Understanding Of Illness Research Articles

Improved patient identification by incorporating symptom severity in deep learning using neuroanatomic images in first episode schizophrenia.

Brain alterations associated with illness severity in schizophrenia remain poorly understood. Establishing linkages between imaging biomarkers and symptom expression may enhance mechanistic understanding of acute psychotic illness. Constructing models using MRI and clinical features together to maximize model validity may be particularly useful for these purposes. A multi-task deep learning model for standard case/control recognition incorporated with psychosis symptom severity regression was constructed with anatomic MRI collected from 286 patients with drug-naïve first-episode schizophrenia and 330 healthy controls from two datasets, and validated with an independent dataset including 40 first-episode schizophrenia. To evaluate the contribution of regression to the case/control recognition, a single-task classification model was constructed. Performance of unprocessed anatomical images and of predefined imaging features obtained using voxel-based morphometry (VBM) and surface-based morphometry (SBM), were examined and compared. Brain regions contributing to the symptom severity regression and illness identification were identified. Models developed with unprocessed images achieved greater group separation than either VBM or SBM measurements, differentiating schizophrenia patients from healthy controls with a balanced accuracy of 83.0% with sensitivity = 76.1% and specificity = 89.0%. The multi-task model also showed superior performance to single-task classification model without considering clinical symptoms. These findings showed high replication in the site-split validation and external validation analyses. Measurements in parietal, occipital and medial frontal cortex and bilateral cerebellum had the greatest contribution to the multi-task model. Incorporating illness severity regression in pattern recognition algorithms, our study developed an MRI-based model that was of high diagnostic value in acutely ill schizophrenia patients, highlighting clinical relevance of the model.

Inclusive, needs-based research for addressing Health Literacy in Parents with immigrant backgrounds

Abstract Research indicates that parental health literacy is associated with child health outcomes. A 2021 study by the Norwegian Public Health Department found that certain immigrant groups struggle with health literacy due to language barriers, cultural differences in understanding of health and illness, and unfamiliarity with the Norwegian health system and services. To reduce differences in health literacy and better support parents with immigrant backgrounds to make health promoting choices for their children, and navigate the Norwegian health and social systems effectively, we need knowledge about their resources, challenges, and needs. This knowledge makes it possible to design strategies to promote parental health literacy and make health services more responsive to the needs of the population. Optimising health literacy amongst parents with immigrant backgrounds (OPAL) is a research collaboration between Oslo Metropolitan University and the Bjerke City District, one of the most culturally and linguistically diverse districts in Oslo. Applying the Optimising Health Literacy and Access (Ophelia) process, parents health professionals, and researchers work systematically together to develop knowledge of parents’ health literacy, identify priority areas for research, design and implement effective solutions in primary health care. In this presentation, we will describe how OPAL is rooted in the strategic priorities of the city district, how the project applies methods for needs identification and involves users and stakeholders at all stages. We will share experiences from planning and conducting inclusive data collection, preliminary results and describe how results will be used in development of targeted health literacy actions.

Ill persons and capable workers: Constructing work ability in return-to-work negotiations after sickness absence.

In return-to-work (RTW) negotiations after sickness absence, the work ability of an individual employee becomes a shared interest for the multiple stakeholders representing both the healthcare sector and working life. In practice, the employee, employer and occupational health professionals need to reach a shared understanding of the employee's work ability to enable shared decision-making concerning the plans for sustainable RTW. Drawing on 14 video-recorded RTW negotiations, we used conversation analysis-informed membership categorization analysis to examine how the participants of RTW negotiations discuss the work ability of an employee to pursue a shared understanding of the situation. Work ability was constructed in a very situational way, using illness categories to both explain the work ability of the employee and argue for or against their ability or inability to work. Our study contributes to research on RTW by introducing a new perspective to work ability. We show how work ability is realized during RTW negotiations through interaction, and how participants leverage their cultural understanding of illness and capability when negotiating work ability. We also demonstrate how membership categorization analysis can reveal the situational and consequential aspects of illness and work ability categories.

Explanatory models in real-world clinical interactions at a pediatric cancer center in Guatemala.

