Provision Of Psychosocial Support Research Articles

Psychosocial Support for Parents, Infants, Children, and Adolescents with Variations of Sex Characteristics: Results from a Pan-European Survey.

Early psychosocial support for parents/legal guardians who have children with variations of sex characteristics (VSCs) is crucial in helping avoid potentially harmful medical procedures. Psychosocial support, including peer support, can help parents/legal guardians choose the best care path for their child, and it remains important throughout childhood. However, there is a lack of data on the provision of psychosocial support for families with a child who has VSCs. We sought knowledge about the timing and types of psychosocial support, and the level of implementation of psychosocial support amongst health and psychosocial care professionals and peer supporters. A survey was conducted using a purposive sample of healthcare professionals and members of peer support groups across Europe. A total of 301 responses were received and analysed using descriptive and inferential methods. The survey results showed that psychosocial support primarily addresses diagnostic procedures, medical treatment, and medical interventions. Whilst the majority of healthcare professionals aspired to have psychosocial support provided at the point where a diagnosis of VSCs was suspected, this was only reported as current practice by a minority of respondents. Overall, the survey indicates that there is a need for greater implementation of psychosocial support, and more collaboration between healthcare professionals and peer support groups in caring for children with VSCs and their families.

Parental Awareness of Children’s Psychosocial Needs: Parents’ and Childcare Professionals’ Perspectives

Despite high rates of child mental health needs globally, these remain largely unmet. Barriers to the provision of psychosocial support to children include stigma and sparse resources. To address this gap, local professionals can promote change by working to capacitate parents on children’s mental health needs. In the current study, five childcare professionals (also referred to as “trainers”) attended a Train-of-Trainer (ToT) child mental health programme before facilitating three awareness workshops for 48 parents. Of those, 16 parents and the five trainers participated in focus groups before and after the workshops to discuss factors that either enabled or hindered psychosocial awareness. Established themes emerged that were related to the concepts of psychosocial needs, parental influences, help-seeking and knowledge generation. The findings suggest that a psychosocial model with social workers at the centre can maximise existing resources, with parents playing an important peer support and education role in mobilising communities.

The Resilience Hub approach for addressing mental health of health and social care workers during the COVID-19 pandemic: a mixed-methods evaluation.

Resilience Hubs provide mental health screening, facilitation of access and direct provision of psychosocial support for health and social care keyworkers in England affected by the coronavirus disease 2019 pandemic. To explore implementation of the Hubs, including characteristics of staff using the services, support accessed, costing data and a range of stakeholder perspectives on the barriers and enablers to Hub use and implementation of staff well-being support within the context of the pandemic. Mixed-methods evaluation. Four Resilience Hubs. Findings were integrated via mixed-method case studies, including: analyses of Hub mental health screening (N = 1973); follow-up questionnaire data (N = 299) on service use and health status of Hub clients; economic information provided by the Hubs; 63 interviews with Hub staff, wider stakeholders, Hub clients and keyworkers who did not use the Hubs. Findings were consistent across Hubs and workstreams. Most Hub clients were NHS staff. Under-represented groups included men, keyworkers from minority ethnic communities, care homes and emergency services staff. Clients reported comorbid mental health needs across multiple domains (anxiety; depression; post-traumatic stress; alcohol use; functioning). Their health status was lower than population norms and relevant pre-pandemic data. Several factors predicted higher needs, but having pre-pandemic emotional well-being concerns was one of the most robust predictors of higher need. Sixty per cent of participants who completed follow-up questionnaires reported receiving mental health support since Hub screening, most of which was directly or indirectly due to Hub support. High levels of satisfaction were reported. As in many services, staffing was the central component of Hub cost. Hubs were predominantly staffed by senior clinicians; this staffing model was consistent with the generally severe difficulties experienced by clients and the need for systemic/team-based working. Costs associated with health and social care use for Hub clients were low, which may be due to barriers to accessing support in general. Enablers to accessing Hubs included: a clear understanding of the Hubs, how to self-refer, and managerial support. Barriers included confusion between Hubs and other support; unhelpful beliefs about job roles, unsupportive managers, negative workplace cultures and difficulties caused by systemic issues. Some keyworkers highlighted a perceived need for further diversity and cultural competency training to improve reach to under-represented communities. Other barriers for these groups included prior negative experiences of services, structural inequalities and stigma. Some wider stakeholders had concerns around growing waiting times for Hub-provided therapy, and insufficient data on Hub usage and outcomes. Feedback was otherwise very positive. Main limitations included lack of comparative and pre-pandemic/baseline data, small numbers from under-represented groups limiting fine-grained analysis, and participant self-selection. Findings highlighted the value of the Hub model of outreach, screening, support navigation and provision of direct support during the coronavirus disease 2019 pandemic, and as a potential model to respond to future crises. The research provided recommendations to improve Hub promotion, equality/diversity/inclusion access issues, management of specialist resources and collection of relevant data on Hub outcomes and activities. Broader recommendations for the primary prevention of mental health difficulties across the health and care system are made, as individual support offers should be an adjunct to, not a replacement for, resolutions to systemic challenges. Research recommendations are made to conduct more robust evaluations of the clinical and cost-effectiveness of the Hubs, using larger data sets and comparative data. This study is registered as researchregistry6303. This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR132269) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 29. See the NIHR Funding and Awards website for further award information.

