Therapeutic Experience Research Articles

Medical Negligence in the Therapeutic Setting (Hospital) from a Sociological Perspective

The sociological study of the interaction between doctor and patient involves the study of the interaction between two different cultures. Both the doctor and the patient have different perceptions of the illness, the patient’s perceptions being shaped by general cultural and social understandings of the illness, while the doctor’s perceptions are shaped by professional training and therapeutic experience in the medical field. This interaction occurs through the physician’s role as a primary actor in the therapeutic process and his or her relationship with the patient as a secondary actor, completing this reciprocal relationship. Throughout this therapeutic process, the patient may be exposed to medical negligence, including diagnostic errors, especially those that occur in the operating room, resulting in the deterioration of the patient’s health and possibly even death as a consequence of the physician’s negligence in fulfilling his role and monitoring the case with the required medical responsibility.

Transformative and therapeutic benefits of digital storytelling: a phenomenological lifeworlds study of Patient Voices participant experiences

ABSTRACT Background References to transformative and therapeutic benefits of digital storytelling are often made, yet this remains an under-explored area, which we foreground in this study. Methods A phenomenological research design was adopted to explore through interview how a purposive sample of Patient Voices storytellers experienced participation in more than one digital storytelling workshop. Analysis was through thematic coding, linguistic analysis and use of van Manen’s lifeworld existentials framework. Results We find that for this particular group, the therapeutic and transformative experiences that re-centre and re-frame personal meaning do so through inter-personal connections and can be understood as a process of social learning. The lifeworld existentials analysis demonstrates that a pluralist and relational conception of wellbeing holds and there is a close relationship between this and Yalom’s 11 therapeutic factors. Conclusions Drawing on group analytic literature, we suggest the concept of a social learning methodology as useful in grounding further research that seeks to understand the beneficial impacts of digital storytelling methodologies in healthcare and in contributing evidence in this field with fidelity to the lived experience as central.

DESIGNING FOR THE SENSES: MULTISENSORY APPROACHES IN THERAPEUTIC CLINICAL SPACES

Spatial design significantly influences interactions with the built environment, engaging senses through visual, auditory, and tactile stimuli. However, in therapeutic clinical settings, the sensory experience is often overlooked in favor of aesthetic considerations, limiting the understanding of user responses to spatial cues. This study investigates the role and impact of multisensory design on user responses in therapeutic clinical environments. By analyzing design parameters such as lighting, acoustics, materials, and textures, the research aims to establish a framework for creating therapeutic clinical spaces that prioritize multisensory stimulation. Through case studies, interviews, and surveys, the study assesses user perceptions and psychological responses to different sensory stimuli in clinical settings. The findings indicate a preference for environments that engage multiple senses, with factors such as layout, color tones, forms, lighting, and finishes playing crucial roles in shaping user experiences. The proposed framework offers practical guidance for designers and architects, emphasizing the importance of sensory design in enhancing interactions between users and clinical environments, ultimately contributing to a more holistic and immersive therapeutic experience.

"Holding the badness": Therapists' experiences of treating incestuous abuse continuing into adulthood.

This study aimed to explore the experience of therapists whose clients report incestuous abuse continuing into adulthood. Ten Australian therapist-participants were recruited through professional forums. After giving informed consent, they completed a semistructured interview. Therapists were asked about their experiences of providing therapy to people who disclosed incestuous abuse that continued into adulthood and their experiences of training, peer support, and supervision in relation to these cases. The interviews were recorded, transcribed, labeled with a pseudonym, and deidentified. The transcripts were subjected to reflexive thematic analysis (TA) following the guidelines of Braun and Clarke (2006, 2022). The study found that three overarching themes described the therapeutic experience and response to this client group: (1) the therapist's emotional distress, vicarious traumatization, and moral injury at the extent of abuse and suffering disclosed by the client; (2) the need to adjust therapeutic goals and their reactions to this; and (3) feelings of professional isolation and a lack of support within mainstream services. The study describes therapeutic experience of a sample of practitioners and concludes that this work is distressing and demanding, requiring therapists to find their own coping methods, training, and supervision. The study points to needs for changes in practitioner training, service delivery, and policy to enable more holistic care of clients reporting complex ongoing abuse. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Ulnar bone tuberculosis in children: Case report and literature review.

