Psychosocial Services Research Articles

Differences in Help-Seeking Behavior among University Students during the COVID-19 Pandemic Depending on Mental Health Status: Results from a Cross-Sectional Survey.

Current evidence suggests that a significant proportion of university students are affected by mental disorders and suicidal ideation. Despite this, a treatment gap exists. Therefore, the present study assessed students' knowledge and past use of on- and off-campus mental health services and help-seeking intentions. Furthermore, resilience was investigated as a potential barrier to help-seeking behavior. Data were collected between April and May 2022 from N = 5510 students from Saxony, Germany. To compare dependent variables, subgroups were computed according to students' mental health status. Variables were assessed using standardized questionnaires. Chi-square tests were used for comparisons between groups. Multiple regression models were used to investigate the influence of resilience on help-seeking behavior. Between 34 and 38% (depending on the subgroup) of participants indicated that they were not aware of their universities' psychosocial counseling services. Furthermore, between 17 and 19% of participants indicated that they were not willing to seek help from professional mental health services. Finally, the previously found negative effect of resilience on help-seeking behavior was confirmed. The results showed a lack of awareness regarding universities' mental health services and a treatment gap among university students. Universities and healthcare providers need to educate students about mental health services and how to access them. Further research is needed to elucidate the differential impact of resilience on mental health and help-seeking.

Examining Parental Alienation Syndrome Behaviors in Divorce, Custody and Personal Relationship Cases

In this study, the objective was to conduct an analysis of behaviors associated with Parental Alienation Syndrome (PAS) within the context of divorce, custody disputes, and personal relationship with children. The present inquiry employed the document/text analysis method, one of the qualitative research methodologies. The reports prepared by psychologists, social workers, and pedagogues (psychological counsellors), including the researcher, in the cases held by Ankara 10th Family Court were included in the study. 27 selected files were descriptively analyzed with respect to PAS behaviors and alienation strategies. Answers were sought to the questions about PAS behaviors toward mother, father and relatives, and what PAS behaviors are in court processes and relations with the child. Results showed that parental alienation behaviors toward parents and relatives are common in divorce, custody, and personal relationship with the child cases. It was found that divorce, custody, and personal relationship with the child cases negatively affect the relationship between the mother, the father, and the child. The research findings, PAS behaviors put all the parties in a difficult situation in the legal process. Therefore, providing psychosocial services to the families, raising the awareness of court experts about PAS, and conducting more research on this issue are important.

Advancements and Considerations in Cardiac Rehabilitation: A Comprehensive Review

Cardiac rehabilitation (CR) stands as a cornerstone in the management of cardiovascular diseases, offering comprehensive programs aimed at improving the health and well-being of individuals with heart conditions. This abstract provides an overview of the advancements and considerations within the realm of cardiac rehabilitation. In recent years, significant advancements have been made in understanding the multifaceted aspects of CR, encompassing exercise training, risk factor modification, psychosocial support, and patient education. Novel exercise modalities, including high-intensity interval training (HIIT) and technology-assisted rehabilitation programs, have emerged as effective strategies to enhance cardiovascular fitness and functional capacity in CR participants. Additionally, personalized approaches to risk factor management, such as tailored dietary interventions and smoking cessation programs, have demonstrated promising outcomes in improving cardiovascular outcomes and reducing disease burden, the integration of psychosocial support services, including stress management techniques, cognitive behavioral therapy, and social support networks, plays a crucial role in addressing the emotional and psychological aspects of cardiovascular rehabilitation. Patient education programs focusing on medication adherence, symptom recognition, and lifestyle modifications empower individuals to actively participate in their care and promote long-term adherence to healthy behaviors. Despite these advancements, several considerations must be addressed to optimize the delivery and effectiveness of cardiac rehabilitation programs. Access barriers, including geographical constraints, socioeconomic disparities, and healthcare system limitations, pose challenges to equitable participation in CR, particularly among underserved populations. Moreover, tailoring CR interventions to the unique needs and preferences of diverse patient populations, including women, older adults, and individuals with comorbidities, remains a critical priority in promoting inclusivity and accessibility in cardiac rehabilitation services.

