Support Network For Patients Research Articles

Forecasting the incidence frequencies of schizophrenia using deep learning

Mental disorders are becoming increasingly prevalent worldwide, and accurate incidence forecasting is crucial for effective mental health strategies. This study developed a long short-term memory (LSTM)-based recurrent neural network model to predict schizophrenia in inpatients in Taiwan. Data was collected on individuals aged over 20 years and diagnosed with schizophrenia between 1998 and 2015 from the National Health Insurance Research Database (NHIRD). The study compared six models, including LSTM, exponential smoothing, autoregressive integrated moving average, particle swarm optimization (PSO), PSO-based support vector regression, and deep neural network models, in terms of their predictive performance. The results showed that the LSTM model had the best accuracy, with the lowest mean absolute percentage error (2.34), root mean square error (157.42), and mean average error (154,831.70). This finding highlights the reliability of the LSTM model for forecasting mental disorder incidence. The study's findings provide valuable insights that can help government administrators devise clinical strategies for schizophrenia, and policymakers can use these predictions to formulate healthcare education and financial planning initiatives, fostering support networks for patients, caregivers, and the public.

A systematic review of research examining mothers, infants, family and staff in psychiatric mother-baby units.

This systematic review aimed to summarise and synthesise research conducted in psychiatric mother-baby units (MBUs) in relation to patients, their families, or staff, published from 1st January 2016 to 1st May 2024. Quantitative, qualitative, and mixed-method studies were included for review if they were published in peer-review journals in English and reported research on MBUs between January 2016 and May 2024. From the initial yield of 10,007 unique studies, 53 studies were included for review. MBU research was found to more frequently investigate maternal characteristics rather than the benefits of MBU treatment compared to studies conducted prior to 2016. Most studies that did investigate impact of admission showed favourable results, however few follow-up studies and studies comparing MBU outcomes to other clinical settings were undertaken. Little research has been conducted to investigate the differential impacts of MBU admission on different diagnoses and long-term (>1 year) patient outcomes. There was a dearth of research investigating partners of women in MBUs and few studies conducted on infant outcomes. MBUs were consistently found to improve mental health systems and mother-infant attachment in patients after admission. More research investigating patient support networks and child health, impact of diagnosis on outcomes, and studies with adequate follow-up are required.

What it means to live with fibromyalgia for Peruvian women: A phenomenological study

IntroductionPatients with fibromyalgia experience pain at a constant and incapacitating pace. It is still a complex entity yet to be fully understood but meanwhile affects patients in every aspect of their lives. ObjectiveThe purpose of this study is to describe what living with fibromyalgia means for Peruvian women and how it affects their family, work, and social lives in 2021. Materials and methodsThe study has a qualitative design with a phenomenological approach; snowball sampling and theoretical saturation sample size; 10 patients were interviewed through semi-structured in-depth interviews. An ideographic and a nomothetic analysis were conducted, divergences and convergences in the statements were sought and units of analysis were obtained. ResultsThere were 12 categories: meaning of fibromyalgia, clinical picture, complications and sequelae, diagnostic process, impact on work, impact on family life, impact on social life, experience with health personnel, lessons learned from fibromyalgia, ecclesiastical support, and myths, misinformation, and prejudices about fibromyalgia. ConclusionThe experiences and the clinical picture are diverse, the family remains an active and reliable support network for patients, unlike social and work lives, where there is a lack of initiative or empathy towards patients. In light of our findings, we expect healthcare workers and the public in general to learn and see beyond “just histrionics” or “attention seekers” and thus improve the patient's quality of life.

How I Treat Alopecia in Patients with Cancer

For general dermatologists, the examination, diagnosis, and treatment of hair loss in patients with a history of cancer can be challenging. Previous and current chemotherapy, radiation therapy, and anti-cancer therapies need to be considered when developing a management strategy. Here we review strategies for reviewing patient medical histories, the incorporation trichoscopic examinations to aid with diagnosis, and special treatment considerations that do not increase risk of cancer reoccurrence. As novel anti-cancer therapeutics continue to be approved, it is imperative that dermatologists serve in support networks of patients experiencing dermatologic side effects. This article aims to aid dermatologists in the safe and effective treatment of hair-related side effects that negatively impact the survivorship of patients with cancer.

