Use Of Psychological Support Research Articles

COVID-19: Mental health and psychological well-being in nursing technicians

This study aimed to understand the mental health and psychological well-being of nursing technicians during their work on the frontline of COVID-19 in the Metropolitan Region of Recife. To achieve this objective, six professionals, of both sexes, aged between 29 and 46 years were interviewed. Data were analyzed according to Minayo's Thematic Content Analysis technique, under the light of systemic theory. The results indicated the recognition of important changes both in the increase in work demands and in the professionals' relationships with the health teams and social support network. Fear of contagion and social isolation measures were highlighted as factors that potentialize psychological suffering, as well as increased work stress and physical and emotional fatigue. As coping measures, the participants reported the use of psychological support, religiosity as well as support from their own colleagues in the health teams. There was a significant impact on the most varied social groups of these workers, as well as on their mental health, where symptoms such as depression, anxiety, burnout and panic were present in the daily lives of these health professionals.

Use of psychological interventions among healthcare workers over the 2-year period following the COVID-19 pandemic: A longitudinal study.

Although healthcare workers (HCWs) have reported mental health problems since the beginning of the COVID-19 pandemic, they rarely use psychological support. Here, we described the use of psychological support among HCWs in Spain over the 2-year period following the initial pandemic outbreak and explore its association with workplace- and COVID-19-related factors measured at baseline, in 2020. We conducted a longitudinal study on HCWs working in Spain. We used an online survey to collect information on sociodemographic characteristics, depressive symptoms, workplace- and COVID-19-related variables, and the use of psychological support at three time points (2020, 2021, and 2022). Data was available for 296, 294, and 251 respondents, respectively at time points 1, 2, and 3. Participants had a median age of 43 years and were mostly females (n = 242, 82%). The percentage of HCWs using psychological support increased from 15% in 2020 to 23% in 2022. Roughly one in four HCWs who did not use psychological support reported symptoms compatible with major depressive disorder at follow up. Baseline predictors of psychological support were having to make decisions about patients' prioritisation (OR 5.59, 95% CI 2.47, 12.63) and probable depression (wave 2: OR 1.12, 95% CI 1.06, 1.19; wave 3: OR 1.10, 95% CI 1.04, 1.16). Our results suggest that there is call for implementing mental health promotion and prevention strategies at the workplace, along with actions to reduce barriers for accessing psychological support.

Control Conditions in Randomized Trials of Psychedelics: An ACTTION Systematic Review.

Objective: To systematically review control conditions of all available randomized psychedelic trials.Data Sources: We searched PubMed, PsycINFO, and EMBASE for randomized trials of psychedelics in humans from 1940 through May 2020 with no language restrictions. PRISMA guidelines were followed. (PROSPERO registration number: PROSPERO-CRD42020205341.).Study Selection: All randomized trials of psychedelics in humans from 1940 through May 2020 were included.Data Extraction: Two independent reviewers performed extraction. Extracted data included study design, demographics, blinding type, whether and how blind integrity was assessed, psychedelic used and dose, drug control condition and dose, type of non-drug control condition, number of dosing sessions, and recruitment source. Outcome data were not collected.Results: In total, 126 articles were included, encompassing 86 unique studies. Of studies with a drug control condition (80), 49 (61.2%) used an inert placebo control, 16 (20.0%) used active comparators, 12 (15.0%) used both, and 3 (3.8%) used only different active psychedelic doses as a control. Only 3 of 21 therapeutic trials compared the use of psychological support to a minimally supportive condition. The majority (81/86; 94%) of studies were blinded, though only 14 (17.3%) included blind assessment; only 8 of these 14 studies assessed participants' blinding. Blinding success, assessed in highly varied ways, was generally poor.Conclusions: Randomized psychedelic trials underutilize elements that would improve quality or provide important information: blind assessment, active drug controls, and testing psychological support against minimal-support conditions. Several queried categories, including blind integrity assessment and details of non-drug control conditions, were insufficiently reported by many reviewed studies. Recommendations are provided to improve trial methods.