Predisposing, need and enabling factors for service utilization amongst newly arrived youth in Sweden

PurposeThe reasons for and experiences during migration, as well as additional stressors in the new host country, may give rise to mental health problems and additional need for public services. The purpose of the study was to investigate factors related to service utilization among newly arrived refugee youth.Design/methodology/approachCross-sectional data were gathered in Sweden where 37 youth aged between 19 and 23 reported on factors related to service utilization, encompassing health-care and support services in school. These factors included predisposition (demographic), need (migration status and mental wellbeing) and enablement (living situation). Service utilization was estimated using multiple logistic regression analysis.FindingsAbout a fourth of the sample used psychosocial services. Use of general support was more common. Neither predisposing, need nor enabling factors were associated with the use of psychosocial or general health-related services.Originality/valueSelf-reported factors related to use of health-related services have previously not been investigated for refugee youth, which is important in assuring access to appropriate services for this exposed youth population.

Overview of Cancers and Impact of Music Therapy in Intervention: A Literature Review

Cancer is taken under consideration as a fatal disease. It’s caused by a spread of things including unhealthy lifestyles, pollution, stress, radiation exposure, infection, tobacco consumption, and unhealthy food choices. There are several varieties of cancer that affect the chassis and their growth varies depending on the type. Cancer could be a major reason for death after a heart condition. There are 10 million new cases of cancer and approximately 5 million deaths in 2020 were caused by cancer (World Health Organization, 2018)1, and deaths from cancer worldwide are projected to still rise to over 20 million by 2025 (Stewart and Wild. 2014)2. There are several intervention modes to treat cancer patients. Besides medical intervention, there are prominent psychosocial concerns that have a very noticeable impact on intervention in the case of cancer patients. Cancer treatment facilities in India have incorporated psychosocial services into cancer care by routinely assessing patients’ levels of distress. For that Music therapy can improve their quality of life by addressing the emotional, spiritual, and physical needs that will arise during this point. Furthermore, music therapy also can be applied to assist relationships throughout the grieving process by providing comfort, continuity, and opportunities for specific feelings of loss (Rossetti et al., 2017)3. Hence, there’s a greater need and justification for exploring the scope of using music therapy with cancer patients, especially in low-income countries, including India

Identifying relevant psychosocial factors in the care of people with dementia: findings of a focus group study with health professionals and informal caregivers

Abstract Aim The extent to which psychosocial factors are considered in the treatment and care of people with dementia is unknown, despite their promising treatment effects. Therefore, the aim of this study was to explore the relevance, implementation, and the challenges of integrating psychosocial factors in dementia care. Subject and methods A qualitative design, in adherence to the COREQ checklist, was used with three expert focus groups in the treatment and care of people with dementia (10 health professionals and 6 informal caregivers). The focus group discussions were transcribed verbatim and analyzed using qualitative content analysis. Results It emerged that psychosocial factors, particularly social contact, seem to come with a beneficial effect on daily life performance and general well-being. Psychosocial interventions also seem to aid people with dementia in experiencing competency. Findings also indicate that needs, interests, and preserved abilities should be the focus when deciding on the integration of psychosocial factors into care. Perceived barriers to the implementation of psychosocial factors in daily life were bureaucracy, inadequate staffing, cost, societal challenges, and limited offers of appropriate psychosocial services. Conclusion Psychosocial factors were consistently perceived as beneficial. Programs should be developed to address the barriers and implement model projects within the respective medical health care system to serve the dementia patients in the community as a whole.

