The effect of remote fitting technology on hearing aid satisfaction

Background: Telemedicine is a method of providing remote healthcare services and consultations to patients using communication technology. Tele-audiology is a sub-branch of telemedicine. It refers to providing audiology services using telehealth strategies. This study aims to compare the satisfaction of patients who come to the hearing aid center and receive device fitting service and patients who have hearing aid fitting using tele-audiology service. For this purpose, hearing aid users were divided into two groups. The study group consisted of 17 participants (10 male, 7 females;mean age 65.17 +/- 13.88) who continued fitting appointments remotely after the first clinic application, while the control group consisted of 23 participants (10 males, 13 females;mean age 62.17 +/- 18.32) who had all hearing aid fittings performed face-to-face in the clinic. The participant's satisfaction was assessed with The International Outcome Inventory for Hearing Aids Turkiye (IOI-HA-TR) questionnaire because it is practical and can be administered over the phone. Result(s): There were no significant differences in hearing aid satisfaction between those who came to the hearing center and filled out the IOI-HA-TR questionnaire personally and those who completed it through the Remote Care application (p < 0.05). In addition, most of the participants stated that using Remote Care solved their problems (35% very good, 24% good) and they were satisfied with the fitting of their hearing aids with this application (35% good, 29% very good). In addition, 13 out of 17 participants stated that they would pay attention to the "remote fitting" feature when purchasing a new hearing aid (76% very good). Moreover, they would like to continue the fitting using the Remote Care application (65% yes). Conclusion(s): Remote fitting technology via smartphone applications can facilitate the lives of hearing aid users and improve their quality of life in cases of risky conditions such as pandemics, various diseases, and physical limitations.Copyright © 2023, The Author(s).

Consensus of Chinese experts on the work and demonstration of online Balint groups working committee on doctor-patient relationship, Chinese psychiatrist association, Chinese medical doctor association.

Balint group helps health professionals to get emotional support and different perspectives of feedback, inspire reflection, and alleviate job burnout. During the outbreak of COVID-19, it was difficult for medical staff to carry out the traditional form of in person Balint group. Referring to the work of international pilot online Balint group, leaders of Balint group all over China have accumulated some experience and encountered new problems by using the internet to carry out discussion. In order to assist and standardize the work of online Balint group and enrich the ways of expanding Balint work, the Working Committee on Doctor-patient Relationship, Chinese Psychiatrist Association, Chinese Medical Doctor Association organized experts to have two rounds of discussion, and developed the consensus on: Principles and forms of online Balint group, the way of using web platforms for demonstration and learning, matters needing attention, the future development, and so on.Copyright © 2021, Peking Union Medical College Hospital. All rights reserved.

Exploring the views of care home staff on the use of antipsychotics for people with dementia amid the COVID-19 pandemic: A qualitative study

Introduction: There was an increase in antipsychotic prescribing for people with dementia during the COVID-19 pandemic (1). To explain this increase, the current study was conducted to explore the views of staff working in care homes for the elderly during the pandemic on the use of antipsychotics for residents with Behavioural and Psychological Symptoms of Dementia (BPSD). Aim(s): The aim was to explore the use of antipsychotics for people with BPSD during the COVID-19 pandemic by interviewing staff in care homes about their experiences during that time. Method(s): Semi-structured interviews were conducted online with staff working in ten UK elderly care settings using convenience sampling. Participants mainly onsite care home staff were recruited through online networks, for example, Twitter, and support groups such as CHAIN and NIHR clinical research network. Interviews were conducted between May 2021-March 2022, were audio recorded, transcribed verbatim, and analysed inductively using thematic analysis in NVivo version 12. Result(s): Ten interviews were completed with managers (n=2), care staff (n=6) and nurses (n=2) in nursing homes (n=7) and residential homes (n=3) (all were female). The first theme 'Challenges experienced in care provision' entails challenges experienced in the care environment;residents were confined to their rooms, activities were suspended, staff were absent and stressed, and family visits were barred. The reduced human contact affected residents' sense of self, mental and physical wellbeing, and in turn, their behaviours. The second theme 'Prescribing process' refers to doctors prescribing medicines in response to staff raising concerns. The third theme 'Attitude toward antipsychotics' denotes participants' positive and negative beliefs about antipsychotics. The positive beliefs included antipsychotics being the right choice and beneficial, an increased need and continued use of antipsychotics, use of a combination of medications and weighing the risks and benefits of antipsychotics. The negative beliefs included reports of adverse effects and short-term benefits of antipsychotics, antipsychotics not always beneficial, benefits in deprescribing, dislike for antipsychotics and belief antipsychotics are the last resort. Some expressed the need for antipsychotics had not increased but been driven by health professionals involved. The fourth theme 'Other psychotropic medication' alluded to other commonly used psychotropic medications and associated risks and benefits. The fifth theme 'Measures implemented within care settings' represented strategies implemented to avert the initiation or bolster antipsychotic deprescribing such as non-pharmacological approaches, nurses' assessment of residents before requesting antipsychotics, multidisciplinary consultation, and medication review. Conclusion(s): This is the first study that reports care home staff views on antipsychotic use for residents with dementia during the pandemic. The limitations include that only views of female respondents were obtained and the limited sample size. Care homes faced enormous challenges in the provision of care services to residents with dementia during the pandemic. The multitude of difficulties experienced in care homes due to lack of preparedness may have influenced staff to have positive views of antipsychotics and their use as an option during the pandemic. It's important to acknowledge and address these difficulties for example through education and training interventions to help with future preparedness.