Psycho-Oncological Care Provision in Highly Distressed Breast Cancer Patients.

Objective To evaluate the proportion of breast cancer (BC) patients with distress or psychological comorbidity as well as offer and use of psychological support in subgroups of BC patients with different extents of distress. Methods 456 patients with BC were evaluated at baseline (t1) and until 5 years after diagnosis (t4) at the BRENDA certified BC centers. Logistic regression was used to analyze if patients with distress at t1 received offers and actual psychological support more often than patients without distress at t1. Regression analyses were used to examine if acute, emerging or chronic disease was associated with higher rates of offer and use of psychotherapy as well as intake of psychotropic drugs. Results In 45% of BC patients psychological affection was detected at t4. The majority of patients with moderate or severe distress at t1 (77%) received the offer for psychological service, while 71% of those received the offer for support at t4. Patients, who were psychologically affected at t1, have not been offered psychological services more often than those without, but they significantly more often used services if offered. Especially patients with acute comorbidity received significantly more often an offer for psychotherapy compared to unimpaired patients, while those patients with emerging or chronic disease did not. 14% of BC patients took psychopharmaceuticals. This mainly concerns patients with chronic comorbidity. Conclusion Psychological services were offered to and used by a fair amount of BC patients. All subgroups of BC patients should be addressed, in order to improve the comprehensive supply with psychological services.

Police staff and mental health: barriers and recommendations for improving help-seeking

ABSTRACT Mental disorders are prevalent among public safety personnel (PSP) yet many people working across public safety professions appear reluctant to seek care for mental health-related concerns. Given the prevalence and impact of compromised mental health on these populations, finding ways to increase use of psychological support for police staff and officers is necessary. We conducted an interview and focus groups (n= 9) with police service members (n= 33) to examine the barriers police officers (n= 25) and communicators (n= 8) report facing when seeking treatment, and their suggestions for improving access to treatment. We identified three main barriers: stigma, worries about confidentiality, and occupation-specific experience with people in the community who present in mental distress. Three suggestions emerged from our participants that may improve current mental health support, namely, ensuring confidentiality, easy-to-use electronic resources, and access to occupation-specific content. We discuss the implications of our results with suggestions for policy and practice.

Mental health impact among hospital staff in the aftermath of the Nice 2016 terror attack: the ECHOS de Nice study

BackgroundThe Nice terror attack of July 14, 2016 resulted in 84 deaths and 434 injured, with many hospital staff exposed to the attack, either as bystanders on site at the time of the attack (‘bystander exposure’) who may or may not have provided care to attack victims subsequently, or as care providers to victims only (‘professional exposure only’). The objective of this study is to describe the impact on mental health among hospital staff by category of exposure with a particular focus on those with ‘professional exposure only’, and to assess their use of psychological support resources.MethodAn observational, cross-sectional, multicenter study conducted from 06/20/2017 to 10/31/2017 among all staff of two healthcare institutions in Nice, using a web questionnaire. Collected data included social, demographic and professional characteristics; trauma exposure category (‘bystanders to the attack’; ‘professional exposure only’; ‘unexposed’); indicators of psychological impact (Hospital Anxiety and Depression Scale); PTSD (PCL-5) level; support sought. Responders could enter open comments in each section of the questionnaire, which were processed by inductive analysis.Results804 staff members’ questionnaires were analysed. Among responding staff, 488 were exposed (61%): 203 were ‘bystanders to the attack’, 285 had ‘professional exposure only’. The staff with ‘professional exposure only’ reported anxiety (13.2%), depression (4.6%), suicidal thoughts (5.5%); rates of full PTSD was 9.4% and of partial PTSD, 17.7%. Multivariate analysis in the ‘professional exposure only’ category showed that the following characteristics were associated with full or partial PTSD: female gender (OR = 2.79; 95% CI = 1.19–6.56, p = 0.019); social isolation (OR = 3.80; 95% CI = 1.30–11.16, p = 0.015); having been confronted with an unfamiliar task (OR = 3.04; 95% CI = 1.18–7.85; p = 0.022). Lastly, 70.6% of the staff with ‘professional exposure only’ with full PTSD did not seek psychological support.ConclusionDespite a significant impact on mental health, few staff with ‘professional exposure only’ sought psychological support. Robust prevention and follow-up programs must be developed for hospital staff, in order to manage the health hazards they face when exposed to exceptional health-related events such as mass terror attacks.Study registrationEthical approval for the trial was obtained from the National Ethics Committee for Human Research (RCBID N° 2017-A00812–51).