Recovery Services for Interpersonal Violence Victims on Healthcare Use at a Trauma Center

IntroductionTreatment of interpersonal violence (IPV) patients is often complicated by social and mental health comorbidities. New American College of Surgeons (ACS) requirements include provision of psychosocial support services for recovery after injury. We aim to describe utilization and patient outcomes after provision of Trauma Recovery Services (TRS) at our institution for the IPV population. These services include assistance with food, housing, criminal justice, and advocacy. MethodsIPV patients were identified between September 6, 2018 and December 20, 2020. Demographic information was collected. TRS utilization and specific services rendered were identified. Primary outcome measures included initial length of stay (LOS), number of subsequent emergency department (ED) visits, and outpatient visits within 1 y after the initial injury. Statistical analyses included t-tests, Chi-squared tests, and multivariate regression analyses. ResultsA total of 502 patients were included in the final cohort, and 394 patients (78.5%) accepted the utilization of TRS services after initial interaction. Patients were on average 33.4 y old, and 59.4% were females. Patients who were older (P < 0.001) and homeless (P = 0.004) were more likely to use TRS, while victims of sexual assault (P < 0.001) and single patients (P = 0.041) were less likely. Patients who utilized TRS had longer initial LOS (P < 0.001), more ED visits (P < 0.001), and more outpatient visits (P = 0.01) related to the initial complaint, independent of potential confounders on multivariate linear regression. Food and housing service utilization associated with LOS (P = 0.01), ED visits (P < 0.001), and outpatient visits (P < 0.001). Additionally, transportation services were associated with longer LOS (P = 0.01) while patient advocacy services were associated with more ED visits (P = 0.03). ConclusionsTRS was extensively utilized by IPV patients, and associated with more follow-up appointments, ED visits, and longer LOS. Emphasis on injury mechanisms, baseline demographics, and social features may further characterize patients in need who tend toward utilization.

Emotional Distress in Portuguese Cancer Patients: The Use of the Emotion Thermometers (ET) Screening Tool.

Cancer patients may experience significant distress. The "Emotion Thermometers" (ETs) are a short visual analogue scale used to screen patients for psychosocial risk. This study aimed to assess emotional distress in a large sample of cancer patients attending psychological services at an non-governmental organization (NGO), and to explore factors that may contribute to it. The ETs were answered by 899 cancer patients. They were, on average, 59.9 years old, the majority were female, had breast cancer, were under treatment or were disease-free survivors, and reported high levels of emotional distress, above the cut-off (≥5). A Generalized Linear Model was used to measure the association between the level of distress, age, gender, disease phase and 33 items of the problem list. Four items-sadness, depression, sleep and breathing-were found to be significantly related to a higher level of distress. Additionally, women and patients who were in the palliative phase also had significantly higher levels of distress. The results confirm the need for early emotional screening in cancer patients, as well as attending to the characteristics of each patient. Additionally, they highlight the utility of the ETs for the clinical practice, allowing to optimize the referral to specialized psychosocial services.

Psychosocial services for pediatric oncology patients in low- and middle-income countries from health care providers' perspectives: A survey-based report from the SIOP Global Health Network Psychosocial Working Group.

While pediatric cancer survival rates have improved in high-income countries, they remain much lower in low- and middle-income countries (L/MICs). While much focus in recent years has been on remediating the survivorship gap, less is known about the psychosocial needs and availability of psychosocial services for this population. A questionnaire was created by the SIOP Global Health Network Psychosocial Working Group to assess psychosocial needs and services in L/MIC. The questionnaire was distributed to pediatric oncology professionals, both in-person at the SIOP Annual Congress in Lyon (2019) conference and then electronically. Individuals not part of SIOP were also invited to participate via social media posts. Sixty-six respondents from 31 countries completed the questionnaire. The majority of participants were physicians, followed by nurses. Participants from low- and lower-middle-income countries (L/LMICs) perceived patients as having higher rates of anxiety and caregivers as having higher rates of depression as compared to those in upper-middle-income countries (UMICs). Across all L/MICs represented, 85% of physicians reported that psychosocial issues sometimes, frequently, or always affect their clinical obligations. Participants reflected on the availability of professionals who treat mental health concerns; the availability of social workers, psychologists, and non-professional volunteers differed significantly between L/LMICs and UMICs. Treatment abandonment and myths/disinformation were highlighted as the most pressing psychosocial priorities. Our study highlights pediatric oncology providers' perceptions of psychosocial concerns. Based on responses, proposals for minimum standards of care are made, as well as the importance of training existing providers and funding additional psychosocially-focused professionals.

