychiatric unit at the Ekiti State University Teaching Hospital (EKUSTH). Data were retrieved from the register and enter in SPSS version 25. Descriptive statistics such as mean with standard deviation and frequency were done to describe the characteristics of interest.&#x0D; Results&#x0D; Of the 33 cases reviewed, the majority were females 51.6%, aged 29years and below, single (67.7%), unemployed 17 (51.5%), and had depression as the primary psychiatry diagnosis (54.5%). Although multiple reasons were given for self-harm, the desire to die was the commonest (54.5%) while ingestion of poisons was the commonest (75.8%) method adopted.&#x0D; Conclusion&#x0D; Previous self-harm is an important risk factor for future attempts and death by suicide, understanding the psychosocial characteristics of people with a history of self-harm may help in developing frameworks for a surveillance system for self-harm and attempted suicides.

Non-suicidal and Suicidal Self-harm at a Psychiatric Centre: A review of cases

Background&#x0D; Previous self-harm has been reported as an important risk factor for future attempts and death by suicide, therefore understanding the psychosocial characteristics of people with a history of self-harm may help in developing models for reduction of suicide. The objective of this study was to present the psychosocial characteristics of patients who presented with self-harm and recorded them in our suicidality register.&#x0D; Method&#x0D; This is a review of the suicidality register of patients who presented with deliberate self-harm and were referred and reviewed by the psychiatric unit at the Ekiti State University Teaching Hospital (EKUSTH). Data were retrieved from the register and enter in SPSS version 25. Descriptive statistics such as mean with standard deviation and frequency were done to describe the characteristics of interest.&#x0D; Results&#x0D; Of the 33 cases reviewed, the majority were females 51.6%, aged 29years and below, single (67.7%), unemployed 17 (51.5%), and had depression as the primary psychiatry diagnosis (54.5%). Although multiple reasons were given for self-harm, the desire to die was the commonest (54.5%) while ingestion of poisons was the commonest (75.8%) method adopted.&#x0D; Conclusion&#x0D; Previous self-harm is an important risk factor for future attempts and death by suicide, understanding the psychosocial characteristics of people with a history of self-harm may help in developing frameworks for a surveillance system for self-harm and attempted suicides.

Psychosocial characteristics of patients evaluated for kidney transplant and associations with functional and frailty metrics at a veterans affairs hospital.

The effect of psychosocial problems on listing outcomes and potential interactions with functional metrics is not well-characterized among Veteran transplant candidates. The results from psychosocial evaluations, frailty metrics, and biochemical markers were collected on 375 consecutive Veteran kidney transplant candidates. Psychosocial diagnoses were compared between patients listed or denied for transplant. Functional abilities were compared among patients with or without psychosocial diagnoses and then evaluated based on reason for denial. Eighty-four percent of patients had a psychosocial diagnosis. Common issues included substance or alcohol abuse (62%), psychiatric diagnoses (50%), and poor adherence (25%). Patients with psychiatric diagnoses, cognitive impairments, and poor adherence were more likely to be denied for transplant (P<.05). Patients with depression, PTSD, and anxiety did not have worse functional ability, but experienced more exhaustion than patients without these problems. Patients denied for medical but not purely psychosocial reasons had worse troponin and functional metrics compared with listed patients. Over 80% of patients with a psychosocial diagnosis were listed; however, poor adherence was a particularly important reason for denial for purely psychosocial reasons. Patients with psychosocial diagnoses generally were not more functionally limited than their counterparts without psychosocial diagnoses or those listed for transplant.

MP13-18 EXAMINING ASSOCIATIONS BETWEEN PATIENT PSYCHOSOCIAL CHARACTERISTICS, COPING, AND QUALITY OF LIFE

INTRODUCTION AND OBJECTIVE:The aims of this study are to: a) describe patient psychosocial characteristics measured as self-efficacy beliefs and perceived social support, and b) explore mediation e...

Impact of social support on severity of depressive symptoms by remission status in patients with rheumatoid arthritis

We aimed to examine the psychosocial characteristics of patients with rheumatoid arthritis (RA) by remission status and determine the impacts of social support on severity of depressive symptoms. We enrolled RA patients aged 40-79 years who visited university hospitals' outpatient clinics. Severity of depressive symptoms (Beck Depression Inventory-II), physical disability (Health Assessment Questionnaire), and support were evaluated. Furthermore, RA disease activity was evaluated by 28-point Disease Activity Score (DAS28) calculation. The independent impacts of instrumental and emotional social support on depressive symptoms by remission status defined as DAS28 score < 2.6 were estimated by multivariable regression analysis. This study included 360 RA patients. In the remission group, emotional support showed a statistically significant negative impact on depressive symptoms, whereas instrumental support had an extremely limited contribution to severity of depressive symptoms. In the non-remission group, instrumental support showed a negative tendency of impact on severity of depressive symptoms, whereas emotional support had a wide range of influence. Favourable association between emotional support and depressive symptoms is confirmed only among RA patients in remission status. The influence of emotional support in non-remission patients and that of instrumental support regardless of remission status are inconclusive.

