Psychoeducational Support Research Articles

Maintaining the mental health of Ukrainians in time of war: searching for a mechanism to provide a comprehensive system of psychosocial support and mental health awareness.

Aim: To substantiate the possibilities of developing a comprehensive system of psychosocial support for Ukrainians during and after the war through thedevelopment of an integrated model of psychosocial service provision in the community, which promotes cross-sectoral interaction and expands the possibilities of integrating and scaling up multiple levels of mental health interventions. Materials and Methods: The article is based on the use of bibliosemantic analysis of scientific works on the topic of mental health and mental health during the war. Conclusions: It is emphasised that in developing a comprehensive system of psychosocial support, it is necessary to: ensure accessibility of services for those in need; integrate services into the general health and social protection system; use a multisectoral approach, involving various organisations, institutions and professionals; train professionals to work in war conditions; develop and implement psychoeducation and psychological support programmes; monitor and evaluate the effectiveness of programmes. Particular attention is paid to psychoeducation as a technology that can be used at different levels of psychological intervention by both mental health professionals and other specialists involved in the provision of social services in communities. The spread of the impact of psychoeducational programmes will contribute to the development of community resilience in the face of social and psychological risks provoked by the war. A mechanism for scaling up the capabilities of the Technical Working Group on Mental Health and Psychosocial Support (MHPSS TWG), an association of leading international and Ukrainian NGOs specialising in mental health, established in Ukraine with the support of the WHO and the Ministry of Health of Ukraine, is proposed. The idea of creating a network of Resilience Centres in communities with the aim of forming a comprehensive system of psychosocial support at the state and community levels is substantiated.

Разработка мероприятий по совершенствованию медико-социальной реабилитации больных параноидной шизофренией

Aim. To substantiate the implementation effectiveness differential programs medical and social rehabilitation voluntarily hospitalized patients with paranoid schizophrenia to reduce the hospitalizations number. Design. Comparative prospective study. Materials and methods. The study included 100 patients with paranoid schizophrenia, the retrograde duration and anterograde observation was ≥ 3 years. Based on the clinical study clinical and social determinants, three patient’s groups were identified depending on the identified motives for self-seeking psychiatric care: a paranoid motive group (PM) associated with delusional behavior (35%); nonrare psychopathological motives group (NPM) associated with other mental disorders not associated with delusional symptoms (38%); non-psychopathological motives group (NM) not associated with psychopathological symptoms (27%). Further, based on the clinical indicators compliance assessment according to the Positive and Negative Syndrome Scale (PANSS) with the social adaptation level according to the Personal and Social Performance Scale (PSP), patients groups were identified based on the disease clinical picture, cognitive, negative and positive symptoms, as well as adaptation potential, social functioning level and life indicators quality: compensated group (compensation in clinical and social aspects — 15%); decompensated group (clinical and social decompensation — 53%); adapted group (severe clinical disorders with satisfactory social compensation — 20%); conflict group (mild clinical manifestations (the non-psychotic register disorders) and severe social decompensation — 12%). Results. Based on the clinical indicators compliance assessment with the social functioning level for various groups of patient’s social adaptation, differential programs have been developed aimed at reducing the hospitalizations number, including various psychosocial interventions kinds. The psychotic attacks frequency in the PM group did not change significantly with a sufficiently significant decrease in the independent requests number for psychiatric care from 1.6 ± 0.2 to 1.4 ± 0.3 (t > 2, p > 0.95). In the NPM group, both the psychotic attacks frequency and the number of independent visits decreased (in both cases, t > 2, p > 0.95). In the NM group, it was not possible to achieve a statistically significant decrease in the independent requests number for psychiatric care with an observed significant decrease in the psychotic attacks frequency (t > 2, p > 0.95). The hospitalizations duration in the NPM and NM groups was significantly reduced (72 ± 9 to 67 ± 6 and 38 ± 4 to 34 ± 6 bed days (t > 2, p > 0.95), respectively) while simultaneously increasing the outpatient treatment days’ number from 53 ± 4 to 59 ± 9 and from 42 ± 8 to 48 ± 6 (t > 2, p > 0.95), respectively. At the same time, the remission increased duration only in the NPM group from 0.62 ± 0.25 to 0.73 ± 0.19 year (t > 2, p > 0.95). Clinically, the affective (depressive) symptoms severity according to the Calgary Depression Scale for Schizophrenia decreased in the NPM and NM groups (10.2 ± 1.4 to 9.0 ± 1.6 score and 7.3 ± 0.8 to 6.6 ± 0.9 score (t > 2, p > 0.95), respectively), and the psychopathological symptoms severity according to the PANSS scale significantly decreased only in the NM group from 91 ± 4 to 87 ± 6 scores (t > 2, p > 0.95). Conclusion. Basically, the clinical and social medical care for patients with paranoid schizophrenia are the synergistic complementarity psychiatric care and social rehabilitation, mandatory psychotherapeutic and psychoeducational support for medicines prescriptions. Keywords: voluntary hospitalization, paranoid schizophrenia, medical and social rehabilitation, psychosocial interventions, number of hospitalizations, social adaptation.