Tuberculosis of the long tubular bones in children's extremities is infrequent, particularly in the ulna. Early diagnosis poses significant challenges. This report presents a case involving a 2-year-old child with tuberculosis of the ulnar bone, accompanied by a comprehensive review of pertinent literature. The purpose of this study is to share diagnostic and therapeutic experiences and provide potentially valuable insights. In this case, the patient exhibited complete destruction and expansion of the ulnar bone, resulting in a forearm size considerably greater than normal. Concerns were raised about the irreversible deformation of the ulna, the potential for a malignant bone tumor, and its impact on forearm function, potentially endangering the patient's life. The diagnosis was confirmed as tuberculosis of the ulnar bone. The patient underwent surgery to remove the affected ulnar tissue and received anti-tuberculosis medication. Subsequent to treatment, the destruction and expansion of the ulnar bone resolved, with the return of normal ulnar morphology and bone structure. Even in the absence of typical symptoms like fever, weight loss, and loss of appetite, extensive destruction and expansion of a long tubular bone should prompt vigilant consideration of bone tuberculosis.

Transdermal gene delivery

Gene delivery has revolutionized conventional medical approaches to vaccination, cancer, and autoimmune diseases. However, current gene delivery methods are limited to either intravenous administration or direct local injections, failing to achieve well biosafety, tissue targeting, drug retention, and transfection efficiency for desired therapeutic outcomes. Transdermal drug delivery based on various delivery strategies can offer improved therapeutic potential and superior patient experiences. Recently, there has been increased foundational and clinical research focusing on the role of the transdermal route in gene delivery and exploring its impact on the efficiency of gene delivery. This review introduces the recent advances in transdermal gene delivery approaches facilitated by drug formulations and medical devices, as well as discusses their prospects.

An Exploration of Satisfaction with Mental Health Counseling Services in Western Australia Among Sexuality and Gender Diverse Youth

ABSTRACT Clinically significant psychological distress affects approximately 29.3% of Australian adolescents and 80.6% of sexuality and/or gender diverse youth (SGD-Y). Often, SGD-Y experience inadequate access and lower satisfaction with mental health services, stemming from age- and sexuality and/or gender diversity-status. Accordingly, exploration of factors affecting SGD-Y’s access to, and satisfaction with, mental health services is critical. Using a social constructionist lens, we explored factors supporting SGD-Y’s satisfaction with mental health services, and how these needs are or could be met. Seven LGBTQA+ youth aged 15 to 21 who received counseling in Western Australia in the last year, recruited via a university student participant pool and community organizations, participated in semi-structured interviews via video-conference, phone call, or SMS. Reflexive thematic analysis was inductively applied to participants’ verbatim accounts. Satisfaction was tied to participants’ sense of control over their healthcare-system experiences, shaped by four themes: person-centered support during the service-access process, resources to guide the search for services, confidence in therapists, and healthcare-system organization. Practices and policies supporting SGD-Y’s self-determination during their service access may allow for empowering and personally meaningful therapeutic experiences. Developers of policies and initiatives may need to adopt a systems approach to foster SGD-Y’s self-determination as they access services.

A Viral Pedagogy: Undoing Things with Long COVID’s Autoimmunities

This article focuses on the scientific and political transformations that the COVID-19 pandemic continues to engender through its impact on the epistemological and ontological foundations of autoimmunity. By discussing an online seminar taught during the COVID pandemic winter of 2020–21, the article considers how the viral autoimmunities involved in severe and long-haul COVID pathogenic mechanisms have fostered transformative pedagogical and therapeutic experiences, spaces, and events. As a highly contagious viral disease, COVID highlights disparities in access to healthcare, whereby certain (racialized, disabled, ageing) bodies are unequally burdened with the labor of staying alive. Predicated on a foundational separation between inside and outside, or between the internal, vulnerable, visceral space of the individual(ized) “human” body and an external(ized), hazardous, contaminated, foreign environment, COVID measures for avoiding viral exposure became paramount, reciting a genealogy of distancing, protection, containment, and isolation. By examining how concepts and practices of autoimmunity animate cutting-edge biomedical research, this article asks, How does autoimmunity undo normative models of health predicated on a militarized model of immunity? How might the viral shift our understanding of autoimmunity and what might autoimmune conditions teach us about virality? In short, what can autoimmunity and the viral show us about uncertainty, care, and transformation in therapeutic and pedagogical contexts?