Explanatory models (EMs) are used in medical anthropology to characterize individual understandings of illness. This study investigated how interdisciplinary clinical interactions elicited caregiver EMs at a pediatric cancer center in Guatemala. This qualitative study included caregivers of 20 children with newly diagnosed cancer at Unidad Nacional de Oncología Pediátrica (UNOP) in Guatemala City, Guatemala. UNOP's diagnostic process includes social work intake, psychoeducation with a psychologist, and a diagnostic conversation with an oncologist and psychologist. Audio-recordings from the diagnostic process and a semi-structured interview were obtained, transcribed, and translated from Spanish. Transcripts were coded using a priori codes based on the five explanatory model (EM) components (occurrence, causation, pathophysiology, course of sickness, and treatment), as well as disease, and illness accounts. Thematic content analysis explored the EM framework as applied to diagnostic interactions between families and clinicians. All five components of the EM were addressed during the diagnostic process at UNOP. Clinicians, particularly psychologists, initiated conversation about the EM more than caregivers. When prompted, caregivers discussed all aspects of the EM but only rarely mentioned pathophysiology. Disease accounts were primarily described by clinicians, while caregivers used illness accounts to describe cancer causation. Clinicians validated existence of both disease and illness accounts. UNOP's interdisciplinary team elicited families' beliefs and facilitated in-depth discussion of all aspects of the EM, leading to a shared understanding of cancer and its treatment. Utilizing the EM framework in clinical practice may support culturally-competent pediatric cancer care.

Wild-grown medicinal plants used by the Asháninka people from the Tambo River, Peruvian Amazonia

Ethnopharmacological relevanceThe Asháninka people are the largest Peruvian Amazonian group, yet the knowledge of their medicinal plants is scarce. This study on Asháninka herbal medicine offers an insight into the Asháninka aetiological system, resting within the wider ontological framework of animism, and cultural expressions of the biomedical understanding of illnesses. Aim of the studyTo document wild-grown (non-cultivated) plant species in current use by the Asháninka people and look closer at their herbal practices during the Covid-19 pandemic. The study examines whether the knowledge and use of medicinal plants is gendered in this society. It also compares the findings with available literature concerning the Arawakan groups from Peruvian Amazonia. Material and methodsThe fieldwork was conducted in 13 native communities of the Asháninka people along the Tambo River (Selva Central), Peru, between 2016 and 2018 and in 2022. The main field technique were guided walks in the forest with 27 female and 28 male participants, during which voucher specimens were collected and relevant information was recorded. Semi-structured interviews were performed with specialists in Asháninka traditional medicine and with lay Asháninka people to better understand Asháninka illness aetiologies. The analysis of medicinal plants included medicinal categories and uses, modes of preparations, the frequency of use and the knowledge about the plants between the genders. It also presents and discusses detailed testimonies of herbal remedies during the Covid-19 pandemic. The list of recorded plants was compared with ethnobotanical studies of other Arawakan groups from Peruvian Amazonia. ResultsAltogether, 169 wild-grown medicinal plant species were documented. Our findings highlight the importance of the Piperaceae and Acanthaceae botanical families in the Asháninka pharmacopoeia. The plants were used for 23 medicinal categories, of which dermatological disorders, digestive problems and venomous bites were the most prevalent. Over 70% of recorded plants were commonly and moderately known by the study participants. More exclusive species were found among the men than women; however, 64 % of all recorded plants were known to both genders. Sixty-one percent of recorded plants were not mentioned by any other study of medicinal plants among other Arawakan groups in Peruvian Amazonia. During the Covid-19 pandemic, nobody in the native communities at the Tambo River died directly due to the virus, which was attributed, amongst others, to effective and culturally-appropriate prophylaxis and treatments with medicinal plants. ConclusionTo this day, the Asháninka people at the Tambo River conserve the knowledge and practices related to medicinal plants which meet the daily needs of dwelling in subtropical forest; these are deeply rooted in animistic ontology, with the emphasis on spirit predation and retaliation. And yet, numerous applications of plants are compatible with the biomedical notion of illness and symptoms. Plant knowledge is shared between the genders, although specific plants exist for men and women, which are related to their gendered social and family roles. Some overlap and consensus exists with other studies regarding medicinal uses, which reflects the rich and diverse knowledge of medicinal plants among the Arawakan groups in Peruvian Amazonia, and this deserves further study.

Psychometric Evaluation of Cognitive and Positive Valence Tasks Chosen for the NIMH Research Domain Criteria Project.

