Support Recovery Research Articles

Patient perspectives on health care models in cardiac surgery: a qualitative evaluation

BackgroundThe implementation of ERAS represents a promising solution to improve treatment efficiency and facilitate patient involvement. This innovative care model aims to optimize recovery processes following surgeries by adopting a holistic, interprofessional approach. At our hospital, ERAS was implemented in minimally invasive heart valve surgery, offering two distinct ERAS models. Additionally, there is also the standard of care without ERAS. The objective of the study is to gain insight into patient satisfaction and perceived differences across these various care models.MethodsPatients were interviewed using semi-structured interviews approximately two to three months after undergoing surgery. The data were analysed using qualitative content analysis in accordance with the methodology proposed by Kuckartz. Four main categories were established: Preoperative care, postoperative care and communication, patient participation and involvement, and rehabilitation and post-clinical course.ResultsComprehensive preoperative education and seamless communication throughout the perioperative care journey were identified as fundamental to patient satisfaction and optimal care processes. Patients in the ERAS + model reported higher overall satisfaction with their care compared to patients in the standard of care and ERAS groups.ConclusionPreoperative education establishes the foundation for patients’ subsequent behaviours and expectations regarding their treatment. Physical activity, nutrition, and mental health are significant aspects. The active involvement and participation of patients and their families in the treatment process facilitated superior postoperative care, intensive physiotherapy, mental support, and faster recovery. A functional flow of information throughout the entire care process is vital. Moreover, having a dedicated point of contact had a beneficial impact on patients´ well-being. The integration of innovative ERAS concepts, which encompass interprofessional preoperative patient education and psychosomatic support, represents a promising approach from a patient perspective, offering benefits to a broad spectrum of cardiac surgical patients.

Barriers to advocacy for recovery and wellbeing: a mixed methods study of challenges faced by mental health hospital social workers in Ontario, Canada

ABSTRACT Although advocacy is a key process in social work practice, there is a dearth of research on the constraints experienced in engaging in this process. Drawing on a larger project on frontline social workers’ advocacy practices, this paper focuses on barriers hospital mental health social workers face as they advocate against systemic inequity and support recovery for clients with serious mental illness. Using descriptive statistics and reflexive thematic analyses of an online survey (n = 43) and in-depth interviews (n = 12), this article presents the intertwined macro, mezzo, and micro-level barriers social workers encounter as they advocate to promote client, family, and community wellbeing.

Supporting medication-assisted recovery in recovery residences: staff support, managing built environment threats, and building a supportive network

ABSTRACT Background: While medications for opioid use disorder (MOUD) are effective in reducing overdoses, widespread adoption and implementation of MOUD remains inadequate. Innovative approaches to promote MOUD use and to support people in their medication-assisted recovery (MAR) are needed. Recovery residences that serve people taking MOUD are steadily growing in number, yet little is known about how MOUD and the MAR pathway is promoted within the recovery residence setting. Objectives: The purpose of this qualitative analysis was to describe how recovery residences facilitate MOUD initiation and support residents’ MAR pathway. Methods: We conducted interviews with 93 residents (59.1% male; 38.7% female) living in recovery residences located in five Texas cities that served people taking medication for opioid use disorder. Results: We found that recovery residence staff addressed linkage to care gaps in their communities by connecting people who might benefit from MOUD to appropriate providers. Recovery residence staff also strengthened participants’ community of MAR-supportive peers by hosting or connecting residents to Medication-Assisted Recovery Anonymous meetings. Additionally, recovery residences helped some residents overcome common logistical barriers (e.g. transportation issues, housing instability, distance to providers) that hinder MOUD access. Conclusion: Recovery residences that serve people taking MOUD are a well-positioned recovery support service to promote MOUD initiation and the MAR pathway.

Clinician Perspectives on How Family Support and Psychological Distress Influence Older Adults' Recovery After Major Surgery.

Clinician Perspectives on How Family Support and Psychological Distress Influence Older Adults' Recovery After Major Surgery.

Supporting mental health recovery in patients with heart disease: a commentary.

Supporting mental health recovery in patients with heart disease: a commentary.