Provision of mental health and psychosocial support services to health workers and community members in conflict-affected Northwest Syria: a mixed-methods study

BackgroundNorthwest Syria (NWS) is a conflict area with challenging political, economic, demographic and social dynamics. The region has a high number of internally displaced persons with increasingly disrupted delivery of basic services, including healthcare. Mental health needs have been increasing in the region while the infrastructure and capacity of the health sector has been negatively affected by the conflict. This study aimed to explore the provision of mental health and psychosocial support (MHPSS) services to communities in NWS (including healthcare workers) and to assess the experiences of beneficiaries with MHPSS services.MethodsThe study followed a mixed-methods research design that included qualitative and participatory methods (44 semi-structured interviews and a group model building workshop with 15 participants) as well as a survey with 462 beneficiaries.ResultsFindings suggested an improvement of MHPSS services in the region over the last few years due to the creation of a specific Technical Working Group for MHPSS that contributed to assessment of community needs and support of the MHPSS response. The key elements of this response were: (1) training non-specialized health workers to address the shortage in specialized providers; (2) securing funding and coordination of services between different organizations; and (3) addressing gaps in the availability and geographical distribution of other needed resources, such as medicines. While those elements contributed to improving access to services and the quality of services—especially among health workers seeking MHPSS services—findings suggested gaps in the sustainability of services and a need to scale up those interventions in an integrated approach.ConclusionThe study findings add to the evidence base on the challenges in scaling up MHPSS interventions and their long-term sustainability concerns. Priority actions should address the intermittent funding of the MHPSS response, incorporate MHPSS outputs and outcomes in the reimbursement of routine services, improve coordination between health partners and non-health actors in order to expand the scope of MHPSS response, and address the inequitable availability of resources in the region.

Social psychological factors and strategies for women’s incarceration-induced phobias

BackgroundThe incarceration of women is a risk factor for phobias in women. Depth phobia can seriously affect patients’ quality of life and even induce the risk of suicide. However, this phenomenon is common in many countries and regions. To study the social and psychological reasons for this phenomenon and propose strategies to help patients escape their fear.Subjects and MethodsFifty women with a history of incarceration and phobias were selected as the experimental group, and 50 women with a history of imprisonment and no phobias were selected as the control group. The Anxiety Disorders Interview Schedule for DSM-IV (ADDIS-IV) was used to analyze the 100 women comprehensively.ResultsThe experimental group had a mean score of 88, and the control group had a mean score of 72 out of 100 on the 20-item comprehensive assessment. The study found that factors such as domestic violence, gender discrimination, mental health, and local culture may lead to the incarceration of women, and women with excessive life stress and a history of incarceration are more likely to develop phobias. In addition, the local social structure and legal system may also lead to the imprisonment and phobias of women.ConclusionsThe results showed domestic violence and gender discrimination were the leading causes of women’s incarceration and phobias. Therefore, the provision of psychosocial counseling and treatment services should be strengthened to reduce the incidence of incarceration and phobia among women.

The police paradox: A qualitative study of post-overdose outreach program implementation through public health-public safety partnerships in Massachusetts.

Post-overdose outreach has emerged in the United States as an increasingly common response to non-fatal overdose. This qualitative study investigates the implementation of such programs through public health-public safety partnerships in Massachusetts. We conducted semi-structured interviews with post-overdose outreach team members, overdose survivors, and family members who received outreach. Interview transcripts were inductively analyzed to identify emergent themes and subsequently organized within the framework of Ecological Systems Theory. Forty-nine interviews were conducted, including 15 police officers (80% male, 100% non-Hispanic White); 23 public health partners (48% male, 87% non-Hispanic White); 8 overdose survivors who received outreach services and 3 parents of survivors who received services (collectively 27% male, 64% non-Hispanic White). Implementation factors identified across all levels (macrosystem, exosystem, mesosystem, and microsystem) of Ecological Systems Theory included key program facilitators, such as access to police data and funding (macro), interagency collaboration (exo), shared recognition of community needs (exo), supportive relationships among team members (meso), and program champions (micro). Common barriers included inherent contradictions between policing and public health mandates (macro), poor local treatment and service capacity (exo), divergent staff views of program goals (exo), overdose survivors' prior negative experiences with law enforcement (meso), difficulty locating overdose survivors (meso), and police officers' lack of qualifications or training in providing psycho-social services (micro). Most post-overdose outreach programs in this study were dependent on funding and data-sharing partnerships, which police agencies largely controlled. Yet, police participation, especially during outreach visits presented numerous challenges for engaging overdose survivors and establishing non-coercive linkages with evidence-based services, which may undermine the public health goals of these programs. These findings should inform state and federal efforts to expand the role of law enforcement in behavioral health initiatives.