“Hope is the Indispensable Life Force”: A Qualitative Study of the Meaning of Hope in the Life Experiences of Lymphoma Patients

Aim Although hope is considered to be of vital importance for cancer patients, it remains uncertain in lymphoma patients. This study aimed to examine the life experiences of patients with lymphoma and reveal the meaning of hope. Method A hermeneutic-phenomenological design was used in this study. 19 lympho¬ma patients who were receiving chemotherapy participated in interviews. Participants were selected through the purposive sampling method, and the interviews were audio-recorded. A phenomenological-hermeneutic approach was used to analyze the data. Results Three themes and 12 sub-themes emerged that summarized the life experiences of patients and the meaning of hope. These themes were as follows: ‘Being in existence’, ‘Hope is the indispensable life force’, and ‘There is always hope, but it varies’. Within the scope of the sub-themes, this study showed that there were changes in the physical and emotional well-being of participants and the importance of discovering the moment. This study, which reveals the meaning of hope as a “desire to return to routine, a bridge from now to the future”, emphasized that both the patients affect hope and the factors related to the disease. Conclusion This study revealed the changes in the physical and emotional well-being of lymphoma patients, the meaning of hope in their life experiences, and the factors affecting hope. It is thought that the findings obtained will contribute to the provision of psychosocial support and care planning by healthcare professionals to strengthen hope in lymphoma patients and may guide future studies.

The Provision of Psychosocial Support to Students in Jordan: Teachers' Knowledge, Attitudes, Skills, Practices, and Perceived Barriers.

Psychosocial support provision in schools is a promising strategy for overcoming barriers to accessing mental health care. This study aimed to assess teachers' knowledge, attitudes, practices, skills, and perceived barriers in providing psychosocial support to students in Jordan. The sample included teachers working in public schools, private schools, the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) schools, and Zaatari camp schools, as well as non-formal education centers. The study utilized a multi-stage stratified cluster sampling technique to select a nationally representative sample. A total of 549 teachers were included, and only 25.2% have ever received mental health training. Most teachers reported a high level of good and acceptable knowledge of psychosocial support and had a positive attitude toward the provision of psychosocial support, however, about a quarter (25.5%) agreed on feeling nervous in discussing students' psychosocial problems with their parents or school administrators. The least enacted practice was the systematic engagement with parents, school administration, and other community resources in students' well-being (sometimes, 31.6%; rarely, 20.4%). Gaps in skills were mainly in communicating with external resources and parents. The main barriers included parents' misunderstanding of teachers' role in providing psychosocial support to students (56.8%), lack of integration of psychosocial support in the curriculum (55.6%), and challenges in identifying students with psychosocial problems due to large class sizes (54.3%). The results show that gaps extend beyond the individual level of teachers to the community level. School-based psychosocial support interventions must consider the multiple factors that influence their implementation at multiple levels, including the individual, relational, community, and societal levels.