Travel as a Tool for Trauma Recovery: A Mixed-Methods Analysis Integrating Quantitative and Qualitative Approaches

This study aims to explore how travel serves as a tool for trauma recovery, aiding individuals in coping with psychological trauma and promoting mental health. We adopted a pragmatic mixed-methods approach, conducting two complementary studies: qualitative interviews with individuals who have experienced trauma and a quantitative survey. The qualitative interviews reveal the mechanisms and key factors of travel in the trauma recovery process. Based on the interview data, we constructed a conceptual model that includes latent variables such as travel experience, emotional regulation, self-reflection, social support, and trauma recovery. This model was subsequently validated through a quantitative survey study using Partial Least Squares Structural Equation Modeling. The results indicate that travel significantly promotes trauma recovery by providing a restorative environment, facilitating emotional regulation, and enhancing social interaction. This study provides new insights into the role of travel in trauma recovery and offers practical guidance for mental health interventions.

Supporting recovery, healing and wellbeing with Aboriginal communities of the southeast coast of Australia: a practice-based study of an Aboriginal community-controlled health organisation’s response to cumulative disasters

BackgroundThe recent crises of bushfires, floods, and the COVID-19 pandemic on the southeast coast of Australia were unprecedented in their extent and intensity. Few studies have investigated responses to cumulative disasters in First Nations communities, despite acknowledgement that these crises disproportionately impact First Nations people. This study was conducted by Aboriginal and non-Aboriginal researchers in partnership with Waminda, South Coast Women’s Health and Wellbeing Aboriginal Corporation, an Aboriginal Community Controlled Health Organisation (ACCHO). It investigated the collective experiences of people affected by cumulative disasters to identify the practices that support healing, and recovery for Aboriginal communities. The study addresses a knowledge gap of how Waminda, designs, manages and delivers responses to address complex health and social issues in the context of cumulative disasters.MethodsUnderpinned by practice theory this study employed Indigenous-informed, narrative inquiry. Culturally-appropriate, multiple interpretive methods were used to collect data including: observations; yarns with Aboriginal community members, yarns with Waminda practitioners, management and board members; interviews-to-the-double, visual images and documentation. The data were collated and analysed using the phases of reflexive thematic analysis.ResultsThe paper articulates a suite of culturally safe and place-based practices that enhance social, emotional and spiritual well-being following cumulative disasters. These practice bundles include: adopting a Country-centred conception of local communities; being community-led; viewing care as a collective, relational, sociomaterial accomplishment and having fluid boundaries. These practice bundles ‘hang together’ through organising practices including the Waminda Model of Care, staff wellbeing framework and emergency management plan which orient action and manage risks. The paper demonstrates the need for disaster responses to be community-led and culturally situated. ACCHOs are shown to play a crucial role, and their local responses to immediate community needs are grounded in contextual knowledge and use existing resources rather than relying on mainstream system-wide interventions.ConclusionsThe paper suggests crafting responses that focus on assisting communities (re)gain their sense of belonging, hope for the future, control over their lives and their capacities to care for and to be cared for by Country, are key to both enhancing healing, health and well-being and harnessing the strengths of communities.

A qualitative investigation into the effectiveness of a housing navigator program linking justice-involved clients with recovery housing

BackgroundRoughly 24–36% of people who are incarcerated in the U.S. are formally diagnosed with opioid use disorder (OUD). Once released, individuals involved with the criminal legal system (CLS) face increased risks of return to use and fatality and are 129 times more likely to die from an overdose within the first two weeks of release compared to those without CLS involvement. People who are CLS-involved and who are seeking a recovery living environment can access temporary stable housing through recovery homes. However, entering a recovery home can be difficult due to fragmentation among recovery housing organizations and their non-uniform application and screening procedures. A navigation pilot program was implemented to provide clients with recovery home placement advice, pre-screening, and referrals in Cook County, IL. Existing research on recovery homes has rarely examined the importance of recovery housing navigation for enhancing service engagement among CLS-involved individuals receiving medications for OUD.MethodsSemi-structured qualitative interviews were conducted with 22 clients and three recovery housing navigators as part of a program evaluation of the navigation program pilot. Qualitative software was used to organize and qualitatively analyze transcripts through several rounds of coding producing emergent themes, which were then triangulated, and expanded using navigator data.ResultsClients seeking recovery home services reported multiple prior challenges securing safe and supportive recovery living environments. Despite low initial expectations, clients described their interactions with housing navigators in favorable terms and felt navigators worked with them effectively to identify and meet their housing and substance use needs in a timely manner. Clients also commented on their partnerships with the navigator throughout the process. Interactions with navigators also calmed fears of rejection many clients had previously experienced and still harbored about the process, which bolstered client-navigator relationships and client motivation to engage with additional services.ConclusionEvidence from this study suggests recovery home navigation can improve the speed and efficiency with which clients are connected to appropriate services that are tailored to their specific needs as well as increase client motivation to engage with a myriad of recovery services.