Psychological support in general population during the COVID-19 lockdown in France: Needs and access.

IntroductionWith France one of the European countries most strongly affected by COVID-19 in the spring of 2020, French authorities imposed a nationwide lockdown for 8 weeks (March 17–May 10). This study explored the perception of the adult population about the need for—and access to—psychological support from health care professionals (HCP) in response to concerns about the psychological needs during lockdown.Material and methodThis online cross-sectional survey of a representative sample of the adult general population of mainland France (N = 2,003) took place during the last four days of the French lockdown (May 7–10, 2020).ResultsOne in eight respondents (12.2%) perceived a need for psychological support from an HCP during the lockdown; most had symptoms of depression and/or anxiety of at least moderate intensity. Only a third (29.8%, 3.6% of the entire sample) actually obtained this support. Factors associated with this perceived need included: age under 35, economic difficulties due to lockdown, pre-lockdown use of psychological support, infection with COVID-19, serious worries about becoming infected, and heavy media use to obtain information about the disease. Among those who perceived a need for psychological support, the elderly were the most likely not to consult an HCP. People aged 35–64, those with high income, and those seriously worried about developing COVID-19 were the most likely to forgo seeking access to care because of their fear of infection by the coronavirus-2019.ConclusionThe perceived need for psychological support from an HCP and access to it appeared to be strongly associated with COVID-19 exposure factor. More research about this association is needed to improve the health authorities’ understanding of the population’s psychological needs in this situation and to enhance HCPs’ abilities to meet them. In particular, further research of its specific impact on youth is necessary.

System of Psychological Support Based on Positive Suggestions to the Critically Ill Using ICU Doulas.

Background:Surviving critical illness often creates a lasting psychological impact, including depression, anxiety, and post-traumatic stress. Memories of frightening and delusional experiences are the largest potentially modifiable risk factor, but currently, there is no proven intervention to improve these inciting factors. Psychological support based on positive suggestion is a psychotherapeutic approach that can be provided even to patients in altered cognitive states and is therefore a viable psychotherapy intervention throughout the ICU stay. Traditional ICU care team members have limited time and training to provide such psychological support to patients. Doulas are trained supportive companions who have been effectively used to provide patient advocacy and emotional support in other clinical settings and may address this need. Our aim was to train and implement a psychological support based on positive suggestion program for the critically ill using doulas, and measure acceptance of this intervention through stakeholder feedback.Methods:Doula training included three objectives: an introduction to ICU practice structure and policies; education about fundamental aspects of critical care conditions and procedures; and didactic and hands-on learning experiences in effective use of psychological support based on positive suggestion in the critically ill. Doulas were evaluated at the end of their training and during subsequent clinical activities using competency-based assessments as well as through survey-based questions and interviews with key stakeholders.Results:The ICU doulas performed psychological support based on positive suggestion on 43 critically ill patients in the ICU setting. Stakeholder feedback from nurses, patients, and patient families was positive. The majority (28/32) of surveyed bedside ICU nurses reported that the doulas’ involvement was helpful for both patients and nurses alike. All interviewed family members offered positive comments about the ICU doula presence and of the 40 patients who recalled the intervention 37 found it comforting.Conclusions:Our program successfully trained two doulas to work effectively in the ICU setting performing patient-centered psychological support based on positive suggestion interventions. Their training improved their skill sets and was reported as beneficial by patients, families, and critical care nursing. This training program offers a proof of concept that could be applied in other medical centers, bringing doulas more commonly into the ICU practice to help humanize the experience for patients, families, and medical teams.