Commentary on “Frontiers: Breaking the Glass Ceiling: Empowering Female Entrepreneurs Through Female Mentors”

Mentoring is vital to developing talent. A critical puzzle in designing mentorship programs involves how mentors are matched to mentees: Would mentees benefit more from mentors with a similar or different demographic background? The article [Germann F, Andersen S, Chintagunta P, Vilcassim N (2024) Frontiers: Breaking the glass ceiling: Empowering female entrepreneurs through female mentors. Marketing Sci., 43(2):239–468] highlights that women entrepreneurs benefit more from having women as mentors relative to men as mentors. In this commentary, I highlight how the implications of this paper depend in part on our understanding of the potential mechanisms underlying the benefits of same-gender mentoring relationships for women. I posit that these benefits stem from differences not only in mentors’ provision of psychosocial support but also in their coaching and sponsorship behaviors. By considering these different mechanisms, I propose an alternative implication that involves training mentors to engage in more appropriate coaching and sponsorship behaviors. Thus, I expand the implications of this article from mentor matching to mentor training. I propose that, by learning how effective mentors coach and sponsor women, mentors in cross-gender relationships can be better equipped to help their mentees. History: Catherine Tucker served as the senior editor for this article.

Peer Support for Caregivers of People Living with Posterior Cortical Atrophy in Melbourne, Australia: A Feasibility Study.

Posterior Cortical Atrophy (PCA) is a rare form of young-onset dementia that causes early visuospatial and visuoperceptual deficits. The symptom profile of Posterior Cortical Atrophy leads to very specific care needs for those affected, who often rely on informal caregivers (including friends and family). Rare dementia support groups can be useful for both patients and their caregivers to assist with knowledge sharing, psychoeducation, and the provision of psychosocial support. Despite this, few such support groups exist. The purpose of this study was to examine a PCA support group for caregivers of individuals living with PCA. We held a structured psychoeducation support group comprised of four sessions with the aim being to provide education, strategies for the management of the disease, and peer support. Caregivers' mental health and quality of life were assessed. The results of our study showed that support group participation was a positive experience and assisted with increasing the knowledge of caregivers and fostering social connections. We suggest that peer support groups may be beneficial for both people living with PCA and their caregivers. We recommend that future quantitative and qualitative research is conducted to further assess health-promotion benefits to people living with PCA and their caregivers, and to assess their development and implementation in different contexts.

Challenges confronting nurses caring for persons diagnosed with intellectual disability at a Mental Health Institution in Gauteng, South Africa

This paper aims to explore and describe the challenges experienced by nurses caring for persons diagnosed with intellectual disability. Caring for persons with intellectual disability is understood be challenging for families. This could be worse for nurses due to the challenging behaviour the persons with intellectual disability present with. This may be exacerbated by the attitudes nurses have towards persons with intellectual disability. The researchers ask the following questions: “What are the challenges experienced by nurses caring for persons with intellectual disability?” We employed an exploratory-descriptive research design, using in-depth individual face-to-face interviews to explore the nurses’ experiences. Using Tesch’s method of open coding, two overarching themes emerged: (1) Care-related challenges and (2). Facilitation of a supportive, caring environment. The findings of the study demonstrate that the experienced challenges are related to the mental status of the persons diagnosed with intellectual disability, the therapeutic environment, shortage of specialized personnel and role ambiguity. Hence, the nurses yearn for a supportive environment which includes family support and support from the institution's management, including the provision of psychosocial support, which plays a pivotal role in achieving a safe, caring environment. The findings of this study could be used to develop strategies to facilitate a supportive, caring environment to minimize therapeutic challenges.

Health-Related Quality of Life in Children and Adolescents With Congenital Adrenal Hyperplasia: A Systematic Review and Meta-Analysis.

