scholarly journals Accuracy of self-referral in health anxiety: comparison of patients self-referring to internet-delivered treatment versus patients clinician-referred to face-to-face treatment

BJPsych Open ◽  
2019 ◽  
Vol 5 (5) ◽  
Author(s):  
Ditte Hoffmann ◽  
Charlotte Ulrikka Rask ◽  
Erik Hedman-Lagerlöf ◽  
Trine Eilenberg ◽  
Lisbeth Frostholm
Keyword(s):  
Health Anxiety ◽  
Diagnostic Delay ◽  
Accurate Method ◽  
Diagnostic Interview ◽  
Self Report ◽  
Eligibility Criteria ◽  
Recruitment Methods ◽  
Face To Face ◽  
Symptom Profile ◽  
Mean Differences

Background Severe health anxiety is a chronic and costly disorder if untreated. Patient self-referral may lower barriers to treatment and decrease diagnostic delay. Aims This study evaluated the accuracy of self-referral for severe health anxiety and compared characteristics of patients self-referred to internet-delivered treatment with patients referred by a clinician to face-to-face treatment. Method Two trials in the same clinic employed different referral methods for health anxiety, namely self-referral and clinician-referral (trial registration: clinicaltrials.gov: NCT01158430 and NCT02735434). The trials were conducted at different time points but with largely comparable eligibility criteria. The accuracy of the recruitment methods was compared by looking at the number of eligible patients in the two trials. Patients completed a baseline questionnaire and subsequently underwent a diagnostic interview by experienced clinicians. Mean differences in self-report and clinical data explored between-group demographic and clinical characteristics. Results In total, 101/151 (67%) self-referred patients were eligible compared with 126/254 (50%) clinician-referred patients (P = 0.001). Self-referred patients were 3.4 years older (P = 0.008) and had a somewhat higher educational level (P = 0.030). Patients who self-referred reported significantly higher levels of health anxiety, emotional distress and somatic symptoms compared with clinician-referred patients. Yet, they had less clinician-assessed comorbid anxiety disorders (P<0.001) and better physical health-related quality of life (P<0.001) suggesting a more distinct symptom profile. Conclusions Self-referral was found to be an accurate method to recruit highly relevant patients with treatment-demanding health anxiety. Thus, both self-referral and clinician-referral seem feasible and valid referral methods, but they may recruit patients with slightly different characteristics. Declaration of interest None.

Real-time telerehabilitation for the treatment of musculoskeletal conditions is effective and comparable to standard practice: a systematic review and meta-analysis

2016 ◽  
Vol 31 (5) ◽  
pp. 625-638 ◽  
Author(s):  
Michelle A Cottrell ◽  
Olivia A Galea ◽  
Shaun P O’Leary ◽  
Anne J Hill ◽  
Trevor G Russell
Keyword(s):  
Usual Care ◽  
Physical Function ◽  
Real Time ◽  
Meta Analysis ◽  
Healthcare Delivery ◽  
Eligibility Criteria ◽  
Musculoskeletal Conditions ◽  
Face To Face ◽  
Conventional Methods ◽  
Mean Differences

Objective: To evaluate the effectiveness of treatment delivered via real-time telerehabilitation for the management of musculoskeletal conditions, and to determine if real-time telerehabilitation is comparable to conventional methods of delivery within this population. Data sources: Six databases (Medline, Embase, Cochrane CENTRAL, PEDro, psycINFO, CINAHL) were searched from inception to November 2015 for literature which reported on the outcomes of real-time telerehabilitation for musculoskeletal conditions. Review methods: Two reviewers screened 5913 abstracts where 13 studies ( n = 1520) met the eligibility criteria. Methodological quality was assessed using the Downs & Black ‘Checklist for Measuring Quality’ tool. Results were pooled for meta-analysis based upon primary outcome measures and reported as standardised mean differences and 95% confidence intervals (CI). Results: Aggregate results suggest that telerehabilitation is effective in the improvement of physical function (SMD 1.63, 95%CI 0.92-2.33, I2=93%), whilst being slightly more favourable (SMD 0.44, 95%CI 0.19-0.69, I2=58%) than the control cohort following intervention. Sub-group analyses reveals that telerehabilitation in addition to usual care is more favourable (SMD 0.64, 95%CI 0.43-0.85, I2=10%) than usual care alone, whilst treatment delivered solely via telerehabilitation is equivalent to face-to-face intervention (SMD MD 0.14, 95% CI −0.10–0.37, I2 = 0%) for the improvement of physical function. The improvement of pain was also seen to be comparable between cohorts (SMD 0.66, 95%CI −0.27–1.60, I2=96%) following intervention. Conclusions: Real-time telerehabilitation appears to be effective and comparable to conventional methods of healthcare delivery for the improvement of physical function and pain in a variety of musculoskeletal conditions.