The healthcare experiences of patients with COPD: An IPA study

Introduction/Aim: Studies of the lived experience of Chronic Obstructive Pulmonary Disease (COPD) reveal a number of challenges patients face when interacting with healthcare providers that may be exacerbated by unwillingness or inability to quit smoking. However, none have explored, in-depth, primary care experiences among patients with COPD in community healthcare settings. The study investigated primary care experiences of patients living independently in the community with doctor diagnosed COPD, who smoke or had recently quit smoking and focused on how vulnerability, stigma and emotional components of care shape care experiences. Method(s): An Interpretative Phenomenological Analysis (IPA) involving thirteen participants purposively recruited from social media posts in COPD and carer support groups, general community groups, community noticeboards and paid adverts on social media. In-depth interviews were held between February and April 2022 by phone or Zoom TM and explored healthcare experiences, smoking, stigma and impact of care during COVID-19. Cross-case analysis was conducted to form group experiential themes. Result(s): Participants were aged between 45 to 75 years. Nine were female and two-thirds were current daily smokers. Both positive and negative experiences were explored. Problematic experiences including time-constrained consultations ('You're a number, and that's where I feel like a sheep and [that] can stress you out more'), having to self-advocate for care, and guilt about smoking were common. Positive care experiences described non-judgemental interpersonal interactions with doctors, timely referral, proactive care and trust ('I have an actual great trust for my GP. they're awesome, they'll look after you'). Conclusion(s): Pro-active, empathetic care from GPs is desired by patients living with COPD who continue to smoke but this is not always reflected in the lived experience of care. Stigma and fear of judgement were important underlying drivers of negative care experiences and need to be carefully considered in provision of care for this group.

Formation of a virtual cystic fibrosis support group: Connecting with Other Parents' Experiences

Background: Before the COVID-19 pandemic, families at a large pediatric cystic fibrosis (CF) center expressed interest in participating in support groups through informal oral feedback during CF clinic visits. Many barriers existed related to CF guidelines restricting in-person contact, traveling to the hospital to attend, feasibility of attending groups regularly, and lack of technology. The COVID-19 pandemic drastically improved the availability of telecommunication, which expanded options for support. This project involved development and implementation of a formal virtual support group for caregivers of children recently diagnosed with CF. Method(s): The psychosocial team (2 licensed clinical social workers, 2 psychologists,1psychology trainee)developedacurriculumwiththemesand discussion topics for each session that included processing and sharing diagnosis story, mobilizing support, treatment fears and frustrations, and celebrating milestones and successes. Eligible group members were caregivers of babies diagnosed with CF who were in their first year of life. All eligible caregivers were emailed to assess interest and collect feedback that was used to inform implementation of the group. A total of 12 families were eligible for the first round of Connecting with Other Parents' Experiences (COPE) group sessions and 14 families for the second round. The first cohort met biweekly in for six 90-minute sessions. After the initial group, adjustments were made based on feedback and participation. The second cohort met weekly for four 1-hour sessions. All participants were scheduled onthelicensedclinicalsocialworkers orpsychologyscheduleandjoinedeach session via the institution's HIPPA-secure virtual platform(Vidyo). Result(s): The first COPE group sessions were held from July to September 2020. Sixty-seven percent of eligible families expressed interest in participating (n = 8). Fifty percent of families who expressed interest in the group attended at least one session (n = 4). Each group session ranged from one to four families. The second COPE group sessions were held in October 2021. Sixty-four percent of eligible families expressed interest in participating (n = 9). Forty-four percent of families who expressed interest in the group attended at least one session (n = 4). Anecdotal evidence from the parent support groups has been overwhelmingly positive. Parents reported appreciating the social support and have begun to connect with each other outside of the group for ongoing support. Conclusion(s): COVID-19 and the increase in telemedicine expanded our ability to provide support to caregivers in away that had not been feasible previously. Caregivers were engaged and reported experiencing less isolation and normalization of emotions and challenges related to having a baby with CF. Several barriers to offering support groups exist, such as determining times that work for most families and interest in regular participationCopyright © 2022, European Cystic Fibrosis Society. All rights reserved