Healthcare professionals' experience regarding competencies in specialized and primary stroke units: A qualitative study

AimTo describe healthcare professionals’ experience of needed competence in patient stroke care within specialist and primary healthcare. BackgroundHealthcare professionals who provide stroke care need multifaceted, multi-professional skills; ongoing training is important for competent stroke care. DesignA descriptive qualitative study. MethodsSix focus group interviews with semi-structured interviews were conducted in October and November 2020. Healthcare professionals (n = 25) working in stroke care units in both specialist and primary healthcare settings were interviewed. The interviews were recorded, transcribed and analyzed inductively by content analysis. The study was conducted, and results were reported according to the Consolidated Criteria for Reporting Qualitative Research. ResultsFive main categories were identified: clinical competence; multiprofessional networking competence; competence in interaction skills; emotional and psychoeducational support competence; and self-management and development competence. ConclusionCompetence in stroke care includes both in-depth and wide-ranging professional competences that require ongoing development. Utilizing various education models and collaborative learning approaches can help meet the requirements for developing competence in stroke care. Patient or public contributionNo patient or public contribution

Perinatal interventions to reduce the severity of postpartum depression: A narrative review

Postpartum depression (PPD) is a mental disorder that can affect mothers and their families, with symptoms of fatigue, mood swings, frequent anger for no reason, and excessive worry for the baby. Several studies regarding interventions that can be given to postpartum women with PPD have been carried out. The purpose of this review is to assess evidence on the effectiveness of a broad range of perinatal interventions to reduce the severity of PPD. The review of the literature has been done through PubMed, for papers with Randomized Control Trial (RCT) design published in 2012-2021. The approach was to explore quantitative parameters which is the EPDS score. More than 300 papers were identified, but only 6 studies met the inclusion criteria. A narrative review was conducted due to the studies' significant heterogeneity. Six studies reported a decrease in EPDS score. Six interventions have been identified to reduce the severity of PPD, they are exercise, psychological intervention, telephone-based Cognitive Behavioral Therapy (CBT), iBA (internet Behavioral Activation), application-based Cognitive Behavioral Therapy (CBT) and psychoeducation. This review suggests that multiple intervention program may lead to better outcomes in terms of client’s satisfaction. There is also some indication that psychoeducation support Maternal Parental Self-efficacy (MPSE) and social support besides EPDS.

Efficacy and Implementation of Stress-Reduction Interventions for Underserved Families of Autistic Preschoolers Across In-Person and Virtual Modalities

