Psychosocial Care For People Research Articles

Psychosocial Care for People With Diabetic Neuropathy: Time for Action.

Psychological factors and psychosocial care for individuals with diabetic neuropathy (DN), a common and burdensome complication of diabetes, are important but overlooked areas. In this article we focus on common clinical manifestations of DN, unremitting neuropathic pain, postural instability, and foot complications, and their psychosocial impact, including depression, anxiety, poor sleep quality, and specific problems such as fear of falling and fear of amputation. We also summarize the evidence regarding the negative impact of psychological factors such as depression on DN, self-care tasks, and future health outcomes. The clinical problem of underdetection and undertreatment of psychological problems is described, together with the value of using brief assessments of these in clinical care. We conclude by discussing trial evidence regarding the effectiveness of current pharmacological and nonpharmacological approaches and also future directions for developing and testing new psychological treatments for DN and its clinical manifestations.

The effects of psychosocial interventions using generic photos on social interaction, mood and quality of life of persons with dementia: a systematic review

BackgroundAlthough family photos are often used in the psychosocial care for people with dementia, little is known about the use and effectiveness of generic photos. This systematic literature review explored psychosocial interventions using generic photos for people with dementia, and the effects they have on their social interaction and/or mood and/or quality of life. In addition, it was investigated whether these interventions made use of technology in its implementation.MethodsA systematic search on the following databases was performed: PubMed, Embase, APA PsychInfo, Cinahl, Web of Science, Scopus and Cochrane Central. Inclusion and exclusion criteria were based on the PICO model (Population, Intervention, Comparison, Outcome), and quality assessment was undertaken using the Weight of Evidence Framework. Narrative synthesis was undertaken to summarize study characteristics- settings and designs, type of psychosocial interventions identified, type of photos and technology used, outcome measures, and results.ResultsA total of 2,035 results were found, however after title, abstract and full-text screening, a total of 8 studies were included. The most common psychosocial intervention using generic photos was found to be reminiscence therapy, followed by art-viewing activities. In studies that used technology, it was reported that viewing digitalized photos were either similar or better to conventional printed photos. Despite photos being generic, it was found that generic photos could still hold personal significance to the person with dementia. Some positive and significant effects were found for the outcomes social interaction, mood and quality of life, though no study evaluated all three outcomes. Two studies were rated as having high overall quality, 4 were rated as fair, and 2 studies had a low quality assessment rating.ConclusionStudies found using generic photos were limited, showing varying outcomes and methodological quality. Firm conclusions on the effectiveness of interventions using generic photos are not possible. However, the use of generic photos in psychosocial interventions is a promising area for future research. Researchers should consider studies with better methodological quality and larger samples; and qualitative studies where the intention is to get better insight into successful implementation and impact mechanisms of such psychosocial interventions.Trial registrationn/a.

Diving deeper into distress screening implementation in oncology care

Background Responding to calls for additional research that identifies effective distress screening (DS) processes, including referral practices subsequent to screening and receipt of recommended care, we engaged in qualitative research as part of a larger (mixed methods) study of distress screening. This qualitative inquiry of oncology professionals across different facilities in the United States examined routine DS implementation, facilitators and challenges staff encounter with DS processes, and staff members’ perceived value of DS. Participants and Methods We conducted key informant interviews and focus groups with staff in 4 Commission on Cancer (CoC)-accredited oncology facilities (a total of 18 participants) to understand implementation of routine DS within oncology care. We used a rigorous data analysis design, including inductive and deductive approaches. Results Respondents believe DS enhances patient care and described ways to improve DS processes, including administering DS at multiple points throughout oncology care, using patient-administrated DS methods, and enhancing electronic health records infrastructure to better collect, record, and retrieve DS data. Respondents also identified the need for additional psychosocial staff at their facilities to provide timely psychosocial care. Conclusions Results reinforce the value of DS in cancer care, including the importance of follow-up to screening with psychosocial oncology providers. Understanding and resolving the barriers and facilitators to implementing DS are important to ensure appropriate psychosocial care for people with cancer. Insights from oncology staff may be used to enhance the quality of DS and subsequent psychosocial care, which is an essential component of oncology care.