The NIMH Research Domain Criteria (RDoC) initiative seeks to utilize multidimensional patterns of socio-cognitive behavior to improve understanding of mental illness. We aimed to evaluate the psychometric properties of a subset of RDoC tasks. Specifically, we investigated two positive valence tasks and five cognitive tasks. Participants (N = 320) were recruited through an online research platform. We used generalizability theory to estimate reliability, and factor analysis to examine factor structure. Reliability was average to excellent with some notable exceptions. Factor analysis results raised concerns about whether the factor structure of task scores aligns with the proposed RDoC model. Effects of cognitive manipulations generally supported the construct representation of tasks. Results indicate that the majority of RDoC task scores examined have acceptable reliability or can be made reliable through modest increases in task length. Future research in diverse populations is needed to better understand the factor structure of RDoC cognitive and positive valence measures.

Assessing traditional medicine in the treatment of neurological disorders in Mali: prelude to efficient collaboration

IntroductionNeurological disorders (ND) have a high incidence in sub-Saharan Africa (SSA). In this region, systemic challenges of conventional medicine (CM) and cultural beliefs have contributed to a large utilization of traditional medicine (TM). Yet, data on TM and those who use it in the treatment of ND in SSA are scarce. Here, we systematically analyze its role as a therapy modality for ND in Mali, the socio-demographic characteristics of its users, and propose next steps to optimize the dual usages of TM and CM for patients with ND.MethodsWe conducted a questionnaire study in two phases. In phase one, patients with ND answered questions on their usage of and attitudes towards TM. In phase two, the TM therapists who provided care to the patients in phase one answered questions regarding their own practices for treating ND. Patients were recruited from the country's two university neurology departments.Results3,534 of the 4,532 patients seen in the Departments of Neurology in 2019 met the inclusion criteria. Among these 3,534 patients, 2,430 (68.8%) had previously consulted TM for their present ND. Patients over 60 years of age most often used TM (83.1%). By education, illiterate patients utilized TM the most (85.5%) while those with more than a secondary education used TM the least (48.6%). An income greater than the minimum guaranteed salary was associated with decreased use of traditional medicine (OR 0.29, CI 0.25–0.35, p < 0.001). Among those using TM, it was overwhelmingly thought to be more effective than CM (84.6%). Linking illness to supernatural causes and believing TM therapists had a better understanding of illnesses were the most common reasons patients used traditional medicine (82.3% and 80.5%, respectively).We then interviewed 171 TM therapists who had provided care to the patients in phase one. These providers most commonly “sometimes” (62.6%) referred patients to CM and 4.1% never had. A majority of TM providers (62.6%) believed collaboration with CM could be improved by having doctor “take into account” our existence.ConclusionOur work shows that TM plays a central role in the provision of care for patients with ND in SSA with certain cohorts using it at higher rates. Future development of treatment of ND in SSA will require optimizing TM with CM and needs buy-in from all stakeholders including conventional medicine clinicians, traditional medicine therapists, researchers, politicians, and most importantly, patients.

Historical perspectives of heat-related illness part 2: the present and future

Part one of this series on heat-related illness described how the disease has been known and written about for thousands of years. Since then, there have been some improvements in our understanding of its risks, mechanisms and treatments. However, heat-related illness remains a significant problem, and can be fatal or cause ongoing disability even after the acute episode has passed. This narrative review, the second article in a two-part series describes current understanding of heat-related illness and offers an insight into what we may learn in the future about its cause and potential new treatments and strategies.

Knowledge and Anguish at Work: the Clinical Case of a Telephone Operator

Objective: The objective of this study was to understand the meaning of mental symptoms manifested at work by articulating their material basis present in the work context and the subject's historical singularity. Theoretical Framework: Psychoanalytic theory is used in this case study as a basis for understanding the relationship between knowledge and anguish at work. On the other hand, it is in ergology that we find the necessary theorizations for a reading of what affects the subject in tele-service work. Method: This is a clinical case study based on the psychoanalytically oriented notes of a telemarketer with work-related symptoms. Results and Discussion: As the main result, we read symptomatic production both as a response on a level of direct material causality to the inconsistency of the assumption of knowledge attributed to the trade and the value of work, and as a way out that the subject finds for their symptomatic position. Implications of the research: We conclude that the orientation of the treatment must seek to preserve the assumption of knowledge in the subject and in their work and enable subjective and material accountability. Originality/Value: This study contributes to the literature by combining psychoanalysis and ergology in the search for an understanding of illness at work. The relevance and value of this research is evidenced by the fact that it presents an original clinical case that seeks to highlight the relationship between the place reserved for knowledge in contemporary work and the symptoms produced by it.

