Self-reported Experiences Research Articles

Patient-Reported Experiences of Persistent Post-COVID-19 Conditions After Hospital Discharge During the Second and Third Waves of the Pandemic in Switzerland: Cross-Sectional Questionnaire Study.

Hospitalized patients infected with SARS-CoV-2 should recover within a few weeks. However, even those with mild versions can experience symptoms lasting 4 weeks or longer. These post-COVID-19 condition (PCC) comprise various new, returning, or ongoing symptoms that can last for months or years and cause disability. Few studies have investigated PCC using self-reports from discharged patients infected with SARS-CoV-2 to complement clinical and biomarker studies. This study aimed to investigate self-reported, persistent PCC among patients infected with SARS-CoV-2 who were discharged during the second and third waves of the COVID-19 pandemic. We designed, pretested, and posted an ad hoc paper questionnaire to all eligible inpatients discharged between October 2020 and April 2021. At 4 months post discharge, we collected data on PCC and scores for the Multidimensional Fatigue Inventory (MFI), the Patient Health Questionnaire-4 (PHQ-4), a Brief Memory Screening Scale (Q3PC), and a posttraumatic stress disorder scale (PCL-5). Descriptive, inferential, and multivariate linear regression statistics assessed PCC symptomatology, associations, and differences regarding sociodemographic characteristics and hospital length of stay (LOS). We examined whether our variables of interest significantly predicted MFI scores. Of the 1993 valid questionnaires returned, 245 were from discharged patients with SARS-CoV-2 (median age 71, IQR 62.7-77 years). Only 28.2% (69/245) of respondents were symptom-free after 4 months. Women had significantly more persistent PCC symptoms than men (P≤.001). Patients with a hospital LOS ≥11 days had more PCC symptoms as well (P<.001)-women had more symptoms and longer LOS. No significant differences were found between age groups (18-64, 65-74, and ≥75 years old; P=.50) or between intensive care units and other hospitalization units (P=.09). Patients self-reported significantly higher PHQ-4 scores during their hospitalization than at 4 months later (P<.001). Three-fourth (187/245, 76.4%) of the respondents reported memory loss and concentration disorders (Q3PC). No significant differences in the median MFI score (56, IQR 1-3, range 50-60]) were associated with sociodemographic variables. Patients with a hospital LOS of ≥11 days had a significantly higher median PCL-5 score (P<.001). Multivariate linear regression allowed us to calculate that the combination of PHQ-4, Q3PC, and PCL-5 scores, adjusted for age, sex, and LOS (of either ≥11 days [median 2 symptoms, IQR 1-5] or <11 days), did not significantly predict MFI scores (R2=0.09; F4,7 =1.5; P=.22; adjusted R2=0.06). The majority of inpatients infected with SARS-CoV-2 presented with PCC 4 months after discharge, with complex clinical pictures. Only one-third of them were symptom-free during that time. Based on our findings, MFI scores were not directly related to self-reported depression, anxiety, or posttraumatic scores adjusted for age, sex, or LOS. Further research is needed to explore PCC and fatigue based on self-reported health experiences of discharged inpatients infected with SARS-CoV-2.

Insights into Knowledge and Attitudes About Autoantibody Screening from People Affected by Type1 Diabetes: A Brief Report.

Screening for islet-specific autoantibodies can identify individuals at risk for type1 diabetes (T1D). Despite calls for increased nationwide autoantibody screening efforts, it is unclear how many individuals have participated in screening among people who may benefit from it. Moreover, knowledge and perceptions of autoantibody screening in real-world samples are not well understood. We surveyed a sample of individuals (aged 18+years old) from T1D Exchange Registry with a personal or family history of T1D to assess their self-reported T1D autoantibody knowledge, experiences, and attitudes. Participants belonged to one of three groups: adults with T1D who had a biological child without T1D or future plans for a child (PWD); parents without T1D who had a biological child with T1D and one or more biological children without T1D (Caregivers); and first-degree adult children or siblings to a person with T1D (Relatives). Descriptive analyses (means, standard deviations, frequencies) are presented by participant groups. A total of 510 participants enrolled in the study. Across groups, participants reported feeling a little to somewhat knowledgeable about autoantibody screening and positive perceptions of autoantibody screening in general. However, few participants had screened their child without T1D (PWDs, 21.94%; Caregivers, 46.30%) or themselves (Relatives, 19.23%). Among those who had screened, participants reported generally positive experiences. Among those who had not screened, many participants were "undecided" about autoantibody screening (PWD, 38.46%; Caregivers, 40.52%; Relatives, 44.44%). Influences reported for participants' decisions to screen, not screen, or their current indecision differed by group: PWDs (21.70%) and Caregivers (26.87%) most often reported self-initiated research as an influence and Relatives reported they had not previously considered screening (48.28%). Results highlight the need for more accessible information about screening, including real experiences from those who have screened.