Every breath: the benefits of a lung cancer support group

Introduction: Cancer support groups provide valuable peer support for patients, carers and families. Lung cancer is the biggest cause of UK cancer deaths, but few local support groups exist due to patients' social vulnerabilities and stigma. A need was identified for a support group in Bromley, South East London. The COVID pandemic provided additional challenges to meet and support others. Method(s): The group was initiated by patients and the lung Clinical Nurse Specialist (CNS). Patients and relatives were invited to participate in a "lung cancer awareness" hospital stand. Sharing experiences was hugely beneficial leading to a regular meeting outside hospital. Patients established aims to provide: A voice for people living with lung cancer A sense of community, belonging and purpose A reason for hope The group is inclusive to patients, families and bereaved relatives. It survived the pandemic as an online community. Result(s): Every breath support group has been invaluable and feedback highlights the importance of a safe space to be understood. It successfully achieved its aims and continues to grow, with over 60 active members. It is recognised as the Bromley Mayors Charity of the year. Group members provide patient representation to local NHS Integrated Care Networks, and patient perspectives educating health professionals. Examples of group member feedback: "Every Breath has been like a family to me... This group have helped me find peace in the unknown." "Lung Cancer is the dirty cancer ... we are here to help support those in need and ... to change the perception of Lung Cancer" Conclusion(s): Every Breath support group offers a model for lung cancer support. Patients and CNS team have reached out to other areas to support establishing groups. Peer support has huge psychosocial benefits and should be available to every lung cancer patient and their family. Disclosure: No significant relationships.Copyright © 2023 Elsevier B.V.

Addressing the unmet social needs of gynecologic oncology patients as identified by a universal screening tool in a safety net hospital

Objectives: To identify the unmet, actionable social needs of gynecologic oncology patients using a self-administered social needs assessment tool and quantify the interventions subsequently provided to our patients. Method(s): This is a study of data collected in an ongoing performance improvement initiative in a gynecologic oncology clinic at a safety net hospital and was determined to be exempt from review by the institutional IRB. Eligible patients completed the social needs screening tool from October 2021 to March 2022. The following social needs domains were assessed: food insecurity, utility insecurity, housing insecurity, transportation insecurity, need for childcare, exposure to violence, lack of companionship, difficulty reading, or difficulty accessing medical care due to fear of losing job. Patients were asked if they desired to speak with a social worker and if any needs were urgent. Data from the screening tool was collected and supplemented by data from the EMR. Univariate descriptive statistics were used to report the patient demographic information, prevalence of social needs, and referral rates for social needs identified. Result(s): There were 475 patients seen in the gynecologic oncology clinic since October 2021. 286 (60%) patients completed the screening tool. 139 (49%) screened positive for at least 1 social need;of those 98 (70%) were Hispanic with a median age of 56 years. 27 (6%) patients were receiving treatment for a gynecologic malignancy, of whom 19 (70%) had at least 1 social need. 25 (92%) patients were insured through Medi-Cal. 12 (44%) patients were being treated for endometrial cancer, followed by ovarian (7, 26%) and cervical (4, 15%). The social needs identified in all patients and in patients actively receiving cancer treatment are summarized in Fig. 1. Patients reporting lack of companionship were referred to mental health or cancer support groups through the American Cancer Society or the Los Angeles County Department of Public Health. Those needing transportation or utility services were linked with services available through their insurance or LA County, ride share vouchers, low-income energy assistance programs, COVID rent/mortgage relief programs. Patients with food and housing insecurity were assisted in applying for public housing or food stamps;local food banks were provided. Patients were assisted with applying for disability insurance as needed. To date, all actively treated patients reporting lack of companionship, need for transportation, avoiding medical care for fear of losing their job, and utility insecurity were provided resources;80% received resources for food insecurity. Conclusion(s): Universal screening for social needs in gynecologic cancer patients identifies a high rate of unmet needs within a safety net hospital. Cancer care navigators can successfully provide these patients community-based resources tailored to their individual social needs. Our next steps will be to determine if and how these resources impact our patients' experiences and treatment outcomes.[Formula presented]Copyright © 2022 Elsevier Inc.