Psychosoziale Versorgung von Menschen mit DDR-Heimerfahrung

Zusammenfassung Hintergrund Menschen, die in Kinderheimen und Jugendwerkhöfen der DDR Vernachlässigung, Missbrauch und Misshandlung erlebt haben, leiden oft Jahre und Jahrzehnte später noch unter den psychosozialen Folgen dieser Erfahrungen. Sie haben deshalb häufig Bedarf an psychosozialer Unterstützung, berichten aber auch über Zugangsschwierigkeiten zum Hilfesystem und Verständigungsprobleme mit den behandelnden Fachkräften. Fragestellung Es wurde untersucht, ob psychosoziale Fachkräfte ihrerseits Herausforderungen in der Behandlung/Beratung von Menschen mit DDR-Heimerfahrungen beschreiben und ob sie Zugangshürden zum Hilfesystem für die Betroffenen wahrnehmen. Weiterhin wurde erfragt, welche psychosozialen Unterstützungsangebote es für Betroffene ihrer Meinung nach geben sollte, und ob es ihrerseits Weiterbildungsbedarf zum Thema gibt. Methoden In einer Online-Studie wurden mithilfe des Mixed-Methods-Ansatz 441 Fachkräfte der psychosozialen Versorgung nach ihren Erfahrungen mit der Behandlung/Beratung von Menschen mit DDR-Heimerfahrung befragt. Ergebnisse und Schlussfolgerungen Schädigungsfolgen, bedingt durch das Aufwachsen im DDR-Heimsystem, tiefverwurzeltes Misstrauen, Angst vor Stigmatisierung sowie subjektive Scham- und Schuldgefühle der Betroffenen stellen die befragten Fachkräfte vor besondere Herausforderungen in der Behandlung/Beratung von Menschen mit DDR-Heimerfahrung und die Betroffenen gleichzeitig vor Zugangshürden in die psychosoziale Versorgung.

Assessment and Management of Cognitive and Psychosocial Difficulties for People with Multiple Sclerosis in Ireland: A National Survey of Clinical Practice.

A recent survey of 109 healthcare professionals explored how UK healthcare professionals typically assess and treat multiple sclerosis (MS)-related cognitive impairment. Little is currently known about what constitutes usual care for cognitive impairment and psychosocial care for people with MS in Ireland. The aim of the current research was to survey healthcare professionals (HCPs) who work with people with MS, to understand current assessment and management of cognition and psychosocial care in people with MS in the Republic of Ireland. A cross-sectional survey design was used. Data were collected online through Microsoft forms and through postal responses. The original UK questionnaire was adapted, piloted, and distributed to Irish HCPs. Participants were qualified HCPs who work clinically with people with MS in the Republic of Ireland. Ninety-eight HCPs completed the survey. Only 34% of those surveyed reported routine screening of cognition for people with MS within their services; approximately, 36% HCPs reported that they did not provide information or services in relation to cognition to people with MS and 39% reported not referring elsewhere when cognitive difficulties were suspected. Out of the 98 HCPs, 47% reported assessing mood difficulties as part of their services, with 14% unsure. In total, 70% of participants reported onward referral took place if mood difficulties were identified. The Montreal Cognitive Assessment was the most commonly administrated cognitive assessment. Cognitive intervention choices were found to be guided by clinical judgement in 75.5% of cases. Discussion. Despite the high importance placed on cognitive and psychosocial care, there is very little consistency in treatment and assessment across services for people with MS in Ireland.

High prevalence of depressive symptoms among people with pediatric-onset and adolescent-onset type 1 diabetes: A cross-sectional analysis of the Diabetes Study from the Center of Tokyo Women's Medical University.