Self-report of symptom cluster experiences in cancer patient-caregiver dyads.

Symptom clusters have important health implications in the context of cancer, but the symptom cluster experiences of cancer caregivers and patient-caregiver dyads are not well studied. To date, most studies report statistically derived symptom clusters among patients and fail to consider the caregivers' experience. This study aimed to assess and characterize self-reported symptom cluster experiences in cancer patient-caregiver dyads. We recruited 30 patient-caregiver dyads from the outpatient oncology clinics at a Comprehensive Cancer Center in the Midwestern U.S. Participants completed web-based surveys reporting their symptom clusters at weekly intervals over 8weeks of cancer treatment. Among 48 eligible dyads, 30 (63%) agreed to participate, 29 provided data, and ≥ 80% (24 patients, 26 caregivers) completed the study. Twenty-eight patients (97%) and twenty-two caregivers (76%) reported experiencing symptoms in clusters. There was substantial variability in the symptoms reported, perceived causality, and directional relationships among symptoms, however both patients' and caregivers' frequently described symptom clusters with psychoneurologic components (co-occurring pain, fatigue, sleep disturbance, anxiety, depression, lack of appetite and/or cognitive disturbance). Symptom clusters were perceived to have a moderate impact on patients' daily lives and a mild-to-moderate impact on caregivers' daily lives. Dyad members experienced and successfully self-reported symptom clusters, with psychoneurologic symptom clusters prevalent among both patients and their caregivers. Self-report of symptom cluster experiences provides unique insight relevant to clinical management. Findings provide foundational support for development and testing of dyad-based interventions to mitigate symptom clusters and their negative impact on daily life among cancer-patient caregiver dyads.

The Role of Interoceptive Sensitivity and Hypnotizability in Motor Imagery.

Motor imagery (MI) requires the mental representation of the body, obtained by integrating exteroceptive and interoceptive information. This study aimed to investigate the role of interoceptive sensitivity (IS) in MI performed through visual and kinesthetic modalities by participants with low (lows, N = 26; SHSS: A, M + SD: 1.00 + 1.52), medium (mediums, N = 11; SHSS: A, 6.00 + 0.77) and high hypnotizability scores (highs, N = 16; SHSS:A, 9.75 + 1.24), as measured by the Stanford Hypnotic Susceptibility Scale: Form A. The three groups displayed different MI abilities and IS levels. The efficacy of MI was measured using the chronometric index and self-reported experience, while IS was measured using the Multidimensional Assessment of Interoceptive Awareness (MAIA) questionnaire. Alpha and beta power spectrum densities (PSDs) were extracted from the EEG signals acquired during baseline, actual movement and visually and kinesthetically imagined movements. The chronometric indices do not reveal significant differences between groups and imagery modalities. The self-report MI efficacy indicates better kinesthetic imagery in highs and mediums than in lows, and no modality difference among lows. The MAIA dimensions sustain the differences in subjective experience and almost all the EEG differences. The latter are slightly different in highs, mediums and lows. This is the first report of the major role played by IS in MI and strongly supports the theory of embodied cognition.

Australian adaptation and external validation of Commissioning for Quality in Rheumatoid Arthritis-RA-Patient Reported Experience Measure (CQRA-RA-PREM).