Program evaluation of a school-based support group for Latinx immigrant children

Rates of migration continue to rise in the United States;between 1965 and 2015, new immigrants and their ancestors accounted for 55% of population growth. In Latin America, ongoing violence, extreme poverty, and political instability force many families to migrate north to the United States. Before, during, and after migration, immigrant children are at risk of being exposed to traumatic events which may lead to mental health issues and impact their school adjustment. Community-based programming, such as school-based support groups, may be particularly helpful in addressing these risk factors and fostering resilience. Support groups have been found helpful in improving school adjustment, which includes school achievement, engagement, and retention. However, there is a lack of high-quality, methodologically rigorous support group programming. In addition, few of these school-based support groups have been evaluated using a structured, systematic process like a program evaluation. To address this gap, the study partnered with a local elementary school to conduct a program evaluation of their pilot program, the Newcomer Support Group (NSG). The NSG is a school-based support group for Latinx immigrant elementary-aged children. The study aimed to explore the program evaluation experience for stakeholders and the NSG's impact on participating children. Results revealed that the program evaluation was, overall, collaborative and informative for stakeholders. However, the NSG did not have a significant impact on Latinx immigrant children's school adjustment. The study explores the results, contributions, and limitations (e.g., the COVID-19 pandemic) in more depth. It is critical that school systems offer targeted, supportive spaces for Latinx immigrant youth and that these programs be evaluated carefully to assess overall impact. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Existential Correlates of Psychosocial Service Use Among GBM Caregivers in the COVID-19 Pandemic

Background/Purpose: Patients with Glioblastoma Multiforme (GBM) have complex care needs and poor prognoses, which places their caregivers at risk for existential distress and psychopathology. Many caregivers seek support in coping with this role;the COVID-19 pandemic further exacerbated caregiver distress and the demand for caregiver support services. The purpose of this study was to examine how psychosocial service use and barriers to use relate to existential distress, anxiety, and depression. Method(s): This study was part of a RCT examining Meaning-Centered Psychotherapy among 60 distressed caregivers of patients with GBM. At baseline, caregivers reported use of psychosocial services and barriers to seeking those services. Additionally, participants completed measures of meaning, existential distress, spiritual wellbeing, anxiety, depression, and caregiver burden. We descriptively analyzed use of healthcare services, prevalence and intensity of barriers to seeking support, and investigated their correlations with outcome measures. Result(s): The most common service endorsed was psychotropic medication use, with 29.3% of caregivers reporting using medications to cope, and it was the only service associated with significantly lower personal meaning and spiritual well-being, and higher anxiety. Of the barriers reported, difficulty finding support (46.4% endorsed), lack of time for support (35.1% endorsed), and caregiving responsibilities (33.9% endorsed) were the most common. Caregivers who endorsed difficulty finding support as a barrier had significantly higher levels of anxiety and depressive symptoms, lack of family support, and impact on schedule. Further, caregivers who reported higher perceived intensity of barriers had elevated levels of existential vacuum, anxiety, and depression. Conclusions and Implications: GBM caregivers often rely on psychotropic medication as a stopgap to manage distress, which may worsen existential distress and anxiety, likely because resources like talk therapy and support groups are inaccessible. These results underscore the need for expanded caregiver support services, and how barriers to these services may exacerbate existential distress and discourage caregivers.

COVID-19 and the Psychosocial Impact of Breast Health Delays

INTRODUCTION: Reallocation of resources during the COVID-19 pandemic resulted in delays for breast health care. Data are sparse regarding the impact of these delays on psychosocial outcomes. METHOD(S): Women seeking breast health care across a multi-site breast program in a large metropolitan area were assessed for psychosocial outcomes including depression, stress, and anxiety as it related to delays in care. Psychosocial outcomes were evaluated utilizing validated instruments (PROMIS, PHQ-9). Outcomes were stratified by treatment group (healthy, breast cancer, survivor) and Kaplan-Meier curves created for breast cancer patients to evaluate the relationship of time to treatment stratified by dichotomous psychosocial outcomes. Demographic and clinical data was ed from the electronic medical record. RESULT(S): 85 women enrolled in the study including 30 (35%) breast cancer patients, 24 (28%) healthy women, and 31 (36%) breast cancer survivors. Overall, 58% reported a delay in breast health care including surgery, radiation, chemotherapy, medical oncology treatments, clinical appointments, breast imaging and/or biopsies, survivorship follow-up, support groups, and/or screening. Compared to women in the no delay group, a greater proportion of women reporting a delay had high anxiety (78% vs. 58%;p = 0.06), high perceived stress (45% vs. 28%;p = 0.17), high loneliness (67% vs. 32%;p = 0.003), moderate or higher depression (16% vs. 8.3%;p = 0.34), and no or low emotional support (58% vs. 28%;p = 0.008). Among breast cancer patients, the first treatment modality was surgery in 73% and the median time to treatment was 33 days. The median time to treatment was 40 days for breast cancer patients reporting a delay compared to 28 days for patients reporting no delay. Longer time to treatment was observed among breast cancer patients with high versus low anxiety, perceived stress, loneliness, and depression and for patients with low versus high emotional support. CONCLUSION(S): Women with and without breast cancer reporting a delay had worse measures for anxiety, depression, perceived stress, loneliness, and emotional support. Longer time to treatment was experienced by breast cancer patients with worse psychosocial measures. Risk stratification of women seeking breast health care during the COVID-19 pandemic is needed to identify and support those at risk for adverse psychosocial outcomes. (Table Presented).