Abstract Objectives Parents of autistic children experience elevated stress relative to parents of children with neurotypical development and children with other intellectual and developmental disabilities. Adverse effects of parenting stress on parent, child, and family functioning may be especially heightened for marginalized families. We conducted a randomized controlled trial that demonstrated the efficacy of Mindfulness-Based Stress Reduction (MBSR) relative to psychoeducational support (PE) for reducing stress in diverse and underserved parents of autistic preschoolers. This paper presents implementation data, and examines efficacy across in-person and virtual intervention modalities. Method Primary caregivers (n = 117; 91% female, 51% Latinx, 44% income < US $50,000) of 3- to 5-year-old autistic children (80% male, 68% with intellectual disability) were randomly assigned to MBSR (n = 59, 46% virtual) or PE (n = 58, 41% virtual). Assessments were conducted at baseline, immediately post-intervention, and at 6 and 12 months post-intervention. Results Both MBSR and PE demonstrated strong feasibility, acceptability, and utility for our diverse families. Comparable efficacy was observed across modalities. However, attendance was significantly better for virtual groups than for in-person groups. Parents participating in virtual MBSR also reported less difficulty completing homework and utilizing learned skills in everyday life than did in-person MBSR participants. Conclusions MBSR and PE appear feasible, acceptable, and efficacious for diverse and underserved parents of young autistic children. Preliminary evidence of comparable efficacy across virtual and in-person modalities indicates the potential to expand access to vital stress-reduction interventions through use of telehealth technology. Preregistration ClinicalTrials.gov Identifier: NCT03459625.

Supporting a Tsonga learner living with Bardet-Biedl syndrome, a rare complex disability.

Bardet-Biedl syndrome (BBS) is a rare, systemic, hereditary disorder characterised by obesity, polydactyly, visual and auditory impairment, and cognitive disability. Providing quality education in appropriate schools for children who present with such complex chronic conditions is challenging. This study explored the dimensions of psycho-educational support needs for a child with BBS in South Africa to contribute to the improvement of early detection and holistic interventions. A descriptive in-depth qualitative case study of Gezani, an adolescent Tsonga boy diagnosed with BBS, was undertaken. Semi-structured interviews were conducted with his parents and teachers to ascertain the boy's psycho-educational support needs. Medical reports provided information on the complexities and prognosis of the syndrome. Observations in the classroom corroborated the learner's symptoms and behaviours. Thematic content analysis revealed the key areas of support needs. Gezani's cognitive disability required a modified, slow-paced curriculum. His visual impairment required mobility orientation training and learning Braille. His emotional needs were supported with psychotherapy to maintain a sense of well-being. Medical monitoring was recommended with interventions for walking and managing his diet and weight. Speech therapy supported his communication skills. Learners with multiple disabilities require carefully planned, individualised psycho-educational support programmes addressing their unique needs and delays with targeted remedial interventions in appropriate special needs schools. This study informs educators about BBS and provides multi-faceted, holistic support. The Department of Basic Education could bring special schools and national policies in tighter alignment for learners presenting with complex disabilities.

Exploring Amico H impact: A promising tool to promote children's knowledge and adherence to medical procedures

mHealth (e.g., the use of mobile devices such as smartphones and tablets for delivering healthcare services) has become a crucial resource in pediatric healthcare, providing children with psychoeducation and distraction, and enhancing treatment compliance. Amico H, a newly developed application, is targeted at ameliorating children's and parents' experience of pediat-ric medical procedures and communication with healthcare professionals. With the virtual en-vironment of a castle, Amico H is a mHealth app for children, offering interactive games and psychoeducational support during medical treatments. The present experience explores the im-pact of the Amico H prototype on children, teens, and parents in terms of pleasantness, usabil-ity, and usefulness. Method: A total of 99 children and teens aged 4-19 years (10.53 ± 3.69 years; 73% female), both hospitalized (28%) or not and N=32 caregivers (72% mothers) re-sponded to an ad-hoc survey on the app's user experience. Descriptive analyses and group comparisons have been computed. Results: Findings highlight that children and caregivers were highly amused and satisfied by Amico H. Compared to teens, children needed more help from adults in the use of the app. Conclusion: All the results indicate that Amico H is a pow-erful tool to ameliorate pediatric hospitalization experience and to promote children's knowledge about health and medical procedures. The need for age-specific versions of Amico H emerged. Future directions and limits are discussed.