OVERLOAD AND STRATEGIES TO FACE THE FAMILIES OF PEOPLE WITH MENTAL DISORDER IN THE FACE OF THE HEALTH PROCESS- DISEASE: A REVIEW OF LITERATURE

The family is the main support network for patients in psychological distress, however, in daily professional life, family members are overloaded. The study aims to present the knowledge produced about the burden on caregivers of people with mental disorders and recognize family members' coping strategies when faced with the health-disease process. This is a literature review carried out in the MEDLINE, LILACS, SCIELO and PEPSIC databases. 11 articles available in full were included, published between 2013 and 2023. It was evident that caregivers changed family dynamics, gave up professional and social life, as well as leisure activities. Coping strategies include using faith, seeking social and group support, using medication, trying to solve the problem, accepting responsibilities, positive reassessment, escape, avoidance and attempts at family integration. The importance of supporting caregivers of patients with severe mental disorders is evident, and it is essential to implement support programs for caregivers of these patients within the scope of the psychosocial care network.

Tell Me More® As A Tool for Provider Connectedness With Hospitalized Patients: A Mixed-Methods Study.

Rates of burnout and compassion fatigue in healthcare professionals have remained high since the beginning of the pandemic with adverse implications for patient care. Tell Me More® (TMM) is a tool licensed by the Gold Foundation, which was created with the purpose of helping patients, caregivers, and hospital staff to connect with each other on a humanistic level. Research has shown the benefits of the TMM with students and anecdotally with patients. This mixed-method study, which consisted of surveys and semistructured interviews with healthcare professionals (n = 72), sought out to understand the impact of implementation of TMM on a hospital floor. Surveys were distributed before and after the occurrence of TMM with interviews only occurring afterward. Three out of 8 survey items were found to be significant. Content analysis from interviews generated 4 themes from participants which included "Connectedness to Patient," "Separation of Person and Illness," "Communication with Patient's Support Network," and "Connectedness with Non-Verbal Patients." TMM is a useful tool for strengthening provider-patient relationships in hospital settings and may therefore lessen compassion fatigue and burnout.

Challenges to dialysis treatment during the COVID-19 pandemic: a qualitative study of patients' and experts' perspectives.

The global COVID-19 pandemic transformed healthcare services in ways that have impacted individual physical and psychological health. The substantial health challenges routinely faced by dialysis-dependent patients with advanced kidney disease have increased considerably during the ongoing COVID-19 pandemic but remain inadequately investigated. We therefore decided to analyze and compare the perspectives of dialysis patients on their own needs and challenges during the COVID-19 pandemic with those of their professional healthcare providers through interviews with both groups. Qualitative study of seven in-center hemodialysis patients, seven peritoneal dialysis patients, seven dialysis nurses, and seven physicians at the Medical University of Vienna between March 2020 and February 2021, involving content analysis of semi-structured interviews supported by a natural language processing technique. Among the main themes emerging from interviews with patients were: (1) concerns about being a 'high-risk patient'; (2) little fear of COVID-19 as a patient on hemodialysis; (3) questions about home dialysis as a better choice than in-center dialysis. Among the main themes brought up by physicians and nurses were: (1) anxiety, sadness, and loneliness of peritoneal dialysis patients; (2) negative impact of changes in clinical routine on patients' well-being; (3) telehealth as a new modality of care. Preventive measures against COVID-19 (e.g., use of facemasks, distancing, isolation), the introduction of telemedicine, and an increase in home dialysis have led to communication barriers and reduced face-to-face and direct physical contact between healthcare providers and patients. Physicians did not perceive the full extent of patients' psychological burdens. Selection/modification of dialysis modality should include analysis of the patient's support network and proactive discussion between dialysis patients and their healthcare providers about implications of the ongoing COVID-19 epidemic. Modification of clinical routine care to increase frequency of psychological evaluation should be considered in anticipation of future surges of COVID-19 or currently unforeseen pandemics.