To conduct a systematic review (SR) and meta-analysis (MA) on health-related quality-of-life (QoL) and associated factors among children/adolescents with congenital adrenal hyperplasia (CAH). Following registration in the PROSPERO International Prospective Register of Systematic Reviews(reg no: CRD42022313389), Google Scholar, PubMed, LILACS, Cochrane, and Scopus databases were searched up to March 5, 2022, using predefined search strategy/MESH terms to identify original studies describing/assessing self-reported/parent-reported health-related QoL in patients with CAH ≤21 years. Methodological quality was assessed by Newcastle-Ottawa Quality Assessment Scale (NOS), and heterogeneity by I2 statistics. MA assessed mean difference (MD) in QoL between children/adolescents with CAH and healthy children/adolescents. Among 1308 publications, the 12 studies eligible for the SR (CAH n = 781) showed NOS scales of 3 to 7/9, and the 6 eligible for MA (CAH n = 227) showed moderate-considerable heterogeneity. MA showed that parent-reported psychosocial QoL (MD 9.9 [-12.6,7.3], P ≤ .001) {consisting of school (MD 7.4[-12.2, -2.5], P = .003), emotional (MD 5.6 [-10.2, -0.9], P = .02) and social domains (MD 4.3 [-8.1, -0.5], P = .03), and self-reported school domain QoL (MD 8.5 [-15.9, -1.2], P = .02) was lower in children/adolescents with CAH while parent-reported and self-reported physical QoL were similar to controls.Factors associated with lower QoL among children/ adolescents with CAH included poor disease control, poor medication compliance, and complications including hyperpigmentation, virilization, hypertension, hospital admission, and urinary incontinence. Based on available data, children/adolescents with CAH had preserved physical QoL but impaired psychosocial QoL, especially in the school domain. Factors associated with lower QoL included poor disease control and disease/treatment-related complications. There is a need for further high-quality research that investigates the relationship between disease control, provision of psychosocial support, and improvement in QoL in children/adolescents with CAH.

Against the tide: Provision of psycho-social support to orphans in a rural primary school in Lesotho

Even before the coronavirus disease (COVID-19), Lesotho had a significant number of orphans. However, the pandemic has caused an increase in the number of orphans, as some children have lost 1 or both parents or caregivers. Many of these orphans are of school-going age, strategically placing schools to meet their psycho-social needs. With this study we aimed to achieve 2 objectives: firstly, to assess how 1 primary school in rural Lesotho provided psycho-social support to orphaned learners during the COVID-19 pandemic, and secondly, to determine how such support was beneficial to the orphans. We used the social-ecological model of the United Nations Children’s Fund (UNICEF) as a theoretical framework and collected data through interviews with 17 purposively selected participants, including 1 principal, 8 guardians and 8 teachers. Thematic data analysis was used to analyse the data collected. The study revealed that teachers provided food packages, lay counselling, and referrals to spiritual counsellors to support orphaned learners. While learners benefited from the school’s psycho-social services, limited resources and skills posed challenges. We recommend developing comprehensive policies to address the psycho-social support needs of orphans.

PSYCHOSOCIAL SUPPORT FOR THE EDUCATIONAL PROCESS PARTICIPANTS AS AN INDICATOR OF THE QUALITY OF EDUCATION UNDER MARTIAL LAW

The article emphasizes that russia’s armed aggression against Ukraine has significantly affected the security situation and the deterioration of the psychological state of the educational process participants, which is a dangerous phenomenon in the context of ensuring the quality of education. The necessity of creating a safe educational environment to reduce the impact of risk factors on the mental health of students, their parents and educators is put stress on. The challenges faced by the psychological service in the education system during the war are identified, in particular the growing number of people who are in need of psychological help and support, an insufficient number of trained practical psychologists and educators for providing psychological support and first psychological aid to the educational process participants, an imperfect system of support for educators and practical psychologists while working in stressful conditions, parents’ lack of awareness of mental health issues and mechanisms for providing psychological support to their children. The article highlights the peculiarities of providing psychosocial support to children and adults affected by the war in crisis situations as well as the mechanisms of psychological self-help as a factor of stress resistance and internal potential to withstand psychological trauma during the war. The ways of implementing the educational policy to ensure constant supervision and timely provision of psychosocial support for the educational process participants under martial law are revealed, which is a guarantee and a necessary prerequisite of quality education in accordance with the goals and objectives of the education system. The results of an empirical study into the war’s impact on the life of students and their mental health have shown that their psychological state underwent significant changes during martial law, which led to the weakening of academic motivation and a deterioration in learning outcomes. It is concluded that psychosocial support for the educational process participants is a prerequisite for ensuring the quality of education in the conditions of war and in the post-war period.

