Psychotherapeutic Support Research Articles

Parents' experiences of psychotherapeutic support on the neonatal unit: A mixed methods systematic review to inform intervention development for a multicultural population.

Parents of infants admitted to neonatal intensive care require support to minimize the impact on their mental health and to encourage engagement with their infants to support infant neurodevelopment. Many interventions aim to address this need, but there is a lack of research considering the accessibility of these for a multicultural population. To systematically identify sources of psychotherapeutic support available for parents with infants admitted to neonatal care (NNU, neonatal intensive care unit [NICU] and special care units), assess their accessibility and acceptability and identify challenges and facilitators. Six electronic databases with no restrictions on language or date were used to identify relevant studies following Preferred Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. Publications were included in the review if they reviewed parent experience of an intervention actively in place to support parent experience during the neonatal unit stay. Any studies where the intervention's primary aim was infant focused, such as developmental care, were excluded. All publications were quality-assessed using quality appraisal tools appropriate for their design type. Data were extracted line by line using Sekhon et al.'s theoretical acceptability framework and questionnaire. A total of 3309 studies were found, of which 36 studies met the inclusion criteria. Included studies were published worldwide between 2000 and 2023 and explored 15 different interventions. Challenges for parental engagement were due to preconceived ideas about intervention requirements and parents' ability to participate in them. Timely information and providers' experience in delivering the intervention were reported to support engagement and as being valuable for enhancing participant knowledge. The emotional content of interventions was found to be challenging by parents across most studies. This was prominent in interventions designed to be carried out in a group format and where keepsakes were created. However, the value of these interventions was in reducing parents' feelings of isolation through increased social support and providing a starting point for conversations with wider family and friends about the family's neonatal experience. Participant demographics were poorly reported, with only two studies taking into consideration the ethicality of the intervention. Poor reporting of participant demographics, and a focus on mothers as participants, means findings are not transferrable to the wider population of parents in neonatal units. Future studies should consider how to ensure that research and interventions are accessible to multicultural populations to improve the understanding of the acceptability of interventions. Better knowledge of neonates and the NNU setting amongst intervention providers could increase the accessibility of psychotherapeutic support for parents. Training for providers on how to manage sensitive conversations may also be beneficial to support parents during interventions. The impact of neonatal admission on parental mental health is increasingly recognized and reported. Interventions have been developed to reduce the negative impact on the mental health of parents. There continue to be significant health inequalities as a result of many services not taking into account the acceptability and accessibility of interventions in this setting for their multicultural populations. This review highlights the need for better reporting of participant demographics in research and the inclusion of those seldom heard to ensure interventions are culturally, religiously and linguistically appropriate for multicultural populations.

Post-COVID-19 condition-Clinical phenotyping in practice

The high number and clinical heterogeneity of neurological impairments in patients with apost-COVID-19 condition (PCC) poses achallenge for outpatient care. Our aim was to evaluate the applicability of the proposed subtypes according to the guidelines "Long/Post-COVID" (30 May 2024) and their phenotyping using clinical and neuropsychological findings from our post-COVID outpatient clinic. The evaluation was based on cross-sectional neurological and psychological test examinations of the patients, which were carried out using standardized questionnaires and test batteries. In addition, adetailed anamnesis of the current symptoms and aretrospective survey of the acute symptoms up to 4 weeks after the confirmed infection was conducted. The subtypes were classified according to the abovementioned guidelines based on the medical history and selected patient questionnaires, to which we added a5th subtype with reference to the previous guidelines "Long/Post-COVID" (as of 5 March 2023). Atotal of 157 patients were included between August 2020 and March 2022. The presentation was at a median of 9.4months (interquartile range, IQR = 5.3) after infection, with amean age of 49.9 years (IQR = 17.2) and more women (68%) presenting, with atotal hospitalization rate of 26%. Subtype1 (postintensive care syndrome) showed the highest proportion of men, highest body mass index (BMI) scores and the highest rates of subjective complaints of word-finding difficulties (70%). Subtype2 (secondary diseases) was dominated by cognitive impairment and had the highest depression scores. Subtype3 (fatigue and exercise-induced insufficiency) was the most common, had the most symptoms and most severe subjective fatigue and the largest proportion of women. Subtype4 (exacerbation) mainly showed affective symptoms. Subtype5 (complaints without relevance to everyday life) had the lowest scores for depression, fatigue and BMI. Neurological and psychological conditions were frequently pre-existing in all groups. The management of PCC can be improved at various levels. Astandardized subtype classification enables early individually tailored treatment concepts. Patients at risk should be identified at the primary care level and informed about risk factors and prevention strategies. Regular monitoring of cardiovascular risk factors and physical activity are essential for PCC treatment. In the case of cognitive deficits and concurrent affective symptoms, psychotherapeutic support and drug treatment with selective serotonin reuptake inhibitors (SSRI) should be provided at an early stage.