ABSTRACTAims/IntroductionTo investigate the prevalence of depressive symptoms by the age of onset of type 1 diabetes, and its association with the condition of individuals with pediatric‐ and adolescent‐onset type 1 diabetes.Materials and MethodsThis single‐center cross‐sectional study enrolled Japanese participants with type 1 diabetes. All participants completed a questionnaire about their diabetes‐related condition and the Patient Health Questionnaire‐9, which was used to evaluate depression. Individuals with a Patient Health Questionnaire‐9 score of ≥10 points were defined as having moderate depressive symptoms.ResultsA total of 1,267 participants (mean age 40 years; mean duration of type 1 diabetes 21 years; 68% female; mean glycated hemoglobin 7.8%) were included and classified according to the age of onset of type 1 diabetes to identify the proportion of moderate depressive symptoms in each group: 21% (0–12 years), 18% (13–19 years) and 13% (20–40 years). The prevalence of moderate depressive symptoms was significantly higher among participants with pediatric‐onset type 1 diabetes (P < 0.05). Moderate depressive symptoms were associated with increased glycated hemoglobin, neuropathy and hypoglycemia unawareness.ConclusionsRegular screening for depressive symptoms and hypoglycemia awareness is important. Healthcare professionals should provide appropriate psychosocial care for people with pediatric‐onset and adolescent‐onset type 1 diabetes from childhood through to adulthood.

Psychosocial care of people with aphasia: Practices of speech-language pathologists in South Africa

Purpose: The study aimed to explore the practices of a sample of South African speech-language pathologists (SLPs) in providing psychosocial care to people with aphasia. People with aphasia are at risk of adverse psychosocial disruptions and access to appropriate support may be particularly challenging for individuals with compromised communication abilities. The study considered the multilingual and multicultural context of South Africa. By understanding current practices, direction for improved psychosocial care to clients as well as support to SLPs is highlighted. Method: A 20-item previously published online survey was completed by 56 South African SLPs. Purposive and snowball sampling were used to recruit participants. Descriptive and inferential statistics, and qualitative content analysis, were used. Result: Respondents recognised addressing psychosocial wellbeing to be very important. A variety of psychosocial approaches were used in practice. However, 67.9% of the sample felt ill-equipped to provide psychosocial care to people with aphasia. Further barriers included: time/caseload pressures (60.7%) and feeling out of their depth (48.2%). Enablers were: access to more training opportunities (89.3%), adequate time (62.5%), and ongoing support from skilled professionals (55.4%). The majority of respondents also perceived mental health professionals to have limited expertise in working with people with aphasia, making onward referral challenging. Conclusion: Respondents support people with aphasia’s psychosocial wellbeing by employing counselling strategies, including family, and person-centred goal-setting. However, many challenges to the provision of psychosocial care to people with aphasia were identified. To improve services, more training opportunities, improved role definition and interprofessional collaboration, are required.

Development of an integrated, holistic care package for people with lymphoedema for use at the level of the Primary Health Care Unit in Ethiopia.

BackgroundNeglected Tropical Diseases (NTDs) are a group of several communicable and non-communicable diseases prevalent in tropical and subtropical areas. The co-endemicity of these diseases, the similarity of their clinical signs, and the need to maximize limited financial and human resources suggest the importance of adoptingan integratedapproach to their prevention and treatment.AimsThis study describes the development of a comprehensive package of physical, mental health and psychosocial care for people with lower-limb lymphoedema caused bypodoconiosis, lymphatic filariasis (LF)or leprosy as part of the EnDPoINT program in Ethiopia.MethodThe care package was developed using a mixed-methods approach, consisting of a literature review, situational analysis, Theory of Change (ToC) workshops, qualitative research, and additional workshops to fine-tune the draft care package. The care package was developed between March 2018 and January 2020 in Addis Ababa and the implementation research site, Awi zone in the North-West of Ethiopia.ResultsThe holistic care package includes components implemented at three levels of the health care system:health organization, facility, and community. Sections of the care package are directed at strengthening capacity building, program management, community engagement, awareness-raising, stigma-reduction, morbidity management, disability prevention, follow-up visits, referral linkage, community-based rehabilitation, and monitoring and evaluation.ConclusionsThe study developed a holistic integrated care package for lower limb disorder and co-morbid mental health problems caused by podoconiosis, LF or leprosy. The approach has the potential to significantly reduce lower limb disorder-associated morbidity, disability, and psychosocial problems. It also standardizes a scalable approach appropriate for the Ethiopian setting and, most likely, other countries where these NTDs are present.

Stopping to Listen: Using Qualitative Methods to Inform a Web-Based Platform for Adults With Neurofibromatosis.