Treatment gap in bereavement care: (Online) bereavement support needs and use after traumatic loss.

People bereaved through road traffic accidents (RTAs) are at risk for severe and disabling grief (i.e., pathological grief). Knowledge about needs and use of bereavement care, including psychotherapy, pharmacotherapy, and support groups, is limited. This study charted (correlates of) the needs and use of bereavement care in RTA bereaved people. Furthermore, although online grief treatment seems effective, it is unknown whether it is perceived as acceptable. Accordingly, we examined the acceptability of online treatment. Dutch RTA bereaved adults (N = 273) completed self‐report measures about needs and use of bereavement care, acceptability of online grief treatment, and pathological grief. Regression analyses were used to identify correlates of care needs and use and acceptability of online treatment. The majority (63%) had received help from psychotherapy, pharmacotherapy, and/or support groups. One in five participants had not used bereavement care services, despite reporting elevated pathological grief levels and/or expressing a need for care, pointing to a treatment gap. Use of psychological support before the loss was the strongest predictor of bereavement care needs and use following the loss. A minority (35%) reported being inclined to use online grief treatment if in need of support. More openness towards online services was related to greater acceptability of online treatment. In conclusion, 20% of RTA bereaved people with pathological grief or care needs had not received care. This treatment gap may be reduced by improving accessibility of online treatments. However, as only 35% was open to using online treatments, increasing the acceptability of (online) treatments appears important.

Psychological Support for the Foreign Language Training of the Students at International Relations Faculties

The article studies the innovative elements of psychological support for the professional foreign language training of students at international relations faculties, offers and experimentally verifies the effectiveness of techniques and exercises for the intensification of the foreign language training, based on professional communicative situations in high-risk foreign language environment. Such elements include the use of stress-management techniques and exercises based on real-life professional situations, along with practicing foreign language skills. The appropriateness of use of the elements of psychological support for the professional foreign language training of would-be professionals in international relations was proved to be effective through the experiment. It was conducted with students of international relations faculties through the comparison of levels of performance of two groups of students: those whose professional foreign language training include elements of psychological support and those with traditional training. In order to assess the difference between two groups of students at the summative stage of the experiment, the Mann –Whitney U test was used. The use of psychological support for the professional foreign language training is significant in terms of improvement of would-be specialists' in international relations professional competence.

Covid-19 bei Beschäftigten im Gesundheitsdienst und in der Wohlfahrtspflege

Covid-19 in health and social welfare workers Objectives: We give details of reports of suspected cases of SARS-CoV-2 infections and Covid-19 disease among health workers (HW). In addition, we describe the provision of support for health workers from the Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW) during the Covid-19 pandemic. Methods: Reports on suspected cases of an occupational disease caused by SARS-CoV-2 or Covid-19 are stored in a special data bank. These data were analysed up to and including 30.02.2020. In addition, the website www.bgw-online.de was searched for the offers of psychological support provided by BGW during the pandemic. Results: 1,920 reports of suspected cases have now been filed after the diagnosis of a SARS-CoV-2 infection among HW. This number is twice that for all infection reports normally filed in a normal year. The mortality rate among HW infected with SARS-CoV-2 is 0.3%. Doctors suffer severe symptoms more often than other occupational groups (8.3% compared to 3.1%). The pandemic is increasing psychological strain among HW and they are therefore making use of psychological support provided by the BGW. Conclusions: Knowledge about the spread of SARS-CoV-2 infections among HW is still limited but our data indicate that they are much affected, as shown by the mortality rate after infection. Occupational health examinations are currently being undertaken to screen for Covid-19 and these are to be analysed systematically in order to gain a further insight into the epidemiology of SARS-CoV-2 infections among HW. Keywords: corona pandemic – SARS-CoV-2 – mortality rate – health worker

The impact of Internet use on mental wellbeing and health behaviours among persons with disability