Building Social Support and Moral Healing on Nursing Units: Design and Implementation of a Culture Change Intervention.

The healthcare industry continues to experience high rates of burnout, turnover, and staffing shortages that erode quality care. Interventions that are feasible, engaging, and impactful are needed to improve cultures of support and mitigate harm from exposure to morally injurious events. This quality improvement project encompassed the methodical building, implementation, and testing of RECONN (Reflection and Connection), an organizational intervention designed by an interdisciplinary team to mitigate the impact of moral injury and to increase social support among nurses. This quality improvement project was conducted in a medical intensive care unit (MICU) in a rural, academic medical center. We employed an Evidence-Based Quality Improvement (EBQI) approach to design and implement the RECONN intervention while assessing the feasibility, acceptability, and preliminary effectiveness via surveys (n = 17). RECONN was found acceptable and appropriate by 70% of nurses who responded to surveys. Preliminary effectiveness data showed small to moderate effect sizes for improving social support, moral injury, loneliness, and emotional recovery. Further evaluation is warranted to establish the effectiveness and generalizability of RECONN to other healthcare settings.

Rank-based correlation matrix estimation for high dimensional microbiome data

In recent years, the progress made in high-throughout sequencing techniques supports the analysis of microbial communities greatly. The fact that real-world microbiome data lie in a high-dimensional simplex makes conventional statistical analysis unreliable owing to the sum-to-one constraint. Motivated by the urgent requirements of directly inferring the dependence pattern and dependence intensity simultaneously among microbial taxa, we address the challenge of correlation matrix estimation for this kind of data. Assuming that the unobserved log-basis random vectors follow the elliptical distribution, a robust method built on the Kendall's tau statistic is developed to estimate the basis generalized correlation matrix. Regardless of the existence of the covariance, the basis generalized correlation matrix is always a reliable measure of dependence structure. Theoretically, we establish the convergence rate of the proposed estimator under the spectral norm. Support recovery is discussed as well. Empirically, simulation studies demonstrate the outstanding numerical performance of our method. We also apply our method to analyse a microbiome dataset from human gut. We provide all the codes at https://github.com/lwfwhunanhero/CRCE.

Skeletal Muscle-Derived Stem Cell Transplantation Accelerates the Recovery of Peripheral Nerve Gap Injury under 50% and 100% Allogeneic Compatibility with the Swine Leucocyte Antigen.

Pig skeletal muscle-derived stem cells (SK-MSCs) were transplanted onto the common peroneal nerve with a collagen tube as a preclinical large animal experiment designed to address long nerve gaps. In terms of therapeutic usefulness, a human family case was simulated by adjusting the major histocompatibility complex to 50% and 100% correspondences. Swine leukocyte antigen (SLA) class I haplotypes were analyzed and clarified, as well as cell transplantation. Skeletal muscle-derived CD34+/45- (Sk-34) cells were injected into bridged tubes in two groups (50% and 100%) and with non-cell groups. Therapeutic effects were evaluated using sedentary/general behavior-based functional recovery score, muscle atrophy ratio, and immunohistochemistry. The results indicated that a two-Sk-34-cell-transplantation group showed clearly and significantly favorable functional recovery compared to a non-cell bridging-only group. Supporting functional recovery, the morphological reconstitution of the axons, endoneurium, and perineurium was predominantly evident in the transplanted groups. Thus, Sk-34 cell transplantation is effective for the regeneration of peripheral nerve gap injury. Additionally, 50% and 100% SLA correspondences were therapeutically similar and not problematic, and no adverse reaction was found in the 50% group. Therefore, the immunological response to Sk-MSCs is considered relatively low. The possibility of the Sk-MSC transplantation therapy may extend to the family members beyond the autologous transplantation.