Providing Educational Resources during the Pandemic for Advanced Breast Cancer Patients

Significance and Background: Metastatic Breast Cancer (MBC) or Advanced Breast Cancer (ABC) is multifaceted and requires high levels of support and resource utilization. The ABC Program at MD Anderson Cancer Center began in 2014 with a goal to increase the quantity and quality of life for patients living with MBC. It offers emotional support, personalized visits with a nurse practitioner navigator, access to clinical trials, specialty clinics, tailored patient education and innovative care projects. Prior to COVID-19, the ABC Program held a 90-minute quarterly town hall series featuring 2-3 presenters and topics of patient interest. In response to COVID-19, it pivoted to a weekly virtual 60-minute educational series called "ABCs of Healthy Living in Challenging Times" that is for patients with breast cancer, caregivers, faculty, staff, community members and advocates. Purpose(s): To address COVID-19 social-distancing related isolation and changes to healthcare, build community, empower patients, and educate on diverse topics including patient services, treatment, symptom management and quality of life. Interventions and Evaluation: The series was facilitated by a nurse practitioner navigator via Zoom. A distribution list created from town hall meetings was the basis for the series' notices and has grown by referrals, word of mouth and marketing opportunities;it began with less than 150 people and has grown to more than 550 people. The facilitator offered a format where the attendees and speakers could interact visually and verbally with each other. From 4/2020 to 6/2022, 104 webinars were held for 2,546 attendees for an average of 24 attendees each week. Topics covered were side effect management/quality of life/healthy lifestyle (26%), patient education/empowerment (18%), treatment (19%), clinical trials/research (11%), quality of life related to COVID-19 (8%), COVID-19 (7%), innovation projects (4%), palliative/end of life care (7%), and financial/disability concerns (3%). The series was evaluated using the Qualtrics survey software (n=53). Respondents said that the series has positively influenced their interactions with healthcare providers (65%), how patients with MBC think about their cancer experiences (65%) and provided an opportunity to connect with others like themselves (65%). Respondents stated actions taken based on the series: shared the information with family/friends (77%), joined or remained in a support group (34%), spoke with a provider for information and services (32%), requested an appointment with the ABC Program or other specialty clinics (26%), started a new healthy behavior (21%), joined a clinical trial (11%), or started using a patient reported outcome tool (9%). The series served mostly patients living with MBC (70%), established patients at MD Anderson (38%) or patients at MD Anderson as well as a community cancer center (17%). Most respondents indicated that they attended about half of the time, usually or always (60%) and are very or completely satisfied with the series (92%). Demographics of the respondents were White (77%), Black (13%), Asian (4%) and Hispanic (16%). Discussion(s): The ABC Program pivoted to COVID-19 by offering services virtually. The virtual series has allowed for more digestible patient education, varied presentations, and participation for those living outside of Houston, TX. Peer support and continuing education are imperative dynamics for patients to use their voice to impact their overall quality of life. The series has impacted attendees with a change in behavior when speaking with their clinical team, awareness and utilization of support resources, and starting healthy behaviors. While the series was created in response to demands of COVID-19, it effectively addressed psychosocial and educational needs and overall quality of life of MBC patients. The series was an easy intervention to initiate with lasting changes relative to the effort and resources required.