Paternal perinatal depression: underestimation of the disorder, its clinical and classificatory entanglements, and therapeutic alternatives

In the perinatal period, fathers may also suffer from depression, referred to as paternal perinatal depression. Studies have shown that the prevalence of paternal perinatal depression is considerably higher than in the general adult population. For example, a meta-analysis showed that the prevalence of depression among fathers was 9.76% during the prenatal period and 8.75% during the postpartum year.1 Paternal perinatal depression can deteriorate the marital relationship and generate psychosocial and behavioral problems in the offspring (Ramchandani et al., 2021).2 However, paternal perinatal depression has received comparatively little clinical attention. A review of the literature on this subject will list the biological, psychological and social risk factors for this condition, which include a history of depression or anxiety disorders, lack of social support, conflicts in the couple's relationship, economic and labor problems. The clinical characteristics of depression share similarities with depressions in other periods of life, and there are differential clinical features, such as anger, aggressiveness, somatic symptoms and greater comorbidity with substance abuse disorder. Early detection with scales such as the Edinburgh, Gotland and PAPA and the appropriate approach are fundamental to mitigate the effects of paternal perinatal depression. Psychotherapeutic support, psychoeducation of the disorder, and self-care tools can be part of a comprehensive approach to help parents experiencing this condition. In conclusion, the proposal to include this disorder within the parental perinatal affective disorders, as proposed by the author Baldoni,3 given the level of overlap that it usually has with other comorbid conditions (anxiety, alcohol abuse, impulse control disorders) and high frequency of masked symptoms, goes in the direction to give the attention it deserves for early detection and provide adequate support and treatment.

Psychotherapeutic Support for Family Caregivers of People With Dementia

Psychotherapeutic Support for Family Caregivers of People With Dementia

Bridging realms: Western client perspectives on psychotherapy inspired by Indigenous healing

ContextThe decolonial turn in psychology criticizes conventional Western psychotherapeutic frameworks and seeks to decolonize therapeutic practices by considering diverse cultural perspectives. Indigenous healing has been increasingly used in the psychotherapy of ethnic communities, but also in the psychotherapy of Western clients. The research questions of the present study were focused on how Western clients experience the therapies inspired by Indigenous healing. ObjectiveThe study aimed to explore the motivations, experiences, and mental health outcomes of participants of therapies inspired by Indigenous healing with a focus on issues related to intercultural transfer of therapeutic practice. DesignSemi-structured qualitative interviews were used to gather narratives from 28 participants. Thematic analysis was used for data analysis. ResultsParticipants reported the following long-lasting outcomes of Indigenous therapies: increased well-being, calm, satisfaction with life, better emotion regulation, coping with stress, behavioral control, problem solving, decision making as well as a more sensitive and deeper experience of reality. Conventional Western psychotherapy was perceived as conversation-based, while Indigenous therapy was perceived as experience-based and more complex. The integration of experiences from Indigenous therapies was more difficult in the Western sociocultural environment compared to participation in the place of their origin, within the community of Indigenous people. ConclusionIndigenous healing has beneficial outcomes for Western clients, but the integration of these experiences is quite difficult and requires systematic psychotherapeutic support in the Western cultural environment.

Book Review: Psychotherapeutic support for family caregivers of people with dementia: The Tele.TAnDem manual by Wilz, G.

Book Review: <i>Psychotherapeutic support for family caregivers of people with dementia: The Tele.TAnDem manual</i> by Wilz, G.

Do Psoriasis and Atopic Dermatitis Affect Memory, Attention, Stress and Emotions?

