Development of a Suicide Prevention Toolkit for VA Home-Based Primary Care Teams.

The U.S. Department of Veterans Affairs Home-Based Primary Care program (HBPC) serves Veterans with multiple comorbid physical and psychological conditions that can increase suicide risk. HBPC teams are uniquely able to implement suicide risk assessment and prevention practices, and the team's mental health provider often trains other team members. An online suicide prevention toolkit was developed for HBPC mental health providers and their teams as part of a quality improvement project. Toolkit development was guided by a needs assessment consisting of first focus group and then data from surveys of HBPC program directors (n = 53) and HBPC mental health providers (n = 56). Needs identified by both groups included training specific to the HBPC patient population and more resources if mental health needs could not be fully managed by the HBPC team. HBPC mental health providers within integrated care teams play a key role in clinical intervention, policy development, and interprofessional team education on suicide prevention. HBPC teams have specific learning and support needs around suicide prevention that can be addressed with a feasible, easily accessible clinical and training resource.

Development and validation of a novel idiographic measure of cystectomy patients' goals and concerns before surgery.

Evaluation of: Morganstern BM, Bochner B, Dalbagni G, Shabsigh A, Rapkin B. The psychological context of quality of life: a psychometric analysis of a novel idiographic measure of bladder cancer patients' personal goals and concerns prior to surgery. Health Qual. Life Outcomes 9:10 (2011). Morganstern et al. presented a brief quality-of-life appraisal profile (BQOLAP) to measure the unique quality-of-life concerns and issues of preoperative bladder cancer patients, setting the stage for future studies that would compare quality of life outcomes following reconstructive cystectomy surgery. Results from 50 patients with bladder cancer revealed 503 goal statements that were coded and developed into 40 content categories based on several overarching domains: motivational themes; health and treatment; functioning; mental health and perceptions; comfort and lifestyle; events; responsibilities; relationship and family; home and community; problems and conflicts; and other/nonanswer. Drawing from measures developed by Rapkin and colleagues, the BQOLAP was designed to prompt patients to create their own unique goals and activity statements and their subsequent ratings of goal-attainment activities, difficulty reaching their goals, support needed to reach their goals and self-ratings of how close they were to reaching their goals.