scholarly journals Challenges of patient recruitment within emergency departments for qualitative research: lessons learnt from the GPs in EDs study

2020 ◽  
Author(s):  
Delyth Price ◽  
Michelle Edwards ◽  
Andrew Carson-Stevens ◽  
Alison Cooper ◽  
Freya Davies ◽  
...  
Keyword(s):  
Qualitative Research ◽  
Emergency Departments ◽  
Patient Recruitment ◽  
Eligibility Criteria ◽  
Future Studies ◽  
Recruitment Methods ◽  
Face To Face ◽  
Emergency Department Setting ◽  
Field Notes ◽  
Models Of Service Delivery

Abstract Background: At times of increasing pressure on emergency departments, and the need for research into different models of service delivery, little is known about how to recruit patients for qualitative research in emergency departments. We aimed to collect evidence on patients’ experiences of different models using general practitioners in emergency departments. Challenges were faced at all stages of patient recruitment, from identifying and inviting eligible patients, consenting them for participation, and finally to engaging them in interviews. Methods: By analysing processes, amendments and outcomes of recruitment methods, as well as conducting a thematic analysis of field-notes taken during research visits, this paper aimed to describe the factors which influenced patient recruitment in the GPs in EDs study, and make recommendations based on our learning. Results: We found the following factors influenced the success of patient recruitment in the emergency department setting: complicated or time-consuming electronic health record systems for identifying patients; narrow participant eligibility criteria; limited NHS research nurse support; and lack of face-to-face communication between researchers and eligible patients. Conclusions: This paper adds to the growing evidence for improving patient recruitment in different settings, with a particular focus on qualitative research in emergency departments. Our findings have implications for future studies attempting to recruit patients in similar settings.

Too Much to Bear

Crisis ◽  
2016 ◽  
Vol 37 (1) ◽  
pp. 59-67 ◽  
Author(s):  
Nicole J. Peak ◽  
James C. Overholser ◽  
Josephine Ridley ◽  
Abby Braden ◽  
Lauren Fisher ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Concurrent Validity ◽  
Medical Center ◽  
Psychiatric Patients ◽  
Preliminary Evidence ◽  
Diagnostic Interview ◽  
Veterans Affairs ◽  
Self Report ◽  
Perceived Burdensomeness ◽  
Scale Method

Abstract. Background: People who feel they have become a burden on others may become susceptible to suicidal ideation. When people no longer feel capable or productive, they may assume that friends and family members would be better off without them. Aim: The present study was designed to assess preliminary psychometric properties of a new measure, the Perceived Burdensomeness (PBS) Scale. Method: Depressed psychiatric patients (N = 173) were recruited from a veterans affairs medical center. Patients were assessed with a structured diagnostic interview and self-report measures assessing perceived burdensomeness, depression severity, hopelessness, and suicidal ideation. Results: The present study supported preliminary evidence of reliability and concurrent validity of the PBS. Additionally, perceived burdensomeness was significantly associated with higher levels of hopelessness and suicidal ideation. Conclusion: It is hoped that with the aid of the PBS clinicians may be able to intervene more specifically in the treatment of suicidality.