To evaluate the reliability and validity of an adapted Commissioning for Quality in Rheumatoid Arthritis-RA-Patient-Reported Experience Measure (CQRA-RA-PREM) for assessing care experience in an Australian rheumatology outpatient cohort. Individual patient interviews were performed to check the language and completion time of the CQRA-RA-PREM before modification. Australian Rheumatology Association Database (ARAD) participants completed the CQRA-PREM-Australian version (CQRA-PREM-AU) (22 items, 5 domains), disease activity measure (RAPID-3, BASDAI) and Assessment of Quality of Life (AQOL-6D) index. Exploratory factor analysis (EFA) assessed item correlation. Cronbach's α assessed internal consistency. Individual patient interviews (n = 8, 62% male, mean age 50 years, mean disease duration 4.5 years) informed CQRA-RA-PREM modification. The ARAD survey response rate was 707/1124 (63%); 459 (65%) RA, 134 (19%) PsA, 114 (16%) AS; 67% female, mean age 62 years, mean disease duration 22 years. The median instrument completion time was 299 s (interquartile range 284-414). Scoring of responses allowed an averaged overall score. EFA extracted five factors: all items loading similarly onto factor 1, indicating validity of the overall score. The CQRA-PREM-AU score correlated with the AQOL-6D score (ρ = 0.23, P < 0.01); partial correlation with disease activity was not significant (ρ = 0.03, P = 0.45), indicating divergent validity. Reliability was comparable across disease subgroups (Cronbach's α >0.94). The mean overall score did not differ by disease subgroup [4.1 (s.d. 0.6, P = 0.73) and there was no floor/ceiling effect. CQRA-PREM-AU is a valid and reliable instrument to measure self-reported care experience in Australian rheumatology patients and may be interpreted as an average overall numerical score.

Attitudes of European psychiatrists on psychedelics: a cross-sectional survey study

Research and public interest in psychedelic-assisted psychotherapy (PAP) are growing. This study investigated attitudes toward psychedelics among a diverse and multinational sample of psychiatrists currently working in Europe. We conducted an anonymous, web-based survey consisting of demographic information, a test of basic knowledge on psychedelics, and the previously validated 20-item Attitudes on Psychedelics Questionnaire (APQ), which was validated for the first time in English within this sample. We included N = 419 participants from 33 countries in the study. One-third of participants (34%) reported past use of psychedelics. The APQ sub-scale with the highest score was Openness to Psychedelics, while Risk Assessment of Psychedelics was rated lowest. Regression modelling, explaining 31.3% of variance in APQ scores, showed that younger male psychiatrists who identified as spiritual, were better at recognizing and classifying substances as psychedelics and had previously used psychedelics had more positive attitudes on psychedelics. No professional variables besides self-reported previous experience with PAP or psychedelic research predicted APQ scores. European psychiatrists, therefore, show a general openness to psychedelics and PAP, but are concerned by the potential risks associated with them. Our findings overall suggest that psychedelics are a subject where it is difficult to remain impartial. Protocol registration: The study was pre-registered at the Open Science Framework (available online at https://osf.io/upkv3).

Environment or behavior: Which childhood nature experiences predict nature relatedness in early adulthood?

Childhood nature experiences have been identified as critical factors of Nature Relatedness (NR) at the individual level. This exploratory study delved into the distinct contribution of different forms of childhood experiences to NR in early adulthood, focusing on the living environment and actual contact with nature, along with nature education and the influence of people around. NR scores and self-reported experiences of Chinese college students (n = 431) were collected using a questionnaire survey. Objective environmental indicators (normalized difference vegetation index, land cover, and nighttime light) in 13 buffers of different sizes were adopted to precisely depict their historical living environments. Based on the results of bivariate correlations and hierarchical linear regressions, the quantity of natural components in the childhood living environment did not predict long-term NR. Nighttime light and impervious surface at large geographic scales had significant but weak negative correlations with NR. Experiences of actual contact with nature, especially the experiences of interactive behaviors rather than merely visiting natural spaces, are better predictors than the objective environment. The interactive behaviors of observing natural processes and cultivating plants had significantly independent contributions to NR, even when other factors were included in the regression models. Nature education could not replace the role of actual contact with nature. This study implies that an urbanized living environment will not necessarily reduce the level of NR of future generations. Rather than simply increasing the quantity of natural components in urban areas, it is more important to support children’s interactive behaviors with nature.

Electromagnetic field enhanced flow state: Insights from electrophysiological measures, self-reported experiences, and gameplay