Care and support for the covid - 19 bereaved family members: The counselor's role

Worldwide, COVID-19 outbreak has been impacting people. The death toll from Covid-19 has reached 57,50,868 globally, with 39,72,59,234 verified cases. In India, there are 4,24,10,976 confirmed cases of COVID-19, and the death toll has risen to 5,05,279. Everyone experiences bereavement at some point during their lifetime. It is a universal sensation. Many find that when they adjust and integrate their loss into their daily life, their level of sadness lessens over time. The grievers or carers may go through deep, persistent, and crippling grief that satisfies the DSM V criteria for Prolonged Grief Condition, a recognised mental disorder. The majority of people adjust after a loss, with two-thirds saying that their financial, emotional, and physical conditions remained unchanged. Severe dyspnea, patient seclusion, visitation limitations, death in intensive care units, anguish of patients/family members, and disruption of relatives' social support networks are the mourning risk factors. The following psychological interventions will be used in this study to attempt to illustrate the treatment, emotional support, and counselling available to bereaved family members and caregivers (Cognitive Behavior Therapy, Acceptance and Commitment Therapy, Art based therapy, Group Therapy, Traumatic Grief Therapy, Complicated Grief Therapy).Copyright © 2023, Anka Publishers. All rights reserved.

Support for patients with MBC

Over the last decade we have witnessed rapid advances in the treatment of patients with metastatic breast cancer (MBC) with seminal discoveries in cancer biology, correlative biomarkers and clinical trials leading to multiple new drug approvals. While these milestones have improved survival, the science of survivorship in this population is just beginning. The diagnosis of MBC is life-changing and requires individualized and multidisciplinary support. The NCI defined the areas of epidemiology and surveillance, symptom management, psychosocial research, health-care delivery, and health behaviors as necessary fields to advance the state of the science in advanced cancer survivors. A multifaceted program addressing these domains is needed to assess MBC patients and their unique and ever-changing needs. With input from patients and providers, program components should include: therapeutic clinical trials, multidisciplinary specialty care, individualized patient navigation, peer support, continuing education, and patient reported outcome (PRO) collection to support patients living with MBC. Input for a program for MBC patients can be guided by a multidisciplinary steering committee in which patient advocates are a major voice. Patients can provide insight into what works for them, and what they are facing may be very different from the experience of an early-stage breast cancer patient. Clinical trials designed to advance the current scientific knowledge of breast cancer treatment are essential to patients living longer, more fulfilled lives with MBC. Clinical trials may include systemic therapy, local therapies such as surgery and radiation for MBC patients, side-effect management and quality of life (may put elsewhere). A comprehensive systemic therapy portfolio should include all biological subtypes as well as recommended treatment options (hormonal therapy, targeted therapy, chemotherapy, and immunotherapy). Multidisciplinary care is necessary to diagnose and treat any condition the MBC patient may encounter and is essential in providing quality care. Comorbidities and debilitating side effects arising from cancer treatment are known to be associated with inferior outcomes. MBC patients may experience lack of familiarity of some providers with novel MBC cancer treatment, side effects, and interactions of their cancer treatment with non-cancer conditions and treatment. With the increasing life expectancy of MBC patients, it is important to manage the medical comorbidities in coordination with the MBC patient's cancer treatment. Integrative Medicine helps support the quality of life of patients through providing clinical modalities such as stress management, yoga, meditation, acupuncture, massage and lifestyle counseling. Supportive care helps support cancer related fatigue and sleep challanges, geriatrics and hospice and palliative care for advanced cancer patients. The role of navigation for MBC patients is unique and should be designed to support the patient's many individual needs. Navigation requires assessment of individual knowledge deficit, coordination of care challenges, internal resource utilization, cultural requests, and emotional health. Navigation should also address the patient's financial and disability questions, medication assistance, symptom management, advanced care planning and goals of care discussions. Additional items to be discussed during navigation visits include primary care provider utilization, COVID-19 vaccination, illness and medication questions, and other patient questions as they arise. A comprehensive registry of MBC patient's medical records and histories will assist researchers in designing future therapeutic and quality of life clinical trials. The categories of patient demographics, clinical variables, pathological variables, treatment variables, outcomes of MBC, and PROs will create a robust registry. A comprehensive patient registry can create a rich database which can guide and inspire future innovative research. Peer support through support groups and peer-to-peer matching s pivotal to MBC patients finding and utilizing their patient voice, emotionally supporting each other and learning from other's similar experiences. Connection between patients and the creation of a community of survivors can empower patients to positively impact their care through self-advocacy and self-efficacy. Continuing patient education is also essential to providing quality cancer care. The format of a weekly virtual education webinars are helpful in creating an engaged patient community and a platform to disseminate educational resources in a reoccurring digestible format. Frequent educational webinars covering a wide variety of topics can positively influence patient interactions with their healthcare providers and influence how patients living with MBC view their own cancer experience. Educational webinars provide opportunities for patients to connect with subject matter experts, other patients like themselves, and share information with their family and friends. Informed patients can discuss and ask questions more confidently with their health care providers about information and services presented during the educational webinars. The symptom profile of patients living with MBC are impacted by numerous variables such as disease burden, treatment plan, comorbidities, supportive regimen etc. The collection of PROs has been shown to improve patient satisfaction with his/her care, improve quality of life, decrease emergency room visits and hospitalizations, and increased overall survival. The routine measurement and management of MBC patients' symptoms has been found to be integral in providing comprehensive cancer treatment. The collection of PROs improves patient and provider communication and elicits the outcome to symptoms that matter most to each patient. Patients diagnosed with MBC are living longer because of the recent advancements in therapeutic treatments. A multifaceted and comprehensive program consisting of therapeutic clinical trials, multidisciplinary specialty care, individualized patient navigation, peer support, continuing education, and PROs collection is integral to fully support patients living with MBC.