Barriers to serious illness conversations in patients with advanced cancer: A mixed methods study.

228 Background: Serious illness conversations (SICs) are discussions between oncology clinicians and patients with cancer about illness understanding and care preferences. SICs are associated with less intensive and more goal-concordant care near the end of life, but many patients die without an SIC. Methods: PATH-SIC is an ongoing, single-center randomized trial (NCT05629065) that enrolls adults without a documented SIC starting a treatment for breast, gastrointestinal, genitourinary, gynecologic, or lung cancers with an expected prognosis of less than one year. The trial examines the effects of clinician- and patient-nudges on SIC documentation within 60 days of patient’s randomization to one of four arms (no nudge, clinician nudge, patient nudge, or both). This embedded mixed methods study recruited patients who still did not have an SIC 60 days from randomization, their caregivers (if present at time of consent) and oncologists. Interviews explored patients’ and caregivers’ 1) experiences with SICs, 2) perceptions about why SICs may not occur, and 3) suggestions to empower others to initiate SICs. Participating oncologists were surveyed by email. We used qualitative content analysis and descriptive statistics to identify themes. Results: The study included 44 participants: 19 patients, 10 caregivers and 15 oncologists. Patients had a median age of 63 years, were 63% female and 58% White and 68% had gastrointestinal cancers. Though no patient had a documented SIC, patients and their oncologists often disagreed about whether an undocumented SIC had occurred previously (Table). Patients’ and caregivers’ reported barriers to SICs included patient factors (lack of readiness, desire to maintain hope, focus on the present), clinician factors (perceived discomfort with prognostic disclosure and SICs), and prognostic uncertainty (current disease control, unpredictable prognosis). Patients’ and caregivers’ reported facilitators to SICs included patient- (self-advocacy, SIC readiness), clinician- (comfortable rapport), disease- (progression, worsening symptoms), and family-related facilitators (advocates for the patient to engage in SICs). To increase SICs, patients and caregivers reported greater acceptance of interventions involving a personal touch (e.g. phone call) over automated processes. Oncologist survey responses were brief. They reported SICs were most frequently triggered by disease progression or treatment intolerance, and recommended longer appointment times and written materials to facilitate SIC. Conclusions: Patient, caregiver and oncologist feedback on barriers and facilitators to SICs provided useful insights to improve interventions to encourage SICs. Patient/oncologist dyad (n=16) concordance of prior SICs. # of dyads Agreed SIC occurred 7 Agreed SIC did not occur 2 Only oncologist reported SIC 6 Only patient reported SIC 1 Total patient/oncologist dyads 16

Obstructive sleep apnea illness perception relative to other common chronic conditions.

Obstructive sleep apnea (OSA) is a common chronic medical condition that results in impaired daytime functioning. While the link between OSA and cardiovascular disease is important, there has been increasing recognition of the impact of OSA on daytime functioning and experience. Better insight into illness perceptions can help better understand how to initiate and maintain treatment. Data from two OSA clinical trials were examined. The baseline Respiratory Event Index (REI) was obtained from diagnostic sleep testing. The Brief Illness Perception Questionnaire (BIPQ) assesses the cognitive and emotional representation of illness and was administered at baseline along with the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI). 523 patients diagnosed with OSA were studied. The sample had a mean age of 51.1 ± 16.6, mean REI of 28.6 ± 17.9/h, and mean body mass index of 32.8 ± 15.5 kg/m^2. The mean BIPQ total score at baseline was 43.3 ± 11.3. BIPQ scores were significantly correlated with sleepiness and sleep quality but not with REI. Relative to other common chronic conditions with major comorbidities, BIPQ scores for patients with OSA were higher on consequences, identity, concern, and emotional representation dimensions. The study shows that Veterans with OSA report elevated illness perceptions across several dimensions at levels as high, or higher, than other common chronic conditions. Implications for clinical practice are that it is important to ask patients about their understanding of illness across several dimensions to appreciate better patient needs and preferences.