P106 Planning and development of a long-term digital self-management tool for osteoarthritis: the Intelligent Knee Osteoarthritis Lifestyle App

Abstract Background/Aims There is strong evidence for beneficial effects of physical activity for people with knee osteoarthritis (KOA). While supervised exercise programmes are effective, they are resource intensive, typically of limited duration and hard to implement at scale. More accessible options should be developed to enable individuals to adopt and maintain appropriate physically active lifestyles. Smartphone apps can monitor activity and symptoms, providing feedback to support self-management. We aimed to co-design a KOA self-management app, with physiotherapists and people experiencing KOA, to support long-term physical activity. Methods We followed the Person-Based Approach to developing health interventions. We initially undertook a rapid review of clinical exercise guidelines and KOA position statements. Views from potential app users were elicited via focus groups, to determine attitudes towards physical activity, KOA self-management technology, and identify desired app features. Physiotherapists were interviewed to establish factors that feed into physical activity advice and recommendations in a clinical context, and determine which features they deemed appropriate to incorporate into an app. We then mapped established behaviour change techniques to potential features. Combining these sources of information, we developed guiding principles, then iteratively developed and refined the app through “think aloud” interviews with potential users and interviews with physiotherapists to assess appropriateness and safety. Results Literature scoping established positive effects for a range of exercise modes, with NICE guidelines highlighting physical activity, education and weight management as core treatments for KOA. Patient focus groups highlighted uncertainty about the potential benefits and/or harms associated with physical activity, as well as confusion regarding appropriate sources of information. Patients emphasised the importance of symptom tracking and the benefits of social support as an important factor in motivation to engage in and sustain activity. Interviews with physiotherapists revealed physical and psycho-social characteristics of patients to consider when recommending physical activities. Physiotherapists and patients both expressed the necessity for activities to be tailored to individual capabilities and preferences. Conclusion The Intelligent Knee Osteoarthritis Lifestyle App (iKOALA) is an evidence-based smartphone app to support long-term self-management for individuals with KOA. The app facilitates appropriate physical activity adoption and maintenance; provides feedback from linked wearable activity trackers; gives information and intelligently tailored physical activity options from patient preferences and symptoms. Broader self-management aspects include rehabilitation exercise content, symptom tracking and alerts, weight management tools and education resources. Crucially, for long-term maintenance, the app includes forum features, fostering social relatedness among users. The app has received positive feedback from potential users in terms of usability and perceived utility. Physiotherapists have provided positive clinical impressions and validated the appropriateness of the content and features. The app is undergoing extended user testing with patients, following which, we aim to assess the effectiveness of the app in a randomised trial. Disclosure E.A. Chowdhury: None. V. Ceballos Inza: None. M.J. Western: None. N.E. Walsh: None. J.L.J. Bilzon: None. S.L. Jones: None.

Drug adherence and psychosocial characteristics of patients presenting with hypertensive urgency at the emergency department.

To identify potentially targetable psychosocial factors associated with nonadherence to prescribed antihypertensive medications in patients presenting with hypertensive urgencies at an emergency department. This prospective study included patients treated with antihypertensive drugs who presented with hypertensive urgencies (SBP ≥180 mmHg and/or DBP ≥110 mmHg) at the emergency department of a tertiary referral clinic between April 2018 and April 2019. Health literacy was assessed using the Newest Vital Sign test. The Hospital Anxiety and Depression Scale (HADS) was used to quantify symptoms of anxiety and depression. Patients were classified nonadherent if less than 80% of the prescribed antihypertensive drugs were detectable in urine or plasma using liquid chromatography-high-resolution mass spectrometry. A total of 104 patients (62% women) presenting with hypertensive urgencies with a median SBP of 200 mmHg (IQR 190-212) and DBP of 97.5 mmHg (IQR 87-104) were included. Twenty-five patients (24%) were nonadherent to their antihypertensive medication. Nonadherent patients were more often men (66 versus 23%, P = 0.039), prescribed higher numbers of antihypertensive drugs (median 3, IQR 3-4 versus 2, IQR 1-3; P < 0.001), and more often treated with calcium channel blockers (76 versus 25%; P < 0.001) and/or diuretics (64 versus 40%; P = 0.030). There was no difference in health literacy (P = 0.904) or the scores on the HADS subscales for depression (P = 0.319) and anxiety (P = 0.529) between adherent and nonadherent patients. Male sex, higher numbers of antihypertensive drugs, and treatment with diuretics and/or calcium channel blockers were associated with nonadherence. We did not identify a specific psychosocial characteristic associated with nonadherence.

What is the optimum rehabilitation for patients who have undergone release procedures for frozen shoulder? A UK survey

ObjectiveDespite usually being considered necessary, the rehabilitation regime that optimises outcomes for patients following release procedures for frozen shoulder has not been established and no accepted best practice guidelines currently exist. The purpose of this study was to gain insight into what physiotherapists considered best practice and factors they considered likely to affect patient outcome. MethodsA cross-sectional, self-administered online questionnaire was developed and distributed to UK based Physiotherapists, undergraduate students and support workers via email, social media and professional networks. Results260 eligible and fully completed surveys were received. Clear preference for early (within 72 h), frequent (2–3 times per week or weekly) and prolonged (greater than 6 weeks) treatment delivered in a 1:1 setting was expressed. 99% were highly likely/likely to advocate education and advice, range of movement exercises (99.6%), stretching (73.5%) and strengthening (61.9%). More passive modalities (manual therapy, massage, electrotherapy, acupuncture) were highly unlikely/unlikely to be used and lack of manual therapy and insufficient contact with a physiotherapist were the reasons deemed least likely to affect outcome. Most clinicians (89.2%) were likely to prescribe exercises that patients reported as painful but persistent pain and poor adherence by patients to exercises were the top reasons given for poor outcome along with psychological and psychosocial patient characteristics. ConclusionPhysiotherapists consistently advocate early, frequent, prolonged, 1:1 treatment following release procedures for frozen shoulder. Most patients are discharged whilst still experiencing symptoms, particularly pain. Further work is needed to establish high value pathways for this patient group.