The Psychological Impacts of COVID-19 on Breast Cancer Patients in China

Background: Approximately 30% to 50% of breast cancer patients experienced mental distress prior to the advent of COVID.The delayed access to cancer treatment due to the outbreak of COVID -19 pandemic posed a unique challenge to breast cancer patients and caused a significant level of mental distress among them. In the current research, we examined the psychological impacts of COVID on breast cancer patients in China using Symptom Checklist-90-R (SCL-90-R). Method(s): Participants were breast cancer patients at the outpatient clinic of Xijing hospital. The study was conducted virtually, and the questionnaires were distributed via Wenjuanxing, the Chinese alternative of Qualtrics. The researchers were healthcare workers affiliated with Xijing hospital, and the survey was sent to a breast cancer patient support group which included 1399 cancer patients and 6 healthcare workers. The initial sample consisted of 199 participants who signed an informed consent form to participate in the study. The inclusion criteria were as follows: 1) diagnosed with breast cancer, 2) aged 18 years or above, and 3) had no history of cognitive impairment or previous diagnosis of psychiatric disorders. The validated Mandarin version of the SCL-90-R (Wang, 1984) was then given to the participants to evaluate their psychological status.Categorical variables were summarized as numbers and percentages;continuous variables were described as mean (M) +/- standard deviation (SD). Data were analyzed using IBM SPSS Statistics Version 26. Result(s): Participants (N = 195) filled out the SCL-90 questionnaire in February, 2020. All participants were female breast cancer patients treated at Xijing hospital, among which 16.41%, 36.41%, 19.49%, and 28.21% had respectively received treatment for less than a year, 1-3 years, 3-5 years, and 5 years or more. 64.62% of the patients were at stage I;0.77% were at stage II and III;4.62% were at stage IV according to TNM classification. The molecular type of participants is as follows: 47.2% of ER+ HER2-, 31.8% of HER2+, and 21.0% of Triple negative.Participants whose treatments continued to be delayed, on average, reported an elevated general psychopathology score (M = 1.48, SD = 0.47) compared to participants whose treatments were resumed (M = 1.30, SD = 0.34), and the difference was statistically significant, t(193) = 2.96, p = .003, d = 0.44, 95%Cl [0.06, 0.30]. The one-way ANOVA revealed a marginally significant effect of length of treatment delay on general psychopathology score, F(4, 190) = 2.09, p = .08, eta2 = .04. Follow-up multiple comparison analysis showed that participants who had their treatment delayed for 3 weeks to 1 month (M = 1.70, SD = 0.70) reported significantly higher general psychopathology scores than participants whose delay in treatment was less than 1 week (M = 1.34, SD = 0.40), p = .05. General health status (p < .001) and current treatment status (p = .02) are the only two variables that were statistically associated with general psychopathology score.Poorer perceived health status and current delay in treatment were associated with higher general psychopathology score, Additionally, younger age was associated with higher interpersonal sensitivity (p = .01) and hostility (p = .006). Conclusion(s): We found that breast cancer patients at an advanced stage were more likely to experience psychological symptoms with longer treatment delay, and whose treatments continued to be delayed reported elevated psychological symptoms than individuals whose treatment were resumed, regardless of treatment type. Additionally, a treatment delay of more than three weeks might have exacerbated breast cancer patients' psychological symptoms, whereas a short-term delay of less than three weeks was less likely to have a significant effect on one's mental wellbeing.

