A One-Session, Brief Acceptance and Commitment Therapy Workshop for Chronic Pain Patients: A One-Sample Pretest-Posttest Prospective Exploratory Study

Chronic pain affects one in every four persons (NIH, 2010). For individuals residing in rural communities where chronic pain treatment is often not accessible (Artnak et al., 2011), a one-session brief mental health intervention is a critical healthcare need. More specifically, acceptance and commitment therapy (ACT) for chronic pain is a novel treatment approach in need of more research (Society of Clinical Psychology, 2016). This current study contributes to the gap in the literature by implementing an ACT workshop in a rural healthcare setting for individuals with chronic pain. It was hypothesized that the workshop would increase adaptive coping mechanisms such as total pain acceptance, activity engagement, and pain willingness. Additionally, it was hypothesized that the workshop would decrease pain catastrophizing post-workshop. Nineteen participants completed pre- and four-week post-workshop questionnaires. The results of this study indicated that those who attended the workshop reported higher total pain acceptance and pain willingness as measured by the CPAQ-R (McCracken et al., 2004). There were no significant results for pain catastrophizing and activity engagement. A majority of the participants who attended the workshop and completed the follow-up questionnaires reported satisfaction with the group and would refer their family and friends to a similar workshop. Future recommendations are aimed at increasing intervention repertoire and providing insight on group composition and workshop layout

Baseline data of a longitudinal assessment of a Bachelor of Science in Health Science (BSHS) Program based on the core competencies for Interprofessional Collaborative Practice (IPCP)

Background: IPCP has been identified as essential to provide quality healthcare: so, IPE is being integrated to professional programs. While IPE is being researched in professional programs, not much is known about IPE at the pre-professional level. Purpose: Stockton’s BSHS program was built based upon the Core Competencies for IPCP. The current study assessed the following IPE-related constructs: Health Science Reasoning, Ethical Decision Making for Health, Attitude Towards Health Care Teams, and Readiness for IP Learning. Description: A cohort of students was recruited during the introductory course to the program. The following measures were administered at baseline: Health Science Reasoning Test (HSRT), Ethical Decision Making (EDM) Measure for Health Science, The Attitudes Toward Health Care Teams Scale (ATHCTS), Readiness for Interprofessional Learning (RIPLS) and demographic questions. Results: A cohort (N = 483) of students was recruited; N = 464 participated of the baseline. Results of main measures are: HSRT (M = 17.2, SD = 4.7), EDM (M = 2.18, SD = 0.20), ATHCTS (M = 4.1, SD = 0.47), RIPLS (M = 3.68, SD = 0.91). Results for subscales and demographic data will be included in the presentation. Conclusions: Results from EDM, ATHCTS and RIPLS suggest undergraduate pre-professional students’ Ethicality is at expected levels, they have positive attitudes toward healthcare teams and are prepared to receive IPE. However, the sample performed significantly below the expected level of critical thinking. Relevance: This suggests that students in an undergraduate health science program can receive interprofessional education, at least at the attitudinal and awareness level. IPE at this level can effectively foster positive attitudes towards working interprofessionally

Efficacy of Existing Interventions for Health Care Provider Stress & Implications for Low-Resource Health Care Settings: A Systematic Review

Introduction: There is a demand for interventions that may help providers cope with inevitably high levels of stress, but there is a paucity of data on the efficacy/feasibility of interventions for provider stress/burnout—particularly in low-resource settings. This study examined existing interventions and their effectiveness in combatting stress and burnout among providers. Methods: The traditional format of a systematic review was employed utilizing PubMed, PsycInfo, and SCOPUS to examine stress and burnout interventions offered to health care providers. Primary outcomes of stress/burnout were analyzed through the use of validated resilience scores. This study initially identified 1,720 records; twelve studies were included in the final review (6 RCT, 6 Observational). Results: Mindfulness-Based Stress Reductions (MBSR) and modified versions of MBSR proved effective in mitigating burnout among healthcare providers. Interventions involving work-hour adjustments and “Balint-type” discussion sessions demonstrated modest results with downward trends in burnout joined by a decrease in other secondary measurements like emotional exhaustion. Interventions focused on protected sleep periods, communication skills training combined with stress management, and online courses did not demonstrate statistically significant reductions in burnout or depression. Conclusion: Some of the mindfulness-based and focused educational interventions analyzed in this review show promise in the sustainable reduction in stress/burnout among physicians and nurses. This review also supports the need for and the potential benefits of long-term follow-up measures regarding healthcare provider stress/burnout interventions in order to develop feasible programs that may help low-resource setting providers that experience burnout in its most extreme form

Foundation degrees in biomedical science: the student experience

The first cohort of students on a University of Westminster foundation degree completed the course recently. Here, Chrystalla Ferrier, Kelly Brookwell and Paul Quinn employ some reflective practice