Introduction: Psychosocial care for people with neurofibromatosis (NF) is challenging to access. Therefore, we sought to develop a self-guided web-based treatment platform for people with NF based on the live video relaxation response resiliency program for NF (3RP-NF). Here we report on qualitative interviews with adult patients who participated in the 3RP-NF to: (a) understand participant perceptions of the 3RP-NF program and (b) gather feedback for a self-guided web-based treatment platform (i.e., NF-Web). Methods: We conducted individual semistructured interviews (N = 23; videoconferencing). We utilized both the Framework method and a hybrid deductive and inductive approach to analyze qualitative data. Results: We examined findings within the following themes for both 3RP-NF and NF-Web: (a) general attitudes, (b) barriers and facilitators, and (c) program-specific factors. Participants endorsed positive attitudes towards the 3RP-NF and NF-Web and described unique barriers and facilitators to each and provided suggestions regarding technology, NF-specific needs, and ways to promote social support virtually. Conclusions: This study highlights the importance of gathering participant feedback when designing novel, illness-specific interventions. In future studies, we aim to provide people with NF effective and efficient access to psychosocial support that matches their needs and life context. Results are informing NF-Web development.

Mental Health and Psychosocial Care for People with Disabilities

Mental Health and Psychosocial Care for People with Disabilities

Psychosocial care for contacts of confirmed cases of COVID-19 in Touba, Senegal

Senegal, like many countries in the world, has been facing the COVID-19 pandemic since March 2, 2020. Psychosocial care for people who are victims of this unexpected and potentially fatal event is essential. As soon as the first cases were registered in Senegal with the announcement of the first cluster in the town of Touba, 150km from Dakar, on March 12, 2020, the country's health authorities set up a multidisciplinary team on the spot with a cell operational psychosocial. This unit has set up for a hundred direct and indirect victims immediate and post-immediate individual and/or group care with home visits. Beyond the therapeutic and support aspect of the psychosocial care of these victims of COVID-19, this intervention allowed the decision-making level to have feedback from the field on certain actions that posed more problems than they did not resolve. The psychosocial field work made it possible to model and adjust the interventions in a particular context of denial by the local population.

392-P: Development of a Fear of Hypoglycemia Screener: Type 1 Diabetes Health Care Provider Insight

Fear of hypoglycemia (FoH) contributes to poor behavioral and glycemic outcomes. The ADA position statement on psychosocial care for people with diabetes recommends screening for FoH, with referral if positive. A clinically useful screener for FoH does not exist, hindering further actions by clinicians to address FoH in their patients. As part of a multi–phase study to develop a validated screener for FoH, we conducted semi–structured interviews with 10 healthcare providers (HCPs) (6 endocrinologists, 4 certified diabetes educators) who treat patients with T1D. The objective was to understand current clinical methods of identifying, diagnosing, and/or assessing FoH, HCP perceptions of T1D patients’ fear of, and experience with, hypoglycemia. Interviews were transcribed, de–identified, and thematically analyzed. Key themes were summarized for each interviewee and common themes across interviews were identified. All HCPs reported assessing patients for FoH through discussion. Most HCPs (7/10) did not use formal screeners for psychosocial issues. Instead, they evaluated patients with open ended questions about their feelings and experiences about low blood sugar. Some HCPs identified FoH behaviors based on CGM and insulin pump usage data; however, this method was not applicable for patients not using these technologies. Most HCPs (9/10) were not familiar with Blood Glucose Awareness Training as a formal program, which is recommended by the ADA to re–establish awareness of hypoglycemia and reduce FoH. Most HCPs made mental health referral decisions after observing anxiety, depression, or chronic poor management behaviors. Results suggest that although clinicians are aware of FoH, due to the lack of a formal screening tool, most HCPs rely on subjective judgment to determine the need for further psychosocial care referral. Creation of a screener will provide a standardized tool to better implement the ADA position statement of psychosocial care on the management of FoH. Disclosure B. Mitchell: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. J. Bispham: None. A. Hughes: None. J. Liu: None. M. Perez-Nieves: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. J. Poon: Employee; Self; Eli Lilly and Company. L. Fan: Employee; Self; Eli Lilly and Company. Stock/Shareholder; Self; Eli Lilly and Company. A. McAuliffe-Fogarty: None. Funding Eli Lilly and Company

Willingness of MSM Living with HIV to Take Part in Video-Groups: Application of the Technology Readiness and Acceptance Model.