Application of the Non-adoption, Abandonment, Scale-up, Spread and, Sustainability (NASSS) Framework to evaluate the role of technology in the Pathways to Comorbidity Care (PCC) implementation project to improve management of comorbid substance use and mental disorders

2020 ◽  
Author(s):  
MariaGabriela Uribe Guajardo ◽  
Andrew James Baillie ◽  
Eva Louie ◽  
Vicki Giannopoulos ◽  
Katie Wood ◽  
...  
Keyword(s):  
Substance Use ◽  
Clinical Supervision ◽  
Mental Health Problems ◽  
Scale Up ◽  
Structured Interview ◽  
Barriers And Facilitators ◽  
Self Report ◽  
Evidence Based ◽  
Face To Face ◽  
Drug And Alcohol

Abstract (250 words)In substance use treatment settings, there is a high prevalence of comorbid mental health problems. Yet an integrated approach for managing comorbidity, implementation of evidence-based intervention in drug and alcohol settings remains problematic. Technology can help the adoption of evidence-based practice and successfully implement effective treatment health care pathways. This study sought to examine aspects of electronic resources utilisation (barriers and facilitators) by clinicians participating in the PCC training. MethodA self-report questionnaire and a semi-structured interview was designed to measure overall satisfaction with the PCC portal and e-resources available throughout the 9-month intervention for participating clinicians. An adapted version of the ‘Non-adoption, Abandonment, Scale-up, Spread and, Sustainability’ (NASSS) framework was used to facilitate discussion in regards to the study findings. ResultsA total of 20 clinicians from drug and alcohol services responded to all the measures. Facilitators of portal use included: i. clinician acceptance of the PCC portal; ii. guidance from the clinical supervisor or clinical champion that encouraged the use of e-resources. Some of the barriers included: i. complexity of the illness (condition), ii. clinicians’ preference (adopter system) for face-to-face resources and training modes (e.g. clinical supervision, clinical champion workshops), and iii. lack of face-to-face training on how to use the portal (technology and organisation).ConclusionBased on the NASSS framework, we were able to identify several barriers and facilitators including such as the complexity of the illness, lack of face-to-face training and clinician preference for training mediums. Recommendations include ongoing consultation of clinicians to assist in the development of tailored e-health resources and offering in-house training on how to operate and effectively utilise these resources.

Assessing OCD Symptoms and Severity

2012 ◽  
Author(s):  
Nicole M. Dorfan ◽  
Sheila R. Woody
Keyword(s):  
Treatment Plan ◽  
Behavioral Assessment ◽  
Assessment Tools ◽  
Self Report ◽  
Obsessive Compulsive ◽  
Self Monitoring ◽  
Evidence Based Treatment ◽  
Compulsive Disorder ◽  
Symptom Profile ◽  
Diagnostic Interviews

This chapter describes methods and tools for assessing obsessive compulsive disorder (OCD). The chapter outlines the purposes of assessment and discusses special challenges presented by OCD, such as shame associated with socially unacceptable obsessional content. Several types of assessment tools are discussed, including structured diagnostic interviews, semistructured clinician interviews to assess OCD symptom profile and severity, self-report instruments, behavioral assessment and self-monitoring, assessment of appraisals and beliefs relevant to OCD, and functional impairment. The importance of linking assessment findings to an evidence-based treatment plan is discussed.

scholarly journals Risk Factors for Oral Health in Anorexia Nervosa: Comparison of a Self-Report Questionnaire and a Face-to-Face Interview

2021 ◽  
Vol 18 (8) ◽  
pp. 4212
Author(s):  
Hélène Rangé ◽  
Alice Pallier ◽  
Aminata Ali ◽  
Caroline Huas ◽  
Pierre Colon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Anorexia Nervosa ◽  
Oral Health ◽  
Statistical Tests ◽  
The Self ◽  
Self Report ◽  
Short Version ◽  
Oral Diseases ◽  
Face To Face ◽  
Local Risk