Psoriasis and atopic dermatitis are chronic skin diseases found all over the world that cause a lot of suffering to patients. The aim of this study was to answer the following questions: whether people suffering from psoriasis and AD have greater problems with recognizing emotions, the effectiveness of attention and memory processes, and whether they use different strategies of coping with stress than healthy people. This study involved 90 patients, including 30 patients with psoriasis, 30 patients with AD and 30 healthy patients, aged 21 to 63 years, including 54 women and 36 men. This study used a battery of the CANTAB Cognitive Tests, Mini-COPE Questionnaire Inventory, Toronto Alexithymia Scale TAS Questionnaire, Psoriasis Area and Severity Index, and Eczema Area and Severity Index. People with psoriasis and AD had higher total scores on the alexithymia scale and had greater difficulty in identifying and verbalizing emotions. People with psoriasis and AD are less likely to choose the correct stimulus and achieve a shorter length of the sequence that should be remembered. Psoriasis patients with more severe symptoms are less likely to use the strategy of a sense of humor in stressful situations. AD patients with more severe symptoms are less likely to use strategies of operative thinking, denial and self-blame, and the strategy of seeking instrumental support is used more often. Patients with psoriasis and AD require a holistic approach; in addition to dermatological treatment, psychological support, psychotherapeutic support and possible psychiatric treatment are recommended.

Psychedelic-assisted psychotherapy: where is the psychotherapy research?

Psychedelic-assisted psychotherapy (PAP) has emerged as a potential treatment for a variety of mental health conditions, including substance use disorders and depression. Current models of PAP emphasize the importance of psychotherapeutic support before, during, and after ingestion of a psychedelic to maximize safety and clinical benefit. Despite this ubiquitous assumption, there has been surprisingly little empirical investigation of the "psychotherapy" in PAP, leaving critical questions about the necessary and sufficient components of PAP unanswered. As clinical trials for psychedelic compounds continue the transition from safety- and feasibility-testing to evaluating efficacy, the role of the accompanying psychotherapy must be better understood to enhance scientific understanding of the mechanisms underlying therapeutic change, optimize clinical outcomes, and inform cost-effectiveness. The present paper first reviews the current status of psychotherapy in the PAP literature, starting with recent debates regarding "psychotherapy" versus "psychological support" and then overviewing published clinical trial psychotherapy models and putative models informed by theory. We then delineate lessons that PAP researchers can leverage from traditional psychotherapy research regarding standardizing treatments (e.g., publish treatment manuals, establish eligibility criteria for providers), identifying mechanisms of change (e.g., measure established mechanisms in psychotherapy), and optimizing clinical trial designs (e.g., consider dismantling studies, comparative efficacy trials, and cross-lagged panel designs). Throughout this review, the need for increased research into the psychotherapeutic components of treatment in PAP is underscored. PAP is a distinct, integrative, and transdisciplinary intervention. Future research designs should consider transdisciplinary research methodologies to identify best practices and inform federal guidelines for PAP administration.

Telephone support vs. self-guidance in an Internet-based self-administered psychological program for the treatment of depression: Protocol for a hybrid type 1 effectiveness-implementation randomized controlled trial

BackgroundDepression is already the leading psychological disability around the world, impairing daily life, well-being, and social functioning and leading to personal and social costs. Despite the effectiveness of Evidence-Based Psychological Practices (EBPP), a significant percentage of depressive individuals remain untreated, especially in Primary Care (PC) settings in Spain. There are numerous barriers that limit access to EBPPs, including high costs, professional training, and adherence problems. Information and Communication Technologies (ICTs) offer a cost-effective way to disseminate and scale EBPPs to address these barriers. The iCBT program Smiling is Fun has been demonstrated to be a cost-effective treatment for depression in various Randomized Control Trials. However, adherence and implementation problems in real-world settings need to be addressed. Implementation research can help evaluate these challenges by identifying facilitators and barriers to the implementation process in PC. In this regard, including human support has been pointed out as a possible key factor in addressing the population's mental health needs and promoting treatment adherence. ObjectiveThe current study aims to examine the effectiveness, adherence rates, and implementation process of Smiling is Fun to address depression in a PC setting considering the influence of telephone support vs no support. MethodsThe proposed research is a Hybrid Effectiveness-Implementation Type I study, with a two-armed randomized controlled design, which will test a clinical intervention for major depressive disorder while gathering information on its implementation in a real-world setting. The study will include adult patients with mild to moderate symptoms of depression. Participants will be randomly assigned to one of two groups: self-applied psychotherapy or self-applied psychotherapy with psychotherapeutic telephone support. The trial will recruit 110 patient participants, with a loss-to-follow-up rate of 30 %. DiscussionA study protocol for a hybrid effectiveness-implementation study is presented with the aim to assess the implementation of Smiling is Fun for the treatment of depression in PC. The study evaluates the influence of telephone support during a self-administered intervention compared to unguided self-administration. The main goal is to address the barriers and facilitators of the implementation process and to promote treatment adherence. Ultimately, the results of the study could help in the uptake of sustainable resources so that the population could gain better access to psychological interventions in mental health services. RegistrationClinicalTrials.gov; NCT06230237.