The intersection of neuroscience and technology hinges on the development of wearable devices and electrodes that can augment brain networks to improve cognitive capabilities such as learning and concentration. The capacity to enhance networks associated with these functions above baseline capabilities, holds the potential to benefit numerous individuals. The purpose of this study was to determine if electromagnetic field exposure modeled from physiological data would increase instances of flow in participants playing a computer game. The flow state refers to a subjective state of optimal performance experienced by individuals during a variety of tasks. For this study, participants (n = 39, 18–65 years, nfemale = 20) played the arcade game Snake for two ten-minute periods (each with a ten-minute rest period immediately following). For one of the trials, an electromagnetic field was applied bilaterally to the temporal lobes, with the other serving as the control. Brain activity was measured using quantitative electroencephalography, flow experience was measured using the Flow Short Scale and game play scores were also recorded. Results showed deceased beta 1 (12–16 Hz) activity in the left cuneus [t = 4.650, p < 0.01] and left precuneus [t = 4.603, p < 0.01], left posterior cingulate [t = 4.521, p < 0.05], insula [t = 4.234, p < 0.05], and parahippocampal gyrus [t = 4.113, p < 0.05] for trials when the field was active, compared to controls during rest periods. Results from the Flow Short Scale showed a statistically significant difference in mean “concentration ease” scores across electromagnetic field conditions, irrespective of difficulty [t = 2.131, p < 0.05]. In the EMF exposure trials, there was no discernible experience effect; participants with prior experience in the game Snake did not exhibit significantly better performance compared to those without prior experience. This anticipated effect was observed in control conditions. The comparable performance observed between novices and experienced players in the EMF condition indicate a noteworthy learning curve for novices. In all, these results provide evidence supporting the ability of EMF patterned from amygdaloid firing (6–20 Hz) to elicit neurological correlates of flow in brain regions previously reported in the literature, facilitate concentration, and subtly improve game scores. The possibility for wearable devices to support learning, concentration, and focus are discussed.

Impact of COVID-19 on Chinese urban consumers’ food safety knowledge and behavior – A comparative study between pre and post pandemic eras

The COVID-19 pandemic caused notable changes to the food-related habits of consumers worldwide due to their concerns about the risk of infection and the requirement to follow government mandates. To investigate the impact of the pandemic on Chinese consumers’ food safety knowledge, food safety behaviors, and their most recent food poisoning experiences, we compared the results from an online survey (n = 583, Dec 2019) conducted before the pandemic was officially announced with an identical survey (n = 599, Aug 2023) conducted seven months after the Chinese government downgraded restrictions related to COVID-19. Post-pandemic there was a significant decrease in consumers’ food safety knowledge and self-reported food safety behaviors and a significant increase in their self-reported experiences of food poisoning. Despite respondents stating that their food safety knowledge and behaviors had improved since the start of the pandemic, the data obtained from the two surveys and the respondents self-reporting of foodborne illness suggest that in fact their safety knowledge and behaviors had decreased. These findings highlight the need to reinforce food safety education and behaviors during times when the food system is disrupted, and consumers are focusing on what they perceive to be more immediate issues.

The Association Between Trajectories of Self-reported Psychotic Experiences and Continuity of Mental Health Care in a Longitudinal Cohort of Adolescents and Young Adults.

Young people (YP) with psychotic experiences (PE) have an increased risk of developing a psychiatric disorder. Therefore, knowledge on continuity of care from child and adolescent (CAMHS) to adult mental health services (AMHS) in relation to PE is important. Here, we investigated whether the self-reported trajectories of persistent PE were associated with likelihood of transition to AMHS and mental health outcomes. In this prospective cohort study, interviews and questionnaires were used to assess PE, mental health, and service use in 763 child and adolescent mental health service users reaching their service's upper age limit in 8 European countries. Trajectories of self-reported PE (3 items) from baseline to 24-month follow-up were determined using growth mixture modeling (GMM). Associations were assessed with auxiliary variables and using mixed models. Study results. At baseline, 56.7% of YP reported PE. GMM identified 5 trajectories over 24 months: medium increasing (5.2%), medium stable (11.7%), medium decreasing (6.5%), high decreasing (4.2%), and low stable (72.4%). PE trajectories were not associated with continuity of specialist care or transition to AMHS. Overall, YP with PE reported more mental health problems at baseline. Persistence of PE or an increase was associated with poorer outcomes at follow-up. PE are common among CAMHS users when reaching the upper age limit of CAMHS. Persistence or an increase of PE was associated with poorer mental health outcomes, poorer prognosis, and impaired functioning, but were less discriminative for continuity of care.

Patient and carer transition outcomes and experiences at the Westmead Centre for Adolescent and Young Adult Health, Westmead, Australia: protocol for a longitudinal cohort study

IntroductionThe Westmead Centre for Adolescent and Young Adult Health is a purpose-built facility supporting integrated care for young patients with a variety of long-term health conditions transitioning from paediatric services...