Improving the cancer adult patient support network (iCAN): a pilot study on a communication model and modified focus group

BackgroundMany consider that cancer has the greatest impact of any disease in the world, and it can drastically limit patients’ quality of life. Combating such a life-threatening disease can pose many challenges to daily life, highlighted by demonstrating the need to discuss one’s health status within a focus group and encourage treatment compliance.Aimthe purposes of this study were to share the authors’ experience of a modified focus group in an Oral Medicine Unit, termed “Improving Cancer Adult Patients Support Network” (iCAN), and to evaluate how effective communication could improve patients’ quality of life and empower them by virtue of enhanced knowledge and an awareness of cancer management.Methodsthe paper adhered to the COREQ checklist regarding its reporting procedures. The iCAN format was precisely reproduced four times with four groups, consisting of 12 adult male and female patients with solid cancers. They discussed several main topics relating to cancer treatment, as chosen by a majority of the participants. Four specialists were involved in the discussion of the selected topics The iCAN format was faithfully reproduced during each meeting, with the participants in the roles of moderator and health specialists. Finally, a satisfaction questionnaire was administered.Resultsthe most reliable results demonstrated a marked change in lifestyle and eating habits in more than 50% of participants. More than 80% were unaware of the side effects of cancer treatments in general and the oral mucosa in particular. Each meeting reported a maximum degree of satisfaction experienced by the participants.ConclusioniCAN focus group meetings appear to have facilitated a process of narrative interviewing, thereby improving the doctor-patient relationship underlying the humanization of the care process.

What it means to live with fibromyalgia for Peruvian women: A phenomenological study

IntroductionPatients with fibromyalgia experience pain at a constant and incapacitating pace. It is still a complex entity yet to be fully understood but meanwhile affects patients in every aspect of their lives. ObjectiveThe purpose of this study is to describe what living with fibromyalgia means for Peruvian women and how it affects their family, work, and social lives in 2021. Materials and methodsThe study has a qualitative design with a phenomenological approach; snowball sampling and theoretical saturation sample size; 10 patients were interviewed through semi-structured in-depth interviews. An ideographic and a nomothetic analysis were conducted, divergences and convergences in the statements were sought and units of analysis were obtained. ResultsThere were 12 categories: meaning of fibromyalgia, clinical picture, complications and sequelae, diagnostic process, impact on work, impact on family life, impact on social life, experience with health personnel, lessons learned from fibromyalgia, ecclesiastical support, and myths, misinformation, and prejudices about fibromyalgia. ConclusionThe experiences and the clinical picture are diverse, the family remains an active and reliable support network for patients, unlike social and work lives, where there is a lack of initiative or empathy towards patients. In light of our findings, we expect healthcare workers and the public in general to learn and see beyond “just histrionics” or “attention seekers” and thus improve the patient's quality of life.

#4421 CHALLENGES TO DIALYSIS TREATMENT DURING THE COVID-19 PANDEMIC: A QUALITATIVE STUDY OF PATIENTS’ AND EXPERTS’ PERSPECTIVES