ÜNİVERSİTE ÖĞRENCİLERİNDE SOSYAL MEDYA BAĞIMLILIĞININ SOSYAL DIŞLANMA İLE İLİŞKİSİ

The aim of this study is to examine the relationship between social media addiction and social exclusion among university students. A descriptive and cross-sectional study included 466 university students, reached through social media platforms. Research data were collected through a questionnaire consisting of an introductory information form, the Social Media Addiction Scale-Student Form, and the Ostracism Scale for Adolescents, all prepared using Google Forms. The data obtained from the research were analyzed using the SPSS program. The mean total score on the Social Media Addiction Scale-Student Form for the participating students was 70.75±18.47, while the mean total score on the Ostracism (social exclusion) Scale for Adolescents was 20.36±5.97. It was determined that 45.9% of the students scored above the scale average on the social media addiction scale, and 60.3% scored above the scale average on the social exclusion scale. It was found that social exclusion is a predictor of social media addiction. In preventing social media addiction among university students, creating healthy environments where students can engage in social activities and considering the situation of social exclusion in the provision of psychosocial health services may be beneficial.

64 Consensus Practice Recommendations Regarding Parental Presence in Canadian NICUs to Inform Ongoing and Post Pandemic Policies

Abstract Introduction/Background In March 2020, parental presence restriction policies were introduced in Canadian NICUs as institutions aimed to prevent COVID-19 transmission during the emerging global pandemic. However, parental presence in NICUs is necessary for maximizing parent and infant health outcomes, and there continues to be significant variation in parental restriction across Canadian NICUs. Objectives To identify the impact of parental restriction policies in Canadian NICUs on parents, infants, and healthcare providers and co-create practice recommendations for ongoing pandemic management and post-pandemic policies. Design/Methods A national survey was conducted to assess the impact of Canadian NICU restriction policies. Recommendations were developed through Delphi and Values and Preferences research methods. For the first Delphi survey, participants rated 50 items of importance from the national survey on a scale from 1 (very low importance) to 5 (very high). On the second Delphi survey, participants ranked the top 20 items from highest relative to lowest importance. A literature review was conducted for the top 10 items, and evidence of known benefits and harms was presented to the panel of decision-makers during the Values and Preferences consensus meetings. Participants voted on the inclusion of each item as a national recommendation and discussed additional caveats. A vote of 80% or more was deemed a consensus. Results Parents (n=426) and healthcare providers (n=205) completed a national survey, from which a list of reported impacts was derived. After two separate Delphi rounds (n=39, and n=20), a series of 10 recommendations with the highest rated importance were identified. A representative panel of decision-makers (n=20), including parents of NICU infants, NICU healthcare providers and managers, and infectious disease and public health policy-makers, took part in a Values and Preferences task. Items of importance included 7 strong recommendations (parents as essential caregivers, providing skin-to-skin contact, direct or mothers’ own expressed milk feeding, attending medical rounds, mental health and psychosocial services access, food and drink access, and inclusion of parent partners in pandemic response planning) and 6 conditional recommendations (providing hands-on care tasks, touch, two parents present at the same time, use of communication devices, and in-person access to medical rounds and mental health and psychosocial services). Consensus was reached on all items in favour of inclusion in national recommendations for Canadian NICUs. Conclusion These recommendations will guide ongoing and future pandemic management and policies with respect to parental presence and involvement in their infants’ care.

