Health Bias in Clinical Work with Older Adult Clients: The Relation with Ageism and Aging Anxiety.

OBJECTIVES: This experimental study examined health bias in mental health trainees' ratings of work with an older adult client and whether differences based on health were moderated by aging anxiety and ageist attitudes. METHODS: Graduate-level mental health trainees (N = 488) were randomly assigned to read a vignette of an older adult client in good health or poor health, after which they rated aspects of clinical work with this client and completed measures of aging anxiety and ageist attitudes. RESULTS: Trainees rated clinical work with the unhealthy older adult client more negatively than with the healthy older adult client. Health-based differences were larger at average and higher levels of ageist attitudes when considering the appropriateness of the client for therapy and at average and higher levels of aging anxiety for perceived competence to treat and comfort in treating the presenting complaint. CONCLUSIONS: Trainees' health bias toward older adults may be magnified by higher aging anxiety and ageist attitudes. Training programs' intervention on these variables may improve geropsychological competencies of future mental health professionals. CLINICAL IMPLICATIONS: Quality of mental health care for older adult clients may be compromised when biases about older adults, particularly those in poor health, are not addressed.

Addressing Barriers to HIV Point-of-Care Testing in Community Pharmacies.

Significant numbers of human immunodeficiency virus (HIV) infections are transmitted unknowingly, making efforts to increase HIV testing accessibility crucial. As trusted healthcare providers, pharmacists can increase accessibility of HIV screening and referral services. However, challenges with lack of private counseling and testing space, need for training and education, lack of adequate staffing, heavy workload, and uncertainty supporting patients with reactive results have been previously reported by community pharmacists as barriers to offering HIV screening. The objective of this study was to investigate pharmacists' opinions of strategies for addressing these barriers. A survey was developed to gather information regarding steps that could be taken to increase pharmacist comfort and interest offering HIV point-of-care testing (POCT) services. Thirty pharmacies were contacted and representatives from twenty-six responded. Pharmacists reported that they were likely or very likely to offer HIV POCT if they were given the following: a 2 h training session on administering and interpreting HIV POCT (73%); a 4 h education session on a variety of HIV education topics (73%); training about couples testing, post-test counseling, and de-escalation techniques (58%); or a semi-annual CE training (58%). Pharmacist respondents were likely or very likely (81%) to implement HIV POCT if there was a protocol in place so that patients with a reactive screening would out be referred for diagnostic testing and if there was a script provided as a template for post-test counseling (81%). The majority of pharmacists (69%) also preferred the appointment-based model rather than a walk-in or combination option and preferred (77%) having 20-30 min of dedicated time with the patient to provide adequate testing, education, and counseling. By using these strategies to improve comfort and likelihood implementing HIV POCT, pharmacists can increase access to HIV testing and decrease the spread of HIV.

Experiences with and attitudes toward interprofessional health care teams among American clinical, counseling, and school psychology doctoral students: a mixed methods study.

Attitudes toward interprofessional collaboration influence interprofessional health care team (IPHCT) functioning and quality of patient care. Yet, research has not examined the attitudes and experiences of psychology doctoral students on IPHCTs. Utilizing a volunteer sample of 214 clinical, counseling, and school psychology doctoral students from at least 47 doctoral programs in the United States, this study aimed to clarify psychology doctoral students' experiences on IPHCTs and explore predictors of their attitudes toward IPHCTs. Discovery-oriented analysis and hierarchical multiple regression were used to identify themes of students' self-reported interprofessional experiences and significant predictors of positive attitudes obtained via online survey questionnaires. Students who had worked on IPHCTs commonly reported taking roles of mental health therapeutic service provision and consultation and reported difficulty with team dynamics and navigating hierarchical structures. Students perceived the psychologist role primarily as clinical expert and team leader. Students reported making positive contributions, increased competency in interprofessional practice, and improvement in patient care as the most common benefits of IPHCTs. Each additional year spent on an IPHCT was related to more positive perceptions of the quality of care delivered by IPHCTs as well as greater endorsement of positive interprofessional socialization practices.

Team inclusion and empowerment among nursing staff in long-term care.

Team-based approaches to long-term care are increasingly part of the landscape in residential care facilities to improve staff performance and resident outcomes vis-à-vis empowering direct care staff. This study characterizes licensed and unlicensed nursing staffs' (N = 95) perceptions of inclusion as care team members by co-workers, supervisors and non-nursing clinicians. Further, we explored whether inclusion was correlated with heightened empowerment and its related dimensions using the Perception of Empowerment Instrument. Linear regression analyses revealed that levels of total empowerment, autonomy, responsibility and participation were associated with how included team members felt and by which members of the care team. These findings shed light on the potential importance of tailoring staff training to target specific team members to increase a sense of empowerment that aligns with the specific dimension(s) for a targeted group.