Anxiety and depressive personality disorders in the modern world

The study's significance lies in the multitude of challenges facing individuals today, such as the COVID-19 pandemic, military conflicts like the war in Ukraine, and the escalating rates of cancer morbidity and mortality. These factors contribute to the onset of anxiety and depressive disorders, disrupting various aspects of individuals' mental functioning and social interactions. Addressing these disorders effectively necessitates a comprehensive approach, combining pharmacological interventions with psychotherapeutic strategies under the guidance of specialized professionals. In this regard, the study is aimed at identifying aspects and features of the development of psychological problems and personality disorders in the modern world filled with various stressors. The leading methods of studying this problem are analysis, synthesis, induction, deduction, comparison, experiment and systematisation of approaches that will help determine a wide range of mental disorders. Theoretical methods were used to analyze the literature and summarize theoretical material on anxiety and depressive disorders. Diagnostic methods were used to assess the psychological state of the study population. The study examines significant clinical syndromes and vegetative disorders that disrupt normal lifestyle, hinder daily activities, and impede professional growth. It evaluates the roles of psychologists, psychiatrists, and social workers in assisting individuals with anxiety disorders. It outlines preventive measures for anxiety and depression, while also delving into various types of anxiety disorders. The research proposes diverse methods to prevent emotional anxiety and instability. It underscores the importance of devising novel strategies for diagnosis and therapy, emphasizing a comprehensive approach involving psychotherapeutic support, medical intervention, and adaptive behavioral techniques. The findings of the study hold both practical and theoretical significance for professionals in psychology, psychiatry, psychoanalysis, and sociology who provide support for individuals with anxiety and depressive disorders. Furthermore, the insights provided may be pertinent to researchers and scholars investigating the psychological well-being of contemporary society amidst adverse external circumstances.

Book Review: Psychotherapeutic Support for Family Caregivers of People With Dementia

Book Review: Psychotherapeutic Support for Family Caregivers of People With Dementia

Book Review: Psychotherapeutic Support for Family Caregivers of People With Dementia by Gabriele Wilz

Book Review: <i>Psychotherapeutic Support for Family Caregivers of People With Dementia</i> by Gabriele Wilz

Psychedelic-assisted therapy for people with gambling disorder?

Gambling disorder is a severe mental health and behavioural problem with harmful consequences, including financial, relationship and mental health problems. The present paper initiates discussion on the use of psychedelics combined with psychotherapeutic support as a potential treatment option for people living with a gambling disorder. Recent studies have shown promising results using psychedelic-assisted therapy (PAT) to treat anxiety, depression, post-traumatic stress disorder, and various substance use disorders. Considering the similarities in the underlying psychosocial and neurobiological mechanisms of gambling disorder and other addictive disorders, the authors suggest that psychedelic-assisted therapy could be effective in treating gambling disorder. The paper also underscores the need for further research into the viability and effectiveness of psychedelic-assisted therapy for gambling disorder.

Socio-Demographic and Clinical Characteristics of Patients Attending Department of Palliative Medicine in Tertiary Care Hospital

Background: Palliative care focuses on improving quality of life for patients with life-limiting illnesses and their families by addressing physical, psychological, emotional, and spiritual needs. Understanding the specific characteristics of these patients accessing this care is crucial for optimizing services and resource allocation. Therefore, studies focusing on the socio-demographic and clinical characteristics of patients attending palliative medicine departments in tertiary care hospitals are vital. These studies shed light on who accesses palliative care, what diseases they have, and the challenges they face. Method: Individuals aged 18 years and above, diagnosed with cancer, were enlisted in our study, and their sociodemographic-clinical information was gathered. A reassessment was conducted after 3 months, during which their treatments and side-effects profile were examined. Result: The predominant cases in our patient population involved oral cavity cancers, primarily affecting married men aged 40–60 residing in the National Capital Region. Those diagnosed with breast cancer were more inclined to undergo chemotherapy, experiencing associated side effects such as nausea, anorexia, and weight loss. Conclusion: Healthcare providers must be cognizant of these complications and should integrate an effective counseling mechanism before initiating treatment in such patients. Palliative care physicians play a pivotal role in palliative management, serving as trusted figures in their communities and offering both professional and psychotherapeutic support.