Abstract Background and Aims The substantial health challenges faced by patients on peritoneal dialysis (PD) or hemodialysis (HD) have increased considerably during the ongoing COVID-19 pandemic, but remain inadequately investigated. We therefore decided to compare the perspectives of PD and in-center HD patients on their needs and challenges through this period with those of their healthcare professionals through interviews with both groups. Method Qualitative study of 7 in-center HD patients, 7 PD patients, 7 dialysis nurses and 7 physicians at the Division of Nephrology and Dialysis, Medical University of Vienna between March 2020 and February 2021, involving content analysis of semi-structured interviews supported by a natural language processing technique. Results Main themes brought up by patients included: 1) Concerns about being a ‘high risk patient’; 2) Having reduced fear of COVID-19 as an HD patient; 3) Whether home dialysis might be better than in-center dialysis during COVID-19; 4) Changes in clinical routine; 5) Positive psychological elements to overcome stress. Main themes emerging from interviews with physicians and nurses included: 1) Fear of COVID-19 infection; 2) Anxiety, sadness, loneliness of PD patients; 3) Negative impact of changes in clinical routine on patients' well-being; 4) Telehealth as a new care modality. Conclusion Physicians did not perceive the full extent of patients’ psychological burdens. Positive psychological constructs were more evident in survivors of previous serious health crises. Patients' concerns related to COVID-19 need to be addressed proactively. Implementation of measures to prevent COVID-19 transmission, introduction of telemedicine, and increased use of home-dialysis have led to communication barriers and reduced contact between healthcare providers and patients. Selection or modification of dialysis modality should include analysis of the patient's support network as well as periodic psychological assessment of patients in anticipation of future surges of COVID-19 or of currently unforeseen pandemics.

Adherence to Hypertensive Treatment among Vietnamese Patients in New Orleans

Our principal objectives were to identify the level of adherence and identify the attitudes, beliefs, and behaviors that influence adherence to antihypertensive treatment among Vietnamese patients in New Orleans, Louisiana. By partnering with a community health center serving the Vietnamese community in New Orleans, we conducted reviews of 250 medical records of hypertensive patients receiving care there, 3 provider interviews, and 8 patient interviews. Descriptive and thematic analyses were used. The level of treatment nonadherence in our sample population was 20.40%. Findings highlighted several key factors that may contribute to adherence, including easy access to providers, who are culturally competent and have used several strategies to help increase adherence, and the social support network of patients within a close-knit community. Other sociodemographic factors, such as age, sex, and tobacco and alcohol use also may play a role in adherence. Adherence to antihypertensive treatment among Vietnamese patients in New Orleans was relatively high compared with other ethnic and racial groups in the United States. Further assessment of the characteristics of patients, providers, and the community may improve adherence to other chronic conditions in this population and patients of other ethnicities and races.

Quality of breast reconstruction service at a university hospital as assessed by the patients.

To evaluate the quality of breast reconstruction service at a university hospital, as assessed by the patients. This cross-sectional study enrolled adult women who underwent immediate or delayed breast reconstruction by any technique performed at a university hospital between 1 and 24 months before the assessment. The Brazilian version of the Health Service Quality Scale (HSQS) was self-applied to the participants. The HSQS produces percentage scores, which are expressed in values ranging from 0 to 10 for each domain of the scale, and into an overall percentage quality score. The management team was asked to establish a minimum satisfactory score for the breast reconstruction service. Ninety patients were included. The management team considered 8.00 the minimum satisfactory score for the service. The overall percentage score was 93.3%. Only one domain, 'Support,' had an average score lower than that considered satisfactory (7.22 ± 3.0); while the others had higher scores. The domain that scored highest was 'Qualification' (9.94 ± 0.3), followed by 'Result' (9.86 ± 0.4). There was a positive correlation between 'type of oncologic surgery' and 'intentions of loyalty to the service' (ρ = 0.272; p = 0.009) and a negative correlation between 'education' and 'quality of the environment' (ρ = -0.218; p = 0.039). The higher the patient's level of education, the higher the score attributed to 'relationship' (ρ = 0.261; p = 0.013) and the lower the score of 'aesthetics and functionality' (ρ = -0.237; p = 0.024). The quality of the breast reconstruction service was considered satisfactory, but there is a demand for structural improvements, better interpersonal relationships, and a stronger support network for patients.

Evaluating the Risk of Suicide and Violence in Severe Mental Illness: A Feasibility Study of Two Risk Assessment Tools (OxMIS and OxMIV) in General Psychiatric Settings.