Group-based programs are important for the psychosocial care of people living with HIV; however, programs are often limited by geography and availability. Video-groups, conducted via group-based video-conferencing on video-phones or computer, offer the benefits of group-based programs while overcoming barriers to attendance. This study sought to explore if, and how, the Technology Readiness and Acceptance Model (TRAM) could be used to explain the willingness of men to take part in video-groups. The TRAM was used as the guiding framework for thematic qualitative analysis. Among 106 participants, there was a general willingness to participate in video-groups. TRAM constructs were present in the data-with perceived usefulness (extent that participating in a technology-based program would facilitate group intervention behaviors) and insecurity (distrust/skepticism of technology) emerging as the most salient themes. The TRAM alone did not account for concerns related to group settings or the level of privacy needed when talking about HIV.

Handbook of Oncology Social Work: Psychosocial Care for People with Cancer. Edited by Grace Christ, Carolyn Messner, and Lynn Behar. 2015. 872 pages. $110.00. ISBN: 9780199941926.

Handbook of Oncology Social Work: Psychosocial Care for People with Cancer. Edited by Grace Christ, Carolyn Messner, and Lynn Behar. 2015. 872 pages. $110.00. ISBN: 9780199941926.

Book Review: Handbook of Oncology Social Work: Psychosocial Care for People with Cancer

The inaugural Handbook of oncology social work: psychosocial care for people with cancer, edited by Grace Christ, DSW/PhD; Carolyn Messner, DSW; and Lynn Behar, PhD, published by the Oxford University Press (OUP) in February 2015, is not just for social workers, it is a must read for all oncology practitioners. As a nurse, cancer educator, and researcher, I discovered numerous easily accessible psychosocial gems to support holistic care along the cancer continuum, or perhaps more importantly, as a friend, family member, and caregiver of people diagnosed with cancer, there are valuable insights that emerge throughout the handbook from the lens of people living with cancer, their caregivers, and practitioners. According to Carolyn Messner, DSW, one of the three editors and a chapter author, this foundational handbook was written to provide a repository for the breadth and scope of oncology social workers’ clinical practice, education, research, policy, and program leadership in the psychosocial care of people with cancer and their families and has been very well received by people practicing within diverse disciplines. This extensive handbook is well organized to accommodate focused inquiry. Information is presented in 108 diverse topic areas plus an epilogue which are organized into 19 sections written by 160 experts. Authors span professions including social workers, oncology nurses, physicians, chaplains, lawyers, and psychologists, all essential to recognize interprofessional expertise and collegial work, vital to provide comprehensive psychosocial care to patients, their caregivers, and the bereaved. Each of the 19 sections begins with an accompanying 1to 2-page overview. This introductory format is extended by highlighting key concepts and salient ideas at the beginning of each chapter. Additionally, there is a 22page index which is a robust navigation tool. However, the devoted reader may choose to savor the knowledge and understandings that unfold throughout the 813 pages. Light a fire in the fireplace, sip a cup of warm tea, and get comfortable for an insightful read. Many of us grapple in our personal relationships and professional experiences with how to effectively address the psychosocial needs of patients and their families experiencing cancer. The coverage of applicable content is extensive. The major psychosocial topics include the following: cancer across the continuum of care; survivorship; site-specific cancers; distress screening; research; quality of life; genetics; sociocultural and economic diversity; assessment and interventions with adults living with cancer, their families, and caregivers; parental cancer; children and adolescents; pediatrics; adult life-span issues; loss, grief, and bereavement; patientand family-centered care; legal and ethical issues; care coordination; technology-integrated interventions; professional development and education; and building resilience in interprofessional settings. Section III entitled BPsychosocial challenges of site-specific cancers^ includes insight from a cancer survivor’s perspective of living with a rare cancer, how to support men challenged with prostate cancer, needs of patients experiencing hematologic cancers, as well as the unique fears and challenges when a person’s cancer returns. Another section invites the reader to consider sociocultural and economic diversity and offers ways to improve access and health outcomes. Population-specific considerations include chapters to respectfully acknowledge and support diverse peoples diagnosed with cancer and their families such as immigrants, political refugees, and patients seeking asylum who have cancer; gay, lesbian, bisexual, and transgender individuals with cancer; indigenous peoples; and African * Melany Cueva mcueva@anthc.org

Returning home: psychosocial care during the re-entry phase of cancer survivorship in rural Australia.