Experiences when using different EHMR models: Implications for different designs and meeting user expectations

New elastomeric half-mask respirator (EHMR) models without exhalation valves (EVs) or with exhalation valve filters (EVFs) are facilitating expanded use in health settings to reduce workers' exposure to airborne hazards while acting as source control to prevent pathogen spread. The physical comfort of new models has not been assessed in comparison to previously used EHMRs with EVs. Researchers assessed 1,962 health care and emergency medical service personnels' self-reported adverse experiences from 2 cohorts while wearing EHMR models with EVs (cohort 1, n=1,080) and without EVs or with EVFs (cohort 2, n=882). Fisher exact test identified differences between the cohorts accounting for organizational factors when possible. Cohort 1 respondents experienced communication challenges and discomfort when wearing the EHMR >1hour statistically significantly more often than cohort 2. Cohort 2 respondents reported statistically significantly more instances of difficulty breathing, moisture buildup, being uncomfortable to wear <1hour, and being uncomfortably warm. Discomfort is prevalent among end users and more often among those wearing EHMRs without an EV/with an EVF. As EHMR research and development advances, prevalence in use may increase for emergency and routine situations. Organizations may not only need guidance about respirator selection but also model-specific selection.

Accumulation of self-reported restorative effects of natural sounds: A seven-day intervention indoors

This study investigated the restorative effects of repeated listening to natural sounds indoors in real-life settings. Previous studies have mainly been cross-sectional and laboratory studies. We designed an online field experiment lasting seven days, in which we assigned 166 university students to one of four intervention groups: (1) listening to natural sounds, (2) sitting in silence (i.e., another means of restoration), (3) reading news online (i.e., a prevalent but not necessarily restorative activity), or (4) no intervention (i.e., the control). Self-reported restorative experience was measured both before and after the daily intervention (but once a day in the no-intervention group), and the weekly-measured perceived stress and state mindfulness were assessed at the beginning and end of the intervention week. Linear hypothesis tests based on a linear mixed-effects model (LMM) showed that, at the day level, natural sounds were the most restorative, followed by silence, while reading news proved not to be restorative. In addition, the daily restorative effect of natural sounds was carried over to later days and its seven-day accumulation was half as great as the general daily restorative effect, although the within-day pre-post change ostensibly diminished over time. An ANCOVA and paired t-tests revealed that a reduction in the weekly-measured perceived stress and an increase in the weekly-measured mindfulness took place after listening to natural sounds or sitting in silence, with the former intervention type having stronger effects, aligning with the results for the restorative experience. Our findings suggest that the carryover effect of repeated listening to natural sounds for psychological restoration may more than compensate for the diminishing returns in within-day pre-post changes over the course of a week.

How many Trainee Clinical Psychologists (TCPs) in the UK self-report lived mental health experience (LMHE)?

Lived mental health experience’ (LMHE) describes direct impact of a mental health problem and/or being a mental health carer. LMHE among Trainee Clinical Psychologists (TCP) is rarely investigated despite encountering challenges throughout training. The current study aimed to estimate point, period, and lifetime prevalence of LMHE among TCPs. UK-based TCPs (N=301) completed an online survey. Results found 39.9% identified as a mental health carer at some point in life (current for 21.2%; historical for 32.8%) with 38.5% acquiring mental health carer responsibilities before training, and 6.6% since training commenced. Additionally, 44.9% and 45.2% respectively reported experiencing a diagnosed or undiagnosed mental health problem at some point in life (current for 55.8%; historical for 63.6%). Moreover, 86.4% reported a mental health problem prior to training, and 11.2% since training started. TCPs are likely to experience a mental health problem or identify as a mental health carer at some point in their life either before or during their doctoral training. This is the first study to estimate point, period and lifetime prevalence of self-reported lived mental health experience among UK based TCPs. Although just an estimate, dissemination of prevalence rates to DClinPsy course staff and employing trusts may be useful to prompt development of supportive resources and adaptations for TCPS with LMHE. This may also facilitate normalisation of LMHE within this population and combat stigma.

Measuring Embodiment: Movement Complexity and the Impact of Personal Characteristics.

A user's personal experiences and characteristics may impact the strength of an embodiment illusion and affect resulting behavioral changes in unknown ways. This paper presents a novel re-analysis of two fully-immersive embodiment user-studies (n = 189 and n = 99) using structural equation modeling, to test the effects of personal characteristics on subjective embodiment. Results demonstrate that individual characteristics (gender, participation in science, technology, engineering or math - Experiment 1, age, video gaming experience - Experiment 2) predicted differing self-reported experiences of embodiment Results also indicate that increased self-reported embodiment predicts environmental response, in this case faster and more accurate responses within the virtual environment. Importantly, head-tracking data is shown to be an effective objective measure for predicting embodiment, without requiring researchers to utilize additional equipment.

