This study highlights psychosocial needs of gynecological cancer survivors, contributing to evaluation of the Cancer Survivors Unmet Needs measure. Of the 45 participants, 28.9% reported clinical anxiety, 20.0% mild-to-severe depression, and 15.6% had probable posttraumatic stress disorder. Strength of unmet needs was associated with anxiety, depression, posttraumatic stress, poorer quality of life, younger age, and greater time since diagnosis. Linear regressions showed clinical measures, quality of life, optimism, and self-blaming coping style explained 56.4% of strength of unmet needs. Anxiety, functional well-being, posttraumatic stress, and emotional well-being accounted for 40.7% of variance in fear of recurrence, with emotional well-being the strongest predictor.
Background and Aims Inflammatory bowel disease is associated with psychosocial issues which reduce quality of life and impair medical management. However, these issues are rarely addressed in routine care. A model of integrated psychological screening and intervention was trialled to measure prevalence, patient participation, and potential benefits to mental health and/or quality of life. Methods During a 12-month period, 490 adult patients at an established hospital-based service were approached to complete screening instruments for anxiety, depression, general distress, quality of life and medication adherence. Disease-specific and demographic data were also collected. Patients who scored highly on screening questionnaires were offered psychological intervention (in-service or externally referred). Participants were reassessed after 12 months. Results Psychological screening was well accepted with 68% (N = 335) participating. Psychological care was ‘needed’, with 55% (N = 183) scoring highly for anxiety, depression and/or general distress. Half of those ‘in need’ (N = 91) accepted intervention. In those who accepted, levels of anxiety (mean at intake [M1] = 12.11 vs mean at follow-up [M2] = 9.59, p < 0.001), depression (M1 = 8.38 vs M2 = 6.42, p < 0.001), general distress (M1 = 17.99 vs M2 = 13.96, p < 0.001), mental health quality of life (M1 = 54.64 vs M2 = 59.70, p < 0.001) and overall quality of life (M1 = 57.60 vs M2 = 64.10, p < 0.001) each improved between intake and follow-up. Engagement in psychological intervention was six times greater for those treated in-service vs externally referred (χ2[1] = 13.06, p < 0.001, odds ratio = 6.47). Conclusions Mental health issues are highly prevalent in people with inflammatory bowel disease. Patients are open to psychological screening and treatment. Psychological care can improve patient mental health and quality of life, and works best when integrated into routine management.
Background Pharmacists are on the frontline caring for patients at risk of an opioid overdose and for patients with an opioid use disorder (OUD). Dispensing naloxone and medications for OUD and counseling patients about these medications are ways pharmacists can provide care. Key to pharmacists’ involvement is their willingness to take on these practice responsibilities. Methods The purpose of this scoping review is to identify, evaluate, and summarize published literature describing pharmacists’ attitudes toward naloxone and medications for OUD, i.e., methadone, buprenorphine, and naltrexone. All searches were performed on December 7, 2018, in 5 databases: Embase.com , PubMed.gov , Cumulative Index to Nursing and Allied Health Literature (CINAHL) via EBSCOhost, Cochrane Central Register of Controlled Trials via Wiley, and Clarivate Web of Science. Articles included original research conducted in the United States, described attitude-related language toward naloxone and medications for OUD, and pharmacists. Results A total of 1323 articles were retrieved, 7 were included. Five studies reported on pharmacists’ attitudes toward naloxone dispensing, 1 study reported on attitudes toward naloxone, buprenorphine, and buprenorphine/naloxone, and 1 reported on attitudes toward buprenorphine/naloxone. Respondents were diverse, including pharmacists from different practice specialties. Studies found that pharmacists agreed with a naloxone standing order, believed that naloxone should be dispensed to individuals at risk of an opioid overdose, and were supportive of dispensing buprenorphine. A minority of pharmacists expressed negative attitudes. Barriers cited to implementation included education and training, workflow, and management support. Conclusions Pharmacists were positive in their attitudes toward increased practice responsibilities for patients at risk of an opioid overdose or with an OUD. Pharmacists must receive education and training to be current in their understanding of OUD medications, and they must be supported in order to provide effective care to this patient population.
Purpose The authors conducted this scoping review to (1) provide a comprehensive evaluation and summation of published literature reporting on interprofessional substance use disorder (SUD) education for students in health professions education programs and (2) appraise the research quality and outcomes of interprofessional SUD education studies. Their goals were to inform health professions educators of interventions that may be useful to consider as they create their own interprofessional SUD courses and to identify areas of improvement for education and research. Method The authors searched 3 Ovid MEDLINE databases (MEDLINE, In-Process & Other Non-Indexed Citations, and Epub Ahead of Print), Embase.com, ERIC via FirstSearch, and Clarivate Analytics Web of Science from inception through December 7, 2018. The authors used the Medical Education Research Study Quality Instrument (MERSQI) to assess included studies’ quality. Results The authors screened 1,402 unique articles, and 14 met inclusion criteria. Publications dated from 2014 to 2018. Ten (71%) included students from at least 3 health professions education programs. The mean MERSQI score was 10.64 (SD = 1.73) (range, 7.5–15). Interventions varied by study, and topics included general substance use (n = 4, 29%), tobacco (n = 4, 29%), alcohol (n = 3, 21%), and opioids (n = 3, 21%). Two studies (14%) used a nonrandomized 2-group design. Four (29%) included patients in a clinical setting or panel discussion. Ten (72%) used an assessment tool with validity evidence. Studies reported interventions improved students’ educational outcomes related to SUDs and/or interprofessionalism. Conclusions Interprofessional SUD educational interventions improved health professions students’ knowledge, skills, and attitudes toward SUDs and interprofessional collaboration. Future SUD curriculum design should emphasize assessment and measure changes in students’ behaviors and patient or health care outcomes. Interprofessional SUD education can be instrumental in preparing the future workforce to manage this pressing and complex public health threat.
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