The Impact of Stakeholder Preferences on Service User Adherence to Treatments for Schizophrenia and Metabolic Comorbidities

<div><p>Objective</p><p>To determine how stakeholder opinions of treatments influence service user decisions to adhere to courses of actions necessary to treat metabolic conditions.</p><p>Methods</p><p>Qualitative open-ended interviews were conducted with 20 service providers, 25 service users, and 9 caregivers. Grounded theory was used to generate an understanding that linked preferences of care with adherence to follow-up treatments.</p><p>Results</p><p>Participants spoke about several considerations when discussing adherence: Resource limitations were the predominant consideration. Social considerations such as stigma and support surfaced in caregiver and service-user interviews. The influence of symptoms, especially their absence could reduce adherence, and organizational considerations related to the opinions they had about the qualifications of professionals.</p><p>Discussion</p><p>A rational patient model partially organizes our findings, but emotional components related to stigma and the opinion of service providers do not fit well into such a model. If service providers do not consider components of the decision making process which fall outside of the rational patient model, they may incorrectly be leveraging suboptimal values to bring about adherence to treatment plans. Being sensitive to the values of service users and their caregivers may allow service providers to better act on points that may bring about change in non-compliant service users with schizophrenia and metabolic comorbidities.</p></div

sj-docx-2-dhj-10.1177_20552076241247194 - Supplemental material for The relationship between therapeutic alliance, frequency of consultation and uptake of telemedicine among patients seeking treatment for early psychosis: A moderated mediation model

Supplemental material, sj-docx-2-dhj-10.1177_20552076241247194 for The relationship between therapeutic alliance, frequency of consultation and uptake of telemedicine among patients seeking treatment for early psychosis: A moderated mediation model by PV AshaRani, Yeow Wee Brian Tan, Ellaisha Samari, Peizhi Wang, Laxman Cetty, Pratika Satghare, Swapna K Verma, Charmaine Tang and Mythily Subramaniam in DIGITAL HEALTH</p

sj-docx-1-dhj-10.1177_20552076241247194 - Supplemental material for The relationship between therapeutic alliance, frequency of consultation and uptake of telemedicine among patients seeking treatment for early psychosis: A moderated mediation model

Supplemental material, sj-docx-1-dhj-10.1177_20552076241247194 for The relationship between therapeutic alliance, frequency of consultation and uptake of telemedicine among patients seeking treatment for early psychosis: A moderated mediation model by PV AshaRani, Yeow Wee Brian Tan, Ellaisha Samari, Peizhi Wang, Laxman Cetty, Pratika Satghare, Swapna K Verma, Charmaine Tang and Mythily Subramaniam in DIGITAL HEALTH</p

Image_1_The protective role of resilience and social support against burnout during the COVID-19 pandemic.jpg

BackgroundThe COVID-19 pandemic brought on a range of stressors in homes and workplaces. With no sign of ending after one year, burnout was a concern. Resilience has been known to shield against the effects of stress. While often thought of as an individual trait, previous studies have shown social support to improve resilience. The study aimed to examine the extent of burnout in the Singapore population and whether social support and resilience cushioned the impact of COVID-19 related stressors a year into the pandemic.MethodsParticipants were 858 Singapore residents who participated in a larger study between October 2021 and September 2022. The Copenhagen Burnout Inventory provided Work-and Personal-related burnout scores. Multivariable linear regression was used to identify demographic variables associated with burnout. Path analysis revealed the associations between COVID-19 stressors, social support, resilience and burnout.Results22 and 19% of the sample reported work and personal burnout respectively, with younger adults being more burnt out than older adults. Higher stress was associated with higher burnout and higher social support was associated with lower burnout. Path analysis revealed that the relationship between social support and burnout was partially accounted for by increased resilience.ConclusionManaging altered work arrangements, career expectations, and increased responsibilities at home may contribute to greater levels of burnout in the younger adults. Increased employer support and targeted interventions could mitigate the impact of these stressors. The study also highlighted the importance of maintaining social connections even while physically distancing.</p

sj-docx-1-tar-10.1177_17534666231224692 – Supplemental material for The significance of dynamic monitoring plasma TMAO level in pulmonary arterial hypertension – a cohort study

Supplemental material, sj-docx-1-tar-10.1177_17534666231224692 for The significance of dynamic monitoring plasma TMAO level in pulmonary arterial hypertension – a cohort study by Yicheng Yang, Xin Li, Peizhi Wang, Songren Shu, Bingyang Liu, Yanru Liang, Beilan Yang, Zhihui Zhao, Qin Luo, Zhihong Liu, Lemin Zheng, Qixian Zeng and Changming Xiong in Therapeutic Advances in Respiratory Disease</p

Table_1_Needs of patients with early psychosis: A comparison of patient’s and mental health care provider’s perception.DOCX

BackgroundNeeds define the capacity of a patient to benefit from health care services and a systematic assessment of needs allows planning and delivery of effective treatment to suit patients. This study aimed to understand the (a) needs felt by patients and those perceived by the care providers (CPs), (b) agreement between patients and CPs in the identified needs and (c) factors associated with unmet needs.MethodsParticipants (N = 215) were recruited through convenience sampling from the Early Psychosis Intervention Programme (EPIP). Data was captured from patients and CPs using the Camberwell Assessment of Needs Short Appraisal Schedule (CANSAS).ResultsPatients and CPs identified an average of 4.06 and 3.84 needs, respectively. The highest number of unmet needs were identified for the social (50% of patients and CPs) and health domains (31.13% of patients’ vs. 28.30% of CPs). Company, intimate relationships, psychotic symptoms, money, sexual expression and psychological distress, information and benefits were the unmet needs identified by patients, whereas company, intimate relationships, physical health, and daytime activities were identified by CPs. The concordance between patients and CPs was low with majority of the items scoring slight to fair agreement (Cohen’s kappa = 0–0.4). Older age, depression, severe anxiety and having Obsessive-Compulsive Disorder (OCD) were positively associated with unmet needs in patients.ConclusionWhile there was an overall consensus on the total needs and met needs between patients and CPs, the level of agreement between the two groups on various items were low. Different perceptions regarding unmet needs were noted between the groups. A holistic approach that takes into account different facets of the needs of patients together with strategic planning to address unmet needs might improve treatment outcomes and satisfaction.</p