Creating solace and hope during COVID-19: An innovative Internet-based social work intervention

During megacity lockdown, a team of social work practitioners and researchers in Beijing developed a rapid, innovative, Internet-based intervention that provided social-emotional support for participating families through indoor micro-gardening. As COVID-19 continues to restrict in-person interactions and traditional social activities, this type of online social-emotional support and community building should become a major social work method for crisis intervention and service provision. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Autism spectrum disorder, parent coping, and parent concerns during the COVID-19 pandemic.

The COVID-19 outbreak beginning in 2019 has created a challenging period for families who have children with autism spectrum disorder (ASD). The purpose of this study was to examine parents' perceptions about the consequences of the pandemic on their child who has ASD and parents' concerns and resources during the pandemic. Data was collected between July to November 2020 from U.S. parents who have at least one child with ASD between 3 and 21 years old. An online survey, consisting of 88 items, was developed and distributed online in newsletters and Twitter pages of several ASD organizations, and various caregiving support groups on Facebook. Descriptive analysis showed that during the data collection time (N = 57), 79% of the children had immediate access to electronic devices to utilize online services. Many of the children used remote learning services for less than 2 h (74%) per day. Many children had difficulties following social distance rules. They spent more time in passive activities than active activities. Twenty-five percent of parents reported that they drank alcohol more often during the pandemic. However, parents who participated in support groups consumed less alcohol. Also, child symptom severity was associated with parents taking less times for themselves. These results can assist practitioners in identifying specific difficulties that parents and children with ASD experienced during the pandemic. This work also underlines the parents' needs for community supports and mental health services.

Creating a Comprehensive Pandemic Response to Decrease Hospitalist Burnout During COVID-19: Intervention vs Control Results in 2 Comparable Hospitals (HOSP-CPR).

BACKGROUND: Physician burnout increased during the COVID-19 pandemic. OBJECTIVE: To evaluate the effectiveness of a multimodal workplace intervention designed to reduce hospitalist burnout. DESIGN: Participants and setting: Our intervention group was composed of internal medicine hospitalists at Providence Portland Medical Center (64 providers including 58 physicians and 6 nurse practitioners). Our control was composed of internal medicine hospitalists at Providence St Vincent's Hospital (59 physicians and 6 nurse practitioners). MEASUREMENTS: Two surveys were given during, before, and after a 12-month intervention period (October 2020 and again in October 2021). Surveys included demographics, job satisfaction, the Maslach Burnout Inventory, the Pandemic Experiences Survey, and 2 questions about leaving the job. INTERVENTIONS: Three hospitalists designated as wellness warriors created weekly COVID group meetings, providing up-to-date information about COVID-19 infection rates, treatments, and work-flow changes. Discussions included coping and vaccine hesitancy, difficult case debriefs, and intensive care unit updates. Individual coaching was also offered. Meeting minutes were taken and sessions were recorded for asynchronous access. RESULTS: No site differences in burnout or job satisfaction were evident pre-intervention. Post-intervention, the intervention group reported 32% burnout while controls reported 56% (p = .024). Forty-eight percent of the intervention group reported high wellness support vs. 0% of the controls (< .001). Intervention participants attributed 44% of wellness support to Providence alone, vs. controls at 12% (< .001). Regressions controlling sex, work hours, experience, race, and children in the home showed the intervention's positive effects on burnout and job satisfaction remained significant (all p < .02). LIMITATIONS: For privacy reasons, all survey responses were anonymous, meaning that individual pre-post changes could not be tracked. CONCLUSION: We believe the intervention resulted in substantial burnout prevention and is feasible for adoption in most hospitals and clinics.

The value of community psychiatric services for the elderly's dementia caregiver group: Exploring the perspectives of participants

Community Psychiatric Services for the Elderly (CPSE) at a large teaching hospital in Toronto has offered a monthly support group for caregivers of persons with dementia for over 30 years. Participants were surveyed in January 2018 about group attendance, benefits of attending the group, and areas for improvement. Results are shared in this case study. A total of 8 participants responded to the survey with a response rate of 47%. The feedback was predominantly positive. The most prevailing theme that emerged from the survey responses was group members' appreciation for the opportunity to meet with one another to discuss relevant issues and gain support from the facilitator and each other. Feedback from the survey also revealed opportunities for improvement on how the group could be better facilitated to elicit more equal participation from all group members. Formally assessing the value of the group from the perspectives of participants confirmed that the group is a safe place for dementia caregivers to get support and a valuable way to access knowledge from dementia care experts. COVID-19 has fostered evolution of the group from in-person to virtual meeting, opening opportunities for more feedback from members to help create the future of the dementia caregiver support group. © The Author(s), 2021.