Abstract Background Disability is frequently related to the digital divide. However, the Internet may be also an opportunity for many people with disabilities, especially for those who suffer from difficulties in involving in social activities. For some of them, it is also a tool for undertaking professional tasks. The aim of the study was the assessment of the impact of the Internet on selected aspects of psychological wellbeing and undertaking health behaviours in persons with disabilities. Methods From the data set of the biannual Social Diagnosis survey, data of respondents confirming the status of disability were extracted. They were used for the development of multivariate logistic regression models for self-assessment of life, the prevalence of suicidal thoughts, feeling lonely, the use of psychological support and health behaviours. The impact of Internet usage was adjusted for sociodemographic variables. Weights provided by the study team were used in the analysis. Results The responses from 3231 respondents were used in the analysis. There were 33.1% of Internet users in the study group. Respondents with a mild disability made 25.3%, with moderate 39.4%, with severe 24.2%, and without an established degree of disability 11.1%. Logistic regression modelling revealed that Internet users more frequently assessed their lives as happy (odds ratio, 95% confidence interval (OR, 95%CI): 1.40, 1.13-1.75) and undertook some form of physical activity (2.32, 1.84-2.91). They also less frequently excessively consumed alcohol (0.51, 0.33-0.80). No relation was found for experiencing loneliness (0.89, 0.71-1.12), suicidal thoughts (0.998, 0.77-1.29), receiving psychological care (0.84, 0.62-1.14) and smoking (0.83, 0.66-1.04). Conclusions Although persons with disabilities suffer from digital divide, Internet use may exert a beneficial impact on their wellbeing and favour more beneficial health behaviours. Key messages Internet access and use among persons with disabilities may be an opportunity for improved wellbeing. Persons with disabilities who are Internet users assess their lives as more happy and demonstrate more favourable health behaviours.

Health outcomes of the July 14, 2016 Nice terror attack among hospital-based professionals and students: the \xab ECHOS de Nice \xbb health survey protocol

BackgroundThe terror attack of July 14, 2016, in Nice, France, resulted in 86 deaths, including children, and several hundred wounded, with a major psychological impact on the population. Hospital staff had to cope with exceptional circumstances which made them vulnerable to detrimental effects on their own health.This paper describes the method that was selected for the survey entitled “ECHOS de Nice 14 Juillet” which aimed to assess the impact of the attack on the psychological, psycho-traumatic and somatic health condition of the Nice University and Lenval hospital staff who were directly or indirectly exposed to the attack, and also to describe the support and care facilities they were offered.MethodECHOS de Nice 14 juillet is an observational, cross-sectional, multicentre study focusing on all the hospital staff and students of both institutions, i.e. 10,100 persons in June 2017. A web-based questionnaire based on the model developed by Santé Publique France (IMPACTS and ESPA 13 novembre 2015) was adapted to the contexts of the healthcare professionals and students employed in these healthcare institutions in Nice and published on line from June 21 to October 30, 2017. The paper describes the tools that were used to meet the aims of the study, i.e. identification of exposure categories (‘civilian’ exposure for those present during the attack and/or ‘professional’ exposure); indicators of psychological impact (anxiety, depression, burnout, compassion fatigue, suicidal states, tobacco and alcohol use, self-medications), psycho-traumatic and somatic impact; professional and social impact. Lastly, awareness of availability and use of psychological support and care-follow-up facilities by professionals were investigated. Respondents could include extensive qualitative comments on the various themes explored in the questionnaire, with text analysis complementing that of quantitative data.DiscussionThe benefits and limitations of the selected methodology are discussed, in view of contributing useful information to help anticipate and manage health issues among hospital staff who have been victims of traumatic events.

The significance of psycho-oncology for urology

National and international guidelines and certification criteria for comprehensive cancer centres require the psycho-oncological co-treatment of distressed cancer patients. Of course, this also applies to the field of uro-oncology. The individual need for psychosocial support should be systematically evaluated by "distress screening" procedures. While in general about 30 % of all cancer patients are considered severely distressed, this rate seems to be lower (about 20 %) in prostate cancer patients, the largest uro-oncological entity. Many patients find it difficult to accept psychotherapeutic support, which leads to high levels of rejection - even in distressed patients. This is especially true for urological patients, the majority of whom are older men. These persons generally find it difficult to perceive their own emotions, to communicate, and to make use of psychological support. Therefore, urologists must have a high level of communication skills in this context.