Intergenerational effects of racism on amygdala and hippocampus resting state functional connectivity

Racism is an insidious problem with far-reaching effects on the lives of Black, Indigenous, and People of Color (BIPOC). The pervasive negative impact of racism on mental health is well documented. However, less is known about the potential downstream impacts of maternal experiences of racism on offspring neurodevelopment. This study sought to examine evidence for a biological pathway of intergenerational transmission of racism-related trauma. This study examined the effects of self-reported maternal experiences of racism on resting state functional connectivity (rsFC) in n = 25 neonates (13 female, 12 male) birthed by BIPOC mothers. Amygdala and hippocampus are brain regions involved in fear, memory, and anxiety, and are central nodes in brain networks associated with trauma-related change. We used average scores on the Experiences of Racism Scale as a continuous, voxel-wise regressor in seed-based, whole-brain connectivity analysis of anatomically defined amygdala and hippocampus seed regions of interest. All analyses controlled for infant sex and gestational age at the 2-week scanning session. More maternal racism-related experiences were associated with (1) stronger right amygdala rsFC with visual cortex and thalamus; and (2) stronger hippocampus rsFC with visual cortex and a temporo-parietal network, in neonates. The results of this research have implications for understanding how maternal experiences of racism may alter neurodevelopment, and for related social policy.

More Movement, Less Bodily Pain? Findings From a Large, Representative Multi-District Aging Study in Ghana

ObjectiveThe association of physical activity (PA) with pain has been characterized. Although the literature largely comes from high-income countries, the mechanistic pathways underlying this association remain unknown, particularly in low- and middle-income countries (LMICs). We aim to examine the association between meeting the World Health Organization (WHO) PA guidelines and pain among aging adults and identify the factors that may mediate this association. DesignWe used a quantitative cross-sectional study design. Setting and ParticipantsRepresentative data from adults aged ≥50 years who participated in the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study were used. MethodsPA was defined using the International Physical Activity Questionnaire (IPAQ). Self-reported pain experience using a cross-culturally validated item over the past month assessed pain severity. Adjusted multivariable ordinal logistic regression and mediation models quantified the hypothesized associations. ResultsThe analysis included 1201 adults (mean 66.1 ± 11.9 years; 63.3% female). After adjusting for confounders, adhering to the WHO-recommended PA guidelines was associated with 42% lower odds for severe/extreme pain [odds ratio (OR) 0.58, 95% CI 0.44-0.77]. The association was much stronger among men (OR 0.52, 95% CI 0.31-0.85) than women (OR 0.60, 95% CI 0.42-0.87). The PA-pain association was explained by functional limitations (84.7%), self-rated health (76.6%), sleep problems (20.4%), and injury (6.6%). Conclusions and ImplicationsMoving more was associated with less pain in older adults from LMICs. Interventions for pain management in old age may focus on enhancing compliance with PA doses, particularly in LMICs. However, longitudinal data will need to confirm these findings.

Young People's Barriers and Facilitators of Engagement with Web-Based Mental Health Interventions for Anxiety and Depression: A Qualitative Study.

The prevalence of anxiety and depressive symptoms in young people have increased in many countries around the world. Web-based mental health interventions (or W-MHIs) have the potential to reduce anxiety and depression symptoms for young people. Although W-MHIs have become more widely used by young people since the coronavirus disease 2019 (COVID-19) pandemic, real-world engagement in these W-MHIs has remained low compared with engagement reported in research studies. Moreover, there are limited studies examining factors influencing engagement with W-MHIs in the post-COVID-19 pandemic years. This study aims to explore barriers and facilitators of engagement with W-MHIs for anxiety and depression among young people. Seventeen semi-structured interviews and one focus group with three participants were conducted online via Zoom between February and March 2023. Participants were young people aged 18-25 years who had self-reported experience of anxiety and/or depression in the past 6months, lived in Australia, and considered using W-MHIs to manage their anxiety and/or depression symptoms. Inductive thematic analysis was performed to understand the key barriers and facilitators of young people's engagement with W-MHIs. Both individual- and intervention-related factors influenced young people's engagement with W-MHIs. Facilitators of engagement included personal trust and beliefs in W-MHIs, ability to contact a health professional, programme suitability (e.g., affordability, content aligning with user needs), programme usability (e.g., user interface), and accessibility of the online platform. Barriers included concerns about online security, lack of human interaction and immediate responses from health professionals (if any), and negative experience with mental health programmes. Participants expressed greater willingness to pay if they could contact health professionals during the programme. Better promotion strategies for mental health and W-MHI awareness are needed to increase the perceived importance and priority of mental health interventions among young people. Young people should be involved in the W-MHI co-design to enhance the programme suitability and usability for young people, fostering their engagement with W-MHIs.