Individual psychological characteristics and features of coping with the disease in patients with the first psychotic episode and post-psychotic depression as targets for psychosocial interventions

Purpose of the study: to determine the individual psychological characteristics and features of coping with the disease in patients with the first psychotic episode and post-psychotic depression in order to identify targets for subsequent psychosocial interventions. We examined 1112 patients who underwent the first psychotic episode, of which, after the introduction of inclusion/exclusion criteria, two groups were formed in the final design: 243 patients with postpsychotic depression and 119 patients without depression in partial remission. Clinical and psychopathological method with objectification by PANSS, CDSS scales, clinical and psychological method with diagnostics of coping, psychological defense mechanisms, perfectionism and self-stigmatization by standardized questionnaires were used, regression analysis was carried out using the method of multiple linear regression with stepwise inclusion. From the numerical characteristics of the samples, the arithmetic mean was determined with the calculation of the standard error of the mean, standard deviation. Statistically significant results were accepted at the p&lt;0.05 significance level.Conclusions: the study found a significant effect on the clinical manifestations of postpsychotic depression in patients who underwent PES of schizophrenia, all studied individual psychological characteristics with the highest coping activity, which indicates the undoubted involvement of reactive mechanisms in the development of this type of pathology. This confirms the importance in the treatment of the studied cohort of patients, not only of differentiated psychopharmacotherapy, but also of active psychotherapeutic support with the study of selected “targets” of coping, individual psychological characteristics.

The Phenomenon of God’s Abandonment in Clinical Psychiatry

Background: God’s abandonment in religious literature is defined as the loss of divine grace, the feeling of distance from God, abandonment by God, God’s departure from man, which is manifested in the weakening of divine support, often perceived as a period of spiritual crisis and accompanied by despair and heartache. At present, there are lack of a psychopathological andclinical studies in the scientiашc literature concerning the phenomenon of God’s abandonment. This phenomenon is complex and little studied neither in the spiritual life nor in the context of clinical psychiatry. The phenomenon of God’s abandonment requires further research for proper diagnosis, choice of the correct treatment, psychotherapeutic support, and adequate tacticsof pastoral care. Objectives: identification of clinical and psychopathological features and structure of the phenomenon of God’s abandonment in order to determine the syndromal and nosological affiliation, prognosis issues and right choice of therapeutic tactics. Patients and methods: 35 patients (16 male and 19 female) aged 18–55 years (mean 39.8 ± 11.6), who had a sense of God’s abandonment in the clinical picture of endogenous depression and depression-delusional disorders, were examined. Clinical-psychopathologic, psychometric (HDRS, CRS, SAG) and statistical methods were used. As a control group, 5 male individuals who were monastic residents and were not in the psychiatrist’s ашeld of vision and not demonstrated obvious signs of psychiatricdisorders were examined. For this group, a retrospective analysis of the peculiarities of the phenomenon of God’s abandonment was carried out on the basis of the assessment of subjective and objective data. Results: the conducted research has revealed that the phenomenon of God’s abandonment is a special psychopathological symptom complex specific for the studied group of patients, regardless the syndromal or nosological affiliation. The main manifestation of this phenomenon is the religiousanesthesia (as the religious equivalent of anaesthesia psychica dolorosa) with the leading manifestations of the absence of sensations of religious feeling with the key experience of abandonment by God in close link with the other psychopathological disorders. Three types of conditions with the phenomenon of God’s abandonment have been identiашed: type 1 — depressions with the phenomenon of God’s abandonment and manifestations of affective delusion (22 patients, 62 %; 12 men, 10 women; mean age 43.4 ± 11.2 years) in the structure of affective psychosis; type 2 — acute psychotic states with the phenomenon of God’s abandonment and noncongruent delusional disorders (13 patients, 37 %; 4 men, 9 women; mean age 31.7 ± 8.2 years) in the structure of schizoaffective disorder or schizophrenia spectrum; type 3 — crisis of faith (5 men from the control group; mean age 40 ± 11.8 years) which is the psychological crisis with experience of God’s abandonment within the framework of personal development. Conclusion: the phenomenon of God’s abandonment can represent a range of psychological and psychopathological conditions: starting from spiritual psychological crisis up to wide range of psychiatric disorders: overvalued ideas, anesthetic and depersonalizing non-psychotic depressions, and delusional depressions or acute psychosis. The identiаfied types of states with the phenomenon of God’s abandonment had different diagnostic value.