12‐month cognitive outcome after acute geriatric TBI not associated with U.S. Military Veteran status

AbstractBackgroundTraumatic brain injury (TBI) increases risk for cognitive decline and Alzheimer’s disease/related dementias (ADRD), and Veterans may be at increased risk of both TBI and cognitive decline due to combat/training related exposures and other risk factors. However, it is unknown whether older Veterans are more likely to experience a poor cognitive outcome after acute TBI compared to civilians.MethodWe examined 112 male Veterans and 320 male civilians (55+) who experienced an acute TBI and enrolled in Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK‐TBI). Data were collected at baseline (i.e., emergency room visit) on demographic and injury characteristics. Cognitive and TBI recovery data (i.e., Rivermead Postconcussive Questionnaire, Brief Symptom Inventory, Satisfaction with Life Scale, and Glascow Outcome Scale‐Extended) were collected at 2 weeks, 6 months, and 12 months. We calculated descriptive statistics and compared across Veterans and civilians. 12‐month cognitive outcome was defined as performance <9th percentile on 2+ cognitive tests, and/or decline from 2‐week or 6‐month score >90% reliable change index on two+ tests. We used propensity weighting to address missing cognitive outcome data and conducted a logistic regression analysis to examine association of Veteran status with classification of cognitive outcome.ResultVeterans were older and less likely to be Hispanic compared to civilians but did not differ on race, education, history of head injury, or injury severity. At 12 months post‐TBI, Veterans endorsed worse mood and satisfaction with life (p’s = 0.05), but these results were attenuated by adjustment for prior TBI and injury severity. In adjusted models Veterans did not differ from civilians on a measure of overall TBI outcome (p = 0.45) or postconcussive symptoms (p = 0.32). Moreover, there was no association between Veteran status and cognitive outcome (Wald chi square = 2.66, p = 0.45).ConclusionRisk of poor cognitive outcome following TBI does not differ between older male Veterans and civilians, and mood and life satisfaction outcomes were worse for Veterans but impacted by injury severity and prior head injury. These findings have implications for understanding risk for cognitive decline and ADRD among older men who experience an acute TBI as well as tailoring care, including provision of psychosocial support, for these patients.

From policy to practice: a qualitive study exploring the role of community health workers during the COVID-19 response in Sierra Leone

BackgroundDuring the COVID-19 pandemic, community health workers (CHWs) were required to help their communities respond to the outbreak in Sierra Leone. The Government of Sierra Leone released a policy that provided an interim guidance on the specific role of CHWs during the pandemic including support required to maintain continuity of routine and essential services during the COVID-19 response. This study explores how CHWs adapted their roles during the COVID-19 pandemic in Sierra Leone and the support they received from families, communities, and the health system.MethodsA qualitative exploratory study was conducted in two districts in Sierra Leone. We conducted eight key informant interviews with district and community level managers and leaders and four focus group discussions with CHWs. Thematic data analysis and synthesis were guided by the interim guidance released by the Government of Sierra Leone at the onset of the COVID-19 pandemic and supported by NVivo 11.ResultsCHWs quickly took on COVID-19 frontline roles which included surveillance, contact tracing, social mobilization, and provision of psychosocial support. CHWs were trusted with these responsibilities as they were recognized as being knowledgeable about the community, were able to communicate effectively with community members and had experience of dealing with other outbreaks. Despite the release of the interim guidance aimed to optimize CHW contribution, motivate CHWs, ensure continuity of core and essential community-based services alongside COVID-19 services, CHWs faced many challenges in their work during the pandemic including heavy workload, low financial remuneration, lack of mental health support, and shortages of protective equipment, communication and transportation allowances. However, they were generally satisfied with the quality of the training and supervision they received. Support from families and communities was mixed, with some CHWs experiencing stigma and discrimination.ConclusionDuring the COVID-19 pandemic, CHWs played a critical role in Sierra Leone. Although, a policy was released by the government to guide their role during the crisis, it was not fully implemented. This resulted in CHWs being overworked and under supported. It is important that CHWs are provided with the necessary training, tools and support to take on their vital roles in managing health crises at the community level. Strengthening the capacity of CHWs will not only enhance pandemic response, but also lay the foundation for improved primary health care delivery and community resilience in the face of future health emergencies.