BackgroundTwo OxRisk risk assessment tools, the Oxford Mental Illness and Suicide (OxMIS) and the Oxford Mental Illness and Violence (OxMIV), were developed and validated using national linked registries in Sweden, to assess suicide and violence risk in individuals with severe mental illness (schizophrenia-spectrum disorders and bipolar disorders). In this study, we aim to examine the feasibility and acceptability of the tools in three different clinical services.MethodWe employed a two-step mixed-methods approach, by combining quantitative analyses of risk scores of 147 individual patients, and thematic analyses of qualitative data. First, 38 clinicians were asked to use OxMIS and OxMIV when conducting their routine risk assessments in patients with severe mental illness. The risk scores for each patient (which provide a probability of the outcome over 12 months) were then compared to the unstructured clinical risk assessment made by the treating clinician. Second, we carried out semi-structured interviews with the clinicians on the acceptability and utility of the tools. Thematic analysis was conducted on the qualitative data to identify common themes, in terms of the utility, accuracy, and acceptability of the tools. The investigations were undertaken in three general adult psychiatric clinics located in the cities of Barcelona and Sevilla (Spain), and Changsha (China).ResultsMedian risk probabilities over 12 months for OxMIS were 1.0% in the Spanish patient sample and 1.9% in the Chinese sample. For OxMIV, they were 0.7% (Spanish) and 0.8% (Chinese). In the thematic analysis, clinicians described the tools as easy to use, and thought that the risk score improved risk management. Potential additions to predictors were suggested, including family history and the patient's support network. Concordance rates of risk estimates between the tools and clinicians was high for violence (94.4%; 68/72) and moderate for suicide (50.0%; 36/72).ConclusionBoth OxMIS and OxMIV are feasible and practical in different general adult psychiatric settings. Clinicians interviewed found that both tools provide a useful structured approach to estimate the risk of suicide and violence. Risk scores from OxMIS and OxMIV can also be used to assist clinical decision-making for future management.

A binational cancer registry analysis of Hispanic patients in Mexico and the United States.

e22513 Background: A marked disparity in cancer burden exists between regions of the world. This global picture can only be obtained because of data obtained from population-based cancer registries, which allow estimates for different geographic areas. We investigate the data differences, clinical characteristics, tumor information, and patient outcomes of Hispanic patients in North America. Methods: We used data from Mexico’s National Cancer Registry and the United States Surveillance, Epidemiology, and End Results Program (SEER) program with four years of follow-up on each registry. of Mexican registry, we excluded outliers and records with more than 80% missing variable; of the United States registry, only patients identified as hispanic or latino were included. On the Mexican registry we re-coded all variables and the United States registry data on secondary neoplasm was excluded to match boths registry. Baseline characteristics and a geographical information system was constructed to map cancer registries and their relative frequencies. A survival analysis was done to understand the correlation between covariates. Lastly, we build machine learning models to predict 3-year overall survival. Results: The Hispanic cancer database (HCB) consists of 291,178 patients (19,904 from Mexico, and 271,274 from the United States). The top three most frequent cancer types were breast, prostate and hematological. The age of diagnosis was 55±17 years. Mexico has a slight skewness towards the earlier age of diagnosis of females. The registries with the highest burden of cancer were New Mexico (USA) and Baja California Sur (Mexico). Average survival months seem very stable across registries in the United States, but not in Mexico. Our linear regression model achieved a coefficient of determination (R-squared) of 0.49, while the logistic regression achieved an AUC of 0.82, with an F1-score of 0.88. Conclusions: Cancer registries are important tools for prevention and development of control programs. Hispanics are a traditionally neglected population in oncological clinical trials, with low enrollment of patients outside of the United States. Mexico enacted its National Cancer Registry Law in 2017, which alongside the Hispanic data on the SEER program in the United States offers enormous opportunities for continued collaboration and understanding of cancer. Both Mexico and the United States can strengthen their cancer prevention strategies and generate trans-border collaboration, research, and patient-support networks.