Psychotherapy training in postgraduate psychiatry training in Nigeria - Are we doing enough?

Nigeria, with an estimated 40 million people living with mental disorders, faces a critical shortage of psychiatrists to address the significant burden. Despite psychotherapy being integral to psychiatric training, it lacks structure, consistency and adequate supervision. This is alarming, particularly given the substantial demand for specialized psychotherapeutic support among those with mental illness. A cross-sectional study utilised an online survey targeting early career psychiatrists recruited from the Early Career Psychiatrists section of the Association of Psychiatrists in Nigeria. The questionnaire was distributed to 252 early career psychiatrists across Nigeria, with a 42.9% response rate, of which 50% were male, with 73.2% trainees and 26.8% early career psychiatrists. While 52.8% had received some psychotherapy training, only 2.8% were qualified psychotherapists. Notably, only 27.6% of those with psychotherapy training had over 100 hours of training. Factors such as receiving psychotherapy training during postgraduate training and having supervised psychotherapy training were found significant for having independent psychotherapy training. There is little emphasis on psychotherapy training in the postgraduate training in Nigeria. Those who had full training in psychotherapy were self-sponsored. Structured, supervised and mandatory psychotherapy within psychiatry training curriculum is recommended.

HISTORICAL AND PSYCHOTHERAPEUTIC ASPECTS OF PENILE IMPLANTATION

Introduction. To date, despite significant progress in the field of erectile dysfunction (ED) pharmacotherapy, for a certain group of patients, the implantation of a penile prosthesis is the only possible way to return them to an active sexual life. To increase the satisfaction with the sexual life of men and their partners, the improvement of models of penile prostheses, which has its own history, is being carried out. In addition, in andrology, methods of psychotherapeutic correction of ED are introduced for both men and their partners.&#x0D; The aim. To determine the influence of the type of penile implant and psychotherapeutic correction on the frequency of satisfaction of sexual partners.&#x0D; Materials and methods. Out of 354 patients operated on by us, 80 men with severe organic ED and their sexual partners consented to participate in the study. Men underwent penile implantation. Participants were divided into two groups:&#x0D; 1st group – 40 couples in which men had a plastic implant installed;&#x0D; The 2nd group – 40 couples in which men had a hydraulic implant installed.&#x0D; Each group was divided into two subgroups. In subgroups 1a (20 couples) and 2a (20 couples), psychological counseling was given to both partners before and after the operation, in subgroups 1b and 2b no psychological counseling was given.&#x0D; Results: Between subgroups 1b and 2b, patients whose psychological counseling was not performed, differences in the general satisfaction with sexual life in women were not observed, and it was observed in both subgroups in 65% of the patients' partners. Men of these subgroups were satisfied with their sex life after implantation in 80% and 85%, respectively.&#x0D; In 95% of women after psychotherapeutic support (subgroups 1a and 2a), satisfaction with sexual life was noted, which was statistically significantly higher (Fisher's exact test, p &lt; 0.05) than in women of subgroups 1b and 2b.&#x0D; In men of subgroups 1a and 2a, this indicator corresponded to 90% and 95%, respectively. Dissatisfaction among partners in subgroups 1b, 2b, respectively, was 35%, among women after psychotherapeutic correction (subgroups 1a, 2a), 10% and 5%, respectively.&#x0D; Conclusions. The obtained data show that satisfaction with sexual life in men does not depend on the implant model and psychological counseling. Unlike men, the frequency of satisfaction with sexual life in female partners after psychotherapeutic correction reaches 95%, which is statistically significant more than without it (р˂0.05).

Trans-disciplinary learnings from lived experience: person-centred integrated infertility care.

