Patient-initiated second opinions during acute hospital care

Second opinions are used in medicine in order to make better-informed decisions. Only a few studies have examined patient-initiated second opinions, and even fewer have examined it in the context of acute hospitalization. It is not clear whether patients and families are aware of this right and how often they exercise it during acute hospitalization. The objective of this paper is to identify factors associated with the awareness and utilization of patient-initiated second opinions. A survey was conducted among 92 neurosurgical patients who completed a questionnaire that included information regarding: awareness of second opinion consultations, reasons for not seeking a second opinion, satisfaction from the second opinion and sharing the results of the second opinion with the first physician. Multivariate Logistic Regression analysis was performed to identify potential confounders associated with awareness and seeking a second opinion. Findings revealed that 79% percent of the participants were aware of their right to receive a second opinion; however, only 31% opted to receive a second opinion before/during the hospitalization. Fifty-eight percent received a second opinion related to previous medical conditions. Fifty-four percent did not inform the first physician about the results. The Logistic Regression showed that health insurance, education, religiosity and gender predicted awareness and utilization of second opinions. Current findings indicate that although patients are aware of their right to a second opinion and many have used it in the past, they rarely use it during acute hospitalization. Encouraging health professionals in hospitals to refer their patients to a second opinion as part of shared decision-making, may improve the liability and efficacy of patients\u27 care. Experience Framework This article is associated with the Quality & Clinical Excellence lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework) Access other PXJ articles related to this lens. Access other resources related to this lens

Palliative care in advanced dementia: comparison of strategies in three countries

Palliative care including hospice care is appropriate for advanced dementia, but policy initiatives and implementation have lagged, while treatment may vary. We compare care for people with advanced dementia in the United States (US), The Netherlands, and Israel. We conducted a narrative literature review and expert physician consultation around a case scenario focusing on three domains in the care of people with advanced dementia: (1) place of residence, (2) access to palliative care, and (3) treatment. We found that most people with advanced dementia live in nursing homes in the US and The Netherlands, and in the community in Israel. Access to specialist palliative and hospice care is improving in the US but is limited in The Netherlands and Israel. The two data sources consistently showed that treatment varies considerably between countries with, for example, artificial nutrition and hydration differing by state in the US, strongly discouraged in The Netherlands, and widely used in Israel. We conclude that care in each country has positive elements: hospice availability in the US, the general palliative approach in The Netherlands, and home care in Israel. National Dementia Plans should include policy regarding palliative care, and public and professional awareness must be increased.Geriatrics in primary carePublic Health and primary car

Beliefs About Dementia: Development and Validation of the Representations and Adjustment to Dementia Index (RADIX)

YesThe Self-Regulation Model (SRM) identifies that the beliefs people hold about an illness can influence their responses to that illness. Although there are generic measures of illness representations, there is a need for a brief tailored measure to use with people with dementia. The aim of this study was to develop and validate a brief measure called the Representations and Adjustment to Dementia Index (RADIX). The RADIX contains questions on the SRM elements: Identity, Cause, Timeline, Control, and Consequences. The RADIX validation was conducted with a sample of 385 community-dwelling people with mild to moderate dementia who were taking part in the IDEAL cohort study. Test-retest reliability was conducted over a 4-week period with a separate sample of 20 people with dementia. The validation process resulted in a reduction in the number of items in the Timeline, Control, and Consequences items. The resulting RADIX demonstrated good acceptability, internal reliability, and test-retest reliability. All the RADIX items had low missing data, indicating good acceptability. The factor analysis confirmed that the Consequences items formed two subscales (practical and emotional consequences) that had Cronbach's α of 8 and 0.91 respectively. Test-retest reliability indicated that the Identity, Timeline, and Control items had moderate reliability and the practical and emotional consequences scales had good reliability. The RADIX demonstrates acceptable psychometric properties, proves to be a useful measure for exploring people's beliefs about dementia, and could aid the provision of tailored information and support to people with dementia

Are Personal Resources and Perceived Stress Associated with Psychological Outcomes among Israeli Teachers during the Third COVID-19 Lockdown?

Teachers’ psychological responses during a pandemic, such as COVID-19, play an important role in their adaptation to the new routine. This research aimed to explore the association between personal resources (sense of control, social support), perceived stress, and three psychological outcomes (resilience, depression, loneliness) among teachers during the third COVID-19 lockdown in Israel. A cross-sectional study was conducted among 208 teachers. Significant associations were found between perceived stress, resilience, depression, and loneliness. Sense of control was significantly associated with perceived social support. The research model was tested using Structural Equation Modeling. The model yielded appropriate indices of fit (χ2(10) = 10.31, χ2/df = 1.03, p = 0.413, NFI = 0.970, NNFI = 0.997, CFI = 0.999, RMSEA = 0.012, 95%CI RMSEA = 0.077), demonstrating that the model fits the data well. Findings suggest that in order to improve teachers’ psychological health during a virus outbreak, it is recommended to pay attention to their personal resources and perceived stress