Psychosocial distress and utilization of professional psychological care in cancer patients: An observational study in National Comprehensive Cancer Centers (CCCs) in Germany

The study aimed to assess cancer patients' use of psychological care and its correlates in a large sample of cancer patients in Comprehensive Cancer Centers (CCCs) in Germany. In a multicenter study in Germany, cancer patients with various diagnoses were evaluated for self-reported use of psychological support. We measured psychological distress, depression and anxiety, quality of life, and social support with standardized questionnaires and analyzed its association with the utilization of psychological care using multivariable logistic regression. This paper focuses on a cross-sectional analysis of the data assessed during inpatient care. Three thousand fifty-four (50%) of hospitalized patients were asked for participation, and n=1632 (53.6%) participated. We were able to analyze n=1,398 (45.9%) patients. Three hundred ninety-seven (28.4%) of the sample utilized psychological support. Users of psychological care were significantly younger than nonusers (odds ratio [OR]: 0.967, P<0.001) and were more often female (OR: 1.878, P<0.001), whereas educational level was not associated with the use of psychological care. In the multivariable analysis, effects on the use of psychological care were observed for Hospital Anxiety and Depression Scale (HADS) anxiety (OR: 1.106, P=0.001) and both subscales of the 12-item Short Form Health Survey (SF-12) quality of life measure (mental, OR: 0.97, P=0.002; physical, OR: 0.97, P=0.002). Psychological distress and anxiety are higher, and quality of life is lower in users of psychological care in comparison with nonusers during inpatient cancer treatment. Although psychooncological services should be provided to all patients who need them, special efforts should be made to reach populations that report low utilization.

ПРОБЛЕМА ДИТЯЧИХ СТРАХІВ У ДОСЛІДЖЕННЯХ ВІТЧИЗНЯНИХ ТА ЗАРУБІЖНИХ НАУКОВЦІВ

У статті здійснюється теоретичний аналіз поняття «страх», визначається його сутність з точки зору різних психологічних течій. Наведено погляди вітчизняних та зарубіжних вчених щодо проблеми страху. Приведені думки науковців з приводу розмежування понять «страх» та «тривога». Визначено місце поняття «страх» в системі психологічних категорій. Проаналізовано особливості виникнення страхів в дітей дошкільного віку. Визначено переважаючі види дитячих страхів та умови переходу страхів у фобії. Показано вплив найближчого оточення дитини на виникнення в неї нав’язливих страхів. Вказано засоби та форми корекції страхів в дітей дошкільного віку. Проаналізовано роль механізмів психологічного захисту у нівелюванні дитиною власних страхів. Підкреслено необхідність надання психологічної допомоги дітям, в яких спостерігаються нав’язливі страхи та фобії.&#x0D; Ключові слова: страх, фобія, тривожність, емоції, дошкільний вік.&#x0D;

Quality of life, anxiety and depression of German, Italian and French couples undergoing cross-border oocyte donation in Spain.