Personhood Disrupted: An Ethnography of Social Practices and the Attribution of Mental Illness in Abeokuta, Nigeria.

This paper explores the intricate interplay between living with mental illness and the processes of identifying mental illness in Abeokuta, Nigeria. With a particular focus on the contextual understanding of personhood, this study reveals how sociocultural backgrounds modulate the understanding of mental illness and its treatments within the Yoruba context. Through nine months of ethnographic fieldwork and discursive narrative analysis, the research revealed that becoming a mentally ill person is deeply intertwined with the everyday social life in the study site. The analysis highlights the multifaceted nature of personhood, encompassing various aspects such as parenthood, friendship, employment, and financial freedom. These facets of personhood are shaped by specific social practices and embedded within complex webs of social relations, often becoming more pronounced when these relationships are disrupted, leading to certain behaviours being categorised as mental illness. This paper underscores the significance of recognising and acknowledging the contextual notion and understanding of mental illness to ensure the provision of acceptable and effective care and recovery strategies.

Constricting Gaps: Protocol development, implementation challenges and lessons learned for the reality map of unmet needs for Palliative Care Interventions in advanced cancer patients study in Romania and Switzerland

BackgroundPatients with advanced cancer experience many symptoms and needs requiring a Palliative Care Intervention (PCI). Identifying gaps between needs for PCIs and experienced delivery may improve health care, furthermore the association of gaps with quality indicators (QI). The multicentre Romanian (RO)-Swiss (CH) reality map study implemented a novel protocol based on needs concepts and culturally adapted quality indicators (QI). MethodsAn interactive mapping guide measuring unmet needs for PCIs monthly over six months, patient characteristics (cognition, EAPC basic data set, Cofactors) and QI (Inappropriate Anticancer Treatment, High Symptom Burden [IPOS, EQ5D], Repeated ER Admissions, Aggressive End-of-Life Care, and Quality of Death-and-Dying) were developed, applying swiss standards for quality assurance. A composite endpoint (QI, cofactors) was planned. Finally, local solutions responding to gaps were piloted. ResultsFrom 308 patients (RO: 262, CH: 46, age 62j [mean], 74 % ECOG PS 1&2, 81 % current anticancer treatment) baseline and first follow-up data revealed main gaps (symptom management, spiritual needs, family support), country differences (e.g. illness understanding, spiritual needs) and a significant association of the number of gaps with depression. Later data become less, and data quality on QI variable, revealing gaps in research conduct competences, resources, and applicability of over-sophisticated quality assurance tools. Nevertheless, the unmet needs data promoted local initiatives, 81 patients participated in feasibility studies. Finally, the joint experience stimulated academic developments and national integration of palliative care into oncology. ConclusionsPairing motivation and enthusiasm with more modest aims, feasibility testing of all outcomes and investment in research competences may disperse gaps.

The Effect of Family-Centered Empowerment Program on Husbands' Understanding of Illness, Perceived Stress and Self-care Behaviors of Type 2 Diabetes Patients

Background: Comprehensive support from individuals with whom one has a deep emotional connection can significantly improve the management of life's stresses. Objectives: This study aims to investigate the impact of a family-oriented empowerment program for husbands on the illness understanding, perceived stress, and self-care behaviors of patients with type 2 diabetes. Methods: In this semi-experimental study, 72 spouses of diabetic patients who met the inclusion criteria were randomly selected and divided into intervention and control groups. The intervention group received an educational program based on the family-centered empowerment model, which consisted of six 60-minute training sessions over six consecutive weeks. The control group received usual care. Data were collected using questionnaires on self-care behaviors, disease understanding, and perceived stress, administered before, immediately after, and three months after the intervention. Data were analyzed using independent t-tests, paired t-tests, and repeated measures ANOVA. Results: There were no significant differences between the intervention and control groups in terms of demographic characteristics and baseline variables (P = 0.11). The Mann-Whitney test revealed significant differences between the two groups in terms of disease understanding, perceived stress, and self-care behaviors after the intervention (P &lt; 0.001). The independent t-test confirmed significant changes in the mean scores for disease perception, perceived stress, and self-care behaviors between the two groups (P &lt; 0.001). Conclusions: The results indicate that a family-centered empowerment program can enhance illness understanding, reduce perceived stress, and improve self-care behaviors among the spouses of diabetic patients. Given the increasing prevalence of diabetes, incorporating such programs into nursing care plans is recommended.