Social support networks of incarcerated women with opioid use disorder: Differences associated with jail-based substance use treatment

IntroductionSocial support is a critical factor for women's engagement with substance use treatment and recovery, particularly for women with criminal-legal system involvement. However, less is known about the social support networks of incarcerated women, particularly as a function of service engagement. Thus, this paper aims to describe the structure, composition, and function of social support networks of women with opioid use disorder (OUD) incarcerated in jails; and compare network differences between women receiving jail-based substance use treatment and non-treatment participants. MethodsAs part of a larger clinical trial under the NIDA-funded Justice Community Opioid Innovation Network (JCOIN), staff conducted an egocentric social network inventory with women who were randomly selected from eight jails in Kentucky, screened for OUD, and consented (N = 445). Women were asked to name people (alters) who provided them with support in the past 90 days and respond to questions about alters who were named. Bivariate comparisons examined differences in social networks among women who were currently receiving jail-based treatment (29.9 %, n = 133) and those who were incarcerated, but not receiving treatment (70.1 %, n = 312). ResultsOn average, women's social support networks consisted of 2.4 alters (range 1–9). Compared to women with OUD who were not receiving treatment, those in treatment were significantly more likely to name at least one alter who was in recovery (57.9 % vs. 43.9 %, p = .007) and less likely to name a partner (21.8 % vs. 37.8 %, p = .001) or someone who had recently used opioids (9.8 % vs. 24.7 %, p < .001). On average, women in treatment also felt significantly closer to their alters (4.70 vs. 4.55 out of 5, p = .021) and rated alters as fulfilling more types of social support functions (5.54 vs. 5.18 out of 6, p < .001) and recovery support functions (2.83 vs. 2.70 out of 3, p = .016). ConclusionResults suggest that women participating in jail-based substance use treatment reported more positive social support network attributes, including network function and composition. Future research should assess longitudinal changes in networks and associated differences in recovery outcomes as women are released to the community.

S69 - Sociodemographic Differences in Engagement With a Mobile Application to Support Recovery From Opioid and Stimulant Use Disorders in Missouri

S69 - Sociodemographic Differences in Engagement With a Mobile Application to Support Recovery From Opioid and Stimulant Use Disorders in Missouri

Perineal lacerations and postpartum well-being: exploring mental health and chronic pain

This review article aims to dissect the multifaceted impact of perineal lacerations on postpartum well-being, with a specific focus on mental health and chronic pain. Employing a systematic analysis of existing literature, the study illuminates the prevalence and severity of perineal trauma, the psychological and emotional repercussions for new mothers, the experiential narrative of women's recovery, and the crucial function of perineal clinics in facilitating holistic recovery. The findings underscore a significant correlation between perineal trauma and adverse postpartum outcomes, including increased risks of postpartum depression, anxiety, and diminished quality of life due to chronic pain. Conclusively, the article advocates for an integrated approach to postpartum care, emphasizing the necessity of addressing both physical injuries and psychological well-being. The novelty of this work lies in its comprehensive exploration of the role of perineal clinics, highlighting their importance in promoting a more inclusive, supportive postpartum recovery process, thereby filling a gap in existing maternal healthcare practices.

Challenges in Supporting Women's Recovery from Sexual Violence in a Village Setting: Addressing Social Structures in Gampong Meurandeh Dayah, Aceh

&lt;p&gt;This article examines the structural challenges in the formation of advocacy policies for female victims of sexual violence in Gampong Meurandeh, Langsa City, Aceh. The data collection process utilized the participatory action research method over four months. Drawing upon social structure theory, the article argues that the causes of sexual violence in rural communities are not only rooted in knowledge and culture but also in the social structures that operate within these communities. The research findings indicate that the reluctance of village authorities to engage in the formulation of sexual violence policies is impeding the successful execution of sexual violence prevention programs. The article highlights two factors that hinder the prevention of sexual violence in Gampong Meurandeh Dayah. Firstly, the lack of female representation in the village government Secondly, support for victims of sexual violence is not a primary concern in the village government's policies. The article concludes that sexual violence prevention programs implemented in patriarchal communities require not only a change in public knowledge but also interventions at the structural level.&lt;/p&gt;

Perceptions of virtual versus in‐person recovery meetings: A cross‐sectional survey of Oxford House residents

AbstractThis study investigates shifts in the modality of addiction recovery communities from person‐to‐person interactions to virtual platforms in the context of the coronavirus disease of 2019 (COVID‐19) pandemic. Our study involves members of the Oxford House recovery homes (n = 284), a major network of recovery‐supportive housing in the United States and abroad. Many residents participate in 12‐step meetings during their stay, traditionally conducted in‐person, but due to physical distancing regulations, many of these meetings transitioned to virtual platforms. We collected cross‐sectional survey data focusing on user perceptions of virtual 12‐step meetings in terms of accessibility, cost, convenience, support network strength and recovery network quality. Our study found significant differences in perceptions among different demographic groups, suggesting challenges in transitioning recovery support to online platforms. Notably, participants aged 46 and older showed a greater propensity to use online recovery forums and found online meetings convenient. Non‐White individuals and women demonstrated a more favourable perception of online meetings—a trend that also held true among those with at least some college education. Furthermore, the results show that those who initiated their recovery prior to the COVID‐19 lockdown viewed online methods more favourably, particularly in terms of accessibility and cost. Our data also revealed that participants who were categorically involved in 12‐step recovery (Alcoholics Anonymous/Narcotics Anonymous) demonstrated a more positive perception of online methods in terms of the strength of social networks and social support quality, despite some resistance to virtual transition and maintaining focus. Further research is needed to understand these nuanced impacts and develop strategies to enhance the effectiveness of online recovery meetings.

