Examining the Relationship between Intrinsic Drivers of Motivation and Functional Outcomes in a Cross-Section of Individuals with Psychotic Disorders

Impaired functioning is recognized as a major barrier to recovery among individuals with psychotic disorders. Research on the role of negative symptomatology on functioning has identified avolition (i.e. lack of motivation) as being highly correlated with functional outcomes. However, current measures of avolition fail to consider more intrinsic factors that influence motivation. There is a need for more nuanced research on the drivers of motivation and their relationship with functioning to inform the observed relationship between avolition and impaired functioning. This cross-sectional study uses data obtained from the Prevention and Early Intervention Program for Psychoses, in London, Ontario. 105 clients of PEPP were assessed using validated measures of motivational drivers. Multivariate analyses did not show a statistically significant relationship between the intrinsic drivers of motivation and functional outcomes. Findings demonstrate the need for updated measures of negative symptoms as well as the need for further research on motivation and functional outcomes

Encouraging Exercise in Pregnancy Through a Video Education Tool: A Pilot Study

Topics in Exercise Science and Kinesiology Volume 4: Issue 1, Article 17, 2023. Evidence-based guidelines recommend physical activity during pregnancy, however, most pregnant individuals fail to achieve the minimum recommended amount of physical activity. Uncertainty about the safety of physical activity is a common reason why pregnant individuals do not participate in regular physical activity. The purpose of this study was to develop an evidence-based educational video and evaluate its effectiveness at improving pregnant individuals’ attitudes regarding the safety of physical activity during pregnancy. Pregnant individuals attending their first prenatal appointment from an urban academic interprofessional teaching unit in Toronto, Canada were invited to participate. Participants (n=37) completed a survey during their first trimester (x̄= 12.4 weeks gestation) before watching an evidence-based physical activity safety video. The cohort was then asked to complete surveys two months later in their second trimester (x̄= 22.6 weeks gestation) after watching the video. While all participants felt confident engaging in physical activity pre-intervention (100%), most participants expressed benefit from further education (80.8%). After watching the video, there was a significant difference in participants’ beliefs regarding high impact activities (p=0.03) and knowledge about physical activity amount as recommended by current guidelines (p\u3c0.01). Overall, participants felt the video improved their knowledge about the safety of physical activity during pregnancy (90.9%) and they would recommend the video to other pregnant individuals (95.5%). The evidence-based video provided to patients early in pregnancy appears effective in reinforcing positive attitudes towards the safety of prenatal physical activity. Future studies exploring more diverse populations are needed to confirm the results of this pilot study

Pregnant during the COVID-19 pandemic: an exploration of patients’ lived experiences

Abstract Background Infectious outbreaks are known to cause fear and panic. Exploration of pregnant individuals’ psychosocial condition using a qualitative lens during an infectious outbreak is limited. In this study we explore pregnant individuals’ lived experiences as well as their psychological and behavioural responses during COVID-19 with the goal of providing useful strategies from the patient’s perspective to enable health care providers to help pregnant patients navigate this and future pandemics. Methods Pregnant individuals between 20-weeks gestation and 3 months postpartum who received maternity care from an urban academic interprofessional teaching unit in Toronto, Canada were invited to participate. Semi-structured 60 min interviews were audio-recorded, transcribed and analyzed using descriptive thematic analysis. Interview questions probed psychological responses to the pandemic, behavioural and lifestyle changes, strategies to mitigate distress while pregnant during COVID-19 and advice for other patients and the healthcare team. Results There were 12 participants, mean age 35 years (range 30–43 years), all 1 to 6 months postpartum. Six main themes emerged: 1) Childbearing-related challenges to everyday life; 2) Increased worry, uncertainty and fear; 3) Pervasive sense of loss; 4) Challenges accessing care; 5) Strategies for coping with pandemic stress; 6) Reflections and advice to other pregnant people and health care professionals. Pregnant individuals described lack of social support due to COVID-19 pandemic restrictions and a profound sense of loss of what they thought their pregnancy and postpartum period should have been. Advice to healthcare providers included providing mental health support, clear and up to date communication as well as more postpartum and breastfeeding support. Conclusions These participants described experiencing psychosocial distress during their pregnancies and postpartum. In a stressful situation such as a global pandemic, health care providers need to play a pivotal role to ensure pregnant individuals feel supported and receive consistent care throughout the pregnancy and postpartum period. The health care provider should ensure that mental health concerns are addressed and provide postpartum and breastfeeding support. Without addressing this need for support, parental mental health, relationships, parent-infant bonding, and infant development may be negatively impacted

Participatory video as a novel recovery-oriented intervention in early psychosis: A pilot study.