328 Assessment of chronically ill or injured feedlot cattle populations at eight United States and nine Canadian feedlots and implications for cattle welfare

Abstract Cattle health management in the feedlot sector continues to evolve and improve cattle welfare by promoting an understanding of illness and injury to minimize their effects. Many papers have focused on treating individual ill or injured cattle in cattle feeding facilities. However, care, treatment, and outcomes for chronically ill or injured cattle (“chronic cattle”) have received little attention in the literature. The purpose of this descriptive study was to present demographics, diagnoses, and outcomes of chronic cattle in 17 feedlots in the U.S. and Canada and discuss potential risk factors and welfare implications. Individual chronic cattle information and treatment records from 17 feedlots (U.S.: 8; Canada: 9) over 7 yr (2014 – 2020) were retrospectively retrieved from a large feedlot consulting and data-management service (Feedlot Health Management Services, a division of TELUS Agriculture Solutions Inc.). Chronic cattle were defined as those that had spent time in a feedlot’s designated chronic pen. Descriptive results are presented as means ± standard deviations. U.S. feedlots averaged 31,280 ± 23,231 cattle/yr, had an average chronicity rate of 2.24 ± 2.42 % (median 1.53%), and contributed 52,709 chronic cattle to the dataset. Canadian feedlots averaged 21,913 ± 10,497 cattle/yr, had an average chronicity rate of 1.41 ± 0.82% (median 1.10%), and contributed 15,940 chronic cattle to the dataset. U.S. chronic cattle were sourced across all seasons primarily from auctions and ranches, had an average arrival weight of 163 ± 59 kg, and an average days on feed (DOF) of 362 ± 172 d. Canadian chronic cattle were primarily auction-sourced in the fall, weighed 272 ± 95 kg at arrival, and averaged 246 ± 141 DOF. Chronic cattle were treated at least once for respiratory issues (U.S.: 46.3%; Canada: 26.9%), bullers (U.S.: 34.5%; Canada: 5.8%), musculoskeletal issues (U.S.: 2.2%; Canada: 1.4%), lameness (U.S.: 1.7%; Canada: 28.1%), metabolic issues (U.S.: 0.5%; Canada: 4.5%), or other diagnoses (U.S.: 2.2%; Canada: 6.3%), with many cattle treated for multiple issues (U.S.: 12.5%; Canada: 27.0%). Outcomes for chronic cattle were shipped (U.S.: 73.1%; Canada: 52.5%), railed (U.S.: 8.1%; Canada: 20.7%), euthanized (U.S.: 0.7%; Canada: 9.9%) died unassisted (U.S.: 18.1%; Canada: 16.2%), or transferred (U.S.: &amp;lt; 0.1%; Canada: 0.8%). These results are some of the first to describe chronic cattle populations and present interesting trends for further analysis. For example, differences in buller and lameness rates could reflect actual differences but may be artifices of the dataset and feedlot definitions. Additionally, high marketed cattle rates (shipped and railed) indicate positive outcomes for most cattle, but variable mortality rates merit further scrutiny.

Young adults living with chronic illness: disclosure strategies and peers’ understanding

Purpose Many young adults living with chronic illness fear being perceived as different by their peers and excluded from social activities. This forces them to consider whether to disclose or conceal their illness. This article analyses young adults’ disclosure strategies and links them to peers’ understanding of illness. Materials and methods The explorative study is based on episodic interviews with sixty young adults living with chronic illnesses (type 1 diabetes, cancer, chronic inflammatory bowel disease or a rare disease) and thirty peers. The interviews were thematically coded. The young adults’ statements were compared to the peer perspectives on a case-by-case basis. Results We identified three groups of young adults: 1) those who are generally open with peers about their illness and its subjective meaning; 2) those who share selected health-related information’s with selected peers; 3) those who refrain from active disclosure and are unsure how they might talk about their illness when it becomes apparent. Our findings also indicate that peers differ in the sophistication of their illness perceptions and the meaning they ascribe to living with a chronic illness. Conclusion Trainings should target both young adults and peers, and should assist both sides in talking about (serious) chronic illness.