Introduction: Infertility is a stigmatising condition with profound psychosocial impacts. It is estimated it affects 48.5 million couples globally (Mascarenhas et al., 2012) and in the UK, one in seven couples have problems conceiving (NHS, 2020). Rates of infertility are increasing in both genders (Sun et al, 2019).&#x0D; Aims: To explore the lived experience of patients with infertility to identify opportunities for improvements in care and education of healthcare professionals (HCPs), and to investigate the potential of nutrition and lifestyle medicine as an adjunct to care.&#x0D; Methods: Critical reflections on a trans-disciplinary portfolio of seven publications about infertility authored or co-authored by a researcher with personal experience of infertility. These were published from 2015, and include peer-reviewed research articles, a case report, a textbook, a performance, creative artefacts including poems and a story. All embed patient voice as a fundamental element. The overall methodological framework adopted reflects a multi-lens interpretive, phenomenological, heuristic inquiry informed by a relativist ontology. Synthesis connectivity has been used to analyse the works, this approach is recommended by both Grant (2011) and Smith (2015). &#x0D; Findings: Three research questions and findings were identified.&#x0D; 1.How to improve care / outcomes? &#x0D; Explored in publications 1, 2, 3, 4, 6, 7. Findings were optimal nutritional status and weight management supports fertility in both men and women, so nutrition care should be an integral part of care. Additionally, understanding the lived experience of infertility better facilitates effective care/counselling and improves patient experience. &#x0D; 2.How lived experience of infertility can shape clinical education/research?&#x0D; Explored in publications 2, 3, 4, 4a, 4b, 4c, 5, 6, 7. Findings were that co-creation of educational resources with people experiencing infertility, narratives of lived experience and interdisciplinary approaches have the potential to improve HCP &amp; medical education; however, this needs to be aligned with involvement and engagement within research and curricula design.&#x0D; 3.The role of gluten (a protein in grains) in infertility?&#x0D; Considered in publications 1,2,3,4,6,7. Gluten can negatively affect fertility in people diagnosed with coeliac disease, but fertility can also be affected in women with non-coeliac gluten sensitivity and more education is needed as professional awareness of the fertility implications of both coeliac disease and gluten sensitivity is low.&#x0D; Conclusions: Person-centred integrated infertility care needs to take account of the psycho-social impacts associated with infertility, include psycho-therapeutic support and also nutritional and lifestyle medicine. Where there is unexplained infertility or recurrent miscarriage, the potential role of gluten should be considered. Lived experience of infertility can be used as tool in HCP and medical education and socially to lessen stigmatisation and improve communication about infertility. Involvement needs to be aligned across the entirety of healthcare delivery, from clinical settings, through to both education and research (a 3-dimensional model called PRISM has been developed to triangulate involvement).&#x0D;

QOL-25. FOR THE LOVE OF WORK: NOVEL STUDY OF VOCATIONAL COGNITIVE REHABILITATION IN PRIMARY BRAIN TUMOR

Abstract BACKGROUND Primary brain cancer survivors live longer, yet experience distress and cognitive impairments that negatively impact their quality of life (QOL), including at work. We present a novel study of vocational tele-cognitive rehabilitation in primary brain cancer survivors. METHODS Retrospective review, post-treatment, radiologically stable adult primary brain cancer patients who completed standardized neuropsychological, psychological, vocational, and QOL assessments. Wilcoxon rank sum and Fisher’s exact or Chi-square tests assessed between-group and within-group comparisons. Tests were two-sided and statistically significant for p &amp;lt; 0.05. RESULTS 79 patients with known baseline work status assessed for between-group comparisons (working versus not). Working (n = 38) and not working (n = 41) subgroups had similar ages, tumor grade/type, and history of radiotherapy. Working had worse executive functioning (p = .05). Not working (n = 41) had worse cognitive function (executive function, attention, verbal learning all p &amp;lt; 0.05) and more engagement in survivorship services (p &amp;lt; 0.04). Of the 79 work-status known patients, 38 underwent vocational tele-cognitive rehabilitation (median 11 sessions) treatment for within-group comparisons. 82% of the treatment group had improved work status compared to 34% in non-treatment. Baseline work status and age were not related to occupational improvements (all p &amp;gt;0.20). Higher dose high radiotherapy dose inversely related to rehab improvements (p&amp;lt; .05). Higher verbal memory (p = 0.05), processing speed (p = .06), executive functioning (p = 0.02), IDH mutation status (p = .06), and motivation for treatment (p = .04) was associated with improvement. Those with depressive symptoms who engaged in clinically indicated psychotherapeutic services significantly improved their work status (p = .01). CONCLUSION Occupational functioning improved after cognitive rehabilitation. Cognitive impairments, IDH mutation status, higher dose radiotherapy, and treatment motivation are important. Not working at baseline, despite more cognitive impairments, improved similar to their working counterparts. Those with depression benefitted from psychotherapeutic support. Vocational tele-cognitive rehabilitation shows promise for improving the work-based abilities of primary brain tumor patients and warrants further investigation.