SAT0583-HPR - Differences between service providers and users when defining feasible optimal NHS occupational therapy treatment for patients with thumb base OA : results from a Delphi study

Background: The OTTER (OsTeoarthritis Thumb ThERapy) trial is a two-year developmental study for a full randomised controlled trial (RCT) into the clinical and cost effectiveness of an occupational therapy and splint intervention for thumb base OA. To develop an optimal package of care for evaluation within a multi-centre RCT, the views of both clinicians and patients are crucial. Objectives: To conduct a Delphi study to obtain agreement between both patients with thumb base OA and AHPs concerning the most appropriate optimal NHS OT programme, splint and placebo splint intervention to use in the RCT. Methods: The Delphi panel consisted of 63 AHPs experienced in treating adults with thumb base OA, and 7 patients with thumb base OA. The panel were asked to rate how much they agreed or disagreed about what optimal NHS OT care for thumb base OA should include, and what method(s) of delivery (individual one-to-one, group, patient leaflets, or telephone advice) they deemed were more appropriate. The Delphi study comprised 3 rounds. A seven-point Likert-type scale was used. Pre-defined inclusion and exclusion criteria were applied in order to reach a final number of statements which, in turn, created the desired tool. Group differences were analysed using Mann-Whitney U tests. Results: Between-groups analyses showed significant differences in the ratings of overall importance of items to be included in an optimal NHS OT consultation (Table 1). Conclusions: AHPs and patients differed in their views about the importance of including ‘Education for Family/Significant Others/Carers’, ‘NHS Clinic Procedures’, ‘Prognosis Advice’, ‘Referral to other Health Care Professional’, ‘Sleep Assessment and Management’ and ‘Treatment Options’ in an optimal NHS OT consultation, and in the methods of delivery used in the consultation. AHPs placed significantly less importance than patients on ‘One-to-One Contact’, ‘Leaflets’ and ‘Telephone Advice’. These findings demonstrate the importance of consulting with patients at an early stage in developing an intervention

Архетип свобода у контексті французької політичної теорії та історії

Розглянуто сучасні підходи щодо аналізу політичної ментальності. У межах політологічного аналізу окреслено коло проблем, які потребують вирішення з використанням підходів психології. Зроблено висновок про те, що архетип “свобода” становить важливий елемент політичної ментальності французів.Modern approaches of analysis of political mentality are considered. Within the limits of political science analysis outlined circle of problems which need decision with the use of approaches of psychology. A conclusion is done that archetype freedom makes the important element of political mentality of French’s

Behavioral Activation for Comorbid Depression in People With Noncommunicable Disease in India: Protocol for a Randomized Controlled Feasibility Trial

BackgroundThe increasing burden of depression and noncommunicable disease (NCD) is a global challenge, especially in low- and middle-income countries, considering the resource constraints and lack of trained human resources in these settings. Effective treatment of depression in people with NCDs has the potential to enhance both the mental and physical well-being of this population. It will also result in the effective use of the available health care resources. Brief psychological therapies, such as behavioral activation (BA), are effective for the treatment of depression. BA has not been adapted in the community health care services of India, and the feasibility of using BA as an intervention for depression in NCD and its effectiveness in these settings have not been systematically evaluated. ObjectiveOur objective is to adapt BA for the Indian NCD context and test the acceptability, feasibility, and implementation of the adapted BA intervention (BEACON intervention package [BIP]). Additionally, we aim to test the feasibility of a randomized controlled trial evaluation of BIP for the treatment of depression compared with enhanced usual care. MethodsFollowing well-established frameworks for intervention adaptation, we first adapted BA (to fit the linguistic, cultural, and resource context) for delivery in India. The intervention was also adapted for potential remote delivery by telephone. In a randomized controlled trial, we will be testing the acceptability, feasibility, and implementation of the adapted BA intervention (BIP). We shall also test if a randomized controlled feasibility trial can be delivered effectively and estimate important parameters (eg, recruitment and retention rates and completeness of follow-up) needed to design a future definitive trial. ResultsFollowing the receipt of approval from all the relevant agencies, the development of the BIP was started on November 28, 2020, and completed on August 18, 2021, and the quantitative data collection was started on August 23, 2021, and completed on December 10, 2021. Process evaluation (qualitative data) collection is ongoing. Both the qualitative and quantitative data analyses are ongoing. ConclusionsThis study may offer insights that could help in closing the gap in the treatment of common mental illness, particularly in nations with limited resources, infrastructure, and systems such as India. To close this gap, BEACON tries to provide BA for depression in NCDs through qualified NCD (BA) counselors integrated within the state-run NCD clinics. The results of this study may aid in understanding whether BA as an intervention is acceptable for the population and how feasible it will be to deliver such interventions for depression in NCD in South Asian countries such as India. The BIP may also be used in the future by Indian community clinics as a brief intervention program. Trial RegistrationClinical Trials Registry of India CTRI/2020/05/025048; https://tinyurl.com/mpt33jv5 International Registered Report Identifier (IRRID)DERR1-10.2196/4112