Behavioral, nutritional, and local risk factors for oral health are frequent in people with anorexia nervosa. However no self-report questionnaire is available for screening in clinical practice or for research purposes. The objective of this study was to design a questionnaire to identify risk factors and symptoms of oral diseases and to test its reliability as a self-report form among people with anorexia nervosa. A 26-item questionnaire was designed based on a sound literature review performed by a group of dentists, psychiatrists, and epidemiologists specialized in the field of eating disorders. Sixty-nine anorexia nervosa inpatients (mean age 18.72 ± 5.1) were included from four specialized units. The questionnaire was first self-reported by the patients, then the same questionnaire was administrated by a dentist during a structured face-to-face interview as the gold standard. The concordance between the two forms was evaluated globally and item per item using Cohen’s kappa statistical tests. The overall concordance between the self-report questionnaire and the face-to-face structured interview was 55%. Of the 26 items, 19 showed significant concordance. Items relating to water intake, extracted teeth, gingival status, and oral hygiene had the best concordance (all kappa coefficients > 0.4). A questionnaire that identifies risk factors and symptoms of oral diseases in anorexia nervosa was developed and tested. The 26-item form of the questionnaire (long version) is moderately reliable as a self-reported form. A short version of the questionnaire, including the 10 most reliable items, is recommended for oral risk assessment in patients with anorexia nervosa. The clinical value of the self-administered questionnaire remains to be evaluated.

scholarly journals Conducting Population Health Research during the COVID-19 Pandemic: Impacts and Recommendations

2021 ◽  
Vol 13 (6) ◽  
pp. 3320
Author(s):  
Amy R. Villarosa ◽  
Lucie M. Ramjan ◽  
Della Maneze ◽  
Ajesh George
Keyword(s):  
Data Collection ◽  
Health Services ◽  
Data Quality ◽  
Population Health ◽  
Health Research ◽  
Alternative Methods ◽  
Residential Aged Care ◽  
Recruitment Methods ◽  
Face To Face ◽  
The Impact

The COVID-19 pandemic has resulted in many changes, including restrictions on indoor gatherings and visitation to residential aged care facilities, hospitals and certain communities. Coupled with potential restrictions imposed by health services and academic institutions, these changes may significantly impact the conduct of population health research. However, the continuance of population health research is beneficial for the provision of health services and sometimes imperative. This paper discusses the impact of COVID-19 restrictions on the conduct of population health research. This discussion unveils important ethical considerations, as well as potential impacts on recruitment methods, face-to-face data collection, data quality and validity. In addition, this paper explores potential recruitment and data collection methods that could replace face-to-face methods. The discussion is accompanied by reflections on the challenges experienced by the authors in their own research at an oral health service during the COVID-19 pandemic and alternative methods that were utilised in place of face-to-face methods. This paper concludes that, although COVID-19 presents challenges to the conduct of population health research, there is a range of alternative methods to face-to-face recruitment and data collection. These alternative methods should be considered in light of project aims to ensure data quality is not compromised.

Childhood trauma moderates morphometric associations between orbitofrontal cortex and amygdala: implications for pathological personality traits

2020 ◽  
pp. 1-10
Author(s):  
Nadia Bounoua ◽  
Rickie Miglin ◽  
Jeffrey M. Spielberg ◽  
Curtis L. Johnson ◽  
Naomi Sadeh
Keyword(s):  
Personality Traits ◽  
Childhood Trauma ◽  
Orbitofrontal Cortex ◽  
Functional Neuroimaging ◽  
Trauma Exposure ◽  
Diagnostic Interview ◽  
Emotional Dysregulation ◽  
Self Report ◽  
Traumatic Experiences ◽  
Pathological Personality Traits

Abstract Background Research has demonstrated that chronic stress exposure early in development can lead to detrimental alterations in the orbitofrontal cortex (OFC)–amygdala circuit. However, the majority of this research uses functional neuroimaging methods, and thus the extent to which childhood trauma corresponds to morphometric alterations in this limbic-cortical network has not yet been investigated. This study had two primary objectives: (i) to test whether anatomical associations between OFC–amygdala differed between adults as a function of exposure to chronic childhood assaultive trauma and (ii) to test how these environment-by-neurobiological effects relate to pathological personality traits. Methods Participants were 137 ethnically diverse adults (48.1% female) recruited from the community who completed a clinical diagnostic interview, a self-report measure of pathological personality traits, and anatomical MRI scans. Results Findings revealed that childhood trauma moderated bilateral OFC–amygdala volumetric associations. Specifically, adults with childhood trauma exposure showed a positive association between medial OFC volume and amygdalar volume, whereas adults with no childhood exposure showed the negative OFC–amygdala structural association observed in prior research with healthy samples. Examination of the translational relevance of trauma-related alterations in OFC–amygdala volumetric associations for disordered personality traits revealed that trauma exposure moderated the association of OFC volume with antagonistic and disinhibited phenotypes, traits characteristic of Cluster B personality disorders. Conclusions The OFC–amygdala circuit is a potential anatomical pathway through which early traumatic experiences perpetuate emotional dysregulation into adulthood and confer risk for personality pathology. Results provide novel evidence of divergent neuroanatomical pathways to similar personality phenotypes depending on early trauma exposure.