The Mental Abuse Matters Virtual Reality Project: creative practice in cinematic VR and immersive sound

ABSTRACT This article discusses my practice work The Mental Abuse Matters VR Project; a live action narrative drama and Virtual Reality experience where the user is an embodied victim, experiencing an episode of emotional abuse in a domestic setting. Immersive sound is used to replicate emotions in the body such as shame, dread, anxiety, humiliation and panic in the user and to represent inner thoughts, memories and states of dissociation, with the goal of moving beyond language towards a visceral narrative. This is a prototype intervention that aims to be used as an empathy training tool for frontline Health and Social Care and Justice sector staff to improve trauma care, and potentially a therapeutic VR experience for victims and perpetrators of mental abuse. The article aims to discuss the development, creative practice and planned dissemination of this pilot VR experience, evaluating it in the context of traditional study methods and existing health and social care interventions in VR.

Successful Treatment of Multiple Arterial Thrombosis in Premature Infant: Clinical Case

Background. Neonatal thrombosis remains a complex and urgent challenge due to the presence of certain features of the hemostasis system in newborns and the variety of clinical signs. Management approaches are still under consideration, therapeutic experience of thrombolytic therapy (TLT) remains limited and requires benefit-risk assessment. Clinical case description. Clinical case of premature infant with multiple arterial thrombosis diagnosed on the 1st day of life is presented. Modern diagnostic features have allowed to establish the right diagnosis quickly and to start the treatment in time despite the similarities of clinical signs with congenital heart disease. Conclusion. TLT and heparin therapy have saved the child’s life, reversed ischemia, and preserved lower limbs from death. Doctors must perform dynamic monitoring during TLT to diagnose and correct hemorrhagic complications in timely manner.

Chemical Experimentation for Solar Pain Reliever

The Solar Pain Reliever is a cutting-edge device that combines renewable energy and therapeutic relaxation. By harnessing the power of the sun, the Solar Pain Reliever utilizes small solar panels to convert sunlight into heat energy to provide gentle and comforting heat therapy. This innovative device offers an eco-friendly alternative to traditional massagers by reducing reliance on electricity grids. The project is a result of thorough research on menstrual and general abdominal pain, its remedy, need for a solution, market survey and technical aspects like use of renewable energy, chemical experimentation, electrical design and ergonomics of product design. It is designed to provide users with a soothing massage experience, relieving muscle tension and promoting relaxation. Its versatile nature allows for indoor and outdoor use, catering to individual preferences and providing flexibility in various settings. With an emphasis on sustainability, it encourages eco-conscious living while enhancing personal well-being. In summary, the Solar Pain Reliever offers a subtle and sustainable solution for relaxation. The product provides users with a therapeutic heat and massage experience while attempting to minimize environmental impact. Keywords: Solar Energy, Electric Energy, Power generation, therapeutic experience

Translation, cross-cultural adaptation, and psychometric properties of the Arabic version of the MedRisk instrument for measuring patient satisfaction with physical therapy care

Purpose This study aimed to translate, cross-culturally adapt, and validate the MedRisk Instrument for Measuring Patient Satisfaction with Physical Therapy Care into Arabic (MRPS-Ar). Materials and Methods The 20-Item MRPS was translated and cross-culturally adapted into Arabic following international guidelines. Patients (n = 229) with musculoskeletal conditions who received physical therapy care completed the MRPS-Ar and global rating of change scale. Of these patients, 95 completed the MRPS-Ar twice. Factor structure, floor and ceiling effects, internal consistency, test-retest reliability, and construct validity of the MRPS-Ar were evaluated. Results Principal component analysis suggested 3-factor solution: a 7-item facility experience, 6-item therapeutic experience, and 3-item positive experience. The MRPS-Ar and its factors showed acceptable internal consistency (Cronbach’s alpha coefficients ranged from 0.819 to 0.936) and excellent test-retest reliability (ICCs ranged from 0.965 to 0.983). The global measures of satisfaction were significantly correlated with the global rating of change (Spearman’s rho = −0.678, p < 0.001 for item “overall satisfaction” and Spearman’s rho = −0.690, p < 0.001 for item “would return”). Conclusions The 18-item MRPS-Ar displayed adequate psychometric properties for measuring patients’ satisfaction with physical therapy care. The MRPS-Ar is a reliable and valid instrument that can be used in medical, clinical, and research fields.