What is the quality of life (QoL) and mental health of infertile heterosexual couples from different nations (Italy, Germany and France) undergoing cross-border oocyte donation (OD) in Spain? Women have lower QoL and more anxiety than their male partners; overall French couples have lower QoL than their Italian and German counterparts. In Europe, thousands of couples move across national borders annually to seek ARTs, primarily OD, driven mainly by legal restrictions in their countries of origin. Most research shows that infertility and ARTs affect patients' mental health and QoL. The decision to undergo reproductive care abroad might add further emotional and practical complexity. Reliable information on how this experience affects the mental health and QoL of cross-border reproductive care (CBRC) patients is lacking. Moreover, most research has focused on women, and further research on male partners and intercultural differences is needed. Cross-sectional study including 548 heterosexual individuals (347 women, 201 men) from Italy, Germany and France seeking IVF with donated oocytes in Barcelona, Spain between March and November 2013. A total of 432 couples were invited to participate and handed a questionnaire set. Questionnaires were answered separately and anonymously by each member of the couple on the day of embryo transfer. The questionnaire set included the Fertility Quality of Life (FertiQoL) instrument, the generic Hospital Anxiety and Depression Scale (HADS) instrument and three close-ended questions assessing perceived usefulness, desire, and use of psychological support. The overall response rate was 63.4%. Men reported significantly higher scores than women in the emotional (+13.74; P < 0.001), mind-body (+13.39; P < 0.001) and social (+4.11; P < 0.01) FertiQoL domains, at multilevel analysis controlled for confounder factors. Intercultural differences in QoL of couples were seen. French individuals had significantly lower emotional (-6.44; P < 0.01), mind-body (-7.41; P < 0.001) and relational scores (-6.41; P < 0.001) compared to Italians. Germans showed higher social scores (+6.41; P < 0.001) but lower relational scores (-8.94; P < 0.002) than Italians. Men reported significantly lower anxiety scores for the HADS than their partners (-1.38; P < 0.001), and German couples reported lower anxiety (-1.70; P = 0.003) and depression than their Italian counterparts (-1.56; P < 0.001). French patients were more likely to have required support by a mental health professional due to fertility problems in the past (+0.19; P < 0.001). The scope of this study is limited to heterosexual couples undergoing cross-border OD. Caution on the interpretation of the results in men is advised, mainly because only three men for every five women completed the questionnaire. These findings call for further work to identify the true nature of the differences in QoL and mental health observed. None.

Medical Care Before and During the Winter Paralympic Games in Turin 2006, Vancouver 2010 and Sochi 2014.

Medical care in disabled sports is crucial both as prophylaxis and as ongoing medical intervention. The aim of this paper was to present changes in the quality of medical care over the consecutive Paralympic Games (PG). The study encompassed 31 paralympians: Turin (11), Vancouver (12), and Sochi (8) competing in cross-country skiing, alpine skiing, biathlon and snowboarding. The first, questionnaire-based, part of the study was conducted in Poland before the PG. The athletes assessed the quality of care provided by physicians, physiologists, dieticians, and physiotherapists, as well as their cooperation with the massage therapist and the psychologist. The other part of the study concerned the athletes’ health before leaving for the PG, as well as their diseases and injuries during the PG. The quality of medical care was poor before the 2006 PG, but satisfactory before the subsequent PG. Only few athletes made use of psychological support, assessing it as poor before the 2006 PG and satisfactory before the 2010 and 2014 PG. The athletes’ health condition was good during all PG. The health status of cross-country skiers was confirmed by a medical fitness certificate before all PG, while that of alpine skiers only before the 2014 PG. There were no serious diseases; training injuries precluded two athletes from participation. The quality of medical care before the PG was poor, however, became satisfactory during the actual PG. The resulting ad hoc pattern deviates from the accepted standards in medical care in disabled sports.

The Prevalence and Determinants of Desire for and Use of Psychological Support in Patients With Low Vision.

The objective of this study was to identify the prevalence and determinants of desire for and use of psychological support in patients with low vision. The study was cross-sectional, utilizing telephone-administered interviews. Patients were recruited from Vision Australia and the Royal Victorian Eye and Ear Hospital with visual acuity of less than 6/12 in the better eye. Measures were the 9-item Patient Health Questionnaire, Stigma Scale for Receiving Psychological Help, Brief Illness Perception Questionnaire, and Impact of Vision Impairment Questionnaire. Of the total 161 participants (mean ± SD, 69.94 ± 15.76 years; 67% female), 63% desired psychological support, but only 20% reported ever receiving this. Higher levels of depressive symptoms and poorer coping in relation to vision impairment were significantly associated with desire for psychological support. Younger age, experience/s of depression, and beliefs about depression and its treatment were associated with use of professional support. Many patients with low vision desired psychological support but were not receiving this, suggesting barriers to receipt of care. This highlights the need for early screening of emotional difficulties, depression education, and easy access to psychological support within low vision services.