Cultural Responsiveness in Academic Physical Therapy: An Administrative Case Report.

This paper describes how the administrative leadership of 1 physical therapy department curated, implemented, and evaluated a culturally responsive administrative support strategy to foster a positive working environment. Participants' perceptions of culturally responsive practices were explored using climate survey data. This case occurred in the physical therapy and rehabilitation science department at an academic medical center in the United States. The department administers 5 educational programs, 3 faculty practices, a community clinic, and a robust research enterprise and employs over 100 employees. After a historic sociocultural event, administrators implemented a series of actions to understand the needs of department employees and to respond in a culturally responsive manner. Interventions included supportive activities, educational opportunities, and community-building events. The department administered an annual climate survey to assess the employees' perceptions of the working climate, perceived impacts of the culturally responsive interventions, and suggestions for improving department climate. Survey analysis included frequency statistics and thematic content analysis with sensitizing concepts from a culturally responsive practice framework previously applied in primary and secondary school settings. A total of 131 employees participated in the annual climate survey from 2020 to 2022. Employees' confidence to identify and address microaggressions in working environments showed trends of overall improvement, and overall self-reported experiences with racial discrimination decreased. Participants reported positive trends in addressing discrimination among colleagues but also reported addressing offensive behaviors perpetrated by patients. Findings suggest that culturally responsive interventions are associated with positive trends in employee climate. Interventions tailored to the audience and curated to deepen cultural knowledge, enhance self-awareness, and validate others fostered a shared commitment to cultural equity. Administrative leaders have a role in fostering an inclusive climate by capitalizing on culturally significant teachable moments with sound culturally responsive strategy, bidirectional culturally sensitive communication, individual development, and collective action.

The implementation and impacts of the Comprehensive Care Standard in Australian acute care hospitals: a survey study

BackgroundComprehensive care (CC) is becoming a widely acknowledged standard for modern healthcare as it has the potential to improve health service delivery impacting both patient-centred care and clinical outcomes. In 2019, the Australian Commission on Safety and Quality in Health Care mandated the implementation of the Comprehensive Care Standard (CCS). However, little is known about the implementation and impacts of the CCS in acute care hospitals. Our study aimed to explore care professionals’ self-reported knowledge, experiences, and perceptions about the implementation and impacts of the CCS in Australian acute care hospitals.MethodsAn online survey using a cross-sectional design that included Australian doctors, nurses, and allied health professionals in acute care hospitals was distributed through our research team and organisation, healthcare organisations, and clinical networks using various methods, including websites, newsletters, emails, and social media platforms. The survey items covered self-reported knowledge of the CCS and confidence in performing CC, experiences in consumer involvement and CC plans, and perceptions of organisational support and impacts of CCS on patient care and health outcomes. Quantitative data were analysed using Rstudio, and qualitative data were analysed thematically using Nvivo.Results864 responses were received and 649 were deemed valid responses. On average, care professionals self-reported a moderate level of knowledge of the CCS (median = 3/5) and a high level of confidence in performing CC (median = 4/5), but they self-reported receiving only a moderate level of organisational support (median = 3/5). Only 4% (n = 17) of respondents believed that all patients in their unit had CCS-compliant care plans, which was attributed to lack of knowledge, motivation, teamwork, and resources, documentation issues, system and process limitations, and environment-specific challenges. Most participants believed the CCS introduction improved many aspects of patient care and health outcomes, but also raised healthcare costs.ConclusionCare professionals are confident in performing CC but need more organisational support. Further education and training, resources, multidisciplinary collaboration, and systems and processes that support CC are needed to improve the implementation of the CCS. Perceived increased costs may hinder the sustainability of the CCS. Future research is needed to examine the cost-effectiveness of the implementation of the CCS.