23 Cross-Sectional Analysis of Rehospitalization Following Discharge from Inpatient Rehabilitation in Veterans with Traumatic Brain Injury Up to 10 Years Postinjury

Objective:To characterize reasons for rehospitalization of Veterans and Service Members with mild, moderate, and severe traumatic brain injury (TBI) who received inpatient rehabilitation at a Veterans Affairs (VA) Polytrauma Rehabilitation Center (PRC) up to 10 years postinjury. TBI is a chronic condition, and a subset of TBI survivors experience rehospitalization after discharge from inpatient rehabilitation. Extant literature focuses primarily on persons with moderate-to-severe TBI and utilizes broad categories when determining readmission reasons. The present study aimed to delineate with greater specificity the reasons for rehospitalization up to 10 years postinjury across the TBI severity spectrum.Participants and Methods:Participants were drawn from the VA TBI Model Systems multicenter longitudinal study for a cross-sectional analysis. Eligibility criteria included TBI diagnosis per case definition; age > 16 years at TBI; admitted for inpatient rehabilitation at one of the five VA PRCs; and informed consent by the participant or legally authorized representative. At follow up interviews 1, 2, 5, and 10 years post-TBI, participants were asked whether they were rehospitalized within the past year (up to five admissions). Rehospitalizations were classified according to the Agency for Healthcare Research and Quality’s Healthcare Cost and Utilization Project classification (18 categories). In the present analyses, TBI severity was classified by duration of posttraumatic amnesia (PTA; 0-1 days=mild, 2+ days=moderate-severe). Statistical analyses were conducted in SPSS.Results:Participants (N=1101; n=338 0-1 days PTA, n=513 2+ days PTA, n=250 no PTA data) ranged in age from 17 years to 91 years at the time of interview. Participants across all follow up timepoints reported 317 rehospitalizations in the past year. 19.45% of Year 1 participants, 24.37% of Year 2 participants, 16.19% of Year 5 participants, and 16.25% of Year 10 participants reported 1+ rehospitalizations in the past year. When controlling for age, participants with at least 2 days of PTA were more likely to be rehospitalized at least once compared to those with 0-1 days of PTA at Year 2 (OR=4.05, p<0.001) and Year 5 (OR=2.39, p=0.03) post-TBI. The three most common reasons for rehospitalization across all timepoints were injury and poisoning (17.3%), mental illness (16.7%), and diseases of the nervous system and sense organs (9.1%). Mental illness was the modal reason for rehospitalization at Years 2, 5, and 10, frequently due to substance- or alcohol-related disorders and suicide/intentional self-inflicted injury.Conclusions:Compared to prior research, rates of rehospitalization were lower in this sample across follow-up time points. The inclusion of mild TBI in this analysis may partially explain the discrepancy. Importantly, two of the top three rehospitalization reasons are potentially preventable, and strategies to reduce risk of re-injury and minimize escalation of psychiatric distress should therefore be explored. Psychoeducation, supervision, and mental health support during the transition from hospital to community should be considered in order mitigate preventable causes of rehospitalization among long-term TBI survivors.

Improving mental ill-health with psycho-social group interventions in South Asia-A scoping review using a realist lens.

This scoping review aimed to synthesise current evidence related to psycho-social groups as part of community-based mental health interventions in South Asia. We used a realist lens to pay attention to the contexts and mechanisms supporting positive outcomes. We included studies published from January 2007 to February 2022 that: were based in communities in South Asia, included a group component, reported on interventions with a clear psychosocial component, targeted adults and were implemented by lay community health workers. Two reviewers extracted data on intervention components, groups and facilitators, participant demographics and enabling contexts, mechanisms and outcomes. Expert reference panels including people with lived experience of psycho-social disability, mental health professionals and policy makers confirmed the validity and relevance of initial review findings. The review examined 15 interventions represented by 42 papers. Only four interventions were solely psycho-social and nearly all included psychoeducation and economic support. Only 8 of the 46 quantitative outcome measures used were developed in South Asia. In a context of social exclusion and limited autonomy for people with psychosocial disability, psychosocial support groups triggered five key mechanisms. Trusted relationships undergirded all mechanisms, and provided a sense of inclusion, social support and of being able to manage mental distress due to improved skills and knowledge. Over time group members felt a sense of belonging and collective strength meaning they were better able to advocate for their own well-being and address upstream social health determinants. This led to outcomes of improved mental health and social participation across the realms of intrapersonal, interpersonal and community. Psychosocial groups merit greater attention as an active ingredient in community interventions and also as an effective, relevant, acceptable and scalable platform that can promote and increase mental health in communities, through facilitation by lay community health workers.