scholarly journals The Prevalence of Pain in People With Chronic Ankle Instability: A Systematic Review

2019 ◽  
Vol 54 (6) ◽  
pp. 662-670 ◽  
Author(s):  
Saeed Al Adal ◽  
Fereshteh Pourkazemi ◽  
Martin Mackey ◽  
Claire E. Hiller
Keyword(s):  
Physical Examination ◽  
Visual Analog Scale ◽  
Ankle Instability ◽  
Chronic Ankle Instability ◽  
Self Report ◽  
Functional Impairments ◽  
Ankle Pain ◽  
Analog Scale ◽  
Eligibility Criteria ◽  
Prevalence Of Pain

ObjectiveTo identify the prevalence of pain in people with chronic ankle instability (CAI) and how pain is related to the impairments of CAI.Data SourcesWe searched the databases of AMED, CINAHL, EMBASE, MEDLINE, PubMed, Scopus, SPORTDiscus, and Web of Science from inception to March 2017.Study SelectionEligible studies were peer-reviewed research in which investigators reported the presence of ankle pain or assessed the effects of pain on impairments in participants with CAI. Age and language were not restricted. Studies that included only surgical interventions were excluded.Data ExtractionStudies identified by the search strategy were screened according to the eligibility criteria, and 2 independent reviewers extracted the data. Outcome measurements were (1) pain ratings using measures such as a visual analog scale and (2) other residual impairments, such as feelings of weakness, giving way, or deficits in functional performance.Data SynthesisOf the 5907 records identified through the database search, 14 studies were included in this review. All authors assessed ankle pain by self-report questionnaires or physical examination, or both. Pain was self-reported by 23% to 79% of participants and present on physical examination in 25% to 75% of participants, depending on the test applied. Among these studies, the highest reported pain level was 4.9 on the 11-point visual analog scale. Studies were heterogeneous for pain measures, participant groups, interventions, and follow-up periods. The relationship between pain and the structural and functional impairments associated with CAI was not investigated in the included studies.ConclusionsPain was present in a large proportion of people who had CAI, but pain levels were low. Information about the effects of pain was not reported, so researchers should examine the association between pain and function, balance, or other activities in people with CAI.

scholarly journals Specificity of psychopathology across levels of severity: a transdiagnostic network analysis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Robin N. Groen ◽  
Marieke Wichers ◽  
Johanna T. W. Wigman ◽  
Catharina A. Hartman
Keyword(s):  
Diagnostic Interview ◽  
Illness Severity ◽  
Self Report ◽  
Global Network ◽  
Network Approach ◽  
Network Characteristics ◽  
Hyperactivity Disorder ◽  
Symptom Domains ◽  
Network Strength ◽  
Standardized Diagnostic Interview

AbstractA prominent hypothesis within the field of psychiatry is that the manifestation of psychopathology changes from non-specific to specific as illness severity increases. Using a transdiagnostic network approach, we investigated this hypothesis in four independent groups with increasing psychopathology severity. We investigated whether symptom domains became more interrelated and formed more clusters as illness severity increased, using empirical tests for two network characteristics: global network strength and modularity-based community detection. Four severity groups, ranging from subthreshold psychopathology to having received a diagnosis and treatment, were derived with a standardized diagnostic interview conducted at age 18.5 (n = 1933; TRAILS cohort). Symptom domains were assessed using the Adult Self Report (ASR). Pairwise comparisons of the symptom networks across groups showed no difference in global network strength between severity groups. Similar number and type of communities detected in the four groups exceeded the more minor differences across groups. Common clusters consisted of domains associated with attention deficit hyperactivity disorder (ADHD) and combined depression and anxiety domains. Based on the strength of symptom domain associations and symptom clustering using a network approach, we found no support for the hypothesis that the manifestation of psychopathology along the severity continuum changes from non-specific to specific.

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