Illness representations of dementia: a scoping review

Shiri Shinan-Altman,1 Perla Werner2 1The Louis and Gabi Weisfeld School of Social Work, Faculty of Social Sciences, Bar Ilan University, Ramat Gan, Israel; 2Department of Community Mental Health, University of Haifa, Haifa, Israel Abstract: As the number of persons with dementia grows, an increasing number of families, professionals, and laypersons will come into contact with persons with cognitive deterioration. Assessing dementia illness representations (IRs) among these groups may have great importance for understanding their responses to dementia. The purpose of this study was to summarize and critically review the literature on dementia IRs. A total of 25 articles that satisfied the inclusion criteria were identified. The review revealed that conceptually, research attention on dementia IRs has increased over the past several years as a result of changes in the notion of IRs and in the dementia discourse. Regardless of the population examined, dementia was mostly described as a chronic condition, presenting more cognitive than behavioral symptoms, and as being caused mainly by age, heredity, and abnormal brain changes. Methodologically, the area of dementia IRs is characterized by design, sample, and data collection weaknesses. Findings suggest that although the literature in the area of dementia and IRs is increasing, several conceptual and methodological limitations still have to be resolved in order to advance knowledge in the area. The research and clinical implications of these findings stress the importance of IRs in the area of dementia. Keywords: dementia, illness representations, scoping revie

Factors Associated with Pro-Environmental Behaviors in Israel: A Comparison between Participants with and without a Chronic Disease

This study examined differences regarding climate change pro-environmental behaviors (PEBs), comparing between individuals with chronic diseases and those without. A cross-sectional survey was conducted among 402 adults, of whom 25% had a chronic disease. Participants completed measures for PEBs, climate change exposure (i.e., exposure to its effects), climate change risk appraisal, environmental self-efficacy, collective efficacy, and sociodemographic variables. Results revealed a significant difference between participants with and without chronic diseases in climate change risk appraisal. Having a chronic disease was associated with higher climate change risk appraisal (β = 0.16, p < 0.001), which in turn was associated with higher collective efficacy (β = 0.29, p < 0.001). The latter was associated with more PEBs (β = 0.10, p = 0.049). Furthermore, higher climate change exposure was associated with higher climate change risk appraisal (β = 0.49, p < 0.001), which in turn was associated with collective efficacy (β = 0.29, p < 0.001). The latter was associated with more PEBs (β = 0.10, p = 0.049). In addition, higher climate change exposure was directly associated with both self-efficacy (β = 0.33, p < 0.001) and collective efficacy (β = 0.10, p = 0.049), which in turn were associated with more PEBs (β = 0.28, p < 0.001 and β = 0.10, p = 0.049, respectively). This study highlights the need to provide efficacy-enhancing information in climate change messaging for PEBs in general. A threat component in environment-relevant messages for people with chronic diseases, specifically, should also be adopted

The Association between Climate Change Exposure and Climate Change Worry among Israeli Adults: The Interplay of Risk Appraisal, Collective Efficacy, Age, and Gender

Guided by the transactional model of stress and coping, we examined the association between climate change exposure and climate change worry among Israeli adults, with the interplay of risk appraisal, collective efficacy, age, and gender. Using an online survey with 402 participants, we found moderate levels of climate change worry. Higher climate change exposure, increased risk appraisal, and greater collective efficacy were associated with higher worry levels. Climate change risk appraisal mediated the relationship between climate change exposure and worry, whereas gender moderated the association between collective efficacy and worry. This study highlights the significant impact of climate change exposure on worry, emphasizing the roles of risk appraisal and collective efficacy, particularly among women, and underscores the need for tailored interventions to address emotional responses to climate change

Depression and Medicine Use among Older Adults during the COVID-19 Pandemic: The Role of Psychosocial Resources and COVID-19 Perceived Susceptibility

A relationship was found between the COVID-19 pandemic and depression among older adults and between depressed mood and increased use of antidepressant medication among older adults during the pandemic. With the aim of broadening the understanding of these relationships, the study examined whether COVID-19 perceived susceptibility mediates the relationship between psychosocial resources (optimism and perceived social support) and depressive symptoms and medication use. Participants included 383 older adults (M = 71.75, SD = 6.77) reporting on socio-demographics, health characteristics, depression, optimism, social support, and COVID-19 perceived susceptibility. Medication use was retrieved from participants medical files. Lower optimism, lower social support, and higher COVID-19 perceived susceptibility were associated with greater depression, related with higher medication use. The findings emphasize the buffering effect of psychosocial resources on the adverse effects of depression affecting older adults during the COVID-19 pandemic, and consequently, the increased use of medication in this population. Practitioners should focus interventions on enhancing optimism and expanding social support among older adults. Moreover, interventions focused on alleviating depression among older adults should aim at improving perceptions of perceived susceptibility in the older population

Arab Teachers’ Well-Being upon School Reopening during COVID-19: Applying the Job Demands–Resources Model

Once the major threat of the COVID-19 pandemic diminished, schools reopened, and teachers once again had to cope with unprecedented challenges. The impact of these challenges on the emotional well-being of Arab teachers, who have a unique set of challenges within the Israeli school educational system, has received little attention in the recent literature. In this cross-sectional study, we examined 300 Arab teachers’ well-being in Israel in May 2021, three months after schools were reopened. All study hypotheses were confirmed. Findings indicate the need to promote a sense of well-being among Arab teachers in stressful conditions and to design solutions specifically tailored to support them in accordance with their cultural and social characteristics. Israel’s Ministry of Education should encourage school administrators to seek ways to provide a supportive environment for Arab teachers in school environments in order to improve their performance and retention, and maintain their well-being