Identifying priority challenges of older adults with COPD: A multiphase intervention refinement study.

Identifying priority challenges of older adults with chronic obstructive pulmonary disease (COPD) is critical to designing interventions aimed at improving their well-being and independence. To prioritize challenges of older adults with COPD and those who care for them to guide refinement of a telephonic nurse coach intervention for patients with COPD and their family caregivers (EPIC: Empowering People to Independence in COPD). Multiphase study guided by Baltes Theory of Successful Aging and the 5Ms Framework: Phase 1: Nominal group technique (NGT), a structured process of prioritizing responses to a question through group consensus. Phase 2: Rapid qualitative analysis. Phase 3: Intervention mapping and refinement. Ambulatory, virtual. Older adults with COPD, family caregivers, clinic staff (nurses, respiratory therapists), clinicians (physicians, nurse practitioners), and health system leaders. NGT sessions were conducted by constituency group with 37 participants (n = 7 patients, n = 6 family caregivers, n = 8 clinic staff, n = 9 clinicians, n = 7 health system leaders) (Phase 1). Participants generated 92 statements across five themes (Phase 2): (1) "Barriers to care", (2) "Family caregiver needs", (3) "Functional status and mobility issues", (4) "Illness understanding", and (5) "COPD care complexities". Supplemental oxygen challenges emerged as a critical problem, and prioritized challenges differed by group. Patients and clinic staff prioritized "Functional status and mobility issues", family caregivers prioritized "Family caregiver needs", and clinicians and health system leaders prioritized "COPD care complexities". Intervention mapping (Phase 3) guided EPIC refinement focused on meeting patient priorities of independence and mobility but accounting for all priorities. Diverse constituency groups identified priority challenges for older adults with COPD. Functional status and mobility issues, particularly related to supplemental oxygen, emerged as patient prioritized challenges. Patient-centered interventions for older adults with COPD must account for their prioritized functional and supplemental oxygen needs and explore diverse constituent perspectives to facilitate intervention enrichment.

Latent Profile Analysis of Self-Stigma Among Individuals With Schizophrenia and Its Relationship With Illness Perception.

To investigate self-stigma among individuals with schizophrenia, identify potential categories of self-stigma, and analyze the association between self-stigma categories and dimensions of disease perception. Convenience sampling was used to select individuals with schizophrenia (N = 216) in psychiatric hospitals. A General Demographic Information Questionnaire, the Internalized Stigma of Mental Illness Inventory, and Brief Illness Perception Questionnaire were used for data collection. A latent profile analysis was performed on self-stigma characteristics of participants, and potential categories of influencing factors and their relationship with illness perception were examined. Participants were classified into three potential categories: low self-stigma-low resistance (19.4%), medium self-stigma (55.6%), and high self-stigma-high discrimination (25%). Compared with the low self-stigma-low resistance group, those with higher illness representation and illness understanding scores were more likely to be classified as medium self-stigma, and emotional representation was the strongest predictor for high self-stigma-high discrimination. Self-stigma among participants was mostly medium to high. Self-stigma of individuals with schizophrenia demonstrates group heterogeneity; therefore, nurses should formulate targeted interventions based on the characteristics of each category to achieve precise interventions and reduce self-stigma. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Extending the theoretical understanding of mental illness and help-seeking self-stigmas.

Extending the theoretical understanding of mental illness and help-seeking self-stigmas.

Ethics and curricular competencies during a three-hour poetry workshop for health professionals.

Poetry is a powerful tool to promote communication, develop insight and empathy, examine ethical issues, and challenge assumptions. We have been using poetry in health professions education for many years and wished to capture its impact on healthcare learners and professionals, with a focus on competencies essential to healthcare providers. A three-hour poetry workshop was conducted during the National Conference for Health Professions Educators, 2022, for volunteers from the health professions. Poems were curated beforehand to highlight ethics concepts, and social and structural healthcare barriers. Participant responses suggested that they connected with the struggles depicted, noticed ethical issues, and experienced empathy. Online feedback from participants after the workshop revealed that the poems motivated self-reflection, gave voice to feelings, and helped understand patient perspectives. Our findings suggest that integrating poetry into the curriculum can improve educational competencies, enhance understanding of illness, and facilitate creativity, reflective learning, and discussions on self-care and burnout.