Self-management-competency as a new target in Hidradenitis suppurativa care

Background: Hidradenitis suppurativa affects approximately 1% of the population.Objective: Highlighting the relevance of self-management-competency as a new therapeutic target.Method: 258 patients from the ‘Epidemiology and Care in Acne inversa (EpiCAi)’ project were included in the study. Disease burden was measured by patient-rated questionnaires in terms of disease activity, pain, quality of life, depression and insomnia and correlated with the domains of the health education impact questionnaire (heiQ) measuring self-management-competency.Results: 66 male (25.6%) and 192 female (74.4%) patients, with a mean age of 40.3 ± 10.24 years were included. Mean scores of pain on the numeric rating scale (NRS), Dermatology Life Quality Index (DLQI) and Hospital Anxiety and Depression Scale (HADS) were 5.11 ± 2.68, 11.35 ± 7.79 and 13.71 ± 7.57, respectively. The Insomnia severity index (ISI) showed a mean of 9.58 ± 5.76. The HADS has the highest increased total risk across all heiQ domains. With respect to the heiQ domains, the highest exposure can be attributed to improving constructive attitudes and approaches as well as decreasing emotional distress.Conclusion: There is a clear association of self-management-competency with overall disease burden, which underlines the need for psychoeducational support. This study provides ideas to develop new possible strategies of care.

Comparative effects of mindfulness-based stress reduction and psychoeducational support on parenting stress in families of autistic preschoolers.

Parents of autistic children often experience high levels of parenting stress, which can have negative mental and physical effects on both the parent and child. This study tested the efficacy of mindfulness-based stress reduction in reducing parenting stress in parents of preschool-aged autistic children compared to a psychoeducation and support intervention. We assessed parenting stress before and after the interventions and at 6- and 12-month follow-up. Both interventions significantly decreased parenting stress, but mindfulness-based stress reduction reduced stress more than did psychoeducation and support, with the strongest effect observed 1 year later. This suggests that the stress-reducing benefits of mindfulness-based stress reduction persist and may increase over time.

Feasibility and Acceptability of Spanish-Language Parenting Interventions for Young Children With Developmental Delays.

Hispanic/Latinx parents of children with developmental delays/disabilities (DD) face disparities in service access and research participation. In the present study, 60 Spanish-speaking caregivers of young children with DD participated in randomly assigned stress reduction interventions (psychoeducation/support groups or Mindfulness-Based Stress Reduction [MBSR]), followed by behavioral parent training (BPT). Caregiver attendance and satisfaction ratings were measured, and focus groups gathered additional information on caregivers' takeaways from the interventions. Caregivers demonstrated high satisfaction across interventions, with slightly greater preference for psychoeducation/support groups, and qualitative data indicated that the relevance of the information and style of delivery may be responsible. Researchers and clinicians may attain greater engagement with this population by focusing on intervention services that include psychoeducation and peer support elements.

Индивидуальный подход при обучении в группе навыкам социального поведения дошкольников с РАС в структуре тяжелых множественных нарушений развития