Psychosocial Support Services in Efforts to Address Feelings of Weariness Among Residents of MedanPlus Rehabilitation Foundation

Purpose: This research aims to tackle the challenge of boredom and weariness among residents in rehabilitation due to monotonous routines. It emphasizes the importance of psychosocial support to enhance engagement and emotional well-being during rehabilitation.&#x0D; Method: Employing a Social Group Work framework, the study involves stages like Preparation, Assessment, Program Planning, Implementation, and Evaluation. Qualitative data from residents' responses is analyzed to gauge the intervention's effectiveness.&#x0D; Practical Applications: This research informs rehabilitation practices by advocating positive activities and motivation to improve residents' experiences and emotional states. Tailored interventions can alleviate boredom and facilitate successful reintegration.&#x0D; Conclusion: This study improves rehabilitation outcomes by addressing boredom through psychosocial support. The Social Group Work approach effectively counters boredom and promotes positive emotions, enriching rehabilitation programs.

64 Driving positive ageing at home: older adults’ engagement with ALONE support services

Abstract Background It is estimated that by 2050 approximately 1.6 million Irish people will be aged 65 or over. This dramatic shift in population highlights the importance of supporting positive ageing, and the need to develop medical and non-medical infrastructure and services that can meet the needs of this growing age group. ALONE is a national organisation that aims to transform ageing in Ireland, by supporting older adults to age within their own homes and communities positively and securely. This research aims to provide a descriptive portrayal of the response of older adults to ALONE’s services. Specifically, this study examined the demographic and clinical characteristics of older adults who seek support from ALONE and described the implications of these findings for policy and service delivery. Methods Data from older people who engage with ALONE services are captured through an online system designed to record salient clinical and service delivery information. Data analysed for this study included demographic characteristics, presenting needs, and nature, duration, and frequency of service engagement. Results Most older people engaging with ALONE were female, aged 76–85 years and were referred to ALONE from the HSE, hospitals and primary care centres. Older people living in non-owner occupied homes, and reporting a recent fall and mobility issues were overrepresented in the data whilst social isolation, physical health issues and housing needs were commonly reported. Visitation support and befriending represented the highest area of need among older people, who generated an average of 3.4 interventions. Conclusion The findings from this research provide insights into older people’s needs and contribute to our understanding of emerging features of innovative health service delivery for older people. These findings will support policymakers and service providers in creating and implementing integrated psychosocial and medical community services for older people.

Availability and Utilization of Psychosocial Services for Breast Cancer Patients in Addis Ababa, Ethiopia: A Mixed Method Study

The provision of psychosocial services has a substantial impact on cancer care by reducing emotional distress and improving both the quality of life and survival of patients, but the availability and utilization of such services have not been well studied in developing countries, particularly, Ethiopia. Therefore, we explored the types of psychosocial services available for breast cancer patients in Addis Ababa, Ethiopia. A mixed method study was conducted using a cross-sectional survey involving 428 breast cancer patients, followed by a qualitative study. A total of nine in-depth interviews (IDIs) were conducted with four breast cancer patients and five key informants using two separate interview guides. In addition to descriptive statistics, logistic regression was performed to identify factors associated with the provision of psychosocial services. Thematic analysis was used for the qualitative data, using NVivo 12 plus software. Only 47 (11.1%) patients received psychosocial services in the form of counselling, emotional support, or information provision. Health professionals reportedly provided such services along with their routine activities, and patients predominantly received social/emotional support from family members, friends, and colleagues. There were no well-structured counselling services, emotional support, or group discussion sessions for breast cancer patients in these health facilities. The main reasons for not providing these services were high patient flow/workload, inadequate space, lack of training, and not having qualified professionals to organise and deliver psychosocial services in these hospitals. Only one in ten breast cancer patients received psychosocial services from health professionals, and the services were not delivered in a structured way. Therefore, psychosocial services should be integrated in both private and government health facilities in Ethiopia.