Ketamine in Substance Use Disorder Treatment: A Narrative Review.

Substance use disorder (SUD) continues to pose a significant global health challenge, necessitating innovative and effective therapeutic interventions. Ketamine, traditionally recognized for its anesthetic properties, has emerged as a novel and promising avenue for the treatment of SUD. This narrative review critically examines the current body of literature surrounding the use of ketamine in various forms and settings for individuals grappling with substance abuse. The review explores the neurobiological underpinnings of ketamine's potential therapeutic effects in SUD, shedding light on its impact on glutamatergic neurotransmission, neuroplasticity, and reward pathways. Special attention is given to the psychotropic and dissociative properties of ketamine, exploring their implications for both therapeutic outcomes and patient experience. Ultimately, this review aims to provide a comprehensive overview of the current state of knowledge regarding ketamine's role in the treatment of SUD, emphasizing the need for further research and clinical exploration. As we navigate the complex terrain of addiction medicine, understanding the nuances of ketamine's potential in SUD holds promise for the development of more effective and personalized therapeutic strategies.

트라우마 이론에 기반한 예술치유콘텐츠 구독자의 치유 과정에 관한 질적연구

channel, which specializes in therapeutic arts content. The research interrogates the therapeutic effects derived from engagement with therapeutic art content in EMOR’s channel, employing Judith Herman's Trauma Recovery Stage Model(1997) as an analytical framework. Data collection involved analyzing comments on a video clip created in collaboration with the channel's creator, augmented by participant observations with ten-time field visits and interviews with thirteen research participants. Findings reveal that the therapeutic experiences facilitated through the consumption of therapeutic arts contents and interactive engagement within the channel lead to establishing safety, remembrance and mourning, and re-connection. These processes echo the healing trajectories observed in traditional offline therapeutic contexts. The study highlights the efficacy of digital media in facilitating therapeutic arts approaches, suggesting its potential to broaden the socio-cultural functions of art within a cultural-economic framework.

Music Therapy in the Neonatal Intensive Care Unit: A Center's Experience with Program Development, Implementation, and Preliminary Outcomes.

The role of music in the NICU continues to evolve, with recent studies documenting the positive impact of music therapy for hospitalized infants and families. With many potential benefits and no substantial adverse effects reported to date in medically stable infants, we aimed to create a clinical guideline to integrate this therapy into the NICU operations. we launched and implemented a pilot music therapy clinical program within a subunit of a level-III NICU, building upon available evidence. In this report, we describe our experience with initial program development and early outcomes in terms of population served, frequency of music therapy, and therapeutic modalities employed to implement service delivery. we highlight the importance of establishing practices that are aligned with currently available data and recommendations, in order to facilitate delivery of a safe, evidence-based, meaningful therapeutic experience with monitoring of preliminary effects of the therapy on all those involved in the experience.

Long-Acting Gonadotropin-Releasing Hormone Analogues for Central Precocious Puberty, Including 45-Mg 6-Month Subcutaneous Leuprolide Acetate: Use for Treatment and Treatment Monitoring

Plain Language SummaryThe gonadotropin-releasing hormone analogue (GnRHa) stimulation test has historically been used for diagnosing and monitoring treatment efficacy in children with central precocious puberty (CPP). However, this test is not always practical due to costs related to lengthy hospital or clinical testing, and additional injections that may negatively impact the child’s therapeutic experience. Therefore, alternative methods of assessing therapeutic efficacy would be valuable. This manuscript presents an overview of the studies supporting the suitability of therapeutic dosing of CPP medications (intramuscular [IM] leuprolide acetate [LA], IM triptorelin pamoate, and subcutaneous [SC] LA) for treatment monitoring. Four studies of injectable CPP medications have demonstrated that these therapies achieved similar stimulated luteinizing hormone (LH) levels compared to a traditional GnRHa stimulation test. However, the effect of SC LA (approved by the US FDA for treatment in May 2020) on LH levels has not been directly compared to those measured as part of a traditional stimulation test. As several studies have shown that SC LA has similar efficacy on the physical characteristics of puberty as IM LA, we postulate that therapeutic SC LA may also be used to monitor the response to CPP treatment, in place of a traditional GnRHa stimulation test.