SCHOOL PRACTICES ON PROVISIONS OF PSYCHOSOCIAL SUPPORT TO TEACHERS OF PEDRO GUEVARA MEMORIAL NATIONAL HIGH SCHOOL : BASIS FOR PROPOSED SEMINAR / WORKSHOP ON COUNSELING PROGRAM TO TEACHERS

This study examined the impact of the work environment and psychosocial factors on teachers health and performance. It focused on the provision of psychosocial support in a school, teachers psychosocial skills, and their correlations. The study used a descriptive research method, with 80 teachers from Pedro Guevara Memorial National High School as respondents. A five-point Likert questionnaire was employed for data collection. The analysis included weighted mean and Spearman rho correlation coefficient. Results showed that the school effectively provided psychosocial support for teachers, and teachers demonstrated strong psychosocial skills, likely due to this support. The study also found significant correlations between teachers profiles and their psychosocial skills, including the number of children, problem-solving skills, and role responsibilities. Additionally, significant correlations were identified between the schools psychosocial support practices and the development of positive identity, management skills, and group effectiveness skills among teachers.

Exploring the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa: a descriptive phenomenological study

ABSTRACT Background The incidence and prevalence of COVID-19 continues to escalate globally, with the consequence to quality of life, the economies of nations and various sectors of society. While there is substantial research on the impact and experiences of the COVID-19 pandemic, little remains known about the perceptions and lived experiences of families living with people diagnosed with COVID-19, particularly within the South African context. Purpose To explore the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa. Methods A descriptive phenomenological design was used. Data were collected from 15 participants who were family members of people diagnosed with COVID-19 in South Africa. Purposive snowball sampling was used to identify and recruit participants, and data were collected at community level in KwaZulu-Natal, Western Cape and Gauteng, South Africa. Individual in-depth interviews were used to collect the data, and an audio tape was used to record all interviews. Data were transcribed verbatim and analysed using a phenomenological data analysis processes. Ethical approval to conduct the study was obtained from the University of KwaZulu-Natal Research Ethics Committee—reference number: BREC00003228/2021. Results Four super-ordinate themes emerged in relation to the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa. The superordinate themes were: (1) sources of information about COVID-19, (2) pandemic perceptions and experiences, (3) impact of diagnosis and related burden and (4) aftermath of living with a family member diagnosed with COVID-19. Discussion and conclusion Family members’ perceptions and lived experiences of COVID-19 are largely influenced by media, moreover, the impact of diagnosis has consequences for the physical, mental and emotional well-being of family members. Diagnosis disrupts family dynamics by depleting financial resources due to the caregiver burden experienced. The findings thus imply that provision of psychosocial support is imperative for families living with persons diagnosed with COVID-19.