<p style="text-align: justify;"><strong>Objectives. </strong>The significant heterogeneity of mental disorders in children with severe multiple developmental dis­orders (SMDD) makes the development of the unified methods of psycho-educational support comprehensive issue. The goal of the article is to report the results of group social adaptation training in children of primary preschool age with autism spectrum disorders (ASD) and SMDD. Training was aimed at the development of social behavior skills with individualization of approach and differentiation of tasks for each child.</p> <p style="text-align: justify;"><strong>Methods. </strong>Article presents the procedure of the development of the social behavior in children from 3 to 8 years old in groups of short-term stay at the Center for Curative Pedagogics of the Pskov Region. Group work is based on the principles of a child-centered approach and the use of Special Individual Development Programs (SIDP). Methods of observation, differentiation of tasks were used to identify the individual characteristics of the child. The subject-activity approach as a special method of the development of social behavior skills was also used.</p> <p style="text-align: justify;"><strong>Results. </strong>The individualization of the general tasks of the SIDP which showed by the cases allows to set up specific goals for each of the participants. As a result of the individualization of tasks, a pronounced positive rehabilitation and developmental effect was observed. The reported result became possible by the step-by-step development of social behavior skills in all types of interaction between the teacher and the child.</p> <p style="text-align: justify;"><strong>Conclusions. </strong>This work demonstrates the comprehensive character of providing an individual educational track for each child. Such characteristics as the interests of participants, their opportunities and abilities and developmental aspects, manifested in a group session are declared as the important for the SIPD individualization. The importance of setting of a small, achievable goals to increase individual dynamics in the development of social skills is emphasized</p>

A Qualitative Study Exploring Parents’ Experiences of Caring for an Adolescent Child with Conduct Problems during the Covid-19 Lockdowns

Young people with conduct problems (CPs) have been detrimentally impacted by Covid-19 restrictions, with increased behaviour problems and internalising symptoms. Parents experienced increased strain, managing their child’s behaviours through lockdowns, while support services have been reduced. The present qualitative study aims to explore the deeper parental experience of caring for an adolescent child with CPs during the Covid-19 period. Participants were purposively recruited through a social media support forum. Semi-structured online interviews were conducted with 14 parents of children with CPs (13 mothers and one father) between June-December 2021. Interviews were analysed through reflexive thematic analysis. Analysis revealed four main themes; Experiencing Positive Changes in Children, Navigating Practicalities of Home Confinement, Parents at “Breaking Point”, and Methods of Survival. Parents observed increased behavioural problems in their children, and expressed great strain and fatigue in relation to their child’s expression. Overall, parents felt isolated, confused, and burnt out, feeling they have no support to turn to. These issues appear to expand beyond the pandemic, highlighting an imperative need to provide more social, practical, and psychoeducational support for these parents whose voices are currently going unheard. These should be more robust and tailored to this unique population, with suggested services including peer social networks or parental hubs, more proficient and targeted psychoeducation, crisis interventions, and a greater capacity for parental respite.

Episod maniacal indus prin corticoterapie postalblaţie de meningiom spinal. Rolul realităţii virtuale în psihoterapia anxietăţii postoperatorii

Corticosteroids have been linked to various neuropsychiatric adverse effects, including mood disorders. This case study describes a post-surgical manic episode (spinal meningioma ablation D11-D12) in a 57-year-old female patient on corticosteroids. This presentation aims to highlight corticosteroids’ potential psychiatric adverse effects and to emphasize the importance of recognizing and treating such complications. In this case, the management strategy involved discontinuing corticosteroids, initiating mood-stabilizing medications, and closely monitoring the symptoms. A mood stabilizer and a second-generation antipsychotic were administered to the patient to treat transient manic symptoms and prevent relapse. After discontinuing corticosteroids and beginning therapy with mood stabilizers, the patient’s bipolar symptoms improved. Psychoeducation and therapeutic support were provided to aid the patient in managing acute symptoms and encourage adherence to the treatment plan. As anxiety persisted after manic symptoms were controlled, the case management involved a psychotherapy technique facilitated by virtual reality. Relaxation breathing techniques were emulated through a virtual reality Oculus Quest 2 headset, improving patient-physician trust, subjectively relieving correlated anxiety, and ensuring therapeutic compliance during the admission and at home. Healthcare professionals must be vigilant to identify and effectively treat these complications of steroid anti-inflammatory medication. Immediate cessation of corticosteroids, the initiation of mood stabilizers and psychoeducation are essential for managing these cases. By presenting this case report, we hope to increase healthcare professionals’ awareness on the psychiatric consequences of corticosteroid use, the necessity of a multidisciplinary therapeutic approach, and the role of add-on virtual reality as integrated, personalized patient care to alleviate anxiety.