Practices Supporting Community Recovery and Healing from Climate-Related Disasters: A Systematic Review

This systematic review investigated the practices that support and hinder the recovery and healing of communities and the environments within which they live, following climate-related environmental disasters. Although the literature focused on recovery is dominated by interventions aimed at the individual and their mental health, a thematic analysis of thirty-six studies established a range of practices that enhance collective recovery and healing. Four narratives were identified from the findings highlighting key practices: (1) collective and community-led recovery; (2) recognising the criticality of context, place, and identity; (3) adopting a holistic conception of well-being and Country-centred practices; and (4) decolonising and Indigenising the literature. This study details recommendations for research and practice. First Nations’ knowledges and healing practices need to be recognised and harnessed in climate-related environmental disaster recovery. Community-led interventions harness local knowledge, networks, and expertise, which improves the dissemination of resources and enables recovery efforts to be tailored to the specific needs of communities.

A new robust covariance matrix estimation for high‐dimensional microbiome data

SummaryMicrobiome data typically lie in a high‐dimensional simplex. One of the key questions in metagenomic analysis is to exploit the covariance structure for this kind of data. In this paper, a framework called approximate‐estimate‐threshold (AET) is developed for the robust basis covariance estimation for high‐dimensional microbiome data. To be specific, we first construct a proxy matrix , which is almost indistinguishable from the real basis covariance matrix . Then, any estimator satisfying some conditions can be used to estimate . Finally, we impose a thresholding step on to obtain the final estimator . In particular, this paper applies a Huber‐type estimator , and achieves robustness by only requiring the boundedness of 2+ moments for some . We derive the convergence rate of under the spectral norm, and provide theoretical guarantees on support recovery. Extensive simulations and a real example are used to illustrate the empirical performance of our method.

A novel framework for online supervised learning with feature selection

Current online learning methods suffer issues such as lower convergence rates and limited capability to select important features compared to their offline counterparts. In this paper, a novel framework for online learning based on running averages is proposed. Many popular offline regularised methods such as Lasso, Elastic Net, Minimax Concave Penalty (MCP), and Feature Selection with Annealing (FSA) have their online versions introduced in this framework. The equivalence between the proposed online methods and their offline counterparts is proved, and then novel theoretical true support recovery and convergence guarantees are provided for some of the methods in this framework. Numerical experiments indicate that the proposed methods enjoy high true support recovery accuracy and a faster convergence rate compared with conventional online and offline algorithms. Finally, applications to large datasets are presented, where again the proposed framework shows competitive results compared to popular online and offline algorithms.

Supporting post-pandemic recovery: a qualitative study of the capabilities, opportunities and motivations to deliver oral health behaviour change messages to parents of young children in community settings.

The COVID-19 pandemic exacerbated vulnerabilities and inequalities in children's oral health, and treatment activity virtually ceased during periods of lockdown. Primary care dentistry is still in the post-pandemic recovery phase, and it may be some years before normal service is resumed in NHS dentistry. However, opportunities to support the dental workforce through offering some preventative care in outreach settings may exist. This has the additional benefit of potentially reaching children who do not routinely see a dentist. The aim of this research was therefore to explore views around upskilling practitioners working in early years educational and care settings to support families of pre-school aged children to adopt and maintain preventative oral health behaviours. Using the Capability, Opportunity and Motivation model of behaviour (COM-B) to structure our data collection and analysis, we conducted semi-structured interviews with 16 practitioners (dental and non-dental) and analysed the data using deductive framework analysis. The data were a good fit with the COM-B model, and further themes were developed within each construct, representing insights from the data. Early years practitioners can reach vulnerable children who are not usually brought to see a dentist, and have the capability, opportunity and motivation to support the oral health behaviours of families of children in their care. Further research is needed to identify training needs (oral health and behaviour change knowledge and skills), acceptability to parents, and supporting dental practice teams to work in partnership with early years settings.