Adaption and pilot testing of a lay HIV supporter program for traditional healers: a mixed methods study in rural Uganda

BackgroundHalf of people living with HIV (PLWH) in sub-Saharan Africa default from care within two years. In Uganda, and across sub-Saharan Africa, traditional healers (TH) are ubiquitous and often serve as the first line of health care. We hypothesized that with lay support training, TH could support relinkage to HIV care and ART adherence among rural Ugandan PLWH who have defaulted from HIV care.MethodsFollowing the ADAPT-ITT framework, we adapted an evidence-based layperson HIV support program from South Africa for delivery by Ugandan TH. The ADAPT-ITT framework consists of (1) Assessment of needs; (2) Deciding which evidence-based interventions to adapt; (3) Adaptation of interventions; (4) Production of drafted adapted interventions; (5) Topical expert feedback; (6) Integration of expert feedback; (7) Training personnel; and (8) Testing the adapted intervention. The Testing phase was completed via a pilot mixed methods prospective cohort study. The study population included 12 TH practicing in Mbarara Township and 20 adult PLWH with suboptimal ART adherence (CASE adherence index score < 10) who received care from a participating TH and who resided in Mbarara Township. Primary outcome was re-linkage to HIV care within 14 days. Secondary outcomes were ART re-initiation, ART adherence, retention in care after 9 months, and implementation measures. Qualitative interviews were conducted with all participants.ResultsData from the Assessment phase indicated that logistical challenges played an important role in disengagement from care among PLWH who receive care from TH, notably geographical distance to clinics and transportation costs. Additionally, HIV-related stigma and lack of social support were identified as barriers to entering and remaining in HIV care. Two core elements of the intervention were identified during the Production phase: (1) TH facilitating rapid re-linkage to HIV care and (2) TH provision of psychosocial support. In the pilot study phase, baseline median CASE adherence score was 3; only 5% of PLWH were adherent to ART via 4-day recall. The TH-delivered support achieved 100% linkage and ART initiation within 14 days, 95% ART adherence, and 100% of PLWH were retained in HIV care after 9 months.ConclusionsThe ADAPT-ITT framework successfully guided the adaption of a community health worker-delivered intervention for delivery by TH. TH successfully facilitated re-linkage to HIV care, support ART adherence, and retention in care for PLWH when trained as part of a lay support person program. Future studies are needed to evaluate scale-up and long-term impact.

Clinician Perspectives on Palliative Care for People with Hepatocellular Carcinoma: Facilitators of and Barriers to Referral.

(1) Background: Little is known about facilitators of and barriers to palliative care referral for people with hepatocellular carcinoma (HCC). The objective of this study is to identify facilitators and barriers of palliative care referral described by HCC-treating clinicians. (2) Methods: Semi-structured interviews (n = 16) were conducted with HCC-treating clinicians at two centers, focusing on referral patterns, palliative care needs, and disease course. A code book was created, axial coding was used to code all interviews, and selective coding was used to identify facilitators and barriers of palliative care referral. (3) Results: Facilitators included helpfulness at times of transition; help with management of certain symptoms; provision of psychosocial support; and positive experiences with referral. Barriers included feasibility concerns; lack of information about palliative care and who is appropriate; lack of symptoms requiring outside referral; and concerns that palliative care conveys loss of hope. (4) Conclusions: Participants noted the helpfulness of palliative care at specific points in the disease trajectory and cited barriers related to feasibility, lack of need, lack of awareness, and loss of hope. The results show actionable issues that can be addressed in future research to leverage the benefits of and overcome the barriers to palliative care for people with HCC.

Caring for the careers: A psychosocial support model for healthcare workers during a pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has further placed additional stress on the already fragile and overstretched healthcare system in Zimbabwe. Most healthcare institutions reported staff shortages, inability to cope with the extra workload, burnout and the resultant psychological implications. This study aimed to develop a psychosocial support model that sustains a support structure that will contribute to an enabling work environment promoting efficiency and effectiveness in response to public health emergencies. Empirical findings from interpretive phenomenological analysis studies on healthcare workers' experiences during the COVID-19 in Zimbabwe formed the basis for model development. The model development in this study was informed by the work of Donabedian, Dickoff, James and Wiedenbach, Walker and Avant, Chinn, Kramer and Wilkes. The developed model is described using the elements of Donabedian's framework (structure, process and outcome) and of Dickoff, James and Wiedenbach's (1968) practice theory elements (agents, recipients, context, process, dynamics and outcome) and within the national and international context of the COVID-19 pandemic. The fragile and under-resourced healthcare system has psychosocial implications to the well-being of healthcare workers. The utilisation of this model is critical and facilitates the provision of an enabling and supportive environment that facilitates efficiency in response activities during pandemics.Contribution:This study provides a reference guide in the provision of psychosocial support for healthcare workers particularly during public health emergencies. There is paucity of evidence focusing on the well-being of healthcare workers during a crisis, hence the significance of this study.