Abstract ND09: Actinium-225 -PSMA-Trillium (BAY 3563254): Preclinical evaluation and clinical imaging study of a novel 225Ac-labeled PSMA-targeting small molecule triad for the treatment of mCRPC

Abstract With the approval of a PSMA-targeting small molecule labeled with the beta-emitter lutetium-177, PSMA is considered a clinically validated target for the treatment of mCRPC. Although effective, many patients treated with this therapeutic experience only transient clinical benefit, and G1/2 xerostomia is common due to salivary gland toxicity. Since the linear energy transfer and degree of induced DNA damage of alpha particles far exceeds that of beta particles, several investigational PSMA-targeting small molecules labeled with the alpha-emitter 225Ac have generated encouraging preliminary efficacy signals, but with severe xerostomia as a common dose-limiting toxicity. 225Ac-PSMA-Trillium is a novel PSMA-targeting radioligand consisting of a triad of important features: (1) a high-affinity PSMA inhibitor for specific tumor-targeting; (2) a customized albumin-binding domain designed to prolong plasma residence time and increase the therapeutic index by improving tumor uptake while reducing salivary gland uptake; and (3) a “macropa” chelator for efficient and stable radiolabeling with actinium-225. A series of compounds containing the same high-affinity PSMA-targeting moiety, but different chain lengths and albumin-binding domains, were evaluated to identify the optimal combination of features required to achieve the best therapeutic index. In vitro preclinical characterization was performed to test affinities for PSMA and albumin, compound stability and cell-killing potential in LNCaP and 22Rv1 CDX models as well as KuCaP-1 PDX model. Preclinical in vivo investigation of selected compounds showed increased plasma residence time, reduced uptake in normal organs, strong uptake and retention in PSMA-expressing tumors and robust anti-tumor activity. These analyses led to the selection of compounds for further evaluation in a Phase 0 imaging and PK study in mCRPC patients (NCT05773703). In this Phase 0 study, PSMA-Trillium compounds were labeled with indium-111 via a DOTA chelator and used as surrogates to facilitate longitudinal imaging. In patients, 111In-PSMA-Trillium demonstrated targeting to PSMA-expressing tumors as defined by PET/PSMA scans and a plasma residence time consistent with albumin-binding affinities. Importantly, 111In-PSMA-Trillium showed robust uptake and prolonged retention in tumors, and reduced uptake and relatively fast washout from salivary glands. Based on these preclinical data and clinical imaging results, a therapeutic first-in-human trial to evaluate 225Ac-PSMA-Trillium in patients with prostate cancer is anticipated to begin enrolling patients in the first half of 2024. Citation Format: Sabine Zitzmann-Kolbe, Jacob Hesterman, Patricia E. Cole, Nicolas Salem, Alex Papple, Michael Jeffers, Goekben Koca, Thorsten Poethko, Miroslav Dostalek, Shawn Hillier, John W. Babich. Actinium-225 -PSMA-Trillium (BAY 3563254): Preclinical evaluation and clinical imaging study of a novel 225Ac-labeled PSMA-targeting small molecule triad for the treatment of mCRPC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 2 (Late-Breaking, Clinical Trial, and Invited Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(7_Suppl):Abstract nr ND09.

The Real-world Experiences of Abemaciclib for Estrogen Receptor-positive Human Epidermal Growth Factor Receptor-negative-2 Metastatic Breast Cancer – Sharing from a Single Institute in Southern Taiwan