Personal Factors, Living Environments, and Specialized Supports: Their Role in the Self-Determination of People with Intellectual Disability.

The self-determination of people with disabilities, and specifically people with intellectual disabilities (ID), is a growing issue due to its relevance in the field of inclusion and human rights. Although research has shown a significant relationship between self-determination and intelligence, other factors also contribute to its development. The purpose of this study was to understand what other variables may be influencing self-determination. Using the scores from 483 adolescents and adults with ID who completed the AUTODDIS scale, we performed inferential and regression analyses to determine the relationships between levels of self-determination, personal variables (sex, age, severity of ID), and contextual variables (living environment, specialized supports). We found that self-determination is affected by the severity of ID, and when this variable is controlled for, greater self-determination is mainly related to receiving occupational support and support for autonomy and independent living. Results also showed that, together with ID severity, occupational and psychoeducational support, as well as support for autonomy and independent living, were also predictors of the level of self-determination. In conclusion, this study confirms the importance of contextual variables in the development of self-determination in people with ID, placing the focus of intervention on social opportunities.

718-P: Digital Health for Self-Management and Psychoeducational Support of Caregivers of Children with Type 1 Diabetes—A Feasibility Study

Becoming a caregiver of child with Type 1 Diabetes (T1D) involves understanding, accepting, and managing the new medical condition that may cause sleep deprivation, depression, anxiety, self-neglection, and poorer quality of life. Related to family caregiver fatigue, parental mental well-being has been associated with less effective parenting and poorer disease management of those kids. Digital Health programs can offer psychoeducational support to caregivers during family daily life, complementing medical care. The present study aims to better understand the barriers/facilitators to the adoption of a digital health solution for adaptive self-management. The digital solution provides a personalized digital program that includes motivational messages, educational units, mental well-being activities, and coaching services. A cohort of 20 caregivers of children with type 1 diabetes was recruited at a large pediatric hospital in Spain. Demographic and health data were recorded at baseline. After joining the program for 1 month, a SUS (System Usability Scale) questionnaire and a semi-structured interview were administrated. Preliminary results showed that the digital solution is widely useful in obtaining a SUS score of 95’38 out of 100 (SD 7’95) and achieved positive engagement outcomes. In the interviews, caregivers expressed that the educational units reinforced disease self-management. Mental health data at baseline exposed a high percentage of caregivers with symptoms of depression (25%), anxiety (35%), and stress (30%). These results highlight the importance of caregivers’ emotional wellness and the digital health solution's potential to empower them to self-manage during the disease. A subsequent study clinical study will evaluate the clinical impact of the digital intervention on a larger cohort during 2023. Disclosure L.Fernandez-luque: Other Relationship; Adhera Health Inc. A.De arriba: Board Member; Merck KGaA, Speaker's Bureau; Novo Nordisk. E.Civitani: None. M.Pilar ferrer: None. T.García castellanos: None. J.López-guimet: None. S.Quer palomas: Employee; AdheraHealth Inc. Funding Novo Nordisk Pharma S.A. (Spain)

Positive orientation and health behaviors in older patients with atherosclerosis.

Human health is determined by a number of physical, social and psychological factors, including the often considered health behaviors. They are an indispensable part of the health recovery process and are also the basis of prevention in the development of such disorders as atherosclerosis. Health behaviors are reinforced by an individual's resources such as positive orientation, which is composed of optimism, high self-esteem and satisfaction with life. The main objective of the study was to determine whether there is a relationship between positive orientation and health behavior, in a group of people with atherosclerosis. Sixty-one patients, both male and female, in late adulthood were surveyed (M = 69.41, SD = 5.44). A researcher-designed questionnaire, the Health Behavior Inventory (IZZ) and the Positive Orientation Scale (P-Scale) were used in the measurement. The study was conducted in accordance with the ethical principles of the 2013 Declaration of Helsinki. The results showed that patients with a more positive attitude toward life are more likely to use health-promoting behaviors. There is a positive relationship between positive orientation and health behaviors. Positive orientation can be enhanced through appropriate psychoeducation and psychological support to prevent ill health and improve treatment of patients with atherosclerosis.