Promoting resilience among adult cancer patients: An integrative review of patient education methods.

To explore the essential elements of patient education methods for promoting resilience among adult cancer patients. The PubMed, Scopus, CINAHL and PsycInfo databases were searched fromJanuary 2010 to April 2021. The outcome of interest was resilience. The integrative review applied the PRISMA statement guidelines. Nine studies were identified, which formed three main patient education strategies that fell under categories: 1. Provision of illness-related information 2. Learning self-management skills 3. Provision of emotional support and the adjustment process. The key elements include promotion of positive factors, easing patients' mental burden, highlighting the importance of illness-related information, developing self-management skills, and emotional support. Interventions prepared patients for the future, enhanced their understanding of illness and recovery process, and comfort in physical and mental aspects of life, and improved their resilience. Resilience among cancer patients is a process that helps them adjust to live with cancer. The provision of psychosocial support and illness-related information, as well as learning self-management skills, are essential elements of patient education interventions that aim to improve resilience among adult cancer patients.

Parent Priorities in End-of-Life Care for Children With Cancer

Robust quality measures to benchmark end-of-life care for children with cancer do not currently exist; 28 candidate patient-centered quality measures were previously developed. To prioritize quality measures among parents who lost a child to cancer. This survey study was conducted using an electronic, cross-sectional discrete choice experiment (DCE) with maximum difference scaling from January to June 2021 in the US. In each of 21 questions in the DCE, participants were presented with a set of 4 quality measures and were asked to select the most and least important measures within each set. All 28 quality measures were presented an equal number of times in different permutations. In the volunteer sample, 69 eligible bereaved parents enrolled in the study; 61 parents completed the DCE (participation rate, 88.4%). Using choices participants made, a hierarchical bayesian multinomial logistic regression was fit to derive mean importance scores with 95% credible intervals (95% Crs) for each quality measure, representing the overall probability of a quality measure being selected as most important. Importance scores were rescaled proportionally from 0 to 100, with the sum of scores for all quality measures adding up to 100. This enabled interpretation of scores as the relative importance of quality measures. Participants included 61 bereaved parents (median [range] age, 48 [24-74] years; 55 individuals self-identified as women [90.2%]; 1 American Indian or Alaska Native [1.6%], 1 Asian [1.6%], 2 Black or African American [3.3%], 1 Native Hawaiian or Pacific Islander, and 58 White [91.8%]; 58 not Hispanic or Latinx [95.1%]). Highest-priority quality measures by mean importance score included having a child's symptoms treated well (9.25 [95% Cr, 9.06-9.45]), feeling that a child's needs were heard by the health care team (8.39 [95% Cr, 8.05-8.73]), and having a goal-concordant end-of-life experience (7.45 [95% Cr, 6.84-8.05]). Lowest-priority quality measures included avoiding chemotherapy (0.33 [95% Cr, 0.21-0.45]), provision of psychosocial support for parents (1.01 [95% Cr, 0.57-1.45]), and avoiding the intensive care unit (1.09 [95% Cr, 0.74-1.43]). Rank-ordering measures by mean importance revealed that symptom management was 9 times more important to parents than psychosocial support for themselves. This study found that bereaved parents prioritized end-of-life quality measures focused on symptom management and goal-concordant care while characterizing quality measures assessing their own psychosocial support and their child's hospital resource use as substantially less important. These findings suggest that future research should explore innovative strategies to measure care attributes that matter most to families of children with advanced cancer.