Challenges for Peritoneal Dialysis Centers Before and During the COVID-19 Pandemic in Mexico

Aim. We aimed at performing a situation analysis to identify challenges that Mexico's peritoneal dialysis centers (PDCs) have faced before and during the COVID-19 pandemic.Methods. From May–August 2021, we conducted a cross-sectional nationwide online survey with the heads of 136 PDCs at the Mexican Institute of Social Security. The survey gathered information about PDCs characteristics and the adaptations and challenges they faced before and during the COVID-19 pandemic. The response rate to the survey was 79.5% (136 out of 171 PDCs). We used descriptive statistics to analyze the data.Results. The survey responses suggest wide variations between PDCs regarding their number of patients, healthcare staff availability, and compliance with the International Society for Peritoneal Dialysis recommendations. In the pre-pandemic period, PDCs faced staff shortages (71.3%); scarcity of supplies (39.0%); catheter dysfunctions (29.4%); poor patient adherence to peritoneal dialysis (PD) (28.6%); and lack of patient support networks (25.7%). During the pandemic, PDCs faced emergent challenges, such as losing designated PDC areas within hospitals (61.0%), and staff and supply shortages (60.2%, 41.1%, respectively) because of a reallocation of human and physical resources towards the COVID-19 response. The pandemic prompted 86.7% of PDCs to implement preventive public health measures, delay non-urgent consultations and procedures (63.6%), and introduce telemedicine (37.3%). Additionally, fewer patients visited PDCs because of their fear of COVID-19 contagion (36.0%).Conclusions. Actions are urgently needed to ensure adherence to evidence-based PD guidelines and sufficient resources, including trained staff, supplies, and designated spaces to strengthen PDCs and provide safe and effective PD.

Living with a genetic, undiagnosed or rare disease: A longitudinal journalling study through the COVID-19 pandemic.

IntroductionCOVID‐19 changed the way we lived with uncertainty from the outset as the pandemic impacted every aspect of our lives from well‐being, socializing to accessing healthcare. For people in vulnerable populations, such as those with genetic, undiagnosed and rare disorders, the experience was heightened.AimThe aim of this study was to identify how the rapidly changing COVID‐19 environment impacted the lives of the Genetic, Undiagnosed and Rare Disease community.MethodsFrom June 2020 to May 2021, we collected monthly open‐ended journals from people living in Australia with genetic, undiagnosed and rare disorders. Data analysis was deductive, using the Resilience Scale for Adults, and inductive using thematic analysis.ResultsWe recruited 29 people (average of n = 9.7 submissions each month). Responses changed over the year, with initial journals focusing on the importance of developing new structures for day‐to‐day lives, while later journals started to focus on mental well‐being. Throughout the project, participants reported challenges in accessing health and social care that was compounded by fear and concern over being exposed to the virus. Later journals highlight inconsistent messaging for vaccinations for this vulnerable community.Discussion/ConclusionIn parallel with the waves of the COVID‐19 pandemic, there need to be waves of targeted support for vulnerable communities. The first support wave needs to focus on facilitating the identification of new frameworks to structure day‐to‐day lives. A later second wave needs to focus on mental well‐being and coping with isolation, while consistent communication relating to health and social care throughout was essential.Patient/Public ContributionThis study was co‐designed, co‐led and analysed with a patient support network.

Multi-centre prospective cohort study of diaphragmatic defect phenotype and repair in neonates with congenital diaphragmatic hernia: ‘The Defect Study’

Abstract Defect size and closure technique in neonates with congenital diaphragmatic hernia (CDH) has long-term consequences for morbidity in survivors. Although subjective operative reporting of the defect size has been standardized, objective evaluation is lacking. There is no reported optimum closure technique related to the size and position of the diaphragmatic defect. We aim to objectively describe diaphragmatic defects and repair methods, at the time of neonatal CDH repair, through a prospective multi-centre service evaluation project. We will evaluate all neonates born with CDH surviving to diaphragmatic repair. All specialist paediatric surgical centres in the UK, Ireland and New Zealand will be invited to participate. Non-identifiable patient data will be collected over a 24-month period using a REDCap database. Diaphragmatic defects and hemidiaphragm measurements will be recorded intra-operatively alongside standardized defect reporting. Closure technique and 1-year outcomes will be captured. Demographics and peri-operative data will be reported as median (interquartile range), mean (standard deviation) or categorical variables. Defect measurement will be calculated as an ellipse with area displayed as a histogram. Patch usage will be compared to the defect area using univariate logistic regression analysis. Univariate logistic regression analysis will also be used to assess for the association between peri-operative variables and complications. Where possible, a multi-variate regression analysis will be performed. Centres will register the project as service evaluation at each participating hospital site. The results will be submitted to an international peer reviewed journal and will be disseminated via appropriate international forums and through patient support networks (CDH-UK).