Connections between family violence and violence in the public sphere in Afghanistan

Afghanistan has endured over four decades of violence in the public sphere, such as war and suicide attacks. To effectively provide psychosocial counseling using a psychodynamic approach in Afghanistan, it is crucial to recognize the potential connection between ongoing public violence and high rates of family violence. In 2019, we conducted a study to explore the relationship between public violence and family violence among Kabul residents, including those seeking counseling and those who were not. Our cross-sectional mixed methods survey recruited 299 participants from a psychosocial counseling service as well as community members who were not receiving the service. The findings revealed a significant positive correlation between experiences of public violence and family violence. Both clients and non-clients reported experiencing high levels of violence, which led to impairments in daily functioning and increased suicidality. Additionally, a thematic analysis of open-ended questions indicated changes in attitudes resulting from exposure to violence, including feelings of helplessness and hopelessness both in and out of the home. We conclude that applying a psychodynamic approach to psychosocial counseling in Afghanistan requires awareness of the positive correlation between public violence and family violence in a society that has been exposed to violence in the public sphere for over forty years. Mental health care needs to contribute towards breaking cycles of violence by empowering clients to take control of their lives and become agents of change within their families and communities.

Association between psychosocial rehabilitation and recovery center service receipt and reported internalized stigma among veterans.

Internalized stigma, also known as self-stigma, is negatively associated with a person's willingness to seek mental health services and follow their treatment plan. This can hinder a person's recovery, exacerbate their mental health illnesses, and reduce their quality of life. A primary directive of the Veteran Affairs Psychosocial Rehabilitation and Recovery Center (PRRC) program is to help veterans overcome their internalized stigma. This study is the first to evaluate the association between receiving PRRC services over time and veteran reported levels of internalized stigma based on Internalized Stigma of Mental Illness-Brief-10 scores using longitudinal PRRC Forms Data. The analysis was performed using a random-effects ordered logistic regression adjusting for veteran sociodemographic and clinical characteristics. Our study cohort consisted of 2,774 veterans who received PRRC services between fiscal years 2018 and 2021 and who had an intake form at the start of the PRRC service and at least one follow-up form. Our study found that veterans had lower odds of having a higher level of internalized stigma at the first follow-up relative to their intake (OR: 0.80; 95% CI [0.70, 0.92]), and these odds continued to decrease with each subsequent follow-up. These results potentially indicate the effectiveness of the PRRC program in reducing levels of internalized stigma among the veterans. Our study also suggests the need for greater clinical attention and resources for subgroups such as older veterans, male veterans, and veterans with posttraumatic stress disorder, anxiety, or personality disorders, who reported higher levels of internalized stigma. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Differential use of postoperative psychosocial and physical services among older adults with head and neck cancer

IntroductionOlder adults undergoing head and neck cancer (HNC) surgery often have significant functional and mental health impairments. We examined use of postoperative physical, nutritional, and psychosocial services among a cohort of older adults with HNC comanaged by geriatricians and surgeons. Materials and MethodsOur sample consisted of older adults who were referred to the Geriatrics Service at Memorial Sloan Kettering Cancer Center between 2015 and 2019 and took a geriatric assessment (GA) prior to undergoing HNC surgery. Physical, nutritional, and psychosocial service utilization was assessed. Physical services included a physical, occupational, or rehabilitation consult during the patient's stay. Nutritional services consisted of speech and swallow or nutritional consult. Psychosocial services consisted of psychiatry, psychology, or a social work consult. Relationships between each service use, geriatric deficits, demographic, and surgical characteristics were assessed using Wilcoxon rank-sum test or Chi-square test. ResultsIn total, 157 patients were included, with median age of 80 and length of stay of six days. The most common GA impairments were major distress (61%), depression (59%), social activity limitation (SAL) (54%), and deficits in activities of daily living (ADL) (44%). Nutritional and physical services were used much more frequently than psychosocial services (80% and 85% vs 31%, respectively). Receipt of services was associated with longer median length of hospital stay, operation time, and greater deficits in ADLs. SAL was associated with physical and psychosocial consult and lower Timed Up and Go (TUG) score; instrumental ADL (iADL) deficits were associated with physical services; and depression and distress were associated with psychosocial services. DiscussionThe burden of psychosocial deficits is high among older adults with HNC. Future work is needed to understand the limited utilization of psychosocial services in this population as well as whether referral to psychosocial services can reduce the burden of these deficits.