The purpose of this research was to highlight gaps in formal psychosocial care for cancer survivors in rural communities. The study was conducted in rural Victoria, Australia, and involved interviews with people with various stages of cancer progression, cancer diagnoses and survival times, who were interviewed about their experiences of psychosocial cancer care. Interviews focused on their experience of psychosocial care and were audio-recorded and transcribed verbatim. Data were thematically analysed to identify key themes. Findings demonstrate that psychosocial care is essentially informal within the re-entry period after cancer diagnosis and treatment. Despite current Australian clinical guidelines on psychosocial care for people with cancer, which indicate the need for the provision of formal psychosocial care, participants in this study largely cared for themselves, or received informal support from family, friends and community members. Many psychosocial needs remained unmet and professional support was lacking. While this study was conducted in rural Australia, many of our findings have been echoed in studies from other countries. The findings have implications for treatment protocols and discharge planning, health professional-patient-family relationships, and the long-term well-being of cancer survivors living in rural communities. A model for understanding the experience of formal supportive care during the re-entry phase of survivorship is proposed.

Practical diagnosis and management of dementia due to Alzheimer's disease in the primary care setting: an evidence-based approach.

To review evidence-based guidance on the primary care of Alzheimer's disease and clinical research on models of primary care for Alzheimer's disease to present a practical summary for the primary care physician regarding the assessment and management of the disease. References were obtained via search using keywords Alzheimer's disease AND primary care OR collaborative care OR case finding OR caregivers OR guidelines. Articles were limited to English language from January 1, 1990, to January 1, 2013. Articles were reviewed and selected on the basis of study quality and pertinence to this topic, covering a broad range of data and opinion across geographical regions and systems of care. The most recent published guidelines from major organizations were included. Practice guidelines contained numerous points of consensus, with most advocating a central role for the primary care physician in the detection, diagnosis, and treatment of Alzheimer's disease. Review of the literature indicated that optimal medical and psychosocial care for people with Alzheimer's disease and their caregivers may be best facilitated through collaborative models of care involving the primary care physician working within a wider interdisciplinary team. Evidence-based guidelines assign the primary care physician a critical role in the care of people with Alzheimer's disease. Research on models of care suggests the need for an appropriate medical/nonmedical support network to fulfill this role. Given the diversity and breadth of services required and the necessity for close coordination, nationwide implementation of team-based, collaborative care programs may represent the best option for improving care standards for patients with Alzheimer's disease.

Value of a Confidant Relationship in Psychosocial Care of People with Multiple Sclerosis

WE EXPLORED THE EFFECTS OF LIVING WITH MULTIPLE SCLEROSIS (MS) ON A PRIMARY RELATIONSHIP: that between the person with MS and his or her closest confidant. We anticipated that this would enhance understanding of the meaning of psychosocial support from the perspective of people with MS. Using a phenomenological qualitative approach, we interviewed 33 people with MS and the people they identified as providing psychosocial support to them (their confidants). The results were presented to a range of health-care workers in two focus groups to explore their responses. Two additional focus groups were held with the participants with MS to add depth and clarity to the findings. Three major themes emerged from the interviews: 1) People with MS do not want to be defined by their condition and want to live as normal a life as possible. 2) The confidant helps to maintain this sense of normality. 3) Both the person with MS and the confidant value the relationship and together try to manage the realities of living with MS. The findings indicate the need to raise awareness among MS care professionals about the value of the confidant relationship. Training professionals to discuss emotional issues with clients and increasing collaboration with agencies that provide emotional support will facilitate a more holistic approach to care.

A Model of Preventive Psychosocial Care for People with HIV Disease

People suffering from human immunodeficiency virus (HIV) infection have vast psychosocial needs that begin with diagnosis and evolve over the course of the illness. The medical focus has changed from intervention primarily in acute medical crises to prevention and outpatient monitoring for people with HIV disease. This article describes a structure that allows hospital social workers to intervene early, to carry out comprehensive assessments, and to continually follow a person with HIV disease throughout the course of illness. The article provides a framework of preventive psychosocial care for people with HIV disease, with particular attention to the use of a specialized assessment.