Individual-level barriers to bariatric surgery from patient and provider perspectives: A qualitative study

BackgroundLess than 1% adults in the United States who meet body mass index criteria undergo bariatric surgery. Our objective was to identify patient and provider perceptions of individual-level barriers to undergoing bariatric surgery. MethodsAdults with severe obesity and obesity care providers described their experiences with the bariatric surgery care process in semi-structured interviews. Using conventional content analysis, individual-level barriers were identified within Andersen's Behavioral Model of Health Services Use. ResultsOf the 73 individuals interviewed, 36 (49%) were female, and 15 (21%) were non-white. Six individual-level barriers were identified: fear of surgery, fear of lifestyle change, perception that weight had not reached its “tipping point,” concerns about dietary changes, lack of social support, and patient characteristics influencing referral. ConclusionsPatient and provider education should address patient fears of surgery and the belief that surgery is a “last resort.” Bariatric surgery programs should strengthen social support networks for patients.

Implementation of a computer-assisted face-to-face intervention for mapping the social support networks of patients with severe mental illness in routine clinical practice: Analysis of the appropriateness and acceptability of the intervention.

Social support is a key dimension of personal recovery for patients with severe mental disorders. Although clinicians and health professionals should monitor the social support resources of patients in order to provide effective treatment, no specific tool or intervention exist for that purpose. Egonet is a computer-assisted intervention for health and social services that enables the mapping, assessment and fostering of patients' social support networks. This paper describes the intervention and evaluates the appropriateness and acceptability of its implementation in a clinical setting. We described the computer-assisted intervention. We used a questionnaire to assess how appropriate and acceptable clinicians found a preliminary version to be. We also collected patients' level of satisfaction with their social support networks before and after the intervention and carried out qualitative interviews. Egonet is made up of four components: (1) a computer-assisted interview for mapping social networks, (2) a remote data server, (3) a data-mining module and (4) a customisable reporting tool. Egonet was implemented for 232 patients by 91 clinicians from five services. The intervention was perceived by clinicians as appropriate and useful for clinical practice, although it was noted that considerable effort was required to obtain its benefits. Patients were slightly more satisfied with their social support after the intervention than before, and expressed the opinion that more attention should be paid to the social support network. EGONET is appropriate and acceptable for use in work related to the social support networks of patients with psychiatric disorders.

Involving Family and Social Support Systems in Tobacco Cessation Treatment for Patients With Cancer.

Individuals from the family and social support network of patients with cancer can have a pivotal role in reinforcing patients' efforts to become and remain tobacco-free. This support is critical along the entire continuum of cancer care. Although NCI-designated Cancer Centers across the United States are increasingly offering tobacco cessation services as a result of the NCI Cancer Center Cessation Initiative (C3I), engaging patients' family and other support network in tobacco treatment is not yet a routine practice. To facilitate the consideration and involvement of patients' social support systems (including family, peers, and non-healthcare provider caregivers), we formed the C3I Family and Social Support Systems Working Group. This paper describes the current practices and challenges among C3I cancer centers centers in engaging the support systems of patients with cancer in order to reduce tobacco use and/or secondhand smoke exposure. Building on this knowledge, this Working Group proposes a research agenda to facilitate support persons' involvement in tobacco treatment as part of oncology care. The research priorities identified include establishing (1) evidence-based strategies for engaging family and social support systems in patients' cessation efforts, (2) interventions to provide cessation treatment options to support persons, and (3) best practices to routinely identify and engage family and social support systems in patients' cessation efforts.