BACKGROUND: Personal narrative plays an important role in the process of recovery from psychotic illnesses. Participatory video is a novel, active intervention that can be used as a tool for fostering narrative development among people with psychosis. AIM: To assess the feasibility, acceptability and potential clinical utility of participatory video as an innovative tool for promoting recovery in early psychosis. METHODS: Ten outpatients of an early psychosis intervention programme were recruited to participate in 13 biweekly workshops to plan, film and produce documentary-style videos of their experiences. Feasibility was measured through recruitment and retention. Acceptability was measured through workshop attendance and client satisfaction. Clinical outcomes were assessed at baseline, post intervention and 3 months post intervention. RESULTS: The participatory video intervention was feasible and associated with a high degree of satisfaction for participants who completed the workshops ( CONCLUSIONS: The findings of this pilot study suggest that participatory video is feasible and acceptable for individuals with early psychosis. This study also provides important pilot data supporting a larger trial investigating the effectiveness of participatory video as a recovery-oriented intervention

A pilot study of participatory video in early psychosis: Qualitative findings.

For people with psychotic disorders, developing a personal narrative about one\u27s experiences with psychosis can help promote recovery. This pilot study examined participants\u27 reactions to and experiences of participatory video as an intervention to help facilitate recovery-oriented narrative development in early psychosis. Outpatients of an early psychosis intervention program were recruited to participate in workshops producing short documentary-style videos of their collective and individual experiences. Six male participants completed the program and took part in a focus group upon completion and in an individual semistructured interview three months later. Themes were identified from the focus group and interviews and then summarized for descriptive purposes. Prominent themes included impacts of the videos on the participants and perceived impacts on others, fulfilment from sharing experiences and expressing oneself, value of collaboration and cohesion in a group, acquiring interpersonal and technological skills, and recommendations for future implementation. Findings of this study suggest that participatory video is an engaging means of self-definition and self-expression among young people in recovery from early psychosis

A pilot study of participatory video in early psychosis: Qualitative findings

For people with psychotic disorders, developing a personal narrative about one’s experiences with psychosis can help promote recovery. This pilot study examined participants’ reactions to and experiences of participatory video as an intervention to help facilitate recovery-oriented narrative development in early psychosis. Outpatients of an early psychosis intervention program were recruited to participate in workshops producing short documentary-style videos of their collective and individual experiences. Six male participants completed the program and took part in a focus group upon completion and in an individual semistructured interview three months later. Themes were identified from the focus group and interviews and then summarized for descriptive purposes. Prominent themes included impacts of the videos on the participants and perceived impacts on others, fulfilment from sharing experiences and expressing oneself, value of collaboration and cohesion in a group, acquiring interpersonal and technological skills, and recommendations for future implementation. Findings of this study suggest that participatory video is an engaging means of self-definition and self-expression among young people in recovery from early psychosis

A pragmatic randomized trial of a primary care antimicrobial stewardship intervention in Ontario, Canada

Abstract Background More than 90% of antibiotics are prescribed in primary care, but 50% may be unnecessary. Reducing unnecessary antibiotic overuse is needed to limit antimicrobial resistance. We conducted a pragmatic trial of a primary care provider-focused antimicrobial stewardship intervention to reduce antibiotic prescriptions in primary care. Methods Primary care practitioners from six primary care clinics in Toronto, Ontario were assigned to intervention or control groups to evaluate the effectiveness of a multi-faceted intervention for reducing antibiotic prescriptions to adults with respiratory and urinary tract infections. The intervention included provider education, clinical decision aids, and audit and feedback of antibiotic prescribing. The primary outcome was total antibiotic prescriptions for these infections. Secondary outcomes were delayed prescriptions, prescriptions longer than 7 days, recommended antibiotic use, and outcomes for individual infections. Generalized estimating equations were used to estimate treatment effects, adjusting for clustering by clinic and baseline differences. Results There were 1682 encounters involving 54 primary care providers from January until May 31, 2019. In intervention clinics, the odds of any antibiotic prescription was reduced 22% (adjusted Odds Ratio (OR) = 0.78; 95% Confidence Interval (CI) = 0.64.0.96). The odds that a delay in filling a prescription was recommended was increased (adjusted OR=2.29; 95% CI=1.37, 3.83), while prescription durations greater than 7 days were reduced (adjusted OR=0.24; 95% CI=0.13, 0.43). Recommended antibiotic use was similar in control (85.4%) and intervention clinics (91.8%, p=0.37). Conclusions A community-based, primary care provider-focused antimicrobial stewardship intervention was associated with a reduced likelihood of antibiotic prescriptions for respiratory and urinary infections, an increase in delayed prescriptions, and reduced prescription durations. Trial registration clinicaltrials.gov ( NCT03517215 )