Advanced Practice Providers Recognized as Valuable Healthcare Resources: Increasing the Illinois PA’s Scope of Practice to Match Their NP Cohort

Abstract: Nurse practitioners (NPs) and physician assistants (PAs) represent a group of non-physician, advanced-practice providers (APPs) within our healthcare system. Non-physician providers are part of an inter-disciplinary team, working alongside physicians and a variety of allied healthcare providers. The purpose of this paper is to take a closer look at these two professions (NP and PA), with a focus on Illinois providers and the legislative strategies that guide their roles and abilities to practice. Illinois is a region where APP practices are inequitably regulated. Their Nurse Practice Act outlines a broad scope of practice for Advanced Practice Registered Nurses (APRNs). However, the Illinois PA Practice Act barely addresses the PA’s scope of practice, and also delineates certain restrictions, which limit practice in ways not paralleled for the NP. The goal of this paper was to construct an objective comparison between these two APP groups, in order to dispel the misconceptions that have led to these disparate Practice Acts. Specifically, the Master of Science in Nursing - Family Nurse Practitioner (MSN-FNP) training was compared to the Master of Science in Physician Assistant Studies (MSPA or MPAS) degree. Using these criteria, fifteen MSN-FNP programs were compared to nine MSPA programs among Illinois universities. Results revealed that NP and PA programs have similar educational objectives, all with demanding medical curricula, guided by strict accreditation standards. The data further revealed that Illinois PA educational training requires completion of more clinical practicum hours than does NP training: 704 (mean) hours for FNP students; compared to 2,108 (mean) hours for PA students. Furthermore, PA program accreditation requires that students complete practicum hours within seven medical fields, as well as elder care in long-term residential facilities, plus procedural skills training and proof of procedural skills competencies. Most NP programs are online and encourage concurrent nursing employment, thus supporting a part-time course load. NP programs are therefore designed to allow a flexible timeline for completion, some permitting five to six years. In comparison, all PA programs are full-time, in-person curricula, and discourage concurrent employment due to extensive course hours, and stringent requirements for advancement. The bottom line here is, NP and PA programs both have sound delivery methods and rigorous requirements, but longer chronological length should not be misinterpreted as greater in substance. Conclusion: This paper evaluated the highly advanced training programs of NPs and PAs in Illinois and found no data to support the differences in the Illinois Practice Acts governing these two groups. Despite the rigorous, highly advanced, and closely monitored training protocols of PA education, legislative bodies in Illinois do not fully recognize the PA provider’s significant potential. It is therefore, fair and reasonable to request these limitations be re-evaluated, in order to allow Illinois PAs to practice to the full potential of their professional training. In Illinois, NPs have achieved full provider status. Equal designation should be delegated to Illinois PAs

Exploring Older Adult Educational Tourism Experiences, Satisfaction and Well-being: A Pre-Post Travel Approach

This study attempts to develop a comprehensive understanding of the older adult educational tourism experiences through exploring the relationship between self-determined motivations, preferred tour attributes, memorable experiences, emotions, overall satisfaction, behavioral intentions and life satisfaction. By applying a concurrent mixed method design, the data will be collected from both pre-post travel surveys and semi structured interviews completed by Australians (50 years old or older) who participate in both domestic and international educational tour packages. It is anticipated the results of this study will demonstrate that educational tourism experiences provide a path to personal growth and the discovery of new meaning in life for older travelers with such journeys offering not only an opportunity to escape from everyday life but also a ‘transitional’ or temporary platform for reflection which ultimately a mean to achieve purpose, meaning and joy in life

Socioeconomic Factors that Affect Self-Management and Transition into Adult Care in Adolescents with Type I Diabetes

Effective transition from pediatric to adult health care during adolescence is crucial for patients with type 1 diabetes to insure adequate disease self-management in adulthood. To improve program delivery, it is important to understand if other socioeconomic barriers impede in successful transition preparation. To examine whether socioeconomic factors such as race, health insurance, and income affect diabetes self-management and transition readiness. The Transition Readiness Assessment in Diabetes (TRAiD), a self-assessment tool that covers diabetes self-management, health insurance, and future plans, was administered to all patients aged 14 and over. We generated a scale to measure readiness (0-8, higher value = higher transition readiness). We describe the differences in disease self-management, transition readiness, and whether outcomes vary by race, insurance status and income. There were 179 surveys completed. Mean readiness for all age groups was 5.9. We find a negative trend towards lower readiness in Hispanics (mean 5.4 vs whites mean 6.0, p=0.06), patients on public insurance (mean 5.7 vs mean 6.0 for private insurance, p = 0.2), and patients from lower income brackets (mean 5.9 for lowest income vs 6.1 for highest income, p = 0.6). Targeted intervention or additional support may be required for Hispanics. While there is a trend towards lower readiness in poor and publically insured patients, further evaluation is required to see if these factors are significant in a larger population