A case study on AI and robot‐assisted psychoeducational support for Alzheimer’s caregivers

AbstractBackgroundMore than 6.2 million older Americans live with Alzheimer’s disease and related dementias (AD/ADRD). Dementia care is mostly provided by family or friends. This long‐duration, time‐intensive care can negatively impact caregivers’ physical and mental health. Dementia caregivers often feel unprepared for their roles. Resources for Enhancing Alzheimer’s Caregiver Health: Offering Useful Treatments (REACH OUT) interventions have been shown to improve caregivers’ health. However, it is challenging and resource‐intensive to implement such interventions in real‐world settings. Artificial intelligence and robotics demonstrate the potential to assist delivering intervention and support caregivers.MethodWe developed a Friendly AI‐ and Robotics‐based REACH (FAIR‐REACH) program to deliver a modified version of REACH OUT using a friendly humanoid social robot, Pepper. FAIR‐REACH included five modules: introduction to AD/ADRD and caregiving, safety information, healthy lifestyle guide, stress and relaxation, and caregiving challenges. The robot delivered the program using multimodal presentation, including a touchscreen tablet, verbal and nonverbal communication. In each module, a list of topics were displayed on Pepper’s tablet for users to choose. Approaches were employed to enable Pepper to deliver interventions engagingly, interactively, and empathetically. After supplying information on the chosen topic, the robot asked users a question relevant to the content and provided a follow‐up comment. We tested FAIR‐REACH on 2 participants and used questionnaires to assess acceptance and user experience.ResultThe participants were 1 female and 1 male, both aged 65‐75. P1 previously worked as a paid in‐home caregiver. P2 currently acts as an informal caregiver. Both participants believed that FAIR‐REACH were useful for dementia caregivers. The program was perceived as easy to use. The robot’s appearance was pleasing to participants and the tablet designs (e.g., layout) were attractive to them. Participants provided suggestions on the robot’s functions, for example, speaking more slowly, talking with caregivers more interactively, and answering caregivers’ questions.ConclusionIn the case study, the FAIR‐REACH was perceived as easy to use and helpful. The future work includes refining FAIR‐REACH to improve user experience according to the feedback/suggestions collected from the case study and assessing the feasibility, Usability, and effectiveness with a large number of dementia caregivers.

"The most important thing is that those closest to you, understand you": a nested qualitative study of persons with psychotic disorders' experiences with family involvement.

Family interventions constitute effective treatment for persons with psychotic disorders. However, the active ingredients and beneficial processes of these interventions are insufficiently examined, and qualitative explorations of patients` experiences are lacking. This study was nested in a cluster randomised trial that implemented national guidelines on family involvement in Norwegian community mental health centres, including family psychoeducation and basic family involvement and support. The aim of this sub-study was to explore how patients with psychotic disorders experience systematic family involvement, and its significance. We conducted semi-structured, individual interviews with 13 persons with a psychotic disorder after systematic family involvement. The participants were recruited through purposive sampling. Qualitative content analysis guided the analysis. Participants reported overall positive experiences with systematic family involvement. It was significant that the relatives increasingly understood more about psychosis and their situation, while they themselves also gained more insight into the relatives` situation. The participants emphasised the need to enable both patients and relatives to safely share experiences in a containing space, led by professionals. Shared understanding and awareness of each other's situation further improved communication, coping with the illness, reduced stress, and stimulated a more caring family environment. The therapist seemed crucial to facilitate these beneficial communication processes, and also to provide continuous support to the relatives. Reported challenges included that the participants felt vulnerable in the initial phase, a need for tailored approaches, and too late start-up. Findings from this study suggest that persons with psychotic disorders may benefit greatly from participating in systematic family involvement. This study also gives new insight into possible mediators of positive outcomes both for the patients and the relatives. Systematic family involvement should be implemented a standard approach in the early phase of the disease, using a step-wise and tailored process.