Abstract Background: CDK 4/6 inhibitor (CDK4/6i) is the first-line therapeutic drug to treat ER-positive (ER+) HER2-negative (HER2 -) metastatic breast cancer (MBC) now. We have three CDK4/6i: Palbociclib, Ribociclib, and Abemaciclib. In the long-term follow-up study, there are some different results among the three CDK4/6i. Some real-world reports demonstrated some patients would have clinical benefits from Abemaciclib in the ER+ HER2- metastatic BC patients who had priorly received the other CDK 4/6 inhibitor (Palbociclib). In Taiwan, Abemaciclib is the third available CDK 4/6 inhibitor behind the other two CDK4/6i. However, Abemaciclib was not reimbursed in ER+ HER2- MBC by Taiwan Health Insurance until now. Most doctors in Taiwan have the less therapeutic experiences for Abemaciclib. In this article, we would share the clinical experiences for the first thirteen patients who were prescribed with Abemaciclib to treat ER+ HER2- MBC. Materials and Methods: This chart review study was conducted from January 1, 2020, to May 31, 2023. We reviewed the medical charts at National Cheng Kung University Hospital (NCKUH) and identified 13 patients who had received abemaciclib treatment for ER+ HER2− MBC. The study was approved by the Institutional Review Board at NCKUH (approval number: B-ER-112-220). All of the 13 patients were treated with abemaciclib (150 mg twice daily initially), in combination with other anti-cancer medications. We recorded the clinical parameters, including sex, age, treatments in neoadjuvant/adjuvant setting, metastatic sites, other prior CDK4/6i therapy, treatment lines of abemaciclib in the metastatic setting, survival period before abemaciclib treatment, time to treatment failure for abemaciclib, causes of abemaciclib discontinuation, dose reduction, and adverse effects (AEs) related to abemaciclib. Results: Up to the cut-off date (May 31, 2023), four (4/13) patients were still receiving therapy and nine patients (9/13) had discontinued abemaciclib therapy. Five (5/9) patients discontinued abemaciclib due to disease progression (PD), and two (2/9) patients interrupted abemaciclib treatment due to personal reasons. Two (2/9) patients stopped abemaciclib early because of AEs, and one patient died due to PD. The time to treatment failure for abemaciclib ranged from 1 to 41 months (average: 19.2 months, median: 14 months). AEs were noted in 12 patients (no recording in one patient), of which diarrhea (10/12), anemia (4/12), and neutropenia (3/12) were the most common. Conclusion: According to our real-world data, Abemaciclib is effective and safe for the ER+ HER2- metastatic BC cancer patients who they were heavily treated.

A single case study of digital art therapy for a child with ADHD using the metaverse platform

This qualitative case study was conducted to explore experiences and meanings of a child with ADHD in digital art therapy utilizing the metaverse platform. The study participant was an 11-year-old boy living in S city of South Korea who was diagnosed with ADHD. The child participated in a digital art therapy program based on the metaverse platform once a week for 12 sessions from July to October 2022. Through continuous comparative analysis, the following five major themes were identified from collected data: ‘enjoyable and self-directed art activities through gamification of metaverse’, ‘enhanced presence and communication in the virtual environment’, ‘expanded experience and immersion through convergence of virtuality and reality in metaverse’, ‘emotional expression and emotional release through multisensory experiences in metaverse’, and 'personal growth and development through digital art therapy using metaverse’. By utilizing the metaverse platform as a space and tool for digital art therapy, this study’s findings support that factors such as gamification, presence, interactivity, scalability, and multisensory stimulation provided participant with an enhanced therapeutic experience. These findings reveal the potential of the metaverse as an art therapy environment and medium suitable for the digital age. They also provide important implications for the development of art therapy.

The Impact of Standardized Patients on First-Year Nursing Students’ Communication Skills

BackgroundTherapeutic communication is essential for nurses to foster rapport with patients and promote safe patient care. Nursing students frequently identify that patient communication is challenging. Limited evidence exists related to simulation with standardized patients focused on therapeutic communication outside of psychiatric and mental health settings in nursing education. This pilot study investigated the effect of therapeutic communication simulation with standardized patients on first-year baccalaureate nursing students’ therapeutic communication skill. MethodsOne-hundred thirty-two baccalaureate nursing students participated in this two-group quasi-experimental pilot study. Members of the control group participated in standard learning activities related to therapeutic communication, while members of the experimental group also engaged in a therapeutic communication simulation-based experience with standardized patients. ResultsThe experimental group had significantly higher therapeutic communication skill than the control group. ConclusionSimulation with standardized patients supports therapeutic communication skill development. More research is needed to understand the impact of simulation with standardized patients on nursing students’ outcomes related to therapeutic communication outside of psychiatric and mental health nursing, including therapeutic communication knowledge and transfer of skill.